bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cataract surgical reach: Falling short to catch white cataracts!
Authors: Rewri Parveen , Lohan Aprajita , Aggarwal Sagarika , Chodhary Priyanka , Singhal Aparna 
Published: June 2021

Purpose:
The aim of this study was to know proportion of white cataracts from among patients coming for cataract surgery, and to find causes delaying uptake of cataract surgery.

Methods:
A hospital-based, prospective study enrolled patients of senile cataract between April 2018 and March 2019. The proportion of white cataract was calculated and underlying causes delaying uptake of cataract surgery studied.

Results:
White cataracts constituted 13.5% of total 3634 senile cataract patients, with gender disparity disfavoring women. Bilateral white cataract was presentation in 39 (8%) patients and lens-related glaucoma in 24 (5%) patients. Pseudophakia in the other eye was single most common cause of delay.

Conclusion:
A large proportion of white cataracts suggest that penetration of cataract surgical services in not reaching to the most eligible individual.
Changes in vergence and accommodation parameters after smartphone use in healthy adults
Authors: Padavettan Chitra , Nishanth Shruti , S Vidhyalakshmi , Madhivanan Nishanth , Madhivanan Nivean 
Published: June 2021

Purpose:
To assess pre and post vergence and accommodation parameters after monitored reading on a smartphone device.

Methods:
This prospective comparative study was performed in a tertiary eye care center for a duration of 6 months (December 2017 – May 2018). A total of 47 healthy emmetropic subjects of age group ranging from 18-30 years were recruited for the study. Participants underwent an initial visual screening protocol, followed by accommodation and vergence parameters assessment. The subjects were given reading text of optotype N6 at 40cm working distance for 30 minutes in a smart phone device. Pre and post measurements were documented.

Results:
Among 47 subjects there were 17 male and 30 females with mean age group of 21.2+2.06 years. There was a statistically significant worsening of accommodative components (negative & positive relative accommodation, lag of accommodation). In vergence parameters, a statistically significant deterioration of negative (12.8 + 1.65 to 12.38 + 1.93 PD) and positive fusional vergence (15.48 + 1.53 to 16.08 +1.61 PD) was observed. The mean vergence facility also showed a statistically significant change in pre and post task measurements (13.51 + 1.64 to 10.71 + 1.91 cpm (cycles per minute)).

Conclusion:
The current study investigated that perusing text with a smart phone for 30 minutes shows significant effect on accommodative and vergence components for near task, with greater impact on vergence parameters. Drawn out exposure to digital screens at near, may bring about visual quality dysfunction.
Rise of the phoenix: Mucormycosis in COVID-19 times
Authors: Ravani Swati A , Agrawal Garima A , Leuva Parth A , Modi Palak H , Amin Krisha D 
Published: June 2021

Purpose:
Rhino-orbital mucormycosis in times of ongoing COVID-19 pandemic.

Aims:
The aim of the study was to document cases of rhino-orbital mucormycosis seen at our Regional Institute of Ophthalmology during COVID-19 (coronavirus disease 2019) times.

Methods:
The study is a retrospective, institutional cohort, interventional study. It was carried out at our Regional Institute of Ophthalmology from September 2020 to mid-March 2021. All patients of biopsy-proven mucormycosis were enrolled in the study. The patients were subjected to complete history taking, ophthalmological examination, and imaging studies. The patients were treated via a multidisciplinary approach with intravenous liposomal amphotericin B and debridement of local necrotic tissue. Exenteration was done when indicated. A minimum 75-day follow-up period was accorded to all study patients. Statistical analysis was done using Chi-square test. A P value ≤0.05 was taken as significant.

