bluuebunny/crossref_metadata_2025_split huggingface dataset:
scSemiAAE: a semi-supervised clustering model for single-cell RNA-seq data
Authors: Wang Zile , Wang Haiyun , Zhao Jianping , Zheng Chunhou 
Published: May 2023

Abstract
Background
Single-cell RNA sequencing (scRNA-seq) strives to capture cellular diversity with higher resolution than bulk RNA sequencing. Clustering analysis is critical to transcriptome research as it allows for further identification and discovery of new cell types. Unsupervised clustering cannot integrate prior knowledge where relevant information is widely available. Purely unsupervised clustering algorithms may not yield biologically interpretable clusters when confronted with the high dimensionality of scRNA-seq data and frequent dropout events, which makes identification of cell types more challenging.

Results
We propose scSemiAAE, a semi-supervised clustering model for scRNA sequence analysis using deep generative neural networks. Specifically, scSemiAAE carefully designs a ZINB adversarial autoencoder-based architecture that inherently integrates adversarial training and semi-supervised modules in the latent space. In a series of experiments on scRNA-seq datasets spanning thousands to tens of thousands of cells, scSemiAAE can significantly improve clustering performance compared to dozens of unsupervised and semi-supervised algorithms, promoting clustering and interpretability of downstream analyses.

Conclusion
scSemiAAE is a Python-based algorithm implemented on the VSCode platform that provides efficient visualization, clustering, and cell type assignment for scRNA-seq data. The tool is available from https://github.com/WHang98/scSemiAAE.
Impact of a multidisciplinary approach involving clinical pharmacist on resolving drug related problems in chronic kidney patients: a prospective interventional study
Authors: Pehlivanli Aysel , Eyupoglu Sahin , Basgut Bilgen , Erturk Sehsuvar , Ozcelikay A. Tanju 
Published: May 2023

Abstract
Background
Chronic kidney disease (CKD) is a major public health concern due to its high mortality risk, high hospitalization rates and cost, and low life expectancy. Thus, CKD patients are among patient group that may benefit from clinical pharmacy services the most.

Methods
This was a prospective interventional study conducted between October 1, 2019, and March 18, 2020, in the nephrology ward of Ankara University School of the Medicine, Ibn-i Sina Hospital. DRPs were classified according to PCNE v8.03. The main outcomes were interventions proposed and the rate of acceptance by the physicians.

Results
269 pre-dialysis patients were included to determine DRPs during the treatment process of the patients. 205 DRPs were found in 131 (48.7%) patients. Treatment efficacy was found to be the main type of DRPs (56.2%) followed by treatment safety (39.6%). When patients with and without DRPs were compared, it was found that the number of female patients (55.0%) was higher in the group with DRPs (p < 0.05). The length of hospital stays (11.3 ± 7.7) and the mean number of drugs used (9.6 ± 3.6) in the group with DRPs were significantly higher than those without DRPs (9.3 ± 5.9; 8.1 ± 3.5, respectively) (p < 0.05). 91.7% of the interventions were accepted by the physicians, and patients and found clinically beneficial. 71.7% of DRPs were fully resolved, 1.9% partially resolved and 23.4% could not be resolved.

Conclusions
A high prevalence of DRPs in patients with chronic kidney disease was determined during therapy. Clinical pharmacist interventions were highly accepted by the physicians and patients. This may indicate implementation of clinical pharmacy services in the nephrology ward has a great impact on optimized therapy and prevention DRPs.
Effectiveness of midwifery-led care on pregnancy outcomes in low- and middle-income countries: a systematic review and meta-analysis
Authors: Fikre Rekiku , Gubbels Jessica , Teklesilasie Wondwosen , Gerards Sanne 
Published: May 2023

Abstract
Background
Midwifery-led care is an evidence-based practice in which a qualified midwife provides comprehensive care for low-risk pregnant women and new-borns throughout pregnancy, birth, and the postnatal period. Evidence indicates that midwifery-led care has positive impacts on various outcomes, which include preventing preterm births, reducing the need for interventions, and improving clinical outcomes. This is, however, mainly based on studies from high-income countries. Therefore, this systematic review and meta-analysis aimed to assess the effectiveness of midwifery-led care on pregnancy outcomes in low- and middle-income countries.

