Mute Swans and Their Chesapeake Bay Habitats:Proceedings of a Symposium

The symposium “Mute Swans and their Chesapeake Bay Habitats,” held on June 7, 2001, provided a forum for biologists and managers to share research findings and management ideas concerning the exotic and invasive mute swan (Cygnus olor). This species has been increasing in population size and is considered by many to be a problem in regard to natural food resources in the Bay that are used by native waterfowl during the winter months. Other persons, however, feel that resource managers are attempting to create a problem to justify more killing of waterfowl by hunters. Some persons also believe that managers should focus on the larger issues causing the decline of native food resources, such as the unabated human population increase in the Bay watershed and in the immediate coastal areas of the Bay. The symposium, sponsored by the Wildfowl Trust of North America and the U.S. Geological Survey, provided the atmosphere for presentation of mute swan data and opinions in a collegial setting where discussion was welcomed and was often informative and enthusiastic. An interesting historic review of the swan in regard to the history of mankind was presented, followed by a discussion on the positive and negative effects of invasive species. Biologists from different parts of the continent discussed the population status of the species in several states in the east and in the Great Lakes area. Data on the food habits of this species were presented in regard to submerged aquatic vegetation, and an interesting discussion on the role that the food habits of Canada geese in regard to native vegetation was presented. Findings and recommendations of the Mute Swan Task Force were presented. Finally, a representative of the Friends of Animals gave a thought-provoking presentation in defense of the mute swan. The presentations, in general, provided the necessary information and recommendations to allow managers to proceed with management of this controversial species with new and valuable perspectives

All interventions differ, although some are more different than others

It is a well-known statement of statistical wisdom that all treatments differ. We could substitute the word ‘intervention’ or the phrase ‘surgical procedure’ for ‘treatment’ and qualify the word ‘differ’ by, for instance, saying “have different outcomes”. Yet, in doing so we challenge far more than semantics, questioning the relevance of much of the research reported in The Bone and Joint Journal, and the wider medical literature. For example, the DRAFFT study compared the clinical effectiveness of Kirschner wire fixation with locking plate fixation for patients with a dorsally displaced fracture of the distal radius. Selectively picking out the key result of the paper one would conclude that there was no difference in outcomes between the two groups; thus that there was no difference between the treatments. This result seems to contradict the first statement in this paragraph, which follows from the simple argument that by definition all treatments must be different because no two things can ever be exactly the same in every respect. This sounds like a matter of philosophical interest only, but understanding how we reconcile this apparent contradiction helps shed light on an issue that continues to be a cause of confusion for many authors submitting papers to our Journal

The Mason-Alberta Phonetic Segmenter: A forced alignment system based on deep neural networks and interpolation

Forced alignment systems automatically determine boundaries between segments in speech data, given an orthographic transcription. These tools are commonplace in phonetics to facilitate the use of speech data that would be infeasible to manually transcribe and segment. In the present paper, we describe a new neural network-based forced alignment system, the Mason-Alberta Phonetic Segmenter (MAPS). The MAPS aligner serves as a testbed for two possible improvements we pursue for forced alignment systems. The first is treating the acoustic model in a forced aligner as a tagging task, rather than a classification task, motivated by the common understanding that segments in speech are not truly discrete and commonly overlap. The second is an interpolation technique to allow boundaries more precise than the common 10 ms limit in modern forced alignment systems. We compare configurations of our system to a state-of-the-art system, the Montreal Forced Aligner. The tagging approach did not generally yield improved results over the Montreal Forced Aligner. However, a system with the interpolation technique had a 27.92% increase relative to the Montreal Forced Aligner in the amount of boundaries within 10 ms of the target on the test set. We also reflect on the task and training process for acoustic modeling in forced alignment, highlighting how the output targets for these models do not match phoneticians' conception of similarity between phones and that reconciliation of this tension may require rethinking the task and output targets or how speech itself should be segmented.Comment: submitted for publicatio

