Still just a matter of taste? Sensorial appreciation of seafood is associated with more frequent and diverse consumption.

Improving health and sustainability outcomes in WEIRD (Western, Educated, Industrial, Rich, Democratic) nations necessitates a reduction in red meat consumption. Seafood is often overlooked in achieving this goal. However, simply consuming more of familiar fish species places high stress on production of these species. For this reason, diversification of seafood consumption is also critical. Here the motives for seafood consumption (frequency and diversity) are investigated across two studies by adapting the 4Ns survey to the seafood category. This 16-item survey measures four factors underpinning meat consumption: namely that it is 'Natural', 'Necessary', 'Normal' and 'Nice'. Swedish consumers' hedonic and sensory expectations of two herring concepts (traditional pickled contra novel minced and presented as a burger) are also evaluated in relation to the 4Ns. Study 1 (N=304) revealed that the seafood 4Ns scale had a similar underlying structure to that of meat and had good test-retest reliability. Study 2 (N=514) showed that consumers expected to like the pickled herring (associated with being 'seasoned', 'salty', 'sweet', 'firm', 'juicy', 'chewy', and 'slimy') more than the minced herring (associated with being 'mushy', 'fishy', 'grainy', 'dry' and having 'small bones'), and that 'Nice' scores affected expectations of both herring concepts. Food neophobia correlated inversely with seafood consumption frequency, expected liking, the 'Nice' subscale, and food agency. Critically, in both studies, enjoyment of seafood (higher 'Nice' scores) predicted more frequent and diverse seafood consumption, whilst agreeing that seafood is 'Necessary' for health predicted only consumption frequency, not diversity. Communicating seafood's positive sensory attributes and developing novel seafood product concepts in ways that disconfirm sceptical consumers' negative sensory expectations may increase acceptance of both familiar and unfamiliar seafood concepts.

Malolactic fermentation in lingonberry juice and its use as a preservative.

Lingonberry is a common wild berry that is often sold as jams and beverages. It naturally contains high amounts of the weak acid preservative benzoic acid making it an interesting ingredient for shelf-life extension. Despite this, their use as a raw ingredient is limited by the inherently intense sour taste. This study aimed to improve the taste of lingonberry juice by subjecting it to malolactic fermentation in order to reduce the sourness, and to investigate the benzoic acid in lingonberries as a natural preservative in juice blends by determining the microbial stability. After initial screening of lactic acid bacteria, a Lactiplantibacillus plantarum strain was used as the starter for subsequent investigations. Upon raising the pH, all malic acid was completely converted to lactic acid after seven days. The fermented juice was mixed with blackcurrant juice in different proportions. Challenge tests of the blends showed Listeria monocytogenes could not grow in any juice samples, while Candida albicans only grew in the pure blackcurrant juice. Aspergillus brasiliensis growth was delayed in all samples containing benzoic acid in a concentration-dependent manner. The sourness and astringency were substantially reduced in the juice with added L. plantarum compared to the unfermented juice.

Use of Machine Learning with Fused Spectral Data for Prediction of Product Sensory Characteristics: The Case of Grape to Wine.

Generations of sensors have been developed for predicting food sensory profiles to circumvent the use of a human sensory panel, but a technology that can rapidly predict a suite of sensory attributes from one spectral measurement remains unavailable. Using spectra from grape extracts, this novel study aimed to address this challenge by exploring the use of a machine learning algorithm, extreme gradient boosting (XGBoost), to predict twenty-two wine sensory attribute scores from five sensory stimuli: aroma, colour, taste, flavour, and mouthfeel. Two datasets were obtained from absorbance-transmission and fluorescence excitation-emission matrix (A-TEEM) spectroscopy with different fusion methods: variable-level data fusion of absorbance and fluorescence spectral fingerprints, and feature-level data fusion of A-TEEM and CIELAB datasets. The results for externally validated models showed slightly better performance using only A-TEEM data, predicting five out of twenty-two wine sensory attributes with R2 values above 0.7 and fifteen with R2 values above 0.5. Considering the complex biotransformation involved in processing grapes to wine, the ability to predict sensory properties based on underlying chemical composition in this way suggests that the approach could be more broadly applicable to the agri-food sector and other transformed foodstuffs to predict a product's sensory characteristics from raw material spectral attributes.

