bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case of extreme mushroom keratoplasty: Retional and long-term follow-up
Authors: Ladki Malik S. , Snyder Michael E. 
Published: February 2025

Abstract:
Full-thickness keratoplasties remain fraught with wound healing and optical problems. We report an enhanced mushroom keratoplasty technique, which maintains a wide anterior optical component of the graft and a smaller internal graft diameter, maximizing preserved host endothelium and graft host junction area. A comparative mathematical modeling of spherical caps and cylindrical areas were calculated for traditional, mushroom, and extreme mushroom keratoplasty techniques. An index case was identified, and its long-term follow-up was reviewed. Greater anterior–posterior trephination disparities provide a refractive advantage while increasing graft host junction and retained host endothelium areas. A case of traumatic, full-thickness axial corneal scarring treated with an extreme mushroom, penetrating keratoplasty had an acute graft rejection at 1 month and failed. Over 18 months, the cornea cleared, and clarity remains at 10 years (and counting). Increased contact area for stromal healing and retention of host endothelial reserve are maximized in extreme mushroom keratoplasty. A representative case demonstrates excellent optical performance without irregular astigmatism and the ability for residual host endothelium to clear a failed graft and has sustained long-term clarity after that.
Behçet syndrome with eye involvement
Authors: Ucar Didar , Esatoglu Sinem N. 
Published: February 2025

Abstract:
Behçet’s uveitis (BU) is a significant form of major organ involvement in Behçet syndrome and is associated with considerable morbidity. Ocular examination is crucial for diagnosing BS and detecting vitreous cells, even in asymptomatic patients. The primary goals in managing BU are to rapidly suppress ocular inflammation and prevent relapses. Initial treatment for posterior segment involvement in BU typically involves immunosuppressive agents combined with glucocorticoids. Biologic agents are increasingly used in BU management, including as first-line treatments for patients with poor prognostic risk factors or sight-threatening uveitis. There is no established consensus on when to discontinue or taper immunosuppressive therapy. Once remission is achieved, the absence of retinal vasculitis should be confirmed with fluorescein angiography, which should be utilized throughout the process of tapering immunosuppressive therapy. In addition to monoclonal tumor necrosis factor-alpha antagonists and tocilizumab, Janus kinase inhibitors may offer the potential for managing BU in the future.
New technique for enhancing the astigmatic correction of intracorneal ring segments in keratoconus eyes with a central cone
Authors: Bteich Yara , Mehanna Carl-Joe , Fattah Maamoun A. , Saad Alain , Antonios Rafic , Nasser Marc , Awwad Shady T. 
Published: February 2025

Abstract:

PURPOSE:
The purpose of this study was to present a case series describing a new simple technique of intrastromal corneal ring segment (ICRS) implantation that shortens the effective arc length of a segment and amplifies its effect on the corneal cylinder.

METHODS:
A 150° ICRS designed to be implanted in the 6-mm optical zone (OZ) (Intacs® SK) was instead implanted in a 7-mm OZ channel using a femtosecond laser.

RESULTS:
The decrease in manifest refraction spherical equivalent (MRSE) at 6 months was significantly less for the SK-7 group compared to the SK-6 group (2.21 ± 0.86 D vs. 8.87 ± 3.22 D, P = 0.004, respectively). The average central corneal power was also more pronounced in the SK-6 group (−2.19 ± 0.98D vs. −4.50 ± 2.87D, P = 0.20, respectively). Greater reduction in corneal and refractive cylinder magnitude (SimK) and vector was observed when Intacs® SK segments were implanted at 7-mm instead of 6-mm OZ. The SK-7 group gained more Corrected distance visual acuity (CDVA) lines at 6 months. The vector analysis variables including surgically induced astigmatic vector, difference vector, correction index, and index of success were all better when Intacs® SK was implanted at 7 mm.

