bluuebunny/crossref_metadata_2025 huggingface dataset:
La guerra en escena. "¡Ay, Carmela!" de José Sachis Sinisterra, entre memoria y conciencia traumática
Authors: Lodi Enrico
Published: March 2021

Este artículo analiza algunos aspectos simbólicos y psicoanalíticos relacionados con la construcción de la memoria histórica en ¡Ay, Carmela! de Sanchis Sinisterra. Conocida también gracias a la película de Saura, la original versión dramatúrgica destaca por su gran riqueza retórica. En la interpretación que se da en este ensayo, el escenario sería una metáfora del paisaje mental del protagonista Paulino, quien, habiéndose quedado solo tras la muerte de su compañera Carmela, vuelve a vivir los asuntos traumáticos de su pasado para aceptar finalmente su pérdida y, gracias al proceso de duelo, valorar su presencia imaginaria como “texto” de la memoria.
FlowHDL, lenguaje de programación visual para el diseño digital de lógica programable
Authors: Antonelli Anibal Fernando , Gayoso Carlos Arturo
Published: March 2021

Dentro del diseño digital de lógica programable se cuenta con una gran cantidad de herramientas de software, sin embargo se observa que existe la necesidad de disponer de mayores facilidades para los usuarios de estos sistemas. Los principios necesarios de usabilidad pueden ser provistos por los lenguajes de programación visual. Por otro lado, para generar código VHDL o Verilog sintentizable en una FPGA a través de un sistema visual coherente, es necesario superar múltiples inconvenientes. En este trabajo se presenta una nueva herramienta visual para el diseño de circuitos electrónicos digitales.
Using Instagram as a Preparation Tool for Study Abroad
Authors: Park Simon
Published: March 2021

This paper describes the usage of Instagram (the social networking platform) in
sophomore English classes at a private Japanese university. Instagram was used
to help students prepare for their study abroad semester. Students created
private Instagram accounts and used this platform for group exercises with a
mixed group of students and staff at potential study abroad sites in the United
States of America. The participants posted images and video of their daily lives
and routines at their schools, and created posts based on tasks set by the
instructor. Group members were then encouraged to ask each other questions
and communicate through Instagram. The study found that Instagram usage has
the potential to help students prepare linguistically and culturally for study
abroad semesters. The paper recommends follow-up studies that use Instagram
and other social networking sites to help students prepare culturally and
linguistically for study abroad semesters. This has implications for language
teachers who are teaching prospective study abroad students or are interested
in incorporating technology into their classes, as well as coordinators of study
abroad programs interested in modernizing their study abroad orientation
programs.

この論文では、日本の私立大学の 2 年生の英語クラスでの Instagram（SNS）の使
用法について説明します。 Instagram は、学生が留学の準備をするのを助けるため
に使用されました。学生はプライベート Instagram アカウントを作成し、このプラ
ットフォームを使用して、米国の潜在的な留学サイトで学生とスタッフの混合グル
ープとのグループ演習を行いました。参加者は、学校での日常生活の画像や動画を
投稿し、講師が設定したタスクに基づいて投稿を作成しました。その後、グループ
のメンバーはお互いに質問し、Instagram を介してコミュニケーションすることが
奨励されました。調査では、Instagram の使用により、学生が留学学期に向けて言
語的および文化的に準備するのに役立つ可能性があることがわかりました。この論
文では、Instagram やその他の SNS を使用して、学生が留学に向けて文化的および
言語的に準備するのに役立つ追跡調査を推奨しています。これは、将来の留学学生
を教えている、またはクラスにテクノロジーを組み込むことに関心のある語学教
師、および留学オリエンテーションプログラムの近代化に関心のある留学プログラ
ムのコーディネーターに影響を及ぼします。
Japanese English Majors’ Experiences and Attitudes to Study Abroad: A Case Study of Students at a Private University in Tokyo
Authors: Tobin Anthony
Published: March 2021

This study investigates both the benefits of and recent trends in studying abroad
for Japanese students and examines the results of a survey on study abroad taken
by students majoring in English at a private university in Tokyo. Statistics from
JASSO showed that the trend in study abroad before 2020 was for an increasing
number of Japanese university students to spend a period of time studying
abroad, though most of the increase was in short-term study. The English
language questionnaire sought to discover what proportion of a group of
seventy-two students had already studied abroad, or planned to do so, and to
establish whether those who had gained experience had benefited from it, as
well as detailing student anxieties which may have deterred students from
studying abroad. The survey on study abroad, taken in January 2018, had a 100%
response rate. Twenty-three (32%) of the students answered that they had
already studied abroad, mostly for short durations in English-speaking countries.
Most of the students who studied abroad had a positive experience, reputedly
improved their English skills and recommended that other students study
abroad. Twenty-six (53%) of the students without study abroad experience were
planning to study abroad, even though they had some issues which concerned
them, such as their ability to communicate in English, personal safety, and
financial matters. The main reason for not electing to study abroad for this
particular sample was found to be related to the overall costs of overseas travel,
accommodation, and tuition.

