bluuebunny/crossref_metadata_2025 huggingface dataset:
RFID Attendance System with Contagious Disease Prevention Module using Internet-of-Things Technology
Authors: Harum Norharyati Binti , Ahmad Mahin Nurul Afifah , Hamid Erman , Emran Nurul A. , Anawar Syarulnaziah , Asnawi Ani Liza
Published: September 2023

This paper presents the development and implementation of an innovative Internet of Things (IoT)-based RFID attendance system integrated with a module focused on curbing the spread of contagious diseases in densely populated settings, such as schools and workplaces. Recognizing the limitations of existing radio frequency identification (RFID) attendance systems, an extensive analysis of prior works was conducted to identify crucial functionalities necessary for an effective solution. Leveraging the IoT paradigm, we devised a 3-layer architecture encompassing thermometer sensors, RFID technology, Arduino microcontrollers, Wi-Fi connectivity, and the message queuing telemetry transport (MQTT) protocol to facilitate seamless data transmission and storage. The resulting prototype enables real-time monitoring of feverish symptoms, serving as an early warning system for potential contagious illnesses while streamlining attendance management. Data collected from the IoT devices is securely stored in a centralized database and accessed through an intuitive information system embedded within the IoT application. Users can effortlessly view and manage attendance data, while administrators gain access to health-related metrics, enabling timely responses to health concerns. User evaluations of the developed system resulted in an outstanding “A” rating, validating its reliability, functionality, and user satisfaction. Future improvements involve real-world testing, scalability assurance, integration with health authorities for comprehensive data management, and automated alerts for potential disease outbreaks.
Exploring the Impact of Gamification on 21st-Century Skills: Insights from DOTA 2
Authors: Samala Agariadne Dwinggo , Bojic Ljubisa , Vergara-Rodríguez Diego , Klimova Blanka , Ranuharja Fadhli
Published: September 2023

This study explores how gamification in DOTA 2 cultivates 21st-century skills (problem-solving, teamwork, communication, and critical thinking). It supports DOTA 2 as an immersive platform for skill development. The study investigated various sources, including player surveys, meticulous gameplay analysis, academic research reviews, and expert opinions. By synthesizing this evidence, the study sheds light on DOTA 2’s potential to hone and refine abilities. Player surveys revealed individuals’ acquisition of adaptability in dynamic situations, cultivation of strategic thinking abilities, and enhancement of effective team collaboration skills. An in-depth examination of gameplay unveiled discernible patterns of collaborative effort and cognitive processes aimed at resolving challenges resembling real-world situations. Existing scholarly literature substantiates these findings and highlights gaming’s role in developing 21st-century competencies. The study emphasizes the potential implications of its results for stakeholders, such as educators, policymakers, and game developers, offering valuable opportunities for the practical application of gamification strategies. It sparks further investigation and exploration of unexplored research avenues. This study contributes to the growing body of literature recognizing gaming’s substantial advantages in fostering crucial 21st-century skills.
Mémoires de la première guerre punique à l’époque impériale et au Moyen Âge
Authors: Courroux Pierre , Engerbeaud Mathieu
Published: September 2023

Cet article propose d’étudier la mémoire de la première guerre punique sur le temps long, du début du Principat jusqu’à la veille de la Renaissance. Cette approche diachronique permet d’observer comment, sur une durée de quinze siècles, les épisodes majeurs de cette guerre ont été interprétés, modifiés, réappropriés au gré de l’évolution des sociétés et des centres d’intérêt des élites cultivées. Assurément, le premier conflit qui opposa les Romains aux Carthaginois retenait l’intérêt des Anciens, car il constituait la première guerre de Rome contre une grande puissance méditerranéenne. Au cours de l’Empire et du Moyen Âge, les Anciens ont plusieurs fois revisité les moments les plus marquants de cette guerre, dont les lettrés antiques et médiévaux se sont emparés pour construire des exempla.
Reconnaissance des acquis de l’expérience : évaluation et émancipation
Authors: Cavaco Carmen
Published: September 2023

Ce texte vise à analyser les effets non prévus découlant du processus de reconnaissance et de validation des acquis de l’expérience, concernant l’émancipation des adultes peu scolarisés, mené à bien au Portugal. Les données empiriques résultent d’une recherche qualitative, plus élargie, à partir d’entretiens biographiques réalisés avec des adultes et d’entretiens semi-structurés réalisés avec des accompagnants et des formateurs de trois centres agréés. La recherche déployée visait la mise en œuvre du processus. L’analyse est orientée vers les dimensions de la biographisation, de la reconnaissance et de la validation, ainsi que vers les dimensions de l’évaluation et de l’émancipation. Les résultats révèlent que la biographisation, assurée par la remémoration, la réflexion, la mise en mots, la (re)élaboration et la socialisation de l’expérience, lorsqu’elle se produit de façon intentionnelle, systématique et accompagnée, a des effets sur l’émancipation du sujet. Ainsi, la reconnaissance et la validation des acquis de l’expérience, qui impliquent les dimensions de l’évaluation, ont des effets sur la formation et l’émancipation des adultes peu scolarisés.
Journal d’apprentissage et mise en mots de l’expérience
Authors: Lafont Pascal
Published: September 2023

