bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary eye care in pediatric population-I study (PREPP-I study): Demographic and clinical profile of pediatric patients treated in six major vision centers of a tertiary eye care facility in South India
Authors: Kalita Iva Rani , Singh Harsh Vardhan , Veena K , Mouttappa Freidrick 
Published: February 2023

Purpose:
The study intends to evaluate the demographic and clinical profile of pediatric patients (0–18 years) attending six vision centers (VCs) of a tertiary eye care facility in south India.

Methods:
This is a cross-sectional observation study conducted at six major peripheral VCs of a tertiary eye care facility in South India from June 20 to Dec 20. All children presenting at the VCs under a base hospital (BH) in Pondicherry, whose parents gave consent were included. Data were entered by the ophthalmic assistants in the VC and cross checked by the principal investigator at the BH.

Results:
A total of 250 pediatric patients were brought to the VCs during the study period, predominantly males (60.8%), with a mean age of 8.2 ± 4.5 years (0–18 years). Half of them were staying within 5 km from the VCs. Most children were escorted by their parents (88%), and the expenditure of travel to the VC was affordable for most of the parents (75%). Also, 53.6% of patients were in their primary school, while schooling had not started for 28% of children. Visual acuity (VA) could be assessed only for school-going children and older children due to lack of age-matched VA assessment tools. Most children (91.3%) had uncorrected VA better than or equal to 6/18 in the better eye, and approximately 3% had VA worse than 6/60. All patients had best corrected VA of 6/6–6/18 after cycloplegic refraction. Most children reported to the VC for allergic conjunctivitis (25%), followed by refractive error (13%) and squint (10.4%). Urgent referral to the BH was made for 47 children.

Conclusion:
Primary eye care in pediatric population-I (PREPP-I) showed that most children can be treated at the VCs and only one-fifth of the children require active intervention at higher referral centers. Further study on satisfaction of services provided for pediatric patients in these VCs and barriers of not reporting to the BH when referred are considered for the PREPP-II study.
Retinal nerve fiber layer thinning found in amyotrophic lateral sclerosis – Correlation with disease duration and severity
Authors: Mohanty Bijendra , Misra Amar Kumar , Kumar Sanjay , Guha Gautam , Bhattacharya Annesh , Ngullie Pideno S , Manna Akash , Nanda Tapashya , Mukherjee Joydeep 
Published: February 2023

Purpose:
The retinal involvement of amyotrophic lateral sclerosis (ALS) is a novel idea about a possible correlation between retinal nerve fiber layer (RNFL) thickness in different spectra of ALS patients. Finding the association of RNFL with disease duration and severity will help identify a novel noninvasive biomarker.

Methods:
The study was designed as a cross-sectional study and was conducted with a suitable proforma. We included the ALS cases based on the revised El Escorial criteria. Healthy controls were age and gender matched. We used the revised ALS functional rating scale (ALSFRS-R) to assess the operational status of the patients. We measured RNFL thickness in the four quadrants with spectral-domain optical coherence tomography (OCT) and analyzed it.

Results:
We included 30 cases (60 eyes) and 10 healthy controls (20 eyes) having a mean (standard deviation [SD]) age of 49.5 (11.1) years with a median of 50 years, and a majority of them (65%) were middle aged (between 41 and 60 years). We found statistically significant differences in RNFL thicknesses between ALS patients and healthy controls. On segmental analysis, the right eye superior and nasal quadrants and the left eye superior, inferior, and nasal quadrants were significantly affected, along with a gross asymmetry found between the left and right eyes among ALS patients. There was a significant decrease in average RNFL thickness in definite ALS patients than probable ALS patients, with significantly reduced average RNFL thickness in moderate to severe ALS patients. On correlation analysis, disease duration showed a good negative correlation with bilateral average RNFL thickness, and the ALSFRS-R score demonstrated a good positive correlation with bilateral average RNFL thickness, which was statistically significant. Thus, a reduced bilateral RNFL thickness is associated with a decreased ALSFRS-R score.

