bluuebunny/crossref_metadata_2025 huggingface dataset:
Cyber-Physical Systems in Agriculture
Authors: Chinnasamy Sasikala , Dharani L. , Thanuja S. , Kavishree P. S.
Published: August 2023

Advanced mechatronic systems have undergone a significant transition to Cyber-Physical Systems (CPS) over the past 20 years. CPS are designed systems that rely on the seamless fusion of computational algorithms and physical elements to function. Agriculture is a basic need and a crucial part of our life. In order to feed the world, CPS will definitely play a significant role in the agricultural sector. CPS is a combination of multiple embedded systems assigned with significant works. CPS is a heterogeneous components that includes electronic chips, software systems, sensors and actuators. The capabilities, adaptability, scalability, resilience, safety, security, and usability of CPS will greatly outpace those of today's uncomplicated embedded systems. The architecture of the agricultural cyber-physical system is covered in this chapter. A detailed discussion of the uses of CPS in many agricultural domains, including plant data collecting, soil water monitoring, field monitoring, field information gathering, and other applications is presented in this chapter.
Internet of Things-Based Micro Climate Monitoring System for Irrigation Water Optimization
Authors: Kumar S. N. , Jacob Andrew Thomas , Varghese Amal , Francis Emma , Sabu Mibin P. , Antony Neenu Rose
Published: August 2023

Precision farming is a relatively new concept that has recently gained popularity. It is based on the idea of using technology to gather and analyze data on various factors that affect crop growth and yield. By analyzing data in real time and responding quickly to changes in the environment, precision farming can help farmers optimize the conditions of their fields and maximize the potential of their crops, leading to increased yields and more efficient use of resources. This research work put forward a study focusing on the role of IoT in smart agriculture. Precision farming offers many benefits, including increased efficiency and accuracy, improved data and analytics, reduced environmental impact, improved compliance with regulations, improved communication with stakeholders, and increased profitability for farmers.
Effective Path Planning of Cyber-Physical Systems for Precision Agriculture
Authors: Sundarrajan M. , Jothi Akshya , Choudhry Mani Deepak , Rose Biji , Jayapratha T. , Nithya V.
Published: August 2023

The usage of cyber-physical systems is well known to play a vital role in the development of precision agriculture, which in turn raises overall output. When a network of Unmanned Aerial Vehicle (UAV) is deployed for these applications, they are considered CPS. One of the most crucial things that needs to be handled is covering the area that needs to be travelled with the least number of UAV traversals possible. UAV traversal is a crucial part of precision agriculture because it enables farmers to gather crucial information and make informed decisions that may lead to higher crop yields and cheaper costs. Thanks to improved algorithms and techniques, UAVs can traverse agricultural land more effectively and precisely. As a result, farming activities become more productive and environmentally friendly. This chapter explores the various approaches that might be used to determine the UAV's best route when it is deployed over farmland.
Assessing and Scoring Elementary Mathematical Writing
Authors: Casa Tutita M. , Arsenault Tessa L. , Powell Sarah R. , Hebert Michael A.
Published: August 2023

Mathematical writing has gained attention as an essential component of discourse. Assessing and scoring students' writing pieces about mathematics has the potential to allow teachers and researchers to gain insights into the depth of students' understanding beyond what they can express orally, including their use of visual representations and symbolic notation. This chapter presents four approaches to assessing mathematical writing available in the research literature, including holistic rubric, analytic rubric, elements, and mathematics-writing sequences scoring. A description of how student writing samples were scored, and the benefits and limitations of each approach is provided. Considerations to allow teachers and researchers to make informed decisions about scoring students' writing in mathematics are provided.
Dialogic Writing Assessment in the History Classroom
Authors: del Calvo Andrew O. , Beck Sarah W.
Published: August 2023

In this chapter, the authors discuss how, in the discipline of history, the dialogic assessment approach to writing conferences can allow teachers to assess and teach students' historical thinking along with their writing. Dialogic assessment is an approach to conducting 1:1 writing conferences designed to elicit a student's live composing—including idea generation, planning, drafting, and revision—through structured questions and prompts. The authors provide a rationale for this method of writing instruction, highlighting its connections to historical thinking and writing. The chapter also depicts examples of teacher mediational moves that support students' writing and historical thinking processes, and several examples of how the first author used these moves in his classroom with a ninth-grade student. It concludes with a discussion of affordances and challenges, along with suggestions for how practitioners can overcome typical obstacles to enacting this practice with students.
Gushing Through the Challenges
Authors: Mishra Sweety , Chowdhary Nimit Ranjan
Published: August 2023

Over the last two decades, women's entrepreneurship has drawn attention because of its noteworthy socioeconomic impact in every field including tourism industry. However, despite the well-documented benefits of women's involvement in entrepreneurship, they continue to confront challenges that restrict them from achieving heights. The existing literature mainly discusses the challenges women face in their entrepreneurial journey, and very few studies address the positively changing scenario. Therefore, this chapter explores the shifting and changing scenario in women's entrepreneurship and to identify what challenges have been overcome and what continues to restrict the growth of women's entrepreneurship. The study attempts to present the challenges and enablers that have changed business dynamics for women. The chapter also analyses how women's entrepreneurship has transformed over time and digs deep into the extant literature to understand if the business environments have become conducive for women over generations. The authors follow an inductive approach to achieve the objectives.
Family Tourism Businesses and Post Pandemic
Authors: Jamshed Kamran Ali , Shah Syed Haider Ali , Al-Ghazali Basheer M.
Published: August 2023

