bluuebunny/crossref_metadata_2025 huggingface dataset:
Peculiarities of extraction of β-lactoglobuline in protein mineral concentrates at electroactivation of whey
Authors: BOLOGA Mircea , VRABIE Elvira , PALADII Irina , ILIASENCO Olga , STEPURINA Tatiana , VRABIE Valeria , POLICARPOV Albert , SPRINCEAN Catalina
Published: June 2021

Introduction. Whey is a by-product and an excellent source of proteins that is rather aggressive due to a large amount of organic substances it contains. The electro-activation of whey applied in the experiments is a wasteless method that allows the va-lorification of all whey components. β-lactoglobulin (β-Lg) makes up 50% of the whey proteins and 12% of the total protein content in milk.

Material and methods. The recovery of β-Lg in protein-mineral concentrates (PMC) by electro-activation processing of different types of whey with different initial protein content was investigated in seven configurations. The recovery of protein fractions in the PMCs were analyzed via electrophoresis with sodium dodecyl sulfate (SDS-PAGE) and 15% non-denaturing polyacrylamide gel (PAAG).     

Results. Whey electro-fractionation and the obtaining of PMCs with predetermined protein content, namely of β-Lg, were studied on three whey types, processed at different treatment regimens and in seven configurations. The proper management of electroactivation by varying the treatment regimens will allow the electro-fractionation of different types of dairy by-products.

Conclusions. The maximum amount of β-Lg recovered in PMCs on electroactivation is  66-71% depending on the processed whey and on the treatment regimens. Obviously, the extraction of β-Lg from initially lower protein content shows a higher recovery degree of β-Lg. The registered temperatures allows formation of PMCs without thermal denaturation.
The lichen genus Lepraria Ach. (Stereocaulaceae, lichenized Ascomycota) in Romania
Authors: CRISAN Florin
Published: June 2021

Introduction. The genus Lepraria includes diffuse or indefinitely delimited species, always sterile, Lendemer (1) naming it „the most unusual member of the sterile lichen crusts”. According to Tonsberg (2), the leprarioid state appeared as an adaptation to a substrate characterized by dry surfaces, in sites with high humidity and low illumination. The thallus is leprose with an entirely sorediate surface. The lack of fruiting bodies has made the lichens from this group among the least known and studied for a long time. The increase in the number of studies on sterile crustose lichens in recent period has led to an increase in the number of accepted species of the genus Lepraria. The information on the genus Lepraria is not uniformly distributed, the current checklist describes only two species, L. caesioalba and L. finkii in Romania. The recent appearance of several studies that indicate the presence in Romania of other species of the genus mentioned, created the motivation of this study.

Material and methods. This study is based on material from the Babes-Bolyai University (CL) herbaria in Cluj-Napoca, Romania and literature data. For 13 species, specimens have been examined.

Results. The key for the species of genus Lepraria is proposed, adapted from Wirth (3). The species distribution maps in Romania are given.

Conclusions. Fifteen Romanian species are revised, Lepraria eburnea, L. ecorticata, L. umbricola were reported from two locations, L. neglecta was found only in one location. Most widely distributed species in Romania seems to be L. finkii and L. membranacea.
Aplikasi Pembelajaran Mengenal Rumah Adat di Pulau Jawa Berbasis Android dengan Teknologi Augmented Reality
Authors: Sirumapea Agustinus , Ramdhan Syaipul , Rismana Deri
Published: June 2021

Rumah adat merupakan peninggalan nenek moyang kita yang sudah lama ada dan digunakan untuk tempat tinggal dan ada juga yang digunakan untuk ruang pertemuan. Rumah adat di setiap daerah memiliki bentuk dan keunikan tersendiri sesuai dengan budaya di daerah tersebut. Seiring berkembangnya zaman, bangunan rumah adat mulai ditinggalkan oleh masyarakat dan menggantinya dengan bangunan yang lebih modern. Hal ini mengakibatkan banyaknya orang tidak mengetahui bentuk dari bangunan rumah adat. Adapun di sekolah anak-anak belajar tentang seni kebudayaan Indonesia melalui media konvenional yaitu buku pelajaran yang didalamnya hanya menampilkan gambar rumah adat yang tampak bagian depan saja atau 2 dimensi, hal ini membuat anak kurang tertarik untuk mempalajarinya,, maka dari itu perlu adanya sebuah inovasi. Dengan menggunakan teknologi Augmented Reality yaitu menggabungkan antara gambar 2 dimensi dan gambar 3 dimensi yang diaplikasikan menggunakan Smartphone Android, maka rumah adat akan terlihat 3 dimensi ketika kamera pada smartphone memindai marker.
Prediksi Prioritas Infrastruktur Jalan di Provinsi Banten Dengan Metode AHP
Authors: Kusnadi Endang , Warnars Harco Leslie Hendric Spits
Published: June 2021

Jalan merupakan sarana infrastruktur utama yang sangat dibutuhkan dalam mendukung kelancaran transportasi guna meningkatkan kondisi perekonomian masyarakat.  Seiring dengan berjalannya waktu jalan akan mengalami kerusakan baik karena faktor alam maupun karena faktor teknis lainnya, sehingga diperlukan upaya penanganan serius dari pemerintah setempat. Dalam hal penanganan kerusakan jalan dibeberapa wilayah masih ditemukannya permasalahan yang perlu segera diselesaikan, salah satunya adalah permasalahan ketersediaan anggaran yang tidak sebanding dengan tingkat kerusakan jalan yang cukup banyak sehingga diperlukan sebuah metode untuk mengetahui urutan prioritas jalan harus segera ditangani. Untuk menentukan prediksi dan urutan prioritas penanganan jalan maka digunakan metode  Analytic Hierarchy Process (AHP) dengan pertimbangan faktor kerusakan, lalulintas dan ekonomi.
Sistem Pakar Diagnosis Penyakit Kulit Balita Menggunakan Forward Chaining Berbasis Web Pada Puskesmas Cisoka
Authors: Julianti M. Ramaddan , Asoka Ega , Syahtami Harriyadi Fadhil
Published: June 2021

