bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Astigmatism Correction in Cataract Surgery Between Simultaneous Femtosecond Laser-Assisted Intrastromal Arcuate Keratotomy and Toric Intraocular Lens Implantation
Authors: Kwon Hye Ji , Lee Hun , Lee Jin Ah , Kim Jae Yong , Tchah Hungwon 
Published: August 2020

Abstract
Objectives
To compare the efficacy of astigmatic correction between simultaneous femtosecond laser-assisted intrastromal arcuate keratotomy (AK) combined with femtosecond laser-assisted cataract surgery (FLACS) and toric intraocular lens (IOL) implantation during cataract surgery in moderate astigmatism.
Design:
Retrospective observational study, tertiary care medical center
Methods
We retrospectively reviewed medical records of patients who underwent astigmatic correction via femtosecond laser-assisted intrastromal AK (AK group; 27 eyes of 27 patients) with FLACS or toric IOL implantation (toric IOL group; 21 eyes of 21 patients). All patients had senile cataracts with corneal astigmatism ranging from + 1.00 to + 2.00 diopters (D) before cataract surgery. We measured visual acuity, intraocular pressure, automated keratometry, manifest refraction and topography preoperatively and at 1-day, 1-month, 3-month, and 6-month postoperatively.
Results
Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. There was significant difference in corneal astigmatism from topography and automated keratometer between the two groups at 6-month postoperatively (0.94 ± 0.40 vs 1.53 ± 0.46 D, P = 0.018 for topography and 0.98 ± 0.69 vs 1.37 ± 0.41 D, P = 0.032 for automated keratometer).
Conclusions
Femtosecond laser-assisted intrastromal AK in FLACS could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.
Comparison of Preoperative Angle Kappa Measurements in the Eyes of Cataract Patients Obtained from Pentacam Scheimpflug System, Optical Low-Coherence Reflectometry, and Ray-Tracing Aberrometry
Authors: Qin Miaomiao , Yuan Yurong , Wang Ying , Li Pengfei , Chen Wei , Wang Yong , Yang Mei , Wu Jian , Ji Min , Luo Jiawei , Tang Jiamin , Chen Xiaojuan , Huang Yemeng , Guan Huaijin 
Published: August 2020

Abstract
Background
Angle kappa plays a vital role in the implantation of multifocal intraocular lens (MIOLs). Large angle kappa is related to higher risk of postoperative photic phenomena. This study aims to compare preoperative angle kappa in the eyes of cataract patients obtained from Pentacam Scheimpflug system (Pentacam), optical low-coherence reflectometry (Lenstar), and ray-tracing aberrometry (iTrace).
Methods
One hundred thirteen eyes of 113 patients with cataracts were included. Each eye was examined by the devices to obtain angle kappa (X-Y Cartesian coordinates) and pupil diameter. When considering dependent eyes for one individual, angle kappa in right eyes and left eyes should be analyzed separately. The difference, correlation, and agreement between values for horizontal and vertical components of angle kappa were evaluated by paired t-tests, Pearson or Spearman tests, and Bland‑Altman analysis, respectively.
Results
No significant differences in the pupil diameter were found between Pentacam and Lenstar or Lenstar and iTrace in both eyes (P > 0.05). Positive angle kappa (nasal light reflex) was found in most cataract patients (79.25–84.91%) through 3 different devices in both eyes. The significant differences of angle kappa were not found between Pentacam and Lenstar compared to Pentacam and iTrace or Lenstar and iTrace in both eyes (P > 0.05). Pentacam and Lenstar showed strong correlation in the horizontal and vertical components of angle kappa compared to Pentacam and iTrace or Lenstar and iTrace in both eyes (r = 0.906 to 0.939). The 95% limits of agreement (LoA) in the horizontal and vertical components of angle kappa with Pentacam and Lenstar were narrower respect to Pentacam and iTrace or Lenstar and iTrace in both eyes.
Conclusions
There were no differences, strong correlation, and good agreement in angle kappa with Pentacam and Lenstar for cataract patients. Based on these findings, the measurement of preoperative angle kappa in the eyes of patients with cataracts by Pentacam and Lenstar has good agreement, and can be used interchangeably, but caution is warranted for outcomes-based iTrace that report angle kappa.
Emergency Department Management Metrics for Severe Pediatric Traumatic Brain Injury
Authors: Liu Maple , Holt Tanya , Hansen Gregory 
Published: August 2020

