Acoustic behavior of humpback whale calves on the feeding ground: Comparisons across age and implications for vocal development.

Studying sound production at different developmental stages can provide insight into the processes involved in vocal ontogeny. Humpback whales (Megaptera novaeangliae) are a known vocal learning species, but their vocal development is poorly understood. While studies of humpback whale calves in the early stages of their lives on the breeding grounds and migration routes exist, little is known about the behavior of these immature, dependent animals by the time they reach the feeding grounds. In this study, we used data from groups of North Atlantic humpback whales in the Gulf of Maine in which all members were simultaneously carrying acoustic recording tags attached with suction cups. This allowed for assignment of likely caller identity using the relative received levels of calls across tags. We analyzed data from 3 calves and 13 adults. There were high levels of call rate variation among these individuals and the results represent preliminary descriptions of calf behavior. Our analysis suggests that, in contrast to the breeding grounds or on migration, calves are no longer acoustically cryptic by the time they reach their feeding ground. Calves and adults both produce calls in bouts, but there may be some differences in bout parameters like inter-call intervals and bout durations. Calves were able to produce most of the adult vocal repertoire but used different call types in different proportions. Finally, we found evidence of immature call types in calves, akin to protosyllables used in babbling in other mammals, including humans. Overall, the sound production of humpback whale calves on the feeding grounds appears to be already similar to that of adults, but with differences in line with ontogenetic changes observed in other vocal learning species.

Surgical Intervention is Associated with Improvement in Health-Related Quality of Life Outcomes in Patients with Symptomatic Sacral Tarlov Cysts: Results from a Prospective Longitudinal Cohort Study.

OBJECTIVE: The treatment of symptomatic Tarlov cysts remains a controversial topic within neurosurgery. We describe our experience with patients who underwent surgical intervention for sacral Tarlov cysts at a single institution. General and disease-specific outcome measures were used to assess health-related quality of life. METHODS: Patients who underwent surgical treatment for one or more sacral Tarlov cysts between 2018 and 2021 were included. The Tarlov Cyst Quality of Life (TCQoL), a validated disease-specific measure, was the primary outcome of the study. Secondary outcomes included general outcome measures: 36-Item Short Form Survey, the Oswestry Disability Index, and Visual Analog Scale. Patients were followed at 3, 6, and 12 months postoperatively. Repeated measures analyses were used to assess change from preoperative to 12 months postoperative. RESULTS: Data were obtained from 144 patients who underwent surgery for sacral Tarlov cysts, average age 52.3 ± 11.3 years, 90.3% female. Patients reported significant mean improvement on the TCQoL over time (preoperative 3.2 ± 0.1; 3-month postoperative 2.1 ± 0.1; 6-month 1.9 ± 0.1; 12-month 1.9 ± 0.1; P < 0.001). Patient age and duration of symptoms were not associated with outcome. A total of 82.3% of patients reported improvement on TCQoL. There was not a significant difference in the proportion of patients reporting improvement on TCQoL by cyst size (small 90.9% vs. large 77.9%; P = 0.066). CONCLUSIONS: Our longitudinal series demonstrated patient-reported improvement following surgery for symptomatic sacral Tarlov cysts using a validated disease-specific health-related quality of life scale through 12 months after surgery. Patient age and preoperative duration of symptoms were not correlated with outcome.

Caller identification and characterization of individual humpback whale acoustic behaviour.

Acoustic recording tags provide fine-scale data linking acoustic signalling with individual behaviour; however, when an animal is in a group, it is challenging to tease apart calls of conspecifics and identify which individuals produce each call. This, in turn, prohibits a robust assessment of individual acoustic behaviour including call rates and silent periods, call bout production within and between individuals, and caller location. To overcome this challenge, we simultaneously instrumented small groups of humpback whales on a western North Atlantic feeding ground with sound and movement recording tags. This approach enabled a comparison of the relative amplitude of each call across individuals to infer caller identity for 97% of calls. We recorded variable call rates across individuals (mean = 23 calls/h) and groups (mean = 55 calls/h). Calls were produced throughout dives, and most calls were produced in bouts with short inter-call intervals of 2.2 s. Most calls received a likely response from a conspecific within 100 s. This caller identification (ID) method facilitates studying both individual- and group-level acoustic behaviour, yielding novel results about the nature of sequence production and vocal exchanges in humpback whale social calls. Future studies can expand on these caller ID methods for understanding intra-group communication across taxa.

