High Rate of Concomitant Lumbo-Sacral Spine Pathology in the Setting of Hip Abductor Tendon Repair.

BACKGROUND: Hip abductor deficiency is a common cause of lateral hip pain in middle-aged patients. Identifying upstream muscle denervation originating in the lumbo-sacral spine could potentially impact the management of patients who have abductor deficiency. The purpose of this study was to estimate the prevalence of lumbo-sacral pathology (L4 to S1) in patients undergoing hip abductor tendon repair. METHODS: All cases of primary hip abductor repair performed at a tertiary care center between January 2010 and December 2021 were reviewed. Patients were classified into the following groups: A) Confirmed L4 to S1 disease based on preoperative or perioperative L4 to S1 interventions (i.e., surgery, epidural injections, and/or positive electromyography findings); B) Radiographic evidence on lumbar spine magnetic resonance imaging (MRI) demonstrating nerve compression at L4 to S1; and C) No evidence of L4 to S1 disease. RESULTS: There were 131 cases of primary hip abductor repair that were included. Over 80% of patients were women, who had a mean age of 64 years (range, 20 to 85). There were thirteen patients (9.9%) who underwent concomitant total hip arthroplasty (THA). Of the included patients, 29% (n = 38) were categorized into group A, 12% (n = 16) into group B, and 59% (n = 77) into group C. Patients who had L4 to S1 pathology were older than patients who did not have L4 to S1 pathology (67 versus 61 years, P = 0.004). Of the patients undergoing concomitant THA and hip abductor repair, 54% demonstrated evidence of lumbo-sacral spine pathology. CONCLUSIONS: Over 40% of patients undergoing isolated hip abductor tendon repair and >50% of patients undergoing concomitant hip abductor tendon repair and THA demonstrated evidence of L4 to S1 disease perioperatively. Patients demonstrating symptomatic hip abductor deficiency should be screened for concomitant lower lumbo-sacral spine pathology.

Recommendations to address respondent burden associated with patient-reported outcome assessment.

Patient-reported outcomes (PROs) are increasingly used in healthcare research to provide evidence of the benefits and risks of interventions from the patient perspective and to inform regulatory decisions and health policy. The use of PROs in clinical practice can facilitate symptom monitoring, tailor care to individual needs, aid clinical decision-making and inform value-based healthcare initiatives. Despite their benefits, there are concerns that the potential burden on respondents may reduce their willingness to complete PROs, with potential impact on the completeness and quality of the data for decision-making. We therefore conducted an initial literature review to generate a list of candidate recommendations aimed at reducing respondent burden. This was followed by a two-stage Delphi survey by an international multi-stakeholder group. A consensus meeting was held to finalize the recommendations. The final consensus statement includes 19 recommendations to address PRO respondent burden in healthcare research and clinical practice. If implemented, these recommendations may reduce PRO respondent burden.

Mitigating human-wildlife conflict and monitoring endangered tigers using a real-time camera-based alert system.

The recovery of wild tigers in India and Nepal is a remarkable conservation achievement, but it sets the stage for increased human-wildlife conflict where parks are limited in size and where tigers reside outside reserves. We deployed an innovative technology, the TrailGuard AI camera-alert system, which runs on-the-edge artificial intelligence algorithms to detect tigers and poachers and transmit real-time images to designated authorities responsible for managing prominent tiger landscapes in India. We successfully captured and transmitted the first images of tigers using cameras with embedded AI and detected poachers. Notifications of tiger images were received in real time, approximately 30 seconds from camera trigger to appearing in a smart phone app. We review use cases of this AI-based real-time alert system for managers and local communities and suggest how the system could help monitor tigers and other endangered species, detect poaching, and provide early warnings for human-wildlife conflict.

Camera Trap Methods and Drone Thermal Surveillance Provide Reliable, Comparable Density Estimates of Large, Free-Ranging Ungulates.

