bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population-based incidence of gastrointestinal stromal tumors in Puglia
Authors: Cuccaro Francesco , Burgio Lo Monaco Maria Giovanna , Rashid Ivan , Bisceglia Lucia , Caputo Enrico , Melcarne Anna , Palma Fernando , Tanzarella Margherita , Cozzi Emma , Coviello Vincenzo 
Published: June 2020

Introduction: This study presents the incidence of gastrointestinal stromal tumors (GISTs) in an Italian region of over 4 million inhabitants monitored for 10 years and is the largest incidence study of this type of cancer conducted so far in Italy. Methods: In order to ensure the registration of all GISTs, including those with nonmalignant behavior, a cancer list was integrated with the cases found through an ad hoc data mining process that covered all the pathologic reports of Puglia. Case distributions by sex, age groups, site, and prognostic groups according to Miettinem and Lasota classification and crude and age-standardized incidence rates were produced. Results: In the 10-year period 2006 to 2015, 708 cases of GIST were recorded in Puglia. The average crude incidence rate was 1.7 per 100,000 person-years and the age-standardized incidence rate, using 2013 European standard population, was 1.8 per 100,000 person-years (95% confidence interval [CI], 1.6–1.9). Incidence was higher in men than in women: crude incidence rate was 2.0 per 100,000 person-years and age-standardized incidence rate 2.2 per 100,000 person-years (95% CI, 2.0–2.4) in men and 1.5 per 100,000 person-years and 1.4 per 100,000 person-years (95% CI, 1.2–1.6) in women. Discussion: Our incidence rates are comparable with those of other international studies and they are located in the medium to high end of the range. The comparisons are affected by a different capacity of the cancer registries to intercept and record GISTs with nonmalignant behavior. Distribution of cases for sex, age groups, sites, and prognostic risk groups are consistent with previous results.
A Malaysian retrospective study of acupuncture-assisted anesthesia in breast lump excision
Authors: Ang Ju-Ying , Bhojwani Kavita , Chan Huan-Keat , Chan Ai-Chen 
Published: June 2020

Introduction The objective of this retrospective study was to evaluate the effectiveness and safety of acupuncture-assisted anesthesia (AAA) in breast lump excision. Methods The medical records of all patients who underwent breast lump excision under AAA in combination with electrical stimulation at traditional acupuncture points in 2016 were examined. All of them (n = 17) received electrostimulation (2–4 Hz) using single needles inserted at bilateral LI4 and PC6. They also underwent insertion of four acupuncture needles at the lump site, which were electrically stimulated at 30 Hz frequency. Results All surgical procedures were successful with minimal use of analgesics and local anesthetic. The median pain score reported was 1/10 (interquartile range (IQR) = 2/10) at the first hour, and slightly increased to 2/10 (IQR = 2/10) between 24 and 48 h of the surgery. No major postoperative adverse events were documented, except for drowsiness in one case. Conclusion AAA was found to be generally safe and effective for anaesthesia and analgesia in breast lump excision. However, a large-scale randomized controlled study is required to verify the findings.
Book review: Devaki Jain, The Journey of a Southern Feminist and Devaki Jain, Close Encounters of Another Kind: Women and Development Economics
Authors: Lingam Lakshmi 
Published: June 2020

Devaki Jain, The Journey of a Southern Feminist. SAGE Publications, 2018, 270 pages, ₹795.00. ISBN: 9789352806218. Devaki Jain, Close Encounters of Another Kind: Women and Development Economics. SAGE Publications, 2018, 398 pages, ₹1,095.00. ISBN: 9789352807710.
Community Engagement in the Liberal Arts: How Service Hours and Reflections Influence Course Value
Authors: Painter David Lynn , Howell Courtney 
Published: June 2020

