bluuebunny/crossref_metadata_2025 huggingface dataset:
Entrepreneurial and SME Resilience During Crisis Episodes
Authors: Brear Andrea Sandra
Published: August 2021

Businesses and individuals have experienced multiple crises that have led to major financial and developmental impacts for entrepreneurs and small and medium sized enterprises (SMEs). Researchers believe that entrepreneurs should be innovative through means of resilience skills, risk management, and identifying new opportunities. This chapter aims to investigate entrepreneurial resilience during crisis episodes, investigating the development of resilience and how it helps a business survive a crisis episode while considering the likelihood that entrepreneurial resilience and risk management are linked, how it is linked, and if it can be improved and utilised for success. An anonymous survey was conducted to investigate how entrepreneurs have been impacted by the pandemic, their attitudes surrounding risk assessments, and how their adaptations and innovations impacted the development and survival of their business. The conclusion discusses research findings and suggestions to support the survival of entrepreneurs and SMEs during crisis episodes.
Small Business Survival of Onslaughts of Boko Haram Insurgency, COVID-19 Pandemic, and Economic Crisis in Yola, North-East Nigeria
Authors: Raimi Lukman , Manishimwe Theoneste
Published: August 2021

Underpinning this chapter on vulnerability and resilience theoretical views, the authors examine the survival strategy of small businesses (SBs) facing triple crises. They adopted a descriptive survey research design as the most appropriate strategy while relying on the primary data collected through structured questionnaires. In the absence of a sample frame for the target population, a sample size of 400 managers of SBs was selected purposively based on objective eligibility criteria. Out of the sample, 257 managers of SBs returned their completed questionnaires. The findings support largely the resilient view and also affirmed the vulnerability view because the four entrepreneurial marketing (EM) dimensions, namely entrepreneurial orientation, market orientation, innovation orientation, and customer orientation, have mixed impacts on the financial and non-financial performance of SBs facing triple crises. The study recommends that vulnerable SBs, when faced with economic crises, should be resilient and leverage the four EM dimensions for business continuity.
Exploring Shared Work Values and Work Collaboration With a Network Approach
Authors: Tursunbayeva Aizhan , Di Lauro Stefano , Antonelli Gilda
Published: August 2021

A real-life case study presented in this chapter reports on how organizational network analysis approach was used in a medium-sized Italian company with circa 100 employees to examine how the company employees were connected by shared values at work, what these values are, and whether and how their value connectedness impacted the quality of their collaboration. The findings indicate that there was a positive correlation between shared work values and work collaboration, present benchmarks for network parameters, as well as propose macro-categories of work values. To the best of the authors' knowledge, this is the first study to use the network-analysis approach to explore shared values and employee collaboration at work. The chapter should be of substantial interest not only to academic scholars but also to organizational leaders and HR practitioners.
Entrepreneurial Resilience and Market Turbulence in SMEs
Authors: Guerra Rodrigo Marques de Almeida , Cardoso Lídia Maria Begot Bento , Nogueira Nathalia Maciel , Carneiro Marcelo Pamplona
Published: August 2021

Entrepreneurial resilience is a recent topic and is widespread in scientific research, especially when associated with periods of instability and crises. This chapter aims to analyze the relationship between the variables open-mindedness (OM), entrepreneurial resilience (ER), market turbulence (MT), and overall performance (OP) in SMEs located in the legal amazon. Data collection coincided with the pandemic of COVID-19, with 384 SME managers participating. The sample was analyzed using structural equation modeling (SEM). The results suggest mediation of the variable ER on the relationship between OM and OP, and moderation of the variable MT on OM and ER. The research's originality is attested by the model's empirical relationships, research context, and adverse scenario provided by the COVID-19 expansion. The practical implications indicate that managers should pay more attention to the variables investigated through the creation of new skills and competencies necessary for entrepreneurial activity in periods of economic crisis and market turbulence.
Business Value Analysis at Yes Bank
Authors: Chouhan Vineet , Saraswat Pranav
Published: August 2021

This case is related with the biggest 2020 scam by one of the major new private sector banks (i.e., YES bank). The case is related with the misuse of the power of banks in providing the benefits to one person, due to the power and influence granted by the political party leaders that influence providing unlimited loans to one person and further the acts of the bank officials that led to the partial breakdown of the banking system in India. Further, the case deals with the major accused and the shell company's creator as DHFL. The present analysis put lights on the future lessons to be learnt by various sectors in order to prevent heavy losses and loss of customer faith (being the most vital component). It starts by giving a background of the crisis that led the RBI to come into picture. It also shows the effectiveness of the actions of RBI for YES bank. At last, it points out the importance of independent management and the roles of auditors and other regulators in dealing with this crisis.
The Appreciative Inquiry Methodology as an Instrument for the Analysis of the Sustainability of Companies
Authors: Díaz Crishelen Kurezyn
Published: August 2021

