bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iris depigmentation and cytomegalovirus in aqueous humor as predictors of uveitic activity and recurrence in chronic and recurrent anterior uveitis
Authors: Kam Ka Wai , Mok Eugenie , Ho Mary , Wong Chung Hei , Sze Ryan Kin Ho , Chan Paul KS , Young Alvin L 
Published: November 2023

Purpose:
To examine the clinical outcomes in chronic or recurrent anterior uveitis in the presence or absence of cytomegalovirus (CMV) and investigate the predictive factors for uveitic activity and recurrence.

Methods:
Polymerase chain reaction (PCR) was performed in a prospective cohort of immunocompetent adults with recurrent or chronic anterior uveitis to detect CMV in aqueous humor. The clinical outcomes were compared between eyes with and without CMV DNA. Logistic regression was performed to evaluate associations between iris depigmentation, CMV-PCR status, uveitic activity, and recurrence.

Results:
Thirty-eight eyes of 38 subjects with a mean age of 61.1 ± 11.2 years old were analyzed. Fifteen eyes were positive for CMV. More eyes with CMV developed recurrences and remained actively inflamed at 6, 12, and 24 weeks though the differences were insignificant. The presence of iris depigmentation was predictive of a greater odd of uveitic recurrences by 12 and 24 weeks (Odds ratio (OR) = 9.17 and 5.72, P = 0.007 and 0.034 respectively), whereas positive CMV-PCR predicts a greater odd of uveitic activity at postoperative 12 and 24 weeks (OR = 13.08, 34.30; P = 0.027, 0.007).

Conclusion:
Eye with and without detectable CMV behaved similarly in their clinical course. Our findings suggested that iris depigmentation was predictive of more frequent uveitic recurrence, regardless of the PCR status, whereas the presence of CMV in aqueous humor was associated with persistent uveitic activity. Iris changes may be present during the earlier phase of the disease and precede the detection of virus from the aqueous humor at a later stage of CMV infection.
Clinical profile of childhood exotropia in a tertiary eye care center in North India
Authors: Gore Jinal , Rath Soveeta , Ganesh Suma 
Published: November 2023

Purpose:
To identify different types of exotropia in children less than 16 years and their clinical presentation. The secondary objective is to identify the age of onset, age of presentation, birth history, and ocular and systemic associations as well as to evaluate their motor and sensory status.

Methods:
This hospital-based descriptive observational study was conducted from September 2018 to December 2019. Patients with a clinical diagnosis of exotropia of age less than 16 years, and exotropia of ≥ 10 PD were included in the study. Data were collected using a structured proforma. All statistical calculations were performed using Microsoft Excel Office version 2016 and R version 4.0.2.

Results:
Two hundred eighty-six (286) consecutive children with exotropia were analyzed. Intermittent exotropia (72%) was the most common form of exotropia, followed by exotropia with a neurological association (11%), infantile (8%), sensory (6%), restrictive (2%), and paralytic (1%) types. Exotropia with neurological association had a significantly earlier age of presentation (median = 42months) as compared to other types (P = 0.039).

Conclusion:
We recorded a huge amount of cases of exotropia associated with neurological abnormalities and this group of patients had significantly more number of preterm and low birth weight children. This study has its limitations as it is not a population-based study and prevalence rates could not be calculated.
Central retinal artery occlusion following pediatric blunt ocular trauma
Authors: Ramachandran Sivaranjan , Chavan Kasturi , Padhi Tapas R , Takkar Brijesh , Karande Sayali , Kelgaonkar Anup , Panda Krushna G , Padhy Srikanta K 
Published: November 2023

Background:
To analyze the clinical profile, presentation, possible pathophysiology, and outcomes of central retinal artery occlusion (CRAO) following blunt trauma in pediatric subjects.

Methodology:
The medical charts of subjects aged 18 years or less with a diagnosis of CRAO following blunt ocular trauma were analyzed retrospectively for demography, details of the trauma, ocular findings, additional imaging reports if any, and final outcome. A Medline search was done (key words like central retinal artery occlusion, blunt trauma, children, pediatric subjects, and adolescents) to gather information available in the literature on the subject.

