bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic use and quality indicators of antibiotic prescription in Bhutan: a point prevalence survey using the Australian National Antimicrobial Prescribing Survey tool
Authors: Chuki Pem , Dorji Thinley , James Rodney , Wangchuk Khando , Yangzom Sonam , Dema Yangchen , Wangchuk Sangay , Wangdi Dorji , Deki Tshering , Limbu Chandra , Dorji Kuenzang Rangdel , Wangda Sonam , Buising Kirsty , Thursky Karin 
Published: August 2023

AbstractBackgroundThe National Action Plan on Antimicrobial Resistance in Bhutan promotes the rational use of antibiotics. It is important to establish baseline data on the use of antibiotics and the quality indicators of antibiotic prescriptions to identify where improvement efforts may need to be focused.ObjectivesTo describe the prevalence and patterns of antibiotic prescription and establish baseline data regarding quality indicators of antibiotic prescriptions in four major hospitals in Bhutan.MethodsThis was a point prevalence survey of antibiotic use among inpatients in June 2022 conducted using the Australian National Antibiotic Prescribing Survey (NAPS).ResultsThere were 314 patients (41.5%) receiving at least one antibiotic on the audit day. Among prescriptions reviewed, 278 (88.5%) had indications for use documented, 102 (32.5%) had a review or stop date documented and 120 (38.2%) had microbiology samples collected prior to antibiotics. Ceftriaxone (68; 21.7%), cefazolin (41; 13.1%) and metronidazole (32; 10.2%), were the common antibiotics prescribed. The most common indications for use were surgical prophylaxis (42; 13.4%), community-acquired pneumonia (39; 12.4%) and sepsis (26; 8.3%). There were 125 prescriptions (39.8%) that were compliant with national/therapeutic antibiotic guidelines and 169 (53.8%) where antibiotic prescriptions were appropriate.ConclusionsThis study identified key areas for targeted interventions in antimicrobial stewardship programmes in Bhutan. The prevalence of antibiotic use, indications for use, and drug choices were similar to data from other countries. Documentation plans for durations of use, prolonged surgical prophylaxis and concordance of choices with guideline recommendations present opportunities for improvement.
Regulation of endogenous retroviruses in murine embryonic stem cells and early embryos
Authors: Lu Xinyi 
Published: August 2023

Abstract
Endogenous retroviruses (ERVs) are important components of transposable elements that constitute ∼40% of the mouse genome. ERVs exhibit dynamic expression patterns during early embryonic development and are engaged in numerous biological processes. Therefore, ERV expression must be closely monitored in cells. Most studies have focused on the regulation of ERV expression in mouse embryonic stem cells (ESCs) and during early embryonic development. This review touches on the classification, expression, and functions of ERVs in mouse ESCs and early embryos and mainly discusses ERV modulation strategies from the perspectives of transcription, epigenetic modification, nucleosome/chromatin assembly, and post-transcriptional control.
Conservative approach for a giant prostatic hyperplasia of 1280 ml: a case report and literature review
Authors: Quaresima Luigi , Tramanzoli Pietro , Fasanella Daniela , Galosi Andrea Benedetto , Giannubilo Willy 
Published: August 2023

Abstract
Benign Prostatic Hypertrophy (BPH) affects at least one-third of men over 60 years. A giant prostatic hyperplasia (GPH) is a prostate enlargement that exceeds 500 g. We present a case of a 72-year-old man with a GPH volume of 1280 ml, referred to our hospital for a worsening of the lower urinary tract symptoms (LUTS), bilateral loin pain and kidney failure. Although the patient had a negligible post-void residual urine, he had bilateral hydronephrosis. The patient was managed conservatory because of a high anesthesiologic risk but a bilateral percutaneous nephrostomy was placed soon due to kidney function worsening. The presence of serious comorbidities and the resolution of the loin pain and the renal failure, achieved first with the nephrostomy and then with periodic replacement of ureteral stents, along with an improvement of the LUTS obtained with medical therapy, have oriented us towards a conservative management of the patient.
Emergent conversion from single-anastomosis gastric bypass to Roux-en-Y gastric bypass with subsequent obstruction of entero-enteric anastomosis by ascaris
Authors: Palacios Mauricio , Guachilema R Alex , Morocho Sandra , Lisintuña Andrea , Yepez Julio , Andrade Mariela 
Published: August 2023

