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Spatial patterns of and competition for resources by territorial carnivores are typically explained by two hypotheses: 1) the territorial defence hypothesis and 2) the searching efficiency hypothesis. According to the territorial defence hypothesis, when food resources are abundant, carnivore densities will be high and home ranges small. In addition, carnivores can maximise their necessary energy intake with minimal territorial defence. At medium resource levels, larger ranges will be needed, and it will become more economically beneficial to defend resources against a lower density of competitors. At low resource levels, carnivore densities will be low and home ranges large, but resources will be too scarce to make it beneficial to defend such large territories. Thus, home range overlap will be minimal at intermediate carnivore densities. According to the searching efficiency hypothesis, there is a cost to knowing a home range. Larger areas are harder to learn and easier to forget, so carnivores constantly need to keep their cognitive map updated by regularly revisiting parts of their home ranges. Consequently, when resources are scarce, carnivores require larger home ranges to acquire sufficient food. These larger home ranges lead to more overlap among individuals' ranges, so that overlap in home ranges is largest when food availability is the lowest. Since conspecific density is low when food availability is low, this hypothesis predicts that overlap is largest when densities are the lowest. We measured home range overlap and used a novel method to compare intraspecific home range overlaps for lionsPanthera leo(n=149) and leopardsPanthera pardus(n=111) in Africa. We estimated home range sizes from telemetry location data and gathered carnivore density data from the literature. Our results did not support the territorial defence hypothesis for either species. Lion prides increased their home range overlap at conspecific lower densities whereas leopards did not. Lion pride changes in overlap were primarily due to increases in group size at lower densities. By contrast, the unique dispersal strategies of leopards led to reduced overlap at lower densities. However, when human-caused mortality was higher, leopards increased their home range overlap. Although lions and leopards are territorial, their territorial behaviour was less important than the acquisition of food in determining their space use. Such information is crucial for the future conservation of these two iconic African carnivores.

Background Carpal tunnel release (CTR) may be concomitantly performed along with distal radius fracture open reduction internal fixation (DRF ORIF) to prevent carpal tunnel syndrome; however, there is little to no literature investigating the rate, risk factors, and complications associated with CTR. Questions/Purposes The purpose was to determine (1) the rate of CTR performed at time of DRF ORIF, (2) factors associated with CTR, and (3) whether CTR was associated with any complications. Patients and Methods In this case-control study, adult patients who underwent DRF ORIF from 2014 to 2018 were identified from a national surgical database. Two cohorts were analyzed, (1) patients with CTR and (2) patients without CTR. Preoperative characteristics and postoperative complications were compared with determine factors associated with CTR. Results Of the 18,466 patients, 769 (4.2%) had CTR. Rates of CTR in patients with intra-articular fractures with two or three fragments were significantly higher than the rate of CTR for patients with extra-articular fractures. Underweight patients underwent CTR at a significantly lower rate compared with overweight and obese patients. The American Society of Anesthesiologists ≥3 was associated with a higher rate of CTR. Male and older patients were less likely to have CTR. Conclusion The rate of CTR at time of DRF ORIF was 4.2%. Intra-articular fractures with multiple fragments were strongly associated with CTR at time of DRF ORIF, while being underweight, elderly, and male were associated with lower rates of CTR. These findings should be considered when developing clinical guidelines to assess the need for CTR in patients undergoing DRF ORIF. This is a retrospective case control study and reflects level of evidence III.

AimAssessing the distribution and persistence of species across their range is a crucial component of wildlife conservation. It demands data at adequate spatial scales and over extended periods of time, which may only be obtained through collaborative efforts, and the development of methods that integrate heterogeneous datasets. We aimed to combine existing data on large carnivores to evaluate population dynamics and improve knowledge on their distribution nationwide.LocationBotswana.MethodsBetween 2010 and 2016, we collated data on African wild dog, cheetah, leopard, brown and spotted hyaena and lion gathered with different survey methods by independent researchers across Botswana. We used a multi-species, multi-method dynamic occupancy model to analyse factors influencing occupancy, persistence and colonization, while accounting for imperfect detection. Lastly, we used the gained knowledge to predict the probability of occurrence of each species countrywide.ResultsWildlife areas and communal rangelands had similar occupancy probabilities for most species. Large carnivore occupancy was low in commercial farming areas and where livestock density was high, except for brown hyaena. Lion occupancy was negatively associated with human density; lion and spotted hyaena occupancy was high where rainfall was high, while the opposite applied to brown hyaena. Lion and leopard occupancy remained constant countrywide over the study period. African wild dog and cheetah occupancy declined over time in the south and north, respectively, whereas both hyaena species expanded their ranges. Countrywide predictions identified the highest occupancy for leopards and lowest for the two hyaena species.Main ConclusionsWe highlight the necessity of data sharing and propose a generalizable analytical method that addresses the challenges of heterogeneous data common in ecology. Our approach, which enables a comprehensive multi-species assessment at large spatial and temporal scales, supports the development of data-driven conservation guidelines and the implementation of evidence-based management strategies nationally and internationally. published

