bluuebunny/crossref_metadata_2025 huggingface dataset:
Geometric Multimodal Deep Learning with Multi-Scaled Graph Wavelet Convolutional Network
Authors: Behmanesh Maysam , Adibi Peyman , Ehsani Mohammad Saeed , Chanussot Jocelyn
Published: April 2022

Multimodal data provide complementary information of a natural phenomenon by integrating data from various domains with very different statistical properties. Capturing the intra-modality and cross-modality information of multimodal data is the essential capability of multimodal learning methods. The geometry-aware data analysis approaches provide these capabilities by implicitly representing data in various modalities based on their geometric underlying structures. Also, in many applications, data are explicitly defined on an intrinsic geometric structure. Generalizing deep learning methods to the non-Euclidean domains is an emerging research field, which has recently been investigated in many studies. Most of those popular methods are developed for unimodal data. In this paper, a multimodal multi-scaled graph wavelet convolutional network (M-GWCN) is proposed as an end-to-end network. M-GWCN simultaneously finds intra-modality representation by applying the multiscale graph wavelet transform to provide helpful localization properties in the graph domain of each modality, and cross-modality representation by learning permutations that encode correlations among various modalities. M-GWCN is not limited to either the homogeneous modalities with the same number of data, or any prior knowledge indicating correspondences between modalities. Several semi-supervised node classification experiments have been conducted on three popular unimodal explicit graph-based datasets and five multimodal implicit ones. The experimental results indicate the superiority and effectiveness of the proposed methods compared with both spectral graph domain convolutional neural networks and state-of-the-art multimodal methods.
Particle Flow Calorimetry
Authors: Ruchti Randal , Kruger Katja
Published: April 2022

The motivation for PF calorimetry is to experimentally measure the energyof hadron jets with excellent resolution. In particle flow designs, σ/E < 5%should be possible for a range of jet energies from ∼ 50 GeV to ∼ 250 GeV, im-portant particularly for experiments at electron-positron colliders (ILC, CLIC,FCCee, CEPC). The high granularity, which is essential for PF calorimetry, canalso be very beneficial for removal of background from pile-up on an event-by-event basis making such calorimeters an attractive approach for hadron colliderexperiments, for example the HGCAL under construction for CMS at the CERNHL-LHC.
Elastis permintaan dan penawaran
Authors: Anwar Khaerul
Published: April 2022

Catatan terkait dengan apa itu elastis permintaan dan penawaran
First quarter review of my 2020 new year health resolutions: Seeking freedom through disciplines
Authors: Ho Tung Manh
Published: April 2022

I review my health-related 2022 resolutions and introduce relevant science of habits and dopamine.
Gambaran Umum Perbankan Syariah di Indonesia
Authors: Nurhamna
Published: April 2022

Perbankan syariah di Indonesia semakin berkembang seiring dengan berkembangnya pertumbuhan penduduk yang berpenduduk mayoritas beragama islam. Perbankan syariah menjadi alternatif sistem perbankan yang memiliki berbagai macam produk dan pelayanan yang beragam akan siklus operasionalnya serta memiliki kemampuan menghasilkan profit menjadi indikator penting untuk keberlanjutan entitas bisnis dan untuk mengukur kemampuan bersaing dalam jangka panjang.Bank syariah adalah bank yang beroperasi dengan tidak mengandalkan bunga. Kedudukan bank syariah dengan para nasabahnya adalah sebagai mitra investor dan pedagang. Pada prinsipnya, Bank Syariah adalah sama dengan perbankan konvensional, yaitu sebagai instrumen intermediasi yang menerima dana dari orang-orang yang surplus dana (dalam bentuk penghimpunan dana) dan menyalurkannya kepada pihak yang membutuhkan (dalam bentuk produk pelemparan dana). Bank syariah menggunakan berbagai teknik dan metode investasi, dimana kontrak hubungan investasi antara bank syariah dengan para nasabahnya disebut dengan istilah pembiayaan. Dalam perbankan, pembiayaan mempunyai peranan penting terutama untuk menyalurkan dana kepada masyarakat untuk menghadapi masalah dan atau modal kerja terutama untuk
Membangun kepuasan pelanggan melalui mutu pelayanan dan nilai
Authors: Yaqin Ainul
Published: April 2022

Penawaran akan berhasil jika memberikan nilai dan kepuasan kepada pembeli sasaran. Pembeli memilih penawaran berbeda berdasarkan presepsinyaakan penawaran yang memberikan nilai terbesar. Nilai menverminkan sejumlahmanfaat, baik yang berwujud maupun yang tidak berwujud. Dan biaya yangdipresepsikan oleh pelanggan. Nilai adalah kombinasi kualitas, pelayanan, dan harga yang disebut dengan “tiga elemen nilai pelanggan”. Nilai meningkat seiring dengan meningkatnya kualitas dan pelayanan. Dan sebaliknya menurun seiringdengan menurunya harga, walauoun faktor lain juga dapat memainkan peran penting dalam memainkan persepsi nilai.
PENGARUH KOMPETENSI PROFESIONAL, MOTIVASI, DAN DISIPLIN KERJA TERHADAP KINERJA GURU DI SMA SE-DISTRIK ABEPURA KOTA JAYAPURA
Authors: Bintarti  , Purwoko  , ABDUROHIM
Published: April 2022

