bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of diffusional kurtosis imaging in grading of brain gliomas: A diagnostic test accuracy systematic review and meta-analysis
Authors: Abdalla Gehad , Sanverdi Eser , Machado Pedro M , Kwong Joey S W , Panovska-Griffiths Jasmina , Rojas-Garcia Antonio , Yoneoka Daisuke , Yousry Tarek , Bisdas Sotirios 
Published: October 2019

Abstract

Aim and objectives
We aim to illustrate the diagnostic performance of diffusional kurtosis imaging (DKI) in the diagnosis of gliomas.

Methods and materials
A review protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P), registered in the international prospective register of systematic reviews, PROSPERO and published. Literature search in 4 databases was performed using the keywords “glioma” and “diffusional kurtosis”.After applying a robust inclusion/exclusion criteria, included articles were independently evaluated according to the QUADAS-2 tool.Data extraction was done in a pre-designed pro forma.Reported sensitivities and specificities were used to construct 2x2 tables and paired forest plots using the Review Manager (RevMan®) software.Random-effect model was pursued using the hierarchical summary receiver operator characteristics.

Results
Initially, 216 hits were retrieved. Considering duplicates and inclusion criteria; 23 articles were eligible for full-text reading. Ultimately, 19 studies were deemed to be eligible for final inclusion. Quality assessment revealed 9 studies with low risk of bias in the 4 domains. Using a bivariate random-effect model for data synthesis; summary ROC curve showed pooled area under the curve (AUC) of 0.92 and estimated sensitivity of 0.87 (95% CI: 0.78 - 0.92) in high/low grade gliomas’ differentiation.A mean difference in Mean Kurtosis (MK) value between HGG and LGG of 0.22 [95% CI: 0.25 - 0.19] was illustrated (p value = 0.0014) and a moderate degree of heterogeneity (I²= 73.8%).

Conclusion
DKI shows good diagnostic accuracy in high/low grade gliomas’ differentiation; which might qualify it to be part of the routine clinical practice, however; further evidence is deemed for technique standardization.
Use of pre-treatment MRI scans to predict toxicity from radiotherapy in patients with Glioblastoma (GB)
Authors: Gill Ramandeep , Mills Samantha , Chalmers Anthony , Lorimer Cressida 
Published: October 2019

Abstract
Median life expectancy of patients with Glioblastoma (GB) is 24.4 weeks. Current best treatment involves concurrent use of Temozolomide and radiotherapy. However, toxicity from radiotherapy can limit patient benefit. The objective of this study was to determine the ability of pre-treatment MRI scans of the brain to predict radiotoxicity.
This pilot study collected survival and toxicity data from 10 patients aged 65 years or older with a histopathological or radiological diagnosis of GB. Brain MRI scans were used to collect information on tumour characteristics alongside imaging scoring systems to assess medial temporal lobe atrophy, global cortical atrophy and small vessel disease. Scans were analysed by two independent readers.
Median survival for this cohort was 35.2 weeks (range 19–59.3 weeks). The beta correlation scores for total contralateral white matter score, global cortical atrophy and T1 contrast volume and survival were all found to equal 1. Beta-correlation coefficients for microanatomical rating score and Schelten’s medial temporal atrophy score were 0.4 and 0.9 respectively. The sum of CTCAE scores for nausea, fatigue and confusion was calculated to provide an overall toxicity score. The mean beta-correlation co-efficient for all scores against toxicity was 1. Use of Bland-Altmann plots showed significant inter-rater reliability for all scores excluding global cortical atrophy. Results from this study suggest a moderate relationship between scan characteristics and increasing toxicity. However, high inter-rater reliability suggests these scoring systems have the potential to be used accurately in clinical practice. A larger study will be conducted to confirm results from this study.
Survival of patients with melanoma metastatic brain metastases in the era of novel systemic therapies in Cardiff, Wales
Authors: Pasquale Joseph , Ocen Joanita , Powell James , Kumar Satish 
Published: October 2019

