bluuebunny/crossref_metadata_2025 huggingface dataset:
Jules Blancard (1815-1888)
Authors: Arnoux-Farnoux Lucile
Published: October 2022

En 1880, un enseignement de grec moderne est créé à l’université de Marseille, alors qu’à cette époque cette langue n’est enseignée, en France, qu’à l’École des langues orientales. Il ne s’agit cependant pas d’une chaire mais d’un « cours annexe » professé à la faculté des sciences par Jules Blancard (1815-1891). Élève de Charles‑Benoît Hase, ce néo‑helléniste a commencé sa carrière comme secrétaire-interprète de la toute nouvelle École française d’Athènes, en 1846, pour se diriger ensuite vers l’enseignement. Il est également l’auteur d’essais historiques et de diverses traductions. Le parcours atypique de ce philhellène révèle à quel point, durant tout le xixe siècle, le domaine des études néo‑helléniques occupe une place marginale dans le monde académique français et repose essentiellement sur l’initiative individuelle.
Les francophiles Grecs au début du XXe siècle
Authors: Manitakis Nicolas
Published: October 2022

En abordant la question de l’intensité des rapports francohelléniques, tout au long de la période allant de la fondation de l’État hellénique et jusqu’à la guerre greco-turque de 1922, en se posant notamment la question des canaux par lesquels se sont opérés les contacts entre les deux pays, cet article focalise sur les francophiles Grecs. En effet, ceux-ci se sont avérés non seulement des solides appuis des intérêts et de la présence française en Grèce, mais également des intermédiaires facilitant les échanges entre les deux pays. Si leur présence est à signaler tout au long du xixe siècle, force est de constater qu’aux cours des deux premières décennies du xxe un important tournant s’est produit. On observe en effet au cours de cette période une mobilisation sans précèdent des milieux francophiles en Grèce, mobilisation ayant conduit, entre autres, à l’apparition des premières associations francophiles. L’article met l’accent sur le contexte national et international favorisant cette évolution. Il examine, par ailleurs, la composition sociale et professionnelle de ces groupements. Il s’avère ainsi que le lien le plus solide avec la France s’est souvent produit au moyen d’un séjour d’études ou d’une formation professionnelle acquise sur le territoire français et par opposition aux activités des diplômés et stagiaires Grecs formés en Allemagne, qui favorisaient la circulation en Grèce d’un savoir-faire concurrent allemand. L’opposition qui n’a pas tardé à se manifester entre francophiles et germanophiles Grecs a eu comme conséquence un renforcement de l’identité même de francophile, alors même que ce type d’opposition traversait, dans les années 1910, un grand nombre de pays européens et même de pays d’autres continents (Amérique Latine).
A Model for MOOC Implementation in Areas of Low Bandwidth in Developing Countries
Authors: Sigama Khuliso , Kalema Billy Mathias
Published: October 2022

Massive open online courses (MOOCs) could have been leveraged to bridge the education accessibility inequality gap in many developing countries, however many of the MOOCs platforms are developed to work in areas with good internet connections and high bandwidth leaving many rural areas excluded. The goal of this study was to develop a MOOCs model for areas with low bandwidth in developing countries. Literature search of technology implementation factors was carried out from which a conceptual model was designed. Using design science approach, the conceptual model was based on to developed an artifact of MOOCs platform that could be used in areas of low bandwidth. The artifact was evaluated using data collected from learners of tertiary institutions in South Africa. Results indicated that the developed artifact is suitable for use in areas of low bandwidth and that the model is a good guideline to the implementation of MOOCs platforms.
Real-Time Surveillance System for Detection of Social Distancing
Authors: Babulal Kanojia Sindhuben , Das Amit Kumar , Kumar Pushpendra , Rajput Dharmendra Singh , Alam Afroj , Obaid Ahmed J.
Published: October 2022

As the corona virus can mutate and due to other scientific factor associated to it, experts believe that COVID-19 will remain with us for decades. Therefore, one has to keep social distancing measures. Accepting the pandemic situation, the paper presents a mechanism for detecting violations of social distancing using deep learning to estimate the distance between individuals to diminish the influence of COVID-19. The focus of this paper is to understand the effect of social distancing on the spread of COVID-19 by using YOLOv3 and Faster-RCNN and proposes IFRCNN (improved faster region – convolution neural network). The proposed method IFRCNN is checked on a live streaming video of pedestrians walking on the street. This paper keeps the live updates of the recorded video along with social distancing violation records on a location, so how many people in a location are maintaining social distancing. Updates will be stored in a cloud-based storage system and any organization or firm can get live updates of that location in their digital devices.
Determining (s, S) Inventory Policy for Healthcare System
Authors: Pham Tai Duc , Sahasoontaravuti Sorachat , Buddhakulsomsiri Jirachai
Published: October 2022

In this paper, an (s, S) policy is determined by using a simulation-optimization approach for a periodic review inventory system at a pharmacy department of a major hospital in Thailand. The simulation, which imitates the inventory system behavior, is constructed on a spreadsheet, while the cyclic coordinate method with a golden section search is adopted as the optimization algorithm. Solutions for the policy's parameters from the search algorithm are evaluated using the simulation, which features randomly generated demand and lead time data from empirical distributions of actual datasets. The objective is to minimize the total inventory cost, including ordering, holding, and shortage costs. This model is applied for 10 medicine items, selected as representatives of the entire item range in the pharmacy department. According to the simulation results, a minimal cost inventory policy for each item is obtained within a short amount of run time. This indicates the effectiveness and efficiency of the proposed approach for this type of problem.
Wolf Pack's Role Matching Labor Division Model for Dynamic Task Allocation of Swarm Robotics
Authors: Hu Jinqiang , Zhan Renjun , Wu Husheng , Li Yongli
Published: October 2022

