bluuebunny/crossref_metadata_2025 huggingface dataset:
Super-strong Magnetic Field in Sunspots
Authors: Okamoto Takenori J. , Sakurai Takashi
Published: January 2018

Sunspots are the most notable structure on the solar surface with strong magnetic fields. The field is generally strongest in a dark area (umbra), but sometimes stronger fields are found in non-dark regions, such as a penumbra and a light bridge. The formation mechanism of such strong fields outside umbrae is still puzzling. Here we report clear evidence of the magnetic field of 6250 G, which is the strongest field among Stokes I profiles with clear Zeeman splitting ever observed on the Sun. The field was almost parallel to the solar surface and located in a bright region sandwiched by two opposite-polarity umbrae. Using a time series of spectral data sets, we discuss the formation process of the super-strong field and suggest that this strong field region was generated as a result of compression of one umbra pushed by the horizontal flow from the other umbra, such as the subduction of the Earth’s crust in plate tectonics.
A Review of Zika Virus: Hurdles toward Vaccine Development and the Way Forward
Authors: Haque Azizul , Akçeşme Faruk Berat , Pant Anudeep B
Published: January 2018

The Zika virus (ZIKV) epidemic has recently emerged as a public health threat due to its teratogenic nature and association with the serious neurological condition Guillain–Barré syndrome (GBS). To date, no approved antiviral therapeutics to treat, nor vaccines to prevent, ZIKV infection are available. In order to develop effective anti-ZIKV vaccines, improved animal models and a better understanding of immunological correlates of protection against ZIKV are required. In this paper, we discuss the recent progress in developing vaccines against ZIKV and the hurdles to overcome in making efficacious anti-ZIKV vaccines. Here, we propose strategies to make efficacious and safe vaccines against ZIKV by using novel approaches including molecular attenuation of viruses and TLR-based nanoparticle vaccines. The question of exacerbating dengue virus infection or causing GBS through the production of cross-reactive immunity targeting viral or host proteins have been addressed in this paper. Challenges in implementing immunogenic and protective ZIKV vaccine trials in immunodepressed target populations (for example, pregnant women) have also been discussed.
Aux États-Unis, des villes sanctuaires
Authors: Paquet Mireille
Published: January 2018

Héritières des mobilisations des années 1980, les villes sanctuaires américaines se définissent dans leur refus de collaborer aux politiques nationales d’immigration. Refus de prendre en compte la situation administrative des personnes pour l’accès aux services municipaux, refus d’appliquer les lois sur l’immigration, mise en place de politiques locales favorisant la participation des résidents à la vie municipale et à l’économie. Cet activisme local peut-il suffir à infléchir la refonte annoncée des politiques migratoires ?
Le lycée, les migrants, le quartier, les habitants
Authors: Coutant Isabelle
Published: January 2018

L’occupation d’un lycée désaffecté du Nord-Est parisien par des « migrants et réfugiés » à l’été 2015 va constituer un événement pour les habitant·e·s des immeubles voisins, avec des réactions diverses et évolutives qui vont de l’inquiétude à la colère, du sentiment d’abandon ou d’impuissance à l’empathie pour finalement aboutir à la solidarité. Dans ce quartier « prioritaire » que les habitant·e·s considèrent comme délaissé, cette mobilisation va laisser des traces.
La solidarité comme « commun »
Authors: Krikorian Gaëlle
Published: January 2018

Face à l’arbitraire des politiques d’« accueil » des populations exilées, à la répression dont elles sont victimes et au non-respect des droits humains les plus élémentaires, des citoyen·ne·s s’engagent dans des actions de solidarité. Peut-on penser cette solidarité comme un commun, au sens d’une ressource produite, utilisée et gérée collectivement ? La question mérite d’être posée dès lors que l’on considère cette production collective comme une modalité d’action politique et non comme un palliatif au désengagement des pouvoirs publics.
1974. Migrants et syndicats se mobilisent en Belgique
Authors: Mauzé Gregory , Vertongen Youri Lou
Published: January 2018

La Belgique a connu trois campagnes de régularisation des sans-papiers dont la première, en 1974, au lendemain de la fermeture des frontières, sous la pression des migrant·e·s et de leurs soutiens. À cette date, la question migratoire en Belgique est liée au travail. Ce sont donc logiquement les syndicats qui apportent leur soutien à la main-d’œuvre immigrée, dans un double mouvement de défense des droits des travailleurs et de lutte contre une immigration illégale qui tire l’ensemble de la condition ouvrière vers le bas.
Numérique et transport : observer et mesurer des formes plus complexes de perception du temps de transport
Authors: Josset Jean-Marc , Rallet Alain
Published: January 2018

Les déplacements sont généralement considérés comme induits par d’autres activités et sans utilité en tant que tels. Dans ce cadre, les politiques publiques d’aménagement des infrastructures de transport ont donc pour objectif principal de réduire les temps de transport, et par là leur « dés-utilité ». L’Internet mobile modifie significativement la nature des activités pouvant être réalisées durant les déplacements tout en permettant de nouvelles mesures in situ. Nous proposons donc d’explorer les déplacements non plus uniquement au travers de leur durée, mais sous l’angle plus large du bien-être des individus. Cette approche va reposer sur l’utilisation combinée des méthodes d’échantillonnage d’expérience via les smartphones et des indicateurs de bien-être. Elle vise à proposer des mesures alternatives au temps de transport qui permettrait d’avoir une nouvelle vision de l’efficacité ou l’utilité des transports.
Approche exploratoire des ressorts « motivationnels » à pratiquer la consommation collaborative
Authors: Huiban Émilie , Fischer-Lokou Jacques , Deporte Nicolas , Petr Christine
Published: January 2018

