bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ionized calcium level predicts in-hospital mortality of severe sepsis patients
Authors: Cekmen Bora , Koylu Ramazan , Akilli Nazire Belgin , Gunaydin Yahya Kemal , Koylu Oznur , Atis Seref Emre , Cander Basar 
Published: November 2021

Objective:
To evaluate the effect of serum ionized calcium levels on the prognosis of severe sepsis patients.

Methods:
This retrospective cross-sectional study included sepsis patients who were hospitalized in an intensive care unit between January 2011 and December 2014. The demographic and baseline data of the patients who died and survived were compared. The cutoff value of ionized calcium for in-hospital mortality was determined by the receiver operating characteristics curve (ROC). In-hospital mortalities and the survival rates were compared between patients with different ionized calcium levels. Besides, the risk factor of in-hospital mortality was determined.

Results:
This study included 145 patients with 113 patients who died in the hospital. The patients who died had significantly lower ionized calcium levels (U=2.25, P=0.034). A cut-off value of 0.93 mmol/L of ionized calcium was determined by the ROC curve. The patients with ionized calcium>0.93 mmol/L showed a significantly lower morality (χ2=9.90, P=0.002) and higher survival rate than with ≤0.93 mmol/L (log rank=6.20, P=0.010). Multivariate Cox regression revealed that ionized calcium ≤0.93 mmol/L was a risk factor of in-hospital mortality.

Conclusions:
Ionized calcium level≤0.93 mmol/L was an independent predictor of in-hospital mortality of severe sepsis.
Folic acid protects against fluoride-induced oxidative stress and testicular damage in rats
Authors: Dibyendu Ray , Tiasa Chatterjee , Das Monalisha , Pradip Panda , Sandip Mukherjee 
Published: November 2021

Objective:
To investigate the effects of folic acid on testicular oxidative damage in sodium fluoride-induced male Wistar rats.

Methods:
A total of 24 male Wistar rats were divided into 4 groups: the control, sodium fluoride (fed with 100 mg/L sodium fluoride through drinking water orally for 21 days), folic acid (36 μg/kg body weight/day, orally), and sodium fluoride plus folic acid (received similar dose orally) groups. At the end of 21 days, epididymal sperm parameters, biochemical analysis of testicular tissue, and serum hormonal levels were performed along with histopathological studies.

Results:
Sodium fluoride intoxication resulted in marked reduction in gonado somatic index, serum luteinizing hormone, and testosterone level along with 3 β -hydroxysteroid dehydrogenase and 17 β -hydroxysteroid dehydrogenase activities. In addition, reduction in sperm density, as well as loss of sperm motility and sperm viability, were also observed. Besides, increased levels of testicular malondialdehyde, nitrite, interleukin-6 and tumor necrosis factor- α as well as decreased levels of superoxide dismutase and catalase activities and reduced glutathione content were found to be associated with this toxicity. Folic acid co-treatment, on the other hand, could prevent all the sodium fluoride-induced testicular pathophysiology and oxidative stress related parameters. Histological examinations of testicular sections from the experimental rats supported these results.

Conclusions:
Combining all, this study suggests that being an antioxidant, folic acid plays a beneficial role against fluoride-induced adverse effects on the male reproductive system.
Somatic Versus Cognitive Depressive Symptoms as Predictors of Coronary Artery Disease Among Women with Suspected Ischemia
Authors: Emami Ashley S. , Bairey Merz C. Noel , Eastwood Jo-Ann , Pepine Carl J. , Handberg Eileen M. , Bittner Vera , Mehta Puja K. , Krantz David S. , Vaccarino Viola , Eteiba Wafia , Cornell Carol E. , Rutledge Thomas 
Published: November 2021

Background:
Depression is an established predictor of coronary artery disease (CAD) progression and mortality. “Somatic” symptoms of depression such as fatigue and sleep impairment overlap with symptoms of CAD and independently predict CAD events. Differentiating between “somatic” and “cognitive” depressive symptoms in at-risk patients may improve our understanding of the relationship between depression and CAD.

Methods:
The study utilized data from the Women's Ischemia Syndrome Evaluation. Participants (N = 641; mean age = 58.0 [11.4] years) were enrolled to evaluate chest pain or suspected myocardial ischemia. They completed a battery of symptom and psychological questionnaires (including the Beck Depression Inventory [BDI]) at baseline, along with quantitative coronary angiography and other CAD diagnostic procedures. The BDI provided scores for total depression and for cognitive and somatic depressive symptom subscales.

