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This study evaluates global health diplomacy and governance by performing bibliometric analysis to investigate the current publication trends, authors and keywords-based clusters, research trends, author's productivity, and future research areas. The analysis results suggest that global health diplomacy has garnered attention only in developed countries and has been researched negligibly in developing countries. The research in this field increases after the onset of pandemics such as Swine Flu and COVID-19. Authors kickbush and lee are the most influential authors based on their h index. The identified future research areas are "International laws" and "Social Determinants of Health."

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This study considers Theory of Reasoned Action and Technology Acceptance Model frameworks to test the mediating role of attitude towards using E-health platforms. 224 medical practitioners' responses are collected in the online mode. The mediation analysis supports the full mediation role of attitude towards using the E-health platforms in the relationship between perceived usefulness and intentions to use with (indirect effect = .15, SE = 0.03, LLCI = 0.09, and ULCI = .22). E-health platform developers should take active measures to improve the attitude of medical practitioners towards using such platforms, to derive the best results of the added features.

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Introduction: Hospitals struggle to implement MEWS. This study aims to improve MEWS implementation in the studied hospital.Objective: Improve the implementation of MEWS with the help of HFMEA.Materials: HFMEA together with training is used to improve the implementation.Results: The pre-intervention RPN got reduced from 1558 to 516 in the post-implementation phase.Application: This demonstrates improvement in the implementation of MEWS with the help of HFMEA, this study design can be widely used.Conclusion: The HFMEA is an effective tool to use for the improvement of MEWS implementation by the hospital nurses.

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PURPOSE: The aim was to investigate the effect of axial length on full-field electroretinogram (ffERG) and multifocal electroretinogram (mfERG) in young Indian subjects. METHODS: One hundred subjects (44 male) with refractive errors from +0.50 to -18.00 DS and no myopic retinopathy underwent axial length measurement. ffERG was measured, which included scotopic and photopic responses according to International Society for Clinical Electrophysiology of Vision (ISCEV) guidelines. The mfERG was recorded after correcting for refractive error according to ISCEV standards. The dark-adapted and light-adapted parameters of ffERG and N1, P1 parameters of six rings in mfERG were analysed with axial length, controlled for refractive error. The subjects were divided into seven groups based on axial length. The b/a ratio of dark-adapted and light-adapted 3.0 ffERG and P1/N1 ratio of mfERG amplitudes were analysed for seven groups of axial length. RESULTS: The axial length ranged from 21.79 to 30.55 mm. Significant negative correlations were noted for ffERG and mfERG amplitudes, whereas implicit times showed minimal delay with increase in axial length. In ffERG, the scotopic responses were more decreased compared to photopic responses. In mfERG, P1 and N1 amplitudes were significantly decreased in all the rings in all groups and more reduction was noted in the central ring compared to peripheral rings. The P1 amplitudes were more affected as compared to N1 amplitudes. The light-adapted and dark-adapted 3.0 ERG b/a ratio and P1/N1 ratio for seven axial length groups did not show statistically significant difference. The ERG parameters were not significant with refractive error. CONCLUSION: This study quantifies the relationship of axial length with ffERG and mfERG parameters in a young Indian population. Although the amplitudes were reduced significantly, the implicit times were not significantly affected. The ERG parameters were more related to axial length than refractive error. Hence, interpretation of ffERG and mfERG parameters needs careful consideration in subjects with increasing axial length.

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PURPOSE: To investigate the effect of optic neuritis (ON), ischemic optic neuropathy (ION) and compressive optic neuropathy (CON) on multifocal visual evoked potential (mfVEP) amplitudes and latencies, and to compare the parameters among three optic nerve disorders. MATERIALS AND METHODS: mfVEP was recorded for 71 eyes of controls and 48 eyes of optic nerve disorders with subgroups of optic neuritis (ON, n = 21 eyes), ischemic optic neuropathy (ION, n = 14 eyes), and compressive optic neuropathy (CON, n = 13 eyes). The size of defect in mfVEP amplitude probability plots and relative latency plots were analyzed. The pattern of the defect in amplitude probability plot was classified according to the visual field profile of optic neuritis treatment trail (ONTT). RESULTS: Median of mfVEP amplitude (log SNR) averaged across 60 sectors were reduced in ON (0.17 (0.13-0.33)), ION (0.14 (0.12-0.21)) and CON (0.21 (0.14-0.30)) when compared to controls. The median mfVEP relative latencies compared to controls were significantly prolonged in ON and CON group of 10.53 (2.62-15.50) ms and 5.73 (2.67-14.14) ms respectively compared to ION group (2.06 (-4.09-13.02)). The common mfVEP amplitude defects observed in probability plots were diffuse pattern in ON, inferior altitudinal defect in ION and temporal hemianopia in CON eyes. CONCLUSIONS: Optic nerve disorders cause reduction in mfVEP amplitudes. The extent of delayed latency noted in ischemic optic neuropathy was significantly lesser compared to subjects with optic neuritis and compressive optic neuropathy. mfVEP amplitudes can be used to objectively assess the topography of the visual field defect.

