bluuebunny/crossref_metadata_2025 huggingface dataset:
Wideband RCS reduction of thin metallic edges mediated by spoof surface plasmon polaritons
Authors: Li Xinghua , Feng Mingde , Wang Jiafu , Fu Xinmin , Han Yajuan , Sui Sai , Pang Yongqiang , Qu Shaobo
Published: February 2021

The back-scattering from front edge diffraction contributes significantly to mono-static radar cross section under TE-polarization when the specular reflection of an object is eliminated by elaborate shaping. With the aim to suppress the back-scattering of thin metallic edge, we propose to achieve wideband radar cross section (RCS) reduction by integrating an absorbing structure (AS) in front of the edge. The unit cell of AS is composed of a longitudinal array of metallic strips with linearly decreasing lengths. Under TE-polarized illumination, spoof surface plasmon polariton (SSPP) can be excited with high efficiency. Due to the deep-subwavelength property of SSPP, electromagnetic waves are highly confined around the AS, leading to strong local field enhancement and hence to wideband absorption. In this way, back-scattering of the edge is suppressed and the mono-static RCS can be reduced significantly over wide band. To verify this method, we designed, fabricated and measured a prototype. The results of both simulation and measurement indicate that our proposal can significantly suppress edge scattering, whose RCS reduction more than 10 dB achieves at range of 8.8–17.8 GHz under TE polarization. This work provides a new alternative of suppressing edge diffraction and may find applications in electromagnetic compatibility, radar stealth, etc.
The Influence and Countermeasures of Citizen Participation in Crisis Management in the Internet Age
Authors: Yao Ke
Published: February 2021

Citizen participation mainly focuses on citizens 'participation in social policies and supervision of public power. Citizen participation in the Internet age has shown some new characteristics in terms of scope of participation, willingness to participate, and means of participation, and it has a profound impact on the process, environment and standards of social crisis management. Public administration departments are urgently required to respond appropriately in terms of regulations, expression channels, etc.
Analysis of Public Service Advertisement's Creation of Fashion Brand Image
Authors: Kuang Xueying , Jin Shui
Published: February 2021

The problem solved by this article is that the new media is increasingly showing a vigorous development, the market competition is becoming more and more fierce, media technology and media are changing rapidly, and traditional advertising can no longer meet the competitive development of some modern brands and the needs of the audience. The research process of this article is from the perspective of public service advertisements, studying the development status of domestic and foreign brand public service advertisements and the case analysis of its application in brand image shaping and dissemination. The conclusion of this article is that now that homogenization is getting higher and higher, if you want to build a brand that is recognized and loved by consumers, you must effectively distribute brand products, reflect the brand's social responsibility and love. The unique research of this article is the integration of public service advertising and fashion brands to create an innovative research model that combines practice and promotion.
The Construction and Characteristics of Foreign Army's Electronic Countermeasure Equipment
Authors: Zhang Cuodong
Published: February 2021

Based on the introduction of the development of electronic countermeasures, this paper introduces the composition, construction and application characteristics of foreign electronic countermeasures equipment, and puts forward some Suggestions on the development of electronic countermeasures.
Research on the Influence Mechanism of Career Insecurity on Individual Career Dynamics
Authors: Wang Peiqi , Zhang Bin , Huang He
Published: February 2021

Career insecurity is widespread in individual career development. Career insecurity has both positive and negative effects on individual career dynamics. It has practical value to explore the influence mechanism between career insecurity and individual career dynamics for both individual career development and organizational performance. Through sorting out the relevant literature, this paper proposes two hypotheses on the influence of career insecurity on individual career dynamics. The negative impact of career insecurity on individual career motivation is mainly reflected in the reduction of organizational commitment, organizational trust, job satisfaction, employee performance, work input, innovative behavior, etc.; the positive impact of job insecurity on individual career motivation is mainly reflected in a low level of career insecurity can lead to social inertia such as absenteeism and increased escapism. this research plans the research methods and steps, laying a foundation for the next empirical study.
Analysis on Infectious Risk Stress in the Supply Chain of Mega Infrastructure Project
Authors: Zhao Na
Published: February 2021

In the implementation process of great infrastructure engineering, the structural safety of supply chain in coping with infectious risks (IR) is of important significance to operation of the whole project. Moreover, infectious risk can influence safety of supply chain of mega project (MP). Therefore, this study constructed a function of infectious risk stress, calculated the infectious risk stress value of supply chain of mega infrastructure project (MPSC), and analysed influences of random variables on infectious risk. Results demonstrate that the maximum infectious risk stress is at the end of supply chain of mega infrastructure project. Research conclusions provide references to anti-risk integrated design of supply chain of mega infrastructure project.
The Embedded Strategy of Enterprise Innovation Network Based on Knowledge Base
Authors: Li Chen Guang , Qiu Zhenjun , Jiang Guihuang
Published: February 2021

