bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing Inclusive, Collaborative Initiatives in Curriculum Delivery
Authors: Gcelu Ntombizandile , Khanare Fumane P.
Published: August 2021

While teaching and learning are underway, the world is still grappling with the COVID-19 pandemic and its impact on educational systems, particularly curriculum delivery across the globe, on both developing and developed countries. As a result, collaboration and partnerships with primary, secondary schools, and higher education institutions are more vital than ever. Unfortunately, many schools have yet to show real leadership when it comes to this. This chapter foregrounds the school management team voices to depict collaborative initiatives and ways to improve curriculum delivery in a rural context of two secondary schools in Free State, South Africa during the crisis. In so doing, the chapter considers collaborative initiatives that are inclusive and provide much-needed practical information for curriculum delivery and sustainable leadership.
School Management Teams' Strategies to Enhance Curriculum Delivery in the Era of the COVID-19 Pandemic
Authors: Mawela Ailwei Solomon
Published: August 2021

The uncertainty of how the curriculum is supposed to be delivered in schools during COVID-19, which is different from traditional practices, was a global challenge. This chapter seeks to explore school management teams' strategies to enhance curriculum delivery in the era of the COVID-19 pandemic. In this qualitative chapter, transformative learning and quality management theories, purposive sampling techniques, and the interpretive paradigm were employed. In addition, data collected from semi-structured interviews were thematically analyzed and discussed to give conclusions and recommendations. This study found that despite the existing policies such as the Curriculum and Assessment Policy System (CAPS) and the National Policy for Assessment (NPA) on planning and implementing curriculum delivery in schools, school management teams (SMTs) found it difficult to execute their duties as a result of the COVID-19 pandemic. Therefore, the study suggests annual in-service training for departmental heads (Dh) and deputy principals (Dp) on planning and implementing curriculum in schools.
Conflicts of Network Embeddedness in Healthcare Organizations
Authors: Vilmányi Márton , Erzsébet Hetesi , Tarjányi Margit
Published: August 2021

This chapter examined the organizations of a university dealing with healthcare and clinical activities operating in an extremely complex network connection. In the framework of qualitative research, with the help of a series of interviews, the authors researched in which networks the university's healthcare organization and organizational units participate, and how participation in these networks influences the value creation implemented in each field. By what means can the organization handle the contradictions and conflicts that arise along the inter-organizational relations embedded in the networks. Interviews were conducted with institution leaders, business leaders, and care workers. Based on the research results, network complexity results in three types of conflicts in healthcare institutions: conflicts related to organizational management, conflicts arising in organizational processes, and personal conflicts.
Positive Technology
Authors: Shirish Anuragini
Published: August 2021

Given the crucial need to bridge the mental health service divide, the author examines the emerging trends in digital well-being management by focusing on the mobile health market. Using a bottom-up perspective and leveraging literature from positive technology and generalized unsafety theory of stress, the author conceptualizes how positive technology as a mobile health solution can help end users to respond effectively to different kinds of stressors during a crisis. It is further argued that the use of positive technology can positively reverse the automatic route to mental ill health that is plausible in the absence of safety perceptions. The chapter offers a theory-driven conceptualization of digital coping through positive technology. By showing how a simple, scalable, and sustainable positive technology design can cater to different user segments, the author urges policymakers, entrepreneurs, and healthcare service providers to participate in the design, propagation, adoption, and diffusion of such holistic positive technologies for fostering societal resilience.
Suggestions for SMEs as They Emerge From Crisis Periods
Authors: Meriç Engin
Published: August 2021

Existing financial problems of SMEs, which have an important place in the economies of countries, deepen even more in times of crisis, affecting businesses negatively and leading them to failure. In the crisis conditions, the strategies that SMEs have implemented in order to maintain their balance in their economic activities and to be successful are of critical importance. For this purpose, a method has been proposed for SMEs to determine the exit method from the crisis in the first crisis phase, which they will notice before entering the chronic crisis phase. In the proposed method, a financial check-up was planned to include 1-Current Assets, 3-Short-Term Liabilities, 5-Equity and production and sales strategies. In addition, as a result of the application of this proposed method periodically, SMEs' control of finance and cash flow will contribute significantly to both their protection from economic problems and their internal control systems.
Credit-Market Imperfection and Monetary Policy Within DSGE Models
Authors: Ben Salem Salha , Mansour Nadia , Labidi Moez
Published: August 2021

This survey presented the various ways that are utilized in the literature to include financial market frictions in dynamic stochastic general equilibrium (DSGE) models. It focuses on the fundamental issue: to what extent the Taylor rules are optimal when the central bank introduces the goal of financial stability. Indeed, the latest financial crisis shows that the vulnerability of the credit cycle is considered the main source for the amplification of a small transitory shock. This conclusion changed the instrument that drives the transmission of monetary policy through the economy and pushed the policymakers to include financial stability as a second objective of the central bank.
Organizational Sustainability and Value Creation by Means of Innovation in Chaotic Environments
Authors: Pérez-Uribe Rafael Ignacio , Ramirez-Salazar Maria Del Pilar , Ocampo-Guzmán David , Saiz-Alvarez Jose Manuel
Published: August 2021

