bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of HPV6/11-reactive T-cell subsets in papillomas of patients with juvenile-onset recurrent respiratory papillomatosis and identification of HPV11 E7-specific candidate TCR clonotypes
Authors: Peng Yun , Wang Wei , Liu Xiangjun , Li Shilan , Zhang Jie , Ni Xin , Gui Jingang 
Published: September 2024

ABSTRACT

Juvenile-onset recurrent respiratory papillomatosis (JORRP) is caused by persistent infection of epithelial cells by low-risk human papillomavirus (HPV) types 6 and 11. While multiple infiltrated immune cells have been reported to mediate disease progress, knowledge of HPV-reactive T-cell subsets in papillomas remains elusive. Through single-cell RNA sequencing and RNA microarray, we found that CD8+ tissue-resident memory T (CD8+ T
RM
) cells with strong interferon-gamma (IFN-γ) production expanded, and were negatively correlated to the disease severity in the frequency of surgery. These IFN-γ+ CD8+ memory T cells were readily activated and expanded
in vitro
by autologous dendritic cells loaded with HPV11 E7 peptide pool. Moreover, T cell receptor (TCR) clonal expansion was observed in JORRP papilloma tissues, indicating a biased TCR repertoire toward HPV-specific recognition. Finally, we identified and characterized HPV11 E7-specific candidate TCR clonotypes from IFN-γ+ CD8+ memory T cells, suggesting their potential application in TCR-engineered T cells (TCR-T) therapy for HPV11-related diseases. Our findings provided insights into the specific local immune response to HPV6/11 infection and highlighted the importance of IFN-γ+ CD8+ T
RM
cells in anti-HPV6/11 T-cell immunity.

IMPORTANCE

The persistent recurrence of human papillomavirus (HPV) 6/11 infection in papillomas underscores the failure of local immune responses in patients with juvenile-onset recurrent respiratory papillomatosis (JORRP). Our previous study demonstrated that T cells constitute the predominant immune cell population in JORRP papilloma tissues. Understanding the T-cell-mediated immune responses within JORRP papilloma tissues is crucial for disease control. In the present study, we characterized CD8+ tissue-resident memory T (CD8+ T
RM
) cells as the primary T-cell subset responsible for local anti-HPV6/11 immunity. Moreover, we identified two HPV11 E7-specific candidate T cell receptor (TCR) clonotypes out of IFN-γ+ CD8+ memory T cells. Overall, our findings provided insights into the local immune responses to HPV6/11 infection and offered information for developing more effective immunotherapeutic strategies against JORRP.
Supporting caregivers of children living with disability in a humanitarian context: realist-informed evaluation of the ‘Mighty Children’programme in Afghanistan
Authors: Evans Natalie , Ahmadi Noorwhiza , Morgan Alice , Zalmai Sadia , Milner Kate M , Atif Mohamed Faiz , Graham Hamish R 
Published: September 2024

IntroductionTo ensure that humanitarian action is disability-inclusive, evidence is needed to understand how different strategies to support children living with disabilities and their families can work in these settings. Evidence from other contexts suggests support groups can improve caregiver quality of life (QOL). This study reports an evaluation of the ‘Mighty Children’programme a participatory educational support group programme for caregivers of children living with disability in Kabul province, Afghanistan.MethodsWe conducted a mixed-methods realist-informed before-and-after study to measure change in caregiver-reported QOL and explore how and for whom the programme worked, and in what contexts. Female caregivers of children with any disability were recruited through clinics in urban Kabul (n=3) and rural Paghman district (n=3). We collected quantitative data on QOL pre/post programme using the Paediatric Quality of Life Inventory Family Impact Module (PedsQL-FIM). Qualitative data were collected through facilitator and participant focus groups postprogramme.Results118 caregivers participated in two cohorts (November 2020, February 2021). Caregivers expressed a significant increase in QOL from baseline to programme completion (t(125)=−10.7, p≤0.0001). Participation in cohort 2 was associated with the greatest PedsQL-FIM change.Qualitative data revealed positive changes postprogramme in five key areas: caregiver mindset, parenting practices, disability-inclusive behaviours, psychological well-being and child functioning. These changes were seen as both outcomes and mechanisms influencing the primary outcome of QOL. Mechanisms that mediated these changes included increased knowledge of disability and the core acceptance and commitment therapy components of mindfulness and acceptance.ConclusionTheMighty Childrencaregiver support programme for children living with disability in Afghanistan was associated with improved caregiver QOL. Further studies are warranted to explore pathways to scale, sustainability and potential application in other settings.
Assessment of abnormal liver function tests and associated factors among COVID-19-infected patients in Addis Ababa, Ethiopia, 2022: a facility-based comparative cross-sectional study
Authors: Mekuanint Amare , Ambachew Sintayehu , Worede Abebaw , Asrie Fikir , Sinishaw Mulusew Alemneh , Gelaw Yemataw , Dagnew Mulat , Gelaw Aschalew , Negash Markos , Kassa Eyuel , Bizuneh Segenet , Wudineh Dessalew , Dimah Belayneh , Abebe Wagaw , Chane Elias , Fetene Getnet 
Published: September 2024