この研究では日本人学生に対する留学の利点および最近の留学の傾向を調べ、さら
に東京の私立大学で英語を専攻している学生に対して実施した留学についての調査
の結果を検討している。JASSO の統計によると、２０２０年までは留学する日本人
大学生の数は増加傾向であったが、そのほとんどは短期留学であった。英語で行わ
れたアンケート調査の目的は、著者の三つのクラスの７２名の学生のうちの何割が
留学経験がある、もしくは留学の予定があるか、またすでに留学した学生はその経
験から恩恵を受けたと感じているか、学生は留学をするにあたってどのような不安
を持つか、さらに留学しないと答えた学生の場合は留学しない理由を明らかにする
ことである。２０１８年１月に行われた調査の回答率は１００パーセントであっ
た。２３人（３２パーセント）の学生は留学経験があり、ほとんどの場合が英語圏
の国への短期留学である。留学経験のある学生の大半数が有益な経験ができ、英語
力が上達したと感じており、他の学生に留学を勧めると答えている。留学経験のな
い学生の２６人（５３パーセント）が留学する予定だが、英語のコミュニケーショ
ン、安全、金銭などについて不安を感じていた。留学しない理由については、旅
費、宿泊代、授業料など経済的な理由が大半であった。
One of the approaches to the organization of the modern educational process
Authors: Savenko A. G. , Skudnyakov Skudnyakov A.
Published: March 2021

This paper proposes a new approach to the creation and use of rotational-hybrid model of organizing a modern educational process representing the integration of educational, information communication, testing, management, rotational and other technologies. A visual and mathematical model, an diagram of information and educational system, an algorithm for the rotation of trainees are presented. An approach is proposed for constructing the optimal way to determine the maximum assimilation of disciplines by students in each set of studied disciplines and the formation of its most acceptable subset. The program-algorithmic implementation of the rotational-hybrid model in the form of a universal teaching-testing electronic learning tool is shown. The mathematical basis of the rotational-hybrid model is set theory using graph models, which compare favorably with other mathematical apparatus in visibility and a matrix form of representation that can be easily processed on a computer. The effectiveness of using the developed rotational-hybrid model and its algorithmic implementation is illustrated with the help of developed teaching-testing electronic teaching tool, introduced into educational process at the Department of Information Systems and Technologies of the Institute of Information Technologies of the Belarusian State University of Informatics and Radioelectronics.
Entornos Personales de Aprendizaje en la Educación Superior: Una alternativa para construir espacios de innovación
Authors: Pereira-Medina Juan Pedro
Published: March 2021

El mundo se encuentra inmerso en una revolución digital; en consecuencia, transita una fase de transformación impactando diferentes áreas del saber, entre ellas, la educación, disciplina obligada a ofrecer respuestas pertinentes a un conjunto de demandas producto de un contexto en cambio constante. Los Entornos Personales de Aprendizaje (PLE), constituyen un enfoque pedagógico orientado a emplear el potencial encerrado en tecnologías digitales a fin de mejorar el aprendizaje. El presente ensayo pretendió mostrar un acercamiento al campo de conocimiento de los PLE, a partir de una revisión de sus principales fundamentos; se sustentó en una investigación documental mediante un arqueo de información combinado con un análisis de contenido. Los resultados evidencian los PLE son una vía para explorar nuevas perspectivas en el ámbito pedagógico. Por lo tanto, las Instituciones de Educación Superior requieren asumir el compromiso de encaminar esfuerzos dirigidos a conformar ecosistemas que crucen los límites entre lo formal e informal, abriendo oportunidades a una educación flexible, capaz de combinar en forma armónica ambos entornos.
The Effects of Weightage Values with Two Objective Functions in iPSO for Electro-Hydraulic Actuator System
Authors: Mau Shern Chai , Ghazali Rozaimi , Shin Horng Chong , Chee Soon Chong , Ghani Muhamad Fadli , Md Sam Yahaya , Has Zulfatman
Published: March 2021

In this paper, the Proportional-Integral-Derivative (PID) controller with improved Particle Swarm Optimization (iPSO) algorithm is proposed for the positioning control of nonlinear Electro-Hydraulic Actuator (EHA) system. PID controller is chosen to control the EHA system due to its popularity in industrial applications. The PID controller parameters will be tuned by using the iPSO algorithm to get the lowest overshoot percentage and steady-state error. The conventional PSO algorithm has only one objective function to get the optimum parameters. However, this is not enough to increase the control performance of the EHA system. Therefore, an improved Particle Swarm Optimization (iPSO) that includes the mean error and overshoot percentage as the two objective functions is proposed in this paper. The most popular method in PSO that included two objective functions is Linear Weight Summation (LWS). In this method, the two objective functions are combined with certain weightage into one equation to give the best control performance. This paper focuses on determining the suitable weightage between these two objective functions so that the EHA system can produce the best control performance with less overshoot and less error. Overshoot percentage and steady-state error are used to indicate the best control performance. The results showed that EHA system can perform better by using suitable weightage between the mean error and overshoot percentage.
Spirituality in the Life of People with HIV in Light of Neuman’s Systems Model
Authors: Abrão Fatima Maria da Silva , Pereira Verônica Mirelle Alves Oliveira , Oliveira Regina Célia de , Silva Carlos Roberto Lyra da , Góis Amanda Regina da Silva
Published: March 2021

