bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Longitudinal Examination of Blood Sugar Dynamics in Diabetes and Non-Diabetes Using Growth Curve Model: The Sabzevar Persian Cohort Study
Authors: Tabarraei Yaser , Keshtkar Abbas Ali , Yekaninejad Mir Saeed , Rahimi Najme , Dowlatabadi Yousef , Azam Kamal 
Published: July 2024

Background:
Diabetes mellitus is a chronic metabolic disorder with substantial implications for public health. Understanding the factors influencing blood sugar fluctuations is crucial for effective diabetes management and prevention. This study aimed to evaluate factors associated with blood sugar changes in diabetic patients and healthy individuals attending the Sabzevar Persian Cohort Center, employing the growth curve model.

Materials and Methods:
Data related to 589 diabetic patients and 589 non-diabetic patients participating in the Persian cohort study of Sabzevar were used. Due to the repetition of blood sugar measurements for each individual over time, we use the conditional latent growth curve model to examine intra-individual changes and variables that affect these changes over time.

Results:
The linear latent growth curve model, fitted with independent variables, exhibited a superior fit. The slope of the line for the diabetic group was measured at 1.78, while for the non-diabetic group, it was estimated to be -0.29. Within the diabetic group, the influence of age, the presence of fatty liver, and history of congenital heart disease (CHD) had a significant impact on the baseline (the intercept), and the effect of body mass index (BMI) on the changing trend of the response variable (slope) was also significant. In the non-diabetic group, significant effects were observed for age variables, BMI, family history of diabetes, and history of stroke in the family.

Conclusion:
Overall, the linear latent growth curve model showed good performance in the evaluation of the factors related to blood sugar changes in diabetic patients and healthy people.
Compare the GCS and the Rotterdam CT Score in Predicting the Mortality and Disability of Patients with Traumatic Brain Injury
Authors: Mahmoodkhani Mehdi , Behfarnia Parham , Aminmansour Bahram 
Published: July 2024

Background:
Given the dearth of extensive research comparing the Glasgow Coma Scale with the Rotterdam scoring system for predicting mortality in trauma patients, this study was conducted to determine which scale provides a more realistic prediction of mortality in trauma patients after three months.

Materials and Methods:
This observational study was performed at Kashani Hospital in Isfahan, Iran. Patients with TBI who were admitted between February 2022 and February 2023 were included in the study. Approval from the Ethical Committee of Isfahan University of Medical Sciences was obtained prior to conducting this study.

Results:
We included 152 adult patients who completed the GOS-E and the QOLIBRI-OS three-month post-injury. The median age was 35 years (IQR = 17–70). Most patients 139 (91.4%) were classified as having a severe TBI.

Conclusion:
The results of the present study showed that both the use of GCS and Rotterdam CT scores can be effective in predicting the three-month mortality and QOLIBRI-OS scores of patients, with the difference that the predictive power of the three-month Rotterdam CT score is greater than that of the GCS.
Smoking and the Risk of Type 2 Diabetes: A Cross-sectional Analytical Study
Authors: Debnath Dhrubajyoti J. , Ray Jayanti , Jah Syed Mustafa , Marimuthu Yamini 
Published: July 2024

Background:
India is undergoing epidemiological transitions with the increase in noncommunicable disease (NCD) burden. Targeting the modifiable risk factors through lifestyle changes in the early years of life remains the most effective strategy for decreasing the prevalence of type 2 diabetes mellitus (T2DM). To determine the association between cigarette smoking and T2DM.

Materials and Methods:
An analytical cross-sectional study was conducted among the patients attending the outpatient department of a tertiary care teaching hospital in Kolkata, West Bengal, India. Patients aged more than 35 years were enrolled, and details regarding sociodemography, clinical status, and NCD risk factors were collected using pretested semistructured questionnaires after obtaining IEC approval. Data collected were entered in MS Excel and analyzed using SPSS software. Simple logistic regression and multivariable logistic regression analysis were used to calculate the crude and adjusted odds ratio with 95% confidence interval.

