bluuebunny/crossref_metadata_2025 huggingface dataset:
A Retrospective Assessment of Partial Cutting to Reduce Spruce Beetle-Caused Mortality in the Southern Rocky Mountains
Authors: Hansen E. Matthew , Negron José F. , Munson A. Steven , Anhold John A.
Published: August 2019

Tree susceptibility to bark beetle-caused mortality has been linked to stand characteristics such as basal area (BA) and average tree size, factors that can be manipulated through partial cutting. There is no experimental evidence, however, demonstrating the efficacy of partial cutting in spruce type. Such experiments are very difficult to complete because of the inability to manipulate bark beetle populations needed to challenge treated stands. To circumvent this difficulty, we identified spruce stands that were partially cut (for nonexperimental reasons) in advance ofbeetle activity and compared beetle-caused mortality to that in nearby spruce stands that were not treated. Treated stands had fewer infested stems and less infested BA than untreated stands, as well as smaller proportions of infested stems and BA. Untreated stands, however, had more residualspruce stems and BA than treated stands. Most of this difference was among stems 3–11 in. dbh with little difference in survivorship among larger stems. Spruce regeneration was not significantly different among treated and untreated stands. Spruce stand density index, spruce BA, and the number of spruce stems >11 in. dbh were the stand variables most strongly correlated with host mortality measurements. Insect population pressure appears to influence the degree of protection to residual spruce following partial cutting.
Effectiveness of Two Systemic Insecticides for Protecting Western Conifers from Mortality Due to Bark Beetle Attack
Authors: Grosman Donald M. , Fettig Christopher J. , Jorgensen Carl L. , Munson A. Steven
Published: August 2019

Bark beetles (Coleoptera: Curculionidae, Scolytinae) are important tree mortality agents in western coniferous forests. Protection of individual trees from bark beetle attack has historically involved applications of liquid formulations of contact insecticides to the tree bole using hydraulic sprayers. More recently, researchers looking for more portable and environmentally safe alternatives have examined the effectiveness of injecting small quantities of systemic insecticides directly into trees. In this study, we evaluated trunk injections of experimental formulations of emamectin benzoate and fipronil for preventing tree mortality due to attack by western pine beetle (Dendroctonus brevicomis LeConte) on ponderosa pine (Pinus ponderosa Dougl. ex Laws.) in California, mountain pine beetle (Dendroctonus ponderosae Hopkins) on lodgepole pine (Pinus contorta Dougl. ex Loud.) in Idaho, and spruce beetle (D. rufipennis [Kirby]) on Engelmann spruce (Picea engelmannii Parry ex Engelm.) in Utah. Fipronil appeared ineffective for protecting P. ponderosa from mortality due to D. brevicomis over the 3 years in California because of insufficient mortality of untreated, baited control trees the first 2 years and high mortality of the fipronil-treated trees in the third year. Emamectin benzoate was effective in providing protection of P. ponderosa from D. brevicomis during the third year following a single application. To our knowledge, this is the first demonstration of the successful application of a systemic insecticide for protecting individual conifers from mortality due to bark beetle attack in the western United States. Estimates of efficacy could not be made during both field seasons in P. contorta because of insufficient mortality in control trees. Both emamectin benzoate and fipronil were ineffective for protecting P. engelmannii from D. rufipennis. Lower ambient and soil temperatures and soil moisture may have limited chemical movement and thus efficacy at the Idaho and Utah sites.
Effectiveness of Financial Incentive Programs in Promoting Sustainable Forestry in the West
Authors: Greene John L. , Daniels Steven E. , Kilgore Michael A. , Straka Thomas J. , Jacobson Michael G.
Published: August 2019

Selected forestry officials in each of the 13 western states were surveyed in 2005 concerning their opinions on the public and private financial incentive programs available to nonindustrial private forest owners in their state. The officials were asked to name and describe the programs and to assess forest owners' awareness of each one, its appeal among owners aware of it, its effectiveness in encouraging sustainable forestry and enabling owners to meet their objectives, and the percent of program practices that remain in place and enrolled acres that remain in forest over time. They also were asked to suggest ways to improve the programs. The FSP, FLEP, and FLP were among the top-rated federal programs. Programs sponsored by states and private organizations tended to be more narrowly targeted than federal programs and scored well for specific attributes of sustainability. The officials' suggestions for program improvement largely centered on increasing visibility and availability, ensuring long-term consistency in funding, and simplifying the application and approval processes.
Susceptibility of Conifers to Three Dwarf Mistletoes in the Klamath-Siskiyou Mountains
Authors: Mathiasen Robert
Published: August 2019

Dwarf mistletoes (Arceuthobium spp., Viscaceae) are parasitic flowering plants that infect members of the Pinaceae family in the western United States. This article reports additional host susceptibility data for three dwarf mistletoes found in the Klamath-Siskiyou Mountains of southwestern Oregon and northwestern California. Three mixed conifer stands, each infested with either mountain hemlock dwarf mistletoe, western white pine dwarf mistletoe, or Wiens' dwarf mistletoe (nine stands total) were sampled to evaluate the susceptibility of conifers to these parasites. At each of the study sites, 10–20 temporary circular plots with a 6-m radius (0.012 ha) were established around large, severely infected trees. Within plots, species, dbh, and dwarf mistletoe rating (six-class system) were determined for each live tree. On the basis of the incidence of infection, conifers were assigned to host susceptibility classes. Western white pine and mountain hemlock were principal hosts of western white pine and mountain hemlock dwarf mistletoes, respectively. Brewer spruce and red fir were principal hosts of Wiens' dwarf mistletoe. Other conifers sampled were less susceptible to these mistletoes. This information can be used by forest managers to mitigate the damage associated with infestations of these dwarf mistletoes in mixed conifer forests of the Klamath-Siskiyou Mountains.
Effects of Length of Storage, and Stratification on Germination of Whitebark Pine Seeds
Authors: Bower Andrew D. , Kolotelo Dave , Aitken Sally N.
Published: August 2019

