bluuebunny/crossref_metadata_2025_split huggingface dataset:
QOL-15. Life happens wherever you are! Use of Avatar AV1 to enhance Health-Related Quality of Life, Sense of Belonging and Social Inclusion in Children and Adolescents with Chronic Illnesses
Authors: Pletschko Thomas , Pelzer Clarissa , Röhsner Martin , Rockenbauer Gerda , Turner Agnes 
Published: June 2022

Abstract
BACKGROUND: Due to regular hospital check-ups, inpatient treatments, or a weakened immune system, children with brain tumors experience frequent and long absences from school and social activities. Returning to school presents a challenge for these patients, as they experience reduced health-related quality of life (HRQOL), decreased sense of belonging and a lack of social inclusion in class. To prevent social and emotional problems, telepresence systems such as the Avatar AV1 are described as promising approach for pediatric patients. OBJECTIVES: To sustainably improve social inclusion in times of illness-related absence for these patients, the first study in Austria investigating effects of the use of the Avatar is pursuing both, a qualitative and quantitative approach. METHODS: To examine effects on social inclusion, sense of belonging and HRQOL in pediatric patients, interviews were conducted with patients, their parents, teachers and classmates within the qualitative approach and questionnaires were administered at three times (before -, after 6 months Avatar-use and 3 months after returning the Avatar) within the quantitative approach. The sample consists of pediatric patients (6 to 18 years). RESULTS: Categories from n=24 interviews indicate that a positive attitude towards and identification with the Avatar as well as the patients’ psychological condition and social inclusion into class before the illness play major roles. Preliminary findings from the ongoing longitudinal quantitative survey indicate that the Avatar has significant positive and stabilizing effects on HRQOL, sense of belonging and social inclusion of pediatric patients. CONCLUSION: This study is the first to describe the impact of Avatar use on social inclusion in children with brain tumors. To strengthen the sense of belonging in these children, the pedagogical-interactional component needs to be brought in focus. Through pedagogical-didactical adaptions, a routine handling of and a positive attitude towards the telepresence system, pediatric patients highly benefit from the Avatar.
QOL-17. Neurocognitive outcomes after treatment for medulloblastoma with reduced primary site target volume margins
Authors: Larkin Trisha , Lin Tong , Ashford Jason M , Onar-Thomas Arzu , Gajjar Amar , Conklin Heather M , Merchant Thomas 
Published: June 2022

Abstract
PURPOSE: Children treated for medulloblastoma (MB) undergo intensive multimodality treatment compromising surgery, irradiation, and chemotherapy, which is associated with a significant risk of neurocognitive deficits. Successive multicenter frontline treatment protocols have introduced reduced posterior fossa boost margins for cranial irradiation for sparing collateral tissue and preserving function. This study examines neurocognitive outcomes in the setting of reduced primary site target volume margins in children treated for MB. PATIENTS & METHODS: Prospective longitudinal neurocognitive data were collected from newly diagnosed patients with MB (n = 372, ages 3-21 years) enrolled on one of two sequential multicenter clinical protocols between 1996 and 2012. The treatment regimen included surgery, risk-adapted craniospinal irradiation with a posterior fossa boost with restricted clinical target volume (CTV) margins (2 cm and 1 cm), and dose-intensive chemotherapy. Comparative analysis of neurocognitive outcomes was performed using linear mixed-effects models. RESULTS: Intelligence quotient (IQ) scores were better preserved in average-risk patients who received treatment using a clinical target volume with a lesser margin of 1 cm (p &lt; 0.0099). Findings were consistent with prior studies on measures of academics including reading performance, mathematical reasoning, and spelling across both risk groups regardless of CTV. CONCLUSION: This study presents compelling evidence in favor of restricted CTVs for preserving IQ without sacrificing treatment efficacy in average childhood MBs.
QOL-18. Neuropsychological screening in a pediatric neuro-oncology multidisciplinary clinic.
Authors: Mietchen Jonathan , Kessler-Jones Alanna , Damodharan Shawn , Puccetti Diane 
Published: June 2022

