bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploratory analysis of immune checkpoint receptor expression by circulating T cells and tumor specimens in patients receiving neo-adjuvant chemotherapy for operable breast cancer
Authors: Wesolowski Robert , Stiff Andrew , Quiroga Dionisia , McQuinn Christopher , Li Zaibo , Nitta Hiroaki , Savardekar Himanshu , Benner Brooke , Ramaswamy Bhuvaneswari , Lustberg Maryam , Layman Rachel M. , Macrae Erin , Kassem Mahmoud , Williams Nicole , Sardesai Sagar , VanDeusen Jeffrey , Stover Daniel , Cherian Mathew , Mace Thomas A. , Yu Lianbo , Duggan Megan , Carson William E. 
Published: May 2020

Abstract
Background
While combinations of immune checkpoint (ICP) inhibitors and neo-adjuvant chemotherapy (NAC) have begun testing in patients with breast cancer (BC), the effects of chemotherapy on ICP expression in circulating T cells and within the tumor microenvironment are still unclear. This information could help with the design of future clinical trials by permitting the selection of the most appropriate ICP inhibitors for incorporation into NAC.

Methods
Peripheral blood samples and/or tumor specimens before and after NAC were obtained from 24 women with operable BC. The expression of CTLA4, PD-1, Lag3, OX40, and Tim3 on circulating T lymphocytes before and at the end of NAC were measured using flow cytometry. Furthermore, using multi-color immunohistochemistry (IHC), the expression of immune checkpoint molecules by stromal tumor-infiltrating lymphocytes (TILs), CD8+ T cells, and tumor cells was determined before and after NAC. Differences in the percentage of CD4+ and CD8+ T cells expressing various checkpoint receptors were determined by a paired Student’s t-test.

Results
This analysis showed decreased ICP expression by circulating CD4+ T cells after NAC, including significant decreases in CTLA4, Lag3, OX40, and PD-1 (all p values < 0.01). In comparison, circulating CD8+ T cells showed a significant increase in CTLA4, Lag3, and OX40 (all p values < 0.01). Within tumor samples, TILs, CD8+ T cells, and PD-L1/PD-1 expression decreased after NAC. Additionally, fewer tumor specimens were considered to be PD-L1/PD-1 positive post-NAC as compared to pre-NAC biopsy samples using a cutoff of 1% expression.

Conclusions
This work revealed that NAC treatment can substantially downregulate CD4+ and upregulate CD8+ T cell ICP expression as well as deplete the amount of TILs and CD8+ T cells found in breast tumor samples. These findings provide a starting point to study the biological significance of these changes in BC patients.

Trial registration
NCT04022616.
Derivation and validation of a prognostic score for neonatal mortality in Ethiopia: a case-control study
Authors: Mediratta Rishi P. , Amare Ashenafi Tazebew , Behl Rasika , Efron Bradley , Narasimhan Balasubramanian , Teklu Alemayehu , Shehibo Abdulkadir , Ayalew Mulugeta , Kache Saraswati 
Published: May 2020

AbstractBackgroundEarly warning scores for neonatal mortality have not been designed for low income countries. We developed and validated a score to predict mortality upon admission to a NICU in Ethiopia.MethodsWe conducted a retrospective case-control study at the University of Gondar Hospital, Gondar, Ethiopia. Neonates hospitalized in the NICU between January 1, 2016 to June 31, 2017. Cases were neonates who died and controls were neonates who survived.ResultsUnivariate logistic regression identified variables associated with mortality. The final model was developed with stepwise logistic regression. We created the Neonatal Mortality Score, which ranged from 0 to 52, from the model’s coefficients. Bootstrap analysis internally validated the model. The discrimination and calibration were calculated. In the derivation dataset, there were 207 cases and 605 controls. Variables associated with mortality were admission level of consciousness, admission respiratory distress, gestational age, and birthweight. The AUC for neonatal mortality using these variables in aggregate was 0.88 (95% CI 0.85–0.91). The model achieved excellent discrimination (bias-corrected AUC) under internal validation. Using a cut-off of 12, the sensitivity and specificity of the Neonatal Mortality Score was 81 and 80%, respectively. The AUC for the Neonatal Mortality Score was 0.88 (95% CI 0.85–0.91), with similar bias-corrected AUC. In the validation dataset, there were 124 cases and 122 controls, the final model and the Neonatal Mortality Score had similar discrimination and calibration.ConclusionsWe developed, internally validated, and externally validated a score that predicts neonatal mortality upon NICU admission with excellent discrimination and calibration.
Determinants of road traffic injuries in Iranian children; results from a National Representative Demographic- Health Survey 2010
Authors: Ghiasvand Hesam , Roshanfekr Payam , Ali Delaram , Ardakani Hossein Malekafzali , Stephens Amanda N. , Armoon Bahram 
Published: May 2020