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PURPOSE: The aim was to investigate multifocal electroretinogram (mfERG) findings in Bietti's crystalline dystrophy (BCD) using a retrospective, non-interventional, consecutive case series. METHODS: Five patients, two women and three men (mean age 31.8 years), clinically diagnosed with BCD underwent full-field electroretinogram (ffERG) and mfERG using Burian Allen bipolar contact lens electrode on the VERIS Science 5.2.1X system. The ffERG and mfERG parameters of patients with Bietti's crystalline dystrophy were compared with age-matched normal subjects. The N1, P1 amplitudes and implicit times of the mfERG for the six concentric rings were analysed. RESULTS: The ffERG showed significant decreases in the amplitude of the scotopic and photopic responses in all patients; however, implicit times were only mildly prolonged. Rod response implicit times appeared to be more affected than the cone responses. The N1 and P1 amplitudes of mfERG showed a significant decrease in all rings in all patients. N1 implicit times were significantly delayed in rings 3, 4 and 5. The P1 implicit time was significantly delayed in all rings except 1 and 6. CONCLUSION: The mfERG in Bietti's crystalline dystrophy can provide insight into the functional retina and objectively help to quantify the extent of retinal damage.

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To investigate the effect of pituitary adenoma compressing the optic chiasm on multifocal visual evoked potential (mfVEP) responses and to compare these responses with visual field defects seen on static automated perimetry (SAP). Eight eyes of four subjects (median age, 41.50 years; interquartile range, 33-51 years) who were diagnosed with pituitary adenoma on magnetic resonance imaging (MRI) and seen to have a bitemporal visual field defect on standard automated perimetry (SAP), and twelve age-matched normal subjects (median age, 47.00 years; interquartile range, 34.75-51.75 years) were subjected to multifocal visual evoked potential (mfVEP) testing. The monocular latencies and monocular amplitudes of each sector of cases were compared with the responses of normative database. The topography of the mfVEP response was compared with corresponding field defect as seen in total deviation threshold on SAP to allow a comparison with conventional subjective perimetry. The mfVEP amplitudes were reduced in the areas with visual field defect on SAP. In 6 out of 8 eyes, locations with preserved amplitudes and no visual defects showed prolonged latency. A prolonged median latency of 9.17 ms (interquartile range, 3.44-17.69 ms) in cases was seen when compared to the median latency of 1.67 ms (interquartile range, 0.94-4.17 ms) in age-matched controls with P value of 0.054. Chiasmal compression due to pituitary adenoma causes the reduction of amplitudes and prolongation of latencies of the mfVEP response. The mfVEP can be used to assess objectively the topography of the visual field in compressive optic neuropathy secondary to pituitary adenomas. It can be used in assessing the subjects whose visual field report is unreliable and prolonged median latency can be an early sign of the disease.

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OBJECTIVE: To evaluate focal retinal function in patients presenting with features of X-linked retinoschisis (XLRS), with the use of multifocal electroretinography (mfERG). DESIGN: Consecutive observational case-control study. PARTICIPANTS: Eighteen eyes of 9 patients who presented to the retina clinic of Sankara Nethralaya from 2005 to 2008. METHODS: XLRS was diagnosed clinically and corroborated with full-field electroretinogram (ffERG), mfERG, and optical coherence tomography. ffERG and mfERG recordings were done with VERIS 5.2.2X according to International Society for Clinical Electrophysiology of Vision standards. The mfERG stimulus consisted of 103 hexagons flickered at a 75 Hz frame rate, subtended 35° horizontally and 31° vertically at a viewing distance of 53 cm. The amplitudes and implicit times of ffERG and first-order kernels of mfERG were analyzed and compared with those of the controls. RESULTS: P1 and N1 amplitudes were reduced and P1 and N1 implicit times were prolonged significantly in patients with XLRS, compared with controls. CONCLUSIONS: mfERG helps estimate focal retinal function in patients with XLRS.

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In new-paradigm research, empathic witnessing by the researcher might create within the researcher-participant relationship a space for participants to share and transcend their suffering. I explore this theme through the constructionist grounded theory analysis of interviews, fieldnotes, and my self-reflexive commentary from an original study conducted to understand the experiences of suffering and healing among the survivors of an earthquake that occurred in India in 2001. The five categories that emerged--getting overwhelmed while verbalizing suffering, search for the cultural meaning of the research relationship, piecing together of self, reaffirmation of moral status, and continuing bond revalidating the self--provide insights about this theme. Also, my reflections on participants' suffering and healing not only facilitated my healing but also inspired me to expand my boundary of I to feel "oneness" with all forms of nature or existence. The findings and discussion not only enhance understanding of the communications and complexities of the researcher-participant relationship, but indicate the nature of support and education needed if researchers are to be effective witnesses to suffering.

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PURPOSE: The purpose of the study was to evaluate focal macular function by using multifocal electroretinography in a patient presenting with features of desferrioxamine maculopathy. METHODS: This is an observational case-control study of a 74-year-old man taking desferrioxamine mesylate 40 mg/kg/d 4 to 5 times a week as an iron-chelating agent for 5 years. Desferrioxamine-related ocular toxicity presenting as bilaterally symmetrical pigmentary maculopathy was diagnosed by clinical examination and relevant history. Retinopathy was further corroborated with full-field electroretinography and multifocal electroretinography using VERIS Science 5.1 with Burian-Allen bipolar contact lens electrodes. First-order kernels were calculated and analyzed from six zones at different retinal eccentricities around the fovea. RESULTS: Clinical and electrophysiological investigations showed a bilaterally symmetric picture of desferrioxamine maculopathy, with P1 and N1 on multifocal electroretinography showing significantly reduced amplitudes and prolonged implicit times in both the eyes as compared with age-matched controls. CONCLUSION: Maculotoxicity may be the presenting feature of desferrioxamine toxicity, and multifocal electroretinography allows simultaneous measurements of multiple focal macular responses in these cases.

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