bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Treatment of Meniscal Extrusion: A Biomechanical Study on the Role of the Medial Meniscotibial Ligaments With Early Clinical Validation
Authors: Paletta George A. , Crane David M. , Konicek John , Piepenbrink Marina , Higgins Laurence D. , Milner John D. , Wijdicks Coen A.
Published: July 2020

Background:

Meniscal extrusion refers to meniscal displacement out of the joint space and over the tibial margin, altering knee mechanics and increasing the risk of osteoarthritis. The meniscotibial ligaments have been shown to have an important role in meniscal stability. However, it remains unclear whether an isolated lesion of the medial meniscotibial ligaments will result in meniscal extrusion and whether repairing the detached ligament will reduce extrusion.

Hypothesis:

A lesion of the medial meniscotibial ligament will result in meniscal extrusion, and repairing the joint capsule will eliminate the extrusion by returning the meniscus back to its original position.

Study Design:

Controlled laboratory study.

Methods:

Fresh-frozen human cadaveric knees (N = 6) were used for biomechanical testing. The test protocol involved 100 flexion-extension cycles. In full extension, meniscal extrusion was measured using ultrasound, in both an otherwise unloaded state and while subjected to a 10-N·m varus load. Each knee was tested in its native condition (baseline), after creating a detachment of the medial meniscotibial ligament, and finally with the joint capsule repaired using 3 knotless SutureTak anchors. We also performed a retrospective review of 15 patients who underwent meniscotibial ligament repair with a minimal follow-up of 5 weeks (mean, 14 weeks; range, 5-35 weeks).

Results:

During biomechanical testing, the mean absolute meniscal extrusion at baseline was 1.5 ± 0.6 mm. After creation of the meniscotibial ligament lesion, the mean absolute meniscal extrusion was significantly increased (3.4 ± 0.7 mm) ( P < .001). After repair, the extrusion was reduced to 2.1 ± 0.4 mm ( P < .001). Clinically, a reduction in absolute meniscal extrusion of approximately 48% was reached (1.2 ± 0.6 vs 2.4 ± 0.5 mm preoperatively; P < .001).

Conclusion:

This study indicates that the medial meniscotibial ligaments contribute to meniscal stability as lesions cause the meniscus to extrude and that repair of those ligaments can significantly reduce extrusion. Early clinical results using this meniscotibial ligament repair technique support our biomechanical findings, as a significant reduction in meniscal extrusion was achieved.

Clinical Relevance:

Our biomechanical findings suggest that repair of medial meniscotibial ligaments reduces meniscal extrusion and clinically may improve meniscal function, with the possible long-term benefit of reducing the risk for osteoarthritis.
Table Quizzes as an Assessment Tool in the Gross Anatomy Laboratory
Authors: Heise Natascha , Meyer Carolyn A , Garbe Brendan A , Hall Heather A , Clapp Tod R
Published: July 2020

Using cadaveric instruction in a graduate-level anatomy course is an expensive and time-consuming undertaking. While this is a worthwhile endeavor, most first-year medical students and students in the health fields struggle with the independent, self-directed learning approach in the cadaveric laboratory, and going beyond rote memorization of the material. As such, effective assessment tools that maximize student learning in the cadaveric laboratory are critical, especially if no lecture component is present. Dissection quality often reflects student attention to detail and therefore may be tied to overall performance in the course. The aim of this study was to investigate the relationship between weekly table quizzes and the overall student outcomes in a graduate biomedical human dissection class as well as examining the benefits and implications of this approach. In this course, a uniquely structured weekly quiz assessed dissection quality and probed student understanding in human anatomy. Student data compiled from 5 years of dissection courses were analyzed to evaluate the relationship between performance in the weekly assessment and on the unit examinations. The results showed a statistically significant relationship between the weekly quizzes and the student examinations at the end of each dissection block in 2013, 2015, 2016, and 2017. The data suggest a potential correlation between performance on weekly quizzes and on unit examinations. The unique nature of the table quizzes provides the students with the opportunity to practice the retrieval of their knowledge, feel more guided throughout their dissection, and receive immediate feedback on their performance. This assessment tool also provides a way to predict student outcomes and an opportunity for early intervention to help at-risk students. The analysis of this research study contributes to the need for more data on the usage of assessment tools in a graduate human dissection class.
Interferon-Gamma and Interleukin-1Beta Enhance the Secretion of Brain-Derived Neurotrophic Factor and Promotes the Survival of Cortical Neurons in Brain Injury
Authors: Abd-El-Basset Ebtesam M , Rao Muddanna Sakkattu , Alsaqobi Ameerah
Published: July 2020

