Influence of age and gender on normative passive range of motion values of the carpometacarpal joint of the thumb.

STUDY DESIGN: Cross-sectional clinical measurement study. INTRODUCTION: The carpometacarpal (CMC) joint of the thumb is a complex joint making accurate measurement of range of motion (ROM) challenging. There are limited normative data available to base rehabilitative decisions, which is unfortunate as this joint is frequently affected by arthritis and is critical to hand function. PURPOSE OF THE STUDY: To provide passive ROM values for the first CMC joint and investigate the effects of age and gender. METHODS: Ninety-six healthy subjects were divided into 4 age groups of equal gender: 20-34, 35-49, 50-64, and 65+ years. Six-inch plastic universal goniometers were used to take 3 measurements of flexion, extension, and abduction of the dominant hand. RESULTS: Mean ROM values were 21.7 ± 6.8 degrees of flexion, 19.5 ± 5.7 degrees of extension, and 51.1 ± 5.5 degrees of abduction. There was a weak negative correlation (r = -0.22; P = .03) between age and abduction and a difference between 2 age groups. No other relationship or difference due to age, gender, or interactions reached significance. CONCLUSIONS: These normative ROM values for adults can be used by clinicians assessing patients for impaired motion at the CMC joint. No differences in flexion, extension, and abduction due to age and gender were supported, except for a small decrease (4.5°) in abduction in adults 65+ years compared with those of 35-49 years. LEVEL OF EVIDENCE: 3.

Erratum to: Quantifying the legacy of the Chinese Neolithic on the maternal genetic heritage of Taiwan and Island Southeast Asia.

In the original article, one of the co-authors' (Ken Khong Eng) given name has been published incorrectly. The correct given name should be Ken Khong. The original article has been corrected.

Quantifying the legacy of the Chinese Neolithic on the maternal genetic heritage of Taiwan and Island Southeast Asia.

There has been a long-standing debate concerning the extent to which the spread of Neolithic ceramics and Malay-Polynesian languages in Island Southeast Asia (ISEA) were coupled to an agriculturally driven demic dispersal out of Taiwan 4000 years ago (4 ka). We previously addressed this question using founder analysis of mitochondrial DNA (mtDNA) control-region sequences to identify major lineage clusters most likely to have dispersed from Taiwan into ISEA, proposing that the dispersal had a relatively minor impact on the extant genetic structure of ISEA, and that the role of agriculture in the expansion of the Austronesian languages was therefore likely to have been correspondingly minor. Here we test these conclusions by sequencing whole mtDNAs from across Taiwan and ISEA, using their higher chronological precision to resolve the overall proportion that participated in the "out-of-Taiwan" mid-Holocene dispersal as opposed to earlier, postglacial expansions in the Early Holocene. We show that, in total, about 20% of mtDNA lineages in the modern ISEA pool result from the "out-of-Taiwan" dispersal, with most of the remainder signifying earlier processes, mainly due to sea-level rises after the Last Glacial Maximum. Notably, we show that every one of these founder clusters previously entered Taiwan from China, 6-7 ka, where rice-farming originated, and remained distinct from the indigenous Taiwanese population until after the subsequent dispersal into ISEA.

End of Green Sahara amplified mid- to late Holocene megadroughts in mainland Southeast Asia.

Between 5 and 4 thousand years ago, crippling megadroughts led to the disruption of ancient civilizations across parts of Africa and Asia, yet the extent of these climate extremes in mainland Southeast Asia (MSEA) has never been defined. This is despite archeological evidence showing a shift in human settlement patterns across the region during this period. We report evidence from stalagmite climate records indicating a major decrease of monsoon rainfall in MSEA during the mid- to late Holocene, coincident with African monsoon failure during the end of the Green Sahara. Through a set of modeling experiments, we show that reduced vegetation and increased dust loads during the Green Sahara termination shifted the Walker circulation eastward and cooled the Indian Ocean, causing a reduction in monsoon rainfall in MSEA. Our results indicate that vegetation-dust climate feedbacks from Sahara drying may have been the catalyst for societal shifts in MSEA via ocean-atmospheric teleconnections.

Adolescent behavior and sexually transmitted diseases: the dilemma of human papillomavirus.

Adolescence is a period of physical, cognitive, psychosocial, and moral development that often results in risk-taking behavior. As a consequence, adolescents are at high risk for sexually transmitted disease (STD). Two of the most common STDs in the United States, chlamydia and human papillomavirus (HPV), affect millions of adolescent women. HPV, contrasted with chlamydia, poses a unique challenge to health care providers. In addition to causing genital warts, HPV has been shown to be the causative agent in the development of cervical cancer. Interventions that are effective in decreasing the transmission of chlamydia, such as increasing condom use, are less effective in prevention of HPV. Efforts to increase adolescent awareness of HPV, to increase age of first coitus, and to decrease numbers of sexual partners are more effective for HPV prevention. Early screening for HPV, smoking cessation, and health promotion may be effective in decreasing the incidence of cervical cancer in young women. Nurse practitioners and other primary health care providers need a more holistic approach to the prevention of HPV in adolescent women.