Diagonal Earlobe Crease: A Warning Sign of Stroke

Abstract Background: The diagonal earlobe crease (DELC), commonly referred to as “Frank’s sign”, was first described in 1973 by an American physician as a crease in the earlobe that originates at the tragus and runs diagonally towards the outer, lower edge. Over the past half-century, research on this dermatologic finding has found a significant correlation between the presence of a DELC and coronary artery disease (CAD). Additionally, DELC has also been associated with other risk factors associated with both CAD and stroke, which include hypertension (HTN), diabetes mellitus (DM), and age. Despite this, skepticism has led to this physical exam finding being overlooked as a predictive marker. Therefore, the purpose of this systematic review was to analyze the association between the DELC and stroke risk. Methods: An exhaustive search of available medical literature was conducted in MEDLINE-PubMed, CINAHL, and Google Scholar, using the search terms diagonal earlobe, Frank’s sign, stroke, cerebrovascular, and cerebral. References from relevant articles were also searched. Articles were included only after screening for relevance and if eligibility criteria were met. An assessment of quality was performed using the GRADE system. Results: The initial literature search yielded 40 articles for review. After eliminating duplicates and screening for relevant articles, a total of 2 qualifying case-control studies remained. The quality of those studies was low, however the results of both studies were consistent. These studies support a positive correlation between the presence of DELC and stroke risk. Conclusion: This systematic review determined there was a correlation between the presence of a DELC and an increased stroke risk. Based on the findings, visual examination of patients’ earlobes should be incorporated into routine physical evaluations and clinical assessments. Doing so may provide a clinician with an additional tool to recognize and provide earlier interventions, decreasing a patient’s risk of future cerebrovascular events

Predicting Temporal Patterns In The Environment: Toward Primitive Mechanisms Of Learning, Memory, And Generalization

Across a wide range of cognitive tasks, recent experience influences subsequent behavior. For example, when individuals repeatedly perform a speeded two-alternative choice task, response latencies vary dramatically based on the immediately preceding sequence. These sequential dependencies (SDs) have been interpreted as adaptation to the statistical structure of an uncertain, changing environment (e.g., Jones & Sieck, 2003; Mozer, Kinoshita, & Shettel, 2007; Yu & Cohen, 2009), and can shed light on how individuals learn and represent structure in binary stimulus sequences. Heretofore, theories have posited that SDs arise from rapidly (exponentially) decaying memory traces of various environmental statistics (e.g., Cho et al., 2002; Yu & Cohen, 2009).

We present a series of experiments and a model that place SDs on a fundamentally different foundation. We show that: (1) decay of recent experience can follow a power function curve, not an exponential, linking the SD literature
to a rich literature on human declarative memory; (2) the simple trace-based mechanism underlying existing accounts is inadequate, but incremental memory adjustments may be explained via error correction, linking the SD literature to the rich literature on human associative learning; and (3) distinct but interacting subsystems are found in the brain that jointly predict upcoming environmental events. 

We conducted three behavioral studies with EEG recordings of individuals performing discrimination of spatial location and motion coherence. Identifying the onset of the lateralized readiness potential (LRP) in an event-related EEG analysis, we are able to decompose the total response latency into two intervals—pre and post LRP onset—and to examine SDs in stimulus and response processing separately. We find evidence for two distinct mechanisms, one reflecting incremental learning of stimulus repetition rate (i.e., the probability that successive
stimuli will match), and the other reflecting incremental learning of response baserates. The data cannot be explained by a model that assumes these rates are based on independent traces, and calls for an account in which the two rates jointly predict future stimuli via error-correction learning. 

By manipulating the autocorrelation structure of the sequences (from a positive to a negative autocorrelation, indicated on the graphs by blue and red lines, respectively), we obtained evidence for incremental learning occurring over hundreds of trials, which is parsimoniously explained by a memory with power function decay. Together, the results highlight a tension between the two broad and well established classes of trace-based memory models and learning models based on error correction. Two attempts at reconciling these approaches via modeling are discussed

The Sooner, the Better? Couples\u27 First Financial Discussion, Relationship Quality, and Financial Conflict in Emerging Adulthood

In couple relationships, discussing finances is often considered taboo. Specifically, emerging adult couples experience several unique financial challenges that may contribute to poorer financial communication and pose relational risks. Utilizing structural equation modeling with a sample of 1,950 U.S. emerging adults, the current study tests associations between the time of a couple’s first financial discussion, financial communication, relationship quality, and financial conflict. Results indicate that initiating financial discussion earlier in a romantic relationship may benefit relationship quality—through financial communication. However, having an earlier first financial discussion as a couple was also positively associated with financial conflict. Financial therapists might consider teaching emerging adult couples to have a first financial discussion earlier along with strategies to overcome financial conflict. Additionally, financial therapists may consider assessing when emerging adult couples first discussed finances in their relationship. Overall, our findings suggest the sooner an emerging adult couple discusses finances, the better

ISSLS PRIZE IN BIOENGINEERING SCIENCE 2019: biomechanical changes in dynamic sagittal balance and lower limb compensatory strategies following realignment surgery in adult spinal deformity patients.

