Changing clinical and therapeutic trends in tentorial dural arteriovenous fistulas: a systematic review

BACKGROUND AND PURPOSE: Tentorial dural arteriovenous fistulas are characterized by a high hemorrhagic risk. We evaluated trends in outcomes and management of tentorial dural arteriovenous fistulas and performed a meta-analysis evaluating clinical and angiographic outcomes by treatment technique. MATERIALS AND METHODS: We performed a comprehensive literature search for studies on surgical and endovascular treatment of tentorial dural arteriovenous fistulas. We compared the proportion of patients undergoing endovascular, surgical, and combined endovascular/surgical management; the proportion of patients presenting with ruptured tentorial dural arteriovenous fistulas; and proportion of patients with good neurologic outcome across 3 time periods: 1980-1995, 1996-2005, and 2006-2014. We performed a random-effects meta-analysis, evaluating the rates of occlusion, long-term good neurologic outcome, perioperative morbidity, and resolution of symptoms for the 3 treatment modalities. RESULTS: Twenty-nine studies with 274 patients were included. The proportion of patients treated with surgical treatment alone decreased from 38.7% to 20.4% between 1980-1995 and 2006-2014. The proportion of patients treated with endovascular therapy alone increased from 16.1% to 48.0%. The proportion of patients presenting with ruptured tentorial dural arteriovenous fistulas decreased from 64.4% to 43.6%. The rate of good neurologic outcome increased from 80.7% to 92.9%. Complete occlusion rates were highest for patients receiving multimodality treatment (84.0%; 95% CI, 72.0%-91.0%) and lowest for endovascular treatment (71.0%; 95% CI, 56.0%-83.0%; P < .01). Long-term good neurologic outcome was highest in the endovascular group (89.0%; 95% CI, 80.0%-95.0%) and lowest for the surgical group (73.0%; 95% CI, 51.0%-87.0%; P < .03). CONCLUSIONS: Patients with tentorial dural arteriovenous fistulas are increasingly presenting with unruptured lesions, being treated endovascularly, and experiencing higher rates of good neurologic outcomes. Endovascular treatment was associated with superior neurologic outcomes but lower occlusion rate

An Organizational Development Assessment Tool for the Jordanian Civil Society Context

Over the last decade, humanitarian and development work has expanded to increasingly complex environments where the number of people in need rises indefinitely, while resources are either inadequate, or remain too scarce, to meet their needs. With donors demanding more measurable results, more robust monitoring, and more detailed data, these trends challenge civil society organizations (CSOs) to improve their performance and work with greater effectiveness and efficiency

Deep tillage tool optimization by means of finite element method: Case study for a subsoiler tine

Technologies and computer capacity currently available allow us to employ design software and numerical methods to solve complicated problems in very wide disciplines of engineering. It is also important for researches in agriculture. This study focused on obtaining optimum geometry parameters of a subsoiler tine by using computer aided engineering (CAE) applications. A field experiment was conducted to determine draft force of the subsoiler. The results from the experimental study were used in the finite element analysis (FEA) to simulate stress distributions on the subsoiler tine. The maximum equivalent stress of 432.49 MPa was obtained in the FEA. Visual investigations and FEA results showed that according to the tine’s material yield stress point of 355 MPa, plastic deformation was evident. Based on the FEA results, an optimization study was undertaken to obtain optimum geometry parameters without the occurrence of plastic deformation. According to the optimization study results, the optimum parameters of the tine geometry and maximum equivalent stress of 346.61 MPa were obtained. In addition to this, the total mass of the tine was reduced by about 0.367 kg

Gaseous optical contamination of the spacecraft environment: A review

Interactions between the ambient atmosphere and orbiting spacecraft, sounding rockets, and suborbital vehicles, and with their effluents, give rise to optical (extreme UV to LWIR) foreground radiation which constitutes noise that raises the detection threshold for terrestrial and celestial radiations, as well as military targets. Researchers review the current information on the on-orbit optical contamination. Its source species are created in interaction processes that can be grouped into three categories: (1) Reactions in the gas phase between the ambient atmosphere and desorbates and exhaust; (2) Reactions catalyzed by exposed ram surfaces, which occur spontaneously even in the absence of active material releases from the vehicles; and (3) Erosive excitative reactions with exposed bulk (organic) materials, which have recently been identified in the laboratory though not as yet observed on spacecraft. Researchers also assess the effect of optical pumping by earthshine and sunlight of both reaction products and effluents

Gate recess engineering of pseudomorphic In0.30GaAs/GaAs HEMTs

The authors report how the performance of 0.12 μm GaAs pHEMTs is improved by controlling both the gate recess width, using selective dry etching, and the gate position in the source drain gap, using electron beam lithography. pHEMTs with a transconductance of 600 mS/mm, off state breakdown voltages >2 V, fτ of 120 GHz, f max of 180 GHz and MAG of 13.5 dB at 60 GHz are reported

Analisis Dan Perancangan Sistem Informasi Pengolahan Data Siswa Smun 2 Bau Bau

By developing science and technology, make all task and human activity more easily. by technology,we can hear and watch the news I the whole world.by technology,a mother can see the gender of the baby being pregnant,by technology human forecast the weather. Also being technology,help the process in making decision in the organization.this is why data and information that is produced by technology more quiclly and accurately so the decisions can be applicated.one of the technology dimensions,expecially computer technology is databases.in the development databases system,data process makes more effectively and efficiently.innovation it includes storage,placing,deleting and searching,view this fact make researcher try to give solution axxactly to fluenst school administration optimally.with development information system with programming languages visual basic 6.0 and Microsoft access Researcher will take the problems,to how increase performance development data system academis and maximal potention tools be longed by development a information system academis that integration in a otomatical system,so can reserve and full fill denied information that hope

Ordinal Logistic Regression for Students Academic Performance in Kurdistan Region of Iraq

The First Attempt Exam is the first final exam for students after their first academic year to show their academic performance. According to the outcomes of our project, some factors influence students’ academic performance. These factors include (Sex, Car Ownership, Relationships, Smoking, Hours of Study, Facebook Use, Father Alive, Mother-Edu, and Father-Edu). These factors have a high effect on the results of the First Attempts Exam. Furthermore, females are more likely to pass the first attempts exam than the males. Also, students with cars, relationships, who smoking, use Facebook regularly, and whose mothers have higherlevels of education are negatively affected by the student’s academic performance. On the other hand, mother alive, higher level education of father, and increasing one-hour daily study are positively affected on the students’ academic performance.&nbsp

A Solution of Second Kind Volterra Integral Equations Using Third Order Non-Polynomial Spline Function

In this paper, third order non-polynomial spline function is used to solve 2nd kind Volterra integral equations. Numerical examples are presented to illustrate the applications of this method, and to compare the computed results with other known methods

The Odontogenic Keratocyst: clinical, radiological, and histopathological study

The odontogenic keratocyst of the jaw refers to an uncommon benign lesionthat originates from dental primordial. A retrospective study was conducted aboutthe odontogenic keratocyst clinically, radiographically, and histopathologically ina fifty-two Iraqi patients from the archives of Oral pathology department, Collegeof Dentistry, University of Baghdad, over a period from 1990-2000. The resultshowed that the mean age was (29.2) years, males were affected more than thefemales with a ratio (1.6:1). The mandibular molar region was the most specificsite involved, followed by mandibular premolar area. The most common clinicalsymptom was the alveolar bone expansion. Radiographic feature revealed adominancy of multilocular appearance in (63.6%), associated with uneruptedtooth in (31.8%). Histologically, the cyst shows ameloblastic variation in onlythree cases