Fellowship-trained physicians who let their geriatric medicine certification lapse: A national survey.

BACKGROUND: Only 62.6% of fellowship-trained and American Board of Internal Medicine (ABIM)-certified geriatricians maintain their specialty certification in geriatric medicine, the lowest rate among all internal medicine subspecialties and the only subspecialty in which physicians maintain their internal medicine certification at higher rates than their specialty certification. This study aims to better understand underlying issues related to the low rate of maintaining geriatric medicine certification in order to inform geriatric workforce development strategies. METHODS: Eighteen-item online survey of internists who completed a geriatric medicine fellowship, earned initial ABIM certification in geriatric medicine between 1999 and 2009, and maintained certification in internal medicine (and/or another specialty but not geriatric medicine). Survey domains: demographics, issues related to maintaining geriatric medicine certification, professional identity, and current professional duties. RESULTS: 153/723 eligible completed surveys (21.5% response). Top reasons for not maintaining geriatric medicine certification were time (56%), cost of maintenance of certification (MOC) (45%), low Medicare reimbursement for geriatricians' work (32%), and no employer requirement to maintain geriatric medicine certification (31%). Though not maintaining geriatric medicine certification, 68% reported engaging in professional activities related to geriatric medicine. Reflecting on career decisions, 56% would again complete geriatric medicine fellowship, 21% would not, and 23% were unsure. 54% considered recertifying in geriatric medicine. 49% reported flexible MOC assessment options would increase likelihood of maintaining certification. CONCLUSIONS: The value proposition of geriatric medicine certification needs strengthening. Geriatric medicine leaders must develop strategies and tactics to reduce attrition of geriatricians by enhancing the value of geriatric medicine expertise to key stakeholders.

Surgical Intervention is Associated with Improved Outcomes in Patients with Symptomatic Cervical Spine Tarlov Cysts: Results from a Prospective Cohort Study.

BACKGROUND: Tarlov cysts are known contributors to radiculopathy but are often misdiagnosed and mismanaged due to a paucity of information. This is particularly true of cervical spine Tarlov cysts because most attention has been focused on sacral cysts. In this study, we describe our longitudinal experience with patients who underwent surgery for cervical spine Tarlov cysts. We hypothesized that patients undergoing surgical treatment for cervical spine Tarlov cysts would report improvement following surgery. METHODS: We conducted a prospective study of patients who underwent surgical treatment for cervical Tarlov cysts between 2010 and 2021. The Short-Form 36-item survey (SF-36) was administered at the preoperative and follow-up visits. Repeated measures analyses were used to assess changes from preoperatively to postoperatively. RESULTS: A total of 37 patients with cervical spine cysts were included in the study. Follow-up data were available for 27 patients with a median follow-up of 1 year. Of the cohort, 97.3% were women, with an average age of 47.5 ± 10.3 years. Patients reported statistically significant improvement in 2 of the 4 SF-36 physical health domains (physical function, P< 0.001; and bodily pain, P < 0.001) and 2 of the 4 mental health domains (vitality/energy, P < 0.003; and social functioning, P = 0.007). Patients also reported less interference in work, education, and retirement activities at follow-up (P = 0.017). CONCLUSIONS: Our longitudinal series consisted of patients with symptomatic cervical spine Tarlov cysts, which, to the best of our knowledge, is the largest series described. Significant improvements in the SF-36 domains were documented, indicating these patients can be successfully treated surgically.

Acoustic recording tags provide insight into the springtime acoustic behavior of sei whales in Massachusetts Bay.

The acoustic ecology of sei whales (Balaenoptera borealis) is poorly understood due to limited direct observation of the behavioral context of sound production and individual behavior. Suction cup-attached acoustic recording tags were deployed on sei whales to unambiguously assign call types and explore the acoustic behavior of this endangered species. Twelve tag deployments resulted in ∼173 h of acoustic data and 1030 calls. Sound types included downsweeps and three previously undescribed call types. Knocks were short duration (<1 s), with an average peak frequency of 330 Hz. Pulse type 1 and pulse type 2 calls, typically produced in sequences, were short in duration (0.08 and 0.28 s) and low in average peak frequency (50 and 26 Hz), with relatively high received levels. Average call rates for all call types combined were three calls per hour, but increased during twilight. Sex differences in call type usage included a higher use of pulses by females and knocks by males. Calls were almost exclusively produced at depths <10 m, although whales rarely dove deeper in this study. These data provide a more comprehensive picture of the acoustic and behavioral ecology of sei whales than previously possible, which can inform future conservation efforts for this endangered species.

