bluuebunny/crossref_metadata_2025 huggingface dataset:
Moving Towards Translanguaging
Authors: Barbosa Mara R.
Published: November 2021

Emerging bilinguals at US schools are generally subject to programs that are inadequate for their learning needs. It is crucial to find teaching models through which they can develop their academic language skills. This chapter presents the program Learn from the Experts, a partnership between a university and a high school, that fosters collaboration between Spanish and English learners. In this program, which follows the translanguaging pedagogy, Spanish learners from the university meet to collaborate with Spanish heritage English learners from the high school in lessons designed to develop each of the participants' skills in the language they are learning. The chapter also presents pedagogical changes made to the program resulting from the program team's reflection. It contributes to the development of models that support emerging bilinguals' language learning through collaboration with more experienced speakers without compelling speakers of minoritized languages to distance themselves from their languages and cultures.
Translanguaging Pedagogy to Support Bi/Multilingual Students' Language Learning in Social Studies
Authors: Deroo Matthew R.
Published: November 2021

This qualitative case study investigates how Mrs. Vega, a high school social studies teacher, supported her emergent bi/multilingual immigrant students' development of academic, content-based language learning in a U.S. Government class. Drawing upon data collected as part of a larger ethnography and using translanguaging pedagogy as a theoretical frame, this chapter centers Mrs. Vega's translanguaging stance, design, and shift. Findings demonstrate the multiple and varied ways Mrs. Vega's pedagogy supported her students' already-present linguistic and cultural abilities in support of their disciplinary learning. Implications are provided for theory and practice.
Fostering Successful Communities of Collaboration Through Educational Partnerships
Authors: Almaguer Isela
Published: November 2021

There is an undisputable need to form collaborative partnerships between schools, families, homes, and communities across the nation. Collaborative educational partnerships are the cornerstone for student success. With increasingly diverse student populations, schools must communicate and collaborate with families and communities to bridge the wide gap that exists between home and school. With a dominant Spanish-speaking population of Mexican descent, as that of children living in the Southern tip of the Texas-Mexican border, known as The Rio Grande Valley, barriers such as low social economic status and limited English proficiency may impede much-needed communication between schools, homes, and communities. These barriers that negatively impede student success must be replaced with strong bridges that support student achievement. Recommendations are anchored in opportunities to increase academic and social partnerships among schools, families, homes, and communities. The premise for establishing educational partnerships is ultimately student achievement and success.
Roadblocks to Bilingualism
Authors: Strid John Evar , Cohen James A. , Gathings Autumn , Stepter Raven , Taylor Amor
Published: November 2021

Most teacher candidates have little experience with learning other languages. They therefore become cogs in the assimilationist machine that causes immigrants to lose native languages and become monolingual in English (Rumbaut, Massey, & Bean, 2006). In a time of devaluing immigrants (and their languages) and failure on the part of most Americans to learn other languages, educators need to focus on the role of other languages in promoting multicultural understanding and to increase language learning in the US. This chapter examines bilingual teacher candidates' experiences with language learning. For four years, students studying for ESL/bilingual licensure were asked to rate their language abilities, finding that 30% rated themselves as bilingual, with 70.43% of bilinguals describing themselves as heritage speakers. The authors report the overall findings as well as the bilingual heritage speaker candidates' own words on their experiences with language learning and maintaining their bilingualism.
Culturally and Linguistically Diverse Students
Authors: Hancı-Azizoglu Eda Başak
Published: November 2021

The structure of American public schools has altered within the past 30 years due to receiving extensive number of linguistically diverse students. The fact that culturally and linguistically diverse (CALD) students often experience academic failure within the U.S. public schools creates a subgroup of students who cannot achieve their educational goals. The purpose of this study is to explore ideal practices in order to enhance teachers' and policy makers' perceptions and awareness on the unique needs of CALD students. The findings of this study reveal the fact that ineffective methods for teaching CALD students and short-term goal-oriented educational policies fall short of meeting the academic needs of CALD students, and this research offers a conceptual framework that could contribute to CALD students' intellectual growth through effective and constructive language learning practices.
Factors Influencing Primary Teachers' Conceptualisations of Literacy
Authors: Fernández-Fernández Raquel
Published: November 2021

This chapter tries to discover how primary school teachers understand what literacy is and to what extent this conceptualisation is influenced by factors indicated by previous literature, such as training, previous experiences, or beliefs (see Korthagen, 2001; and Pozo et al., 2006), while also considering whether working in a bilingual context or being a bilingual teacher may be influential to produce certain types of definitions. Data was gathered using an online questionnaire directed to teachers in Years 3 and 4 in the Madrid Autonomous Community. The responses from the participants (n=115) were categorised and analysed using SPSS. The findings indicate that most definitions rarely fulfil the requirements to be considered complete or entirely accurate. Results also show that only age is a significant variable in producing better definitions. Finally, the study recommends reshaping and offering appropriate teacher training on literacy to update teachers' knowledge and ultimately boost leads to better learning in the classrooms.
Alternative Digital Credentials in Higher Education
Authors: Breckenridge Courtney , Ettling Mary , Fuhrmann Tony , Dixon Robert P. , Bridger Wyatt E.
Published: November 2021

