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The main purpose of this paper is to investigate multi-temporal land surface temperature (LST) and Normalized Difference Vegetation Index (NDVI) changes of Konya in Turkey using remotely sensed data. Konya is located in the semi-arid central Anatolian region of Turkey and hosts many important wetland sites including Salt Lake. Six images taken by Landsat-5 TM and Landsat 8- OLI satellites were used as the basic data source. These raw images were taken in 1984, 2011 and 2014 intended as long-term and short-term. Firstly, those raw images was corrected radiometric and geometrically within the scope of project. Three mosaic images were obtained by using the full-frame images of Landsat-5 TM / 8- OLI which had been already transformed comparison each other. Then, Land Surface Temperature (LST), Normalized Difference Vegetation Index (NDVI) maps have been produced to determine the dimension of the drought. The obtained results showed that surface temperature rates in the basin increased about 5°C between 1984 and 2014 as long periods, increased about 2-3°C between 2011and 2014 as short periods. Meteorological data supports the increase in temperature.

The main purpose of this paper is to investigate climate change effects that have been occurred at the beginning of the twenty-first century at the Konya Closed Basin (KCB) located in the semi-arid central Anatolian region of Turkey and particularly in Salt Lake region where many major wetlands located in and situated in KCB and to share the analysis results online in a Web Geographical Information System (GIS) environment. 71 Landsat 5-TM, 7-ETM+ and 8-OLI images and meteorological data obtained from 10 meteorological stations have been used at the scope of this work. 56 of Landsat images have been used for extraction of Salt Lake surface area through multi-temporal Landsat imagery collected from 2000 to 2014 in Salt lake basin. 15 of Landsat images have been used to make thematic maps of Normalised Difference Vegetation Index (NDVI) in KCB, and 10 meteorological stations data has been used to generate the Standardized Precipitation Index (SPI), which was used in drought studies. For the purpose of visualizing and sharing the results, a Web GIS-like environment has been established by using Google Maps and its useful data storage and manipulating product Fusion Tables which are all Google’s free of charge Web service elements. The infrastructure of web application includes HTML5, CSS3, JavaScript, Google Maps API V3 and Google Fusion Tables API technologies. These technologies make it possible to make effective “Map Mash-Ups” involving an embedded Google Map in a Web page, storing the spatial or tabular data in Fusion Tables and add this data as a map layer on embedded map. The analysing process and map mash-up application have been discussed in detail as the main sections of this paper.

Abstract??The anatomical features of the autonomous nerves, including the greater, lesser and least splanchnic nerves, were examined in 4 female and 4 male adult pigs (Sus scrofa). The origin and course of these nerves were examined with regard to sex and the side of the body. The greater splanchnic nerve was present in all of the animals included in the study, whereas the lesser splanchnic nerve was present at a rate of 87.5% on the right side and 75% on the left side of the median plane. On the other hand, the least splanchnic nerve was present on the right side at a rate of 62.5% and on the left side at a rate of 37.5%. The greater, lesser and least splanchnic nerves on the right side of the median plane were determined to originate from a more cranial location. Furthermore, these nerves were observed to be longer and larger on the right side in comparison with the left side. Evaluation of the findings revealed no significant difference between both sides of the median plane with regard to the origin, course and dimensions of these nerves. Similarly, no significant difference was detected between sexes. [ABSTRACT FROM AUTHOR]

Microplastic pollution is a growing environmental and health issue. This study evaluates microplastic pollution awareness among medical students at Pamukkale University and the factors influencing it. A cross-sectional study was conducted in June 2023 with 474 students from the 1st, 3rd, and 6th years, using a 26-item questionnaire, including the 14-item Microplastic Pollution Awareness Scale (MPAS). The mean MPAS score was 22.94 ± 3.67, reflecting moderate to high awareness. Female students ( p  = 0.001), prior knowledge of microplastics ( p  < 0.001), and concern about microplastic health risks ( p  < 0.001) were associated with higher awareness. Social media was the most common source of information (49.2%). Although awareness is moderate, significant gaps exist in students' understanding of microplastic health impacts. Targeted educational interventions are needed to close these gaps, empowering future healthcare professionals to address the risks of microplastic pollution.

