Origin Of Branch Research Articles

Bilateral asymmetrical variation of median artery in coexistence with bifid median nerve and variation in the origin and course of its palmar cutaneous branch: a case study with clinical implications.

The median artery typically regresses after two months of intrauterine life, although it may persist into adulthood in some individuals. The presence of a persistent median artery (PMA) may be associated with other anatomical variations including a bifid median nerve. In the present cadaveric study, we report a rare variation of bilateral asymmetry of PMA associated with the bifid median nerve, and unilateral variation of the origin and course of the palmar cutaneous branch of the median nerve (PCBMN) which to our knowledge, is the first study to report all these variations in an individual. Classical dissection of the upper limb was performed on a 45-year-old male cadaver. The cadaver was donated to the Department of Anatomy at Kerman University of Medical Sciences. Bilateral PMA was observed in both upper limbs. The PMA originated from the ulnar artery and contributed to the formation of an incomplete superficial palmar arch (SPA) on both sides; however, the branching pattern of these arteries was different between the right and left hands. Also, a bilateral high division of the median nerve was observed proximal to the carpal tunnel. We also encountered a very rare variation of PCBMN, in which it originated from the ulnar side of the median nerve, and passed beneath the flexor retinaculum of the left hand. Awareness of anatomical variations of the median nerve and also the presence of PMA is of utmost importance due to their implication in carpal tunnel syndrome and surgical complications.

Distribution of branches of anterior choroidal artery in the uncus: an anatomical study.

The aim of our study was to examine the relationship between uncus and uncal branches of anterior choroidal artery (AChA) and to observe the morphological and morphometric features of these branches. 124 hemispheres from 62 fresh cadavers were included in the study. Measurement of the length of AChA and the distances of the uncal branches to the origin of AChA were measured by ImageJ software. Morphological variations of uncal branches originating from AChA were observed. The length of AChA was found as mean 26.24 ± 4.34mm. It was determined that the average distance of these uncal branches arising from the AChA was 13.48 ± 7.31mm. In 4 out of 124 AChAs, no branches were observed. 594 branches originating from 120 were detected. 130/594 branches appeared to be terminal branches. AChAs of 80/120 hemispheres have been reported to have uncal branches. Thirty of 130 uncal branches were observed to originate as the first branch of AChA. It was found that uncal branches may originate from AChA with a variability between 1 and 4. When evaluated according to the origin of each branch from the AChA, it was observed that the uncal branches originated from the midpoint of the AChA on average. Also, in 64 hemispheres, morophological variations were detected regarding the origin of uncal branches. We believe that the morphological and morphometric data we obtained from the uncal branches of the AChA are of clinical importance in terms of understanding this complex region and minimizing errors in surgical procedures.

Surgical Removal of Pulmonary Flow Restrictors in Children with Congenital Heart Disease: What the Outcomes Reveal

ObjectivePulmonary flow restrictors (PFRs) are interesting devices, but their surgical removal outcomes are poorly understood. MethodsRetrospective review of clinical data from children with bilateral PFRs who underwent device removal during follow-up surgery. ResultsThirty-four PFRs were explanted from 17 patients (41.2% males) at a median of 2 months (IQR, 1.2-5.2) post-implantation, with a median patient age of 2.5 months (IQR, 1.6-5.8). One patient experienced life-threatening bilateral pulmonary artery (PA) aneurysms two months after PFR implantation, necessitating urgent surgery. Two PFRs were found migrated across left PA's upper lobe branch origin. Twenty-six were removed intact, 1 in two fragments, and 7 piecemeal. No thrombus was noted. Neoendothelium was observed on 11 PFRs. Seven PFRs caused endothelial damage, requiring sharp and blunt dissection for removal. Six right and four left PA arteriotomies were patched. Hegar dilators, with median sizes of 7 mm (IQR, 6.8-8.3) for right PA and 7 mm (IQR, 7-8) for left PA, confirmed branch patency. At a median follow-up of 14.8 months (IQR, 10.2–18.3), echocardiographic maximum velocities in 13 biventricular patients and 2 awaiting future biventricular repair were 1.5m/s (IQR, 1.4–1.7) for the left PA and 1.6m/s (IQR, 1.4–1.7) for the right PA. One patient with deferred Norwood had normal PAs and well-positioned PFRs on pre-stage-II catheterization. A patient who underwent stage-II Norwood 3.2 months post-PFR implantation died from sepsis 1 month later, but post-Glenn angiogram revealed no stenosis. ConclusionsPFR removal is safe and effective. Complications are manageable, with no PA stenosis observed.

