bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D receptor antagonist activity in wastewater effluents—potential for endocrine disruption
Authors: Lundqvist Johan , Mandava Geeta , Oskarsson Agneta 
Published: May 2023

Abstract
Background
Endocrine disrupting chemicals have been identified for a number of human endocrine systems, but there are no reports on vitamin D-antagonistic activities in environmental samples.

Objectives
We have investigated if there are compounds present in the environment that can act as Vitamin D receptor (VDR) antagonists.

Methods
Water samples were collected of the influent and effluent water from five Swedish wastewater treatment facilities and concentrated with solid phase extraction. VDR antagonistic properties of the samples were tested with a cell-based in vitro assay responsive to vitamin D signaling. Cytotoxicity was monitored by three different assays.

Results
We observed a dose-dependent decrease in the VDR signaling in most studied samples, although the effect was overlapping with cytotoxicity for the influent samples. For effluent samples, we observed clear VDR antagonistic effects also in non-cytotoxic concentrations. The observed effects could not be explained by presence of natural organic matter or cadmium in the water.

Discussion
The vitamin D endocrine system regulates a broad range of physiological processes, and disruption of this system could be associated with serious health consequences. In this study, we report environmental presence of compounds with VDR antagonistic properties, compounds which constitute a new group of potential endocrine disruptors. The VDR antagonism was observed in wastewater treatment facility effluent waters, which are discharged into water systems used as raw water for drinking water production. The findings reported in this study may indicate a potential hazard to human health and aquatic life. Future research is needed to investigate the presence of VDR antagonists in the environment, identification of the causative compounds, and studies of exposure of humans and aquatic organisms to these compounds.
The role of the calcofluor white staining in the diagnosis of Acanthamoeba keratitis
Authors: Elhardt Carolin , Schweikert Romina , Hartmann Lennart Maximilian , Vounotrypidis Efstathios , Kilani Adnan , Wolf Armin , Wertheimer Christian Maximilian 
Published: May 2023

Abstract
Purpose
Acanthamoeba keratitis is often misdiagnosed at disease onset. This study presents data to confirm the diagnosis using calcofluor white (CFW) staining.

Methods
Forty three patients were retrospectively included who presented to the Department of Ophthalmology at the University Hospital Ulm with keratitis between 2000 and 2022. Condition positive cases were diagnosed based on the typical clinical presentation of Acanthamoeba keratitis with a positive polymerase chain reaction (PCR). Condition negative were patients with ulcers due to other causing pathogens with a negative Acanthamoeba PCR result. The condition was compared with the CFW test results.

Results
After symptom onset, time until presentation was 17 ± 12 days and until diagnosis 27 ± 13 days in the 15 condition positive patients. Among the 35 patients with additional CFW test, 7 patients were condition positive and 28 negative. 5 of the 7 patients were true positive, 2 were false negative. In the 28 condition negative patients, 1 was false positive. Sensitivity of CFW was 71% and specificity 96%. The positive PCR results were available 3.4 ± 2.3 days after corneal scraping, the positive CFW test results on the same day in each case.

Conclusion
Our data demonstrate that diagnosis of Acanthamoeba keratitis remains difficult and therapy is initiated late. A positive CFW test confirms the diagnosis as there are almost no false positive results and it was available faster than PCR. In case of a negative CFW test, Acanthamoeba keratitis cannot be ruled out because of a high false negative rate.
Investigation of hollow mesoporous NiFe2O4 nanospheres fabricated via a template-free solvothermal route as pH-responsive drug delivery system for potential anticancer application
Authors: Qi Qing , Zhang Hui , Liu Mengru , Qi Shujing , Huo Zhongchao , Ma Yingying , Zhang Zhongqiang , Lu Yongchang , Qi Xiongwei , Han Shuai , Wang Guangshuo 
Published: May 2023

