bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Dry Eye Syndrome on Vision-Related Quality Of Life
Authors: Javaid Afifa , Hayat Sakina , Khan Muhammad Rizwan , Ghalib Saba , Akram Sehrish , Latif Muhammad Hammad 
Published: February 2025

Objective: To assess the extent to which dry eye syndrome Impacts the quality of life related to vision in patients.
Study design: It was a descriptive cross-sectional hospital-based study
Place and duration of study: The study was conducted at Ophthalmology Department of Holy Family Hospital from 1st July 2023 to 10th December 2023.
Material and Methods: The study was conducted among 50 patients diagnosed with dry eye syndrome. Patients completed the Ocular Surface Disease Index (OSDI) questionnaire,Patient Performa and underwent clinical assessments for dry eye syndrome severity. A Tear Film Breakup Time Test (TBUT) was performed to assess the level of dry eye.
Results: Dry eye syndrome significantly impaired quality of patients’ life related to vision, with symptoms like blur vision, discomfort, watering and photophobia. Females (76%) were more affected than males (24%). OSDI scores show mild, moderate and severe dry eye. IT students, individuals were having high screen time, adults (aged between 40 to 55 years) and older individuals were affected mostly. Individuals with severe dry eye symptoms reported greater difficulty in daily activities such as reading, during driving, while using a computer or ATM machine and while watching television associated with more severity and decreased quality of life. Windy conditions and low humidity areas were also problematic for the dry eye patients.
Conclusion: OSDI Questionnaire shows that the dry eye syndrome significantly influences the quality of life related to vision for individuals, impacting their daily activities and emotional well-being. So, there is a need for comprehensive management strategies that address both the physiological symptoms and associated decline in quality of life. Further research should be conducted to develop targeted interventions and improve the overall well-being of individuals with dry eyes.
Determinat of Tax Aggressiveness in Banking Companies at 2021-2022 Period
Authors: Anggraeni Annisa Fitri , Roswinna Winna , Yulianti Maria Lusiana , Putri Kartika Pratiwi , Aisyah Taty Siti 
Published: February 2025

This study aims to analyze the influence of liquidity, earnings management, independent commissioners, and executive compensation of tax aggressiveness. The population in the study is a Banking Company Registered in Indonesia Stock Exchange in the period 2021-2022. The sample is taken by using purposive sampling method, where the banking company that issued the financial statements, did not move sector, listed its shares and did not have negative profit during the period 2021-2022. The design in the study is hypothesis testing, where the sample consists of 60 samples. Data processing using multiple linear regression with eviews 13.The results of this study found that liquidity, earnings management and independent komisais affect tax aggressiveness, while executive compensation does not affect the aggressiveness of taxes. Based on total adjusted R-Square results prove that liquidity, earnings management, independent commissionist, and executive compensation only affect 65.8%, while 24.2% is influenced by other variable not tested in this research.
Multiwavelength Variability Analysis of the Blazar PKS 0727-11: An ~ 168 day Quasiperiodic Oscillation in the γ-Ray
Authors: Shen Yuncai , Yi Tingfeng , Dhiman Vinit , Mao Lisheng , Dong Liang 
Published: February 2025

Abstract
We performed variability analysis of the multiwavelength light curves (LCs) for the flat-spectrum radio quasar PKS 0727-11. Using the generalized Lomb–Scargle periodogram, we identified a possible quasiperiodic oscillation (QPO) of ~168.6 days (persisted for six cycles, with a significance of 3.8σ) in the γ-ray LC during the flare period (MJD 54687–55738). It is the first time that periodic variations have been detected in this source, and further supported by other methods: weighted wavelet z-transform, phase dispersion minimization, REDFIT, autoregressive integrated moving average model, and structure function analysis. Cross-correlation analysis shows that there is a strong correlation between multiband light variations, indicating that γ-ray and radio flares may originate from the same disturbance, and the distance between the emission regions of γ-ray and radio flares is calculated based on the time lag. We demonstrate that QPO arising from the non-ballistic helical jet motion driven by the orbital motion in a supermassive binary black hole is a plausible physical explanation. In this scenario, the estimated mass of the primary black hole is M ∼ 3.66 × 108–5.79 × 109
M
⊙.
A Study on the Line of Sight to Galaxies Detected at Gamma-Ray Energies
Authors: Furniss Amy , Amador Josepf N. , Hervet Olivier , Jackson Ollie , Williams David A. 
Published: February 2025