Camera traps and drone surveys both leverage advancing technologies to study dynamic wildlife populations with little disturbance. Both techniques entail strengths and weaknesses, and common camera trap methods can be confounded by unrealistic assumptions and prerequisite conditions. We compared three methods to estimate the population density of white-tailed deer (Odocoileus virgnianus) in a section of Pilot Mountain State Park, NC, USA: (1) camera trapping using mark-resight ratios or (2) N-mixture modeling and (3) aerial thermal videography from a drone platform. All three methods yielded similar density estimates, suggesting that they converged on an accurate estimate. We also included environmental covariates in the N-mixture modeling to explore spatial habitat use, and we fit models for each season to understand temporal changes in population density. Deer occurred in greater densities on warmer, south-facing slopes in the autumn and winter and on cooler north-facing slopes and in areas with flatter terrain in the summer. Seasonal density estimates over two years suggested an annual cycle of higher densities in autumn and winter than in summer, indicating that the region may function as a refuge during the hunting season.

The relationship between biodiversity and wetland cover varies across regions of the conterminous United States.

Identifying the factors that determine the spatial distribution of biodiversity is a major focus of ecological research. These factors vary with scale from interspecific interactions to global climatic cycles. Wetlands are important biodiversity hotspots and contributors of ecosystem services, but the association between proportional wetland cover and species richness has shown mixed results. It is not well known as to what extent there is a relationship between proportional wetland cover and species richness, especially at the sub-continental scale. We used the National Wetlands Inventory (NWI) to model wetland cover for the conterminous United States and the National Land Cover Database to estimate wetland change between 2001 and 2011. We used a Bayesian spatial Poisson model to estimate a spatially varying coefficient surface describing the effect of proportional wetland cover on the distribution of amphibians, birds, mammals, and reptiles and the cumulative distribution of terrestrial endemic species. Species richness and wetland cover were significantly correlated, and this relationship varied both spatially and by taxonomic group. Rather than a continental-scale association, however, we found that this relationship changed more closely among ecoregions. The species richness of each of the five groups was positively associated with wetland cover in some or all of the Great Plains; additionally, a positive association was found for mammals in the Southeastern Plains and Piedmont of the eastern U.S. Model results indicated negative association especially in the Cold Deserts and Northern Lakes & Forests of Minnesota and Wisconsin, though these varied greatly between groups. Our results highlight the need for wetland conservation initiatives that focus efforts at the level II and III ecoregional scale rather than along political boundaries.

Phylogenomics of the genus Tursiops and closely related Delphininae reveals extensive reticulation among lineages and provides inference about eco-evolutionary drivers.

Phylogeographic inference has provided extensive insight into the relative roles of geographical isolation and ecological processes during evolutionary radiations. However, the importance of cross-lineage admixture in facilitating adaptive radiations is increasingly being recognised, and suggested as a main cause of phylogenetic uncertainty. In this study, we used a double digest RADseq protocol to provide a high resolution (~4 Million bp) nuclear phylogeny of the Delphininae. Phylogenetic resolution of this group has been especially intractable, likely because it has experienced a recent species radiation. We carried out cross-lineage reticulation analyses, and tested for several sources of potential bias in determining phylogenies from genome sampling data. We assessed the divergence time and historical demography of T. truncatus and T. aduncus by sequencing the T. aduncus genome and comparing it with the T. truncatus reference genome. Our results suggest monophyly for the genus Tursiops, with the recently proposed T. australis species falling within the T. aduncus lineage. We also show the presence of extensive cross-lineage gene flow between pelagic and European coastal ecotypes of T. truncatus, as well as in the early stages of diversification between spotted (Stenella frontalis; Stenella attenuata), spinner (Stenella longirostris), striped (Stenella coeruleoalba), common (Delphinus delphis), and Fraser's (Lagenodelphis hosei) dolphins. Our study suggests that cross-lineage gene flow in this group has been more extensive and complex than previously thought. In the context of biogeography and local habitat dependence, these results improve our understanding of the evolutionary processes determining the history of this lineage.

Using stakeholders' preference for ecosystems and ecosystem services as an economic basis underlying strategic conservation planning.

Ecosystem services (ES), commonly defined as the benefits people get from ecosystems, are key components in improving human well-being. However, as land utilization transitions from forest and agricultural land to urban areas and industrial complexes, the continuous provision of ES is affected. To ensure sustainable development, conservation programs should be implemented that consider both the stakeholders' well-being while also maintaining ecosystem health and integrity. Consequently, to improve the strategic implementation of conservation programs, it is critical to understand stakeholders' preferences. Using an online survey, we elicited South Carolina residents' preference in prioritizing the target ecosystems and ecosystem services in the state. The results identified that the priority ecosystem service is water quality regulation. However, the residents' preference for water quality regulation does not discredit the importance of maintaining the continuous water supply provision. In terms of ecosystem preference, residents indicated that the forest ecosystem is the priority ecosystem to be conserved, particularly for younger residents, respondents with high income, and those in the midland and the upstate. This could be attributed to the forest's effect on the ecosystem services that these respondents receive, particularly towards water-related ecosystem services. Understanding the residents' preference provides information that could improve the state water plans and other potential policy implications to land use-land cover planning and landscape sustainability management.

