bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of simulated cataract on the accuracy of artificial intelligence in detecting diabetic retinopathy in color fundus photos
Authors: Crane Alexander B , Choudhry Hassaam S , Dastjerdi Mohammad H 
Published: December 2023

Purpose:
Artificial intelligence (AI) is often trained on images without ocular co-morbidities, limiting its generalizability. This study aims to evaluate the accuracy of a convolutional neural network (CNN) applied to color fundus photos (CFPs) with simulated cataracts (SCs) in detecting diabetic retinopathy (DR).

Methods:
A database of 3662 CFPs (from Asia Pacific Tele-Ophthalmology Society (APTOS) 2019) was used. Using transfer learning, a CNN was trained to classify the training images as either DR or non-DR. The CNN was then applied to classify the testing images after an SC was applied, using varying degrees of Gaussian blur.

Results:
Accuracy without SC was 97.0%, sensitivity (Sn) 95.7%, specificity (Sp) 98.3%. For mild SC, accuracy was 93.1%, Sn 91.8%, Sp 94.3%. For moderate SC, accuracy was 62.8%, Sn 31.4%, Sp 95.2%. For severe SC, accuracy was 53.5%, Sn 11.8%, Sp 96.5%.

Conclusion:
SCs significantly impaired AI accuracy. To prepare AI for clinical use, cataracts and other real-world clinical challenges affecting image quality must be accounted for.
Reasons for declining corneal refractive laser correction for refractive candidates in Southern India
Authors: Anitha Venugopal , Rajaraman Revathi , Periasamy Mangala , Ravindran Meenakshi , Rangappa Ramakrishnan , Uduman Mohammed Sithiq 
Published: December 2023

Purpose:
To analyze the reasons for declining corneal refractive laser correction procedures in patients presenting to tertiary eye care centers in Tamil Nadu, Southern India, and review the literature.

Methods:
Retrospective case records of subjects presenting from January 2019 to December 2021 for refractive surgery workup were analyzed. Demographic details and refractive parameters of patients rejected for corneal refractive laser corrections (CRLC) were documented and reviewed.

Results:
A total of 2358 patients presented for refractive surgery evaluation during the study period, and out of them, 395 patients (16.8%) were not considered ideal candidates for undergoing CRLC. The common reasons for rejecting the patients were unfit topography (n = 110, 27.8%), unstable refraction over a one-year duration (n = 9, 2.27%), low corneal thickness (n = 85, 21.5%), keratoconus (n = 5, 12.9%), and other ocular and systemic disorders (n = 48, 12.1%).

Conclusion:
There was a marked change in magnitude and rationalization for not performing either laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy in our study. The reasons are unfit topography, keratoconus, and systemic disorders, which were diagnosed during pre-LASIK screening workup, being the most common cause for rejecting patients for corneal refractive corrections.
Late postoperative vitreous cavity hemorrhage after vitrectomy for proliferative diabetic retinopathy—observation versus intervention
Authors: Brar Anand S , Behera Umesh C , Karande Sayali , Kanakagiri Akhila , Sugumar Shalini , Rani Padmaja K , Vignesh T P , Manayath George , Salian Romit , Giridhar Anantharaman , Indurkhya Swati , Bhattacharjee Harsha , Raman Rajiv , Sivaprasad Sobha 
Published: December 2023

Purpose:To analyze the outcome of intervention versus observation for vitreous cavity hemorrhage occurring after a 2-month period of blood-free cavity (late postoperative vitreous cavity hemorrhage—POVCH) in eyes operated by vitrectomy for complications of proliferative diabetic retinopathy (PDR).Methods:This study was a 10-year retrospective, observational, multi-center study involving eight major vitreoretinal surgical centers across India from January 2010 to December 2019. The primary objective of the study was to assess the visual and clinical outcomes of various management approaches for late POVCH. The key secondary objective was to determine the best management option that prevented recurrence. Patients with follow-up of less than 6 months of POVCH management were excluded.Results:The occurrence of late POVCH was studied in 261 eyes. The median time to occurrence was 7 months (range: 2–87) postvitrectomy/silicone oil removal. The majority (58%) experienced a single, nonrecurring POVCH event. Visual acuity outcome was independent of all management approaches (P= 0.179; mean follow-up 20.7 ± 14.1 months). With watchful observation, spontaneous resolution was noted in 83% (60/72 eyes) of eyes in 81.5 days (interquartile range, 169.75). Silicone oil injection was most effective in preventing recurrence (P< 0.001).Conclusion:The current treatment practice of late POVCH management in PDR suggests that watchful observation for at least 3 months could be as efficacious as any surgical intervention.
An outbreak of subhyaloid hemorrhage after accidental laser exposure during an Indian festival
Authors: Shah Rachana Prashant , Dabre Zeenal George , Sengupta Sabyasachi 
Published: December 2023

