bluuebunny/crossref_metadata_2025_split huggingface dataset:
CTNI-39. FIGHT-209: A PHASE 2, OPEN-LABEL, MULTICENTER STUDY OF PEMIGATINIB IN PATIENTS WITH PREVIOUSLY TREATED GLIOBLASTOMA OR OTHER PRIMARY CENTRAL NERVOUS SYSTEM TUMORS WITH ACTIVATING FGFR1-3 ALTERATIONS
Authors: Ahluwalia Manmeet , Franceschi Enrico , Veronese Luisa , Oliveira Natalia , Li Xin , van den Bent Martin 
Published: November 2022

Abstract
Fibroblast growth factor receptor (FGFR) signaling plays a role in progression of gliomas. Pemigatinib is a potent selective inhibitor of FGFR1-3, with demonstrated antitumor activity in patients with cholangiocarcinoma harboring FGFR2 fusions/rearrangements. The FIGHT-209 study will evaluate pemigatinib treatment for patients with glioblastoma or other primary central nervous system tumors harboring activating FGFR mutations or fusions/rearrangements. Eligible patients are adults with a radiologically measurable and histologically or molecularly confirmed recurrent glioblastoma, other diffuse glioma, or circumscribed astrocytic tumors harboring a FGFR1-3 gene alteration or fusion/rearrangement. Patients must have Karnofsky performance status ≥ 60, life expectancy ≥ 12 weeks, and documented disease progression after prior therapy with no available therapy likely to provide clinical benefit. Exclusion criteria include prior treatment with FGFR or VEGF/VEGFR inhibitors (other than bevacizumab for radiation necrosis), evidence of corneal or retinal disorder, or history of calcium or phosphate homeostasis disorder. Patients will be assigned to 1 of 3 cohorts based on genomic testing: A: glioblastoma with FGFR1-3 fusions/rearrangements; B: other CNS tumors with FGFR1-3 fusions/rearrangements; C: glioblastoma or other CNS tumors with FGFR1-3 activating mutations. Patients will receive pemigatinib 13.5 mg administered orally QD on a 21-day treatment cycle (2 weeks on/1 week off). Hyperphosphatemia, an on-target pharmacologic effect of FGFR inhibition, will be managed with diet modification, phosphate binders, diuretics, or dose reduction. Treatment will continue until disease progression or unacceptable toxicity. Primary endpoints are objective response rate (ORR) in cohorts A and B based on response assessment in neuro-oncology and assessed by ICR. Secondary endpoints include ORRs in cohorts A and B combined, in all cohorts, and in cohort C alone and the following endpoints for cohorts A and B individually: disease control rate, progression-free survival, duration of response, and overall survival. Safety and tolerability will also be assessed. Clinical trial information: NCT05267106
INNV-17. EXTRANEURAL METASTASES OF MYXOPAPILLARY EPENDYMOMA TREATED WITH DOSE-DENSE TEMOZOLOMIDE AND LAPATINIB
Authors: Riegel Devon , Connelly Jennifer 
Published: November 2022

