bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Conjunctival Dysplasia (Squamous Intraepithelial Neoplasia) with Melanosis (Microscopic Non-Proliferative Melanin Pigmentation)
Authors: Fariba Fattahi Seyede , Khalili Mohammad Reza , Navahi Roshanak Aliakbar , Ashraf Mohammad Javad 
Published: August 2020

Purpose:
To determine the association between conjunctival epithelial dysplasia (squamous intraepithelial neoplasia) and its melanosis (microscopic non-proliferative melanin pigmentation) in conjunctival biopsies.

Methods:
In this retrospective case series, histopathological slides from all conjunctival biopsies obtained in Khalil Hospital affiliated with Shiraz University of Medical Sciences for a period of 6 years (April 2009–July 2015) were reviewed. After considering the exclusion criteria (non-melanotic pigmentation, melanocytic proliferations, and squamous cell carcinoma), conjunctival biopsies were divided histopathologically into two groups of dysplastic and non-dysplastic. Then, the slides were reviewed by one ophthalmopathologists and one general pathologist. Melanin pigmentation was recorded in both groups as 0, 1+, 2+, and 3+. The data were analyzed, and the groups were compared.

Results:
Overall, 685 cases with a mean age of 47.78 (±17.74) years were included in this study. Dysplastic and non-dysplastic groups comprised 135 (19.7%) and 550 (80.3%) specimens, respectively. Seventy-six percent (76%) of the specimens in the dysplastic group versus 40% in the non-dysplastic group had melanosis (P = 0.001). However, the degree of dysplasia (1+, 2+, and 3+) was not statistically correlated with the degree of melanosis (1+, 2+, and 3+) (P = 0.393).

Conclusion:
Our results demonstrated that melanosis is a common finding in conjunctival epithelial dysplasia and might indicate an association with conjunctival epithelial dysplasia.
Corneal Collagen Cross-Linking Using Epithelium Disruptor Instrument in Progressive Keratoconus
Authors: Zaheryani Seyed Mohammad Salar , Movahedan Hossein , Salouti Ramin , Mohaghegh Sahar , Javadpour Sara , Shirvani Mohammad , Kasraei Farzaneh , Bamdad Shahram 
Published: August 2020

Purpose:
To compare the effects of accelerated corneal collagen cross-linking (CXL) in progressive keratoconus (KCN) patients via epithelium removal and transepithelial techniques, using Daya Disruptor (Duckworth and Kent, Hertfordshire, UK).

Methods:
This study is a double-blinded, randomized clinical trial. Patients with documented bilateral progressive KCN were randomized into two groups: one eye underwent epithelium removal (Group 1), and the fellow eye underwent epithelium disruption (Group 2). The primary outcomes were best corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA), Scheimpflug-extracted keratometric indices, and anterior segment-optical coherence tomography-derived epithelial thickness profiles. These parameters were evaluated before and 12 months after CXL.

Results:
Sixty-four eyes from 34 patients with progressive KCN (34 eyes in the epithelium-removal group and 30 eyes in the epithelium-disruption group) were included. The mean ± standard deviation (SD) of age was 23.4 ± 3.8 years in the epithelium-removal group and 23.2 ± 3.5 years in the epithelium-disruption group. The mean ± SD of the preoperative spherical equivalent (SE), front maximum keratometry (K-max), back K-max, thickness of thinnest point, and corneal apex thickness were − 2.9 ± 3.0 diopter (D) and − 3.7 ± 3.1 D (P = 0.183), 53.8 ± 5.15 D and 54.4 ± 5.53 D (P = 0.653), −6.63 ± 2.40 D and − 6.68 ± 2.48 D (P = 0.131), 459.2 ± 37.4 μm and 460.8 ± 32.7 μm (P = 0.708), 470.5 ± 37.7 μm and 469.7 ± 33.1 μm (P = 0.679), and 55.4 ± 4.97 μm and 54.6 ± 7.16 μm (P = 0.767) in the epithelium-removal and epithelium-disruption groups, respectively. The mean ± SD changes of the UCVA and BCVA 12 months after CXL were − 0.1 ± 0.11 and − 0.02 ± 0.18 and − 0.04 ± 0.12 and − 0.02 ± 0.14 in the epithelium-removal and epithelium-disruption groups, respectively. No statistically significant improvement was observed in the UCVA and BCVA between the two groups (P = 0.868 and P = 0.937, respectively). The mean ± SD changes of the SE, superior epithelial thickness, corneal apex thickness, and thickness of thinnest point 12 months after CXL were − 0.21 ± 1.1 D and + 0.32 ± 1.6 D (P = 0.0001), −0.08 ± 0.26 μm and + 0.03 ± 0.33 μm (P = 0.028), −23 ± 11 μm and − 2 ± 6 μm (P = 0.0001), and − 25 ± 8 μm and − 3 ± 7 μm (P = 0.0001) in the epithelium-removal and epithelium-disruption groups, respectively.

