bluuebunny/crossref_metadata_2025 huggingface dataset:
Publication trend of COVID-19 and non-COVID-19 articles in the Indian Journal of Ophthalmology during the pandemic
Authors: Gurnani Bharat , Kaur Kirandeep
Published: May 2021

Purpose:

To analyze the trend of COVID-19-related and non-COVID-19-related articles published in the Indian Journal of Ophthalmology (IJO) during the COVID-19 pandemic.

Methods:

A retrospective analysis of all COVID-19 and non-COVID-19-related articles published in all the issues of IJO from January 2020 to March 2021 was performed. The data were obtained from the official website of IJO, Editor IJO monthly email, and PubMed. The monthly data were analyzed and a comparative analysis was done. The articles were segregated as Original, Review, Case Report/Series, Letter to the Editor/Commentary, Guest Editorial, Research methodology, Point-Counterpoint, Consensus Criteria, Ophthalmic Images, Photo Essay, Surgical Techniques, and AIOS Meeting Papers.

Results:

Out of 1343 articles published in IJO during the pandemic, 182 (13.55%) were COVID-19-related and 1161 (86.45%) were non-COVID-19-related articles. Among COVID-19 articles (182), majority were letter to the editors 66 (36.26%), followed by original articles 39 (21.42%), commentaries 24 (13.18%), editorials 18 (9.89%), and preferred practices 13 (7.14%). The least were case reports five (2.74%), current ophthalmology and innovation three (1.64%) each, and one (0.54%) each of consensus criteria, images, and photo assays. In the non-COVID-19-related articles (1161), maximum were original articles 276 (23.77%), followed by case reports 179 (15.41%), photo assays 157 (13.52%), and commentaries 141 (12.14%). The least were three (0.25%) consensus criteria and two (0.17%) each of current ophthalmology and innovations. The lockdown issue with 223 articles, postlockdown phase 1 had 267, postlockdown phase 2 had 321, and postlockdown phase 3 with 316 (1127 articles) articles in IJO showed a rising trend in a number of published articles compared with the prelockdown issues (216 articles).

Conclusion:

The quality and quantity of articles published in IJO increased and improved significantly. The results were seen with progressive improvement in citations and impact factors of the journal.
Circumpapillary optical coherence tomography angiography differences in perimetrically affected and unaffected hemispheres in primary open-angle glaucoma and the preperimetric fellow eye
Authors: Sihota Ramanjit , Shakrawal Jyoti , Azad Shorya Vardhan , Kamble Neha , Dada Tanuj
Published: May 2021

Purpose:

Evaluation of circumpapillary vessel density (VD) and perfusion density (PD) on optical coherence tomography angiography (OCTa) in mild-moderate glaucoma patients having unilateral visual field defects, with their fellow eyes and controls.

Methods:

Both eyes of 24 patients having a definitive nasal step or arcuate scotoma in one hemisphere of one eye only, and 24 controls, underwent OCTa.

Results:

In eyes with a superior field defect, the superior/inferior quadrant ratios, (SQ/IQ) of 3 mm scan of VD and PD were significantly higher in eyes with a superior arcuate scotoma than fellow eyes (P = 0.03,0.02) as also controls, (P = 0.004,0.001). The mean percentage loss of inferior quadrant VD between control to fellow eyes, and superior nasal step eyes were similar, 20.19%/19.57% respectively, P = 0.85, while a loss in arcuate scotoma eyes was 38.81% (P = 0.001). The percentage decrease in inferior quadrant PD in fellow eyes was 14.70%, superior nasal step 23.39%, and an arcuate scotoma 34.74% (P = 0.02). Eyes with a superior nasal step had significantly lower VD and PD absolute values in the inferior quadrant OCTa in 3 mm and 6 mm circle scan only as compared to control eyes, VD, P = 0.03,0.04/PD, P = 0.008,0.02. Fellow eyes of superior field defects had significantly lower VD and PD absolute values in the inferior quadrant in 3 mm and 6 mm circle scan as compared to control eyes, VD, P = 0.006,0.04/PD, P = 0.01,0.03. Eyes with an isolated inferior field defect in only one eye, showed a significant decrease in both VD and PD in all quadrants as compared to fellow eyes and control eyes. A significant positive correlation was found between VD and RNFL thickness in peripapillary superior unaffected quadrants in eyes with superior field defects and inferior unaffected quadrants in inferior defects (P = 0.001 and 0.01).

Conclusion:

There was a statistically significant increasing SQ/IQ ratio and percentage loss of vascular parameters from control to fellow eyes, those with a superior nasal step, and those with a superior arcuate scotoma. Inferior VFDs appeared to be associated with a more generalized circulatory loss. The asymmetry between hemispheres and between eyes could be used as a biomarker for early glaucomatous neuropathy.
Impact of COVID-19 on follow-up and medication adherence in patients with glaucoma in a tertiary eye care centre in south India
Authors: Subathra GN , Rajendrababu Sharmila R , Senthilkumar Vijayalakshmi A , Mani Iswarya , Udayakumar B
Published: May 2021

Purpose:

COVID-19 pandemic has affected the healthcare system worldwide hindering the continuum of treatment of chronic disease patients. The objective of the study is to analyze the barriers encountered by the glaucoma patients for the follow-up visit and medication adherence during the pandemic.

Methods:

This cross-sectional study included glaucoma patients who did not attend the scheduled appointment from April 1, 2020 to July 31, 2020 in a tertiary eye care center (88.21%). Eligible patients of age >18 years and advised antiglaucoma medication in Madurai Zone were interviewed with validated questionnaire through telephonic call.