Kulit adalah organ tubuh yang terletak paling luar dan membatasi organ lainnya dari lingkungan hidup manusia. Kulit merupakan organ yang esensial dan vital serta merupakan cermin kesehatan dan kehidupan. Penyakit kulit salah satu penyakit yang sering dijumpai di negara beriklim tropis seperti Indonesia, khususnya pada golongan usia balita. Balita menjadi kelompok yang rentan terkena penyakit kulit yang disebabkan masih dalam tahap perkembangan imunitas, pasalnya dibutuhkan waktu hingga satu tahun bagi epidermis kulit untuk berkembang dengan cepat dan berfungsi secara efektif. Penelitian ini bertujuan untuk membangun sebuah sistem pakar untuk mendiagnosis penyakit kulit balita. Peneliti melakukan penelitian ini dengan menggunakan metode observasi langsung ke tempat yang dituju, dan menggunakan metode interview dengan stakeholder. Penerapan teknologi web application diperlukan agar komponen-komponen sistem pakar dapat berjalan dengan lancar. Sistem pakar memiliki keunggulan yang menyerupai seorang pakar, sehingga sistem pakar dapat digunakan untuk konsultasi atau mendiagnosa suatu penyakit. Hasil dari pengembangan aplikasi ini dapat membantu diagnosis suatu penyakit melalui web atau internet.
How Sublimation Delays the Onset of Dusty Debris Disk Formation around White Dwarf Stars
Authors: Steckloff Jordan K. , Debes John , Steele Amy , Johnson Brandon , Adams Elisabeth R. , Jacobson Seth A. , Springmann Alessondra
Published: June 2021

Although numerous white dwarf stars host dusty debris disks, the temperature distribution of these stars differs significantly from the white dwarf population as a whole. Dusty debris disks exist exclusively around white dwarfs cooler than 27,000 K. This is all the more enigmatic given that the formation processes of dusty debris disks should favor younger, hotter white dwarfs, which likely host more dynamically unstable planetary systems. Here we apply a sophisticated material sublimation model to white dwarf systems to show that these statistics are actually a natural result of the interplay of thermal and tidal forces and how they define the circumstellar regions where dusty debris disks can form. We demonstrate that these processes tend to prevent stability against both sublimative destruction and reaccretion into planetesimals for rocky materials until white dwarfs cool to below ∼25,000–32,000 K, in agreement with the observed limit of ∼27,000 K. For pure water ice, this critical temperature is less than 2700 K (requiring a cooling age older the universe); this precludes pure water ice–rich debris disks forming through the accepted two-step mechanism. The critical temperature is size-dependent; more massive white dwarfs could potentially host dusty debris disks at warmer temperatures. Our model suggests that the location of the disks within the PG 0010+280, GD 56, GD 362, and PG 1541+651 systems are consistent with a forsterite-dominated olivine composition. We also find that very cool white dwarfs may simultaneously host multiple, independently formed dusty debris disks, consistent with observations of the LSPM J0207+3331 system.
Balticeler kerneggeri gen. nov., sp. nov., an enigmatic Baltic amber fossil of the ground beetle subfamily Trechinae (Coleoptera, Carabidae)
Authors: Schmidt Joachim , Scholz Stephan , Maddison David R.
Published: June 2021

Balticeler kerneggerigen. nov., sp. nov., is described based on six fossil specimens preserved in Eocene Baltic amber and imaged using light microscopy and X-ray micro-computed tomography. Based on certain characters observed in the fossil species it is considered a “middle grade” Carabidae, outside of the large family Harpalinae (as it possesses a scrobal seta, the lack of which is a synapomorphy of that subfamily), but possessing four synapomorphies that indicate Balticeler belongs to a large clade of carabids including Harpalinae (anisochaetous Grade B antennal cleaner, conjunct mesocoxae, closed procoxal cavities, and a well-developed external lobe of the metepimeron). This remarkable beetle has several striking features, including lack of externally-visible sexually dimorphic characters, lack of lateral borders on the pronotum, and very long and thin mandibles and maxillae. In combination, these states are unique within Carabidae. We consider the presence of a dorsally completely open aedeagal median lobe as a synapomorphy of the fossil species with the subfamily Trechinae, a pubescent and relatively long second antennomere and a 4+2+2 pattern of umbilicate setae as synapomorphies of the supertribe Trechitae, and a quadrisetose clypeus as a synapomorphy with the Trechitae clade Bembidarenini + Trechini sensu Maddison et al. (2019). As it lacks a synapomorphy of Bembidarenini + Trechini, we propose that it is a member of the stem group of that clade.
Interpretation of Pulmonary Function Tests and Optimization of Inhalation Therapy
Authors: Lim Sung Yoon , Yoon Ho Il
Published: June 2021

