bluuebunny/crossref_metadata_2025 huggingface dataset:
Drainage Tube Implants in the Treatment of Glaucoma Following Penetrating Keratoplasty
Authors: Sherwood Mark B , Smith M Fran , Driebe William T , Stern George A , Beneke John A , Zam Z Suzanne
Published: April 2021

ABSTRACT

A retrospective review was undertaken to compare outcomes in 26 eyes that underwent penetrating keratoplasty (PKP) and drainage tube surgery (Morteno double-plate implant or Schocket procedure). Drainage tube surgery was performed either before PKP (10 eyes), after PKP (7 eyes), or at the same time as PKP (9 eyes). Mean follow up was 22 months. The average preoperative intraocular pressure (IOP) for all of the eyes was 31 mm Hg; 96% of them achieved a final IOP of less than 18 mm Hg (average, 14 mm Hg on a mean of 0.8 medications). Graft failure occurred in 11/26 (42%). Eight of these eyes were regrafted, and six of these eight have remained clear at a mean follow up of 22 months after grafting. The overall PKP success rate, including the eyes that underwent repeat PKP, was 81%. Visual acuity remained stable or improved in 70% of the eyes.
The Glaucoma Laser Trial (GLT): 5. Subgroup Differences at Enrollment
Authors: Anonymous
Published: April 2021

Glaucoma Laser Trial Research Group*

ABSTRACT

Data collected at enrollment on the 271 patients (542 eyes) who participated in the Glaucoma Laser Trial IGLT) were analyzed for subgroup differences. The subgrouping variables included four patient characteristics (race, sex, age, and history of a vascular disease) and one ocular characteristic (myopia). The strongest differences observed were between blacks and whites. As compared with the eyes of the white patients, those of the black patients had lower mean decibels per test location in the visual field (P < .001), greater mean defect (P < .001), number of abnormal test locations (P < .001), and corrected loss variance (P = .009), as well as greater cup depth (P < .001 ), and larger mean horizontal (P = .002) and vertical (P < .001) cup/disc ratios.
Scleral Flap Sutures and the Development of Shallow or Flat Anterior Chamber After Trabeculectomy
Authors: Blok Michiel D W , Greve Erik L , Dunnebier Erwin A , Muradin Farley , Kijlstra Aize
Published: April 2021

ABSTRACT

To determine whether closing the scierai flap with extra sutures can reduce the risk of overfiltration after trabeculectomy, we divided 339 trabeculectomies into three groups based on the number of scierai flap sutures used in the procedure, and studied the postoperative complications and results. The incidence of shallow or flat anterior chamber was significantly less in eyes that had received seven to nine sutures than in those that had received from two to six. Also, the incidence of cornea-lens touch was significantly less in the eyes with seven to nine sutures (P = .02, Fisher Exact Test). This study suggests that extra scierai flap sutures (in combination with laser suture lysis) is a safe and effective method of significantly reducing the risk of overfiltration after trabeculectomy.
Intraocular Dexamethasone Penetration via Subconjunctival or Retrobulbar Injections in Rabbits
Authors: Bodker Fred S , Ticho Benjamin H , Feist Richard M , Lam Tim T
Published: April 2021

ABSTRACT

Using high-performance liquid chromatography, we compared tissue levels of dexamethasone in the aqueous, vitreous, retina, and choroid of rabbits, 1 and 4 hours following subconjunctival or retrobulbar injection. One hour following injection, dexamethasone levels in all of these tissues were similar in both the subconjunctival and retrobulbar groups. Four hours following injection, the concentrations in the two groups also were similar, except in the choroid, in which the subconjunctival injection yielded significantly lower dexamethasone levels than the retrobulbar injection. Tissue steroid levels were comparable ipsilateral and contralateral to the injected eyes in both treatment groups after 4 hours, except in the retina, in which the levels were lower in the contralateral eye after subconjunctival injection. These data suggest that dexamethasone absorption and delivery is predominantly hematogenous following both subconjunctival and retrobulbar injection, especially in highly vascular tissues, such as the choroid. Hematogenous delivery of dexamethasone appears to peak earlier in the choroid and presumably in other intraocular tissues following subconjunctival injections, while retrobulbar injections provide more steady, long-term delivery.
Merkel Cell Carcinoma of the Eyelid
Authors: Hamilton Jenny , Levine Mark R , Lash Richard , Koenigsberg Adam
Published: April 2021

ABSTRACT

The Merkel cell is part of the dendritic cell population of the epidermis, and studies suggest it has a role as a slowly adapting mechanoreceptor involved with mediating the sense of touch. Merkel cells can give rise to malignant neoplasms, one tenth of which occur in the eyelid and periocular area, and manifest as painless erythematous nodules, with overlying telangiectatic blood vessels. Merkel cell carcinoma can mimic other malignant lesions, and the diagnosis can be difficult. One third of the tumors recur, and there is a high rate of metastasis. The estimated 5-year survival rate is 38%.

