bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combat Exposure and Risk for Suicidal Thoughts and Behaviors Among Military Personnel and Veterans: A Systematic Review and Meta‐Analysis
Authors: Bryan Craig J. , Griffith James E. , Pace Brian T. , Hinkson Kent , Bryan AnnaBelle O. , Clemans Tracy A. , Imel Zac E. 
Published: April 2015

Due to seemingly mixed empirical results, questions persist about the possible role of deployments and combat exposure. We conducted a narrative review and meta‐analysis of 22 published studies to integrate findings regarding the relationship of deployment‐related predictors (i.e., deployment, deployment to a combat zone, combat experience, and exposure to specific combat events) with suicide‐related outcomes (i.e., suicide ideation, attempt, and death). Across all predictors and outcomes, the combined effect was small and positive, r = .08 [0.04, 0.13], and marked by significant heterogeneity, I2 = 99.9%, Q(21)=4880.16, p < .0001, corresponding to a 25% increased risk for suicide‐related outcomes among those who have deployed. Studies examining the relationship between exposure to killing and atrocities (k = 5) showed the largest combined effect, r = .12 [0.08, 0.17], and less heterogeneity, I2 = 84.4%, Q(4)=34.96, p < .0001, corresponding to a 43% increased risk for suicide‐related outcomes among those exposed to killing or atrocity. Implications for theory, research, and clinical practice are discussed.
Comparative effectiveness of plasma prepared with amotosalen‐UVA pathogen inactivation and conventional plasma for support of liver transplantation
Authors: Cinqualbre Jacques , Kientz Daniel , Remy Emilie , Huang Norman , Corash Laurence , Cazenave Jean Pierre 
Published: April 2015

BACKGROUNDLiver transplant may require large‐volume plasma transfusion with increased risk of transfusion‐transmitted infection (TTI). Pathogen inactivation of plasma with amotosalen‐UVA offers the potential to mitigate TTI risk.STUDY DESIGN AND METHODSA retrospective cohort design was used to compare the therapeutic efficacy and key safety outcomes for liver transplants supported with quarantine plasma (Q‐FFP [reference]) or amotosalen‐UVA plasma (IBS plasma [test]). The outcomes evaluated were volume of plasma, the numbers of red blood cell (RBC) components, and the total dose of platelets (PLTs) transfused during and 7 days after transplant. The safety outcomes were acute hepatic artery thrombosis (HAT) and mortality.RESULTSTransplantation and transfusion records for 212 Q‐FFP transplants and 215 IBS plasma transplants were reviewed. Not all transplants required plasma; 161 received Q‐FFP and 174 received IBS plasma. Among the transplants that required plasma, there were significant differences in median values between cohorts for delay to transplantation (p = 0.002), model end‐stage liver disease score (p < 0.001), pretransplant hematocrit (p = 0.006), and graft cold perfusion time (p = 0.033). The median volumes of plasma transfused were not different for test and reference (2.160 L vs. 1.969 L, p = 0.292). Transplants in the test cohort required a mean of 3.7% more RBC components (p = 0.767) and on average a 16.5% increase in total PLT dose (p = 0.518). No significant differences were observed for the frequency of acute HAT or mortality.CONCLUSIONIn this retrospective study, IBS plasma provided therapeutic support of liver transplant not different from Q‐FFP.
Evaluation of a Real-Time Reverse Transcription-PCR Assay for Detection of Enterovirus D68 in Clinical Samples from an Outbreak in New York State in 2014
Authors: Zhuge Jian , Vail Eric , Bush Jeffrey L. , Singelakis Lauren , Huang Weihua , Nolan Sheila M. , Haas Janet P. , Engel Helen , Della Posta Millicent , Yoon Esther C. , Fallon John T. , Wang Guiqing 
Published: April 2015

