bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Deadwood and Understory Vegetation 12 Years after Partial and Clearcut Harvesting in Mixedwood Stands of Western Quebec, Canada
Authors: Maleki Kobra , Lafleur Benoit , Harvey Brian D , Mazerolle Marc J , Fenton Nicole J 
Published: March 2020

AbstractEcosystem management promotes the integration of knowledge of natural ecosystem dynamics into forest-management planning and practices, and provides a useful framework for understanding and mitigating the impacts of timber harvesting on biodiversity and ecosystem functions. Understory vegetation and deadwood are involved in many ecosystem functions including nutrient and carbon, and tree-regeneration dynamics. The study objective was to compare the 12-year post-treatment effects on forest floor attributes of two intensities of partial harvesting (gap harvesting [62 percent basal area retention; BAR] and diameter-limit harvesting [35 percent BAR]) to clearcutting (10 percent BAR). We quantified the standing and downed deadwood abundance and the understory plant community composition in mixed, northern temperate forests, in western Québec, Canada. Our results suggest that moderate-intensity gap harvesting can best preserve a standing deadwood stem density and a diameter structure comparable to unmanaged stands. Downed deadwood abundance of all diameter classes was not altered, 12 years following the gap harvesting. Finally, understory plant communities in the gap treatment were more similar to those of unmanaged stands than those in diameter-limit and clearcutting treatments. These results illustrate the importance of tree retention levels for the maintenance of deadwood and understory plant species associated with closed-canopy or old-growth forests.
Shape optimization of stirring rods for mixing binary fluids
Authors: Eggl Maximilian F , Schmid Peter J 
Published: March 2020

Abstract
Mixing is an omnipresent process in a wide range of industrial applications, which supports scientific efforts to devise techniques for optimizing mixing processes under time and energy constraints. In this endeavour, we present a computational framework based on nonlinear direct-adjoint looping for the enhancement of mixing efficiency in a binary fluid system. The governing equations consist of the nonlinear Navier–Stokes equations, complemented by an evolution equation for a passive scalar. Immersed and moving stirrers are treated by a Brinkman penalization technique, and the full system of equations is solved using a Fourier-based pseudospectral approach. The adjoint equations provide gradient and sensitivity information which is in turn used to improve an initial mixing strategy, based on shape, rotational and path modifications. We utilize a Fourier-based approach for parameterizing and optimizing the embedded stirrers and consider a variety of geometries to achieve enhanced mixing efficiency. We consider a restricted optimization space by limiting the time for mixing and the rotational velocities of all stirrers. In all cases, non-intuitive shapes are found which produce significantly enhanced mixing efficiency.
Evaluating the Safety and Efficacy of Intraoperative Enteral Nutrition in Critically Ill Burn Patients: A Systematic Review and Meta-analysis
Authors: Pham Christopher H , Fang Mike , Vrouwe Sebastian Q , Kuza Catherine M , Yenikomshian Haig A , Gillenwater Justin 
Published: March 2020

Abstract
Major burn injuries incite a hypermetabolic response, and the initiation of early enteral nutrition is the standard of care in patients with large burns and contributes to improved outcomes. Perioperative fasting is a common cause of caloric deficits in burn patients and can be obviated with intraoperative enteral nutrition. However, the risks and benefits of this practice are unknown, and there is a concern for aspiration. We conducted a systematic review and meta-analysis to evaluate the safety and efficacy of intraoperative enteral nutrition. We performed a systematic literature search using PubMed, Scopus, and OvidSP MEDLINE databases. We identified studies that evaluated the effects of intraoperative enteral nutrition in adult burn patients compared to those undergoing routine perioperative fasting. We performed a meta-analysis on the incidence of mortality, pneumonia, wound infections, and aspiration in burn patients receiving intraoperative enteral nutrition. We identified seven articles for qualitative review and four for quantitative review (N = 83 patients). There were no statistically significant increases in the risk of mortality (odds ratio [OR] = 1.28, 95% confidence interval [CI]: 0.49, 3.31), wound infections (OR = 0.71, 95% CI: 0.16, 3.24), pneumonia (OR = 2.1, 95% CI: 0.7, 6.1), and aspiration (OR = 1.14, 95% CI: 0.07, 18.75) in patients receiving intraoperative enteral nutrition. Within individual studies, intraoperative enteral nutrition patients received significantly more calories than standard fasting patients. Intraoperative enteral nutrition may increase nutritional intake in burn patients without an increase in complications; however, this is based on limited studies. Randomized controlled trials are needed before recommendations on intraoperative enteral nutrition practice can be made.
Celiac disease: a rare cause of ‘postoperative’ ileoileal intussusception after surgical reduction of ileocolic intussusception in a toddler
Authors: Gawrieh Bardisan , Salhab Nabila , Omran Ammar , Alshehabi Zuheir , Taishori Norma , Ali Wajih 
Published: March 2020

