bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive functioning in patients with low-grade glioma: effects of hemispheric tumor location and surgical procedure
Authors: Rijnen Sophie J. M. , Kaya Gülizar , Gehring Karin , Verheul Jeroen B. , Wallis Olga C. , Sitskoorn Margriet M. , Rutten Geert-Jan M.
Published: December 2019

OBJECTIVE

The authors evaluated the cognitive performance of patients with low-grade glioma (LGG) before and after surgery, and specifically investigated 1) the effects of hemispheric tumor location and 2) the type of surgery (either with or without intraoperative stimulation mapping [ISM]).

METHODS

Patients underwent neuropsychological assessment 1 day before (T0) and 3 months after (T3) surgery. ISM targeted motor and/or language functions, but no other cognitive functions. Using 2-way mixed ANOVAs, differences between groups (i.e., for patients with right- vs left-sided lesions and normative controls [NCs], and also for patients operated on with vs without ISM and NCs), effects over time (T0–T3), and interaction effects in cognitive functioning were explored. Individual changes over time were assessed with reliable change indices for each neuropsychological test.

RESULTS

In total, 77 patients with LGG were included (38 and 39 patients with right- and left-sided lesions, respectively; and 42 patients with and 35 patients without ISM). The majority of patients who were operated on with ISM had left-sided lesions. Patients with right- and left-sided lesions scored significantly lower on 6 and 3 out of 8 tests, respectively, compared to NCs. No significant differences between hemispheric groups were found at T0 or at T3. Patients with left-sided lesions showed significant deterioration of performance on verbal memory and sustained attention over time. Patients who underwent operation with versus without ISM scored significantly lower on 6 and 3 out of 8 tests, respectively, compared to NCs. Patients in the ISM group scored significantly lower on the Stroop test, shifting attention test, and verbal fluency test than patients without ISM. Also, the ISM group showed a significant decline in mean cognitive flexibility and sustained attention performance over time.

CONCLUSIONS

Cognitive impairments were found in patients irrespective of hemispheric tumor location, whereby patients who were operated on with ISM performed slightly worse after surgery than patients without ISM. The authors conclude that there is room for improvement of cognitive functioning in surgically treated patients with LGG. The use of specific tests for higher cognitive functions during surgery may potentially improve functional outcome, but that is to be determined in future studies and balanced against oncological outcome. Implementation of neuropsychological assessments into the clinical management of patients with LGG should be encouraged, to inform and alert patients and clinicians on the status of cognitive functioning.
Using postoperative remodeling of donor arteries on MR angiography to predict the development of surgical collaterals in moyamoya disease
Authors: Uchino Haruto , Yamamoto Shusuke , Kashiwazaki Daina , Akioka Naoki , Kuwayama Naoya , Noguchi Kyo , Kuroda Satoshi
Published: December 2019

OBJECTIVE

The calibers of donor arteries can change dynamically after bypass surgery in patients with moyamoya disease (MMD). The present study aimed to evaluate the cutoffs of caliber changes in donor arteries associated with good surgical revascularization and to assess the impact of clinical factors potentially related to bypass development.

METHODS

The authors studied 71 hemispheres of 30 adults and 16 children with MMD who underwent combined direct and indirect revascularization. They quantitatively measured the calibers of the superficial temporal artery (STA), deep temporal artery (DTA), and middle meningeal artery (MMA) with MR angiography (MRA) source images and calculated the postoperative caliber change ratios (CCRs) to assess direct and indirect bypass development. These values were compared with the findings of digital subtraction angiography, in which revascularization areas were categorized into 3 groups (poor, good, and excellent).

RESULTS

In both adult and pediatric hemispheres, the median STA and DTA CCRs were higher in better-revascularization groups (p < 0.05), while MMA CCRs were not significantly different among the groups. Receiver operating characteristic analysis revealed that the cutoff STA CCRs of > 1.1 and > 1.3 were associated with good direct revascularization in adult and pediatric hemispheres, respectively. Cutoff DTA CCRs of > 1.6 and > 1.2 were associated with good indirect revascularization in adult and pediatric hemispheres, respectively. Considering these cutoff values, STA and DTA CCRs showed high median values, irrespective of age, severity of cerebrovascular reserve, disease stage, and disease-onset type.

CONCLUSIONS

Caliber changes in STAs and DTAs can be easily measured using MRA, and they could be indicators of direct and indirect bypass development. The dual development of a direct and indirect bypass was most frequently observed in the context of a combined bypass procedure in both adults and children with MMD.
Presence of direct vertebrobasilar perforator feeders in posterior fossa arteriovenous malformations and association with poor outcomes after endovascular treatment
Authors: Lefevre Etienne , Robert Thomas , Escalard Simon , Fahed Robert , Smajda Stanislas , Ciccio Gabriele , Desilles Jean-Philippe , Mazighi Mikael , Blanc Raphaël , Piotin Michel
Published: December 2019

OBJECTIVE

Treatment of posterior fossa arteriovenous malformations (PFAVMs) remains controversial as it is always challenging and may lead to major complications. Nonetheless, these lesions are more likely to bleed and generate poorer outcomes than other brain AVMs. The aim of this study was to evaluate the effect of endovascular treatment on long-term outcomes and identify the patient subgroups that might benefit from endovascular treatment.

METHODS

The authors performed a retrospective analysis of all consecutive cases of PFAVM managed at the Fondation Rothschild Hospital between 1995 and 2018. Clinical, imaging, and treatment data were prospectively gathered; these data were analyzed with respect to long-term outcomes.