There are currently various social innovation practices and efforts to address sustainability and its impact on the world. One of them is the use of the appreciative inquiry methodology (AIM), which results in applying a SOAR analysis focused on sustainability and discovering the strengths, opportunities, aspirations, and results of a company. Thus, the company plays a fundamental role through corporate social responsibility (CSR) that seeks to carry out concrete actions that benefit society. This chapter will define what this methodology consists of, its scope, uses, and initiatives that have adopted it as part of their practices for the measurement and promotion of sustainability. One of the main results of using this methodology is to share success stories about innovations that meet the Sustainable Development Goals (SDGs) through organizations such as AIM2Flourish and B Corp.
The Impact of the Work Environment on Innovation and Business Sustainability in SMEs
Authors: Pérez-Uribe Rafael Ignacio , Bustamante Solange Dianira Jordan , Salcedo -Perez Carlos
Published: August 2021

Innovation is a process, where the interpersonal relationships of employees are key to the creation of ideas that will contribute to the generation of value for organizations in the face of disruptive environments. This chapter analyzes the relationship between the work environment as a key factor and its impact on the development of innovation processes and business sustainability, taking as a sample 182 SMEs, from commercial, footwear, and textile sectors from the city of Cúcuta. The results showed an interrelation between the organizational climate and the culture of innovation as an agent that generates change that contributes to business sustainability.
Instrument Validation of Organizational Dimensions That Learn in a Context of Chaos
Authors: Zamora Martha Nelia Martínez , Torres Christian Paulina Mendoza
Published: August 2021

The ability to learn and thus adapt to change is without doubt one of the most effective tools to emerge victorious in the face of chaos. But how do you know if an organization has this capability? The objective of this study is to validate the instrument of the dimensions of the organization that learns DLOQ (Dimensions of the Learning Organization Questionnaire). The DLOQ has 21 items or reagents distributed in seven different but related dimensions. The instrument seeks to be an initial intervention tool for contexts of chaos. The instrument was applied with a total of 21 items, in 14 organizations in the southern center of the state of Guanajuato, in Mexico, achieving the application of 536 valid cases. Based on the factor analysis carried out in the SPSS program, two important dimensions are observed, one of which is more important and contributes to 34,113% of the total average, a second factor of 28,764% of the total average. Factor one is called the organization's ability to learn, the second dialogue, and team learning.
Scenario Planning as a Tool to Manage Crises in Chaotic and Uncertain Environments
Authors: Tomas Cynthia Maria Montaudon , Pinto-López Ingrid N. , Amsler Anna
Published: August 2021

This chapter will describe scenario planning and establish its value in facing crises and chaotic situations. It explains how research in the field has evolved and describes context conditions such as uncertainty, crisis, and chaos, which provide fertile grounds for scenario planning. A bibliometric analysis is presented to illustrate the increase in the study of scenario planning as a tool to deal with uncertainty. Examples from scenario planning around the world are introduced to show its global application and potential. A comparative analysis is presented based on different exercises in scenario planning developed during the COVID-19 pandemic to provide an insight into the key uncertainties linked to the health crisis and how a broad perspective can help provide clarity in chaotic environments.
Prediction of the Disappearance of Companies From the Market in Bogotá, Colombia Using Machine Learning
Authors: Fajardo-Moreno William Stive , Velásquez Rubén Dario Acosta , Pérez Ivan Dario Castaño , Espinosa-Leal Leonardo
Published: August 2021

In this chapter, the results concerning the modeling of companies' disappearance from Bogota's market using machine learning methods are presented. The authors use the available information from Bogota's Chamber of Commerce, where the companies are registered yearly. The dataset comprises the years 2017 to 2020 with almost 3 million registries. In this work, a deep analysis of the different features of the data is presented and explained. Next, four state-of-the-art machine learning models are trained for comparison: logistic regression (LR), extreme learning machine (ELM), random forest (RF), and extreme gradient boosting (XGBoost), all with five-fold cross-validation and 50 steps in the randomized grid search. All methods showed excellent performance, with an average of 0.895 in the area under the curve (AUC), being the latter algorithm the best overall (0.97). These results are in agreement with the state-of-the-art values in the field and will be of paramount importance to assess companies' stability for Bogota's local economy.
Chaos Management Leadership Resulting From the Pandemic in Ibero-American Universities
Authors: Ramírez Iván Vargas , Rincon Lissette Adriana Murcia , De Miguel Jesús M. , Vargas Diego Sebastian
Published: August 2021

The pandemic and its effects on the development of a new normality in the Latin American education sector has transformed the traditional education systems creating new means of communication, coordination, and learning assessment. This study uses a qualitative methodology with descriptive basic statistics, applied to 16 leaders (deans and directors) responsible for the direction and management of universities in an atmosphere of chaos. The above allows creating a conceptual model that explains context components, leadership, and initiatives. At the same time, the variables and their connections are defined establishing a novating flexible, technological, and inclusive education strategy in the region that is here to stay for management and building of knowledge.
Cultural Values as Strategic Support to Organizational Sustainability in Times of Pandemic
Authors: Ariza Dora
Published: August 2021