Purpose:
To report the clinical manifestations and outcomes of patients who experienced retinal damage due to accidental laser exposure during a festival in Kolhapur, Maharashtra.

Methods:
Consecutive patients who presented with sudden loss of vision following exposure to laser lights during a religious Indian festival (Ganapati festival) on the same day (9 September 2022) at the same location (idol visarjan procession) were identified from the medical records of various eye hospitals in Kolhapur district of Maharashtra. Eyes with persistent subhyaloid hemorrhage (SHH) were taken up for neodymium-doped yttrium aluminum garnet (Nd: YAG) posterior hyaloidotomy. Patients were examined at weekly intervals up to 1 month.

Results:
Thirty-four eyes of 34 men were identified with age ranging from 18 to 27 years. The mean duration of exposure to the laser projections was 4.9 ± 1.7 h, and the mean distance from the laser source was 7.3 ± 2.7 feet. All presented with SHH involving the macula. SHH had a median size of 3 disc diameters or larger in 30 eyes (88%), and 29 (97%) of these required hyaloidotomy while one patient underwent pars plana vitrectomy. The mean visual acuity improved from 1.45 ± 0.5 log of minimum angle of resolution (logMAR; 20/560 Snellen) to 0.11 ± 0.19 logMAR (20/25 Snellen) (P < 0.001). One eye showed full-thickness macular hole with visual acuity of 20/200.

Conclusion:
We report a large number of patients experiencing laser-induced SHH, resembling an outbreak, due to exposure to a malfunctioning high-powered recreational laser during a religious festival.
Surgical challenges of posterior optic capture in pediatric cataract surgery
Authors: Sukhija Jaspreet , Kaur Savleen , Korla Shagun , Kumari Kiran 
Published: December 2023

Purpose:
The efficacy of posterior optic capture (POC) in reducing posterior capsule opacification (PCO) in pediatric cataract is well recognized. The purpose of this paper was to identify the surgical challenges when attempting this technique and highlight the etiquettes to follow when performing this maneuver.

Methods:
Prospective observational noncomparative case series. Children diagnosed with congenital or developmental cataracts undergoing cataract surgery and primary IOL implantation with posterior optic capture (and no anterior vitrectomy) from June 2017 to April 2022 at a tertiary care referral institute were included. Records of all intraoperative findings and postoperative complications until the last follow-up were noted.

Results:
Posterior optic capture was attempted in 53 eyes of 49 children aged 2.4 ± 1.98 years. The mean follow-up of the patients was 16.5 ± 14.2 months (range 6 months–5 years). Successful POC could be performed in 46 eyes (86.8%). Two eyes developed posterior capsular opacification at the last follow-up. In eyes where POC could not be performed, five of these (83%) were children below 12 months of age with half of them having a preexisting posterior capsular defect.

Conclusion:
Posterior optic capture is technically challenging with a steep learning curve that can be mastered over time. Adequate relative sizing of the anterior and posterior capsulorhexis is important. Caution is advised when using this technique in infants and in cases with posterior capsular defects.
Preferred practice patterns for keratoconus: An e-survey among Indian cornea specialists
Authors: Kapur Neha , Chatterjee Samrat , Gomase Sharad Nivrutti , Khurana Ashi , Parmar Gautam , Sangwan Virendra Singh 
Published: December 2023

Purpose:
This study aimed to report practice patterns in the management of keratoconus in India.

Methods:
An e-survey was conducted among members of the Cornea Society of India to assess preferred practice patterns for keratoconus.