ABSTRACT
An outbreak of severe respiratory illness associated with enterovirus D68 (EV-D68) infection was reported in mid-August 2014 in the United States. In this study, we evaluated the diagnostic utility of an EV-D68-specific real-time reverse transcription-PCR (rRT-PCR) that was recently developed by the Centers for Disease Control and Prevention in clinical samples. Nasopharyngeal (NP) swab specimens from patients in a recent outbreak of respiratory illness in the lower Hudson Valley, New York State, were collected and examined for the presence of human rhinovirus or enterovirus using the FilmArray Respiratory Panel (RP) assay. Samples positive by RP were assessed using EV-D68 rRT-PCR, and the data were compared to results from sequencing analysis of partial VP1 and 5′ untranslated region (5′-UTR) sequences of the EV genome. A total of 285 RP-positive NP specimens (260 from the 2014 outbreak and 25 from 2013) were analyzed by rRT-PCR; EV-D68 was detected in 74 of 285 (26.0%) specimens examined. Data for comparisons between rRT-PCR and sequencing analysis were obtained from 194 NP specimens. EV-D68 detection was confirmed by sequencing analysis in 71 of 74 positive and in 1 of 120 randomly selected negative specimens by rRT-PCR. The EV-D68 rRT-PCR showed diagnostic sensitivity and specificity of 98.6% and 97.5%, respectively. Our data suggest that the EV-D68 rRT-PCR is a reliable assay for detection of EV-D68 in clinical samples and has a potential to be used as a tool for rapid diagnosis and outbreak investigation of EV-D68-associated infections in clinical and public health laboratories.
Determination of a Viral Load Threshold To Distinguish Symptomatic versus Asymptomatic Rotavirus Infection in a High-Disease-Burden African Population
Authors: Bennett A. , Bar-Zeev N. , Jere K. C. , Tate J. E. , Parashar U. D. , Nakagomi O. , Heyderman R. S. , French N. , Iturriza-Gomara M. , Cunliffe N. A. 
Published: April 2015

ABSTRACT
We evaluated quantitative real-time PCR to establish the diagnosis of rotavirus gastroenteritis in a high-disease-burden population in Malawi using enzyme immunoassay as the gold standard diagnostic test. In 146 children with acute gastroenteritis and 65 asymptomatic children, we defined a cutoff point in the threshold cycle value (26.7) that predicts rotavirus-attributable gastroenteritis in this population. These data will inform the evaluation of direct and indirect rotavirus vaccine effects in Africa.
Creation of Matrix Protein Gene Variants of Two Serotypes of Vesicular Stomatitis Virus as Prime-Boost Vaccine Vectors
Authors: Kim Gyoung Nyoun , Wu Kunyu , Hong Jiho Patrick , Awamleh Zain , Kang C. Yong 
Published: April 2015

ABSTRACT

To take advantage of live recombinant vesicular stomatitis viruses (rVSVs) as vaccine vectors for their high yield and for their induction of strong and long-lasting immune responses, it is necessary to make live vaccine vectors safe for use without losing their immunogenicity. We have generated safer and highly efficient recombinant VSV vaccine vectors by combining the M51R mutation in the
M
gene of serotype VSV-Indiana (VSV
Ind
) with a temperature-sensitive mutation (
ts
O23) of the VSV
Ind
Orsay strain. In addition, we have generated two new serotype VSV-New Jersey (VSV
NJ
) vaccine vectors by combining M48R and M51R mutations with G22E and L110F mutations in the
M
gene, rVSV
NJ
(G22E M48R M51R) [rVSV
NJ
(GMM)] and VSV
NJ
(G22E M48R M51R L110F) [rVSV
NJ
(GMML)]. The combined mutations G21E, M51R, and L111F in the M protein of VSV
Ind
significantly reduced the burst size of the virus by up to 10,000-fold at 37°C without affecting the level of protein expression. BHK
21
cells and SH-SY5Y human neuroblastoma cells infected with rVSV
Ind
(GML), rVSV
NJ
(GMM), and rVSV
NJ
(GMML) showed significantly reduced cytopathic effects
in vitro
at 37°C, and mice injected with 1 million infectious virus particles of these mutants into the brain showed no neurological dysfunctions or any other adverse effects. In order to increase the stability of the temperature-sensitive mutant, we have replaced the phenylalanine with alanine. This will change all three nucleotides from UUG (leucine) to GCA (alanine). The resulting L111A mutant showed the temperature-sensitive phenotype of rVSV
Ind
(GML) and increased stability. Twenty consecutive passages of rVSV
Ind
(GML) with an L111A mutation did not convert back to leucine (UUG) at position 111 in the M protein gene.

