bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late-time X-Ray Observations of the Jetted Tidal Disruption Event AT2022cmc: The Relativistic Jet Shuts Off
Authors: Eftekhari T. , Tchekhovskoy A. , Alexander K. D. , Berger E. , Chornock R. , Laskar T. , Margutti R. , Yao Y. , Cendes Y. , Gomez S. , Hajela A. , Pasham D. R. 
Published: October 2024

Abstract
The tidal disruption event (TDE) AT2022cmc represents the fourth known example of a relativistic jet produced by the tidal disruption of a stray star, providing a unique probe of the formation and evolution of relativistic jets in otherwise dormant supermassive black holes (SMBHs). Here we present deep, late-time Chandra observations of AT2022cmc extending to t
obs ≈ 400 days after disruption. Our observations reveal a sudden decrease in the X-ray brightness by a factor of ≳14 over a factor of ≈2.3 in time, and a deviation from the earlier power-law decline with a steepening α ≳ 3.2 (F

X
∝ t
−α
), steeper than expected for a jet break, and pointing to the cessation of jet activity at t
obs ≈ 215 days. Such a transition has been observed in two previous TDEs (Swift J1644+57 and Swift J2058+05). From the X-ray luminosity and the timescale of jet shut-off, we parameterize the mass of the SMBH in terms of unknown jet efficiency and accreted mass fraction parameters. Motivated by the disk–jet connection in active galactic nuclei, we favor black hole masses ≲105
M
⊙ (where the jet and disk luminosities are comparable), and disfavor larger black holes (in which extremely powerful jets are required to outshine their accretion disks). We additionally estimate a total accreted mass of ≈0.1 M
⊙. Applying the same formalism to Swift J1644+57 and Swift J2058+05, we favor comparable black hole masses for these TDEs of ≲ a few × 105
M
⊙, and suggest that jetted TDEs may preferentially form from lower-mass black holes when compared to nonrelativistic events, owing to generally lower jet and higher disk efficiencies at higher black hole masses.
Comparison of the Accuracy Between the Z CALC2 Calculator and Barrett Toric Calculator in Toric IOL Calculation
Authors: Wang Lan , Meng Jiaqi , Fang Yanwen , He Wenwen , Zhao Chen , Lu Yi , Zhu Xiangjia 
Published: October 2024

Purpose
To compare the accuracy of the Z CALC2 calculator and Barrett toric calculator in toric intraocular lens (IOL) calculation.

Methods
Eighty-five eyes of 85 patients who underwent uneventful cataract surgery with toric IOL implantation were included. The accuracy was compared between the Z CALC2 calculator and Barrett toric calculator under two calculation modes: using simulated keratometry (SimK) from the IOLMaster 700 (Carl Zeiss Meditec AG) for posterior corneal astigmatism (PCA) prediction and employing total corneal astigmatism (total corneal refractive power [TCRP] or measured PCA) obtained from the Pentacam (Oculus Optikgeräte GmbH). The centroid of prediction errors, percentage of eyes with prediction errors within ±0.50 diopter (D), mean prediction error, and mean absolute prediction error were calculated. Subgroup analysis was conducted based on the orientation and magnitude of anterior corneal astigmatism and axial length.

Results

When using SimK, the two calculators with predicted PCA showed comparable accuracy. When employing total corneal astigmatism, the Barrett toric calculator with measured PCA showed a lower centroid error (0.15 vs 0.38 D), a higher percentage of eyes with prediction errors within ±0.50 D (47.1% vs 32.9%,
P
= .018), and a lower mean prediction error (0.57 vs 0.71 D,
P
= .033) compared to the Z CALC2 calculator with TCRP in the 4-mm zone. In subgroup analysis, when employing total corneal astigmatism, the Barrett toric calculator with measured PCA exhibited superior accuracy, especially in the with-the-rule and anterior corneal astigmatism of 2.00 D or less subgroups.

Conclusions
When using SimK, the Z CALC2 calculator and Barrett toric calculator yield comparable accuracy. The Barrett toric calculator with measured PCA may be more recommended when employing total corneal astigmatism.

[
J Refract Surg
. 2024;40(10):e681–e691.]
Evaluation of Visual Outcomes in Patients With Aberrated Corneas Implanted With the IC-8 Small-Aperture IOL
Authors: Teo Zhen Ling , Sie Nicole Ming , Mehta Jodhbir S. 
Published: October 2024

Purpose
To assess the visual outcomes in patients with cataract implanted with a small-aperture intraocular lens (IOL) in eyes with aberrated corneas.

