bluuebunny/crossref_metadata_2025_split huggingface dataset:
RADI-24. VENTRICULOMEGALY AFTER STEREOTACTIC RADIOSURGERY (SRS) FOR BRAIN METASTASES (BM): A PILOT ANALYSIS OF TWO INSTITUTIONAL EXPERIENCES
Authors: Alattar Ali , Bartek Jiri , HIrshman Brian , Chen Clark 
Published: August 2019

Abstract
INTRODUCTION: Ventriculomegaly, or dilatation of the cerebrospinal fluid (CSF) space, occurs after whole-brain radiation (WBRT) of brain metastasis (BM) patients due to either 1) hydrocephalus or 2) cerebral atrophy from radiation-induced white matter injury. In this study, we examined whether cumulative radiation from repeat stereotactic radiosurgery (SRS) increases the risk of ventriculomegaly. METHODS: Patients were included if they underwent SRS of BM from 2007–2017 and had imaging follow-up. We examined a cohort of 214 patients treated at the University of California San Diego (1,106 BM) and a second cohort of 148 patients (1,760 BM) treated at Karolinska Institutet. Ventriculomegaly was defined according to established morphometric criteria. Patients were grouped according to the development of new ventriculomegaly at last follow-up. Demographic, clinical, and dosimetric factors were compared between groups using univariable and multivariable logistic regressions. RESULTS: In the UCSD cohort, 63 patients (29%) presented with ventriculomegaly before SRS. Of 151 remaining patients with normal ventricular size before first SRS, 30 (20%) developed new ventriculomegaly. The odds of developing ventriculomegaly increased with history of WBRT (OR 5.247, p&lt; 0.001) and trended toward significance with a greater number of SRS treatments (OR 1.296, p=0.075). In the Karolinska cohort, the odds of developing new ventriculomegaly trended towards significance with a greater number of SRS treatments (OR 1.605, p=0.26). To test whether this trend would achieve significance in a larger sample, we repeated the analysis in the combined cohort of 362 patients. The association between number of SRS treatments and developing ventriculomegaly reached significance (OR 1.254, p=0.049). CONCLUSIONS: These pilot findings suggest that cumulative radiation from repeat stereotactic radiosurgery (SRS) potentially increases the risk of ventriculomegaly. Based on our study, a prospective study of &gt;350 patients will be needed to further test this hypothesis.
RADI-27. ROLE OF STEREOTACTIC RADIOSURGERY IN THE CARE OF PATIENTS WITH &gt;/= 25 CUMULATIVE BRAIN METASTASES
Authors: Benjamin Carolina , Mureb Monica , Donahue Bernadine , Sulman Erik , Silverman Joshua , Bernstein Kenneth , Kondziolka Douglas 
Published: August 2019

Abstract
INTRODUCTION: Stereotactic radiosurgery (SRS) is an accepted treatment for multiple brain metastases. However, the upper limit of the number of brain metastases over the course of care suitable for this approach is controversial. METHODS: From a review of our prospective registry, 48 patients treated with SRS for ≥ 25 brain metastases in either single or multiple sessions between 2013 and 2019 were identified. Patient, tumor, and treatments characteristics were evaluated. Clinical outcomes and overall survival (OS) were analyzed. RESULTS: Thirty-one females (64.6%) and 17 males (35.4%) with a median age of 56 years (25–91) were included. Primary diagnoses included lung (n=23, 47.9%), breast (n=13, 27.1%), melanoma (n=8, 16.7%), and other (n=4, 8.33%). Initial median GPA index was 2 (0.5–3). Nine patients (18.8%) had received whole brain radiation therapy (WBRT) prior to first SRS treatment, with a median dose of 35Gy (30–40.5Gy). Ten patients (20.8%) received WBRT after initial SRS, with a median dose of 30Gy (20-30Gy). Thus, only 19 patients (40%) ever received WBRT. Median number of radiosurgeries per patient was 3 (1–12). Median number of cumulative tumors irradiated was 31 (25–110). Median number of tumors irradiated at first SRS was 10 (1–35). Median marginal dose for the largest tumor per session was 16Gy (10-21Gy). Median SRS total tumor volume was 6.8cc (0.8–23.4). Median follow-up since initial SRS was 16 months (1–71). At present, 21 (43.7%) are alive. Median OS from the diagnosis of brain metastases was 31 months (2–97), and OS from the time of first SRS, 22 months (1–70). Median KPS at first SRS and last follow-up was the same (90). Sixty-three percent did not require a corticosteroid course. CONCLUSION: In selected patients with a large number of cumulative brain metastases (≥ 25), SRS is effective and safe. Therefore, WBRT may not be required in this population.
RADI-30. TREATMENT OF MULTIPLE BRAIN METASTASES WITH CYBERKNIFE® (CK) INITIAL EXPERIENCE AT THE RADIONCOLOGY DEPARTMENT JÚLIO TEIXEIRA SA – PORTO – PORTUGAL
Authors: Costa Maria Adelina , Vale Joana , Silva Catarina , Campos Guilherme , Fonseca Graça , Cavaco Ana , Guedes Ricardo , Genésio Paula , Rodrigues Fátima , Conde João , Calçada Cármen , Fardilha Carlos , Ponte Fernanda , Costa Paulo 
Published: August 2019