Initial treatment should be aggressive, including surgical resection, with consideration of postoperative radiation. Merkel cell carcinoma responds to chemotherapy, but routinely recurs on cessation of treatment. Two cases are presented to illustrate the typical presentation of Merkel cell carcinoma and the importance of electron microscopy and immunohistochemical studies.
Nanophthalmic Uveal Effusion Managed With Scleral Windows and Topical Mitomycin-C
Authors: Akduman Levent , Adelberg Daniel A , Del Priore Lucian V
Published: April 2021

Abstract. The authors treated a 38-year-old man with nanophthalmic uveal effusion with scleral windows and local application of mitomycin-C. The patient underwent two separate surgical procedures, involving placement of scleral windows in all four quadrants and topical application of mitomycin-C in one quadrant. Episcleral scarring led to closure of scleral windows in all quadrants except one quadrant where mitomycinC was applied during the first surgery. The uveal effusion resolved following the second surgery. No complications related to mitomycin-C were observed. Topical mitomycin-C may be a useful adjunct in the surgical management of uveal effusion syndrome. [Ophthalmic Surg Lasers 1997;28:325-327.]
Intraoperative Stress Experienced by Surgeons and Assistants
Authors: Yamamoto Akira , Hara Tsutomu , Kikuchi Keiko , Hara Takako , Fujiwara Takaaki
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the intraoperative stress on surgeons and assistants during cataract surgery, 12 surgeons and 3 assisting nurses were assessed based on their level of professional experience.

* METHODS: Surgeons were classified as inexperienced, intermediate, or experienced. Nurse assistants were classified as inexperienced or experienced. The intraoperative heart rates and urine adrenaline levels of each participant were measured.

* RESULTS: Inexperienced surgeons and nurse assistants had the highest heart rates at the beginning of surgery, and the rates tended to decrease toward the end of surgery. All values were higher than the other two groups throughout surgery. In surgeons with intermediate experience, the heart rates were not as high as in the inexperienced personnel; however, the heart rates were high throughout the surgery. The heart rate in one intermediate surgeon was markedly increased when a surgery was simultaneously broadcast on closed-circuit television. In experienced surgeons and a nurse assistant, the measurements increased slightly.

* CONCLUSIONS: The variations in heart rates and urine adrenaline levels showed characteristic patterns based on the experience of the surgical personnel.

[Ophthalmic Surg Lasers 1999; 30: 27-30.]
Extrusion and Granuloma Formation with Mersilene Mesh Brow Suspension
Authors: Mutlu F Mehmet , Tuncer Kemal , Can Cevat
Published: April 2021

BACKGROUND AND OBJECTIVE: A variety of biologic or synthetic materials have been used in brow suspension ptosis surgery. We describe extrusion and granuloma formation in 5 cases of congenital ptosis operated with Mersilene mesh sling.

PATIENTS AND METHODS: Case reports with review of literature.

RESULTS: Two cases of extrusion and 3 cases of granuloma formation were encountered in 79 eye lids of 52 (6.3%) patients performed for the treatment of congenital ptosis. Mersilene mesh fibers in the cut surface and a foreign body reaction were found by microscopic evaluation of tissue harvested at the time of surgical removal of the sling.

CONCLUSION: Despite the operative precautions, the probability of extrusion and granuloma formation should be in mind in cases of congenital ptosis operated with Mersilene mesh sling, a synthetic material.

[Ophthalmic Surg Lasers 1999; 30: 47-51.]
Apraclonidine 0.5% Versus Brimonidine 0.2% for the Control of Intraocular Pressure Elevation Following Anterior Segment Laser Procedures
Authors: Chevrier Robert L , Assalian Alfred , Duperré Jean , Lesk Mark R
Published: April 2021

* BACKGROUND AND OBJECTIVE: Both apraclonidine hydrochloride 0.5% and brimonidine tartrate O. 5% are potent alpha-2 agonists, effective in controlling the intraocular pressure (IOP) rise following argon laser trabeculoplasty (ALT). Brimonidine has recently become available commercially as a 0.2% solution. Our goal in this study was to compare the efficacy and side effect profile of 0.2% brimonidine to that of 0.5% apraclonidine in the prevention of IOP spikes following anterior segment laser procedures.

* PATIENTS AND METHODS: Patients undergoing argon laser trabeculoplasty, Nd:Yag peripheral iridectomy or posterior capsulotomy were prospecrively randomized to receive either apraclonidine 0.5% or brimonidine 0.2%, approximately 10 minutes prior to laser surgery. Intraocular pressure was measured by a masked observer, using Goldmann applanation tonometry, before and 1 hour after the treatment.

* RESULTS: 51 ALTs, 21 peripheral iridectomies, and 13 posterior capsulotomies were performed. The incidence of an IOP rise greater than 5 mmHg was 3/43 (7.0%) in the brimonidine group and 0/42 (0%) in the apraclonidine group (P=0.08, chi-squared). There were no IOP elevations greater than 8 mmHg. All IOP rises of greater than 5 mmHg occurred in the ALT sub-group, and within this sub-group, the mean change in IOP from pre- to post-op was -4.00 ± 5.87 in the brimonidine group versus -4.29 ± 3.86 in the apraclonidine group (.P=O. 84). There was a statistically significant decrease in IOP from baseline in both drug groups (P<.0001).

* CONCLUSIONS: Both drugs are highly effective in controlling IOP spikes following anterior segment laser procedures. There is a tendency toward higher risk of IOP rise following argon laser trabeculoplasty with 0.2% brimonidine as compared to 0.5% apraclonidine, however, this was not statistically significant.