IMPORTANCE
Recombinant vesicular stomatitis viruses as live vaccine vectors are very effective in expressing foreign genes and inducing adaptive T cell and B cell immune responses. As with any other live viruses in humans or animals, the use of live rVSVs as vaccine vectors demands the utmost safety. Our strategy to attenuate rVSV
Ind
by utilizing a temperature-sensitive assembly-defective mutation of L111A and combining it with an M51R mutation in the M protein of rVSV
Ind
significantly reduced the pathogenicity of the virus while maintaining highly effective virus production. We believe our new temperature-sensitive
M
gene mutant of rVSV
Ind
(GML) and
M
gene mutants of rVSV
NJ
(GMM) and rVSV
NJ
(GMML) add excellent vaccine vectors to the pool of live viral vectors.
Zinc Binding Activity of Human Metapneumovirus M2-1 Protein Is Indispensable for Viral Replication and Pathogenesis
In Vivo
Authors: Cai Hui , Zhang Yu , Ma Yuanmei , Sun Jing , Liang Xueya , Li Jianrong 
Published: April 2015

ABSTRACT

Human metapneumovirus (hMPV) is a member of the
Pneumovirinae
subfamily in the
Paramyxoviridae
family that causes respiratory tract infections in humans. Unlike members of the
Paramyxovirinae
subfamily, the polymerase complex of pneumoviruses requires an additional cofactor, the M2-1 protein, which functions as a transcriptional antitermination factor. The M2-1 protein was found to incorporate zinc ions, although the specific role(s) of the zinc binding activity in viral replication and pathogenesis remains unknown. In this study, we found that the third cysteine (C21) and the last histidine (H25) in the zinc binding motif (CCCH) of hMPV M2-1 were essential for zinc binding activity, whereas the first two cysteines (C7 and C15) play only minor or redundant roles in zinc binding. In addition, the zinc binding motif is essential for the oligomerization of M2-1. Subsequently, recombinant hMPVs (rhMPVs) carrying mutations in the zinc binding motif were recovered. Interestingly, rhMPV-C21S and -H25L mutants, which lacked zinc binding activity, had delayed replication in cell culture and were highly attenuated in cotton rats. In contrast, rhMPV-C7S and -C15S strains, which retained 60% of the zinc binding activity, replicated as efficiently as rhMPV in cotton rats. Importantly, rhMPVs that lacked zinc binding activity triggered high levels of neutralizing antibody and provided complete protection against challenge with rhMPV. Taken together, these results demonstrate that zinc binding activity is indispensable for viral replication and pathogenesis
in vivo
. These results also suggest that inhibition of zinc binding activity may serve as a novel approach to rationally attenuate hMPV and perhaps other pneumoviruses for vaccine purposes.

IMPORTANCE
The pneumoviruses include many important human and animal pathogens, such as human respiratory syncytial virus (hRSV), hMPV, bovine RSV, and avian metapneumovirus (aMPV). Among these viruses, hRSV and hMPV are the leading causes of acute respiratory tract infection in infants and children. Despite major efforts, there is no antiviral or vaccine to combat these diseases. All known pneumoviruses encode a zinc binding protein, M2-1, which is a transcriptional antitermination factor. In this work, we found that the zinc binding activity of M2-1 is essential for virus replication and pathogenesis
in vivo
. Recombinant hMPVs that lacked zinc binding activity were not only defective in replication in the upper and lower respiratory tract but also triggered a strong protective immunity in cotton rats. Thus, inhibition of M2-1 zinc binding activity can lead to the development of novel, live attenuated vaccines, as well as antiviral drugs for pneumoviruses.
Delayed diagnosis of angiosarcoma of the spleen: clinically presenting as recurrent haemoperitoneum following embolisation
Authors: Kornmann Verena , van Rijn Philip , Mulder Dries , Reijnders Koen 
Published: April 2015

Angiosarcoma is a highly aggressive and extremely rare neoplasm of the spleen, with a limited number of reported cases worldwide.We report a case of a 69-year-old man who presented with progressive symptoms of fatigue, abdominal and back pain, anaemia and haemoperitoneum 1 year following embolisation of the spleen for splenic rupture. Additional imaging and colonoscopy with biopsy revealed intra-abdominal fluid and a colonic adenocarcinoma. Diagnostic laparoscopy demonstrated a haemoperitoneum and colon carcinoma, after which splenectomy via laparotomy was performed. Pathology report revealed an angiosarcoma of the spleen with peritoneal tumour deposits.Rupturing of a spleen may be due to an underlying disease. Therefore, the differential diagnosis of splenic rupture should include the possibility of a splenic tumour. The definitive diagnosis and treatment of a splenic angiosarcoma may require splenectomy, although prognosis is poor.
Clinical decision-making of cardiologists regarding admission and treatment of patients with suspected unstable angina or non-ST-elevation myocardial infarction: protocol of a clinical vignette study
Authors: Engel Josien , van der Wulp Ineke , Poldervaart Judith M , Reitsma Johannes B , de Bruijne Martine C , Wagner Cordula 
Published: April 2015