Abstract
The large-scale universal structure comprises strands of dark matter and galaxies with large underdense volumes known as voids. We measure the fraction of the line of sight that intersects voids for active galactic nuclei (AGN) detected by Fermi Large Area Telescope (LAT) and quasars from the Sloan Digital Sky Survey (SDSS). This “voidiness” fraction is a rudimentary proxy for the density along the line of sight to the galaxies. The voidiness of SDSS-observed quasars (QSOs) is distinctly different from randomly distributed source populations, with a median p-value of 4.6 × 10−5 and ≪1 × 10−7, when compared with 500 simulated populations with randomly simulated locations but matching redshifts in the 0.1 ≤ z < 0.4 and 0.4 ≤ z < 0.7 intervals, respectively. A similar comparison of the voidiness for LAT-detected AGN shows median p-values greater than 0.05 in each redshift interval. When comparing the SDSS QSO population to the LAT-detected AGN, we mitigate potential bias from a relationship between redshift and voidiness by comparing the LAT-detected AGN to a “redshift-matched” set of SDSS QSOs. The LAT-detected AGN between a redshift of 0.4 and 0.7 show higher voidiness compared to the redshift-matched SDSS QSO populations, with a median p-value of 2.3 × 10−5 (a 4.1σ deviation). No deviation is found when comparing the same populations between redshifts of 0.1 and 0.4 (p > 0.05). We do not study possible causes of this voidiness difference. It might relate to propagation effects from lower magnetic or radiative background fields within voids or to an environment more favorable for gamma-ray production for AGN near voids.
Experiences of Athletic Trainers Following the Death of a Student-Athlete by Suicide, Part 2: Institutional and Personal Response
Authors: Milliet Maegan M. , Neil Elizabeth R. , Torres-McGehee Toni M. , Gilmore Ginger , Moore Kenya , Winkelmann Zachary K. 
Published: February 2025

Context:
The NCAA's 2016 and 2024 Mental Health Best Practice documents outline essential guidelines for athletic programs, including mental health recognition, referral pathways, and critical incident management. Despite these recommendations, there remains a significant gap in literature and practice regarding the response to and management of suicide bereavement among athletic trainers (ATs), highlighting the need for further exploration of their experiences and institutional responses following a student-athlete's death by suicide

Objective:
To explore the lived experiences of collegiate ATs following the death of a student-athlete by suicide.

Design:
Qualitative.

Setting:
Individual interview.

Participants:
12 ATs (age=37±7 years; credentialed experience=14±7 years) who were providing patient care to a student-athlete who died by suicide.

Main Outcome Measures:
Each AT completed a semi-structured, audio-only interview. Interviews were audio-recorded and transcribed verbatim. Analysis followed the consensual qualitative research tradition using a 3-person coding team. Credibility and trustworthiness were established through member checking, triangulation, and internal auditing.

Results:
Participants revealed several experiences and reactions following the death of a student-athlete by suicide that focused on their institutional reaction, their emotional reaction and coping mechanisms, and shared advice for other ATs moving forward. Following the student-athlete death by suicide, ATs shared their institutional reaction, which included a collaborative approach with resources and changes to policy, procedures, and their overall system. They also shared their emotional reaction and coping mechanisms following the death, which included a grief response influenced by guilt, concern for other student-athletes, and the use, and lack of use, of support systems and formal therapy. Finally, they provided shared advice concerning death by suicide that included taking care of oneself and taking mental health seriously.

Conclusions:
Following the death, most participants expressed grief and concern for others but often did not recognize themselves as needing help. Institutional policy and provider postvention strategies are recommended.
Hip Abductors Strength and Endurance in Individuals with Recent and Long-Standing Patellofemoral Pain
Authors: Van Cant J. , Serres W. , Farraj M. , Nguyen AP. , Tittley J. , Briani RV. , Roy JS. 
Published: February 2025

Context:
Numerous studies report deficits in hip muscle performance in individuals with patellofemoral pain (PFP). However, the exact stage at which these deficits emerge and the impact of symptom duration remain unclear.