The effects of length of storage and stratification on germination of whitebark pine (Pinus albicaulis Engelm.) seeds were determined for 180 open-pollinated families from throughout most of the species range. Seeds came from four geographic regions and were stored from 0 to 10 years at one of four storage facilities. Seeds received a standard 1 month of warm moist treatment and 2 months of cold stratification treatment and germination regime, and germination capacity was determined for 100 viable seeds per family. A subset of families received an additional 6 months of cold stratification. Mean germination was 13.4% after 2 months of cold stratification and 76.6% after an additional 6 months of cold stratification, with a wide range among seedlots for both assessments. The length of storage did not affect germination significantly in the first test, but it was associated with a decline in the second test. Germination capacity of up to 80% was achieved with seeds that had been in storage for 10 years. High viability of stored seeds indicate that ex situ seed storage should provide a viable means of conserving genetic resources; however, we recommend that standard protocols for germination of whitebark pine seeds be modified by extending the cold stratification period.
Effects of Stand Density on Top Height Estimation for Ponderosa Pine
Authors: Ritchie Martin , Zhang Jianwei , Hamilton Todd
Published: August 2019

Site index, estimated as a function of dominant-tree height and age, is often used as an expression of site quality. This expression is assumed to be effectively independent of stand density. Observation of dominant height at two different ponderosa pine levels-of-growing-stock studies revealed that top height stability with respect to stand density depends on the definition of the dominant height. Dominant height estimates calculated from a fixed number of trees per acre (ranging from 10 to 60 of the tallest trees per acre) were less affected by density than those calculated from a proportion (with the cutoff ranging from 95th to the 70th percentile) of the largest trees in the stand.
Mastication and Prescribed Fire Influences on Tree Mortality and Predicted Fire Behavior in Ponderosa Pine
Authors: Reiner Alicia L. , Vaillant Nicole M. , Dailey Scott N.
Published: August 2019

The purpose of this study was to provide land managers with information on potential wildfire behavior and tree mortality associated with mastication and masticated/fire treatments in a plantation. Additionally, the effect of pulling fuels away from tree boles before applying fire treatment was studied in relation to tree mortality. Fuel characteristics and tree mortality data were gathered before and after treatments in a 25-year-old ponderosa pine (Pinus ponderosa C. Lawson) plantation. A random block design was used with three treatments plus a control at each of four blocks. Four plots were established as subsamples within each of the treatment and control sections of each block. Potential wildfire behavior for posttreatment fuel conditions was modeled for 90th and 97th percentile fire weather. Predicted rates of spread and flame lengths were higher for fuel conditions resulting from the mastication treatments than for the masticated/fire treatments or the controls. Torching and crowning indices indicated that higher windspeeds would be necessary to promote torching for areas treated with mastication/fire than for mastication or the controls. Tree mortality was 32 and 17% the first year after burning in masticated/fire and masticated/pull-back/fire plots, respectively, and 49 and 27% the second year. Our potential wildfire behavior results indicate that the risk of crown fire can be somewhat reduced by mastication and further reduced if mastication is followed up with prescribed fire to consume surface fuels. However, moderate levels of tree mortality seem inevitable when burning masticated fuels in a plantation and may only marginally be reduced by pulling fuels away from tree boles, which increases treatment costs.
Economic Evaluation of Thinning Alternatives in a Western Hemlock-Sitka Spruce Forest
Authors: Kellogg Loren D. , Olsen Eldon D.
Published: August 2019

As part of a multidisciplinary study on managing young western hemlock (Tsuga heterophylla)-Sitka spruce (Picea sitchensis) stands in the Pacific Northwest, a present net worth analysis of thinning impacts on financial returns at final harvest was completed. Two 32-year-old precommercially thinned stands were selectively and strip thinned with a skyline logging system, and stand growth was projected to rotation age 70 years with a stand-table projection model. A harvest simulation model was then used to estimate harvest costs and revenues from clearcutting at rotation age. Regardless of model assumptions, present net worth was highest for the control (no thinning). A sensitivity analysis of variations from base-case assumptions did not alter the outcome. Study results suggest that if density of managed western hemlock-Sitka spruce stands has been sufficiently controlled with precommercial thinning, they will develop adequately to a rotation-age harvest without intermediate thinning. West. J. Appl. For. 3(1):14-17, January 1988.
Ecological Adaptations in Douglas-fir (Pseudotsuga menziesii var. glauca). IV. Montana and Idaho Near the Continental Divide
Authors: Rehfeldt G. E.
Published: August 2019

