bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elements of disturbance that affect epiphyte vitality in a temperate rainforest: an experimental approach
Authors: Nadkarni Nalini M , Kohl Kevin D 
Published: July 2018

Abstract

Aims
Epiphytes are an abundant and diverse component of many wet temperate forests and have significant roles in ecosystem processes. Little is known about the processes and rates of their death and decomposition when they fall from the canopy, which limits our understanding of their role in forest carbon sequestration and nutrient cycling. In the temperate rainforest of the Quinault River Valley, Washington State, our aim was to test hypotheses regarding four elements of disturbance that might contribute to their decline.

Methods
We established set of experiments in which we placed samples of canopy epiphytes and their branch segments: (i) in the canopy versus forest floor microenvironment (stratum); (ii) attached to live versus dead branch substrates; (iii) subjected to physical disruption and ‘jarring’; and (iv) in direct versus indirect contact with the forest floor. Over the 2-year study, we assigned a non-destructive ‘vitality index’ (based on color and apparent mortality and dryness) to each sample every 2–3 months to compare effects of the experimental treatments and analyzed with a statistical model and post hoc pairwise comparisons of treatments.

Important Findings
The canopy versus ground stratum and live/dead branch status significantly affected epiphyte vitality. Effects of physical disruption and ground contact were not significant. There were seasonal effects (low vitality during the sampling times in the summer, revitalization upon sampling times in the winter) for all treatments except samples in contact with the ground. One implication of these results relates to effects of climate change, which is predicted to shift to hotter, drier summers and wetter winters. Climate change may affect forest dynamics and nutrient cycling in unpredictable ways. Results also point to future experiments to understand biotic and abiotic effects on epiphyte disturbance and dynamics.
New Hope for Relative Overlap Measures of Coherence
Authors: Koscholke Jakob , Schippers Michael , Stegmann Alexander 
Published: July 2018

Abstract
Relative overlap measures of coherence have recently been shown to have two devastating properties: (i) according to the plain relative overlap measure, the degree of coherence of any set of propositions cannot be increased by adding further propositions, and (ii) according to the refined relative overlap measure, no set can be more coherent than its most coherent two-element subset. This result has been taken to rule out relative overlap as a foundation for a probabilistic explication of coherence. The present paper shows that this view is premature: we propose a relative overlap measure that does not fall victim to the two properties. The guiding idea is to employ a well-established recipe for the construction of coherence measures and to adapt it to the idea of relative overlap. We show that this new measure keeps up with, or even outperforms, former overlap measures in a set of desiderata for coherence measures and a collection of popular test cases. This result re-establishes relative overlap as a candidate for a proper formalization of coherence.
Correlations of the feedback energy and BCG radio luminosity in galaxy clusters
Authors: Iqbal Asif , Kale Ruta , Nath Biman B , Majumdar Subhabrata 
Published: July 2018

ABSTRACT
We study the excess entropy and the corresponding non-gravitational feedback energy (Efeedback) in the intra-cluster medium (ICM) by considering a sample of 38 galaxy clusters using Chandra X-ray and NRAO VLA Sky Survey/Giant Metrewave Radio Telescope radio observations. We find moderate correlation of the feedback energy and brightest cluster galaxy (BCG) radio luminosity (LR) with the various cluster thermal properties. We show conclusively that the active galactic nucleus is more effective in transferring feedback energy to the ICM in less massive clusters. We find that within 0.3r500, the feedback energy correlates with cluster temperature as $E_{\rm feedback}\propto T_{\mathrm{ obs}}^{0.98\pm 0.37}$. Moreover, for radio-detected BCG sample, we find that BCG radio luminosity at 1.4 GHz scales with gas mass as $L_\mathrm{ R}\propto m_{\mathrm{ g},\mathrm{ obs}}^{ 1.76\pm 0.71}$ and with an X-ray luminosity as $L_\mathrm{ R}\propto L_{\mathrm{ X},\mathrm{ obs}}^{0.94\pm 0.35}$. Finally, we discuss the implications of our results with regard to feedback in clusters.
Functional impairment attenuates the association between high serum phosphate and mortality in dialysis patients: a nationwide cohort study
Authors: Wakasugi Minako , Kazama Junichiro James , Wada Atsushi , Hamano Takayuki , Masakane Ikuto , Narita Ichiei 
Published: July 2018

Abstract

Background
Both functional impairment and abnormalities in mineral and bone disorder (MBD) parameters are well-known predictors of mortality in dialysis patients. However, previous studies have not evaluated whether functional impairment modifies the association between MBD parameters and mortality.

