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It is commonly thought that unconscious processes cannot produce actions deserving praise or blame. I present a thought experiment designed to generate a contradicting intuition: at least in this case, we do give credit for the product of an unconscious process. The target is creativity. Many instances of creative thought begin with a step that unconsciously generates a new idea by combining existing ideas. The resulting ideas are selected and developed by later processing. This first step could be replaced with a simple machine that randomly pairs concepts. Now, imagine a philosopher, Liberty, who gets all of his paper ideas from this machine. Compare him to another philosopher, Libertad, who comes up with all the same papers using her own mind. If you share the intuition that Liberty's work deserves less credit for creativity, you are giving credit for the product of an unconscious process. [ABSTRACT FROM AUTHOR]

This paper presents a new unreliable failure detector, called the Impact failure detector (FD), that, contrarily to the majority of traditional FDs, outputs a trust level value which expresses the degree of confidence in the system. An impact factor is assigned to each process and the trust level is equal to the sum of the impact factors of the processes not suspected of failure. Moreover, a threshold parameter defines a lower bound value for the trust level, over which the confidence in the system is ensured. In particular, we defined a flexibility property that denotes the capacity of the Impact FD to tolerate a certain margin of failures or false suspicions, i.e. its capacity of considering different sets of responses that lead the system to trusted states. The Impact FD is suitable for systems that present node redundancy, heterogeneity of nodes, clustering feature and allow a margin of failures which does not degrade the confidence in the system. The paper also includes a timer-based distributed algorithm which implements an Impact FD, as well as its proof of correctness, for systems whose links are lossy asynchronous or for those whose all (or some) links are eventually timely. Performance evaluation results, based on PlanetLab (Planetlab. http://www.planet-lab.org. 'Online. Access date: 16 September 2016') traces, confirm the degree of flexible applicability of our FD and that, due to the accepted margin of failure, both failures and false suspicions are more tolerated when compared to traditional unreliable FDs. [ABSTRACT FROM AUTHOR]

Background Determinants of hypertension diagnosis and/or awareness and control among older adults are understudied in Albania, a former communist country in South Eastern Europe, which is experiencing rapid demographic, socioeconomic and epidemiological transition. This paper examines the association of individual, interpersonal, organizational and community factors with hypertension awareness and control among older adults in Tirana, the Albanian capital. Methods Using 2012 International Mobility in Aging Study data on older adults from Albania's capital city (n = 393) and the socioecological model as a conceptual framework, multinomial regression models identified factors associated with controlled, uncontrolled and undiagnosed hypertension. Results For hypertension, 17.3% participants had none, 23.4% were controlled, 48.4% were uncontrolled and 10.9% were undiagnosed/unaware. Compared to those with controlled hypertension, in multivariable models, a high level of friend support was negatively associated with uncontrolled (OR: 0.4; 95% CI: 0.2–0.9) and undiagnosed (OR: 0.2; 95% CI: 0.1–0.6) hypertension. A high level of perceived neighbourhood safety was negatively associated with uncontrolled (OR: 0.6; 95% CI: 0.3–1.0) and undiagnosed (OR: 0.4; 95% CI: 0.2–1.0) hypertension. Compared to those with no hypertension, children's social support was positively associated with uncontrolled (OR: 2.2; 95% CI: 1.1–4.3) and undiagnosed (OR: 3.6; 95% CI: 1.3–9.6) hypertension. Conclusion This study provides new insights about distinct risk factors for inadequate hypertension management in Albania. It highlights the importance of community-level factors (safety) and interpersonal factors (family and friend ties) to hypertension diagnosis/awareness and control, which may provide novel intervention opportunities for hypertension programs. [ABSTRACT FROM AUTHOR]

In a recent paper, Wigglesworth claims that syntactic criteria of theoretical equivalence are not appropriate for settling questions of equivalence between logical theories, since such criteria judge classical and intuitionistic logic to be equivalent; he concludes that logicians should use semantic criteria instead. However, this is an artefact of the particular syntactic criterion chosen, which is an implausible criterion of theoretical equivalence (even in the non-logical case). Correspondingly, there is nothing to suggest that a more plausible syntactic criterion should not be used to settle questions of equivalence between different logical theories; such a criterion (which may already be found in the literature) is exhibited and shown to judge classical and intuitionistic logic to be inequivalent. [ABSTRACT FROM AUTHOR]

