bluuebunny/crossref_metadata_2025 huggingface dataset:
La conférence de Seelisberg (1947). Préparatifs, déroulé et premières retombées
Authors: Rota Olivier
Published: January 2023

La conférence de Seelisberg (1947) est la seconde conférence internationale réunissant Juifs et chrétiens dans l'après-guerre. L'article traite des difficultés de sa longue préparation et de son déroulement, mais aussi de ses retombées médiatiques, plutôt modestes dans un premier temps, avant que les « Dix Points » de Seelisberg s'imposent comme un texte majeur dans l'histoire des relations judéo-chrétiennes.
Our Matters
Authors: Johnson Harrison P. , Cook Louis L.
Published: January 2023

Higher education is filled with a significant number of Black educators. Their leadership is the cornerstone that makes this possible. The authors discussed experiences and leadership theories to foster a positive future for Black leadership in higher education. Each experience and leadership approach places value on creating a space for diversity, inclusion, and equality in higher education, especially for Black leaders. This can be done by knowing the responsibilities and potential leadership opportunities to establish and maintain high-quality LMX relationships and interactions. These relationships and interactions can, directly and indirectly, affect the outcomes for individuals, groups, and organizations in higher education.
Oh, to Be Young, Black, and in Higher Education
Authors: Guillory Jay D.
Published: January 2023

Being young and Black in the field of higher education has its challenges. In the first few years as a new student affairs professional, they navigated some challenging things that can be seen as “on-the-job training.” This chapter seeks to invite the reader into the author's personal journey as they navigate transitioning from graduate school to full-time professional and from one institution to another. The ideas of mentorship, coaching, and sponsorship and why they are essential to a new professional in the field are explored.
When I Grow Up
Authors: Pruitt Sharonda , Childs Kamshia , Powell Hattie M.
Published: January 2023

This chapter clearly and succinctly explores accounts of terminally degreed, second career Black women who work in higher education. This chapter is a real-world exploration with real experiences. Thus, as discussed later, the authors will share their stories. The chapter will focus on the literature of such women including the assets that these women bring to the workplace. The themes that emerge from each story will provide the basis for the principle/guidelines that women who are entering the field, or struggling in higher education, can utilize as they blaze new paths.
Flipping the Indian HEI Classroom Based on Technology
Authors: Singh Amandeep , Verma Jyoti , Kaur Gagandeep
Published: January 2023

Flipping the classroom serves as a foundation to foster self-learning in the student. This study aims to explore the benefits and challenges of implementing the flipped classroom method in Indian HEIs. Different HEIs in India reveal student comfort, expanded learning, further developed execution and criticism, customized consideration and upgraded cooperation, better survey, and ideal use of class time as the major benefits of this method. This method also faces certain challenges like shortfall of requirements, weakening of educator impact, food of model, and particular flipping. It can possibly adjust the conveyance and absorption of HEI instruction. Nonetheless, while examining a flip of the HEI classroom, there is a necessity to tread carefully. The obstructions in the method of the successful execution of this method should be battled before the method can convey the ideal outcomes.
An Examination of the Emotional Impact of Technology-Driven E-Learning
Authors: George Abin , Ravindran D. , Sirothiya Monika , Goli Mahendar , Rajan Nisha
Published: January 2023

This chapter examines how emotional intelligence can be used in e-learning to help students get a better understanding of the learning process. This study focuses on the role of emotions in students' perceptions and interactions with new ways of improving learning and how technology can stimulate this growth. It examines how the introduction of new technologies can enhance the growth of students in the physical absence of teachers. A major focus of the study is the development of different technology-driven learning tools that help students to feel and connect with the learning process more deeply. The purpose of this chapter is to review how updated technologies and physical interactions can coexist in the process of e-learning. The findings of this study will provide a good foundation for future research avenues and for researchers to pursue further research related to the application and benefits of emotional intelligence in e-learning.
Study of Students Emotional Intelligence Influencing Factor of Their Readiness for Online Learning
Authors: Srivastava Rajshree , Nathani Bhavika
Published: January 2023

The effectiveness of students to perform in an online learning system is very well linked to their readiness or willingness to adopt the new technological innovations in the e-learning strategies. The conventional notion of a student readiness for online learning is linked to their ability to use technology effectively. E learning platform has provided flexibility, convenience, and opportunities to students and faculty to interact with each other around the world to make teaching more interactive. The purpose of this study is to investigate the influence of students' emotional intelligence on their readiness to adopt online learning with special focus on graduates and those pursuing postgraduation programmes.
Mapping the Migration
Authors: Kesler Karen Keller , Bunch Rick
Published: January 2023

Monarch butterfly populations have been declining at an accelerating rate. While local mitigative measures can provide some relief, the larger scale loss of habitat and lack of flyway continuity must also be addressed. This study utilized a site suitability model to rank all locations within the Western monarch migratory zone in relation to factors that collectively attribute to butterfly viability, sustainability, and functionality. The two overarching study goals were to identify flyway gaps and to compare the model outcomes with geolocated butterfly sightings. The model weighed temperature, precipitation, elevation, and land cover/use factors based on their overall impact on site suitability. In addition to these factors, wildfires, solar farms, genetically modified crops, snow/ice cover, and open water were modeled as uninhabitable zones incapable of sustaining butterfly populations. The study results illuminated the heterogeneity of the Western monarch migratory range as well as raised questions regarding possible abnormal butterfly behaviors.
College Students Consumption Behavior Under the Background of E-Commerce and Smart Logistics Technologies
Authors: Zhang Xuefeng , Lyu Weihua , Han Su
Published: January 2023

