HistoryMiami

After decades of study, much remains unknown about the foraging practices of the earliest inhabitants of Puerto Rico. Here, we present an analysis of the malacological assemblages of two neighboring and (partially) contemporary early sites from the island's southwest, finding intriguing intersite differences in shellfish collection practices. We attribute this diversity to differences in site type, chronology, or changes in local coastal configuration. This work not only provides insights into prehistoric Puerto Rican foraging dynamics but also demonstrates the importance of considering factors including intra-age chronology, site type, and changes in paleoenvironmental conditions when considering ancient foraging practices.

OBJECTIVE: To evaluate the practicability of large-scale sleep research in underserved remote populations. BACKGROUND: Sleep disorders remain under recognized with scarce data on sleep patterns from low- and middle-income countries (LIMC). DESIGN/METHODS: A convenience random sample of 50 healthy Atahualpa’s residents aged 蠅60 years were invited to our Community Center for the practice of diagnostic night polysomnography (PSG). Consented individuals were interviewed with culturally validated field instruments including the Berlin questionnaire, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale and the Insomnia Severity Index. PSGs were performed with an Embletta® X100™ Comprehensive Portable PSG System. Local nurses received training on PSG data collection. Processing and scoring of raw data was conducted by certified polysomnographic technicians. Analysis of sleep efficiency, architecture, respiratory parameters, heart rate and motor activity were determined by a board-certified sleep neurologist according to AASM criteria. RESULTS: Forty persons (mean age 74 ± 7 years, 65[percnt] women) agreed to participate. Twenty-four persons (60[percnt]) had a positive Berlin questionnaire, 14 (35[percnt]) had poor sleep quality, 11 (28[percnt]) had excessive daytime somnolence, and three (8[percnt]) had primary insomnia. PSG recordings were satisfactory in 38 persons. Mean total sleep times were 344 ± 80 min, with only four persons sleeping ≤4 hours. Sleep efficiency was poor in 23 (58[percnt]) persons, arousal indexes were increased in 9 (23[percnt]), the apnea/hypopnea index was greater than 15 per hour in 11 (28[percnt]), and periodic leg movements were >25 per hour in 12 (30[percnt]). CONCLUSIONS: Sleep disorders are prevalent in this asymptomatic random sample from a rural community. High-quality sleep research is possible in rural areas of LMIC and may help enhance population awareness on the importance of these conditions as major determinants of health. Study Supported by: This study was supported by an unrestricted grant from Universidad Espiritu Santo-Ecuador, and Mayo Clinic.

Purpose:To evaluate the image quality and imaging dose of the Varian TrueBeam OBIv.1.5 CBCT system in a clinical adaptive radiation therapy environment, simulated by changing phantom thickness.Methods:Various OBI CBCT protocols(Head, Pelvis, Thorax, Spotlight) were used to acquire images of Catphan504 phantom(nominal phantom thickness and 10 cm additional phantom thickness). The images were analyzed for low contrast detectability(CNR), uniformity(UI), and HU sensitivity. These results were compared to the same image sets for planning CT(pCT)(GE LightSpeed 16‐ slice). Imaging dose measurements were performed with Gafchromic XRQA2 film for various OBI protocols (Pelvis, Thorax, Spotlight) in a pelvic‐sized phantom(nominal thickness and 4cm additional thickness). Dose measurements were acquired in the interior and at the surface of the phantom.Results:The nominal CNR[additional thickness CNR] for OBI was—Pelvis:1.45[0.81],Thorax:0.86[0.48], Spotlight:0.67[0.39],Head:0.28 [0.10]. The nominal CNR[additional thickness CNR] for pCT was— Pelvis:0.87[0.41],Head:0.60[0.22]. The nominal UI[additional thickness UI] for OBI was—Pelvis:11.5[24.1],Thorax:17.0[20.6], Spotlight:23.2[23.2], Head:15.6[59.9]. The nominal UI[additional thickness UI] for pCT was— Pelvis:9.2[8.6],Head:2.1[2.9]. The HU difference(averaged over all material inserts) between nominal and additional thickness scans for OBI: 8.26HU(Pelvis), 33.39HU(Thorax), 178.98HU(Head), 108.20HU (Spotlight); for pCT: 16.00HU(Pelvis), 19.85HU(Head). Uncertainties in electron density were calculated based on HU values with varying phantom thickness. Average electron‐density deviations (ρ(water)=1)for GE‐Pelvis, GE‐Head, OBI‐Pelvis, OBI‐Thorax, OBI‐Spotlight, and OBI‐Head were: 0.0182, 0.0180, 0.0058, 0.0478, 0.2750, and 0.3115, respectively. The average phantom interior dose was(OBI‐nominal):2.35cGy(Pelvis), 0.60cGy(Thorax), 1.87cGy(Spotlight); OBI‐increased thickness: 1.77cGy(Pelvis), 0.43cGy(Thorax), 1.53cGy (Spotlight). Average surface dose(OBI‐nominal): 2.29cGy(Pelvis), 0.56cGy(Thorax), 1.79cGy (Spotlight); OBI‐increased thickness: 1.94cGy(Pelvis), 0.48cGy(Thorax), 1.47cGy (Spotlight).Conclusion:The OBI‐Pelvis protocol offered comparable CNR and HU constancy to pCT for each geometry; other protocols, particularly Spotlight and Head, exhibited lower HU constancy and CNR. The uniformity of pCT was superior to OBI for all protocols. CNR and UI were degraded for both systems/scan types with increased thickness. The OBI interior dose decreased by approximately 30% with additional thickness.This work was funded, in part, under a grant with the Pennsylvania Department of Health. The Department of Health specifically declaims responsibility for any analyses, interpretations, or conclusions.

Norwegian, or crusted, scabies can be defined as a generalized severe scabies (Sarcoptes scabiei var. hominis) infestation usually affecting the immunocompromised patient that is most commonly seen with the leukemia-lymphoma group of neoplasms. The diagnosis is commonly missed, which can lead to mismanagement. We describe a patient with Norwegian scabies involving the lower extremities. The patient circumstances and treatment, as well as a review of the literature, are presented. The diagnosis of scabies should always be considered in patients with advanced malignancies and associated pruritus.

Slant-Lock overdentures, Class I: Division 3 prostheses, provide a stable and retentive prosthetic design for edentulous patients with osseointegrated implants. In patients who have moderate to severe atrophy of the edentulous ridge, the Slant-Lock overdenture provides additional support for the para-oral structures. The prostheses increase the ease of oral hygiene for the edentulous patient, can be constructed using conventional prosthodontic techniques, and are reasonably economical.