Publications by authors named "Sunit Das"

Background: Improving the surgical outcomes for commonly occurring spinal neoplasms of extradural and intradural extramedullary origins requires precise intraoperative diagnosis provided by highly trained neuropathologists.

Methods: Through a retrospective study of n=319 patient specimens, verified where appropriate by learning curve analysis to be sufficient for statistically significant observations, we aimed to assess the utility of 10-second picosecond infrared laser mass spectrometry (PIRL-MS) for non-subjective diagnosis of major spinal tumour types of metastatic carcinoma, schwannoma and meningiomas.

Results: The sensitivity and specificity values of spinal tumour type diagnosis (based on n=182 independent specimens) were (93±1)% and (97±2)%, respectively.

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The planar Hall effect in 3D systems is an effective probe for their Berry curvature, topology, and electronic properties. However, the Berry curvature-induced conventional planar Hall effect is forbidden in 2D systems as the out-of-plane Berry curvature cannot couple to the band velocity of the electrons moving in the 2D plane. Here, we demonstrate a unique 2D planar Hall effect (2DPHE) originating from the hidden planar components of the Berry curvature and orbital magnetic moment in quasi-2D materials.

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Purpose: To review applications of cerebral spinal fluid (CSF) biomarkers for the diagnosis, monitoring and treatment of leptomeningeal metastatic disease (LMD) among patients with metastatic solid tumors.

Methods: A narrative review identified original research related to CSF biomarkers among patients with metastatic solid tumors and LMD. Pre-clinical research (e.

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Background: Gliomas are a major cause of cancer-related death among children, adolescents, and young adults (age 0-40 years). Primary mismatch repair deficiency (MMRD) is a pan-cancer mechanism with unique biology and therapeutic opportunities. We aimed to determine the extent and impact of primary MMRD in gliomas among children, adolescents, and young adults.

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Despite significant advancements in neuro-oncology, management of glioblastoma remains a formidable challenge. Over the last century, the role and goals of surgery for patients with glioblastoma have evolved dramatically, with surgical intervention maintaining a central role in patient care. To understand the future role of surgery in the management of glioblastoma, we must review and appreciate the historical journey that has led us to this juncture.

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Article Synopsis
  • Brain metastases significantly contribute to cancer-related deaths and currently have poor treatment options; existing diagnostic methods are invasive and lack precision.
  • The study presents a new liquid biopsy technique using extracellular vesicles (EVs) as biomarkers for brain metastases, leveraging an advanced sensor created through femtosecond laser technology.
  • Molecular profiling of EVs shows unique signatures for metastatic tumors that enable a machine learning model to differentiate metastatic brain cancer from primary brain cancer with high accuracy, potentially improving diagnosis and treatment strategies in neuro-oncology.
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Intracranial metastatic disease is a serious complication of cancer, treated through surgery, radiation, and targeted therapies. The central role of radiation therapy makes understanding the radioresistance of metastases a key interest for prognostication and therapeutic development. Although historically defined clinic-radiographically according to tumour response, developments in new techniques for delivering radiation treatment and understanding of radioprotective mechanisms led to a need to revisit the definition of radioresistance in the modern era.

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Purpose: Treatment response assessment for gliomas currently uses changes in tumour size as measured with T- and T-weighted MRI. However, changes in tumour size may occur many weeks after therapy completion and are confounded by radiation treatment effects. Advanced MRI techniques sensitive to tumour physiology may provide complementary information to evaluate tumour response at early timepoints during therapy.

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  • Uncertainty is a fundamental aspect of medicine, as physicians often make critical decisions without complete information, influenced by factors like patient knowledge gaps and diagnostic limitations.* -
  • AI tools are emerging as potential aids in reducing this uncertainty by enhancing data collection and promoting better communication between physicians and patients.* -
  • Despite their promise, there is significant resistance to adopting AI in medical practice, highlighting the need for education on AI ethics and practical skills in medical training.*
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  • - Breast cancer is a highly variable disease with complex characteristics, making it hard to detect its intratumor heterogeneity, which is essential for effective treatment and understanding progression.
  • - The study focuses on using an Immuno Nano Sensor and machine learning to analyze metabolic differences in breast tumors by examining immune cells, achieving high accuracy in distinguishing cancer from healthy tissue.
  • - The method demonstrates significant sensitivity in identifying tumor types and receptor statuses, suggesting potential for improved diagnosis and management strategies through less invasive techniques like liquid biopsies.
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  • Glioblastoma is a highly aggressive brain tumor with a low median survival rate of about 14.6 months, and its recurrence is inevitable despite current treatment methods like surgery and chemotherapy.
  • Researchers have found that the epigenetic modifier ID-1 plays a key role in glioblastoma's resistance to the chemotherapy drug temozolomide by promoting a specific metabolic process called one-carbon (1-C) mediated purine synthesis.
  • The study suggests that targeting the abnormal metabolic pathways in treatment-resistant glioblastoma cells could provide new therapeutic strategies to combat this aggressive cancer.
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Adolescents and young adults (AYAs; ages 15-39 years) are a vulnerable population facing challenges in oncological care, including access to specialized care, transition of care, unique tumor biology, and poor representation in clinical trials. Brain tumors are the second most common tumor type in AYA, with malignant brain tumors being the most common cause of cancer-related death. The 2021 WHO Classification for central nervous system (CNS) Tumors highlights the importance of integrated molecular characterization with histologic diagnosis in several tumors relevant to the AYA population.