Results:
Two hundred and fourteen (33.4%) women met criteria for obstructive CAD. Logistic regression models were used to examine relationships between depression symptoms and obstructive CAD. Neither BDI total scores (odds ratio [OR] =1.02, 95% confidence interval [CI], 0.99–1.05, P = 0.053) nor BDI cognitive scores (OR = 1.02, 95% CI, 1.00–1.04, P = 0.15) predicted CAD status. BDI somatic symptom scores, however, significantly predicted CAD status and remained statistically significant after controlling for age, race, and education (OR = 1.06, 95% CI, 1.01–1.12, P = 0.02).

Conclusion:
Among women with suspected myocardial ischemia, somatic but not cognitive depressive symptoms predicted an increased risk of obstructive CAD determined by coronary angiography. Consistent with prior reports, these results suggest a focus on somatic rather than cognitive depressive symptoms could offer additional diagnostic information.
A Comparative Epidemiology Model for Understanding Mental Morbidity and Planning Health System Response to the COVID-19 Pandemic
Authors: Cawthorpe David 
Published: November 2021

Introduction:
This particular coronavirus disease is a pandemic giving rise to great global affliction and uncertainty, even among those who have dedicated their lives to health care or the study of disease, or both. Notwithstanding those directly affected, the lives of all people have been turned upside down. Each person has to cope with her or his personal situation and a story is taking shape for everyone on earth. Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 virus, the source of the 2020 pandemic. This paper contains brief highlights from a duplicable PubMed search of the COVID-19 literature published from January 1 to March 31, 2020, as well as a duplicable search of past influenza-related publications. Excerpts from select papers are highlighted. The main focus of this paper is a descriptive analysis of influenza and other respiratory viruses based on a 16-year population-based dataset. In addition, the paper includes analyses based on the presence or absence of mental disorder (MD) in relation to influenza and all other respiratory viruses.

Methods:
The investigation is descriptive and exploratory in nature. Employing a case-comparison design, a 16-year population-based dataset was analyzed to both understand the present and plan for the future. While not all viral infections are equal, this paper focuses on system responses by describing the epidemiology of respiratory viruses, such as influenza. Influenza is established in the global population and has caused epidemics in the past. Where possible direct comparisons are made between COVID-19, influenza, and other respiratory viruses.

Results:
Those with MD had a higher rate of viral infection per 100,000 capita compared to those with the viral infection and no MD. Further, the postviral infection MD rate was not higher compared to the MD per capita rate before viral infection. The postinfluenza rate of MD among those who were without mental disorder before influenza represents an estimate of postinfection mental health burden.

Conclusions:
In summary, those with preinfluenza MD are at greater risk for viral infection. Further, while the postviral infection MD rate was not higher compared to the MD per capita rate before viral infection, this independent estimate may inform the degree to which services may need to undergo a sustained increase to address the bio psychosocial needs of each served population were COVID-19 to persist and become established in the global population.
Immediate impact of COVID-19 on eye banking in India
Authors: Nathawat Rakhi , Sharma Namrata , Sachdev Mahipal S , Sinha Rajesh , Mukherjee Gobinda 
Published: November 2021

Purpose:
In India, COVID-19 infected more than 10 million and caused more than 148,000 fatalities during 2020. Due to “lockdown” eye banks were shuttered in March, 2020 and reopened for operations in the month of May, 2020. This study assesses the immediate impact of the pandemic on eye banking and cornea transplantation in India.

Methods:
Data was gathered through an online survey of the eye banks and cornea surgeons in India. The questionnaire collected information on the vital statistics of eye bank operations and cornea transplants for the period from March to June for the years 2019 and 2020.

Results:
47 eye banks responded to the survey. Collectively in the March–May 2020 period, corneas collected and transplanted declined by 78.27% and 79.14%, respectively, compared to the same period of 2019. In June 2020, the first full month after operations restarted, the collection and transplants were respectively, 82.10% and 81.82%, lower than June, 2019. Long-term glycerine preservation of corneas in the period from March to June 2020 increased by 124.5% compared to same period in 2019, but overall only 5.26% of the corneas recovered were preserved in this way. 44.44% of the eye banks collected corneas only from donors with negative COVID-19 diagnosis. 36.11% of the respondents rejected all suspicious cases, such as donors with respiratory pathologies, and 2.78% of the respondents accepted donations from medico legal cases only. 19.44% of the responding eye banks did SARS-CoV-2 nasal swab test for the deceased donor. 79.5% of the eye banks reported that staff were willing to work during the pandemic, and 82.05% eye banks gave special training to staff before restarting services.

