bluuebunny/crossref_metadata_2025 huggingface dataset:
Wildland—Urban Interface Communities' Response to Post-Fire Salvage Logging
Authors: Ryan Robert L. , Hamin Elisabeth
Published: August 2019

Salvage logging, the removal for profit of standing trees that have been damaged by extensive wildfires, has been quite controversial and subject to lawsuits that can delay the logging past the time in which the lumber is still useful. It has not been clear, however, whether the public that has been most affected by wildfires—those that live near burned areas—support or oppose postfire logging. In this research we use focus groups and stakeholder interviews in urban interface communities that have experienced significant wildfires to examine in some detail the perspectives these members of the public have regarding salvage logging. Public support for salvage logging in communities that have recently experienced wildfires was much stronger than hypothesized at the beginning of this study from our review of the number of unsuccessful salvage logging proposals or even popular press reports. Key reasons for supporting salvage logging were that letting useful timber rot was wasteful, that it improves the postfire aesthetics and safety of the forest, and that it can provide some income for local postfire restoration activities. Caveats include assuring that any environmental impacts, such as new roads, are mitigated postlogging, and assuring that appropriate snags are left to provide wildlife habitat.
The Potential Use of the Light Drop-Weight Deflectometer to Control Subgrade Compaction on Forest Roads
Authors: Boston Kevin , Robek Robert , Rathom Jesse
Published: August 2019

Improving subgrade strength can reduce a road's construction and maintenance costs. Additionally, it may lessen some of the environmental impacts from forest roads. However, most forest roads receive little effort to establish or control compaction because of the perceived increase in construction costs and potential delays in the flow of wood from the area. A light drop-weight deflectometer was tested on two forest roads in western Oregon to determine if this tool could aid with improving forest road construction by improving the quality of the road's subgrade. One road was built on a fine sand-silt soil and the other was constructed on a silt-clay soil. The goal was to correlate the easily collected subgrade values produced from the light drop-weight deflectometer and wet unit weight to the soaked and nonsoaked California bearing ratio (CBR) values for the subgrade, which are common design variables used to determine the minimum thickness of the aggregate surface. The light drop-weight deflectometer showed mixed results with regards to its ability to predict the values from the more expensive CBR laboratory test. The results from site 1, sand-silt soils, showed the potential of the light drop-weight deflectometer to aid in construction control as the values from light drop-weight deflectometer, when combined with the wet unit weight, explained a statistically significant amount of the variability in the soaked and nonsoaked laboratory CBR values. These variables explain approximately 60% of the variation in CBR values. The data from site 2, the silt-clay soils, were not able to significantly predict the subgrade strength variables, and the road will need to continue to use the traditional methods for establishing and controlling compaction.
Thinning Ponderosa Pine Affected by Armillaria Root Disease: 40 Years of Growth and Mortality on an Infected Site in Central Oregon
Authors: Filip Gregory M. , Fitzgerald Stephen A. , Chadwick Kristen L. , Max Timothy A.
Published: August 2019

Portions of a 30-year-old stand of ponderosa pine were precommercially thinned in 1966 and commercially thinned in 2000 at age 64 years to determine the effects of thinning from below on tree growth and mortality caused by Armillaria root disease in central Oregon. Thirty years after precommercial thinning, leave-tree mortality was significantly less in thinned plots than in unthinned plots, but leave-treeߝdiameter growth was not significantly increased by thinning. Leave-tree basal area (BA) per acre growth, however, was significantly greater in thinned plots.In 2007 at age 71 years, 7 years after commercial thinning of the same plots that were precommercially thinned in 1966, leave-tree mortality was less in thinned plots than in unthinned plots, but more time probably is necessary to adequately assess Armillaria-caused mortality after commercial thinning. Both tree diameter and BA growth were significantly increased by commercial thinning. Hypotheses on fungal-host dynamics are discussed, and recommendations for multiple thinning based on stand density index are given.
Fall Planting and Tree Shelters for Reforestation in the East Washington Cascades
Authors: Taylor Michael , Haase Diane L. , Rose Robin L.
Published: August 2019

Reforestation on harsh, high-elevation sites near the crest of the Cascade Mountains in Washington can be challenging because of persistent snowpack and extreme climatic variation. The use of tree shelters was investigated with two species, Douglas-fir (Pseudotsuga menziesii [Mirb.] Franco) and western larch (Larix occidentalis Nutt.), on two Yakama Nation sites across three fall planting dates. For both species, seedlings inside tree shelters had increased survival compared with nonsheltered seedlings after one growing season despite increased damage by crushing from snowpack. Volumetric soil moisture content on the western larch site increased from 10% to 17% between the first and second planting dates, resulting in no effect of planting date on western larch survival. On the Douglas-fir site, however, soil moisture content was below 12% for all fall planting dates, resulting in only 2% survival for those seedlings planted on the first planting date. First-season seedling growth was unaffected by planting date or tree shelter treatment for both species. These results indicate the critical importance of soil moisture at time of planting and onset of precipitation after planting. Use of tree shelters may improve seedling survival on a harsh, high-elevation site, but it increases potential seedling damage because of crushing by snowpack.
Fuel Supply Planning for Small-Scale Biomass Heating Systems
Authors: Farr Angela K. , Atkins David
Published: August 2019

