bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative procedures in patients with advanced lung cancer: Analysis from a prospective outcomes database
Authors: Miner T. J. , Gaydos-Gabriel J. , Jaques D. P. 
Published: April 2020

8606 Background: Decisions regarding the appropriate use of palliative procedures continue to challenge those who care for patients with advanced cancer. This study examines the outcomes of palliative procedures performed for lung cancer compared to other primary malignancies. Methods: Procedures to explicitly palliate symptoms of advanced cancer were identified prospectively. Patients were observed for >90 days or until death. Clinical outcomes were evaluated based on the type of primary malignancy. Results: There were 1,022 palliative procedures performed in 823 patients from July 2002 to June 2003. Palliative procedures were most commonly performed in patients with lung cancer (14%, 117/823) for neurologic symtpoms-39%, shortness of breath-29%, gastrointestinal obstruction-15%, and other symtpoms-17%. Symptom improvement or resolution within 30 days was less common in patients with lung cancer (66%, 77/117) than in those with other primary malignancies (82%, 579/706, p=0.02). As observed in other cancers, recurrence of the primary symptom occurred in 25% (p=0.46) while treatment of debilitating additional symptoms was required in 30% (p=0.39). Palliative procedures in patients with lung cancer were associated with similar 30-day postoperative morbidity (33% versus 34%, p=0.97) but increased mortality (22% versus 10%, p<0.001). Median overall survival from the time of the palliative procedure was significantly shorter in patients with lung cancer than all other primary malignancies (90 days versus 124 days, p<0.001). Conclusions: Careful patient selection for palliative procedures is required in patients with advanced lung cancer. These interventions are associated with shorter anticipated survival, higher perioperative mortality and less frequent symptom resolution compared to palliative procedures performed in patients with other primary malignancies. Symptom severity may necessitate, however, palliative procedures in patients with lung cancer. The compelling nature of shortness of breath often dictates intervention regardless of durability and illustrates the importance of symptom relief for a significant percentage of remaining life even when measured in days. No significant financial relationships to disclose.
Determinants of failure of venous access devices in outpatient oncology
Authors: Sanjay R. , Bielagus K. , Mohamed T. , Krentzin M. , Weinstein R. 
Published: April 2020

8613 Background: Little guidance is available regarding the optimum placement and use of implantable venous access devices (VAD) in cancer treatment. We present herein 10 years of experience with VAD in a university hospital oncology clinic. Methods: Post hoc analysis of prospectively collected records of 346 cancer patients in whom 362 VAD (Port-a-Caths) were placed between January 1995 to December 2005. Primary end points included need for instillation of tissue plasminogen activator (TPA) to restore patency, need for an x-ray dye study to determine catheter salvageability, and premature removal because of VAD failure. We used Chi-square analysis to compare VAD placement by the Radiology service under fluoroscopy vs. placement by Surgery in the operating room (OR), placement in the right vs. left chest and internal jugular (IJ) vs. subclavian (SC) vein placement. Results: OR-placed VAD, more often than Radiology-placed VAD required TPA for patency (18.6% vs 8.07%, p<0.01), a dye study (11.7% vs 2.69%, p=0.001) or premature removal (14.7% vs 5.38%, p<0.01). Right- and left-sided VAD were equally likely to receive TPA (9.2% vs 16.1%, p=0.11) but left-sided VAD required more dye studies (3.3% vs 10.7%, p=0.013) and were prematurely removed more often (5.5% vs 15%, p=0.007). 29 (8%) of VAD were prematurely removed because of infection (n=11), thrombosis(n=6), pain (n=2), mechanical malfunction (n=6) and others (n=4). Gender, age (< vs. > 60 years), site of placement (IJ vs. SC) or body mass index (< vs. > 25) had no bearing on the primary endpoints. Intrathoracic cancer was associated with more TPA treatment of the VAD (16.8% vs. 8.4%, p<0.023) but not with dye studies (7.9% vs. 4%, p=0.191) or removal (6.1% vs. 8.8%, p=0.517). Conclusions: AVAD will usually last until completion of cancer therapy. Occlusion or premature removal is less likely in a VAD placed on the right side under fluoroscopic guidance by an experienced radiologist. Thoracic disease, site of placement, obesity, age or gender do not determine adverse outcomes for VAD. No significant financial relationships to disclose.
Hand-foot syndrome (HFS) in patients treated with capecitabine (CAP) and the role of thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD)
Authors: Juneja V. , Black G. , Thornton J. , Russo S. , Johnson M. , Diasio R. , Saif M. W. 
Published: April 2020