Objective: To evaluate the relationship between bone mineral density (BMD) by measuring the prepatellar fat thickness with knee radiography and to gain a measurement method that has not been done before in the literature., Study Design: Cross-sectional descriptive study. Place and Duration of the Study: Department of Physical Medicine and Rehabilitation, Training and Research Hospital, Sanliurfa, Turkiye, between January and June 2020., Methodology: Patients' age, body mass index (BMI) data, prepatellar fat thickness (mm), L1-L4 total, bone mineral density femoral neck, femur trochanter major, and femur total T scores were recorded. The relationships between these three groups (normal, osteopenia, osteoporosis) and between prepatellar fat tissue measurement were evaluated. One-way analysis of variance (ANOVA) and Post Hoc Tukey tests were used in the analysis., Results:  A statistically significant difference was found in terms of trochanter major T score measurements (X2 = 20.435; p <0.001) and BMI (X2 = 66.535; p <0.001) measurements of prepatellar fat thickness measurement. A statistically significant difference was found between the three groups in terms of prepatellar fat thickness measurement, L1-4 T-score, femoral neck, and femur total values (p <0.001)., Conclusion:  Prepatellar fat thickness in postmenopausal Turkish women was positively correlated with BMD; BMD increases as the prepatellar fat thickness increases. This explains that perapatellar fat thickness creates a mechanical load on the bones and causes an increase in BMD., Key Words: Osteoporosis, Fat thickness, Bone mineral density.

Background: Polymorphous low-grade neuroepithelial tumor of the young (PLNTY) is a rare entity of low-grade neuroepithelial tumors that primarily affects children and young adults. This distinct type of tumor presents unique challenges in diagnosis and management. With its relatively recent identification, researchers and clinicians are striving to understand the characteristics, behavior, and optimal treatment strategies. The symptoms are primarily related to seizures. However, PLNTY can be asymptomatic in some cases., Materials and Methods: This is a single-center case report study and a literature review paper. We reviewed a case treated and diagnosed at the Ankara University Faculty of Medicine, Department of Neurosurgery. The demographic data, clinical follow-ups, laboratory, and radiological data of the patients were assessed., Results: We present a 32-year-old male patient who has undergone gross total surgical excision with strict clinical follow-up. Clinical course as well as surgical data of the patient were observed and analyzed., Conclusion: On imaging, morphologic resembling and indistinctive clinical course can be nonspecific, contributing to diagnostic uncertainties. This case report was written with the notion that rare diagnoses present an opportunity to understand the progression and patho-oncological factors that can pave the way for better treatment.