The Fuels for Schools and Beyond initiative partners have gained experience assisting with installation and fuel supply planning for woody biomass heating systems in six western states. In attempting to use forest management waste or slash that would otherwise be piled and burned, thepartners are promoting changes in currently available biomass systems technology and current forest practices. The many benefits of forest biomass heat can be realized today with careful communication about fuel supply specifications. Guidance based on the partners' experience in fuel supplyplanning and defining fuel specifications is presented.
Growth Response of Pinus ponderosa following a Mixed-Severity Wildfire in the Black Hills, South Dakota
Authors: Keyser Tara L. , Smith Frederick W. , Shepperd Wayne D.
Published: August 2019

In late summer 2000 the Jasper Fire burned ∼34,000 ha of ponderosa pine forest in the Black Hills of South Dakota. Although regarded as a catastrophic event, the Jasper Fire left a mosaic of fire severity across the landscape, with live trees present in areas burned under low andmoderate fire severity. In October 2005, we cored 96 trees from unburned, low-severity, and moderate-severity stands and assessed whether tree growth differed among fire severity classes during the 5 years postfire. We observed no differences in basal area increment (BAI) 10 years prefireamong fire severities with BAI averaging 9.6 cm2 per year. Despite severe drought conditions, BAI in moderate severity sites 2 years postfire was 58% greater than in unburned and low-severity stands. Although significant, this growth increase was short-lived. Three, 4, and 5 yearspostfire, no differences in growth among unburned, low-severity, and moderate-severity sites were detected, as BAI averaged 8.3, 7.5, and 7.0 cm2, respectively. The lack of a consistent and prolonged growth response suggests that the Jasper Fire did not result in any short-termchanges in growth patterns. Data extending beyond 5 years postfire are required to infer potential long-term changes in tree growth and productivity.
The Effects of Forestry Site Preparation on Mountain Beaver Demographics and Associated Damage to Tree Seedlings
Authors: Arjo Wendy
Published: August 2019

Timber resources are a vital part of the economy in the Pacific Northwest, yet reforestation efforts are often hampered by animal damage. Understanding the factors that influence seedling damage can assist managers in implementing appropriate techniques to reduce species-specific damage. I radio-collared and monitored mountain beavers (Aplodontia rufa) from preharvest to seedling planting to determine the impacts of forest management practices on demographics. In addition, I monitored Douglas-fir (Pseudotsuga menziesii) seedlings on 28 plots on two harvest units (Vesta and Schoolhouse) to determine the effects of chemical site preparation on mountain beaver foraging and subsequent seedling damage. Mountain beaver densities differed between silvicultural treatments (F3,39 = 3.58, P < 0.02), although reproductive success did not (χ2 = 0.14, df = 1, P = 0.70). Larger mountain beaver home ranges were documented in the mature timber compared with those following harvest. Home ranges were also larger in the chemical site preparation portion of the unit (mean = 3.37 ± 0.9 ha) than in the nontreated portion of the unit (mean = 0.82 ± 0.17 ha) on Vesta. Herbicide treatment did not promote seedling damage on either unit. Vegetation does not appear to be the only factor influencing mountain beaver movements and seedling damage. Availability of water is very important for mountain beavers and may also influence their foraging choice, as well as contributing to their increased movements in mature timber (reduced groundwater) versus clearcut areas. Understanding the effects of vegetation on population demographics and subsequent seedling damage may allow for initiating a nonlethal management method using alternative forage.
Effect of Diameter Limits and Stand Structure on Relative Density Indices: A Case Study
Authors: Curtis Robert O.
Published: August 2019

An understory of shade-tolerant species often develops in stands in the Douglas-fir region of western Washington and Oregon and can have a disproportionate effect on relative density indices, such as Reineke stand density index and Curtis relative density. The effects of such understories and of other departures from the even-aged condition are illustrated with selected stand data. In general, the summation methods are less influenced by departures from the even-aged condition than are the conventional calculations based on quadratic mean diameter. Recommendations are made for consistent definition of the lower diameter limit of trees to be included in such computations
The Effects of a Western Spruce Budworm Outbreak on the Dead Wood Component in Relation to Ownership in Forests of Eastern Oregon
Authors: Azuma David
Published: August 2019

Forest Inventory and Analysis data were used to investigate the effects of a severe western spruce budworm outbreak on the dead wood component of forests in 11 counties of eastern Oregon for two time periods. The ownership and the level of damage (as assessed by aerial surveys) affected the resulting down woody material and standing dead trees. The pattern of coarse woody debris with respect to ownership and management intensity remained consistent into the next 10-year period. Harvesting tended to lower the amount of coarse woody debris on private forests. Federally managed forests had more standing dead trees than private lands, with more in the reserved than nonreserved areas. There was a reduction in the number of standing dead trees between the two periods.
Costs, CO2 Emissions, and Energy Balances of Applying Nordic Slash Recovery Methods in British Columbia
Authors: Lindroos Ola , Nilsson Björn , Sowlati Taraneh
Published: August 2019

