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BackgroundChronic subdural hematoma (cSDH) is a disease affecting mainly elderly individuals. The reported incidence ranges from 2.0/100,000 to 58 per 100,000 person-years when only considering patients who are over 70 years old, with an overall incidence of 8.2–14.0 per 100,000 persons. Due to an estimated doubling of the population above 65 years old between 2000 and 2030, cSDH will become an even more significant concern. To gain an overview of cSDH hospital admission rates, treatment, and outcome, we performed this multicenter national cohort study of patients requiring surgical treatment of cSDH.MethodsA multicenter cohort study included patients treated in 2013 in a Swiss center accredited for residency. Demographics, medical history, symptoms, and medication were recorded. Imaging at admission was evaluated, and therapy was divided into burr hole craniostomy (BHC), twist drill craniostomy (TDC), and craniotomy. Patients' outcomes were dichotomized into good (mRS, 0–3) and poor (mRS, 4–6) outcomes. A two-sided t-test for unpaired variables was performed, while a chi-square test was performed for categorical variables, and a p-value of

BackgroundSkiing is a very popular sport worldwide, with increasing trends over the past decades. This study aimed to evaluate the importance of traumatic brain injury (TBI), especially in the elderly, after a ski accident, and to describe its short-term repercussions.MethodologyPatients were analyzed who were admitted to our neurotrauma center from 2012-2018 after a head trauma while skiing. Three different age groups were differentiated and analyzed for the severity of TBI depending on the initial Glasgow Coma Scale as the primary outcome and as secondary outcomes need and type of surgery, Glasgow Outcome Score, preexisting use of anticoagulant or antiplatelet drugs, time to presentation, and pattern of brain injury. TBI severity was adjusted to the time to initial medical consultation.ResultsNo significant difference in TBI severity was found when comparing the middle (>29-54) and older (≥54) age groups to the reference group ConclusionNo differences were observed in terms of TBI severity between age groups after acute trauma. Nonetheless, a different pattern of head injury after TBI in older patients was demonstrated. Accordingly, the management differs for these TBIs compared to those of younger patients.

The evacuation of a chronic subdural hematoma (cSDH) is one of the most common procedures in neurosurgery. The aim of this study was to assess the influence of drainage suction in the surgical treatment of cSDH on the recurrence rate. Post hoc analysis was conducted on two randomized controlled trials (cSDH-Drain-Trial and TOSCAN trial) stratifying a total of 581 patients into active or passive drain type. Of the 581 patients, 359 (61.8%) and 220 (37.9%) were stratified into the active and passive drainage groups, respectively. The reoperation rate following postoperative recurrence was 23.1% and 14.1% in the active and passive drainage groups, respectively (p < 0.011). After propensity score matching, the differences in recurrence rate remained significant (26.6% versus 15.6%, p = 0.012). However, the functional outcome (mRS) at 6–12 months did not differ significantly (median [IQR]) between the 2 groups (passive drainage group 0.00 [0.00, 2.00], active drainage group 1.00 [0.00, 2.00], p = 0.431). Mortality was comparable between the groups (passive drainage group 12 (5.5%), active drainage group 20 (5.6%), p = 0.968). In the univariate analysis, active drainage, short (

Brain tumors are the most common solid tumors in children and are associated with high mortality. The most common childhood brain tumors are grouped as low-grade gliomas (LGG), high grade gliomas (HGG), ependymomas, and embryonal tumors, according to the World Health Organization (WHO). Advances in molecular genetics have led to a shift from pure histopathological diagnosis to integrated diagnosis. For the first time, these new criteria were included in the WHO classification published in 2016 and has been further updated in the 2021 edition. Integrated diagnosis is based on molecular genomic similarities of the tumor subclasses, and it can better explain the differences in clinical courses of previously histopathologically identical entities. Important advances have also been made in pediatric neuro-oncology. A growing understanding of the molecular-genetic background of tumorigenesis has improved the diagnostic accuracy. Re-stratification of treatment protocols and the development of targeted therapies will significantly affect overall survival and quality of life. For some pediatric tumors, these advances have significantly improved therapeutic management and prognosis in certain tumor subgroups. Some therapeutic approaches also have serious long-term consequences. Therefore, optimized treatments are greatly needed. Here, we discuss the importance of multidisciplinary collaboration and the role of (pediatric) neurosurgery by briefly describing the most common childhood brain tumors and their currently recognized molecular subgroups.

