bluuebunny/crossref_metadata_2025_split huggingface dataset:
SURG-10. Pediatric PF-A ependymoma: a case series of cytogenetics and progression-free survival
Authors: Sharma Shelly , Colliander Reid , DeCuypere Michael 
Published: June 2022

Abstract
Ultra-high risk PF-A ependymoma, defined as 6q chromosome deletion in the setting of 1q gain, represents a biologically unique entity. These tumors are associated with significantly worse progression-free survival and 6q loss is an independent predictor of overall survival. Here, we present cytogenetics and progression-free survival from all PF-A ependymomas diagnosed at Lurie Children’s Hospital of Chicago over a 10-year period (2011 and 2021). Twelve patients were identified with the diagnosis of PF-A ependymoma (42% males, average age at diagnosis 5.75 years) during the study period. Four patients demonstrated gain of 1q on methylation profiling. Two patients with a gain of 1q also had a deletion of 6q, carrying the ultra high-risk designation. All patients underwent surgical resection and post-operative radiation therapy. Patients who received chemotherapy had a significant increase in overall number of surgical resections (p-value &lt; 0.0001). Patients without 1q gain had an average of 2.1 surgeries, while patients with 1q gain had an average 2.75 surgeries. Patients with 1q gain and 6q deletion had an average of 3.5 surgeries. All patients with 1q gain had recurrence of their tumor, compared to 38% of patients without 1q gain. In this series, progression-free survival for the PF-A without 1q gain, 1q gain, and 1q gain with 6q deletion cohort was 27.9, 18.4, and 19.5 months, respectively. The most common complications were radiation toxicity and cerebellar dysfunction (ataxia, dysmetria, and gait imbalance). Not surprisingly, complications were more common in those patients undergoing a greater number of subsequent resections. All PF-A ependymomas should be evaluated for 1q gain and 6q deletion, which can be reliably ascertained using cytogenetic markers in routine clinical use. In this series, 1q gain was associated with a decrease in progression-free survival. Only 2 patients were designated ultra high-risk based on cytogenetic analysis.
SURG-11. Evaluation of surgical results and predictive factors of hydrocephalus in pediatric patients with posterior fossa tumors
Authors: Formentin Cleiton , Matias Leo Gordiano , dos Santos Lucas de Souza Rodrigues , de Andrade Erion Junior , Joaquim Andrei Fernandes , Tedeschi Helder , Ghizoni Enrico 
Published: June 2022

Abstract
INTRODUCTION: Infratentorial tumors represent 45 to 60% of all brain tumors in children and are associated with hydrocephalus in 70 to 90% of cases. The aim of this study is to describe and analyze the surgical results and correlate them with the incidence of hydrocephalus, as well as identify predictive factors of hydrocephalus in patients underwent to a surgical treatment of posterior fossa tumors. METHODS: This is a retrospective observational study, based on demographic, clinical and radiological information of pediatric patients underwent to surgical resection of posterior fossa tumors by a single group between 2011 and 2019. RESULTS: We included 135 patients with a mean age of 7.56 years, mean follow-up of 35.7 months and overall survival of 18.8 months. Considering the histology, most tumors were pilocytic astrocytomas (34.1%), followed by medulloblastomas (27.4%) Total resection was achieved in 77.8% and tumor recurrence was observed in 16.2%. The rate of hydrocephalus was 36.3%, with most shunt procedures performed preoperatively. There was a high rate of complications associated with shunting (42.9%), mostly represented by infection (71.5%). Patients with hydrocephalus were younger (p = 0.001), showing a faster evolution between the onset of symptoms and diagnosis (p = 0.008). Tumor volume (p = 0.1) and location (p = 0.32) were not statistically significant for hydrocephalus, however, the presence of leptomeningeal disease (p = 0.001) was. The resection rate was also significant, with lesions totally resected showing the best results (p = 0.009). Regarding tumor histology, 33.3% of patients with medulloblastoma and 62.5% of patients with ependymoma were shunted. CONCLUSION: One third of children with posterior fossa tumors will require a shunt procedure. Some factors should guide the neurosurgeon during patient counseling and surgical planning to minimize the use of permanent shunts and avoid related complications.
SURG-16. Pediatric oncology neurosurgery, four years after centralization in the Princess Máxima Center
Authors: van Baarsen Kirsten , Slot Mariam , Woerdeman Peter , Han Sen , Hoving Eelco 
Published: June 2022