Results:
Out of 434 participants, 37.3% had diabetes mellitus, 51.6% were males, and 28.6% had alcohol consumption. Univariate logistic regression analysis revealed age, BMI, systolic BP, diastolic BP, and cigarette smoking were significantly associated with increased risk of T2DM. Multivariable logistic regression analysis revealed cigarette smoking, systolic BP, age, and female gender were significant risk factors for T2DM.

Conclusions:
Our study reported cigarette smoking and systolic BP are modifiable risk factors associated with T2DM. Early identification of smoking through screening and appropriate control of hypertension in T2DM patients will decrease the morbidities and mortalities in T2DM cases.
Trend, Pattern, and Prevalence of Adverse Pregnancy Outcomes among Women of Reproductive Age in India, 1992–2021
Authors: Swain Prafulla K. , Jena Anmol 
Published: July 2024

Background:
Adverse pregnancy outcomes (APOs) are the most important vital statistics used to assess maternal health and child health statistics. They are an indicator of the quality of maternal and child health care services, i.e., antenatal care, intrapartum care, and medical services.

Material and Methods:
The objective of the study is to analyze the trend, pattern, and prevalence of APOs among women of reproductive age group at the national level over successive NFHS rounds. The current study uses data from the National Family Health Survey (NFHS), conducted during 1992–2021. The study uses geo-spatial mapping techniques through QGIS software and report analysis to arrive at definitive conclusions.

Results:
The study finds that the incidence of APOs among women of reproductive age (15–49 years) has increased over the years. Twenty states and union territories have APOs that are below the national average. On the other hand, States like Madhya Pradesh, Meghalaya, Sikkim, Goa, Maharashtra, Andhra Pradesh, Karnataka, and Kerala have witnessed their APOs worsening as per NFHS-5 vis-à-vis NFHS-4. The study also finds that apart from the Himalayan belt and the east coast of India, APOs are more prominent in the contiguous regions adjoining these areas.

Conclusions:
The findings of the study have thrown on very interesting facts. Despite rapid economic development during the intervening period between NFHS-4 and NFHS-5, rising APOs are a testament to the fact that the policymakers in the country need to be more target-oriented and get their acts together.
Qualitative Study to Identify Strengths, Weakness, Opportunities, and Challenges of Family Adoption Programs among Students
Authors: Reshmi Panchasheela S , Lunagariya Ruchita , Patel Hiren , Patel Nikhil , Chauhan Dixit , Patel Ravi 
Published: July 2024

Background:
National Medical Commission (NMC) in their recent notification included Family Adoption Program (FAP) in the undergraduate curriculum to provide a learning opportunity towards community-based health care to Indian medical graduates. This study is carried out to explore and know strengths, weaknesses, opportunities, and challenges of FAP.

Materials and Methods:
FAP were used to gather data using Focus Group Discussion (FGD) and in-depth interviews of the stakeholders of the program. FGD of students was conducted. In-depth interviews of families, Sarpanch, Panchayat members, ASHA workers of the village, faculties, and Head of the Department of Community Medicine were conducted. Data analysis was done by using deductive–inductive content analysis method using computer software NVivo.

Results:
Four main categories or themes were formed: strengths, weaknesses, opportunities, and challenges. Strengths include increased understanding about Community Medicine subject, beneficence to students, and community. Weakness includes difficulties in field with respect to time and availability and implementation of programs. Opportunities include early field exposure and FAP as a platform for primary healthcare. Challenges include competencies not aligned with phasewise curriculum and difficulties in adopting five families per student.

Conclusions:
The family adoption program needs to be adopted and implemented as a part of curriculum for MBBS students as there are many strengths and opportunities, while weaknesses and challenges need to be addressed.
Assessing the surgical competency of novice surgeons by using a three-dimensional heads-up display microscope
Authors: Varman Aadithreya , Varman N V Arulmozhi , Balakumar Dinesh 
Published: July 2024

