bluuebunny/crossref_metadata_2025_split huggingface dataset:
DO NEURO ONCOLOGY PATIENTS FEEL SUﬃCIENTLY SUPPORTED TO MANAGE THEIR SURGICAL WOUNDS AFTER SURGERY?
Authors: Kostick Ms Ellie , Suarez Mr Aeron , Harding Ms Nicola , Hedges Ms Sarah , Sabido Ms Pat , Mullens Ms Laura , Hurwitz Mrs Victoria 
Published: October 2024

Abstract

AIMS
Establish if neuro oncology patients feel they are suﬃciently well supported to manage their wounds post operatively. Is there any correlation to patient wound care management and developing wound infections.

METHOD
There was an anecdotal rise in wound infections in the neuro oncology department, which led to the team investigation a cause. This project was looking to see if patients felt they were suﬃciently supported to manage their wounds post operatively. A survey was sent via email to 94 patient’s who had undergone neurosurgery under the neuro oncology team at a London teaching Hospital in December 2023, January 2024, and February 2024.

RESULTS
There was a response rate of 23.5%. Overall 96% of patients felt able to manage their wound post operatively. 76% of people wished to have the information on wound care at discharge from hospital. 68% advised that they would like to receive information about wound care via printed material and 76% would like verbal instruction with questions. Patients commented that ‘there was a conﬂict of information’, and ‘the information at discharge could have been better’. They would like information on’ how to clean it [the wound]. 3 patients had a suspect infection but did not have treatment, and 1 had a conﬁrmed infection with treatment.

CONCLUSION
Neuro oncology patients are able to manage their wounds post operatively, but they feel that they would beneﬁt from extra support via written material, and verbal instructions. Future projects may include developing an evidence based post operative wound care information leaﬂet and instructions for wound care. Although in this cohort there was only 1 conﬁrmed infection, further investigation is needed to establish the cause for the apparent increase.
MENINGIOMA OEDEMA AND SEIZURES – A META-ANALYSIS
Authors: Tanti Dr Matthew , Nevitt Dr Sarah , Yeo Dr Molly , Bolton Dr William , Chumas Mr Paul , Mathew Mr Ryan , Maguire Dr Melissa 
Published: October 2024

Abstract

AIMS
Meningiomas are primary intracranial neoplasms. Oedema and seizures can occur in the pre and postoperative period and oedema is commonly cited as a risk factor for seizures. A meta-analysis of eight studies published in 2016 identiﬁed preoperative oedema as a risk factor for preoperative seizures. Our aim is to perform an updated review. The literature base has grown and there are studies presenting data on postoperative seizures.

METHOD
The meta-analysis protocol is uploaded to INPLASY (DOI: 10.37766/inplasy2023.7.0101). Existing literature from seven databases was collected and Cochrane guidance was followed. Data was analysed using packages within R programming software. Part of this work was presented in draft form at ILAE 2023 and here we present updated work.

RESULTS
Our search identiﬁed 44 unique studies for meta-analysis. Many studies were biased by subjective oedema measurement or lack of seizure deﬁnition. Preoperative oedema increased the odds of preoperative seizures; odds ratio (OR) 3.41, 95% conﬁdence interval (CI) 3.00 to 3.87, p &lt;.001, studies (k) 24, participants (n) 6,917, low heterogeneity (I2) 0%. There were no subgroup differences by oedema measurement or use of seizure deﬁnition. Preoperative oedema was associated with increased odds of early postoperative seizure (within one week of surgery) but the difference was not signiﬁcant; OR 1.39, CI 0.97-1.99, p =.063, k = 6, n = 2,445, I2 = 0% (low). Preoperative oedema increased the odds of late postoperative seizures; OR 1.95, CI 1.55-2.45, p &lt;.001, k = 7, n = 1,722, I2 = 0% (low). Oedema was associated with seizures following stereotactic radiosurgery in two studies.

CONCLUSION
Preoperative oedema is associated with seizures prior to and following treatment. While there is a positive association between preoperative oedema and early postoperative seizure it is not statistically signiﬁcant.
INTRAOPERATIVE MRI FOR BRAIN TUMOURS: A 15-YEAR RETROSPECTIVE REVIEW AT A SINGLE AUSTRALIAN INSTITUTION
Authors: Madani Dr Daniel , Muralidharan Dr Krishna , Chang Dr Nick , Tang Mr Patrick , Wong Dr Johnny 
Published: October 2024

Abstract

AIMS
Maximal safe resection is the objective of most neuro-oncological operations. The extent of resection can be maximized using imaging updated intraoperatively, including intraoperative MRI (iMRI) theatre, which may translate to improved overall survival. This study aimed to present our 15-year iMRI theatre experience and review its utility.

