bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebellopontine angle meningiomas: postoperative outcomes in a modern cohort
Authors: Agarwal Vijay , Babu Ranjith , Grier Jordan , Adogwa Owoicho , Back Adam , Friedman Allan H. , Fukushima Takanori , Adamson Cory 
Published: December 2013

Object
Tumors of the cerebellopontine angle (CPA) have always proven difficult for neurosurgeons to optimally manage. Studies investigating the natural history and treatment of vestibular schwannomas have dominated the literature in this regard. Distinguishing meningiomas from schwannomas in this location carries particular importance as each tumor type has certain prognostic and surgical considerations. In this study, the authors have characterized the outcomes of 34 patients surgically treated for CPA meningiomas and have investigated various factors that may affect postoperative neurological function.

Methods
The medical records of patients with CPA meningiomas who underwent surgery from 2005 to 2013 at the Duke University Health System were reviewed. Various patient, clinical, and tumor data were gathered from the medical records including patient demographics, pre- and postoperative neurological examinations, duration of symptoms, procedural details, tumor pathology and size, and treatment characteristics. Differences in continuous variables were then analyzed using the Student t-test while categorical variables were evaluated using the chi-square test.

Results
A total of 34 patients underwent surgical treatment for CPA meningiomas during the 8-year period. Jugular foramen invasion was seen in 17.6% of tumors, with nearly half (41.2%) extending into the internal acoustic canal. The most common presenting symptom was hearing loss (58.8%), followed by headache (52.9%) and facial numbness/pain (50.0%). The most common cranial nerve (CN) affected was CN X (11.8%), followed by CNs VI and VII (5.9%). Postoperatively, no patients experienced a decrease in hearing, with only 5.9% of patients experiencing facial nerve palsies. Patients with tumors larger than 3 cm had a significantly higher incidence of permanent CN deficits than those with smaller tumors (45.5% vs 5.9%, respectively; p = 0.011). Also, tumor extension into the jugular foramen was associated with the occurrence of lower CN deficits, none of which occurred in tumors without jugular foramen invasion. Internal acoustic canal tumor extension was not seen to be associated with postoperative complications or CN deficits.

Conclusions
Meningiomas of the CPA are challenging lesions to treat surgically. However, the risk of facial palsy and hearing loss is significantly lower when compared with vestibular schwannomas. Novel methods for preoperative differentiation are needed to appropriately counsel patients on surgical risks. Also, due to the significant potential for neurological deficits, further studies are needed to investigate the utility of radiotherapy for these lesions.
Endoscopic extended transsphenoidal resection of tuberculum sellae meningiomas: nuances of neurosurgical technique
Authors: Kulwin Charles , Schwartz Theodore H. , Cohen-Gadol Aaron A. 
Published: December 2013

Over the past decade, advances in endoscopic microsurgical techniques have resulted in an increasingly aggressive endonasal approach to tumors of the midline skull base. Meningiomas of the tuberculum sellae are often closely associated with cerebrovascular structures, and their removal has traditionally required a transcranial approach. An endonasal approach offers many advantages, including early tumor devascularization and tumor debulking (without manipulation of the optic apparatus), direct access to the medial optic canal, and a minimal-access corridor.
Although recent articles have focused on techniques for reaching and approaching the area of the pathology (how to get there), the authors of this report discuss the technical nuances of endoscopic microsurgery when the operator is already “there.” They describe their 6-step technique for endoscopic skull base bone removal, tumor dissection/resection, and closure. They also augment their description with elaborate illustrations.
Petroclival meningiomas: an update on surgical approaches, decision making, and treatment results
Authors: Xu Feng , Karampelas Ioannis , Megerian Cliff A. , Selman Warren R. , Bambakidis Nicholas C. 
Published: December 2013

Object
Petroclival meningiomas remain a formidable challenge for neurosurgeons because of their location deep within the skull base and proximity to eloquent neurovascular structures. Various skull base approaches have been used in their treatment, and deciding which is the optimal one remains controversial. Attempts at achieving gross- or near-total resections are associated with an increased rate of morbidity and mortality. As adjunctive treatment options such as stereotactic radiosurgery have been developed and become widely available, there has been a trend toward accepting subtotal resections in an effort to minimize neurological morbidity. This paper reviews a recent series of patients with petroclival meningiomas and highlights current management trends and important considerations useful in surgical decision making.

