bluuebunny/crossref_metadata_2025 huggingface dataset:
LAPORAN PEMBUATAN PAPAN NAMA MASJID
Authors: Sofia
Published: October 2020

Kuliah Kerja lapang plus ( KKLP ) merupakan suatu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk pengabdian pada masyarakat yang dilakukan oleh mahasiswa dalam jangka waktu tertentu. Oleh karena sifatnya intrakurikuler sehingga setiap mahasiswa yang akan menyelesaikan studi di perguruan tinggi pada suatu program strata satu ( S1) harus mengikuti KKLP.
Membersihkan masjid Nurul iman
Authors: emita Sri Lela
Published: October 2020

Kuliah Kerja Lapang Plus (KKLP) merupakan salah satu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk pengabdian pada masyarakat yang dilakukan oleh mahasiswa dalam jangka waktu yang tertentu. Oleh karena itu, sifatnya intrakurikuler sehingga setiap mahasiswa yang akan menyelesaikan studi perguruan tinggi pada suatu Program Strata Satu (S1) harus mengikuti KKLP.
laporan kegiatan pembuatan papan masjid
Authors: Veniandriani
Published: October 2020

kuliah kerja lapang plus ( kklp) merupakan suatu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk pengabdian pada masyarakat yang dilakukan oleh mahasiswa dalam jangka waktu tertentu. oleh karena sifatnya intrakurikuler sehingga setiap mahasiswa yang akan menyelesaikan studi di perguruan tinggi pada suatu program strata satu (s1) harus mengikuti kklp
LAPORAN BELAJAR MENGAJI TK/TPA
Authors: A.m.yusuf
Published: October 2020

Kuliah Kerja lapang plus ( KKLP ) merupakan suatu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk pengabdian pada masyarakat yang dilakukan oleh mahasiswa dalam jangka waktu tertentu. Oleh karena sifatnya intrakurikuler sehingga setiap mahasiswa yang akan menyelesaikan studi di perguruan tinggi pada suatu program strata satu ( S1) harus mengikuti KKLP.
KEGIATAN MENGAJAR MENGAJI TK/TPA
Authors: M Karmila
Published: October 2020

kuliah kerja lapang plus (kklp) merupakan suatu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk pengabdian pada masyarakat yang dilakukan oleh mahasiswa dalam jangka waktu tertentu. oleh karena sifatnya intrakurikuler sehingga setiap mahasiswa yang akan menyelessaikan studi di perguruan tinggi pada suatu program strata satu (s1) harus mengikuti kklp
Pembagian masker di pasar paitana
Authors: Andika Nur
Published: October 2020

Pembagian masker untuk melindungi sekitar kita agar tidak terjadi hal yang tidak di inginkan, seperti terkena covid 19.Kuliah kerja lapangan Plus (KKLP) merupakan suatu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk ke masyarakat yang dilakukan oleh,karena sifatnya intrakurikuler sehingga setiap mahasiswa yang akan menyelesaikan studi perguruan tinggi pada suatu program Strata satu (S1) harus mengikuti KKLP.
LAPORAN BELAJAR MENGAJI TK/TPA
Authors: Sofia
Published: October 2020

Kuliah Kerja lapang plus ( KKLP ) merupakan suatu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk pengabdian pada masyarakat yang dilakukan oleh mahasiswa dalam jangka waktu tertentu. Oleh karena sifatnya intrakurikuler sehingga setiap mahasiswa yang akan menyelesaikan studi di perguruan tinggi pada suatu program strata satu ( S1) harus mengikuti KKLP.
ACOFT ANZCOP SPIE Melb 2019 GOPol
Authors: Moss David
Published: October 2020

We experimentally demonstrate integrated waveguide polarizers and polarization-selective micro-ring resonators (MRRs) incorporated with layered graphene oxide (GO) films. We achieve a high polarization dependent loss (PDL) of ~53.8 dB for the GO-coated waveguide and a high polarization extinction ratio of ~8.3 dB for the GO-coated MRR.
South-West Nigeria
Authors: Omoniyi Ayodetimi
Published: October 2020

Omoniyi Ayodetimi Resume
Personality and perceptions of major life events: Implications for personality development
Authors: Rakhshani Andrew , Lucas Richard E. , Donnellan Brent , Fassbender Ina , Luhmann Maike
Published: October 2020

Research about the associations between major life events and personality trait development is mixed. Work that evaluates perceptions of life events and how those perceptions are themselves associated with personality traits may help clarify the existing literature. We used a large student sample (N = 1509) to conduct exploratory analyses examining the associations among big five personality traits, different types of life events, a dimensional taxonomy of event characteristics, and beliefs about event-related personality change. Results suggested that (1) associations between personality and event perceptions are often nuanced; and (2) event perceptions were more predictive of beliefs about event-related personality change than were the big five. These findings indicate that event perceptions are not merely proxies for personality traits. This study highlights the importance of subjective event perceptions in the study of major life events and personality development.
A practical guide to doing behavioural research on fake news and misinformation
Authors: Pennycook Gordon , Binnendyk Jabin , Newton Christie , Rand David Gertler
Published: October 2020

