bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of a hinged pupil expansion device in small pupil cataract surgery
Authors: Uy Harvey S , Cruz Franz M , Kenyon Kenneth R 
Published: October 2021

Purpose:
To evaluate the efficacy and safety of a hinged pupil expansion device (PED) in eyes with small pupils undergoing phacoemulsification.

Methods:
In this prospective, multicenter, interventional case series of 57 eyes with suboptimal pharmacologic pupil dilation (<5 mm diameter), a hinged PED (I-Ring, Beaver-Visitec International, Waltham, MA) was applied to facilitate surgical visualization during cataract surgery. The pupil diameters (PD) were measured at different stages of the procedure and at the 1-month follow-up visit. Rate of successful intraoperative PED deployment, pupil size, and shape were assessed.

Results:
The mean patient age was 70.5 ± 12.1 years. The I-Ring PED was successfully applied in all eyes. The mean PD at various stages were 4.1 ± 1.1 mm (dilation with eye drops only preoperatively), 4.3 ± 1.1 mm (dilation after intracameral epinephrine and ophthalmic viscoelastic device), 6.80 ± 0.00 mm (with PED applied), and 5.7 ± 1.1 mm (end of surgery). A statistically significant difference (P < 0.001) was observed between the mean PD with intracameral medications and with PED application. Postoperative circular pupil was observed in 54 of 57 eyes (94.7%) and the mean eccentricity index (n = 57 eyes) was 0.11 ± 0.22. No significant adverse events were observed.

Conclusion:
The I-Ring PED safely and effectively provided and maintained adequate pupil expansion and surgical visualization in eyes with small pupils undergoing cataract surgery. Postoperatively 95% of eyes attained circular pupils. This hinged PED is an additional instrumentation option for the safe and effective expansion of inadequately sized pupils during cataract surgery.
Cobalt blue light unit filter - A smartphone attachment for blue light photography
Authors: Puthalath Athul S , Gupta Neeti , Samanta Ramanuj , Singh Anupam , Kumawat Devesh , Mittal Sanjeev K 
Published: October 2021

Purpose:
The aim of this study was to carry out blue light photography of fluorescein-stained corneas using a novel smartphone attachment.

Methods:
A smartphone attachment known as the cobalt blue light unit (C-BLU) was developed. It can filter out all wavelengths of light except the blue light emerging from the flashlight of a smartphone. A pilot study was carried out wherein the images captured with the C-BLU system were compared with slit-lamp photographs of the same patients. This setup was then used to photo document fluorescein-stained corneas in various clinical settings assembled at point-of-care.

Results:
Many pathologies of the fluorescein-stained cornea were captured using the C-BLU filter. It was used effectively in various settings (remote eye camps, intensive care units (ICU), pediatric group, corneal trauma triaging, etc.). C-BLU was assembled and used by optometrists and ophthalmology residents. The images captured were used for documenting, assisting in the treatment, and also for telecommunication of the patients’ findings.

Conclusion:
C-BLU is a low-cost pocket-size filter which is easy to use with a modern smartphone without any technical expertise needed to obtain a clear image of fluorescein-stained pathological corneas.
The prevalence of E-cigarette uses among medical students at Umm Al-Qura University; a cross-sectional study 2020
Authors: Alshanberi Asim Muhammed , Baljoon Tebra , Bokhari Aziza , Alarif Sara , Madani Abrar , Hafiz Haneen , Altayyar Abrar , Abo-Ali Ehab A. 
Published: October 2021

Background:
Electronic cigarette (e-cigarette) is becoming increasingly popular worldwide, and commercially a commonplace in the media. Health concerns and the avoidance of smoking are the most frequently reported factors for conventional smokers to turn to e-cigarettes. However, there is insufficient information about the use of e-cigarettes in Makkah city; therefore, this study aims to determine the prevalence of electronic cigarette uses among medical students at Umm al-Qura University (UQU).

Methods:
A cross-sectional study was conducted in February 2020 among medical students at UQU, Makkah, Saudi Arabia. Data were collected using a prevalidated printed version of a self-questionnaire to determine the prevalence and the main factors that influence medical students to smoke e-cigarettes and to evaluate their awareness, knowledge, and attitude.

