bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macular vessel densities by optical coherence tomography angiography in patients with intermediate uveitis
Authors: Sarıgül Sezenöz Almila , Güngör Sirel Gür , Kurt Rengin Aslıhan , Gökgöz Gülşah , Adwan Noor , Toprak Uğur 
Published: January 2023

Purpose:
To evaluate the macular microvascular changes in patients with intermediate uveitis (IU) using optical coherence tomography angiography (OCT-A) and to determine the relationship of OCT-A measurements with disease duration and activity.

Methods:
This cross-sectional study was performed at the uvea department of a tertiary hospital. Patients with IU (8 women, 8 men; mean age: 28.80 ± 12.80 years) were included in the study. The macular thickness measurements obtained by optical coherence tomography (OCT) (Heidelberg Spectralis, Heidelberg Engineering, Heidelberg, Germany) and macular superficial and deep vessel density (VD) parameters obtained by OCT-A (Avanti RTVue-XR; Optovue, Fremont, CA, USA) were compared with healthy subjects (12 men, 22 women; mean age: 28.40 ± 8.32 years). Eyes with pathology including marked obvious edema in the macula were not included in the study.

Results:
The macular thickness was found to be higher in the patient group (p < 0.001). The deep and superficial VD measurements in almost all quadrants in both superficial and deep layers were significantly lower in the IU patient group (p < 0.05). Macular thickness was increased in the active state of IU (p = 0.03), however, none of the OCT-A parameters showed a significant difference between active and inactive IU patients (p > 0.05). No correlation was observed between OCT-A parameters and total IU disease duration.

Conclusion:
Quantitative analyses of macular vascular structures demonstrate significantly reduced VD in both superficial and deep retinal layers in IU patients. Considering the importance of the macula in visual prognosis, OCT-A can provide crucial data for the monitoring and follow-up of IU patients.
Factors affecting the epithelial integrity of human donor corneas
Authors: Kaur Amanjot , Mohamed Ashik , Priyadarshini Smruti R , Mohanty Amrita , Sahu Srikant K , Das Sujata 
Published: January 2023

Purpose:
To evaluate various factors affecting the integrity of human donor corneal epithelium.

Methods:
Donor corneal buttons were evaluated for epithelial defect (ED) and exposure. The slit-lamp photographs were taken on day 01, and the data such as age and gender of the donor, cause of death, refrigeration of cadavers, death-to-preservation time (DPT), experience of technician, and distance from site of collection to eye bank were collected.

Results:
A total of 100 consecutive corneal buttons belonging to 56 donors were evaluated. The median age of donors was 50 years. Males constituted 45 (80.4%). The mean DPT was 9.7 ± 5.3 hours. After death, 34 donors (60.7%) were refrigerated before the collection/retrieval. Most of the corneas (80%) were recovered by technicians having an experience of 0–5 years. Thirty-one donors (55.3%) were located at 1–50 km from the eye bank. The mean area of exposure was 15 ± 4.3 mm2. The mean area of ED was 28.7 ± 5.9 mm2. ED was significantly associated with refrigeration of cadavers and longer DPT. On multivariate analysis, only DPT was found to be significantly associated (P = 0.006; odds ratio [OR] = 1.54 ± 0.24) with the presence of ED. After transplantation, only two corneas had persistent epithelial defects and were treated successfully using various interventions.

Conclusion:
Integrity of donor corneal epithelium is mainly influenced by the refrigeration of cadavers and DPT.
Comparison of topical steroids versus adjunctive intracameral triamcinolone versus posterior subtenon triamcinolone in pediatric cataract surgery
Authors: Raina Usha K , Ravinesh Kumar , Bhattacharya Shruti , Pavitra Banu , Thakar Meenakshi 
Published: January 2023

Purpose:
Prolonged postoperative topical corticosteroids are commonly given after pediatric cataract surgery to control inflammation. This study was undertaken to compare the efficacy, safety, and compliance of postoperative topical steroids and adjunctive intracameral (I/C) triamcinolone acetonide (tricort) and posterior subtenon (PST) triamcinolone in modulating postoperative inflammation after surgery.