Abstract
BACKGROUND: The purpose of this project was to examine the usefulness of neuropsychological screening in a multidisciplinary clinic for neuro-oncology populations and determine whether a brief evaluation can adequately screen children for cognitive dysfunction or psychiatric comorbidities. METHODS: Thirty-one children or young adults with a history of CNS tumor had neuropsychological screening as part of their multidisciplinary clinic visit. This screening evaluation consisted of clinical interview, neuropsychological testing, and the completion of emotional/behavioral checklists. Our neuropsychological test battery included the Kaufman Brief Intelligence Test-Second Edition (KBIT-2) and the NIH Toolbox Fluid Cognition Composite, which consists of 6 subtests - flanker task, working memory, processing speed, oral reading, card sort, and memory. RESULTS: Over a 15-month period 31 children, adolescents, and young adults with CNS tumors were seen in our neuropsychology screening clinic. Females made up 39% of the sample. The average age was 12.7 years (range=5–24 years). The average time to complete neuropsychological testing was 60.3 minutes. Thirty-six percent did not have any new neuropsychological diagnoses, 42% had one new diagnosis, 19% had two new diagnoses, and 3% had three new diagnoses. The most common new diagnoses were mild or major neurocognitive disorder (mild=29%, major=6%), anxiety (32%), ADHD (10%), and mood disorder (13%). Neurocognitive test scores were mostly in the average range (Verbal-IQ=97.7; Nonverbal-IQ=95.3; Total IQ=96.2; Flanker T-Score=46.1; Working Memory T-Score=44.0; Card Sort T-Score=43.7; Picture Memory T-Score=48.5). Processing speed and fluid cognition composite scores for the group were in the low-average range (Processing Speed T-Score=42.7; Fluid Cognition Composite T-Score=41.4). Behavioral health recommendations were needed for 71% of this sample. Educational recommendations were needed for 58%. CONCLUSIONS: Brief neuropsychological screening completed as part of multidisciplinary clinics for pediatric neuro-oncology patients was efficient and useful in identifying neuropsychological diagnoses in children and assisted with informing necessary behavioral health and academic interventions.
QOL-20. Post-Intensive-Care Syndrome – pediatric (PICS-p) among patients with brain tumors – therapeutic strategies and preventive recommendations
Authors: Korzeniewska Justyna 
Published: June 2022

Abstract
BACKGROUND: Patients with brain tumors needed in intensive care unit (ICU) stay due to tumors symptoms or neurosurgery, experience a complex of physical, psychological, and cognitive symptoms. This constellation of signs and symptoms has been named Post-Intensive-Care Syndrome – pediatric (PICS-p). An interesting problem emerging from this research and requires a deeper exploration are the differences between PICS-p symptoms and primary tumors effects or side effects of treatment e.g. irradiation. METHOD: Psychological repeated testing and long-term observation was performed in 350 childhood brain tumor survivors (various types and localizations of tumor) to determine PICS-p symptoms. Age at psychological diagnosis ranged from 6 to 20 years. Full psychological outcome included assessment of psychophysical, cognitive and affective problems. The patients were examined using battery of neuropsychological methods and psychological interview. Analysis of medical history was also performed. The next level of the study was distinguished between PICS-p symptoms and the effects of tumor localization and oncology treatment, including radiotherapy. RESULTS: In our sample patients presents low scores in the all PICS-p domains: physical, cognitive and mental. Low level of motor skills, impairing daily living activities are characteristic. In this group lower IQ scores, poorer visual motor integration, learning disabilities, memory and language problems persisted. Typical problems in mental area are depressive symptoms, anxiety with intrusive memories, emotional and behavioural disruptions, socialization problems with significantly low level of social contacts. CONCLUSIONS: The results of this study suggest that PICS-p well describes and explains the psychosocial problems of these patients. It allows prepare an individual psychological interventions and rehabilitative program for particular patient as well as therapeutic strategies for whole group of patients. Draft recommendations for diagnosis of PICS-p specific for patients with brain tumors, risk factors and preventive procedures will be presented and discussed.
QOL-26. Exploring the experience of young people receiving remotely delivered Acceptance and Commitment Therapy following treatment for a brain tumour
Authors: Powers Katie , Airdrie Jac , Thomas Sophie , Gibson Faith , Geagan Chloe , Davies Nic , Malins Sam 
Published: June 2022