This study evaluated the costs, CO2 emissions, and energy balances associated with three potential systems for recovering roadside slash in British Columbia, Canada, in which the biomass is transported as slash, hog fuel, or bundles. Costs, CO2 emissions, and energy balances of all three systems showed strong dependence on transportation distance and considerably weaker dependence on slash amounts at landing (cutting block size). The results indicated that the hog fuel system is the cheapest, per unit of delivered biomass, whereas the bundle system is the most expensive system when transportation distances are short (<100 km), and the slash system is the most expensive when transportation distances exceed 100 km. However, the viability of the systems is strongly dependent on payload assumptions.
Wildland Fire Science for Management: Federal Fire Manager Information Needs, Sources, and Uses
Authors: Ryan Clare M. , Cerveny Lee K.
Published: August 2019

A Web-based survey of wildland fire managers in federal agencies in the western United States explored fire science information needs and sources, why particular sources are used, and barriers to obtaining and using information. The fire managers we surveyed rely heavily on internal agency information sources (colleagues, technical experts, and resource advisors) and are more likely to face barriers in their ability to access and use relevant information (lack of time, funding, and personnel) than problems with the quality or availability of data. Information accessibility and applicability are important to managers when deciding which information sources to use. Managers frequently access research provided by US Forest Service Research and Development specialists and university scientists through various publications, the Internet, and direct communication with scientists. Understanding the types of information fire managers need, the sources they access for information, and the barriers they face in obtaining and using information may lead to improved fire science and its dissemination, as well as more effective and efficient fire management.
A Modeling Approach to Estimating Skidding Costs of Individual Trees for Thinning Operations
Authors: Contreras Marco A. , Chung Woodam
Published: August 2019

Thinning is a common silvicultural treatment used for different forest management purposes. Traditionally, thinning prescriptions are derived from sample plots and applied to stands with various vegetation conditions. A few studies have optimized cut-tree selection to create site-specific thinning prescriptions. However, these studies greatly simplify the estimation of harvesting costs by ignoring the location of the cut trees relative to the extraction point. Consequently, resulting tree-level thinning prescriptions might not provide the most economically efficient selection of cut trees. In this study, we developed a model to estimate skidding costs of individual cut trees based on size, location, and spatial distribution of selected cut trees. The model uses a log-bunching algorithm to identify log-pile locations and then creates a skid-trail network that connects log piles to the exit point at a minimum skidding cost. We applied the model to a treatment unit, where light detection and ranging data were used to obtain terrain and tree data, considering two thinning scenarios with target densities of 400 and 300 leave trees/ha, respectively. Comparison of the model results with those obtained from the existing cost models indicates that our model results are within a reasonable range for skidding costs. As our model considers terrain slope to create skid trails, it can be effectively used to delineate nonaccessible or difficult terrain areas for skidding operations. The model can also be used to automatically generate optimal skid-trail networks connecting multiple log piles to the exit point.
Foliar Sulfate-Sulfur as a Nutrient Diagnostic Tool for Interior Douglas-Fir
Authors: Schmalz Heidi J. , Coleman Mark D.
Published: August 2019

Foliar diagnostic tools have been used with varying success to identify limiting nutrients in Douglas-fir (Pseudotsuga menziesii [Mirab.] Franco var. glauca [Beissn.] Franco). The mechanisms of sulfur and nitrogen metabolism in plants enable the measurement of nutrient fractions that may yield more informative results. Measurements of sulfate-sulfur in conifer foliage have shown potential as a diagnostic tool for predicting tree response to nitrogen fertilization. Using archived samples and data from previously established fertilizer trials in northern Idaho, we tested the relationship between foliar sulfate-sulfur concentrations in unfertilized trees and 2-year growth response to nitrogen fertilization in Rocky Mountain Douglas-fir (P. menziesii [Mirab.] Franco var. glauca [Beissn.] Franco). Sulfate-sulfur concentrations explained 42% of the variability in growth response, compared with 17% for the total nitrogen to sulfur ratio. Sulfate-sulfur concentrations were variable within sites, presenting a challenge to the feasibility of sampling. Our results suggest that further controlled research would aid in development of sulfate-sulfur as a foliar diagnostic tool.
Evaluating Global Positioning System Accuracy for Forest Biomass Transportation Tracking within Varying Forest Canopy
Authors: Simwanda Matamyo , Wing Michael G. , Sessions John
Published: August 2019

We examined the accuracy and reliability of consumer-grade global positioning system (GPS) receivers for tracking vehicles transporting forest biomass within several forested road systems. The road systems featured a range of forest canopy types on mountainous terrain. GPS receiver measurements were clearly influenced by forest canopy and varied among the receivers. Under mature forest canopy, the best average measurement accuracy was 5.9 m for one set of GPS receivers. The least favorable average accuracy in mature forest was 14.3 m for a different set of GPS receivers. Measurement accuracies generally increased on roads that featured less forest canopy, with considerable increases in accuracy in some cases. The consumer-grade GPS receivers we tested provided measurement accuracies that support forest biomass transportation applications, including transportation monitoring and planning, mapping forest road networks, and cataloging forest resource locations.
Financial Feasibility of a Log Sort Yard Handling Small-Diameter Logs: A Preliminary Study
Authors: Han Han-Sup , Bilek E.M. (Ted) , Dramm John (Rusty) , Loeffler Dan , Calkin Dave
Published: August 2019

