Age-related reproductive effort in male chimpanzees: terminal investment or alternative tactics?

Because senescence impairs the ability of older males to compete successfully for mates, male reproductive strategies are expected to change with age. The terminal investment hypothesis proposes that older males, who could die soon, should take greater risks to obtain mating opportunities. Another possibility is that older males avoid such risks, adopting alternative reproductive tactics, such as increased affiliation with females, increased reliance on coalitions or sexual coercion to continue to compete with younger animals. We tested these hypotheses in wild chimpanzees, Pan troglodytes schweinfurthii, of the Kanyawara community, Kibale National Park, Uganda, where old males sire offspring at relatively high rates. Our data set included >40 000 incidents of male aggression and >5800 copulations observed between 2005 and 2017. We found that, even as their dominance status declined, old males maintained relatively high copulation rates, especially with established mothers. There was no evidence for terminal investment in response to ageing. Males became generally less aggressive as they aged. Neither did old males form affiliative bonds with females, nor use sexual coercion more frequently, as alternative reproductive tactics. Old males did, however, participate in coalitionary aggression at higher rates than young males and increased the proportion of their aggression that was coalitionary over time. Coalitions were positively associated with mating success, particularly for low- and middle-ranking males. These results support the hypothesis that ageing male chimpanzees use coalitions as an alternative reproductive tactic. The lack of evidence for terminal investment in response to ageing appears to reflect a broader mammalian pattern in which males who rely on fighting to secure mating opportunities avoid excessive risk taking as their formidability wanes.

Dynamic Coalition Formation among IoT Service Providers: A Systematic Exploration of IoT Dynamics Using an Agent-Based Model.

This paper introduces an Agent-Based Model (ABM) designed to investigate the dynamics of the Internet of Things (IoT) ecosystem, focusing on dynamic coalition formation among IoT Service Providers (SPs). Drawing on insights from our previous research in 5G network modeling, the ABM captures intricate interactions among devices, Mobile Network Operators (MNOs), SPs, and customers, offering a comprehensive framework for analyzing the IoT ecosystem's complexities. In particular, to address the emerging challenge of dynamic coalition formation among SPs, we propose a distributed Multi-Agent Dynamic Coalition Formation (MA-DCF) algorithm aimed at enhancing service provision and fostering collaboration. This algorithm optimizes SP coalitions, dynamically adjusting to changing demands over time. Through extensive experimentation, we evaluate the algorithm's performance, demonstrating its superiority in terms of both payoff and stability compared to three classical coalition formation algorithms: static coalition, non-overlapping coalition, and random coalition. This study significantly contributes to a deeper understanding of the IoT ecosystem's dynamics and highlights the potential benefits of dynamic coalition formation among SPs, providing valuable insights and opening future avenues for exploration.

Worldwide Trends in COVID-19-Related Attacks Against Healthcare: A Review of the Safeguarding Health in Conflict Coalition Database.

During the COVID-19 pandemic, violence targeting healthcare reportedly increased. Attacks against healthcare can severely hamper the public health response during a pandemic. Descriptive data analysis of these attacks may be helpful to develop prevention and mitigation strategies. This study aimed to investigate trends regarding COVID-19-related attacks against healthcare from January 2020 until January 2023. COVID-19-related incidents occurring between January 2020 and January 2023 were extracted from the Safeguarding Health in Conflict Coalition database and screened for eligibility. Included incidents were linked to COVID-19 health measures or were attacks directly interfering with COVID-19 healthcare, including conflict-related attacks. Data collected per incident included temporal factors; country; setting; attack and weapon type; perpetrator; motive; number of healthcare workers (HCWs) killed, injured, or kidnapped; and health facility damage. The study identified 255 COVID-19-related attacks against healthcare, with 18 HCWs killed, 147 HCWs injured, and 86 facilities damaged. The highest attack frequency was reported during the beginning of the pandemic and predominantly concerned stigma-related attacks against healthcare. Reported incidents in 2021 included attacks targeting vaccination campaigns, as well as conflict-related attacks interfering with COVID-19 healthcare. COVID-19-related attacks against healthcare occurred in heterogeneous contexts throughout the pandemic. Due to underreporting, the data presented are a minimum estimate of the actual magnitude of violence. The findings of this study emphasize the importance of public education campaigns, improved coordination between healthcare organizations and law enforcement, and the possible need to bolster the security of medical facilities and health workers.

