bluuebunny/crossref_metadata_2025_split huggingface dataset:
Green supply management and green marketing strategy on green purchase intention: SMEs cases
Authors: Sugandini Dyah , Muafi Muafi , Susilowati Christin , Siswanti Yuni , Syafri Wirman 
Published: February 2020

Purpose: This study aims to analyze green supply chain management (GSCM) and green marketing strategies (GMS) to green purchasing intentions (GPI). This study conducts on craft SMEs in the Special Region of Yogyakarta, Indonesia. Design/methodology/approach: This study uses primary data which is obtained through questionnaires. The unit of analysis in this study is organizations and individuals. The sampling technique is purposing sampling, with the criteria of SMEs that conduct environmentally friendly production processes and consumers who have ever bought green products. Data analysis uses structural equation modeling. Research limitations/implications: This study is limited by relatively small sample size. The sample is only environmentally oriented SMEs. Large companies that are also environmentally friendly have not been included as samples in this study, so the results of this study only generalized to SMEs. Future research should accommodate these two types of companies, namely SMEs and companies, so that it can be easier to generalize the findings and allow different tests of GSCM to be applied to SMEs and large companies. This study only analyzed GSCM from two dimensions, namely GP and GCC. Other variables that can be used to explain GSCM are internal environmental, green information systems, eco-design and packaging. Practical implications: GSCM can be started with conducts the right GP and always coordinating with consumers which related to green products. GP (green purchasing) and GCC (green consumer cooperation) as GSCM elements have a strong association in predicting the success of a green marketing strategy. It is expected that SMEs should pay attention to the raw material purchase so that the problem of environmentally friendly raw materials can be truly obtained to enter the production process and produce environmentally friendly products. Originality/value: This study analyzes the relationship between GSCM practices and organizational performance in the green marketing and business strategies context, where there is still a scarcity of studies in this context. Besides that, there is an increase in awareness of green operations and green marketing in Asia, but the relevant studies in Asian countries have not been conducted much, especially in Southeast Asia. The result of this study proves that the GSCM model can increase value along the supply chain by emphasizing green supply chain management and green marketing.
Nursing Students' Perceptions of Anxiety-Producing Situations in the Clinical Setting
Authors: Kleehammer Kelly , Hart A Louise , Keck Juanita Fogel 
Published: February 2020

ABSTRACT
Aspects of nursing students' clinical experiences are anxiety provoking. High anxiety may contribute to decreased learning. The purpose of this study was to identify potentially anxiety-producing clinical experiences for student nurses. Thirty-nine junior and 53 senior nursing students from a BS degree program completed the "Clinical Experience Assessment form," a 16-item Likert scale. The items included communication and procedural aspects of patient care, interpersonal relationships with healthcare providers, and interactions with faculty. An open-ended question asked students to identify the most anxiety-producing aspect of their clinical practice. The students expressed the highest anxiety for the initial clinical experience on a unit and the fear of making mistakes. Faculty evaluation and observation were also anxiety-producing. The results of the student t-test indicated that juniors were significantly higher in their expression of anxiety than seniors. The main theme from the content analysis was that students' anxiety was increased in the clinical setting by their perceptions of nonsupportive faculty.
Échanges linguistiques et interculturels en tandem en français sur objectifs spécifiques
Authors: Zsak Helga 
Published: February 2020

