bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Accuracy of Rapid Antigen Detection Tests for Respiratory Syncytial Virus Infection: Systematic Review and Meta-analysis
Authors: Chartrand Caroline , Tremblay Nicolas , Renaud Christian , Papenburg Jesse 
Published: September 2015

ABSTRACT

Respiratory syncytial virus (RSV) rapid antigen detection tests (RADT) are extensively used in clinical laboratories. We performed a systematic review and meta-analysis to evaluate the accuracy of RADTs for diagnosis of RSV infection and to determine factors associated with accuracy estimates. We searched EMBASE and PubMed for diagnostic-accuracy studies of commercialized RSV RADTs. Studies reporting sensitivity and specificity data compared to a reference standard (reverse transcriptase PCR [RT-PCR], immunofluorescence, or viral culture) were considered. Two reviewers independently extracted data on study characteristics, diagnostic-accuracy estimates, and study quality. Accuracy estimates were pooled using bivariate random-effects regression models. Heterogeneity was investigated with prespecified subgroup analyses. Seventy-one articles met inclusion criteria. Overall, RSV RADT pooled sensitivity and specificity were 80% (95% confidence interval [CI], 76% to 83%) and 97% (95% CI, 96% to 98%), respectively. Positive- and negative-likelihood ratios were 25.5 (95% CI, 18.3 to 35.5) and 0.21 (95% CI, 0.18 to 0.24), respectively. Sensitivity was higher in children (81% [95% CI, 78%, 84%]) than in adults (29% [95% CI, 11% to 48%]). Because of this disparity, further subgroup analyses were restricted to pediatric data (63 studies). Test sensitivity was poorest using RT-PCR as a reference standard and highest using immunofluorescence (74% versus 88%;
P
< 0.001). Industry-sponsored studies reported significantly higher sensitivity (87% versus 78%;
P
= 0.01). Our results suggest that the poor sensitivity of RSV RADTs in adults may preclude their use in this population. Furthermore, industry-sponsored studies and those that did not use RT-PCR as a reference standard likely overestimated test sensitivity.
Molecular Testing for Plasmodium falciparum by Use of Serum or Plasma and Comparison with Microscopy and Rapid Diagnostic Testing in Febrile Nigerian Patients
Authors: Waggoner Jesse J. , Okangba Chika , Mohamed-Hadley Alisha , Lefterova Martina I. , Banaei Niaz , Oyibo Wellington , Pinsky Benjamin A. 
Published: September 2015

ABSTRACT

Plasmodium
nucleic acids have been detected in serum and plasma, but there is little published data describing the diagnostic performance of malaria nucleic acid amplification tests (NAATs) using these specimen types. Previously, our group described a multiplex NAAT for the detection of dengue virus,
Leptospira
, and
Plasmodium
species with a callout for
P. falciparum
(the DLM assay) that demonstrated sensitive detection of
P. falciparum
from plasma samples during initial evaluation. In this study, we evaluated the sensitivity and specificity of
P. falciparum
detection in febrile Nigerian patients using the DLM assay, microscopy, and a rapid diagnostic test (BinaxNOW Malaria). Assay performances were compared using a composite reference, which was considered positive if malaria was detected by two or more methods. Serum (
n
= 182) or plasma (
n
= 148) from 317 patients was tested; the average sample volume was 70 μl (range, 5 to 300 μl). The sensitivity and specificity of the DLM assay were 97.1% and 93.5%, respectively. The sensitivity of the malaria rapid diagnostic test (98.1%) was similar to that of the DLM assay, and both proved significantly more sensitive than microscopy (79%;
P
< 0.0001). When analysis was limited to samples with ≥75 μl of serum or plasma, the sensitivity of the DLM assay improved to 99% and specificity was 97.5%. For
P. falciparum
cases, cycle threshold values in the DLM assay correlated with the parasite density detected by microscopy (Spearman's rank correlation coefficient,
P
< 0.0001). In conclusion, malaria detection using the DLM assay on serum or plasma is more sensitive than and equal in specificity to microscopy in patients with
P. falciparum
malaria.
Usefulness of Adjunctive Fecal Calprotectin and Serum Procalcitonin in Individuals Positive for Clostridium difficile Toxin Gene by PCR Assay
Authors: Popiel Kristin Y. , Gheorghe Romina , Eastmond Jennifer , Miller Mark A. 
Published: September 2015

