Complete resection of skull base meningiomas (SBMs) is often limited by their proximity to critical neurovascular structures, potentially increasing the risk of postoperative progression. This study quantified long-term progression risk after SBM resection, identified predictors of progression, and developed a data-driven MRI surveillance protocol using Bayesian methods.

Patients undergoing SBM resection between 2002 and 2020 at two neurosurgical centres were analysed. Kaplan–Meier and Cox regression analyses were used to estimate intervention-free survival (IFS). Conditional probability modelling was used to derive an MRI surveillance schedule that maintained a ≤ 3% risk of progression requiring intervention, stratified by extent of resection.

A total of 358 SBMs were included. Median age at diagnosis was 57 years (IQR 18), and 76.0% of patients were female. WHO Grade 1 tumours accounted for 80.3% of cases and Grade 2 for 19.7%. Median follow-up was 97 months (IQR 64–128). Progression requiring re-intervention occurred in 14.1% of patients. Subtotal resection (STR) increased the risk of re-intervention (HR 2.62, 95% CI 1.30–5.30, p = 0.009), whereas higher comorbidity burden (HR 0.78, 95% CI 0.62–0.98, p = 0.038) and incidental presentation (HR 0.11, 95% CI 0.01–0.88, p = 0.038) were associated with lower risk. Conditional probability modelling demonstrated higher annual progression risk following STR, supporting more intensive imaging surveillance. Recommended MRI schedules were: gross total resection (GTR), scans at 3 months, 2, 5, 8, and 10 years; STR, scans at 3 months, 1 year, 18 months, annually from years 2–8, and at 10 years.

Background and ObjectivesIncidental hyperintense lesions on diffusion-weighted imaging (DWI) are suggested as emerging marker of cerebral small vessel disease (SVD). To further determine their role in SVD, we aimed to describe their prevalence on high-…

In this Review, Liu et al. describe the established and emerging tools for the generation of comprehensive 3D tumour atlases, the analysis of which has the potential to uncover novel biomarkers for risk stratification, early detection, preventive interventions, and transformative diagnostic and treatment strategies.

Most heart attack patients have significantly higher concentrations of micro- and nanoplastics in their blood compared to individuals with stable heart conditions, new research found.

Butterfly gliomas are an aggressive subset of high-grade glioma characterized by bilateral hemispheric involvement. These patients often only receive biopsy followed by chemoradiation rather than surgical resection. Laser interstitial thermal therapy (LITT) provides a minimally invasive alternative that can improve survival.

We retrospectively compare outcomes in biopsy alone versus LITT cohorts. Demographic characteristics, perioperative outcomes, and survival metrics were analyzed. Within the LITT cohort, procedural and volumetric analyses were performed to examine the relationship between extent of ablation (EOA), residual tumor burden (RTB).

Of 44 patients, 15 underwent biopsy only and 29 received LITT was associated with a longer median overall survival compared to biopsy (14.86 versus 4.93 months, p = 0.0489), and median progression-free survival (4.67 versus 2.53 months, p = 0.0389). Within the LITT cohort, larger preoperative tumor volumes were associated with lower EOA (r²=0.46, p = 0.0002) and a higher RTB (r² = 0.90, p = 0.0001). Longer ablation times correlated with a larger EOA (r² = 0.21, p = 0.0320). Neither EOA nor RTB were associated with survival. Postoperative KPS improvement correlated with improved OS after multivariable Cox proportional hazards analysis (HR (death) = 0.93, 95%CI:0.87–0.99, p = 0.026), with a similar trend in PFS. Total operating room time was longer in the LITT group (median 4.0 vs. 2.57 h, p = 0.0034), while time-to-chemoradiation, ICU stay, and hospital stay were comparable. Post-operative re-admissions and complications were not statistically different between groups.

All cellular life-from humans to bacteria-possesses two layers of immunity: innate and adaptive. Scientists have long understood how these two types of immunity work together in higher organisms but not in the microbial world.

Bacteria and archaea use CRISPR-Cas as their sole form of adaptive immunity-a precise, sequence-specific defense that remembers past invaders. But what about innate immunity? Now, a study led by Prof. LI Ming from the Institute of Microbiology of the Chinese Academy of Sciences (CAS) reveals that CRISPR-Cas plays a broader role. Rather than acting alone like a solitary sniper shooting at phages, it also serves as a central command center, directing a network of diverse innate immune systems.

This work was published in Nature on July 22.