bluuebunny/crossref_metadata_2025_split huggingface dataset:
559. Inpatient Allergy Delabeling of Pediatric Patients with Low-Risk Penicillin Allergy Status through Direct Graded Oral Amoxicillin Challenge
Authors: Lim Peter Paul , Desai Ankita P , Wessell Kathryn Ruda , Moore LeAnne , Minich Nori M 
Published: December 2022

Abstract

Background
Only 1% of patients with penicillin allergy are truly allergic but it remains the most common drug allergy reported. Studies show that direct oral challenge is a safe method to delabel low-risk patients using institutional screening stratification tools. There is no verified universal screening tool to perform this function, underscoring the need to address this clinical gap. This study aims to assess the efficacy of our institutional screening questionnaire at correctly stratifying penicillin allergy risk status and determine whether direct graded oral amoxicillin challenge can be safely used to delabel patients with low-risk penicillin allergy status. Figure 1Flow chart showing patient categorization based on penicillin allergy risk status and subsequent disposition following screening.

Methods
This was a pilot prospective study to verify penicillin allergy status among patients 3-18 years old in our institution from September 2021-March 2022. Patients were stratified using institutional screening questionnaire to no-risk, low-risk and high-risk penicillin allergy status. Low-risk patients underwent direct graded oral amoxicillin challenge using an institutional algorithm and delabeled based on their response to the testing. No-risk patients were delabeled without challenge testing. High-risk patients were referred to allergy.

Results
Ninety-two patients were identified with penicillin allergy. Forty (43.5%) of the 92 patients were screened using our institutional screening questionnaire. Of the 40 screened patients, 6 (15%) were identified as no-risk, 28 (70%) were identified as low-risk, and 6 (15%) were identified as high-risk. Twenty-four (86%) of the 28 low-risk patients were eligible for direct amoxicillin oral challenge. Seventeen (71%) of the 24 consented to the challenge testing but only 12 (70%) underwent direct amoxicillin oral challenge. Eleven (92%) of the 12 who underwent oral challenge were successfully delabeled. Five (83%) of the 6 no-risk patients were successfully delabeled. Three (50%) of 6 high-risk patients were referred to allergy. Overall, 16 (40%) of the 40 patients who were screened were successfully delabeled.

Conclusion
Our institutional risk stratification screening tool is effective at identifying penicillin allergy risk status and direct graded oral amoxicillin challenge is a safe initiative to delabel patients with low-risk penicillin allergy status.

Disclosures
All Authors: No reported disclosures.
666. Outcomes Using Cefiderocol for the Treatment of Acinetobacter baumannii Infections from the PROVE (Real-World Evidence) Study
Authors: Marcella Stephen , Kobic Emir , Carr Amy L , Georgiades Benjamin , Margiotta Caroline 
Published: December 2022

Abstract

Background
PROVE is an ongoing international, retrospective study assessing cefiderocol (CFDC) for Gram-negative (GN) infections. Carbapenem-resistant Acinetobacter baumannii (CRAB) infections are difficult-to-treat with limited treatment options. CFDC is a novel sidero cephalosporin with activity against CRAB. This analysis describes the outcomes and treatment patterns of CFDC treatment in CRAB infections from this study.

Methods
Patients were eligible if they received ≥ 72 hours of CFDC. Key patient characteristics, infecting pathogen susceptibility, illness severity, and treatment patterns were assessed. Fourteen and 30-day all-cause mortality (ACM) and clinical cure were examined as outcomes. Susceptibility testing was performed locally. Serious adverse drug reactions (SADR) were recorded.

Results
To date,123 patients treated with CFDC at 12 sites were included. Forty-one had monomicrobial (n=29) or polymicrobial (n=12) Acinetobacter baumannii (AB) infection. All but one were CRAB. The median age was 53 years; 71% were male. The most prevalent comorbidity was severe burns (N=9, 22%). Sixty-one percent of patients received CFDC in the ICU, 51% required mechanical ventilation, and 34% required vasopressor support. The median time from positive culture to CFDC initiation was 5 days. CFDC monotherapy was used in 61%. Tetracyclines were the most common concurrent GN antibiotics used with CFDC (N = 8, 19.5%). Targeted therapy with or without prior GN antibiotics was used in 76%, salvage in 20%, and empirical in 2%. Susceptibility results were available for 28 AB cultures from 28 patients of which 82% were susceptible to CFDC. Post-CFDC 14- and 30-day ACM was 12% (95% CI: 4%-26%) and 22% (95% CI: 11%-38%), respectively. Clinical resolution was achieved in 59% (95% CI: 42% -74%). Thirty-day ACM varied by susceptibility to CFDC: 26% for susceptible, 40% for resistant. One SADR (interstitial nephritis) was reported.
Cefiderocol Use Patterns in Acinetobacter baumannii