Results:

363 patients answered the questionnaire through telephonic interview. 57.3% of the patients were found to be non-adherent to medication. The main barriers for glaucoma follow-up visit during the pandemic were lockdown restriction, transport problem, and financial difficulties. The top barriers for medication adherence were non availability of medication (54.81%), financial difficulties (30.29%), did not feel much improvement with eye drops (20.19%). On multiple regression analysis, longer distance to hospital, low socioeconomic status, more than one antiglaucoma medication use, lack of awareness of glaucoma, non-complaint before COVID-19 and stress due to the pandemic were found to be significant factors for medication non adherence.

Conclusion:

COVID-19 pandemic has emphasized the need for reformation in health care system for accessibility of medical care to patients in rural areas. Decentralization of health system to primary care level and utilization of teleophthalmology should be considered by health care planners in future.
Retrospective multifactorial analysis of Pythium keratitis and review of literature
Authors: Gurnani Bharat , Christy Josephine , Narayana Shivananda , Rajkumar Purushothama , Kaur Kirandeep , Gubert Joseph
Published: May 2021

Purpose:

The aim of this work was to study the demographic profile, clinical diagnostic features, challenges in management, treatment outcomes, and ocular morbidity of microbiological culture-proven Pythium keratitis in a tertiary eye care hospital in South India.

Methods:

Retrospective analysis of microbiologically proven Pythium keratitis patients was performed at a tertiary eye center from October 2017 to March 2020. Demographic details, risk factors, microbiological investigations, clinical course, and visual outcomes were analyzed.

Results:

Thirty patients were analyzed. The mean age was 43.1±17.2 years. Most common risk factors were history of injury in 80% and exposure to dirty water in 23.3%. Visual acuity at baseline was 20/30 to perception of light (PL). The most common clinical presentation was stromal infiltrate and hypopyon in 14 (46.6%) patients each. The microbiological confirmation was based on culture on blood agar and vesicles with zoospores formation with incubated leaf carnation method. Seven (23.3%) patients improved with topical 0.2% Linezolid and topical 1% Azithromycin, 19 (63.3%) patients underwent Therapeutic keratoplasty (TPK) and 4 were lost to follow-up. Seven (23.3%) patients had graft reinfection, and 3 (10%) developed endophthalmitis. The final visual acuity was 20/20- 20/200 in 6 (20%) patients, 20/240-20/1200 in 5 (16.6%) patients, hand movement to positive perception of light in 16 patients and no perception of light (Pthisis Bulbi) in 3 (10%) patients.

Conclusion:

P. insidiosum keratitis is a rapidly progressive infectious keratitis with prolonged and relapsing clinical course. It usually results in irreparable vision loss in majority of the patients. Prompt diagnosis, clinical awareness, and specific treatment options are needed for successfully managing this devastating corneal disease.
Iris cerclage pupilloplasty and IOL implantation for traumatic mydriasis and aphakia after the blunt trauma of the eye
Authors: Lumi Xhevat , Lumi Anila , Pajic Sanja Petrovic
Published: May 2021

Four patients with traumatic mydriasis and aphakia following blunt injury of the eye globe were evaluated. Patients with severe glare and photophobia due to wide pupil diameter from 6.0 to 9.0 mm were managed by combined iris cerclage pupilloplasty and retropupillar iris-claw lens implantation. The postoperative anatomic results, visual acuity, subjective degree of glare, photophobia, as well as intraoperative and postoperative complications were evaluated. The mean follow-up time was 32.6 months. Best-corrected visual acuity improved in all patients from preoperative 20/60, 20/30, 20/25, 20/22 to postoperative 20/20, 20/22, 20/20, and 20/20 (Snellen charts). All eyes achieved satisfactory anatomic result with round pupil diameter 3.5–4.5 mm. Glare and photophobia disappeared in all patients. There were no intraoperative or postoperative complications. During the follow-up period, pupils remained round and iris-claw lenses well positioned, without tilting. Combined iris cerclage pupilloplasty with retropupillar iris claw lens implantation appears to be a safe and effective surgical technique in reducing pupil size and improving visual outcomes. It is also a cost- and time-effective procedure, providing great results with a single surgery.
Temporal trend of microsporidial keratoconjunctivitis and correlation with environmental and air pollution factors in India
Authors: Das Anthony Vipin , Basu Sayan
Published: May 2021

Purpose:

The aim of this study was to describe the correlation between the temporal pattern of presentation of acute microsporidial keratoconjunctivitis (MKC) with meteorological parameters such as environmental temperature, rainfall, humidity, windspeed, and air pollution.

Methods:

This cross-sectional hospital-based study included 182,789 patients presenting between January 2016 and December 2019 hailing from the district of Hyderabad. Patients with a clinical diagnosis of MKC in at least one eye with an acute onset (≤1 week) of presentation were included as cases. Correlation analysis was performed with the local environmental temperature, rainfall, humidity, and windspeed (Telangana State Development and Planning Society) and air pollution (Central Pollution Control Board, Government of India).

Results:

Overall, 84 (0.05%) patients were diagnosed with acute onset MKC from the district of Hyderabad. The mean monthly prevalence in this cohort was 0.05% with peak prevalence in the months of July (0.08%), August (0.09%), September (0.12%), and October (0.08%). The environmental parameters of rainfall (r
2 = 0.87/P = < 0.0001), humidity (r
2 = 0.78/P = 0.0001), windspeed (r
2 = 0.38/P = 0.0321) were significantly positively correlated and the air pollution parameters such as ground level ozone (r
2 = 0.89/P = < 0.0001), particulate matter PM10 (r
2 = 0.65/P = 0.0013), PM2.5 (r
2 = 0.50/P = 0.0095), nitrogen dioxide (r
2 = 0.53/P = 0.0071), and carbon monoxide (r
2 = 0.69/P = 0.0008) were significantly negatively correlated with the temporal pattern of MKC in the population.