The purpose of this chapter is to provide a summary of the family tourism industry's reaction to the COVID-19 pandemic in Europe. Family tourism businesses are usually run by a single family or a small group of families. These companies provide their clients with exceptional, customised solutions. The tourism and hospitality sectors in Europe have been hit hard by the COVID-19 pandemic. As a result, family-friendly tourism enterprises have had to get creative to survive. The importance of ensuring the security and happiness of your customers, as well as embracing digitalization and sustainability, has never been higher. Businesses catering to families in the tourism industry have been thriving despite the pandemic because of their accommodating cancellation policies and personable approach to the industry. Though the road to recovery is still hazy, family-run tourism businesses in Europe are developing innovative strategies to maintain competitiveness and fortify their resilience.
Tourism as an Empowerment Tool in Sustainable Development
Authors: Jamshed Kamran Ali , Afzal Muhammad Imran , Al-Ghazali Basheer M. , Jamshaid Samrah , Eman Noor E. , Shamsi Azzam Inayatullah
Published: August 2023

Sustainable development is the practise of ensuring that current needs are met without jeopardising future generations' capacity to do the same. The goal of sustainable development requires people all over the world to work together and think carefully about how their actions will affect the planet and the next generation. One sector with the potential to advance sustainable development is the tourism industry. China's hospitality industry has grown rapidly, which could lead to sustainable development and tourism and empowers sustainable development in China's hospitality industry, according to this research chapter. Tourism can help achieve sustainability and local autonomy, two goals that have garnered attention recently. China must encourage responsible tourism practises that are kind to the local environment and culture while also boosting the economy of the host community. This research emphasises tourism's potential to empower China's sustainable development while acknowledging the need to continue efforts to distribute tourism's benefits fairly and sustainably.
Halal Holidays
Authors: Sultan Muhammad Faisal , Asim Muhammad , Mahar Imamuddin , Tunio Muhammad Nawaz
Published: August 2023

Halal tourism is getting more popular day after day due to the increase in Muslim tourists all around the globe. In fact, non-Muslim countries are also striving towards providing Muslim-friendly facilities to attract Muslim tourists. However, Halal holidays is a bit different from Halal tourism as these are the holidays that provide complete leverage to Muslim tourists. In fact, Halal holidays are not associated with any religious act like a pilgrim, etc., but all the aspects associated with leisure and fun will be according to Sharia principles and will never obstruct any of the religious act of Muslims. However, the concept has not been discussed yet, especially with reference to Muslim women. Therefore, this study has been written purposively to describe all the aspects that may make readers understand the concept of Halal holidays in a detailed manner in order to make readers understand the relationship of Halal's perceived value with the intention to visit the destination.
Stigma, Double-Stigma, and Associated Hurdles
Authors: Sultan Muhammad Faisal , Kazi Abdul Kabeer , Saleem Muhammad Furquan , Khurram Sadia
Published: August 2023

Women always face issues while travelling alone or in the form of a group. However, these issues became more devastating for Muslim women due to religious, safety, personal, and familial issues. Therefore, there is a need for a thorough concentration of motivation, perception and hurdles of Muslim solo or group female tourists. In fact, there are few studies that tried to determine the motivation behind the preference for solo travelling. However, there are few studies that may highlight issues, problems, and threats that may be faced by Islamic women while travelling. Therefore, this chapter has been written purposively to highlight the obstacles that may halt females from travelling. The philosophy of research used for writing this study is epistemology, and the research strategy is archival as the chapter has been formulated by analyzing available literature.
Influencers and Travel Agencies in the Focus of Influencer Communication
Authors: Alkan Zeynep
Published: August 2023

The aim of this study is to reveal how influencer communication takes place during collaborations with travel agencies and to evaluate how they communicate with their followers in this context. The study has a descriptive nature and covers the collaborations of “Korea Tourism Organization & Meryem Can,” “Visit Dubai & Meryem Can,” “Visit Dubai & Gülnihal Eren (Cocobolinho),” and “Costa Cruises & Gülnihal Eren (Cocobolinho)” as case studies. Within this framework, collaborations with different travel agencies are examined through the relevant content on the official Instagram accounts of influencers. At the same time, this compilation study shows that influencers actively participate in social networks during the experiential process of travel agencies. Additionally, the preference for female influencers who collaborate in the tourism industry is considered as another feature of the study.
Women's Travel Issues and Constraints
Authors: Anış Esra
Published: August 2023

In this chapter, the author presents ıssues and constraints of solo female travelers to Turkey based on their travel blogs reflecting their pre-travel and during-travel constraints and safety tips they adopted to energize their desire to travel to and within Turkey's cities. The author asks, “What are the travel issues and constraints for solo women travelers?” and “How is Turkey less safe and at the same time the most preferred destination for women travelers?” The study employs netnographic research methodology to understand complex social phenomena and assist researchers in developing themes from female travel bloggers' experiences of solo travels to Turkey. Using content analysis, the findings show that the constraints were mainly intrapersonal barriers about Turkey: like personal, religious requirements, perceived risk, and safety constraints. Other constraints such as interpersonal barriers and structural barriers have not reflecting solo travel bloggers' pre-travel and during-travel restrictions about Turkey. For all bloggers, safety is a key factor in the travel decision.
Women's Entrepreneurship in Halal Tourism
Authors: Rafique Muhammad Omer
Published: August 2023