The value and use of the trees removed in fuel reduction thinning and restoration treatments could be enhanced if the wood were effectively evaluated and sorted for quality and highest value before delivery to the next manufacturing destination. This article summarizes a preliminary financial feasibility analysis of a log sort yard that would serve as a log market to buy and sell small-diameter logs in western Montana. We based our evaluations on equipment for a medium-sized log sort yard that would preprocess and sort 33 million board feet of small-diameter logs per year to seven different products. The delivered log input costs represent 78.1% of the total sales revenue, whereas the yard's operating costs account for 17.7% of the revenue. The log sort yard's operating cost would be $3.74/piece or $79.53/thousand board feet. Douglas-fir (Pseudotsuga menziesii) would make the biggest contribution to the yard's gross margin because this species both represents the largest volume (45% of the input log volume) into the yard and produces high-value products (house and veneer logs). Improved knowledge regarding wood market conditions and local log supplies is a prerequisite to understanding a log sort yard's financial feasibility.
Equipment Trials for Uprooting Root-Rot-Infected Stumps
Authors: Bloomberg W. J. , Reynolds G.
Published: August 2019

Root residues were measured following stump-root extraction 1 year after harvesting a 55-year-old Douglas-fir (Pseudotsuga menziesii [Mirb.] Franco) stand with 20% infestation of Phellinus weirii (Murr. Gilbertson) root rot. A D8 Cat, a 180-hp (large) backhoe, and a 115-hp (small) backhoe were each used to uproot stumps on 1.2-1.3 ha blocks. All treatments resulted in less than 10% of root volume remaining in the soil compared with pretreatment volumes calculated from dbh-root volume relationships on a similar site. Average numbers and lengths of root residues/m³ soil were significantly greater for the small backhoe than for the other treatments, and volume was greatest for the D8 Cat treatment. The large backhoe treatment resulted in smaller residual volumes than the other treatments. West. J. Appl. For. 3(3):80-82, July 1988.
Chemical Root Pruning Improves the Root System Morphology of Containerized Seedlings
Authors: Wenny David L. , Woollen Richard L.
Published: August 2019

Douglas-fir (Pseudotsuga menziesii var. glauca) ponderosa pine (Pinus ponderosa var. ponderosa), and western white pine (Pinus monticola) where chemically root pruned with cupric carbonate (CuCO3) during greenhouse production. The interior walls of Styroblock 4A® and Ray Leach® pine cell containers (each 66 cm³) were coated with latex paint containing CuCO3 at concentrations of 0, 30, 100, or 300 g/l. Seedlings were potted after one growing season, initiating a standard root growth potential test (Duryea 1984). The number and length of new roots more than 1 cm in length were measured. Seedling root systems increased in total root number and length, especially in the upper segments of the root plug, as a result of chemical root pruning. Seedling height and caliper were unaffected by the cupric carbonate treatments during the production phase, and a latex paint carrier did not decrease seedling growth. West. J. Appl. For. 4(1):15-17, January 1989.
Grading Ponderosa Pine Seedlings for Outplanting According to their Root Volume1
Authors: Rose Robin , Gleason John , Atkinson Mary , Sabin Tom
Published: August 2019

In probably one of the first studies of its kind, three different seed sources of 2 + 0 ponderosa pine (Pinus ponderosa) seedlings were graded on the basis of three root-volume categories (< 4.5, 4.5-7, and > 7 cm³) and out-planted to determine differences in survival and growth over 1 and 2 growing seasons, examine the relationship of seedling field height to nursery root volume, total fresh weight, diameter, and height over the same period, and observe differences in nutrient uptake by seedlings among the three categories over 174 days in the field. Seedling survival was good over the two growing seasons. Seedlings graded to the largest root-volume category were significantly taller and grew significantly more than those in the two smaller categories over the 2 years. Nitrogen and potassium contents decreased over the growing season, those seedlings with larger root volumes showing the greatest decrease. The results suggest that root volume has potential as a useful criterion for grading seedlings. West. J. Appl. For. 6(1):11-15.
Serbian Spruce is as Vulnerable as Sitka Spruce to Damage by the Sitka Spruce Weevil
Authors: Hulme Michael A. , Dawson Allan F.
Published: August 2019

Serbian spruce (Picea omorika) was first damaged naturally by the Sitka spruce weevil (Pissodes strobi) at about 15 years of age in an area on Vancouver Island where this weevil commonly attacks Sitka spruce (Picea sitchensis). By about 20 years of age, all 35 trees in the observation group had been damaged at least once. Serbian spruce cannot therefore be considered a suitable replacement for Sitka spruce in areas where attack by the Sitka spruce weevil is a forest management concern. West. J. Appl. For. 7(1):5-6.
Controlled Release Fertilizer Effects on Growth and Foliar Nutrient Concentration of Container Grown Jeffrey Pine and Singleleaf Pinyon
Authors: Walker R. F. , Huntt C. D.
Published: August 2019

