bluuebunny/crossref_metadata_2025 huggingface dataset:
SURG-16. THALAMIC GLIOMAS AND THEIR SURGICAL STRATEGY: A SYSTEMATIC REVIEW
Authors: Levy Adam , Eatz Tiffany , Morell Alexis , Merenzon Martin , Higgins Dominique , Guyot Manuela , Patel Nitesh , Eichberg Daniel , Kader Michael , Luther Evan , Komotar Ricardo , Ivan Michael
Published: November 2022

INTRODUCTION

Until recent decades, thalamic gliomas had been considered largely inoperable. These lesions are deep-seated and surrounded by vital structures. However, as technology and imaging modalities have improved, so have treatment modalities. Currently, a range of surgical approaches are used, partially dependent on the location of the lesion; although no consensus has been reached regarding optimal surgical management.

OBJECTIVE

To conduct a systematic review of the literature to describe the current surgical outcomes of adult thalamic gliomas.

METHODS

Four databases were searched with keywords “‘thalamic glioma’ AND ‘surgical intervention’ OR ‘thalamic glioma’ AND ‘surgical treatment’” for articles assessing surgical techniques of adult thalamic glioma resection. Our systematic review was reported in accordance with the PRISMA guidelines. 793 full-text studies were assessed for eligibility. Ultimately, 14 studies were included.

RESULTS

The mean age was of 33.57 years (18-83). In 479/507 cases the surgical strategy used was described. The transcortical approach was the most utilized (37.8% of cases). The remaining cases employed transventricular (23.8%), transcallosal (22.8%), and trans-sylvian transinsular (2.92%) approaches, among others. Gross total resection (GTR), subtotal resection (STR), and partial resection were achieved in 36.7%, 47.4%, and 15.9%, respectively. New temporary postoperative deficits were observed in 57/507 patients and new permanent deficits in 56/507 patients. There were 18 total perioperative deaths reported. The degree of morbidity across approaches was recorded in just one study, where no significant difference was found. The mean overall survival of adult patients after surgery ranged from 11.5 to 27.39 months across studies.

CONCLUSION

There is a lack of statistically strong data that addresses which surgical approach causes less morbidity and allows a better surgical resection for thalamic gliomas. Ultimately, surgical resection of adult thalamic gliomas can increase overall survival but at the risk of operative morbidity. Transcortical approaches appear to carry a greater overall survival
SURG-18. VARIOUS APPLICATIONS OF INTRAOPERATIVE ELECTROCORTICOGRAPHY FOR EPILEPTOGENIC TISSUE MAPPING IN AWAKE GLIOMA SURGERY
Authors: Sun Dongqing , Schaft Eline , van Stempvoort Bibi , van Klooster Maryse 't , Gebbink Tineke , Dankbaar Jan Willem , van Eijsden Pieter , Zijlmans Maeike , Robe Pierre
Published: November 2022

New-onset epilepsy is a symptomatic expression of diffuse glioma and lowers the quality of life. Surgical resection could extend beyond the traditional lesionectomy and include the epileptic focus when permitted by neurological function. Intraoperative electrocorticography (ioECoG) is used during epilepsy surgery to estimate the epileptogenic tissue by mapping the irritative zone. We aimed to determine the added value of ioECoG for postoperative seizure control in patients with non-refractory, glioma-related seizures. We retrospectively included patients who underwent ioECoG-assisted (awake) tumor resection. The ioECoG tailoring strategy was based on electrographic seizures and interictal discharges (sporadic spikes, continuous spiking patterns, and sharp waves). The extent of resection (EOR) and the residual tumor volume (cm3) were quantified from pre- and postoperative magnetic resonance imaging. We used the Weibull regression model for multivariate time to event (seizure recurrence) analyses. Fifty patients underwent ioECoG-assisted surgery. IoECoG recorded eight (16%) spontaneous electrographic seizures. Seventeen patients had residual interictal discharges after tumor resection. Residual interictal discharges were significantly associated with shorter seizure-free period after surgery (HR = 3.1 [1.3 – 7.2], p-value = 0,01). This effect was especially prominent in primary high-grade glioma resections. Residual tumor volume and EOR did not associate with seizure outcome. We sampled 14 interictal spike-positive brain tissues (three inside and 11 outside the MRI abnormalities) for additional histopathological analyses. Tumor cells were found in all specimens. The overall sensitivity of interictal spikes for tumor infiltration was 78% (95%CI [56 – 93]) and the specificity was 100%. IoECoG could serve multiple purposes in brain tumor surgery. It can assist in intraoperative seizure detection. Complete resection of epileptic discharges may improve seizure outcome independently of rest tumor volume or EOR. IoECoG could help guide supramaximal resection to improve seizure control and assist patient counseling. Furthermore, interictal spikes might serve as markers for intraoperative tumor identification.
SURG-23. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR NEWLY DIAGNOSED AND RECURRENT IDH WILD-TYPE GLIOBLASTOMA
Authors: de Groot John , Kim Albert , Prabhu Sujit , Rao Ganesh , Laxton Adrian , Fecci Peter , O'Brien Barbara , Sloan Andrew , Chiang Veronica , Tatter Stephen , Mohammadi Alireza , Placantonakis Dimitris , Strowd Roy , Chen Clark , Hadjipanayis Constantinos , Khasraw Mustafa , Sun David , Piccioni David , Sinicrope Kaylyn , Campian Jian , Kurz Sylvia , Williams Brian , Smith Kris , Tovar-Spinoza Zulma , Leuthardt Eric
Published: November 2022

Treatment options for glioblastoma remain limited, particularly for those who are not eligible for traditional resection, whether due to lesion location or inability to tolerate open craniotomy. Maximal-safe resection followed by radiation with concurrent and adjuvant temozolomide offers the best outcomes for patients. Unfortunately, not all tumors are amenable to conventional surgical resection at the time of diagnosis with only about 1/3 of patients able to receive a gross-total resection and 15-25% of patients receiving biopsy only, thus reducing their projected overall survival to 9 months. Laser interstitial thermal therapy (LITT) is a minimally invasive, cytoreductive tool, that has demonstrated safety as a surgical approach to treat primary brain tumors.

