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A common part of hopelessness is sadness—notnecessarily the absence of hope itself, according to the psychiatrist Mark Sul-livan, but more often an “attachment to a form of hope that is lost.”37 Hope-lessness has a predictive value in both suicidal thinking and acting. Intraoperative adverse prognostic factors associated with low survival includethe patient’s general medical condition, the time interval from original diagnosis torecurrence, lesion size, and others are also important

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