bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolution, Societal Sexism, and Universal Average Sex Differences in Cognition and Behavior
Authors: Ellis Lee
Published: March 2018

During the past century, social scientists have documented many cross-cultural sex differences in personality and behavior, quite a few of which now appear to be found in all human societies. However, contrary to most scientists’ expectations, these so-called universal sex differences have been shown to be more pronounced in Western industrial societies than in most non-Western developing societies. This chapter briefly reviews the evidence bearing on these findings and offers a biologically based theory that could help shed light on why cross-cultural sex differences exist. The following hypothesis is offered: The expression of many genes influencing sexually dimorphic traits is more likely among descendants of couples who are least closely related to one another. If so, societies in which out-marriage is normative (i.e., Western industrial countries) will exhibit a stronger expression of genes for sexually dimorphic traits compared to societies in which consanguineal marriages are common.
Evolutionary Theory and Criminology
Authors: Walsh Anthony , Jorgensen Cody
Published: March 2018

Evolutionary criminology is part of a broader biosocial approach to criminology. The evolutionary perspective can help organize the hodgepodge of extant, and often contradictory, criminological theories in a coherent way, thus providing a more robust explanation of criminality. This chapter demonstrates the relevance of evolutionary theory to criminology, discusses the evolutionary origins of both prosocial and antisocial traits, and shows that evolutionary theory is invaluable to understanding two key issues that have been impervious to solution using the standard social science model—the sex ratio in criminal offending and the age–crime curve. The chapter also provides a discussion on the distal causes of traits conducive to criminal behavior as well as a Darwinian explanation of why humans can be altruistic toward some humans yet victimize others.
DNA Is Not Destiny
Authors: McDermott Rose , Hatemi Peter K.
Published: March 2018

Genetic influences are often misinterpreted to mean that an individual with a particular genotype is inevitably predisposed to engage in a given behavior or that genetic influences operate outside of human agency and social context. This chapter undertakes a qualitative investigation of a genetically informed (MAOA) sample to illustrate the critical differences between population estimates and individual accountability. The sample includes those whose lives have revolved around violence (e.g., gang members) and those whose lives are committed to peace (e.g., Buddhist monks). It is found that genotype alone cannot predict any one individual’s social behaviors, and it is argued that any decisions or legal precedents targeted toward predicting how a specific individual may act based on his or her DNA sequence require a more nuanced appreciation of how social factors, genetic dispositions, and personal experience intertwine in the context of human agency.
On the Need for a Nuanced Understanding of “Community” in Heritage Policy and Practice
Authors: Mulligan Martin
Published: March 2018

The alleged benefits of community participation in cultural resource management has been an article of faith in the international heritage community since the early 1990s, yet the ambiguous and multi-layered concept of community is commonly deployed uncritically. This chapter argues that “community” should be seen as an open-ended, never complete process rather than end-product. It suggests that heritage practitioners inevitably contribute to the creation of a sense of community at scales ranging from the local to the national. The projection of community identities can enhance or undermine social cohesion at and across geographic scales and the chapter argues that heritage practitioners need to work with a nuanced understanding of their role in the creation of community identities. The link between heritage values and community formation remains powerful but the power needs to be unleashed with due diligence.
Problematizing the Idea of Heritage Management
Authors: Dantas de Figueiredo Marina
Published: March 2018

This chapter aims to problematize heritage management, focusing on the way it came to be framed and how it turned into a practice with different orientations in the academic fields of heritage studies and public archaeology. Both heritage and management are concerned with value, but in distinct yet complimentary ways. These two perspectives are not oppositional, but counterparts entwined around one elemental fact: the social and moral transformations that have made the idea of “management” to be closer to the idea of “business” in the present day. The intellectual effort of such problematizing process seeks to develop a line of reasoning through which heritage management can be understood and undertaken as a complex practice. While acknowledging the importance of the maintenance of heritage value in the dynamics of contemporary societies, this chapter concludes that heritage management in its most basic sense is a concept that needs further theorizing.
The Special Responsibility of Public Spaces to Dismantle White Supremacist Historical Narratives
Authors: Burgard Karen L. B. , Boucher Michael L.
Published: March 2018

Public historical spaces hold a powerful role in the teaching of a regional and national heritage curriculum. Those public sites, markers, museums, and monuments provide the narrative from which citizens conceptualize the past and they comprise a curriculum of American history. However, the calculated and intentional omission of the histories and identities of marginalized and oppressed people creates an unequal, ahistorical void that is filled by the hegemonic normality of the White supremacist narrative, creating a curriculum of White supremacy. Using research of historical understanding, racialized historical understanding, historical understanding in museums and public spaces, and the concept of erasure in history, this chapter investigates the important role public spaces play in presenting a holistic and complete historical narrative that goes beyond the additive models of multiculturalism and preserves the culture and heritage of all peoples.
Public Heritage and the Promise of the Digital
Authors: Kidd Jenny
Published: March 2018

