bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phase IIa Study of SurVaxM Plus Adjuvant Temozolomide for Newly Diagnosed Glioblastoma
Authors: Ahluwalia Manmeet S. , Reardon David A. , Abad Ajay P. , Curry William T. , Wong Eric T. , Figel Sheila A. , Mechtler Laszlo L. , Peereboom David M. , Hutson Alan D. , Withers Henry G. , Liu Song , Belal Ahmed N. , Qiu Jingxin , Mogensen Kathleen M. , Dharma Sanam S. , Dhawan Andrew , Birkemeier Meaghan T. , Casucci Danielle M. , Ciesielski Michael J. , Fenstermaker Robert A. 
Published: December 2022

PURPOSE Despite intensive treatment with surgery, radiation therapy, temozolomide (TMZ) chemotherapy, and tumor-treating fields, mortality of newly diagnosed glioblastoma (nGBM) remains very high. SurVaxM is a peptide vaccine conjugate that has been shown to activate the immune system against its target molecule survivin, which is highly expressed by glioblastoma cells. We conducted a phase IIa, open-label, multicenter trial evaluating the safety, immunologic effects, and survival of patients with nGBM receiving SurVaxM plus adjuvant TMZ following surgery and chemoradiation (ClinicalTrials.gov identifier: NCT02455557 ). METHODS Sixty-four patients with resected nGBM were enrolled including 38 men and 26 women, in the age range of 20-82 years. Following craniotomy and fractionated radiation therapy with concurrent TMZ, patients received four doses of SurVaxM (500 μg once every 2 weeks) in Montanide ISA-51 plus sargramostim (granulocyte macrophage colony-stimulating factor) subcutaneously. Patients subsequently received adjuvant TMZ and maintenance SurVaxM concurrently until progression. Progression-free survival (PFS) and overall survival (OS) were reported. Immunologic responses to SurVaxM were assessed. RESULTS SurVaxM plus TMZ was well tolerated with no serious adverse events attributable to SurVaxM. Of the 63 patients who were evaluable for outcome, 60 (95.2%) remained progression-free 6 months after diagnosis (prespecified primary end point). Median PFS was 11.4 months and median OS was 25.9 months measured from first dose of SurVaxM. SurVaxM produced survivin-specific CD8+ T cells and antibody/immunoglobulin G titers. Apparent clinical benefit of SurVaxM was observed in both methylated and unmethylated patients. CONCLUSION SurVaxM appeared to be safe and well tolerated. The combination represents a promising therapy for nGBM. For patients with nGBM treated in this manner, PFS may be an acceptable surrogate for OS. A large randomized clinical trial of SurVaxM for nGBM is in progress.
Henry Thoreau's Perpetual Grief and Unquenchable Life
Authors: Richardson Robert D. 
Published: December 2022

Abstract
This review essay offers an enthusiastically positive review of Branka Arsić's Bird Relics: Grief and Vitalism in Thoreau (2016). Arsić gives us a Thoreau who is a pondside Pythagoras, learned and disciplined, with roots deep in Greek and Ionian and Persian and Hindu thought. Her Thoreau is a prophet with a freshly thought-out message about how perpetual mourning drives the perpetual renewal of life, about the importance of disindividualizing, and about the persistence of life at its most basic and elemental level. Arsić shows how, once we learn to see and hear and walk and sit without filters, without metaphors, and without other preconceived containers for pure experience, we can come to see, with Thoreau, that at the most important level, there is no death.
The Effective Use of Laser Ablation to Treat Mesial Temporal Lobe Epilepsy in the Setting of Implanted Responsive Neurostimulation
Authors: Luu Cuong P. , Kotloski Robert J. , Lake Wendell Bradley 
Published: December 2022

BACKGROUND:
Up to 16% of patients with responsive neurostimulation (RNS) implants for bilateral temporal epilepsy are found to have seizures originating mainly from just 1 lobe.

OBJECTIVE:
To describe the first use of laser interstitial thermal therapy (LITT) in a patient with a bilateral RNS implant to ablate the predominant temporal lobe and help control seizures.