Methods
This prospective, non-interventional, single-center clinical study was conducted at Singapore National Eye Centre, Singapore. Twenty-one patients with aberrated corneas had IC-8 IOL (Bausch & Lomb, Inc) implantation. An aberrated cornea was defined as from natural causes: keratoconus (n = 1, 4.8%), high coma (n = 2, 9.5%), corneal scar (n = 1, 4.8%), or iatrogenic causes: keratorefractive procedure (n = 17, 86%). Uncorrected and corrected visual acuities were measured at distance (600 cm) (UDVA and CDVA), intermediate (66.7 cm) (UIVA and CIVA), and near (40 cm) (UNVA and CIVA). Defocus curve was tested monocularly and binocularly. Contrast sensitivity (CS) was measured under photopic and mesopic conditions with and without glare.

Results
In IC-8 eyes, the mean ± standard deviation UDVA, UIVA, and UNVA was 0.24 ± 0.18, 0.19 ± 0.18, and 0.14 ± 0.14 logMAR, respectively. Mean CDVA, CIVA, and CNVA in IC-8 eyes was 0.12 ± 0.17, 0.16 ± 0.15, and 0.19 ± 0.13 logMAR, respectively. Binocular mean UDVA, UIVA, and UNVA was 0.07 ± 0.10, 0.07 ± 0.10, and 0.13 ± 0.12 logMAR, respectively. Defocus curve testing yielded a depth of focus of 1.50 D monocularly and 2.00 D binocularly at a 0.2 logMAR threshold. Photopic binocular CS with and without glare improved over monocular CS of IC-8 and fellow eyes under all spatial frequencies. Mesopic binocular CS with and without glare were similar among monocular IC-8 and fellow eyes across spatial frequencies. Most patients reported low levels of visual symptoms.

Conclusions
The IC-8 IOL provides good monocular and binocular visual outcomes for patients with cataract who had aberrated corneas.

[
J Refract Surg
. 2024;40(10):e716–e723.]
Corneal Epithelial Remodeling Following Cylinder Correction With SMILE or FS-LASIK: A Contralateral Comparative Study
Authors: Chen Pei , Hou Xiangtao , Yu Na , Ye Yiming , Wei Han , Zhuang Jing , Yu Keming 
Published: October 2024

Purpose
To compare the corneal epithelial remodeling in eyes with high astigmatism that had small incision lenticule extraction (SMILE) and femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK).

Methods
Seventy-four patients with myopic astigmatism of greater than −2.00 diopters (D) and little binocular difference in spherical equivalent were included in this contralateral comparative study. All patients received SMILE in one eye and FS-LASIK in the other eye randomly. The corneal epithelial remodeling pattern was mapped using the latest RTVue spectral-domain optical coherence tomographer (Optovue) by region.

Results
Satisfactory refractive correction was achieved in all enrolled eyes with either SMILE or FS-LASIK. The corneal epithelium gradually thickened following surgical cylinder correction, distributing mainly along the flat medium. The corneal epithelium proliferation is milder centrally but more pronounced in the mid-peripheral area after SMILE, compared with FS-LASIK. The flat-steep difference in corneal epithelial thickness (CET) is evident in the mid-peripheral and peripheral areas, which is more obvious in SMILE. Residual cylinder was positively correlated with CET in eyes that had FS-LASIK, but not SMILE. More importantly, these epithelial changes were positively correlated with the ablation depth and higher order aberrations following surgical refractive correction.

Conclusions
The postoperative CET map varied between SMILE and FS-LASIK. In eyes with high astigmatism, SMILE surgery is followed by milder and more stable corneal epithelial thickening. Moreover, the corneal epithelium is sensitive to stromal ablation and corneal remodeling is crucial to the postoperative visual quality. This study rigorously distinguished the CET difference between SMILE and FS-LASIK in astigmatic eyes and shed light on subsequent research.

[
J Refract Surg
. 2024;40(10);e728–e741.]
Evaluation of Corneal Biomechanics Using Brillouin Microscopy in Chinese Adults With Myopia
Authors: Cao Jian , Yu Yanze , Ma Yong , Bao Yongle , Niu Lingling , Wang Xiaoying , Zhou Xingtao , Zhao Jing 
Published: October 2024

Purpose
To evaluate the corneal biomechanical metrics of Chinese adults with myopia and identify relevant factors of Brillouin microscopy.

Methods
In this cross-sectional study, corneal biomechanics in Chinese adults with myopia were quantified and analyzed using Brillouin microscopy and the Corvis ST (CST) (Oculus Optikgeräte GmbH) and analyzed. Univariate linear regression was used with potential factors including age, sex, spherical equivalent (SE), intraocular pressure (IOP), central corneal thickness (CCT), and mean keratometry (Kmean).

