It is necessary to elucidate the individual effects of temozolomide (TMZ) on carcinogenesis and tumor resistance to chemotherapy mechanisms. The study aimed to investigate the TMZ 50 and 100 μM dose effect difference between PBT24 and SF8628 cell line high-grade pediatric glioblastoma (phGBM) xenografts in a chicken chorioallantoic membrane (CAM) model, on PCNA and EZH2 immunohistochemical expression in the tumor and on the expression of NKCC1, KCC2, E- and N-cadherin genes in TMZ-treated and control cell groups in vitro. TMZ at a 100 μg dose reduced the incidence of PBT24 xenograft invasion into the CAM, CAM thickening and the number of blood vessels in the CAM (p < 0.05), but did not affect the SF8628 tumor in the CAM model. The TMZ impact on PBT24 and SF8628 tumor PCNA expression was similarly significantly effective but did not alter EZH2 expression in the studied tumors. The TMZ at 50 μM caused significantly increased RNA expression of the NKCC1 gene in both studied cell types compared with controls (p < 0.05). The expression of the KCC2 gene was increased in PBT24 TMZ-treated cells (p < 0.05), and no TMZ effect was found in SF8628-treated cells. The study supports the suggestion that individual sensitivity to TMZ should be assessed when starting treatment.

Objectives: Subarachnoid Hemorrhage (SAH) is a serious neurological emergency case with a higher mortality rate. An automatic SAH detection is needed to expedite and improve identification, aiding timely and efficient treatment pathways. The existence of noisy and dissimilar anatomical structures in NCCT images, limited availability of labeled SAH data, and ineffective training causes the issues of irrelevant features, overfitting, and vanishing gradient issues that make SAH detection a challenging task. Methods: In this work, the water waves dynamic factor and wandering strategy-based Sand Cat Swarm Optimization, namely DWSCSO, are proposed to ensure optimum feature selection while a Parametric Rectified Linear Unit with a Stacked Convolutional Neural Network, referred to as PRSCNN, is developed for classifying grades of SAH. The DWSCSO and PRSCNN surpass current practices in SAH detection by improving feature selection and classification accuracy. DWSCSO is proposed to ensure optimum feature selection, avoiding local optima issues with higher exploration capacity and avoiding the issue of overfitting in classification. Firstly, in this work, a modified region-growing method was employed on the patient Non-Contrast Computed Tomography (NCCT) images to segment the regions affected by SAH. From the segmented regions, the wide range of patterns and irregularities, fine-grained textures and details, and complex and abstract features were extracted from pre-trained models like GoogleNet, Visual Geometry Group (VGG)-16, and ResNet50. Next, the PRSCNN was developed for classifying grades of SAH which helped to avoid the vanishing gradient issue. Results: The DWSCSO-PRSCNN obtained a maximum accuracy of 99.48%, which is significant compared with other models. The DWSCSO-PRSCNN provides an improved accuracy of 99.62% in CT dataset compared with the DL-ICH and GoogLeNet + (GLCM and LBP), ResNet-50 + (GLCM and LBP), and AlexNet + (GLCM and LBP), which confirms that DWSCSO-PRSCNN effectively reduces false positives and false negatives. Conclusions: the complexity of DWSCSO-PRSCNN was acceptable in this research, for while simpler approaches appeared preferable, they failed to address problems like overfitting and vanishing gradients. Accordingly, the DWSCSO for optimized feature selection and PRSCNN for robust classification were essential for handling these challenges and enhancing the detection in different clinical settings.

Background and Objectives: The aim of this study was to explore the association between the cerebral autoregulation (CA) index, the pressure reactivity index (PRx), the patient’s clinical outcome, and the quality of arterial blood pressure (ABP(t)) and intracranial blood pressure (ICP(t)) signals by comparing two filtering methods to derive the PRx. Materials and Methods: Data from 60 traumatic brain injury (TBI) patients were collected. Moving averaging and FIR (Finite Impulse Response) filtering were performed on the ABP(t) and ICP(t) signals, and the PRx was estimated from both filtered datasets. Sensitivity, specificity, and receiver-operating characteristic (ROC) curves with the area under the curves (AUCs) were determined using patient outcomes as a reference. The outcome chosen for comparison among the two filtering methods were mortality and survival. Results: The FIR filtering approach, compared with clinical outcome, had a sensitivity of 70%, a specificity of 81%, and a level of significance p = 0.001 with an area under the curve (AUC) of 0.78. The moving average filtering method compared with the clinical outcome had a sensitivity of 58%, a specificity of 72%, and a level of significance p = 0.054, with an area under the curve (AUC) of 0.66. Conclusions: The FIR (optimal) filtering approach was found to be more sensitive for discriminating between two clinical outcomes, namely intact (survival) and impaired (death) cerebral autoregulation for TBI treatment decision making.

