bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive potential of optical coherence tomography parameters for the prognosis of decreased visual acuity after trabeculectomy in open-angle glaucoma patients with good vision
Authors: Takeda Yoko , Takahashi Naoki , Kiyota Naoki , Kokubun Taiki , Tsuda Satoru , Omodaka Kazuko , Yokoyama Yu , Nakazawa Toru 
Published: October 2023

Abstract
Background
Trabeculectomy (trab) is the most effective surgical procedure for lowering IOP and preventing glaucoma progression. However, decline in best-corrected visual acuity (BCVA) is one of the most serious postoperative complications of trab. Here, we investigated methods to predict decreased BCVA after trab in glaucoma patients with good preoperative BCVA.

Methods
This study included 35 eyes of 35 open-angle glaucoma (OAG) patients (male / female: 21 / 14, age: 64.0 ± 9.7 years old, preoperative intraocular pressure: 15.9 ± 5.4 mmHg, mean deviation: -18.1 ± 5.6 dB) with preoperative BCVA of 0.7 or better who underwent trab and were observed for more than 12 months. As a preoperative analysis, we measured temporal quadrant circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and ganglion cell complex thickness in a central strip between the disc and fovea (csGCCT), an area that corresponds to the location of the papillomacular bundle (PMB) in swept-source optical coherence tomography (OCT). We defined BCVA decline as a loss of more than 3 lines of BCVA after 12 months. Measurement parameters were compared between the BCVA-decline group and the non-BCVA-decline group.

Results
BCVA decline was detected in 11 cases (31.4%) 12 months after trab. There was a statistically significant difference in axial length (P = 0.049). A single logistic analysis showed that the BCVA-decline group had significantly lower cpRNFLT than the non-BCVA-decline group (27.7 ± 8.0 μm vs. 45.1 ± 5.3 μm, P < 0.001, cut-off value: 33.4 μm), as well as lower csGCCT (72.4 ± 7.7 μm vs. 87.5 ± 5.1 μm, P = 0.002, cut-off value: 82.3 μm). Multivariable logistic analysis showed that the BCVA-decline group had significantly lower temporal quadrant cpRNFLT (P < 0.001) and lower middle csGCCT (P < 0.001) compared to the non-BCVA-decline group.

Conclusions
Lower temporal quadrant cpRNFLT and middle csGCCT, OCT scan areas that correspond to the location of the PMB, might be biomarkers that predict BCVA decline after trab in OAG patients with good vision.
Effect of community based nutritional education on knowledge, attitude and compliance to IFA supplementation among pregnant women in rural areas of southwest Ethiopia: a quasi experimental study
Authors: Abdisa Diriba Kumara , Jaleta Debela Dereje , Tsegaye Dereje , Jarso Mohammedamin Hajure , Jaleta Gemechis Dereje , Tolesa Gamachis Firdisa , Kitila Keno Melkamu 
Published: October 2023

Abstract
Background
Compliance with the iron folic acid supplementation is low and not at the required level to prevent anaemia during pregnancy in many countries, including Ethiopia, even though an iron-folic acid supplementation program is being implemented. The aims of this study were to determine the effect of community-based nutritional education on knowledge, attitude, and compliance to IFA supplementation in Ilu Aba Bor zone of southwest Ethiopia.

Method
A pretest–posttest quasi-experimental study design consisting of intervention and control group was conducted among pregnant women. The total sample size of 472, therefore, 236 pregnant women for each interventional and control group from 16 kebeles were randomly selected in two districts. A multi-stage sampling technique was used to select the study participants. Then, individual study units were selected using a simple random sampling technique and followed until the end of the study period. Effect of community-based nutritional education on knowledge, attitude, and compliance to IFA supplementation among pregnant women in rural areas were measured.

