bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphometric analysis of the Australian freshwater crocodile (Crocodylus johnstoni)
Authors: Edwards Glenn P. , Webb Grahame J. , Manolis S. Charlie , Mazanov Alex
Published: July 2017

We conducted a morphometric analysis of 279 Crocodylus johnstoni, using specimens from the McKinlay River (n = 265) and Arnhem Land (n = 14), to meet the management need for predicting body size of C. johnstoni from isolated body parts. The results also allow reconstruction of C. johnstoni dimensions for comparison with other crocodilian species. We detected sexual dimorphism in some body measurements from the McKinlay River, and geographic variation in the morphology of McKinlay River and Arnhem Land populations, but differences were slight. There is pronounced allometric growth in C. johnstoni in the immediate post-hatching phase, largely due to elongation of the snout after exiting the confines of the egg. We compared the size, shape and relative growth of C. johnstoni with that of other crocodilian species for which equivalent data are available, but particularly the other Australian crocodile, Crocodylus porosus. C. porosus has a proportionately longer tail and a shorter but wider snout than C. johnstoni, and we discuss possible ecological correlates of these and other differences.
Do female dingo–dog hybrids breed like dingoes or dogs?
Authors: Cursino Marina S. , Harriott Lana , Allen Benjamin L. , Gentle Matthew , Leung Luke K.-P.
Published: July 2017

Hybridisation between animals that breed once (e.g. dingoes) and twice (e.g. domestic dogs) annually may produce offspring that breed either way. This question was investigated by determining the breeding seasonality of female dingo–dog hybrids in south-east Queensland, Australia, through evaluating macroscopic and histological features of 71 female reproductive tracts. All animals were sourced from urban areas where levels of hybridisation are generally high. Most animals trapped in summer were pups less than 6 months of age. A peak of uterus diameter and weight coincided with a peak of corpus luteum in winter. The follicular phase was characterised by growing follicles, ~1–3 mm wide, in late summer and autumn. Only two of the animals (1.4%) showed out-of-season reproductive cycles: one was found with corpus luteum in summer and another in autumn. Our data clearly show that hybrids have a single annual breeding season in winter, exhibiting the same breeding seasonality as dingoes. Our findings are similar to those found in the New Guinea singing dog. Future studies should be conducted to understand and exploit the mechanism and drivers of the breeding seasonality of dingo–dog hybrids to develop more effective management of their populations.
Gene–culture coevolution in whales and dolphins
Authors: Whitehead Hal
Published: July 2017

Whales and dolphins (Cetacea) have excellent social learning skills as well as a long and strong mother–calf bond. These features produce stable cultures, and, in some species, sympatric groups with different cultures. There is evidence and speculation that this cultural transmission of behavior has affected gene distributions. Culture seems to have driven killer whales into distinct ecotypes, which may be incipient species or subspecies. There are ecotype-specific signals of selection in functional genes that correspond to cultural foraging behavior and habitat use by the different ecotypes. The five species of whale with matrilineal social systems have remarkably low diversity of mtDNA. Cultural hitchhiking, the transmission of functionally neutral genes in parallel with selective cultural traits, is a plausible hypothesis for this low diversity, especially in sperm whales. In killer whales the ecotype divisions, together with founding bottlenecks, selection, and cultural hitchhiking, likely explain the low mtDNA diversity. Several cetacean species show habitat-specific distributions of mtDNA haplotypes, probably the result of mother–offspring cultural transmission of migration routes or destinations. In bottlenose dolphins, remarkable small-scale differences in haplotype distribution result from maternal cultural transmission of foraging methods, and large-scale redistributions of sperm whale cultural clans in the Pacific have likely changed mitochondrial genetic geography. With the acceleration of genomics new results should come fast, but understanding gene–culture coevolution will be hampered by the measured pace of research on the socio-cultural side of cetacean biology.
Pursuing Darwin’s curious parallel: Prospects for a science of cultural evolution
Authors: Mesoudi Alex
Published: July 2017

In the past few decades, scholars from several disciplines have pursued the curious parallel noted by Darwin between the genetic evolution of species and the cultural evolution of beliefs, skills, knowledge, languages, institutions, and other forms of socially transmitted information. Here, I review current progress in the pursuit of an evolutionary science of culture that is grounded in both biological and evolutionary theory, but also treats culture as more than a proximate mechanism that is directly controlled by genes. Both genetic and cultural evolution can be described as systems of inherited variation that change over time in response to processes such as selection, migration, and drift. Appropriate differences between genetic and cultural change are taken seriously, such as the possibility in the latter of nonrandomly guided variation or transformation, blending inheritance, and one-to-many transmission. The foundation of cultural evolution was laid in the late 20th century with population-genetic style models of cultural microevolution, and the use of phylogenetic methods to reconstruct cultural macroevolution. Since then, there have been major efforts to understand the sociocognitive mechanisms underlying cumulative cultural evolution, the consequences of demography on cultural evolution, the empirical validity of assumed social learning biases, the relative role of transformative and selective processes, and the use of quantitative phylogenetic and multilevel selection models to understand past and present dynamics of society-level change. I conclude by highlighting the interdisciplinary challenges of studying cultural evolution, including its relation to the traditional social sciences and humanities.
Conformity does not perpetuate suboptimal traditions in a wild population of songbirds
Authors: Aplin Lucy M. , Sheldon Ben C. , McElreath Richard
Published: July 2017