Conclusions:
This study showed that the epithelium-disruption CXL using Daya has a similar potential for halting KCN progression as the epithelium-removal CXL. However, regarding the 12-month changes, the epithelium-disruption CXL is superior to the epithelium-removal CXL in the SE and corneal pachymetry.
White pine and Scots pine tree-ring chronologies as indicators of climate-related non-native and native tree growth patterns in Estonia
Authors: Läänelaid Alar , Helama Samuli 
Published: August 2020

Three tree-ring chronologies of white pine (Pinus strobus), a species which are non-native to Europe, were constructed for Suuremõisa, Jädivere and Järvselja sites in Estonia. These chronologies were related to instrumental climate records and Scots pine (P. sylvestris) chronologies from nearby sites. Growth rates of P. strobus exceeded those of P. sylvestris. The chronologies of the non-native and native pine species relatively well correlated with each other. Moreover, tree-ring growth of both species correlated positively with late-winter and spring (February–May) temperatures and negatively with spring (April) precipitation. While P. strobus growth was positively associated with summer precipitation, the growth of P. sylvestris remained positively related to the growing season temperatures. Both species exhibited a negative growth anomaly from 1939 to 1942.

Keywords: Pinus strobus, Pinus sylvestris, dendroclimatology, Estonia
Estilos de aprendizaje y tecnología educativa virtual en la carrera de Derecho
Authors: Loarca Marroquín Salvador 
Published: August 2020

El presente artículo da a conocer los resultados producto de la investigación “Los efectos del uso de las tecnologías educativas virtuales”. La metodología que se utilizó es con enfoque mixto, de tipo descriptivo, a través de una encuesta, un cuestionario de estilos de aprendizaje validado por Honey Alonso y una ficha de observación. Se tomaron como sujetos de estudio a 37 estudiantes y 7 docentes del quinto ciclo de la carrera Abogacía y Notariado de la Universidad de San Carlos de Guatemala del Centro Universitario de Sololá –CUNSOL- extensión San Juan La Laguna. Los principales resultados evidencian que el uso constante de las tecnologías educativas virtuales en las actividades académicas estimula los estilos de aprendizaje sensoriales, de la siguiente manera, el estilo visual en un 51%, visual-auditivo en un 46%, auditivo y kinestésico con menor porcentaje. Se concluye que los efectos del uso de las tecnologías educativas virtuales en los estudiantes, según su estilo de aprendizaje son acertados, debido a que estos estimulan los sentidos de la vista y el oído, por medio de las imágenes y sonidos que se reproducen en videos y otras aplicaciones digitales. Los recursos disponibles con éstas tecnologías se adecuan a las necesidades de cada estudiante, además fortalecen su aprendizaje de acuerdo a su estilo para la captación y retención de información.
PENENTUAN PARAMETER LEARNING RATE SELAMA PEMBELAJARAN JARINGAN SYARAF TIRUAN BACKPROPAGATION MENGGUNAKAN ALGORITMA GENETIKA
Authors: Saputra Ade chandra 
Published: August 2020

One of the weakness in backpropagation Artificial neural network(ANN) is being stuck in local minima. Learning rate parameter is an important parameter in order to determine how fast the ANN Learning. This research is conducted to determine a method of finding the value of learning rate parameter using a genetic algorithm when neural network learning stops and the error value is not reached the stopping criteria or has not reached the convergence. Genetic algorithm is used to determine the value of learning rate used is based on the calculation of the fitness function with the input of the ANN weights, gradient error, and bias. The calculation of the fitness function will produce an error value of each learning rate which represents each candidate solutions or individual genetic algorithms. Each individual is determined by sum of squared error value. One with the smallest SSE is the best individual. The value of learning rate has chosen will be used to continue learning so that it can lower the value of the error or speed up the learning towards convergence.