RESULTS

Among the 1311 patients with brain AVMs, 114 (8.7%) had a PFAVM, and 88 (77.2%) of these patients had a history of bleeding. Of the 114 PFAVMs, 101 (88.6%) were treated (83 ruptured and 18 unruptured). The mean duration of follow-up was 47.6 months (range 0–240 months). Good neurological outcome at last follow-up was achieved in 79 cases (78.2%). Follow-up angiography showed obliteration of the PFAVM in 68.3% of treated cases. The presence of direct vertebrobasilar perforator feeders was associated with neurological deterioration (OR 5.63, 95% CI 11.15–30.76) and a lower obliteration rate (OR 15.69, 95% CI 2.52–304.03) after endovascular treatment. Other predictors of neurological deterioration and obliteration rate were consistent with the Spetzler-Martin grading system.

CONCLUSIONS

Advances in endovascular techniques have enabled higher obliteration rates in the treatment of PFAVMs, but complication rates are still high. Subgroups of patients who might benefit from treatment must be carefully selected and the presence of direct vertebrobasilar perforator feeders must call into question the indication for endovascular treatment.
Cushing’s disease: a prospective case-control study of health-related quality of life and cognitive status before and after surgery
Authors: Zarino Barbara , Verrua Elisa , Ferrante Emanuele , Sala Elisa , Carosi Giulia , Giavoli Claudia , Serban Andreea L. , Del Sindaco Giulia , Sirtori Martina A. , Bertani Giulio A. , Rampini Paolo , Carrabba Giorgio G. , Arosio Maura , Spada Anna , Locatelli Marco , Mantovani Giovanna
Published: December 2019

OBJECTIVE

Some studies have highlighted psychological and neuropsychological difficulties and a potential reduction in health-related quality of life (HRQOL) in patients with pituitary tumors, despite hormone deficits or excess. To the authors’ knowledge, this study is the first prospective longitudinal case-control study with the aim of simultaneously testing whether HRQOL and psychiatric and neuropsychological disabilities are related to neural dysfunction due to hypercortisolism per se, or tumor mass and/or surgery in patients with Cushing’s disease (CD). The authors evaluated a homogeneous cohort of patients with CD and nonfunctioning pituitary adenomas (NFPAs) before and after neurosurgery and compared these patients with healthy controls.

METHODS

Twenty patients (10 with NFPA and 10 with CD) were evaluated using 3 validated questionnaires (SF-36, Beck Depression Inventory–II [BDI-II], and Minnesota Multiphasic Personality Inventory–II [MMPI-II]) to assess HRQOL and psychological status preoperatively and 12 months after neurosurgery. Neuropsychological tests were assessed preoperatively, 3–7 days postoperatively, and 12 months postoperatively. Twenty healthy matched controls were recruited.

RESULTS

Preoperatively, the NFPA and CD subgroups had worse HRQOL scores than controls on the basis of SF-36 scores, although the NFPA subgroup experienced significant recovery 12 months postoperatively. Preoperatively, CD patients had depressive symptoms according to the BDI-II and MMPI-II that persisted 12 months postoperatively, together with social introversion and hypochondriasis; NFPA patients were similar to controls except for hypochondriasis scores that were clinically significant at all timepoints. Preoperatively and 3–7 days postoperatively, both subgroups showed significant neuropsychological disabilities compared with controls, but only the CD subgroup did not completely recover over time.

CONCLUSIONS

HRQOL and neuropsychological impairments were observed in all patients at early timepoints, independent of hypercortisolism, tumor mass, and successful surgery. Over time, CD patients showed persistent changes in HRQOL, in particular in social activities. In this light, CD seems to have a strong impact on HRQOL and to be associated with more psychological and neuropsychological comorbidities than NFPA.
Outcomes of stereotactic radiosurgery for pilocytic astrocytoma: an international multiinstitutional study
Authors: Murphy Erin S. , Parsai Shireen , Kano Hideyuki , Sheehan Jason P. , Martinez-Alvarez Roberto , Martinez-Moreno Nuria , Kondziolka Douglas , Simonova Gabriela , Liscak Roman , Mathieu David , Lee Cheng-Chia , Yang Huai-Che , Lee John Y. , McShane Brendan J. , Fang Fang , Trifiletti Daniel M. , Sharma Mayur , Barnett Gene H.
Published: December 2019

OBJECTIVE

The current standard initial therapy for pilocytic astrocytoma is maximal safe resection. Radiation therapy is considered for residual, recurrent, or unresectable pilocytic astrocytomas. However, the optimal radiation strategy has not yet been established. Here, the authors describe the outcomes of stereotactic radiosurgery (SRS) for pilocytic astrocytoma in a large multiinstitutional cohort.

METHODS

An institutional review board–approved multiinstitutional database of patients treated with Gamma Knife radiosurgery (GKRS) between 1990 and 2016 was queried. Data were gathered from 9 participating International Radiosurgery Research Foundation (IRRF) centers. Patients with a histological diagnosis of pilocytic astrocytoma treated using a single session of GKRS and with at least 6 months of follow-up were included in the analysis.

RESULTS

A total of 141 patients were analyzed in the study. The median patient age was 14 years (range 2–84 years) at the time of GKRS. The median follow-up was 67.3 months. Thirty-nine percent of patients underwent SRS as the initial therapy, whereas 61% underwent SRS as salvage treatment. The median tumor volume was 3.45 cm3. The tumor location was the brainstem in 30% of cases, with a nonbrainstem location in the remainder. Five- and 10-year overall survival rates at the last follow-up were 95.7% and 92.5%, respectively. Five- and 10-year progression-free survival (PFS) rates were 74.0% and 69.7%, respectively. On univariate analysis, an age < 18 years, tumor volumes < 4.5 cm3, and no prior radiotherapy or chemotherapy were identified as positive prognostic factors for improved PFS. On multivariate analysis, only prior radiotherapy was significant for worse PFS.

