bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender Perspectives
Authors: Varghese Bindi , Joseph Emilda K. , Kallarakal Tomy K.
Published: July 2022

The travel business is an extensively engaging sector, and it is quite a paradox to see how tourism businesses play a leadership role within the industry and in the business community. This chapter aims to precipitate and reflect on the nature of tourism employability and examine the gender space and women employability for inclusive tourism development. This chapter examines varied aspects affecting the tourism industry and addresses economic resilience building. The significance of the gender parity revolves around the dynamic capacities related to the women in the private business space in the hospitality sector. This chapter indicates how women-centric employee engagement is attained in a globalized world. The gender-centric perspective and the women empowerment in the hospitality business are assessed.
The Perspectives of Female Tourists on Food Tourism in Different Countries
Authors: Jayawardena Nirma Sadamali , Karunarathne Sanjeewa Kumara
Published: July 2022

The objective of this chapter is to review the literature to identify the different marketing strategies used by different countries in promoting food tourism with special reference to the viewpoints of female tourists. The viewpoints of female tourists have been selected as female travelling category has seen rapid expansion in today's worldwide outbound tourism industry. This study contributes by becoming the first systematic literature review on different marketing strategies used by different countries in promoting food tourism with special reference to the viewpoints of female tourists during the period 2015 to 2021.
Tourism, Contradiction, and Afro-Religious (In)Visibility
Authors: Melo Emerson Costa de , Gonçalves Marina Furtado , Braga Solano de Souza , Silveira Aline da Fonseca Sá e , Costa Denilson Damasceno
Published: July 2022

Since the mid-1980s, studies on cultural heritage, whether material or immaterial, have been gaining prominence in tourism. However, there have been few debates and approaches dedicated to the understanding of socio-historical and ethnic-racial cultural peculiarities that promote the establishment of an agenda of tourist services that involve cultural heritage that recall Afro-Brazilian traditions. It is in this perspective that the authors propose a reflection elaborated from the intersection between the debate of ethnic-racial relations and tourism in Afro-religious communities, analyzing the challenges and contradictions of the promotion of tourist activities in Terreiros of Candomblé and Umbanda, in addition to gathering information that show the invisibility and prejudices in relation to these religions at the national level and valuing their tourist potential.
Tourism Promotion and Racism Against Indigenous People in Rio Grande do Norte (Brazil)
Authors: Gonçalves Marília Barbosa , Lemos Daniel Dantas , Nunes Guilherme Arnaud Lopes , Gouveia Juanna Beatriz de Brito , Paino Ribeiro Renata Laíze Alves Coelho Lins
Published: July 2022

Perceiving that the fields of tourism and communication are linked with a certain degree of dependence of the former on the latter, this chapter reinforces the importance of media discourse as an element to sustain the orientation of tourism production. For this reason, discursive elements that permeate this type of production, especially, in institutional and official spaces on the internet are the main goal. This text is based in studies about racism from a theoretical-methodological perspective of the critical discourse analysis based on ethics and aims to recognize the abuse of power in language in order to empower those under such oppression. From this perspective, two discursive events will be analyzed in spaces of official and institutional touristic publicity in Rio Grande do Norte on the internet.
Gamification in Healthcare Education
Authors: Padilha José Miguel , Rosa João Frias , Cunha Daniel José
Published: July 2022

This chapter calls for reflection on one of the most promising technologies in healthcare education, the use of virtual patients and clinical virtual simulation as a pedagogical strategy to improve clinical decision-making and enhance clinical safety and healthcare quality. This chapter discusses the new challenges in healthcare education and the use of clinical virtual simulation in undergraduate healthcare education and lifelong learning, integrating gamification and serious games as strategies to increase intrinsic and extrinsic students' motivation. Considering the novelty of this topic, this chapter will be strategic for technology developers and healthcare educators, identifying emerging challenges and opportunities.
Gamification in Higher Education
Authors: Arufe Giráldez Víctor , Navarro-Patón Rubén , Sanmiguel-Rodríguez Alberto
Published: July 2022

This chapter addresses the elements to consider for creating a gamified learning environment in higher education, specifically in the university classroom. It investigates various didactic proposals for gamification at the university made by different authors in recent years, the variables they have addressed in their study, how they have been evaluated, and the most relevant findings. It is intended to develop a text that will serve as a basis for many scholars in education and gamification, which casts its own light on gamification in higher education, presenting its strengths and weaknesses and offering clear ideas and strategies to get the maximum educational potential to gamification.
Gamified Learning Effectiveness Model
Authors: Ohn May Honey , Ohn Khin Maung , Luen Ng Pey
Published: July 2022

The increasing use of gamification in educational institutions may be attributed to its efficacy in enhancing learning. The objective of this study was to evaluate the impact of online gamified learning among undergraduate medical students. The study developed a hypothetic model to investigate the impact of game characteristics, learning climate, and learners' self-efficacy on medical students' motivation, engagement, and improved learning process. Structural equation modeling (SEM) examined the causal relationships between the observed and latent variables. This study showed that game characteristics positively influence learners' learning engagement and intrinsic motivation. However, the learning environment and self-efficacy did not influence the perceived satisfaction of users. The findings generated in this study indicate those game elements can positively influence students' performance and learning achievement through motivation and engagement.
The Efficacy of Gamification for the Involvement of Students in Distance Education
Authors: Pimentel Fernando S. C. , de Barros Daniel A. M. , Silva Janaina M. da , Silva Emerson M. P. da , Marques Margarida M.
Published: July 2022

