Expertise in surgical neuro-oncology. Results of a survey by the EANS neuro-oncology section

Introduction: Technical advances and the increasing role of interdisciplinary decision-making may warrant formal definitions of expertise in surgical neuro-oncology. Research question: The EANS Neuro-oncology Section felt that a survey detailing the European neurosurgical perspective on the concept of expertise in surgical neuro-oncology might be helpful. Material and methods: The EANS Neuro-oncology Section panel developed an online survey asking questions regarding criteria for expertise in neuro-oncological surgery and sent it to all individual EANS members. Results: Our questionnaire was completed by 251 respondents (consultants: 80.1%) from 42 countries. 67.7% would accept a lifetime caseload of >200 cases and 86.7% an annual caseload of >50 as evidence of neuro-oncological surgical expertise. A majority felt that surgeons who do not treat children (56.2%), do not have experience with spinal fusion (78.1%) or peripheral nerve tumors (71.7%) may still be considered experts. Majorities believed that expertise requires the use of skull-base approaches (85.8%), intraoperative monitoring (83.4%), awake craniotomies (77.3%), and neuro-endoscopy (75.5%) as well as continuing education of at least 1/year (100.0%), a research background (80.0%) and teaching activities (78.7%), and formal interdisciplinary collaborations (e.g., tumor board: 93.0%). Academic vs. non-academic affiliation, career position, years of neurosurgical experience, country of practice, and primary clinical interest had a minor influence on the respondents’ opinions. Discussion and conclusion: Opinions among neurosurgeons regarding the characteristics and features of expertise in neuro-oncology vary surprisingly little. Large majorities favoring certain thresholds and qualitative criteria suggest a consensus definition might be possible

Detection of Transmutational Elements in Copper by Means of Total-Reflection X-Ray-Fluorescence Spectrometry Using Synchrotron-Radiation

High-purity copper samples were irradiated with high-energy protons and neutrons, The concentration of transmutational elements was measured by means of the total reflection x-ray fluorescence method using synchrotron radiation, The spectra of non-irradiated samples were substracted from the spectra of the irradiated samples, By this evaluation method, the minimum detectable concentration was as low as 1.5 mu g g(-1) in a copper matrix

Detection of transmutational elements in copper by means of total reflection X-ray fluorescence spectrometry using synchrotron radiation

High-purity copper samples were irradiated with high-energy protons and neutrons. The concentration of transmutational elements was measured by means of the total reflection x-ray fluorescence method using synchrotron radiation. The spectra of non-irradiated samples were substracted from the spectra of the irradiated samples. By this evaluation method, the minimum detectable concentration was as low as 1.5 μg g−1 in a copper matrix

Total reflection X-ray fluorescence analysis with synchrotron radiation monochromatized by multilayer structures

To achieve lowest detection limits in total reflection X-ray fluorescence analysis (TXRF) synchrotron radiation has been monochromatized by a multilayer structure to obtain a relative broad energy band compared to Bragg single crystals for an efficient excitation. The energy has been set to 14 keV, 17.5 keV, 31 keV and about 55 keV. Detection limits of 20 fg and 150 fg have been achieved for Sr and Cd, respectively

TXRF with synchrotron radiation Analysis of Ni on Si-wafer surfaces

SR-TXRF (Synchrotron Radiation excited Total Reflection X-ray Fluorescence Analysis) with monoenergetic radiation produced by a multilayer monochromator has been applied to the analysis of Ni on a Si-wafer surface. An intentionally contaminated wafer with 100 pg has been used to determine the detection limits. 13 fg have been achieved for Ni at a beam current of 73 mA and extrapolated to 1000 s. This technique simulates the sample preparation technique of Vapour Phase Decomposition (VPD) on a wafer surface

Surgical Outcome of Patients With Supratentorial Meningiomas Aged 80 Years or Older-Retrospective International Multicenter Study.

BACKGROUND AND OBJECTIVES Demographic changes will lead to an increase in old patients, a population with significant risk of postoperative morbidity and mortality, requiring neurosurgery for meningiomas. This multicenter study aims to report neurofunctional status after resection of patients with supratentorial meningioma aged 80 years or older, to identify factors associated with outcome, and to validate a previously proposed decision support tool. METHODS Neurofunctional status was assessed by the Karnofsky Performance Scale (KPS). Patients were categorized in poor (KPS ≤40), intermediate (KPS 50-70), and good (KPS ≥80) preoperative subgroups. Volumetric analyses of tumor and peritumoral brain edema (PTBE) were performed; volumes were scored as small (50 cm3). RESULTS The study population consisted of 262 patients, and the median age at surgery was 83.0 years. The median preoperative KPS was 70; 117 (44.7%) patients were allotted to the good, 113 (43.1%) to the intermediate, and 32 (12.2%) to the poor subgroup. The median tumor and PTBE volumes were 30.2 cm3 and 27.3 cm3; large PTBE volume correlated with poor preoperative KPS status (P = .008). The 90-day and 1-year mortality rates were 9.0% and 13.2%, respectively. Within the first postoperative year, 101 (38.5%) patients improved, 87 (33.2%) were unchanged, and 74 (28.2%) were functionally worse (including deaths). Each year increase of age associated with 44% (23%-70%) increased risk of 90-day and 1-year mortality. In total, 111 (42.4%) patients suffered from surgery-associated complications. Maximum tumor diameter ≥5 cm (odds ratio 1.87 [1.12-3.13]) and large tumor volume (odds ratio 2.35 [1.01-5.50]) associated with increased risk of complications. Among patients with poor preoperative status and large PTBE, most (58.3%) benefited from surgery. CONCLUSION Patients with poor preoperative neurofunctional status and large PTBE most often showed postoperative improvements. The decision support tool may be of help in identifying cases that most likely benefit from surgery