bluuebunny/crossref_metadata_2025 huggingface dataset:
Sports events and project managent. A PM2 proposal
Authors: Caminero-Granja José Antonio , Pajares-Gutierrez Javier , Martin-Cruz Natalia
Published: March 2022

Purpose: To use the project management approach for the management of the events and, particularly, to adapt the PM2 methodology to sports events.Design/methodology/approach: Theoretical analysis about whether a sport event is a project, and what must be fulfilled for it to be so. Theoretical analysis approach into the roles of the event manager and project manager. Theoretical adaptation of the PM2 to sport management.Findings: Event management could benefit from PM2 with several adaptations. The main ones imply separating the execution phase in two separate ones due to simultaneous and mass involvement of participants and spectators in the event; introducing a marketing orientation in the management of the project to maximize the economic return of the event, or introducing the concept of extended customer to include the owner of the event, the participant and the spectator and including this concept into the governance model.Research limitations/implications: Further empirical research is needed to analyze the implementation of this adaptation of PM2.Practical implications: We offer an adaptation of PM2 for the event managers that allow them to apply project management standards in their particular events. We made the particular case of sport events sector by introducing the marketing approach and the market orientation of the event manager to the PM2 methodology.Social implications: The redefinition of the role of sport event managers with a project management orientation allows to introduce the cost-benefit analysis in the development of a sport event, and by measuring the relative efficiency sport events could be not only successful, but also profitable and sustainable.Originality/value: For the first time, PM2 is applied to events, in particular, to sport events. The specific characteristics of PM2 makes it interesting in any sector, as sports events, where managers do not have extensive experience using project management standards and methodologies.
An optimization model for demand-driven distribution resource planning DDDRP
Authors: Haji Mohammad Fatemeh , Benali Maha , Baptiste Pierre
Published: March 2022

Purpose: Demand-Driven Distribution Resource Planning (DDDRP) has recently been proposed in the literature to deal with higher supply networks complexity, shorter customer tolerance times, and inaccurate forecasts. The DDDRP requires to position inventory buffers in critical network nodes, where the inventory level in each buffer is replenished based on actual demands rather than on demand forecasts. This paper aims to identify optimal buffer positions in a distribution network driven by the DDDRP approach and to assess the performance of the DDDRP approach compared to the conventional Distribution Resource Planning (DRP) approach.Design/methodology/approach: First, a mixed-integer non-linear model is proposed to optimize buffer positioning under supply network constraints and with the objective of minimizing supply chain holding costs. Then, a case study is investigated to validate the optimization model and to evaluate the performance of the optimized distribution network driven by the DDDRP approach, compared to the DRP approach.Findings: Results of the considered case study demonstrate that the distribution network optimized and driven by the DDDRP approach achieves savings of 75% in terms of total holding costs and 67% in terms of inventory amounts, compared to a distribution network driven by the DRP approach.Research limitations/implications: Results of this paper cannot be generalized since several assumptions have been considered. Thus, addressing real case studies in different industrial contexts may be of theoretical and practical interest.Originality/value: This paper is the first to propose a mathematical model to optimize buffer positioning in a distribution network driven by the DDDRP approach.
Advancing Gerontological Health Research With Sexual and Gender Minorities Across the Globe
Authors: Flatt Jason D. , Cicero Ethan C. , Kittle Krystal R. , Brennan-Ing Mark , Anderson Joel G. , Wharton Whitney , Hughes Tonda L.
Published: March 2022

The current article presents results of a scoping review of international research on the health and health care needs of sexual and gender minority (SGM) older adults. Electronic databases and related resources were used to identify empirical and review studies published during the past 10 years. We reviewed 33 peer-reviewed articles from 19 countries. Findings were organized using the SGM Health Disparities Research Framework, which highlights factors at individual, interpersonal, community, and societal levels that impact health. Overall, historic and current environmental factors, including stigma, discrimination, and social exclusion, played an important role in SGM older adults' health, health care access, and use of related aging and social services. There is a critical need for training and future research, and health professionals are needed to advance gerontological health and health care research and improve the health and care of SGM older adults globally. [
Journal of Gerontological Nursing, 48
(4), 13–20.]
Tailored, Community-Based Programs for People Living With Dementia and Their Family Caregiver
Authors: McGhan Gwen , McCaughey Deirdre , Flemons Kristin , Shapkin Kimberly , Parmar Jasneet , Anderson Sharon , Poole Lisa
Published: March 2022