ObjectiveLiver function test (LFT) abnormalities are higher in patients with severe COVID-19. Most of the studies on this theme were conducted in foreign nations, and the association with LFT abnormalities was not sufficiently addressed in the study areas. Therefore, the current study aimed to investigate the effects of COVID-19 infection on liver function of patients.SettingA facility-based comparative cross-sectional study was carried out from 10 April to 15 June 2022, among COVID-19 infected individuals admitted in Eka Kotebe General Hospital and Saint Petrous Specialized Hospitals, Addis Ababa, 2022.ParticipantsA total of 284 confirmed COVID-19-positive and COVID-19-negative controls matched by gender and age were included in the present study.ResultsAmong SARS-COV-2 positive groups, 63 (44.4%) had one or more LFT abnormalities. The most common elevated level of the LFTs among patients with COVID-19 were gamma-glutamyl transferase (GGT) 50 (35.2%), while the most common lowered level was albumin 58 (40.8%). The mean values of aspartate aminotransferase (AST) (35.4±26.9 vs 22.9±12.6, p<0.001) were significantly different between patients with COVID-19 and the COVID-19-free groups. Being COVID-19-positive was significantly associated with an elevated level of AST (AOR=3.0, 95% CI 1.2 to 7.4) and GGT (AOR=4.55, 95% CI 2.02 to 10.3). Being male was significantly associated with an elevated level of total bilirubin (BILT, AOR=2.41, 95% CI 1.2 to 4.9) and direct bilirubin (BILD, AOR=3.7, 95% CI 1.72 to 8.2), and also severe stage of COVID-19 was associated with hypoalbuminaemia (AOR=3.3, 95% CI 1.4 to 7.9). SARS-COV-2 infection was independently associated with LFT abnormality.ConclusionPatients with COVID-19 had decreased albumin levels, and elevated AST, GGT, BILT and BILD levels.
Effect of ketogenic diets on lipid metabolism in adults: protocol for a systematic review
Authors: Hilary Serene , Östlundh Linda , Platat Carine , Al-Rifai Rami H , Almehairbi Osha , Alshamsi Fayeza , Ali Habiba I , Al Dhaheri Ayesha S , Cheikh Ismail Leila , Stojanovska Lily 
Published: September 2024