Complete Ankle Joint that is Tibiotalar and Distal Tibiofibular Coalition Presenting with Foot and Ankle Pain - A Case Report.

Introduction: Coalition is an abnormal, usually congenital, or developmental connection in between or the complete fusion of two bones that are otherwise separate. It is of three types, i.e., synostosis (bony connection), synchondrosis (cartilaginous connection), or syndesmosis (fibrous tissue). Its typical cause is the failure of mesenchymal segmentation and differentiation. Usually, it is seen in tarsal or carpal bones and very rarely in between other bones. Only a single case of a tibiotalar coalition has been reported previously in literature. Herein, we are reporting a case of the talocrural coalition, which is the first one from the Indian sub-continent. Case Report: A 16-year-old moderately built female patient of Indian origin presented with chronic pain of 1-year duration in the right foot and ankle region on weight bearing. The pain was dull aching type, mild-to-moderate in severity and worsened with activity or prolonged walking, and relieved on taking non-steroidal anti-inflammatory drugs. No relevant history was present. On local examination, diffuse tenderness was present in the ankle and the tarsal bones. Almost negligible dorsiflexion and about 15° plantar flexion of the foot were possible. An initial radiograph of the right ankle revealed osseous fusion between the distal tibia and fibula, as well as between the tibia, fibula, and the dome of the talus. Magnetic resonance imaging (MRI) revealed osseous fusion involving the distal tibia, fibula, and the dome of the talus (both medially and laterally), indicative of talocrural fusion. No edema or inflammation was appreciable in the adjacent tendons or synovium. The patient was explained regarding the pathology and the prognosis. She was managed conservatively and was satisfied. Conclusion: Radiographs play a crucial role in evaluating patients suspected of having a coalition or ankylosis. Complementary tools such as computed tomography and MRI are valuable for a more in-depth assessment of the fusion and aid in surgical planning.

Lunotriquetral Synostosis as a Cause of Ulnar Sided Wrist Pain: A Case Report.

The diagnostic workout of ulnar sided wrist pain may be challenging, since there can be many different causes for it, varying from ulnar nerve problems to fractures. Congenital lunotriquetral synostosis may present as a source of pain in some cases, but it is a rare diagnosis. The author presents a case of post-traumatic ulnar sided wrist pain in a patient with Minnaar's type 1 congenital lunotriquetral synostosis.

Differences in expression of male aggression between wild bonobos and chimpanzees.

Researchers investigating the evolution of human aggression look to our closest living relatives, bonobos (Pan paniscus) and chimpanzees (Pan troglodytes), as valuable sources of comparative data.1,2 Males in the two species exhibit contrasting patterns: male chimpanzees sexually coerce females3,4,5,6,7,8 and sometimes kill conspecifics,9,10,11,12 whereas male bonobos exhibit less sexual coercion13,14 and no reported killing.13 Among the various attempts to explain these species differences, the self-domestication hypothesis proposes negative fitness consequences of male aggression in bonobos.2,15,16 Nonetheless, the extent to which these species differ in overall rates of aggression remains unclear due to insufficiently comparable observation methods.17,18,19,20,21,22,23 We used 14 community-years of focal follow data-the gold standard for observational studies24-to compare rates of male aggression in 3 bonobo communities at the Kokolopori Bonobo Reserve, Democratic Republic of Congo, and 2 chimpanzee communities at Gombe National Park, Tanzania. As expected, given that females commonly outrank males, we found that bonobos exhibited lower rates of male-female aggression and higher rates of female-male aggression than chimpanzees. Surprisingly, we found higher rates of male-male aggression among bonobos than chimpanzees even when limiting analyses to contact aggression. In both species, more aggressive males obtained higher mating success. Although our findings indicate that the frequency of male-male aggression does not parallel species difference in its intensity, they support the view that contrary to male chimpanzees, whose reproductive success depends on strong coalitions, male bonobos have more individualistic reproductive strategies.25.