Deployment of biologging tags on free swimming large whales using uncrewed aerial systems.

Suction-cup-attached biologging tags have led to major advances in our understanding of large whale behaviour. Getting close enough to a whale at sea to safely attach a tag is a major limiting factor when deploying these systems. Here we present an uncrewed aerial system (UAS)-based tagging technique for free-swimming large whales and provide data on efficacy from field testing on blue (Balaenoptera musculus) and fin (B. physalus) whales. Rapid transit speed and the bird's-eye view of the animal during UAS tagging contributed to the technique's success. During 8 days of field testing, we had 29 occasions when a focal animal was identified for attempted tagging and tags were successfully attached 21 times. The technique was efficient, with mean flight time of 2 min 45 s from launch to deployment and a mean distance of 490 m from the launch vessel to tagged animal, reducing potential adverse effects resulting from close approaches for tagging. These data indicate that UAS are capable of attaching biologging tags to free-swimming large whales quickly and from large distances, potentially increasing success rates, decreasing attempt times, and reducing animal disruption during tagging.

Acceptability of Telemedicine in a Geriatric Outpatient Practice During the COVID-19 Pandemic.

Background: Telemedicine utilization has increased dramatically during the COVID pandemic. Few studies have evaluated the use and acceptability of telemedicine in older populations. This study examined the use and acceptability of telemedicine with older adults in an urban, geriatric practice. Methods: An anonymous survey was sent to patients seen at an urban, geriatric practice using MyChart in EPIC in March 2021. This population of patients is 55 years and older, 50% Black, 40% white, 3% Latino, 3% Asian, and 4% other. This panel is comprised of 71% Medicare, 23% non-Medicare/non-Medicaid, and 6% Medicaid. The total panel of patients includes ∼1,400 patients. The percent of patients on MyChart at the time of the survey was 78%. Thus, about 1,092 patients received the survey. Results: Of the 1,092 patients who received the survey, 247 (22.6%) responded. Around 80.37% of respondents rated their overall experience with telemedicine as good or excellent. Theme areas emerged around the advantages and disadvantages of telemedicine. A majority (70.28%) of respondents rated themselves as Somewhat Confident to Very Confident in use of telemedicine without family/friend assistance. A majority (74.16%) of respondents stated they plan to use telemedicine again. Conclusions: This survey demonstrated the feasibility and acceptability of telemedicine in an urban, geriatric population. A limit to this study is that the survey was administered on-line, so that participants may be biased regarding use of online technology. However, this study showed that the vast majority of older adults were confident in using telemedicine as an alternative to in-person visits during the COVID pandemic and plan on using it again.

Pose-gait analysis for cetacean biologging tag data.

Biologging tags are a key enabling tool for investigating cetacean behavior and locomotion in their natural habitat. Identifying and then parameterizing gait from movement sensor data is critical for these investigations, but how best to characterize gait from tag data remains an open question. Further, the location and orientation of a tag on an animal in the field are variable and can change multiple times during a deployment. As a result, the relative orientation of the tag with respect to (wrt) the animal must be determined for analysis. Currently, custom scripts that involve species-specific heuristics tend to be used in the literature. These methods require a level of knowledge and experience that can affect the reliability and repeatability of the analysis. Swimming gait is composed of a sequence of body poses that have a specific spatial pattern, and tag-based measurements of this pattern can be utilized to determine the relative orientation of the tag. This work presents an automated data processing pipeline (and software) that takes advantage of these patterns to 1) Identify relative motion between the tag and animal; 2) Estimate the relative orientation of the tag wrt the animal using a data-driven approach; and 3) Calculate gait parameters that are stable and invariant to animal pose. Validation results from bottlenose dolphin tag data show that the average relative orientation error (tag wrt the body) after processing was within 11 degrees in roll, pitch, and yaw directions. The average precision and recall for detecting instances of relative motion in the dolphin data were 0.87 and 0.89, respectively. Tag data from humpback and beluga whales were then used to demonstrate how the gait analysis can be used to enhance tag-based investigations of movement and behavior. The MATLAB source code and data presented in the paper are publicly available (https://github.com/ding-z/cetacean-pose-gait-analysis.git), along with suggested best practices.