People living with dementia (PLWD) have voiced a desire to remain in their home environment as long as possible; unfortunately, there is limited integrated person-and family-centered community support. To examine the need for tailored supports for PLWD and their family caregivers (caregiving dyad), a meeting was conducted in Spring 2020. Thirty key provincial stakeholders with diversity in geographic location, employer and/or organization, range of roles, and family representatives participated in the meeting. Stakeholders identified a series of gaps, including: (a) systemic gaps; (b) gaps between communities of practice; (c) underserved populations; (d) program content and delivery gaps; and (e) PLWD and family caregiver support gaps. With input from stakeholders, we highlighted the need for consistent resources for the caregiving dyad that are flexible, timely, and accessible, which are embedded in the community and led by qualified and trained staff. [
Journal of Gerontological Nursing, 48
(4), 26–32.]
Some novel mathematical results on the existence and uniqueness of generalized Caputo-type initial value problems with delay
Authors: Kumar Pushpendra , Govindaraj V. , Khan Zareen A.
Published: March 2022

In this article, we propose some novel results on the existence and uniqueness of generalized Caputo-type initial value problems with delay by using fixed point theory. The characteristics of space of continuous and measurable functions are the main basis of our results. The proposed results are very useful to prove the existence of a unique solution for the various types of fractional-order systems defined under the generalized Caputo fractional derivative consisting of delay terms.
Tracking glioblastoma progression after initial resection with minimal reaction-diffusion models
Authors: Harris Duane C. , Mignucci-Jiménez Giancarlo , Xu Yuan , Eikenberry Steffen E. , Quarles C. Chad , Preul Mark C. , Kuang Yang , Kostelich Eric J.
Published: March 2022

We describe a preliminary effort to model the growth and progression of glioblastoma multiforme, an aggressive form of primary brain cancer, in patients undergoing treatment for recurrence of tumor following initial surgery and chemoradiation. Two reaction-diffusion models are used: the Fisher-Kolmogorov equation and a 2-population model, developed by the authors, that divides the tumor into actively proliferating and quiescent (or necrotic) cells. The models are simulated on 3-dimensional brain geometries derived from magnetic resonance imaging (MRI) scans provided by the Barrow Neurological Institute. The study consists of 17 clinical time intervals across 10 patients that have been followed in detail, each of whom shows significant progression of tumor over a period of 1 to 3 months on sequential follow up scans. A Taguchi sampling design is implemented to estimate the variability of the predicted tumors to using $ 144 $ different choices of model parameters. In $ 9 $ cases, model parameters can be identified such that the simulated tumor, using both models, contains at least 40 percent of the volume of the observed tumor. We discuss some potential improvements that can be made to the parameterizations of the models and their initialization.
Advancing Core Competencies Among Early Childhood Educators/Caregivers
Authors: Gbadegesin Taiwo Frances , Ajayi Hannah Olubunmi , Jegede P. O.
Published: March 2022

This chapter examines the adequacy of preparedness to tackle the spread of COVID-19 and the prevailing challenges as the impetus for the emerging competencies required in nursery and primary schools for children aged 5-10. It then unfolded the emerging skills needed by the practitioners in the wake of the pandemic. Policy recommendations were solicited from the teachers, proprietors, and children. The authors adopted a qualitative approach, using semi-structured interviews driven by the saturation point. The use of computer-aided qualitative data software (Atlas. ti) through visualization networks indicated evidence of inadequate preparedness to tackle the spread of COVID-19. They found 13 thematic challenges associated with the Centre for Diseases Control and Prevention (CDC) protocols and the need for training. The findings also unfolded a visualization network featuring 11 pre-requisite skills that emphasized hygienic protocols. Appropriate training, government, and international organization interventions to cover the identified lapses are recommended.
Managing Medical Emergencies in Schools
Authors: Afolabi Ifedayo
Published: March 2022

Emergencies will occur in schools; schools must be prepared to prevent and respond effectively to school emergencies. Research done by J. O. Ogbe revealed that most schools in Nigeria are not prepared for emergencies. Having a safe healthful environment is an integral part of the success of the school's goal of raising well-educated students. In this chapter, how schools can prevent and also manage medical emergencies effectively will be discussed extensively.
Insights Into Preparing Training Courses on Financial Services for Entrepreneurs in Africa
Authors: Teixeira Nuno , Carvalho Luisa Margarida Cagica
Published: March 2022

Access to financing for micro, small, and medium entrepreneurs continues to face obstacles and difficulties. This scenario becomes even more evident when we refer to the situation of the African continent, where the financial system still shows tendencies that do not favor the productive sector. Under the Envolver project, which aims to promote the development of a sustainable and inclusive private sector, based on the diversification and availability of financial services adapted to MSMEs and entrepreneurs, a diagnostic study was developed to map the financial products currently available to micro, small, and medium enterprises. This study allows us to outline a set of recommendations for innovative financial solutions adjusted to this audience, based on examples of success in contexts similar to Angola.
Leader Effects on Engagement
Authors: Walker-Schmidt Wendi
Published: March 2022

Employee engagement is defined as an employee's emotional connectedness with an organization. One of the key levers that affects employee engagement is leadership support. Leaders who effectively manage are vital to all organizations as they play a key role in helping to establish relational networks which lead to higher levels of engagement for their employees. This chapter discusses how leaders can impact engagement. Furthermore, it outlines how leaders can grow and develop in their leadership practice. Leaders who focus on creating a culture of learning and engagement experience higher levels of performance.
Organizational Sustainability
Authors: Rivera Garzón Nicolás , Rivera Lozano Miller
Published: March 2022