Alternative digital credentials (ADCs), also known as digital badges, demonstrate great promise as a strategy for closing the skills gap and supporting the alignment of industry skills with traditional and nontraditional higher education programs. The authors seek to highlight advances in ADC development in a public university setting, demonstrating how higher education institutions can weave ADCs into both traditional classrooms and larger community initiatives such as workforce development and non-credit offerings. The chapter details the institution's ADC pathway from conception to a workforce development project awarded in response to the COVID-19 pandemic including key project objectives, strategies, and best practices. The authors also discuss the use of existing learning resources and tools such as EMSI, Jove, and augmented reality technology, including learner reviews from current program participants. Finally, institutional strategies for prior learning assessment and integration of digital badges into undergraduate degree programs are discussed.
Current Advancements and Future Prospects of Alternative Digital Credentials (ADCs) in a Technology-Disrupted World
Authors: Pour Mirza Arezou
Published: November 2021

This chapter focuses on the current and future state of traditional and alternative digital credentials (ADCs) and discusses their importance for economies, societies, and individuals. It provides an overview of the unprecedented technology disruption within tertiary education and its impact on evaluating skills and competencies. Further, it discusses ADCs in greater detail (e.g., similarities, differences, challenges, and potential opportunities), and finally, it concludes the discussion by highlighting ADCs' prospects in the higher education sector.
Achieving a Representative Democracy in Europe
Authors: Rivas-de-Roca Rubén , García-Gordillo Mar
Published: November 2021

The concept of public spheres is based on the classic notion of deliberative democracy. The emergence of a European Public Sphere (EPS) at the European Union (EU) level has been widely discussed in the literature. However, the deliberative quality of this sphere is questioned because of its weak connection with citizens. This chapter explores how recent research addresses the EPS. Three categories are defined: (1) political and public communication of the EU, (2) citizen participation through technologies, and (3) the growing politicization and polarization of the European project. The methods in use, as well as remaining challenges in research, are also analyzed. This study contributes to discussions on the future of EU democracy, arguing that politicization and the interrelation of digital platforms and legacy media may enhance a true public discussion in Europe.
The Contribution of Spatial Augmented Reality to the Synergy of Special and Alternative Forms of Tourism in Greece
Authors: Bouzis Stylianos , Poulaki Panoraia
Published: November 2021

This research investigates whether the evolution of augmented reality contributes to the combination of specific and alternative forms of tourism in Greece. More specifically, in the first stage, information and communication technologies and the new emerging perspectives that appear over time are described. Then, talking about special and alternative forms of tourism, the authors talk about cultural, gastronomic, and educational tourism, elements of which intersect in the light of spatial augmented reality (SAR). The main purpose of the chapter is to prove that SAR excels in the synergy of the three forms of tourism mentioned. Also, a successful example of the development of SAR in the Greek tourist area is given, with the presentation of a case study of a museum in Greece. Finally, the benefits provided by the combination of special forms of tourism with SAR are presented, and it is concluded that all ages have the opportunity to actively participate in such projects using SAR, without the informal exclusion of older people.
Relationship Between ICT and Tourism
Authors: Bayrakcı Selman , Özcan Ceyhun Can
Published: November 2021

The relationship between tourism and information and communication technology (ICT) is called electronic tourism or e-tourism. The use of ICT makes markets from local to global and has a positive effect in increasing the market share of firms. Managing, planning, developing, and marketing tourism data through ICT increase the development and economic potential of tourism. ICT has provided the strategic management of all tourism-oriented companies and revolutionized the operations within the tourism distribution channel, causing tourism-related stakeholders to reassess their actions and positions. The purpose of this chapter is to reveal the relationship between ICT and tourism in the case of 14 Mediterranean countries from approximately 1995–2019. Dumitrescu and Hurlin Panel causality test was used for this analysis. The main findings indicate that ICT stimulates tourism that, in turn, boosts ICT even further in some countries (Algeria, Egypt, Morocco, Tunisia, and Turkey).
Digital Detox, Trends, and Segmentation in Tourism
Authors: Juncal Beatriz , Vides Gabriela , Matos Pedro , Sousa Bruno Barbosa
Published: November 2021

The chapter aims to demonstrate the growing importance of the concept of 'digital detox' as a segment of the tourism market to indicate the reasons and factors that encourage its demand, the diversity of establishments, the strategies employed by them, the limits, facilitating the adaptation to market conditions, and assisting in the development of marketing strategies that respond to customer needs. Through a content analysis of some research papers from the last 10 years and websites, as well as an interview with the founder from one of the establishments specialized in “disconnection with technologies” experiences, the “Offline House,” this study presents inputs on marketing (digital), tourism (niches), and consumer behavior.
The Role of Social Media Marketing in the Tourism and Hospitality Industry
Authors: Khan Md Yusuf Hossein , Abir Tanvir
Published: November 2021

