Impacts of land cover data selection and trait parameterisation on dynamic modelling of species' range expansion

Peer reviewedPublisher PD

Mechanical analysis of cranial distractor attachment with three different resorbable fixation systems

Distraction osteogenesis (DO) has become increasingly popular to correct craniosynostosis. Disadvantages of DO include the secondary operation needed for device removal and titanium screw related dura injury. To reduce invasiveness of the secondary device removal operation and to overcome titanium-related problems, fixation of the cranial distractor with resorbable materials is a potential alternative. New resorbable fixation methods, such as ultrasound-activated pins (UAPs) or heat-activated pins (HAPs), allow faster attachment on thinner bone than conventional resorbable screws (CRSs) since tapping is not required. However, resorbable materials are designed to be attached with a resorbable plate, not with a titanium distractor. We evaluated the suitability of CRSs, HAPs and UAPs for the cranial distractor fixation in a laboratory setting with a mechanical testing machine. Fracture tests were conducted in two directions with respect to the longitudinal axis; vertical i.e. axial pull-out strength, and horizontal i.e. shear strength. Mean maximum pull-out strength for CRS, HAP and UAP was 48.9 N, 32.5 N and 14.7 N, respectively. Mean maximum shear strength for CRS, HAP and UAP was 40.8 N, 77.9 N and 38.9 N, respectively. According to our in vitro tests, the cranial distractor attachment with four CRSs or six HAPs per footplate would provide sufficient fixation stability. (C) 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Promoting ossification of calvarial defects in craniosynostosis surgery by demineralized bone plate and bone dust in different age groups

Correction of calvarial defects after calvarial vault reconstruction (CVR) is challenging in craniosynostosis patients of advanced age and typically employs autologous bone. Demineralized bone matrix (DBM) is a potential alternative material for autologous bone, but its use has not been extended to correct calvarial defects. CVR patients operated at the Department of Plastic Surgery, Helsinki University Hospital, during 2008-2010 were retrospectively reviewed. Inclusion criteria of the study were CVR patients who received DBM plate, with or without bone dust, on calvarial defects and who had suitable uncovered defect on the contralateral side as control. This study included 17 craniosynostosis and one positional plagiocephaly patient, whose mean age was 6.9 years (range 0.9-19 years). The mean follow-up time was 5.6 years. The fusion degree of all defects was measured from 1 week to 1 year postoperatively using three-dimensional computed tomography (3D CT) images by the OsiriX (R) method. Medical records were reviewed for DBM-related complications. A total of 26 defects were covered with a DBM plate (mean area 11.1 cm(2)) and 26 control defects were identified (mean area 7.8 cm2). The mean fusion degree of the DBM defects was 74% and 54% for the controls (p 30 months) than in younger patients or when used with bone dust. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

The use of patient specific polyetheretherketone implants for reconstruction of maxillofacial deformities

Purpose: The aim of this study was to evaluate polyetheretherketone (PEEK) as a patient-specific implant (PSI) material in maxillofacial reconstructive surgery. Materials and methods: The retrospective study included a cohort of 24 patients who underwent maxillofacial surgery using PEEK PSIs. Each patient underwent preoperative multislice computed tomography (CT) with 0 degrees tilt of gantry. Based on the CT scan, the PEEK PSIs were planned and manufactured using three-dimensional (3D) modeling and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. All procedures were performed under general anesthesia. Implants were placed intraorally, extraorally or through subciliary, transconjuctival or coronal incisions. Results: In 22 of 24 cases, the PEEK PSI fit well without adjustments. Although the fit to the surrounding bone was perfect in almost all of the cases, the outer contour of the PSI was modified in nine cases before fixation. However, intraoperative implant modification did not affect the infection rate. In two cases, postoperative wound dehiscence and infection needed additional treatment and healed without removal of the implants. Conclusion: The follow-up data in this study showed good outcomes with reliable results for PSI made of PEEK in the maxillofacial region. (C) 2019 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd.Peer reviewe

Force measurements during posterior calvarial vault osteodistraction : A novel measurement method

Posterior calvarial vault osteodistraction (PCVO) has become increasingly popular in the correction of craniosynostosis. When compared to cranioplasty, PCVO offers a shorter, less invasive operation, greater intracranial volume advancement and a lower rate of relapse. In general, distraction protocols are based primarily on clinical observations rather than systematic research. Faster distraction protocols may reduce complications. However, distraction protocols producing higher forces can increase complications. Thus, we need to understand these forces in order to improve distraction protocols and devices. We developed a force measurement method that can be used on PCVO devices. Here, we present preliminary data about the forces developed during PCVO. We measured the forces in four bicoronal craniosynostosis patients during PCVO. We observed a linear-like trend between the force increase and the distraction distance within distraction sessions. We also observed a step-wise force increase between distraction sessions and found that the distraction force relaxed rapidly shortly after the distraction session. The mean maximum pre distraction force for one distracter was 20.4 N, while the mean maximum end-distraction force for one distracter was 57.6 N. Our data suggests that current treatment protocols might be re-evaluated favouring shorter distraction distances and more frequent distraction sessions. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Writing children's geography books: Challenges, experiences, and observations