The presentation of the COVID-19 pandemic in 2020 has led all organizations worldwide to rethink their strategies and even the products and services they offered, with the aim of surviving and overcoming the economic and social difficulties that guarantee their permanence in the market. The practices framed in the Sustainable Development Goals are more current than ever, given the need to respond to the demands imposed by healthcare, while humanity's battle against the virus is taking place. This chapter details the results found in a case study investigation in a Colombian organization of the textile sector that accesses the national and international market. Its objective was to determine the values of the culture that have guided the management of the company during the COVID-19 pandemic, allowing them to achieve economic and social sustainability. It was evident that values such as solidarity promoted by the founder and integrated into the organizational culture have directed the management of the company in times of pandemic, avoiding the dismissal of its workers.
Entrepreneurial Competencies
Authors: Pachón-Palacios Martha Lucía , Velosa-García Edward , Osorio-Vera Francisco Javier
Published: August 2021

The entrepreneurial education has had a significant impact on the education system. One of the differentiating elements of business training is the approach that can be achieved through a set of effective competencies. In this work, the authors discuss the key competencies that need to be addressed in training future university professionals for business success. For this discussion, they use the structural analysis as a tool for construction and analysis. Initially, they discuss the purpose of the investigation. Then, they focus on the selection of the main entrepreneurial competencies according to literature. Finally, they structure a set of key variables that professionals should develop for business success. Experts with experience in the business and educational fields assess the degree of dependence and influence of the relevant competencies. From the results, they reveal a system of strategic entrepreneurial competencies that is consistent with the need for entrepreneurial training.
Self-Perception of Leadership in Mexican Businesswomen
Authors: Diaz-Acevedo Natalie Berenice , Hernández-Sampieri Roberto
Published: August 2021

The purpose of this chapter is to analyze the self-perception of their own leadership in Mexican businesswomen. With this information, it can build a female leadership model, which allows knowing the self-perception of skills and characteristics they have as leaders, the situations that led them to use this leadership, the challenges they face daily in the performance of their activities, and the context in which they operate. Among the main results, it was found that Mexican businesswomen have a balanced leadership between the search for economic results and the development of quality relationships. This means that they manage to have efficient communication, they take their employees into account in the development of their companies, but they are also interested in the achievement of organizational objectives. They develop this leadership in a context where family support is key to achieving success and the main challenge they face is economic. Also, they have managed to break with the traditional scheme of work and female business leadership.
Exporting Without Direct Access to International Markets
Authors: Erkut Burak
Published: August 2021

In the literature on exports, the question of why some firms decide to export and why others decide to focus on the domestic market has only received fragmented and different answers. The only overemphasized factor, productivity, seems to be a dead end when empirical evidence is given for high productivity firms which decide to remain in the domestic market. This is mainly due to the ignorance of the role of the firm in international trade by the majority of the literature. In this empirical research, the aim of the author is to test the impact of legal, institutional, and financial conditions on the firm decision to export based on the Enterprise Survey by the World Bank for the Turkish Cypriot people, which remained out of the international community for 57 years, where Turkey emerged as its access point to international markets. Hence, the study contributes to the existing literature on export development by highlighting the obstacles in front of the export decisions of firms and addressing a hitherto not addressed case in international economics.
A Literature Survey on Extensive and Intensive Margins in International Trade
Authors: Berke Burcu
Published: August 2021

Products and firms are homogeneous in traditional foreign trade theories; products show no horizontal or vertical differentiation. It is observed that growth in exports is only related to an increase in export quantity and that this is not decomposed into margins. Since Melitz's work, there has been an increase in studies that decompose the firms' heterogeneity and export growth in foreign trade into extensive and intensive margins. The concepts are addressed in the literature known as “new-new” foreign trade theories which include extensive margins, the number of exporting firms, the number of new trade partners, and the volume or variety of exported products. In brief, the growth of global trade is the result of new trade relations (extensive margin) or a rise in existing trade relations (intensive margin). As one of the rapidly developing trade theories in international economics, the main purpose of this study is to conduct a literature survey on the extensive and intensive margins of export growth.
Upgrading the Global Value Chains After COVID-19
Authors: Sesliokuyucu Osman Seraceddin
Published: August 2021

The COVID-19 pandemic-related economic lockdowns and restrictions have caused socio-economic uncertainties in the world since 2020. The pandemic-induced economic shocks affected world trade, especially the reactions in fragile markets. As a result of the strict rules taken by the countries, the decrease in the supply of intermediate goods inputs used in industries worldwide, supply shock has caused global supply chains and economic problems to spread through supply chains. Due to the increase in demand exceeding the current supply and production capacity, the fragmented production system, which spread throughout the world, led to the risks related to global value chains (GVC). In this context, discussion of the uplift processes within the chain, which expresses the upgrading perspective, has come to the fore again. The solutions in chains, which are applied by industries in the pandemic process, emphasize the importance of backward and forward linkages in the chain.
Reconceptualisation of Democratic Citizenship Education Against Social Inequalities and Electoral Violence in Zimbabwe
Authors: Zembere Monica
Published: August 2021

