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- Bø, Hans Kristian, et al.
(författare)
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Intraoperative 3D ultrasound-guided resection of diffuse low-grade gliomas: radiological and clinical results.
- 2020
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Ingår i: Journal of neurosurgery. - 1933-0693. ; 132:2, s. 518-529
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVEExtent of resection (EOR) and residual tumor volume are linked to prognosis in low-grade glioma (LGG) and there are various methods for facilitating safe maximal resection in such patients. In this prospective study the authors assess radiological and clinical results in consecutive patients with LGG treated with 3D ultrasound (US)-guided resection under general anesthesia.METHODSConsecutive LGGs undergoing primary surgery guided with 3D US between 2008 and 2015 were included. All LGGs were classified according to the WHO 2016 classification system. Pre- and postoperative volumetric assessments were performed, and volumetric results were linked to overall and malignant-free survival. Pre- and postoperative health-related quality of life (HRQoL) was evaluated.RESULTSForty-seven consecutive patients were included. Twenty LGGs (43%) were isocitrate dehydrogenase (IDH)-mutated, 7 (14%) were IDH wild-type, 19 (40%) had both IDH mutation and 1p/19q codeletion, and 1 had IDH mutation and inconclusive 1p/19q status. Median resection grade was 93.4%, with gross-total resection achieved in 14 patients (30%). An additional 24 patients (51%) had small tumor remnants < 10 ml. A more conspicuous tumor border (p = 0.02) and lower University of California San Francisco prognostic score (p = 0.01) were associated with less remnant tumor tissue, and overall survival was significantly better with remnants < 10 ml (p = 0.03). HRQoL was maintained or improved in 86% of patients at 1 month. In both cases with severe permanent deficits, relevant ischemia was present on diffusion-weighted postoperative MRI.CONCLUSIONSThree-dimensional US-guided LGG resections under general anesthesia are safe and HRQoL is preserved in most patients. Effectiveness in terms of EOR appears to be consistent with published studies using other advanced neurosurgical tools. Avoiding intraoperative vascular injury is a key factor for achieving good functional outcome.
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| 2. |
- Rust, Niki, et al.
(författare)
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Perceived Causes and Solutions to Soil Degradation in the UK and Norway
- 2022
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Ingår i: Land. - : Multidisciplinary Digital Publishing Institute. - 2073-445X. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Soil quality is declining in many parts of the world, with implications for the productivity, resilience and sustainability of agri-food systems. Research suggests multiple causes of soil degradation with no single solution and a divided stakeholder opinion on how to manage this problem. However, creating socially acceptable and effective policies to halt soil degradation requires engagement with a diverse range of stakeholders who possess different and complementary knowledge, experiences and perspectives. To understand how British and Norwegian agricultural stakeholders perceived the causes of and solutions to soil degradation, we used Q-methodology with 114 respondents, including farmers, scientists and agricultural advisers. For the UK, respondents thought the causes were due to loss of soil structure, soil erosion, compaction and loss of organic matter; the perceived solutions were to develop more collaborative research between researchers and farmers, invest in training, improve trust between farmers and regulatory agencies, and reduce soil compaction. In Norway, respondents thought soils were degrading due to soil erosion, monocultures and loss of soil structure; they believed the solutions were to reduce compaction, increase rotation and invest in agricultural training. There was an overarching theme related to industrialised agriculture being responsible for declining soil quality in both countries. We highlight potential areas for land use policy development in Norway and the UK, including multi-actor approaches that may improve the social acceptance of these policies. This study also illustrates how Q-methodology may be used to co-produce stakeholder-driven policy options to address land degradation.
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