Conclusion:
Due to the steep decline in collections and transplants, 2020 can be termed as a lost year in Indian eye banking. Attention to Hospital Cornea Recovery Programs, continuous situation monitoring, and ongoing staff training programs are recommended.
COVID-19-associated mucormycosis: Preliminary report from a tertiary eye care centre
Authors: Walia Shweta , Bhaisare Vijay , Rawat Preeti , Kori Neetu , Sharma Manushree , Gupta Niti , Urdhwareshwar Shishir , Thakur Sanchiyka , Arya Niharika 
Published: November 2021

Purpose:
Mucormycosis is a life-threatening infection that has made sudden comeback in COVID-19 era. We conducted this study to determine demography, site of involvement, management, and outcome in these patients.

Methods:
All cases presenting with signs and symptoms of mucormycosis were thoroughly evaluated and confirmed diagnosis was made on demonstration of fungi in the tissue (or body fluids) either by direct microscopy and/or culture. Patients underwent computerized tomography scan for paranasal sinuses and magnetic resonance imaging scan with contrast orbit and brain to know extent of disease.

Results:
540 proven cases of mucormycosis were included. Most common age group affected was 41–50 years with male preponderance (69%). Sinonasal was the most common site of involvement in mucormycosis (100%), followed by orbital (51.85%), cerebral (9.44%), cutaneous (1.85%), and pulmonary (0.18%). Most common presentation was periocular and facial swelling (28%). 97.96% patients had associated diabetes and 89.44% patients had history of COVID-19 with concurrent steroids use (84.85%), higher antibiotics (82.59%), oxygen therapy (52.40%), remdesivir (28.89%), and biological agents (2.56%). Duration from COVID-19 positivity to presentation of mucormycosis was 22.56 days, while 4.44% patients had coexisting COVID-19 with mucormycosis. The mortality rate was 9.25% (50/540).

Conclusion:
Timely diagnosis and appropriate management can ameliorate the consequences of mucormycosis. With the third wave of COVID-19 coming, epidemiological study to identify risk factors and possible management options can help physicians to develop the treatment strategy.
Effect of short-term meditation training in central serous chorioretinopathy
Authors: Nongrem Grisilda , Surve Abhidnya , Venkatesh Pradeep , Sagar Rajesh , Yadav Raj K , Chawla Rohan , Vohra Rajpal , Kumar Atul 
Published: November 2021

Purpose:
Stress and Type A personality are established risk factors for the development of central serous chorioretinopathy (CSC). Meditation is known to have a positive effect on reducing stress levels. This study aimed to assess the effect of short-term meditation training in patients of CSC.

Methods:
A pilot study was conducted where 40 patients diagnosed with acute and non-resolving CSC were randomly assigned to either of two groups – meditation training and routine care (without meditation). The primary outcome measure was time to resolution of CSC based on optical coherence tomography and fluorescein angiography. Secondary outcome measures were changes in anxiety score (State–Trait Anxiety Inventory [STAI] scores) and blood pressure. The patients were followed up for a minimum period of 4 months.

Results:
Twenty cases were included in each group. The demographic pattern, baseline swept-source optical coherence tomography parameters, and STAI scores were similar in both groups. The time to disease resolution was 9.4 ± 4.22 weeks in the meditation group and 19.5 ± 2.79 weeks in the nonmeditation group (P < 0.001). At 4 months, CSC had failed to resolve in 60% of patients with routine care compared with 8% in cases following short-term meditation training. STAI scores showed a reduction in stress levels in the meditation group. Furthermore, statistically significant improvement in systolic and diastolic blood pressures was also observed following meditation training.

Conclusion:
Short-term meditation training may be a useful approach in the management of patients with CSC as it tends to reduce stress and prehypertension, and promotes earlier resolution of the condition. However, patient’s motivation to complete and pursue the meditation training is a significant barrier.
Outdoor activity and myopia progression in children: A follow-up study using mixed-effects model
Authors: Gupta Saroj , Joshi Ankur , Saxena Harsha , Chatterjee Anirban 
Published: November 2021

Purpose:
The purpose of this study was to determine the influence of outdoor activity on myopia progression.

