Publications by authors named "Weingart J"

The role of glioma-associated myeloid cells in tumor growth and immune evasion remains poorly understood. We performed single-cell RNA sequencing of immune and tumor cells from 33 gliomas, identifying two distinct myeloid-derived suppressor cell (MDSC) populations in isocitrate dehydrogenase-wild-type (IDT-WT) glioblastoma: an early progenitor MDSC (E-MDSC) population with up-regulation of metabolic and hypoxia pathways and a monocytic MDSC (M-MDSC) population. Spatial transcriptomics demonstrated that E-MDSCs geographically colocalize with metabolic stem-like tumor cells in the pseudopalisading region.

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Elucidating the interaction between membrane proteins and antibodies requires whole-cell imaging at high spatiotemporal resolution. Lattice light-sheet (LLS) microscopy offers fast volumetric imaging but suffers from limited spatial resolution. DNA-based point accumulation for imaging in nanoscale topography (DNA-PAINT) achieves molecular resolution but is restricted to two-dimensional imaging owing to long acquisition times.

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Purpose: Social determinants of health including neighborhood socioeconomic status, have been established to play a profound role in overall access to care and outcomes in numerous specialized disease entities. To provide glioblastoma multiforme (GBM) patients with high-quality care, it is crucial to identify predictors of hospital length of stay (LOS), discharge disposition, and access to postoperative adjuvant chemoradiation. In this study, we incorporate a novel neighborhood socioeconomic status index (NSES) and develop three predictive algorithms for assessing post-operative outcomes in GBM patients, offering a tool for preoperative risk stratification of GBM patients.

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Unlabelled: Patients who have radiographically detectable lesions in their brain or other symptoms compatible with brain tumors pose challenges for diagnosis. The only definitive way to diagnose such patients is through brain biopsy, an obviously invasive and dangerous procedure. Here we present a new workflow termed "CSF-BAM" that simultaneously identifies cell or T cell receptor rearrangements, neuploidy, and using PCR-mediated amplification of both strands of the DNA from CSF samples.

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Article Synopsis
  • Timely placement of external ventricular drains (EVDs) is crucial in emergency neurosurgery, and the introduction of portable electrical drills like the Hubly drill offers potential improvements in the procedure.
  • In a study, two patients successfully received EVDs using the new portable drill, with quick access times and no complications observed during the procedures.
  • The findings suggest that the smart autostop feature of the drill could enhance safety and efficiency in EVD placement, highlighting the need for further development and research in this technology.
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Background: Robotic platforms have increased in sophistication for pedicle screw placement. Here, we review our institutional experience using ExcelsiusGPS to assess the accuracy rate of pedicle screw placement throughout the spine and characterize predictors of placement inaccuracy.

Study Design: Retrospective cohort study.

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  • Oligodendroglioma is a brain tumor characterized by specific genetic mutations and treatments typically involve surgery followed by either observational care or a combination of radiation and chemotherapy.
  • This study analyzed data from 277 patients with IDH-mutant, 1p/19q codeleted oligodendrogliomas to examine the impact of different adjuvant treatment regimens on progression-free survival (PFS).
  • Results indicated that patients with grade 3 tumors showed significantly longer PFS when treated with radiation and PCV chemotherapy compared to those receiving radiation with TMZ or no adjuvant therapy, emphasizing the need for more research in this area.
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Objective: Brain metastases (BM) constitute the most common intracranial tumor in adults. Prior literature indicates the 10-year atherosclerotic cardiovascular disease (ASCVD) risk score is associated with increased risk of cancer, potentially attributable to shared risk factors. Understanding the role of ASCVD risk scores in BM may help optimize their care and inform clinical decision-making.