8615 Background: HFS is the most common toxicity of CAP. Preclinical studies have shown that radiation (XRT) up-regulates TP, which may in turn increase efficacy of CAP. CAP is degraded by DPD, and a deficiency in this enzyme may increase toxicity of CAP. However, effect of XRT on frequency of HFS and association with TP and DPD has not been fully characterized. Methods: Toxicity data were collected from pts with LA pancreatic cancer enrolled in 3 clinical trials conducted at UAB between Apr 2001 and Jul 2005. Overall results of these trials have been reported elsewhere. Pts received XRT (50.4 Gy) with CAP (1,200–1,600 mg/m2 BID M-F) followed CAP (2,000 mg/m2 BID x 14 days). Pts were classified into 2 groups to evaluate HFS: CAP-XRT and CAP. Roche grading was used to assess HFS. Dose modifications were according to drug insert. Pts received prophylactic udder cream and pyridoxine. Tumor specimens were procured in 36 pts by EUS-FNA 1 wk pre- and 2 wks post XRT to evaluate TP and DPD. Age, race, sex, and PS were evaluated as prognostic factors. Results: Median duration of CAP was 6 wks (range: 3–6) for CAP-XRT and 2.5 cycles (range: 0–17) for CAP. Among 58 pts, 14 developed HFS (24%). CAP group had a higher incidence of HFS than CAP-XRT (17.2 % vs. 10.3 %; P = 0.12). Grade 2/3 HFS was observed in 15.5 % of CAP and 1.7 % of CAP-XRT (P = 0.0078). Median cumulative dose of CAP for first development of HFS was 235,000 mg/m2 in CAP-XRT group and 3,185,000 mg/m2 in CAP, with relative frequency of an event occurring in CAP-XRT vs. CAP of 0.59. HFS occurred at a median of 5 wks in CAP-XRT and 6 wks in CAP. Log-rank test showed neither age, sex, ECOG PS, or race was associated with development of HFS. There was no difference in tumor responses of pts with vs. without HFS. Mean tumor TP was higher among pts with vs. without HFS (275.77 vs. 215.29; P = 0.32). Mean tumor DPD was lower among pts with vs. without HFS (55.18 vs. 63.58; P = 0.49). Mean TP:DPD ratio was higher among pts with vs. without HFS (10.29 vs. 3.04; P = 0.31). Conclusions: This study suggests that incidence, severity, and time to occurrence of HFS with CAP-XRT < CAP, indicating no effect of XRT. No significant association of HFS with higher tumor TP or lower tumor DPD was found. Pharmacological basis for HFS with CAP needs to be explored. [Table: see text]
Aprepitant as salvage antiemetic therapy in breast cancer patients receiving doxorubicin and cyclophosphamide (AC)
Authors: Hesketh P. J. , Younger J. , Sanjay R. , Trainor B. , Sanz-Altamira P. , Krentzin M. , Hayden M. , Hesketh A. M. 
Published: April 2020

8618 Background: Aprepitant (APR), a neurokinin-1 receptor antagonist, has efficacy in the prevention of nausea and vomiting (NV) in breast cancer (BC) patients (pts) receiving doxorubicin (A) and cyclophosphamide (C) (JCO 2005, 23:2822). Nevertheless, many pts continue to receive only 5-hydroxytryptamine antagonists and dexamethasone (doublet therapy) during cycle 1 of AC. APR is often used as a salvage treatment, with anecdotal reports of improved outcome. We sought to prospectively evaluate this issue in a phase II trial. Methods: Design: multicenter study funded by an unrestricted grant from Merck. Eligibility: BC pts receiving their first cycle of A (≤ 60 mg/m2) and C (≥ 500 mg/m2) on day (d) 1. Antiemetics: ondansetron 8mg IV/PO, or dolasetron 100 mg IV/PO, or granisetron 1 mg IV or 2 mg PO on d 1; and dexamethasone (dex) 8–10 mg IV/PO d 1 and 4 mg PO bid d 2–3. Pts without complete control (no emesis, nausea, or rescue antiemetics) during cycle 1 could continue to cycle 2.During cycle 2, pts again received AC and identical antiemetics (except dex only 4 mg qd d 2–3) plus APR 125 mg PO d 1 and 80 mg PO d 2–3. Data on nausea (4-point scale), emesis and rescue was collected with a pt-report diary. Primary end point: proportion of pts with complete control (CC) during the 120-hours after chemotherapy. Secondary endpoints included acute (< 24 hrs), delayed (24–120 hrs) CC and complete response (no emesis or rescue) Results: Pts: total (47), female (47), eligible (46), analyzed (42), still on study (4). Median age: 49 yrs. CC during cycle 1: 8 pts (19%). Thirty-four pts continued to cycle 2. During cycle 2, 7 pts (21%)(95% CI 9–38%) achieved CC and 13 pts (38 %) complete response (CR) for the 120-hour study period. Acute CR and delayed CR rates for cycles 1 and 2 were 32%(11 pts) vs 68% (23 pts) (p=0.01) and 12%(4 pts) vs 44% (15 pts) (p=0.02) respectively. No emesis rates were 38 vs 79 % during cycles 1 and 2 respectively(p=0.02). The proportion of pts with no nausea or severe nausea for cycles 1 and 2 were 0 vs 21% and 12 vs 3 % respectively. Conclusions: The addition of APR to standard doublet therapy improves antiemetic outcome in BC pts receiving AC who failed to achieve CC during cycle 1 with standard doublet therapy alone. Improvement is seen in the control of emesis and nausea. APR was well tolerated. [Table: see text]
Intravenous ghrelin for cancer-related anorexia/cachexia: A randomized, placebo-controlled, double-blind, double cross-over phase I/II study
Authors: Strasser F. , Lutz T. , Thürlimann B. , Mäder M. , Büche D. , Brändle M. , Von Moos R. , Tschöp M. , Demmer R. , Cerny T. 
Published: April 2020