Constructing the innovation network is an important means of breakthrough in the traditional manufacturers for the emerging e-commerce platform, based on two different levels of innovation network node, content and structure, YEATION and YOUPIN were chosen to analyse and research the relationship and between knowledge base and the embedding strategy of electric business platform enterprises to create innovation network. To put forward the knowledge base width wider, insufficient depth of the enterprise should adopt structural strategy give priority to relational embeddedness, on the other hand, enterprises of which the depth of knowledge base is deep and width of insufficient shall adopt strategy give priority to the embedding of structure. At the same time, it is proposed that platform enterprises should not adopt a single embeddedness strategy, but should adopt auxiliary embeddedness strategy in a timely manner.
Modeling of content and language integrated learning for students of economics
Authors: Rodionova Elena , Firsova Svetlana , Garifullina Fliura
Published: February 2021

The English language is considered to be the global language of communication and professional activity in the field of Economics. One of the effective techniques of professional communicative competence is Content and Language Integrated Learning (CLIL). The aim of the research is to elaborate the model of CLIL for students of Economics at the Volga State University of Technology. Such methods as theoretical (literature review, analysis, generalization, comparison, interpretation, analogy, modeling), general empiric (study and generalization of teaching practices), specific empiric (questionnaires, testing, observation, documents review) statistical (processing of questionnaires and testing results) proved successful in the course of research. The undertaken research allowed identifying the interest of the majority of teachers and students of Economics in using the English language when teaching and learning some subject-matter disciplines. Consequently, it is possible to make a conclusion concerning the necessity of taking some special measures such as preliminary language courses, meeting the organizational and financial requirements. The research results have allowed to establish that the intermediate (according to the scale ‘soft-hard’) subject-led model is the most appropriate for the implementation in the educational process of students of Economics at the Volga State University of Technology. For this purpose, the authors elaborated the conceptual didactic CLIL model.
Digital multitasking problem in modern universities educational process - review
Authors: Lyubova Tatyana
Published: February 2021

This article is a review of recent researches on digital multitasking problem. Claiming that digital technologies are changing the traditional roles of a teacher and a student, we must clearly understand a kind of effects arised at the moment digital technologies are used in the classroom. Moreover, the methods of applying digital technologies for the success of students’ academic progress are not always obvious to the teacher himself. The goal of the research analysis on digital multitasking in education problem is to identify shifts in settings and accents from the operationalism methodology to attempts of application of analytical philosophy of consciousness methodology and / or postmodern philosophy. This allows us to analyze the intentions, motives of the educational process participants and thereby define new conceptual boundaries of digital multitasking.
Teaching russian as a foreign language in the modern educational paradigm: training dictionaries
Authors: Iniutina Liudmila Alexandrovna , Shilnikova Tatiana Sergeevna
Published: February 2021

The work is devoted to the problem of intensification of teaching Russian as a foreign language in the process of formation and development of the lexical competence of students. The role of educational dictionaries of various types is emphasized. The Experimental Electronic Multilingual Dictionary of Military Terms is presented. It is based on ABBYY Lingvo software for teaching Russian to foreign students of military universities. His vocabulary includes a special vocabulary describing various segments of military activity (weapons, equipment, commands, military life, etc.). For each word there are translations into European languages (boi - English batttle, combat; French combat (m); Portuguese combate) and Asian languages (Laos ; Arabic ; Pashto ). The potential of an electronic multilingual dictionary in the implementation of multicultural and professionally oriented teaching of Russian as a foreign language in a non-linguistic university is identified. The role of the electronic translated multilingual thesaurus in the formation of speech professional competence, which ensures the removal of language barriers in the study of military-technical sciences by foreigners, is determined. The universality of the dictionary is characterized. It was created taking into account those national languages whose speakers receive special education in Russian military universities, and provides opportunities for the redistribution of classroom and independent work of students. Its effectiveness has been proven as a tool for modern interactive, multilingual and multicultural education.
Content of professional training of teacher-choreographers in China
Authors: Kasimanova L.A. , Boven In
Published: February 2021

The article is devoted to the analysis of the state of modern professional training of teachers-choreographers in China. The article presents the authors’ vision of modeling the content of modern professional training of choreographers. The analysis of the existing literature on the topic of the research made it possible to determine the tendencies and patterns of modern professional training of teachers- choreographers. Considering in the study the problems of training teachers of the artistic and creative direction, namely, teachers-choreographers, to solve professional problems, we proceed from the fact that their professional training should be aimed at mastering the teacher’s professional competencies, as well as deep knowledge and skills in the field of choreographic art The rationale for this is the demand for teachers- choreographers in the modern labor market in the field of education - in its various segments (preschool, school, professional, general and additional, as well as in the field of educational leisure). The analysis presented in the study confirms that the content of professional training of teachers - choreographers remains largely at the same level and does not meet modern requirements. The study is devoted to the peculiarities of the organization of the educational process, the content of professional training. Professional training is carried out in the direction of “Pedagogical education” with an appropriate profile, however, in this case, the actual choreographic training of students is significantly limited. We consider it important to note that the art of dancing, which is the subject of professional training for teachers-choreographers, should be considered as an artifact of modern culture, bearing all its inherent features, is the main tool for their professional training. The vector of building an educational cluster is its social demand, which sets the attractors of the development of the content of modern professional training of choreographers and pedagogues. Modern professional training of teachers-choreographers is, first of all, a system of preserving cultural traditions of which students-choreographers master the basis in the learning process, bringing their own understanding and understanding creating their own, new, modern choreographic culture.
Developing media literacy skills of future specialists in the contemporary teacher training education
Authors: Semenova Yulia , Sotnikova Svetlana
Published: February 2021