Genomics of Population Differentiation in Humpback Dolphins, Sousa spp. in the Indo-Pacific Ocean.

Speciation is a fundamental process in evolution and crucial to the formation of biodiversity. It is a continuous and complex process, which can involve multiple interacting barriers leading to heterogeneous genomic landscapes with various peaks of divergence among populations. In this study, we used a population genomics approach to gain insights on the speciation process and to understand the population structure within the genus Sousa across its distribution in the Indo-Pacific region. We found 5 distinct clusters, corresponding to S. plumbea along the eastern African coast and the Arabian Sea, the Bangladesh population, S. chinensis off Thailand and S. sahulensis off Australian waters. We suggest that the high level of differentiation found, even across geographically close areas, is likely determined by different oceanographic features such as sea surface temperature and primary productivity.

Whole genome sequencing and variant discovery in the ASPIRE autism spectrum disorder cohort.

Autism spectrum disorder (ASD) is a highly heterogeneous genetic disorder with strong evidence of ASD-association currently available only for a small number of genes. This makes it challenging to identify the underlying genetic cause in many cases of ASD, and there is a continuing need for further discovery efforts. We sequenced whole genomes of 119 deeply phenotyped ASD probands in order to identify likely pathogenic variants. We prioritized variants found in each subject by predicted damage, population frequency, literature evidence, and phenotype concordance. We used Sanger sequencing to determine the inheritance status of high-priority variants where possible. We report five novel de novo damaging variants as well as several likely damaging variants of unknown inheritance; these include two novel de novo variants in the well-established ASD gene SCN2A. The availability of rich phenotypic information and its concordance with the literature allowed us to increase our confidence in pathogenicity of discovered variants, especially in probands without parental DNA. Our results contribute to the documentation of potential pathogenic variants and their associated phenotypes in individuals with ASD.

Cognitive impairment and Charles Bonnet syndrome: a prospective study.

OBJECTIVES: Charles Bonnet syndrome (CBS) is a common cause of visual hallucinations in older people. The relationship between CBS and cognitive impairment is unclear, but anecdotal reports exist of dementia emerging in patients diagnosed with CBS. This work set out to determine if there is an increased incidence of dementia, and increased severity of cognitive impairment, in people with CBS compared to controls from the same clinical setting. METHOD: People over 65 attending low-vision and glaucoma clinics, and a cohort of age-matched controls, underwent a psychiatric assessment. The cohorts were followed up after one year. RESULTS: Mild cognitive impairment was present in 2/12 CBS participants and 2/10 controls. Partial insight was seen in nine CBS participants. Two participants with CBS, and no controls, developed dementia at follow-up. No significant differences in performance on the ACE-R were found between the groups. Both participants who developed dementia had partial insight and hallucinations of familiar figures at diagnosis of CBS, and one had mild cognitive impairment. CONCLUSIONS: Reassurance that CBS is universally benign may be misplaced. Some people given this diagnosis go on to develop dementia. Cognitive testing at the point of diagnosis was unable to identify those at risk of this outcome. Partial insight, the presence of Mild Cognitive Impairment, and hallucinations of familiar figures at diagnosis of CBS may confer an increased risk of subsequent dementia diagnosis. Copyright © 2017 John Wiley & Sons, Ltd.

Randomised controlled trial of a sexual risk reduction intervention for STI prevention among men who have sex with men in the USA.

