bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unanswered Questions Pertaining to the Economic and Workforce Issues in Pediatric Ophthalmology
Authors: Lee Karen E. , Sussberg Jake A. , Nelson Leonard B. , Thuma Tobin B. T. 
Published: May 2023

Purpose:
To create a survey that examines remaining unanswered questions related to the economic and workforce issues in pediatric ophthalmology.

Methods:
A 12-question survey was distributed to U.S.–based pediatric ophthalmologists on the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) discussion board and various other social media forums. Statistical analysis was performed on the basis of practice setting groups.

Results:
Two hundred eighty-seven pediatric ophthalmologists completed the survey. Of all respondents, 150 (52.3%) believed pediatric ophthalmology is a prestigious subspecialty, 137 (47.7%) thought that a hybrid fellowship combining pediatric ophthalmology and adult cataract surgery would increase the number of practicing pediatric ophthalmologists, 189 (65.9%) felt that early exposure during medical school would increase the number of residents who ultimately apply to pediatric ophthalmology fellowship, and 81 (28.2%) believed that the lobbyists hired by the AAPOS will be successful in preventing further Centers for Medicare and Medicaid Services reimbursement cuts. Medicaid patients comprised more than 25% of the total practice for 156 (54.4%) respondents. New patient, follow-up, and surgery wait times were greater than 2 months in 50.9%, 46.7%, and 38.7% of respondents, respectively.

Conclusions:
As the economic crisis in pediatric ophthalmology continues to worsen, questions related to increasing interest in the field through early exposure, hybrid fellowship, prestige, appointment wait times, and belief in the success of AAPOS lobbyists remain. Exceptional measures are required to revitalize the field and improve access to care.

[
J Pediatr Ophthalmol Strabismus
. 2023;60(3):163–169.]
Clinical Results of Accelerated Iontophoresis-Assisted Epithelium-on Corneal Cross-linking for Progressive Keratoconus in Children
Authors: Oliverio Giovanni William , Vagge Aldo , Gargano Romana , Aragona Pasquale , Roszkowska Anna M. 
Published: May 2023

Purpose:
To evaluate the clinical characteristics of pediatric patients with progression of keratoconus after accelerated iontophoresis-assisted epithelium-on corneal cross-linking (I-ON CXL) and to assess the efficacy and safety of re-treatment using accelerated epithelium-off CXL (epi-OFF CXL).

Methods:
Sixteen eyes of 16 patients (mean age: 14.6 ± 2.5 years) with keratoconus underwent I-ON CXL. The main outcome measures were uncorrected distance visual acuity, corrected distance visual acuity, maximum keratometry index (Kmax), minimum corneal thickness, elevation front and elevation back measured at the thinnest point, total higher order aberrations root main square (HOA RMS), coma RMS, and spherical aberration. An increment of Kmax greater than 1.00 diopter (D) and a decrease of greater than 20 µm in pachymetry were considered to determine the progression of keratoconus. Patients with progression of keratoconus after I-ON CXL were re-treated using an epi-OFF CXL protocol.

Results:

Two years after I-ON CXL, 12 patients showed progression of keratoconus, whereas 4 patients were stable. There was significant worsening of Kmax (
P
= .04) and steepest keratometric reading (
P
= .01). Furthermore, a significant correlation was documented between progression of keratoconus and age (
P
= .02). These patients were re-treated using an epi-OFF protocol and after 2 years all patients were stable, and a statistically significant reduction of the mean Kmax (
P
= .007), HOA RMS (
P
= .05), and coma RMS (
P
= 05) was observed.

Conclusions:
I-ON CXL was ineffective in the treatment of pediatric keratoconus in younger children, whereas it had an efficacy of 2 years in older children. Re-treatment using epi-OFF CXL proved effective to halt progression of keratoconus after I-ON CXL failure.