Neuro-inflammation is associated with the production of cytokines, which influence neuronal and glial functions. Although the proinflammatory cytokines interferon-γ (IFN-γ) and interleukin-1Beta (IL-1β) are thought to be the major mediators of neuro-inflammation, their role in brain injury remains ill-defined. The objective of this study was to examine the effect of IFN-γ and IL-1β on survival of cortical neurons in stab wound injury in mice. A stab wound injury was made in the cortex of male BALB/c mice. Injured mice (I) were divide into IFN-γ and IL-1β treatment experiments. Mice in I + IFN-γ group were treated with IFN-γ (ip, 10 µg/kg/day) for 1, 3 and 7 days and mice in I + IL-1β group were treated with 5 IP injection of IL-1β (0.5 µg /12 h). Appropriate control mice were maintained for comparison. Immunostaining of frozen brain sections for astrocytes (GFAP), microglia (Iba-1) and Fluoro-Jade B staining for degenerating neurons were used. Western blotting and ELISA for brain-derived neurotrophic factor (BDNF) were done on the tissues isolated from the injured sites. Results showed a significant increase in the number of both astrocytes and microglia in I + IFN-γ and I + IL-1β groups. There were no significant changes in the number of astrocytes or microglia in noninjury groups (NI) treated with IFN-γ or IL-1β. The number of degenerating neurons significantly decreased in I + IFN-γ and I + IL-1β groups. GFAP and BDNF levels were significantly increased in I + IFN-γ and I + IL-1β groups. Interferon-γ and IL-1β induce astrogliosis, microgliosis, enhance the secretion of BDNF, one of the many neurotrophic factors after brain injury, and promote the survival of cortical neurons in stab wound brain injury.
Cardiovascular risk screening of patients with serious mental illness or use of antipsychotics in family practice
Authors: Jakobs Kirsti M. , Posthuma Anne , de Grauw Wim J. C. , Schalk Bianca W. M. , Akkermans Reinier P. , Lucassen Peter , Schermer Tjard , Assendelft Willem J. J. , Biermans Marion J. C.
Published: July 2020

Background

Patients with serious mental illness (SMI) and patients on antipsychotics (AP) have an elevated risk for cardiovascular diseases. In the Netherlands, the mental healthcare for these patients is increasingly taken care of by family practitioners (FP) as a result of a shift from secondary to primary care. Therefore, it is essential to increase our knowledge regarding the characteristics of this patient group and the (somatic) care provided by their FPs. The aim was to examine the rate of cardiovascular risk screening in patients with SMI or the use of AP in family practice.

Methods

We performed a retrospective cohort study of 151.238 patients listed in 24 family practices in the Netherlands.

From electronic medical records we extracted data concerning diagnoses, measurement values of CVR factors, medication and frequency of visits over a 2 year period. Primary outcome was the rate of patients who were screened for CVR factors. We compared three groups: patients with SMI/AP without diabetes or CVD (SMI/AP-only), patients with SMI/AP and diabetes mellitus (SMI/AP + DM), patients with SMI/AP and a history of cardiovascular disease (SMI/AP + CVD). We explored factors associated with adequate screening using multilevel logistic regression.

Results

We identified 1705 patients with SMI/AP, 834 with a SMI diagnosis, 1150 using AP. The screening rate for CVR in the SMI/AP-only group (n = 1383) was adequate in 8.5%. Screening was higher in the SMI/AP − +DM (n = 206, 68.4% adequate, OR 24.6 (95%CI, 17.3–35.1) and SMI/AP + CVD (n = 116, 26.7% adequate, OR 4.2 (95%CI, 2.7–6.6). A high frequency of visits, age, the use of AP and a diagnosis of COPD were associated with a higher screening rate. In addition we also examined differences between patients with SMI and patients using AP without SMI.

Conclusion

CVR screening in patients with SMI/AP is performed poorly in Dutch family practices. Acceptable screening rates were found only among SMI/AP patients with diabetes mellitus as comorbidity. The finding of a large group of AP users without a SMI diagnosis may indicate that FPs often prescribe AP off-label, lack information about the diagnosis, or use the wrong code.
Addressing knowledge gaps in Parkinson’s disease: a report on the Movement Disorder Society’s Centre-to-Centre initiative to improve Parkinson’s disease services in Lao People’s Democratic Republic
Authors: Phokaewvarangkul Onanong , Vorachit Somchit , Phoumindr Appasone , Keosodsay Saysavath , Postuma Ronald B. , Meissner Wassilios G. , Bhidayasiri Roongroj
Published: July 2020

Background

Lao People’s Democratic Republic (Lao PDR) has only nine neurologists for seven million people; none have formal training in Parkinson’s disease (PD). Medical specialists require sufficient PD knowledge to provide high-quality care.

Methods

This study outlines a Centre-to-Centre programme for developing PD expertise in underserved regions through a tailored two-year educational enterprise between an established movement disorder mentor centre at Chulalongkorn University in Thailand and mentee centres in Lao PDR. Background knowledge of 80 Laotian physicians was assessed using a validated PD knowledge questionnaire containing 26 questions divided into 3 sections (diagnosis, therapeutic options, disease course) before and immediately after one-day kick-start training. Responses were compared across physicians’ demographic groups.

Results

Of 80 respondents, 50 (62.5%) were board-certified physicians, of which 27 (54%) specialised in internal medicine. Apparent knowledge gaps were shown by a 51.2% correct response rate for total score, 52.8% for diagnosis, 50.6% for therapeutic options, and 48.2% for disease course. No significant differences in total score or any domain sub-scores between neurologists and other specialties were found. Many did not know which non-motor symptoms could occur as prodromal symptoms or late in course of PD. Incorrect responses mainly reflected a lack of knowledge of the impact of medication on disease. Total and domain sub-scores significantly improved after the course (p < 0.05, each). The size of difference of the means was significant for the total score (d = 0.82), therapeutic option (d = 0.56), and disease course (d = 0.68) sub-scores.