Purpose: This retrospective magnetic resonance imaging investigation aimed to obtain information related to the anatomy of the massa intermedia (MI) in an adult population., Methods: The work conducted on MRI views of 1058 (539 males and 519 females) healthy adult samples aged with 48.93 ± 17.63 years. Initially, the presence or absence of MI was noted, and then if present, its numbers and location in the third ventricle were recorded. Its horizontal (HDMI) and vertical (VDMI) diameters were measured on MRI views, while the cross-sectional area (CSAMI) was calculated using its diameters., Results: MI was missing in 2.6% (27 cases) of 1058 adult samples. Six subjects (0.6%) had a double MI. HDMI, VDMI and CSAMI were measured as 4.83 ± 1.01 mm, 4.86 ± 0.98 mm, and 19.11 ± 7.23 mm 2 , respectively. MI size did not show a significant alteration from 19 up to 49 years, but then its size distinctly decreased between 50 and 60 years. After age 60, MI dimension did not display an important change. MI was settled in the antero-superior quadrant in 929 cases (90.63% of 1025 subjects), in the postero-superior quadrant in 22 cases (2.15%), in the antero-inferior quadrant in 32 cases (3.12%), in the postero-inferior quadrant in 8 cases (0.78%), and in the central part in 34 cases (3.32%)., Conclusions: The size, position and incidence of MI were not affected by sex, and its position and incidence were not affected by adult age periods. In adults, MI size demonstrated a significant decrease in the middle age., (© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Objective: Virtual simulation and imaging systems have evolved as advanced products of computing technology over the years. With advancements in mobile technology, smartphones, and tablets, the quality of display and processing speed have gradually improved, thanks to faster central processing units with higher capacity. Integrating these two technologies into the fields of healthcare and medical education has had a positive impact on surgical training. However, contemporary neurosurgical planning units are expensive and integrated neuronavigation systems in operating rooms require additional accessories. The aim of this study was to investigate the compatibility of smartphone applications in augmented reality (AR)-based craniotomy planning, which can be available even in disadvantaged workplaces with insufficient facilities., Methods: Thirty patients diagnosed with supratentorial glial tumor and who underwent operations between January 2022 and March 2023 were included in the study. The entire stages of the surgical procedures and the surgical plans were executed with neuronavigation systems. The patient CT scans were reconstructed using software and exported as a 3D figure to an AR-enhanced smartphone application. The evaluation of the application's success was based on the spatial relationship of the AR-based artificial craniotomy to the neuronavigation-based craniotomy, with each AR-based craniotomy scaled from 0 to 3., Results: In the comparison between neuronavigation-based and AR fusion-based craniotomies, 8 of 30 (26.6%) patients scored 0 and were considered failed, 6 (20%) scored 1 and were considered ineffective, 7 (23.3%) scored 2 and were considered acceptable, and 9 (30%) scored 3 and were considered favorable., Conclusions: AR technology has great potential to be a revolutionary milestone of neurosurgical planning, training, and education in the near future. In the authors' opinion, with the necessary legal permissions, there is no obstacle to the integration of surgical technological systems with mobile technology devices such as smartphones and tablets that benefit from their low-budget requirements, wide-range availability, and built-in operating systems.

Aim: To assess the frequency of thoracolumbar junction (TLJ) fractures (T10-L2) in survivors of the 2023 East Turkey earthquake., Material and Methods: This single-center retrospective stdy evaluated 10 earthquake survivors, who were trapped under the rubble and rescued alive by rescue teams, and were assessed for spinal trauma after the earthquake in Eastern Turkey on February 6, 2023. All patients underwent full spinal magnetic resonance imaging and computed tomography examinations to determine the level of spinal fracture and decide the treatment methods., Results: All patients had sustained spinal fractures. Eight underwent surgery, while two were managed conservatively. Nine out of ten patients had TLJ fractures. Five patients had L1 fractures, four of them were treated surgically. Three patients had a T12 level fracture, two of whom were treated surgically. One patient with a T7-level fracture was treated surgically. Only one patient had multiple fractures (T12 and L2 levels) and was treated surgically., Conclusion: The TLJ was the commonest vertebral fracture level as of the 2023 Turkey earthquake survivors in our study population. In the event of an earthquake, people tend to attain a fetal posture (fix and hyperflex the spine) when taking shelter in a narrow area (triangle of life). This position might place an excessive load on the TLJ, predisposing it to injuries.