[
J Pediatr Ophthalmol Strabismus
. 2024;61(1):44–50.]
Gestion du fait religieux en milieu de travail : le juge français, garant d’un équilibre des droits
Authors: Desbarats Isabelle 
Published: May 2023

En 2021, plus de 66 % des encadrants déclaraient observer occasionnellement ou régulièrement des faits religieux au travail*. Certes, les conflits semblent rares ou en tout cas sont peu médiatisés. Reste que le fait religieux se banalise en entreprise, ce qui soulève deux questions. D’une part, il s’agit de savoir de quelle façon les entreprises peuvent réagir sans discriminer. D’autre part, l’enjeu est d’identifier la manière dont le juge peut, ou non, s’immiscer dans des prises de décisions à connotation religieuse.*. L. Honoré, Religion au travail : croire au dialogue. Baromètre du Fait Religieux en Entreprise 2020-2021, Institut Montaigne, mai 2021.
La Cour suprême des États-Unis face aux prérogatives managériales et à la négociation collective
Authors: Finkin Matthew W. 
Published: May 2023

Cet article s’intéresse au rôle de la prérogative managériale dans le cadre des négociations collectives. La loi - qui est en fin de compte entre les mains des juges - décide des questions sur lesquelles les syndicats peuvent exiger de négocier et de faire grève. La prérogative managériale joue ici un rôle très important et elle est unitaire, c’est-à-dire qu’elle concerne une loi dont la signification ultime est entre les mains d’un seul tribunal : la Cour suprême des États-Unis.
Interaction, appropriation et complémentarité des normes de l’OIT sur la liberté syndicale et la grève dans l’avis consultatif OC 27/21 de la Cour interaméricaine des droits de l’homme
Authors: Barretto Ghione Hugo 
Published: May 2023

La Convention n°87 de l’OIT sur la liberté syndicale fait l’objet d’une interprétation large qui est contestée par le groupe des employeurs de l’OIT selon lequel le droit de grève n’est pas reconnu en droit international, s’opposant ainsi à la position adoptée de longue date par la Commission d’experts pour l’application des conventions et recommandations et par le Comité de la liberté syndicale. Cette approche restrictive a donné lieu à un débat qui est toujours d’actualité. La Cour interaméricaine des droits de l’homme (Cour IDH) a pris le parti de suivre les directives et positions des organes de contrôle de l’OIT, considérant que la grève est un droit fondamental et un « corollaire » de la liberté syndicale. La Cour IDH s’est « appropriée » cette doctrine pour interpréter les normes du système interaméricain, renforçant ainsi le droit à la liberté syndicale dans un contexte juridique latino-américain particulièrement réticent à l’égard de la grève et de la négociation collective. L’avis consultatif OC 27/21 adopte également une approche inédite et très opportune fondée sur le genre.
Histological evaluation of ProRoot mineral trioxide aggregate and Cold ceramic as root-end filling materials in animal models
Authors: Modaresi Jalil , Khademi Abbasali , Hemati Hamidreza , Mokhtari Fatemeh 
Published: May 2023

Background:
This study aimed to evaluate the reaction of the periapical tissue to Cold ceramic and mineral trioxide aggregate (MTA) following periapical endodontic surgery.

Materials and Methods:
In this experimental study, a total of 12 mandibular first, second, and third premolars of two male dogs were selected. All procedures were performed under general anesthesia. The access cavities were prepared, and the length of canals was determined. Root canal treatment was performed. A week later, periradicular surgery was performed. After osteotomy, 3 mm of the root end was cut. Then, a 3-mm cavity was created by an ultrasonic. The teeth were randomly divided into two groups (n = 12). The root-end cavities were filled with MTA in the first group and with Cold ceramic in the second group. After 4 months, the animals were scarified. Histological evaluation of the periapical tissues was performed. Data were analyzed using SPSS 22 and Chi-square test and P = 0.05.

Results:
The findings showed 87.5% and 58.3% cementum formation in MTA and Cold ceramic groups, respectively, indicating a significant difference (P < 0.001). In addition, the results showed 91.7% and 83.3% bone formation in MTA and Cold ceramic groups, respectively, but the difference was not statistically significant (P = 0.6). Furthermore, the findings revealed 87.5% and 58.3% periodontal ligament (PDL) formation in MTA and Cold ceramic groups, respectively (P = 0.05).