Results

The study included 87 eyes of 87 participants (mean age: 24.47 ± 6.27 years). Central, Mean, maximum (Max), minimum (Min), standard deviation, and Max–Min Brillouin modulus (BM) values obtained from Brillouin microscopy exhibited values of 2.826 ± 0.039, 2.827 ± 0.027, 2.864 ± 0.034, 2.790 ± 0.038, 0.108 ± 0.042, and 0.074 ± 0.041 GPa, respectively. No significant correlations were found between BM parameters and age, sex, SE, IOP, or CCT. However, the Mean (β = −0.251,
P
= .019), Min (β = −0.315,
P
= .003), and Max–Min (β = 0.229,
P
= .033) BM values were significantly associated with Kmean. The Central, Mean, Min, and Max BM values negatively correlated with the Tomographic Biomechanical Index measured by CST (Spearman's
r
= −0.24, −0.35, −0.29, and −0.23, respectively, all
P
< .05).

Conclusions
Brillouin microscopy accurately reflects corneal biomechanical parameters in Chinese adults with myopia, independent of IOP and CCT, with a good correlation with CST. Concurrent evaluation of the corneal curvature is imperative when employing Brillouin microscopy in clinical practice.

[
J Refract Surg
. 2024;40(10):e768–e776.]
Clinical Performance of an Extended Range of Vision Intraocular Lens After LASIK
Authors: Carreras Humberto , Reñones Josefina , Carreras María del Rosario , Cantó Carlos , Piñero David P. 
Published: October 2024

Purpose
To evaluate the clinical and patient-reported outcomes (PROMs) of cataract surgery with implantation of a wavefront-shaping extended depth of focus (EDOF) intraocular lens (IOL) in eyes with previous laser in situ keratomileusis (LASIK) for myopia correction.

Methods
This prospective observational study enrolled 50 eyes with previous LASIK from 25 patients (age: 46 to 70 years) who underwent cataract surgery with implantation of the AcrySof IQ Vivity IOL (Alcon Laboratories, Inc). Visual and refractive outcomes were evaluated during a 3-month follow-up. PROMs were evaluated with the Intraocular Lens Satisfaction (IOLSAT; Alcon Vision, LLC) (general satisfaction), Catquest-9SF (difficulty in doing vision-related activities), and Questionnaire for Visual Disturbances (QUVID; Alcon Vision, LLC) (photic phenomena) questionnaires.

Results
Mean 3-month postoperative binocular uncorrected distance, intermediate, and near visual acuities were 0.02 ± 0.11, −0.02 ± 0.09, and 0.14 ± 0.13 logarithm of the minimum angle of resolution (logMAR), respectively. Mean binocular distance-corrected intermediate and near visual acuities were 0.05 ± 0.11 and 0.32 ± 0.14 logMAR, respectively. All eyes had a postoperative spherical equivalent within ±0.75 diopters (D). The mean defocus curve showed visual acuity values better than 0.20 logMAR for defocus levels from +0.50 to −1.50 D. Most patients (92.0%) confirmed that they had no vision-related difficulties limiting their normal daily life. Perception of starbursts, halos, glare, hazy vision, blurry vision, and double vision was referred by 24%, 24%, 28%, 28%, 8%, and 4% of patients, respectively. Most of symptoms were described as mild and not or a little bothersome.

Conclusions
The wavefront-shaping EDOF IOL evaluated provides efficacious distance, intermediate, and near visual restoration in eyes with previous LASIK, with minimal photic phenomena associated.

[
J Refract Surg
. 2024;40(10):e742–e753.]
Recomposer les territoires pour les adapter aux effets de la crise climatique : l’après-catastrophe comme opportunité pour une meilleure habitabilité ?
Authors: Rode Sylvain 
Published: October 2024

La période qui s’ouvre après une catastrophe est considérée par certains comme une fenêtre d’opportunité pour repenser l’aménagement des territoires vulnérables. Dans un contexte de crise climatique, n’est-ce pas l’occasion de changer la manière de penser l’aménagement, avec les risques, les milieux et leurs dynamiques ? Nous nous efforçons de répondre à ce questionnement à travers l’étude du processus de recomposition urbaine engagé par deux communes du département de l’Aude suite à l’inondation d’octobre 2018. Ce n’est pas, comme trop souvent, la reconstruction à l’identique qui a été privilégiée par les acteurs locaux mais au contraire la volonté de repenser l’organisation du territoire pour le rendre plus résilient face aux crises et plus agréable à vivre au quotidien. Fruit d’une dynamique collective, la recomposition de ces deux territoires s’inscrit dans une logique d’adaptation et de résilience incarnant ainsi, à certains égards, une nouvelle manière d’envisager l’aménagement à l’heure de l’Anthropocène.
Effect of cycloplegia on the refractive status of children
Authors: Tharwat Ehab , Hassanein Mohamed , Ezzeldin Ezzeldin R. , Soliman Haitham B. , Eltantawy Basheer , Elgazzar Akram F. , Abdella Walid S. , Abdelkader Amr M.E. 
Published: October 2024