Between 2017 and 2020, the RISE model (Route for Innovative and Sustainable Enterprises) has been applied in 86 Colombian organizations of different sizes and belonging to different economic sectors. That model allows any organization's upper management to make a thorough assessment of the company by means of analyzing nine (9) organizational factors with reference to four (4) specific dimensions (social, environmental, managerial, and economic). These nine (9) organizational factors are deployed in 48 variables for analyses, and one of these variables is value creation through innovation. From the assessments and analyses derived from the RISE model, several research-worthy questions arise, such as, Which variables explain better the phenom of value creation through innovation? Which variables must the upper echelons concentrate their efforts on to generate value and grant sustainability? This work aims to present the results of the application of the RISE model and to answer the mentioned questions, especially during these uncertain, chaotic, and turbulent times.
Project Management Tools and Techniques to Deal With Disruptive Situations in Projects
Authors: Rincón-González César Hernando , Castro-Silva Hugo Fernando , Florez Libardo
Published: August 2021

This research work aims to analyze how project management tools and techniques help project managers to deal the disruption in projects in the Colombian business context. Firstly, a detailed literature review about project management and disruption was conducted. Secondly, a comprehensive scientometric analysis of project management and disruptive situations on this kind of endeavor was undertaken. Thirdly, tools and techniques suitable for handling disruptive situations on projects were identified. Fourthly, an extensive fieldwork over 700 organizations from the Colombian organizational context was executed. Fifthly, a detailed statistical analysis was carried out to determinate how project management tools and techniques contribute to handle disruption on this kind of initiatives. And finally, research findings were documented, a positive effect of the use of project management tools and techniques to face disruptive situations on project was found, conclusions were set, and future lines of research were defined.
Critical Analysis of the Relocation Strategy of Production Between National Protectionist Policies and Global Supply and Value Chains
Authors: Vargas-Hernández José G.
Published: August 2021

This chapter aims to critically analyze the implications that the national protectionist policies have on the global supply and value chains and the relocation of production. The analysis is based on the assumptions that the global economy is facing the possibility of decoupling of many trade connections, and this trend favors deglobalization processes long promoted by populism, nationalism, and economic protectionism. It is concluded that global supply, production, and value chains, although being economically efficient, are no longer any more secure under national protectionist policies, and therefore, the relocation of production processes is mainly due to the increase in the level of income and wages of the developing countries that are the destination and which reduce the advantages to relocate.
Impact of COVID-19 on International Trade
Authors: Kumari Reenu , Sharma Ashwani
Published: August 2021

All the countries are facing serious problems affecting their economic growth. In 2020, many countries faced negative GDP per capita growth due to the coronavirus pandemic. Therefore, this chapter investigates how coronavirus (COVID-19) affected international trade (IT) and how this changed over time. Secondly, the authors analyzed how international trade collapsed. Thirdly, the chapter highlights the negative effects of COVID-19 on international trade including economic sectors. Furthermore, it discussed the opportunities and forthcoming policies and what kinds of actions have been taken by the government bodies.
Performance Aspirations and Corporate Tax Avoidance
Authors: Lukas Timbate
Published: August 2021

The current study examines whether performance discrepancy from the aspiration level affects corporate tax avoidance. Prior studies show that performance discrepancies from the aspiration level significantly affect firms' behavior; thus, it is important to examine whether such discrepancies affect corporate tax avoidance. Based on the behavioral theory of the firm (BTOF), this study posits that firms performing below the aspiration levels avoid more taxes in the subsequent period than other firms. Empirical findings using data from a sample of U.S. firms for the period covering 1993-2016 support the hypothesis. The findings also show that, while there is a difference among firms meeting or beating the aspiration level, there is no statistically significant difference in tax avoidance level among firms performing short of their aspiration level. The study contributes to the existing literature by providing additional evidence extending the scope of literature in BTOF and tax avoidance areas.
An Incremental Model Projection Applied to Streamline Software Architecture Assessment and Monitoring
Authors: Kadri Salim , Aouag Sofiane , Hedjazi Djalal
Published: August 2021

Managing software architecture represents a big challenge throughout the development lifecycle. The complexity of the involved structural elements and the relations among them make the specified models look oversized and fuzzy, which makes the architecture incomprehensible, hard to maintain, and difficult to assess its quality. This paper's goal is to propose a powerful methodology for simplifying and reducing models' complexity to increase understandability, smoothing maintenance, and facilitating architecture monitoring and assessment. For this purpose, the authors rely heavily on two major concepts, multi-view modeling, and incremental model projection. The multi-viewing requires that all models must have two main views to describe the architecture and the mapping to its relevant quality attributes. The incremental projection is a methodology used to specialize and minimize models progressively to make them simpler and clearer. The results show that projecting models incrementally can reduce and narrow them significantly.
A Methodology of Task Allocation to Design a Human-Robot Assembly Line
Authors: Tram Anh Vo Ngoc , Raweewan Morrakot
Published: August 2021