Coincident with the global rise in concern about the spread of misinformation on social media, there has been influx of behavioral research on so-called “fake news” (fabricated or false news headlines that are presented as if legitimate) and other forms of misinformation. These studies often present participants with news content that varies on relevant dimensions (e.g., true v. false, politically consistent v. inconsistent, etc.) and ask participants to make judgments (e.g., accuracy) or choices (e.g., whether they would share it on social media). This guide is intended to help researchers navigate the unique challenges that come with this type of research. Principle among these issues is that the nature of news content that is being spread on social media (whether it is false, misleading, or true) is a moving target that reflects current affairs in the context of interest. Steps are required if one wishes to present stimuli that allow generalization from the study to the real-world phenomenon of online misinformation. Furthermore, the selection of content to include can be highly consequential for the study’s outcome, and researcher biases can easily result in biases in a stimulus set. As such, we advocate for pretesting materials and, to this end, report our own pretest of 225 recent true and false news headlines, both relating to U.S. political issues and the COVID-19 pandemic. These headlines may be of use in the short term, but, more importantly, the pretest is intended to serve as an example of best practices in a quickly evolving area of research.
Cognitive and physiological measures of listening effort during degraded speech perception: Relating dual-task and pupillometry paradigms
Authors: Colby Sarah Elizabeth Margaret , McMurray Bob
Published: October 2020

Purpose: Listening effort is quickly becoming an important metric for assessing speech perception in less-than-ideal situations. However, the relationship between the construct of listening effort and the measures used to assess it remain unclear. We compared two measures of listening effort: a cognitive dual task and a physiological pupillometry task. We sought to investigate the relationship between these measures of effort and whether engaging effort impacts speech accuracy.Method: In Experiment 1, 30 participants completed a dual task and pupillometry task that were carefully matched in stimuli and design. The dual task consisted of a spoken word recognition task and a visual match-to-sample task. In the pupillometry task, pupil size was monitored while participants completed a spoken word recognition task. Both tasks presented words at three levels of listening difficulty (unmodified, 8-channel vocoding, and 4-channel vocoding) and provided response feedback on every trial. We refined the pupillometry task in Experiment 2 (n=31); crucially, participants no longer received response feedback. Finally, we ran a new group of subjects on both tasks in Experiment 3 (n=30).Results: In Experiment 1, accuracy in the visual task decreased with increased listening difficulty in the dual task, but pupil size was sensitive to accuracy and not listening difficulty. After removing feedback in Experiment 2, changes in pupil size were predicted by listening difficulty, suggesting the task was now sensitive to engaged effort. Both tasks were sensitive to listening difficulty in Experiment 3, but there was no relationship between the tasks and neither task predicted speech accuracy.Conclusions: Consistent with previous work, we found little evidence for a relationship between different measures of listening effort. We also found no evidence that effort predicts speech accuracy, suggesting that engaging more effort does not lead to improved speech recognition. Cognitive and physiological measures of listening effort are likely sensitive to different aspects of the construct of listening effort.
Research on Covid-19 from Biophysical Perspective
Authors: Lamichhane Tika Ram , Ghimire Madhav Prasad
Published: October 2020

In this report, we discuss the current aspect of biophysics which is an essential field to investigate the structural and related properties of SARS-CoV-2 components, possible drugs likeliness and their interactions, and mathematical as well as clinical data modeling. We have emphasized that a mathematical model generates the sigmoid logistic equation that predicts the total corona virus cases and deaths in a model country with population averaged from the most vulnerable countries, such as India or USA, where the COVID-19 cases are still spiking up and from the countries which are on the process of recovering from the current pandemic. Further, the current status of COVID-19 research has been explained to understand its impacts taking Nepal as the reference country having low-income. In particular, focus is on biophysical study on structural analysis of novel coronavirus main protease which is found to influence the radial distributions of H-bonding atom pairs when interacting with the inhibitors N3. Explorations of the variations of physical parameters are found to be important in drug selective mechanism against COVID-19 infections.
Visibility of Invisible: Covid-19 and Nepal-India Migration
Authors: Baniya Jeevan , Bhattarai Sadikshya , Pradhan Vibhav , Thapa Binay Jung
Published: October 2020

India remains the preferred destination for Nepali migrant workers. There is a freedom of movement and work to citizens of both the countries without the need of passport or visa requirements. This paper studies the impact of COVID-19 on Nepali migrants in India by employing a mixed method research approach. The imposition of nationwide lockdowns in both India and Nepal has resulted in multiple forms of impacts on migrants, revealing a complicated cross-border dynamics. Sudden enforcement of restrictive measures including lockdowns, while necessary, adversely triggered vulnerabilities and precarity onto millions of Nepali migrants in India. The lack of political and legal recognition and inadequate state policies towards social protections worsened the magnitude and severity. While immediate relief measures and safe return is necessary in the short term, it suggests revising their foreign policy, development and social security policies to address the adverse drivers that Nepali migrants have faced.
Buovo d’Antona fra originale veneziano e suo adattamento yiddish: la narrazione cavalleresca veicolo delle ideologie
Authors: Artico Davide
Published: October 2020