Un dispositif pédagogique visant l’amélioration des parcours académiques a été créé dans une université de l’Est parisien en faveur d’étudiant·es primo-arrivant·es, issu·es de cursus et d’origines variées. Dans ce contexte, une recherche exploratoire a été menée afin d’appréhender la manière dont les étudiant·es élaborent leur journal d’apprentissage au moyen d’une mise en mots de l’expérience permettant de découvrir une forme de liberté d’agir et de penser, source d’émancipation permissive et capacitante. Cette contribution s’appuie sur l’analyse de 19 extraits de journaux relatifs à un enseignement modulaire au cours duquel 179 journaux d’apprentissage ont été produits entre 2019 et 2023. Les premiers résultats tendent à montrer que l’usage du journal d’apprentissage prédisposerait différemment les apprenant·es dans la mesure où la mise en mots de l’expérience transformerait leur relation au savoir au moyen d’un rapport libérateur d’apprentissage.
Preparo dos pais para a desospitalização de crianças em uso de traqueostomia e gastrostomia
Authors: Nascimento de Jesus Manuela , Siqueira Samylla , Jesus Fernandes Lucas , Costa da Cunha Ferreira Diego , Silva de Jesus Viviane , Laura de Camargo Climene
Published: September 2023

Objetivo: relatar a experiência de uma ação educativa para o preparo dos pais para a desospitalização de crianças em uso de traqueostomia e gastrostomia. Método: relato de experiência sobre uma ação educativa, que é parte de um Programa de Treinamento de um hospital público de alta complexidade referência em pediatria, no período de dezembro de 2017 a dezembro de 2018. Resultados: o preparo dos responsáveis para a desospitalização de crianças em uso de traqueostomia e gastrostomia foi feito a partir de 5 etapas: 1) Instruções aos pais; 2) Treinamento dos pais para manuseio do dispositivo utilizado pela criança; 3) Manipulação dos dispositivos pelos pais sob supervisão do enfermeiro; 4) Feedback oferecido pela Enfermagem; e 5) Avaliação da ação educativa. Considerações finais: Acredita-se que a educação terapêutica fornecida aos envolvidos contribuiu na qualificação do cuidado à criança em uso de traqueostomia e gastrostomia, favorecendo sua qualidade de vida e reduzindo as intercorrências domiciliares relacionadas ao manuseio inadequado dos dispositivos em questão.
Boas práticas da enfermeira obstétrica na assistência ao parto em um centro de parto normal
Authors: Carneiro Nery Hiarimy , Marien Knupp Medeiros Renata , Spanevello Alvares Aline , De Arruda e Silva Dalprá Luanna , Teixeira Beltrame Renata Cristina , Ferreira Lima Juliana , Dos Santos Coutinho Aguiar Lorrayne
Published: September 2023

Objetivo: descrever a assistência prestada pelas enfermeiras obstétricas em um Centro de Parto Normal de um hospital de grande porte, no período de janeiro a dezembro de 2020. Método: trata-se de uma pesquisa quantitativa, de caráter descritivo. A amostra foi composta de 1.442 partos normais. Os dados foram coletados de um banco já existente na maternidade, organizados em uma planilha eletrônica do Microsoft Excel e analisados no Epi Info, versão 7. Resultados: dos partos atendidos por enfermeiras obstétricas, 100% das parturientes fizeram uso de pelo menos um método não farmacológico de alívio de dor. Em relação ao nascimento, o clampeamento oportuno do cordão umbilical ocorreu em 85,16% dos partos. Quanto à prática prejudicial quando utilizada de forma indiscriminada, identificou-se a taxa de 0,42% de episiotomia. As posições mais adotadas foram semissentada/semideitada (75,38%), seguidas da banqueta (15,55%). Referente à presença de laceração, identificou-se períneo íntegro em 41,82%. Conclusões: este estudo evidenciou que a maioria dos partos realizados pelas enfermeiras teve bons resultados quanto às boas práticas de atenção ao parto e nascimento. Ademais, as intervenções indiscriminadas no processo de trabalho de parto e parto não se mostraram presentes na maioria dos atendimentos realizados, o que traz benefícios para o parto.
Cuidado ao recém-nascido em maternidades públicas assistidos pelo programa Rede Mãe Paranaense: o vivido materno
Authors: Miranda Maicon de Moraes de , Araujo Juliane Pagliari , Caldeira Sebastião , Ferrari Rosangela Aparecida Pimenta , Zani Adriana Valongo
Published: September 2023