Spirometry, also called office-based pulmonary function testing, is a useful tool for diagnosis and classification of lung disease. Here, we outline a simple stepwise approach for interpretation of spirometry results. The first step is to determine the forced expiratory volume in a one second/forced vital capacity (FEV1/FVC) ratio. If airflow is limited, a bronchodilator is administered followed by reassessment. The next step is to determine whether FVC is low; an observed decrease in FVC indicates a restrictive patten. For patients with obstructive disease, inhalation medication is needed. Therefore, this review also describes the most appropriate inhalation device for each patient and the correct use of the device to maximize inhalation therapy benefits.
Hepatopulmonary Syndrome with Finger Clubbing
Authors: Kim Ho Kyung , Kim Won Ki , Kim Joo Han , Lee Jeong Woo , Chung Wook Jin , Kwon Oh Sang , Kim Ju Hyun
Published: June 2021

Hepatopulmonary syndrome is a rare lung complication of liver cirrhosis, caused by pulmonary microvascular vasodilation that induces abnormal arterial oxygenation. Typical findings on physical examination are finger clubbing and cyanosis. Dyspnea is a common symptom and is worse in the upright position. Contrast echocardiography is a useful diagnostic test. Currently, the only effective treatment is liver transplantation. We report the case of a woman with cirrhosis who has hepatopulmonary syndrome with finger clubbing, confirmed by contrast echocardiography. The patient is waiting for a liver transplant.
Virtual Interprofessional Learning Due to COVID-19
Authors: Sharpe Elizabeth Li , Sykes Stephanie R. , Marzalik Penny R.
Published: June 2021

Background:

The COVID-19 pandemic necessitated sweeping changes in a neonatal nurse practitioner (NNP) program's approach to distance-accessible learning. Prioritizing student learning and safety, we developed a new alternative model for individualized simulation.

Method:

The scenario created for a student to deliver an unexpected diagnosis of trisomy 21, or Down syndrome, to a postpartum mother was redesigned to take place using web-conference technology.

Results:

We successfully transitioned the planned in-person individualized simulation for NNP students delivering an unexpected diagnosis to a web-conference environment and added nurse–midwifery (NM) students.

Conclusion:

This simulation presented an authentic clinical situation encountered in practice, supporting the specialty-specific competencies for the NNP, NM, and core competencies for interprofessional collaborative practice. The web-conference platform is an effective strategy for simulation. Advanced practice nurses completing individualized simulation through technology are uniquely poised to leverage these skills as telemedicine increasingly influences their future clinical practice.

[
J Nurs Educ
. 2021;60(6):346–351.]
Ciencia y patronazgo real en el imperio español del siglo XVII: Fray Ignacio Muñoz y su Propuesta de trabajo en Artes Náuticas
Authors: Moreno Madrid José María
Published: June 2021

El objetivo de este artículo es analizar minuciosamente la trayectoria vital de fray Ignacio Muñoz, fraile dominico del siglo XVII enviado a servir a Filipinas. Especial interés reviste la utilización que el dominico hace de sus conocimientos científicos, adaptándolos a las necesidades del imperio español para conseguir el mecenazgo de Felipe IV. La documentación manuscrita del propio Muñoz y la emitida en respuesta por las instituciones españolas son las principales fuentes para el estudio.
Los primeros pasos de la democracia en Venezuela bajo el prisma de la diplomacia española (1958-1962)
Authors: Luis León Ángel Dámaso
Published: June 2021

El proceso de cambio político propiciado en Venezuela generó incertidumbre en algunos países con estrecha relación. La transición a la democracia producida a finales de los cincuenta y el posterior proceso de construcción sus instituciones fue objeto de interés de muchos países, entre ellos, de España. En este artículo, se buscará analizar cómo es percibido ese proceso por parte de la legación diplomática española. A través de la documentación de archivo generada, se observarán las visiones y opiniones emitidas acerca de los diferentes actores que jugaban un papel importante en la política venezolana de mediados de siglo.
Identification of morphologically challenging Delia (Diptera: Anthomyiidae) species from field vegetable crops using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP)
Authors: Mlynarek Julia J. , Sim Kathrin A.
Published: June 2021

Root feeding by the larvae of multiple Delia species can lead to economic loss in many agricultural crops. Field vegetables are subject to infestations by a species complex composed of Delia radicum (Linnaeus) (Diptera: Anthomyiidae), a pest in brassica crops (Brassicaceae), Delia antiqua (Meigen), believed to cause the majority of crop damage in onions, and the generalists Delia florilega (Zetterstedt), Delia platura (Meigen), and Botanophila fugax (Meigen) (Diptera: Anthomyiidae). Correct species identification is necessary to implement field management strategies, but these species are challenging to identify morphologically. We propose a polymerase chain reaction–restriction fragment length polymorphism method as a molecular tool to distinguish between five species of Delia and between two genetic lines of D. platura. The mitochondrial DNA cytochrome c oxidase subunit 1 barcode fragment is targeted, then the polymerase chain reaction product digested with four different restriction enzymes (AccI, BsrI, MlyI, and StyI). The BsrI enzyme distinguishes the two genetic lines of D. platura and D. florilega. The MlyI enzyme identifies B. fugax from the Delia species. Combining BsrI, StyI, AccI, and MlyI into double digestion reactions allows for rapid diagnostics among the species tested. Our method was validated using DNA from specimens collected in eastern Canada. This method provides tools in ecological and environmental studies where these species are of interest.
Morphology, clearing efficacy, and mTOR dependency of the organelle autophagoproteasome
Authors: Limanaqi Fiona , Biagioni Francesca , Salvetti Alessandra , Puglisi-Allegra Stefano , Lenzi Paola , Fornai Francesco
Published: June 2021