Methods:
Forty-eight eyes of children with pediatric cataract between the ages of 5 and 10 years were randomized into three equal groups (T, I, S) before surgery. Group T received postoperative topical 1% prednisolone tapered over 4 weeks; Group I received adjunctive intraoperative I/C 1.2 mg/0.03 ml tricort and topical 1% prednisolone for 2 weeks postoperatively, and Group S received a single 0.5 ml (40 mg/ml) PST tricort without topical steroids. Signs of inflammation, intraocular pressure (IOP), and central corneal thickness were assessed at day 1, week 1, week 3, week 6, and week 12 postoperatively with optical coherence tomography (OCT) macula to rule out cystoid macular edema at the sixth and 12th weeks postoperatively.

Results:
Posterior synechiae were present in two eyes out of 16 in groups T and I, which resolved. Severe anterior chamber cells were present in four eyes out of 16 in group T, in two eyes in group I, and in one eye in group S, which resolved. All groups had comparable pre- and postoperative IOP.

Conclusion:
In pediatric cataracts, outcomes were better with PST tricort and the adjunctive I/C tricort compared to postoperative topical prednisolone, for modulating postoperative inflammation.
Evaluation of retinal function and morphology in isoametropic amblyopia
Authors: Sharma Pradeep , Anand Mrinalini , Sharma Anu , Phuljhele Swati , Saxena Rohit 
Published: January 2023

Purpose:
To observe the photoreceptor anomalies in cases of ametropic amblyopia.

Methods:
A prospective study with 25 isoametropic amblyopic children in the age group of 5–14 years and 25 age-matched controls was done. Examination included refraction, best-corrected visual acuity (BCVA), and color vision. Adaptive optics (AO) and multifocal electroretinogram (mf-ERG) were done to assess the anatomy and function of photoreceptors. The subgroup analysis of the improved and non-improved groups was done.

Results:
The mean cone density in cases and control in the superior, temporal, and nasal quadrants was respectively as follows (21640 ± 5713, 24040 ± 3386, P = 0.01) (19755 ± 6282, 21832 ± 2911, P = 0.03) (19897 ± 5418, 22171 ± 3660, P = 0.01) (20768 ± 4799, 22819 ± 3241, P = 0.01). The amplitude of N1 wave and P1 wave in cases was significantly low compared to the controls. Cases with subnormal color vision had reduced BCVA (0.55 ± 0.018) in comparison to the children with normal response (0.350 ± 0.014). Cone density was also significantly reduced in children with subnormal color vision. Sixteen out of 25 cases showed BCVA improvement with spectacles. Baseline cone density was found to be significantly higher in the improved group. There was no correlation between BCVA and AO parameters.

Conclusion:
Patients with ametropic amblyopia show subnormal photoreceptor properties than controls. Low cone density may be associated with defective color vision and poor prognosis in these cases.
A stitch in time saves my (ne) (vision)
Authors: Shivanna Yathish , Koul Ameeta , Sanjay Srinivasan 
Published: January 2023

Background:
Corneal melt with iris prolapse is a rare complication of autoimmune diseases, especially rheumatoid arthritis.

Purpose:
To highlight a challenging case of a peripheral ulcerative keratitis (PUK) with corneal melt and iris prolapse in a patient’s only eye.

Synopsis:
A 56-year-old Asian Indian male presented with blurring of vision in the right eye and was diagnosed with cataract. He was a known type 2 diabetes mellitus and a rheumatoid arthritis patient and was not on treatment. He had been previously diagnosed with PUK in the left eye and was lost to follow-up due to coronavirus disease 2019 (COVID-19) after therapeutic penetrating keratoplasty and lost his vision in that eye. Cataract surgery in the right eye was done under cover of immunosuppression. Subsequently, he developed PUK and was treated with a glue and bandage contact lens. Again, he was lost to follow-up and then presented a few months later with corneal melt with iris prolapse in the right eye. We describe in the video the surgical and medical challenges and successful salvage of both the eyeball and the vision.

