bluuebunny/crossref_metadata_2025_split huggingface dataset:
Refractive Outcomes of Cataract Surgery in Patients With Intrastromal Femtosecond Laser Treatment of Presbyopia (INTRACOR)
Authors: Naujokaitis Tadas , Hallak Mustafa K. , Blöck Louise , Khoramnia Ramin , Auffarth Gerd U. 
Published: October 2023

Purpose:
To evaluate the outcomes of cataract surgery with intraocular lens (IOL) implantation in patients who underwent intrastromal femtosecond laser treatment of presbyopia (INTRACOR).

Methods:
This was an interventional case series of 8 patients (10 eyes) who presented for cataract surgery 6.1 ± 3.2 years (mean ± standard deviation [SD]) after INTRACOR (Technolas Perfect Vision GmbH) treatment. A monofocal IOL was implanted in 9 eyes (7 patients) and a small-aperture IOL was implanted in 1 eye. The IOL power was calculated without adjustments using biometry obtained after the INTRACOR treatment. For additional calculations, keratometry obtained before the INTRACOR treatment was used. Postoperative examinations included visual acuity testing, manifest refraction, defocus curve, ocular biometry, corneal tomography, aberrometry, anterior segment optical coherence tomography, and slit-lamp examination.

Results:
After the cataract surgery, the mean ± SD uncorrected distance visual acuity was 0.37 ± 0.17 logMAR, the corrected distance visual acuity was 0.10 ± 0.10 logMAR, and the manifest refraction spherical equivalent, adjusted to infinity, was +0.39 ± 0.63 diopters (D). Intermediate and near visual acuity, both uncorrected and distance-corrected, and distance-corrected defocus curves varied considerably among patients. Using biometry performed after INTRACOR, the traditional IOL power calculation formulas produced hyperopic outcomes, with the mean ± SD prediction error ranging from +0.72 ± 0.34 to +0.96 ± 0.41 D. Although the mean ± SD prediction error decreased (range: −0.34 ± 0.56 to −0.15 ± 0.53 D) when using keratometry obtained before INTRACOR, the accuracy remained low due to high variability.

Conclusions:
In patients with cataract who had previous INTRACOR treatment, IOL power calculation could be inaccurate, with a tendency toward hyperopic outcomes. These results require confirmation in more extensive studies.

[
J Refract Surg
. 2023;39(10):676–682.]
Châteaux et communautés rurales en Auvergne. Entre guerres privées et protections relatives
Authors: Phalip Bruno 
Published: October 2023

Le propos analyse ici le problème des relations entre aristocratie et communautés rurales à partir du début du XIe siècle. Dans les textes, le château n’a pas de rôle de lieu de protection, il sert à justifier un ordre social. Dans le paysage et dans l’architecture, le château est l’expression monumentale d’un pouvoir et les paysans se méfient du clan familial noble. À l’aide de plusieurs exemples issus du territoire auvergnat, l’auteur présente différents cas de figure qui traduisent ces interactions : un village et un espace castral séparés jusqu’à la guerre de Cent Ans dans les montagnes d’Auvergne, des basses-cours accueillant de manière temporaire des biens face à un village dont la fortification l’émancipe de ces espaces, des fortifications seigneuriales mal entretenues car contraignantes, et des coseigneuries qui dispersent ces espaces de coercitions.
Un Paradis perdu. Restaurer ou les effets de l'intervention humaine sur le cours du temps – à propos de quelques réalités monumentales (France, Cambodge)
Authors: Phalip Bruno , André Marie-Françoise , Vautier Franck , Voldoire Olivier , Roussel Erwan , Morel David , Benbakkar Mhammed , Constantin Christophe 
Published: October 2023

