bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heterosubtypic Protections against Human-Infecting Avian Influenza Viruses Correlate to Biased Cross-T-Cell Responses
Authors: Zhao Min , Liu Kefang , Luo Jiejian , Tan Shuguang , Quan Chuansong , Zhang Shuijun , Chai Yan , Qi Jianxun , Li Yan , Bi Yuhai , Xiao Haixia , Wong Gary , Zhou Jianfang , Jiang Taijiao , Liu Wenjun , Yu Hongjie , Yan Jinghua , Liu Yingxia , Shu Yuelong , Wu Guizhen , Wu Aiping , Gao George F. , Liu William J. 
Published: August 2018

ABSTRACT
Against a backdrop of seasonal influenza virus epidemics, emerging avian influenza viruses (AIVs) occasionally jump from birds to humans, posing a public health risk, especially with the recent sharp increase in H7N9 infections. Evaluations of cross-reactive T-cell immunity to seasonal influenza viruses and human-infecting AIVs have been reported previously. However, the roles of influenza A virus-derived epitopes in the cross-reactive T-cell responses and heterosubtypic protections are not well understood; understanding those roles is important for preventing and controlling new emerging AIVs. Here, among the members of a healthy population presumed to have previously been infected by pandemic H1N1 (pH1N1), we found that pH1N1-specific T cells showed cross- but biased reactivity to human-infecting AIVs, i.e., H5N1, H6N1, H7N9, and H9N2, which correlates with distinct protections. Through a T-cell epitope-based phylogenetic analysis, the cellular immunogenic clustering expanded the relevant conclusions to a broader range of virus strains. We defined the potential key conserved epitopes required for cross-protection and revealed the molecular basis for the immunogenic variations. Our study elucidated an overall profile of cross-reactivity to AIVs and provided useful recommendations for broad-spectrum vaccine development.

IMPORTANCE
We revealed preexisting but biased T-cell reactivity of pH1N1 influenza virus to human-infecting AIVs, which provided distinct protections. The cross-reactive T-cell recognition had a regular pattern that depended on the T-cell epitope matrix revealed via bioinformatics analysis. Our study elucidated an overall profile of cross-reactivity to AIVs and provided useful recommendations for broad-spectrum vaccine development.
Protocol for the study of cervical cancer screening technologies in HIV-infected women living in Rwanda
Authors: Murenzi Gad , Dusingize Jean-Claude , Rurangwa Theogene , Sinayobye Jean d’Amour , Munyaneza Athanase , Murangwa Anthere , Zawadi Thierry , Hebert Tiffany , Mugenzi Pacifique , Adedimeji Adebola , Mutesa Leon , Anastos Kathryn , Castle Philip E 
Published: August 2018

IntroductionThe optimal method(s) for screening HIV-infected women, especially for those living in sub-Saharan Africa, for cervical precancer and early cancer has yet to be established.Methods and analysisA convenience sample of >5000 Rwandan women, ages 30–54 years and living with HIV infection, is being consented and enroled into a cross-sectional study of cervical cancer screening strategies. Participants are completing an administered short risk factor questionnaire and being screened for high-risk human papillomavirus (hrHPV) using the Xpert HPV assay (Cepheid, Sunnyvale, California, USA), unaided visual inspection after acetic acid (VIA) and aided VIA using the Enhanced Visual Assessment (EVA) system (Mobile ODT, Tel Aviv, Israel). Women positive for hrHPV and/or by unaided VIA undergo colposcopy, which includes the collection of two cervical specimens prior to undergoing a four-quadrant microbiopsy protocol. The colposcopy-collected specimens are being tested by dual immunocytochemical staining for p16INK4aand Ki-67 (CINtec PLUS Cytology, Ventana, Tucson, Arizona, USA) and for E6 or E7 oncoprotein for 8 hrHPV genotypes (HPV16, 18, 31, 33, 35, 45, 52 and 58) using the next-generation AV Avantage hrHPV E6/E7 test (Arbor Vita Corporation, Freemont, California, USA). Women with a local pathology diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2) or more severe (CIN2+) or pathology review diagnosis of CIN grade three or more severe (CIN3+) will receive treatment. Clinical performance and cost-effectiveness (eg, sensitivity, specificity and predictive values) of different screening strategies and algorithms will be evaluated.Ethics and disseminationThe protocol was approved by local and institutional review boards for human subjects research. At the completion of the study, results will be disseminated to the scientific community through peer-reviewed publication and to the Rwandan stakeholders through an external advisory panel.
Self-perception of adaptation among homicidally bereaved individuals following a psychoeducational intervention: a UK longitudinal qualitative study
Authors: Alves-Costa Filipa , Hamilton-Giachritsis Catherine , Christie Hope , Halligan Sarah L 
Published: August 2018