Peer reviewe

A forest typology for monitoring sustainable forest management: The case of European Forest Types

Sustainable forest management (SFM) is presently widely accepted as the overriding objective for forest policy and practice. Regional processes are in progress all over the world to develop and implement criteria and indicators of SFM. In continental Europe, a set of 35 Pan-European indicators has been endorsed under the Ministerial Conference on the Protection of Forests in Europe (MCPFE) to measure progress towards SFM in the 44 countries of the region. The formulation of seven indicators (forest area, growing stock, age structure/diameter distribution, deadwood, tree species composition, damaging agents, naturalness) requires national data to be reported by forest types. Within the vast European forest area the values taken by these indicators show a considerable range of variation, due to variable natural conditions and anthropogenic influences. Given this variability, it is very difficult to grasp the meaning of these indicators when taken out of their ecological background. The paper discusses the concepts behind, and the requirements of, a classification more soundly ecologically framed and suitable for MCPFE reporting than the three (un-informative) classes adopted so far: broadleaved forest, coniferous forest, mixed broadleaved and coniferous forest. We propose a European Forest Types scheme structured into a reasonably higher number of classes, that would improve the specificity of the indicators reported under the MCPFE process and its understanding.L'articolo è disponibile sul sito dell'editore www.tandf.co.uk/journals

A Photo Score for Aesthetic Outcome in Sagittal Synostosis:An ERN CRANIO Collaboration

European Reference Network (ERN) CRANIO is focused on optimizing care for patients with rare or complex craniofacial anomalies, including craniosynostosis and/or rare ear, nose, and throat disorders. The main goal of ERN CRANIO is to collect uniform data on treatment outcomes for multicenter comparison. We aimed to develop a reproducible and reliable suture-specific photo score that can be used for cross-center comparison of phenotypical severity of sagittal synostosis and aesthetic outcome of treatment. We conducted a retrospective study among nonsyndromic sagittal synostosis patients aged &lt;19 years. We included preoperative and postoperative photo sets from 6 ERN CRANIO centers. Photo sets included bird's eye, lateral, and anterior-posterior views. The sagittal synostosis photo score was discussed in the working group, and consensus was obtained on its contents. Interrater agreement was assessed with weighted Fleiss' Kappa and intraclass correlation coefficients.The photo score consisted of frontal bossing, elongated skull, biparietal narrowness, temporal hollowing, vertex line depression, occipital bullet, and overall phenotype. Each item was scored as normal, mild, moderate, or severe. Results from 36 scaphocephaly patients scored by 20 raters showed kappa values ranging from 0.38 [95% bootstrap CI: 0.31, 0.45] for biparietal narrowness to 0.56 [95% bootstrap CI: 0.47, 0.64] for frontal bossing. Agreement was highest for the sum score of individual items [intraclass correlation coefficients agreement 0.69 [95% CI: 0.57, 0.82]. This is the first large-scale multicenter study in which experts investigated a photo score to assess the severity of sagittal synostosis phenotypical characteristics. Agreement on phenotypical characteristics was suboptimal (fair-moderate agreement) and highest for the summed score of individual photo score items (substantial agreement), indicating that although experts interpret phenotypical characteristics differently, there is consensus on overall phenotypical severity.</p

Perinatal features and rate of cesarean section in newborns with non-syndromic sagittal synostosis

The purpose of this study was to evaluate perinatal features and the rate of cesarean section in children with non-syndromic sagittal synostosis and to compare these with the official statistics. The birth data of 36 consecutive children (25 boys) operated on using cranial vault remodeling because of primary sagittal synostosis were analyzed retrospectively from hospital records. The children were born between 2007 and 2011, and the surgery was performed before the age of 1 year. The official statistics of all Finnish newborns from the year 2010 (n = 61 371) were used as a reference. Chi-square and Fisher's exact tests were used in statistical analyses. The average gestational age of the newborns with sagittal synostosis was 39.8 weeks (reference 39.7 weeks). The average birth weight was 3565.8 g (3540 g) for boys and 3197.2 g (3427 g) for girls, and the average lengths at birth are 51 cm (50.4 cm) and 49.4 cm (49.6 cm), respectively. The average head circumference was 36 cm for both sexes (35.2 and 34.6 cm for reference boys and girls). The mean age of mothers was 30.5 years (30.1 years). The rate of cesarean section was significantly increased 30.5 % (reference 16.6 %), and the rate of suction cup delivery was increased 13.9 % (9 %). In addition, a prolonged or difficult delivery was reported in three childbirths. Newborns with non-syndromic sagittal synostosis appear to be of average birth size and gestational age. The incidences of perinatal complications and cesarean sections were increased with problems occurring in more than half of the childbirths.Peer reviewe