The objective of the chapter is to develop an organizational sustainability index based on development indicators from 1980 to 2019. The sample is made up of the aggregation of low, low middle, upper middle, and high income countries constructed by the World Bank. High-income economies had the least sustainable organizations in 1980 with an index value of -13.8, while in 2019 its value was 25.7. On the other hand, the lower middle-income countries had an increase of 15.2, going from -9.2 in 1980 to 5.9 in 2019. Similarly, the upper middle-income economies went from -3.8 in 1980 to 6.6 in 2019, with a growth of 10.48. Low-income countries started with the highest levels of sustainability among the four categories with 1.6; in 2019 the value of the calculated index was 5.20, that is, a growth of only 3.5 units.
Hand Gesture Recognition Through Depth Sensors
Authors: Dewangan Bhupesh Kumar , Mishra Princy
Published: March 2022

A hand gesture recognition system allows for nonverbal communication that is natural, inventive, and modern. It can be used in a variety of applications involving human-computer interaction. Sign language is a type of communication in which people communicate using their gestures. The identification of hand gestures has become one of the most important aspects of human-computer interaction (HCI). The goal of HCI is to get to a point where human-computer interactions are as natural as human-human interactions, and adding gestures into HCI is an essential research topic in that direction. The history of hand gesture recognition is initially presented in this chapter, followed by a list of technical challenges. Researchers from all over the world are working on developing a reliable and efficient gesture recognition system, particularly a hand gesture recognition system, for a variety of applications. In this chapter, the core and advanced application areas and various applications that use hand gestures for efficient interaction have been addressed.
Multi-Input CNN-LSTM for End-to-End Indian Sign Language Recognition
Authors: Gupta Rinki
Published: March 2022

Sign language predominantly involves the use of various hand postures and hand motions to enable visual communication. However, signing is mostly unfamiliar and not understood by normal hearing people due to which signers often rely on sign language interpreters. In this chapter, a novel multi-input deep learning model is proposed for end-to-end recognition of 50 common signs from Indian Sign Language (ISL). The ISL dataset is developed using multiple wearable sensors on the dominant hand that can record surface electromyogram, tri-axial accelerometer, and tri-axial gyroscope data. Multi-channel data from these three modalities is processed in a multi-input deep neural network with stacked convolutional neural network (CNN) and long short-term memory (LSTM) layers. The performance of the proposed multi-input CNN-LSTM model is compared with the traditional single-input approach in terms of quantitative performance measures. The multi-input approach yields around 5% improvement in classification accuracy over the traditional single-input approach.
Optimal Long Distance ECG Signal Data Delivery Using LoRa Technology
Authors: Nugraha Priyambada Cahya , Wisana I Dewa Gede Hari , Titisari Dyah , Amrinsani Farid
Published: March 2022

Cardiovascular disease is the leading cause of death in the world and the number one killer in Indonesia, with a mortality rate of 17.05%. The target of this research is to increase the range of electrocardiograph (ECG) equipment using LoRa Technology. With LoRa Technology, it is expected that the data transmission process can run effectively and produce an accurate ECG signal and minimal noise. The research method is by sending a heart signal from the ECG simulator by the microcontroller via LoRa Technology which is received by the PC (Personal Computer) and the ECG signal is displayed on the PC display. The most optimal setting will be obtained from the sender-receiver distance and baudrate by measuring data loss and delay. In this study, the simulated cardiac signal from the phantom ECG is fed to an analog signal processing circuit, then the signal is converted to digital and digitally filtered on the microcontroller, then the signal is sent via the LoRa HC-12 Transceiver to a PC with baudrate, distance and barrier settings. The results obtained are that data transmission can be carried out at a distance of 175 meters without a barrier and a distance of 50 meters with a barrier. This remote ECG equipment can detect heart signals and the results can be sent to a PC using LoRa Technology. The implication is that the transmission of ECG signal data via the Lora HC-12 Transceiver media can be carried out optimally at the 9600 baudrate setting.
The Cell-Material Interaction in the Replacement and Regeneration of the Meniscus: A Mini-Review
Authors: Putra Alfian Pramudita , Nisa Khairun , Mayasari Dita Ayu
Published: March 2022