Background: The purpose of this study was to evaluate rates of distal radioulnar joint (DRUJ) fixation based on location of the radial shaft fracture and risk factors associated with postoperative complications following radial shaft open reduction internal fixation (ORIF). Methods: Adult patients who underwent isolated radial shaft ORIF from 2014 to 2018 were identified from American College of Surgeons National Surgical Quality Improvement Program database and stratified by fracture location and by the presence or absence of DRUJ fixation. Preoperative patient characteristics and postoperative complications were compared to determine risk factors associated with DRUJ fixation. Results: We identified 1517 patients who underwent isolated radial shaft ORIF, of which 396 (26.1%) underwent DRUJ fixation. Preoperative patient characteristics and postoperative complications were similar between cohorts. Distal radioulnar joint fixation was performed in 50 (30.7%) of 163 distal radial shaft fractures, 191 (21.8%) of 875 midshaft fractures, and 3 (13.0%) of 23 proximal shaft fractures ( P = .025). Risk factors for patients readmitted include male sex (odds ratio [OR] = 12.76, P = .009) and older age (OR = 4.99, P = .035). Risk factors for patients with any postoperative complication include dependent functional status (OR = 6.78, P = .02), older age (50-69 vs Conclusions: The rate of DRUJ fixation in radial shaft ORIF exceeded previously reported rates of concomitant DRUJ injury, especially among distal radial shaft fractures. More distally located radial shaft fractures are significantly associated with higher rates of DRUJ fixation. Male sex is a risk factor for readmission, whereas dependent functional status, older age, and ASA ≥3 are risk factors for postoperative complications.

SummaryHumans are contributing to large carnivore declines around the globe, and conservation interventions should focus on increasing local stakeholder tolerance of carnivores and be informed by both biological and social considerations. In the Okavango Delta (Botswana), we tested new conservation strategies alongside a pre-existing government compensation programme. The new strategies included the construction of predator-proof livestock enclosures, the establishment of an early warning system linked to GPS satellite lion collars, depredation event investigations and educational programmes. We conducted pre- and post-assessments of villagers’ livestock management practices, attitudes towards carnivores and conservation, perceptions of human–carnivore coexistence and attitudes towards established conservation programmes. Livestock management levels were low and 50% of farmers lost livestock to carnivores, while 5–10% of owned stock was lost. Respondents had strong negative attitudes towards lions, which kill most depredated livestock. Following new management interventions, tolerance of carnivores significantly increased, although tolerance of lions near villages did not. The number of respondents who believed that coexistence with carnivores was possible significantly increased. Respondents had negative attitudes towards the government-run compensation programme, citing low and late payments, but were supportive of the new management interventions. These efforts show that targeted, intensive management can increase stakeholder tolerance of carnivores.

In Africa's pastoral conservation landscapes, apex predators frequently kill livestock. Retaliatory persecution such as poisoning threatens predators, but also non-target biota. Several factors influence conflict severity, including livestock husbandry, overlap in seasonal habitat use, and the degree to which livestock perceive and are able to respond to a landscape of fear. We investigated these factors by GPS-tracking 42 Tswana beef cattle (Bos taurus) from 29 herds in 2017 and six lions (Panthera leo) from different prides (May 2016–Dec. 2017) in the northern Okavango Delta, Botswana, where cattle depredation significantly impacts the livelihoods of rural agro-pastoralists. Cattle exhibited seasonal habitat selection patterns similar to wild ungulates in the region. They preferred woodland habitats, with more digestible grasses, during the wet season. During the dry season, they preferred wetland habitats with reliable forage and water availability. Cattle also preferred areas close to human settlements, but the necessity to forage in wetlands during the dry season exposed them to significant depredation risk, especially >4 km from settlements. Lions killed most cattle in wetlands during the late dry season but the intensity of recent lion presence (previous 14 days) only had a weak negative effect on cattle habitat selection patterns. Cattle used rangelands according to nutritional requirements, irrelevant of the associated predation risk, suggesting that socio-ecologically acceptable conflict solutions cannot rely on the exclusion of livestock from seasonal wetlands. Curbing depredation by lions will best be achieved by a combination of resource- and predation-cognisant seasonal herding strategies with adequate livestock protection. Understanding the ecological constraints that intensify conflict is pertinent to any livestock production landscape with predator presence. It is also a central prerequisite for future land use planning and devolution of legal, controlled resource access rights through policy. Coexistence strategies must account for the strong reliance of people, their livestock, and wildlife on shared key resources. This is particularly important in large trans-frontier conservation areas where the successful merging of biodiversity conservation and rural development is a strategic goal. Omission will foster resentment and resistance to coexistence with apex predators, particularly if livestock productivity and human livelihoods are negatively affected.