Background: The American Optometric Association (AOA), in its 2017 Recommendation for Clinical Practice, proposed cycloplegic testing when initially screening preschool children to detect potential vision-impairing diseases such as strabismus, amblyopia and anisometropia.Aim: This study aims to detect the effect of cycloplegia on the measurement of refractive errors in children.Setting: Ophthalmology department, Al-Azhar University, Egypt.Methods: This retrospective interventional study included 388 children with refractive error attending our outpatient clinic in the ophthalmology department, at Al-Azhar University between January 2020 and April 2022. Cycloplegia was induced in each child with topical eye drops of 1% cyclopentolate instilled two times at 5-min intervals. The same optometrist repeated an auto-refraction 30 min after the last eye drop was applied.Results: We compared the pre- and post-cycloplegic refractions and found that the sphere, spherical equivalence and cylinder had significant hypermetropic shift after cycloplegia (P = 0.001).Conclusion: Cycloplegic refractions are more accurate and eliminate the risk of inaccurate refractive error findings, which is essential when managing children.Contribution: This article provides valuable insight, which may inform public health policy.
Factors influencing nursing students’ learning in a clinical skills laboratory
Authors: Hoffman Catherine M. , Willemse Juliana 
Published: October 2024

Background: Achieving competence in clinical skills requires various resources and preparation time for undergraduate nursing students. Intentional opportunities should be created for student nurses to experience meaningful encounters in the clinical skills laboratory (CSL) to broaden their knowledge and competence. Therefore, factors that influence the competence in clinical learning in a CSL were explored.Aim: This study aimed to explore and describe the perceptions of nursing students regarding factors influencing their learning in a CSL.Setting: The study was conducted at a School of Nursing at a university in the Western Cape province.Methods: A qualitative descriptive design was adopted. Purposive sampling was used to select participants for this study based on specific inclusion and exclusion criteria. Following the attainment of ethical clearance, 10 focus group interviews were undertaken to explore the perceptions of nursing students regarding factors influencing their learning in a CSL. The focus group sessions continued until data saturation was established. Data were analysed using a thematic analysis process.Results: Three major themes emerged from the data analysis that was explored to make the following recommendations: physical environment, psychosocial environment and organisational environment.Conclusion: The results of this study highlighted the necessity for implementing interventions to enhance specific elements within the CSL, aiming to foster high-quality clinical learning experiences for nursing students.Contribution: Areas were identified within the CSL environment that requires enhancement to ensure the provision of quality clinical learning, thereby enabling student nurses to attain clinical competence.
Incidence and risk factors of neutropenia in neonates with hemolytic disease of the newborn
Authors: Alkhani Abdullah , Arefi Albara , AlTayeb Maryam , Naaz Sayyada , Alghanbar Jude , Alhuthil Raghad , Alrowaily Fouzah , Almidani Eyad 
Published: October 2024

Background
Hemolytic disease of the newborn (HDN) is a less recognized cause of neonatal neutropenia. Therefore, this study aims to estimate the incidence of neutropenia and identify associated factors in infants with HDN at a tertiary care center.

Methods
This retrospective cohort study included infants with HDN who presented at a tertiary care center in Saudi Arabia between March 2008 and September 2023. Neutropenia was defined as an absolute neutrophil count of less than 1.5 μL.

Results
Among 339 neonates with HDN, 50.1% were male, and 49.9% were female. Rh isoimmunization was the most common antibody type, observed in 58.7% of cases. The severity of HDN was classified as mild in 62.6% of neonates, moderate in 33.3%, and severe in 4.1%. Neutropenia was more prevalent in moderate-to-severe HDN cases (P = 0.047). The incidence rate of neutropenia was 4.1 per 1,000 person-days, with 7.4% of neonates (25/339) being neutropenic at birth. Among these, 17 out of 25 neonates showed resolution within 2 days. Multivariate analysis identified male gender (P = 0.022), low gestational age (P = 0.008), low birth weight (P = 0.039), and the need for exchange transfusion (P = 0.036) as significant risk factors for neutropenia.