ABSTRACT

In 54/64 subjects with nosocomial diarrhea, fecal calprotectin levels correlated with the results of stool samples tested for
Clostridium difficile
toxin gene by PCR. Fecal calprotectin levels can be used as an adjunctive measure to PCR to support the diagnosis of
C. difficile
infection.
Virus-Like Particle Vaccine Containing the F Protein of Respiratory Syncytial Virus Confers Protection without Pulmonary Disease by Modulating Specific Subsets of Dendritic Cells and Effector T Cells
Authors: Kim Ki-Hye , Lee Young-Tae , Hwang Hye Suk , Kwon Young-Man , Kim Min-Chul , Ko Eun-Ju , Lee Jong Seok , Lee Youri , Kang Sang-Moo 
Published: September 2015

ABSTRACT

There is no licensed vaccine against respiratory syncytial virus (RSV) since the failure of formalin-inactivated RSV (FI-RSV) due to its vaccine-enhanced disease. We investigated immune correlates conferring protection without causing disease after intranasal immunization with virus-like particle vaccine containing the RSV fusion protein (F VLP) in comparison to FI-RSV and live RSV. Upon RSV challenge, FI-RSV immune mice showed severe weight loss, eosinophilia, and histopathology, and RSV reinfection also caused substantial RSV disease despite their viral clearance. In contrast, F VLP immune mice showed least weight loss and no sign of histopathology and eosinophilia. High levels of interleukin-4-positive (IL-4
+
) and tumor necrosis factor alpha-positive (TNF-α
+
) CD4
+
T cells were found in FI-RSV immune mice, whereas gamma interferon-positive (IFN-γ
+
) and TNF-α
+
CD4
+
T cells were predominantly detected in live RSV-infected mice. More importantly, in contrast to FI-RSV and live RSV that induced higher levels of CD11b
+
dendritic cells, F VLP immunization induced CD8α
+
and CD103
+
dendritic cells, as well as F-specific IFN-γ
+
and TNF-α
+
CD8
+
T cells. These results suggest that F VLP can induce protection without causing pulmonary RSV disease by inducing RSV neutralizing antibodies, as well as modulating specific subsets of dendritic cells and CD8 T cell immunity.

IMPORTANCE
It has been a difficult challenge to develop an effective and safe vaccine against respiratory syncytial virus (RSV), a leading cause of respiratory disease. Immune correlates conferring protection but preventing vaccine-enhanced disease remain poorly understood. RSV F virus-like particle (VLP) would be an efficient vaccine platform conferring protection. Here, we investigated the protective immune correlates without causing disease after intranasal immunization with RSV F VLP in comparison to FI-RSV and live RSV. In addition to inducing RSV neutralizing antibodies responsible for clearing lung viral loads, we show that modulation of specific subsets of dendritic cells and CD8 T cells producing T helper type 1 cytokines are important immune correlates conferring protection but not causing vaccine-enhanced disease.
Prevalence and sociodemographic risk factors of chlamydia, gonorrhoea and syphilis: a national multicentre STI survey in New Caledonia, 2012
Authors: Corsenac Philippe , Noël Martine , Rouchon Bernard , Hoy Damian , Roth Adam 
Published: September 2015

ObjectivesTo estimate prevalence and identify sociodemographic risk factors forNeisseria gonorrhoeae(NG),Chlamydia trachomatis(CT) andTreponema palliduminfections in New Caledonia.MethodA national cross-sectional survey was undertaken using a three-stage random sampling of general practice surgeries and public dispensaries. Participants were included through opportunistic screening and using a systematic step for selection. The study sample was weighted to the general population aged 18–49 years. Prevalence and risk factors were calculated by logistic regression.ResultsCT was the most common sexually transmitted infection, with a prevalence of 9% (95% CI 6.6% to %11.4), followed by NG 3.5% (95% CI 1.9% to 5.1%), previous or latent syphilis 3% (95% CI 1.7% to 4.3%), NG and CT co-infection 2.1% (95% CI 0.8% to 3.3%) and active syphilis 0.4% (95% CI 0.0% to 0.9%). Being from a young age group (18–25 years), being single, having a low level of education and province of residence were all associated with higher prevalence of all three STIs. Being of Melanesian origin was associated with higher prevalence of both CT and NG. There was a significant interaction between ethnic group and province of residence for prevalence of CT.Female gender was associated with higher prevalence of CT.ConclusionsThe prevalence of CT was similar to estimates from other healthcare-based surveys from the Pacific, but higher for NG and lower for active syphilis infection. All sexually transmitted infections estimates were much higher than those found in population-based surveys from Europe and the USA. The sociodemographic risk factors identified in this study will help guide targeted prevention and control strategies in New Caledonia.
Reasons for non-participation in the Northern Ireland Bowel Cancer Screening Programme: a qualitative study
Authors: Bradley Declan T , Treanor Charlene , McMullan Colin , Owen Tracy , Graham Adele , Anderson Diane 
Published: September 2015