First, through in-depth analysis of the diversified collective behaviors in wolf pack, this study summarizes four remarkable features of wolf pack's labor division. Second, the wolf pack's role-task matching labor division mechanism is investigated, namely the individual wolves perform specific tasks that match their respective roles, and then a novel role matching labor division model is proposed. Finally, the performances of RMM are tested and evaluated with two swarm robotics task allocation scenarios. It is proved that RMM has higher solving efficiency and faster calculation speed for the concerned problem than the compared approach. Moreover, the proposed model shows advantages in the task allocation balance, robustness, and real time, especially in the dynamic response capability to the complex and changing environments.
A Privacy-Preserving Authentic Healthcare Monitoring System Using Blockchain
Authors: Raj Anu , Prakash Shiva
Published: October 2022

Integrating the internet of things (IoT) and healthcare monitoring systems is one of the most dynamic innovations in the research area. Since the tremendous number of IoT devices in smart healthcare systems is increasing exponentially, privacy and security issues related to the patient's data are significant concerns. The authors propose an access control for a healthcare monitoring system using blockchain-based smart contracts. They created four smart contract forms for user registration, authentication, access control including misbehavior detection and access revocation. The sensor automatically measures the patient's health data and filters the data before determining whether to write the data into the blockchain or not. The sensor detects abnormal data and alerts doctors and hospitals for immediate treatment. The efficiency of the proposed framework is verified by performance evaluation based on the Ethereum test environment. The proposed system outperforms existing approaches by reducing deployment and execution latency and average response latency in the real-time smart healthcare system.
The art of colour blind neurologist Paul Richer
Authors: Gunatilake Saman B.
Published: October 2022

No abstract available.
Letter to the Editor, Vol.8(1)
Authors: Gunesekera Sudath
Published: October 2022

No Abstract available.
Neurology Quiz Vol.8(1)
Authors: Alibhoy A.T.
Published: October 2022

No abstract available.
Anticancer Activity of tin Oxide and Cerium-Doped Tin Oxide Nanoparticles Synthesized from Ipomoea Carnea Flower Extract
Authors: Prasanth Manivannan , Muruganandam Gurusamy , Ravichandran Krishnasamy , Dayana Jeyaleela Gnanasekar , Shanthaseelan Krishnasamy , Priyadharshini Baskaran Pradhiba
Published: October 2022

Background:

The aim of the study is to investigate the anticancer potential of tin oxide (SnO2) and different concentrations (2%, 4%, 6%, and 8%) of cerium-doped tin oxide nanoparticles (Ce-SnO2 NPs) using Ipomoea
carnea flower extract. The synthesized SnO2 and different concentrations (2%, 4%, 6%, and 8%) of Ce-SnO2 NPs was tested using a colorimetric-based 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay against MCF-7 human breast cancer cell line cells.

Methods:

Collection and preparation of plant extract is preliminarily carried out followed by the synthesis of Undoped and Cerium doped Tin oxide nanoparticles is achieved by standard protocol along with that its anticancer activity also studied in this research.

Results:

The anticancer activity increased in direct proportion to the cerium-dopant concentration. Experimental results demonstrated that 8% Ce-SnO2 NPs exhibited a potential anticancer effect compared with SnO2 and other concentrations of Ce-SnO2 NPs.

Conclusion:

According to the current findings, large-scale manufacturing of Ce-SnO2 NPs might be recommended to have effective anticancer agents against breast cancer cell lines.
Synthesis of Silver Nanoparticles using Nigella sativa Seed Extract and its Efficacy Against Some Multidrug-Resistant Uropathogens
Authors: Ezeh Christian Kelechi , Eze Chibuzor Nwadibe , Dibua Marie Esther Uju , Emencheta Stephen Chijioke , Ezeh Cornelius Chukwuemeka
Published: October 2022

Background:

Urinary tract infection (UTI) is one of the most chronic infections in humans, as well as the most common cause of multidrug-resistant (MDR) pathogen emergence, necessitating the quest for stringent antibiotic treatment. In the imperative search for effective drugs to combat MDR, silver nanoparticles (AgNPs) are given priority. The objective of this study was to synthesize, characterize, and evaluate the antimicrobial activity of AgNPs synthesized using Nigella
sativa on MDR uropathogens.

Methods:

Urine samples of suspected UTI patients were collected using sterile sample bottles and cultured on different agar media to isolate and identify uropathogens using conventional method. All isolates were screened for multidrug resistance by disk diffusion method following the Clinical and Laboratory Standards Institute guideline with slight modification. N. sativa seed extract was used to synthesize AgNPs from aqueous solution of silver nitrate (AgNO3). AgNPs formed were characterized using ultraviolet-visible (UV-Vis) spectroscopy, scanning electron microscope (SEM), dynamic light scattering, Fourier transform infrared spectroscopy, and X-ray diffraction spectroscopy (XRD). Antibacterial activities of synthesized AgNPs were assessed (in vitro) by disc diffusion method against MDR isolates, and cytotoxicity was evaluated using brine shrimp lethality assay. The formed AgNPs were characterized using UV-Vis, and antibacterial activity of synthesized AgNPs was assessed (in vitro) by impregnated disc diffusion method against MDR isolates.