Abstract
Intussusception (IS) is defined as invagination of part of the bowel into an adjacent section of the intestines and is the second most common cause of small bowel obstruction in children. Postoperative ileoileal intussusception after surgical reduction is a special type of ileoileal intussusception and is considered idiopathic. This research paper examines the case of a female Syrian toddler who had been diagnosed with ileoileal intussusception after surgical reduction. Diagnosis of celiac disease was later histopathologically confirmed. Celiac disease (CD) may be the underlying cause for special types of intussusception that may be considered idiopathic, and further investigations, such as endoscopy, should be considered.
Vibration Does Not Affect Short Term Outcomes Following Traumatic Brain Injury in a Porcine Model
Authors: Jung Andrew D , Morris Mackenzie C , Veile Rosalie , Friend Lou Ann , Stevens-Topie Sabre , Cox Daniel D , McGuire Jennifer L , Foreman Brandon , Hartings Jed A , Pritts Timothy A , Makley Amy T , Goodman Michael D 
Published: March 2020

Abstract

Introduction
Traumatic brain injury (TBI) has become increasingly prevalent among the injuries sustained in the military. Many wounded warriors require emergency medical evacuation via helicopter and subsequently fixed wing transport. During aeromedical evacuation, both pilots and patients experience whole body vibration due to engine, rotor, and propeller rotation. The impact of posttraumatic vibration and hypoxia exposure characteristic of the aeromedical evacuation environment on TBI is currently unknown.

Methods
A swine TBI model of controlled cortical impact was utilized. The pigs first underwent TBI or sham injury and were subsequently exposed to vibration or no vibration and hypoxia or normoxia for 2 hours. They were monitored for an additional 4 hours following vibration/hypoxia and blood was drawn at hourly intervals for cytokine and serum biomarker analysis. Continuous physiologic and neurologic monitoring were utilized. Prior to the conclusion of the experiment, the animals underwent brain magnetic resonance imaging. At the end of the study, the brain was extracted for histologic analysis.

Results
Physiologic parameters except for peripheral capillary oxygen saturation (SpO2) were similar between all groups. The hypoxia groups demonstrated the expected decrease in SpO2 and pO2 during the hypoxic period, and this was sustained throughout the study period. The pH, pCO2 and electrolytes were similar among all groups. Neuron specific enolase was increased over time in the TBI group, however it was similar to the sham TBI group at all time points. There were no differences in IL-1β, IL-6, IL-8, TNFα, GFAP, HIF1α, syndecan-1, or S100β serum levels between groups. The mean ICP during cortical impact in the TBI group was 279.8 ± 56.2 mmHg. However, the postinjury ICP was not different between groups at any subsequent time point. Brain tissue oxygenation and perfusion were similar between all groups.

Conclusion
In this novel study evaluating the effect of vibration on short-term outcomes following TBI, we demonstrate that the moderate vibration and hypoxia simulating aeromedical evacuation do not impact short term outcomes following TBI.
Orbitomeningeal Band in Transcavernous Dissection and Anterior Clinoidectomy: 3-Dimensional Operative Video
Authors: Campero Alvaro , Baldoncini Matias , Villalonga Juan F , Sáenz Amparo 
Published: March 2020

Abstract
The orbitomeningeal or meningo-orbital band (MOB) has been described as the most superficial dural band responsible for tethering the frontotemporal basal dura to the periorbita.
1,2
The MBO usually interferes with the surgical approach to the most profound areas of the anterior and middle skull base. It is known that there are no cranial nerves on the lateral surface of the superior orbital fissure; therefore, the neurosurgeon can cut the MOB without causing any neurological deficit and, at the same time, achieving fully exposure of the anterior clinoid process
1-4
and/or the lateral wall of the cavernous sinus.
5