Highlights:
Highlights include the following: A rare case of corneal melt with iris prolapse. 2. Demonstration of surgical technique of patch graft. 3. Anterior segment optical coherence tomography before and after the procedure.

Video link:

https://youtu.be/HbgixlEAYKU

Key words: Corneal melt, iris prolapse, immunosuppression, patch graft, rheumatoid arthritis
Taming the polar bear: Ten tips to manage posterior polar cataract
Authors: Mohan Sashwanthi , Mohan Sujatha , Rajan Mohan 
Published: January 2023

Background:
Posterior polar cataracts are challenging even for skilled cataract surgeons due to the high risk of posterior capsule rupture and vitreous loss during cataract surgery; hence, it is important to know how to manage such cases.

Purpose:
In this video, we describe the necessary precautions and steps to be taken to prevent and manage complications in phacoemulsification cataract surgery for posterior polar cataracts.

Synopsis:
The video contains ten tips to follow to avoid complications while performing phacoemulsification cataract surgery in patients with posterior polar cataracts and includes preoperative identification on slit-lamp examination, size of capsulorhexis, avoidance of hydrodissection, technique of nucleus management, viscoelastic injection to keep the anterior chamber formed, epinucleus and cortical matter removal, posterior capsular rupture management, anterior vitrectomy, and intraocular lens (IOL) implantation in eyes with posterior capsular rupture.

Highlights:
The video highlights ten different steps to be followed in the surgical management of patients with posterior polar cataract which, if followed meticulously, can give excellent outcomes in these patients.

Conclusion:
Posterior polar cataracts can be managed with phacoemulsification, with good visual outcomes if these precautions are followed.

Video link:

https://youtu.be/TeoLckE83xM. Additional information: Won Best Educational Video in a contest by phacotraining.org
Interdisciplinary care in orbital complications of acute rhinosinusitis in children
Authors: Trbojević Tena , Penezić Ana , Sitaš Ingrid , Grgić Marko Velimir , Ravlić Maja Malenica , Štefanović Iva Mihatov 
Published: January 2023

Purpose:
Orbital cellulitis is a serious condition with potentially severe complications. Treatment requires interdisciplinary care and early introduction of antimicrobial therapy. In our tertiary center, a team of pediatricians, pediatric ophthalmologists, and otorhinolaryngologists successfully participated in the management of pediatric periorbital/orbital cellulitis. This study aimed to demonstrate our interdisciplinary approach and to investigate clinical profile and management of pediatric periorbital/orbital cellulitis.

Methods:
A retrospective chart review was performed of all pediatric patients hospitalized for periorbital and orbital cellulitis in a tertiary hospital center from September 15, 2016, to March 15, 2020.

Results:
A total of 26 children—median age 2.7 years (range 0.5–12)—were treated during the study period. Disease presentation was unilateral, mainly during winter (n = 12) and autumn (n = 12), without ophthalmoplegia/proptosis. Seven patients had orbital cellulitis (Chandler classification of ≥III) and were older (6.5 years, P = 0.011) with sinusitis (P < 0.001), required surgery (P = 0.004), underwent longer antimicrobial treatment (13 days, P < 0.001), and had a longer length of hospital stay (13.43 days, P = 0.001). Orbital cellulitis occurred in a median of three days (range 1–12) of acute rhinosinusitis. Radiological survey was performed in 11 patients, whereas six patients were treated surgically. All intraoperatively collected cultures (sinus swabs) were positive, whereas Streptococcus pyogenes and Peptostreptococcus were isolated in five cases. All patients fully recovered. No recurrence was documented.