METHOD
A retrospective cohort analysis was conducted to include all intracranial tumour operations performed in the iMRI theatre (2007–2022). Cases were classiﬁed according to their histopathology: low- and high-grade gliomas (LGG and HGG respectively), meningiomas, pituitary adenomas, and metastases. Demographic, clinical, and histological data was extracted from SurgiNet and analyzed by using the WHO 2021 classiﬁcation. The impact of intraoperative MRI on operative outcomes was reviewed.

RESULTS
A total of 478 neuro-oncology cases were identiﬁed, consisting of 194 pituitary adenomas (n= 69 cases via microscope), 162 HGG, 108 LGG (n= 7 cases for biopsy), 10 cerebral metastases, and 4 meningiomas. Intraoperative MRI theatre utilization averaged 41 cases per year throughout our 15-year experience. The median age was 47 years old (range 35-59 yo.) with a slight predominance in the female population (n= 298, 52%). We identiﬁed 85 (17.8%) re-do cases, which include: pituitary adenoma (n= 15, 17.6%), glioma (n= 68, 80%), and intracranial metastasis (n= 2, 2.4%). Of the 10 intracranial metastases, melanoma consisted of 5, lung carcinoma of 3, and renal cell- and colorectal-carcinoma represented 1 case, respectively. Intraoperative MRI conﬁrmed complete resection in all meningioma cases.

CONCLUSION
In this series, iMRI has been utilised mostly for pituitary adenoma resection and gliomas. It provides near realtime intraoperative navigation and imaging to maximise the extent of resection, prevent injury to important structures and improve patient outcomes in tumour resections.
A NEW INTERNATIONAL ACCELERATOR PROGRAMME FOR NOVEL BRAIN TUMOUR THERAPIES
Authors: Aitken Dr Charlotte , Huskens Dr Nicky , Bushby Prof Katie , Noble Dr Karen , Hamerilk Prof Petra , Kaye Dr Edward , Kobayashi Dr Dione , Mathew Mr Ryan , McCall Dr John , Nazarian Dr Javad , Plummer Prof Ruth , Rahman Dr Ruman , Lopez Dr Juanita , Nagaraju Prof Kanneboyina 
Published: October 2024

Abstract

AIMS
Developing a comprehensive translational programme for brain tumours involves navigating numerous challenges, including preclinical study robustness, safety, clinical trial design, understanding and addressing regulatory requirements, and commercialisation. Recognising the diﬃculty of this journey, the Brain Tumour Research Novel Therapeutics Accelerator (BTR-NTA) was launched in 2023. The BTR-NTA is an accelerator programme providing independent expert guidance to de-risk drug or device development through systematic evaluation. The international, multidisciplinary BTR-NTA Committee spans expertise across the entire therapeutic development pathway. Supported by Brain Tumour Research, BTR-NTA is free for academics and available at nominal cost for industry.

METHOD
Researchers at any stage of therapeutic development may apply to BTR-NTA. Accepted applicants proceed as follows: 1. Applicants complete a form highlighting their current and prospective data and ﬁndings. All materials are covered under a conﬁdentiality agreement that protects their intellectual property; 2. Applicants’ proposals are reviewed by the BTR-NTA Committee; 3. The Applicants and BTR-NTA Committee meet in-person to constructively evaluate the work; and 4. Applicants receive a comprehensive report with feedback on strengths, identiﬁcation of potential risks, and guidance on next steps. The BTR-NTA Committee dedicates time for in-person meetings with each applicant, and extensive time pre and post-meeting.

RESULTS
Since the launch of BTR-NTA, 13 international groups have applied to the programme and three groups have had their therapies reviewed in-person by the BTR-NTA committee to date. Of the groups who provided feedback on the programme, 100% intended to adjust or reﬁne their future work based on the BTR-NTA Committee’s input and the average rating of the programme’s helpfulness was 9.5/10.