IntroductionThe ketogenic diet is a very low carbohydrate diet known for its ability to reduce weight and counteract hyperglycaemia. However, ketogenic diets recommend an increased intake of fats, raising concerns about cardiometabolic risk in adults. Due to the higher intake of fats in the ketogenic diet, there is significant variability in outcomes of lipid metabolism in the population. Interventions have reported improvements in lipid profile while other studies did not find changes, and there are reports of increased low density lipoprotein (LDL) and triglyceride values. Hence, this is a protocol for a systematic review of the published literature and a summary of the effect of ketogenic diets on lipid metabolism in adults.Methods and analysisFive databases (PubMed, Embase, Scopus, Cochrane Library and Web of Science) will be searched for studies on ketogenic diets in adult populations. Studies will be included if they report results from ketogenic diet interventions among adults. Exclusion is populations with diagnosed neurological disorders. Two reviewers will independently screen retrieved citations, extract data and appraise the risk of bias. Quantitative estimates (eg, standardised mean difference) measuring the change in the total cholesterol, LDL and triglyceride concentration will be pooled using random effects meta-analysis to produce one summarised weighted estimate. Sources of heterogeneity will be explored using subgroup analysis. This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols (PRISMA), and the final review will be reported following the PRISMA 2020 guidelines.Ethics and disseminationThe present protocol and the systematic review to be carried out do not require ethics clearance. The data source will be published studies. This review will provide estimates to inform the public about the effect of ketogenic diets on lipid metabolism and the possible peril of increasing cardiometabolic risk. The results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42022309665.
Examining attitudes to uptake and sustainment of technology among care aides in the delivery of care: a scoping review protocol
Authors: Omotunde Muyibat , Hunter Kathleen , Wagg Adrian 
Published: September 2024

IntroductionCare aides are health workers who deliver hands-on care to patients across the healthcare continuum. The use of technology in healthcare delivery is increasing, and evidence regarding how care aides’ attitudes may either facilitate or hinder the adoption of healthcare technologies is lacking.The aim of the proposed scoping review is to examine available evidence regarding care aides’ attitudes towards the adoption of innovation and factors that may influence the sustainable use of technology in healthcare delivery. Published studies, grey literature and review articles that identify a method for the review, conference abstracts and website publications regarding the attitude, uptake and sustainable use of technology in care delivery by care aides will be included. For abstracts that have resulted in publications, the full publications will be included. The search for evidence commenced in June 2023 and will end in March 2024.Methods and analysisThe Joanna Briggs Institute (JBI) method will be used to conduct the review. The CINAHL, Cochrane Library, EMBASE, MEDLINE, ProQuest, PubMed, SCOPUS, PROSPERO, Web of Science and JBI Evidence Synthesis databases will be searched using keywords for publications within the last 20 years to examine trends in health technology and attitudes of care aides towards innovation over the last two decades. A search of grey literature and websites will be conducted. The reference list of the retrieved articles will be used to identify additional literature. The search results will be exported into a literature management tool for screening and analysis. Article screening will be performed by two authors and if a third is needed to resolve any differences. Data analysis will be guided by two theoretical frameworks.Ethics and disseminationNo ethics approval is required. The findings will be disseminated in a peer-reviewed journal and presented in conferences.Registration detailshttps://doi.org/10.17605/OSF.IO/CZQUP
Arterial stiffness after 6 weeks postdelivery in women with a history of hypertensive disorders of pregnancy: a systematic review protocol
Authors: Mbongozi Xolani , Galloway Stuart , Hunter Angus , Businge Charles Bitamazire 
Published: September 2024

IntroductionHypertensive disorders of pregnancy (HDP) are one of the leading causes of maternal morbidity and mortality. The risk of developing cardiovascular diseases following HDP is high. Arterial stiffness is a prognostic indicator for cardiovascular disease in the general population, and it is elevated during pregnancy in women with HDP. No systematic reviews have been conducted to determine if arterial stiffness remains elevated beyond puerperium in these women with HDP.Methods and analysisWe will conduct a systematic literature search in the following electronic databases: Medline, PubMed, Embase, Cochrane Library, Google Scholar, Web of Science and CINAHL. The review will consider studies that investigate arterial stiffness in women who had HPD and are between 43 days and 10 years postdelivery and under 60 years of age. This systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines. Estimates of mean ± SD for arterial stiffness indices (cfPWV, AIx and AIx@75) for the women in the included studies will be obtained. For studies where the estimates were reported as the median and IQR, approximate estimates of mean ± SD will be calculated by using the low and high end of the range, median and sample size. Data from the individual studies will be pooled by use of a random-effects model. The risk of bias assessment will be assessed using the Cochrane Collaboration tool and the Newcastle-Ottawa Quality Assessment Scale as appropriate. Sources of heterogeneity will be explored by sensitivity and subgroup analyses.Ethics and disseminationNo ethics approval is required as only published data will be used in this study. The research study’s outcomes will be shared through scientific conferences and peer-reviewed publications.PROSPERO registration numberCRD42023461867.
Establishing national hospital costing systems: insights from the qualitative assessment of cost surveillance pilot in Indian hospitals
Authors: Chugh Yashika , Sharma Shuchita , Guinness Lorna , Sharma Deepshikha , Garg Basant , Mehndiratta Abha , Prinja Shankar 
Published: September 2024

