bluuebunny/crossref_metadata_2025_split huggingface dataset:
823 IPAX-1: Phase ½ Study of 4-L-[131l] IODO-Phenylalanine (131I-IPA) Combined with External Radiation Therapy (XRT) as Treatment for Patients with Glioblastoma Multiforme
Authors: Pichler Joseph , Hayward Colin , Jessel Mary 
Published: March 2022

INTRODUCTION:
Many tumor types, including glioblastoma multiforme (GBM),overexpress the L-type amino transporter 1 (LAT-1). I-iodo-phenylalanine( I-IPA) is a small-molecule amino acid derivative taken up by LAT-1 withdesignated orphan status in the United States and European Union for thetreatment of GBM. Tumor accumulation of I-IPA was shown in a proof-of-principlestudy and confirmed with single dosing of 2–7 GBq I-IPA in combination with XRT in recurrentGBM. The I-IPA + XRT as Treatment for Patients with GBM (IPAX-1) study evaluates the safety,tolerability, dosing schedule, and preliminary efficacy of I-IPA in combinationwith second-line XRT in patients with recurrent GBM.

METHODS:
IPAX-1 is a multi-center, open-label, phase 1/2, dose-finding study recruiting patients with previously confirmed histological diagnosis of GBM and evidence of first recurrence, history of GBM standard therapy, at least 6 months since end of first-line XRT, pathologically increased amino acid tumor uptake shown by molecular imaging, and current indication for repeat radiation. Participants receive intravenous I-IPA either as a single fraction (1f) followed by XRT, or as three equal fractions (3f) at weekly intervals followed by XRT commencing between the first and second I-IPA administration.

RESULTS:
Good tolerability and safety profile Promising progression free survival median 4.33 months and overall survival median 15.97 months Patients with unmethylated MGMT have a worse response to therapy than methylated MGM.

CONCLUSIONS:
Early evidence indicates that the combination of 131I-IPA and XRT may have an anti-neoplastic effect.
830 SPECT-CT as a Predictor of Pain Generators in Patients Undergoing Intraarticular Injections for Chronic Neck and Back Pain
Authors: Garcia Diogo P. , Sousa-Pinto Bernardo , Akinduro Oluwaseun , De Biase Gaetano , Deen Hugh Gordon , Nottmeier Eric W. , Chen Selby G. , Bydon Mohamad , Sandhu Sukhwinder , Scholten Paul , Quinones-Hinojosa Alfredo , Abode-Iyamah Kingsley O. 
Published: March 2022

INTRODUCTION:
The ability to accurately predict pain generators for chronic neck and back pain remains elusive. The use of hybrid single-photon emission computerized tomography- computerized tomography (SPECT-CT) to guide facet injections has emerged as a potential approach to improve patient outcomes with unclear effectiveness.

METHODS:
A retrospective review was completed on all patients who had a SPECT-CT for evaluation of chronic back pain between January 2016 and June 2020 at a single tertiary academic center. Patients’ records were reviewed for demographic, clinical, imaging, and outcomes data. Only patients who had facet injections following SPECT-CT were included in this evaluation. Patients undergoing injections targeted at foci of abnormal radiotracer uptake were compared to patients without uptake concerning immediate positive response, visual analog score – VAS -, and need for additional injection or surgery at the target level.

RESULTS:
A total of 2849 patients were evaluated with a SPECT-CT for chronic neck and back pain. Of those, 340 (11.9%) patients received facet joint injections following SPECT-CT. A propensity score regression analysis adjusted for age, gender, bone mass index (BMI), hypertension, multiple targets injections and injection location showed uptake targeted injections not being associated with an improved immediate positive response (OR=0.64; 95%CI=0.34-1.21; p=0.172). In patients with a failed facet injection preceding SPECT-CT, adding SPECT-CT to guide facet injections was associated with a decrease in VAS pain scores two weeks after injection (p=0.018), particularly when changes were made to the facets being targeted (p=0.047).

