bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forest stand and canopy development unaltered by 12 years of CO2 enrichment*
Authors: Norby Richard J , Warren Jeffrey M , Iversen Colleen M , Childs Joanne , Jawdy Sara S , Walker Anthony P 
Published: August 2021

Abstract
Canopy structure—the size and distribution of tree crowns and the spatial and temporal distribution of leaves within them—exerts dominant control over primary productivity, transpiration and energy exchange. Stand structure—the spatial arrangement of trees in the forest (height, basal area and spacing)—has a strong influence on forest growth, allocation and resource use. Forest response to elevated atmospheric CO2 is likely to be dependent on the canopy and stand structure. Here, we investigated elevated CO2 effects on the forest structure of a Liquidambar styraciflua L. stand in a free-air CO2 enrichment experiment, considering leaves, tree crowns, forest canopy and stand structure. During the 12-year experiment, the trees increased in height by 5 m and basal area increased by 37%. Basal area distribution among trees shifted from a relatively narrow distribution to a much broader one, but there was little evidence of a CO2 effect on height growth or basal area distribution. The differentiation into crown classes over time led to an increase in the number of unproductive intermediate and suppressed trees and to a greater concentration of stand basal area in the largest trees. A whole-tree harvest at the end of the experiment permitted detailed analysis of canopy structure. There was little effect of CO2 enrichment on the relative leaf area distribution within tree crowns and there was little change from 1998 to 2009. Leaf characteristics (leaf mass per unit area and nitrogen content) varied with crown depth; any effects of elevated CO2 were much smaller than the variation within the crown and were consistent throughout the crown. In this young, even-aged, monoculture plantation forest, there was little evidence that elevated CO2 accelerated tree and stand development, and there were remarkably small changes in canopy structure. Questions remain as to whether a more diverse, mixed species forest would respond similarly.
Divergent stem hydraulic strategies of Caragana korshinskii resprouts following a disturbance
Authors: Nie Zheng-Fei , Liao Zhong-Qiang , Yao Guang-Qian , Tian Xue-Qian , Bi Min-Hui , Teixeira da Silva Jaime A , Gao Tian-Peng , Fang Xiang-Wen 
Published: August 2021

Abstract
Resprouting plants are distributed in many vegetation communities worldwide. With increasing resprout age post-severe-disturbance, new stems grow rapidly at their early age, and decrease in their growth with gradually decreasing water status thereafter. However, there is little knowledge about how stem hydraulic strategies and anatomical traits vary post-disturbance. In this study, the stem water potential (Ψstem), maximum stem hydraulic conductivity (Kstem-max), water potential at 50% loss of hydraulic conductivity (Kstem P50) and anatomical traits of Caragana korshinkii resprouts were measured during a 1- to 13-year post-disturbance period. We found that the Kstem-max decreased with resprout age from 1-year-old resprouts (84.2 mol m−1 s−1 MPa−1) to 13-year-old resprouts (54.2 mol m−1 s−1 MPa−1) as a result of decreases in the aperture fraction (Fap) and the sum of aperture area on per unit intervessel wall area (Aap). The Kstem P50 of the resprouts decreased from 1-year-old resprouts (−1.8 MPa) to 13-year-old resprouts (−2.9 MPa) as a result of increases in vessel implosion resistance (t/b)2, wood density (WD), vessel grouping index (GI) and decreases in Fap and Aap. These shifts in hydraulic structure and function resulted in an age-based divergence in hydraulic strategies i.e., a change from an acquisitive strategy to a conservative strategy, with increasing resprout age post-disturbance.
Treatment Choice of Complete Distal Forearm Fractures in 8 to 14 Years Old Children
Authors: Liu Ya , Zhang Fu-Yong , Zhen Yun-Fang , Zhu Lun-Qing , Guo Zhi-Xiong , Wang Xiao-Dong 
Published: August 2021

Background:
New surgical techniques have challenged traditional guidelines for nonsurgical treatment in pediatric and adolescent distal forearm fractures. This study was performed to compare outcomes and costs between closed reduction with percutaneous pinning (CRPP) and closed reduction with casting in the treatment of complete distal forearm fractures in children 8 to 14 years old.