Background: since its discovery as the etiological agent of the Acquired Immune Deficiency Syndrome (AIDS), the Human Immunodeficiency Virus (HIV) has infected 75.7 million people worldwide Due to the specific characteristics of the Brazilian population, it is considered that spirituality, or spiritual well-being, is an important factor in the way individuals face the HIV/AIDS problematic and its consequences. To understand the spirituality of living with HIV in the light of Neuman's Systems Model.
Method: qualitative, descriptive-exploratory research in the light of the Systems Model proposed by Betty Neuman. Data collection took place between the months of March and August 2016 in an outpatient clinic specialized in the treatment of patients with HIV/AIDS of a university hospital located in the city of Recife, Pernambuco, Brazil. Thirty people living with HIV participated in the study. The data were collected through a questionnaire and an interview with a semi-structured script and underwent categorical content analysis.
Results: the understanding of spirituality in living with HIV is presented in three categories: the discovery of the diagnosis and the initial reactions: stressors that affect the lines of defense; the spiritual and religious search: protection when stressors penetrate the lines of defense; and the influence of faith combined with ART in living with HIV: dynamic relationship of the variable spirituality with the other variables.
Conclusion: the applicability of the theory can provide important gains to the patient living with HIV/AIDS, generating a way to ensure the strengthening and establishment of lines of defense during their daily lives, and thus maintaining the balance of the patient's system, as well as the harmonic relationship between its variables and the environment.
Development of a methodological approach for the computational investigation of the coolant flow in the process of the sodium cooled reactor cooldown
Authors: Didenko Denis V. , Baluyev Dmitry Ye. , Nikanorov Oleg L. , Rogozhkin Sergey A. , Shepelev Sergey F. , Aksenov Andrey A. , Zhestkov Maksim N. , Shchelyaev Aleksandr Ye.
Published: March 2021

A methodological approach has been developed for the computational investigation of the thermal-hydraulic processes taking place in a sodium cooled fast neutron reactor based on a Russian computational fluid dynamics code, FlowVision. The approach takes into account the integral layout of the reactor primary circuit equipment and the peculiarities of heat exchange in the liquid metal coolant, and makes it possible to model, using well-defined simplifications, the heat and mass exchange in the process of the coolant flowing through the reactor core, and the reactor heat-exchange equipment. Specifically, the methodological approach can be used for justification of safety during the reactor cooldown, as well as for other computational studies which require simulation of the integral reactor core and heat-exchange equipment.

The paper presents a brief overview of the methodological approaches developed earlier to study the liquid metal cooled reactor cooldown processes. General principles of these approaches, as well as their advantages and drawbacks have been identified.

A three-dimensional computational model of an advanced reactor has been developed, including one heat-exchange loop (a fourth part of the reactor). It has been demonstrated that the FlowVision gap model can be applied to model the space between the reactor core fuel assemblies (interwrapper space), and a porous skeleton model can be used to model the reactor’s heat-exchange equipment. It has been shown that the developed methodological approach is applicable to solving problems of the coolant flow in different operating modes of liquid metal cooled reactor facilities.
Disjunctive Constellations: On Climate Change, Conjunctures and Cultural Studies
Authors: Highmore Ben
Published: March 2021

The planetary scale of climate change challenges forms of conjunctural analyses that are based around the scale of national politics and culture. Global warming insists on planetary dimensions and invites us to treat humankind as a species that has developed a taste for fossil fuels.
Critical cultural studies, and the human sciences more generally, seem founded on the principle that culture and society have historically worked to differentiate humans, and that the task of a critical practice is to investigate this process within and across specific geographical locales.
How do we reconcile what seems to be an irreconcilable difference between cultural studies and climate change? Below I argue that, alongside the necessary work of conjunctural analysis, we should remember that the critical human sciences have other capacities that are more suited to negotiating
the monstrous diversity of scales that global warming and the microcultures of the everyday articulate. Alongside conjunctural analysis I argue for the relevance of an approach that would posit 'disjunctive constellations' as objects for attention. While it might seem counter-intuitive, the
disjunctive constellations I have in mind are at once more modest and (potentially) more expansive than a conjuncture. In my understanding, disjunctive constellations are not in opposition to conjunctures; they may well be the critical kernel at the heart of a conjunctural sensitivity.
Virtual Reality and BIM Methodology as Teaching- Learning Improvement Tools for Sanitary Engineering Courses
Authors: Rossado Espinoza Verónica Paola , Cardenas-Salas Daniel , Cabrera Angela , Coronel Lucía
Published: March 2021

Virtual Reality (VR) is the term often used to describe a 3D environment where objects and images of the real world are simulated through technology. In Architecture or Civil Engineering, the design process with 2D planes could lead to error due to misinterpretation in the visualisation of elements. The civil engineering programme of a University mandates teaching of the BIM methodology in all courses, allowing the students to learn about the organisation and optimisation of projects from design to construction. The engineering students are required to manage many variables with BIM methodology, especially in mechanical, electrical and plumbing systems (MEP). Nevertheless, the BIM´s teaching method could be enriched by analysing 3D project models using virtual reality (VR). Whereas BIM organises and optimises a project through a 3D model, VR can introduce the user into a model very close to reality, improving the interpretation and analysis of details. The present study contributes to the implementation of a Plumbing Engineering course in a Civil Engineering programme. The proposed methodology was applied in an experimental group of undergraduate students and test results compared with a corresponding group that made used of a traditional approach. Based on the results of the study, students can visualise the accessories and recognise a good design in a creative and innovative way using the VR–BIM method
The Cultivating Strategies of Pre-Service Teachers' Informatization Teaching Ability Oriented to Wisdom Generation
Authors: Liu Li , Wang Yongchao , Ma Chizhu
Published: March 2021