CONCLUSIONS:
This study suggests that there is benefit with SPECT-CT especially to guide facet injections after a failed prior facet injections.
831 Pain Networks Connectivity Changes Following the Relief of Prolonged Cancer Pain
Authors: Berger Assaf , Jalon Itamar , Gonen Tal , Shofty Ben , Tellem Rotem , Hochberg Uri , Artzi Moran , Ben-Bashat Dafna , Hendler Talma , Strauss Ido 
Published: March 2022

INTRODUCTION:
The “salience network” is normally engaged in humans’ response to acute internal or environmental stimuli, including pain. It comprises connections between the anterior insula (AI) and dorsal anterior cingulate cortex (dACC), among others. Chronic pain conditions have been associated with abnormally increased functional connectivity (FC) within the salience network in comparison to healthy individuals.

METHODS:
We prospectively followed patients that underwent cervical cordotomy (n=15) and cingulotomy (n=11) for relief of intractable oncological pain during the years 2016-2019. All patients did resting-state functional Magnetic Resonance Imaging (rsfMRI) before and after the procedures. Clinical data was collected, including pre- and post-operative numeric rating scale (NRS) pain scores.

RESULTS:
All patients (aged 62±11) reported a significant improvement in their pain from NRS 9±1 to 1±1 in cordotomy (p=0.001) and 2±3 in cingulotomy (p=0.005). By comparing pre- and post-operative rsfMRI scans, we demonstrated a significant decrease in the FC between components of the salience network following both cordotomy (p=0.007) and cingulotomy (p=0.009). In the cordotomy group we found a significant decrease in the connectivity between the thalamus and dACC (p=0.019) and within the sensory-motor cortex (p=0.003).

CONCLUSIONS:
Surgical interventions along the pain pathways can lead to a sudden relief of chronic pain in parallel to a significant decrease in the functional connectivity within pain related networks.
834 Whole-Brain Visualization of Single-Neuron Activity During the Development of Neuropathic Pain
Authors: Moosa Shayan , Coley Justin , Liu Chang-Chia , Elias W. Jeffrey , Kapur Jaideep 
Published: March 2022

INTRODUCTION:
Chronic neuropathic pain is severely disabling and difficult to treat. The pathophysiological mechanisms behind the transition from an acute to chronic neuropathic pain state are not well defined.

METHODS:
TRAP2 mice are genetically engineered to express tdTomato under dual control of a c-Fos gene promoter and estrogen receptor activation. Seven adult TRAP2 mice underwent unilateral chronic constrictive injury (CCI) of the sciatic nerve, while another six underwent exposure of the nerve without constriction. The mice were administered 4-OHT (to “TRAP” active neurons) one week, three weeks, or six weeks post-injury and maintained for six days before transcardial perfusion. Tissue clarification and confocal imaging/processing allowed for active neuronal populations in distinct brain regions to then be quantified and compared between groups.

RESULTS:
Allodynia developed in only the CCI groups, as confirmed by paw withdrawal thresholds. Active neuronal populations in the medial thalamus became significantly increased from baseline in all CCI groups. The anterior insula, secondary somatosensory cortex, and lateral parabrachial nucleus demonstrated significantly increased activity from baseline at one week post-injury, but this activity decreased at three and six weeks post-injury. Neuronal activity in the ventral orbital cortex was significantly increased from baseline only at three weeks post-injury, while activity in the anterior nucleus of the periventricular thalamus increased with time and became significantly elevated from baseline at three and six weeks post-injury.

CONCLUSIONS:
Our model demonstrates a clear increase in the neuronal activity of pain-related medial thalamic and cortical structures in mice who develop a chronic neuropathic pain state. The TRAP model is an ideal method to study brain plasticity during the transition from an acute pain state to chronic pain condition - enhancing our understanding of the mechanisms responsible for central sensitization to chronic neuropathic pain.
835 The Use of In-patient Concussion Consultation for Patient Education as a Model for Anticipatory Guidance in a Cohort of Pediatric Patients to Improve Symptom Score and Associated Health Outcomes
Authors: Henson Jeffrey Curran , Hanks-Clark Elizabetheth , Cook Alicia , Ocal Eylem 
Published: March 2022

INTRODUCTION:
It is estimated that 10% of all pediatric emergency room visits are due to concussions, and although most children recover without complications, problems including physical, emotional, somatic symptoms and sleep disturbances may occur. Pediatric populations are especially sensitive to these damaging sequelae as the plasticity of the developing neural networks of children are highly dynamic. It is with these considerations we have decided to undertake this study to evaluate if early in-patient concussion consultation in patients who have suffered traumatic brain injury (TBI) decreases recovery time, increases symptom reduction, and improves recovery to baseline neurocognitive functioning.