Results:
A total of 11 patients (11 eyes), mean age of 14.3 ± 3.4 years, and 100% male preponderance, with an average time duration from trauma to presentation to the hospital of 8.1 days were included. Visual acuity ranged from no light perception (four eyes) to finger count at a 1 m distance. Intraocular pressure was raised in three patients, of which two were suffering from sickle cell disease. In two eyes, the CRAO coexisted with optic nerve avulsion and the cilioretinal artery was spared. Disk pallor was seen in six eyes as early as 12 days from the trauma. None of the cases revealed any bony fracture in the CT scan.

Conclusion:
CRAO was observed to be an important primary or contributory cause of visual loss in children following blunt trauma, reflex vasospasm being the most common etiology. Early onset disk pallor could suggest an underlying vascular compromise of both retinal and optic disk circulation in addition to direct disk damage.
A randomized controlled trial to assess safety and efficacy between terminal chop, stop and chop, and direct chop
Authors: Sinha Aprajita , Morya Arvind Kumar , Gupta Vinita , Prasad Ripunjay 
Published: November 2023

Purpose:
The goal in developing new techniques of cataract surgery is to provide a safer, more efficient surgical experience with the lowest complication rate and endothelial cell loss. We compared the efficiency and safety of stop-and-chop, direct chop, and the novel terminal chop techniques of nuclear fragmentation for cataracts grade II-V.

Methods:
We conducted a prospective randomized clinical trial comparing three different techniques of phacoemulsification, namely, stop-and-chop, direct chop, and terminal chop to assess any differences between them and to establish whether any one method was superior to the others. The pre- and postoperative parameters studied, included central corneal thickness (CCT), ultrasonic time (UST), endothelial cell density (CD), cell loss and effective phacoemulsification time (EPT), average cumulative dissipative energy (CDE), and best-corrected visual acuity, among others.

Results:
307 eyes were recruited to the study, 102 were recruited to the stop-and-chop group, 103 to the direct chop group, and 102 to the terminal chop group. Statistical differences were found between the techniques with regard to postoperative CCT among NS II (P. 0001) and NS IV cataracts (P = .005) with the lowest values in the terminal chop group among NS II, NS III, and NS IV cataracts. Endothelial cell loss was minimum with a terminal chop in NS II (P = .018) and NS IV cataracts (P = .245). CDE was minimum in terminal chop across different cataract densities.

Conclusion:
Terminal chop showed improvement over the other two techniques in terms of CDE and was comparable to them with regard to other parameters.
The effect of blue light filter on visual and task performance
Authors: Usgaonkar Ugam P S , Dessai Sailee P , Shetty Aksha 
Published: November 2023

Purpose:
This study aimed to determine the effect of the blue light (BL) filter on the different tasks performed on a laptop on a daily basis.

Methods:
Forty subjects were required to perform a 45-minute task on the laptop screen with or without the BL filter on two different days. In the first task, subjects were made to watch a video. In the second task, subjects were made to read a passage from the laptop for 3 minutes, and reading speed was calculated. In the third task, subjects were made to enter the data on the laptop. The time taken to fill in the data was recorded. After the completion of the task, questionnaires were administered. Pre- and post-task accommodative tests were performed.

Results:
Forty emmetropes with a mean age of 21 ± 2 were recruited. In visual performance, the subjective response showed a significant difference in visual fatigue level with and without the filter. A statistically significant difference was seen in reading speed and data entry during task performance with and without the filter. Pre- and post-task accommodative parameters showed variable responses.

Conclusion:
This study showed that the use of a BL filter improves task performance, but subjectively, people experienced more visual fatigue while using the filter.
Combat ocular trauma in counterinsurgency operations
Authors: Rana Vipin , Patra Vinod K , Bandopadhayay Sandepan , Raj Biresh , Sharma Vijay K , Gupta Atul , Mishra Sanjay K , Kumar Pradeep 
Published: November 2023

Purpose:
To identify the pattern, distribution, and causes of ocular injuries among the security personnel participating in counterinsurgency operations (CIOps).

Methods:
This was a multicentric, retrospective review of chart records of patients reporting to three hospitals located in the geographic region affected by CIOps. The hospital registry was examined for all patients diagnosed with any type of ocular trauma between January 1, 2016, and December 31, 2019. A standardized proforma was filled out using the case records, and entries were validated.