Abstract
Myxopapillary ependymomas (MPEs) are recently reclassified WHO grade II tumors that usually affect the sacral spinal cord. MPEs have a high recurrence rate, especially if gross total resection (GTR) is not achieved. Recurrence tends to be local, but distant CNS metastases are not uncommon. Rarely, MPEs can metastasize to extraneural locations, including the lungs. Patient outcomes are worse with recurrence, and there is an absence of consensus for the best treatment approach for extraneural MPE metastases. The standard of care for initial MPE diagnosis is GTR, or subtotal resection (STR) with radiotherapy. Systemic treatment has shown inconclusive results regarding improvement of MPE outcomes. A recent phase II clinical trial demonstrated the efficacy of using dose-dense temozolomide (TMZ) and lapatinib for the treatment of metastatic, recurrent ependymoma. We present a case of a 35-year-old female with a history of MPE status post GTR who developed extraneural metastases 11 years after her initial resection. Sites of metastases included multiple bilateral intrapulmonary and pleural based masses with pleural effusion and pelvic mass. Her original site of disease had no evidence of recurrence and imaging of the neuro-axis was negative. Biopsy of the lung mass and pelvic mass confirmed metastatic MPE. She proceeded with dose-dense TMZ and lapatinib and had a positive radiographic response after 3 cycles of treatment. This is the first known case of extraneural metastases of MPE to demonstrate response to dose-dense TMZ and lapatinib.
INNV-20. INCORPORATING EXPERT OPINIONS INTO THE DEVELOPMENT OF FEARLESS: A PSYCHOTHERAPEUTIC INTERVENTION TARGETING FEAR OF CANCER RECURRENCE IN THOSE WITH BRAIN TUMORS
Authors: Loughan Ashlee , Braun Sarah , Lanoye Autumn , Willis Kelcie 
Published: November 2022

Abstract

INTRODUCTION
A brain tumor diagnosis brings about emotional distress, including significant fear of cancer recurrence (FCR). Three evidence-based interventions that target FCR exist, but all excluded patients with brain tumors (PwBT) from their efficacy trials. Preliminary evidence suggests that FCR may be categorically different in PwBT compared to other cancer populations, thereby necessitating tailored intervention development. For these reasons, we convened a neuro-oncology Expert Advisory Board (EAB) to assist in the creation of a psychotherapeutic intervention targeting FCR in PwBT.

METHODS
The EAB included neuro-oncology professionals, patients, and caregivers (N=7). To facilitate open dialogue, the patients and caregivers (n=3) met separately from the professionals (n=4). The EAB met virtually over five consecutive weeks to discuss three evidence-based FCR manuals, identify topic applicability, determine medical relevance, and discuss necessary adaptations to meet the specific needs of PwBT. Readings were provided in advance, two moderators (ARL & SEB) led group discussions, and all sessions were recorded following consent.

RESULTS
The EAB determined the content contained in the three FCR intervention required tailoring to meet the distinct needs of PwBT. Hypervigilance patterns were determined to be unique for PwBT (e.g., headache, fatigue, word-finding, auras). Language surrounding uncertainty of progression and inclusion of healthcare providers in therapy were less relevant in PwBT. Strategies and skills to enhance acceptance of existential themes were spotlighted. Mindfulness practices were requested. Results called for a blend of three therapeutic orientations: cognitive behavioral therapy, existential therapy, and mindfulness-based therapy. Professionals promoted group intervention delivery, whereas patients and caregivers promoted individual or dyadic sessions. Caregiver participation was unanimously supported.

CONCLUSION
The development of a psychotherapeutic intervention targeting FCR in PwBT offers a distinct opportunity for interdisciplinary and community collaboration. Results from the EAB were overwhelmingly informative, and recommendations will be incorporated into the newly developed FCR intervention for PwBT: FearLess.
INNV-32. COMPARING THE MONTREAL COGNITIVE ASSESSMENT (MOCA) FULL AND 5-MINUTE PROTOCOLS IN MILD COGNITIVE IMPAIRMENT SCREENING OF ADULT CNS TUMOR PATIENTS
Authors: Kim Yeonju , Rogers James , Jammula Varna , Vera Elizabeth , Christ Alexa , Leeper Heather , Acquaye Alvina , Boris Lisa , Briceno Nicole , Burton Eric , Choi Anna , Grajkowska Ewa , Komlodi-Pasztor Edina , Levine Jason , Lindsley Matthew , Lollo Nicole , Panzer Marissa , Penas-Prado Marta , Pillai Valentina , Polskin Lily , Reyes Jennifer , Roche Kayla , Smith-Cohn Matthew , Theeler Brett , Wu Jing , Gilbert Mark , Armstrong Terri 
Published: November 2022

Abstract

BACKGROUND
Mild cognitive impairment (MCI) commonly occurs in primary CNS tumor patients (PCTP). Our group and others have reported on the Montreal Cognitive Assessment (MoCA) as an MCI screening tool. Several abbreviated MoCA protocols have been developed for telehealth administration in other neurological diseases, with varied literature on scoring and clinical utility. We compared MoCA Full and 5-minute scores to assess utility in neuro-oncology.