Social learning is important to the life history of many animals, helping individuals to acquire new adaptive behavior. However despite long-running debate, it remains an open question whether a reliance on social learning can also lead to mismatched or maladaptive behavior. In a previous study, we experimentally induced traditions for opening a bidirectional door puzzle box in replicate subpopulations of the great tit
Parus major
. Individuals were conformist social learners, resulting in stable cultural behaviors. Here, we vary the rewards gained by these techniques to ask to what extent established behaviors are flexible to changing conditions. When subpopulations with established foraging traditions for one technique were subjected to a reduced foraging payoff, 49% of birds switched their behavior to a higher-payoff foraging technique after only 14 days, with younger individuals showing a faster rate of change. We elucidated the decision-making process for each individual, using a mechanistic learning model to demonstrate that, perhaps surprisingly, this population-level change was achieved without significant asocial exploration and without any evidence for payoff-biased copying. Rather, by combining conformist social learning with payoff-sensitive individual reinforcement (updating of experience), individuals and populations could both acquire adaptive behavior and track environmental change.
Changes in cognitive flexibility and hypothesis search across human life history from childhood to adolescence to adulthood
Authors: Gopnik Alison , O’Grady Shaun , Lucas Christopher G. , Griffiths Thomas L. , Wente Adrienne , Bridgers Sophie , Aboody Rosie , Fung Hoki , Dahl Ronald E.
Published: July 2017

How was the evolution of our unique biological life history related to distinctive human developments in cognition and culture? We suggest that the extended human childhood and adolescence allows a balance between exploration and exploitation, between wider and narrower hypothesis search, and between innovation and imitation in cultural learning. In particular, different developmental periods may be associated with different learning strategies. This relation between biology and culture was probably coevolutionary and bidirectional: life-history changes allowed changes in learning, which in turn both allowed and rewarded extended life histories. In two studies, we test how easily people learn an unusual physical or social causal relation from a pattern of evidence. We track the development of this ability from early childhood through adolescence and adulthood. In the physical domain, preschoolers, counterintuitively, perform better than school-aged children, who in turn perform better than adolescents and adults. As they grow older learners are less flexible: they are less likely to adopt an initially unfamiliar hypothesis that is consistent with new evidence. Instead, learners prefer a familiar hypothesis that is less consistent with the evidence. In the social domain, both preschoolers and adolescents are actually the most flexible learners, adopting an unusual hypothesis more easily than either 6-y-olds or adults. There may be important developmental transitions in flexibility at the entry into middle childhood and in adolescence, which differ across domains.
Genetics and Juvenile Abundance Dynamics Show Congruent Patterns of Population Structure for Depleted River Herring Populations in the Upper Chesapeake Bay
Authors: Ogburn Matthew B. , Hasselman Daniel J. , Schultz Thomas F. , Palkovacs Eric P.
Published: July 2017

River herring (Alewife Alosa pseudoharengus and Blueback Herring A. aestivalis) populations have declined dramatically along the U.S. Atlantic coast. Conservation efforts are currently inhibited by an incomplete understanding of stock structure for the upper Chesapeake Bay, which once supported some of the largest spawning runs across the species’ ranges. We collected genetic samples from 512 adult river herring from five rivers and used microsatellites to explore genetic differentiation and population structure. Juvenile abundance indices were also evaluated for spatiotemporal patterns using time series analyses. Statistically significant allelic heterogeneity was observed among most collections, and we identified genetically distinguishable groups for each species. Regression analysis indicated stable or declining juvenile abundance, and empirical orthogonal function analysis supported groupings of tributaries based on temporal patterns in abundance. Results suggest a divide between eastern shore and western shore tributaries, with the Susquehanna River and the head of the bay showing similarities to both groups and possible temporal shifts in genetic structure due to straying. The Patuxent River likely represents a third genetic group for Blueback Herring. Cumulatively, our results suggest at least two genetically distinguishable groups of spawning populations for Alewives and at least three for Blueback Herring; these groups should be considered separately for conservation and management.

Received December 22, 2016; accepted June 3, 2017 Published online August 31, 2017
Phenomena and Objects of Research in the Cognitive and Behavioral Sciences
Authors: Feest Uljana
Published: July 2017

It is commonly held that research efforts in the cognitive and behavioral sciences are mainly directed toward providing explanations and that phenomena figure into scientific practice qua explananda. I contend that these assumptions convey a skewed picture of the research practices in question and of the role played by phenomena. I argue that experimental research often aims at exploring and describing “objects of research” and that phenomena can figure as components of, and as evidence for, such objects. I situate my analysis within the existing literature and illustrate it with examples from memory research.
Responsiveness and Robustness in the David Lewis Signaling Game
Authors: Brusse Carl , Bruner Justin
Published: July 2017