Kualitas pendidikan yang baik sangat dibutuhkan demi terciptanya sumber daya manusia yang berkualitas. Secara kualitas, profesi guru harus ditunjang oleh kompetensi yang memenuhi persyaratan akademiknya. Pada sisi lain aspek kuantitas guru harus juga proporsional rasionya terhadap kuantitas siswa yang dididiknya. Untuk memenuhi keinginan tersebut diperlukan kompetensi seorang guru dengan mengukur sarana untuk memetakan guru, alat seleksi penerimaan guru, sarana untuk mengelompokkan guru, acuan dalam pengembangan kurikulum, sarana untuk pembinaan guru, alat untuk mendorong kegiatan dan hasil belajar, dan sarana pemberdayaan guru.
Menganalisis pasar dan perilaku konsumen/nasaba
Authors: Nurhamna  , ikram
Published: April 2022

Tujuan pemasaran adalah memenuhi dan melayani kebutuhan dan kemampuan konsumen sasaran. Pasar konsumen dan perilaku pembeli konsumen harus dikembangkan sebelum rencana pemasaran nyata. Pasar konsumen membeli barang dan jasa untuk konsumsi pribadi, dan ini adalah pasar yang paling akhir dimana kegiatan perekonomian diatur. Istilah pasar banyak diartikan secara beda sesuai dengan sudut pandang penglihatan. Disini, kebutuhan dan keinginan konsumen mengawali kehadiran produk dapat memenuhinya. Hal tersebut, terungkap melalui jembatan penyebrangan motivasi dan kemampuan membeli yang dimiliki konsumen. Akan tetapi, tidak diingkari kondisinya bervariasi yang tercengkram perubahan. Kegenerikan produk, jenis produk, tingkatan produk, dan persaingan merk memberikan pertolongan kita untuk menentukan pasar. Pasar yang ditentukan dengan cara demikian, tergores garis batas jelas tujuan, keberadaan alternatif, serta daya lenting terhadap aksi dobrakan perubahan. Pelanggan mungkin menyatakan kebutuhan dan keinginan mereka namun bertindaksebaliknya. Pelanggan mungkin menanggapi pengaruh yang mengubah pikiran mereka pada menitmenit terakhir perubahan produk, tetap mendapat laba dari memahami bagaimana dan mengapa pelanggan membeli.
Teori nilai guna (utility)
Authors: Anwar Khaerul
Published: April 2022

Catatan terkait dengan apa itu teori nilai guna (utility)
Lý thuyết mới về cơ chế và bản chất của sự sáng tạo
Authors: Quang-Loc Nguyen
Published: April 2022

TS. Vương Quân Hoàng cùng 4 tác giả ThS. Nguyễn Minh Hoàng, ThS. Lê Tâm Trí, TS. Khúc Văn Quý và kỹ sư Lã Việt Phương vừa ra mắt cuốn sách đem lại một cái nhìn hoàn toàn mới về khái niệm “Serendipity”. Serendipity được coi là một “phép màu”. Đó là bí ẩn về sự đổi mới.
Robust Online Multi-target Visual Tracking using a HISP Filter with Discriminative Deep Appearance Learning
Authors: Baisa Nathanael L.
Published: April 2022

We propose a novel online multi-target visual tracker based on the recently developed Hypothesized and Independent Stochastic Population (HISP) filter. The HISP filter combines advantages of traditional tracking approaches like MHT and point-process-based approaches like PHD filter, and it has linear complexity while maintaining track identities. We apply this filter for tracking multiple targets in video sequences acquired under varying environmental conditions and targets density using a tracking-by-detection approach. We also adopt deep CNN appearance representation by training a verification-identification network (VerIdNet) on large-scale person re-identification data sets. We construct an augmented likelihood in a principled manner using this deep CNN appearance features and spatio-temporal information. Furthermore, we solve the problem of two or more targets having identical label considering the weight propagated with each confirmed hypothesis. Extensive experiments on MOT16 and MOT17 benchmark data sets show that our tracker significantly outperforms several state-of-the-art trackers in terms of tracking accuracy.
Neuralink: A cheat code for evolution?
Authors: Gadda Navjot Singh
Published: April 2022

The first living organisms to use chemical signals to coordinate behavior and build communities must have faced a fundamental dilemma. Natural selection would favor the evolution of neural circuits that represented those signals, but any such circuits would be sensitive to their own ongoing activity and that of all other simultaneously active components. Neuralink claims to override the processes of STP, LTP and natural synaptic encoding by means of microstimulators implanted within the brains’ white matter. This not only violates causality, it also conflicts with neuroscientists’ consensus on how these processes actually work. Furthermore, since neuralink does not produce the relevant neurotransmitters itself (but merely excites or inhibits those already present in brain tissue) then there is no reason why its electrodes should not also activate adjacent neurons or axons that were never intended targets and potentially cause serious unintended damage as well. One plain proposition is that an agent didn't read a book or perform an activity to learn a task, yet he is able to do it using an implant. We show why this assumption fails in general using simple game theory analysis. We conclude with some thoughts on how future research can help us understand whether neural implants can ever really augment human memory in practice rather than just in theory.
EDUCATION PROGRAM DEVELOPMENT POLICY THROUGH FULLDAY SCHOOL LEARNING PROGRAM IN MAN 2 MEDAN MODELS
Authors: Fahmi Syawal , Wijaya Candra , Purwoko Bambang , ABDUROHIM
Published: April 2022