The impact of online systems and processes worldwide makes online purchasing popular. College students are among the possible buyers of E-commerce. This study looks at the characteristics that influence college students' online purchase intention in one of Chinese quickest cities. With smart logistics, it is possible to follow the transportation and dispatch of goods and services in almost real-time. Smart logistics has long been implemented by e-commerce enterprises, taxi apps, and food delivery services. The student's Consumption Behavior Approach (SCBA) is suggested in this article. The survey collection is analyzed to group the learner's research on online activityand smart logistics technology. Because the sample group is thus tiny, approaches are used. The findings reveal that fun, risk, and cultural pressure substantially influence pupils' online buying behavior. SCBA grouping produces three behavioral sections: that mostly impacted by social power and perception of risk, that features by pleasure and online trust.
Liver Disease Detection
Authors: Pan Aritra , Mukhopadhyay Shameek , Samanta Subrata
Published: January 2023

In recent times, intelligent predictive systems are showing greater levels of accuracy and effectiveness in early detection of the critical diseases of cancer in the liver, lungs, etc. Predictive models assist medical practitioners to identify the diseases based on symptoms and health indicators like hormones, enzymes, age, blood counts, etc. This article focuses on proposing an optimal classification model to detect chronic liver disease by enhancing the prediction accuracy through cutting-edge analytics. The article proposes an enhanced framework on the original study by Ramana et al. It uses measures like precision and balanced accuracy to choose the most efficient classification algorithm in Indian and USA patient datasets using various factors like enzymes, age, etc. Using Youden's index, individual thresholds for each model were identified to increase the power of sensitivity and specificity, respectively. The study proposes a framework for highly accurate automated disease detection in the medical industry and helps in strategizing preventive measures for patients.
A case of hoarseness of voice following COVID-19 infection
Authors: Joseph Ruby , Venkatnarayan Kavitha , Nanaiah Ashitha , Ramachandran Priya
Published: January 2023

Mucormycosis is a fatal angio-invasive fungal infection associated with a high mortality. Apart from the traditional risk factors, COVID-19 infection and steroid therapy for the same have been recently identified to predispose to this life-threatening infection. Usual presentations of mucormycosis include rhino-orbito-cerebral, pulmonary, gastrointestinal, renal and cutaneous involvement. We report an unusual case of mediastinal involvement by mucormycosis in a patient recovering from moderate COVID-19 pneumonia. Early diagnosis, prompt initiation of antifungal therapy accompanied by timely surgical debridement were pivotal in averting morbidity and mortality in this patient.
Association of Myosteatosis with Nonalcoholic Fatty Liver Disease, Severity, and Liver Fibrosis Using Visual Muscular Quality Map in Computed Tomography
Authors: Kim Hwi Seung , Lee Jiwoo , Kim Eun Hee , Lee Min Jung , Bae In Young , Lee Woo Je , Park Joong-Yeol , Kim Hong-Kyu , Jung Chang Hee
Published: January 2023

Background: The association of myosteatosis measured using visual muscular quality map in computed tomography (CT) with nonalcoholic fatty liver disease (NAFLD), its severity, and fibrosis was analyzed in a large population.Methods: Subjects (n=13,452) with abdominal CT between 2012 and 2013 were measured total abdominal muscle area (TAMA) at L3 level. TAMA was segmented into intramuscular adipose tissue and skeletal muscle area (SMA), which was further classified into normal attenuation muscle area (NAMA) and low attenuation muscle area (LAMA). The following variables were adopted as indicators of myosteatosis: SMA/body mass index (BMI), NAMA/BMI, NAMA/TAMA, and LAMA/BMI. NAFLD and its severity were assessed by ultrasonography, and liver fibrosis was measured by calculating the NAFLD fibrosis score (NFS) and fibrosis-4 index (FIB-4) scores.Results: According to multiple logistic regression analyses, as quartiles of SMA/BMI, NAMA/BMI, and NAMA/TAMA increased, the odds ratios (ORs) for NAFLD decreased in each sex (P for trend <0.001 for all). The ORs of moderate/severe NAFLD were significantly higher in the Q1 group than in the Q4 group for SMA/BMI, NAMA/BMI, and NAMA/TAMA in men. The ORs of intermediate/high liver fibrosis scores assessed by NFS and FIB-4 scores increased linearly with decreasing quartiles for SMA/BMI, NAMA/BMI, and NAMA/TAMA in each sex (P for trend <0.001 for all). Conversely, the risk for NAFLD and fibrosis were positively associated with LAMA/BMI quartiles in each sex (P for trend <0.001 for all).Conclusion: A higher proportion of good quality muscle was associated with lower risks of NAFLD and fibrosis.
A metagenomic assessment of gut microbiota in Indian colon cancer patients
Authors: Bamola V. Deepak , Kapardar Rajkishor , Lal Banwari , Sharma Atul , Chaudhry Rama
Published: January 2023

Background:

Gut microbiota plays an important role in the development of different diseases including colorectal cancer. The geography, lifestyle, and dietary habits of Indians are different from Western world, thus microbiome studies of Western population could not be extrapolated to their Indian counterparts.

Method:

Therefore, we have conducted a study on gut microbiota in Indian healthy subjects and patients of colon cancer using 16S ribosomal RNA Amplicon sequencing. Operational taxonomic units were calculated for different bacterial taxon including phylum, class, order, family, and genus level.