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Objective: Brain metastases (BM) are the most common adult intracranial tumors, representing a significant source of morbidity in patients with systemic malignancy. Frailty indices, including 11- and 5-factor modified frailty indices (mFI-11 and mFI-5), American Society of Anesthesiologists (ASA) physical status classification, and Charlson Comorbidity Index (CCI), have recently demonstrated an important role in predicting high-value care outcomes in neurosurgery. This study aims to investigate the efficacy of the newly developed Hospital Frailty Risk Score (HFRS) on postoperative outcomes in BM patients.

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  • Oligodendrogliomas, known for specific genetic mutations (IDH1/2) and chromosome deletions (1p/19q), were analyzed in a study to understand the clinical significance of additional genomic alterations like CIC, FUBP1, and TERTp using clinically standardized NGS panels.
  • The analysis included 277 patients diagnosed between 2005 and 2021, revealing that among the 95 patients with NGS reports, CIC, FUBP1, and TERTp were the most commonly altered genes.
  • While these genetic alterations were frequent, the study found that most did not significantly impact progression-free or overall survival, except for a noted reduction in progression-free survival associated with CIC alterations in specific
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Article Synopsis
  • - The study examined how coordination of care among primary care providers (PCPs), neurosurgeons, and oncologists impacts treatment and survival outcomes for glioblastoma (GBM) patients.
  • - Results showed that having a PCP and participating in electronic health information exchange (HIE) significantly increased the likelihood of starting and completing necessary treatments, and ultimately led to better overall survival rates.
  • - The findings suggest that enhancing collaboration through coordination between different healthcare specialists could be a key strategy to improve the care and outcomes for GBM patients.
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Objective: The Hospital Frailty Risk Score (HFRS) is a tool for quantifying patient frailty using International Classification of Diseases, Tenth Revision codes. This study aimed to determine the utility of the HFRS in predicting surgical outcomes after resection of glioblastoma (GBM) and compare its prognostic ability with other validated indices such as American Society of Anesthesiologists score and Charlson Comorbidity Index.

Methods: A retrospective analysis was conducted using a GBM patient database (2017-2019) at a single institution.

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Objective: Careful hematologic management is required in surgical patients with traumatic acute subdural hematoma (aSDH) taking antithrombotic medications. We sought to compare outcomes between patients with aSDH taking antithrombotic medications at admission who received antithrombotic reversal with patients with aSDH not taking antithrombotics.

Methods: Retrospective review identified patients with traumatic aSDH requiring surgical evacuation.

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Article Synopsis
  • Acute subdural hematoma (aSDH) after traumatic brain injury often requires urgent surgical procedures, specifically craniotomy (CO) or decompressive craniectomy (DC), and the study aimed to compare outcomes and identify variables linked to each approach.
  • The study analyzed data from multiple centers, identifying significant differences in patient characteristics between those undergoing CO and DC, including age, gender, and severity of symptoms at presentation.
  • Findings indicated that patients undergoing DC were generally younger and more likely to have poorer clinical outcomes, with DC being associated with higher mortality rates both during hospitalization and at 90 days and 1 year post-surgery after adjusting for patient differences.
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  • This study examines the impact of two hemodialysis methods—continuous venovenous hemodialysis (CVVHD) and intermittent hemodialysis (iHD)—on the rates of subdural hematoma (SDH) re-expansion in patients with end-stage renal disease (ESRD).
  • Researchers found that patients undergoing CVVHD had lower rates of SDH expansion affecting neurological function compared to those on iHD, highlighting a significant difference in outcomes between the two methods.
  • The conclusion suggests that CVVHD may provide better stability for SDH in ESRD patients, indicating a potential preference for this dialysis approach in their treatment.
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While the central nervous system (CNS) tumor classification has increasingly incorporated molecular parameters, there is a paucity of literature reporting molecular alterations found in intraventricular glioblastoma (IVGBM), which are rare. We present a case series of nine IVGBMs, including molecular alterations found in standardized next-generation sequencing (NGS). We queried the clinical charts, operative notes, pathology reports, and radiographic images of nine patients with histologically confirmed IVGBM treated at our institution (1995-2021).

