bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are malaria transmission-blocking vaccines acceptable to high burden communities? Results from a mixed methods study in Bo, Sierra Leone
Authors: McCoy Kaci D. , Weldon Caroline T. , Ansumana Rashid , Lamin Joseph M. , Stenger David A. , Ryan Sadie J. , Bardosh Kevin , Jacobsen Kathryn H. , Dinglasan Rhoel R. 
Published: April 2021

Abstract
Background
Malaria transmission-blocking vaccines (TBVs) could help break the cycle of malaria transmission by conferring community rather than individual protection. When introducing new intervention strategies, uptake is dependent on acceptability, not just efficacy. In this exploratory study on acceptability of TBVs in Sierra Leone, it was hypothesized that TBVs would be largely acceptable to adults and health workers in areas with relatively few ongoing malaria interventions, and that (i) knowledge of malaria and vaccines, (ii) health behaviours associated with malaria and vaccines, and (iii) attitudes towards different vaccines types could lead to greater TBV acceptability.

Methods
This study used a mixed methods approach in Bo, Sierra Leone, to understand community knowledge, attitudes, and practices related to malaria and vaccination in general. This included: (i) a population-based cross-sectional survey (n=615 adults), (ii) 6 focus group discussions with parents, and (iii) 20 key informant interviews. The concept of a TBV was explained to participants before they were asked about their willingness to accept this vaccine modality as part of an integrated malaria elimination programme.

Results
This study found that most adults would be willing to receive a TBV vaccine. Respondents noted mostly positive past experiences with adult and childhood vaccinations for other infectious diseases and high levels of engagement in other malaria prevention behaviors such as bed nets. Perceived barriers to TBV acceptance were largely focused on general community-level distribution of a vaccine, including personal fears of vaccination and possible costs. After an explanation of the TBV mechanism, nearly all focus group and interview participants believed that community members would accept the vaccine as part of an integrated malaria control approach. Both parents and health workers offered insight on how to successfully roll-out a future TBV vaccination programme.

Conclusions
The willingness of community members in Bo, Sierra Leone to accept a TBV as part of an integrated anti-malarial strategy suggests that the atypical mechanism of TBV action might not be an obstacle to future clinical trials. This study’s findings suggests that perceived general barriers to vaccination implementation, such as perceived personal fears and vaccine cost, must be addressed in future clinical and implementation research studies.
Interaction between major dietary patterns and cardiorespiratory fitness on metabolic syndrome in Iranian adults: a cross-sectional study
Authors: Shahinfar Hossein , Ghanbari Mahtab , Jalilpiran Yahya , Payande Nastaran , Shahavandi Mahshid , Babaei Nadia , Djafarian Kurosh , Clark Cain C. C. , Shab-Bidar Sakineh 
Published: April 2021

Abstract
Background
Several researches have been conducted on the associations between diet and cardiorespiratory fitness (CRF) and major cardiovascular risk factors. However, there is no report about the interaction between major dietary patterns and CRF on metabolic syndrome (MetS) and its components. To investigate the combined association of major dietary patterns and CRF on MetS and its components.

Methods
This cross-sectional study was conducted on 270 apparently healthy adults living in Tehran, Iran. Dietary intake was evaluated using a validated food frequency questionnaire (FFQ). CRF was assessed using a graded exercise treadmill test. Socio-economic status, anthropometric measures, biochemical parameters, and blood pressure were evaluated according to standard methods. Major dietary patterns were identified by factor analysis.

Results
Three major identified dietary patterns were (healthy, mixed, and western). Significant positive association was found between mixed dietary pattern and metabolic syndrome (OR = 2.68, 95% CI (1.92,7.78), P = 0.04). There were not relations between tertiles of identified dietary patterns and remained outcomes. Those who had higher adherence to mixed pattern with also higher CRF showed a significant decrease for diastolic blood pressure (P < 0.01). Also we found that there was no significant interaction between any of dietary patterns and CRF on odds of MetS.