Abstract
Background: As the majority of severe pediatric traumatic brain injuries (TBI) are received and managed in the emergency department (ED), the ED trauma center is vital to optimizing management. This study aimed to evaluate current management guidelines, and to recognize other high-risk components of TBI management. Methods: A retrospective chart review was conducted solely at the Jim Pattison Children’s Hospital in Saskatoon, Canada. Data pertaining to emergency department metrics included transport to trauma center, injury severity, indicators for raised intracranial pressure, airway and breathing, circulation, disability/central nervous system, complications, and outcome scores. Results: A total of 56 charts were included in the study population. Mean age of patient population was 14.3 years of age, with 76% being male. Thirty four percent of patients received a blood gas within 15 minutes of admission, and 20% received intervention to correct PCO2. Of the seven patients who received hyperosmolar therapy, three were based on computed tomography (CT) findings and four were based clinically. For 95% of patients, the position of the bed was not documented, and just 4% of patients had head of bed elevated to 30 degrees. Sixty four percent of patients were accompanied by a physician with airway expertise during CT. Conclusions: Building on current TBI guidelines, timeliness of PCO2 retrieval and improvements for targeted hyperosmolar therapy were noted. Two other potential areas for improving management included deliberate considerations for head of bed positioning and personnel accompanying patients undergoing CT.
Study of the Internal Exposure Monitoring and the New Monitoring Methods of Thyroid I-131 for Radiological Staff in Nuclear Medicine
Authors: Liu Gang , Li Ye 
Published: August 2020

Abstract
Background：In general, medical staff dealing with nuclear medicine should be entirely safe in their professional environment. Nevertheless, their exposure to radioactive iodine seems to be partially uncontrolled while they perform their duties, namely while administering iodine in the form of tablets or solutions or while taking care of the patients already treated with the isotope. Purpose: To verify such a hypothesis, develop a simple method for internal exposure monitoring，131I activity measurements in the thyroids of the personnel employed at the three hospitals of Gansu province grade a hospital nuclear medicine. Mastered the internal exposure of nuclear medical personnel.Methods: Choosing 20 employees of the department of three hospitals of gansu province grade a hospital nuclear medicine, which corresponds to circa 100% of all of the all the staff of the nuclear medicine department who carry out iodine therapy. Automatic packaging and drug delivery staffs were 6, manual packaging and drug delivery staffs were 14. According to the rules of the judgment principles proposed in IAEA safety guidelines, An InSpector 1000 portable spectrometer and its supporting software served as the basic research instrument. In four out of twenty examined staff members. The sitting position was adopted with NaI portable spectrometer. The measurement time was 120s. Result: Among the manual packaging and drug delivery staffs was 4 (20.0%) detected 131I in the thyroid, with activity range of 27.6-1030.3Bq. Automatic packaging and drug delivery staffs were not detected. Conclusions: The highest activities in thyroids were detected for the manual packaging and drug delivery staffs, Automatic packaging and drug delivery staffs were not detected. The dose of some workers is high, so the prevention and control of pollution in nuclear medicine discipline needs to be strengthened urgently.
Efficacy of left ventricular unloading strategies during venoarterial extracorporeal membrane oxygenation in patients with cardiogenic shock: a protocol for a systematic review and Bayesian network meta-analysis
Authors: Zhang Pengbin , Wei Shilin , Zhai Kerong , Huang Jian , Cheng Xingdong , Tao Zhenze , Gao Bingren , Liu Debin , Li Yongnan 
Published: August 2020