Avec la création d'un contexte et de tâches d'apprentissages internationaux et multidisciplinaires en tandem, nous nous sommes efforcés de favoriser l'accès à la langue par la collaboration entre les étudiants hongrois de la faculté de tourisme Budapest et les étudiants français des établissements partenaires. Le domaine ciblé a été celui du français sur objectif spécifique (FOS) : le curriculum du tourisme des affaires. S’inscrivant dans la lignée théorique d’éducation des « Écoles nouvelles », répandues en Hongrie, des théories socioconstructivistes, et nous inspirant des résultats de recherches scientifiques hongroises sur le fonctionnement mental dans l’interaction sociale. Le travail des étudiants s'est articulé autour de cinq rencontres en tandem en français et anglais hors cours. La tâche à accomplir fut de créer un projet interculturel commun sur une thématique culturelle ou patrimoniale. D'après l’observation des contributions initiale et finale des étudiants, il semble que les projets élaborés et réunis sur des sites Internet, ont contribué à améliorer les dimensions cognitives, affectives et comportementales des compétences interculturelles des apprenants et leur niveau linguistique. Les éléments nouveaux du code culturel ont peut-être aidé au façonnement individuel et collectif de leur personnalité
HIV-1 gp120–CD4-Induced Antibody Complex Elicits CD4 Binding Site–Specific Antibody Response in Mice
Authors: Galkin Andrey , Chen Yajing , Guenaga Javier , O’Dell Sijy , Acevedo Roderico , Steinhardt James J. , Wang Yimeng , Wilson Richard , Chiang Chi-I , Doria-Rose Nicole , Grishaev Alexander V. , Mascola John R. , Li Yuxing 
Published: February 2020

Abstract
Elicitation of broadly neutralizing Ab (bNAb) responses toward the conserved HIV-1 envelope (Env) CD4 binding site (CD4bs) by vaccination is an important goal for vaccine development and yet to be achieved. The outcome of previous immunogenicity studies suggests that the limited accessibility of the CD4bs and the presence of predominant nonneutralizing determinants (nND) on Env may impede the elicitation of bNAbs and their precursors by vaccination. In this study, we designed a panel of novel immunogens that 1) preferentially expose the CD4bs by selective elimination of glycosylation sites flanking the CD4bs, and 2) minimize the nND immune response by engineering fusion proteins consisting of gp120 Core and one or two CD4-induced (CD4i) mAbs for masking nND epitopes, referred to as gp120–CD4i fusion proteins. As expected, the fusion proteins possess improved antigenicity with retained affinity for VRC01-class, CD4bs-directed bNAbs and dampened affinity for nonneutralizing Abs. We immunized C57BL/6 mice with these fusion proteins and found that overall the fusion proteins elicit more focused CD4bs Ab response than prototypical gp120 Core by serological analysis. Consistently, we found that mice immunized with selected gp120–CD4i fusion proteins have higher frequencies of germinal center–activated B cells and CD4bs-directed memory B cells than those inoculated with parental immunogens. We isolated three mAbs from mice immunized with selected gp120–CD4i fusion proteins and found that their footprints on Env are similar to VRC01-class bNAbs. Thus, using gp120–CD4i fusion proteins with selective glycan deletion as immunogens could focus Ab response toward CD4bs epitope.
Required Treatment Expenditures for Hepatitis C Virus Infection and Advantage in the Reduction of Hepatocellular Carcinoma Incidence: Analysis of Possible Options in an Endemic Area
Authors: Joob Beuy , Wiwanitkit Viroj 
Published: February 2020

Abstract
Background: Hepatitis C virus (HCV) infection is a known underlying factor contributing to hepatocellular carcinogenesis. The use of direct-acting antiviral (DAA) medication is a form of clinical management for controlling HCV infection and reducing the hepatocellular carcinoma incidence. This medication is introduced to several endemic areas. The big concern is on the treatment expenditures. Several alternative options are proposed and it is required to assess the effect of each alternative option. Objective: Here, the authors assessed and estimated the required treatment expenditures for HCV infection and advantage in the reduction of hepatocellular carcinoma incidence based on the analysis of possible options in an endemic area. Methods: A medical economics analysis was done. Results: According to the cost–utility analysis, the best alternative option that is hereby recommended is DAA medication coverage for all cases. Conclusion: DAA medication coverage for all cases is recommended.
Histopathological Spectrum of Bone Changes in Skeletal Metastasis
Authors: Baliyan Asif , Punia Rajpal Singh , Kundu Reetu , Dhingra Harshi , Aggarwal Purnima , Garg Sudhir Kumar 
Published: February 2020