There are successful cases in lean manual assembly lines; however, in some cases, such as the ease of assembly in quicker cycle time, the designs are not satisfactory and must be transformed to semi-automation. This research studies human-robot task allocation when designing for semi-automation considering not only time-cost effectiveness as in the existing research but also assembly difficulty and ergonomic issues. A proposed methodology optimally determines what tasks should be performed by humans or robots, at which station, and in what sequence. A multi-objective linear programming (MOLP) model is proposed to simultaneously minimize total operating cost, cycle time, and ergonomic difficulty. Solving the model has two approaches: with and without optimal weights. The methodology is applied to a Lego-car assembly line. To illustrate the benefits of the proposed MOLP, a comparison between it and three single-objective models is made. Results show that the optimal-weight MOLP yields a better performance (a shorter cycle time, a lower cost, and especially, a significant ergonomic improvement) when compared to the other MOLP and single-objective models.
A Systems Study on Interprofessional Collaboration in Healthcare
Authors: Matsushita Hironobu , Orchard Carole , Fujitani Katsumi , Ichikawa Kaori
Published: August 2021

This study aims to translate and adapt the Assessment of Interprofessional Team Collaboration Scale II (AITCS-II) cross-culturally for effective and systemic use in Japan, to describe floor and ceiling values, and to examine in terms of such criteria as reliability and face and content validity. The AITCS-II was translated from English into Japanese to develop the Japanese version of the Assessment of Interprofessional Team Collaboration Scale II (hereinafter referred to AITCS-II-J). Then, cross-sectional and cross-professional data analyses were carried out to seek evidence of construct validity. Analysis demonstrated good content and face validity. With a Cronbach's alpha coefficient greater than 0.9 (r varied from 0.912 to 0.940), the AITCS-II-J exhibited excellent internal consistency. The AITCS-II-J showed evidence of acceptable validity and reliability; therefore, this measurement system will be useful for informing the enhancement of interprofessional team collaboration within the Japanese acute healthcare context.
Prospecting the Effect of Topic Modeling in Information Retrieval
Authors: Sharaff Aakanksha , Dewangan Jitesh Kumar , Sisodia Dilip Singh
Published: August 2021

Enormous records and data are gathered every day. Organization of this data is a challenging task. Topic modeling provides a way to categorize these documents, where high dimensionality of the corpus affects the result of topic model, making it important to apply feature selection or information retrieval process for dimensionality reduction. The requirement for efficient topic modeling includes the removal of unrelated words that might lead to specious coexistence of the unrelated words. This paper proposes an efficient framework for the generation of better topic coherence, where term frequency-inverse document frequency (TF-IDF) and parsimonious language model (PLM) are used for the information retrieval task. PLM extracts the important information and expels the general words from the corpus, whereas TF-IDF re-estimates the weightage of each word in the corpus. The work carried out in this paper improved the topic coherence measure to provide a better correlation among the actual topic and the topics generated from PLM.
Host Defense against Klebsiella pneumoniae Pneumonia Is Augmented by Lung-Derived Mesenchymal Stem Cells
Authors: Rangasamy Tirumalai , Ghimire Laxman , Jin Liliang , Le John , Periasamy Sivakumar , Paudel Sagar , Cai Shanshan , Jeyaseelan Samithamby
Published: August 2021

Klebsiella pneumoniae is a common cause of Gram-negative pneumonia. The spread of antibiotic-resistant and hypervirulent strains has made treatment more challenging. This study sought to determine the immunomodulatory, antibacterial, and therapeutic potential of purified murine stem cell Ag-1+ (Sca-1+) lung mesenchymal stem cells (LMSCs) using in vitro cell culture and an in vivo mouse model of pneumonia caused by K. pneumoniae. Sca-1+ LMSCs are plastic adherent, possess colony-forming capacity, express mesenchymal stem cell markers, differentiate into osteogenic and adipogenic lineages in vitro, and exhibit a high proliferative capacity. Further, these Sca-1+ LMSCs are morphologically similar to fibroblasts but differ ultrastructurally. Moreover, Sca-1+ LMSCs have the capacity to inhibit LPS-induced secretion of inflammatory cytokines by bone marrow–derived macrophages and neutrophils in vitro. Sca-1+ LMSCs inhibit the growth of K. pneumoniae more potently than do neutrophils. Sca-1+ LMSCs also possess the intrinsic ability to phagocytize and kill K. pneumoniae intracellularly. Whereas the induction of autophagy promotes bacterial replication, inhibition of autophagy enhances the intracellular clearance of K. pneumoniae in Sca-1+ LMSCs during the early time of infection. Adoptive transfer of Sca-1+ LMSCs in K. pneumoniae–infected mice improved survival, reduced inflammatory cells in bronchoalveolar lavage fluid, reduced inflammatory cytokine levels and pathological lesions in the lung, and enhanced bacterial clearance in the lung and in extrapulmonary organs. To our knowledge, these results together illustrate for the first time the protective role of LMSCs in bacterial pneumonia.
Expansion of Unique Hepatitis C Virus–Specific Public CD8+ T Cell Clonotypes during Acute Infection and Reinfection
Authors: Mazouz Sabrina , Boisvert Maude , Abdel-Hakeem Mohamed S , Khedr Omar , Bruneau Julie , Shoukry Naglaa H
Published: August 2021