METHODS:
The patient cohort consisted of an initial 74 patients who were an in-patient concussion consultation using the acute concussion evaluation (ACE) tool to assess symptom score [0-22]. Patient files were queried for demographic information, comorbidities, and covariates of interest. The primary endpoints are clinical follow-up and reduction in symptom score between initial evaluation and clinical follow-up. All statistical analysis was performed using a significance level of α = 0.05.

RESULTS:
Delta score as a primary outcome was assessed only on patients retained during clinical follow-up. The difference in initial consult score compared to score at clinical follow-up was significant, p < 0.001, with means of 12.125, and 3.889 respectively. Delta score was found to have resulted in a mean 8.289 reduction in symptom score, and a positive correlation was observed between initial symptom score and delta score. The results for linear and logistic regression of covariates will be presented during CNS 2021.

CONCLUSIONS:
The use of an in-patient concussion consultation provides families with an invaluable tool regarding education and management of concussion symptoms. Our initial results verify this modality of early intervention as an important tool to educate and highlight the importance of early engagement in increasing clinical retention and reducing concussive symptoms in this sensitive patient population.
836 Value of Clinical and Ultrasonic Parameters as Preoperative Predictors of Risk of Developing Hydrocephalus Post Myelomeningocele Repair: A Cohort Study
Authors: Adebayo Bamidele Oludele , Okezie  , Bankole Olufemi B. , Omidiji Olubukola 
Published: March 2022

INTRODUCTION:
The risk of developing hydrocephalus after myelomeningocele repair may be determined by using preoperative clinical and transcranial ultrasound parameters.

METHODS:
A prospective longitudinal cohort study from November 2016 to October 2018, that involved 28 patients with myelomeningocele who presented to a tertiary hospital in southwestern Nigeria. Transcranial ultrasound was done before myelomeningocele repair and patients followed up for six months to detect hydrocephalus. Analysis of the state of the anterior fontanelle, the occipitofrontal circumference (OFC), ventricular index, bicaudate diameter, lateral ventricular ratio, thalamo-occipital distance and maximum transverse lateral ventricular diameter were done to determine their predictive values for the development of hydrocephalus after myelomeningocele repair.

RESULTS:
Age range was 1 -120 days with a mean of 20 days and the average age at the time of myelomeningocele repair was 23 days. There were 16 (57.1%) females and 12(42.9%) males in the study. OFC range at presentation was 31- 42cm with a mean of 34.7cm ±2.6 SD. The probability that a patient will develop hydrocephalus after myelomeningocele repair increased by 1.74 times for every1cm increase in the OFC above 34.5cm before myelomeningocele repair, p= 0.03. However, the state of the anterior fontanelle as well as the trans cranial ultrasound parameters were not found to be predictors of hydrocephalus post myelomeningocele repair.

CONCLUSIONS:
The OFC of the patients before myelomeningocele repair was predictive of development of hydrocephalus post repair, but the state of the anterior fontanelle and pre-operative trans fontanelle ultrasound parameters were not.
Soy Flour Substitution in Polymeric Diphenylmethane Diisocyanate Resin Reduces Press Platen Sticking*
Authors: Asafu-Adjaye Osei , Alawode Abiodun Oluseun , Via Brian , Banerjee Sujit 
Published: March 2022