The final result of this study is to provide a new solution to resolve the problem in the backpropagation learning that often have problems in determining the learning parameters. These results indicate that the method of genetic algorithms can provide a solution for backpropagation learning in order to decrease the value of SSE when learning of ANN has been static in large error conditions, or stuck in local minima
MESA 2: DIABETES MELLITUS TIPO 1 Y ACTIVIDAD FÍSICA
Authors: Menéndez Estrella , Rodríguez Martín , Muratore Carolina , Re Matías Alberto , Burgos Mariana Andrea , Apoloni Susana , Bertona Altieri María Celina , Koleff Claudia Karina , Pomares María Laura , Remón Javier Agustín , Roccatagliata Laura Elisa , Rodríguez María Virginia , Scalitti Gabriela 
Published: August 2020

En personas con diabetes tipo 1 (DM1) el ejercicio físico realizado en forma regular brindaría protección cardiovascular y tendría propiedades inmunomoduladoras pero la compleja interacción entre los efectos del ejercicio sobre el metabolismo glucídico y la terapia con insulina exógena supone un verdadero desafío. El ejercicio aeróbico por la contracción muscular disminuye la glucemia, conduce a un estado de hiperinsulinemia relativa y genera hipoglucemia al inicio o después del mismo mientras que el ejercicio anaeróbico se asocia a hiperglucemia por aumento de catecolaminas e incremento de lactato que favorece la neoglucogénesis hepática. El deterioro de la respuesta de hormonas contrarreguladoras existente en la DM1 amplifica la variabilidad glucémica y dificulta el control metabólico.Existen guías y recomendaciones que buscan brindar un marco de seguridad para la prescripción de actividad física considerando la multiplicidad de disciplinas deportivas, la edad del paciente y la evaluación de las complicaciones crónicas de la diabetes antes del inicio de la misma. Entre las estrategias terapéuticas se encuentran la modulación con hidratos de carbono, la adecuación pre y pos ejercicio de la insulinoterapia y el control intensivo de glucemia y cetonas. Los nuevos infusores de insulina y monitoreo glucémico ofrecen la posibilidad del fraccionamiento y/o suspensión de dosis convirtiéndose en el gold standard entre los deportistas de alto rendimiento. A futuro modelos integrados con calculadoras de ejercicio inteligentes, capacidad predictiva y de “aprendizaje individualizado” (páncreas artificial) posibilitarán mantener la euglucemia y optimizar los beneficios del ejercicio como parte del tratamiento.
Identifying Recurrent Laryngeal Nerve in Thyroid Surgery Using Relationship with Superior Parathyroid Gland and Tubercle of Zuckerkandl
Authors: Mozumder Somesh , Dubey Shirish , Dam Aniruddha , Bhowmick Anup Kumar 
Published: August 2020

Introduction: Recurrent laryngeal nerves (RLN) are particularly prone to injury during thyroid surgeries due to its intimate relationship and proximity with the gland. Zuckerkandl’s tubercle (ZT) helps in preserving RLN intra operative.
Material and Methods: A prospective study for identifying RLN in thyroid surgery using relationship with superior parathyroid gland and tubercle of Zuckerkandl was conducted on 50 thyroidectomy patients between August 2013 and February 2014.
Results: In all cases ZT was identified. Temporary paralysis of RLN was seen in 3 (6%) cases and permanent paralysis in 2 (4%) of cases.
Discussion: The site of greatest risk during thyroidectomy to the RLN is in the last 2-3 cm extralaryngeal course of the nerve. Relationship of recurrent laryngeal nerve with superior parathyroid gland and tubercle of Zukerkandl (ZT) is known.
Conclusion: Use of ZT and superior parathyroids as a landmark allows safe dissection of RLN.
Community Awareness - A Key to the Early Detection of Head and Neck Cancer
Authors: Manickam Ajay , Saha Jayanta , Ghosh Debangshu , Sengupta Shaswati , Biswas Debabrata , Basu Sumit Kumar , Kumar Satish , Ray Souradeep 
Published: August 2020