Methods
A nationwide prospective cohort study was conducted using data from the Japanese Society for Dialysis Therapy Renal Data Registry collected at the end of 2009 and 2010. The Eastern Cooperative Oncology Group performance status (PS) was used to assess functional status. Cox proportional hazards models were used to assess the associations of baseline functional status, serum phosphate, albumin-corrected calcium and intact parathyroid hormone (PTH) with 1-year all-cause mortality

Results
By 31 December 2010, 18 447 of 220 054 prevalent dialysis patients (8.4%) had died. Mortality significantly increased with worsening PS grade. PS grade modified the association of serum phosphate levels with mortality (Pinteraction = 0.001). Worsening PS grade attenuated the association of hyperphosphatemia (≥7.4 mg/dL) with mortality, and hyperphosphatemia was no longer significant on mortality among patients with the worst PS grade (hazard ratio = 1.1, 95% confidence interval 0.88–1.39), compared with the level between 3.5 and 4.7 mg/dL. In contrast, hypophosphatemia (<3.5 mg/dL) had a greater adjusted risk of mortality irrespective of PS grade. Serum-corrected calcium (Pinteraction = 0.26) and intact PTH (Pinteraction = 0.17) showed consistent associations with mortality irrespective of PS grade. Findings were robust in several sensitivity analyses.

Conclusions
Functional impairment was significantly associated with 1-year mortality and attenuated the effect of hyperphosphatemia on mortality among prevalent dialysis patients.
Patients Who Benefit from Intracranial Pressure Monitoring without Cerebrospinal Fluid Drainage After Severe Traumatic Brain Injury
Authors: Lele Abhijit , Kannan Nithya , Vavilala Monica S , Sharma Deepak , Mossa-Basha Mahmud , Agyem Kwesi , Mock Charles , Pandey R M , Dash H H , Mahapatra Ashok , Gupta Deepak ,   on behalf of the CHIRAG (Collaborative Head Injury and Guidelines) Study
Published: July 2018

Abstract

BACKGROUND
India has a high traumatic brain injury (TBI) burden and intracranial pressure monitoring (ICP) remains controversial but some patients may benefit.

OBJECTIVE
To examine the association between ICP monitor placement and outcomes, and identify Indian patients with severe TBI who benefit from ICP monitoring

METHODS
We conducted a secondary analysis of a prospective cohort study at a level 1 Indian trauma center. Patients over 18 yr with severe TBI (admission Glasgow coma scale score < 8) who received tracheal intubation for at-least 48 h were examined. Propensity-based analysis using inverse probability weighting approach was used to examine ICP monitor placement within 72 h of admission and outcomes. Outcomes were in-hospital mortality and Glasgow Outcome Scale (GOS) score at discharge, 3, 6, and 12 mo. Death, vegetative, or major impairment defined unfavorable outcome.

RESULTS
The 200 patients averaged 36 [18 to 85] yr of age and average injury severity score of 31.4 [2 to 73]. ICP monitors were placed in 126 (63%) patients. Patients with ICP monitor placement experienced lower in-hospital mortality (adjusted relative risk [aRR]; 0.50 [0.29, 0.87]) than patients without ICP monitoring. However, there was no benefit at 3, 6, and 12 mo. With ICP monitor placement, absence of cerebral edema (aRR 0.54, 95% confidence interval 0.35-0.84), and absence of intraventricular hemorrhage (aRR 0.52, 95% confidence interval 0.33-0.82) were associated with reduced unfavorable outcomes.

CONCLUSION
ICP monitor placement without cerebrospinal fluid drainage within 72 h of admission was associated with reduced in-patient mortality. Patients with severe TBI but without cerebral edema and without intraventricular hemorrhage may benefit from ICP monitoring.
Drivers of Variability in 90-Day Cost for Elective Laminectomy and Fusion for Lumbar Degenerative Disease
Authors: Sivaganesan Ahilan , Chotai Silky , Parker Scott L , McGirt Matthew J , Devin Clinton J 
Published: July 2018

Abstract

BACKGROUND
Considerable variability exists in the cost of surgery following spine surgery for common degenerative spine diseases. This variation in the cost of surgery can affect the payment bundling during the postoperative 90 d.

OBJECTIVE
To determine the drivers of variability in total 90-d cost for laminectomy and fusion surgery.