Results:
Out of 1249medical students, 910 participated in the survey, about 31.8 % of them confirmed using e-cigarette regularly. 14.7% think e-cigarettes are medically approved method for smoking cessation, while 59.5% believe it can cause addiction similar to tobacco cigarettes. Among the regular users, 24.3% used it to quit tobacco smoking, 18.9% think it is less harmful, 20.3 % use it because it is less costly, and 18.9% because of stress. Also, 28.4% found it tasty. 30.8% believed that it is less harmful, about 74% stated that they received information about e-cigarettes and only 16% of them received it from medical school.

Conclusion:
The prevalence of e-cigarette uses among medical student in UQU found to be relatively high, and their overall knowledge is insufficient, which conflict our hypothesis.
Clinical features and mortality in COVID-19 SARI versus non COVID-19 SARI cases from Western Rajasthan, India
Authors: Sharma Ankur , Kothari Nikhil , Goel Akhil Dhanesh , Narayanan Balakrishnan , Goyal Shilpa , Bhatia Pradeep , Kumar Deepak , Bohra Gopal Krishna , Chauhan Nishant Kumar , Jalandra Ramniwas , Dutt Naveen , Bhardwaj Pankaj , Garg Mahendra Kumar , Misra Sanjeev 
Published: October 2021

Background:
In March 2020, the Indian Council of Medical Research (ICMR) issued guidelines that all patients presenting with severe acute respiratory infections (SARI) should be investigated for coronavirus disease 2019 (COVID-19). Following the same protocol, in our institute, all patients with SARI were transferred to the COVID-19 suspect intensive care unit (ICU) and investigated for COVID-19.

Methods:
This study was planned to examine the demographical, clinical features, and outcomes of the first 500 suspected patients of COVID-19 with SARI admitted in the COVID-19 suspect ICU at a tertiary care center. Between March 7 and July 20, 2020, 500 patients were admitted to the COVID-19 suspect ICU. We analyzed the demographical, clinical features, and outcomes between COVID-19 positive and negative SARI cases. The records of all the patients were reviewed until July 31, 2020.

Results:
Of the 500 suspected patients admitted to the hospital, 88 patients showed positive results for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) of the nasopharyngeal swabs. The mean age in the positive group was higher (55.31 ± 16.16 years) than in the negative group (40.46 ± 17.49 years) (P < 0.001). Forty-seven (53.4%) of these patients in the COVID-19 positive group and 217 (52.7%) from the negative group suffered from previously known comorbidities. The common symptoms included fever, cough, sore throat, and dyspnea. Eighty-five (20.6%) patients died in the COVID-19 negative group, and 30 (34.1%) died in the COVID-19 positive group (P = 0.006). Deaths among the COVID-19 positive group had a significantly higher age than deaths in the COVID-19 negative group (P < 0.001). Among the patients who died with positive COVID-19 status had substantially higher neutrophilia and lymphopenia (P < 0.001). X-ray chest abnormalities were almost three times more likely in COVID-19 deaths (P < 0.001).

Conclusion:
In the present article, 17.6% of SARI were due to COVID-19 infection with significantly higher mortality (34.1%) in COVID-19 positive patients with SARI. Although all patients presenting as SARI have considerable mortality rates, the COVID-19-associated SARI cases thus had an almost one-third risk of mortality.
Effect of peer support on breastfeeding self-efficacy in ilamian primiparous women
Authors: Chehreh Razhan , Zahrani Shahnaz Tork , Karamelahi Zolaykha , Baghban Alerza Akbarzadeh 
Published: October 2021

Introduction:
Mother's belief, ability, and self-confidence, which is interpreted as breastfeeding self-efficacy, play a key role in the initiation and continuation of breastfeeding. Numerous factors affect this ability of the mother. Therefore, this study aimed to investigate the effect of peer support on breastfeeding self-efficacy in primiparous women.

Materials and Methods:
In this clinical trial, 240 primiparous women were randomly divided into experimental and control groups. The control group program included routine training, and the experimental group received counseling and training by 30 peers during the first three months after delivery. To determine breastfeeding self-efficacy, Denis's long-term breastfeeding self-efficacy questionnaire was used at the end of week 12 after delivery. Data were analyzed using SPSS software program, version 16.0 and independent t test, Chi-square test, and Mann–Whitney U test.