This chapter presents quantitative research that analyzes gamification's effectiveness in a distance learning mathematics undergraduate course. First, the growth of the culture of digital games and the development of gamification from a methodological perspective were discussed. Then, the fundamentals regarding gamification in distance education are presented. Methodologically, the research followed the research steps done by Rahman, Ahmad, and Hashim with some adaptations are indicated in this chapter. The data collection instrument used for this investigation consisted of a questionnaire for 37 students. The research data suggest that gamification promoted students' engagement with learning. It is concluded that the categories presented in the study indicate that students perceive gamification as an alternative to create more dynamic classes and promote learning.
Escape Rooms and Breakouts
Authors: Jadán-Guerrero Janio , Chacón-Castro Marcos , Aimacaña-Espinosa Luis
Published: July 2022

The escape rooms and breakouts are immersive games in which the participants are locked in a room and must solve a series of puzzles to escape. In virtuality, these games have also aroused interest in the educational field as a learning tool to transform students from passive spectators to active participants. Immersive learning allows students to learn about a topic while practicing teamwork and communication. This chapter aims to explain how these tools work and describe the implementation process using digital educational resources available on the web. Some examples developed by the authors are mentioned, and the evaluation results concerning the students' motivation, satisfaction, and participation in a virtual environment are presented.
Gamification in the Space Sector
Authors: Galeone Annalisa
Published: July 2022

Firstly, the authors introduce the concept of gamification design applied to various contexts. Then, they discuss how the gamification approach is used within the space sector to develop online and offline resources to foster passion and interest in STEM-related subjects. Indeed, a decreasing number of students nowadays decide to take up STEM-related studies and careers. Therefore, following an edutainment logic, it is essential to design more gamification activities to increase students' motivation and engagement with STEM topics. Given this, they consider the cases of the videogames Kerbal Space Program (KSP) and MinecraftEdu, the ESA Kids website, Mission X, CanSat Competition, Moon Camp, Climate Detectives, Astro-Pi Challenge, and the ESERO Project. They also carry out a netnographic study on some social media pages. Moreover, they discuss how gamification activities may promote the company's corporate brand for NASA and the European Space Agency (ESA). Finally, they focus on the digital divide, which might limit the gamification methodology in approaching disadvantaged socio-economic countries.
Interdisciplinary Communication
Authors: Danielsson Alicia , Hyams-Ssekasi Denis
Published: July 2022

This chapter presents a collaborative autoethnography study whereby two academics at a medium-sized UK university explore their experiences of teaching entrepreneurship in different business and law school departments to combine expertise and resources to develop interdisciplinary gamification solutions. The combined experiential reflections have contributed to the generation of ideas that will prompt future interdisciplinary content to be created to bridge together fields such as business, social, legal, and technical studies. The chapter concludes that critical factors limiting developments in interdisciplinary entrepreneurship games include a lack of focus on entrepreneurial skills in departments within HEIs other than business schools and a lack of cross-departmental communication and collaboration. Although all the required expertise and resources are present within the university, a genuinely holistic approach can only be developed if innovative teaching tools combine multidisciplinary content from all faculties.
Scrumming
Authors: Peña Pérez Negrón Adriana , Bonilla Carranza Jose Luis David , Muñoz Mirna , Osorio Angel Sonia
Published: July 2022

Software project management is a multitask process that involves planning, organizing, monitoring, and controlling. And Scrum is an agile project management method based on self-organized teams; that is, the team members, although guided by a product owner and the Scrum master, evaluate the project's tasks and decide who will take care of them and the schedule. However, in academia, the Scrum method might not work as expected in a professional environment because of the commitment of the team members. Also, it seems more proper for the students to be motivated to take care of more diverse tasks, not just those they are comfortable with. By gamifying the Scrum dashboard for their final subject project, the motivation to take varied and challenging activities is expected. A study was conducted where the main results indicate that the teams under a gamified project in the academy context, have a greater tendency to complete the project.
Fostering Motivation to Learn Through Gamification
Authors: Marinensi Giada , Botte Brunella
Published: July 2022

The implementation of gamification in educational contexts has experienced steady growth over the last few years. This may be due to many factors, including that teachers are increasingly familiar with video games and their students and are more willing to experiment with different game-inspired learning approaches in the classroom. However, designing an effective gamified system is a challenging task. Therefore, this paper aims to provide teachers with more guidance in the gamification design process, especially concerning the difficult task of planning a motivating reward system. To do so, the authors conducted a qualitative study of the gamified learning app Duolingo. The study focused on understanding how users respond to the different kinds of rewards the app provides and how rewards affect their motivation to learn by fulfilling their need for competence, relatedness, and autonomy in the framework of self-determination theory.
The Effects of a Low Volume Physical Training Program on Functional Movement and Strength in Dancers
Authors: Conceição Fabrízia de Souza , Martins Paula de Faria Fernandes , Marques Anna Carolina Souza , Minikovski Geovana S. , Matos Mariana , Pessali-Marques Bárbara
Published: July 2022