Results:

Observed results indicated a considerable difference in the bacterial diversity in both the groups. Phylum Firmicutes was significantly dominated in both the groups followed by Bacteroidetes, Actinobacteria, and Proteobacteria which clearly indicates the dominance of phylum Firmicutes in Indian population. Phylum Firmicutes and Actinobacteria were significantly abundant in the healthy group while phylum Bacteroidetes in the colon cancer group. Bacterial genera Megamonas, Megasphaera, Mitsuokella, and Streptococcus were significantly abundant in the healthy group and Veillonella, Prevotella, and Eubacterium in the colon cancer group. Bacterial genus Bradyrhizobium was present in the healthy group and Alistipes, Coprococcus, Dorea, and Rhodococcus were present in the colon cancer group but absent in the healthy group.

Conclusion:

There was a considerable difference in bacterial diversity in both the study groups indicating dysbiosis in the colon cancer group.
Sociodemographic and clinical characteristics of SARS-CoV-2 infected population during the second and third epidemiological waves in Sri Lanka
Authors: Harshani Hewa Babarandage Chathurika , Wijewickrama Ruvini Tharuka , Wimalarathne Gayan , Jayamaha Chrishan Jude S , Abeynayake Janaki I
Published: January 2023

Objective:

To analyze data on socio-demographic and clinical characteristics of SARS-CoV-2 infected population whose samples were received from Medical Research Institute, Sri Lanka.

Methods:

Laboratory based retrospective study was done on patient samples which were tested positive for SARS-CoV-2 by National Reference Virology Laboratory at the Medical Research Institute, Sri Lanka, from November, 2020 to November, 2021. Data on socio-demographic characteristics and clinical presentation of 13 126 patients were examined.

Results:

The mean age of the study population was (36.0±7.2) years and the majority were men (64.0%). The highest number of positive cases were found in the 21-30 years-of-age group. Two distinct peaks were noted in the incidence of SARS-CoV-2 positive individuals. In addition, 42.5% of the positive samples tested positive (42.5%) were from Medical Officer of Health collection centres. Furthermore, 60.6% (7 951) of the infected subjects were asymptomatic whereas the remaining were symptomatic. The highest percentage of symptomatic patients were observed in the 91-100 years-of-age group while the highest asymptomatic subjects were found in the 31-40 years-of-age group. The percentage of asymptomatic children (65.3%) was significantly (P<0.05) higher than that of adults (43.4%).

Conclusions:

The findings of this study aid decision makers to focus on the vulnerable groups, and geographic and temporal distribution of patients in the public health strategies that aim at preventing the spread of the disease and reducinig its mortalities.
Knowledge and associated factors of healthcare workers on measles vaccine and cold chain management at health institutions in Gondar, Ethiopia
Authors: Gelaw Aschalew , Belyhun Yeshambel , Wondimeneh Yitayih , Kokeb Mehretie , Dagnew Mulat , Amare Azanaw , Mulu Mesert , Alemayehu Martha , Gelaw Baye
Published: January 2023

Objective:

To assess the knowledge of healthcare workers on the measles vaccine and its cold chain management.

Method:

An institutional-based cross-sectional study was conducted from February 1 to March 30, 2022 in Gondar City Administration public health institutions among 165 healthcare workers. Data were collected using a structured questionnaire. In addition, an on-spot observation checklist was used to assess the availability, status and management of the cold chain. A logistic regression model was used to assess the relationship between the outcome and predictor variables. Crude and adjusted odds ratios were calculated with 95% confidence intervals.

Results:

Overall, 87 (52.7%; 95% Cl 44.8%-60.5%) of the healthcare workers had unsatisfactory knowledge regarding the measles vaccine and its cold chain management. One hundred thirty-six (82.4%) healthcare workers correctly mentioned the recommended range of temperature (2-8 °C) for measles vaccine storage. Healthcare workers aged 18-29 years (P=0.001) and 30-44 years (P=0.014) were observed as determinants of unsatisfactory knowledge on the measles vaccine and its cold chain management. One hundred and five (63.6%) of the healthcare workers did not correctly mention the type of measles vaccine used in routine immunization. More than one-third (36.4%) of the healthcare workers perceived that the measles vaccine is not safe and could cause measles.

Conclusions:

More than half of the healthcare workers in the study area had unsatisfactory knowledge on the measles vaccine and its cold chain management. It is necessary to provide technical support and in-service training for healthcare workers to ensure optimal immunization effectiveness.
Intractable Vomiting
Authors: Thapliyal Khyati , Garg Ashutosh , Singh Vivek Pal
Published: January 2023

Nausea and vomiting constitute one of the most common presenting symptoms in a variety of diseases in clinical practice. Recurrent vomiting can be due to simple gastritis which may lead to dehydration and electrolyte disturbances to threatening intracranial hypertension. Prolonged recurrent vomiting can also lead to malnutrition. Esophageal dysmotility is usually associated with dysphagia but is infrequently associated with recurrent vomiting. We report a case of acute-onset intractable vomiting in a 50-year-old Indian female who presented with severe dehydration and hypernatremia. A timed barium esophagogram revealed dilated esophagus with a rat-tail appearance. Upper gastrointestinal endoscopy revealed dilated esophagus with a tight esophageal-gastric junction. With a diagnosis of achalasia cardia, the patient underwent peroral endoscopic myotomy with complete resolution of symptoms.
Evaluation of metastatic neck nodes search for primary and subsequent management
Authors: Gupta Ashutosh , Singh Inderpal , Gupta Meenu , Puri Isha
Published: January 2023

Background:

Cancers in the head-and-neck region are the sixth most common cancers worldwide with an increasing incidence in developing countries.