Seventy-seven seedling populations of Douglas-fir (Pseudotsuga menziesii var. glauca) sampled from near the Continental Divide in Idaho and Montana exhibited pronounced genetic differences when compared in three common environments. Differentiation involved several traits that are components of an annual developmental cycle that must be completed within a growing season of finite length. Consequently, the elevational and geographic dines of genetic variation tend to parallel variation in the length of the growing season at the seed source. Such clines suggest that maladaptation in artificial reforestation can be controlled by limiting the transfer of seeds. While geographic transfers can be relatively liberal, elevational transfers should be limited to ±90 m (300 ft) from the seed source at elevations below 1,400 m (4,600 ft), to ±125 m (410 ft) for elevations between 1,400 and 2,000 m (4,600 and 6,550 ft), and ±200 m (560 ft) for elevations above 2,000 m (6,550 ft). West. J. Appl. For. 3(4):101-105, October 1988.
Natural Variation Among Seedlings from Colorado Sources of Blue Spruce
Authors: Diebel Kenneth E. , Fechner Gilbert H.
Published: August 2019

Germination value, seed weight, cotyledon number, cone length, date of bud set, and height growth were examined on 75 single-tree Colorado sources of blue spruce (Picea pungens Engelm.) grown under accelerated conditions in a greenhouse. The 75 sources were grouped according to seed zone of origin; and nested analysis of variance indicated significant differences between zones for all traits except cotyledon number and date of bud set. No differences were found among families (grouped according to subregions) within seed zones. Trees in families from low elevations and southern latitudes set bud later than trees of other origins. Variation in date of bud set conformed to local altitudinal clinal patterns. West. J. Appl. For. 2(4):106-109, October 1988.
Production and Cost Comparison for Three Skyline Thinning Systems
Authors: Hochrein Peter H. , Kellogg Loren D.
Published: August 2019

Cable thinnings were conducted in a Douglas-fir stand containing 350 trees/ac (average dbh 12 in.). Production rates and costs for a small and a midsize yarder were compared at a light (80 trees/ac) and a heavy (125 trees/ac) thinning intensity. Conventional yarding cost 11 to 12% less with the small than the midsize yarder, depending on thinning intensity. Conventional yarding cost 20 to 22% more in light than heavy thinning for the midsize and small yarders, respectively. This is due in part to increased number of landing and road changes required and smaller turn sizes in the light thinning. Prebunching with the small yarder and swinging with the midsize yarder, studied at the light intensity only, cost about the same as conventional yarding with the midsize yarder and about 9% more than conventional yarding with the small yarder. Gentle skyline chord slopes, large amounts of brush, and excessive mainline sag due to high ground-to-carriage clearance should be avoided where slack is pulled manually. We project that avoiding these conditions, operating with a smaller crew than was used in this study, and reducing delays could render prebunch and swing yarding less expensive than conventional yarding with either a small or midsize yarder and therefore more suitable for handling small-diameter wood. West. J. Appl. For. 3(4):120-123, October 1988.
Marketing Fee Hunting Opportunities in the Presence of Abundant Public Land
Authors: Johnson Rebecca L.
Published: August 2019

A survey was conducted of hunters holding elk and deer permits for northeastern Oregon to determine their attitudes toward fee hunting in an area where public land access is readily available. They were also asked about their preferences for different attributes of the fee hunt. Forty-five percent of the respondents indicated a willingness to pay an access fee to hunt on private lands in northeastern Oregon. The attributes most desired were related to hunting success, although "low contact with other people" was considered necessary by 44% of the respondents. The presence of other recreational opportunities would not make most hunters more willing to pay an access fee. West. J. Appl. For. 4(1):24-26, January, 1989.
Aerial Application of Ethephon is ineffective in Controlling Lodgepole Pine Dwarf Mistletoe
Authors: Robbins Kathryn , Johnson David W. , Hawksworth Frank G. , Nicholls Thomas H.
Published: August 2019

Ethephon is an ethylene-releasing plant growth regulator that induces abscission of dwarf mistletoe (Arceuthobium americanum) aerial shoots on lodgepole pine (Pinus contorta) when applied from the ground. However, ethephon was not effective when applied by helicopter in two Colorado tests, because it did not come into enough direct contact with dwarf mistletoe shoots to induce abscission. West. J. Appl. For. 4(1):27-28, January 1989.
Age Distribution and Reproduction of Intermountain Aspen Stands
Authors: Mueggler Walter F.
Published: August 2019

Stand age and sucker reproduction was measured in 713 aspen-dominated forest plots on nine National Forests in Utah, southeastern Idaho, and western Wyoming. About 95% of the quaking aspen (Populus tremuloides Michx.) stands are dominated by mature or over-mature trees. Almost one-sixth are in the 120-year or older age class and can be expected to deteriorate rapidly. The oldest aspen measured was 222 years. Stands in central and southern Utah are generally older than those in southeastern Idaho and western Wyoming. A fourth of the stands had more than 2,000 suckers per acre; half had fewer than 800 per acre. Approximately a third of the essentially pure (i.e., not invaded by conifers), mature or over-mature stands may experience regeneration problems because they contain less than 500 suckers per acre. A decision model is presented that will assist managers in identifying stands that require direct management intervention to ensure their survival as aspen-dominated communities. West J. Appl. For. 4(2):41-45, April 1989.
Organic Debris and the Management of Small Stream Channels
Authors: Potts Donald F. , Anderson Bruce K. M.
Published: August 2019