In recent years, there have been significant advances in the technology used to collect data on the movement and activity patterns of humans and animals. GPS units, which form the primary source of location data, have become cheaper, more accurate, lighter and less power‐hungry, and their accuracy has been further improved with the addition of inertial measurement units. The consequence is a glut of geospatial time series data, recorded at rates that range from one position fix every several hours (to maximize system lifetime) to ten fixes per second (in high dynamic situations). Since data of this quality and volume have only recently become available, the analytical methods to extract behavioral information from raw position data are at an early stage of development. An instance of this lies in the analysis of animal movement patterns. When investigating solitary animals, the timing and location of instances of avoidance and association are important behavioral markers. In this paper, a novel analytical method to detect avoidance and association between individuals is proposed; unlike existing methods, assumptions about the shape of the territories or the nature of individual movement are not needed. Simulations demonstrate that false positives (type I error) are rare (1%–3%), which means that the test rarely suggests that there is an association if there is none.

Home range size is a fundamental measure of animal space use, providing insight into habitat quality, animal density, and social organization. Human impacts increasingly are affecting wildlife, especially among wide-ranging species that encounter anthropogenic disturbance. Leopards (Panthera pardus) provide a useful model for studying this relationship because leopards coexist with people at high and low human densities and are sensitive to human disturbance. To compare leopard home range size across a range of human densities and other environmental conditions, we combined animal tracking data from 74 leopards in multiple studies with new analytical techniques that accommodate different sampling regimes. We predicted that home ranges would be smaller in more productive habitats and areas of higher human population density due to possible linkage with leopard prey subsidies from domestic species. We also predicted that male leopards would have larger home ranges than those of females. Home ranges varied in size from 14.5 km2 in India to 885.6 km2 in Namibia, representing a 60-fold magnitude of variation. Home range stability was evident for 95.2% of nontranslocated individuals and 38.5% of translocated individuals. Leopard home range sizes were negatively correlated with landscape productivity, and males used larger areas than females. Leopards in open habitats had a predicted negative correlation in home range size with human population density, but leopards in closed habitats used larger home ranges in areas with more people.

Despite being a common form of abuse, there is a paucity of literature describing shackling and wrist restraint injuries among survivors of torture. Forensic evaluation of alleged wrist restraint/handcuff injuries in survivors of torture presents challenges to the evaluator, especially if the injuries are remote and do not leave lasting marks nor neurologic deficits. Thorough history-taking and physical examination are critical to effective forensic documentation. Guidance is provided in The Manual on Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (Istanbul Protocol), the gold standard for the medicolegal documentation of torture. This guidance relies primarily on physical findings, with less direction provided on how to interpret historical evidence or when historical evidence provided by the patient can be interpreted as highly consistent with alleged injury in the absence of current physical findings. Through a case-based review, we present diagnostic strategies for the evaluation of alleged abuse involving wrist restraints/handcuffs, focusing on skin, neurologic, and osseous injuries. We highlight key findings from both the history and physical examination that will allow the evaluator to improve the accuracy of their expert medical opinion on the degree to which medical findings correlate with the patient's allegations of wrist restraint injuries.

Fortified kraals are predator-proof enclosures designed to protect livestock at night. Globally, they show great promise in reducing depredation by carnivores, thus promoting co-existence with people. Their efficacy depends on effectiveness, durability, regular use, owner satisfaction, cost-efficiency, and design. We monitored 32 fortified kraals for 18 months in a high conflict area in northern Botswana (n = 427 kraal months) where lions (Panthera leo) frequently kill cattle. Monthly kraal use was 60% and was significantly influenced by kraal type, age, and shape. When used and maintained, kraals stopped livestock depredation. Due to poor maintenance, however, kraal age had a significant, negative influence on kraal use and effectiveness, compromising sustainability and cost-effectiveness. Fortified kraals built by a non-governmental organisation cost US$1322.36 per unit (n = 20) and mitigated a mean annual loss of $187.32. This suggests cost-recuperation after 7.0 years, or 2.3 times longer than observed kraal lifetime. Conversely, owner-built replicates cost $579.90 per unit (n = 4), recuperating investment after 3.1 years. Owner satisfaction was significantly higher for fortified kraals when compared with traditional kraals. However, owners of fortified kraals did not kraal their cattle more frequently than owners of traditional kraals. Regionally, the mean annual kraaling rate for 29 GPS-monitored cattle herds (n = 3360 nights) was 40%, leaving cattle vulnerable to depredation, and highlighting the importance of promoting vigilant herding together with kraaling to prevent losses. This combination could reduce regional livestock losses by 80%, or >$38,000 annually, however, kraal fortification alone does not provide a blanket solution to carnivore conflicts in Africa's agro-pastoral landscapes.