ObjectiveThe Indian Government launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), the world’s largest health insurance scheme, in 2018. To reform pricing and gather evidence on healthcare costs, a hospital cost-surveillance pilot was initiated among PM-JAY empanelled hospitals. We analysed the process and challenges from both healthcare providers and payer agency’s perspectives and offer recommendations for implementing similar systems in lower- and middle-income countries.DesignWe employed an open-ended, descriptive and qualitative study design using in-depth interviews (IDI) as the data collection strategy.SettingsThe interviews were conducted in both virtual and face-to-face modes depending on the convenience of the participants. The IDIs for the National Health Authority (NHA) officials and all providers in Kerala were conducted virtually, while face-to-face interviews were conducted and in Haryana and Chhattisgarh.ParticipantsStaff from 21 hospitals in three states (Haryana, Chhattisgarh and Kerala), including officials from State Health Agency (n=5) and NHA (n=3) were interviewed.ResultsThe findings highlight significant challenges in reporting cost data at the hospital level. These include a shortage of trained staff, leading to difficulties in collecting comprehensive and high-quality data. Additionally, the data collection process is resource-intensive and time-consuming, putting strain on limited capacity. Operational issues with transaction management system, such as speed, user-friendliness and frequent page expirations, also pose obstacles. Finally, current patient records data has gaps, in terms of quantity and quality, to be directly put to use for pricing.ConclusionAccurate cost data is vital for health policy decisions. Capacity building across healthcare levels is needed for precise cost collection. Integration into digital infrastructure is key to avoid burdening providers and ensure quality data capture.
Development of a core outcome set of clinical research on the integration of traditional Chinese and Western medicine for spinal metastases:a study protocol
Authors: Fang Guozheng , Yu Wenlong , Chen Dingbang , Ding Xing , Qiao Liang , Zhang Luosheng , Gao Xin , Yan Yinjie , Huang Quan , Ma Junming , Yin Mengchen 
Published: September 2024

BackgroundIn recent years, the incidence of spinal metastasis (SM) has been increasing steadily. In response to this serious public health problem, researchers have made progress by using the integration of traditional Chinese and Western medicine. However, considerable heterogeneity in the definition and measurement of outcomes across clinical research studies, along with the lack of uniform measurement standards for study data, makes it difficult for researchers to compare different treatments. Therefore, it is crucial to accurately evaluate clinical research on the integration of traditional Chinese and Western medicine for SM.MethodsThis study protocol outlines a comprehensive research programme based on the Core Outcome Set Standards Protocol Items. The study consists of four phases: a literature review, semistructured interviews, a two-round modified Delphi survey, a consensus meeting. Phase 1 involves a comprehensive literature review to extract outcomes used in current clinical studies of integrated traditional Chinese and Western medicine or Western medicine for the treatment of SM. A semistructured interview format will be used to survey patients and caregivers in phase 2 to collect suggestions from the patient perspective. Phase 3 involves a two-round modified Delphi survey to complete a prioritisation evaluation of outcomes to generate a candidate list for core outcome set (COS). Finally, phase 4 involves a face-to-face consensus meeting to review and establish the COS.Ethics and disseminationConducted in response to the current dilemma of SM, the study was endorsed by the Spine Oncology Group of the Orthopaedic Surgeons Branch of the Chinese Physicians’ Association. It will be developed and reported through a rigorous process, with the results of the study to be published in a peer-reviewed journal.Registration:COMET Registry: COMET 2938;https://www.comet-initiative.org/Studies/Details/2938.
Development of an interprofessional diagnostic toolkit to enhance outside walking gait-related participation of people after stroke in Germany: study protocol of an ongoing multi-methods study
Authors: Pott Claudia , Dreischulte Tobias , Koller Daniela , Fegl Marlene , Langemeyer Jürgen , Bauer Petra 
Published: September 2024