Longitudinal profiles, riparian and in-channel debris loads, and sediment storage were measured in eight reaches of first- to third-order, snowmelt-dominated, intermittent, and perennial streams in western Montana. Low-order channels tended to concentrate debris. Organic matter providedover 60% of total sediment storage in all study reaches. We suggest that Streamside Management Zones (SMZs) be extended to include intermittent channels and possibly the lowest portions of ephemeral channels in anticipation of their activation. Predisturbance appraisal of downed woody fuelsin these SMZs is recommended to provide a target debris loading during site preparation, thus ensuring a steady-state supply of organic materials to maintain channel stabdity following timber harvest. West. J. Appl. For. 5(1):25-28.
Effects of Single Tree Selection Harvests on Stand Structure, Species Composition, and Understory Tree Growth in a Sierra Mixed Conifer Forest
Authors: Lilieholm R. J. , Davis L. S. , Heald R. C. , Holmen S. P.
Published: August 2019

After 20-28 years of single tree selection harvests in initially irregular even-aged stands, stand structure is approaching a target uneven-aged diameter distribution. Seedling stocking in managed stands is nearly three times greater than that of unmanaged stands. Although shade-tolerant species comprise the bulk of most size classes in both managed and unmanaged stands, selection harvests have resulted in adequate quantities of seedlings from all five conifer species, including pines. In managed stands, current small-tree stocking and rates of growth appear adequate to sustain single tree selection harvests over much of a 90-year growth simulation. Simulated peak growth rates of uneven-aged stands compare favorably with actual and anticipated yields from the forest's uneven- and even-aged stands. West. J. Appl. For. 5(2):43-47, April 1990.
Diameter Growth Losses in Western Larch Caused by Larch Casebearer Defoliation
Authors: Alfaro Rene I. , Qiwei Liang , Vallentgoed John
Published: August 2019

The diameter growth of western larch, Larix occidentalis, was studied in two stands defoliated by the larch casebearer, Coleophora laricella. Before defoliation, the growth pattern of larch was highly synchronized (correlation coefficient ≥0.82) with that of Douglas-fir, Pseudotsuga menziesii, a nonhost for the casebearer on the same site, indicating that both species were under the influence of the same environmental factors. During the defoliation years, the growth of larch was only loosely related to the growth of Douglas-fir. A model which predicted growth of larch based on growth of Douglas-fir indicated that defoliation caused a loss of approximately 29% in the breast height diameter growth of larch. West. J. Appl. For. 6(4):105-108.
Establishment of Jeffrey Pine Seedlings from Animal Caches
Authors: Vander Wall Stephen B.
Published: August 2019

Jeffrey pine (Pinus jeffreyi) seeds have large wings and are effectively dispersed by wind, but 37% of the seedling emergence sites in spring 1989 in the Sierra Nevada of western Nevada consisted of tight clumps of seedlings. By fall 1989, 41% of all emergence sites where seedlings survived had resulted from what were originally clumps of seedlings. As Jeffrey pines aged, clumps became smaller, and the frequency of clumps decreased. These seedling clumps and many single seedlings emerged from the scattered caches of seed-hoarding rodents and corvids, and the activities of these animals in the study area were sufficient to account for most of the Jeffrey pine seedling establishment observed. Cached seeds may gain important advantages over uncached seeds in the semiarid habitat occupied by this pine. West. J. Appl. For. 7(1):14-20
Heritability and Expected Gain Estimates for Traits of Scotch Pine Christmas Tree Seed Sources
Authors: Diebel Kenneth E. , Geyer Wayne A. , Lynch Keith D.
Published: August 2019

Forty-five full-sib families of Scotch pine (Pinus sylvestris L.) from an incomplete factorial mating design were planted in northeastern Kansas in 1981. The trees were evaluated in 1986 for survival, height growth, crown width, taper (crown width/height), number of stems per tree, the presence or absence of stem crooks, and the number of full faces. Needle length and needle color were measured at a consistent location on each tree in December 1987. Individual tree heritabilities were high; 49.68% for taper, 61.64% for crown width, 66.83% for height, and 71.46% for needle length. Estimated genetic gains showed that rapid improvements through selection are possible for these four traits. Combined selection consistently had the highest percentage gain and is the recommended selection procedure. Genetic correlation indicated that taper is negatively correlated with height (-0.651). Therefore, because of the commercial importance of form, selection for rapid height growth should not be the emphasis in future breeding efforts. West. J. Appl. For. 7(3):82-86.
Cone Production by Rooted Cuttings, Grafts, and Seedlings of Western Larch
Authors: Fins Lauren , Reedy Verna
Published: August 2019

Cone production in 1991 was compared among rooted cuttings from juvenile trees, grafts from mature scions, and seedlings planted in a common garden in Plains, MT, in 1981 and 1983. The differences among tree types were statistically significant for the mean number of cones per tree, but were not significant for the percent of trees producing cones. A projection of cone production per 1,000 trees showed that the grafts would produce nearly twice the number of cones as the seedlings and more than five times the number of cones as the rooted cuttings under the same conditions. West. J. Appl. For. 7(4):108-109.
Rapid Decline of Whitebark Pine in Western Montana: Evidence from 20-Year Remeasurements
Authors: Keane Robert E. , Arno Stephen F.
Published: August 2019