Two controlled release fertilizers, Sierra 17-6-12 Plus Minors controlled release nutrients and Agriform 14-4-6 container tablets, were evaluated for their effects on containerized Jeffrey pine (Pinus jeffreyi) and singleleaf pinyon (Pinus monophylla) planting stock. Seedlings produced with a conventional water soluble fertilizer, Peters 20-10-20, and unfertilized seedlings provided bases for comparison of fertilizer effects on growth and mineral nutrition. After 12 mo, mean volume of Jeffrey pine seedlings fertilized with Sierra prills exceeded that of Agriform and Peters treatments by >40% and unfertilized seedlings by 215%. Volume of singleleaf pinyon in the Sierra and Peters treatments exceeded those of the Agriform and unfertilized treatments by ≥100%. Shoot/root ratios of seedlings fertilized with Agriform tablets were significantly higher than those of the other treatments in both species. Foliar analyses for 11 plant-essential elements revealed that concentrations of most elements in fertilized seedlings were sufficient for adequate seedling nutrition. Apparent luxury consumption of one or more nutrients, particularly N, was detected in Jeffrey pine fertilized with Sierra prills and Agriform tablets. Overall, Sierra 17-6-12 proved effective for growth of Jeffrey pine and singleleaf pinyon container seedlings, while Agriform 14-4-6 was marginal for growing Jeffrey pine and unsuitable for singleleaf pinyon. West. J. Appl. For. 7(4):113-117.
Young-Growth Redwood Stands Respond Well to Various Thinning Intensities
Authors: Oliver William W. , Lindquist James L. , Strothmann Rudolph O.
Published: August 2019

Three 45- to 50-yr-old redwood (Sequoia sempervirens) sawtimber stands spanning a substantial portion of the species' commercial range were thinned to three stocking levels. Treatments were low thinnings leaving 25%, 50%, 75%, and 100% of the before-treatment stand density, expressed as basal area/ac. Trees were measured for dbh, and a sampling of heights was taken for volume estimations at 0, 5, 10, and 15 yr after thinning. Leave trees responded strongly to the increased growing space, in spite of the vigorous stump sprouting of cut trees. Stand growth in basal area and volume varied narrowly among treatments. Overall, volume production was significantly different only in the 25% leave plots where sites were not fully occupied by the leave trees. Results illustrate the similarity between two growth/growing stock theories which appear to conflict. We conclude that 50% of the basal area in fully stocked stands could be removed in a low thinning without significant loss in volume production. West. J. Appl. For. 9(4):106-112.
The Effect and Extent of Railroad Tie Drives in Streams of Southeastern Wyoming
Authors: Young Michael K. , Haire David , Bozek Michael A.
Published: August 2019

Millions of railroad ties were floated (driven) down streams in southeastern Wyoming between 1868 and 1940. We identified 61 tie-driven streams in or near the Medicine Bow National Forest. We hypothesized that tie drives, and the stream clearing associated with driving, altered channel morphology and riparian vegetation. When comparing stream reaches of similar width and gradient, we found that tie-driven stream reaches contained less coarse woody debris and had significantly lower densities of large riparian trees than did unaffected reaches. Tie-driven reaches had lower channel complexity, a greater proportion of riffles, and fewer plunge and dammed pools than did unaffected reaches. We found significant relations among characteristics of the riparian trees, coarse woody debris, and stream channel structure. Recovery of the affected reaches may be contingent on the long-term increase in large trees in the riparian zone. West. J. Appl. For. 9(4):125-130.
Effective treatments for head lice
Authors: Imboden Annie
Published: August 2019

Head lice is a parasitic infestation common in children. Proper management is essential to treat lice in a safe, convenient, cost-effective, and efficacious manner. School lice policies are often antiquated and can stigmatize the child and family. Evidence-based care guidelines may significantly help families minimize the stress of lice.
Using health coaches to help patients manage chronic disease
Authors: Burger Susan
Published: August 2019

This exploratory pilot study analyzed the transition to a new patient-centered care team model at three separate clinical sites of an urban community health center. The findings provide insights from both providers and health coaches on benefits and barriers of this new model.
Medical Student Psychological Distress and Mental Illness Relative to the General Population: A Canadian Cross-Sectional Survey
Authors: Maser Brandon , Danilewitz Marlon , Guérin Eva , Findlay Leanne , Frank Erica
Published: August 2019

Purpose

To provide national data on Canadian medical students’ mental health and show how their mental health compares with that of similarly aged postsecondary graduates from the general population.

Method

In 2015–2016, the authors conducted a survey of medical students in all years of study at all 17 Canadian medical schools. The surveys included validated items and instruments to assess for psychological distress, suicidal ideation, and diagnosed mood and anxiety disorders. Comparative analyses were performed between medical students and similarly aged postsecondary graduates using data from the Canadian Community Health Survey–Mental Health 2012.

Results

The participation rate across all medical students was 40.2% (4,613/11,469). Relative to the general population of postsecondary graduates aged 20–34, medical students aged 20–34 had significantly higher rates of diagnosed mood disorders, diagnosed anxiety disorders, suicidal ideation, and psychological distress. Among medical students, being female was associated with having a mood or anxiety disorder, lifetime suicidal ideation, moderate or severe psychological distress, and higher mean Kessler Psychological Distress Scale 6-item summative scores. Being in clinical training was associated with having suicidal ideation, moderate or severe psychological distress, and mood and anxiety disorders.