Les interventions sur les monuments anciens en milieu rural gagneront à être plus « légères » qu’en milieu urbain, dès lors que la part du temps est prise en considération. En France comme au Cambodge, toute restauration complète appelle d’autres travaux à un rythme plus rapproché, plus difficiles d’exécution, plus importants en moyens et plus impactants sur les architectures et sculptures. Entre le XIIe et le XIXe siècle, les maçonneries des églises romanes d’Auvergne ont été peu entretenues, mais l’épiderme des matériaux de construction a globalement bien tenu. Un siècle après les restaurations du XIXe siècle, du fait de l’utilisation des ciments durs et de matériaux exogènes, la dégradation des parties restaurées et non restaurées impose de nouvelles interventions rapprochées dans le temps, alors que la première période n’avait connu aucune grande phase de restauration, l’entretien seul ayant suffi.La déforestation est quant à elle la principale cause de la dégradation accélérée des maçonneries assemblées à sec des temples khmers, mais on tirera une leçon utile de l’exemple du temple de Ta Prohm à Angkor qui conserve son couvert forestier protecteur. Dès lors que l’exubérance de la végétation est contrôlée, au Cambodge comme en France, un édifice ancien supporte aisément la présence de mousses, lichens et cyanobactéries, voire de graminées, qui enveloppent le site dans un biofilm protecteur. À l’inverse, chaque restauration ou nettoyage déclenche l’installation rapide d’organismes jeunes plus agressifs que les organismes âgés vivant au ralenti et finissant par former une « biopatine » protectrice. Face aux bouleversements industriels, le XIXe siècle a restauré ses édifices emblématiques. Notre siècle doit probablement conserver de manière raisonnée des références monumentales synonymes d’une lente disparition. Pourtant un édifice ayant subi de multiples interventions se corrigeant les unes les autres, produit d’une économie de loisirs, ne produira jamais l’émotion d’une ruine discrètement entretenue dans laquelle il est possible de se perdre, en dehors de tout itinéraire balisé et de toute proposition pédagogique. Le « réensauvagement » de sites ruraux est donc un enjeu qui dépasse « l’absolue nécessité », en réalité toute relative des restaurations.
Role of Magnetic Resonance Imaging in Dementia
Authors: Koppal Divyashree , Wahab Shagufta , Akhouri Deoshree , Ahmad Ibne 
Published: October 2023

Background: Dementia is a condition of elderly individuals, marked with emotional and cognitive disabilities which are severe enough to impair their routine daily life and its quality. It is mainly a disease affecting elderly population with an approximate prevalence rate of 1% at the age of 60 years and quadruples every 10 years, up to 30%–50% by the age of 85 years. There are about 5.5 crore people suffering with dementia with more than 60% in developing countries.To overcome this, a multipronged strategy with timely diagnosis is the need of the hour. Materials and Methods: The present study was conducted at the Department of Radiodiagnosis and Department of Psychiatry of J. N. Medical College and Hospital, Aligarh, over a period of 2 years. Forty-five patients in the age group of more than 55 years who presented with the complaints of cognitive impairment and were referred for magnetic resonance imaging (MRI) head after clinical examination and Mini–Mental State Examination (MMSE) score assessment were included in the study. On MRI images are assessed using the Global Cortical Atrophy (GCA) scale, medial temporal lobe (MTL) atrophy scale, and Fazekas Scale, then findings are correlated with clinical MMSE scores. Results: There were 45 patients with the age group of more than 50 years, among 66.67% of patients were males and 33.33% of patients were females. In 60.00% of patients, socioeconomic status was lower middle class, 46.67% of patients were illiterate followed by studied till primary school (22.22%). In 66.67% of patients, mini–mental score examination score was mild. Among the imaging scales, 82.22% of patients showed moderate GCA scale; in 55.56% of patients, interpretation of MTL atrophy scale was widening of choroid fissure and temporal horn of lateral ventricle. 33.33% of patients showed Fazekas 3 Scale with large confluent lesions. All these imaging scales showed a significant negative correlation with MMSE scores. Conclusion: MRI plays an important role in the assessment of structural changes in patients presenting with cognitive impairment as well as it points toward the diagnosis of certain type of dementia depending on the involvement of specific areas or lesions and their distribution in the cerebral hemispheres. Visual assessment using various scales has helped in assessing the severity as well as possible type. There has been establishment of significant correlation between the MRI scales of atrophy and clinical MMSE scoring system.
Clinical Evaluation and Investigations of Atrial Fibrillation in Rheumatic Mitral Valve Disease: An Observational Study in a Tertiary Care Hospital in Western India
Authors: Shastri Minal Hemant , Mistry Heti P. , Vinod Vishakha , Rathod Vaishnavi Mahendrasinh , Sirajwala Abulkalam A. , Patel Nilay Shetal , Dobariya Riya Kantibhai 
Published: October 2023