[Ophtalmie Surg Lasers 1999;30:199-204.]
A Simplified Technique for Stable Transscleral Suture Fixation of Posterior Chamber Intraocular Lenses
Authors: Epley K David , Levine Eric S , Katz Harold R
Published: April 2021

Abstract. We describe a technique for implanting ciliary sulcus posterior chamber intraocular lenses (PCIOLs). This technique uses radial keratotomy (RK) markers to facilitate PCIOL centration, 2-point scleral suture fixation for each haptic to prevent PCIOL tilt, and partial thickness sclerotomies to prevent suture erosion. Postoperative results of 20 eyes with PCIOLs sutured to the ciliary sulcus were reviewed. Suture placement was determined using a Mendez degree gauge with Bores axis marker (Katena USA, Denville, NJ). Two-point scleral suture fixation without a scleral flap was used for each haptic. Average follow-up was 17.1 months. Postoperative best corrected visual acuity was 20/40 or better in 95% of eyes. Average best-corrected post-operative visual acuity was 20/29. One patient with a previous retinal disease lost 3 lines of visual acuity. This technique results in excellent postoperative visual acuity without PCIOL decentration, tilt, or suture erosion. [Ophthalmic Surg Lasers 1999;30:398-402.]
Intravitreal Tissue Plasminogen Activator for Acute Central Retinal Vein Occlusion
Authors: Lahey J Michael , Fong Donald S , Kearney John
Published: April 2021

* OBJECTIVES: We investigated the efficacy of intravitreal tissue plasminogen activator (tPA) for the treatment of acute central retinal vein occlusion.

* DESIGN: Twenty-six eyes with central retinal vein occlusion (CRVO, n=23) and hemi-retinal vein occlusion (n=3) with recent onset of visual symptoms (^ 21 days) were identified and given an intravitreal injection of 65 -1 10 µg of tPA.

* RESULTS: Among eyes with CRVO, visual acuity improved to 2* 20/40 in 7 of 23 patients (30.4%) at 6 weeks, and 8 of 23 patients (34.8%) at 6 months. Visual acuity improved or stabilized in 69.6% (16 of 23 patients) at the 6 week visit and persisted with longer follow-up. Four patients developed doubling of the visual angle. No patients developed rhegmatogenous retinal detachment, infection or neovascular glaucoma. One patient developed a small vitreous hemorrhage and 2 developed an increase in the size of pre-existing macular hemorrhage.

* CONCLUSION: Intravitreal tPA administered early in the course of central retinal vein occlusion did not lead to catastrophic hemorrhagic events. Intravitreal tPA may cause worsening of vision in some patients. While some eyes appear to have benefited from the therapy, no conclusions can be reached because there was not a concurrent control group. A randomized clinical trial is necessary to determine its efficacy.

* SUMMARY STATEMENT: Intravitreal tPA administered early in the course of central retinal vein occlusion did not lead to catastrophic hemorrhagic events. A randomized clinical trial is necessary to determine its efficacy.

[Ophthalmic Surg Lasers 1999;30:427-434.]
Corneal Endothelial Cell Loss After Multiple Vitreoretinal Procedures and the Use of Silicone Oil
Authors: Friberg Thomas R , Guibord Nathalie M
Published: April 2021

* BACKGROUND AND OBJECTIVE: Corneal decompensation and complications are a frequent cause of visual loss after vitreoretinal surgery. This paper presents data regarding endothelial cell loss in aphakic and Pseudophakie silicone oil filled eyes when oil was retained for many months. This study updates our previous investigation on the subject.

* PATIENTS AND METHODS: The corneal endothelial cell count of 10 eyes of 10 consecutive patients who had undergone vitreoretinal surgery, including fluid-gas exchange and ultimately silicone oil placement, were obtained. The patients underwent an average of 2.7 ± 0.9 vitreoretinal procedures before the final procedure which induced the placement of silicone oil in the vitreous cavity. All had inferior iridectomies. The endothelial cell density measurements were obtained an average of 1 year after silicone oil placement. In all eyes, the oil was felt necessary for long term tamponade and therefore was not removed. The cell density of the operated eye was compared to the fellow eye, none of which had undergone silicone oil placement.

* RESULTS: Both gas and retained silicone oil contribute to the loss of corneal endothelial cell density. The average endothelial cell loss in the 10 eyes with oil retained for an average of 10 ± 12 months was 68.8 ± 31.4%, as compared to the fellow eye. The average cell loss was higher in the three eyes with silicone oil in the anterior chamber (range 44 to >95%). Pseudophakie eyes fared better, on average, than aphakic eyes (51.66 ± 28% vs. 66.63 ± 26.3%) with respect to cell loss. Five aphakic eyes and 1 Pseudophakie eye developed corneal edema.

* CONCLUSIONS: Endothelial cell loss occurs after vitreoretinal surgery and is exacerbated by long term silicone oil retention. The corneal endothelial cell damage is probably cumulative from procedure to procedure. Endothelial cell loss may be pronounced in eyes without a physical barrier between the anterior segment and the vitreous cavity, and in eyes where oil migrates into anterior chamber.

[Ophthalmic Surg Lasers 1999;30:528-534]
Surgical Chorioretinal Venous Anastomosis for Ischemic Central Retinal Vein Occlusion
Authors: Peyman Gholam A , Kishore Kamal , Conway Mandi D
Published: April 2021

* BACKGROUND AND PURPOSE: To report results of a pilot study to create chorioretinal venous anastomosis (CRVA) in eyes with ischemie central retinal vein occlusion (CRVO) via a pars plana approach.

* PATIENTS AND METHODS: Five eyes of 5 patients with ischemic CRVO underwent surgical CRVA. Following pars plana vitrectomy, the posterior hyaloid face was removed, and slit-like incisions were made with a microvitreoretinal blade adjacent to a major retinal vein in each quadrant. Small pieces of 5-0 Mersilene sutures (Ethicon, Somerville, NJ) were positioned over the vein and inserted into these incisions to promote vascularization. Panretinal photocoagulation was applied.