There is a fundamental disagreement about which norm regulates assertion. Proponents of factive accounts argue that only true propositions are assertable, whereas proponents of non-factive accounts insist that at least some false propositions are. Puzzlingly, both views are supported by equally plausible (but apparently incompatible) linguistic data. This paper delineates an alternative solution: to understand truth as the aim of assertion, and pair this view with a non-factive rule. The resulting account is able to explain all the relevant linguistic data, and finds independent support from general considerations about the differences between rules and aims. [ABSTRACT FROM AUTHOR]

It is commonly believed that human-centred design (HCD) approach is very beneficial to interactive systems development. However, not much is known about the state of HCD practice in developing countries, especially the sub-Saharan Africa. This paper explores the state of HCD practice in three Nigerian software companies. We used the interview technique to explore two key issues. First, the perception of humans as a component of sociotechnical systems, and second, how HCD process is being approached in software companies. A cross-case analysis of the three companies was performed and the usability maturity model-human-centredness scale was used to determine the state of maturity of the three companies. The outcomes of this study reveal that HCD practice is currently at the least stage of maturity in the three companies and user involvement is not practiced in the right manner. The outcomes of the study suggest the need for reflective HCD practice and localizing human–computer interaction approaches to contexts. [ABSTRACT FROM AUTHOR]

The effects of media exposure differ when people are given the opportunity to choose content compared to when they are forced to view it. Contemporary explanations propose that differences between forced and selected exposure occur because of between-subject differences. We propose that differences also result from within-subject psychological reactions. Using a novel experimental design, a representative sample of U.S. adults (N = 1,967) provided their content preferences in a first session and then, in a second session, were randomly assigned to choose content or to view randomly-assigned content. Results confirm that forced exposure yields different psychological reactions than selected exposure, even in some cases among participants forced to view their preferred content. [ABSTRACT FROM AUTHOR]

Background and objectives The objective was to systematically review transalveolar transplantation of maxillary canines and the long-term outcome for an average follow-up period of 2 years or more. Data collection and analysis A systematic review of the currently available literature until December 2017 was conducted, using Medline, Cochrane Central, Web off Science, and PubMed. Articles were screened for 1. indications, 2. contra-indications, 3. surgical planning, 4. surgical technique, 5. associated risk factors, and 6. long-term outcome for transalveolar transplantation of maxillary canines with the following outcome measures: bone-related outcomes, tooth-related outcomes, soft tissue-related outcomes, and aesthetic outcome measures. Descriptive statistics, as well as a quality assessment of included articles, were performed. Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed using the Methodological index for non-randomized studies (MINORS). Results Twelve articles were included in this review. These studies included outcome data for 783 autotransplanted maxillary canines, with long-term studies indicating a clinically acceptable overall outcome. Limitations Since the lack of randomized controlled trials considering this topic, the quality of the evidence in the present review is considered low. However, impacted maxillary canines are a rare anomaly and different aspects, such as position of the impacted canine, patient's age and patient's demands, and expectancies must be taken into account, it is practically impossible to randomize treatment. Conclusions There is sufficient evidence to justify the transalveolar transplantation of maxillary canines as a legitimate treatment technique for impacted maxillary canines deemed difficult to treat with surgical exposure and subsequent orthodontic alignment. Long-term studies have shown that a good overall outcome is to be expected. There is no clear agreement in the literature on the indications and contra-indications for transalveolar transplantation of maxillary canines. Implication of key findings It is highly desirable that further research on this issue be undertaken, high-quality observational studies are recommended. Registration PROSPERO (CRD42017056348) [ABSTRACT FROM AUTHOR]

Despite the promise of abundant renewable energy resources in the world, the poultry sector is still dominated by traditional energy sources. In this study, results of a field trial of an innovative and cost-effective HVAC system design applied to a poultry house have been presented. This system comprises of two integrated novel components; a polyethylene heat exchanger (PHE) based a photovoltaic thermal (PVt) array and an efficient and innovative ground pipe array coupled to a heat pump driven HVAC system. The analysis included the daily PV electrical output and heat pump performance. The results of the experimental study reveal that 3733 kWh and 2432 kWh heat energy have been supplied in the 7-week growth cycle of chickens condition, respectively. The COP of the HP has been calculated for the winter period and observed between 2.3 and 2.43. The PV system was able to generate 1876 kWh electrical energy with potential to meet HP's energy needs in the most energy needing period. [ABSTRACT FROM AUTHOR]