Methods
We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Three electronic databases (PubMed, CINAHL, and EMBASE) were searched. The search results were systematically screened by two independent researchers. Two authors independently extracted all relevant data using a structured data extraction format. Data analysis for the meta-analysis was done using STATA Version 16 software. A weighted inverse variance random-effects model was used to estimate the effectiveness of midwifery-led care on pregnancy outcomes. Odds ratio with a 95% confidence interval (CI) was presented using a forest plot.

Results
Ten studies were eligible for inclusion in this systematic review, of which five studies were eligible for inclusion in the meta-analysis. Women receiving midwifery-led care had a significantly lower rate of postpartum haemorrhage and a reduced rate of birth asphyxia. The meta-analysis further showed a significantly reduced risk of emergency Caesarean section (OR = 0.49; 95% CI: 0.27–0.72), increased odds of vaginal birth (OR = 1.14; 95% CI: 1.04–1.23), decreased use of episiotomy (OR = 0.46; 95% CI: 0.10–0.82), and decreased average neonatal admission time in neonatal intensive care unit (OR = 0.59; 95% CI: 0.44–0.75).

Conclusions
This systematic review indicated that midwifery-led care has a significant positive impact on improving various maternal and neonatal outcomes in low- and middle-income countries. We therefore advise widespread implementation of midwifery-led care in low- and middle-income countries.
The association of healthy lifestyle score and risk of non-alcoholic fatty liver disease
Authors: Jahromi Mitra Kazemi , Daftari Ghazal , Farhadnejad Hossein , Tehrani Asal Neshatbini , Teymoori Farshad , Salehi-Sahlabadi Ammar , Mirmiran Parvin 
Published: May 2023

Abstract
Background
The combined role of important environmental factors as a single lifestyle index in predicting non-alcoholic fatty liver disease (NAFLD) risk is not fully assessed. Therefore, we aimed to investigate the association of healthy lifestyle factor score (HLS) with the odds of NAFLD in Iranian adults.

Methods
This case-control study was conducted on 675 participants, aged ≥ 20–60 years, including 225 new NAFLD cases and 450 controls. We measured dietary intake information using a validated food frequency questionnaire and determined diet quality based on the alternate healthy eating index-2010(AHEI-2010). The score of HLS was calculated based on four lifestyle factors, including a healthy diet, normal body weight, non-smoking, and high physical activity. An ultrasound scan of the liver was used to detect NAFLD in participants of the case group. Logistic regression models were used to determine the odds ratios(ORs) and 95% confidence interval(CI) of NAFLD across tertiles of HLS and AHEI.

Results
Mean ± SD age of the participants were 38.13 ± 8.85 years. The Mean ± SD HLS in the case and control groups was 1.55 ± 0.67 and 2.53 ± 0.87, respectively. Also, the Mean ± SD AHEI in the case and control groups was 48.8 ± 7.7 and 54.1 ± 8.1, respectively. Based on the age and sex-adjusted model, the odds of NAFLD were decreased across tertiles of AHEI (OR:0.18;95%CI:0.16–0.29,Ptrend<0.001) and HLS(OR:0.03;95%CI:0.01–0.05,Ptrend<0.001). Also, in the multivariable model, the odds of NAFLD were decreased across tertiles AHEI (OR:0.12;95%CI:0.06–0.24,Ptrend<0.001) and HLS(OR:0.02;95%CI:0.01–0.04,Ptrend<0.001).