Objetivo: compreender a vivência materna frente à assistência ao recém-nascido em maternidades públicas. Método: estudo qualitativo, fenomenológico, fundamentado no referencial teórico-metodológico de Alfred Schütz. Os dados foram coletados com uma amostra de 30 mães de recém-nascidos, por meio de entrevista semiestruturada, no período de fevereiro a julho de 2018. As entrevistas foram realizadas no domicílio das mães. Resultado: As mães vivenciaram momentos de alegria, mas também de sofrimento em relação ao nascimento e cuidado de seus filhos nas primeiras horas de vida, e devido a essas vivencias, expectativas quanto à assistência para algumas foram além do esperado e para outras ocasionaram frustação como pode-se observar nas duas categorias que emergiram de seus relatos: A primeira referente a experiência vivida, ou seja, os “motivos por que”: Vivenciando as primeiras horas de vida do filho nos serviços de maternidade (Sala de Parto: aproximações e distanciamento do contato; Alojamento conjunto: (re) aprendendo o cuidado com o bebê; Apoio a amamentação; Falta de comunicação, Orientações de alta e Gratidão frente a assistência recebida), a segunda categoria traz as expectativas, os “motivos para”: O que espera da assistência nas primeiras horas após o nascimento do filho (Assistência de qualidade e Acompanhamento no parto: desejos e desafios). Considerações finais: a vivência do nascimento foi tida com momentos de interação e contato com o recém-nascido, porém, também de pouco contato devido realização de procedimentos e intercorrências. As mães vivenciaram momentos de aprendizados e também verbalizaram ausência do profissional, gerando desejos e expectativas de melhora da qualidade da assistência.
Distribuição espacial e caracterização da violência sexual contra crianças e adolescentes no Sul do Brasil
Authors: Vilhalba Elisa Fortes , Barreto Camila Nunes , Goi Cíntia Beatriz , Attuy Mayara Menezes , Faria Rivaldo Mauro de , Neves Eliane Tatsch
Published: September 2023

Objetivo: caracterizar a violência sexual sofrida por crianças e adolescentes de um município do sul do Brasil e identificar o seu padrão de distribuição espacial. Método: trata-se de um estudo ecológico transversal, com caráter quantitativo a partir de dados disponíveis no setor de Vigilância Epidemiológica do município do estudo dos anos de 2018 e 2019. A coleta de dados ocorreu em novembro de 2020. A análise foi realizada por meio do programa Q-GIS® versão 2.18 e o uso da técnica de Kernel. O trabalho foi aprovado pelo Comitê de Ética e Pesquisa da instituição. Resultados: foram analisados 137 registros de violência sexual. As ocorrências foram mais prevalentes no sexo feminino (83,9%) de cor branca (74,4%) e nas faixas etárias de 5 a 9 (25,5%) e de 10 a 14 anos (40,8%). Ocorreu principalmente na área urbana da cidade (62,04%) concentrando-se na região periférica e na residência da pessoa agredida (65,6%). O principal agressor foi do sexo masculino (91,9%). A distribuição espacial concentrou-se com uma maior densidade de casos notificados nas regiões administrativas Norte, Oeste e Centro-Leste do município. Conclusão: o principal tipo de violência foi o estupro contra crianças e o padrão de distribuição espacial desses casos de violência apresentou uma densidade maior nas regiões periféricas caracterizadas como áreas de carência, privação social e econômica.
Time in sedentary behavior and physical activity as discriminators of diabesity in quilombolas
Authors: Pereira Poliana Santana , Alves dos Santos Clarice , Mussi Ricardo Franklin de Freitas , Rocha Saulo Vasconcelos
Published: September 2023

Introduction: Diabesity is characterized as a simultaneous condition of type 02 diabetes and obesity. Among the aspects that influence the development of diabetes, the time in sedentary behavior and the time of physical activity are important risk factors. Objectives: To estimate cut-off points for time spent in sedentary behavior and physical activity as a discriminator of the presence of diabesity and to evaluate the predictive ability of WC and PA to identify this condition in quilombola adults. Methodology: this is a cross-sectional study with a sample composed of 332 adults (age ≥ 50 years), participants in the study of the Epidemiological Profile of Quilombolas from Bahia living in the micro-region of Guanambi, Brazil. The data were obtained by means of interviews and anthropometric evaluation. Sociodemographic and lifestyle information (physical activity and sedentary behavior) were included. To analyze the cut-off point of Sedentary Behavior as a predictor of diabesity, the Receiver Operating Characteristic (ROC) curve was used. Results: Time in sedentary behavior >120 min/day and time in physical activity <240 min/week were the best cut-off points for discriminating diabesity in quilombola, with area under the ROC curve of 0.62, 95% CI (0.56-0.67) and 0.62 (95% CI: 0.55-0.67), respectively. Conclusions: The results showed that time in sedentary behavior and time in physical activity showed a good ability to discriminate the presence of diabesity among quilombola adults.
Daily physical activity in children enrolled in extracurricular activity
Authors: Leite Marlon , Forti Barela Ana Maria , Barela José Angelo
Published: September 2023

This study aimed to verify and compare the physical activity practices of children enrolled and non-enrolled on different days of week in a specific program offered at school. Seventy-eight children comprised two groups: children with extra physical activity (EPA; n=39; 15 females and 24 males; age: 9.2±0.8 years) and those with no involvement in extra physical activity (NPA; n=39; 21 females and 18 males; age: 9.0±0.4 years). To infer caloric expenditure, number of steps per day, and total distance traveled, children were monitored with pedometers during three nonconsecutive days: a day with a physical education class at school, a normal activity weekday, and a weekend day. Children enrolled in extra activities at school presented higher levels of caloric expenditure (EPA=132±61, NPA=61±25), performed more steps per day (EPA=7742±2473, NPA=5245±2306) and traveled longer distances (EPA=4201±1318, NPA=2799±1269), with boys (calories=154.1±91.6; steps=9763±3804; traveled distance=5114±2205) more active than girls (calories=94.4±46.7; steps=6691±2394; traveled distance=3726±1387). In the extracurricular physical activity day, children expended more calories (155.8±88.3), performed mores steps (10133±3724) and traveled longer distance (5442±2118) than in the physical education day (calories=127.2±79.3; steps=8409±3283; traveled distance=4478±1864) and in the weekend (calories=96.8±58.8; steps=6493±2687; traveled distance=3500±1466). Extracurricular physical activity at school leads to an increase of physical activity of boys and girls, even on days when the extracurricular activity is not offered.
Factors Affecting Quality of Sustainability Reporting: Evidence from Banking Industry in Sri Lanka
Authors: Darshi G. A. N. , Gunawardana Kennedy D. , Banda Y. K. Weerakoon
Published: September 2023