This article analyses the implications of a reconceptualised democratic citizenship education on universities in Africa with special emphasis on Zimbabwe. This is a qualitative research where data has been gathered through interviews and observation. Democratic citizenship education theory is used as a theory speaking to the argument. The arguments proffered in the research are that the concepts of DCE, education, and democracy that are rooted in liberal ideas of education have the potential to develop critical thinking necessary for political participation, justice, and political tolerance. The findings are that an African university education can teach students to become human with others, meaning students are taught to respect and value human dignity as dictated by Ubuntu.
Service Design as a Catalyst for Patient-Centered eHealth Innovation
Authors: Nyatuka Danny Ronald , De La Harpe Retha
Published: August 2021

Today's healthcare industry is confronted with a myriad of challenges amidst emerging trends and opportunities which trigger a paradigm shift in healthcare design from stand-alone products to holistic services. These three dimensions are critical in assessing and managing healthcare, particularly in underserved settings. This study aims to maximize opportunities presented by both design and information and communication technologies to enhance the implementation of integrated people-centered health services. It is a qualitative study conducted across six government health facilities within Nairobi slums in Kenya as a case study of maternal health information services. Co-design-oriented service design research strategy is employed while a representative sample of (n=47) participants is drawn from different stakeholders in the public health sector. An architectural design framework for cloud-based patient-centered health information service is designed to support maternal care in underserved settings. A prototype service (AfyaTab app) is developed as a proof-of-concept of the proposed design solution.
Blog Backlinks Malicious Domain Name Detection via Supervised Learning
Authors: Alshdadi Abdulrahman A. , Alghamdi Ahmed S. , Daud Ali , Hussain Saqib
Published: August 2021

Web spam is the unwanted request on websites, low-quality backlinks, emails, and reviews which is generated by an automated program. It is the big threat for website owners; because of it, they can lose their top keywords ranking from search engines, which will result in huge financial loss to the business. Over the years, researchers have tried to identify malicious domains based on specific features. However, lighthouse plugin, Ahrefs tool, and social media platforms features are ignored. In this paper, the authors are focused on detection of the spam domain name from a mixture of legit and spam domain name dataset. The dataset is taken from Google webmaster tools. Machine learning models are applied on individual, distributed, and hybrid features, which significantly improved the performance of existing malicious domain machine learning techniques. Better accuracy is achieved for support vector machine (SVM) classifier, as compared to Naïve Bayes, C4.5, AdaBoost, LogitBoost.
Certain and Uncertain Temporal Data Representation and Reasoning in OWL 2
Authors: Achich Nassira , Ghorbel Fatma , Hamdi Fayçal , Métais Elisabeth , Gargouri Faiez
Published: August 2021

Temporal data given by Alzheimer's patients are mostly uncertain. Many approaches have been proposed to handle certain temporal data and lack uncertain ones. This paper proposes an approach to represent and reason about quantitative time intervals and points and qualitative relations between them. It is suitable to handle certain and uncertain temporal data. It includes three parts. (1) The authors extend the 4D-fluents approach with certain components to represent certain and uncertain temporal data. (2) They extend the Allen's interval algebra to reason about certain and uncertain time intervals. They adapt these relations to relate a time interval and a time point, and two time points. All relations can be used for temporal reasoning by means of transitivity tables. (3) They propose a certain ontology based on the extensions. A prototype is implemented and integrated into an ontology-based memory prosthesis for Alzheimer's patients to handle uncertain data inputs. The evaluation proves the usefulness of the approach as all the inferences are well established and the precision results are promising.
Probabilistic Graph Model Mining User Affinity in Social Networks
Authors: Su Jie , Li Jun , Chen Jifeng
Published: August 2021

In social networks, discovery of user similarity is the basis of social media data analysis. It can be applied to user-based product recommendations and inference of user relationship evolution in social networks. In order to effectively describe the complex correlation and uncertainty for social network users, the accuracy of similarity discovery is improved theoretically for massive social network users. Based on the Bayesian network probability map model, network topological structure is combined with the dependency between users, and an effective method is proposed to discover similarity in social network users. To improve the scalability of the proposed method and solve the storage and computation problem of mass data, Bayesian network distributed storage and parallel reasoning algorithm is proposed based on Hadoop platform in this paper. Experimental results verify the efficiency and correctness of the algorithm.
Web Service Clustering Approach Based on Network and Fused Document-Based and Tag-Based Topics Similarity
Authors: Ping Deng Li , Bing Guo , Wen Zheng
Published: August 2021