AbstractA novel magnetic-targeted pH-responsive intelligent drug carrier based on hollow mesoporous structured NiFe2O4 nanospheres was designed and developed for potential anticancer treatment in the present study. The hollow mesoporous NiFe2O4 nanospheres were fabricated through a template-free solvothermal approach and the possible formation mechanism of this structure was proposed. The products were investigated comprehensively for their morphology, microstructure, composition and magnetic properties using a wide series of characterization methods. The NiFe2O4 nanospheres were demonstrated to possess a well-defined spherical morphology, homogeneous particle size distribution, large hollow cavities and abundant mesopores, unique superparamagnetic behavior, high saturation magnetization as well as good biocompatibility. Due to these desirable physicochemical properties, the hollow mesoporous NiFe2O4 nanospheres were expected to be employed as a potential vehicle for loading and delivering anticancer drug of doxorubicin hydrochloride (DOX). Drug release behavior was evidenced to be controllable and pH-responsive with effective DOX release of 73.1% and 58.8% in acidic conditions (pH 4.0 and 5.5), whereas insufficient drug release of 44.7% at a neutral atmosphere (pH 7.4) within 48 h. More importantly, the DOX-loaded NiFe2O4 nanospheres displayed significant anti-proliferation and apoptosis effects on human breast cancer cells (MCF-7), which further indicated the promising potential application of constructed drug delivery nanocarriers in the field of cancer therapy.
HostSeq: a Canadian whole genome sequencing and clinical data resource
Authors: Yoo S , Garg E , Elliott LT , Hung RJ , Halevy AR , Brooks JD , Bull SB , Gagnon F , Greenwood CMT , Lawless JF , Paterson AD , Sun L , Zawati MH , Lerner-Ellis J , Abraham RJS , Birol I , Bourque G , Garant J-M , Gosselin C , Li J , Whitney J , Thiruvahindrapuram B , Herbrick J-A , Lorenti M , Reuter MS , Adeoye OO , Liu S , Allen U , Bernier FP , Biggs CM , Cheung AM , Cowan J , Herridge M , Maslove DM , Modi BP , Mooser V , Morris SK , Ostrowski M , Parekh RS , Pfeffer G , Suchowersky O , Taher J , Upton J , Warren RL , Yeung RSM , Aziz N , Turvey SE , Knoppers BM , Lathrop M , Jones SJM , Scherer SW , Strug LJ 
Published: May 2023

AbstractHostSeq was launched in April 2020 as a national initiative to integrate whole genome sequencing data from 10,000 Canadians infected with SARS-CoV-2 with clinical information related to their disease experience. The mandate of HostSeq is to support the Canadian and international research communities in their efforts to understand the risk factors for disease and associated health outcomes and support the development of interventions such as vaccines and therapeutics. HostSeq is a collaboration among 13 independent epidemiological studies of SARS-CoV-2 across five provinces in Canada. Aggregated data collected by HostSeq are made available to the public through two data portals: a phenotype portal showing summaries of major variables and their distributions, and a variant search portal enabling queries in a genomic region. Individual-level data is available to the global research community for health research through a Data Access Agreement and Data Access Compliance Office approval. Here we provide an overview of the collective project design along with summary level information for HostSeq. We highlight several statistical considerations for researchers using the HostSeq platform regarding data aggregation, sampling mechanism, covariate adjustment, and X chromosome analysis. In addition to serving as a rich data source, the diversity of study designs, sample sizes, and research objectives among the participating studies provides unique opportunities for the research community.
An optimized graph-based structure for single-cell RNA-seq cell-type classification based on non-linear dimension reduction
Authors: Abadi Saeedeh Akbari Rokn , Laghaee Seyed Pouria , Koohi Somayyeh 
Published: May 2023

Abstract
Background
It is now possible to analyze cellular heterogeneity at the single-cell level thanks to the rapid developments in single-cell sequencing technologies. The clustering of cells is a fundamental and common step in heterogeneity analysis. Even so, accurate cell clustering remains a challenge due to the high levels of noise, the high dimensions, and the high sparsity of data.

Results
Here, we present SCEA, a clustering approach for scRNA-seq data. Using two consecutive units, an encoder based on MLP and a graph attention auto-encoder, to obtain cell embedding and gene embedding, SCEA can simultaneously achieve cell low-dimensional representation and clustering performing various examinations to obtain the optimal value for each parameter, the presented result is in its most optimal form. To evaluate the performance of SCEA, we performed it on several real scRNA-seq datasets for clustering and visualization analysis.