Aim: To retrospectively evaluate the cranial magnetic resonance imaging (MRI) features and determine the incidence of intracranial arachnoid cysts (ACs) based on sex, age, location, size, affected side, Galassi type, and their association with hydrocephalus, mega cisterna magna (MCM), bone erosion, and midline brain shift in 15,108 patients during outpatient headache evaluations., Material and Methods: Between 2012 and 2022, cranial MRI scans of 15,108 adult patients aged 20-70 years undergoing outpatient evaluations for headaches were retrospectively reviewed to analyze the features of ACs detected incidentally. Patients who had previously undergone a craniotomy or craniectomy were excluded from the study., Results: The relationship between the location of AC and hydrocephalus did not show statistically significant differences between the supratentorial and infratentorial subgroups (p = 0.557). The relationship between the location of AC and MCM showed statistically significant differences between the two groups (p = 0.008). MCMs occur more commonly in supratentorial ACs than in posterior fossa ACs., Conclusion: The increased use of MRI in assessing patients with headaches has resulted in an increased detection of ACs. Although managing asymptomatic lesions typically involves periodic follow-ups, symptomatic lesions can sometimes require surgical treatment, such as AC fenestration, cyst aspiration, endoscopic shunt placement, or microneurosurgery.

Objective: The lower extremity contains a variety of functional structures therefore re-establishing soft tissue coverage in large-scale injuries is a challenging procedure. Microsurgery has made progress in reducing donor morbidity and achieving a functional and aesthetic appearance in recent years. This study aimed to apply anterolateral thigh (ALT) flap to tissue defects in the lower extremity and to discuss the results., Patients and Methods: Twenty-three patients who were admitted to our hospital with lower extremity trauma and underwent ALT flap surgery due to soft tissue defect between November 2020 and March 2022 were included in the study. Patients' demographic data, the applied surgical procedure, the development of postoperative complications, and postoperative functional results were evaluated., Results: Twenty-three patients were included in this research. The mean age of the patients was 36.56±14.67 (10-61). Of these patients, 3 were female (13%), and 20 were male (87%). The most common etiology was traffic accident (n=8, 34%), followed by gunshot injuries (n=5, 21%), electrical burn (n=4, 17%), open fractures (n=2, 7%), infection (n=2, 7%), diabetic foot (n=1, 4%), skin tumor (n=1, 4%). Flaps were raised from the contralateral extremity in twelve patients (52%) and on the ipsilateral extremity in eleven patients (48%). The average time from first trauma to free flap surgery was 10.7±5 days (4-22). The average postoperative hospitalization was 13.6 days (9-23 days). The average follow-up time of patients was 8 months (3-13 months). The donor site is closed with primary saturation in 19 patients (82%) and closed with split-thickness skin grafting in 4 patients (18%). Our overall success rate was 96%. We had only one total flap failure out of twenty-three patients (4%)., Conclusions: ALT-free flap is an excellent choice for reconstructing lower extremity complex defects. For experienced surgeons, the ALT flap can be used successfully in the treatment of soft tissue defects of variable size in the lower extremity.