Background: Medicare reimbursement is known to exhibit geographic variation for inpatient orthopedic procedures. This study determined whether US geographic variations also exist for commonly performed hand surgeries. Methods: Using the Medicare Provider Utilization and Payment Data (2012-2013) from Centers for Medicare & Medicaid Services, we analyzed regional physician charges/payments for common outpatient hand surgeries. Results: The most commonly performed procedures in the United States were open carpal tunnel release (n = 21 944), trigger finger release (n = 15 345), endoscopic carpal tunnel release (n = 7106), and basal joint arthroplasty/ligament reconstruction and tendon interposition (n = 2408). A range of average Medicare physician reimbursements existed based on geographic region for basal joint arthroplasty ($669-$571), endoscopic carpal tunnel release ($400-$317), open carpal tunnel release ($325-$261), and trigger finger release ($215-$167). The latter three exhibited statistically significant variation across geographic regions with regard to both charges and physician reimbursement. However, the overall percentage physician reimbursement (70%-79%) to charges was similar across all geographic regions. Conclusions: In conclusion, further research is warranted to determine why regional or geographic variations in physician payments exist in the United States for commonly performed hand surgeries.

Case A 46-year-old man presented with extensive swelling and ecchymosis of the arm and antecubital fossa after a 4-foot fall from a ladder in which he attempted to arrest his decent by grabbing onto a wooden ceiling beam. Ultrasound and magnetic resonance imaging confirmed a complete intrasubstance rupture of the biceps brachii. Nonoperative management was recommended and, at 9-week follow-up, the patient had resumed light weightlifting and demonstrated painless full active range of motion. Conclusions Uncommon complete intrasubstance biceps brachii ruptures can occur via an atypical mechanism of isotonic eccentric muscle contraction and satisfactory results may be realized through nonoperative management.

Delayed unions and nonunions of the scaphoid are most often treated by open reduction and internal fixation with bone grafting. We sought to evaluate a large consecutive series of nondisplaced or minimally displaced scaphoid nonunions and delayed unions treated by a compression screw without bone grafting by 2 fellowship trained hand surgeons. A total of 23 patients (19 males, 4 females) were identified who had fractures located at the distal third (2), the waist (18), and the proximal third (3). Of the 23 patients, 19 had a complete follow-up (mean follow-up period, 5.2 months) with evidence of radiographic union. There were no radiographic signs of arthrosis, osteonecrosis of the scaphoid, hardware-related complications, or reported revision surgeries. In conclusion, nonunions and delayed unions in nondisplaced or minimally displaced scaphoids without carpal malalignment can be successfully treated using compression screw fixation without bone grafting.

Introduction: Aberrant positioning of the ulnar nerve volar to the transverse carpal ligament is a rare anatomic variation.Case Presentation: We present the case of a 55-year-old female with unique ulnar nerve anatomy that was discovered introperatively during carpal tunnel release. The ulnar nerve was running directly adjacent to the median nerve in the distal forearm and as the median nerve traversed dorsal to the transverse carpal ligament (flexor retinaculum) to enter the carpal tunnel the ulnar nerve continued directly volar to this structure before angling towards Guyon’s Canal. The unique ulnar nerve anatomy was successfully identified, carefully dissected and managed with a successful patient outcome.Conclusion: Variations of the anatomy at the level of the carpal tunnel are rare but do exist. Awareness of these anatomic variations and adequate visualization of the ulnar nerve along with the surrounding structures is crucial to avoid iatrogenic injuries during carpal tunnel release.