To produce a web services clustering with values that satisfy many requirements is a challenging focus. In this article, the authors proposed a new approach with two models, which are helpful to the service clustering problem. Firstly, a document-tag LDA model (DTag-LDA) is proposed that considers the tag information of web services, and the tag can describe the effective information of documents accurately. Based on the first model, this article further proposes an efficient document weight and tag weight-LDA model (DTw-LDA), which fused multi-modal data network. To further improve the clustering accuracy, the model constructs the network for describing text and tag respectively and then merges the two networks to generate web service network clustered. In addition, this article also designs experiments to verify that the used auxiliary information can help to extract more accurate semantics by conducting service classification. And the proposed method has obvious advantages in precision, recall, purity, and other performance.
Model-Driven Open Ecological Cloud Enterprise Resource Planning
Authors: Zhang Yi , Hu Bo , Zhang YIwen
Published: August 2021

Cloud enterprise resource planning (Cloud ERP) is an internet- and cloud computing-based enterprise information system developed on the cloud platform. Cloud ERP has lower costs and shorter development time compared with traditional ERP system, but it remains in a state of information isolated island. To maximize the advantages of cloud computing and make up the deficiency of traditional ERP systems, it is necessary to break down the "wall" between enterprises, making cloud ERP enter a more open and interconnected ecological environment. The model-driven development approach contributes to a better resilient scheduling capability of ERP system, leading to faster development and deployment of it. In this article, the authors propose a “knowledge + data” model-driven open ecological cloud ERP and explain the definition and functions of each model layer. Finally, the effectiveness of model layers is demonstrated in the open ecological cloud ERP reference architecture.
Preparing Families of Intensive Care Patients for Withdrawal of Life Support: A Pilot Study
Authors: Kirchhoff Karin T. , Palzkill Jenna , Kowalkowski Jennifer , Mork Anne , Gretarsdottir Elfa
Published: August 2021

Background Most deaths in intensive care occur after withdrawal of life support. Although preparation of patients’ families is recommended, the specific information required has not been theoretically developed or tested.

Objective To assess the feasibility of testing 4 tailored messages to prepare families of patients having a planned withdrawal of life support, to assess barriers to conducting such a study, and to obtain preliminary data on measurable effects that could be used to compare such preparation with usual care. Self-regulation theory was used to structure the messages.

Methods Families were randomly assigned to usual care (n=10) or to an intervention group (n=10) that received 1 of 4 tailored messages to prepare them for withdrawal of life support. They were contacted 2 to 4 weeks later to complete the Profile of Mood States and to give their evaluation of the experience, inclusive of the information received.

Results Compared with the usual-care group, the intervention group was significantly more satisfied with the information they received and understood better what was to happen. The intervention group had lower negative mood scores and higher positive mood scores than did the usual-care group, although the difference was not significant. Unsolicited comments by the usual-care participants were requests for the specific information that had been received by the intervention group.

Conclusions The information provided was considered helpful. A larger sample might yield more significant differences. Further work is needed on other aspects of preparation such as healthcare support, spiritual issues, and preparation for funeral arrangements.
Design of Broadly Cross-Reactive M Protein–Based Group A Streptococcal Vaccines
Authors: Aranha Michelle P , Penfound Thomas A , Salehi Sanaz , Botteaux Anne , Smeesters Pierre , Dale James B , Smith Jeremy C
Published: August 2021

Group A streptococcal infections are a significant cause of global morbidity and mortality. A leading vaccine candidate is the surface M protein, a major virulence determinant and protective Ag. One obstacle to the development of M protein–based vaccines is the >200 different M types defined by the N-terminal sequences that contain protective epitopes. Despite sequence variability, M proteins share coiled-coil structural motifs that bind host proteins required for virulence. In this study, we exploit this potential Achilles heel of conserved structure to predict cross-reactive M peptides that could serve as broadly protective vaccine Ags. Combining sequences with structural predictions, six heterologous M peptides in a sequence-related cluster were predicted to elicit cross-reactive Abs with the remaining five nonvaccine M types in the cluster. The six-valent vaccine elicited Abs in rabbits that reacted with all 11 M peptides in the cluster and functional opsonic Abs against vaccine and nonvaccine M types in the cluster. We next immunized mice with four sequence-unrelated M peptides predicted to contain different coiled-coil propensities and tested the antisera for cross-reactivity against 41 heterologous M peptides. Based on these results, we developed an improved algorithm to select cross-reactive peptide pairs using additional parameters of coiled-coil length and propensity. The revised algorithm accurately predicted cross-reactive Ab binding, improving the Matthews correlation coefficient from 0.42 to 0.74. These results form the basis for selecting the minimum number of N-terminal M peptides to include in potentially broadly efficacious multivalent vaccines that could impact the overall global burden of group A streptococcal diseases.
FECAL MICROBIOTA TRANSPLANTATION: FAST PARASITES DIAGNOSIS BY MULTIPLEX PCR
Authors: Mura Omar , Gamalero Elisa , Di Matteo Luigi , Rocchetti Andrea
Published: August 2021

