Despite its importance in movement of the upper limb, the soft-tissue morphology of the shoulder joint complex (the acromioclavicular, coracoclavicular, and glenohumeral joints) across primates is poorly understood. This study compares soft-tissue morphology of these three shoulder joint components among broad phylogenetic, locomotor, and postural behavior ranges in prosimian primates. Two adult specimens of Galago moholi (a vertical clinger and leaper) were dissected for study, along with one adult each of Cheirogaleus medius (an arboreal quadruped), Eulemur macaco (an arboreal quadruped that also frequently engages in suspensory behavior), and Tarsius syrichta (a vertical clinger and leaper). Because of their role in glenohumeral joint movement and stabilization, the rotator cuff muscles were also dissected and weighed among the species. Results showed that muscle mass of individual components of the rotator cuff musculature may be adaptive to locomotor and postural behaviors of the taxa in this study. Two soft-tissue components of the glenohumeral joint, but not the acromioclavicular and coracoclavicular joints, were also considered adaptive. The quadrupedal species, C. medius and E. macaco, both had glenohumeral ligaments and E. macaco had a relatively deeper glenoid articular surface for the humerus because of the shape of the glenoid labrum. Additionally, this study noted a lack of a teres minor muscle in G. moholi, C. medius, and E. macaco despite previous studies describing them. A relatively robust teres minor muscle was found in T. syrichta. Even with the limited sample dissected here, these results suggest that soft-tissue joint morphology itself may be as adaptive to locomotory and postural styles as osseous morphology. Anat Rec,
This method meets the defined criteria for the ideal experimental tracheostomy, demonstrating potential benefit in a laryngotracheal stenosis model and a rabbit model of evoked phonation.
Within a matter of 48 hours, the promotion of the article entitled "Prevalence of unprofessional social media content among young vascular surgeons," aptly demonstrated the power of social media and the dangers of unconscious bias as it spread across Twitter with the #MedBikini tag. In response, vascular surgeons from around the world have come together in a call to action to address the article and highlight the misogynistic, racist, and oppressive issues facing young surgeons today. We, as female vascular surgery trainees, would like to make our own call to action. The publication of this article (now appropriately retracted) has encouraged important dialogue among female vascular surgeons, male colleagues who support #HeforShe initiatives, other disadvantaged and marginalized groups in surgery, and the future generation of surgeons who will pave the path forward. We have converged to discuss the current climate of our specialty and have determined that now is an opportunity for change.It is essential that we pursue ethics, as well as excellence, in surgical practice and research. The inherent conscious and unconscious biases, poor study design, and unethical data collection methods within the article have demonstrated a critical flaw within the editorial process of the Journal of Vascular Surgery (JVS). We are disappointed to find ourselves represented by the article. The publication was both tone deaf toward, and discriminatory against, us as professionals, trainees, and women. As vascular surgeons, we must hold ourselves to a higher standard. Our call to action for the JVS includes the following:1. Re-examine the review process for publication of ethical abstracts from regional and national meetings and manuscripts, and provide training in ethical research for all editors and reviewers.
Background: Anatomic severity grade (ASG) can be used to assess abdominal aortic aneurysm (AAA) anatomic complexity. High ASG is associated with complications following endovascular repair of AAAs and we have demonstrated that ASG correlates with resource utilization. The hypothesis of this study is that ASG is directly related to midterm mortality in patients undergoing AAA repair. Methods: Patients who underwent infrarenal AAA repairs between July 2007 and August 2014 were retrospectively reviewed and ASG scores were calculated using 3-dimensional computed tomography reconstructions. Perioperative mortalities (≤30 days) were excluded. The ASG value of 15 was chosen based on previous receiver–operator curve analysis, which showed that an ASG of 15 was predictive of postoperative complications and resource utilization. The 5-year survivors and mortalities were compared utilizing comorbidities, pharmacologic variables, and anatomic variables at or above the defined threshold. Results: A total of 402 patients (80% male and 96% Caucasian) with complete anatomic and survival data were included in the analysis. Mean ASG and age at the time of repair were 16 ± 0.15 and 73 ± 0.43 years old, respectively. The 5-year mortality was significantly associated with ASG >15 (hazard ratio [HR]: 1.504, confidence interval [CI]: 1.077-2.100, P < .017), hyperlipidemia (HR: 1.987, CI: 1.341-2.946, P < .001), coronary artery disease (HR: 1.432, CI: 1.037-1.978, P < .029), and chronic obstructive pulmonary disease (HR: 1.412, CI: 1.027-1.943, P < .034). Kaplan-Meier analysis demonstrated improved survival in the low score ASG ≤15 group at 1, 3, and 5 years (96% vs 93%, 81% vs 69%, and 53% vs 41%; P = .0182; Figure 1). Conclusions: Increasing aortic anatomic complexity as characterized by ASG >15 is an independent predictor of midterm mortality following elective infrarenal AAA repair. Therefore, it may be a useful tool for appropriate patient selection and risk stratification prior to elective infrarenal AAA repair.
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