OBJECTIVES: Novel interventions to address sexual risk taking and slow rates of STIs are urgently needed, in particular among black men who have sex with men (MSM) in the USA. Serosorting, or limiting condomless sex acts to partners of the same HIV status, is commonly practised among MSM, yet can lead to STI and remains largely unaddressed by public health agencies. METHODS: A two-arm, randomised controlled trial was conducted from 2012 to 2015. This trial assessed the effects of a single-session, sexual partner selection and risk decision intervention (experimental arm) versus a single-session, Centers for Disease Control and Prevention-based, sexual risk reduction intervention (control arm) on psychosocial measures, sexual risk taking and STI. RESULTS: At study follow-ups, multiple beneficial changes were observed on sexual risk beliefs measures (ie, changes in serosorting and condom use beliefs, and HIV risk perceptions) and sexual risk taking among the experimental arm relative to the control arm. Overall main effects, however, of the intervention on STI outcomes on year-long follow-ups were non-significant. There was evidence for short-term effects on STI outcomes, and self-report of multiple STIs and STI symptoms demonstrated positive effects over the follow-up period. CONCLUSIONS: Brief interventions to address sexual risk taking can result in short-term beneficial outcomes and can be incorporated into currently existing infrastructure at healthcare agencies. Additional intervention will be necessary for demonstrating long-term results. TRIAL REGISTRATION NUMBER: NCT02128594.

Landscape-scale conservation design across biotic realms: sequential integration of aquatic and terrestrial landscapes.

Systematic conservation planning has been used extensively throughout the world to identify important areas for maintaining biodiversity and functional ecosystems, and is well suited to address large-scale biodiversity conservation challenges of the twenty-first century. Systematic planning is necessary to bridge implementation, scale, and data gaps in a collaborative effort that recognizes competing land uses. Here, we developed a conservation planning process to identify and unify conservation priorities around the central and southern Appalachian Mountains as part of the Appalachian Landscape Conservation Cooperative (App LCC). Through a participatory framework and sequential, cross-realm integration in spatial optimization modeling we highlight lands and waters that together achieve joint conservation goals from LCC partners for the least cost. This process was driven by a synthesis of 26 multi-scaled conservation targets and optimized for simultaneous representation inside the program Marxan to account for roughly 25% of the LCC geography. We identify five conservation design elements covering critical ecological processes and patterns including interconnected regions as well as the broad landscapes between them. Elements were then subjected to a cumulative threats index for possible prioritization. The evaluation of these elements supports multi-scaled decision making within the LCC planning community through a participatory, dynamic, and iterative process.

Social and spatial relationships driving landowner attitudes towards aquatic conservation in a Piedmont-Blue Ridge landscape.

More than half of land in the U.S. is privately owned and covers most of known endangered species habitat. An understanding of private landowners' attitudes towards conservation may help to bridge the science-practice gap in regards to conservation initiatives. Aquatic biodiversity is particularly imperiled; in the United States headwaters and isolated wetlands receive little protection through regulations, becoming a focus of conservation planning. In an effort to assess how landowners view such efforts, a 27-question mixed methods survey was mailed to 409 landowners in the Blue Ridge and Piedmont ecoregions of South Carolina with wetland areas and where land was owned by a family or individual, not a corporation. We received 70 completed surveys and analyzed the results using an encapsulated mixed methods approach that analyzed both scaled and qualitative questions. The combined results gave a more contextual understanding of conservation on private lands in the study area. In this article we present a history of private land conservation and surveying landowners in understanding conservation potential. This demonstrates a need for a more comprehensive method needed in conservation planning. We then show our use of an integrated methodology, using quantitative and qualitative questions, to measure landowners' interest in conserving land. Through classification and spatial analysis, our study demonstrated that aquatic areas and wildlife are valued by and show influence on landowners' decisions. We also found that distance from protected area has a positive correlation to the willingness to protect aquatic areas. Landowners showed concern for threats of pollution from runoff and siltation. Disinterest in conservation seemed prevalent throughout many of the respondents' answers. These results suggest a relation to geographic distance and that the attitudes are more related near each other and specific places in the landscape. We conclude that any successful implementation of aquatic conservation initiatives must include focused outreach and communicating the benefits for society and landowners for building capacity for landscape-scale cooperation.

Randomized Controlled Trial in Clinical Settings to Evaluate Effectiveness of Coping Skills Education Used With Progressive Tinnitus Management.