Flow Diversion for Intracranial Aneurysms With Incorporated Branch: A Subanalysis From the SEASE International Registry

Background The presence of an incorporated branch as well as its anatomical relationship to the intracranial aneurysms (IAs) and the parent artery may affect the occlusion outcome following flow diversion. This study evaluated the safety and effectiveness of the cobalt‐chromium Surpass Evolve (Stryker), a 64‐wire flow diversion device for the treatment of IAs with incorporated branches. Methods This subanalysis uses data from the SEASE (Safety and Effectiveness Assessment of Surpass Evolve) registry to retrieve data related to IAs with incorporated branches. Those IAs were classified by a core lab into 4 categories based on their anatomical relationship to the parent artery and branch: (A) sidewall anatomic, (B) sidewall hemodynamic, (C) neck branch, and (D) dome branch. We compared the outcomes based on their incorporated branch's relation to the dome (A–C versus D). Results This study included 67 patients and IAs. Most IAs were in the posterior communicating artery (46.3%), with a median size of 4.35 mm. Age, sex, comorbidities, baseline functional‐status, and IA features were similar between the 2 groups. Among those, 53 (79.1%) had branches emerging from the dome, and 14 (20.9%) had branches originating from other locations (A = 7, B = 2, and C = 5). At a median imaging follow‐up of 10.5 months, complete occlusion was lower in IAs with a branch from the sac compared with those with the neck (60.8% versus 92.9%; P = 0.026), with an overall occlusion of 67.7%. Thromboembolic and hemorrhagic complications, as well as retreatment, were reported in 1.6% and 3.1% of cases, respectively, with no significant differences between groups. Conclusion Our analysis underscores the influence of branch origin on occlusion rates, with the neck‐originating branch demonstrating higher occlusion rates. These insights emphasize the role of anatomical considerations in treatment strategies, follow‐up timelines, and designing future clinical trials. Further studies are warranted to explore these variations across different flow diversion technologies.

Origin and Course Cavernous Internal Carotid Artery Branches from the Endoscopic Endonasal Perspective: Cadaveric Study and Analysis Clinical Implications.

Endoscopic endonasal approaches to treat cavernous sinus lesions require detailed knowledge of the origin, course, and anatomic variations of the branches of the cavernous internal carotid artery (cICA) because inadvertent avulsion can cause intraoperative ICA injury. We aim to study the origin and course of the branches of the cICA from an endoscopic endonasal perspective and relate these branches to surgically relevant anatomic references. Sixty sides of 30 formalin-fixed specimens were dissected to identify the origin and course of cICA branches, including the inferolateral trunk (ILT), the meningohypophyseal trunk (MHT), anterior and inferior McConnell's capsular arteries (MCAs), and the superolateral trunk (SLT). The ILT and MHT were bilaterally in all specimens, whereas the anterior and inferior MCAs were identified in 28% and 25% of dissected sides, respectively. The SLT was only found in 3% of sides dissected. The MHT was the most proximal branch of the cICA, and its origin was an average of 8.9 mm anterior to the foramen lacerum and 3.8 mm superior to the sellar floor. The ILT was the second most proximal branch of the cICA, which originated 6.4 mm from the MHT on average. The anterior and inferior MCAs were present in 28% and 25% of specimens, respectively. The SLT, when present, was the second most proximal branch of the cICA, which originated at a mean height of 2.7 mm from the sellar floor. Overall, complete ILT and MHT were identified in 68% and 77% of cases, respectively. The MHT and ILT are constant branches of the cICA, with the MHT originating from the medial cICA posterior bend 4 mm superior to the sellar floor and 9 mm anterior to the foramen lacerum, whereas the ILT arises from the lateral horizontal cICA, 2.3 mm superior to the sellar floor and 6 mm anterior to the MHT.