CONCLUSION
The ultimate goal of BTR-NTA is to help researchers with a potential therapy for brain tumours navigate the development journey and reach the clinic in an eﬃcient way. This programme will support development of novel therapies to improve outcomes for brain tumour patients.
USING CCA-MRI TO PREDICT RESPONSE TO STEREOTACTIC RADIOSURGERY IN PATIENTS WITH BRAIN METASTASES
Authors: de Boisanger Dr James , Henderson Ms Julia , Guo Mr Yifan , Blackledge Dr Matthew , Harris Dr Emma , Benjamin Dr Philip , Mackinnon Dr Andrew , Rich Dr Philip , Brewer Mr Martin , Solda Dr Francesca , Creak Dr Antonia , Welsh Dr Liam , Rosenfelder Dr Nicola 
Published: October 2024

Abstract

AIMS
Brain metastases (BMs) from different primary cancers may have different radiosensitivity, for example melanoma and renal cell cancers are considered more radioresistant. Radiosensitivity is determined by the intrinsic radiobiological properties of tumours, which include vascularisation and oxygenation. Contrast Clearance Analysis (CCA)-MRI measures delayed contrast behaviour to offer a window into tumour vascularity. The CCA colour map shows areas of contrast accumulation (red), suggesting vascular damage, and rapid contrast clearance (blue), suggesting intact and increased vasculature. We aim to interrogate CCA-MRIs pre-stereotactic radiosurgery (SRS) for differences in contrast handling between BMs from different primaries.

METHOD
10 patients, with 70 BMs, were included in the study. All had CCA-MRIs pre-SRS as part of their planning-MRIs. Radiotherapy-planning-CT scans were fused with the planning-post-contrast-T1-MRI, with consultant clinical oncologist-approved contoured targets, and the CCA-images. Threshold analysis was performed to obtain proportions of red and blue within the enhancing areas of each tumour.

RESULTS
There was a signiﬁcant difference in the proportion of blue between BMs from different primaries (p=0.0294). In pairwise-comparisons, only the difference between lung and renal was signiﬁcant (mean difference 37.65%, p=0.0390). The difference between the proportion of red was also signiﬁcant overall (p=0.0084) (Figure 2). In pairwise comparisons, renal was signiﬁcantly different from lung, breast and melanoma (mean difference 12.65%, p=0.0161; mean difference 12.97%, p=0.0154; and mean difference 11.29%, p=0.0169, respectively).

CONCLUSION
This study offers a novel insight into the vascularity of BMs from different primaries. Further research to explore if these ﬁndings can explain differential SRS outcomes is underway.
Media, Communication, and Democratic Decline: Thoughts on The Paradox of Democracy
Authors: Lawrence Regina G 
Published: October 2024

Abstract
The Paradox of Democracy: Free Speech, Open Media, and Perilous Persuasion, by Zac Gershberg and Sean Illing, argues that the study of democratic decline is mistakenly focused on reversal. Drawing on media ecology theory and an interpretive reading of media and politics in the Western world, the authors argue that the conditions that allowed liberal democracy to become temporarily dominant have now been disrupted and eroded by the rise of new forms of media and communication. This review article assesses that argument in terms of (1) the central role of media and communication in studying of trajectory of democracy; (2) the empirical contributions of political communication scholarship; and (3) the authors’ call for revitalizing a core liberal institution: the press.
Impact of Ticagrelor vs. Clopidogrel in Patients With Acute Coronary Syndrome Undergoing Left Main Percutaneous Coronary Intervention
Authors: Qiu Miaohan , Zhi Xuehan , Liu Haiwei , Liang Zhenyang , Wang Bin , Xu Kai , Guan Shaoyi , Wang Geng , Wang Xiaozeng , Ma Yingyan , Jing Quanmin 
Published: October 2024

Abstract

Objective:
There is limited evidence regarding the choice of P2Y12 receptor inhibitors as a component of dual antiplatelet therapy (DAPT) in patients with left main (LM) disease undergoing percutaneous coronary intervention (PCI). This study aimed to evaluate long-term clinical outcomes of ticagrelor- vs. clopidogrel-based DAPT strategy in acute coronary syndrome (ACS) patients undergoing LM PCI.

Methods:
This is a post-hoc analysis from a prospective, single-center, real-world PCI registry. A total of 1,163 patients discharged post-ACS who underwent LM PCI and received ticagrelor or clopidogrel between March 2016 and March 2019 were included in the study. The primary endpoint was ischemic events at 12 months, including cardiac death, myocardial infarction, or stroke. Secondary outcomes included all-cause death and Bleeding Academic Research Consortium types 2, 3, and 5, and types 3 and 5 bleeding. Propensity score matching was used to adjust for bias due to confounders between the 2 groups.

