bluuebunny/crossref_metadata_2025 huggingface dataset:
Gespannte Übersetzungen – Michael Hamburger revisited
Authors: Fritzenkötter Viktor , Schmitz Julius
Published: February 2023

Après un bref examen de la pensée théorique de Michael Hamburger sur la traduction, enracinée dans sa pratique traductive, l’article s’intéresse aux traductions par Hamburger des poèmes de Paul Celan et aux réflexions sur les difficultés concrètes de leur traduction, qu’il expose dans son essai On Translating Celan (1984/2000). Hamburger constate que la « façon de respirer » l’emporte sur la sémantique du poème traduit ; pourtant, Hamburger commence par décrire notamment les difficultés sémantiques rencontrées au cours de la traduction. Ces réflexions font l’objet d’un examen critique et sont développées dans la deuxième partie de l’article. La troisième partie complète et fait contrepoint à la deuxième, en sondant les tensions identifiées dans les écrits de Hamburger. Elle traite de la manière et de la mesure dans lesquelles Hamburger satisfait à la « prescription de Celan » identifiée par Hamburger dans Sprich auch Du de restituer dans ses traductions l’obscurité qui habite les poèmes de Celan. L’article examine comment cette obscurité, qui n’est pas une obscurité hermétique, mais plutôt une obscurité ouverte et communicative, peut être traduite, conservée dans la traduction.
T.S. Eliot’s “significance”
Authors: Ducroux Amélie
Published: February 2023

L’année 1922 fut marquée, notamment, par la publication de The Waste Land et la création, par Eliot, de la revue The Criterion . Un autre événement majeur de 1922 fut la publication d’ Ulysse , événement déterminant pour Eliot, qui s’empressa de louer la capacité de Joyce à « revivifier » le passé en recourant à ce qu’il appela alors la « méthode mythique ». Prenant pour point de départ la courte recension d’ Ulysse qu’Eliot publia en 1923 dans The Dial , cet article s’attachera à mettre en évidence le lien établi entre Eliot et Joyce en 1922 et à envisager cette année comme un moment-clé lorsqu’il s’agit de réinterroger le lien complexe entre littérature du passé et littérature du présent et la nécessité pour tout écrivain de redéfinir son lien avec la tradition tout en affichant sa modernité. L’article se concentrera en particulier sur l’emploi du mot «  significance  » et sur ses possibles implications dans le contexte de certaines des affirmations les plus remarquables d’Eliot au début des années 1920.
Le fer et l’aimant : l’explication épicurienne des phénomènes d’attraction dans le De naturalibus facultatibus de Galien
Authors: Scalas Giulia
Published: February 2023

L’objectif de cette étude est de reconstituer l’explication épicurienne des phénomènes d’attraction (ὁλκή). On cherche notamment à vérifier la fiabilité du témoignage de Galien qui attribue à Épicure une théorie de l’aimantation très différente de celle qui nous a été transmise par Lucrèce dans son De rerum natura . En examinant de près la théorie exposée par Galien, je cherche à montrer que, telle qu’elle est présentée, elle n’arrive pas, d’un point de vue strictement épicurien, à rendre compte du mouvement attractif. J’envisage donc deux hypothèses. Ou bien Épicure est l’auteur de la théorie transmise par Galien et, dans un deuxième moment, l’aurait mise de côté au profit d’une théorie plus solide et efficace (celle de Lucrèce), ou bien la théorie en question est une version très remaniée de la véritable théorie d’Épicure, fruit d’une réinterprétation assez libre de Galien. La deuxième possibilité me paraît être plus probable, étant donné le contexte très polémique dans lequel ce témoignage se trouve.
Activité historienne et appartenance urbaine
Authors: Vanz Jennifer
Published: February 2023

Emprisonné puis contraint de s’exiler à Tunis au début des années 1360, Ibn Marzūq (m. 781 H/1379) choisit de mettre par écrit la vie de ses ancêtres les plus illustres et d’ancrer leur biographie dans un espace urbain, celui de Tlemcen. Ces biographies contrastent avec la situation précaire de leur auteur qui leur fait porter un message politique : en tant qu’héritier, son appartenance urbaine dépasse les allégeances politiques et le placent au-dessus de l’affrontement entre Abdelwadides et Mérinides autour de Tlemcen. Par-delà les vies singulières des biographiés et de son auteur, les Manāqib donnent à voir les changements à l’œuvre dans l’écriture de l’histoire dans l’Occident musulman de la seconde moitié du VIII e H/ xiv e siècle et la place privilégiée que les villes y occupent.
Activité historienne et appartenance urbaine
Authors: Certin Aude-Marie
Published: February 2023

Dans les villes germaniques, à partir du xiv e siècle, nombre de citadins se passionnent pour l’histoire de leur ville ou celle de leur famille et prennent l’habitude de consigner toutes les informations de nature politique, économique ou privée qui leur semblent dignes de mémoire. Au sein de cette documentation foisonnante, on se centrera ici sur les livres de famille et les écrits autobiographiques de Nuremberg, Augsbourg et Francfort entre le xiv e et le xvi e siècle. Nous montrerons que ces chroniques privées prennent sens dans la cité et témoignent du lien étroit existant entre histoire familiale et histoire urbaine. Dans cette perspective, on reviendra sur le profil des chroniqueurs et sur les caractéristiques de ces formes d’écriture, en étudiant la façon dont elles sont conçues et transmises dans la cité. Puis, on verra que dans ces écrits privés, la ville constitue à la fois le cadre et l’horizon de la mémoire familiale.
Activité historienne et appartenance urbaine
Authors: Dessaux Nicolas
Published: February 2023

