bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transscleral Diode Laser Cyclophotocoagulation on Autopsy Eyes With Abnormally Thinned Sclera
Authors: Palmer David J , Cohen Jack , Torczynski Elise , Deutch Thomas A 
Published: April 2021

BACKGROUND AND OBJECTIVE: To determine, using autopsy eyes, whether diode laser energy adjustments are indicated in patients with thin sclera.
MATERIALS AND METHODS: In the laboratory, the superior 1 80° of sclera at the limbus was dissected to the level of barely visible anterior uvea and the opposite 1 80° of sclera served as the control in three human cadaver eyes. A contact G-probe was placed at the limbus, and settings of a diode laser were increased in increments from 1 .0 to 9.0 J at 4 burns per setting in each location.
RESULTS: On gross examination, circular hypopigmented lesions were seen in the ciliary body (CB) beginning at 3.0 J in thin sclera and at 5.0 J in normal sclera. On light microscopic examination of thin scleral sections, CB damage began at 2.9 J and CB/ciliary body epithelium (CBE) damage occurred beginning at 3.5 J. In normal sclera, minimal CB/CBE changes occurred at 6.0 to 7.5 J. No scleral damage was visible in either the experimental or the control groups.
CONCLUSION: Cycloablation energy adjustments are indicated on eyes with abnormally thin sclera to achieve similar histologic end points using the diode laser.
[Ophthalmic Surg Lasers 1997;28:495-500.]
Transpupillary Thermotherapy for Age-Related Macular Degeneration: Long-Pulse Photocoagulation, Apoptosis, and Heat Shock Proteins
Authors: Mainster Martin A , Reichel Elias 
Published: April 2021

* OBJECTIVE: To provide a biophysical foundation for using transpupillary thermotherapy (TTT) to manage choroidal neovascularization in age-related macular degeneration (ARMD).
* METHODS: Retinal temperature rise in laser therapy is proportional to retinal irradiance (laser power/area) for a particular spot size, exposure duration, and wavelength. TTT is a low irradiance, large spot size, prolonged exposure (long-pulse), infrared laser photocoagulation protocol. Results from an experimentally confirmed, finite element model of retinal light absorption and heat conduction are used to analyze laser parameter selection and its consequences. Results from apoptosis, heat shock protein and hyperthermia research are used to examine how chorioretinal damage from clinical procedures might be reduced.
* RESULTS: Chorioretinal thermal equilibration occurs during long-pulse TTT photocoagulation. Retinal temperature increases are similar in the RPE where laser radiation absorption is significant and in the adjacent neural retina where there is negligible radiation absorption. For parameters used to treat occult choroidal neovascularization in lightly-pigmented fundi (800-mW, 810-nm, 3-mm retinal spot diameter, 60-sec exposure duration), the maximum chorioretinal temperature elevation is calculated to be roughly 10°C, significantly lower than the 20°C temperature elevations measured in threshold, conventional short-pulse retinal photocoagulation.
* CONCLUSIONS: To achieve a preselected temperature rise, TTT laser power must be increased or decreased in proportion to the diameter rather than the area of the laser spot. Clinical power settings should be adjusted for fundus pigmentation and media clarity because both of these factors affect absorbed retinal irradiance and thus retinal temperature rise. Noninvasive thermal dosimetry currently is unavailable for clinical retinal photocoagulation, but potential thermometric techniques include MRI, liposomal-encapsulated dyes, multispectral imaging or reflectometry, and subretinal or episcleral thermometry. TTT may be useful not only as independent therapy, but also as an adjunct to PDT, antiangiogenic drugs and ionizing radiation therapy in the management of neovascular ARMD. Low temperature, longpulse photocoagulation is a potential strategy for decreasing neural retinal damage in subsequent TTT or short-pulse photocoagulation and perhaps even for treating glaucoma or retinal degenerations.
[Ophthalmic Surg Lasers 2000;31:359-373]
Protective Effect of Different Ophthalmic Viscosurgical Devices on Corneal Endothelium During Severe Phacoemulsification Model in Rabbits
Authors: Ben-Eliahu Shmuel , Tal Kfir , Milstein Asher , Levin-Harrus Tal , Ezov Nati , Kleinmann Guy 
Published: April 2021

Background and Objective:
To evaluate the protective effect of different ophthalmic viscosurgical devices (OVDs) on corneal endothelial cells against relatively severe phacoemulsification damage in a rabbit model.