Results:
The ticagrelor and clopidogrel groups comprised 529 (45.49%) and 634 (54.51%) patients, respectively. During the follow-up period, ticagrelor significantly reduced the rate of ischemic events compared to clopidogrel before (1.32% (7/529) vs. 3.63% (23/634), P = 0.0136) and after propensity score matching (1.41% (6/425) vs. 4.00% (17/425), P = 0.0201). The rates of all-cause death, Bleeding Academic Research Consortium-defined type 2, 3, and 5 bleeding, and type 3 and 5 bleeding were similar between the ticagrelor group and clopidogrel group before or after propensity score matching adjustment (all P > 0.05).

Conclusion:
Among patients with ACS undergoing LM PCI, ticagrelor use was associated with ischemic events benefit without excessive risk of bleeding at 12 months compared with clopidogrel.
Canonical Transient Receptor Potential (TRPC) Channels in Cardiovascular Pathology and their Modulators
Authors: Rubaiy Hussein N. 
Published: October 2024

Ion channels play a crucial role in various aspects of cardiac function, such as regulating rhythm and contractility. As a result, they serve as key targets for therapeutic interventions in cardiovascular diseases. Cell function is substantially influenced by the concentration of free cytosolic calcium (Ca2+) and the voltage across the plasma membrane. These characteristics are known to be regulated by Ca2+-permeable non-selective cationic channels, although our knowledge of these channels is still inadequate. The transient receptor potential (TRP) superfamily comprises of many non-selective cation channels with diverse Ca2+ permeability. Canonical or classical TRP (TRPC) channels are a subgroup of the TRP superfamily that are expressed ubiquitously in mammalian cells.
TRPC channels are multidimensional signalling protein complexes that play essential roles in a variety of physiological and pathological processes in humans, including cancer, neurological disorders, cardiovascular diseases, and others. The objective of this article is to focus on the role that TRPC channels play in the cardiovascular system. The role of TRPC channels will be deeply discussed in cardiovascular pathology. Together, a critical element in developing novel treatments that target TRPC channels is comprehending the molecular mechanisms and regulatory pathways of TRPC channels in related cardiovascular diseases and conditions.
Lymphatic Fistula Treatment: Indocyanine Green Lymphography-guided Microsurgery
Authors: Metz Aaron Antaeus , Steinbacher Johannes , Roka-Palkovits Julia , Huettinger Nina , Tinhofer Ines E. , Tzou Chieh-Han John , Rusli Siti Muyassarah 
Published: October 2024

Background:
Lymphatic fistulas are a common complication from surgery or interventional procedures resulting in persistent lymphatic leakage and delayed wound healing. The management of lymphatic fistula remains a subject of debate, ranging from conservative treatment to surgical lymphatic ligation. The implementation of a novel microsurgical approach involving lymphatic fistula ligation and/or lymphovenous anastomosis (LVA) using indocyanine green (ICG) lymphography is expected to decrease occurrence and complications. In this study, we share our experience in treating lymphatic fistula–guided microsurgical treatment.

Methods:
A total of 13 patients from our hospital with persistent lymphatic fistula were enrolled in this retrospective study. Lymphatic fistulas and their leakages were identified and ligated by using ICG lymphography and a surgical microscope. In two cases, additional LVA surgery was performed.

Results:
We were able to precisely identify lymphatic fistulas and treat them in all 13 patients. Lymph ligation was performed in all 13 cases, with additional distal LVA in two cases. In all patients, wound healing occurred following lymphatic ligation, except in one patient due to persistent infection. Patients with a lymphatic fistula were referred to our unit within 3 weeks to 1 year after onset, with an average consultation occurring after 5 months of persistent lymphatic fistula.

Conclusions:
Targeted lymphatic vessel ligation with or without LVA with ICG-guided surgical microscope represents a promising highly efficacious therapy for persistent lymphatic fistula. This technique may accelerate wound healing and reduce hospitalization duration, thus advocating for its preferential use in managing lymphatic fistulas.
Progressive maculopathy in a child resulting from vitreopapillary traction on a congenitally anomalous nerve
Authors: Kennamer-Chapman Ross M. , Jampol Lee M. , Rajagopal Rithwick 
Published: October 2024

Purpose:
To present a case of worsening maculopathy and vision loss due to vitreopapillary traction associated with an anomalous optic nerve head in a pediatric patient successfully managed with pars plana vitrectomy.