Abstract
INTRODUCTION: In 2018, the Princess Máxima Center officially opened its doors as a national referral center for pediatric oncology in the Netherlands. This centralization of pediatric oncology also reshaped the pediatric neurosurgery landscape. Almost four years after centralization it is time to make up the balance. METHODS: From the start in May 2018, a predesigned database was kept for all neurosurgical procedures performed in the Princess Máxima Center, Utrecht. Data was collected by a well-trained medical student and under close supervision of a pediatric neurosurgeon. Patient demographic data, tumor data (location, pathology), surgical data (approach, intended and obtained extent of resection), radiology data, and follow up data (complications, functional outcome) were collected. PRELIMINARY RESULTS: From May 2018 to December 2021, 783 oncology related surgeries have been performed in 472 individual patients (56% male; mean age 8 years). There were 316 cranial tumor resections, 279 of which were first resections. Pilocytic astrocytoma was the most frequent diagnosis (38%), followed by medulloblastoma (14%) and ependymoma (11%). Among the more rare tumors there were 29 diffuse midline gliomas and 29 craniopharyngiomas, reflecting the high volume after centralization. The extent of tumor resection and Clavien Dindo complication grading are correlated to time after centralization. CONCLUSION: Four years after the start of centralization, the pediatric oncology neurosurgery service in the Netherlands is well established. Clustering has resulted in high absolute numbers, even for rare tumor types, and growing experience. With this series we hope to create an international benchmark for pediatric oncology neurosurgery.
NURS-03. Effect of psychological intervention on peripherally inserted central catheterization in children with central nervous system tumors
Authors: Zhang Yangqiong , Xiang Yuliang , Zhang Fuqiang , Zhang Xing , Li Juan , Lai Mingyao , Cai Linbo 
Published: June 2022

Abstract
OBJECTIVE: Peripherally inserted central catheterization (PICC) is a frequently used invasive clinical procedure in children with central nervous system (CNS) tumors. How to reduce the psychological impact brought by the operation process and increase the cooperation of children is a concern of medical staff .The study is to investigate the effect of psychological intervention with game strategy on PICC in children with CNS tumors. METHODS: A total of 120 children with CNS tumors who underwent PICC in Guangdong Sanjiu Brain Hospital from January 2019 to February 2021 were enrolled in this study. Patients were divided into two groups according to whether psychological intervention therapy was accepted during PICC, one group was the intervention group and the other group was the control group, with 60 patients in each group. Anxiety was assessed before and after PICC using the FLACC and Spence scores. T test was used to compare the scores of the two groups. RESULTS: Anxiety was found in both groups before PICC, and there was no significant statistical difference between the two groups (p &gt; 0.05). The FLACC score of the two groups during PICC showed that the degree of pain in the intervention group was lower than that in the control group (P &lt; 0.05). After catheterization, the anxiety score of the intervention group was significantly lower than that of the control group (P &lt; 0.05). CONCLUSION: Psychological intervention based on game can reduce the medical fear of children with CNS tumors in the process of PICC and increase the cooperation of children.
NURS-04. Marijuana, Hemp, and the Child with Cancer: Education for Nurses
Authors: Hemenway Molly 
Published: June 2022