This research aims to analyze the policy of education program development through the Fullday School Learning program in MAN 2 Model Medan. This research will focus on implementing Fullday school policies and how they impact student learning achievements. Using the qualitative method, the results of this research show that the Fullday School program applied is focused on two subjects, namely Tahfiz Qur'an and life skill development. As for the Tahfiz Qur’an-related, students are required to memorize the 30 juz and several surahs of their choice. The Life Skills program or talent development and the student’s creed include computers, English, Mandarin, and graphic design. Fullday School Program implemented in MAN 2 Model Medan has a significant impact on student learning achievement, both academically and non-academic
The COVID States Project #83: Executive Approval
Authors: Quintana Alexi , Lazer David , Baum Matthew , Druckman James , Perlis Roy , Ognyanova Katherine , Santillana Mauricio , Safarpour Alauna , Urmi Tamanna , Trujillo Kristin Lunz , Qu Hong , Uslu Ata , Green Jon , Pippert Caroline H , Shere Anjuli
Published: April 2022

The Covid States Project has been tracking trends in executive approval of management of the COVID-19 outbreak throughout the pandemic. We find:● Generally, there has been a downward trend for approval of all governors since the beginning of the pandemic.● Republican respondents in particular have trended downwards in their approval of governors. Republican approval of Democratic governors has dropped from a high of 57% in April 2020, to 19% in April, 2022. Approval of Republicans for Republican governors has fallen almost as quickly, from a high of 77% in April 2020, to 44% currently.● In the early stages of the pandemic, President Trump had notably low approval for his handling of the pandemic, far below the average approval levels of governors. President Biden has generally had approval levels above those of President Trump, peaking in the spring of 2021, and declining steadily since. This decline has been somewhat faster than the decline in approval of governors, reaching a nadir in April 2022 one point below that of the average governor at 38%.
Soil dryness and its lead relationship to wildfires in the Apalachicola National Forest, Florida, USA
Authors: Law Zachery , Elsner James
Published: April 2022

Climate models show rainy seasons getting rainier and dry seasons getting drier due to global warming from increasing greenhouse gases but local changes in drying, the understanding of which is important for mitigation efforts, will not necessarily match the global response. Here long-term weather observations from the Weather Service Office in Tallahassee are used to examine soil moisture deficits and to quantify the extent to which these deficits are related to wildfire occurrences in the nearby Apalachicola National Forest (ANF). Results show a 20% increase in the average rate of wildfires from May through July for every one cm increase in soil moisture deficit during April. The out-of-sample correlation between the observed number and the predicted rate of wildfires is +.57. Tracking daily soil moisture deficits prior to the start of the wildfire season provides a real-time update on developing drought conditions that have had an impact on wildfire activity in the ANF during the weeks to months ahead. Further, long-term upward trends in soil dryness are identified with the most pronounced changes occurring during the driest months. Taken together these findings, and assuming a continuation of the chronic drying, indicate a greater future risk of fires in the ANF.
Understanding surface-wave modal content for high-resolution imaging of submarine sediments with Distributed Acoustic Sensing
Authors: Viens Loïc , Perton Mathieu , Spica Zack , Nishida Kiwamu , Shinohara Masanao , Yamada Tomoaki
Published: April 2022

Ocean Bottom Distributed Acoustic Sensing (OBDAS) is emerging as a new measurement method providing dense, high-fidelity, and broadband seismic observations from fibre-optic cables deployed offshore. In this study, we focus on 33 km of a telecommunication cable located offshore the Sanriku region, Japan, and apply seismic interferometry to obtain a high-resolution 2-D shear-wave velocity (VS) model below the cable. We first show that the processing steps applied to two weeks of continuous data prior to computing Cross-Correlation Functions (CCFs) impact the modal content of surface waves. Data pre-processed with 1-bit normalisation allow us to retrieve dispersion images with high Scholte-wave energy between 0.5 and 5 Hz, whereas spatial aliasing dominates dispersion images above 3 Hz for non-1-bit CCFs. Moreover, the number of receiver channels considered to compute dispersion images also greatly affects the resolution of extracted surface-wave modes. In some regions of the array, we observe up to 30 higher modes. To better understand the remarkably rich modal nature of OBDAS data, we simulate Scholte-wave dispersion curves from constant VS gradient media. For soft marine sediments, simulations confirm that a large number of modes can be generated. Based on pre-processing and theoretical considerations, we extract surface-wave dispersion curves from 1-bit CCFs spanning over 400 channels (i.e., ~2 km) along the array and invert them to image the subsurface. The 2-D velocity profile generally exhibits slow shear-wave velocities near the ocean floor that gradually increase with depth. Lateral variations are also observed. Flat bathymetry regions, where sediments tend to accumulate, reveal a larger number of Scholte-wave modes and lower shallow velocity layers than regions with steeper bathymetry. We also compare and discuss the velocity model with that from a previous study and finally discuss the combined effect of bathymetry and shallow VS layers on earthquake wavefields. Our results provide new constraints on the shallow submarine structure in the area and further demonstrate the potential of OBDAS for high-resolution offshore geophysical prospecting.
Violence Victimization in Latina/o/x Young Adults: The Multiplicative Effects of Cultural and High Betrayal Trauma (Submitted Manuscript)
Authors: Howard Rebecca , Ahrens Courtney , Gómez Jennifer M.
Published: April 2022