Objectives: Evaluation of the analytical performance of the Novodiag  Stool Parasites biomolecular assay for the detection of intestinal parasites in faeces of the faecal microbiota transplant donor. Methodology: Comparison between the gold standard for the diagnosis of intestinal parasites, light microscopy, and the Novodiag  Stool Parasites biomolecular assay through the use of 22 fecal samples. Results: Twelve out of 22 samples were positive on microscopic examination. In order to assess the overlapping between the results obtained through parasitological examination and the molecular methodology, all samples were tested to the Novodiag  Stool Parasites assay. Positive samples detected by biomolecular assay were 11 out of 22. Conclusion: The preliminary evaluation of the analytical performance of the Novodiag  Stool Parasites kit can be considered promising. The Novodiag  Stool Parasites kit can be effectively used as a tool in the fast diagnosis of intestinal parasitoses on the faecal microbiota transplant donor faeces.
A Rare Case Report of BCG Induced Balanitis in a Patient with Transitional Cell Carcinoma of Urinary Bladder
Authors: Mitra Debdeep , Bhatnagar Anuj , Suhag Devinder , Sandhu Sunmeet
Published: August 2021

Primary Bacillus Calmette–Guérin (BCG) infection of the glans penis is not a very common entity and has been rarely reported in literature. BCG has been used as an adjuvant therapy in patients of transitional cell urinary bladder carcinoma following transurethral resection of bladder tumor. We report a 66-year-old male patient who was being managed for urinary bladder carcinoma with nine sittings of adjuvant BCG therapy. He developed painless swelling with multiple pustules over glans penis and prepuce along with inguinal lymphadenopathy. He had a BCG inoculation scar over his arm and his chest X-ray was within normal limits. His workup for sexually transmitted disease was negative. The biopsy from the nodule on prepuce revealed mixed inflammatory infiltrate comprising of neutrophils, lymphocytes, and eosinophils along with numerous congested blood vessels and hemosiderin macrophages. Mycobacterium tuberculosis gene expert from tissue was positive for acid fast bacilli (AFB). Fine-needle aspiration cytology from the right inguinal lymph node also revealed AFB on Ziehl–Neelsen stain. The BCG immunotherapy was stopped and the patient was started on a standard four-drug antitubercular therapy comprising isoniazid, rifampicin, ethambutol, and pyrazinamide along with daily doses of pyridoxine. The edema resolved and papules subsided within 2 weeks after starting antitubercular therapy. This is a very rare presentation although intravesical BCG therapy is a very common treatment modality, hence this report is intended to increase awareness of this condition in dermatologists and venereologists.
Efficacy of NB-UVB in Progressive Versus Non-Progressive Non-Segmental Vitiligo
Authors: Bhatia Saurabh , Khaitan Binod K. , Gupta Vishal , Khandpur Sujay , Sahni Kanika , Sreenivas Vishnubhatla
Published: August 2021

Introduction:

Narrow-band (NB) ultraviolet B (UVB) phototherapy has been shown to halt disease progression in vitiligo, but whether there is any difference in the response to NB-UVB seen in patients with progressive vitiligo versus non-progressive vitiligo has not been evaluated.

Objectives:

To evaluate the effect of NB-UVB on progressive versus non-progressive non-segmental vitiligo.

Study Design:

Prospective observational comparative study.

Duration:

April 2016-November 2017.

Methods:

Adult patients having non-segmental vitiligo involving 2-50% body surface area were divided into two subsets; patients developing >5 lesions in the last 1 month or >15 lesions in the last 3 months (progressive vitiligo, Group I) and patients with static disease for the last 6 months (non-progressive vitiligo, Group II). Both groups were treated with NB-UVB for 6 months (26 weeks) cumulatively and its efficacy in halting disease progression, re-pigmentation, side effects and psychosocial impact were evaluated.

Results:

Nineteen out of 24 patients with progressive vitiligo had arrest of disease progression. Rest five patients developed lesions at a slower pace. Group II had earlier onset of re-pigmentation, while Group I had more NB-UVB fluence (34.73 J/cm2 vs 25.2 J/cm2, P value = 0.034), more time for the fluence to be fixed (P value = 0.001) and more pruritus (P value = 0.001).

Conclusions:

NB-UVB has the potential to halt disease progression in some patients with progressive vitiligo; but is associated with more total NB-UVB fluence and time taken for fixing it. Progressive vitiligo patients have more pruritus as compared to patients with non-progressive vitiligo.
A Study of Clinical, Dermoscopic and Histopathological Correlation in Follicular Keratotic Diseases
Authors: Gangadhar Meghana , Adya Keshavmurthy A. , Inamadar Arun C.
Published: August 2021

Context:

Follicular keratotic disorder is an abnormal keratinization affecting the follicular orifices and clinically characterized by hyperkeratotic follicular papules affecting various sites. Dermoscopy is a non-invasive diagnostic tool and differentiates closely resembling diseases as well as possibly prevents need for an invasive biopsy.

Aim:

This study was aimed to find the correlation between clinical, dermoscopic and histopathological findings in follicular keratotic diseases and to establish the dermoscopic criteria in the diagnosis of primary follicular keratotic diseases.

