bluuebunny/crossref_metadata_2025_split huggingface dataset:
1235 Using Supervised Machine Learning to Validate a Novel Scoring System for the Prediction of Disease Remission of Functional Adenomas Following Transsphenoidal Resection
Authors: McKevitt Chase , Gabriel Ellie , Hillembrand Lina Marenco , Otamendi-Lopez Andrea , Jeevaratnam Suren , Cavalcante de Almeida Joao Paulo , Samson Susan , Chaichan Kaisorn L. 
Published: March 2024

INTRODUCTION:
Functional pituitary adenomas are common primary central nervous system tumors with potent systemic endocrinological effects. Postoperatively, remission rates range from 65-98%.

METHODS:
392 adult patients who underwent primary resection of a functional pituitary adenoma at the three Mayo Clinic between 2006-2022 were retrospectively reviewed. Multivariate logistic regression was performed to identify variables predictive of disease remission. Variables found statistically significant on multivariate analysis were incorporated into our proposed pituitary-SCHEME score. Machine learning models were implemented to compare the accuracy of the pituitary-SCHEME score against the multivariate models. After training (314 patients) and cross-validation of the machine learning models, an independent testing set of 78 patients was performed. SPSS V27 and R4.2.1 were used for statistical analyses.

RESULTS:
261 (66.6%) patients achieved post-operative biochemical remission. On multivariate analysis gross-total resection and Knosp-Grade 0,I,II adenomas were predictive of disease remission following resection, while macroadenomas (adenoma > 10mm), male sex, mammosomatotroph and Mixed Growth-Hormone + Prolactin adenomas were predictive of continued disease. In machine learning models, without Pituitary-SCHEME score, the K-Nearest Neighbors (KNN) model achieved the highest accuracy at 75.6% followed by Naive Bayes model. An increase in model sensitivity was achieved with inclusion of Pituitary-SCHEME score with the Linear-Discriminant-Analysis (LDA) model achieving the highest accuracy at 86.9%, followed by the Classification and Regression Trees (CART) model. The random forest model had the largest AUC-ROC among models with and without pituitary-SCHEME score. Model prediction accuracy (with vs. without pituitary-SCHEME score) were found to be statistically different based on Wilcoxon rank sum testing (p < 0.0001).

CONCLUSIONS:
The novel pituitary-SCHEME score, which incorporates perioperative and endocrinological measures, has promise as a clinical tool to predict patient outcomes following surgical resection of functional adenomas.
1237 The Mutational Landscape of Molecularly Defined Oligodendrogliomas
Authors: Weber-Levine Carly , Rakovec Maureen , Jiang Kelly , Kalluri Anita , Raj Divyaansh , Parker Megan , Materi Joshua , Sepehri Sadra , Ferres Abel , Schreck Karisa C. , Aldecoa Iban , Lucas Calixto-Hope , Redmond Kristin , Holdhoff Matthias , Sair Haris , Brem Henry 
Published: March 2024

INTRODUCTION:
Oligodendrogliomas are molecularly defined by IDH1/2 mutation and codeletion of chromosome arms 1p/19q. Prior studies identified capicua transcriptional repressor (CIC), far upstream binding protein (FUBP1), and the promoter region of telomerase reverse transcriptase (TERTp) as commonly mutated in oligodendrogliomas. However, prognostically relevant molecular signatures have yet to be identified.

METHODS:
A retrospective single-center study evaluated adults with pathologically confirmed IDH-mutant and 1p/19q co-deleted oligodendrogliomas that underwent surgery between 2005 and 2021. Genetic data from formalin-fixed, paraffin-embedded specimens were analyzed with the NGS Solid Tumor Panel at the Johns Hopkins Medical Laboratories, which tested over 400 genes. Kaplan-Meier curves and log-rank tests were used to compare progression-free survival (PFS) and overall survival (OS). Chi-squared tests compared clinical characteristics between mutation status in the ten most frequently mutated genes.

RESULTS:
From 277 patients with IDH-mutated, 1p/19q co-deleted oligodendrogliomas, 95 patients with NGS were included. Ten genes had 9 or more patients with a mutation, with CIC and FUBP1 being the most frequently mutated genes (n = 60 and n = 23, respectively). Kaplan-Meier curves showed that most genes were not associated with differences in PFS or OS. CIC conferred a reduction in PFS in patients with a PFS <100 months (p = 0.038), though this significance was lost when including all PFS durations (p = 0.52). While no biomarkers had sufficient statistical power, our analysis showed trends in shortened survival in patients with TP53 (p = 0.01) and PIK3CA (p = 0.03) mutations.