Objective:
To compare hip abductor strength and endurance based on the presence or absence of PFP and its duration.

Design:
Cross-sectional study

Patients or Other Participants:
68 with PFP and 29 pain-free controls

Main Outcome Measure(s):
We evaluated isometric maximal strength, isometric endurance, and dynamic endurance of hip abductors. Comparisons were made between participants with PFP and pain-free controls and among different PFP duration subgroups (&lt; 12 months, ≥ 12 months, ≤ 6 months, &gt; 24 months) and pain-free controls.

Results:
Hip abductor isometric strength (% body mass [BM]) was significantly lower in the PFP group (203.8 ± 46.8) and all PFP subgroups (&lt; 12 months: 203.9 ± 57.0; &gt; 12 months: 203.7 ± 42.2) (≤ 6 months: 205.1 ± 59.6; &gt; 24 months: 207.7 ± 41.9), compared to pain-free controls (254.6 ± 60.3). However, no significant differences were found between PFP subgroups. There were also no significant differences in hip abductor isometric or dynamic endurance between PFP group and pain-free controls, or between PFP subgroups and pain free controls.

Conclusions:
Hip abductors strength deficits emerge early in the course of PFP. However, further studies are needed to understand the observed lack of difference in endurance.
Systematic Review on Technical Aspects and Clinical Outcomes of Various Diagnostic Modalities in Breast Imaging: Have We Still Got a Full Proof Modality?
Authors: Modi Swati , Kothari Sandhya 
Published: February 2025

Abstract
Identification of breast cancer at early stage is essential for theinitialization of treatment of patient. Mammography, ultrasound (US), and magnetic resonance imaging (MRI) each have pros and cons, and preoperative marking is essential. A multimodal approach and teamwork optimize patient care. Therefore, this review aims for the study on different aspects of the various diagnostic modalities in breast imaging. The present systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, incorporating an extensive search across major electronic databases. It includes diverse study types, comprising of analytical studies and full-text literature. The review specifically includes studies that provide information about breast imaging modalities. The risk of bias in this study was assessed using the recommended methodology. A total of 14 studies on breast imaging modalities were included. These studies collectively examined 295,262 cases, with an average participant age of 54 years. Most of the studies utilized US and MRI for diagnosing breast cancer. Specifically, US improves the screening p ability to identify cancer in women at average risk. Breast imaging modalities such as MRI and digital breast tomosynthesis enhance cancer diagnosis but may lead to an increase in false positives. Artificial intelligence in breast cancer care faces challenges such as verifying algorithms and overcoming biases. Future initiatives should prioritize large-scale research and transparent models to enhance results and eliminate inequities.
Frequency and Antifungal Susceptibility Patterns of Candida Species Isolated from Clinical Samples of Patients Attending to a Tertiary Healthcare Setting in Karnataka, India
Authors: Ashraf Asem Ali , Karnaker Vimal Kumar , Ramanath Ganesh , Roy Anulekha , Raveendran Athira , Nag Sayantani 
Published: February 2025

Abstract

Context:

Candida species are common pathogens causing a range of infections from mucocutaneous to systemic. The increasing antifungal resistance among Candida species presents a substantial challenge in healthcare settings.

Aims:
This study examines the distribution and antifungal susceptibility patterns of Candida species to provide insights into regional epidemiology and resistance.

Settings and Design:
A retrospective, observational, single-center study was conducted to analyze the distribution of Candida species in various clinical samples and their antifungal susceptibility patterns at Justice K. S. Hegde Charitable Hospital, a 1000-bed tertiary healthcare teaching hospital in Mangalore.

Subjects and Methods:

Candida identification was performed using automated identification systems, while antifungal susceptibility testing was done using the VITEK 2 AST YS08 system. Relevant clinical information from electronic medical records of all positively identified Candida species cases was reviewed and recorded.

Statistical Analysis Used:
Statistical Package for Social Sciences (SPSS) software version 20 was used to evaluate, code, verify, and statistically analyze the acquired data.