CONCLUSIONS

This represents the largest study of single-session GKRS for pilocytic astrocytoma to date. Favorable long-term PFS and overall survival were observed with GKRS. Further prospective studies should be performed to evaluate appropriate radiosurgery dosing, timing, and sequencing of treatment along with their impact on toxicity and the quality of life of patients with pilocytic astrocytoma.
Lateral transorbital approach: an alternative microsurgical route for supratentorial cerebral aneurysms
Authors: Ulutas Murat , Çinar Kadir , Dogan Ihsan , Secer Mehmet , Isik Semra , Aksoy Kaya
Published: December 2019

OBJECTIVE

Transorbital approaches for neurosurgery have recently attracted attention and several anatomical studies have aimed to improve these techniques, but significant deficiencies in clinical practice remain, especially for aneurysm surgery. The authors present an alternative microsurgical route and the results of an analysis of patients with intracranial aneurysms who underwent a lateral transorbital approach (LTOA) using lateral orbito-zygoma-sphenotomy (LOZYGS).

METHODS

The clinical and surgical results of a series of 54 consecutive patients with 1 or more aneurysms who underwent surgery via LTOA are reported. A lateral orbitotomy was performed after making a 3-cm skin incision parallel to the lateral orbital rim. A second bone flap, which included the zygoma and sphenoid bones that form the lateral orbital wall, was removed. The lesser sphenoid wing, including the anterior clinoid process, was fully drilled, except in cases of middle cerebral artery (MCA) aneurysms. Cisternal dissection was performed using the classic microsurgical technique starting from the proximal Sylvian fissure and carotid cistern. After the aneurysm was clipped following microsurgical principles, the dura mater was closed in a watertight fashion and 2-piece bone reconstruction was achieved.

RESULTS

Sixty aneurysms in 54 patients were clipped using the LOZYGS route. Twenty-one aneurysms were located on the MCA, 30 on the anterior communicating artery, 8 on the internal carotid artery, and 1 at the apex of the basilar artery. The unruptured-to-ruptured aneurysm ratio was 17:43. The operative field was moved to the orbit using the LTOA to avoid interference by bone and muscle tissues. Early proximal control was achieved using a short working distance and direct exposure of the base of the cerebrum, without any requirement for retraction. Because different view angles and surgical corridors were used, no segment of the aneurysm or the parent artery remained unexposed. Therefore, the introduction of additional tools was not required.

CONCLUSIONS

The LTOA allowed enhanced broad-perspective exposure of the operative field, early proximal control, and satisfactory surgical freedom. This alternative surgical approach safely exposed the target area and the operative field. The LOZYGS route is safe and effective for the LTOA and microsurgical clipping of anterior circulation aneurysms. According to the authors’ surgical experience and clinical experience, the LTOA can be considered an alternative surgical route to supratentorial aneurysm surgery.
Corpus callosotomy performed with laser interstitial thermal therapy
Authors: Roland Jarod L. , Akbari Syed Hassan A. , Salehi Afshin , Smyth Matthew D.
Published: December 2019

OBJECTIVE

Corpus callosotomy is a palliative procedure that is effective at reducing seizure burden in patients with medically refractory epilepsy. The procedure is traditionally performed via open craniotomy with interhemispheric microdissection to divide the corpus callosum. Concerns for morbidity associated with craniotomy can be a deterrent to patients, families, and referring physicians for surgical treatment of epilepsy. Laser interstitial thermal therapy (LITT) is a less invasive procedure that has been widely adopted in neurosurgery for the treatment of tumors. In this study, the authors investigated LITT as a less invasive approach for corpus callosotomy.

METHODS

The authors retrospectively reviewed all patients treated for medically refractory epilepsy by corpus callosotomy, either partial or completion, with LITT. Chart records were analyzed to summarize procedural metrics, length of stay, adverse events, seizure outcomes, and time to follow-up. In select cases, resting-state functional MRI was performed to qualitatively support effective functional disconnection of the cerebral hemispheres.

RESULTS

Ten patients underwent 11 LITT procedures. Five patients received an anterior two-thirds LITT callosotomy as their first procedure. One patient returned after LITT partial callosotomy for completion of callosotomy by LITT. The median hospital stay was 2 days (IQR 1.5–3 days), and the mean follow-up time was 1.0 year (range 1 month to 2.86 years). Functional outcomes are similar to those of open callosotomy, with the greatest effect in patients with a significant component of drop attacks in their seizure semiology. One patient achieved an Engel class II outcome after anterior two-thirds callosotomy resulting in only rare seizures at the 18-month follow-up. Four others were in Engel class III and 5 were Engel class IV. Hemorrhage occurred in 1 patient at the time of removal of the laser fiber, which was placed through the bone flap of a prior open partial callosotomy.

CONCLUSIONS

LITT appears to be a safe and effective means for performing corpus callosotomy. Additional data are needed to confirm equipoise between open craniotomy and LITT for corpus callosotomy.
Imaging characteristics of adult H3 K27M-mutant gliomas
Authors: Qiu Tianming , Chanchotisatien Apisara , Qin Zhiyong , Wu Jinsong , Du Zunguo , Zhang Xialing , Gong Fangyuan , Yao Zhenwei , Chu Shuguang
Published: December 2019

OBJECTIVE

H3 K27M-mutant gliomas present heterogeneously in terms of pathology, imaging, and prognosis. This study aimed to summarize the imaging characteristics of adult H3 K27M-mutant gliomas.