METHODS

Data from LAANTERN prospective multicenter registry (NCT02392078) was analyzed to determine clinical outcomes for patients with new and recurrent IDH wild-type glioblastoma (N=89). Demographics, intraprocedural data, adverse events, KPS, health-economics, and survival data were prospectively collected then analyzed separately for newly diagnosed GBM (N=29) and recurrent GBM (N=60).

RESULTS

Median overall-survival was 9.73 months (95% CI: 5.16, 15.91) for newly diagnosed patients and median post-procedure survival was 8.97 (6.94, 12.36) months for recurrent patients. Median overall-survival for newly diagnosed patients receiving post-LITT chemoradiotherapy was 16.14 months (6.11, not reached). The median length of hospital stay was 50 hours and 80% of patients were discharged to home.

CONCLUSIONS

LITT offers an effective cytoreductive approach for patients with newly diagnosed and recurrent IDH wild-type glioblastoma. Importantly, its use in newly diagnosed patients who receive post-LITT chemoradiotherapy leads to a median OS similar to that of patients treated with conventional surgical resection. LITT remains an important alternative for patients with inoperable tumors or those not amenable to resection. Enrollment in LAANTERN is ongoing and these cohorts will be revisited as data continues to mature. Benefits beyond cytoreduction are also being actively explored.
SURG-25. PATTERNS OF RECURRENCES ACCORDING TO THE EXTENT OF RESECTION IN PARIETNS WITH GLIOBLASTOMA, IDH-WILDTYPE: A RETROSPECTIVE STUDY
Authors: Chang Jong Hee , Yoo Jihwan , Kim Kyung Hwan , Kim Woohyun , Yoon Hong In , Kim Se Hoon , Moon Ju Hyung , Park Hun Ho , Kim Eui Hyun , Suh Chang-Ok , Kang Seok-Gu
Published: November 2022

OBJECTIVE

In glioblastoma (GBM) patients, controlling the microenvironment around the tumor using various treatment modalities, including surgical intervention, is essential in determining the outcome of treatment. This study was conducted to elucidate whether recurrence patterns differ according to the extent of resection (EOR) and whether this difference affects prognosis.

METHODS

This single-center study included 358 eligible patients with histologically confirmed isocitrate dehydrogenase (IDH)-wild-type GBM from November 1, 2005, to December 31, 2018. Patients were assigned to one of three separate groups according to EOR: supratotal resection (SupTR), gross-total resection (GTR), and subtotal resection (STR) groups. The patterns of recurrence were classified as local, marginal, and distant based on the range of radiation. The relationship between EOR and recurrence pattern was statistically analyzed.

RESULTS

Observed tumor recurrence rates for each group were as follows: SupTR group, 63.4%; GTR group, 75.3%; and STR group, 80.5% (p = 0.072). Statistically significant differences in patterns of recurrences among groups were observed with respect to local recurrence (SupTR, 57.7%; GTR, 76.0%; STR, 82.8%; p = 0.036) and distant recurrence (SupTR, 50.0%; GTR, 30.1%; STR, 23.2%; p = 0.028). Marginal recurrence showed no statistical difference between groups. Both overall survival and progression-free survival were significantly increased in the SupTR group compared with the STR and GTR groups (p < 0.0001).

CONCLUSIONS

In this study, the authors investigated the association between EOR and patterns of recurrence in patients with IDH-wild-type GBM. The findings not only show that recurrence patterns differ according to EOR but also provide clinical evidence supporting the hypothesized mechanism by which distant recurrence occurs.
SURG-28. ADULT MIDLINE GLIOMAS TREATED WITH LASER INTERSTITIAL THERMAL THERAPY (LITT): OUR COMPARATIVE EXPERIENCE WITH NEEDLE BIOPSY
Authors: Merenzon Martin , del Pont Francisco Marcó , Morell Alexis , Higgins Dominique , Patel Nitesh , Kader Michael , Levy Adam , Eatz Tiffany , Eichberg Daniel , Shah Ashish , Silva Michael , Luther Evan , Lu Victor , Komotar Ricardo , Ivan Michael
Published: November 2022

INTRODUCTION

Adult midline gliomas are rare entities, with a scarcity of available clinical data. These patients have variable courses, with limited evidence to predict outcomes. Emerging evidence suggests that biomolecular profiles may play a significant role in outcomes, so tissue diagnosis is a key component of management. However, the role of cytoreductive therapy, such as Laser Interstitial Thermal Therapy (LITT) remains unknown. To date, only a few studies have described the use of MRI-guided LITT for managing midline gliomas.

OBJECTIVE

To present a retrospective analysis of a single-center two-surgeon experience treating adult midline gliomas with either biopsy/LITT or biopsy alone.