Sustainability reporting (SR) has been identified as a rapidly expanding area of modern corporate reporting. It is crucial in the current setting to explore the elements determining the quality of SR in Sri Lanka. Therefore, the study aims to identify the factors influencing the quality of SR in Sri Lanka. The sample of the study consists of ten commercial banks in Sri Lanka listed on the Colombo Stock Exchange. Secondary data was acquired from each commercial bank's annual reports over a six-year period from 2016 to 2021 in conducting the study. The quality of SR was evaluated using content analysis. This study applied the comprehensive approach developed by Permatasari, Gunawan, and El-Bannany(2020) to measure the quality of SR. Profitability, leverage, company size, and sustainability committee were the independent variables of the study. This analysis reveals that the most important elements influencing SR quality are company size, profitability, leverage, and the sustainability committee. Furthermore, the current study contributes significantly to expanding knowledge in the field of SR.
A Study of Job Seekers’ Perceptions of the Job Portals in Sri Lanka: With Special Reference to “Millennials” and Generation “Z”
Authors: Navaratnam Lakshija , Edirisooriya Waruni Ayesha
Published: September 2023

In today's digital age, organizations are relying more on online platforms to recruit job applicants instead of using traditional recruitment methods. Organizations are adapting their practices to meet the needs of younger workers. However, the perceptions of these job seekers towards job portals may vary depending on several factors. Thus, the purpose of this study was to identify the factors that influence the perceptions of young job seekers toward job portals. The study used the quantitative research approach and data was collected through a survey questionnaire from a sample of 250 young job seekers. The findings of the study revealed that information quality, perceived ease of use, perceived usefulness, perceived trustworthiness, and extended services have a significant influence on young job seekers' perceptions of job portals. Extended services, perceived usefulness, perceived ease of use, and information quality seem to be the strongest predictors out of the five variables. This leads to the conclusion that job portal providers must pay close attention to their online recruiting simplicity, quality of information, and extended services if they want to attract additional clients. Companies should also prioritize offering accurate and comprehensive job descriptions and making sure the portals are user-friendly. The implications of the study provide valuable insights for job portal providers to enhance their services and increase their user base among young job seekers. This study provides practical and theoretical insights for job portal service providers, companies, and individuals seeking employment.
The Role of Shopping Values, Cognitive and Affective Evaluations on the Relationship between Store Environment and Store Patronage Intention: A Future Research Agenda
Authors: Rathnasiri M. S. H. , De Silva W. V.
Published: September 2023

This study aims to investigate the role of shopping values, cognitive, and affective evaluations on the relationship between store environment and store patronage intention while proposing a future research agenda through a systematic literature review (SLR) approach. Based on the Stimulus-Organism-Response (S-O-R) model, the store environment is identified as the stimuli, affective evaluations are identified as the organism and response is the store patronage intention. The SLR proposed that cognitive evaluations can be included as a mediator between store environment and affective evaluations based on the Cognitive Theory of Emotions. Further, based on the literature, it is suggested that hedonic and utilitarian shopping values may have a moderating effect on the relationship between affective evaluations and store patronage intention. This theoretical association between store environment and store patronage intention of supermarket shoppers will reveal significant managerial and theoretical implications for future research studies.
Immune Evasion of G-CSF and GM-CSF in Lung Cancer
Authors: Park Yeonhee , Chung Chaeuk
Published: September 2023

Tumor immune evasion is a complex process that involves various mechanisms, such as antigen recognition restriction, immune system suppression, and T cell exhaustion. The tumor microenvironment contains various immune cells involved in immune evasion. Recent studies have demonstrated that granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) induce immune evasion in lung cancer by modulating neutrophils and myeloid-derived suppressor cells. Here we describe the origin and function of G-CSF and GM-CSF, particularly their role in immune evasion in lung cancer. In addition, their effects on programmed death-ligand 1 expression and clinical implications are discussed.
Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic Review
Authors: Nyanti Larry Ellee , Rahim Muhammad Aklil Abd , Huan Nai-Chien
Published: September 2023

Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted.Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE.Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test.Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation.
A comparison of the range of motion and dynamic stability of the ankle joint of athletes with an ankle sprain as compared to healthy controls: A cross-sectional study
Authors: Alomar Ahmed I. , Nuhmani Shibili , Ahsan Mohammad , Muaidi Qassim I.
Published: September 2023

Background:

Ankle sprains are the most common lower-leg musculoskeletal injuries, frequently occurring among athletes and other physical activity individuals. The objective of this study was to compare the ankle range of motion and dynamic stability of healthy and injured athletes for their dominant and nondominant legs.

Methods:

A cross-sectional study design was selected to investigate this study with 32 male soccer players with average age: 22.6 ± 3.3 years, weight: 69.6 ± 5.7 kg, height: 176.8 ± 5.32 cm, with a history of a lateral ankle sprain on the dominant leg for the past 2 years. Ankle range of motion was determined using dorsiflexion and plantar flexion by a goniometer. The dynamic stability was determined using the SWAY medical system. An independent t-test was used to study the differences between healthy and injured groups and between dominant and nondominant legs for dynamic stability, dorsiflexion, and plantar flexion range.