The “promise” of the digital has been a democratization of the notion of heritage, and a disruption of ideas about ownership, authorship, and authenticity that might have seemed more straightforward in the recent past. This chapter overviews the possibilities brought about by these developments before introducing a series of ethical questions that they bring sharply into focus for museum and heritage practitioners. It appraises three practices which exemplify this conflicted terrain and demonstrate the issues at stake: heritage institutions’ uses of social media, crowd-based methods, and immersive mobile encounters. The chapter concludes that reflexivity is fast becoming a core professional competency for those working in digital heritage contexts.
Emotion Dysregulation and Internalizing Spectrum Disorders
Authors: Hostinar Camelia E. , Cicchetti Dante
Published: March 2018

Emotion dysregulation is a pattern of emotional experience or expression that interferes with goal-directed behavior, and may set children and adolescents on developmental trajectories toward psychopathology. Despite accumulating evidence linking emotion dysregulation to various forms of internalizing psychopathology (e.g., depression, anxiety), several open questions remain. What are the developmental pathways leading to emotion dysregulation and modifiable environmental conditions that appear to foster it? What is the evidence that emotion dysregulation precedes or plays a causal role in the development of internalizing spectrum disorders? What are the biological underpinnings of emotion dysregulation, and how can we integrate this research with recent discoveries about internalizing spectrum disorders from neuroscience, psychophysiology, genetics, and epigenetics? This review discusses recent research pertinent to these three primary questions and concludes with suggestions for future research and implications for interventions that promote resilience in youth.
Treating Emotion Dysregulation in Internalizing Disorders
Authors: Kehoe Christiane , Havighurst Sophie
Published: March 2018

Dysregulation of emotions is a core feature of virtually all internalizing disorders. This chapter reviews the literature on relations between emotion dysregulation and internalizing disorders, with specific attention to the treatment of emotion dysregulation as a transdiagnostic focus. It describes several commonly used therapy approaches, considering how each targets emotion dysregulation. It also reviews the efficacy of programs with regard to reducing maladaptive emotion regulation strategies. Finally, it outlines how parent emotion dysregulation is targeted in emotion socialization parenting programs (the Tuning into Kids suite of programs). These programs provide parents with skills to manage their and their children’s emotions effectively. The chapter finishes with summarizing how treatments for emotion dysregulation may be strengthened.
Delivering DBT in an Inpatient Setting
Authors: Fox Emily
Published: March 2018

This chapter reviews the literature on DBT provision in inpatient units and shows that shorter-term DBT programmes tend to focus on the acquisition of a limited repertoire of DBT skills and teach these skills intensively. It also focuses on longer-term DBT programmes that structure the environment with a particular emphasis on managing risk through clear protocols, and provides examples. It discusses how treatment hierarchies need to focus on decreasing behaviours that led to admission and increasing those necessary to effect discharge. It describes common problems to delivering DBT in the milieu, e.g., the ways in which inpatient programmes have to work harder to establish the patient’s life-worth-living off the unit, and to ensure the generalisation of DBT skills to the real world, and offers solutions. Some dialectical dilemmas in inpatient settings mirror those in Rathus and Miller’s adolescent treatment model, and ‘splitting’ of staff can be redefined in behavioural terms, and addressed using DBT principles.
Evidentiality
Authors: Aikhenvald Alexandra Y.
Published: March 2018

This chapter sets out semantic and analytic parameters for understanding evidentials—closed grammatical sets whose main meaning is information source. A noun phrase may have its own evidentiality specification, different from that of a verb. Other means of expressing information source offer open-ended options in terms of their semantics, and can be more flexible in their scope. Evidentiality is distinct from tense, aspect, modality, mirativity, and egophoricity. An evidential can be questioned or be within the scope of negation. The concept of evidentiality is different from the lay person’s notion of ‘evidence’. Evidentiality involves numerous semantic parameters and cannot be reduced to a simplistic ‘direct’ versus ‘indirect’ opposition. Evidentiality needs to be worked out inductively, based on painstaking work with primary materials on a language, rather than on translation and elicitation. Guidelines for fieldworkers investigating evidentials are offered in the Appendix, alongside a glossary of terms.
The Interactional and Cultural Pragmatics of Evidentiality in Pastaza Quichua
Authors: Nucholls Janis B.
Published: March 2018

This paper analyses the interactional and pragmatic effects of two evidential enclitics in the Pastaza Quichua language of Amazonian Ecuador. Attention is also given to represented discourse in a variety of genres. The overall goal is a better understanding of the perspectival encoding of experience through evidential enclitics and represented discourse, and the role of these devices in articulating concepts of sociability and politeness principles. A broader aim is to clarify how discourse practices making use of evidentiality and represented discourse may clarify Quichua peoples’ understandings of their relationships with each other and with non-human nature. Finally, this paper points to the need for future work which attempts to disentangle evidentiality from epistemic modality in Pastaza Quichua by suggesting that epistemic modality may be generated from evidentials as an implicature that depends in part on intonation.
Evidentiality and the Cariban Languages
Authors: Carlin Eithne B.
Published: March 2018