The widespread appearance of smart classrooms in basic education puts forward higher requirements for teachers' informatization teaching ability. The educational goal of pre-service teachers is changed from "knowledge mastering" to "wisdom generation", that is, to cultivate their wisdom-generating informatization teaching ability in the informatization education classroom to solve problems effectively. The purpose of this study is to propose cultivating strategies along the theoretical path of wisdom generation, and to test the effectiveness of the cultivating strategies in pre-service teachers’ classroom teaching. This research was conducted at Shandong Normal University, and a total of 272 students (pre-service teachers) participated. Through 18 weeks of teaching practice, the results show that pre-service teachers’ informatization teaching awareness, knowledge, skills and high-level abilities have generally improved.
Mobile Learning Programs for Spatial Decision Making
Authors: Troyanskaya Marija , Tyurina Yuliya , Morgunovа Natalia , Nemtyreva Liudmila , Choriyev Ruzimurat
Published: March 2021

The proliferation of mobile devices and easy internet access open up a huge number of opportunities for many people around the world. Anywhere anytime learning is one of these opportunities. Despite the prevalence of mobile learning, it is not always possible to find a convenient application that covers several areas. The uniqueness of the research is the development of an application that could become an excellent solution for studying several academic disciplines and developing spatial skills on the example of a certain subject. As a result, an application model that allows studying geometry, physics, chemistry, geography, economics and social studies has been developed; these are the disciplines that most involve spatial thinking. Spatial skills are taught based on two-dimensional and three-dimensional objects, animation, images, maps. The use of augmented reality technology to increase the effectiveness of teaching spatial thinking has been considered. The model implementation allows using the app for independent activities and educational purposes.
Blended Learning as a Means of Foreign Students’ Integration into a University Educational Process
Authors: Kuzmina Nadezhda , Kochkina Darya , Kuzmin Maksim
Published: March 2021

This paper considers the problem of blended learning as a means of foreign students’ integration into higher school environment. This process is not that simple, it demands special methods to help foreign students to be integrated easily. The use of blended learning in education facilitates easy students’ integration and leads to positive learning results. However, the application of blended learning is connected with challenges both educators and foreign students can face. The aim of the article is to consider and assess the use of blended learning at the lessons of English implemented into a university educational process. For that purpose, we applied such methods as a needs analysis (among lecturers of English from South Ural State University), a questionnaire and an interview (among three groups of students from similar bachelor’s programs). The findings show that the majority of those surveyed do understand the importance of blended learning as a means of foreign students’ integration, but they are not familiar with the types and how to use them. Based on the results of this analysis, the authors applied blended learning into the process of English teaching, such as flipped classroom, station rotation, and a new online language development course, “Methodological support to the textbook by McCarthy, M. “Touchstone”. The drawn conclusions indicate that blended learning allows not only to boost foreign language skills, but to promote easy foreign students’ integration into the educational process of the university.
Wiki Trans : une communauté de savoir sur la transidentité
Authors: Stassin Bérengère
Published: March 2021

Cet article porte sur Wiki Trans, un site collaboratif créé par une femme transgenre pour permettre la mise en commun d’expériences et le partage d’informations liées aux aspects sociaux et médicaux de la transidentité et répondre aux besoins informationnels qu’elle suscite. Le site vise à centraliser des informations dispersées au sein du web, à traduire en français des ressources anglophones et à vulgariser de l’information médicale et scientifique. Ce projet favorise l'émergence d'une communauté de savoir en ligne composée de personnes transgenres et cisgenres, de bénévoles et de médecins. Une hybridation entre savoirs expérientiels et savoirs experts est alors observée.
Pour différencier : individualiser ou personnaliser ?
Authors: Connac Sylvain
Published: March 2021

La prise en compte de la diversité des élèves pose toujours des problèmes à l’école. La plupart des pratiques de différenciation employées dans les écoles a montré des limites importantes. Les constitutions en groupes de niveau, les organisations de remédiations, les aides en dehors de la classe, l’adaptation des activités aux caractéristiques des élèves sont des modalités qui semblent décourager les élèves les plus vulnérables. Cette revue de littérature propose de faire un état des lieux de ces recherches, puis d’explorer deux options de différenciation : l’individualisation et la personnalisation des apprentissages. Nous montrerons pourquoi une pédagogie systématiquement individualisante serait préjudiciable aux élèves et comment peut se structurer une pédagogie personnalisante, par une articulation entre des situations d’étayage, une part d’individualisation et de la coopération entre élèves.
La place de la différenciation dans la préparation de cours d’enseignants de cycle 3
Authors: Doelrasad Aurélie
Published: March 2021

Cet article s’inscrit dans la continuité de la recherche sur le travail enseignant. En adoptant une approche par l’expérience subjective du travail, nous mettons au jour la place occupée par la différenciation pédagogique dans l’enseignement de l’écriture lors de la préparation de cours d’enseignants de cycle 3. L’étude révèle que, malgré des différences nettes entre le premier et le second degré dans le travail réalisé en classe, la différenciation est bien présente dans la préparation de cours de tous les enseignants et est unanimement reconnue comme une façon de bien faire son travail. Un paradoxe est alors mis en évidence et interrogé : chez les enseignants du secondaire, la différenciation pédagogique est présente dans la préparation, mais pas dans les pratiques de classe.
THE EFFECTS OF INCREASING INSOLE STIFFNESS ON FOOT AND ANKLE MECHANICS IN WALKING GAIT
Authors: Jin Li
Published: March 2021

