bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental health aspects and microbial infections of the recreational water
Authors: Hassanein Faika , Masoud Inas M. , Fekry Marwa M. , Abdel-Latif Mohamed S. , Abdel-Salam Hussein , Salem Mohamed , Shehata Amany I 
Published: February 2023

Abstract
Background
Swimming pools are places for practicing sports, recreation, relaxation, and socialization. However, swimming pools can expose swimmers to physicochemical and microbiological risks. Accordingly, we studied the environmental health aspects and microbial infections for such recreational water aiming to disclose the possible risks they pose on swimmers.

Methods
26 pools in Alexandria, Egypt were checked for water quality; 13 pools were checked in winter then summer, and other 13 pools were checked in summer only. Water was collected from both the top and the bottom of each pool; a total of 78 samples were collected in sterile containers. Each sample was divided into three parts; the first part was used for assessing the bacteriological quality of water. They were tested for total colony count (TCC), total coliform (TC), fecal coliform, and E. coli. The second part was used for chemical analysis. The third part was checked for parasitological study.

Results
Obtained data showed that only 7.7%, 78.2%, and 100% of the examined water samples have been found to fulfill the Egyptian standards for TCC, TC, and E. coli, respectively. Moreover, parasitic infection (PI) was noticed in 73.1% of the collected water samples; mainly Cyclospra and Isospora (37.2% each), followed by Cryptosporidium spp., Giradia lamblia, Microsporidia spp., and Blastocystis spp. (34.6%, 21.8%, 15.4%, and 14.1%, respectively). Acanthameba spp. was detected but at a lower rate (5.1%). The frequency of cleaning the swimming pools, flow rate, Cl2, and total dissolved solids are significantly affected PI, independently.

Conclusion
The tested water samples don’t meet Egyptian bacteriological criteria. High parasitic contamination despite high residual chlorine level mainly intestinal coccidia, G. lamblia, microsporidia, and Blastocystis spp. Thus, monitoring pool’s water quality and improving the disinfection system are mandatory. Consequently, Health education regarding hygienic behaviors before and during swimming should be included in governmental programs.
Trends of completed suicide rates among Malaysian elderly between 1995 and 2020
Authors: Abu Bakar Nurul Salwana , Zainuddin Nur Azmiah , Seman Zamtira , Khamal Noor Raihan , Ismail Masrol Hafizal 
Published: February 2023

Abstract
Background
Suicide among the elderly has become a global public health concern. This study was carried out to determine the trend of completed suicide rates according to age, sex, and ethnicity and the suicidal methods among the elderly in Malaysia.

Methods
All suicide-related deaths in elderly aged 60 years and above from the Year 1995 to 2020 reported to the National Registration Department (NRD) were analyzed. Causes of death for suicide were coded based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). The completed suicide rate was calculated by dividing the completed suicide number by the total elderly population for the respective year.

Results
Overall, the analysis of 1,600 suicide-related deaths was investigated over 26 years. Male was seen to be correlated with higher suicidal risk, with a male–female relative risk (RR) = 1.89 (95%CI:1.46,2.45). The risk of suicide was also found to be significantly higher for those aged 60 to 74 years old and Chinese, with RR = 4.26 (95%CI:2.94, 6.18) and RR = 5.81 (95%CI: 3.70, 9.12), respectively. Hanging was found to be a statistically significant suicide method (IRR:4.76, 95%CI:2.34,9.65) as compared to pesticide poisoning. The completed suicide rate was fluctuating over the years.