Conclusions
Overall, adherence to mixed dietary pattern in this population was associated with increasing odds of MetS. However, nor CRF neither the combination of dietary patterns and CRF was related to the odds of MetS among Iranian adults. More studies are needed to clarify these associations and to consider interpersonal determinants.
Prevalence of plasma lipid disorders with an emphasis on LDL cholesterol in selected countries in the Asia-Pacific region
Authors: Lee Zhen-Vin , Llanes Elmer Jasper , Sukmawan Renan , Thongtang Nuntakorn , Ho Huynh Quang Tri , Barter Philip ,   on behalf of the Cardiovascular RISk Prevention (CRISP) in Asia Network
Published: April 2021

AbstractCardiovascular disease (CVD) is a major cause of mortality and morbidity within the Asia-Pacific region, with the prevalence of CVD risk factors such as plasma lipid disorders increasing in many Asian countries. As members of the Cardiovascular RISk Prevention (CRISP) in Asia network, the authors have focused on plasma lipid disorders in the six countries within which they have clinical experience: Indonesia, Malaysia, Philippines, Thailand, Vietnam, and Australia. Based on country-specific national surveys, the prevalence of abnormal levels of total cholesterol, low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), and triglycerides (TG) are reported. An important caveat is that countries have used different thresholds to define plasma lipid disorders, making direct comparisons difficult. The prevalence of abnormal lipid levels was as follows: high total cholesterol (30.2–47.7%, thresholds: 190–213 mg/dL); high LDL-C (33.2–47.5%; thresholds: 130–135 mg/dL); low/abnormal HDL-C (22.9–72.0%; thresholds: 39–50 mg/dL); and high/abnormal TG (13.9–38.7%; thresholds: 150–177 mg/dL). Similarities and differences between country-specific guidelines for the management of plasma lipid disorders are highlighted. Based on the authors’ clinical experience, some of the possible reasons for suboptimal management of plasma lipid disorders in each country are described. Issues common to several countries include physician reluctance to prescribe high-dose and/or high-intensity statins and poor understanding of disease, treatments, and side effects among patients. Treatment costs and geographical constraints have also hampered disease management in Indonesia and the Philippines. Understanding the factors governing the prevalence of plasma lipid disorders helps enhance strategies to reduce the burden of CVD in the Asia-Pacific region.
Dual activity of PD-L1 targeted Doxorubicin immunoliposomes promoted an enhanced efficacy of the antitumor immune response in melanoma murine model
Authors: Merino María , Lozano Teresa , Casares Noelia , Lana Hugo , Troconiz Iñaki F. , ten Hagen Timo L. M. , Kochan Grazyna , Berraondo Pedro , Zalba Sara , Garrido María J. 
Published: April 2021

Abstract
Background
The immunomodulation of the antitumor response driven by immunocheckpoint inhibitors (ICIs) such as PD-L1 (Programmed Death Ligand-1) monoclonal antibody (α-PD-L1) have shown relevant clinical outcomes in a subset of patients. This fact has led to the search for rational combinations with other therapeutic agents such as Doxorubicin (Dox), which cytotoxicity involves an immune activation that may enhance ICI response. Therefore, this study aims to evaluate the combination of chemotherapy and ICI by developing Dox Immunoliposomes functionalized with monovalent-variable fragments (Fab’) of α-PD-L1.

Results
Immunoliposomes were assayed in vitro and in vivo in a B16 OVA melanoma murine cell line over-expressing PD-L1. Here, immune system activation in tumor, spleen and lymph nodes, together with the antitumor efficacy were evaluated. Results showed that immunoliposomes bound specifically to PD-L1+ cells, yielding higher cell interaction and Dox internalization, and decreasing up to 30-fold the IC50, compared to conventional liposomes. This mechanism supported a higher in vivo response. Indeed, immunoliposomes promoted full tumor regression in 20% of mice and increased in 1 month the survival rate. This formulation was the only treatment able to induce significant (p < 0.01) increase of activated tumor specific cytotoxic T lymphocytes at the tumor site.

Conclusion
PD-L1 targeted liposomes encapsulating Dox have proved to be a rational combination able to enhance the modulation of the immune system by blocking PD-L1 and selectively internalizing Dox, thus successfully providing a dual activity offered by both, chemo and immune therapeutic strategies.

Graphic Abstract
‘I perceive it to be less harmful, I have no idea if it is or not:’ a qualitative exploration of the harm perceptions of IQOS among adult users
Authors: East Katherine A. , Tompkins Charlotte N. E. , McNeill Ann , Hitchman Sara C. 
Published: April 2021

Abstract
Background
Harm perceptions of tobacco and nicotine products can influence their use and could be targeted by policies to change behaviour. IQOS was introduced to the UK in 2016, and there is little independent qualitative research on IQOS harm perceptions. This study explored the perceived health harms of IQOS to users and those exposed to the emissions, what shapes these perceptions, and what participants wanted to know about the harms of IQOS.