L’étude de l’émergence urbaine des paroisses Saint-Maurice et Saint-Sauveur de Lille amène à réexaminer les questions foncières autour du site de Fins. L’enquête part du domaine carolingien de Gisèle de Frioul, célèbre par le Capitulaire de Villis , dont une nouvelle configuration fondée sur les sources toponymiques est proposée. Plusieurs éléments suggèrent que ce domaine est ensuite partagé entre les comtes de Flandre et les seigneurs du Breucq qui ont sans doute agi en tant qu’avoués de l’abbaye de Cysoing. L’examen des liens entre cette abbaye, le prieuré de Fives et Reims, livre des indices sur cette transmission, les possibles usurpations et restitutions. Contrairement à l’historiographie qui fait des chanoines de Saint-Pierre de Lille les propriétaires fonciers des paroisses Saint-Maurice et Saint-Sauveur, l’étude amène à réduire la « terre de saint-Pierre » à des proportions plus modestes, le comte et le seigneur du Breucq étant les principaux propriétaires. Enfin, l’examen permet de nuancer l’historiographie existante quant à la date de fortification de cette partie sud de Lille et sa densité démographique.
Coût d’un enfant et élaboration d’une nouvelle méthode de calcul de la contribution alimentaire dans le contexte belge
Authors: El Imayem Nesrine
Published: February 2023

Résumé − L’objectif de cette contribution est d’élaborer une méthode de calcul des contributions alimentaires dans le contexte belge. Notre méthode se base sur une estimation du coût de l’enfant. Nous nous basons sur l’enquête budget des ménages de 2016 pour estimer « le coût global » et « les coûts spécifiques » de l’enfant. Les résultats de l’estimation ont montré que le coût théorique de l’enfant diminue entre ]0-2,5 ans] et ]2,5-6 ans] et augmente à partir de 6 ans jusqu’à 25 ans. Concernant les coûts spécifiques de l’enfant, nos résultats montrent que les postes ayant le plus de poids dans le coût de l’enfant sont ceux relatifs à « l’habillement et les effets personnels » (34 %), « l’alimentation et les soins corporels » (26 %), « culture, loisirs et éducation » (16 %) et « transport et communication » (12 %).
Analysis of the effectiveness of using Kahoot! in university degrees in building engineering
Authors: Bienvenido-Huertas David , Rubio-Bellido Carlos , León-Muñoz Miguel
Published: February 2023

Gamification is increasingly used for better content assimilation. However, it is hardly used in theoretical and technical courses related to building and architecture. This study focuses on assessing the use of gamification with Kahoot! to arouse students’ interest and to ease content assimilation. Experimentation was undertaken during the 2020/2021 and 2021/2022 academic years. All students enrolled in the course participated in experimentation: 67 and 65 students, respectively. Gamification sessions took place in the middle and at the end of each academic year (the week before partial exams). Students were also surveyed to assess their degree of satisfaction with gamification sessions. The results showed that gamification dynamics improved students’ performance in exams, obtaining a lower percentage of failures and increasing higher marks. Cluster analysis results also showed that students’ performance in Kahoot! is not a clear indicative of their performance in exams, so it is useful as a self-assessment tool. Moreover, most students positively assessed gamification sessions for better content assimilation. This study stresses the implementation potential of Kahoot! in teaching dynamics in university degrees in architecture and building engineering.
Local multiset dimension of comb product of tree graphs
Authors: Alfarisi Ridho , Susilowati Liliek , Dafik
Published: February 2023

Resolving set has several applications in the fields of science, engineering, and computer science. One application of the resolving set problem includes navigation robots, chemical structures, and supply chain management. Suppose the set $ W = \left\{{s}_{1}, {s}_{2}, \dots , {s}_{k}\right\}\subset V\left(G\right) $, the vertex representations of $ x\in V\left(G\right) $ is $ {r}_{m}\left(x\right|W) = \{d(x, {s}_{1}), d(x, {s}_{2}), \dots , d(x, {s}_{k})\} $, where $ d(x, {s}_{i}) $ is the length of the shortest path of the vertex $ x $ and the vertex in $ W $ together with their multiplicity. The set $ W $ is called a local $ m $-resolving set of graphs $ G $ if $ {r}_{m}\left(v|W\right)\ne {r}_{m}\left(u\right|W) $ for $ uv\in E\left(G\right) $. The local $ m $-resolving set having minimum cardinality is called the local multiset basis and its cardinality is called the local multiset dimension of $ G $, denoted by $ m{d}_{l}\left(G\right) $. In our paper, we determined the bounds of the local multiset dimension of the comb product of tree graphs.
Des îles et des lunes
Authors: Ségard Arthur
Published: February 2023

À partir de quatre œuvres de fiction, cet article interroge les usages politiques des hétérotopies queer. Les œuvres étudiées produisent en leur sein des contre-espaces opposés aux normes hétéropatriarcales que sous-tendent des technologies disciplinaires. La notion d’hétérotopie, telle que développée par Michel Foucault, permet de saisir le lien qu’établissent ces contre-espaces fictionnels entre spatialité, imaginaire et contestation politique. Ces hétérotopies queer, qui permettent d’expérimenter des identités et des pratiques alternatives, font en effet signe vers une autre organisation politique du monde, de nouveaux rapports, plus libres et plus harmonieux, entre les êtres, les corps et les genres. Si elles ont souvent une dimension ambiguë et précaire, soulignée par les œuvres elles-mêmes, elles peuvent cependant avoir des effets politiques concrets, notamment à travers les moyens propres de la fiction, qui permettent d’agir sur les affects individuels du lecteur et sur les imaginaires sociaux.
The surgical approach of late-onset tracheoesophageal fistula in a tracheostomized COVID-19 patient
Authors: Rotolo Nicola , Cattoni Maria , De Maio Silvia , Filipponi Luca , Mateo-Ramos Pau , Imperatori Andrea
Published: February 2023