This chapter investigates the phenomenon of evidentiality in two Cariban languages, showing that the statement of source of information is not only a matter of grammatical expression, rather as a category it permeates the cultures of these Cariban peoples. Trio and Wayana distinguish a witnessed versus non-witnessed evidentiality pattern. Wayana has an additional reportative marker that has developed out of the non-witnessed form. This chapter looks into the use of evidentials in everyday speech as well as in oral traditions and shows how Trio and Wayana storytellers use evidential forms as a perspectivization strategy to position themselves vis-à-vis the source of information contained in the narratives. In addition, this chapter shows how the discourse of shamanic journeying is distinguishable from that of a speaker who has entered into an altered state of consciousness, such as coma, sleep-state and the like.
Evidentiality in the Languages of New Guinea
Authors: Sarvasy Hannah
Published: March 2018

While most languages spoken on the island of New Guinea lack grammatical evidentiality, attested evidentiality systems are diverse. These range from small systems with only one marked evidentiality category to systems in which five or more categories are marked. Minimal systems mark only reported, only non-firsthand, or only inferred evidentiality; maximal systems mark visual, non-visual sensory, inferred, reasoning, and factual/participatory or reported evidentiality. Most languages with well-developed grammatical evidentiality are found in a region of Papua New Guinea known as the Highlands Evidentiality Area. Several of these are noteworthy for marking timing of the perception event relative to the speech act.
Evidentiality in Formosan Languages
Authors: Pan Chia-jung
Published: March 2018

This chapter investigates evidentiality in Formosan languages. Five Formosan languages—Bunun, Paiwan, Kanakanavu, Saaroa, and Tsou—are discussed. Evidentiality in these languages is a grammatical category in its own right, and not a subcategory of epistemic or some other modality, or of tense-aspect. The system of grammatical evidentials in Formosan languages has a limited number of choices. Formosan languages with grammatical evidentials divide into types depending on how many information sources are assigned a distinct grammatical marking. Except for Tsou with the richest system of grammatical evidentials, other Formosan languages are relatively poor in evidentiality. In Formosan languages with grammatical evidentials, Tsou is the only language that requires information source to be obligatorily marked in grammar. Other Formosan languages optionally use evidentials in order to ensure efficient communication. This chapter is the first typological study of grammatical evidentiality in Formosan languages.
The Acquisition of Evidentiality
Authors: Fitneva Stanka A.
Published: March 2018

How do children learn the evidential system of their language? The primary goal of this chapter is to summarize existing research on this topic. Its secondary goal is to position this research within a broader framework of investigating language development focusing on the learner, the target language, and the environment as key explanatory factors. The chapter reviews both observational and experimental studies, the latter exploring the production and comprehension of evidentials as well as their use in assessing the reliability of information. This research provides insight primarily into the contributions of cognitive processes to children’s learning of evidentials. The data, however, also hint at how the environment, in particular socialization processes, could help children break the code of evidentials, suggesting that this may be the next frontier of research in the area.
Selfhood and Its Disorders
Authors: Parnas Josef , Henriksen Mads Gram
Published: March 2018

This article explores some of the major views of selfhood in modern philosophical and psychopathological literature, including the distinction between minimal-experiential and narrative-personal self, and it presents a simplified classification of how different levels of selfhood can be disturbed in different mental disorders. It proposes that schizophrenia spectrum disorders primarily involve a trait-like disturbance of the minimal-experiential self, which also may affect the coherence and stability of the narrative-personal self. Melancholia may involve some state-like disturbances of the minimal-experiential self, but with largely intact ipseity, and these disturbances appear here to be secondary to disorders of mood, temporality, and embodiment. Personality disorders outside the schizophrenia spectrum involve disturbances of the personal-narrative self and here the minimal-experiential self is never at stake. Finally, it offers some critical reflections on the epidemic-like rise of diagnoses such as dissociative disorders and depersonalization.
The Slave Trade and Coastal West Africa
Authors: Kelly Kenneth G.
Published: March 2018

The Atlantic slave trade has been the focus of archaeological work in a number of West African countries. Much of the work has emphasized the impressive trade castles of the Ghana coast, where extensive European constructions demonstrate the importance of the slave trade in the regions’ history. Work has also been conducted on other settings, including in Bénin, where African agency manifested itself differently than on the Gold Coast of modern Ghana; Sierra Leone and Gambia, where European trading establishments were typically smaller; and Guinea, where the ‘illegal’ slave trade of the nineteenth century blossomed. Many of these sites of enslavement have become important parts of local heritage, as well as a global heritage of African-descended people and the heritage tourism associated with the African Diaspora.
Shell Middens and Seashores
Authors: Jerardino Antonieta
Published: March 2018