Methods:
Retrospective case report

Results:
A 13-year-old boy presented with unilateral maculopathy that slowly progressed over a four-year period. As his visual acuity declined, he became increasingly symptomatic. The macular pathology occurred in the setting of vitreopapillary traction overlying multiple congenital optic nerve abnormalities, including a myelinated nerve fiber layer and a Bergmeister papilla. Following pars plana vitrectomy to alleviate the traction, the patient’s macular appearance improved, and his vision slowly recovered to baseline.

Conclusion:
There are limited reports of congenital optic nerve anomalies associated with vitreopapillary traction and maculopathy among any age group. This report illustrates a pediatric case in which removal of traction on the nerve head by pars plana vitrectomy was the key therapeutic intervention to alleviate the maculopathy.
“Sterile hypopyon following pars plana vitrectomy and silicone oil injection”
Authors: Stamoulas Konstantinos , Manzar Haider , Raman Vasant , Chandra Aman 
Published: October 2024

Purpose:
To report five cases of post-operative sterile endophthalmitis in patients who underwent pars plana vitrectomy with silicone oil injection for retinal detachment.

Methods:
Review of the medical records of five patients who underwent pars plana vitrectomy with silicone oil injection at Southend University Hospital and the Royal Eye Infirmary, Derriford Hospital for rhegmatogenous or tractional retinal detachment.

Results:
All five patients presented with signs of anterior chamber inflammation exhibiting flare, fibrin and hypopyon in the early or late post-operative period following vitrectomy with silicone oil injection. Treatment with topical antibiotics and steroids was commenced, with rapid resolution of the anterior chamber inflammatory reaction and no further intervention required.

Conclusion:
The use of silicone oil as a tamponade agent for retinal detachment can rarely induce sterile anterior chamber inflammation with signs resembling infectious endophthalmitis. Onset of symptoms, absence of pain and good response to topical steroids can help differentiate between the two entities.
The Use of a Single Risk Assessment Tool for Mortality and Numerous Hospital-Acquired Conditions
Authors: Wang Erwin , Samaroo Aditya , Weisstuch Joseph , Rudy Bret 
Published: October 2024

ABSTRACT
Quality assessment organizations leverage numerous patient safety measures to evaluate hospital performance, resulting in significant financial, administrative, and operational burdens on health systems. Low-intensity approaches that allow for reliable risk stratification of patients can reduce the required investment. The Braden score is a routinely performed bedside nursing evaluation validated to assess risk for hospital-acquired pressure injury. We hypothesized that the tool can be used to evaluate risk for other hospital-related adverse outcomes, including mortality, catheter-associated urinary tract infection (CAUTI), and central line–associated bloodstream infection (CLABSI). We found that abnormal Braden scores have significant association with numerous adverse outcome measures, including mortality, CLABSI, CAUTI, and iatrogenic hypoglycemia. Because of its frequency of reevaluation, we have found preliminary evidence that leveraging this tool can reduce harm by quickly identifying the most at-risk patients for various types of iatrogenic harm. We conclude that in the face of increasing automation and technical applications, for example, artificial intelligence–driven tools, highly reliable clinician bedside physical examination and evaluation can still have significant, low-cost, and high-value impact in improving patient safety.
Sarcomas of the Head and Neck Region
Authors: Dimitrijević Milovan V. , Tomić Ana Marija M. , Todorović Nikola R. , Dimitrijević Ana M. , Kablar Đurđina B. 
Published: October 2024

Introduction:
Sarcomas are relatively rare malignant tumors of mesenchymal origin, representing only about 1% of tumors in the head and neck region.

Materials and Methods:
A retrospective study involved patients with sarcomas of the head and neck region who were diagnosed and treated over a 5-year period.

Results:
Nine patients were included, 4 men and 5 women. The mean age of the patients was 51 years. Eight patients had soft tissue sarcomas, and 1 patient had osteosarcoma. The most common histologic types were dermatofibrosarcoma protuberans and angiosarcoma. Tumors presented predominantly with local symptomatology. All patients were treated only by surgical excision. No distant or regional metastases were found in any patient. Complete surgical excision was achieved in all cases, except in patients with chondrosarcoma of the nose and sinuses, who died due to local progression in the second year of follow-up. Other patients were disease-free during the observed period; a patient with osteosarcoma died in the fourth year of follow-up without recurrence of the malignant disease.

Conclusion:
Large prospective and multicenter studies are necessary to provide relevant data on the distribution of different types of sarcoma in the head and neck region, their clinical behavior and response to therapeutic modalities, as well as on recurrence, presence of metastases, and survival.