METHODS
A total of 752 patients who underwent elective laminectomy and fusion for degenerative lumbar conditions and were enrolled into a prospective longitudinal registry were included in the study. Total cost during the 90-d global period was derived as sum of cost of surgery, cost associated with postdischarge utilization. Multivariable regression models were built for total 90-d cost.

RESULTS
The mean 90-d direct cost was $29 295 (range, $28 612-$29 973). Based on our regression tree analysis, the following variables were found to drive the 90-d cost: age, BMI, gender, diagnosis, postop imaging, number of operated levels, ASA grade, hypertension, arthritis, preop and postop opioid use, length of hospital stay, duration of surgery, 90-d readmission, outpatient physical/occupational therapy, inpatient rehab, postop healthcare visits, postop nonopioid pain medication use nonsteroidal antiinflammatory drug (NSAIDs), and muscle relaxant use. The R2 for tree model was 0.64.

CONCLUSION
Utilizing prospectively collected data, we demonstrate that considerable variation exists in total 90-d cost, nearly 70% of which can be explained by those factors included in our modeling. Risk-adjusted payment schemes can be crafted utilizing the significant drivers presented here. Focused interventions to target some of the modifiable factors have potential to reduce cost and increase the value of care.
Posterior Approach and Spinal Cord Release for 360° Repair of Dural Defects in Spontaneous Intracranial Hypotension
Authors: Beck Jürgen , Raabe Andreas , Schievink Wouter I , Fung Christian , Gralla Jan , Piechowiak Eike , Seidel Kathleen , Ulrich Christian T 
Published: July 2018

Abstract

BACKGROUND
Spinal cerebrospinal fluid (CSF) leaks are the cause of spontaneous intracranial hypotension (SIH).

OBJECTIVE
To propose a surgical strategy, stratified according to anatomic location of the leak, for sealing all CSF leaks around the 360° circumference of the dura through a single tailored posterior approach.

METHODS
All consecutive SIH patients undergoing spinal surgery were included. The anatomic site of the leak was exactly localized. We used a tailored hemilaminotomy and intraoperative neurophysiological monitoring (IOM) for all cases. Neurological status was assessed before and up to 90 d after surgery.

RESULTS
Forty-seven SIH patients had an identified CSF leak between the levels C6 and L1. Leaks, anterior to the spinal cord, were approached by a transdural trajectory (n = 28). Leaks lateral to the spinal cord by a direct extradural trajectory (n = 17) and foraminal leaks by a foraminal microsurgical trajectory (n = 2). The transdural trajectory necessitated cutting the dentate ligament accompanied by elevation and rotation of the spinal cord under continuous neuromonitoring (spinal cord release maneuver, SCRM). Four patients had transient defiticts, none had permanent neurological deficits. We propose an anatomic classification of CSF leaks into I ventral (77%, anterior dural sac), II lateral (19%, including nerve root exit, lateral, and dorsal dural sac), and III foraminal (4%).

CONCLUSION
Safe sealing (with IOM) of all CSF leaks around the 360° surface of the dura is feasible through a single posterior approach. The exact surgical trajectory is selected according to the anatomic category of the leak.
Neurosurgical Coverage for Emergency and Trauma Call
Authors: Babu Maya A , Stroink Ann R , Timmons Shelly D , Orrico Katie O , Prall J Adair 
Published: July 2018

Abstract
Traditionally, neurosurgeons have responded to calls to treat new patients or address emergent, acute neurosurgical pathology in the hospitals they staff as part of their duty to the medical profession and community. Due to increasing financial pressures placed upon neurosurgical practice from hospitals and regulatory mandates, remuneration for neurosurgeon availability to serve on trauma call has become more frequent and is increasingly seen as essential. In this study, we present the first peer-review published survey of neurosurgical emergency and trauma call coverage patterns, scope, schedules, compensation, liability exposure, and call cessation. We surveyed all practicing neurosurgeon members of the American Association of Neurological Surgeons and Congress of Neurological Surgeons with a 24% response rate. The vast majority of respondents (86%), through their practice, provide 24/7/365 trauma coverage at their primary hospital site. About a third (29%) of respondents have been sued by a patient seen in the emergency department. Twenty percent of respondents anticipate retiring within the next 2 yr. Understanding trauma call coverage, remuneration, and the barriers to taking call provide needed transparency to neurosurgeons who are providing emergency, life-saving services for patients across the country. An understanding of supply and demand forces governing call coverage also assists the field in necessary workforce planning and innovation in providing access to needed, timely acute neurosurgical care.
Postsurgical Salvage Radiosurgery for Nonfunctioning Pituitary Adenomas Touching/Compressing the Optic Chiasm: Median 13-Year Postirradiation Imaging Follow-up Results
Authors: Yamamoto Masaaki , Aiyama Hitoshi , Koiso Takao , Watanabe Shinya , Kawabe Takuya , Sato Yasunori , Higuchi Yoshinori , Barfod Bierta E , Kasuya Hidetoshi 
Published: July 2018

