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Wildlife translocations are increasingly used to combat declining biodiversity worldwide. Successful translocation often hinges on coexistence between humans and wildlife, yet not all translocation efforts explicitly include human dimensions (e.g., economic incentives, education programs, and conflict reduction assistance). To evaluate the prevalence and associated outcomes of including human dimensions as objectives when planning translocations, we analyze 305 case studies from the IUCN's Global Re-Introduction Perspectives Series. We find that fewer than half of all projects included human dimension objectives (42%), but that projects including human dimension objectives were associated with improved wildlife population outcomes (i.e., higher probability of survival, reproduction, or population growth). Translocation efforts were more likely to include human dimension objectives if they involved mammals, species with a history of local human conflict, and local stakeholders. Our findings underscore the importance of incorporating objectives related to human dimensions in translocation planning efforts to improve conservation success.

Large carnivores play critical roles in terrestrial ecosystems but have suffered dramatic range contractions over the past two centuries. Developing an accurate understanding of large carnivore diets is an important first step towards an improved understanding of their ecological roles and addressing the conservation challenges faced by these species.The puma is one of seven large felid species in the world and the only one native to the non-tropical regions of the New World. We conducted a meta-analysis of puma diets across the species' range in the Americas and assessed the impact of varying environmental conditions, niche roles, and human activity on puma diets. Pumas displayed remarkable dietary flexibility, consuming at least 232 different prey species, including one Critically Endangered and five Endangered species.Our meta-analysis found clear patterns in puma diets with changing habitat and environmental conditions. Pumas consumed more larger-bodied prey species with increasing distance from the equator, but consumption of medium-sized species showed the opposite trend.Puma diets varied with their realized niche; however, contrary to our expectations, puma consumption of large species did not change with their trophic position, and pumas consumed more small prey and birds as apex predators. Consumption of domestic species was negatively correlated with consumption of medium-sized wild species, a finding which underscores the importance of maintaining intact native prey assemblages.The tremendous dietary flexibility displayed by pumas represents both an opportunity and a challenge for understanding the puma's role in ecosystems and for the species' management and conservation. Future studies should explore the linkages between availability and selection of primary and other wild prey, and consequent impacts on predation of domestic species, in order to guide conservation actions and reduce conflict between pumas and people.

Sensor technology embedded within the total knee arthroplasty (TKA) implant has the potential to record data that can track recovery and provide diagnostic information. In this study, we introduce the concept of physical function recovery curve analytics, which are created from daily spatial-temporal gait metrics and step counts from a large cohort of TKA patients. In our study population, 258 patients underwent a primary TKA with a smart implanted tibial extension between October 4, 2021, and July 15, 2022, by 33 surgeons. The average age was 63 years, with 138 (54%) women. All kinematic data were collected on a Health Insurance Portability and Accountability Act–compliant cloud data management platform. Summaries of the gait parameters at 6 weeks are suggestive of differences between people over and under 65 years, with the older patients walking more slowly and having shorter stride lengths. The 6-week percentiles demonstrated a strong linear correlation to the 12-week percentiles for each gait parameter, with correlation coefficients ranging from 0.87 to 0.92. A novel screening gait test at 6 weeks shows promising results for predicting patients who will likely have poor recovery based on at least one gait parameter recovery curve at 12 weeks with high sensitivity and specificity. A future study is needed to validate the screening tool with an independent set of patients. [ABSTRACT FROM AUTHOR]

Regional, national, and international 30 × 30 conservation initiatives would be strengthened by including a specific focus on freshwater ecosystem conservation that supplements terrestrial conservation strategies. Globally, freshwater habitats support essential biodiversity and ecosystem services, yet are being lost at disproportionately high rates relative to terrestrial systems. Making freshwater ecosystems an explicit focus of 30 × 30 initiatives would assist in curtailing these losses while advancing 30 × 30's mission to address climate change, economic sustainability, food security, and equitable outdoor access across a variety of landscapes. Here, we explain how fresh water can serve as a key piece of 30 × 30 conservation efforts. We emphasize that to address the challenges of traditional area‐based conservation programs, 30 × 30 should (1) focus on watershed‐scale conservation planning and (2) evaluate conserved areas based on five freshwater priorities: connectivity, watershed disturbance, flow alteration, water quality, and biodiversity. We use examples from the US state of California to illustrate how addressing freshwater systems can help guide 30 × 30 conservation. [ABSTRACT FROM AUTHOR]