Methods:

This study was carried out in the department of ENT and head-and-neck surgery in collaboration with the department of radiotherapy for a period of 1 year extending from May 01, 2014, to April 30, 2015. A total of 48 cases of metastatic secondary nodes were included in the study.

Results:

The male-to-female ratio in the present study was 4.33:1. Maximum number of patients were seen in the seventh decade. The youngest patient was a female 30 years old and the oldest was a male of 80 years. About 95.84% of primary tumors were squamous cell carcinomas and 40.47% of the patients of head-and-neck cancer with metastatic lymph nodes had well-differentiated squamous cell carcinomas. Majority of cases presented with N2 nodes, while N1 nodes were highest in cases of carcinomas larynx.

Conclusions:

Metastatic neck disease is a major problem in patients with head-and-neck cancer. The therapeutic goal includes not only known disease but also the elimination of possible subclinical disease. The judicious use of moderate doses of irradiation and modified surgical procedures should be used in specific clinical situations to significantly decrease neck recurrences while eliminating morbidity.
Is fractionated robotic stereotactic body radiosurgery optional salvage treatment for the re-irradiation of locally recurrent nasopharyngeal carcinoma?
Authors: Dogan Ozlem Yetmen , Yaprak Gokhan , Ozyurt Hazan , Bicakci Beyhan Ceylaner , Demircioglu Fatih , Algul Emriye , Isik Naciye
Published: January 2023

Purpose:

Recurrent nasopharyngeal carcinoma (NPC) after previous radiation therapy is a significant problem. This study was to determine the potential benefits from re-irradiation by fractionated stereotactic body radiotherapy (FSRT) on survival benefits and effects of severe late toxicities.

Materials and Methods:

Between 2009 and 2018, treatment outcomes were evaluated retrospectively in 26 patients with locally recurrent NPC treated using FSRT with CyberKnife. Five patients who had metastatic disease and one who had second recurrence were excluded from the study, and the remaining 20 patients were analyzed. The median age was 52 years (range, 28–80 years); re-treatment T stage was as follows: 6 (30%) – T2, 5 (25%) – T3, and 9 (45%) – T4. The median time from initial RT to recurrence was 22 months (range, 8–159 months). The median re-irradiation FSRT dose was 30 Gy in 5 fractions.

Results:

The median follow-up was 44 months; the overall survival (OS), local failure-free survival, and disease progression-free survival rates at 3 years were 89%, 73%, and 53%, respectively. All patients were evaluated for response after treatment: 9 (45%) had complete, 3 (15%) had partial, and 6 (30%) had no response. Univariate analysis demonstrated that higher cumulative total radiotherapy dose, gross tumor volume, and recurrent time interval were prognostic factors for local failure-free survival. The recurrent time interval was also an independent factor for progression-free survival and OS. The incidence of temporal lobe necrosis and trismus was 10% and 20%, respectively. One patient had Grade 5 toxicity to treatment-related bleeding.

Conclusion:

Tumor dose coverage is important for treating recurrent NPC, and treatment-related mortality was vascular in nature. FSRT is a promising treatment modality for recurrent NPC.
A 47-year-old man with rare serous cyst adenocarcinoma of the testis
Authors: Pourvali-Souraki Zahra , Zaboli Ehsan , Janbabaei Ghasem , Alizadeh-Navaei Reza
Published: January 2023

Although papillary serous cyst adenocarcinoma of the ovary is a common tumor, the incidence of ovarian-type papillary serous cyst adenocarcinoma in the testis is rare. Based on medical documents, there are only about 50 cases reported about testicular and paratesticular serous tumors.[1-3] Herein, we report a case of low-grade serous cyst adenocarcinoma of the testis that did unilateral orchiectomy and then came with retroperitoneal mass and lung metastasis. Chemotherapy was well tolerated, and now, after 1 year, he does not have any complaint.
Evaluation of enzyme-linked immunosorbent assay plasma p16INK4a protein in squamous cell carcinoma in uterine cervix
Authors: Raju Kalyani , Raghuveer C. V. , Sheela S. R. , Natarajan Arvind , Jagadish T. V. , Sunil B. N. , Sharat B.
Published: January 2023

Background:

Cervical cancer is one of the common cancers in females. The common method of screening is Pap test which has low sensitivity. Hence, better methods are explored with different biomarkers, of which estimation of P16 protein can be opted in early detection of cervical cancer.

Materials and Methods:

Seventy cases and seventy controls were considered for the study. Cases were invasive squamous cell carcinoma (SCC) of cervix confirmed by histopathology. Controls were healthy age-matched females. The blood sample of cases and controls was collected in K2 Ethylenediaminetetraacetic acid vacutainer, and the separated plasma was subjected to estimation of P16 protein by quantitative sandwich Enzyme-Linked ImmunoSorbent Assay method. The data were analyzed for the association between p16 protein in plasma in cases and controls.

Results:

The age among cases and controls ranged from 30 to 80 years. The P16 levels among cases ranged from 3.4 to 19.6 ng/ml with a mean of 7.24 ± 2.35 ng/ml. The plasma P16 level in controls ranged between 0.9 and 9.7 ng/ml with mean of 4.1 ± 2.22 ng/ml. At cutoff more than 4.8 ng/ml in cases, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 92.86%, 72.86%, 77.4%, 91.1%, and 82.86%, respectively. The specificity increased with increase in plasma p16 levels. The P16 levels were maximum in stage IV disease.