The purpose of this video is to describe the microsurgical anatomy of the MOB and illustrate the technique for its detachment, accompanied by 2 illustrative cases. To achieve this, we use 3-dimensional recordings of 2 cadaveric specimens’ dissections performed by the senior author.
Case 1: 58-yr-old female with left blindness. Magnetic resonance imaging (MRI) shows an anterior and middle skull base lesion with orbital compression.
Case 2: 32-yr-old male presenting with headache and trigeminal neuralgia. The MRI revealed an hourglass-shaped lesion in the posterior and middle fossa. Both patients signed an informed consent and agree with the use of their images for research purposes.
We used a step-by-step approach for an adequate and secure dissection of the MOB highlighting the anatomic structures involved in the process. This approach allows safe and adequate access to the deeper structures of the anterior and middle skull base.
Reconstruction of smeared spectral functions from Euclidean correlation functions
Authors: Bailas Gabriela , Hashimoto Shoji , Ishikawa Tsutomu 
Published: March 2020

Abstract
We propose a method to reconstruct smeared spectral functions from two-point correlation functions measured on the Euclidean lattice. An arbitrary smearing function can be considered as long as it is smooth enough to allow an approximation using Chebyshev polynomials. We test the method with numerical lattice data of charmonium correlators. The method provides a framework to compare lattice calculation with experimental data including excited-state contributions without assuming quark–hadron duality.
The Titanium-coated PEEK Cage Maintains Better Bone Fusion With the Endplate Than the PEEK Cage 6 Months After PLIF Surgery
Authors: Hasegawa Tomohiko , Ushirozako Hiroki , Shigeto Ebata , Ohba Tetsuro , Oba Hiroki , Mukaiyama Keijiro , Shimizu Satoshi , Yamato Yu , Ide Koichiro , Shibata Yosuke , Ojima Toshiyuki , Takahashi Jun , Haro Hirotaka , Matsuyama Yukihiro 
Published: March 2020

Study Design.
A multicenter, randomized, open-label, parallel-group trial.

Objective.
To investigate interbody bone fusion rates in titanium-coated polyetheretherketone (TiPEEK) and polyetheretherketone (PEEK) cages after posterior lumbar interbody fusion (PLIF) surgery.

Summary of Background Data.
Previous clinical studies have not revealed any significant difference in bone fusion rates between TiPEEK and PEEK cages.

Methods.
During one-level PLIF surgery, 149 patients (84 men, 65 women, mean age 67 yr) were randomly allocated to use either a TiPEEK cage (n = 69) or PEEK cage (n = 80). Blinded radiographic evaluations were performed using computed tomography and assessed by modified intention-to-treat analysis in 149 cases and per-protocol analysis in 143 cases who were followed for 12 months. Clinical outcomes were assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and the Oswestry Disability Index.

Results.
The interbody union rate at 12 months after surgery was 45% owing to a very strict definition of bone fusion. The rates of bone fusion were significantly higher at 4 and 6 months after surgery in the TiPEEK group than in the PEEK group in the unadjusted modified intention-to-treat analysis and were significantly higher at 6 months in the unadjusted per-protocol analysis. Binary logistic regression analysis adjusted for sex, age, body mass index, bone mineral density, and surgical level showed that using a TiPEEK cage (odds ratio, 2.27; 95% confidence interval: 1.09–4.74; P = 0.03) was independently associated with bone fusion at 6 months after surgery. Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and Oswestry Disability Index results improved postoperatively in both groups.

Conclusion.
Using the TiPEEK cage for PLIF enabled the maintenance of better bone fusion to the endplate than using the PEEK cage at 6 months after the surgery. Our findings suggest the possibility of an earlier return to rigorous work or sports by the use of TiPEEK cage.

Level of Evidence: 1
Disk Area Is a More Reliable Measurement Than Anteroposterior Length in the Assessment of Lumbar Disk Herniations
Authors: Gupta Anmol , Upadhyaya Shivam , Yeung Caleb M. , Ostergaard Peter J. , Fogel Harold A. , Cha Thomas , Schwab Joseph , Bono Chris , Hershman Stuart 
Published: March 2020

Study Design:
Retrospective study.

Objective:
The goal of this study is to identify and validate the reliability and accuracy of 2 methods used to assess lumbar disk herniations (LDHs): anteroposterior length and cross-sectional area.

