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BACKGROUND: The risk of recurrence is overestimated by the Kaplan-Meier method when competing events, such as death without recurrence, are present. Such overestimation can be avoided by using the Aalen-Johansen method, which is a direct extension of Kaplan-Meier that accounts for competing events. Meningiomas commonly occur in older individuals and have slow-growing properties, thereby warranting competing risk analysis. The extent to which competing events are considered in meningioma literature is unknown, and the consequences of using incorrect methodologies in meningioma recurrence risk analysis have not been investigated. METHODS: We surveyed articles indexed on PubMed since 2020 to assess the usage of competing risk analysis in recent meningioma literature. To compare recurrence risk estimates obtained through Kaplan-Meier and Aalen-Johansen methods, we applied our international database comprising ~ 8,000 patients with a primary meningioma collected from 42 institutions. RESULTS: Of 513 articles, 169 were eligible for full-text screening. There were 6,537 eligible cases from our PERNS database. The discrepancy between the results obtained by Kaplan-Meier and Aalen-Johansen was negligible among low-grade lesions and younger individuals. The discrepancy increased substantially in the patient groups associated with higher rates of competing events (older patients with high-grade lesions). CONCLUSION: The importance of considering competing events in recurrence risk analysis is poorly recognized as only 6% of the studies we surveyed employed Aalen-Johansen analyses. Consequently, most of the previous literature has overestimated the risk of recurrence. The overestimation was negligible for studies involving low-grade lesions in younger individuals; however, overestimation might have been substantial for studies on high-grade lesions.

The monomer 1-(isopropylamino)-3-(1-naphthyloxy)-2-propanoacrylate (IANOPA) and monomer 1-(isopropylamino)-3-(1-naphthyloxy)-2-propanomethacrylate (IANOPMA) were synthesized by treating 1-(isopropylamino)-3-(1-naphthyloxy)-2-propanol with acryloylchloride/methacryloyl chloride. The above esterification reactions were carried out in the presence of triethylamine. By employing the free radical polymerization method, the synthesized monomers were converted into polymers by using an initiator 2, 2′-azobisisobutyronitrile in the presence of nitrogen environment at 70±2°C. The monomers and polymers were characterized by various techniques such as FT-IR, UV, 1H NMR, and 13C NMR spectroscopic analyses. Further, differential scanning calorimetry (DSC) was used to estimate the glass transition temperature (Tg). Gel permeation chromatography (GPC) was used to estimate the molecular weight of the polymers. In addition, monomer and polymer surfaces’ morphology was analyzed using SEM analysis. As a primary application, the effectiveness of synthesized monomers and polymers was explored as antibacterial agents against gram-positive bacteria (Staphylococcus aureus) and gram-negative bacteria (Pseudomonas aeruginosa) which were measured from their inhibitory zone diameters. Further, the synthesized polymers, poly-IANOPA and poly-IANOPMA, were utilized for the uptake ability study of heavy metal ions such as Zn2+, Cu2+, Ni2+, and Pb2+ present in water sources by equilibrium method.