Results:
Of the 912 members, 234 (25.7%) completed the survey. About 88.4% worked in private eye care facilities and 76.1% in cities. Of all the respondents, 91.5% had access to a Scheimpflug-based device or an Orbscan II®; 71.4% of the respondents dispensed scleral contact lenses, and 66.7% dispensed Rose K contact lenses; 92.7% of the respondents performed corneal cross-linking (CXL); and 73.1% of the respondents performed deep anterior lamellar keratoplasty (DALK). A Scheimpflug device or Orbscan II®, Rose K or scleral contact lenses, and CXL were more readily available (P < 0.05) in private eye care facilities. The diagnostic criteria for keratoconus followed by the majority of the respondents (52.1%) were increase in corneal curvature, elevation, and thickness. An increase in keratometry values greater than 0.5 or 1.0D in a 6-month to 1-year period was considered the most favored criterion for keratoconus progression. Epithelium-off, 0.1% riboflavin solution in dextran, and accelerated protocol were the more commonly reported techniques in CXL. About 77.2% of the respondents routinely performed CXL in corneas <400 microns thick. Spectacles (91.0% of the respondents) and topography-guided photorefractive keratectomy (37.6% of the respondents) were, respectively, the preferred optical and surgical methods used to improve vision.

Conclusion:
While keratoconus management in India is comparable to other developed healthcare systems, the concentration of trained corneal surgeons in cities and private eyecare facilities may lead to less equitable distribution of treatment across the country.
Comparative Evaluation of Different Endodontic Access Cavity Designs with Different Burs—An in vitro Experimental Insight into the Aspect of Fracture Resistance
Authors: Langaliya Akshayraj K. , Parmar Girish , Panchal Drashti , Thakkar Jainish , Shah Jinali , Patel Rushvi 
Published: December 2023

ABSTRACT

Introduction:

In vitro fracture resistance of extracted mandibular molars treated with various access cavity designs, including traditional endodontic cavity (TradAC), conservative/contracted endodontic cavity (ConsAC), ninja endodontic cavity (UltraAC), truss endodontic cavity (TrussAC), caries-driven access cavity (CariesAC), and intact teeth, is the focus of this study.

Materials and Methods:
Six groups of 20 mandibular molars, totaling 120, were used in the investigation. While the other five groups underwent various access cavity preparations, chemomechanical preparation, and obturation procedures before being repaired with composite resin, Group 1 was left unaltered (the control). A 6 mm round head tip was used to apply the fracture force, which was measured in newtons, at a crosshead speed of 1 mm/min until fracture developed.

Results:
According to the current study, the intact control group had the maximum fracture resistance. The access cavity groups’ mean values were maximum in CariesAC followed by ConsAC, TrussAC, UltraAC, and TraditonalAC respectively.

Conclusion:
While among the four minimally invasive designs, CariesAC showed a higher fracture resistance despite the results being statistically insignificant, TradAC had a significantly lower resistance than other conservative access cavity designs.
Assessment of Efficacy of Various Bracket Base Retention Qualities on Shear Bond Strength
Authors: Tomer Geetika , Verghese Yohan , Raje Batham Prerna , Panika Ashok , Sharma Shaivi , Kochhar Anuraj Singh , Kaur Manpreet 
Published: December 2023

ABSTRACT

Introduction:
Numerous manufacturers have improved bracket retention systems as a result of the frequent bond failure that occurs during orthodontic treatment. One of the elements affecting the adhesive’s bond strength is the bracket retention mechanism.

Objectives:
This study’s objective was to assess how various bracket base retention characters affected shear bond strength.

Materials and Methods:
Four distinct base features for brackets were evaluated. The basic design was examined using a scanning electron microscope. On the Universal testing equipment, brackets were glued to human teeth and then released.

Results:
The findings indicate that the polymer-coated base’s overall mean SBS, which had a mean value of 21.64 ± 4.14 MPa, was considerably greater than that of the other brackets (P 0.05). The foil meshpad, photochemically etched base, and laser-structured base had mean SBS values of 15.12 ± 5.75 MPa, 16.86 ± 3.76 MPa, and 19.32 ± 4.23MPa, respectively.