METHODS

The authors retrospectively identified all cases of glioma diagnosed using histopathological studies (n = 3300) that tested positive for histone H3 K27M mutations (n = 75) between January 2016 and December 2018 in a single hospital. Preoperative and follow-up MR images of 66 adult patients (age ≥ 18 years) were reviewed for anatomical location, degree of contrast enhancement, enhancement patterns, hemorrhage, edema, diffusion restriction, tumor dissemination, and tumor spread.

RESULTS

The study included 66 cases (40 in men, 26 in women) of H3 K27M-mutant glioma in adult patients. Tumors were found in the following sites: thalamus (n = 38), brainstem (n = 6), brainstem with cerebellar or thalamic involvement (n = 4), whole brain (n = 8), corpus callosum (n = 3), hypothalamus (n = 1), hemispheres (n = 2), and spinal cord (n = 4). All pure brainstem lesions were located posteriorly, and all corpus callosal lesions were in the genu. Most spinal tumors were long-segment lesions. Hemispheric lesions mimicked gliomatosis cerebri in presentation, with the addition of traditional midline structure involvement. Most tumors were solid with relatively uniform signals on plain MRI. Of the 61 cases with contrast-enhanced MR images, 36 (59%) showed partial to no enhancement, whereas 25 (41%) showed diffuse or irregular peripheral enhancement. Hemorrhage and edema were rare. Most lesions were solid and showed mild diffusion restriction on diffusion-weighted imaging. Tumor dissemination to the leptomeninges (n = 8) and subependymal layer (n = 3) was observed.

CONCLUSIONS

The authors described the MRI features of diffuse midline glioma with H3 K27M mutation in the largest study done to date in adult patients. Tumors were found in both midline and nonmidline structures, with the thalamus being the most common site. Although adult H3 K27M-mutant gliomas demonstrated highly variable presentations in this cohort of patients, the authors were able to observe shared characteristics within each location.
New endovascular perforation subarachnoid hemorrhage model for investigating the mechanisms of delayed brain injury
Authors: Kumagai Kosuke , Tomiyama Arata , Takeuchi Satoru , Otani Naoki , Fujita Masanori , Fujii Kazuya , Wada Kojiro , Mori Kentaro
Published: December 2019

OBJECTIVE

Delayed brain injury (DBI) is considered one of the most important causes of mortality and morbidity after subarachnoid hemorrhage (SAH). However, no suitable experimental rat endovascular perforation (EVP) SAH model was available for investigating DBI. The authors added early cerebral hypoperfusion to a mild EVP SAH model by unilateral common carotid artery occlusion (UCCAO) 24 hours after induction of SAH to mimic the clinical course of early cerebral hypoperfusion after SAH.

METHODS

A total of 109 adult male Sprague-Dawley rats were randomly divided into 2 groups: no SAH and SAH. Next, no-SAH rats were randomly divided on day 1 into 2 groups: sham and UCCAO. SAH rats with a neurological score of 15 or greater were randomly divided into 2 groups: SAH − UCCAO and SAH + UCCAO group.

RESULTS

The mild SAH model had a lower mortality rate of 5.4% within the first 24 hours. No rat died in the SAH + UCCAO group until day 7. DBI as well as early brain injury (EBI), reactive astrogliosis, and cerebral vasospasm significantly worsened in the SAH + UCCAO group.

CONCLUSIONS

The present SAH + UCCAO model can simulate EBI with aggravation of reactive astrogliosis, cerebral vasospasm, and DBI but without high mortality.
An artificial intelligence framework for automatic segmentation and volumetry of vestibular schwannomas from contrast-enhanced T1-weighted and high-resolution T2-weighted MRI
Authors: Shapey Jonathan , Wang Guotai , Dorent Reuben , Dimitriadis Alexis , Li Wenqi , Paddick Ian , Kitchen Neil , Bisdas Sotirios , Saeed Shakeel R. , Ourselin Sebastien , Bradford Robert , Vercauteren Tom
Published: December 2019

OBJECTIVE

Automatic segmentation of vestibular schwannomas (VSs) from MRI could significantly improve clinical workflow and assist in patient management. Accurate tumor segmentation and volumetric measurements provide the best indicators to detect subtle VS growth, but current techniques are labor intensive and dedicated software is not readily available within the clinical setting. The authors aim to develop a novel artificial intelligence (AI) framework to be embedded in the clinical routine for automatic delineation and volumetry of VS.

METHODS

Imaging data (contrast-enhanced T1-weighted [ceT1] and high-resolution T2-weighted [hrT2] MR images) from all patients meeting the study’s inclusion/exclusion criteria who had a single sporadic VS treated with Gamma Knife stereotactic radiosurgery were used to create a model. The authors developed a novel AI framework based on a 2.5D convolutional neural network (CNN) to exploit the different in-plane and through-plane resolutions encountered in standard clinical imaging protocols. They used a computational attention module to enable the CNN to focus on the small VS target and propose a supervision on the attention map for more accurate segmentation. The manually segmented target tumor volume (also tested for interobserver variability) was used as the ground truth for training and evaluation of the CNN. We quantitatively measured the Dice score, average symmetric surface distance (ASSD), and relative volume error (RVE) of the automatic segmentation results in comparison to manual segmentations to assess the model’s accuracy.

RESULTS

Imaging data from all eligible patients (n = 243) were randomly split into 3 nonoverlapping groups for training (n = 177), hyperparameter tuning (n = 20), and testing (n = 46). Dice, ASSD, and RVE scores were measured on the testing set for the respective input data types as follows: ceT1 93.43%, 0.203 mm, 6.96%; hrT2 88.25%, 0.416 mm, 9.77%; combined ceT1/hrT2 93.68%, 0.199 mm, 7.03%. Given a margin of 5% for the Dice score, the automated method was shown to achieve statistically equivalent performance in comparison to an annotator using ceT1 images alone (p = 4e−13) and combined ceT1/hrT2 images (p = 7e−18) as inputs.