Abstract
Background: Metastatic carcinoma is the most common secondary malignant tumor affecting the bone. Bone is the third most common site for metastasis after lung and liver. The present study was planned to analyze the histomorphological patterns of bone changes in metastatic tumors and their correlation with the radiological findings. Materials and Methods: The current prospective study was conducted over a span of 2 years, encompassing 150 patients with clinically and radiologically suspected metastatic bone disease. Bone biopsy samples were studied for the pattern of bone changes. Results: Of 150 total cases, 30 cases had metastatic bone tumors. The age of the patients ranged from 37 to 84 years (mean: 57.57 ± 11.9 years). Male-to-female ratio was 2:1. All patients with metastasis presented with a complaint of pain followed by tenderness (20, 66.7%). The lesions were commonly located in the vertebral column (14, 46.7%), followed by femur (6, 20%). The primary site was known in 21 (70%) cases. The tumor histotypes were adenocarcinoma (23, 76.7%), squamous cell carcinoma (5, 16.7%), pleomorphic sarcoma (1, 3.3%), and malignant melanoma (1, 3.3%). Histomorphological patterns of bone changes were osteolytic (16, 53.3%), mixed (8, 26.7%), and osteoblastic (6, 20.0%). Correlation between the radiological findings and histopathological patterns of metastases was found to be statistically significant. Conclusions: Histomorphological assessment of bone changes in metastasis is an important parameter. Besides the histological categorization of metastatic bone disease, it plays a pivotal role in identification of the primary tumor site.
Giant Sacrococcygeal Teratoma in Neonate: A Case Report and Review of Literature
Authors: Meshram Rajkumar Motiram , Nikila R , Nagdive Nilesh 
Published: February 2020

AbstractSacrococcygeal teratoma is considered the most common tumor in the neonatal period with a female-to-male ratio of 3–4:1. They are believed to arise early in gestation from the totipotential cells of Hensen’s node and the derived ectoderm, mesoderm, and endoderm. A 2.25 kg cesarean-delivered male, term neonate presented with large nonpulsatile, globular erythematous mass with lobulated surface and variable consistency. Magnetic resonance imaging of the lumbosacral spine showed multilocular cystic and solid lesion with foci of calcification and subtle communication with spinal canal. Histopathological examination showed mature endodermal, ectodermal, and mesenchymal elements such as cartilage, glial tissues, keratin cyst, and glandular elements with focus of primary neuroepithelial and pancreatic elements. Entire tumor was excised. The baby expired secondary to wound infection. Early diagnosis by improving antenatal care with timely surgical intervention and good nursing care improves the outcome.
Thyroid Transcription Factor-1 Expression in Adenocarcinoma Lung and Its Association with Histomorphological Features
Authors: Shukla Saumya , Husain Nuzhat , Anand Nidhi , Kant Surya , Garg Rajiv , Verma SK , Kumar Santosh , Prakash Ved 
Published: February 2020

Abstract
Objectives: Thyroid transcription factor-1 (TTF-1) expression is frequently associated with adenocarcinoma lung. This study was undertaken with the objectives to assess the expression of TTF-1 in non-small cell lung carcinoma (NSCLC) with adenocarcinoma phenotype and to evaluate the TTF-1 expression with clinicopathological and histomorphological features. Materials and Methods: This was a tertiary care hospital-based case series that included 250 cases of NSCLC. TTF-1 immunostaining along with a basic panel of immunohistochemistry markers was performed. The histomorphological analysis was done to compare the morphological features of TTF-1-positive versus TTF-1-negative cases. Results: TTF-1 was positive in 144 cases (57.6%), while 106 cases were negative for TTF-1. The M: F ratio in the TTF-1-positive group was 1:2, and the mean age of the cases that expressed TTF-1 was 48.5 years. The most common pattern in the TTF-1-positive group was loose clusters or singly dispersed cells (77.78%), followed by the acinar (54.86%) and solid pattern (42.36%). In the TTF-1-negative group, 86.79% of cases had singly dispersed cells or loose cohesive clusters, followed by a solid pattern in 50.94% cases. Conclusion: TTF-1 is a useful and reliable marker for pulmonary adenocarcinoma. TTF-1 expression does not have any association with the patterns and degree of differentiation evident in the tumor.
The Conundrum of Dual Primary Malignancies: Four Years’ Experience of a Single Tertiary Care Institute in India
Authors: Bisht Niharika , Singh Sankalp , Sarin Arti , Gupta Samir , Singh Harinder Pal , Kapoor Amul , Mulajker Deepak , Joshi Richa , Purkayastha Abhishek , Mishra Prabha Shankar , Shelly Divya 
Published: February 2020