METHODS

Patients with midline intraxial tumors surgically treated at our tertiary care referral center were identified using our established database. Twenty-one patients managed either with biopsy/LITT or needle biopsy from 2015 to 2021 were included. Demographics and clinical records including, among others, length of hospital stay, preoperative lesion size, ablation volume, perioperative complications, adjuvant treatment, and stratified overall survival (OS) were collected.

RESULTS

The two cohorts were composed of 7 patients who underwent LITT, and 14 biopsies. The mean age was 60.95y (25-82). The average tumor volumes were 16.99 cm3 and 15.41 cm3 for LITT and biopsy, respectively. No post-surgical complications were found in the LITT group, one patient had a postsurgical hemorrhage after biopsy. The mean OS was 20.28 ± 9.63 months in the LITT group, which was greater but not statistically significant than in the biopsy group (11.05 ± 4.45 months) (p = 0.605).

CONCLUSION

Our results show that LITT is as safe as needle biopsy for the treatment of adult midline gliomas, and may offer a survival benefit given its cytoreductive properties.
SURG-29. CAN NEOADJUVANT CHEMOTHERAPY INCREASE EXTENT OF RESECTION IN DIFFUSE LOWER-GRADE GLIOMA?
Authors: Ramakrishnan Piravin , Moughal Saad , Bolton William , Gooden John , Chumas Paul , Mathew Ryan
Published: November 2022

INTRODUCTION

Maximal safe surgical resection remains front-line treatment for diffuse lower-grade gliomas (DLGGs). Greater extent of resection (EOR) can delay transformation, control seizures, and improve survival. EOR is limited by the infiltrative nature of DLGGs and eloquent brain location preponderance. We investigated the role of neoadjuvant chemotherapy in tumour volume reduction (TVR) for cases in which a meaningful EOR was deemed unachievable.

METHODS

Retrospective review (2000-2020) of patients in a large tertiary UK brain tumor centre who serendipitously underwent management that did or could mimic a neoadjuvant chemotherapy pathway. Inclusion criteria: >18 years at diagnosis; histologically-proven WHO grade 2 supratentorial glioma; received chemotherapy alone after biopsy then +/- debulking. Tumour volume delta +/- EOR were calculated on serial MRI T2/FLAIR sequences using a semi-automated quantitative analysis tool (Smartbrush, BrainLab® AG).

RESULTS

Group 1 (neoadjuvant chemotherapy and then surgery, n=4): debulking was considered unachievable initially but then possible post-chemotherapy. Median TVR post-chemotherapy was 16.90% (range 0.45–64.90%). Mean EOR was 68.67% (33.72–100%). Median overall survival (OS) and progression free survival (PFS) were 85 (18–154) and 62 (13–153) months, respectively. Group 2 (biopsy followed by chemotherapy alone, n=7): debulking was considered unachievable initially. Median TVR post-chemotherapy was 25.68% (-294.95–46.02%, one patient progressed during chemotherapy). Median OS and PFS were 92 (6–135) and 27 (3–80) months, respectively. On re-review, and based on Group 1 results, some Group 2 patients may have been able to undergo debulking with meaningful EOR post-chemotherapy.

CONCLUSIONS

Chemotherapy can have a significant impact on reducing tumour volumes, such that cases initially deemed unsuitable for debulking may be converted into those in which a meaningful EOR can be achieved. Larger, multicentre, retrospective studies, and prospective trials are needed to determine the role of chemotherapy as a neoadjuvant tool in the management of DLGGs.
SURG-31. UTILITY OF TRANEXAMIC ACID (TXA) FOR RESECTION OF INTRACRANIAL MENINGIOMAS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Brown Nolan , Nguyen Brandon , Nguyen Andrew , Beyer Ryan , Harris Mark , Singh Rohin , Shahrestani Shane , Mohyeldin Ahmed
Published: November 2022

Due to its anti-fibrinolytic action, tranexamic acid (TXA) can be utilized to help maintain hemostasis during surgical operations. With respect to surgery for intracranial tumors, we hypothesize that TXA could help mitigate blood loss during resection of highly vascular tumors such as meningiomas. We therefore conducted a systematic review of the literature and meta-analysis to analyze the effects of TXA administration in patients undergoing surgical resection of intracranial meningioma. Study inclusion criteria were (1) primary data articles describing use of TXA in surgical resection of meningioma. In this meta-analysis, which included four primary comparative studies, outcome measurements between TXA and non-TXA groups were compared. Primary outcomes included operative length, complications, transfusion requirements, estimated blood loss, and postoperative Hb for TXA versus non-TXA (control) groups. Pooled-comparative analysis was conducted for each of these perioperative variables and formal meta-analysis was applied toward statistically significant parameters. A total of 221 patients were analyzed (110 TXA, 111 non-TXA). Patient age (p = 0.1632), gender (p = 0.8317), and tumor location (p = -.8334) were similar for TXA and control groups. TXA was associated with decreased complication rate (logRR: -0.85; CI95% = -1.49 to -0.22; p = 0.0087), decreased transfusion requirement (logRR: -0.50; CI95% = -0.92 to -0.08; p = 0.0039), reduced blood loss (SMD: -1.76; CI95% = -3.21 to -0.31; p < 0.0001), and increased postoperative Hb (SMD: 0.46; CI95% = -0.15 to 1.07; p < 0.0001). In three trials, TXA was administered intravenously as a loading dose of 20 mg/kg for 20 minutes preoperatively with an intraoperative maintenance rate of 1mg/kg/hr; in one trial, administration design was identical except that infusion rate of the 20 mg/kg preoperative loading dose was unspecified. TXA may be associated with reduced complications, transfusion requirements, perioperative estimated blood loss, and increasedpostoperative Hb when administered perioperatively for surgical resection of intracranial meningiomas.
SURG-32. A NOVEL MACHINE LEARNING APPROACH FOR MODELING THE PREDICTIVE VALUE OF COMORBIDITY INDICES IN PITUITARY SURGERY
Authors: Shahrestani Shane , Brown Nolan , Gendreau Julian , Bakhsheshian Joshua , Strickland Ben , Ruzevick Jacob , Carmichael John , Zada Gabriel
Published: November 2022