ObjectiveResearch on homicidal bereavement has focused on postloss impact and coping. Less is known about how individuals perceive their adjustment posthomicide. Adverse experiences are likely to leave individuals with an increased risk of developing severe psychological difficulties, such as depression, Post-traumatic stress(PTSD), anxiety and complicated grief. This study aimed to explore how individuals perceive their change and progression posthomicide and post-psychoeducational intervention.DesignSemistructured qualitative interviews were conducted both as part of a prospective study and retrospectively to allow for a longer follow-up period.SettingHomicidally bereaved individuals who participated in a residential psychoeducational intervention offered by a national charity (Escaping Victimhood (EV)).ParticipantsTwenty-nine individuals (mainly females) took part: 14 as part of a 6–9-month follow-up (short-term trajectory group (STG) individuals—mean age 45.25) and 15 individuals (long-term trajectory group (LTG) individuals—mean age 48.50), retrospectively, 2 to 5 years postintervention.ResultsInterviews were analysed using an inductive Thematic Analysis method. Three main themes and nine subthemes emerged, and applied to both groups, as follows: (1) actual changes perceived by the participants (increased understanding, improved coping strategies and positive self-change), (2) barriers to recovery (severe psychological difficulties over time, need for further support, reminders and close relationships with both victim and perpetrator), and finally perceived future progression (living day by day, hope and hopelessness). The only significant differences between the two groups related to the reported self-growth among LTG individuals and the perceived increased informal support among STG individuals by keeping in touch in other EV participants.ConclusionThis unique study provides insight into how homicidally bereaved individuals perceive their bereavement paths and helped to identify elements that appear to contribute for their adjustment. Importantly, it has highlighted that positive changes can also be an outcome.
What non-technical skills competencies are addressed by Australian standards documents for health professionals who work in secondary and tertiary clinical settings? A qualitative comparative analysis
Authors: Peddle Monica , Bearman Margaret , Radomski Natalie , Mckenna Lisa , Nestel Debra 
Published: August 2018

ObjectivesAt minimum, safe patient outcomes are recognised as resulting from a combination of technical and non-technical skills. Flin and colleagues provide a practical framework of non-technical skills, cognitive, social and interpersonal, that complement technical skills, with categories identified assituational awareness, communication, team working, decision-making, leadership, coping with stressandmanaging fatigue. The aim of this research was to explore the alignment of categories and elements of non-technical skills with those in the published standards documents of several health professions in Australia.DesignA qualitative comparative analysis using document analysis and deductive coding examined, extracted and interpreted data from competency standards documents focusing on non-technical skills categories and elements.ParticipantsA purposive sample of 11 health professions competency standards documents required for registration in Australia.FindingsThe 11 competency standards documents contained 1616 statements. Although standards documents addressed all non-technical skills categories, there was limited reporting ofmanaging stressandcoping with fatigue.Of the 31 elements included in the non-technical skills framework, 22 were not common to all health professions and 3 elements were missing from the standards documents. Additionally, the documents were composed differently with no common taxonomy and multifaceted statements.ConclusionWhile commonalities identified in the standards documents related to non-technical skills categories are likely to support patient safety, gaps in associated elements may undermine their effectiveness. The notable lack of reference to stress and fatigue requires further attention for health professional well-being in Australia. A shared taxonomy with clear statements may offer the best support for collaborative practice and positive patient outcomes. Competency standards need to be flexible to respond to the emerging demands of current healthcare practice along with consumer and health service needs.
Coronary stenosis as a modifier of the effect of cold spells on the risk of sudden cardiac death: a case-crossover study in Finland
Authors: Ryti Niilo R I , Junttila M Juhani , Antikainen Harri , Kortelainen Marja-Leena , Huikuri Heikki V , Jaakkola Jouni J K 
Published: August 2018

