A Nation-Wide Survey of Program Directors at a Large Health Care Organization: Prevalence and Perceptions of Resident Wellness Activities.

Background: This study evaluated wellness programs in a large hospital network to determine residency program directors' (PDs) perspectives on their wellness programs' state, including wellness prioritization, frequency of wellness activities, and wellness' influence on decision-making across organizational levels. Methods: In 2021, 211 PDs were sent surveys on program policies, program implementation frequency, perceptions of the administration's ability to prioritize wellness, funding sources, and perceptions of resident wellness' impact on decision-making. Results: Among 211 contacted programs, 148 surveys were completed (70.1%). The majority reported having wellness programs, committees, and funding. Fewer than 25% reported having a chief wellness officer. PDs perceived that fellow colleagues in their institution linked wellness to markers of institutional success to a greater extent than other available options (ie, Accreditation Council for Graduate Medical Education [ACGME] requirements, budgetary concerns, resident input, core faculty priorities, and education quality). Financial well-being was perceived as least connected to wellness. Perceptions of wellness were rated across 3 organizational levels: program, institution, and organization. Across all levels, ACGME requirements (31.0%-32.8%) and budgetary/financial concerns (21.9%-37.0%) were perceived as having the most significant influence on overall decision-making, whereas resident wellness was rated lower in influence (8.0%-12.2%). Most programs allowed residents to attend mental health appointments without using paid time off (87.9%) and while on duty (83.1%). Conclusion: The frequency of wellness activities varied greatly across programs. PDs reported challenges making resident self-care and personal development a priority and perceived resident wellness as having limited importance to decision-making at higher levels.

A Qualitative Follow-Up to a Survey of Program Directors on Wellness Programming at a Large Healthcare Organization: Interviews of High- and Low-Exemplar Programs.

Background: The current research used a qualitative approach to understand which factors facilitate and hinder wellness programming in residency programs. Methods: Program directors identified from a previous quantitative study as having residency programs with notably more or less resident wellness programming than others (ie, high- and low-exemplars, respectively) were contacted. In total, semi-structured interviews were conducted over Zoom with 7 low-exemplars and 9 high-exemplars. Results: The results of this qualitative examination suggest common themes across the 2 exemplar groups, such as wanting more resources for resident wellness with fewer barriers to implementation, viewing wellness as purpose-driven, and seeing wellness as a shared responsibility. There were also critical distinctions between the exemplar groups. Those high in wellness programming expressed more of an emphasis on connections among residents in the program and between the faculty and residents. In contrast, those low in wellness programming described more barriers, such as staffing problems (ie, turnover and lack of faculty wellness) and a lack of integration between the varying levels involved in graduate medical education (GME) operations (ie, between GME programs and sponsoring hospitals, and between GME facilities and the larger health care organization). Conclusion: This study provides insight into program directors' experiences with wellness programming at a large health care organization. The results could point to potential next steps for investigating how the medical education community can improve resident wellness programming.

Common evolutionary origin of acoustic communication in choanate vertebrates.

Acoustic communication, broadly distributed along the vertebrate phylogeny, plays a fundamental role in parental care, mate attraction and various other behaviours. Despite its importance, comparatively less is known about the evolutionary roots of acoustic communication. Phylogenetic comparative analyses can provide insights into the deep time evolutionary origin of acoustic communication, but they are often plagued by missing data from key species. Here we present evidence for 53 species of four major clades (turtles, tuatara, caecilian and lungfish) in the form of vocal recordings and contextual behavioural information accompanying sound production. This and a broad literature-based dataset evidence acoustic abilities in several groups previously considered non-vocal. Critically, phylogenetic analyses encompassing 1800 species of choanate vertebrates reconstructs acoustic communication as a homologous trait, and suggests that it is at least as old as the last common ancestor of all choanate vertebrates, that lived approx. 407 million years before present.

Matamatas Chelus spp. (Testudines, Chelidae) have a remarkable evolutionary history of sex chromosomes with a long-term stable XY microchromosome system.