Sodium reduction in foods: Challenges and strategies for technical solutions.

In many parts of the world, sodium consumption is higher than recommended levels, representing one of the most important food-related health challenges and leading to considerable economical costs for society. Therefore, there is a need to find technical solutions for sodium reduction that can be implemented by food producers and within food services. The aims of this review are to discuss the barriers related to sodium reduction and to highlight a variety of technical solutions. The barriers relate to consumer perception, microbiology, processing, and physicochemistry. Existing technical solutions include inhomogeneous salt distribution, coated salt particles, changing particle sizes and forms, surface coating, multisensory combinations, sodium replacements, double emulsions, adapted serum release by microstructure design, and adapted brittleness by microstructure design. These solutions, their implementation and the associated challenges, and applicable product categories are described. Some of these solutions are ready for use or are in their early development stages. Many solutions are promising, but in most cases, some form of adaptation or optimization is needed before application in specific products, and care must always be taken to ensure food safety. For instance, further research and innovation are required in the dynamic evolution of saltiness perception, consumer acceptance, the binding and migration of sodium, juiciness, microbiological safety, and the timing of salt addition during processing. Once implemented, these solutions will undoubtedly support food producers and food services in reducing sodium content and extend the application of the solutions to different foods.

Investigation of Fluoroscopy Time and Radiation Dose by the Number of Cerebral Angiography Operator Experiences.

Objective: We investigated the fluoroscopy time (FT) and radiation dose by the number of cerebral angiography (CA) operator experiences to clarify the learning curve of CA. Methods: The subjects were cases for whom CA was performed at our hospital for 5 years between April 2015 and March 2020. Based on the number of CA operator experiences, they were classified into four groups: 1-50 cases (group A), 51-100 cases (group B), 101-200 cases (group C), and 201 cases and later (group D). The FT and radiation dose were retrospectively investigated. Results: Of the 865 consecutive CA cases, 293 cases for follow-up, i.e. after treatment, 54 for arteriovenous shunt diseases, 21 lacking data, and 1 case requiring intervention for thrombosis during CA were excluded. In total, 496 CA cases were investigated. There were 61 cases in group A, 56 cases in group B, 44 cases in group C, and 335 cases in group D, and there was no significant difference in patient background factors among the groups. The median FT and radiation dose (interquartile range) in each group were 20.2 min (14.6) and 374 mGy (185.3) in group A, 14.8 min (12.1) and 366 mGy (167.9) in group B, 10.8 min (6) and 320 mGy (151.7) in group C, and 9.4 min (6.4) and 336 mGy (171) in group D. The FT was significantly shorter in group C than in group A, and significantly shorter in group D than in groups A, B, and C. The radiation dose was significantly lower in groups C and D than in groups A and B. Conclusion: This study suggested that CA can be performed alone after experiencing approximately 100 cases as an operator.

Identifying barriers to decreasing meat consumption and increasing acceptance of meat substitutes among Swedish consumers.

A key lifestyle change people could make to reduce their environmental impact is to reduce their meat consumption. However, meat is still a staple in many people's diet, and some consumers are reluctant to cut down. Meat substitutes, if accepted as adequate replacements for meat, may offer a suitable alternative without leaving consumers feeling dissatisfied. The aim of the present study was to identify psychological barriers to reducing meat consumption and increasing use of meat substitutes among Swedish consumers. Participants engaged in focus group discussions around purchasing, preparing, and consuming meat and meat substitutes. Four main themes were identified through thematic analysis: uncertainty, scepticism, health, and identity. These are discussed in relation to previous work on the barriers to reducing meat consumption. Strategies to communicate the environmental impact of meat to consumers and effect change through behavioural interventions are considered.