Studies on Middle and Late Pleistocene hominin dietary adaptations have argued that aquatic foods played a key role during this evolutionary process. This chapter presents a summary account on the use and significance of marine resources, particularly shellfish, for early modern humans in southern Africa during oxygen isotope stages (OIS) 6–4. The methods used to identify, quantify, and compare archaeomalacological assemblages in South Africa and beyond, their drawbacks, as well as palaeoenvironmental, taphonomical and foraging considerations necessary to evaluate these data are discussed. The significance of diet broadening in the context of emerging modern humans about 160 ka and their exit out of Africa ~80–60 ka is reflected upon in the light of coastal adaptations by other early hominins groups elsewhere, such as Neanderthals in the Mediterranean Basin. The implications of longer residential permanence and higher population densities generally possible near productive shorelines are also examined.
Material Worlds
Authors: Hunter Fraser
Published: March 2018

This chapter considers material culture themes beyond any single region or country in order to look at recurring problems and possibilities across the European Iron Age. Often these are analogies (such as problems of taphonomic bias) rather than direct linkages, but large-scale issues in European prehistory are also considered, such as the development, selective adoption, and adaptation of new technologies, linkages to the Mediterranean world, and the role of art. Major areas of untapped research in the archaeology of the everyday are highlighted: the tools and other items which are often ignored beyond specialist reports can provide great insights into the changing lives of people in Iron Age Europe. Here, best practice in other areas and periods, along with experimental work, could cast fresh light on these fascinating material worlds.
Tank Mixing Fungicides for Effectiveness Against Eastern Filbert Blight of Hazelnut
Authors: Pscheidt J. W. , Heckert S. , Cluskey S. A.
Published: March 2018

Hazelnut (Corylus avellana) production in Oregon primarily occurs on cultivars susceptible to Anisogramma anomala, the causal agent of eastern filbert blight (EFB). Management of EFB involves planting resistant cultivars, removal of cankered limbs, and the application of fungicides. Tank mixes of demethylation-inhibiting (DMI; Fungicide Resistance Action Committee [FRAC] group 3) or quinone outside inhibitor (QoI; FRAC group 11) fungicides with chlorothalonil (FRAC group M5) at full or reduced rates were evaluated for effectiveness against A. anomala. The use of chlorothalonil in a mix with a DMI or QoI fungicide was an effective treatment for EFB even if each component of the mix was at half the labeled rate. Different liquid or dry formulations of chlorothalonil were equally effective in a tank mix for EFB control. The combination of propiconazole (FRAC group 3) tank mixed with trifloxystrobin (FRAC group 11) was not effective, whereas trees treated with propiconazole tank mixed with pyraclostrobin (FRAC group 11) resulted in significantly fewer EFB cankers compared with nontreated trees. When using tank mixes for EFB management, DMI fungicides should remain at full rates while mixing with a half-rate of chlorothalonil. In contrast, QoI fungicides and chlorothalonil could both be used at half-rates and still maintain acceptable EFB control. Tank mixing chlorothalonil with fungicides at risk of resistance development can help maintain consistent EFB control and should help prevent or delay the emergence of fungicide-resistant A. anomala isolates.
Neoscytalidium dimidiatum Causing Canker, Shoot Blight and Fruit Rot of Almond in California
Authors: Nouri Mohamed T. , Lawrence Daniel P. , Yaghmour Mohammad A. , Michailides Themis J. , Trouillas Florent P.
Published: March 2018

Almond trees with trunk and branch cankers were observed in several orchards across almond-producing counties in California. Symptoms of cankers included bark lesions, discoloration of xylem tissues, longitudinal wood necrosis, and extensive gumming. Spur and shoot blight associated with rotted fruit were detected in two orchards in Kern County. The fungus Neoscytalidium dimidiatum was consistently recovered from the various cankers, infected fruit, and blighted shoots and its identity was confirmed based on phylogenetic and morphological studies. Phylogenetic analyses of the internal transcribed spacer, translation elongation factor 1-α, and β-tubulin genes comparing 47 strains from California with reference specimens within the family Botryosphaeriaceae and coupled with detailed morphological observations validated the identity of the pathogenic fungus. Pathogenicity tests conducted in the field using 1- to 2-year-old branches inoculated with mycelium plugs or conidial suspensions and attached fruit inoculated with conidial suspensions fulfilled Koch’s postulates. N. dimidiatum appeared highly virulent in almond-producing cankers of up to 22 cm in length within 4 weeks using mycelium plug inoculations as well as severe fruit rot combined with spur blight on the fruit-bearing spurs. This study reports, for the first time, the fungus N. dimidiatum as a pathogen of almond in California causing canker, shoot blight, and fruit rot. Disease symptoms are described and illustrated.
Stable Fixation and Immediate Weight-Bearing After Combined Retrograde Intramedullary Nailing and Open Reduction Internal Fixation of Noncomminuted Distal Interprosthetic Femur Fractures
Authors: Hussain Mohammed S. , Dailey Steven K. , Avilucea Frank R.
Published: March 2018