CONCLUSIONS:
Oligodendrogliomas harbor frequent mutations in CIC, FUBP1, and TERTp, but most patients typically have minimal additional alterations. As NGS becomes routine, understanding these mutations may inform therapeutic and prognostic recommendations or the development of novel targeted therapies. Additional molecular assays beyond mutation analysis with NGS may reveal prognostically relevant biologic subgroups of oligodendrogliomas.
1238 Next Generation Sequencing of Gliomas to Identify Predictors of Time to Postoperative Epilepsy
Authors: Nguyen Minh P. , Shukla Poojan , Young Jacob , Lee Anthony T. , Chang Edward 
Published: March 2024

INTRODUCTION:
Seizures during the course of disease for patients with diffuse gliomas is common. As genetic characterization of gliomas has improved, how a tumors mutational profile influences the timing of postoperative seizures, and if postoperative seizures relate to survival and tumor progression, is poorly understood.

METHODS:
A retrospective review of consecutive adults from 2017 to 2020 who underwent resection of gliomas with next generation sequencing of tumors at a single institution was performed. Cox proportional hazards regression was performed to identify factors associated with time to postoperative seizures. Seizures within 72 hours of surgery were excluded.

RESULTS:
363 patients with newly diagnosed or recurrent tumor tissue genotyped via next generation sequencing were included. Median follow-up time was 37.4 months, median time to seizure after surgery was 39.2 months (95% CI 34.6 – 60.8), and IDH-mutant tumors comprised 38.3% of the cohort. Patients with IDH-mutant tumors were more likely to have non-immediate postoperative seizures (p = 0.031) and more persistent postoperative seizures (p = 0.004) compared to IDH-wildtype tumors. PDGFRA mutation was associated with shorter time to seizure in IDH-mutant gliomas (p = 0.033), with no such genetic factors in IDH-wildtype tumors. Among IDH-mutant and wildtype tumors, patients with shorter seizure freedom had significantly shorter overall and progression-free survival.

CONCLUSIONS:
PDGFRA mutation is associated with earlier seizures after resection of IDH-mutant diffuse gliomas. Earlier first non-immediate postoperative seizure after resection is associated with worse overall and progression-free survival.
1240 Assessing Survival Outcomes of PCV-Based and Temozolamide-Based Adjuvant Therapy in Oligodendroglioma Patients
Authors: Chen Adrian , Begley Sabrina , Schulder Michael , Goenka Anuj 
Published: March 2024

INTRODUCTION:
When treating oligodendroglioma patients, choosing between temozolomide (TMZ) and procarbazine, lomustine, and vincristine (PCV), with concurrent radiotherapy still poses a challenge. Given the commonality of tumor recurrence, optimizing progression-free survival while minimizing adverse effects is crucial to improving quality of life.

METHODS:
87 patients treated for oligodendroglioma between 1994-2022 were retrospectively reviewed. Progression-free survival (PFS) and overall survival (OS) from initial resection were compared between PCV-based or TMZ-based treatment groups using Kaplan-Meier and multi-variable Cox survival analysis.

RESULTS:
The median age at diagnosis was 41 years and 62% were male. After initial resection, 42.8% received PCV-based treatment and 57.2% received TMZ-based treatment. Treatment groups were balanced in the following variables: age, tumor genetic profiling, the extent of resection, and KPS score. However, more patients in the TMZ-based group received concurrent radiation. The entire cohort had a 6.3-year PFS and 21.0-year OS. The median time to recurrence was significantly longer in those treated with PCV (12 years) compared to those treated with TMZ (4.7 years). PFS [HR = 0.46, p = 0.04] and OS [HR = 0.26, p = 0.04] were significantly longer in those receiving PCV-based treatment compared to TMZ-based treatment. After adjusting for previously mentioned variables, Cox regression analysis revealed no difference in OS between PCV- and TMZ-based treatment. The overall adverse effect rate did not significantly differ between PCV-based and TMZ-based treatment (25% vs. 28.1%, p > 0.99).