This research aimed to evaluate the effect of 20 low-volume remotely-guided training sessions within the daily life of dancers with different routines who practice different dance modalities. The experimental research investigated 10 female individuals chosen for convenience who volunteered to participate in the "I Festival Dance comCiência." As a research instrument, functional and physical tests adapted explicitly for this study were performed remotely by physical therapists and body conditioners. Afterwards, the dancers were instructed to carry out twenty 10-minute daily training sessions. Data were collected individually by video calls with a physiotherapist and a body conditioner. The comparison between the pre- and post-training test results was performed using paired t-test. It is possible to assume that remotely oriented low-volume training seems to be a viable and effective alternative for implementing physical conditioning in dance, but further studies with larger samples would help to state more solid answers.
Resource Optimization in Cloud Data Centers Using Particle Swarm Optimization
Authors: R. B. Madhumala , Tiwari Harshvardhan , Verma C. Devaraj
Published: July 2022

To meet the ever-growing demand for computational resources, it is mandatory to have the best resource allocation algorithm. In this paper, Particle Swarm Optimization (PSO) algorithm is used to address the resource optimization problem. Particle Swarm Optimization is suitable for continuous data optimization, to use in discrete data as in the case of Virtual Machine placement we need to fine-tune some of the parameters in Particle Swarm Optimization. The Virtual Machine placement problem is addressed by our proposed model called Improved Particle Swarm Optimization (IM-PSO), where the main aim is to maximize the utilization of resources in the cloud datacenter. The obtained results show that the proposed algorithm provides an optimized solution when compared to the existing algorithms.
Stock Market E-Assistance on Platform-as-a-Service (PaaS)
Authors: Hameed Shahul Chettali
Published: July 2022

Stock market has received widespread attention from investors. How to grasp the changing regularity of the stock market and predict the trend of stock prices has always been a hot spot for investors and researchers. The rise and fall of stock prices are influenced by many factors such as politics, economy, society and market. For stock investors, the trend forecast of the stock market is directly related to the acquisition of profits. The more accurate the forecast, the more effectively it can avoid risks. For listed companies, the stock price not only reflects the company’s operating conditions and future development expectations, but also an important technical index for the analysis and research of the company. Stock forecasting research also plays an important role in the research of a country’s economic development. Therefore, the research on the intrinsic value and prediction of the stock market has great theoretical significance and wide application prospects.
A Fault Tolerance and Recovery Formal Model for IoT Systems
Authors: Smaali Sahar , Benbessem Riadh , Touati Hatem Mohamed Nazim
Published: July 2022

In an increasingly connected world, the internet of Things (IoT), Cloud and Fog computing are a major asset allowing to overcome previously inconceivable limits in terms of innovation. However, Fault Tolerance remains a major challenge for assuring IoT systems dependability. In order to tackle this issue, we propose a generic microservice architecture called FaTMA (Fault Tolerance- Microservice Architecture for IoT) permitting detection of Things failures by providing continuous and real-time monitoring of their states. In addition, it offers mechanisms to strengthen the reliability of the designed systems. We adopt Bigraphical Reactive Systems (BRS) as formalism to define a formal model that describes architectural elements of different IoT system layers and their behavior. It provides a clear separation between the various microservices controlling this system type and their side effects. Indeed, the execution of the proposed model, through BigraphER tool, permits to simulate and analyze different failure scenarios as well as their restitution strategies.
Enhancing Student Engagement and Structured Learning in Online Discussion Forums
Authors: Whitfield Agnes , Evans Vanessa , Simpson Breanna E. M.
Published: July 2022

Discussion forums remain an important component in student engagement and learning in many online courses, but current research suggests that refining their pedagogical design could significantly enhance their effectiveness. The Worksheet Video Walk Formula offers one such option. Drawing on scaffolding and question techniques, the worksheet structures the interactive learning tasks closely around the concepts and skills to be learned, while the video walk reinforces students’ connection and engagement with the task activities. This article discusses the pedagogical challenges in designing and implementing the Formula in a large (104 students) second-year English literature course on the short story. The impact of the Formula on the quality of student interaction with concepts and texts as well as their development of close reading and critical thinking skills is assessed, and future applications are explored. This study has implications for teacher presence in discussion forums, learning outcomes, student satisfaction, and online pedagogy in large classes.
Food Apartheid and Food Insecurity
Authors: Burrell Darrell Norman
Published: July 2022

A Food desert usually occurs in a low-income or minority community with limited access to low-cost fresh and healthy food options. This is due mainly to a lack of grocery stores, farmers’ markets, and healthy food providers, resulting in food insecurity. Household food insecurity was related to significantly worse general health, some acute and chronic health problems, and worse health care access, including forgone care and heightened emergency department use, for children. Compared to rates had they not been food insecure, children in food-insecure households had higher rates of lifetime asthma diagnosis and depressive symptoms, which were 19.1% and 27.9% higher, rates of forgone medical care that were 179.8% higher, and rates of emergency department use that were 25.9% higher. This paper explores food deserts, food insecurity, and occurrences of food apartheid and recommends potential solutions.
Off to a Quiet Start
Authors: Gann Shawna M.
Published: July 2022