Background: In response to critics’ charges that the liberal arts lack practical value, most colleges have incorporated service-learning in their curricula. Ideally, these service-learning activities not only benefit the community but also enhance the course’s (a) pedagogical effectiveness as well as the students’ (b) civic engagement and (c) professional development. Purpose: This investigation uses a survey to measure the extent to which service-learning in community engagement courses at a liberal arts college achieved these three outcomes. Methodology/Approach: Specifically, we parsed the influence of service hours and reflection activities on 740 students’ ratings of pedagogical effectiveness, civic engagement, and professional development. Findings/Conclusions: The results suggest students in community engagement courses that included at least 15 service hours and three different types of reflections reported significantly greater outcome achievement than those with fewer hours or reflections. Moreover, class discussions and individual conversations were rated the most effective types of reflection activities. Implications: Based on these findings, we provide some best practice suggestions for service hours and reflection activities in liberal arts community engagement courses.
Return to Sport and Patient Satisfaction at 5-Year Follow-up After Nonoperative Treatment for Acute Achilles Tendon Rupture
Authors: Lerch Till D. , Schwinghammer Andreas , Schmaranzer Florian , Anwander Helen , Ecker Timo M. , Schmid Timo , Weber Martin , Krause Fabian 
Published: June 2020

Background: There is controversy whether nonoperative or operative treatment for Achilles tendon rupture is superior. It is unknown if patients with acute Achilles tendon rupture return to previous sports activity. The purpose of this study was to assess 5-year return to sport and subjective satisfaction, minimum 1-year functional outcomes, and complications in patients following nonoperative treatment of Achilles tendon rupture with early weightbearing rehabilitation. Methods: An institutional review board–approved, retrospective observational study involving 89 patients was performed. Out of 114 consecutive patients, 89 (78%) responded to questionnaires for sports activity. Nonoperative treatment consisted of an equinus cast and rehabilitation boot that enabled early weightbearing. Sports activity at 1-year and 5-year follow-up was compared to the prerupture status. Based on the prerupture Tegner Activity Scale (TAS), patients were divided into low-level (<6) and high-level (≥6) activity groups. Clinical assessment at minimum 1-year follow-up was performed with the Thermann score. Mean clinical follow-up was 34 ± 23 months. Results: Overall, >70% of the patients returned to their previous sports activity level after a nonoperative early weightbearing treatment. Return-to-sport rate was significantly ( P = .029) higher for patients in the low-level activity group (91%) compared to patients (67%) in the high-level activity group at 5-year follow-up. Subjective satisfaction with treatment was good in both groups (93% and 96%, respectively). The mean Thermann score did not differ between the 2 groups at 1-year follow-up. There were 11 reruptures, 5 deep venous thromboses, and 1 case of complex regional pain syndrome. Conclusion: Nonoperative treatment for Achilles tendon rupture yielded good functional outcome and high patient satisfaction. For patients with a high preinjury activity level, return to previous sporting level (assessed by TAS) was possible in 67% of the patients compared to >90% of patients with low preinjury activity level. Level of Evidence: Level III, retrospective comparative series
Identification of target small molecule tyrosine kinase inhibitors that need monitoring and clinical application of protocol for early detection of cancer therapeutics-related cardiac dysfunction using signal detection: An investigation of real world data
Authors: Mizuno Takahito , Sakai Takamasa , Tanabe Kouichi , Kozaki Koji , Umemura Takumi , Higashikawa Mariko , Kimura Tomoki , Yamada Tetsuya , Goto Nobuyuki , Ohtsu Fumiko 
Published: June 2020

Purpose In order to detect cancer therapeutics-related cardiac dysfunction (CTRCD) early, we identified which drugs were to be monitored using signal detection and the package insert, and created and applied a protocol to address this. Methods Adverse event data recorded in the Japanese Adverse Drug Event Report (JADER) database between April 2004 and January 2018 were used. Among small molecule tyrosine kinase inhibitors that are not described in the serious side-effects section of the package insert despite signal detection, tyrosine kinase inhibitors with severe side-effects in the background of cases reported by JADER database were selected to be monitored in clinical practice. We applied our findings clinically by creating a protocol to detect CTRCD early. All cases at Tosei General Hospital where the target tyrosine kinase inhibitors were administered from when they were first released in November 2019 were included. We compared the results from before and after we began the protocol to clarify its effects. Results We found that CTRCD was not described in the serious side-effect section of the package inserts for Bosutinib, Alectinib, and Osimertinib even though CTRCD signals were detected for them. Therefore, it is possible that we may have previously overlooked CTRCD. When we applied our protocol using Osimertinib as the target drug, we were able to detect CTRCD early in 5/21 (24%) patients. Conclusions It was clarified that the drug identification method used in this study for early detection of adverse events leads to early detection of adverse events when applied clinically.
Pre-hospital versus hospital acquired HEART score for risk classification of suspected non ST-elevation acute coronary syndrome
Authors: van Dongen Dominique N , Badings Erik A , Fokkert Marion J , Tolsma Rudolf T , van der Sluis Aize , Slingerland Robbert J , van’t Hof Arnoud W J , Ottervanger Jan Paul 
Published: June 2020