Although pituitary adenomas (PAs) are common intracranial tumors, literature evaluating the utility of comorbidity indices for predicting perioperative complications in patients undergoing pituitary surgery remains limited, thereby hindering the development of complex models that aim to identify high-risk patient populations. Accordingly, we utilized comparative modeling strategies to evaluate the predictive validity of various comorbidity indices and combinations thereof in predicting key pituitary surgery outcomes. The Nationwide Readmissions Database was used to identify patients who underwent transsphenoidal pituitary tumor operations (n=19,653) in 2016-2017. Patient frailty was assessed using the Johns Hopkins Adjusted Clinical Groups (JHACG). Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) were calculated for each patient. Five sets of generalized linear mixed-effects models were developed, using 1) Frailty, 2) CCI, 3) ECI, 4) Frailty+CCI, or 5) Frailty+ECI as the primary predictor. Complications investigated included inpatient mortality, non-routine discharge (e.g., to locations other than home) , length of stay (LOS) within the top quartile, cost within the top quartile, and one-year readmission rates. Postoperative mortality occurred in 73 patients (0.4%), one year readmission was reported in 2,994 patients (15.2%),and non-routine discharge occurred in 2,176 (11.1%) patients. The mean adjusted all-payer cost for the procedure was $25,553.85±$26,518.91 (Top Quartile: $28,261.20) and mean LOS was 4.8 days±7.4 days (Top Quartile: 5.0 days). The model using frailty+ECI as the primary predictor consistently outperformed other models, with statistically significant p-values as determined by comparing their AUCs, for most complications. For prediction of mortality, however the Frailty+ECI model (AUC:0.831) was not better than the ECI model alone (AUC:0.831;p=0.95). For prediction of readmission the Frailty+ECI model (AUC:0.617) was not better than the frailty model alone (AUC:0.606;p=0.10) or the Frailty+CCI model (AUC:0.610;p=0.29). Knowledge gained from these models may help neurosurgeons identify high-risk patients requiring additional clinical attention or specific resource utilization prior to surgical planning.
The Top 100 Twitter Influencers in Infectious Diseases
Authors: Santana Marcela Araujo de Oliveira , Butt Saira
Published: November 2022

Healthcare professionals in infectious diseases have been using Twitter to disseminate knowledge and interact with other professionals. This study aimed to identify and characterize the top 100 Twitter influencers in infectious diseases and to analyze the correlation between Twitter and academic influence. The Right Relevance Application Programming Interface was used to search for the term “infectious diseases,” producing a Twitter topic score for the top 100 infectious disease influencers. The influencers' Hirsch index (h-index) was compared with their Twitter topic score for a possible correlation. We identified that 46% of the infectious disease influencers were physicians. A correlation between the Twitter topic score of the infectious disease influencers and their h-index was not identified (r = 0.123, P = 0.22). The study also provides a list of the infectious disease influencers for those who have an interest in engaging and interacting with them on Twitter.
The clinicopathological and genetic differences among gastric cancer patients with no recurrence, early recurrence, and late recurrence after curative surgery
Authors: Chen Meng-Chao , Su Hsuan-Yu , Su Yen-Hao , Huang Kuo-Hung , Fang Wen-Liang , Lin Chii-Wann , Chen Ming-Huang , Chao Yee , Lo Su-Shun , Fen-Yau Li Anna , Wu Chew-Wun
Published: November 2022

Background:

To date, few reports have investigated the genetic alterations and clinicopathological features among gastric cancer (GC) patients with no tumor recurrence, early recurrence, and late recurrence following curative surgery.

Methods:

A total of 473 GC patients undergoing curative surgery were included. The clinicopathological characteristics, patient prognosis, recurrence patterns, and genetic alterations were compared between GC patients with early recurrence and late recurrence.

Results:

Among the 473 GC patients, 119 had early recurrence (<2 years) and 45 had late recurrence (≥2 years). Patients with early recurrence had tumor size larger than 5 cm, fewer superficial-type tumors, more lymphovascular invasion, more advanced pathological T and N categories and Tumor, Node, Metastasis (TNM) stages, and worse 5-year overall survival than patients with late recurrence and no recurrence. For intestinal-type GC, patients with no tumor recurrence had more Helicobacter pylori infection than patients with early recurrence and late recurrence; for diffuse-type GC patients, the frequency of PIK3CA amplification was the highest in early recurrence, followed by late recurrence and no recurrence. GC patients with single-site recurrence had more ARID1A mutations than those with multiple-site recurrence. Multivariate analysis demonstrated that age, tumor recurrence, and pathological N categories were independent prognostic factors.