When protected carnivores harm people’s livelihoods, conservationists often seek non-lethal mitigation strategies. Large carnivore translocation is one such strategy but it has shown limited success. Many reported examples used methods that likely contributed to their failure. We conducted six leopard (Panthera pardus) translocations (three males, three females) within Namibia to test specific criteria for improved protocols. We moved leopards 402.7 km (SD = 279.6 km, range 47–754 km). Overall translocation success, using strict criteria, was 67 % and increased to 83 % when post-release conflict was not considered in this assessment. Four individuals successfully established new territories after exploratory periods of

The geographic distribution and habitat association of most mammalian polymorphic phenotypes are still poorly known, hampering assessments of their adaptive significance. Even in the case of the black panther, an iconic melanistic variant of the leopard (Panthera pardus), no map exists describing its distribution. We constructed a large database of verified records sampled across the species’ range, and used it to map the geographic occurrence of melanism. We then estimated the potential distribution of melanistic and non-melanistic leopards using niche-modeling algorithms. The overall frequency of melanism was ca. 11%, with a significantly non-random spatial distribution. Distinct habitat types presented significantly different frequencies of melanism, which increased in Asian moist forests and approached zero across most open/dry biomes. Niche modeling indicated that the potential distributions of the two phenotypes were distinct, with significant differences in habitat suitability and rejection of niche equivalency between them. We conclude that melanism in leopards is strongly affected by natural selection, likely driven by efficacy of camouflage and/or thermoregulation in different habitats, along with an effect of moisture that goes beyond its influence on vegetation type. Our results support classical hypotheses of adaptive coloration in animals (e.g. Gloger’s rule), and open up new avenues for in-depth evolutionary analyses of melanism in mammals.

Panthera pardus (leopard; Linnaeus, 1758) is the smallest of the 4 large felids in the genus Panthera. A solitary and adaptable species, P. pardus is the widest ranging of all wild felids, inhabiting rain forests, mountains, semiarid environments, and suburban areas throughout sub-Saharan Africa, the Middle East, and South Asia to the Russian Far East. Despite this distribution, P. pardus is listed as “Near Threatened” by the International Union for Conservation of Nature and Natural Resources and several Asian subspecies are listed as endangered. P. pardus primarily feeds on small to medium-sized ungulates, but has a varied diet including fish, reptiles, birds, and small mammals.

We identified the diet of brown hyaenas (Hyaena brunnea) on the farmlands of north-central Namibia based on scat analysis, den site orts, and evidence of scavenging at leopard (Panthera pardus) kills. In the absence of larger carnivores, which have been credited with providing larger food items for brown hyaenas elsewhere, we compared interspecific dietary overlap and activity patterns with the remaining large carnivores, leopards and cheetahs (Acinonyx jubatus). Where hyaenas and leopards were sympatric, diets of both nocturnal species (n = 212 hyaena scats and 41 leopard scats) were quite similar (both >89% wild, with some domestic ungulates), and only somewhat different from cheetahs in a previous study. Additionally, evidence of brown hyaena scavenging was found at 76% of 29 leopard kills available to them. Brown hyaenas occurring on Namibian farmlands likely find medium-sized to large ungulate prey by scavenging from leopards and perhaps cheetahs.

Protected areas are commonly assumed to (and most do)harbour higher densities of wildlife than adjacent, human-modified landscapes (Woodroffe & Ginsberg, 1998; Melville& Bothma, 2006; Gaston et al., 2008; Newmark, 2008;Kiner et al., 2009). In north-central Namibia, farmersbelieved that leopard (Panthera pardus) densities weregrowing on farmland areas adjacent to Waterberg PlateauPark and that the Park was a source population for leop-ards venturing beyond park boundaries during the night tofeed on the livestock in the farmlands (Stein, 2008).Leopard densities elsewhere have been correlated withungulate abundance (Stander et al., 1997; Marker D Henschel & Ray,2003; Silver et al., 2004; Jackson et al., 2006) combinedwith home range sizes estimated from telemetry data.

Finger necrosis has rarely been described as the presenting symptom of Chiari Malformation Type 1 (CM-1). We present a case of a 36-year-old man who presented with extensive thumb necrosis as the first presenting sign of a cervicothoracic syrinx in the setting of CM-1. The patient underwent debridement and partial amputation with groin flap coverage but subsequently developed additional neurological complaints of the left upper extremity. A suboccipital decompressive craniectomy, bilateral C1 laminectomy, and occipital duraplasty successfully relieved most of his symptoms. Healthcare professionals should consider CM-1 as a rare cause of finger necrosis.

We investigated the livestock farms surrounding the Waterberg Plateau Park in north-central Namibia to assess farmer attitudes, management techniques, financial impacts, as well as the potential benefits of tourism and trophy hunting, with respect to leopard Panthera pardus conservation. Farmers were asked about their use of six livestock husbandry techniques and farmers who employed at least one had 85% less reported conflict than farmers not employing any. Livestock farmers lost on average 3.8% of their calves to depredation annually (US$1370 per farm per year) but were willing to lose 3.3%, a difference of only US$180 per farm or US$3064 regionally. Where losses were higher than stated tolerance, we found that potential benefits from tourism and trophy hunting could offset losses. Surveys with tourists and professional hunters in the region strengthened this conclusion.