Methods:
A retrospective cohort study was performed of 175 displaced distal forearm fractures treated with 2 different methods in the emergency department of a children’s trauma center. One hundred and fourteen children were managed using CRPP. The remaining 61 were treated with closed reduction and casting. All patients had initial follow-up radiographs. The quality of reduction and the residual angulation in both the coronal and sagittal planes were recorded. Outcomes included the angulation after reduction, residual angulation at final follow-up, radiation exposure, total immobilization time, days absent from school, total costs, and postoperative complications.

Results:
The postreduction sagittal plane angulation was significantly lower in the CRPP group (P=0.037). While residual deformity between the groups at the 6-month final follow-up was not significantly different in either the sagittal or coronal planes (P=0.486, 0.726), patients in the nonoperative group received greater radiation than those in the operative group (P<0.001). Patients in the nonoperative group missed fewer classes and sustained lower costs (P<0.001, <0.001). The mean immobilization time in each group was not significantly different (31.4±4.4 vs. 32.8±5.9 d; P=0.227).

Conclusions:
Although the postreduction quality was a little better and radiation exposure was less in the CRPP group, there was no difference between the 2 groups in angulation, total immobilization time, or complication rates after 6 months. The cost and time absent from school of patients in the nonoperative group was significantly lower than in the operative group. There is no clear advantage to CRPP treatment on outcomes. Therefore, closed reduction and casting is recommended in complete distal forearm fractures of children 8 to 14 years old.

Level of Evidence:
Level III—therapeutic study.
Assessment of the Viability and Union Feature of Diaphysis Reconstruction Using Pasteurized Tumor Bone and Intramedullary Free Fibular After Tumor Resection
Authors: Ji Tao , Li Yuan , Xing Zhili , Tang Xiaodong , Yang Rongli , Guo Wei 
Published: August 2021

Background:
Reconstruction using pasteurized tumor bone (PTM) and intramedullary-placed vascularized free fibular (VFG) has the combined advantages of mechanical strength and biological activity. The aims of this study were to investigate scintigraphic viability and radiographic union patterns of composite grafts after surgery, union rates, functional outcomes, and complication rates.

Methods:
Seventeen patients underwent intercalary composite reconstruction using PTM and VFG (12 male, 2 female, mean age: 10.9 y). Retrospective evaluation of radiography and bone scintigraphy was performed. The most common diagnosis was osteosarcoma (12/14, 85.7%). All radiography and bone scintigraphy was reviewed for bone healing and tracer uptake semiquantitatively using the ratio of the reconstructed portion to the contralateral side. Complications and oncological and functional outcomes were recorded.

Results:
At a mean follow-up of 33.1 months, primary union was achieved in all 28 host-graft junctions in all 14 patients. The respective mean times to proximal and distal junction bone union were 6.9 and 6.5 months. Metaphyseal junctions healed faster than diaphysis junctions (5.2 vs. 8.0 mo, P=0.02). Free fibular was integrated with surrounding bone after a mean of 10.1 months. The mean tracer uptake ratio was 1.1 after a mean of 4.8 months postoperatively. Half patients (50%) had higher uptake on bone scan than contralateral side. There was no significant correlation between uptake value and bone healing time. Five complications occurred in 4 patients (28.6%), and 1 patient (7.1%) contracted an infection. No fractures or breakages were observed. The mean Musculoskeletal Tumor Society 93 score was 87.6%.

Conclusions:
Reconstruction using PTM combined with VFG is associated with good short-term biological activity as indicated by bone scintigraphy, a high union rate, and an acceptable complication rate. The technique is a useful reconstruction option for large segmental bone defects after tumor resection in lower extremities.

Level of Evidence:
Level IV—therapeutic study.
Association between night-time extubation and clinical outcomes in adult patients
Authors: Ippolito Mariachiara , Catalisano Giulia , Iozzo Pasquale , Raineri Santi Maurizio , Gregoretti Cesare , Giarratano Antonino , Einav Sharon , Cortegiani Andrea 
Published: August 2021

BACKGROUND
Whether night-time extubation is associated with clinical outcomes is unclear.

OBJECTIVE
The aim of this systematic review and meta-analysis was to evaluate the association between night-time extubation and the reintubation rate, mortality, ICU and in-hospital length of stay in adult patients, compared with daytime extubation.

DESIGN
A systematic review and meta-analysis.

DATA SOURCES
PubMed, EMBASE, CINAHL and Web of Science from inception to 2 January 2021 (PROSPERO registration - CRD42020222812).