Conclusions
The experimental results show that SCEA generally outperforms several popular single-cell analysis methods. As a result of using all available datasets, SCEA, in average, improves clustering accuracy by 4.4% in ARI Parameters over the well-known method scGAC. Also, the accuracy improvement of 11.65% is achieved by SCEA, compared to the Seurat model.
Determinants of referral for suspected coronary artery disease: a qualitative study based on decision thresholds
Authors: Winkler Katja , Gerlach Navina , Donner-Banzhoff Norbert , Berberich Anika , Jung-Henrich Jutta , Schlößler Kathrin 
Published: May 2023

Abstract
Background
Chest pain is a frequent consultation issue in primary care, with coronary artery disease (CAD) being a serious potential cause. Primary care physicians (PCPs) assess the probability for CAD and refer patients to secondary care if necessary. Our aim was to explore PCPs’ referral decisions, and to investigate determinants which influenced those decisions.

Methods
PCPs working in Hesse, Germany, were interviewed in a qualitative study. We used ‘stimulated recall’ with participants to discuss patients with suspected CAD. With a sample size of 26 cases from nine practices we reached inductive thematic saturation. Interviews were audio-recorded, transcribed verbatim and analyzed by inductive-deductive thematic content analysis. For the final interpretation of the material, we used the concept of decision thresholds proposed by Pauker and Kassirer.

Results
PCPs reflected on their decisions for or against a referral. Aside from patient characteristics determining disease probability, we identified general factors which can be understood as influencing the referral threshold. These factors relate to the practice environment, to PCPs themselves and to non-diagnostic patient characteristics. Proximity of specialist practice, relationship with specialist colleagues, and trust played a role. PCPs sometimes felt that invasive procedures were performed too easily. They tried to steer their patients through the system with the intent to avoid over-treatment. Most PCPs were unaware of guidelines but relied on informal local consensus, largely influenced by specialists. As a result, PCPs gatekeeping role was limited.

Conclusions
We could identify a large number of factors that impact referral for suspected CAD. Several of these factors offer possibilities to improve care at the clinical and system level. The threshold model proposed by Pauker and Kassirer was a useful framework for this kind of data analysis.
Functional outcomes following knee replacement in community-dwelling older adults
Authors: Wang Yuanyuan , Owen Alice , Franks Angus , Ackerman Ilana , Fitzgerald Sharyn M. , Liew Susan , Woods Robyn L. , Wluka Anita E. , McNeil John J. , Cicuttini Flavia M. 
Published: May 2023

Abstract
Background

Knee replacements are increasingly performed in older adults but uncertainty remains regarding their benefits in the context of age-related decline in physical function and other comorbidities. This study aimed to examine (1) the effect of knee replacement on functional outcomes in the context of age-related decline in physical function and (2) the factors associated with minimal important improvement in physical function after knee replacement in community-dwelling older adults aged ≥ 70 years.

Methods
This cohort study was performed within the ASPREE trial, with 889 participants undergoing knee replacement during the trial and 858 age- and sex-matched controls without knee or hip replacement identified from 16,703 Australian participants aged ≥ 70 years. Health-related quality of life was assessed annually using the SF-12, including its physical and mental component summary (PCS and MCS). Gait speed was measured biennially. Multiple linear regression and analysis of covariance were used to adjust for potential confounders.

Results
Participants with knee replacement had significantly lower pre- and post-replacement PCS scores and gait speed compared with age- and sex-matched controls. Participants with knee replacement had significant improvement in PCS score following knee replacement (mean change 3.6, 95% CI 2.9–4.3) while PCS score remaining unchanged in age- and sex-matched controls (-0.02, 95% CI -0.6 to 0.6) during follow-up period. The greatest improvements were observed for bodily pain and physical function. Following knee replacement, 53% of participants experienced minimal important improvement in PCS score (increased by ≥ 2.7), while 24% experienced worsened PCS score (reduced by > 2.7). Participants experiencing improved PCS score postoperatively had significantly lower PCS and higher MCS scores pre-surgery.

Conclusions
Although community-based older adults experienced a significant improvement in PCS scores after knee replacement, their postoperative physical functional status remained significantly lower than age- and sex-matched controls. The degree of preoperative physical function impairment was a strong predictor of functional improvement, suggesting that this could be an important consideration when identifying older people most likely to benefit from knee replacement surgery.
Previous antibiotic therapy as independent risk factor for the presence of vancomycin-resistant enterococci in surgical inpatients. Results from a matched case-control study
Authors: MacKenzie Philip , Färber Jacqueline , Post Marius , Esser Torben , Bechmann Lukas , Kropf Siegfried , Croner Roland , Geginat Gernot 
Published: May 2023

Abstract
Background
Investigation of risk factors for the presence of vancomycin-resistant enterococci (VRE) in inpatients on surgical wards and associated intensive care units of a German tertiary care hospital.