Purpose:To evaluate the surgical performance of novice surgeons operating on a three-dimensional (3D) heads-up display system compared to those using a traditional microscope (TM).Methods:Prospective study design in a private practice setting. Twenty novice surgeons with similar experiences in cataract surgery were selected. Each surgeon performed 20 phacoemulsification cataract surgeries: 10 surgeries on the 3D heads-up display microscope, and 10 surgeries using a TM system. Data were collected from a total of 400 patients operated on by 20 surgeons. Outcome measures were recorded and graded according to the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric-Phacoemulsification system. The main outcome measure was mean surgical competency scores.Results:Overall, 400 data points were equally distributed between TM (200) and 3D (200) surgeries. The mean surgical competency scores were 60.19 (11.41) for TM surgeries and 62.99 (11.11) for 3D surgeries. 3D surgeries had significantly higher surgical competency scores than TM surgeries (P= 0.013). The mean surgical duration for TM and 3D surgeries was 35.98 (6.02) min and 34.31 (7.12) min, respectively. 3D surgeries took significantly less time than TM surgeries (P= 0.012). The overall mean best corrected visual acuity in the logarithm of the minimum angle of resolution units was 0.27 (0.42); in TM and 3D surgeries, it was 0.28 (0.43) units and 0.26 (0.41) units, respectively.Conclusion:The 3D heads-up display system enhances stereopsis in cataract surgery, making it a valuable training tool for novice surgeons in phacoemulsification procedures.
Association of fracture type with enophthalmos and intraorbital volume correction in orbital fractures: A computed tomographic study
Authors: Parameswaran Anantanarayanan , Panneerselvam Elavenil , Mukherjee Bipasha 
Published: July 2024

Purpose:
To determine the influence of different types of orbital fractures on the radiographic post-treatment outcomes.

Methods:
The investigation was a retrospective cohort study involving CT data of all patients who underwent delayed primary or secondary surgery for orbital/zygomatico-orbital trauma between 2019 and 2021. The sample was divided into three groups 1, 2, and 3: isolated floor, floor and medial wall, and combined orbit and zygomatic complex fractures. The type of orbital fracture was the exposure, while the outcome measures were reduction in enophthalmos and intraorbital volume and linear relationship between the two variables. Data were analyzed for variance between groups and association. Statistical significance was set at < 0.05.

Results:
Forty-four patients (3 females and 41 males) with a mean age of 28.6 years were included in the study. Reductions in enophthalmos (P < 0.001) and intraorbital volume (P = 0.003) demonstrated significant variance between the groups. For every cubic centimeter of reduction in volume, the reduction in enophthalmos was 0.78 mm (P < 0.001) in isolated floor fractures, 0.60 mm (P = 0.013) in combined fractures involving the floor and medial walls, and 0.24 mm (P = 0.456) in combined fractures of the orbit and zygoma.

Conclusion:
Correction of enophthalmos strongly depends on the type of orbital fracture. There exists a significant linear relationship between enophthalmos and intraorbital volume in fractures involving the internal orbit.
Gonioscopy-assisted transluminal trabeculotomy (GATT) with scleral or iris fixation for subluxated intraocular lenses and glaucoma
Authors: Sharon Tal , Ben-Haim Liron Naftali , Dar Nimrod , Assia Ehud I , Belkin Avner 
Published: July 2024

Abstract

Introduction:
This retrospective chart review aims to report a combined surgical approach of intraocular lens (IOL) fixation and gonioscopy-assisted transluminal trabeculotomy (GATT) for the treatment of subluxated IOLs and glaucoma or ocular hypertension.

Methods:
Charts of patients who underwent IOL fixation combined with GATT between November 2019 and July 2023 were reviewed. The main outcome measure was surgical success, defined as a well-centered IOL and an IOP of 18 mmHg or lower and either a 30% IOP reduction or a reduction in medications as compared to baseline. Complications and the need for reoperation were recorded.

