Miracle-dz/UniFAR-FTUs huggingface dataset:
Electrocardiogram Artifact Caused by Peripheral Nerve Stimulation During Regional Anesthesia

To the Editor: W e write with reference to an article by Fredrickson et al, which claims an advantage for continuous peripheral nerve catheter management of pain relief versus single-shot blocks after a range of more Bminor[ shoulder surgeries. We, too, have had a large experience in this area and wish to query certain aspects of their study. We are puzzled that no pain scores have been included for the period within the first 24 hours after surgery. Presumably, both groups had no pain initially. It would be interesting to know when the single-shot blocks wore off and what strategies were used to counter its effect? There seems to have been more difficulty siting the single-shot blocks, and how this may or may not have affected the duration of the block is uncertain. From the data presented, it is difficult to judge the extent of the separation between the 2 groups. There was some mixing of surgical groups, which has the potential to confound results. For example, our experience has been that lateral clavicular surgeries do not warrant continuous catheter management. Elastomeric pumps require a large volume (400 mL) to fill. Given that there is no advantage to running a catheter longer than a day and a half according to their data, a large volume of local anesthetic (È200 mL) is likely to be wasted with this approach. The authors have rightly commented on other costsVsurely, this is another one to consider. We do agree, however, with the authors’ comment that the first 36 hours after surgery seems to be the time of greatest advantage for running peripheral nerve catheters in these situations.
Conflicting selection on diaspore traits limits the evolutionary potential of seed dispersal by ants

Conflicts of selection on diaspore traits throughout the dispersal cycle can limit the evolutionary consequences of seed dispersal. However, these conflicts have never been investigated in directed dispersal systems. We explored conflicts of selection through life stages of dispersal in the myrmecochorous herb Helleborus foetidus. Seeds are subject to two contrasting partial selective scenarios. Undispersed seeds are subject to positive directional selection on seed size characters, whereas seeds dispersed are subject to stabilizing selection for size. In both scenarios, seedling establishment determined the magnitude and direction of selection. This does not reflect ant preferences for seed size. However, total selection still depends largely on ant activity, as ants control the relative importance of each selective scenario. We advocate the use of analytical approaches combining multiplicative fitness and microenvironment‐specific selection to more realistically estimate the realized selection on traits functional during several life stages. This approach may be extended to any organism dispersing offspring to different environments.
Bone Morphogenetic Protein and Activin Membrane–Bound Inhibitor, a Transforming Growth Factor β Rheostat That Controls Murine Treg Cell/Th17 Cell Differentiation and the Development of Autoimmune Arthritis by Reducing Interleukin‐2 Signaling

Transforming growth factor β (TGFβ) plays a prominent role in the establishment of immunologic tolerance, and mice lacking TGFβ1 die of multiorgan inflammation early in life. TGFβ controls the differentiation of CD4+ lymphocytes into Treg cells or proinflammatory Th17 cells. Although this dual capacity is modulated by the presence of additional cytokines around the activated cells, TGFβ also dissociates Th17/Treg cell differentiation in a dose‐dependent manner by mechanisms still unknown. The purpose of this study was to explore the contribution of bone morphogenetic protein and activin membrane–bound inhibitor (BAMBI) to the modulation of TGFβ activity during the differentiation of CD4+ cells and in the control of immunologic tolerance in mice with collagen‐induced arthritis (CIA).
X Chromosome Dose and Sex Bias in Autoimmune Diseases: Increased Prevalence of 47,XXX in Systemic Lupus Erythematosus and Sjögren's Syndrome

More than 80% of autoimmune disease predominantly affects females, but the mechanism for this female bias is poorly understood. We suspected that an X chromosome dose effect accounts for this, and we undertook this study to test our hypothesis that trisomy X (47,XXX; occurring in ∼1 in 1,000 live female births) would be increased in patients with female‐predominant diseases (systemic lupus erythematosus [SLE], primary Sjögren's syndrome [SS], primary biliary cirrhosis, and rheumatoid arthritis [RA]) compared to patients with diseases without female predominance (sarcoidosis) and compared to controls.
Divergence in host use ability of a marine herbivore from two habitat types

We studied ecological divergence of host use ability in a generalist marine herbivore living in two distinct host plant assemblages. We collected Idotea balthica isopods from three populations dominated by the brown alga Fucus vesiculosus and three dominated by the seagrass Zostera marina. In two reciprocal common garden feeding experiments for adult and laboratory‐born juvenile isopods, we found that isopods from both assemblages performed better with their sympatric dominant host species than did isopods allopatric to this host. This indicates parallel divergence of populations according to the sympatric host plant assemblage. Furthermore, initial body size and body size‐dependent mortality differed between populations from the two assemblages. In nature, this may result in lower fitness of immigrants compared with that of residents and consequently reinforce divergence of the populations. Finally, we discuss how phenotypic plasticity and maternal and random effects may associate with the results.
Male personality, life‐history strategies and reproductive success in a promiscuous mammal