METHODS
71 PCTP completed the MoCA Full (abnormal: &lt; 26/30) assessing: visuospatial/executive functioning, naming, memory, attention, language, abstraction, delayed recall, and orientation. Full scores were retrospectively recoded to the Pendlebury MoCA 5-minute protocol (abnormal: &lt; 10/12) assessing: memory, delayed recall, and orientation. Correlation was assessed using Pearson’s coefficient. Disagreements between tests were examined using t-test and chi-square test.

RESULTS
Patients were primarily White (83%), college-educated (71%) males (54%) diagnosed with glioblastoma (20%), with average age of 43 years (range: 19-75), KPS &gt; 80 (57%), prior radiation treatment (78%), and imaging surveillance at time of testing (79%). MoCA Full and 5-minute mean scores were 25.3 (SD: 4.8) and 9.9 (SD: 2.3), respectively. MCI was indicated in 32% (n= 23) of patients using MoCA Full and 27% (n= 19) using MoCA 5-minute. Where the protocols disagreed, MCI was detected only by MoCA Full in 6 patients (8%), and MoCA 5-minute in 2 patients (3%). Visuospatial/executive (p= 0.025) and abstraction (p&lt; 0.001) subdomain scores, unique to MoCA Full, were significantly associated with MCI detected only by the MoCA Full; other subdomains, patient characteristics, and total score were not significant. The MoCA versions were highly correlated (r= 0.90).

CONCLUSION
High correlation and agreement between MoCA Full and 5-minute scores in this neuro-oncology patient population highlight potential telehealth utility of the MoCA 5-minute. Future prospective assessment of the MoCA 5-minute is warranted to describe optimal scoring threshold and utility in neuro-oncology.
SURG-19. PROGNOSTIC VALIDATION OF A NEW CLASSIFICATION SYSTEM FOR EXTENT OF RESECTION IN GLIOBLASTOMA: A REPORT OF THE RANO RESECT GROUP
Authors: Karschnia Philipp , Young Jacob S , Dono Antonio , Häni Levin , Sciortino Tommaso , Bruno Francesco , Jünger Stephanie T , Teske Nico , Morshed Ramin A , Haddad Alexander F , Zhang Yalan , Stöcklein Sophia , Weller Michael , Vogelbaum Michael , Beck Juergen , Tandon Nitin , Hervey-Jumper Shawn L , Molinaro Annette , Rudà Roberta , Bello Lorenzo , Schnell Oliver , Esquenazi Yoshua , Ruge Maximilian I , Grau Stefan J , Berger Mitchel S , Chang Susan M , van den Bent Martin , Tonn Joerg-Christian 
Published: November 2022

Abstract

BACKGROUND
Terminology to describe extent of resection in glioblastoma is inconsistent across clinical trials. A surgical classification system was previously proposed based upon residual contrast-enhancing (CE) tumor. We aimed to (I) explore the prognostic utility of the classification system and (II) define how much removed non-CE tumor translates into a survival benefit.

METHODS
The international RANO resect group retrospectively searched the databases from seven neuro-oncological centers in the USA and Europe for patients with newly diagnosed glioblastoma per WHO 2021 classification. Clinical and volumetric information from pre- and post-operative MRI were collected.

