Spinal hemangioblastomas: analysis of surgical outcome and prognostic factors

The prognostic factors for surgically removed spinal hemangioblastomas, the impact of VHL disease on outcome, and the role of intraoperative neuromonitoring are still not completely clear. The aim of this study was to review our experience with spinal hemangioblastomas in order to assess potential predictors of neurological outcome after surgery. All cases of spinal hemangioblastomas removed at two Italian academic institutions from 1985 to 2020 were reviewed. Data about clinical presentation and symptom duration, diagnosis of VHL, surgical approach, use of IONM, duration of hospital stay, follow-up, and modified McCormick grade before and after surgery were extracted. Sixty-one patients (31 F, 30 M) underwent 69 surgeries to remove 74 spinal hemangioblastomas (37 cervical, 32 thoracic, 5 lumbar). Improvement was found in 32.3% of cases, neurological condition remained stable in 51.6% of cases, and deteriorated in 16.1% of patients. A worsening trend in VHL patients and an improvement trend in non-VHL patients were detected, despite the lack of statistical significance. Laminotomy and use of IONM were found to be associated with better outcome, although no association was found between surgery without IONM and worse outcome. In most cases, patients affected by spinal hemangioblastomas can expect a good long-term outcome. In our experience, laminotomy seems to be associated with better outcome compared to laminectomy. While its absence is not associated with worse outcome, IONM seems to be associated with a better neurological outcome. Our study suggests that the more impaired the preoperative neurological condition, the worse the outcome

Performance and Stability of Doped Ceria–Zirconia Catalyst for a Multifuel Reforming

In the present work, the catalytic behavior of nickel-based catalysts supported on ceria/zirconia, undoped and doped with lanthanum and neodymium (3.5Ni/Ce0.8La0.5Nd0.2Zr0.13O2−x), was investigated under different reactions: steam reforming, partial oxidation and autothermal reforming of different fuels (methane, biogas, and propane). The catalytic properties of these catalysts were evaluated at a temperature of 800 °C, under atmospheric pressure, at GSHV = 120,000 h−1, using steam/carbon and oxygen/carbon ratio, respectively, of S/C = 2.5 and O/C = 0.5 and, in the case of autothermal conditions, with the addition of H2S (100 ppm) as a contaminant. Depending on the tested fuel, ATR, SR, and POX reactions over doped and undoped catalysts showed different results. In particular, the doped catalyst, due to neodymium and lanthanum doping, better distributed nickel species on the catalyst surface, promoting a higher concentration of defect groups and oxygen vacancies. This resulted in improved catalytic performance and resistance to deactivation. Endurance catalytic test also confirmed the beneficial effect of the doped catalysts

Visualization, navigation, augmentation. The ever-changing perspective of the neurosurgeon

Introduction: The evolution of neurosurgery coincides with the evolution of visualization and navigation. Augmented reality technologies, with their ability to bring digital information into the real environment, have the potential to provide a new, revolutionary perspective to the neurosurgeon. Research question: To provide an overview on the historical and technical aspects of visualization and navigation in neurosurgery, and to provide a systematic review on augmented reality (AR) applications in neurosurgery. Material and methods: We provided an overview on the main historical milestones and technical features of visualization and navigation tools in neurosurgery. We systematically searched PubMed and Scopus databases for AR applications in neurosurgery and specifically discussed their relationship with current visualization and navigation systems, as well as main limitations. Results: The evolution of visualization in neurosurgery is embodied by four magnification systems: surgical loupes, endoscope, surgical microscope and more recently the exoscope, each presenting independent features in terms of magnification capabilities, eye-hand coordination and the possibility to implement additional functions. In regard to navigation, two independent systems have been developed: the frame-based and the frame-less systems. The most frequent application setting for AR is brain surgery (71.6%), specifically neuro-oncology (36.2%) and microscope-based (29.2%), even though in the majority of cases AR applications presented their own visualization supports (66%). Discussion and conclusions: The evolution of visualization and navigation in neurosurgery allowed for the development of more precise instruments; the development and clinical validation of AR applications, have the potential to be the next breakthrough, making surgeries safer, as well as improving surgical experience and reducing costs

New insights into the dynamics that control the activity of ceria-zirconia solid solutions in thermochemical water splitting cycles

