bluuebunny/crossref_metadata_2025_split huggingface dataset:
SURG-04. SIMULTANEOUS CRANIOTOMIES FOR MULTIPLE BRAIN METASTASES
Authors: Gassie Kelly , Chaichana Kaisorn , Garcia Henry Ruiz , Brown Desmond , Trifiletti Daniel , Burns Terry 
Published: August 2019

Abstract
BACKGROUND: It is well known that for patients with solitary metastatic disease in the brain, aggressive surgical treatment can prolong survival. However, there is a paucity of literature focusing on simultaneous resection of multiple metastatic brain tumors. METHODS: We analyzed 13 patients and 26 tumors between 2005–2019 who had simultaneous resection of at least 2 metastatic brain tumors via either one or two craniotomies. We independently analyzed those patients with simultaneous resection of metastatic disease in both the supra- and infratentorial compartments. RESULTS: Overall, 26 tumors were resected in a simultaneous fashion. There were 7 females (53.8%) and 6 males (46.2%) total. 5/13 (38.5%) patients had previously known brain metastases in which all 5 had previous adjuvant radiation. All 13 patients had 2 metastatic lesions resected during one operation. Gross total resection rate reached 88.5% with a median post-operative stay of 3 days. Complications presented in only 3 out of 13 cases (grade 2 and 3 according to CTCAE). Primary sites of metastatic disease were lung, breast, skin and renal. 12/13 (92.3%) had two distinct craniotomies and 23/26 (88.5%) tumors had gross total resection of both lesions. There were 11 frontal (42.3%), 7 parietal (26.9%), 2 temporal (7.7%), 1 occipital (3.8%) and 5 cerebellar (19.2%) tumors. There were three patients with both supra- and intratentorial tumors with simultaneous resection. All three patients had two craniotomies and two separate incisions. 1 of the 3 had pre-operative SRS. Overall, average local progression since surgery to at least one resected tumor bed was 88.3 days. CONCLUSIONS: Our results suggest that patients with multiple metastatic brain lesions have comparable outcomes and similar rates of surgical risk to those with solitary brain lesions. In patients with simultaneous supra- and infratentorial brain metastatic disease and indications for decompression, safe resection is feasible.
SURG-13. EVALUATION OF 5-ALA FLUORESCENCE IN BRAIN METASTASES OF VARIOUS PRIMARY TUMORS: A MULTICENTER STUDY WITH EXPERIENCE IN 157 CASES
Authors: Mercea Petra Andreea , Marhold Franz , Scheichel Florian , Kiesel Barbara , Mischkulnig Mario , Berghoff Anna , Woehrer Adelheid , Preusser Matthias , Knosp Engelbert , Ungersboeck Karl , Widhalm Georg 
Published: August 2019

Abstract
INTRODUCTION: Local recurrence of brain metastases following incomplete resection is not uncommon. One reason is insufficient intraoperative visualization of tumor tissue. Recently, visible intraoperative 5-aminolevulinic acid (5-ALA) fluorescence was reported in the first brain metastases series. Thus, the aim of this study was to investigate intraoperative 5-ALA fluorescence in brain metastases at two specialized centers in the largest patient cohort up to date. METHODS: 5-ALA was administered prior to resection of 157 brain metastases in 154 patients. Intraoperatively, the fluorescence quality (strong, vague or none) and fluorescence homogeneity (homogeneous or heterogeneous) of each brain metastasis was investigated. These 5-ALA fluorescence characteristics were correlated with primary tumor and histopathological subtype according to the current World Health Organization (WHO) 2016 criteria. RESULTS: Visible 5-ALA fluorescence was observed in 104 brain metastases (66%), whereas fluorescence was absent in the remaining 53 cases (34%).53/104 (51%) brain metastases showed strong fluorescence and 51/104 (49%) vague fluorescence. The majority of brain metastases (84%) demonstrated a heterogeneous fluorescence pattern. In context of primary tumor, visible fluorescence was less frequent in brain metastases of melanomas compared to all other tumors (p=0.037). Moreover, visible fluorescence was more common for ductal breast cancer subtype than other subtypes (p=0.008). CONCLUSION: Our data indicate that 5-ALA fluorescence is a valuable for intraoperative visualization of brain metastases to improve the extent of resection and thus patient prognosis. However, the frequent heterogeneous 5-ALA fluorescence pattern and lack of strong fluorescence limits the use of 5-ALA in brain metastases, claiming for further technical refinement.
The Feminine Origins of American Literary Realism
Authors: Forster Sophia 
Published: August 2019