Results
A total of 472 pregnant women participated in the study during the baseline and 437 (92.6%) were in the study until the end. The majority (49.2%) of respondents were 21–25 years of age, with a mean age of 23.4 (SD = 3.7) years. Community-based nutrition has resulted in a statistically significant increase in levels of maternal knowledge of IFAS by 15.2% in the intervention group compared to 5.1% in the control group. Similarly, the intervention group had odds of developing a positive attitude toward IFA 5.6 (4.01, 7.85) times higher than the control group. Moreover, in this study, the odds of compliance towards IFA supplementation were 3.9 (2.67, 5.57) times higher among those who received nutrition education than those women who did not.

Conclusion
This study revealed that community-based nutritional education can result in a significant change in knowledge, attitude, and compliance towards IFA supplementation and supports the literature suggesting the importance of the intervention to overcome the problem of poor compliance and its associated consequences.
Palliative care in Malawi: a scoping review
Authors: Palumbo Natalie , Tilly Alyssa , Namisango Eve , Ntizimira Christian , Thambo Lameck , Chikasema Maria , Rodin Gary 
Published: October 2023

Abstract
Background
Universal access to palliative care remains a distant goal in many low resource settings, despite the growing evidence of its benefits. The unmet need for palliative care is evident in Africa, but great strides in palliative care development have occurred in several African countries. Located in sub-Saharan Africa, Malawi has been regarded as an exemplar of progress in this area that is achievable in a low resource region. This scoping review examined the literature on the development and state of palliative care in Malawi according to the pillars of health care policy, medicine availability, education, implementation, research activity, and vitality of professionals and advocates.

Methods
A scoping review was conducted of the MEDLINE, Embase, Global Health, CINAHL, Web of Science and PsycINFO databases, as well as grey literature sources. Articles were included if they explored any aspect of palliative care in Malawi.

Results
114 articles were identified that met the inclusion criteria. This literature shows that Malawi has implemented diverse strategies across all pillars to develop palliative care. These strategies include creating a national stand-alone palliative care policy; integrating palliative care into the curricula of healthcare professionals and developing training for diverse service providers; establishing systems for the procurement and distribution of opioids; implementing diverse models of palliative care service delivery; and launching a national palliative care association. Malawi has also generated local evidence to inform palliative care, but several research gaps were identified.

Conclusions
Malawi has made considerable progress in palliative care development, although initiatives are needed to improve medicine availability, access in rural areas, and socioeconomic support for patients and their families living with advanced disease. Culturally sensitive research is needed regarding the quality of palliative care and the impact of therapeutic interventions.
Comparative analysis of serum and saliva samples using Raman spectroscopy: a high-throughput investigation in patients with polycystic ovary syndrome and periodontitis
Authors: Hu Dangli , Wang Jianmei , Cheng Tianfan , Li Huijun , Zhang Feng , Zhao Dan , Xu Xiaoyi , Yu Rong , Wen Ping , Cheng Yunfei , Xu Jian , Jin Lijian , Yao Jilong 
Published: October 2023

Abstract
Background
Polycystic ovary syndrome (PCOS) and periodontitis significantly affect women’s oral and systemic health worldwide, and yet increase the risk of cardiovascular-metabolic diseases like diabetes and coronary heart disease. Regarding the PCOS-periodontitis connection, whether sex hormones, metabolic and inflammatory mediators could account for the underlying linking mechanism needs to be further investigated. This case–control study evaluated the hormonal, metabolic and inflammatory profiles in PCOS and non-PCOS subjects with various periodontal conditions, via assessing serum and saliva samples by Raman spectroscopy.

Methods
A total of 66 females with PCOS and 22 systemically healthy female volunteers were recruited in a single hospital. Full-mouth periodontal examination was undertaken for identifying the subjects with periodontal health, gingivitis or periodontitis. The datasets of sex hormones and metabolic indicators were retrieved from the hospital information system. Both serum and saliva samples were collected for detecting inflammatory mediators and Raman spectroscopic assessment. The subjects were categorized into four groups according to their conditions of PCOS and periodontitis for Raman spectroscopic analysis. Partial least squares discriminant analysis was performed to examine the inter-group differences in Raman spectra.

