Role of Proton Beam Therapy in Spinal Chordomas: A Narrative Review of The Literature.

Chordomas are rare malignant neoplasms arising from vestigial remnants of the embryonic notochord. Approximately 55-70% of chordomas develop within the vertebral column. Their affinity to develop within the bones of the axial skeleton and propensity to locally invade and recur makes them challenging candidates for complete surgical excision. Adjuvant therapies are hence necessary to improve outcomes; for which chemotherapy has been observed to be largely ineffective, owing to the tumour being resistant to it. Radiotherapy is the current adjuvant therapy of choice for chordoma management. Over the years, proton beam therapy (PBT) has been the subject of medical attention, given the dosimetric benefits it confers over traditional radiotherapy, allowing more concentrated radiation to be given to the target of interest and reducing damage to surrounding normal tissue. A review of the current literature reveals PBT offers significantly better outcomes when used as an adjuvant to maximal surgical resection rather than as a definitive therapy.

Application of Endothermic Fluids to Lower the Breakdown Pressure of Unconventional Reservoirs: Implications for Hydraulic Fracturing.

Unconventional hydrocarbon reservoirs are challenging media to exploit and develop for energy due to very low permeability. As such, unconventional means, such as horizontal drilling and hydraulic fracturing, are typically practiced. During hydraulic fracturing, the formation breakdown pressure is of great importance and determines the fluid pumping cost. Less attention has been given to breakdown pressure reduction for a cost-effective and enhanced hydraulic fracturing operation. The objective of this study is to explore the application of thermochemical fluids to induce thermal shock with the purpose of generating microcracks and reducing the breakdown pressure in high-temperature unconventional reservoirs. For this, thermochemical fluids of an endothermic nature (reduces the temperature when mixed) and Kentucky Sandstone and Eagle Ford Shale were utilized. In particular, we investigated the effect of endothermic reactions between ammonium chloride (NH4Cl) and sodium hydroxide (NaOH) on the strength and breakdown pressure of both samples by applying multiple cycle treatments. The obtained results indicated a significant reduction in both the strength and breakdown pressure of the rocks, with Kentucky Sandstone showing a reduction of 53.07% and Eagle Ford Shale by 34.71% in breakdown pressure. This novel approach not only provides a promising alternative to traditional fracturing methods in high-temperature reservoirs but also could bring a significant reduction in fluid pumping requirements as well as the operational cost of hydraulic fracturing.

Consensus guidelines for the management of vestibular schwannoma for lowand middle-income countries.

Vestibular Schwannoma (VS), previously known as acoustic neuroma, constitutes the majority of tumours found in the cerebellopontine angle (CPA). Most guidelines for managing CPA tumours have been developed by high-income countries (HICs). However, these guidelines often fall short in addressing the unique challenges encountered in low- and middle-income countries (LMICs), such as Pakistan. In LMICs, issues related to a limited healthcare workforce, inadequate infrastructure, and constrained financial resources hinder the effective implementation of these HIC-derived guidelines. Additionally, it has been observed that VS tends to present at a larger size in LMICs compared to HICs. Given that VS is the predominant type of CPA tumour and other types are covered under separate guidelines, this article aims to provide practical, contextspecific recommendations for the screening, diagnosis, and management of Vestibular Schwannoma in LMIC settings. Our focus is to bridge the gap in care strategies and adapt them to the resource constraints and clinical realities of LMICs.

Consensus guidelines for the management of pineal region tumours for low- and middle-income countries.

Pineal region tumours are rare and mainly arise at a younger age. They can be categorized into various types: germ cell tumours (GCT), pineal parenchymal tumours (PPT), meningiomas, gliomas, pineoblastoma, pineal parenchymal tumours of intermediate differentiation, papillary tumours of the pineal region, and SMARCB1- mutant desmoplastic myxoid tumour. Within GCT, germinomas are the most prevalent, comprising the majority of tumours in this region, while nongerminomatous GCTs are also present. In rare instances, metastases from other sites may manifest. These tumours often lead to obstructive hydrocephalus and commonly exhibit symptoms related to mass effect, including headache, nausea, vomiting, and impaired gait stability. Different subtypes of pineal region tumours exhibit distinct radiological characteristics, thus imaging remains the primary diagnostic tool. Histologic diagnosis necessitates biopsy, unless in cases of germ cell tumours, particularly germinomas, which can be identified through elevated levels of tumour markers like alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) in both cerebrospinal fluid (CSF) and serum. While benign tumours might be effectively treated with radical resection alone, malignant tumours demand additional chemotherapy and radiotherapy following surgical removal.