Abstract
One anastomosis gastric bypass (OAGB), the third most commonly performed procedure worldwide, has shown excellent results in terms of weight loss and resolution of comorbidities compared with other bariatric surgeries. However, its use remains limited in various parts of the world due to postoperative complications. After the efficacy of this procedure was established, the focus of treatment shifted toward resolving postoperative complications. Protein-energy malnutrition after OAGB is one of the main issues that needs to be addressed. There are several operative options for patients who require revision surgery including reversal and conversion to Roux-en-Y gastric bypass (RYGB). The conversion from OAGB to RYGB is a feasible method that has shown excellent results when performed by experts in the field. Here, we present the case of a woman with symptoms of acute obstruction secondary to OAGB who underwent conversion to RYGB under emergent conditions.
Pathologically confirmed pancreatic hamartoma after surgical resection with an aldosterone-producing adrenal tumor: a case report
Authors: Kim Jae Han , Yoon Seung Hyun , Choi Ji Ahn , Kwak Ji Hyeon , Kim Milim , Kim Sung Hyun 
Published: August 2023

Abstract
Pancreatic hamartoma is a benign tumor of the pancreas with an extremely low incidence and is commonly diagnosed by pathologic examination after surgery. This report describes the case of a 57-year-old female who was referred for the evaluation of a pancreatic mass and an adrenal incidentaloma. Further imaging studies suggested pancreatic neuroendocrine tumor and aldosterone-producing adrenal tumor. Pylorus-preserving pancreaticoduodenectomy was performed with the initial impression of a pancreatic neuroendocrine tumor. However, pathology results revealed a pancreatic hamartoma. Multiple endocrine neoplasia type 1 syndrome was discussed as a probable explanation for tumor masses in both the pancreas and adrenal gland.
Hospitalists as Facilitators of Surge and Contingency Medical Operations and Planning
Authors: Olson Christina A , Eng-Kulawy Jennifer , Buckland-Coffey Debra D 
Published: August 2023

ABSTRACT
Hospital medicine, a specialty encompassing physicians and advanced practice providers in internal medicine, pediatrics, and family medicine, has been a core and rapidly growing component of civilian health care for the past two decades. More recently, hospitalists have been taking on key roles during surge and contingency planning and operations, most notably during the COVID-19 pandemic which necessitated marked changes in inpatient care across the United States. The military health system has been slower to incorporate hospitalists into clinical care and planning than civilian organizations due to its unique features. However, an increasing focus on future distributed operations in contested environments, pandemic care, and humanitarian assistance/disaster response requires new consideration of their role in military medicine. This stems from hospitalists’ value as clinicians who include triage, resource utilization stewardship, medical inpatient care, pre-/post-operative management of surgical patients, and high acuity patient stabilization and management within their scope, often working collaboratively with other specialists such as emergency medicine physicians, surgeons, and intensivists. Just as importantly, hospitalists are system-level facilitators and leaders of patient capacity expansion and/or clinical process changes when needed for response to incidents in a variety of acute care scenarios. With uniformed billets being increasingly targeted to military platform requirements, there is now an opportunity to revisit the value of hospitalists in military medicine. In this Commentary, we review the roles that hospitalists can fill in hospital and operational medical settings, with a focus on surge and contingency operations. To demonstrate this capability, we present here the experience of two operational units employing hospitalists for high acuity patient management and two civilian hospitals implementing surge operations during the 2022–2023 “tripledemic” of viral respiratory infections in the United States. Their innovations facilitated the care of higher acuity and higher volume during times when medical care requirements were limited by traditional staffing models. We end by reviewing opportunities and challenges related to expanding hospitalist use within the military health system and describing efforts that are underway to address the challenges.
On the nature of the continuum reverberation of X-ray/UV and optical emission of IRAS 09149−6206
Authors: González-Buitrago D H , García-Díaz Ma T , Pozo Nuñez F , Guo Hengxiao 
Published: August 2023