Conclusions

Significant improvement of PD knowledge amongst Laotian physicians is demonstrated after a training course, focusing on practical management of PD. Our findings highlight the importance of continued medical education, especially PD-specific training.
Status and associated factors of birth registration in selected districts of Tigray region, Ethiopia
Authors: Abay Shishay Tadesse , Gebre-egziabher Ataklti Gebreyesus
Published: July 2020

Background

Birth registration establishes the existence of a child under law and provides the foundation for ensuring many of his/her rights. Despite its significance, a continuous, effective and comprehensive birth registration system has not been established in Ethiopia until the recent past. This paper examines the status of child’s birth registration and its associated factors in selected districts of Tigray Region, Ethiopia.

Method

A community-based cross-sectional study was conducted from April to May 2018 among 383 randomly selected mothers who had given birth to at least one child since August 2016. A structured questionnaire was used to gather the quantitative data. Qualitative data were collected using key informant interviews and focus group discussions. To analyze the data, SPSS version 20 was used. Logistic regression analysis was employed to assess the association between dependent and independent variables.

Results

Findings reveal that significant number of the respondents did not have knowhow about birth registration and its uses. As a result, only 117(30%) of them registered the birth of their children and secured certificates. Inaccessibility of the registrar offices, lack of relevant manpower and political will of the government were reported as major reasons for such a gap. Mother’s education was identified to be positively associated with the likelihood of a child being registered. Children born from mothers living in urban areas were found more likely to be registered compared to their rural counterpart [AOR = 1.46, 95% CI = 0.76, 2.76]. In light of Religion, children from the Muslim community had better opportunity for birth registration and owning birth certificate compared to children from Orthodox Christian parents. Compared to those who have possessed own birth certificates, the likelihood of mothers who did not possess own birth certificates to register the birth of their children was found lower by the factor of 86% [AOR = 0.14, 95%CI = 0.07, 0.26].

Conclusion

Birth registration of a child and subsequent issuance of certificate should be pursued as a right issue. To make this a reality, extensive awareness raising programs that underscore the need for a birth registration and its significance for rural communities is needless to say critical.
Cell-specific expression of lung disease risk-related genes in the human small airway epithelium
Authors: Zuo Wu-lin , Rostami Mahboubeh R. , Shenoy Shushila A. , LeBlanc Michelle G. , Salit Jacqueline , Strulovici-Barel Yael , O’Beirne Sarah L. , Kaner Robert J. , Leopold Philip L. , Mezey Jason G. , Schymeinsky Juergen , Quast Karsten , Visvanathan Sudha , Fine Jay S. , Thomas Matthew J. , Crystal Ronald G.
Published: July 2020

Background

The human small airway epithelium (SAE) plays a central role in the early events in the pathogenesis of most inherited and acquired lung disorders. Little is known about the molecular phenotypes of the specific cell populations comprising the SAE in humans, and the contribution of SAE specific cell populations to the risk for lung diseases.

Methods

Drop-seq single-cell RNA-sequencing was used to characterize the transcriptome of single cells from human SAE of nonsmokers and smokers by bronchoscopic brushing.

Results

Eleven distinct cell populations were identified, including major and rare epithelial cells, and immune/inflammatory cells. There was cell type-specific expression of genes relevant to the risk of the inherited pulmonary disorders, genes associated with risk of chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis and (non-mutated) driver genes for lung cancers. Cigarette smoking significantly altered the cell type-specific transcriptomes and disease risk-related genes.

Conclusions

This data provides new insights into the possible contribution of specific lung cells to the pathogenesis of lung disorders.
Highly secure edge-intelligent electric motorcycle management system for elevators
Authors: Zhu Zongwei , Cao Jing , Hao Tiancheng , Zhai Wenjie , Sun Bin , Jia Gangyong , Li Ming
Published: July 2020

Because of their portability, electric motorcycles are usually pushed into elevators by residents and charged in the home, which has serious safety risks. Traditional manual-based methods to manage this behavior have poor monitoring effects and high costs. As for automatic management systems using artificial intelligence (AI), the deployment method matters. Cloud-based deployment methods have the disadvantages of high latency, high risk of privacy leakage, and heavy network transmission loads. In this paper, we propose a highly secure edge-intelligent electric motorcycle management system for elevators. By using edge-based deployment method, the monitor pictures are processed locally without being uploaded to the cloud, which can effectively resist network attacks and prevent residents’ private data from being leaked. To improve the system security, we fully analyze the challenges faced in the application scenarios and introduce security threat identification (STI-1H8) model to identify the security threats. In addition, we propose several data enhancement methods to improve the system recognition accuracy. Experimental results show that our system can achieve a high recall rate of 0.82. By using data enhancement and data mixing strategies, it can reduce the misjudgment rate by 0.35. Moreover, compared to cloud computing, our edge-based method can reduce the latency by 19.6%, meeting real-time requirements.
Pharmacokinetic interactions of esaxerenone with amlodipine and digoxin in healthy Japanese subjects
Authors: Kirigaya Yoshiaki , Shiramoto Masanari , Ishizuka Tomoko , Uchimaru Hinako , Irie Shin , Kato Manabu , Shimizu Takako , Nakatsu Takafumi , Nishikawa Yasuhiro , Ishizuka Hitoshi
Published: July 2020

Background

To investigate the effects of coadministration of esaxerenone with amlodipine on the pharmacokinetics (PK) of each drug, and of esaxerenone on the PK of digoxin.