Development of media literacy looks especially crucial in context of globalization characterized by a high level culture-language interaction. Contemporary education environment is defined by intensive information saturation which demands skills to act effectively and be flexible from a modern teacher in accordance with constantly changing needs of modern community. Evidently, media literacy is a significant component of professional competence for specialists of modern teacher training education. The advanced level of media literacy skills allows to raise efficacy and quality of teacher training education which is aimed at training a specialist who is ready for development, improvement and selfrealization in professional sphere. Media literacy is connected with applying information and communication technologies in theory and practice of contemporary professional education. So, the term “media literacy” implies future specialist’s skills to work not only with mass media but with various information and communication sources allowing to search, select and present necessary information possibilities for solving academic, personal, cognitive and developing tasks.
Legal framework for quality assurance in the Republic of Moldova higher education
Authors: Usaci Doina , Sargu Lilia
Published: February 2021

In the current economic context, quality has become a source of competitive advantage, and universities that want to achieve academic excellence must perceive quality as something integral to their activities. The purpose of this research is to demonstrate that without establishing an efficient mechanism for quality assurance and evaluation, higher education institutions turn into diplomas mills, being rather an impediment to the cultural, economic and social development of society. So, in order to ensure the success of the scientific approach, the following methods were used: scientific documentation; analytical-synthetic methods; the method of comparing and generalizing theoretical and practical data. The analysis of the quality of higher education in Moldova in terms of the provisions of the Bologna Process raised a fundamental question - the acute need for effective external evaluation mechanisms of higher education institutions in parallel with the internal mechanisms of institutions. As a result, following the empirical study, we conclude that the universities of the Republic of Moldova do not face significant problems that seriously affect the performance of the total quality management system, but they must really make efforts to improve the dimensions analyzed in within this research, in order to obtain the benefits expected from the implementation of the total quality management system.
Linguocultural approach as means of managing learning strategies when teaching a foreign language
Authors: Sinichkina Anastasia , Faizrahmanova Lilya , Muhtarova Rezeda
Published: February 2021

The article deals with the survey conducted upon the basis of the Pedagogical University with the students learning English as a foreign language. The study is aimed at finding the correlation between applying the linguocultural approach and improving students’ leaning strategies implication. Thus, the study defined the positive impact of the linguocultural approach upon the frequency of learning strategies usage by the students. The study deals with such types of learning strategies as common, metacognitive, affective, and social strategies implemented by the students learning English grammar and phonetics. The authors of the article used a questionnaire method to assert the fact that linguocultural approach has positive impact upon the development of the students’ learning strategies depending upon their gender and national peculiarities.
Comparison of the outcomes between locally advanced cervical squamous cell carcinoma and adenocarcinoma patients treated with definitive chemoradiation
Authors: Ahlawat P. , Mitra S. , Sharma M. K. , Saxena U. , Wahi I. K. , Choudhary A. K. , Tandon S. , Surkar P.
Published: February 2021

Objective: To present comparison of survival outcomes between locally advanced adenocarcinoma and squamous cell carcinoma patients treated with definitive chemoradiation.

Methods: It is a retrospective analysis and direct comparison between adenocarcinoma and squamous cell carcinoma cervix treated from January 2011 to December 2015. Of 73 patients analyzed 61 had squamous carcinoma histology and remaining 12 had adenocarcinoma. Inclusion criteria were patients with locally advanced stage (IIA) who have completed definitive chemoradiation and were available for response evaluation at 3 months of completion of treatment. Endpoints for the study were disease response evaluation at 3 months, progression rate, median progression free survival, median recurrence free survival, median loco-regional control, median distant metastasis free survival, median overall survival.

Results: There was no significant difference between the two histology groups with respect to rate of achieving complete response (78.6 vs 75%, p = 0.718) and rate of disease progression (36% vs 50%, p = 0.517). There was no significant difference between median PFS (57.75 vs 17.74 months; p = 0.964), median RFS (NR vs 66.03 months; p = 0.876), median loco-regional control (not reached for both; p = 0.315), median DMFS (NR vs 66.03 months; p = 0.438) and median OS (NR vs 66.13 months; p = 0.884).