A nationwide cohort study of slipped capital femoral epiphysis

Objectives To describe the epidemiology of slipped capital femoral epiphysis (SCFE), to examine associations with childhood obesity and socioeconomic deprivation, and to explore factors associated with diagnostic delays. Design Historic cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink and Hospital Episode Statistics. Setting All contacts with healthcare services, including emergency presentations, outpatient appointments, inpatient admissions and primary care visits, within the UK National Health Service. Patients All individuals <16 years old with a diagnosis of SCFE and whose electronic medical record was held by one of 650 primary care practices in the UK between 1990 and 2013. Main outcome measures Annual incidence, missed opportunities for diagnosis and diagnostic delay. Results Over the 23-year period the incidence remained constant at 4.8 (95% CI 4.4 to 5.2) cases per 100,000 0–16-year-olds. There was a strong association with socioeconomic deprivation. Predisease obesity was also strongly associated with SCFE; mean predisease z-score of body mass index was 1.43 (95% CI 1.20 to 1.68) compared with the UK reference mean. Diagnostic delays were common, with most children (75.4%) having multiple primary care contacts with relevant symptomatology, and those who presented with knee pain having significantly longer diagnostic delay (median 161 (IQR 27–278) days) than those with hip pain (20 (5–126)) or gait abnormalities (21 (7–72)). Conclusions SCFE has a strong association with both area-level socioeconomic deprivation and predisease obesity. The majority of patients with SCFE are initially misdiagnosed and those presenting with knee pain are particularly at risk

Perception of Unfamiliar English Phonemes by Native Mandarin Speakers

In second language acquisition, speech sounds, or phonemes, not present in a learner’s native language often pose an extra challenge for speech production. When hearing one of these unfamiliar phonemes, the learner either maps it to a similar native phoneme, perceives it as a completely foreign sound, or does not perceive it as speech at all. In the first case, the learner is unable to perceive a difference between the unfamiliar phoneme and the native phoneme to which it is mapped. This mapping difficulty potentially creates problems for the learner during word recognition. The present research investigated the extent to which English phonemes absent from the Mandarin phonological inventory impact processing of native Mandarin speakers in an auditory lexical decision task. Results of this research will expand the understanding of second language perception, especially within the context of auditory lexical decision tasks. A list of ten phonemes—/ɪ/, /æ/, /ʊ/, /ɛ/, /v/, /z/, /ʒ/, /ɵ/, /ð/, /ʤ/—present in the English phonological inventory but absent from that of Mandarin were identified as unfamiliar to native Mandarin speakers. Data from the Massive Auditory Lexical Decision (MALD) database, in which participants decided whether recorded utterances were English words or made-up words, were utilized. The effects of the proportion of unfamiliar phonemes, proportion of unfamiliar vowels, and proportion of unfamiliar consonants on reaction time, representative of processing difficulty, were then calculated using statistical techniques. It was found that the proportion of all unfamiliar phonemes in an utterance had no significant effect on the reaction time of the native Mandarin speakers. However, when the list of unfamiliar phonemes was divided into vowels and consonants, a greater proportion of unfamiliar vowels was noticed to increase reaction time, while a greater proportion of unfamiliar consonants was found to decrease reaction time. Further research in this area is required to determine a concrete explanation for these results. Interestingly, when the same analysis was performed on the data of native English speakers, similar results were observed. This may reflect a common language processing mechanism in second language learners and native speakers

Knowledge and Perceptions of HPV Vaccine Acceptance among African-American College Women

Human papillomavirus (HPV) is the most prevalent sexually transmitted disease in the United States. Prevalence rates among sexually active young women are approximately 50%. An HPV vaccine has been created that has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, and genital warts caused by four HPV subtypes. The purpose of this study was to assess African-American college women’s knowledge and perceptions of HPV, and their association with the acceptance of HPV vaccination. Variable selection was guided by the Health Belief Model and the Theory of Planned Behavior. Written surveys were administered to 122 African-American women between the ages of 18 and 26 who were enrolled as undergraduates at Florida Agricultural and Mechanical University (FAMU). Statistically significant associations were found between planning to get vaccinated against HPV and several perception variables. Health education efforts aimed at African-American women in college should be renewed, given the high percentage of misconceptions about HPV among members of the study population. Interventions should appeal to social networks of the young women, as their opinions regarding the vaccine weighs in their decision to plan to get vaccinated. This study underscores the need for continuous and consistent health education interventions directed at African-American women of college age

Competing Risk of Death and Time-Varying Covariates in Cardiovascular Epidemiologic Research: Modeling the Hazards of Coronary Heart Disease in the First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study