Methods

In three open-label, single-sequence, crossover studies, healthy Japanese males received single oral doses of esaxerenone 2.5 mg (Days 1, 15), with amlodipine 10 mg/day (Days 8–18) (Study 1, N = 24); single doses of amlodipine 2.5 mg (Days 1, 21), with esaxerenone 5 mg/day (Days 8–25) (Study 2; N = 20); or digoxin 0.25 mg/day (Days 1–15) with esaxerenone 5 mg/day (Days 11–15) (Study 3; N = 20). PK parameters and safety were assessed.

Results

Study 1: esaxerenone peak plasma concentration (Cmax) and time to Cmax were unaltered by amlodipine coadministration, but mean half-life was slightly prolonged from 18.5 to 20.9 h. Geometric least-squares mean (GLSM) ratios for Cmax, area under the plasma concentration–time curve (AUC) from zero to last measurable concentration and from zero to infinity for esaxerenone + amlodipine versus esaxerenone were 0.958, 1.154, and 1.173, respectively. Study 2: corresponding GLSM ratios for amlodipine + esaxerenone versus amlodipine were 1.099, 1.185, and 1.214. Study 3: esaxerenone did not markedly alter digoxin PK. GLSM ratios for Cmax, trough plasma concentration, and AUC during a dosing interval for digoxin versus esaxerenone + digoxin were 1.130, 1.088, and 1.072, respectively.

Conclusions

No drug–drug interactions are expected during combination therapy with esaxerenone and either amlodipine or digoxin, based on a lack of any clinically relevant PK changes.

Trial registration

Studies 1 and 2: JapicCTI-163379 (registered on 20 September 2016); Study 3: JapicCTI-163443 (registered on 24 November 2016).
Living donor domino liver transplantation in a hepatitis C virus/human immunodeficiency virus-coinfected hemophilia patient: a case report
Authors: Yamamoto Hidekazu , Sugawara Yasuhiko , Sambommatsu Yuzuru , Shimata Keita , Yoshii Daiki , Isono Kaori , Honda Masaki , Yamashita Taro , Matsushita Shuzo , Inomata Yukihiro , Hibi Taizo
Published: July 2020

Background

Outcome of the liver transplantation (LT) is worse in hepatitis C virus (HCV)/human immunodeficiency virus (HIV)-coinfected patients compared to patients infected with HCV alone. We report the world’s first case of living donor domino liver transplantation (LDDLT) using a familial amyloid polyneuropathy (FAP) liver in a coinfected recipient with HCV-related liver cirrhosis.

Case presentation

The recipient was a 43-year-old male with a CD4 cell count of 52/μL and undetectable HIV-RNA at the time of LT. He received a domino liver graft from a 41-year-old female with FAP. No acute cellular rejection or infection occurred after LT. HCV recurrence was confirmed histologically on the posttransplant day 34. Peginterferon/ribavirin therapy resulted in non-response; however, the patient achieved a sustained viral response with sofosbuvir (SOF)/ledipasvir (LDV). Currently, HCV and HIV testing are negative, and symptomatic de novo amyloidosis has not occurred.

Conclusions

LDDLT allows successful LT in HCV/HIV-coinfected patients; posttransplant HCV recurrence can be successfully treated with anti-viral therapy.
Vitamin D and early rheumatoid arthritis
Authors: Harrison Stephanie R. , Jutley Gurpreet , Li Danyang , Sahbudin Ilfita , Filer Andrew , Hewison Martin , Raza Karim
Published: July 2020

Background

Previous studies have linked rheumatoid arthritis (RA) risk and disease activity with vitamin D-deficiency (low serum 25-hydroxyvitamin D (25OHD)), but a causal role for vitamin D in RA is still unclear, with conflicting results from many previous studies, partly due to heterogeneity in study design and patient populations. In this study we aimed to (1) analyse serum 25OHD in early inflammatory arthritis, (2) compare 25OHD with disease activity and fatigue in early RA and (3) determine whether low 25OHD is associated with progression to RA.

Methods

An analysis of 790 patients recruited to the Birmingham Early Inflammatory Arthritis Cohort and followed longitudinally to determine clinical outcomes. The following were recorded at baseline: demographic data, duration of symptoms, duration of early morning stiffness (EMS), tender and swollen joint counts, Visual Analogue Scale (VAS) pain/fatigue/EMS, PHQ-9, HAQ and FACIT-Fatigue scores, DAS28-ESR, DAS28-CRP, CRP, ESR, anti-CCP antibody status, rheumatoid factor status, and serum 25OHD (ng/ml). Diagnosis was recorded at 0 and 12 months onwards as either RA, Undifferentiated Inflammatory Arthritis (UIA; synovitis not meeting other classification/diagnostic criteria), Clinically Suspect Arthralgia (CSA; arthralgia of an inflammatory type without synovitis), or Other.

Results

Baseline demographic data were similar between all groups, with median symptom duration of 16.8–34.0 days. Baseline 25OHD was not significantly different between groups [median, interquartile range (IQR): RA 46.7, 30.0–73.3; UIA 51.4, 30.0–72.3; CSA 47.7, 30.3–73.0; Other 39.9, 28.6–62.2]. In RA (n = 335), there were no significant differences between 25OHD and measures of disease activity or fatigue. No association between 25OHD and progression from UIA or CSA to RA was observed.