Conclusions
Our findings reported that higher adherence to lifestyle with a higher score of HLS was associated with decreased odds of NAFLD. Also, a diet with a high AHEI score can reduce the risk of NAFLD in the adult population.
Community dialogue meetings among district leaders improved their willingness to receive COVID-19 vaccines in Western Uganda, May 2021
Authors: Nsubuga Edirisa Juniour , Fitzmaurice Arthur G. , Komakech Allan , Odoi Tom Dias , Kadobera Daniel , Bulage Lilian , Kwesiga Benon , Elyanu Peter James , Ario Alex Riolexus , Harris Julie R. 
Published: May 2023

Abstract
Background
Widespread COVID-19 vaccine uptake can facilitate epidemic control. A February 2021 study in Uganda suggested that public vaccine uptake would follow uptake among leaders. In May 2021, Baylor Uganda led community dialogue meetings with district leaders from Western Uganda to promote vaccine uptake. We assessed the effect of these meetings on the leaders’ COVID-19 risk perception, vaccine concerns, perception of vaccine benefits and access, and willingness to receive COVID-19 vaccine.

Methods
All departmental district leaders in the 17 districts in Western Uganda, were invited to the meetings, which lasted approximately four hours. Printed reference materials about COVID-19 and COVID-19 vaccines were provided to attendees at the start of the meetings. The same topics were discussed in all meetings. Before and after the meetings, leaders completed self-administered questionnaires with questions on a five-point Likert Scale about risk perception, vaccine concerns, perceived vaccine benefits, vaccine access, and willingness to receive the vaccine. We analyzed the findings using Wilcoxon’s signed-rank test.

Results
Among 268 attendees, 164 (61%) completed the pre- and post-meeting questionnaires, 56 (21%) declined to complete the questionnaires due to time constraints and 48 (18%) were already vaccinated. Among the 164, the median COVID-19 risk perception scores changed from 3 (neutral) pre-meeting to 5 (strong agreement with being at high risk) post-meeting (p < 0.001). Vaccine concern scores reduced, with medians changing from 4 (worried about vaccine side effects) pre-meeting to 2 (not worried) post-meeting (p < 0.001). Median scores regarding perceived COVID-19 vaccine benefits changed from 3 (neutral) pre-meeting to 5 (very beneficial) post-meeting (p < 0.001). The median scores for perceived vaccine access increased from 3 (neutral) pre-meeting to 5 (very accessible) post-meeting (p < 0.001). The median scores for willingness to receive the vaccine changed from 3 (neutral) pre-meeting to 5 (strong willingness) post-meeting (p < 0.001).

Conclusion
COVID-19 dialogue meetings led to district leaders’ increased risk perception, reduced concerns, and improvement in perceived vaccine benefits, vaccine access, and willingness to receive the COVID-19 vaccine. These could potentially influence public vaccine uptake if leaders are vaccinated publicly as a result. Broader use of such meetings with leaders could increase vaccine uptake among themselves and the community.
LGBTQ College student health and wellbeing at the onset of the pandemic: additional evidence and lessons learned from COVID-19
Authors: Gonzales Gilbert , de Mola Emilio Loret , Robertson Lee , Gavulic Kyle A. , McKay Tara 
Published: May 2023

Abstract
Background
The coronavirus (COVID-19) pandemic has killed more than six million people and disrupted health care systems globally. In the United States alone, more than one million people have died from COVID-19 infections. At the start of the pandemic, nearly all aspects of our lives paused to prevent the spread of the novel coronavirus. Many institutions of higher education transitioned to remote learning and enacted social distancing measures. This study examined the health needs and vulnerabilities of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) college students at the start of the COVID-19 pandemic in the United States.

Methods
We fielded a rapid-response online survey between April and June of 2020. We recruited 578 LGBTQ-identifying college students aged 18 years and older by reaching out to LGBTQ-serving organizations on 254 college campuses and via targeted social media advertising.

Results
Approximately 40% of LGBTQ college students surveyed were dissatisfied with life at the start of the COVID-19 pandemic, and almost all (90%) were concerned that COVID-19 would threaten their mental health. Moreover, about 40% of LGBTQ college students reported unmet mental health needs, and 28% were worried about seeking care during the pandemic because of their LGBTQ identity. One out of four LGBTQ college students had to go back in the closet because of the pandemic, and approximately 40% were concerned about their finances or personal safety during the COVID-19 pandemic. Some of these adverse outcomes were prominent among younger students, Hispanic/Latinx students, and students with unsupportive families or colleges.