AbstractIntroductionAlthough increasing evidence shows that in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) both hospital and pre-hospital acquired HEART (History, ECG, Age, Risk factors, Troponin) scores have strong predictive value, pre-hospital and hospital acquired HEART scores have never been compared directly.MethodsIn patients with suspected NSTE-ACS, the HEART score was independently prospectively assessed in the pre-hospital setting by ambulance paramedics and in the hospital by physicians. The hospital HEART score was considered the gold standard. Low-risk (HEART score ≤3) was considered a negative test. Endpoint was occurrence of major adverse events within 45 days.ResultsA total of 699 patients were included in the analyses. In 516 (74%) patients pre-hospital and hospital risk classification was similar, in 50 (7%) pre-hospital risk classification was false negative (45 days mortality 0%) and in 133 (19%) false positive (45 days mortality 1.5%). False negative risk classifications were caused by differences in history (100%), risk factor assessment (66%) and troponin (18%) and were more common in older patients. Occurrence of major adverse events was comparable in pre-hospital and hospital low-risk patients (2.9% vs. 2.7%, p = 0.9). Incidence of major adverse events was 0% in the true negative group, 26% in the true positive group, 10% in the false negative group and 5% in the false positive group. Predictive value of both pre-hospital and hospital acquired HEART scores was high, although the ‘area under the curve’ of hospital acquired HEART score was higher (0.84 vs. 0.74, p &lt; 0.001).ConclusionIn approximately 25% of patients hospital and pre-hospital HEART score risk classifications disagree, mainly by risk overestimation in the pre-hospital group. Since disagreement is primarily caused by different scoring of history and risk factors, additional training may improve pre-hospital scoring.
Overview: Why and How Does Reflection Matter in Workplace Learning?
Authors: Faller Pierre , Lundgren Henriette , Marsick Victoria 
Published: June 2020

The Problem While reflection is central to adult learning processes and theories, its meaning and definitions vary. Authors approach reflection from different perspectives and assumptions. The Solution This article is a conceptual map to guide the reader through key definitions and perspectives discussed in upcoming articles. We provide a compass for reflection, critical reflection, reflective practice, and how these terms apply to learning from experience, meaning-making, and action in the workplace. We also show how different perspectives or lenses can impact a human resource development (HRD) practitioner’s approach to reflection and present several studies looking at reflection and reflective practices. The Stakeholders This article should help HRD practitioners and others engaged in supporting workplace learning to gain clarity about how to conceptualize reflection and reflective practices and become familiar with the different ways reflection is understood by authors of upcoming articles.
Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1
Authors: Dumonceau Jean-Marc , Delhaye Myriam , Charette Nicolas , Farina Annarita 
Published: June 2020

It is frequently challenging to make the correct diagnosis in patients with biliary strictures. This is particularly important as errors may have disastrous consequences. Benign-appearing strictures treated with stents may later be revealed to be malignant and unnecessary surgery for benign strictures carries a high morbidity rate. In the first part of the review, the essential information that clinicians need to know about diseases responsible for biliary strictures is presented, with a focus on the most recent data. Then, the characteristics and pitfalls of the methods used to make the diagnosis are summarized. These include serum biomarkers, imaging studies, and endoscopic modalities. As tissue diagnosis is the only 100% specific tool, it is described in detail, including techniques for tissue acquisition and their yields, how to prepare samples, and what to expect from the pathologist. Tricks to increase diagnostic yields are described. Clues are then presented for the differential diagnosis between primary and secondary sclerosing cholangitis, IgG4-related sclerosing cholangitis, cholangiocarcinoma, pancreatic cancer, autoimmune pancreatitis, and less frequent diseases. Finally, algorithms that will help to achieve the correct diagnosis are proposed.
Value of ambulatory blood pressure measurement in diagnosing hypotension in hypertensive diabetic patients with medication-controlled BP
Authors: Alghalayini Kamal 
Published: June 2020

