Acute Comitant Esotropia in a Child With a Cerebellar Tumor

We report a case of acute comitant esotropia in a child with a cerebellar tumor. A 3-year-old boy was referred for management of a 9 month history of acute acquired comitant esotropia. On first presentation, the patient's angle of esodeviation was 50 prism-diopters (PD) at distance and near fixation without any lateral incomitance. The cycloplegic refraction revealed +0.75 diopters in both eyes. Very mild bilateral papilledema was found on the fundus examination, but the neurological examination did not reveal any other pathological findings. Brain MRI showed a 5 cm mass located in the midline of the cerebellum as well as hydrocephalus. The mass was completely excised and histological examination confirmed the diagnosis of pilocytic astrocytoma. Despite neurosurgery, the patient's strabismus remained unresolved. One year after neurosurgery, both medial rectus muscles were surgically recessed by 6 mm, resulting in esotropia of 8PD at distant and near fixation without restoration of bifoveal fusion at follow-up 2 years after the eye muscle surgery. Therefore, acute onset comitant esotropia in a child can be the first sign of a cerebellar tumor, even without any other neurological signs and symptoms

Leading open innovation across global strategic alliances: A grounded theory study

A problem exists in complex global markets to successfully coordinate and align the total competence of the value chain required to lead open innovation across global strategic alliances (Koudal & Coleman, 2003; Phipps, 2004). Forty-five individuals representing 36 organizations participated in the research study. The participants were asked 13 questions on how leaders coordinate and align human, information, and organizational capital to lead open innovation externally across alliance partners. Grounded theory qualitative research was used to analyze the content to ground leadership theory from the interrelationship of the categories. To lead open innovation, the data findings indicate the core phenomenon centers on unmet customer needs. The data indicate the importance of culture, collaboration, partner selection, and alliance management. The intervening condition that empowers organizational change is thought leadership. The causal conditions are directly linked to globalization and fueled by technology advances and intense competition. The strategies that emerged from each of these categories interrelate with open innovation leadership theory