Conclusions: Locally advanced squamous cell carcinoma and adenocarcinoma treated with definitive chemoradiation have similar outcomes. Small sample size is the limitation of this study.
Role of complementary cytology, colposcopy and histopathology in detecting premalignant and malignant lesions of cervix
Authors: Mangla Akanksha , Sinha Renuka
Published: February 2021

Objective: Cervical cancer is the second most common gynecologic malignancy worldwide. India alone accounts for one fifth of total number of cases worldwide. The aim of our study was to calculate sensitivity, specificity, positive predictive value, negative predictive value, false positive rate and false negative rate of complementary cytology and colposcopy with histopathology as gold standard for detection of premalignant and malignant cervical lesions.

Methods: A cross sectional study was conducted at Vardhman Mahavir Medical College and Safdarjung hospital, Delhi, India. 100 non pregnant females with complaint of post coital or irregular vaginal bleeding and those who had unhealthy cervix on visual inspection were included in study.

Results: Colposcopy exhibited a high degree of accuracy in diagnosis of high grade lesions. Overall sensitivity of cytology was 50% whereas that of colposcopy was 83.3%. Cytology had specificity of 93.4% whereas colposcopy had specificity of 89.4%. 100% of high grade and invasive cancers on colposcopy were associated with similar findings on histology. The degree of agreement between cytology and colposcopy with histology was significant (p<0.001).

Conclusion: Colposcopy is sensitive method as compared to cytology, especially in the higher grade lesions and combination of both methods appears to be of higher diagnostic importance.
The impact of tumour regression in locally advanced carcinoma cervix during external beam radiotherapy and the need for adaptive planning
Authors: Choudhary Amit Kumar
Published: February 2021

Aim: To study the impact of tumour regression occurring during IMRT for locally advanced Carcinoma cervix and study dose distribution to target volume and OARs and hence the need for any replanning.

Methods and Materials: 40 patients undergoing IM-IGRT and weekly chemotherapy were included in the study. After 36Gy, a second planning CT-scan was done and target volume and OARs were recontoured. First plan (non-adaptive) was compared with second plan (adaptive plan) to evaluate whether it would still offer sufficient target coverage to the CTV and spare the OARs after having delivered 36Gy. Finally new plan was created based on CT-images to investigate whether creating a new treatment plan would optimize target coverage and critical organ sparing. To measure the response of the primary tumour and pathologic nodes to EBRT, the differences in the volumes of the primary GTV and nodal GTV between the pretreatment and intratreatment CT images was calculated. Second intratreatment IMRT plans was generated, using the delineations of the intratreatment CT images. The first IMRT plan (based on the first CT-scan or non adaptive plan) was compared with second IMRT plan (based on the second CT-scan or adaptive plan).

Results: 35% patients had regression in GTV in the range of 4.1% to 5%, 20% in the range of 1.1%-2%, 15% in the range of 2.1%-3% and 20% in the range of 6%-15%. There was significant mean decrease in GTV of 4.63cc (p=0.000). There was a significant decrease in CTV on repeat CT done after 36Gy by 23.31cc (p=0.000) and in PTV by 23.31cc (p=0.000). There was a statistically significant increase in CTV D98, CTV D95, CTV D50 and CTV D2 in repeat planning CT done after 36Gy. There was no significant alteration in OARs doses.

Conclusion: Despite tumour regression and increased target coverage in locally advanced carcinoma cervix after a delivery of 36Gy there was no sparing of OARs. Primary advantage of adaptive RT seems to be in greater target coverage with non-significant normal tissue sparing.
Role of interstitial brachytherpy using template (mupit) in locally advanced carcinoma cervix
Authors: Bhange Ashish , Gulia Abhishek , Punnakal Anirudh , Anand Anil Kumar , Bansal Anil Kumar , Patro Ch. Kartikeshwar , Kumawat Naveen
Published: February 2021

Introduction: Locally advanced carcinoma cervix includes stages IIB, IIIA, IIIB and IVA. Interstitial brachytherapy has the potential to deliver adequate dose to lateral parametrium and to vagina. Hence, it is preferable in cases with distorted anatomy, extensive (lower) vaginal wall involvement, bulky residual disease post EBRT and parametrium involvement upto lateral pelvic wall.

Aim and Objective: To determine clinical outcome and complications (acute and chronic) in locally advanced carcinoma cervix, treated with interstitial brachytherapy using template (MUPIT - Martinez universal perineal interstitial template).

Materials and Methods: This study is a retrospective analysis of 37 cases of locally advanced carcinoma cervix (stage IIB-2, IIIB-30, IVA-5), treated with EBRT (dose-median 45Gy/25#) ± concurrent chemotherapy (CCT) - Inj. Cisplatin/Inj Carboplatin, followed by interstitial brachytherapy using MUPIT from December 2009 to June 2015. Initial treatment with EBRT ± CCT was followed by intertstitial brachytherapy. Under spinal anaesthesia and epidural analgesia, MUPIT application was done. Straight and divergent needles (median 26, range 19-29) were inserted to cover parametrium adequately. Needle position was verified with planning CT scan and Brachytherapy planning was done. Dose was normalized to 5 mm box surface from outermost needle with optimization of dose to OAR (Bladder, Rectum and Sigmoid colon). Prescription dose –25Gy in 5#. Treatment was delivered by Microselectron HDR using Ir192 source. Treatment fractions were delivered twice daily with min 6 Hrs. gap in-between fractions.