Abstract
This chapter describes American literary realism as emerging from the efforts of a group of early postbellum women writers—Elizabeth Stoddard, Rebecca Harding Davis, Louisa May Alcott, and Elizabeth Stuart Phelps—to access the newly minted American high literary culture exemplified by the work of Nathaniel Hawthorne. The origins of realism, these writers’ texts show, lie in intertextuality. They not only revise their own and one another’s work to excise the vestiges of the popular feminine tradition of domestic sentimentalism, but they also rework Hawthorne’s canonical gothic plots and imagery in the context of a shift in literary tastes away from the romance and toward an aesthetic that values the contemporary and the everyday. Their adaptation of the Hawthornean gothic to address the patriarchal and capitalist foundations of social life yields the earliest version of American literary realism as a mode of structural social critique.
Spaces of Consumption in American Literary Realism
Authors: Totten Gary 
Published: August 2019

Abstract
This chapter discusses how consumer culture affects the depiction and meaning of the natural world in the work of American realist writers. These writers illuminate the relationship between natural environments and the social expectations of consumer culture and reveal how such expectations transform natural space into what Henri Lefebvre terms “social space” implicated in the processes and power dynamics of production and consumption. The representation of nature as social space in realist works demonstrates the range of consequences such space holds for characters. Such space can both empower and oppress individuals, and rejecting or embracing it can deepen moral resolve, prompt a crisis of self, or result in one’s death. Characters’ attempts to escape social space and consumer culture also provide readers with new strategies for coping with their effects.
Realism and the New Woman
Authors: Petty Leslie 
Published: August 2019

Abstract
This chapter discusses how the changing social and political landscape in late nineteenth-century America led to the figure of the New Woman and, specifically, how realist writers responded to the contemporary debate about gender exemplified by this new ideal. In the early nineteenth century, the True Woman ideal dictated gender norms of middle-class propriety, but because of the efforts of women’s rights activists—and in part because of the changes wrought by the Civil War—women gained more access to education, work, and the political arena via the suffrage movement. Widely read white novelists did not necessarily depict more politically engaged, professional women because of these changes, but they did explore the dehumanization and tragedy that attended conventional marriages. African American writers explored the role of women of color within the racial uplift movement as well as the women’s rights movement, revising the New Woman ideal to account for their black identity.
Realism and Medicine
Authors: Barrish Phillip 
Published: August 2019

Abstract
Exploring the relationship between literature and medicine, this chapter analyzes how three novels from the American realist period—Henry James’s Washington Square (1880), Sarah Orne Jewett’s A Country Doctor (1884), and Charles Chesnutt’s The Marrow of Tradition (1901)—represent the medical profession during its rise to what Paul Starr has called “professional sovereignty” in the United States. Although today we may take medicine’s elite status in our society for granted, together these novels reveal that its turn-of-the-century consolidation as a profession in which society would ultimately invest unique forms of authority and prestige was anything but uncontested. Through the fictions they created, realist writers offered nuanced critical perspectives on the modes through which medicine asserted its sovereignty and also probed underlying gendered and racial tensions, even violence, that the profession’s own self-representations sought to occlude.
Introduction
Authors: Newlin Keith 
Published: August 2019

Abstract
The Oxford Handbook of American Literary Realism offers thirty-five original chapters with fresh interpretations of the artistic and political challenges of representing life accurately. Organized by topic and theme, the chapters draw on recent scholarship in literary and cultural studies to offer an authoritative and in-depth reassessment of major and minor figures and the contexts that shaped their work. One set of chapters explores realism’s genesis and its connection to previous and subsequent movements. Others examine the inclusiveness of representation, the circulation of texts, and the aesthetic representation of science, time, space, and the subjects of medicine, the New Woman, and the middle class. Still others trace the connection to other arts—poetry, drama, illustration, photography, painting, and film—and to pedagogical issues in the teaching of realism.
Least Restrictive Environment and the Education of Children with Disabilities
Authors: Weber Mark C. 
Published: August 2019