Conclusions

Compared with postsecondary graduates from the general population, medical student respondents had significantly higher rates of psychological distress, suicidal ideation, and mood and anxiety disorders. Further research is needed to understand the factors that are contributing to these higher rates.
Total intravenous anaesthesia in ambulatory care
Authors: McIlroy Edward I. , Leslie Kate
Published: August 2019

Purpose of review

The purpose of this article is to review the use of total intravenous anaesthesia (TIVA) in ambulatory care.

Recent findings

The number of ambulatory surgery cases is likely to increase in coming years. Recent meta-analyses suggest that TIVA offers decreased postoperative nausea and vomiting (PONV) and decreased pain scores in the postanaesthesia care unit (PACU) in day case/ambulatory surgery patients when compared with volatile anaesthesia. Particular improvements have also been shown in endoscopic nasal surgery in terms of decreased blood loss. TIVA consistently scores higher than volatile techniques in patient satisfaction surveys. Surveys of anesthetists suggest that TIVA is not in widespread use. This may be because of the perceived lack of training or confidence in the technique, therefore, recent internationally agreed guidelines aimed at formalizing its practice are welcome. There is also some recent evidence to suggest that intraoperative dexmedetomidine is superior to remifentanil with respect to postoperative pain and speed of recovery, and that intraoperative lignocaine infusion may reduce chronic pain incidence in breast surgery.

Review of recent evidence of TIVA's use in ambulatory surgery and summary of new international guidelines on its use.
Tailoring Individualized Evaluation of Pediatric Abdominal Pain Using Ecological Momentary Assessment (EMA)
Authors: Cushing Christopher C. , Kichline Tiffany , Blossom Jennifer B. , Friesen Craig A. , Schurman Jennifer V.
Published: August 2019

Objective:

The current study aimed to determine if it was feasible and acceptable to use ecological momentary assessment to assess individual associations between biopsychosocial contributors to chronic abdominal pain with 2 objective sensors and a mobile application. Specifically, we aimed to determine if it was possible to identify individualized associations between idiopathic pain associations. The goal was to determine if idiographic profiles have clinical value while the field works torward consensus about nomothetic trends.

Materials and Methods:

Participants included 30 pediatric chronic abdominal pain patients, aged 8 to 17, who wore a physiological monitor and accelerometer that measured sleep and physical activity and answered 4 surveys per day on an app over the course of a 14-day study period.

Results:

Results indicated that participants were 96.2% and 95.5% compliant to the wrist-worn accelerometer measuring sleep and physical activity, respectively. Participants completed 76.3% of expected surveys and were least adherent to the physiological monitor (37.9%). In addition, it was possible to generate 24 (80%) personalized reports describing unique associations with pain for participants in the study.

Discussion:

Findings provide initial support for the use of ecological momentary assessment over a 2-week period to inform and create personalized profiles for improved clinical care in this population.
Early Postnatal Exposure to Isoflurane Disrupts Oligodendrocyte Development and Myelin Formation in the Mouse Hippocampus
Authors: Li Qun , Mathena Reilley P. , Xu Jing , Eregha O’Rukevwe N. , Wen Jieqiong , Mintz Cyrus D.
Published: August 2019

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Early postnatal exposure to general anesthetics may interfere with brain development. We tested the hypothesis that isoflurane causes a lasting disruption in myelin development via actions on the mammalian target of rapamycin pathway.

Methods

Mice were exposed to 1.5% isoflurane for 4 h at postnatal day 7. The mammalian target of rapamycin inhibitor, rapamycin, or the promyelination drug, clemastine, were administered on days 21 to 35. Mice underwent Y-maze and novel object position recognition tests (n = 12 per group) on days 56 to 62 or were euthanized for either immunohistochemistry (n = 8 per group) or Western blotting (n = 8 per group) at day 35 or were euthanized for electron microscopy at day 63.

Results

Isoflurane exposure increased the percentage of phospho-S6–positive oligodendrocytes in fimbria of hippocampus from 22 ± 7% to 51 ± 6% (P < 0.0001). In Y-maze testing, isoflurane-exposed mice did not discriminate normally between old and novel arms, spending equal time in both (50 ± 5% old:50 ± 5% novel; P = 0.999), indicating impaired spatial learning. Treatment with clemastine restored discrimination, as evidenced by increased time spent in the novel arm (43 ± 6% old:57 ± 6% novel; P < 0.001), and rapamycin had a similar effect (44 ± 8% old:56 ± 8% novel; P < 0.001). Electron microscopy shows a reduction in myelin thickness as measured by an increase in g-ratio from 0.76 ± 0.06 for controls to 0.79 ± 0.06 for the isoflurane group (P < 0.001). Isoflurane exposure followed by rapamycin treatment resulted in a g-ratio (0.75 ± 0.05) that did not differ significantly from the control value (P = 0.426). Immunohistochemistry and Western blotting show that isoflurane acts on oligodendrocyte precursor cells to inhibit both proliferation and differentiation. DNA methylation and expression of a DNA methyl transferase 1 are reduced in oligodendrocyte precursor cells after isoflurane treatment. Effects of isoflurane on oligodendrocyte precursor cells were abolished by treatment with rapamycin.