RESULTS
We collected 1021 patients with newly diagnosed glioblastoma, including 1008 IDHwt patients. 744 IDHwt glioblastomas were treated with radiochemotherapy per EORTC 26981/22981 (TMZ/RT→TMZ) following surgery. Among such homogenously treated patients, lower absolute residual tumor volumes (in cm3) were favorably associated with outcome: patients with ‘maximal CE resection’ (class 2) had superior outcome compared to patients with ‘submaximal CE resection’ (class 3) or ‘biopsy’ (class 4) (median OS: 19 versus 15 versus 10 months; p=0.001). Extensive resection of non-CE tumor (≤ 5 cm3 residual non-CE tumor) provided an additional survival benefit in patients with complete CE resection, thus defining class 1 (‘supramaximal CE resection’) (median OS: 24 versus 19 months; p=0.008). The prognostic value of the resection classes was retained on multivariate analysis when adjusting for molecular and clinical markers including MGMT promotor status. Relative tumor reduction (in percentage) was not prognostic for outcome on multivariate analysis, and inter-rater agreement for CE and non-CE tumor on post-operative MRI was sufficient.

CONCLUSION
The proposed “RANO categories for extent of resection in glioblastoma” are highly prognostic and may serve for stratification of clinical trials. Removal of non-CE tumor beyond the CE tumor borders translates into additional survival benefit, providing a rationale to explicitly denominate such a ‘supramaximal CE resection’.
The (Un)fairness of Vaccination Freeriding
Authors: Verweij Marcel 
Published: November 2022

AbstractFor contagious diseases like measles a successful immunization program can result in herd protection. Small outbreaks may still occur but fade out soon, because the possibilities for the pathogen to spread in the ‘herd’ are very small. This implies that people who refuse to participate in such a program will still benefit from the protection it offers, but they don’t do their part in maintaining protection. Isn’t that a case of freeriding—and isn’t that unfair towards all the people who do collaborate? If so, that might be considered an additional ground for making vaccination mandatory or compulsory.In this paper I argue that vaccination refusal can be considered as freeriding, but that this might not be unfair. The public good of herd protection is a peculiar public good because it supervenes on private benefits that are enjoyed by all who do opt for vaccination. For vaccinated individuals, the additional benefit of herd protection comes about, as it were, for free, and hence they can’t complain that others benefit without sharing in the burdens. There are however still other grounds for making vaccination compulsory or at least for seeing refusal as a morally wrong choice.
Twists of rational Cherednik algebras
Authors: Bazlov Y , Jones-Healey E , Mcgaw A , Berenstein A 
Published: November 2022

Abstract
We show that braided Cherednik algebras introduced by Bazlov and Berenstein are cocycle twists of rational Cherednik algebras of the imprimitive complex reflection groups $G(m,p,n)$, when m is even. This gives a new construction of mystic reflection groups which have Artin–Schelter regular rings of quantum polynomial invariants. As an application of this result, we show that a braided Cherednik algebra has a finite-dimensional representation if and only if its rational counterpart has one.
Cataract surgery in adult eyes with short axial length
Authors: Elhusseiny Abdelrahman M. , Sallam Ahmed B. 
Published: November 2022

Purpose of review
Cataract surgery in eyes of patients with short axial length (AL) can be technically challenging and is associated with a high risk of intra- and postoperative complications. Several technical and surgical strategies have been proposed to optimize the visual outcome and decrease the rate of surgical complications and it is important to understand their applications in these cases

Recent findings
Traditional intraocular lens (IOL) measurement formulas in eyes with short AL have reduced reliability. Novel formulas such as the Kane formula provide a better refractive prediction. Surgery can be difficult in short eyes due to the crowdedness of the anterior chamber (AC) and the associated scleral abnormalities increasing the risk of uveal effusion. Surgical techniques such as prophylactic scleral incisions, limited pars plana anterior vitrectomy, and modified hydrodissection, have been shown to facilitate surgery in extremely short eyes and decrease the rate of operative complications. Although cataract surgery improves vision in these cases, short AL and shallow AC have been associated with worse visual outcomes.