Hepatitis C virus (HCV) infection resolves spontaneously in ∼25% of acutely infected humans where viral clearance is mediated primarily by virus-specific CD8+ T cells. Previous cross-sectional analysis of the CD8+ TCR repertoire targeting two immunodominant HCV epitopes reported widespread use of public TCRs shared by different subjects, irrespective of infection outcome. However, little is known about the evolution of the public TCR repertoire during acute HCV and whether cross-reactivity to other Ags can influence infectious outcome. In this article, we analyzed the CD8+ TCR repertoire specific to the immunodominant and cross-reactive HLA-A2–restricted nonstructural 3-1073 epitope during acute HCV in humans progressing to either spontaneous resolution or chronic infection and at ∼1 y after viral clearance. TCR repertoire diversity was comparable among all groups with preferential usage of the TCR-β V04 and V06 gene families. We identified a set of 13 public clonotypes in HCV-infected humans independent of infection outcome. Six public clonotypes used the V04 gene family. Several public clonotypes were long-lived in resolvers and expanded on reinfection. By mining publicly available data, we identified several low-frequency CDR3 sequences in the HCV-specific repertoire matching human TCRs specific for other HLA-A2–restricted epitopes from melanoma, CMV, influenza A, EBV, and yellow fever viruses, but they were of low frequency and limited cross-reactivity. In conclusion, we identified 13 new public human CD8+ TCR clonotypes unique to HCV that expanded during acute infection and reinfection. The low frequency of cross-reactive TCRs suggests that they are not major determinants of infectious outcome.
PROGNOSTIC VALUE OF PRO-ADM BIOMARKER IN PATIENTS WITH COVID-19.
Authors: Daidone Nashua , Callegari Tiziana , Ranzato Elia
Published: August 2021

This study was performed at the analytical laboratory of the Hospital SS. Antonio e Biagio e Cesare Arrigo" Hospital in Alessandria (AL) in the period March-June 2020. This is an observational, prospective, single-center study carried out on a cohort of patients diagnosed with ARDS secondary to SARS-CoV2 infection admitted in the first wave of the pandemic at the Sub-Intensive Care Unit of the Hospital of Alessandria. OBJECTIVE The aim of this study was to assess plasma concentrations of the regional mean proadrenomedullin biomarker (MR-proADM) at the time of patient access to the Emergency Department and subsequently 1, 3 and 5 days after admission, to verify its prognostic value in terms of short-term mortality. The second objective of the study was to compare this biomarker with other commonly used biomarkers such as PCR and Procalcitonin, to evaluate the effectiveness of MR-proADM in risk stratification in these patients. METHODOLOGY Samples used in this study were collected in a tube containing the anticoagulant EDTA, and measurements were performed using a fully automated instrument: the Kryptor Compact Plus. RESULTS Among the various Biomarkers assayed only MR-proADM and LDH concentrations were significantly higher in deceased patients than in surviving patients while no statistically significant difference was observed for PCR PCT concentrations. Increasing levels of MRproADM between the second and fifth day of admission to the intensive care unit represent the key to determining mortality risk. CONCLUSIONS Mr-proADM was found to be a more effective biomarker than other commonly used biomarkers (PCR, WBC, Procalcitonin) in identifying Covid-19 patients with poor prognosis at an early stage. This study allowed clinicians to routinely include the assay of this biomarker, useful in the stratification of these patients and in predicting a higher or lower risk of mortality, in the second wave of the epidemic.
Autoimmune Diseases, End Organ Dysfunction and Adverse Drug Reaction Following Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
Authors: Sasidharanpillai Sarita , Joseph Amala Theresa , Ajithkumar Kidangazhiathmana , Devi Keerankulangara
Published: August 2021

Context:

Autoimmune diseases, organ dysfunction and new drug allergies are mentioned as long-term complications after DRESS. There is scarcity of data on this from the country.

Aims:

To determine the frequency of autoimmune diseases, organ dysfunction, and new drug allergies after the resolution of DRESS.

Settings and Design:

This retrospective cohort study was carried out among patients who received treatment for DRESS in a tertiary referral center.

Materials and Methods:

In this retrospective cohort study, DRESS patients who received inpatient care in the dermatology department of our tertiary referral center from August 2014 to February 2017 were included. We excluded patients aged 12 years or below and those who had not completed minimum two years after the resolution of DRESS as on December 2019. We collected information on new onset autoimmune disease, end organ damage and new drug allergies detected after the resolution of DRESS through a telephonic interview. Those who consented were evaluated in our department.

Results:

We could contact 40/50 (80%) identified individuals and all of them consented for telephonic interview. 17 patients gave consent for revaluation in our department. There were 22 females and 18 males. 17 had definite and 23 had probable DRESS. The frequency of detection of a new disease and a new drug allergy after DRESS was 10% (4/40) and 7.5% (3/40), respectively. We noted three (7.5%) autoimmune diseases (rheumatoid arthritis 1, alopecia areata 1, chronic autoimmune urticaria 1) and one end organ damage (chronic kidney disease) among the study participants.

Limitations:

Small sample size and retrospective study design were the limitations.