Conclusions
In conclusion, it is believed that Malaysia's elderly suicide rate has reached an alarmingly high incidence. By identifying the crucial criteria of sociodemographic factors, the government and responsible agencies have the essential and additional information to put together a more effective strategy and approach to overcome the issue in the future.
Construct validity and internal consistency of the Home and Family Work Roles Questionnaires: a cross-sectional study with exploratory factor analysis
Authors: Dabbagh A. , Seens H. , Fraser J. , MacDermid J. C. 
Published: February 2023

AbstractIntroductionExploratory Factor Analysis (EFA) measures the underlying relationships between questionnaire items and the factors (“constructs”) measured by a questionnaire. The Home and Family Work Roles Questionnaire has not been assessed using EFA; therefore, our objective was to identify the factors measured by this questionnaire.MethodsWe recruited 314 persons to complete the questionnaire and to answer several demographic questions. We determined if the data was factorable by performing Bartlett’s test of sphericity and the Kaiser–Meyer–Olkin measure of sampling adequacy. We used the Factor package in Jamovi statistical software to perform EFA. We employed an Oblimin rotation and a Principal Axis extraction method. We also calculated the internal consistency of the questionnaire as a whole as well as each individual question.ResultsOur sample consisted of 265 (85%) women, 45 (14%) men, and 3 (1%) non-binary or other genders. The mean age of our participants was 34.65 (SD = 11.57, range = 18–65) years. EFA suggested a three-factor model. Questions 11, 13, 14, 15, and 16 measured one factor (we interpreted this as “Caregiving Roles”), questions 1, 3, 4, 8, 9, 10, 18, and 19 measured a different factor (“Traditionally Feminine Roles”), and questions 2, 5, 6, and 12 measured the “Traditionally Masculine Roles”. The questionnaire and each individual question demonstrated excellent internal consistency (Cronbach's α > 0.90).ConclusionThe Home and Family Work Roles Questionnaire may measure three distinct factors, which we have named Caregiving, Traditionally Feminine, and Traditionally Masculine Roles. This aligns with the theory used in developing the questionnaire. Separation of the Home and Family Work Roles Questionnaire into three sub-scales with distinct scores is recommended to measure each of the recommended constructs.
Maximizing the cost-effectiveness of cervical screening in the context of routine HPV vaccination by optimizing screening strategies with respect to vaccine uptake: a modeling analysis
Authors: Choi Horace C. W. , Leung Kathy , Chan Karen K. L. , Bai Yuan , Jit Mark , Wu Joseph T. 
Published: February 2023

AbstractBackgroundRegarding primary and secondary cervical cancer prevention, the World Health Organization proposed the cervical cancer elimination strategy that requires countries to achieve 90% uptake of human papillomavirus (HPV) vaccines and 70% screening uptake. The optimal cervical screening strategy is likely different for unvaccinated and vaccinated cohorts upon national HPV immunization. However, health authorities typically only provide a one-size-fits-all recommendation for the general population. We aimed to evaluate the cost-effectiveness for determining the optimal screening strategies for vaccinated and unvaccinated cohorts.MethodsWe considered the women population in Hong Kong which has a unique HPV infection and cervical cancer epidemiology compared to other regions in China and Asia. We used mathematical models which comprise a deterministic age-structured compartmental dynamic component and a stochastic individual-based cohort component to evaluate the cost-effectiveness of screening strategies for cervical screening. Following the recommendations in local guidelines in Hong Kong, we considered strategies that involved cytology, HPV testing, or co-testing as primary cervical screening. We also explored the impacts of adopting alternative de-intensified strategies for vaccinated cohorts. The 3-year cytology screening was used as the base comparator while no screening was also considered for vaccinated cohorts. Women’s lifetime life years, quality-adjusted life years, and costs of screening and treatment were estimated from the societal perspective based on the year 2022 and were discounted by 3% annually. Incremental cost-effectiveness ratios (ICERs) were compared to a willingness to pay (WTP) threshold of one gross domestic product per capita (US $47,792). Probabilistic and one-way sensitivity analyses were conducted.ResultsAmong unvaccinated cohorts, the strategy that adds reflex HPV to triage mild cytology abnormality generated more life years saved than cytology-only screening and could be a cost-effective alternative. Among vaccinated cohorts, when vaccine uptake was 85% (based on the uptake in 2022), all guideline-based strategies (including the cytology-only screening) had ICERs above the WTP threshold when compared with no screening if the vaccine-induced protection duration was 20 years or longer. Under the same conditions, HPV testing with genotyping triage had ICERs (compared with no screening) below the WTP threshold if the routine screening interval was lengthened to 10 and 15 years or screening was initiated at ages 30 and 35 years.ConclusionsHPV testing is a cost-effective alternative to cytology for vaccinated cohorts, and the associated optimal screening frequency depends on vaccine uptake. Health authorities should optimize screening recommendations by accounting for population vaccine uptake.
Higher white-nose syndrome fungal isolate yields from UV-guided wing biopsies compared with skin swabs and optimal culture media
Authors: Seidlova Veronika , Pikula Jiri , Kolarik Miroslav , Nováková Alena , Cmokova Adela , Ghazaryan Astghik , Nemcova Monika , Bednarikova Sarka , Patra Sneha , Kokurewicz Tomasz , Piacek Vladimir , Zukal Jan 
Published: February 2023