Abstract
The incidence of malignant melanoma (MM) is increasing in the UK; it’s projected to rise by 7% by 2035. MM has high predisposition to developing brain metastases (BM) with 50–60% of patients being affected. Stereotactic radiosurgery (SRS) and surgery, key interventions in managing patients with BM, have been shown to improve survival outcomes of patients. Patients’ prognosis and survival has also significantly improved with the advent of novel therapies in the last few years. It was noted that the Cardiff Neuro-Oncology multidisciplinary team were receiving increasing amount of referrals for consideration of surgery or SRS in patients with MM. 106 MDT referrals were retrospectively reviewed. 31 patients had surgery, 20 patients had SRS and the remaining 54 patients had WBRT. There was no significant difference in the patient distribution. The majority of patients had 1 brain lesion in both groups (in similar proportions). The 12 month survival for the surgical cohort was 65% for immunotherapy group, 55%- targeted therapy and 30%- no therapy. For the SRS group the 12 month survival for immunotherapy was 45%, targeted therapy- 40% and 20%- no therapy. The median OS for surgery versus SRS was 8 and 7 months respectively. The results suggest that simultaneous treatment with surgery or SRS in conjunction with SACT does improve survival. Interpretation of results will have to be taken with caution due to the retrospective nature and the small sample size. Going forward, we will delve deeper and review local progression rates and SACT timing/sequencing in our practice.
Exploring the lived experience of a high grade glioma
Authors: Soni Shivani , Williamas Matthew , Lannie Antonia 
Published: October 2019

Abstract

Introduction
Brain tumour patients face a variety of challenges during diagnosis and treatment. Although most treating clinicians are familiar with these, it can be difficult to obtain a comprehensive overview of which are the most common problems, which patients they affect and how to address them.

Methods
We conducted a systematic review of all work relating to the lived experience of patients and carers of a glioblastoma. We identified articles published between 2008 and 2018 these had to be published in English, using the search terms cares and patients, lived experience, glioblastoma and perspective with relative alternative terms. We excluded articles that were previous systematic reviews, included low grade/brain metastasis from another primary site and articles that combined results for patients and carers. We extracted key theme and concerns, and summarised and tabulated and developed a discussion/recommendation.

Results
We identified 405 potential studies. We rejected 374 after screening abstract and titles, and a further 23 on further review. This left a set of 8 unique publications. The 8 publications included were comprised of qualitative studies that explored patient and carers experience at different points in the patient pathway. The main concerns/themes identified were issues around communication specifically the shock of diagnosis, re-negotiating relationships and finally accessing support.

Conclusions
This is the first systematic review that collates the lived experience of patients with high grade gliomas. It differs from the palliative care literature and from the James Lind Alliance, and is more specific than generic health needs assessments that are being used in practice.
Contrasting multidisciplinary clinic follow up for patients with high and low grade glioma.
Authors: Critchley Giles , Bucur Sorin , Walsh Gill , Smith Ruth , Creak Antonia , Brock Juliet 
Published: October 2019

Abstract
Patients with high grade glioma (HGG) and low grade glioma (LGG) may enter a period of stability in their disease when surveillance is required; during this time they often require different forms of support. We describe two different multidisciplinary clinics approaches to patients with gliomas, both of which are linked to the relevant multidisciplinary meetings (MDMs).
Since 1987 the ‘joint glioma clinic’ (HGG clinic) has been run with a neurosurgeon, neurooncologist and clinical nurse specialist seeing patients and their carers in one room. Patients under surveillance undergo MRI scans and if there is evidence of recurrence then an immediate discussion can be held with the patient regarding options for further management.
Since 2011 the Low grade glioma clinic (LGG clinic) has run with a multi room model. There are two neurosurgeons, a neurooncologist, a neuroradiologist, a neuropsychologist, a neurologist and a clinical nurse specialist present who discuss patients in a MDM. Subsequently a patient may then see one or more of the team in sequence in different rooms as needed. This allows issues such as epilepsy, neuropsychology, treatment options and surveillance intervals to be discussed with patients at one visit.
There is a cohort of 106 patients under surveillance in the HGG joint glioma clinic and 270 patients in the LGG clinic.
We believe a single visit can minimize the impact of the disease and provide different forms of support a needed. Both models allow rapid decision making when the period of surveillance ends due to transformation or recurrence.
The Glioma Elephant in The Room
Authors: Davis Charles 
Published: October 2019

Abstract

Radiotherapy is the most effective treatment of glioblastoma, radical surgery and chemotherapy will help some patients. Tumour Treating Fields (TTF) is used in many countries in the developed world. Thousands of patients have been treated.