Abstract
Background: Encountering more than one malignancy in a cancer patient is no longer uncommon; this increasing incidence is mostly attributable to the improvements in life expectancy, awareness, and diagnostic facilities. This article aims to highlight this institute’s experience in diagnosis and treatment of patients of multiple primary malignancies and a comprehensive review of literature. Materials and Methods: This is a descriptive study of retrospectively collected data of a single institution over 4 years from 2013 to 2016. Known cases of cancer who were diagnosed with a second primary malignancy were included in the study. Various details such as age, sex, site of disease, temporal relation of two cancers (synchronous or metachronous), family history, tobacco use, treatment given, and survival at 1 year were recorded, organized in a tabular form, analyzed, and described. Results: A total of 29 cases of dual malignancies comprising 0.74% of a total of 3879 patients of cancer were encountered. Seventy-two percent of the cases were metachronous and 5 years was the mean time interval between tumors. There was a female preponderance, and the average age was 56 years. Breast was the most common site of malignancy. At 1 year from diagnosis of second primary, 69% of the patients were alive and 27% were disease-free. Conclusion: Second primary in a patient of cancer is becoming increasingly common and the suspicion of the same should always be borne in mind during follow-up. Prognosis as well as intent of treatment depends on respective stages of the two malignancies.
Secondary Osteosarcoma of Pelvic Bone: Long-Term Complication of Bladder Cancer Radiotherapy
Authors: Prasad K Siva , Bala Stalin , Ravichandran Ambalathandi , Sadashivudu Gundeti 
Published: February 2020

AbstractSecond cancer in the irradiated area is one of the complication of radiotherapy of which bone and soft tissue sarcomas predominate. Radiation-induced osteosarcoma (RIOS)accounts for 3.4%–5.5% of all osteosarcoma cases. A 70-year old male presented with complaints of swelling and pain in left gluteal region without any antecedent trauma. On clinical examination 8 × 8 cm size swelling palpable in left gluteal region arising form left iliac bone. He had history of bladder carcinoma 20 years ago for which he received concurrent chemoradiation. CT scan showed a large, erosive and lytic lesion of left iliac bone and biopsy of the lesion was suggestive of osteosarcoma. In view of extensive lesion eroding left half of pelvic bone, surgery was not done, and chemotherapy was planned.
Management and Long-term Outcomes of Giant Mediastinal Germ Cell Tumors in Children
Authors: Khanna Kashish , Agarwala Sandeep , Bishoi Akshay Kumar , Bakhshi Sameer , Bhatnagar Veereshwar 
Published: February 2020

Abstract
Purpose: The purpose of the study is to evaluate the outcome of children with giant mediastinal germ cell tumors (GCTs). Materials and Methods: A retrospective study of children diagnosed with GCTs treated at our hospital from 1998 to 2014 was performed. They were evaluated for their tumor size, malignancy, treatment, complications, and outcome. Results: Twelve giant mediastinal GCT patients were included in the study. Age ranged from 7 to 144 months (median 12 months) and all except one were males. The average tumor size was 10.4 cm (range 6 cm × 5 cm–16 cm × 13 cm) and in four patients, they were large enough to occupy nearly the entire hemithorax. Nine children had benign tumors, and these were resected upfront. The remaining three cases with malignant disease received neoadjuvant chemotherapy. No significant reduction in size was noticed in these patients, but alpha-fetoprotein levels decreased in all the three, and they were later resected. Eight (67%) were resected through posterolateral thoracotomy and 4 (33%) through median sternotomy approach. One patient had a dumbbell-shaped thoracoabdominal tumor extending through a Bochdalek hernia. He required additional laparotomy as well as diaphragmatic repair. There were no postoperative complications. The malignant GCTs received total four courses of PEB. All patients were alive and asymptomatic at a mean follow-up of 55.4 months (range 10–146 months). Conclusions: Mediastinal GCTs have bimodal age distribution and show male preponderance. Malignant mediastinal GCTs responded well to neoadjuvant chemotherapy through a reduction in size was not noticed. Complete excision often in coordination with cardiothoracic-vascular surgeons can lead to long-term symptom-free survival even in giant tumors.
Choroid Plexus Carcinoma Enmasked with Soft Signs and Symptoms
Authors: Appaji Shruti , Prasad KNV 
Published: February 2020