Conclusions:

Prospective studies with large sample size are needed to delineate the link between DRESS and autoimmunity, end organ damage, and new drug allergies.
Acquired Dermal Macular Hyperpigmentation
Authors: Vinay Keshavamurthy , Bishnoi Anuradha , Kamat Divya , Chatterjee Debajyoti , Kumaran Muthu Sendhil , Parsad Davinder
Published: August 2021

Acquired dermal macular hyperpigmentation (ADMH) is an umbrella term that includes disorders clinically characterized by small and large pigmented macules/patches and histopathologically showing an evidence of current or resolved interface dermatitis with pigment incontinence, without clinically significant prior inflammatory phase. The term intends to include diseases previously described in the literature as lichen planus pigmentosus, Riehl's melanosis/pigmented cosmetic dermatitis and ashy dermatosis/erythema dyschromicum perstans. The nomenclature and origin of these disorders have always been a matter of discussion. These disorders share many clinicopathological similarities, are difficult to treat and adversely affect the quality of life. Recent consensus points towards the need for a unifying term to facilitate research and therapeutic trials. This article aims to provide a comprehensive review of the recent advances in ADMH.
All India Ophthalmological Society Financial Impact Survey on ophthalmology practice in India during COVID-19
Authors: Agarwal Divya , Saxena Rohit , Sinha Rajesh , Mishra Deepak , Sachdev Mahipal S , Sharma Namrata
Published: August 2021

Purpose:

A survey was conducted by the All India Ophthalmological Society (AIOS) to document the initial coronavirus disease 2019 (COVID-19)-related financial impact on ophthalmology practice in India. It also assessed various measures taken by ophthalmologists and the possible role of AIOS in mitigating the economic crisis.

Methods:

An online questionnaire-based cross-sectional survey was conducted among its registered members from July to August 2020. The prevalidated questionnaire contained 25 items related to the impact of COVID-19 on patient volume, the extent of financial distress faced by the ophthalmologists, and various proactive measures taken by them. All valid responses were tabulated and analyzed.

Results:

Out of 1,026 respondents, more than 90% ophthalmologists faced a 25% or more reduction in outpatient and surgical volume. Nearly 59% reported that they can suffer from serious financial distress in near future due to COVID-19 pandemic-related losses. Those who are young (P < 0.0005), salaried (P < 0.0005), and practicing in private sector (P < 0.0005) and Tier 1 cities (P < 0.0005) are reported to be more vulnerable to become financially unstable. The major concerns were revenue losses (70%), preexisting debts (39%), and increased operating costs (27%). The majority (90%) believed that AIOS can help in alleviating the distress. There was also hesitancy regarding the adoption of teleophthalmology and home-based care.

Conclusion:

COVID-19 has significantly affected the financial sustainability of ophthalmologists practicing in India. Identification of vulnerable groups and timely advocacy efforts by AIOS can help in mitigating this financial crisis.
Impact of COVID-19 pandemic on income and opportunities of ophthalmologists in India: Ophthalmologists’ Workplace Expectations and Satisfaction Survey (OWESS) Report 1
Authors: Edakhlon Sreeni , Mohan Prashob , Pillai Gopal S , Verma Lalit , Honavar Santosh G , Sharma Namrata , Nadaraj Ambily
Published: August 2021

Purpose:

To evaluate the impact of COVID-19 pandemic on the income and surgical training opportunities among the ophthalmologists in India and their opinion on salary reduction during this period.

Methods:

A questionnaire in the form of a Google survey was sent to ophthalmologists across India on May 1, 2021. The data collected until May 11, 2021 was analyzed.

Results:

A total of 1057 ophthalmologists all over India participated in the survey. Of the respondents, 559 (52.9%) were women and 730 (69.1%) were young ophthalmologists (below the age of 40 years). Salary reduction was reported by 569 (53.8%) of the respondents. The categories suffering the maximum salary reduction were – young ophthalmologists (407, 55.8%) (P < 0.001), women (304, 54.4%) (P < 0.001), and private sector employees (457, 67%) (P < 0.001). More women ophthalmologists (438, 78.4%) felt it was unfair to reduce the salary during the pandemic, as compared to men (330, 66.3%) (P < 0.001). A reduction in surgical training opportunities was reported by 689 (65.2%) of ophthalmologists. The categories who suffered the maximum loss of surgical training opportunities were young ophthalmologists (565, 77.4%) (P < 0.001), women ophthalmologists (415, 74.2%) (P < 0.001), and ophthalmologists in the government sector (147, 82.6%) (P < 0.001).

Conclusion:

Ophthalmologists in India, especially women and the younger professionals, had to face salary reduction and loss of surgical training opportunities during the COVID-19 pandemic. Most ophthalmologists in India do not favor a reduction in salary. There is a need to formulate policies to safeguard ophthalmologists, especially women and younger generation from future crises in training, employment, and income.
Perceptual visual dysfunction in children - An Indian perspective
Authors: Pehere Niranjan K , Dutton Gordon N
Published: August 2021