Results:
A total of 131 ocular injuries fulfilled the criteria of the study. The mean age of the patients was 32.46 ± 10.2 years. All the patients were males. The causes of the injuries were explosive blasts in 60 eyes (45.80%), gunshot wounds in 15 eyes (11.42%), stone pelting in 16 eyes (12.21%), training-related causes in 26 eyes (29.84%), vehicular accidents in 13 eyes (9.92%), and battery blast in one eye (0.76%). Among the type of injuries, open globe injuries included 66 eyes (50.38%), closed globe injuries included 35 eyes (26.72%), isolated lid lacerations included 14 eyes (10.68%), and isolated chemical injury was seen in two eyes (1.52%). Optic nerve head avulsion was seen in two eyes (1.52%).

Conclusion:
The study revealed a considerable number of ocular injuries related to combat, with explosive bursts being the leading cause. The incidence of ocular injuries was found to be highest in zone 1. This study emphasizes the importance of the need for soldiers deployed in active CIOps regions to wear protective eyewear, such as ballistic goggles or military combat eye protection, to reduce the risk of ocular injuries.
Did healthy life awareness affect the behavioral or cognitive avoidance attitude from COVID-19? An observational study
Authors: Şen Ayşegül , Başpınar Melike Mercan , Basat Okcan 
Published: November 2023

Aim:
This study purposed to evaluate the healthy life awareness (HLA) level versus the COVID-19 avoidance attitudes.

Materials and Methods:
A single-centered observational study was conducted in the Family Medicine Clinics of a tertiary hospital between April 30, 2021 and July 30, 2021. The HLA scale was used to determine the participants' HLA levels. In addition, the avoidance attitudes from the COVID-19 scale score assessed attitudes toward avoiding COVID-19. Data were analyzed with E-Picos (MediCRES) Statistical Programme.

Results:
Of the 311 participants aged 30.79 ± 8.37 years, 58.52% (n = 182) were female and 41.48% (n = 129) were male. A negative relationship between the HLA and cognitive avoidance scores (r = −0.255, P < 0.001) and a positive relationship between HLA and behavioral avoidance scores (r = 0.119, P = 0.036) have been indicated. The results of a binary logistic regression, taking the presence of a higher HLA score as the dependent variable, have shown that high awareness was observed in women, approximately 1.7 times more than in men [odds ratio (OR): 1.684, 95% confidence interval (CI) = 1.058–2.696; P = 0.030]. Participants with high HLA had 1.06 times higher behavioral avoidance scores than others (OR: 1.066, 95% CI = 1.012–1.455; P = 0.049). As the cognitive avoidance score increased, the presence of high HLA decreased by nearly 33%. (OR: 0.666, 95% CI = 0.512–0.867; P = 0.002).

Conclusion:
This study emphasized that a higher HLA was associated with increased behavioral avoidance and decreased cognitive avoidance from COVID-19. HLA has led to doing what needed to be done without being affected by negative discourses.
Comparative study of ‘the clinical profile of COVID-19-positive patients with and without vaccination profile’
Authors: Kullolli Dhruv Vijay , Kullolli Monika , Gore Alka Dilip 
Published: November 2023

Background:
More than 4.5 million people have perished from the COVID-19 virus, which has so far been linked to more than 200 million reported cases. Vaccination is an ultimatum for survival from this disease. Hence, this research was designed to study the course of disease in vaccinated and unvaccinated group and to understand the significance of blood markers, to study lung involvement (HRCT), number of hospitalised days, number of O2 days, and number of days of ventilator support in both the groups in hospitalised patients.

Material and Methods:
A cohort study was conducted among COVID-19-positive patients tested either with rapid antigen test or RT-PCR test hospitalised in Kullolli Institute of Health Services. Patients who had received at least one dose of vaccination were included in the analysis. Data were analysed by using unpaired t-test, between the two groups of survived and non-survived patients. Chi-square test and/or Fisher's exact tests were used to check the association.