Biophysics-based, patient-specific modeling remains challenging for clinical translation, particularly for cerebrospinal fluid (CSF) flow where anatomical detail and computational cost are tightly coupled. We present a computational framework for steady net CSF redistribution in an MRI-derived cranial CSF domain reconstructed from T₂-weighted imaging, including the ventricular system, cranial subarachnoid space, and periarterial pathways, to the extent resolvable by clinical MRI. Cranial CSF spaces were segmented in 3D Slicer and a steady Darcy formulation with prescribed CSF production/absorption was solved in COMSOL Multiphysics^®. Geometrical and flow descriptors were quantified using region-based projection operations. We assessed discretization cost–accuracy trade-offs by comparing first- and second-order finite elements. First-order elements produced a 1.4% difference in transmantle pressure and a <10% difference in element-wise mass-weighted velocity metric for 90% of elements, while reducing computation time by 75% (20 to 5 min) and peak memory usage five-fold (150 to 30 GB). This proof-of-concept framework provides a computationally tractable baseline for studying steady net CSF pathway redistribution and sensitivity to boundary assumptions, and may support future patient-specific investigations in pathological conditions such as subarachnoid hemorrhage, hydrocephalus and brain tumors.

Galvos traumos epidemiologija Vilniuje ir Vilniaus apskrityje Aidanas Preikšaitis, Saulius RočkaVilniaus universiteto Medicinos fakultetas,M. K. Čiurlionio g. 21, LT-03101 VilniusVilniaus universiteto Neurologijos ir neurochirurgijos klinikosNeurochirurgijos skyrius,Šiltnamių g. 29 LT-04130 VilniusEl paštas: danas911@gmail.com, ross@aiva.lt Įvadas / tikslas Galvos trauma – tai dažniausia žmonių iki 40 metų mirties bei invalidumo priežastis visame pasaulyje. Galvos traumų kiekvienais metais vis daugėja dėl nuolat kintančios socialinės aplinkos. Lietuvos sveikatos informacijos centro duomenimis, 2001 metais registruota beveik 40 tūkst. paauglių ir suaugusių asmenų galvos traumų, o tai sudarė 1370 iš 10 000 gyventojų per metus. Vidutinis galvos traumos paplitimas kitose pasaulio šalyse yra 218 iš 10000. Atrodytų, kad Lietuvoje galvos traumų yra šešis kartus daugiau negu vidutiniškai pasaulyje, o epidemiologinių tyrimų, mūsų žiniomis, Vilniuje nebuvo atlikta. Siekiant išsiaiškinti tikrąją padėtį buvo suplanuotas ir atliktas šis tyrimas. Ligoniai ir metodai Retrospektyvusis tyrimas atliktas Vilniaus greitosios pagalbos universitetinėje ligoninėje (VGPUL). Iš viso ištirta galvos traumą patyrusių 1800 pacientų. Duomenys buvo renkami į asmeninį kompiuterį, naudojant "MS Office Excel 2003" programą. Duomenų analizei pasitelkta "SPSS 10" programa. Rezultatai Paaiškėjo, kad vyrai galvos traumas patiria dažniau. Jie sudarė 64,78%, moterys – 35,22% visų ištirtų ligonių (p < 0,05). Pagal traumos priežastį vyrauja smurtiniai sužalojimai (36,3%), kiek mažiau – kritimų (34,7%), trečioji priežastis – eismo įvykiai (12,1%). Tik 230 (12,8%) pacientų turėjo bent vieną neurologinį simptomą. Išvados Nustatytas neigiamas ryšys tarp amžiaus ir eismo įvykio metu patirtos galvos traumos bei smurtinių sužalojimų. Ryšys tarp kritimų ir amžiaus yra teigiamas. Nuo amžiaus taip pat priklauso ir dėl susidūrimo su krintančiu objektu patirta galvos trauma: dažniau nukenčia jauni ir garbaus amžiaus asmenys. Nuo metų laiko priklauso galvos traumų skaičius, patirtas nukritus (daugiau žiemą) ir susidūrus su krintančiu objektu (daugiau rudenį). Vertinant pasaulinius standartus, reikėtų patikslinti Lietuvoje nusistovėjusias galvos ir galvos smegenų traumos statistikos normas. Reikšminiai žodžiai: galvos trauma, epidemiologija, neurochirurgija Epidemiology of head injury in Vilnius and Vilnius district Aidanas Preikšaitis, Saulius RočkaVilnius University, Faculty of Medicine,M. K. Čiurlionio str. 21, LT-03101 Vilnius, LithuaniaVilnius University, Clinic of Neurology and Neurosurgery,Department of Neurosurgery,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mails: danas911@gmail.com, ross@aiva.lt Background / objective Head injury is one of the most frequent causes of death and disablement worldwide. Because of changes in the social and economic environment, the prevalence of head injury is increasing. According to the data of Lithuanian Health Information Center, the prevalence of head injury in Lithuania in 2001 was 1370/10000 inhabitants. The average prevalence of head injury in other countries was 218/10000. It appears that the cases of head injury are six times more frequent in Lithuania, although there were no epidemiological studies performed in the country. This study was aimed to clarify real statistical situation. Patients and methods A retrospective study was carried out in Vilnius University Emergency Hospital. In total, 1800 patients were enrolled into the study. The data were stored in a personal computer and analyzed with a Microsoft Excel 2003 and SPSS 10 statistical package. Results The prevalence of male gender (64.7%) was statistically significant. The main causes of trauma were assault (36.3%), fall (34.7%) and motor vehicle accidents (12.1%). Neurological signs were found only in 230 patients (12.8%). Conclusions A negative correlation was established between the age and head injury during the motor vehicle accident or assault. Head injury after the contact with a falling object was also age-dependent. Seasonal variations were found in falls (more in winter) and in traumas after a contact with a falling object (more in autumn). Official Lithuanian standards of head and brain injury need to be re-evaluated in the light of international statistical rules. Key words: head injury, epidemiology, neurosurgery