Abstract
Brain metastases (BM) represent an important cause of morbidity and mortality being the most common intracranial tumors in adults. Their incidence is rising for several reasons: an aging population, better systemic treatment and better diagnostic imaging techniques allowing the detection of smaller metastases in asymptomatic patients. Traditionally, the most widely used treatment for patients with multiple BM is whole brain radiation therapy (WBRT), which remains a source of debate because, although distant brain control rates have been shown to be greater with WBRT, it has no impact on overall survival and the negative effects on cognition and quality of life are higher. Radiosurgery plays a significant role in the modern management of BM. We analyzed 38 patients with multiple BM (13 with more than one treatment, totalizing 61 cases) treated with CyberKnife® (CK) in the Radioncology Department Júlio Teixeira SA, from August 2016 to February 2019, for a total of 178 lesions. The average volume was 9,2cc (0,01-73,2). Total dose ranged 18-30Gy delivered in 1–5 fractions. The average nCI was 1,23 (0,19-1,69). Tumor coverage of at least 95% was obtained by prescribing the therapeutic dose to isodose lines ranging from 69–90%. Whole brain tissue was outlined as a critical structure. The average volume of 14Gy (single fraction) and 23Gy (multiple fractions) for normal brain tissue was 6,35cc and 12,4cc, respectively. The treatment was well tolerated, with improvement or resolution of the initial neurological symptoms. Among all radiosurgical platforms the CK offers the advantage of delivering with stereotactic precision high doses of radiation without the invasive attachment of a localizing frame. As a result, in many cases, became the method of choice for treating multiple brain metastases. The attractive therapeutic profile of CK radiosurgery is reflected by a high tumor control and low toxicity allowing retreatment for recurrent metastases.
The Impact of E-liquid Propylene Glycol and Vegetable Glycerin Ratio on Ratings of Subjective Effects, Reinforcement Value, and Use in Current Smokers
Authors: Smith Tracy T , Heckman Bryan W , Wahlquist Amy E , Cummings K Michael , Carpenter Matthew J 
Published: August 2019

Abstract

Introduction
Electronic nicotine delivery systems (ENDS) vary on a wide range of characteristics that may affect reinforcement value and use. One characteristic is the ratio of two solvents commonly used in most e-liquids: propylene glycol (PG) and vegetable glycerin (VG). The goal of this study was to understand how PG/VG ratio affects subjective effects, reinforcement value, and tobacco use patterns among current smokers who try using ENDS.

Aims and Methods
Current smokers with minimal ENDS use history (n = 30) sampled, in a double-blind fashion, three different e-liquids that varied in PG/VG ratio (70/30, 50/50, 0/100) while holding constant other aspects of the e-liquid and ENDS. Participants tried each e-liquid before rating the subjective effects on a modified version of the Cigarette Evaluation Questionnaire. Reinforcement value was assessed using a preference task where participants chose between the three e-liquids. The impact of each e-liquid on cigarette reinforcement was assessed using a modified version of the Cigarette Purchase Task. Participants were randomly assigned to receive one e-liquid to take home for 1 week.

