bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microperimetric analysis of eyes after macular hole surgery with indocyanine green staining: a retrospective study
Authors: Jun Sung Yeon , Kong Mingui 
Published: October 2023

Abstract
Background
Indocyanine green (ICG) aids in the visualization of the internal limiting membrane (ILM). Retinal damage from ICG dye toxicity has been reported through in vitro and in vivo studies. However, the clinical toxic effect of ICG during macular surgery has not been functionally evaluated. In this study, we evaluated functional and structural changes in retinal sensitivity and retinal thickness associated with ICG toxicity using microperimetry before and after ICG-assisted ILM peeling in patients with macular holes.

Methods
ICG staining was performed only on the macular area below the horizontal line connecting the fovea and optic disc. ILM peeling was performed over the entire macular area inside the vascular arcade. Visual acuity assessment, spectral domain optical coherence tomography, and microperimetry were performed at baseline and one, three, and six months postoperatively. The mean retinal sensitivity of four macular areas was calculated and analyzed.

Results
Eleven eyes were included. Macular holes were successfully closed in all patients. Six months postoperatively, retinal sensitivity improved insignificantly in Area 1 (ICG−/ILM−) and Area 2 (ICG−/ILM+) but decreased in Area 4 (ICG+/ILM−). Three months postoperatively, retinal sensitivity significantly decreased in Area 3 (ICG+/ILM+; 26.63 ± 1.80 vs. 25.52 ± 2.08 dB, p = 0.036). However, the statistical significance of this result was lost six months after the surgery (p = 0.059). The change of Gc-IPL thickness in Area 3 was significantly different compared to Area 2 at post-operative 3- and 6-months (p = 0.01, 0.05).

Conclusions
Retinal sensitivity decreased three months after ICG-assisted ILM peeling. However, the statistical significance was lost six months after surgery. ICG staining can be performed with caution during macular hole surgery.
Delivery of public health interventions by the ambulance sector: a scoping review
Authors: Ablard Suzanne , Miller Elisha , Poulton Steven , Cantrell Anna , Booth Andrew , Lee Andrew , Mason Suzanne , Bell Fiona 
Published: October 2023

Abstract
Background
With millions of unscheduled patient contacts every year and increasing call outs clustered around the most deprived communities, it is clear the ambulance sector could have a role to play in improving population health. However, the application and value of a public health approach within the ambulance sector has not been comprehensively explored.

A scoping review was undertaken to explore the role of the ambulance sector in the delivery of public health interventions and what impact this has on population health and ambulance sector outcomes.

Methods
A search strategy was developed on MEDLINE and translated to other major medical and health related bibliographic databases (Embase; CINAHL; HMIC; Science and Social Sciences Citation Index; Cochrane Library) to identify literature published since 2000 in OECD countries. Targeted grey literature, reference list, and citation searching was also carried out.
Search results were downloaded to Microsoft Excel and screened by three reviewers according to pre-determined inclusion / exclusion criteria. Data from included studies, such as the type of activity noted within the paper, the population involved and the public health approach that was utilised, was extracted from within the paper using a data extraction form and narratively synthesised.

Results
Fifty-two references were included in the final review (37 database searching; 9 reference list searching; 6 grey literature).
Included articles were categorised according to the relevant public health domains and subdomains as articulated by the UK Faculty of Public Health:

Health improvement domain:

Public health education and advice (Health promotion sub-domain) (n=13)

Emergency Services personnel providing vaccines (Disease prevention sub-domain) (n=1)

Health care public health domain

Paramedicine (Service delivery sub-domain) (n=30)

Screening tools and referral pathways used by the ambulance sector (Service delivery sub-domain) (n=28)

Health intelligence using ambulance sector data (population health management sub-domain) (n=26)

Of note, some domains (e.g. health protection) returned nil results.