‘Halal' travelers are a rising market niche for tourism, and they look for locations that accommodate their dietary, sartorial, and ritual needs. “Halal” implies lawful in accordance with Islamic teachings. Gambling, drinking, eating pork, and nudity are prohibited. By 2022, it is anticipated that Muslim tourists would spend $220 billion, up from 121 million in 2016, and they will number 156 million. The chapter is intended to present the concept of the role of women in halal tourism and highlight the opportunity to increase entrepreneurship in developing countries through a robust model. The majority of the developing or underdeveloped countries are Islamic, with extraordinary tourism destinations. However, the tourism business in these countries is still monopolized by males. The discussed topic promotes SDG 5 (Gender Equality) and SDG 8 (Economic Growth). Encouraging women's entrepreneurship in Halal tourism shall attract an inflow of finance into the local economy and reduce the unemployment level while maintaining the cultural limitations and securing the belief systems.
Women Empowerment in Human Resource Management
Authors: Kamran Balaach , Anwar Osama , Zaidi Syed Asad , Naseer Hafiz Qasim , Yousaf Saad , Qureshi Muhammad Asif
Published: August 2023

Researchers all over the globe have showed increased research attention in management literature towards discrimination at the workplace. The research has revealed that human resource management practices play a critical role in shaping the extent of discrimination that occurs within an organization as they influence the access that women employees have to opportunities within the workplace regarding training, fair performance appraisals, career advancement, equal rewards, and developmental assignments.
Women in Tourism Opportunities for Women in Remote Areas
Authors: Javed Muhammad Affan , Brohi Rimsha , Ahmed Aisha Aqeel , Khan Asad Ahmed , Iqbal Mubashir Zafar , Aslam Muhammad Bilal , Razzaq Areej
Published: August 2023

In this chapter, the authors are going to look into tourism regarding women as it is known gender equality is a priority for national governments and international organizations, as evidenced by their adherence to a number of agreements, including the Beijing Declaration and Platform for Action, the Sustainable Development Goals, and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW). Just and equitable societies must priorities gender equality and women's empowerment.
An Empirical Investigation on the Influence of Social Networks on Purchase Decision Making
Authors: Kalavathy K. S. , Swapna H. R. , Nallasivam Anitha , Pandey Digvijay , Mahajan Darshan A. , Dadheech Pankaj
Published: August 2023

The purpose of this chapter is to examine the factors which influence the intention to use Facebook among Generation Y consumers and its influence on purchase decision making. A quantitative research methodology was used, and the data was collected from 404 respondents in Bangalore city. Partial least square structural equation model using R software was used to analyse data collected. The findings showed that perceived usefulness, perceived enjoyment, perceived credibility, and subjective norm have a significant influence on intention to use Facebook while perceived ease of use does not have a significant influence on intention to use Facebook. Perceived enjoyment has the highest influence on intention to use Facebook followed by subjective norm, perceived credibility, and perceived usefulness. The results of this study also indicated that intention to use Facebook has a significant positive effect on consumers. The findings of this study contribute to an understanding of the importance of the selected factors in affecting the intention to use Facebook.
Integration of Blockchain Into Medical Data Security
Authors: Makinde Ayodeji Samuel , Agbeyangi Abayomi O. , Omaji Samuel
Published: August 2023

There are a number of real-world instances of blockchain-based systems that are being used or suggested for medical data security, but their implementation is limited and fraught with difficulties. To assure the moral and legal use of patient data in blockchain-based medical data systems, legal and regulatory challenges must be addressed. The technological, legal, and adoption issues relating to blockchain-based medical data systems are currently being researched and developed. Furthermore, there are many benefits and problems associated with implementing blockchain-based medical data systems, including enhanced data security and privacy, interoperability and care coordination, efficiency and cost reduction, and support for medical research and innovation. This research explored the advantages, constraints, and legal and regulatory ramifications of blockchain technology's use in protecting medical data. This study discusses how medical data management could be substantially more secure, interoperable, and effective via blockchain technology.
Design and Development of Robots for Medical Assistance
Authors: Pramila P. V. , Amudha S. , Saravanan T. R. , Sankar Sasi Rekha , Poongothai E. , Boopathi Sampath
Published: August 2023

In this chapter, artificially intelligent assistive robotics for medical applications have been discussed. The voice identification, object identification, grasping, feature selection, and classification by the assisted robots can be demonstrated by the Fuzzy Temporal Rule-based Semantic Analysis algorithm (FTRSAA) and intelligent techniques. The image processing and machine learning techniques using a vision camera can be applied in assistive robot programming for the voice and object recognition, graphing, and tracking of objects have been performed by machine learning techniques. The algorithms suggested for grabbing objects, such as image segmentation, RoI extraction, and classification, are thus explained. Machine vision connected to gripping three things has been explored.
Predictive Analytics in Recruitment
Authors: Baskaran Kamaladevi
Published: August 2023