S’il est aujourd’hui manifeste que la généralisation de la consommation collaborative a été considérablement favorisée par l’évolution de la numérisation [Heilbrunn et Benoît, 2016], les sources « motivationnelles » des individus à s’engager dans cette nouvelle forme de consommation semblent faire l’objet d’interprétations divergentes. Les conclusions de certaines enquêtes avancent l’idée que le lien social serait la première motivation à s’adonner à la consommation collaborative alors que d’autres mettent davantage en relief des raisons de nature économique ou pour d’autres encore, écologiques. En s’appuyant sur une nouvelle enquête menée en juin 2016 auprès de 2 000 panélistes représentatifs des Français âgés de 18 ans et plus, cette étude rend saillants et plus compréhensibles les ressorts de cette forme alternative d’échange via le prisme de la théorie de l’autodétermination (TAD). Cette théorie, largement reconnue et utilisée pour analyser les motivations, permet ici d’expliquer plus globalement comment, au vu des valeurs des individus, ils choisissent de s’engager dans ce mode alternatif de consommation.
Institutionalization of Activity Based Costing in a Sri Lankan Manufacturing Firm: A Case Study
Authors: Cardes S. , Gooneratne Tharusha N.
Published: January 2018

The aim of this paper is to identify the reasons for the implementation and subsequent institutionalization of activity based costing (ABC) in a manufacturing subsidiary of a large local conglomerate, Sigma and the uses of ABC information by various managers. The paper adopts the qualitative case study approach and leans on the theoretical lens of old institutional economics (OIE). Our findings reveal that the implementation of ABC in Sigma was driven by the parent company’s decision to implement SAP (for the group) as the enterprise resource planning (ERP) system of which ABC was embedded as the accounting module. ABC has been in use for over ten years in Sigma, and it has become an institutionalized practice. The institutionalization of ABC in Sigma characterizes both ceremonial as well as instrumental institutionalization, and show that ceremonial institutionalization can be made effective if it can be successfully embedded to the operations of the firm, through instrumental institutionalization. This is a useful theoretical contribution of this research. This study is also an important addition to existing management accounting literature in the area of ABC, and its findings offer valuable insights to practicing managers on the implementation and use of ABC.
Trends and Issues in Hospitality and Tourism
Authors: Udunuwara Maduka , Sanders Dale
Published: January 2018

Tourism is one of the most important and competitive economic sectors in the world. According to United Nations World Tourism Organisation (UNWTO) (2016), the tourism industry contributes nine percent of the world’s GDP, provides one out of eleven jobs, and accounts for 1.5 trillion US dollars in exports. The UNWTO projects continued growth in the number of international tourists rising to 1.8 billion in 2030, which would be an increase of 3.3 percent from compared to 2010. The UNWTO (2015) also predicts a 4.4 per cent annual rise in arrivals to emerging destinations which included Sri Lanka which is twice the rate of the percentage in advanced economies (2.2 percent a year). In addition, the market share of emerging economies will increase and is expected to reach 57 percent by 2030, equivalent to over 1 billion international tourist arrivals.
Customer Relationship Management (CRM) Practices towards Customer Brand Engagement: Evidence from the Hotel Industry in Sri Lanka
Authors: Kumarapeli K.G.N. , Samarasinghe G.D. , Kuruppu G.N.
Published: January 2018

Customer Relationship Management (CRM) practices and its effects on Customer Brand Engagement (CBE) are an emerging trend in many industries including the hotel industry. Therefore, the main objective of this study is to examine whether there is a relationship between customer relationship management practices and customer brand engagement in the Sri Lanka hotel firms. The population is senior and middle managers of the hotel industry with a sample comprised of 183 managers. The data was gathered using a structured questionnaire and analyzed using Structural Equation Modeling (SEM) techniques. The key findings of the study showed that customer relationship management practices are significantly related to customer brand engagement in hotel industry of Sri Lanka and consequently, customer relationship management can be utilized as a tool to enhance customer brand engagement in the hotel firms in Sri Lanka. The findings further depict managerial implications and opportunities for future research in the same area.
Ecotourism Practices in Sri Lanka: The Case Study of Rainforest Eco Lodge
Authors: Fernando S.M.D. , Kaluarachchi K.A.S.P.
Published: January 2018