In the COVID-19 era the tracheal complications due to prolonged mechanical ventilation have significantly increased. Acquired tracheoesophageal fistula is one of those in ventilated COVID-19 patients. Thus, the knowledge of their management in such fragile patient is crucial. We report a case of tracheoesophageal fistula in a 56-year-old female under prolonged mechanical ventilation for COVID-19 bilateral pneumonia and discuss its management. A surgical approach was proposed. By a collar-shaped transverse cervicotomic access, we transected the trachea at level of fistula en-bloc with the tracheostoma. The esophageal lesion was longitudinally repaired in two-layers. Protective left strap muscle was sandwiched between esophagus and trachea. The tracheal end-to-end anastomosis was completed without a re-tracheostoma. Even if surgical approach of tracheoesophageal fistula in COVID-19 patients has not been tested before, surgery remains the treatment of choice according to the multidisciplinary board.
Noninvasive ventilation in acute exacerbation of interstitial lung diseases
Authors: Ahmed Naglaa B. , Abou Zeid Amany A. , Abo Elhasab Mai A. , Abo Elwafa Gihan S.
Published: February 2023

Introduction

Noninvasive ventilation (NIV) has been recognized as a mean to avoid intubation and to reduce the risk of complications.

Aims

To study the role of NIV in acute respiratory failure in patients with interstitial lung diseases (ILD).

Settings and design

This was a prospective study.

Patients and methods

The present study included 30 mechanically ventilated patients through noninvasive masks subjected basically to informed consent, clinical data collection, laboratory investigations, chest radiograph, and arterial blood gas samples.

Results

A total of 20 patients were found to be survivors, whereas 10 patients were found to be nonsurvivors. The most common type of ILD in our study was hypersensitivity pneumonitis (53.3% of all patients) with fibrosis, and ground glass opacities were the most common radiological findings on high-resolution computed tomography, and moderate restrictive pattern in pulmonary function tests. Infection was the main cause of exacerbation as evidenced by fever, elevated total leukocytic count, staff neutrophilic count, and erythrocyte sedimentation rate. None of our patients developed complications or intolerance to NIV.

Conclusion

There was improvement in oxygenation parameters, so NIV could be a valuable option for management of acute type I mild to moderate respiratory failure in patients with ILD.
Anxiety and depression in patients with obstructive sleep apnea before and after treatment with continuous positive airway pressure
Authors: Zamzam Mohammed A. , El-Wahsh Rabab , El-Abedin Afaf Z. , Bedir Hend , Abdel Tawab Asmaa M.
Published: February 2023

Aim

To evaluate the prevalence of anxiety and depression in patients with obstructive sleep apnea (OSA) and effect of continuous positive airway pressure (CPAP) or weight reduction treatments on anxiety and depression.

Background

OSA is a life-threatening condition. Poor sleep quality, frequent arousals during sleep, and intermittent hypoxia that accompany patients with OSA could contribute to psychological disturbances.

Patients and methods

A total of 40 patients with OSA (19 males and 21 females) who were admitted to the Chest Department of Menoufia University Hospitals were included and divided into two groups based on different treatment: 20 patients were treated with CPAP and 20 patients were treated with weight reduction.

Results

There were no significant differences between both groups regarding age, sex, and BMI. The patients in both groups had high scores in Hamilton anxiety rating scale, Hamilton depression scale, and quality-of-life scale. CPAP and weight reduction treatment for 3 months resulted in significant improvements of anxiety and depressive symptoms. The Hamilton anxiety rating scale decreased from 11.7 ± 6.5 to 3.3 ± 1.8 in group 1 and from 9.6 ± 4.4 to 3 ± 2.1 in group 2, whereas the Hamilton depression scale score decreased from 16.5 ± 5.8 to 4.8 ± 2.1 in group 1 and from 17.5 ± 6.4 to 5.7 ± 2.6 in group 2 (both P<0.001). There were significant improvements in the quality of life in the two groups after 3 months of treatment.

Conclusion

Anxiety and depression are associated with OSA which improved after CPAP and weight reduction treatment.
Diagnostic accuracy of direct ophthalmoscopy in the rapid assessment of avoidable blindness protocol
Authors: Alfin Ruth Jeneral , Ramyil Alice Venyir , Mpyet Caleb D.
Published: February 2023

Background:

Rapid Assessment of Avoidable Blindness (RAAB) relies mainly on direct ophthalmoscopy (DO) for the diagnosis of posterior segment eye diseases (PSEDs). There is, however, a growing concern that DO may not be sufficiently sensitive to detect PSED owing to inherent diagnostic limitations.

Aim of the Study:

The aim of the study was to determine the sensitivity and specificity of DO for the detection of PSEDs in RAAB, using indirect ophthalmoscopy (IO) as a reference standard.

Materials and Methods:

Participants were patients 50 years and older, presenting to the eye clinic of a tertiary hospital in Jos, between April and September 2016 who gave consent. Their visual acuity was assessed as is done in RAAB6. Those found to be unilaterally or bilaterally visually impaired underwent anterior and posterior segment eye examinations to identify the cause. Dilated fundoscopy was first performed by a senior ophthalmology resident with DO (index test), followed by IO (reference standard test) by a consultant ophthalmologist.