Materials and Methods:

This was a hospital-based prospective cross-sectional study of 30 consecutive patients clinically diagnosed with follicular keratotic diseases, irrespective of age and duration of the disease.

Results:

The study consisted of 30 patients with a mean age of 19.57 ± 9.69 years. The most common primary follicular keratotic disease observed was phrynoderma and secondary follicular keratotic disease was follicular lichen planus (lichen planopilaris). The predominant dermoscopic finding among all the follicular keratotic diseases was perifollicular scaling 29 (96.7%) followed by keratotic plug 28 (93.3%). The most common histopathological feature was dilated follicular infundibulum 22 (73.3%) followed by follicular plug 15 (50%) and dermal perivascular infiltration 22 (73.3%). The clinical and dermoscopic features showed a significant statistical association with the histopathological findings.

Conclusion:

Dermoscopy is a simple, non-invasive diagnostic tool that helps in differentiating and diagnosing the closely resembling follicular keratotic diseases.
Prevalence of refractive errors among the school-going children in East Sikkim
Authors: Bhutia Karma Loday , Bhutia Sonam Choden , Gupta Nisha , Shenga Diki O
Published: August 2021

Purpose:

Vision plays an important role in child’s development for learning and communication. Uncorrected refractive error (URE) has become a major challenge to health care policy makers especially in school going children. We aim to report the prevalence of refractive error among the school students of the east district of Sikkim, India.

Methods:

A cross-sectional study was carried out among 15,954 school children under school health program of national program for control of blindness. The screening was conducted in 40 schools of east district which included primary, higher secondary, monastic and private schools.

Results:

The prevalence of refractive error was 6.7% among which myopia was the most common error present in 335 (31.1%) children, followed by astigmatism in 317 (29.4%) and the remaining 29 (2.6%) with hyperopia. The age group between 14-17 years had high prevalence of refractive error (9.2%). Females had slightly higher refractive error (6.93%) than males (5.9 %). Most backward classes were found to be highest suffering from refractive error (26.65%) and the least seen was found in schedule tribe (11.6%).

Conclusion:

The study provides a useful and baseline data about the refractive error amongst the school children of east Sikkim. A larger study needs to be conducted in all the schools of the state to get a clearer picture of RE and other eye related diseases to detect vision problem as early as possible.
Five-year demographic profile of retinopathy of prematurity at a tertiary care institute in North India
Authors: Tekchandani Uday , Katoch Deeksha , Dogra Mangat R
Published: August 2021

Purpose:

The purpose of this study is to study the demographic profile and pattern of retinopathy of prematurity (ROP) at a tertiary care institute in India.

Methods:

An ambispective study from January 2013 to December 2017. Infants with birth weights (BWs) <1750 g and gestational ages <34 weeks were screened for ROP. Demographic details and ROP severity were recorded.

Results:

Data of 2595 of the 3697 infants screened were analyzed. The number of infants screened and treated for ROP increased from 190 and 29, respectively (2013), to 818 and 132, respectively (2017). The overall incidence of “any ROP” was 32.3%, and severe ROP was 17.7%. Though 39.5% of all infants were outborns (not born in the study center), severe ROP was present in 69.7% of these compared to 18.8% among inborns. Outborns with ROP had a higher mean BW (1308 g) compared to inborns (1202 g) (P < 0.01). ROP Stage 1 was seen in 12%, Stage 2 in 34%, Stage 3 in 13%, Stage 4 in 6%, Stage 5 in 14%, and aggressive posterior ROP (APROP) in 20%. APROP was seen in 16% of infants in 2013, 10% in 2014, 15% in 2015, 22% in 2016, and 28% in 2017. Infants with Stage 4B/Stage5 (15.6% of all ROP) were presented at a mean age of 7.5 months and all had no/delayed screening.

Conclusion:

Incidence of any ROP was 32.3% and was more common in outborns than inborns. The proportion of infants with APROP showed a rising trend over the years. Nearly 15.6% of infants were presented with stage4B/5 ROP due to delayed/absent screening.
Outcomes of vitreoretinal surgery in retinal detachment associated with morning glory disc anomaly
Authors: Sen Parveen , Maitra Puja , Vaidya Harshit , Bhende Pramod , Das Kalpita
Published: August 2021

Purpose:

Morning glory disc anomaly (MGDA) is associated with a high prevalence of retinal detachment (RD), sometimes requiring multiple surgeries. The study aimed to establish the outcomes of RD surgery in such eyes and predict factors influencing the outcome, if any.

Methods:

It was a retrospective observational study of 9 eyes that underwent pars plana vitrectomy (PPV) for RD associated with MGDA. Clinical and surgical details were correlated with outcomes of surgery as noted at the final follow-up.