Conclusion
Real-world use of CFDC for AB demonstrates that most patients were complex with multiple comorbidities and severe illness prior to treatment. It was used mostly as targeted therapy. CFDC may be a treatment option in these difficult-to-treat infections.

Disclosures
Stephen Marcella, MD, MPH, Shionogi: Shionogi employee|Shionogi, Inc: Employee Amy L. Carr, PharmD, BCIDP, Shionogi: Advisory Board Benjamin Georgiades, PharmD, Shionogi, Inc: Employee Caroline Margiotta, MA, Shionogi, Inc: contracting work for Shionogi, Inc.
1093. Multiparametric Investigation Of Spike-Protein Specific T-cell Cytokine Expression Profile In Children With Symptomatic COVID-19 Or Multisystem Inflammatory Syndrome
Authors: Filippatos Filippos , Tzanoudaki Marianna , Tatsi Elizabeth-Barbara , Efthymiou Vasiliki , Liatsis Manolis , Syriopoulou Vasiliki , Michos Athanasios 
Published: December 2022

Abstract

Background
Data regarding cell-mediated immunological differences in children across COVID-19 clinical spectrum are limited. We prospectively investigated Spike-protein specific cellular immunity in children with symptomatic COVID-19 or MIS-C, by single cell cytokine expression profiling.

Methods
PBMCs from children with MIS-C, symptomatic COVID-19 (one month after hospitalization) and healthy controls were isolated prospectively. Cell suspensions were divided into two quantitatively equal samples (a negative control-unstimulated and a positive-stimulated). Cells stimulation was performed using SARS-CoV-2 Spike antigenic peptides mix (Peptivator SARS-CoV-2 Prot_S). Cells of each sample were stained with fluorochrome monoclonal antibodies against 8 surface markers (CD3, CD4, CD8, CD14, CD19, CD137, CD197, CD45RA) and 6 intracellular markers (IL-4, IL-2, IL-17, IFN-γ, TNF-α, Granzyme B). Viability was assessed by 7AAD. Stained cell preparations were analysed using 13 colour Flow Cytometry (DX Flex, Beckman Coulter). Flow cytometric analysis was performed using Kaluza 2.1 Software.

Results
Sixteen children (4 MIS-C, 8 post-COVID-19 and 4 healthy controls) were included in the study. The mean age (±SD) of the participants was 11.22 years (±3.48). Children with MIS-C had significantly higher mean (±SD) values of CD8+IFN-γ/million CD3+ [226.68 (134.92) vs 45.43 (57.28); P: 0.033] and median (IQR) of CD8+IFN-γ/ml [156.38 (184.13) vs 26.34 (82.36);P: 0.033] compared to symptomatic COVID-19 children. Compared to healthy controls, MIS-C patients had significantly higher median (IQR) values of CD4+IL-2/million CD3+ [923.12 (3777.95) vs 97.59 (71.71); P: 0.042] and CD4+IL-2/ml median (IQR) [626.33 (2744.98) vs 169.3 (173.91); P: 0.042]. No other significant differences were observed regarding other immunological markers in 3 study groups.

Conclusion
IFN-γ production by CD8+ T cells is highly expressed in children with MIS-C compared to hospitalized children one month after acute COVID-19 and could consist possible immunological biomarker. Further studies are needed in order to elucidate the pathophysiological basis of these findings.