Results:

There were higher significant differences for dynamic stability in healthy participants than in injured participants for their dominant (P = 0.001) and nondominant (P = 0.001) legs. There were significant differences in dynamic stability in the dominant and nondominant leg (healthy [P = 0.033] and injured [P = 0.000] participants). The dominant leg shows higher dynamic stability in healthy group, whereas nondominant leg shows higher dynamic stability in the injured group.

Conclusion:

The study found significant differences between the injured and sound legs. The injured dominant and nondominant leg revealed a striking disparity in the ankle range of motion. Therefore, the study demonstrated that ankle sprain causes due to less stability of the ankle joint, which limits ankle movements.
The Association between Perceived Job Stress and Satisfaction, Empathy and Spiritual Beliefs on Burnout and Emotional Distress in Nurses: A Cross-sectional Study
Authors: Debnath Sudipta , Sathiyaseelan Manoranjitham , Tharyan Prathap , Mahasampath Gowri
Published: September 2023

Background:

Nursing is a noble profession, which comes with a lot of responsibilities, workload, and demands made by the various stakeholders of health-care industry. Maintaining an empathic nurse–patient relationship is at its core, irrespective of the types of nursing care being rendered. This study aims to assess the association between perceived job stress and satisfaction, empathy, and spiritual beliefs on burnout and emotional distress, in nurses.

Methodology:

A cross-sectional research design was undertaken to meet the study objectives. Data were collected from a total of 257 consenting nurses, using the modified Consultants Job Stress and Satisfaction questionnaire, Maslach Burnout Inventory, Jefferson Scale of Physician Empathy-Health Provider Version, and General Health Questionnaire-12.

Results:

High empathy was related to lower depersonalization (DP) and higher personal accomplishment. Nurses who agreed on to their work beliefs being influenced by spiritual beliefs also had more commonly reported high job stress. More than a third (34.24%) of the nurses were emotionally distressed with a significant score in General Health Questionnaire-12 (GHQ-12). The GHQ-12 score significantly varied with high emotional exhaustion (EE), high DP, and job stress.

Conclusion:

Empathy and spiritual belief act as modifying factors for job stress and job satisfaction, respectively. A significant proportion of the nurses were found to have emotional distress which was significantly related to EE, DP, and job stress. A training module including strategies to build empathetic skills, stress management, and ways to promote psychological well-being, should be embedded in the curriculum of new graduate nurses.
Management and outcome of EGFR mutant lung cancer with SARS-CoV-2 infection
Authors: Kolluri Spoorthy , Panda Soumya Surath , Panda Adyakinkar , Singh Santosh Kumar
Published: September 2023

The world and India, in particular, have been grappling with the coronavirus disease (COVID-19) pandemic for more than a year now. The simultaneous presence of active COVID-19 infection with lung cancer poses both a diagnostic and therapeutic dilemma, because of similar clinical, radiological features along with increased susceptibility to ICU admissions and death. We present the case of a metastatic EGFR mutant lung cancer patient who was started on Gefitinib during active COVID-19 infection. He had made a complete recovery from COVID-19 infection while achieving a partial response to therapy in terms of primary lung cancer. The case highlights the importance of active involvement of a medical oncologist in the care of all cancer patients with COVID-19 infection instead of the traditional holding of all therapy for cancer until COVID-19 recovery as suggested by the majority of guidelines.
p16 expression in urothelial carcinoma: Experience from a tertiary care center in coastal South India
Authors: Sachdeva Sanjana , Suresh Pooja K. , Basavaiah Sridevi H. , Sahu Kausalya K. , Sreeram Saraswathy , Kini Hema , Kini Jyoti R. , Pinto Amanda C.
Published: September 2023

Background:

Urothelial carcinomas (UC) account for 6 and 2% of all cancers in men and women, respectively. Human papillomavirus (HPV) is one of the causative agents in cancers of the uterine cervix and head and neck. The role of HPV is also being studied in cancers of the urinary bladder, penis, and prostate. As p16-INK4a is a surrogate marker for high-risk HPVE7 oncoprotein, this study aims to highlight the utility of p16 immunohistochemistry (IHC) in the evaluation of HPV-associated UC.

Materials and Methods:

A retrospective study was conducted on UC of the bladder received in the Pathology department between January 2013 and December 2018. Bladder biopsies from non-neoplastic lesions served as controls. IHC was done for the detection of the p16 antigen. The p16 staining was recorded as positive, when there was strong staining in >50% of tumor nuclei. The p16 positive and negative tumors were compared based on age, gender, tumor size, grade, and muscle invasion. P value <0.05 was considered statistically significant.

Results:

The expression of p16 was analyzed in 72 UC and compared with 20 non-neoplastic cases, of which 26.4% of the cases showed p16 expression. The p16 expression was absent in the non-neoplastic lesions. While the majority (87.5%) of the low-grade tumors were negative for p16 expression, 43.8% high-grade tumors were positive. Similarly, a larger proportion of invasive carcinomas (38.8%) expressed p16 as compared to non-invasive carcinomas (13.8%). Thus, p16 expression showed a significant association with grade and stage in these malignancies (P < 0.05).

