bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study
Authors: Zager Jonathan S. , Orloff Marlana , Ferrucci Pier Francesco , Choi Junsung , Eschelman David J. , Glazer Evan S. , Ejaz Aslam , Howard J. Harrison , Richtig Erika , Ochsenreither Sebastian , Reddy Sunil A. , Lowe Michael C. , Beasley Georgia M. , Gesierich Anja , Bender Armin , Gschnell Martin , Dummer Reinhard , Rivoire Michel , Arance Ana , Fenwick Stephen William , Sacco Joseph J. , Haferkamp Sebastian , Weishaupt Carsten , John Johnny , Wheater Matthew , Ottensmeier Christian H. 
Published: May 2024

Abstract
Background
Uveal melanoma (UM) has a poor prognosis once liver metastases occur. The melphalan/Hepatic Delivery System (melphalan/HDS) is a drug/device combination used for liver-directed treatment of metastatic UM (mUM) patients. The purpose of the FOCUS study was to assess the efficacy and safety of melphalan/HDS in patients with unresectable mUM.

Methods
Eligible patients with mUM received treatment with melphalan (3.0 mg/kg ideal body weight) once every 6 to 8 weeks for a maximum of six cycles. The primary end point was the objective response rate (ORR). The secondary end points included duration of response (DOR), overall survival (OS), and progression-free survival (PFS).

Results
The study enrolled 102 patients with mUM. Treatment was attempted in 95 patients, and 91 patients received treatment. In the treated population (n = 91), the ORR was 36.3 % (95 % confidence interval [CI], 26.44–47.01), including 7.7 % of patients with a complete response. Thus, the study met its primary end point because the lower bound of the 95 % CI for ORR exceeded the upper bound (8.3 %) from the benchmark meta-analysis. The median DOR was 14 months, and the median OS was 20.5 months, with an OS of 80 % at 1 year. The median PFS was 9 months, with a PFS of 65 % at 6 months. The most common serious treatment-emergent adverse events were thrombocytopenia (15.8 %) and neutropenia (10.5 %), treated mostly on an outpatient basis with observation. No treatment-related deaths were observed.

Conclusion
Treatment with melphalan/HDS provides a clinically meaningful response rate and demonstrates a favorable benefit-risk profile in patients with unresectable mUM (study funded by Delcath; ClinicalTrials.gov identifier: NCT02678572; EudraCT no. 2015-000417-44).
Νέοι εκπαιδευτικοί, νέες συνθήκες και νέα εργαλεία για την εκπαίδευση παιδιών με μεταναστευτικό και προσφυγικό υπόβαθρο
Authors: Μακρογιάννη Τσαμπίκα , Κούρτη-Καζούλλη Βασιλεία 
Published: May 2024

The main objective of the Language Curriculum is to make the educational system responsive to the new conditions that have emerged in schools. Considering the requirements of the Curricula, new learning tools were used in this research and were applied in the context of language teaching at primary schools at the Department of Primary Education, University of the Aegean. These tools included a combination of theories, i.e. Cummins' (2005) theory for the development of Academic Language Proficiency, approaches about New Learning (Kalantzis & Cope, 2005) and Transformative Pedagogy (Cummins, 2005; Kalantzis & Cope, 2013). The aim of the research was for future teachers to learn how to support the multilingual students in schools in critically processing the diverse textual types in the language lessons, thereby achieving both the development of linguistic and communicative competence and the interaction of the school community with the wider society.
How carers' needs can be met by staff within inpatient settings: a qualitative study
Authors: Berry Katherine , King Jenna , Vikram Anvita , Muller Claire 
Published: May 2024