The reactivity of a ceria-rich Ce0.85Zr0.15O2 solid solution toward the thermochemical water splitting process (TWS) was studied over repeated H2/H2O redox cycles. The structural and surface modifications after treatment at high temperature under air or N2 atmospheres were characterized by high-resolution transmission electron microscopy (HRTEM), X-ray diffraction (XRD), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), and positron annihilation lifetime spectroscopy (PALS). Samples treated under nitrogen resulted more active due to phase segregation with formation of a zirconyl oxynitride phase in catalytic amount. Insertion of N3- into the structure contributes to an increase in the numbers of oxygen vacancies that preferably arrange in large clusters, and to the stabilization of Ce3+ centers on the surface. In comparison, treatment under air resulted in a different arrangement of defects with less Ce3+ and smaller and more numerous vacancy clusters. This affects charge transfer and H-coupling processes, which play an important role in boosting the rate of H2 production. The behavior is found to be only slightly dependent on the starting ceria-zirconia composition, and it is related to the development of a similar surface heterostructure configuration, characterized by the presence of at least a ceria-rich solid solution and a (cerium-doped) zirconyl oxynitride phase, which is supposed to act as a promoter for TWS reaction. The above findings confirm the importance of a multiphase structure in the design of ceria-zirconia oxides for water splitting reaction and allow a step forward to find an optimal composition. Moreover, the results indicate that doping with nitrogen might be a novel approach for the design of robust, thermally resistant, and redox active materials.Postprint (author's final draft

Deep neural networks allow expert-level brain meningioma segmentation and present potential for improvement of clinical practice

Accurate brain meningioma segmentation and volumetric assessment are critical for serial patient follow-up, surgical planning and monitoring response to treatment. Current gold standard of manual labeling is a time-consuming process, subject to inter-user variability. Fully-automated algorithms for meningioma segmentation have the potential to bring volumetric analysis into clinical and research workflows by increasing accuracy and efficiency, reducing inter-user variability and saving time. Previous research has focused solely on segmentation tasks without assessment of impact and usability of deep learning solutions in clinical practice. Herein, we demonstrate a three-dimensional convolutional neural network (3D-CNN) that performs expert-level, automated meningioma segmentation and volume estimation on MRI scans. A 3D-CNN was initially trained by segmenting entire brain volumes using a dataset of 10,099 healthy brain MRIs. Using transfer learning, the network was then specifically trained on meningioma segmentation using 806 expert-labeled MRIs. The final model achieved a median performance of 88.2% reaching the spectrum of current inter-expert variability (82.6-91.6%). We demonstrate in a simulated clinical scenario that a deep learning approach to meningioma segmentation is feasible, highly accurate and has the potential to improve current clinical practice

Surgery vs. biopsy in the treatment of butterfly glioblastoma: a systematic review and meta-analysis

: Butterfly glioblastomas (bGBM) are grade IV gliomas that spread to bilateral hemispheres by infiltrating the corpus callosum. Data on the effect of surgery are limited to small case series. The aim of this meta-analysis was to compare resection vs. biopsy in terms of survival outcomes and postoperative complications. A systematic review of the literature was conducted using PubMed, EMBASE, and Cochrane databases through March 2021 in accordance with the PRISMA checklist. Pooled hazard ratios were calculated and meta-analyzed in a random-effects model including assessment of heterogeneity. Out of 3367 articles, seven studies were included with 293 patients. Surgical resection was significantly associated with longer overall survival (HR 0.39, 95%CI 0.2-0.55) than biopsy. Low heterogeneity was observed (I2: 0%). In further analysis, the effect persisted in extent of resection subgroups of both ≥80% and <80%. No statistically significant difference between surgery and biopsy was detected in terms of postoperative complications, although these were numerically larger for surgery. In patients with bGBM, surgical resection was associated with longer survival prospects compared with biopsy

Efficacy and safety of flexible versus rigid endoscopic third ventriculostomy in pediatric and adult populations: a systematic review and meta-analysis