Geographical-based variations in white truffle Tuber magnatum aroma is explained by quantitative differences in key volatile compounds.

The factors that vary the aroma of Tuber magnatum fruiting bodies are poorly understood. The study determined the headspace aroma composition, sensory aroma profiles, maturity and bacterial communities from T. magnatum originating from Italy, Croatia, Hungary, and Serbia, and tested if truffle aroma is dependent on provenance and if fruiting body volatiles are explained by maturity and/or bacterial communities. Headspace volatile profiles were determined using gas chromatography-mass spectrometry-olfactometry (GC-MS-O) and aroma of fruiting body extracts were sensorially assessed. Fruiting body maturity was estimated through spore melanisation. Bacterial community was determined using 16S rRNA amplicon sequencing. Main odour active compounds were present in all truffles but varied in concentration. Aroma of truffle extracts were sensorially discriminated by sites. However, volatile profiles of individual fruiting bodies varied more within sites than across geographic area, while maturity level did not play a role. Bacterial communities varied highly and were partially explained by provenance. A few rare bacterial operational taxonomical units associated with a select few nonodour active volatile compounds. Specificities of the aroma of T. magnatum truffles are more likely to be linked to individual properties than provenance. Some constituents of bacteria may provide biomarkers of provenance and be linked to nonodour active volatiles.

Comparison of Treatment Results by Coil Embolization Procedures for Ruptured Cerebral Aneurysms.

Objective: In coil embolization of ruptured cerebral aneurysms, intraoperative cerebral aneurysm re-rupture and thromboembolism are of concern. A good embolic condition can be expected by adjunctive techniques, but there is an increased risk of complications. We investigated the treatment results by coil embolization procedures for ruptured cerebral aneurysms. Methods: Between January 2016 and December 2019, 75 ruptured saccular cerebral aneurysms were treated by coil embolization at our hospital. The background factors, results of aneurysm embolization, intraoperative re-rupture, symptomatic cerebral embolism, and other factors were investigated retrospectively. We compared and examined these factors based on the procedure. Results: The mean age was 62.8 and there were 57 female patients (76.0%). The single catheter technique (SCT) was used in 44 cases (58.7%) and the adjunctive technique was used in 31 cases (41.3%). Complete obliteration (CO) was achieved in 24 cases (32.0%), there was a neck remnant (NR) in 23 (30.7%), body filling (BF) was observed in 28 (37.3%), intraoperative re-rupture occurred in 7 (9.3%), and symptomatic cerebral embolism developed in 6 (8.0%), but no postoperative re-rupture was observed. Retreatment was required in only three cases of SCT. On comparison by procedure, the incidence of symptomatic cerebral embolism was significantly lower in SCT group than in the adjunctive technique group (2.3% vs 16.1%, p = 0.04). Conclusion: Among the cases of coil embolization for ruptured cerebral aneurysms at our hospital, SCT resulted in a lower incidence of symptomatic cerebral embolism than adjunctive techniques. It is essential to select an appropriate procedure in each case by understanding the characteristics of each procedure.

Prediction of wine sensory properties using mid-infrared spectra of Cabernet Sauvignon and Chardonnay grape berries and wines.

The study determined optimal parameters to four preprocessing techniques for mid-infrared (MIR) spectra of wines and grape berry homogenates and tested MIR's ability to model sensory properties of research Cabernet Sauvignon and Chardonnay wines. Savitsky-Golay (SG) derivative, smoothing points, and polynomial order, and extended multiplicative signal correction (EMSC) polynomial were investigated as preprocessing techniques at 2, 2, 5, and 3 levels, respectively, all in combination. Preprocessed data were analysed with partial least squares regression (PLS) to model the wine sensory data and the regression coefficients of PLS calibration models (R2) were further analysed with multivariate analysis of variance (MANOVA). SG transformations were significant factors from the MANOVA that influenced R2, while EMSC did not. Overall, PLSR models that predicted wine sensory characteristics gave a poor to moderate R2. Consistently predicting wine sensory attributes within a variety and across vintages is challenging, regardless of using grape or wine spectra as predictors.