The paper contains some partial findings of a comparative research on the chivalry romance Buovo d’Antona as printed in Bologna and in Venice in the 1480s in a number of different, yet quite similar one to another, incunables; and its ottava rima adaptation in yiddish-taytsh, made by Elye Bokher (Elia Levita) in Padua around 1507, and then published as Bovo-Buch in Isny, Württemberg, as late as 1541. Respectively, the narratives implicitly deliver two different ideologies, meant as consequent sets of socially shared convictions about the good living. In particular, the place of women in society and the family, or better said, the male representation thereof, substantially differs in the Yiddish adaptation compared to the Venetian original.
Correlations between linear dimensions of the lumbar intervertebral discs and somatometric parameters in the youth (18-28 years) and young adult males in norm
Authors: Danylevych V. P. , Guminskyi Yu. Y. , Orlovskyi V. O. , Babych L. V.
Published: October 2020

The research for new vertebro-somatometric correlations will significantly improve the possibilities of methods for individualizations of the normal parameters and will accelerate the introduction of scientific developments into the daily practice of clinicians, radiologists, neurosurgeons and other specialists. The aim of research is to investigate the peculiarities of relationships between partial linear dimensions of the lumbar intervertebral discs, their total sizes and relative indicators with somatometric parameters in the youth and young adult males in norm. The linear dimensions of the lumbar intervertebral discs (height, sagittal and transverse sizes) were measured noninvasively on the MRI images in the axial, sagittal and coronal plains. The somatometric investigation was performed individually with measuring of the general (length and weight of body) and particular sizes (the longitudinal sizes, the transverse sizes, the circumferences, pelvic sizes and skinfolds thickness). The bony, muscle and fat components of the body mass were calculated. Correlation analysis was performed in the «Statistica 6.1» license package. The arithmetic means of absolute correlation coefficients between particular and total individual sizes of IVDL1-L2, IVDL2-L3, IVDL3-L4, IVDL4-L5 and relative quantity with somatometric parameters were calculated with following results: arithmetic means of absolute correlation coefficients for particular individual sizes are within 0.080 – 0.150; for total sizes – 0.240; for ratio of the total sizes to the mass-growth coefficient – 0.490. Analysis of arithmetic mean values of absolute correlations with somatometric parameters in youth and young adult males in the norm (17-28 years) showed a gradual increase in the values of correlation coefficients and an increase in the number of significant correlations with maximum values in relative indicators. Thus, in youth and young adult males aged 18-28 years, the features of the relationship of somato-anthropometric parameters with the linear dimensions of the intervertebral discs of the lumbar spine in the norm were studied. The numerous relationships between the partial (height, sagittal and transverse sizes) linear dimensions and total sizes of the lumbar intervertebral discs in the youth and young adult males in norm (17-28 years) with their somatometric parameters were found. Thus, the use of relative indicators can be more acceptable in the subsequent mathematical modeling of individual indicators, in particular, the parameters of the intervertebral discs.
Features of electron microscopic changes in the liver of rats aged 24-26 months under conditions of hyperhomocysteinemia
Authors: Halahan Yu. V. , Маievskyi O. Ye. , Guminskyi Yu. Y. , Korol A. P. , Prokopenko S. V.
Published: October 2020

Disruption of the metabolism of the essential amino acid methionine causes the syndrome of hyperhomocysteinemia. This pathological condition is associated with the risk of developing a number of diseases, including chronic liver disease. The mechanisms of liver tissue damage in hyperhomocysteinemia remain poorly understood and require more detailed study. The aim of the study is to establish the features of submicroscopic changes in the liver structure of old rats with hyperhomocysteinemia. The experimental study was performed on 22 white nonlinear old (24-26 months) male rats, which were divided into a control group and an experimental group. A model of persistent hyperhomocysteinemia was created by administering to rats of experimental group of thiolactone homocysteine at a dose of 200 mg/kg body weight intragastrically for 60 days. The study of ultrastructural changes in the lungs of rats was performed using an electron microscope PEM-125K. At experimental hyperhomocysteinemia in a liver of old rats there are changes in all structural components. Mitochondrial destruction and edema were observed in the vascular endothelium. Organelles have an enlightened matrix, a reduced number of cristae. A significant content of destructively altered mitochondria in endothelial cells indicates a failure of adaptation mechanisms. Erythrocyte sludges are observed in the lumens of the sinusoids. The number of fat-accumulating cells decreases, which indicates their transformation into fibroblasts and leads to the growth of collagen fibers, expansion of the sinusoidal spaces and the development of stromal fibrosis.
ANÁLISE CRIMINAL COMO FOMENTADORA DE POLITICAS DE SEGURANÇA PÚBLICA
Authors: Ferreira Rogério Cardoso
Published: October 2020

O crime deixou de ser considerado algo inato do ser humano desde fim da criminologia positiva, o atavismo Lombrosiano demonstra-se insuficiente para justificar a ocorrência do evento criminoso e combatê-lo. Com a evolução trazida pela criminologia sociológica, o ambiente e o contexto social integram aos fatores do crime. A Análise Criminal nasce como um campo de estudo e prática capaz de coletar, colar e organizar os dados e as informações para produzir conhecimento aos tomadores de decisão no campo policial e no campo político, influenciando no triângulo do crime (vítima, infrator e ambiente favorável). No Brasil, a Análise Criminal ainda possui tímida produção de conhecimento para solução de problemas relacionados à segurança pública. As forças policiais concentram-se na esfera federal e estadual, sobrando a esfera municipal as ações de cunho não policial. O presente artigo busca demonstrar como a Análise Criminal pode fomentar as políticas públicas de segurança, em especial no âmbito municipal, aplicando o ciclo PDCA e outras técnicas próprias da Análise Criminal. Utilizar-se-á de relatórios produzidos pelo Núcleo de Estatística e Análise Criminal/Rio Verde-GO, bem como das ações que partiram desses relatórios, demonstrando o método de trabalho e os resultados alcançados a partir dessa metodologia.
AS CRIPTOMOEDAS E A INVESTIGAÇÃO POLICIAL: Desafios e Soluções
Authors: Montenegro Guilherme Augusto de Oliveira
Published: October 2020