Conclusions
Our study adds novel findings to the large body of research demonstrating that LGBTQ college students experienced distress and elevated mental health needs early in the pandemic. Future research should examine the long-term consequences of the pandemic among LGBTQ and other minoritized college students. Public health policymakers, health care providers, and college and university officials should provide LGBTQ students affirming emotional supports and services to ensure their success as the COVID-19 pandemic transitions to endemic.
Association between sleep problems and multimorbidity patterns in older adults
Authors: Idalino Stefany Cristina Claudino , Canever Jaquelini Betta , Cândido Letícia Martins , Wagner Katia Jakovljevic Pudla , de Souza Moreira Bruno , Danielewicz Ana Lúcia , de Avelar Núbia Carelli Pereira 
Published: May 2023

Abstract
Background
Sleep problems are frequent in older adults and are associated with chronic diseases. However, the association with multimorbidity patterns is still unknown. Considering the negative impacts that multimorbidity patterns can have on older adults’ life, knowledge of this association can help in the screening and early identification of older adults with sleep problems. The objective was to verify the association between sleep problems and multimorbidity patterns in older Brazilian adults.

Methods
This was a cross-sectional study conducted with data from 22,728 community-dwelling older adults from the 2019 National Health Survey. The exposure variable was self-reported sleep problems (yes/no). The study outcomes were: multimorbidity patterns, analyzed by self-report of the coexistence of two or more chronic diseases with similar clinical characteristics: (1) cardiopulmonary; (2) vascular-metabolic; (3) musculoskeletal; (4) coexisting patterns.

Results
Older adults with sleep problems had 1.34 (95%CI: 1.21; 1.48), 1.62 (95%CI: 1.15; 2.28), 1.64 (95%CI: 1.39; 1.93), and 1.88 (95%CI: 1.52; 2.33) greater odds of presenting vascular-metabolic, cardiopulmonary, musculoskeletal, and coexisting patterns, respectively.

Conclusions
These results suggest that public health programs aimed at preventing sleep problems in older adults are essential to reduce possible adverse health outcomes, including multimorbidity patterns and their negative consequences for older adults’ health.
Association of depressive symptoms with retirement in Chinese employees: evidence from national longitudinal surveys from 2011 to 2018
Authors: Xu Fenglin , Yuan Jingmin , Wu Hongxia 
Published: May 2023

Abstract
Background
The relationship between depressive symptoms and retirement remains controversial. Thus, we aimed to explore the effect of retirement on individuals' depressive symptoms in Chinese employees.

Methods
In this panel data analysis, a data set from China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015 and 2018 was adopted with a total of 1390 employees aged ≥ 45-years-old who had complete follow-up for the four waves. Random-effects logistic regression was used to examine the associations between retirement and depressive symptoms.

Results
After adjusting several socio-demographic variables, retirement still increases the risk of depressive symptoms in the retirees (odds ratio 1.5, 95% CI 1.14–1.97). Through subgroup analysis, we found that people who are male, with lower education level, married, living in rural areas, suffering from chronic diseases, and those who do not participate in social activities are more likely to experience depression after retirement.

Conclusions
Retirement can increase the depression risk of Chinese employees. It is necessary to formulate relevant supporting policies to reduce the risk of depression.
Impacts of COVID-19 on career choices in health professionals and medical students
Authors: Doan Linh Phuong , Dam Vu Anh Trong , Boyer Laurent , Auquier Pascal , Fond Guillaume , Tran Bach , Vu Thuc Minh Thi , Do Hoa Thi , Latkin Carl A. , Zhang Melvyn W.B. , Ho Roger C.M. , Ho Cyrus S.H. 
Published: May 2023

Abstract
Backgrounds
The COVID-19 pandemic has resulted in not only significant mortalities in Vietnam but has had an impact on its economy. Previous studies have highlighted how the pandemic has had a marginal impact on Vietnamese healthcare workers working at the frontlines. To date, there have been several other studies examining the impact of COVID-19 on intentions to transition between jobs among healthcare professionals, but this has yet to be explored amongst Vietnamese healthcare workers.