Distribution of the Middle Meningeal Artery Variants in Patients Undergoing Embolization for Chronic Subdural Hematoma

The middle meningeal artery (MMA) is a major dural vessel that plays a significant role in developing chronic subdural hematomas (cSDH). Understanding its variable anatomy is essential for the effective management of cSDH and the prevention of complications. Middle meningeal artery anatomy was retrospectively assessed in a population of 92 patients who underwent digital subtraction angiography of cerebral vessels before middle meningeal artery embolization for chronic subdural hematoma. We assessed 121 middle meningeal arteries in 92 patients who underwent digital subtraction angiography for chronic subdural hematoma treatment from October 2020 to July 2023. The most common type in the extended Adachi classification was IC (19.82%) and the rarest was IB (6.31%). The anterior branch of the MMA was the most frequently dominant, while the most common origin of the posterior branch was observed in the distal segment. We reported 4 cases (3.31%) of the MMA arising from the ophthalmic artery. The most common configuration of MMA was Adachi-type IC. The MMA most often originated from the maxillary artery. The anterior branch of the MMA was typically dominant, and the posterior branch most frequently originated from the distal segment. There was no significant impact of Adachi type on treatment results or fluoroscopy time.

Initial Experience with the New DERIVO® Mini Embolisation Device for the Treatment of Intracranial Aneurysms.

The aim of this study is to present the outcomes of cerebral aneurysm treatment with the DERIVO® mini Embolisation Device (DMD), which is compatible with microcatheters with 0.021-inch inner diameters. Consecutive patients treated with DMD were identified retrospectively. Patient and aneurysm characteristics, procedural findings, clinical outcomes and follow-up imaging results were evaluated. A total of 44 target aneurysms in 30 patients were treated with DMD. The mean age of the patients was 49.9 (range, 4-77 years). Four patients with five aneurysms presented with acute subarachnoid hemorrhage. The mean aneurysm size was 6.8 mm (range, 1.5-22 mm). In 29 (65.9%) aneurysms, adjunctive devices were used for endovascular treatment. The overall mortality rate was 3.3% and procedure-related mortality was 0%. Overall neurologic morbidity was 6.6% and none of the patients had a permanent sequela secondary to the procedure. The mean clinical follow-up period was 20.9 months (range, 3 days-46 months) and the mean DSA follow-up period was 10.9 months. A total of 37 (84.1%) aneurysms demonstrated total occlusion (Raymond-Roy [RR 1]); 3 (6.8%) aneurysms had a neck remnant or infundibular filling at the origin of the jailed side branch (RR 2), 4 (9.1%) aneurysms had residual aneurysm filling (RR 3). For those aneurysms treated with bare DMD, the total occlusion rate was 73.3% at a mean follow-up of 16.1 months. In this initial clinical single-center experience, DMD had a good safety profile and efficacy comparable with the currently used flow diverters.

Effectiveness of Embolization for Pulmonary Arteriovenous Malformations from Distal of the Last Normal Branch of the Pulmonary Artery.

This retrospective study of patients with pulmonary arteriovenous malformations aims to assess the efficacy of embolization distal to the origin of the last normal branch of the pulmonary artery. A total of 30 consecutive patients with 38 untreated pulmonary arteriovenous malformations underwent coil embolization distal to the origin of the last normal branch of the pulmonary artery between September 2015 and October 2021. The median (interquartile range) age of patients (5 males, 25 females) was 59 years (50-68 years old), and the median (interquartile range) sizes of the feeding artery and sac were 2.9 mm (2.3-3.8 mm) and 6.7 mm (5.4-9.7 mm), respectively. The technical success rate, persistence rate, and treatment-related complications were evaluated. Technical success was defined as the inability to identify the draining vein on feeding arteriography after coil embolization. Persistence was assessed using time-resolved magnetic resonance angiography. Coil embolization was successful in all patients (100%). There was no persistence during a median (interquartile range) follow-up period of 23 months (10-45 months) for the 38 pulmonary arteriovenous malformations embolized with coils. No major complications were reported. Only minor complications following embolization occurred in 4 of 36 sessions, including local pain in 2 sessions (6%) and hemosputum in 2 sessions (6%). Embolization distal to the origin of the last normal branch of the pulmonary artery is effective in preventing the persistence of pulmonary arteriovenous malformations.