Results:
Thirty-one patients were seen, with a mean age of 56.3 years. The major risk factors included uncontrolled diabetes (96.7%) and COVID-19 positivity (61.2%), with concomitant steroid use in 61.2% patients. The most common presentation was diminution of vision (<6/60 in 80.64% patients) and ophthalmoplegia (77.4%). The most common imaging findings were orbital cellulitis (61.29%) and pansinusitis (77.4%). Intravenous liposomal amphotericin B was given to all patients for an average 18.93 days. Exenteration was required in (n = 4) 12.9% of cases. Twenty-eight patients recovered and were alive on follow-up. Mortality was seen in three patients. The presence of cerebral involvement and a HbA1c value of ≥8 were found to be significant in the prediction of survival of patients with mucormycosis.

Conclusion:
We present the largest institutional cohort of rhino-orbital mucormycosis patients during the ongoing COVID-19 pandemic era from our unique perspective.
Knowledge, attitude and practices of PHC physicians in Aseer region regarding management of acute asthma
Authors: Assiri Hassan Ahmed , Alkhaldi Yahia Matter , Alsaleem Safar Abadi , Alqarni Hassan Mohammad 
Published: June 2021

Objectives:
This study aims to explore knowledge, attitude and practices of physicians working at primary health care (PHC) in Abha, KSA, regarding assessment and management of acute bronchial asthma.

Subjects and Methods:
This is a cross-sectional study that was conducted among PHC physicians in Abha, Khamis Mushayt and Ahad Rufeida cities, Aseer region KSA in 2018. A questionnaire that was constructed by the investigators was used to assess the knowledge, attitude and practices of PHC physicians regarding the diagnosis and management of patients with acute asthma. The questionnaire was distributed under the supervision of the first investigator. Data management was carried out using SPSS version 23.

Results:
A total of 200 PHC physicians participated in this study. About two-thirds of them (63.5%) had good grade of knowledge regarding acute asthma management, whereas 44% had positive attitude toward acute asthma management. The main knowledge gaps were doses of drugs used in the management of acute severe asthma attack (36%), and diagnosis of acute severe asthma attack (51.5%). Physicians' main source of knowledge on asthma included textbooks (26%) and guidelines (61.5%). Physicians' practice grades were significantly higher among those with less experience in PHC (p = 0.011). Almost all PHC centers (PHCC) (98%) had oxygen and nebulizers, 72.5% had steroids, 71.5% had salbutamol, 50.5% had ipratropium and 41% had peak flow meter, whereas 73.5% had the Saudi Initiative for Asthma (SINA) guidelines.

Conclusion:
This study revealed that knowledge of PHC physicians regarding the management of bronchial asthma was suboptimal, their attitude is not completely positive, and their adherence to asthma management guidelines is quite low. Some PHCCs were lacking important drugs and equipment for management acute asthma that should be provided. Well-structured training of PHCC doctors on SINA is mandatory to upgrade their knowledge, promote their attitude and improve their skills.
Asymptomatic Bacteriuria (ASB) in diabetic patients
Authors: Tauseef Abubakar , Zafar Maryam , Syyed Erum , Thirumalareddy Joseph , Sood Akshat , Mirza Mohsin 
Published: June 2021

Background:
The term asymptomatic bacteriuria (ASB) refers to the isolation of bacteria in a urine specimen of individuals who denied symptoms of urinary tract infection. Diabetes mellitus (DM) is a disease involving multiple organ systems, hallmarked for its chronicity and thus-forth endless complications including asymptomatic bacteriuria.

Objectives:
This study aimed to determine the characteristics of asymptomatic bacteriuria and antibiotic susceptibility pattern amongst patients with diabetes.

Settings and Design:
A prospective observational study was conducted at a tertiary care hospital in Karachi, Pakistan.

Methods and Material:
The study included all those patients with a diagnosis of diabetes with no signs and symptoms of urinary tract infection but showing the growth of an organism in urine culture. Pregnant females and subjects who used antibiotics in last two weeks were excluded. A total of 222 urine cultures were observed prospectively who met the inclusion criteria through non-probability consecutive sampling.