Conclusion:

PIK3CA amplifications were more common in diffuse-type GC with early recurrence, whereas ARID1A mutations were more common in patients with single-site recurrence. Targeted therapy and immunotherapy might be helpful for these patients.
Second Laparoscopic Colorectal Resection: Safety and Feasibility
Authors: Casas María A. , Angeramo Cristian A. , Schlottmann Francisco , Bras Harriott Camila , Bun Maximiliano E. , Rotholtz Nicolás A.
Published: November 2022

Background:

As laparoscopic colorectal surgery continues increasing worldwide, the need of having a second laparoscopic colorectal resection (SLCR) might increase as well. Experience with this challenging procedure is scarce. The aim of this study was to evaluate the safety and feasibility of SLCR.

Methods:

A retrospective analysis of a prospectively collected database of patients undergoing colorectal surgery who needed an SLCR during the period 2008–2020 was performed. Demographics, operative variables, and postoperative outcomes were analyzed. A propensity score matching with a control population undergoing a first elective colorectal resection was performed.

Results:

A total of 1918 patients underwent colorectal surgery and 32 patients (1.7%) who required a SLCR were included for analysis; 17 (53.1%) were male, and the mean age was 71 (39 to 89) years. The median time between the first and second operations was 69 (6 to 230) months. At the second resection: The median operative time was 170 (90 to 380) minutes, there were 3 (9%) intraoperative complications and 2 (6%) conversions. Overall postoperative morbidity and major morbidity rates were 34% and 19%, respectively. Four patients (12.5%) required reoperation and 1 (3.1%) died of septic shock after an anastomotic leak. After propensity score matching, SLCR was more frequently performed by colorectal surgeons, and no differences in perioperative variables were observed compared with the control group.

Conclusions:

SLCR can be safely performed without jeopardizing perioperative outcomes. Further studies are needed to confirm the benefits of the minimally invasive approach in colorectal second resection and to elucidate the long-term outcomes.
Assessment and management of neonatal pain: a best practice implementation project
Authors: Zhou Xuan , Zhou Kai , Yang Ming , Wu Hongli , Chen Qiuan , Li Ting , Zeng Jiali , Li Dan , Ou Yulan , Wu Yanni
Published: November 2022

Background and aims:

Neonates are exposed to varying degrees of pain during their hospitalization, which are going to have a profound impact on their lives. Interventions to alleviate neonatal pain are inadequate and inconsistent. The project aims to promote evidence-based practice (EBP) for the assessment and management of neonatal patients with acute pain and to evaluate the impact of these practices on neonatal pain in hospital.

Methods:

The current project was conducted in the neonatal department of a tertiary hospital in China. Five audit criteria were developed for baseline and follow-up audits. The project used the JBI PACES software and JBI's Getting Research into Practice audit and feedback tool to take evidence-based healthcare into practice. A total of 100 neonates with acute pain procedures were evaluated at baseline and follow-up audit.

Results:

The results showed a poor compliance of the five audit indicators in the baseline audit and a significantly improved compliance of the five audit indicators in the follow-up audit. Compared to the baseline audit, audit criterion 1 increased from 0% to 86.1%, audit criterion 2 increased from 36.1% to 82.5%, audit criterion 3 increased from 12% to 61%, audit criterion 4 increased from 0% to 66%, and audit criterion 5 increased from 6% at baseline to 71% in the follow-up audit.

Conclusion:

The project found that EBP can help nursing staff effectively manage neonatal patients who are experiencing acute painful operations. Further studies are necessary to ensure the sustainability of the criteria in the project.
Person-centered care approach to prevention and management of falls among adults and aged in a Brazilian hospital: a best practice implementation project
Authors: Albertini Anna Carolina da Silva , Fernandes Renato Pinheiro , Püschel Vilanice Alves de Araújo , Maia Flavia de Oliveira Motta
Published: November 2022

Objectives:

The objective is to assess compliance with evidence-based criteria regarding a person-centered care approach to the prevention and management of falls among adults and the elderly in a Brazilian private hospital.

Methods:

This project used the JBI audit and feedback method to implement evidence into practice. The JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit tools have been used to promote changes in oncology and medical–surgical wards. The implementation protocol was designed based on the primary barriers and facilitators identified in the baseline audit, along with a training program and changes in the electronic medical records. Nursing documentation available in medical records, interviews with nurses who worked in oncology and medical–surgical wards, and interviews with patients admitted in oncology and medical–surgical wards were used to assess the baseline and follow-up audit compliance rates.

Results:

The baseline and follow-up audits showed improvement for criteria 3 and 9 (100%) and criteria 6 and 7 (97%), respectively. The compliance for criteria 4 (97.6%), 5 (76.7%), and 8 (18%) showed slight variations from baseline and follow-up audits. Compliance for criteria 1 (76.9%) and 2 (63.3%) decreased in the follow-up audit.