Molecular imaging with 68Ga-PSMA PET/CT in high grade glioma: A biomarker for tumour neo-angiogenesis.

There are several promising radiotracers used for both staging and restaging of primary and recurrent brain tumours based on various mechanisms of tracer localization in tumour cells. 68Ga-PSMA PET has extremely low background uptake in normal brain tissue and consequently high tumour-to-brain ratio making it a promising imaging radiotracer for gliomas. 68Ga-PSMA demonstrates utility in evaluating high grade glioma during both initial workup or when suspecting recurrence. Herein the authors evaluate the role of this imaging modality and the potential future it holds in the management of high grade gliomas.

Patient-Reported Outcomes and Complications of Simultaneous versus Staged Surgical Decompression for Tandem Spinal Stenosis.

Introduction Tandem spinal stenosis (TSS) refers to the narrowing of the spinal canal at two distinct anatomic areas. Symptoms can present due to either cervical myelopathy or lumbar stenosis. Consequently, determining the symptomatic anatomical levels requiring surgery can pose a challenge. We sought to identify the surgical approach associated with better patient-reported outcomes. Materials and Methods The Information Management System was queried using the International Classification of Diseases Ninth and Tenth Edition codes to identify patients who underwent simultaneous or staged decompression surgery for TSS between 2011 and 2020. Patient records were reviewed to collect data on age, sex, comorbidities, surgical approach, modified Japanese Orthopedic Association (mJOA) score, and complications. The mJOA is a validated composite assessment used to quantify postoperative neurological status. Multivariable regression models were utilized to identify factors associated with better postoperative neurological recovery. Results Among 42 patients included in the analytical cohort, 33 (78.6%) underwent simultaneous cervical and lumbar decompression, while 9 (21.4%) underwent staged decompression (cervical followed by lumbar). The patient's age, sex, comorbid conditions, and American Society of Anesthesiologists level were similar between the two groups. Furthermore, simultaneous decompression was associated with higher blood loss (676.97 vs. 584.44 mL) and an increased need for transfusion (259.09 vs. 111.11 mL) compared with staged decompression. Moreover, patients who underwent simultaneous decompression experienced a higher number of postoperative complications (10 vs. 1; p = 0.024). Notably, postoperative mJOA scores improved in both groups; however, the improvement was more pronounced in the staged group (mJOA score: 15.16% [ ± 2.18] vs. 16.56% [ ± 1.59]). On follow-up visits, patients who underwent staged decompression showed better recovery rates (mJOA score: 78.20% [ ± 24.45] vs. 59.75% [ ± 25.05]). Conclusion The patient's clinical history and examination findings should be the main determinants of surgical decision-making. Our study showed a slightly higher postoperative mJOA score and a recovery rate with fewer complications in staged decompression of TSS.

Dorsal intercostal artery flap; A reliable option for coverage of myelomeningocele defects: A case series.

Meningomyelocele is a common congenital condition and its reconstruction poses a challenge for surgeons. The dorsal intercostal artery (DICA) flap offers a one-stage tension-free closure with adequate results. This study, spanning from January 2019 to September 2022, analyses the outcome of nine DICA flaps for meningomyelocele reconstruction, where the average size of the DICA flap was 6.8 x 4.6 cm for an average defect of 6.33 x 4 cm. Notably, no post-operative blood transfusion was required, nor any complications occurred except for one patient's septic shock-related death. Two had post-operative cerebrospinal fluid (CSF) leak, repaired primarily with one requiring VP shunt. Based on our experience, the DICA flap, with its consistent anatomy, is a reliable option for the reconstruction of meningomyelocele defects.

