Comparison of two electrofishing gears (backpack and parallel wires) and abundances of fishes of the upper Greenbrier River drainage

The type of electrofishing gear influences capture efficiencies and abundance estimates of stream fishes. Few studies have examined the Holton and Sullivan (1954) parallel wires method of electrofishing. For this study, I modeled removal data with seven sampling occasions of three common species, western blacknose dace (Rhinichthys obtusus), fantail darter (Etheostoma flabellare), and mottled sculpin ( Cottus bairdi) from 10 paired sites in the upper Greenbrier River drainage, West Virginia, and estimated capture efficiencies of two electrofishing gear types (the Holton and Sullivan parallel wires method with alternating current and backpack units with pulsed-direct current). Ten candidate models represented alternative hypotheses of how capture efficiency differs among sites, among stream segments, among gear types, and by site covariates of stream width, water current velocity, water depth, and rock size. Additionally, depending on sample size, I modeled capture probabilities based on four sampling occassions for estimates of abundance or reported total numbers of fish species separated by site and gear type. For each sampling occasion and data for western blacknose dace and fantail darter, capture efficiencies of parallel wires exceeded that of the backpack electrofisher at all sites, and were obtained from the best approximating models of either gear or gear + stream width effects. For mottled sculpin, capture efficiencies of parallel wires was less than that of the backpack electrofisher at all sites, and were taken from the best approximating models with gear or gear + rock size effects. First pass estimates of capture probabilities of western blacknose dace and fantail darter were consistently higher for the parallel wires sampling. For mottled sculpin, first pass estimates of capture probabilities were consistently highest from backpack sampling. The parallel wires electrofisher with AC electrical current, through use of electrodes that span the width of the stream, effectively samples pelagic, near-benthic, and some benthic species, but is less effective than DC-pulsed backpack gears at sampling species that use under-rock habitats as refuge. Modification of parallel wires to include DC or pulsed-DC current should improve capture efficiencies of benthic fishes in cobble/boulder streams

Professions of love : the discursive construction of love and romance in intimate heterosexual relationships

For this thesis, my aim was to deconstruct the notion of heterosexual love in order to question if and how current stories of love are involved in producing gender inequality. Using discourse analysis, informed by feminist theory, I analysed, in detail, qualitative interviews with eleven women and eleven men about their most important intimate heterosexual relationships and their experiences of love. The traditional view of romantic love as a symbol of freedom and redemption has been challenged by feminist arguments that romantic love obscures male privilege in intimate heterosexual relationships. Mainstream social psychological research has tended to measure and categorize 'love' with little regard to wider historical and social contexts which means that the few in-depth explorations of the complex meanings of love are primarily sociological. Where some research has suggested that gender inequality may proceed from women's investment in romance and men's in emotional illiteracy (e.g. Jackson, 1993; Langford, 1999), others conceive that a wider democratization of social life is producing a shift to more rational and equitable intimate relationships (e.g. Giddens, 1992; Illouz, 1997). My findings demonstrate that talk of love is extremely complex while also cliched and inchoate. I identified two broad and pervasive discourses, in tension with each other - the discourse of romantic love and the work discourse of love and intimacy. The romantic discourse was inextricably inscribed with discourses of emotion where the work discourse was associated with doing rather than feeling. The work discourse allowed the male interviewees, in particular, to construct relationships as contexts for their own personal growth work and exercise of expertise. The democratization of heterosexual love may not be well underway if a shift to rational intimacy involves a transformation of romantic feeling into a narcissistic discourse of personal success. I also identified how male privilege was instantiated in discourses of infidelity

Predictors of Swallowing Outcomes in Patients with Combat-Injury Related Dysphagia

Background: Traumatic injuries, such as those from combat-related activities, can lead to complicated clinical presentations that may include dysphagia. Methods: This retrospective observational database study captured dysphagia-related information for 215 US military service members admitted to the first stateside military treatment facility after sustaining combat-related or combat-like traumatic injuries. A multidimensional relational database was developed to document the nature, course, and management for dysphagia in this unique population and to explore variables predictive of swallowing recovery using Bayesian statistical modeling and inferential statistical methods. Results: Bayesian statistical modeling revealed the importance of maxillofacial fractures and soft tissue loss as primary predictors of poor swallowing outcomes. The presence of traumatic brain injury (TBI), though common, did not further complicate dysphagia outcomes. A more detailed examination and rating of videofluoroscopic swallow studies from a subset of 161 participants supported greater impairment for participants with maxillofacial trauma and no apparent relationship between having sustained a TBI and swallow functioning. Conclusion: These analyses revealed that maxillofacial trauma is a stronger indicator than TBI of dysphagia severity and slower or incomplete recovery following combat-related injuries. Level of evidence: Therapeutic/Care Management study, level IV

Management of Monophasic Synovial Sarcoma of the Small Intestine

Although prognosis for patients with intraabdominal synovial sarcoma is poor, laparoscopic wide regional excision may allow for a more prolonged disease-free survival

Use of Generative AI for Improving Health Literacy in Reproductive Health: Case Study.