As criptomoedas atualmente possuem um papel crescente no mercado de transações financeiras, gerando fortes impactos econômicos e sociais, e, como toda nova tecnologia possuem aspectos positivos, como segurança e privacidade. Por outro lado, também podem ser associadas a aspectos negativos, como sendo potenciais facilitadores de atividades criminosas, uma vez que a regulamentação ainda incipiente pode permitir que sejam menos detectáveis as transações através delas realizadas, bem como dificultar a identificação de seus autores. No entanto, como demonstrado através de pesquisas teóricas e do estudo de casos práticos, através dos princípios que regem essa tecnologia e do histórico de investigações criminais, verifica-se que, apesar das dificuldades, é possível, sim, reprimir a prática de atos delituosos instrumentalizados pelas criptomoedas. Nesse sentido, percebe-se que há necessidade de se manter uma cooperação entre diversos órgãos de controle, uma preparação e capacitação dos policiais em investigar esse tipo de delito, sem abandonar os métodos tradicionais de investigação que complementam os recursos tecnológicos no rastreamento das transações e localização dos autores. Palavras-Chave: Criptomoedas. Lavagem de dinheiro. Investigação Policial. Rastreabilidade das transações.
MÉTODOS DE IDENTIFICAÇÃO POST MORTEM EM NECROPAPILOSCOPIA FORENSE: revisão de literatura
Authors: Delgado Simone Mariana , Mariotti Kristiane de Cassia
Published: October 2020

A Necropapiloscopia Forense é uma área pericial que trata da identificação humana post mortem por meio de impressões digitais. Para a realização da perícia necropapiloscópica os papiloscopistas utilizam métodos convencionais preconizados pela literatura e previstos em manuais e POP’s (procedimentos operacionais padrão). Porém, fenômenos cadavéricos e condições de morte como putrefação, mumificação, carbonização, saponificação e maceração, podem dificultar e até mesmo inviabilizar a obtenção de impressões digitais com qualidade suficiente para exame, o que faz com que muitos cadáveres permaneçam sem identificação. Diante disso, este artigo pretende fazer levantamento e discussão de trabalhos científicos que ofereçam propostas de técnicas de identificação humana post mortem na área de Necropapiloscopia Forense, caracterizando-as, descrevendo-as e avaliando-as, para que possam ser direcionadas à prática forense, fundamentada em conhecimento científico. A revisão integrativa foi eleita como metodologia de pesquisa. Buscou-se publicações completas sobre a temática no período de janeiro/2002 a março/2019, nas bases de dados Scopus, Pubmed e Google Scholar, nos idiomas português e inglês. 17 publicações enquadraram-se no critério de inclusão. As técnicas recomendadas incluem desde procedimentos manuais, relativamente simples, como técnica do pó e técnica da moldagem; à procedimentos mais complexos, como as técnicas de maceração química que exigem excisão de falanges e tratamento com reagentes químicos. As novas tendências apontam o uso da tecnologia como câmeras fotográficas, smartphones, scanners agregados a softwares para captura digital de impressões digitais e compartilhamento em tempo real das imagens, bem como, dos fatores de correção do sistema AFIS, uma vez que resolvem problemas como encolhimento e colapso das estruturas dos dedos. Os resultados encontrados neste estudo apontam que: métodos de identificação post mortem em Necropapiloscopia é uma área ainda pouco explorada pela literatura forense, principalmente aqui no Brasil; há necessidade de desenvolvimento de estudos científicos que preencham lacunas na área; as técnicas recomendadas na literatura devem ter continuidade na prática forense, para que possam ser devidamente aplicadas, aprimoradas, difundidas e incluídas em protocolos e POP’s da área, visando a melhoria significativa nos resultados que envolvam identificação humana de  cadáveres em diferentes estágios e condições de morte.
EXPEDIENTE
Authors: RBCP Equipe Editorial
Published: October 2020

RBCP
Editorial: A PERÍCIA CRIMINAL COMO INSTRUMENTO DE PROMOÇÃO DOS DIREITOS HUMANOS
Authors: Melo Cristiano Barros de
Published: October 2020

O trabalho da polícia judiciária é complexo e envolve, entre outras questões, o cumprimento da sua missão constitucional, o respeito ao devido processo legal, os direitos humanos, a inteligência, o sigilo e a confidencialidade, a habilidade em lidar com a grande diversidade de casos e a fundamentação no conhecimento técnico e científico balizados pelas ciências forenses. Esse último é um dos fatores mais cruciais, em vista da grande diversidade da natureza humana, das condições e das diferenças sociais, do contingenciamento de recursos financeiros disponibilizados para os estudos e estímulo aos profissionais para capacitação e as inovações. Por outro lado, visto que a prática das organizações criminosas é orientada por uma ruptura com o ideal ético que pauta as normas legais, há de se considerar o alto potencial de adaptação que possuem para se evadir do escopo da justiça, o que promove, geralmente, uma luta desigual entre o crime e as forças policiais, além dos inerentes prejuízos à sociedade.
Actualización sobre patología tiroidea durante el embarazo
Authors: Fernandez Vaglio Roxana , Pérez Céspedes Natalia
Published: October 2020