Recent theoretical work suggests that personality is a component of life history, but links between personality and either age‐dependent reproductive success or life‐history strategy are yet to be established. Using quantitative genetic analyses on a long‐term pedigree we estimated indices of boldness and docility for 105 bighorn sheep rams (Ovis canadensis), born between 1983 and 1999, and compared these indices to their reproductive history from 2 years of age until death. Docility and boldness were highly heritable and negatively genetically correlated. Docile and bold rams survived longer than indocile and shy rams. Docility and boldness had a weak negative effect on reproductive success early in life, but a strong positive effect on older rams. Our findings highlight an important role of personality on reproductive success and suggest that personality could be an important component of life‐history strategy.
Females benefit from multiple mating but not multiple mates in the burying beetle Nicrophorus vespilloides

Male reproductive success generally increases with number of mates but this need not be true for females. If females are the limiting sex, as few as one mate can be optimal. Despite the theoretical differences driving multiple mating in the sexes, multiple mating is the norm rather than the exception. Empirical investigations are therefore required to determine why females mate with multiple males. Both nonadaptive (correlated responses to selection on males, given the mean mating rates have to be the same) and adaptive (direct or indirect fitness benefits) can drive the evolution of multiple mating in females. Females of the burying beetle Nicorphorus vespilloides often mate repeatedly with the same male, but this appears to be a correlated response to selection on males rather than reflecting direct benefits to females for multiple mating. However, an unexamined alternative to this nonadaptive explanation is that females benefit by mating with multiple different males and therefore are selected for general promiscuity. Here we examine if mating polyandrously provides fitness benefits by examing the effects of number of mates (1, 2 or 3), mating system (monogamous, polyandrous) and their interaction. The only significant influence was mating more than once. This did not depend on type of mating. We suggest that unlike most other species examined, in N. vespilloides mating with the same male repeatedly or with several different males reflects an indiscriminate willingness to mate as a result of correlated selection on males for high rates of mating.
Brief Report: Intensification to Triple Therapy After Treatment With Nonbiologic Disease‐Modifying Antirheumatic Drugs for Rheumatoid Arthritis in the United States From 2009 to 2014

Several trials suggest that triple therapy (methotrexate, sulfasalazine, and hydroxychloroquine) and biologic disease‐modifying antirheumatic drugs (DMARDs) have similar efficacy in patients with rheumatoid arthritis (RA). This study was undertaken to investigate intensification to triple therapy after initial nonbiologic prescription among patients with RA.
Opposites attract: MHC‐associated mate choice in a polygynous primate

We investigated reproduction in a semi‐free‐ranging population of a polygynous primate, the mandrill, in relation to genetic relatedness and male genetic characteristics, using neutral microsatellite and major histocompatibility complex (MHC) genotyping. We compared genetic dissimilarity to the mother and genetic characteristics of the sire with all other potential sires present at the conception of each offspring (193 offspring for microsatellite genetics, 180 for MHC). The probability that a given male sired increased as pedigree relatedness with the mother decreased, and overall genetic dissimilarity and MHC dissimilarity with the mother increased. Reproductive success also increased with male microsatellite heterozygosity and MHC diversity. These effects were apparent despite the strong influence of dominance rank on male reproductive success. The closed nature of our study population is comparable to human populations for which MHC‐associated mate choice has been reported, suggesting that such mate choice may be especially important in relatively isolated populations with little migration to introduce genetic variation.
Does Continuous Sciatic Nerve Block Improve Postoperative Analgesia and Early Rehabilitation After Total Knee Arthroplasty?: A Prospective, Randomized, Double-Blinded Study

Introduction: The aim of this prospective, randomized, double-blind study was to evaluate whether continuous sciatic nerve block can improve postoperative pain relief and early rehabilitation compared with single-injection sciatic nerve block in patients undergoing total knee arthroplasty (TKA) and lumbar plexus block. Methods: After ethical committee approval and written informed consent, 38 patients with ASA physical status I to II were enrolled. The first group received continuous sciatic and continuous lumbar plexus blocks (group regional or R, n = 19), whereas the second group received a single sciatic nerve block followed by saline infusion through the sciatic catheter and continuous lumbar plexus block (group control or C, n = 19). We assessed morphine consumption, scores for visual analog scale for pain at rest (VASr), and during continuous passive motion (VASi during CPM) for 48 hours postoperatively. Effectiveness of early ambulation was also evaluated. Results: Scores for VASr and VASi during CPM, as well as morphine consumption, were significantly higher in group C than in group R (P < 0.01). Moreover, patients in group R showed earlier rehabilitation with more effective ambulation (P < 0.05). Conclusions: Continuous sciatic nerve block improves analgesia, decreases morphine request, and improves early rehabilitation compared with single-injection sciatic nerve block in patients undergoing TKA and lumbar plexus block.
The long and the short of sperm selection in vitro and in vivo: swim‐up techniques select for the longer and faster swimming mammalian sperm