Conclusion:

This was a pilot study to detect the plasma p16INK4a levels in SCC of cervix. The levels of plasma p16 protein between 3.9 and 5 ng/ml can be considered as the range for the test to be positive. In clinically suspected cases of cervical cancer, levels more than 4.8 ng/ml can be considered for the diagnosis as point of care test.
Radiotherapy for locally advanced unresectable gallbladder cancer - A way forward
Authors: Sinha Shwetabh , Engineer Reena , Ostwal Vikas , Ramaswamy Anant , Chopra Supriya , Shetty Nitin
Published: January 2023

Background:

For nonmetastatic locally advanced gallbladder cancer (LAGBC) which remains unresectable and nonmetastatic after chemotherapy, there is no consensus on whether to continue chemotherapy or add local radiotherapy (RT) for improving outcomes.

Materials and Methods:

Forty-five patients of surgically unresectable nonmetastatic LAGBC were analyzed. Twenty patients did not receive RT (no RT cohort) and received only chemotherapy, while 25 patients received RT (RT cohort) with conformal techniques along with concurrent gemcitabine-based chemotherapy. No RT and RT cohorts were compared for disease-related outcomes and toxicities.

Results:

Median follow-up of the entire cohort was 11.5 months. Two-year progression-free survival (18.6% vs. 0%, P = 0.0001) and overall survival (37.3% vs. 5%, P = 0.0001) were significantly better in the RT cohort as compared to a no RT cohort. More number of patients had locoregional progression in the no RT cohort (85% vs. 32%, P = 0.0002). Radiation-induced acute and late gastrointestinal toxicity ≥ RTOG Grade 3 were seen in one and two patients, respectively.

Conclusion:

Addition of local RT to chemotherapy improves the survival outcomes and can be considered as a definite treatment modality for nonmetastatic LAGBC patients not amenable to surgery who have responded to chemotherapy.
Isolated intracholecystic metastasis of renal cell carcinoma: A report of a rare case
Authors: Osama Md A. , Chatterjee Priti , Batra Gunjan , Nehra Neema , Ali Shadan , Mohta Anup
Published: January 2023

Renal cell carcinomas are known for their unforeseeable metastatic pattern. They are known to have high metastatic potential, thus commonly associated with synchronous or metachronous metastatic presentation. At the time of diagnosis, approximately one-third of patients present with metastatic disease. We present a case of synchronous metastasis of clear cell carcinoma to the gallbladder in a 54-year-old male within two months after radical nephrectomy.
Interaction between peritumoral reactivity and histomorphological pattern of lymph node reactivity in oral squamous cell carcinoma
Authors: Bhatta Archana , Rath Rachna , Das Surya Narayan , Mishra Sudha Smruti , Sethi Debashis
Published: January 2023

Background:

The invasive tumor front (ITF) of oral squamous cell carcinoma (OSCC) and the reactive changes in regional lymph nodes (RLNs) are believed to carry integral prognostic information about the tumor's invasive capacity and insight into host immune response, respectively.

Aim:

This study aims to evaluate the reactivity patterns of RLNs in relation to the tumor stage, grade and various histopathological parameters at the ITF of primary tumor, in an attempt to elucidate the nature of host-immune response to tumor.

Materials and Methods:

Pattern of invasion (POI) using Bryne's criteria, peritumoral inflammation, and status of connective tissue (CT) stroma of 50 OSCC cases, that underwent selective neck dissection were assessed at the ITF. Immunoreactivity patterns in corresponding 450 RLNs were assessed as proposed by Tsakraklides and Ioachim. Further, 97 metastatic lymph nodes (LNs) were evaluated for degree and pattern of tumor invasion. The datasets were subjected to the Chi-square analysis.

Results:

There was statistically significant association (P = 0.001) of Type III and Type IV POI as well as mild peritumoral inflammation (P = 0.024) with the advanced stages of OSCC as compared to early stages. Significant association was observed between LN reactivity pattern and tumor stage (P = 0.05), with metastatic nodes exhibiting germinal center predominance (97.9%) and lymphocyte predominance (69.1%) largely observed in nonmetastatic nodes. Majority of metastatic nodes showed Grade 3 invasion (54.7%) in the form of large islands (57.7%), whereas two (2.1%) nodes were totally effaced by tumor metastasis. Statistical significance was observed between CT stroma at ITF and degree of tumor invasion in metastatic LN (P = 0.001). POI also showed significant correlation with peritumoral inflammation (P = 0.002), CT stroma (P = 0.02), and LN reactivity pattern (P = 0.03).

Conclusion:

This study supports the presence of a strong immunological host-tumor relationship.
Fine needle aspiration cytology of primary thyroid non-hodgkins lymphoma
Authors: Singh Meeta , Nain Gunjan , Jain Shyama , Singh Sarika , Malhotra Vikas
Published: January 2023

Presentation:

Twelve cases of Primary Thyroid Non-Hodgkin's Lymphoma (PT-NHL) were retrieved from the records suspected or diagnosed as NHL on fine needle aspiration cytology (FNAC) over a period of nine years from 2010-2018. During this period 5236 patients underwent thyroid FNAC;of these 685 cases were diagnosed under Bethesda Caregory V and VI. Thyroid NHL constituted 0.23 % of all thyroid FNA (12/5236 cases)and 1.7% (12/685) of all thyroid malignancies. Patients ranged in age from 40–61 years with Female:Male 7:5. All patients presented with thyroid enlargement (5-14 cms), and were of two months to five years duration. Patients had history of tobacco intake (smoking/chewing)in nine cases (75%). Thyroid function tests showed hypothyroidism in four (33%), positive antithyroid antibodies in three (25%) and; two cases(16.7%) were known cases of Hashimotos thyroiditis with follow up