Purpose: Cribriform neuroepithelial tumor (CRINET) is a provisional category of intraventricular tumors, sharing similarities with AT/RTs, and there is a lack of data about its pathology, prognosis, and surgical approaches in the literature. We have been challenged to describe the surgical approach to a rare case of CRINET and describe the intraoperative features since none has been described before. Surgical resection and chemotherapy hold a great importance of favorable prognosis., Methods: Twenty-month-old male with intraventricular tumor underwent transcallosal intraventricular tumor resection and endoscopic intraventricular second look stages. The tumor was initially considered choroid plexus carcinoma and histopathological results pointed CRINET. The patient also received Ommaya reservoir for intrathecal chemotherapy employment. The patient's preoperative and postoperative MRI scans and tumor's pathological features are described with a brief history of the disease in the literature., Results: Lack of SMARCB1 gene immunoreactivity and presence of cribriform non-rhabdoid trabecular neuroepithelial cells led to the CRINET diagnosis. The surgical technique helped us to approach directly into the third ventricle and perform total resection and intraventricular lavage. The patient recovered without any perioperative complications and is consulted pediatric oncology for further treatment planning., Conclusion: With our limited knowledge on the matter, our presentation may provide an inside to the course and progress of the CRINET as a very rare tumor and may help to set a basis for future investigations focused on its clinical and pathological features. Long courses of follow-up periods are required for establishing treatment modules and assessing the responses to surgical resection techniques and chemotherapy protocols., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To assess the effect of the enhanced recovery after surgery (ERAS) protocol for cesarean deliveries (CD) on postoperative outcomes., Methods: This multicenter prospective cohort study was conducted in six different centers between September 2020 and March 2021 and involved women who underwent either planned or unplanned CD. The primary outcome was time to the first passage of flatus following CD. Secondary outcomes included postoperative pain score, postoperative complications, and patient satisfaction. The protocol included early postoperative oral intake of ice cream and coffee, multimodal analgesia, antiemetic medications, and early ambulation., Results: A total of 448 patients were included. The median time to the first passage of flatus was 10 h in the Hermes group and 18 hours in the control group (P < 0.001). Postoperative visual analog scale scores were significantly higher in the control group. Patient satisfaction scores and the frequency of postoperative complications did not differ between the groups (P = 0.08, P = 0.604, respectively)., Conclusions: The ERAS protocol, including early serving of ice cream and coffee in the early postoperative period, enabled early discharge and a faster return of bowel function. Implementation of the ERAS protocol for patients who underwent planned and unplanned CD appeared to be safe and effective., (© 2022 International Federation of Gynecology and Obstetrics.)

