bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative low muscle mass and malnutrition affect the clinical prognosis of locally advanced gastric cancer patients undergoing radical surgery
Authors: Zhao Ailing , Hou Chong , Li Yingzi , Liu Yipin 
Published: April 2023

BackgroundGastric cancer is a common and highly aggressive malignant tumor of the gastrointestinal tract that poses a serious threat to human life and health. As the clinical symptoms of early gastric carcinoma are not obvious, many patients are diagnosed in the middle or late stages. With the advancement of medical technology, gastrectomy has become a safer surgical procedure, but it still has a high recurrence and mortality rate after surgery. The prognosis of gastric cancer patients after surgery is not only related to tumor-related factors (i.e., tumor stage) but the patient’s nutritional status. This study aimed to investigate the effect of preoperative muscle mass combined with the prognostic nutritional index (PNI) on clinical prognosis in locally advanced gastric carcinoma.MethodsThe clinical data of 136 patients with locally advanced gastric carcinoma diagnosed by pathology and undergoing radical gastrectomy were retrospectively reviewed. To analyze the influencing factors of preoperative low muscle mass and its correlation with the prognostic nutritional index. Patients with both low muscle mass and low PNI (≤46.55) were assigned a score of 2, and those with only one or neither of these abnormalities were assigned a score of 1 or 0, respectively, according to the new prognostic score (PNIS). The relationship between PNIS and clinicopathological characteristics was analyzed. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS).ResultsLow muscle mass was associated with a lower PNI (P &lt; 0.01). The optimal cut-off value of PNI was 46.55, the sensitivity was 48%, and the specificity was 97.1%. There were 53 (38.97%), 59 (43.38%), and 24 patients (17.65%) in the PNIS 0, 1, and 2 groups, respectively. A higher PNIS and advanced age were independent risk factors for postoperative complications (P &lt; 0.01). The overall survival rate in patients with PNIS 2 score was significantly poorer than in patients with scores of 1 or 0 (3-year OS: 45.8% vs 67.8% vs 92.4%, P &lt; 0.001). A Multivariate Cox hazards analysis showed that PNIS 2, depth of tumor invasion, vascular invasion, and postoperative complications were independent predictors of the poor 3-year survival in patients with locally advanced gastric cancer.ConclusionsThe combination of muscle mass and the PNI score system can be used to predict the survival outcome of patients with locally advanced gastric cancer.
Differences in kinetic characteristics during countermovement jump of football players with cerebral palsy according to impairment profiles
Authors: Henríquez Matías , Sabido Rafael , Barbado David , Roldan Alba , Elvira Jose L. L. , Yanci Javier , Reina Raúl 
Published: April 2023

Objectives: The purpose of this study was 1) to determine and compare kinetic parameters during the realization of a countermovement jump (CMJ) between footballers with cerebral palsy (CP) and non-impaired footballers, and 2) to analyze the differences in this action between different players’ impairment profiles and a group of non-impaired footballers.Methods: This study involved 154 participants comprising 121 male footballers with CP from 11 national teams and 33 male non-impaired football players recruited as the control group (CG). The footballers with CP were described according to the different impairment profiles (bilateral spasticity = 10; athetosis or ataxia = 16; unilateral spasticity = 77; minimum impairment = 18). All participants performed three CMJs on a force platform to record kinetic parameters during the test.Results: The group of para-footballers presented significantly lower values than the CG in the jump height (p &lt; 0.01, d = −1.28), peak power (p &lt; 0.01, d = −0.84), and the net concentric impulse (p &lt; 0.01, d = −0.86). Concerning the pairwise comparisons between CP profiles and the CG, significant differences were found for the bilateral spasticity, athetosis or ataxia, and unilateral spasticity subgroups compared to the non-impaired players for jump height (p &lt; 0.01; d = −1.31 to −2.61), power output (p &lt; 0.05; d = −0.77 to −1.66), and concentric impulse of the CMJ (p &lt; 0.01; d = −0.86 to −1.97). When comparing the minimum impairment subgroup with the CG, only significant differences were found for jump height (p = 0.036; d = −0.82). Footballers with minimum impairment presented higher jumping height (p = 0.002; d = −1.32) and concentric impulse (p = 0.029; d = −1.08) compared to those with bilateral spasticity. Also, the unilateral spasticity subgroup reports a higher jump height performance than the bilateral group (p = 0.012; d = −1.12).Conclusion: These results suggest that the variables related to power production during the concentric phase of the jump are crucial for the performance differences between groups with and without impairment. This study provides a more comprehensive understanding of kinetic variables that would differentiate CP and non-impaired footballers. However, more studies are necessary to clarify which parameters better differentiate among different profiles of CP. The findings could help to prescribe effective physical training programs and support the classifier’s decision-making for class allocation in this para-sport.
Optimization and reflexivity in interdisciplinary agri-environmental scholarship
Authors: Chiles Robert Magneson , Drohan Patrick J. , Cibin Raj , O'Sullivan Lilian , Doody Donnacha , Schulte Rogier P. O. , Grady Caitlin , Jiang Fei , Preisendanz Heather E. , Dingkuhn Elsa L. , Veith Tamie L. , Anderson Aine 
Published: April 2023