Methods:
It was a hospital-based longitudinal prospective observational study. Children between 7 and 14 years of age with a myopia of − 0.5 D or worse were included. Myopia progression was evaluated by cycloplegic refraction, every 6 months for 18 months. Parents were asked to record the daily outdoor activity of the child in hours per day at school and at home during weekdays and at weekends separately, based on which the daily outdoor activity score was calculated. The independent variables measured included age and gender of the participant, degree of myopia, and the daily outdoor activity score. Progression of myopia was defined as an increase in the spherical equivalent (SE) over 18 months. The magnitude of the association was determined by two mixed-effects models.

Results:
A total of 495 participants (250 males and 245 females) completed three visits during the study period. On taking age groups and paired observations as a random effect and adding SE at the last visit as the random slope in Model 1, each unit increase in outdoor activity had a negative effect on change in SE of − 0.01 (−0.02 to 0.00; P = 0.045). The same inverse relationship between outdoor activity and absolute SE as − 0.06 (−0.07 to − 0.03; P < 0.001) is estimated in Model 2.

Conclusion:
The study demonstrates a statistically significant inverse relationship between outdoor activity and myopia.
Pathologic evidence of retinoblastoma seeds supported by field emission scanning electron microscopy and Raman spectroscopy
Authors: Das Dipankar , Bhattacharjee Kasturi , Barman Manab J , Bhattacharjee Harsha , Maity Surjendu , Bandyopadhyay Dipankar , Thakur Siddharth , Deshmukh Saurabh , Garg Mohit , Deka Apurba 
Published: November 2021

Purpose:
The aim of this study was to examine the pathology of retinoblastoma (RB) seeds with supportive evidence by field emission scanning electron microscopy and Raman spectroscopy.

Methods:
This study was a laboratory-based observational study. Enucleated eyeballs received in the ocular pathology department of a tertiary eye care center in northeast India were included in the cohort after obtaining written informed consent during the surgery. The study was carried out for 6 years (2015–2020). Most of the eyeballs were Group-E RBs. Standard eyeballs sectioning were done by bread loaf techniques. Gross documentations included RB seeds seen in the smallest calotte done with utmost care. Seeds were documented also in permanent sections. Scanning electron microscopy and Raman spectroscopy were carried out in an index case.

Results:
Out of the total 59 cases, 35 RB cases had different seedings. The mean age at enucleation was 2.9 years. RB seeds were seen in vitreous (n = 19), subretinal plus vitreous (n = 7), anterior chamber (n = 1), over crystalline lens (n = 3), retinal surface (n = 1), retinal pigment epithelium (RPE; n = 2), subretinal (n = 1), calcified seeds (n = 2). Other characteristics were dusts (n = 7), clouds (n = 11), spheres (n = 4), and unspecified type (n = 13). Histopathological high-risk factors showed significant choroidal (n = 22) and optic nerve (n = 15) involvement. Few cases had extraocular spread. Undifferentiated tumor (n = 24) was seen with higher evidence of necrosis (n = 23). Raman spectra differentiated the seeds from the normal tissue on the basis of lipid and protein content.

Conclusion:
This study highlights the different types of RB seeds with high-risk factors. The morphology of those seeds showed the difference between vitreous and subretinal seeds under advanced microscopic observations.
The relationship between angle kappa and astigmatism after phacoemulsification with implanting of spherical and aspheric intraocular lens
Authors: Tutchenko Larysa , Patel Sudi , Skovron Mykhailo , Horak Olha , Voytsekhivskyy Oleksiy 
Published: November 2021

Purpose:
To determine the significance of any association between either change in angle kappa (K°) or the rectilinear displacement (L, mm) of the first Purkinje image relative to the pupil center and unexpected changes in astigmatism after phacoemulsification.

Methods:
Orbscan II (Bausch and Lomb) measurements were taken at 1, 2, and 3 months after unremarkable phacoemulsification in patients implanted with spherical (group 1, SA60AT, Alcon) or aspheric (group 2, SN60WF, Alcon) nontoric IOLs. The outputs were used to calculate L. Astigmatism, measured by autorefractometry and subjective refraction, was subjected to vector analysis (polar and cartesian formats) to determine the actual change induced over the periods 1–2 and 2–3 months postop.