ObjectiveTo test the a priori hypothesis that the association between cold spells and ischaemic sudden cardiac death (SCD) is modified by the severity of coronary stenosis.MethodsThe home coordinates of 2572 autopsy-verified cases of ischaemic SCD aged ≥35 in the Province of Oulu, Finland, were linked to 51 years of weather data. Cold spell was statistically defined for each home address as unusually cold weather pertinent to the location and time of year. We estimated the occurrence of cold spells during the hazard period (7 days preceding death) and reference periods (the same calendar days over 51 years) in a case-crossover setting applying conditional logistic regression, controlling for temporal trends and stratifying by severity of coronary stenosis.ResultsThe association between cold spells and ischaemic SCD was stronger among patients with 75%–95% stenosis (OR 2.03; 95% CI 1.31 to 3.17), and weaker to non-existent among patients with <75% stenosis (OR 0.97; 95% CI 0.37 to 2.55) or coronary total occlusion (100% stenosis) (OR 1.01; 95% CI 0.52 to 1.96). Lack of calcium-channel blockers and statin therapy seemed to accentuate the role of stenosis during cold spells.ConclusionsWe provide evidence that the association between cold spells and ischaemic SCD is modified by the severity of coronary stenosis. The findings suggest that disturbances in coronary circulation play part in the pathogenesis of SCD during cold weather.
Xylitol for the prevention of acute otitis media episodes in children aged 2–4 years: protocol for a pragmatic randomised controlled trial
Authors: Persaud Nav , Laupacis Andreas , Azarpazhooh Amir , Birken Catherine , Hoch Jeffrey S , Isaranuwatchai Wanrudee , Maguire Jonathan L , Mamdani Muhammad M , Thorpe Kevin , Allen Christopher , Mason Dalah , Kowal Christine , Bazeghi Farnaz , Parkin Patricia 
Published: August 2018

IntroductionXylitol (or ‘birch sugar’) is a naturally occurring sugar with antibacterial properties that has been used as a natural non-sugar sweetener in chewing gums, confectionery, toothpaste and medicines. In this preventative randomised trial, xylitol will be tested for the prevention of acute otitis media (AOM), a common and costly condition in young children. The primary outcome will be the incidence of AOM. Secondary outcomes will include upper respiratory tract infections (URTIs) and dental caries.Methods and analysisThis study will be a pragmatic, blinded (participant and parents, practitioners and analyst), two-armed superiority, placebo-controlled randomised trial with 1:1 allocation, stratified by clinical site. The trial will be conducted in the 11 primary care group practices participating in the TARGet Kids! research network in Canada. Eligible participants between the ages of 2–4 years will be randomly assigned to the intervention arm of regular xylitol syrup use or the control arm of regular sorbitol use for 6 months. We expect to recruit 236 participants, per treatment arm, to detect a 20% relative risk reduction in AOM episodes. AOM will be identified through chart review. The secondary outcomes of URTIs and dental caries will be identified through monthly phone calls with specified questions.Ethics and disseminationEthics approval from the Research Ethics Boards at the Hospital for Sick Children and St. Michael’s Hospital has been obtained for this study and also for the TARGet Kids! research network. Results will be submitted for publication to a peer-reviewed journal and will be discussed with decision makers.Trial registration numberNCT03055091; Pre-results.
Prevalence of diabetes, pre-diabetes and associated risk factors: second National Diabetes Survey of Pakistan (NDSP), 2016–2017
Authors: Basit Abdul , Fawwad Asher , Qureshi Huma , Shera A S 
Published: August 2018