IntroductionThe Chesapeake Bay and Upper Bann watersheds in the United States and Northern Ireland, respectively, exemplify how agricultural systems contribute to groundwater and surface water pollution, which leads in turn to water quality issues in downstream water bodies. Interdisciplinary research, public outreach, and stakeholder engagement have received increased attention and consideration as pragmatic approaches for addressing these types of complex agri-environmental dilemmas. However, such approaches are far from guaranteed to improve water quality, as political-economic constraints, power asymmetries, cultural differences, divergent incentives, research gaps, and personality differences all complicate the process, and this can ultimately impact water quality efforts.MethodsWe present a holistic approach to addressing these challenges in the Chesapeake Bay and Upper Bann watershed management efforts by integrating the methodological strategies of optimization and reflexivity. Our use of these approaches, widely recognized as respective successful practices in quantitative and qualitative research, is novel in that it focuses directly on the researchers themselves as they discuss, evaluate, and develop potential solutions for complex agri-environmental water quality dilemmas. More specifically, our quantitative optimization is explored via a Functional Land Management (FLM) approach to land and natural resources management, while our qualitative reflexivity is explored through the process of participant observation.ResultsThis paper provides a behind-the-scenes perspective on how interdisciplinary teams can improve their cooperation efficiency when addressing complex agri-environmental issues. In being reflexive, we sought to “optimize” on the methodological, ethical, social, and environmental possibilities of our scholarship. We found that our reflexive work on this project furthered our interest in FLM, a tool that embraced complexity and creativity over rigidity and oversimplification - the very same principles that guided our reflexive work.DiscussionThroughout our collaborative investigation of FLM as a potential solution to soil and water quality issues, we came to appreciate that in order to better understand agri-environmental challenges issues, we also needed to better understand ourselves—our own disciplinary, cultural, and ethical standpoints. Reflexive approaches to research can provide practical guidance in this process by encouraging us to critique and analyze our assumptions, our methodologies, and the socio-historical context of our research.
The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgery
Authors: Pirozzolo Giovanni , Quoc Bao Riccardo , Vignotto Chiara , Baiano Livio , Piangerelli Alfredo , Peluso Claudia , Palumbo Rubina , Cimino Fabrizio Giuseppe Maria , Meneghetti Guido , Grassetto Alberto , Rizzo Maurizio , Viola Gabriele Giuseppe Maria , Fiumara Francesco , Scarpa Marco , Recordare Alfonso Giovanni 
Published: April 2023

BackgroundOn March 9, 2020, the Italian Prime Minister announced the lockdown, which was officially closed on May 4. This extraordinary measure was necessary to contain the COVID-19 pandemic spread in Italy. During this phase, a significant decrease in patients' access to Emergency Department (ED) was observed. Delayed access to treatment determined a delay in the diagnosis of acute surgical conditions, as already documented in other clinical areas, with consequences on surgical outcome and survival. Aim of this study is to provide a detailed description of abdominal urgent-emergent conditions surgically treated and surgical outcomes during the lockdown in a tertiary referral Italian hospital, compared with historical data.MethodsA retrospective review of urgent-emergent patients surgically treated in our department was conducted in order to compare patients' characteristics and surgical outcomes during the period March 9th—May 4th, 2020 with the same period of the previous year.Results152 patients were included in our study, 79 patients in 2020 group and 77 patients in 2019. We found no significant differences between the groups regarding ASA score, age, gender, and disease prevalence. Significant differences were found in symptom duration before ER access and abdominal pain as the main symptom in non-traumatic conditions. We also performed a sub-analysis on peritonitis which showed significant differences in: hospital length of stay, presence of colostomy vs. ileostomy, and fatal events in 2020. No differences were found in the use of laparoscopy.ConclusionsWhile the overall number of ER accesses has decreased in 2020 group, the number of patients surgically treated in emergency-urgency conditions has not decreased. However, those patients waited significantly more before the hospital access. This diagnostic delay was associated with a more severe clinical condition and a consequent significantly worse prognosis.
Demographics and Clinicopathologic Profile of Pulmonary Sarcomatoid Carcinoma with Survival Analysis and Genomic Landscape
Authors: Ullah Asad , Ahmed Asim , Yasinzai Abdul Qahar Khan , Lee Kue Tylor , Khan Israr , Asif Bina , Khan Imran , Tareen Bisma , Kakar Kaleemullah , Andam Gul , Heneidi Saleh , Khan Jaffar , Khan Hina , Karki Nabin R. , Del Rivero Jaydira , Karim Nagla Abdel 
Published: April 2023

Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of non-small cell lung cancer (NSCLC) with an aggressive clinical nature and poor prognosis. With novel targeted therapeutics being developed, new ways to effectively treat PSC are emerging. In this study, we analyze demographics, tumor characteristics, treatment modalities, and outcomes of PSC and genetic mutations in PSC. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) database were reviewed to analyze cases of pulmonary sarcomatoid carcinoma from 2000 to 2018. The molecular data with the most common mutations in PSC were extracted from the Catalogue Of Somatic Mutations in Cancer (COSMIC) database. Results: A total of 5259 patients with PSC were identified. Most patients were between 70 and 79 years of age (32.2%), male (59.1%), and Caucasian (83.7%). The male-to-female ratio was 1.45:1. Most tumors were between 1 and 7 cm in size (69.4%) and poorly differentiated (grade III) (72.9%). The overall 5-year survival was 15.6% (95% confidence interval (95% CI) = 14.4–16.9)), and the cause-specific 5-year survival was 19.7% (95% CI = 18.3–21.1). The five-year survival for those treated with each modality were as follows: chemotherapy, 19.9% (95% CI = 17.7–22.2); surgery, 41.7% (95% CI = 38.9–44.6); radiation, 19.1% (95% CI = 15.1–23.5); and multimodality therapy (surgery and chemoradiation), 24.8% (95% CI = 17.6–32.7). On multivariable analysis, age, male gender, distant stage, tumor size, bone metastasis, brain metastasis, and liver metastasis were associated with increased mortality, and chemotherapy and surgery were associated with reduced mortality (p < 0.001). The best survival outcomes were achieved with surgery. The most common mutations identified in COSMIC data were TP53 31%, ARID1A 23%, NF1 17%, SMARCA4 16%, and KMT2D 9%. Conclusions: PSC is a rare and aggressive subtype of NSCLC, usually affecting Caucasian males between 70 and 79. Male gender, older age, and distant spread were associated with poor clinical outcomes. Treatment with surgery was associated with better survival outcomes.
General practice experiences for parents of children with intellectual disability: a systematic review
Authors: Thomas Nicky , Atherton Helen , Dale Jeremy , Smith Kayla , Crawford Hayley 
Published: April 2023

BackgroundParents of children diagnosed with intellectual disability are at increased risk of mental and physical health difficulties compared with other parents. They are likely to regularly seek medical treatment for their health concerns from general practice as well as on behalf of their child with intellectual disability, yet there is limited evaluation of the role general practice plays for this patient group.AimTo explore parents’ experiences of general practice support when caring for a child with intellectual disability.Design & settingSystematic review of studies reporting experiences of general practice as described by parents who care for children with intellectual disability.MethodDatabases were searched using a pre-defined search strategy. Studies were included based on detailed inclusion criteria, title, abstract, and full-text screening. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). A narrative synthesis was conducted.ResultsA total of nine studies were identified. There was a clear absence of data on parents' own health experience and consultation in general practice. Findings related to navigating general practice on behalf of their child’s health including accessibility of general practice and positive and negative experiences of GPs.ConclusionFindings from this review highlight priority areas for research, including further exploration of parents’ perspectives on seeking support specifically for their own health concerns, while caring for a child with intellectual disability, to bring more awareness and understanding of the role general practice plays in supporting the health of this carer group. This review also considers implications for clinical services, including tailoring appointments for this patient group as a priority for continuity of care, which may result in improved experiences of general practice and encourage better communication.
Early-Stage vs. Growth-Stage Startups: Examining the Differences in the Perception of Factors Instrumental to Success
Authors: Lovrincevic Marina 
Published: April 2023