Methods
The records of patients with large (> 3 cm) petroclival meningiomas surgically treated by the senior author over the past 5 years were reviewed. The clinical results are presented as examples of the surgical approaches available for approaching these tumors, and treatment options are reviewed.

Results
Of 196 meningiomas surgically treated during the study period, 8 lesions in 8 patients met the study criteria. Overall clinical results were excellent, with no death or major morbidity. Intracranial gross- or near-total resection (Simpson Grade 1, 2, or 3) was achieved in 5 patients (67%). New cranial nerve deficits occurred in 3 patients (37%) and were more common in patients in whom a subtotal resection was performed (2 of 3 cases). A variety of surgical approaches were used. Important considerations determining the best approach include the location of the tumor relative to the internal auditory canal, the presence of preoperative hearing loss, and the location of the tumor relative to the tentorium.

Conclusions
Achieving gross- or near-total resections of large petroclival meningiomas remains achievable and should be the primary goal of surgical treatment. A retrosigmoid craniotomy remains a workhorse surgical approach for most petroclival tumors of any size. Tumors that are medial to the internal auditory canal and span both middle and posterior cranial fossae are often best treated with a combined transpetrosal approach, which is especially true if there is a preoperative hearing deficit.
Controversies in the role of preoperative embolization in meningioma management
Authors: Singla Amit , Deshaies Eric M. , Melnyk Vlad , Toshkezi Gentian , Swarnkar Amar , Choi Hoon , Chin Lawrence S. 
Published: December 2013

The role of preoperative embolization in meningioma management remains controversial, even though 4 decades have passed since it was first described. It has been shown to offer benefits such as decreased blood loss and “softening of the tumor” during subsequent resection. However, the actual benefits remain unclear, and the potential harm of an additional procedure along with the cost of embolization have limited its use to a small proportion of the meningiomas treated.
In this article the authors retrospectively reviewed their experience with preoperative embolization of meningiomas over the previous 6 years (March 2007–March 2013). In addition, they performed a MEDLINE search using a combination of the terms “meningioma,” “preoperative,” and “embolization” to analyze the indications, embolizing agents, timing, and complications reported during preoperative embolization of meningiomas. In this retrospective review, 18 cases (female/male ratio 12:6) were identified in which endovascular embolization was used prior to resection of an intracranial meningioma. Craniotomy for tumor resection was performed within 4 days after endovascular embolization in all cases, with an average time to surgery of 1.9 days. The average duration of surgery was 4 hours and 18 minutes, and the average blood loss was 574 ml, with a range of 300–1000 ml. Complications following endovascular therapy were identified in 3 (16.7%) of 18 cases, including one each of transient hemiparesis, permanent hemiparesis, and tumor swelling.
The literature review returned 15 articles consisting of a study population greater than 25 patients. No randomized controlled study was found. The use of small polyvinyl alcohol particles (45–150 μm) is more effective in preoperative devascularization than larger particles (150–250 μm), but is criticized due to the higher risk of complications such as cranial nerve palsies and postprocedural hemorrhage. Time to surgery after embolization is inconsistently reported across the articles, and conclusions on the appropriate timing of surgery could not be drawn. The overall complication rate reported after treatment with preoperative meningioma embolization ranges from as high as 21% in some of the older literature to approximately 6% in recent literature describing treatment with newer embolization techniques. The evidence in the literature supporting the use of preoperative meningioma embolization is mainly from case series, and represents Level III evidence. Due to the lack of randomized controlled clinical trials, it is difficult to draw any significant conclusions on the overall usefulness of preoperative embolization during the management of meningiomas to consider it a standard practice.
The role of radiosurgery in the management of WHO Grade II and III intracranial meningiomas
Authors: Ding Dale , Starke Robert M. , Hantzmon John , Yen Chun-Po , Williams Brian J. , Sheehan Jason P. 
Published: December 2013

Object
WHO Grade II and III intracranial meningiomas are uncommon, but they portend a significantly worse prognosis than their benign Grade I counterparts. The mainstay of current management is resection to obtain cytoreduction and histological tissue diagnosis. The timing and benefit of postoperative fractionated external beam radiation therapy and stereotactic radiosurgery remain controversial. The authors review the stereotactic radiosurgery outcomes for Grade II and III meningiomas.