Abstract
Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been widely used for patients with refractory cardiogenic shock (CS). A common side-effect of this technic is the resultant increase in left ventricular (LV) afterload which could potentially aggravate myocardial ischemia, delay ventricular recovery, and increase the risk of pulmonary congestion. Several LV unloading strategies have been proposed and implemented to mitigate these complications. However, it is still indistinct that which one is the best choice for clinical application. The objective of this Bayesian network meta-analysis (NMA) is to summarize the evidence and compare the efficacy of different LV unloading strategies during VA-ECMO.Methods: We will perform a systematic search to identify random controlled trials and cohort studies comparing different LV unloading strategies during VA-ECMO. PubMed, Embase, the Cochrane Library, and the International Clinical Trials Registry Platform (ICTRP) will be explored from their inception to 31 December 2020. The primary outcome will be in-hospital mortality. The secondary outcomes will include neurological complications, hemolysis, bleeding, limb ischemia, renal failure, gastrointestinal complications, sepsis, duration of mechanical ventilation, length of intensive care unit, and hospital stays. Pairwise and network meta-analysis will respectively be conducted using Stata (V.16, StataCorp) and Aggregate Data Drug Information System (ADDIS V.1.16.5), and the cumulative probability will be used to rank the included LV unloading strategies. The risk of bias will be conducted using the Cochrane Collaboration’s tool or Newcastle-Ottawa Quality Assessment Scale (NOS) according to their study design. Subgroup analysis, sensitivity analysis, and publication bias assessment will be performed. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be conducted to explore the quality of evidence.Discussion: This Bayesian network meta-analysis (NMA) will address the problem that which strategy could achieve left ventricular (LV) unloading most effectively during venoarterial extracorporeal membrane oxygenation and increase cardiogenic shock patient survival benefit, and will provide evidence for clinical decision-making.Systematic review registration: PROSPERO registry number: CRD42020165093.
Covid-19 associated Acute Haemorrhagic Leukoencephalomyelitis
Authors: Handa Rahul , Nanda Satyan , Prasad Atul , Anand Rajiv , Zutshi Dhruv , Dass Sujata K. , Bedi Prabhjeet Kaur , Pahuja Aarti , Shah Pankaj Kumar , Sharma Bipan 
Published: August 2020

Abstract
Since the first appearance of Covid-19 in December 2019 in Wuhan, China, the disease has spread world-wide infecting more than 13 million people and causing approximately five hundred eighty-five thousand deaths. The disease which was initially thought to primarily involve respiratory and cardiovascular system only, over time has been reported to involve central and peripheral nervous system with varying frequency. The importance of identifying neurological symptoms cannot be over emphasised by the fact that loss of sense of smell is now considered as one of the earliest features of Covid-19. Although, impaired consciousness has been reported in approximately 17% patients with Covid-19, acute haemorrhagic leukoencephalomyelitis (AHL) as its cause has been reported in a very few cases. It is imperative for the emergency and respiratory physicians to be aware of this condition as mostly they are the ones who initially come in contact with the Covid-19 patients, as early diagnosis and aggressive treatment would greatly help in improving the prognosis and reducing the morbidity in this otherwise fatal disease. We herein report a case of acute haemorrhagic leukoencephalomyelitis secondary to Covid-19 from a tertiary care centre in India. To the best of our knowledge, this is the first case of Covid-19 associated AHL to be reported from India.
Transition to Online Higher Education during COVID-19 Pandemic: Turmoil and Way Forward to Developing Country - Nepal
Authors: Gautam Dhruba Kumar , Gautam Prakash Kumar 
Published: August 2020

Abstract
Every day thousands of academic institutes suspend their classes and students are staying home maintaining social distancing due to the fear of COVID-19 pandemic and Nepal is no exception. Realizing this facts, this study aims to explore the factors for the effectiveness of online mode of classes especially to the on-class course-based students analyzing perception of faculties and students during the COVID-19 pandemic. Based on exploratory research design following mixed methods of qualitative and quantitative procedures for data collection, this study revealed triplet factors as infrastructure- specific, student-specific and teacher-specific as antecedents of effectiveness of online classes to the on-class based courses during pandemic. Students faced anxiety during the COVID-19 pandemic but a higher willingness to learn has little anxiety. The findings significantly contribute to the future management of higher education during the pandemic as well as digs the future path of online and on-class teaching-learning practices in higher education.
Indirect Hemagglutination Test for Detection of Antibodies to&nbsp;Toxoplasma gondii&nbsp;in Venezuelan felids
Authors: Cañizales Israel 
Published: August 2020