CONCLUSIONS

The authors developed a robust AI framework for automatically delineating and calculating VS tumor volume and have achieved excellent results, equivalent to those achieved by an independent human annotator. This promising AI technology has the potential to improve the management of patients with VS and potentially other brain tumors.
Patterns of care for ruptured aneurysms of the middle cerebral artery: analysis of a Swiss national database (Swiss SOS)
Authors: Maldaner Nicolai , Steinsiepe Valentin K. , Goldberg Johannes , Fung Christian , Bervini David , May Adrien , Bijlenga Philippe , Schaller Karl , Roethlisberger Michel , Zumofen Daniel W. , D’Alonzo Donato , Marbacher Serge , Fandino Javier , Maduri Rodolfo , Daniel Roy Thomas , Burkhardt Jan-Karl , Chiappini Alessio , Robert Thomas , Schatlo Bawarjan , Seule Martin A. , Weyerbrock Astrid , Regli Luca , Stienen Martin Nikolaus , _ _
Published: December 2019

OBJECTIVE

The objective of this study was to determine patterns of care and outcomes in ruptured intracranial aneurysms (IAs) of the middle cerebral artery (MCA) in a contemporary national cohort.

METHODS

The authors conducted a retrospective analysis of prospective data from a nationwide multicenter registry of all aneurysmal subarachnoid hemorrhage (aSAH) cases admitted to a tertiary care neurosurgical department in Switzerland in the years 2009–2015 (Swiss Study on Aneurysmal Subarachnoid Hemorrhage [Swiss SOS]). Patterns of care and outcomes at discharge and the 1-year follow-up in MCA aneurysm (MCAA) patients were analyzed and compared with those in a control group of patients with IAs in locations other than the MCA (non-MCAA patients). Independent predictors of a favorable outcome (modified Rankin Scale score ≤ 3) were identified, and their effect size was determined.

RESULTS

Among 1866 consecutive aSAH patients, 413 (22.1%) harbored an MCAA. These MCAA patients presented with higher World Federation of Neurosurgical Societies grades (p = 0.007), showed a higher rate of concomitant intracerebral hemorrhage (ICH; 41.9% vs 16.7%, p < 0.001), and experienced delayed cerebral ischemia (DCI) more frequently (38.9% vs 29.4%, p = 0.001) than non-MCAA patients. After adjustment for confounders, patients with MCAA were as likely as non-MCAA patients to experience DCI (aOR 1.04, 95% CI 0.74–1.45, p = 0.830). Surgical treatment was the dominant treatment modality in MCAA patients and at a significantly higher rate than in non-MCAA patients (81.7% vs 36.7%, p < 0.001). An MCAA location was a strong independent predictor of surgical treatment (aOR 8.49, 95% CI 5.89–12.25, p < 0.001), despite statistical adjustment for variables traditionally associated with surgical treatment, such as (space-occupying) ICH (aOR 1.73, 95% CI 1.23–2.45, p = 0.002). Even though MCAA patients were less likely to die during the acute hospitalization (aOR 0.52, 0.30–0.91, p = 0.022), their rate of a favorable outcome was lower at discharge than that in non-MCAA patients (55.7% vs 63.7%, p = 0.003). At the 1-year follow-up, 68.5% and 69.6% of MCAA and non-MCAA patients, respectively, had a favorable outcome (p = 0.676).

CONCLUSIONS

Microsurgical occlusion remains the predominant treatment choice for about 80% of ruptured MCAAs in a European industrialized country. Although patients with MCAAs presented with worse admission grades and greater rates of concomitant ICH, in-hospital mortality was lower and long-term disability was comparable to those in patients with non-MCAA.
Fluorescein-guided removal of peripheral nerve sheath tumors: a preliminary analysis of 20 cases
Authors: Vetrano Ignazio G. , Acerbi Francesco , Falco Jacopo , Devigili Grazia , Rinaldo Sara , Messina Giuseppe , Prada Francesco , D’Ammando Antonio , Nazzi Vittoria
Published: December 2019

OBJECTIVE

Benign peripheral nerve sheath tumors (PNSTs) include mainly schwannomas—the most common tumors arising from peripheral nerves—and neurofibromas. Due to their origin, distinguishing between functional intact nerve and the fibers from whence the PNST arose may not always be easy to perform. The introduction of intraoperative tools to better visualize these tumors could be helpful in achieving a gross-total resection. In this study, the authors present a series of patients harboring PNST in which the surgery was performed under fluorescein guidance.

METHODS

Between September 2018 and February 2019, 20 consecutive patients with a total of 25 suspected PNSTs underwent fluorescein-guided surgery performed under microscopic view with a dedicated filter integrated into the surgical microscope (YELLOW 560) and with intraoperative monitoring. All patients presented with a different degree of contrast enhancement at preoperative MRI. Fluorescein was intravenously injected after intubation at a dose of 1 mg/kg. Preoperative clinical and radiological data, intraoperative fluorescein characteristics, and postoperative neurological and radiological outcomes were collected and analyzed.

RESULTS

Six patients were affected by neurofibromatosis or schwannomatosis. There were 14 schwannomas, 8 neurofibromas, 1 myxoma, 1 reactive follicular hyperplasia, and 1 giant cell tumor of tendon sheath. No patient experienced worsening of neurological status after surgery. No side effects related to fluorescein injection were found in this series. Fluorescein allowed an optimal intraoperative distinction between tumor and surrounding nerves in 13 of 14 schwannomas and in all neurofibromas. In 6 neurofibromas and in 1 schwannoma, the final YELLOW 560 visualization showed the presence of small tumor remnants that were not visible under white-light illumination and that could be removed, obtaining a gross-total resection.