Background/Aims Inpatient admissions can increase carer stress rather than provide respite. The aim of this study was to gain carers' perspectives about how their needs can be met during an inpatient admission. Methods Semi-structured interviews were conducted with 12 carers whose relatives had been admitted to inpatient care at least once. Interviews were analysed thematically. Results Carers described a fear of relinquishing responsibility for care, which was exacerbated by concerns about the quality of care provided by staff. Better experiences were possible when carers were given information, ranging from generic information about symptoms or how the mental health system works, information about patients' needs and carer support systems. Conclusions Communication is key and needs to be a two-way process, with carers and staff learning from each other to support patients. Implications for practice Inpatient staff need training in carer involvement, including ways of engaging carers when patients do not give consent to information sharing.
PLATELET-RICH PLASMA FOR ACUTE ACHILLES TENDON RUPTURE: RESULTS OF THE PATH-2 STUDY, A DOUBLE-BLIND MULTICENTRE RANDOMIZED PLACEBO-CONTROLLED TRIAL
Authors: Keene D.J. , Alsousou J. , Harrison P. , Hulley P. , Wagland S. , Parsons S. , Thompson J. , O'Connor H. , Schlüssel M.M. , Dutton S. , Lamb S.E. , Willett K. 
Published: May 2024

BackgroundDisability and slow return to sport and work after tendon rupture are major challenges. Platelet Rich Plasma (PRP) is an autologous supraphysiological concentration of platelets from whole blood that has demonstrated positive cellular and physiological effects on healing in laboratory conditions but evidence from adequately powered robust clinical trials is lacking. We aimed to determine the clinical efficacy of PRP for treatment of acute Achilles tendon rupture.MethodsIn a placebo-controlled, participant- and assessor-blinded, trial at 19 NHS hospitals we randomly assigned 230 adults starting acute Achilles rupture non-surgical management to PRP injection or dry-needle insertion (placebo) to the rupture gap under local anaesthetic. Patients with confounding or contraindicated concurrent medical conditions were excluded. The primary outcome was muscle-tendon function, assessed by the limb symmetry index (LSI, uninjured limb/injured limb × 100, higher scores better) of the work (Joules) performed during the heel-rise endurance test at 24 weeks. Secondary outcomes were: Achilles Tendon Rupture Score (ATRS, 0–100, higher scores better), quality of life (SF-12), pain, and goal attainment. Trial registration: ISRCTN54992179ResultsParticipants were aged mean 46 years and 57 (25%) were female. 103/114 (90%) of the PRP group and all (n=116) in the placebo group received allocated treatment. At 24 weeks, mean LSI was 34.4 for the PRP group and 38.8 for placebo (adjusted mean difference −4.4 95% CI −11.2 to 2.5, n=201) and ATRS was mean 65.2 PRP vs 65.8 (adjusted mean difference −0.6, 95% CI −4.9 to 3.7, n=224). There were no differences between groups in the other secondary outcomes.ConclusionWe found no evidence of PRP efficacy for improving muscle-tendon function or patient-reported recovery after acute Achilles tendon rupture. Our findings challenge the increasing global use of PRP for acute tendon injury and indicate that robust evaluations are required in other applications.
ANATOMY OF THE INSERTION OF THE POSTERIOR INFERIOR TIBIOFIBULAR LIGAMENT AND ITS RELEVANCE TO POSTERIOR MALLEOLAR ROTATIONAL PILON FRACTURES
Authors: Jayatilaka M.L. , Fisher A. , Fisher L. , Molloy A. , Mason L. 
Published: May 2024

IntroductionThe treatment of posterior malleolar fractures is developing. Mason and Molloy (Foot Ankle Int. 2017 Nov;38(11):1229-1235) identified only 49% of posterior malleolar rotational pilon type fractures had syndesmotic instabilities. This was against general thinking that fixation of such a fragment would stabilize the syndesmosis.MethodsWe examined 10 cadaveric lower limbs that had been preserved for dissection at the Human Anatomy and Resource Centre at Liverpool University in a solution of formaldehyde. The lower limbs were carefully dissected to identify the ligamentous structures on the posterior aspect of the ankle. To compare the size to the rotational pilon posterior malleolar fracture (Mason and Molloy 2A and B) we gathered information from our posterior malleolar fracture database. 3D CT imaging was analysed using our department PACS system.ResultsThe PITFL insertion on the posterior aspect of the tibia is very large. The average size of insertion was 54.9×47.1mm across the posterior aspect of the tibia. Medially the PITFL blends into the sheath of tibialis posterior and laterally into the peroneal tendon sheath.78 posterior lateral and 35 posterior medial fragments were measured. On average, the lateral to medial size of the posteromalleolar fragment was 24.5mm in the posterolateral fragment, and 43mm if there is a posteromedial fragment present also. The average distal to proximal size of the posterolateral fragment was 24.5mm and 18.5mm for the posteromedial fragment.ConclusionThe PITFL insertion on the tibia is broad. In comparison to the average size of the posterior malleolar fragments, the PITFL insertion is significantly bigger. Therefore, for a posterior malleolar fracture to cause posterior syndesmotic instability, a ligamentous injury will also have to occur. This explains the finding by Mason and Molloy that only 49% of type 2 injuries had a syndesmotic injury on testing.
ARTHROSCOPIC ARTHRODESIS OF THE ISOLATED TALONAVICULAR JOINT
Authors: Parsons A. , Parsons S. 
Published: May 2024