8619 Background: Ghrelin is a natural hormone with stimulatory effects on appetite and body weight. We assessed safety, tolerability, pharmacokinetics, and preliminary efficacy of intravenous ghrelin in patients (pts) with cancer-related anorexia/cachexia. Methods: In a cross-over study 21 pts (median age 68 [44, 79]) were randomized for ghrelin (Merck Biosciences, Switzerland) given over 60 min before lunch or placebo on d1 and d8, or d4 and d11. Ten pts received low dose ghrelin (LD) 2mcg/kg, 11 pts high dose ghrelin (HD) 8mcg/kg. Safety and tolerability were assessed using CTC-Toxicity Criteria, cardiac examination, tumour measurement, and IGF-1. Pts preference for ghrelin or placebo was assessed at d8 and d17/18. Nutritional intake of lunch at treatment days (NIL) was measured in the hospital and thereafter daily by pts. Eating-related symptoms and blood levels of hormones were monitored during treatment days. Results: Adverse events possible or probable related to study drug, including 1 SAE (apoplectiform deafness, placebo), did not differ between ghrelin and placebo in pts on LD (7 vs. 14) and HD (19 vs. 13). Of 8 pts with SD at study entry, 1 had PD, 1 dropped out, and 6 pts remained SD during study. Of 12 pts with PD at study entry, 1 remained PD, 10 were SD, and 1 dropped out. 1 pat with PR at study entry had SD. Ghrelin treatment was preferred at d8 by 8/10 pts of LD and 9/11 of HD, and at d17/18 by 6/9 pts of LD and 6/10 of HD. Variability of nutritional intake and eating-related symptoms were high. They did overall not statistically differ between ghrelin (LD, HD) and placebo. At study start NIL was 642 kcal (SD 284) for LD and 424 (196) for HD. Weight remained unchanged. Total ghrelin levels were higher (p<0.05) for HD at d17/18 (3580pg/ml) than study start (990), not for LD (950/1000). Active ghrelin, GH, or IGF-1 did not increase at d17/18 compared to study start. Conclusions: Ghrelin is well tolerated and safe in pts with far advanced cancer and anorexia/cachexia. More patients preferred ghrelin than placebo, without significant changes in nutritional intake or symptoms. Higher levels of total ghrelin at study end may suggest carry-over effects. Further research will explore schedule and dose modifications and mechanisms of ghrelin resistance. [Table: see text]
Transwomen and bone mineral density: a cross-sectional study in Brazilian population
Authors: Chrisostomo Kadija Rahal , Skare Thelma L. , Chrisostomo Henrique Rahal , Barbosa Edna J. Litenski , Nisihara Renato 
Published: April 2020

Objectives:
Transgender individuals submitted to hormone or surgical treatment may have alterations in their bone metabolism as these elements are important players in bone remodeling. We aimed to study bone mineral density (BMD) and body composition in transwomen undergoing cross-sex hormonal treatment (CSHT) from Brazil for over 3 years, comparing them with female and male controls.

Methods:
93 individuals (31 transwomen, 31 females and 31 males paired for age and body mass index) were studied for bone mass, and body composition by densitometry (by DXA). Epidemiological and clinical data were collected through direct questioning.