Results:
Eleven patients who underwent GATT with IOL fixation were included. The mean age was 80.45 years (range: 73–90). IOL subluxation was associated with pseudoexfoliation in all cases. Seven patients underwent scleral fixation, and four underwent iris fixation. The mean follow-up was 15.36 (range: 2.7–26.6) months. The success rate was 72.73%. The mean baseline IOP was 20.63 ± 6.56 mmHg on 2.81 ± 1.53 medications. Four patients were on oral carbonic-anhydrase inhibitor (CAI) before surgery. The mean IOP at the end of the follow-up was 13.86 ± 3.5 mmHg on 1.36 ± 1.57 medications, and none were on oral CAIs. No intraoperative complications occurred, and transient hyphema and vitreous hemorrhage were the most common postoperative complications. All patients had a well-centered IOL. No patients needed additional surgery for IOL position or IOP control. The mean corrected distance visual acuity was 0.634 ± 0.62 logMAR at baseline and 0.36 ± 0.38 at the end of follow-up.

Conclusions:
GATT can be combined with IOL fixation to the sclera or iris to effectively reduce IOP and medication usage.
Effective low-cost pediatric vision screening by naive nonophthalmic examiners using the ‘Arclight’ device
Authors: Gore Rujuta , Wang Jenny N , Yang Christopher D , An Miranda , Hunter Stephen C , Shahraki Kourosh , Blaikie Andrew , Suh Donny W 
Published: July 2024

Purpose:
To explore whether a low-cost ophthalmoscope (Arclight) can be used by naive nonophthalmic examiners to effectively screen for pediatric eye disease.

Methods:
Fifty-four children (108 eyes) were examined by five medical students using an Arclight. Gold standard examination was performed by an ophthalmologist using a slit lamp and indirect ophthalmoscope. Examinations performed included ophthalmoscopy of the optic disc, estimation of the cup-to-disc ratio (CDR), corneal light reflex test (CRT), Bruckner’s reflex test (BRT), and evaluation of refractive error. We determined the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the nonophthalmologist’s Arclight exam compared to the gold standard findings of comprehensive evaluation by pediatric ophthalmologists.

Results:
Using the Arclight, the optic nerve exam was successfully completed in 65% of patients. CDRs above and below 0.5 could be determined with 66.7% sensitivity and 84.4% specificity. Arclight CRT measurements were significant (P < .00001) predictors of strabismus, with 80% sensitivity, 95.1%, specificity, 80% PPV, and 95.1% NPV. BRT was not a significant predictor of amblyopia, with a 34.6% sensitivity, 85.7% specificity, 69.2% PPV, and 58.5% NPV. Refractive error was estimated with a success rate of 81% for emmetropia, 38% for myopia, and 21% for hyperopia. The Arclight ease-of-use was rated on average as 4.4 (SD = 0.9) on a scale of 1 to 5, with 1 being the hardest and 5 being the easiest.

Conclusions:
Our study shows the Arclight as an affordable and effective alternative to the traditional ophthalmoscope for assessing eye disease in children. This device can improve eye health services in under-resourced regions.
Microkeratome versus manually dissected donor tissue for Descemet stripping endothelial keratoplasty: A randomized prospective study
Authors: Mali Ritu , Priyadarshini Smruti R. , Sahu Srikant K. , Mohanty Amrita , Das Sujata 
Published: July 2024

Purpose:
To compare the visual outcomes, postoperative complications, and graft asymmetry between precut and manually dissected donor tissues for Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet stripping endothelial keratoplasty (DSEK) procedures, respectively.

Methods:
Seventy eyes of 70 patients undergoing DSEK/DSAEK at a tertiary eyecare center in eastern India were included in this prospective randomized control study. The 70 eyes were divided equally into two groups. Group A (n = 35) and Group B (n = 35) underwent DSEK and DSAEK procedures, respectively. the operating surgeons prepared the manually dissected corneal grafts using lamellar dissectors. the eye bank technicians prepared the precut corneal grafts using a microkeratome. The patients were investigated postoperatively after 1 day, 1 week, 1 month, 3 months, and 6 months. The data were compared for visual outcomes [uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical and cylindrical refraction, and spherical equivalent], incidence of postoperative complications, and pachymetry.