The meniscus is a part of the knee joint consisting of a medial and lateral component between the femoral condyles and the tibial plateau. Meniscal tears usually happen in younger and active people due to sports or daily activities. Some approaches are chosen for meniscus replacement and regeneration from the problems above, such as meniscal repair, meniscal allograft transplantation, gene therapy techniques, and tissue engineering techniques. Biomaterials and tissue engineering have a primary role in meniscus regeneration and replacement. The cell-material interactions are influenced by the biomaterials' design, structure, and composition to promote the growth o meniscus tissue. This study aims to give a brief review of the cell-material interaction in the replacement and regeneration process of the meniscus. Based on several studies, the use of growth factors in the meniscal regeneration and replacement could modulate and promote angiogenesis, differentiation, and cell migration beneficial in the repair process of the meniscus. Furthermore, combining the Mesenchymal Stem Cells and growth factors in healing the meniscal tears could be one of the best approaches to obtaining the new tissue resembling the meniscal tissue. The follow-up and long-term studies in meniscus regeneration and replacement are needed and recommended, especially implanting with good chondroprotective and long-term evaluation to obtain the best properties similar to the natural meniscus.
Chronic Obstructive Pulmonary Disease Combined with Interstitial Lung Disease
Authors: Choi Joon Young , Song Jin Woo , Rhee Chin Kook
Published: March 2022

Although chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors such as smoking, male sex, and old age. Patients with both emphysema in upper lung fields and diffuse ILD are diagnosed with combined pulmonary fibrosis and emphysema (CPFE), which causes substantial clinical deterioration. Patients with CPFE have higher mortality compared with patients who have COPD alone, but results have been inconclusive compared with patients who have idiopathic pulmonary fibrosis (IPF). Poor prognostic factors for CPFE include exacerbation, lung cancer, and pulmonary hypertension. The presence of interstitial lung abnormalities, which may be an early or mild form of ILD, is notable among patients with COPD, and is associated with poor prognosis. Various theories have been proposed regarding the pathophysiology of CPFE. Biomarker analyses have implied that this pathophysiology may be more closely associated with IPF development, rather than COPD or emphysema. Patients with CPFE should be advised to quit smoking and undergo routine lung function tests, and pulmonary rehabilitation may be helpful. Various pharmacologic agents and surgical approaches may be beneficial in patients with CPFE, but further studies are needed.
An Epidemic Zika Virus Isolate Drives Enhanced T Follicular Helper Cell and B Cell–Mediated Immunity
Authors: Pardy Ryan D , Gentile Maria E , Carter Alexandria M , Condotta Stephanie A , King Irah L , Richer Martin J
Published: March 2022

Zika virus (ZIKV) is a mosquito-borne pathogen that recently caused a series of increasingly severe outbreaks. We previously demonstrated that, compared with a pre-epidemic isolate (ZIKVCDN), a Brazilian ZIKV isolate (ZIKVBR) possesses a novel capacity to suppress host immunity, resulting in delayed viral clearance. However, whether ZIKVBR modulates CD4 T cell responses remains unknown. In this study, we show that, in comparison with ZIKVCDN infection, CD4 T cells are less polarized to the Th1 subtype following ZIKVBR challenge in mice. In contrast, we observed an enhanced accumulation of T follicular helper cells 10, 14, and 21 d postinfection with ZIKVBR. This response correlated with an enhanced germinal center B cell response and robust production of higher avidity-neutralizing Abs following ZIKVBR infection. Taken together, our data suggest that contemporary ZIKV strains have evolved to differentially induce CD4 T cell, B cell, and Ab responses and this could provide a model to further define the signals required for T follicular helper cell development.
IFITM3 Is Upregulated Characteristically in IL-15–Mediated Bystander-Activated CD8+ T Cells during Influenza Infection
Authors: Jeong Seongju , Jeon Minwoo , Lee Hoyoung , Kim So-Young , Park Su-Hyung , Shin Eui-Cheol
Published: March 2022

In bystander activation, pre-existing memory CD8+ T cells unrelated to the infecting microbes are activated by cytokines without cognate Ags. The detailed mechanisms and unique gene signature of bystander activation remain to be elucidated. In this study, we investigated bystander activation of OT-1 memory cells in a mouse model of influenza infection. We found that OT-1 memory cells are activated with upregulation of granzyme B and IFN-γ, during PR8 (A/Puerto Rico/8/1934) infection, and IL-15 is a critical cytokine for bystander activation. In transcriptomic analysis, the IFN-induced gene signature was upregulated in bystander-activated OT-1 memory cells during PR8 infection but not in the presence of TCR stimulation. Among the IFN-induced genes, upregulation of IFN-induced transmembrane protein 3 (IFITM3) distinguished bystander-activated OT-1 memory cells from TCR-activated OT-1 memory cells. Therefore, we reveal that bystander-activated memory CD8+ T cells have a unique transcriptomic feature compared with TCR-activated memory CD8+ T cells. In particular, IFITM3 upregulation can be used as a marker of bystander-activated memory CD8+ T cells at early infection.
Il microbiota: Il mio ruolo
Authors: Pini Paola
Published: March 2022

Intendo subito fare una precisazione: non sono un semplice ospite! Nell'intestino, ad esempio, svolgo un ruolo essenziale in molte funzioni vitali: i) funzioni metaboliche: trasformo il cibo ingerito e rendo digeribile glutine e lattosio (laddove sono poco o male rappresentato si manifestano intolleranze a glutine e lattosio), produco Vit.K2, cobalamina, niacina, tiamina, etc., stimolo il metabolismo lipidico, il riciclo degli acidi biliari, il metabolismo dei polifenoli e degli antiossidanti, e tanto altro [...]
Sviluppo adolescenziale e comportamenti sessuali
Authors: Di Pietro Maria Luisa
Published: March 2022