Disclosures
All Authors: No reported disclosures.
Cabotegravir—Global Access to Long-Acting Pre-exposure Prophylaxis for HIV
Authors: Pepperrell Toby , Cross Samuel , Hill Andrew 
Published: December 2022

Abstract
A novel injectable pre-exposure prophylaxis, cabotegravir, has greater efficacy and acceptability than oral tenofovir/emtricitabine for prevention of HIV infection. Cabotegravir is currently priced at $22 200 per year, &gt;185 times higher than the $60–$119 estimated cost-effectiveness threshold for middle-income countries (MICs). Following civil society pressure, ViiV provided access to generic versions in 90 countries with the Medicines Patent Pool (MPP), including all African nations. However, several MICs outside Africa have rapidly growing HIV epidemics. We analyzed the ViiV-MPP deal to assess population covered and gross domestic product (GDP) per capita. There were 38 countries excluded from the ViiV-MPP deal despite having a GDP per capita lower than the highest-earning African country. These countries include 2.4 billion people (30% global population), with an incidence of 122 000 (8%). For cabotegravir to have a significant impact on HIV infections, millions will need to be treated at affordable prices in a wide range of countries.
Self-Injury
Authors: Granello Darcy Haag , Granello Paul F. , Juhnke Gerald A. 
Published: December 2022

Abstract
About one in five middle and high school students has engaged in nonsuicidal self-injury within the last year. These behaviors, and their severity, can vary greatly, with the most common types being cutting, burning, punching, throwing oneself down the stairs, and headbanging. Identifying the students who engage in self-injury, contacting parents, and getting the students to appropriate care—all without encouraging contagion—is the appropriate role of school mental health professionals. The motivations for self-injury differ by student, and the link between self-injury and suicide is unclear and differs by student. Following a set, predetermined, and evidence-based protocol for working with these students is the best approach.
Building the Foundation of a School-Based Suicide Prevention Program
Authors: Granello Darcy Haag , Granello Paul F. , Juhnke Gerald A. 
Published: December 2022

Abstract
Schools have an important role to play in suicide prevention. Universal prevention models are based on a public health approach. They help limit stigma, increase help seeking, and promote strategies to reach out to those at risk. A Comprehensive School-Based Suicide Prevention Program, with 10 component pieces, includes developing a Core Team, universal prevention (training staff, teaching students, helping parents, engaging peers, lowering stigma through advocacy and anti-stigma campaigns, screening students); selective and intensive prevention (refer and consult, reintegration); and Postvention. Although the research on these types of programming varies significantly, all of these types of interventions have initial empirical support as methods to reduce suicide risk in schools.
School-Based Suicide Prevention Programming
Authors: Granello Darcy Haag , Granello Paul F. , Juhnke Gerald A. 
Published: December 2022

Abstract
Once schools have developed a comprehensive suicide prevention plan, the next step is implementation. In most schools, school mental health professionals will require some advanced preparation and training in suicide assessment and intervention first. Once there are members of the school who are prepared to assist with suicidal students, the next step involves training the staff and teachers. All adults who interact with students should be confident, competent, and willing to interact with suicidal students and to refer them to the appropriate staff in the school building. To do this, everyone will require training that enhances their knowledge, beliefs, attitudes, skills, and self-efficacy. Schools should also prepare parents so they know how to speak with their children who either express suicidal ideation themselves or voice concerns about their friends. Students will require developmentally appropriate education. Other strategies should align with the comprehensive plan.
Assessing Suicide Risk in Schools
Authors: Granello Darcy Haag , Granello Paul F. , Juhnke Gerald A. 
Published: December 2022

Abstract
Students who are at risk for suicide need special attention in schools. Selective interventions are for students who have certain risk factors that require remediation and support. When these students are identified, helping them connect to selective interventions means they can receive school-based interventions that help them develop positive social and emotional skills. Indicated interventions are for those students who have been identified as at risk for suicide. These students must first be identified through a prompt and accurate school-based suicide risk assessment. School-based risk assessments are not the same as comprehensive suicide risk assessments, but they typically are conducted with a semistructured interview that guides the assessor and student through major areas of risk so that information can be shared with parents and treating professionals.
After a Suicide
Authors: Granello Darcy Haag , Granello Paul F. , Juhnke Gerald A. 
Published: December 2022