Conclusion:

Parasitic infections like MKC show a distinct temporal trend peaking during the monsoon season in the population. An increase in humidity, wind speed, and especially rainfall contributes to a higher prevalence of MKC cases during the year. An increase in ground-level ozone seems to be protective against infection.
Update on ocular graft-versus-host disease
Authors: Nair Sridevi , Vanathi Murugesan , Mukhija Ritika , Tandon Radhika , Jain Sandeep , Ogawa Yoko
Published: May 2021

Ocular graft-versus-host disease (oGVHD) occurs as a complication following hematopoietic stem cell transplantation and is associated with significant ocular morbidity resulting in a marked reduction in the quality of life. With no current consensus on treatment protocols, management becomes challenging as recurrent oGVHD often refractory to conventional treatment. Most authors now diagnose and grade the disease based on criteria provided by the National Institutes of Health Consensus Conference (NIH CC) or the International Chronic oGVHD (ICCGVHD) consensus group. This article will provide an insight into the diagnostic criteria of oGVHD, its classification, and clinical severity grading scales. The inflammatory process in oGVHD can involve the entire ocular surface including the eyelids, meibomian gland, corneal, conjunctiva, and lacrimal system. The varied clinical presentations and treatment strategies employed to manage them have been discussed in the present study. The recent advances in ocular surface imaging in oGVHD patients such as the use of meibography and in vivo confocal microscopy may help in early diagnosis and prognostication of the disease. Researching tear proteomics and identification of novel potential tear biomarkers in oGVHD patients is an exciting field as they may help in objectively diagnosing the disease and monitoring the response to treatment.
Stereoscopic three-dimensional (3D) slit-lamp photography using a compact 3D digital camera
Authors: Solyman Omar , Ahmad Meleha , Arora Karun , Henderson Amanda D , Carey Andrew
Published: May 2021

We describe a novel method of stereoscopic 3D slit-lamp photography using a portable compact 3D digital camera. Thirteen eyes of 13 patients underwent slit-lamp photography using a Fujifilm 3D compact digital camera. We modified a universal smartphone microscope adapter to attach the camera to the slit-lamp. Photography was attempted on Zeiss and on HAAG-Streit slit-lamps. Success was defined as capturing a stereogram that consists of two simultaneous pictures, one from each slit-lamp ocular. Stereoscopic 3D slit-lamp photos could be captured in all 13 eyes in which they were attempted on Zeiss slit-lamps. Captured 3D media included external, eyelid, conjunctival, corneal, anterior chamber, lens, vitreous, and optic disc pathologies. Stereoscopic 3D photography could not be obtained using this Fujifilm 3D digital camera on Haag-Streit slit-lamps because of alignment incompatibility between the oculars of the slit-lamp and the camera. Digital stereoscopic 3D slit-lamp photography is feasible using a compact 3D digital camera and compatible slit-lamp design. Images obtained using this technique may be helpful in clinical education.
Ocular Leishmaniasis - A systematic review
Authors: Mignot Guillaume , Bhattacharya Yagnaseni , Reddy Aravind
Published: May 2021

The incidence of leishmaniasis is reported to be up to 1 million per year. To date, there has been no comprehensive review describing the diversity of clinical presentations of ocular leishmaniasis (OL) and its treatment. This systematic review aims to address this knowledge gap and provide a summary of the clinical presentation, natural course, and treatment options for OL. Our study identified a total of 57 published articles as describing cases of OL involving: adnexa (n = 26), orbit (n = 1), retina (n = 7), uvea (n = 18) and cornea (n = 6). Though well described and easily treated, palpebral leishmaniasis is often misdiagnosed and may lead to chronic issues if untreated. The retinal manifestations of Leishmaniasis consist of self-resolving hemorrhages secondary to thrombocytopenia. Two main uveitis etiologies have been identified: uveitis in the context of active Leishmanial infection (associated with immunosuppression) and uveitis occurring as an immune reconstitution syndrome. Corneal involvement in most geographic areas generally follows an aggressive course, most often ending in corneal perforation if left untreated. In the Americas, a chronic indolent interstitial keratitis may also occur. Topical steroids are of little use in keratitis (systemic antileishmanials being the cornerstone of treatment). However, these are essential in cases of uveitis, with or without concomitant systemic antileishmanial therapy. In conclusion, though ocular involvement in Leishmaniasis is rare, severe sight-threatening consequences follow if left untreated. Early diagnosis, enthusiastic follow-up and aggressive treatment are essential for good outcomes.
Hyperreflective foci as biomarkers for inflammation in diabetic macular edema: Retrospective analysis of treatment naïve eyes from south India
Authors: M Arthi , Sindal Manavi D , R Rashmita
Published: May 2021

Purpose:

The aim of this study was to analyze the factors associated with hyperreflective foci (HRF) in diabetic macular edema (DME) in treatment naïve eyes.

Methods:

This retrospective observational study included 131 eyes of 91 treatment naïve patients with DME. Details of ophthalmological examination with duration of vision loss and systemic parameters were noted. The spectral-domain optical coherence tomography (SD-OCT) images were analyzed for number and location of HRF and the associated imaging biomarkers.

Results:

Inner retinal (IR) HRF were seen in 88 eyes (67%), outer retinal (OR) in 28 (21%), and subretinal (SR) in 12 (9%). The IR had (7.1 ± 7) HRF, the OR (6.5 ± 4.8), and SR (3.9 ± 2.9). A greater proportion of eyes with HRF also had subretinal fluid (SRF), significantly higher blood pressure and lower serum triglycerides. Univariate linear regression analysis showed women (3 HRF greater vs. men, P = 0.04), eyes with cystoid spaces (2.95 more HRF vs. no cystoid spaces, P = 0.02), and SRF (2.96 more HRF vs. no SRF, P = 0.007) had more HRF, whereas higher triglycerides (1 HRF lesser per 50 mg lower TGL, P = 0.03) had lesser.