METHODS:
A 55-year-old woman treated for temporal lobe epilepsy with conflicting information regarding lateralization underwent RNS implantation. She was then discovered to have seizures with electrographic onset nearly all from the right amygdala and hippocampus. She was offered LITT to ablate the affected region in the right temporal lobe, followed by reimplantation of the RNS lead in the remnant of the right hippocampal tail.

RESULTS:
Despite the positioning of the RNS ferrule on the operative side and the depth electrode in the contralateral lobe, we observed no significant artifact and obtained stable LITT temperature mapping using magnetic resonance. Laser ablation and RNS device replacement proceeded without complications. The patient has remained seizure-free for 6 months since the ablation in the setting of weaning antiseizure medications and regaining ambulation.

CONCLUSION:
LITT ablation can safely and effectively be performed in a patient with a concurrent RNS implant. Maintenance of the RNS device after ablation allows for continual detection and management of seizures.
Residual and Recurrent Spinal Cord Cavernous Malformations: Outcomes and Techniques to Optimize Resection and a Systematic Review of the Literature
Authors: Srinivasan Visish M. , Karahalios Katherine , Shlobin Nathan A. , Koester Stefan W. , Nguyen Candice L. , Rumalla Kavelin , Rahmani Redi , Catapano Joshua S. , Labib Mohamed A. , Mitha Alim P. , Spetzler Robert F. , Lawton Michael T. 
Published: December 2022

BACKGROUND:
Intramedullary spinal cord cavernous malformations (SCCMs) account for only 5% of overall cavernous malformations (CMs). The occurrence of recurrent or residual SCCMs has not been well discussed, nor have the technical nuances of resection.

OBJECTIVE:
To assess the characteristics of residual SCCMs and surgical outcomes and describe the techniques to avoid leaving lesion remnants during primary resection.

METHODS:
Demographic, radiologic, intraoperative findings and surgical outcomes data for a cohort of surgically managed intramedullary SCCMs were obtained from an institutional database and retrospectively analyzed. A systematic literature review was performed using PRISMA guidelines.

RESULTS:
Of 146 SCCM resections identified, 17 were for residual lesions (12%). Patients with residuals included 13 men and 4 women, with a mean age of 43 years (range 16-70). All patients with residual SCCMs had symptomatic presentations: sensory deficits, paraparesis, spasticity, and pain. Residuals occurred between 3 and 264 months after initial resection. Approaches for 136 cases included posterior midline myelotomy (28.7%, n = 39), pial surface entry (37.5%, n = 51), dorsal root entry zone (27.9%, n = 38), and lateral entry (5.9%, n = 8). Follow-up outcomes were similar for patients with primary and residual lesions, with the majority having no change in modified Rankin Scale score (63% [59/93] vs 75% [9/12], respectively, P = .98).

CONCLUSION:
SCCMs may cause significant symptoms. During primary resection, care should be taken to avoid leaving residual lesion remnants, which can lead to future hemorrhagic events and neurological morbidity. However, satisfactory results are achievable even with secondary or tertiary resections.
Starożytne źródła patosu i jego współczesne reminiscencje w fenomenologii responsywnej Bernharda Waldenfelsa
Authors: Wolińska Anna , Krasińska Magdalena 
Published: December 2022