Conclusions

Early postnatal exposure to isoflurane in mice causes lasting disruptions of oligodendrocyte development in the hippocampus via actions on the mammalian target of rapamycin pathway.
Macrophages and cadherins in fibrosis and systemic sclerosis
Authors: To Sarah , Agarwal Sandeep K.
Published: August 2019

Purpose of review

Macrophages are key players in systemic sclerosis (SSc) and fibrosis. The mechanism by which macrophages regulate fibrogenesis is unclear and understanding the origin and function of macrophages is critical to developing effective therapeutics. Novel targets on macrophages are under investigation and recently, cadherins have emerged as a potential therapeutic target on macrophages. The current review will discuss the importance of macrophages in SSc and fibrosis and summarize recent studies on the role of cadherin-11 (Cdh11) on macrophages and fibrosis.

Recent findings

Genome-wide expression studies demonstrate the importance of macrophages in SSc and fibrosis. Although M2 macrophages are associated with fibrosis, the presence of a mixed M1/M2 phenotype in fibrosis has recently been reported. Several studies aiming to identify macrophage subsets involved in fibrogenesis suggest that monocyte-derived alveolar macrophages are key players in the development of murine lung fibrosis. Recent functional studies show that Cdh11 regulates macrophages, fibroblast invasion, and adhesion of macrophages to myofibroblasts.

Macrophages play an important role in SSc and fibrosis. New insights into the mechanisms by which macrophages regulate fibrogenesis have been discovered on the basis of Cdh11 studies and suggest that targeting Cdh11 may be an effective target to treat fibrosis.
Role of dose-dense chemotherapy in high-risk early breast cancer
Authors: Blondeaux Eva , Poggio Francesca , Del Mastro Lucia
Published: August 2019

Purpose of review

Adjuvant chemotherapy for breast cancer significantly reduces the risk of recurrence and improves overall survival (OS). The purpose of the current article is to review available evidence on dose-dense chemotherapy, also focusing on special population, including premenopausal women and those with HER2-positive disease.

Recent findings

A recent patient-level meta-analysis showed that the use of dose-dense chemotherapy is associated with significant reduction in disease recurrence, breast cancer mortality and improvement in OS. The benefit of dose-dense chemotherapy is irrespective from HER2 status, although women with HER2-positive disease enrolled in trials included in the meta-analysis did not receive the current standard of treatment with anti-HER2 agents. Among premenopausal women, dose-dense chemotherapy improved OS, and thus should be considered standard of care for them.

In conclusion, high-risk early stage breast cancer patients should be treated with (neo)adjuvant dose-dense anthracycline-based chemotherapy followed by paclitaxel. In the era of trastuzumab, the benefit of dose-dense chemotherapy is still unclear for patients with HER2-positive breast cancer.
Optical Coherence Tomography Angiography in Pinguecula and Pterygium
Authors: Zhao Fengping , Cai Sijie , Huang Zhu , Ding Peisheng , Du Chixin
Published: August 2019

Purpose:

To investigate the density of conjunctival blood vessels in normal eyes and in eyes with pinguecula or pterygium.

Methods:

In this cross-sectional study, the conjunctival blood vessel density of 15 normal eyes, 15 pinguecula eyes, and 15 pterygium eyes of 43 healthy adults was assessed using optical coherence tomography angiography with an anterior segment lens adapter. The nasal surface of each eye (3 × 3 mm) was scanned 3 times to a depth of 800 μm. Conjunctival vessel density was defined as the percent of the scanned volume occupied by vessels in which blood flow was measured.

Results:

The high reliability of data measurement was supported by good coefficients of repeatability (<10%) of the image quality score and high intraclass correlation coefficients (>0.9). The vessel density in normal conjunctivas, 52.2 ± 4.1%, was similar to that in pinguecula conjunctivas, 50.5 ± 4.7% (P = 0.3006). However, the vessel density in conjunctivas with pterygium, 63.6 ± 3.7%, was greater than that in either normal (P < 0.0001) or pinguecula (P < 0.0001) conjunctivas.

Conclusions:

Using optical coherence tomography angiography with an anterior segment lens adapter, the ocular surface blood vessel density was imaged and assessed with good repeatability and reliability. The blood vessel density of conjunctivas with pterygium was significantly greater than that in either normal or pinguecula conjunctivas. This suggests that, in contrast to pinguecula development, pterygium development includes angiogenesis and neovascularization.
Laying the Foundation for the National TeleNursing Center: Integration of the Quality-Caring Model Into TeleSANE Practice
Authors: Meunier-Sham Joan , Preiss Rachel M. , Petricone Randi , Re Cheryl , Gillen Leah
Published: August 2019