In northcentral Namibia, Waterberg Plateau Park (WPP) is a protected area that acts as a refuge for rare and endangered species, while the farmlands surrounding the Park are managed for livestock production, but support populations of wildlife for game farming, trophy hunting, and conservation. During June–October 2006, camera-traps were set within and surrounding WPP to assess leopard (Panthera pardus) density (n = 19 camera stations and 946 camera-trap-nights). Fortuitously, photographic results (2,265 photos of identifiable mammal (n = 37) and bird (n = 25) species) allowed us to assess aspects of species diversity and differences among the Park, the farmland areas along the Waterberg Plateau escarpment, and the flatlands surrounding the escarpment. Species composition among the three areas was markedly different, and made sense with respect to differences in habitat and management features. Camera-trapping efforts, although intended for a narrow purpose, may also provide a rather robust record of differences in mammal and bird diversity in adjacent habitats and can be incorporated into long-term monitoring programs.

The leopard’s (Panthera pardus) broad geographic range, remarkable adaptability, and secretive nature have contributed to a misconception that this species might not be severely threatened across its range. We find that not only are several subspecies and regional populations critically endangered but also the overall range loss is greater than the average for terrestrial large carnivores. To assess the leopard’s status, we compile 6,000 records at 2,500 locations from over 1,300 sources on its historic (post 1750) and current distribution. We map the species across Africa and Asia, delineating areas where the species is confirmed present, is possibly present, is possibly extinct or is almost certainly extinct. The leopard now occupies 25–37% of its historic range, but this obscures important differences between subspecies. Of the nine recognized subspecies, three (P. p. pardus, fusca,andsaxicolor) account for 97% of the leopard’s extant range while another three (P. p. orientalis, nimr,andjaponensis) have each lost as much as 98% of their historic range. Isolation, small patch sizes, and few remaining patches further threaten the six subspecies that each have less than 100,000 km2of extant range. Approximately 17% of extant leopard range is protected, although some endangered subspecies have far less. We found that while leopard research was increasing, research effort was primarily on the subspecies with the most remaining range whereas subspecies that are most in need of urgent attention were neglected.

INTRODUCTION A person's health literacy is one of the most important indicators of a patient's health status. According to national recommendations, patient education materials should be written at no higher than the sixth- to eighth-grade reading level. The purpose of our study was to assess the readability of online patient education materials related to orthopaedic oncology on the websites of the American Academy of Orthopaedic Surgeons (AAOS), American Cancer Society (ACS), Bone and Cancer Foundation (BCF), and National Cancer Institute (NCI). METHODS We searched the online patient education libraries of the AAOS, ACS, BCF, and NCI for all articles related to orthopaedic oncology. The Flesch-Kincaid (FK) readability score was calculated for each article and compared between sources. RESULTS A total of 227 articles were identified with an overall mean FK grade level of 9.8. Stratified by source, the mean FK grade levels were 10.1, 9.6, 11.1, and 9.5 for the AAOS, ACS, BCF, and NCI, respectively (P < 0.003). Only 31 articles (14%) and 1 article (0.4%) were at or below the recommended eighth- and sixth-grade levels, respectively. DISCUSSION Online patient education materials related to orthopaedic oncology appear to be written at a level above the comprehension ability of the average patient.

Most large mammalian carnivores are in global decline, principally due to conflict with livestock farmers. Because endangered African wild dogs (Lycaon pictus) range widely, often beyond the boundaries of protected areas, they may be particularly exposed to lethal control by farmers, even where nominally protected by reserves. Hence, effectively conserving wild dogs demands resolution of their conflicts with farmers. We investigated livestock depredation by African wild dogs living outside protected areas in northern Kenya. Scat analysis confirmed the distribution of depredation events reported by local farmers, indicating that farmer reports – collated by local Community Liaison Officers – gave a reasonably good index of the true pattern of depredation. Although livestock were abundant throughout the study area, depredation was exceedingly uncommon (approximately one attack per 1000 km2 per year) and the costs of tolerating wild dogs were very low (US $3.40/wilddog/year) where wild prey remained, even at low densities. However, where wild prey were seriously depleted, wild dogs killed livestock repeatedly, and the cost of sustaining them rose to US $389/wilddog/year. Hence, although wild dogs had a negligible economic impact in the region, their impact was locally severe. Conservation activities for wild dogs are most likely to be successful if targeted at areas where wild prey remain, and where traditional herding practices have been retained.