BackgroundWhereas arthroscopic arthrodesis of the ankle is commonplace and of the subtalar joint is established, reports of arthroscopic talo-navicular fusion are a rarity.AimTo review a case series to establish if arthroscopic talo-navicular arthrodesis is a feasible surgical option.MethodsArthroscopic decortication of the talo-navicular joint is performed via x1-2 sinus tarsi portals and x1-2 accessory talo-navicular portals using a standard arthroscope and a 4.5 barrel burr. Internal fixation is by a 5mm screw from the navicular tuberosity and x2 headless compression screws introduced under image intensification from the dorsal navicular to the talar head. Between 2004 and 2017 a consecutive series of 164 patients underwent arthroscopic hindfoot arthrodeses of which 72 involved the talo-navicular joint. Only 13 procedures were of that joint alone in unsullied feet. The medical records of these 13 patients were reviewed to assess radiological fusion, complications and improvement of pre-operative state.ResultsAll Talo-navicular joints were successfully decorticated. All united radiologically by a mean 4.4 months (range 3–8). There were no major complications. All patients reported improvement to their pre-operative symptoms but one patient developed lateral column pain requiring fusion.ConclusionsArthroscopic Talo-navicular arthrodesis is technically feasible with good rates of union. Complications were rare, making the technique attractive when encountering a poor soft tissue envelope. The surgery cannot be used if bone grafting is required. Long term discomfort can arise from adjacent joints. Accurate alignment is critical.
Bio-psycho-social problems of a child with bronchial asthma with regard to the educational and caring role of the parent
Authors: Piaszczyk Diana , Gryz Paulina 
Published: May 2024

Bronchial asthma is a chronic respiratory disease of heterogeneous nature, manifested by paroxysmal but reversible bronchoconstriction. The aim of this work is to identify nursing problems of a child with bronchial asthma and determine nursing interventions based on ICNP® guidelines. In the study the fallowing research methods were used: individual case study, interview, observation, measurement, documentation analysis, scales, and nursing process. The research subject is a patient 17 years and 7 months old admitted to the children’s hospital on an emergency basis with suspected pneumonia of unknown etiology and an exacerbation of asthma. History: runny nose, cough for 3 weeks, and periodic dyspnea for 2 weeks. On admission to the hospital: weakness, difficulty climbing stairs, expiratory dyspnea, headache, pallor, decreased appetite, nausea, and vomiting. On physical examination: weakened alveolar murmur over the lung fields, expiratory wheezes, furrows, moist rales, reddened throat. As a result of treatment, the patient’s condition improved. She was discharged home with the recommendation: systematic medication, avoidance (of noxious agents and human concentrations), overheating, hypothermia, oral rehydration, oral hygiene, an easy-to-digest diet, blood count control in 1-2 months and follow-up at the Pulmonology Clinic. During hospitalization, the child was diagnosed with biological, psychological, and social problems, which were solved by the diagnostic, care and therapeutic, educational activities of the nurse. Education about the disease (symptoms and treatment) was required by the patient’s mother. The prevalence of asthma imposes an obligation to implement educational activities in educational institutions, since comprehensive education of parents and teachers improves the emotional state of a child with asthma.
Children of re-emigrants in a Polish school
Authors: Jędryszek-Geisler Aleksandra 
Published: May 2024

