bluuebunny/crossref_metadata_2025_split huggingface dataset:
O4-S1.06 HPV 16 predicts clinical outcome in oral cancer patients treated by radiotherapy
Authors: Apolinario R M , Lara P C , Henriquez L A , Lloret M , Pinar B 
Published: July 2011

Growing molecular and clinical evidence indicates that human papillomavirus (HPV) is involved in the aetiology of oral squamous cell carcinomas (SCCs). HPV(+) tumours appear to be clinically distinct from HPV(−) tumours, conferring improved survival outcomes for patients in oropharyngeal cancer but limited knowledge exist on oral cancer. Determination of the HPV status of tumours may assist in patient risk-stratification and ultimately guide optimum treatment. The primary aim of this study was to examine the distribution of HPV in oral SCCs as assessed in vitro amplification assays and correlated with clinical and demographic data. The secondary aim was to correlate the positivity of HPV tumours with clinical outcome in the largest series of oral cancer published with a long follow-up (up to 20 years).Materials and MethodsOne hundred thirty-one invasive oral SCCs were tested for HPV using laboratory-developed PCR assays for HPV16. P53 expression, tumour angiogenesis (CD-31 staining) and proliferation (MIB-1) were also assessed by immunohistochemistry in parafine embedded tissue. Patients mean age was 58.09±10.41, median 59 (116 men and 15 women). Clinical Stage distribution was: st I:17 cases; II: 56,III:32.IV:26. Most tumours were histological grade I (39) and II (74). Patients with pathological stage I-II were refereed to surgery (65 cases) and patients with Stage III-IVA were referred to surgery and postoperative radiation therapy (66 cases). Mean radiotherapy given doses were 62.13±7.74, median 65 Gy in 1.8-2 Gy fractions. No chemotherapy was used in any case.Results41 cases (31.3%) were HPV 16(+). No relation was found with age, gender, or tumour characteristics. In fact no relation was found to p53 expression, tumour proliferation or angiogenesis. 15-year DFS was 62.20% in HPV(+) patients was, compared to 37.3% in the HPV(-) group (p<0.076). In stage III-IV cases (treated by surgery and radiation therapy) this differences reached statistical signification (15 y DFS 72.4% vs 36.0% p<0.020). Similar results were found for Cause Especific Survival (15 y DFS 68.4% vs 26.2% p<0.054).ConclusionThese data show that the HPV status is a good predictor of DFS and survival in patients treated with radical surgery and adjuvant radiotherapy in oral carcinomas. This prognostic advantage seem to be independent of tumour proliferation, p53 status or angiogenesis. Other molecular processes could be implicated in the different response to radiotherapy.
O4-S2.02 Seroprevalence of novel immunogens of chlamydia trachomatis and their cytokine response in PBMC Cells under in vitro conditions
Authors: Saluja D , Patel A , Mishra P , Sachdev D 
Published: July 2011

BackgroundChlamydia trachomatis (CT) is an obligate intracellular parasite which causes STD and trachoma. Despite major research into Chlamydial pathogenesis and host immune responses, immuno-protection has been hampered by the incomplete understanding of protective immunity in the genital tract. Characterised vaccine candidates in general have shown variable efficacy ranging from no protection to partial protection. It is therefore a research priority to identify novel Chlamydial antigens that may elicit protective immune responses.ObjectivesThe goal of the present study was to assess the seroprevalence to pkn1and DNA j following natural CT infection in human. The prospects of pkn1 as a Type third secretion substrate and DNA j a non surface Chlamydial protein as potential antigen, prompted us to explore the immunogenic potential of both protein.Methodspkn, DNA j and ompA were cloned in bacterial expression vector pTrcHis. Ni+-NTA affinity chromatography was used to purify the recombinant proteins. Antigenic stretches of Pkn1, DNA j and OmpA were identified using Bcepred web server, designed for identification of subunit vaccine candidate by Bioinformatics Centre of IMTECH Chandigarh, India. To validate the bioinformatics based analysis, sera of human patient were used to determine seroreactivity of pkn1 and DNA j proteins. OmpA was used as a positive control during the study.ResultsPresent study showed a high seroprevalence of antibodies against Pkn1 and OmpA (p<0.001) in sera of humans infected with CT. while, no antibodies were observed for DNA j. Our studies have shown an association between release of TNF-α and IFN-y levels upon stimulation of PBMC with Pkn1 and OmpA. Cytokine expression profiling (IL-1ß, TNF-α, IL-2 , IL10 and IFN-y) of Human PBMCs in response to Pkn1 stimulation demonstrate for the first time that Pkn1 is a novel immunodominant Chlamydial antigen that is capable of influencing both Th1 and Th2 immune responses by stimulating the release of both Humoural and Cell-mediated regulatory cytokines.ConclusionsOur study demonstrated strong serological responses to Pkn1 and major outer membrane in natural human infection suggesting the role of pkn1 in immune response. Studies are in progress to check how the immunomodulation by Pkn1 alters host-pathogen interactions.
O4-S2.03 An anti-adhesive approach to prevention ofC trachomatisinfection
Authors: Campbell L A , Zidal S V , Patton D , Kuo Cho-chou 
Published: July 2011