Conclusion:

Our study highlights the importance of HRF as an imaging biomarker in DME suggesting an inflammatory origin. Long-term observations of large cohorts with automated analysis can give more insights.
Perfect anterior capsulorhexis using a dented cystitome
Authors: Khadia Anjali , Ghosh Aditi , Gupta Isha , Mouttapa Fredrick , K Veena , Venkatesh Rengaraj
Published: May 2021

We describe a novel intraoperative technique of measuring and creating an adequate size continuous curvilinear capsulorhexis (CCC) in phacoemulsification, using a dented cystitome as the ruler. A pair of curved tenotomy scissors is used to create a dent on the cystitome at a distance of 2.5 mm length (i.e., half of the desired approximate capsulorhexis diameter). The dented cystitome is used as a guide for making a CCC of approximately 5 mm diameter, which is considered adequate for phacoemulsification. This method of measuring the capsulorhexis helps in achieving a well centered and stable intraocular lens with a 360° overlap of the optic edge by the anterior capsular rim in the postoperative period. Using a dented cystitome for capsulorhexis mandates reliable and consistent results in the hands of the novice as well as the experienced surgeons.
Medial and lateral canthal ligaments shown in P45 sheet plastination and dissection
Authors: Qin Tao , Chun Pu , Li Fei-Fei , Yu Sheng-Bo , Hwang Kun , Sui Hong-Jin
Published: May 2021

Purpose:

Ocular suspensory ligament is an important part of the lower eyelid retractors. However, there is a scarcity of studies examining detailed en-block histologies of ocular suspensory ligaments.

Methods:

In this study, we included the cadavers of Chinese adults as subjects. These cadavers of Chinese adults were processed using P45 plastination techniques. The polymer resulted in transparent plastination, and the P45 sheet-plastinated sections of the lower eyelid were observed. The gross anatomy results of three Chinese adult heads (six hemifaces) were included as gross dissection data. All photographic documentation was performed via a Canon EOS 7D Mark camera.

Results:

The results showed that the inferior rectus muscle, inferior oblique muscle, ocular suspensory ligament, and its arcuate expansion are under the eyeball. The medial and lateral parts of the ocular suspensory ligament end at the medial and lateral canthal ligament. The middle part, a hammock-like shape, is slightly lower. The ocular suspensory ligament holds up the inferior oblique muscle, inferior rectus muscle, and the eyeball. As the inferior oblique muscle passes through the sheath of the inferior rectus, the fascia is thickened, forming the ocular suspensory ligament. The ocular suspensory ligament connects to the intermuscular septum, the inferior tarsal muscle, and the medial and lateral check ligaments.

Conclusion:

This study observed the ocular suspensory ligament and arcuate expansion through P45 sheet plastination for the first time and identified the distribution of the lower eyelid ligaments, thus laying the foundation for further research.
Aerobic exercise reduces intraocular pressure and expands Schlemm’s canal dimensions in healthy and primary open-angle glaucoma eyes
Authors: Yuan Ye , Lin Timothy P H , Gao Kai , Zhou Rouxi , Radke Nishant V. , Lam Dennis S C , Zhang Xiulan
Published: May 2021

Purpose:

Aerobic exercise (AE) has been reported to decrease intraocular pressure (IOP) in healthy subjects and there are concomitant morphological changes in the anterior segment of the eye including the Schlemm’s canal (SC). However, its effects on IOP and SC morphology in glaucoma patients had not been studied before. We aim to investigate the effect of AE on the IOP and SC dimension in both healthy and primary open-angle glaucoma (POAG) eyes.

Methods:

The area and diameter of SC and IOP were measured in 35 primary open-angle glaucoma (POAG) patients (59 eyes) and 36 healthy subjects (72 eyes) before and after performing moderate intensity of AE by running on a treadmill for 30 min. SC was imaged by swept-source optical coherence tomography (SS-OCT) for evaluation.

Results:

In comparison with baseline values, mean IOP decreased significantly following AE in both POAG and healthy eyes (both P < 0.001), in which POAG eyes showed a greater degree of reduction compared to healthy eyes (P = 0.002). In comparison with baseline values, in both POAG and healthy eyes, the average cross-sectional area (POAG: 80.48 +/- 59.54 vs. 99.20 +/- 54.87 pixels; healthy: 151.84 +/- 52.76 vs. 198.23 +/- 53.70 pixels; both P < 0.001) and diameter (POAG: 3.73 +/- 1.69 vs. 4.33 +/- 1.74 pixels; healthy: 5.61 +/- 1.02 vs. 6.47 +/- 1.20 pixels; both P < 0.001) of SC significantly increased after AE. In POAG, both treated and untreated with IOP-lowering medications, a significant reduction in mean IOP and increase in SC dimensions following AE were observed (all P < 0.05), and there were no significant differences of such measurements between the two subgroups (all P > 0.05).