We consider modifications to the standard David Lewis signaling game and relax a number of unrealistic implicit assumptions that are often built into the framework. In particular, we motivate and explore various asymmetries that exist between the sender and receiver roles. We find that endowing receivers with a more realistic set of responses significantly decreases the likelihood of signaling, while allowing for unequal selection pressure often has the opposite effect. We argue that the results of this article can also help make sense of a well-known evolutionary puzzle regarding the absence of an evolutionary arms race between sender and receiver in conflict-of-interest signaling games.
A novel expression of the spherical-wave reflection coefficient at a plane interface
Authors: Li Jingnan , Wang Shangxu , Tao Yonghui , Dong Chunhui , Tang Genyang
Published: July 2017

The spherical-wave reflection coefficient (SRC) describes the reflection strength when seismic waves emanating from a point source impinge on an interface. In this study, the SRC at a plane interface between two infinite half-spaces is investigated. We derive an analytical equation of the SRC when kR → 0 (k is the wave number and R is the wave propagation distance). It only depends on the density ratio; it is independent of the velocity ratio and incidence angle. On the other hand, we find that the SRCs at different kR lie along an elliptical curve on the complex plane (the complex plane is a geometric representation of the complex numbers established by the real axis and perpendicular imaginary axis). Based on this feature, we construct a new analytical equation for the reflected spherical wave with high accuracy, which is applicable to both small and large kR. Using the elliptical distribution of the SRCs for a series of frequencies recorded at only one spatial location, the density and velocity ratios can be extracted. This study complements the spherical-wave reflection theory and provides a new basis for acoustic parameters inversion, particularly density inversion.
The formation and coalescence sites of the first gravitational wave events
Authors: Schneider Raffaella , Graziani Luca , Marassi Stefania , Spera Mario , Mapelli Michela , Alparone Matteo , Bennassuti Matteo de
Published: July 2017

We present a novel theoretical model to characterize the formation and coalescence sites of compact binaries in a cosmological context. This is based on the coupling between the binary population synthesis code SeBa with a simulation following the formation of a Milky Way-like halo in a well-resolved cosmic volume of 4 cMpc, performed with the GAMESH pipeline. We have applied this technique to investigate when and where systems with properties similar to the recently observed LIGO/VIRGO events are more likely to form and where they are more likely to reside when they coalesce. We find that more than 70 per cent of GW151226 and LVT151012-like systems form in galaxies with stellar mass M* > 108 M⊙ in the redshift range [0.06–3] and [0.14–11.3], respectively. All GW150914-like systems form in low-metallicity dwarfs with M* < 5 × 106 M⊙ at 2.4 ≤ z ≤ 4.2. Despite these initial differences, by the time they reach coalescence the observed events are most likely hosted by star-forming galaxies with M* > 1010 M⊙. Due to tidal stripping and radiative feedback, a non-negligible fraction of GW150914-like candidates end-up in galaxies with properties similar to dwarf spheroidals and ultrafaint satellites.
Three-Dimensional Endoscopic Magnification for Treatment of Thoracic Spinal Dural Arteriovenous Fistulas: Technical Note
Authors: Weil Alexander G , Obaid Sami , Chaalala Chiraz , Shedid Daniel , Magro Elsa , Seizeur Romuald , Bojanowski Michel W
Published: July 2017

BACKGROUND

Treatment of thoracic spinal dural arteriovenous fistulas (DAVFs) by microsurgery has recently been approached using minimally invasive spine surgery (MISS). The advantages of such an approach are offset by difficult maneuverability within the tubular retractor and by the creation of “tunnel vision” with reduced luminosity to a remote surgical target.

OBJECTIVE

To demonstrate how the pitfalls of MISS can be addressed by applying 3-D endoscopy to the minimally invasive approach of spinal DAVFs.

METHODS

We present 2 cases of symptomatic thoracic DAVFs that were not amenable to endovascular treatment. The DAVFs were excluded solely via a minimally invasive approach using a 3-D endoscope.

RESULTS

Two patients underwent exclusion of a DAVF following laminotomy, one through a midline 5-cm incision and the other through a paramedian 3-cm incision using minimally invasive nonexpandable tubular retractors. The dura opening, intradural exploration, fistula exclusion, and closure were performed solely under endoscopic 3-D magnification. No incidents were recorded and the postoperative course was marked by clinical improvement. Postoperative imaging confirmed the exclusion of the DAVFs. Anatomical details are exposed using intraoperative videos.

CONCLUSION

When approaching DAVFs via MISS, replacing the microscope with the endoscope remedies the limitations related to the “tunnel vision” created by the tubular retractor, but at the expense of losing binocular vision. We show that the 3-D endoscope resolves this latter limitation and provides an interesting option for the exclusion of spinal DAVFs.
Endoscopic Approach of the Insula Through the Anterior Middle Temporal Gyrus: A Feasibility Study in the Laboratory
Authors: Corrivetti Francesco , Froelich Sébastien , Mandonnet Emmanuel
Published: July 2017

BACKGROUND

Insular glioma surgery still represents a challenge. Nonetheless, advances in microsurgical anatomy and brain mapping techniques have allowed an increase in the extent of resection with acceptable morbidity rates. Transsylvian and transcortical approaches constitute the main surgical corridors, the latter providing considerable advantages and a high degree of reliability. Nevertheless, both surgical corridors yield remarkable difficulties in reaching the most posterior insular region.

OBJECTIVE

To study the feasibility of an endoscopic transtemporal approach in brain specimens, with the aim to provide a suitable access for posterior insular region.