Results:
Out of 222 urine cultures observed, mean age of subjects were 62.89 ± 13.77 out of which 76% were females, and 61% had a family history of diabetes. The most frequent organisms isolated were Escherichia. Coli (E. Coli), Enterococcus, Klebsiella, Pseudomonas, and Enterobacter species. A total of 20 subjects got dual bacterial growth in their cultures among which 17 subjects had a growth of Enterococcus with any other pathogen causing UTI. Gender, family history of diabetes, levels of HBA1c, and older age groups all were found significantly associated with ASB.

Conclusions:
Our study is the first to analyze and study the associated risk factors amongst ASB in DM patients, and to identify the pathogens involved along with assessing their antibiotic resistance profiles. Also, due to the increase resistance to antibiotics we would recommend to use antibiotics in ASB patients only if they have any two or more comorbidities.
Evaluation of levels of oxidative stress as a potential biomarker in patients with rheumatoid arthritis
Authors: Mukhopadhyay Kaushik , De Soumita , Kundu Sunanda , Ghosh Parasar , Chatterjee Suparna , Chatterjee Mitali 
Published: June 2021

Objectives:
One of the most prevalent autoimmune disease globally, rheumatoid arthritis (RA) is caused by interplay of multiple inflammatory mediators in specific joints. Altered redox balance is one of the key factors in pathophysiology of RA. This study aims to find whether oxidative stress in peripheral blood neutrophil correlates with the disease activity and disability associated with it.

Methods:
Ten healthy controls and 29 RA patients with moderate to severe disease activity (DAS28 score >3.2) were recruited and reactive oxygen species (ROS) level in peripheral blood neutrophil was measured using flow cytometry at baseline visit and after 6 months follow-up. Functional status of RA patients was measured using Health Assessment Questionnaire Disability Index (HAQ-DI).

Results:
RA patients showed significantly higher level of ROS in compared to healthy control. DAS28 correlated well with ROS at baseline visit (Pearson's r = +0.63) as well as follow-up visit (Pearson's r = +0.75). HAQ-DI showed weak positive correlation at baseline visit (Pearson's r = 0.1) but it was negative at follow-up visit (Pearson's r = -0.19).

Conclusions:
Oxidative stress mirrors the disease activity in RA and can be considered as a biomarker, but it is not related with functional ability of the patients.
DESAIN MODEL PEMBELAJARAN PROJECT BASED LEARNING BERBASIS TEKNOLOGI PADA MATERI TEKS BIOGRAFI
Authors: Yanti Suhariyanti 
Published: June 2021

Masalah dalam penenlitian ini adalah kurangnya ke mampuan siswa untuk menulis teks biografi, kemudian siswa kurang minat mengikuti materi teks biografi dikarenakan harus banyak membaca sehingga nilai yang dicapai siswa tidak mencapai nilai yang maksimal. nilai yang harus mereka peroleh minimal rata-rata 76. Jika yang mereka peroleh tidak sesuai dengan nilai tersebut maka pembelajaran mereka kurang maksimal. Dalam hal ini masih banyak siswa yang kurang mampu dalam belajar menulis teks, sehingga nilai yang mereka peroleh masih banyak yang rendah, seperti nilai 55. Penelitian ini bertujuan untuk mengetahui hasil desain model pembelajaran project based learning berbasis teknologi pada materi teks biografi oleh siswa kelas VIII SMP Plus Jabal Rahma Mulia. Untuk menentukan sampel, peneliti menggunakan teknik random kelas dan terpilih kelas VIII-A yang berjumlah 36 siswa sebagai kelas eksperimen dan VIII-B yang berjumlah 36 siswa sebagai kelas kontrol. Metode dalam penelitian ini menggunakan metode eksperimen. Berdasarkan hasil penelitian menggunakan desain model pembelajaran project based learning berbasis teknologi pada materi teks biografi menunjukan kenaikan hasil belajar siswa meningkat dengan nilai rata-rata 85. Sedangkan hasil belajar tidak menggunakan desain model pembelajaran project based learning berbasis teknologi pada materi teks biografi memperoleh hasil rata-rata 65.
Modelo de gestión administrativa para proponer procesos de industrialización del cacao
Authors: Troya Francisco Cedeño , Pérez Iglesias Carlos Javier 
Published: June 2021