Conclusion:
The retinal changes can serve as a marker for diagnosing and monitoring patients with ALS.
Impact of crossplay between ocular aberrations and depth of focus in topo-guided laser-assisted in situ keratomileusis outcomes
Authors: Khamar Pooja , Shetty Rohit , Annavajjhala Sriram , Narasimhan Raghav , Kumari Savitri , Sathe Priyanka , Roy Abhijit Sinha 
Published: February 2023

Purpose:
To develop a nomogram in cases with mismatch between subjective and Topolyzer cylinder, and based on the magnitude of the mismatch, customize a treatment plan to attain good visual outcomes post-laser-assisted in situ keratomileusis (LASIK) surgery.

Methods:
The patients were evaluated preoperatively using corneal tomography with Pentacam. Five optimal corneal topography scans were obtained from the Topolyzer Vario were used for planning the LASIK treatment. For the nomogram purpose, the patients were divided into three categories based on the difference between the subjective cylinder and Topolyzer (corneal) cylinder. The first group (group 1) consisted of eyes of patients, where the difference was less than or equal to 0.4 D. The second group (group 2) consisted of eyes, where the difference was more than 0.4 D and the subjective cylinder was lesser than the Topolyzer cylinder. The third group (group 3) included eyes where the difference was more than 0.4 D but the subjective cylinder was greater than the Topolyzer cylinder. LASIK was performed with the WaveLight FS 200 femtosecond laser and WaveLight EX500 excimer laser. Assessment of astigmatism correction for the three groups was done using Aplins vector analysis. For comparison of proportions, Chi-square test was used. A P value less than 0.05 was considered statistically significant.

Results:
The UDVA was statistically significantly different when compared between groups 1 and 2 (P = 0.02). However, the corrected distance visual acuity (CDVA) was similar among all the three groups (P = 0.1). Group 3 showed an increase of residual cylinder by −0.25 D, which was significant at intermediate and near reading distances (P < 0.05). Group 3 showed significantly higher target-induced astigmatism (TIA) compared to groups 1 and 2 (P = 0.01). The mean surgically induced astigmatism (SIA) was the least in group 2, which was statistically significant (P < 0.01).

Conclusion:
The outcomes for distance vision using our nomogram postoperatively were excellent, but further refinement for improving the near vision outcomes is required.
Development of the modified Safety Attitude Questionnaire for the medical imaging department
Authors: Eturajulu Ravi Chanthriga , Tan Maw Pin , Zakaria Mohd Idzwan , Chinna Karuthan , Ng Kwan Hoong 
Published: February 2023

Abstract

Introduction:
Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments.

Methods:
Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach’s α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups.

Results:
A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach’s α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker–Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach’s α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups.

Conclusion:
The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.
Factors associated with readmission after long-term administration of tolvaptan in patients with congestive heart failure
Authors: Yamashita Shoko , Takenaka Miki , Ohbayashi Masayuki , Kohyama Noriko , Kurihara Tatsuya , Sunaga Tomiko , Ishiguro Hisaaki , Kogo Mari 
Published: February 2023

Abstract

Introduction:
We investigated the factors associated with readmission in patients with congestive heart failure (HF) receiving long-term administration of tolvaptan (TLV) to support treatment decisions for HF.

Methods:
This retrospective cohort study included 181 patients with congestive HF who received long-term administration of TLV. Long-term administration of TLV was defined as the administration of TLV for 60 days or longer. The outcome was a readmission event for worsening HF within 1 year after discharge. Significant factors associated with readmission were selected using multivariate analysis. To compare the time to readmission using significant factors extracted in a multivariate analysis, readmission curves were constructed using the Kaplan–Meier method and analysed using the log-rank test.