Background:
Many clinicians characterize LDHs through the measurement of the anteroposterior length in the axial plane. Radiologists, on the other hand, have utilized software to measure the disk and canal areas to define the injury. In this study, the authors consider the reliability and accuracy of anteroposterior length in comparison with the area.

Methods:
Using International Classification of Diseases, 10th Revision (ICD-10) code M51.26, patients at a single academic medical center who received a diagnosis of primary lumbar radicular pain with subsequent magnetic resonance imaging documentation of a single-level disk herniation in 2015 and 2016 were identified. AGFA-IMPACS software was utilized to make the following measurements: anterior-posterior canal length; anterior-posterior disk length; mid-canal width; mid-disk width; total canal area; total disk area. Data analysis was conducted in SPSS and a 2-tailed reliability analysis using Cronbach alpha as a measure of reliability was obtained.

Results:
A total of 408 patients met the inclusion and exclusion criteria for this study. Sixteen (3.9%) had L3-L4 herniation, 208 had L4-L5 herniation (51.0%), and 184 had L5-S1 herniation (47.5%). The least reliable interobserver metrics, with respective Cronbach alpha values of 0.381 and 0.659, were the linear measurements of mid-disk width and anterior-posterior canal length. Area measurements of the disk and canal areas generated Cronbach alpha values of 0.707 and 0.863. Intraobserver Cronbach alpha values for all measurements, including all areas and lengths, met or exceeded 0.982.

Conclusions:
The cross-sectional area provides a more reliable measurement modality for diskLDHs in comparison to linear measurements. Unlike anteroposterior length, cross-sectional area incorporates the shape of a herniation or canal in its measurement. Thus, it is superior in its characterization LDH particularly in light of its stronger reproducibility.

Level of Evidence:
Level III—retrospective study.
Lumbar Percutaneous Pedicle Screw Breach Rates
Authors: Panchmatia Jaykar R. , Vaccaro Alexander R. , Wang Wenhai , Harris Jonathan A. , Bucklen Brandon S. 
Published: March 2020

Study Design:
Cadaveric study.

Summary of Background Data:
Pedicle screw fixation is an established means of stabilizing the thoracic and lumbar spine. However, there are associated complications including pedicle breach which can result in neurological injury, durotomy, vascular injury, and suboptimal fixation.

Objective:
The aim of this study is to determine whether use of a navigated robotic platform results in fewer pedicle breaches and the underlying reasons for any difference in pedicle breach rates.

Materials and Methods:
Ten board-certified neuro- and orthopedic spine surgeons inserted 80 percutaneous lumbar screws in 10 unembalmed human cadavers. Forty screws were inserted using conventional fluoroscopic guidance and 40 were inserted using a navigated robotic platform. None of the participating surgeons had any prior experience with navigated robotic spine surgery. At the end of the study each screw was assessed with a computed tomography scan, plain radiographs and visual inspection to determine the presence or absence of pedicle breaches.

Results:
Forty percent (40%) of screws inserted using conventional fluoroscopic guidance breached compared with 2.5% of screws inserted with robot assistance (P=0.00005). Lateral breaches accounted for 88.2% (15/17) of all breaches. Detailed analysis revealed that the starting point of screws that breached laterally were significantly more lateral than that of the contralateral accurate screw (P=0.016). Pedicle screw diameter, length, and angulation in the transverse plane did not differ significantly between accurate screws and those that breached (P>0.05).

Conclusions:
The use of a navigated robotic platform in the present study resulted in significantly fewer pedicle breaches. This was achieved through correct starting point selection with subsequent safe pedicle screw insertion.
Tumoral Melanosis in the Setting of Targeted Immunotherapy for Metastatic Melanoma—A Single Institutional Experience and Literature Review
Authors: Jurgens Andrea , Guru Swadha , Guo Ruifeng , Brewer Jerry , Bridges Alina , Jakub James , Comfere Nneka 
Published: March 2020

Background:
Tumoral melanosis clinically resembles metastatic melanoma, occurs in the context of regressed disease, and requires evaluation to rule out underlying melanoma and metastatic disease. Histopathology demonstrates a nodular infiltrate of melanophages in the dermis, subcutaneous tissue, deep soft tissue, or lymph nodes in the absence of viable melanocytes. Recent limited reports of tumoral melanosis in the context of immunotherapy with ipilimumab (monoclonal antibody targeting CTLA-4) as well as nivolumab and pembrolizumab (humanized monoclonal antibodies against programmed death 1 receptor) highlight a unique presentation representative of treatment-related tumor regression and an association with a favorable clinical response.