ABSTRACT
We present the results of a continuum reverberation mapping study of the radio-quiet type 1 Seyfert galaxy IRAS 09149−6206. The analysis was performed using X-ray, ultraviolet (UV), and optical observations made with the Swift telescope between 2017 January and December. The time delays between different light curves were measured using three different algorithms: PyI2CCF, PyROA, and JAVELIN. Our results show that the time delays increase with wavelength after τ ∝ λ4/3, as predicted for a geometrically thin and optically thick accretion disc, but only after accounting for significant diffuse continuum emission from the broad-line region. However, the measured size of the accretion disc can be up to five times larger than that predicted by standard theory. To our surprise, the strong increase in soft X-ray fluxes is delayed by about 15 d compared to the optical UV fluctuations, which challenges the prediction of the lamp-post model. Our analysis of the X-ray variability reveals the presence of a non-variable spectral component at 0.3–6.0 keV along with variable excess emission at 2.0–3.0 keV, which could be partly related to relativistic reflection in the inner region of the accretion disc. IRAS 09149−6206 joins the list of objects for which the traditional lamp-post model cannot explain the observed time delays. A scenario that incorporates other geometric considerations into the lamp-post model, e.g. an extended corona along a scattering source, might be better suited to explain the observed long time delays.
One to many: comparing single gravitational-wave events to astrophysical populations
Authors: Mould Matthew , Gerosa Davide , Dall’Amico Marco , Mapelli Michela 
Published: August 2023

ABSTRACT
Gravitational-wave observations have revealed sources whose unusual properties challenge our understanding of compact-binary formation. Inferring the formation processes that are best able to reproduce such events may therefore yield key astrophysical insights. A common approach is to count the fraction of synthetic events from a simulated population that are consistent with some real event. Though appealing owing to its simplicity, this approach is flawed because it neglects the full posterior information, depends on an ad hoc region that defines consistency, and fails for high signal-to-noise detections. We point out that a statistically consistent solution is to compute the posterior odds between two simulated populations, which crucially is a relative measure, and show how to include the effect of observational biases by conditioning on source detectability. Applying the approach to several gravitational-wave events and simulated populations, we assess the degree to which we can conclude model preference not just between distinct formation pathways but also between subpopulations within a given pathway.
Photometric metallicities of fundamental-mode RR Lyr stars from Gaia G band photometry of globular-cluster variables
Authors: Jurcsik Johanna , Hajdu Gergely 
Published: August 2023

ABSTRACT
Photometric metallicity formulae of fundamental-mode RR Lyr (RRab) stars are presented using globular-cluster data exclusively. The aim is to check whether this selection may help increasing the overall accuracy of the fits and eliminating the systematic bias of the photometric results, namely that they tend to overestimate [Fe/H] of the most metal-poor variables. The G band time-series data available in the Gaia DR3 archive and a new compilation of the published spectroscopic globular cluster [Fe/H] values on a uniform solar reference metallicity scale are utilized. We have derived a new [Fe/H]phot − P, φ31 formula, and have diagnosed that no significant increase in the accuracy of the fit can be achieved using non-linear or multiparameter formulae. The best result is obtained when different formulae are applied for variables with Oosterhoff (Oo)-type I and II properties. However, even this solution cannot eliminate the systematic bias of the results completely. This separation of the variables has also led to the conclusion that the photometric estimates of the [Fe/H] are less reliable for the Oo-type II variables than for the Oo-type I sample. Published [Fe/H]phot values and the results of the available photometric formulae in the Gaia G band are compared with the present results. It is found that each of the solutions yields very similar results, with similar accuracy and systematic biases. Major differences are detected only in the zero-points of the [Fe/H] scales, and these offsets are larger than differences in the accepted solar reference values would explain.
A neural network emulator for the Lyman-α forest 1D flux power spectrum
Authors: Cabayol-Garcia L , Chaves-Montero J , Font-Ribera A , Pedersen C 
Published: August 2023