El artículo contempla el diseño de un modelo de gestión administrativa para establecer procesos de industrialización del cacao en Montalvo, provincia de Los Ríos, el cual conllevó a realizar un análisis de la situación interna y externa del proceso y comercialización del cacao en la empresa, del mismo modo, identificar los recursos administrativos, operativos y técnicos que la agroindustria utiliza en los procesos de producción y comercialización del cacao, y finalmente el análisis de la situación económica-financiera que presenta. La investigación, se justifica ante la necesidad de optimizar los procesos de industrialización del cacao, se propone desarrollar nuevos productos, como la pasta de chocolate, que tiene una alta demanda en el mercado internacional y va a generar ingresos significativos para la empresa, aportando de esta forma al crecimiento económico del sector; considerando aquello, existe la viabilidad comercial, debido a que el cacao ecuatoriano presenta una favorable aceptación por su sabor, aroma y presentación, por lo cual se considera una gran oportunidad para las empresas del sector, el implementar procesos de industrialización, como alternativa de crecimiento.
Impact of Green Initiatives on the Financial Performance of Small and Medium Enterprises: The Case of Manufacturing Firm in Central Luzon
Authors: Alfaro Mª Teresa B. , Diaz Rowell Agliones 
Published: June 2021

This study was conducted to propose the Green Economic Development Plan for Manufacturing S.M.E.s based on financial performance and operations thru Green Initiatives. The descriptive survey method used to gather data to determine the green initiative's implementation of small and medium (S.M.E.s) manufacturing enterprises. Green initiatives use as a basis for crafting a green economic development plan. Document analysis was also employed to obtain data from any available printed materials and records provided by the respondents. Such methods of gathering information used to validate data gathered from local and foreign-related literature. The observation also employed to survey the assets owned and validate any green initiatives practiced, including their implementation. The study's findings show that among the green initiatives implemented by SMMEs, which resulted in the reduction of total costs and expenses, were the proper disposal and segregation of waste materials, water management by recycling wastewater and using water-efficient equipment, natural resources, and raw materials management. SMMEs should encourage active participation and support of suppliers and customers in achieving G.E.D.'s objectives by developing incentive schemes. Furthermore, SMMEs should continue to benchmark with G.E.D. Practitioners are operating locally and abroad to adopt best greening strategies and regularly network with concerned government agencies for continuous updating on G.E.D. Initiatives that may benefit the firm. Further research may be conducted on green initiatives implemented by small and medium enterprises in other industry sectors.
HIỆU QUẢ CỦA ĐIỀU TRỊ LÂU DÀI BẰNG HORMON TÁI TỔ HỢP Ở TRẺ THIẾU HỤT HORMON TĂNG TRƯỞNG
Authors: Thị Hằng Nguyễn , Chí Dũng Vũ 
Published: June 2021

