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This article, published in the Journal of Neurological Surgery, examines the risk factors for reoperation following microvascular decompression (MVD) for trigeminal neuralgia (TN) and hemifacial spasm (HFS). The study analyzed patient data from 2015 to 2020 and found that patients with morbid obesity (BMI > 40) had an 8% risk of reoperation compared to 3% for patients with BMI < 40. Diabetes and procedure duration were also identified as risk factors for reoperation. The study suggests that preoperative optimization and alternative treatment strategies may help reduce the risk of surgical complications and reoperation in this patient population. [Extracted from the article]

This article explores the impact of tumor and socioeconomic factors on the survival outcomes of minority patients with meningiomas. The study found that Black patients had worse overall survival compared to White patients, while Latinx/White, Latinx/Other, and Asian patients had improved survival. Subtotal resection (STR) was associated with worse survival, and Black and Latinx patients were more likely to undergo STR. Higher grade tumors and larger tumor size were more common in Black, Latinx/Black, and Asian populations. Additionally, Black and Latinx patients were more likely to live in areas with lower education and income levels, and were less likely to have health insurance coverage. The study suggests that genetic factors may play a role in the aggressiveness of tumors in different populations. [Extracted from the article]

Inland waterway transport (IWT) is currently in focus for EU countries due to a shift in policy towards a more sustainable and green economy. The aim of this article is to analyze the possibility of using a grey incidence analysis (GIA) to identify key factors related to the functioning of the IWT system. GIA is classified as a multi-criteria decision-making method and is one of the key applications of grey systems theory (GTS), i.e., systems with incomplete and uncertain information about structure and behavior. GIA identifies the most favorable (or quasi-preferred) system characteristics and the most favorable (or quasi-preferred) system factors. The identification of such characteristics and factors enables a reduction in the inconsistencies in decision making on the functioning of the system. The application of the GIA to the assessment of the IWT system is an original concept. [ABSTRACT FROM AUTHOR]

Supplementary motor area (SMA) syndrome refers to varying degrees of transient hemiparesis and mutism following insult to the medial posterior frontal lobe. We describe a rare case of an isolated lower limb SMA deficit with associated pre- and post-operative multimodality neurophysiological monitoring data. We review the literature on SMA somatotopy and the prognostic abilities of intraoperative motor evoked potentials in suspected SMA dysfunction. A 45-year-old male underwent staged resection of a complex parasagittal WHO grade II meningioma involving the posterior superior frontal gyrus bilaterally. Intraoperative neurophysiological monitoring with transcranial motor evoked potentials (TCMEP) and direct cortical motor evoked potentials (DCMEP) were used during both stages of resection. The patient developed an isolated left foot drop despite unchanged DCMEP and TCMEP data obtained during the first stage of the procedure. During the second stage of resection 3 days later, repeat neurophysiological monitoring confirmed intact corticospinal tracts. Deep peroneal somatosensory evoked potentials (SSEPs) revealed good morphology, appropriate latency and amplitudes during the second stage of resection. These results suggested a diagnosis of focal SMA dysfunction. Left foot drop persisted 7 days post-operatively. At one month follow up, the patient was neurologically intact with full strength noted in all muscle groups of the left lower extremity. An improved understanding of the somatotopic organization of the SMA with additional neuromonitoring data can allow neurosurgeons to better predict and understand perioperative SMA dysfunctions. [ABSTRACT FROM AUTHOR]

The field of risk assessment and risk management is becoming increasingly more complex. Risk assessment is a powerful tool that provides a rational framework for designing and managing an OHSP at institutions that use nonhuman primates. The process of risk assessment requires a factual base to define the likelihood of adverse health effects of workplace-associated injuries and exposures, and it attempts to balance scientific knowledge with concerns of staff, investigators and administration. Practical guidance should be provided for Romanian mining companies get started and make progress in the risk assessment process. The article offers guidance on how to most effectively introduce the quantitative risk assessment process in mining industry, and has as main goal to highlight that the most valuable resource remains the practical experience gained by effectively performing the process. [ABSTRACT FROM AUTHOR]