INTRODUCTION
Mortality and morbidity associated with head and neck cancers have decreased to a great extent in many developed countries of the world due to early diagnosis and treatment with advances in surgical techniques and better availability of radiotherapist and oncologists. But the situation in developing countries like India is quite different.
AIMS AND OBJECTIVES
This study was conducted amongst the patients attending the Otolaryngology department of a teaching hospital in Kolkata to find the incidence of various types and sites of head and neck cancer, to assess time delay from the date of onset of symptom to the final disease confirmation in relation to patients’ demographic profile, to assess time delay in histopathological diagnosis after reaching a tertiary care setup and also to correlate tobacco consumption and alcohol intake as risk factors for head and neck cancer and to note the reasons for late presentation, as described by the patient.
MATERIALS AND METHODS
The descriptive study was conducted at a tertiary level teaching hospital, in the Department of Otorhinolaryngology for a period from August 2013 to August 2015 with a study population of 133.
OBSERVATIONS
An average time lag from the onset of symptom to final diagnosis as malignancy was found to be 6 months to one year in nearly 72% of cases. Most of the patients were uneducated males of more than 50 years of age, hailing from rural areas. Cancer larynx was found to be the commonest of all head and neck cancers (31.6%). More than 65% of the patients were addicted to tobacco chewing or smoking or consumption of alcohol.
DISCUSSION
Poverty, lack of education, poor communication, lack of health care infrastructure in rural areas, community awareness about various risk factors, lack of effective health policy to achieve early diagnosis of head neck cancer were common factors related to delay in diagnosis.
CONCLUSION
Tobacco use and alcohol intake are the modifiable risk factors of head and neck cancer. Educating the field workers about the danger signs of head and neck cancer may promote early referral of the suspected cases to tertiary health care setup for early detection of cancer.
Noise Induced Hearing Loss with Tinnitus: Does TRT Help?
Authors: Vohra Maggon Nidhi , Sethi Ashwani , Gupta Atul 
Published: August 2020

Introduction
To determine if hearing augmentation and tinnitus retraining therapy (TRT) helps in cases of Tinnitus with Noise induced hearing loss (NIHL) and does degree of hearing loss, severity or duration of tinnitus affect recovery
Materials and Methods
A prospective study was done on 100 patients of NIHL with tinnitus from Jan 14-Jul 15. Degree of hearing loss was assessed. Tinnitus severity was scored on Tinnitus handicap inventory (THI) scale as Slight, Mild, Moderate, severe or catastrophic and patients were subjected to TRT. Patients scored after 1 year of TRT. A relation between tinnitus severity, duration and degree of hearing loss on recovery from tinnitus was analysed.
Result
62 of the 100 patients improved following TRT.
Discussion
In 100 patients THI scores improved from a mean of 63.12 (SD-21.12) to 38.16 (SD-18.21). Mean difference between pre and post-intervention THI scores was 24.96 (SD-17.97). Improvement was significant in severe or profound hearing loss (P<.001).
Tinnitus severity was slight, mild, moderate, severe or catastrophic on THI. Following TRT, 82.35% with Catastrophic, 70.96% with severe, 52.63% with moderate, 20% with mild tinnitus improved. 1 patient with slight tinnitus did not improve.
Based on duration of tinnitus three groups made; 0-6 months, 6-12 months and >12 months. All groups showed improvement. Reduction in Post-TRT THI was significant but did not show any difference among groups.
Conclusion
TRT helps in tinnitus with NIHL particularly if hearing loss is severe. Severe or catastrophic tinnitus patients experience greater improvement. Duration of tinnitus has no impact.
Present Scenario of Childhood Deafness: A Tertiary Level Health Care Study
Authors: Majumdar Kinjal Shankar , Roy Aditya Ghosh , Mondal Kasturi , Samanta Nirmalya , Jana Utpal , Sikder Biswajit , Shrestha Devjani Ghosh 
Published: August 2020

Introduction
Hearing loss is the most common sensory deficit in humans today. Approximately 63 million people in India suffer from significant auditory impairment.
Materials and Methods
Fifty children of 0-7 years age group, presented to a tertiary level center in Kolkata were assessed by objective and behavioural audiological tests.
Result
Mean age of presentation was found to be 40.5 months. No risk factor could be identified in 72% of the cases. 47% fell into the profoundly deaf category.
Discussion
Numerous studies agree that half of the infants with sensorineural hearing loss have no risk factors at birth and thus would be missed by a targeted hearing screening.
Conclusion
India certainly faces a worse situation regarding childhood deafness. Implementation of universal neonatal hearing screening along with pre-school hearing assessment can certainly change the scenario.
Fractured Tracheostomy Tube - An Unusual Foreign Body in Tracheobronchial Tree
Authors: Moideen Sanu P , Arun G , Mohan M , Afroze Khizer Hussain 
Published: August 2020