CONCLUSION:
Shortening the effective arc length of the ICRS to 129° resulted in greater astigmatism correction with less effect on overall corneal flattening and MRSE. This technique would allow the surgeon to obtain a different effective ICRS arc length from the actual one and can be useful to reduce the inventory of ICRS in a given center.
Sosialisasi Penggunaan Alat Pemadam Api Ringan kepada Generasi Penerus Majelis Taklim AtTawabien Samarinda
Authors: Mustafa  , Harjanto  , Thahir Ramli 
Published: February 2025

Majelis taklim Attawabien merupakan tempat kegiatan siar islam yang memiliki lingkungan cukup komplek. Termasuk komponen didalamnya meliputi sarana kegiatan pengajian berupa meja, kursi dan alquran serta buku-buku islam penunjang lainnya yang bervariasi beserta fasilitas dan peralatannya. Sarana, fasilitas dan peralatan yang digunakan harus dipelihara sesuai dengan teknis dan fungsinya guna menjaga keamanan dan mencegah terjadinya resiko bahaya termasuk bahaya kebakaran. Upaya ini dilaksanakan dalam rangka memberikan rasa aman kepada para anak didik pada kegiatan pengajian, pengurus majelis taklim dan masyarakat disekitarnya. Tujuan kegiatan Pengabdian ini adalah terwujudnya peningkatan kesadaran dan pengetahuan masyarakat tentang tindakan yang harus dilakukan dalam menghadapi kebakaran serta betapa pentingnya pencegahan dan penanggulangan kebakaran bagi warga melalui sosialisasi tentang penggunaan alat pemadam api ringan kepada muda mudi generasi penerus di Majelis taklim At-towwibin jalan DR.Sutomo Samarinda dan juga terciptanya keharmonisan antara lingkungan civitas akademika dengan masyarakat tempat diadakannya program kegiatan pengabdian ini. Metodologi pelaksanaan program ini menggunakan metode sosialisasi dan tata cara penggunaan alat pemadam api ringan. Hasil dari kegiatan ini berupa laporan kegiatan, media cetak dan video kegiatan pengabdian kepada masyarakat serta sosialisasi tentang penggunaan alat pemadam api ringan kepada muda mudi generasi penerus di Majelis Taklim At-towwibin jalan DR.Sutomo Samarinda.
International Legal Aspects of Whale Hunting by Indigenous Legal Communities
Authors: Tahalea Rensy Elma Tahalea , Daties Dyah Ridhul Airin , Riry Welly Angela 
Published: February 2025

Introduction: Greenland in Denmark, Siberia in Russia, Bequia in the island nation of Saint Vincent and the Grenadines, Alaska in the United States, Canada and the Faroe Islands located in the North Atlantic Ocean are some of the countries that still practice traditional whaling. Unlike Japan, which conducts commercial whaling and uses modern tools. Indonesia is a country that recognizes indigenous peoples and their customary law in the constitution. The Leva Nuang tradition or Lewa tradition is a tradition of the Lamalera people in East Nusa Tenggara Province in carrying out whaling in a traditional way for their own needs. Whales themselves are protected animals in the Convention on International Trade In Endangerad Species of Wild Fauna and Flora (CITES 1973).Purposes of the Research: The issue discussed in this paper is how international legal instruments regulate whaling and how international law protects the right of indigenous peoples to carry out whaling traditions.Methods of the Research: The research method used is normative juridical, using a concept approach, a statutory approach and a case approach. The sources of legal materials used are primary, secondary, and tertiary legal materials. Analysis of such legal materials uses qualitative analysis techniques.Results of the Research: The results showed that the Convention on International Trade In Endangerad Species of Wild Fauna and Flora (CITES 1973) regulates protected animals, one of which is whales. There is also an international legal instrument governing whaling, the International Convention for the Regulation of Whaling (ICRW 1946). The Government of Indonesia ratified CITES 1973 on December 15, 1978 through Presidential Decree Number 43 of 1978. However, the 1946 ICRW Convention and ILO Convention 169 on Indigenous Peoples have not been ratified by the Indonesian government. Nevertheless, the Indonesian government recognizes and protects the rights of indigenous peoples, including the Leva Nuang tradition or Lewa tradition.
Legal Protection for Salak Riring as a Geographical Indication
Authors: Raihan Muhammad , Berlianty Teng , Soplanit Miracle 
Published: February 2025