AbstractBACKGROUNDThere is little information on long-term outcomes after salvage treatment by either surgery or stereotactic radiosurgery (SRS) for patients with recurrent/residual nonfunctioning pituitary adenomas (NFPAs).OBJECTIVETo reappraise the efficacy and safety of SRS for patients with NFPAs touching/compressing the optic apparatus (OA).METHODSWe studied 27 patients (14 females, 13 males; mean age: 61 [range, 19-85] yr) who underwent SRS between 1998 and 2008 for NFPAs with such condition. The median tumor volume was 4.9 (range, 1.8-50.8) cc. To avoid excess irradiation to the OA, the lower part of the tumor was covered with a 50% or a 60% isodose gradient, ie 49% to 98% (mean, 84%; median, 88%) of the entire tumor received the selected doses. Median doses at the tumor periphery/OA were 7.6/11.0 (interquartile range [IQR], 5.8-9.1/10.1-11.8) Gy.RESULTSSeven patients (26%) were confirmed to be deceased due to unrelated diseases at a median post-SRS period of 149 (IQR, 83-158) mo. Follow-up magnetic resonance imaging (MRI) showed tumor growth in 2 patients (7%) at the 11th and 134th post-SRS month; the former underwent surgery and the other SRS. Excluding these 2 patients, the latest follow-up MRI examinations, performed 13 to 238 (median: 168, IQR: 120-180) mo after SRS, showed no size changes in 5 (19%) and shrinkage in 20 (74%) patients. Cumulative incidences of tumor growth control were 96.3% and 91.8% at the 120th and 180th post-SRS month. None of our patients developed subjective symptoms suggesting SRS-induced optic neuropathy or endocrinological impairment.CONCLUSIONIn patients with NFPAs touching/compressing the OA, SRS achieves good long-term results.
Postoperative Rigid Cervical Collar Leads to Less Axial Neck Pain in the Early Stage After Open-Door Laminoplasty—A Single-Blinded Randomized Controlled Trial
Authors: Cheung Jason Pui Yin , Cheung Prudence Wing Hang , Law Karlen , Borse Vishal , Lau Yuk Ming , Mak Ling Fung , Cheng Aldous , Samartzis Dino , Cheung Kenneth Man Chee 
Published: July 2018

Abstract

BACKGROUND
Cervical collars are used after laminoplasty to protect the hinge opening, reduce risks of hinge fractures, and avoid spring-back phenomena. However, their use may lead to reduced range of motion and worse neck pain.

OBJECTIVE
To investigate the clinical, radiological, and functional outcomes of patients undergoing single-door laminoplasty with or without collar immobilization.

METHODS
This was a prospective, parallel, single-blinded randomized controlled trial. Patients underwent standardized single-door laminoplasty with mini-plates for cervical myelopathy and were randomly allocated into 2 groups based on the use of collar postoperatively. Clinical assessments included cervical range of motion, axial neck pain (VAS [visual analogue scale]), and objective scores (short-form 36-item, neck disability index, and modified Japanese Orthopaedic Association). All assessments were performed preoperatively and at postoperative 1, 2, 3, and 6 wk, and 3, 6, and 12 mo. Comparative analysis was performed via analysis of variance adjusted by baseline scores, sex, and age as covariates.

RESULTS
A total of 35 patients were recruited and randomized to collar use (n = 16) and without (n = 19). There were no dropouts or complications. There were no differences between groups at baseline. Subjects had comparable objective scores and range of motion at postoperative time-points. Patients without collar use had higher VAS at postoperative 1 wk (5.4 vs 3.5; P = .038) and 2 wk (3.5 vs 1.5; P = .028) but subsequently follow-up revealed no differences between the 2 groups.

CONCLUSION
The use of a rigid collar after laminoplasty leads to less axial neck pain in the first 2 wk after surgery. However, there is no additional benefit with regards to range of motion, quality of life, and complication risk.
The Effect of Flow-Related Aneurysms on Hemorrhagic Risk of Intracranial Arteriovenous Malformations
Authors: Hung Alice L , Yang Wuyang , Jiang Bowen , Garzon-Muvdi Tomas , Caplan Justin M , Colby Geoffrey P , Coon Alexander L , Tamargo Rafael J , Huang Judy 
Published: July 2018

Abstract

BACKGROUND
Previous reports indicated an association between hemorrhagic presentation and flow-related aneurysms in arteriovenous malformation (AVM) patients. However, it remains unclear whether these flow-related aneurysms result in the hemorrhage of AVM.