Abstract
Partial (10% to 30%) substitution of soy flour in polymeric diphenylmethane diisocyanate (pMDI) resin substantially reduces platen sticking during hot-pressing of particle mats. Adding the soy flour to a fixed dose of pMDI (instead of substituting it) reduces platen sticking to an even greater extent. The soy decreases the tack of cured pMDI, thereby reducing the propensity of resinated particles to transfer to the platen. The tack reduction effect of soy on cured pMDI contrasts with its effect on uncured pMDI, where the cold tack is increased.
A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria
Authors: Nwankwo Ogonna N. O. , Ugwu Chukwuebuka I. , Nwankwo Grace I. , Akpoke Michael A. , Anyigor Collins , Obi-Nwankwo Uzoma , Andrew Sunday , Nwogu Kelechukwu , Spicer Neil 
Published: March 2022

Introduction
Globally, the population in rural communities are disproportionately cared for by only 25% and 38% of the total physicians and nursing staff, respectively; hence, the poor health outcomes in these communities. This condition is worse in Nigeria by the critical shortage of skilled healthcare workforce. This study aimed to explore factors responsible for the uneven distribution of healthcare workers (physicians and nurses) to rural areas of Ebonyi State, Nigeria.

Methods
Qualitative data were obtained using semi-structured in-depth interviews and focus group discussions from purposively selected physicians, nurses, and policymakers in the state. Data was analysed for themes related to factors influencing the mal-distribution of healthcare workers (physicians and nurses) to rural areas. The qualitative analysis involved the use of both inductive and deductive reasoning in an iterative manner.

Results
This study showed that there were diverse reasons for the uneven distribution of skilled healthcare workers in Ebonyi State. This was broadly classified into three themes; socio-cultural, healthcare system, and personal healthcare workers’ intrinsic factors. The socio-cultural factors include symbolic capital and stigma while healthcare system and governance issues include poor human resources for health policy and planning, work resources and environment, decentralization, salary differences, skewed distribution of tertiary health facilities to urban area and political interference. The intrinsic healthcare workers’ factors include career progression and prospect, negative effect on family life, personal characteristics and background, isolation, personal perceptions and beliefs.

Conclusions
There may be a need to implement both non-financial and financial actions to encourage more urban to rural migration of healthcare workers (physicians and nurses) and to provide incentives for the retention of rural-based health workers.
PRINCÍPIO DA PRECAUÇÃO E O DESAFIO DA SUSTENTABILIDADE: UMA PERSPECTIVA DA FILOSOFIA PRÁTICA
Authors: De Almeida Vieira Paulo Eduardo , Altmann Berwig Juliane , Weyermuller André Rafael 
Published: March 2022

Contextualização do tema: há uma tendência, hegemônica, de priorizar o crescimento econômico em detrimento do desenvolvimento sustentável. Daí deriva a agressão aos bens da natureza e a própria teia da vida. Está coloca em xeque, a sociedade de risco e o destino do homem.Objetivos: diante deste cenário, o presente artigo objetiva esboçar a possível contribuição da filosofia prática e da phrónesis para uma maior efetividade do princípio da precaução tomada como instrumento normativo apto ao enfrentamento dos problemas, ameaças e tragédias ambientais.Metodologia:A metodologia da pesquisa adotada é a exploratória, com método de abordagem dedutivo, utilizando-se da pesquisa bibliográfica como procedimento técnico.Resultados: Como resultado, diante da necessidade de sustentabilidade, aponta-se o princípio da precaução com um papel fundamental, devendo ser estudado e compreendido funcionalmente e em conexão com os seus efeitos práticos e jurídicos. Assim, a filosofia prática, enquanto mediação pode ser uma alternativa para que seja desvelada a sua melhor inteligência e aplicação empírica nos casos de controle de riscos ambientais.
A MULTIFUNCIONALIDADE DA BOA-FÉ OBJETIVA E A REVELAÇÃO DE CONDUTAS DAS PARTES NO CONTRATO PARA SEREM ATENDIDAS: REALIDADES SOCIOJURÍDICAS
Authors: Faria de Carvalho Diógenes , Lopes Matsushita Thiago , Ishikawa Lauro 
Published: March 2022