BackgroundWe have reported that the major outer membrane ofC trachomatisis glycosylated and the glycan is a high mannose oligosaccharide. Cumulative studies have demonstrated that the glycan is important in attachment and infectivity through binding to the mannose receptor (MR). Glycan removal decreases infectivity in vitro and in vivo and simultaneous administration of mannan, a ligand of the MR, abrogatesC trachomatisinfection in a mouse model of pneumonitis. Thus, we are investigating the feasibility of an anti-adhesive therapy to preventC trachomatisinfection by identifying oligosaccharides that are effective in inhibiting infection in vitro and testing their efficacy in a mouse model of genital tract infection.MethodsHeLa 229 cell monolayers were pretreated with serial concentrations of oligosaccharides prior to infection withC trachomatis. Neutralisation of infectivity was scored as >50% inhibition. For animal experiments, 8-week-old Swiss Webster female mice were primed with subcutaneous injections of Depo-Provera 1 week prior to challenge. Subsequently, mice were inoculated intravaginally with carbohydrates or PBS (n=5 mice per group) 30 min prior to infection withC trachomatis. Vaginal swab samples were obtained at 24, 48, and 72 h. post-infection, at peak times of shedding. Statistical significance was determined by the Student's t test.ResultsCarbohydrates have been tested in vitro in hapten inhibition experiments against three serovars (D, E, F) most frequently isolated from genital tract infection. At the highest concentration tested, 4-nitrophenyl-α-D-mannopyranoside inhibited infectivity by 91%–92%; α-D-mannose-PAA from 77 to 93%; hen ovalbumin by 85%–89%; mannan by 77%–83%; and the high mannose fraction prepared from ovalbumin by 59%–98%. To determine efficacy in vivo, Swiss Webster mice were inoculated with different concentrations of inhibitors. Of those tested thus far, shedding of organism was significantly decreased (p<0.05). The maximum inhibitions observed were: 4-nitrophenyl-α-D-mannopyranoside (86%), α-D-mannose-PAA (81%), mannan (93%), and the high mannose fraction from ovalbumin (94%).ConclusionsThese preliminary studies suggest the potential feasibility for developing an “anti-adhesive therapy” as an alternate topical microbicide approach to preventC trachomatisgenital tract infection.
O4-S2.04 Can a cervical barrier prevent chlamydia infection in the pigtailed macaque cervical challenge model?
Authors: Patton D , Sweeney Y Cosgrove , Moench T 
Published: July 2011