Prospective Validation of a Quality-of-Life Measure for Women Undergoing Surgical Intervention for Symptomatic Sacral Tarlov Cysts: The Tarlov Cyst Quality of Life Scale.

BACKGROUND: The use of health-related quality-of-life scales has expanded into most areas of medicine. Established quality-of-life scales are used in several areas of neurosurgery, but none have been validated for use in patients with symptomatic Tarlov cysts. The majority of symptomatic Tarlov cysts are found in the sacral spinal canal of women. We, therefore, validated a site-specific quality-of-life measure for women with symptomatic sacral nerve root compression caused by Tarlov cysts. METHODS: Women undergoing surgical treatment for sacral Tarlov cysts at a single institution between 2017 and 2020 were enrolled in this prospective validation study. Participants were administered a 13-item version of the survey along with other validated quality-of-life measures preoperatively and at 3 months postoperatively. Psychometric analyses were performed to validate the measure. RESULTS: One hundred twelve patients met inclusion criteria and completed surveys preoperatively and at 3 months postoperatively. Patients' mean scale scores decreased significantly preoperatively to postoperatively, reflecting good discriminability (P < 0.001). Interitem correlations suggested 2 items were correlated at >0.80, which were dropped to create an 11-item scale. The internal consistency of the 11-item scale was 0.822. Concurrent validity was established by correlating scale scores with the Oswestry Disability Index (P < 0.001) and the physical function (P < 0.001) and pain (P < 0.001) subscales of the Short-Form 36 Survey. CONCLUSIONS: We prospectively validated a site-specific, health-related quality-of-life survey for women with symptomatic sacral Tarlov cysts. This measure will be useful in future studies to inform clinicians and researchers about the progression of Tarlov cysts and patient response to surgical treatment.

Preferred shallow-water nursery sites provide acoustic crypsis to southern right whale mother-calf pairs.

Adaptations to sound production behaviour can reduce the detectability of animal signals by eavesdroppers in a phenomenon known as acoustic crypsis. We propose that acoustic crypsis can include selection of locations that affect how sound transmits through the environment: habitats with poor acoustic propagation can minimize the range of detectability of animal signals. We investigated the potential for the preferred habitats of southern right whales to confer acoustic crypsis. We modelled acoustic propagation and range of detection of calls from southern right whales in the shallow, sandy, near shore waters where mothers and calves aggregate during the calving season. At three nursery sites across three continents in the southern hemisphere, results showed that the depth at which right whales are most commonly sighted has the most limited acoustic detection range for their calls. Thus, these habitats allow mother-calf pairs to remain acoustically cryptic from potential eavesdroppers, both predators and conspecifics, when their calves are the most vulnerable. Our results provide preliminary evidence that, in addition to other behavioural strategies, the use of habitats with poor acoustic propagation can contribute to acoustic crypsis. This adaptation may be a widespread and underappreciated mechanism for avoidance of eavesdroppers.

Lessons Learned From a Pilot Project on Telemedicine Advance Care Planning in an Urban Geriatric Primary Care Office.

PURPOSE: There is a dearth of literature regarding the documentation of advance care planning (ACP) in the geriatric population, despite the controversial, yet well-studied need for ACP. The purpose of this pilot study was to provide an update to a prior study from our institution that outlined the need for increased documentation of advance care planning (ACP) in an urban geriatric population. METHODS: Our study involved using telemedicine to conduct dedicated ACP visits and an electronic medical record (EMR) note-template specifically designed for these visits in an attempt to increase the amount of documented ACP in the EMR in this population. RESULTS: The study did not yield significant results due to the inability to schedule enough patients for these dedicated visits. DISCUSSION: While our study was ultimately unsuccessful, 3 crucial lessons were identified that will inform and fuel future interventions by the authors to further the study of documentation of ACP.

An overview of North Atlantic right whale acoustic behavior, hearing capabilities, and responses to sound.