The purpose of this paper is to review literature about pertaining to best practices for virtual onboarding and to encourage discourse about employees with introverted tendencies who must onboard remotely. Accounting for these domains is relevant considering the increase in remote work and, subsequently, the increase in virtual onboarding. Of additional relevance is the importance for organizational leaders in position to influence culture and common practices to employ inclusive practices that consider new employees with introverted tendencies. Encouragement for further study of intersectional aspects, such as various dimensions of diversity, are also included within.
Leading Virtual Teams, Globally
Authors: Wickramasinghe Amanda S.
Published: July 2022

Virtual teams allow professionals to work across boundaries, borders, cultures, and time zones. A number of companies across the globe have adapted to remote work due to the COVID-19 pandemic in the year 2020, using platforms such as Zoom, WebEx, Skype and Microsoft Teams. Due to the pandemic, most professional organizations were forced to utilize virtual platforms to communicate because of the worldwide stay-at- home orders. These platforms allow professionals across the world to connect instantly (Frisch & Greene, 2020).Within that context, a virtual team's leader has a significant responsibility for leading the virtual team to success. The purpose of this study was to explore how to lead virtual global teams successfully. The study examined 25 global leaders' lived experiences utilizing qualitative research methodology and explored the phenomenon of leading virtual teams effectively (and successfully) through using the input and process outcome framework (Eyrich, Quinn & Fessell, 2019). Findings included an effective virtual leadership approach.
Awareness of varicella-zoster virus among undergraduate students at the University of Namibia
Authors: Tomas Nestor , Kampanza Festus
Published: July 2022

Although varicella-zoster virus (VZV) is preventable and curable, the disease remains a public health problem in Namibia. Access to vaccination in the country remains a challenge for many citizens including students. No previous study has been conducted to assess awareness on the prevention and control of VZV in Namibia.  The overall purpose of the study was to investigate the awareness of hostel students on prevention and control measures for VZV in Namibia. The objective of the study was to assess and describe the awareness of hostel students on the prevention and control measures for VZV in Namibia. A quantitative descriptive study using an online questionnaire was used. Simple random sampling was used to select 165 respondents. Descriptive statistics and a non-parametric Kruskal Wallis test were performed to test the mean differences between variables and the significance of the data. A great proportion of the respondents, 70.7% (n=118), were aware that VZV is caused by a virus (0.71±0.45) while 76% (n=127) (0.76±0.42) were aware that VZV can be vaccinated against. The study found a strong association between aetiology (p=0.03), available information (p=0.00), mode of transmission (p=0.23), and knowledge on contagious diseases (p=0.03). The results were inconclusive as to whether the level of awareness is high or low, owing to the differences in scores for each variable. The study recommends that a mobile clinic be established on campus to offer health education information.
Botulinum Toxin Type A for the Treatment of Limb Myokymia
Authors: Işıkay Sedat
Published: July 2022

Myokymia is a rare neuromuscular disorder and limb involvement is not common in this disease. To the best of our knowledge, isolated peroneus longus muscle myokymia was not reported before in the literature; and for that reason treatment protocols were not established. Botulinum toxin type A (BoNT-A), which is used in the treatment of a variety of neurologic disorders, was also defined as a treatment option in myokymia. Herein, we will report three cases of peroneus longus muscle myokymia in children in the absence of any other neurological findings, and the successful results of treatment with local BoNT-A injections. BoNT-A is a safe and effective treatment in myokymia when administered by an experienced clinician and should always be considered when the disorder is persistent and affecting the life of the patient.
Intense venous reflux, quantified by a new software to analyze presurgical ultrasound, is associated with unfavorable outcomes of microsurgical varicocelectomy
Authors: You Kai , Chen Bang-Bin , Wang Peng , Bu Ren-Ge , Xu Xue-Wen
Published: July 2022

The hemodynamic characteristics of venous reflux are associated with infertility in patients with varicocele; however, an effective method for quantifying the structural distribution of the reflux is lacking. This study aimed to predict surgical outcomes using a new software for venous reflux quantification. This was a retrospective cohort study of a consecutive series of 105 patients (age range: 22–44 years) between July 2017 and September 2019. Venous reflux of the varicocele was obtained using the Valsalva maneuver during scrotal Doppler ultrasonography before microsurgical varicocelectomy. Using this software, the colored reflux signals were segmented, and the gray scale of the color pixels representing the reflux velocity was comprehensively quantified into the mean reflux velocity of the green layer (MRVG) and the reflux velocity standard deviation of the green layer (RVSDG). Spontaneous pregnancy and changes from baseline in the semen parameters were assessed during a 12-month follow-up period. Data were analyzed using logistic regression analysis. An association of the high MRVG group with impaired progressive motility (odds ratio [OR] = 2.868, 95% confidence interval [CI]: 1.133–7.265) and impaired sperm concentration (OR = 2.943, 95% CI: 1.196–7.239) was found during multivariate analysis. High MRVG (OR = 2.680, 95% CI: 1.086–6.614) and high RVSDG (OR = 2.508, 95% CI: 1.030–6.111) were found to be independent predictors of failure to achieve pregnancy following microsurgical repair. In summary, intense venous reflux is an independent predictor of impaired progressive motility, sperm concentration, and pregnancy outcomes after microsurgical varicocelectomy.
Psychological Distress and Post-COVID Sequelae in Postpartum Females after Clinically Stable COVID-19 Infections
Authors: Bahadur Anupama , Mundhra Rajlaxmi , Sharma Shloka , Ajmani Megha , Zaman Rabia , Chaturvedi Jaya
Published: July 2022