Sinonasal-inverted papilloma (SNIP) is a rare, benign tumor of the sinonasal tract. Although these tumors are inherently benign, they are prone to malignant transformation and are associated with an unusually high rate of recurrence, even after complete surgical resection. As such, these patients must be followed long-term to monitor for recurrence or the presence of cancer. Unfortunately, there are currently no standards for long-term surveillance, and protocols usually require routine radiography and/or nasal endoscopy, which are not highly sensitive or specific, are time consuming, expensive, and confer morbidity to the patient. There is evidence that suggests that SNIP is associated with a uniquely detectable volatile metabolite signature. This study investigates the ability of four privately owned dogs to learn to identify the presence of SNIP in patients based on blood plasma samples. This type of medical detection is currently being used to create early diagnostic tools for other disease processes, which suggests promising results for the outcome of this study. Blood/plasma and nasal secretions were collected from both patients with SNIP, and healthy age-, sex-, and smoking-status-matched controls. Training was conducted twice weekly using errorless learning techniques that allowed the dogs to utilize odor concentration to guide their understanding of the target odor. After further training, a subsequent double-blind testing phase was conducted, in which the dogs' ability to expand recognition of the target odor from blood plasma samples to nasal secretion samples was assessed. Analysis of recorded training sessions revealed that the dogs exhibited successful odor discrimination between SNIP-positive plasma samples and SNIP-negative controls. Their pattern of behavior change also suggested similarity between SNIP odor in plasma and nasal secretions. [Display omitted] • Trained detection dogs can differentiate between blood plasma from people with sinonasal inverted papillomas (SNIP) and healthy blood plasma. • Dogs differentiated positive and negative SNIP odor in blood plasma, even though they were trained on a very small sample set. • These trained detection dogs demonstrate that there is similarity between the SNIP-positive odor from the medium of blood plasma to the SNIP-positive odor in the medium of nasal secretions, suggesting that may be a common SNIP odor biomarker between the two sample types. [ABSTRACT FROM AUTHOR]

• Predominance of STEMI occurrence in male patients and 50–90 years patients, without differences over decades; • Incidence of STEMI following ambulance call may suggest worse patient clinical condition compared to direct ER access; • Young patients (under 40 years of age) seem to be more used to going directly to ER instead of calling the ambulance; • Highest percentage of STEMI occurrence in August and between 10 A.M. and 12 A.M. and the lowest one at 2–5 A.M.. [ABSTRACT FROM AUTHOR]

A theoretical framework, united by a "system effect" is formulated to model the cutting/haptic force evolution at the cutting edge of a surgical cutting instrument during its penetration into soft biological tissue in minimally invasive surgery. Other cutting process responses, including tissue fracture force, friction force, and damping, are predicted by the model as well. The model is based on a velocity-controlled formulation of the corresponding equations of motion, derived for a surgical cutting instrument and tissue based on Kirchhoff's fundamental energy conservation law. It provides nearly zero residues (absolute errors) in the equations of motion balances. In addition, concurrent closing relationships for the fracture force, friction coefficient, friction force, process damping, strain rate function (a constitutive tissue model), and their implementation within the proposed theoretical framework are established. The advantage of the method is its ability to make precise real-time predictions of the aperiodic fluctuating evolutions of the cutting forces and the other process responses. It allows for the robust modeling of the interactions between a medical instrument and a nonlinear viscoelastic tissue under any physically feasible working conditions. The cutting process model was partially qualitatively verified through numerical simulations and by comparing the computed cutting forces with experimentally measured values during robotic uniaxial biopsy needle constant velocity insertion into artificial gel tissue, obtained from previous experimental research. The comparison has shown a qualitatively similar adequate trend in the evolution of the experimentally measured and numerically predicted cutting forces during insertion of the needle. [Display omitted] [ABSTRACT FROM AUTHOR]