Results:
Low bone mass (T score ≤2) was found in 12.9% of transwomen; in 3.2% of females and 3.3% of males. Transwomen individuals had lower spine Z score (0.26 ± 1.42 vs 0.50 ± 1.19) and femur Z score (−0.41 ± 0.95 vs 0.29 ± 1.04) than females. They had lower total femur Z score than males (−0.41 ± 0.95 vs 0.20 ± 0.83). Lean mass values correlated positively with total femur BMD (ρ = 0.40; 95% confidence interval = 0.009–0.68; p = 0.04) and BMD in femoral neck (ρ = 0.48; 95% confidence interval = 0.11–0.74; p = 0.01) but neither the type of therapy received nor the time that they were used, impacted bone mass.

Conclusion:
Low BMD is found frequently in transwomen and it is correlated with lean body mass.

Advances in knowledge:
There are few studies of the effects of hormone therapy on the bones and muscles of transwomen. This study demonstrated that significant changes occur, and that the population studied needs greater care in musculoskeletal health.
Length–weight relationships and condition factors of mullets Liza macrolepis and Moolgarda engeli (Pisces: Mugilidae) harvested from Lambada Lhok waters in Aceh Besar, Indonesia
Authors: Yulianto Derita , Indra Indra , Batubara Agung Setia , Efizon Deni , Nur Firman M. , Rizal Syamsul , Elvyra Roza , Muchlisin Zainal Abidin 
Published: April 2020

Background: The mullets fish Liza macrolepis and Moolgarda engeli are predominant in the Lambada Lhok waters in Aceh province. At present, no scientific report on this species in Aceh waters is available. Therefore, the objective of the present study is to examine the growth pattern and condition factor of the species of mullets L. macrolepis and M. engeli harvested from the aforementioned coastal waters. Methods: The sampling was done in three locations in the Lambada Lhok waters from July to November 2018. The fish were captured using gillnets from 6:00 AM to 3:00 PM four times a month for five months. A total of 242 L. macrolepis and 109 M. engeli were used for the analysis. The growth pattern was analyzed using linear allometric model; then, two condition factors, Fulton’s and relative weight, were calculated. Results: The study revealed a b value of 2.49 for the male L. macrolepis and 1.81 for the female. The b value was 3.22 for the male M. engeli and 3.41 for the female. The b value of the fish was higher during the dry season. The Fulton’s condition factor of the male L. macrolepis was 1.19, and that of the female was 1.19. The relative condition factor of this species was 100.11 and 100.01 for males and females, respectively. The Fulton condition factor of male M. engeli was 1.05 and that of the female was 1.06. The relative weight condition factors were 101.08 and 100.61 for the male and female, respectively. Conclusions: The growth pattern of M. engeli tends to be isometric, whereas that of L. macrolepis has a negative allometric growth pattern. The condition factors indicate that the Lambada Lhok waters are still in good condition and support the growth of the mullets, but M. engeli is more adaptable than L. macrolepis.
Two Eyes, Two Fingers, Two Minutes: Making It Easier to Recognize and Manage Medical Emergencies in Dental Practice Part 1: The Modified Dental Early Warning Score (M-DEWS2)
Authors: Morse Jerry , Bonsor Stephen J 
Published: April 2020

Medical emergencies can happen at any time and in any place, including the dental practice setting. Recognizing the patient who is becoming unwell and remembering how to manage such emergencies can be quite daunting, especially for those who do not do so on a regular basis. The present paper describes the development of an observation recording sheet (M-DEWS2), including an escalation protocol and quick medication reference table for dealing with the common medical emergencies that may occur in the dental setting. A second paper will review how to manage and treat the eight common medical emergencies using treatment algorithms in conjunction with the M-DEWS2 tool. CPD/Clinical Relevance: All members of the dental team must possess an up-to-date knowledge of dealing with medical emergencies and managing such situations.
A Novel way to identify individual eruption chains
Authors: Bronkhorst Adele , Santhanam Vijay , Jeremiah Huw G 
Published: April 2020

A common way of treating impacted teeth is by orthodontic extrusion. When the teeth are deeply buried in the alveolar bone a closed eruption technique is often indicated. When multiple teeth are impacted and need to be extruded in a particular sequence, it may be difficult to be sure which eruption chain is attached to a particular tooth. This case report demonstrates a novel way of identifying individual eruption chains. CPD/Clinical Relevance: This case report demonstrates a novel way of identifying individual eruption chains attached to multiple impacted teeth.
Substrate-engraved antireflective nanostructured surfaces for high-power laser applications
Authors: Ray Nathan J. , Yoo Jae-Hyuck , Nguyen Hoang T. , Johnson Michael A. , Elhadj Selim , Baxamusa Salmaan H. , Feigenbaum Eyal 
Published: April 2020