The energetic pattern of the foot–ankle system is critical in human walking gait. While some of the mechanical energy was dissipated due to foot segment deformation in walking stance phase. Increasing footwear insole bending stiffness was reported to restrict foot segment bending behavior and this was reported to reduce foot segment energy dissipation. While little is known whether increasing footwear insole bending stiffness would alter foot–ankle system mechanical work generation and absorption patterns. Two healthy subjects (one female, one male; age [Formula: see text] years, height [Formula: see text][Formula: see text]cm, weight [Formula: see text][Formula: see text]kg) participated in this study and they were asked to walk at self-selected normal speed with the same footwear (Nike Free RN Flyknit, 2017) in two different insole stiffness conditions: (i) normal shoe insole (NSI); (ii) carbon fiber insole (CFI). Paired sample [Formula: see text]-test was conducted between NSI and CFI for all outcome measures. No statistically significant differences in the outcome variables were found between the two insole conditions. While foot segment positive work and mechanical work ratio were 45.54% and 68.43% higher in CFI than in NSI condition, respectively; foot negative work was 25.02% lower in CFI than in NSI condition. However, ankle joint positive work and work ratio were around more than 10% higher in NSI than in CFI condition, and ankle peak positive power in NSI was 23.93% higher than in CFI condition. Additionally, foot–ankle system overall positive work and mechanical work ratio were both similar between NSI and CFI conditions. The findings indicate increasing footwear insole bending stiffness may influence foot segment and ankle joint energetic patterns in walking stance phase. And the mechanical energy generation compensatory mechanism may exist between foot segment and ankle joint. Specifically, a decreased foot segment energy generation tended to result in a higher amount of ankle joint positive work and peak power generation. This will be beneficial for maintaining a relatively consistent foot–ankle system overall energy generation and work ratio in response to altered insole stiffness and foot segment work during gait.
Effect of tranexamic acid on the treatment of patients with upper gastrointestinal bleeding
Authors: Bashiri Homayoon , Hamzeii Mehdi , Bozorgomid Arezoo
Published: March 2021

Objective:

To determine the efficacy of tranexamic acid (TXA) in the management of acute upper gastrointestinal (GI) bleeding.

Methods:

A total of 70 patients with acute upper GI bleeding were included in this double-blinded randomized controlled clinical trial from September 2018 to December 2018. Patients were divided into the control group (received fluid therapy and intravenous infusion of pantoprazole, 35 cases) and the TXA group (received intravenous TXA besides the treatment of control group, 35 cases). Rebleeding, admission duration, and need for blood transfusion were compared between the two groups.

Results:

Fifteen patients (42.9%) in the TXA group and 10 patients (28.6%) in the control group stayed in hospital for more than 3 days during their admission (P=0.21). Rebleeding occurred in 8 patients (22.9%) and 5 patients (14.3%) of the TXA group and the control group, respectively (P=0.35). More patients in the TXA group (21 cases, 60%) received blood transfusion than the control group (8 cases, 22.9%) (P=0.02).

Conclusions:

TXA did not improve the outcome of patients with acute upper GI bleeding.
Ripretinib
Authors: Kumar Silpa S. , Philip Arun , Pavithran Keechilat
Published: March 2021

Gastrointestinal stromal tumors (GISTs) are rare primary neoplasms of the gastrointestinal tract, mesentery, or omentum. In the past, for patients with resectable tumors, surgery was the only viable treatment option. However, therapy of GISTs has undergone a fundamental change with the advent of receptor tyrosine kinase inhibitors primarily targeting the tyrosine-protein kinase KIT and the platelet-derived growth factor receptor alpha (PDGFRA). Ripretinib is one such novel Type-II tyrosine switch control inhibitor which is used in the treatment of advanced KIT proto-oncogene-driven and PDGFRA-induced tumors, including GISTs. The Food and Drug Administration approved ripretinib on May 15, 2020, for the treatment of adult patients with progressive GISTs who had undergone prior treatment with three or more kinase inhibitors. A comprehensive search in PubMed and other sources were done, using the search terms, “GIST” and ripretinib. On combining all the abstracts and conference proceedings, here we present a comprehensive review on ripretinib's history, pharmacology, and clinical applications.
Do oncology nurses have sufficient knowledge of exercise oncology? A mini narrative review
Authors: Okechukwu Chidiebere Emmanuel
Published: March 2021

There is a need to broaden the knowledge of oncology nurses about exercise prescription and recommendations for the improvement of quality of life and physical and mental health of patients with cancer and survivors. In addition, oncology nurses need to have comprehensive knowledge regarding the physiological mechanisms underlying these improvements. Through this mini review, we aimed to describe the level of expertise of nurses in the field of exercise oncology and identify appropriate solutions to improve this knowledge. Articles concerning exercise and oncology nursing practices published between January 1996 and September 2020 were searched in the PubMed electronic database; relevant articles were selected, full-text articles were assessed, and important information was extracted. A standard exercise oncology curriculum needs to be developed and implemented for oncology nursing practitioners and those training in oncology nursing. Oncology nurses should be trained in exercise oncology, rehabilitation, and exercise prescription and follow-up. This could boost the rate of adherence to self-managed/home-based exercise routine among cancer survivors.
Non-small-cell lung cancer metastasis to unusual sites
Authors: Ganguly Sandip , Ghosh Joydeep , Gehani Anisha , Basu Archisman , Chatterjee Meheli , Dabkara Deepak , Biswas Bivas
Published: March 2021

Background:

The majority of all lung cancers are non-small-cell lung cancers (NSCLCs). They usually spread to the pleura, brain, adrenal gland, lungs, liver, and bones. However, clinical data for NSCLC metastasizing to unusual sites are sparse in the literature.