Results:
In total, 701 Candida isolates were identified, with C. albicans being the most common species (290, 41.4%). Among non-albicans Candida, C. tropicalis (209, 29.8%) was predominant, followed by C. parapsilosis (91, 13%), C. glabrata (32, 4.6%) and C. krusei (32, 4.6%). Resistance patterns showed C. krusei and Candida auris had the highest resistance to fluconazole and voriconazole. Sensitivity was highest for micafungin and caspofungin. Most patients had type 2 diabetes or hypertension as comorbidities.

Conclusions:
Resistance patterns varied by species, revealing differences from international studies. The results underscore the importance of ongoing local surveillance and epidemiological studies to monitor antifungal resistance. Understanding species distribution and resistance mechanisms is essential for effective treatment strategies and controlling invasive Candida infections. Enhanced local data can help in optimizing antifungal therapies and preventing resistance.
Evaluation of Newborn Hearing Screening Programs in Riyadh, Saudi Arabia: A Mixed Methods Study
Authors: Alanazi Ahmad A. , Alothman Noura I. , AlHarbi Mohammed F. , Alkhalaf Alanood , Almsened Alshima , Alzahrani Manar , Alsawaji Hana 
Published: February 2025

Abstract

Background:
Newborn hearing screening (NHS) programs were established globally to reduce the negative consequences of hearing loss. Limited information is available about NHS programs in Riyadh and Saudi Arabia generally. This study explored how NHS programs are conducted in healthcare settings for quality assurance.

Methods:
The concurrent triangulation mixed methods design was used to gather data from the supervisors of NHS programs who were invited to answer a questionnaire and set for a structured interview. The questionnaire consisted of two categories: the facility and test personnel, and the test protocol. The structured interview included two questions about these programs’ opportunities and challenges.

Results:
Data were collected from 24 participants who represented 11 public and 13 private healthcare facilities in Riyadh. The results showed that nurses were the most test personnel who were primarily trained by audiologists. Less than half of NHS programs were supervised by audiologists. The combination of otoacoustic emissions and automated auditory brainstem responses was the most used test protocol. More than half of newborns who failed the first NHS were referred to audiology clinics within a month of the first screening. Most test personnel were not trained on how to counsel parents. The interview resulted in one core category, three themes, and 15 subthemes. Low parental awareness about the NHS was identified, with suggestions to educate parents on the NHS before and after the screening. Not all insurance companies include NHS in all their insurance classes.

Conclusions:
Establishing a tracking system and standardizing test protocols with a surplus of test personnel and equipment were identified as areas for improvement. The Council of Health Insurance in Saudi Arabia is recommended to include NHS as a mandatory screening for all patients in the private sector, either covered by insurance or cash-pay patients.
Psychophysiological Biomarkers for the Effects of Yoga as an Alternative Therapy among Healthcare Professionals with Chronic Low Back Pain: A Randomized Controlled Trial
Authors: Saleem Yusra , Noushad Shamoon , Ahmed Sadaf , Ansari Basit 
Published: February 2025

Abstract

Aims:
This trial investigates the effects of Sphinx Pose Yoga therapy on psychophysiological outcomes in healthcare professionals (HCPs) suffering from chronic low back pain (CLBP). By examining the changes in key biomarkers (Substance P, beta-endorphins, and cortisol), this study aims to compare yoga therapy to standard care in terms of improvement in pain intensity, disability, stress levels, and quality of life.

Settings and Design:
Koohi Goth Women’s Hospital, Randomized Controlled Trial.

Subjects and Methods:
A total of 221 HCPs (nurses and midwives) with CLBP were enrolled. Out of these, 140 were randomly assigned to either Group A (Sphinx Yoga therapy) or Group B (usual care) for 12 weeks. The study assessed pain relief, disability, quality of life (QoL), and physical stress using psychophysiological biomarkers, and social and physical parameters. Evaluations were conducted at baseline and postintervention (after 12 weeks) to measure the impact of the interventions.

Statistical Analysis Used:
Baseline data were analyzed using χ² tests and independent sample t-tests. Paired sample t-tests were used for pre- and postintervention comparisons. One-way analysis of variance identified differences between groups at follow-up, and analysis of covariance adjusted for potential confounders.