IntroductionCardiologists face the difficult task of rapidly distinguishing cardiac-related chest pain from other conditions, and to thoroughly consider whether invasive diagnostic procedures or treatments are indicated. The use of cardiac risk-scoring instruments has been recommended in international cardiac guidelines. However, it is unknown to what degree cardiac risk scores and other clinical information influence cardiologists’ decision-making. This paper describes the development of a binary choice experiment using realistic descriptions of clinical cases. The study aims to determine the importance cardiologists put on different types of clinical information, including cardiac risk scores, when deciding on the management of patients with suspected unstable angina or non-ST-elevation myocardial infarction.Methods and analysisCardiologists were asked, in a nationwide survey, to weigh different clinical factors in decision-making regarding patient admission and treatment using realistic descriptions of patients in which specific characteristics are varied in a systematic way (eg, web-based clinical vignettes). These vignettes represent patients with suspected unstable angina or non-ST-elevation myocardial infarction. Associations between several clinical characteristics, with cardiologists’ management decisions, will be analysed using generalised linear mixed models.Ethics and disseminationThe study has received ethics approval and informed consent will be obtained from all participating cardiologists. The results of the study will provide insight into the relative importance of cardiac risk scores and other clinical information in cardiac decision-making. Further, the results indicate cardiologists’ adherence to the European Society of Cardiology guideline recommendations. In addition, the detailed description of the method of vignette development applied in this study could assist other researchers or clinicians in creating future choice experiments.
Respondent-driven sampling to assess mental health outcomes, stigma and acceptance among women raising children born from sexual violence-related pregnancies in eastern Democratic Republic of Congo
Authors: Scott Jennifer , Rouhani Shada , Greiner Ashley , Albutt Katherine , Kuwert Philipp , Hacker Michele R , VanRooyen Michael , Bartels Susan 
Published: April 2015

ObjectivesAssess mental health outcomes among women raising children from sexual violence-related pregnancies (SVRPs) in eastern Democratic Republic of Congo and stigma toward and acceptance of women and their children.DesignParticipants were recruited using respondent-driven sampling.SettingBukavu, Democratic Republic of Congo in 2012.Participants757 adult women raising children from SVRPs were interviewed. A woman aged 18 and older was eligible for the study if she self-identified as a sexual violence survivor since the start of the conflict (∼1996), conceived an SVRP, delivered a liveborn child and was currently raising the child. A woman was ineligible for the study if the SVRP ended with a spontaneous abortion or fetal demise or the child was not currently living or in the care of the biological mother.InterventionTrained female Congolese interviewers verbally administered a quantitative survey after obtaining verbal informed consent.Outcome measuresSymptom criteria for major depressive disorder, post-traumatic stress disorder, anxiety and suicidality were assessed, as well as stigma toward the woman and her child. Acceptance of the woman and child from the spouse, family and community were analysed.Results48.6% met symptom criteria for major depressive disorder, 57.9% for post-traumatic stress disorder, 43.3% for anxiety and 34.2% reported suicidality. Women who reported stigma from the community (38.4%) or who reported stigma toward the child from the spouse (42.9%), family (31.8%) or community (38.1%) were significantly more likely to meet symptom criteria for most mental health disorders. Although not statistically significant, participants who reported acceptance and acceptance of their children from the spouse, family and community were less likely to meet symptom criteria.ConclusionsWomen raising children from SVRPs experience symptoms of mental health disorders. Programming addressing stigma and acceptance following sexual violence may improve mental health outcomes in this population.
A cost-benefit analysis of twice-daily consultant ward rounds and clinical input on investigation and pharmacy costs in a major teaching hospital in the UK
Authors: Ahmad Aftab , Weston Philip J , Ahmad Mahin , Sharma Dushyant , Purewal Tejpal 
Published: April 2015