Social networking is a series of Web 2.0-based applications that connect, communicate, and exchange ideas, views, perspectives, knowledge, and relationships among internet users worldwide. In the age of social media, businesses' marketing tactics have shifted from bringing products out to encouraging customers to buy things into their stores to foster a more engaging and mutually beneficial relationship. It is a significant player in the online tourism sector since it is a common and influential information source for tourists looking for destination-specific information. This study was conducted qualitatively, and this illustrates and discusses the role of social media marketing and how it works in the tourism and hospitality industries, with an emphasis on Bangladesh in particular, using a range of literature, including academic articles, journals, and books. This study would educate academics, researchers, politicians in tourism industries, and government officials about the importance of social media marketing.
Leadership, Vision, and Values in a Time of Change and Crisis
Authors: Fung Dilly , Gordon Claire E.
Published: November 2021

This chapter analyses the principles and practices of effective leadership and management in times of complex change. It presents an illustrative case study of a UK research-intensive university's strategic response to global and national changes in the higher education sector as they intersected with a profound and unexpected crisis – the COVID-19 pandemic. The chapter explores emergent possibilities for practising leadership that respects the culture(s) of the academic and professional collective of a research-intensive university, while considering some of the lived contradictions and kinds of emotional labour experienced during this time of great pressure. The authors propose a new cross-cutting articulation of ‘leadership in academia' based on seven key principles as a means of bringing faculty members and professional staff into new collaborative spaces. Their conclusion highlights the importance of establishing a culture of consent to cooperation to enable institutions to navigate disagreements over policy decisions.
Can New Education Policy 2020 Serve as a Paradigm Shift to the Employability Gap in India?
Authors: Chaturvedi Shakti , Purohit Sonal , Verma Meenakshi
Published: November 2021

Employment and employability have lately surfaced as a significant concern for India that stands as the world's second central higher education system. The post-COVID-19 era further demanded a comprehensive policy at the national level. The Indian government approved the new education policy (NEP), bringing changes to higher education in the country on 29th July 2020. After an exhaustive reading of all education policies published in Indian literature, the authors present this viewpoint chapter, contributing to the extant literature on education policies in the following three ways. The first purpose is to evaluate and compare the current NEP 2020 to the last two educational policies of 1968 and 1986 to understand how far each policy could realize the goal of employability. The second purpose is to adumbrate the gaps between industry and academia in the proposed NEP 2020 to propose some transformative steps to fill the outlined gap. Thirdly, the main findings are depicted through a graphical representation to give some directions for future policy and research in employability.
Developing Student Self-Assessment Competences in the Online Learning Environment Amid the COVID-19 Pandemic
Authors: Blândul Valentin , Bradea Adela
Published: November 2021

Didactic self-assessment represents students' ability to make value judgments on their own academic performances obtained as a result of the instructive-educational process. Developing self-assessment competences in the virtual environment represents a major challenge, given that teachers' regulatory intervention to ensure the objectivity of the process is very limited. The aim of the present study conducted on a sample of 139 students from the University of Oradea, Romania was to identify how the implementation of an interactive teaching approach may contribute to the formation of student self-assessment competences as objectively as possible. The results obtained showed that most students tend to underestimate themselves in exams due to a lack of confidence in their own abilities due to insufficient preparation for the subjects studied. However, the use of specific strategies for the development of self-assessment competences can lead to their improvement but only if they are implemented constantly and to as many study subjects as possible.
Applying Communication Ethics to Pharmacy Students' Education
Authors: Gălăţanu Mona Luciana , Sandulovici Roxana Colette
Published: November 2021

This chapter addresses the problem of applying communication ethics to pharmacy students' education. The purpose of the chapter is to stimulate reflection about the importance of teaching and integrating communication ethics in their curricula in order to make pharmacists capable of professional counselling to the patients by pharmaceutical care. Existing literature refers mainly of the effectiveness of teaching ethics in medical education, engineering, accounting, psychology, and business. There is little evidence about using this concept in the pharmacist's activity and their communication with the patients. Consequently, this chapter tries to provide an overview of how communication ethics can be integrated in the educational curricula for pharmacy students. It is the responsibility of the higher education institutions to offer to pharmacy students a modern, adequate, and upgraded curricula program to increase the communication skills of the future pharmacists.
Digital Communication in the Inclusive Classroom
Authors: Folostina Ruxandra , Dumitru Tabacaru Cristina
Published: November 2021

