bluuebunny/crossref_metadata_2025_split huggingface dataset:
807 Outcomes of Endovascular Embolization for Vein of Galen Malformations: An Individual Participant Data Meta-Analysis
Authors: Hale Andrew T. , Savage Cody , Parr Matthew Saifi , Hedaya Alexander , Saccomano Benjamin , Tsema Georges Bouobda , Hafeez Muhammad , Tanweer Omar , Kan Peter , Solomon Laurent , Deloison Benjamin , Meila Dan , Blount Jeffrey P. , Johnston James M. , Rocque Brandon George , Rozzelle Curtis J. , Bhatia Kartik , Muthusami Prakash , Krings Timo , Jones Jesse 
Published: March 2023

INTRODUCTION:
Understanding outcomes of Vein of Galen malformation (VOGM) embolization have been limited by small sample size and heterogeneity of reported series.

METHODS:
We performed a systematic review and individual patient data meta-analysis of VOGM endovascular outcomes according to PRISMA guidelines. Individual patient data (IPD) including demographic, intra/post-operative complications, treatment efficacy (partial or complete occlusion), and neurological outcome were collected. Mixed-effects logistic regression with random effects modeling and Bonferroni correction was used (p<0.003 threshold for statistical significance). The primary and secondary outcomes were all-cause mortality and poor clinical outcome (moderate/severe developmental delay or permanent disabling injury), respectively.

RESULTS:
Thirty-five studies totaling 307 patients evaluating outcomes of endovascular embolization for VOGM were included. Mean follow up was 42 (±57) months. Our analysis contained 42% neonates (<1 month) at first embolization, 45% infants (1 month < 2 years), and 13% children (>2 years). Complete occlusion was obtained in 48% of patients. Overall all-cause mortality was 16%. Overall, good clinical outcome was achieved in 68% of patients. First embolization as a neonate (OR = 6.93 [1.99-24.08] p<0.001) and incomplete occlusion (OR = 10.87 [1.86-63.55], p < 0.001) were associated with mortality. First embolization as a neonate (OR = 3.24 [1.47-7.15], p < 0.001), incomplete occlusion (OR = 5.26 [2.06-13.43], p < 0.001), and heart failure at presentation (OR = 3.10 [1.03-9.33], p = 0.002) were associated with poor clinical outcomes. Sex, angioarchitecture of lesion, embolization technique, and single or multistage embolization were not associated with mortality or clinical outcome.

CONCLUSIONS:
For the first time, we identify incomplete embolization treatment associated with poor clinical outcome and mortality. While this study provides the highest level of evidence for VOGM embolization to date, prospective multicenter studies are needed to understand the optimal treatment strategies, outcomes, and natural history after VOGM embolization.
827 The Use of High Resolution Ultrasound in the Evaluation of Traumatic Peripheral Nerve Injury: A Systematic Literature Review
Authors: Braverman Aaron , Shi Shi , Herring Eric , Labak Collin , Azghadi Adel , Preston David , Miller Jonathan 
Published: March 2023

INTRODUCTION:
Traumatic peripheral nerve injury (TPNI) represents a heterogeneous pathology with potential for severe disability. High-resolution ultrasound (HRU) has potential as a non-invasive diagnostic tool to assess injury and inform management decisions, potentially at an earlier time point than traditional electrodiagnostic testing. Standardized assessment of TPNI using HRU is not available in the current literature. We aimed to evaluate the effectiveness of pre-operative HRU in the setting of TPNI through a literature review.

METHODS:
A systematic literature review was performed adhering to PRISMA guidelines, yielding 84 articles for review. Inclusion criteria included papers that examined ballistic, sharp, and avulsion etiologies of TPNI, and that used ultrasound for initial evaluation of the TPNI. Exclusion criteria included papers with primarily pediatric patients, reviews, meta-analyses, papers not in English, and papers that focused on iatrogenic PNIs.

RESULTS:
48 studies met inclusion and exclusion criteria, including 19 case studies, 8 retrospective studies, and 19 prospective studies describing 569 total patients who experienced TPNI. Mean age was 33 years. The studies characterized 121 median, 97 ulnar, 141 radial, and 222 other TPNI from 24 ballistic, 231 sharp, 78 avulsion, and 13 unspecified injuries. The most common HRU findings preoperatively were neuroma formation (79), fascicular swelling (141), and complete discontinuity of epineurium (155). The timing of HRU after TPNI was variable with 37% and 41% of patients undergoing HRU within 6 weeks after TPNI versus more than 6 weeks after TPNI respectively.