Summary
Newer 4th generation IOL formulas have improved the refractive outcomes of cataract surgery in eyes with short AL. There are multiple evolving surgical strategies for optimizing surgery in these eyes. However, studies on the surgical and visual outcomes of cataract surgery in eyes with short AL are limited by their design and sample size. With further research and continued clinical experiences, we hope to develop evidence-based algorithms for the management of these complex cases.
Long-Term Safety and Outcomes of β-radiation for Trabeculectomy
Authors: Murdoch Ian , Puertas Renata , Hamedani Mehran , Khaw Peng Tee 
Published: November 2022

Précis:
β-radiation is a neglected antiscarring therapy with past concerns for safety. This report found it safe and efficacious when used as an adjuvant to trabeculectomy surgery in 101 people (135 eyes) over 20 years

Purpose:
β-radiation has been used as an adjunct to prevent scarring in trabeculectomy surgery for many decades. Safety concerns were raised with the use of high doses on the bare sclera. Moorfields Eye Hospital has a large cohort of patients who have received β-radiation therapy. We report a review of the long-term safety and efficacy.

Methods:
Cases undertaken between August 1992 and August 1996 were reviewed. Those with records available for postoperative review of more than 5 years were included. Failure (reintervention/>21 mm Hg on 2 successive occasions) and any complication previously reported in association with β-radiation were the primary outcomes.

Results:
In total, 292 operations using β-radiation were recorded and 101 people (135 eyes) with trabeculectomy surgery and postoperative follow-up for over 4.5 years were included. The median follow-up period was 22.5 years. At the final follow-up, 48 (48%) single eyes per person had failed and 20/51 (51%) eyes with primary open angle glaucoma had cataract surgery. Other complications were rare and associated with copathology.

Conclusion:
In glaucoma patients at risk of scarring and failure after trabeculectomy, as an antiscarring adjuvant, a 750 cGY dose of β-radiation was found to be safe and efficacious in the long term.
An update on the diagnosis and treatment of adrenoleukodystrophy
Authors: Gujral Jasmine , Sethuram Swathi 
Published: November 2022

Purpose of review
The present review summarizes recent advances in the diagnosis and management of patients with X-linked adrenoleukodystrophy (ALD).

Recent findings
Although ALD screening has been on the list of Recommended Uniform Screening Panel since 2016, only 30 states in the United States are currently testing their newborns for this disease. Hematopoietic stem cell transplant (HSCT) remains the only successful treatment option available for early cerebral ALD but does not reverse neurological changes or affect the course of adrenal insufficiency. There remains a significant knowledge gap in our understanding and treatment of this disease. Novel therapies such as gene therapy and gene editing have shown promising results in animal models and are exciting potential treatment options for the future.
Recently, the American Academy of Neurologists released their consensus guidelines on the diagnosis, surveillance, and management of ALD.

Summary
Early diagnosis and HSCT are key to improving the morbidity and mortality associated with ALD. The implementation of universal newborn screening for ALD and rigorous investigations of novel diagnostic and therapeutic agents is the need of the hour.
Long-term Health Outcomes of New Persistent Opioid Use After Surgery Among Medicare Beneficiaries
Authors: Santosa Katherine B. , Priest Caitlin R. , Oliver Jeremie D. , Kenney Brooke , Bicket Mark C. , Brummett Chad M. , Waljee Jennifer F. 
Published: November 2022

Objective:
We examined long-term health outcomes associated with new persistent opioid use after surgery and hypothesized that patients with new persistent opioid use would have poorer overall health outcomes compared with those who did not develop new persistent opioid use after surgery.

Background:
New persistent opioid use is a common surgical complication. Long-term opioid use increases risk of mortality, fractures, and falls; however, less is known about health care utilization among older adults with new persistent opioid use after surgical care.