Results:

Escherichia
coli, Klebsiella sp., and Staphylococcus aureus were isolated. Multiple antibiotic-resistant indexes of the isolates ranged between 0.4 and 0.75 against the different standard antibiotics tested. The color change from pale yellow to dark brown was indicative of AgNP formation. UV-Vis spectrum of solution containing AgNPs exhibited peak wavelengths of 378 nm. Fourier transform infrared spectroscopic analysis showed that terpenoids, flavonoid, and phenols played an important role in the biosynthesis. Irregular shapes within nanoscale range were detected using SEM. XRD showed that the particles were crystalline in structure with an average size of 32 nm. The mean diameter zone of inhibition (in mm) for the different isolates at the dose of 100 μg/mL concentration showed maximum for E. coli (18 mm) followed by both Klebsiella sp. and S.
aureus at 17 mm.

Conclusion:

The study underscores the efficacy of the plant-mediated nanoparticles as well as their potential for use as broad-spectrum antimicrobial agents for the management of MDR uropathogens.
Phytochemical and Pharmacological Profile Review of Bryophyllum Pinnatum
Authors: Selvakumar P.
Published: October 2022

Herbs are plants grown for their medicinal, flavoring, or aromatic properties. Herbal treatments are safe and efficient for treating a wide range of ailments. Western medicine, or allopathy, is primarily reliant on medicinal plants for some of its constituents. Herbal plants are the traditional and widely used type of medication, according to research. Until the last century, most remedies were made by hand, either from plants or animals. Synthetic pharmaceuticals are becoming increasingly popular, whereas natural drugs are showing promise in treating various disorders. A perennial plant thrives in India's wet and hot regions, like Bengal. It has 25 genera and 450 species. Succulent perennials have hollow stems, four-angled leaves, and numerous branches. The leaves are 10–20 cm elongated and decussate. A long petiole surrounds the three- to seven-foliate top leaf. They are dark green and scalloped with red ribbons. 30-35 cm long, 2–4 cm petioles, 6–8 X 3-5.5 cm blades, with latent buds that can develop into healthy plantlets with an acute tip. Rooting vegetative buds are on the leaves. This aromatic plant has been used for groups to heal many ailments. These studies look at the plant's acute toxicity, antiulcer effectiveness, and pharmacognostic properties. The plant's macrostructure varied. Microscopic examination discovered lignified walls in the root and stem bark. Phytochemical examination can identify plant metabolites. Leaves, stems, and roots had more physiologically lively constituents than the other three plant sections. Although more research is required to identify the molecules and their potential health effects, these substances must be extracted and evaluated for future application. This study's findings support Bryophyllum
pinnatum medicinal potentials. B. pinnatum roots, stems, and leaves contain bioactive compounds worth investigating. This could help B. pinnatum-based pharmaceuticals.
Pretargeting Articulation for Improving the Deliverance of Injected Dose to the Tumor
Authors: Garg Pankaj
Published: October 2022

Background:

Radiobioconjugate targeting using monoclonal antibodies linked to a high-energy radionuclide is a promising approach for treating metastatic cancer. The central problem of radiobioconjugate targeting is the small fraction of radiobioconjugate localized in the tumor. Pretargeting based on avidin–biotin approach has been recommended to maximize tumor targeting. The current study was conceded with an aim to assess a selective targeting strategy for the site-specific deliverance of an injected radioactive dose to the tumor cells.

Methods:

Two labeling protocols were tested and evaluated, both for the direct and indirect radiolabeling of antibodies with radionuclide technetium. A comparative evaluation of biodistribution studies relating to the deposition of injected dose in different organs was carried out in tumor-bearing nude mice both for a direct single-step and indirect multistep pretargeting approach.

Results:

High concentration of the injected dose was accounted in the nontarget organs and blood for a direct targeting mode, as compared to indirect multistep pretargeting with high tumor uptake. Better tumor visibility and high tumor/nontumor ratio were observed at 24 h and 48 h. However, a considerable deposition of radioactivity in the organs such as liver, spleen, kidney, and lungs as a nonspecific, reticuloendothelial system uptake was observed as a cause of concern and the use of certain blocking agents were explored, effective for reducing the same.

Conclusions:

The study demonstrates a successful targeting efficiency of the radiolabeled bioconjugate for technetium (Tc-99m), through a multistep pretargeting approach, and the same can be applied for other related therapy radionuclides also.
Characterization of Small Colony Variants of Klebsiella pneumoniae
Authors: Hassan Dania , Magaogao Michael , Hossain Ashfaque
Published: October 2022

Background:

Small colony variants (SCVs) of bacterial pathogens are smaller, slow-growing variants which often pose a challenge to the clinical microbiologist in their identification and characterization. SCVs are receiving much attention in recent years due to their association with several types of chronic infections. In this study, we aimed to develop a suitable culture media for high frequency generation and stable maintenance of SCV of Klebsiella
pneumoniae. We also intended to compare different phenotypic characteristics such as growth, antibiotic resistance pattern, and biofilm-forming potential of SCVs with the original parental strain.

Methods:

We used Mueller–Hinton agar containing the extract of clove (Syzygium
aromaticum) for the generation of SCV. Antibiotic sensitivity was determined using disk diffusion method and minimum inhibitory concentration determinations using microdilution method. Biofilm formation was assessed using crystal violet dye binding assay.