Conclusion:

The p16 expression was associated with high-grade and muscle-invasive UC. The p16 was absent in all non-neoplastic and precursor lesions. Thus, it can provide essential information not only about HPV association but also on the prognostic implications for the patients.
Spontaneous vanishing of hepatocellular carcinoma: A case report of an extremely rare incident
Authors: El-Kassas Mohamed , El Sheemy Reem Y. , Sweedy Ahmad T. , Abdelmaksoud Ahmed Hosni
Published: September 2023

One of the very uncommon clinical conditions is the spontaneous remission of tumors, with scarce reports around the world in various types of tumors. Spontaneous remission of hepatocellular carcinoma (HCC) is extremely rare, but it is well documented with a still unclear underlying mechanism. In this case report, we present one of those exceptional incidents of HCC regression with a trial to tackle possible explanations. Our case, which has a history of successfully treated hepatitis C virus, presented with a large infiltrative right lobar mass invading the main portal vein, with markedly elevated alpha fetoprotein (AFP). According to the applied diagnostic and treatment guidelines, the patient was scheduled for conservative management. Although he did not receive any specific treatments for his condition, the mass regressed in size with recanalization of the portal vein and normalization of AFP after 6 months of follow-up and keep the same for the following 3 years. The mechanisms by which spontaneous regression of HCC can occur are still unknown and should be furtherly investigated better to understand the behavior of such aggressive neoplastic disease.
Dietary risk factors in gastrointestinal cancers: A case–control study in North India
Authors: Nadeem Shoket , Dinesh Kumar , Tasneef Zargar , Bhavna Sahni , Rahul Sharma , Kiran Bala
Published: September 2023

Background:

One-third of all cancer deaths are preventable by alterations in diet.

Methods:

A case control study was conducted in a Regional Cancer Center in North India to evaluate the relationship of diet with selected gastrointestinal cancers. A total of 171 cases, 151 hospital controls, and 167 healthy controls were interviewed using food frequency questionnaire. Data was analyzed using odds ratio with 95% confidence interval and Chi-square test.

Results:

Two to three times increased risk of GI cancers was observed with hot and salted tea. Alcohol [OR 2.30 (1.32-4)] and smoking [OR (2.77 (1.77-4.33)] emerged as risk factors in healthy controls among whom freshly prepared food had significant protective effect [OR 0.57 (0.37-0.88)]. Sweet tea showed protective effect in hospital and healthy controls (OR 0.33 and 0.26, respectively). NSAIDS was associated with significantly higher risk of GI cancers. Consumption of dietary fibers decreased risk, which was significant for wheat and pulses but insignificant for rice. Vegetables and fruits showed significant protective effect ranging from 20 to 80% while intake of non-vegetarian foods showed significantly higher odds among controls (OR 2.37–13.4). Odds of GI cancer cases having consumed chutneys and pickles were significantly higher in comparison to healthy controls while consumption of dairy products showed protection. Low and medium intake of mixed spices inclusive of curcumin showed protection (OR 0.13 and 0.39, respectively) while intake of red chillies was associated with 2–30 times significantly higher odds.

Conclusions:

We have been able to generate baseline evidence of association between diet and selected GI cancers to encourage prevention and further research.
The utility of serum amylase as a prognostic marker in multiple myeloma
Authors: Chetana Panthula Sree Vamsee , Krishnan Sajitha , Jose Wesley M.
Published: September 2023

Background:

Ectopic production of amylase by tumor cells is known since 1951. Elevated amylase in multiple myeloma (MM) was first described in 1988. It has been postulated that translocation of chromosome 1, where amylase gene is situated, is responsible for ectopic production from the malignant plasma cells. Anecdotal reports have shown hyperamylasemia in MM to be associated with extensive bone disease, rapid progression, and shorter survival. Serum amylase estimation is a ubiquitous test. This prospective study was conducted to ascertain the degree of elevated amylase, its clinical utility, and implications in MM patients.

Materials and Methods:

In an 18-month period, all consenting patients with newly diagnosed or relapsed MM were tested for serum amylase levels. The study excluded patients with elevated lipase, abnormal creatinine clearance, and evidence of intestinal obstruction or perforation. Patients with amylase value >100 U/L were designated to have “elevated amylase level” for the purpose of this study.

Results:

We enrolled 58 patients with MM, of which 29.3% (n = 17) were found to have elevated serum amylase levels. The median age of patients with elevated amylase was 65 years. The male-to-female ratio was 1.9:1. There was no statistical association between age, gender, type of heavy chain class, light chain, or high-risk cytogenetics. Among patients with the International Staging System (ISS), Stages I, II, and III, 20.8% (n = 5), 31.3% (n = 5), and 41.2% (n = 7) were noted to have elevated amylase levels. A statistically significant association was noted between the presence of extramedullary disease (EMD) and elevated amylase level (P = 0.028). Higher mortality (29.4% versus 17%) and shorter mean survival of (30.2 ± 3.3 months versus 51.7 + 4.9 months) were recorded in patients with elevated amylase levels in comparison to those with normal levels.