Las alteraciones de la función tiroidea son un conjunto de patologías relativamente comunes en la población general. Estas patologías también se pueden presentar durante el embarazo y de no ser diagnosticadas y tratadas de forma oportuna pueden ocasionar complicaciones para la mujer gestante e incluso causar afectación fetal. El diagnóstico de la disfunción tiroidea durante el embarazo se realiza mediante la cuantificación de los niveles sanguíneos de TSH. Por su parte el tratamiento se encuentra bien definido para la patología clínica, ya sea con levotiroxina para el hipotiroidismo o con propiltiouracilo y derivados de imidazol para el hipertiroidismo. La terapéutica para el manejo de pacientes con enfermedad subclínica no se encuentra bien definido.
Alopecia areata
Authors: Rivas López Pedro Javier
Published: October 2020

La alopecia areata es una enfermedad de origen multifactorial en la cual intervienen la presencia de factores genéticos, ambientales y autoinmunes locales del folículo piloso que terminan causando la pérdida de cabello. Las presentaciones clínicas pueden ser diversas desde el sisaifo hasta la alopecia universalis o alopecia totalis y aunque se trata de una condición benigna, se ha encontrado una importante asociación con otras enfermedades autoinmunes de carácter no tan benigno. Aunque se desconocen todas las vías fisiopatológicas, se ha documentado evidencia clara de una disregulación de las vías de señalización mediadas por las Janus kinasas entre otras. Actualmente existen múltiples tratamientos tópicos y orales para la Alopecia Areata con resultados variables, los inhibidores de Janus Kinasa son una nueva opción terapéutica en investigación.
Safinamida como tratamiento complementario al levodopa para la enfermedad del Parkinson en fase media o avanzada
Authors: Mc Donald Molina Christa , Tully Sancho Stephanie , Lizano Salas Marco
Published: October 2020

La safinamida es un medicamento novedoso tanto con dopaminérgico como efectos no dopaminérgicos. Su mecanismo funciona como un inhibidor selectivo reversible de la monoaminooxidasa-B aprobado como tratamiento complementario a la levodopa en pacientes con enfermedad de Parkinson de etapa media a tardía y fluctuaciones motoras. La safinamida no causa discinesia nueva ni empeora la existente sino es capaz de reducir este síntoma en estos pacientes.
THE ISSUE OF DENATIONALIZATION IN HISTORICAL PROSE OF I. NECHUI-LEVYTSKYI (THE CASE OF NOVEL “KNIAZ JEREMIAH VYSHNEVETSKYI”)
Authors: Vilna Yaroslava Volodymyrivna
Published: October 2020

The article considers the format of figurative thinking of the classic of Ukrainian realistic literature of the XIX century – I. Nechui-Levytskyi – in the field of historical prose. The novel “Kniaz Jeremiah Vyshnevetskyi”, which considers the problem of denationalization, is analysed. The peculiarities of the author's optics in tracking the formation of conformist features and later a renegade, in the descendant of the glorious Ukrainian family of Jeremiah Vyshnevetskyi are recorded. The author's opinion on the role of education, objective realities and individual psychology in the processes of formation and deformation of personality on the example of the protagonist of the work, the prototype of which was a real historical figure, is taken into account.
New genus and species of the tribe Gryllini (Orthoptera: Gryllidae: Gryllinae) from Peru
Authors: Gorochov A.V.
Published: October 2020

A new genus with a new species (Itarogryllus proprius gen. et sp. nov.) from the tribe Gryllini are described from Peru. Possible belonging of this genus to the subtribe Brachytripina is discussed. The genus is similar to Brachytrupina in the structure of its male ectoparameres but differs from all other genera of this subtribe in its small body size in combination with the following characters: male tegmen wide and having a wide mirror; epiphallus characteristic, having a pair of arcuate posterior lobes; ectoparamere with a complete fusion of the apical and proximal parts, with a developed but very narrow and completely isolated mesal lobe, and with poserodorsal sclerite having a very short and rounded “spine-like process” at the apex.
Fiery Streams of Lava, Frozen into Memory. Many Farewells to War
Authors: Koselleck Reinhart , Pernau Margrit , Tremblay Sébastien
Published: October 2020

The bells tolling on 9 May 1945 were heralding peace. The question remained: what kind of peace and for whom? Thousands of us marched on a trail for many kilometers, from Mährish-Ostrau eastward, like a silent accordion, sometimes extended, sometimes compressed, chased, not knowing where we were going. The voices of the bells echoed over our column and raised hopes from whose nonfulfillment countless people would perish, not being able to bear the disappointments of the new forthcoming peace. However, it was all unknown to us, we did not even know where we were going. Yet we knew where we were coming from, from the cauldron that had continuously tightened over four weeks, and from which we had definitely failed to escape on 1 May. With a wounded soldier on my back, I laid down my gun. At that point, we didn’t know yet that the Americans would hand all the prisoners that had reached the redemptive West from Bohemia and Moravia back to the Russians. So this fight had been futile and every death in vain. The dead were still lying around in countless numbers.
Dealing with an Ocean of Meaninglessness
Authors: Pernau Margrit , Tremblay Sébastien
Published: October 2020