Methods
A survey at a neuro-oncology meeting of clinicians, scientists and charity members asking them about TTF.

Results
1. 7 out of 8 clinicians did not discuss TTF with patients.: 2. The reasons being “not available”, “very expensive”, “don’t know enough”.: 3. Out of 17 non clinicians, 14 stated that TTF should be discussed with all patients.: 4. Out of 22 clinicians and non clinicians, 16 said they would consider trying to raise £200.000 for treatment from crowd funding.

Discussion
The report of the chief scientific officer of the department of health on brain tumours, the report of the Tessa Jowell funding, BNOS, do not discuss TTF.?why. NICE guidelines for NHS patients state “Do not offer TTF” but do not say “Do not discuss”.

Conclusion
Sadly, clinicians are not telling the patients about options for treatment. TTF is controversial and expensive and is now being used in several cancer treatments. The UK is one of the few developed countries that is not researching or discussing this treatment.
The impact of the neuro-oncology research radiographer role in the effective facilitation of an advanced imaging study in glioblastoma
Authors: Fernandez Sharon , Murray Louise , Scarsbrook Andrew , Broadbent David , Shelley David , Currie Stuart , Short Susan 
Published: October 2019

Abstract

Background
A neuro-oncology research radiographer was included in the multi-disciplinary study team (MDT) from the set-up stage of a new advanced imaging study in glioblastoma, as it was envisaged that this would enhance progress and provide better patient-centred care.

Aims
This pilot study aimed to include 12 participants. This specialist radiographer role was to support recruitment, co-ordinate appointments and monitor patients’ progress. We aimed to ensure that optimal treatment and patient-centred care remained at the forefront of the study pathway.

Method
Patients were identified and approached by the radiographer prior to consent by a trial investigator. Additional scans were planned prior to radiotherapy (RT), 2 weeks into RT and 6 weeks post RT. The radiographer ensured streamlined appointments and was present during each study visit to liaise with health professionals, provide a specific point of contact with the patient and to ensure continuity.

Results
6 patients have been recruited since November 2018. The specialist radiographer has attended 28 study scans to date. Over 40 face-to-face interactions have been undertaken, 30 email communications and 18 telephone consultations. Patient feedback has been extremely positive, all patients convey that they feel supported and value continuity throughout the pathway. Enhanced communication across the entire study team has also guaranteed efficient recruitment.

Conclusion
The research radiographer has a key role in the multi-disciplinary team delivering this study. Effective liaison between the radiotherapy and imaging departments has been crucial and patients value a consistent point of contact through the study and treatment pathways.
Cavernous Malformations in and Around the Third Ventricle: Indications, Approaches, and Outcomes
Authors: Woodall M Neil , Catapano Joshua S , Lawton Michael T , Spetzler Robert F 
Published: October 2019

Abstract

BACKGROUND
Cavernous malformations in structures in and around the third ventricle are a challenging conceptual and surgical problem. No consensus exists on the ideal approach to such lesions.

OBJECTIVE
To perform a retrospective review of our institutional database to identify and evaluate approaches used to treat cavernous malformations located in and around the third ventricle.

METHODS
Information was extracted regarding lesion size and location, extent of resection, time to last follow-up, surgical approach, presenting symptoms, preoperative and postoperative neurological status, and specific approach-related morbidity.

RESULTS
All 39 neurosurgical operations (in 36 patients) were either an anterior interhemispheric (AIH) (44%, 17/39) or a supracerebellar infratentorial (SCIT) (56%, 22/39) approach. Gross-total resection was achieved in 23 of 39 procedures (59%), a near-total resection in 1 (3%), and subtotal resection in 15 (38%). For the 31 patients with at least 3 mo of follow-up, the mean modified Rankin Scale (mRS) score was 1.5. Of the 31 patients, 25 (81%) had an mRS score of 0 to 2, 4 had a mRS score of 3 (13%), and 1 each had a mRS score of 4 (3%) or 5 (3%).