Cytological Findings:

Eight cases (66.7%) had monomorphic large cell morphology, other four had mostly intermediate cell types (33.3%). A panel of immunocyto/ histochemistry (ICC/ IHC) showed CD 19 and CD 20 positivity in all cases;sixof these could be correlated on Flow cytometry (FC) with expression of FMC7, CD20, CD19 with kappa light chain restriction (5) and Lambda (1). FC findings corroborated completely with IHC on biopsy sections. The final diagnosis were Diffuse large B cell Lymphoma (DLBCL, 8) and MALT- Lymphoma(4). The follow up was available in DLBCL (4) and MALT- Lymphoma (1). CHOP therapy were given in all patients followed by radiotherapy in DLBCL; one patient of DLBCL died following pulmonary complications, rest are well and alive on follow-up.

Discussion:

PT-NHL is rare in India. DLBCL is the commonest histological type reported. In the present study, tobacco exposure has shown strong association. Combined FNAC-FC provide definitive diagnosis and thus can replace histopathology reducing turn around time.

Conclusion:

FNAC –FC provides a definitive diagnosis and thus can reduce turnaround time.
Urachal adenocarcinoma
Authors: Güral Zeynep , Yücel Serap , Oskeroğlu Sedenay , Ağaoğlu Fulya
Published: January 2023

The urachus is a canal between the allantois and the early fetal bladder. Urachal carcinoma is a rare and aggressive type of bladder cancer. This cancer usually presents at an advanced stage. We report a 70-year-old patient with malignant transformation of urachal cyst several years later. The patient was treated with partial cystectomy and adjuvant radiotherapy. A review of the published literature is also presented.
Erythroderma
Authors: Kataria Pritam , Patel Apurva , Kendre Pradip , Tahiliani Nahush , Mule Tushar , Bohra Murtaza
Published: January 2023

Imatinib is a tyrosine kinase inhibitor that selectively inhibits several protein tyrosine kinases which is central to the pathogenesis of human cancer. It forms the first-line treatment for chronic myeloid leukemia (CML) and gastrointestinal stromal tumors. Usually, the drug is well-tolerated with relatively few side effects. Adverse effects most commonly associated with imatinib include mild-to-moderate edema, nausea and vomiting, diarrhea, muscle cramps, and cutaneous reactions. Other side effects such as the elevation of hepatic transaminase and myelosuppression occur less frequently and resolve with interruption of imatinib therapy. Skin rash is one of the most common adverse effects of imatinib incidence of which range from 7% to 88.9%. Exfoliative dermatitis, i.e., erythroderma has been very rarely reported with this drug. We here report a rare case of erythroderma in a patient with CML on imatinib 400 mg/day therapy within 3 months of starting the treatment.
Incidence of xerostomia in locally advanced head-and-neck cancers in elderly patients treated with intensity-modulated radiotherapy
Authors: Jain Neeraj , Jain Sakshi , Kaur Amandeep , Sachdeva Kanchan , Sharma Ramita , Sudan Meena , Rakesh Abhimanyu , Abrol Deepak
Published: January 2023

Introduction:

Dysphagia and xerostomia are the main sequelae of radiotherapy for head and neck cancer (HNC) and the main factors in reducing the longterm patient quality of life. Intensitymodulated radiotherapy (IMRT) uses advanced technology to focus the high radiation doses on the targets and avoid irradiation of noninvolved tissues.

Material and Methods:

During 2016–2017, 44 patients of locally advanced HNCs were treated with a curative intent with IMRT. They were in the age range of 65–75 years. The median age was 69 years. Thirtyfive patients were male and nine patients were female. Histopathologically, all had squamous cell carcinoma. Stage wise all were T3N2 or more. No concurrent chemotherapy was given. The Eastern Clinical Oncology Group criteria were used for grading the toxicities. Patients were assessed after 4 weeks of completion of treatment.

Results and Conclusion:

The incidence of mucositis was of Grade 1–2 in 37 patients. Moreover, patients experienced severe mucositis. Six patients had treatment interruptions due to mucositis. Xerostomia was Grade 1–2 in 42 patients and Grade 3 in 2 patients. Dysphagia was Grade 1–2 only. No hematological toxicity was seen. Patients having dysphagia during the treatment were given nasogastric feed. Response wise 14 patients achieved complete response, 28 patients had partial response, and 2 had stable disease. There was no treatmentrelated mortality.
Molecular profiling of oral squamous cell carcinoma associated with oral submucous fibrosis
Authors: Choudhari Sheetal , Masne Sneha , Bhandare Prachi , Dhumal Snehal
Published: January 2023

Context:

Areca nut, a causative factor for oral submucous fibrosis (OSMF), is identified as a Group 1 human carcinogen. Oral squamous cell carcinoma (OSCC) associated with OSMF is now one of the most common malignancies in South and Southeast Asian countries.

Aim:

The present study was aimed to have clarity whether OSCC associated with OSMF is a pathologically different disease having different prognosis.

Settings and Design:

The difference between OSCC associated with OSMF and OSCC not associated with OSMF was studied in relation to expression of molecular markers, Ki-67, a proliferative and prognostic marker for OSCC and matrixmetalloproteinase-9 (MMP-9), and alpha smooth muscle actin (α-SMA), markers for invasiveness.