Latinas/os/xs experience pervasive rates of interpersonal violence victimization (Black et al., 2011) while also experiencing frequent discrimination (Findling et al., 2019) and societal trauma (e.g., hate crimes; FBI, 2019). Betrayal trauma theory (Freyd, 1997) and cultural betrayal trauma theory (Gómez, 2019b) provide frameworks for examining the distinct harm of violence perpetrated by a close other (Goldsmith et al., 2012) and by a member of the same marginalized group(s) (Gómez, 2021), respectively. However, no known research has examined the concurrent impacts of both forms of betrayal among Latina/o/x young adults. The current study examined the unique and multiplicative effects of high betrayal trauma (i.e., violence perpetrated by a close other) and cultural betrayal trauma (i.e., violence perpetrated by someone of the same marginalized group(s)) on psychological and physical health symptoms in Latina/o/x young adults. Latina/o/x undergraduate students (N = 208) participated in a 60-minute online survey assessing violence victimization, psychological symptoms, and physical health. Rates of victimization (91.35%, n = 190) were high across differing forms of violence. Interactions of high betrayal trauma and cultural betrayal trauma were significant for psychological, physical, and anxiety symptoms. Although there were no significant simple effects, the pattern of results suggested that being assaulted by someone who shares one’s Latina/o/x identity was more strongly associated with psychological and physical symptoms when participants had not been assaulted by someone with whom they were close. The current study highlights the importance of culturally competent therapy for Latina/o/x survivors that incorporates the interpersonal and cultural contexts of victimization.
Ask the Editors: Assessing the Publishing Needs of Faculty Editors
Authors: Hunter Matthew Eric , Dunne Liz , Thomas Camille , Miller Laura , Soper Devin
Published: April 2022

Introduction: This article reports results from a survey of faculty members with editorial responsibilities. The survey explored what publishing services and platform functionalities respondents found most valuable in their work as editors, how satisfied they were with the services provided by commercial publishers, and to what extent they were aware of alternative publishing practices. Method: The authors used data collected from a survey instrument that was distributed to a sample (n = 515) of faculty members with editorial responsibilities at their institution. Results: Collected data suggest that faculty editors value specific publishing services (e.g., coordination of peer review and copyediting) and platform functionality (e.g., submission and peer-review management) more than others, recognize several challenges facing academic publishing in their disciplines (including the transition to open access publishing models), and are mostly aware of common forms of open access research dissemination such as open access journals and institutional repositories. Discussion: The survey results may be helpful to library publishers in making decisions about what publishing services and platform functionalities to prioritize in the development of their publishing programs. In addition to utilizing the survey data to assess the needs of editors, the authors also identified a number of expanded uses of the survey related to marketing and outreach. Conclusion: Insofar as faculty editors are key stakeholders that library publishers seek to build partnerships with, it is important to understand their needs and preferences as editors. This article provides some insight into these questions that may prove helpful to library publishers.
Determination of Minerals of Cassiterite Tailings and its Recycling Potential Using Empirical Method at Plateau State Nigeria
Authors: Paul Akinola Abayomi , Obams Abinya , Ifeanyi Achuenu
Published: April 2022

The mineral potential of cassiterite fines from tailing dumps in the Jos Tin Mining Community Resource Centre (MCRC), Plateau State Nigeria, were studied through a wet concentration process and dry electrostatic and magnetic processes and then evaluated using empirical evidence. Three samples of the tailing dumps with the size of mineral smaller than 5 mm were collected at random through the “Tin Mining Community Resource Centre”. The huge pile of the tailing dumps may have an environmental impact in the area, so they need to be treated and recovered for the valuable heavy minerals and sand tailing for the local construction industry. The grade of the average tailing dumps as analyzed using XRF were 2.08% Sn, 3.51% Nb, 25.5% Fe, 14.91%Ti, 8.36% Zr, 12.99% Al, and 45.68% Si. The percentage compositions of the cassiterite tailings were expressed to its simplest genetic mineral forms using an empirical formula. The genetic mineral forms were ilmenite, zircon and sand. Since ilmenite has the highest concentration in the cassiterite tailings and the highest economic values, then recycling of ilmenite should be ascertained. After the wet processing by the screen, hydro cyclone, spiral concentrator, and shaking table, the concentrate consists the most of, ilmenite, zircon, and sand. The following dry processes used rotary dryer, screening, electrostatic separator, magnetic separator to separate cassiterite from the heavy minerals and sand. The final iron and titanium concentrate can be upgraded to 72% Fe and Ti using certain reagents such as fluoride acids which can be sold to the Iron ore smelting plant.
Penfield, focal microgyria, and epilepsy
Authors: Leblanc Richard
Published: April 2022

Wilder Penfield (1891–1976) is widely regarded as a dominant figure in 20th century neurobiology for his singular contributions to the structure-function relationship of the brain, his discovery of the language function of the supplementary motor area, the discovery (with Herbert Jasper and Brenda Milner) of the anatomy of recall, and his pioneering work in the surgical treatment of focal epilepsy. But another of his significant discoveries has escaped notice: the recognition that focal microgyria can generate epileptic seizures, and that these can be treated surgically. Penfield discussed the case of the patient through which this discovery was made during his Shattuck Lecture to the Massachusetts Medical Society in 1939. As Penfield gave only a fragmentary account of this case, the patient's chart was retrieved from the Montreal Neurological Institute archives, and his operative note and brain map, intraoperative photographs, and the histopathological and cytological examinations of the resected specimen were reviewed. Based on these primary sources, this paper provides a complete, detailed account of the first case in which microgyria was recognized as a cause of focal epilepsy, which was successfully treated surgically.
Charles Jacques Bouchard (1837–1915) and the Charcot-Bouchard aneurysm
Authors: Akmal Sarfraz , Jumah Fareed , Ginalis Elizabeth E. , Raju Bharath , Nanda Anil
Published: April 2022