Methods
To achieve the study’s objectives an online cross-sectional study was conducted between September to November 2021. Snowball sampling methodology was adopted for the recruitment of participants. The questionnaire that was used for this study comprised of the following sections: (a) socio-demographic information; (b) impact of COVID-19 on work; (c) risk of exposure to COVID-19; (d) career choices/intentions to change job, and (e) motivation at work.

Results
There were 5727 completed the entire survey. 17.2% of the respondents have had increased job satisfaction, 26.4% reported increased motivation to work, and 40.9% reported decreased motivation to work. Whilst there were changes in the daily work intensity and the level of work-related stress, more than 60% of respondents we sampled did not intend to switch careers. Demographic variables like gender, whether one was a student or an existing healthcare worker, and income related to work motivation. The community’s stigma was a negative factor that declined intrinsic motivation as well as decreased work retention.

Conclusions
Our study is instrumental in identifying the impact of COVID-19 on career choices amongst Vietnamese healthcare workers. The factors identified have clear implications for policymaking.
Spatial differentiation and driving factors of the high-quality development of undertakings for the aged of China
Authors: Peng Rong , Huang Jianhang , Deng Xueqin , Wang Yingying 
Published: May 2023

Abstract
Background
Promoting the high-quality development (HQD) of undertakings for the aged is an important action to proactively respond to the rapid population aging in China. This study analyzes spatial differentiation and driving factors of the HQD of China’s undertakings for the aged.

Methods
Based on a quantitative indicator system consisting of old-age social security, elder care services, health care service and older adults’ social participation, the HQD levels of 31 Chinese provincial administrative regions during 2013–2019 are measured by using the entropy weight method. Spatial panel regression models are used to analyze the impact of population aging, economic development and digital technology on the HQD of undertakings for the aged.

Results
The comprehensive level of the HQD slightly increased from 0.212 to 2013 to 0.220 in 2019, and the overall level was low. The HQD of the eastern region was the highest (0.292), followed by the western region (0.215), and the central region was the lowest (0.151). The high-high cluster type was mainly distributed in the eastern region; the low-low cluster type was mainly distributed in the western and central regions. Economic development and digital technology have significant positive effects while population aging has significant negative effects on the HQD of undertakings for the aged.

Conclusion
There is a significantly spatial differentiation in the HQD of China’s undertakings for the aged. In order to promote the HQD of undertakings for the aged, it is necessary to identify development gaps through making HQD evaluation and to focus on the indicators that are critical in maintaining sustainable economic development and to develop digital technology in order to get rid of those gaps.
Tumor microenvironment-responsive spherical nucleic acid nanoparticles for enhanced chemo-immunotherapy
Authors: Ma Bing , Ma Yingying , Deng Bo , Xiao Pengjun , Huang Pengyu , Wang Dali , Liu Lanxia 
Published: May 2023

AbstractCertain chemotherapeutics can induce tumor cells’ immunogenic cell death (ICD), release tumor antigens, and thereby trigger personalized antitumor immune responses. Co-delivery of adjuvants using nanocarriers could amplify the ICD-induced tumor-specific immunity achieving a synergistic chemo-immunotherapeutic effect. However, complicated preparation, low drug loading efficiency, and potential carrier-associated toxicity are the major challenges that limited its clinical applications. Herein, a carrier-free core–shell nanoparticle (MPLA-CpG-sMMP9-DOX, MCMD NPs) was constructed by facile self-assembly of spherical nucleic acids (SNA) with two adjuvants of CpG ODN and monophosphoryl lipid A (MPLA) as a core and doxorubicin (DOX) radially around the dual-adjuvants SNA as a shell. The results demonstrated that MCMD NPs could enhance drugs accumulation in tumors, and release DOX upon enzymatic degradation of matrix metalloproteinase-9 (MMP-9) peptide in the tumor microenvironment (TME), which enhanced the direct-killing effect of DOX on tumor cells. The core of MPLA-CpG SNA efficiently boosted the ICD-induced antitumor immune response to further attack tumor cells. Thus, MCMD NPs achieved a synergistic therapeutic effect of chemo-immunotherapy with reduced off-target toxicity. This study provided an efficient strategy for the development of a carrier-free nano-delivery system for enhanced cancer chemo-immunotherapy.