AbstractBackgroundRoad Traffic Injuries (RTIs) are a leading cause of disabilities and mortalities in Iran. The occurrence of RTIs among children is increasing. This study aims are to assess RTIs among Iranian children and to determine the main socio-economics determinants.MethodsThe National Institute of Health Research (NIHR) in collaboration with the Iran Ministry of Health (MoH) conducted a nationwide survey: The Multiple Indicator Demographic and Health Survey 2010 (IrMIDHS 2010). The Survey was undertaken by Medical Universities in Iran. Based on multistage clustered randomized sampling, 30,960 households were included in the survey. We performed a multivariate logistic regression to determine the main socio-economic factors associated with RTIs among children.ResultsApproximately 0.9% of the children received RTIs in 2010. Main socio-economics contributors to RTIs involving Iranian children included household size (Adjusted OR: 1.06 (CI 95% 1.01, 1.14), sex (Adjusted ORfemale: 0.38 (CI 95% 0.29, 0.50), living with both parents (Adjusted OR: 0.55 (CI 95% 0.13, 0.95), being in the 2nd (Adjusted OR: 0.81 (CI 95%: 0.60, 0.90) or 4th income quartile (Adjusted OR: 0.13 (CI 95%: 0.02, 0.92) rather than the 1st income quartile, being aged five to nine (Adjusted OR: 1.39 (CI 95%: 1.10, 2.10), or aged 15 to 18 (Adjusted OR: 2.94 (CI 95%: 2.07, 4.97), and residency in a non- owned or non-tenancy house (Adjusted OR: 0.42 (CI 95%: 0.23 0.74).ConclusionsChildren need safe places for playing and doing their daily activities. Policy and regulation development aimed at protecting children from road traffic injuries needs to take into consideration the socio-economic factors associated with risk of road traffic injury among children.
Microbiological analyses of nasally guided catheters after less invasive surfactant administration – a pilot study
Authors: Maiwald Christian A. , Dick Julia , Marschal Matthias , Gille Christian , Franz Axel R. , Poets Christian F. 
Published: May 2020

Abstract
Background
Respiratory distress syndrome (RDS) is a frequent complication of premature birth. Treating RDS by continuous positive airway pressure and less invasive surfactant administration (LISA) may reduce bronchopulmonary dysplasia. Surfactant, however, can be inactivated by bacterial infection. Therefore, potential routes of microbe transmission into the airway are of interest. The aim of this study was to evaluate microbiological contamination of catheters used for LISA procedures and its association with postnatal age.

Methods
Catheter tips used for LISA procedures via the nasal route (LISA-n) in infants with RDS were placed into a sterile eSwab container directly after the procedure, cultured and examined for microbiological contamination.

Results
Interpretable results could be collected from 20 catheter tips. Four showed positive culture results (20%) with microbes potentially associated with the development of early onset neonatal sepsis. Risk of positive microbe detection increased with postnatal age (< 4 h: 10%; 4–18 h: 20%; > 18 h: 40%).

Conclusions
In this pilot study, the risk of tracheal microbe transmission following the LISA-n procedure increased with postnatal age. Although the clinical relevance of this finding is unclear, earlier surfactant administration might reduce the risk of catheter contamination.

Trial registration number
Substudy of the registered Trial: feasibility study – Neofact: NCT04086095, www.ClinicalTrials.gov, September 11, 2019.
Improving mental health literacy in year 9 high school children across Wales: a protocol for a randomised control treatment trial (RCT) of a mental health literacy programme across an entire country
Authors: Simkiss Nicola J. , Gray Nicola S. , Malone Greg , Kemp Andrew , Snowden Robert J. 
Published: May 2020

AbstractBackgroundAdolescence is a crucial period for developing and maintaining good habits for mental health and well-being. This is important for future mental health, as most mental health problems manifest during adolescence. Mental health literacy is the foundation for mental health prevention, stigma reduction, and increased help-seeking efficacy particularly among adolescents. The mental health literacy programme “The Guide”, which was developed in Canada, has shown success in increasing mental health literacy in North American 16–17 year olds. “The Guide Cymru” is an adaptation of The Guide designed for a younger age group (13–14 year olds) and for the Welsh culture and context and is being offered to all state schools in Wales.MethodsThis two-armed cluster randomised control trial (RCT) will evaluate the effectiveness of The Guide Cymru. All 205 secondary schools in Wales will be invited to take part, involving up to 30,000 year 9 pupils. Schools will be randomised to either the immediate implementation of The Guide Cymru or to a wait-list control. The wait-list control will receive The Guide Cymru around 12 weeks later. Measures of mental health literacy (assessed via the Knowledge and Attitudes to Mental Health scale) and mental health problems (via the PedsQL and Strengths and Difficulties Questionnaire) will be taken at baseline (pre-intervention), 12 weeks later (after the active group has received The Guide Cymru), and 24 weeks later (after the wait-list control has received The Guide Cymru).DiscussionThe trial aims to evaluate if The Guide Cymru increases mental health literacy, including reduced stigma to others and to the self, and increased levels of good mental health behaviours and help-seeking for mental health problems.Trial registrationISRCTN15462041. Registered 03/10/2019.
HIV understanding, experiences and perceptions of HIV-positive men who have sex with men in Amazonian Peru: a qualitative study
Authors: Tattsbridge Jasmine , Wiskin Connie , de Wildt Gilles , Clavé Llavall Anna , Ramal-Asayag César 
Published: May 2020