Results: The median duration of follow-up was 25 months. Local control was achieved in 28 patients with residual disease in 7 patients and local recurrence in 2 patients. 10 patients had acute lower GI toxicity {Grade1 (n=6), Grade 2 (n=4)}, 2 patients had acute Grade 1 bladder toxicity. 1 patient had grade 3 and 1 patient had grade 4 chronic bladder toxicity. Chronic rectal toxicity was seen in 10 patients {Grade 2 (n=4), Grade 3 (n=4), Grade 4 (n=2)}.

Conclusion: Local control was achieved in 28/37 patients (75.6%) and overall survival rate of 81.1% at median follow up of 25 months in patients with locally advanced carcinoma cervix and unfavorable prognostic factors.
Evaluation of adequacy of conventional radiotherapy fields based on bony landmarks in cervical cancer patients using contrast enhanced CT
Authors: Deepak Tuli , Gupta M. K. , Seam R. , Sharma S. , Gupta M. , Fotedar V. , Vats S. , Himthani N. , Rana A. , Kaundal R.
Published: February 2021

Introduction: Cervical cancer is the second leading cause of cancer death in Indian women. Although, it is known that in Western women the conventional pelvic fields based on bony landmarks provided inadequate coverage for pelvic lymph nodes in cervical cancer; it remains unclear in Indian patients because of the pelvic anatomic discrepancies. In the present study, we have tried to evaluate the adequacy of conventional pelvic fields based on bony landmarks by using CECT using pelvic vessels as surrogate of lymph nodes.

Aims and Objectives: To evaluate the lymph node location in CECT pelvis using vessels as surrogate markers.

(a) To compare the data, so obtained, with the usual radiotherapy field; where bony landmarks are used to define the field.

(b) To evaluate the adequacy of radiation portal defined on bony landm-arks in covering pelvic lymph nodes.

Materials and Methods: This study was conducted in the Department of Radiotherapy and Oncology, Regional Cancer Centre, IGMC, Shimla in patients suffering from carcinoma of cervix. Two dimensional radiation portals were designed on conventional simulator “Acuity.” CECT pelvis was done in the same position along with same immobilization accessories used during conventional simulation. 2 mm thick slices were taken from L1 to mid femur. Using vessels as surrogates for lymph nodes and applying Taylors guidelines, adequacy of conventional GOG field was judged.

Results: Most of the parameters failed in this study, signifying inadequacy of GOG defined field in Indian population, detailed results will be discussed at the time of presentation.
Audit on early stage carcinoma cervix primarily treated with radical surgery: A tertiary cancer care centre experience
Authors: Dharmarajan Adarsh , Geetha M.
Published: February 2021

Introduction: Clinical staging is universally accepted for ca cervix. In early stage of carcinoma cervix both radiation and radical hysterectomy given equivalent local control rates as well as survival. Poor prognostic factors following surgery would necessitate-post-operative adjuvant radiation. Selecting the patients who is unlikely to require adjuvant treatment after surgery spares them the toxicity of multiple treatment modalities, which is worse than alone.

Aim: To find out clinico-pathological correlation in early stage carcinoma cervix treated with the surgery.

Materials and Methods: It is a retrospective audit of study. All carcinoma cervix cases primarily treated with surgery.

Results: A total of 25 cases were treated in this study. The median age of patients observed with 48 years. The common symptoms and stage were vaginal discharge (i.e., 42.30%) and 1B1 (61.53%). Most of patients were treated with type III radical hysterectomy and their clinical staging was correlated with the final histo-pathological staging. A total of 11 (i.e., 42.30%) required adjuvant treatment among them 7 (63.633%), 1 (9.09%) and 3 (27.27%) patients were in 1B1 1B2 and 2A respectively. The chi-square test has been performed to compute the correlation between clinical and histo-pathological finding. It shows that significant amount of relation present between clinical and histo-pathological findings.
Comparative evaluation of concomitant chemoradiation with weekly cisplatin and gemcitabine versus weekly cisplatin in the management of locally advanced carcinoma of uterine cervix
Authors: Gupta Vikas , Chauhan Ashok Kumar , Kaur Paramjeet , Khurana Anil , Verma Yashpal , Bansal Nupur
Published: February 2021

Aim: To evaluate feasibility of concomitant chemoradiation with weekly cisplatin and gemcitabine, and comparing the advantage of using this regimen over cisplatin alone in terms of disease control and toxicities in management of locally advanced carcinoma cervix.