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Background And Objectives: Robot-assisted pedicle screw placement is associated with greater accuracy, reduced radiation, less blood loss, shorter hospital stays, and fewer complications than freehand screw placement. However, it can be associated with longer operative times and an extended training period. We report the initial experience of a surgeon using a robot system at an academic medical center.

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  • Scientists have created a new method called Real-CSF to help tell the difference between brain cancer and non-cancerous spots.
  • This technique looks at DNA in a special fluid around the brain to find signs of cancer more accurately than regular tests.
  • In tests with 280 samples, Real-CSF correctly identified most of the cancerous and non-cancerous cases, making it a useful tool for doctors.
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Background And Objectives: Awake vs asleep craniotomy for patients with eloquent glioma is debatable. This systematic review and meta-analysis sought to compare awake vs asleep craniotomy for the resection of gliomas in the eloquent regions.

Methods: MEDLINE and PubMed were searched from inception to December 13, 2022.

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Objectives: This study evaluated the accuracy of deep neural patchworks (DNPs), a deep learning-based segmentation framework, for automated identification of 60 cephalometric landmarks (bone-, soft tissue- and tooth-landmarks) on CT scans. The aim was to determine whether DNP could be used for routine three-dimensional cephalometric analysis in diagnostics and treatment planning in orthognathic surgery and orthodontics.

Methods: Full skull CT scans of 30 adult patients (18 female, 12 male, mean age 35.

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Objective: To the best of our knowledge, prior research has not investigated the uncertainty in the relationship between patient frailty and postoperative outcomes after brain tumor surgery. The present study used Bayesian methods to quantify the statistical uncertainty between the 5-factor modified frailty index (mFI-5) and postoperative outcomes for patients undergoing brain tumor resection.

Methods: The present study used retrospective data collected from patients undergoing brain tumor resection during a 2-year period (2017-2019).

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Unlabelled: The diversity of genetic programs and cellular plasticity of glioma-associated myeloid cells, and thus their contribution to tumor growth and immune evasion, is poorly understood. We performed single cell RNA-sequencing of immune and tumor cells from 33 glioma patients of varying tumor grades. We identified two populations characteristic of myeloid derived suppressor cells (MDSC), unique to glioblastoma (GBM) and absent in grades II and III tumors: i) an early progenitor population (E-MDSC) characterized by strong upregulation of multiple catabolic, anabolic, oxidative stress, and hypoxia pathways typically observed within tumor cells themselves, and ii) a monocytic MDSC (M-MDSC) population.

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Background: Computer Assisted Design and Computer Assisted Manufacturing (CAD/CAM) have revolutionized oncologic surgery of the head and neck. A multitude of benefits of this technique has been described, but there are only few reports of donor site comorbidity following CAD/CAM surgery.

Methods: This study investigated comorbidity of the hip following deep circumflex iliac artery (DCIA) graft raising using CAD/CAM techniques.

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Objective: In recent years, frailty indices such as the 11- and 5-factor modified frailty indices (mFI-11 and mFI-5), American Society of Anesthesiologists (ASA) physical status classification, and Charlson Comorbidity Index (CCI) have been shown to be effective predictors of various postoperative outcomes in neurosurgical patients. The Hospital Frailty Risk Score (HFRS) is a well-validated tool for assessing frailty; however, its utility has not been evaluated in intracranial tumor surgery. In the present study, the authors investigated the accuracy of the HFRS in predicting outcomes following intracranial tumor resection and compared its utility to those of other validated frailty indices.

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 While predictive analytic techniques have been used to analyze meningioma postoperative outcomes, to our knowledge, there have been no studies that have investigated the utility of machine learning (ML) models in prognosticating outcomes among skull base meningioma patients. The present study aimed to develop models for predicting postoperative outcomes among skull base meningioma patients, specifically prolonged hospital length of stay (LOS), nonroutine discharge disposition, and high hospital charges. We also validated the predictive performance of our models on out-of-sample testing data.

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