ObjectivesMisuse of investigations, medications and hospital beds is costing the National Health Service (NHS) billions of pounds with little evidence that approaches centred on reducing overuse are sustainable. Our previous study demonstrated that twice-daily consultant ward rounds reduce inpatient length of stay and suggested a reduction in overuse of investigations and medications. This study aims to assess the impact of daily consultant ward rounds on the use of investigations and medications and estimate the potential cost benefit.SettingsThe study was performed on two medical wards in a major city university teaching hospital in Liverpool, UK, receiving acute admissions from medical assessment and emergency departments.Participants and interventionThe total number of patients admitted, investigations performed and pharmacy costs incurred were collected for 2 years before and following a change in the working practice of consultants from twice-weekly to twice-daily consultant ward rounds on the two medical wards.Outcome measuresWe performed a cost-benefit analysis to assess the net amount of money saved by reducing inappropriate investigations and pharmacy drug use following the intervention.ResultsDespite a 70% increase in patient throughput (p<0.01) the investigations and pharmacy, costs per patient reduced by 50% over a 12-month period (p<0.01) and were sustained for the next 12 months. The reduction in investigations and medication use did not have any effect on the readmission or mortality rate (p=NS), whereas, the length of stay was almost halved (p<0.01). Daily senior clinician input resulted in a net cost saving of £336 528 per year following the intervention.ConclusionsDaily consultant input has a significant impact on reducing the inappropriate use of investigations and pharmacy costs saving the NHS more than £650K on the two wards over a 2-year period.
CareTrack Kids—part 3. Adverse events in children's healthcare in Australia: study protocol for a retrospective medical record review
Authors: Hibbert Peter D , Hallahan Andrew R , Muething Stephen E , Lachman Peter , Hooper Tamara D , Wiles Louise K , Jaffe Adam , White Les , Wheaton Gavin R , Runciman William B , Dalton Sarah , Williams Helena M , Braithwaite Jeffrey 
Published: April 2015

IntroductionA high-quality health system should deliver care that is free from harm. Few large-scale studies of adverse events have been undertaken in children's healthcare internationally, and none in Australia. The aim of this study is to measure the frequency and types of adverse events encountered in Australian paediatric care in a range of healthcare settings.Methods and analysisA form of retrospective medical record review, the Institute of Healthcare Improvement's Global Trigger Tool, will be modified to collect data. Records of children aged <16 years managed during 2012 and 2013 will be reviewed. We aim to review 6000–8000 records from a sample of healthcare practices (hospitals, general practices and specialists).Ethics and disseminationHuman Research Ethics Committee approvals have been received from the Sydney Children's Hospital Network, Children's Health Queensland Hospital and Health Service, and the Women's and Children's Hospital Network in South Australia. An application is under review with the Royal Australian College of General Practitioners. The authors will submit the results of the study to relevant journals and undertake national and international oral presentations to researchers, clinicians and policymakers.
The PRONE score: an algorithm for predicting doctors’ risks of formal patient complaints using routinely collected administrative data
Authors: Spittal Matthew J , Bismark Marie M , Studdert David M 
Published: April 2015

BackgroundMedicolegal agencies—such as malpractice insurers, medical boards and complaints bodies—are mostly passive regulators; they react to episodes of substandard care, rather than intervening to prevent them. At least part of the explanation for this reactive role lies in the widely recognised difficulty of making robust predictions about medicolegal risk at the individual clinician level. We aimed to develop a simple, reliable scoring system for predicting Australian doctors’ risks of becoming the subject of repeated patient complaints.MethodsUsing routinely collected administrative data, we constructed a national sample of 13 849 formal complaints against 8424 doctors. The complaints were lodged by patients with state health service commissions in Australia over a 12-year period. We used multivariate logistic regression analysis to identify predictors of subsequent complaints, defined as another complaint occurring within 2 years of an index complaint. Model estimates were then used to derive a simple predictive algorithm, designed for application at the doctor level.ResultsThe PRONE (Predicted Risk Of New Event) score is a 22-point scoring system that indicates a doctor's future complaint risk based on four variables: a doctor's specialty and sex, the number of previous complaints and the time since the last complaint. The PRONE score performed well in predicting subsequent complaints, exhibiting strong validity and reliability and reasonable goodness of fit (c-statistic=0.70).ConclusionsThe PRONE score appears to be a valid method for assessing individual doctors’ risks of attracting recurrent complaints. Regulators could harness such information to target quality improvement interventions, and prevent substandard care and patient dissatisfaction. The approach we describe should be replicable in other agencies that handle large numbers of patient complaints or malpractice claims.