Conclusion:

AE-induced reduction in IOP and an increase in SC dimensions in POAG eyes as in healthy eyes. Further studies to evaluate the long-term effect of AE on IOP control and SC morphology in POAG seem warranted.
COVID-19 related multi-inflammatory syndrome presenting with uveitis - A case report
Authors: K Karthika I , Gulla Krishna Mohan , John Joseph , Satapathy Amit Kumar , Sahu Suchanda , Behera Bijayini , Mishra Priyadarshini
Published: May 2021

Multi Inflammatory Syndrome (MIS-C) associated with Corona Virus Disease (COVID) in children and young adults presents with a varied clinical spectrum; from that mimicking Kawasaki disease (KD), Incomplete Kawasaki disease to even Hemophagocytic Lymphohistiocytosis. A 14-year-old girl, presented to us, with headache, fever, bilateral uveitis, unilateral cervical lymphadenopathy, oral mucosal changes and abdominal pain. A disproportionate increase in inflammatory markers and Interleukin – 6, in the setting of a negative COVID real-time reverse transcription polymerase chain reaction (RTPCR) and significantly elevated COVID antibody titre confirmed our diagnosis. She was treated with intravenous Immunoglobulin and oral steroids with which she recovered. We want to highlight considering the possibility of MIS-C in children presenting with uveitis at a time when COVID-19 has been conquering the world with community spread.
Psychiatric evaluation in patients with central serous chorioretinopathy in Asian Indians
Authors: Dudani Ajay I , Hussain Nazimul , Ramakrishnan Minu , Telang Omkar , Patil Vrunda M , Dudani Krish , Jadhav Bindu , Gholap Veena
Published: May 2021

Purpose:

This study aimed at psychiatric evaluation of patients with central serous chorioretinopathy (CSCR) and its association.

Material:

Consecutive patients diagnosed to have CSCR were included in the study. The participants underwent a routine eye examination. After informed consent, participants were subjected to psychiatric evaluation by a qualified psychiatrist. Details of evaluation and psychiatric disorders were documented and if treatment required were given by the psychiatrist. The outcome measure was the incidence of psychological disorder.

Results:

Cross-sectional observational data analysis of 40 patients diagnosed to have treatment-naive CSCR who agreed to undergo psychiatric evaluation were included in the study. The ethnic origin of the patients was Asian Indian. The mean age was 39.55 ± 8.33 years with a male to female ratio of 33:7. After a thorough psychiatric evaluation, 31 individuals (77.5%) diagnosed to have mixed anxiety disorders, 4 (10%) had the major depressive disorder, and 5 (12.5%) had adjustment disorder. All 40 patients had stressed personality. All 40 patients had treatment with anti-anxiolytics and advised lifestyle modification. Of these 40 patients, one patient (2.5%) underwent treatment additionally with an antidepressant.

Conclusion:

All patients with acute CSCR had some form of psychiatric disorder. Psychiatric evaluation in acute treatment naïve CSCR may contribute to the management besides other factors known in the management.
Impact of intraoperative Cone-Beam Computed Tomography use on patient satisfaction after closed nasal reduction
Authors: Bruehlmann C. , Blumer M. , Soyka M.B.
Published: May 2021

Background: The aim of the study was to assess, whether there is a difference in aesthetic and functional patient satisfaction between closed nasal reductions with intraoperative Cone-Beam Computed Tomography (CBCT) and without using intraoperative medical imaging. Methods: A monocentric, retrospective cohort study of 43 patients (20 patients treated with intraoperative CBCT and 23 patients treated without intraoperative imaging) was conducted. Subjective postoperative aesthetic and functional aspects of the nose were assessed. Additionally, questions comparing the aesthetics and function of the nose before and after the accident and on the desire of revision surgery were asked. Results: Both the SCHNOS-C and total SCHNOS score in the non-CBCT group were higher than the respective scores of the CBCT-group. The comparison of SCHNOS-C between male subjects of the two groups showed no statistical significance. The comparison of SCHNOS-C between male and female subjects over both groups showed significantly higher scores for female subjects. Conclusions: Patients undergoing surgery with intraoperative CBCT imaging showed better aesthetical outcomes than patients, treated without intraoperative imaging. However, the difference showed no clinical importance, so that both strategies appear to have comparable outcomes regarding postoperative aesthetics and function of the nose. Gender instead of the different strategies could contribute to the demonstrated differences. Female subjects seem to be less satisfied with the aesthetics of their nose postoperatively, potentially being more sensitive to remaining nasal deformities after surgery.
Production of electricity employing sewerage lines using a micro cross flow turbine
Authors: Tahir Muhammad Hamza , Mugheri Shoukat Ali , Ahmad Salman , Shahid Mughees , Zaffar Nouman , Malik Muhammad Arsalan , Saeed Muhammad Asad
Published: May 2021

In the design of cross flow turbines, efficiency is a significant parameter. The crossflow turbine for developing nations is the most cost-efficient electricity generation source and often used in isolated power systems. This research work analyzes the potential of electricity production using a micro-cross flow turbine from sewage lines. To measure the hydraulic potential of the sewage’s wastewater, flow rate at the connection point was investigated by experimentation on site and the efficiency of the micro cross flow turbine was evaluated. The experimental results show that the hydraulic potential of the selected point for electricity production is enough throughout the year. It also shows that the micro-cross flow turbine can be used effectively to produce electricity from the sewage at the link points. The highest efficient 2 mm head was observed with a maximum flow rate of 0.112 m3/s. Depending on the flow rate, the turbine velocity was 103-263 rpm. The maximum power of shaft was 284.58 W and the highest power generated was 196.24 W. The maximum overall efficiency was 68.2%. This article discusses the design, efficiency, operation and cost of low-head micro crossflow turbines.

Keywords: Electricity Generation, Hydraulic Potential, Micro Cross Flow Turbine, Sewage
Diagnostic tools and CFTR functional assays in cystic fibrosis: utility and availability in Switzerland
Authors: Fernandez Elviro Clara , Blanchon Sylvain , Hoehnel Sylke , Schumacher Urs , Sauty Alain , Brandenberg Nathalie , Regamey Nicolas
Published: May 2021