Results
PG/VG ratio had minimal impact on most of the tested outcomes. Participants rated the highest PG concentration as having a stronger “throat hit” than the other two. There was no significant difference between the number of participants who preferred each of the PG/VG ratios in the preference assessment. PG/VG ratio did not affect cigarette or ENDS use during the sampling week.

Conclusions
These data suggest that PG/VG ratio has minimal impact on subjective effects and reinforcement value in ENDS naive current smokers.

Implications
These data suggest that PG/VG ratio, within the range that is commonly used, has minimal impact on subjective effects, reinforcement value, or uptake in current smokers with minimal ENDS experience.
High Rates of Menthol Cigarette Use Among Pregnant Smokers: Preliminary Findings and Call for Future Research
Authors: Stroud Laura R , Vergara-Lopez Chrystal , McCallum Meaghan , Gaffey Allison E , Corey Alana , Niaura Raymond 
Published: August 2019

Abstract

Introduction
Smoking during pregnancy remains widespread and is causally associated with infant morbidity and mortality. Despite links between menthol cigarette use and decreased smoking cessation, little is known regarding rates or characteristics of pregnant menthol cigarette smokers.

Methods
Participants were drawn from two low-income, racially/ethnically diverse cohorts of pregnant smokers recruited from 2006 to 2015 (N = 166, Mage = 25 ± 5). Demographics, menthol cigarette use, daily cigarette use, quit status, and consecutive weeks quit were assessed by prospective interviews. Nicotine dependence was assessed using the Fagerström Test of Nicotine Dependence. Nicotine levels were assessed via saliva cotinine.

Results
High rates of menthol use were found in both cohorts (85% and 87%). Across both cohorts, menthol smokers were more likely to identify as racial/ethnic minorities, were less educated, and reported lower income than non-menthol smokers (ps &lt; .03). Menthol smokers also reported fewer continuous weeks quit (8.4 vs. 14.5 weeks quit; p &lt; .03) and a tendency toward decreased likelihood of quitting smoking over pregnancy (29% vs. 48%; p &lt; .08) in unadjusted but not in covariate-adjusted analyses. No differences emerged in cigarettes per day, nicotine dependence or nicotine exposure.

Conclusions
We found very high rates of menthol cigarette use in pregnant smokers—particularly among racial/ethnic minority and low socioeconomic status smokers—and some evidence for associations with reduced smoking cessation in pregnancy. Consideration of pregnant smokers as a uniquely vulnerable population is warranted in evaluating regulation of menthol in cigarettes. Further research is needed regarding the impact of menthol on smoking persistence in pregnancy and on maternal and infant health outcomes.

Implications
This study highlights high rates of menthol cigarette use in pregnant women in the Northeast, United States, with evidence for higher rates of menthol use among racial/ethnic minority, less educated and low-income pregnant smokers, and preliminary evidence for associations between menthol cigarette use and reduced smoking cessation. Consideration of the effects of menthol on smoking persistence in pregnant women and on the health of their offspring is warranted in the development of regulations regarding menthol in cigarettes.
Sofosbuvir Add-on to Ribavirin Treatment for Chronic Hepatitis E Virus Infection in Solid Organ Transplant Recipients Does Not Result in Sustained Virological Response
Authors: van Wezel E M , de Bruijne J , Damman K , Bijmolen M , van den Berg A P , Verschuuren E A M , Ruigrok G A , Riezebos-Brilman A , Knoester M 
Published: August 2019

Abstract
Ribavirin is effective for treating immunocompromised patients with chronic hepatitis E virus infection. However, ribavirin treatment is not always successful. We describe 3 solid organ transplant recipients treated with sofosbuvir and ribavirin after failing ribavirin monotherapy. Complete elimination of hepatitis E virus could not be achieved.
Central Banks’ New Macroprudential Consensus
Authors: Taylor Michael W. , Arner Douglas W. , Gibson Evan C. 
Published: August 2019

Abstract
The traditional central bank consensus is designed around two mandates: monetary and financial stability. Following the Great Stagflation of the 1970s, central banks’ policy objective became biased toward maintaining a low and stable rate of inflation or monetary stability. This was based on the presumption that a stable price level would achieve both monetary and financial system stability. The deemphasis on financial stability remained until the global financial crisis, when the prevailing consensus was exposed for being thoroughly inadequate. A new consensus has emerged that broadens central banks’ financial stability mandate to include macroprudential supervision. This chapter analyzes the new central bank consensus, how this has resulted in institutional redesign, and the effectiveness of discharging postcrisis financial and monetary stability mandates.
Twin Studies and Politics
Authors: Littvay Levente 
Published: August 2019