The main objective of this study was to check the knowledge of teachers from Polish schools about the problems faced by children with migration experience, awareness of the possibilities of helping these students and teachers’ knowledge about the functioning of Polish schools in the world.The respondents were 312 primary school teachers from the Pomorskie, Warmińsko-Mazurskie, Mazowieckie, Wielkopolskie, Kujawsko-Pomorskie and Podlaskie. A self-designed questionnaire was used in the study. The analysis of the results showed that the teachers had partial knowledge about the problems of children with migration experience, possibilities of help and generally little knowledge about the functioning of Polish schools in the world.
Analysis of educational support for children with special educational needs
Authors: Grądzki Waldemar 
Published: May 2024

The article discusses the educational support process for children with special educational needs (SEN), who may have various dysfunctions such as speech, hearing, vision impairments, motor problems, shyness, high abilities, or developmental issues, including children with the autism spectrum. Technological development, especially in the field of multimedia and artificial intelligence, is changing the traditional approach to educating these children. Information and communication technologies, virtual reality, augmented reality, and the Internet of Things are becoming increasingly common in the teaching process. Despite the wealth of educational tools available, educators often do not fully utilize them, partly due to a lack of adequate technical support, equipment, software, and teacher training. Older teachers may have more difficulty adapting to new technologies compared to younger ones.
The phenomenon of suicides among adolescents
Authors: Lukasek Aleksandra , Zalewska Wioleta 
Published: May 2024

The article is devoted to the phenomenon of suicide, which occurs not only in Poland, but all over the world. Suicidal death means the end of life, and for many young people it is the solution to life’s problems. Minors aged 14 to 17 often struggle with a sense of powerlessness in the face of existing life problems. Often these people rebel against commonly accepted social norms, looking for their own paths, goals and senses of an existential nature. The undertaken research was aimed at understanding the phenomenon of suicide among young people. The study used the method of diagnostic.
Speech disorders in children and activities carried out by preschool teachers. analysis of the phenomenon in the light of own research
Authors: Nazaruk Stanisława , Waszczuk Joanna , Kisiel Paulina , Korpysz Karolina , Semeniuk Gabriela , Łukaszuk Natalia 
Published: May 2024

Correct speech development is important for the child‘s proper education, personality building and overall development. In view of this widely acknowledged fact, attention has been drawn to the need for the formation of correct speech development in the child and its disorders in the aspect of the pedagogical work of preschool teachers. Pedagogical observations in pre-school institutions during the implementation of student internships motivated us to undertake a study to determine the importance of the pedagogical work of teachers in the process of supporting the normal speech development of the pre-school child. The research was conducted in 2022 among 60 teachers working in pre-school institutions in the Biała Podlaska district. The results of the study showed the variety of activities carried out by teachers, especially in the field of diagnosis, selection of speech therapy exercises, individualisation of work with the child and cooperation with parents. Motivation and interaction between teachers and parents are among the key factors determining the effectiveness of speech therapy activities with children. On the basis of the analysis of the research results, some important recommendations were formulated, which can be used in the future by those interested in the above-mentioned issues.
Association between emergency department attendances, sociodemographic factors and long-term health conditions in the population of Norfolk and Waveney, England: Cross sectional study
Authors: Jones Charlotte E. L. , Shabuz Zillur Rahman , Bachmann Max , Burke Amanda , Brainard Julii , Cullum Rachel , Saunders Mike , Dalton Alice M. , Enwo Oby O. , Steel Nick 
Published: May 2024

Introduction
Demand for urgent and emergency health care in England has grown over the last decade, for reasons that are not clear. Changes in population demographics may be a cause. This study investigated associations between individuals’ characteristics (including socioeconomic deprivation and long term health conditions (LTC)) and the frequency of emergency department (ED) attendances, in the Norfolk and Waveney subregion of the East of England.

Methods
The study population was people who were registered with 91 of 106 Norfolk and Waveney general practices during one year from 1 April 2022 to 31 March 2023. Linked primary and secondary care and geographical data included each individual’s sociodemographic characteristics, and number of ED attendances during the same year and, for some individuals, LTCs and number of general practice (GP) appointments. Associations between these factors and ED attendances were estimated using Poisson regression models.