On the Origin of soft ticks (Parasitiformes, Ixodoidea, Argasidae)

The origin of the common evolutionary branch of soft and hard ticks is dated to the later Permian, approximately coinciding with the Permian extinction, and divergence of the common branch of Ixodoidea into ancestral forms of Argasidae and Ixodidae occurred in the Triassic. Ancestors of the common branch of Ixodoidea (Ixodidae, Argasidae, Nuttalliellidae) were not bloodsucking arthropods and were closely related to modern representatives of Holothyridae. Bloodsucking and, later, temporary ectoparasitism had developed only after divergence of the main branches (Ixodidae, Argasidae and Nuttalliellidae), independently in each group. At early stages of the soft tick evolution, bloodsucking was a short-time process, long-time feeding had developed later in larvae and promoted dispersal of ticks. Maintenance of the short-time feeding can be explained by adaptation to dwelling in bird nests or in shelters visited by birds, and later, also in mammal burrows. Displacements of gnathosomе to the ventral side of idiosome hampered combing of a parasite from the host during short-time bloodsucking. Short-time feeding resulted in maintenance and development of coxal glands as the main organ for removal of superfluous liquid during bloodsucking. Adaptation to shelter habitats (nests, burrows, rock crevices, under dead tree cork, etc.) promoted development of polyphagia and adaptations for long-term starvation.

Thalamo-mesencephalic Branches of the Posterior Cerebral Artery: a 3D Rotational Angiography Study

PurposeThe thalamo-mesencephalic (TM) branches of the posterior cerebral artery (PCA) supply critical structures. Previous descriptions of these vessels are inconsistent and almost exclusively rely on cadaver studies. We aimed to provide a neuroradiological description of TM vessels in vivo based on routine 3D rotational angiographies (3D-RA).MethodsWe analyzed 3D-RAs of 58 patients with pathologies remote from the PCA. PCA-origins were considered. Delineation, origin and number of branches of the collicular artery (CA), the accessory CA (ACA), the posterior thalamoperforating artery (PTA), the thalamogeniculate artery (TGA), and the posterior medial (PMCA) and lateral (PCLA) choroid arteries were assessed. The PTAs were categorized based on Percheron’s suggested classification.ResultsA CA was identified in 84%, an ACA in 20%. The PTA was delineated in 100%. In 27%, PTA anatomy had features of several Percheron types (n = 7) or vessels emanating from a net like origin (n = 9). 26% had a type IIb PTA. A fetal type PCA origin with hypoplastic ipsilateral P1 was observed in 5 cases with type IIa (n = 2) or type IIb (n = 3) PTAs originating from contralateral P1. The TGA was identified in 85% of patients, with ≥ 2 branches in 67%. The PMCA was delineable in 41%, the PLCA in 100%.ConclusionThe prevalence of a proper “Artery of Percheron” type IIb PTA seems to be higher than previously reported. A fetal type P1-origin may be predictive of a type IIa/b PTA emanating from contralateral P1. 3D-RA may be useful for planning PCA interventions, as impairment of TM branches is a severe risk.

The Crossing Motor Ulnar Nerve Branch at Elbow.