L'autore analizza la situazione italiana ed europea in relazione all'inserimento dell'educazione sessuale nella scuola. Per quanto riguarda l'Italia, dopo una breve valutazione delle aspettative degli adolescenti sull'opportunità dell'intervento della scuola nell'educazione sessuale, vengono messe in evidenza le diverse interpretazioni date alla materia dai DDL presentati al Parlamento, diversità che non hanno però impedito la stesura di un testo di legge unificato. Altrettanto non definitiva sembra essere la situazione a livello europeo: in alcuni paesi, infatti, l'educazione sessuale non è stata ancora oggetto di una specifica legislazione, mentre nei paesi ove l'educazione sessuale è già un insegnamento scolastico obbligatorio, viene lasciato ampio margine all'iniziativa dei singoli.
The Role of Government in a Partial Transition from Public to Private in the Expanding Australian Protected Area System
Authors: Kirkpatrick Jamie B. , Fielder Julie , Davison Aidan , Pearce Lilian M. , Cooke Benjamin
Published: March 2022

Since the 1980s in democratic societies, neoliberal reforms and neofeudal governance have transferred the delivery of many public goods and services from governments to non-government actors. Privatisation is a core neoliberal agenda, but little is known of the nature and extent of its application to nature conservation through reservation. We investigate the degree of privatisation of the expanding protected area system in our case study areas of Australia and Tasmania, hypothesising that governments have: disrupted public agencies managing the protected area estate by repeated reorganisation; diverted public funds from public to private protected areas; and increasingly alienated public reserves for subsidised private profit from tourism. We found frequent restructuring of agencies managing protected areas. Although Federal Government expenditure on private reserves increased markedly in the twenty-first century, so did expenditure on public conservation reserves. All States except Queensland increased public protected area funding. Direct subsidisation of private reserves by government has not had a steady upward trajectory. In contrast, subsidisation of private alienation of public conservation reserves for tourism may have accelerated in the twenty-first century. We conclude that, while Australian governments see value in protected areas as a source of economic development and electoral advantage, they are agnostic on ownership.
Augmenting the public health response to ensure effective containment of the Omicron variant
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: March 2022

The ongoing coronavirus disease–2019 (COVID-19) pandemic continues to disrupt human lives and almost all sectors and industries. The purpose of the current review was to explore the Omicron variant, the associated global risk, and the public health measures that need to be taken to contain the new variant. An extensive search of all materials related to the topic was carried out in the PubMed search engine and the World Health Organization website. A total of 13 articles were selected based upon their suitability with the current review objectives. Keywords used in the search include COVID-19 and Omicron in the title alone only. The World Health Organization identified a new variant of concern – Omicron on November 26, 2021, which has been reported in more than 170 nations. Depending on the evidence that has surfaced till now, the overall global risk associated with Omicron has been identified as very high. However, the variant has not been linked with serious forms of illness and complications; nevertheless, the large number of cases resulting due to high transmissibility has definitely accounted for a proportional rise in the number of hospital admissions and thus overwhelming the health-care delivery systems. To conclude, the Omicron variant of the causative virus has been associated with high transmissibility but low rates of development of serious infections. This call for the need to raise to the occasion, and all of us should adhere to the standard prevention and control measures and get immunized with the vaccine at the earliest.
Split Type Postman videolaryngoscope: The newer device versus the standard Macintosh laryngoscope in simulated difficult airway – A new hope for difficult intubation scenarios
Authors: Nisanth NS , Ali Qazi E. , Amir Syed H.
Published: March 2022

Background and Aims:

Studies on simulated difficult airway provide an opportunity to evaluate the performance of intubation devices for use in limited neck mobility. We did a comparative study between Split Type Postman videolaryngoscope and Macintosh laryngoscope, evaluating their efficacy for tracheal intubation in a simulated difficult airway.

Methods:

Sixty American Society of Anesthesiologists (ASA) physical status I and II patients aged between 20 and 60 years, having body mass index <30 kg m−2, posted for elective surgery under general anaesthesia were allocated to two groups. Endotracheal intubation was done with either Split Type Postman videolaryngoscope or Macintosh laryngoscope after placing a rigid cervical collar around the neck to simulate a difficult airway. The primary outcome measure was time for tracheal intubation as assessed from the time of introduction of laryngoscope between incisors till visual confirmation of passage of endotracheal tube through the vocal cords by the anaesthesiologist. Success rate of intubation, number of attempts required for successful intubation, haemodynamic alterations and airway complications were measured as secondary outcomes.