Conclusion:

These findings support that baseline, and follow-up audits allied to a fall training program and changes in the electronic nursing records increase the compliance rates related to evidence-based practice regarding a person-centered care approach to preventing and managing falls. We will implement new strategies according to the best practices to achieve better outcomes.
tFold-Ab: Fast and Accurate Antibody Structure Prediction without Sequence Homologs
Authors: Wu Jiaxiang , Wu Fandi , Jiang Biaobin , Liu Wei , Zhao Peilin
Published: November 2022

Accurate prediction of antibody structures is critical in analyzing the function of antibodies, thus enabling the rational design of antibodies. However, existing antibody structure prediction methods often only formulate backbone atoms and rely on additional tools for side-chain conformation prediction. In this work, we propose a fully end-to-end architecture for simultaneous prediction of backbone and side-chain conformations, namely tFold-Ab. Pre-trained language models are adopted for fast structure prediction by avoiding the time-consuming search for sequence homologs. The model firstly predicts monomer structures of each chain, and then refines them into heavy-light chain complex structure prediction, which enables multi-level supervision for model training. Evaluation results verify the effectiveness of tFold-Ab for both antibody and nanobody structure prediction. In addition, we provide a public web service for antibody structure prediction athttps://drug.ai.tencent.com/en.
A Modular, Adaptive, Deep-Learning-Based Brain-VR Interface
Authors: Kapitonova Maryna , Häringer Zacharias , Bongk Eric , Ball Tonio
Published: November 2022

Brain-Computer Interfaces (BCIs) may open up new possibilities for Virtual Reality (VR) applications: BCIs may be used for active brain control of VR avatars, or to make VR content passively-adaptive based on information decoded from ongoing brain activity. Application domains for such Brain-VR Interfaces (BVRI) include medical and healthcare, entertainment, and education. Conversely, VR technology also opens up new possibilities for BCI research and development: E.g., gamified immersive BCI paradigms may improve subject engagement and long-term motivation, helping to study learning and adaptivity in the BCI-control context. Previously, we have demonstrated a first adaptive, deep-learning-based online BCI for the control of robotic assistants. Here, we describe the extension of this setup to a modular, extensible, VR-compatible online BCI setup. We describe how we integrated a classical active BCI control paradigm using motor imagery into a gamified interactive VR scenario, designed to enhance the long-term motivation of subjects. We also present an initial quality assessment of electroencephalographic (EEG) signals acquired with a dry-electrode system. We anticipate that the presented modular adaptive Brain-VR Interface will help to understand and facilitate (co-)adaptivity during long-term BCI usage.
Network mechanisms underlying representational drift in area CA1 of hippocampus
Authors: Devalle Federico , Roxin Alex
Published: November 2022

Chronic imaging experiments in mice have revealed that the hippocampal code drifts over long time scales. Specifically, the subset of cells which are active on any given session in a familiar environment changes over the course of days and weeks. While some cells transition into or out of the code after a few sessions, others are stable over the entire experiment. Similar representational drift has also been observed in other cortical areas, raising the possibility of a common underlying mechanism, which, however, remains unknown. Here we show, through quantitative fitting of a network model to experimental data, that the statistics of representational drift in CA1 pyramidal cells are consistent with ongoing synaptic turnover in the main excitatory inputs to a neuronal circuit operating in the balanced regime. We find two distinct time-scales of drift: a fast shift in overall excitability with characteristic time-scale of two days, and a slower drift in spatially modulated input on the order of about one month. The observed heterogeneity in single-cell properties, including long-term stability, are explained by variability arising from random changes in the number of active inputs to cells from one session to the next. We furthermore show that these changes are, in turn, consistent with an ongoing process of learning via a Hebbian plasticity rule. We conclude that representational drift is the hallmark of a memory system which continually encodes new information.
A targeted, low-throughput compound screen in aDrosophilamodel of neurofibromatosis type 1 identifies simvastatin and BMS-204352 as potential therapies for autism spectrum disorder (ASD)
Authors: Dyson Alex , Ryan Megan , Garg Shruti , Evans D. Gareth , Baines Richard A.
Published: November 2022

Autism spectrum disorder (ASD) is a common neurodevelopmental condition for which there are no pharmacological therapies that effectively target its core symptomatology. Animal models of syndromic forms of ASD, such as neurofibromatosis type 1, may be of use in screening for such treatments.Drosophilalarvae lackingNf1expression exhibit tactile hypersensitivity following mechanical stimulation, proposed to mirror the sensory sensitivity issues comprising part of the ASD diagnostic criteria. Such behaviour is associated with synaptic dysfunction at the neuromuscular junction (NMJ). Both phenotypes may thus provide tractable outputs with which to screen for potential ASD therapies. In this study, we demonstrate that, while loss ofNf1expression within the embryo is sufficient to impair NMJ synaptic transmission in the larva, constitutiveNf1knockdown is required to induce tactile hypersensitivity, suggesting that a compound must be administered throughout development to rescue this behaviour. With such a feeding regime, we identify two compounds from a targeted, low-throughput screen that significantly and consistently reduce, but do not fully rescue, tactile hypersensitivity inNf1P1larvae. These are the HMG-CoA reductase inhibitor simvastatin, and the BKCachannel activator BMS-204352. At the NMJ, both compounds induce a significant reduction in the enhanced spontaneous transmission frequency ofNf1P1larvae, though again not to the level of vehicle-treated controls. However, both compounds fully rescue the increased quantal size ofNf1P1mutants, with simvastatin also fully rescuing their reduced quantal content. Thus, the further study of both compounds as potential ASD interventions is warranted.