Though ecotourism has become a new concept in modern tourism, it has not been practiced by ventures in its true sense. This issue is also true for the eco tourist ventures in Sri Lanka since they have been unable to identify the eco tourist markets and customer segments clearly. As a result, there is a lack of common principles and frameworks of ecotourism to guide the eco tourist ventures who then only try to satisfy their ecotourism destinations to a basic level. Such a short-term orientation can prevent eco tourist ventures to focus more on the sustainability of their business. The present study using a comprehensive framework of ecotourism, examines the ecotourism practices of an ecotourism lodge in Sri Lanka and it has revealed that the company has given attention to the best practices of ecotourism to a greater extent. However, the broader issue faced by the company as an ecotourism venture in Sri Lanka is the lack of ecotourism standards and practices maintained by Sri Lanka as a nation to meet the international ecotourism principles.
Transformation of the Nature of Managerial Work in Modernity: Evidence from the Japanese Workplace
Authors: Kimata Akira , Takahashi Masayasu
Published: January 2018

The present study discusses modern managerial means and nature through telework, which has been viewed favourably for not only increasing white-collar productivity but also for improving work/life balance. In existing studies, the effect on society has been at the forefront of discussions while investigations about introductory methods or the actual conditions of telework are also active. However, there are few studies on conceptualization and the essential significance. For these reasons, this study will exactingly define the classifications and examine whether telework is a modern labour form in the context of “space-time” and “trust” and clarify the functions of organizational communication and leadership. Finally, we will present a research framework for further studies to comprehend the transformation of managerial nature from traditional work to modern telework through interviews with two Japanese information and communications technology companies.
The Study of Professional Training to Improve Customer Satisfaction in Small and Medium Scale Hotels in Sri Lanka
Authors: Ambepitiya Kalpana R. , Dharmasiri Upul Rohana
Published: January 2018

Sri Lanka is currently in the stage of rebuilding its economy after three decades of civil war. One of the major focuses in this development endeavour is the leisure and hotel industry. Therefore, opportunities are open for international hotel chains as well as small providers. Small and medium scale hotels face many challenges in operating their businesses economically. Retention of customers is one of the major problems faced by those engaged in this sector. This study discusses the effects of professional training to ensure the satisfaction of customers in small and medium scale hotels in Sri Lanka. In collecting data, two questionnaires were distributed between two samples of respondents. One sample comprised 53 employees from 10 small and medium hotels while the other sample comprised of 30 local and foreign customers. This study indicates that professional training of employees has a direct impact on building customer satisfaction in small and medium scale hotels in Sri Lanka. Both customers and the employees believe that when the professional training is high, the quality of service at these hotels also increases. Thus, it indicates that providing continuous professional training is beneficial to the organization and to the individual concerned. A well-trained employee can increase customer satisfaction and repetition of purchase.
Social Marketing for a Farmer's Market in an Underserved Community: A Needs Assessment
Authors: Skizim Meg , Sothern Melinda , Blaha Ondrej , Tseng Tung Sung , Griffiths Lauren , Joseph Jonathan , Nuss Henry
Published: January 2018

The aim of the present paper is to assess local residents’ awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers’ markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (La, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers’ markets; 63% of low-income participants never attended a farmers’ market compared to 27% of mid/high-income. Over 50% of the low-income respondents have access to the internet at least once per day. The results show the potential of raising awareness among a wide range of members in the community. This needs assessment will serve as the foundation for a social marketing intervention, which will be disseminated city-wide.
Initiation of Complementary Feeding and Associated Factors Among Children of Age 6-23 Months in Sodo Town, Southern EthiopiA: Cross-Sectional Study
Authors: Chane Tefera , Bitew Shimelash , Mekonen Tesfa , Fekadu Wubalem
Published: January 2018

Timely introduced complementary foods, which are appropriate for age, safe and nutrient dense are vital for child growth and development. The aim of the study was to identify associated factors that hampered timely introduction of complementary feeding practices among children 6-23 months. A community-based cross-sectional study was carried out. The data were collected from March 02-20, 2015 in seven-selected Kebeles of Wolaita Sodo town. Systematic sampling technique was employed to select 623 mothers/caregivers with children. The analysis was done using SPSS version 21. Principal component analysis was used to measure household economic status. Binary logistic regression was used to identify predictors of timely initiation of complementary feeding practice. The proportion of timely (at six months) introduction of complementary feeding was 71.2% [95% CI: 66.4%-75.3%], and 25.5% [95% CI: 21.7%- 30%] of children were experienced delayed introduction of complementary feeding. Variables like maternal education [AOR=0.33; 95% CI (0.14-0.78)], household economic status [AOR=0.40;95% CI(0.17-0.85)], history of child medical illness [AOR= 0.63; 95% CI (0.40-0.98)], early initiation of breastfeeding [AOR=2.59; 95% CI (1.02-7.35)] and having source of information about child feeding practices [AOR=0.41; 95% CI (0.24- 0.73)] were identified as independent predictors of introduction of complementary foods at the age of six months. The study came up with nearly three-fourth of children were initiated complementary food just at six months of age. It is not much higher than the target of the current national health sector development program. Maternal illiteracy, low socioeconomic status, presence of medical illness and lack of source of information about complementary feeding practices were associated with timely initiation of complementary feeding. Unreserved support and encouragement should be made to raise level of timely introduction of complementary foods and to diminish delayed introduction of complementary food.
Primary central nervous system lymphoma in immunocompetent patients: A regional cancer center experience
Authors: A. Rudresha H. , Chaudhuri Tamojit , Lakshmaiah Kuntegowdanahalli C , Babu Govind , Lokesh K. N. , Rajeev L. K.
Published: January 2018