Results:
In the study, only 71 (18.6%) patients were vaccinated. There were 49 (69.01%) patients out of 71, representing a massive number of vaccinations for people over the age of 50. There were 40 patients with co-morbid conditions, 31 (77.50%) of whom were vaccinated. CRP levels were significantly severe in non-survived patients of non-vaccinated group (Fisher's exact = 8.938, P = 0.024). d-Dimer levels, serum ferritin levels, and HRCT scores were significantly related to the outcome (survival/non-survival). Patients who did not survive have higher levels of these parameters. In the vaccinated group, these associations were not significantly associated. Vaccination did not show statistically significant benefits in patients with co-morbid conditions.

Conclusion:
Vaccination has enormous life-saving potential. Regardless of the type of vaccine used, the immunisation provides life-saving protection against a disease that has killed millions.
Perception and attitude of type 2 diabetic patients toward insulin therapy in the primary care of National Guard for Health Affairs (NGHA) in Jeddah, Saudi Arabia
Authors: Alzahrani Abdullah M. , Alshareef Reem J. , Balubaid Marwan M. , Alzahrani Mohammed , Alsoubhi Mohammed , Shaheen Mostafa 
Published: November 2023

Purpose/Background:
Our study explores and determines the perception toward insulin among patients with diabetes in the National Guard for Health Affairs (NGHA), Jeddah, the Kingdom of Saudi Arabia (KSA), and aims to gain insight into the causes of refusal. Patients with type 2 diabetes (T2D) are likely to need the use of insulin to keep blood glucose levels within normal range and delay the onset of diabetes-related problems. Individuals with diabetes may be hesitant to begin insulin therapy if they have a negative attitude toward it, which might add to the delay in beginning treatment.

Materials and Methods:
A cross-sectional study was conducted in the primary healthcare centers of the NGHA in Jeddah, Saudi Arabia. Data were collected through a validated self-administered questionnaire that was divided into three sections, with a total of 32 questions. The first section concerned demographic data, the second part was directed toward insulin users, and the last section was directed toward non-insulin patients.

Results and Conclusion:
Our study collected 314 responses. Males constituted 54.8% of participants and insulin users resembled 45.7%. According to our study, important deterrents to starting insulin therapy among non-insulin users included the following: the cost of insulin, the pain associated with injections, the difficulty in maintaining food control while on insulin treatment, scarring at the injection site, and the weight gain impact. Factors that were found to influence compliance to insulin therapy among insulin users included fear of weight gain and self-administration of insulin.
Description of HIV risk behavior among adolescent female sex workers: Findings from the nationwide cross-sectional integrated biological and behavioral surveillance (IBBS) 2014–15 survey for HIV in India
Authors: Rai Sanjay K. , Thakur Nishakar , Jha Shreya , Kumar Pradeep , Haldar Partha , Kant Shashi , Misra Puneet , Venkatesh Srinivas 
Published: November 2023

Introduction:
Adolescent female sex workers are at high risk of acquiring human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) infection. There was paucity of information regarding their sexual practices. The main objective of this study was to study the sexual behavior, condom use practices, and physical and sexual violence experienced by adolescent female sex workers (FSWs).

Materials and Methods:
This study was a secondary data analysis of the data collected during the nationwide IBBS 2014–15 survey. All adolescent FSWs aged 15 to 19 years were included in the analysis. The primary outcome variable was HIV serostatus, and independent variables included sexual behavior and condom use practices and socio-demographic variables. Descriptive analyses were performed to estimate the prevalence of independent variables. Ethical approval of the original IBBS study was obtained by the Ethics Committee of National AIDS Control Organization.

Results:
A total of 948 adolescent FSWs were included in the final analysis. The prevalence of HIV in adolescent FSWs was 1.2% [95% confidence interval, 0.1–1.9%]. The mean age [standard deviation (SD)] of FSWs was 18.2 (0.9) years. The mean (SD) age at first sexual intercourse was 15.6 (1.7) years, and the mean (SD) age of starting sex work was 16.6 (1.5) years. The majority of the FSWs (94%) had used condom during the last sexual intercourse with a commercial partner, and about one-thirds (66%) had consistently used condom with a commercial partner. About a quarter (26%) of the FSWs had anal intercourse with a commercial partner in the last 1 month. About one in five FSWs (21%) had experienced physical violence in the last 1 year.