Cystic fibrosis (CF) is a genetic disease caused by a bi-allelic mutation of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. When the diagnosis cannot be confirmed by a positive sweat test or/and the identification of two CF-causing variants, international guidelines recommend the use of CFTR functional assays. These tests assess whether CFTR activity is normal or diminished/absent through measurement of CFTR-mediated chloride secretion/absorption.
CFTR functional assays are not only useful for diagnostic purposes but can also serve as a surrogate outcome for clinical trials of CFTR modulators, which are emerging therapeutic agents designed to correct the malfunctioning protein. In the near future they could also be used as precision-medicine techniques, to help guidance and optimisation of treatment.
Until now, sweat testing has been the only CFTR functional assay available in Switzerland. Since 2020, the Centre Hospitalier Universitaire Vaudois (CHUV) at Lausanne and the Lucerne Children’s Hospital perform nasal potential difference measurement. Moreover, The Ecole Polytechnique Fédérale de Lausanne (EPFL) established a reliable procedure to generate adult intestinal organoids, i.e., stem cell-derived in-vitro grown mini tissues, extracted from rectal biopsies, which can be used to assess CFTR function in vitro.
This narrative review describes the most popular CFTR functional assays, as well as their indications, limitations and availability in Switzerland.
Sự thống nhất giữa tính chính trị và tính nhân văn trong con đường cách mạng mà chủ tịch Hồ Chí Minh đã chọn
Authors: Sỹ Nguyễn Tiến
Published: May 2021

Tư tưởng Hồ Chí Minh về con đường cách mạng Việt Nam là tư tưởng cách mạng không ngừng, là sự thống nhất giữa độc lập dân tộc, dân chủ và chủ nghĩa xã hội. Vì vậy, chủ nghĩa xã hội là con đường phát triển tất yếu của cách mạng Việt Nam do Đảng Cộng sản lãnh đạo.
Formation of Field-Based Pedagogical Resources: The Role of Leadership of Regional Heads in Educational Sports and Sports Achievement
Authors: Marwanto IGG Heru , Satriyono Gandung
Published: May 2021

This study is inspired by the limited educational resources in sports education, especially those that discuss the role of leadership in improving the quality of education and training of athletes in achieving the quality of human resources in the form of improving performance in sport. Through this research, it is hoped that a pedagogical resource can be used as a model, that improving the achievements of the young generation in the field of sport is not enough with the education and training of athletes, but strong leadership is needed by the Regional Head of Kediri, East Java, Indonesia, and the Indonesian National Sports Committee of Kediri City is the parent of the research. This method of research is qualitative. Data was collected using in-depth interviewing and participatory observation techniques. The results showed that the role of leadership in the education and training of athletes plays a very important role in improving the performance of sport in the area. Its form may be in the form of a leader's decision on the allocation of funds, monitoring, motivation and maximum moral support.
Physical Education and Sports Lesson in Distance Education: Content Analysis of Videos on Youtube
Authors: SAĞIN Ahmet Enes
Published: May 2021

In this study, it was aimed to examine how physical education and sports teachers taught lessons in the distance education process and which activities they included in the course content during the Covid 19 pandemic process. The videos published under the title of distance education physical education and sports lessons written in Turkish on YouTube were analyzed. The videos were analyzed using content analysis technique. Three themes were obtained as a result of the content analysis. These are the themes of "educational games", "practice" and "theoretical expression". As a result of the study, it was concluded that it was tried to meet the movement needs of students through videos uploaded to YouTube under the title of distance education physical education and sports lessons, what students should do to protect their health is supported by information within the framework of "health - sports" and it was tried to make the process fun through educational games during the period of staying at home. It is recommended to provide an in-service training course for teachers on how to handle physical education and sports lessons through distance education, especially in the Covid 19 pandemic process.
THE SOCIOLOGY OF BATTERED WOMEN
Authors:   Chhatrapati Shahu Ji Maharaj University Kanpur , Uttar Pradesh, India., Tewar Babita
Published: May 2021

This paper undertakes to examine the hitherto neglected but nevertheless important area of Research , the Sociology of Battered Women. As there are very few researches in Sociological Literature in this area, particularly from the Indian perspective, hence a study in this direction in Kanpur City was carried out. The analysis reveals the diverse factors which lead to wife battering such as the age, religion, caste, educational background, rural or urban background, childbearing, sex, dowry, male child, economic status, dominance of in-laws, etc. The study explores that despite the various empowerment and emancipation strategies adopted by the different sectors of society for women , the ghastly reality still persists that whatsoever be the religion, caste, background of the women, they are being tortured and battered even today. The basic causes behind this being the prevalence of male domination & patriarchal systems, gender discrimination, social dependency and unequal power relations. This social devil can be eliminated only and only after the women gain political and economic power.
MODULAÇÃO DE EFEITOS DE DECISÕES CONSTITUCIONAIS DO DIREITO TRIBUTÁRIO BRASILEIRO: ESPECIFICIDADES E LIMITES
Authors: Freire André Borges Coelho de Miranda
Published: May 2021

Este artigo analisa as peculiaridades da modulação de efeitos de decisões constitucionais no Direito Tributário. Depois de definir a modulação, à luz de suas origens e finalidades na Alemanha, debruça-se sobre as peculiaridades constitucionais do Direito Tributário brasileiro, para concluir que há entre nós relevantes especificidades que conduzem a um regime particular de modulação. Em seguida, coloca os limites da modulação em matéria tributária no Brasil. À luz dessas condicionantes, analisa, ainda, criticamente a jurisprudência do Supremo Tribunal sobre o tema, para aferir se se desvia ou não do modelo proposto. Conclui com a apreciação do pedido de modulação no RE 574.706/PR.
REIDI – NOÇÕES GERAIS E NATUREZA JURÍDICA: UM ESTUDO SOBRE ISENÇÃO E SUSPENSÃO
Authors: Costa Valterlei A. da
Published: May 2021