METHODS

Four postmortem human hemispheres, embalmed using Klingler's technique, were dissected by means of a 30° rigid endoscope. The specimens underwent magnetic resonance imaging scans and, using the neuronavigation system, we were able to design a safe cortical window and an optimized endoscopic trajectory for the posterior insular dissection.

RESULTS

Insular dissection was led subpially through a small 2-cm cortical access, located in the anterior part of the middle temporal gyrus. During the posterior insula dissection, the endoscope allowed for optimized surgical view all along the long gyri, up to the posterior insular point. Anterior insular dissection was accomplished with more difficulties, as the endoscopic trajectory was not aligned to the axis of the short gyri.

CONCLUSION

This new surgical approach provides a favorable transcortical access to reach the most posterior insular portion. It seems to be a promising tool, in combination with intraoperative functional brain mapping, to further improve extent of resection rates in insular glioma surgery.
Identification of Clusters that Condition Resistance to Anthracnose in the Common Bean Differential Cultivars AB136 and MDRK
Authors: Campa Ana , Trabanco Noemí , Ferreira Juan José
Published: July 2017

The correct identification of the anthracnose resistance systems present in the common bean cultivars AB136 and MDRK is important because both are included in the set of 12 differential cultivars proposed for use in classifying the races of the anthracnose causal agent, Colletrotrichum lindemuthianum. In this work, the responses against seven C. lindemuthianum races were analyzed in a recombinant inbred line population derived from the cross AB136 × MDRK. A genetic linkage map of 100 molecular markers distributed across the 11 bean chromosomes was developed in this population to locate the gene or genes conferring resistance against each race, based on linkage analyses and χ2tests of independence. The identified anthracnose resistance genes were organized in clusters. Two clusters were found in AB136: one located on linkage group Pv07, which corresponds to the anthracnose resistance cluster Co-5, and the other located at the end of linkage group Pv11, which corresponds to the Co-2 cluster. The presence of resistance genes at the Co-5 cluster in AB136 was validated through an allelism test conducted in the F2population TU × AB136. The presence of resistance genes at the Co-2 cluster in AB136 was validated through genetic dissection using the F2:3population ABM3 × MDRK, in which it was directly mapped to a genomic position between 46.01 and 47.77 Mb of chromosome Pv11. In MDRK, two independent clusters were identified: one located on linkage group Pv01, corresponding to the Co-1 cluster, and the second located on LG Pv04, corresponding to the Co-3 cluster. This report enhances the understanding of the race-specific Phaseolus vulgaris–C. lindemuthianum interactions and will be useful in breeding programs.
Morphological and Genetic Analyses of the Invasive Forest Pathogen Phytophthora austrocedri Reveal that Two Clonal Lineages Colonized Britain and Argentina from a Common Ancestral Population
Authors: Henricot Béatrice , Pérez-Sierra Ana , Armstrong April C. , Sharp Paul M. , Green Sarah
Published: July 2017

Phytophthora austrocedri is causing widespread mortality of Austrocedrus chilensis in Argentina and Juniperus communis in Britain. The pathogen has also been isolated from J. horizontalis in Germany. Isolates from Britain, Argentina, and Germany are homothallic, with no clear differences in the dimensions of sporangia, oogonia, or oospores. Argentinian and German isolates grew faster than British isolates across a range of media and had a higher temperature tolerance, although most isolates, regardless of origin, grew best at 15°C and all isolates were killed at 25°C. Argentinian and British isolates caused lesions when inoculated onto both A. chilensis and J. communis; however, the Argentinian isolate caused longer lesions on A. chilensis than on J. communis and vice versa for the British isolate. Genetic analyses of nuclear and mitochondrial loci showed that all British isolates are identical. Argentinian isolates and the German isolate are also identical but differ from the British isolates. Single-nucleotide polymorphisms are shared between the British and Argentinian isolates. We concluded that British isolates and Argentinian isolates conform to two distinct clonal lineages of P. austrocedri founded from the same as-yet-unidentified source population. These lineages should be recognized and treated as separate risks by international plant health legislation.
Accreditation of Medical Education Programs: Moving From Student Outcomes to Continuous Quality Improvement Measures
Authors: Blouin Danielle , Tekian Ara
Published: July 2017

Accreditation of undergraduate medical education programs aims to ensure the quality of medical education and promote quality improvement, with the ultimate goal of providing optimal patient care. Direct linkages between accreditation and education quality are, however, difficult to establish. The literature examining the impact of accreditation predominantly focuses on student outcomes, such as performances on national examinations. However, student outcomes present challenges with regard to data availability, comparability, and contamination.

The true impact of accreditation may well rest in its ability to promote continuous quality improvement (CQI) within medical education programs. The conceptual model grounding this paper suggests accreditation leads medical schools to commit resources to and engage in self-assessment activities that represent best practices of CQI, leading to the development within schools of a culture of CQI. In line with this model, measures of the impact of accreditation on medical schools need to include CQI-related markers. The CQI orientation of organizations can be measured using validated instruments from the business and management fields. Repeated determinations of medical schools’ CQI orientation at various points throughout their accreditation cycles could provide additional evidence of the impact of accreditation on medical education. Strong CQI orientation should lead to high-quality medical education and would serve as a proxy marker for the quality of graduates and possibly for the quality of care they provide.