Conclusion
Neutropenia in infants with HDN, irrespective of antibody type, is generally a benign, self-limiting condition. This condition predominantly affects male neonates with moderate-to-severe HDN and prematurity and can be managed conservatively.
Effect of Phalatrikadi ghana vati in a patient of non-alcoholic fatty liver disease: a case report
Authors: Chaudhary Piyush , Rathi Bharat , Lamba Neha , Sharma Anil , Rathi Renu 
Published: October 2024

Abstract
A 39-year-old male patient presented with complaints of decreased appetite, generalized weakness, nausea, gastric distension of the abdomen on and off, and mild pain in the upper abdomen. Ultrasonography of the whole abdomen revealed hepatomegaly with grade II diffuse fatty infiltration of the liver or nonalcoholic fatty liver disease (NAFLD). Such disorders of the hepatobiliary system are categorized as Yakritroga in Ayurveda. A drug, Phalatrikadi ghana vati, which is a combination of eight herbs known to pacify and normalize the functions of the three doshas, was prescribed to the patient for 12 weeks along with lifestyle modifications (pathya ahara–vihara). The individual contents of this drug are known to possess hepatoprotective activity. The patient showed significant relief in subjective parameters Udarasula (pain in the abdomen), Utklesa (feeling of nausea and vomiting), Aruchi (loss of appetite), and Klama (fatigue). The elevated liver enzymes were also reported to be in the normal range after the treatment, along with improved fatty liver grading. This single case report of NAFLD was managed satisfactorily with significant improvement with no side effects.
Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography
Authors: Liu Cui , Tian Lingyun , Ze Xingyu , Yang Ting , Wang Luowei , Li Zhaoshen 
Published: October 2024

Abstract
Common bile duct (CBD) stones are usually caused by biliary tract infection, biliary stricture, duodenal peripapillary diverticulum, Oddis sphincter dysfunction, and so on. Treatment is preferably with endoscopic retrograde cholangiopancreatography (ERCP), where an iodine-containing contrast agent is injected into the CBD to display the stone under fluoroscopy and then to confirm complete removal of the stone(s). We described a 65-year-old woman with CBD stones who had undergone cardiac pacemaker implantation and was allergic to iodinated contrast media. We performed ERCP + lithotomy + stent implantation under local anesthesia, with injection of carbon dioxide instead of iodinated contrast into the CBD, and successfully visualized the stones under fluoroscopy and then confirmed complete removal of them. The patient was generally in good condition without complications. Thus, we have demonstrated in this case report that carbon dioxide can be used as a safe, economical, and effective alternative to iodinated contrast agent during ERCP.
Ileal perforation by a solidified root pulp – Minimally invasive surgery management
Authors: Galhotra Anmol , Veetil Deepa Kizhakke , Wadhawan Randeep , Bhardwaj Arun , Verma Naveen 
Published: October 2024

Abstract
Foreign body (FB) ingestion results in perforation in 1% of cases and is associated with significant morbidity and rarely mortality. This case reports the delayed presentation of distal ileal perforation following accidental ingestion of solidified root pulp. A 46-year-old male presented to the emergency department with complaints of right iliac fossa pain, clinical diagnosis of appendicitis was made. Computed tomography of the abdomen revealed an FB in the distal ileum with contained perforation. Revised history was suggestive of FB aspiration during root canal therapy 3 weeks back. The patient underwent diagnostic laparoscopy, removal of FB and primary closure of the perforation. FB was revealed to be solidified root pulp macroscopically and hyalinised material microscopically. Localised perforation following ingestion of FB results in significant morbidity due to delayed diagnosis. With the increasing number of dental procedures, this becomes relevant globally as well. Varied clinical presentations pose diagnostic challenges to the clinician.
Vital Pulp Therapy in Primary Teeth Having Signs and Symptoms of Irreversible Pulpitis
Authors: Clins T. , Harris Anoop , Gopalakrishnan Anjana , Suresh Saarika 
Published: October 2024

Abstract
Dental caries being the most prevalent disease worldwide usually ends in pulpitis due to negligence of the patient and the caretaker. The major diagnostic factor followed in deciding the status of pulpitis as, reversible or irreversible, is the severity and intensity of the pain. Traditionally, a tooth diagnosed as irreversible pulpitis results in the removal of coronal and radicular pulp resulting in the non-vitality of the tooth. This case report describes the use of vital pulp therapy (VPT) in three paediatric patients with primary teeth showing signs and symptoms suggestive of irreversible pulpitis. Calcium silicate cement (Biodentine) was used to preserve the radicular pulp, demonstrating favourable clinical and radiographic outcomes over a 1-year follow-up. The findings support the potential of VPT as an alternative to traditional pulpectomy in cases where radicular pulp tissue remains healthy, despite a history of severe pain.