Abstract
Background
North American bat populations have suffered severe declines over the last decade due to the Pseudogymnoascus destructans fungus infection. The skin disease associated with this causative agent, known as white-nose syndrome (WNS), is specific to bats hibernating in temperate regions. As cultured fungal isolates are required for epidemiological and phylogeographical studies, the purpose of the present work was to compare the efficacy and reliability of different culture approaches based on either skin swabs or wing membrane tissue biopsies for obtaining viable fungal isolates of P. destructans.

Results
In total, we collected and analysed 69 fungal and 65 bacterial skin swabs and 51 wing membrane tissue biopsies from three bat species in the Czech Republic, Poland and the Republic of Armenia. From these, we obtained 12 viable P. destructans culture isolates.

Conclusions
Our results indicated that the efficacy of cultures based on wing membrane biopsies were significantly higher. Cultivable samples tended to be based on collections from bats with lower body surface temperature and higher counts of UV-visualised lesions. While cultures based on both skin swabs and wing membrane tissue biopsies can be utilised for monitoring and surveillance of P. destructans in bat populations, wing membrane biopsies guided by UV light for skin lesions proved higher efficacy. Interactions between bacteria on the host's skin also appear to play an important role.
Revealing novel pyroptosis-related therapeutic targets for sepsis based on machine learning
Authors: Chen Ying , Wang Xingkai , Wang Jiaxin , Zong Junwei , Wan Xianyao 
Published: February 2023

Abstract
Background
Sepsis is one of the most lethal diseases worldwide. Pyroptosis is a unique form of cell death, and the mechanism of interaction with sepsis is not yet clear. The aim of this study was to uncover pyroptosis genes associated with sepsis and to provide early therapeutic targets for the treatment of sepsis.

Methods
Based on the GSE134347 dataset, sepsis-related genes were mined by differential expression analysis and weighted gene coexpression network analysis (WGCNA). Subsequently, the sepsis-related genes were analysed for enrichment, and a protein‒protein interaction (PPI) network was constructed. We performed unsupervised consensus clustering of sepsis patients based on 33 pyroptosis-related genes (PRGs) provided by prior reviews. We finally obtained the PRGs mostly associated with sepsis by machine learning prediction models combined with prior reviews. The GSE32707 dataset served as an external validation dataset to validate the model and PRGs via receiver operating characteristic (ROC) curves. The NetworkAnalyst online tool was utilized to create a ceRNA network of lncRNAs and miRNAs around PRGs mostly associated with sepsis.

Results
A total of 170 genes associated with sepsis and 13 hub genes were acquired by WGCNA and PPI network analysis. The results of the enrichment analysis implied that these genes were mainly involved in the regulation of the inflammatory response and the positive regulation of bacterial and fungal defence responses. The prolactin signalling pathway and IL-17 signalling pathway were the primary enrichment pathways. Thirty-three PRGs can effectively classify septic patients into two subtypes, implying that there is a reciprocal relationship between sepsis and pyroptosis. Eventually, NLRC4 was considered the PRG most strongly associated with sepsis. The validation results of the prediction model and NLRC4 based on ROC curves were 0.74 and 0.67, respectively, both of which showed better predictive values. Meanwhile, the ceRNA network consisting of 6 lncRNAs and 2 miRNAs was constructed around NLRC4.