Discussion
The scoping review demonstrates the breadth of public health related activities in which the ambulance sector is involved. However, an overemphasis on demand management outcomes precludes definitive conclusions on the impact of ambulance sector-led public health initiatives on public health outcomes. Future evaluations of public health initiatives should incorporate wider health system perspectives beyond the immediately apparent remit of the ambulance sector.
Exploring the health consequences of armed conflict: the perspective of Northeast Ethiopia, 2022: a qualitative study
Authors: Arage Mulugeta Wodaje , Kumsa Henok , Asfaw Mulu Shiferaw , Kassaw Abebe Tarekegn , Dagnew Ephrem Mebratu , Tunta Abayneh , Kassahun Woldeteklehymanot , Addisu Amanuel , Yigzaw Molla , Hailu Tilahun , Tenaw Lebeza Alemu 
Published: October 2023

Abstract
Background
Conflict is a complicated topic with a multidimensional consequences for community health. Its effects have a broad pattern, starting from direct war-related morbidity and mortality caused by bullets and bombs to indirect consequences due to the interruption of the delivery of preventive and curative health services. This study aimed to explore the health consequences of the northern Ethiopian conflict in the North Wollo zone, northeast Ethiopia, in 2022.

Methods
This descriptive qualitative study was conducted from May to June 2022 on six conflict-affected Woredas in the north Wollo zone. A total of 100 purposively selected participants, which included patients, pregnant women, elders, community and religious leaders, and health professionals, were interviewed using IDI and FGD. The data was entered, coded, and analyzed using Open Code version 4.03. Thematic analysis approach employed to conduct the interpretation. Data was presented using descriptive statistics in the form of texts and tables.

Results
The findings indicate that the conflict has caused a profound consequence on population health. It has resulted in a wide range of direct and indirect consequences, ranging from war-related casualties, famine, and disruptions of supply chains and forced displacement to instances of violence and rape associated with insecurity. The conflict also caused a breakdown in the health system by causing distraction of health infrastructure, fleeing of health workers and shortage of medication, together with insecurity and lack of transportation, which greatly affected the provision and utilization of health services. Additionally, the conflict has resulted in long-term consequences, such as the destruction of health facilities, interruption of immunization services, posttraumatic stress disorders, and lifelong disabilities. The coping strategies utilized were using available traditional medicines and home remedies, obtaining medications from conflict-unaffected areas, and implementing home-to-home healthcare services using available supplies.

Conclusion
The Northern Ethiopian conflict has an impact on community health both directly and indirectly through conflict-related causalities and the breakdown of the health system and health-supporting structures. Therefore, this study recommends immediate rehabilitation interventions for damaged health infrastructure and affected individuals.
Sakuranin represses the malignant biological behaviors of human bladder cancer cells by triggering autophagy via activating the p53/mTOR pathway
Authors: Hao Ling , Mu Dandan , Mu Haitao 
Published: October 2023

Abstract
Objective
Sakura extract is a natural flavonoid compound that may have potential anti-tumor effects. The paper focuses on investigating Sakuranin mechanism on bladder cancer (BC) cells.

Methods
BC cells (T24) were treated with different concentrations of Sakuranin, with 48-h IC50 determined. T24 cells were treated with Sakuranin at IC50, followed by assessment of cell proliferative/apoptotic/migrative/invasive activities by CCK-8, EdU and plate clone formation assays/flow cytometry/Transwell/scratch test. MMP-2 (migration and invasion-related protein) protein level was assessed by Western blot. Cell autophagy was evaluated by measuring the protein levels of autophagy markers (LC3-I/LC3-II/p62) through Western blot. The autophagy inhibitor 3-MA was used to validate the role of autophagy in the regulatory mechanism of Sakuranin in T24 cell behaviors. Furthermore, the activation of the p53/mTOR pathway in cells was detected and a combination of Sakuranin and p53 inhibitor Pifithrin-µ was adopted to explore the involvement of this pathway.

Results
Sakuranin decreased T24 cell proliferation/EdU positive cell percentage/colony formation number and area/migration/invasion/scratch healing/MMP-2 protein level, and accelerated apoptosis. Sakuranin elevated the LC3-II/I ratio and lowered p62 level in T24 cells. 3-MA partially averted Sakuranin-mediated repression on cell malignant behaviors. Sakuranin upregulated p-p53 and p53 levels, and decreased the p-mTOR/mTOR ratio in T24 cells. The effects of Sakuranin on cell biological behaviors were partly annulled by Pifithrin-µ treatment.