Exploration of microRNAs as transcriptional regulator in mumps virus infection through computational studies.

Mumps is a common childhood infection caused by the mumps virus (MuV). Aseptic meningitis and encephalitis are usual symptoms of mumps together with orchitis and oophoritis that can arise in males and females, respectively. We have used computational tools: RNA22, miRanda and psRNATarget to predict the microRNA-mRNA binding sites to find the putative microRNAs playing role in the host response to mumps virus infection. Our computational studies indicate that hsa-mir-3155a is most likely involved in mumps infection. This was further investigated by the prediction of binding sites of hsa-mir-3155a to the MuV genome. Additionally, structure prediction using MC-Fold and MC-Sym, respectively has been applied to predict the 3D structures of miRNA and mRNA. The miRNA-mRNA interaction profile between has been confirmed through molecular docking simulation studies. Taken together, the putative miRNA (hsa_miR_6794_5p) has been found to be most likely involved in the regulation of transcriptional activity in the MuV infection.

Quality of life of pediatric patients with craniopharyngioma: A retrospective series from a low-middle-income country with more than 4 years follow-up.

Background: Craniopharyngiomas (CPs) are rare, low-grade tumors characterized by a range of debilitating symptoms. Most of the existing literature reports postoperative outcomes of the different treatment modalities of childhood CP. However, few studies have reported the impact of these different treatment methods on the quality of life (QoL) of survivors of childhood CP. Therefore, we aim to assess the correlation between different surgical modalities on the QoL of patients with childhood CP from a lower-middle-income country. Methods: Twenty-nine survivors who underwent treatment for CP were included in the study. The selected patients had either been managed with complete resection, debulking, or placement of an Ommaya reservoir. QoL was assessed by the pediatric quality of life (PedsQL) questionnaire. The effect of the different treatment modalities on the QoL was assessed. Results: Mean follow-up was 4.4 ± 2.19 years. The type of surgery was significantly related to the mean PedsQL scores for the total score as well as each of the individual domain scores (P < 0.001). Complete resection of the tumor resulted in the lowest mean (standard deviation) PedsQL total score of 56.6 ± 7.12 compared to the Ommaya reservoir with biopsy (83.3 ± 5.69) and debulking (93.8 ± 3.37) (P < 0.001). Conclusion: There was a significant effect of the type of surgical treatment on the QoL of the survivors of childhood CP. It is important to consider the long-term outcomes in addition to immediate postoperative outcomes when deciding on a treatment strategy while managing children with CP.

Role of Machine Learning in Liquid Biopsy of Brain Tumours.

Liquid biopsy has multiple benefits and is used extensively in other fields of oncology, but its role in neuro-oncology has been limited so far. Multiple tumour-derived materials like circulating tumour cells (CTCs), tumour-educated platelets (TEPs), cell-free DNA (cfDNA), circulating tumour DNA (ctDNA), and miRNA are studied in CSF, blood (plasma, serum) or urine. Large and complex amounts of data from liquid biopsy can be simplified by machine learning using various algorithms. By using this technique, we can diagnose brain tumours and differentiate low versus highgrade glioma and true progression from pseudo-progression. The potential of liquid biopsy in brain tumours has not been extensively studied, but it has a bright future in the coming years. Here, we present a literature review on the role of machine learning in liquid biopsy of brain tumours.

Improving Water-Based Drilling Mud Performance Using Biopolymer Gum: Integrating Experimental and Machine Learning Techniques.

Drilling through shale formations can be expensive and time-consuming due to the instability of the wellbore. Further, there is a need to develop inhibitors that are environmentally friendly. Our study discovered a cost-effective solution to this problem using Gum Arabic (ArG). We evaluated the inhibition potential of an ArG clay swelling inhibitor and fluid loss controller in water-based mud (WBM) by conducting a linear swelling test, capillary suction timer test, and zeta potential, fluid loss, and rheology tests. Our results displayed a significant reduction in linear swelling of bentonite clay (Na-Ben) by up to 36.1% at a concentration of 1.0 wt. % ArG. The capillary suction timer (CST) showed that capillary suction time also increased with the increase in the concentration of ArG, which indicates the fluid-loss-controlling potential of ArG. Adding ArG to the drilling mud prominently decreased fluid loss by up to 50%. Further, ArG reduced the shear stresses of the base mud, showing its inhibition and friction-reducing effect. These findings suggest that ArG is a strong candidate for an alternate green swelling inhibitor and fluid loss controller in WBM. Introducing this new green additive could significantly reduce non-productive time and costs associated with wellbore instability while drilling. Further, a dynamic linear swelling model, based on machine learning (ML), was created to forecast the linear swelling capacity of clay samples treated with ArG. The ML model proposed demonstrates exceptional accuracy (R2 score = 0.998 on testing) in predicting the swelling properties of ArG in drilling mud.