Methods
A comprehensive literature search was performed using PubMed to identify all radiosurgery series reporting the treatment outcomes for Grade II and III meningiomas. Case reports and case series involving fewer than 10 patients were excluded.

Results
From 1998 to 2013, 19 radiosurgery series were published in which 647 Grade II and III meningiomas were treated. Median tumor volumes were 2.2–14.6 cm3. The median margin doses were 14–21 Gy, although generally the margin doses for Grade II meningiomas were 16–20 Gy and the margin doses for Grade III meningiomas were 18–22 Gy. The median 5-year PFS was 59% for Grade II tumors and 13% for Grade III tumors, which may have been affected by patient age, prior radiation therapy, tumor volume, and radiosurgical dose and timing. The median complication rate following radiosurgery was 8%.

Conclusions
The current data for radiosurgery suggest that it has a role in the management of residual or recurrent Grade II and III meningiomas. However, better studies are needed to fully define this role. Due to the relatively low prevalence of these tumors, it is unlikely that prospective studies will be feasible. As such, well-designed retrospective analyses may improve our understanding of the effect of radiosurgery on tumor recurrence and patient survival and the incidence and impact of treatment-induced complications.
Clinical, Functional, and Radiographic Implications of Time to Treatment Response in Patients With Early Rheumatoid Arthritis: a Posthoc Analysis of the PREMIER Study
Authors: Keystone Edward C. , Haraoui Boulos , Guérette Benoît , Mozaffarian Neelufar , Liu Shufang , Kavanaugh Arthur 
Published: December 2013

Objective.Rheumatoid arthritis (RA) treatment recommendations suggest target attainment within the first 3 months of therapy, yet delayed clinical responses can occur. This analysis assessed the longterm clinical, functional, and radiographic outcomes associated with delayed responses to methotrexate (MTX) monotherapy or to the combination of adalimumab (ADA) + MTX.Methods.In this posthoc analysis, patients with early RA who received MTX monotherapy or ADA + MTX in the PREMIER study were categorized based on clinical responses at 3 and 6 months [American College of Rheumatology response, 28-joint Disease Activity Score (DAS28)-C-reactive protein (CRP) improvement and targets]. “Month 3” responders met the clinical measure at both months 3 and 6, and “Month 6” responders met the clinical measure only at Month 6. The odds of achieving longterm outcomes [remission (DAS28-CRP < 2.6), normal function (Health Assessment Questionnaire-Disability Index < 0.5), or rapid radiographic progression (Δ modified total Sharp score > 3 U/yr)] were modeled using logistic regression, including treatment, response, and interaction.Results.A delayed or low-level response was associated with poorer longterm outcomes. Generally, MTX Month 6 responders demonstrated worse clinical, functional, and radiographic outcomes than Month 3 MTX and Month 3 or 6 ADA + MTX responders. Although similar longterm benefit was observed for ADA + MTX responders, delayed (Month 6) responders exhibited downward trends in clinical, functional, and radiographic outcomes that were comparable with those experienced by Month 3 MTX responders.Conclusion.Response speed and magnitude predict longterm outcomes in patients with early RA treated with MTX or ADA + MTX. MTX-treated patients failing to demonstrate a Month 3 clinical response have less-favorable outcomes than other groups, while outcomes in ADA + MTX Month 3 and Month 6 responders tended to be comparable.
Extubation With or Without Spontaneous Breathing Trial
Authors: Wang Jing , Ma Yingmin , Fang Qiuhong 
Published: December 2013

Purpose—
To evaluate whether spontaneous breathing trials (SBTs) are necessary when extubating critical care patients.