This study aims to identify the competencies and skills possessed by the job seekers to secure jobs in the field of business administration, analyses the impact of soft skills, technical skills, and social networking sites on their employment using predictive analytical tool and proposes skill gap employability model to streamline recruitment process. Primary data of 172 samples were obtained from the UAE residents using simple random sampling. The employability skills are extracted from the secondary sources like job search portals. The regression analysis reveals that soft skills have significant impact on employment and the results state that it is statistically significant at 5% level. The author derives the skill gap employability model to bridge the skill gap to ensure job demand meets the supply of right candidates. This research provides insights to the business administration professionals who are searching for employment in the areas of human resources, finance, accounting, marketing, sales, operations, logistics, supply chain management, and business analytics in UAE.
Stakeholders' Expressions of Tech Layoffs
Authors: Kalyani V. , Praveen Babu P. , Pradeep Melvin
Published: August 2023

The volume and nature of work undertaken by the tech employees is humongous, tech employees are known to manage those high tides because of attractive salary packages, perks, and other incentive options, which turn out to be a catastrophic collapse when such layoffs are levied, giving little or no room for a quick transfer to another job from the viewpoint of the affected employees. User-generated unstructured data content in the forms of either tweets, reviews, or comments from around seven major social media platforms were collected to understand the various expressions and discussions linked to layoffs. The collected data is further segregated into – employee expressions, social media reviewers, news critiques views, etc., and their perspectives were further analysed. The overall analysis of sentiments on various stakeholders are formulated using Python (Juypter Notebook) package. The authors attempt to model out the viewpoints of various expressors and suggests various measures to be taken by the tech majors to better handle the phenomenon of layoffs.
HR Analytics in Employee Engagement and Turnover
Authors: Jaiwant Sunanda Vincent , Vazirani Kiran
Published: August 2023

HR Analytics has expanded increasingly in the last two decades. Nowadays, several companies use the supremacy of analytics, in gaining a competitive edge over others by recognizing all essentials of the employees. Organizations aim to optimize employee-performance, and hence are making use of HR analytics to drive strategic HR decisions. This study examines the advent of HR analytics by in measuring and improving employee engagement and turnover. Employee engagement analytics stands for exercising the use of data in decision-making process by integrating employee engagement with other HR and non-HR data. Employee engagement analytics is a subsection of workforce-analytics. It has become the standard contemporary system in advanced employee administration and retention. Employee engagement analytics benefits all stakeholders within the organization.
New Perspectives on Public Diplomacy
Authors: Yigit Sureyya
Published: August 2023

Diplomacy, in its international meaning, refers to the art and practice of negotiations between representatives of states or international organisations. In international relations, the interaction between said representatives can focus on aspects as diverse as war and peace, trade, economy, and culture. This chapter endeavours to shed light on the emerging new public diplomacy. Specifically, it introduces a competency model for new global diplomacy with several objectives. The first is the need to audit real power, which escapes international law legislation. The power audit suggests that one is facing a trilemma, a problem with three elements that require prioritization. The first point concerns the debate between freedom and security: how to reconcile both dimensions in the face of the growing threats to the integrity of people. The second is the balance between transparency and confidentiality. Third, it questions what public knowledge is when faced with Wikileaks and the Snowden leaks and how much it affects the relationships based on mutual trust.
Assessing Patients With Altered Level of Consciousness
Authors: Hill Michelle , Moreda Melissa , Navarro Jacqueline , Mulkey Malissa
Published: August 2023

Patients with alterations in level of consciousness are among the most difficult to assess, so knowledge of how to assess these patients is important for tracking trends and identifying changes. This article discusses methods used to assess patients admitted with an altered level of consciousness and describes the neurological assessment of and potential causes for altered level of consciousness. Identifying and understanding certain examination findings enable faster recognition and intervention for life-threatening neurological events, directly impacting outcomes for neurologically compromised individuals.
Development of "Aria," a Compact, Quiet Personal Electric Helicopter
Authors: Coleman David , Halder Atanu , Saemi Farid , Runco Carl , Denton Hunter , Lee Bochan , Subramanian Vishaal , Greenwood Eric , Lakshminaryan Vinod , Benedict Moble
Published: August 2023

This paper describes the development and flight testing of a personal air vehicle by team Harmony for the GoFly Prize competition. The competition emphasized an open-air ight experience, and the nal aircraft was scored by size (≤ 8.5 ft), noise (<87 dBA), and speed (>30
kt). The highest scoring team would win a $1 million grand prize. Team Harmony endeavored to develop an aircraft which would maximize the competition score. A counterrotating coaxial electric helicopter con guration was chosen to maximize rotor area and reduce disk loading for efficiency
and acoustic benefits. The rotors were designed through a parametric study using an in-house aerodynamics code, an in-house acoustics code, and CREATE TM -AV Helios CFD. A quiet electric power train and custom 11 kWh battery were developed. Flight control was implemented with dual, independent,
electronically coupled swashplates. A one-third-scale prototype aircraft was first developed and flighttested. Then a full-scale, 520 lb (235.4 kg) prototype with an 8.45 ft(2.58 m) rotor diameter was developed and flight-tested. During hovering, the measured sound pressure levels at 50 ft(15.24
m) were 73 dBA. The full-scale vehicle crashed before its speed capabilities could be tested, but the aircraft would have likely scored well, achieving the goal of the project. This work encompassed several design trade-offs, especially between aerodynamic and acoustic performance in the rotor
and blade design, and between acoustics and endurance in the power source selection, and in availability and flight-worthiness of off-the-shelf hardware for personal flight.
Correction. Spatial cluster analysis of COVID-19 in Malaysia (Mar-Sep, 2020)
Authors: Publisher The
Published: August 2023

In the Article titled "Spatial cluster analysis of COVID-19 in Malaysia (Mar-Sep, 2020)." published May 5th, 2021, in Vol. 16(1) of Geospatial Health, an author's name was misspelled. The seventh author's name should be "Alamgir".
 