Endoscopic third ventriculostomy (ETV) is a well-established surgical procedure for hydrocephalus treatment, but there is sparse evidence on the optimal choice between flexible and rigid approaches. A meta-analysis was conducted to compare efficacy and safety profiles of both techniques in pediatrics and adults. A comprehensive search was conducted on PubMED, EMBASE, and Cochrane until 11/10/2019. Efficacy was evaluated comparing incidence of ETV failure, while safety was defined by the incidence of perioperative complications, intraoperative bleedings, and deaths. Random-effects models were used to pool the incidence. Out of 1365 studies, 46 case series were meta-analyzed, yielding 821 patients who underwent flexible ETV and 2918 who underwent rigid ETV, with an age range of [5 days-87 years]. Although flexible ETV had a higher incidence of failure in adults (flexible: 54%, 95%CI: 22-82% vs rigid: 20%, 95%CI: 22-82%) possibly due to confounding due to etiology in adults treated with flexible, a smaller difference was seen in pediatrics (flexible: 36%, pediatric: 32%). Safety profiles were acceptable for both techniques, with a certain degree of variability for complications (flexible 2%, rigid 18%) and death (flexible 1%, rigid 3%) in pediatrics as well as complications (rigid 9%, flexible 13%), death (flexible 4%, rigid 6%) and intra-operative bleeding events (rigid 6%, flexible 8%) in adults. No clear superiority in efficacy could be depicted between flexible and rigid ETV for hydrocephalus treatment. Safety profiles varied by age but were acceptable for both techniques. Well-designed comparative studies are needed to assess the optimal endoscopic treatment option for hydrocephalus

Dry matter production of common bean with different magnesium levels in nutrient solution

Com o objetivo de avaliar a influência dos níveis de Mg sobre a produção de matéria seca de feijoeiro (Phaseolus vulgaris L. cv. Carioca), empregou-se a solução nutritiva no 2 de Hoagland & Arnon, modificada pela variação da concentração desse mineral, obtendo-se os níveis de 2,4; 24,3; 48,6; 72,9 e 97,2 ppm de Mg. O experimento foi realizado em blocos ao acaso, com três repetições, em esquema fatorial, com cinco níveis de Mg e cinco colheitas, realizadas a intervalos de 14 dias. Os resultados, avaliados em relação aos observados nas plantas submetidas a tratamento com 48,6 ppm de Mg, demonstraram que plantas nutridas com nível de Mg acima desse, não apresentaram alterações pronunciadas, enquanto foram marcantes os aumentos do peso de matéria seca do caule, folhas e total da planta, com a utilização de 2,4 ppm de Mg. Tais resultados sugerem que, para o Phaseolus vulgaris cv. Carioca o nível de 2,4 ppm de Mg seria o ideal quando são considerados os pesos da matéria seca dos órgãos estudados.The effect of Mg levels in nutrient solution upon root, stem, leaf, fruit and total dry matter production of common bean (Phaseolus vulgaris L. cv. Carioca) was studied. Bean plants were grown in Hoagland & Arnon n. 2 solution modified to obtain 2.4, 24.3, 48.6, 72.9 and 97.2 ppm of Mg. The experimental design was a split-plot factorial replicated three times with five Mg levels and five samplings which were done fortnightly. Results were compared with those observed in plants submitted to a nutrient solution with 48.6 ppm of Mg concentration, considered the ideal Mg content. Only a mild prejudicial effect was observed with Mg excessive levels. Stem, leaves and total dry matter were higher when 2.4 ppm were used, suggesting this level as the concentration chosen for the culture of common bean

Lophine derivatives as activators in peroxyoxalate chemiluminescence

Lophine and four of its derivatives were used as activators (ACTs) of the chemiluminescent peroxyoxalate (PO) reaction of bis(2,4,6-trichlorophenyl) oxalate with H2O2, catalysed by imidazole. Kinetic emission assays have shown that with the tested compounds the reaction mechanism, regarding the formation of the high energy intermediate (HEI) of the PO reaction, occurs as previously seen for commonly used ACTs. A bimolecular interaction of the compounds with the HEI leads to chemiexcitation through the chemically initiated electron exchange luminescence (CIEEL) mechanism, as confirmed by a linear free-energy correlation between the relative catalytic rate constants and the oxidation potentials of the compounds. the yields of excited state formation and light emission, in the range of 10(-2)-10(-3) E mol(-1), are comparable to the ones seen with commonly used ACTs. A Hammett plot with rho = -0.90 indicates the buildup of a partial positive charge on the transition step of the catalytic process, consistent with the formation of a radical cation of the ACT, being an additional validation of the CIEEL mechanism in this system.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Univ Fed ABC, Ctr Ciencias Nat & Humanas, Santo Andre, SP, BrazilUniversidade Federal de São Paulo, Inst Ciencias Ambientais Quim & Farmaceut, Diadema, SP, BrazilUniversidade Federal de São Paulo, Inst Ciencias Ambientais Quim & Farmaceut, Diadema, SP, BrazilFAPESP: 2013/17332-6FAPESP: 2011/17587-9FAPESP: 2012/02428-5FAPESP: 2012/13807-7Web of Scienc