Conclusions

There was no clear association between serum 25OHD and baseline diagnosis, RA disease activity, or progression from UIA or CSA to RA. Future studies of other vitamin D metabolites may better define the complex role of vitamin D in RA.
Management of failed UKA to TKA: conventional versus robotic-assisted conversion technique
Authors: Yun Andrew G. , Qutami Marilena , Chen Chang-Hwa Mary , Pasko Kory B. Dylan
Published: July 2020

Background

Failure of unicompartmental knee arthroplasty (UKA) is a distressing and technically challenging complication. Conventional conversion techniques (CCT) with rods and jigs have produced varying results. A robotic-assisted conversion technique (RCT) is an unexplored, though possibly advantageous, alternative. We compare our reconstructive outcomes between conventional and robotic methods in the management of failed UKA.

Methods

Thirty-four patients with a failed UKA were retrospectively reviewed. Patients underwent conversion total knee arthroplasty (TKA) with either a CCT or RCT. Seventeen patients were included in each group. All procedures were done by a single surgeon at a single institution, with a mean time to follow-up of 3.6 years (range, 1 to 12). The primary outcome measures were the need for augments and polyethylene thickness. Secondary outcome measures were complications, need for revision, estimated blood loss (EBL), length of stay, and operative time.

Results

The mean polyethylene thickness was 12 mm (range, 9 to 15) in the CCT group and 10 mm (range, 9 to 14) in the RCT groups, with no statistical difference between the two groups (P = 0.07). A statistically significant difference, however, was present in the use of augments. In the CCT group, five out of 17 knees required augments, whereas none of the 17 knees in the RCT group required augments (P = 0.04). Procedurally, robotic-assisted surgery progressed uneventfully, even with metal artifact noted on the preoperative computerized tomography (CT) scans. Computer mapping of the residual bone surface after implant removal was a helpful guide in minimizing resection depth. No further revisions or reoperations were performed in either group.

Conclusions

Robotic-assisted conversion TKA is technically feasible and potentially advantageous. In the absence of normal anatomic landmarks to guide conventional methods, the preoperative CT scans were unexpectedly helpful in establishing mechanical alignment and resection depth. In this limited series, RCT does not seem to be inferior to CCT. Further investigation of outcomes is warranted.
Intratumoral hyperthermic chemotherapy injection in peripheral non-small cell lung cancer
Authors: Tohlob Mohamed A. , Suliman Lucy A. , Elmorsy Ahmed S. , Ibrahim Mohamed A. , Hewidy Asem A.
Published: July 2020

Background

Intratumoral chemotherapy (ITC) has been used by many groups; the combination of heat and cytotoxic drugs increases the ability to destroy the malignant cells. The aim of this study was to assess the efficacy and safety of percutaneous injection of hyperthermic chemotherapy in conjunction with systemic chemotherapy as a palliative management of peripheral inoperable non-small cell lung cancer (NSCLC) compared to conventional systemic chemotherapy.

Results

There was a statistically significant improvement in quality of life score in group A and B, but deterioration in group C after 6 months. As regards radiology, after 6 months in group A, one patient (10%) showed complete response, 6 patients (60%) showed partial response, one patient (10%) stable response, and two patients (20%) showed progression; in group B, 6 patients (60%) showed partial response, two patients (20%) showed stable response, and two patients (20%) showed progression; and in group C, 7 patients (70%) showed progression, two patients (20%) showed partial response, and one patient (10%) showed stable response. There were few controllable complications. Median survival in group A was 16 months, in group B was 15 months, and in group C was 8 months.

Conclusion

Intratumoral hyperthermic chemotherapy is a promising, effective, harmless palliative therapy for inoperable peripheral NSCLC.
Youth Enfranchisement, Political Responsiveness, and Education Expenditure: Evidence from the US
Authors: Bertocchi Graziella , Dimico Arcangelo , Lancia Francesco , Russo Alessia
Published: July 2020

We examine the link between the political participation of the young and fiscal policies in the United States. We generate exogenous variation in participation using the passage of preregistration laws, which allow the young to register before being eligible to vote. After documenting that preregistration promotes youth enfranchisement, we show that preregistration shifts state government spending toward higher education, the type of spending for which the young have the strongest preference. A 1 percent increase in youth voter turnout generates a 0.77 percent increase in higher education spending. The results collectively suggest political responsiveness to the needs of the newly enfranchised constituency. (JEL D72, E62, H52, H75, I23, I28, J13)
Taxing Hidden Wealth: The Consequences of US Enforcement Initiatives on Evasive Foreign Accounts
Authors: Johannesen Niels , Langetieg Patrick , Reck Daniel , Risch Max , Slemrod Joel
Published: July 2020