Results:

A total of 250 patients were recruited into the study, of which 188 took the index and reference standard tests. PSEDs were detected in 65 (34.6%) persons and glaucoma accounted for 87.7% of these. The sensitivity of DO for the detection of glaucoma was 95.3%, while the specificity was 91.0%. Sensitivity and specificity for the detection of diabetic retinopathy and central retinal vein occlusion were both 100%. Specificity for the detection of other PSEDs was good even though sensitivity was below acceptable limits.

Conclusion:

The performance of DO against IO in this study, suggests that it is a satisfactory modality for the detection of the most common PSEDs in RAAB.
Persistent hypotony following high-intensity focused ultrasound treatment in a glaucomatous eye
Authors: Kolipaka Gowri Pratinya , Tyagi Mudit , Senthil Sirisha
Published: February 2023

We report the case of a 60-year-old female with primary angle-closure glaucoma, who presented with intraocular pressure (IOP) of 0 mmHg, significant cataract, and finger-counting vision in her left eye (LE) following high-intensity focused ultrasound (HIFU) treatment. She underwent LE cataract surgery combined with pars plana vitrectomy, membrane peeling, and silicon oil injection. Postoperatively, hypotony improved, and visual acuity improved to 20/160. One and a half years later, she underwent silicone oil removal (SOR) in view of recovered ciliary secretion and elevated IOP. Post-SOR, IOP remained elevated due to complete synechial closure secondary to prolonged hypotony and the patient is awaiting an incisional surgery. This case highlights the serious vision-threatening complications of persistent hypotony following HIFU treatment. We caution the surgeons regarding the use of HIFU in eyes with good visual potential and discuss the importance of understanding the safety and efficacy of a cycloablative procedure.
Netarsudil-associated reversible “honeycomb” pattern corneal epithelial edema
Authors: Parthasarathi Sathyan , Ramesh Prasanna Venkatesh , Sathyan Padma , Ray Prajnya
Published: February 2023

Netarsudil (Rho-associated protein kinase inhibitor) is one of the newer anti-glaucoma medications used for the management of glaucoma. It has the most common side effects, such as conjunctival hyperemia, subconjunctival hemorrhage, and cornea verticillata. This manuscript focuses on a rarer side effect of netarsudil-associated reticular corneal epithelial edema, after netarsudil application for 3 months in a 62-year-old male. This side effect is rarely reported in the literature. In this manuscript, netarsudil-associated reversible corneal epithelial edema and its management have been reported.
Photoscreener
Authors: Sabherwal Shalinder , Sharma Manasvini , Majumdar Atanu , Singh Birendra Pratap , Siddiqui Zeeshan , Sood Ishaana , Tibrewal Shailja , Ganesh Suma
Published: February 2023

Background:

Although studies compare the accuracy of spot photoscreeners, few evaluate photoscreeners in community settings. To our knowledge, all studies from India have been purely hospital based, particularly in children under 5 years.

Aim:

The aim was to evaluate the effectiveness of using a commercially available photoscreener for pediatric vision screening in a community setting.

Settings and Design:

This cross-sectional comparative study was conducted from December 2018 to February 2019 in a north-eastern district of Delhi.

Methods:

The automated Spot™ Vision Screener was used to screen the vision of preschoolers. A result displayed as “complete eye exam recommended” on the photoscreener was considered as screening positive and the child was referred to the pediatric ophthalmology unit of a tertiary eyecare institution, as per predefined international guidelines.

Statistical Analysis:

Referral rate and positive predictive value (PPV) of using the photoscreener were considered as primary outcome measures.

Results:

A total of 1205 children were screened using a photo-screener. Almost 16.4% of them were identified and referred a significantly higher referral rate than that in the historic control (2.7%, P < 0.001). Nearly 51.5% of the referred children reported to the unit. The PPV of pediatric eye screening done in a community setting by the photoscreener for refractive error (RE) was 81.4%. Fifty-nine percent of the children detected with REs were found to be at risk of amblyopia. Mean spherical equivalent, sphere, and cylinder of final glass prescription were significantly different from that of photoscreener refraction.

Conclusion:

Photoscreener improves the referral rate and has a high PPV. It could be a standard tool to screen preschoolers in community settings.
Pattern retinal dystrophy in a case of myotonic dystrophy
Authors: Bindra Chahveer Singh , Bindra Parminder Singh , Preeti Bindra
Published: February 2023

Myotonic dystrophy is an autosomal dominant disease which can present with various ocular manifestations. A case of myotonic dystrophy presented with limited visual recovery postcataract surgery. Multimodal imaging analysis, including fundus photography, spectral domain optical coherence tomography (SD-OCT), and fundus fluorescein angiography, were performed showing pattern dystrophy of the pigment epithelium. Fundus photography revealed mild pigmentary alteration over the macular area, whereas fluorescein angiography showed hyperfluorescent staining from the disc to macular area with intervening hypofluorescent linear streaks. On SD-OCT, an epiretinal membrane was seen over the foveal area with mild puckering of inner retinal layers. Furthermore, intraretinal hyperreflective foci were seen along with intermittently disrupted photoreceptor layer. Annual follow-up with fundus photography, SD-OCT, and fluorescein angiography is required to avoid associated complications of scarring and choroidal neovascularization. High suspicion of retinal involvement is warranted in a case of myotonic dystrophy with limited visual recovery postcataract surgery.
Horizontal recti-down displacement for unilateral dissociated vertical deviations – A case series
Authors: Mohan Akshay , Srivastava Rajat M , Agrawal Siddharth
Published: February 2023