Objectives:

We aimed to assess the pattern of metastases to unusual sites and evaluate the clinicopathological characteristics, treatment details, and outcomes of patients with NSCLC.

Materials and Methods:

This retrospective case series was conducted in the Department of Medical Oncology of a tertiary cancer center in Eastern India between May 2011 and December 2018. Patients with cytologically or biopsy-proven treatment-naive stage IV NSCLC were included in this audit. Sites other than the pleura, brain, adrenal gland, lung, liver, and bones were considered as unusual sites of metastases. Clinicopathological characteristics, site of metastases, treatment details, and outcomes were recorded. Data were described using descriptive statistics, survival was estimated using the Kaplan–Meier analysis, and log-rank test was used to determine survival estimates.

Results:

A total of 1549 patients with metastatic NSCLC were registered, of which 121 (7.8%) had metastases to unusual sites. The median age of the cohort was 72 years (range, 19–87 years), and the male:female ratio was 7:1. The most common site of unusual metastasis was the skin with soft tissue, followed by the kidney; metastasis to these sites was seen in 31 (2%) and 26 (1.6%) patients, respectively. Systemic chemotherapy was given to 67 (55.3%) patients. At a median follow-up of 11.2 months (95% confidence interval [CI], 6.8–17.5), the median progression-free survival of the cohort was 5.9 months (95% CI, 3.8–9.1).

Conclusions:

In <10% of the patients, NSCLC can spread to unusual sites, most commonly to the skin/soft tissue and the kidney. A detailed discussion with the radiologists is necessary to distinguish NSCLC that has metastasized to unusual sites from second primary tumors and to avoid unnecessary tissue biopsies from these areas.
Polypharmacy and potentially inappropriate medication use in older Indian patients with cancer
Authors: Noronha Vanita , Ramaswamy Anant , Gattani Shreya Chandrashekhar , Castelino Renita , Krishnamurthy Manjunath Nookala , Menon Nandini , Patil Vijay M. , Gota Vikram S. , Banavali Shripad , Prabhash Kumar
Published: March 2021

Background:

Polypharmacy and the use of potentially inappropriate medications (PIMs) are important issues in older patients with cancer.

Objectives:

We aimed to study the prevalence of polypharmacy, and the use of PIMs, including the peri-chemotherapy supportive care regimens in older Indian patients with cancer.

Materials and Methods:

This was an analysis of a prospective observational study of patients aged 60 years and over with a diagnosis of malignancy who were assessed in the geriatric oncology clinic at the Tata Memorial Hospital (Mumbai, India). Patients on five or more medications were considered to have polypharmacy; excessive polypharmacy was defined as ten or more medications and PIMs were defined and categorized according to the Beers criteria.

Results:

Between June 2018 and October 2020, 285 patients were enrolled in the study. Polypharmacy was noted in 55% of the patients and excessive polypharmacy in 13%. Polypharmacy was noted in 70% of the patients with lung cancer, compared to 45% for other malignancies, P < 0.001. Unindicated medications such as vitamins and calcium were being taken by 20% of the patients and 23% were taking alternative medications (ayurvedic/homeopathic/naturopathic). Eighty percent of the patients were taking PIMs, commonly proton-pump inhibitors (33%) and tramadol (30%). The median number of PIMs was 2 (interquartile range, 1–2). Of the peri-chemotherapy supportive care medications, 53% were potentially inappropriate, commonly intravenous antihistamines in 39%, histamine H2 blockers in 15%, and steroids in 12%.

Conclusions:

Polypharmacy and PIM use are common problems in older Indian patients with cancer. Recognizing the problem and taking steps to ensure safe medication prescription practices should be a priority.
Economic and non-economic burden of cancer
Authors: Goyanka Roopali
Published: March 2021

Background:

Cancer affects the well-being not only of the patients but also of the other members of the household.

Objectives:

In this study, we assessed the nature and magnitude of the economic and non-economic burden on patients with cancer and their families due to the inpatient and outpatient cancer care.

Materials and Methods:

This study was conducted using the secondary data from the 75th round of the National Sample Survey Organization survey on health and morbidity, titled “Social Consumption: Health,” for the year 2017–2018. The burden of cancer on individuals was assessed in terms of the health-care expenditure and utilization of inpatient and outpatient cancer treatment. At the household level, cancer burden was assessed in terms of per person health-care expenditure, impact on the standard of living, strategies adopted for financing the health-care expenditure, and utilization of and expenditure on health-care by other members of the family. Propensity score matching was used to generate matched data separately for inpatient and outpatient cases and at individual and household levels to control for confounders. The difference in the burden between the matched cancer-affected and unaffected individuals/households was estimated using the average treatment effect.