Results
PCOS patients exhibited greater mean probing depth (P < 0.05) and higher serum levels of triglycerides (P < 0.05) and matrix metalloproteinase-8 (P < 0.05) than those in non-PCOS participants. Both probing depth and triglyceride level were positively correlated with PCOS (P < 0.05). There was a significant difference in mean Raman spectra of saliva samples among the four groups with different conditions of PCOS and periodontitis (P < 0.05), while no significant inter-group difference existed in serum samples.

Conclusions
The present study shows that periodontal condition may affect the biomolecular profiles of Raman spectra in serum and saliva of PCOS patients. It underscores the importance of the collaborative teamwork of dentists and gynecologists for enhancing women’s oral health, general wellbeing and quality of life.
Assessment of developmental rate of mouse embryos yielded from in vitro fertilization of the oocyte with treatment of melatonin and vitamin C simultaneously
Authors: Navid Shadan , Saadatian Zahra , Talebi Ali 
Published: October 2023

Abstract
Background
In recent decades, in vitro fertilization (IVF) has been widely used as a method of assisted reproductive technology (ART) to improve fertility in individuals. To be more successful in this laboratory method, we used the presence of two common types of antioxidants (melatonin and vitamin C) simultaneously and exclusively in IVF medium.

Methods
The cumulus-oocyte complexes (COCs) were obtained from Gonadotropin-releasing hormone (GnRH) and Human Chorionic Gonadotropin (HMG) -stimulated mice. Subsequently, metaphase II (MII) oocytes were fertilized in vitro. In the experiment, the IVF medium was randomly divided into two equal groups: The control group did not receive any antioxidants. In the treatment group, 100 µM melatonin and 5 mM vitamin C were added to the IVF medium. Finally, oocytes and putative embryos transferred into developmental medium and cultured 120 h after IVF to the blastocyst stage. After and before IVF, oocytes and putative embryos were stained with dichlorodihydrofluorescein diacetate (DCFDA) and the H2O2 level was measured with an inverted fluorescence microscope using ImageJ software. At the end of the fifth day after IVF, the expression of Bax and B cell lymphoma 2 (Bcl2) was evaluated using real-time PCR.

Results
The levels of reactive oxygen species (ROS) in oocytes and putative embryos observed in the treatment group demonstrated a significant reduce compared to the control group (p ≤ 0.01. (.Furthermore, the number of embryos in the blastocycte stage(P < 0.05), the expression level of the Bcl2 (P < 0.05) gene, the Bax unlike gene, significantly increased compared with the control group.

Conclusion
We conclude that the presence of melatonin and vitamin C antioxidants simultaneously and exclusively in the IVF medium leads to a reduction in ROS and ,as a result, improves the growth of the embryo up to the blastocyst stage.
Arts-based therapies, practices, and interventions in health
Authors: Van Lith Theresa , Ettenberger Mark 
Published: October 2023

AbstractThis collection focuses on creative art therapies, practices, and interventions in health contexts as part of the Mind-body interventions series of BMC Complementary Medicine and Therapies. The collection highlights the emerging value of the arts in complementary medicine and contributes to the expanding knowledge and integration of mind-body interventions and creative art practices.
Reasons for using traditional and complementary care by people living with HIV on antiretroviral therapy and association with interrupted care: a mixed methods study in Eswatini
Authors: Molemans Marjan , Reis Ria , Shabalala Fortunate , Dlamini Njabuliso , Masilela Nelisiwe , Simelane Njabulo , Pell Christopher , Chao Ariel , Spiegelman Donna , Vernooij Eva , van Leth Frank 
Published: October 2023