This is a case series of 3 patients of comitant horizontal deviations with unilateral dissociated vertical deviations (DVD) who underwent half tendon down displacement of horizontal recti during recession resection surgery. Out of these 3 patients, 2 had exotropia and 1 had esotropia. The mean horizontal deviation preoperatively was 31.6 ± 7.6 prism diopters (PD) and post-operatively was 3.0 ± 2.6 PD. Mean preoperative DVD was 11.3 ± 1.1 PD which had a near-complete resolution in all patients. No increase in DVD of the other eye was noticed in any of the patients. None of the patients required second surgery for correction of horizontal deviation or DVD. The DVD was corrected in all patients with no complications. Half tendon down displacement with recession and resection surgery of horizontal recti is effective in the correction of unilateral DVD in selected patients.
Surgical resection of chemotherapy-insensitive pulmonary metastases in children with hepatoblastoma in China
Authors: Xie Huawei , Liu Gang , Shen Zhou , Xing Guodong , Xia Qiao , Wang Xianqiang , Huang Liuming
Published: February 2023

Objective:

The objective of this study is to investigate the operation timing, methods, and outcome of pulmonary metastases of hepatoblastoma (HB) in children.

Methods:

The clinical and follow-up data of 53 children with pulmonary metastases of HB that were admitted to our hospital from January 2012 to December 2018 were retrospectively analyzed. The pediatric patients, 36 male and 17 female, aged 13–124 months with the median age of 41 months, and all underwent routine thoracotomy.

Results:

In the 53 cases, 77 lung metastatic tumors were resected. Further, 37 patients received only one operation, 10 received two operations, 4 received 3 operations, and 2 received 4 operations. Based on Kaplan–Meier analysis, the accumulative overall survival (OS) rates at 1, 3, and 5 years were 86.8%, 69.0%, and 57.0%, respectively (median OS time: 60 months; 95% CI: 50.675–69.709 months), and accumulative EFS (vent-free survival) rates at 1, 3, and 5 years were 86.8%, 67.0%, and 55.4%, respectively (median EFS time: 59 months; 95% CI: 49.519–68.578 months). According to univariate analysis, OS was significantly altered for patients with no more than 5 nodules (p = 0.023), lung metastases without extrapulmonary metastases (p = 0.000), and laterality (p = 0.029). Gender and age (less than three years) were not significantly related to survival. According to univariate analysis, lung metastases with extrapulmonary metastases could be considered as individual factor contributing to poorer prognosis.

Conclusion:

In this pediatric group, patients with residual nodules after chemotherapy of HB could benefit from surgical treatment, but the appropriate surgical indication of metastasectomy needs to be further investigated.
Bronchial artery chemoembolization with apatinib for treatment of central lung squamous cell carcinoma
Authors: Zhu Jun , Xu Xiaoqian , Chen Yaoyong , Wang Qiang , Yue Quanji , Lei Kaijian , Jia Yuming , Xiao Guo , Xu Guohui
Published: February 2023

Objective:

To evaluation the clinical efficacy and safety of bronchial artery chemoembolization (BACE) combined with apatinib for treatment of advanced central lung squamous cell carcinoma (LSCC).

Methods:

Forty-seven patients with pathologically diagnosed stage IIIB or IV central LSCC that was not resectable were selected among hospital patients presenting after November 2016. Twenty-one patients were treated with BACE combined with apatinib; the remaining patients served as a control group treated with BACE alone. Objective response rate (ORR) and disease control rate (DCR) were evaluated with postoperative contrast-enhanced CT scans at 3, 6, and 12 months. Progression-free survival (PFS) curves were used to evaluate curative effects. Adverse events were recorded to assess safety.

Results:

BACE operations were successfully completed in all 47 patients. Significant differences were found at six and 12 months (P < 0.05). Median PFS was 322 days in the observation group and 209 days in the control group: a statistically significant difference (P = 0.042). One-year survival rates were 76.19% and 46.15% for observation and control patients, respectively; this difference was also significant (P = 0.037). Three patients in the observation group received emergency interventional embolization for hemoptysis, and patients with grade III or greater adverse reaction events (AE) accounted for 19.05% of patients (4/21); these subjects improved or were controlled after active treatment.

Conclusion:

BACE combined with apatinib is effective for treatment of advanced central LSCC, with definite short-term efficacy, controllable risk, and high safety. Investigation with a larger sample size is warranted to confirm study results.
Tumor regression during radiotherapy as a predictor of response in locally advanced nonsmall cell carcinoma
Authors: Thimmarayappa Arun , Ashok Nidhun V. , Pandey Rambha , Mohan Anant , Sharma Seema , Pandey Shivam
Published: February 2023

Aims:

To compare the predicted response with observed response to treatment by measuring gross tumor volume-primary (GTVp) using onboard kilovoltage (kV) cone-beam computed tomography (CBCT), to analyze the serial tumor volumes during radiotherapy (RT) with serial tumor volumes during follow-up, and to identify the variables associated with survival outcomes.

Materials and Methods:

Between June 2017 and December 2019, 23 patients of histologically proven locally advanced nonsmall cell lung cancer (LA-NSCLC) received definitive chemoradiation. Serial kV-CBCT images X-ray volume imaging (XVI) were generated weekly for image guidance and were used to generate serial GTVp. Posttreatment follow-up images were used to generate follow-up GTVp. Relative volume regression (VR) during RT and relative response assessment (RA) during follow-up were defined from Avg Vol, of planning CT. The predicted progression model was generated from VR and analyzed against observed progression events. Regression–response model was generated to analyze VR against RA.