In 2008, the IRS initiated efforts to curb the use of offshore accounts to evade taxes. This paper uses administrative microdata to examine the impact of enforcement efforts on taxpayers’ reporting of offshore accounts and income. We find that enforcement caused approximately 50,000 individuals to disclose offshore accounts with a combined value of about $100 billion. Most disclosures happened outside offshore voluntary disclosure programs by individuals who never admitted prior noncompliance. Disclosed accounts were concentrated in countries often characterized as tax havens. Enforcement-driven disclosures increased annual reported capital income by $2–$4 billion, corresponding to $0.6–$1.2 billion in additional tax revenue. (JEL H24, H26, K34)
Automated Monte-Carlo re-calculation of proton therapy plans using Geant4/Gate: implementation and comparison to plan-specific quality assurance measurements
Authors: Aitkenhead Adam H , Sitch Peter , Richardson Jenny C , Winterhalter Carla , Patel Imran , Mackay Ranald I
Published: July 2020

Objectives:

Software re-calculation of proton pencil beam scanning plans provides a method of verifying treatment planning system (TPS) dose calculations prior to patient treatment. This study describes the implementation of AutoMC, a Geant4 v10.3.3/Gate v8.1 (Gate-RTion v1.0)-based Monte-Carlo (MC) system for automated plan re-calculation, and presents verification results for 153 patients (730 fields) planned within year one of the proton service at The Christie NHS Foundation Trust.

Methods:

A MC beam model for a Varian ProBeam delivery system with four range-shifter options (none, 2 cm, 3 cm, 5 cm) was derived from beam commissioning data and implemented in AutoMC. MC and TPS (Varian Eclipse v13.7) calculations of 730 fields in solid-water were compared to physical plan-specific quality assurance (PSQA) measurements acquired using a PTW Octavius 1500XDR array and PTW 31021 Semiflex 3D ion chamber.

Results:

TPS and MC showed good agreement with array measurements, evaluated using γ analyses at 3%, 3 mm with a 10% lower dose threshold:>94% of fields calculated by the TPS and >99% of fields calculated by MC had γ ≤ 1 for>95% of measurement points within the plane. TPS and MC also showed good agreement with chamber measurements of absolute dose, with systematic differences of <1.5% for all range-shifter options.

Conclusions:

Reliable independent verification of the TPS dose calculation is a valuable complement to physical PSQA and may facilitate reduction of the physical PSQA workload alongside a thorough delivery system quality assurance programme.

Advances in knowledge:

A Gate/Geant4-based MC system is thoroughly validated against an extensive physical PSQA dataset for 730 clinical fields, showing that clinical implementation of MC for PSQA is feasible.
Updates in rare and not-so-rare complications of acromegaly: focus on respiratory function and quality of life in acromegaly
Authors: Langlois Fabienne , Suarez Gabriela M. , Fleseriu Maria
Published: July 2020

Acromegaly is a complex disease with excessive growth hormone and insulin-like growth factor 1 (IGF-1) causing multisystem effects, particularly cardiovascular, respiratory, and metabolic. Psychological concerns and poor quality of life (QoL) are also major disease consequences. This review is intended for clinicians and focuses on the latest developments related to respiratory and QoL effects of long-term growth hormone excess. Along with biochemical disease control, patient treatment satisfaction and outcomes have become major treatment objectives; current knowledge and tools to evaluate and manage this aspect of the disease are described. Sleep apnea syndrome and other derangements of lung function and apparatus, from pathophysiology to treatment, and evaluation tools and determinants of QoL in patients with acromegaly are discussed.
Raising awareness of seizure triggers and pre-seizure behaviour changes in dogs
Authors: Packer Rowena
Published: July 2020

A new study by the Royal Veterinary College (RVC) has identified pre-seizure behavioural changes and potential seizure triggers that may help owners predict when a seizure is going to occur. The RVC's animal behaviour scientist Dr Rowena Packer explains.
DNA Fingerprinting of Wolves
Authors: Rabenold Patricia , De Gortari Mauricio
Published: July 2020

There are proposals to reintroduce (Canis lupus) to Yellowstone National Park through translocation of individuals from other populations. Ideally, these wolves should have a genotype similar to that possessed by the subspecies previously found in the Park. This genetic similarity would enhance the probability that genetically based adaptations to the environment of the Park were present, and thus enhance the likelihood that a viable population would be established with minimum animals and effort. Concern has been expressed about preserving the genetic purity of potentially translocated wolves. A genetic test which would permit differentiation between restored pure wolves and clandestinely introduced ones, as well as between pure wolf and wolf x coyote, and wolf x dog hybrid genotypes would be valuable. Furthermore, it is important to understand the power of DNA fingerprinting as a tool for monitoring breeding structure of the restored pack(s) at intervals subsequent to their release in Yellowstone.
The Interaction of Fire, Vegetation, and Large Mammalian Herbivores on Ecosysystem Processes in Yellowstone National Park
Authors: Tracy Benjamin , McNaughton Samuel
Published: July 2020

There is considerable evidence that interactions among fire, large mammals and vegetation exist in Yellowstone National Park. These interactions are likely complex, and discerning their nature will provide valuable information about basic ecosystem processes in the Park. The fires of 1988 have given us an excellent opportunity to evaluate potential interactions and consequently; provide additional information to resource managers regarding the importance of these factors in ecosystem dynamics.
Index
Authors: Boyce Mark , Plumb Glenn
Published: July 2020

This section contains the index for the 14th Annual Report, 1990.
Paleontological Survey of the Jurassic Morrison Formation in Dinosaur National Monument
Authors: Engelmann George
Published: July 2020