Conclusion:
Almost one-third of FSWs had high-risk sexual behavior like multiple clients, anal intercourse, inconsistent condom use, and so on. These behaviors in turn increase their vulnerability to HIV infection.
NAT yield in blood donors: An observational study
Authors: Sharma Ankit , Bundas Sunita , Parashar Rashmi 
Published: November 2023

Introduction:
Individual donation nucleic acid testing (ID-NAT) is considered as highly sensitive technology for viral transfusion-transmissible infections (TTIs) in blood donors. The present study was aimed to analyze the results of ID-NAT with special reference to different types of donors, their age, gender, blood group ranges in a tertiary care center in north India.

Methodology:
The present study was done from 24th June 2019 to 31st December 2021 in Blood Center, Department of Immunohematology and Blood Transfusion, SMS Hospital, Jaipur. A total of 18313 apparently healthy adult donors were included in present study.

Result:
In 2019 Combined NAT yield was 1 in 754, in 2020 it was 1 in 2368 and in 2021 it was 1 in 741. With Total NAT yield was 1 in 1017 (0.09 %) over a period of study. NAT yield in HBV is 1 in 1077, in HCV 1 in 18313 and no NAT Yield in HIV.

Conclusion:
NAT testing for hepatitis B provides additional safety because ELISA does not pick up occult hepatitis. The non-seroconverting or delayed seroconverting disease is missed by ELISA alone and can be picked up by NAT.
Applications of artificial intelligence in the management of childhood obesity
Authors: Alghalyini Baraa 
Published: November 2023

Background:
Childhood obesity has emerged as a significant public health challenge, with long-term implications that often extend into adulthood, increasing the susceptibility to chronic health conditions.

Objective:
The objective of this review is to elucidate the applications of artificial intelligence (AI) in the prevention and treatment of pediatric obesity, emphasizing its potential to complement and enhance traditional management methods.

Methods:
We undertook a comprehensive examination of existing literature to understand the integration of machine learning and other AI techniques in childhood obesity management strategies.

Results:
The findings from numerous studies suggest a strong endorsement for AI's role in addressing childhood obesity. Particularly, machine learning techniques have shown considerable efficacy in augmenting current therapeutic and preventive approaches.

Conclusion:
The intersection of AI with conventional obesity management practices presents a novel and promising approach to fortify interventions targeting pediatric obesity. This review accentuates the transformative capacity of AI, thereby advocating for continued research and innovation in this rapidly evolving domain.
Association of medication adherence quality measures for diabetes, hypertension, and hyperlipidemia with cognitive decline
Authors: Racsa Patrick N. , Booth Tori A. , Chung Linda N. , Dixon Suzanne W. , Poonawalla Insiya B. 
Published: November 2023

Background:
While diabetes, hypertension, and hyperlipidemia each are associated with increased risk of cognitive decline, little is known regarding how nonadherence to medications for these conditions is associated with cognitive decline risk.

Methods:
We identified patients enrolled in a Medicare Advantage Prescription Drug plan who were eligible for inclusion in the CMS Star Medication Adherence quality measures for diabetes, hypertension, and hyperlipidemia in 2018, 2019, and 2020. To achieve an adherence quality measure, patients had to meet 80% of the proportion of days for the medication. We used propensity score with inverse probability of treatment weighting to balance outcomes for baseline characteristics and logistic regression models to compare odds of cognitive decline outcomes across patient groups.

Results:
The study population of 99,774 individuals had a mean age of 71.0 years and was 49.1% female, 73.9% White, and 17.8% Black, with 62.0% living in an urban setting. Compared with patients who missed zero adherence measures, those who missed one measure had 23%–33% increased odds of cognitive decline (any decline OR = 1.23; dementia OR = 1.33; Alzheimer's disease OR = 1.27; all P values <0.01). Patients who missed 2–3 measures had 37%–96% increased odds of cognitive decline (any decline OR = 1.37; dementia OR = 1.58; Alzheimer's disease OR = 1.96; all P values <0.01). Patients who missed ≥4 adherence measures had the greatest odds of cognitive decline (any decline OR = 1.64; dementia OR = 2.05; Alzheimer's disease OR = 2.48; all P values <0.01).

Conclusion:
Not achieving CMS Star Medication Adherence quality measures for diabetes, hypertension, and hyperlipidemia therapies was associated with increased risk of cognitive decline outcomes.