Charles Jacques Bouchard was a distinguished French physician and scientist of the early 19th century. Despite his humble beginnings, Bouchard was able to achieve meteoric success within the scientific and medical fields, establishing himself as one of the most influential physician-scientists of his time. This was in part due to his superb commitment, as well as the prosperity engendered by the strong influence of his teachers, which can be seen as a testament to the importance of mentorship in medicine. Besides his myriad contributions, Bouchard is most well known for describing the Charcot-Bouchard aneurysm in 1866 alongside his mentor Jean-Martin Charcot, linking them for the first time to intracranial hemorrhage. Bouchard’s thesis entitled “A Study of Some Points in the Pathology of Cerebral Hemorrhage” was regarded by some as the most original and important of all recent works on the subject of cerebral hemorrhage at the time of publication. Sadly, the great relationship Bouchard shared with his mentor Charcot would later deteriorate into perhaps one of the most well-known student-mentor quarrels in the history of medicine. Herein, the authors present a historical recollection of Bouchard’s life, career, and contributions to medicine, as well as the famous controversy with Jean-Martin Charcot.
Septal rhinopharyngeal flap: a novel technique for skull base reconstruction after endoscopic endonasal clivectomies
Authors: Simal-Julian Juan Antonio , Pérez de San Román-Mena Laila , Sanchis-Martín María Rosa , Quiroz-Tejada Arnold , Miranda-Lloret Pablo , Botella-Asunción Carlos
Published: April 2022

Endoscopic endonasal reconstruction techniques have improved CSF leak rates that were initially reported after surgery for cranial base and intradural lesions. However, wide surgical defects still pose a problem, especially if located in the clival region. The authors propose and describe a novel reconstruction technique they call a septal rhinopharyngeal flap (SRF) specifically designed to address this issue. The SRF is formed by three components of mucosa: 1) septal, 2) rhinopharyngeal roof, and 3) rhinopharyngeal posterior wall components, which allows for the coverage of the tuberculum/sellar region, midclivus, and lower clivus, respectively. A step-by-step procedure is described and its results analyzed in cases in which it has been used. The SRF was performed in 8 patients, which included diagnoses of 4 chordomas, 2 petroclival meningiomas, 1 invasive pituitary adenoma, and 1 chondrosarcoma. The size of the flap was considered optimal in all patients (100%). Postoperative MRI revealed contrast enhancement covering the entire surface of the flap. No CSF leaks were encountered after at least 1 postoperative year. The SRF is a novel vascularized reconstruction technique specifically indicated for wide endosanasal clivectomies focused on the middle clivus with caudal extension into the lower clivus and craniocervical junction, as well as rostral extensions into the tubercular or planum sphenoidale. This new reconstruction technique could be added to the skull base reconstruction armamentarium as a safe and optimal option.
Early repeat resection for residual glioblastoma: decision-making among an international cohort of neurosurgeons
Authors: Kim Anya A. , Dono Antonio , Khalafallah Adham M. , Nettel-Rueda Barbara , Samandouras George , Hadjipanayis Constantinos G. , Mukherjee Debraj , Esquenazi Yoshua
Published: April 2022

OBJECTIVE

The importance of extent of resection (EOR) in glioblastoma (GBM) has been thoroughly demonstrated. However, few studies have explored the practices and benefits of early repeat resection (ERR) when residual tumor deemed resectable is unintentionally left after an initial resection, and the survival benefit of ERR is still unknown. Herein, the authors aimed to internationally survey current practices regarding ERR and to analyze differences based on geographic location and practice setting.

METHODS

The authors distributed a survey to the American Association of Neurological Surgeons and Congress of Neurological Surgeons Tumor Section, Society of British Neurological Surgeons, European Association of Neurosurgical Society, and Latin American Federation of Neurosurgical Societies. Neurosurgeons responded to questions about their training, practice setting, and current ERR practices. They also reported the EOR threshold below which they would pursue ERR and their likelihood of performing ERR using a Likert scale of 1–5 (5 being the most likely) in two sets of 5 cases, the first set for a patient’s initial hospitalization and the second for a referred patient who had undergone resection elsewhere. The resection likelihood index for each respondent was calculated as the mean Likert score across all cases.

RESULTS

Overall, 180 neurosurgeons from 25 countries responded to the survey. Neurosurgeons performed ERRs very rarely in their practices (< 1% of all GBM cases), with an EOR threshold of 80.2% (75%–95%). When presented with 10 cases, the case context (initial hospitalization vs referred patient) did not significantly change the surgeon ERR likelihood, although ERR likelihood did vary significantly on the basis of tumor location (p < 0.0001). Latin American neurosurgeons were more likely to pursue ERR in the provided cases. Neurosurgeons were more likely to pursue ERR when the tumor was MGMT methylated versus unmethylated, with a resection likelihood index of 3.78 and 3.21, respectively (p = 0.004); however, there was no significant difference between IDH mutant and IDH wild-type tumors.

CONCLUSIONS

Results of this survey reveal current practices regarding ERR, but they also demonstrate the variability in how neurosurgeons approach ERR. Standardized guidelines based on future studies incorporating tumor molecular characteristics are needed to guide neurosurgeons in their decision-making on this complicated issue.
Functional connectivity between mesial temporal and default mode structures may help lateralize surgical temporal lobe epilepsy
Authors: Narasimhan Saramati , González Hernán F. J. , Johnson Graham W. , Wills Kristin E. , Paulo Danika L. , Morgan Victoria L. , Englot Dario J.
Published: April 2022

OBJECTIVE

The most common surgically treatable epilepsy syndrome is mesial temporal lobe epilepsy (mTLE). Preoperative noninvasive lateralization of mTLE is challenging in part due to rapid contralateral seizure spread. Abnormal connections in both the mesial temporal lobe and resting-state networks have been described in mTLE, but it is unclear if connectivity between these networks may aid in lateralization.