With an aging population, treatment of interprosthetic femur fractures continues to pose a challenge to the orthopaedic surgeon. Retrograde intramedullary nailing combined with open reduction internal fixation using a tissue-preserving plating technique was used in our series of 9 patients with noncomminuted, distal femur fractures. No interfragmentary screws, cables, cerclage wires, or supplemental bone grafts of any type were used. Each patient initiated weight-bearing as tolerated after operative intervention. Every fracture healed at an average of 20 weeks (range 18–24 weeks). Use of a lateral locking plate combined with a retrograde intramedullary nailing enables immediate postoperative weight-bearing and stable fixation for patients with interprosthetic femur fractures.
Impact of Health Insurance Status on Prostate Cancer Treatment Modality Selection in the United States
Authors: Bledsoe Trevor J. , Park Henry S. , Rutter Charles E. , Aneja Sanjay , Nguyen Paul L. , Yu James B.
Published: March 2018

Objectives:

A variety of treatment modalities are available for the management of clinically localized prostate cancer in the United States. In addition to clinical factors, treatment modality choice may be influenced by a patient’s insurance status. Using a national data set, we investigated the relationship between insurance status and prostate cancer treatment modality selection among nonelderly men in the United States.

Methods:

Nonelderly men age 18 to 64 years treated for localized prostate cancer from 2010 to 2014 were identified within the National Cancer Database. Patients with no insurance, Medicaid, or private insurance were included. The χ2 and multivariable logistic regression analyses were used to evaluate the association of insurance status, other demographic and facility factors, and D’Amico risk classification with treatment modality.

Results:

We identified 135,937 patients with either no insurance (2.8%), Medicaid (4.2%), or private insurance (92.9%) treated for prostate cancer who underwent cancer-directed treatment or active surveillance between 2010 and 2014. Patients with private insurance were more likely to receive minimally invasive surgery (61.4% vs. 35.4%, respectively; P<0.001) and less likely to receive external beam radiotherapy (10.9% vs. 26.9%, respectively; P<0.001) than patients with no insurance. On multivariable analysis, among patients with no insurance and private insurance, private insurance was the strongest predictor of receipt of minimally invasive surgery (adjusted odds ratio, 2.61; 95% confidence interval, 2.44-2.79; P<0.001).

Conclusion:

Insurance status is a strong predictor of prostate cancer treatment modality among nonelderly men in the United States.
Use of prescription opioids before and after an operation for chronic pain (lumbar fusion surgery)
Authors: Deyo Richard A. , Hallvik Sara E. , Hildebran Christi , Marino Miguel , O'Kane Nicole , Carson Jody , Van Otterloo Joshua , Wright Dagan A. , Millet Lisa M. , Wakeland Wayne
Published: March 2018

Lumbar fusion surgery is usually prompted by chronic back pain, and many patients receive long-term preoperative opioid analgesics. Many expect surgery to eliminate the need for opioids. We sought to determine what fraction of long-term preoperative opioid users discontinue or reduce dosage postoperatively; what fraction of patients with little preoperative use initiate long-term use; and what predicts long-term postoperative use. This retrospective cohort study included 2491 adults undergoing lumbar fusion surgery for degenerative conditions, using Oregon's prescription drug monitoring program to quantify opioid use before and after hospitalization. We defined long-term postoperative use as ≥4 prescriptions filled in the 7 months after hospitalization, with at least 3 occurring >30 days after hospitalization. Overall, 1045 patients received long-term opioids preoperatively, and 1094 postoperatively. Among long-term preoperative users, 77.1% continued long-term postoperative use, and 13.8% had episodic use. Only 9.1% discontinued or had short-term postoperative use. Among preoperative users, 34.4% received a lower dose postoperatively, but 44.8% received a higher long-term dose. Among patients with no preoperative opioids, 12.8% became long-term users. In multivariable models, the strongest predictor of long-term postoperative use was cumulative preoperative opioid dose (odds ratio of 15.47 [95% confidence interval 8.53-28.06] in the highest quartile). Cumulative dose and number of opioid prescribers in the 30-day postoperative period were also associated with long-term use. Thus, lumbar fusion surgery infrequently eliminated long-term opioid use. Opioid-naive patients had a substantial risk of initiating long-term use. Patients should have realistic expectations regarding opioid use after lumbar fusion surgery.
Quantitative Elastography Versus Fine-needle Aspiration by Endoscopic Ultrasound for the Assessment of Pancreatic Solid Masses
Authors: Hernández Mondragón Oscar V. , Velez Resendiz Juan M. , Ruiz Rodolfo R.
Published: March 2018

Background and Aims:

Pancreatic solid masses (PSM) are difficult to assess; endoscopic ultrasound with fine-needle aspiration (FNA) enables tissue acquisition, but has high false-negative rates. Quantitative elastography (QE) predicts diagnosis on the basis of the strain ratio (SR). We aimed to compare both methods to evaluate PSM.