Abstract
Suicide postvention is a critical component of school-based suicide prevention. A comprehensive protocol that is in place prior to any crises and clearly defines the decisions and responsibilities of all staff and personnel is essential. Importantly, all staff must know and understand the protocol and be ready to implement it on a moment’s notice. The sad reality is that many schools and districts make decisions in the aftermath of a student suicide that are well intentioned but made in the moment of grieving. These decisions can have the unintended consequence of escalating suicide risk among vulnerable members of the student population. The essential take-home message from this chapter is to develop evidence-based policies that have the potential to limit suicide contagion.
Problem Mothers
Authors: Chettiar Teri 
Published: December 2022

Abstract
Chapter 3 investigates new rehabilitative programs designed to tackle the increasingly visible problems of child neglect and post-partum mental illness in post-1945 Britain, focusing on the joint admission of mothers and their young children at the Cassel Hospital for Functional Nervous Disorders in London. Although Cassel medical and nursing staff sought to humanize “bad” mothers and establish greater empathy for severe cases of emotional distress, they ultimately reinforced post-WWII expectations that childcare was the “natural” central preoccupation of female adults. Treatment at the hospital focused on helping mostly young married female patients resolve their “emotional immaturity” through an intensive around-the-clock therapeutic regime that centered on patients’ appropriately loving relationships with their children. This chapter argues that new post-WWII visibility surrounding the emotional burdens of motherhood ended up further reifying, rather than undermining, the presumption that women were, by nature, relational “experts” and better suited to childcare than men.
An Art School Education
Authors: Quin Jack 
Published: December 2022

Abstract
The first chapter constructs an unfamiliar portrait of Yeats—the famous autodidact—as a fledgling poet who was educated at art school in Dublin. The opening section documents Yeats’s art school years at the Dublin Metropolitan School of Art and later the Royal Hibernian Academy. It outlines how Yeats’s art school training in the mid-1880s put him in contact with John Hughes and Oliver Sheppard who would become the foremost Irish sculptors of the early twentieth century. By tracing his time at art school, the chapter recovers Yeats’s earliest exposure to the visual arts; sketching from casts of classical statues, and comparing antique and modern artworks. Subsequent sections compare Yeats’s earliest poems, The Island of Statues, ekphrastic verses, and verse fragments, with his later recollections of the Metropolitan School of Art and Royal Hibernian Academy in Reveries over Childhood and Youth, a 1906 committee deposition, and his draft Memoirs, arguing that a poetics of sculpture offered Yeats a creative escape from the dry, academic neoclassicism of his art schooling. The art writing of Yeats and George Russell (Æ)—another art school student—in the Daily Express promoted the sculpture of Sheppard and Hughes in the 1890s to early 1900s. The later sections propose a reciprocal relationship between Irish sculpture and poetry of the Revival, tracing Yeats and Russell’s reinterpretation of Matthew Arnold and his critique of the Celtic plastic arts, and closing with an examination of Sheppard’s unpublished essay on public sculpture in Ireland.
Yeats’s Late Sculptural Poetics
Authors: Quin Jack 
Published: December 2022

Abstract
The fifth chapter traces the prominence of sculpture in Yeats’s late poems. It begins with close readings of poems about Maud Gonne and Iseult Gonne, where statues or busts are invoked to address concerns with aging, loneliness, and a thwarted or unreciprocated desire. A comparative study of these sculptural love poems with the poems of Eva Gore-Booth and H.D. underscore the gender dynamics of Yeats’s use of statues in verse. Subsequent sections connect Yeats’s esoteric ideas about ancient statues in A Vision and a Rapallo Notebook to New Poems and Last Poems, where statues are nonstatic, seemingly organic, and consequently subject to aging or material degrading. The chapter concludes that Yeats’s late “sculptural poetics” brings him into dialogue with Pound and T.S. Eliot. In his last poems he returns to and reanimates his early fantasies—as well as the material realities—of the art of sculpture.
Original Common Possession of the Earth
Authors: Huber Jakob 
Published: December 2022

AbstractThis chapter unpacks the relation between earth dwellers further by focusing on the idea of original common possession of the earth. It argues against the widespread attempt to liken Kant’s notion to that prevalent in the natural law tradition, that is, as constituting a community of proto-ownership. For Kant, the notion does not provide a distributive standard for carving up the world. Instead, it spells out our shared task of coming to terms with the fact that embodied agents who jointly inhabit a bounded territory can affect and constrain each other with their choices; a challenge that normatively transcends any division of the earth’s surface into slices of property and territory. A detour into the Critique of Pure Reason helps to illuminate that Kant’s disjunctive community of original common possession describes a system of mutual exclusion in which a plurality of different persons stand in a relation of ‘possible physical interaction’. To act from the ‘global standpoint’ is to respect distant strangers as justificatory equals in the process of coming to terms with the fact that we have to share the earth in common.
The Jurisprudence of Constitutional Conflict in the European Union
Authors: Bobić Ana 
Published: December 2022