Study designA longitudinal cohort study.ObjectiveTo define a set of objective biomechanical metrics that are representative of adult spinal deformity (ASD) post-surgical outcomes and that may forecast post-surgical mechanical complications. Current outcomes for ASD surgical planning and post-surgical assessment are limited to static radiographic alignment and patient-reported questionnaires. Little is known about the compensatory biomechanical strategies for stabilizing sagittal balance during functional movements in ASD patients.MethodsWe collected in-clinic motion data from 15 ASD patients and 10 controls during an unassisted sit-to-stand (STS) functional maneuver. Joint motions were measured using noninvasive 3D depth mapping sensor technology. Mathematical methods were used to attain high-fidelity joint-position tracking for biomechanical modeling. This approach provided reliable measurements for biomechanical behaviors at the spine, hip, and knee. These included peak sagittal vertical axis (SVA) over the course of the STS, as well as forces and muscular moments at various joints. We compared changes in dynamic sagittal balance (DSB) metrics between pre- and post-surgery and then separately compared pre- and post-surgical data to controls.ResultsStandard radiographic and patient-reported outcomes significantly improved following realignment surgery. From the DSB biomechanical metrics, peak SVA and biomechanical loads and muscular forces on the lower lumbar spine significantly reduced following surgery (- 19 to - 30%, all p < 0.05). In addition, as SVA improved, hip moments decreased (- 28 to - 65%, all p < 0.05) and knee moments increased (+ 7 to + 28%, p < 0.05), indicating changes in lower limb compensatory strategies. After surgery, DSB data approached values from the controls, with some post-surgical metrics becoming statistically equivalent to controls.ConclusionsLongitudinal changes in DSB following successful multi-level spinal realignment indicate reduced forces on the lower lumbar spine along with altered lower limb dynamics matching that of controls. Inadequate improvement in DSB may indicate increased risk of post-surgical mechanical failure. These slides can be retrieved under Electronic Supplementary Material

Climate Variability and Local Environmental Stressors Influencing Migration in Nang Rong, Thailand

Scholars point to climate change, often in the form of more frequent and severe drought, as a potential driver of migration in the developing world, particularly in populations that rely on agriculture for their livelihoods. To date, however, there have been few large-scale, longitudinal studies that explore the relationship between climate change and migration. This study significantly extends current scholarship by evaluating distinctive effects of slow onset climate change and short-term extreme events upon different migration outcomes. Our analysis models the effect of the environment--as measured by Normalized Difference Vegetation Index (NDVI) and the occurrence of El Nino Southern Oscillation (ENSO) events—on migration out of Nang Rong. Our preliminary findings indicate that predominantly dry El Niño periods of 24 months duration lead to outmigration, while predominantly wetter La Niña periods of 12-month duration reduce outmigration. Clustered monthly patterns of annual NDVI fluctuation indicate that villagers living in pixels that exhibit early, consistently higher, and steep rising green-up are less likely to migrate out in the subsequent year

Magnetic effects on the low-T/|W| instability in differentially rotating neutron stars

Dynamical instabilities in protoneutron stars may produce gravitational waves whose observation could shed light on the physics of core-collapse supernovae. When born with sufficient differential rotation, these stars are susceptible to a shear instability (the "low-T/|W| instability"), but such rotation can also amplify magnetic fields to strengths where they have a considerable impact on the dynamics of the stellar matter. Using a new magnetohydrodynamics module for the Spectral Einstein Code, we have simulated a differentially-rotating neutron star in full 3D to study the effects of magnetic fields on this instability. Though strong toroidal fields were predicted to suppress the low-T/|W| instability, we find that they do so only in a small range of field strengths. Below 4e13 G, poloidal seed fields do not wind up fast enough to have an effect before the instability saturates, while above 5e14 G, magnetic instabilities can actually amplify a global quadrupole mode (this threshold may be even lower in reality, as small-scale magnetic instabilities remain difficult to resolve numerically). Thus, the prospects for observing gravitational waves from such systems are not in fact diminished over most of the magnetic parameter space. Additionally, we report that the detailed development of the low-T/|W| instability, including its growth rate, depends strongly on the particular numerical methods used. The high-order methods we employ suggest that growth might be considerably slower than found in some previous simulations.Comment: REVTeX 4.1, 21 pages, 18 figures, submitting to Physical Review

Electrophysiological correlates of high-level perception during spatial navigation

We studied the electrophysiological basis of object recognition by recording scalp\ud electroencephalograms while participants played a virtual-reality taxi driver game.\ud Participants searched for passengers and stores during virtual navigation in simulated\ud towns. We compared oscillatory brain activity in response to store views that were targets or\ud nontargets (during store search) or neutral (during passenger search). Even though store\ud category was solely defined by task context (rather than by sensory cues), frontal ...\ud \u

Dollfustrema durum n. sp. and Heterobucephalopsis perardua n. sp. (Digenea: Bucephalidae) from the giant moray eel, Gymnothorax javanicus (Bleeker) (Anguilliformes: Muraenidae), and proposal of the Heterobucephalopsinae n. subfam.