Materials and Methods: The study has been conducted on fifty previously untreated, histopathologically proven FIGO stage II B - IV A patients of carcinoma cervix, attending the Department of Radiotherapy, Post Graduate Institute of Medical Sciences, Rohtak for definitive treatment by radiation therapy. The patients were divided randomly in two groups of 25 patients each. Group I received cisplatin 40 mg/m2 and gemcitabine 125 mg/m2 with concomitant external beam radiotherapy 50 Gy/25 fractions/5 weeks, followed by intracavitary high dose rate brachytherapy 7 Gy to point A, for 3 times, once in a week. Group II received concomitant chemotherapy with cisplatin 40 mg/m2 weekly alone while radiotherapy schedule were same as in group I.

Results: Total treatment duration in group I and II were 9-11 and 8-10 weeks respectively. Complete response rate in group I and II were 92% and 80%. Grade III skin and mucosal reactions was 20% in group I and none in group II. Diarrhoea was 24% in group I & 8% in group II. Grade II & III leucopenia was seen in 28% and 4% cases of group I & group II respectively. Upper gastrointestinal and renal toxicities were comparable in both arms. After six month of follow up, no evidence of disease was seen in 92% and 80% cases of group I and group II.

Conclusion: If the toxicity is managed adequately in platinum based doublet group, it may produce improvement in response. Study is ongoing.
Association of TNF-α rs-281865419 polymorphism with reproductive tract infections in Indian population
Authors: Sharma Vineeta , Singhal Pallavi , Kumar Anoop , Ramachandran V. G. , Das Shukla , Bharadwaj Mausumi
Published: February 2021

Aim: To investigate the presence of reproductive tract infections (RTIs) in symptomatic and asymptomatic women in North India and association of SNPs in TNFα gene (rs-281865419 C/T) with susceptibility to these RTIs.

Methods: We collected 100 symptomatic (cases) and 100 asymptomatic women (controls) samples and screened them for RTIs. Then genotyping of TNF-α gene was performed by PCR-RFLP.

Results: Among cases the frequencies of RTIs infection is higher than control. The prevalence of HPV, C. trachomatis, T. vaginalis, Bacterial vaginosis and N. gonorrhoeae are 28% & 6%; 11%, 32% respectively while in controls it was 5%, 2%, 1% and 8% & 1%. In the present study we found that the frequency of wild homozygous genotype (TT) was lower in cases 30% (6/20) as compared to controls 60% (12/20). The frequency of the heterozygous polymorphic genotype (CT) was higher in cases 65% (65/100) as compared to controls 32% (32/100). It was interesting to note that the frequency of the polymorphic homozygous genotype (CC) was higher in cases 15% (15/100) than controls 2% (2/100). While the frequency of the carrier genotype (CT + TT) was found to be more in cases 70% (70/100) than in controls 40/100 (40%). This study shows that T allele may be risk factor for Reproductive tract infections as its percentage is higher in cases as compare to normal controls.

Conclusion: TNF-? rs-281865419 locus may serve as an important biomarker for RTIs predisposition in Indian population though larger sample size is needed to validate the findings.
To evaluate the role of training session on ‘Cervical Cancer Screening’ in improving knowledge and attitude of Accredited Social Health Activists (ASHA) in East Delhi population
Authors: Singh Nilanchali , Rajaram Shalini , Gupta Bindiya , Mendiratta Anita , Kumar Sanjay
Published: February 2021

Background: India has the world’s largest load of cervical malignancy. A lot of it can be attributed to lack of cervical cancer screening awareness among the general population. The Accredited Social Health Activists (ASHA) are grass root workers who have good reach in the remote areas, where health care facilities are lacking. Training these ASHAs may increasethe general awareness about cervical cancer screening.

Methods: We organized a training programme of 250 ASHA workers in a tertiary care hospital with aim of improving their knowledge and attitude about cervical cancer screening which will eventually improve their practise of training women in general population. It comprised of 5 lectures in language they understand, slogans, posters, question answer session etc. A test comprising of 17 questions was conducted before and after session to check their knowledge and attitude.

Results: There was an overall improvement of 25% in knowledge of the ASHAs i.e. 38% answers were correct in pre-test and 63% were correct in post-test. Questions were pertaining to symptomatology, risk factors, screening methods, their utility and prerequisites of performing the screening tests, when and how often to repeat. Improvement was seen in all the areas. There was improvement in attitude too and most of them wanted themselves (98%), their relatives (100%) and the woman within their area (98%) to be screened for cancer cervix.

Conclusion: It was a small initiative and successful result was obtained after the training session of ASHAs. The impact on general population needs further evaluation.
Radiotherapy after hysterectomy in carcinoma cervix: Audit from a tertiary care cancer hospital in India’s largest state “Rajasthan”
Authors: Soni Tej Prakash , Prakash Aaditya , Takia Tinku , Goyal Jaishree
Published: February 2021

Purpose: To explore the reasons of hysterectomy and indications of post-hysterectomy radiotherapy in carcinoma cervix cases.