It is time to move away from a focus on student outcomes as measures of the impact of accreditation and embrace additional markers, such as indicators of organizational CQI orientation.
Impact of a Mandated Change in Buprenorphine Formulation
Authors: Graddy Ryan , Rastegar Darius A.
Published: July 2017

Objective:

This study examines the impact of an insurance-mandated change in formulation of buprenorphine/naloxone (BNX) for patients with opioid use disorder treated in a primary care clinic.

Methods:

A retrospective cohort study was conducted to determine the proportion of patients who were switched back to the previous BNX formulation and rates of aberrant urine drug tests for the 3 months before and 3 months after a mandated change in BNX from the sublingual film to the rapidly dissolving tablet (BNX-RDT). Aberrant urine drug tests were defined as the presence of cocaine, nonprescribed opioids/benzodiazepines, or the absence of buprenorphine.

Results:

In all, 186 patients were included in the analysis. At 3 months after the change, 36.0% of patients remained on BNX-RDT at equivalent dose, 9.1% were prescribed a higher dose of BNX-RDT, 52.7% were switched back to their previous formulation after a trial of BNX-RDT, and 2.2% dropped out of care. There was no significant change in the rates of aberrant urine drug tests pre and postchange (36.6% vs 33.7%; P = 0.27) or in any individual component of urine drug testing. Age, sex, and starting dose were not associated with remaining on BNX-RDT at equivalent dose, compared with increasing dose or changing formulation.

Conclusions:

Most patients were dissatisfied with the change in formulation and requested a return to the previous formulation. This change did not appear to impact drug use; however, the flexibility that permitted patients to switch back to their previous BNX formulation likely attenuated the policy's impact.
Arthroscopy in the treatment of pigmented villonodular synovitis of the ankle and subtalar joints: a technique guide and case series
Authors: Sweeney Kyle R. , Slone Harris S. , Labib Sameh A.
Published: July 2017

Pigmented villonodular synovitis is a proliferative synovial-based inflammatory process that can lead to joint destruction and debilitating pain. Surgical excision is the “gold standard” for treatment of pigmented villonodular synovitis. Given the limited soft tissues surrounding the ankle in conjunction with the ability of arthroscopy to easily access the entire joint, arthroscopic management of ankle pigmented villonodular synovitis allows for successful treatment while minimizing the surgical complications of an open approach. The preoperative planning and surgical technique are described in detail. Additionally, three patients with pigmented villonodular synovitis in the tibiotalar and subtalar joints who were successfully treated with arthroscopically assisted synovectomy are reported.Three patients with pigmented villonodular synovitis in the tibiotalar and subtalar joints underwent arthroscopically assisted synovectomy without adjuvant radiotherapy. With a mean age of 37.7 yr (range 23-52) and mean follow-up of 83 wk (range 19-184), there was no evidence of recurrence. Mean Short Form-12 scores for physical and mental component summaries were, respectively, 49.05±4.76 and 54.57±4.55. The mean Foot and Ankle Disability Index (FDAI) score for the patients was 88.13±9.6. These results suggest good to excellent results. Arthroscopically assisted synovectomy in patients with pigmented villonodular synovitis of the ankle and hindfoot is an effective treatment option, providing adequate visualization for complete excision while minimizing soft-tissue complications related to larger surgical exposures.
Radiographic and clinical results of iliosacral screw fixation of posterior pelvic ring injuries
Authors: Jawed Abdulla , El-Bakoury Ahmed , Williams Mark Rees
Published: July 2017

Background:

Percutaneous iliosacral screw fixation is now the preferred option for posterior pelvic ring stabilization. Outcome reporting for this procedure remains inconsistent and unstandardized. We sought to evaluate the early outcomes of iliosacral screw fixation of unstable posterior pelvic ring injuries, with particular reference to leg-length differences.

Methods:

We retrospectively reviewed 28 patients who underwent percutaneous iliosacral screw fixation of posterior pelvic ring injuries between 2008 and 2012 at our trauma center. Only those with a minimum of 1-year follow-up, were included. Clinical outcomes were measured with EuroQol (EQ5D) and Majeed pelvic scores, and the radiographic outcomes were measured by the method of Matta and Tornetta.

Results:

The mean Majeed score was 83, mean EQ-Visual Analog Score (EQ-VAS) was 75; and the two scores correlated with statistical significance. Measured reductions of these injuries were good to excellent. Leg-length discrepancies improved initially but increased on further follow-up. This did not negatively affect the clinical outcome measures. The incidence of multiple surgical procedures in these patients was significantly associated with worse outcomes.

Conclusions:

Percutaneous iliosacral screw fixation of unstable posterior pelvic ring is performed with high patient-reported outcomes and excellent radiographically measured reductions at this center. We detected a trend towards increased leg-length difference on longer follow-up, but there was no detrimental effect on the clinical progress. We also found a previously unreported correlation between the Majeed score and the EQVAS score in our patient population.
Personal economic impact of performing elective Saturday hand surgery
Authors: Katz Jonathan S. , O’Callaghan Patrick K. , Patel Dil D. , Peterson Ann M. , Angermeier Eric W. , Kokko Kyle P.
Published: July 2017

Background:

The economic impact of performing elective hand surgery on Saturdays has yet to be studied. The purpose of this study was to evaluate patient preferences and factors for Saturday hand surgery and to analyze the personal economic and societal costs regarding missed days of work for elective hand surgery.