Abstract
Many pediatric oncology patients report medical marijuana (MMJ) and hemp-based cannabidiol (CBD) use. Nearly 4,000 minors are registered users of marijuana in Colorado, the first state in the United States of America (USA) to legalize recreational marijuana. Medical marijuana is legalized in 37 states and four territories in the USA. Additionally, due to the bipartisan Farm Bill passed in December of 2018, hemp is federally legal. Forty-three countries have also legalized medical marijuana. With increased legality and many countries decriminalizing marijuana, the use of MMJ and hemp-based CBD is also increasing. This upsurge in use raises significant concerns with pharmacological interactions with CBD and the medications routinely administered to children with cancer (including chemotherapy). Cannabis-derived pharmaceuticals can also have pharmacological interactions. Nurses are the frontline for discussions with patients about MMJ and must be aware of the emerging field of MMJ in pediatric cancer. Education including the difference between tetrahydrocannabinol (THC) and CBD and their indications, extraction methods and safety, product types, infection control, and dosing considerations are important for nurses to learn. Nurses with increased knowledge will then help patients and families make educated and safer choices in treating their children for tumor treatment and side effect management with MMJ and hemp-based CBD. Additionally, nurses can influence patient care protocols and processes for alternative therapy administration enabling an open dialogue between providers, parents, and patients regarding treatments, symptoms, adverse effects, and drug interactions.
OTHR-02. Ways to lower anxiety and influence pain perception by reducing stress hormones and impacting the neurochemicals of patients
Authors: Fernjack Jennifer 
Published: June 2022

Abstract
In this session, you will learn how things in everyday life such as music, laughter, gratitude, acts of kindness and pets can take the edge off a patient’s experience by affecting them physically. The speaker can describe these things first hand by sharing what she experienced through her meningioma brain tumor scare and the corresponding radiation treatments. She can also speak to the benefits of “salient stimulus,” whereby patients who listen to music that is relevant to them during radiation treatments are more apt to be less stressed than other patients because the songs that have meaning can increase dopamine levels. The same can be said for people with dementia who listen to their favorite songs. The balance and stride length of people who have Parkinson’s disease can improve as well when they dance to music that has meaning for them and dopamine levels are influenced along the way. Promoting such things in a hospital setting can benefit the underlying patient and their caregivers, e.g., their families and the people who help them at the hospital. The hospital itself has the potential to benefit too through lower turn over rates with staff and lower sedation rates of patients. Great reminder that even though we can’t control the quantity of life, we can still influence the quality of it, regardless of who you are or where you’re from.
OTHR-04. Single-nucleus transcriptomic atlas of human hindbrain development identifies cellular origins of pediatric brainstem tumors
Authors: Joshi Piyush , Okonechnikov Konstantin , Sepp Mari , Sarropoulos Ioannis , Leiss Kevin , Kutscher Lena M , Kaessmann Henrik , Pfister Stefan M 
Published: June 2022

Abstract
The hindbrain is a key central nervous system structure involved in communication between the brain and the spinal cord, integrating sensory information and coordinating motor responses. Dysregulation in hindbrain development is frequently associated with behavioral disorders and maybe associated tumor formation, stressing the importance of understanding the intricacies of human hindbrain development. Here we performed RNA-sequencing of over 300,000 single nuclei to construct a developing human hindbrain atlas, focusing on pons and medulla, ranging from embryonic to adult stages, profiling the entirety of the hindbrain’s neural and glial populations from progenitors to mature cell types. We describe the transcriptional identity of neuronal cells constituting the pontine and medullary nerve centers including precerebellar, respiratory, auditory and vestibular nuclei; and their differentiation trajectory from the progenitor domains in the embryonic rhombencephalon. To identify the origins of pediatric brain tumors, we mapped ~2,900 bulk and ~50 single-cell transcriptome tumor datasets to the developmental hindbrain atlas, focusing on medulloblastomas, and pediatric low- and high-grade gliomas, and determined cell populations and differentiation states associated with specific tumor groups. We confirmed migrating lower rhombic lip derivatives as the lineage of origin for WNT medulloblastoma. Further, we ascertained early ventral neural progenitor-derived oligodendrocyte lineage as the source of diffuse midline glioma H3K27-altered and postnatal oligodendrocyte progenitors as the origin of pilocytic astrocytoma. In addition, the ependymal lineage originating from glial progenitors was identified as the best match for ependymomas. We show that tumor development has a component that transcriptomically follows its cellular lineage of origin, and identify genes with preserved expression between the respective normal and malignant cell populations. Tumor to normal comparisons also identified tumor-specific genes, providing promising therapeutic candidates. We plan to make our data and analysis pipeline publicly available via user-friendly graphical interface at brain-match.org for unrestricted use of the generated results.
OTHR-18. A pilot study evaluating the access, utilization, and patient satisfaction of basic skin care products among pediatric patients prescribed medications that target the mitogen-activated protein kinase pathway
Authors: Meyer Ashley , Armstrong Amy , Cluster Andrew , Ogle Andrea , Sisk Bryan , Brossier Nicole , Beck Mary , McHugh Michele , Abdelbaki Mohamed , Coughlin Carrie 
Published: June 2022

