bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the male&rsquo;s parameters always exceed female&rsquo;s parameters in a generally coexisting patterns of death under generalized Makeham&rsquo;s mortality intensity?
Authors: Ogungbenle G. M. 
Published: January 2025

Although the results in actuarial statistics and mortality analysis for (x) are currently being rediscovered, till now, the generation of individual mortality rate and the comparison of gender-specific parameters within the framework of Makeham’s law remain inadvertently neglected. Mortality rate intensities serve as an effective tool for analyzing mortality levels within the insured population. These intensities are derived from the instantaneous measure of the probability of death at a specific moment, conditional upon survival up to that point. In this study, an algebraic method is employed to measure the mortality intensities of both males and females using survival data from the US actuarial surveillance area. Further, this paper intends to stimulate computational derivations using R software for further use in pension and annuity applications within the framework of our algebraic technique. Consequently, the specific objectives are (i) to estimate the main parameters {A, B, C} of the Makeham’s law (ii) to compute the individual mortality rate intensity based on the parameters as against interval estimate (iii) to investigate if the disparity between the male and female parameters has significant effect on the overall mortality rates of either gender. From the trajectories of the computed mortality results, the mortality intensities of both gender exhibit same asymptotic behaviour along the x-axis initially and then smoothly rises exponentially around age 75. Consequently, the mortality law could not explain the decline in mortality. Although the ageing rate C of female is higher than that of men, computational evidence from our results confirms that the men’s overall mortality rate is correspondingly still higher than women’s mortality.
A MULTICENTER ICET-A SURVEY ON ADHERENCE TO ANNUAL ORAL GLUCOSE TOLERANCE TEST (OGTT) SCREENING IN TRANSFUSION-DEPENDENT THALASSEMIA (TDT) PATIENTS - THE EXPERT CLINICIANS’ OPINION ON FACTORS INFLUENCING THE ADHERENCE AND ON ALTERNATIVE STRATEGIES FOR ADHERENCE OPTIMIZATION
Authors: De Sanctis Vincenzo 
Published: January 2025

Abstract. Background: Current guidelines for screening glucose dysregulation (GD) in patients with transfusion-dependent thalassemia (TDT) recommend an annual 2-hour oral glucose tolerance test (OGTT) starting at the age of 10 years. Objective: Assessment of adherence to OGTT screening in patients with TDT.
Methods: A questionnaire was distributed to 18 Thalassemia Centers in 10 different countries, targeting factors influencing adherence to annual OGTT screening in specialized multidisciplinary pediatric and adult TDT units and identifying strategies to improve adherence to OGTT in TDT patients.
Results: The mean reported percentage of all types of GD across 16 of the 18 centers ,at last OGTT assessment, was 32.0% while the mean percentage for thalassemia-related diabetes mellitus (Th-RDM) was 12.2 ± 9.7% (range: 0% - 41%; median:13.2 % ) in all participating centers. Notably, a high percentage of suboptimal or poor adherence to annual OGTT screening (mean 41.3%; range 10-90%) was reported by 17/18 centers. Poor adherence to annual OGTT among eligible patients was multifactorial, related to both patient-, and healthcare system barriers. The most commonly suggested actions by hematologists and endocrinologists for improving the adherence to OGTT were: flexibility in timing, easy approach to test location, improved collaboration among team members and persistent reminding.
Conclusions: Young adult patients with TDT are at high risk for developing GD and Th-RDM, thus annual screening with a 2-hour OGTT is recommended. Nevertheless, there are several patient barriers associated with low adherence to annual OGTT. It is desirable to develop intensive initiatives to improve screening rate for GD, while studies are warranted to update the current guidelines in TDT patients with low risk factors for GD and for countries with low-resource settings.
Topical silymarin versus combined topical silymarin and microneedling in treatment of melasma: split-face study
Authors: Ismail Sahar A. , Attay Dina A.E. , Shehata Rofaida R. 
Published: January 2025

Background
Melasma is a common acquired pigmentary skin disease that is more predominant in females and darker skin types.

Objectives
To evaluate and to compare the efficacy and safety of topical silymarin alone and of combined topical silymarin and microneedling in the treatment of melasma.