Background: Primary central nervous system lymphoma (PCNSL) is a rare form of aggressive extranodal non-Hodgkin's lymphoma which occurs in both immunocompromised and immunocompetent patients. It has an overall poor prognosis in spite of a multimodality treatment approach including chemotherapy and radiotherapy. This study attempts to further delineate the clinicopathological, immunohistochemical, and radiological profile of PCNSL at Kidwai Memorial Institute of Oncology, Karnataka, India. Materials and Methods: All the pathologically confirmed PCNSL cases between January 2010 and June 2016, at our center, were analyzed retrospectively. The influence of potential prognostic parameters on overall survival (OS) was investigated by log-rank test and Cox regression analysis. Results: Of the 26 PCNSL patients, 17 (65.3%) were males. Median age at diagnosis was 42.5 years. None of the patients had HIV or Epstein-Barr virus positivity and only four patients (15.4%) had B-symptoms. The most common location in the brain was cerebral hemispheres in 15 patients (57%) and 10 patients (38.5%) had multiple intracranial lesions. Histologically, all were diffuse large B-cell lymphomas, except one case of anaplastic large cell lymphoma. Immunohistochemically, 18 patients (69%) had MUM 1 positivity and 20 cases (77%) belonged to nongerminal center subtype. DeAngelis protocol was followed in 24 patients (92%), and among this cohort, Memorial Sloan Kettering Cancer Center Class 1 (n = 17) and Class 2 (n = 7) patients had a median OS of 25 months and 11 months, respectively. Conclusion: None of the potential prognostic factors had a statistically significant influence on OS in our patients. High-dose methotrexate combined with radiation is an effective therapeutic approach. However, further prospective studies with a large number of patients are needed to identify more effective primary chemotherapy regimens to further improve the treatment outcome.
EMERALD: Emergency visit audit of patients treated under medical oncology in a tertiary cancer center: Logical steps to decrease the burden
Authors: Joshi Amit , Patil Vijay M. , Noronha Vanita , Ramaswamy Anant , Gupta Sudeep , Bhattacharjee Atanu , Bonda Avinash , Chandrakanth M. V. , Ostwal Vikas , Khattry Navin , Banavali Shripad , Prabhash Kumar
Published: January 2018

Background: We are a tertiary care cancer center and have approximately 1000–1500 emergency visits by cancer patients undergoing treatment under the adult medical oncology unit each month. However, due to the lack of a systematic audit, we are unable to plan steps toward the improvement in quality of emergency services, and hence the audit was planned. Methods: All emergency visits under the adult medical oncology department in the month of July 2015 were audited. The cause of visit, the demographic details, cancer details, and chemotherapy status were obtained from the electronic medical records. The emergency visits were classified as avoidable or unavoidable. Descriptive statistics were performed. Reasons for avoidable emergency visits were sought. Results: Out of 1199 visits, 1168 visits were classifiable. Six hundred and ninety-six visits were classified as unavoidable (59.6%, 95% CI: 56.7–62.4), 386 visits were classified as probably avoidable visit (33.0%, 95% CI: 30.4–35.8) whereas the remaining 86 (7.4%, 95% CI: 6.0–9.01) were classified as absolutely avoidable. Two hundred and ninety-seven visits happened on weekends (25.6%) and 138 visits converted into an inpatient admission (11.9%). The factors associated with avoidable visits were curative intention of treatment (odds ratio - 2.49), discontinued chemotherapy status (risk ratio [RR] - 8.28), and private category file status (RR – 1.89). Conclusion: A proportion of visits to emergency services can be curtailed. Approximately one-fourth of patients are seen on weekends, and only about one-tenth of patients get admitted.
Epidemiology of cancer in young in central India: An analysis of rural cancer hospital data
Authors: Gupta Novak , Chitalkar Prakash , Mishra Renu , Punia Ankur
Published: January 2018

Background: Cancers in teenage and young adults (TYAs), though an increasing cause of mortality in our country, have been scarcely studied. The lack of studies of TYAs can significantly affect the outcomes of the youth in the prime of their lives. Aims: The aim of this study was to study the type of cancers in the TYA at a rural cancer center in central India. Design and Methods: A prospective study in the department of medical oncology, from the period of January 2013 till March 2016, was done. Data regarding socioepidemiological factors were collected for new cancer patients between the age group of 15–30 years in semi-structured questionnaire and from the hospital records. Cancers were classified according to the Birch classification. The cases were analyzed according to the epidemiological profile, classification of cancer, and age-wise distribution using descriptive analysis. Results: In this study, out of 5221 cancer patients, TYAs accounted for 327 (6.26%) with 189 males and 138 females (M: F– 1.37:1). The maximum cases were seen in 25–30 years' age group. Carcinoma was the most common malignancy (54.74%) with an increase from 19.56% in the 15–19 years' age group to 64.82% in the 25–30-year-old patients. Conclusion: The present study gives a glimpse of the TYA cancers in the central India. More than half of the young cancer patients suffer from carcinomas with about half of these being head and neck cancers.
Oncology gold standard® practical consensus recommendations for the use of monoclonal antibodies in the management of squamous cell carcinoma of head and neck
Authors: Babu Govind , Bahl Ankur , Bhattacharya G. S. , Bhowmik K. T. , Dattatraya P. S. , Ghadyalpatil Nikhil , Karandikar S. M. , Kulkarni Padmaj , Sridharan Nithya , Parikh Purvish , Prabhash Kumar , Raja T. , Rajasundaram S. , Subramanian S. , Talapatra Kaustav , Vaid Ashok
Published: January 2018