Cubital tunnel syndrome is the second most common nerve entrapment, and understanding the anatomy is crucial for the success of the nerve release. During ulnar nerve release for cubital tunnel syndrome, a motor branch is frequently encountered crossing anteriorly over the ulnar nerve from its medial/ulnar side proximally to the lateral/radial side distally. Little has been noted about this crossing branch in the literature. In this anatomic study, we sought to characterize this branch further and discuss its potential significance in cubital tunnel release. We performed a cadaveric dissection of 48 elbow specimens as if performing a cubital tunnel release. We assessed for the presence of the crossing motor branch of the ulnar nerve and measured the distance from the medial epicondyle to the branch takeoff and to its target of innervation. Of our 48 specimens, 34 (71%) were noted to have a crossing motor branch at the area of compression by the deep flexor carpi ulnaris muscle fascia (common aponeurosis). On average, the distance from the medial epicondyle to the branch origin from the ulnar nerve was 18.2 mm and to the target muscle innervation was 28.4 mm. Identifying this branch is important for performing a cubital tunnel release, and awareness of this anatomy during ulnar nerve decompression procedures may help avoid injury to this motor branch.

Autologous Reconstruction of Anomalous Origin of a Right Pulmonary Artery From the Aorta.

Anomalous origin of a pulmonary artery branch from the aorta is a rare congenital anomaly in which one of the pulmonary arteries arises from the aorta. These patients require early surgery to prevent development of severe irreversible pulmonary arterial hypertension. Multiple techniques have been described for repair of this condition. In this report, we describe a different technique compared with previously described procedures and discuss its advantages.

Investigation of the anatomical course of articular branches to the thoracic zygapophysial joints

BackgroundRecent studies have questioned the validity of targeting the thoracic medial branch via anesthetic blocks or radiofrequency neurotomy for the diagnosis or treatment of pain from the thoracic zygapophysial joints. PurposeTo define the origin and course of the articular branches to the thoracic zygapophysial joints at all levels. DesignCadaveric dissection. SettingThe Gross Anatomy Laboratory at the University of New England College of Osteopathic Medicine. SubjectsOne cadaveric thoracic spine. MethodsGross and stereoscopic dissection of the bilateral dorsal rami T1–T12 was performed on one embalmed cadaver. The medial and lateral branches were traced from their cutaneous distribution to the origin at the dorsal ramus. The articular branches were identified using stereoscopic dissection by tracing their origin from the dorsal ramus or medial branch to the capsule of the zygapophysial joint. The images were recorded using digital photography. ResultsTwenty-two of the twenty-four articular branches were identified in a single cadaveric specimen. Articular branches at T7 on the right side and T9 on the left side were not identified. 5 of the 22 (18%) articular branches were observed to arise from the proximal segment of the medial branch of the dorsal ramus. Of the remainder, 17 of the 22 (78%) articular branches were observed to arise from the dorsal primary ramus itself. At levels T1-9, the articular branch coursed inferiorly along the lamina to reach the joint capsule. At levels T10-T12, the articular branch traversed the intervertebral foramen to reach the facet joint. The T12 medial branch on the left was seen to travel inferior to innervate the L1/L2 zygapophysial joint. ConclusionThe source of the innervation for the thoracic zygapophysial is variable and can arise from the dorsal ramus itself or from the proximal segment of the medial branch. Unlike the cervical and lumbar medial branches, which innervate two joints each, in this case, the thoracic dorsal rami appear to innervate only the zygapophysial joint at the level of the nerve exit. It should be noted that the findings may be limited in their generalizability due to the reliance on a single cadaver study.

Anomalous origin of the right subclavian artery in a Neotropical otter (Lontra longicaudis, Olfers-1818).

The Neotropical otter (Lontra longicaudis) is a mustelid distributed geographically from Mexico to Argentina. Anomalous origins of the aortic arch branches are rarely reported in wild carnivorans. Therefore, this study aimed to report the anomalous branching of the aortic arch in one formaldehyde-fixed specimen of L. longicaudis. The aortic arch provided three branches: the bicarotid trunk and the left and right subclavian arteries. The latter passed dorsally to the esophagus toward the right side without a mark of compression at the esophagus. This is the first report of an anomalous origin of the right subclavian artery in L. longicaudis.

Aneurysms Located beyond the Origin of the Major Branches in the Posterior Circulation.