OBJECTIVE
To characterize this hemorrhage risk using our institutional experience over 25 yr.

METHODS
We retrospectively reviewed records of patients at our institution diagnosed with AVM from 1990 to 2015. Patients without associated aneurysms (AVM only) and those with flow-related aneurysms (AVM-FA) were compared. Those with intranidal or unrelated aneurysms were excluded. Annual risk of AVM-related hemorrhage was calculated using the birth-to-treatment approach and compared using Poisson rate ratio test.

RESULTS
Among 526 patients, there were 457 AVM only patients and 69 with flow-related aneurysms. AVM-FA patients were older (P = .005). AVMs with flow-related aneurysms were more likely located in the cerebellar vermis and hemispheres (P = .023 and .001, respectively). Presence of flow-related aneurysms increased the risk of presentation with subarachnoid hemorrhage (P < .001). Interestingly, no significant differences in presenting hemorrhage due to AVM rupture were found (P > .356). The majority of aneurysms were untreated (69.5%), and only 8 (9.8%) had ruptured presentation. At follow-up (mean = 5.3 yr), patients with flow-related aneurysms were less likely to develop seizures (P = .004). The annual risk of AVM hemorrhage was 1.33% and 1.05% for AVM only patients and AVM-FA patients, respectively (P = .248).

CONCLUSION
Despite increased risk of subarachnoid hemorrhage at presentation, there was no increased likelihood of rupture in AVMs with flow-related aneurysms. More studies are warranted, as clarifying the competing risks of AVM vs aneurysm rupture may be critical in determining optimal treatment strategy.
Is Visible Aminolevulinic Acid-Induced Fluorescence an Independent Biomarker for Prognosis in Histologically Confirmed (World Health Organization 2016) Low-Grade Gliomas?
Authors: Jaber Mohammed , Ewelt Christian , Wölfer Johannes , Brokinkel Benjamin , Thomas Christian , Hasselblatt Martin , Grauer Oliver , Stummer Walter 
Published: July 2018

Abstract

BACKGROUND
Approximately 20% of low-grade gliomas (LGG) display visible protoporphyrin fluorescence during surgery after 5-aminolevulinic acid (5-ALA) administration.

OBJECTIVE
To determine if fluorescence represents a prognostic marker in LGG.

METHODS
Seventy-four consecutive patients with LGG (World Health Organization 2016) were operated on with 5-ALA. Fluorescent tissue was specifically biopsied. Tumor size, age, Karnofsky index, contrast-enhancement, fluorescence, and molecular factors (IDH1/IDH2-mutations, Ki67/MIB1 Index, 1p19q codeletions, ATRX, EGFR, p53 expression, and O6-methylguanine DNA methyltransferase promotor methylation), were related to progression-free survival (PFS), malignant transformation-free survival (MTFS) and overall survival (OS).

RESULTS
Sixteen of seventy-four LGGs (21.6%) fluoresced. Fluorescence was partially related to weak enhancement on magnetic resonance imaging and increased (positron emission tomography)PET-FET uptake, but not to Karnofsky Performance Score, tumor size, or age. Regarding molecular markers, only EGFR expression differed marginally (fluorescing vs nonfluorescing: 19% vs 5%; P = .057). Median follow-up was 46.4 mo (95% confidence interval [CI]: 41.8-51.1). PFS, MTFS, and OS were shorter in fluorescing tumors (PFS: median 9.8 mo, 95% CI: 1.00-27.7 vs 45.8, 31.9-59.7, MTFS: 43.0 [27.5-58.5] vs 64.6 [57.7-71.5], median not reached, P = .015; OS: 51.6, [34.8-68.3] vs [68.2, 62.7-73.8], P = .002). IDH mutations significantly predicted PFS, MTFS, and OS. In multivariate analysis IDH status and fluorescence both independently predicted MTFS and OS. PFS was not independently predicted by fluorescence.

CONCLUSION
This is the first report investigating the role of ALA-induced fluorescence in histologically confirmed LGG. Fluorescence appeared to be a marker for inherent malignant transformation and OS, independently of known prognostic markers. Fluorescence in LGG might be taken into account when deciding on adjuvant therapies.