Chemical and Sensory Impacts of Accentuated Cut Edges (ACE) Grape Must Polyphenol Extraction Technique on Shiraz Wines.

Accentuated Cut Edges (ACE) is a recently developed grape must extraction technique, which mechanically breaks grape skins into small fragments but maintains seed integrity. This study was the first to elucidate the effect of ACE on Shiraz wine's basic chemical composition, colour, phenolic compounds, polysaccharides and sensory profiles. A further aim was to investigate any potential influence provided by ACE on the pre-fermentation water addition to must. ACE did not visually affect Shiraz wine colour, but significantly enhanced the concentration of tannin and total phenolics. Wine polysaccharide concentration was mainly increased in response to the maceration time rather than the ACE technique. ACE appeared to increase the earthy/dusty flavour, possibly due to the different precursors released by the greater skin breakage. The pre-fermentation addition of the water diluted the wine aromas, flavours and astringency profiles. However, combining the ACE technique with water addition enhanced the wine textural quality by increasing the intensities of the crucial astringent wine quality sub-qualities, adhesive and graininess. Furthermore, insights into the chemical factors influencing the astringency sensations were provided in this study. This research indicates that wine producers may use ACE with pre-fermentation water dilution to reduce the wine alcohol level but maintain important textural components.

The Usefulness of Prasugrel as Rescue Medication in Neuroendovascular Therapy.

Objective: In neuroendovascular therapy, clopidogrel resistance and thrombosis are common problems. In such cases, we use prasugrel as rescue medication, and we clarified its usefulness. Methods: We retrospectively investigated 199 consecutive cases of neuroendovascular therapy performed at our hospital from April 2016 to March 2018, and examined the safety and effectiveness of prasugrel. Results: There were 14 cases of prasugrel administration: six cases of coil embolization for cerebral aneurysm, five cases of carotid artery stenting (CAS), and three other cases.The reasons for prasugrel administration were as follows: emergency stent use in four cases, intraoperative thrombosis in three cases, intra-stent thrombosis after CAS in three cases, and others in four cases. In all cases, it was used in combination with aspirin and the median duration of administration was 212 days. Regarding its safety, there was one hemorrhagic complication at the puncture site for which the involvement of prasugrel was unable to be excluded, but it was improved by conservative treatment and there was no major hemorrhage such as intracranial hemorrhage. Regarding its efficacy, in one case, the thrombus during coil embolization did not completely disappear after prasugrel administration and additional mechanical thrombolysis was required. However, no new thrombosis was observed during prasugrel administration in all 14 cases. Conclusion: Prasugrel may be useful as a rescue medication in neuroendovascular therapy.

[Are Localized Lesions in the Common Carotid Artery a Risk Factor for Recurrence of Ischemic Stroke in Patients with Symptomatic Carotid Artery Stenosis?]