Patients and methods
The study design was a split-face, right-left, randomized controlled trial, which was done on 30 adult patients with melasma. History taking and dermatological examination were done. Each side of the patient’s face was randomly (by closed envelop method) allocated to either topical silymarin 0.7% and microneedling or topical silymarin 0.7% alone. All patients were assessed monthly by hemi-Melasma Area and Severity Index (MASI) score hemi-modified Melasma Area and Severity Index (mMASI) score by comparing hemi-mMASI score throughout the 3-month treatment course, patient self-assessment scale, and Melasma Quality of Life Scale.

Results
There was an insignificant difference in the mean hemi-MASI and hemi-mMASI scores between both sides at each study point (P>0.05 for each). Mean hemi-MASI and hemi-mMASI scores showed significant (P<0.001 for each) steady reduction after treatment for both groups.

Conclusions
Both modalities of treatment can be used effectively and safely in the treatment of melasma.
Assessment of serum levels of total thiol, thiol-disulfide, and total thiol/thiol-disulfide ratio in patients with vitiligo before and after narrowband ultraviolet B therapy
Authors: Ali Nura A. , Atwa Mona A. , El-Sayed Marie Radwa , Abdelmaogood Asmaa K. 
Published: January 2025

Background
Vitiligo pathogenesis entails an autoimmune response targeting melanocytes. Oxidative stress is a major contributor to melanocyte cytotoxicity in vitiligo. One useful therapeutic option for vitiligo is the narrowband ultraviolet B (NB-UVB) therapy. However, ultraviolet radiation is associated with elevated oxidative stress. The thiol/disulfide equilibrium is the balance between thiols, as potent antioxidants, and their oxidized molecules, thiol disulfides. This balance is altered with increased oxidative stress.

Patients and methods
The study included 33 vitiligo patients and 33 controls. The severity and activity of vitiligo were evaluated using the Vitiligo Extent Score and Vitiligo Disease Activity Score, respectively. Serum levels of total thiol and thiol-disulfide were assessed, before and after NB-UVB therapy, using enzyme-linked immunosorbent assay. Finally, the total thiol/thiol-disulfide ratio was calculated.

Results
Pretreatment and posttreatment serum levels of total thiol were found to be significantly lower in vitiligo patients compared with controls (P=0.001), while pretreatment and posttreatment serum levels of thiol-disulfide were significantly higher (P=0.001 and 0.012, respectively), and the pretreatment and posttreatment total thiol/thiol-disulfide ratios were significantly lower (P=0.001). There were insignificant differences between pretreatment and posttreatment levels of total thiols, thiol-disulfide, or their ratios among vitiligo patients.

Conclusions
NB-UVB therapy does not probably improve the disrupted thiol/thiol-disulfide equilibrium in vitiligo patients. Combining NB-UVB with antioxidants, such as thiols, may therefore achieve a better outcome in vitiligo treatment.
Secondary pyoderma in dermatology patient: clinical and microbiological profile
Authors: Ahuja Jayshree , Patil Ankita , Talanikar Hemant , Mathur Ajay K. , Sharma Yugal K. , Mukhida Sahjid 
Published: January 2025

Introduction
Pyoderma is a purulent skin infection influenced by a variety of factors like, poor hygiene, along with poverty, malnourishment, overcrowding, and climatic conditions. Primary infections are initiated by a single organism and occur in healthy skin. Secondary infections are a superimposed condition in diseased skin where organisms do not play a significant role. The present study was designed to check the clinical and microbiological profile and antibiotic resistance patterns in secondary pyodermas patients to choose appropriate antibiotic treatment.

Patients and methods
A prospective observational study was conducted in the Outpatient Department of a dermatology clinic in a tertiary care hospital in western India for 1 year on 33 secondary pyoderma patients. A detailed history and complete physical examination of patients was undertaken. Pus collection was done and bacterial culture along with drug susceptibility testing was carried out.

Results
Of 33 patients, 57.57% were male and 42.42% were female. Among all secondary pyoderma patients, 42.42% of patients belonging to the above 40 years age group. Contact history regarding infection was reported in 54.54% of cases. Most frequently occurring in our study was infectious eczema, seen in 3030% of patients. The most commonly encountered organisms were Staphylococcus species in 87.09% of patients. The highest resistance was notified against gentamicin at 78.57% for methicillin-susceptible Staphylococcus aureus and 50% methicillin-resistant Staphylococcus aureus.