CONCLUSIONS:
HRU is a promising clinical tool for the evaluation of TPNI. Further work is needed to define the appropriate timing for when HRU can be used to evaluate TPNI, as well as radiographic findings that may be clinically relevant in operative evaluations.
837 Responsive Neurostimulation of the Thalamus for the Treatment of Refractory Epilepsy
Authors: Roa Jorge A. , Abramova Marina , Madeline  , La Vega-Talbott Maite , Wolf Steven , Yoo Jiyeoun , Marcuse Lara , Ghatan Saadi , Panov Fedor 
Published: March 2023

INTRODUCTION:
One-third of patients with epilepsy experience seizures despite antiepileptic medications. Some of these refractory patients may not be candidates for surgical resection. The Responsive Neurostimulation System (RNS) is a closed-loop device that uses programmable detection and stimulation.

METHODS:
We performed a prospective single-center study of consecutive refractory epilepsy patients who underwent RNS system implantation in the anterior (ANT) and centromedian (CM) thalamic nuclei from September 2015 to December 2020. Patients were followed postoperatively to evaluate seizure freedom and complications.

RESULTS:
Twenty-three patients underwent placement of 36 RNS thalamic leads (CM = 27 leads, ANT = 9 leads). Mean age at implant was 18.8 ± 11.2 years. Two patients (8.7%) developed infections: 1 improved with antibiotic treatments alone, and 1 required removal with eventual replacement of the system. Mean follow-up was 22.3 months. Based on overall reduction of seizure frequency, 2 patients (8.7%) had no- to <25% improvement, 6 patients (26.1%) had 25-49% improvement, 14 patients (60.9%) had 50-99% improvement, and 1 patient (4.3%) became seizure-free. All patients reported significant improvement in seizure duration and severity, and 17 patients (74%) reported improved post-ictal state. There was a trend for subjects with foci located in the temporal lobe to achieve better outcomes after thalamic RNS compared to those with extratemporal foci. Seizure etiology was syndromic in 12 cases (52.2%).

CONCLUSIONS:
Thalamic RNS achieved ≥50% seizure control in ∼65% of patients. Infections were the most common complication. This therapeutic modality may be particularly useful for patients affected by aggressive epilepsy syndromes since a young age, those whose seizure foci are located in the mesial temporal lobe, and those who have failed prior surgical interventions.
838 Gamma Knife Stereotactic Radiosurgery Retreatment of Trigeminal Neuralgia: Prognostic Factors and Clinical Outcomes
Authors: Ramanathan Siddharth , Loving Bailey , Fontanesi James , Grills Inga S. , Michael Daniel B. , Chen Peter , Fahim Daniel K. 
Published: March 2023

INTRODUCTION:
Trigeminal neuralgia(TN) is a debilitating nerve disorder affecting approximately 4.5 per 100,000 people annually. While medical management is the first line of treatment, Gamma Knife Stereotactic Radiosurgery(GKSRS) may be used. Long-term outcomes after GKSRS retreatment are not well elucidated.

METHODS:
Of the 168 patients treated since 2012 at our institution, 149 had adequate follow-up data, and 53(40.4%) received 2 treatments. The Barrow Neurological Institute (BNI) pain intensity score was used to grade pain. Pain relief was defined as post-GKSRS BNI score of I-III. Treatment failure was defined as post-GKSRS score of IV-V without pain-relief. Pain-recurrence was defined as a post-GKSRS score of IV-V after achieving pain-relief. Univariable analyses were performed to examine the effects of multiple factors on outcomes.

RESULTS:
Median follow-up was 15(1-63) months; 136(90%) and 49(83.0%) patients achieved pain-relief after T1 and T2 respectively. Median time to pain-relief was 3 months and 1 month after T1 and T2 respectively. Median freedom from pain-recurrence was 24.0 months and 13.7 months following T1 and T2 respectively; 44 (30.0%) and 6 (12.2%) patients developed pain-recurrence following T1 and T2 respectively. High KPS score, V1+V2 pain distribution, and absence of mastication deficits reduced the risk of T1 treatment failure by 21%, 58%, and 54% respectively(p<0.05). Patients with lower BNI scores after T1 had a 39% reduced risk of T2 failure(p<0.001); 2(1.3%) and 4(6.8%) patients developed facial and/or mastication deficits following T1 and T2 respectively. Neither isocenter location nor dose affected outcomes.