Materials and Methods:
Twenty-four rabbit eyes were randomly assigned to four similar groups: in three groups the aqueous humor was completely replaced by Visiol (TRB CHEMEDICA, München, Germany), Biolon (Bio-Technology General Ltd., Kiryat Malachi, Israel), and Viscoat (Alcon, Puurs, Belgium) and in the control group no OVD was applied. Endothelial cell counts were performed prior to initiating the study. All eyes were exposed to continuous 5 minutes of phacoemulsification. Endothelial cell counts were repeated 4 days postoperatively.

Results:

Viscoat showed the highest endothelial cell loss (30%), followed by Biolon (25%), Visiol (22%), and the control group (19%). None of the differences between the groups were found to be statistically significant, although they were within each group (
P
= .028).

Conclusion:
None of the tested OVDs demonstrated protective effect on corneal endothelial cells in comparison to the control group. This model was found to be too aggressive for the demonstration of the protective effect of different OVDs even for hard cataract.
Rule Modifications to Reduce Checking-Related Injuries in High School Boys' Lacrosse
Authors: Guillaume Stanley , Lincoln Andrew E. , Hepburn Lisa , Caswell Shane V. , Kerr Zachary Y. 
Published: April 2021

Context
The National Federation of State High School Associations previously implemented 2 lacrosse rule modifications: Rule 5.4 in the 2012–2013 academic year to heighten the penalty for a head or neck hit to the head, face, or neck (HFN) and Rule 5.3.5 in the 2013–2014 academic year to minimize body checking.

Objective
To determine if the rates of overall injury, HFN injuries, and concussions due to intentional contact (checking) differed for boys' high school lacrosse players after Rule 5.4 and 5.3.5 modifications were enacted.

Design
Descriptive epidemiology study.

Setting
Web-based online surveillance system.

Patients or Other Participants
Boys' high school lacrosse players during the 2008–2009 to 2016–2017 seasons whose teams involved athletic trainers participating in the High School Reporting Information Online sports injury-surveillance system.

Intervention(s)
Rule 5.4 in the 2012–2013 academic year increased the penalty for any intentional hits to the HFN, and Rule 5.3.5 in the 2013–2014 year eliminated body checking to a player in a defenseless position.

Main Outcome Measure(s)
Overall, HFN, and concussion injury rate ratios (IRRs) by checking mechanism; overall and checking-related injury ratios by competitions and practices.

Results
A decrease was shown in checking-related HFN injuries (IRR = 0.29, 95% CI = 0.13, 0.65) and checking-related concussions (IRR = 0.29, 95% CI = 0.12, 0.70) during practices in the seasons after both rule modifications were imposed, but no decreases occurred in any checking-related injuries during competitions. By injury mechanism, no decreases were evident after the Rule 5.4 modification. When both rule modifications (Rules 5.4 and 5.3.5) were enacted together, concussion rates due to delivering body checks (IRR = 0.51, 95% CI = 0.29, 0.91) and overall injury risk due to being body checked (IRR = 0.72, 95% CI = 0.53, 0.97) decreased.

Conclusions
When both Rule 5.4 and 5.3.5 modifications were in effect, concussion and overall injury risks decreased for the body checker and the player being body checked, respectively.
Patients' perspective of one-stop breast clinic, Lagos University Teaching Hospital
Authors: Adegboyega Bolanle C. , Irurhe Kayode N. , Yakubu Caleb , Bashir Adebola M. , Ogunyemi Adedoyin O. , Alabi Adewumi O. , LUTH One Stop Breast Clinic Team Members  
Published: April 2021

Introduction:
The complex nature of cancer diagnosis and treatment, with the pressing need for individualized patient care, has led to the services being organized into multidisciplinary teams (MDTs), also called tumor boards or cancer conferences. MDTs are beneficial as they provide coordinated, consistent, expert-driven, and cost-effective care that is delivered in a timely fashion to the patient. This study is aimed to assess the level of impact of a one-stop breast clinic on the management of breast cancer among breast cancer patients in Lagos University Teaching Hospital (LUTH).

Methodology:
A cross-sectional descriptive study was carried out among patients who attended the MDT breast clinic on referral from within and outside Lagos University Teaching Hospital LUTH.