Conclusions:

Elevated serum amylase level in MM is indicative of advanced ISS stage, the presence of EMD, higher risk of mortality, and shorter survival. Serum amylase can be used as a cost-effective tool in myeloma management.
Association of serum adiponectin levels and ADIPOQ SNP rs2241766 with breast cancer risk in Indian women
Authors: Govindarajan Sumitra , Saxena Alpana , Mahajan Bhawna , Mahto Mala
Published: September 2023

Context:

Adiponectin, an adipokine, and its gene polymorphisms have been associated with breast cancer risk in various populations.

Subjects and Methods:

In this study, we evaluated the association of the circulating levels of adiponectin and adiponectin gene polymorphism SNP rs2241766 with breast cancer and its clinicopathological characteristics in Indian women. A case-control study was carried out with 60 Ductal Infiltrating Breast Carcinoma patients and 60 age-matched healthy controls. Serum adiponectin levels were measured by ELISA. SNP genotyping was done by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism.

Statistical Analysis:

Serum adiponectin levels were compared using the Mann Whitney U test. The frequency of genotypes was compared using the Chi-square test. The odds ratio was calculated using logistic regression.

Results:

Lower serum adiponectin level was associated with increased risk of breast cancer in postmenopausal women (OR – 7.69; 95% CI – 2.16–27.43, P = 0.002) but not in the reproductive age group women. There was no association between adiponectin levels with the TNM stage of the tumor, histopathological grade, erbB2, and ER/PR status. The SNP rs2241766 polymorphism was not associated with breast cancer risk but the mutant genotypes TG/GG was found to be significantly associated with the lower histopathological grade of the tumor (X2 (2, N = 60) = 8.62, P = 0.01).

Conclusion:

Our results suggest that low serum adiponectin levels are associated with an increased risk of breast cancer in postmenopausal women. The TG/GG genotypes of SNP rs2241766 polymorphism were associated with a lower histological grade of the tumor.
Real-world evidence of sorafenib for the treatment of hepatocellular carcinoma: A single-center study
Authors: Lopez-Lopez Aida , Gayoso-Rey Mónica , Garcia-Beloso Nerea , Romero-Ventosa Yaiza , Robles-Torres David , Martinez-Reglero Cristina , Piñeiro-Corrales Guadalupe
Published: September 2023

Context:

Hepatocellular carcinoma is the third leading cause of cancer death. Currently, sorafenib is the treatment of choice in advanced hepatocarcinoma.

Aims:

Assessing the effectiveness and toxicity of sorafenib in real-word clinical practice in patients with hepatocarcinoma.

Settings and Design:

Single-centered observational retrospective study.

Methods and Material:

We included patients with hepatocarcinoma who began treatment with sorafenib between 2008 and 2018. We evaluated overall survival, time to progression, and response using RECIST (Response Evaluation Criteria in Solid Tumors) criteria. Toxicity was assessed according to the Common Terminology Criteria for Adverse Events version 5. 2020.

Statistical Analysis Used:

Kaplan–Meier curves and the log-rank test were used to determine the survival time and estimate factors associated with these events. Data were analyzed with SPSS 19.0 software.

Results:

We included 36 patients (88.9% male) with an average age of 64 ± 3.4 years. The tumor stage was advanced (C) in 21 patients (61.8%). We obtained a median overall survival of 8.5 months (IQR 3.14–18.9) and a time to progression of 4.5 months (IQR 2.4–8.8). The main degree of response was progression in 19 patients (36.1%), followed by stable disease in 13 (52.8%). The most commonly reported adverse reactions were: constitutional (83.3%), gastrointestinal (55%) and dermatological symptoms (50.0%). The development of grades 3 or 4 toxicity was not associated with increased overall survival (P = 0.719).

Conclusions:

The findings of the survival analysis obtained in real practice are similar to those obtained in pivotal clinical trials. Adverse reactions were different from those expected.
Treating low- and intermediate-risk acute promyelocytic leukemia with and without chemotherapy: A comparison in a tertiary care center
Authors: Saxena Mohit , Madabhavi Irappa V. , Patel Apurva , Panchal Harsha , Anand Asha
Published: September 2023

Background:

Acute promyelocytic leukemia (APL) comprises approximately 10% of acute myeloid leukemia (AML) cases.

Material and Methods:

Both options of treatment (ATRA–ATO and ATRA–chemotherapy) were discussed with patients with low- and intermediate-risk APL, pros and cons explained in details, and treatment regimen selected after getting informed written consent.

Results:

Total 71 patients were included in the study; among these patients, 3 were negative for both FISH for t (15,17) and RT-PCR for promyelocytic leukemia retinoic acid receptor alpha, and 36 patients with APL had white blood cell count at diagnosis >10 × 109/l. Total 30 patients with newly diagnosed as low- and intermediate-risk-APL fulfilled all inclusion criteria, treated and followed for a minimum period of 2 years up to June, 2016. Fifteen patients liked to be treated with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO), while rest of the 15 patients preferred treatment with ATRA and chemotherapy.

Conclusion:

Combination of ATRA and ATO is equally effective, less toxic, and more feasible in comparison to ATRA and chemotherapy for patients with low- and intermediate-risk APL and is a viable option for this subset of patients, especially in countries with limited resources.
Comparative study of concurrent conventional chemoradiotherapy versus hypofractionated chemoradiotherapy in newly diagnosed glioblastoma multiforme postoperative patients
Authors: Khatri Naresh Kumar , Kumar H. S. , Sharma Neeti , Jakhar Shankar Lal , Dhaka Saroj
Published: September 2023

Purpose:

To assess the treatment response and toxicity profile among two groups of newly diagnosed glioblastoma multiforme (GBM) postoperative patients receiving conventional radiotherapy (RT) versus hypofractionated RT with concurrent temozolomide (TMZ) in both.