CONCLUSIONS:
GKSRS remains an effective treatment for patients with refractory TN. Our data show that patients who fail or recur after T1 may still receive symptomatic relief following T2 with minimal toxicity. Abstract not yet presented, but accepted for presentation at ASTRO 2022
869 Loss to Follow-Up for Radiation Treatment After Resection of Metastatic Brain Tumors: Analysis of a Non-Irradiated Cohort from a Private Insurance Database
Authors: Haider Ghani , Amoah Dadey David Yaw , Rodrigues Adrian , Pollom Erqi , Adler John R. , Veeravagu Anand 
Published: March 2023

INTRODUCTION:
Radiation treatment to the surgical bed of resected brain metastases is considered the standard of care due to its advantages in improving local and distant disease control. Overtime, SRS has replaced WBRT as the preferred modality due to preservation of long-term neuro-cognition. Despite this data and growing adoption, socio-economic disparities in clinical access, treatment and outcomes have been reported in minority groups, especially in oncologic patients – leading to sub-standard care for some patient populations.

METHODS:
Our sample was obtained from Optum Commercial Claims and Encounters Database and included all patients from 2004 to 2021 who did not receive SRS or WBRT within sixty days after resection of tumors metastatic to the brain. Regression analysis was done to identify factors responsible for loss to adjuvant radiation treatment.

RESULTS:
A total of 8,362 patinets were identified who had undergone craniotomy for resection of metastatic brain tumors, of which 3,430 (41%) patients did not receive any radiation treatment. Lung cancer, breast cancer, melanoma and colon cancer were the most common sites of primary tumor. Compared to patients who did receive some form of radiation treatment (SRS or WRBT), patients who did not get any form of radiation were more likely to be older (P = 0.0189), and non-white (P = 0.008). Patients with Elixhauser Comorbidity Index ≥3 were less likely to receive radiation treatment (P < 0.01). Fewer patients with household income ≥ $75,000 did not receive radiation treatment (P < 0.01).

CONCLUSIONS:
Age, race, household income and comorbidity status were associated with differential likelihood to receive radiation treatment. This highlights the need for additional investigation of socio-economic determinants of radiation treatment delivery.
873 Next Generation Sequencing of Gliomas to Identify Predictors of Postoperative Seizures
Authors: Nguyen Minh P. , Shukla Poojan , Young Jacob , Lee Anthony T. , Chang Edward 
Published: March 2023

INTRODUCTION:
Seizures are common in patients who have undergone resection of diffuse gliomas. As genetic characterization of gliomas has improved, how a tumors mutational profile influences the risk of postoperative epileptogenesis is currently unknown.

METHODS:
A retrospective review of patients who underwent resection of gliomas with next generation sequencing of tumors at a single institution was performed. Logistic regression, Fisher’s Exact Test, and linear regression were performed to identify factors associated with development of postoperative seizures, seizure frequency, seizure type, and number of antiepileptic drugs (AEDs).

RESULTS:
140 patients with tumor tissue genotyped via next generation sequencing from 2017-2020 are included in this interim analysis (this cohort includes both newly diagnosed and recurrent tumors). Glioblastomas comprised the majority (59.3%) of tumors, followed by astrocytomas (18.6%), oligodendrogliomas (13,6%), and IDH-mutant diffuse gliomas (8.6%). Fifty-two (37.1%) patients had a seizure after tumor resection, median age at seizure onset was 56.5 years, and patients were on a median of 2 AEDs for their seizures. 75.0% of these patients experienced multiple seizures with 57.1% being simple partial seizures. Multivariate analysis of the most common mutations revealed that CDKN2B/CDKN2A mutation was significantly associated with postoperative seizures (OR 2.47, 95% CI 1.02 – 6.27, p = 0.0487), while NF1 mutation and 1p/19q codeletion were not. The common GBM copy number variant Polysomy 7/monosomy 10 was associated with use of fewer AEDs (β = -0.81, p <0.0001). Analysis of mutations most common in low grade tumor samples found no significant associations with seizure development.