* RESULTS: A functional CRVA site was noted at 10 of 16 attempted sites (4 sites in 1 patient could not be evaluated because of cataract). Minor fibrous proliferation was noted at CRVA sites in all eyes. Optic atrophy developed in 3 eyes. Visual acuity improved in 3 eyes, remained unchanged in 1, and deteriorated in 1 eye after a mean follow up of 13.4 months (range 8-20 months).

* CONCLUSION: Surgically induced CRVA may improve the prognosis in some eyes with ischemic CRVO.

[Ophthalmic Surg Lasers 1999;30:605-614.]
Primary Trabeculectomy in Young Adults: Long-term Clinical Results and Factors Influencing the Outcome
Authors: Jacobi Philipp C , Dietlein Thomas S , Krieglstein Günter K
Published: April 2021

* OBJECTIVE: To assess the long-term clinical outcome of primary trabeculectomy in young adults, and evaluate potential risk factors contributing to failure of filtering surgery.

* MATERIAL AND METHODS: A retrospective review was carried out of the charts of all glaucomatous patients between the age of 15 to 45 years. These patients had no history of previous extra- or intraocular surgery and had undergone primary trabeculectomy without the use of antimetabolites from January 1988 to January 1995 at the University Eye Hospital of Cologne. A total of 51 eyes of 45 patients fulfilled the inclusion criteria. There were no drop-outs from follow-up. Mean follow-up was 5.2 years (range, 2.5 to 9.5 years). Outcome was defined as a success when postoperative intraocular pressure (IOP) was 21 mm Hg or lower. If further glaucoma medication was required the outcome was described as a qualified success, and when the patient was free of medication the outcome was considered a complete success.

* RESULTS: Using the Kaplan-Meier survival curve, cumulative life-table success rates were 88% at 1 year (n = 51), 82% at 3 years (n = 47), 76% at 5 years (n = 26), and 70% at 7 years (n = 22). At final visit 71% (n = 36) were classified as successes, with 54% (n=30) being successful without adjunct medication. Seventeen percent (n = 6) required additional topical medication. Previous laser trabeculoplasty and an IOP greater than 40 mm Hg during the course of the disease was found to adversely affect the outcome. Eyes with iridocorneal epitheliaiopathy (ICE) syndrome, Riegers anomaly, and uveitic glaucoma failed more frequently than those with juvenile, pigmentary, and primary open-angle glaucoma (POAG). Younger age (< 30 years) was not associated with a lower success rate after controlling for glaucoma category.

* CONCLUSION: The success rate of the uncomplicated group compares favorably with the 75% to 90% success rates of trabeculectomy commonly cited for primary glaucomas in older adults. Primary trabeculectomy in young patients may have a favorable outcome even without antimetabolite therapy.

[Ophthalmic Surg Lasers 1999;30:637-646.]
Le football des immigrés
Authors: Frenkiel Stanislas
Published: April 2021

Depuis la naissance du professionnalisme en 1932, plus de 500 footballeurs algériens jouent dans le Championnat de France. D’Ali Benouna à Zinédine Zidane, qui sont ces travailleurs immigrés du sport ? Et quelles sont leurs histoires ? En croisant des archives exceptionnelles et des entretiens inédits avec une centaine d’anciens joueurs et leurs proches, Stanislas Frenkiel révèle un pan méconnu de l’immigration algérienne en France. Loin des masques du business et du spectacle, il met en lumière trois générations de footballeurs professionnels dont les carrières sportives et trajectoires sociales s’inscrivent dans les ambiguïtés et turbulences du XXe siècle : décolonisation et mondialisation, désindustrialisation et émancipation, démocratisation et professionnalisation du sport. À la suite d’une longue et passionnante enquête de terrain et plusieurs dizaines de milliers de kilomètres parcourus en France et en Algérie, l’auteur dévoile un livre de référence sur l’immigration dans le football. Il est issu du remaniement approfondi de sa thèse de doctorat.
Encountering COVID-19: Human Resource Management (HRM) Practices in a Pandemic Crisis
Authors: Dissanayake Kumudinei
Published: April 2021

Scholars highlight the lack of preparations for unexpected shocks of employment and human resources all over the world, while stressing its possible adverse impacts on work organizations, employees and the economy. Given the prevailing COVID-19 pandemic threat and the dearth of clear findings on how human resource (HR) departments and the HR professionals should encounter a global pandemic, present study aims to examine and inform the basic HR practices to be adopted in a pandemic and prospects for HR professionals in handling such situations. Aim of the study is achieved by reviewing past research findings and relevant information which are available on wider media. Findings suggest a typology of HR practices identified with ‘6Cs’ for the successful handling of human resources in organizations in a pandemic. Further, the study finds a cluster of post-pandemic HR practices to be used, mostly for the service sector organizations, when attempting human resources recovery.
Oviposition after sex: mated Anastrepha ludens (Diptera: Tephritidae) females increase oviposition without receiving an ejaculate
Authors: Reyes-Hernández M. , Córdova-García G. , Díaz-Fleischer F. , Flores-Estévez N. , Pérez-Staples D.
Published: April 2021