Abstract
This chapter discusses the obligation in the federal special education law to provide education to children with disabilities in the least restrictive environment. It describes the relevant statutory and regulatory provisions and the prominent cases, and explores ongoing scholarly controversies about the least restrictive environment requirement and its application. The chapter observes that disputes over the least restrictive environment for a given child are often disputes over the range of accommodations and services that the schools must provide so that appropriate education of a child with disabilities may be achieved without separating the child from peers who do not have disabilities. Both the text and the judicial interpretations of the Individuals with Disabilities Education Act operate in such a way that the negative command to not segregate students with disabilities becomes a positive command to afford services to make inclusive education work. The chapter concludes by briefly comparing the developments in the United States with those in other countries.
How Public Engagement Became a Core Part of the House of Commons Select Committees
Authors: Walker Aileen , Jurczak Naomi , Bochel Catherine , Leston-Bandeira Cristina 
Published: August 2019

Abstract
This article explores the role of public engagement by select committees of the House of Commons. It shows that committees’ public engagement activity has been transformed since 1979, when departmental select committees were introduced. We start by outlining the different elements of public engagement, showing that it entails a wide range of types of activity from information about committees’ activity to opportunities through which citizens can shape parliamentary decisions. We then proceed to outline how public engagement has become a core activity of select committees in the House of Commons. We show developments taking place within all elements of public engagement. Through the use of case studies, we illustrate specific innovations that have led towards more agile and inclusive ways to consult and involve the public into committees’ activities. We finish by identifying some of the challenges still present, namely the need to reach new and more varied audiences.
Mid-infrared spectroscopy of zodiacal emission with AKARI/IRC
Authors: Takahashi Aoi , Ootsubo Takafumi , Matsuhara Hideo , Sakon Itsuki , Usui Fumihiko , Chihara Hiroki 
Published: August 2019

Abstract
Interplanetary dust (IPD) is thought to be recently supplied from asteroids and comets. Grain properties of the IPD can give us information about the environment in the proto-solar system, and can be traced from the shapes of silicate features around 10$\, \mu$m seen in the zodiacal emission spectra. We analyzed mid-infrared slit-spectroscopic data of the zodiacal emission in various sky directions obtained with the Infrared Camera on board the Japanese AKARI satellite. After we subtracted the contamination due to instrumental artifacts, we successfully obtained high signal-to-noise spectra and have determined detailed shapes of excess emission features in the 9–12$\, \mu$m range in all sky directions. According to a comparison between the feature shapes averaged over all directions and the absorption coefficients of candidate minerals, the IPD was found to typically include small silicate crystals, especially enstatite grains. We also found variations in the feature shapes and the related grain properties among the different sky directions. From investigations of the correlation between feature shapes and the brightness contributions from dust bands, the IPD in dust bands seems to have a size frequency distribution biased toward large grains and shows indications of hydrated minerals. The spectra at higher ecliptic latitudes showed a stronger excess, which indicates an increase in the fraction of small grains included in the line of sight at higher ecliptic latitudes. If we focus on the dependence of detailed feature shapes on ecliptic latitudes, the IPD at higher ecliptic latitudes was found to have a lower olivine/(olivine + pyroxene) ratio for small amorphous grains. The variation of the mineral composition of the IPD in different sky directions may imply different properties of the IPD from different types of parent bodies, because the spatial distribution of the IPD depends on the type of the parent body.
‘Our Looks, Two Looks’: Miniature Portraits in the Letters of Elizabeth Bishop and Robert Lowell
Authors: Baldock Sophie 
Published: August 2019