Abstract
Background
HIV-related incidence and mortality is increasing across Peru, with highest mortality rates recorded in the Amazonian region of Loreto. This epidemic is concentrated in men who have sex with men, a population with 14% HIV treatment adherence despite free national provision. This study investigates barriers and facilitators to following healthcare advice through experiences and perceptions of HIV-positive men who have sex with men and healthcare professionals in Loreto.

Methods
Twenty qualitative interviews with HIV-positive men who have sex with men and one focus group with HIV-specialist healthcare professionals were conducted in Loreto, January–February 2019. Interviews were transcribed per verbatim. Thematic content analysis and deviant case analysis were used.

Results
A culture of isolation and discrimination was identified, propagated by poor public knowledge surrounding HIV transmission and treatment. Employment potential was hampered and 7/20 patients had suicidal thoughts post-diagnosis. Barriers to care included: shame, depression, travel cost/times, a preference for traditional plant-based medicine and side-effects of antiretroviral therapy. Facilitators included: education, family and clinic support, disease acceptance and lifestyle changes.

Conclusion
More effective, focussed community education and workplace discrimination investigations are recommended to reduce stigma and increase adherence to treatment in this population.
Spatial analysis of individual- and village-level sociodemographic characteristics associated with age at marriage among married adolescents in rural Niger
Authors: Shakya Holly B. , Weeks John , Challa Sneha , Fleming Paul J. , Cislaghi Beniamino , McDougal Lotus , Boyce Sabrina C. , Raj Anita , Silverman Jay G. 
Published: May 2020

AbstractBackgroundNiger has the highest prevalence of child marriage in the world. While child marriage in Niger is clearly normative in the sense that it is commonly practiced, the social and contextual factors that contribute to it are still unclear.MethodsHere, we tested the importance of village-level factors as predictors of young age at marriage for a group of married adolescent girls (N = 1031) in the Dosso district of rural Niger, using multi-level and geographic analyses. We aggregated significant individual level factors to determine whether, independent of a girl’s own sociodemographic characteristics, the impact of each factor is associated at the village level. Finally, we tested for spatial dependence and heterogeneity in examining whether the village-level associations we find with age at marriage differ geographically.ResultsThe mean age of marriage for girls in our study was 14.20 years (SD 1.8). Our statistical results are consistent with other literature suggesting that education is associated with delayed marriage, even among adolescent girls. Younger ages at marriage are also associated with a greater age difference between spouses and with a greater likelihood of women being engaged in agricultural work. Consistent with results at the individual level, at the village level we found that the proportion of girls who do agricultural work and the mean age difference between spouses were both predictive of a lower age at marriage for individual girls. Finally, mapping age at marriage at the village level revealed that there is geographical variation in age at marriage, with a cluster of hot spots in the Hausa-dominated eastern area where age at marriage is particularly low and a cluster of cold spots in the Zarma-dominated western areas where age at marriage is relatively high.ConclusionsOur findings suggest that large-scale approaches to eliminating child marriage in these communities may be less successful if they do not take into consideration geographically and socially determined contextual factors at the village level.
Reaching hard-to-reach men through home-based couple HIV testing among pregnant women and their male partners in western Kenya: a qualitative study
Authors: Krakowiak Daisy , Makabong’o Pamela , Goyette Marielle , Kinuthia John , Osoti Alfred Onyango , Asila Victor , Gone Molly Ann , Mark Jennifer , Farquhar Carey 
Published: May 2020

Abstract
Background
Globally only 79% of adults living with HIV (human immunodeficiency virus) know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives.

Methods
Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process.

Results
Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) provided privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers.

Conclusions
The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services.