Contextualização do tema: A boa-fé objetiva é informadora das relações de consumo; importante compreender os reflexos decorrentes de sua funcionalização nas relações obrigacionais.O princípio da boa-fé objetiva descrito no art.4o., III, do Código de Defesa do Consumidor (CDC) não é só visto como defesa do consumidor vulnerável, mas também atua como critério auxiliar na viabilização dos ditames constitucionais sobre a ordem econômica, compatibilizando interesses contraditórios.Objetivos: o objetivo do presente artigo é identificar, tanto na Constituição Federal quanto na anatomia do Código de Defesa do Consumidor, a amplitude da orientação principiológica da boa-fé e diretiva do microssistema para a proteção e a defesa do consumidor, sob o cotejo da multifuncionalidade da boa-fé objetiva e sua contextualização como um conceito ético e econômico, que se dirige para o aspecto externo na economia contratual e harmonização dos interesses dos consumidores, sem deixar de referenciar a Lei 14.181/21, sobre prevenção e tratamento do consumidor superendividado. Metodologia: utiliza-se na pesquisa o método científico dedutivo, com investigação em doutrinas, jurisprudências e legislações nacionais e internacionais referentes ao tema.Resultados: conclui-se, em síntese, diante do trabalho realizado que o direito está se abrindo para uma certa porosidade, a fim de dar relevância à boa-fé e demais valores sociais e éticos que ingressam na esfera jurídica sob as vestes da boa-fé objetiva, revelando sua multifuncionalidade.
Treatment With Balloon Angioplasty of Chronic Portal Vein Thrombosis
Authors: Tumgor Gokhan , Yavuz Sibel , Uskudar Oguz , Ozkan Ugur 
Published: March 2022

ABSTRACT
The therapeutic options in portal vein thrombosis cases of young age and low weight, as in this case, are limited. Interventional radiologists also have minimal experience in pediatric patients. There are no reported cases anywhere worldwide, especially in this age group. However, we think that balloon angioplasty can be safely applied in cases in which esophageal variceal bleeding cannot be controlled using traditional treatment.
Severe Cholestatic Hepatitis Secondary to SARS-CoV-2
Authors: Lindholm Christopher R. , Zhang Xiaofei , Spengler Erin K. , Daniel Kimberly E. 
Published: March 2022

ABSTRACT
Liver injury is a common manifestation of coronavirus disease 2019 (COVID-19), with most injuries manifesting as transient mild hepatocellular injury. Cholestatic injury occurs less commonly and is typically mild. Severe cholestatic injury is rare, with only 4 cases reported in the literature. We present a 70-year-old woman with no known liver disease who presented with severe COVID-19 and developed severe cholestatic hepatitis. A liver biopsy was performed demonstrating bile duct injury, uncommonly reported in patients with COVID-19. This complication needs greater awareness because it has been known to cause progressive liver disease requiring transplantation.
Financial Performance: An Early Abandoned or Independently Sufficient Approach. (A Systematic Literature Review)
Authors: Ait Jillali Sanae , Belkasseh Mohammed 
Published: March 2022

The organizational performance is a central subject of management sciences since it occupies an axial position in the control and steering mechanisms. Several researchers have tried to explore it and fix it by relying on certain concepts that are easy to grasp, including effectiveness and efficiency. Furthermore, dissecting it by dimensions according to approaches such as; the goal achievement model, the resource acquisition model, and theories like; the stakeholder theory.
In the literature, the financial approach was most advocated for judging and measuring the success of any business. Besides, many authors have affirmed that with the development and inseparability of social, economic, and environmental factors, the financial aspect becomes insufficient and abandoned.
It is in this perspective that the present paper, by being part of a series of works seeking to clarify the contours of organizational performance, aims to provide answers to the problem of the relative importance given to financial indicators and their reliability for the evaluation and measurement of performance in different contexts. Based on literature and main models of performance, we tried to collect then analyze a set of theoretical and empirical articles likely to better display the perception of financial performance by the organization and its shareholders, as well as the role of this dimension in translating the financial success (using purely economic PIs) or global prowess (leaning on extra-financial PIs) of companies regardless of their structure. Knowing that the performance doesn’t have the same meanings depending on features and many factors specific to the company.