Introduction
Approximately 20% of patients with tracheostomy are discharged from hospital with the tracheostomy tube in situ. Proper long term care and management of such tracheostomy patients remains as a challenge to care givers. Fracture of metallic tracheostomy tube (TT) with aspiration of the fragment into tracheobronchial airway is a rare complication of tracheostomy.
Case Report
Here we are presenting a case of a 42-year-old male patient, presented to the emergency department with complaint of mild respiratory distress following aspiration of fractured metallic TT and a novel method in removing the dislodged fragment.
Discussion
A detailed review of literature has been included to discuss different aspects of aspiration of fractured fragment of tracheostomy tube and best practice recommendations for proper tracheostomy care.
Conclusion
Educating the care-giver about care of the tracheostomized patient in general and care of the tracheostomy tube in particular, may help reduce accidental complications.
A Comparative Study of Conventional versus Endoscopic Septoplasty
Authors: Singh Ankita , Bhat Nalini , Bhandarkar Pallavi , Singh Ram 
Published: August 2020

Introduction
The standard surgical treatment for symptomatic deviated septum is septoplasty. This is usually done conventionally using the headlight. However, in recent years the endoscopic method has emerged as an alternative technique. This study aims to compare results of conventional and endoscopic septoplasty
Materials and Methods
A study comprising of 44 patients, randomly divided in two groups, was undertaken to compare the efficacy of both the techniques. This study evaluated parameters like postoperative subjective improvement in symptoms, using the NOSE questionnaire, intra-operative blood loss, duration of surgery, post-operative pain and complications across the two groups.
Further, cases were subgrouped according to the site of deviation as anterior, posterior or combined and the efficacy of these two methods for correcting different sites of deviation was assessed, using the same parameters.
Results
The endoscopic approach showed better overall clinical results, irrespective of the site of deviation. It was noted that correcting posterior deviations required shorter time and had lesser blood loss when operated using the endoscope whereas anterior deviations were dealt faster and had lesser bleeding by the conventional method. There was less pain and morbidity in the postoperative period in the endoscopic group as compared to conventional group.
Discussion
Historical perspective of the conventional and endoscopic septal surgery is mentioned. In review of literature on the four parameters of this study – Symptomatic improvement, intra-operative blood loss, post-operative pain and surgical complications, were compared with published reports.
Conclusion
Endoscopic septoplasty was found to have distinct advantages over the conventional method, more so for posterior septal deviations. It should be an option offered to all patients requiring septoplasty.
Primary Thyroid Lymphoma
Authors: Gupta Manish , Datta Ginni , Rao Naiya , Dadwal Eshita 
Published: August 2020

Introduction
Lymphoma primarily arising from thyroid gland is very rare. Most patients give a history of previous Hashimoto’s thyroiditis and hypothyroidism.
Case Report
We hereby report one such rare case, who presented with neck swelling and hoarseness. The fine needle aspiration cytology being inconclusive, the patient was taken up for near total thyroidectomy. The histopathology revealed it to be lymphoma, which was further confirmed on immunohistochemistry. The further whole body checkup showed it to be Stage IIE tumor. The patient received chemotherapy for residual mass in neck and is under follow-up for last one year with no recurrence.
Discussion
The case is being presented here due to its rarity, diagnostic dilemma and to discuss the management protocol for same.
Fat Plug Myringoplasty Vs Trichloroacetic Acid Cauterization as Office Procedures for Managing Small Central Perforation
Authors: Dhote Kanchan Sandeep , Dhoke Priti Rakesh , Harkare Vivek Vishwas , Deosthale Nitin Vasant , Khadakkar Sonali Prabhakar 
Published: August 2020

Introduction
In a series of day care office procedures, techniques like fat plug myringoplasty and Trichloroacetic acid (TCA) cauterization are becoming increasingly popular for managing small central perforations now-a-days[Office1] . These are minor, cost effective procedures and have success rates that match success rates of conventional tympanoplasty[Office2] . The aim of this prospective randomized controlled trial, was to compare the effectiveness of fat plug myringoplasty and chemical cauterization in the management of small centrally located perforations of the pars tensa.
Materials and Methods
The study was carried out over a period of 2 years on 62 patients selected from ENT OPD in our tertiary health care setup of central India. All the selected patients were grouped into two using a random allocation software EPi Info7.1.1.14. Group A included those who underwent fat plug myringoplasty while group B were those who underwent TCA cauterization.
Results
At 6 months follow up there was closure of perforation in 29 out of 30(96.6%) patients of group A and 29 out of 32(91%) patients of group B. In both groups success was defined by closure of perforation. Comparison of results was done using Fisher Exact Test. The difference between the success rates of the two procedures was statistically insignificant with p value of 0.6624, indicating that both the office procedures are equally effective and can be used according to the needs of the patients.
Conclusion
These office procedures can revolutionize the protocol of tympanoplasty which has an obvious higher morbidity and more days of absenteeism as compared to these minor procedures.