Conclusion
Pyodermas were frequently encountered in the elderly male patients who mainly belonged to the lower socioeconomic strata of the society. Eczema constituted the major portion of secondary pyodermas and Staphylococcus aureus was the frequently isolated organism in the majority of the cases from skin lesions of pyoderma patients.
Atypical location of Becker nevus on face − clinical and dermoscopic features: a case report
Authors: Mahajan Mohita , Mahajan Bharat Bhushan 
Published: January 2025

Becker nevus also known as pigmented hairy epidermal nevus, is a cutaneous hamartoma localized on upper extremities and trunk. It is characterized by a unilateral, hyperpigmented patch with irregular border and hypertrichosis.
In most cases, the lesions are more common in males than in females and appear in late childhood or adolescence. The etiology of Becker nevus remains uncertain but it is thought that there is a relationship between androgen metabolism and Becker nevus. There have been rare reports of cases with atypical location such as the face and lower extremities. Here we report a case of a young boy with Becker nevus localized on the left cheek with asymmetrical growth of beard hair. Becker nevus must be kept in mind in the differential diagnosis of hyperpigmented lesions with hypertrichosis which are located on the face.
Oncological outcomes and complications following radical cystectomy with or without neoadjuvant chemotherapy – A retrospective comparative cohort study from a single-center in South India
Authors: Jayanth E Selvin Theodore , Jat Subhash L. , Samuel Benedict P. , Singh Ashish , John Nirmal Thampi , Joel Anjana , Mukha Rajiv Paul , Rebecca Grace , Mahasampath Gowri , Berry Chandrasingh Jeyachandra , Devasia Antony , Kekre Nitin , Kumar Santosh 
Published: January 2025

ABSTRACT

Introduction:
Neoadjuvant chemotherapy (NAC) in the management of muscle-invasive bladder carcinoma has not been adopted universally. We studied the oncological outcomes and complications in patients who underwent radical cystectomy (RC) with or without NAC.

Methods:
A retrospective review of patients who underwent RC with or without NAC from June 2009 to June 2020 was conducted. Oncological outcomes, overall survival (OS) and recurrence-free survival (RFS), complications, and prognostic factors were analyzed.

Results:
Of the 314 patients who underwent RC, 83 patients received NAC (Group A), and 231 underwent RC alone (Group B). The median age was 58 years. The median follow-up duration was 22 (3–64) and 24 (3–62) months, respectively. The median OS in Group A was significantly higher than Group B (38 months [confidence interval (CI): 34–42] and 32 [CI: 29–35], respectively, [P = 0.033]). The RFS in Groups A and B was 34 (CI: 30–39) and 31 (CI: 28–34) months, respectively (P = 0.47). Higher pathological T stage (T3/4), node positivity and lymphovascular invasion (LVI) were predictors of poor OS and RFS (P < 0.0001). Clavien grades 3/4 complications were comparable (8% vs. 15%; P = 0.19). Glomerular filtration rate (GFR) <60 mL/min/1.73 m2 was associated with higher postoperative complications in both groups (P = 0.012).

Conclusion:
The OS with NAC was superior to upfront RC. RFS was, however, comparable. NAC was safe and well-tolerated. Pathologically, higher T stage, node positivity, and LVI were associated with poorer OS and RFS. Low GFR negatively influenced postoperative complications.
An endeavor for excellent and aberration-free vision in advanced keratoconus: Penetrating or deep anterior keratoplasty?
Authors: Joshi Shilpa Dike , Gundecha Nikita Vilas 
Published: January 2025

Purpose:
The purpose of this study was to describe the refractive outcomes and finer aspects of visual acuity such as contrast, aberrations, and quality of vision after keratoplasty for keratoconus.

Design:
This was a longitudinal clinical study of 50 eyes of 50 patients undergoing optical penetrating keratoplasty (OPK) or deep anterior lamellar keratoplasty (DALK).

Materials and Methods:
Visual acuity, slit-lamp evaluation, corneal topography, fundus evaluation, intraocular pressure measurement, contrast, and aberrometry were performed preoperatively and postoperatively at 1, 3, 6, and 12 months. The Visual Function Questionnaire-25 criteria were used to determine the quality of life.