In 2012, the Massachusetts Department of Public Health Sexual Assault Nurse Examiner (SANE) Program was awarded a grant from the Department of Justice, Office for Victims of Crime, to pilot the use of telemedicine technology to extend the reach of SANE expertise to six diverse communities across the United States. To meet the goals of this project, the National TeleNursing Center (NTC) developed a three-phase professional practice model integrating the Quality-Caring Model (QCM) to support the delivery of NTC teleSANE services. Using the QCM as a foundation for teleSANE practice ensures that patients experiencing a recent sexual assault who participate in teleSANE encounters receive quality forensic nursing care. In this article, we briefly review elements of the QCM, describe the application of the model to the NTC Professional Practice Model, and detail how teleSANEs integrate the QCM Caring Behaviors into all three phases of its model. The NTC Professional Practice Model provides a quality-based teleSANE model that may be translatable to other areas of telenursing practice.
Hypertriglyceridemia and Intravenous Lipid Titration During Routine Parenteral Nutrition in Small Preterm Infants
Authors: Correani Alessio , Giretti Ilaria , Antognoli Luca , Monachesi Chiara , Cogo Paola , D'Ascenzo Rita , Biagetti Chiara , Carnielli Virgilio P.
Published: August 2019

Objectives:

In case of hypertriglyceridemia (HiTG) during parenteral nutrition (PN), the 2018 European Society of Paediatric Gastroenterology, Hepatology and Nutrition guidelines recommend an intravenous (IV) lipid titration, but its consequences in small preterm infants are largely unknown. We compared macronutrient and energy intakes, growth, diseases associated with prematurity, and neurodevelopment in small preterm infants on PN who developed (cases) or did not develop HiTG (controls, CNTR).

Methods:

We retrospectively reviewed data of preterm infants with a birth weight (BW) <1250 g consecutively admitted to our neonatal intensive care unit (2004–2016) who received routine PN. HiTG infants were defined by at least 1 triglyceride (TG) measurement >250 mg/dL during the first 10 days of life. Patients with and without HiTG were match‐paired for BW and gestational age.

Results:

A total of 658 infants were analyzed and 196 (30%) had HiTG. One hundred thirty‐six HiTG patients were matched with 136 CNTR. In the first 10 days of life, IV lipid, non‐protein energy and total energy intakes, but not IV amino acids and carbohydrates, were significantly lower in HiTG infants. We found no differences between groups in diseases associated with prematurity. Anthropometry at 36 weeks (W), anthropometry at 2‐year (Y) corrected age (CA), and neurodevelopment at 2Y CA were not different.

Conclusions:

Growth, diseases associated with prematurity, and neurodevelopment at 2Y CA in HiTG infants were similar to CNTR. This occurred despite a statistically significant albeit small reduction in IV lipid and non‐protein energy intakes due to a strict TG monitoring and IV lipid titration at TG levels >250 mg/dL.
The Effect of Stroke on Middle Cerebral Artery Blood Flow Velocity Dynamics During Exercise
Authors: Kempf Katie S. , Whitaker Alicen A. , Lui Yumei , Witte Emily , Perdomo Sophy J. , Ward Jaimie L. , Eickmeyer Sarah , Ledbetter Luke , Abraham Michael , Billinger Sandra A.
Published: August 2019

Background and Purpose:

Previous work demonstrates that older adults have a lower response in the middle cerebral artery velocity (MCAv) to an acute bout of moderate-intensity exercise when compared with young adults. However, no information exists regarding MCAv response to exercise after stroke. We tested whether MCAv response to an acute bout of moderate-intensity exercise differed between participants 3 months after stroke and an age- and sex-matched control group of older adults (CON). A secondary objective was to compare MCAv response between the stroke- and non-stroke-affected MCAv.

Methods:

Using transcranial Doppler ultrasound, we recorded MCAv during a 90-second baseline (BL) followed by a 6-minute moderate-intensity exercise bout using a recumbent stepper. Heart rate (HR), end-tidal CO2 (PETCO2), and beat-to-beat mean arterial blood pressure (MAP) were additional variables of interest. The MCAv response measures included BL, peak response amplitude (Amp), time delay (TD), and time constant (τ).

Results:

The Amp was significantly lower in the stroke-affected MCAv compared with CON (P < 0.01) and in the nonaffected MCAv compared with CON (P = 0.03). No between-group differences were found between TD and τ. No significant differences were found during exercise for PETCO2 and MAP while HR was lower in participants with stroke (P < 0.01). Within the group of participants with stroke, no differences were found between the stroke-affected and non-stroke-affected sides for any measures.

Discussion and Conclusions:

Resolution of the dynamic response profile has the potential to increase our understanding of the cerebrovascular control mechanisms and test cerebrovascular response to physical therapy–driven interventions such as exercise.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A284).
A History of the Frenchay Hospital Plastic Surgery Unit, Bristol, United Kingdom
Authors: Davies Alex J. , Pleat Jonathon M. , Wilson Sherif M.
Published: August 2019

Frenchay Hospital has long since been established as the center for plastic surgery in Bristol, providing care to the city and its surrounding catchment area. From humble origins in the Second World War when the site took on the role of a large military hospital providing reconstructive surgery for the victims of war to a busy modern-day National Health Service establishment, the plastic surgery unit at Frenchay Hospital has grown and developed through in parallel with the genesis and development of the specialty. Recent centralization of care in Bristol has seen a massive reorganization of services, and with it the closure of Frenchay Hospital. Because the plastic surgery unit establishes a new home at Southmead Hospital, this review documents the foundations of reconstructive surgery in Bristol and the South West United Kingdom.