Results:
The mean of breastfeeding self-efficacy score at the end of week 12 after delivery was 141.11 ± 93.4 in the experimental group versus 114.40 ± 60.16 in the control group. Then, the two groups had a statistically significant difference (P = 0.001). Also, exclusive breastfeeding in the experimental group was higher than in the control group (P = 0.001).

Conclusion:
Peer support for primiparous women can effectively improve breastfeeding self-efficacy and continuity of exclusive breastfeeding.
Nonalcoholic fatty liver disease in lean and obese patients in Saudi patients from a single center
Authors: Alsuhaibani Khalid A. , Althunayyan Faris S. , Alsudays Ali M. , Alharbi Ahmad A. , Aljarallah Badr M. 
Published: October 2021

Background:
Fatty liver is a disease caused by the accumulation of fat in the liver. It is one of the major risk factors for developing cirrhosis and hepatocellular carcinoma. Saudi Arabia is one of the most prevalent countries in diabetes and obesity; the overall prevalence of diabetes is 23.7% and obesity is 35.6%.

Aim:
To study the correlation between fatty liver finding on abdominal ultrasound (US) and their clinical and biochemical profile including BMI, blood glucose level, lipid profile, liver function tests, and blood pressure in both group lean and obese patients.

Methods:
Cross-sectional study of 346 fatty liver ultrasound-proven patients were enrolled in the study from January to May 2016 in King Saud Hospital- Qassim, Saudi Arabia.

Results:
Mean age of the participants was 50.3 years. Female participants were 55% of the cohort. Participants were divided based on their BMI: BMI <25 (lean), BMI of 25–30 (overweight and mild obesity), and BMI >30 (morbid obesity). We found that cholesterol (P = 0.007) and low-density lipoprotein (LDL) (P = 0.015) were higher in lean compared to others (5 and 3.1), respectively. Gamma-glutamyl transferase (GGT) was higher in mildly obese patients (113.2) and ALT, which was higher in lean patients (60.4). In addition, 34.5% of the overall patients had Diabetes Mellitus (DM). We found that HbA1c was lower in lean (7.3) compared to morbidly obese patients (7.6). Platelets counts were higher in morbidly obese patients (278) compared to other groups.

Conclusion:
High cholesterol and LDL strongly correlated with lean fatty liver patients. There was a significant relationship between the female gender and the risk of development of fatty liver. However, liver enzymes were within the normal range, except GGT, which was higher in all the groups, with the highest value in mildly obese patients. Therefore, they are not sensitive for diagnosing fatty liver patients.
The barriers for tobacco cessation counseling in teaching health care institutions
Authors: Koka Krishna M. , Yadlapalli Sravanthi , Pillarisetti Pranitha , Yasangi Manoj Kumar , Yaragani Anusha , Kummamuru Satyendra 
Published: October 2021

Introduction:
Recently, Dental Council of India directed all the teaching dental institutions in the country to set up tobacco cessation centers (TCC). International experiences suggest that there are many barriers for the provision of tobacco cessation counseling at dental clinics. In this context, it is important to understand the dental students' attitudes toward this initiative of tobacco cessation counseling at dental settings.

Materials and Methods:
This qualitative study to document the dental students' perspectives toward the provision of tobacco cessation counseling using focus group interviews was conducted in two teaching dental institutions in the state of Andhra Pradesh, India. 133 house surgeons from two dental institutions participated in the study and were interviewed as 13 focus groups. MAXQDA (version 12, VERBI GmbH, Berlin, Germany) was used for data analysis. All the interviews were audio recorded and the transcripts were open coded by three independent investigators.

Results:
The response rate in this study was 78.45%. The following themes were extracted from the views and opinions shared by the students: the reluctance of patients to discuss tobacco-related problems; tobacco use among students discouraging them to actively participate in counseling; an opinion that dental clinics are not suitable for the provision of tobacco cessation counseling; belief among students that they are not qualified enough.