We present the 2017 Oncology Gold Standard Practical Consensus Recommendation for use of monoclonal antibodies in the management of advanced squamous cell carcinoma of head neck region.
Short message service prompted mouth self-examination in oral cancer patients as an alternative to frequent hospital-based surveillance
Authors: Vaishampayan Sagar , Malik Akshat , Pawar Prashant , Arya Kavi , Chaturvedi Pankaj
Published: January 2018

Introduction: Oral squamous cell carcinoma (OSCC) are amongst commonest cancer in the Indian sub-continent. After treatment, these patients require frequent followup to look for recurrences/second primary. Mouth Self Examination (MSE) has a great potential in all levels of prevention of oral cancer. However, the compliance to self-examination has been reported as poor. Mobile phone is a cheap and effective way to reach out to people. Short Message Service (SMS) is extremely popular can be a very effective motivational and interactive tool in health care setting. Methodology: We aimed to identify in adequately treated OSCC patients, the influence of health provider initiated SMS on the compliance to the MSE and to establish the efficacy of MSE by comparing patients' MSE interpretation via replies to the SMS with that of the experts' opinion on clinical examination status during follow up. Conclusion: We conclude that MSE can be very useful in adequately treated OSCC patients for evaluating disease status. All treated OSCC patients must be adequately educated for MSE as an integral part of treatment & follow-up protocol by the health provider facility. Health provider generated SMS reminders do improve motivation and compliance towards MSE but don't seem to reduce dropouts in follow up for large and diverse population like that in India.
Adolescents and young adults: A study of distribution of cancer at ages 15–39 years in a tertiary care hospital from North India: Epidemiological considerations
Authors: Kakkar Neha , Gupta Ajay , Sharma Neeraj Kumar , Agarwal Prachi , Kaur Jaspreet
Published: January 2018

Purpose: This study aimed to analyze cancer pattern among adolescents and young adults (AYA) in a tertiary care center in North India. Materials and Methods: A retrospective study from January 2011 to December 2014 was undertaken on AYA cancer patients (aged 15–39 years). Results: Totally 1077 cases of AYA cancers were identified for analyzing the frequency and pattern of cancer distribution. The most common cancer was head and neck (32%) followed by breast (14.2%). The distribution pattern was observed to be varying in different age groups with lymphoma, leukemia, bone tumors, and sarcomas in adolescents while carcinomas being more frequent in young adults. Conclusion: Cancer distribution patterns are distinct among AYA in terms of epidemiology and biology.
Male breast cancer: A retrospective review of clinical profile from a tertiary cancer care center of India
Authors: Ram Dharma , Rajappa Suhas K. , Selvakumar Veda P. , Shukla Himanshu , Goel Ashish , Kumar Rajeev , Kumar Kapil
Published: January 2018

Aim: Present study was done with an aim to analyse the clinicopathological and survival characteristics of male breast cancer patients. Methods: We did a retrospective review of our database and analysed total 27 patients who presented to breast oncology unit of Rajiv Gandhi cancer centre and research institute from January 2010 to April 2016. Results: Most common stage at presentation in our study was in stage II. The median follow up was 32.75 months. The actuarial 5-year survival was 92.30% and DFS was 76.30%. Only hormone receptor status was found as a significant prognostic variable among the prognostic factors studied for disease free survival. Conclusions: Carcinoma breast in male is a relatively rare disease and management principles are translated from our understanding of breast cancer in women. A relatively early stage at presentation is a contrasting finding of our series which may be responsible for a significantly better actuarial 5 year survival rates.
Tolerance and adverse event profile with sorafenib in Indian patients with advanced hepatocellular carcinoma
Authors: Ostwal Vikas , Gupta Tarachand , Chopra Supriya , Lewis Sherly , Goel Mahesh , Patkar Shraddha , Shetty Nitin , Ramaswamy Anant
Published: January 2018