Mating and receiving ejaculate can alter female insect physiology and postcopulatory behaviour. During mating, females receive both internal and external stimuli and different components in the ejaculate. In insects, these components consist mostly of sperm and male accessory gland secretions. Some of the most important changes associated with receiving male accessory gland secretions are a reduction in female sexual receptivity and an increase in oviposition. However, a clear function for these molecules has not been found in the Mexican fruit fly Anastrepha ludens (Loew) (Diptera: Tephritidae). Here, we tested how the stimulus of mating, receiving a full ejaculate, or only receiving accessory gland secretions can influence ovarian development and oviposition. Our results indicate that the stimulus of mating per se is enough to induce oviposition and increase egg laying in females even if ejaculate is not received, whereas receiving only accessory gland secretions does not increase ovarian development and is not enough to induce oviposition or increase egg production. Further research on the internal and external copulatory courtship of A. ludens will increase our understanding of the role of these secretions in stimulating oviposition independent of ejaculate effects. A biological function for male accessory gland secretions on female behaviour for A. ludens still needs to be found.
Interdisciplinary Approach in the Diagnosis and Treatment of Orofacial Granulomatosis
Authors: Dhalkari Chandulal , Patil Sayali Chandrakant , Indurkar Maya
Published: April 2021

Orofacial granulomatosis (OFG) is an uncommon disease and represents an idiopathic, nonnecrotizing granulomatous lesion of soft tissue in the orofacial region. Medical history is very important in the diagnosis of OFG as medical condition such as Crohn's disease can also present an extraintestinal manifestation of OFG. Exclusion of other entities such as sarcoidosis, myocardial infections, foreign body reactions, and biopsy helps establish a correct diagnosis. The term idiopathic OFG is used in cases with unknown etiology. This case report describes idiopathic OFG in a 35-year-old female patient with persistent upper lip swelling and gingival enlargement. Management with intralesional acetonide 20 mg/ml, twice week for 3 weeks and gingivectomy, resulted in significant remission without recurrence after a 6-month follow-up.
Learning Style Preference
Authors: Agu Augustine U. , Esom Emmanuel A. , Anyanwu Emeka G. , Obikili Emmanuel N.
Published: April 2021

Background:

Understanding the differences in learning styles among medical students and their impact on the learning processes may enhance better learning and knowledge acquisition that is necessary for improving learning outcomes. This study aimed at the determination of the learning style preferences of the University of Nigeria preclinical medical students and the impact they have on their academic performance.

Materials and Methods:

The study involved 158 third-year medical students (102 males and 56 females). Each student completed the VARK questionnaire (Version 7) comprising 16 questions that identified four different learning style preferences, namely V – visual, A – aural, R – read–write, and K – kinesthetic. The academic performance of the students was obtained from the results of their second MBBS professional examination. Analysis of data was done using Statistical Package for the Social sciences (SPSS) version 21; the percentages and charts of distribution for each VARK component were determined. The presence/absence of significant interactions between academic performance and learning style preferences was determined using Chi-square test.

Results:

The results showed that 30.4% of the students were unimodal (V-2.5%, A-7%, R-17.1% and K-3.8%), while 69.6% were multimodal in learning. With respect to gender, the males (70.6%) and females (67.9%) preferred multimodal learning, and both genders showed similar patterns in their preferences (read–write, followed by aural, kinesthetic, and visual). Visual learners exhibited the highest scores among unimodal learners, followed by kinesthetic, aural, and read–write learners, although the mean performance of multimodal learners (65%) was higher than those of unimodal learners (54%) (P < 0.001).

Conclusion:

A blend of V-A-R-K instructional techniques would benefit most students. Students who are strongly unimodal in learning need to be specifically targeted with their unique learning style.
Megaloblastic Anemia Associated with Small Bowel Resection in an Adult Patient
Authors: Ibijola Ajayi Adeleke , Okunlola Abiodun Idowu
Published: April 2021

Megaloblastic anemia is characterized by macro-ovalocytosis, cytopenias, and nucleocytoplasmic maturation asynchrony of marrow erythroblast. The development of megaloblastic anemia is usually insidious in onset, and symptoms are present only in severely anemic patients. We managed a 57-year-old male who presented at the Hematology clinic on account of recurrent anemia associated with paraesthesia involving the lower limbs, 4-years-post small bowel resection. Peripheral blood film and bone marrow cytology revealed megaloblastic changes. The anemia and paraesthesia resolved with parenteral cyanocobalamin.
A Survey of Pediatric Eye Diseases in a Tertiary Hospital in Osogbo, South-west Nigeria
Authors: Isawumi Michaeline Asuquo , Ubah Josephine Ngozi
Published: April 2021

Background:

Identifying common eye diseases in childhood is a Step towards the prevention of visual impairment and preservation of vision in children who still have many productive years ahead.

Aim:

The aim is to determine the spectrum of eye disorders in children attending a tertiary health institution to plan preventive and curative strategies

. Methodology:

This was a 4-year retrospective study of children 0–16 years who presented to a tertiary institution. Through retrieval and study of case notes, information on age, sex, duration before the presentation, month of presentation, and diagnosis were obtained and analyzed using descriptive statistics.

Results:

Of 1120 case notes, studied, (53.8%) were male and (46.2%) female in a ratio of 1.6:1. The mean age was 8.54 years ± 5.03 and the modal age group was 11–16 years ± 0.85. About 51% (51.2%) had normal vision while (13.4%) were blind. The commonest eye disorders were conjunctivitis 488 (43.3%), refractive errors 292 (26.1%), and cornea-related problems 94 (8.4%). The less frequent disorders found were trauma 65 (5.8%), cataract 63 (5.6%), glaucoma 14 (4.3%), uveitis 7 (0.6%), and strabismus/others 67 (6.0%). Cataract 36/150 (24.0%) and refractive error 107/198 (54.0%) were the most common causes of blindness and visual impairment. Most children presented after 2–3 weeks of the onset of symptoms. Refractive error was more prevalent in females 176/518 (34.0%), while trauma was more prevalent in males 42/602 (7.0%).

