Because the motor component of the GCS contains virtually all the information of the GCS itself, can be measured in intubated patients, and is much better behaved statistically than the GCS, we believe that the motor component of the GCS should replace the GCS in outcome prediction models. Because the m component is nonlinear in the log odds of survival, however, it should be mathematically transformed before its inclusion in broader outcome prediction models.

Outcomes with this novel endovascular therapy for AAA, the Nellix EVAS System, are encouraging. The primary safety and effectiveness end points have been met. Low morbidity, low mortality, and high procedural and treatment success were achieved despite the inevitability of a learning curve and unique risks associated with a new device and technique. Long-term follow-up is in progress.

Human adaptation depends upon the integration of slow life history, complex production skills, and extensive sociality. Refining and testing models of the evolution of human life history and cultural learning will benefit from increasingly accurate measurement of knowledge, skills, and rates of production with age. We pursue this goal by inferring individual hunters' of hunting skill gain and loss from approximately 23,000 hunting records 20 generated by more than 1,800 individuals at 40 locations. The model provides an improved picture of ages of peak productivity as well as variation within and among ages. The data reveal an average age of peak productivity between 30 and 35 years of age, though high skill is maintained throughout much of adulthood. In addition, there is substantial variation both among individuals and sites. Within study sites, variation among individuals depends 25 more upon heterogeneity in rates of decline than in rates of increase. This analysis sharpens questions about the co-evolution of human life history and cultural adaptation. It also demonstrates new statistical algorithms and models that expand the potential inferences drawn from detailed quantitative data collected in the field.Ohtsuka 1989) while others do not (Bird and Bliege Bird 2005).

Human adaptation depends on the integration of slow life history, complex production skills, and extensive sociality. Refining and testing models of the evolution of human life history and cultural learning benefit from increasingly accurate measurement of knowledge, skills, and rates of production with age. We pursue this goal by inferring hunters’ increases and declines of skill from approximately 23,000 hunting records generated by more than 1800 individuals at 40 locations. The data reveal an average age of peak productivity between 30 and 35 years of age, although high skill is maintained throughout much of adulthood. In addition, there is substantial variation both among individuals and sites. Within study sites, variation among individuals depends more on heterogeneity in rates of decline than in rates of increase. This analysis sharpens questions about the coevolution of human life history and cultural adaptation.

In selected patients, perioperative outcomes with the Nellix system for endovascular aneurysm sealing are encouraging, with very low 30-day morbidity and mortality and high procedural success. The primary safety end point has been achieved. Longer term follow-up is in progress.

Consistent with the introduction of a novel therapy, the presentation of failure modes of EVAS over time was inevitable. Using detailed imaging as well as engineering and statistical analysis, we were able to understand risk factors for adverse events specific to EVAS and defined those patients best suited for Nellix. With this EVAS-specific approach to defining IFU, on-IFU patients were identified as those with large aneurysms with little thrombus that would be prone to type II endoleaks and sac expansion with traditional devices. When treated with Nellix, these patients were predicted to experience exceptional results, especially with regard to a low composite endoleak rate and low all-cause mortality.

No abstract

Internal iliac artery aneurysms (IIAs) are rare but can be the source of considerable morbidity when rupture occurs. IIAs have traditionally been treated with direct surgical exclusion or ligation. More recently, the advent of endovascular techniques have been adapted to treat isolated common and IIAs in lieu of elective surgical correction. This case report describes an 81-year-old patient with multiple medical problems and a symptomatic IIA, initially diagnosed with computed tomographic scan. Arteriography results showed extravasation of contrast from a left IIA. The aneurysm was treated with endovascular exclusion, with multiple coils in the IIA followed by placement of a covered stent within the common and external iliacs to exclude the orifice of the IIA. The patient tolerated the procedure well, and at 2 months after the procedure, no endoleak was present on follow-up computed tomographic scan results. At 12 months postprocedure, the patient has remained well. This case shows that endovascular therapies may offer a good treatment option in symptomatic or ruptured IIA, particularly in a patient who is at poor operative risk.