Conclusion:
Cold ceramic was able to induce the regeneration of cementum, bone, and PDL; hence, it can be considered as a biocompatible root-end filling material in endodontic surgery.
Investigation of the effect of fibrin glue as a sealant in the unilateral alveolar bone grafting successes
Authors: Attar Bijan Movahedian , Naeini Mohammad Hossein Manouchehri , Abdinian Mehrdad 
Published: May 2023

Background:
Bone grafting is the primary treatment for the alveolar cleft. Due to the reduced complications by the sealant materials, this study aimed to evaluate fibrin glue's effect on the success rate of unilateral alveolar bone grafting.

Materials and Methods:
This study was a single-blind clinical trial performed on 20 patients with a unilateral alveolar cleft. Patients were randomly divided into groups: group A patients as a control group underwent bone grafting without fibrin glue, and in Group B, patients were grafted using fibrin glue. The subject was followed up through routine examination and the cone-beam computed tomography systems technique for up to 4 months. Paired t-test and Chi-square tests were used to analyze the data and the P < 0.05 was considered the significance threshold.

Results:
The mean age, gender, and cleft side distribution did not represent significant differences. Before surgery, the average alveolar cleft volume in Group A and B patients was 0.95 ± 0.25 cm3 and 0.99 ± 0.22 cm3, respectively, which was not statistically different. After the surgery procedure, the alveolar cleft volume in Group A and B patients was determined to be 0.31 ± 0.10 cm3 and 0.23 ± 0.11 cm3, which represented 66.7% ± 8.9% cm3 and 76.2 ± 11.4 cm3 bone formation, respectively, with no remarkable difference. Our examination did not reveal any necrosis and infection in both groups. However, despite no dehiscence observation in fibrin glue treatment patients, one subject showed dehiscence complication in the control group.

Conclusion:
According to results, fibrin glue may increase the percentage of bone volume formed and prevent dehiscence.
Investigation of the effect of hydrochloric acid with different concentrations on mineral trioxide aggregate plug and dentin
Authors: Gharechahi Maryam , Moradi Saeed , Nasirnia Sina , Peighoun Maryam 
Published: May 2023

Background:
Mineral trioxide aggregate (MTA) becomes a hard mass after setting and making it difficult to remove and can cause significant problems in the retreatment process. The aim of this study was to evaluate the effect of different concentrations of hydrochloric acid (HCl) on MTA dissolution and its effect on dentin.

Materials and Methods:
In this in vitro study, 45 single-root premolars were selected. Artificially open apex was created in all samples with similar process. The samples were randomly divided into 4 experimental groups of 10, and a control group of 5. Four-millimeter thick apical plugs of Root MTA were placed in all samples in an orthograde manner. HCl was used at concentrations of 3.75%, 7.5%, 15%, and 22.5% (w/v) for the experimental groups and normal saline for the control group. Each sample was exposed to the desired solution for 15 min. Then, MTA retrieval and reaching the working length were attempted with k-file # 30. The times of each sample were recorded. Furthermore, after longitudinal incision of the roots with a disc, the dentin surfaces of canals were examined with a Dino-Lite microscope (×50). Results were analyzed by Shapiro–Wilk test and one-way analysis of variance tests. The level of significance P value was set at 0.05.

Results:
The lowest average time of reaching working length was observed with group 22.5% that was significantly lower than 15% and 7.5% concentrations (P = 0.005 and P = 0.011). Furthermore, by examining with ×50 of Dino-Lite microscope, no difference was observed on the canal walls.

Conclusion:
The optimum concentration of HCl was 7.5%. Furthermore, different concentrations of HCl had no significantly different effect on the dentinal canal wall using Dino-Lite microscope with ×50.
Large distal tear of aortic dissection
Authors: Lv Lizhi , Chen Yanqing , Shen Yu , Jing Zaiping , Shi Yi , Zhang Simeng , Lu Qingsheng 
Published: May 2023

BACKGROUND:
The traditional treatment for aortic dissections (ADs) is a proximal repair of AD, but the long-term prognosis of residual distal dissection is unsatisfactory. The distal aortic intimal tear of distal aortic segmental enlargement (DASE) is evaluated via its size, with risk assessment, and assessed its risk, which will provide clinicians with diagnosis and treatment direction.