ABSTRACT
The Lyman-α forest offers a unique avenue for studying the distribution of matter in the high redshift universe and extracting precise constraints on the nature of dark matter, neutrino masses, and other ΛCDM extensions. However, interpreting this observable requires accurate modelling of the thermal and ionization state of the intergalactic medium, and therefore resorting to computationally expensive hydrodynamical simulations. In this work, we build a neural network that serves as a surrogate model for rapid predictions of the one-dimensional Lyman-α flux power spectrum (P1D), thereby making Bayesian inference feasible for this observable. Our emulation technique is based on modelling P1D as a function of the slope and amplitude of the linear matter power spectrum rather than as a function of cosmological parameters. We show that our emulator achieves sub-percent precision across the full range of scales (k∥ = 0.1 – $4\, \mathrm{Mpc}^{-1}$) and redshifts (z = 2 – 4.5) considered, and also for three ΛCDM extensions not included in the training set: massive neutrinos, running of the spectral index, and curvature. Furthermore, we show that it performs at the 1 per cent level for ionization and thermal histories not present in the training set and performs at the percent level when emulating down to $k_{\parallel }=8\, \mathrm{Mpc}^{-1}$. These results affirm the efficacy of our emulation strategy in providing accurate predictions even for cosmologies and reionization histories that were not explicitly incorporated during the training phase, and we expect it to play a critical role in the cosmological analysis of the DESI survey.
The timeless timing argument and the total mass of the Local Group
Authors: Sawala Till , Peñarrubia Jorge , Liao Shihong , Johansson Peter H 
Published: August 2023

ABSTRACT
The timing argument connects the motion of a two-body system to its mass in an expanding Universe with a finite age, under the assumption that it has evolved on a self-gravitating orbit. It is commonly applied to the present-day Milky Way (MW)–M31 system in order to infer its unknown mass from the measured kinematics. We use a set of Local Group analogues from the uchuu simulation to investigate the timing argument over cosmic time. We find that the median inferred mass remains almost constant over the past 12 Gyr, even while the haloes themselves grew in mass by more than an order of magnitude. By contrast, we find a closer, and nearly time-invariant agreement between the timing argument value and the mass within a sphere of radius equal to the MW–M31 separation, and we identify this as the total mass of the system. We conclude that the comparatively close present-day agreement between the timing argument and the sum of the halo masses reflects no underlying relation, but merely echoes the fact that the MW and M31 now contain most (but not all) of the mass of the Local Group system.
Cryo-electron microscopy structure and translocation mechanism of the crenarchaeal ribosome
Authors: Wang Ying-Hui , Dai Hong , Zhang Ling , Wu Yun , Wang Jingfen , Wang Chen , Xu Cai-Huang , Hou Hai , Yang Bing , Zhu Yongqun , Zhang Xing , Zhou Jie 
Published: August 2023

Abstract
Archaeal ribosomes have many domain-specific features; however, our understanding of these structures is limited. We present 10 cryo-electron microscopy (cryo-EM) structures of the archaeal ribosome from crenarchaeota Sulfolobus acidocaldarius (Sac) at 2.7–5.7 Å resolution. We observed unstable conformations of H68 and h44 of ribosomal RNA (rRNA) in the subunit structures, which may interfere with subunit association. These subunit structures provided models for 12 rRNA expansion segments and 3 novel r-proteins. Furthermore, the 50S–aRF1 complex structure showed the unique domain orientation of aRF1, possibly explaining P-site transfer RNA (tRNA) release after translation termination. Sac 70S complexes were captured in seven distinct steps of the tRNA translocation reaction, confirming conserved structural features during archaeal ribosome translocation. In aEF2-engaged 70S ribosome complexes, 3D classification of cryo-EM data based on 30S head domain identified two new translocation intermediates with 30S head domain tilted 5–6° enabling its disengagement from the translocated tRNA and its release post-translocation. Additionally, we observed conformational changes to aEF2 during ribosome binding and switching from three different states. Our structural and biochemical data provide new insights into archaeal translation and ribosome translocation.
Exposure to Tobacco-Specific Nitrosamines Among People Who Vape, Smoke, or do Neither: A Systematic Review and Meta-Analysis
Authors: Taylor Eve , Simonavičius Erikas , McNeill Ann , Brose Leonie S , East Katherine , Marczylo Tim , Robson Debbie 
Published: August 2023