Digital communication is being extensively used, and during COVID-19 pandemic, it has transformed the way teaching is delivered and how learning happens which became even more problematic for children with learning difficulties. The digitalization of education during the lockdown period has forced teachers, children, and parents to develop and enhance their digital skills to maintain and keep ensuring efficient learning. Digital communication can be provided in the educational system by the simple use of email or WhatsApp groups up to the integration of complex digitalized learning programs and software adapted to the specific educational needs of each student. Being digital natives, students nowadays seem more engaged if learning is mediated by the use of digital communication tools. They are opened and interested in participating in educational activities that are technology-based.
Porto, Gaia, and the Sant'Ana Arch
Authors: Freitas Isabel Vaz de , Albuquerque Helena
Published: November 2021

This study aims to analyse the novel O Arco de Sant'Ana, by Almeida Garrett, one of the most important Portuguese writers of the 19th century. O Arco de Sant'Ana is a historical novel that describes a medieval narrative that is used as a context and emphasis for the presentation of the author's liberal ideas of his time. Using geographical information system as a methodological tool, a literary cartographic analysis will be conducted by identifying places, streets as well as tangible and intangible heritage, described in the novel. Several analyses will be performed to pinpoint the places where the medieval narrative occurs, transposing them to the current urban map. In this way, it should be possible to overlay the literary landscape onto the present map of Porto to offer the tourist a new product based on a journey through time based on the writer's literary work.
A Post-Secondary Writing Bridge Program for Incarcerated Learners
Authors: Benetollo Chiara
Published: November 2021

This chapter discusses a College Bridge Writing Program piloted by the Petey Greene Program inside the Washington D.C. Department of Corrections (DOC) Jail. The program is designed to foster racial and social justice by addressing some of the barriers that prevent incarcerated students from accessing higher education, from succeeding in college-level courses, and more generally, from finding meaningful employment. After providing an overview of the structure and the objectives of the course, the author focuses on the challenges posed by the pandemic and on two of the main features that contributed to the success of the program – the use of learning technology and the role of volunteer tutors, who provided one-on-one support to incarcerated students.
Designing of Container Feeder Service Networks Under Unstable Demand Conditions
Authors: Polat Olcay
Published: November 2021

The COVID-19 pandemic has greatly magnified supply challenges in all industries, and virus waves continue to cause an extraordinary amount of variation in both the demand for and the availability of necessary products. This uncertainty has also forced many organizations including container liner shipping to redesign their supply chain. Feeder services from hub ports are essential chain of shipping networks. This chapter addresses the design of feeder networks under consideration of demand fluctuations over the year. For this purpose, a perturbation-based variable neighbourhood search approach is developed in order to determine the feeder ship fleet size and mix, the fleet deployment, service routes, and voyage schedules to minimize operational costs. In the case study investigation, the authors consider the feeder network design problem faced by a feeder shipping company as a sample application. The performance of alternate network configurations is compared under dynamic demand conditions. Numerical results highlight the advantage of dynamic and flexible design of feeder service networks.
Queer Phenomenology
Authors: Weeks Thomas C.
Published: November 2021

Phenomenology is an often-used form of inquiry within education and the social sciences more broadly. As scholars have employed its methods to answer complex social and political questions, new modes of inquiry have emerged. One such mode is queer phenomenology, which has sought to engage queer theory with phenomenology for an enriched form of inquiry. In this chapter, queer phenomenology will be explored, including its origins in the 21st century and the kinds of questions it can answer. A discussion of queer phenomenology's relation to the field of critical phenomenology is also included. Current research in both the social sciences and education that use this method is covered in depth.
Creating the [Insert Name Here] Methodology
Authors: Bradford Melissa Riley
Published: November 2021

In this chapter, the author uses a first-person narrative to describe her dissertation journey as she shifted from deductively hunting for the “right” methodology in order to follow an inductive process as she developed the “Melissa Methodology” of value-creative dialogue inspired by Ikeda's philosophical perspectives and practice. She illustrates one way that non-Western ways of knowing, being, and doing might inform curriculum studies student researchers. In addition, she highlights the importance of having supportive advisors and colleagues who pose and answer questions that push one's thoughts in new directions. Finally, she discusses implications for doctoral students based on her observations as an instructor of doctoral research methods courses. By sharing her journey, she hopes to provide an example of how doctoral students can be guided by their pursuit of what is worth knowing in creating their own research methodology.
Menopause
Authors: Ekanayake C.
Published: November 2021

No abstract available
Do South Asian women with menopausal symptoms have access to optimal therapy?
Authors: Abhayaratna S. A. , Pinidiyapathirage J.
Published: November 2021