Abstract
Despite high survival rates of children and young people diagnosed with a brain tumour, survival is often associated with poor psychological, physical, and social outcomes. Acceptance and Commitment Therapy (ACT) is an evidence-based psychological intervention shown to improve psychological and physical outcomes in adults and children with chronic disease, including cancer. The ACT Now study investigates the feasibility of ACT delivered remotely with young people who have experienced a brain tumour. This study aims to describe participant experience whilst better understanding the impact of therapy and capturing the barriers and facilitators to engagement. Participants of the ACT Now study were invited to take part in a semi-structured interview with questions covering experience of study initiation, receipt of ACT, remote delivery and overall impact of ACT. Ten participants who had previously undergone treatment for a brain tumour have been interviewed to date. Interviews were transcribed verbatim and coded into broad themes. We found that pre-therapy mood and altruism served as motivation for interviewees’ involvement in the study. Interviewees reported hoping to learn coping techniques to navigate fluctuating moods and the pressures of young adult life. Despite the technology used for remote delivery occasionally malfunctioning, interviewees reported increased ability to access therapy via this method. However, an overall preference for face-to-face therapy delivery was reported with interviewees describing that they felt communication might have been easier in person. The therapeutic relationship and the therapists’ flexible schedules were seen as facilitators to session attendance. Barriers to attendance were scarcely reported but included scheduling conflicts due to work or school. ACT was highly regarded amongst interviewees and provided an opportunity for them to learn about themselves and how they can live in accordance with their personal values. Interviewees benefitted from ACT psychologically, physically, and socially and reported an overall positive experience of study involvement.
QOL-29. Neuropsychology for you“ – tools to improve awareness of and access to neuropsychological care
Authors: Weiler-Wichtl Liesa Josephine , Fohn-Erhold Verena , Kollmann Alina , Fries Jonathan , Schneider Carina , Holzer angelika , Rosenmayr Verena , Schreiber-Gollwitzer Beate , Lüttich Peggy , Ross Henning , Pletschko Thomas , Hopfgartner Maximilian , Leiss Ulrike 
Published: June 2022

Abstract
OBJECTIVE: The occurrence of neuropsychological late effects in childhood brain tumor patients is well known in literature and practice, as well as the use of neuropsychological testing and therapy procedures. Despite guidelines, actual care is quite heterogeneous and often does not meet the needs due to lack of resources. Therefore, a standardized tool to improve awareness of and access to neuropsychological assessment, but even more treatment was developed. METHODS: The core of this Quality-Improvement project is a multilevel and interdisciplinary approach characterized by iterative processes (PDSA-cycles): (1) conceptualization by interdisciplinary, multicenter teams of experts, (2) consensus in Delphi surveys by medical, nursing and psychosocial experts (N=45) and final approval by the steering group. (3) Pilot phases (N=44): Manageability and acceptance, emotional well-being and the degree of information were recorded using a process-oriented screening. RESULTS: The expert meetings resulted in two booklets ("Look closely - Psychosocial assessment" & "1,2,3 - All about Neuropsychology"): Each booklet offers creative methods with a high prompting character to motivate the child to participate actively in two face-to-face sessions (psychoeducational, work and exercise and reflection section). They enable patients to make themselves experts on these topics with age-appropriate, interactive methods. The Delphi survey revealed a consensus of 69%-93%. Patients using the Psychosocial-assessment booklet showed generally low negative emotions and stable positive emotions, which significantly increased during the second session (Z = 2.156, p = .031). Moreover, positive emotions increase significantly during the second session (Z = 2.805, p = .005). Self-indicated degree of information increases significantly with both booklets (Psychosocial assessment: Z = 3.133, p = .002; Neuropsychology: Z = 2.751, p = .006). CONCLUSION: The results illustrate a positive emotional approach to neuropsychological assessment and treatment. Likewise, the rapid increase in expert knowledge supports access to this specific topic and can be considered a minimum standard.
SURG-01. The Tentative Application of En Bloc concept in the Pediatric Brain Tumor: A Retrospective Study of 171 Cases from A Large Pediatric Center in China
Authors: Cao Liangliang , Tian Shuaiwei , Zhao Yang , Wang Baocheng , Wang Jiajia , Ma Jie 
Published: June 2022