Methods—
A prospective, randomized, double-blind study was performed in adult patients supported by mechanical ventilation for at least 48 hours in the general intensive care unit of a teaching hospital. Patients ready for weaning were randomly assigned to either the SBT group (extubation with an SBT) or the no-SBT group (extubation without an SBT). Patients in the SBT group who tolerated SBT underwent immediate extubation. Patients in the no-SBT group who met the weaning readiness criteria underwent extubation without an SBT. The primary outcome measure was a successful extubation or the ability to maintain spontaneous breathing for 48 hours after extubation.

Results—
A total of 139 adult patients were enrolled. No significant difference in the demographic, respiratory, and hemodynamic characteristics was indicated between the groups at the end of weaning readiness assessment. Successful extubation was achieved in 56 of 61 patients (91.8%) in the SBT group and 54 of 60 patients (90.0%) in the no-SBT group. In the SBT and no-SBT groups, 5 (8.2%) and 6 (10.0%) patients, respectively, needed reintubation; 7 (11.5%) and 9 (15.0%) patients, respectively, required noninvasive ventilation after extubation. In-hospital mortality did not differ significantly between the groups.

Conclusion—
Intensive care patients can be extubated successfully without an SBT.
Numerical Simulation of Unidirectional Stratified Flow by Moving Particle Semi Implicit Method
Authors: Rong Shaoshan , Li Haiwang , Skote Martin , Wong Teck Neng , Duan Fei 
Published: December 2013

AbstractNumerical simulation of stratified flow of two fluids between two infinite parallel plates using the Moving Particle Semi-implicit (MPS) method is presented. The developing process from entrance to fully development flow is captured. In the simulation, the computational domain is represented by various types of particles. Governing equations are described based on particles and their interactions. Grids are not necessary in any calculation steps of the simulation. The particle number density is implicitly required to be constant to satisfy incompressibility. The weight function is used to describe the interaction between different particles. The particle is considered to constitute the free interface if the particle number density is below a set point. Results for various combinations of density, viscosity, mass flow rates, and distance between the two parallel plates are presented. The proposed procedure is validated using the derived exact solution and the earlier numerical results from the Level-Set method. Furthermore, the evolution of the interface in the developing region is captured and compares well with the derived exact solutions in the developed region.
Educational innovations for empowering teachers in acomplishing better education in Indonesia
Authors: Ramdhani Neila , Ancok Djamaludin 
Published: December 2013

AbstractAn assessment of Indonesian teacher competence, conducted nationally in 1999, indicated that
there were less than 25% of teachers meeting the national standard requirement. To address the
pressing need of improving their competence, the Ministry of National Education (MONE) issued
Regulation No. 16/2077 on teacher competence certification. The Teacher Quality Improvement
(TQI) program was invented to address the requirement in accordance with the regulation. TQI
focuses on facilitating teachers to be inspiring teachers and equipping them with capacity to
implement a sound teaching method.
Occupational standards quality procedure
Authors: Klaffke Henning 
Published: December 2013

AbstractThis paper was presented at the Global Innovators 2013 Conference in Doha, Qatar. The issue of
assessing the quality of occupational standards is important as a first step to identify the needs
of a countries vocational training system. Elaborate methods like DACUM and functional analysis
can be applied to develop occupational standards. Subject matter experts usually assess the
results and quality of the standard development. This assessment does not rely on objective
scientific evidence and is often driven by politics and subjective decision. This manuscript shows
an approach how to apply a quality procedure with reflect the needs of the labor market.
Shift work and cancer screening: Do females who work alternative shifts undergo recommended cancer screening?
Authors: Tsai Rebecca J. , Luckhaupt Sara E. , Sweeney Marie Haring , Calvert Geoffrey M. 
Published: November 2013