Objective

The objective of this study was to identify the presence of any post-COVID physical and stress sequelae up to 3 months postpartum.

Materials and Methods:

This prospective cross-sectional study was carried out in a tertiary center from India wherein all clinically stable COVID-positive pregnant women delivering between May 2020 to January 2021 were included. These women were evaluated at 3 months postpartum using Standard Posttraumatic Stress Disorder (PTSD)-Civilian Checklist, Depression, Anxiety, and Stress Scale-21 (DASS-21), and Fatigue Severity Scale (FSS).

Results

Among 42 women evaluated, most of the women felt that they had returned to their pre-COVID health (76.19%, 32 women). Three women (7.14%) had some persistent symptoms, and another seven women (16.66%) were not sure whether they felt the same as pre-COVID health status. Self-reported symptoms such as fatigue, myalgia, and nightmare were reported in 21.43%, 14.28%, and 2.38%, respectively. The frequency of stress and anxiety as seen with the DASS was seen in one (2.38%) and three (7.14%) women, respectively. Although none of the women had PTSD, 9.52% were potential candidates for PTSD. The mean score in FSS was 12.57 ± 4.14 and through Visual Analog Fatigue Scale score was 4.76 ± 1.28.

Conclusion

Postpartum women are at risk of post-COVID physical and stress sequelae.
Rehabilitation of Phthisis Bulbi using Thick Scleral Shell Prosthesis
Authors: Vijayan Anuraj , Aggarwal Anju , S. Khurana Punit R. , Sinha Tushar
Published: July 2022

The eyes are a vital organ that not only allows us to see but also allows us to express ourselves. The loss of an eye has a debilitating effect on a patient’s mentality. Due to injuries, pathology, or tumor, a natural eye is surgically removed through enucleation, evisceration, or exenteration. Implant-retained and acrylic eye prosthesis is used by a maxillofacial prosthodontist to restore the patient’s quality of life in such rehabilitation circumstances. A removable acrylic prosthesis is recommended over an implant-retained prosthesis due to various reasons such as remaining orbital rim, comorbidity associated with implant placement, healing time, and cost considerations. We present an instance of a bespoke acrylic scleral shell prosthesis that demonstrated outstanding retention and esthetics.
Actinomycosis of the Cervix Mimicking Stage II Cervical Cancer
Authors: Ramya Chitturi , Inuganti Renuka V. , Vaddatti Tejaswini , Shaik Nasseruddin
Published: July 2022

Actinomycosis is a chronic bacterial infection, characterized by suppurative and granulomatous inflammation. In humans, actinomycosis is most frequently caused by Actinomyces israelii. It is a normal commensal which becomes pathogenic upon any breach in the mucosa. We report the case of cervical actinomycosis in a 45-year-old female who had a mass per vagina for 2 years. There was no history of any intrauterine contraceptive device insertion. The radiological diagnosis was a neoplasm as the lesion is extending into the adjacent structures. Surgery was planned and a biopsy was taken which revealed Actinomyces. The patient was administered long-term penicillins and advised follow-up. Pelvic actinomycosis should be included in the differential diagnosis of pelvic masses. Even though actinomycosis can present as a large pelvic mass invading adjacent structures, it can be treated with medications and without any surgical intervention.
Microsatellite instability in colon cancer
Authors: Arora Savita , Adhikari Narayan , Rathi Arun Kumar , Singh Kishore , Sakhuja Puja
Published: July 2022

Background:

Due to the defects of mismatch repair (MMR) genes MLH1, PMS2, MSH2, and MSH6, the mutations which occur in microsatellite region are not repaired during deoxyribonucleic acid synthesis, leading to microsatellite instability (MSI). MSI is one of the major molecular changes that occur in colorectal carcinoma (CRC). Studies have shown that MMR deficient CRC has different clinicopathological characteristics and a better stage adjusted survival when compared to microsatellite stable tumors.

Materials and Methods:

We have retrospectively analyzed the cases of colon cancers treated in our institute for 3 years from 2017 to 2019. Most of the patients underwent surgery and received adjuvant chemotherapy. MSI testing was done in surgical specimen with immunohistochemistry. The clinical details of the patients were tabulated in Microsoft Excel, and statistical analysis was done using IBM SPSS Statistics for Windows, version 21 (IBM Corp., Armonk, NY, USA).