CONCLUSIONS

Fluorescein was demonstrated to be a feasible, safe, and helpful intraoperative adjunct to better identify and distinguish PNSTs from intact functional nerves, with a possible impact on tumor resection, particularly in diffuse neurofibromas.
YABANCI DİLLER YÜKSEKOKULUNDA AKADEMİK KAYTARMAYA YÖNELİK OLGU BİLİMSEL BİR ARAŞTIRMA
Authors: Çetin Ezgi , ÇETİN Yavuz , YAVUZ Yaşar
Published: December 2019

Bu araştırmanın temel amacı, öğretim görevlilerinin akademik kaytarma eğilimlerini belirlemek, kaytarmaya neden olan faktörleri ortaya koymak ve buna yönelik çözüm önerilerini açıklamaktır. Araştırma 2018-2019 akademik yılında Ege Bölgesi’nde bir devlet üniversitesinin Yabancı Diller Yüksekokulu’nda görev yapan 10 öğretim görevlisinin katılımıyla yürütülmüştür. Araştırma stratejisi, nitel araştırma yöntemlerinden fenomenoloji (olgu bilim) desenine dayanmaktadır. Çalışma grubu aykırı (uç) örnekleme yöntemiyle seçilmiştir. Görüşmeler en az 8 dakika ve en çok 16 dakika sürmüştür. Elde edilen verilerin analizinde betimsel analiz kullanılmıştır. Öğretim görevlileri akademik kaytarmayı tanımlarken derse geç girme, düşük motivasyona sahip olma, güncel alan yazını takip etmeme, akademik yayın yapmama kodlarına ulaşılmıştır. Öğretim görevlileri akademik kaytarmanın nedenlerini öğrenciler açısından isteksiz olma ve düşük akademik başarı gösterme; öğretim görevlileri açısından karakter özelliği, yorgunluk, arkadaşlardan etkilenme, ekonomik sorunlar, deneyim eksikliği, mesleki tükenmişlik; yönetim açısından baskıcı idare tutumu, iletişim problemleri, zayıf denetim, yetersiz gözlem, hantal bürokrasi ve motivasyon artırmama; görev açısından ise işe inanmama, ders yükü fazlalığı, memur anlayışı şeklinde belirtmişlerdir. Öğretim görevlilerinin akademik kaytarmaya yönelik çözüm önerileri makro düzeyde; kaytarma davranışı gösteren öğretim görevlilerinin işten çıkarılması, 657 ve 2547 sayılı kanunlarında performans değerlendirme yaklaşımının benimsenmesi, ekonomik koşulların iyileştirilmesi, hizmet içi eğitim, motivasyon artırıcı önlemlerin alınması şeklindeyken mikro düzeyde çözüm önerileri ise sert idari disiplinin olması, gerektiğinde ceza verilmesi, sosyal etkinlik düzenlenmesi, kurumsal reel hedefler oluşturulması ve takım olma bilincinin geliştirilmesi şeklindedir.
ORTAÖĞRETİMDE GÖREV YAPAN ÖĞRETMENLERİN SINIF YÖNETİMİ KAYGI DÜZEYLERİNİN İNCELENMESİ
Authors: SADIK Fatma , NASIRCI Hasan
Published: December 2019

Öğretmenlerin sınıf yönetimi açısından temel görevi, olumlu bir öğrenme ortamı oluşturma ve öğretimin etkili olmasını sağlamaktır. Ancak günlük hayatta karşılaşılan güç ilişkileri çoğu zaman sınıf ortamında da kendini gösterebilmekte, bu durum gerek deneyimli gerekse mesleğinin ilk yıllarında olan öğretmenlerin sınıf yönetimi konusunda kaygılanmasına neden olabilmektedir. Bu araştırmanın amacı ortaöğretim kurumlarında çalışan öğretmenlerin sınıf yönetiminde yaşadıkları kaygı düzeyini belirleyerek, bazı değişkenler açısından incelemektir. Araştırmaya 2017-2018 eğitim-öğretim döneminde Adana’daki merkez ilçelerde bulunan liselerde çalışan öğretmenlerden 187’si gönüllü olarak katılmıştır.  Verilerin toplanmasında “Kişisel Bilgi Formu” ve “Sınıf Yönetimi Kaygı Ölçeği” kullanılmış, verilerin analizinde Mann Whitney-U ve Kruskal Wallis testleri kullanılmıştır. Araştırmanın sonucunda öğretmenlerin sınıf yönetimi konusunda kaygı düzeylerinin genel olarak düşük olduğu saptanmış, erkek öğretmenlerin kaygı düzeylerinin nispeten daha yüksek düzeyde olduğu görülmüştür. Ulaşılan sonuçlara göre meslek liselerinde meslek derslerine giren ve mevcudu daha az olan sınıflarda çalışan öğretmenlerin sınıf yönetimi kaygı düzeyi daha yüksektir.
PENERAPAN MODEL PEMBELAJARAN BERBASIS MASALAH UNTUK MENINGKATKAN HASIL BELAJAR FISIKA SISWA PADA POKOK BAHASAN LISTRIK
Authors: Ismail Ali
Published: December 2019