Purpose Carpal tunnel syndrome coexists with basal joint arthritis in a large percentage of patients. These 2 conditions are often treated surgically through separate incisions. The purpose of this cadaver study is to show the effect of trapeziectomy and transverse carpal ligament release from the scaphoid tubercle on carpal canal pressures. This technique may permit both problems to be addressed through the same Wagner incision. Methods In 4 fresh frozen cadaver limbs pressures in the carpal canal were elevated to 30 mm Hg through a percutaneously placed balloon. Pressures were measured using an 18-gauge sideport needle via a transducer. Trapeziectomy and release of the transverse carpal ligament from the scaphoid were performed in succession through a Wagner incision with canal pressures measured after each step. Results Carpal canal pressures decreased after trapeziectomy (mean, 7 mm Hg; range, 3–14 mm Hg) but did not return to baseline (0 mm Hg) until complete release of the ligament. Conclusions Decompression of the carpal tunnel can be performed effectively through a Wagner incision during basal joint arthroplasty. This cadaver model shows reduction in the canal pressures after trapeziectomy and release of the transverse carpal ligament. This single-incision approach is attractive because it may decrease morbidity compared with a 2-incision approach in patients with concomitant carpal tunnel syndrome and basal joint arthritis.

Though the distribution of Atlantic sturgeon Acipenser oxyrinchus is relatively well known in freshwater and estuarine habitats in the northern portion of their range, their distribution in marine habitats is poorly understood. Sturgeon migrate into marine waters to forage between spawning events and probably maintain gene flow between river populations by entering nonnatal river systems to spawn. While at sea, they are captured in commercial fishing gears. We investigated data collected by onboard fishery observers to determine the occurrence and habitat preference of Atlantic sturgeon off the northeastern coast of the United States. Sturgeon distributions were based on monitored fishing trips over the period 1989–2000 and referenced to local bathymetry and sediment data. The results show that peak sturgeon captures along the coast were approximately bracketed by isobaths ranging from 10 to 50 m. Sturgeon were present more frequently on gravel and sand sediment types and were associated with spe...

Protected sturgeon Acipenser spp. are caught in a number of different commercial fishing gears along the east coast of the USA. During their life cycle, Atlantic sturgeon Acipenser oxyrinchus migrate into marine waters, where they are caught by otter trawls, sink gill nets, and drift gill nets targeting other species. We investigated fishing records collected by onboard observers to calculate Atlantic sturgeon bycatch and mortality rates for each fishing gear. Bycatch rates were based on fishing trips monitored between 1989 and 2000 and were indexed by landed species and state. Rates were then raised to fisherywide estimates of bycatch based on total landings for the relevant gears at each location. Where data were available, we estimated sturgeon mortality for each gear. The results showed that Atlantic sturgeon bycatch was highest for sink gill nets in specific areas of the coast. The observed immediate mortality rates of Atlantic sturgeon captured in sink gill nets and drift gill nets were 22%...

Context Conflicts between wildlife and humans have occurred for millennia, and are major drivers of wildlife decline. To promote coexistence, Botswana established buffer zones called wildlife-management areas (WMAs) adjacent to National Parks and Reserves where communities assume stewardship of wildlife and derive financial benefits from it. In contrast, communities outside WMAs are generally excluded from these benefits despite incurring ‘coexistence costs’, including crop damage and livestock depredation, although they may receive compensation for these losses. Aims To investigate the perceptions and actions of a livestock farming community outside (but surrounded by) WMAs in northern Botswana, especially in relation to predator management. Methods We conducted standard-format interviews with 62 heads of households (cattleposts), and evaluated responses using descriptive and multivariate statistics. Key results Almost half (46%) of respondents expressed negative perceptions of predators, with 67% reporting losses to predation. After disease, predation was the most commonly reported source of livestock losses. Increased age of the head of household was the strongest predictor of reported predation. Few households employed husbandry beyond kraaling at night, but some (21%) reported conducting lethal control of predators. Reported use of lethal control was independent of the household experience with predation and whether they derived financial benefits from wildlife. Instead, households with larger herds were more likely to report using lethal control, despite the most educated farmers tending to have larger herds. Lethal control was almost twice as likely in households previously denied government compensation for losses (42%) than in those granted compensation (23%). Perhaps as a result of perceived failures of the government compensation scheme, most households (91%) supported the development of an independent insurance program, with 67% expressing willingness to pay a premium. Conclusions Our results challenge the assumption that deriving financial benefit from wildlife increases tolerance. A measurable disconnect also exists between the willingness of a household to employ lethal control and their experience with predation, suggesting that lethal control was used pre-emptively rather than reactively. Implications Efforts must be made to connect the financial costs incurred during farming alongside wildlife with the financial benefits derived from wildlife. Where compensation schemes exist, timely payments may reduce retaliatory killing.