Abstract
This article examines parallels between the exchange of miniature portraits in late eighteenth-century letters and the exchange of photographs and keepsakes in the twentieth-century correspondence of American poets Elizabeth Bishop and Robert Lowell. Drawing on theories of the miniature in Susan Stewart’s work, alongside art-historical and literary-critical accounts of the practice of exchanging miniature portraits in letters, the article builds on arguments that portraits go hand-in-hand with the genre of letter writing. I argue that previous criticism of the Bishop-Lowell correspondence has not yet adequately explored their epistolary discussion and exchange of visual materials. As in the case of their eighteenth- and nineteenth-century predecessors, for Bishop and Lowell, letter writing frequently involved a literal and metaphorical exchange of portraits. The article places particular photographs in their original context alongside letters, demonstrating the symbiotic relationship between images and text and the key role played by the visual in letter writing. It provides a fresh reading of Bishop’s and Lowell’s linked poems, ‘The Armadillo’ and ‘Skunk Hour’, arguing that these poems are a means of portrait-painting in relation to the other. The poems are examined alongside descriptions of an antique miniature cameo, sent by Lowell to Bishop as a companion to his poem, which functions as an ambivalently gendered portrait of Bishop. Finally, the poets’ interlocking memoirs, ‘91 Revere Street’ and ‘Memories of Uncle Neddy’, are analysed to show their origin in letters, and their shared preoccupation with portraiture, scale and framing.
Role of good oral hygiene on clinical evolution of rheumatoid arthritis: a randomized study nested in the ESPOIR cohort
Authors: Mariette Xavier , Perrodeau Elodie , Verner Christian , Struillou Xavier , Picard Nicolas , Schaeverbeke Thierry , Constantin Arnaud , Ravaud Philippe , Bouchard Philippe 
Published: August 2019

Abstract

Objective
There is a relationship between RA and periodontal disease. We aimed to investigate if a good oral hygiene could improve activity of RA.

Methods
The patients with RA according to ACR/EULAR 2010 criteria and included in the French early arthritis ESPOIR cohort were included in a randomized nested study into: (i) intervention group: general recommendations of good oral hygiene including teeth brushing, daily antiseptic mouthwash and twice a year scaling; and (ii) control group: no intervention. The primary end point was the delta DAS28-ESR.

Results
Four hundred and seventy-two patients were randomized (238 in intervention and 234 in control). 92/238 from the intervention group accepted the procedure and 81 had a first visit to the dentist. 56% of patients had periodontal disease at baseline. Duration of RA was 9.0±0.7 years. Baseline DAS28-ESR was 2.7±1.3. After a median duration of 24 months, delta DAS28-ESR was −0.17±1.29 and −0.09±1.28 in intervention and control groups, respectively (mean difference (complier average causal effect): −0.37 (95% CI −1.12, 0.37), P = 0.33). In the intervention group, there was a significant decrease of the bacteria involved in the red complex: Porphyromonas gingivalis (P = 0.002), Tannerella forsythia (P = 0.002) and Treponema denticola (P = 0.019). The patients with baseline periodontal disease and those who became negative for one red complex bacterium had a slightly more important decrease of DAS28-ESR.

Conclusion
Oral hygiene instruction together with regular scaling and polishing of the teeth significantly decreased the load of periodontal pathogens but did not decrease RA activity. This intervention should be tested in patients with earlier RA and more active disease.

Trial registration
ClinicalTrials.gov, http://clinicaltrials.gov, NCT01831648.
Leprosy and the Colonial Gaze: Comparing the Dutch West and East Indies, 1750–1950
Authors: Snelders Stephen , van Bergen Leo , Huisman Frank 
Published: August 2019

Summary
This article is looking at colonial governance with regard to leprosy, comparing two settings of the Dutch colonial empire: Suriname and the Dutch East Indies. Whereas segregation became formal policy in Suriname, leprosy sufferers were hardly ever segregated in the Dutch East Indies. We argue that the perceived needs to maintain a healthy labour force and to prevent contamination of white populations were the driving forces behind the difference in response to the disease. Wherever close contact between European planters and a non-European labour force existed together with conditions of forced servitude (either slavery or indentured labour), the Dutch response was to link leprosy to racial inferiority in order to legitimise compulsory segregation. This mainly happened in Suriname. We would like to suggest that forced labour, leprosy and compulsory segregation were connected through the ‘colonial gaze’, legitimising compulsory segregation of leprosy sufferers who had become useless to the plantation economy.
17Theory on Theory
Authors: Sims Robin 
Published: August 2019