AbstractThe use of traditional, complementary, and alternative medicine (TCAM) can lead to delays and interruptions in the HIV continuum of care. This study explores reasons for TCAM use in people living with HIV on antiretroviral therapy (ART) in Eswatini and compares interrupted care between different types of TCAM users. Data were collected using surveys in the MaxART study (a test-and-treat trial) between 2014 and 2017 to assess the exposure, namely visiting a TCAM provider. Additionally, visit dates were retrieved from clinic records to assess the outcome, interrupted care. Open-ended questions were analysed with qualitative content analysis (n = 602) and closed questions with bivariable and multivariable analysis (n = 202). Out of 202 participants, 145 (72%) never used TCAM, 40 (20%) ever used, and 17 (8%) is currently using TCAM (diviners, herbalists, and religious healers). No differences in interrupted care were found comparing never (reference category), past (Odds Ratio: 1.31, 95% confidence interval: 0.63–2.72), and current users (1.34, 0.47–3.77), while adjusting for gender, time since HIV diagnosis, and time on ART. Contextual factors affecting the choice for TCAM were the influence of family, advice from the health facility, and religious beliefs. Individual factors include trust in biomedical care, type of illness, no need for additional care, and practical reasons such as financial means. In conclusion, individual and contextual factors influence the choice for TCAM. Interrupted care does not differ between never, past, and current users.
Bayesian belief network modelling approach for predicting and ranking risk factors for malaria infections among children under 5 years in refugee settlements in Uganda
Authors: Semakula Henry Musoke , Liang Song , Mukwaya Paul Isolo , Mugagga Frank , Nseka Denis , Wasswa Hannington , Mwendwa Patrick , Kayima Patrick , Achuu Simon Peter , Nakato Jovia 
Published: October 2023

Abstract
Background
Malaria risk factors at household level are known to be complex, uncertain, stochastic, nonlinear, and multidimensional. The interplay among these factors, makes targeted interventions, and resource allocation for malaria control challenging. However, few studies have demonstrated malaria’s transmission complexity, control, and integrated modelling, with no available evidence on Uganda’s refugee settlements. Using the 2018–2019 Uganda’s Malaria Indicator Survey (UMIS) data, an alternative Bayesian belief network (BBN) modelling approach was used to analyse, predict, rank and illustrate the conceptual reasoning, and complex causal relationships among the risk factors for malaria infections among children under-five in refugee settlements of Uganda.

Methods
In the UMIS, household level information was obtained using standardized questionnaires, and a total of 675 children under 5 years were tested for malaria. From the dataset, a casefile containing malaria test results, demographic, social-economic and environmental information was created. The casefile was divided into a training (80%, n = 540) and testing (20%, n = 135) datasets. The training dataset was used to develop the BBN model following well established guidelines. The testing dataset was used to evaluate model performance.

Results
Model accuracy was 91.11% with an area under the receiver-operating characteristic curve of 0.95. The model’s spherical payoff was 0.91, with the logarithmic, and quadratic losses of 0.36, and 0.16 respectively, indicating a strong predictive, and classification ability of the model. The probability of refugee children testing positive, and negative for malaria was 48.1% and 51.9% respectively. The top ranked malaria risk factors based on the sensitivity analysis included: (1) age of child; (2) roof materials (i.e., thatch roofs); (3) wall materials (i.e., poles with mud and thatch walls); (4) whether children sleep under insecticide-treated nets; 5) type of toilet facility used (i.e., no toilet facility, and pit latrines with slabs); (6) walk time distance to water sources (between 0 and 10 min); (7) drinking water sources (i.e., open water sources, and piped water on premises).