ELIGIBILITY CRITERIA
Randomised, quasi and cluster randomised, and nonrandomised studies describing associations between adult patients’ outcomes and time of extubation (daytime/night-time) in intensive care or postanaesthesia care units.

RESULTS
Seven retrospective studies were included in the systematic review and meta-analysis, for a total of 293 663 patients. All the studies were performed in United States (USA). All the studies were judged at moderate risk of bias for reintubation and mortality. The analyses were conducted with random effects models. The analyses from adjusted estimates demonstrated no association between night-time extubation and increased risk of either reintubation (OR 1.00; 95% CI 0.88 to 1.13; P = 1.00; I
2 = 66%; low-certainty evidence) or all-cause mortality at the longest available follow-up (OR 1.11; 95% CI 0.87 to 1.42; P = 0.39; I
2 = 79%; low-certainty evidence), in comparison with daytime extubation. Analyses from unadjusted data for reintubation, mortality and ICU or in-hospital length of stay showed no significant association with night-time extubation. Analyses based on type of admission, number of centres or duration of mechanical ventilation showed no significant subgroup effects.

CONCLUSION
Night-time extubation of adult patients was not associated with higher adjusted risks for reintubation or death, in comparison with daytime extubation, but the certainty of the evidence was low.
Panax Notoginseng Saponins Protect H9c2 Cells From Hypoxia-reoxygenation Injury Through the Forkhead Box O3a Hypoxia-inducible Factor-1 Alpha Cell Signaling Pathway
Authors: Liu Xin-Wen , Lu Meng-Kai , Zhong Hui-Ting , Liu Jing-Jing , Fu Yong-Ping 
Published: August 2021

Abstract:

Panax notoginseng saponins (PNS) are commonly used in the treatment of cardiovascular diseases. Whether PNS can protect myocardial ischemia-reperfusion injury by regulating the forkhead box O3a hypoxia-inducible factor-1 alpha (FOXO3a/HIF-1α) cell signaling pathway remains unclear. The purpose of this study was to investigate the protective effect of PNS on H9c2 cardiomyocytes through the FOXO3a/HIF-1α cell signaling pathway. Hypoxia and reoxygenation of H9C2 cells were used to mimic MIRI in vitro, and the cells were treated with PNS, 2-methoxyestradiol (2ME2), and LY294002.” Cell proliferation, lactate dehydrogenase, and malonaldehyde were used to evaluate the degree of cell injury. The level of reactive oxygen species was detected with a fluorescence microscope. The apoptosis rate was detected by flow cytometry. The expression of autophagy-related proteins and apoptosis-related proteins was detected by western blot assay. PNS could reduce H9c2 hypoxia-reoxygenation injury by promoting autophagy and inhibiting apoptosis through the HIF-1α/FOXO3a cell signaling pathway. Furthermore, the protective effects of PNS were abolished by HIF-1α inhibitor 2ME2 and PI3K/Akt inhibitor LY294002. PNS could reduce H9c2 hypoxia-reoxygenation injury by promoting autophagy and inhibiting apoptosis through the HIF-1α/FOXO3a cell signaling pathway.
Tumor Control Following Stereotactic Radiosurgery in Patients with Vestibular Schwannomas – A Retrospective Cohort Study
Authors: Santa Maria Peter L. , Shi Yangyang , Aaron Ksenia A. , Gurgel Richard K. , Corrales C. Eduardo , Soltys Scott G. , Santa Maria Chloe , Chang Steven D. , Blevins Nikolas H. , Jackler Robert K. , Gibbs Iris C. 
Published: August 2021

Background:
To better counsel vestibular schwannoma patients, it is necessary to understand the tumor control rates of stereotactic radiosurgery (SRS).

Objectives:
To determine tumor control rates, factors determining control and complication rates following SRS.

Methods:
Tertiary hospital retrospective cohort.