BackgroundNumerous microbicides that inactivateChlamydia trachomatisin vitro have failed to prevent transmission of this pathogen in the pigtailed macaque cervical challenge model. SinceC trachomatisreplicates in endocervical columnar epithelium but not in the squamous vaginal epithelium, we tested whether a cervical barrier would improve protection when used in conjunction with an otherwise non-protective microbicide.MethodsMiniature diaphragm-like cervical barriers were manufactured and provided by ReProtect, Inc. BufferGel, previously found ineffective in this model when used alone, was also provided by ReProtect, Inc. Twenty-four pigtailed macaques were randomly assigned to one of three study arms: cervical barrier device alone; cervical barrier with BufferGel; or no barrier device and no gel (control arm). Eight animals were enrolled in each arm. Each macaque underwent baseline exam, product administration if applicable, cervical challenge with C. trachomatis (E: 5×105 IFU), and weekly follow-up exams for 5 weeks. Chlamydia challenge occurred within 30 min of baseline exams. Cervical barrier devices were removed from all test macaques 18 h after insertion. Each exam included cervicovaginal colposcopy, vaginal pH and cervical swabs for chlamydia detection (culture and NAAT: GenProbe Aptima Combo2). Blood for serum antibody testing was collected at baseline and weeks 2 though five post-inoculation.ResultsDetection of chlamydial infection is detailed in the Abstract O4-S2.04 table 1 below. Colposcopic exams were comparable across each of the three test arms of the study, and thus did not detect toxic effects of the gel or the cervical barrier. Baseline vaginal pH was somewhat higher in the No Product arm than in either of the test arms. After chlamydial challenge and throughout the duration of the study, mean vaginal pH remained lowest in the barrier with BufferGel arm, but were similar (within 1 pH unit) in all three study arms.Abstract O4-S2.04 Table 1CxBarWorking definition of confirmed infection: Positive NAAT AND Positive culture and Positive IgG/IgM>1:16Working definition of probable infection: positive NAAT and positive culture & IgG/IgM<1:32 OR negative culture & negative culture IgG/IgM>1:32Working definition of no infection: negative or self-limited NAAT AND negative culture AND IgG/IgM<1:32Barrier with buffergel224Barrier only422No Product530ConclusionsIn this pilot study, a cervical barrier used alone provided little or no protection, but the barrier used with BufferGel reduced transmission by 50% (p=0.08). These results should encourage further study of the ability of a cervical barrier combined with a microbicide to provide greater protection against sexually transmitted infections than either used alone.
O5-S1.01 Employing school nurses as a healthcare point of contact for male high school students: a school-based intervention to prevent STD, HIV, and teen pregnancy
Authors: Dittus P , De Rosa C , Jeffries R , Afifi A , Cumberland W , Ethier K , Chung E , Martinez E , Loya R , Kerndt P 
Published: July 2011

BackgroundAdolescent males tend to have lower levels of knowledge about sexual and reproductive health (SRH), and access health care less frequently than adolescent females. Innovative strategies are needed to reach males with accurate information and resources regarding their SRH needs. Such strategies may improve adolescent males' access to SRH services, including STD screening, treatment, and contraception.MethodsA multi-level intervention was delivered and evaluated across 5 years in a large public school district in Los Angeles, California. One intervention component sought to improve students' awareness and utilisation of condom availability programs (CAPs) in schools by working with key school personnel, particularly nurses, to more effectively implement district CAP policies. Six intervention and six control high schools participated in the study . Analyses included survey data from 13 733 high school males across 5 years (T1–T5). A mixed model logistic regression analysis was used to test for an intervention effect on males' reports of services sought from the school nurse. Random effects on the student level were included to control for repeated measures on the same student.ResultsThe sample was 80% Latino and 9% African American; the mean age was 16.3. In the intervention as compared to the control condition, statistically significant increases were observed across 5 years of intervention in respondents' reports of going to the school nurse for information about birth control, STDs, pregnancy, or sex (see Abstract O5-S1.01 figure 1), as well as reports of going to the school nurse for condoms. For example, 5.4% of intervention school males reported going to the nurse for condoms at T1; reports increased to 9.6% at T5 for this group, whereas an opposite trend was observed for control school males.Abstract O5-S1.01 Figure 1Adjusted ORs* for the change between time points in males going to the school nurse.ConclusionsSchool district policy combined with promotion of a CAP increased the number of adolescent males who sought out SRH information and condoms from the school nurse. With few points of access to the healthcare system available to males, school nurses may be especially important in connecting males to the healthcare system for services such as STD screening and contraception. As budget shortfalls affect all areas of school administration, school nurses should be recognised and retained as key players in promoting access to SRH services.
O5-S1.03 Young adults' views on telemedicine consultations for sexual health in Australia
Authors: Garrett C C , Kirkman M , Hocking J , Chen M , Fairley C K 
Published: July 2011