Purpose: This randomized controlled trial evaluated, within clinical settings, the effectiveness of coping skills education that is provided with progressive tinnitus management (PTM). Method: At 2 Veterans Affairs medical centers, N = 300 veterans were randomized to either PTM intervention or 6-month wait-list control. The PTM intervention involved 5 group workshops: 2 led by an audiologist (teaching how to use sound as therapy) and 3 by a psychologist (teaching coping skills derived from cognitive behavioral therapy). It was hypothesized that PTM would be more effective than wait-list control in reducing functional effects of tinnitus and that there would be no differences in effectiveness between sites. Results: At both sites, a statistically significant improvement in mean Tinnitus Functional Index scores was seen at 6 months for the PTM group. Combined data across sites revealed a statistically significant improvement in Tinnitus Functional Index relative to wait-list control. The effect size for PTM using the Tinnitus Functional Index was 0.36 (small). Conclusions: Results suggest that PTM is effective at reducing tinnitus-related functional distress in clinical settings. Although effect sizes were small, they provide evidence of clinical effectiveness of PTM in the absence of stringent research-related inclusion criteria and with a relatively small number of sessions of cognitive behavioral therapy.

A Test of Concept Study of At-Home, Self-Administered HIV Testing With Web-Based Peer Counseling Via Video Chat for Men Who Have Sex With Men.

BACKGROUND: Men who have sex with men (MSM), particularly MSM who identify as African-American or Black (BMSM), are the sociodemographic group that is most heavily burdened by the human immunodeficiency virus (HIV) epidemic in the United States. To meet national HIV testing goals, there must be a greater emphasis on novel ways to promote and deliver HIV testing to MSM. Obstacles to standard, clinic-based HIV testing include concerns about stigmatization or recognition at in-person testing sites, as well as the inability to access a testing site due to logistical barriers. OBJECTIVE: This study examined the feasibility of self-administered, at-home HIV testing with Web-based peer counseling to MSM by using an interactive video chatting method. The aims of this study were to (1) determine whether individuals would participate in at-home HIV testing with video chat-based test counseling with a peer counselor, (2) address logistical barriers to HIV testing that individuals who report risk for HIV transmission may experience, and (3) reduce anticipated HIV stigma, a primary psychosocial barrier to HIV testing. METHODS: In response to the gap in HIV testing, a pilot study was developed and implemented via mailed, at-home HIV test kits, accompanied by HIV counseling with a peer counselor via video chat. A total of 20 MSM were enrolled in this test of concept study, 80% of whom identified as BMSM. RESULTS: All participants reported that at-home HIV testing with a peer counseling via video chat was a satisfying experience. The majority of participants (13/18, 72%) said they would prefer for their next HIV testing and counseling experience to be at home with Web-based video chat peer counseling, as opposed to testing in an office or clinic setting. Participants were less likely to report logistical and emotional barriers to HIV testing at the 6-week and 3-month follow-ups. CONCLUSIONS: The results of this study suggest that self-administered HIV testing with Web-based peer counseling is feasible and that MSM find it to be a satisfactory means by which they can access their test results. This study can serve as a general guideline for future, larger-scale studies of Web-based HIV test counseling for MSM.

How the hydrophobic factor drives protein folding.

How hydrophobicity (HY) drives protein folding is studied. The 1971 Nozaki-Tanford method of measuring HY is modified to use gases as solutes, not crystals, and this makes the method easy to use. Alkanes are found to be much more hydrophobic than rare gases, and the two different kinds of HY are termed intrinsic (rare gases) and extrinsic (alkanes). The HY values of rare gases are proportional to solvent-accessible surface area (ASA), whereas the HY values of alkanes depend on special hydration shells. Earlier work showed that hydration shells produce the hydration energetics of alkanes. Evidence is given here that the transfer energetics of alkanes to cyclohexane [Wolfenden R, Lewis CA, Jr, Yuan Y, Carter CW, Jr (2015) Proc Natl Acad Sci USA 112(24):7484-7488] measure the release of these shells. Alkane shells are stabilized importantly by van der Waals interactions between alkane carbon and water oxygen atoms. Thus, rare gases cannot form this type of shell. The very short (approximately picoseconds) lifetime of the van der Waals interaction probably explains why NMR efforts to detect alkane hydration shells have failed. The close similarity between the sizes of the opposing energetics for forming or releasing alkane shells confirms the presence of these shells on alkanes and supports Kauzmann's 1959 mechanism of protein folding. A space-filling model is given for the hydration shells on linear alkanes. The model reproduces the n values of Jorgensen et al. [Jorgensen WL, Gao J, Ravimohan C (1985) J Phys Chem 89:3470-3473] for the number of waters in alkane hydration shells.