Perceptual visual dysfunction (PVD) comprises a group of vision disorders resulting from dysfunction of the posterior parietal and/or temporal lobes. Often, affected children have normal/near normal visual acuities and/or visual fields, but have difficulties in activities of daily living involving the use of vision. PVDs are known to be common among children with risk factors such as a history of prematurity and/or neurodevelopmental disorders. The inferior temporal lobes and ventral stream transform visual signals into perception, while the posterior parietal lobes and dorsal stream transform visual signals to non-consciously map the scene to guide action and facilitate attention. Dysfunction of these can lead to specific visual impairments that need to be identified during history taking, triggering ascertainment of further details by a structured inventory approach. Clinical tests to elicit dorsal and ventral stream visual dysfunctions have good specificity but low sensitivity. Neuropsychologists are rarely available in the developing world to perform detailed assessments, but there are a few tests that can be used by eye care professionals with some training. Optical coherence tomography (OCT) showing thinning of the ganglion cell layer and retinal nerve fiber layer is being explored as a potential tool for rapid assessment in the clinic. The behavioral outcomes of PVD can mimic psychological conditions including autism spectrum disorder, attention deficit hyperactivity disorder, specific learning disability, and intellectual impairment, and one needs to be aware of overlap among these differential diagnoses. A practical functional approach providing working solutions for each child’s set of difficulties in day-to-day activities is needed.
Risk of corneal epithelial defects with and without postoperative erythromycin ointment after laser photocoagulation for retinopathy of prematurity
Authors: Khan Hirah , Chebolu Apoorv , Richards Alan B , Barry Gerard P
Published: August 2021

Purpose:

We aim to compare the incidence of corneal epithelial defects after laser for retinopathy of prematurity (ROP) with and without the use of postoperative erythromycin ointment.

Methods:

In this retrospective observational cohort study, a total of 100 infants (200 eyes) consecutively treated with laser for ROP between 2012 and 2018. The primary outcome was presence or absence of corneal epithelial defect using fluorescein on bedside examination within the first week following laser for ROP. Additional data assessed included: the use of postoperative prophylactic erythromycin ointment for 1 week, postoperative day on which examination using fluorescein occurred, presence of corneal opacity, gender, birth weight, and gestation age. The presence or absence of postoperative corneal epithelial defects was compared between eyes receiving postoperative erythromycin ointment or not using a Fisher’s exact test.

Results:

Postoperative corneal epithelial defects were more common in eyes which did not receive postoperative erythromycin (7 of 40 eyes; 17.5%), compared to eyes which did receive erythromycin (1 of 160 eyes; 0.6%; P < 0.0001). Postoperative bedside examinations with fluorescein were performed within 2 days of surgery on 136 of 200 of eyes (68%). Corneal opacities were noted in 3 of 200 eyes (1.5%).

Conclusion:

We observed less corneal epithelial defects in eyes which received postoperative erythromycin ointment for 1 week after laser for ROP than in those which did not. While multiple variables may influence the presence or absence of postoperative corneal epithelial defects following laser for ROP, consideration for postoperative lubricating ointment following laser for ROP seems reasonable.
Combined intravitreal ranibizumab and zone I sparing laser ablation in infants with posterior zone I retinopathy of prematurity
Authors: Parchand Swapnil M , Agrawal Deepanshu , Gangwe Anil , Saraogi Tripti , Agrawal Deepshikha
Published: August 2021

Purpose:

To evaluate the efficacy of combined intravitreal ranibizumab (IVR) and zone I sparing laser ablation in infants with posterior zone I Retinopathy of Prematurity (ROP).

Methods:

This was a retrospective, interventional case series including premature infants diagnosed with posterior zone I ROP (n = 24) on ROP screening. Charts and RetCam images of preterm infants with posterior zone I ROP treated with immediate IVR and zone I sparing laser ablation at 4 weeks between April 2016 and September 2019 were reviewed. Data were analyzed and tabulated using frequency and descriptive statistics to describe the demography, morphology, and treatment outcomes. Primary outcome measure was structural outcome at 6 months. It was further categorized as favorable and unfavorable.

Results:

Twenty-four infants (48 eyes) with a mean gestational age of 28.54 ± 1.98 weeks and birth weight of 1180.33 ± 280.65 grams were analyzed. Thirty-six (75%) eyes had persistent tunica vasculosa lentis and twenty-six (54.1%) eyes had iris neovascularization. All eyes had features of aggressive posterior retinopathy of prematurity (APROP) limited to posterior zone I. The mean duration between IVR and zone I sparing laser ablation was 29.62 ± 6.36 (range: 24-34) days. One infant (2 eyes) received a second IVR treatment for recurrence of plus disease and persistent new vessels close to the fovea. Laser augmentation was done in 13 (27.1%) eyes. A favorable structural outcome was seen in 45 (93.7%) eyes.

Conclusion:

Posterior zone I ROP presents as APROP. Combined IVR and zone I sparing laser ablation appears effective treatment option in these eyes.
Correlation between systemic immune-inflammation index and routine hemogram-related inflammatory markers in the prognosis of retinopathy of prematurity
Authors: Akdogan Muberra , Ustundag Yasemin , Cevik Sadik G , Dogan Pelin , Dogan Nurhan
Published: August 2021

Purpose:

To evaluate the prognostic potential of systemic inflammatory index in the course of retinopathy of prematurity (ROP).

Methods:

This is a retrospective case-control study. 303 infants with a gestational age of ≤35 weeks were screened with and without ROP at birth and 1 month after the birth of complete blood counts (CBC) were included in this study. Serum neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte (PLR), and systemic immune-inflammation index (SII) was calculated at birth and one month after. LMR was calculated by dividing the absolute lymphocyte count by the absolute monocyte count. NLR and PLR were determined by dividing the absolute neutrophil count or the absolute platelet count by the absolute lymphocyte count, respectively. The SII was calculated by the formula = neutrophilxplatelet/lymphocyte. All statistical analyses were performed using SPSS 22 (SPSS for Windows, version 22.0; SPSS, Inc. Chicago, IL, USA).