Significance Statement

No therapies currently exist that consistently and effectively target the core symptoms of autism spectrum disorder (ASD), which include altered responses to sensory stimuli. Previously it was shown thatDrosophilalarvae lacking expression of ASD-associatedNf1display a heightened response to a mechanical stimulus and increased neuronal excitability, likely due to excessive Ras activity. Here, out of a screen for compounds targeting such mechanisms, we identified simvastatin and BMS-204352 to reduce the likelihood of a response inNf1−/-larvae following mechanical stimulation. These compounds also improved synaptic transmission defects at the neuromuscular junction. Such findings support the further study of these drugs as potential ASD therapies in the clinic.
The HCN1 hyperpolarization-activated cyclic nucleotide-gated channel enhances evoked GABA release from parvalbumin positive interneurons
Authors: Bock Tobias , Buss Eric W. , Lofaro Olivia M. , Leroy Felix , Santoro Bina , Siegelbaum Steven A.
Published: November 2022

Hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels generate the cationic Ih current in neurons and regulate the excitability of neuronal networks. The function of HCN channels depends, in part, on their subcellular localization. Of the four HCN isoforms (HCN1-4), HCN1 is strongly expressed in the dendrites of pyramidal neurons in hippocampal area CA1 but also in presynaptic terminals of parvalbumin-positive interneurons (PV+ INs), which provide strong inhibitory control over hippocampal activity. Yet, little is known about how HCN1 channels in these cells regulate the evoked release of the inhibitory transmitter GABA from their axon terminals. Here, we used several genetic, optogenetic, electrophysiological and imaging techniques to investigate how the electrophysiological properties of PV+ INs are regulated by HCN1, including how HCN1 activity at presynaptic terminals regulates the release of GABA onto pyramidal neurons (PNs) in CA1. We found that application of HCN1 pharmacological blockers reduced the amplitude of the inhibitory postsynaptic potential recorded from CA1 pyramidal neurons in response to selective optogenetic stimulation of PV+ INs. Homozygous HCN1-/-knockout mice also show reduced IPSCs in postsynaptic cells. Finally, two-photon imaging using genetically encoded fluorescent calcium indicators revealed that HCN1 blockers reduced the probability that an extracellular electrical stimulating pulse evoked a Ca2+response in individual PV+ IN presynaptic boutons. Taken together, our results show that HCN1 channels in the axon terminals of PV+ interneurons facilitate GABAergic transmission in the hippocampal CA1 region.
The variegation of human brain vulnerability to rare genetic disorders and convergence with behaviorally defined disorders
Authors: Levitis Elizabeth , Liu Siyuan , Whitman Ethan T , Warling Allysa , Torres Erin , Clasen Liv S , Lalonde Francois , Sarlls Joelle , Alexander Daniel C , Raznahan Armin
Published: November 2022

Diverse gene dosage disorders (GDDs) increase risk for psychiatric impairment, but characterization of GDD effects on the human brain has so far been piecemeal and lacked simultaneous analysis of multiple brain features across different GDDs. Here, through multimodal neuroimaging of 3 aneuploidy syndromes (XXY, XYY, trisomy 21), we reveal considerable diversity in cortical changes across GDDs and imaging-derived phenotypes (IDPs). This variegation of IDP change underlines the limitations of studying GDD effects unimodally. Integration across all IDP maps reveals highly distinct architectures of cortical change in each GDD, along with partial coalescence onto a common spatial axis of cortical vulnerability. This common axis shows strong alignment with shared cortical changes in behaviorally defined psychiatric disorders, and is enriched for specific molecular and cellular signatures - offering a high-priority target for future translational research.
Revealing unexpected complex encoding but simple decoding mechanisms in motor cortex via separating behaviorally relevant neural signals
Authors: Li Yangang , Zhu Xinyun , Qi Yu , Wang Yueming
Published: November 2022

In motor cortex, behaviorally-relevant neural responses are entangled with irrelevant signals, which complicates the study of encoding and decoding mechanisms. It remains unclear whether behaviorally-irrelevant signals could conceal some critical truth. One solution is to accurately separate behaviorally-relevant and irrelevant signals at both single-neuron and single-trial levels, but this approach remains elusive due to the unknown ground truth of behaviorally-relevant signals. Therefore, we propose a framework to define, extract, and validate behaviorally-relevant signals. Analyzing separated signals in three monkeys performing different reaching tasks, we found neural responses previously considered to contain little information actually encode rich behavioral information in complex nonlinear ways. These responses are critical for neuronal redundancy and reveal movement behaviors occupy a higher-dimensional neural space than previously expected. Surprisingly, when incorporating often-ignored neural dimensions, behaviorally-relevant signals can be decoded linearly with comparable performance to nonlinear decoding, suggesting linear readout may be performed in motor cortex. Our findings prompt that separating behaviorally-relevant signals may help uncover more hidden cortical mechanisms.
Paired aptamer capture and FISH detection of individual virions enables cell-free determination of infectious titer
Authors: Liu Yifang , Potts Jacob L. , Bloch Dylan , Nian Keqing , McCormick Caroline A. , Fanari Oleksandra , Rouhanifard Sara H.
Published: November 2022

Early detection of viruses can prevent the uncontrolled spread of viral infections. Determination of viral infectivity is also critical for determining the dosage of gene therapies, including vector-based vaccines, CAR T-cell therapies, and CRISPR therapeutics. In both cases, for viral pathogens and viral vector delivery vehicles, fast and accurate measurement of infectious titer is desirable. The most common methods for virus detection are antigen-based (rapid but not sensitive) and reverse transcription polymerase chain reaction (RT-PCR)-based (sensitive but not rapid). Current viral titer methods heavily rely on cultured cells, which introduces variability within labs and between labs. Thus, it is highly desirable to directly determine the infectious titer without using cells. Here, we report the development of a direct, fast, and sensitive assay for virus detection (dubbed rapid-aptamer FISH or raptamer FISH) and cell-free determination of infectious titers. Importantly, we demonstrate that the virions captured are “infectious,” thus serving as a more consistent proxy of infectious titer. This assay is unique because it first captures viruses bearing an intact coat protein using an aptamer, then detects genomes directly in individual virions using fluorescence in situ hybridization (FISH)– thus, it is selective for infectious particles (i.e., positive for coat protein and positive for genome).
Neuronal contact predicts connectivity in theC. elegansbrain
Authors: Cook Steven J. , Kalinski Cristine A. , Hobert Oliver
Published: November 2022