The Kangerlussuaq margin is well furrowed by icebergs. The margin favors furrow preservation since sedimentation on the continental shelf is low, at least since the last (Flakkerhuk) glaciation and because shelf depths are well below wave base. While furrows are common in the Kangerlussuaq region, the icebergs that created the larger furrows are mostly absent. "Fresh" iceberg furrows are observed only on the bathymetric highs surrounding the 750-m-deep Kangerlussuaq Trough. Bathymetric barriers around the trough prevent icebergs with deep keels from entering the trough. Enormous and weathered (older) furrows are located inside the protected trough, apparently formed at paleocalving ice sheet termini, when the Greenland Ice Sheet extended onto the shelf. In the deeper sections of Kangerlussuaq Trough, Holocene mud is presently burying these older iceberg furrows. Paleocalving ice sheet margins, possibly from Iceland, account for muted furrows found on the upper continental slope of East Greenland. No sediment has been deposited over these hardground sites since 14,750 ? 720 BP.

The thumb frequently is involved in rheumatoid arthritis and often is a source of significant functional loss, pain, and deformity. Fortunately, much can be done to provide pain relief, improve function, enhance appearance, and slow the progression of disease. Specific surgical interventions should be based on the nature and stage of deformity as well as the status of tendons, ligaments, and adjacent joints. Treatment options, in isolation or in combination, include synovectomy, arthrodesis, arthroplasty, and tendon repair or transfer. Although most thumb deformities can be classified as one of six common types, other patterns of deformity also are seen. It therefore is imperative not to operate on pattern recognition alone, but to examine each patient carefully and individualize treatment.

Marine sediment cores were obtained from in front of the Müller Ice Shelf in Lallemand Fjord, Antarctic Peninsula in the austral summer of 1990–91. Sedimentological and geochemical data from these cores document a warm period that preceded the advance of the Müller Ice Shelf into Lallemand Fjord. The advance of the ice shelf is inferred from a reduction in the total organic carbon content and an increase in well-sorted, aeolian, sand in cores proximal to the present calving line. This sedimentological change is paralleled by a change in the foraminiferal assemblages within the cores. Advance of the ice shelf is indicated by a shift from assemblages dominated by calcareous benthic and planktonic forms to those dominated by agglutinated forms. A 14C chronology for the cores indicates that the advance of the Müller Ice Shelf took place c. 400 years ago, coincident with glacier advances in other high southern latitude sites during the onset of the Little Ice Age. Ice core evidence, however, documents this period as one of warmer temperatures for the Antarctic Peninsula. We suggest that the ice shelf advance was linked to the exclusion of circumpolar deep water from the fjord. This contributed to increased mass balance of the ice shelf system by preventing the rapid undermelt that is today associated with warm circumpolar deep water within the fjord. We also document the recent retreat of the calving line of the Müller Ice Shelf that is apparently in response to a recent (four decade long) warming trend along the western side of the Antarctic Peninsula.

Leopards (Panthera pardus) are the most widely distributed wild felid in the world, living sympatrically with numerous competitively dominant species in various large carnivore guilds. Leopards generally feed on small to medium-sized ungulates and risk kleptoparasitism from intraguild competitors. One unique, adaptive response to intraguild competition is arboreal caching (‘hoisting’) by leopards. Hoisting behaviour is thought to vary in frequency among individuals, populations, and between sexes. In our study, leopards fed primarily (85% of observed kills) on impala (Aepyceros melampus), which is the most locally abundant potential prey species. Although we did not detect statistical differences in hoisting rates among individuals within each sex, our results confirmed moderate hoisting rates of 35% in an area with medium densities of lions (Panthera leo), spotted hyaenas (Crocuta crocuta) and African wild dogs (Lycaon pictus). Sex differences in prey hoisting were related to size, and males as the large...

A 41-year-old professional guitar player who was in an automobile accident sustained a distal radial fracture. The patient is neurologically intact and has no open wounds.

Debris flow deposits dominate the acoustic profiles of the East Greenland continental slope (Figures 1 and 2). Huntec Deep Tow Seismic (DTS)® and 10 in3 sleeve gun provided the seismic source signatures. Huntec data recorded by the internal hydrophone were prefiltered between 1.0 and 6.0 kHz and digitized by the Ferranti SE880 at 50 µsec (20 kHz) with a data window of 400 to 500 µsec (i.e. between 8000 to 10000 samples per shot trigger). The boomer source was an ED10F/C powered by 4 kv (560 joules). The sleeve gun data were prefiltered between 100 and 1500 kHz and digitized by the Ferranti SE880 at 200 µsec (5 kHz) with a data window of 1 and 2 sec (at 5000 to 10000 samples per shot trigger). Details of the methodology are well described in Asprey et a 1. (1994).