Inicialmente, apresentar o REIDI como benefício é correto. Todavia, havendo complemento – de que o incentivo é implementado, a princípio, via suspensão de PIS e COFINS e, na sequência, com a conversão de suas alíquotas a zero –, é caso para aprimoramento, quando se deve expor em que consistem a suspensão e a alíquota zero. Dessarte, é possível investigar o sentido em que o regime utilizou tais termos, para se concluir, em relação a esses tributos, ser a suspensão uma mudança na data de vencimento para pagamento, e a alíquota zero, uma isenção, operada mediante recorte nas hipóteses das respectivas normas de tributação.
Problemorientierte Verbraucherpolitik. Der Beitrag der Verhaltensökonomik zu einem verbesserten Verbraucherschutz
Authors: Döring Thomas , Rischkowsky Franziska
Published: May 2021

Der vorliegende Beitrag zeigt auf, welche Erkenntnisse sich aus verhaltensökonomischen Ansätzen gewinnen lassen, um sowohl die Rechtfertigung als auch die Ausgestaltung von staatlicher Verbraucherpolitik auf eine breitere ökonomische Basis zu stellen. Zu diesem Zweck sollen zu-nächst die unterschiedlichen ökonomischen Argumente in Erinnerung gerufen werden, die bereits herkömmlicherweise zur Begründung einer eigenständigen Verbraucherpolitik angeführt werden, um den diesbezüglich zusätzlichen Erkenntnisgewinn der Verhaltensökonomik in einem grundsätzlich Sinne aufzuzeigen (Kapitel 2). Daran anschließend werden die verbraucherpolitischen Implikationen der Informationsökonomik als dem gegenwärtig zentralen Bezugspunkt eines ökonomisch begründeten Verbraucherschutzes in ihren Kernaussagen dargestellt und kritisch diskutiert (Kapitel 3). Dies liefert zugleich die Grundlage, um unter der Zielsetzung einer Erweiterung eines rein informationsökonomisch gestalteten Verbraucherschutzes den Erkenntnisgewinn von Verhaltensökonomik und verhaltenswissenschaftlicher Konsumforschung mit Blick auf eine problemorientierte Verbraucherpolitik anhand des relevanten Verbraucherleitbilds sowie darauf bezogener Politikmaßnahmen entsprechend darzulegen (Kapitel4). Der Beitrag schließt mit einem kurzen Fazit zur Relevanz der Verhaltensökonomik für einen verbesserten Verbraucherschutz (Kapitel 5).
Compact Guidelines: Practical Procedure in Interdisciplinary Institutional Analysis
Authors: Bizer Kilian , Führ Martin
Published: May 2021

These guidelines compactly describe how an interdisciplinary institutional analysis is to be implemented in practice: Which steps of analysis and control have to be taken? Which research questions are important and which role do empirical results play in the analysis?The description will be based on the requirements that the legislator has to fulfil with regard to the estimation of effects (as it is regulated in § 44 of the Joint Rules of Procedure of the Federal Ministries (Gemeinsame Ges-chäftsordnung der Bundesministerien, GGO) and in the guidelines of the Eu-ropean Commission). The steps of analysis and examination outlined in this paper can be equally used in relation to institutional design problems in companies (like the ad-justment of determining factors regarding ‘Governance, Risk Management, Compliance’ – GRC), associations or authorities. At the end of the compact guidelines, key terms of institutional analysis will be explained in a glossary. The glossary further contains recommendations on secondary literature.
Einfluss des Alters auf private Verkehrsausgaben - ein europäischer Vergleich
Authors: Aigner-Walder Birgit , Döring Thomas
Published: May 2021

Bezogen auf die vorliegenden statistischen Daten zur Altersstruktur gibt es kaum ein Land, in dem die Alterung der Bevölkerung nicht unmittelbar sichtbar ist. Der langfristige Wandel der Bevölkerungsstruktur von einer jungen hin zu einer alternden Gesellschaft – auch unter dem Begriff des demografischen Wandels bekannt – ist ein weltweit zu beobachtendes Phänomen. Diese Entwicklung wird durch eine Verringerung der Fertilitätsrate (Anzahl der Geburten je Frau) in Verbindung mit einem Anstieg der Lebenserwartung bewirkt (vgl. Schimany, 2003: 16). Die zunehmende Alterung der Bevölkerung wird mit unterschiedlichen ökonomischen Effekten verbunden sein. So wird etwa der Anstieg des Anteils an älterer Bevölkerung zu einem Rückgang des Anteils an Personen im erwerbsfähigen Alter führen, was mit spezifischen Herausforderungen nicht allein für den Arbeitsmarkt, sondern auch für die Produktivitätsentwicklung sowie die Entwicklung der öffentlichen Einnahmen und Ausgaben verbunden sein wird. Unabhängig von diesen erwarteten gesamtwirtschaftlichen Entwicklungstrends und damit verbundenen Herausforderungen ist davon auszugehen, dass die Alterung der Bevölkerung sich ebenso auf das Konsumverhalten der Bevölkerung auswirken wird. So konsumieren ältere im Vergleich zu jüngeren Menschen andere Güter und Dienstleistungen. Zugleich variiert die Höhe der gesamten Konsumausgaben über den Lebenszyklus hinweg. Vor diesem Hintergrund geht der vorliegende Beitrag der Fragestellung nach, mit welchen Veränderungen durch den demografischen Wandel bezogen auf die private Nachfrage nach verkehrsbezogenen Gütern und Dienstleistungen gerechnet werden muss. Zu diesem Zweck werden zunächst vorliegende theoretische Überlegungen ebenso wie bereits vorhandene empirische Befunde bezogen auf altersbedingte Unterschiede im Konsumverhalten unter besonderer Berücksichtigung des Verkehrsbereichs näher betrachtet (Kapitel 2). Im Anschluss daran erfolgt eine Erläuterung der verwendeten statistischen Daten für die empirische Auswertung des vorliegenden Beitrags (Kapitel 3). Es folgt eine Darstellung der Untersuchungsergebnisse bezogen auf das Niveau verkehrs-bezogener Ausgaben der privaten Haushalte innerhalb der EU über den Lebenszyklus hinweg (Kapitel 4), bevor in einem weiteren Schritt die entsprechenden Ergebnisse hinsichtlich der Struktur verkehrsbezogener Konsumaus-gaben präsentiert werden (Kapitel 5). Der Beitrag schließt mit einigen Überlegungen zu den möglichen Gründen und weiteren Auswirkungen des empirisch beobachtbaren Entwicklungstrends.
IMPORTANCE OF SERVICES TRADE AND A CASE ON COMPETITIVE ADVANTAGES OF TURKEY
Authors: VURDU Selahattin Armağan
Published: May 2021