Background Hypotension is a common clinical finding in diabetic patients on anti-hypertensive medications. In the absence of clearly defined and documented hypotensive episodes, clinicians are faced with the challenge of modifying antihypertensive medication in potentially symptomatic diabetic patients. Objective To determine the value of ambulatory blood pressure monitor (ABPM) in diagnosing hypotensive episodes in hypertensive diabetic patients with medication-controlled blood pressure. Patients and methods The records of all hypertensive diabetic patients with medication-controlled were obtained between 2017 and 2018. Patients’ demographic data, comorbid conditions, hypotensive symptoms and echocardiography results were obtained and compared to office-based blood pressure and ABPM. Results Of 926 patients screened in the department of medicine outpatient clinics, 231 patients had diabetes and hypertension and were taking antihypertension medications, so only 86 patients were recruited. Using 24 h ABPM, hypotensive events were documented in 65 (75.6%) patients without correlated hypotensive symptoms in the patient sheet. Patients who had hypotensive episodes recorded by ABPM tended to have these between 5 and 10 a.m. and were significantly older – 60.71 versus 58.76 ( P = .022) – and more likely to have lower ejection fractions by echocardiography 46.31 versus 62.85 (EF) ( P < .001). Conclusion In treated hypertensive diabetic patients with antihypertensive medication, ABPM may be beneficial in capturing bouts of asymptomatic (silent) hypotension readings that occur in the out-of-hospital setting. Diabetic patients with controlled hypertension based on office reading showed a significant number of asymptomatic hypotensive readings detected with ambulatory BP monitoring that can have a role in following up such patients.
Suicide prevention skills, confidence and training: Results from the Zero Suicide Workforce Survey of behavioral health care professionals
Authors: Wakai Sara , Schilling Elizabeth A , Aseltine Robert H , Blair Ellen W , Bourbeau Jill , Duarte Andrea , Durst Linda S , Graham Patricia , Hubbard Nancy , Hughey Kimberly , Weidner Deborah , Welsh Amanda 
Published: June 2020

Introduction: In behavioral health care settings, a workforce well trained in suicide prevention is critically important for behavioral health care professionals across different disciplines and service sectors who are likely to have considerable exposure to patients at risk for suicidal behavior. This study examined the types of training behavioral health care professionals received, their self-reported skills, comfort level and confidence related to suicide prevention, the association of types and length of training with skills, comfort level and confidence, and areas in which participants would like more training. Methods: The Zero Suicide Workforce Survey was administered electronically to behavioral health care professionals at six behavioral health treatment centers with both inpatient and ambulatory programs in Connecticut, USA. Item numbers and percentages were calculated for 847 respondents with behavioral health care roles. The chi-square tests were performed to determine the statistical significance of group differences. Non-parametric sign tests were performed to determine the statistical significance of the collective differences in direction among items between groups. Results: Suicide prevention training is associated with increased levels of behavioral health care professionals’ skills and confidence, but one-third of behavioral health care professionals in the sample received no formal training in suicide prevention/intervention. Even brief training appears to have a positive impact on behavioral health care professionals’ assessment of their skills and confidence. Prominent topics for additional training include suicide-specific treatment approaches, suicide prevention and awareness, and identification of risk factors and warning signs. Conclusion: Although behavioral health care professionals may often encounter patients at risk for suicide, many have not obtained any relevant training. The findings highlight the need to strengthen suicide identification, assessment and treatment within behavioral health care treatment settings as part of an effort to prevent suicide.
Sphenoid Sinus Involvement in Chronic Rhinosinusitis Without Polyps
Authors: Sumaily Ibrahim , Alarifi Ibrahim , Alahmari Abdussalam , Aloulah Mohammad , Alsaleh Saad 
Published: June 2020