The genus Chelus, commonly known as Matamata is one of the most emblematic and remarkable species among the Neotropical chelids. It is an Amazonian species with an extensive distribution throughout Negro/Orinoco and Amazonas River basins. Currently, two species are formally recognized: Chelus orinocensis and Chelus fimbriata and although it is still classified as "Least Concern" in the IUCN, the Matamatas are very appreciated and illegally sold in the international pet trade. Regardless, little is known regarding many aspects of its natural history. Chromosomal features for Chelus, for instance, are meagre and practically restricted to the description of the diploid number (2n = 50) for Chelus fimbriata, and its sex determining strategies are yet to be fully investigated. Here, we examined the karyotype of Chelus fimbriata and the newly described Chelus orinocensis, applying an extensive conventional and molecular cytogenetic approach. This allowed us to identify a genetic sex determining mechanism with a micro XY sex chromosome system in both species, a system that was likely present in their most common recent ancestor Chelus colombiana. Furthermore, the XY system found in Chelus orinocensis and Chelus fimbriata, as seen in other chelid species, recruited several repeat motifs, possibly prior to the split of South America and Australasian lineages, indicating that such system indeed dates back to the earliest lineages of Chelid species.

The Amazonian Red Side-Necked Turtle Rhinemys rufipes (Spix, 1824) (Testudines, Chelidae) Has a GSD Sex-Determining Mechanism with an Ancient XY Sex Microchromosome System.

The Amazonian red side-necked turtle Rhynemis rufipes is an endemic Amazonian Chelidae species that occurs in small streams throughout Colombia and Brazil river basins. Little is known about various biological aspects of this species, including its sex determination strategies. Among chelids, the greatest karyotype diversity is found in the Neotropical species, with several 2n configurations, including cases of triploidy. Here, we investigate the karyotype of Rhinemys rufipes by applying combined conventional and molecular cytogenetic procedures. This allowed us to discover a genetic sex-determining mechanism that shares an ancestral micro XY sex chromosome system. This ancient micro XY system recruited distinct repeat motifs before it diverged from several South America and Australasian species. We propose that such a system dates back to the earliest lineages of the chelid species before the split of South America and Australasian lineages.

The correlations between certain features of the journal Neotropical Ichthyology and its impact factor: a comparative analysis at the thematic and national levels

The present article analyzes the relationship between characteristics of the journal Neotropical Ichthyology and its impact factor (IF) between 2006 and 2011 using bibliometric descriptive quantitative methods. To perform this analysis, two samples of journals included in Journal Citation Reports (JCR) were studied. One sample was composed of journals classified within the subject of zoology, and the other contained journals from different areas published in Brazil. The instrument used for data collection was a database created in Microsoft Excel 2007 and the Statistical Package for the Social Sciences (SPSS) version 18. The results show that despite its short history, Neotropical Ichthyology has exhibited a distinctive impact, as manifested in a significant progression in the IF of this journal in the field of zoology during the investigated period.

Este trabalho analisa as características do periódico Neotropical Ichthyology e de seu Fator de Impacto no período entre 2006 e 2011, utilizando métodos quantitativos descritivos do tipo bibliométrico. Duas amostras de periódicos indexados no JCR foram estudadas para a realização das análises: uma constituída pelos periódicos categorizados como sendo da área de Zoologia e a outra formada por títulos de diferentes áreas publicados no Brasil. O instrumento de coleta de dados foi um banco de dados criado no programa Excel versão 2007 e no SPSS versão 18. Os resultados encontrados nas análises mostram que o Neotropical Ichthyology é um periódico que, apesar de sua história recente de publicação vem apresentando uma evolução de impacto distintiva. Esse aspecto é demonstrado por mudanças significativas na classificação por IF na área de Zoologia no período analisado.

Injúria facial por artefato de metal / Facial injury caused by metal artifact

As injúrias penetrantes na face apresentam-se como um grande desafio para o cirurgiäo bucomaxilofacial. A íntima relaçäo entre o corpo estranho e as estrutura anatômicas vitais da face geram uma importância especial no manejo inicial, tratamento, evoluçäo e prognóstico dessas lesöes. O intervalo de tempo entre o acidente e o reparo da ferida é muito importante para o resultado final. A falta de cuidados básicos no manejo dessas feridas pode resultar no estabelecimento de processos infecciosos, como também em cicatrizes hipertróficas ou queloideanas. A reparaçäo definitiva das feridas faciais depende de sua adequada exploraçäo, do tipo e da extensäo da lesäo, bem como do comprometimento das estruturas vitais