Abstract
As recently as 2005, John Alford and colleagues surprised political science with their twin study that found empirical evidence of the genetic transmission of political attitudes and behaviors. Reactions in the field were mixed, but one thing is for sure: it is not time to mourn the social part of the social sciences. Genetics is not the deterministic mechanism that social scientists often assume it to be. No specific part of DNA is responsible for anything but minute, indirect effects on political orientations. Genes express themselves differently in different contexts, suggesting that the political phenomenon behavioral political scientists take for granted may be quite volatile; hence, the impact of genetics is also much less stable in its foundations than initially assumed. Twin studies can offer a unique and powerful avenue to study these behavioral processes as they are more powerful than cross-sectional (or even longitudinal) studies not only for understanding heritability but also for asserting the direction of causation, the social (and, of course, genetic) pathways that explain how political phenomena are related to each other. This chapter aims to take the reader through this journey that political science has gone through over the past decade and a half and point to the synergies behavioral political science and behavioral genetics offer to the advancement of the discipline.
Native American Realism
Authors: Schweninger Lee 
Published: August 2019

Abstract
This chapter argues that American Indian realist writings provide glimpses into cultures essentially unknown to mainstream readers of literary realism by writers outside the mainstream realist canon. It thus takes as one of its points of departure arguments for canon expansion. It also argues for widening the parameters of realism to include genres other than the novel, because so many of the writers during this era are mixed-genre writers. Basing its argument on a variety of genres, then, the chapter places several American Indian writers and their writings in social-historical contexts, such as resistance to mainstream culture, compulsory boarding school, allotment of Indian lands, coerced assimilation, and the 1890 Massacre at Wounded Knee.
African American Realism
Authors: Wooley Christine A. 
Published: August 2019

Abstract
Critical accounts of American literary realism have often focused on how realism is an intervention in, rather than a simple representation of, reality. Truth, however, remains a powerful referent for realists and a particularly complex one for postbellum African American writers whose works exemplify, but also interrogate, realism as a mode of representation. This chapter argues that linking African American writers such as Paul Laurence Dunbar and Charles Chesnutt to the realism of William Dean Howells reveals how for these writers, realism itself becomes a way to interrogate the power of stories to define what is true and to intervene in such assumptions. At the same time, these authors’ works increasingly show the limits of such interventions in relation to the intractability of racialized and racist discourse—and the racial disparities such discourse reinforces—at the turn of the twentieth century.
Asian American Realism
Authors: Lee Julia H. 
Published: August 2019

Abstract
This chapter examines the use of realism in Asian American literature and the debate surrounding its political and aesthetic meanings in Asian American literary criticism. Even though realist narratives have dominated Asian American literary history, the use and significance of realism nevertheless continue to stir controversy within the field. The chapter explores both sides of the “realism controversy” within Asian American studies and makes the case that realism exposes the contradictions of Asian American identity and that Asian American identity exposes the contradictions of realism. The chapter concludes with an analysis of Hisaye Yamamoto’s short story “The Legend of Miss Sasagawara” (1950), focusing on how the author deploys a realist mode of narration to reveal the historically contingent process by which Japanese American identity and community in the internment era are constituted.
The Campaign for Realism in the New York Periodical Press
Authors: Noonan Mark J. 
Published: August 2019

Abstract
This chapter demonstrates that the fight for greater realism in literature and life was long-lasting and transpired not on a single front but across many battlefields involving a wide variety of actors. Often, war itself was the impetus, first in the rewriting of the “facts” and significance of the Civil War and later as a means of response to the masculine bluster and bloodlust wrought by the Spanish-American War. The gender and class wars of the 1880s and 1890s were also relevant to this embattled genre, as were the effects of industrialization and immigration, which led to the massive growth of New York at this time, where so many of the newspapers and magazines promoting the various strands of realism were based. New York, war, and social issues were all entangled in the emergence of this genre, as numerous New York authors and artists sought to make sense of modern America and mold it to their own visions.
Realism and the Profession of Authorship
Authors: Thompson Graham 
Published: August 2019