Conclusion:

The common causes of ocular diseases in children in this study are avoidable. There should be an unrelenting effort toward the prevention of visual impairment or amblyopia by the provision of adequate treatment through subsidized eye care services. A follow-up study to ascertain the causes of delay in presentation would be helpful.
Establishing Sexual Dimorphism in Diameter of Carotid Arteriesamong Normotensive Adult Nigerians
Authors: Kespi Kpuduwei Selekeowei Peter , Fawehinmi Hakeem B. , Oladipo Gabriel Sunday
Published: April 2021

Background:

The Doppler scan serves as an early and non-invasive diagnostic tool for carotid artery disease due to its location, which is significant for cerebrovascular accidents. The carotid diameter has been associated with hypertension just as a sexual variation in hypertensives is documented. However, the difference among healthy individuals with normal pressure and body weight with relation to the diameter of the carotid is not proven among healthy Nigerians.

Objective:

The objective of the study is to identify a sexual dimorphism in the diameter of the carotid artery and its association with body mass index and blood pressure among normotensive Nigerians.

Materials and Methods:

A total of 104 were sampled with the average age of 28 years comprising 62 males and 42 females. Doppler ultrasound scans of common, internal, and external carotid arteries were made by an experienced radiologist using a linear transducer with a frequency of 7.0 Mhz. Diameter measurements were taken in end-diastolic alongside blood pressure, pulse, height, weight, and neck and waist circumference.

Results:

The total diameter measurements of the common carotid artery for male and female were 0.62 ± 0.09 and 0.60 ± 0.07 cm, respectively, internal carotid artery were 0.60 ± 0.08 and 0.61 ± 0.08 cm, respectively, and external carotid artery were 0.48 ± 0.11 and 0.50 ± 0.08 cm, respectively. Although the differences were not statistically significant, their associations with the measured biophysical and clinical parameters showed significant differences in both sexes.

Conclusion:

we opine that sexual dimorphism should not be ruled out by the mere absence of significant difference in the descriptive analysis but also in the associations with other parameters.
On the infinitesimal Terracini Lemma
Authors: Ciliberto Ciro
Published: April 2021

In this paper we prove an infinitesimal version of the classical Terracini Lemma for 3-secant planes to a variety. Precisely we prove that if

X \subseteq \mathcal P'

is an irreducible, non-degenerate, projective complex variety of dimension

n

with

r \geq 3n + 2

, such that the variety of osculating planes to curves in

X

has the expected dimension

3n

and for every 0-dimensional, curvilinear scheme

\gamma

of length 3 contained in

X

the family of hyperplanes sections of

X

which are singular along

\gamma

has dimension larger that

r-3(n+1)

, then

X

is 2-secant defective.
On the Schwartz correspondence for Gelfand pairs of polynomial growth
Authors: Astengo Francesca , Di Blasio Bianca , Ricci Fulvio
Published: April 2021

Let

(G,K)

be a Gelfand pair, with

G

a Lie group of polynomial growth, and let

\Sigma\subset\mathbb R^\ell

be a homeomorphic image of the Gelfand spectrum, obtained by choosing a generating system

D_1,\dots,D_\ell

of

G

-invariant differential operators on

G/K

and associating to a bounded spherical function

\phi

the

\ell

-tuple of its eigenvalues under the action of the

D_j

's.

We say that property (S) holds for

(G,K)

if the spherical transform maps the bi-

K

-invariant Schwartz space

\mathcal S(K\backslash G/K)

isomorphically onto

\mathcal S(\Sigma)

, the space of restrictions to

\Sigma

of the Schwartz functions on

\mathbb R^\ell

. This property is known to hold for many nilpotent pairs, i.e., Gelfand pairs where

G=K\ltimes N

, with

N

nilpotent.

In this paper we enlarge the scope of this analysis outside the range of nilpotent pairs, stating the basic setting for general pairs of polynomial growth and then focussing on strong Gelfand pairs.
Motivational analysis of tourists who visit a city with inscriptions World Heritage Site, Granada, Spain
Authors: Valverde-Rodaa José , Gomez-Casero Gema , López-Guzmán Tomás , Medina-Viruel Miguel Jesús
Published: April 2021

In recent times, it has been noticed that cultural tourism attracts millions of people. One interesting aspect is the analysis of WHS (World Heritage Site) destinations or cultural destinations that have an inscription WHS. This research has the goal of analysing the different groups of tourists who visit a cultural destination with an inscription WHS, specifically the city of Granada (Spain). For this, segmentation was performed, studying the socio-demographic profile of the tourists and their assessment of the attributes of this destination. For the tourist segmentation, two models have been followed. Four different groups of tourists were found: alternative, cultural, emotional and heritage. In this last one, the relationship between curiosity about the culture of the tourist destination and the heritage visited has a determining role. This study makes an important contribution to the literature regarding the links between the tourist and the historic and monumental heritage they visit and their tourist behaviour.
Sustainable Environmental Practices in Malawian Hotels
Authors: Khonje Lameck Zetu , Bello Felix , Sepula Michael Bennett
Published: April 2021