Results:
The mean age ± standard deviation of the respondents was of 33.4 ± 7.62 years. More than half of the respondents (66%) felt satisfied about the workings of the MDT clinic, with less than a quarter of respondents reporting that were very satisfied with the clinic. Almost all the respondents (90%) were of the view that it allowed for a more expert opinion. Problems faced by the clinic in the MDT Clinic included filled up booking times (6%) and not taking enough time to attend to patients (2% each).

Conclusion:
The study revealed a good level of satisfaction among respondents about the MDT clinic; however, reservation on issues such as booking time, better patient to doctor relationship, and availability of more doctors were still of concern to patients. Addressing these issues are vital in achieving an all-round great experience in the multidisciplinary setting.
Effect of topical xylocaine for pain relief during hysterosalpingography among infertile women in Zaria, Nigeria
Authors: Yahya Anisah , Bello Nafisa , Umaru-Sule Hajara , Umar Aminatu Makari , Muhammad Halima Mono , Ibinaiye Philip Oluleke 
Published: April 2021

Background/Aim:
Hysterosalpingography (HSG) is a radiological procedure that is used to assess the patency of the female genital tract. It is a routine procedure for evaluating female factor infertility in our environment where the incidence of tubal factor infertility is high. It is associated with varying degrees of discomfort and pain. The study aimed at comparing the efficacy of topical analgesia to a placebo for providing pain relief in women undergoing HSG as workup for infertility.

Subjects and Methods:
The study was a double-blind, parallel group randomized controlled trial of 117 infertile women who had HSG at the Ahmadu Bello University Teaching Hospital, Zaria, from February to December 2019. The intervention group (n = 59) and the control (n = 58) had 15 ml of 2% xylocaine gel and 15 ml of K-Y jelly (placebo) applied directly on their uterine cervical lip, respectively. The primary outcome measure was the mean Visual Analog Scale (VAS) for pain perception on each group during HSG at the point of cervical manipulation and uterine filling with contrast.

Results:
The mean VAS scores for pain perception in the xylocaine group during cervical manipulation and uterine filling were 2.3 (0.24) and 3.5 (0.35), respectively, while the scores for the placebo group during cervical manipulation and uterine filling were 7.1 (1.8) and 5.5 (0.32), respectively. The observed difference was statistically significant (P ≤ 0.001).

Conclusion:
During HSG of infertile women in Zaria, Nigeria, the use of topical xylocaine on the uterine cervix was associated with decreased pain perception during cervical manipulation and uterine filling with contrast when compared to placebo.
“Trial registry: http://Www.clinicaltrials.gov, Identifier NCT03802032.”
Pattern of sub-clinical dysthyroidism in a postthyroidectomy cohort: Implications for supplementary treatment
Authors: Kintu-Luwaga Ronald , Makumbi Timothy , Kilyewala Cathy , Fualal Jane O. 
Published: April 2021

Background: Defective thyroid functioning is referred to as dysthyroidism. Despite incomplete thyroidectomy or thyroxine supplementation, post-thyroidectomy patients may still experience dysthyroidism. Many times, this may be sub - clinical. This study aimed to assess the prevalence and pattern of sub-clinical dysthyroidism following thyroid surgery. Methods: In this prospective cohort study, 40 patients were consecutively recruited following conventional thyroidectomy and followed up to 12months. All patients were euthyroid at surgery. At 12 months serum TSH, T4 and T3 levels were measured and the patients clinically assessed. The prevalence and pattern of dysthyroidism was analysed statistically against the patient demographics, clinical and peri-operative variables for significance, using stata version 13. The confidence interval was at 95% and the statistical significance at a p-value of <0.05. Results: The mean age was 44.3 years (M:F= 1: 12.3). 20% of the patients had medical comorbidities. The types of surgery performed were sub-total thyroidectomy (55%), near total thyroidectomy (25%) and total thyroidectomy (20%). The prevalence of postoperative dysthyroidism was 52.5%. 22.7% of patients who underwent sub-total thyroidectomy had dysthyroidism. Most patients (90%) who were on thyroxine supplement (following total or near total thyroidectomy) still developed dysthyroidism (P= 0.017). The type of resection done had the greatest significance (P= 0.000). Other factors associated with dysthyroidism albeit non-significantly were history of pre-operative hyperthyroidism, middle age (40 - 60 years), and female gender. Conclusions: The prevalence of dysthyroidism in this cohort was high which may reflect the broader picture among post - thyroidectomy patients in this setting. Regular biochemical testing in post-thyroidectomy patients is important to identify and correct dysthyroidism early. This requires frequent follow-up and accurate dose adjustment, based on objective assessments like weight or body mass index. Keywords: post-thyroidectomy; dysthyroidism; hypothyroidism; hyperthyroidism; sub-clinical dysthyroidism; prospective; cohort
HOUSING FINANCE: IMPACT OF HEAVY INTEREST INCOME TAX
Authors: Semenenko Igor , Yoo Jun Wook 
Published: April 2021