Methods:

An anonymous quality improvement survey was distributed to 125 consecutive patients who were planning to undergo elective outpatient hand surgery. Demographics included age, gender, zip code, education, occupation, income level, and interest in Saturday hand surgery. IBM-SPSS Statistics 20 for Windows (SPSS, Chicago, IL) was used for data analysis.

Results:

Seventy-eight (62.4%) patients responded they would want elective hand surgery performed on a Saturday. Of those who reported income (n=66), the average daily salary was estimated to be $269.50. If these patients had been given the opportunity to have Saturday hand surgery, a total of $17,787 in lost income or paid leave could have been saved. We did not identify any significant factors that correlated with a patient’s decision to undergo elective Saturday hand surgery.

Conclusions:

Over half (62.4%) of our respondents would request Saturday elective hand surgery if offered at our institution. If 62.4% of patients requiring hand surgery at our institution were to elect for Saturday surgery, we estimated a savings of over $100,000 in lost wages or paid leave annually. This study shows that there is a patient population that would be interested in elective Saturday surgery, and providing availability could help to take care of this market.
Association Between Survival and Time of Day for Rapid Response Team Calls in a National Registry
Authors: Churpek Matthew Michael , Edelson Dana P. , Lee Ji Yeon , Carey Kyle , Snyder Ashley
Published: July 2017

Objectives:

Decreased staffing at nighttime is associated with worse outcomes in hospitalized patients. Rapid response teams were developed to decrease preventable harm by providing additional critical care resources to patients with clinical deterioration. We sought to determine whether rapid response team call frequency suffers from decreased utilization at night and how this is associated with patient outcomes.

Design:

Retrospective analysis of a prospectively collected registry database.

Setting:

National registry database of inpatient rapid response team calls.

Patients:

Index rapid response team calls occurring on the general wards in the American Heart Association Get With The Guidelines-Medical Emergency Team database between 2005 and 2015 were analyzed.

Interventions:

None.

Measurements and Main Results:

The primary outcome was inhospital mortality. Patient and event characteristics between the hours with the highest and lowest mortality were compared, and multivariable models adjusting for patient characteristics were fit. A total of 282,710 rapid response team calls from 274 hospitals were included. The lowest frequency of calls occurred in the consecutive 1 am to 6:59 am period, with 266 of 274 (97%) hospitals having lower than expected call volumes during those hours. Mortality was highest during the 7 am hour and lowest during the noon hour (18.8% vs 13.8%; adjusted odds ratio, 1.41 [1.31–1.52]; p < 0.001). Compared with calls at the noon hour, those during the 7 am hour had more deranged vital signs, were more likely to have a respiratory trigger, and were more likely to have greater than two simultaneous triggers.

Conclusions:

Rapid response team activation is less frequent during the early morning and is followed by a spike in mortality in the 7 am hour. These findings suggest that failure to rescue deteriorating patients is more common overnight. Strategies aimed at improving rapid response team utilization during these vulnerable hours may improve patient outcomes.
Lung cancer and annual mean exposure to outdoor air pollution in Crete, Greece
Authors: Sifaki-Pistolla Dimitra , Lionis Christos , Koinis Filippos , Georgoulias Vassilis , Tzanakis Nikos
Published: July 2017

The increasing burden of lung cancer (LC) in Crete, Greece, has raised certain concerns about the potential association of environmental risk factors with LC. The aim of this study was to assess outdoor air pollution (OAP) and the risk for LC mortality for the first time in Crete using LC primary data. 5057 LC cases (diagnosed from 1992 to 2013) were obtained from the Cancer Registry of Crete (
http://www.crc.uoc.gr
) and followed up until 2014. The age-standardized incidence and mortality rates (ASIR) were calculated. Data on OAP indicators [particulate matter (PM)2.5, between 2.5 and 10 μm (PM2.5–10), PM10, PM2.5 absorbance (black carbon measure), nitrogen dioxide (NO2), and nitrogen oxides (NOx)] were collected. Spatial statistics were calculated and the binary logistic regression model was constructed at α=0.05 in IBM SPSS 24 and ArcMap 10.3.1. LC in Crete accounts for 40.2 new cases/100 000/year for both sexes (ASIRmales=73.1 new cases/100 000/year; ASIRfemales=11.8 new cases/100 000/year). Annual median estimates of environmental concentrations in Crete were as follows: PM2.5=20.7 (±1.5) µg/m3, PM10=38.9 (±2.5) µg/m3, PM2.5–10=59.6 (±3.7) µg/m3, PM2.5 absorbance=1.2 (±0.3)×10−5/m, NO2=15.2 (±3.8) µg/m3, and NOx=20.1 (±4.9) µg/m3. A statistically significant association was observed between OAP and LC mortality (mean correlation coefficient=0.75; P<0.05). The highest risk for 5-year LC mortality was found in the major urban centers and several south-east and north-west rural regions of Crete (relative risk=3.2, 95% confidence interval=1.6–4.7). OAP seems to be an important determinant of LC mortality. Targeted interventions should be performed in the high-risk areas.
Nutritional Deficiency–Related Oral and Cutaneous Lesions in an Obese Patient
Authors: Esquivel-Pedraza Lilly , Méndez-Flores Silvia , Cicero-Casarrubias Alba , Saeb-Lima Marcela , Domínguez-Cherit Judith , Fernández-Cuevas Laura
Published: July 2017