Results:
The mean age was 56.5 (±17.8) years, and the male-to-female ratio was 1.3:1. The most common indications were pseudophakic bullous keratopathy (45.71%, 32/70), failed graft (32.86%, 23/70), and Fuchs’ endothelial corneal dystrophy (10%, 7/70). The indications for surgery (P = 0.732) and donor (P = 0.258) and host pachymetry (P = 0.986) were comparable between both groups. There was no significant difference in change of UCVA, BCVA, and postoperative refraction (mean spherical refraction, P = 0.849; mean cylindrical refraction, P = 0.516; spherical equivalent, P = 0.518) between the two groups. Postoperative complications like graft detachment (P = 0.179), graft failure (P = 0.513), graft infiltrate (P = 0.428), and endophthalmitis (P = 0.493) were higher in the DSAEK group; however, the difference between the groups was insignificant. The graft asymmetry index was higher in DSAEK than in DSEK; the difference was significant till the 1-month follow-up (P = 0.005).

Conclusion:
The outcome was similar in both groups. Therefore, manual donor dissection can be an alternative for microkeratome-assisted dissection in low-resource centers and countries to achieve good results.
Clinical profile and outcomes of rejection after deep anterior lamellar keratoplasty in keratoconus
Authors: Sudaboina Priyanka , Chaurasia Sunita , Murthy Somasheila 
Published: July 2024

Purpose:
To report the clinical features and management outcomes of rejection after deep anterior lamellar keratoplasty (DALK).

Methods:
The clinical features, indications, predisposing risk factors, management, and outcome of six eyes of six patients with rejection after DALK were analyzed retrospectively.

Results:
The median time of rejection from the day of surgery was 12 (range 3–36) months. Median duration of symptoms was 4 (range 2–28) days. The indication for DALK was keratoconus in all eyes. The clinical features at presentation included graft haze, vascularization, and melt at the graft–host junction. The risk factors noted were noncompliance to steroids in all eyes, vernal conjunctivitis (four eyes), and eccentric graft (one eye). The rejection episode reversed with topical steroids in all eyes and intravenous methylprednisolone in one eye. One eye developed secondary fungal keratitis after initial recovery and one eye had a second episode of rejection 3 months later, which resulted in progressive vessels and lipid keratopathy in the visual axis. The median best corrected visual acuity was 20/40 (range 20/30–20/200).

Conclusion:
Severe stromal rejection can present with graft melt. Repeat episodes of rejection can occur on sudden cessation of topical steroids. Prompt recognition of clinical signs and symptoms with timely management helps in quick reversal of the rejection episode. Reversal of graft rejection results in good visual outcomes.
Therapeutic Potential of Adipose-Derived Stem Cells and Their Secretome in Reversible Alopecias: A Systematic Review
Authors: Ortega-Cuartiella Alexis 
Published: July 2024

ABSTRACT
Androgenic alopecia (AGA) and alopecia areata (AA) are two highly prevalent conditions, affecting both men and women of a wide range of ages, which strongly impact their quality of life and self-esteem. Both pathologies are deemed to be reversible, although conventional therapies have shown limited scope and efficacy. New therapeutic approaches, focusing on the degenerative changes that take place in the hair follicle, are needed to achieve better outcomes. For instance, adipose-derived stem cells (ADSC), abundant and easy to obtain, hold great potential in follicular regeneration. ADSCs can be isolated as stromal vascular fraction (SVF) by the enzymatic digestion of the lipoaspirate or as nanofat by the mechanical breakdown of adipocytes. In addition, commercial preparations of the conditioned medium of the ADSCs secretome (ADSC-conditionate medium [CM]) have entered the market as an appealing alternative because of their comparatively lower cost and accessibility. A search was conducted, crossing relevant terms, on PubMed Central and Google Scholar. Criteria for inclusion were studies in the past 10 years on humans with AGA or AA, where either SVF, nanofat, or ADSC-CM was tested as the main treatment. Eleven publications qualified: two studied nanofat, three, ADSC-CM, and six, SVF, either individually or in combination with other therapies. Only one randomized controlled trial (RCT) was found and classified as evidence 2b according to the Sackett scale. The rest were case–control studies or case series with small samples and no control, graded as evidence 3b and 4. A meta-analysis could not be conducted due to the heterogenicity of the study designs. Given the evidence obtained, Level D NICE recommendation was established. However, we consider that the positive findings are sufficiently consistent to support the elaboration of further RCTs that share criteria and methods.