BACKGROUND AND PURPOSE: Various studies have addressed risk factors for recurrence of ischemic stroke in patients with symptomatic carotid artery stenosis. However, no investigations have compared common localized carotid artery lesions and internal carotid artery lesions, including carotid bifurcation. This retrospective study investigated risk factors for ischemic stroke recurrence in patients with symptomatic carotid artery stenosis, including a comparison of lesion sites. METHODS: Of 61 consecutive patients admitted to the authors' hospital due to a diagnosis of symptomatic carotid artery stenosis between April 2015 and March 2018, data from 59 were retrospectively reviewed(2 patients diagnosed with arterial dissection were excluded). The primary end point was recurrence of ischemic stroke caused by symptomatic carotid artery stenosis, the cause of the first event. Patients were censored at the time of surgical intervention;events occurring during and after surgical intervention were not included. In the ischemic stroke recurrence and non-recurrence groups, each item was analyzed using the Kaplan-Meier method, and a log-rank test was performed with a significance level set to 5%. RESULTS: Ischemic stroke recurrence before surgical intervention was observed in 5(8.5%)patients. In comparing the recurrence and non-recurrence groups, a significant difference was observed in age(p=0.027)and lesion site(p <0.001). CONCLUSION: A localized lesion in the carotid artery was a risk factor for recurrence of ischemic stroke in patients with symptomatic carotid artery stenosis. For individuals with symptomatic localized lesions in the common carotid artery, surgical intervention should be considered-in addition to medical treatment-regardless of the degree of stenosis.

Potato Protein Fining of Phenolic Compounds in Red Wine: A Study of the Kinetics and the Impact of Wine Matrix Components and Physical Factors.

Producing wines within an acceptable range of astringency is important for quality and consumer acceptance. Astringency can be modified by fining during the winemaking process and the use of vegetable proteins (especially potato proteins) as fining agents has gained increasing interest due to consumers' requirements. The research presented was the first to investigate the effect of a potato protein dose on the kinetics of tannin and phenolic removal compared to gelatin for two unfined Cabernet Sauvignon wines. To further understand the results, the influence of the wine matrix and fining parameters (including pH, ethanol concentration, sugar concentration, temperature, and agitation) were tested according to a fractional 25-1 factorial design on one of the Cabernet Sauvignon wines using potato proteins. The results from the factorial design indicate that potato protein fining was significantly influenced by wine pH, ethanol concentration, fining temperature as well as an interaction (pH × ethanol) but not by sugar content or agitation. Insights into the steps required for the optimisation of fining were gained from the study, revealing that potato protein fining efficiency could be increased by treating wines at higher temperatures (20 °C, rather than the conventional 10-15 °C), and at both a lower pH and/or alcohol concentration.

Dynamic characterization of wine astringency profiles using modified progressive profiling.

Wine astringency is important for quality and consumer acceptance. Perception of this mouthfeel is temporal and can be separated further into unique textural sub-qualities. Quantitative data on these astringent sub-qualities in wine however are poorly understood. The aim of this study was to characterize the dynamic astringency profiles of 13 Australian commercial red wines and 2 rosés made from 11 grape varieties using modified progressive profiling by a trained sensory panel (n = 8). Seven attributes generated and defined by the panel (overall astringent intensity and 6 sub-qualities: pucker, mouth coat, dry, grippy, adhesive and graininess) were scored at six time periods (each lasting 10 s), with 20 s gap between each time period. Attributes were rated on 15 cm scales with anchors at 10 and 90% and samples were evaluated in duplicate. The wine composition as well as phenolic profiles were determined. Intensities of astringent sub-qualities were correlated with overall intensity, but the sub-quality profiles at a specific evaluation period and the progression of an attribute varied differently depending on the wine. The discrimination of wines at each time interval was dependent on attribute, and the relative importance of each astringent sub-quality varied at different evaluation periods. Correlations between mouthfeel attributes and chemical measures were established. This study demonstrated the utilisation of modified progressive profiling for wine astringency evaluation, providing a tool to capture quantitative data on astringent sub-qualities in wine.

Linking soil's volatilome to microbes and plant roots highlights the importance of microbes as emitters of belowground volatile signals.