Trial Registration
Clinicaltrials.gov registry: NCT01784783. Registered prospectively on June 15, 2012.
Prevalence and healthcare seeking practice of work-related musculoskeletal disorders among informal sectors of hairdressers in Ethiopia, 2019: findings from a cross-sectional study
Authors: Mekonnen Tesfaye Hambisa , Kekeba Getachew Guteta , Azanaw Jember , Kabito Gebisa Guyasa 
Published: May 2020

Abstract
Background
Work-related musculoskeletal disorders (MSDs) are the major threats to public health, with a significant impact on workers, employers, and the general population. Musculoskeletal disorder related to work not only results in adverse health effects such as physical injury, disability, and a reduction in workers’ quality of life, but it also places immense burdens on the use of healthcare facilities and a substantial loss of productivity. The purpose of this research was to discover the prevalence and associated factors of work-related MSDs among hairdressers in Oromia Special Zone Surrounding Finfine, Ethiopia.

Methods
A cross-sectional survey was carried out between March and April 2019. We included a total of 699 hairdressers with a systematic random sampling technique. Work-related MSDs was evaluated with the standardized Nordic Musculoskeletal survey, and the survey was administered by the interviewer. We employed SPSS version 20 software to perform a bivariate and multivariate analysis. A p-value of < 0.05 was considered a significant association.

Results
In total, 652 hairdressers were interviewed with a response rate of 93.2%. Participants’ mean age was 33.19 (SD ± 9.639) years. The prevalence of work-related MSDs was 70.2% (N = 458) [95% CI (66.7, 73.9)] and 55.7% in the past 12-months and 7 days, respectively. The study showed the highest prevalence rate was observed in shoulder 53.7% (n = 350) followed by 53.4% (n = 348) neck and 53.2% (n = 347) low back. Of the participants, 33.4% (n = 153) perceived their pain to be severe whereas 28% (n = 128) a high disabling. Almost one-third (n = 187) of the respondents used healthcare services. Age [AOR = 2.73; 95% CI (2.55, 5.46)], work experience [AOR = 1.51; 95% CI (1.03, 2.20)], number of customers served per day [AOR = 2.35; 95% CI (1.35, 4.11)], and hours spent standing to make hair [AOR = 3.4; 95% CI (2.49, 7.77)] were significantly associated factors.

Conclusion
This study found work-related MSDs were prevalent among hairdressers, but the use of healthcare services remains low. Age, length of employment, number of customers served per day, and number of hours spent standing per day to make hair were significantly associated. Therefore, we recommend employers need to develop health and safety programs that account for factors related to the workplaces. The findings also demonstrate that health practitioners would encourage pain management procedures.
The relationship between individual characteristics and HIV-related stigma in adults living with HIV: medical monitoring project, Florida, 2015–2016
Authors: Williams Renessa , Cook Robert , Brumback Babette , Cook Christa , Ezenwa Miriam , Spencer Emma , Lucero Robert 
Published: May 2020

Abstract
Background
Human Immunodeficiency Virus (HIV) disproportionately affects the Southern United States, accounting for approximately 46% of people living with HIV. HIV-related stigma is recognized as a barrier to testing, treatment, and prevention efforts. However, little is known about HIV-related stigma experiences in Florida. Using data collected from the Florida Medical Monitoring Project, we sought to examine individual characteristics associated with HIV-related stigma.

Methods
We analyzed secondary data from the 2015–2016 Medical Monitoring Project in Florida (n = 603). Stigma was measured using the 10-item HIV Stigma Scale. Exploratory factor analysis of the HIV Stigma Scale revealed three subscales: negative self-image, anticipated, and personalized stigma. Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV Stigma Scale.

Results
Multivariate analysis indicated that people with severe depression scores (OR: 3.13; CI: 1.38–7.13) and persons with disability (OR: 1.64; CI: 1.03–2.61) had significantly increased odds of higher overall stigma. In the subscale analyses, negative self-image was significantly associated with alcohol misuse (OR: 2.02; CI: 1.15–3.56) depression (OR: 2.81; CI: 1.38–5.72) and/or those who identify as homosexual (OR: 0.54; CI: 0.31–0.93). Anticipated stigma was significantly associated with people who had mild-moderate depression (OR: 3.03; CI: 1.20–7.65), severe depression (OR: 2.87; CI: 1.38–5.98), identified as Black (OR: 0.60; CI: 0.37–0.98), non-injection drug use (OR: 0.55; CI: 0.33–0.91), and/or people aged 50 years and older (OR: 0.28; CI: 0.09–0.82). Personalized stigma was not associated with any of the variables examined.

Conclusions
The implications of these findings reveal that certain individuals are more vulnerable to stigma. Researchers could consider distinct stigma interventions strategies based on the characteristics of specific individuals (i.e., targeting depression, disability, sexual orientation, avoidant coping, racial/ethnic groups, and youth) in Florida.