Conclusion
Sakuranin suppressed T24 cell proliferation/migration/invasion, and enhanced apoptosis by potentiating autophagy through activating the p53/mTOR pathway. This study provided a theoretical basis for Sakuranin as a potential drug for clinical treatment of BC.
A comparative assessment of color stability among various commercial resin composites
Authors: Uctasli MB , Garoushi Sufyan , Uctasli M , Vallittu PK , Lassila L 
Published: October 2023

Abstract
Objectives
The aim was to evaluate the color stability of six commercial restorative resin composites after being exposed to commonly consumed beverages. Repolishing impact on the stained composite was also assessed.

Methods
One-hundred and fifty disc specimens (8 mm diameter & 3 mm thickness) were prepared from Filtek™ Universal Restorative, SDR flow+, everX Flow, G-ænial A’CHORD, G-ænial Universal Flo and G-ænial Universal Injectable. To assess the color stability in five various beverages, 25 specimens from each material were randomly distributed into five groups (n = 5), according to the utilized staining solution. Group 1: distilled water, Group 2: coffee, Group 3: red wine, Group 4: energy drink, Group 5: coke. The color changes (∆E) for all materials were measured using spectrophotometer at the baseline, after 84 days of staining and after repolishing. Data was collected and analyzed using ANOVA (α = 0.05).

Results
Both material type and staining solution had a significant effect on the color stability of specimens (p < 0.05). Compared to other beverages, the color value of the specimens submerged in coffee and wine showed the most statistically significant (p < 0.05) mean ∆E. SDR flow + in coffee and wine presented the highest ∆E when compared to other tested materials (p < 0.05). After staining of the composites, repolishing was successful in lowering the ∆E value.

Conclusions
All the beverages had an impact on the color stability of the tested resin composites, with coffee and wine demonstrating the most significant effects. The variations in color stability varied depending on the specific material utilized. Dentists should possess awareness regarding the chemical interactions that occur between different beverages and various types of resin composites. Additionally, repolishing serves as an effective technique for eliminating surface discoloration in composite restorations.
Residential status and household wealth disparities in modern contraceptives use among women in Ghana: a cross-sectional analysis
Authors: Tampah-Naah Anthony Mwinilanaa , Yendaw Elijah , Sumankuuro Joshua 
Published: October 2023

Abstract
Background
Modern contraceptive refers to “a product or medical procedure that interferes with reproduction from acts of sexual intercourse”. The aim of this study was to assess the relationship between residential status and wealth quintile, and modern contraceptive use among women in Ghana.

Methods
We examined residential status and wealth quintile on contraceptive use analysing the 2006, 2011 and 2018 Multiple Indicator Cluster Surveys datasets. A sample of 30,665 women in their reproductive ages (15–49 years) were enrolled in the surveys across Ghana. STATA version 13 was used to process and analyse the data. It examined socioeconomic and demographic characteristics, assessed modern contraceptive use prevalence among women, and used logistic regression models to determine predictors. The results were presented in odds ratio and adjusted odds ratio with 95% confidence intervals. All statistical tests were measured with p < 0.05.

Results
In the three survey years, the highest prevalence of modern contraceptive usage was observed in 2011 (27.16%). The odds of using modern contraceptive increased by 19% in rural places (AOR = 1.19; 95% CI = 1.097–1.284) compared to urban places. The likelihood of women in second (AOR = 1.17; 95% CI = 1.065–1.289), middle (AOR = 1.24; 95% CI = 1.118–1.385), and fourth (AOR = 1.25; 95% CI = 1.113–1.403) wealth quintile using contraceptives increased compared to those of low wealth quintile. With the interactive terms, rural-second (AOR = 1.38; 95% CI = 1.042–1.830), rural-middle (AOR = 1.45; 95% CI = 1.084–1.933), rural-fourth (AOR = 1.52; 95% CI = 1.128–2.059), and rural-high (AOR = 1.42; 95% CI = 1.019–1.973) were more likely to use contraceptives compared to urban-low women. Despite lower odds, women of the age groups 20–24 (AOR = 2.33; 95% CI = 2.054–2.637), cohabitaing (AOR = 1.07; 95% CI = 0.981–1.173), secondary or higher education (AOR = 1.55; 95% CI = 1.385–1.736), Central (AOR = 1.48; 95% CI = 1.296–1.682) and Eastern (AOR = 1.48; 95% CI = 1.289–1.695) regions significantly predicted modern contraceptive use.