Results:
Contrast sensitivity and visual acuity had significantly improved at each assessment postoperatively. There was a statistically significant improvement in the postoperative 1-year subjective visual score and maximum keratometry in both groups. In the OPK group, all aberration values showed significant improvements in the anterior and total corneal surfaces. The DALK group showed significant improvements in spherical aberration, root mean square (RMS) total, and RMS higher-order aberrations in the anterior corneal surface. The total corneal surface showed a significant improvement only in spherical aberration and RMS total values.

Conclusion:
From our study we conclude, that there was a statistically significant improvement in preoperative versus postoperative 1-year logMAR visual acuity, contrast sensitivity, subjective visual score, maximum keratometry, spherical aberration, and total aberrations in both OPK and DALK. OPK patients also show a statistically significant improvement in vertical coma, RMS higher-order aberration, and trefoil as compared to DALK. The selection of the surgical procedure depends on the surgeon’s preference, the patient profile, cone size, and pachymetry.
Influences of AC/A ratio and accommodation facility on near vision in presbyopic individuals: A prospective study done on North Indian population by comparing the presbyopic glass users with nonglass users
Authors: Jain Amit Kumar , Rajpoot Suman , Batham Vandana , Singh Praveen Kumar , Rajput Neeraj Singh , Rajput Nirmala 
Published: January 2025

Background:
“Presbyopia” is the most common age-related condition of progressive loss of accommodative ability, typically occurs around the fourth decade of life. Accommodative convergence (AC) and accommodation facility (AF) are essential for near vision and play a significant role in presbyopia.

Objectives:
The study aim was to evaluate the influences of Accommodative convergence/accommodation (AC/A) ratio and binocular AF for near vision in presbyopics, by comparing near-glass users and nonglass users.

Materials and Methods:
This cross-sectional, comparative study included 192 patients aged between 38 and 48 years, with 96 patients each in Group A (glass users) and Group B (nonglass users). Distance and near visual acuity were measured using Snellen’s and Jaeger’s charts, respectively. AC/A ratio and binocular AF were assessed by heterophoria method and manual flipper (+2.00/−2.00D lenses), respectively. Statistical analysis was done by SPSS software.

Results:
Mean ± standard deviation age in glass users and nonglass users was 42.41 ± 2.77 and 43.06 ± 2.98 years, respectively; whereas the mean AC/A ratio was 4.07∆D and 3.91∆D, respectively; P = 0.020. The mean binocular AF for distance in glass users and nonglass users was 16.70D and 13.97D, respectively; P = 0.000. Mean binocular AF for near in glass users and nonglass users was 13.72D and 14.00D, respectively, with P = 0.241.

Conclusions:
Our study concludes that wearing of near glasses in presbyopic individuals was associated with a higher deviation of eyes for distance and AC/A ratio with better distance binocular AF; however, wearing of near glasses does not seem to significantly affect the deviation of eyes for near or binocular AF for near objects.
Real-world Evidence from a Cluster Survey of Patients Guided by Multi-center Dermatologists toward the Philippine Psoriasis Registry
Authors: Verallo-Rowell Vermén Mendoza , Guillano Victoria Patino , Tinio Patricia Anne Ty , Jamisola Lian Cruz , Eugenio Eliza Cabal 
Published: January 2025

Background:
Psoriasis (PsO) is characterized by a chronic relapsing course with mild, moderate, or severe presentations associated with significant physical, mental, emotional, and socioeconomic burdens. To help the patients living with this condition, health agencies, lawmakers, and other stakeholders need accurate information generated from real-world data (RWD).

Objective:
The objective of this study was to derive RWD on demography, disease severity, comorbidities, and treatment regimens utilized by Filipino PsO patients.

Methods:
This prospective noninterventional study collects data from patients with PsO, screened and diagnosed by Philippine Dermatological Society-certified dermatologists through answering the Philippine Psoriasis Registry (PPR) questionnaires.

Results:
Answers by 780 participants to 9 specific questions from demographics to unmet needs at dermatology and rheumatology consultations were tabulated. A majority of patients (86.53%) had moderate-to-severe PsO, and only a few (8.72%) utilized the more effective medications due to socioeconomic factors of the underserved.