Abstrakt
Analizy w zakresie starogreckich znaczeń słowa pathos skłaniają do postawienia tezy, że należy mówić o czterech głównych kontekstach, które ukształtowały rozumienie tej kategorii: o kontekście retorycznym, etycznym, tragicznym i emotywnym (passio). Chociaż wszystkie cztery wspomniane obszary pozostawały względem siebie stosunkowo niezależne, modyfikując sens pojęcia pathos w czasem bardzo odległych rejestrach czasowych, to można wskazać pewien wspólny rdzeń, determinujący charakter omawianej kategorii: mianowicie jej inherentną zakłóceniowość, kryzysogenność i afektywność. Pozostaje on w ścisłej relacji z odniesieniem patosu do doświadczeń bolesnych, nagłych, zadziwiających, a także – tak, jak w ślad za Grekami czyni to Waldenfels – do stanów pasywnych, z których podmiot, pod wpływem patycznego ugodzenia, wybudza się jako żywo reagujący, cielesny „respondent”.
Celem niniejszego artykułu jest prześledzenie owych starożytnych źródeł patosu i wskazanie ich współczesnych reminiscencji, rozbrzmiewających w Waldenfelsowskiej fenomenologii responsywnej. Struktura tekstu jest następująca: w pierwszej części przyglądamy się historycznym zastosowaniom pojęcia pathos (głównie w ramach tradycji greckiej); w części drugiej analizujemy patos pod kątem zdziwienia, uchodzącego według Platona i Arystotelesa za akt inicjujący myślenie filozoficzne; w części trzeciej, poświęconej fenomenologii Waldenfelsa, prezentujemy afektywny i cielesny wymiar doświadczenia patycznego, zradykalizowanego zarówno względem kartezjańskiego dualizmu, jak i Husserlowskiej teorii autoafekcji; w części czwartej powracamy do wyróżnionych wcześniej historycznych kontekstów patosu, aby pokazać, w jaki sposób Waldenfels na gruncie fenomenologii responsywnej aktualizuje je w ramach swojej polemiki z „klasycznymi” ujęciami doświadczenia i emocji.
Słowa kluczowe:
Patos, fenomenologia responsywna, Bernhard Waldenfels, retoryka, tragedia, etyka, afekt
A Fenomenologia segundo a Filosofia de Martin Heidegger
Authors: Saadeh Manuela 
Published: December 2022

Resumo Para Heidegger, é preciso desenvolver um conceito de fenomenologia a partir da questão do Ser para que se manifeste a estrutura articulada das questões fundamentais que constituem uma problemática. Toda investigação tem seu tema, desde o qual encontramos sua sistemática interna. O tema da fenomenologia heideggeriana é o sentido do Ser enquanto Ser e enquanto tempo, e a problemática são todas as questões que concernem ou não historicamente a este tema. A meta da investigação fenomenológica de Heidegger é, portanto, a de esclarecer tais problemas a partir do seu fundamento histórico, pois para o filósofo, somente desenvolvendo a aparelho conceitual a partir da sua fundamentação histórica, podemos trazer a questão do Ser propriamente à exposição. Entretanto, não se trata de fazer um apanhado ontológico-historiográfico (algo próprio à corrente moderna da filosofia), mas sim de pensar os motivos desde os quais o Ser foi implicitamente concebido não enquanto Ser, mas enquanto a “entidade do ente”, a presentidade constante (frente ao não constante), e isto em toda a História da Filosofia enquanto História da Metafísica.
Randomised controlled trial to assess and compare the performance and safety of two-piece ostomy appliances
Authors: Sagap Ismail , Loo Guo Hou , Azman Zairul Azman Mohd , Mazlan Luqman , Gan Seng Yeong , Eng Hooi Sian , Henry Fitjerald 
Published: December 2022

Background: Choice of ostomy appliances is based on multiple factors including economic considerations, individual patient requirements and lifestyle. A recently launched two-piece ostomy collection device with an extended tape border is expected to provide a long wear time and increase patients' sense of security. Aims and methods: A randomised controlled, non-blinded, cross-over study involving 38 patients (with colostomies and ileostomies) compared the test device to a similar device from the same manufacturer but without the tape border. The main objective was to assess wear time for non-inferiority as a measure of efficacy. Secondary efficacy assessment included peristomal skin condition using the DET (discolouration, erosion and tissue growth) score and patient acceptability, which was assessed through questionnaires using Likert-scale options. Safety was assessed according to the incidence and intensity of device-related adverse events, and the condition of the peristomal skin. Results and conclusion: Analysis of results in the per-protocol population showed an average wear time of 4.5 days for both devices and demonstrated non-inferiority. DET scores were similar in both groups, and both had low rates of device-related adverse events, all of which related to peristomal skin. Patients said the devices were user friendly. While the two devices are similar, some patients may find one with an adhesive tape more suited to their needs.
Frailty in older Turkish cancer patients undergoing post-surgical adjuvant chemotherapy
Authors: Goktas Sonay , Akin Semiha , Kosucu Sibel Nargiz , Dogan Pinar 
Published: December 2022