ObjectivesTo identify the reasons why some people do not participate in bowel cancer screening so that steps can be taken to improve informed decision-making.DesignQualitative study, using focus groups with thematic analysis of data to identify, analyse and report patterns. Transcripts were repeatedly read and inductively coded using a phenomenological perspective, and organised into key themes.SettingBelfast and Armagh, two areas of Northern Ireland with relatively low uptake of bowel cancer screening.ParticipantsTen women and 18 men in three single-gender focus groups (two male and one female), each with 9–10 participants. Study participants were recruited by convenience sampling from the general public and were eligible for, but had not taken part in, the Northern Ireland Bowel Cancer Screening Programme.ResultsKey themes identified were fear of cancer; the test procedure; social norms; past experience of cancer and screening; lack of knowledge or understanding about bowel cancer screening; and resulting behaviour towards the test. Fear about receiving bad news and reluctance to conduct the test themselves were reactions that participants seemed willing to overcome after taking part in open discussion about the test.ConclusionsWe identified barriers to participation in bowel cancer screening and used these insights to develop new materials to support delivery of the programme. Some of the issues raised have been identified in other UK settings, suggesting that knowledge about barriers, and strategies to improve uptake, may be generalisable.
Eliciting preferences for waterpipe tobacco smoking using a discrete choice experiment: implications for product regulation
Authors: Salloum Ramzi G , Maziak Wasim , Hammond David , Nakkash Rima , Islam Farahnaz , Cheng Xi , Thrasher James F 
Published: September 2015

ObjectivesWaterpipe smoking is highly prevalent among university students, and has been increasing in popularity despite mounting evidence showing it is harmful to health. The aim of this study was to measure preferences for waterpipe smoking and determine which product characteristics are most important to smokers.SettingA large university in the Southeastern USA.ParticipantsAdult waterpipe smokers attending the university (N=367).DesignParticipants completed an Internet-based discrete choice experiment to reveal their preferences for, and trade-offs between, the attributes of hypothetical waterpipe smoking sessions. Participants were presented with waterpipe lounge menus, each with three fruit-flavoured options and one tobacco flavoured option, in addition to an opt out option. Nicotine content and price were provided for each choice. Participants were randomised to either receive menus with a text-only health-warning message or no message.Outcome measuresMultinomial and nested logit models were used to estimate the impact on consumer choice of attributes and between-subject assignment of health warnings respectively.ResultsOn average, participants preferred fruit-flavoured varieties to tobacco flavour. They were averse to options labelled with higher nicotine content. Females and non-smokers of cigarettes were more likely than their counterparts to prefer flavoured and nicotine-free varieties. Participants exposed to a health warning were more likely to opt out.ConclusionsFruit-flavoured tobacco and lower nicotine content labels, two strategies widely used by the industry, increase the demand for waterpipe smoking among young adults. Waterpipe-specific regulation should limit the availability of flavoured waterpipe tobacco and require accurate labelling of constituents. Waterpipe-specific tobacco control regulation, along with research to inform policy, is required to curb this emerging public health threat.
Implementation research in emergency medicine: a systematic scoping review
Authors: Tavender Emma J , Bosch Marije , Fiander Michelle , Knott Jonathan C , Gruen Russell L , O'Connor Denise 
Published: September 2015