Introduction: Registration of geographical indication protection of Salak Riring in West Seram Regency will popularize the area as a producer of quality salak fruit, increase sales, and contribute to local economic growth. This protection also provides legal certainty for producers, protecting the product from counterfeiting and misuse. Salak Riring, also known as Salak Merah, has been recognized as a superior commodity of West Seram Regency, Salak Merah received an award in the form of a Certificate from the Minister of Agriculture of the Republic of Indonesia Number 454/KPTS/PD.210/9/2003, and was designated as a national superior variety due to its distinctive botanical characteristics and high economic value.Purposes of the Research: The purpose is to examine and explain the legal protection of Salak Riring as a geographical indication.Methods of the Research: The research method used is normative juridical, which examines legal materials such as laws and regulations, legal theories, and opinions of scholars in order to solve the problems studied.Results of the Research: The results of this study show that the legal protection of Salak Riring as a geographical indication has a significant economic impact on the people of Riring Village in West Seram. The registration of Salak Riring provides legal protection and certainty to the community in production and marketing, and protects against counterfeiting or misuse. Salak Riring as one of the geographical indication products with special characteristics, makes legal protection a must to maintain the sustainability of quality production and sales.
Criminal Law Policy in Efforts to Combat the Illegal Distribution of Hard Drugs Without a Doctor's Prescription
Authors: Kabanga Yoshua Andres , Sopacua Margie Gladies , Saimima Judy Marria 
Published: February 2025

Introduction: Nowadays, there are many irregularities related to the Health Act. The urgency of problem solving arising from medication errors is very great because one type of medication error, namely administration error, ranks first compared to other types of medication errors. With the percentage of administration errors amounting to 81.32% of errors related to medical administration that occur in Indonesia.Purposes of the Research: To understand and explain the juridical responsibility that must be imposed on the perpetrators of selling prescription drugs without a doctor's prescription through online buying and selling sites.Methods of the Research: Research methods are used to find and process data in accordance with the research objectives and solve the problems posed by researchers.Results of the Research: The results showed that: (1). In Law Number 17 of 2023 concerning Health (hereinafter referred to as the Health Law) there are offenses that can be imposed on the perpetrator, these offenses are listed in Article 435 & Article 436. Article 435 states that every violation of medication error will be sentenced to imprisonment for a maximum of 12 (twelve) years or a maximum fine of Rp5,000,000,000.00 (five billion rupiah). Meanwhile, a person who does not have the expertise in the field of pharmacy in accordance with the provisions of the Law but continues to distribute pharmaceutical preparations will be subject to the offense in article 436 with a maximum imprisonment of 5 (five) years or a maximum fine of Rp. 500,000,000.00 (five hundred million rupiah).” Countermeasures against prescription drugs without a doctor's prescription can basically be dealt with by article 435 and article 436 of the Health Law, and there is a lot of evidence of the existence of these two articles that apply to offline prescriptions drug dealers. (2). Countermeasures against the distribution of prescription drugs through online buying and selling sites are still somewhat ambiguous because there is no law that specifically regulates the countermeasures of prescription drugs online, which causes a legal vacuum in countermeasures against the distribution of prescription drugs online. Therefore, elaboration, and hard work from every law enforcement officer is needed to tackle the problem.
Factors Contributing to Low Academic Performance of First-Generation Students in Occupational Therapy
Authors: Ham Pola 
Published: February 2025