Results:

A total of 52 patients who were treated in our institution from 2017 to 2019 were analyzed. The mean age was 46.8 ± 13.5 (19–72) years. The male-to-female ratio was 8:5. No significant association in patient demographics and clinicopathological parameters was observed between MSI stable and unstable disease. However, lymphovascular invasion showed a significantly higher trend in MSI unstable patients (P = 0.052). The median progression-free survival (PFS) of the entire cohort was 27.8 months (95% confidence interval = 22.7–32.9) and the median overall survival (OS) is not reached. The median PFS is 21.3 months in MSI stable patients whereas it is not reached in MSI unstable patients (P = 0.049). The median OS is 27.1 months in MSI stable patients, but it is not reached in MSI unstable patients and the difference shows a trend towards statistical significance (P = 0.061).

Conclusion:

MSI unstable tumors were found to have higher PFS and higher OS in our study. It needs prospective validation in larger studies in Indian scenario.
Ovarian squamous cell carcinoma
Authors: Tobar Paulina Reyes , Assad Roberto Altamirano , Nazal Omar Nazzal , Suárez Eugenio R.
Published: July 2022

Ovarian squamous cell carcinoma is a rare and aggressive ovarian neoplasm, where most of the cases arise from mature teratoma, which represents up to 20% of all ovarian tumors. Moreover, primary squamous cell carcinoma is considered to be related to human papillomavirus infection. The diagnosis is difficult and metastasis from bladder, genital tract, lung, and digestive tract cancers must be ruled out. There are no guidelines for treatment, however, radical surgery combined with adjuvant chemotherapy and radiation therapy, are the most common approach. We present the case of a young women diagnosed with a de novo ovarian squamous cell carcinoma, as well as the treatment and follow-up that she received.
Reappraisal of SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1/INI-1 deficient tumor
Authors: Gurung Niteeka , Kapoor Neha , Mukherjee Urmi , Khurana Anuj
Published: July 2022

SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1 is a tumor suppressor gene located at chromosome 22q11.2. In the past decade, a major stride has been taken for decoding the molecular genesis of various tumors which has resulted in the addition of newer tumors harboring loss of this gene.
A Case-Control Study to Determine the Microbiological Spectrum and Antibiotic Sensitivity Patterns in Congenital Nasolacrimal Duct Obstruction
Authors: Muthumalai Muthumeena , Alam Md. Shahid , Shrirao Neha , Mahalakshmi B. , Mukherjee Bipasha
Published: July 2022

Purpose:

To analyze the microbiological spectrum and antibiotic sensitivity patterns in children with congenital nasolacrimal duct obstruction (CNLDO).

Methods:

One hundred thirty-four eyes of 123 children in the age group of 0–16 years with a diagnosis of CNLDO who underwent lacrimal surgical procedures were included in this prospective comparative study. Sixty-two children in the age-matched group planned for intraocular surgery with patent nasolacrimal duct were deemed controls. The conjunctival swab after performing Regurgitation on Pressure over the Lacrimal Sac in the CNLDO group and the conjunctival swab in controls were sent for microbiological analysis. Antibiotic susceptibility testing was done for commonly employed antibiotics by the Kirby Bauer disk diffusion method.

Results:

Of 134 samples collected in the CNLDO group, 111 (82.8%) samples were culture positive. There were 165 bacteria isolated, among which 139 (84.24% of isolates) were Gram-positive bacteria, and 26 (15.75% of isolates) were Gram-negative. Fungal isolates were obtained in 2.23% of cases. The most common Gram-positive isolate was Staphylococcus epidermidis (S. epidermidis) (n = 51, 30.9% of total isolates), and the most common Gram-negative isolate was Haemophilus influenza species (n = 9, 5.5% of total isolates). Gram-positive isolates were sensitive mostly to gentamicin and vancomycin (95.5% each), and Gram-negative isolates to amikacin (92.3%). Both Gram-positive and Gram-negative isolates were susceptible to gatifloxacin (80% each). Probing outcomes were similar among Gram-positive (success, 84.6%) and Gram-negative (success, 84.0%) organisms.

Conclusions:

There was a predominance of Gram-positive isolates in children with CNLDO with S. epidermidis being the most common. The microbiological profile did not have any effect on the outcomes of probing.
Comparison of Pterygium Recurrence with and Without Using Postsurgical Topical Cyclosporin a 0.05%
Authors: Alizadeh Yousef , Akbari Mitra , Moghadam Reza Soltani , Dourandeesh Maryam , Moravej Zahra
Published: July 2022

Purpose:

To evaluate the efficacy of 3-month administration of topical cyclosporin A (CsA) 0.05% on postoperative recurrence after pterygium surgery.

Methods:

In this randomized clinical trial, 78 patients undergoing pterygium surgery (using the rotational conjunctival flap technique with mitomycin C [MMC]) were enrolled and randomly allocated into the control (n = 39) and case (CsA) (n = 39) groups in a single-blind method. The patients were examined on postoperative days 1, 3, and 7 and months 1, 3, and 6, and their best-corrected visual acuity, intraocular pressure, clinical inflammation, postoperative complications, and recurrence were compared.