CONCLUSION
Most approaches to cavernous malformations in and around the third ventricle treated at our institution have been either an AIH or a SCIT approach. The AIH approach was used for lesions involving the lateral wall of the third ventricle or the midline third ventricular floor, whereas the SCIT approach was used for lesions extending from the third ventricle into the dorsolateral midbrain, with acceptable clinical results.
Differences in the Clinical Characteristics of Persistent Idiopathic Facial Pain (Atypical Odontalgia) Patients with or Without Neurovascular Compression of the Trigeminal Nerve
Authors: Kawasaki Kaoru , Sugawara Shiori , Watanabe Kazuya , Hong Chaoli , Tu Trang Thi Huyen , Watanabe Takeshi , Sakamoto Junichiro , Yoshino Norio , Suga Takayuki , Mikuzuki Lou , Takenoshita Miho , Takada Satoshi , Kurabayashi Tohru , Toyofuku Akira 
Published: October 2019

Abstract

Background
Persistent idiopathic facial pain (PIFP) is the unexplained pain along the territory of the trigeminal nerve, including nonorganic tooth pain called atypical odontalgia (AO). Though PIFP is debilitating to patients’ livelihood and well-being, its pathophysiology remains poorly understood. Although neurovascular compression (NVC) of the trigeminal nerve is known to be associated with trigeminal neuralgia (TN), the relationship between NVC and other orofacial pains has not been fully elucidated.

Methods
In this study, we investigated the differences in the characteristics of PIFP (primarily AO) patients in the presence or absence of NVC. A retrospective analysis was performed on data from 121 consecutive patients who had been diagnosed with unilateral PIFP according to the criteria of the International Classification of Headache Disorders (ICHD)–3 and underwent magnetic resonance imaging scans of the head.

Results
In the group without NVC, characteristic findings were significant for psychiatric morbidity, somatization, and pain disability, when compared with the group with NVC. Furthermore, the group without NVC exhibited significant headache, noncardiac chest pain, shortness of breath, and pain catastrophizing.

Conclusions
These results suggest that PIFP patients can be divided into two groups: one consistent with a neuropathic pain phenotype when NVC is present and a functional somatic symptom phenotype when presenting without NVC. Our findings may enable a more precise understanding of pathophysiology of PIFP and lead to better treatment strategies.
An unbiased high-throughput drug screen reveals a potential therapeutic vulnerability in the most lethal molecular subtype of pancreatic cancer
Authors: Pan Chun-Hao , Otsuka Yuka , Sridharan BanuPriya , Woo Melissa , Babu Sruthi , Leiton Cindy V. , Bai Ji Dong K. , Chang David K. , Biankin Andrew , Scampavia Louis , Spicer Timothy , Escobar-Hoyos Luisa F. , Shroyer Kenneth R. 
Published: October 2019

AbstractPancreatic ductal adenocarcinoma (PDAC) is predicted to become the second leading cause of cancer-related deaths in the United States by 2020, due in part to innate resistance to widely used chemotherapeutic agents and limited knowledge about key molecular factors that drive tumor aggression. We previously reported a novel negative prognostic biomarker, keratin 17 (K17), whose overexpression in cancer results in shortened patient survival. In this study, we aimed to determine the predictive value of K17 and explore the therapeutic vulnerability in K17-expressing PDAC, using an unbiased high-throughput drug screen. Patient-derived data analysis showed that K17 expression correlates with resistance to Gemcitabine (Gem). In multiple in vitro models of PDAC, spanning human and murine PDAC cells, we determined that the expression of K17 results in a more than two-fold increase in resistance to Gem and 5-fluorouracil, key components of current standard-of-care chemotherapeutic regimens. Furthermore, through an unbiased drug screen, we discovered that Podophyllotoxin (PPT), a microtubule inhibitor, showed at least two-fold higher sensitivity in K17-expressing compared to K17-negative PDAC cells. In the clinic, another microtubule inhibitor, Paclitaxel (PTX), is used in combination with Gem as a first line chemotherapeutic regimen for pancreatic, breast, lung, and ovarian cancer. Surprisingly, we found that when combined with Gem, PPT but not PTX, was synergistic in inhibiting the viability of K17-expressing PDAC cells. This provides evidence that PPT or its derivatives could potentially be combined with Gem to enhance treatment efficacy for the approximately 50% of PDACs that express high levels of K17. In summary, we reported that K17 is a novel target for developing a biomarker-based personalized treatment for PDAC.
Developmental Changes in Visual Responses to Social Interactions
Authors: Walbrin Jon , Mihai Ioana , Landsiedel Julia , Koldewyn Kami 
Published: October 2019