Objective:
To describe our experience with tumoral melanosis in the setting of immunotherapy for metastatic melanoma and elucidate the clinical and histopathological features.

Methods:
Retrospective case series from a single tertiary care institution.

Results:
We describe 10 cases of patients with metastatic melanoma who received treatment with immunotherapy before the development of tumoral melanosis. Length of time between the initiation of therapy and the onset of tumoral melanosis ranged from 2 to 20 months with a mean time of 10 months. At the end of the follow-up period, 8 patients were classified as having a complete or partial response to treatment with immunotherapy. One patient had progression of visceral and cutaneous disease on ipilimumab despite developing tumoral melanosis, and 1 patient had yet to undergo repeat imaging. Furthermore, at the end of follow-up, 3 patients were alive with no evidence of active disease, 5 patients were alive with disease, and 1 patient was deceased, although this patient died of a cardiovascular event unrelated to his underlying melanoma. Of the patients who were classified as alive with disease, 2 patients had minimal remaining disease, and 2 patients had an almost complete response on immunotherapy with recurrence of visceral metastases after immunotherapy was discontinued. One patient developed new peritoneal and cutaneous metastases on pembrolizumab despite development of tumoral melanosis.

Conclusions:
The underlying biologic mechanisms and prognostic implications of tumoral melanosis in the setting of immunotherapy remain to be elucidated. Further prospective studies with a larger cohort and prolonged follow-up are necessary to better understand the incidence, prevalence, and oncologic outcomes in patients with tumoral melanosis who receive immunotherapy.
SOX-10 and S100 Negative Desmoplastic Melanoma: Apropos a Diagnostically Challenging Case
Authors: Kooper-Johnson Sarah , Mahalingam Meera , Loo Daniel S. 
Published: March 2020

Abstract:
An 83-year-old man presented with a tumor of the neck, clinically consistent with an epidermal inclusion cyst. Excisional biopsy revealed a deeply infiltrating spindled cell tumor. Immunohistochemical markers for S100, SOX-10, Melan-A, HMB-45, and NK1/C3 were negative. Based on the presence of an area of lentigo maligna and the histologic pattern of the spindle cell component, a diagnosis of desmoplastic melanoma was made despite the absence of immunophenotypic evidence for melanocytic differentiation. To the best of our knowledge, the complete lack of both S100 and SOX-10 makes this tumor an unprecedented case. To avoid ruling out the diagnosis of desmoplastic melanoma prematurely, physicians should be made aware of this possible immunohistochemical profile.
Does a Subset of Localized Chronic Fibrosing Vasculitis Represent Cutaneous Manifestation of IgG4-Related Disease/a Histologic Pattern of IgG4-Related Skin Disease? A Reappraisal of an Enigmatic Pathologic Entity
Authors: Tran Tien Anh 
Published: March 2020

Abstract:
Localized chronic fibrosing vasculitis (LCFV) is a rare cutaneous fibroinflammatory and vasculitic process of poorly defined etiology. Furthermore, controversy remains as to whether LCFV represents a primary pathologic process or a histologic pattern. The current case documents a 52-year-old male patient with a scrotal mass and clinical history of a retroperitoneal mass as well as a previously resected tumor of the right submandibular salivary gland displaying morphologic features of eosinophilic angiocentric fibrosis. Histologic examination of the resected scrotal mass revealed a tumefactive lesion characterized by focally storiform fibrosis, obliterative phlebitis, tissue infiltration by IgG4-positive plasma cells, and leukocytoclastic vasculitis. Apart from the leukocytoclastic vasculitis, the scrotal lesion demonstrated characteristic morphologic features of an IgG4-related disease (IgG4-RD). In recognition of the combined histologic findings of both LCFV and IgG4-RD in the scrotal mass, it was postulated that a subset of LCFV cases might represent cutaneous manifestations of IgG4-RD or a new histologic pattern of IgG4-related skin disease (IgG4-RSD). The literature analysis of previously reported LCFV cases appeared to lend credence to this hypothesis. Pathologists should be aware of this new histologic pattern of IgG4-RSD as judicious consideration for additional studies might potentially detect an unexpected systemic IgG4-RD in the patient, particularly in cases of LCFV displaying storiform fibrosis associated with plasma cell infiltrate.