Methods
A single-centre retrospective matched case-control study was performed with surgical inpatients admitted between July 2013 and December 2016. Patients with in-hospital detection of VRE later than 48 h after admission were included and comprised 116 VRE-positive cases and 116 VRE-negative matched controls. VRE isolates of cases were typed by multi-locus sequence typing.

Results
ST117 was identified as the dominant VRE sequence type. Next to length of stay in hospital or on an intensive care unit and previous dialysis the case-control study revealed previous antibiotic therapy as a risk factor for the in-hospital detection of VRE. The antibiotics piperacillin/tazobactam, meropenem, and vancomycin were associated with the highest risks. After taking into account length of stay in hospital as possible confounder other potential contact-related risk factors such as previous sonography, radiology, central venous catheter, and endoscopy were not significant.

Conclusions
Previous dialysis and previous antibiotic therapy were identified as independent risk factors for the presence of VRE in surgical inpatients.
Pregnancy- and lactation-induced osteoporosis: a social-media-based survey
Authors: Peltz-Sinvani Naama , Raz Hadar Milloh , Klein Pinchas , Ish-Shalom Sophia , Vered Iris , Tripto-Shkolnik Liana 
Published: May 2023

Abstract
Background
Pregnancy- and lactation-induced osteoporosis (PLO) presenting as spinal fractures is rare, and the spectrum of clinical presentation, risk factors and pathophysiology are incompletely understood. The aim of this study was to delineate clinical parameters, risk factors and osteoporosis-related quality of life (QOL) of women with PLO.

Methods
Participants of a social-media (WhatsApp) PLO group and mothers of a parents’ WhatsApp group (control group) were offered to fill a questionnaire, including an osteoporosis-related QOL section. The groups were compared using the independent Students t test for numerical variables, and the Chi-square test or Fisher’s exact test for categorical variables.

Results
Twenty-seven women with PLO and 43 in the control group (aged 36.2 ± 4.7 and 38.8 ± 4.3 years, respectively, p = 0.04) participated. Among women with PLO, more than 5 vertebrae were involved in 13 (48%), 4 vertebrae in 6 (22%), and 3 or fewer vertebrae in 8 (30%). Among the 24 women with relevant data, 21 (88%) had nontraumatic fractures; 3 (13%) women had fractures during pregnancy, and the remaining during the early postpartum period. Diagnosis was delayed for over 16 weeks for 11 (41%) women; 16 (67%) received teriparatide. Significantly lower proportions of women in the PLO group engaged in physical activity over 2 hours/week, before and during pregnancy (37 vs. 67%, p < 0.015 and 11 vs. 44%, p < 0.003, respectively). A lower proportion of the PLO than the control group reported calcium supplementation during pregnancy (7% vs. 30%, p = 0.03) and a higher proportion reported treatment with low-molecular-weight-heparin during pregnancy (p = 0.03). Eighteen (67%) of the PLO group expressed fear of fractures and 15 (56%) fear of falls, compared to none and 2%, respectively, of the control group (p < 0.00001 for both).

Conclusions
Most of the women with PLO who responded to our survey reported spinal fractures involving multiple vertebrae, delayed diagnosis, and treatment with teriparatide. Compared to a control group, they reported less physical activity and impaired QOL. For this uncommon yet severe condition, a multidisciplinary effort should be exerted for early identification and treatment, to alleviate back pain, prevent subsequent fractures and improve QOL.
Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021
Authors: Schranz Madlen , Boender T. Sonia , Greiner Timo , Kocher Theresa , Wagner Birte , Greiner Felix , Bienzeisler Jonas , Diercke Michaela , Grabenhenrich Linus ,   AKTIN-Research Group, Brokmann Jörg , Mach Carsten , Wehler Markus , Blaschke Sabine , Esslinger Katrin , Schunk Domagoj , Wolfrum Sebastian , Hofmann Tobias , Lucas Benjamin , Klein Matthias , Peschel Thomas , Grupp Caroline , Wenderoth Hardy , Horn Oliver , Wrede Christian , Hoeger-Schmidt Heike , Dormann Harald , Ullrich Greta , Habbinga Kirsten , Henke Thomas , Schilling Tobias , Erdmann Bernadett , Wetzel Eckart , Baacke Markus , Grashey Rupert , Röhrig Rainer , Majeed Raphael , Kombeiz Alexander , Triefenbach Lucas , Walcher Felix , Schirrmeister Wiebke , Otto Ronny , Drynda Susanne , Aigner Annette , Ullrich Alexander 
Published: May 2023

