Imaging characteristics and treatment of recurrent germinoma.

Objective: An MRI protocol for germinoma surveillance after complete remission has not been established. Moreover, the standard treatment for recurrent or refractory germinoma has not been determined. In this study, the authors explored the imaging characteristics of recurrent germinoma and discuss their institution's experience with multidisciplinary treatment of this malignancy.

Efficacy comparison and outcome predictors of GPi- and STN-targeted deep brain stimulation for Meige syndrome: a systematic review of individual patient data.

Objective: The aim of this study was to evaluate outcomes of deep brain stimulation (DBS) for Meige syndrome, compare the efficacy of globus pallidus internus (GPi) and subthalamic nucleus (STN) as targets, and identify potential outcome predictors.

Methods: The PubMed, Embase, and Web of Science databases were systematically searched to collect individual data from patients with Meige syndrome receiving DBS. Outcomes were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale motor (BFMDRS-M) and disability (BFMDRS-D) scores.

A novel posterior decompression technique (anterior sliding decompression osteotomy) for beak-type ossification of the posterior longitudinal ligament in the thoracic spine.

Objective: Conventional decompression surgery for beak-type ossification of the posterior longitudinal ligament (OPLL) of the thoracic spine, whether approached anteriorly or posteriorly, poses several challenges, including technical complexity, cerebrospinal fluid leakage, incomplete decompression, and potential neurological deterioration. Therefore, the authors introduce a novel technique, anterior sliding decompression osteotomy (ASDO), for thoracic myelopathy caused by OPLL and evaluate the efficacy and safety of this technique.

Methods: Six patients (4 men and 2 women) who underwent ASDO surgery for beak-type OPLL in the thoracic spine with a follow-up period of at least 2 years were included in the cohort.

Standardizing postoperative pain control for decompression of pediatric Chiari type I malformation by limiting narcotic usage.

Objective: The aim of this study was to assess the effectiveness of a postoperative multimodal pain control protocol on perioperative pain scores in children undergoing decompression for Chiari type I malformation (CM-I).

Methods: This retrospective matched cohort study included patients < 21 years of age who underwent elective suboccipital craniectomy and C1 laminectomy for CM-I with or without duraplasty at a single center from January 2020 to July 2023. A standardized, multimodal postoperative pain protocol was implemented in August 2021 that did not use narcotic patient-controlled analgesia.

Smartphone accelerometers as tools to study the effect of socioeconomic disparities in neurosurgical outcomes: a multi-institutional retrospective analysis.

Objective: Smartphones and wearable devices can be effective tools to objectively assess patient mobility and well-being before and after spine surgery. In this retrospective observational study, the authors investigated the relationship between these longitudinal perioperative patient activity data and socioeconomic and demographic correlates, assessing whether smartphone-captured metrics may allow neurosurgeons to distinguish intergroup patterns.

Methods: A multi-institutional retrospective study of patients who underwent spinal decompression with and without fusion between 2017 and 2021 was conducted.

Development and validation of a radiomics-visual evoked potential nomogram for preoperative prediction of visual outcome after endoscopic craniopharyngioma resection.

Objective: Craniopharyngiomas are rare, benign brain tumors that are primarily treated with surgery. Although the extended endoscopic endonasal approach (EEEA) has evolved as a more reliable surgical alternative and yields better visual outcomes than traditional craniotomy, postoperative visual deterioration remains one of the most common complications, and relevant risk factors are still poorly defined. Hence, identifying risk factors and developing a predictive model for postoperative visual deterioration is indeed necessary.

Development of a unified and comprehensive definition of successful spinal fusion: a systematic review.

Objective: Spinal fusion is a commonly performed surgical procedure used to relieve pain, deformity, and instability of various spinal pathologies. Although there have been attempts to standardize spinal fusion assessment radiologically, there is currently no unified definition that also considers clinical symptomology. This review attempts to create a more holistic and standardized definition of spinal fusion.

Desmopressin prescription safety in adult inpatients: a real-world tertiary centre experience.

Omissions or delays in desmopressin can result in serious patient harm in patients with Arginine-Vasopressin Deficiency (AVP-D), formally known as Cranial Diabetes Insipidus (CDI). Desmopressin administration practice in hospitals has not been thoroughly investigated previously. This study evaluated desmopressin prescription and administration practice at a large tertiary centre.

Clinical significance of intraoperative bidirectional corticocortical evoked potential monitoring to evaluate language function.

Objective: Awake craniotomy is commonly used to resect lesions located near the language area during brain surgery. However, it is often difficult to perform language tasks due to several limitations such as difficulty in awakening during surgery and intraoperative seizures. This study investigated the clinical significance of bidirectional corticocortical evoked potential (CCEP) monitoring as a new approach to evaluate intraoperative language function.

The Use of AI in Mental Health Services to Support Decision-Making: Scoping Review.

Background: Recent advancements in artificial intelligence (AI) have changed the care processes in mental health, particularly in decision-making support for health care professionals and individuals with mental health problems. AI systems provide support in several domains of mental health, including early detection, diagnostics, treatment, and self-care. The use of AI systems in care flows faces several challenges in relation to decision-making support, stemming from technology, end-user, and organizational perspectives with the AI disruption of care processes.

Association between pituitary adenoma consistency, resection techniques, and patient outcomes: a single-institution experience.