Prediction of Foam Rheology Models Parameters Utilizing Machine Learning Tools.

Rheological models are usually used to predict foamed fluid viscosity; however, obtaining the model constants under various conditions is challenging. Hence, this paper investigated the effect of different variables on foam rheology, such as shear rate, temperature, pressure, surfactant types, gas phase, and salinity, using a high-pressure high-temperature foam rheometer. Power-law, Bingham plastic, and Casson fluid models fit the experimental data well. Therefore, the data were fed to different machine learning techniques to evaluate the rheological model constants with different features. In this study, seven different machine learning techniques have been applied to predict the rheological models' constants, including decision tree, random forest, XGBoost (XGB), adaptive gradient boosting, gradient boosting, support vector regression, and voting regression. We evaluated the performance of our machine learning models using the coefficient of determination (R2), cross-plots, root-mean-square error, and average absolute percentage error. Based on the prediction outcomes, the XGB model outperformed the other ML models. The XGB model exhibited remarkably low error rates, achieving a prediction accuracy of 95% under ideal conditions. Furthermore, our prediction results demonstrated that the Casson model accurately captured the rheological behavior of the foam. Additionally, we used Pearson's correlation coefficients to assess the significance of various properties in relation to the constants within the rheological models. It is evident that the XGB model makes predictions with nearly all features contributing significantly, while other machine learning techniques rely more heavily on specific features over others. The proposed methodology can minimize the experimental cost of measuring rheological parameters and serves as a quick assessment tool.

Influence of Varying Oil-Water Contents on the Formation of Crude Oil Emulsion and Its Demulsification by a Lab-Grown Nonionic Demulsifier.

This study describes how varying oil/water contents affect emulsion formation and the impact they have on emulsion droplet size, viscosity, and interfacial behavior. Crude oil (continuous phase) volume fractions of 40, 50, 60, and 70 vol % were probed in the various W/O emulsions formed. Experimental results from optical morphology revealed the emulsion droplets kept reducing as the crude oil fraction kept increasing, while the droplets were nearly unnoticeable in the emulsions derived from 60 and 70% crude oil. The viscosity-shear rate of emulsions produced from 40, 50, and 60 vol % crude oil exhibited a non-Newtonian behavior owing to the substantial volume of water content in their emulsions, whereas the viscosity-shear rate of the emulsion with 70 vol % crude oil exhibited a Newtonian behavior similar to the pure crude oil, suggesting a thorough blending of oil-water at this crude oil fraction. Besides, the viscosity-temperature measurements revealed that the viscosity of these emulsions diminished as the temperature increased and the viscosity reduction became more noticeable in an emulsion comprising 70 vol % crude oil. In the interfacial assessment, the increased crude oil content in the produced emulsion led to a sharp reduction in the interfacial tension (IFT). The IFT values after 500 s contacts between the emulsion and water (surrounding phase) were 11.86, 10.02, 8.08, and 6.99 mN/m for 40, 50, 60, and 70 vol % crude oil, respectively. Demulsification experiments showed that water removal becomes more challenging with a large volume of crude oil and a small water content. Demulsification performances of the lab-grown nonionic demulsifier (NID) after 10 h of demulsification activity at room temperature (25 °C) were 98, 90, 17.5, and 10% for the emulsions formed from 40, 50, 60, and 70 vol % crude oil, respectively, indicating that the demulsification degree decreases with an increasing crude oil content. Viscosity-time determination was applied to affirm the activity of NID on the emulsion formulated with a 50% crude oil fraction. The injection of NID in this emulsion triggered a sharp viscosity reduction, indicating the adsorption of NID at the oil-water interface and disruption of emulsifiers, enabling emulsion stability.