Results:
Chief findings were that the mean (n, ±SD, 95%CI) values for L over each period were as follows: Group 1, 0.407 (38, ±0.340, 0.299–0.521), 0.315 (23, ±0.184, 0.335–0.485); Group 2, 0.442 (45, ±0.423, 0.308–0.577), 0.372 (26, ±0.244, 0.335–0.485). Differences between groups were not significant. There was a significant linear relationship between (A) the change in K (ΔK = value at 1 month-value at 2 months) and K at 1 month (x), where ΔK =0.668-3.794X (r = 0.812, n = 38, P = <0.001) in group 1 and ΔK = 0.263x -1.462 (r = 0.494, n = 45, P = 0.002) in group 2, (B) L and the J45 vector describing the actual change in astigmatism between 1 and 2 months in group 2, where J45 (by autorefractometry) =0.287L-0.160 (r = 0.487, n = 38, P = 0.001) and J45 (by subjective refraction) =0.281L-0.102 (r = 0.490, n = 38, P = 0.002), and (C) J45 and ΔK between 2 and 3 months in group 2, where J45 (by subjective refraction) =0.086ΔK-0.063 (r = 0.378, n = 26, P = 0.020).

Conclusion:
Changes in the location of the first Purkinje image relative to the pupil center after phacoemulsification contributes to changes in refractive astigmatism. However, the relationship between the induced change in astigmatism resulting from a change in L is not straightforward.
Results of using the AssiAnchor capsule device for subluxated crystalline lenses
Authors: Goldfeather Ben-Zaken Shalhevet , Kleinmann Guy 
Published: November 2021

Purpose:
To describe our results with the AssiAnchor capsule device in cases of subluxated crystalline lenses.

Methods:
This was a retrospective consecutive case series. Seven eyes of four patients with subluxated crystalline lenses underwent lensectomy/phacoemulsification with intraocular lens (IOL) implantation using the AssiAnchor capsule device in the Kaplan medical center, ophthalmology department. Three patients had Marfan syndrome and one patient had experienced blunt trauma. Demographic data were collected as well as parameters of pre- and postoperative distance visual acuity and refraction, intra-, and postoperative complications, and IOL stability and centration.

Results:
Six out of the seven surgical procedures were uneventful with in-the-bag implantation of the IOL. In the first surgery, a tear of the capsular bag lead to IOL exchanging and fixating to the AssiAnchor and to the iris. In the traumatic cataract case, two AssiAnchors were used. A capsular tension ring was implanted in six out of seven surgeries. The average follow-up time was 9.5 ± 6.8 months. All the IOLs were stable and well centered except for the first IOL that exhibited a slight temporal, but not clinically significant, decentration. The distance visual acuity and the refractive parameters improved significantly in all cases.

Conclusion:
We found the AssiAnchor capsule device an effective tool with a short learning curve for treating subluxated lenses.
Clinical profile and demographic distribution of Terrien’s marginal degeneration in a multitier ophthalmology network in India
Authors: Das Anthony V , Pillutla Nimeshika L , Chaurasia Sunita 
Published: November 2021

Purpose:
To describe the clinical profile and demographic distribution of Terrien’s marginal degeneration (TMD) in patients presenting to a multitier ophthalmology hospital network in India.

Methods:
This cross-sectional hospital-based study included 2,470,793 new patients presenting between September 2012 and September 2020 (~8 years period). Patients with a clinical diagnosis of TMD in at least one eye were included as cases. The data were collected using an electronic medical record system.

Results:
Overall, 184 (0.007%) new patients were diagnosed. Over half of patients were males (56.52%) with bilateral affliction (54.89%). The mean age of the patients was 38.63 ± 16.75 years. Majority (28.26%) of the patients were between 21 and 30 years of age bracket. The number of patients were from rural and urban districts were comparable (41.85% vs. 48.37%). The most common clinical signs were ectasia/thinning (50.53%), corneal scar (44.21%), and prominent nerves (5.26%). Associated ocular comorbidities included vernal keratoconjunctivitis in 6 (2.11%) eyes, meibomitis in 6 (9.7%) eyes, squamous blepharitis in 2 (3.2%) eyes, dry eye in 2 (3.2%) eyes, cataract in 46 (74.2%) eyes, and glaucoma in 6 (9.7%) eyes. Most of the eyes had mild or no visual impairment (43.86%). Two (0.7%) eyes had spontaneous perforation patients. None of patients had hydrops in the years of follow-up. Keratoplasty was performed in 3.86%.

Conclusion:
TMD is a rare disease affecting patients seeking eye care at the ophthalmology network. It commonly affects adult males and is predominantly bilateral. The disease progression is slow, and risk of spontaneous perforation was low. At initial presentation, visual impairment was mild to moderate in majority and the most common surgical intervention was cataract surgery during the study period.