Materials and Methods:

This prospective study, carried out between January and December 2016, included suspected PSM cases; those with advanced disease and cystic components were excluded. Both procedures were performed; histologic information was obtained for the final diagnoses. Diagnostic tests and receiver-operating characteristic curve were calculated. P<0.05 was considered statistically significant.

Results:

We included 134 patients (53% women; mean, 53±16.2 y). The median tumor size was 30 (10 to 78) mm, with 69.4% and 30.6% malignant and benign tumors (median SR: 19.5 vs. 7.5; P=0.000), respectively, and 87% were pancreatic adenocarcinoma. QE with SR cutoff ≥10 showed similar parameters to FNA in both PSM types: sensitivity, 94% in both; specificity, 85% versus 87%; positive predictive value, 93% versus 94%; negative predictive value, 87% in both; and accuracy, 92% for malignant and sensitivity, 85% versus 87%; specificity, 94% in both; positive predictive value, 87% in both; negative predictive value, 93% versus 94%; and accuracy, 92% for benign. The area under the curve was 0.96 (P<0.000; 95% confidence interval, 0.940-0.995). New classifications on the basis of positive likelihood ratio were grouped as follows: A ≤8.7 (benign tumor); B >8.7 to <15.5 (indeterminate); and C ≥15.5 (malignant).

Conclusions:

QE has similar capacity to FNA in PSM evaluation. However, the former can be used potentially as a substitute of the latter in certain cases on the basis of these new SR cutoff-based classifications.
Implementing Statewide Severe Maternal Morbidity Review: The Illinois Experience
Authors: Koch Abigail R. , Roesch Pamela T. , Garland Caitlin E. , Geller Stacie E.
Published: March 2018

Context:

Severe maternal morbidity (SMM) rates in the United States more than doubled between 1998 and 2010. Advanced maternal age and chronic comorbidities do not completely explain the increase in SMM or how to effectively address it. The Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists have called for facility-level multidisciplinary review of SMM for potential preventability and have issued implementation guidelines.

Implementation:

Within Illinois, SMM was identified as any intensive or critical care unit admission and/or 4 or more units of packed red blood cells transfused at any time from conception through 42 days postpartum. All cases meeting this definition were counted during statewide surveillance. Cases were selected for review on the basis of their potential to yield insights into factors contributing to preventable SMM or best practices preventing further morbidity or death. If the SMM review committee deemed a case potentially preventable, it identified specific factors associated with missed opportunities and made actionable recommendations for quality improvement.

Evaluation:

Approximately 1100 cases of SMM were identified from July 1, 2016, to June 30, 2017, yielding a rate of 76 SMM cases per 10 000 pregnancies. Reviews were conducted on 142 SMM cases. Most SMM cases occurred during delivery hospitalization and more than half were delivered by cesarean section. Hemorrhage was the primary cause of SMM (>50% of the cases).

Discussion:

Facility-level SMM review was feasible and acceptable in statewide implementation. States that are planning SMM reviews across obstetric facilities should permit ample time for translation of recommendations to practice. Although continued maternal mortality reviews are valuable, they are not sufficient to address the increasing rates of SMM and maternal death. In-depth multidisciplinary review offers the potential to identify factors associated with SMM and interventions to prevent women from moving along the continuum of severity.
Root-Cause Analysis for Enhancing Public Health Emergency Preparedness: A Brief Report of a Salmonella Outbreak in the Alamosa, Colorado, Water Supply
Authors: Piltch-Loeb Rachael , Kraemer John , Nelson Christopher , Savoia Elena , Osborn David R. , Stoto Michael A.
Published: March 2018

To demonstrate how public health systems can use root-cause analysis (RCA) to improve learning from critical incidents, the research team utilized a facilitated look-back meeting to examine the public health systems' response to a Salmonella outbreak in the water supply in Alamosa, Colorado. We worked with public health, emergency management agencies, and other stakeholders to identify response challenges related to public health emergency preparedness capabilities, root causes, and lessons learned. The results demonstrate that RCA can help identify systems issues that, if addressed, can improve future responses. Furthermore, RCA can identify more basic issues that go beyond a specific incident or setting, such as the need for effective communication and coordination throughout the public health system, and the social capital needed to support it.
Just-in-Time Training of the Evidence-Based Public Health Framework, Oklahoma, 2016-2017
Authors: Douglas Malinda R. , Lowry Jon P. , Morgan Latricia A.
Published: March 2018