Background: Atrial fibrillation (AF) is the most common sustained supraventricular arrhythmia encountered in clinical practice. Due to the higher prevalence of rheumatic fever in several regions of India, rheumatic heart disease (RHD) is the most common etiological factor of AF. Aims and Objectives: The objective of the study was to study clinical features, electrocardiographic (ECG) and echocardiographic (ECHO) findings, complications, and incidence of AF in rheumatic mitral valve disease (R-MVD). Methods: It is an observational cross-sectional study of 40 indoor patients in a Tertiary Care Hospital in Vadodara, Gujarat, carried over a period of a year. Clinical data including symptoms, signs, systemic examination, and relevant investigations were studied. Results: 67.5% ( n = 27) of patients having AF were below the age of 50 years with higher incidence among females (72.50%) as compared to males (27.5%). Fifteen (37.5%) had mitral stenosis (MS) and 13 (32.5%) had MS with regurgitation. Most of the patients 35 (87.5%) presented with breathlessness, followed by palpitation 28 (70%). The most commonly heard murmur was mid-diastolic (65%, n = 26), followed by pansystolic murmur (40%, n = 16) at the apex. Out of 40 patients, 15 (37.5%) had evidence of left ventricular hypertrophy on ECG, whereas only 5 (12.5%) had right ventricular hypertrophy. Four out of five patients with the evidence of cardioembolic stroke had left atrium (LA) size >45 mm which suggests an increased risk of embolic stroke with increased LA size. Only 3 (7.5%) patients had a visible LA clot in LA on two-dimensional ECHO, whereas only one patient had vegetation on valves. Twenty-seven out of 30 patients treated with diltiazem show good response. Heart failure was the most common complication affecting 85% ( n = 34) of the patients with AF with R-MVD. Four (10%) patients out of 40 expired including 1 (25%) of the four pregnant patients, suggesting higher mortality among pregnant females due to superimposed physiological changes occurring during pregnancy. Conclusion: In developing countries like India, RHD is a major cause of AF affecting the younger population and more commonly females. Most of the patients in our study presented with breathlessness and palpitation. LA size was directly proportional to the risk of cardioembolic stroke and most of the patients developed heart failure as a complication.
Luliconazole: A Novel Potent Imidazole Activity against Aspergillus niger and Aspergillus flavus Causing Otomycosis
Authors: Sukumar Bavadharani , Premamalini Thayanidhi , Sasikumar Nivetha Shree , Lakhmanan Somu , Kindo Anupma Jyoti 
Published: October 2023

Background:

Aspergillus
niger and Aspergillus
flavus are the most common causative agents of otomycosis with worldwide distribution. Extensive surgical debridement and systemic antifungal therapy are needed in cases of refractory otomycosis. Luliconazole is currently confirmed for the topical therapy of dermatophytosis. Moreover, it is found that luliconazole has in vitro activity against some molds and yeast species.

Objectives:
The aim of the present study was to evaluate the efficacy of luliconazole in comparison to routinely used triazole antifungals on Aspergillus isolates, obtained from otomycosis cases using microbroth dilution method.

Materials and Methods:
This study was carried out in the department of microbiology, from March 2020 to February 2022. A total of 55 strains of Aspergillus isolates obtained from otomycosis cases were confirmed based on macroscopic and microscopic identification. Antifungal susceptibility patterns of itraconazole, voriconazole, posaconazole and luliconazole were determined by broth microdilution method as per the Clinical Laboratory Standards Institute M38-A2 guidelines.

Results:
Among the azoles tested, the lowest minimum inhibitory concentration (MIC) geometric mean (0.00309 μg/ml), MIC50 (0.00098 μg/ml), and MIC90 (0.00781 μg/ml) values were attributed to luliconazole. Being the drug of choice for aspergillosis, voriconazole had a slightly higher MIC50 and MIC90 value of 1 μg/ml and 2 μg/ml, respectively. Even for the pan azole resistant isolates (n = 3), luliconazole was found to be more effective with lower MIC values.

Conclusion:
The results of this study showed that luliconazole had an excellent in vitro activity with a lower MIC values than the triazoles tested. Hence, this novel imidazole antifungal agent can be considered an appropriate candidate for the treatment of otomycosis caused by A.
niger and A.
flavus strains. Furthermore, luliconazole showed better efficacy with lower MIC values for pan azole resistant isolates, suggesting that it could be a potential antifungal for treating aspergillosis caused by pan azole resistant isolates.
Screening for Hearing Loss in High-Risk Neonates Using Otoacoustic Emissions
Authors: Chawla Deeksha , Verma Rohit , Bhargava Siddharth , Munjal Manish , Dhawan Anshuman , Singh Udeyana 
Published: October 2023

Context:
The development and maturation of the hearing process begin in the fetal stage and progresses up to 6 months of age. Neonatal screening is therefore an essential method to screen for hearing loss at an early age. As there is a paucity of literature on the use of otoacoustic emissions (OAEs) and brainstem evoked response (BERA) tests for screening, hence we conducted a prospective observational study to screen the high-risk neonates admitted to neonatal intensive care unit (NICU) using OAE and further BERA (wherever indicated).