Conclusion
Ranking, rather than the statistical significance of the malaria risk factors, is crucial as an approach to applied research, as it helps stakeholders determine how to allocate resources for targeted malaria interventions within the constraints of limited funding in the refugee settlements.
Exosome-derived circ_0001785 delays atherogenesis through the ceRNA network mechanism of miR-513a-5p/TGFBR3
Authors: Tong Xiao , Dang Xuan , Liu Dongmei , Wang Ning , Li Miao , Han Jianbin , Zhao Jinjin , Wang Yueqing , Huang Meijiao , Yang Yanliang , Yang Yuhang , Wang Weili , Kou Yan , Kou Junjie 
Published: October 2023

Abstract
Purpose
Endothelial cell dysfunction is a major cause of early atherosclerosis. Although the role of extracellular vesicles in stabilizing atherosclerotic plaques is well established, the effect of circulating exosomes on plaque formation is still unknown. Here, we explored the effect of exosomes on atherosclerosis based on the function that exosomes can act on intercellular communication.

Patients and methods
We extracted serum exosomes from the blood of CHD patients (CHD-Exo) and healthy individuals (Con-Exo). The obtained exosomes were co-cultured with human umbilical vein endothelial cells (HUVECs) in vitro. In addition, we determined that circ_0001785 functions as a competing endogenous RNA (ceRNAs) in coronary artery disease by dual luciferase reporter gene analysis. The protective effect of circ_0001785 against endothelial cell injury was also verified using over-expression lentiviral transfection functional assays. In vivo experiments, we injected over-expressed circ_0001785 lentivirus into the tail vein of mice to observe its therapeutic effect on a mouse model of atherosclerosis.

Results
The vitro co-cultured results showed that the amount of plasma-derived exosomes have an increase in patients with coronary artery disease, and the inflammation and apoptosis of endothelial cells were exacerbated. Over-expression of circ_0001785 reduced endothelial cell injury through the ceRNA network pathway of miR-513a-5p/TGFBR3. Quantitative reverse transcription-polymerase chain reaction identified that the expressed amount of circ_0001785 was reduced in the circulating peripheral blood of CHD patients and increased within human and mouse atherosclerotic plaque tissue. The results of in vivo experiments showed that circ_0001785 reduced aortic endothelial cell injury and the formation of intraplaque neo-vascularization, and enhanced left ventricular diastolic function, thereby delaying the development of atherosclerosis in mice.

Conclusion
Our results demonstrated a new biomarker, exosome-derived circ_0001785, for atherogenesis, which can reduce endothelial cell injury and thus delay atherogenesis through the miR-513a-5p/TGFBR3 ceRNA network mechanism, providing an exosome-based intervention strategy for atherosclerosis.
Loss ratio of the capitation payment unit of the health-promoting entities in Colombia between 2017 and 2021: a financial–actuarial approach
Authors: Espinosa Oscar , Rodríguez Jhonathan , Urdinola B. Piedad , Do Nascimento Silva Pedro Luis , Sánchez Alejandra , Arias Martha-Liliana , Valdez Emiliano A. , Cheng Terence , Fisher Sara-Ellison 
Published: October 2023

Abstract
Background
Because of a change of government, the Colombian Ministry of Health and Social Protection is in the process of presenting a structural reform for the General System of Social Security in Health (GSSSH), in order to implement a ‘preventive and predictive health model’. However, it will always be relevant to review and analyze the fiscal implications of any proposed public policy program, to protect financial sustainability and to promote the better functioning of the system in question.

Methods
To contribute to this topic, we have calculated, using a financial–actuarial approach, the loss ratio for the years 2017 to 2021 for the Capitation Payment Unit (CPU) for all the Health-Promoting Entities (HPE) for both contributory and subsidized schemes. This information, derived from public reports available on the official website of the National Health Superintendency, allows us to estimate the financial burden of the institutions that guarantee access to and provision of health services and technologies in Colombia.

Results
The study shows that close to half of the HPEs in Colombia (which represent 11.6 million affiliates) have CPU loss ratios of more than 100% for the year 2021, evidencing insufficient resources for the operation of health insurance.

Conclusions
Finally, we propose some policy recommendations regarding the strengthening of informed decision-making to allow the healthy financial sustainability of the Colombian GSSSH.