Conclusion:
The directives given by the Ministry of Health and Family Welfare in association with Dental council of India to set up TCC at every teaching dental institution are laudable and demonstrate the commitment at policy level toward bringing down tobacco consumption in the country. However, few reforms need to be made in the curriculum to better execute the delegated responsibilities, which include orientation programs for dental students on the scope of the dental profession and workshops on tobacco cessation counseling.
Sociodemographic and clinical characteristics associated with COVID mortality among hospitalized patients in Rajasthan
Authors: Verma Anjana , Patyal Ashish , Mathur Medha , Choudhary Suresh , Mathur Navgeet 
Published: October 2021

Background:
It has been over a year since the declaration of novel coronavirus disease (COVID-19) as pandemic by World Health Organization on March 11, 2020. Although mortality in India is low, as compared to western countries, the steady increase in the number of cases is still a worrying sign. The objectives of this study were to identify and quantify the association between sociodemographic and clinical characteristics with mortality among patients, suffering from COVID-19 at a tertiary care hospital in Udaipur, Rajasthan.

Material and Methods:
This retrospective observational study involved 824 patients hospitalized for COVID 19 at a tertiary hospital in Udaipur, who were discharged or had died. Electronic health records of the patients were accessed to retrieve the sociodemographic information (age, gender, residence, religion, socioeconomic status), history of exposure, clinical characteristics on admission, comorbidities, and outcomes (recovery or death). The Cox regression model was used to calculate associations between mortality and baseline characteristics in the form of hazard ratios (HRs).

Results:
Mortality in this study was found to be 5.82%. The mean age of the patients was 48.14 ± 16.2 years. The median time from time of admission to discharge was 8 days (interquartile range (IQR) 5–11), whereas the median time to death was 5 days (IQR 4–10). The variables found to be associated with higher mortality were age (HR 1.17; 95% confidence interval (CI) 1.15–1.24), residing in urban area (HR 1.29; 95% CI 1.17–2.15), diabetes mellitus (HR 1.3; CI 1.02–5.57), and patients having both diabetes and hypertension (HR 2.4; CI 1.69–3.14).

Conclusion:
Sociodemographic variables and comorbidities impact the mortality among COVID 19 patients. The variables most clearly associated with a greater hazard of death were older age, urban area, diabetes, and having both diabetes and hypertension.
Epidemiological determinants of leptospirosis in rural and urban districts of Maharashtra, India
Authors: Kembhavi Ravindra S. , Velhal Gajanan D. , Shah Anuradha K. 
Published: October 2021

Background:
Leptospirosis is emerging as one of the growing public health problems in many parts of India. It can occur in both rural and urban areas with varied risk factors. This study was taken up in three districts of Maharashtra namely—Mumbai, Ratnagiri, and Sindhudurg to understand the determinants of leptospirosis in both the urban and rural areas and look for differences if any.

Materials and Methods:
This cross-sectional study was carried out during the year 2017. A pretested validated questionnaire was used to collect data. Field observations were made. Eighty-seven cases from Sindhudurg and 14 from Ratnagiri and 307 cases from Mumbai were included in the study.

Results:
A total of 408 cases were included in the study. A total of 63 (62.4%) were males and 38 (37.6%) were females. Most cases belonged to the 20–35 year age group (37%). In rural areas, 32.7% of them visited government facilities first, whereas, in the urban areas, it was 73.9% (P = 0.006). Headache, myalgia, and prostration were more common in cases from rural areas (P = <0.05). Skin rash was found to be associated with urban cases of leptospirosis. The presence of rodents, cattle sheds, pets, and working in paddy fields were common environmental risks in rural areas, and using water for recreational activities were common in urban areas (P < 0.001).

Conclusions:
Context-specific risk factors were found significantly associated with the cases. No important difference was found in the epidemiology of leptospirosis in the urban and rural areas except the source of infection.
Agreement between WHO-UMC causality scale and the Naranjo algorithm for causality assessment of adverse drug reactions
Authors: Shukla Ajay K. , Jhaj Ratinder , Misra Saurav , Ahmed Shah N. , Nanda Malaya , Chaudhary Deepa 
Published: October 2021

Background:
The Pharmacovigilance Program of India recommends the use of the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) scale, while many clinicians prefer the Naranjo algorithm for its simplicity. In the present study, we assessed agreement between the two widely used causality assessment scales, that is, the WHO-UMC criteria and the Naranjo algorithm.