Abstract
Current knowledge of Toxoplasma gondii infection in Venezuelan ecosystems is limited. T. gondii is a ubiquitous intracellular protozoan parasite. Mammals and birds are intermediate hosts and felid species are definitive hosts. In most human altered habitats, the domestic cat is the predominant definitive host. Cats are important in the epidemiology of T. gondii infection because they are the only hosts that can excrete the environmentally resistant oocysts. Other carnivores can be infected by the consumption of tissue cysts when feeding on infected animals and by incidental ingestion of oocysts from environmental contamination. This study aimed to quantify the values of antibodies for T. gondii in blood serum of some felids species by means of the technique of Indirect Hemoagglutination. In the present study, seropositivity of T. gondii was determined in serum of 35 animals (22 stray cats and 13 wild cats) from Venezuela, South America. Antibodies to T. gondii were assayed by the indirect hemagglutination test and found in 21 of 22 (95.45 %) stray catstiters of 1:64 in four, 1:128 in four, 1:256 in one, 1:512 in one, 1:1024 in three, and 1:2048 or higher in eight. In 4 of 6 (66.67 %) ocelots titers of 1:64 in one, 1:256 in one, 1:1024 in one, and one with titers 1:2048. In 3 of 4 (75.00 %) jaguars titers of 1:512 in one, and two with titers 1:2048. The Kruskal-Wallis test showed a statistically significant difference between species (H = 6.983, p = 0.03).
Laparoscopically assisted uterovaginal canalization and vaginoplasty for patients with congenital cervical and vaginal atresia: a step-by-step guide and long-term outcomes
Authors: Kang Jia , Chen Na , Zhang Ye , Ma Congcong , Ma Yidi , Wang Yuan , Tian Weijie , Zhu Lan 
Published: August 2020

Abstract
Objective: To study the long-term outcomes of laparoscopically assisted uterovaginal canalization and vaginoplasty in patients with congenital cervical and vaginal atresia and to introduce the surgery step-by-step.Methods: A prospective observational study was conducted including 10 patients diagnosed with congenital cervical and vaginal atresia underwent laparoscopically assisted cervicovaginal canalization between January 2016 and Jun 2020 in a tertiary teaching hospital. Clinical characteristics and perioperative data were recorded. Patients were followed up in outpatient clinic at 3, 6 and 12 months postoperatively, and once a year thereafter. Menstruation cycles and degree of dysmenorrhea were recorded. Gynecological examination was performed to measure vaginal length and to examine whether there was restenosis.Results: All procedures went smoothly, with no case requiring conversion to laparotomy or no intraoperative complications occurred. Postoperative febrile morbidity occurred in one patient (1/10, 10%). The median (quartile) follow-up time was 26.0 (21.3, 48.3) months. All patients resumed menstruation, including nine patients (9/10, 90%) with regular monthly menstruation. Eight patients (8/10, 80%) experienced mild-to-moderate dysmenorrhea; the remaining 2 patients (2/10, 20%) had no dysmenorrhea. Cervical restenosis occurred in one patient (1/10,10%) 12 months postoperatively, and cervical dilation was performed. So far, eight months after the second surgery, no restenosis has been found. The mean postoperative vaginal length was 7.9 ± 1.3 cm by the time of last follow up. Only one patient prepared for pregnancy for two years, but she had not conceived yet.Conclusion: Laparoscopically assisted uterovaginal canalization and vaginoplasty is an easy, safe and promising management option for correcting congenital cervical and vaginal atresia.
Bacterial Profile and Their Antibiotic Resistance Pattern Among HIV Patients Diagnosed with Pneumonia in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia
Authors: Genetu Deribew Eniyew , Zenebe Yohannes 
Published: August 2020