Plants and microbes release a plethora of volatiles that act as signals in plant-microbe interactions. Characterizing soil's volatilome and microbiome might shed light on the nature of relevant volatile signals and on their emitters. This hypothesis was tested by characterizing plant cover, soil's volatilome, nutrient content and microbiomes in three grasslands of the Swiss Jura Mountains. The fingerprints of soil's volatiles were generated by solid-phase micro-extraction gas chromatography/mass spectrometry, whereas high-throughput sequencing was used to create a snapshot of soil's microbial communities. A high similarity was observed in plant communities of two out of three sites, which was mirrored by the soil's volatilome. Multiple factor analysis evidenced a strong association among soil's volatilome, plant and microbial communities. The proportion of volatiles correlated to single bacterial and fungal taxa was higher than for plants. This suggests that those organisms might be major contributors to the volatilome of grassland soils. These findings illustrate that key volatiles in grassland soils might be emitted by a handful of organisms that include specific plants and microbes. Further work will be needed to unravel the structure of belowground volatiles and understand their implications for plant health and development.

Application of sequential and orthogonalised-partial least squares (SO-PLS) regression to predict sensory properties of Cabernet Sauvignon wines from grape chemical composition.

The current study determined the applicability of sequential and orthogonalised-partial least squares (SO-PLS) regression to relate Cabernet Sauvignon grape chemical composition to the sensory perception of the corresponding wines. Grape samples (n = 25) were harvested at a similar maturity and vinified identically in 2013. Twelve measures using various (bio)chemical methods were made on grapes. Wines were evaluated using descriptive analysis with a trained panel (n = 10) for sensory profiling. Data was analysed globally using SO-PLS for the entire sensory profiles (SO-PLS2), as well as for single sensory attributes (SO-PLS1). SO-PLS1 models were superior in validated explained variances than SO-PLS2. SO-PLS provided a structured approach in the selection of predictor chemical data sets that best contributed to the correlation of important sensory attributes. This new approach presents great potential for application in other explorative metabolomics studies of food and beverages to address factors such as quality and regional influences.

Sensory profiling and quality assessment of research Cabernet Sauvignon and Chardonnay wines; quality discrimination depends on greater differences in multiple modalities.

The sensory profiles of Cabernet Sauvignon and Chardonnay research wines were determined and analysed together with wine quality scores of expert judges. Research Cabernet Sauvignon and Chardonnay wines from three and two vintages, respectively, were evaluated. Wines of both varieties were produced with grapes harvested from across South Australian wine making regions throughout 2013-2016 vintages. Wines within varieties were vinified identically across samples and also across vintages. Wines were profiled in triplicate using descriptive analysis with a panel of trained assessors (n=9-11) and graded for quality in triplicate by winemakers (n=6-9) using a sorting task based on similarity of quality and with the aid of definitions formed by the winemakers prior to sorting. The data sets were analysed using canonical variate analysis (CVA) and multidimensional scaling (MDS). The scores from CVA and MDS per variety per vintage were analysed using Generalised Procrustes Analysis (GPA). Differences in Cabernet Sauvignon samples by provenance were determined, where associations with regions by sensory attributes were observed in all vintages. These wines were consistently sorted based on quality by the winemakers, evident from GPA. Chardonnay in comparison were poorly discriminated in both sensory profiles and quality. The combination of descriptive sensory analysis with sorting was complimentary to each other and was able to uncover additional information about the sensory properties of wines when the two methods were used in concert, such as balance and complexity. However the red wine variety had more intrinsic characteristics that lead to better discrimination based on sensory properties and hence quality than the white wine variety.

[Usefulness of Bilateral rSO2 Monitoring for Predicting Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting].