Results:
The median age was 78 years (range, 38–96 years), 117 patients (64.6%) were males, and 77 patients (42.5%) had a hospitalisation history of HF. Readmission for worsening HF within 1 year after long-term TLV treatment occurred in 62 patients (34.3%). In the multivariate analysis, estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 (odds ratio, 3.22; 95% confidence interval, 1.661–6.249; P = 0.001) was an independent significant factor. When eGFR at discharge was divided into two groups (eGFR < 30 vs. eGFR ≥ 30), readmission rates within 1 year were 53.3% vs. 25.4%, respectively (P = 0.001).

Conclusion:
We revealed that eGFR was strongly associated with readmission in patients with HF who received long-term administration of TLV. Furthermore, we showed that eGFR is an important indicator in guiding treatment of HF in patients receiving TLV.
Botulinum Toxin Type A for Refractory Neurogenic Detrusor Overactivity in Spinal Cord Injured Patients in Singapore
Authors: Tow Adela M , Toh Khai-Lee , Chan Siew-Pang , Consigliere David 
Published: February 2023

Introduction: Managing neurogenic detrusor overactivity (NDO) successfully in spinal cord-injured patients is a challenge. The aims of preserving kidney function by achieving safe bladder pressures with anticholinergic medication often leave a significant proportion of patients with side effects. Botulinum toxin type A has been shown to be a promising alternative.

Materials and Methods: Spinal cord injury patients who had NDO, on clean intermittent self-catheterisation, and were refractory to oral medications, were recruited. Three hundred units of botulinum toxin type A (Botox) in 30 mL NaCl solution were injected under cystoscopic guidance into the bladder.

Results: Fifteen patients were recruited of whom 9 were tetraplegic and 6 were paraplegic. Eleven (73.3%) had complete injuries. There was a significant reduction in the mean number of leakages from 3.75 ± 1.79 pre-injection to 0.67 ± 1.31 and 1.5 ± 1.5 at 6 and 26 weeks post-injection, respectively (P <0.05). Seventy-five per cent, 37.5% and 50% were completely dry at 6, 26 and 39 weeks post-injection, respectively. The mean maximal catheterisable volume increased from 312.3 ± 145.6 mL pre-injection to 484.6 ± 190 mL, 422.3 ± 157.3 mL and 490.0

±	230.4 mL at 6, 26 and 39 weeks post-injection, respectively (P <0.005). Maximum detrusor pressure decreased significantly from 66.3 ± 22.6 cmH2O to 21.2 ± 23.1 cmH2O and 33.6 ± 30.2 cmH2O at 6 and 26 weeks post-injection, respectively (P <0.05). The volume at which reflex detrusor contractions first occurred increased from 127.8 ± 57.5 mL pre-injury to 305.7 ± 130.8 mL at 6 weeks and 288.3 ± 13.0 mL at 26 weeks post-injection (P <0.05). Mean cysometric bladder capacity increased from 187.8 ± 69.2 mL to 305 ± 136.4 mL and 288.3 ± 13.0 mL at 6 and 26 weeks post- injury, respectively (P <0.05). Sixty per cent of patients were completely off medications at 6 and 26 weeks post-injection. One patient had urinary tract infection and 1 experienced autonomic dysreflexia during cystoscopy. Satisfaction levels increased from 4.3 ± 2.3 pre-injury to 7.2 ± 1.9 and 7.3 ± 2.3 at 6 weeks and 26 weeks, respectively. This also correlated with fewer leakages.

Conclusion: Botulinum toxin type A injected into the detrusor is safe and efficacious for spinal cord injured patients with refractory detrusor overactivity. This effect is maintained at 26 weeks post-injection.