Conclusion:
Sinusitis is associated with severe orbital cellulitis and surgical management. Orbital cellulitis occurred early in the course of acute rhinosinusitis, as a distinctive presentation of rhinosinusitis. Interdisciplinary care and early management are crucial in treatment of pediatric periorbital/orbital cellulitis.
Parallelism between hypovitaminosis D3 and recently detected myopia in children with amplified screen use in the COVID-19 era—A preliminary study
Authors: Pannu Anju , Vichare Nitin , Pushkar K , Kumar Anupam , Gupta Simple 
Published: January 2023

Purpose:
This introductory study aims to analyze the association of serum vitamin D3 levels with recently detected myopia in Indian children following home confinement post-COVID-19 pandemic.

Methods:
Children aged 5–15 years who had not attended physical school in the past 1 year and visited the ophthalmology department with various ocular symptoms were divided into two groups: the myopic group with recently detected myopia and the non-myopic group with ocular ailments other than myopia. All children underwent basic ophthalmic evaluation and a general physical examination. Blood samples were collected for serum vitamin D3 levels. A pretested questionnaire inquiring about the duration of exposure to a digital screen, outdoor activities, and socioeconomic status was filled out for all children.

Results:
The mean serum vitamin D3 level in the myopic group was 28.17 ± 15.02 ng/dl in comparison to 45.36 ± 17.56 ng/dl in the non-myopic group (P value < 0.05). Linear regression of the data establishes that myopia is associated with hypovitaminosis D3 (OR- 13.12, 95% CI 2.90–50.32, a P value of 0.001). The correlation between spherical equivalent and vitamin D3 levels was significant (Pearson correlation value: 0.661). In the myopic group, 63.3% of children had screen use >6 hours against 43.3% of children in the non-myopic group. In the myopic group, 33.3% of the children had an outdoor activity duration of <2 hours against 6.6% of children in the non-myopic group.

Conclusion:
This study proposes hypovitaminosis D3 as a strong factor associated with the development of myopia in children. Although it is a preliminary study, it suggests that the trial for vitamin D3 supplementation in young children to delay or cease the development of myopia is warranted.
Apples to Oranges
Authors: Wlodarczyk Jordan R. , Yoon Dong Hum , Wickham Carey J , Mirza Kasim L. , Wang Johnny , Lee Sang W. , Ault Glenn T. , Cologne Kyle G. 
Published: January 2023

Background:
Over- prescription of opioids after surgery contributes to the national opioid epidemic. Differences may exist with procedure type, but these are understudied.

Objective:
This study aims to evaluate opioid consumption patterns following hemorrhoidectomy vs. other anorectal operations, as hemorrhoidectomy recovery is reportedly more painful.

Design:
Retrospective cohort study with prospective telephone survey.

Setting:
Single safety net hospital.

Patients:
Group of 27 and 73 patients undergoing outpatient hemorrhoidectomy and anorectal surgery other than hemorrhoidectomy, respectively, between July 2019 and March 2020.

Main Outcome Measures:
We measured the prescription and consumption quantities of morphine milligram equivalents (MME) after surgery for hemorrhoids vs. other anorectal procedures.

Results:
MME prescribed at discharge was higher for the hemorrhoid cohort vs. for other anorectal surgery (86.1 ± 17.5 vs. 76.0 ± 6.3, P < 0.001). The hemorrhoid group utilized higher quantities of MME during recovery: 30 (IQR 75 MME) vs. 6.25 (IQR 30 MME), P = 0.017), and also expressed lower satisfaction with their post-operative pain control regimen (33.3% vs. 88.3%, P < 0.001). No differences were seen in patients continuing on opioids on postoperative day seven (p = 0.348), and patients with complete compliance with their non-opioid multimodal pain control regimen (p = 1.0). Return trips to the emergency department for pain and patients requiring additional opioid medication after discharge were higher in the hemorrhoidectomy group (33.3% vs. 1.3%, P < 0.001 and 14.8% vs. 1.3% P = 0.016, respectively). The 50th, 75th, and 90th percentile for total MME consumed by the hemorrhoidectomy (vs. other anorectal surgery) cohort were 75 (vs. 30), 75 (vs. 54), and 97.5 (vs. 75) MME, respectively.