Results:

For the year 2017–2018, data were available for a total of 113,823 households with 555,352 individuals across India. The mean out-of-pocket expenditure (OOPE) for a patient with cancer exceeded that of patients with other chronic diseases by 2895 for each outpatient visit and 52393 for each inpatient admission. The mean length of the hospital stay due to cancer was found to be 7 days longer than that due to any other chronic disease. The per person inpatient health-care expenditure for the other members of a cancer-affected household was 11,000 less than that of other members of the unaffected households. More than 50% of households with cancer patients had to borrow money to pay for inpatient care compared to control households. The share of OOPE for outpatient care in the monthly consumption expenditure of a cancer-affected household was twice as high as that of an unaffected household. Moreover, the number of outpatient visits for other ailing persons in a cancer-affected household was one-fourth that of an unaffected household.

Conclusion:

Cancer imposes an immense economic and non-economic burden on affected individuals and households. Therefore, there is a need to design appropriate health-care strategies for providing optimal financial support to patients with cancer.
Cyclodialysis cleft following sutureless intraocular lens fixation by Yamane's technique and its management
Authors: Mishra Samarth , Rishi Ekta , George Ronnie
Published: March 2021

Intrascleral haptic fixation of intraocular lens fixation by Yamane's technique is a popular technique of scleral fixation of intraocular lens (IOL). We herein describe two eyes of two patients with cyclodialysis cleft formation as a complication of Yamane's technique and its subsequent management.
Double lacrimal puncta
Authors: Asfuroglu Mahmut , Üçer Mehmet B , Asfuroğlu Yonca
Published: March 2021

Supernumerary puncta are uncommon lacrimal anomalies. Besides being a rare condition, it is usually overlooked. In this study, we report 3 cases of supernumerary lacrimal puncta. While two patients presented with epiphora; one patient was asymptomatic. In biomicroscopic examination, two lacrimal puncta on the lower lid were observed. A supernumerary punctum should be considered in patients with excessive tearing. Supernumerary puncta may alter the efficacy of topical medications, therefore, patients need to be informed about this rare anomaly.
Interface fluid
Authors: Agarwal Rinky , Bafna Rahul Kumar , Shakkarwal Chetan , Sharma Namrata
Published: March 2021

Superficial anterior lamellar keratoplasty (SALK) is a useful therapeutic modality to treat anterior and mid-stromal corneal opacities due to various pathologies including trachoma. The interface created during the surgery due to host and donor stroma-to-stroma apposition can be associated with potential complications that can affect its final surgical outcome. Collection of fluid in the interface after sutureless SALK has, rarely, if ever been reported. A 62-year-old man with bilateral pseudophakia and trachomatous keratopathy underwent microkeratome and fibrin-glue-assisted SALK for anterior stromal opacity in the left eye with an improvement of visual acuity to 6/18. Interface fluid was noted 1 week after the surgery which progressed to appear like a cyst subsequently. The visual acuity declined to 3/60. The fluid was drained and graft sutured under the guidance of intraoperative optical coherence tomography. No recurrence was noted till 3-months follow-up and the visual acuity resumed to 6/18.
Open-angle glaucoma in a case of cornea plana with unilateral microcornea
Authors: Menon Meena , Shreeshruthi N , Sudhakar Priyanka , Balasubramaniam Anand
Published: March 2021

Cornea plana is a rare congenital condition, usually occurring bilaterally, characterized by flat cornea and low refractive power. Glaucoma due to angle closure is a more common association owing to the shallow anterior chamber. We report a case of an elderly lady with bilateral cornea plana with immature cataract and open-angle glaucoma, and unilateral microcornea. The patient is visually rehabilitated. Her glaucoma is stable, maintained on a single anti-glaucoma medication. In conclusion, IOP measurement in these patients can be biased due to varied corneal morphology. However, with proper evaluation, these challenging cases can be well managed.
Preretinal exudates in ocular tuberculosis
Authors: Govindahari Vishal , Raghavendra Rao Kolavali , Kelgaonkar Anup
Published: March 2021

Preretinal exudates have been described in various ocular diseases. We present a case of preretinal exudates in tubercular retinal vasculitis with an inflammatory choroidal neovascular membrane (CNVM). The patient was treated with a tapering dose of oral corticosteroids, antitubercular therapy. Inflammatory CNVM which develops in active disease or during regression can be treated with intravitreal bevacizumab. In our case, the resolution of exudates was seen within 8 weeks of starting the treatment without any scar formation. In conclusion, we report a picture of exudates in a novel plane (preretinal) concerning tubercular vasculitis.
Coincident iridocorneal endothelial syndrome and keratoconus
Authors: Li Ye , McLintock Cameron , Lake Damian , McKelvie James
Published: March 2021

This report describes a rare case coincident keratoconus and Iridocorneal Endothelial (ICE) syndrome in a 43-year-old male with atopy who presented with progressively declining vision. A beaten silver appearance of the right endothelium with a dark-light reversal pattern and endothelial pleomorphism was consistent with the Chandler's syndrome variant of ICE. Keratoconus was demonstrated by irregular astigmatism with thinning and steepening on corneal tomography. He remained stable throughout 14 years with no evidence of secondary glaucoma or progression in keratoconus with conservative management. Coincident ICE and keratoconus is a rare entity with only one other published case of the Chandler's syndrome variant.
Computed tomography-based diagnostics and management of worsening postenucleation socket syndrome
Authors: Gushchina Marina B , Afanasyeva Daria S , Gushchin Alexander V , Chernenkiy Mikhail M , Brusova Liudmila A
Published: March 2021