Objective: The present study aimed to investigate the association between pituitary adenoma (PA) consistency and other measurable tumor characteristics, extent of resection (EOR), postoperative complications, and outcomes.

Methods: In total, 507 PA resections were intraoperatively assigned a consistency grade from 1 (cystic/hemorrhagic tumors) to 5 (calcified tumors) based on intraoperative tumor characteristics. Tumor consistency was analyzed in tertiles (grades 1 and 2, grade 3, and grades 4 and 5) to determine associations with tumor characteristics, EOR, recurrence, postoperative outcomes, and complications.

Competing pathways of intracranial aneurysm growth: linking regional growth distribution and hemodynamics.

Objective: The complex mix of factors, including hemodynamic forces and wall remodeling mechanisms, that drive intracranial aneurysm growth is unclear. This study focuses on the specific regions within aneurysm walls where growth occurs and their relationship to the prevalent hemodynamic conditions to reveal critical mechanisms leading to enlargement.

Methods: The authors examined hemodynamic models of 67 longitudinally followed aneurysms, identifying 88 growth regions.

Digital Mindfulness Training for Burnout Reduction in Physicians: Clinician-Driven Approach.

Background: Physician burnout is widespread in health care systems, with harmful consequences on physicians, patients, and health care organizations. Mindfulness training (MT) has proven effective in reducing burnout; however, its time-consuming requirements often pose challenges for physicians who are already struggling with their busy schedules.

Objective: This study aimed to design a short and pragmatic digital MT program with input from clinicians specifically to address burnout and to test its efficacy in physicians.

Role of Ribosomal Protein bS1 in Orthogonal mRNA Start Codon Selection.

In many bacteria, the location of the mRNA start codon is determined by a short ribosome binding site sequence that base pairs with the 3'-end of 16S rRNA (rRNA) in the 30S subunit. Many groups have changed these short sequences, termed the Shine-Dalgarno (SD) sequence in the mRNA and the anti-Shine-Dalgarno (ASD) sequence in 16S rRNA, to create "orthogonal" ribosomes to enable the synthesis of orthogonal polymers in the presence of the endogenous translation machinery. However, orthogonal ribosomes are prone to SD-independent translation.

Improved accuracy of delayed cerebral ischemia diagnosis with plasma nitric oxide synthase 3, nicotinamide adenine dinucleotide phosphate, and 8-iso-prostaglandin F2α.

Objective: The pathophysiology of delayed cerebral ischemia (DCI) is not fully elucidated. The lack of accurate diagnostic tools increases the probability of delayed diagnosis and timely treatment. The authors assessed the relationship of 8-iso-prostaglandin F2α (F2-IsoP) and oxidative stress biomarkers, nitric oxide synthase 3 (NOS3) and nicotinamide adenine dinucleotide phosphate (NADPH), with DCI after aneurysmal subarachnoid hemorrhage (aSAH).

Focused ultrasound therapy as a strategy for improving glioma treatment.

The infiltrative and diffuse nature of gliomas makes complete resection unfeasible. Unfortunately, regions of brain parenchyma with residual, infiltrative tumor are protected by the blood-brain barrier (BBB), making systemic chemotherapies, small-molecule inhibitors, and immunotherapies of limited efficacy. Low-frequency focused ultrasound (FUS) in combination with intravascular microbubbles can be used to disrupt the BBB transiently and selectively within the tumor and peritumoral region.

Auricular vagus nerve stimulation for mitigation of inflammation and vasospasm in subarachnoid hemorrhage: a single-institution randomized controlled trial.

Objective: Inflammation contributes to morbidity following subarachnoid hemorrhage (SAH). The authors of this study evaluate how applying noninvasive transauricular vagus nerve stimulation (taVNS) can target this deleterious inflammatory response following SAH and reduce the rate of radiographic vasospasm.

Methods: In this prospective, triple-blinded, randomized controlled trial, 27 patients were randomized to taVNS or sham stimulation.

The Fit Older Adult with Acute Myeloid Leukemia: Clinical Challenges to Providing Evidence-Based Frontline Treatment.

Recent advances in acute myeloid leukemia (AML) come from studies investigating younger (age<60 years) adults or older (age≥75 years) or less fit adults. Uncertainty exists for the management of otherwise healthy adults with AML in their 60s and 70s, which also represents a significant proportion of AML cases. We discuss current considerations in older, fit adults with AML including determination of fitness, what factors beyond fitness should be assessed, and finally what challenges and innovations lie ahead to improve outcomes for these patients.

One hundred thirty-four germ line PU.1 variants and the agammaglobulinemic patients carrying them.

Leukopoiesis is lethally arrested in mice lacking the master transcriptional regulator PU.1. Depending on the animal model, subtotal PU.

Behavioral Profiling in Zebrafish Identifies Insecticide-Related Compounds.

Pesticides, including insecticides, are indispensable for large-scale agriculture. Modulating chloride ion channels has proven highly successful as a mode of action (MoA) for insect management. Identifying new ligands for these channels affords opportunities for the potential development of new insecticide products.

DDAVP response and its determinants in bleeding disorders: a systematic review and meta-analysis.

Desmopressin (DDAVP) can be used to prevent or stop bleeding. However, large inter-individual variability is observed in DDAVP response and determinants are largely unknown. In this systematic review and meta-analysis we aim to identify the response to DDAVP, and the factors that determine DDAVP response in patients.