Training of practitioners on evidence-based public health has shown to be beneficial, yet overwhelming. Chunking information and proximate practical application are effective techniques to increase retention in adult learning. Evidence-based public health training for practitioners from African American and Hispanic/Latino community agencies and tribes/tribal nations incorporated these 2 techniques. The community-level practitioners alternated attending training and implementing the steps of the evidence-based public health framework as they planned state-funded programs. One year later, survey results showed that participants reported increased confidence in skills that were reinforced by practical and practiced application as compared with posttraining survey results. In addition, at 1 year, reported confidence in skills that were not fortified by proximate application decreased when compared with posttraining confidence levels. All 7 community programs successfully created individualized evidence-based action plans that included evidence-based practices and policies across socioecological levels that fit with the unique culture and climate of their own community.
Effectiveness and Drug Survival of Anti–Tumor Necrosis Factor α Therapies in Patients With Spondyloarthritis
Authors: Chiowchanwisawakit Praveena , Katchamart Wanruchada , Osiri Manathip , Narongroeknawin Pongthorn , Chevaisrakul Parawee , Kitumnuaypong Tasanee , Siripaitoon Boonjing , Louthrenoo Worawit
Published: March 2018

Objective

This study aimed to evaluate the long-term effectiveness and safety of the first anti–tumor necrosis factor α therapy (TNFi) and to identify the associated factors of drug discontinuation in patients with spondyloarthritis.

Methods

This was a medical records review study. Patients with spondyloarthritis who were prescribed the first TNFi between December 2009 and October 2014 in the Rheumatic Disease Prior Authorization registry were enrolled. Baseline clinical data were retrieved. The Cox proportional hazards model was used to identify factors associated with discontinuation of drugs.

Results

Among 138 patients, 97 had ankylosing spondylitis (AS), and 41 had psoriatic arthritis (PsA). The effectiveness of TNFi in AS and PsA was 55% to 59% at 4 months and 75% to 96% at 3 years, as measured by a 50% decrease in the Bath Ankylosing Spondylitis Disease Activity Index from baseline. For PsA with peripheral arthritis, improvement of the joint count by 50% was observed in 61.8% of patients at 4 months and 100% at 3 years. Survival from TNFi was 63% for AS and 56% for PsA at 3 years. For AS, the factors associated with good response leading to discontinuation of TNFi were baseline patient global assessment 3 to 6/10 (hazard ratio [HR], 6.3) and the use of leflunomide (HR, 6.0) and infliximab (HR, 4.8). A good response (38.5%) was the most common cause of discontinuation of the first TNFi, followed by toxicity (28.2%), nonadherence (20.5%), and lack of effectiveness (12.8%).

Conclusions

Ankylosing spondylitis and PsA responded well to TNFi during the 3-year follow-up. The retention rate was approximately 60% for AS and PsA. A good response to the first TNFi was the most common reason for discontinuation.
Prominent Pulmonary Metastases Without Concurrent Intra-abdominal Metastasis in a Case of Ovarian Carcinoma
Authors: Cheng Junjun , Ou Xiaohong , Ye Yunxia
Published: March 2018

Because ovarian cancer often advances by dissemination, pulmonary metastases are rarely unaccompanied by intra-abdominal metastases. We report a case of ovarian clear cell carcinoma having multiple bilateral lung metastases and without concurrent intra-abdominal lesions, as demonstrated by FDG PET/CT scan.
Another Strategy for the Treatment of Thyroglossal Duct Cyst: Totally Endoscopic Surgery by Breast Approach
Authors: Qu Rui , Wang Cunchuan , Dong Zhiyong , Li Jinyi , Liu Daosheng
Published: March 2018

Objective:

Open surgery is the most common treatment of thyroglossal duct cyst (TGDC), but it leaves obvious neck scarring. This study aimed to explore the feasibility and strategy of total endoscopic procedure by breast approach to avoid such scarring on the neck.

Materials and Methods:

This study reviewed 13 patients who underwent endoscopic resection of TGDC and 15 patients who underwent open resection of TGDC. We compared and analyzed factors including operative time, estimated blood loss, postoperative hospitalization, complications, and cosmetic effect.

Results:

The surgery by the endoscopic approach was successfully completed in 13 cases and no one was converted to an open procedure. Another 15 cases were successfully performed by an open procedure. There were no significant differences between the 2 procedures in the mean cyst size, drainage time, intraoperative blood loss, and postoperative hospital stay. The cosmetic effect was better and the operative time was longer in the endoscopic approach. Two cases had swallowing discomfort after surgery in the endoscopic approach, whereas one case developed this complication in the open approach. On patient treated with each approach developed infection. One patient developed skin bruise and one patient developed subcutaneous hydros in the endoscopic approach, whereas no complications developed in the open approach. There were no incidences of uncontrolled bleeding, tracheal injury, dysphagia, salivary fistula, or asphyxia/dyspnea in both approaches, nor were there any deaths or recurrences of TGDC during the follow-up period.