Importance: Research on the factors contributing to low academic performance of first-generation students studying occupational therapy is limited, and how these factors affect the students’ academic performance is insufficiently described.
Objective: To explore how first-generation students in occupational therapy perceive their academic self-efficacy, academic engagement, and social integration.
Design: Explanatory sequential mixed-methods design.
Setting: Occupational therapy program on the East Coast of the United States.
Participants: The total sample included 18 first-generation students in occupational therapy through purposeful sampling. Eighteen participants completed the survey, and 5 participants participated in the interview.
Outcomes and Measures: Measures included a demographic questionnaire, the Self-Efficacy for Learning Form–Abridged, the Survey of Student Engagement, the Social Integration Scale, and semistructured interviews.
Results: Participants reported a low level of academic self-efficacy, academic engagement, and social integration.
Conclusions and Relevance: This study fills the gap in research regarding factors contributing to low academic performance of first-generation students in occupational therapy and how the identified barriers of academic self-efficacy, academic engagement, and social integration can be addressed for these students.
Plain-Language Summary: This study explored how first-generation occupational therapy students think about their academic performance, engagement, and social integration. Students reported a low level of academic performance, engagement, and social integration. Identifying and understanding the factors that affect the academic performance of first-generation students can improve the support and services provided by occupational therapy programs to first-generation students.
Positionality Statement: Positionality is described as the location of the researcher in their research (Milner, 2007). It influences the researcher’s assumptions, findings, and interpretations (Banks, 2015). As a first-generation doctoral student, I identify with the unique challenges faced by many first-generation students. As Milner (2007) suggested, it is important to be introspective during research and acknowledge any internal biases to maintain objectivity during the research process. I aimed to be reflexive by taking notes about my thoughts throughout the study to actively reflect on my understanding of how my positionality may affect my data collection and analysis.
Endometrial thickness as a predictive value of ectopic pregnancy in in-vitro fertilization/intracytoplasmic sperm injection cycles: a case-control study
Authors: Alsadhan Haifa F. , Aljahdali Ghadeer L. , Alfaraj Samaher S. , Masud Nazish , Almutlaq Mutlaq , Alwasel Lujain , Alfaraj Lena H. , Abualburak Salem , Alrabieaa Hayat , Alsalman Fahad 
Published: February 2025

BACKGROUND:
The incidence rate of ectopic pregnancy (EP) with assisted reproductive technology (ART) has been reported to be higher than that of spontaneous pregnancy. Endometrial thickness (EMT) is considered an independent risk factor.

OBJECTIVES:
Evaluation of endometrial thickness as a predictor of ectopic pregnancy in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles.

DESIGN:
Case-control study

SETTING:
Women's Health Specialist Hospital, formerly known as King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.

PATIENTS AND METHODS:
This study was a 1:2 matched case–control study that enrolled 24 ectopic pregnancy patients and 50 matched intrauterine pregnancy patients. They were matched on maternal age, the presence of tubal factor, and parity. The estimated sample size for patients with ectopic pregnancy was 25–30, whereas that for controls was estimated to be 60 patients. The sampling technique was a purposive (nonprobability).

MAIN OUTCOME MEASURES:
Endometrial thickness after IVF/ICSI is a predictor of ectopic pregnancy.

SAMPLE:
79 patients

RESULTS:
Multivariate logistic regression analysis was performed to analyze EP predictors, and a receiver operating characteristic (ROC) curve was used to evaluate the predictors of EP. After adjustment for other factors in the logistic regression model, we found that the tubular factor increased the risk of EP by 7.6 times, whereas the ovarian factor significantly decreased EP by 85%. Other factors, including EMT, did not significantly affect the probability of developing ectopic pregnancy.

CONCLUSIONS:
EMT was not predictive nor protective of EP in women who underwent ART cycles. Nevertheless, the presence of tubular factors has strong predictive value, whereas ovarian factors have significant protective value against EP.

LIMITATIONS:
The study design affects the generalizability and level of evidence provided. The small sample size and single-center inclusion had an impact on the results and statistical tests used.
Nontraumatic headaches in the emergency department: identifying clinical associations and predictive warning signs of intracranial pathologies
Authors: Alghamdi Abdulaziz M. , Alghamdi Abdulkarim M. , Allarakia Yousof Fahad , Alghamdi Arwa S. , Alrashid Abdulaziz S. , Alotaibi Abdulwhab M. , Addas Reem , Lary Ahmed I. 
Published: February 2025

BACKGROUND:
Although headaches are common, only 3–21% are estimated to be secondary, with their causes ranging from non-alarming to life-threatening conditions.

OBJECTIVES:
Evaluate the associated factors and predictive warning signs of intracranial pathologies in patients presenting with nontraumatic headaches to the emergency document (ED).