Due to environmental problems related to using fossil fuels and limitations in the sources of these types of fuels, renewable energies have sharply developed in recent decades. Renewable energy systems are applicable in various fields to provide clean energy. In the current study, medical and dental applications of renewable energies are reviewed. Based on the literature review, technologies based on renewable energy sources can be utilized in medical buildings and instruments. For instance, solar-based technologies can be applied in heating and cooling of hospitals and other healthcare facilities. In addition, the thermal energy of the sun is applicable in autoclaves and medical dryers. Although utilizing renewable energy systems for these applications requires more investment cost and probably more complicated structures, it would result in lower carbon dioxide emission which leads to sustainable development. [ABSTRACT FROM AUTHOR]

Uncertainty in the estimation of daytime ecosystem carbon cycling due to the light inhibition of leaf respiration and photorespiration, and how these small fluxes vary through the growing season in the field, remains a confounding element in calculations of gross primary productivity and ecosystem respiration. Our study focuses on how phenology, short-term temperature changes and canopy position influence leaf-level carbon exchange in Quercus rubra L. (red oak) at Harvard Forest in central Massachusetts, USA. Using leaf measurements and eddy covariance, we also quantify the effect of light inhibition on estimates of daytime respiration at leaf and ecosystem scales. Measured rates of leaf respiration in the light and dark were highest in the early growing season and declined in response to 10-day prior air temperatures (P < 0.01), evidence of within-season thermal acclimation. Leaf respiration was significantly inhibited by light (27.1 ± 2.82% inhibited across all measurements), and this inhibition varied with the month of measurement; greater inhibition was observed in mid-summer leaves compared with early- and late-season leaves. Increases in measurement temperature led to higher rates of respiration and photorespiration, though with a less pronounced positive effect on photosynthesis; as a result, carbon-use efficiency declined with increasing leaf temperature. Over the growing season when we account for seasonally variable light inhibition and basal respiration rates, our modeling approaches found a cumulative 12.9% reduction of leaf-level respiration and a 12.8% reduction of canopy leaf respiration, resulting in a 3.7% decrease in total ecosystem respiration compared with estimates that do not account for light inhibition in leaves. Our study sheds light on the environmental controls of the light inhibition of daytime leaf respiration and how integrating this phenomenon and other small fluxes can reduce uncertainty in current and future projections of terrestrial carbon cycling. [ABSTRACT FROM AUTHOR]

The aim of this article is to shed light on the decision-making process at university technology transfer offices and show that the last steps in the process of international patent extension, when costs step up, tend to be only taken conditional on the existence of a licensing agreement. This information has so far been underexploited by policymakers and innovation scholars in search of innovation indicators. We argue that the number of international patent families filed by a university can be used as a rough indicator of technology transfer activity mediated through patents, especially in the context of tight public university budgets and national patent systems with fee reductions for universities. To support our argument, we review qualitative information from interviews at technology transfer offices, regulations, and internal statutes from a selection of Spanish universities and present a statistical analysis of the relation between patent internationalisation and licensing. [ABSTRACT FROM AUTHOR]

This article aims to provide a deeper understanding of the individual factors behind scientists' involvement in a wide variety of knowledge transfer and exchange (KTE) activities. By doing so, the article addresses three major shortcomings in the literature. First, this article considers scientists' involvement in both formal and informal KTE activities. Secondly, the study focuses not only on KTE activities with the private sector, but also with other types of agents. Thirdly, the article adopts an individual approach to distinguish between three types of KTE predictors: individual capacities, training and career trajectories, and motivations. Overall, the results of the regression model applied to a sample of 1,295 researchers active in the largest public research organization in Spain (CSIC) suggest that, while some individual features are connected to some KTE activities, other individual predictors (e.g. multitasking and interdisciplinarity) are more evenly associated to a variety of KTE mechanisms and users. Based on those findings, the article offers policy recommendations to craft more accurate policies to encourage scientists' KTE engagement. [ABSTRACT FROM AUTHOR]