CONCLUSIONS:
PCV treatment confers longer progression-free survival than TMZ treatment for oligodendroglioma patients, noting that most patients in our series received concurrent radiation with TMZ, and those receiving PCV not having received upfront radiation. As we anticipate the results of the CODEL trial, our findings suggest PCV-based therapy warrants consideration as the preferred therapeutic option for oligodendroglioma patients.
1248 Optimal Connectivity Map Predicts Seizure Freedom Rates After Laser Interstitial Thermal Therapy in Mesial Temporal Lobe Epilepsy
Authors: Kim Min Jae , Hwang Brian Y. , Mampre David Michael , Negoita Serban , Tsehay Yohannes , Kang Joon , Anderson William S. 
Published: March 2024

INTRODUCTION:
Laser Interstitial Thermal Therapy (LiTT) is increasingly becoming a first-line surgical therapy for mesial temporal lobe epilepsy (mTLE). While promising, its seizure outcomes have also been highly variable, presumably due to an incomplete understanding of mechanisms behind LiTT. Epilepsy is a network disorder, and therefore it is crucial to account for both the effect on local destruction of epileptogenic foci, as well as global intervention of limbic circuitry, to elucidate the circuit-level mechanisms of LiTT and devise improved ablation strategies. In this study, we explore LiTT's network-level effect by investigating functional connectivity patterns and identifying optimal connectivity patterns predictive of seizure freedom.

METHODS:
27 mTLE patients who underwent unilateral LiTT were classified as seizure-free (ILAE Class I) or seizure-present (ILAE Class II–VI) cohort based on one-year postoperative outcomes. Individual ablation volumes were segmented from intraoperative MRI sequences. Ablation volumes were seeded into a normative functional connectome (Brain Genomics Superstruct Project) to extract patient-specific connectivity profiles associated with ablation volumes. FC patterns were compared between the two cohorts to produce voxel-wise “t-maps” to identify local and global differences in connectivity strengths predictive of seizure freedom.

RESULTS:
Ten mTLE patients achieved complete seizure freedom. In seizure-free patients, right ablated volumes shared higher FC with regions such as calcarine, cuneus, and thalamic anterior pulvinar nucleus than patients with seizure presence.

CONCLUSIONS:
For the right-sided ablations, seizure freedom was associated with a distinctive whole-brain connectivity pattern beyond the local surgical target. Further investigation is required to explore if this pattern is specific between the two surgical sides in mTLE population.
1249 Single-Center Outcomes of Onyx Frontier and Resolute Onyx Drug-Eluting Balloon Mounted Stents for Rescue Stenting for Acute Large Vessel Occlusion
Authors: Mehta Shyle , White Timothy G. , Werner Cassidy , Shah Kevin , Teron Ina , Link Thomas W. , Patsalides Athos , Woo Henry H. 
Published: March 2024

INTRODUCTION:
Mechanical thrombectomy (MT) is a common treatment for large vessel occlusions with recent literature expanding its indications. In cases where MT fails, rescue stenting may be necessary to achieve reperfusion; however, the absence of standardized techniques or devices poses a challenge.

METHODS:
A retrospective chart review was performed of all patients who underwent rescue stenting, in the setting of MT, using Onyx Frontier or Resolute Onyx stents at a single institution. Technical details, procedural complications, and patient outcomes were recorded for each case.

RESULTS:
In total, 21 Onyx Frontier and Resolute Onyx stents were deployed in 18 patients undergoing rescue stenting. Among these, 13 involved the use of Resolute Onyx stents, while 5 cases utilized Onyx Frontier stents. Stent locations included the middle cerebral artery (40%), internal carotid artery (15%), vertebral artery (20%), and basilar artery (25%). The average NIHSS score before MT was 13.83 (range 0-31). The median initial mRS score was 0, while the median mRS score at follow-up was 3. Successful reperfusion, as assessed by TICI scores, was achieved in 43.8% of patients for TICI 3, 43.8% for TICI 2C, and 12.5% for TICI 2B. The average proximal vessel diameter was 2.31 mm, and the most used stent length was 12 mm. Post-revascularization, 33% of patients experienced hemorrhage, of which only one patient (16.7%) had symptomatic hemorrhage due to vessel rupture necessitating hemicraniectomy.