Key words: Anticholinergics, Spinal cord injury, Urodynamics, Voiding
Impact of Climate Change on Food Security in Northern Nigeria
Authors: Sambo Usman , Sule Babayo 
Published: February 2023

Climate change is gradually transforming the globe into a difficult zone of survival for all faunas and floras owing to the existential threat that some changes are causing in the environment. The careless and unguarded activities and detrimental practices of man created a chain of reaction of nature in the surrounding environment leading to the collapse of the green zone and global warming which are all tantamount to undesired repercussions. One of the regions heavily affected by the impacts of climate change in Nigeria, specifically Northern Nigeria. The Northern part of Nigeria is known for many centuries as an agrarian region that is producing sufficient food which sustained the region and supplies Lake Chad and other West African states with food. However, this productive trend was radically reversed owing to many factors with climate change as the prime. This study will examine analytically how climate change influences or affects food production and food security in Northern Nigeria. The study proposes to use documented sources including books, journal articles, reports, media sources, maps and charts where applicable for data collection while thematic analytical interpretations will be used for data analysis. It is anticipated that the study explored the roots of the problem uniquely in the Northern Nigerian context, how it manifests and how it is directly or indirectly linked with socioeconomic and political problems such as violence, insurgency, forced migration, ethnic and religious clashes, famine, diseases and malnourishment. The study used the discoveries and findings from the investigation to proffer alternative remedies, models and practical policy suggestions for addressing the phenomenon permanently.

Received: 9 December 2022 | Revised: 5 January 2023 | Accepted: 30 January 2023

Conflicts of Interest
The authors declare that they have no conflicts of interest to this work.

Data Availability Statement
Data sharing not applicable – no new data generated.
Maclaurin Symmetric Mean Aggregation Operators Based on Spherical Fuzzy Information and Application to Decision-Making
Authors: Zedam Lemnaouar , Ullah Kifayat , Sajjad Hafiz Muhammad , Hussain Amir , Parveen Azra 
Published: February 2023

In contemporary information fusion theory, the Maclaurin symmetric mean (MSM) operator is a traditional mean type aggregation operator (AO) that is an appropriate-able technique for aggregating numerical quantities. The MSM operator’s ability to record the relationships between the several input arguments is one of its standout features. The spherical fuzzy set (SFS) is also a remarkable technique that covers the maximum information from real-life scenarios with the help of four grades. This manuscript consists of the development of the MSM and weighted MSM for the information obtained by SFS. Consequently, the spherical fuzzy MSM (SFMSM) and spherical fuzzy weighted MSM (SFWMSM) operators are developed, and their basic properties are studied. Finally, the developed SFMSM and SFWMSM operators have been applied to the real-life problem of the multi-attribute decision-making problem. All the results are compared and then clearly tabulated and graphed.

Received: 24 November 2022 | Revised: 6 January 2023 | Accepted: 23 January 2023

Conflicts of Interest
The authors declare that they have no conflicts of interest to this work.
Menstrually-related stabbing headache in a patient without migraine: case report
Authors: Valença Marcelo Moraes , Silva-Néto Raimundo Pereira 
Published: February 2023

Introduction
Stabbing headache is considered a primary headache and is a prevalent entity in the general population.
Objective
To present an unusual case of stabbing headache associated with menstruation.
Method
Data collected through complete anamnesis.
Case report
The authors report a case of a woman suffering from a stabbing headache which features that has not been previously described – a menstrual pattern in the presentation of stabbing headache attacks.
Conclusions
We conclude that this menstrual pattern of stabbing headache attacks is unusual in patients with primary stabbing headache and that it does not fulfil diagnostic criteria for migraine or tension-type headache.
Development and Psychometric Evaluation of the Computer-Aided Measure of Chinese Handwriting Legibility (CAM-CHL) for School-Age Children
Authors: Huang Wen-Feng , Wang Tien-Ni , Chuang Po-Ya , Chen Hao-Ling 
Published: February 2023