AbstractBackgroundAlternative shift work is classified as a probable human carcinogen. Certain cancer screening tests reduce cancer mortality.MethodsThe 2010 National Health Interview Survey was used to examine associations between adherence to breast, cervical, and colon cancer screening recommendations and alternative shift work among female workers.ResultsWorkers on alternative shifts, compared to workers on daytime shifts, were more likely to be non‐adherent to screening recommendations for breast (34% vs. 23%) and colorectal (55% vs. 48%) cancer (P < 0.05). Workers on alternative shifts in two industries (“Manufacturing” and “Accommodation/Food Services”) and three occupations (“Food Preparation/Serving,” “Personal Care Services,” and “Production”) were more likely to be non‐adherent to screening recommendations for at least two cancers (P < 0.05).ConclusionsThe Affordable Care Act eliminates out‐of‐pocket screening expenses for these three cancers. Greater efforts are needed to promote this benefit, particularly among workers with demonstrated non‐adherence. Am. J. Ind. Med. 57:265–275, 2014. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
Preparation of polyvinylchloride membranes from solvent mixture by immersion precipitation
Authors: Maghsoud Zahra , Famili Mohammad Hossein Navid , Madaeni Sayed Siavash 
Published: December 2013

AbstractIn this study, polyvinylchloride (PVC) membranes were prepared through the immersion precipitation method using a mixture of two solvents (tetrahydrofuran (THF) and dimethyl formamide (DMF)), which had different affinities with the nonsolvent (water). Membranes prepared from PVC/THF/water system showed a sponge‐like structure with isolated pores, which were impermeable to water even at a feed pressure of 20 bars, whereas those prepared from PVC/DMF/water exhibited a porous macrovoid containing morphology with a high water flux. The precipitation time and polymer concentration profiles were calculated by using a simple mathematical model and were in good agreement with the experimental findings on PVC/THF/water and PVC/DMF/water systems. By using a mixture of DMF and THF as solvent and changing the mixed solvent composition, membranes with different morphologies from sponge‐like to macrovoid containing were obtained. The membranes showed no water flux below a DMF concentration of 50 wt % and then became increasingly permeable with increasing DMF content in the casting solution. Measurement of the system cloud points showed a linear change of system thermodynamics with variation of the mixed solvent composition. The obtained results showed that although the system thermodynamics could explain the overall behavior of the system, but the local changes such as change of membrane performance from impermeable to permeable at a certain mixed solvent composition could not be explained by the thermodynamics alone. © 2013 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2014, 131, 40206.
The effect of side chains on the reactive rate and surface wettability of pentablock copolymers by ATRP
Authors: Pan Aizhao , He Ling , Yang Shao , Niu Mingjun 
Published: December 2013

AbstractThe reactive rate and surface wettability of three pentablock copolymers PDMS‐b‐(PMMA‐b‐PR)2 (R = 3FMA, 12FMA, and MPS) obtained via ATRP for coatings are discussed. Poly(dimethylsiloxane) (PDMS) is used as difunctional macroinitiator, poly(methyl methacrylate) (PMMA) as the middle block, while poly(trifluoroethyl methacrylate) (P3FMA), poly(dodecafluoroheptyl methacrylate) (P12FMA) and poly(3‐(trimethoxysilyl)propyl methacrylate) (PMPS) as the end block, respectively. Their reactive rates obtained by gas chromatography (GC) analysis indicate that 3FMA gains 8.053 × 10−5 s−1 reactive rate and 75% conversion, higher than 12FMA (4.417 × 10−5 s−1, 35%), but MPS has 1.9389 × 10−4 s−1 reactive rate and 96% conversion. The wettability of pentablock copolymer films is characterized by water contact angles (WCA) and hexadecane contact angles (HCA). The PDMS‐b‐(PMMA‐b‐P12FMA)2 film behaves much higher advancing and receding WAC (120° and 116°) and HCA (60° and 56°) than PDMS‐b‐(PMMA‐b‐P3FMA)2 film (110° and 106° for WAC, 38° and 32° for HAC) because of its fluorine‐rich surface (20.9 wt % F). However, PDMS‐b‐(PMMA‐b‐PMPS)2 film obtains 8° hysteretic contact angle in WAC (114°–106°) and HAC (32°–24°) due to its higher surface roughness (138 nm). Therefore, the fluorine‐rich and higher roughness surface could produce the lower water and oil wettability, but silicon‐rich surface will produce lower water wettability. © 2013 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2014, 131, 40209.