CONCLUSIONS:
Onyx Frontier and Resolute Onyx stents are well-suited for rescue stenting in cases where aspiration and stentriever techniques fail during MT. These balloon-mounted drug-eluting stents exhibit excellent navigability, rendering them appropriate for rescue revascularization procedures. Our findings demonstrate that these stents confer a high degree of technical success and a low rate of intra- and post-procedural complications.
125 Contribution of Sensory Neuron-associated Macrophages to Neuropathic Pain via Up-regulation of Calcium Channel in C Fiber Sensory Neurons in Dorsal Root Ganglion: An Animal Model Study
Authors: Kim Keonhee , Jung Eunyee , Chung Seungsoo , Shin Dong Ah 
Published: March 2024

INTRODUCTION:
Animal models have demonstrated that sensory neuron-associated macrophages (sNAMs) play a key role in the initiation and persistence of neuropathic pain. The Cav3.2 calcium channel (Cav3.2) is also known to be involved in modulating neuropathic pain in peripheral sensory neurons.

METHODS:
Male Sprague-Dawley rats underwent unilateral tight ligation of the lumbar 5 spinal nerve and were divided into three groups: a control group (SHAM), a group that underwent ligation without, and with minocycline (SNL and SNL+Mino). The mechanical pain threshold of the hind paw was assessed with von-Frey filament application. Immunohistochemical staining techniques were used to evaluate the levels of sNAM, Cav3.2, and C-fiber sensory neurons with anti-Iba1, anti-Cav3.2, and IB4 antibodies, respectively. Cytokine levels were analyzed using cytokine arrays and western blotting.

RESULTS:
The SNL group had a significantly lower pain threshold compared to the control group (p < 0.001). In the DRG, neuropathic pain led to an accumulation of macrophages and increased their ability to attach to Cav 3.2. The expression of Cav 3.2 then triggered the activation of IB4 cells in the DRG. Additionally, cytokine array and western blot analyses revealed a higher expression rate of TNF-α in the SNL group compared to the control group (p = 0.048). Treatment with minocycline resulted in increased pain threshold, decreased number of macrophages in the DRG, and interruption of the attachment between macrophages and Cav 3.2, leading to lower expression of TNF-α.

CONCLUSIONS:
In conclusion, the results of this study suggest that sNAMs may play a role in the development of neuropathic pain by increasing the expression of Cav3.2 through the upregulation of TNF-α release in peripheral sensory nociceptive neurons.
132 Optimizing Success Rates of CSF Liquid Biopsy Examined With Next Generation Sequencing in Pediatric Central Nervous System Tumors
Authors: Chapman Nicholas , Chiarelli Peter , O'Halloran Katrina , Biegel Jaclyn , Krieger Mark D. 
Published: March 2024

INTRODUCTION:
Cerebrospinal fluid (CSF) liquid biopsy presents an attractive option for minimally invasive diagnosis and follow up for pediatric brain tumors. Best practice for obtaining appropriate cfDNA for next generation sequencing (NGS) is not currently known.

METHODS:
CSF was collected from patients under a prospective study to evaluate diagnostic utility of NGS. Samples were collected from control (non-tumor) and CNS tumor patients. CSF was collected at the dura opening, immediate ventricular catheter (IVC) from CSF divergent procedures, or ventricular shunt taps. Data was gathered on demographics, pathological diagnosis, tumor location, volume of CSF extraction, and DNA yield.

RESULTS:
CSF was extracted from 72 CNS tumor patients and 20 controls (48 female, 44 male). Of the CNS tumors, there were forty low-grade tumors (40/72) and thirty-two high-grade tumors (32/72). CSF collection location included dura opening (57), ventricular catheter (23), and shunt taps (12). cfDNA yield (ng) for CNS tumors displayed a mean of 135.5 ng (±353.4) and controls displayed a mean of 95.6 ng (±241.0). CNS tumor patients generated a significantly higher (p < 0.0001) DNA concentration (ng/cc) with a mean of 18.9 ng/cc (±82.7) compared to 0.5 ng/cc (±0.7) mean for controls. High grade tumors demonstrated a significantly greater amount of cfDNA concentration with a mean of 33.6 ng/cc (±116.6) whereas low grade tumors had a mean of 4.2 ng/cc (±5.0). CSF acquisition was 90.2% successful for NGS with a mean volume of 4.9 cc. In addition, infratentorial tumors revealed a 96% success rate with a mean volume of 5 cc.