During his prolific career, Reinhart Koselleck left his mark on a myriad of topics beyond the history of concepts: iconology, memory, and temporality. The first part of this piece is a never before published English translation of one of Koselleck’s numerous public interventions. Second, taking as a starting point his reflection about the end of the war and the impossibility to collectivize certain memories, this article links his considerations about the unsayable with his work on images and political sensuality. Going beyond a simple analysis of Koselleck’s writings, the article opens a dialogue between the history of concepts and affective memories, offering news ways to link experiences, emotions, and practices while underlining the limits of communication and collective memory.
To drill or not to drill, that is the question: nonsurgical treatment of chronic subdural hematoma in the elderly. A systematic review
Authors: Scerrati Alba , Visani Jacopo , Ricciardi Luca , Dones Flavia , Rustemi Oriela , Cavallo Michele Alessandro , De Bonis Pasquale
Published: October 2020

OBJECTIVE

Chronic subdural hematoma (CSDH) is one of the most common neurosurgical pathologies, typically affecting the elderly. Its incidence is expected to grow along with the aging population. Surgical drainage represents the treatment of choice; however, postoperative complications and the rate of recurrence are not negligible. For this reason, nonsurgical alternatives (such as middle meningeal artery embolization, steroids, or tranexamic acid administration) are gaining popularity worldwide and need to be carefully evaluated, especially in the elderly population.

METHODS

The authors performed a systematic review according to PRISMA criteria of the studies analyzing the nonsurgical strategies for CSDHs. They collected all papers in the English language published between 1990 and 2019 by searching different medical databases. The chosen keywords were “chronic subdural hematoma,” “conservative treatment/management,” “pharmacological treatment,” “non-surgical,” “tranexamic acid,” “dexamethasone,” “corticosteroid,” “glucocorticoid,” “middle meningeal artery,” “endovascular treatment,” and “embolization.”

RESULTS

The authors ultimately collected 15 articles regarding the pharmacological management of CSDHs matching the criteria, and 14 papers included the endovascular treatment.

CONCLUSIONS

The results showed that surgery still represents the mainstay in cases of symptomatic patients with large CSDHs; however, adjuvant and alternative therapies can be effective and safe in a carefully selected population. Their inclusion in new guidelines is advisable.
Is age an additional factor in the treatment of elderly patients with glioblastoma? A new stratification model: an Italian Multicenter Study
Authors: Ius Tamara , Somma Teresa , Altieri Roberto , Angileri Filippo Flavio , Barbagallo Giuseppe Maria , Cappabianca Paolo , Certo Francesco , Cofano Fabio , D’Elia Alessandro , Della Pepa Giuseppe Maria , Esposito Vincenzo , Fontanella Marco Maria , Germanò Antonino , Garbossa Diego , Isola Miriam , La Rocca Giuseppe , Maiuri Francesco , Olivi Alessandro , Panciani Pier Paolo , Pignotti Fabrizio , Skrap Miran , Spena Giannantonio , Sabatino Giovanni
Published: October 2020

OBJECTIVE

Approximately half of glioblastoma (GBM) cases develop in geriatric patients, and this trend is destined to increase with the aging of the population. The optimal strategy for management of GBM in elderly patients remains controversial. The aim of this study was to assess the role of surgery in the elderly (≥ 65 years old) based on clinical, molecular, and imaging data routinely available in neurosurgical departments and to assess a prognostic survival score that could be helpful in stratifying the prognosis for elderly GBM patients.

METHODS

Clinical, radiological, surgical, and molecular data were retrospectively analyzed in 322 patients with GBM from 9 neurosurgical centers. Univariate and multivariate analyses were performed to identify predictors of survival. A random forest approach (classification and regression tree [CART] analysis) was utilized to create the prognostic survival score.

RESULTS

Survival analysis showed that overall survival (OS) was influenced by age as a continuous variable (p = 0.018), MGMT (p = 0.012), extent of resection (EOR; p = 0.002), and preoperative tumor growth pattern (evaluated with the preoperative T1/T2 MRI index; p = 0.002). CART analysis was used to create the prognostic survival score, forming six different survival groups on the basis of tumor volumetric, surgical, and molecular features. Terminal nodes with similar hazard ratios were grouped together to form a final diagram composed of five classes with different OSs (p < 0.0001). EOR was the most robust influencing factor in the algorithm hierarchy, while age appeared at the third node of the CART algorithm. The ability of the prognostic survival score to predict death was determined by a Harrell’s c-index of 0.75 (95% CI 0.76–0.81).