To evaluate the clinical and radiological features, treatment modalities, and outcomes of unusual aneurysms located beyond the origin of the major branches in the posterior circulation, and to introduce changes in the recent treatment trends due to rapid innovations in endovascular technology. This was a retrospective study of patients who underwent treatment for these unusual aneurysms, including those that were identified in regular follow-up after treatment, between March 2009 and April 2023. Medical information including the radiological features of the aneurysms, incidences of rebleeding, associated vascular diseases, treatment modalities, and outcomes, was documented. A total of 22 cases consisting of two unruptured and 20 ruptured aneurysms were included. Their locations were the posterior cerebral artery in four cases, the superior cerebellar artery in three, the anterior inferior cerebellar artery in two, and the posterior inferior cerebellar artery in 13. Sixteen were saccular, five fusiform, and one blister-like. Eight were pseudo-aneurysms and pre- or intra-operative rebleeding occurred in 13 (65%) of 20 cases with ruptured aneurysms. Five aneurysms coexisted with causative vascular diseases such as arteriovenous malformation, moyamoya disease, or dolichoectasia. Four cases were treated by microsurgical operations and 18 by endovascular operations. In one of the microsurgical cases and five of the endovascular cases, parent arteries were sacrificed. Stents were used in six cases, including low-profile stents in four. Intermediate guiding catheters were used in seven cases for distal access. Full recoveries were seen in 17 cases and death occurred in three. Treatments for these aneurysms are technically demanding due to the high rate of rebleeding, difficult accessibility, and inevitable necessity of sacrifice of the parent artery in some cases. However, advancing endovascular techniques and devices enable distal access to the lesion and help preserve the parent artery.

Ductus Arteriosus Stenting as a Method of Palliative Treatment of Truncus Arteriosus Type A3: Literature Review and Clinical Case

Introduction. Van Praagh A3 variant of truncus arteriosus (TA A3) is a condition when the one pulmonary artery branch origins from the TA, the other is filled through the patent ductus arteriosus (PDA).
 PDA constriction in the early neonatal period can cause absence of blood supply to the one pulmonary artery branch. To prevent this, prolonged infusion of prostaglandin E1, PDA stenting or systemic-to-pulmonary shunt are used. These methods allow to postpone total repair (TR) and reduce mortality risks associated with neonatal period.
 The aim. To analyze research papers dedicated to endovascular approach of TA A3 staged treatment and to present our own experience.
 Materials and methods. We conducted a systematic literature search and analyzed various options for the TA A3 staged treatment. After the review, we used endovascular approach as the first stage of treatment in our clinical case.
 We studied a newborn weighing 4 kg with TA A3 (left pulmonary artery branch origins from the non-coronary sinus of the truncal valve, right pulmonary artery branch filling through the PDA). Nakata index was 83 mm2/m2. McGoon ratio was 1. We decided to perform PDA stenting with the aim of postponing surgical correction until the patient’s optimal age and weight.
 Discussion. In total, the number of publications about TA A3 staged treatment is limited. Most institutions prefer TA A3 staged treatment in newborns, because it is associated with a lower risk of complications than early TR. In our clinical case, the first step was PDA stenting. The staged approach allowed us to perform TR with a good result at the age of 3 months. Before TR, Nakata index and McGoon ratio were increased to 248 mm2/m2 and 1.9, respectively.
 Conclusions. The current trend of TA A3 repair has few different options of staged treatment. Staged approach helps to get out of the newborn period and achieves the optimal condition for TR. Our patient successfully received PDA stenting as the first stage of treatment, which created conditions for the pulmonary artery branches growth. The second stage was TR with good long-term results. After analyzing the publications, we noted that the use of endovascular PDA stenting is a good and safe alternative to surgical palliative treatment.

First green lacewing species of the tribe Chrysopini (Insecta: Neuroptera: Chrysopidae: Chrysopinae) from the Eocene Baltic amber and Miocene Mexican amber

The family Chrysopidae (green lacewings) is a highly diverse group of Neuroptera, with rich fossil records. The Cenozoic fossils of green lacewings currently comprise 21 genera and 42 species. Here we describe two new green lacewing species of the tribe Chrysopini, tentatively placed in the genus Chrysopa Leach, 1815, namely Chrysopa? extensa sp. nov. and Chrysopa? prominenta sp. nov. from Eocene Baltic amber and Miocene Mexican amber, respectively. These species represent the second chrysopid occurrence and the first record of the tribe Chrysopini from Baltic amber, and the first occurrence of Chrysopidae from Mexican amber, respectively. Both new species are assigned to Chrysopini based on the following characters: the intramedian cell eutriangular without crossvein, and the basal-most RP branch origins distal to the intramedian cell in the forewing.

