Fluorescein-stained confocal laser endomicroscopy versus conventional frozen section for intraoperative histopathological assessment of intracranial tumors.

Background: The aim of this clinical trial was to compare Fluorescein-stained intraoperative confocal laser endomicroscopy (CLE) of intracranial lesions and evaluation by a neuropathologist with routine intraoperative frozen section (FS) assessment by neuropathology.

Methods: In this phase II noninferiority, prospective, multicenter, nonrandomized, off-label clinical trial (EudraCT: 2019-004512-58), patients above the age of 18 years with any intracranial lesion scheduled for elective resection were included. The diagnostic accuracies of both CLE and FS referenced with the final histopathological diagnosis were statistically compared in a noninferiority analysis, representing the primary endpoint.

CTA Supplemented by CTP Increases Interrater Reliability and Endovascular Treatment Use in Patients with Aneurysmal SAH.

Background And Purpose: Cerebral vasospasm is a common complication of aneurysmal SAH and remains a risk factor for delayed cerebral ischemia and poor outcome. The interrater reliability of CTA in combination with CTP has not been sufficiently studied. We aimed to investigate the reliability of CTA alone and in combination with CTP in the detection of cerebral vasospasm and the decision to initiate endovascular treatment.

Clinical, radiological and pathological features of temporomesial tumors in the adult. A single center experience from 15 years.

Introduction: The mesial temporal lobe plays a distinct role in epileptogenesis, and tumors in this part of the brain potentially have specific clinical and radiological features. Differentiating high-grade from lower-grade tumors or non-neoplastic lesions can be challenging, preventing the decision for early resection that can be critical in high-grade tumors.

Methods: A brain tumor database was analyzed retrospectively to identify patients with temporomesial tumors.

sEMG-based prediction of human forearm movements utilizing a biomechanical model based on individual anatomical/ physiological measures and a reduced set of optimization parameters.

For assistive devices such as active orthoses, exoskeletons or other close-to-body robotic-systems, the immediate prediction of biological limb movements based on biosignals in the respective control system can be used to enable intuitive operation also by untrained users e.g. in healthcare, rehabilitation or industrial scenarios.

Postoperative Communicating Hydrocephalus Following Grade 2/3 Glioma Resection: Incidence, Timing and Risk Factors.

Background: In diffusely infiltrating gliomas, the maximum extent of tumor resection is an important predictor of overall survival, irrespective of histological or molecular subtype or tumor grade. For glioblastoma WHO grade 4 (GBM), it has been shown that resection-related events, such as ventricular opening and ventriculitis, increase the risk for development of communicating hydrocephalus (CH) requiring cerebrospinal fluid (CSF) diversion surgery. Risk factors for the development and the incidence of hydrocephalus following resection of other types of infiltrating gliomas are less well established.

Imaging the WHO 2021 Brain Tumor Classification: Fully Automated Analysis of Imaging Features of Newly Diagnosed Gliomas.

Background: The fifth version of the World Health Organization (WHO) classification of tumors of the central nervous system (CNS) in 2021 brought substantial changes. Driven by the enhanced implementation of molecular characterization, some diagnoses were adapted while others were newly introduced. How these changes are reflected in imaging features remains scarcely investigated.

Brain metastases in the elderly - Impact of residual tumor volume on overall survival.

Background: Due to demographic changes and an increased incidence of cancer with age, the number of patients with brain metastases (BMs) constantly increases, especially among the elderly. Novel systemic therapies, such as immunotherapy, have led to improved survival in recent years, but intracranial tumor progression may occur independently of a systemically effective therapy. Despite the growing number of geriatric patients, they are often overlooked in clinical trials, and there is no consensus on the impact of BM resection on survival.

Revised historical Northern Hemisphere black carbon emissions based on inverse modeling of ice core records.

Black carbon emitted by incomplete combustion of fossil fuels and biomass has a net warming effect in the atmosphere and reduces the albedo when deposited on ice and snow; accurate knowledge of past emissions is essential to quantify and model associated global climate forcing. Although bottom-up inventories provide historical Black Carbon emission estimates that are widely used in Earth System Models, they are poorly constrained by observations prior to the late 20th century. Here we use an objective inversion technique based on detailed atmospheric transport and deposition modeling to reconstruct 1850 to 2000 emissions from thirteen Northern Hemisphere ice-core records.

Sequential and Hybrid PET/MRI Acquisition in Follow-Up Examination of Glioblastoma Show Similar Diagnostic Performance.

Both positron emission tomography (PET) and magnetic resonance imaging (MRI), including dynamic susceptibility contrast perfusion (DSC-PWI), are crucial for treatment monitoring of patients with high-grade gliomas. In clinical practice, they are usually conducted at separate time points. Whether this affects their diagnostic performance is presently unclear.

Low-Energy X-Ray Intraoperative Radiation Therapy (Lex-IORT) for Resected Brain Metastases: A Single-Institution Experience.

Background: Resection followed by local radiation therapy (RT) is the standard of care for symptomatic brain metastases. However, the optimal technique, fractionation scheme and dose are still being debated. Lately, low-energy X-ray intraoperative RT (lex-IORT) has been of increasing interest.

Assessment of the incidence and nature of adverse events and their association with human error in neurosurgery. A prospective observation.