Whitebark pine (Pinus albicaulis), an important producer of food for wildlife, is decreasing in abundance in western Montana due to attacks by the white pine blister rust fungus (Cronartium ribicola), epidemics of mountain pine beetle (Dendroctonus ponderosae) and successional replacement mainly by subalpine fir (Abies lasiocarpa). Plots established in 1971 were remeasured in 1991 and 1992 to determine the rate and causes of whitebark pine mortality. Mortality rates averaged 42% over the last 20 yr. indicating a rapid decline in whitebark pine populations of western Montana. This decline is most pronounced in northwestern Montana with the southward extension of heaviest mortality centered along the continental divide and Bitterroot Mountain range. Management treatments such as prescribed fire can serve to maintain whitebark pine in the landscape. West. J. Appl. For. 8(2):44-47.
Effects of Tree Spacing and Height Reduction on Cone Production in Two Douglas-Fir Seed Orchards
Authors: Copes D. L. , Bordelon Mike
Published: August 2019

Two treatments involving tree spacings (12 and 24 ft) within rows spaced 24 ft apart and height control (topped or not topped at 20 ft) were evaluated in 17- and 22-yr-old coast Douglas-fir (Pseudotsuga menziesii var. menziesii) seed orchards. Treatment differences for cone production were not significant because of the large tree-to-tree variation in cone production and, at one orchard, the confounding of location with treatment. Cone production in 1990 averaged slightly more than 2 bushels per tree (range 0 to 11.7 bushels). Average production per 96 linear ft of orchard row was 14.8 bushels. West. J. Appl. For. 9(1):5-7.
Growth Responses of Tanoak Sprout Clumps to Thinning
Authors: Harrington Timothy B.
Published: August 2019

At two sites in southwestern Oregon, stands of tanoak (Lithocarpus densiflorus) were thinned in the second year after sprouting (1983) to create relative covers of 25, 50, or 100% of that for unthinned stands. At one site, relative covers were replicated with and without suppression of understory vegetation. Height, crown width and dominant-stem diameter were measured annually on each of 135 sprout clumps of tanoak from 1983-1988. Reductions in relative cover caused a proportionate increase in mean relative growth rate (RGR) of tanoak; however, the effect of understory suppression was not consistent. Increases in RGR of individual clumps from thinning were considerably greater for crown width (73% and 43% for large and small clumps, respectively) than for height (28% and 22%). Predicted crown width of tanoak 6 yr after thinning and understory suppression was up to 46% greater than that of clumps in untreated stands. West. J. Appl. For. 9(4):101-105.
XVII New Literatures
Authors: Batra Kanika , Griffiths Michael , Gui Weihsin , Kamugisha Aaron , Lorre-Johnston Christine , Mcneill Dougal , Niblett Michael , Raja Ira , Sharrad Paul , Uraizee Joya , Williams Mark
Published: August 2019

This chapter has seven sections: 1. Africa; 2. Australia; 3. Canada; 4. The Caribbean; 5. South Asia: The Indian Subcontinent and Sri Lanka; 6. New Zealand and Pacific; 7 Southeast Asia. Section 1 is by Kanika Batra, Joya Uraizee, and Mark Williams; section 2 is by Michael Griffiths and Paul Sharrad; section 3 is by Christine Lorre-Johnston and Mark Williams; section 4 is by Michael Niblett and Aaron Kamugisha; section 5 is by Ira Raja; section 6 is by Dougal McNeill; section 7 is by Weihsin Gui.
Chronic Reducible Scapholunate Ligament Dissociation: A Simple Surgical Technique for a Complex Injury
Authors: Alnaeem Hassan , Alnaeem Khalid , Tsai Tsu-Min
Published: August 2019

Purpose:

Report the outcomes following chondrectomy of scapholunate (SL) joint, temporary stabilization of the SL joint using Kirshner wires and extensor carpi radialis longus (ECRL) transfer to dorsal scaphoid pole to restore normal SL gap and correct dorsal intercalated ligament instability deformity.

Materials and Methods:

Retrospective case series of 11 patients with a mean age of 45 years were treated by the senior author 7 months after SL injury. The SL joint cartilage was removed, the SL joint was stabilized temporarily with 2 Kirshner wires for 8 weeks and ECRL tenodesis to scaphoid dorsally. Visual analog scale, disability of the arm, shoulder, and hand score, wrist flexion and extension range of motion, grip strength, return to work, SL gap, and SL angle were evaluated preoperatively and in last follow-up visit after the procedure. Modified Mayo score and complications were evaluated in the last visit.

Results:

Average follow-up was 15.6 months. In the last follow-up, the average visual analog scale pain score improved significantly from 6.4 to 1.5. Average postoperative grip strength improved significantly compared with preoperative strength (41 to 56 Ib). Average disability of the arm, shoulder, and hand score improved significantly postoperatively (30 to 18 points). Average Mayo score was satisfactory in the last visit. Average SL gap reduced significantly from 4.1 to 2.8 mm and average SL angle decreased significantly from 82 to 62 degrees. Postoperative extension-flexion arc of motion significantly decreased compared with preoperative measurements. SL advanced collapse developed in 1 case after 15 months follow-up. All patients return to regular work at a mean of 16 weeks.

Conclusions:

Chronic reducible SL dissociation can be treated affectively with SL chonderectomy, temporary SL stabilization, and ECRL tenodesis to scaphoid to restore radiologic anatomy without compromising strength or work status. Level of Evidence:

Therapeutic type IV.
Fitting Scleral Lenses Less Than 15 mm in Diameter: A Review of the Literature
Authors: Porcar Esteban , Montalt Juan C. , España-Gregori Enrique , Peris-Martínez Cristina
Published: August 2019

Objective:

To perform a comprehensive review of the current and historical scientific literature on fitting small scleral lenses (diameter <15 mm) and clarifying their advantages and disadvantages, in addition to their clinical applications.