The interplay between autophagy (ATG) and ubiquitin proteasome (UP) cell-clearing systems was recently evidenced at biochemical and morphological levels, where subunits belonging to both pathways co-localize within a novel organelle named autophagoproteasome (APP). We previously documented that APP occurs at baseline conditions, while it is hindered by neurotoxicant administration. This is bound to the activity of the mechanistic target of rapamycin (mTOR), since APP is stimulated by mTOR inhibition, which in turn, is correlated with cell protection. In this brief report, we provide novel, morphological and biochemical evidence on APP, suggesting the presence of active UP subunits within ATG vacuoles. Although a stream of interpretation considers such a merging as a catabolic pathway to clear inactive UP subunits, our data further indicate that UP-ATG merging may rather provide an empowered catalytic organelle.
The effect of corneal crosslinking on the rigidity of the cornea estimated using a modified algorithm for the Schiøtz tonometer
Authors: Tutchenko Larysa , Patel Sudi , Skovron Mykhailo , Horak Olha , Voytsekhivskyy Oleksiy
Published: June 2021

Purpose:

The aim of this study was to test a method for estimating corneal rigidity before and after cross-linking (CXL) using a Schiøtz tonometer.

Methods:

The study was performed in the Kyiv City Clinical Ophthalmological Hospital “Eye Microsurgical Center”, Ukraine. This was a prospective, consecutive, randomized, masked, case-by-case, clinical study. Corneal rigidity, indicated by the gradient (G) between lg applied weight and corresponding lg scale reading during Schiøtz tonometry, were obtained by increasing (A-mode) then reducing (D-mode) weights by two operators [A] in keratoconus, post-CXL and control subjects for estimation of (i) interoperator and (ii) intersessional errors, (iii) intergroup differences; [B] before and after CXL. Central corneal thickness CCT was measured by scanning slit pachymetry. ANOVA, t tests, linear regression were the statistical tools used.

Results:

Average interoperator difference (ΔG) was –0.120 (SD = ±0.294, 95%CI = –0.175 to –0.066). A significant correlation between ΔG and the mean of each pair of G values was found (r = –0.196, n = 112, P = 0.038). Intersessional differences in mean G values were insignificant (P > 0.05). There was a significant correlation between G at first session (X1) and difference between sessions (ΔG) [Operator 1, ΔG = 0.598x1–0.461, r = 0.601, n = 27, P = 0.009]. Significant intergroup differences in G were found (Operator 1, one-way ANOVA, F = 4.489, P = 0.014). The difference (Δ) between the pre-(X2) and post-CXL treatment G values was significantly associated with the pre-CXL treatment value (Operator 1, Δ = 1.970x2-1.622, r = 0.642, n = 18, P = <.001). G values were correlated with CCT in keratoconus and post-CXL.

Conclusion:

Corneal rigidity (G) estimated using the Schiøtz tonometer can be useful for detecting changes after CXL. However, G values are linked to CCT, can vary from time-to-time and the procedure is operator dependent.
Mobile application as a complementary tool for differential diagnosis in Neuro-ophthalmology: A multicenter cross-sectional study
Authors: Vinny Pulikottil Wilson , Takkar Aastha , Lal Vivek , Padma Madakasira Vasantha , Sylaja P N , Narasimhan Lakshmi , Dwivedi Sada Nand , Nair Pradeep P , Iype Thomas , Gupta Anu , Vishnu Venugopalan Y
Published: June 2021

Purpose:

Drawing differential diagnoses to a Neuro-ophthalmology clinical scenario is a difficult task for a neurology trainee. The authors conducted a study to determine if a mobile application specialized in suggesting differential diagnoses from clinical scenarios can complement clinical reasoning of a neurologist in training.

Methods:

A cross-sectional multicenter study was conducted to compare the accuracy of neurology residents versus a mobile medical app (Neurology Dx) in drawing a comprehensive list of differential diagnoses from Neuro-ophthalmology clinical vignettes. The differentials generated by residents and the App were compared with the Gold standard differential diagnoses adjudicated by experts. The prespecified primary outcome was the proportion of correctly identified high likely gold standard differential diagnosis by residents and App.

Results:

Neurology residents (n = 100) attempted 1500 Neuro-ophthalmology clinical vignettes. Frequency of correctly identified high likely differential diagnosis by residents was 19.42% versus 53.71% by the App (P < 0.0001). The first listed differential diagnosis by the residents matched with that of the first differential diagnosis adjudicated by experts (gold standard differential diagnosis) with a frequency of 26.5% versus 28.3% by the App, whereas the combined output of residents and App scored a frequency of 41.2% in identifying the first gold standard differential correctly. The residents correctly identified the first three and first five gold standard differential diagnosis with a frequency of 17.83% and 19.2%, respectively, as against 22.26% and 30.39% (P < 0.0001) by the App.

Conclusion:

A ruled based app in Neuro-ophthalmology has the potential to complement a neurology resident in drawing a comprehensive list of differential diagnoses.
Sequelae of microsporidial keratoconjunctivitis and its management
Authors: Mohanty Amrita , Mitra Sanchita , Mallick Aparajita , Barik Manas Ranjan , Das Sujata , Priyadarshini Smrutirekha , Sahu Srikant K
Published: June 2021

Purpose:

To characterize the sequelae of microsporidia keratoconjunctivitis (MKC) and outline its management.

Methods:

Retrospective analysis of microbiologically proven MKC returned with persistent disease between January 2015 and December 2019 was done. Demographics, clinical features, management, and outcome were analyzed.