Results:

The median XVI vol1, XVI vol2, and XVI vol3 were 78.123, 56.571, and 48.513 cc during the 2nd, 4th, and 6th weeks of RT, respectively. The median VR0 was 11.777% in the 2nd-week, VR1 was 20.959% in the 4th week, and 33.661% in the 6th week. The predicted responders and progression using the VR were similar to the observed response during the follow-up. The prediction of both RA0 and RA1 obtained from VR2 was statistically significant. Predication of RA0 from VR1 tended towards significant (P=0.084). VR2 was statistically significant in predicting RA2 (P = 0.04). The median progression-free survival (PFS) was not reached and the median overall survival (OS) was 24.2 months (95% confidence interval, 20.3–28.2 months). There was no statistically significant difference in PFS and OS between Avg Vol ≤ 99.5 cc and > 99.5 cc or other clinical parameters.

Conclusions:

Tumor regression during RT is a potential predictor of response in LA-NSCLC. kV-CBCT is a strong tool in assessing tumor regression during RT.
The feasibility of dose escalation using intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT) with FDG PET/CT guided in esophageal cancer
Authors: Zhang Yiyuan , Fan Bingjie , Sun Tao , Xu Jin , Yin Yong , Chen Zhaoqiu , Zhu Jian , Yu Jinming , Hu Man
Published: February 2023

Context:

Previous studies show that dose escalation for gross tumor volume (GTV) improves local control of esophageal cancer (EC). However, optimal boosting remains uncertain. Recently, functional imaging guidance to achieve dose escalation in high-risk areas of tumors has been proposed.

Aims:

This study evaluated the feasibility of dose escalation in tumor regions with high fluorodeoxyglucose (FDG) uptake using intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT).

Settings and Design:

GTVPET was defined as a high FDG uptake region with 50% SUVmax threshold for dose escalation. IMRT and IMPT plans were generated for three boosting modes: plan 50.4 (50.4 Gy in clinical target volume, CTV), plan 63 (50.4 Gy in CTV, 63 Gy in GTV), plan 70 (50.4 Gy in CTV, 63 Gy in GTV, and 70 Gy in GTVPET).

Methods and Material:

Eleven patients with squamous cell carcinoma were evaluated. Dose parameters for heart, lung, and spinal cord were compared based on the dose-volume histogram (DVH).

Statistical Analysis Used:

Paired t-test was performed on the doses to organs-at-risk (OARs) among plan 50.4, plan 63, and plan 70 for IMRT and IMPT.

Results:

Dosimetric parameters for IMRT for heart, lung, and spinal cord increased significantly for plan 63 and some parameters even exceeded dose limits for OARs. Further dose escalation in GTV-PET did not increase dosimetric parameters significantly. Most dosimetric parameters of OARs in IMPT exhibited no statistical change compared with plan 50.4, and doses to OARs were far less than dose constraints.

Conclusions:

Dose escalation by IMRT may lead to increased risk of radiation-related injury. Further dose escalation in high FDG uptake regions did not increase doses to OARs. This dose escalation is ideal for achieving better outcomes for EC treatment.
A mathematical model to predict the different isodose volumes using TRAK value in HDR intracavitary brachytherapy for revised Manchester and ICRU-89 based Point A plans using computer tomography images
Authors: Mourya Ankur , Choudhary Sunil , Sharma Neeraj , Shahi Uday Pratap , Singh Gaganpreet , Pradhan Satyajit , Aggarwal Lalit Mohan
Published: February 2023

Purpose:

To find out the simple relationship between Total Reference Air Kerma (TRAK) and various isodose volumes. Calculated isodose volumes were compared with experimental data for revised Manchester and International Commission on Radiation Units and measurements (ICRU)-89 Point A-based treatment plans. The accuracy of the formula was compared with the results of other relationships available in the literature.

Materials and Methods:

Dosimetric data from 62 intracavitary brachytherapy (ICBT) treatment plans of 31 patients with cervical cancer were studied. Each patient had treatment plans normalized to revised Manchester and ICRU-89 Points A (Aflange and Aicru89). For each treatment plan, TRAK values, V350, V700, V1050, and V1400 were obtained. The modeling curve was plotted between Isodose volume (Vd) and the ratio of d/TRAK obtained from Aflange plans to get a mathematical relation. The results of this formula were compared with the experimental data and outcomes of other formulas available in the literature. A paired-sample t-test was performed to assess the statistical significance.

Results:

In the case of revised Manchester-based Aflange normalization plans, the mean isodose volume of V350, V700, V1050, and V1400 were 285.98 ± 32.3 cm3, 101.96 ± 10.63 cm3, 52.71 ± 4.72 cm3, and 31.44 ± 2.33 cm3 respectively. Likewise, for ICRU-89 based Aicru89 normalization plans, the mean isodose volumes of V350, V700, V1050, and V1400 were 304.11 ± 26.17 cm3, 108.88 ± 8.29 cm3, 56.62 ± 3.69 cm3 and 34 ± 2.23 cm3 respectively. The mean difference was significant. The Mathematical relationship developed was [INLINE:1]. No correlation was found between TRAK and D0.1cm
3,D2cm
3 for organs at risk.

Conclusions:

The developed formula calculated isodose volumes within the accuracy of ± 3% in ICBT plans.
Clinical impact of extended field radiation therapy in Stage III carcinoma cervix versus conventional field techniques
Authors: Daga Prateek , Kumar H. S. , Sharma Neeti , Jakhar Shankar Lal , Harsh Kamlesh Kumar , Dhaka Saroj
Published: February 2023

Aim:

The aim of the study was to examine tumor control and clinical outcomes of extended field irradiation and compare it with those treated with conventional field in same disease profile and also to determine toxicities associated with radiation treatment.