Thiếu hormon tăng trưởng là nguyên nhân thường gặp gây tầm vóc thấp, được điều trị bằng phác đồ thay thế hormon tăng trưởng tái tổ hợp tiêm dưới da. Bệnh nhân thường đạt được vận tốc chiều cao tối đa trong năm đầu điều trị, sau đó sẽ giảm dần trong những năm sau cho đến khi ngừng điều trị. Mục tiêu: nhận xét kết quả điều trị lâu dài ở các bệnh nhân sử dụng GH tái tổ hợp. Đối tượng và phương pháp: nghiên cứu một loạt ca bệnh bao gồm 3 bệnh nhân thiếu hụt hormon tăng trưởng được bắt đầu điều trị hormon tái tổ hợp thay thế ở tuổi 47 tháng và 75 tháng. Tất cả bệnh nhân tại thời điểm bắt đầu điều trị đều có tầm vóc thấp (< - 4SD theo tuổi và giới), nồng độ IGF1 thấp hơn so với chuẩn, tuổi xương thấp hơn so với tuổi thực. Phim chụp MRI sọ não không phát hiện khối bất thường. Đối với ca bệnh đầu tiên, trẻ được làm test kích thích hormon tăng trưởng với glucagon và kết quả nồng độ GH đỉnh thấp 0.024 ng/ml. Phác đồ hormon thay thế đã được điều trị trong vòng 3- 5 năm. Kết quả: tốc độ tăng chiều cao được cải thiện sau điều trị: 14 - 18 cm trong năm đầu tiên, giảm dần trong các năm tiếp theo. Trẻ bắt kịp tốc độ tăng trưởng bình thường theo WHO sau 3 năm điều trị. Kết luận: tầm vóc thấp là triệu chứng lâm sàng chính. Điều trị hormon thay thế sớm trên trẻ bị GHD giúp trẻ có được tốc độ tăng trưởng chiều cao bình thường.
KẾT QUẢ SỚM PHẪU THUẬT NỘI SOI CẮT GẦN TOÀN BỘ DẠ DÀY ĐIỀU TRỊ UNG THƯ DẠ DÀY GIAI ĐOẠN cT1,2N0M0 TẠI BỆNH VIỆN K
Authors: Văn Bình Phạm , Hải Nam Hà 
Published: June 2021

Mục tiêu: Đánh giá kết quả sớm ứng dụng phẫu thuật nội soi cắt dạ dày gần toàn bộ điều trị ung thư dạ dày giai đoạn cT1,2N0M0 tại bệnh viện K. Đối tượng và phương pháp nghiên cứu: mô tả tiến cứu, theo dõi dọc (đánh giá kết quả trước mổ và sau mổ) trên37 bệnh nhân ung thư dạ dày được phẫu thuật nội soi cắt dạ dày gần toàn bộ (cắt dạ dày cực xa)tại khoa Ngoại Bụng 1-Bệnh viện K Tân Triều từ tháng 12/2019 đếntháng 12/2020. Kết quả: Tổng số có 37 ca được ứng dụng phẫu thuật nội soi cắt dạ dày gần toàn bộ, nam/nữ = 2/1, tuổi trung bình 54,1. Thời gian mổ trung bình là 192 phút (ngắn nhất là 135 phút, dài nhất 255 phút). Lượng máu mất trung bình là 44ml.Số lượng hạch vét được trung bình là 23 hạch (ít nhất là 15 và nhiều nhất là 45 hạch).Miệng nối Delta chiếm 64,9%, kiểu Roux-en-Y chiếm 35,1%.Thời gian rút sonde dạ dày và sonde bàng quang trung bình lần lượt là 13 giờ và 40,3 giờ, thời gian trung tiện trung bình là 47,8 giờ, thời gian tập ăn đường miệng là 2,1 ngày. Thời gian rút dẫn lưu và nằm viện trung bình là 6,4 và 7,1 ngày. Chúng tôi không gặp tai biến trong mổ hay biến chứng sau mổ như chảy máu, rò bục mỏm tá tràng, rò miệng nối, nhiễm trùng. Kết luận: Phẫu thuật nội soi cắt gần toàn bộ dạ dày là phương pháp phẫu thuật an toàn, hiệu quả, áp dụng cho các trường hợp điều trị ung thư dạ dày giai đoạn cT1,2N0M0 tại bệnh viện K .
Naujos išteklių atskleidimo ir pristatymo sistemos: kintantis katalogo vaidmuo
Authors: Cathro Warwick 
Published: June 2021