Results:

Sixteen patients (21 eyes) of 332 treated for MKC returned with the persisting disease. The mean age of 11 males (68.7%), and 5 females was 35.1 ± 12.2 years. Three-quarter of them did not have a known predisposing risk factor and one-quarter of them were referred for chronic conjunctivitis. Past medications included topical antivirals (n = 8) and topical corticosteroid (n = 6). Three predominant presentations were persistent (>3 weeks) superficial punctate keratitis (SPKs, n = 7), sub-epithelial infiltrates (SEIs, n = 13), and uveitis (n = 2). The lesions recurred in eight eyes (SPK and SEI 4 each) after a disease-free interval of 60.4 ± 40.6 days; there were 13 episodes of recurrence. Topical low potent corticosteroids (loteprednol/fluorometholone), and tacrolimus ointment 0.03% were used in 17 (80.9%) and 8 (38%) eyes, respectively, for a mean duration of 44.8 ± 31.6 and 226.8 ± 180.5 days, respectively. At follow-up, 172.3 ± 183.6 days, visual recovery was statistically significant in persistent eyes (BCVA 0.07 ± 0.07 logMAR; P < 0.00001) but, not in recurrent eyes (BCVA 0.16 ± 0.08 logMAR; P = 0.07). Five of 21 eyes were left with residual significant scar.

Conclusion:

The sequelae of microsporidial keratoconjunctivitis are not uncommon. Topical 0.03% tacrolimus ointment appeared to be an effective corticosteroid-sparing agent for the treatment of SEIs and prevention of recurrence.
An exploratory study of compliance to anti-glaucoma medications among literate primary glaucoma patients at an urban tertiary eye care center in South India
Authors: Ramesh Prasanna Venkatesh , Parthasarathi Sathyan , John Rajesh Kumar
Published: June 2021

Purpose:

To understand the factors that explain compliance to anti-glaucoma medication (AGM) in terms of application,purchase, stocking and compliance behaviour.

Methods:

This was a cross-sectional study conducted in the outpatient department of an urban tertiary eye care center in South India. Interviews were completed with consenting, consecutive, literate primary glaucoma patients. The components of the questionnaire included duration, application, purchase, stocking and caregiver’s role. Self-reported compliance in medication taking was tested for association with rest of the components by Chi-square test and discriminant analysis.

Results:

A total of 101 patients, aged 34–87 years, were interviewed. Majority (64.4%) were on AGM for more than two years. Early purchase was reported among 44.3% and stocking among 41.2%. Cost was high for income among 28.7%. Majority (91.1%) of them were not aware of side-effects. Fear of blindness was the major factor (68.1%) encouraging regular usage. Half (50.5%) of the patients though, still reported missing medication in the past month. Major reasons cited were relative priority (45.1%) and forgetfulness (35.3%). Self-reported compliance was not different by demographic variables or with responses to questions regarding duration (P = 0.070), application (0.825), time of purchase (0.272), stocking (0.598), and cost perception (0.415).

Conclusion:

Self-reporting of AGM compliance behaviour did not reflect with responses regarding application, purchase, stocking behaviour or cost perception. Awareness and knowledge of the above factors, with an aim of improving compliance by regulating counselling for even literate patients using AGM is called for.
Anterior chamber intraocular lens - An effective alternative in traumatic and surgical aphakia in the era of scleral-fixated intraocular lens
Authors: Mahapatra Santosh K , Mannem Navya
Published: June 2021

Purpose:

To evaluate outcomes of anterior chamber intraocular lens (ACIOL) implantation with vitrectomy in eyes with surgical or traumatic aphakia, and subluxated or dislocated lens.

Methods:

In this retrospective study, we evaluated patients who underwent pars plans vitrectomy with ACIOL implantation from April 2016 to March 2019. Patients with minimum follow-up period of 1 year and operated by single surgeon were included. Ophthalmic history, indication for surgery, BCVA, IOP, slit-lamp examination, and fundus assessment findings were noted. Postoperatively best-corrected visual acuity (BCVA), intraocular pressure (IOP) and complications if any were noted.

Results:

Ninety eyes of 88 patients were included in the study. The mean age of the patients was 60.2 ± 10.2 yrs. Majority (75.6%) were males and 24.4% were females. Indications for pars-plana vitrectomy (PPV) with ACIOL implantation were nucleus drop in 16.6%, IOL drop in 25.5%, large posterior capsular rupture (PCR) with vitreous disturbance or zonular dehiscence (ZD) during cataract surgery in 33.3%, more than 180° subluxation of lens in 10% and traumatic lens or intraocular lens (IOL) drop in 14.4% cases. Preoperative and postoperative mean Log MAR visual acuity was 1.59 ± 0.44 and 0.36 ± 0.33 respectively, with few complications like cystoid macular edema (CME) in 8.8%, persistently raised IOP in 4.4%, persistent uveitis in 2.2%, retinal detachment (RD) in 2.2%, and tilted IOL in 1.1% cases.

Conclusion:

Out of different options available for secondary IOL implantation in patients with poor capsular support ACIOL has the advantages of cost-effectiveness, small learning curve, faster surgical time with a lesser rate of complications like IOL tilt, vitreous hemorrhage, and suture erosion as compared to scleral-fixated IOL (SF-IOL). Comparable visual outcome can be obtained by proper patient selection in these cases.
Can the postoperative follow-up visit be deferred up to four weeks after an uneventful cataract surgery? - A randomized controlled trial
Authors: Deshpande Rahul , Vora Ushma , Mangiraj Varsha , Dole Kuldeep , Deshpande Madan
Published: June 2021

Purpose:

The aim of this study was to compare the postoperative visual outcome after a Day 0 examination in patients with two follow-ups, one between Day 3 to Day 7 and other between Day 25 to Day 30 to those with a single ophthalmic follow-up directly after 25–30 Days and to assess the safety of deferral of the first follow-up visit at 1 week.