IntroductionImplementation research aims to increase the uptake of research findings into clinical practice to improve the quality of healthcare. This scoping systematic study aims to assess the volume and scope of implementation research in emergency medicine (EM) to obtain an overview and inform future implementation research.MethodsStudies were identified by searching electronic databases and reference lists of included studies for the years 2002, 2007 and 2012. Titles/abstracts were screened, full papers checked and data extracted by one author, with a random sample checked by a second author.ResultsA total of 3581 citations were identified with 197 eligible papers included. The number of papers significantly increased over time from 26 in 2002 to 77 in 2007 and 94 in 2012 (p<0.05). Eighty-two (42%) focused on identifying evidence–practice gaps, 77 (39%) evaluated the effectiveness of implementation interventions and 38 (19%) explored barriers and enablers to change. Only two papers explicitly stated that theory was used. Five of the 77 effectiveness studies used a randomised design and few provided sufficient detail about the intervention undergoing evaluation.ConclusionsAlthough there was a significant increase in the number of implementation research papers, most studies focused on identifying evidence–practice gaps or used weak study designs to evaluate the effects of implementation interventions. Recommendations for improving implementation research in EM include identifying barriers and enablers to implementation, using theory in areas where proven important gaps exist, improving the reporting of the content of interventions and using rigorous study designs to evaluate their effectiveness.
Structural, magnetic behaviors and temperature-dependent Raman scattering spectra of Y and Zr codoped BiFeO3 ceramics
Authors: Zhang Cheng , Xie Dan , Xu Jianlong , Sun Yilin , Zang Yongyuan , Zhang Xiaowen , Gao Xingsen 
Published: September 2015

Multiferroic [Formula: see text] (BFO) and Y, Zr codoped BFO [Formula: see text] ceramics were prepared and the influence of codoping on the crystal structure and magnetic properties were investigated in this work. Confirmed by the evolution of X-ray diffraction and Raman modes, the codoping has changed the crystal structure from rhombohedral to tetragonal in bulk BFO ceramics. The enhancement of magnetic behaviors is demonstrated by the damage of space-modulated spiral spin structure, and it can be attributed to the crystal structure change and size effects. Meanwhile, Raman spectra from 300 to 800 K demonstrates that lower frequency phonon modes show rapid softening near the Neel temperature.
Dabigatran use in elderly patients with atrial fibrillation
Authors: Avgil-Tsadok Meytal , Jackevicius Cynthia , Essebag Vidal , Eisenberg Mark J. , Rahme Elham , Behlouli Hassan , Pilote Louise 
Published: September 2015

SummaryIn elderly patients (≥75 years), evidence of dabigatran efficacy is lacking and increased vigilance is warranted. We aimed to assess dabigatran effectiveness and safety in elderly patients in real-world practice. We conducted a population-based study using administrative databases, in Quebec (1999–2013). Dabigatran users (110/150 mg) were compared with matched warfarin users with regard to stroke and bleeding events. Age was categorised into < 75 or ≥ 75 years. Propensity score adjusted models were used. The cohort consisted of 15,918 dabigatran users and 47,192 matched warfarin users, with 67.3 % being elderly patients. The elderly predominantly used the lower dose (80.1 %) while younger patients mainly used the higher dose (80.0 %). In multivariable analyses adjusted for propensity score, the risk of stroke in elderly patients using dabigatran, was no different than the risk in warfarin users (HR 1.05, 95 % CI: 0.93, 1.19) regardless of dabigatran dose. However, dabigatran was associated with lower rates of intracranial haemorrhage (HR 0.60, 95 % CI: 0.47–0.76) and higher rates of gastrointestinal bleeding (HR 1.30 95 % CI: 1.14–1.50) when compared to warfarin. Based on real-life experience, dabigatran can offer an alternative to warfarin in elderly patients, with fewer intracranial bleeding events. However, caution is warranted for gastrointestinal bleeding.
Histidine-rich glycoprotein binds DNA and RNA and attenuates their capacity to activate the intrinsic coagulation pathway
Authors: Vu Trang T. , Leslie Beverly A. , Stafford Alan R. , Zhou Ji , Fredenburgh James C. , Weitz Jeffrey I. 
Published: September 2015