Conclusion
Modern contraceptive use in Ghana is low. Women in rural-rich categories are more likely to use modern contraceptives. Background factors such as age, marital status, educational attainment, and previous child experiences predict modern contraceptive use. It is recommended for the intensification of contraceptive awareness and utilization for all reproductive age women, regardless of education, marriage, or wealth.
Professional identity formation amongst peer-mentors in a research-based mentoring programme
Authors: Krishna Lalit Kumar Radha , Pisupati Anushka , Teo Kelly Jia Hui , Teo Mac Yu Kai , Quek Chrystie Wan Ning , Chua Keith Zi Yuan , Venktaramana Vaishnavi , Raveendran Vijayprasanth , Singh Harpreet , Hui Sabine Lauren Wong Chyi , Ng Victoria Wen Wei , Ting Ong Yun , Loh Eleanor Kei Ying , Yeoh Ting Ting , Owyong Jasmine Lerk Juan , Ong Eng Koon , Phua Gillian Li Gek , Hill Ruaraidh , Mason Stephen , Ong Simon Yew Kuang 
Published: October 2023

Abstract
Background
Mentoring plays a pivotal yet poorly understood role in shaping a physician’s professional identity formation (PIF) or how they see, feel and act as professionals. New theories posit that mentoring nurtures PIF by functioning as a community of practice through its structured approach and its support of a socialisation process made possible by its assessment-directed personalized support. To test this theory and reshape the design, employ and support of mentoring programs, we evaluate peer-mentor experiences within the Palliative Medicine Initiative’s structured research mentoring program.

Methods
Semi-structured interviews with peer mentors under the Palliative Medicine Initiative (PMI) at National Cancer Centre Singapore were conducted and triangulated against mentoring diaries to capture longitudinal data of their PMI experiences. The Systematic Evidence-Based Approach (SEBA) was adopted to enhance the trustworthiness of the data. SEBA employed concurrent content and thematic analysis of the data to ensure a comprehensive review. The Jigsaw Perspective merged complementary themes and categories identified to create themes/categories. The themes/categories were compared with prevailing studies on mentoring in the Funnelling Process to reaffirm their accuracy.

Results
Twelve peer-mentors participated in the interviews and eight peer-mentors completed the mentoring diaries. The domains identified were community of practice and identity work.

Conclusions
The PMI’s structured mentoring program functions as a community of practice supporting the socialisation process which shapes the peer-mentor’s belief system. Guided by a structured mentoring approach, stage-based assessments, and longitudinal mentoring and peer support, peer-mentors enhance their detection and evaluation of threats to their regnant belief system and adapt their self-concepts of identity and personhood to suit their context. These insights will help structure and support mentoring programs as they nurture PIF beyond Palliative Medicine.
Factors related to the resignation and migration of physicians in public health administration agencies using nationwide survey data in Japan
Authors: Saijo Yasuaki , Yoshioka Eiji , Sato Yukihiro , Kunori Yuki 
Published: October 2023

Abstract
Background
Physicians in public health administration agencies (public health physicians: PHP) play important roles in public health; however, there are not enough such physicians in Japan. This study aimed to elucidate the factors related to the resignation and migration of PHPs using nationwide survey data.

Methods
Data from the Survey of Physicians, Dentists, and Pharmacists (2010, 2012, 2014, and 2016) were analyzed. The outcome was the resignation of PHPs or migration to public health administration agencies. The explanatory variables in the resignation analysis were age, sex, workplace, and board certification status. The type of work was added as an explanatory variable in the migration analysis, and clinical specialty was added to the clinical doctor-restricted analysis. The odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations.