Conclusions:
Following laser-structured base and photochemically etched base brackets in terms of shear bond strength were polymer-coated base brackets. The shear bond strength was the lowest in the plain foil mesh pads.
Assessment of a Bracket-Bonding System’s Shear Bond Strength after it has been Cured using Various Light-Curing Units at Different Time Intervals
Authors: Alharbi Adel 
Published: December 2023

ABSTRACT

Objectives:
To assess a bracket-bonding system’s shear bond strength cured with dissimilar light-curing units at different time intervals.

Materials and Method:
Sixty premolar teeth removed for orthodontic purposes were categorized into four types based on the light-curing unit and exposure times used. The specimens in the halogen group were exposed to light for 15 (Group I) and 30 (Group II) sec, respectively. The specimens were exposed to light for 10 (Group III) and 15 sec in the LED group (Group IV). The amount of adhesive still present on the teeth was measured using a stereomicroscope at a magnification of 10 and was then assessed with the help of adhesive remnant index (ARI).

Result:
The group with the highest mean SBS was in Group II followed by Group I, Group III, and the group with the lowest mean SBS. The ARI was unaffected by the light-curing technique, with score 2 predominating

Conclusion:
In all groups, polymerization using halogen and LED led to SBS values that were clinically suitable for orthodontic procedures.
The Effect of Ferritin, Vitamin D, and Some Hormonal and Biochemical Parameters on Patients with Female-pattern Hair Loss after COVID-19 Infection
Authors: Falih Israa Qusay 
Published: December 2023

BACKGROUND:
This study aims to shed light on the problem of female-pattern hair loss, especially for women, after recovering from the viral infection of COVID-19 and their deficiency of iron store level, Vitamin D, and some parameters that cause complications.

MATERIALS AND METHODS:
The study included Sixty-eight females ranging from 20 to 30 years old; they were divided into two groups. Group I has 18 women as a control group; the women had recovered from COVID-19 infection and were not affected by viral complications. Group II of 50 women had recovered from infection with COVID-19 and suffered from hair loss. Levels of iron stores (ferritin), Vitamin D3, thyroid-stimulating hormone, follicle-stimulating hormone, luteinizing hormone, testosterone hormone, triglycerides (TGs), and serum total cholesterol (TC) were measured after 2 months of infection recovery and compared with controls.

RESULTS:
The results of TG showed a significant increase (P ≤ 0.05) between women in Group II compared to the control group (Group I). On the other hand, the data obtained from both Vitamin D3 and ferritin levels showed a significant decreases (P ≥ 0.001 in Group II compared to the control group (Group I). In contrast, there is no statistical significance recorded in hormonal parameters, except testosterone hormone, which witnessed a highly significant increase (P ≤ 0.01) of Group II, whereas for TC, there was no statistical significance. In addition, a high positivity was also observed (P < 0.01, P = 0.05) for ferritin, Vitamin D, testosterone, and TG level in the blood.

CONCLUSIONS:
Our results showed a close co -relation between low levels of Vitamin D3, ferritin, high male hormones, and hair loss complications with COVID-19 viral infection. Both ingredients are consumed to protect the body from viruses. Vitamin D plays a major role in stimulating the body’s immunity to disease, so their concentration decreases after recovery from the disease and after the appearance of symptoms of the effects that have occurred because of this deficiency.
Investigating the Security of Health-care Information in Iranian Hospitals in Confronting with Threatening Risks
Authors: Hassanzad Maryam , Arian Mahdieh , Mollaei Roghayeh , Ansari Masoumeh , Khaledian Mehrdad , Valinejadi Ali , Velayati Ali Akbar 
Published: December 2023

BACKGROUND:
Like other organizations, hospitals are at risk of information security threats. The implementation and use of various kinds of electronic health records and information systems challenge the privacy and security management of personal care as well as health-care organizations.

OBJECTIVE:
This survey aims to evaluate information security by focusing on the differences among hospitals based on their size and type.

MATERIALS AND METHODS:
We conducted a survey, as a cross-sectional study, in 2023. The chief information officers of 165 hospitals in Iran were invited to participate. Furthermore, we designed an online questionnaire based on the ISO/IEC 27002. The scores of the hospitals were analyzed for significant differences in terms of seven factors of this questionnaire with respect to the size and type of hospitals.