Background Menopausal symptoms can have a significant impact on a woman's quality of life. Information on availability of menopausal hormone therapy (MHT) in National Essential Medicines Lists (NEMLs) of South Asian (SA) countries has not been widely studied. Objective To review the availability of non-injectable MHT included in NEMLs of SA countries and to assess differences in availability compared to the recommended MHT preparations in the World Health Organization (WHO) model essential medicines list and the list of MHT available to women of a developed country in the Asia Pacific Region, while comparing with the healthcare expenditure and country's economic status. Methods Most recent NEMLs were obtained from all eight SA counties by visiting the Ministry of health/regulatory website of the respective country. Latest WHO model essential medicines list and Pharmaceuticals Benefits Scheme (PBS) schedule from Australia were obtained from the WHO and PBS websites respectively. Per capita health expenditure was obtained from The WHO Global Health Expenditure Database. Two investigators extracted the non-injectable MHT preparations independently from NEMLs and conducted the comparison. Results Except in two countries, in all other SA coun­tries NEMLs were updated within the preceding five years. According to available data, seven SA countries had at least one separate preparation of oestrogen suitable for MHT while all countries had a separate progesterone preparation suitable for MHT. The oestrogen preparations available in the SA NEMLs were limited to either ethinyl estradiol or conjugated oestrogen tablets whilst in the WHO model, oestrogen preparations were not specified. In Australia, estradiol tablets were the only available oral oestrogen while there were four more different dosage forms of oestrogens available through the PBS Scheme. Progesterone preparations found in SA countries, WHO list and PBS schedule were similar, but oestrogen progesterone combination MHT preparations were only available in the PBS schedule. Per capita health expenditure was much higher in Australia compared to SA countries where a wide variation was observed. Conclusions The available evidence suggests that a larger population of SA women have access only to a very limited number of options if in need of MHT. In contrast, importance of MHT is highlighted in PBS Schedule. Although per capita health expenditure was low in SA countries, given that MHT products are relatively low cost and that there is a large proportion of women in menopausal age in this region, it would be imperative to update the WHO model list and NEMLs of SA countries to address the growing need of safe MHT and to improve the quality of life of postlnenopausal women in our region.
The Long-term Efficacy of Domiciliary Noninvasive Positive-Pressure Ventilation in Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials
Authors: Park So Young , Yoo Kwang Ha , Park Yong Bum , Rhee Chin Kook , Park Jinkyeong , Park Hye Yun , Hwang Yong Il , Park Dong Ah , Sim Yun Su
Published: November 2021

Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD).Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients.Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65–0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72–1.36; p=0.94).Conclusion: Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.
Chronic Obstructive Pulmonary Disease Is Not Associated with a Poor Prognosis in COVID-19
Authors: Kim Youlim , An Tai Joon , Park Yong Bum , Kim Kyungjoo , Cho Do Yeon , Rhee Chin Kook , Yoo Kwang-Ha
Published: November 2021

Background: The effect of underlying chronic obstructive pulmonary disease (COPD) on coronavirus disease 2019 (COVID-19) during a pandemic is controversial. The purpose of this study was to examine the prognosis of COVID-19 according to the underlying COPD.Methods: COVID-19 patients were assessed using nationwide health insurance data. Comorbidities were evaluated using the modified Charlson Comorbidity Index (mCCI) which excluded COPD from conventional CCI scores. Baseline characteristics were assessed. Univariable and multiple logistic and linear regression analyses were performed to determine effects of variables on clinical outcomes. Ages, sex, mCCI, socioeconomic status, and underlying COPD were selected as variables.Results: COPD patients showed older age (71.3±11.6 years vs. 47.7±19.1 years, p<0.001), higher mCCI (2.6±1.9 vs. 0.8±1.3, p<0.001), and higher mortality (22.9% vs. 3.2%, p<0.001) than non-COPD patients. The intensive care unit admission rate and hospital length of stay were not significantly different between the two groups. All variables were associated with mortality in univariate analysis. However, underlying COPD was not associated with mortality unlike other variables in the adjusted analysis. Older age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.11–1.14; p<0.001), male sex (OR, 2.29; 95% CI, 1.67–3.12; p<0.001), higher mCCI (OR, 1.30; 95% CI, 1.20–1.41; p<0.001), and medical aid insurance (OR, 1.55; 95% CI, 1.03–2.32; p=0.035) were associated with mortality.Conclusion: Underlying COPD is not associated with a poor prognosis of COVID-19.
ISAR Consensus Guidelines on Safety and Ethical Practices in In vitro Fertilization Clinics
Authors: Malhotra Jaideep , Malhotra Keshav , Talwar Pankaj , Kannan Priya , Singh Prabhakar , Kumar Yogesh , Chimote Nishad , Joshi Charudutt , Bawle Sachin , Agarwal R. B. , Agarwal Saroj , Prakash Ved , Awasthi Pooja , Shukla Sanjay , Prakash Ram , Adiga Satish Kumar
Published: November 2021

Study Question:

What are the Safe and Ethical practices for ART applicable in INDIA?

What is Already Known:

The Indian IVF industry is booming; with mushrooming of assisted reproductive technology (ART) clinics in the country, the need for regulation is immense. The ISAR has taken up this initiative to lead the way forward in establishing practice guidelines for the safe and ethical use of ARTs in our country. These guidelines discuss the points to consider before the starting of an IVF unit, to the designing of the laboratory, the staffing pattern and experience recommendations, laboratory safety guidelines, documentation and patient traceability, gamete traceability, handling biological material, the consumables and media, and different consents and checklists and also propose key performance indicators for the Indian scenario.