Methods:

The literature search was performed through PubMed from MEDLINE.

Results:

Eleven studies of case series (258 eyes) were found. Indications were similar to those of larger scleral lenses, 74% for corneal irregularities (mainly keratoconus), whereas 26% for ocular surface diseases. In the studies on cases of irregular corneas, visual acuity improved significantly regarding the values before and after fitting the lenses (mean, 0.4–0.03 logMar, respectively). Moreover, no significant adverse effects on the ocular surface were reported, and most studies reported over 10 hr (or thereabouts) of daily wear without removing the lenses. A better corneal physiology and visual quality, easier fitting procedure and lens handling, and prolonged hours of wear are proposed as significant advantages over larger scleral lenses.

Conclusion:

Small scleral lenses may be a safe and healthy alternative option to treat corneal irregularities and ocular surface diseases. These lenses can be fitted when it is necessary to improve visual quality and corneal physiology, when discomfort with other contact lenses is experienced, or when patients have difficulty handling larger diameters of scleral lenses. However, fitting these lenses is not suggested in severe cases or when it is not a reasonable clinical option.
Poor Long-Term Outcomes of Keratopigmentation With Black Ink for the Treatment of Dysphotopsia Secondary to Laser Peripheral Iridotomies
Authors: Jabbour Samir , Choremis Johanna , Boutin Tanguy , Brunette Isabelle , Mabon Michèle , Talajic Julia C.
Published: August 2019

Purpose:

To report outcomes of keratopigmentation (KP) with commercial black ink in the treatment of dysphotopsia secondary to laser peripheral iridotomies (LPI) using manual anterior stromal puncture (ASP) and manual lamellar pocket (LP).

Methods:

This is a retrospective case series of eyes that underwent KP for treatment of dysphotopsia secondary to LPI. Patients' postoperative symptoms were categorized as resolved, improved, no change, or worse. Any intraoperative and postoperative complications were noted, as well as the need for further treatments.

Results:

Five eyes in 4 patients underwent ASP, and 14 eyes in 13 patients underwent LP. Only 1 patient had improvement in symptoms in the AK group. Four patients had a complete resolution of symptoms after LP, whereas 7 had symptomatic improvement and 3 did not notice any change. Fifty-five percent of patients in the LP group experienced late-onset depigmentation between 3 and 5 years postoperatively. One patient who underwent 2 LP re-treatments experienced irregular corneal steepening with nonprogressive corneal thinning. Overall, there were no serious adverse reactions to the pigment used.

Conclusions:

ASP was not suitable for the treatment of dysphotopsia secondary to LPI. In the short term, LP had good outcomes, but commercial black ink was prone to depigmentation at 3 to 5 years postoperatively. We therefore do not recommend the use of such pigment for long-term management of dysphotopsia secondary to LPI.
Nurses' Moral Distress, Burnout, and Intentions to Leave: An Integrative Review
Authors: Karakachian Angela , Colbert Alison
Published: August 2019

Moral distress has been widely addressed across the nursing profession and within other disciplines. Forensic nurses are a vital part of the nursing profession as they care for complex patients who may suffer physically and psychologically. However, forensic nurses' moral distress in the context of caring for victims of violence has not been addressed. This integrative review of the literature reveals the consequences of moral distress on the nursing workforce particularly regarding nurses' burnout and intentions to leave their jobs. Turnover contributes to the country's critical shortage of nurses, which affects the quality of care patients receive and increases the costs for healthcare institutions.
Physician Practice Patterns for Performing Thoracentesis in Patients Taking Anticoagulant Medications
Authors: DeBiasi Erin M. , Murphy Terrence E. , Araujo Katy L.B. , Pisani Margaret A. , Puchalski Jonathan T.
Published: August 2019

Background:

Patients undergoing thoracentesis often have comorbid conditions or take medications that potentially put them at higher bleeding risk. Direct oral anticoagulant (DOAC) use has also increased significantly. There are no published guidelines or consensus on when to perform thoracentesis in patients on anticoagulants. Recent studies support the safety of a more liberal approach for thoracentesis among patients with coagulopathy.

Methods:

We conducted a survey to ascertain the practices of physicians regarding thoracentesis in patients with increased bleeding risk. The survey was administered to the email distribution lists of the American Association of Bronchology and Interventional Pulmonology and of the American Thoracic Society.

Results:

The survey was completed by 256 attending physicians. Most of them were general pulmonologists practicing at academic medical centers. Most of them would perform a thoracentesis in patients receiving acetylsalicylic acid or prophylactic doses of unfractionated heparin or low molecular weight heparin (96%, 89%, and 88%, respectively). Half of the respondents would perform a thoracentesis in patients on antiplatelet medications (clopidogrel and ticagrelor, 51%; ticlopidine, 53%). A minority would perform thoracentesis in patients on direct oral anticoagulants or infused thrombin inhibitors (19% and 12%, respectively). The only subgroup that had a higher proclivity for performing thoracentesis without holding medications were attending physicians practicing for under 10 years. Relative to noninterventional pulmonologists, there were no significant differences in the responses of interventional pulmonologists.