Results:

Mueller–Hinton agar (MHA) containing clove (Syzygium
aromaticum) extract (10% volume/volume; MHA-C10) supported generation of SCV from K.
pneumoniae at high frequency. SCVs were smaller in colony size and grew slowly in comparison to the wild-type original strain. In addition, SCVs exhibited increased resistance to aminoglycoside group of antibiotics (gentamicin and kanamycin). Crystal violet dye binding spectrophotometric method showed increased biofilm formation potential by SCVs in comparison to their parental counterparts.

Conclusions:

The findings of this study show that MHA-C10 can be used as a bacterial culture media for the formation of SCV by K.
pneumoniae. SCVs, thus, generated on MHS-C10 exhibited typical characteristics of SCVs.
A Novel Experimental Static Deflection Equation for Specific Cantilever beam Made of Ionic Polymer–Metal Composite
Authors: Nasrollah Amin , Farnia Poopak , Hamidgorgani Saba , Ghanavi Jalaledin
Published: October 2022

Background:

Nowadays, ionic polymer–metal composites are widely used in various industries. They are in the group of electroactive polymers and smart materials with electromechanical properties. By applying a small amount of voltage, the nonlinear stress inside them will happen and their deformation can be seen. The energy transformation from electrical to mechanical is observable during the process of giving voltage to a specimen. The aim of this study is to investigate a novel experimental static deflection equation for specific cantilever beam made of ionic polymer–metal composite.

Methods:

In this paper, an ionic-polymer-metal composite is provided; the main core is based on an electroactive Fluoropolymer named Nafion, and the coated electrodes are made of Platinum. The length of the specimen is 27.131 mm and its width is 5.728mm. Voltage from 1.5 to 4.3V was applied to the specimen used in this study; the y-directional displacement of the IPMC at each step is measured and recorded; then, a finite element analysis was performed. Curve fitting of the data for the experimental analysis was also done. Moreover, the governing relations of IPMC according to the Nernst–Planck equation were investigated in this study.

Results:

The results have been validated in two forms of finite element method and experimental analysis. The results of finite element analysis showed that the ion flux in the polymer is calculated by the equation: [INSIDE:1]. In other words, this equation, which is called Nernst–Planck, is the basic equation of this type of material. This equation is the main governing equation to describe the transfer phenomena of IPMC materials. Furthermore, in order to calculate the deflection of IPMC membrane, 19 equations designed in this study were used. In the next step, the results of the experimental analysis showed that, based on the field emission scanning electron microscope images, the Nafion surface is completely sandblasted and its area is completely uniform. The right image taken by Dino-Lite shows the thesis effect on the electrode. Furthermore, the results showed that IPMC has high-quality coated electrodes.

Conclusions:

It is shown that a nonlinear equation governs the behavior of IPMCs' deflection versus voltage.
The Association of Serum Creatine Phosphokinase Levels with Severity of Lung Involvement and Hypoxia in Patients with COVID-19
Authors: Kiani Arda , Rahimi Fatemehsadat , Afaghi Siamak , Mehrparvar Marjan , Tavana Sasan , Varharam Mohammad , Abedini Atefeh
Published: October 2022

Background:

An increase in the serum levels of creatine phosphokinase (CPK) could be associated with an unfavorable clinical outcome in coronavirus disease (COVID-19) patients; however, detailed information on this association is scarce. The aim of this study was to investigate upon admission CPK serum level and its relationship with the degree of involvement in chest computed tomography (CT) scans and hypoxia in patients with COVID-19.

Methods:

This cross-sectional survey was conducted on 191 COVID-19 patients who were referred to a major respiratory referral center in Tehran, Iran, in 2019. CPK serum level, oxygen saturation, blood pressure, temperature, and severity of lung involvement (based on lung CT scan) were measured. The severity of lung involvement in cuts of CT imaging was reported with a score between 1 and 4. The descriptive and relational statistics were conducted using Pearson's correlation coefficient and one-way analysis of variance.

Results:

The average age of the patients was 55.22 ± 15.39 years, and the male was predominant in gender (65.4%). There was a statistically significant relationship between CPK serum level and the severity of lung involvement in patients with COVID-19 (P = 0.04). Furthermore, a significant and reverse correlation was observed between CPK serum level and oxygen saturation in the patients (r = –0.160, P = 0.04).

Conclusion:

The results of this study showed that COVID-19 patients with elevated CPK levels upon admission are prone to more severe lung involvement, worsening oxygenation, and respiratory failure. Hence, considering the initial critical care strategies for such patients could be of the essence.
Endoscopic Changes in the Gastrointestinal Tract in Children with Helicobacteriosis
Authors: Turdieva Shokhida Tolkunovna
Published: October 2022

Background:

All over the world, chronic gastroduodenal pathology (CGDP) occurs in children from 3.2% to 52% and takes 2nd place after diseases of the respiratory system. The main pathogen is Helicobacter pylori (HP), and the problem of studying endoscopic changes in the stomach and duodenum in n these children remains relevant. This study investigated changes observed by esophagogastroduodenoscopy (EGD) examination of the mucous layer of the upper digestive tract in children CGDP and its features in HP infection.

Methods:

A total of 128 children aged 6 to 15 years exhibited CGDP. All patients underwent EGD, with a description of the visible mucous membrane of the stomach and duodenum. Research on HP infection was carried out by two methods: a breath test and an immunochromatographic faecal test.

Results:

It was noted that the rate of Helicobacter pylori infection was higher in patients with ulcerative lesions of the gastrointestinal tract than in patients with inflammatory processes (on average 1: 0.6). A high prevalence of gastroesophageal and duodenogastric reflux was revealed in patients with HP infection. In children with HP infection, atrophic lesions of the antrum and body of the stomach, bulbar and distal duodenum prevailed.