Competing risk of death and time-varying covariates, often overlooked during statistical analyses of longitudinal studies, can alter the magnitude of estimates of the effect of covariates on the hazards of health outcomes. This study aimed to investigate whether estimates obtained when modeling the effect of risk factors on the hazards of coronary heart disease (CHD) varied significantly while accounting for the presence of competing risk of death and time-varying covariates. We used data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study (n=6346) to model estimates of the effect of risk factors on the hazards of CHD using Cox proportional hazards model, Cox extension with time-varying covariates, and the Fine Gray approach. We used a chi-square test to compare coefficient estimates obtained from the three modeling techniques. We obtained a P-value > 0.05 when comparing coefficient estimates for body mass index, age, cholesterol, smoking, and diabetes after fitting the three models. Coefficient estimates obtained when modeling the effect of risk factors on the hazards of CHD did not vary significantly in the presence of competing risk of death and time-varying covariates. Researchers should consider exploring these concepts more systematically in cohort studies with cardiovascular outcomes

After Implementation of the ACA – Coverage Gaps among Rural Latinos Still Remain

In this study, we assessed health needs and insurance coverage among a rural Latino population. A health needs survey was conducted in 2015 with approximately 100 Latino residents living in a rural Florida county. The survey included questions on socio-economic characteristics, type of insurance coverage, lapses in coverage, delays in care and satisfaction with health services. Only 15% of respondents had insurance through their employer, and 11% had Medicaid. Over 45% of participants had no health insurance, and 20% had no insurance for more than three years. One in ten had a medication delay due to lack of coverage/money, and 17% expressed they had medical bills they were paying off. Gaps in coverage highlight the need for targeted outreach efforts, while gaps in access and affordability highlight the need for new strategies to address barriers to care and out of pocket expenses for those with health insurance

Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016

The Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic outcomes. All reported SHC results were extracted from routinely collected program data. Field staff were surveyed about SHC’s utility. Analyses investigated differences between SHC and traditional syphilis testing outcomes. Of 3,630 SHC results reported, 442 were reactive; 92 (20.8%) had prior diagnoses of syphilis; 7 (1.6%) had no further testing. Of the remaining 343; 158 (46.0%) were confirmed cases, 168 (49.0%) were considered false-positive, and 17 (5.0%) were not cases but not clearly false-positive. Estimated specificity of SHC was 95.0%. Overall, 48.5% of positives became confirmed cases (PPV). PPV varied according to prevalence of syphilis in populations tested. Staff (90%) thought SHC helped identify new cases but expressed concern regarding discordance between reactive SHC and lab-based testing. Programmatic outcomes assessment showed shorter time to treatment and increased numbers of partners tested for the SHC group; these enhanced outcomes may better mitigate the spread of syphilis compared to traditional syphilis testing alone, but more research is needed

Development and management of systemic lupus erythematosus in an HIV-infected man with hepatitis C and B co-infection following interferon therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>The association of human immunodeficiency virus and immune dysfunction leading to development of autoimmune markers is well described, but human immunodeficiency virus infection is relatively protective for the development of systemic lupus erythematosus. In contrast, development of systemic lupus erythematosus with hepatitis C and with interferon therapy is well described in a number of case reports. We here describe the first case of systemic lupus erythematosus developing in a man infected with human immunodeficiency virus, hepatitis C and hepatitis B co-infection where the onset seems to have been temporally related to interferon therapy.</p> <p>Case presentation</p> <p>We report the occurrence of systemic lupus erythematosus complicating interferon-α therapy for hepatitis C in a 47-year-old asplenic male with haemophilia co-infected with human immunodeficiency virus and hepatitis B. He presented with a truncal rash, abdominal pains and headache and later developed grade IV lupus nephritis requiring haemodialysis, mycophenolate mofetil and steroid therapy. We were able to successfully withdraw dialysis and mycophenolate while maintaining stable renal function.</p> <p>Conclusion</p> <p>Interferon-α is critical in antiviral immunity against hepatitis C but also acts as a pathogenic mediator for systemic lupus erythematosus, a condition associated with activation of plasmacytoid dendritic cells that are depleted in human immunodeficiency virus infection. The occurrence of auto-antibodies and lupus-like features in the coinfections with hepatitis C require careful assessment. Immunosuppressant therapy for lupus risks exacerbating underlying infections in patients with concurrent human immunodeficiency virus, hepatitis B and C.</p