ObjectiveThe second National Diabetes Survey of Pakistan (second NDSP) was planned to ascertain the updated prevalence of diabetes, pre-diabetes and associated risk factors at the national and provincial levels.Research design and methodsThe survey was conducted by using multistage clustering technique in all four provinces of Pakistan from February 2016 to August 2017. An estimated sample size of 10 800 was calculated using probability sampling and multistage stratified sampling technique. Twenty-seven clusters were selected out of total 213 clusters from all four provinces (strata) of Pakistan. A total of 46 subclusters were selected by using the ‘Rule of thumb’. Out of 12 486 targeted individuals, 10 834 study subjects finally participated in the study (87% response rate). Seventeen trained teams collected data using the structured questionnaire. The clinical and anthropometric measurements included height, weight, blood pressure, waist circumference and waist-to-hip ratio while the blood tests included Oral Glucose Tolerance Test (OGTT), haemoglobin A1c and fasting lipid profiles. WHO criteria were used for the diagnosis of diabetes and pre-diabetes.ResultsOverall weighted prevalence of diabetes was 26.3%, of which 19.2% had known diabetes, and 7.1% were newly diagnosed people with diabetes. Prevalence of diabetes in urban and rural areas was 28.3% and 25.3%, respectively. Prevalence of pre-diabetes was 14.4% (15.5% in urban areas and 13.9% in rural areas). Age greater than or equal to 43 years, family history of diabetes, hypertension, obesity and dyslipidaemia were significant associated risk factors for diabetes.ConclusionThe findings of the 2nd NDSP imply that diabetes has reached epidemic proportion and urgently need national strategies for early diagnosis and effective management as well as cost-effective diabetes primary prevention programme in Pakistan.
Good, bad or indifferent: a longitudinal multi-methods study comparing four modes of training for healthcare professionals in one Australian state
Authors: Martin Priya , Kumar Saravana , Abernathy LuJuana , Browne Matthew 
Published: August 2018

ObjectivesThe aim of the study was to compare the differences in learning outcomes for supervision training of healthcare professionals across four modes namely face-to-face, videoconference, online and blended modes. Furthermore, changes sustained at 3 months were examined.Design/methodsA multimethods quasi-experimental longitudinal design was used. Data were collected at three points—before training, immediately after training and at 3 months post-training. Quantitative and qualitative data were collected through anonymous surveys and reflective summaries, respectively.ResultsParticipants reported an increase in supervision knowledge and confidence immediately after training that was sustained at 3 months with all four modalities of training. Using analysis of variance, we found these changes were sustained at 3 months postcompletion (confidence p<0.01 and knowledge p<0.01). However, there was no statistically significant difference in outcomes between the four modes of training delivery (confidence, p=0.22 or knowledge, p=0.39). Reflective summary data highlighted the differences in terminology used by participant to describe their experiences across the different modes, the key role of the facilitator in training delivery and the merits and risks associated with online training.ConclusionsWhen designed and delivered carefully, training can achieve comparable outcomes across all four modes of delivery. Regardless of the mode of delivery, the facilitator in training delivery is critical in ensuring positive outcomes.
In which groups of pregnant women can the caesarean delivery rate likely be reduced safely in the USA? A multicentre cross-sectional study
Authors: Zhang Jin-Wen , Branch Ware , Hoffman Matthew , De Jonge Ank , Li Sheng-Hui , Troendle James , Zhang Jun 
Published: August 2018