Background: Understanding the frailty levels of older patients undergoing surgery and chemotherapy will contribute to timely and reliable care practices and improve care outcomes. Aims: To determine the frailty of cancer patients who received chemotherapy treatment after surgery. Methods: This descriptive study included 192 Turkish patients aged over 60 years who received chemotherapy after surgery for cancer. Data were collected using a patient survey and the Edmonton Frailty Scale. Results: The average age of the participants was 66.3±5.3 years. Around 40% (40.6%) of the sample were diagnosed with breast cancer. The Edmonton Frailty Scale score of the group was 6.6 (SD±3.7). A quarter of the sample (22.9%) were at risk of frailty. Frailty levels were higher in older individuals with gastrointestinal cancers and other cancer groups compared with patients with breast cancer (p<0.001); patients with additional chronic diseases other than cancer (p=0.004); and in those with a history of falling and hospitalisation in the past year (p<0.001). Conclusions: Older patients with gastrointestinal cancer, additional chronic disease and a history of falling and hospitalisation within the past year should be evaluated closely for frailty before and during chemotherapy. It is crucial to consider the patient's vulnerability when making care and treatment decisions for older patients with cancer. Understanding the frailty levels of older patients who undergo surgery and receive chemotherapy can help health professionals to decide on timely and reliable care practices and improve care outcomes.
All-polyethylene tibia components have the same functional outcomes and survival, and are more cost-effective than metal-backed components in patients 70 years and older undergoing total knee arthroplasty
Authors: Jabbal Monu , Clement Nick , Walmsley Phil J. 
Published: December 2022

Aims The tibial component of total knee arthroplasty can either be an all-polyethylene (AP) implant or a metal-backed (MB) implant. This study aims to compare the five-year functional outcomes of AP tibial components to MB components in patients aged over 70 years. Secondary aims are to compare quality of life, implant survivorship, and cost-effectiveness. Methods A group of 130 patients who had received an AP tibial component were matched for demographic factors of age, BMI, American Society of Anesthesiologists (ASA) grade, sex, and preoperative Knee Society Score (KSS) to create a comparison group of 130 patients who received a MB tibial component. Functional outcome was assessed prospectively by KSS, quality of life by 12-Item Short-Form Health Survey questionnaire (SF-12), and range of motion (ROM), and implant survivorships were compared. The SF six-dimension (6D) was used to calculate the incremental cost effectiveness ratio (ICER) for AP compared to MB tibial components using quality-adjusted life year methodology. Results The AP group had a mean KSS-Knee of 83.4 (standard deviation (SD) 19.2) and the MB group a mean of 84.9 (SD 18.2; p = 0.631), while mean KSS-Function was 75.4 (SD 15.3) and 73.2 (SD 16.2 p = 0.472), respectively. The mental (44.3 vs 45.1; p = 0.464) and physical (44.8 vs 44.9; p = 0.893) dimensions of the SF-12 and ROM (97.9° vs 99.7°; p = 0.444) were not different between the groups. Implant survivorship at five years were 99.2% and 97.7% (p = 0.321). The AP group had a greater SF-6D gain of 0.145 compared to the MB group, with an associated cost saving of £406, which resulted in a negative ICER of -£406/0.145 = -£2,800. Therefore, the AP tibial component was dominant, being a more effective and less expensive intervention. Conclusion There were no differences in functional outcomes or survivorship at five years between AP and MB tibial components in patients aged 70 years and older, however the AP component was shown to be more cost-effective. In the UK, only 1.4% of all total knee arthroplasties use an AP component; even a modest increase in usage nationally could lead to significant financial savings. Cite this article: Bone Jt Open 2022;3(12):969–976.
The effect of short-course point-of-care echocardiography training on the performance of medical interns in children
Authors: Nazari Esfandiar , Tajani Zahra Bahman , Maroufizadeh Saman , Ghorbani Mohammad , Rad Afagh Hassanzadeh , Badeli Hamidreza 
Published: December 2022

Background
Point-of-care ultrasound (POCUS) can add complementary information to physical examination. Despite its development in several medical specialties, there is a lack of similar studies on children by medical interns and cardiologists. Therefore, investigators aimed to assess the effect of short-course training on the performance of medical interns in point-of-care echocardiography in children.