Sperm competition and sexual selection outcomes are sometimes reported as depending on sperm velocity and flagellar length, suggesting that sperm shape may be optimized for maximum efficiency. This is a largely unexamined assumption regarding sperm performance. Here, we examine this idea using a ‘swim‐up’ selection technique as a proxy for sperm transport within the female tract, testing the hypothesis that variation in sperm tail length should be reduced by this procedure. We detected small but significant (P < 0.001) increases in mean flagellar length in brown hare, pig and bull spermatozoa without reduction in variance. Applying the swim‐up technique to boar ejaculates confirmed that the selected populations were enriched for fast motile spermatozoa. These effects were also reflected in vivo where boar spermatozoa with both short and long flagellae were able to reach and colonize the oviductal sperm reservoir. The benefits of possessing a longer flagellum thus appear to be marginal, suggesting that sperm selection in vivo is based on more complex criteria.
The role of phenotypic plasticity in responses of hunted thinhorn sheep ram horn growth to changing climate conditions

When phenotypic change occurs over time in wildlife populations, it can be difficult to determine to what degree it is because of genetic effects or phenotypic plasticity. Here, we assess phenotypic changes over time in horn length and volume of thinhorn sheep (Ovis dalli) rams from Yukon Territory, Canada. We considered 42 years of horn growth from over 50 000 growth measurements in over 8000 individuals. We found that weather explained a large proportion of the annual fluctuation in horn growth, being particularly sensitive to spring weather. Only 2.5% of variance in horn length growth could be explained by an individual effect, and thus any genetic changes over the time period could only have had a small effect on phenotypes. Our findings allow insight into the capacity for horn morphology to react to selection pressures and demonstrate the overall importance of climate in determining growth.
Ecological divergence and habitat isolation between two migratory forms of Japanese threespine stickleback (Gasterosteus aculeatus)

When two closely related species migrate to divergent spawning sites, divergent use of spawning habitats can directly reduce heterospecific mating. Furthermore, adaptations to divergent spawning habitats can promote speciation as a by‐product of ecological divergence. Here, we investigated habitat isolation and ecological divergence between two anadromous forms of threespine stickleback (Gasterosteus aculeatus), the Japan Sea and Pacific Ocean forms. In several coastal regions of eastern Hokkaido, Japan, these forms migrate to the same watershed to spawn. Our field surveys in a single watershed revealed that segregation of distinct spawning sites between the two forms was maintained within the watershed across multiple years. These spawning sites diverged in salinity and predator composition. Morphological and physiological divergence between the forms also occurs in the direction predicted by ecological differences between the spawning sites. Our data indicate that migration into divergent spawning habitats can be an important mechanism contributing to speciation and phenotypic divergence in anadromous fishes.
Challenges facing postgraduate training in family medicine in Saudi Arabia: Patterns and solutions

Objective: The objective of this paper was to show the challenges that are faced by the Family Medicine Training Programmes in the Kingdom of Saudi Arabia as well as suggests appropriate and practical solutions. Materials and Methods: This study was conducted from 2010 - 2013 using a semi-structured questionnaire to achieve the objective. The questionnaire was designed and completed by the investigators during their visits to accredit the training centres all over the Kingdom. It consisted of questions concerning the trainers' and trainees' opinions regarding all the aspects of training. Another tool used was the accreditation checklist, which contained a comprehensive list of training structures and processes mandatory for any training centre. The accreditation checklist and questionnaire were reviewed by the investigators after visiting all the training centres. The challenges were then classified manually and solutions were reviewed as well as approved by the members of the Accreditation Committee. Results: Seventy-five training centres were visited and 250 trainees along with 75 trainers participated in this study. Twenty-five challenges were identified and classified under 6 major groups. The practical solutions to these challenges were discussed with participants and then approved by the investigators. Conclusion: This study showed that Family Medicine Training in the Kingdom of Saudi Arabia faces many different challenges. Early identification along with key solutions to these difficulties are extremely important in the efforts to produce a new generation of competent Saudi Family Physicians who can improve the quality of healthcare for the population of Saudi Arabia.
Female Cape sugarbirds (Promerops cafer) modify egg investment both for extra‐pair mates and for male tail length