Two new species of bucephalid trematode (Platyhelminthes: Digenea) are described from the giant moray eel, Gymnothorax javanicus (Anguilliformes: Muraenidae), from off Lizard Island, Australia. We used a combined morphological and molecular-based approach targeting the internal transcribed spacer 2 (ITS2) of the ribosomal DNA (rDNA) and the D1-D3 region of the large subunit (28S) of rDNA to circumscribe the species. Dollfustrema durum n. sp. is distinguished from seven congeners in having 5-6 rows of enlarged body spines circling the anterior portion of the rhynchus. From the remaining 10 species, D. durum n. sp. differs in body length, and in having a caecum that terminates posteriorly to the confluent arc formed by the vitelline follicles, gonads predominantly anterior to the pharynx, testes in tandem, an anterior testis positioned posteriorly to the vitelline follicles, and the pre-vitelline field 23-40% of the body length. Heterobucephalopsis perardua n. sp. differs from Heterobucephalopsis gymnothoracis, the type- and only other reported species, in being two to three times smaller. Heterobucephalopsis, currently considered a genus inquirendum, is confirmed as valid and is rediagnosed. Bayesian inference analysis of 28S rDNA sequences representing 28 species from nine genera and four subfamilies of bucephalid, indicates that i) subfamily classifications previously based on morphological characters are broadly robust, ii) the sequence representing H. perardua n. sp. is resolved as distinct, and basal, to sequences representing the Bucephalinae, the Prosorhynchinae, the Paurorhynchinae, and the Dolichoenterinae, iii) the Dolichoenterinae and the Prosorhynchinae are monophyletic sister clades, basal to the Bucephalinae and the Paurorhynchinae, iv) sequences representing Grammatorcynicola, Prosorhynchus, and Dollfustrema are also monophyletic, v) the Bucephalinae is paraphyletic relative to the Paurorhynchinae, and vi) the bucephaline genera Prosorhynchoides, Rhipidocotyle, and Bucephalus are each polyphyletic. The morphological and molecular differences observed among the four previously recognised subfamilies in this study lead us to propose Heterobucephalopsinae n. subfam. to accommodate the genus Heterobucephalopsis.Continued funding from the Australian Research Council and the Australian Biological Research Study to THC supported this study.This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/j.parint.2015.07.00

\u3ci\u3eDollfustrema durum\u3c/i\u3e n. sp. and \u3ci\u3eHeterobucephalopsis perardua\u3c/i\u3e n. sp. (Digenea: Bucephalidae) from the giant moray eel, \u3ci\u3eGymnothorax javanicus\u3c/i\u3e (Bleeker) (Anguilliformes: Muraenidae), and proposal of the Heterobucephalopsinae n. subfam

Two new species of bucephalid trematode (Platyhelminthes: Digenea) are described from the giant moray eel, Gymnothorax javanicus (Anguilliformes: Muraenidae), from off Lizard Island, Australia. We used a combined morphological and molecular-based approach targeting the internal transcribed spacer 2 (ITS2) of the ribosomal DNA (rDNA) and the D1–D3 region of the large subunit (28S) of rDNA to circumscribe the species. Dollfustrema durum n. sp. is distinguished from seven congeners in having 5–6 rows of enlarged body spines circling the anterior portion of the rhynchus. From the remaining 10 species, D. durum n. sp. differs in body length, and in having a caecum that terminates posteriorly to the confluent arc formed by the vitelline follicles, gonads predominantly anterior to the pharynx, testes in tandem, an anterior testis positioned posteriorly to the vitelline follicles, and the pre-vitelline field 23–40% of the body length. Heterobucephalopsis perardua n. sp. differs from Heterobucephalopsis gymnothoracis, the type- and only other reported species, in being two to three times smaller. Heterobucephalopsis, currently considered a genus inquirendum, is confirmed as valid and is rediagnosed. Bayesian inference analysis of 28S rDNA sequences representing 28 species from nine genera and four subfamilies of bucephalid, indicates that i) subfamily classifications previously based on morphological characters are broadly robust, ii) the sequence representing H. perardua n. sp. is resolved as distinct, and basal, to sequences representing the Bucephalinae, the Prosorhynchinae, the Paurorhynchinae, and the Dolichoenterinae, iii) the Dolichoenterinae and the Prosorhynchinae are monophyletic sister clades, basal to the Bucephalinae and the Paurorhynchinae, iv) sequences representing Grammatorcynicola, Prosorhynchus, and Dollfustrema are also monophyletic, v) the Bucephalinae is paraphyletic relative to the Paurorhynchinae, and vi) the bucephaline genera Prosorhynchoides, Rhipidocotyle, and Bucephalus are each polyphyletic. The morphological and molecular differences observed among the four previously recognised subfamilies in this study lead us to propose Heterobucephalopsinae n. subfam. to accommodate the genus Heterobucephalopsis