Results:

Time taken for endotracheal intubation was significantly shorter in Postman group (26.23 ± 7.18 vs. 31.43 ± 9.83 s) (P = 0.012) compared to Macintosh group. The groups were comparable in terms of incidence (P = 0.491) of successful intubation, with significantly lesser number of attempts required for intubation in Postman group (P = 0.022). The incidence of airway trauma and postoperative sore throat was comparable between the groups.

Conclusion:

Split Type Postman videolaryngoscope was superior with respect to intubation characteristics when compared to conventional laryngoscope.
Comparison between C-MAC and King Vision video laryngoscope (channelled blade) for tracheal intubation in aerosol-prevention intubation box for COVID-19 patients: A manikin-based study
Authors: Kumar Balbir , Ratre Brajesh K. , Garg Rakesh , Meena Jitendra K. , Singh Ram , Bhatnagar Sushma
Published: March 2022

Background and Aims:

The risk of contracting infection while intubating a coronavirus disease 2019 (COVID-19)-positive patient can be reduced by the use of personal protective equipment (PPE), video laryngoscope (VL) and aerosol-preventing intubation box. We compared two VLs (C-MAC and King Vision laryngoscope [KVL]) for ease of intubation and time taken to intubate the manikin using an intubation box.

Methods:

This randomised study involved healthcare workers having experience in using both C-MAC and KVL. After explaining the study and five practice sessions, a total of 63 volunteers were included; 61 participants gave consent and were enroled. The participants were allowed to intubate initially with one VL as per random sequence. Each participant performed three tracheal intubations with each device (C-MAC VL and KVL) on a manikin using an aerosol-prevention box over the head end at the time of intubation.

Results:

Time taken, percentage of glottic opening (POGO) score and the number of attempts taken for successful intubation with C-MAC and KVL were comparable in any of the three attempts (P > 0.05). The participants reported more difficulty in using KVL compared to C-MAC, and insertion of laryngoscope blade into the mouth of manikin for intubation was easy in group C-MAC compared to KVL in all three intubations (P < 0.01).

Conclusion:

C-MAC and KVL take comparable time for successful intubation under COVID-19 simulation conditions. But C-MAC is more user-friendly.
Tracheal intubation practices and adverse events in trauma victims on arrival to trauma triage: A single centre prospective observational study
Authors: Jafra Anudeep , Jain Kajal , Sravani M. Venkata , Yaddanapudi Laxmi Narayana , Kumar Pankaj
Published: March 2022

Background and Aims:

Trauma is one of the leading causes of global disease burden. Data on airway management in trauma patients from developing countries, particularly India is sparse. Hence, we planned a prospective observational study to assess the airway management practice patterns and associated complications.

Methods:

The study was conducted in trauma triage of a tertiary care hospital. Data was collected on all tracheal intubations occurring in trauma victims requiring definitive airway control, a detailed proforma including patient details, mode of injury, drugs used, intubation procedure, and complications were filled out for each patient.

Results:

We observed that the airway in trauma patients was primarily managed by non-anaesthesia speciality residents (426 patients); anaesthesia residents were primarily called for deferred or difficult intubations. The first attempt success rate of intubation by anaesthesia residents was significantly higher than speciality residents (P = 0.0001; 95% CI 9.02-24.66). Non-anaesthesia residents used midazolam in varying doses (3-12 mg) for intubation, whereas, rapid sequence intubation was the most common technique used by anaesthesia residents. Airway injuries were the most frequent complication observed in 32.8% of patients intubated by specialty residents compared to 5.9% of patients intubated by anaesthesia residents.

Conclusion:

The trauma triage is a high-volume area for frequent tracheal intubations which are manned by non-anaesthesia speciality teams. A number of factors related to the patient, staff, availability of airway equipment and unfavourable surroundings impact airway management and may explain the high incidence of airway complications, such as airway injuries in these trauma victims.
A cross-sectional study to assess knowledge, attitude, and practices regarding Zika virus among nursing students in a tertiary care center of central India
Authors: Kumar Rakesh Mahore , Gupta Vikas , Kumar Ram Panika , Palaniyandi Subramani , Palaniyandi Anitha
Published: March 2022

Introduction:

Recently, the Zika virus (ZIKV) has become a major concern across the world. ZIKV can primarily spread through the bite of infected Aedes aegypti mosquitoes. Till now, ZIKV is considered an incurable infectious disease. As Zika is an emerging disease of an international concern with the ongoing speculation about a potential outbreak in India in the future, the present study was conducted with an aim to assess knowledge, attitude, and practices regarding ZIKV among nursing students.

Materials and Methods:

This hospital-based cross-sectional study was conducted among 240 nursing students during 2019, and data were collected using a pretested, predesigned, standardized, and self-administered questionnaire. The ethical approval was obtained from the Institutional Ethical committee before the conduct of the study. All tests were performed at 5% level of significance.