DESIGN:
Retrospective chart review

SETTINGS:
Medical center in Jeddah

PATIENTS AND METHODS:
Data were collected from all patients who presented to the ED with nontraumatic headaches and underwent brain computed tomography (CT) scans from September 2021 to September 2022.

MAIN OUTCOME MEASURES:
The associated factors and predictive warning signs of intracranial pathologies.

SAMPLE SIZE:
387

RESULTS:

Sixty-seven (17.31%) patients had intracranial pathologies. The median (IQR) age of all patients was 49 (23) years and females constituted 61.8%. Patients with intracranial pathologies were significantly more likely to have severe headaches (59.7% vs. 33.7%,
P
<.001), to have compressing or sharp headaches (16.4% vs. 6.2%, P=.003), to have constant headaches (16.4% vs. 7.8%,
P
=.003), to be on chemo-therapy or radiotherapy (10.5% vs. 2.8%,
P
=.004), and to be smokers (13.4% vs. 6.2%,
P
=.042) than the other group. Multiple logistic regression of headache warning signs revealed that significant changes or progression in pattern, frequency, or severity of headache (OR: 3.2, CI: 1.5–6.6,
P
=.001), motor deficits, including abnormal reflexes (OR: 2.9, CI: 1.2–6.9,
P
=.011), personality changes, confusion, memory impairment, drowsiness, slurred speech or loss of consciousness (OR: 2.6, CI: 1.4–5.0,
P
=.002), and sudden onset of headache (OR: 1.9, CI: 1.0–3.6,
P
=.046) were predictive of intracranial pathologies.

CONCLUSIONS:
Our findings suggest that these four headache warning signs can help physicians predict intracranial pathologies and subsequently decide which patients should undergo brain imaging in non-traumatic headache cases.

LIMITATIONS:
Single-center study and retrospective design
Incidence, outcomes, and mortality risk factors of acute kidney injury in critically ill children: a tertiary care center study in Saudi Arabia
Authors: Alayed Tareq , Alansary Abdulaziz , Al-Nahdi Mohammed , Alotaibi Abdullah , Alhuthil Raghad , Al Abdulsalam Moath , Aljofan Fahad , Alturki Abdullah , Alofisan Tariq 
Published: February 2025

BACKGROUND:
Acute kidney injury (AKI) is a critical concern in pediatric intensive care units (PICUs) due to its high mortality rate.

OBJECTIVES:
Investigate AKI incidence, outcomes, and mortality-related risk factors among critically ill children.

DESIGN:
Retrospective cohort

SETTING:
A PICU

PATIENTS AND METHODS:
The study included children (aged 4 weeks to 14 years) who were admitted to the PICU from (2016 to 2019) and developed AKI at King Faisal Specialist Hopsital and Research Centre.

MAIN OUTCOMES MEASURES:
AKI incidence, outcomes, and mortality-related risk factors.

SAMPLE SIZE:
111 records of patients with AKI

RESULTS:

Of 969 PICU admissions, 111 cases developed AKI and were entered in the analysis, with an incidence rate of (11.5%). The median age was 43 months [interquartile range (IQR): 16–120], with hematology/oncology conditions being the most prevalent underlying diseases (56.8%). Septic shock and nephrotoxin medications were the leading causes of AKI, accounting for (46.8%) and (45.0%), respectively. Regarding AKI severity, (37.8%) were classified as stage 1, (25.2%) as stage 2, and (37.0%) as stage 3 AKI. As for PICU interventions, the highest was inotropic support (63.1%), followed by mechanical ventilation (56.8%) and renal replacement therapy (23.4%). The PICU mortality rate was (38.7%) (43/111), with no significant association between AKI stage and mortality. However, the multivariable analysis identified bone marrow transplant (BMT) (
P
=.042) and inotropic support (
P
=.001) as significant predictors of mortality.

CONCLUSION:
These findings underscore the importance of early recognition and tailored management of AKI in PICU settings. Despite advancements in critical care, AKI remains a significant challenge, contributing to prolonged hospitalization, mortality, and increased health-care resource utilization. Therefore, more investigation is warranted.

LIMITATIONS:
Retrospective study single-center nature.