Aims:
The primary objective was to estimate the incidence of hearing loss in high-risk neonates admitted to NICU using OAEs as a screening tool. A secondary objective was to determine the risk factors predictive of hearing impairment in these neonates.

Settings and Design:
It was a prospective observational study conducted in a tertiary care hospital.

Subjects and Methods:
The study was conducted over a period of 1 year from April 1, 2021, to March 31, 2022. Fifty neonates with high-risk factors who fulfilled the inclusion criteria were enrolled and subjected to a two-staged OAE screening test and further BERA (in neonates where overall OAE result was REFER).

Statistical Analysis Used:
Continuous data variables were presented as means and standard deviations. Categorical data were presented as percentages and Chi-square test was used to derive comparisons. For all statistical testing, P < 0.05 was considered statistically significant.

Results:
Of 50 neonates enrolled in the study, 22 (44%) passed the Stage I OAE. The remaining 28 (56%) underwent Stage II OAE, out of which 17 (34%) passed the Stage II screening. Eleven neonates with overall OAE results as REFER were taken up for BERA. Three neonates (6%) had a hearing loss on BERA while in 8 (16%) BERA was normal. The overall incidence of hearing loss was 6%. The variables with a statistically significant correlation with the results of OAE were - APGAR score and perinatal asphyxia at a low APGAR score.

Conclusions:
The incidence of hearing loss in this study was 6%. APGAR score and perinatal asphyxia at a low APGAR score at 1 and 5 min had statistically significant correlation with the outcomes of OAE screening.
Are We Teaching Evidence-Based and Inclusive Practices in Gender-Affirming Care? Perspectives From Plastic Surgery In-Service Examinations
Authors: Aryanpour Zain , Min-Tran Dominic , Ghafoor Essie , Wojcik Christopher , Peters Blair R. 
Published: October 2023

Background Resident physicians take annual in-service examinations (ISEs) as part of continuing medical education, which set educational priorities, allow for formative feedback, and guide preparation for final board examinations. Gender-affirming care is provided in many specialties but has been an underrepresented area in medical education. Plastic surgeons provide a large portion of gender-affirming surgical care. Educational gaps in standardized ISEs may contribute to ongoing health care disparities for transgender and gender diverse people.Objective To evaluate the quality of content pertaining to gender-affirming surgery (GAS) on plastic surgery ISEs.Methods Plastic surgery ISEs from years 2012 to 2020 were accessed online through the American Council of Academic Plastic Surgeons website in June 2022. All 5 gender diverse authors analyzed examinations for the presence of GAS questions; identified questions were analyzed for quantity, organization based on content category, affirming language, and accuracy against current guidelines.Results Of 1959 ISE questions available for review, 11 GAS questions were identified for a total frequency of 0.56%. Most GAS questions (6 of 11, 55%) were miscategorized. Inappropriate language, including misgendering of patients, occurred in 7 of 11 (64%) questions. No questions discussed GAS beyond chest or genital surgery, or common variations of these procedures. Transgender identities were represented as only binary, with no mention of nonbinary or gender-fluid individuals.Conclusions Our study illustrates that there are significant gaps in educational content pertaining to gender-affirming care on plastic surgery ISEs.
Human growth hormone, a marker for HIV infection among adult Igbo Nigerians: relationship between human growth hormone and CD4+ count with viral load
Authors: U Obi Collins , U Achukwu Peter , N Okwuosa Chukwugozie , S Aladeyelu Okikioluwa , N Agbiogwu Ijeoma , C Agu Nneka , O Udeh Mercy , A Arusiwon Joseph 
Published: October 2023