This study presents an analysis of 2,216 European higher education institutions (HEIs) from 27 countries. It investigates determinants of participation in the European Union's Framework Programme for research and innovation (EU FP), Horizon 2020, and empirically assesses how influential network position affects the chances of applying for and receiving funding in collaborative projects. Having a strong, influential network position in collaborative EU research is found to affect participation in H2020 greatly—suggesting 'closed clubs', to the detriment of less influential HEIs. Greater access to resources and capabilities significantly strengthens the effect of network position on EU FP participation. [ABSTRACT FROM AUTHOR]

The evolution of reproductive isolation following hybridization is a major obstacle that may limit the prevalence of hybrid speciation among specific groups of organisms. Here, we use a flea beetle system to offer a behavioral hypothesis for why there are so few examples of homoploid hybrid speciation among insects. Specifically, we examined cuticular hydrocarbon (CHC) mating signals and mate-choice decisions of Altica fragariae and A. viridicyanea to test whether the signals produced by hybrids cause prezygotic reproductive isolation. Although hybrids of A. fragariae and A. viridicyanea had unique CHC profiles as compared to the parental species, mate-choice trials indicated that these differences were insufficient to prevent gene flow between hybrids and parental species. We found that mate-choice decisions and CHC signals were not correlated. Considering the ubiquity of CHC signaling molecules in insects, we propose that decoupling of CHC signals and mate choice may be a general mechanism limiting hybrid speciation in insects. [ABSTRACT FROM AUTHOR]

Ineffective hunters in cooperative foraging groups may be shielded from natural selection by their more effective group mates, whereas those living solitarily would starve and thus be removed from the population. The problem may be exacerbated in large groups where it may be easier for individuals to withhold participation. Group foragers may thus be ineffective individual hunters or exhibit greater inter-individual variation in hunting abilities, in particular, when living in large groups. We test these hypotheses in spider species of the genus Anelosimus that differ in their level of sociality and, among social species, in colonies of different sizes. We found that individuals from the more social species, and those from larger groups, reacted more slowly to prey than those from solitary species or small groups. Individuals from these categories also had greater inter-individual variation in reaction times. Individuals from large social groups also had lower prey-capture success than those from small ones. These differences may have been driven by the size of the group from which the social individuals were taken, as those from small colonies behaved similarly to individuals of the 2 less social species. This finding suggests that hunting ability may develop as a phenotypically plastic trait. [ABSTRACT FROM AUTHOR]

Learning associations between food-related stimuli and nutrients allows foragers to collect resources efficiently. In turn, the nutrients that foragers consume can themselves affect learning performance, through innate preferences for pre-ingestive stimuli, as well as post-ingestive reinforcement. Bees are insect models of learning and memory, yet the vast majority of this research concerns nectar (carbohydrate) rather than pollen (protein/lipid) rewards, despite the fact that many bees collect both simultaneously. We asked how one component of pollen surface chemistry, a free fatty acid (oleic acid), affected bees' performance in a nectar-learning task. We found that ingestion of oleic acid enhanced visual learning, likely through positive post-ingestive reinforcement. This was supported by our finding that although bees did not prefer to consume the oleic acid solution, its ingestion both decreased motor activity and increased survival. These results are a step towards understanding how nutritionally complex floral rewards may affect cognitive processes that underlie pollination mutualisms. [ABSTRACT FROM AUTHOR]

We propose a novel perceptual image hashing based on weighted discrete wavelet transform (DWT) statistical features. This hashing converts input image into a normalized image by bi-linear interpolation and color space conversion, extracts edge image of the normalized image via Canny operator, and divides the edge image into non-overlapping blocks. For each block, a three-level 2D DWT is applied to obtain different sub-bands and the weighted sum of the DWT statistics of these sub-bands is calculated. Finally, image hash is generated by concatenating and quantizing these weighted DWT features. Similarity of image hashes is measured by Euclidean distance. The Copydays dataset and the Uncompressed Color Image Database (UCID) are both used to evaluate classification between robustness and discrimination. Receiver operating characteristics curve comparisons illustrate that our hashing is superior to some state-of-the-art algorithms in classification performance with respect to robustness and discrimination. The LIVE Image Quality Assessment Database is used to validate our application in reduced-reference image quality assessment. Experimental results show that our hashing has better performance in image quality assessment than two popular measures, i.e. peak signal-to-noise ratio and structural similarity. [ABSTRACT FROM AUTHOR]