Conclusion:

There was variation in the practice patterns of attending physicians in performing thoracentesis in patients with elevated bleeding risk. Further data and guidelines regarding the safety of thoracentesis in these patients are needed.
Short‐term Effects of Mitomycin C Infiltration for Caustic Oesophageal Strictures in Children
Authors: Wishahy Ahmed M.K. , Seleim Hamed , Qinawy Mohamad , Mohamed Wesam , Mansour Omar , Abdullateef Khaled S. , Elkadi Reda , Raslan Heba , Arafa Ahmed , Yassin Tamer
Published: August 2019

Objectives:

The aim of this study was to investigate the efficacy and safety of endoscopic local infiltration of mitomycin C (MMC) after oesophageal dilation for children suffering from refractory postcorrosive oesophageal stricture (OS).

Methods:

Children referred to Cairo University Specialized Paediatric Hospital with refractory postcorrosive OS during the period from March 2016 to August 2017 were included in this study. MMC was infiltrated endoscopically at the stricture site by the end of the dilation session. The measured outcomes were dysphagia score (DS) and periodic dilation index (PDI).

Results:

During the inclusion period of the presented study, 17 children met the inclusion criteria. There were 7 boys and 10 girls. During the follow‐up period, an average of 3.8 dilation sessions with MMC infiltration per case were performed, using a total dose of 1 mg each session. The median follow‐up period was 9.5 months. The median DS improved from DS 3 before application of MMC to DS 0 at the last follow‐up (P < 0.001). Additionally, the median PDI declined from 1 to 0.75 after MMC application (P = 0.052). Sixteen cases (94%) became dysphagia free after 6 months. Seven patients experienced postdilation minor bleeding that was spontaneously resolved, not triggering blood transfusion. There were no infiltration‐related complications in the included series.

Conclusion:

Stricture‐site MMC endoscopic infiltration by the end of a dilation session proved to be safe and effective in improving the DS and PDI.
Using a Mixed‐method Approach to Develop a Transition Program for Young Adults With Inflammatory Bowel Disease
Authors: Maddux Michele H. , Drovetta Megan , Hasenkamp Rachel , Carpenter Ellen , McCullough Jennifer , Goyal Alka , Bass Julie
Published: August 2019

Background:

Although transition guidelines have been specified in pediatric inflammatory bowel disease (IBD), few IBD centers implement these into standard care. We describe a mixed qualitative and quantitative process of developing a needs‐based transition program for adolescents and young adults with IBD.

Methods:

We enrolled 29 adolescents with IBD, 8 young adults with IBD in adult care, 14 pediatric gastroenterologists, and 58 adult gastroenterologists to provide input into barriers to successful transition, essential patient competencies, and key targets of clinical intervention.

Results:

The availability and expertise of adult gastroenterologists in childhood‐onset IBD were identified by pediatric providers as primary barriers to health care transfer. A medical summary containing pertinent health information was identified by adult providers as instrumental to assume patient care post transfer. Young adults with IBD identified self‐advocacy, education on insurance basics, and peer mentoring as essential targets of transition support and preparation in pediatric care. Findings were used to develop educational materials, a portable medical summary, a referral database of adult gastroenterologists, and a young adult clinic geared towards transition planning.

Conclusion:

Involving key patient and provider stakeholders in the development of a transition program is aimed at ensuring that the individual needs of patients and their families are met. Collaboration between pediatric and adult providers is also intended to facilitate a seamless continuum from pediatric to adult health care services. Efforts to evaluate the impact of such programming on self‐management in adult care are needed.
Mental Singing Reduces Gait Variability More Than Music Listening for Healthy Older Adults and People With Parkinson Disease
Authors: Harrison Elinor C. , Horin Adam P. , Earhart Gammon M.
Published: August 2019

Background and Purpose:

Previously, we showed that internal cues (such as singing) produce similar motor benefits as external cues (such as listening to music) for people with Parkinson disease (PD). This study takes that research further by exploring how singing—either aloud or mentally—at different tempos can ameliorate gait, and it offers insight into how internal cueing techniques may enhance motor performance for older adults and people with PD.

Methods:

Sixty participants aged 50 years and older (30 female) were recruited; 30 had PD and 30 were healthy age-matched controls. Participants completed walking trials involving internal and external cueing techniques at 90%, 100%, and 110% of preferred cadence. The effects of different cue types and rates were assessed in a repeated-measures cross-sectional study by comparing gait characteristics (velocity, cadence, stride length) and variabilities (coefficients of variation of stride length, stride time, single support time).

Results:

All participants modified their cadence and stride length during cued conditions, resulting in changes in gait velocity closely reflecting expected changes based upon cue rate. External cues resulted in increased gait variability, whereas internal cues decreased gait variability relative to uncued walking. Variability decreases were more substantial during mental singing at tempos at or above preferred cadence.

Discussion and Conclusions:

Matching movement to one's own voice improves gait characteristics while reducing gait variability for older adults and people with PD. Optimizing the use of internal cues to facilitate movement is an important step toward more effectively meeting the needs of people with gait disorders related to aging or neurological disease.

Video Abstract available for more insights from authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A286)
Factors Associated With Opioid Prescribing for Distal Upper Extremity Fractures at a Pediatric Emergency Department
Authors: Chua Wee-Jhong , Klein Eileen J. , al-Haddad Benjamin J.S. , Quan Linda
Published: August 2019

Objective

The aims of this study were to describe the prescribing patterns of oxycodone for patients with distal upper extremity fractures and to evaluate factors that influence the quantity of oxycodone prescribed at discharge.

