Temporal Muscle Thickness Compared to Functional Scales as a Prognostic Parameter in Patients with Brain Metastases.

Metastases are the most frequent intracranial malignant tumors in adults. While Karnofsky Performance Status (KPS) and Clinical Frailty Scale (CFS) are known to have significant impact on overall survival (OS), temporal muscle thickness (TMT) has been postulated to be a promising new parameter to estimate prognosis. Patients who received a resection of one to three brain metastases in our institution were included. Temporal muscle thickness was measured in preoperative MRI scans according to a standardized protocol. In 199 patients, the mean TMT was 7.5 mm (95CI 7.3-7.7) and the mean OS during follow-up was 31.3 months (95CI 24.2-38.3). There was no significant correlation of TMT and preoperative or follow-up CFS and KPS. While CFS and KPS did significantly correlate with OS (p < 0.001 for each), no correlation was demonstrated for TMT. CFS showed a superior prognostic value compared to KPS. TMT failed to show a significant impact on OS or patient performance, whereas the clinical scales (KPS and CFS) demonstrate a good correlation with OS. Due to its superiority over KPS, we strongly recommend the use of CFS to estimate OS in patients with brain metastases.

Clinical Depression and Anxiety Are Relieved by Microvascular Decompression in Patients with Trigeminal Neuralgia-A Prospective Patient-Reported Outcome Study.

Objective: Patients with idiopathic trigeminal neuralgia (TN) live in constant fear of triggering shock-like pain episodes, which may cause symptoms of depression and a reduction in quality of life. Microvascular decompressive surgery has been demonstrated to achieve satisfactory and stable results. With this study, we wanted to investigate prevalence and risk factors for depression and perceived stress in correlation with symptom relief after surgical treatment. Methods: In this prospective study, patients undergoing microvascular decompression (MVD) for TN were included. The Barrow Neurological Institute Pain Score (BNI), Beck Depression Inventory (BDI), Chronic Pain Acceptance Questionnaire (CPAQ), Perceived Stress Questionnaire (PSQ) and McGill questionnaire were used to evaluate depression, stress and anxiety disorders before and 3 months after MVD. Results: A total of 35 patients (16 male (46%)) with a mean age of 55.4 (SD 15) years were included in this study. The BDI revealed that 24 (68.8%) patients harbored mild-to-extreme depression preoperatively (2.4 ± 1.4), which improved to 1.2 (±0.6, p < 0.0001). Pain acceptance also changed from 64 (±11.3) to 67.7 (±9.3, p = 0.006). Perceived stress decreased from 46.9 (±21.9) to 19.6 (±18.6) (p < 0.0001) postoperatively, and pain decreased from 31.0 (±11.7) to 9.4 (±12.9, p < 0.0001). Microvascular decompression reduced the mean BNI pain score significantly from 4.6 to 1.8 postoperatively (p < 0.00001). Conclusions: Depression and perceived stress are prevalent in patients with idiopathic TN. Adequate treatment not only provides a high rate of satisfaction through pain relief, but also leads to immediate and significant improvements in depression and stress. Thus, in patients with TN who do not reach an adequate and timely pain reduction through medical management and develop signs of depression, early treatment with microvascular decompression should be considered.

Food production and resource use of urban farms and gardens: a five-country study.

There is a lack of data on resources used and food produced at urban farms. This hampers attempts to quantify the environmental impacts of urban agriculture or craft policies for sustainable food production in cities. To address this gap, we used a citizen science approach to collect data from 72 urban agriculture sites, representing three types of spaces (urban farms, collective gardens, individual gardens), in five countries (France, Germany, Poland, United Kingdom, and United States). We answered three key questions about urban agriculture with this unprecedented dataset: (1) What are its land, water, nutrient, and energy demands? (2) How productive is it relative to conventional agriculture and across types of farms? and (3) What are its contributions to local biodiversity? We found that participant farms used dozens of inputs, most of which were organic (e.g., manure for fertilizers). Farms required on average 71.6 L of irrigation water, 5.5 L of compost, and 0.53 m2 of land per kilogram of harvested food. Irrigation was lower in individual gardens and higher in sites using drip irrigation. While extremely variable, yields at well-managed urban farms can exceed those of conventional counterparts. Although farm type did not predict yield, our cluster analysis demonstrated that individually managed leisure gardens had lower yields than other farms and gardens. Farms in our sample contributed significantly to local biodiversity, with an average of 20 different crops per farm not including ornamental plants. Aside from clarifying important trends in resource use at urban farms using a robust and open dataset, this study also raises numerous questions about how crop selection and growing practices influence the environmental impacts of growing food in cities. We conclude with a research agenda to tackle these and other pressing questions on resource use at urban farms. Supplementary Information: The online version contains supplementary material available at 10.1007/s13593-022-00859-4.