CONCLUSIONS

The CART algorithm provided a promising, thorough, and new clinical prognostic survival score for elderly surgical patients with GBM. The prognostic survival score can be useful to stratify survival risk in elderly GBM patients with different surgical, radiological, and molecular profiles, thus assisting physicians in daily clinical management. The preliminary model, however, requires validation with future prospective investigations. Practical recommendations for clinicians/surgeons would strengthen the quality of the study; e.g., surgery can be considered as a first therapeutic option in the workflow of elderly patients with GBM, especially when the preoperative estimated EOR is greater than 80%.
The role of frailty in geriatric cranial neurosurgery for primary central nervous system neoplasms
Authors: Shahrestani Shane , Lehrich Brandon M. , Tafreshi Ali R. , Brown Nolan J. , Lien Brian V. , Ransom Seth , Ransom Ryan C. , Ballatori Alexander M. , Ton Andy , Chen Xiao T. , Sahyouni Ronald
Published: October 2020

OBJECTIVE

Frailty is a clinical state of increased vulnerability due to age-associated decline and has been well established as a perioperative risk factor. Geriatric patients have a higher risk of frailty, higher incidence of brain cancer, and increased postoperative complication rates compared to nongeriatric patients. Yet, literature describing the effects of frailty on short- and long-term complications in geriatric patients is limited. In this study, the authors evaluate the effects of frailty in geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm.

METHODS

The authors conducted a retrospective cohort study of geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm between 2010 and 2017 by using the Nationwide Readmission Database. Demographics and frailty were queried at primary admission, and readmissions were analyzed at 30-, 90-, and 180-day intervals. Complications of interest included infection, anemia, infarction, kidney injury, CSF leak, urinary tract infection, and mortality. Nearest-neighbor propensity score matching for demographics was implemented to identify nonfrail control patients with similar diagnoses and procedures. The analysis used Welch two-sample t-tests for continuous variables and chi-square test with odds ratios.

RESULTS

A total of 6713 frail patients and 6629 nonfrail patients were identified at primary admission. At primary admission, frail geriatric patients undergoing cranial neurosurgery had increased odds of developing acute posthemorrhagic anemia (OR 1.56, 95% CI 1.23–1.98; p = 0.00020); acute infection (OR 3.16, 95% CI 1.70–6.36; p = 0.00022); acute kidney injury (OR 1.32, 95% CI 1.07–1.62; p = 0.0088); urinary tract infection prior to discharge (OR 1.97, 95% CI 1.71–2.29; p < 0.0001); acute postoperative cerebral infarction (OR 1.57, 95% CI 1.17–2.11; p = 0.0026); and mortality (OR 1.64, 95% CI 1.22–2.24; p = 0.0012) compared to nonfrail geriatric patients receiving the same procedure. In addition, frail patients had a significantly increased inpatient length of stay (p < 0.0001) and all-payer hospital cost (p < 0.0001) compared to nonfrail patients at the time of primary admission. However, no significant difference was found between frail and nonfrail patients with regard to rates of infection, thromboembolism, CSF leak, dural tear, cerebral infarction, acute kidney injury, and mortality at all readmission time points.

CONCLUSIONS

Frailty may significantly increase the risks of short-term acute complications in geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm. Long-term analysis revealed no significant difference in complications between frail and nonfrail patients. Further research is warranted to understand the effects and timeline of frailty in geriatric patients.
Morbidity and mortality in elderly patients undergoing evacuation of acute traumatic subdural hematoma
Authors: Kerezoudis Panagiotis , Goyal Anshit , Puffer Ross C. , Parney Ian F. , Meyer Fredric B. , Bydon Mohamad
Published: October 2020

OBJECTIVE

Acute traumatic subdural hematoma (atSDH) can be a life-threatening neurosurgical emergency that necessitates immediate evacuation. The elderly population can be particularly vulnerable to tearing bridging veins. The aim of this study was to evaluate inpatient morbidity and mortality, as well as predictors of inpatient mortality, in a national trauma database.

METHODS

The authors queried the 2016–2017 National Trauma Data Bank registry for patients aged 65 years and older who had undergone evacuation of atSDH. Patients were categorized into three age groups: 65–74, 75–84, and 85+ years. A multivariable logistic regression model was fitted for inpatient mortality adjusting for age group, sex, race, presenting Glasgow Coma Scale (GCS) category (3–8, 9–12, and 13–15), Injury Severity Score, presence of coagulopathy, presence of additional hemorrhages (epidural hematoma [EDH], intraparenchymal hematoma [IPH], and subarachnoid hemorrhage [SAH]), presence of midline shift > 5 mm, and pupillary reactivity (both, one, or none).

RESULTS

A total of 2508 patients (35% females) were analyzed. Age distribution was as follows: 990 patients at 65–74 years, 1096 at 75–84, and 422 at 85+. Midline shift > 5 mm was present in 72% of cases. With regard to additional hemorrhages, SAH was present in 21%, IPH in 10%, and EDH in 2%. Bilaterally reactive pupils were noted in 90% of patients. A major complication was observed in 14.4% of patients, and the overall mortality rate was 18.3%. In the multivariable analysis, the presenting GCS category was found to be the strongest predictor of postoperative inpatient mortality (3–8 vs 13–15: OR 3.63, 95% CI 2.68–4.92, p < 0.001; 9–12 vs 13–15: OR 2.64, 95% CI 1.79–3.90, p < 0.001; 30% of overall variation), followed by the presence of SAH (OR 2.86, 95% CI 2.21–3.70, p < 0.001; 25% of overall variation) and the presence of midline shift > 5 mm (OR 2.40, 95% CI 1.74–3.32, p < 0.001; 11% of overall variation). Model discrimination was excellent (c-index 0.81). Broken down by age decile group, mortality increased from 8.0% to 15.4% for GCS 13–15 to around 36% for GCS 9–12 to almost as high as 60% for GCS 3–8, particularly in those aged 85 years and older.