Reference:
Ullah S, Mohd Nor NH, Daud H, Zainuddin N, Gandapur MS J, Ali I, Khalil A, 2021. Spatial cluster analysis of COVID-19 in Malaysia (Mar-Sep, 2020). Geospatial Health, 16:961. https://doi.org/10.4081/gh.2021.961
Anthocyanins estimation in homogeneous bean landrace (Phaseolus vulgaris L.) using probabilistic representation and convolutional neural networks
Authors: Morales-Reyes José Luis , Acosta-Mesa Héctor-Gabriel , Aquino-Bolaños Elia-Nora , Herrera Meza Socorro , Márquez Grajales Aldo
Published: August 2023

Studying chemical components in food of natural origin allows us to understand their nutritional contents. However, nowadays, this analysis is performed using invasive methods that destroy the sample under study. These methods are also expensive and time-consuming. Computer vision is a non-invasive alternative to determine the nutritional contents through digital image processing to obtain the colour properties. This work employed a probability mass function (PMF) in colour spaces HSI (hue, saturation, intensity) and CIE L*a*b* (International Commission on Illumination) as inputs for a convolutional neural network (CNN) to estimate the anthocyanin contents in landraces of homogeneous colour. This proposal is called AnthEstNet (Anthocyanins Estimation Net). Before applying the CNN, a methodology was used to take digital images of the bean samples and extract their colourimetric properties represented by PMF. AnthEstNet was compared against regression methods and artificial neural networks (ANN) with different characterisation in the same colour spaces. The performance was measured using precision metrics. Results suggest that AnthEstNet presented a behaviour statistically equivalent to the invasive method results (pH differential method). For probabilistic representation in channels H and S, AnthEstNet obtained a precision value of 87.68% with a standard deviation of 10.95 in the test set of samples. As to root mean square error (RMSE) and R2, this configuration was 0.49 and 0.94, respectively. On the other hand, AnthEstNet, with probabilistic representations on channels a* and b* of the CIE L*a*b* colour model, reached a precision value of 87.49% with a standard deviation of 11.84, an RMSE value of 0.51, and an R2 value of 0.93.
Clinical characteristics for distinguishing between acute cardiogenic pulmonary edema and community-acquired pneumonia in elderly patients: a prospective observational study
Authors: Inui Genki , Tomita Katsuyuki , Fukuki Masaharu , Touge Hirokazu , Ikeuchi Tomoyuki , Hisatome Ichiro , Yamasaki Akira
Published: August 2023

Heart failure and pneumonia are highly prevalent in elderly patients. We conducted a study to evaluate the differences in the patterns of symptoms, laboratory findings, and computed tomography (CT) results in elderly patients with acute cardiogenic pulmonary edema (ACPE) and community-acquired pneumonia (CAP). From January 1, 2015 to December 31, 2017, we studied 140 patients aged >75 years who were diagnosed with ACPE and CAP. Symptoms, laboratory findings, mean ostial pulmonary vein (PV) diameter and patterns on CT images were assessed. The primary measures of diagnostic accuracy were assessed using the positive likelihood ratio (LR+). The cutoff value of ostial PVs for differentiating patients with ACPE from CAP was evaluated using the receiver operating characteristic (ROC) analysis. Ninety-three patients with ACPE, 36 with CAP, and 11 with complicated ACPE/CAP were included. In patients with ACPE, edema (LR+ 5.4) was a moderate factor for rule-in, and a high brain natriuretic peptide level (LR+ 4.2) was weak. In patients with CAP, cough (LR+ 5.7) and leukocytosis (LR+ 5.2) were moderate factors for rule-in, while fever (LR+ 3.8) and a high C-reactive protein level (LR+ 4.8) were weak factors. The mean diameter of ostial PVs in patients with ACPE was significantly larger than that of patients with CAP (15.8± 1.8 mm vs 9.6±1.5 mm, p< 0.01). ROC analysis revealed that an ostial PV diameter cutoff of 12.5 mm was strong evidence for distinguishing ACPE from CAP with an area under the ROC curve of 0.99 and LR+ 36.0. In conclusion, as ACPE and CAP have similar symptoms and laboratory findings, dilated ostial PVs were useful in characterizing CT images to distinguish ACPE from CAP.
“It’s real. It’s a thing:” Mental health counselors’ listening exhaustion during COVID-19
Authors: Ricks Damla , Brannon Grace Ellen
Published: August 2023