Conclusions:
The RWD from this PPR captures a snapshot of the PsO population within the Philippines. This is beneficial for understanding the current state of the population and explores disease progression and efficacy of interventions over time. Information sharing for future research through the strategic dissemination of findings from this study is imperative to enhance the understanding of PsO and its management on both local and global scales.
Impact of laparoscopic surgeries on optic nerve sheath diameter (ONSD) in children
Authors: Yasmeen Mohsina , Sabreen Sumaiya , Bettanayaka Akshay , Nagappa Saraswathi 
Published: January 2025

Background:
The pneumoperitoneum in laparoscopic surgeries elevates intracranial ICP because of the increased abdominal pressure, and ICP increases even further in the Trendelenburg position. A new noninvasive method to measure optic nerve sheath diameter (ONSD) via ultrasonography detects the raised ICP is reliable and inexpensive and can be repeated many times.

Methods:
In this prospective observational study, 23 pediatric patients aged between 5 and 16 years, undergoing elective laparoscopic procedures under general anesthesia, were included. After endotracheal intubation with proper aseptic precautions, ocular ultrasound was performed to measure baseline ONSD in both eyes. Later, pneumoperitoneum was established by maintaining the intra-abdominal pressure (IAP) at 12 cmH2O. Again, ONSD was estimated at 15 minutes of pneumoperitoneum and observed for any variation from the previous readings. The cutoff considered for ONSD was 5 mm, above which the intracranial pressure (ICP) was regarded as increased.

Results:
In our study, the mean age of subjects was 9.67 ± 5.18 years. The majority were males (60.9%). The subjects showed an increase in ONSD at the 15th minute after inducing pneumoperitoneum using abdominal CO2 insufflation, in comparison with the baseline values, in the left eye [4.67 ± 0.48, P 0.016] and the right eye [4.63 ± 0.43]. The readings of ONSD were observed to be <5 mm, not statistically significant.

Conclusion:
USG-guided ONSD measurements serve as a valuable tool in ensuring optimal intra-abdominal pressures and safe administration of anesthesia for patients undergoing laparoscopic surgery, particularly those vulnerable to an increase in ICP.
Perioperative airway management techniques and complications in patients with temporomandibular joint ankylosis: Experience from a tertiary care teaching institute
Authors: Trikha Anjan , Roychoudhury Ajoy , Goswami Devalina , Maitra Souvik , Bhutia Ongkila , Baidya Dalim Kumar 
Published: January 2025

Background and Aims:
Temporomandibular Joint (TMJ) ankylosis patients pose serious anesthetic challenges due to difficult airway and obstructive sleep apnoea (OSA). However, data are sparse on anesthetic management and perioperative outcomes of such patients. This study aimed to identify the anesthetic and airway management techniques in children and adolescents with TMJ ankylosis and whether the presence of retrognathia and OSA increases the risk of airway-related complications.

Materials and Methods:
A retrospective anesthetic chart review of TMJ ankylosis patients undergoing maxillo-facial surgery from 2008 to 2018 in a tertiary care teaching hospital in India was performed. Available anesthetic data were tabulated and analyzed. Difficult mask ventilation, use of nasopharyngeal airway (NPA), difficult intubation, desaturation at induction and extubation, maneuvers to open the airway at extubation, and any post-operative anesthetic complications were noted.

Results:
Three hundred seventy-two children including 85 patients of OSA were available for analysis. All patients with OSA had retrognathia. Fiber-optic bronchoscopy (FOB) guided intubation was performed in 362 (97.3%) patients. Desflurane and fentanyl were common anesthetics used for the maintenance of anesthesia. Difficult mask ventilation, use of nasopharyngeal airway (NPA) and requirement of airway maneuvers were more common in OSA patients than in non-OSA patients. Difficult mask ventilation was observed in 18.0% and difficult intubation in 12.9% of patients. Desaturation at induction was noted in 5.1% of patients but none required emergency surgical airway access. Maneuvres to open the airway at extubation were required in 24.5% of patients and the incidence of desaturation at extubation was 7.2%. However, no serious adverse event was noted and only one patient required reintubation.

Conclusion:
FOB-guided intubation should be considered the technique of choice in TMJ ankylosis patients. In the presence of retrognathia and OSA chance of difficult mask ventilation, requirement of NPA and difficulty in maintaining the airway after extubation increase significantly.