Abstract
This chapter examines tensions between authorship and publishing in the era of American literary realism. The publishing industry changed with the emergence of literary agents, the growing financial significance of magazines and syndication, and the increasingly influential role of publishing-house editors. All were signs of a centralizing and marketizing publishing system flexible enough to withstand changes in dominant literary genres, tastes, and fashions. With examples from the careers of well- and lesser-known realists—William Dean Howells, Mark Twain, Stephen Crane, Constance Fenimore Woolson, Charles Chesnutt—authorship remained stubbornly immune to professionalization, in part because writing is better considered as a craft than as a profession and in part because the practices creating authorship’s marketization did not require its professionalization.
Local Color, World-System; or, American Realism at the Periphery
Authors: Storey Mark 
Published: August 2019

Abstract
This chapter employs recent approaches to the study of world literature to offer a new reading of nineteenth-century American regionalism. The huge body of texts usually included in the regional or “local-color” genre often take rural communities as both subject matter and foregrounded setting, communities that are held in a structurally “peripheral” position within the combined and uneven world economy of the late nineteenth century. This chapter argues that such a position is registered in the genre’s distinctive oscillation between realist and “irrealist” literary modes—between the professionalized and ascendant cultural standard of the core and the persistence of nonrealist generic devices and registers. Calling on two of the genre’s quintessential representatives, Hamlin Garland and Sarah Orne Jewett, the chapter ultimately makes a case for reading local-color writing as a form of (semi)peripheral realism within world literature’s expanded geographical and temporal horizons.
American Realism and Photography
Authors: Böger Astrid 
Published: August 2019

Abstract
This chapter explores the relationship between realist literature and photography since their emergence in the mid-nineteenth century. Both media responded to the challenges of modernity by contriving new means of representing reality. Whereas photography became the standard for objective reproduction following the pictorial turn, realist authors including Henry James and Paul Laurence Dunbar honed literature’s capacity to focus on inner realities, such as subjective experience and memory, impossible to capture in a photograph. Jacob Riis, in turn, adopted the aesthetic of the urban picturesque for How the Other Half Lives, a photo-textual record of immigrant life in New York serving as a precursor for the documentary books of the Great Depression, which advocated national relief programs to alleviate the distress of rural Americans. Countering such facile approaches to complex realities, James Agee and Walker Evans’s Let Us Now Praise Famous Men, finally, presents a fundamental critique of representation itself.
Realist Literature, Painting, and Immediacy
Authors: Betjemann Peter 
Published: August 2019

Abstract
Literary realism traditionally seems painterly to the degree that it features museums, galleries, and specific works or to the degree that its descriptive qualities parallel the interest of nineteenth-century artists in observed subjects. This chapter, however, connects realist literature and painting less through decorative or observational features than through certain practices of sociocultural critique. The first section, “Visuality,” focuses on a series of shared formal strategies used by writers and painters to depict unconventional women in conventional society, to orient the eye to sociological critique, and to challenge post–Civil War tendencies to sentimentalize unity and harmony. The second section, “Temporality,” focuses on different relations to time in the two mediums: painters tended to minimize narrative sequence even as writers depended on it. Close readings of Henry James’s “A Landscape-Painter” and Edith Wharton’s “The Portrait,” however, reveal that the “instantaneity” of contemporary painting served writers as a point of reference for critically interrogating the sociocultural orientation of realism itself.
Teaching American Realism in Germany
Authors: Schmidt Klaus H. 
Published: August 2019

Abstract
Starting with a critical introduction to the problematic beginnings and US-supported rise of American studies in pre– and post–WWII Germany, this chapter looks at the teaching of American realism and its development in a nation strongly influenced by US culture. Based on archival research, a statistical evaluation of annual bulletins, and information collected from fifty practitioners, the chapter offers the first quantitative and thematic analysis of course offerings at German universities (1953–2016), the first comparison of the relative importance of American realist literature in German university courses and research publications from German-speaking countries (2000–2015), and the first survey of German Americanists on methods and experiences of teaching US realism and naturalism in the Federal Republic (2017). The chapter concludes by calling for new didactic approaches to illustrate the continuing relevance of writers active in the core period of the realist tradition.