Results:

The present study has included 240 nursing students (228 female students and 12 male students). The most common source of information related to ZIKV was social media among 75.6% of the students and 46.7% of the participants has low knowledge regarding ZIKV. Surprisingly, about one-tenth of the participants (14.2%) made an attempt to gain more knowledge about ZIKV, and nearly one-fifth of the participants were not using any method at all (17.1%) to prevent mosquito bites.

Conclusion:

This study showed inadequate knowledge among nursing students which will be future health care providers about ZIKV infection. The awareness about ZIKV infection should be ensured and maintained among health care providers to face any possible emergence in the region.

The following core competencies are addressed in this article:

Medical knowledge, Patient care, Practice-based learning, and Systems-based practice.
Outpatient antibiotic prescribing behavior and their psychosocial predictors among early-career clinicians in Delhi, India
Authors: Basu Saurav , Santra Sahadev , Bhatnagar Nidhi , Laul Anish
Published: March 2022

Introduction:

Psychosocial factors are significant drivers of inappropriate antibiotic prescription leading to antibiotic resistance. We ascertained the psychosocial predictors of outpatient antibiotic prescribing (OAP) behavior among early-career clinicians in India.

Materials and Methods:

We enrolled 200 early-career clinicians, including 100 medical interns and 100 junior residents (postgraduate student doctors) in six clinical departments, and collected data using a self-administered questionnaire. Response options were coded on five-item Likert scales.

Results:

Antimicrobial resistance was viewed as a significant public health problem by most (95%) participants. Presumptive antibiotic prescribing was reported by 84% of participants, although the participant attitude indicated a slight disinclination against the presumptive use of antibiotics (mean = 2.8, standard deviation = 0.72). The majority (52.5%) of the participant's perceived social pressure frequently influenced their decision to prescribe antibiotics to the outpatients. Furthermore, the maximum social pressure was perceived as driven by patient expectation for antibiotics and the existing antibiotic prescribing behavior of their peers and colleagues. The perception of increased social pressure stipulating antibiotic prescribing negatively correlated with the participant's intention to reduce antibiotic use in outpatients (r= −0.124, P < 0.001). Social pressure was reported to be higher when treating adult patients reporting diarrheal symptoms and children having cough.

Conclusions:

OAP practices among early-career clinicians working in the government health sector in India are mediated by considerable social pressure despite behavioral intention for reducing antibiotic use.

The following core competencies are addressed in this article:

Practice-based learning and improvement, Professionalism.
LV Prasad Eye Institute EyeSmart electronic medical record-based analytics of big data: LEAD-Uveitis Report 1: Demographics and clinical features of uveitis in a multi-tier hospital based network in Southern India
Authors: Tyagi Mudit , Das Anthony Vipin , Kaza Hrishikesh , Basu Soumyava , Pappuru Rajeev R , Pathengay Avinash , Murthy Somasheila , Agrawal Hitesh
Published: March 2022

Purpose:

To describe the demographics and epidemiology of uveitis presenting to a multi-tier ophthalmology hospital network in Southern India.

Methods:

Cross-sectional hospital-based study of 19,352 patients with uveitis presenting between March 2012 and August 2018.

Results:

In total, 1,734,272 new patients were seen across the secondary and tertiary centers of our multi-tier ophthalmology hospital network during the study period. Among them, 25,353 eyes of 19,352 patients were diagnosed with uveitis and were included in the study. Uveitis constituted 1.11% of all cases. The majority of patients were male (60.33%) and had unilateral (68.09%) affliction. The most common age group was 21–50 years with 12,204 (63.06%) patients. The most common type of uveitis was anterior uveitis, which was seen in 7380 (38.14%) patients, followed by posterior uveitis in 5397 (23.89%) patients. Among the infectious causes, tuberculosis was the most common etiology (2551 patients, 13%) followed by toxoplasmosis (1147 patients, 6%)

Conclusion:

Uveitis constituted 1.11% of all cases presenting to our clinics. It was more common in the age group of 21–50 and was predominantly unilateral. Anterior uveitis was the most common subtype seen in 38%.
Distichiasis: An update on etiology, treatment and outcomes
Authors: Singh Swati
Published: March 2022

Distichiasis, an extra row of eyelashes emerging from meibomian gland orifices, occurs due to the metaplastic transition of sebaceous glands into the pilosebaceous unit. It can present congenitally, such as in lymphedema distichiasis syndrome, or secondary to acquired conditions, such as cicatrizing conjunctivitis, trachoma. This review summarizes the etiology of distichiasis, its presentation, the evolution of various surgical techniques, and their outcomes in human and animal eyes. The published literature has focused on the different treatment modalities and their outcomes; the etiopathogenesis of this condition remains elusive. Truncating mutations (missense, frameshift, and nonsense) in the Forkhead family gene FOXC2 are involved in the distichiasis–lymphedema syndrome. The treatment options are no different for congenital versus acquired distichiasis, with no specific available algorithms. Acquired distichiasis in cicatrizing ocular surface diseases is difficult to manage, and existing treatment options offer success rates of 50%–60%. The outcomes of electroepilation or direct cryotherapy are not as good as surgical excision of distichiatic lashes after splitting the anterior and posterior lamella under direct visualization. The marginal tarsectomy with or without free tarsoconjunctival graft has shown good results in eyes with congenital and acquired distichiasis. The details of differences between normal and distichiatic lash, depth, or course of distichiatic eyelashes remain largely unknown. Studies exploring the distichiatic eyelash depth might improve the outcomes of blind procedures such as cryotherapy or radiofrequency-assisted epilation.
Association between ocular trauma and attention-deficit/hyperactivity disorder in adult patients
Authors: Keles Ali , Ilhan Cagri , Karayagmurlu Ali , Citirik Mehmet , Yetkin Esat , Karatepe Mustafa Salih , Varol Ersin
Published: March 2022