Conclusions:
Hemorrhoidectomy surgery requires up to five times the amount of opioids for postoperative pain control compared to other anorectal surgeries. Prescribed opioids still exceed the amount used, although dissatisfaction with pain control remains high after hemorrhoid surgery. Further study is required to better understand this unique entity.

Limitations:
Retrospective single-center design, patient-reported outcomes, male majority in the non-hemorrhoidectomy group.

Conflict of Interest:
None.
Second-order estimates for collapsed limits of Ricci-flat Kähler metrics
Authors: Broder Kyle 
Published: January 2023

AbstractWe show that the singularities of the twisted Kähler–Einstein metric arising as the longtime solution of the Kähler–Ricci flow or in the collapsed limit of Ricci-flat Kähler metrics are intimately related to the holomorphic sectional curvature of reference conical geometry. This provides an alternative proof of the second-order estimate obtained by Gross, Tosatti, and Zhang (2020, Preprint, arXiv:1911.07315) with explicit constants appearing in the divisorial pole.
A retrospective analysis of Vulva Carcinoma patients treated at a cancer center in Nepal in ten years
Authors: Rana Sarita , Chandra Acharya Bijay , Jalan Aditya , Pandey Manju , Subedi Hemnath , Dhungana Ishan , Lamichhane Nirmal , Shrestha Binuma 
Published: January 2023

Introduction:
Vulvar cancer is not an uncommon condition, accounting for 4-6% of all female genital tract cancers. More than ninety percent of cancers are squamous cell type. In this study, we have attempted to retrospectively analyze the socio-demographic profile of vulvar cancer patients managed at BP Koirala Memorial Cancer Hospital.
Material and methods:
This is a descriptive cross-sectional study, that altogether included 77 patients from January 2009 to December 2019 diagnosed with vulvar cancer conducted at BP Koirala Memorial Cancer Hospital, Nepal. All the demographic and clinicopathological data were collected and analyzed using SPSS 16.0 software. Tumor staging was standardized according to the International Federation of Gynecology and Obstetrics (FIGO) staging system. Quantitative data were represented as mean and standard deviation whereas categorical variables were expressed as frequencies and percentages of an appropriate denominator.

Results:
Among 77 patients, the median age was 55 years. Most were married (97.4%, n=75), farmers (53.2% n=41), smokers (45.45%, n=35), had poor personal hygiene (65.6%, n=50) and illitrate (61%, n=47). The most common presentation was ulcer or growth (88.31%, n=68). Inguinal lymph nodes were palpable in 80.5% (n=62) of patients, out of which 26% (n=20) had fixed and fungating lymph nodes. Most diagnosed clinical was stage III (40.25%, n=31), stage IV (27%, n=21), stage II (19.48%, n=15) and Stage I (13%, n =10). The most common histological grading was moderately differentiated SCC (50.6%, n=39). Management was surgical in 72.72% (n=56) and rest 27.27%(n=21) were sent for chemoradiation. The most common postoperative complications were lymphedema (27%, n= 15) and wound infections (12.5%, n=7). Recurrence observed in 28.57% (n=22) of cases.
Conclusion:
Vulvar cancer is more common among smokers and farmers. The disease is already locally advanced at the time of diagnosis. However, surgery is the main modality of treatment.
A educação superior no projecto camoesas
Authors: Casulo José Carlos de Oliveira 
Published: January 2023