In the presented clinical case of a patient with worsening postenucleation socket syndrome, we demonstrate using of modern computed methods for preoperative diagnostics, surgery planning, and production of a custom implant. We consider that computed tomography being accompanied by three-dimensional reconstruction and parameter measurements of the orbital tissues in the medical images enable ophthalmologists to gain comprehensive and precise information. All these enable us to provide better clinical results and better quality of life for the patients with monolateral anophthalmos.
The tale of two siblings with gaze palsy
Authors: Kapoor Rajat , Dubay Surabhi , Sachdeva Virender , Varma Ravi , Chougule Pratik , Patil-Chhablani Preeti
Published: March 2021

Horizontal gaze palsy and progressive scoliosis (HGPPS) is an autosomal recessive disease with a mutation in the ROBO3 gene. Features include horizontal gaze palsy, preserved vertical eye movements, and convergence. Progressive scoliosis is present in all patients. On MRI, HGPPS is characterized by brainstem hypoplasia, bifid medulla, split pons sign, and absence of facial colliculi. We report two siblings who presented with characteristic ocular and neuroimaging features of HGPPS but no scoliosis. The diagnosis was confirmed by neuroimaging and genetic analysis. This case report highlights the role of suspecting HGPPS in children with gaze palsy and characteristic neuroimaging findings even when there is an absence of clinical manifestation of scoliosis. Subsequent referral should be made to the orthopedician to rule out scoliosis both clinically and radiologically.
Focal laser photocoagulation in the management of perifoveal exudative vascular anomalous complex
Authors: Reddy Subhakar , Agrawal Hitesh , Agarwal Komal
Published: March 2021

Perifoveal exudative vascular anomalous complex is an unilateral, isolated, perifoveal aneurysm with adjacent exudative maculopathy. It has been hypothesized to develop due to progressive endothelial injury leading to aneurysmal changes. Usually, it is unresponsive to routinely used anti-VEGF agents. We present a case of a 33-year-old woman presented with PEVAC who was treated with a thermal focal laser. Complete resolution of PEVAC and improvement in BCVA was noted.
Posterior stromal crystalline keratopathy in gout
Authors: Asif Mohamed Ibrahime , Bafna Rahul Kumar , Shaji Kalathil Reshmi , Yadav Mrinalini Anand , Sinha Rajesh
Published: March 2021

A 55-year-old female presented with painless, diminution of vision in the right eye for 6 months. She had episodes of knee pain in the past. Slit lamp bio-microscopy revealed crystal-like deposits in the deeper corneal stroma in the right eye. Anterior segment optical coherence tomography and confocal microscopy revealed crystalline deposits. Systemic work-up revealed tophi in the right great toe with persistently high serum uric acid over the past ranging from 9 to 12 mg%. The patient is on follow-up and currently on medical therapy for gout. Gout may be associated with crystalline deposits in corneal stroma that may cause blurring of vision.
Cataract surgery in Keratitis Ichthyosis Deafness (KID) syndrome. Performing a routine surgery in a rare entity - Points to consider
Authors: Balyan Monika , Malhotra Chintan , Jain Arun Kumar
Published: March 2021

We describe the clinical features of a rare congenital ectodermal dysplasia - Keratitis Icthyosis Deafness (KID) syndrome in a 45-year-old female patient, who presented with corneal neovascularization and advanced cataract in both eyes. Sequential bilateral extracapsular cataract extraction with implantation of posterior chamber intraocular lens (PCIOL) in the bag was performed for visual rehabilitation. A review of published literature for this rare disease is also presented.
Ophthalmic artery occlusion due to orbital compartment syndrome after a frontotemporal craniotomy
Authors: DeMaria Lauren , Tran Ann Q , Tooley Andrea , Abdelhakim Aliaa , Belinsky Irina , Kim Eleanore
Published: March 2021

A 32-year-old female with a right frontal lobe glioma underwent an elective frontotemporal craniotomy. One hour postoperatively, the patient developed a right orbital compartment syndrome (OCS) with unilateral acute vision loss, proptosis, afferent pupillary defect, and complete ophthalmoplegia. The patient underwent emergent lateral canthotomy and inferior cantholysis. Neuroimaging revealed extensive vascular congestion along the extraocular muscles at the orbital apex. Retinal imaging demonstrated an ophthalmic artery occlusion. OCS following a frontal or frontotemporal craniotomy relates to increased orbital venous congestion from direct compression of the myocutaneous flap and subsequent intraorbital pressure elevation, vascular compromise, and ocular ischemia.
Lens particle glaucoma as a presenting feature of Hallermann–Streiff syndrome
Authors: Kapoor Monika , Madan Siddharth , Singh Preeti , Beri Sarita , Nayana TK
Published: March 2021

Hallermann–Streiff syndrome (HSS), an asymmetric second branchial arch defect affects growth, cranial and dental development. A 40-year-old lady with HSS developed severe pain and redness in her right eye due to raised intraocular pressure (IOP; 51 mmHg). A ruptured anterior capsule with cortical lens matter and granulomatous reaction was seen in anterior chamber (AC) along with absorbed cataract. Treatment with antiglaucoma medications, steroids followed by AC wash, anterior capsulotomy with anterior vitrectomy normalized IOP and inflammation reduced. Lens particle glaucoma is a rare presentation of HSS. Therefore, early cataract surgery is recommended that also avoids the risk of suppression amblyopia.