Surgical clipping compared to endovascular coiling of ruptured coil able middle cerebral aneurysms: A single-center experience

Objective: The middle cerebral artery (MCA) is the third most common site for ruptured intracranial aneurysms. Aneurysms in this location are known to be challenging to treat endovascularly and are commonly treated with microsurgery. Although advances in endovascular treatment options for cerebral aneurysms have markedly reduced the need for surgery in recent years and decades, there is no compelling scientific evidence that endovascular treatments are superior to surgical treatment. The present study aimed to determine the appropriate treatment modality in ruptured MCA aneurysms. Methods: We retrospectively evaluated and compared the treatment outcomes of 80 patients with ruptured MCA aneurysms who underwent either endovascular or microsurgical treatment in our center between 2011 and 2016. Post-treatment clinical and radiological outcomes were assessed in all patients. Furthermore, we compared intraoperative complications and the need for re-treatments between the two groups. Results: According to our findings, complete aneurysm occlusion was achieved in 90.5 and 89.2 of the patients in the clipping and coil group, respectively (p = 0.850). Moreover, 14.3 of the patients in the clipping group and 15.8 of the subjects in the coil group developed intraoperative complications (p = 0.851), including 3 cases of intraoperative hemorrhage and 3 cases of ischemia in the clipping group as well as 2 cases of thromboembolism and 4 cases of vasospasm during endovascular treatment in the coil group. There was an improvement in the modified Rankin score (mRS) at six months, with no significant difference between the two groups (p = 0.916). Conclusion: The results of coiling only with coil able MCA aneurysms were comparable to the results of clipping with difficult cases. Sufficient follow-up study of recurrence and retreatment are needed to determine the indication for coiling for ruptured MCA aneurysm. © 202

Non-standard errors

In statistics, samples are drawn from a population in a data-generating process (DGP). Standard errors measure the uncertainty in estimates of population parameters. In science, evidence is generated to test hypotheses in an evidence generating process (EGP). We claim that EGP variation across researchers adds uncertainty: Non-standard errors (NSEs). We study NSEs by letting 164 teams test the same hypotheses on the same data. NSEs turn out to be sizable, but smaller for better reproducible or higher rated research. Adding peer-review stages reduces NSEs. We further find that this type of uncertainty is underestimated by participants

Contribution to the speleology of Sterkfontein cave, Gauteng province, South Africa.

The authors present more data about the speleological aspect of the Sterkfontein Cave, famous for its bone breccia which yielded abundant hominid remains. They also briefly review the previous voluminous studies by numerous authors, which are mainly dealing with the paleontology, stratigraphy and sedimentology of the breccia. The present investigations were oriented to hitherto poorly investigated aspects such as detail mapping of the cave, its country rock stratigraphy and recording the underground extension of the basal part of the breccia body. The cave consists of a complex network of phreatic channels, developed along joints in Neoarchaean cherty dolostone over a restricted surface of 250x250m. The combined length of all passages within this area amounts to 5,23km. The system extends over a height of about 50m and the dry part of it is limited downwards by the water-table appearing as numerous static pools. The fossiliferous breccia (= Sterkfontein Formation) forms an irregular lenticular mass 75x25m horizontally by 40m vertically, which is included within the passage network. It crops out at surface and in the cave, and resulted from the filling of a collapse chamber, which was de-roofed by erosion. The present investigation confirmed that the cave and the Sterkfontein Formation are part of a single speleogenetic event. The breccia resulted from cavity filling by sediments introduced from a pit entrance, whereas many of the phreatic passages around it, which are developed at the same elevation, were only partly filled or remained entirely open up to present. This filling took place mainly in a vadose environment. Taking into account the age of the Sterkfontein Formation (>3,3-1,5 My, from base to top), the geomorphic evolution of the landscape and the context of other caves in the region, it seems that the cave might have started to form 5 My ago. It has been continuously developing up to present as a result of a slow drop of the water-table

Contribution to the speleology of Sterkfontein Cave, Gauteng Province, South Africa

The authors present more data about the speleological aspect of the Sterkfontein Cave, famous for its bone breccia which yielded abundant hominid remains. They also briefly review the previous voluminous studies by numerous authors, which are mainly dealing with the paleontology, stratigraphy and sedimentology of the breccia. The present investigations were oriented to hitherto poorly investigated aspects such as detail mapping of the cave, its country rock stratigraphy and recording the underground extension of the basal part of the breccia body. The cave consists of a complex network of phreatic channels, developed along joints in Neoarchaean cherty dolostone over a restricted surface of 250x250m. The combined length of all passages within this area amounts to 5,23km. The system extends over a height of about 50m and the dry part of it is limited downwards by the water-table appearing as numerous static pools. The fossiliferous breccia (= Sterkfontein Formation) forms an irregular lenticular mass 75x25m horizontally by 40m vertically, which is included within the passage network. It crops out at surface and in the cave, and resulted from the filling of a collapse chamber, which was de-roofed by erosion. The present investigation confirmed that the cave and the Sterkfontein Formation are part of a single speleogenetic event. The breccia resulted from cavity filling by sediments introduced from a pit entrance, whereas many of the phreatic passages around it, which are developed at the same elevation, were only partly filled or remained entirely open up to present. This filling took place mainly in a vadose environment. Taking into account the age of the Sterkfontein Formation (\u3e3,3-1,5 My, from base to top), the geomorphic evolution of the landscape and the context of other caves in the region, it seems that the cave might have started to form 5 My ago. It has been continuously developing up to present as a result of a slow drop of the water-table