Study Design, Size, Duration:

This is the report of a 2-day consensus meeting where two moderators were assigned to a group of experts to collate information on safe and ethical ivf practices in INDIA. This meeting utilised surveys, available scientific evidence and personal laboratory experience into various presentations by experts on pre-decided specific topics.

Participants/Materials, Setting, Methods:

Expert professionals from ISAR representing clinical and embryology fields.

Main Results and the Role of Chance:

The report is divided in various components including the regulations, the various requirements for an ART center, qualifications and trainings, recommendations on good practices and quality management: the report and recommendations of the expert panel reflect the discussion on each of the topics and try to lay down good practice points for labs to follow.

Limitations, Reasons for Caution:

The recommendations are solely based on expert opinion. Future availability of data may warrant an update of the same.

Wider Implications of the Findings:

These guidelines can help labs across the country to standardise their ART services and improve clinical outcomes.

Study Funding/Competing Interest(S):

The consensus meeting and writing of the paper was supported by funds from CooperSurgical India.
Failed Airway Despite Securing the Airway
Authors: Prakash Raju KNJ , Anandhi D , Ayyan S Manu , Ashok N , Naik Bhukya Kiran
Published: November 2021

Inability to ventilate or oxygenate can be catastrophic. Critical tracheal stenosis may present as a life-threatening airway emergency. We report a 25-year-male who presented to the Emergency Department in respiratory arrest. After endotracheal intubation, there was no tidal volume delivery despite generating high peak airway pressures. Unfortunately, even an emergency surgical airway did not succeed in providing adequate ventilation. Postmortem examination revealed near-total occlusion of the distal tracheal lumen. When a patient has refractory ventilatory failure due to possible airway obstruction, the acute care provider should consider distal tracheal stenosis as one among the differential diagnosis. Conventional approach to airway management, including surgical airway, may not be of help in the presence of distal tracheal stenosis. A skilled emergency physician should possess the ability to think out-of-the-box and be aware of novel techniques to achieve oxygenation and ventilation in a 'failed airway' of this nature. Though appropriate, fibreoptic intubation, extracorporeal membrane oxygenation or emergency thoracotomy may not be readily available or practically feasible options to manage a failed airway due to distal tracheal stenosis.
Evaluation of Upper Lip Bite Test and Thyromental Height Test for Prediction of Difficult Laryngoscopy
Authors: Bhanushali Alpesh , Date Aparna
Published: November 2021

Background and Aims:

Unanticipated difficult laryngoscopy (DL) can cause life-threatening complications in the operation theatre, intensive care unit and emergency department. Various screening tests have been developed to predict DL. While modified Mallampati test (MMT) is the most commonly used one, it has poor sensitivity. Upper lip bite test (ULBT) and thyromental height test (TMHT) have been shown to be more reliable in predicting DL. The aim of this study was to compare the three tests and evaluate whether a combination of ULBT and TMHT would show better accuracy in predicting DL.

Patients and Methods:

A total of 109 adult patients undergoing elective surgery under general anaesthesia with endotracheal intubation were assessed using the MMT, ULBT and TMHT before surgery. The required sample size for the study was calculated using the Fisher Z test. The three tests, and a combination of ULBT with TMHT, were compared for their sensitivity, specificity, positive predictive value, negative predictive value and accuracy in predicting DL.

Results:

The accuracy of MMT, ULBT, TMHT and ULBT + TMHT in predicting DL was found to be 81.65%, 86.23%, 97.24% and 95.41%, respectively. MMT exhibited the lowest sensitivity and had the highest number of false negatives. TMHT exhibited the best accuracy and sensitivity, with the lowest number of false negatives. A combination of ULBT and TMHT did not improve the PPV in the sample tested.

Conclusion:

TMHT was found to be the best test for predicting DL, and its combination with ULBT did not improve the accuracy.
Comparison of efficacy & safety of iron polymaltose complex & ferrous ascorbate with ferrous sulphate in pregnant women with iron-deficiency anaemia
Authors: Chavan Suyash , Rana Proteesh , Tripathi Reva , Tekur Uma
Published: November 2021

Background & objectives:

Iron-deficiency anaemia (IDA) is a common nutritional deficiency among pregnant women in India. It has a significant impact on the health of the mother as well as that of the foetus. IDA generally responds well to treatment with oral iron supplementation. However, oral iron supplements are toxic to the gastrointestinal mucosa and intolerance is common, resulting in poor compliance and failure of treatment. The iron salts such as iron hydroxide polymaltose complex (IPC) and ferrous ascorbate (FeA) are claimed to have low gastrointestinal intolerance, therefore better patient compliance than the conventionally used ferrous sulphate (FS). These preparations also claim to increase haemoglobin level faster as well as improve the iron storage better than FS. This study was done to compare the efficacy and safety of FS with IPC and FeA.