BackgroundPatients find technology tools to be more approachable for seeking sensitive health-related information, such as reproductive health information. The inventive conversational ability of artificial intelligence (AI) chatbots, such as ChatGPT (OpenAI Inc), offers a potential means for patients to effectively locate answers to their health-related questions digitally.ObjectiveA pilot study was conducted to compare the novel ChatGPT with the existing Google Search technology for their ability to offer accurate, effective, and current information regarding proceeding action after missing a dose of oral contraceptive pill.MethodsA sequence of 11 questions, mimicking a patient inquiring about the action to take after missing a dose of an oral contraceptive pill, were input into ChatGPT as a cascade, given the conversational ability of ChatGPT. The questions were input into 4 different ChatGPT accounts, with the account holders being of various demographics, to evaluate potential differences and biases in the responses given to different account holders. The leading question, "what should I do if I missed a day of my oral contraception birth control?" alone was then input into Google Search, given its nonconversational nature. The results from the ChatGPT questions and the Google Search results for the leading question were evaluated on their readability, accuracy, and effective delivery of information.ResultsThe ChatGPT results were determined to be at an overall higher-grade reading level, with a longer reading duration, less accurate, less current, and with a less effective delivery of information. In contrast, the Google Search resulting answer box and snippets were at a lower-grade reading level, shorter reading duration, more current, able to reference the origin of the information (transparent), and provided the information in various formats in addition to text.ConclusionsChatGPT has room for improvement in accuracy, transparency, recency, and reliability before it can equitably be implemented into health care information delivery and provide the potential benefits it poses. However, AI may be used as a tool for providers to educate their patients in preferred, creative, and efficient ways, such as using AI to generate accessible short educational videos from health care provider-vetted information. Larger studies representing a diverse group of users are needed

Taste Manipulation and Swallowing Mechanics in Trauma-Related Sensory-Based Dysphagia

Purpose: This study explored the effects of highconcentration taste manipulation trials on swallow function in persons with sensory-based dysphagia. Method: Dysphagia researchers partnered with clinical providers to prospectively identify traumatically injured U.S. military service members (N = 18) with sensorybased dysphagia as evidenced by delayed initiation and/or decreased awareness of residue/penetration/ aspiration. Under videofluoroscopy, participants swallowed trials of 3 custom-mixed taste stimuli: unflavored (40% weight/volume [wt/vol] barium sulfate in distilled water), sour (2.7%wt/vol citric acid in 40% wt/vol barium suspension), and sweet–sour (1.11% wt/vol citric acid plus 8% wt/vol sucrose in 40% wt/vol barium suspension). Trials were analyzed and compared via clinical rating tools (the Modified Barium Swallow Impairment Profile [Martin-Harris et al., 2008] and the Penetration-Aspiration Scale [Rosenbek, Robbins, Roecker, Coyle, & Wood, 1996]). Additionally, a computational analysis of swallowing mechanics (CASM) was applied to a subset of 9 swallows representing all 3 tastants from 3 participants. Results: Friedman’s tests for the 3 stimuli revealed significantly (p \u3c .05) improved functional ratings for Penetration-Aspiration Scale and pharyngoesophageal opening. CASM indicated differences in pharyngeal swallowing mechanics across all tastant comparisons (p ≤ .0001). Eigenvectors revealed increased tongue base retraction, hyoid elevation, and pharyngeal shortening for sweet–sour and, to a lesser extent, sour than for unflavored boluses. Conclusion: Advantageous changes in certain parameters of oropharyngeal swallowing physiology were noted with high-intensity tastants per both clinical ratings and subsequent CASM, suggesting potential therapeutic application for taste manipulation

Dysphagia Management and Research in an Acute-Care Military Treatment Facility: The Role of Applied Informatics