Methods
Qualitative interviews in London, UK, with 30 adult current and former IQOS users who currently smoked or quit smoking in the last 2 years.

Results
IQOS was perceived as less harmful than smoking but not risk-free, although there was great uncertainty. Influences on harm perceptions were consolidated into six themes: (1) dominance of manufacturer claims influenced perceptions that IQOS is less harmful than smoking to users and those around them, although mistrust of the tobacco industry heightened scepticism about harms; (2) limited independent and long-term research led to uncertainty about harms, although some participants trusted IQOS would not be marketed if it were very harmful. Participants wanted more independent and long-term studies into harm; (3) appearance of HEETS (tobacco sticks) packaging conveyed reduced harm because packets were ‘pretty’, without graphic/specific warnings, although written warnings conveyed some harm. Participants wanted more information on HEETS packets about harms; (4) process of heating and HEETS contents—heating, compared with burning, tobacco was perceived to produce fewer harmful chemicals, while tobacco, nicotine, and chemicals in HEETS were perceived to cause some harm. Participants wanted clarification about the harms of heating tobacco and HEETS ingredients; (5) improvements in physical health and personal appearance reduced perceptions of harm; (6) differences in sensory experiences (taste, sight, smell) when using IQOS over smoking reduced perceptions of harm, while ‘black’ deposits inside IQOS led to perceptions of some harm. Reduced volume and smell of IQOS emissions also reduced perceptions of harm to non-users exposed to the emissions.

Conclusions
IQOS was perceived as less harmful than smoking but not risk-free, although there was great uncertainty. Participants wanted clarification about IQOS harms from independent sources in accessible forms, specifically related to HEETS ingredients, heating tobacco, and emissions to others.
Translation and validation of the Japanese version of the measure of moral distress for healthcare professionals
Authors: Fujii Tomoko , Katayama Shinshu , Miyazaki Kikuko , Nashiki Hiroshi , Niitsu Takehiro , Takei Tetsuhiro , Utsunomiya Akemi , Dodek Peter , Hamric Ann , Nakayama Takeo 
Published: April 2021

Abstract
Objectives
Moral distress occurs when professionals cannot carry out what they believe to be ethically appropriate actions because of constraints or barriers. We aimed to assess the validity and reliability of the Japanese translation of the Measure of Moral Distress for Healthcare Professionals (MMD-HP).

Methods
We translated the questionnaire into Japanese according to the instructions of EORTC Quality of Life group translation manual. All physicians and nurses who were directly involved in patient care at nine departments of four tertiary hospitals in Japan were invited to a survey to assess the construct validity, reliability and factor structure. Construct validity was assessed with the relation to the intention to leave the clinical position, and internal consistency was assessed with Cronbach’s alpha. Confirmatory factor analysis was conducted.

Results
308 responses were eligible for the analysis. The mean total score of MMD-HP (range, 0–432) was 98.2 (SD, 59.9). The score was higher in those who have or had the intention to leave their clinical role due to moral distress than in those who do not or did not have the intention of leaving (mean 113.7 [SD, 61.3] vs. 86.1 [56.6], t-test p < 0.001). The confirmatory factor analysis and Cronbach’s alpha confirmed the validity (chi-square, 661.9; CMIN/df, 2.14; GFI, 0.86; CFI, 0.88; CFI/TLI, 1.02; RMSEA, 0.061 [90%CI, 0.055–0.067]) and reliability (0.91 [95%CI, 0.89–0.92]) of the instrument.

Conclusions
The translated Japanese version of the MMD-HP is a reliable and valid instrument to assess moral distress among physicians and nurses.
Pre-colectomy location and TNM staging of colon cancer by the computed tomography colonography: a diagnostic performance study
Authors: Zhou Yadong , Han Zhiwei , Dou Fafu , Yan Tao 
Published: April 2021

Abstract
Background
The Chinese Society of Clinical Oncology guidelines 2018 and the recent update of that (version 2020) recommends accurate examination before major treatment for decision(s) in cases of colon cancer. Also, the difficulty in the identification of the lesion during colectomy may lead to resection of a wrong segment of the colon or a more extensive resection than planned. Accurate pre-colectomy local staging of colon cancer is required to make decisions for treatment of colon cancer. The objective of the study was to evaluate the diagnostic performance of the computed tomography colonography (CTC) for pre-colectomy tumor location and tumor, node, and metastasis (TNM) staging of colon cancer.