Methods
This analytic cross-sectional study was conducted on 161 hospitalized children in 17 Shahrivar children’s hospital, Iran, from January 2021 to May 2021. Seven interns (trainees) participated in a short course of point-of-care echocardiography to assess left ventricular ejection fraction (LVEF), inferior vena cava collapsibility index (IVCCI), and the presence of pericardial effusion (PEff). Each patient underwent point-of-care echocardiography by one of the trainees. Then, in less than one hour, the echocardiography was performed by a single cardiologist. Agreement between the cardiologist and trainees was examined using Cohen’s kappa coefficient and Prevalence-Adjusted Bias-Adjusted Kappa (PABAK). For numerical variables, the agreement was examined using the concordance correlation coefficient (CCC) and intraclass correlation coefficient (ICC).

Results
Results showed that the cardiologist and trainees detected LVEF >50, IVCCI >50%, and the absence of PEff in most of the participants. A good agreement in terms of ICC and CCC for LVEF (0.832 and 0.831, respectively) and a good agreement in terms of ICC and CCC for IVCCI (0.878 and 0.877, respectively) were noted. Using categorical scoring of LVEF and IVCCI showed 94.4% and 87.6% complete agreement, respectively. Furthermore, using categorical scoring of LVEF and IVCCI, Cohen’s kappa coefficient was 0.542 (moderate) and 0.619 (substantial), respectively. The PABAK for LVEF and IVCCI were 0.886 (almost perfect) and 0.752 (substantial), respectively. For PEff, Cohen’s kappa and PABAK were 0.797 (moderate) and 0.988 (almost perfect), respectively, and the complete agreement was noted in 160 patients (99.4%).

Conclusions
This study showed that a short teaching course could help medical interns to assess LVEF, IVCCI, and PEff in children. Therefore, it seems that adding this course to medical interns’ curricula can be promising.
Individual and situational predictors of psychological and physiological stress and burnout among maternity providers in Northern Ghana
Authors: Nutor Jerry John , Aborigo Raymond A. , Okiring Jaffer , Kuwolamo Irene , Dorzie John Baptist K. , Getahun Monica , Mendes Wendy Berry , Afulani Patience A. 
Published: December 2022

Background
Maternity providers, including nurses, midwives, physicians, are at significant risk for stress and burnout due to the nature of care provision in maternal and child health settings. Yet, the empirical evidence on stress and burnout among maternity providers in sub-Saharan Africa is scarce. Therefore, the purpose of our study was to (1) assess levels of stress and burnout among maternity providers and support staff in Ghana, and (2) identify individual and situational factors associated with maternity provider stress, burnout, and physiology.

Method
Using a purposive sampling technique, we recruited 150 maternity providers from 19 high delivery health facilities within the 15 districts of the Upper East region (UER) of Ghana into a cross-sectional study. Participants completed Cohen’s Perceived Stress Scale, the Shirom-Melamed Burnout scale, and sociodemographic, health-, and work-related items. Participants’ heart rate variability (HRV) and hair cortisol levels were assessed for stress-related physiologic responses. We computed bivariate and multivariate linear regression models to examine factors associated with stress and burnout.

Result
Most participants were experiencing moderate to high stress (58.0%) and burnout (65.8%). Each unit increase in overcommitment to work was associated with 0.62 higher perceived stress scores (β = 0.62, 95% CI: 0.22, 1.02) and 0.15 higher burnout scores. On average, those who had experienced disrespect from colleagues in the last year had higher perceived stress scores compared to those who had not experienced disrespect (β = 1.77, 95% CI: 0.50, 3.04); and those who had experienced disrespect from patients in the last year had higher cortisol levels than those who had not (β = 0.52, 95% CI: 0.11, 0.93). Those who work for more than 5 days also had higher cortisol levels, on average, compared to those who worked fewer days a week.

Conclusion
We found high levels of stress and burnout among maternity providers in Northern Ghana, underscoring the need for interventions to manage the effects of stress and burnout on maternity providers’ wellbeing, quality of care, and patient outcomes. Healthcare management teams should assist providers in reducing their overcommitment by hiring more staff, given its strong link to stress and burnout. Additionally, facilitating a respectful workplace culture could also help reduce stress and burnout among maternity providers.