Carotid endarterectomy (CEA) is among the most commonly performed vascular procedures. Some have suggested worse outcomes with contralateral internal carotid artery (ICA) occlusion. We compared patients with and patients without contralateral ICA occlusion using the Society for Vascular Surgery Vascular Quality Initiative database. Deidentified data were obtained from the Vascular Quality Initiative. Patients with prior ipsilateral or contralateral CEA, carotid stenting, combined CEA and coronary artery bypass graft, or <1-year follow-up were excluded, yielding 1737 patients with and 45,179 patients without contralateral ICA occlusion. Groups were compared with univariate tests, and differences identified in univariate testing were entered into multivariate models to identify independent predictors of outcomes and in particular whether contralateral ICA occlusion is an independent predictor of outcomes. Patients with contralateral ICA occlusion were younger and more likely to be smokers; they were more likely to have chronic obstructive pulmonary disease, preoperative neurologic symptoms (56% vs 47%), nonelective CEA (16% vs 13%), and shunt placement (75% vs 53%; all P <.001). The 30-day ipsilateral stroke risk was 1.3% with vs 0.7% without contralateral ICA occlusion (P =.004). The 30-day and 1-year survival estimates were 99.0% ± 0.5% and 94.1% ± 1.1% with vs 99.6% ± 0.1% and 96.0% ± 0.2% without contralateral ICA occlusion (log-rank, P <.001). Logistic regression analysis identified prior neurologic event (P =.046), nonelective surgery (P =.047), absence of coronary artery disease (P =.035), and preoperative angiotensin-converting enzyme inhibitor use (P =.029) to be associated with 30-day ipsilateral stroke risk, but contralateral ICA occlusion remained an independent predictor in that model (odds ratio, 2.29; P =.026). However, after adjustment for other factors (Cox proportional hazards), risk of ipsilateral stroke (including perioperative) during follow-up was not significantly greater with contralateral ICA occlusion (hazard ratio, 1.21; P =.32). Results comparing propensity score-matched cohorts mirrored those from the larger data set. This study demonstrates likely clinically insignificant differences in early stroke or death in comparing CEA patients with and those without contralateral ICA occlusion. After adjustment for other factors, contralateral ICA occlusion was not associated with a greater risk of ipsilateral stroke (including perioperative) in longer follow-up. Mortality was greater with contralateral ICA occlusion, and this difference was more pronounced at 1 year despite younger age of the contralateral ICA occlusion group. CEA risk remains low even in the presence of contralateral ICA occlusion and appears to be explained at least in part by other factors. CEA should still be considered appropriate in the face of contralateral ICA occlusion. [ABSTRACT FROM AUTHOR]

The authors report the procedural and 30-day results of the PASCAL Transcatheter Valve Repair System (Edwards Lifesciences, Irvine, California) in patients with mitral regurgitation (MR) enrolled in the multicenter, prospective, single-arm CLASP study. Severe MR may lead to symptoms, impaired quality of life, and reduced functional capacity when untreated. Eligible patients had grade 3+ or 4+ MR despite optimal medical therapy and were deemed appropriate for the study by the local heart team. All outcomes were assessed through 30 days post-procedure. Major adverse events (MAEs) were adjudicated by an independent clinical events committee, and echocardiographic images were assessed by a core laboratory. The primary safety endpoint was the rate of MAEs at 30 days. Between June 2017 and September 2018, 62 patients with grade 3+ or 4+ MR were enrolled. The mean age was 76.5 years, and 51.6% of patients were in New York Heart Association functional class III or IV, with 56% functional, 36% degenerative, and 8% mixed MR etiology. At 30 days, the MAE rate was 6.5%, with an all-cause mortality rate of 1.6% and no occurrence of stroke; 98% had MR grade ≤2+, with 86% with MR grade ≤1+ (p < 0.0001); and 85% were in New York Heart Association functional class I or II (p < 0.0001). Six-minute walk distance improved by 36 m (p = 0.0018), and Kansas City Cardiomyopathy Questionnaire and EQ-5D scores improved by 17 (p < 0.0001) and 10 (p = 0.0004) points, respectively. The PASCAL repair system showed feasibility and acceptable safety in the treatment of patients with grade 3+ or 4+ MR. MR severity, irrespective of etiology, was significantly reduced and accompanied by clinically and statistically significant improvements in functional status, exercise capacity, and quality of life. (The CLASP Study Edwards PASCAL Transcatheter Mitral Valve Repair System Study; NCT03170349) [ABSTRACT FROM AUTHOR]