Mental health counselors regularly use active listening skills to be present with each client; however, active listening may cause burnout due to high emotional labor, inadequate staffing, excessive workload, and many other issues, each of which contributes to career exits. COVID-19 exacerbated all of these factors, and—adding to already stressful conditions—most mental health professionals were forced to conduct therapy sessions via telehealth. For this study, twenty licensed mental health counselors at various stages of their careers were interviewed during the height of the pandemic to understand their experiences with the technology and other factors related to their workload during that time. Thematic qualitative analysis was used to explore effects of active listening—including requisite adjustments made for virtual therapy sessions—on counselors’ emotional exhaustion and burnout levels. Results show how back-to-back, daily therapy sessions increased listening exhaustion levels and that counselors experienced both long-term and short-term listening exhaustion when utilizing telehealth due to lack of nonverbal cues and other related factors pertaining to online delivery. Implications for counselors, social workers, and other mental health professionals are discussed.
Comparison between ocular biometry parameters in patients with unilateral congenital glaucoma
Authors: Chandran Premanand , Sneha Chavan , Subramanian Sunada , Raman Ganesh V
Published: August 2023

Purpose:

To compare the axial length (AL) and corneal diameter between glaucomatous eye (GE) and fellow normal eye (NE) in patients with unilateral congenital glaucoma and to obtain a normative database for ocular growth among Indian children below 3 years of age.

Methods:

Retrospective longitudinal study. Patients who had a follow-up of 3 years from diagnosis with ocular biometry parameters being recorded at least thrice (once a year) and fellow eye being normal were included. Data collected were age, gender, intraocular pressure (IOP), AL, corneal diameter, optic disc findings, diagnosis, and surgery details.

Results:

Eleven patients were analyzed. All GE underwent combined trabeculotomy with trabeculectomy. Mean (SD) baseline IOP, AL, and corneal diameter were 17.1 (6.7) mmHg, 18.9 (1.1) mm and 12 (0.91) mm in GE, and 11.1 (3.8) mmHg, 17.8 (0.44) mm, and 10.5 (0.58) mm in NE, respectively. Increase in AL was 3.1 mm in the first year followed by 0.6 mm in second year and 0.4 mm in third year in GE compared to 2.6, 0.6, and 0.5 mm in NE, respectively. Corneal diameter increased by 1.1 mm in GE in the first year and remained stable thereafter compared to 0.7 mm in first year followed by 0.3 mm in second year and stable thereafter in NE. The percentage of success was 73% at 3 years.

Conclusion:

Axial length and corneal diameter were higher in GE than NE at all-time points. With prompt intervention, the growth curve of the GE was made parallel to that of NE.
Assessing the validity of flap motility sign in predicting the extent of anterior capsular tears in phacoemulsification
Authors: Parkash Rohit Om , Gurnani Bharat , Kaur Kirandeep , Parkash Tushya Om , Sharma Trupti
Published: August 2023

Capsulorhexis is an integral step of cataract surgery, and continuous curvilinear capsulorhexis is crucial during phacoemulsification to prevent intraoperative complications. However, sometimes during phacoemulsification in complicated and hard cataract cases, rhexis extension may occur, resulting in posterior capsular rent, nucleus drop, cortex drop, and aphakia. It may not always be possible to continue with phacoemulsification in all cases. In this perspective, the authors describe a novel flap motility sign (FMS) to predict the extent of anterior capsular tear during phacoemulsification. A total of 21,678 patients underwent phacoemulsification for three years, from July 2016 to June 2019. One hundred and twenty-one patients had an anterior capsular tear. There were 102 cases (84.3%) with pre-equatorial tears and 19 cases (15.70%) with postequatorial tears. All pre-equatorial flaps were everted and fluttering, and all postequatorial flaps were inverted and nonfluttering. Posterior capsule rupture (PCR) was observed in all 19 cases of postequatorial flaps (100%). No PCR was observed in patients with fluttering and everted flaps (0%). In-the-bag and scleral-fixated intraocular lens implantations succeeded in pre-equatorial and postequatorial tears, respectively. There was no case of a nucleus drop. This study validates FMS as a predictor for identifying the extent of anterior capsular tears, thereby determining the endpoint of safe phacoemulsification and the site for intraocular lens implantation. Pre-equatorial tears allow for the continuation of safe phacoemulsification and in-the-bag intraocular implantation. Postequatorial tears necessitate timely conversion to small-incision cataract surgery or extracapsular cataract extraction.
Comparative proteomics of proliferative diabetic retinopathy in people with Type 2 diabetes highlights the role of inflammation, visual transduction, and extracellular matrix pathways
Authors: Sen Sagnik , Udaya Prithviraj , Jeya Maheshwari Jayapal , Kohli Piyush , Parida Haemoglobin , Kannan Naresh Babu , Ramasamy Kim , Dharmalingam Kuppamuthu
Published: August 2023

Purpose:

To explore the vitreous humor proteome from type 2 diabetes subjects with proliferative diabetic retinopathy (PDR) in the Indian population.

Methods:

We performed mass spectrometry-based label-free quantitative analysis of vitreous proteome of PDR (n = 13) and idiopathic macular hole (IMH; control) subjects (n = 14). Nine samples of PDR and 10 samples of IMH were pooled as case and control, respectively, and compared. Four samples each of PDR and IMH were analyzed individually without pooling to validate the results of the pooled analysis. Comparative quantification was performed using Scaffold software which calculated the fold changes of differential expression. Bioinformatics analysis was performed using DAVID and STRING software.