Subjects and Methods:

Expression was analyzed immunohistochemically using paraffin-embedded tissues from ten normal oral mucosa (Group I), thirty OSCC associated with OSMF (Group II), and thirty OSCC not associated with OSMF (Group III).

Results:

Group II showed OSCC occurring at younger age with more cases of well-differentiated OSCC. It also showed lower expression of Ki-67, MMP-9, and α-SMA as compared to Group III, and the difference was statistically significant. In addition, statistically significant low expression of markers was found in well and moderate grades of Group II as compared to those of Group III.

Conclusion:

OSCC associated with OSMF may have better prognosis and survival rate as it is found to occur at younger age with better grade of tumor differentiation and less expression of molecular markers Ki-67, MMP-9 and α-SMA. Thus, OSCC associated with OSMF can be considered a different disease pathologically and biologically. In-depth analysis of this molecular profiling can help to establish diagnostic, prognostic and therapeutic modalities for this unique malignancy.
An audit of Grade III or more skin reactions in consecutively assessed patients at a modern radiation oncology center
Authors: Pandey Vikas Kumar , Munshi Anusheel , Mohanti Bidhu Kalyan , Bansal Kanika , Rastogi Khushboo , Ganesh Tharmarnadar , Chauhan Rohit Singh , Chaudhari Bhavini , Pandey Pramod
Published: January 2023

Purpose:

Radiation dermatitis is most common and debilitating side effects of radiotherapy leading to treatment interruption, thereby compromising the local control, and effecting quality of life. With the invent of modern imaging and recent advances in megavoltage radiotherapy, radiation-related side effects have reduced. In this audit, we report the risk factors associated with Grade III dermatitis in modern centers.

Materials and Methods:

We analyzed 172 patients treated with volume modulated arc therapy (VMAT) and static field intensity-modulated radiotherapy (SFIMRT) at our center. All head and neck, breast, gynecological, GU malignancies, and sarcoma patients treated with a dose of >45 Gy from April 2018 to December 2019 were included in the study. On couch, treatment verification was done with cone-beam computer tomography (CBCT). Slice-by-slice verification of planning target volume (PTV) with CBCT was done in the first three fractions and weekly thereafter. Skin evaluation was done using CTCAE v. 5. Statistical analysis was done using SPSS v. 22.

Results:

Of the 172 patients treated with VMAT and SFIMRT, 15 patients (8.7%) had Grade III dermatitis. Grade III dermatitis was mostly seen in breast cancer followed by head-and-neck patients. More reactions were observed in patients with advanced stage disease. Treatment verification is important at the later course of treatment, especially in head-and-neck cases where the treatment volume is large and PTV may extend outside skin. Contributing factors of radiation dermatitis at modern radiotherapy center are gene mutation, use of concurrent chemoradiotherapy, and bolus.

Conclusion:

We hereby conclude that PTV mismatch in weekly treatment verification, genetic mutations, concurrent chemo-radiotherapy, use of thermoplastic mask, and bolus are the contributing factors for Grade III dermatitis in modern radiotherapy centers.
Detection of differential expression of miRNAs in computerized tomography-guided lung biopsy
Authors: Singh Anjana , Kant Ravi , Nandi Soumyadeep , Husain Nuzhat , Naithani Manisha , Mirza Anissa Atif , Saluja Tajindra Singh , Srivastava Kamini , Prakash Ved , Singh Satyendra Kumar
Published: January 2023

Aims:

Nonsmall-cell lung carcinoma comprises 85% of lung malignancies and is usually associated with a poor prognosis due to diagnosis at advanced stages. Molecular diagnosis of computerized tomography (CT)-guided biopsy has the potential to identify subtypes of lung carcinoma like adenocarcinoma (AC) and squamous cell carcinoma (SCC) along with its molecular stratification. This approach will help predict the genetic signature of lung cancer in individual patients.

Subjects and Methods:

Histopathologically proved a CT-guided biopsy sample of lung cancer cases was used to screen for the expression of microRNA (miRNA) earlier quantitated in blood plasma. Primers against hsa-miR2114, hsa-miR2115, hsa-miR2116, hsa-miR2117, hsa-miR449c, and hsa-miR548q with control RNU6 were used to screen 30 AC, 30 SCC, 5 nonspecific granulomatous inflammation, and 8 control samples. Reverse transcription polymerase chain reaction (RT-PCR) data revealed expression of hsa-miR2114 and hsa-miR548q in AC as well as SCC.

Results:

RT-PCR data revealed that the expression of hsa-miR2116 and hsa-miR449c was found upregulated in AC while hsa-miR2117 was expressed in SCC cases. Bioinformatic analysis revealed that genes, where these miRNAs are located, were also upregulated while targets of these miRNAs were downregulated.