Abstract
A comparative and comprehensive account of the jurisprudence of constitutional conflict between the Court of Justice and national courts with the power of constitutional review, this book addresses the incidences of, and the reasons for, constitutional clashes in the application and enforcement of EU law. Its aim is to determine how the principle of primacy of EU law works in reality and whether the jurisprudence of the courts under analysis supports this concept. To this end, the book explores the three areas of constitutional conflict: ultra vires review, identity review, and fundamental rights review. The book substantiates the descriptive, and strengthens the normative contributions of the theory of constitutional pluralism in relation to the web of relations in the European judicial space. By examining the influence that the jurisprudence of constitutional conflict has on the balance of powers between the Court of Justice and constitutional courts, the book uses the judicial triangle as an analytical tool that depicts the consequences for the horizontal (constitutional courts vis-à-vis the Court of Justice) and vertical judicial relationships (Court of Justice vis-à-vis ordinary national courts; constitutional courts vis-à-vis ordinary national courts). By offering a thorough compilation of the jurisprudence of constitutional conflict in the EU, this book thus improves our understanding of the principle of primacy of EU law and its limits; as well as reinforces the theory of constitutional pluralism in explaining and guiding judicial interactions and power relations in the EU.
Trade wars and economic warfare in history
Authors: Oermann Nils Ole , Wolff Hans-Jürgen 
Published: December 2022

AbstractThe chapter describes the many, mostly violent, trade wars and instances of economic warfare from around 1500 to 1956, the year of the Suez Crisis. It shows the predatory European expansion into the Americas, Asia, and Africa, and the attending introduction of mass slavery. It deals with the East India Company and its Dutch equivalent. It shows that China and Russia expanded their empires, too. It concentrates, though, on the experience and example of Great Britain, because that country proved exceptionally successful in trade and economic warfare, and formed the entire international system during the nineteenth century. It shows how geography, institutional reforms like the rule of law and reliable finance, naval mastery and the fortunes of war, progress in ideas about trade, and the industrial revolution, all helped Britain to achieve its towering position, and how in the twentieth century the United States took over most of Britain’s former role.
The Developer’s Dilemma
Authors: Alisjahbana Armida Salsiah , Sen Kunal , Sumner Andy , Yusuf Arief 
Published: December 2022

Abstract
The developer’s dilemma is this: developing countries seek inclusive economic development—that is, structural transformation—sufficiently broad-based to raise the income of the poor. Inclusive economic growth requires falling income inequality to maximize income growth at the lower end of the distribution. Yet, this is at odds with Kuznets hypothesis that economic development puts upward pressure on income inequality—at least in the absence of countervailing policies. Our book explores the developer’s dilemma between structural transformation and income inequality. The core questions of our book are: (i) What are the varieties of structural transformation experienced in developing countries? (ii) What inequality dynamics are associated with each variety? (iii) Which policies have been utilized to manage trade-offs between structural transformation, income inequality, and inclusive growth? We answer using a comparative case-study approach, contrasting nine developing countries, while employing a common analytical framework and a set of common data sets across the studies.
Getting Rich and Unequal?
Authors: Li Yanan , Xing Chunbing 
Published: December 2022

Abstract
In this chapter, we analyse the relationship between China’s structural transformation and the inclusiveness of its economic growth. In the past four decades, China’s economic activities have shifted from the low-productivity agricultural sector to the high-productivity industrial sector and, more recently, the tertiary sector, with a large portion of the labour force moving from rural to urban areas, from inland to coastal regions, and from the public to the private sectors. These changes have only happened because of major reforms to the land system, the Hukou system, the ownership of state-owned enterprises, trade policies, and the education system. Despite its great success in poverty reduction, China has witnessed rapidly increasing income inequality which only began to decline in the late 2000s. We analyse the political economy that determined the inclusiveness of the structural transformation.