Quality of Life of Children Treated for Split Cord Malformation.

OBJECTIVE: Split cord malformation (SCM), associated with neurologic deficits, necessitates surgical intervention for spinal cord detethering. Limited evidence exists regarding its impact on children's quality of life. Our study aims to evaluate the postoperative quality of life in children treated for SCM. METHODS: This retrospective cohort study examined records of patients with SCM operated on between July 1, 2012, and July 31, 2022, at a single center. Data, including Health Utility Index-3 (HUI-3) scores provided by guardians, was collected to assess quality of life. Clinical and neurologic outcomes were also analyzed. RESULTS: Twenty-five patients, predominantly female (68%), with a median age of 7 years, were included. Most presented with normal motor function (76%). The most common anatomic level of SCM was lumbar (12; 48%) followed by lumbosacral (5; 20%). A bony spur from the lamina was the most common cause of splitting the cord (64%). Over a median follow-up of 3.3 years, 64% of patients showed neurologic stability, 16% showed neurologic improvement, and 4% experienced deterioration. The mean HUI-3 score for 21 children was 0.93 ± 0.24. CONCLUSIONS: Surgical management of SCM showed favorable neurologic outcomes and a positive long-term quality of life, as shown by HUI-3 scores. Our findings emphasize the efficacy of surgical intervention in improving the lives of children with this condition.

RAPNO efforts in Brain Tumour Outcomes.

Assessing treatment efficacy for brain tumours has evolved since its inception with the introduction of MacDonald's criteria, which pioneered the utility of imaging to determine an objective and quantifiable response to treatment. This criterion failed to distinguish pseudo response or progression from progression and did not account for non-enhancing disease therefore; the response assessment in neuro-oncology (RANO) working group was established to account for these limitations. Since, its commencement it has worked to determine response assessment for multiple tumours. As paediatric tumours exhibit heterogeneous and variable-enhancing characteristics, the response assessment in paediatric neuro-oncology (RAPNO) working group was formed to create separate criteria. Six response criteria have been published to date, and the article summarizes them.

Multi-IsnadSet MIS for Sahih Muslim Hadith with chain of narrators, based on multiple ISNAD.

In the Islamic domain, Hadiths hold significant importance, standing as crucial texts following the Holy Quran. Each Hadith contains three main parts: the ISNAD (chain of narrators), TARAF (starting part, often from Prophet Muhammad), and MATN (Hadith content). ISNAD, a chain of narrators involved in transmitting that particular MATN. Hadith scholars determine the trustworthiness of the transmitted MATN by the quality of the ISNAD. The ISNAD's data is available in its original Arabic language, with narrator names transliterated into English. This paper presents the Multi-IsnadSet (MIS), that has great potential to be employed by the social scientist and theologist. A multi-directed graph structure is used to represents the complex interactions among the narrators of Hadith. The MIS dataset represent directed graph which consists of 2092 nodes, representing individual narrators, and 77,797 edges represent the Sanad-Hadith connections. The MIS dataset represents multiple ISNAD of the Hadith based on the Sahih Muslim Hadith book. The dataset was carefully extracted from online multiple Hadith sources using data scraping and web crawling techniques tools, providing extensive Hadith details. Each dataset entry provides a complete view of a specific Hadith, including the original book, Hadith number, textual content (MATN), list of narrators, narrator count, sequence of narrators, and ISNAD count. In this paper, four different tools were designed and constructed for modeling and analyzing narrative network such as python library (NetworkX), powerful graph database Neo4j and two different network analysis tools named Gephi and CytoScape. The Neo4j graph database is used to represent the multi-dimensional graph related data for the ease of extraction and establishing new relationships among nodes. Researchers can use MIS to explore Hadith credibility including classification of Hadiths (Sahih=perfection in the Sanad/Dhaif=imperfection in the Sanad), and narrators (trustworthy/not). Traditionally, scholars have focused on identifying the longest and shortest Sanad between two Narrators, but in MIS, the emphasis shifts to determining the optimum/authentic Sanad, considering narrator qualities. The graph representation of the authentic and manually curated dataset will open ways for the development of computational models that could identify the significance of a chain and a narrator. The dataset allows the researchers to provide Hadith narrators and Hadith ISNAD that could be used in a wide variety of future research studies related to Hadith authentication and rules extraction. Moreover, the dataset encourages cross-disciplinary research, bridging the gap between Islamic studies, artificial intelligence (AI), social network analysis (SNA), and Graph Neural Network (GNN).