Methods:

This study included 50 biopsy-proven and registered International Federation of Gynecology and Obstetrics Stage III cases of carcinoma cervix treated with concurrent computed tomography (injection cisplatin 40 mg/m2 weekly) + external beam radiotherapy (EBRT) upto 50 Gy + high-dose-rate intracavitary brachytherapy (ICBT) (22.5 Gy). Twenty-five patients were randomized to each arm. Arm A: Conventional field EBRT 50 Gy with concurrent weekly chemotherapy followed by ICBT. Arm B: Extended field EBRT 50 Gy with concurrent weekly chemotherapy followed by ICBT.

Results:

At 12-month follow-up, 43 patients (86%) had attained CR. Overall, seven patients (14%) were in noncomplete response (CR) group (non-CR = patients with partial response, stable disease, or progressive disease). The non-CR rate was 16% for Arm A and 20% for Arm B. Among seven patients of non-CR group, six had local disease and one had failure at distant site. Five (10%) patients died in this study, 2 (8%) in Arm A and 3 (12%) patients in Arm B. Residual disease was seen in 2 (4%) patients. Grade III diarrhea was seen in eight patients (16%), 3 in Arm A (12%) and 5 in Arm B (20%). Fifteen patients (30%) developed Grade III skin toxicity. Seven patients in Arm A (28%) and 8 patients (32%) in Arm B developed Grade III toxicity. Twenty-five (50%) cases presented with varying stages of vaginal adhesions and stenosis.

Conclusion:

Majority of patients achieved CR with minimal acute and late toxicities with similar results in both arms. No patient had pelvic or para-aortic metastasis until recent follow-up.
Assessment of combined modality therapy for non-small-cell lung carcinoma
Authors: Rezaei Hadi , Mostaghimi Hesameddin , Mehdizadeh Ali Reza
Published: February 2023

Although surgery is the treatment of choice for early-stage non-small-cell lung carcinoma, almost two-thirds of patients do not have acceptable pulmonary function for extensive surgeries. The alternative approach for this large group of patients is sublobar resection along with low-dose-rate (LDR) brachytherapy (BT). However, patients with resected lungs have a high risk of recurrence and are often treated with platinum-based (Pt-based) chemotherapy (CT). In this study, we aimed to evaluate the absorbed doses of lung and other thoracic organs, considering concurrent chemo-BT with LDR sources in two modalities: conventional vs. unconventional Pt-based CT. We used the MCNPX code for simulations and to obtain the lung absorbed dose, dose enhancement factor (DEF), and Pt threshold concentration for the abovementioned modalities. Our results indicate that DEF correlates directly with Pt concentration at prescription point and is inversely correlated with depth. Dose enhancement for conventional CT concurrent with BT is <2%, while it is >2% in case of unconventional Pt-based CT wherein the Pt concentration exceeds 0.2 mg/g lung tissue. Also, the absorbed dose of healthy thoracic organs decreased by 2–11% in the latter approach. In conclusion, the concurrent chemo-BT in the lung environment could enhance the therapeutic doses merely by using unconventional CT methods, while lung Pt accumulation exceeds 0.2 mg/g.
Malignant gastrointestinal neuroectodermal tumor
Authors: Mishra Pritinanda , Biswas Dipanwita , Pattnaik Sandeep Abhijit , Patra Susama , Muduly Dilip Kumar , Balasubiramaniyan Vigneshwaran , Adhya Amit Kumar
Published: February 2023

Malignant gastrointestinal (GI) neuroectodermal tumor is an extremely rare entity that was first described by Zambrano et al. in 2003 as “clear cell sarcoma (CCS)-like tumor of the GI tract.” It shares some of the histopathological features of CCS but lacks the immunohistochemical (IHC) reactivity for melanocytic markers. Most mesenchymal neoplasms of the GI tract belong to the category of GI stromal tumors and are characterized by the IHC expression of c-KIT. In cases, without detectable KIT receptor expression, several differential diagnoses have to be taken into consideration. In this article, we describe such a case and present a review of all the reported cases till date. We also present the current available knowledge on its pathology and molecular genetics along with the limitations in its diagnosis. Here, we report a case of a 32-year-old man with a tumor of the small bowel composed of polygonal tumor cells arranged in solid nests, alveolar pattern, and pseudopapillary and admixed with numerous osteoclast-like multinucleated giant cells. Immunohistochemically, the tumor cells strongly expressed S-100 protein only. HMB-45, melan-A, CD117, cytokeratin, desmin, smooth muscle actin, and CD-34 were absent. Ki-67 index was 15%. The diagnosis was further confirmed by fluorescence in situ hybridization (FISH) demonstrating the presence of EWSR1 (22q12) translocation. A final diagnosis of malignant gastroneuroectodermal tumor was rendered. The patient is disease-free for 20 months of postsurgery. The diagnosis of this entity should be considered in the presence of S-100-positivity and multinucleated osteoclastic giant cells and the absence of melanocytic differentiation in a tumor arising from GI tract. Further confirmation can be done by performing FISH analysis.
Efficacy, safety, and prognostic factors of anlotinib treatment in advanced non-small cell lung cancer patients
Authors: Huang Aimi , Wang Weimin , Qin Ruoyan , Chen Guojie , Gu Aiqin , Han Baohui
Published: February 2023

Objective:

This study aimed to evaluate the treatment response, survival profiles, prognostic factors and adverse events of anlotinib in treating advanced non-small cell lung cancer (NSCLC) patients.