Methods: From January 2013 to May 2015, medical records of 64 cases of carcinoma cervix (post-hysterectomy) who were referred for radiotherapy to our hospital were analyzed retrospectively.

Results: Medical records of 64 cases were reviewed. The median age was 47 years. In 45% of females hysterectomy was done in towns, but in majority of cases (55%) hysterectomy was done in different cities of Rajasthan. Simple hysterectomy was done in 31 of (48%) cases. Wertheim’s hysterectomy was done in remaining 33 cases (52%). 15 cases (23%) were treated by IMRT technique, while remaining 87% cases were treated by 3DCRT technique to dose of 50 Gy in 25 fractions followed by CVS brachytherapy. All cases also received concurrent chemotherapy. Reason for hysterectomy was analyzed. In 32 (50%) cases, biopsy from gross lesion at cervix or PAP smear test was not done before surgery. In 32 cases (50%) understaging of the tumor or inadequate staging before hysterectomy was performed. Histopathology report analysis revealed that in 9 cases (14%) primary tumor size was less than 4 cm, in 27 cases (64%) there was no comment on pT size, in 22% cases primary tumor was larger than 4 cm. Surprisingly in one case the pT size was 7 cm. LVSI was not seen in 18 cases (28%), positive in 20 case (31%) and with no comment in 26 cases. More than 50% of stroma thickness was involved in 54 cases (84%), and in remaining 10 cases there was no comment on stroma invasion. In 33 cases (52%) pelvic lymphadenectomy was done, in 48% cases lymph nodes were not addressed in surgery. In 36 cases (56%) pelvic lymph node metastasis was seen either in preoperative imaging (USG/CT scan) or in histopathology. Median follow-up duration was 6 months. Locoregional failure was seen in 10 cases (16%), 6 cases (9%) also developed distant metastasis.

Conclusion: Failure to perform biopsy from gross lesion at or under staging/inadequate staging before surgery was the main reasons for inappropriate hysterectomy for carcinoma cervix. Inappropriate hysterectomy followed by chemo-radiotherapy resulted in poor tumor control rate as in our study, 1 out of every 4 patients failed loco-regionally with median follow up of 6 months. Strict adherence to guidelines for cervical cancer diagnosis and treatment is advised to prevent inappropriate hysterectomy.
Cervical cancer screening of female of rural community of Nepal: Knowledge, attitude and practices
Authors: Shrestha Anju
Published: February 2021

Purpose and Objectives: Cervical cancer is leading female cancer in Nepal. Despite the existence of effective screening using Pap smear, the uptake of screening is poor. This is mainly due to lack of knowledge, lack of availability of services in rural area and low priority of women’s health issue. Objectives of this study were to determine the baseline information about the knowledge of cervical cancer and explore attitude and practice of Pap smear screening among the women of rural community of Nepal.

Materials and Methods: A cross sectional population based descriptive study of female attending free health camp in different rural community of Nepal organized by Nepal Cancer Hospital was conducted using self-administered questionnaire to elicit information on demographic characteristics, knowledge, screening behaviors and determinants of cervical cancer. Knowledge is elicited about eligibility for screening and screening interval according to American Congress of Obstetricians and Gynecologists (ACOG) guidelines. Practices are evaluated as having ever been screened themselves. Attitudes referred to the various reasons for not getting screened themselves.

Results: A total of 500 women participated in this study, out of which 44.4% (228) were either illiterate or just educated up to primary school. Mean age of participates were 40.6±10.3 yrs. 47.4% (238) of women married before age of 18 and 57% (258) women had their first childbirth before age of 21 years. Only 33.8% (169) female knew that cervical cancer is preventable and is curable in early stage. Although 42.6% (213) women heard about Pap smear, only 38.2% (191) knew about eligibility of screening and 11% (55) knew about screening interval. However, knowledge of risk factors for cervical cancer was found in 8.2% (41). About 26.8% (134) women had done Pap test at least once. The most common reason for not doing Pap test is they never heard about it (41.8%: 209). The other reason includes do not know where to do (9.6%: 48); never adviced by doctor (9%: 45); embarrassment (2.4%: 12); fear of finding out cancer (3.2%: 16) and do not have any symptoms (2.4%: 12).

Conclusions: The study revealed low cervical cancer knowledge and poor screening behavior among the women. This may be suggestive of even poorer awareness and screening and practices among older women who are less educated or with no education.
Diagnostic dilemma of mesonephric adenocarcinoma cervix
Authors: Soni Abhishek , Bansal Nupur , Dhull A. K. , Kaushal Vivek , Atri Rajeev , Verma Monica
Published: February 2021

Introduction: Mesonephric carcinoma is a rare type of epithelial tumor of the uterine cervix which derive from the remnants of the paired mesonephric (Wolff’s) ducts. The incidence of such neoplasms is difficult to determine due to rarity, previous misclassification of clear cell carcinomas and yolk sac tumours as mesonephric carcinomas and potential underreporting due to misclassification of mesonephric carcinoma as Mullerian tumours or mesonephric hyperplasia. The evidence regarding the clinical course, prognosis and optimal treatment is limited.