Results:

The mean age of patients was 53.22 ± 9.99 years; most (57.7%) of them were men. The two groups were not different in terms of demographics, pterygium size, or pterygium grade. The clinical inflammation at the first and third postoperative months was not different between the groups (P = 0.108 and 0.780, respectively). No serious complications were detected; complication rates were not different between the groups (P = 0.99). The recurrence rate was 5.1% in the case group and 7.7%% in the control group (P = 0.99).

Conclusion:

The present study showed no priority for 3-month administration of CsA 0.05% drops on postoperative outcomes, including prevention of pterygium recurrence, complications, and inflammation after the rotational conjunctival autograft technique with MMC.
Bilateral Vision Loss in An Adult Patient with Woakes' Syndrome
Authors: Aghdam Kaveh A , Aghajani Ali , Hemmati Sara , Sanjari Mostafa Soltan
Published: July 2022

Purpose:

To report a rare case of Woakes' syndrome presented with bilateral vision loss.

Methods:

A 28-year-old male with a 1-year history of vision loss in the left eye was referred to the neuro-ophthalmology clinic after sudden vision loss in his right eye. A detailed review of clinical findings and the presumed pathophysiological basis of vision loss was performed.

Results:

Neuroimaging revealed bilateral massive nasal polyps, sphenoid sinus mucocele formation, and optic nerve dehiscence inside the sphenoid sinus. The vision in the right eye was restored after pulse corticosteroid therapy; however, the left eye remained severely visually compromised even after nasal polypectomy and mucocele drainage.

Conclusion:

Sinonasal disorders should be sought for patients with unexplained vision loss, as prompt intervention could be vision-saving in these patients.
Prevalence of Pediatric Cataract in Asia
Authors: Tariq Muhammad Ali , Uddin Qazi Shurjeel , Ahmed Bilal , Sheikh Shehryar , Ali Uzair , Mohiuddin Ashar
Published: July 2022

Purpose:

To conduct a systematic review and meta-analysis for estimating the prevalence of pediatric cataracts across Asia.

Methods:

A detailed literature search of PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases, from 1990 to July 2021, was performed to include all studies reporting the prevalence of cataracts among children. Two researchers performed the literature search and screening of articles independently, and a third researcher critically reviewed the overall search and screening process to ensure the consistency. The JBI Critical Appraisal Checklist for studies reporting prevalence data was used to assess the methodological quality of the included studies.

Results:

Of the 496 identified articles, 35 studies with a sample size of 1,168,814 from 12 Asian countries were included in this analysis. The estimated pooled prevalence of pediatric cataracts in Asian children is 3.78 (95% confidence interval: 2.54–5.26)/10,000 individuals with high heterogeneity (I[2] = 89.5%). The pooled prevalence by each country per 10,000 was 0.60 in Indonesia, 0.92 in Bangladesh, 1.47 in Iran, 2.01 in Bhutan, 3.45 in Laos, 3.68 in China, 4.27 in Thailand, 4.47 in India, 5.33 in Malaysia, 5.42 in Nepal, 9.34 in Vietnam, and 10.86 in Cambodia.

Conclusions:

This study utilizes existing literature to identify the prevalence of cataracts in Asian children. Moreover, it highlights the need for more epidemiological studies with large sample sizes from other countries in Asia to accurately estimate the burden of disease.
Presumed Combined Brilliant Blue G and Endolight-Induced Macular Damage Following Epiretinal Membrane Removal Surgery
Authors: Venkatesh Ramesh , Gupta Aditi , Yadav Naresh Kumar , Chhablani Jay
Published: July 2022

Purpose:

To report a rare case of macular outer retinal and retinal pigment epithelium (RPE) damage following brilliant blue G (BBG)-assisted epiretinal membrane (ERM) removal surgery.

Methods:

Retrospective, observational case report.

Results:

An 85-year-old lady presented with decreased vision in the left eye and a best-corrected visual acuity of 20/400. The right eye examination was within normal limits. The left eye had a significant cataract, and the fundus examination through the cataractous haze showed an ERM with macular pucker, which was confirmed on an optical coherence tomography (OCT) scan. A combined cataract surgery with intraocular lens implantation and BBG-assisted ERM removal and internal limiting membrane peeling surgery was performed. Over the subsequent visits, a well-defined area of outer retinal and RPE alteration was identified on OCT and fundus autofluorescence without significant improvement in visual acuity. At the last follow-up visit, the visual acuity minimally improved to 20/200.