Methods
Data of preoperative colonoscopies, CTC, surgeries, and surgical pathology of a total of 269 patients diagnosed with colon cancer by colonoscopy and biopsy and underwent pre-colectomy location and TNM staging by CTC were collected and analyzed. The consistency between the radiological and the surgery/surgical-pathological for location and TN stages of colon tumor were estimated with the weighted kappa or kappa coefficient (κ) at 95% confidence interval (CI).

Results
CTC detected 261 (93%) and colonoscopy detected 201 (72%) correct locations of tumors. Sensitivity and accuracy of CTC for detection of location of colon tumors were 100% and 92.58% (κ = 0.89; 95% Cl: 0.83–0.95). 72.48% sensitivity, 90.64% specificity, and 83.57% accuracy were reported for CTC in differentiation of tumors confined to the colon wall (T1/T2) from advanced tumors (T3/T4) (κ = 0.69, 95% Cl: 0.51–0.75). 81.01% sensitivity, 89.11% specificity, and 83.93% accuracy of CTC was reported for differentiation of tumors between low–intermediate risk and high risk (κ = 0.68, 95% Cl: 0.53–0.75). 69.31% sensitivity, 66.15% specificity, and 67.14% accuracy of CTC were reported for N staging of tumors (κ = 0.41, 95% Cl: 0.59–0.69).

Conclusions
CTC has high diagnostic parameters for pre-colectomy location and T staging of colon tumors except patients of colon cancer who received neoadjuvant chemotherapy.

Level of Evidence
III.

Technical Efficacy Stage
2.
Adolescents’ sedentary time, affect, and contextual factors: An ecological momentary assessment study
Authors: Kracht Chelsea L. , Beyl Robbie A. , Maher Jaclyn P. , Katzmarzyk Peter T. , Staiano Amanda E. 
Published: April 2021

Abstract
Background
Few adolescents achieve sufficient levels of physical activity, and many are spending most of their time in sedentary behavior. Affective response following sedentary time may influence motivation to remain sedentary. Ecological Momentary Assessment (EMA) is a real-time data capture methodology that can be used to identify factors influencing sedentary time, such as the context of the home setting, and resulting affective state within a free-living setting. The purpose of this study was to evaluate the relationship between context at home and adolescent sedentary time, and the relationship of sedentary time and subsequent affect.

Methods
Adolescents (n = 284; 10–16 y) participated in an EMA study that used random, interval-based sampling methods. Adolescents each received 22 unannounced surveys over 7-days through a smartphone application. One survey was randomly sent within each 2-h time-period. These time-periods occurred between 4:00 pm-8:00 pm on weekdays and 8:00 am-8:00 pm on the weekend. This 15-question survey included a series of questions on context (indoors/outdoors, alone/not alone) and positive affect. Adolescents concurrently wore an accelerometer at the hip, and the 30-min bout of accelerometry data prior to each survey was used in analyses. Mixed-effect location scale models were used to examine the association between context at home and sedentary time (stage 1) and the adjusted sedentary time and positive affect (stage 2), with each model adjusted for covariates.

Results
Adolescents were 12.6 ± 1.9 y of age on average, about half were White (58%), and engaged in high levels of sedentary behavior during the 30 min prior to the survey (21.4 ± 6.8 min). Most surveys occurred when adolescents were with others (59%) and indoors (88%). In Stage 1, both being alone and being indoors at home were positively associated with sedentary time (p <  0.001 for both). In Stage 2, adjusted sedentary time was not related to positive affect. Age was negatively related to positive affect (p <  0.001).

Conclusions
Both contextual factors, being alone and indoors at home, were related to additional time spent sedentary compared to being with someone or outdoors. After adjustment, sedentary time was not related to subsequent positive affect, indicating other factors may be related to adolescent’s positive affect in home settings.
New-onset focal seizure as a presenting feature of HIV infection: a case report and mini review to the challenge in resource-limited settings
Authors: Ayele Biniyam A. , Getu Zemichael , Samuel Amen 
Published: April 2021

Abstract
Background
The frequency of new-onset HIV-associated seizure in the HIV-infected patient is estimated to be between 2 and 11%. Identifying the underlying etiology of new-onset seizure will have a vital impact on the mortality and morbidity of patients living with HIV infection.