Results:

PPV was performed in 9 eyes. Lensectomy was done in 5 of 9 eyes (55.5%) during PPV. Laser photocoagulation around the disc was performed in 55.5% (5/9) of the eyes. Silicone oil tamponade was used in 77.7% (7/9) of eyes and gas tamponade (14% C3F8) was used in 22.3% (2/9) of eyes. Attached retina at final visit was observed in 66% of the eyes (6/9). Two out of 3 eyes that were seen to have preoperative glial tissue at the disc had poor outcome (odds ratio 10, P = 0.16). Five out of 7 (71%) eyes that had silicone oil tamponade, had an attached retina. No identifiable breaks were noted preoperatively in 5 eyes, of which 4 (80%) had an attached retina postoperatively. Vision improved by 1 line in 67% of the eyes that underwent surgery.

Conclusion:

MGDA related RD presents a unique set of challenges; meticulous PPV with or without lensectomy can help in achieving a successful anatomical and functional outcome in about two-thirds of patients.
Anti-vascular endothelial growth factor in the management of retinopathy of prematurity: A survey among the members of Indian Retinopathy of Prematurity Society
Authors: Gangwe Anil , Agrawal Deepanshu , Vinekar Anand , Azad Raj V , Parchand Swapnil M , Agrawal Deepshikha
Published: August 2021

Purpose:

To report the results of the survey for the role of anti-VEGF in the management of retinopathy of prematurity (ROP) among the members of Indian ROP (iROP) society.

Methods:

A questionnaire was designed in English using Google forms and its link was circulated to the members of the iROP society on their mobile numbers. The survey included questions pertaining to demographics, anti-VEGF agents, injection technique, post-injection follow-up, and documentation pertaining to their ROP practice. Anonymous responses were obtained and analyzed for individual questions.

Results:

226 members of the society were contacted and 157 responded (69.4%) to the survey. 137 (87.2%) respondents used anti-VEGF in the management of ROP. Aggressive posterior ROP (APROP) was the most common indication (78, 52.7%). The procedure was carried out in the main operation room (102, 70.3%) simultaneously for both the eyes (97; 68%) under topical anesthesia (134; 86.4%) by most of the respondents. One-hundred thirteen (77.9%) respondents used half of the adult dose, irrespective of the agent used; however, more than half of them preferred bevacizumab (85, 54%). 53 (36.3%) respondents followed up infants as per disease severity rather than a fixed schedule while only 33 (23%) performed photo documentation. 151 (96.2%) respondents felt the need for guidelines regarding the usage of anti-VEGF in ROP.

Conclusion:

There is an increase in the trend towards the use of anti-VEGF in the management of severe ROP, particularly APROP. However, there are considerable variations among the ROP practitioners regarding the agent, dosage, follow-up schedule, and documentation, suggesting the need for uniform guidelines.
Visual function assessment, ocular examination, and intervention in children with developmental delay: A systematic approach - Part 2
Authors: Jayaraman Deiva , Jacob Namita , Swaminathan Meenakshi
Published: August 2021

In India, there is increasing number of children with development delay and vision impairment with or without additional disabilities due to prematurity, brain damage, cerebral palsy, or genetic syndromes. Despite initiatives from Government of India, early intervention for these children remains a challenge across the country due to lack of trained professionals and appropriate resources. This paper describes the developmental screening tools, intervention aspects including Individualized Education Plan, procedures for handling children with cerebral visual impairment, team approach, and guidelines derived from the inputs of experts in vision rehabilitation centers of premier eye institutes in India
Effectiveness of Kanna photoscreener in detecting amblyopia risk factors
Authors: Murali Kaushik , Krishna Viswesh , Krishna Vrishab , Kumari B , Murthy Sowmya Raveendra , C Vidhya , Shah Payal
Published: August 2021

Purpose:

Amblyopia is a significant public health problem. Photoscreeners have been shown to have significant potential for screening; however, most are limited by cost and display low accuracy. The purpose of this study was validate a novel artificial intelligence (AI) and machine learning–based facial photoscreener “Kanna,” and to determine its effectiveness in detecting amblyopia risk factors.

Methods:

A prospective study that included 654 patients aged below 18 years was conducted in our outpatient clinic. Using an android smartphone, three images of each the participants’ face were captured by trained optometrists in dark and ambient light conditions and uploaded onto Kanna. Deep learning was used to create an amblyopia risk score based on our previous study. The algorithm generates a risk dashboard consisting of six values: five normalized risk scores for ptosis, strabismus, hyperopia, myopia and media opacities; and one binary value denoting if a child is “at-risk” or “not at-risk.” The presence of amblyopia risk factors (ARF) as determined on the ophthalmic examination was compared with the Kanna photoscreener.

Results:

Correlated patient data for 654 participants were analyzed. The mean age of the study population was 7.87 years. The algorithm had an F-score, 85.9%; accuracy, 90.8%; sensitivity, 83.6%; specificity, 94.5%; positive predictive value, 88.4%; and negative predictive value, 91.9% in identifying amblyopia risk factors. The P value for the amblyopia risk calculation was 8.5 × 10−142 implying strong statistical significance.

Conclusion:

The Kanna photo-based screener that uses deep learning to analyze photographs is an effective alternative for screening children for amblyopia risk factors.