Methods:

Randomized Controlled Trial was conducted at a tertiary eye care hospital, with 848 patients enrolled for the study. Patients meeting the inclusion criteria were selected. Their pre-operative and post-operative data was collected and the patients were divided into groups based on the type of cataract surgery and the postoperative follow-up protocol through randomization.

Results:

No significant difference was observed in the postoperative visual outcome in patients that underwent postoperative review at Day 3–7 and Day 25–30 as opposed to those that followed up directly at Day 25–30 after a mandatory Day 0 examination for all patients.

Conclusion:

In patients with no preexisting ocular or systemic comorbidity undergoing an uneventful cataract surgery, the postoperative follow-up visit can be safely deferred until 4 weeks, without any impact on the postoperative visual outcome, thereby conserving the available resources which can be deviated towards better eye care services.
Visual demand, visual ability and vision standards for hairdressers – An observational study from Chennai, Tamil Nadu
Authors: Janani Suresh , Dhanalakshmi Sankar , Rashima Asokan , Krishnakumar Ramani , Santanam PP
Published: June 2021

Purpose:

The aim of this study was to create vision standards for various tasks performed by hairdressers and to assess the spectacle compliance and its impact at work.

Methods:

The observational cross-sectional study enrolled hairdressers in and around Chennai, Tamil Nadu. It was done in three phases: (i) Job profiling from visual task analysis, creating vision standards for various hairdressing tasks and arriving at test protocols; (ii) Comprehensive eye examination, and (iii) Assessment of spectacle compliance and its impact on work. Descriptive analysis using Microsoft Excel and SPSS (IBM SPSS Statistics Version 21.0) was performed.

Results:

There were 305 participants with a mean age of 48 (SD ± 12) years. The visual acuity demand was found to be 6/18 and N15, for distance and near, respectively. Appropriate spectacles were prescribed for 203 (67%) hairdressers. Even with the best possible refractive correction, a few hairdressers did not meet the distance (13) and near (11) visual acuity standard. In all, 54 hairdressers were referred for further examination to a tertiary eye care center for lenticular changes, retinal abnormalities, and glaucoma screening. Among the subjects who were dispensed with spectacles, 181 (86%) were available for telephonic spectacle compliance assessment, and 164 (90%) were compliant with spectacle usage at work. Improved visual ability was reported by 133 (81%) hairdressers at work.

Conclusion:

This study provides vision standards for hairdressers. From the visual task analysis, hairdressing tasks were found to be visually demanding and hazardous. The study emphasizes that providing appropriate spectacle correction showed a clinically evident positive impact at work.
Prolonged face mask use might worsen dry eye symptoms
Authors: Scalinci Sergio Zaccaria , Pacella Elena , Battagliola Edoardo Trovato
Published: June 2021

Purpose:

The aim of this study was to explore whether prolonged and consistent face mask use might be associated with worsening of dry eye symptoms in patients with dry eye disease (DED).

Methods:

Subjects with a previous diagnosis of DED. Their OSDI scores were compared with those recorded in Fall 2019 using the Wilcoxon paired test. Participants were stratified by face mask use: heavy (Group A) or standard (Group B) face mask users. Heavy use was defined as wearing any type of face mask for at least 6 hours a day, at least 5 days per week in the last 2 months.

Results:

67 subjects (mean age: 45.27 ± 10.06 SD years, 40% males and 60% females). Median OSDI score in Fall 2019: 18.75. Median OSDI in Spring 2020: 20.83. The Hodges-Lehmann median difference was 2.09 (95% CI [1.05, 4.17]) (P < 0.0001). The population was then stratified into heavy and standard face mask users: Group A included heavy users (31 subjects; mean age: 42.81 ± 10.48 SD years; 35% males and 65% females), Group B included standard users (36 subjects; mean age: 47.39 ± 9.31 SD years; 44% males and 56% females). The Hodges-Lehmann median difference was 5.21 (95% CI [3.13, 7.29]) in Group A (P < 0.0001), and 1.04 (95% [0, 2.08]) in Group B (P = 0.0177).

Conclusion:

Prolonged and consistent face mask use is associated with an increase in OSDI scores. Whether face mask use is responsible for the worsening of symptoms of DED remains to be elucidated.
Risk of SARS-CoV-2 virus transmission from donor corneal tissue: A review
Authors: Salz Anna K , Acharya Manisha , Hofmann Nicola , Wittmershaus Ilka , Sangwan Virender , Börgel Martin , Mathur Umang
Published: June 2021

Since the outbreak of respiratory coronavirus disease (COVID-19) caused by the coronavirus SARS-CoV-2, there is an ongoing discussion about whether the virus could be transmitted through corneal transplantation from donor to recipient. The purpose of this review was to summarize the current knowledge in the scientific community to provide aid in risk evaluation for potential virus transfer by corneal transplants. Literature was searched in PubMed.gov for relevant articles on coronavirus in conjunction with cornea processing, cornea transplantation and eye banking. Further, guidelines of health authorities and eye banking associations were reviewed. Studies have shown that SARS-CoV-2 RNA can be detected in ocular swabs and/or fluid of patients with COVID-19. However, the risk of SARS-CoV-2 virus transmission through these ocular tissues or fluid of patients is judged differently. To date, per literature and official guidelines, no evidence of viable virus in ocular tissue and no cases of transmission of SARS-CoV-2 via tissue preparations have been reported.
A graft-free scleral sleeve technique of Ahmed Glaucoma Valve implantation in refractory glaucoma- Rising to the challenge of COVID-19 pandemic
Authors: Gupta Richa
Published: June 2021