RESULTS:
The 165 participating hospitals had a score of <55% of the maximum possible score (100%). The hospitals with more than 200 beds had the highest level of information security, and the lowest level of information security was far hospitals with 150–200 beds. In all studied hospitals, the highest score was related to the component “Backup and security zones,” and the lowest score was related to the component “Encryption and staging.” Even the analysis based on the number of beds did not change this result. Furthermore, the private and university hospitals were weaker than other hospitals in terms of “organization and risk management” and “protection against attacks.”

CONCLUSION:
All participating hospitals in this study in Iran had an average score. Therefore, due to the importance of confidentiality of information in the health-care system, it is essential to provide a secure platform for information retention in hospitals. The causes of these threats should also be identified and controlled before experiencing harmful effects. We thus suggest that managers of health-care information and information technology departments in hospitals take appropriate corrective measures in policy development, user training, access control, risk management, as well as physical standards and protection against attacks.
Oral Manifestations among Coronavirus Disease 2019 Patients: Evidence from the Thar Desert Region of India
Authors: Joshi Nitin Kumar , Jain Yogesh Kumar , Suthar Praveen , Joshi Vibha , Bhardwaj Pankaj , Singh Kuldeep 
Published: December 2023

Introduction:
The global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been known to cause fever, cough, and difficulty in breathing. However, several case studies and case reports have also documented alteration of taste, dryness of mouth, and vesiculobullous lesion, but there is a scarcity of planned epidemiological studies to provide scientific evidence regarding such associations. Thus, this study was conducted to assess oral manifestations in symptomatic coronavirus disease 2019 (COVID-19) patients.

Subjects and Methods:
A cross-sectional study was conducted in a dedicated COVID facility of Jodhpur. Mild and moderate symptomatic laboratory-confirmed cases of COVID-19 were included in the study. Data collection was done using the WHO Oral Health Self-Assessment Questionnaire for adults. Compiled data were analyzed using Chi-square statistics and odds ratio considering P < 0.05 as statistically significant.

Results:
Out of 351 participants, 65.5% developed oral manifestations, with ageusia being the most common with 56.4% prevalence. Significant associations of the manifestations were observed with chronic systemic conditions and oral deleterious habits.

Conclusion:
The study provided epidemiological evidence regarding oral manifestations due to SARS-CoV-2 infection and their associations with chronic conditions and oral deleterious habits. Due to the continued resurgence of COVID-19, it is recommended that oral evaluation and management accompany the routine treatment in infected patients.
Determinants of Iron–Folic Acid Supplementation Compliance among Pregnant Women Attending Primary Health Center: A Cross-Sectional Study
Authors: Akham Ngamba , Thounaojam Usha Devi 
Published: December 2023

Background:
Intermittent iron and folic acid supplementation (IFAS) is advised in areas where the prevalence of anemia among pregnant women is 20% or higher. Effectiveness and successful interventions of national strategy will depend on compliance to IFAS. This study was conducted to determine the proportion of antenatal mothers compliant to IFAS and to identify the factors affecting it.

Methods:
A cross-sectional study among pregnant women attending antenatal clinic was done from September 2020 to February 2021 at an Urban Primary Health Centre, Imphal East. Patient aged ≥18 years, completed 12 weeks of pregnancy and started IFAS were consecutively enrolled according to the outpatient department registration list and interviewed using a pretested questionnaire. Descriptive statistics and logistic regression were performed for determining the association between selected variables, taking P < 0.05 for statistical significance. Ethical clearance was obtained from the institutional ethics committee.

Results:
Of 142 participated, 97 (68%) were compliant to IFAS. Women who were multigravida (adjusted odds ratio [AOR]: 0.14; 95% confidence interval [CI]: 0.038–0.48), self-purchased IFAS (AOR: 0.16; 95% CI: 0.054–0.47) were found less likely to be compliant to IFAS. Women of good knowledge score (AOR: 6.4; 95% CI: 1.7-23.8) regarding anemia and IFAS were more likely to be compliant.

Conclusion:
Almost one-third of participants was compliant to IFAS and associated with knowledge, educational level, and mode of obtaining IFAS. Thus, highlighting the need to scale up health awareness on IFAS and antenatal care coverage of antenatal IFAS supply through community-level workers.