Materials and Methods:
In this study, 842 individual case safety reports were randomly selected from 1000 spontaneously reported forms submitted to the ADR Monitoring Center at a tertiary healthcare Institute in Central India between 2016 and 2018. Two well-trained independent groups performed the causality assessment. One group performed a causality assessment of the 842 ADRs using the WHO-UMC criteria and the other group performed the same using the Naranjo algorithm. The agreement between two ADR causality scales was assessed using the weighted kappa (κ) test.

Results:
Cohen's kappa coefficient (κ) statistical test was applied between the two scales (WHO-UMC scale and Naranjo algorithm) to find out the agreement between these two scales. “No” agreement was found between the two scales {Kappa statistic with 95% confidence interval = 0.048 (P < 0.001)}.

Conclusion:
There was no agreement found between the WHO-UMC criteria and the Naranjo algorithm in our study.
Del “engaño de masas” de la teoría crítica al “vecindario indefinido” de Bauman
Authors: Núñez Ladevéze Luis , Vázquez Barrio Tamara , Álvarez de Mon Pan de Soraluce Ignacio 
Published: October 2021

Introducción. Frente a la atribución al progreso comunicativo de un imperativo políticamente democratizador, Bauman, en su póstuma Retrotopía, describe la red como flujo individualista de autorreproducción expansiva que forma un «vecindario indefinido global» de «servidumbre voluntaria». Método. Análisis fenomenológico del diagnóstico de Bauman mediante revisión de sus obras. Adoptada la perspectiva del «vecindario indefinido», examinar si las tendencias de la red pueden interpretarse como consumismo masivo igualitario o como imperativamente democratizadoras. Resultados. La proposición de que la red global de comunicación interindividual generaliza una «servidumbre voluntaria» merece ser planteada en proyectos de investigación empírica como hipótesis contrastable. Discusión. La red ecuménica de prosumidores que constituye el «vecindario indefinido» en la globalización líquida necesita ser visible en todos los ámbitos sociales y en el mercado. Conclusiones. La condición para establecer una relación entre teoría crítica y empiría es circular: requiere describir la “visibilidad” por medios cuantitativos como suma de elecciones individuales.
Prophetic Education at Pesantren As A Efforts To Prevent Religious Radicalism
Authors: Dimas Indianto s  , Sunhaji  , Intan Nur Azizah  , Ahmad Roja Badrus Zaman  
Published: October 2021

Whether it is recognized or not, religion is the most influencing factor in many social conflict phenomena. An unbalanced understanding of religion is suspected of being one of the triggers. Thus, efforts are needed to educate the public about good religious behaviour so that people understand that religion's existence is to create harmony in life, not contrary to incite hostility. Pesantren is one of the alternatives which is expected to be a way out to untangle the tangled threads of religious issues that have become a classic problem in Indonesia today. Pesantren have an essential role in realizing peace in heterogeneous life, namely through prophetic education. One of the pesantren that applies a predictive education pattern is Pesantren An Najah Purwokerto. This research is qualitative, to analyze prophetic teaching at Pesantren An Najah Purwokerto to prevent religious radicalism and describe the supporting and inhibiting factors of prophetic education at Pesantren An Najah Purwokerto. The results showed that the application of prophetic teaching at Pesantren An Najah Purwokerto through several activities, including (1) Introducing the concept of "liyan" or the other in the context of social or community life; (2) Grounding the rationales of the "hubbul wathan" nationalism; (3) Implementing "Peace Education". (4) Religious education based on local culture.
The Development of Two Stay-Two Stray Cooperative Learning Instrument on Respiratory System to Improve Scientific Literacy Skills
Authors: Sylvani Kumala Ulinnuha  , Muslimin Ibrahim  , Utiyah Azizah  
Published: October 2021

Science literacy is an ability to understand, communicate science through oral or written, apply and analyze the current scientific issues in society. This study aims to produce a valid, practical, and effective learning tool, and has been carried out using the 4D (Define, Design, Development, and Disseminate) method; however, the Disseminate one wasn’t carried out. The examination was limited in using one group pretest-post test design. The study was conducted within two meetings with 16 who were doing online learning. The data retrieval used a validated instrument. RPP tools with very decent results, LKPD tools (Student Worksheets) with very decent results, and test kits (Pre-test and post-test) with very decent results. As the result, the learning method shows to be very decent, effective, and practical, while the items of the method used are included in the sensitive category ≥0.30.