The differential allocation hypothesis predicts that females should invest more in reproduction when paired with attractive males. We measured egg volume in Cape sugarbirds (Promerops cafer), a sexually dimorphic passerine, in relation to paternity of the offspring and in response to an experimental tail length treatment. We manipulated tail length, after pair formation, but before egg laying: males had their tails either shortened or left unmanipulated. Our manipulation was designed to affect female allocation in a particular breeding attempt rather than long‐term mate choice: males with shortened tails would appear to be signalling at a lower level than they should given their quality. We found that egg volume was smaller in the nests of males with experimentally shortened tails but larger when the offspring were the result of extra‐pair matings. Both these findings are consistent with the differential allocation hypothesis. We suggest that tail length may be used by females as a cue for mate quality, eliciting reduced female investment when breeding with social mates; and with males with shortened tails.
The lifetime costs of increased male reproductive effort: courtship, copulation and the Coolidge effect

The reproductive effort that a male directs to a familiar female declines over time, suggesting decreasing marginal returns. But is this diminishing returns a function of increasing reproductive costs or decreasing benefits of sustained effort? Here, we use the restoration of male reproductive effort with unfamiliar females to differentiate the role of diminishing returns and lifetime costs of increased reproductive effort of male guppies. We kept males with familiar or unfamiliar females throughout their lives and manipulated their ability to either court or mate with females. We found that increased male reproductive effort with novel mates lead to an immediate trade‐off in the form of reduced foraging effort. Further, males able to mate with a series of unfamiliar females had lower lifetime growth, indicating the primary cost of male reproductive effort in guppies arises from copulation rather than courtship. The lifetime growth trade‐offs were significant only when males mated with unfamiliar mates, suggesting that male reproductive effort with familiar females declines before it is restricted by physical exhaustion. These findings provide some of the first evidence of longitudinal costs of increased male reproductive effort in a vertebrate.
Phenome‐Wide Association Study of Rheumatoid Arthritis Subgroups Identifies Association Between Seronegative Disease and Fibromyalgia

The differences between seronegative and seropositive rheumatoid arthritis (RA) have not been widely reported. We performed electronic health record (EHR)–based phenome‐wide association studies (PheWAS) to identify disease associations in seropositive and seronegative RA.
Sympatric shift in a male sexual ornament in the damselfly Calopteryx splendens

Character displacement is a process by which interactions between two species that exhibit similar traits, results in geographical patterns of trait divergence in one or both species. These traits evolve to reduce costs of interspecific interactions in sympatry and thus differ from their condition in allopatry. In male damselflies Calopteryx splendens, large wing spots are sexually selected. However, in sympatric populations with Calopteryx virgo, wing spot size decreases as C. virgo abundance increases. The stability of this pattern is unclear, because previous studies have focused on sympatric populations with potentially fluctuating relative abundances. We studied the wing spot sizes of C. splendens in both sympatric and allopatric populations. Our data show that male C. splendens’ wing spots are larger in allopatry than in sympatry with C. virgo. We suggest that both interspecific aggression and avoidance of interspecific reproductive interactions may result in this pattern, although their relative importance remains unclear.
Locally asymmetric introgressions between subspecies suggest circular range expansion at the Antirrhinum majus global scale

Assessing processes of geographic expansion in contact zones is a crucial step towards an accurate prediction of the evolution of species genetic diversity. The geographic distribution of cytonuclear discordance often reflects genetic introgression patterns across a species geographic range. Antirrhinum majus pseudomajus and A. m. striatum are two interfertile subspecies that occupy nonoverlapping areas but enter in contact in many locations at the margin of their geographic distribution. We found that genetic introgression between both subspecies was asymmetric at the local scale and geographically oriented in opposite directions at both ends of their contact zone perimeter in the Pyrenees. Our results suggest that the geographic expansion of A. majus subspecies was circular around the perimeter of their contact zone and pinpoint the need to integrate different spatial scales to unravel complex patterns of species geographic expansion.
Natural selection on a measure of parasite resistance varies across ages and environmental conditions in a wild mammal

Parasites detrimentally affect host fitness, leading to expectations of positive selection on host parasite resistance. However, as immunity is costly, host fitness may be maximized at low, but nonzero, parasite infection intensities. These hypotheses are rarely tested on natural variation in free‐living populations. We investigated selection on a measure of host parasite resistance in a naturally regulated Soay sheep population using a longitudinal data set and found negative correlations between parasite infection intensity and annual fitness in lambs, male yearlings and adult females. However, having accounted for confounding effects of body weight, the effect was only significant in lambs. Associations between fitness and parasite resistance were environment‐dependent, being strong during low‐mortality winters, but negligible during harsher high‐mortality winters. There was no evidence for stabilizing selection. Our findings reveal processes that may shape variation in parasite resistance in natural populations and illustrate the importance of accounting for correlated traits in selection analysis.