BackgroundYoung adults in Australia face barriers to accessing sexual health services including concerns over confidentiality and privacy, cost, lack of transportation and limited options around medical providers. A possible solution to decreasing these barriers is the use of telemedicine.MethodAn online questionnaire examined young adults' (aged 16–24) views on using webcam and telephone consultations for sexual health in Australia. Descriptive statistics were used to describe the study sample and χ2was used to assess associations. Free text responses were analysed thematically.Results662 people completed the questionnaire. Overall, 23% (n=150) of participants were willing to have a sexual health consultation with a doctor using a webcam if no genital examination was necessary; this number decreased to 16% (n=105) if a genital examination over webcam was needed. Men were more willing than women to have a webcam consultation (28% vs 21%, p=<0.01). In addition, men with same sex partners were more willing to have webcam consultation, with an unknown doctor, than men without any same sex partners (48% vs 26%, p=0.04). Participants' top preference for consulting a doctor if asymptomatic and living 2 h from a doctor was telephone (51%, n=340, compared with 10% for webcam); if symptomatic, participants' top preference was in person (62%, n=412, compared with 16% for webcam) instead of having the consultation over a webcam. While it was hypothesised that webcam consultations would decrease privacy and confidentiality concerns by preventing people from having to present at a sexual health clinic, preliminary results suggest that webcam consultations may instead augment such concerns. Free text responses suggest that this may be due to the fact that online consultations can be recorded, stored and potentially, if security measures are breached, be retrievable and searchable online.ConclusionTo our knowledge, no study has examined the use of webcam consultations between healthcare providers and clients for sexually transmitted disease care. Results suggest that webcam consultations are not yet an acceptable medium for sexual health consultations for youth in Australia. Concerns about trust, privacy and security around online medical consultations are likely to influence whether such technology is eventually adopted into routine medical care.
O5-S1.04 Social media and chlamydia testing by university students: a pilot study
Authors: Turner A Norris , Comston T , Davis J , Nasrin Z , Vaughn J 
Published: July 2011

BackgroundFacebook is the world's largest social media site, and university students comprise one of the largest user groups. Sexually transmitted infections are also highly prevalent among university students in the USA. We evaluated a targeted Facebook advertisement for easy, inexpensive chlamydia testing at The Ohio State University (OSU), a public university with 55 000 students.MethodsOver 2 weeks in May 2010, our advertisement for $25 chlamydia testing was displayed to Facebook users who had self-identified as OSU students between 19 and 28 years of age. Students provided a urine sample directly to the laboratory; a clinician visit was not required. To a separate convenience sample we administered a short survey capturing demographics, social media use and interest in future testing.ResultsThe advertisement received 401 732 impressions” (displays of the advertisement to users). Nearly all 98%) impressions were to 19–24-year-olds. The daily impressions varied enormously, from 0 to more than 100 000. In the first week, although the advertisement received up to 2,900 daily impressions, no one clicked it. We gradually increased our “bid per click”—the amount we agreed to pay Facebook for each click—from $0.62 to $0.90. We also modified the advertisement format to depict a college student and to clearly specify the $25 cost of the test. Following these changes, both the number of impressions and “clicks” rose dramatically. Seventy-five individuals clicked the advertisement (25 women and 50 men), with an average cost per click of $0.84. Three students, all female, came for chlamydia testing; one tested positive. Among surveyed individuals (n=60), 75% reported using Facebook daily or more often. Few (10%) reported ever clicking on Facebook advertisements. Only one surveyed student noticed our Facebook advertisement. The direct-to-laboratory testing concept was popular, with 75% reporting willingness to use this service in the future.ConclusionsIn this short pilot study, 75 individuals clicked on a Facebook advertisement about chlamydia testing, three came for testing and one tested positive. Facebook advertisements are inexpensive, with high exposure to the target population. A small increase in bid per click can make a very large difference in total impressions. The format of the advertisement is critical for catching the attention of the target audience, because many students report never noticing or clicking Facebook advertisements.
O5-S2.02 Delay of entry into care in HIV positive individuals
Authors: van Veen M , de Wolf F , Heijman T , Zaheri S , Fennema H , Götz H , van der Sande M 
Published: July 2011