AbstractThis chapter reviews work published in 2018 which involves consideration of the significance of critical and cultural theory in the present day as well as the diverse legacies of some of its key figures. Books discussed include the English translation of Alain Badiou’s seminar on Lacan, a new series examining the legacies of Lacan alongside those of Derrida, Foucault, and Said, and Thomas Docherty’s analyses of the University’s turn towards servicing the market and of the relation between literature and capital. The chapter demonstrates the ongoing vitality of theory today, as well as its capacity to examine and challenge the supposed obviousness of the assumptions that underpin the status quo.
“Progress in Medicine Is Slower to Happen”: Qualitative Insights Into How Trans and Gender Nonconforming Medical Students Navigate Cisnormative Medical Cultures at Canadian Training Programs
Authors: Butler Kat , Yak Adryen , Veltman Albina 
Published: August 2019

Purpose
Trans and gender nonconforming (TGNC) people face significant health disparities compared with their cisgender (nontrans) counterparts. Physician-level factors play a role in these disparities, and increasing the participation of individuals from sexuality and gender minority (SGM) communities in medical training has been proposed as one way of addressing this issue; however, very little is known about the experiences of TGNC medical students. This study aimed to understand the experiences of TGNC medical students in Canada.

Method
Between April 2017 and April 2018, 7 TGNC participants either currently enrolled in or recently graduated from a Canadian medical school completed audiorecorded semistructured interviews. Interviewers asked about experiences with admissions; academic, clinical, and social environments; and interactions with administration. The authors analyzed interviews using a constructivist grounded theory approach.

Results
The authors developed 5 overarching themes: navigating cisnormative medical culture; balancing authenticity, professionalism, and safety; negotiating privilege and power differentials; advocating for patients and curricular change; and seeking mentorship in improving access and quality of care to TGNC patients. This article focuses on the first theme, with associated subthemes of culture and context; interactions with classmates, curriculum, policy, and administration; and gendered spaces.

Conclusions
The results of this study delineate heterogeneous experiences of medical cultures with a shared underlying pattern of erasure of TGNC people as both patients and clinicians. Findings were largely consistent with previously published recommendations for improving academic medical institutional climates for SGM people, though the need for access to appropriate gendered spaces beyond washrooms was highlighted.
Closing the Gap Between Preclinical and Clinical Training: Impact of a Transition-to-Clerkship Course on Medical Students’ Clerkship Performance
Authors: Ryan Michael S. , Feldman Moshe , Bodamer Cheryl , Browning Joel , Brock Ellen , Grossman Catherine 
Published: August 2019

Problem
Medical students typically perform worse on clinical clerkships that take place early in their training compared with those that occur later. Some institutions have developed transition-to-clerkship courses (TTCCs) to improve students’ preparedness for the clinical phase of the curriculum. Yet, the impact of TTCCs on students’ performance has not been evaluated.

Approach
The authors developed and implemented a TTCC at Virginia Commonwealth University School of Medicine and measured its impact on students’ clerkship performance. During the 2014–2015 academic year, they introduced a 2-week intersession TTCC. The goal was to improve students’ readiness for clerkships by fostering the knowledge, skills, and attitudes required to care for patients throughout a hospitalization. The TTCC included panel discussions, skills development sessions, case-based workshops, and a 4-station standardized patient simulation. The authors assessed the feasibility of designing and implementing the TTCC and students’ reactions and clerkship performance.

Outcomes
The total direct costs were $3,500. Students reacted favorably and reported improved comfort on entering clerkships. Summative performance evaluations across clerkships were higher for those students who received the TTCC with simulation compared with those students who received the standard clerkship orientation (P < .001–.04, Cohen’s d range = 0.23–0.62). This finding was particularly apparent in those clerkships that occurred earlier in the academic year.

Next Steps
Future plans include evaluating the impact of the TTCC on student well-being and incorporating elements of the TTCC into the preclinical curriculum.