Results
1,027,422 individuals were included of whom 57.4% had GP data on the presence or absence of LTC, and 43.1% had both LTC and general practitioner appointment data. In the total population ED attendances were more frequent in individuals aged under five years, (adjusted Incidence Rate Ratio (IRR) 1.25, 95% confidence interval 1.23 to 1.28) compared to 15–35 years); living in more socioeconomically deprived areas (IRR 0.61 (0.60 to 0.63)) for least deprived compared to most deprived,and living closer to the nearest ED. Among individuals with LTC data, each additional LTC was also associated with increased ED attendances (IRR 1.16 (1.15 to 1.16)). Among individuals with LTC and GP appointment data, each additional GP appointment was also associated with increased ED attendances (IRR 1.03 (1.026 to 1.027)).

Conclusions
In the Norfolk and Waveney population, ED attendance rates were higher for young children and individuals living in more deprived areas and closer to EDs. In individuals with LTC and GP appointment data, both factors were also associated with higher ED attendance.
Analisis Faktor Risiko Kesehatan Ligkungan Dengan Kejadian Diare Pada Balita Di Wilayah Kerja Puskesmas Tanon 1 Kabupaten Sragen Tahun 2015-2020
Authors: Munawaroh Dinni Asmini , Sulistiyani Sulistiyani , Darundiati Yusniar Hanani 
Published: May 2024

Diarrhea disease is ranked second as the most common cause of death in children under five, both preventable and treatable. Diarrhea in the children under five group is the most vulnerable group and can result in death if not treated seriously. The highest incidence of diarrhea cases occurs in the first two years of life and will decrease as the child gets older. The purpose of this study was to determine the risk factors for the occurrence of diarrhea in toddlers in the working area of the Tanon 1 Public Health Center, Sragen Regency in 2015-2020. This type of research is analytic by design cross sectional. Secondary data in this study arecase children under five diarrhea, environmental sanitation factors, food sanitation factors and social economic factors. The data analysis used was univariate and bivariate with the chi square test α = 0.05. The results of the study show that there is a relationship between latrine management in 2015 (p-value=0.001) in 2016 (p-value=0.007) in 2017 (p-value= 0.032), there is a relationship between waste management (p-value=0,048) and cleanliness of food equipment in 2016 (p-value= 0.021), there is a relationship with clean water sources (p-value=0.049) and food management in 2017 (p-value= 0.003), there is a relationship with the condition of the floor of the house in 2019 (p-value= 0.49) with the incidence of diarrhea in children under five at the Tanon 1 Public Health Center, Sragen Regency.
HUBUNGAN USIA, MASA KERJA, WAKTU KERJA, SIKAP KERJA DAN AKTIVITAS PEKERJAAN DENGAN KEJADIAN NYERI PUNGGUNG BAWAH PADA PETANI PADI DESA SEMEN
Authors: Nurcahyani Ari Dwi , Ekawati Ekawati , Jayanti Siswi 
Published: May 2024

Indonesia is an agrarian country so that agriculture is one of the sectors with the largest number of workers. Agriculture is an informal sector job that still uses a lot of manual handling methods so that it has the potential to cause complaints of low back pain. Low back pain is a health problem in the form of acute pain that is felt in the lower back (lumbosacral) area in the form of local or radicular pain. Risk factors for low back pain include individual factors, occupational factors and environmental factors. This research is a quantitative-research with analytic observational method and cross-sectional approach. The population is farmers from of Semen village and registered on rukun tani group. The sample is 30 people using total sampling. Independent variables is age, working period, working time, work attitudes and work activities with dependent variable Low Back Pain. Data collection techniques used individual characteristic questionnaires, nordic body map, VAS scale and OWAS method. Data analysis technique uses Fisher’s Exact Test statistical test. The results showed a greater distribution of independent variables age > 35 years, work experience > 5 years, work attitudes requiring improvement, and heavy work activities. The results of the bivariate analysis showed that there was a significant relationship between age (p-value = 0.035), working period (p-value = 0.002) and working time (p-value = 0.004) with complaints of low back pain in rice farmers in hamlet X Semen Village as evidenced by p-value <0.05. Keywords: Low Back Pain, Rice Farmes, VAS scale, OWAS method.