Women’s careers in Germany are strongly shaped by employment interruptions following child birth. This article examines the duration of employment interruption and job changes after the birth of a first child, employing the occupational characteristics of the job held before the familyrelated break as central predictors. In line with economic theory of labor supply and the theory of social production function, we argue that mothers compare the benefits of family time and the benefits of employment before they decide to return to the labor market. The empirical analysis uses data from the German Socio-Economic Panel and reveals that psychological strains in the job held before the birth increase the likelihood of a job change after a family-related break. A high income before the birth accelerates women’s return to the labor market without a job change. Zusammenfassung Die Erwerbsverläufe von Frauen sind in Deutschland weiter stark durch familiäre Unterbrechungen geprägt. Der vorliegende Beitrag betrachtet zwei Aspekte des mütterlichen Erwerbsverlaufs nach der Geburt des ersten Kindes: die Dauer bis zur Rückkehr in den Arbeitsmarkt und berufliche Wechsel, und zwar in Abhängigkeit vom vor der Geburt ausgeübten Beruf. Auf Basis der neoklassischen Theorie des Arbeitsangebots und der Theorie der Sozialen Produktionsfunktion wird die These aufgestellt, dass Frauen den Nutzen der Familienzeit mit dem Nutzen der Arbeitszeit vergleichen und der Wiedereinstieg in den Arbeitsmarkt und in den Herkunftsberuf von dieser Nutzenkalkulation abhängt. Die empirische Untersuchung auf Basis des Sozio-oekonomischen Panels zeigt, dass psychische Belastungen im Herkunftsberuf Frauen nach der Geburt des ersten Kindes eher veranlassen, den Beruf zu wechseln. Ein hohes Einkommen vor der Geburt wirkt beschleunigend auf den Wiedereintritt in den Arbeitsmarkt ohne beruflichen Wechsel.

Background: Previous research has shown that fertility is influenced by the family of origin. However, there is only little evidence about intergenerational transmission of fertility expectations in younger birth cohorts. Objective: We investigate if there is a positive relationship between the number of full siblings and expected family size in a young birth cohort in Germany and whether this association can be explained by transmission of socioeconomic status. Methods: We use the fifth wave of the German Family Panel (birth cohort 1991-1993) and estimate multinomial logistic regression models. Results: We find a positive effect of the number of full siblings on expected family size that remains stable when controlling for the socioeconomic status of the parents. The effect is smaller on an expected family size of two children compared to other parities which is compatible with the prevailing two-child norm in Germany. Contrary to our expectations there is no effect of the number of siblings on being uncertain about having children. Conclusions: The family of origin influences fertility expectations in a cohort born in the 1990s in Germany, which cannot be explained by transmission of socioeconomic status. Although it is theoretically plausible, there is no final proof that the relationship is instead due to transmission of family values, as the number of siblings is only a proxy variable for the family values of the parents. Contribution: We verify the results of previous studies for a cohort born in the 1990s in Germany, account for parity differences, and include uncertainty in fertility expectations.

Abstract  Biomineralization, which means the formation of inorganic materials by biological processes, currently finds increasing research interest. It involves the synthesis of calcium-based minerals such as bones and teeth in vertebrates, and of shells. Silica biomineralization occurs, for example, in diatoms and silica sponges. Usually, biominerals are made up of amorphous compounds or small microcrystalline domains embedded into an amorphous matrix. Nevertheless, they exhibit very regular shapes and, as in the case of diatoms, intricate nanopatterns of amazing beauty. It is, therefore, commonly assumed that biominerals are formed under the structure-directing influence of templates. However, single molecules are by far too small to direct the formation of the observed shapes and patterns. Instead, supramolecular aggregates are shown to be involved in the formation of templating superstructures relevant in biomineralization. Specific biomolecules were identified in both diatoms and silica sponges, which elegantly combine two indispensable functions: on the one hand, the molecules are capable of inducing silica precipitation from precursor compounds. On the other hand, these molecules are capable of self-assembling into larger, structure-directing template aggregates. Such molecules are the silaffins in the case of diatoms and the silicateins in sponges. Long-chain polyamines of similar composition have meanwhile been discovered in both organisms. The present review is especially devoted to the discussion of the self-assembly behavior of these molecules. Physico-chemical studies on a model compound, poly(allylamine), are discussed in detail in order to elucidate the nature of the interactions responsible for self-assembly of long-chain polyamines and the parameters controlling this process. Numerous biomimetic silica synthesis experiments are discussed and evaluated with respect to the observations made on the aforementioned “natural” biomolecules. [ABSTRACT FROM AUTHOR]