Results:

We identified 469 proteins in PDR and 517 proteins in IMH vitreous, with an overlap of 172 proteins. Also, 297 unique proteins were identified in PDR and 345 in IMH. In PDR vitreous, 37 proteins were upregulated (P < 0.05) and 19 proteins were downregulated compared to IMH. Protein distribution analysis clearly demonstrated a separation of protein expression in PDR and IMH. Significantly upregulated proteins included fibrinogen gamma chain, fibrinogen beta chain, and carbonic anhydrase 1 and downregulated proteins included alpha-1-antitrypsin, retinol-binding protein 3, neuroserpin, cystatin C, carboxypeptidase E and cathepsin-D.

Conclusion:

Diabetic retinopathy pathogenesis involves proteins which belong to inflammation, visual transduction, and extracellular matrix pathways. Validation-based experiments using enzyme-linked immunosorbent assay (ELISA) or western blotting are needed to establish cause and effect relationships of these proteins to the disease state, to develop them as biomarkers or drug molecules.
A technological approach to “Reaching the Unreached” – Leveraging teleophthalmology services in Rural Gujarat
Authors: Shah Zalak , Shroff Uma , Gajiwala Uday , Shamanna B R
Published: August 2023

Purpose:

Early detection of sight-threatening disorders by technological applications like teleophthalmology and prompt treatment can help decrease visual impairment. This study evaluated the role of teleophthalmology in underserved rural areas along with cost-saving estimates for the end user.

Methods:

A prospective, observational, cross-sectional hospital-based study was conducted over 3 months. First 1000 teleconsultations were included. None of the patients denied providing informed consent. The patients were consulted at the eight vision centers and three satellite centers of the hospital in the nearby rural and tribal regions closer to their residential places. These vision and satellite centers were connected to the base hospital like a hub and spoke model with a teleophthalmology network.

Results:

Cataract (n = 301, 30.1%) and refractive error (n = 290, 29%) were the most common diagnosis. 42.1% of patients were referred to base hospital for further evaluation. Thus, a total of 57.9% of patients were not required to visit the base hospital for initial consultation, saving time and money. Furthermore, 15.1% of patients were provided medical treatment at the vision center and satellite center, which helped in making teleophthalmology cost-saving for the patients. An average of Rs. 621/- were saved per patient for the community in our study.

Conclusion:

Networked teleophthalmology model can be an affordable and feasible tool for providing eye care delivery services in rural and tribal regions of Gujarat and the whole country, especially for the end user. Thus, it may be a workable model in ophthalmology practice with substantial cost saving to the community.
Dacryoadenitis post COVID-19 infection and immunization
Authors: Singh Saumika , Gandhi Arpan , Das Sima
Published: August 2023

Dacryoadenitis can be a rare presentation following COVID-19 infection or can be an immunological response post COVID-19 vaccination. Herein we report two cases of lacrimal gland involvement, one post COVID-19 infection, and the other post COVID-19 vaccination. A definitive causal relationship, however, remains uncertain.
Diabetic microaneurysms detected by fluorescein angiography spatially correlate with regions of macular ischemia delineated by optical coherence tomography angiography
Authors: Abdel-Kader Ahmed A , Ramsey David J , Yussuf Wael A , Mohalhal Ahmed A , Eldaly Mohamed A , Elnahry Ayman G
Published: August 2023

Purpose:

To characterize the relationship between diabetic macular ischemia (DMI) delineated by optical coherence tomography angiography (OCTA) and microaneurysms (MAs) identified by fundus fluorescein angiography (FFA).

Methods:

Patients with diabetic retinopathy (DR) who underwent OCTA and FFA were retrospectively identified. FFA images were cropped and aligned with their respective OCTA images using i2k Align Retina software (Dual-Align, Clifton Park, NY, USA). Foveal avascular zone (FAZ) and ischemic areas were manually delineated on OCTA images, and MAs were marked on the corresponding FFA images before overlaying paired scans for analysis (ImageJ; National Institutes of Health, Bethesda, MD, USA).

Results:

Twenty-eight eyes of 20 patients were included. The average number of MAs identified in cropped FFA images was 127 ± 42. More DMI was noted in the superficial capillary plexus (SCP; 36 ± 13%) compared to the deep capillary plexus (DCP; 28 ± 14%, P < 0.001). Similarly, more MAs were associated with ischemic areas in SCP compared to DCP (92.0 ± 35.0 vs. 76.8 ± 36.5, P < 0.001). Most MAs bordered ischemic areas; fewer than 10% localized inside these regions. As DMI area increased, so did associated MAs (SCP: r = 0.695, P < 0.001; DCP: r = 0.726, P < 0.001). Density of MAs surrounding FAZ (7.7 ± 6.0 MAs/mm2) was similar to other DMI areas (SCP: 7.0 ± 4.0 MAs/mm2, P = 0.478; DCP: 9.2 ± 10.9 MAs/mm2, P = 0.394).

Conclusion:

MAs identified in FFA strongly associate with, and border areas of, DMI delineated by OCTA. Although more MAs are localized to SCP ischemia, the concentration of MAs associated with DCP ischemia is greater. By contrast, few MAs are present inside low-flow regions, likely because capillary loss is associated with their regression.
A pilot non-randomized trial of smartphone-based anaglyph system for treatment of adult amblyopia through VR (Virtual Reality)
Authors: Sutar Samir , Maan Veenu , Chaurasiya Ritesh Kumar , Agarwal Pradeep , Omaer Mossab , Chauhan Lokesh , Sengar Ajay Kumar , Kumari Bhavana
Published: August 2023

Purpose:

To evaluate the effectiveness of amblyopia treatment through a smartphone-based anaglyph system by virtual reality (VR) in adult patients.