Methods:
We analyzed claims from a 20% national sample of Medicare beneficiaries ≥65 years undergoing surgery between January 1, 2009, and June 30, 2019. We estimated associations between new persistent use and subsequent health events between 6 and 12 months after surgery, including mortality, serious fall/fall-related injury, and respiratory or opioid/pain-related readmission/emergency department (ED) visits using a Cox proportional hazards model to estimate mortality and multivariable logistic regression for the remaining outcomes, adjusting for demographic/clinical characteristics. Our primary outcome was mortality within 6 to 12 months after surgery. Secondary outcomes included falls and readmissions or ED visits (respiratory, pain related/opioid related) within 6 to 12 months after surgery.

Results:
Of 229,898 patients, 6874 (3.0%) developed new persistent opioid use. Compared with patients who did not develop new persistent opioid use, patients with new persistent opioid use had a higher risk of mortality (hazard ratio 3.44, CI, 2.99–3.96), falls [adjusted odds ratio (aOR): 1.21, 95% CI, 1.05–1.39], and respiratory-related (aOR: 1.67, 95% CI, 1.49–1.86) or pain-related/opioid-related (aOR: 1.68, 95% CI, 1.55–1.82) readmissions/ED visits.

Conclusions:
New persistent opioid use after surgery is associated with increased mortality and poorer health outcomes after surgery. Although the mechanisms that underlie this risk are not clear, persistent opioid use may also be a marker for greater morbidity requiring more care in the late postoperative period. Increased awareness of individuals at risk for new persistent use after surgery and close follow-up in the late postoperative period is critical to mitigate the harms associated with new persistent use.
Suprapapillary Needle Knife Fistulotomy Versus Conventional Precut Sphincterotomy in Difficult Biliary Cannulation: A Retrospective Comparative Study
Authors: Başpinar Batuhan , Ödemiş Bülent , Erdoğan Çağdaş , Yüksel Mahmut 
Published: November 2022

Background:
Endoscopic retrograde cholangiopancreatography (ERCP) is an important therapeutic tool for many biliary diseases. Selective biliary cannulation is the first step of the treatment process. Needle knife fistulotomy (NKF) and conventional precut sphincterotomy (CPS) are widely used in difficult biliary cannulation. However, there are different results in their effectiveness and safety. This study aimed to compare both methods regarding cannulation success and adverse event profile.

Materials and Methods:
All eligible consecutive patients with naive papillae who underwent biliary ERCP by a single experienced endoscopist over a 3-year period were included retrospectively. The standard cannulation method with a guidewire-loaded sphincterotome was initially used for biliary cannulation in all patients. Cannulation was accepted as difficult in the case of failure of standard cannulation within 5 minutes or despite 5 attempts or insertion of the guidewire to the pancreatic duct 5 times. Three modalities in patients with difficult biliary cannulation were employed according to the structure and configuration of the papillae in addition to unintentional pancreatic cannulation: (1) NKF, (2) CPS, (3) Double guidewire technique or guidewire orientation/precut following pancreatic stenting. Latter was excluded to enable direct comparison between NKF and CPS groups.

Results:
A total of 644 patients were recruited. Analyses were performed with 541 patients after the exclusion of 103 patients. Mean (SD) age was 60.4 (18.2) years, and 257 (47.5%) patients were male. While standard cannulation was successful in 366 (67.6%), difficult biliary cannulation was observed in 175 (32.4%) patients. NKF was performed in 101 (57.7%) patients, and cannulation success was 100% in the first ERCP session. In contrast, CPS was performed in 74 (42.3%) patients with a lower cannulation success rate (79.7%) than NKF (P<0.001). Post-ERCP pancreatitis rate was higher in CPS (9.5%) than NKF group (3.0%, P=0.063). Bleeding and cholangitis were similar in both groups.

Conclusions:
In patients with difficult biliary cannulation with appropriate papillary structure and configuration, NKF should be used as the first choice in experienced hands because of high biliary cannulation success and low Post-ERCP pancreatitis risk.