AbstractChoroid plexus carcinomas (CPCs) are rare brain tumors, with preponderance in infants. They are highly invasive tumors with a dismal prognosis. The 5-year survival rates for CPC vary between 10% and 50%. They commonly arise from the lateral ventricles. CPCs in infants present with the subtle features of raised intracranial tension (ICT). Surgical resection is the mainstay of management with adjuvant chemotherapy and radiotherapy. We report a case of 11-month-old child with CPC, presented with subtle nonspecific signs and symptoms of raised ICT, treated by surgical resection and chemotherapy.
Treatment Adherence and Abandonment in Acute Myeloid Leukemia in Pediatric Patients at a Low-Resource Cancer Center in India
Authors: Sinha Sudha , Brattström Gustav , Palat Gayatri , Rapelli Vineela , Segerlantz Mikael , Brun Eva , Wiebe Thomas 
Published: February 2020

Abstract
Aim: One of the causes for lower cure rates in acute childhood leukemia in low- and middle- income countries (LMIC) compared to high-income countries is abandonment from treatment. The International Society of Pediatric Oncology (SIOP) defines abandonment as failure to begin treatment or an absence of 4 weeks during treatment. The aim of this study was to evaluate the extent of abandonment among patients diagnosed with acute myeloid leukemia (AML) at the pediatric ward at a low-resource cancer center in India. Methods: Medical records of all patients, aged 0–15 years, diagnosed with AML between January 1, 2014, and March 31, 2015, at the hospital were reviewed. Age, sex, date of diagnosis, and survival during the short follow-up time after completed treatment and information regarding abandonment were collected. SIOP definition of abandonment was used. Eight patients were diagnosed with AML at the hospital whereof 65 met the inclusion criteria of this study. Results: Of the included 65 patients, 6 died before treatment could be initiated and 3 were referred to palliative care upfront. Thus, 56 patients were offered curatively intended treatment. Of these patients, six refused treatment at this stage and another five abandoned during therapy. Altogether, 11 children abandoned treatment. Conclusion: In this study, the abandonment rate from treatment of childhood AML was 20%, which is in concordance from other studies conducted in India and other LMIC, stating that abandonment is a problem and hindrance when treating with a curative intent.
Mucoepidermoid Carcinoma of the Vulva: A Distinct Pathological and Clinical Entity
Authors: Sinha Satyendra Narayan , Choudhary Brajesh Kumar , Kumar Sanjay , Singh Manisha 
Published: February 2020

AbstractUnlike their major salivary gland counterparts, primary mucoepidermoid carcinoma of the vulva is extremely rare tumor. Here, we describe an unusual case of MEC arising from vulva and a short review of literature. This report describes an interesting and unusual case of mucoepidermoid carcinoma of vulva. A 42-year female presented with approx. 3.5 x 3.0 cm size painless polypoidal growth on right labia majora. CT scan abdomen & pelvis showed 30 x 27 cm size well defined lobulated polypoidal lesion is noted in right side of labia majora. Wide local excision had done with margin. Histological evaluation revealed a typical MEC with negative margin. Our tumor board has decided to keep on close follow-up because of the aggressive behaviour of such type of tumour. Follow-up at 6 months has revealed no evidence of recurrence. This is, to our knowledge, the first report of MEC arising from vulva in India. We report a very rare case of primary mucoepidermoid carcinoma of the vulva and this is the first case reported in India. Treatment strategy for MEC vulva yet to decide and patients should be closely followed-up for life to rule out late recurrence.