Conclusion
NLRC4, as the PRG mostly associated with sepsis, could be considered a potential target for treatment. The 6 lncRNAs and 2 miRNAs centred on NLRC4 could serve as a further research direction to uncover the deeper pathogenesis of sepsis.
Malaria patient spectrum representation in therapeutic clinical trials of uncomplicated malaria: a scoping review of the literature
Authors: Arena Lorenzo , Zanamwe Mazvita , Halleux Christine M. , Carrara Verena , Angus Brian J. , Ariana Proochista , Humphreys Georgina S. , Richmond Caitlin , Stepniewska Kasia , Guérin Philippe J. , Olliaro Piero L. 
Published: February 2023

Abstract
Background
For the results of clinical trials to have external validity, the patients included in the study must be representative of the population presenting in the general clinical settings. A scoping literature review was performed to evaluate how the eligibility criteria used in anti-malarial efficacy and safety trials translate into patient selection.

Methods
A search of the WorldWide Antimalarial Resistance Network (WWARN) Clinical Trials Publication Library, MEDLINE, The Cochrane Library, and clinicaltrials.gov was conducted to identify trials investigating anti-malarial efficacy and safety, published between 14th April 2001 and 31st December 2017. An updated search using the WWARN Clinical Trial Publication Library was undertaken to identify eligible publications from 1st January 2018 to 31st July 2021. The review included studies in patients of any age with uncomplicated malaria and any pharmaceutical therapeutic intervention administered. The proportion of trials with malaria-positive patients excluded was calculated and linked to the reported reason for exclusion. A subgroup analysis on eligibility criteria and trial baseline demographics was conducted to assess whether criteria are complied with when recruiting patients.

Results
Out of 847 studies, 176 (21%) trials were included in the final synthesis, screening a total of 157,516 malaria-positive patients, of whom 56,293 (36%) were enrolled and treated. Across the 176 studies included, 84 different inclusion and exclusion criteria were identified. The reason for exclusion of patients who tested positive for malaria was reported in 144 (82%) studies. Three criteria account for about 70% of malaria-positive patients excluded: mixed-species malaria infections or other specific Plasmodium species, parasite counts outside the set study ranges, and refusal of consent.

Conclusions
Nearly two-thirds of the malaria-positive subjects who present to health facilities are systematically excluded from anti-malarial treatment trials. Reasons for exclusions are largely under-reported. Anti-malarial treatment in the general population is informed by studies on a narrow selection of patients who do not fully represent the totality of those seeking antimalarial treatment in routine practice. While entry criteria ensure consistency across trials, pragmatic trials are also necessary to supplement the information currently available and improve the external validity of the findings of malaria clinical trials.
Notification of malaria cases in the Brazilian Amazon Basin from 2010 to 2020: an analysis of the reporting times
Authors: Ayala Mario J. C. , Valiati Naiara C. M. , Bastos Leonardo S. , Villela Daniel A. M. 
Published: February 2023

Abstract
Background
As controlling malaria transmission remains a public-health challenge in the Brazilian Amazon basin, the National Surveillance System for Malaria (SIVEP-MALARIA) has registered malaria notifications for over fifteen years helping in the decision-making on control and elimination. As a surveillance database, the system is prone to reporting delays, and knowledge about reporting patterns is essential in decisions.

Methods
This study contains an analysis of temporal and state trends of reporting times in a total of 1,580,617 individual malaria reports from January 2010 to December 2020, applying procedures for statistical distribution fitting. A nowcasting technique was applied to show an estimation of number of cases using a statistical model of reporting delays.