Materials and Methods:

Totally, 158 advanced NSCLC patients were included in this retrospective study. All patients received anlotinib treatment until disease progression or intolerance: Administrated orally 12 mg/d for 2 weeks then discontinued for 1 week (3 weeks as a treatment cycle). Furthermore, treatment response, adverse events, and survivals were evaluated.

Results:

After 2 treatment cycles, no (0%) patients achieved complete response (CR), 7 (5.0%) patients achieved partial response (PR), 112 (80.0%) patients achieved standard deviation (SD), and 21 (15.0%) patients achieved progressive disease (PD), resulting in objective response rate (ORR) of 5.0% and disease control rate (DCR) of 85.0%. After 4 treatment cycles, no (0%) patients achieved CR, 3 (4.3%) patients achieved PR, 51 (74.0%) patients achieved SD, and 15 (21.7%) patients achieved PD, resulting in ORR of 4.3% and DCR of 78.3%. For survivals, the median progression-free (PFS) was 3.7 months (95% confidence interval [CI]: 2.7–4.7 months), and the median overall survival (OS) was 12.4 months (95% CI: 9.4–15.3 months). Subsequently, multivariate Cox's regression analyses illuminate that histological type (adenosquamous carcinoma vs. adenocarcinoma) and other mutation apart from epidermal growth factor receptor independently predicted shorter PFS; meanwhile, history of smoke and brain metastases independently predicted decreased OS. Regarding safety, most of the adverse events were at mild grade.

Conclusion:

Anlotinib displays good efficacy and well-tolerant safety profiles in the treatment of advanced NSCLC patients.
Camel-Related Head Injury in a High-Income Developing Country
Authors: Hefny Ashraf F. , Hefny Mohamed A. , Al-Ali Mohamed A. , Mousa Hussam M.
Published: February 2023

Introduction:

Injury caused by large animals varies according to the regional distribution of the animals and their relationship to humans. Camels are usually friendly to humans; however, occasionally they become very hostile, especially in rutting season. Most in-hospital trauma deaths are related to head injury. Very few studies in the literature have discussed camel-related head injuries. We aimed to study the incidence, mechanism of injury, types, and outcome of camel-related head injury in a high-income developing country to give recommendations on preventive measures.

Methods:

We retrospectively collected data from all patients who were admitted to Al Ain Hospital with a camel-related head injury from January 1, 2015, to January 1, 2021. Data collected included demography, mechanism of injury, anatomical location, severity of the injury, associated injuries, and management. The patients were followed up during their hospital stay to record the length of hospital stay, complications, and outcome.

Results:

During the study period, 98 patients were admitted to Al Ain Hospital with camel-related injury. Thirty-nine (39.8%) of the admitted patients with a camel-related injury sustained a head injury; a camel-related head injury was more common during August (23.1%). Thirty-four (87.2%) patients were camel caregivers. Thirty-three patients (84.6%) were injured on farms. Seven patients suffered an intracranial hemorrhage, and six (85.7%) of them had a history of fall from a camel. Glasgow Coma Score was significantly correlated to the severity of head injury measured by Abbreviated Injury Severity of the head (P = 0.006, Spearman’s correlation). One patient died during the study period after having decompressive craniectomy for subdural hemorrhage (overall mortality 2.6%).

Conclusions:

The majority of camel-related head injury occurred in camel caregivers at camel farms and can be considered a work-related injury. Careful handling of camels, especially during the summertime can reduce the toll of camel-related head injury and its serious consequences. None of the injured patients was wearing a helmet at the time of injury. Legislation for compulsory helmet usage by camel caregivers at farms may decrease the incidence of head injuries in those patients.
Acute Oral Toxicity Evaluation of Andrographolide Self-Nanoemulsifying Drug Delivery System (SNEDDS) Formulation
Authors: Ramadani Arba Pramundita , Syukri Yandi , Hasanah Elma , Syahyeri Afrizal Wahyu
Published: February 2023

Context:

Andrographolide (AND) is an active compound of well-known medicinal plant Andrographis paniculata. It has been widely published for various activities. AND is difficult to develop into dosage form due to its poor solubility and bioavailability. This problem could be solved by using self-nanoemulsifying drug delivery system (SNEDDS) for its formulation. However, the increase of bioavailability might result in potential toxicity as a large amount of drug is absorbed.

Aims:

The aim of this study is to evaluate the acute potential toxicity using Organization for Economic Cooperation and Development (OECD) test: 401 methods.

Subjects and Methods:

The OECD 401 method employs groups of animals treated by a single dose or repeated dose (<24 h) of the drug with three variances of doses. In this study, thirty male Wistar rats were divided into five groups which consisted two groups of control and three groups of AND SNEDDS formulation (500, 700, and 900 mg/kg body weight [BW], respectively). Intensive observation of toxicity symptom was performed during the first 30 minutes followed by periodic observation for 14 days. Posttermination, histopathological examination of the liver and kidney was conducted to confirm the toxicity symptoms. To determine the level of toxicity, the lethal dose 50 (LD50) value was calculated at the end of the study.

Results:

The result showed that all groups presented similar toxicological symptoms such as salivation, lethargy, and cornea reflex. However, based on histopathological examination, there were abnormalities, but still in an early stage. The toxicological symptom that emerged seems related to the SNEDDS formulation with lipophilic properties. Furthermore, the value of LD50 was 832.6 mg/kg BW (po).

Conclusions:

The AND SNEDDS formulation was slightly toxic in male Wistar rats po.