METHODS

In 52 patients with left mTLE (LmTLE) or right mTLE (RmTLE) and 52 matched control subjects, the authors acquired 20 minutes of resting-state functional MRI (fMRI) and evaluated functional connectivity of bilateral hippocampi and amygdalae with selected resting-state networks. They used Pearson correlation, network-based statistic, and dynamic causal modeling. Also, to evaluate the clinical utility of a resting-state connectivity model in lateralizing unilateral presurgical mTLE patients, they used receiver operating characteristic curve analysis.

RESULTS

RmTLE patients demonstrated decreased nondirected connectivity between the right hippocampus and default mode network compared with LmTLE patients and control subjects. Network-based statistic analysis revealed that the network with most decreased connectivity that distinguished LmTLE from RmTLE patients included the right hippocampus and amygdala, right lateral orbitofrontal cortices, and bilateral inferior parietal lobules, precuneus, and medial orbitofrontal cortices. Dynamic causal modeling analysis revealed that cross-hemispheric connectivity between hippocampi and amygdalae was predominantly inward toward the epileptogenic side. A regression model incorporating these connectivity patterns was used to accurately lateralize mTLE patients with an area under the receiver operating characteristic curve of 0.87.

CONCLUSIONS

Evaluating fMRI connectivity between mesial temporal structures and default mode network may aid in mTLE lateralization, reduce need for intracranial monitoring, and guide surgical planning.
Social determinants of health and the prediction of 90-day mortality among brain tumor patients
Authors: Jimenez Adrian E. , Cicalese Kyle V. , Chakravarti Sachiv , Porras Jose L. , Azad Tej D. , Jackson Christopher M. , Gallia Gary L. , Bettegowda Chetan , Weingart Jon , Mukherjee Debraj
Published: April 2022

OBJECTIVE

Within the neurosurgical oncology literature, the effect of structural and socioeconomic factors on postoperative outcomes remains unclear. In this study, the authors quantified the effects of social determinant of health (SDOH) disparities on hospital complications, length of stay (LOS), nonroutine discharge, 90-day readmission, and 90-day mortality following brain tumor surgery.

METHODS

The authors retrospectively reviewed the records of brain tumor patients who had undergone resection at a single institution in 2017–2019. The prevalence of SDOH disparities among patients was tracked using International Classification of Diseases Ninth and Tenth Revisions (ICD-9 and ICD-10) codes. Bivariate (Mann-Whitney U-test and Fisher’s exact test) and multivariate (logistic and linear) regressions revealed whether there was an independent relationship between SDOH status and postoperative outcomes.

RESULTS

The patient cohort included 2519 patients (mean age 55.27 ± 15.14 years), 187 (7.4%) of whom experienced at least one SDOH disparity. Patients who experienced an SDOH disparity were significantly more likely to be female (OR 1.36, p = 0.048), Black (OR 1.91, p < 0.001), and unmarried (OR 1.55, p = 0.0049). Patients who experienced SDOH disparities also had significantly higher 5-item modified frailty index (mFI-5) scores (p < 0.001) and American Society of Anesthesiologists (ASA) classes (p = 0.0012).

Experiencing an SDOH disparity was associated with a significantly longer hospital LOS (p = 0.0036), greater odds of a nonroutine discharge (OR 1.64, p = 0.0092), and greater odds of 90-day mortality (OR 2.82, p = 0.0016) in the bivariate analysis. When controlling for patient demographics, tumor diagnosis, mFI-5 score, ASA class, surgery number, and SDOH status, SDOHs independently predicted hospital LOS (coefficient = 1.22, p = 0.016) and increased odds of 90-day mortality (OR 2.12, p = 0.028).

CONCLUSIONS

SDOH disparities independently predicted a prolonged hospital LOS and 90-day mortality in brain tumor patients. Working to address these disparities offers a new avenue through which to reduce patient morbidity and mortality following brain tumor surgery.
Single low-dose targeted bevacizumab infusion in adult patients with steroid-refractory radiation necrosis of the brain: a phase II open-label prospective clinical trial
Authors: Dashti Shervin R. , Kadner Robert J. , Folley Bradley S. , Sheehan Jason P. , Han Dong Y. , Kryscio Richard J. , Carter Mary B. , Shields Lisa B. E. , Plato Brian M. , La Rocca Renato V. , Spalding Aaron C. , Yao Tom L. , Fraser Justin F.
Published: April 2022

OBJECTIVE

There is an unmet need for safe and rapidly effective therapies for refractory brain radiation necrosis (RN). The aim of this prospective single-arm phase II trial was to evaluate the safety and efficacy of a single low-dose targeted bevacizumab infusion after blood-brain barrier disruption (BBBD) in adult patients with steroid-refractory brain RN.

METHODS

Ten adults with steroid-refractory, imaging-confirmed brain RN were enrolled between November 2016 and January 2018 and followed for 12 months after treatment. Bevacizumab 2.5 mg/kg was administered as a one-time targeted intra-arterial infusion immediately after BBBD. Primary outcomes included safety and > 25% decrease in lesion volume. Images were analyzed by a board-certified neuroradiologist blinded to pretrial diagnosis and treatment status. Secondary outcomes included changes in headache, steroid use, and functional status and absence of neurocognitive sequelae. Comparisons were analyzed using the Fisher exact test, Mann-Whitney U-test, linear mixed models, Wilcoxon signed-rank test, and repeated-measures 1-way ANOVA.