Results:
579 tumors (576 patients) were treated with SRS. 477 tumors (474 patients, 82%) had ≥1 year follow up and 60% (344) ≥3 years follow up. 88% of tumors had primary SRS and 6.7% salvage SRS. Median follow up time was 4.6 years. At 3 years, the tumor control rate of primary SRS was 89% (258 of 290) in sporadic tumors compared to 43% in Neurofibromatosis type II (3 of 17) (p < 0.01). Our bivariable survival data analysis showed that Neurofibromatosis type II, documented pre-SRS growth, tumor measured by maximum dimension, SRS given as nonprimary treatment increased hazard of failure to control. There was one case of malignancy and another of rapid change following intra-tumoral hemorrhage. For tumors undergoing surgical salvage (25 of 59), 56% had a total or near-total resection, 16% had postoperative CSF leak, with 12% new facial paralysis (House-Brackmann grade VI) and worsening of facial nerve outcomes (House-Brackmann grade worse in 59% at 12 mo).

Conclusions:
Control of vestibular schwannoma after primary SRS occurs in the large majority. Salvage surgical treatment was notable for higher rates of postoperative complications compared to primary surgery reported in the literature.
Glasgow Benefit Inventory in Cochlear Implantation: A Reliable Though Ancillary Quality of Life Metric
Authors: Lui Justin T. , Lee John J.W. , Ma Yifei , Dixon Peter R. , Crowson Matthew G. , Dahm Valerie , Shipp David B. , Chen Joseph M. , Lin Vincent Y. 
Published: August 2021

Objective:
The Glasgow Benefit Inventory (GBI) is a health-related quality of life instrument used to detect changes in health status following otolaryngologic interventions. Despite its use in cochlear implant literature, assessment of utility, reliability, and validity of GBI in an adult cochlear implants (CI) patient population has yet to be performed.

Study Design:
Retrospective case series.

Setting:
Academic, tertiary referral center.

Patients:
Postlingually deafened, adult CI patients with at least 1 year of device use.

Interventions:
Five hundred fifty-two patients were administered GBI questionnaires at least 1 year following CI activation during follow-up visits.

Main Outcome Measures:
GBI total and subscale scoring were compared to either the Hearing Handicap Inventory for Adults or Hearing Handicap Inventory for the Elderly. Moreover, a factor analysis and Cronbach's alpha were performed to determine GBI validity and internal reliability, respectively.

Results:
The average overall GBI score was 38.6 ± 21.7. This was weakly correlated to the reduction in Hearing Handicap Inventory for Adults/Hearing Handicap Inventory for the Elderly (τb = 0.282, p < 0.05). High factor loading with minimal cross-loading was noted on a three-factor solution, which emulated the original GBI development. Internal reliability was acceptable for the general benefit (α = 0.913) and social support subclasses (α = 0.706), whereas physical health's was low (α = 0.643).

Conclusions:
Although GBI possesses adequate convergent and discriminant validity with acceptable reliability, its routine use to capture CI-specific health-related changes should not supersede validated CI-specific QoL instruments.
Morphological Analysis of the Adult Eustachian Tube: A Fresh-Frozen Human Cadaver Study
Authors: Kwak Min Young , Kang Jeon Min , Park Jung-Hoon , Lee Dong Kyu , Ryu Sung Seok , Chun Taeuk , Kim Yehree , Park Jin Taek , Kang Woo Seok , Park Hong Ju 
Published: August 2021

Objectives:
To evaluate the dilated Eustachian tube (ET) anatomy configuration using fresh human cadavers.

Methods:
Fourteen ears from human cadavers were used to identify the ET configuration. The cadaver head was cut in the sagittal plane parallel to the nasal septum, dividing it into right and left sides. Silicone was then inserted into the ET through the nasopharyngeal orifice (NO). The volume and length of the impression were measured using 3D computed tomography imaging.

Results:
The ET lumen was found to narrow from the NO to the isthmus, and the ET surface was concave anteriorly and convex posteriorly. The lower portion of the ET lumen was the most dilated and displayed a narrow top. The average volume of the ET impression was 1.4 ± 0.5 ml. The total length of the posterior side was 30.5 ± 3.6 mm, and that of the anterior side was 26.3 ± 3.4 mm. The widest ET area of the NO was 10.1 ± 0.9 mm in height and 8.0 ± 1.5 mm in width. The preisthmus was 2.4 ± 0.4 mm in height and 1.3 ± 0.5 mm in width. The height and width were 8.37 and 5.33 mm at the 5 mm point from the NO, and 5.51 and 1.94 mm at the 20 mm point from the NO, respectively.