A stream of research available in the literature focuses on startup success factors, although there is a lack of consensus in determining what these factors are. In general, there are two critical groups of success factors, organizational and entrepreneurial, both considered to be integral parts of internal startup environment. Since the perception of early-stage (incubation stage) and growth stage (post incubation stage) startup entrepreneurs differ significantly they tend to perceive important success factors distinctively. As a result, attributes of success differ considerably. This paper aims at capturing internal startup environment as it is considered to be crucial in shaping startup’s success in contrast to external environment that is more remote and (usually) not manageable.
Primary data were collected using an online survey questionnaire and quantitative approach was used; data were analysed using descriptive statistics and Mann-Whitney U test. The final research sample consisted of 70 startups and the findings indicate that the perception of internal environment and its contribution to overall success differs significantly from the perspective of early-stage and growth stage startup entrepreneurs. Out of analysed internal factors, statistically significant differences were identified for prior experience in starting the company and self-confidence (individual’s/entrepreneur’s category factors) and internal startup organization and team-level competencies (organizational category factors).
The contribution of this research is evident in identifying important internal factors that determine startup’s success (that aspiring startup founders can benefit from) and providing an insight into the startup community in Croatia, thus contributing to a scarce empirical literature on the topic available. Limitations of the research include sample size and subjective assessment of the success factors, so recommendations for future research include repeating the research on a larger sample, covering the international level and widening a set of key-performance indicators that can be assessed at a higher level of rigour with objective metrics.
Refining Employees' Engagement by incorporating Self-Directedness in Training and Work Environments
Authors: Viterouli Mary , Belias Dimitrios , Koustelios Athanasios , Tsigilis Nikolaos 
Published: April 2023

Employee engagement constitutes a critical driver of business success in today's competitive marketplace, since it effectuates internal stimuli for action and reaction. Fostering engagement into one’s workforce is not a simple, one-dimensional task, but rather entails a multiplicity of factors and a conglomeration of approaches. The term ‘Employee Engagement’ relates to the level and breadth of an employee's commitment and connection to an organization and is influenced by a variety of factors such as organisational culture and communication schemata, managerial styles and leadership types, general policies and practices within the workplace. To this end, the aim of this paper is to introduce a strong connection between engagement and self-directedness by melding it with psychologically, educationally and strategically elaborated notions of facilitation (Knowles, 1975), self-actualization (Maslow, 1943) and autonomy (Lopes, Calapez and Lopes, 2015) along with operational tactics of learning and training that can address different mentalities and generations (Berkup, 2014). Employees need to be assisted in developing and evolving critical skills such as their self-directedness by means of empowerment. This study considers that empowerment and commitment can be achieved if management integrates self-directedness notions and principles into one’s training and work environment. A self-directed employee is a dynamic, self-reflective, mature and autonomous person that chooses to engage and remain engaged. Self-initiation can be displayed, communicated and instructed, since people are the making of social, cultural and discursive constructions (Lopez et al. 2015). Considering that self-directedness leads to improved personal agency and initiative, adaptability and employability in the labour market, and efficiency in terms of organisational performance, instilling it in employees translates to endorsing engagement into one’s personnel. That is why a detail literature review approach has been adopted for the research purpose highlighting significant works on self-directedness, empowerment and engagement. The data is collected from various databases, research articles, whitepapers, magazines, project works and the internet. This study contributes to extending literature on the relationship between self-directedness and engagement by addressing key practices and factors that attribute to fortifying their interrelation.
The Islands of Sanity in the Killing Fields of Inequalities: A juxtaposed case in Management, Leadership and Governance Practices!
Authors: Dwayi Valindawo Valile M 
Published: April 2023

This article was motivated by the conversations which ensued at ECMLG 2021 after a presentation on a similar topic. The question from the audience was whether the researcher and analyst still had tenure in the insider research project he had just shared. The response was in the affirmative, although serious concerns were expressed about the quality of the tenure, symbolized by the brutality and dehumanising tendencies of the then University Regime. Therefore, this project-based article at ECMLG 2022 continues from that debate. Mirrored on the national events as a result of the Justice Zondo Commission about State Capture in South Africa, the article focuses on one case of a university institution, which was arguable under a capture during a particular regime of a Vice Chancellor and Principal. The case of “The Killing Fields of Inequalities” is very typical of the national contexts, which is still steeped in settler colonialism and in a structured racist system, strangely almost thirty years into constitutional democracy. Such a case is juxtaposed with what can be referred to as “Islands of Sanity”! The two African folklore illustrate the case as reported in the article. Firstly, that the system can be changed but it will first try to eat you up! Secondly, that when the hyena wants to eat its own children, it first accuses them of smelling like rats. Therefore, the main argument, which serves as the anchor for the article, is to problematise the taken for granted claims about management, leadership and governance practices in university education spaces. This can be done by means of realist oriented scholarship projects, which ought to dig deeper than what appears on surface as leadership for the idea of university education as the public good. In this regard, the article suggests a realist social program, which is anchored on the critical realist philosophy, in accounting for the cited practices and in ways that can shed more light for the transformative outcomes than those reported in the article. It is envisaged that the article will have as the result, promotion of systemic conversations about the default position and fault consciousness in the idea of university education in general and how such an idea should be better managed, led and governed in the national development plans (in the case of South Africa, for example).