Purpose:

To investigate the potential relationship between ocular trauma and attention-deficit/hyperactivity disorder (ADHD)-related clinical outcomes in adults.

Methods:

This prospective case-control study included 108 ocular trauma patients and 90 age-sex-matched healthy control. The ocular trauma group was separated into the subgroups home accident, outdoor activity, and work related in terms of the reasons for ocular trauma, and as ocular surface problems, blunt trauma-related, and open globe injury in terms of the clinical findings. The ADHD-related clinical outcomes were evaluated using the Wender-Utah Rating Scale (WURS). The outcomes were compared between ocular trauma and control groups, and ocular trauma subgroups.

Results:

The demographic characteristics of ocular trauma groups and controls were similar (P > 0.05, for all). In comparison to the control group, the ocular trauma group had higher total WURS score and WURS subscale scores, but not significantly (P > 0.05, for all). According to comparisons of the subgroups separated by the reasons, there was significant difference in the mean behavioral problems/impulsivity scores in favor of outdoor activities (P = 0.015). On the other hand, the mean scores for WURS subscales of the subgroups separated by the clinical findings were similar (P > 0.05, for all)

Conclusion:

WURS scores in ocular trauma patients are similar to control; however, the score in behavioral problems/impulsivity subscales is higher for ocular trauma caused by outdoor activities.
Acceptability of artificial intelligence-based retina screening in general population
Authors: Shah Payal , Mishra Divyansh , Shanmugam Mahesh , Vighnesh M J , Jayaraj Hariprasad
Published: March 2022

Purpose:

A deep learning system (DLS) using artificial intelligence (AI) is emerging as a very promising technology in the future of healthcare diagnostics. While the concept of telehealth is emerging in every field of medicine, AI assistance in diagnosis can become a great tool for successful screening in telemedicine and teleophthalmology. The aim of our study was to assess the acceptability of AI-based retina screening.

Methods:

This was a prospective non-randomized study performed in the outpatient department of a tertiary eye care hospital. Patients older than 18 years who came for a regular eye check-up or a routine retina screening were recruited in the study. Fundus images of the posterior pole were captured on fundus on a phone camera (REMIDIO™, India) with a built-in AI software (Netra.AI) that can identify normal versus abnormal retina. The patients were then given an 8-point questionnaire to assess their acceptance and willingness toward AI-based screening. We recruited 104 participants.

Results:

We found that 90.4% were willing for an AI-based fundus screening; 96.2% were satisfied with AI-based screening. Patients with diabetes (P = 0.03) and the male population (P = 0.029) were more satisfied with the AI-based screening. The majority (i.e., 97.1%) felt that AI-based screening gave them a better understanding of their eye condition and 37.5% felt that AI-based retina screening prior to a doctor’s visit can help in routine screening

Conclusion:

Considering the current COVID-19 pandemic situation across the globe, this study highlights the importance of AI-based telescreening and positive patient approach toward this technology.
Visual impairment in children with multiple disabilities in schools for children with special needs in South India
Authors: Bhaskaran Sahithya , Flora Jeyaseeli , Perumalsamy Vijayalakshmi , Durairaj Deepa Chitra
Published: March 2022

Purpose:

To understand/assess ocular and functional vision impairment in children with multiple disabilities with a functional vision assessment battery in addition to standard ophthalmic examinations in an outreach setting.

Methods:

Seven schools for children with special needs, 243 children in total, were screened for ocular disorders and functional vision impairment through school camps.

Results:

Among them, 37% had refractive errors needing spectacle correction. With standard ocular testing methods, the visual impairment was around 32%, but when functional vision was assessed, the functional vision impairment amounted to 70% in these children. The presence of functional vision impairment was found to be independent of the associated disability. Assessment of visual capacities such as visual closure, saccade pursuits, optic ataxia, and developmental milestones early on can help in suspecting the presence of CVI

Conclusion:

Children with multiple disabilities are more at risk of functional vision impairment, which significantly impairs their ability to function in daily life. A complete functional vision assessment becomes essential to plan early intervention for these children. The significant proportion of vision impairment and functional vision loss in our study indicates the need for coordinated structured programs to address vision-related problems in children with multiple disabilities.