Berdasarkan observasi awal di SMK Negeri 2 Garut, diketahui bahwa hasil belajar fisika rendah. Dalam kegiatan pembelajaran, siswa hanya menerima fakta-fakta yang harus dihafal dan masih kurangnya keterlibatan siswa karena hampir selalu diajar dengan metode ceramah.Tujuan penelitian ini untuk mengetahui penerapan Model pembelajaran berbasis masalah dalam meningkatkan hasil belajar fisika pada pokok bahasan Listrik siswa kelas X jurusan multimedia 2 di SMK Negeri 2 Garut.Penelitian ini menggunakan penelitian tindakan (action research) sebanyak tiga putaran. Setiap putaran terdiri dari empat tahap yaitu: rancangan, kegiatan dan pengamatan, refleksi, dan revisi .Penelitian tindakan kelas ini dilaksanakan di SMK Negeri 2 Garut tahun pelajaran 2015/2016 dengan subjek penelitian siswa kelas X Jurusan multimedia 2 dengan jumlah siswa 34 orang. Teknik pengumpulan data yang digunakan adalah tes dan observasi. Tes digunakan untuk mengumpulkan data tentang hasil belajar siswa (aspek kognitif) dalam pokok bahasan Listrik melalui tes obyektif berupa soal pilihan ganda. Sedangkan observasi dilaksanakan untuk mengetahui keterlaksanaan model pembelajaran berbasis masalah dengan menggunakan lembar observasi kegiatan belajar mengajar. Dari hasil analisis didapatkan bahwa hasil belajar siswa mengalami peningkatan dari siklus I sampai siklus III yaitu, siklus I (62%,), siklus II (76%), siklus III (91%). Kesimpulan dari penelitian ini adalah Model pembelajaran berbasis masalah ini berpengaruh positif terhadap hasil belajar Siswa kelas X, serta model pembelajaran ini dapat digunakan sebagai salah satu alternative dalam pembelajaran Fisika
Tongkonan Social Identity: Families Harmonization on Interfaith Marriage in Toraja
Authors: Mashuri Muhammad Fath , Helmi Avin Fadilla
Published: December 2019

Interfaith marriage can be called a meeting of inter-social identities specifically within the context of family. It is therefore an indispensable part of the process for every interfaith marriage couple to de-categorize and re-categorize and consolidate their social identity as a couple so that they can successfully define their new family values. The purpose of this study is to analyze how married couples of different faiths in Toraja harmonize their differences from the perspective of social identity. This study used an ethnographic approach with six informant actors from three interfaith families in Toraja. The results show that these married couples operationalize a dual-hierarchical identity model in an inter-family harmonization effort. Tongkonan identity is placed vertically as a collective identity, while the identity of religion as a person-based social identity is placed horizontally. Both of these have consequences for the emergence of a cross-categorized identity.
Becoming Balinese Islam: Bale Banjar and Subak in Islamic Village of Segara Katon, Karangasem, Bali.
Authors: Segara I Nyoman Yoga
Published: December 2019

Muslims in Karangasem are relatively homogeneous since they originate from the Sasak tribe, Lombok. The story of the conquest of the kingdom in Lombok by the Kingdom of Karangasem turned out to be the beginning of the Sasak tribe Muslims occupying 25 of the 26 Islamic villages, except the Saren Javanese Islamic Village from Demak, Java. The pattern of settlement through the Islamic Village further spreads around the Kingdom of Karangasem. Sasak tribe Muslims were then currently placed in the catu land which belonged to the kingdom. One of the numerous fascinating Muslim villages is Segara Katon. Some of its residents are still of Balinese origin as the result of the marriage of converted Gamongan people to Segara Katon women. Another uniqueness is the existence of the bale banjar which even though it has been acknowledged as a form of acculturation between Hinduism and Islam in the past, yet, it has been left standing although its function has presently begun to shift along with the establishment of the Nurul Jihad Mosque. The long history and traditions that they experienced in a relatively long time were made a fabulous social capital to survive in the midst of various changes, including being active and creative in strengthening peaceful relations with Hindus through multiple local wisdom. To be able to explore data and analyze how Balinese Muslim people in Segara Katon see themselves and their social world, field research was carried out through interviews, observation, and document studies.
Representation of the Context of Petik Laut (Sea-Picked) Traditions in the Macapat Mursada Text
Authors: Ummah Khothibhatul , Suryadi Suryadi
Published: December 2019

This article aims to analyze a series of Petik Laut traditions that are the background for the emergence of the Mursada song text. Culture that is continuously carried out will form a tradition. One of the traditions found in Indonesia is the tradition of Petik Laut carried out in Muncar. Another term for the sea quotation is charity marine coastal communities. In its implementation, the Petik Laut tradition has several series of events that must be carried out. The series of events became the background for the emergence of the Mursadasong text that was read when one day before the core event was held. This research is a qualitative descriptive study. The main data source is a series of Petik Laut traditions and tembang macapat texts. The provision of data is obtained by observation-participation techniques, interviews, and document analysis.  The data were analyzed using linguistic anthropological theory to find out how the context of the tradition of seas was based on the emergence of the text of the Mursadasong in the Muncar fishing community. The results showed that the context of the sea-picking tradition behind the emergence of the text of the Mursadasong was the opening, the macapatan, the ider bumiand the release of offerings, and the pilgrimage of the grave.
Communication Behaviour of Street Children and Beggars in Makassar
Authors: Bahfiarti Tuti
Published: December 2019