ObjectivesTo identify obstetrical subgroups in which (1) the caesarean delivery (CD) rate may be reduced without compromising safety and (2) CD may be associated with better perinatal outcomes.DesignA multicentre cross-sectional study.Setting19 hospitals in the USA that participated in the Consortium on Safe Labor.Participants228 562 pregnant women in 2002–2008.Main outcome measuresMaternal and neonatal safety was measured using the individual Weighted Adverse Outcome Score.MethodsWomen were divided into 10 subgroups according to a modified Robson classification system. Generalised estimated equation model was used to examine the relationships between mode of delivery and Weighted Adverse Outcome Score in each subgroup.ResultsThe overall caesarean rate was 31.2%. Repeat CD contributed 29.5% of all CD, followed by nulliparas with labour induction (15.3%) and non-cephalic presentation (14.3%). The caesarean rates in induced nulliparas with a term singleton cephalic pregnancy and women with previous CD were 31.6% and 82.0%, respectively. CD had no clinically meaningful association with perinatal outcomes in most subgroups. However, in singleton preterm breech presentation and preterm twin gestation with the first twin in non-cephalic presentation, CD was associated with substantially improved maternal and perinatal outcomes.ConclusionsWomen with repeat CD, term non-cephalic presentation, term twins or other multiple gestation and preterm births may be the potential targets for safely reducing prelabour CD rate, while nulliparas or multiparas with spontaneous or induced labour, women with repeat CD, term non-cephalic presentation, term twins or other multiple gestation and preterm births are potential targets for reducing intrapartum CD rate without compromising maternal and neonatal safety in the USA. On the other hand, CD may still be associated with better perinatal outcomes in women with singleton preterm breech presentation or preterm twins with the first twin in non-cephalic presentation.
Complementary vaccination protocol with dendritic cells pulsed with autologous tumour lysate in patients with resected stage III or IV melanoma: protocol for a phase II randomised trial (ACDC Adjuvant Trial)
Authors: Ridolfi Laura , de Rosa Francesco , Fiammenghi Laura , Petrini Massimiliano , Granato Anna Maria , Ancarani Valentina , Pancisi Elena , Soldati Valentina , Cassan Serena , Bulgarelli Jenny , Riccobon Angela , Gentili Giorgia , Nanni Oriana , Framarini Massimo , Tauceri Francesca , Guidoboni Massimo 
Published: August 2018

IntroductionSurgery is one of the treatments of choice for patients with a single metastasis from melanoma but is rarely curative. Such patients could potentially benefit from consolidation immunotherapy. Vaccination with dendritic cells (DCs) loaded with tumour antigens elicits a tumour-specific immune response. In our experience, patients who developed delayed type hypersensitivity (DTH) after DC vaccination showed a median overall survival (OS) of 22.9 monthsvs4.8 months for DTH-negative cases. A phase II randomised trial showed an advantage OS of a DC vaccine over a tumour cell-based vaccine (2-year OS 72% vs31%, respectively). Given that there is no standard therapy after surgical resection of single metastases, we planned a study to compare vaccination with DCs pulsed with autologous tumour lysate versus follow-up.Methods and analysisThis is a randomised phase II trial in patients with resected stage III/IV melanoma. Assuming a median relapse-free survival (RFS) of 7.0 months for the standard group and 11.7 months for the experimental arm (HR 0.60), with a two-sided tailed alpha of 0.10, 60 patients per arm must be recruited. An interim futility analysis will be performed at 18 months. The DC vaccine, produced in accordance with Good Manufacturing Practice guidelines, consists of autologous DCs loaded with autologous tumour lysate and injected intradermally near lymph nodes. Vaccine doses will be administered every 4 weeks for six vaccinations and will be followed by 3 million unit /day of interleukin-2 for 5 days. Tumour restaging, blood sampling for immunological biomarkers and DTH testing will be performed every 12 weeks.Ethics and disseminationThe protocol, informed consent and accompanying material given to patients were submitted by the investigator to the Ethics Committee for review. The local Ethics Committee and the Italian Medicines Agency approved the protocol (EudraCT code no.2014-005123-27). Results will be published in a peer-reviewed international scientific journal.Trial registration number2014-005123-27.