CONCLUSIONS:
CDKN2B/CDKN2A mutations are associated with more postoperative seizures. Further analysis of this cohort may yield more relationships between genetic markers and seizures, including time to onset of seizures, which can inform operative planning and postoperative management.
876 Significant Survival Improvements for Patients with Melanoma Brain Metastases: Can We Reach Cure in the Current Era?
Authors: Berger Assaf , Bernstein Kenneth , AlzateRamirez Juan , Mullen Reed , Silverman Joshua S. , Sulman Erik P. , Donahue Bernadine , Anna Pavlick , Gurewitz Jason , Mureb Monica , Mehnert Janice , Madden Kathleen , Palermo Amy , Weber Jeffrey , Golfinos John G. , Kondziolka Douglas 
Published: March 2023

INTRODUCTION:
New therapies for melanoma have been associated with increasing survival expectations, as opposed to the dismal outcomes of only a decade ago.

METHODS:
We reviewed 171 melanoma patients with BM receiving stereotactic radiosurgery (SRS) who were followed with point-of-care data collection between 2012-2020. Clinical, molecular and imaging data were collected, including systemic treatment and radiosurgical parameters.

RESULTS:
Mean age was 63 ± 15 years, 39% were female and 29% had BRAF-mutated tumors. Median overall survival after radiosurgery was 15.7 months (95% Confidence Interval: 11.4-27.7) and 25 months in patients managed since 2015. Thirty-two patients survived 5 years from their initial SRS. BRAF mutation-targeted therapies showed a survival advantage in comparison to chemotherapy (p = 0.009), but not to immunotherapy (p = 0.09). In a multivariable analysis, both immunotherapy and the number of metastases at 1st SRS were predictors of long-term survival (5 years) from initial SRS (p = 0.023 and p = 0.018, respectively). Five patients (16%) of the long-term survivors required no active treatment for 5 years.

CONCLUSIONS:
Long-term survival in patients with melanoma BM is achievable in the current era of SRS combined with immunotherapies. For those alive 5 years after first SRS, 16% had been also off systemic or local brain therapy for over 5 years. Given late recurrences of melanoma, caution is warranted, however prolonged survival off active treatment in a subset of our patients raises the potential for cure.
885 Reprogramming the Glioblastoma Immune Microenvironment With Convection Enhanced Gene Therapy Reveals Intratumor IL6 Drives Glioblastoma Immunosuppression and Growth
Authors: Young Jacob , Cho Nam Woo , Lucas Calixto-Hope , Seo Kyounghee , Santos Raquel , Liu S. John , Phillips Joanna , Ozawa Tomoko , Bhaduri Aparna , Aghi Manish Kumar , Berger Mitchel , Raleigh David R. 
Published: March 2023

INTRODUCTION:
The glioblastoma microenvironment is an immunosuppressive barrier to therapeutic innovation.

METHODS:
SB28 or GL261 glioblastoma allografts were implanted into immunocompetent mice and treated with CED of attenuated adeno-associated virus 9 vectors (AAV9) encoding experimental cytokines (Il1b, Ccl4, or Apoa1) underlying infiltration or activation of anti-tumor immune cells in other intracranial tumors. Serial intracranial bioluminescence was used to assess glioblastoma growth and animals were monitored for survival. The impact of gene therapy perturbations on the glioblastoma immune microenvironment was assessed using histology, immunohistochemistry, single-cell mass cytometry (CyTOF), and multiplexed cytokine assays.

RESULTS:
Serial body weight and systemic multiplexed cytokine measurements showed no evidence of treatment toxicity. AAV9-APOA1 or AAV9-IL1B gene therapy CED treatments attenuated SB28 growth and prolonged survival, decreasing immunosuppressive macrophage infiltration and increasing CD8 T cell and microglia infiltration of the glioblastoma microenvironment compared to control AAV9 vectors. Gene therapy CED treatments did not attenuate GL261 growth or prolong survival, but CyTOF of human glioblastomas (n = 6) in comparison to preclinical models revealed untreated GL261 glioblastomas were endogenously enriched in CD8 T cells and other lymphoid lineages compared to untreated SB28 or human glioblastomas. Multiplexed cytokine assays demonstrated suppression of intratumor IL6 is a conserved mechanism of action underlying glioblastoma gene therapy responses. Analysis of single-cell RNA sequencing of 32,877 cells from human glioblastomas (n = 11) showed IL6 is predominantly produced by radial glial like cancer stem cells or endothelial cells in the tumor microenvironment. In support of these findings, survival from intracranial SB28 glioblastomas was prolonged in Il6 knockout C57BL/6J mice compared to wildtype C57BL/6J mice.