We describe a case of 63-year-old woman, with primary open-angle glaucoma (POAG) who presented to us in the COVID era with uncontrolled intraocular pressure (IOP) on maximum medical therapy (MMT) in the right eye (OD), previously operated twice for trabeculectomy in (OD), and once in left eye (OS). A modified graft-free surgical technique of inserting the Ahmed Glaucoma valve (AGV) tube through a scleral sleeve was employed. Visual acuity and IOP remained stable during 6-month follow-up period.
Measurement of dose enhancement factor for Xoft Axxent electronic brachytherapy device using nanoparticle-embedded alginate film and radiochromic film
Authors: Kakade Nitin R. , Das Abhishek , Kumar Rajesh , Sharma S. D. , Maiti Nandita , Chadha Ridhima , Sapra B. K.
Published: June 2021

Aim:

In nanoparticles-aided radiotherapy, the radiation sensitivity of tumor is increased with the infusion of nanoparticles in tumor. This therapeutic modality is capable of delivering enhanced dose to tumor, without exceeding the normal tissue tolerance dose. Further, the quantification of the enhanced dose using suitable dosimeter is important. The present study is aimed at measuring the dose enhancement factors (DEFs) using the combination of nanoparticles-embedded alginate (Alg) film and unlaminated Gafchromic EBT3 film.

Materials and Methods:

Gold nanoparticles (AuNPs)- and silver nanoparticles (AgNPs)-embedded Alg polymer films were synthesized and characterized using standard techniques. Further, a customized version of the Gafchromic EBT3 film, i.e., unlaminated EBT3 film, was specially fabricated. The DEFs were measured using Xoft Axxent electronic brachytherapy device.

Results:

The surface plasmon resonance (SPR) and particle size of AuNPs were found to be 550 and 15 ± 2 nm, respectively. In the case of AgNPs, the SPR and particle size were recorded as 400 and 13 ± 2 nm, respectively. The DEFs measured, using unlaminated EBT3 film, for Xoft Axxent electronic brachytherapy using AuNPs and AgNPs were 1.35 ± 0.02 and 1.20 ± 0.01, respectively.

Conclusion:

The increase in dose enhancement during nanoparticles-aided electronic brachytherapy can be attributed to dominance of photoelectric effect, due to the presence of low-energy X-rays. The investigation indicates that the Xoft Axxent electronic brachytherapy device is suitable for nanoparticles-aided brachytherapy.
Exposure of second hand smoke in women and children
Authors: Sharma Twinkle , Khapre Meenakshi
Published: June 2021

Second-hand smoke is a neglected public health issue. Every year 1.2 million people die due to this exposure. Second-hand smoke is also related to various other diseases like cardiovascular diseases, lung diseases, low birth weight, maternal depression, etc. The purpose of this review is to look over various studies and to gain an understanding of existing research about second-hand smoke and its adverse effects. In addition, we tried to identify the barriers behind creating a smoke-free environment at home and successful strategies employed and suggestion given in various studies. A comprehensive search of the recent literature related to Second-hand smoke was undertaken using electronic databases like MEDLINE, PUBMED, Google Scholar, and Research gate. Keyword searches were conducted for publications published since 2004 or later on Second-hand smoke exposure in pregnant women. Prevalence of SHS among pregnant women ranged from 24% 92%. Lack of knowledge, absence of comprehensive smoking ban, low status of women was among the main contributing factors. Community awareness and counseling by primary health-care physician was found to be successful strategies. There are various cultural and social barriers behind a smoke-free home for pregnant women. Interventional approaches like focused counseling by primary care physicians can help to overcome this issue. There is a need for behavioral interventions and community awareness to be done in this aspect.
Assessment of knowledge, attitude, and practice regarding Deep Margin Elevation (DME) among dental practitioners in Riyadh, Saudi Arabia
Authors: Binalrimal Sultan R. , Banjar Weam M. , Alyousef Sara H. , Alawad Mada I. , Alawad Ghalia I.
Published: June 2021

Objectives:

To evaluate Knowledge, Attitude, and Practice (KAP) regarding deep margin elevation (DME) among dental practitioners in Riyadh city.

Materials and Methodology:

A cross-sectional study that comprised a total number of 535 dental practitioners: 255 (47.7%) were males and 280 (52.3%) females. A self-constructed 21 close-ended self-administered questionnaire was utilized in the study. The data were entered and analyzed by Chi-square test and descriptive analysis using Statistical Package for the Social Sciences (SPSS) software.

Results:

Although the majority of the respondents have heard about DME, only 30.4% have utilized this technique in their clinical practice by having general practitioners and specialists utilize this technique more often than consultants. Among the participants, 65.4% of them have agreed that adhesion by bonding to deep cervical dentin is predictable and related to the success of the final restoration.

Conclusion:

The knowledge level of DME among the study participants was adequate. The findings of this study revealed that the total number of dentists who utilize the technique in restoring large subgingival defects of posterior teeth with proximal caries is very minimal. Thus, it is recommended that dental practitioners have this technique introduced in their dental clinics as an alternative to surgical crown lengthening. Although years of experience and dentist rank may influence the clinical decision, in-depth factorial analysis with a greater sample size is necessary.
Job satisfaction among Saudi healthcare workers and its impact on the quality of health services
Authors: Halawani Layla Aiman , Halawani Mohammed Aiman , Beyari Ghada Mohammed
Published: June 2021

Background:

Job satisfaction among health care workers is crucial and considered as an essential parameter that affects their productivity and work's quality.