Conclusions:

Gastric ulcers and duodenal ulcers developed 94% more often in children with HP infection than in HP-uninfected patients (P<0.005), and atrophic changes in the mucous layer of the stomach and intestines were 4 times more common against the background of the more common gastroduodenal (by 77.6%) and duodenogastric (by 67.4%) reflux.
Semiautomated disinfection of ophthalmic contact lenses
Authors: Sudheer Kandagaddala Venkata , Kamesh Kodavali Venkata , Vardhan Ashok
Published: October 2022

The ophthalmic lenses that come in contact with the eyes pose a high risk for the transmission of bacterial and viral infections in eye clinics. Disinfecting these lenses does not happen stringently in a busy practice. We describe a novel method of disinfecting ophthalmic contact lenses using a semiautomated lens disinfector equipment, semiautomated lens disinfector. The equipment has motors to pump in and pump out water and disinfecting solution into a reservoir bath. The used ophthalmic lenses will be placed in a tray that partially dips into the bath for disinfection. Microbiology tests that were done to check the quality of the disinfection cycle showed good outcomes. Disinfection of ophthalmic contact lenses with the new equipment appeared to effectively eliminate contaminant microorganisms. This equipment can be used in busy ophthalmic clinics to alleviate the chances of cross-infection.
Evaluation of visual field changes with retinal nerve fiber layer thickness in primary congenital glaucoma
Authors: Naik Anand , Sihota Ramanjit , Mahalingam Karthikeyan , Angmo Dewang , Dada Tanuj , Kumar Ajay , Kumar Ashok , Gupta Amisha
Published: October 2022

Purpose:

To evaluate visual field changes in primary congenital glaucoma (PCG) with retinal nerve fiber layer thickness on optical coherence tomography.

Methods:

In this cross-sectional, observational study, consecutive PCG children who underwent combined trabeculotomy with trabeculectomy and on regular follow-up were enrolled. All patients were aged over four years and co-operative for RNFL OCT and visual field examination. Perimetry was done on Humphrey visual field (HVF) analyzer using 30-2 and 10-2 SITA standard algorithms as appropriate. If a reliable automated perimetry was not feasible, kinetic perimetry was done. The following were noted at baseline and every follow-up: age, sex, visual acuity, intraocular pressure (IOP), cup–disc ratio (CDR), corneal diameters, refraction, any topical antiglaucoma medications, surgeries underwent, age at surgery and duration between surgery and final examination.

Results:

Forty-eight eyes of 34 children operated for PCG and 19 eyes of 17 controls were analyzed. A statistically significant thinner average RNFL thickness of 87.2 ± 28 μm was noted in PCG eyes as compared to controls with 100.6 ± 7.2 μm (P = 0.04). The mean cup–disc area ratio on OCT in PCG eyes was 0.43 ± 0.2 (0.02–0.93) and in control eyes was 0.23 ± 0.07 (0.1–0.4) (P < 0.001). On RNFL OCT, there was significant focal RNFL loss in temporal superior (P = 0.003), nasal inferior (P = 0.037) and temporal inferior (P < 0.001) quadrants compared to controls. Among PCG eyes, 20/48 eyes (41.7%), had definitive, reproducible glaucomatous VF defects. Mean baseline IOP in PCG eyes with VF defect was 28.7 ± 5.7 mmHg and in eyes with normal VF was 24.6 ± 5.9 mmHg (P = 0.03). On univariate regression analysis, higher baseline IOP was significantly associated with both RNFL loss (odds ratio (OR): −2.17) and VF defects (OR: 3.35). Fluctuation in follow-up IOP (OR: 3.33) was also significantly associated with the presence of VF defects. On multivariable regression analysis maximum, IOP was significantly associated with RNFL loss and VF defects.

Conclusion:

Peripapillary RNFL thickness could be used to identify PCG eyes having visual field loss and possibly poor visual function from PCG eyes without visual field defects. Baseline and follow-up IOP, significantly correlated with RNFL thickness in PCG eyes.
The economic and social costs of visual impairment and blindness in India
Authors: Wong Brad , Singh Kuldeep , Khanna Rohit K , Ravilla Thulasiraj , Shalinder Sabherwal , Sil Asim , Dole Kuldeep , Jain Elesh , Chase Heidi
Published: October 2022

Purpose:

To provide a current estimate of the economic and social costs (or welfare costs) of visual impairment and blindness in India.

Methods:

Using evidence from the recently conducted Blindness and Visual Impairment Survey across India, the Lancet Global Health Commission on Global Eye Health and other sources, we developed an economic model that estimates the costs of reduced employment, elevated mortality risk, education loss for children, productivity loss in employment, welfare loss for the unemployed, and caregiver costs associated with moderate and severe visual impairment (MSVI) and blindness. Probabilistic sensitivity analyses were also conducted by varying key parameters simultaneously.

Results:

The costs of MSVI and blindness in India in 2019 are estimated at INR 1,158 billion (range: INR 947–1,427 billion) or $54.4 billion at purchasing power parity exchange rates (range: $44.5–67.0 billion), accounting for all six cost streams. The largest cost was for the loss of employment, whereas the the second largest cost was for caregiver time. A more conservative estimate focusing only on employment loss and elevated mortality risk yielded a cost of INR 504 billion (range: INR 348–621 billion) or $23.7 billion (range: $16.3–29.2 billion).