A critical component for all high-power laser systems that is particularly susceptible to laser damage is the antireflective coating, which maximizes energy transmission and minimizes scattered and stray light. We demonstrate the ability to generate substrate-engraved nanostructured surfaces (NS) for scalable and designable antireflective (AR) coatings that are monolithic to the substrate and can handle peak power levels comparable to the bulk material. Experimentally measured reflectance from these fabricated structures has validated our effective index theory-based transmission matrix model, demonstrating the designability of the AR properties. Upon exposure to sufficiently high fluences, a new mode of damage, nanostructured surface damage, has been observed and is likely the result of thermally driven material reflow accompanied by plasma initiation on the nanostructured surface. At 1053 nm, nanostructured surface damage onsets at

39

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/

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m

2

with sample cleaning and

74

J

/

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m

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after laser conditioning—very close to the reference substrate at

81

J

/

c
m

2

. At 351 nm we show damage onset of

30

J

/

c
m

2

, with reference substrate material damage onset of

47

J

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m

2

. Therefore, damage is close to the bulk material and represents an improvement with respect to other methods. The nanostructured surfaces were found to be mechanically durable and able to withstand cleaning procedures with sonication. Under normal incidence mechanical testing with a 200 µm radius indenter tip, the AR performance of these nanostructured surfaces was minimally impacted at pressures orders of magnitude higher than an average fingerprint pressure—indicating that incidental handling contact will not affect NS structures. Mechanical damage is attributed to plastic compression, not fracturing of the NS features. We demonstrate for the first time, to the best of our knowledge, that NS AR coatings, despite being rich in etched surface features, can tolerate laser fluences comparable to unprocessed optical surfaces. Furthermore, laser-damage features of NS indicate a unique non-growing failure mode whereby following absorption the featureless damage site does not precipitate future damage growth, reducing considerably the burdens for managing optics processing in high-power laser systems.
‘These are modern times’: Nostalgia and the adaptation of history in Billy Morrissette’s Scotland, PA
Authors: Gearhart Stephannie S. 
Published: April 2020

Abstract
Set in America in the 1970s, Billy Morrissette’s 2001 adaptation of Shakespeare’s Macbeth, Scotland, PA, waivers between nostalgia and critique. In order to understand the film’s conflicting attitudes towards the era in which it is set and to appreciate how adaptations, generally, often feel ambivalent about their past(s), this essay begins by discussing Scotland, PA’s construction of the 1970s. In an effort to answer Lynne Bradley’s call for ‘a new model’ of modern adaptation, seeing it as ‘a complex double gesture’, the essay discusses how although Scotland, PA appears to illustrate many of the qualities of what Fredric Jameson has called the nostalgia film, this categorization of the adaptation neither accounts for its use of irony nor for the inherently complex nature of nostalgia. Ultimately, Scotland, PA’s ambivalence about history, the essay proposes, encourages us to conceive of the relationship between source/past and adaptation/present as a site of complex, dynamic negotiations rather than a static dichotomy that obliges us to choose between an adaptation’s acceptance or rejection of its forebears.
Screening the Royal Shakespeare Company: A Critical History, John Wyver (2019)
Authors: Heijes Coen 
Published: April 2020

Abstract

Screening the Royal Shakespeare Company: A Critical History, John Wyver (2019)
London and New York: The Arden Shakespeare, 288 pp.,
ISBN 978-1-35000-658-4, h/bk, £67.50; ISBN 978-1-35000-659-1, e/bk, £64.80
Cycles, Sequels, Spin-offs, Remakes, and Reboots: Multiplicities in Film and Television, Amanda Ann Klein and R. Barton Palmer (eds) (2016)
Authors: Cascajosa Concepción 
Published: April 2020

Review of: Cycles, Sequels, Spin-offs, Remakes, and Reboots: Multiplicities in Film and Television, Amanda Ann Klein and R. Barton Palmer (eds) (2016)
Austin: University of Texas Press, 367 pp.,
ISBN 978-1-47730-817-2, p/bk, $29.95
Pixar with Lacan: The Hysteric’s Guide to Animation, Lilian Munk Rösing (2016)
Authors: King Edward 
Published: April 2020

Review of: Pixar with Lacan: The Hysteric’s Guide to Animation, Lilian Munk Rösing (2016)
New York and London: Bloomsbury, 181 pp.,
ISBN 978-1-62892-059-8, h/bk, £31.30