Dabartiniu melu aktyviai diskutuojama apie bibliotekos katalogo vaidmenį ir jo santykį su kitomis išteklių atskleidimo priemonėmis. Tokios diskusijos pavyzdžiu gali būti neseniai paskelbtas Kongreso bibliotekos užsakytas pranešimas apie „besikeičiantį katalogo pobūdį“. Šioje diskusijoje taip pat buvo peržiūrėtas suvestinio katalogo vaidmuo. Kai kas mano, kad suvestiniai katalogai pakankamai išsamūs, ir jų teikiamų paslaugų pasiūla atitinka paklausą, todėl padidėjo tikimybė, kad vartotojai ras jiems aktualius, palyginti retai naudojamus išteklius.
2005 m. Australijos nacionalinėje bibliotekoje vyko diskusija apie katalogo ateitį, taip pat katalogo vaidmenį išteklių atskleidimo ir pristatymo procese. Ją iš dalies paskatino Australijos suvestinio katalogo reforma ir jo, pavadinto „Libraries Australia“, pateikimas žiniatinklyje, kaip nemokama viešoji paslauga. Australijos nacionalinė biblioteka išnagrinėjo pasiūlymo „pakeisti jos katalogą „Libraries Australia“ katalogu, kaip pirmine vartotojams skirta duomenų baze“, privalumus ir trūkumus. Šio tikslo įgyvendinimui Nacionalinė biblioteka numato nemažai konkrečių uždavinių, kurie netolimoje ateityje padėtų atsisakyti vietinio katalogo.
Regional centroid moment tensor inversion of small to moderate earthquakes in the Alps using the dense AlpArray seismic network: challenges and seismotectonic insights
Authors: Petersen Gesa Maria , Cesca Simone , Heimann Sebastian , Niemz Peter , Dahm Torsten , Kühn Daniela , Kummerow Jörn , Plenefisch Thomas ,   the AlpArray and AlpArray-Swath-D working groups
Published: June 2021

Abstract. The Alpine mountains in central Europe are characterized by a heterogeneous crust accumulating different tectonic units and blocks in close proximity to sedimentary foreland basins. Centroid moment tensor inversion provides insight into the faulting mechanisms of earthquakes and related tectonic processes but is significantly aggravated in such an environment.
Thanks to the dense AlpArray seismic network and our flexible bootstrap-based inversion tool Grond, we are able to test different setups with respect to the uncertainties of the obtained moment tensors and centroid locations. We evaluate the influence of frequency bands, azimuthal gaps, input data types, and distance ranges and study the occurrence and reliability of non-double-couple (DC) components. We infer that for most earthquakes (Mw≥3.3) a combination of time domain full waveforms and frequency domain amplitude spectra in a frequency band of 0.02–0.07 Hz is suitable. Relying on the results of our methodological tests, we perform deviatoric moment tensor (MT) inversions for events with Mw>3.0. Here, we present 75 solutions for earthquakes between January 2016 and December 2019 and analyze our results in the seismotectonic context of historical earthquakes, seismic activity of the last 3 decades, and GNSS deformation data. We study regions of comparably high seismic activity during the last decades, namely the Western Alps, the region around Lake Garda, and the eastern Southern Alps, as well as clusters further from the study region, i.e., in the northern Dinarides and the Apennines. Seismicity is particularly low in the Eastern Alps and in parts of the Central Alps. We apply a clustering algorithm to focal mechanisms, considering additional mechanisms from existing catalogs. Related to the N–S compressional regime, E–W-to-ENE–WSW-striking thrust faulting is mainly observed in the Friuli area in the eastern Southern Alps. Strike-slip faulting with a similarly oriented pressure axis is observed along the northern margin of the Central Alps and in the northern Dinarides. NW–SE-striking normal faulting is observed in the NW Alps, showing a similar strike direction to normal faulting earthquakes in the Apennines. Both our centroid depths and hypocentral depths in existing catalogs indicate that Alpine seismicity is predominantly very shallow; about 80 % of the studied events have depths shallower than 10 km.