Flood disasters resulting from excessive water in stream beds inflict extensive damage. Floods are caused by the expansion of cities, the erosion of riverbeds, inadequate infrastructure, and increasing precipitation due to climate change. Floods cause great damage to agricultural areas and settlements. Regions that may be affected by floods should be identified, and precautions should be taken in these areas to prevent these damages. Flood susceptibility maps are produced for this reason. The purpose of this study was to construct a flood susceptibility map so that susceptible locations in Mersin may be identified. Firstly, 429 flood events were identified for the flood inventory map. Twelve conditioning factors, namely elevation, slope, distance to river, distance to drainage, drainage density, soil permeability, precipitation, land cover/land use, stream power index (SPI), topographic wetness index (TWI), aspect, and curvature were used to create flood susceptibility maps, applying logistic regression and best-worst methods. The flood inventory data were used to prepare susceptibility maps and test their consistency. The receiver operating characteristic (ROC) curve was used for consistency analysis. In logistic regression, 86% of floods were located within 20% of the study area that was categorized as high and very high susceptibility. According to the value of the area under the ROC curve (AUC), logistic regression had a 0.901 value. Land use, soil permeability, and elevation were the most important factors in the logistic regression method. In the best-worst method, 85% of floods were located within the 14% of the study area categorized as high and very high susceptibility. According to the AUC value, the best-worst method had a 0.898 value. Elevation, distance to river, and precipitation factors had the highest coefficient value in the best-worst method. Based on the AUC values, the flood susceptibility maps had a high prediction capacity., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Third ventricle lesions, especially those located proximally to the foramen of Monro, generally present with obstructive hydrocephalus symptoms. In this report, we present a case with acute obstructive hydrocephalus secondary to a gel-foam material. The patient has previously underwent an endoscopic cystectomy. At postoperative third month, she admitted to our hospital with the complain of headache. Neuroradiological imaging revealed triventricular hydrocephalus. A second endoscopic operation was performed, and a piece of gelatin-sponge material was detected at the level of cerebral aqueduct, which obstructed the flow of cerebrospinal fluid (CSF). The CSF flow was immediately restored after removing this material, and an additional third ventriculostomy was performed., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Due to rapid urbanization and the resulting rapid population increases, an important problem for cities today is the elimination of solid waste or finding suitable places for waste storage. Municipal solid waste disposal (MSWD) site selection is one of the most important steps in urban waste management. Many criteria political, economic, social, and technological should be considered in this process. Geographic information systems (GIS) and multi-criteria decision-making (MCDM) are tools that are superior to traditional methods in the planning phase of site selection studies. In this study, suitable MSWD sites were determined in Mersin (a Turkish province) based on GIS and the analytic hierarchy process, an MCDM method. Unsuitable areas in the study were removed at the beginning of the analysis. Eleven evaluation criteria were selected: elevation, slope, permeability, distance from lineaments, groundwater level, distance from rivers and water surfaces, distance from roads, distance from settlements, distance from protected areas, and land cover. Considering the evaluation and exclusion criteria, 19.12% of the study area was deemed suitable, and 80.88% was determined unsuitable for an MSWD site. An MSWD suitability map was created as a result of the study. The outcomes indicate that 80,377 ha and 83,022 ha of the study area were classified as high and very high suitability, respectively. Based on these results, we evaluate whether the locations of existing solid waste landfills are appropriate and propose alternative solid waste landfills for each district., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Long head of biceps tendon (LHBT) instability is an important source of pain and disability for the shoulder. Supraspinatus and subscapularis tendons contribute to the formation of the biceps pulley system, which maintains biceps stability during shoulder movements. The aim of this study is to evaluate the effect of morphology of bicipital groove on the stability of LHBT. Also, to evaluate the relationship between bicipital groove morphology and subscapularis rupture and supraspinatus rupture., Material and Methods: Surgical images and magnetic resonance images of 200 patients who underwent shoulder arthroscopy surgery in our clinic between January 2016 and December 2017 were retrospectively analyzed. The depth of groove, medial wall angle and opening angle values of 200 patients were measured on MRI. The stability of the biceps long head tendon, rotator cuff tear and SLAP lesions was recorded by monitoring the shoulder arthroscopy records in each groups., Results: There were 200 patients, 131 male and 69 female, with an average age of 40.9 ± 14.2 (range: 17.0-79.0) years. In 69 (34.5%) patients, long head of the biceps tendon (LHBT) instability was detected. The patients were divided into two groups according to LHBT instability.The subscapularis rupture was significantly more frequent in the group with LHBT instability (52.2%) than the group without LHBT instability (4.6%) (p < 0.001). The supraspinatus tear was observed in 72.5% in the group with instability and 56.5% in the non-instability group, which shows a statistical difference between the two groups (p = 0.027). The presence of SLAP was observed in similar rates in both groups (p = 0.053). Mean depth of groove, medial wall angle, and opening angle measurements were similar in both groups (p = 0.568, p = 0.393 and p = 0.598, respectively)., Conclusion: To conclude, the morphology of the bicipital groove is not related to the stability of LHBT, and the soft tissue factors above the bicipital groove rather than bone morphology are important in stability. In addition, subscapularis rupture is a pre-disposing factor for LHBT instability; therefore, we recommend a more careful examination of LHBT in patients with subscapularis rupture., Level of Evidence: III., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)