This paper discusses the governance practices in the Malawi tourism and hospitality sector and their impact on the sustainability of natural resources. The focus of this paper is the National Tourism Policy (NTP) for Malawi and how central and local government structures enforce it to promote environmental sustainability practices in hotels. The paper uses a Case Study approach whereby the Sogecoa Golden Peacock Hotel and the Sunbird Mount Soche Hotel are used to explore how the NTP has ensured sustainable environmental practices are followed. A qualitative research method was used through semi-structured interviews to secure the perceptions of key informants. Through a Grounded Theory analysis, the findings revealed that the NTP does not facilitate the enforcement of sustainable environmental practices. Furthermore, because of this shortfall in the NTP, hotels do not have an environmental management policy to promote sustainable environmental practices. This paper, therefore, recommends an urgent need to revise the NTP and introduce sustainable environmental management guidelines in order for the hotel sector to emulate. It is further recommended that hotel managers should have a thorough understanding of environmental sustainability to ensure that the industry addresses negative environmental impacts.
A Matching Method of Heterogeneous Database based on SOM and BP Neural Network
Authors: Zhu Yongjie , Feng Shenzhan
Published: April 2021

In the process of data integration among heterogeneous databases, it is significantly important to analyze the identical attributes and characteristics of the databases. However, the existing main data attribute matching model has the defects of oversize matching space and low matching precision. Therefore, this paper puts forward a heterogeneous data attribute matching model on the basis of fusion of SOM and BP network through analyzing the attribute matching process of heterogeneous databases. This model firstly matches the heterogeneous data attributes in advance by SOM network to determine the centre scope of attribute data to be matched. Secondly, the accurate match will be carried out through BP network of the standard heterogeneous data various attribute center. Finally, the matching result of the relevant actual database shows that this model can effectively reduce the matching space in the case of complex pattern. As for the large-scale data matching, the matching accuracy is relatively high. The average precision is 89.52%, and the average recall rate is 100%.
Online Mediatization of the Identity of the Writers During the Pandemic
Authors: Ozon Corina
Published: April 2021

Self-exposure has become a mode of communication on which the functioning of social networks and blogs is based. Internet users create content in the digital environment, built on habits acquired in the old media. Remixability and mobility make possible new forms of mediation and self-production in the process of mediatization. During the research on the self-exposure of Romanian writers in the online environment, the pandemic represented the opportunity to investigate the behavioral changes in the conditions of prohibiting face-to-face events (including cultural ones). Starting from the hypothesis that, given the quarantine period and the prohibition of events, the only sources of information are traditional media, especially television. Through mediatization, the authors apply strategies to keep their visibility online to promote their books through self-exposure and emergence of identities. The research used autoethnography, based on the writer's experience, to track the emergence of identities and the types of narration used in the posts and their multimodality. Monitoring for data collection was performed on a private site like a diary/blog and processed with empirical tools. We noticed that the writers had exposed themselves online by mediatized identities, and the narratives had diversified during that period; identities and posts are mediatized around the news provided by the media. Researched periods: 23-29 March and 13-20 April 2020. Total posts: 224. This study could be apart from a bigger social image of life during the pandemic when online activity had intensified.
A NEW APPROACH TO WESTINGHOUSE TEMPO RATING SYSTEM WITH FUZZY LOGIC
Authors: KİRAZ Alper , CENGİZ TOKLU Merve , ADALI Mehmet Rıza
Published: April 2021

When calculating the production cost of a product, two basic items are taken into consideration. The first is the material cost and the second is the labor cost. Material costs can be calculated very clearly due to the lack of personal judgment. Because the amount of material used for the production of that product is certain. However, the calculation of labor costs may not always be as simple and precise. The amount of product produced per unit time directly affects product costs. Therefore, to calculate the costs correctly, the number of parts produced per unit time must be calculated correctly. At this point, production times per product gain importance. It is not considered sufficient to use the values on the chronometer when calculating the production times of parts or products. Standard production times are calculated by adding performance and tolerance values to the chronometer values. Worker performance may vary from person to person. Performance varies depending on worker ability, effort, consistency and working environment. This difference in performance becomes very important in manual production processes. In automatic production processes, this difference is especially important when disassembling and assembly processes of the parts to the automatic machines. Tempo rating systems have been proposed to standardize worker performances and to minimize the negative effects of performance differences between individuals. The Classical Westinghouse Method is one of the common use tempo rating system. In the CWM, the performance of the worker is calculated by using skill, effort, environmental conditions, and consistency values. Evaluations of these four criteria are obtained by observing by decision-makers. In this study, the fuzzy rule-based Westinghouse method was developed because decision-makers use linguistic expressions to evaluate worker performance. The proposed Fuzzy Westinghouse Method is applied to a part of the company that produces automatic cutting machines in order to prove its validity. As a result of the study, it was determined that the proposed model produces more sensitive values.
OPTIMIZATION OF PLATE RECOGNITION SENSOR LOCATIONS: A CASE STUDY IN TURKEY
Authors: GÖR Buğra , KARAKAYA Gülşah
Published: April 2021