Heavy taxation of interest income becomes a structural driver of property prices in a low-interest-rate environment. Inflation-adjusted price appreciation in 1996-2017 is approximately 200 basis points higher in 14 countries allowing no exemptions on interest income than in 37 countries that tax interest income at favorable rates or provide exemptions. Results for average returns over long-term periods are confirmed in models with annual frequencies, city-level data, and in a sample of 39 OECD countries for which price/rent ratios are available. It appears that investors view direct real estate, a heavily tax-favored asset, as an inflation hedge and/or alternative to fixed income asset. Higher interest income taxation may be fueling demand for direct real estate investments by retail investors. Separately, my empirical findings suggest that easy monetary policy effects can be magnified through the housing channel in countries that do not allow exemptions on interest income. Consequently, we should expect larger investment misallocations due to asset prices departure from fundamentals in some geographies.
JEL Classification Codes: E3, E4, F3, G1, G5, H2.
Orthodontic management of skeletal class II malocclusion with horizontally impacted maxillary canine: A case report
Authors: Gupta Sanjay Prasad , Rauniyar Dr. Shristi 
Published: April 2021

Management of skeletal class II relation in growing patient require careful evaluation of growth status, proper diagnosis and treatment plan to address the patient’s need. Twin block is the appliance of choice among functional appliance to correct the skeletal class II malocclusion due to it’s acceptability by the patient and simplified design. Maxillary canine impaction is the second most prevalent impaction after the third molars. Treatment of maxillary canine impaction is usually a challenge to orthodontic approach as the defect lies in the esthetic region of the jaw.
This case report describes the orthodontic management of a 9 years male patient having skeletal Class II malocclusion with horizontally impacted maxillary canine. Some modifications in the treatment mechanics are deemed essential to address the patient’s need for achieving the optimal esthetic and to improve the occlusion.
Twin block is beneficial for the treatment of skeletal malocclusion in a growing patient to achieve the maximum benefit. The orientation of impacted teeth may change from horizontal to favorable one, hence it should be considered a viable treatment alternative. In such case, early diagnosis and interception at the right time along with radiographic follow-ups are necessary to achieve successful results.
Keywords: Canine Impaction, Class II malocclusion, Growth modification, Twin block appliance
Nursing Students’ Computer Self-Efficacy and Attitudes toward Its Use in The Health Care Setting: A Comparative Study
Authors: Hassona Farida M. , Ali Aziza Z. F. , Nageeb Shaimaa M. 
Published: April 2021

Context: The use of technology and computers in health care has been reported to improve nurses' decision-making and competencies, which in turn increase the quality of health-care practice.
Aim: of this study is to assess and compare nursing students’ computer self-efficacy and attitudes toward its use in a health care setting in the Faculty of nursing – Benha and Hail Universities.
Methods: A descriptive comparative cross-sectional study design was used to achieve the current study aim. The study conducted in the Faculty of Nursing - Banha University, Egypt, and Faculty of Nursing – Hail University, Kingdom of Saudi Arabia. Quota sampling of 219 students was chosen as follows; 190 students from the Faculty of Nursing - Banha University and 29 students from the Faculty of Nursing – Hail University. A structured self-administered questionnaire covering sociodemographic data, the pretest for attitudes toward computers in healthcare, and computer self-efficacy scales were the tool used to collect the study data.
Results: 33% of nursing students from Benha University were have a realistic view of current computer capabilities in health care. In contrast, 28% of nursing students from Hail had a very positive view of computer use in health care. Nursing students at Hail University have the highest mean score compared to Benha nursing students (79.45±15.85 & 61.2±7.25, respectively) in their attitudes toward computer and computer self-efficacy. Benha nursing students have moderate computer self-efficacy compared with Hail nursing students who have a high computer self-efficacy level. A highly statistically significant relationship was detected between students' attitudes toward computers and computer self-efficacy (p-value=0.000). Also, there was a highly positive, statistically significant correlation between the demographic variables of nursing students and both students’ attitudes toward computers in health care and computer self-efficacy (p-value =0.00).
Conclusion: Nursing students in both universities have a positive attitude toward computer use. A significant difference between the mean scores of the two groups in their attitude toward computer and self-efficacy was detected, with a highly statistically significant correlation between both students’ attitudes and their self-efficacy. Also, a significant relationship revealed between the studied students’ demographics and their attitude and self-efficacy. Future studies are recommended to evaluate existing technologies in terms of acceptance, effectiveness, and efficiency in real-life settings and to examine its effect on patient outcomes. Nurse educators should design training courses and educational programs to enhance computer self-efficacy beliefs among nursing students.
Effect of Care Bundle Education Program on Nurses’ Performance Regarding Central Line-Associated Blood Stream Infection in High Risk Neonates
Authors: Abou Zed Safaa A. F. , Mohammed Amira A. 
Published: April 2021