Abstract
Background
During the COVID-19 pandemic and associated public health and social measures, decreasing patient numbers have been described in various healthcare settings in Germany, including emergency care. This could be explained by changes in disease burden, e.g. due to contact restrictions, but could also be a result of changes in utilisation behaviour of the population. To better understand those dynamics, we analysed routine data from emergency departments to quantify changes in consultation numbers, age distribution, disease acuity and day and hour of the day during different phases of the COVID-19 pandemic.

Methods
We used interrupted time series analyses to estimate relative changes for consultation numbers of 20 emergency departments spread throughout Germany. For the pandemic period (16-03-2020 – 13-06-2021) four different phases of the COVID-19 pandemic were defined as interruption points, the pre-pandemic period (06-03-2017 – 09-03-2020) was used as the reference.

Results
The most pronounced decreases were visible in the first and second wave of the pandemic, with changes of − 30.0% (95%CI: − 32.2%; − 27.7%) and − 25.7% (95%CI: − 27.4%; − 23.9%) for overall consultations, respectively. The decrease was even stronger for the age group of 0–19 years, with − 39.4% in the first and − 35.0% in the second wave. Regarding acuity levels, consultations assessed as urgent, standard, and non-urgent showed the largest decrease, while the most severe cases showed the smallest decrease.

Conclusions
The number of emergency department consultations decreased rapidly during the COVID-19 pandemic, without extensive variation in the distribution of patient characteristics. Smallest changes were observed for the most severe consultations and older age groups, which is especially reassuring regarding concerns of possible long-term complications due to patients avoiding urgent emergency care during the pandemic.
Complete childhood vaccination and associated factors among children aged 12–23 months in Dabat demographic and health survey site, Ethiopia, 2022
Authors: Gelagay Abebaw Addis , Worku Abebaw Gebeyehu , Bashah Debrework Tesgera , Tebeje Nigusie Birhan , Gebrie Mignote Hailu , Yeshita Hedija Yenus , Cherkose Endeshaw Adimasu , Ayana Birhanu Abera , Lakew Ayenew Molla , Bitew Desalegn Anmut , Asmamaw Desale Bihonegn , Negash Wubshet Debebe , Belachew Tadele Biresaw , Fentie Elsa Awoke 
Published: May 2023

Abstract
Introduction
Childhood immunization is one of the most cost-effective public health strategies to prevent children’s mortality and morbidity from infectious diseases, but the Covid-19 pandemic and associated disruptions have strained health systems, and worldwide 25 million children missing out on vaccination in 2021. Of the 25 million, more than 60% of these children live in 10 countries including Ethiopia. Therefore, this study aimed to assess complete childhood vaccination coverage and associated factors in the Dabat district.

Method
A community-based cross-sectional study was conducted from December 10/2020 to January 10/2021Gregorian Calendar. The data for this study was extracted from information collected for the assessment of maternal, Neonatal, and Child Health and health services utilization in the Dabat demographic and health survey site. Vaccine-related data were collected using an interviewer-administered questionnaire. An adjusted odds ratio with a 95% confidence interval was used to identify the presence and the direction of the association.

Results
Based on vaccination cards and mothers/caretakers’ recall 30.9% (95%CI: 27.9-34.1%) of children aged 12–23 months in the Dabat district were completely immunized. Urban residency [AOR 1.813, 95% CI: (1.143, 2.878)], delivered in the health facility [AOR = 5.925, 95% CI: (3.680, 9.540)], ANC follow-up during their pregnancy [AOR 2.023, 95% CI: (1.352, 3.027)], rich wealth index [AOR = 2.392, 95% CI: (1.296, 4.415)], and parity [AOR 2.737, 95% CI: (1.664, 4.500)] were significantly associated with complete child vaccination.

Recommendation and conclusion
Complete vaccination coverage among children aged 12–23 months in the Dabat district was lower than the Global vaccine plan and Ethiopian ministry of health goal in 2020. Therefore, Health care providers and other stakeholders should mobilize the community to improve mothers’ health-seeking behavior toward pregnancy follow-up and health facility delivery to improve childhood vaccination. Besides, expanding the service to remote areas are necessary to increase the immunization access.