BackgroundChronic rhinosinusitis (CRS) is a common chronic disease. It has 2 main clinical subtypes: CRS with nasal polyposis (CRSwNP) and without nasal polyps (CRSsNP). The sphenoid sinus appears to be less frequently involved in CRSsNP cases. Thus, we aimed to compare the incidence of sphenoid sinus involvement between CRSsNP and CRSwNP cases.MethodsA retrospective chart review of CRS cases was performed. The clinical and imaging findings, including age, sex, adenoid, and inferior turbinate hypertrophy (ITH), deviation of the nasal septum (DNS), presence of polyps, Lund–McKay scores, and the final diagnosis, were assessed. The incidence of sphenoid sinus involvement in each CRS subtype and its correlation with the aforementioned variables were studied.ResultsOf the 289 cases, 151 met the inclusion criteria including 82 CRSwNP and 69 CRSsNP cases. The mean patient age was 35.48 ± 11.88 years. The incidence of men and women were 66.9% and 33.1%, respectively. The sphenoid sinus involvement was 89% and 65.2% in the CRSwNP and CRSsNP cases ( P = .0001), respectively. The involvement of other paranasal sinuses showed no statistically significant differences between the 2 phenotypes. No other evaluated variables, including age, gender, DNS, ITH, or adenoid hypertrophy, significantly correlated with the incidence of sphenoid sinus involvement.ConclusionsThis is the first study to demonstrate that the sphenoid sinus is less frequently involved in CRSsNP cases. Further studies should investigate the underlying factors causing the lower incidence of sphenoid sinus involvement in CRSsNP.
Preoperative denosumab treatment with curettage may be a risk factor for recurrence of giant cell tumor of bone
Authors: Sano Kei , Suehara Yoshiyuki , Okubo Taketo , Sasa Keita , Kurihara Taisei , Akaike Keisuke , Kubota Daisuke , Torigoe Tomoaki , Hasegawa Nobuhiko , Ishii Midori , Nakamura Yasuhiro , Kim Youngji , Takagi Tatsuya , Kaneko Kazuo , Hayashi Takuo , Saito Tsuyoshi 
Published: June 2020

Purpose: Giant cell tumor of bone (GCTB) is a local aggressive bone tumor, histologically classified as intermediate malignancy. Recently, the RANKL inhibitor, denosumab, was developed as a novel and effective treatment option for GCTB. Since the risk of preoperative use of denosumab with curettage had been previously reported, this study aimed to investigate the relationship between recurrences and clinicopathological features associated with adjuvant denosumab treatment in GCTB. Methods: A total of 87 GCTB cases were treated at our institution. We reviewed 66 patients with conventional-type GCTB occurring in the extremities and analyzed 78 surgical treatments, including curettages and resections, with clinicopathological features and denosumab treatment. Results: GCTB lesions, including 66 primary and 12 recurring, underwent surgical treatment like curettage and resection. Recurrence-free survivals in 78 GCTB surgeries were 78.7% in 3 years and 71.9% in 5 years. In the resected cases of GCTBs, there was no recurrence either with or without denosumab. In curettage cases, 3-year recurrence-free survivals were 0.0% ( n = 3) in preoperative treatment of denosumab, 66.7% ( n = 6) in postoperative treatment, and 76.6% ( n = 43) in no treatment. Interestingly, three preoperative treatment cases demonstrated low MIB-1 index despite 100% recurrence. The other clinicopathological factors did not contribute much to the risk of recurrence in curettage cases. Conclusion: Our findings revealed the use of denosumab in GCTB, prior to curettage, to possibly increase the risk of local recurrence. Together with previous reports, our finding might provide information for beneficial treatment of GCTB.
CSR and battered women: Stakeholder engagement beyond salience?
Authors: Awan Amer , Murillo David , Mellen Teodor 
Published: June 2020

The use of salience as a tool to determine which stakeholders matter may lead to the marginalization of some stakeholder groups. As a normative theory, salience is problematic because it uproots stakeholder theory from its moral foundations. As a descriptive theory, its prevalence has found mixed support in literature. In order to overcome these limitations, scholars have recommended grounding stakeholder theory in ethics of care. These recommendations have largely been normative but still lack empirical support. We present the case of Escuela Social Ana Bella to show that, particularly when dealing with marginalized stakeholders, stakeholder theory rooted in ethics of care has considerable explanatory power. We find that firms can engage with fringe stakeholders when the decisions of managers are informed by emotions. We also find that this engagement can have the power to transform the beneficiary stakeholder group to an extent where they may become, paradoxically, salient stakeholders for the firm. JEL CLASSIFICATION: M14