Introduction: Adverse events in surgery are a relevant cause of costs, disability, or death, and their incidence is a key quality indicator that plays an important role in the future of health care. In neurosurgery, little is known about the frequency of adverse events and the contribution of human error.

Research Question: To determine the incidence, nature and severity of adverse events in neurosurgery, and to investigate the contribution of human error.

Manual and semi-automatic determination of elbow angle-independent parameters for a model of the biceps brachii distal tendon based on ultrasonic imaging.

Tendons consist of passive soft tissue with non linear material properties. They play a key role in force transmission from muscle to skeletal structure. The properties of tendons have been extensively examined in vitro.

Postoperative communicating hydrocephalus following glioblastoma resection: Incidence, timing and risk factors.

Introduction: Glioblastoma (GBM) is the most common malignant primary brain tumor. Treatment includes maximally safe surgical resection followed by radiation and/or chemotherapy. However, resection can lead to ventricular opening, potentially increasing the risk for development of communicating hydrocephalus (CH).

The Relation of Patient Expectations, Satisfaction, and Outcome in Surgery of the Cervical Spine: A Prospective Study.

Study Design: We performed a prospective nonblinded single center observational study.

Objective: To investigate the relationship between expectations, outcome, and satisfaction with the outcome in patients undergoing cervical spine stabilization surgery.

Summary Of Background Data: In modern healthcare, patient-reported outcome measures and patient satisfaction have become an important aspect of quality control.

Connectomic comparison of mouse and human cortex.

The human cerebral cortex houses 1000 times more neurons than that of the cerebral cortex of a mouse, but the possible differences in synaptic circuits between these species are still poorly understood. We used three-dimensional electron microscopy of mouse, macaque, and human cortical samples to study their cell type composition and synaptic circuit architecture. The 2.

Surgery in Acute Metastatic Spinal Cord Compression: Timing and Functional Outcome.

Patients with metastatic spinal cord compression (MSCC) may experience long-term functional impairment. It has been established that surgical decompression improves neurological outcomes, but the effect of early surgery remains uncertain. Our objective was to evaluate the impact of early versus late surgery for acute MSCC due to spinal metastases (SM).

Navigation for surgical treatment of disorders of the cervical spine - A systematic review.

Introduction: Computer-assisted navigation (CAN) is a well-established tool in spinal instrumentation surgery. Different techniques - each with specific advantages and disadvantages - are used in the cervical spine.

Methods: A structured summary of different spinal navigation techniques and a review of the literature were done to discuss the advantages and disadvantages of specific navigation tools in the cervical spine.

Motion parallax for object localization in electric fields.

Parallax, as a visual effect, is used for depth perception of objects. But is there also the effect of parallax in the context of electric field imagery? In this work, the example of weakly electric fish is used to investigate how the self-generated electric field that these fish utilize for orientation and communication alike, may be used as a template to define electric parallax. The skin of the electric fish possesses a vast amount of electroreceptors that detect the self-emitted dipole-like electric field.

Visualizing cellularity and angiogenesis in newly-diagnosed glioblastoma with diffusion and perfusion MRI and FET-PET imaging.

Purpose: Combining imaging modalities has become an essential tool for assessment of tumor biology in glioblastoma (GBM) patients. Aim of this study is to understand how tumor cellularity and neovascularization are reflected in O-(2-[18F]fluoroethyl)-L-tyrosine positron emission tomography ([18F] FET PET) and magnetic resonance imaging (MRI) parameters, including cerebral blood volume (CBV), fractional anisotropy (FA) and mean diffusivity (MD).

Methods: In this prospective cohort, 162 targeted biopsies of 43 patients with therapy-naïve, isocitrate dehydrogenase (IDH) wildtype GBM were obtained after defining areas of interest based on imaging parameters [18F] FET PET, CBV, FA and MD.

[F]FET PET Uptake Indicates High Tumor and Low Necrosis Content in Brain Metastasis.

Amino acid positron emission tomography (PET) has been employed in the management of brain metastases. Yet, histopathological correlates of PET findings remain poorly understood. We investigated the relationship of O-(2-[F]Fluoroethyl)-L-tyrosine ([F]FET) PET, magnetic resonance imaging (MRI), and histology in brain metastases.

Extreme climate after massive eruption of Alaska's Okmok volcano in 43 BCE and effects on the late Roman Republic and Ptolemaic Kingdom.

The assassination of Julius Caesar in 44 BCE triggered a power struggle that ultimately ended the Roman Republic and, eventually, the Ptolemaic Kingdom, leading to the rise of the Roman Empire. Climate proxies and written documents indicate that this struggle occurred during a period of unusually inclement weather, famine, and disease in the Mediterranean region; historians have previously speculated that a large volcanic eruption of unknown origin was the most likely cause. Here we show using well-dated volcanic fallout records in six Arctic ice cores that one of the largest volcanic eruptions of the past 2,500 y occurred in early 43 BCE, with distinct geochemistry of tephra deposited during the event identifying the Okmok volcano in Alaska as the source.

Image Analysis Reveals Microstructural and Volumetric Differences in Glioblastoma Patients with and without Preoperative Seizures.

: Seizures related to tumor growth are common in glioma patients, especially in low-grade glioma patients this is often the first tumor manifestation. We hypothesize that there are associations between preoperative seizures and morphologic features (e.g.