The role of 18F-FDG PET/CT in Neurolymphomatosis: A Comprehensive Imaging Approach.

Neurolymphomatosis (NL) is an uncommon and rare neurologic disorder characterised by extranodal lymphoma, where the tumour cells invade the cranial nerves, nerve plexus, nerve root, spinal nerve roots, trunk nerves or peripheral nerves. MRI is the modality of choice, but is often challenging in detection of early recurrence, assessing residual disease and response evaluation. 18FFDG PET/CT has superior diagnostic performance compared with body CT in the evaluation of NL. 18F-FDG PET-CT is helpful in evaluation of disease extent and potential to guide biopsy. 18F-FDG PETCT is a highly sensitive technique for early localisation of NL than MRI or CT alone. Besides diagnostic and prognostic value in NL, it might be very helpful in response assessment.

Country-wide, multi-location trials of Green Super Rice lines for yield performance and stability analysis using genetic and stability parameters.

Rice (Oryza sativa L.) is an important member of the family Poaceae and more than half of world population depend for their dietary nutrition on rice. Rice cultivars with higher yield, resilience to stress and wider adaptability are essential to ensure production stability and food security. The fundamental objective of this study was to identify higher-yielding rice genotypes with stable performance and wider adaptability in a rice growing areas of Pakistan. A triplicate RCBD design experiment with 20 Green Super Rice (GSR) advanced lines was conducted at 12 rice growing ecologies in four Provinces of Pakistan. Grain yield stability performance was assessed by using different univariate and multivariate statistics. Analysis of variance revealed significant differences among genotypes, locations, and G x E interaction for mean squares (p < 0.05) of major yield contributing traits. All the studied traits except for number of tillers per plant revealed higher genotypic variance than environmental variance. Broad sense heritability was estimated in the range of 44.36% to 98.60%. Based on ASV, ASI, bi, Wi2, σ2i and WAAS statistics, the genotypes G1, G4, G5, G8, G11 and G12 revealed lowest values for parametric statistics and considered more stable genotypes based on  paddy yield. The additive main effects and multiplicative interaction (AMMI) model revealed significant variation (p < 0.05) for genotypes, non-signification for environment and highly significant for G × E interaction. The variation proportion of PC1 and PC2 from interaction revealed 67.2% variability for paddy yield. Based on 'mean verses stability analysis of GGE biplot', 'Which-won-where' GGE Biplot, 'discriminativeness vs. representativeness' pattern of stability, 'IPCA and WAASB/GY' ratio-based stability Heat-map, and ranking of genotypes, the genotypes G1, G2, G3, G5, G8, G10, G11 and G13 were observed ideal genotypes with yield potential more than 8 tons ha-1. Discriminativeness vs. representativeness' pattern of stability identifies two environments, E5 (D.I Khan, KPK) and E6 (Usta Muhammad, Baluchistan) were best suited for evaluating genotypic yield performance. Based on these findings we have concluded that the genotypes G1, G2, G3, G5, G8, G10, G11 and G13 could be included in the commercial varietal development process and future breeding program.

Evolution of RANO in Assessing Brain Tumour Outcomes.

Assessing treatment response is extremely important in management of brain tumours. Response assessment in neuro-oncology (RANO) was introduced in 2008 for the purpose of making recommendations for it by addressing and countering the limitations in previously reported response criteriae. Subsequently, multiple RANO working groups have been formed to cater to different tumour types and to update their previous recommendations to counter the limitations in their criteria. Herein we have a summarized list of RANO criteria for adult brain tumours.