The cutaneous and oral lesions related to nutritional deficiencies are scarcely reported. Micronutrient deficiencies may significantly affect mouth mucosa and skin, causing great morbidity. We report an extraordinary case with detailed clinical and microscopic findings affecting the oral cavity and skin. Physicians must be familiar with these manifestations to suspect the diagnosis.
Parental Psychological Distress and Family Food Insecurity: Sad Dads in Hungry Homes
Authors: Tseng Katie K. , Park Su Hyun , Shearston Jenni A. , Lee Lily , Weitzman Michael
Published: July 2017

Objective:

To examine whether household food insecurity is associated with serious psychological distress (SPD) in fathers and mothers in a nationally representative US sample.

Methods:

We analyzed cross-sectional, matched child-parent data from the 2014 to 2015 National Health Interview Survey (N = 18,456). Parental psychological distress was assessed using the Kessler-6 (K-6) scale. Family food security was measured using the USDA's 10-item Food Security scale, and households were dichotomized as food secure or food insecure. Multivariate logistic regression analyses were performed to examine associations between SPD and food insecurity stratified by parental status (mother/father), controlling for sociodemographic factors.

Results:

One hundred forty-seven (2.0%) fathers, 444 (3.9%) mothers, and 591 (3.2%) of all parents had K-6 scores indicating SPD. A total of 2414 (13.1%) parents reported being food insecure, including 750 (10.4%) fathers and 1664 (14.8%) mothers. In multivariate analyses, food insecurity was significantly associated with SPD both among fathers and mothers (odds ratio [OR] = 4.2; 95% confidence interval [CI], 2.4–7.3 and OR = 2.6; 95% CI, 1.9–3.5, respectively).

Conclusion:

This is the first study we are aware of to demonstrate that food insecurity is independently associated with SPD among fathers and mothers, and that fathers may be at higher risk of SPD than mothers in food insecure homes. These findings highlight the need to assess and treat the mental health of fathers, a historically underrepresented group in the fields of mental health and pediatrics, in addition to mothers, in food insecure homes.
Unusual Volar Pulp Location of Glomus Tumor
Authors: Rosner Ian A. , Argenta Anne E. , Washington Kia M.
Published: July 2017

Glomus tumors are benign, painful growths originating from glomus bodies and comprise just 1% of tumors arising in the hand, with fewer than 10% in the volar pulp of digits. Hallmark symptoms of glomus tumors include hypersensitivity to cold, heightened pinprick sensitivity, and paroxysmal pain. We report a 72-year-old, right-hand dominant man who presented with pain in the left middle finger, localized to the tip. The fingertip was incredibly sensitive to touch, and his pain increased at night. He reported no recollection of trauma. Palpation of the finger revealed no mass, although it did indicate a focal point of pain within the distal pulp of the digit. Magnetic resonance imaging of the left hand revealed a round 7.0 × 4.0 × 6.0-mm soft tissue lesion along the volar ulnar aspect of the distal third digit. An incision was made in the mid-axial plane, circumscribing and removing the mass bluntly. It was a tan-yellow, soft tissue nodule of 0.8-cm in diameter without stalk or adherences to joints. Pathology revealed the mass was a glomus tumor. Symptoms improved on removal, and he healed without complication. Glomus tumors in the volar digital pulp can be difficult to diagnose. However, the presence of localized pain in the fingertip was reason to consider glomus tumor and proceed with treatment. Complete surgical removal of a glomus tumor is necessary to resolve symptoms and prevent recurrence.
A Review of the Epigenetic Contributions to Endometriosis
Authors: GRIMSTAD FRANCES W. , DECHERNEY ALAN
Published: July 2017

Epigenetic influences have been postulated to affect the course of endometriosis. DNA methyltransferases, estrogen and progesterone receptors, micro-RNAs, and histone deacetylators, have shown differential expression in endometriosis compared with normal endometrium. Others such as aromatase, Steroid Factor-1, COX-2, and Homeobox A10 also have epigenetic modifications in endometriosis. Limitations in this area of research include heterogeneity in study design, patient populations, and methods of analysis. Larger, controlled studies are needed. Future targeted uses of this work may include using methylomes to noninvasively diagnose endometriosis, or targeting histone-deacetylase inhibitors for treatment.
Quality and Safety of Obstetric Practices Using New Modalities— Ultrasound, MR, and CT
Authors: HOLT ROXANE , ABRAMOWICZ JACQUES S.
Published: July 2017

Quality assurance (QA) and safety are important components of obstetric imaging. Quality involves accreditation of the imaging unit as well as equipment inspection for function and image quality. The personnel working in the unit must demonstrate qualifications to perform, evaluate, and interpret the studies. Standardizing the required elements of the examination helps assure that a quality examination has been performed. QA and safety as well as physician requirements and equipment QA programs in ultrasound, computed tomography, and magnetic resonance will be discussed with an in depth look at ultrasound due to its more frequent use in pregnancy.
Failed Intrauterine Pregnancy: What Is a Failed Pregnancy, What Is Not?
Authors: CANAVAN TIMOTHY P.
Published: July 2017