Conclusion:

With strict indications, the total endoscopic breast procedure is feasible and effective for selected patients. This procedure can be another choice for patients who wish to avoid neck scarring when undergoing treatment for TGDC.
Splenectomy in Gaucher Disease: A Call for Minimally Invasive Surgery
Authors: Freund Michael R. , Reissman Petachia , Zimran Ari , Alberton Joseph
Published: March 2018

Objective:

The objective of this article was to demonstrate that Gaucher disease (GD) patients with refractory hypersplenism and massive splenomegaly may successfully undergo hand-assisted laparoscopic splenectomy (HALS).

Methods:

This was a retrospective audit conducted at the Gaucher clinic at a national referral center over a 10-year period.

Patient Population:

This study included 8 GD patients who underwent hand-assisted or conventional laparoscopic splenectomy for massive or complicated splenomegaly between the years 2007 and 2017.

Results:

Seven patients underwent an elective HALS procedure because of refractory hypersplenism, whereas 1 patient underwent an urgent conventional laparoscopic splenectomy because of torsion of a wandering spleen. Only 1 patient required conversion to open surgery because of multiple adhesions from a previous partial splenectomy. The mean weight of the removed spleens was 2373 g (range, 480 to 4900 g), mean craniocaudal length of the removed spleens was 25 cm (range, 20 to 33.5 cm), and mean operating time was 150 minutes (range, 96 to 280 min). Postoperative complications were limited to 2 patients and included thrombosis of the splenic vein stump in 1 patient, and propagation of a preoperative splenic vein thrombus to the portal system, as well as an accumulation of an intra-abdominal hematoma in another patient. There was no mortality. Mean length of hospital stay was 5 days (range, 2 to 11 d).

Conclusion:

HALS for GD patients with refractory hypersplenism and massive splenomegaly is safe and feasible in experienced hands.
Limited by the roof of the world: mountain radiations of Apollo swallowtails controlled by diversity-dependence processes
Authors: Condamine Fabien L.
Published: March 2018

Mountainous areas contain a substantial part of the world species richness, but the evolutionary origins and diversification of this biodiversity remain elusive. Diversification may result from differences in clade age (longer time to diversify), net diversification rates (faster speciation rate) or carrying capacities (number of niches). The likelihood of these macroevolutionary scenarios was assessed for six clades of Apollo swallowtails (Parnassius) that diversified mainly in the Himalayan–Tibetan region. The analyses suggest that neither the clade age nor the speciation rate could explain the mountain butterfly diversification. Instead diversity-dependence models were strongly supported for each group. Models further estimated clades' carrying capacities, which approximate to the current number of species, indicating that diversity equilibrium has been reached (or close to being reached). The results suggest that diversification of mountain butterflies was controlled by ecological limits, which governed the number of niches, and provide macroevolutionary justification for regarding mountains as islands.
Synergistic adhesion mechanisms of spider capture silk
Authors: Guo Yang , Chang Zheng , Guo Hao-Yuan , Fang Wei , Li Qunyang , Zhao Hong-Ping , Feng Xi-Qiao , Gao Huajian
Published: March 2018

It is well known that capture silk, the main sticky component of the orb web of a spider, plays an important role in the spider's ability to capture prey via adhesion. However, the detailed mechanism with which the spider achieves its unparalleled high-adhesion performance remains elusive. In this work, we combine experiments and theoretical analysis to investigate the adhesion mechanisms of spider silk. In addition to the widely recognized adhesion effect of the sticky glue, we reveal a synergistic enhancement mechanism due to the elasticity of silk fibres. A balance between silk stiffness, strength and glue stickiness is crucial to endow the silk with superior adhesion, as well as outstanding energy absorption capacity and structural robustness. The revealed mechanisms deepen our understanding of the working principles of spider silk and suggest guidelines for biomimetic designs of spider-inspired adhesion and capture devices.
Raptor migration in an oceanic flyway: wind and geography shape the migratory route of grey-faced buzzards in East Asia
Authors: Nourani Elham , Safi Kamran , Yamaguchi Noriyuki M. , Higuchi Hiroyoshi
Published: March 2018

Flapping flight is relatively costly for soaring birds such as raptors. To avoid costly flight, migrating raptors generally avoid flying over water. As a result, all but one of the global raptor migration flyways are largely over land. The East Asian oceanic flyway for raptors is the exception. Raptor species using this flyway migrate by island-hopping, flying over open ocean for distances of up to 300 km between islands. We used satellite telemetry data for grey-faced buzzardsButastur indicus, a species that dominates the southern part of the flyway, to investigate the geographical and atmospheric factors responsible for the suitability of this flyway for raptor migration. Using a combination of least-cost path analysis and a step selection function, we found that the occurrence of numerous islands and also suitable wind support along the oceanic flyway are responsible for route selection in grey-faced buzzards. These results confirm the role of islands, but also wind, in shaping the East Asian oceanic flyway of long-distance raptor migration.