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Background: Patients with small cell lung cancer (SCLC) have historically been characterised by poor overall survival (OS) and high risk for brain metastasis (BM), but large-scale real-world evidence on clinical presentation and treatment in this population is lacking. Our aim was to describe the clinical characteristics and outcomes of patients with SCLC and BM in Ontario, Canada.

Methods: This population-based, retrospective cohort study included all patients in Ontario, Canada, who were diagnosed with SCLC between April 1, 2010, and March 31, 2018.

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  • Brain surgeons need standardized rules for handling brain tumors during surgery to improve diagnosis and treatment.*
  • Right now, guidelines mainly exist for one type of brain tumor, but others could also benefit from these rules.*
  • Having experts from different fields work together is important for creating these standardized practices to help patients and research better.*
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  • The study examines how certain variables affect the development of brain metastases in patients with oligometastatic disease treated with stereotactic body radiation therapy.
  • Researchers analyzed data from 404 patients, determining that while various factors didn’t influence brain metastases, the primary cancer site and extensive extracranial progression did.
  • The findings suggest that colorectal and prostate cancers have a lower risk of brain metastases compared to lung cancer, emphasizing the need for close monitoring in patients with significant extracranial disease progression.
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  • Patients with brain tumors want to help doctors understand their illness better by participating in tests that involve taking samples of their tumor tissue.
  • To improve treatments, everyone including patients, researchers, and regulatory agencies need to work together and use consistent methods when taking these samples.
  • Even though new tests using blood samples show some promise, they can't replace the need for the usual tissue tests just yet, and it's important to clearly explain the risks and benefits of these procedures to patients.
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Glioblastoma is the most common primary malignant brain tumor in adults, with a median survival of just over 1 year. The failure of available treatments to achieve remission in patients with glioblastoma (GBM) has been attributed to the presence of cancer stem cells (CSCs), which are thought to play a central role in tumor development and progression and serve as a treatment-resistant cell repository capable of driving tumor recurrence. In fact, the property of "stemness" itself may be responsible for treatment resistance.

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  • Large language models like ChatGPT show promise in medical fields, especially clinical neuroscience, with significant developments from OpenAI's GPT-3.5 and GPT-4.
  • The paper explores how ChatGPT can assist in neurosurgery education, including passing medical licensing exams and creating personalized study materials.
  • Caution is advised when using AI tools due to risks like hallucinations and the potential for user overreliance, highlighting the need for careful integration into neurosurgical training.
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 Radiation therapy is a mainstay of treatment for brain tumors, but delayed complications include secondary malignancy which may occur months to years after treatment completion.  We reviewed the medical records of a 41-year-old female treated with 60 Gy of radiation for a recurrent astrocytoma, who 6 years later developed a locally advanced sinonasal teratocarcinosarcoma. We searched MEDLINE, Embase, and Web of Science to conduct a scoping review of biopsy-proven sinonasal malignancy in patients who previously received cranial irradiation for a brain tumor.

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The majority of the literature focused on whether consent should be extended to the adolescent population arises from themes adapted from American tort law. In contrast to the USA, Ontario does not delineate an age of consent for medical treatment and relying on American guidelines to guide practice in Ontario is problematic. While the literature is saturated with discussions for and against seeking adolescent consent, there are currently no bioethical guidelines on adolescent consent in the province of Ontario.

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Background And Purpose: Glioblastoma (GBM) is the most common malignant primary brain tumour in adults. Receipt of adjuvant therapies has been shown to exert a significant positive effect on patient survival. Little is known however about how changes in standards of care and healthcare system factors, such as access, affect real-world outcomes.

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