Abstract
BACKGROUND: The less allowable blood loss and tolerance of intraoperative blood loss of children lead to the high rate of massive blood transfusion. The surgical concepts of en bloc resection may contribute to the improvement of brain tumor resection. OBJECTIVE: To investigate the effects of en bloc concept on short outcomes of pediatric brain tumors and factors associated with the application of en bloc concept. METHODS: According to the surgical concept involved, the patients were divided into three subgroups-complete en bloc concept, partial en bloc concept and piecemeal concept. The matching-comparison(en bloc group consisting of the first two subgroups and piecemeal group) was conducted to investigate the effect of the en bloc concept on the short-term outcomes. Then the patient data after January 2018, when the en bloc concept was routinely integrated into brain tumor surgery in our medical center, were reviewed and analyzed to find out the predictors associated with the application of en bloc concept. RESULTS: In the en bloc group, the perioperative outcomes, including hospital stay(p=0.001), PICU stay(p=0.003), total blood loss(p=0.015), transfusion rate(p=0.005) and complication rate(p=0.039), were all significantly improved. The multinomial logistic regression analysis showed that tumor volume, bottom vessel, and imaging features, like encasing nerve or pass-by vessel, finger-like attachment, ratio of “limited line” and ratio of “clear line” remained independent predictors for the application of en bloc concept in our medical center. CONCLUSION: The application of en bloc concept based on the imaging features can improve the short-term outcomes.
SURG-02. The site of origin of medulloblastoma: Does the neurosurgical perspective support the current concept from molecular data?
Authors: Ciobanu-Caraus Olga , Cho Anna , Kasprian Gregor , Peyrl Andreas , Haberler Christine , Slavc Irene , Frischer Josa M , Czech Thomas , Rössler Karl , Gojo Johannes , Dorfer Christian 
Published: June 2022

Abstract
BACKGROUND: Medulloblastoma (MB) are the most common malignant brain tumor in childhood. Developmental gene expression data supported by neuroradiological studies suggest that Wingless (WNT)-MB originate from the lower rhombic lip (LRL), Sonic-Hedgehog (SHH)-MB from the cerebellar hemispheres, and Group 3 and Group 4 MB from the cerebellar vermis. However, there is still insufficient evidence from a neurosurgical perspective supporting this proposed concept. METHODS: Clinical and molecular data from patients aged under 18 years at time of diagnosis who were operated on a histologically confirmed MB at the Department of Neurosurgery of the Medical University of Vienna between 1990 and 2020 were retrospectively analyzed. The location of the tumor origin was defined based on operative reports, surgical videos and preoperative imaging data by an experienced neurosurgeon blinded to the subgroup information. RESULTS: Sufficient data were available in 53 patients. In 28.6% (2 / 7) WNT-MB, 66.7% (6 / 9) SHH-MB and 70.3% (26 / 37) Group 3 and Group 4 MB, the intraoperatively defined site of origin corresponded well with the cellular origin suspected from the molecular subgroup. Within the WNT-subgroup, 57.1% (4 / 7) originated from the vermis, 28.6% (2 / 7) from the LRL and 14.3% (1 / 7) from the cerebellar hemisphere. The origin of SHH-MB was predominantly located in cerebellar hemispheres (66.7% (6 / 9)), while 33.3% (3 / 9) originated from the vermis. Of Group 3 and Group 4 MB, 70.3% (26 / 37) had their origin in the vermis and 29.7% (11 / 37) in the LRL.CONCLUSION: Our results indicate that there is a considerable level of inconsistency between the intraoperatively observed site of origin and the expected cellular origin based on the molecular subgroup, especially in WNT-MB. This discrepancy needs to be discussed when it comes to surgical decision-making accounting for risk stratification.
SURG-05. Survival and functional outcomes in pediatric thalamic and thalamopeduncular low grade gliomas
Authors: Benes Vladimir , Zapotocky Michal , Liby Petr , Taborsky Jakub , Blazkova Jr. Jana , Blazkova Sr. Jana , Sumerauer David , Misove Adela , Pernikova Ivana , Kyncl Martin , Krskova Lenka , Koblizek Miroslav , Zamecnik Josef , Bradac Ondrej , Tichy Michal 
Published: June 2022