Results:

A total of 303 infants were included 145 with ROP and 158 without ROP. The NLR, LMR, PLR and SII values were 0.56 ± 1.17/0.51 ± 1.04 (P = 0.997), 13.7 ± 18/9.49 ± 13.1 (P = 0.014), 31.69 ± 68/24.1 ± 37.7 (P = 0.268), 131.42 ± 326/124.66 ± 267 (P = 0.935) in with ROP and without ROP infant at birth respectively. The NLR, LMR, PLR, and SII values were 0.68 ± 1.27/0.34 ± 0.99 (P = 0.001), 2.58 ± 6.01/2.46 ± 14.5 (P = 0.706), 47.5 ± 78.33/33.55 ± 42.4 (P = 0.035), and 253 ± 681/114 ± 345 (P = 0.001), respectively in with ROP and without ROP infant at 1 month after birth.

Conclusion:

The NLR, PLR, and SII seem an independent predictor of the development of ROP.
Prevalence of color vision deficiency among school-going boys in South India
Authors: Krishnamurthy Sruthi Sree , Rangavittal Subhiksha , Chandrasekar Ambika , Narayanan Anuradha
Published: August 2021

Purpose:

Impact of color vision deficiency (CVD) on activities at school and productivity at work and consequential psychosocial difficulties has been reported. Although early detection and awareness help in overcoming these difficulties, screening for CVD is not a part of the school eye-screening initiatives in many countries. This study aimed at reporting the prevalence of CVD among school-going boys in Kanchipuram district, South India.

Methods:

The study was carried out as part of a school eye-screening program (SES) conducted in Kanchipuram district, Tamil Nadu, India for children between 6 and 17 years. The SES followed a three-phased protocol, which also included screening for CVD for all the boys between 11 and 17 years. The boys underwent CVD screening with Dalton’s pseudo isochromatic plates (PIPs) followed by confirmation with Ishihara’s PIP. The data were analyzed and the proportion of CVD in boys among different class grades, type of schools, location of schools, blocks of the district, and other clinical characteristics are presented.

Results:

Totally 250,052 children were screened in 1047 schools of which 74986 (60.61%) were boys between 11 and 17 years (mean age: 13.75 ± 1.91). The overall prevalence of CVD was found to be 2.76% (n = 2073; 95% confidence interval [CI]: 2.65–2.88). CVD was associated with urban locations (3.17% odds ratio [OR]: 1.90 95%CI: 1.69–2.13 P < 0.05) and public schooling (2.87%) (OR: 1.29 95%CI: 1.17–1.43 P < 0.05). Boys with CVD were less likely to have vision impairment (P = 0.002) and myopia (P < 0.001) as compared with boys with normal color vision. There was no significant difference in the proportion of other ocular conditions between children with and without CVD (P > 0.05).

Conclusion:

The study shows a significant proportion of CVD among boys in Kanchipuram district, India and its association with various demographic and clinical characteristics. Identification of CVD and counseling the stakeholders earlier through school children screening is crucial.
Retrospective analysis of silicon intubation by Ritleng probe and Sutupak suture fixed in silicone tube in congenital nasolacrimal duct obstruction
Authors: Killedar Milind , Sasurkar Pooja , Gokhale Nikhil , Shah Mitali , Visapure Rahul
Published: August 2021

Purpose:

The aim of this study was to perform a retrospective review of the outcome of silicon intubation using the Ritleng probe and a modified braided silk suture (Ethicon Sutupak) fixed in a silicone tube in children with congenital nasolacrimal duct obstruction (CNLDO).

Methods:

Records of all children between 1 and 12 years of age who underwent silicone tube intubation with the Ritleng probe and Ethicon Sutupak suture (2-0) fixed in silicone tube for CNLDO with a minimum of 1-year follow-up were identified. The hollow Ritleng probe was inserted via the canaliculus into the inferior meatus. The Sutupak thread-guide, attached to the silicone tube, was advanced through the probe lumen and retrieved using a hook under endoscopic visualization. The tube ends were tied to each other and tube removal was planned after 3 months. Absence of watering, discharge, and matted lashes after removal of silicone tube was defined as success.

Results:

One hundred and fifty-two eyes of 152 children with a mean age of 3.26 ± 2.3 years were included in the study. The procedure was successful in 145 eyes (95%) after removal of the silicone intubation with relief of symptoms observed in most patients by fifth-day follow-up (n = 120 eyes, 83%). The mean duration of follow-up was 3.48 ± 1.3 years. No other significant differences were observed between patients who did (n = 47) and did not (n = 105) have previous probing including success rates (95% vs. 96%, P = 0.89).

Conclusion:

Silicone intubation with Ritleng probe and Sutupak suture fixed in silicone tube was successful in resolution of symptoms of CNLDO in majority of patients. Using a low-cost suture did not affect success rates.
A survey of visual impairment and blindness in children attending eight schools for the blind in Myanmar: An update
Authors: Huang Sonia , Sun Michelle T , Mallipatna Ashwin , Carrillo Cesar , Tang Yi Fan , Nweni Khine , Win Tin , Aung Than Htun , Lin Naing , Win Ye , Griffiths Andy , Holmes Martin , Thapaw Naw Marina , Hlaing Soe , Casson Robert , Muecke James
Published: August 2021

Purpose:

To determine the causes of visual impairment (VI) and blindness among children in schools for the blind in Myanmar; to identify the avoidable causes of VI and blindness; to provide spectacles, low-vision aids, and ophthalmic treatment where indicated; to provide an update of the 2007 survey performed and identify any major epidemiological changes.