Results:
Our findings support the hypothesis that the Sphinx Yoga Pose reduces pain, disability, physical stress, and improves the QoL among HCPs with CLBP. A significant variation was observed in psychophysiological biomarkers, with a decline in substance P and cortisol levels and elevated β-endorphin levels among Group A subjects compared to those in Group B after 12 weeks of yoga therapy. The assessed parameters, disability, quality of life, and stress scores significantly improved post-intervention in Group A. No serious adverse events were reported during the study. Although some participants experienced minor and temporary discomfort during the initial sessions, these issues were manageable. Hence, no participant withdrew from the study due to these issues.

Conclusions:
Offering a 12-week Yoga therapy to HCPs with CLBP significantly reduced pain, increased functional ability, and improved QoL. Sphinx Yoga Pose emerged as an effective alternative therapy for managing CLBP among healthcare professionals.
Incidence, Risk Factors, and Outcomes of Postoperative Atrial Fibrillation after Cardiac Surgery
Authors: AlHamzah Musaad , Alokayli Shirin , Alarify Ghadah A. , Alghamdi Abdullah , Alsultan Fahad , Alsulais Naif , Asfina Kazi Nur , Zamzam Abdelrahman , Alayadhi Walid , Alqarawi Wael 
Published: February 2025

Abstract

Objective:
Postoperative atrial fibrillation (POAF) is a known complication after cardiac surgery. This study investigated the incidence, perioperative outcomes, and predictors of POAF.

Methods:
We conducted a retrospective review of all eligible patients undergoing cardiac surgery procedures at King Khalid University Hospital, Riyadh, Saudi Arabia, between April 2015 and June 2021. Prespecified demographic, perioperative, and comorbidity data were collected, and summary statistics were done.

Results:
The incidence of POAF was 10.8% (114/1053 patients). Most patients had POAF detected in the first 72 h, except those who underwent septal defect repair procedures. Patients who developed POAF had significantly higher rates of complications, including major adverse cardiovascular events, pneumonia, bleeding and shock, acute kidney injury, and congestive heart failure (all had a P ≤ 0.005). Advanced age and increased body mass index were the preoperative predictors of POAF. Furthermore, undergoing coronary artery bypass grafting (CABG), valve replacement surgery, or a combined procedure were also predictors of POAF.

Conclusion:
POAF after cardiac surgery is a common complication with increased risks of significant complications. Efforts to prevent POAF incidence are required through prediction and preventive measures. More studies are needed to determine if early detection and prompt treatment could mitigate the clinical sequelae of POAF.
Enhancing Breastfeeding Outcomes: Nurse-Led Interventions in Breast Hygiene for Primigravida Mothers—A Mixed-Methods Analysis
Authors: Madhan Jamuna , Ethiraj Theranirajan , Rajendran Shankar Shanmugam , Vijayalakshmi Valveeman , Murugan Uma , Wilson Vinitha 
Published: February 2025

ABSTRACT

Background:
Breastfeeding is vital for maternal and infant health, offering unparalleled benefits and fostering emotional bonding. However, many primigravida mothers face challenges such as latching issues, nipple pain, and concerns about milk adequacy. Insufficient knowledge and inconsistent breast hygiene practices exacerbate these difficulties.

Aims:
This study explores breastfeeding experiences among primigravida mothers and evaluates a nurse-led intervention aimed at improving breast hygiene knowledge and practices.

Materials and Methods:
Using a mixed-methods approach, qualitative data were analyzed phenomenologically, while quantitative data followed a quasi-experimental pre-test/post-test control group design. Sixty mothers were equally divided into experimental and control groups. Data collection included interviews and pre/post-intervention assessments. The experimental group underwent a structured breast hygiene education program.

Results:
Key themes identified were physical challenges, emotional impacts, breastfeeding support, and knowledge about breastfeeding. Post-intervention, the experimental group showed significant improvements in breast hygiene knowledge (36.33% to 69.58%) and practices, unlike the control group. Sociodemographic factors, such as age, education, and family type, correlated with improved knowledge in the experimental group.

Conclusion:
Nurse-led educational interventions significantly enhance breast hygiene knowledge and practices in primigravida mothers. Tailored strategies should be integrated into maternal health programs to improve breastfeeding outcomes.