Projecto Camoesas é uma das designações atribuídas à Proposta de lei sobre a reorganização da educação nacional, da autoria de João José da Conceição Camoesas, na altura Ministro da Instrução Pública, apresentada à Câmara dos Deputados portuguesa em 1923.Devido à queda do governo que a apadrinhava, tal proposta de lei acabou por não singrar, mas, não obstante, ficou na História, devido, entre outros, ao facto de ter sido a primeira tentativa de sistematização de uma lei de bases da educação portuguesa. O ensino superior, no âmbito do qual merece ser destacada a vontade de se criarem faculdades de Ciências da Educação nas três universidades portuguesas então existentes (Coimbra, Lisboa e Porto), teve, neste projecto de lei, atenção própria, mormente quanto à sua estrutura, aos seus professores, à sua distribuição territorial e ao seu financiamento, entre outros aspectos. Assim, nesta comunicação, começando por ter em conta a parte do preâmbulo que fundamenta as medidas propostas para este nível de ensino, continua-se com a análise daquelas que, de entre as vinte e quatro bases fixadas, parcial ou totalmente, directa ou indirectamente, se referem ao ensino superior.
EXPLORING TEACHERS' PRACTICAL DECISION MAKING IN TERMS OF TEACHING PROCEDURES
Authors: Samsuri Wulan , Sumarta Sumarta , Acep Bahrum Acep Bahrum 
Published: January 2023

The role of teaching English in senior secondary schools as a component of Indonesian education policy has increased. The curriculum states that the main objectives of English language education are to improve students' basic communication skills, to develop English language, or learning, interests and habits, and to introduce global culture to society. Since language education is based on interpersonal relationships and communication with others, which stem from self-knowledge and understanding, exploring oneself together with oneself can be an important professional in the field. Borg (2003) states that there are several problems related to language education that have not been studied in contact with teacher cognition. This study is about the teacher's consideration in making decisions about teaching procedures. This study uses a qualitative research design to collect data using interviews and observations.
Keyword: Decision making, Teachers, Teaching procedures.
Ultraschall des Bewegungsapparates
Authors: Horn Rudolf , Dietrich Christoph F. 
Published: January 2023

Sicher in jeder Untersuchungssituation!

Der Ultraschall des Bewegungsapparates stellt Ärztinnen und Ärzte in der Notfallmedizin, Orthopädie, Rheumatologie und Chirurgie vor neue Anforderungen: Gerade Anfänger des Ultraschalls, insbesondere im Bereich des Bewegungsapparates, haben sehr häufig Mühe sich vorzustellen, in welchem Ultraschallschnitt welche Strukturen gesehen werden.

Der muskuloskelettale Ultraschall ist ein sehr wertvolles diagnostisches Hilfsmittel bei der Beurteilung von

Erkrankungen oder Verletzungen am Bewegungsapparat. Insbesondere bei Notfallpatienten bietet der Ultraschall die Möglichkeit, die anatomischen Strukturen zu differenzieren und die pathologischen Befunde zu erkennen. Somit können weiterführende Untersuchungen bzw. die Therapie veranlasst werden.

Jede Region am gesamten Bewegungsapparat hat ihre diagnostischen Eigenheiten, sowohl klinisch als auch sonografisch.

Das vorliegende praktisch orientierte Ultraschallbuch im Ringbuchformat

-	zeigt Untersuchungen der wichtigsten Regionen,

-	die Schnittebenen der zu beurteilenden Strukturen (am Körper, am anatomischen Bild sowie am Ultraschallbild)

-	und erklärt die wichtigsten Pathologien mit entsprechenden sonografischen Abbildungen.

Das Ringbuch hat ein handliches Format, das es Ihnen ermöglicht, das Buch neben Ihren Patientinnen und Patienten

und während der Untersuchung zu benutzen. Es enthält viele Kniffe und Tricks, wie der Schallkopf bewegt werden kann, um

die entsprechenden Schnittebenen bestmöglich darstellen zu können. Die bebilderten Hinweise auf Pathologien helfen

Ihnen, Ihre Patientinnen und Patienten richtig zu diagnostizieren und richtig zu behandeln.

Ihr Praxisbegleiter am Ultraschallgerät!