Abstract
BACKGROUND: The mitogen-activated protein kinase (MAPK) pathway is dysregulated in approximately one third of all malignancies. Agents targeting this pathway are known to cause frequent and significant skin toxicity. METHODS: Patients &lt;21 years of age prescribed any medication targeting the MAPK pathway within the past six months were eligible for this prospective, pilot study. Each participant received a complimentary skin care kit consisting of basic skin and oral care items. At baseline and three months after enrollment, participants completed surveys assessing demographics, skin symptoms, use of the products, and quality of life (QOL; Dermatology Life Quality Index and Child Dermatology Life Quality Index, CDLQI). OBJECTIVES: Primary aims were evaluating utilization of the kit and measuring patient satisfaction of the items included. Secondary aims included determining skin-related QOL and assessing adherence to MAPK targeted therapy. RESULTS: Eleven participants (seven male, four female; median age 13 years, range 4-21 years) have enrolled to date (enrollment goal of 30). Participant therapies included MEK inhibitors (nine), a pan-RAF inhibitor (one), and combination MEK-mTOR inhibition (one). Six have completed the three-month follow-up. Of these six, four rated their satisfaction with the kit as excellent, one each rated very good and fair satisfaction. Five participants rated the kit helpful and thought the kits should be distributed when patients begin therapy. Three started taking their targeted agent before enrolling in the study and their CDLQI changed from 3 to 0.3 (means; improved). Three participants started their targeted agent after enrollment and their CDLQI changed from 1 to 3.3 (means; worsened). CONCLUSIONS: Participants reported that skin care kits were helpful and recommended use by other patients on MAPK-targeted agents. Continued follow-up and enrollment in the study will help further explore the utility of specific products in the kits, as well as changes in patients’ QOL.
OTHR-20. Precision neuro-oncology in the real world. Opportunity and challenges from a UK Oncology Centre
Authors: Apps John , Peet Andrew , English Martin , Adamski Jenny 
Published: June 2022

Abstract
The last five years has shown advances in the molecular classification of brain tumour, molecular profiling techniques and an increased use of targeted therapies. We reviewed the molecular analysis pathways and use of targeted agents at Birmingham Children’s Hospital (BCH), a large (~55 new cases/year) neuro-oncology centre, between 2016-2021. Having previously been analysed locally by limited directed immuno-histochemical stains and referral for specific genetic tests, tissue is now referred for a range of second histopathological opinions and in depth molecular classification, via methylation array, panel sequencing, RNA fusion analysis, and whole genome sequencing. These are accessed through different evolving pathways and consent processes, including referral to other centres, national reference laboratories, clinical studies, and local genetics laboratories with links to national sequencing infrastructures. Different routes result in different reporting structures, timescales and with varying levels of interpretation, often without adequate access to clinical information and context. 21 patients were treated on five targeted agent clinical trials (Afatanib (n=6), Biomede (n=3), eSmart(n=1), PARC (n=7), Vinilo (n=5)), with one patient on both Afatanib and PARC trials. A further two patients visited other centres for trials. Eight patients received MAPK pathway inhibitors through compassionate access pathways, with benefit, including radiological response, in four. Cardiac toxicity was observed in three and retinal oedema in one. Two patients received immune checkpoint inhibition, with rapid fatal enlargement, either progression or pseudo-progression, in one case. These rapid changes in diagnostic and management options offer new opportunities for patients, but bring challenges to the delivery of neuro-oncology services, including the logistics of sample, report, clinical trial, compassionate access management and the increased multi-specialist support required for monitoring and management of toxicities. Integration of targeted agents into the appropriate part of a patient’s treatment strategy requires skilled interpretation of the benefits compared to conventional therapies.
OTHR-21. Ethical reflections via the dilemma method in a pediatric neuro-oncology department
Authors: van Meeteren Antoinette Schouten- , Lenting Simone , Sulkers Mirjam , van de Wetering Marianne 
Published: June 2022