SummaryWhen triggered by factor (F) XII and nucleic acids, we showed that thrombosis in HRG-deficient mice is accelerated compared with that in wild-type mice. In this study, we set out to identify the mechanisms by which nucleic acids promote contact activation, and to determine whether HRG attenuates their effects. DNA or RNA addition to human plasma enhances thrombin generation via the intrinsic pathway and shortens the clotting time. Their effect on the clotting time is seven- to 14-fold greater in HRG-deficient plasma than in control plasma. Investigations into the mechanisms of activation reveal that nucleic acids a) promote FXII activation in the presence of prekallikrein- and high molecular weight kininogen (HK), and b) enhance thrombin-mediated FXI activation by 10– to 12-fold. Surface plasmon resonance studies show that DNA and RNA bind FXII, FXIIa, HK, FXI, FXIa and thrombin with high affinity. HRG attenuates DNA- and RNA-mediated FXII activation, and FXI activation by FXIIa or by thrombin, suggesting that HRG down regulates the capacity of DNA and RNA to activate the intrinsic pathway. Therefore, HRG attenuates the procoagulant activity of nucleic acids at multiple levels.
Pulmonary collapse alone provides effective de-airing in cardiac surgery: a prospective randomized study
Authors: Landenhed Maya , Cunha-Goncalves Doris , Al-Rashidi Faleh , Pierre Leif , Höglund Peter , Koul Bansi 
Published: September 2015

Objectives: We previously described and showed that the method for cardiac de-airing involving: (1) bilateral, induced pulmonary collapse by opening both pleurae and disconnecting the ventilator before cardioplegic arrest and (2) gradual pulmonary perfusion and ventilation after cardioplegic arrest is superior to conventional de-airing methods, including carbon dioxide insufflation of the open mediastinum. This study investigated whether one or both components of this method are responsible for the effective de-airing of the heart. Methods: Twenty patients scheduled for open, left heart surgery were randomized to two de-airing techniques: (1) open pleurae, collapsed lungs and conventional pulmonary perfusion and ventilation; and (2) intact pleurae, expanded lungs and gradual pulmonary perfusion and ventilation. Results: The number of cerebral microemboli measured by transcranial Doppler sonography was lower in patients with open pleurae 9 (6-36) vs 65 (36-210), p=0.004. Residual intra-cardiac air grade I or higher as monitored by transesophageal echocardiography 4-6 minutes after weaning from cardiopulmonary bypass was seen in few patients with open pleurae 0 (0%) vs 7 (70%), p=0.002. Conclusions: Bilateral, induced pulmonary collapse alone is the key factor for quick and effective de-airing of the heart. Gradual pulmonary perfusion and ventilation, on the other hand, appears to be less important.
Development of a model for integrated care at the end of life in advanced dementia: A whole systems UK-wide approach
Authors: Jones Louise , Candy Bridget , Davis Sarah , Elliott Margaret , Gola Anna , Harrington Jane , Kupeli Nuriye , Lord Kathryn , Moore Kirsten , Scott Sharon , Vickerstaff Victoria , Omar Rumana Z , King Michael , Leavey Gerard , Nazareth Irwin , Sampson Elizabeth L 
Published: September 2015

Background: The prevalence of dementia is rising worldwide and many people will die with the disease. Symptoms towards the end of life may be inadequately managed and informal and professional carers poorly supported. There are few evidence-based interventions to improve end-of-life care in advanced dementia. Aim: To develop an integrated, whole systems, evidence-based intervention that is pragmatic and feasible to improve end-of-life care for people with advanced dementia and support those close to them. Design: A realist-based approach in which qualitative and quantitative data assisted the development of statements. These were incorporated into the RAND/UCLA appropriateness method to achieve consensus on intervention components. Components were mapped to underlying theory of whole systems change and the intervention described in a detailed manual. Setting/participants: Data were collected from people with dementia, carers and health and social care professionals in England, from expert opinion and existing literature. Professional stakeholders in all four countries of the United Kingdom contributed to the RAND/UCLA appropriateness method process. Results: A total of 29 statements were agreed and mapped to individual, group, organisational and economic/political levels of healthcare systems. The resulting main intervention components are as follows: (1) influencing local service organisation through facilitation of integrated multi-disciplinary care, (2) providing training and support for formal and informal carers and (3) influencing local healthcare commissioning and priorities of service providers. Conclusion: Use of in-depth data, consensus methods and theoretical understanding of the intervention components produced an evidence-based intervention for further testing in end-of-life care in advanced dementia.