Methods:

Two hundred and ninety children under 16 years of age from all eight schools for the blind in Myanmar were examined and the data entered into the World Health Organization Prevention of Blindness Examination Record for Childhood Blindness.

Results:

In total, 271 children (93.4%) were blind (visual acuity [VA] <3/60 in the better eye) and 15 (5.17%) had severe visual impairment (SVI = VA <6/60 to 3/60 in the better eye). Most children had whole globe as the major anatomical site of SVI or blindness (105, 36.6%). The cause was unknown in the majority of these (155, 54.0%). One hundred and twelve children had avoidable causes of blindness and SVI (39.0%). Forty children (13.9%) required an optical device and 10.1% required surgical or medical attention, with a potential for visual improvement through intervention in 3.48%.

Conclusion:

In all, 39.0% of children had potentially avoidable causes of SVI and blindness with cataracts and measles being the commonest causes. This follow-up survey performed after the first one completed in Myanmar in 2007 demonstrates a change in the major site of abnormality from the cornea to whole globe and a reduction in avoidable blindness but highlights the ongoing burden of measles.
Retinopathy of prematurity screening and retinal hemorrhages – Our experience among Indian babies
Authors: Hemalatha B C , Kalpana B N , Shilpa Y D , Ravi B , Bhavana G , Meghana S , Basumatary Jessica
Published: August 2021

Purpose:

To evaluate the clinical characteristics of intraocular hemorrhages among babies screened for retinopathy of prematurity (ROP) and thereby their additional risk to the progression of ROP.

Methods:

A descriptive study was conducted at a tertiary referral hospital, which included 108 eyes of 60 neonates who were discovered to have retinal hemorrhages on retinal screening of 540 babies at risk for ROP. Maternal, obstetric, and neonatal risk factors were assessed in neonates with retinal hemorrhages. Retinal hemorrhages were assessed in terms of type, area, and relation to different retinal zones.

Results:

Among 540 neonates who were screened, retinal hemorrhages were found in 11.2% (n = 60 babies). Elderly primigravida mothers and spontaneous vaginal deliveries with prolonged second stage of labor were a common maternal risk factors for retinal hemorrhages. Low birth weight and preterm were fetal risk factors with neonatal retinal hemorrhages. These hemorrhages were more often bilateral (no. of babies = 48, 80%). Flame-shaped hemorrhages were more common than dot and blot ones. The majority of cases (no. of eyes = 74, 65%) resolved within 4 weeks, whereas four babies (8 eyes, 7.4%) progressed to ROP were treated with laser.

Conclusion:

Retinal hemorrhages in neonates are commonly associated with prolonged duration of second stage of labor, advanced maternal age, and anemia. Although not all progress to ROP, recognizing preterm and low birth weight babies with junctional hemorrhages is crucial not to delay the treatment. Regular follow-up until the clearance of hemorrhages and monitoring systemic conditions in these babies of amblyogenic age-group are required.
Analysis of the parental satisfaction for retinopathy of prematurity screening using binocular indirect ophthalmoscopy versus wide field retinal imaging
Authors: Dhami Abhinav , Gupta Gaurav , Dhami Nimrata Bajaj , Arora Nishant , Dhami Gobinder Singh
Published: August 2021

Purpose:

Analysis of the parental satisfaction for retinopathy of prematurity screening using binocular indirect ophthalmoscopy versus wide field retinal imaging.

Methods:

This was an observational, questionnaire survey-based study. The study cohort comprised of parents/legal guardians of consecutive Asian Indian premature infants enrolled for retinopathy of prematurity screening (for infants less than 2000 gms and/or 34-weeks gestational age) using binocular indirect ophthalmoscopy (BIO) with scleral depression and b) wide field retinal imaging using the 3Nethra Neo Camera (Forus Health, India). We evaluated the retina for the presence or absence of stages of ROP and plus disease. The survey analysis used closed-ended (multiple-choice) and open-ended questions for assessing 1) parents’ experience/preference among the two screening modalities namely, BIO and wide field imaging used in the study, 2) knowledge prior to ROP screening, 3) knowledge gained post ROP screening, in the outpatient ophthalmologic care unit in our hospital.

Results:

Parents/legal guardians of 90 infants were included in the study. Among the 90 parents who filled in the questionnaire, 62.3% were referred by their pediatrician, 23.3% came for self check-up and 14.4% incidentally came to the hospital for complaints like ocular discharge and were screened. 93.3% parents were satisfied with either ROP screening modality in our study, with 54.4% stated a preference for retinal imaging. In the study 20% of the parents felt that retinal imaging was painful for the infant and 31.1% felt that BIO was painful for the infant.

Conclusion:

Wide field imaging is increasingly becoming an effective tool and screening tool in ROP screening and helps in better understanding of the disease amongst parents.