METHODS:
We analyzed 419 ADs patients who underwent radiographic examination of the aorta between September 1999 and May 2014. We recorded the area of the aortic intimal tear and divided it into two groups (75 patients in DASE group and 344 patients in non-DASE group). Logistics regression analysis or natural logarithm transformation was used to explore the potential risk of remaining distal tears to DASE, while the Logistic multiple regress equations were used to find out the independent risk factors.

RESULTS:
The postoperative large tear was defined as short diameter ≥5.0 mm. The independent risk factors of DASE are as follows: Short diameter of postoperative tears (odds ratios [ORs], 1.10;95% confidence interval [CI], 1.02–1.19; P < 0.0120); short diameter of the first tear after operation (OR, 1.12; 95% CI, 1.00–1.26; P < 0.0580) and the existence of large tears (OR, 1.13; 95% CI, 1.01–1.26; P < 0.0298).

CONCLUSIONS:
Our findings suggest that the size of the remaining tears and the existence of large tears are the key risk factors for patients with DASE. Patients with large remaining tears should be supervised regularly and treated timely.
A Prospective, Randomized, Interventional, Comparative Study between Dexmedetomidine and Propofol Infusion for Monitored Anesthesia Care during Internal Jugular Vein Chemoport Insertion
Authors: Alam Shahbaz , Goel Nitesh , Bhasin Nikhil , Modi Shikha , Kaur Charanjeet 
Published: May 2023

Background:
Chemotherapy through peripheral intravenous cannula causes severe thrombophlebitis. Chemoport is a best and favorable alternative for the same. It is done under local infiltration along with monitored anesthesia care with sedation. However, due to the lack of any fixed regimen, overt to under sedation is more common. To maintain an effective, consistent, and continuous level of sedation, we compared dexmedetomidine and propofol infusion in patients requiring monitored anesthesia care (MAC) for chemoport insertion.

Methodology:
Fifty patients posted for internal jugular vein chemoport insertion were randomly distributed into two groups: the propofol group and dexmedetomidine group. In Group P-injection, propofol infusion started at 125 μg/kg/min. Once observer's OAAS score 3 was achieved, propofol infusion was reduced to 25–75 μg/kg/min, whereas in Group D-Injection, dexmedetomidine bolus infusion was started at 1 μg/kg for 10 min and followed by 0.3–0.7 μg/kg/h and titrated to an OAAS score of 3.

Results:
OAAS score 3 was achieved significantly earlier in the propofol group as compared to the dexmedetomidine group (3.12 ± 1.7 vs. 8.04 ± 2.07, respectively). We were also able to maintain the desired sedation level throughout the procedure. Satisfaction scores in both the groups were comparable and patients in both the groups were hemodynamically stable throughout the procedure.

Conclusion:
In the current study, we found that propofol infusion was better regarding early onset and maintenance of OAAS score 3 with no requirement of rescue sedation during the procedure. The hemodynamic parameters and satisfaction scores were comparable in both groups. Hence, we suggest the use of injection propofol infusion for MAC under sedation in a patient requiring internal jugular vein chemoport insertion when compared to dexmedetomidine.
A prospective observational study of changes in intraocular pressure before and after cataract surgery using noncontact tonometer in small incision cataract surgery and phacoemulsification
Authors: Kesireddy Alekya , Vivekanand Undrakonda , Lobo Sarita 
Published: May 2023

Purpose:
To compare the changes in intraocular pressure (IOP) before and after cataract extraction using noncontact tonometer (NCT) in small incision cataract surgery (SICS) and phacoemulsification.

Materials and Methods:
A prospective observational study of 100 eyes that underwent phacoemulsification and 100 eyes that underwent SICS with intraocular lens implantation for senile cataract with normal IOP were included. Both groups underwent IOP recording using NCT, preoperatively, postoperatively at the 1st, 4th, and 6th weeks, respectively. Repeated-measure analysis of variance and independent sample t-test were applied to analyze the data.