This article charts the application and development of the Polluter-Pays Principle (PPP) in one sphere of international law (civil liability for accidental marine oil pollution); a liability regime, very much grounded in its own traditions, which often interacts uncomfortably with national and regional law. The article explores the application of the principle at international, regional and national levels, using the demise of the vessels 'Erika' and 'Prestige' and the case law flowing from the subsequent environmental disasters to illustrate how the principle has developed in this area of international law and how this has the potential to influence its development in other jurisdictions. [ABSTRACT FROM AUTHOR]

The Antarctic marine environment is changing, and changes in the Southwest Atlantic sector have included decreases in sea ice and increases in water temperature. Associated with these changes is a reported 38% and 81% per decade decline in the numerical density (hereafter density) of Antarctic krill Euphausia superba Dana, 1850, between 1976 and 2003. Few changes in other components of the ecosystem that could be attributed to such a change, such as a mass decline in krill-dependent predators, have been detected. In an ecosystem so dependent on this keystone species, a massive population decline in krill ought to have had an obvious effect. In the absence of such an effect, it is timely to revisit the issue of the purported decline in krill density. The original analysis that indicated a decline in krill density was based on the 2004 version of KRILLBASE, a database of net samples. We analysed the publicly available and updated version (version 1, accessed 30 November 2017) and our analyses did not suggest a significant decline in krill density. Rather, after accounting for sampling heterogeneity and habitat variables, average krill density appears to have been stable but with considerable inter-annual variability. Since our results were unable to find any evidence for a decline in krill density we recommend a re-appraisal of many of the paradigms that underlie much of the recent thinking about ecosystem change Antarctic waters. Such a revision is necessary to provide a firmer foundation for predictions of the effects of climate change and resource extraction on the Southern Ocean ecosystem. [ABSTRACT FROM AUTHOR]

Better understanding of the mechanisms by which novel species arrive in marine communities is not only important for documenting such arrivals but can also lead to a better awareness of the abiotic and biotic limits on species distributions. Here we integrate spatial survey data, metapopulation hindcast modeling, and new genetic data from allozymes and mitochondrial loci to identify how cryptic diversity within the barnacle species Chthamalus fragilis Darwin, 1854 responds to the coastal environment to establish contemporary patterns of diversity and abundance. This is of interest because C. fragilis has long been recognized as novel in the southern New England intertidal community, having arrived in the late 1800s as the likely result of either human introduction or increased global temperature. Our results demonstrate an elevated and somewhat distinct genetic diversity for this species in southern New England relative to the rest of its distributional range. Our models explain this best as resulting from a "natural" expansion of the barnacle's range late in the 19thcentury, with genetic connectivity between its northern and southern populations now hampered by a recruitment gap along the Delmarva Peninsula. [ABSTRACT FROM AUTHOR]

As university–industry cooperation is associated with the transfer of knowledge and technology, this collaboration is an extremely important field of study for the world's economies that helps companies become more competitive. The present research, thus, sought to explore and analyse the literature related to university–industry cooperation, using a co-citation analysis. This study's objectives were to (1) identify the main co-cited references and the groups (i.e. clusters) they form and (2) discuss the challenges this literature presented in the study of university–industry cooperation. The articles reviewed were obtained with a search of the ISI's Web of Science and were submitted to a bibliometric analysis using VOSviewer software. This systematic literature review revealed that companies are increasingly focused on cooperation with universities. The results include four clusters, namely, (1) Absorption Capacity, Knowledge and Competitiveness in University–Industry Relations, (2) Impact of Knowledge Spill-overs on University–Industry Relations, (3) Strategic Alliances for Industry Innovation, and (4) University–Industry Cooperation. This study thus contributes to a greater and more detailed understanding of the production flow, scientific practices, and trends in this new and stimulating field of research. [ABSTRACT FROM AUTHOR]