Axons must project to particular brain regions, contact adjacent neurons, and choose appropriate synaptic targets to form a nervous system. Multiple mechanisms have been proposed to explain synaptic partnership choice. In a ‘lock-and-key’ mechanism, first proposed by Sperry’s chemoaffinity model1, a neuron selectively chooses a synaptic partner among several different, adjacent target cells, based on a specific molecular recognition code2. Alternatively, Peters’ rule posits that neurons indiscriminately form connections with other neuron types in their proximity; hence, neighborhood choice, dictated by initial neuronal process outgrowth and position, is the sole predictor of connectivity3,4. However, whether Peters’ rule plays an important role in synaptic wiring remains unresolved5. To assess the nanoscale relationship between neuronal adjacency and connectivity, we evaluate the expansive set ofC. elegansconnectomes. We find that synaptic connectivity can be accurately modeled as a path-length-dependent process of neuronal adjacency and brain strata, offering strong support for Peters’ rule as an organizational principle ofC. elegansbrain wiring.
Impact for good: a journey toward impact through marketing scholarship
Authors: Scott Maura L. , Mende Martin
Published: November 2022

Purpose

This study aims to propose approaches to cocreating new knowledge at the intersection of theory, practice, policy and consumers, broadly inspired by the United Nations’ sustainable development goals.

Design/methodology/approach

Following a process perspective, this study’s approach begins with a well-being-related problem and collaboratively works with stakeholders to exchange, disseminate and generate knowledge, with the goal of helping to improve quality-of-life for consumers.

Findings

To demonstrate applications of impact in action, this study provides illustrative cases from three scholarly research collaborations that involve working closely with organizations in health-care and financial services.

Research limitations/implications

This research provides recommendations for facilitating impactful research collaborations.

Practical implications

This study emphasizes the vital role that consumers and practitioners play in collaboration for impact.

Originality/value

A central theme in this work is the idea that being more inclusive of vulnerable and previously underserved customer populations can lead to potentially beneficial outcomes for consumers and firms, while also helping to facilitate the creation of new scholarly marketing knowledge in the process.
Initiating salary negotiations: a mixed-methods study into the effects of gender, shame and pay-raise justifications
Authors: Nelson Noa , Kalfon Hakhmigari Maor , Horesh Neta
Published: November 2022

Purpose

Based on gender role theory, this study aims to test a moderated mediation model in which gender, mediated by shame, affected salary negotiation initiation and writing pay raise justifications before the negotiation moderated gender effects, by boosting women’s negotiation initiation and lowering their shame.

Design/methodology/approach

Mixed-methods approach: in a scenario experiment, participants (N = 172; 92 women) imagined initiating salary negotiations with real employers, and shame and the inclination to actually initiate the negotiation were measured. About half the sample wrote pay raise justifications as part of the task. In the qualitative phase of the study, justifications were analyzed.

Findings

The model’s predictions were not supported. Women were neither less inclined to negotiate nor reported higher shame than men. Across gender, shame related to lower negotiation initiation and was alleviated by justifications’ preparation. Writing justifications did not affect men’s negotiation initiation, but lowered women’s. The qualitative analysis revealed that while all participants preferred communal themes in their justifications, women used themes of confidence, entitlement and power less than men.

Originality/value

The study provides original evidence in negotiation literature, on the effects of shame, on the practice of preparing pay raise justifications and on specific patterns in justifications’ content.
The relationship between body mass index, anthropometric measurements and GRACE risk score in acute coronary syndrome
Authors: Arslan Nurgul , Akbulut Gamze , Süleymanoğlu Muhammed , Alataş Hacer , Yaprak Bülent
Published: November 2022

Purpose

This study aims to determine the relationship between body mass index (BMI) and Global Registry of Acute Coronary Events (GRACE) risk score in patients diagnosed with acute coronary syndrome (ACS) and to evaluate the results in this context.

Design/methodology/approach

This was a prospective cohort study of ACS patients admitted to a cardiac care unit in high specialization hospital's cardiology service. The study included 140 men aged >35 years who were diagnosed with ACS.

Findings

The mean age of the individuals participating in the study was 61.4 ± 10.9 years old. The mean BMI of the individuals was 25.3 ± 6.6 kg/m2, and the mean value of the waist/hip ratio was 0.85 ± 0.01. Individuals were divided into four quarters according to the GRACE score. It was determined that individuals with the highest GRACE score were very underweight or morbidly obese according to their BMI values (p = 0.04).

Originality/value

It has been observed that there is a U-shaped relationship between the GRACE score and the BMI in individuals diagnosed with ACS. The risk of death of ACS patients with very high or very low BMI values was found to be close to each other. Although there is a relationship between BMI and GRACE score, it is concluded that it is insufficient to determine the risk in coronary disease alone, and body fat distribution should be examined together with BMI.