Conclusions:

Macular toxicity due to repeated usage of BBG dye and high intensity focal endo-illumination may lead to poor visual outcome following ERM removal or similar macular surgeries. Adequate precautions need to be taken to prevent vision loss.
Regardless of the Source of Products, Pharmacists Must Be a Source for Trustworthy Advice
Authors: Alderman Chris
Published: July 2022

Complementary and alternative medicines (CAMs) present a range of unique challenges for health care practitioners, including pharmacists who provide care for older people. Albeit many pharmacists receive little or no training that would provide them with an insight into the nature of CAMs, CAM products are widely embraced by American consumers, with 42% of people in the United States reporting that they have used at least one CAM therapy, but in less than 40% of cases is the use of these products disclosed to a physician.
Aducanumab for Alzheimer's Disease: Summarized Data From EMERGE, ENGAGE, and PRIME Studies
Authors: Yuksel Jaylan M. , Noviasky John , Britton Sarah
Published: July 2022

Objective To review the data informing the US Food and Drug Administration (FDA) approval for aducanumab for mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD). Data Sources At the time of writing there were no peer-reviewed published
studies on aducanumab. All data presented are derived directly from the material Biogen submitted to the FDA for approval. The three studies that will be reviewed are: Multiple Dose Study of Aducanumab in Participants With Prodromal or Mild AD (PRIME), 221AD302 Phase 3 Study of Aducanumab
in Early AD (EMERGE), 221AD301 Phase 3 Study of Aducanumab in Early AD (ENGAGE). Data Synthesis PRIME, which was a phase 1 study, demonstrated the most common adverse drug reactions were amyloid-related imaging abnormalities (ARIA), which occurred at rates up to 47% (10
mg/kg group), headache (25%), urinary tract infection (16%), and upper respiratory tract infection (19%). EMERGE demonstrated that high-dose aducanumab was clinically significant at slowing down clinical decline. However, ENGAGE was terminated early based on a futility analysis. Prior to termination
ENGAGE demonstrated no clinical difference between treatment and placebo regarding the primary endpoint of slowing clinical decline. Conclusion Based on the data to date, it is difficult to accurately assess the role of aducanumab in patients with MCI or mild AD. EMERGE
showed benefit with high-dose aducanumab slowing clinical decline. However, ENGAGE did not duplicate this benefit. With conflicting evidence of positive outcomes, future phase III studies are needed to confirm efficacy.
Evolution of the Comprehensive Medication Review Completion Rate for Medicare Part D Plans: What Do the Stars Tell Us?
Authors: Cooke Catherine E. , Olshanskaya Sofiya , Lee Merton , Brandt Nicole J.
Published: July 2022

Objective To describe changes in the Medicare Part D Comprehensive Medication Review (CMR) completion rate within the Centers for Medicare & Medicaid Services (CMS) Star Ratings program since its inception. Methods Publicly available information for
Star Ratings years 2014 to 2021 was obtained from the CMS website and through indexed literature and internet searches. Data elements for the CMR completion measure were extracted for Medicare Advantage prescription drug plans (MA-PDs) and prescription drug plans (PDPs) and included the annual
weighted value, cut-points for star rating, completion rates, and star achievement. Results In 2014 and 2015, the CMR completion rate was a display measure in the Star Ratings program with rates between 10 and 16%. This measure was added in 2016 with a weighted value of
1 that has remained the same. The cut-points when comparing 2016 with 2021 have increased from less than 13.6 to less than 48% for 1 star and 76 to 89% or more for 5 stars for MA-PDs and from less than 8.5 to less than 24% for 1 star and 36.7 to 61% or more for 5 stars for PDPs. From 2016
to 2021, the average Star Ratings for CMR completion increased from 2.3 to 3.7 for MA-PDs and 2.3 to 3.6 for PDPs. Conclusion Since the inception of the CMR completion rate as a quality measure, an increasing proportion of eligible beneficiaries has received a CMR with
MA-PDs consistently providing this service to more beneficiaries than PDPs. The cut-points for star achievement have also risen, requiring higher CMR completion rates to achieve higher star ratings. Further evolution of the CMR quality measure is needed for improving medication management.
The Regulation of Dietary Supplements in the United States
Authors: Baldwin Paul
Published: July 2022

Is it legal to make health claims for a product sold in the United States without being required to prove those claims? Yes, but only if those claims relate to dietary supplements, not drugs. The world of dietary supplement regulation is quite unlike any other. First, dietary supplements are not drugs, but "food" in the regulatory scheme. The US Food and Drug Administration has no authority to approve or deny approval to manufacturers for the marketing of dietary supplements. There is, however, a general prohibition against marketing drugs that are "adulterated or misbranded." The author discusses information for pharmacists relative to this topic.
On the Commutants of Generators of $q$-Deformed Araki–Woods von Neumann Algebras
Authors: Bikram Panchugopal , Mukherjee Kunal
Published: July 2022

The generating abelian subalgebras arising from vectors in the ergodic component of Hiai’s construction of

q

-deformed Araki–Woods von Neumann algebras are quasi-split.
Boundedness of Operators and Inequalities on Morrey–Banach Spaces
Authors: Ho Kwok-Pun
Published: July 2022

This paper establishes the boundedness of the spherical maximal function, Rubio de Francia operators, Bochner–Riesz operators, Fourier integral operators, geometric maximal operator, minimal operator and strongly singular integral operators on Morrey spaces built on Banach function spaces. We also establish the Coifman–Fefferman inequalities, Gundy–Wheeden inequalities and Sobolev–Lieb–Thirring inequalities on Morrey–Banach spaces. In particular, our results include the boundedness of the above operators and inequalities on classical Morrey spaces, generalized Morrey spaces, Orlicz–Morrey spaces, Morrey–Lorentz spaces and Morrey spaces with variable exponents.