Results
Reporting delays increased over time for the states of Amazonas, Rondônia, Roraima, and Pará. Amapá has maintained a similar reporting delay pattern, while Acre decreased reporting delay between 2010 and 2020. Predictions were more accurate in states with lower reporting delays. The temporal evolution of reporting delays only showed a decrease in malaria reports in Acre from 2010 to 2020.

Conclusion
Malaria notifications may take days or weeks to enter the national surveillance database. The reporting times are likely to impact incidence estimation over periods when data is incomplete, whilst the impact of delays becomes smaller for retrospective analysis. Short-term assessments for the estimation of malaria incidence from the malaria control programme must deal with reporting delays.
Effect of omega-3 supplementation on lipid profile in children and adolescents: a systematic review and meta-analysis of randomized clinical trials
Authors: Khorshidi Masoud , Hazaveh Zohreh Sajadi , Alimohammadi-kamalabadi Malek , Jamshidi Sanaz , Moghaddam Omid Moradi , Olang Beheshteh , Hatefi Sayeh , Hosseini Amirhossein , Jamilian Parsa , Zarezadeh Meysam , Kohansal Parichehr , Heshmati Javad , Jamilian Parmida , Sayyari Aliakbar 
Published: February 2023

AbstractPurposeDyslipidemia is considered as a known risk factor for cardiovascular disease. Yet various trials with wide ranges of doses and durations have reported contradictory results. We undertook this meta-analysis of randomized controlled trials (RCTs) to determine whether omega-3 supplementation can affect lipid profile in children and adolescents.MethodsCochrane Library, Embase, PubMed, and Scopus databases were searched up to March 2021. Meta-analysis was performed using random-effect method. Effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Heterogeneity was assessed using the I2index. In order to identification of potential sources of heterogeneity, predefined subgroup and meta-regression analysis was conducted.ResultsA total of 14 RCTs with 15 data sets were included. Based on the combination of effect sizes, there was a significant reduction in TG levels (WMD: -15.71 mg/dl, 95% CI: -25.76 to -5.65,P=0.002), with remarkable heterogeneity (I2=88.3%,P<0.001). However, subgroup analysis revealed that omega-3 supplementation significantly decreased TG only in studies conducted on participants ≤13 years old (WMD=-25.09, 95% CI: -43.29 to -6.90,P=0.007), (I2=84.6%,P<0.001) and those with hypertriglyceridemia (WMD=-28.26, 95% CI: -39.12 to -17.41,P<0.001), (I2=0.0%,P=0.934). Omega-3 supplementation had no significant effect on total cholesterol, HDL, and LDL levels. Also, results of nonlinear analysis showed significant effect of treatment duration on HDL status (Pnon-linearity=0.047).ConclusionOmega-3 supplementation may significantly reduce TG levels in younger children and those with hypertriglyceridemia. Also, based on the HDL-related results, clinical trials with longer duration of intervention are recommended in this population.
Cyclists’ exposure to air pollution, noise, and greenery: a population-level spatial analysis approach
Authors: Willberg Elias , Poom Age , Helle Joose , Toivonen Tuuli 
Published: February 2023

AbstractUrban travel exposes people to a range of environmental qualities with significant health and wellbeing impacts. Nevertheless, the understanding of travel-related environmental exposure has remained limited. Here, we present a novel approach for population-level assessment of multiple environmental exposure for active travel. It enables analyses of (1) urban scale exposure variation, (2) alternative routes’ potential to improve exposure levels per exposure type, and (3) by combining multiple exposures. We demonstrate the approach’s feasibility by analysing cyclists’ air pollution, noise, and greenery exposure in Helsinki, Finland. We apply an in-house developed route-planning and exposure assessment software and integrate to the analysis 3.1 million cycling trips from the local bike-sharing system. We show that especially noise exposure from cycling exceeds healthy thresholds, but that cyclists can influence their exposure by route choice. The proposed approach enables planners and individual citizens to identify (un)healthy travel environments from the exposure perspective, and to compare areas in respect to how well their environmental quality supports active travel. Transferable open tools and data further support the implementation of the approach in other cities.