A method for identifying and segmenting branches of Scots pine (Pinus sylvestris L.) trees using terrestrial laser scanning

Abstract Terrestrial laser scanning (TLS) has been adopted as a feasible technique to characterize tree stems while the characterization of trees’ branching architecture has remained less explored. In general, branching architecture refers to the spatial arrangement of branches and their characteristics that are important when exploring the eco-physiological functioning of trees or assessing tree biomass and wood quality. Our aim was to develop a point cloud processing method for identifying and segmenting individual branches from TLS point clouds. We applied a Cartesian-to-cylinder coordinate transformation and a simple morphological filtering for stem surface reconstruction and stem-branch separation. Then branch origins were identified as their intersections with the stem surface, and individual branches were segmented based on their connectivity with the branch origins. The method, implemented in MATLAB and openly available, was validated on a 0.4-ha mature and managed southern boreal forest stand. The branch identification performance was assessed based on visual interpretation of 364 randomly sampled stem sections from 100 Scots pine (Pinus sylvestris (L.)) trees that were inspected for branch identification accuracy. The results showed that the branches could only be identified up to the height where the stem could be reconstructed. For 90% of the trees, this threshold ranged between 59.3% and 81.2% relative tree heights. Branches located below this threshold were identified with a recall of 75%, a precision of 92%, and an F1-score of 0.82. Based on our study, it appears that in a managed Scots pine stand, most of the branches can be identified with the developed method for the most valuable stem part eligible for logwood. The findings obtained in this study promote the feasibility of using TLS in applications requiring detailed characterization of trees. The developed method can be further used in quantifying the characteristics of individual branches, which could be useful for biomass and wood quality assessment, for example.

Industry diversification in industrial districts: is it about embedded regional or firm-level capabilities?

ABSTRACT We analyse whether regionally embedded or firm-level capabilities drive regional diversification in industrial districts, examining the relationship between relatedness and Marshallian agglomerations. We argue that regional diversification lacks an explicit mechanism to explain branching into new products, positing that the origin of regional product branching is based on firm-level heterogeneity of capabilities and diversification, which is overlooked. Using mixed methods and patent analysis (1895–2019; 3592 patents and utility models), product diversification in the Toy Valley district in Alicante (Spain) is analysed, showing that firm-level related diversification with extensive local search explains the mechanism of the regional relatedness diversification.

Criss-cross pulmonary arteries in common arterial trunk – Implications to management and outcome

ObjectivesTo investigate the incidence, types and pathophysiology of criss-cross pattern of the proximal pulmonary arteries in common arterial trunk and its influence on management and outcomes. MethodsRetrospective review of all patients with common arterial trunk who underwent Aswan Truncus Operation with regard to the origin and course of the proximal pulmonary artery branches as defined by 3D segmented models pre, immediately and 1 and 2 years after operation. ResultsBetween January 2019 and September 2022, 39 patients (19 males, aged 1–12 months) underwent the Aswan Truncus Operation. 18 patients (46%) had criss-cross arrangement of the proximal pulmonary artery. The mortality, ICU and hospital stay were not affected by the presence or absence of the criss-cross pattern. However, following operation in the criss-cross group, there was evidence of different degrees of kinking and twisting of the right pulmonary artery. This resulted in severe narrowing which required stenting or reoperation at different stages (1 during ICU stay and another after 1 year). Separate origin of the left pulmonary artery (Criss-cross Type 2) from a long stenotic ductus arteriosus required resection of the stenotic segment followed by anastomosis to the right pulmonary artery recreating a 60° angle of bifurcation. ConclusionCriss-cross pattern of proximal pulmonary arteries is common in patients with common arterial trunk. Pre-operative diagnosis and tailored approaches of repair are required to prevent late complications.