A series of localized high-temperature granulite-facies domains ('hot spots') are present within the regional (10–100 km2scale) amphibolite-facies rocks of the Central Maine Terrane in central New Hampshire (NH), USA. Based on the spatial coincidence of a thermal anomaly and contours of depressed δ18O values centered on networks of quartz–graphite and pegmatitic veins in the vicinity of Bristol, NH, it was proposed in an earlier study that large-scale ascending hot fluid focused through a vein network drove heating and introduced isotopically distinct fluids. The thermal anomaly could be preserved only if the timescales of heating were extremely short, otherwise conduction would smooth the field temperature gradient. Herein, we conduct a petrological test to estimate the peak temperatures and the durations of metamorphism across the Bristol region, using pseudosection analysis as well as forward modeling of garnet growth–diffusion–resorption profiles. This region attained granulite-facies conditions in the sillimanite–K-feldspar–cordierite zone over a larger area than previously mapped. Cordierite is variably present, which reflects bulk compositional controls on its stability as well as its destruction during retrogression. The forward modeling reveals protracted (5–8 Myr) granulite-facies conditions of 0·5–0·6 GPa and ∼750–820°C, and an overall counterclockwise P – T path. Furthermore, a short-lived thermal anomaly or 'spike' (>100°C, ∼0·15 Myr) is superimposed on the granulite-facies core, reaching ultrahigh-temperature (UHT) conditions >900°C, much higher than previously recognized in the area. The short timescale is fully consistent with the localized radius of the thermal anomaly of ∼1·5 km. Subsequently, the area underwent variably developed amphibolite-facies retrogression at ∼650°C and 0·4–0·5 GPa, accompanied by fluid infiltration, garnet breakdown, and muscovite growth. The transient thermal spike and the counterclockwise P – T path indicate that heat transfer could not have been solely the result of internal heating of overthickened crust. We posit that external heat fluxes driven by Acadian plutonism, in addition to heat generation in crust enriched in heat-producing elements, led to the granulite-facies metamorphism. Magmatic loading in the crust, potentially in response to an elevated basal heat flux during the Acadian orogeny, can account for the counterclockwise P – T path. Heat transported advectively by channelized flow of magma or magma evolving hydrothermal fluids is the most likely cause of the transient and local UHT thermal anomaly. The results show that UHT metamorphic events can be extremely brief. [ABSTRACT FROM AUTHOR]

As one of the most geochemically unique drill cores recovered within the Yellowstone–Snake River Plain (YSRP) province, the Sugar City geothermal test well was drilled into intra-caldera rhyolite lavas and tuffs erupted during the middle to late Pliocene and the resurgent basaltic volcanism erupted during the Pleistocene. This sequence parallels the two main stages proposed for YSRP hotspot calderas: i.e. the eruption of several large-volume, ash-flow tuff sheets followed by caldera collapse, then cessation of major rhyolitic activity and gradual subsidence accompanied by filling and eventual burial of the caldera by basalt lava flows. We employ stratigraphic relationships, paleomagnetism, and major, trace element, and Sr–Nd isotope geochemistry to develop models for the origin of the basaltic and rhyolitic magmas within a geographical and temporal context. The basalts are characterized by distinct groupings based on depth and geochemistry and reflect the dominant compositions observed on the surface, e.g. Snake River olivine tholeiite (SROT) and evolved type (e.g. Craters of the Moon). We also observe contaminated basalts that interacted with rhyolite/granite. The basaltic magma formed by shallow partial melting in the plume channel carved into the lithosphere. The older rhyolites preserve the classical characteristics of A-type granites and display major element and trace element concentrations typical for Eastern SRP caldera centres and minimal stratigraphic variation. Multiple lines of evidence document extensive magmatic differentiation and coupled basalt–rhyolite interactions. We find that the most plausible origin for the rhyolites is via partial melting of a hybrid source, comprising Archean crustal components and younger juvenile mafic intrusions. Assimilation of hydrothermally altered material is also required for some eruptive units. The rhyolites did not evolve from residual magma left over from the climactic Kilgore eruption (4·0 Ma), but instead represent discrete magma generation events in the course of a few hundred thousand years between 4·0 to 3·8 Ma. Beginning at approximately 3.3 Ma, basalts were able to erupt through the solidified composite pluton that formed below the caldera. The transition from rhyolite to basalt is tied to the declining flux of basaltic magma as North America moved away from the Yellowstone hotspot core. [ABSTRACT FROM AUTHOR]