Methods:

A cross-sectional questionnaire-based study was conducted among health care workers in Saudi, males and females, to assess the impact of job satisfaction on health service quality. A random sampling technique was applied to select the participants. An online questionnaire was sent electronically to all health workers in Saudi. The data was collected and analyzed using SPSS version 21, P value < 0.05 was considered significant. Chi-square test of significance will be applied at the 5% level of significance.

Results:

Out of 226 participants, 73.9% were females, and 26.1% were males, and the majority of the participants (n = 108, 47.8%) aged between 31 to 40 years old. Half of the participants (50%) were married, 37.2% were physicians, 70.8% of the participants work at the public organization, and 61.9% of them had more than 3 years of work experience. Stress management and patient satisfaction significantly impacted the participant's satisfaction with their job (P = 0.001 and P = 0.021, respectively). Poor management was the highest factor that affected the quality of the provided care in the hospitals (40%), but without any significant difference (P-value = 0.210). The participants showed neutral satisfaction with their work (38.1%), and most of them had a low satisfaction level (n = 119, 52.7%).

Conclusion:

Job satisfaction and the quality of the provided care are strongly associated with each other. The overall level of job satisfaction among health care providers in Saudi Arabia was low.
Insights from national survey on household expenditure for primary healthcare services availed through informal healthcare providers
Authors: Prasad Banuru Muralidhara , Tripathy Jaya Prasad , Thekkur Pruthu , Muraleedharan V.R.
Published: June 2021

Introduction:

Ensuring accessible and affordable primary healthcare services of optimal quality is a core component of universal health coverage (UHC). Though a substantial percentage of population avail healthcare services from informal healthcare providers (IHPs) in rural India, the information regarding the extent of out-of-pocket (OOP) expenditure during such encounters is limited.

Method:

The study analyzed publicly available data of 75th National Sample Survey (NSS) to understand the household expenditure pattern on availing service from IHPs. OOP expenditure for services availed from IHPs were extracted from main data sets and analyzed for both out-patient care and hospitalization. The OOP was summarized across the five wealth quintiles based on monthly per capita expenditure (MPCE) and disease groupings derived from the ailments recorded during the survey.

Results:

In total, 721 households accessed IHPs as part of out-patient consultation for infectious disease (67%). Households from rural areas (78%), households belonging to backward groups (75%), households from the poorest quintile and women (52%) access the services of IHPs. The median OOP for all services was INR 240 (IQR 120–600) and more than 90% of total OOP is accounted for medical expenditure.

Conclusion:

The programs need to define healthcare packages to engage IHPs to increase the reach and reduce OOP expenditure on households.
Possible COVID-19 reinfection case in Duhok City, Kurdistan
Authors: Hussein Nawfal R. , Musa Dildar H. , Saleem Zana Sidiq M. , Naqid Ibrahim A. , Ibrahim Nashwan
Published: June 2021

Since the discovery of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus disease (COVID-19) pandemic has become the most important health-care crisis globally, having spread to millions of people worldwide. Patients who recover from COVID-19 are still susceptible to reinfection. In this report, we present the case of a patient who had recovered from COVID-19. Recovery was defined as the resolution of symptoms accompanied by two consecutive SARS-CoV-2-negative real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test results. Two months after the first infection, the patient tested positive for anti-SARS-CoV-2 antibodies. Three months after this test, the patient presented with mild COVID-19 symptoms that was confirmed by RT-PCR. These findings indicate a possible reinfection case. If the occurrence of reinfections is demonstrated to be true, then it may change the strategy of community-based disease prevention. More research is needed to confirm the concept of reinfection.
Social, health system and clinical determinants of fever mortality during an outbreak of dengue fever in Kerala, India
Authors: Sujatha Chintha , Sudha Reshma R. , Surendran Anish T. , Reghukumar Aravind , Valamparampil Mathew J. , Sathyadas Indu P. , Chandrasekharan Prajitha K.
Published: June 2021

Background and Objectives:

The morbidity and mortality spectrum of the south Indian state of Kerala is dominated by chronic non-communicable diseases, yet febrile illnesses because of neglected tropical diseases and emerging viral infections are often reported. As fever deaths are mostly avoidable, understanding the determinants of mortality is essential for implementing preventive measures.

Methods:

A case-control study was done during an ongoing dengue outbreak in Thiruvananthapuram district, Kerala during 2017–18. Cases included all fever deaths from the line list of Integrated Disease Surveillance Program (IDSP). Data were obtained from hospital case records and by interviewing patients or care givers. The theoretical model for determinants of mortality was constructed at three levels namely sociodemographic factors, access to health care and health seeking behavior, and clinical determinants.

Results:

This study confirmed association of mortality with age above 40 years (P = 0.010, OR = 3.48), being heavy built (P = 0.029, OR = 13.25), clinical symptoms of breathlessness (P < 0.001, OR = 24.89), restlessness (P < 0.001, OR = 97.26), clinical signs of drowsiness (P = 0.024, OR = 7.97), hypotension (P < 0.001, OR = 42.22), complications such as ARDS (P = 0.047, OR = 171.56), and myocarditis (P = 0.012, OR = 16.59). A low occupation status of semiskilled work or less (P = 0.012, OR = 0.30), choosing a nearby hospital for treatment (P = 0.018, OR = 0.48) and shortening the time gap between onset of symptom and final diagnosis (P = 0.044, OR = 0.72) was found to be protective.

Conclusion:

Along with biological and clinical factors, distal determinants like social factors, health seeking behavior, and health system factors are associated with fever mortality.