RESULTS

Ten adults (mean ± SD [range] age 35 ± 15 [22–62] years) participated in this study. No patients died or exhibited serious adverse effects of systemic bevacizumab. At 3 months, 80% (95% CI 44%–98%) and 90% (95% CI 56%–100%) of patients demonstrated > 25% decrease in RN and vasogenic edema volume, respectively. At 12 months, RN volume decreased by 74% (median [range] 76% [53%–96%], p = 0.012), edema volume decreased by 50% (median [range] 70% [−11% to 83%], p = 0.086), and headache decreased by 84% (median [range] 92% [58%–100%], p = 0.022) among the 8 patients without RN recurrence. Only 1 (10%) patient was steroid dependent at the end of the trial. Scores on 12 of 16 (75%) neurocognitive indices increased, thereby supporting a pattern of cerebral white matter recovery. Two (20%) patients exhibited RN recurrence that required further treatment at 10 and 11 months, respectively, after bevacizumab infusion.

CONCLUSIONS

For the first time, to the authors’ knowledge, the authors demonstrated that a single low-dose targeted bevacizumab infusion resulted in durable clinical and imaging improvements in 80% of patients at 12 months after treatment without adverse events attributed to bevacizumab alone. These findings highlight that targeted bevacizumab may be an efficient one-time treatment for adults with brain RN. Further confirmation with a randomized controlled trial is needed to compare the intra-arterial approach with the conventional multicycle intravenous regimen.

Clinical trial registration no.: NCT02819479 (ClinicalTrials.gov)
Intracranial aneurysms in the infant population: an institutional case series and individual participant data meta-analysis
Authors: Clarke Jamie E. , Luther Evan , Oppenhuizen Brooke , Leuchter Jessica D. , Ragheb John , Niazi Toba N. , Wang Shelly
Published: April 2022

OBJECTIVE

Infantile intracranial aneurysms are exceedingly rare. The goal of this study was to evaluate an institutional case series of infantile intracranial aneurysms, as well as those reported in the contemporary literature, to determine their demographics, presentation, management, and long-term outcome.

METHODS

A comprehensive literature review from 1980 to 2020 was performed to identify individual cases of intracranial aneurysms in the infantile population ≤ 2 years of age. Additional cases from the authors’ institution were identified during the same time period. An individual participant data meta-analysis (IPDMA) was performed, abiding by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Patient demographic, radiographic, and clinical information was obtained. Descriptive statistical data were recorded, and multivariate logistic regression analyses were performed.

RESULTS

Patient data were obtained for 133 patients from 87 articles in the literature. Ten additional patients at the authors’ institution were also identified, for a total of 143 patients included in the IPDMA. The majority (72.7%) of this cohort consisted of idiopathic aneurysms, while 13.3% were posttraumatic pseudoaneurysms, 9.8% were infectious mycotic aneurysms, and 4.2% were aneurysms associated with a systemic connective tissue disorder or vasculitis. The mean age at presentation was 6.6 months. The majority of infants (97.9%) harbored only 1 aneurysm, and hemorrhage was the most common presenting feature (78.3%). The mean aneurysm size was 14.4 mm, and giant aneurysms ≥ 25 mm comprised 12.9% of the cohort. Most aneurysms occurred in the anterior circulation (80.9%), with the middle cerebral artery (MCA) being the most commonly affected vessel (51.8%). Management strategies included open surgical aneurysm ligation (54.0%), endovascular treatment (35.0%), surgical decompression without aneurysm treatment (4.4%), and medical supportive management only (13.9%). Surgical aneurysm ligation was more commonly performed for MCA and anterior cerebral artery aneurysms (p = 0.004 and p = 0.015, respectively), while endovascular techniques were favored for basilar artery aneurysms (p = 0.042). The mean follow-up period was 29.9 months; 12.4% of the cohort died, and 67.0% had a favorable outcome (Glasgow Outcome Scale score of 5).

CONCLUSIONS

This study is, to the authors’ knowledge, the largest analysis of infantile intracranial aneurysms to date. The majority were idiopathic aneurysms involving the anterior circulation. Surgical and endovascular techniques yielded equally favorable outcomes in this cohort. Long-term outcomes in the infantile population compared favorably to outcomes in adults.
Increased utilization of healthcare services in children with craniosynostosis
Authors: Ruiz Colón Gabriela D. , Jin Michael C. , Grant Gerald A. , Prolo Laura M.
Published: April 2022

OBJECTIVE

Craniosynostosis is characterized by the premature fusion of at least one cranial suture. Although evidence suggests that patients with both syndromic and nonsyndromic craniosynostosis may benefit from developmental, behavioral, and mental health support, data on utilization of healthcare services are lacking. In this study the authors compared utilization of mental health care, rehabilitation therapies, and other specialty medical services among children with craniosynostosis, children with plagiocephaly, and healthy controls.

METHODS

The Optum Clinformatics Data Mart database was queried to identify 1340 patients with craniosynostosis, of whom 200 had syndromic craniosynostosis. Long-term utilization of mental health care, rehabilitation therapies, and other medical services up to the age of 6 years was calculated. Rates of utilization were compared to healthy controls (n = 1577) and children with plagiocephaly (n = 1249).