Abstract
Importance: Handwriting legibility is the main criterion for determining whether a child has handwriting difficulties. A comprehensive assessment of handwriting legibility with sound psychometrics is essential to timely identification of handwriting difficulties and outcome measurement after handwriting interventions.
Objective: To evaluate the psychometrics of the Computer-Aided Measure of Chinese Handwriting Legibility (CAM-CHL) and to investigate Chinese handwriting legibility in school-age children using the CAM-CHL.
Design: Cross-sectional, repeated observation, test–retest.
Setting: Elementary schools in Taiwan.
Participants: We recruited 25 lower-grade children for the examination of test–retest reliability, 75 children from all grade levels, and 10 senior schoolteachers for the examination of the CAM-CHL’s convergent validity and the investigation of handwriting legibility.
Outcomes and Measures: Children were asked to copy a set of Chinese characters as legibly as possible. We used the CAM-CHL to assess handwriting legibility in four domains: Size, Orientation, Position, and Deformation. The schoolteachers were asked to subjectively assess the handwriting legibility using a 3-point Likert-type scale.
Results: The CAM-CHL demonstrated good to excellent test–retest reliability and acceptable random measurement error in all legibility domains. The CAM-CHL had fair to moderate convergent validity with schoolteachers’ perceptions. Additionally, upper-grade children had better handwriting legibility in the Size and Position domains than lower-grade children.
Conclusions and Relevance: The CAM-CHL, a comprehensive and objective method of assessing Chinese handwriting legibility, has sound reliability and acceptable validity, suggesting its potential as an outcome measure for school-age children.
What This Article Adds: The CAM-CHL can be used in comprehensive evaluations of Chinese handwriting legibility in school-age children. The CAM-CHL has acceptable psychometrics for use as an outcome measure.
Association of Type 2 Diabetes Mellitus with Fatty Liver
Authors: Shah Syed Umer , Hafeez Muhammad , Naveed Muhammad , Hussain Altaf , Khan Muhammad Shahid , Shahbaz Shanzah 
Published: February 2023

Objective: To assess the association of fatty liver with type 2 diabetes and other socio-demographic factors among the patients at Pak Emirates military hospital Rawalpindi.
Study Design: Cross-sectional analytical Study.
Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan from Aug 2019 to Jan 2020.
Methodology: This study was conducted on 300 patients of type 2 diabetes mellitus reporting for a routine checkup at the medical Outpatient department. Fatty liver was diagnosed on ultrasound by a consultant radiologist.
Results: Out of three hundred patients with diabetes mellitus included in the final analysis, 225(75.0%) were males, and 75(25.0%) were females. 176(58.6%) had fatty liver on ultrasound, while 124(41.4%) had no fatty liver on ultrasound examination at the time of the study. we found that increasing age, long duration of diabetes and poor control of illness had a statistically significant relationship with the presence of fatty liver among the target population (p<0.05).
Conclusion: Patients with type 2 diabetes had a high frequency of fatty liver on routine ultrasound examinations. In addition,patients with more age, long duration of diabetes mellitus and poor control of illness were at a high risk of developing fatty liver among the study participants.
Diagnostic Accuracy of Kramer Visual Assessment of Jaundice in Term Neonates Taking Total Serum Bilirubin Levels as the Gold Standard
Authors: Mumtaz Shaista , Shafiq Muhammad Faisal , Khan Kenan Anwar , Hussain Murtaza , Rahman Asbah , Shafiq Sania 
Published: February 2023

Objective: To determine the Diagnostic accuracy of Kramer's visual assessment of jaundice in term neonates by taking total serum bilirubin levels as a gold standard.
Study Design: Cross-sectional study.
Place and Duration of Study: Neonatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, Mar to Sep 2019.
Methodology: The study was based on examining and investigating 300 neonates. Kramer scale was used to examine jaundice in all neonates, and results were compared to total serum bilirubin levels.
Results: A total of 300 patients were included in this study. The mean bilirubin level was 229.1±74.5mol/L. The sensitivity and specificity of visual assessment of jaundice using the Kramer visual scale were 83.84% and 73.53%, respectively, for neonates who were not jaundiced below the abdomen and thighs included in Kramer zones 1 to 3.
Conclusion: Kramer visual assessment can be used as a noninvasive screening method in neonates jaundiced up to the abdomen and thighs, which is included in Kramer zones 1 to 3 but for markedly jaundiced neonates Kramer scale is not a reliable noninvasive method of bilirubin estimation.