Routine viral load and CD4+ testing is key to monitoring the extent of danger caused by HIV and response to antiretroviral therapy (ART) for HIV individuals, but its availability has been limited in low and middle-income countries. The study sort to ascertain relationship between serum Human Growth Hormone (HGH) gold standard with CD4 cells and viral load in HIV-infected patients. CD4+ T-cells, HIV viral load, and HGH were assayed in HIV- infected patients from May to December 2020. 460 subjects were engaged and separated into two groups: the HIV-infected untreated (Pre-ART) and the control groups. An interventional study was conducted for the Pre-Art group after six months. Serum HGH was assayed by the ELISA method, CD4 cell count was examined by BD-FACScan flow cytometer, and HIV viral load was assessed using RT-PCR. The CD4 count and serum HGH of Pre-ART HIV-infected subjects were significantly low (p<0.05), while the viral load was significantly high compared to those treated with ART for 6months (p<0.05). CD4 count and serum HGH were significantly higher (p<0.05) in females than in males. It also reveals that CD4 count correlates positively with HGH level (r= 0.191**). Serum HGH could serve as a surrogate marker and valuable index in monitoring HIV patients.
Keywords: Viral load; HIV/AIDS; human growth hormone.
Biological parameters determining the effectiveness of monitoring of HIV / AIDS infected patients in Morocco
Authors: Echchakery Mohamed , Boumezzough Ali , Boussaa Samia 
Published: October 2023

Background & objective: Human Immunodeficiency Virus (HIV) remains one of the world's most serious health challenges. The development of therapeutic regimens has significantly increased survival and reduced HIV-associated morbidities in HIV-infected individuals. However, some people living with HIV may not respond as expected, resulting in treatment failure. The objective of this study is to identify and characterize, by immunological (T-cell CD4) and virological (viral load) parameters, HIV infected patients with therapeutic failure in Morocco.
Methods: Prospective cross-sectional studies were conducted over a 5-years period (between January 2015 and December 2019) at the referral center of Ibn Zohr Hospital, Marrakech, Morocco. A total, of 1088 HIV-infected patients diagnosed by the rapid test (Immunochromatography) in addition to Western Blot analysis, was recruited. All patients were under the antiretroviral therapy (ART) for at least six months and followed every six months. Sociodemographic, clinical, and biological data as well as information on patient adherence were collected.
Results: Out of 1088 patients, 92.46% were under treatment based on non-nucleoside reverse transcriptase inhibitors (NNRTIs) including 26.20% first line first intention and 66.26% first line second intention, and 7.54% of patients on a protease inhibitor (PI) therapy. Regarding the immunological and virological status, 76% of HIV-infected patients had a CD4 count > 200 cells/μl and 24% had a CD4 count < 200 cells / μl, while 69.5% had an undetectable viral load and 30.05% had a detectable viral load (including 11.86% with viral load < 1000 copies / ml and 18.20% viral load > 1000 copies / ml) (P-values < 0.05).
Conclusion: In our study, we showed a therapeutic failure rate of 18.2% in HIV-infected patients under treatment in Marrakech region. These failures were mainly related to poor adherence and low CD4+ rates at the initiation of treatment. We concluded that immunological monitoring alone is insufficient to predict virological suppression and therapeutic success. Consequently, we recommend the HIV plasma viral load test be accessible as a routine exam.
Keywords: HIV; viral load; CD4; therapeutic failure; antiretroviral treatment; Morocco.
Risk factors for pancreatitis occurrence after gallstone treatment using endoscopic retrograde cholangiopancreatography
Authors: Jiang Feibao , Zhang Jilong , Hu Zhenghua 
Published: October 2023

Background: Patients with gallstones are prone to pancreatitis after treatment using endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to explore the risk factors for pancreatitis occurrence after gallstone treatment using ERCP.
Methods: A total of 193 patients treated from October 2017 to October 2020 were assigned into pancreatitis group (n=55) and non-pancreatitis group (n=138). Multivariate logistic regression analysis was utilized to analyse the risk factors for post-ERCP pancreatitis. The discrimination and accuracy of an established nomogram model were evaluated using receiver operating characteristic and calibration curves, respectively.
Results: The incidence rate of pancreatitis was 28.50% (55/193). Young age, long course of disease, gallbladder wall thickness >3 mm, sand-like stones, history of pancreatic disease, number of intubation ≥2 and absence of pancreatic duct stenting were risk factors for post-ERCP pancreatitis (P<0.05). The established model had high discrimination and accuracy. The incidence rates of pancreatitis in patients with and without pancreatic duct stenting were 11.84% (9/76) and 39.31% (46/117), respectively. The patients undergoing pancreatic duct stenting had lower serum amylase levels 6, 12 and 24 h after ERCP than those of patients who did not.
Conclusion: Patients with gallstones have a higher risk of developing pancreatitis. Young age, long course of disease, gallbladder wall thickness >3 mm, sand-like stones, history of pancreatic disease, pancreatic duct visualization and number of intubation ≥2 are risk factors for post-ERCP pancreatitis.
Keywords: risk factor; endoscopic retrograde cholangiopancreatography; pancreatitis; gallstone; pancreatic duct stenting.