IntroductionPersons after stroke experience limitations in activities of daily living even in the chronic phase. Many patients who had a stroke report mobility limitations with loss of social roles such as reduced gait-related participation. International best-practice recommendations for patients who had a stroke include interprofessional diagnostics as a core element for goal setting and intervention planning to improve social participation. Interprofessional diagnostics has not yet been implemented in Germany.Methods and analysisThe aim is to develop an interprofessional diagnostic toolkit. This will be done in a multi-step process: first, an integrative review is conducted to synthesise the literature. Second, the experiences regarding diagnostics and walking outside is captured in focus groups with persons after stroke, relatives and health professionals. Third, a toolkit for the interprofessional diagnostic process of gait-related-participation will be developed based on the results of the previous steps in a future workshop. Fourth, the results of each work package will be integrated into the iterative development process for evaluation and implementation. All steps will be performed in accordance with the respective reporting guidelines.Ethics and disseminationThis study has been approved by the ethics committee at the Ludwig Maximilians University (LMU), Germany and is overseen by LMU-Medical Institutional Review Board. Written informed consent will be obtained from all participants. Results will be disseminated through knowledge exchange with stakeholders and in peer-reviewed journal publications, scientific conferences, formal and informal reports. Stakeholders, patients and providers will be involved in most steps of the development from the beginning, which will facilitate later implementation at a larger scale.Trial registration numberGerman Register Clinical Trials/Deutsches Register Klinischer Studien DRKS00032389.
Barriers and facilitators to implementing imaging-based diagnostic artificial intelligence-assisted decision-making software in hospitals in China: a qualitative study using the updated Consolidated Framework for Implementation Research
Authors: Liao Xiwen , Yao Chen , Jin Feifei , Zhang Jun , Liu Larry 
Published: September 2024

ObjectivesTo identify the barriers and facilitators to the successful implementation of imaging-based diagnostic artificial intelligence (AI)-assisted decision-making software in China, using the updated Consolidated Framework for Implementation Research (CFIR) as a theoretical basis to develop strategies that promote effective implementation.DesignThis qualitative study involved semistructured interviews with key stakeholders from both clinical settings and industry. Interview guide development, coding, analysis and reporting of findings were thoroughly informed by the updated CFIR.SettingFour healthcare institutions in Beijing and Shanghai and two vendors of AI-assisted decision-making software for lung nodules detection and diabetic retinopathy screening were selected based on purposive sampling.ParticipantsA total of 23 healthcare practitioners, 6 hospital informatics specialists, 4 hospital administrators and 7 vendors of the selected AI-assisted decision-making software were included in the study.ResultsWithin the 5 CFIR domains, 10 constructs were identified as barriers, 8 as facilitators and 3 as both barriers and facilitators. Major barriers included unsatisfactory clinical performance (Innovation); lack of collaborative network between primary and tertiary hospitals, lack of information security measures and certification (outer setting); suboptimal data quality, misalignment between software functions and goals of healthcare institutions (inner setting); unmet clinical needs (individuals). Key facilitators were strong empirical evidence of effectiveness, improved clinical efficiency (innovation); national guidelines related to AI, deployment of AI software in peer hospitals (outer setting); integration of AI software into existing hospital systems (inner setting) and involvement of clinicians (implementation process).ConclusionsThe study findings contributed to the ongoing exploration of AI integration in healthcare from the perspective of China, emphasising the need for a comprehensive approach considering both innovation-specific factors and the broader organisational and contextual dynamics. As China and other developing countries continue to advance in adopting AI technologies, the derived insights could further inform healthcare practitioners, industry stakeholders and policy-makers, guiding policies and practices that promote the successful implementation of imaging-based diagnostic AI-assisted decision-making software in healthcare for optimal patient care.