Creating a baseline understanding of communicative signals and perceptual abilities is imperative for gaining insight into a species' life history. This is especially relevant for at-risk species, as it can aid in monitoring and conservation efforts. Marine mammals communicate predominately through acoustic modalities for a variety of functions, including foraging and reproduction. The acoustic signals produced by marine mammals, and their ability to perceive signals produced by conspecifics, are directly impacted by the level of ambient noise in the underwater environment in which they inhabit. Modern ocean noise levels are considerably louder than historical levels, and noise is therefore considered to be a threat to acoustically communicating marine mammal species. This review summarizes the documented acoustic signals, hearing abilities, and responses to sound of a critically endangered baleen whale, the North Atlantic right whale (Eubalaena glacialis), highlights gaps in the current body of literature, and identifies priorities for future research.

Animal-borne tags provide insights into the acoustic communication of southern right whales (Eubalaena australis) on the calving grounds.

This study investigated the repertoire, call-type variability and call rates of southern right whales on a calving ground off Brazil in the western South Atlantic. Acoustic tag data were collected from four lactating females and one juvenile. Pulsive, hybrid, and upcalls showed the greatest variability among call-types with up to 23% of non-standard forms detected. Quiet sounds (grunt, single, and double pulse) were detected for the first time in this species on the calving grounds. Although the sample size was limited, results suggest that social interaction increased call-type diversity and call rates, in line with other acoustic studies on right whales.

Exploring movement patterns and changing distributions of baleen whales in the western North Atlantic using a decade of passive acoustic data.

Six baleen whale species are found in the temperate western North Atlantic Ocean, with limited information existing on the distribution and movement patterns for most. There is mounting evidence of distributional shifts in many species, including marine mammals, likely because of climate-driven changes in ocean temperature and circulation. Previous acoustic studies examined the occurrence of minke (Balaenoptera acutorostrata) and North Atlantic right whales (NARW; Eubalaena glacialis). This study assesses the acoustic presence of humpback (Megaptera novaeangliae), sei (B. borealis), fin (B. physalus), and blue whales (B. musculus) over a decade, based on daily detections of their vocalizations. Data collected from 2004 to 2014 on 281 bottom-mounted recorders, totaling 35,033 days, were processed using automated detection software and screened for each species' presence. A published study on NARW acoustics revealed significant changes in occurrence patterns between the periods of 2004-2010 and 2011-2014; therefore, these same time periods were examined here. All four species were present from the Southeast United States to Greenland; humpback whales were also present in the Caribbean. All species occurred throughout all regions in the winter, suggesting that baleen whales are widely distributed during these months. Each of the species showed significant changes in acoustic occurrence after 2010. Similar to NARWs, sei whales had higher acoustic occurrence in mid-Atlantic regions after 2010. Fin, blue, and sei whales were more frequently detected in the northern latitudes of the study area after 2010. Despite this general northward shift, all four species were detected less on the Scotian Shelf area after 2010, matching documented shifts in prey availability in this region. A decade of acoustic observations have shown important distributional changes over the range of baleen whales, mirroring known climatic shifts and identifying new habitats that will require further protection from anthropogenic threats like fixed fishing gear, shipping, and noise pollution.

Acoustically advertising male harbour seals in southeast Alaska do not make biologically relevant acoustic adjustments in the presence of vessel noise.

Aquatically breeding harbour seal (Phoca vitulina) males use underwater vocalizations during the breeding season to establish underwater territories, defend territories against intruder males, and possibly to attract females. Vessel noise overlaps in frequency with these vocalizations and could negatively impact breeding success by limiting communication space. In this study, we investigated whether harbour seals employed anti-masking strategies to maintain communication in the presence of vessel noise in Glacier Bay National Park and Preserve, Alaska. Harbour seals in this location did not sufficiently adjust source levels or acoustic parameters of vocalizations to compensate for acoustic masking. Instead, for every 1 dB increase in ambient noise, signal excess decreased by 0.84 dB, indicating a reduction in communication space when vessels passed. We suggest that harbour seals may already be acoustically advertising at or near a biologically maximal sound level and therefore lack the ability to increase call amplitude to adjust to changes in their acoustic environment. This may have significant implications for this aquatically breeding pinniped, particularly for populations in high noise regions.

Energetic and physical limitations on the breaching performance of large whales.