CONCLUSIONS:
We report a novel strategy using gene therapy and CED to reprogram the glioblastoma immune microenvironment, revealing IL6 drives glioblastoma immunosuppression and growth.
Ontogenetic exposure to light influences seabird vulnerability to light pollution
Authors: Atchoi Elizabeth , Mitkus Mindaugas , Vitta Pranciškus , Machado Biana , Rocha Margarida , Juliano Manuela , Bried Joël , Rodríguez Airam 
Published: March 2023

ABSTRACTLight pollution critically affects fledglings of burrow-nesting seabirds, leading to massive mortality events. The successful management of this pollutant depends upon a comprehensive understanding of the factors influencing visual sensitivity and corresponding behaviours towards light. Factors shaping the development of the visual system could account for variation in seabirds' vulnerability to light pollution. We investigated how Cory's shearwater chicks respond to selected contrasting artificial light stimuli. Chicks were subjected to blue and red light treatments, and repeatedly tested throughout the nestling period. We analysed behavioural responses (number, timing and orientation of reactions) to determine how age, exposure to experimental light stimuli and spectra influenced the onset of visually guided behaviours, thus inferring drivers of vulnerability to light pollution. Repetitive exposure to light significantly increased the number of reactions, and chicks predominantly displayed light avoidance behaviour. We did not find differences in the number of reactions, timing and orientation between blue and red light treatments. The responses did not differ across different age groups. These results provide empirical evidence for the contribution of the light available in the rearing environment to seabird visual development. They support the hypothesis that differential exposure to light during the growth period influences responses to artificial light, and that the state of visual development at fledging could be a main driver of the age bias observed during seabird fallout events. It is thus important to evaluate lighting schemes in both urban and natural areas, and determine the as yet unknown consequences that may be affecting the populations.
Development and Pilot Testing of a Telehealth Weight Loss Program
Authors: Hales Sarah B. , Smith Caitlin E. , Turner Tonya F. , Sword David O. , DuBose-Morris Ragan , Blackburn David , Malcolm Robert , O’Neil Patrick M. 
Published: March 2023

ABSTRACT

Introduction/Purpose
Behaviorally based in-person multidisciplinary programs for weight loss have been studied for decades; however, delivery, scalability, and accessibility remain a challenge. We report pilot findings from a new asynchronous protocol-based telehealth weight loss program.

Methods
This 12-wk single-arm pilot study included adults (18–65 yr old) with body mass index (BMI) of 25–40 kg·m−2. The Home Weight Loss (HWL) program consisted of weekly app- and e-mail-delivered lesson modules covering traditional diet, exercise, and behavioral topics for weight loss. Daily weight and activity level were monitored automatically via a wireless scale and an activity tracker, and participants logged their caloric intake into the system. Monitoring data were reviewed weekly by clinicians who provided brief video-recorded feedback for participants to view at their convenience. Weight and height were measured in person at baseline and postintervention. Postintervention participants completed a satisfaction survey.

Results
Thirty participants (70% female; 80% White; mean age = 41 yr, standard deviation (SD) = 13.7 yr; mean BMI = 32.4 kg·m−2, SD = 4.3 kg·m−2) were enrolled, and 27 provided posttreatment data. Percent weight loss was 4.12% (SD = 4.22%). Overall, 93% of participants reported being satisfied with their overall experience in the program, and 59% cited individualized feedback as a benefit of the program.

Conclusions
The HWL program produced modest weight loss and demonstrated feasibility and participant acceptability. This model appears to be generally scalable for broader use and can be used to extend weight loss services for those not residing near medical centers and those in need of asynchronous and virtual feedback.
The complete mitochondrial genome Hainan Gymnure Neohylomys hainanensis
Authors: Tu Feiyun , Hou Xiaodan , Lu Qiujie , Zhai Xiaofei 
Published: March 2023

The Hainan Gymnure Neohylomys hainanensis is a small-size mammal which occurs in Hainan, China and north Vietnam. Here, we report the complete mitochondrial genome of N. hainanensis. The whole mitochondrial genome is 17,337 bp, and contains 13 protein-coding genes, 22 tRNAs, 2 rRNAs and one control region. The base composition of the N. hainanensis total mitogenome is: 33.4% A, 12.2% G, 33.1% T, and C 21.3%, with an A + T content of 66.5%. The K2P genetic distance analysis supports current taxonomy that places the hainanensis, sinensis and suillus in different genera. Phylogenetic analysis suggests that N. hainanensis is closely related to Neotetracus sinensis based on the complete mitochondrial genome sequences. The mitogenomic data will contribute to molecular phylogenetics and conservation genetics of the species.