Conclusion:
We evaluated the configuration of the cartilaginous ET lumen, which is the main target of balloon dilation, and our findings may give insights into this dilation process and assist with the further development of ET balloons and stents.
Mini-incision and open repair for acute Achilles tendon rupture
Authors: Cao Le , Wang Ping , Wu Yongping , Zhang Qiang , Miao Xudong 
Published: August 2021

Abstract

Background:
The treatment of acute Achilles tendon ruptures remains controversial; operative options include open, mini-invasive, and percutaneous repair of the tendon. This trial aimed to compare the clinical effects of mini-invasive and open repair in treating acute Achilles tendon rupture.

Methods:
We performed a prospective randomized controlled trial of 100 patients with acute Achilles tendon rupture. Patients will be randomized into a mini-invasive group and an open group. The mini-invasive group will undergo a mini-invasive technique using a percutaneous Achilles repair system device, and the open group will undergo open repair using the Krackow technique. The primary outcomes were the Achilles Tendon Total Rupture Score, ankle range of motion, American Orthopaedic Foot and Ankle Society ankle-hindfoot score, and visual analog scale pain score. The secondary outcomes will be the Leppilahti score, SF-36, time to return to sports, calf circumference difference, and percentage of recovery to pre-injury physical activity. Complications such as rerupture, sural nerve problems, superficial/deep infections, deep venous thromboembolism, and wound complications will be recorded and analyzed. All analyses were performed using SPSS software. The value of P < .05 was considered significant.

Discussion:
The results of this study will provide comprehensive data and outcomes on mini-incision vs open repair in treating acute Achilles tendon rupture, so as to help surgeons and patients make better choices.

Trial registration:
This study protocol was registered at www.chictr.org.cn (registration number: ChiCTR2000041053).
Sternoclavicular joint septic arthritis manifesting as deep neck infection in patients with recent acupuncture history and intra-articular injection
Authors: Kim Min Ji , Kim Young-Mo , Choi Jeong-Seok , Kim Ji Won 
Published: August 2021

Abstract

Introduction:
Septic arthritis in sternoclavicular joint (SCJ) with neck abscesses is very rare. Acupuncture and intra-articular injections have been reported as a cause of septic arthritis.

Patient concerns:
Two patients, one with a history of acupuncture and the other with a history of intra-articular injection complained of fever and neck abscess arising as a complication of SCJ septic arthritis.

Diagnosis:
Computed tomography revealed abscesses in the upper chest wall, retrosternum, anterior mediastinum, lower portion of the neck, and SCJ area.

Interventions:
Surgical drainage was performed successfully for both patients. The tissues from the SCJ, proximal clavicle, and deep cervical fascia showed chronic active inflammation without granulomas, accompanied with joint arthritis and osteomyelitis. In the abscesses, methicillin-resistant & sensitive Staphylococcus aureus was isolated. Empirical antibiotic treatment covering these organisms was administered to these patients.

Outcomes:
Following the surgical drainage, the hospital stay was free of complications and there was no recurrence of SCJ arthritis at 6 months follow-up.

Conclusion:
Neck abscesses in patients with a recent acupuncture or intra-articular injection may develop due to SCJ septic arthritis. If SCJ septic arthritis is not detected early, fatal complications can occur. Therefore, awareness of such an atypical presentation is essential for prompt diagnosis and appropriate management.
New therapies for esophageal strictures in children
Authors: Angelino Giulia , Tambucci Renato , Torroni Filippo , De Angelis Paola , Dall’Oglio Luigi 
Published: August 2021

Purpose of review
The present review aims at describing recent advances in therapeutic strategies for the treatment of benign esophageal strictures in children. We discuss current knowledge and practice on esophageal dilations, which are still the mainstream of treatment. We present new evidence about adjuvant treatments for recurrent and refractory strictures, including endoscopic incisional therapy, esophageal stenting, intralesional or topical mytomicin C and intralesional, systemic or topical steroids.

Recent findings
Current evidence on esophageal dilations is not sufficient to establish superiority of one of the available techniques, especially the use of balloon or bougie dilators, but a prospective international cohort study on anastomotic stricture in esophageal atresia is underway to address this issue. Recurrent and refractory strictures still represent a challenge, since none of the adjuvant pharmacological and mechanical interventions has shown to be enough feasible, effective and safe to revolutionize clinical practice.

Summary
In the last couple of years, several encouraging results have been published on management of esophageal strictures in children. Further research is needed, hopefully directed toward secure, easily reproducible and minimally invasive measures.