Abstract

Introduction
Smoking exposes people to high levels of Tobacco-Specific Nitrosamines (TSNAs), which include potent carcinogens. We systematically reviewed TSNA exposure between people smoking, vaping, and doing neither.

Aims and Methods
Databases were searched between August 2017–March 2022, using vaping-related terms. Peer-reviewed articles reporting TSNA metabolites (NNAL, NNN, NAB, and NAT) levels in bio-samples among adults exclusively vaping, exclusively smoking, or doing neither were included. Where possible, meta-analyses were conducted.

Results
Of 12 781 identified studies, 22 were included. TSNA levels fell substantially when people who smoke switched to vaping in longitudinal studies and were lower among people who vaped compared to smoked in cross-sectional studies. Levels of TSNAs were similar when comparing people who switched from smoking to vaping, to those who switched to no use of nicotine products, in longitudinal studies. Levels were higher among people who vaped compared to people who neither vaped nor smoked in cross-sectional studies.
When comparing people who vaped to smoked: pooled urinary NNAL was 79% lower across three randomized controlled trials and 96% lower across three cross-sectional studies; pooled NAB was 87% lower and NAT 94% lower in two cross-sectional studies. When comparing people who neither vaped nor smoked to people who vaped, pooled urinary NNAL was 80%, NAB 26%, and NAT 27% lower in two cross-sectional studies. Other longitudinal data, and NNN levels could not be pooled.

Conclusions
Exposure to all TSNAs was lower among people who vaped compared to people who smoked. Levels were higher among people who vaped compared to people who neither vaped nor smoked.

Implications
As well as TSNAs, there are many other toxicant exposures from smoking and vaping that can increase the risk of disease. However, it is likely that the reduced exposure to TSNAs from vaping relative to smoking reduces the risk to health of those who use vaping products to quit smoking. Future high-quality research, with robust definitions of exclusive vaping and smoking, and accounting for TSNAs half-lives, is needed to fully assess exposure to TSNAs among people who vape.
Telemedicine during the COVID-19 pandemic: Egyptian healthcare professionals’ views
Authors: Hegazy AA , Abdelhai R , Aboushady AT , Elessawy R , Seddik S 
Published: August 2023

Abstract
Introduction: Despite its suggested positive outcomes, telemedicine will only be a helpful health service when people begin to utilize it. Healthcare professionals (HCPs) represent the principal users of telemedicine services, and their willingness to adopt them has a remarkable impact on their successful implementation. Aim: Identify the acceptability of telemedicine services and the relations between the key facilitators and inhibitors of telemedicine services from the perspective of HCPs in Egypt. Methodology: An observational, analytical cross-sectional study employing the internet platforms of social media among HCPs all over Egypt, via a web-based survey over six months, from August 2020 to January 2021. Results: 262 HCPs participated in the study; 32.8% of the studied HCPs stated they had a high knowledge of telemedicine technology, 41.6% stated that telemedicine was easy to implement and 41.3% believed telemedicine was necessary for patient care. Conclusion: While the use of telemedicine is every day in many countries, the results of the current study showed that the knowledge of telemedicine technology was quite limited, which influenced their attitude toward that technology. Therefore, increasing users' knowledge and demonstrating its capabilities and benefits is essential before deployment.