Materials and Methods: Searches were performed on MEDLINE, EMBASE and Google Scholarly articles. All the relevant articles were included in the study. Only approximate 40 cases have been reported till now.

Discussion: Mesonephric adenocarcinoma cervix has different morphologies like ductal, tubular, solid, retiform, sex-cord like pattern, clear cell and serous papillary structures. IHC assessment is helpful in differentiating it from Mullerian counterpart, as it is negative for CEA, CK20, p16, PAX2, ER/PR and vimentin and positive for CD10, calretinin, CK7, CAM5.2 and EMA. It has no relation with HPV infection. Unlike squamous epithelial carcinoma, it is rarely presenting with the abnormal cervical smear result, has more advanced age at presentation and its incidence does not appear to decline with age. The diagnosis has been supported by endometrial curettings, directed/cone cervical biopsies and hysterectomy specimens. The majority of patients are diagnosed at stage IB with mean DFS of 48.6 months. Recurrence rate is 23%, with a mean interval of 40 months. Hysterectomy is the primary treatment. Advanced stage disease of adenocarcinoma seemed to respond to radiotherapy, but for the MMMTs the combination of chemotherapy with radiotherapy appears to be preferable.

Conclusion: Rarity of the neoplasm, varied morphology, mix presentation and very low number of cases leads to difficulty in correct diagnosis in a small biopsy specimen. IHC helpful in differentiating it from other lesions.
Implementing quality indicators for cytoreductive surgery in ovarian cancer: Experience from a tertiary referral center in Eastern India
Authors: Mukhopadhyay Asima , Chakraborti Basumita , Ghosh Anik , Bhaumik Jaydip
Published: February 2021

Background: Debate continues whether primary surgery or neo-adjuvant chemotherapy (NACT) or primary debulking surgery (PDS) should be offered in advanced epithelial ovarian cancer as frontline therapy. Since 2015, there has been a paradigm shift at Tata Medical center, whereas increasing number of patients are being offered PDS and a quality improvement programme was initiated. Recently, ESGO in October 2015 has published a document indicating 10 quality indicators for cytoreductive surgery in advanced ovarian cancer surgery.

Aim: We compared our performance against all 10 quality indicators.

Results: Primary cytoreduction rate has increased from 20% in 2012 to >70% at the end of 2015. Optimal cytoreduction rates were obtained in 90% cases and recently complete (CCO/CC1) cytoreduction rates are being achieved in >80% cases. All 10 quality indicators were achieved successfully including prospective documentation of morbidity and surgical findings in all cases. Morbidity figures are showing a downwards trend after the initial learning curve.

Conclusions: Implementation of a quality improvement programme is the key to overcome the barriers of implementing a cytoreductive program in advanced ovarian cancer. However, standards similar to developed countries can be achieved through a dedicated team effort.
Role of CA 19-9 in complex ovarian tumors
Authors: Thomas Dhanya S. , Sebastian Ajit , Thomas Vinotha , Thomas Anitha , Chandy Rachel , Peedicayil Abraham
Published: February 2021

Background: Cancer antigen 19-9 (CA 19-9) is a tumor-associated mucin glycoprotein antigen that may be elevated in healthy individuals as well as in patients with benign and malignant tumors. It is useful in the management of pancreatic and other gastrointestinal tumors. CA 19-9 is also elevated in benign and malignant ovarian tumors.

Aim: To study the pattern of serum CA19-9 in complex ovarian tumors.

Methods: The study design was descriptive, based on data collected from medical records. Patients with a complex ovarian mass, who were investigated with CA 19-9 and had undergone surgery, wereincluded in the study. The study duration was 2 years from January 2014 to December 2015. A total of 273 patients (119 - benign and 154 malignant) with complex ovarian mass and elevated CA 19-9 underwent surgery during the study period.

Results: CA 19-9 was elevated in 55 patients (20%). Of these, 23 patients had benign tumors while 32 had malignant tumors.

Among patients with benign tumors, 21 had dermoid, 23 had mucinous tumors and 75 had other types of tumors. CA 19-9 was elevated in 10 (47.6%) of the dermoids, 7 (30.4%) of the mucinous tumors and 6 (8%) of the other benign tumors. Among patients with malignant tumors, 138 were epithelial and 16 were non epithelial tumors. Of the epithelial tumors, 31 were mucinous and 107 were non mucinous types. Overall, 29 (21%) had elevated CA 19-9. Of the epithelial tumors, 22.6% of the mucinous type and 20.6% of the non mucinous type had elevated CA 19-9. Among the non-epithelial tumors, 3 (18.8%) had elevated CA19-9.

Conclusion: CA 19-9 is elevated in several conditions but most likely to be raised in dermoid cysts and mucinous tumours. CA19-9 levels need to be interpreted along with clinical and radiological findings.