Background: The current standard of treatment for advanced hepatocellular cancer Hepatocellular carcinoma (HCC) is Sorafenib. Data regarding its tolerance and adverse event profile in Indian patients is scarce. Materials and Methods: The primary aim of this analysis was to assess the adverse events (Grade 3 and Grade 4 as per CTCAE v4.0) and requirements for dose reduction with sorafenib in advanced HCC. Details of consecutive patients started on 800 mg/day dosing were obtained from a prospectively maintained database (over a period of 6 months) and analyzed. Results: Thirty-nine patients were available for inclusion in the study. Median age was 58 years (range: 20–75). All patients were classified as Barcelona clinic liver cancer C. Common side effects seen were liver dysfunction (38.5%), hand-foot-syndrome-rash (HFSR) (Grade 2 and 3-25.6%), fatigue (Grade 2 and Grade 3–10.3%), and diarrhea (7.7%). Dose reduction was required in 43.6% of patients. Drug interruptions/cessation was required in 38.5% of patients within the first four months of treatment. Nearly 41% of patients required cessation of sorafenib due to intolerable side-effects while 28.2% stopped sorafenib due to progressive disease. At a median follow-up of 4.9 months, median event-free survival (EFS) was 4.20 months (95% confidence interval: 3.343–5.068). Conclusion: A higher incidence of liver dysfunction and HFSR is seen in Indian patients as compared to published data. A significant proportion of patients required cessation of sorafenib due to adverse events in our series. However, EFS remains on par with that seen in larger studies with sorafenib in advanced HCC.
Clinicopathological and molecular epidemiological study of lung cancer patients seen at a tertiary care hospital in Northern India
Authors: Singh Randeep , Rohtagi Nitesh
Published: January 2018

Aims: The primary objective of this study was to estimate the clinicopathological and molecular profile of lung cancer patients along with the evaluation of their clinical characteristics at a tertiary care hospital in Northern India. Subjects and Methods: A total of 421 patients with lung cancer histology who were treated at Max Super Speciality Hospitals were included in the study. The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki and permission was obtained from the Ethics Committee before the start of the study. Clinical characteristics and molecular profiling data were collected from the patient's medical records. Results: There were 330 (78.4%) men and 91 (21.6%) women with a median age of 62 years (range: 30–93 years). Of the 421 patients, 388 (92.2%) patients had the nonsmall cell lung cancer (NSCLC) histology whereas 33 (7.8%) patients were of SCLC histology. Histology and gender had a significant association with NSCLC and SCLC (P < 0.05). Epidermal growth factor receptor (EGFR) and echinoderm microtubule-associated protein like 4-anaplastic lymphoma kinase (EML4-ALK) fusion gene testing was done in 120 and 93 patients, respectively. Of the 120 patients, 24 (20%) cases were positive for EGFR mutations whereas EML4-ALK fusion gene was present in 8 (8.6%) out of 93 patients. Conclusions: Our study confirms the importance of molecular testing in the NSCLC patient subgroup with an aim to identify the exact molecular targets that can benefit from the newer generation of targeted therapies.
Percutaneous fixation of acute scaphoid fractures
Authors: Yassin Ismail , El-Nahas Mohammad , Awadallah Mostafa
Published: January 2018

Objective

The aim of this study were to determine whether the functional outcome of the evaluation of the effectiveness of percutaneous retrograde (volar) approach of insertion of cannulated Herbert's screw to stabilize acute scaphoid fractures and to evaluate the functional outcome after this minimally invasive operative management of this problematic fracture.

Background

Scaphoid fracture is the most common carpal fracture. It accounts for ∼60–90% of carpal and 11% of hand fractures. Scaphoid fracture is a common fracture affecting mainly young active people during their work or while participating in sports activities.

Patients and methods

This is a retrospective observational study of patients undergoing surgery for percutaneous fixation of acute scaphoid fracture. In our study, 12 patients with less than 14-day-old fractures were fixed percutaneously by Herbert's screw and reviewed for a minimum of 12 months (average of 24 months). The functional outcome of this method was assessed.

Results

Fracture union was achieved in 11 (91.6%) cases at a mean of 8.29 weeks (6–12 weeks), whereas one case was ununited.

Conclusion

This study proves that fixation of acute scaphoid fractures results in predictable satisfactory union rate and functional outcome. Moreover, it proves that percutaneous Herbert's screw insertion carries no risk of damage to soft tissues or vascular supply.
Cerebrovascular reactivity and neurogenic inflammation in migraine
Authors: Maabady Manal H. , Saed Ghada , El-Said Seham , Saif Eldeen Eman M.
Published: January 2018

Background

The exact mechanism of migraine is still unknown; however, it is believed to be a neurovascular disorder, where the cerebral vascular reactivity is malfunctioning. Although several studies have found alterations in velocity of blood flow and in cerebral vasomotor reactivity of intracranial arteries in migraineurs in headache-free periods, as well as during migraine attacks, the results are inconclusive. Another theory of migraine is the neurogenic inflammation involving the release of various vasoactive neuropeptides, which evoke a cascade of events that have a role in migraine attacks.

Aim of work

To evaluate the role of both vascular and inflammatory theories in migraine with and without aura.

Objective

The objective of this study was to examine the cerebrovascular reactivity to repetitive flash stimulation during interictal period of migraine and determine the serum levels of transforming growth factor β-1 (TGFβ-1) as an inflammatory mediator in migraine with and without aura.

Patients and methods

The changes in peak systolic volume (PSV) of both middle cerebral and posterior cerebral arteries in response to repetitive flash stimulation were evaluated by transcranial Doppler in 35 migraineurs (23 patients with aura and 12 without aura), during interictal period, and in 25 age-matched and sex-matched apparently healthy control participants. Moreover, serum levels of TGFβ-1 were determined in both the patients and control participants.