This project was undertaken to survey the surface exposures of the Jurassic Morrison Formation within Dinosaur National Monument (DNM) for fossil occurrences of any sort. The primary purpose of this survey is to provide an assessment of the extent and characteristics of the paleontological resource in this geologic formation within DNM. In so doing, the survey may also have the effect of discovering specimens of obvious and immediate scientific importance and providing observations that will contribute to an improved understanding of the stratigraphy of the Morrison Formation. Dinosaur National Monument was originally established for, and takes its name from the unique occurrence of a quarry (the Carnegie Quarry (CQ) that has produced a diverse and abundant dinosaur fauna. The CQ occurs within the Morrison Formation which is known worldwide as one of the most prolific dinosaur-bearing units in the paleontologic record (Colbert. 1968). In addition to the dinosaurs, the Morrison has produced the best represented fauna of early mammals from the Jurassic (Clemens et al. 1979) and fossils of other vertebrates (Chure & Engelmann 1989). This suggests that the area beyond the CQ at DNM may contain important paleontological resources. This project will provide the first systematic survey of the Morrison Formation within DNM. It will provide a basis for management of the paleontologic resource in the future and is likely to yield immediate results in the discovery of specimens that can be important to ongoing research projects.
Changes in Geomorphic Processes in the Snake River Following Impoundment of Jackson Lake and Potential Changes Due to 1988 Fires in the Watershed
Authors: Marston Richard
Published: July 2020

The purpose of this three-year study is to describe, explain and predict changes in the geomorphology of the Snake River (from Jackson Lake Dam to Moose) and related changes in riparian vegetation due to Jackson Lake Dam and 1988 fires in the watershed. Specific objectives are to determine changes over time and space in: 1) sediment mobilization on hillslopes from rainsplash and overland flow; 2) sediment delivery to streams from slope failures; 3) equilibrium condition and relative stability of the Snake River; and 4) extent of various riparian vegetation communities in the Snake River floodplain.
Habitat Distribution of Small Mammal Communities in Grand Teton National Park
Authors: Stanton Nancy , Buskirk Steven , Miller Steven
Published: July 2020

One primary objective of this study was to survey small mammal communities in a burn chronosequence. During the summer of 1990, small mammals were live-trapped in five burned sites and in adjacent unburned coniferous forests in and around Grand Teton National Park. In 1991, two burns (Huckleberry Mountain, 1988 fires) and adjacent unburned forests were trapped for the third consecutive year in June, July and August to continue to monitor post-burn small mammal population trends and species composition. In addition, in 1991 rodents were live-trapped from seven vegetation types along an elevational gradient, and microhabitat measurements were made at successful and unsuccessful trap stations within each vegetation type. The purpose was to survey small mammal communities in common habitat types within the Park and to determine whether microhabitat features can be used to predict trap success for common rodent species.
The Interaction of Fire, Vegetation and Large Mammalian Herbivores, on Ecosystem Processes in Yellowstone National Park
Authors: Tracy Benjamin , McNaughton Samuel
Published: July 2020

There is substantial observational evidence suggesting positive interactions among fire, vegetation and large mammalian herbivores within Yellowstone National Park. The purpose of this research project is to quantify these potential interactions and explain their interactive effects on ecosystem processes (e.g. nutrient cycling). The basic study design utilizes burned areas from the 1988 fires with adjacent unburned areas to comparatively quantify ecosystem process information. Two paired study sites were chosen in three locations (Hellroaring Slope, Swan Lake Flat and Hayden Valley) representing winter, transitional and summer range for portions of the Northern elk herd. All study sites can be characterized as mesic sagebrush steppe dominated by the grasses Festuca idahoensis and Agropryron spp.
Postglacial Fire Frequency and its Relation to Long Term Vegetational and Climatic Changes in Yellowstone Park
Authors: Whitlock Cathy , Millspaugh Sarah
Published: July 2020

The paleoecologic record provides unique insights into the response of coinmunities to environmental perturbations of different duration and intensity. Climate is a primary agent of environmental change and its long-term effect on the vegetation of the Yellowstone region is revealed in a network of pollen records. Fire frequency is controlled by climate, and as climate changes so too does the importance of fire in shaping and maintaining spatia\l patterns of vegetation. The prehistoric record of Yellowstone's northern range, for example, shows the response of vegetation to an absence of major fires in the last 150 years (Whitlock et al. 1991; Engstrom et al. 1991). In longer records spanning the last 14,000 year8, periods of frequent fires are suggested â¢ by sediments containing high percentages of fire-adapted trees and high amounts of charcoal (Bamosky et al. 1987).
Historical Vegetation, Fuel Loads, and Integrated Resource Information System for Bryce Canyon National Park
Authors: Roberts David , Jenkins Michael , Wight Doug
Published: July 2020