With the advances in sensor and data transfer technologies, the usage areas of Automatic License Plate Recognition (ALPR) systems have been expanded in the public and private sectors. In public safety, ALPR systems are used to monitor and control traffic data at both individual and collective levels. To build an efficient sensor network, the locations of ALPR systems should be determined optimally. This study provides an approach to determine optimal locations of ALPR systems that maximize network coverage consisting of two measures: i) vehicle coverage and ii) road coverage. The former represents the daily average vehicle flow whereas the latter stands for the number of road-links covered. The relative importance of vehicle and road coverages are taken into consideration, and optimal solutions under various scenarios are presented. A close neighbor constraint is introduced to avoid inefficient distribution of ALPR systems on the network. A case study with numerical examples designed for two cities in Turkey is provided. The centralized and decentralized solutions are compared against the current state, and the results show that the network coverage increases substantially in the centralized case.
AUDIT OF CALCULATIONS WHEN USING COMPENSATION OPERATIONS
Authors:   Moscow State University named after S.Y. Witte, Povarova E.S.
Published: April 2021

In a difficult economic situation, with an unfavorable influence of external or internal factors, organizations can use compensation operations. In the course of the audit, the auditor should comprehensively consider not only the compensation transactions, but also identify the reasons for such repayment of obligations by the audited debtor or obtaining the performance of obligation by the audited creditor. Compensation transactions may indicate to the auditor a certain aspects of the audit that need special attention. However, this requires effective tools for conducting verification of these operations in the form of working document formats and descriptions of the stages of verification of compensation operations. The purpose of the study is to present an algorithm for conducting an audit of compensation transactions in the course of conducting an audit, indicating the stages and use of audit procedures, as well as to propose working documents for conducting an audit. The used research methods are the grouping and systematization of information, the method of logical generalization, comparative and factor analysis. The article presents an algorithm for checking compensation transactions, considers the tax aspect of the features of compensation accounting, and provides the format of a working document when checking compensation transactions - both in the accounting of the debtor and the creditor. The above algorithm and working documents provide a methodological basis for conducting an audit.
SISTEM PAKAR MENDIAGNOSA KELAINAN ORIENTASI SEKSUAL PADA ORANG DEWASA MENGGUNAKAN METODE CASE BASED REASONING (CBR)
Authors: Nasyuha Asyahri Hadi
Published: April 2021

Ketidaktahuan orang awam untuk mendiagnosa kelainan orientasi seksual maka dapat diatasi dengan menggunakan sistem pakar. Sistem pakar merupakan sistem yang berusaha mengadopsi pengetahuan manusia kekomputer dapat menyelesaikan masalah seperti yang biasa dilakukan oleh para ahli. Diharapkan dengan sistem pakar ini, pengguna dapat menyelesaikan masalah tertentu, tanpa bantuan para ahli dalam bidang tersebut.Untuk mengatasi permasalahan yang terjadi maka diperlukan sebuah aplikasi sistem pakar untuk mendiagnosa kelainan orientasi seksual. Salah satu metode sistem pakar  yang dapat mendiagnosa kelainan orientasi seksual pada orang dewasa adalah Case Based Reasoning (CBR). Case Based Reasoning (CBR) merupakan salah satu metode pemecahan masalah yang dalam mencari solusi dari suatu kasus yang baru, sistem akan melakukan pencarian terhadap solusi dari kasus lama yang memiliki permasalahan yang sama dan sudah pernah terjadi sebelumnya.Aplikasi yang dibangun dapat menghasilkan laporan hasil diagnosa. Laporan yang dihasilkan berdasarkan perhitungan yang dilakukan oleh sistem telah mengadopsi algoritma Nearest Neighbour sehingga lebih akurat dan tepat.Kata Kunci— Sistem Pakar, Kelainan Orientasi Seksual, Case Base Reasoning (CBR), Nearest Neighbour.
Kajian Literatur Evaluasi dan Sertikasi Kompetensi Lulusan Vokasi Bidang IT Indonesia Berbasis Sistem Pendukung Keputusan
Authors: Khairul Khairul , Tasril Virdyra
Published: April 2021

Pada era revolusi industri 4.0 manusia dituntut mampu menjawab tantangan zaman dengan kesiapan kompetensi kerja. Hal ini sejalan dengan arah pendidikan vokasi dimana lulusan dipersiapkan untuk mampu memenuhi permintaan dunia industri. Sehingga dibutuhkan evaluasi secara sistematis terhadap lulusan vokasi dalam hal ini difokuskan kepada lulusan dengan kompetensi bidang IT agar mereka sepenuhnya siap untuk terjun ke dunia kerja. Penelitian ini dilakukan untuk mengkaji literatur secara mendalam apakah evaluasi kompetensi lulusan vokasi bidang IT mampu memberikan kontribusi yang signifikan terhadap lulusan vokasi bidang IT untuk memenuhi standar kompetensi kerja industri. Evaluasi difokuskan pada beberapa metode pada bidang ilmu sistem pendukung keputusan. Untuk mengukur dan menganalisa kompetensi yang mereka miliki terhadap standar kebutuhan kompetensi kerja industri yang bergerak pada bidang IT. Kata Kunci : Evaluasi, Lulusan Vokasi Bidang IT, Sistem Pendukung Keputusan
The sunk cost fallacy in the implementation of virtual medical education
Authors: Gorshkov M.
Published: April 2021

Administrative decisions in the medical education are subject to the general theory of management, one of the key concepts of which is «sunk cost» – financial investment, time or other resource input that cannot be returned in the future. In medical education, these include investments in the construction, reorganization and reconstruction of buildings and premises, installations and upgrade of technologies, equipment and software, research and development, training and retraining of pedagogical personnel. One should avoid the sunk cost fallacy by not taking into consideration such non-returnable investment, when making a managerial decision on the implementation of virtual technologies into medical education.