Abstract
BACKGROUND: Childhood thalamopeduncular gliomas arise at the interface of thalamus and cerebral peduncle. The optimal treatment is total resection but not at the cost of neurological function. We present long-term clinical and oncological outcomes of maximal safe resection. METHODS: Retrospective review of prospectively collected data: demography, symptomatology, imaging, extent of resection, surgical complications, histology, functional and oncological outcome. RESULTS: During 16-year period (2005-20) 21 patients were treated at our institution. These were 13 girls and 8 boys (mean age 7.6 years). Presentation included progressive hemiparesis in 9 patients, raised intracranial pressure in 9 patients and cerebellar symptomatology in 3 patients. The tumor was confined to the thalamus in 6 cases. Extent of resection was judged on postoperative imaging as total (6), near-total (6) and less extensive (9). Surgical complications included progression of baseline neurological status in 6 patients, 5 of these gradually improved to preoperative status. All tumors were classified as low-grade gliomas. Disease progression was observed in 9 patients (median progression free survival 7.3 years). At last follow-up (median 6.1 years) all patients were alive; median Lansky score of 90. Seven patients were without evidence of disease, 6 had stable disease, 7 stable following progression and 1 had progressive disease managed expectantly. CONCLUSION: Pediatric patients with low grade thalamopeduncular gliomas have excellent long-term functional and oncological outcomes even when gross total resection is not achievable. Surgery should aim at total resection; however neurological function should not be endangered due to excellent chance for long-term survival.
SURG-09. Hypothalamic involvement in pediatric craniopharyngiomas;how to define and to realize optimal neurosurgical resections
Authors: Hoving Eelco , van Baarsen Kirsten , van Schaik Jiska , van Santen Hanneke 
Published: June 2022

Abstract
The optimal neurosurgical strategy for pediatric craniopharyngiomas is on debate with shifts from gross total resection to limited resections in combination with local radiotherapy. The most relevant question underlying this ongoing discussion is how to prevent additional surgical morbidity to the hypothalamus. Limited neurosurgical resection in combination with local radiotherapy has been proved a safe alternative to gross total resection concerning tumor control. Pre-operative anatomical grading of hypothalamic involvement has been proposed by Puget et al using MRI discriminating between no hypothalamic involvement (grade 0), hypothalamic displacement (grade 1), and hypothalamic disruption (grade 2). Subsequently, post-operative hypothalamic damage can also be assessed on post-op MRI by the grading of the Vile et al in no discernable damage (grade 0), abnormality of floor of third ventricle (grade 1), or damaged or deficient floor of third ventricle (grade 2). Three questions remain to be settled: 1. How to define pre-operatively the extent of resection 2. How to realize per-operatively the intended limited resection, and three. How to determine post-operatively the (additional) surgical damage to the hypothalamus. We retrospectively evaluated a series of 25 children with craniopharyngioma being resected in our center from June 2018 until January 2022, with pre- and post-operative grading of hypothalamic involvement. In total 11 patients were downgraded on the post-operative compared to the pre-operative scale; either by 1 grade (n=6) or by 2 grades (n=5). These findings illustrate that the preoperative grading score does not always represent the actual hypothalamic involvement. This complicates the definition of limited surgery pre-operatively and illustrates the importance of both how to integrate per-operative findings in the realization of the intended limited resection and how to evaluate hypothalamic damage caused by tumor growth versus neurosurgical intervention. A more detailed treatment algorithm will be discussed.