Conclusion:

Poor eye health imposes a non-trivial recurring cost to the Indian economy equivalent to 0.47% to 0.70% of GDP in the primary scenario, a substantial constraint on the country’s growth aspirations. Furthermore, the absolute costs of poor eye health will increase over time as India ages and becomes wealthier unless further progress is made in reducing the prevalence of MSVI and blindness.
Gore-tex a magic sheet for symblepharon prevention!
Authors: Venugopal Anitha , Ravindran Meenakshi
Published: October 2022

Background:

Symblepharon occurs as chronic sequelae of severe chemical injuries. The risk of recurrence is high due to unpredictable wound healing of conjunctiva and tenons following excision in young patients. Gore-tex aids in prevention of the recurrence of pterygium 1.

Purpose:

To present a surgical video on role of Gore-tex in grade 4 Symblepharon lysis.

Synopsis:

A 28-year-old male with a previous history of Grade 4 chemical injury presented with symblepharon and total obliteration of both upper and lower fornices after one year in the right eye. He underwent symblepharon lysis, Living related conjunctival allograft, Amniotic membrane graft and Gore-tex. The video explains the surgical steps in detail. A 360-degree complete peritomy was done, Symblepharon was released from the corneal surface, and the fibrotic tissue was extensively dissected away from the corneal surface and released into the fornix. Further, cryopreserved AMG was placed over the entire raw ocular surface and sutured to the episclera with glue. Prepared Gore-tex was placed on the superior and inferior fornix and sutured with 10-0 nylon suture. Again, AMG was placed over the Gore-tex in the fornices and covered with glue. A small 2x2mm biopsy of limbal stem cells from the superior limbus was already excised from the fellow eye (CLAG) and then Lr-CLAL was prepared from the patient’s mother. These two grafts were placed on the nasal and temporal bulbar surface over the AMG and sutured to the underlying AMG and the episclera with glue. The entire surface was then covered with the AMG to promote epithelisation. At one month postoperative period, patient had stable ocular surface with intact Limbal conjunctival graft with mild conjunctival recurrence of fibrosis superiorly.

Highlights:

The video clearly explains the surgical steps of Symblepharon and the benefits of using Gore-tex.

Online Video Link:

https://youtu.be/aFfq2x9QBwA

Key words: Gore-Tex, Symblepharon recurrence, Prevention of growth
Analysis of hesitancy and motivational factors for COVID-19 vaccination among patients presenting to eye care hospitals – A multicenter questionnaire-based survey
Authors: Kaur Kirandeep , Annamalai O , Gurnani Bharat , Rekha Sreedhar , Jayashree B , Venugopal Anitha , Narendran Kalpana , Ravilla Sathya T , PR Aswin , Venkatesh Rengaraj
Published: October 2022

Purpose

To analyze the hesitancy and motivational factors related to coronavirus disease 2019 (COVID-19) vaccination among patients visiting for eye care.

Methods

A telephonic survey was conducted using validated questionnaires consisting of 36 questions in five sections from July 1 to July 31, 2021. Patients visiting six tertiary centers and one secondary center of our eye hospitals were interviewed over their phones, and their responses were entered onto the Google forms. The responses were recorded as demographics, health status, awareness about vaccination, factors contributing to hesitancy or acceptance to vaccinate, and general perception about the vaccine.

Results

A total of 5033 patients were surveyed. The mean age was 49.0 ± 14.2 years. A total of 563 (11.2%) patients gave a history of symptoms or were tested positive for COVID-19; 2225 (44.2%) patients were already COVID-19 vaccinated. Around 2883 (56%) patients were aware of getting infection despite vaccination, and 4092 (81.3%) perceived vaccination should be compulsory. The main reason for vaccination hesitancy was the fear of side effects (n = 487, 17.3%). The fear of getting infected was the most common reason for vaccination (n = 911, 40.9%). Factors associated with a lower proportion of vaccinated individuals included younger age (P < 0.001), female gender (P < 0.001), lower education (P < 0.001), lower income (P < 0.001), and rural residence (P = 0.33).

Conclusion

Creating awareness about the minor side effects and reassurance can allay an individual’s fears. The fear associated with the rapid spread of infection and associated mortality needs to be utilized to increase vaccination acceptance. A targeted approach toward groups with poor uptake of vaccination is necessary.
Potential impact of fluorescein angiography as a primary imaging modality in the management of diabetic retinopathy
Authors: Ashraf Mohamed , Wagdy Walaa , Tawfik Mohamed A , Ahmed Islam Shereen Hamdy , Souka Ahmed
Published: October 2022

Purpose:

To evaluate current practice patterns for Egyptian ophthalmologists in the diagnosis of diabetic retinopathy (DR) and explore potential implications of these approaches on management.

Methods:

Cross-sectional survey conducted in Egypt amongst practicing ophthalmologists.

Results:

The study had 203 responses (~6% of all Egyptian ophthalmologists). A majority of respondents were general ophthalmologists (78.2%), practicing for five to ten years (41.9%). In patients with DR and no diabetic macular edema (DME), 33.0% of respondents would use FA in patients with mild DR, 44.3% in patients with moderate DR and 51.2% in patients with severe non-proliferative diabetic retinopathy (NPDR). Color imaging (CI) was used by less than 1% as the sole imaging modality for any level of DR. Approximately 70% of respondents used fluorescein angiography (FA) to grade and base treatment decisions for DR, either alone or in conjunction with dilated eye exams and/or CI. Given the known more severe appearance of DR on FA than on standard color imaging upon which treatment guidelines are based, use of FA as the primary modality over a one-year period could result in PRP that would otherwise not be suggested in approximately 78,820 eyes at an additional cost of $10.1 million US dollars. These numbers are projected to double by 2045.