Methods:

A total of 10 subjects diagnosed with anisometropic amblyopia were enrolled during the study period. Best Corrected Visual Acuity (BCVA), stereoacuity, and contrast acuity were evaluated during three visits (at presentation, 3 months and 6 months) of smartphone-based anaglyph video run in the VR mode. All the amblyogenic factors including stereopsis, color vision, and contrast acuity were compared using Friedman two-way analysis of variance. Statistical significance was considered if P < 0.05.

Results:

Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.73 ± 0.64 before Virtual reality vision therapy (VRVT) to a post-training VRVT value of 0.48 ± 0.44 (P < 0.01). Mean stereoacuity changed from a value of 560.00 ± 301.58 before VRVT to a value of 263.00 ± 143.58 seconds of arc after training (VRVT) (P < 0.01). Mean accommodation changes from a value of 15.00 ± 7.40 before training or VRVT to value of 12.60 ± 6.10 cm after training (P < 0.01). Mean contrast acuity changes from a value of 1.21 ± 0.72 at presentation to a value of 1.52 ± 0.49 log unit after VRVT.

Conclusion:

A smartphone-based anaglyph system using VR vision therapy appears to be an effective treatment option for amblyopia in adults.
Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiography
Authors: Nidhi Vatsala , Verma Saurabh , Shaikh Nawazish , Azad Shorya V , Chawla Rohan , Venkatesh Pradeep , Vohra Rajpal , Kumar Vinod
Published: August 2023

Purpose:

To analyze the topographic distribution of neovascularization (NV) and capillary nonperfusion (CNP) using ultra-wide field fluorescein angiography (UWFFA) in patients with proliferative diabetic retinopathy (PDR).

Methods:

This was a prospective, single-center, observational study in which all patients who presented between March 2019 and December 2020 and satisfied the inclusion criteria were recruited. In our study, patients with treatment-naïve PDR without any fibrovascular proliferation underwent UWFFA. The images were analyzed qualitatively for the topographic distribution of NV and the CNP area was quantified. The number of lesions picked by UWFFA was compared with 7 standard field (7SF) image using overlay of 7SF. The main outcome measure was characteristics of neovascularization, such as the number, location, and area of CNP, measured using UWFFA, which was considered with 95% confidence intervals (CI).

Results:

Two hundred and fifty-three eyes of 187 patients with a mean age of 56.03 ± 8 years were included. Mean neovascularization elsewhere (NVE) was 2.91 ± 3.43. Maximum NVEs were seen in the superotemporal (ST; 0.9 ± 1.13) quadrant, followed by the inferotemporal (IT; 0.7 ± 1.08), inferonasal (IN; 0.66 ± 1.02) and superonasal (SN; 0.66 ± 1.01) quadrants. Maximum CNP area was seen in the SN (13.75 ± 8.83 disc diameter square [DD2]) quadrant, followed by the IN (13.48 ± 8.59 DD2), IT (11.34 ± 8.37 DD2), and ST (11.3 ± 8.34 DD2) quadrants. Mean CNP area was maximum in patients with only neovascularization of disc (NVD; 64.99 ± 41.47 DD2), followed by both NVD and NVE (61.37 ± 35.61 DD2), and was minimum in patients with only NVE (36.44 ± 22.03 DD2). Eighty-one (32%) eyes out of 253 had NVE and 189 (75%) out of 253 had CNP area outside 7SF (overlay) of Early Treatment Diabetic Retinopathy Study (ETDRS).

Conclusion:

Diabetic NV lesions and CNP areas are distributed asymmetrically throughout the retina and are not restricted to the posterior pole. Compared to conventional 7SF imaging, UWFFA reveals significantly more retinal vascular pathology in patients with PDR.
Study 3: Anterior segment optical coherence tomography-guided surgical approach in slipped medial rectus muscle
Authors: Pujari Amar , Maddu Sai Vineeth , Batwani Vineet Kumar , Khokhar Sudarshan , Jha Paritosh , Sharma Namrata
Published: August 2023

Purpose:

To discuss the novel swept-source anterior segment optical coherence tomography (SS-ASOCT)-guided surgical approach in slipped medial rectus muscles.

Methods:

Prospectively (between February 2020 and July 2022), six patients with a clinical suspicion of slipped medial rectus muscle were recruited. After complete ophthalmic and orthoptic evaluation, the missing medial rectus muscle is screened using Anterior Segment Optical Coherence Tomography (ASOCT). In presence of a traceable muscle, its morphology, depth, and distance from a fixed anatomical landmarks were noted; in its absence, the status of other recti was noted. Intraoperatively, the features were confirmed and the intended intervention was performed.

Results:

The mean age of six patients was 25.66 ± 9.72 years, two with surgical trauma and four with penetrating trauma (66.66%). In five patients, the ASOCT traced the slipped medial rectus muscle successfully (83.33%); intraoperatively, the same was confirmed (within 1–2 millimeters) with favorable outcomes. ASOCT made a significant contribution in all subjects by reducing the number of interventions and muscle surgeries.

Conclusions:

In eyes with slipped medial rectus muscle, especially those which are within a finite distance from the angle can be traced using ASOCT. This approach impacts the outcomes in many ways.