The considerable power needed for large whales to leap out of the water may represent the single most expensive burst maneuver found in nature. However, the mechanics and energetic costs associated with the breaching behaviors of large whales remain poorly understood. In this study we deployed whale-borne tags to measure the kinematics of breaching to test the hypothesis that these spectacular aerial displays are metabolically expensive. We found that breaching whales use variable underwater trajectories, and that high-emergence breaches are faster and require more energy than predatory lunges. The most expensive breaches approach the upper limits of vertebrate muscle performance, and the energetic cost of breaching is high enough that repeated breaching events may serve as honest signaling of body condition. Furthermore, the confluence of muscle contractile properties, hydrodynamics, and the high speeds required likely impose an upper limit to the body size and effectiveness of breaching whales.

Retention in Outpatient Child Behavioral Health Services Among Military and Civilian Families.

Retention in treatment for children with behavior problems is critical to achieve successful outcomes, and clinical evidence suggests the behavioral health needs and retention of military-connected and civilian families differ meaningfully. Military and civilian children in outpatient behavioral treatment were compared in terms of presenting problems as well as appointment adherence (n = 446 children and their parents). Demographics and rates of externalizing behavior were similar across the two groups. More military than civilian children had internalizing problems. Military parents had more parenting distress and depressive symptoms. Fewer military families dropped out of treatment early. Within-military comparisons demonstrated that children whose parent had recently deployed were more likely to have internalizing problems and poor adaptive skills. Although retention was better among military families, the early treatment drop-out proportions (20-30%) for both groups highlight a barrier to effective behavioral intervention.

Phenological changes in North Atlantic right whale habitat use in Massachusetts Bay.

The North Atlantic right whale (Eubalaena glacialis) is one of the world's most highly endangered baleen whales, with approximately 400-450 individuals remaining. Massachusetts Bay (MB) and Cape Cod Bay (CCB) together comprise one of seven areas in the Gulf of Maine where right whales seasonally congregate. Here, we report on acoustically detected presence of right whales in MB over a nearly 6 year period, July 2007-April 2013, a time of both rapid ocean warming throughout the Gulf of Maine and apparent changes in right whale migratory dynamics. We applied an automated detection algorithm to assess hourly presence of right whale "up-calls" in recordings from a 19-channel acoustic array covering approximately 4,000 km2 in MB. Over the survey, up-calls were detected in 95% of 8 day periods. In each year, as expected, we observed a "peak season" of elevated up-call detections in late winter and early spring corresponding to the season when right whales congregate to feed in CCB. However, we also saw an increase in right whale occurrence during time periods thought to be part of the "off-season." With the exception of 2009-2010, when acoustic presence was unusually low, the mean percent of hours in which up-calls were detected increased every year, both during the peak season (from 38% in 2008 to 70% in 2012), and during the summer-fall season (from 2% in 2007 to 13% in 2012). Over the entire study, the peak season start date varied between 17 January and 26 February. Changes in right whale phenology in MB likely reflect broadscale changes in habitat use in other areas within the species range. This study demonstrates the value of continuous long-term survey datasets to detect and quantify shifts in cetacean habitat use as environmental conditions change and the long-term continued survival of right whales remains uncertain.

Acoustic crypsis in communication by North Atlantic right whale mother-calf pairs on the calving grounds.

Mammals with dependent young often rely on cryptic behaviour to avoid detection by potential predators. In the mysticetes, large baleen whales, young calves are known to be vulnerable to direct predation from both shark and orca predators; therefore, it is possible that mother-calf pairs may show cryptic behaviours to avoid the attention of predators. Baleen whales primarily communicate through low-frequency acoustic signals, which can travel over long ranges. In this study, we explore the potential for acoustic crypsis, a form of cryptic behaviour to avoid predator detection, in North Atlantic right whale mother-calf pairs. We predicted that mother-calf pairs would either show reduced calling rates, reduced call amplitude or a combination of these behavioural modifications when compared with other demographic groups in the same habitat. Our results show that right whale mother-calf pairs have a strong shift in repertoire usage, significantly reducing the number of higher amplitude, long-distance communication signals they produced when compared with juvenile and pregnant whales in the same habitat. These observations show that right whale mother-calf pairs rely upon acoustic crypsis, potentially to minimize the risk of acoustic eavesdropping by predators.