Context: Catheter-related bloodstream infections are the most common type of nosocomial infections among those populations. Central line-associated bloodstream infection (CLABSI) is a preventable complication of the use of CVC.
Aim: This study aimed to evaluate the effect of the care bundle education program on nurses' performance regarding central line-associated bloodstream infections in high-risk neonates. Through the following: assessing nurses' knowledge and performance regarding central line-associated bloodstream infection in high-risk neonates, designing, implementing and evaluating the effect of the care bundle education program on nurses' performance regarding central line-associated bloodstream infection in high-risk neonates.
Methods: A quasi-experimental (pre/post-test) design was utilized to conduct this study at neonatal intensive care units affiliated to Ain Shams University Hospitals and Teaching Hospitals in Cairo. A convenient sample of forty-five 45 nurses was included in the study as a single study group. A structured interview questionnaire, nurses’ observation checklists were used to evaluate the effect of care bundle education on nurses’ performance regarding central line-associated bloodstream infection in high-risk neonates. The care bundle education program was premeditated as reference guidelines for nurses.
Results: There were statistically significant differences between mean scores of the pre and post-test as regards nurses’ knowledge and practices regarding central line-associated bloodstream infection in high-risk neonates.
Conclusion: The study revealed an unsatisfactory knowledge as well as an incompetent practice among nurses regarding central line-associated bloodstream infections in high-risk neonates before the care bundle education program. The research hypotheses are supported, and the care bundle education program achieved a significant improvement in nurses’ knowledge and performance regarding CLABSI in high-risk neonates. The current study recommended establishing educational centers in all hospitals for educating and updating the knowledge and performance of new nursing staff working in NICUs and supporting them by instructional brochure and illustrative booklets.
Alimento Funcional: Uma Nova Abordagem Terapêutica das Dislipidemias como Prevenção da Doença Aterosclerótica
Authors: Braga Adriana D‘Auria Aparecida , Barleta Valéria Calmeto Noronha 
Published: April 2021

A nutrição é uma das ciências mais antigas que visa estudar o alimento e as modificações que este sofre ao passar pelo organismo. No Japão na década de 80, estudos comprovaram que certos alimentos além de suas funções básicas nutricionais demonstraram benefícios fisiológicos e reduziram o risco de doenças; foram denominados alimentos funcionais, que podem potencialmente reduzir a ocorrência de doenças cardiovasculares, cânceres, osteoporose, problemas intestinais. A associação Americana do Coração já indica o uso de alimentos funcionais como parte da dieta para dislipidemias, o principal fator desencadeador da aterosclerose. As doenças cardiovasculares lideram o índice de mortalidade no Brasil, e são responsáveis por 50% das mortes nos EUA. Os principais compostos ativos responsáveis pelas ações preventivas das doenças cardiovasculares pertencem ao grupo dos polifenóis (flavonóides e isoflavonas), carotenóides e ômega–3; encontrados em alimentos usuais como: alho, tomate, berinjela, chocolate amargo, uva - vinho tinto, peixe, oleaginosas, chá verde, soja, especiarias, leguminosas, cogumelos e maçã. Hoje os alimentos com atividade funcional fazem parte da nutrição aplicada no dia-a-dia de muitos nutricionistas, nas mais diversas atividades,exigindo do profissional um aprofundamento na ciência dos compostos funcionais.