Purpose: The services sector has been emerging as a key driver of global trade rather than merchandise trade. Together with the re-shaping role of digitalization, ICT and ICT enabled services have been of high importance for the global growth and presenting opportunities both for developed and even more for developing economies. Telecommunications, computer and information, insurance and pension, financial services, intellectual property are emphasized for being more efficient on economic growth and after the Covid-19 pandemic outbroke, the importance of ICT and related services were highlighted due to the rapid digital transformation the pandemic has triggered. The purpose of this paper is to analyze Turkey’s foreign trade competitiveness in ICT and ICT-enabled services comparing with the major exporters of aforementioned services.
Method: Competitiveness of Turkey, USA, India and China are compared in the trade in services by using competitive advantage indices RCA, RXA, RMP, RTA, RC.
Findings: Turkey has a surplus in its services trade, however, the sectors Turkey has competitiveness are travel and transport but not the ICT and ICT-enabled services. Digital transformation may help Turkey to both enable sustainable trade and faster recovery from pandemic.
Originality: Originality of the paper comes from the indication of necessity to change the mixture of Turkey’s trade in services and the literature lacks this kind of research.
Responsabilidad social como estímulo de la innovación en las mypes del municipio de San Juan del Río, Querétaro.
Authors: Navarrete Fernández Ángel Custodio , Castillo González Águeda Ma. del Pilar , Sandoval López Sol Karina , García Leticia Trejo
Published: May 2021

La innovación es un aspecto crucial para la sobrevivencia de las mipymes cuestión que puede no considerar otro aspecto esencial como lo es la Responsabilidad Social Empresarial, por tal motivo el presente artículo tiene como objetivo indagar la correlación que existe entre la RSE y la innovación en las Mypes como un fomento para esta última. Se utilizó un estudio cuantitativo, no experimental de forma transversal correlacional, aplicándose una encuesta a 490 empresas de San Juan del Río.  Como resultado principal se obtuvo que hay una relación significativa entre la innovación y la Responsabilidad Social, y que ésta última si puede llegar a influir en que se dé la innovación.
El análisis de los costos ocultos como punto de partida para el crecimiento en las miypes en Puerto Vallarta, Jalisco.
Authors: Becerra Bizarron Manuel Ernesto , Sandoval Ballesteros Georgina Dolores , Diaz Luz Amparo Delgado
Published: May 2021

En la actualidad las micro, pequeñas y medianas empresas (mipymes) enfrentan grande retos como baja productividad y falta de disciplina por parte de los empleados, ocasionando así, problemas laborales referentes a los costos ocultos, considerados también como gastos innecesarios, ya que estos surgen en las operaciones diarias de la empresa a causa de la falta de comunicación entre el personal o equipo de trabajo, desmotivación, por conflictos, de esta manera se genera una mala planeación en la estructura de la organización y por ende  hay perdidas de utilidades, que la empresa no detecta a simple vista.

     El presente artículo tiene como finalidad analizar los costos ocultos como punto de partida de crecimiento en las micro y pequeñas empresas de puerto vallarta, con diseño no experimental, alcance descriptivo. La muestra fue de 320 empresas, se realizó un instrumento de 12 dimensiones y 62 items.

     Los resultados encontrados muestran que las condiciones de trabajo son buenas, un clima laboral agradable, herramientas indispensables para realizar sus actividades, capacitación exporadica, sin embargo se observa el retrabajo,  la perdida de potencias estrategico y la comunicación-concertación como principales generadores de costos ocultos.
Enseñanza de la lengua inglesa en bachilleratos rurales: condiciones de la transición hacia la educación superior
Authors: Berzunza Criollo Milton Carlos , Garrido Ayala Suemy Del Rosario , Estrella Moguel César Eduardo
Published: May 2021

La Universidad de Oriente en Valladolid, Yucatán recibe cada año a estudiantes de comunidades y comunidades rurales, quienes llegan con niveles inferiores a los deseables para el dominio del idioma inglés, de acuerdo con el diagnóstico obtenido después de su ingreso. Se analizaron las características de las estrategias de enseñanza, recursos didácticos, así como de la percepción que se tiene de la utilidad de la lengua inglesa para su desarrollo académico y profesional o laboral, encontrándose que se perpetúan prácticas tradicionales para la instrucción, condicionadas por la carencia de materiales o tecnologías a disposición del personal docente de un bachillerato en la comunidad de Temozón.
THE INVERTED CLASS (LA CLASSE INVERSÉE) AS A NEW PEDAGOGICAL APPROACH IN HIGHER EDUCATION
Authors: Karimova Maftuna , Gulamjanova Maxina , Mirzabekova Nafisa
Published: May 2021

Многие сферы общества оказывают давление на высшее образование, чтобы лучше учитывать потребности ученика. Перевернутый класс может оказать положительное влияние как на обучение, так и на удовлетворенность учащихся. Цель этой статьи - представить обзор перевернутого класса в высшем образовании. Эта статья помогает лучше понять перевернутый класс, как он был документирован эмпирически, и просветить практиков, которые хотели бы максимально эффективно мобилизовать его, независимо от дисциплинарного контекста.