CONCLUSIONS

The present results from a national trauma database will, the authors hope, assist surgeons in preoperative discussions with patients and their families with regard to expected postoperative outcomes following surgical evacuation of an atSDH.
Magnetic resonance–guided laser interstitial thermal therapy for brain tumors in geriatric patients
Authors: Ginalis Elizabeth E. , Danish Shabbar F.
Published: October 2020

OBJECTIVE

There is a paucity of studies assessing the use of MR-guided laser interstitial thermal therapy (LITT), specifically in the elderly population. The aim of this study was to evaluate the safety of LITT for brain tumors in geriatric patients.

METHODS

Geriatric patients (≥ 65 years of age) treated with LITT for intracranial tumors at a single institution between January 2011 and November 2019 were retrospectively identified. The authors grouped patients into two distinct age cohorts: 65–74 years (group 1) and 75 years or older (group 2). Baseline characteristics, operative parameters, postoperative course, and morbidity were recorded for each patient.

RESULTS

Fifty-five geriatric patients underwent 64 distinct LITT procedures for brain tumors. The majority of lesions (40 [62.5%]) treated were recurrent brain metastases or radiation necrosis. The median modified frailty index was 0.1 (low frailty; range 0–0.4) for patients in group 1 and 0.2 (intermediate frailty; range 0–0.4) for patients in group 2 (p > 0.05). The median hospital length of stay (LOS) was 1 day (IQR 1–2 days); there was no significant difference in LOS between the age groups. The hospital stay was significantly longer in patients who presented with a neurological symptom and in those who experienced a postoperative complication. The majority of patients (43 [68.3%] of 63 cases) were fit for discharge to their preoperative accommodation following LITT. The rate of discharge to home was not significantly different between the age groups. Those discharged to rehabilitation facilities were more likely to have presented with a neurological symptom. Nine patients (14.1% of cases) were found to have acute neurological complications following LITT, with nearly all patients showing complete or partial recovery at follow-up. The 30-day postoperative mortality rate was 1.6% (1 case). The complication and 30-day postoperative mortality rates were not significantly different between the two age groups.

CONCLUSIONS

LITT can be considered a minimally invasive and safe neurosurgical procedure for the treatment of intracranial tumors in geriatric patients. Careful preoperative preparation and postoperative care is essential as LITT is not without risk. Appropriate patient selection for cranial surgery is essential, because neurosurgeons are treating an increasing number of elderly patients, but advanced age alone should not exclude patients from LITT without considering frailty and comorbidities.
Risk factors, comorbidities, quality of life, and complications after surgery in idiopathic normal pressure hydrocephalus: review of the INPH-CRasH study
Authors: Israelsson Hanna , Larsson Jenny , Eklund Anders , Malm Jan
Published: October 2020

OBJECTIVE

Idiopathic normal pressure hydrocephalus (INPH) is a dementia treatable by insertion of a shunt that drains CSF. The cause of the disease is unknown, but a vascular pathway has been suggested. The INPH-CRasH (Comorbidities and Risk Factors Associated with Hydrocephalus) study was a modern epidemiological case-control study designed to prospectively assess parameters regarding comorbidities and vascular risk factors (VRFs) for INPH, quality of life (QOL), and adverse events in patients with shunted INPH. The objective of this review was to summarize the findings of the INPH-CRasH study.

METHODS

VRFs, comorbidities, QOL, and adverse events were analyzed in consecutive patients with INPH who underwent shunt placement between 2008 and 2010 in 5 of 6 neurosurgical centers in Sweden. Patients (n = 176, within the age span of 60–85 years and not having dementia) were compared to population-based age- and gender-matched controls (n = 368, same inclusion criteria as for the patients with INPH). Assessed parameters were as follows: hypertension; diabetes; obesity; hyperlipidemia; psychosocial factors (stress and depression); smoking status; alcohol intake; physical activity; dietary pattern; cerebrovascular, cardiovascular, or peripheral vascular disease; epilepsy; abdominal pain; headache; and clinical parameters before and after surgery. Parameters were assessed through questionnaires, clinical examinations, measurements, ECG studies, and blood samples.

RESULTS

Four VRFs were independently associated with INPH: hyperlipidemia, diabetes, obesity, and psychosocial factors. Physical inactivity and hypertension were also associated with INPH, although not independently from the other risk factors. The population attributable risk percent for a model containing all of the VRFs associated with INPH was 24%. Depression was overrepresented in patients with INPH treated with shunts compared to the controls (46% vs 13%, p < 0.001) and the main predictor for low QOL was a coexisting depression (p < 0.001). Shunting improved QOL on a long-term basis. Epilepsy, headache, and abdominal pain remained common for a mean follow-up time of 21 months in INPH patients who received shunts.

CONCLUSIONS

The results of the INPH-CRasH study are consistent with a vascular pathophysiological component of INPH. In clinical care and research, a complete risk factor analysis as well as screening for depression and a measurement for QOL should probably be included in the workup of patients with INPH. The effect of targeted interventions against modifiable VRFs and antidepressant treatment in INPH patients should be evaluated. Seizures, headache, and abdominal pain should be inquired about at postoperative follow-up examinations.