Abstract
Background: Bacterial pneumonia remains the major cause of morbidity and admissiondiagnosis among human immunodeficiency virus infected individuals. In the study area, data about the bacterial profile of pneumonia and their antimicrobial resistance pattern among people living with human immunodeficiency virus is limited. Hence, this study was aimed to estimate the prevalence of bacterial pneumonia, antibiotic resistance patterns of isolated bacteria and associated factors among HIV patients in Felege Hiwot Referral Hospital.Method: Hospital based cross-sectional study was conducted from February 15 to June 15, 2019. Sputum specimens were collected from 163 pneumonia presumptive HIV seropositive individuals. Data on socio-demographic characteristics and risk factors were also collected using a structured questionnaire. Blood, Chocolate, and MacConkey agar plates were used to grow the isolates. The isolated colonies were identified based on Gram Stain, colony morphology, hemolysis, and biochemical tests. The antimicrobial susceptibility test was performed using the modified Kirby-Bauer Disc Diffusion method. Descriptive and multivariate analyses were performed using SPSS version 23. P-value < 0.05 was considered statistically significant.Result: Out of 163 sputum samples, 68 (41.7%) were culture positive for common bacterial infections. The predominant bacterial isolates were Klebsiella pneumoniae, 19 (27.9%), and Staphylococcus aureus, 17 (25%). From multivariate analysis, age groups 18-29 (AOR = 5.4, 95 % CI: 1.26-23.35), age groups 30-39 (AOR = 3.8, 95% CI: 1.03-13.80), recent viral load greater than or equal to 150 copies/ml (AOR= 24.3, 95 % CI: 2.61-56.38), viral load less than 150 copies/ml (AOR= 5.1, 95% CI: 1.26-21.04), cigarette smoking (AOR=15.5, 95% CI: 1.61-48.59), and alcohol consumption (AOR=8.1, 95% CI: 2.76-23.51) were found to have statistically significant association with bacterial pneumonia. Out of the tested antibiotics 46 (70.8%) were resistant to cotrimoxazole and P. aeruginosa were 100% resistant to gentamycin and ceftazidime. Overall, 77.9% of the isolates were MDR.Conclusion: The study showed high prevalence of bacterial pneumonia and a high percentage of drug resistance including MDR in the study area. Therefore, we recommend that culture and antimicrobial susceptibility tests should be routinely performed for the selection of appropriate treatment.
Dutch patients, caregivers and healthcare professionals generate first nationwide research agenda for juvenile idiopathic arthritis
Authors: Verwoerd Anouk , Armbrust Wineke , Cowan Katherine , Berg Lotte van den , de Boer Joke , Bookelman Sanne , Britstra Marjan , Cappon Jeannette , Certan Maria , Dedding Christine , Haspel Karin van den , Muller Petra Hissink , Jongsma Karin , Lelieveld Otto , Loosdregt Jorg van , Olsder Wendy , Rocha Johanna , Schatorjé Ellen , Schouten Natasja , Swart Joost F. , Vastert Sebastiaan , Walter Margot , Schoemaker Casper G 
Published: August 2020

Abstract
Background: Involving the end-users of scientific research (patients, carers and clinicians) in setting research priorities is important to formulate research questions that truly make a difference and are in tune with the needs of patients. We therefore aimed to generate a national research agenda for Juvenile Idiopathic Arthritis (JIA) together with patients, their caregivers and healthcare professionals through conducting a nationwide survey among these stakeholders.Methods: The James Lind Alliance method was used, tailored with additional focus groups held to involve younger patients. First, research questions were gathered through an online and hardcopy survey. The received questions that were in scope were summarised and a literature search was performed to verify that questions were unanswered. Questions were ranked in the interim survey, and the final top 10 was chosen during a prioritisation workshop.Results: Two hundred and seventy-eight respondents submitted 604 questions, of which 519 were in scope. Of these 604 questions, 81 were generated in the focus groups with younger children. The questions were summarised into 53 summary questions. An evidence checking process verified that all questions were unanswered. A total of 303 respondents prioritised the questions in the interim survey. Focus groups with children generated a top 5 of their most important questions. Combining this top 5 with the top 10 s of patients, carers, and clinicians led to a top 21. Out of these, the top 10 research priorities were chosen during a final workshop. Research into pain and fatigue, personalised treatment strategies and aetiology were ranked high in the Top 10.Conclusions: Through this study, the top 10 research priorities for JIA of patients, their caregivers and clinicians were identified to inform researchers and research funders of the research topics that matter most to them. The top priority involves the treatment and mechanisms behind persisting pain and fatigue when the disease is in remission.