Abstract
BACKGROUND: Professional care for children with a brain tumor can bring considerable ethical questions in clinical practice. These questions can be burdensome and cause distress among professionals, parents and patients. Awareness and skills to bring these aspects into a respectful discussion among colleagues can be meaningful and alleviate the distress. Our objective is to give overview of the ethical case deliberations which took place during a monthly multidisciplinary meeting on the pediatric neuro-oncology department.
METHOD: To describe the type of ethical case deliberations as spontaneously proposed and selected by the team members for discussion. To identify main values in the care process for professionals via the dilemma method in monthly meetings led by a trained facilitator.
RESULTS: The monthly meetings were visited regularly by 9-14 diverse professionals (median 10) of the team: nurses, oncologists, social worker, psychologist, educational specialist. The selected moral questions concerned children with a brain tumor between 4-13 year old (median 9) with following ten subjects: 3 not sharing the infaust prognosis with a child, 2 avoiding medical care in follow up /treatment, 2 cultural different approach for food and drink intake, 2 crossing professional boundaries and 1 time worries about emotional safety of a child. The main values that were recognized to play crucial role in the care process were honesty, respect, autonomy, quality of life, health, tolerance, courage and safety. The participants felt supported in their professional skills by sharing reflections on personal moral considerations and by openly discussing different views and experiences of other participants.
CONCLUSION: The monthly ethical case discussions disclose high lights in the burden of professional care in pediatric neuro-oncology. These meetings about moral questions are supportive in the competence of the professionals to recognize and communicate about these important dilemmas.
OTHR-24. Impact of physical activity on postural stability and coordination in children with posterior fossa tumor: randomized control phase III trial
Authors: Usama Mahmoud , Abdelaziem Faten H , Rashed Wafaa M , Maher Eslam , El Beltagy Mohamed , Zekri Wael 
Published: June 2022

Abstract
BACKGROUND: Posterior fossa tumor is a type of brain tumor that is located at the borders of both the brain stem and cerebellum. The cerebellum is the brain region in charge of balance and coordination. Pediatric patients diagnosed with posterior fossa tumor have been reported to fall frequently. OBJECTIVES: The aim of this study is to investigate the effectiveness of balance and coordination training in these children. METHODS: This randomized control clinical trial was carried out between September 2020 and April 2021 at Children’s Cancer Hospital-57357. The inclusion criteria of the participants were - patients with posterior fossa tumor in maintenance phase and, age between 5-12 years. The study participants were randomly assigned into three groups: Group I/Control group: they received Pilates core stability exercises program, Group II/Balance group: They received the same program plus HUMAC balance program, and Group III/Coordination group: They received the same program plus coordination exercises of BOT-2. Descriptive statistics for patients’ characteristics were reported as medians and interquartile ranges for quantitative variables, frequencies, and percentages for qualitative ones. Significance level of P value was at &lt;0.05. RESULTS: Sixty children including 38 boys and 22 girls were enrolled in this study. In all three groups, postural stability and coordination improved significantly in terms of modified clinical test of sensory integration of balance, center of pressure, limits of stability, bilateral coordination, and upper-limb coordination.CONCLUSION: The current study supports the value of adding postural stability and coordination training to the physiotherapy plan for children with posterior fossa tumor. Clinical trial information: RCT no#NCT04528316.
Keywords: Posterior fossa tumor, Children, HUMAC, BOT-2, Postural stability, Balance, Coordination.