Methods:

It was a randomized, parallel, open label, study among pregnant women of gestational age between 12 to 26 wk with moderate anaemia. Patients were randomly allocated to receive either FS, IPC or FeA. They were then followed up for 90 days to observe for improvement in the haemoglobin levels and other haematological parameters or any adverse drug reaction.

Results:

The haemoglobin levels were comparable in the three groups except at day 90 when FeA group had significantly higher haemoglobin level as compared to FS group (P<0.05). The overall adverse effect profiles were also comparable among the study groups except epigastric pain which was more commonly reported in the FS group.

Interpretation & conclusions:

The results of the study showed that FS, IPC and FeA have comparable efficacy and safety profile in the treatment of IDA of pregnancy.
Epidemiology & attributing factors for chronic kidney disease
Authors: Palo Subrata Kumar , Swain Subhasisha , Chowdhury Sayantan , Pati Sanghamitra
Published: November 2021

Background & objectives:

Chronic kidney disease (CKD) is one of the leading causes of mortality in developing countries, however, evidence from some geographical areas of India is scantly available on its risk factors. Other than diabetes and hypertension, several personal and environmental factors are also associated with CKD.

Methods:

A population-based case–control study was conducted over a period of 12 months in two high CKD reporting districts of Odisha, India. A total of 236 participants, 1:2 age- and sex-matched cases (83):controls (153), were included. Various factors were modelled with univariate and multivariable conditional logistic regression and analyzed using the Bayesian method in STATA SE v.12.

Results:

Among the study cases, about 81 per cent were male and about 25 per cent were aged <40 yr. CKD-associated risk factors were hypertension for more than five years [adjusted odds ratio (aOR)=4.24; 95% credible interval: 1.23-10.05], scheduled tribe/caste (aOR=2.81; 1.09-5.95), use of tube well/bore well water for drinking (aOR=1.21; 1.02-1.43), consumption of locally made alcohol (aOR=1.09; 1.02-1.17) and eating red meat and vegetarian diet with (aOR=1.24; 1.12-1.39) and (aOR=1.09; 1.04-1.14), respectively.

Interpretation & conclusions:

The presence of CKD among younger age groups and association of multiple factors including personal and environmental suggest for more research to establish the cause and effect relation of these factors.
Comparative study of endometrial & subendometrial angiogenesis in unexplained infertile versus normal fertile women
Authors: Singh Monisha , Acharya Neema , Shukla Samarth , Shrivastava Deepti , Sharma Gaurav
Published: November 2021

Background & objectives:

Local angiogenesis in endometrium has been shown to be an essential pre-requisite for endometrial receptivity needed for implantation and gestation. Recently, numerous diagnostic gears have been projected to ‘measure’ or ‘estimate’ the endometrial receptivity relying upon angiogenic factors helping throughout implantation. This study evaluated the endometrial and subendometrial blood flow and the local endometrial gland vascular endothelial growth factor (EG-VEGF) expression as markers of local angiogenesis.

Methods:

The present study was done to give quantitative assessment of endometrial thickness (ET), endometrial blood flow and subendometrial blood flow colour Doppler indices with endometrial vascular zones. Endometrial biopsy was taken and with VEGF stained and scored with immunohistochemistry.

Results:

The mean ET for fertile women was 9.41 mm, while in unexplained infertile women it was around 7.90 mm. Upon comparison of ET with EG-VEGF which is considered as a gold standard with correlation coefficient, the present study suggested a positive correlation of EG-VEGF with ET, endometrial pulsatility index (PI), and subendometrial PI also the vascular zones were considered as significant. However, a strong negative correlation was seen with subendometrial resistivity index and PI.

Interpretation & conclusions:

The present study suggests that uterine ultrasound, uterine colour Doppler and EG-VEGF are parameters which can be used as markers of local angiogenesis for endometrial receptivity in the evaluation of women with unexplained infertility.
Truenat™ - micro real-time-polymerase chain reaction for rapid diagnosis of leptospirosis at minimal resource settings
Authors: Rajamani M. , Maile Anwesh , Sugunan A.P. , Vijayachari P.
Published: November 2021

Background & objectives:

The biological spectrum of leptospirosis ranges from acute undifferentiated febrile illness to severe fatal syndrome or a combination of syndromes. Diagnosis on clinical grounds alone is difficult and depends on laboratory support. However, no confirmatory tests are available, which is rapid and can be performed with minimum facilities available. The objectives of this study were to evaluate the diagnostic utility, accuracy and reproducibility of a rapid real time-PCR based method (Truenat™) for early diagnosis of leptospirosis, and its usage in low resource settings.

Methods:

The Truenat™ test was performed using plasma sample collected from confirmed patients and controls. DNA was extracted from plasma samples and the reaction was performed as per the manufacturer’s instructions. Leptospiral isolates were also used to assess the performance using different serovars.