Pregnancy failure is defined as a lack of sonographic evidence of current or expected viability. Technologic advances in ultrasound imaging continue to redefine diagnostic criteria of pregnancy failure or success. When evaluating a pregnancy, the first step is an assessment of maternal risk factors for failure. Imaging clues such as an empty gestational sac measuring ≥25 mm or an embryo ≥7 mm without cardiac activity are reliable signs of pregnancy failure, whereas embryonic growth <1 mm/d is not. Combinations of sonographic findings can be used for a more accurate prediction of pregnancy success or failure.
Endometriosis and Imaging
Authors: HOYOS LUIS R. , JOHNSON SAMUEL , PUSCHECK ELIZABETH
Published: July 2017

Endometriosis is a condition with variable location, size, and lesion composition which poses a diagnostic imaging challenge for the practicing gynecologist. Transvaginal ultrasound and magnetic resonance imaging are the most frequent imaging techniques used for its evaluation, but transvaginal ultrasound should be the first-line approach, as it is often sufficient, followed by modified ultrasound techniques. Magnetic resonance imaging should be considered when a diagnosis has not been achieved by sonographic means or when the renal system needs to be concurrently evaluated. Computed tomography has no role in the routine evaluation of endometriosis except in very few particular scenarios.
Pathway for the Management of Sleep Apnea in the Cardiac Patient
Authors: Aziz Emad F. , Selby Allison , Argulian Edgar , Aziz Joshua , Herzog Eyal
Published: July 2017

Sleep-disordered breathing is a highly prevalent medical condition, which if undiagnosed leads to increased morbidity and mortality, particularly related to increased incidence of cardiovascular events. It is therefore imperative that we identify patient population at high risk for sleep apnea and refer them to the appropriate therapy as early as possible. Up-to-date there is no management guideline specifically geared towards cardiac patients. Thus, we propose a (SAP) Sleep Apnea Pathway to correctly identify and triage these patients to the appropriate therapy.
Simple Single-Pass Technique for Ultrathin Descemet Stripping Automated Endothelial Keratoplasty: A Pilot Study
Authors: Dimitry Maria E.S. , Lewis Adam D. , Zacharaki Fani , Chandran Manju , Robson Deana , Menon Geeta , Poole Thomas R. G.
Published: July 2017

Purpose:

To assess intraoperative and postoperative graft thickness (GT) after donor deturgescence for ultrathin Descemet stripping automated endothelial keratoplasty and to evaluate visual outcomes, endothelial cell density, and patient satisfaction at 1 year.

Methods:

Prospective interventional case series of patients with Fuchs endothelial dystrophy, Fuchs endothelial dystrophy and cataract, and pseudophakic bullous keratopathy (n = 12 grafts). The donor cornea was allowed to thin out by simple evaporation on an artificial anterior chamber, to the required precut thickness, before a single microkeratome pass. GT after microkeratome cut, at 1 week, 1, 3, 6, and 12, months was measured. Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity, Pelli–Robson contrast sensitivity, endothelial cell density, and score on the visual function questionnaire (VFQ-25) were assessed.

Results:

Mean intraoperative postmicrokeratome cut GT was 78.9 ± 33.3 μm. Mean GT at 1 week, 1, 3, 6, and 12 months was 70.7, 70.9, 62.8, 66.5, and 58.9 μm, respectively. Mean initial donor corneal thickness was 647 ± 67 μm, and mean precut thickness was 526 ± 4.5 μm (mean thinning time: 17 min). Best-corrected visual acuity at 1 week, 1, 3, 6, and 12 months was 68.8, 76.9, 76.3, 76.9, and 78.6 letters with 9-letter gain at 12 months (P = 0.02). Mean endothelial cell loss at 3, 6, and 12 months was 36.8% ± 6.75%, 37.2% ± 8%, and 37.9% ± 9.75% loss, respectively. At 1 year, 83.3% of patients achieved ≥20/40 (6/12) and 66.7% of patients achieved ≥20/32 (6/9.5). VFQ-25 testing showed an improvement in the visual function.

Conclusions:

This pilot study demonstrates a simple graft deturgescence technique that reproducibly creates ultrathin grafts without donor wastage.
Long-Term Tomographic Evaluation of Unilateral Keratoconus
Authors: Imbornoni Lauren M. , Padmanabhan Prema , Belin Michael W. , Deepa M.
Published: July 2017

Purpose:

To report 5 cases of advanced unilateral keratoconus documented by sequential tomographic evaluation.

Methods:

Retrospective review over a 10-year period at a single practice identifying patients with unilateral keratoconus by advanced imaging throughout the follow-up period.

Results:

Five patients were identified with progressive keratoconus in 1 eye and no changes in the fellow eye based on full tomographic evaluation and analysis of both anterior and posterior corneal surfaces and corneal thickness with a mean follow-up period of 59 months (range 39–86).

Conclusions:

Keratoconus is believed to be a bilateral disease that can present asymmetrically. We present 5 cases that appear to be true unilateral keratoconus with no associated mechanical environmental factors.