OBJECTIVE: Cerebral hyperperfusion syndrome(CHS)and cerebral hyperperfusion phenomenon(CHP)induce intracranial hemorrhage and can become critical complications after carotid artery stenting(CAS). The purpose of the present study was to predict and avoid CHS after CAS using bilateral rSO2 intraoperative monitoring. METHODS: We retrospectively analyzed 100 consecutive patients who underwent CAS between January 2012 and May 2014 in our institution. We performed continuous bilateral rSO2 monitoring from anesthetic induction to the day following CAS. CHS was defined as the deterioration of neurological conditions post-CAS, no ischemic changes on post-CAS head CT or brain MRI, an increase in cerebral blood flow(CBF)and cerebral blood volume(CBV), and shortening of the mean transit time(MTT)or time to peak(TTP)on CT perfusion. To compare the CHS/CHP group and non-CHS/CHP group, we defined four parameters:rSO2 difference(rSO2 at the endpoint of the procedure-baseline rSO2), ΔrSO2 difference(affected side rSO2 difference-unaffected side rSO2 difference), rSO2 ratio(rSO2 at the endpoint of the procedure/baseline rSO2), and ΔrSO2 ratio(affected side rSO2 ratio/unaffected side rSO2 ratio). RESULTS: There were 2 CHS cases(2.2%)and 3 CHP cases(3.3%). In the CHS/CHP group, the ΔrSO2 difference and ΔrSO2 ratio were significantly higher than those in the non-CHS/CHP group(p value<0.05);however, no significant differences were found in the affected side rSO2 difference(p value=0.063)and affected side rSO2 ratio(p value=0.054)between the groups. CONCLUSION: We could promptly detect CHS and CHP in all cases by using continuous bilateral rSO2 monitoring and analysis of the ΔrSO2 difference and ΔrSO2 ratio.

Wine consumers' subjective responses to wine mouthfeel and understanding of wine body.

Wine mouthfeel is considered important for wine quality by experts, while consumers understanding of mouthfeel and the role of wine body in their wine choice is unknown. One experiment determined the influence of intrinsic wine mouthfeel on consumers' wine liking and emotions, and the other, how consumers understand the term wine body. The first experiment used a 2 astringency level×2 body level experimental design. The samples were base wine with; nothing added (control), added xanthan gum (for increased body), added grape seed extract (GSE, for increased astringency), and with both added xanthan gum and GSE. The consumer taste trial (n=112) indicated that wine with increased body did not influence wine liking and emotions; while increased astringency decreased liking and elicited more intense negative emotions. The second experiment examined consumers' knowledge of wine body through an online survey (n=136). Consumers described wine body most frequently using words such as flavour, fullness, and strength. Wine body was therefore understood by consumers predominantly as a holistic multi-sensory perception of flavour. Wine flavour was indicated by consumers to be the most important factor driving purchase decisions followed by balance of flavours and wine body. It is crucial that wine professionals carefully communicate wine characteristics to consumers to prevent possible misunderstandings such as the meaning of wine body and as a result better meet consumer expectations. In future, the term body may benefit from a clearer definition for academic research as well as industry.

The safety and efficacy of preoperative embolization of meningioma with N-butyl cyanoacrylate.

OBJECTIVE: Preoperative embolization of meningioma is commonly performed; however, there is no consensus on the best embolic material to reduce intraoperative blood loss and surgery time. METHOD: We retrospectively assessed the safety and efficacy of 56 cases of preoperative embolization of the middle meningeal artery with N-butyl cyanoacrylate (NBCA) in 105 cases of surgery for meningioma. We also defined a blood loss to tumor volume ratio to compensate for bias caused by tumor volume, and analyzed limited cases (the embolized group n = 52, the non-embolized group n = 21) of the convexity, the parasagittal region, the falx, and the sphenoidal ridge. RESULT: The blood loss to tumor volume ratio was significantly less in the embolized group (p < 0.007). Preoperative embolization could be useful for cases with the external carotid artery as the dominant feeder vessel (p < 0.02); however, the efficacy decreased for cases with an internal carotid artery feeder. Transient complications occurred in four cases (hemiparesis secondary to edema: two cases; intratumoral bleeding: one case; trigeminal nerve disorder: one case). The cases that showed a postoperative increase in edema or intratumoral bleeding were large tumors with the early filling of veins. For such cases, surgeons should pay close attention to slow injection speed and higher NBCA viscosity, not to cause the occlusion of draining vessels. CONCLUSION: Tumor embolization with NBCA can be safely performed, and the procedure significantly reduces intraoperative blood loss.