RESULTS

Patients with syndromic and nonsyndromic craniosynostosis used mental health care, occupational therapy, speech–language pathology, and other medical services at similar rates (p = 0.1198, p > 0.9999, p = 0.1097, and p = 0.8119, respectively). Mental health services were used more frequently by patients with craniosynostosis (11.0% in patients with syndromic craniosynostosis and 7.5% in those with nonsyndromic craniosynostosis) compared to patients in the plagiocephaly (5.0%, p = 0.0020) and healthy control (2.9%, p < 0.0001) cohorts. Rehabilitation therapies were more frequently used by patients with syndromic craniosynostosis and plagiocephaly (16.0% and 14.1%, respectively), which was significantly higher than use by healthy controls (p < 0.0001). Other medical subspecialty services (developmental pediatrics, ophthalmology, optometry, and audiology) were used by 37.0% of patients with craniosynostosis, compared with 20.9% (p < 0.0001) and 15.1% (p < 0.0001) of patients with plagiocephaly and healthy controls, respectively. Among patients with craniosynostosis, utilization did not differ by race or household income, but it was not uniform by age. Whereas ophthalmology utilization did not differ by age (p = 0.1003), mental health care was most commonly used among older children (p = 0.0107).

CONCLUSIONS

In this study, the authors demonstrate that rates of utilization of mental health care, rehabilitation therapies, and other medical subspecialty services are similar between patients with syndromic and those with nonsyndromic craniosynostosis, but higher than in healthy controls. Although surgical correction may be considered an isolated event, providers and parents need to monitor all children with craniosynostosis—syndromic and nonsyndromic—for developmental and mental health support longitudinally. Future work should explore risk factors driving utilization, including suture involvement, repair type, and comorbidities.
The declining incidence of cervical spine surgery in patients with rheumatoid arthritis: a single-surgeon series and literature review
Authors: Perez-Roman Roberto J. , Govindarajan Vaidya , Levi David J. , Luther Evan , Levi Allan D.
Published: April 2022

OBJECTIVE

With an increasing number of disease-modifying drugs available to manage rheumatoid arthritis (RA), spine surgeons have anecdotally noted decreased rates of cervical spine surgical procedures in this population. Although these medications have been shown to mitigate RA progression and its systemic effects on joint destruction, there are currently no large-scale studies of RA patients that suggest the use of these disease-modifying drugs has truly coincided with a decline in cervical spine surgery.

METHODS

Patients with RA who underwent cervical spinal fusion from 1998 to 2021 performed by the senior author were retrospectively reviewed. The cohort was stratified into 3 categories based on procedure level: 1) occipitocervical, 2) atlantoaxial, and 3) subaxial. The number of surgical procedures per year in each subgroup was evaluated to determine treatment trends over time. National (Nationwide) Inpatient Sample (NIS) data on both RA and non-RA patients who underwent cervical fusion were analyzed to assess for surgical trends over time and for differences in likelihood of surgical intervention between RA and non-RA patients over the epoch.

RESULTS

From 1998 to 2021, the number of overall cervical fusions performed in RA patients significantly declined (–0.13 procedures/year, p = 0.01) in this cohort, despite an overall significant increase in cervical fusions in non-RA patients over the same period. NIS analysis of cervical fusions across all patients similarly demonstrated a significant increase in cervical fusions over the same epoch (19,278 cases/year, p < 0.0001). When normalized for changes in population size, the incidence of new surgical procedures was lower in patients with RA regardless of surgical technique. Anterior cervical fusion was the most common approach used over the epoch in both RA and non-RA patients; correspondingly, RA patients were significantly less likely to undergo anterior cervical fusion (OR 0.655, 95% CI −0.4504 to −0.3972, p < 0.0001).

CONCLUSIONS

At the authors’ institution, there was a clear decline in the number of cervical fusions performed to treat the 3 most common forms of cervical spine pathology in RA patients (basilar impression, atlantoaxial instability, and subaxial cervical deformity). Although national trends suggest an increase in total cervical fusions in both RA and non-RA patients, the incidence of new procedures in patients with RA was significantly lower than in patients without RA, which supports the anecdotal results of spine surgeons nationally.
Febrile Seizures among Children Admitted to the Department of Paediatrics of a Tertiary Care Centre: A Descriptive Cross-sectional Study
Authors: Poudel Sumita , Adhikari Sudhir , Thapa Rohit , Parajuli Biraj , Regmi Shanti , Kunwar Prajjwal
Published: April 2022

Introduction: Febrile seizure is the most common convulsive event in children younger than 60 months. Fever plays an important role in causing disturbances in fluid and electrolyte balance, also hyponatremia has been thought to enhance the susceptibility to seizures. The objective of this study is to find out the prevalence of febrile seizures among children admitted to the Department of Paediatrics of a tertiary care centre.
Methods: A descriptive cross-sectional study among children admitted to the Department of Paediatrics was done at a tertiary care centre between December, 2020 to September, 2021. Ethical approval was taken from the Institutional Review Committee (Reference number: 077/078-098). A total of 1052 children were included in this study. A convenience sampling technique was used. Statistical Package for the Social Sciences version 25.0 was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: Among 1052 children, the prevalence of febrile seizure was 100 (9.50%) (7.73-11.27 at 95% Confidence Interval). Among these 100 patients, 68 (68%) had simple febrile seizures while 32 (32%) had recurrent febrile seizures.
Conclusions: The prevalence of febrile seizures was found to be higher than in other studies conducted in similar settings. This knowledge may be of practical value in advising parents or caregivers of the risk of a febrile seizure and its recurrence.