The composition and distribution of plant communities across a natural landscape is determined by a complex interaction of environment, interspecies relations and disturbance. Environmental factors associated with particular locations, such as precipitation and temperature regimes, limit the species which can occur at a given site to those with a metabolism suited to the environmental conditions. These environmental factors, while variable across the landscape, are relatively constant at a fixed point in space. Consequently, environment acts as a relatively constant constraint on vegetation distribution and composition. Within the usually large set of species which can exist at a given point, interspecies competition further limits the species present at a given time. The ecological characteristics of the species are also rather fixed, and the interspecies relations lead to a fairly directional and predictable change with time, i.e. succession. Disturbance reduces or eliminates some species directly, and leads indirectly to changes in composition through changes in the competitive hierarchy. In contrast to environmental and interspecies effects, the occurrence and effects of disturbance are highly variable, and depend in a complex way on previous disturbance and the current and previous vegetation. Historically, fire played an enormous role in determining the characteristics of vegetation in western forests. Additionally, fire suppression has preserved species which would have been reduced or eliminated under a regime of repeated burning, and has led to an increase in fuel loads in many natural communities. The high fuel loads cause relatively severe fires when fires do occur, causing relatively greater disturbance than occurred in the historical past. The results of these high intensity fires are very different from low intensity fires, with increased mortality of even fire-tolerant species, and occasionally catastrophic results. To evaluate the current landscape with reference to the historic landscape information is needed in several related areas. First, more baseline information is required on the historic vegetation mosaic. Specifically, what was the distribution of plant communities on the historic landscape, and what was the typical composition of these communities? Second, how does the pattern compare to the current pattern and how is this relation affected by the vegetation potential of the environment and the interspecies relations? How can natural ecosystem processes, including fire, be reintroduced so as to return the vegetation mosaic to one more similar to the historic vegetation mosaic? How can the guidelines which emerge from this information be implemented in an operational and spatially-explicit manner? These information needs are best met through a comprehensive information system incorporating the basic ecological relations of the vegetation and environment, fuel load accumulation, and fire behavior models.
Temperature Variation and Species Interactions in Aquatic Systems in Grand Teton National Park
Authors: Woodward Bruce , Mitchell Sandra
Published: July 2020

Temperature variation and species interactions were examined in small montane ponds in Grand Teton National Park during summer 1991. Temperature variation was pronounced, both over time and from place to place within one pond or across ponds. The magnitude of the temperature variation is such that it is likely to lead to large differences in the growth rates of poikilotherms that occupy these ponds. Growth rates determine body sizes at any one point in time. Tadpole body size influenced the probability of predation by salamander larvae in these montane ponds in Grand Teton National Park. Given the natural body size ratios of predator and prey (observed in 1991}, salamanders biased predation towards smaller tadpoles. Other predation experiments revealed that the salamander larvae biased predation towards tadpoles and away from damselfly naiads. This suggests that damselflies may experience lower predation by salamanders when in the presence of tadpoles than when in the absence of tadpoles. Several species, including snails, caddisfly larvae, and tadpoles were very abundant in some ponds, but could be essentially absent from others. These three taxa appear to share similar diets. A simple experiment revealed the Pseudacris tadpoles and the snails compete, and that presence of salamander larvae had no effect on the strength of their competitive interaction.
Remote Sensing of Vegetation Recovery in Grasslands After th 1988 Fires
Authors: Merrill Evelyn , Marrs Ron
Published: July 2020

Traditional methods for measurement of vegetative biomass can be time-consuming and laborÂ­intensive, especially across large areas. Yet such estimates are necessary to investigate the effects of large scale disturbances on ecosystem components and processes. One alternative to traditional methods for monitoring rangeland vegetation is to use satellite imagery. Because foliage of plants differentially absorbs and reflects energy within the electromagnetic spectrum, remote sensing of spectral data can be used to quantify the amount of vegetative biomass present in an area (Tucker and Sellers 1986). In 1987 we found that Landsat Multispectral Scanner (MSS) imagery could be used to quantify green herbaceous phytomass (GHP) on ungulate summer range in the northeastern portion of Yellowstone National Park. Estimates of GHP in the study area were well within values reported for the habitat types sampled (Mueggler and Steward 1980). Annual variation in GHP was related to winter snow accumulation probably due to the timing of snow melt (Merrill et al. 1988). Additionally, we found that GHP explained a significant amount of the variation in the per capita growth rate of elk population from 1972 to 1987 (Merrill and Boyce 1991). The extensive fires that occurred in the Park in the summer of 1988 provided an opportunity to determine whether remote sensing could be used to monitor grassland vegetation recovery in the Park and to explore the effects of the 1988 fires on ungulate populations using models we developed in 1987. Previous studies have used Landsat imagery to monitor succession of seral stages after fire in pine (Jakubauskas et al. 1990), but no studies to our knowledge have used this approach to quantify herbaceous recovery in grasslands. The objectives during this study period were: (1) to develop and validate a model for predicting GHP in sagebrush-grassland communities using 1989-91 Landsat TM spectral information and field data on GHP; and (2) to describe broad-scale vegetation recovery in burned areas and physiographic and soil features which influence the recovery.
Postglacial Fire Frequency and its Relation to Long-Term Vegetational and Climatic Changes in Yellowstone Park
Authors: Whitlock Cathy
Published: July 2020

The primary research objective has been to study the vegetational history of Yellowstone and its sensitivity to changes in climate and fire frequency. To establish a sequence of vegetational changes, a network of pollen records spanning the last 14,000 years has been studied from different types of vegetation within the Park. The relationship between modern pollen rain, modern vegetation and presentÂ­day climate in the northern Rocky Mountains has been the basis for interpreting past vegetation and climate from the fossil records. Changes in fire regime during the past 14,000 years have been inferred from sedimentary charcoal and other fire proxy in lake sediments. Calibration of the fire signal is based on a study that measures the input of charcoal into lakes following the 1988 fires in Yellowstone.