AbstractRecent evidence demonstrates that a region of the posterior superior temporal sulcus (pSTS) is selective to visually observed social interactions in adults. In contrast, we know comparatively little about neural responses to social interactions in children. Here, we used fMRI to ask whether the pSTS would be ‘tuned’ to social interactions in children at all, and if so, how selectivity might differ from adults. This was investigated not only in the pSTS, but also in socially-tuned regions in neighbouring temporal cortex: extrastriate body area (EBA), face-selective STS (STS-F), fusiform face area (FFA), and temporo-parietal junction (TPJ-M).Both children and adults showed selectivity to social interaction within right pSTS, while only adults showed selectivity on the left. Adults also showed both more focal and greater selectivity than children (6–12 years) bilaterally. Exploratory sub-group analyses showed that younger children (6–8 years), but not older children (9-12), are less selective than adults on the right, while there was a developmental trend (adults > older > younger) in left pSTS. These results suggest that, over development, the neural response to social interactions is characterized by increasingly more selective, more focal and more bilateral pSTS responses, a process that likely continues into adolescence.HighlightsChildren show less interaction selectivity in the pSTS than adultsAdults show bilateral pSTS selectivity, while children are more right-lateralizedExploratory findings suggest interaction selectivity in pSTS is more focally tuned in adults
Stretching DNA to twice the normal length with single-molecule hydrodynamic trapping
Authors: Jiang Yan , Feldman Theodore , Bakx Julia A.M. , Yang Darren , Wong Wesley P. 
Published: October 2019

AbstractSingle-molecule force spectroscopy has brought many new insights into nanoscale biology, from the functioning of molecular motors, to the mechanical response of soft materials within the cell. To expand the single-molecule toolbox, we have developed a surface-free force spectroscopy assay based on a high-speed hydrodynamic trap capable of applying extremely high tensions for long periods of time. High-speed single-molecule trapping is enabled by a rigid and gas-impermeable microfluidic chip, rapidly and inexpensively fabricated out of glass, double-sided tape and UV-curable adhesive. Our approach does not require difficult covalent attachment chemistries, and enables simultaneous force application and single-molecule fluorescence. Using this approach, we have induced a highly extended state with twice the contour length of B-DNA in regions of partially intercalated double-stranded (dsDNA) by applying forces up to 250 pN. This highly extended state resembles the hyperstretched state of dsDNA, which was initially discovered as a structure fully intercalated by dyes under high tension. It has been hypothesized that hyperstretched DNA could also be induced without the aid of intercalators if high-enough forces were applied, which matches our observation. Combining force application with single-molecule fluorescence imaging is critical for distinguishing hyperstretched DNA from single-stranded DNA that can result from peeling. High-speed hydrodynamic trapping is a powerful yet accessible force spectroscopy method that enables the mechanics of biomolecules to be probed in previously difficult to access regimes.
Dataset Decay: the problem of sequential analyses on open datasets
Authors: Thompson William Hedley , Wright Jessey , Bissett Patrick G , Poldrack Russell A 
Published: October 2019

AbstractOpen data has two principal uses: (i) to reproduce original findings and (ii) to allow researchers to ask new questions with existing data. The latter enables discoveries by allowing a more diverse set of viewpoints and hypotheses to approach the data, which is self-evidently advantageous for the progress of science. However, if many researchers reuse the same dataset, multiple statistical testing may increase false positives in the literature. Current practice suggests that the number of tests to be corrected is the number of simultaneous tests performed by a researcher. Here we demonstrate that sequential hypothesis testing on the same dataset by multiple researchers can inflate error rates. This finding is troubling because, as more researchers embrace an open dataset, the likelihood of false positives (i.e. type I errors) will increase. Thus, we should expect a dataset’s utility for discovering new true relations between variables to decay. We consider several sequential correction procedures. These solutions can reduce the number of false positives but, at the same time, can prompt undesired challenges to open data (e.g. incentivising restricted access).