Results

The middle cerebral artery in migraineurs shows significant increase in PSV after flash stimulation in comparison with control participants who showed a habituation in PSV levels in response to stimulation. In posterior cerebral artery, compared with normal participants, migraineurs showed significant increase in PSV measures and PSV changes at the beginning and after the end of stimulation. The lack of habituation is significantly pronounced in patients with migraine with aura, in comparison with those without aura. Regarding TGFβ-1 serum levels, they were significantly higher in migraineurs than control participants. Moreover, patients with migraine without aura show significantly higher serum levels of TGFβ-1 in comparison with patients with migraine with aura.

Conclusion

Lack of habituation of the cerebrovascular response in migrainers might contribute to a disturbance in the metabolic homeostasis of the brain that might induce migraine attacks. Neurogenic inflammation has a role in migraine attacks.
Effect of female increased body mass index on intracytoplasmic sperm injection outcome
Authors: Shehata Mohamed
Published: January 2018

Background

BMI is calculated by dividing the weight in kilograms by height in meters squared (kg/m2). It is known that the reproductive potential in obese women is decreased and to be associated with suboptimal outcomes after assisted reproductive technologies.

Objective

The aim of this study was to evaluate the effect of increased BMI on pregnancy outcome in women undergoing intracytoplasmic sperm injection (ICSI) cycle.

Patients and methods

This retrospective study was conducted on 200 Women at Assisted Reproductive Technology Unit, International Islamic Centre for Population Studies and Research (IICPSR), Al-Azhar University. Data were recruited from patient files at IICPSR from January 2013 to December 2015, who had ICSI trial during this period. Patients who were included in the study were subdivided into two groups according to BMI − first group: normal-weight women with BMI between 18 and 24.9 kg/m2 (100 cases); secondgroup: overweight and obese women weighing at least 25 kg/m2 (100 cases). The outcomes in the two groups were demonstrated in all stages of ICSI.

Results

The duration of infertility was progressively higher as BMI increased. Basal luteinizing hormone, follicle-stimulating hormone, and estradiol levels were higher in group 2 than in group 1. Higher total doses of gonadotropin were required in group 2 to obtain equivalent ovarian response than in group 1. No significant difference was observed on ovarian response and embryonic parameters. Serum estradiol level on ovulation triggering day was significantly higher in group 2. Ovarian hyperstimulation and cycle outcome were not significantly different between both groups.

Conclusion

Overweight and obesity appear to have independent adverse effects on ovarian response to stimulation and outcomes in women undergoing ICSI.
Prognostic factors of brainstem infarction in a sample of Egyptian patients
Authors: El-Zayat Sayed A. , Abd El-Hamid Tarek M. , Sobh Khaled M. , Abd El-Aziz Ahmed F. , Mohamed Mohie EL-Din T. , Attia Mahmoud S.
Published: January 2018

Background

Ischemic brainstem stroke is estimated to constitute 10% of all first ischemic brain strokes. Because the brainstem is involved in almost all of the important functions of the central nervous system, brainstem infarction (BSI) is relatively dangerous with a high mortality. Early prediction of the severity and degree of disability and identification of high-risk patients are critical for the treatment of patients with BSI.

Objective

This study aimed to evaluate patients with BSI in terms of clinical, laboratory, and radiological factors to study the outcomes of these patients.

Patients and methods

Patients were admitted at the Stroke Unit and Internal Neurology Department of Al-Azhar University Hospitals (Al-Hussein and Sayed Galal Hospitals), over a period of 6 months, from 1 December 2016 to 30 May 2017, with a diagnosis of acute BSI, confirmed by computed tomography brain and MRI brain with diffusion. The study included 31 patients and were subjected to clinical, laboratory, radiologic assessment (by computed tomography brain and MRI brain with diffusion), and assessment of severity by the National Institute of Health Stroke Scale (NIHSS) score at the time of admission and discharge. The modified Rankin Scale (mRS) score at discharge was used to divide patients into three groups: patients with mRS less than or equal to 2 were considered to have achieved a good outcome, those with mRS greater than 2–5 were considered to have achieved a poor outcome, and those who died had mRS equal to 6.

Results

Overall, 14 (45.2%) patients had a good prognosis, 13 (41.9%) patients had a poor prognosis, and four (12.9%) patients died. Dysphagia, vomiting, cranial neuropathy, and high NIHSS score on admission were associated with a poor outcome. There was no relationship between the outcomes of the studied patients in relation to age, sex, hypertension, atrial fibrillation, diabetes mellitus, ischemic heart disease, high lipid profile, smoking, previous cerebrovascular stroke, obesity.

Conclusion

Dysphagia, vomiting, cranial neuropathy, and high NIHSS score were associated with a poor prognosis.
Prospective, comparative, randomized, and controlled study of endotracheal intubation conditions without muscle relaxant in children receiving general anesthesia
Authors: Hegazy Abdelazim A. T.
Published: January 2018

Introduction

Intubation without the need for a muscle relaxant is a common practice in pediatric patients. Many drugs are used; sevoflurane and propofol are used to improve the intubation score and to decrease the usage of a muscle relaxant and avoid its side effects.

Aim

This study aimed to compare intubation conditions and hemodynamic responses to two induction regimens, without a muscle relaxant using an anesthetic, sevoflurane versus propofol, in children, who required general anesthesia.