Results
In the resignation analysis among PHPs, women had a significantly lower OR, whereas younger PHPs and those with board certifications had significantly higher ORs. In the migration to public health administration agencies analysis among medical doctors, women and those aged between 35 and 39 years had significantly higher ORs, but those with board certifications had significantly lower ORs. Hospital/clinic founders or directors had significantly lower ORs, but the clinic staff and ‘others/not working’ had significantly higher ORs. In the migration to public health administration agencies analysis among clinical physicians, those aged between 35 and 39 years had significantly higher ORs. Still, those with two or more board certifications had significantly lower ORs. Hospital/clinic founders or directors had significantly lower ORs, but the clinic staff had significantly higher ORs. Clinical doctors specializing in surgery and other specialties had significantly lower ORs, but those specializing in pediatrics and psychiatry/psychosomatic medicine had significantly higher ORs.

Conclusions
Having board certifications were significantly related to the resignation of PHPs and migration to public health administration agencies. Women migrated to public health administration agencies more than men and younger PHPs were more likely to resign. However, medical doctors aged between 35 and 39 years were more likely to migrate to public health administration agencies. Similarly, clinic staff, non-clinical physicians, and those whose specialties were pediatrics and psychiatry/psychosomatic medicine were more likely to migrate to public health administration agencies.
Global issues, local action: exploring local governments use of research in “tackling climate change and its impacts on health” in Victoria, Australia
Authors: Dam Jennifer , Wright Annemarie , Bos Joannette J , Bragge Peter 
Published: October 2023

Abstract
Background
Local government plays an important role in addressing complex public health challenges. While the use of research in this work is important, it is often poorly understood. This study aimed to build knowledge about how research is used by investigating its use by local government authorities (LGAs) in Victoria, Australia in responding to a new legislative requirement to prioritise climate and health in public health planning. The role of collaboration was also explored.

Methods
Informed by Normalization Process Theory (NPT), this study adopted multiple research methods, combining data from an online survey and face-to-face interviews. Quantitative data were analysed using descriptive statistics; thematic analysis was used to analyse qualitative data.

Results
Participants comprised 15 interviewees, and 46 survey respondents from 40 different LGAs. Research was most commonly accessed via evidence synthesis, and largely used to inform understanding about climate and health. When and how research was used was shaped by contextual factors including legislation, community values and practical limitations of how research needed to be communicated to decision-makers. Collaboration was more commonly associated with research access than use.

Conclusions
Greater investment in the production and dissemination of localised research, that identifies local issues (e.g. climate risk factors) and is tailored to the communication needs of local audiences is needed to foster more impactful research use in local public health policy.
A robot-aided visuomotor wrist training induces motor and proprioceptive learning that transfers to the untrained ipsilateral elbow
Authors: Zhu Huiying , Wang Yizhao , Elangovan Naveen , Cappello Leonardo , Sandini Giulio , Masia Lorenzo , Konczak Jürgen 
Published: October 2023

Abstract
Background
Learning of a visuomotor task not only leads to changes in motor performance but also improves proprioceptive function of the trained joint/limb system. Such sensorimotor learning may show intra-joint transfer that is observable at a previously untrained degrees of freedom of the trained joint.

Objective
Here, we examined if and to what extent such learning transfers to neighboring joints of the same limb and whether such transfer is observable in the motor as well as in the proprioceptive domain. Documenting such intra-limb transfer of sensorimotor learning holds promise for the neurorehabilitation of an impaired joint by training the neighboring joints.

Methods
Using a robotic exoskeleton, 15 healthy young adults (18–35 years) underwent a visuomotor training that required them to make continuous, increasingly precise, small amplitude wrist movements. Wrist and elbow position sense just-noticeable‐difference (JND) thresholds and spatial movement accuracy error (MAE) at wrist and elbow in an untrained pointing task were assessed before and immediately after, as well as 24 h after training.

Results
First, all participants showed evidence of proprioceptive and motor learning in both trained and untrained joints. The mean JND threshold decreased significantly by 30% in trained wrist (M: 1.26° to 0.88°) and by 35% in untrained elbow (M: 1.96° to 1.28°). Second, mean MAE in untrained pointing task reduced by 20% in trained wrist and the untrained elbow. Third, after 24 h the gains in proprioceptive learning persisted at both joints, while transferred motor learning gains had decayed to such extent that they were no longer significant at the group level.

Conclusion
Our findings document that a one-time sensorimotor training induces rapid learning gains in proprioceptive acuity and untrained sensorimotor performance at the practiced joint. Importantly, these gains transfer almost fully to the neighboring, proximal joint/limb system.