CONCLUSIONS:
Extracting 4.9 cc of CSF had an 90.2% success rate for NGS. CSF may be acquired from either ventricular catheter or dura opening. High grade tumors had significantly higher cfDNA yield and concentration in CSF compared to low grade.
135 Guillain-Barré Syndrome After COVID-19 Vaccination: A Systematic Review and Analysis of Case Reports
Authors: Jamal Taha Mohammad Jehad , Falah Obaida , Hammad Elsayed Mohamed , Kozaa Yasmeena Abdelall , Taha Ahmad J. , Sameer Shams Khalid , Alrubasy Warda A. , Abuawwad Mohammad T. 
Published: March 2024

INTRODUCTION:
Cases of Guillain-BarrÉ Syndrome (GBS) have been believed to be associated with the novel COVID-19 infection, and also with the following vaccines developed against the infection.

METHODS:
An electronic search was conducted through four databases: PubMed, Scopus, medRxiv, and Google Scholar for all case reports after COVID-19 vaccine administration. Differences between groups were assessed by Pearson chi-square test. Modified Erasmus GBS Outcome Score for the ability to walk after GBS was calculated for all cases with sufficient clinical data, and Kaplan-Meier survival analysis was performed to study the effect of vaccine type on the relationship between vaccination time and complication of GBS.

RESULTS:
175 cases of GBS following COVID-19 vaccination were included. The Acute Inflammatory Demyelinating Polyradiculoneuropathy subtype was the most reported subtype with 74 cases (42.29%). The affected age group averaged around 53.59 ± 18.83 years, with AMSAN occurring in a rather older group (63.88 ± 20.87 years, p = 0.049). The AstraZeneca vaccine was associated with AIDP (n = 38, 21.71%) more than other vaccines, p = 0.02. The bilateral facial palsy subtype was mostly linked to adenoviral vector vaccinations, accounting for an average of 72% of the total BFP cases. Most GBS patients survived (96%, p = 0.036), however, most patients had low mEGOS scores (4 ± 3.57, p < 0.01). On average, patients developed GBS at 13.43 ± 11.45 days from vaccination (p = 0.73), and survival analysis for complication of GBS into mechanical ventilation or walking impairment yielded a severely increased probability of complication after 25 days (p < 0.01).

CONCLUSIONS:
Guillain-BarrÉ Syndrome can manifest after COVID-19 vaccination. Most cases occurred after receiving the AstraZeneca vaccine, and despite low mortality rates, ambulation was compromised in most patients. A higher risk of GBS complication is associated with an onset later than 12-13 days, particularly with Pfizer, AstraZeneca, and Moderna vaccines.
136 Initial Clinical Safety and Feasibility From the RESET RA Study of a Novel Implantable Neuroimmune Modulation Device for the Treatment of Rheumatoid Arthritis
Authors: Peterson Daniel L. , Van Poppel Mark Daniel , Boling Warren , Santos Perry , Schwalb Jason M. , Eisenberg Howard , Mehta Ashesh , Spader Heather , Botros James , Vrionis Frank D. , Ko Andrew , Adelson P. David , Lega Bradley Charles , Konrad Peter , Calle Bill , Bucholz Richard D. , Richardson Robert Mark 
Published: March 2024

INTRODUCTION:
Electrical stimulation of the vagus nerve activates the inflammatory reflex to inhibit cytokines and decrease clinical signs and symptoms of chronic inflammatory disease such as rheumatoid arthritis (RA) (Genovese et al. Lancet Rheum 2020).

METHODS:
The device system consists of two implanted components: a miniature integrated pulse generator and a silicon sleeve positioning device that holds the generator in apposition to the nerve. There are two external components: a wireless charger and an iPad application for programming the pulse generator. Subjects were randomly assigned (1:1) after device implantation on the left vagus nerve to receive active or sham stimulation. The risks of the surgical procedure, device, and stimulation were blindly assessed after 12 weeks of stimulation therapy in the first 60 subjects enrolled in the study.

RESULTS:
All implant procedures were completed without intraoperative complications, infections, or surgical revisions. No unanticipated adverse events (AEs) were reported during the perioperative period and at the end of 12 weeks of follow-up. No serious AEs related to the device, stimulation, or explant procedures were reported. Vocal cord paresis and prolonged hoarseness were reported in two subjects. The former resolved following vocal cord augmentation with injectable filler; the latter is ongoing and improving with speech therapy.

CONCLUSIONS:
Initial results demonstrated that implantation and programming of the novel neuroimmune modulation device were safe, and the surgical procedure and device were well tolerated.