Results:

Evaluation of the Truenat™ test with RT-PCR as the gold standard showed that Truenat™ had a sensitivity of 97.4 per cent and a specificity of 98.6 per cent. The overall agreement with RT-PCR was 98.2 per cent.

Interpretation & conclusions:

Our results showed that the test would be a useful tool for early diagnosis of leptospirosis in settings with minimal facilities and the test results could be obtained within an hour. This indicates that a specific therapy can be instituted during the early phase of the disease even at peripheral healthcare facilities as well during the outbreaks.
Cost-effectiveness of incorporating Mycobacterium indicus pranii vaccine to multidrug therapy in newly diagnosed leprosy cases for better treatment outcomes & immunoprophylaxis in contacts as leprosy control measures for National Leprosy Eradication Programme in India
Authors: Muniyandi Malaisamy , Singh Malkeet , Singh Manjula , Rajshekhar Kavitha , Katoch Kiran
Published: November 2021

Background & objectives:

The elimination goal for leprosy as a public health problem at the national level was achieved in 2005 in India. However, the number of new cases reporting annually remained nearly the same during the last 10-15 years. Moreover, a substantial number of these new cases reported disabilities for the first time. Therefore, besides multidrug therapy (MDT), newer strategies with focus on effectively decreasing the number of new cases, optimizing the treatment of detected cases, averting disabilities and arresting the transmission of the disease are required. So the objective of this study was to assess the cost-effectiveness of Mycobacterium indicus pranii (MIP) vaccine implementation in National Leprosy Eradication Programme (NLEP) for newly diagnosed leprosy patients as well as their contacts to arrest/decrease the transmission and occurrence of new cases.

Methods:

This was a model-based estimation of incremental costs, total quality-adjusted life years (QALYs) gained, new cases averted, deaths averted, incremental cost-effectiveness ratio (ICER) and budget impact of the vaccination intervention. This model included the addition of MIP treatment intervention to the newly detected leprosy patients as well as vaccination with MIP to their contacts.

Results:

Using the societal perspective, discounted ICER was estimated to be

JOURNAL/ijmer/04.03/02223309-202107000-00018/math_18MM1/v/2022-09-30T185838Z/r/image-tiff

73,790 per QALY gained over a five-year time period. Probabilistic sensitivity analysis (PSA) was assessed by varying the values of input parameters. Majority (96%) of simulations fell in North East quadrant of cost-effectiveness plane, which were all below the willingness to pay threshold.

Interpretation & conclusions:

Introduction of MIP vaccination in the NLEP appears to be a cost-effective strategy for India. Significant health gains were reduction in the number of new leprosy cases, decreased incidence and severity of reactions during treatment, and after release from treatment, prevention of disabilities, thus reducing the cost as well as stigma of the disease.
Diagnostic Characteristics of Lactate Dehydrogenase on a Multiplex Assay for Malaria Detection Including the Zoonotic Parasite Plasmodium knowlesi
Authors: Barney Rebecca , Velasco Miguel , Cooper Caitlin A. , Rashid Andrew , Kyle Dennis E. , Moon Robert W. , Domingo Gonzalo J. , Jang Ihn Kyung
Published: November 2021

Plasmodium lactate dehydrogenase (pLDH) is a common target in malaria rapid diagnostic tests (RDTs). These commercial antibody capture assays target either Plasmodium falciparum–specific pLDH (PfLDH), P. vivax–specific pLDH (PvLDH), or a conserved epitope in all human malaria pLDH (PanLDH). However, there are no assays specifically targeting P. ovale, P. malariae or zoonotic parasites such as P. knowlesi and P. cynomolgi. A malaria multiplex array, carrying the specific antibody spots for PfLDH, PvLDH, and PanLDH has been previously developed. This study aimed to assess potential cross-reactivity between pLDH from various Plasmodium species and this array. We tested recombinant pLDH proteins, clinical samples for P. vivax, P. falciparum, P. ovale curtisi, and P. malariae; and in vitro cultured P. knowlesi and P. cynomolgi. P. ovale-specific pLDH (PoLDH) and P. malariae-specific pLDH (PmLDH) cross-reacted with the PfLDH and PanLDH spots. Plasmodium Knowlesi-specific pLDH (PkLDH) and P. cynomolgi-specific pLDH (PcLDH) cross-reacted with the PvLDH spot, but only PkLDH was recognized by the PanLDH spot. Plasmodium ovale and P. malariae can be differentiated from P. falciparum by the concentration ratios of PanLDH/PfLDH, which had mean (range) values of 4.56 (4.07–5.16) and 4.56 (3.43–6.54), respectively, whereas P. falciparum had a lower ratio of 1.12 (0.56–2.61). Plasmodium knowlesi had a similar PanLDH/PvLDH ratio value, with P. vivax having a mean value of 2.24 (1.37–2.79). The cross-reactivity pattern of pLDH can be a useful predictor to differentiate certain Plasmodium species. Cross-reactivity of the pLDH bands in RDTs requires further investigation.