Conclusions:

miRNAs expression pattern in the CT-guided biopsy samples can be used as a potential tool to differentially diagnose lung cancer subtypes. The expression pattern of miRNAs matches very well in blood plasma and tissue samples, albeit levels were very low in the earlier case than later. This approach can also be used for screening mutations and other molecular markers in a personalized manner for the management of lung cancer patients.
Clinical response of carboplatin-based chemotherapy and its association to genetic polymorphism in lung cancer patients from North India – A clinical pharmacogenomics study
Authors: Tiwari Sonia , Vijayaraghavalu Sivakumar , Siddiqui Maqsood A. , Al-Khedhairy Abdulaziz A. , Kumar Munish
Published: January 2023

Purpose:

Lung cancer mostly diagnosed at advanced inoperable stages; thereby, the chemo-, radiation-, targeted or immune-therapy alone or in combination remains the treatment of choice. In chemotherapy, platinum-based compounds such as cisplatin and carboplatin and third-generation drugs such as docetaxel, paclitaxel, gemcitabine, and vinorelbine are widely used. The beneficial therapeutic outcome of the chemotherapy alone or in combination with radiation (chemoradiation) and/or development of drug resistance depends on the inter-individual genetic differences. Hence, this study was carried out to find gene biomarker that could be useful in the diagnosis of the disease and to predict the outcome of chemo/chemoradiation therapy in ethnic North Indian population.

Materials and Methods:

In this clinical study, lung cancer (n = 52) patients from North Indian population were recruited. All the patients were treated with carboplatin target area under curve-5 in combination with third-generation drugs (gemcitabine 1.2 mg/m2; paclitaxel 175 mg/m2; and etopside 100 mg/m2) and radiation therapy. The genomic DNA was isolated from the blood sample and performed polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism.

Results:

We found hazard ratio to be significantly higher for XPDLys751Gln (hazard ratio [HR] =2.11, 95% confidence interval [CI]: 0.98–4.53, P = 0.056) and IL1 β511C/T (HR = 9.9, 95% CI: 2.55–38.40, P = 0.001). GSTT1 null (HR = 0.39, 95%CI: 0.18-0.84, P = 0.017) genotype has better response to chemotherapy. Generalized multidimensional reduction model suggested that IL1RN (cross-validation consistency [CVC] =10/10, P = 0.054) and XRCC1399Gln, GSTM1 (CVC = 10/10, P = 0.001) as best predicted model in lung cancer patients to the treatment response.

Conclusion:

Genetic polymorphisms and single nucleotide polymorphisms in DNA repair gene (XRCC1, XPD) and drug-metabolizing gene (GSTM1 and GSTT1) could serve as genetic biomarkers in lung cancer patients treated with the above indicated chemotherapy. Based on genotype and chemotherapy treatments, the toxicity effects can be minimized, this will help in the development of personalized medicine in future with better efficacy.
Cryoablation treatment of oral and maxillofacial tumors
Authors: Li Xiao , Wang Ya-Wen , Wang En-Bo , Liu Yuan-Shui
Published: January 2023

Oral and maxillofacial anatomy and function are important and complex. They are involved in facial expressions, chewing, language, breathing, and other functions. It is therefore important to choose the optimal treatment plan for oral and maxillofacial tumors. For patients with who cannot tolerate surgery or who refuse surgery or radiotherapy can be treated with cryoablation. Cryoablation can maintain local tissue integrity and organ function and protect facial integrity. It is a repeatable treatment that, if necessary, can be followed by traditional antineoplastic therapies. This study introduces five cases with severe basic diseases who cannot tolerate or have refused surgery or radiotherapy. The patients were diagnosed as having oral and maxillofacial tumors. These patients experienced painful local swelling or breaking of the tumor. All patients received cryoablation combined with other treatments. Local control of the tumors and improved function and quality of life were achieved. In clinical work, for patients with severe basic diseases who cannot tolerate or refuse surgery or radiotherapy, cryoablation has unique advantages, and this approach is expected to become a widely used treatment for oral and maxillofacial tumors.
Modified neoadjuvant clinicopathological risk stratification as a prognostic score in early and locally advanced triple-negative breast cancer
Authors: Dubashi Biswajit , Matta Kirankumar , Kayal Smita , Thumathy Divya Bala , Nisha Yadav , Dharanipragada Kadambari , Gunaseelan Karunanithi , ch Toi Pampa , Ganesan Prasanth
Published: January 2023

Background:

Triple-negative subtype is an aggressive breast cancer with inferior survival. Pathological complete remission (pCR) is a good surrogate endpoint for survival among patients receiving neoadjuvant chemotherapy (NACT). We attempted to validate the clinical pathological score (CPS) with a modified risk grouping among Triple-negative breast cancer (TNBC) patients receiving NACT at our center.

Methodology:

Data of patients with TNBC who underwent NACT between January 2014 to July 2017 were retrospectively analyzed. The composite CPS score included cTN stage and y pTN stage and ranged from 0 to 4. This was calculated using an available online software developed by MD Anderson Center. The score obtained from the calculator was used to develop a risk grouping into low risk (0, 1) and high risk (2, 3, 4). Invasive disease-free survival (iDFS) and locoregional recurrence-free survival (LRFS) were calculated using the Kaplan–Meier method.

Results:

Seventy-eight patients with TNBC (median age: 45 [24-75]) had received NACT (anthracyclines and taxanes). Early and locally advanced breast cancer constituted 17 (21.8%) and 61 (78.2%), respectively, and 22 (28.2%) achieved pCR. After a median follow-up of 25 months (5–62), 3-year iDFS and OS were 59% and 81%, respectively, for the entire population. The 3-year iDFS in low-risk (n = 18) and high-risk (n = 60) patients was 85% and 51%, respectively (P = 0.03). The 3-year LRFS in low risk and high risk was 93% versus 58% (P = 0.03). The 3-year OS in the low and high risk was 93% and 77%, respectively (P = 0.24, NS).

Conclusion:

Our study supports the use of the modified neoadjuvant clinicopathological score as a prognostic marker in patients with nonmetastatic triple-negative breast cancer. This needs to be validated in a larger subset of patients.