Patients and methods

A prospective controlled study was carried out on 90 patients with ASA physical status I and II scheduled for elective pediatric day case surgeries. Patients were divided into three equal groups of 30 patients each. The patients in the S group received inhalational induction sevoflurane. The P group received 3 mg/kg propofol intravenously. The C group received 2 mg/kg succinylcholine after 3 mg/kg propofol intravenously as a control group; maintenance was performed by inhalation using sevoflurane after intubation in all groups. The intubation conditions, hemodynamic parameters (heart rate, peripheral oxygen saturation) induction time, and recovery time were all recorded and statistically analyzed.

Results

With respect to the intubation conditions, no patient in any of the two groups (S and P groups) needed rescue a muscle relaxant for intubation. The S group showed more acceptable and excellent intubation conditions versus the propofol groups (100 and 96.7%, respectively). The heart rate was comparable in all groups at all readings; except during intubation, reading was highly significantly low in the sevoflurane group. Induction time was longer in the sevoflurane group than in the other groups. The recovery time was short in the S group than in the propofol group.

Conclusion

Endotracheal intubation without neuromuscular blocking agents in pediatric patients undergoing day case surgeries was achieved with no severe respiratory or hemodynamic adverse events by using propofol (3 mg/kg) or sevoflurane 8% at induction and then reduced to a maintenance level after intubation.
Early Neolithic population dynamics in the Eastern Balkans and the Great Hungarian Plain
Authors: Blagojević Tamara , Porčić Marko , Penezić Kristina , Stefanović Sofija
Published: January 2018

In this study, we reconstruct population dynamics in the Early Neolithic of the Eastern Balkans and the Great Hungarian Plain using frequency of radiocarbon dates as a population proxy. The method of summed calibrated radiocarbon probability distributions is applied to a set of dates recently published in Bulgaria and Hungary. The aim is to test the hypothesis of the Neolithic demo­graphic transition (NDT) in these regions and to compare the patterns between these two and neighbouring regions. The results show that episodes of population growth occurred in both regions, which is in partial agreement with the predictions of the NDT theory. Population growth is detected, but it is followed by a bust, rather than stabilisation as predicted for the second phase of the NDT.
The past in the past in the mortuary practice of hunter-gatherers: an example from a settlement and cemetery site in northern Latvia
Authors: Larsson Lars Olof Georg
Published: January 2018

During excavations of burials at Zvejnieki in northern Latvia, it transpired that the grave fill included occupation material brought to the grave. It contained tools of a type that could not be contemporaneous with the grave. This is confirmed by the dating of bone tools and other bone finds in the fill. The fill was taken from an older settlement site a short distance away. The fill also included skeletal parts of humans whose graves had been destroyed with the digging of the grave for a double burial. This provides an interesting view of the mortuary practice of hunter-gatherers and an insight into the use of the past in the past.
I remember. Differences between the Neanderthal and modern human mind
Authors: Petru Simona
Published: January 2018

Modern humans remember things they experience as personal events. An important reason for this personal perception of time is episodic memory, which enables mental time travel. This type of memory could not have been fully evolved in Neanderthals and they might not have imagined their personal past and future. Thus, their archaeological record does not contain durable objects which would be preserved from one generation to another. Their burials also do not include convincing grave goods that indicate a belief that personal time continues after death.
Introduction to the absolute chronology of Neolithic cultures in Eastern Europe
Authors: Mazurkevich Andrey
Published: January 2018

This paper is an introduction to the discussion of radiocarbon chronology of Neolithic cul­­tures in Eastern Europe. It relates to a number of papers published in this volume.
The Early and Middle Neolithic in NW Russia: radiocarbon chronologies from the Sukhona and Onega regions
Authors: Piezonka Henny , Nedomolkina Nadezhda , Ivanishcheva Marina , Kosorukova Natalya , Kulkova Marianna , Meadows John
Published: January 2018

The onset of the Neolithic period in the Russian North is defined by the emergence of pottery vessels in the archaeological record. The ceramics produced by mobile hunter-gatherer-fisher groups in the north-eastern European forest zone are among the earliest in Europe, starting around 6000 cal BC. After the initial mosaic of local styles in the Early Neolithic, including sparsely decorated wares and early Comb Ware, the Middle Neolithic period, starting in the 5th millennium cal BC, saw the development and spread of larger, more homogenous typological entities between the Urals and the Baltic, the Comb-Pit and Pit-Comb wares. Absolute chronologies, however, are still subject to debate, due to a general lack of reliable contextual information. Direct 14C dating of carbonised surface residues (‘food crusts’) on pots can help to address this problem, as it dates the use of the pottery; but if aquatic foods were processed in the vessels, the respective radiocarbon ages can appear to be too old due to the freshwater reservoir effect. In this pa­per, we discuss the radiocarbon chronologies of four important stratified archaeological complexes in the region between Lake Onega and the Sukhona basin, Berezovaya Slobodka, Veksa, Karavaikha, and Tudo­zero. A growing series of dates, including AMS dates, sheds new light on the onset and further periodisation of the Early and Middle Neolithic in this important area between Eastern Fennoscandia, Central Rus­sia and the Far North-East of Europe, although problems concerning the absolute chronology of the initial Neolithic remain.