Materials and Methods:

A total of 50 patients randomly allotted into two arms (25 in each). Dose received 60 Gy (2 Gy/#) in conventional fractionation RT versus 50 Gy (2.5 Gy/#) in hypofractionated RT with concurrent TMZ 75 mg/m2 orally daily in both arms, respectively. Follow-up was done at 1, 3, 6, and 12 months after completion of treatment to evaluate toxicities, treatment response, and progression-free survival (PFS).

Results:

All patients were well tolerated with treatment; no major adverse effects were monitored in two arms. There was no statistical significant difference in treatment response, which was found 64% versus 60% in arm A and arm B, respectively, at 3 months of follow-up (P = 0.768). Toxicity profiles were also noted similar in both arms. The 6-month PFS was 84% and 80% in arm A and arm B, respectively (P = 0.71) and 12-month PFS was 60% and 52% in arm A and arm B, respectively (P = 0.69).

Conclusion:

Among the patients followed, this study showed that hypofractionated RT regimen was not inferior to conventional RT regimen.
Ipsilateral lung dose as a correlative measure for radiation pneumonitis in patients treated with definitive concurrent radiochemotherapy
Authors: Kirakli Esra Korkmaz , Erdem Sevilay , Susam Seher , Erim Eser
Published: September 2023

Objective:

Mean lung dose (MLD) and percent of total lung (TL) volume that receive a dose greater than 20 Gy (V20) have been the most validated parameters in the prediction of radiation pneumonitis (RP). However, these parameters present mean values of TL parenchyma and predict the right and the left lung as a unique functional organ unit, not take into account the difference in function and dose density between the lungs. Furthermore, there have been very limited data evaluating ipsilateral lung dosimetric constraints in addition to TL parameters to predict RP in non-small cell lung cancer (NSCLC) patients treated with radiochemotherapy (RCT).

Methods:

Between 2010 and 2017, clinical–radiological findings of NSCLC patients treated with RCT were evaluated in terms of RP, retrospectively. MLD, V20, and V30 values of ipsilateral lung were assessed from dose–volume histogram and registered. The primary endpoint was to assess the relation between ipsilateral lung dose constraints and RP risk.

Results:

There were 75 patients. There was ≥Grade 2 RP in 33 cases (%44). In univariate analysis, ipsilateral MLD, ipsilateral V20, ipsilateral V30, and TL V30 were found to be significant. Ipsilateral MLD and PTV were found to be the independent risk factors for RP. Cutoff values for RP risk were determined as 18Gy, 35%, and 28% for ipsilateral MLD, ipsilateral V20, and ipsilateral V30, respectively. Predictive values for ipsilateral MLD and ipsilateral V20 were higher than TL.

Conclusions:

In NSCLC patients treated with RCT, MLD, V20, and V30 values of ipsilateral lung parameters might increase the predictability of RP risk in addition to TL parameters.

Advances in Knowledge:

Cutoff values for RP risk were determined as 18Gy, 35%, and 28% for ipsilateral MLD, ipsilateral V20, and ipsilateral V30, respectively. Predictive values for ipsilateral MLD and ipsilateral V20 were higher than TL.
Naturally Occurring Radionuclides in Tiles Available in Ibadan, Nigeria, and the Associated Radiological Hazards
Authors: Farinde Damilola Adegbenro , Alatise Olufunmilayo Omotunde , Atanley Pauline Ayoola , Oloruntola Rachael Foluke , Mustapha Amidu Olalekan , Idowu Olufemi Abiola
Published: September 2023

Introduction:

All building materials of natural origin contain some amounts of primordial radionuclides, 40K, 232Th, and 238U, as well as other radionuclides in the decay series of 232Th and 238U.

Purpose:

The use of tiles to beautify walls and floors in dwellings has become popular worldwide and in Nigeria in particular. However, not much has been done in assessing the impact of the use of floor and wall tiles on the radiation exposure of dwellers. In this study, radioisotopes of natural origin (226Ra, 232Th, and 40K) in selected ceramic tiles often used in Ibadan Southwest Nigeria were estimated and the associated radiological parameters evaluated.

Methodology:

Forty-five samples of different types of floor and wall tiles were obtained from local markets within the study area. Each of the 45 samples was pulverized and sealed in an airtight sample container for 4 weeks before analysis using a sodium iodide-based gamma-ray spectrometer.

Results:

The average values of 226Ra, 232Th, and 40K obtained were 44.28 ± 0.56, 84.71 ± 0.60, and 830.44 ± 0.63 Bqkg−1, respectively, which shows that they are greater than the corresponding estimated worldwide average concentration. Again, the estimated average values obtained for the radiological hazard parameters for equivalent activity due to radium and representative gamma-ray level index were found to be lower than the world averages. Similarly, the absorbed dose rates due to gamma-ray emission were found to be higher than the world common values.

Conclusion:

This study indicates that the use of these tiles will not be posing potential radiological risk if used in dwellings. However, construction works that requires the use of these tiles must be designed in such a way that the emission of dangerous radiation will not be a threat to the occupants.