BackgroundDelay between HIV diagnosis and entry into care may impact not only on the individual prognosis, but hinders interruption of further HIV transmission. Insight into duration and determinants of care-delay and differences between those who do and do not delay are important to further public health policy aimed at reducing ongoing HIV transmission.Methods(1). Data from the ATHENA national observational cohort for HIV patients with a first date of care from January 2008 until May 2010 were analysed to assess place, date of initial positive diagnosis and entry date into care. (2). Prospective data collection is set up regionally from consenting patients testing HIV positive at the STI clinics in Amsterdam and Rotterdam. Results from February 2009 until April 2010 for time into care and delay are presented. For this analysis delay of entry into care is defined as a time period of 4 weeks or more between confirmed HIV diagnosis and first consultation at the HIV treatment centre.Results(1). At the national level, 28% of all new patients entering care (n=2775) was diagnosed HIV positive at their GP, 25% at an STI clinic, 23% in the hospital, 2% at the pregnancy screening, 4% abroad, 4% other and 14% unknown. Median number of days between HIV diagnosis and entry into care was 19 days (IQR 7–49 days). In 16% of patients time to enter care took over 150 days; those infected by heterosexual contact or injecting drug use were more likely to be in this group. Patients born outside the Netherlands were also more likely to enter care late. 2). From February 2009 until April 2010, 120 participants were included in the study (response 70%). The majority (n=108) were men who have sex with men (MSM). For 78% of participants a date of entry into care was known; median time into care was 8 days (range 0–104 days). Twenty two per cent had not entered care yet of whom 16% had CD4 cell counts below 350. Of participants who were directly referred to an HIV treatment 10% delayed for medical care compared to 45% of participants wanted to make an appointment on their own initiative.ConclusionsSpecific subpopulations such as heterosexuals and ethnic minorities are at risk for entering care late after being diagnosed HIV positive. Results from the prospective study show that direct referral from STI clinic to an HIV treatment centre leads to less delay. Testing of those at risk is not enough to interrupt HIV transmission chains, entry into care needs to be assured as well.
O5-S2.03 Effect of improving the STI services in seven provinces of China
Authors: Gong X D , Jiang J , Su X h , Cao N X , Yue X L 
Published: July 2011

BackgroundThe STI services can reduce HIV transmission and have been the important component of HIV control programmes. In China, the STI services remain weak. Under the framework of AIDS control programme of the Global Funds Round 4, we conducted the sub-programme to improve STI services in 21 counties of 7 provinces in China from 2007 to 2009, including one-week training workshops for all STI care providers, two-month field training for key STI clinicians at STD Clinic of National Center for STD Control, STI drug assurance, and quality services offering for STI patients. Annually the effect of STI services was assessed according to the guideline of WHO/UNAIDS in the 21 counties.MethodsThe assessment of STI services was through health facility survey, including three indicators: (1)STI service indicator 1 (SI1) is defined as the per cent of patients with STIs at observed health care facilities who are appropriately diagnosed and treated according to the national guidelines on STI treatment in China; (2) STI service indicator 2 (SI2) is defined as the per cent of patients with STIs who are given advice on condom use and partner notification and referral for HIV testing in term of national standards; (3)Standardised STI service indicator (SSI) means the comprehensive case management including SI1 and SI2. The sample size of STI patients between provider and client interactions observed was 40 per county according to the recommendation of national experts. Data were collected in observations of provider-client interaction at the health-care facilities offering STI services by trained professionals. The software of EpiData3.1 and SPSS 11.5 was used to data entry and analysis.ResultsFrom 2007 to 2009, the SI1 was 46.16% (397/860) (95% CI 42.83% to 49.49%), 62.94% (603/958) (95% CI 59.88% to 66.00%), 81.96% (686/837) (95%CI 79.35% to 84.57%) on average in 21 counties, respectively, and there was significantly increased trends (χ2is 234.30, p=0.000); the SI2 was 28.32% (243/858) (95%CI 25.31% to 31.33%), 45.04% (431/957) (95% CI 41.89% to 48.19%), 80.33% (678/844) (95% CI 77.65% to 83.01%) on average for these counties, respectively, and there was also significantly increased trends (χ2is 459.37, p=0.000). For overall STI service quality, SSI was 20.98% (180/858) (95% CI 18.26% to 23.70%), 40.02% (383/957) (95% CI 36.92% to 43.12%), 67.26% (563/837) (95% CI 64.08% to 70.44%), respectively in 2007–2009, and there was significantly increased trends (χ2is 370.81, p=0.000). The STI service indicators in rich areas were higher than in poor counties.ConclusionsThe quality of STI services was significantly improved through the Global Funds Round 4 in 21 counties of seven provinces in China, and should be scaled up to other areas in the country.