Purpose: This report describes the development and preliminary analysis of a database for traumatically injured military service members with dysphagia. Methods: A multidimensional database was developed to capture clinical variables related to swallowing. Data were derived from clinical records and instrumental swallow studies, and ranged from demographics, injury characteristics, swallowing biomechanics, medications, and standardized tools (e.g.. Glasgow Coma Scale, Penetration-Aspiration Scale). Bayesian Belief Network modeling was used to analyze the data at intermediate points, guide data collection, and predict outcomes. Predictive models were validated with independent data via receiver operating characteristic curves. Results: The first iteration of the model (n = 48) revealed variables that could be collapsed for the second model (n = 96). The ability to predict recovery from dysphagia improved from the second to third models (area under the curve = 0.68 to 0.86). The third model, based on 161 cases, revealed “initial diet restrictions” as first-degree, and “Glasgow Coma Scale, intubation history, and diet change” as second-degree associates for diet restrictions at discharge. Conclusion: This project demonstrates the potential for bioinformatics to advance understanding of dysphagia. This database in concert with Bayesian Belief Network modeling makes it possible to explore predictive relationships between injuries and swallowing function, individual variability in recovery, and appropriate treatment options

A Comparison of NAL and DSL Prescriptive Methods for Paediatric Hearing-Aid Fitting: Predicted Speech Intelligibility and Loudness

Objective: To examine the impact of prescription on predicted speech intelligibility and loudness for children. Design: A between-group comparison of speech intelligibility index (SII) and loudness, based on hearing aids fitted according to NAL-NL1, DSL v4.1, or DSL m[i/o] prescriptions. A within-group comparison of gains prescribed by DSL m[i/o] and NAL-NL2 for children in terms of SII and loudness. Study sample: Participants were 200 children, who were randomly assigned to first hearing-aid fitting with either NAL-NL1, DSL v4.1, or DSL m[i/o]. Audiometric data and hearing-aid data at 3 years of age were used. Results: On average, SII calculated on the basis of hearing-aid gains were higher for DSL than for NAL-NL1 at low input level, equivalent at medium input level, and higher for NAL-NL1 than DSL at high input level. Greater loudness was associated with DSL than with NAL-NL1, across a range of input levels. Comparing NAL-NL2 and DSL m[i/o] target gains revealed higher SII for the latter at low input level. SII was higher for NAL-NL2 than for DSL m[i/o] at medium- and high-input levels despite greater loudness for gains prescribed by DSL m[i/o] than by NAL-NL2. Conclusion: The choice of prescription has minimal effects on speech intelligibility predictions but marked effects on loudness predictions

Multiclinic Observations on the Simplified Diet in PKU

Phenylketonuria is an inborn error of metabolism that historically has been treated with a strict phenylalanine-restricted diet where all foods are weighed and measured. This is cumbersome and difficult for patients and caregivers, especially patients with high phenylalanine blood concentrations who often have neurocognitive deficits. The Simplified Diet is an alternative approach that allows for increased flexibility, promotes healthy food choices, and is easier to manage than a traditional diet for PKU. This paper describes the implementation of the Simplified Diet and outlines education, counseling strategies, and challenges encountered by three metabolic clinics in the United States

Dose-Response of Aerobic Exercise on Cognition: A Community-Based, Pilot Randomized Controlled Trial

Epidemiological studies suggest a dose-response relationship exists between physical activity and cognitive outcomes. However, no direct data from randomized trials exists to support these indirect observations. The purpose of this study was to explore the possible relationship of aerobic exercise dose on cognition. Underactive or sedentary participants without cognitive impairment were randomized to one of four groups: no-change control, 75, 150, and 225 minutes per week of moderate-intensity semi-supervised aerobic exercise for 26-weeks in a community setting. Cognitive outcomes were latent residual scores derived from a battery of 16 cognitive tests: Verbal Memory, Visuospatial Processing, Simple Attention, Set Maintenance and Shifting, and Reasoning. Other outcome measures were cardiorespiratory fitness (peak oxygen consumption) and measures of function functional health. In intent-to-treat (ITT) analyses (n = 101), cardiorespiratory fitness increased and perceived disability decreased in a dose-dependent manner across the 4 groups. No other exercise-related effects were observed in ITT analyses. Analyses restricted to individuals who exercised per-protocol (n = 77) demonstrated that Simple Attention improved equivalently across all exercise groups compared to controls and a dose-response relationship was present for Visuospatial Processing. A clear dose-response relationship exists between exercise and cardiorespiratory fitness. Cognitive benefits were apparent at low doses with possible increased benefits in visuospatial function at higher doses but only in those who adhered to the exercise protocol. An individual’s cardiorespiratory fitness response was a better predictor of cognitive gains than exercise dose (i.e., duration) and thus maximizing an individual’s cardiorespiratory fitness may be an important therapeutic target for achieving cognitive benefits