Conclusion:

Given that FA detects significantly greater pathology than CI, and that treatment and follow-up recommendations are based on CI, its use as the primary imaging modality in DR grading may result in apparently significantly higher DR severity, with subsequently increased procedures and associated costs.
Perceptual learning with hand – eye coordination as an effective tool for managing amblyopia: A prospective study
Authors: Shah Shreya , Shah Mehul , Purohit Anand , Khanguda Vaibhav
Published: October 2022

Purpose

Amblyopia is a serious condition resulting in monocular impairment of vision. Although traditional treatment improves vision, we attempted to explore the results of perceptual learning in this study.

Methods

This prospective cohort study included all patients with amblyopia who were subjected to perceptual learning. The presenting data on vision, stereopsis and contrast sensitivity were documented in a pretested online format, and the pre- and post-treatment information was compared using descriptive, cross-tabulation and comparative methods on SPSS 2.2. The mean values were obtained, and P < 0.05 was considered statistically significant.

Results

The cohort consisted of 47 patients (23 females and 24 males) with a mean age of 14.11 ± 7.13 years. A statistically significant improvement was detected in visual acuity after the perceptual learning session, and the median follow-up period was 17 days. Also, significant improvements were observed in stereopsis but not in the visual outcomes among the age groups.

Conclusion

Perceptual learning with hand–eye coordination is an effective method for managing amblyopia. This approach can improve vision in all age groups. However, visual improvement is significantly influenced by ocular alignment.
Comparing retinal sensitivities on blue-on-yellow and green-on-yellow perimetry in glaucoma suspects
Authors: Pokal Upasana , Swathi N , Rajalakshmi A R , Lokeshmaran A
Published: October 2022

Purpose:

To compare the retinal sensitivities between the blue-on-yellow perimetry (BYP)/short-wavelength automated perimetry (SWAP) and green-on-yellow perimetry (GYP) among patients with and without nuclear sclerosis among glaucoma suspects.

Methods:

After ophthalmic examination, patients were subjected to two perimetric tests: BYP and GYP. The visual field (VF) parameters were compared between the two perimeters (p < 0.05 was considered significant).

Results:

Fifty-five eyes of 39 patients with a mean age of 60.53 ± 9.70 years were included in the study. Twenty-one eyes had clear lens or pseudophakia. Twenty-six eyes had lower grades of nuclear sclerosis (NO2NC2, NO3NC3) and eight eyes had higher grades of cataract (NO4NC4, NO5NC5). The mean retinal sensitivity (RS) in BYP was 22.08 ± 5.02 (dB) and in GYP was 23.84 ± 5.50 (dB) (p = 0.08). The mean defect in BYP was -2.56 ± 4.40 (dB) and in GYP was -3.24 ± 5.05 (dB), pattern standard deviation (PSD) in BYP was 3.65 ± 1.91 (dB) and in GYP was 3.83 ± 1.99 (dB), and foveal threshold (FT) was 24.20 ± 4.32 (dB) in BYP and 28.10 ± 4.50 (dB) in GYP. The two perimeters showed good agreement by the Bland–Altman plot for all parameters. Fourteen eyes showed perimetric changes suggestive of glaucoma by BYP. In these, GYP had a sensitivity of 92.86% (95% CI of 66.13% to 99.82%) and specificity of 95.12% (95% CI of 83.47% to 99.40%).

Conclusion:

BYP and GYP show good agreement. They are comparable in clear media as well as in different grades of nuclear sclerosis. GYP showed good sensitivity and specificity compared to BYP.
The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosis
Authors: Kim Kyung Jun , Kim Doh Hyung
Published: October 2022

Background: Studies on the effects of viral coinfection on bacterial pneumonia are still scarce in South Korea. This study investigates the frequency and seasonal distribution of virus infection and its impact on the prognosis in patients with community-acquired pneumonia (CAP).Methods: The medical records of CAP patients with definite etiology, such as viruses and bacteria, were retrospectively reviewed. Their epidemiologic and clinical characteristics, microbiologic test results, the severity of illness, and 30-day mortality were analyzed.Results: Among 150 study subjects, 68 patients (45.3%) had virus infection alone, 47 (31.3%) had bacterial infection alone, and 35 (23.3%) had viral-bacterial coinfection, respectively. Among 103 patients with viral infections, Influenza A virus (44%) was the most common virus, followed by rhinovirus (19%), influenza B (13%), and adenovirus (6%). The CURB-65 score of the viral-bacterial coinfection was higher than that of the viral infection (median [interquartile range]: 2.0 [1.0–4.0] vs. 2.0 [0.3–3.0], P=0.029). The 30-day mortality of the viral infection alone group (2.9%) was significantly lower than that of bacterial infection alone (19.1%) and viral-bacterial coinfection (25.7%) groups (Bonferroni-corrected P<0.05). Viral-bacterial coinfection was the stronger predictor of 30-day mortality in CAP (odds ratio [OR], 18.9; 95% confidence interval [CI], 3.0–118.3; P=0.002] than bacterial infection alone (OR, 6.3; 95% CI, 1.1–36.4; P=0.041), compared to viral infection alone on the multivariate analysis. Conclusions: The etiology of viral infection in CAP is different according to regional characteristics. Viral-bacterial coinfection showed a worse prognosis than bacterial infection alone in patients with CAP.
The prognostic impact of rheumatoid arthritis in sepsis: a population-based analysis
Authors: Oud Lavi , Garza John
Published: October 2022