Case presentation
We report a 34-year old newly diagnosed HIV+ male patient presented with abnormal body movement (ABM) involving his right hemibody associated with loss of consciousness lasting few minutes of two weeks duration. The ABM occurred frequently (> five times per week) and associated with frothy and excessive salivation. He reported headache following each spells. Brain magnetic resonance imaging (MRI) showed bilateral frontal T2 and FLAIR hyperintensity and T1 hypointensity; post contrast study showed bilateral small ring enhancing lesion with perilesional oedema, the biggest one on the left hemisphere, with a 10 mm diameter; considering patient advanced immunosuppression and underlying HIV infection, the brain MRI findings were consistent with cerebral toxoplasmosis. Bipolar montage electroencephalography (EEG) study showed generalized background slowing, prominent in the left fronto-centeral region. Patient was managed with combination antiretroviral therapy, anti-toxoplasmosis medication, and anticonvulsant. On follow up, the frequency of seizure attack has significantly reduced.

Conclusion
Considering the high prevalence of HIV infection and associated seizure among people living with HIV in sub-Saharan Africa, this case fairly highlights on the importance of utilizing advanced imaging techniques such as MRI and EEG in identifying the underlying causes of HIV-associated seizures.
The role of SOCS proteins in the development of virus- induced hepatocellular carcinoma
Authors: Xie Jinyan , Wang Mingshu , Cheng Anchun , Jia Renyong , Zhu Dekang , Liu Mafeng , Chen Shun , Zhao XinXin , Yang Qiao , Wu Ying , Zhang Shaqiu , Luo Qihui , Wang Yin , Xu Zhiwen , Chen Zhengli , Zhu Ling , Liu Yunya , Yu Yanling , Zhang Ling , Chen Xiaoyue 
Published: April 2021

Abstract
Background
Liver cancer has become one of the most common cancers and has a high mortality rate. Hepatocellular carcinoma is one of the most common liver cancers, and its occurrence and development process are associated with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections.
Main body
The serious consequences of chronic hepatitis virus infections are related to the viral invasion strategy. Furthermore, the viral escape mechanism has evolved during long-term struggles with the host. Studies have increasingly shown that suppressor of cytokine signaling (SOCS) proteins participate in the viral escape process. SOCS proteins play an important role in regulating cytokine signaling, particularly the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway. Cytokines stimulate the expression of SOCS proteins, in turn, SOCS proteins inhibit cytokine signaling by blocking the JAK-STAT signaling pathway, thereby achieving homeostasis. By utilizing SOCS proteins, chronic hepatitis virus infection may destroy the host’s antiviral responses to achieve persistent infection.

Conclusions
This review provides recent knowledge regarding the role of SOCS proteins during chronic hepatitis virus infection and provides some new ideas for the future treatment of chronic hepatitis.
Self-assembled raccoon dog parvovirus VP2 protein confers immunity against RDPV disease in raccoon dogs: in vitro and in vivo studies
Authors: Xia Linya , Luo Guoliang , Wu Mingjie , Wang Lei , Zhang Ning , Wu Congmei , Yin Yuhe 
Published: April 2021

Abstract
Background
Raccoon dog parvovirus (RDPV) causes acute infectious diseases in raccoon dogs and may cause death in severe cases. The current treatment strategy relies on the extensive usage of classical inactivated vaccine which is marred by large doses, short immunization cycles and safety concerns.

Methods
The present study aimed at optimization of RDPV VP2 gene, subcloning the gene into plasmid pET30a, and its subsequent transfer to Escherichia coli with trigger factor 16 for co-expression. The protein thus expressed was purified with ammonium sulfate precipitation, hydrophobic chromatography, and endotoxin extraction procedures. VLPs were examined by transmission electron microscopy, dynamic light scattering, and the efficacy of VLPs vaccine was tested in vivo.

Results
Results indicated that RDPV VP2 protein could be expressed soluble. Transmission electron microscopy and dynamic light scattering results indicated that RDPV VP2 self-assembled into VLPs. Hemagglutination inhibition antibody titers elicited by Al(OH)3 adjuvanted RDPV VLPs were comparable with RDPV inactivated vaccines, and the viral loads in the blood of the struck raccoon dogs were greatly reduced. Hematoxylin and eosin and Immunohistochemical results indicated that RDPV VLPs vaccine could protect raccoon dogs against RDPV infections.

Conclusions
These results suggest that RDPV VLPs can become a potential vaccine candidate for RDPV therapy.