Results:
The mean IOP at the preoperative and postoperative 1st, 4th, and 6th weeks was 13.07, 12.24, 11.78, and 11.66 mmHg, respectively, in SICS group and 14.39, 13.94, 13.08, and 12.90 mmHg in phacoemulsification groups, respectively (P < 0.001).

Conclusion:
A decline in postoperative IOP was present in both SICS and phacoemulsification groups, but a more significant decline was noticed in SICS group.
Thyroid hormone status during pregnancy in Bangladesh
Authors: Shahid Mohammad Moin , Islam Fatema Binte , Begum Shamima 
Published: May 2023

Background:
Pregnancy is a physiological condition where early detection of any pathological change of thyroid hormone is very important to prevent complications. Population-specific thyroid hormone reference intervals are a key to this. Since Bangladesh is yet to develop such reference intervals, the aim of this study was to establish trimester-specific reference intervals addressing the physiological changes of thyroid hormone during pregnancy for Bangladeshi women.

Materials and Methods:
One thousand nine hundred and thirty-seven women with singleton pregnancy consuming iodinated salt were selected for this cross-sectional study. Participants having a history of thyroid disorder (TD), any illness influencing thyroid function, presence of goiter, recent history of consumption of thyroid status-altering medications, family history of TDs, and presence of thyroid antibodies were excluded from the study. 1038 pregnant women with thyroid-stimulating hormone (TSH) level within normal (nonpregnant) laboratory reference value (0.35–5.5 mIU/mL) were considered eligible for the study.

Results:
The mean age of the eligible cases was 28.06 ± 4.633 years ranging from 18 years to 42 years. The mean gestational ages of the study population while checking thyroid function were 8.83 ± 2.344 weeks, 19.99 ± 4.824 weeks, and 31.77 ± 2.123 weeks during 1st, 2nd, and 3rd trimesters, respectively. TSH level raised significantly from 1st trimester to 2nd trimester (1.85 ± 1.00 vs. 2.03 ± 1.02; P = 0.018) but the decline in 3rd trimester comparing to 2nd trimester (2.03 ± 1.02 vs. 1.90 ± 0.90; P = 0.071) was not statistically significant. The 2.5th–97.5th percentiles of TSH level of the study population were 0.440–4.050 mIU/mL, 0.531–4.570 mIU/mL, and 0.622–3.917 mIU/mL in 1st, 2nd, and 3rd trimesters, respectively.

Conclusion:
Reliance on nonpregnant reference intervals or any generalized gestational reference interval can hinder the desired progression of pregnancy influencing diagnosis and management for TDs in case of certain populations. Establishment of individual reference intervals for thyroid hormone in pregnancy bears great clinical importance for every population.
Thyrovigilance for hypothyroidism in India
Authors: Bajaj Sarita 
Published: May 2023

ABSTRACT
Among endocrine abnormalities, thyroid diseases are the commonest both in India and worldwide. However, the prevalence of hypothyroidism in India is more than twice as high compared to its Western counterparts. Therefore an efficient and effective strategy to manage the disease in India is necessary. We reviewed published literature to determine the prevalence, and identify the challenges in the screening and management of hypothyroidism in India. A review of published literature indicates that nearly one-third of the patients with hypothyroidism across age groups remain undiagnosed and untreated in various regions of India. Based on the critical evaluation of these data from India, we have suggested certain best practices for screening, timely diagnosis, and the treatment of hypothyroidism. Primarily non-specific presentation necessitates a high index of suspicion to detect hypothyroidism in neonates and the juvenile population. An individualized approach is key in managing adult patients with hypothyroidism. In elderly patients recognizing hypothyroidism and its treatment, are challenging due to comorbidities and concomitant medications respectively. When managing any age group with hypothyroidism or subclinical hypothyroidism, clinicians should encourage patients for regular follow-up visits. With timely diagnosis delays in treatment and serious sequelae can be averted.