The purpose of this reseach is to explore, and categorize verbal and non verbal communication behavior in the performances of street children and beggars in Makassar. This study explored the operational actions and motivations of street children and beggars who work the streets. This study uses a qualitative method that seeks to interpret the meaning of data to understand a community's social life. The ethnographic approach to communication studies focuses on studying the interactions and activities of individuals as social creatures in using verbal and non-verbal symbols.  Primary data collection was carried out through in-depth interviews with 21 street children informants and beggars operating in three sectors, namely, the Panakukang/ Fly Over/Red Light Sector, the Losari Beach Platform Sector, and the Hertasning Sector. Non-participant observation by repeatedly observing themselves both verbally and non-verbally in performing actions and actions in front of benefactors. This study found verbal and non verbal communication behaviors that are displayed as a form of impression management on the front stage in attracting the sympathies of benefactors. Verbal communication behavior in the form of spoken and written language based on categorical finding verbal symbols of street children and beggars using three elements, namely the structure of the message, the style of the message, and the attractiveness of the message.  Furthermore, the categorization of non-verbal communication behaviors is facial expressions, body movements (kinetic), physical appearance (body and manner of dress), and paralinguistic(vocalic).
Nature as Culture of Penghayat: The Landscape, Reaction, and Movement of Penghayat in Cilacap
Authors: Nafiya Siti Khoir
Published: December 2019

This article aims to explain how Penghayat does not remain silent when their views and their ritual practice are questioned. This paper explains about Penghayat views that nature as a looking way in their daily lives and practices. They use metaphors such as folksong or traditional art contained in nature to interaction and reaction, not only with their members/citizens (self) but also with other people (others). They have knowledge about nature presenting and functioning. The knowledge of the Jagad Gumelar ginulung in Jagad Alit is the blueprint, as guiding, from their Kaki and Nini (ancestors) spoken. With ethnographic research and landscape discourse, the author reveals how nature is seen as a culture in society. The rituals show how the values of the role of nature, both the universe and the human self contribute to daily life, including Penghayat belief.
Manca': A Study of the Martial Arts' Symbol as Makassar Cultural Identity in Gowa, South Sulawesi
Authors: Syan Mutahhar , Hamdat Supriadi
Published: December 2019

This study aims to describe and analyze the symbols of movements and costumes used from martial arts as a cultural identity that is present and attached to the Sulawesi Pencak Silat Association (IPS). The study used a qualitative descriptive approach with ethnographic methods. This research was conducted in Padepokan Pencak Silat Sulawesi Association (IPS) in Taeng Village, Gowa Regency. The analysis technique used is symbolic interpretation, which sees symbols and meanings going hand in hand from each movement used. This research shows that silat or manca tidak is not talking about stance as a form of organized movement, but rather on the functions, benefits, risks posed. The parts of silat contain meanings and symbols that are understood as cultural identity and forms of belief, namely: the fingers describe three in one form of respect, stepping with the right foot first, the foot is always shaped like an easel.
Exploring Male-Female Dynamics in Muslim Society: A Review of Mernissi’s Beyond the Veil (Revised Edition)
Authors: Al Isra Andi Batara
Published: December 2019

This is a review of Mernissi’s Beyond the Veil, one of the most influential book discussing Islam and gender.I have to admit that I have not read Mernissi before I take a course called Anthropology and World Religions focusing in Islam in the University of Auckland. Later I know that the reason why her name rarely echoed in anthropological atmosphere in Indonesia (particularly in Sulawesi) is because Mernissi only well-known in gender studies (especially in Islam) and Islamic studies. I know it because the only colleague who knows Mernissi is my professor who studied anthropology and gender (and Islam). Beyond the Veil is an interesting book. It explores the relation and the dynamics within male-female Muslims which even I, as a Muslim, have not realised it before. Excluding the introduction (with three different versions) and the conclusion, Beyond the Veil is divided into two parts. Part one consist of three chapters which are more theoretic (or conceptual) background of the book and I think, it would be easier for the readers to understand the context and to grasp Mernissi’s arguments briefly. Part two consist of six chapters which are more ethnographic oriented (fieldwork-based) since it tells the readers about the dynamics between men and women in modern Morocco (as a case or sample of modern Islamic society).
Medicine and Art – science and emotion
Authors: Morgan Peter
Published: December 2019

As medical librarians and information professionals we are familiar with the role of art in our work, through the atlases that line our bookshelves and the illustrations that routinely appear in both printed and digital literature. Why is this role important? There’s a clue in the familiar aphorism “A picture is worth a thousand words”, which captures the essential truth that art is about communicating information. Since our professional role is also the business of communicating information, there should be obvious benefits for us in studying and understanding how art performs this function.
The healing presence of art
Authors: Walshaw Thomas
Published: December 2019

The arts offer a broad range of historically-documented benefits to mental, physical and social health. UK-based charity Paintings in Hospitals was a pioneer of the modern “arts in health” movement and has provided arts services to willing healthcare partners for 60 years. Despite a large and continually-growing body of clinical evidence supporting the health benefits of the arts, and a recent parliamentary report suggesting that the arts could alleviate structural and financial stresses on health and social care services, resistance to nationwide integration of the arts with healthcare remains. The majority of this resistance stems from misunderstanding and misinformation that must be properly addressed before the “arts in health” sector is able to fulfil its potential.
Religious and Church Issues in Secular Secondary School Subjects under New Program
Authors: Nedavnya Olga V.
Published: December 2019

The problem of church-religious and spiritual subjects in school subjects, in the educational process of different educational units is not limited to the questions of the introduction or non-introduction of Christian ethics, ethics of faith, religious studies or theology. There is no relevant oral and printed discussion. However, scholars and educators have so far received the same meticulous attention to the fact that, in addition to these special subjects, other humanities have been taught and read in the schools, which deal with issues of faith, religion, spirituality - directly or indirectly, in connection with one or another. historical events or in the composition of various works of art, also not neutral in terms of formation of world outlook and confessional prejudices or preferences.