Konya, which is located within the Konya Closed Basin, is the most important agricultural production region in Turkey. The future of agriculture is threatened in this region due to the decline in groundwater levels and the intensive agricultural activities that require high water consumption and are not suitable to the climate conditions of the region. In addition to these parameters, the geological structure of Konya also poses various environmental problems such as land subsidence and sinkhole formation. This study aimed to investigate the causes of the land subsidence problem in Konya and its surroundings with the help of the interferometric synthetic aperture radar (InSAR) technique and auxiliary data, namely optic, Coordination of Information on the Environment (CORINE), and groundwater monitoring station data. In order to investigate the land subsidence in the study area, 58 Sentinel-1A images acquired between 2014 and 2018 were processed by using the small baseline subset (SBAS) technique. In addition, the time series derived from the SAR data was validated by a global navigation satellite system (GNSS) station located in the study area. The results revealed that severe land subsidence, some of which reached 75 mm/year, occurred in certain areas of the study area over a period of three and a half years. High consistency was found between the land subsidence and the groundwater level change observed in the region, with a cross-correlation of over 95%. Moreover, the temporal and spatial patterns of the cultivated area and urbanization, which are the main reasons for the consumption of groundwater in the region, were revealed using the optic data.

We designed, implemented and evaluated a near-peer simulation training programme teaching diagnostic and therapeutic abdominal paracentesis to core medical trainees (CMTs). We taught diagnostic and therapeutic abdominal paracentesis to 77 north-west London CMTs over 8 training days over 4 years, 2015 to 2019. The programme was optimised by use of plan, do, study, act (PDSA) cycles and the content was evaluated by anonymous pre- and post-course questionnaires. There was a need for this training; 89% of participants reported inadequate training opportunities pre-course and only 28% felt 'confident' or 'very confident' to insert an ascitic drain. Simulation training appears effective when teaching these skills. Having been low in confidence before the course, all participants reported increased confidence after completing the course. Simulation training has been highlighted as a key aspect of the new internal medicine training programme, which replaces CMT. We would recommend using PDSA cycles to implement effective simulation programmes., (© Royal College of Physicians 2021. All rights reserved.)

The Karapinar basin, located in the Central Anatolian part of Turkey, is subjected to land subsidence and sinkhole activity due to extensive groundwater withdrawal that began in the early 2000s. In this study, we use Interferometric Synthetic Aperture Radar (InSAR), Global Navigation Satellite System (GNSS), and groundwater level data to monitor and better understand the relations between groundwater extraction, land subsidence, and sinkhole formation in the Karapinar basin. The main observations used in the study are InSAR-derived subsidence velocity maps calculated from both Sentinel-1 (2014-2018) and COSMO-SkyMed (2016-2017) SAR data. Our analysis reveals broad areas of subsidence with rates exceeding 70 mm/yr. The InSAR-derived subsidence was compared with GNSS data acquired by a continuously operating GNSS station located in the study area, which show a similar rate of subsidence. The temporal characteristic of both InSAR and GNSS time series indicate a long-term subsidence signal superimposed by seasonal variability, which follows the overall groundwater level changes, with over 80% cross-correlation consistency. Our results also indicate that sinkhole activity is limited to slow subsidence areas, reflecting strong cohesion of near-surface rock layers that resist subsidence but yield to collapse in response to aquifer system deformation induced by groundwater extraction.

Background: Ulnar nerve entrapment neuropathy at the elbow is the most common upper-extremity entrapment neuropathy after carpal tunnel syndrome. Surgical treatment can be complicated by perineural scarring and fibrosis, which may lead to recurrent symptoms. Expanded polytetrafluoroethylene (ePTFE) is a synthetic polymer with antiadhesive properties., Objective: To introduce the operative technique and outcomes of anterior subcutaneous transposition with ePTFE (ASTEP) in primary and recurrent cubital tunnel neuropathy., Methods: We studied 14 adult patients (11 men, 3 women; mean age, 45 yr) with cubital tunnel neuropathy (10 primary, 4 revision) who underwent surgery with the ASTEP technique between January 2008 and May 2018. Pain, numbness in the fourth/fifth fingers, and weakness of the intrinsic hand muscles were the most common presenting symptoms. Surgical outcomes were assessed using the modified McGowan and Wilson-Krout criteria., Results: The average (± standard deviation) preoperative symptom duration was 12.1 ± 5.2 mo (McGowan Grade 1, n = 5; Grade 2, n = 6; Grade 3, n = 3). No intraoperative or postoperative complications were observed with the ASTEP technique. Postoperative follow-up ranged from 9 mo to 7 yr (mean, 4.3 yr). All 14 patients experienced improvement in or complete resolution of their symptoms after this unique intervention., Conclusion: Our novel technique of anterior transposition of the ulnar nerve with ePTFE was safe and highly effective in treating primary and recurrent ulnar nerve entrapment neuropathy at the elbow and represents an alternative to the current techniques., (Copyright © 2020 by the Congress of Neurological Surgeons.)