Background Reptiles are a species-rich group with great phenotypic and life history diversity but are highly underrepresented among the vertebrate species with sequenced genomes. Results Here, we report a high-quality genome assembly of the tegu lizard, Salvator merianae, the first lacertoid with a sequenced genome. We combined 74X Illumina short-read, 29.8X Pacific Biosciences long-read, and optical mapping data to generate a high-quality assembly with a scaffold N50 value of 55.4 Mb. The contig N50 value of this assembly is 521 Kb, making it the most contiguous reptile assembly so far. We show that the tegu assembly has the highest completeness of coding genes and conserved non-exonic elements (CNEs) compared to other reptiles. Furthermore, the tegu assembly has the highest number of evolutionarily conserved CNE pairs, corroborating a high assembly contiguity in intergenic regions. As in other reptiles, long interspersed nuclear elements comprise the most abundant transposon class. We used transcriptomic data, homology- and de novo gene predictions to annotate 22,413 coding genes, of which 16,995 (76%) likely have human orthologs as inferred by CESAR-derived gene mappings. Finally, we generated a multiple genome alignment comprising 10 squamates and 7 other amniote species and identified conserved regions that are under evolutionary constraint. CNEs cover 38 Mb (1.8%) of the tegu genome, with 3.3 Mb in these elements being squamate specific. In contrast to placental mammal-specific CNEs, very few of these squamate-specific CNEs (<20 Kb) overlap transposons, highlighting a difference in how lineage-specific CNEs originated in these two clades. Conclusions The tegu lizard genome together with the multiple genome alignment and comprehensive conserved element datasets provide a valuable resource for comparative genomic studies of reptiles and other amniotes. [ABSTRACT FROM AUTHOR]

Esophageal leaks remain a life-threatening postoperative complication of esophagectomy. Currently, self-expanding metal stents (SEMS) represent the endoscopic mainstay of treatment. Recently, endoscopic vacuum therapy (EVT) has emerged and shown promising results in these patients. We conducted an electronic systematic search using MEDLINE databases (PubMed, EMBASE, and Web of Science) looking for studies comparing EVT and SEMS for the treatment of esophageal leak and/or perforation. Four studies including 163 patients matched the inclusion criteria. Esophageal leak closure rate is significantly higher with EVT than SEMS [pooled odds ratio 5.51 (95% CI 2.11–14.88; P < 0.001)]. Additionally, EVT has a shorter treatment duration [pooled mean difference −9.0 days (95% CI 16.6–1.4; P = 0.021)], lower major complication (P = 0.011), and in-hospital mortality (P = 0.002) rate compared to SEMS. EVT for esophageal leak is feasible and safe. It has the potential to become the new gold standard in the endoscopic treatment of esophageal leaks and perforations. However, further comparative studies with SEMS are needed to strengthen the current evidence. [ABSTRACT FROM AUTHOR]

Postesophagectomy anastomotic leak is a common postsurgical complication. The current standard method of detecting leak is esophagram usually late in the postoperative period. Perianastomotic drain amylase level had shown promising results in early detection anastomosis leak. Previous studies have shown that postoperative day 4 amylase level is more specific and sensitive than esophagram. The purpose of this study is to determine if implementing a drain amylase-based screening method for anastomotic leak can reduce length of stay and hospital cost relative to a traditional esophagram-based pathway. The drain amylase protocol we propose uses postoperative day 4 drain amylase level to direct the initiation of PO intake and discharge. We designed a decision analysis tree using TreeAge Pro software to compare the drain amylase-based screening method to the standard of care, the esophagram. We performed a retrospective review of postesophagectomy patients from a tertiary academic medical center (University hospital Cleveland medical center) where amylase level was measured routinely postoperatively. The patients were separated into amylase-based pathway group and the standard of care group based on their postop management. The length of stay, costs, complications, and leak rate of these two groups were used to inform the decision analysis tree. In the base-case analysis, the decision analysis demonstrated that an amylase-based screening method can reduce the hospital stay by one day and reduced costs by ∼$3,000 compared to esophagram group. To take the variability of the data into consideration, we performed a Monte Carlo simulation. The result showed again a median saving of 0.71 days and ∼$2,500 per patient in hospital cost. A ballistic sensitivity analysis was performed to show that the sensitivity of postoperative day 4 amylase level in detecting a leak was the most important factor in the model. We conclude that implementing an amylase-based screening method for anastomotic leak in postesophagectomy patient can significantly reduce hospital cost and length of stay. This study demonstrates a novel protocol to improve postesophagectomy care. Based on this result, we believe a prospective multicenter study is appropriate. [ABSTRACT FROM AUTHOR]