Background: Rheumatoid arthritis (RA) is associated with increased risk of sepsis and higher infection-related mortality compared to the general population. However, the evidence on the prognostic impact of RA in sepsis has been inconclusive. We aimed to estimate the population-level association of RA with short-term mortality in sepsis.Methods: We used statewide data to identify hospitalizations aged ≥18 years in Texas with sepsis, with and without RA during 2014–2017. Hierarchical logistic models with propensity adjustment (primary model), propensity score matching, and multivariable logistic regression without propensity adjustment were used to estimate the association of RA with short-term mortality among sepsis hospitalizations.Results: Among 283,025 sepsis hospitalizations, 7,689 (2.7%) had RA. Compared to sepsis hospitalizations without RA, those with RA were older (aged ≥65 years, 63.9% vs. 56.4%) and had higher burden of comorbidities (mean Deyo comorbidity index, 3.2 vs. 2.7). Short-term mortality of sepsis hospitalizations with and without RA was 26.8% vs. 31.4%. Following adjustment for confounders, short-term mortality was lower among RA patients (adjusted odds ratio [aOR], 0.910; 95% confidence interval [CI], 0.856–0.967]), with similar findings on alternative models. On sensitivity analyses, short-term mortality was lower in RA patients among sepsis hospitalizations aged ≥65 years and those with septic shock, but not among those admitted to intensive care unit (ICU; aOR, 0.990; 95% CI, 0.909¬¬–1.079).Conclusions: RA was associated, unexpectedly, with lower short-term mortality in septic patients. However, this “protective” association was driven by those patients without ICU admission. Further studies are warranted to confirm these findings and to examine the underlying mechanisms.
Evidence-based optimisation of empirical antibiotic regimens in paediatric complicated appendicitis: a retrospective study of 94 patients
Authors: Gerber Filippo , Joseph  Jean-Marc , Crisinel  Pierre-Alex , Andrey Véronique
Published: October 2022

BACKGROUND: Acute appendicitis is the most frequent surgical emergency in the paediatric population. Complicated appendicitis accounts for 30% of cases and is inextricably linked to postoperative infectious complications. A study at our institution showed that amoxicillin-clavulanate resistant Escherichia coli  in complicated appendicitis was significantly linked to postoperative infectious complications. These findings led to a change in the empirical antibiotic protocol (amoxicillin-clavulanate changed to ceftriaxone + metronidazole as of 2017), intending to reduce postoperative infectious complications in complicated appendicitis in our institution.
AIM OF THE STUDY: This study aimed to analyse the microbiology and resistance profiles of pathogens of complicated appendicitis at our institution since implementing the new antibiotic protocol and the postoperative infectious complications rate.
METHODS: We designed a retrospective comparative cohort study. During the defined study period (01 January 2017 to 31 July 2020), medical records were analysed for cases of acute appendicitis, complicated appendicitis and postoperative infectious complications, retaining only those who fulfilled inclusion criteria. Postoperative outcomes, microbiology and antibiotic resistance of peritoneal swabs were analysed.
RESULTS: During the study period, 95 patients presented with a complicated appendicitis, and 11 (12%) developed postoperative infectious complications. The most frequent pathogens found in complicated appendicitis were E. coli (66%), Streptococcus anginosus (45%), and Bacteroides fragilis (22%). Pseudomonas aeruginosa was present in 17% of complicated appendicitis. Pathogens involved in postoperative infectious complications mirrored the distribution found in complicated appendicitis without postoperative infectious complications. Antibiotic susceptibility analysis showed that 10 (15%) of E. coli strains were resistant to amoxicillin-clavulanate but sensitive to ceftriaxone + metronidazole, with only one strain responsible for causing a postoperative infectious complication. Six additional strains of E. coli (9%) were resistant to amoxicillin-clavulanate and our empirical antibiotic regimen but were not associated with an increase in postoperative infectious complications. Compared with our previous study, there was a decrease in postoperative infectious complications from 16% to 12%. Postoperative infectious complications caused by amoxicillin-clavulanate-resistant E. coli decreased from 28% to 9%.

CONCLUSION: This retrospective study demonstrated a decrease in the rate of postoperative infectious complications due to amoxicillin-clavulanate-resistant E. coli in complicated appendicitis. These findings accentuate the need to implement evidence-based treatment protocols based on local microbiology profiles and resistance rates to optimise post-operative antibiotics in complicated appendicitis.
Swiss Latin Airway Guidelines: a holistic approach for improving airway management
Authors: Casso  Gabriele , Savoldelli  Georges L. , Balmer  Christian , Ravussin  Patrick , Schoettker Patrick
Published: October 2022

Airway management is a core competency for many different medical specialties. Despite continuous improvements in equipment, clinical understanding, education and training, airway management complications remain a significant cause of morbidity and mortality worldwide. Several international airway management guidelines already exist, but there has never been a national consensus document for Switzerland. The Fondation Latine des Voies Aériennes (FLAVA) has developed a new set of airway management guidelines based on the latest scientific evidence and the authors’ extensive clinical experience. These recommendations are intended to guide and assist clinicians in managing a wide array of airway situations. They are applicable to the daily routine management of anticipated and unanticipated airway difficulties. The new 2022 FLAVA Airway Guidelines (FLAGs) combine cognitive aids for using the latest technical skills and non-technical skills. Specially-designed key mnemonics and ergonomic tools complement these guidelines, including a colour-coded airway cart.