Methods

We retrospectively studied oxycodone prescriptions for patients with upper extremity fractures presenting to a single center tertiary pediatric emergency department (ED) from June 1, 2014, to May 31, 2016. We used logistic regression models to evaluate the association of opioid administration in the ED, fracture reduction under ketamine sedation, initial pain scores (low, medium, and high), patient demographics, and type of prescriber (residents, attendings, fellows, and advanced registered nurse practitioners) with oxycodone prescription at discharge and the number of doses prescribed (≤12 or >12 doses).

Results

A total of 1185 patients met the inclusion criteria. Of these, 669 (56%) were prescribed oxycodone at discharge. Children with fractures requiring reduction had 13 times higher odds [95% confidence interval (CI), 9.45–20.12] of receiving an oxycodone prescription compared with children with fractures not requiring reduction. Opioid administration in the ED was associated with 7.5 times higher odds (95% CI, 5.41–10.51) of receiving an outpatient prescription. Children were more likely to have a higher quantity of oxycodone prescribed if they had a fracture reduction in the ED [odds ratio (OR), 1.73; 95% CI, 1.20–2.50], received an opioid in the ED (OR, 2.13; 95% CI, 1.43–3.20), or received their prescription from an emergency medicine resident (OR, 2.8; 95% CI, 1.44–5.74).

Conclusions

Opioid prescribing differs based on patient- and provider-related factors. Given the variability in prescribing patterns, changing suggested opioid prescriptions in the electronic medical record may lead to more consistent practice and therefore decrease unnecessary prescribing while still ensuring adequate outpatient analgesia.
Management of Five Hundred Patients With Gut Failure at a Single Center
Authors: Abu-Elmagd Kareem M. , Armanyous Sherif R. , Fujiki Masato , Parekh Neha R. , Osman Mohammed , Scalish Marissa , Newhouse Elizabeth , Fouda Yasser , Lennon Elizabeth , Shatnawei Abdullah , Kirby Donald , Steiger Ezra , Khanna Ajai , Radhakrishnan Kadakkal , Quintini Cristiano , Hashimoto Koji , Barnes Julie , Costa Guilherme
Published: August 2019

Objective(s):

To define the evolving role of integrative surgical management including transplantation for patients gut failure (GF).

Methods:

A total of 500 patients with total parenteral nutrition-dependent catastrophic and chronic GF were referred for surgical intervention particularly transplantation and comprised the study population. With a mean age of 45 ± 17 years, 477 (95%) were adults and 23 (5%) were children. Management strategy was guided by clinical status, splanchnic organ functions, anatomy of residual gut, and cause of GF. Surgery was performed in 462 (92%) patients and 38 (8%) continued medical treatment. Definitive autologous gut reconstruction (AGR) was achievable in 378 (82%), primary transplant in 42 (9%), and AGR followed by transplant in 42 (9%). The 84 transplant recipients received 94 allografts; 67 (71%) liver-free and 27 (29%) liver-contained. The 420 AGR patients received a total of 790 reconstructive and remodeling procedures including primary reconstruction, interposition alimentary-conduits, intestinal/colonic lengthening, and reductive/decompressive surgery. Glucagon-like peptide-2 was used in 17 patients.

Results:

Overall patient survival was 86% at 1-year and 68% at 5-years with restored nutritional autonomy (RNA) in 63% and 78%, respectively. Surgery achieved a 5-year survival of 70% with 82% RNA. AGR achieved better long-term survival and transplantation better (P = 0.03) re-established nutritional autonomy. Both AGR and transplant were cost effective and quality of life better improved after AGR. A model to predict RNA after AGR was developed computing anatomy of reconstructed gut, total parenteral nutrition requirements, cause of GF, and serum bilirubin.

Conclusions:

Surgical integration is an effective management strategy for GF. Further progress is foreseen with the herein-described novel techniques and established RNA predictive model.
Laparoscopic Paraesophageal Hernia Repair and Pulmonary Embolism
Authors: Davila Daniel G. , Stetler Jamil L. , Lin Edward , Davis Steven Scott , Yheulon Christopher G.
Published: August 2019

Objective:

Pulmonary embolism (PE) following laparoscopic paraesophageal hernia repair (PEHR) is rare but occurs at a higher frequency than other laparoscopic procedures. We describe a series of patients who developed PEs after PEHR in hopes of capturing potential risk factors for further study.

Materials and Methods:

Five cases of PE after PEHR were observed between 2017 and 2018. Individual and perioperative risk factors, and postoperative courses were reviewed.

Results:

Patients had a mean age of 73 years (range, 59 to 86). All were female. Two patients presented acutely. Three patients underwent revisional surgery. The average procedure duration was 248 minutes (range, 162 to 324). All patients had gastrostomy tubes placed. The diagnosis of PE occurred within 3 to 19 days postoperatively. Four were treated with 3 months of oral anticoagulation; 1 was managed expectantly.

Conclusions:

Highly complex cases, marked by revisional status, need for mesh, large hernia size, and percutaneous endoscopic gastrostomy placement are likely at increased risk for PEs. Preoperative venous thromboembolism chemoprophylaxis should be considered in the majority of laparoscopic PEHR patients.