Hindfoot joint kinematics analysis after the resection of talocalcaneal coalition.

BACKGROUND: The subtalar joint movement between the talus and calcaneus is restricted in patients with talocalcaneal coalition (TCC). When the motion of the subtalar joint is restricted, shock absorption in the foot decreases, leading to pain during walking. Resection methods to maintain subtalar motion by removing abnormal unions have been proposed. The purpose of this study was to analyze the joint kinematics of patients who underwent TCC resection and to quantitatively evaluate the results of the surgery based on the measured kinematics. METHODS: Joint kinematics of five patients with TCC were obtained using a biplane fluoroscopic imaging system and an intensity-based two-/three-dimensional registration method. The joint kinematics of the tibiotalar and subtalar joints and the tibiocalcaneal motion during the stance phase of walking were obtained. From the kinematics of the hindfoot joints, the inversion/eversion range of motion (ROM) of the patients before and after resection was statistically analyzed using the Wilcoxon signed-rank test to test whether TCC resection improved the ROM. RESULTS: During the loading response period, the eversion ROM of the subtalar joint and tibiocalcaneal motion significantly increased postoperatively. In addition, a significant postoperative increase was observed in the subtalar and tibiocalcaneal inversion ROM during the pre-swing period. SIGNIFICANCE: TCC resection surgery increased the ROM of the subtalar joint, which in turn contributed to the increase in tibiocalcaneal ROM. Increased subtalar and tibiocalcaneal ROM could result in increased shock attenuation and may be a contributing factor to pain relief during walking.

Talocalcaneal coalition classifications: A critical analysis review and suggested new classification system with implications for treatment.

Talocalcaneal coalitions (TCC) is the second most frequent tarsal coalition reported. Our aim was to review talocalcaneal coalition classifications and to propose a new classification emphasizing a therapeutic approach. None of the classifications described for TCC mention the presence of flatfoot or valgus hindfoot, which are the key elements when defining the optimal treatment of this disease. We defined five clinical and radiological factors that would guide the choice of surgical treatment and based on these, we proposed a new classification system.

Advocacy Coalitions, Policy Entrepreneurs, and Windows of Opportunity: Tobacco Control in South Africa, 1948-2018.

This article examines the political history of tobacco control policy in South Africa from 1948 to 2018 by drawing on available historical documents, media reports, published books and articles, the grey literature, and face-to-face interviews with key policy actors. Tracing the historical evolution of tobacco control policies in South Africa reveals how embedded opposition from vested interest groups at every stage of the policy process complicates responses to the tobacco issue. This case study demonstrates how, despite such embedded difficulties, a confluence of regime change, evidence-based messaging, political will, policy entrepreneurs, and advocacy coalitions have led to the gradual transformation of tobacco control policy in South Africa over time. Understanding the historical evolution of tobacco control policy in South Africa opens up space for an in-depth inquiry that allows researchers to trace the policy-making process over the last seven decades, and to understand how those processes have facilitated a shift in the orientation of policy makers over time.

Bilateral Cubonavicular and Synchronous Talocalcaneal Tarsal Coalition with Stress Response-Case Report and Review of Literature.

Tarsal coalition occurs in 1% of the population and represents a congenital failure of segmentation in two or more tarsal bones. It most commonly occurs at the talocalcaneal and calcaneonavicular joint. Although commonly asymptomatic, it may present with pain, rigidity, and pes planus. Cubonavicular, multiple synchronous, and bilateral coalitions are rare but an awareness is required to ensure accurate diagnosis and management. In this article, we presented the first reported case (to the best of our knowledge) of bilateral cubonavicular coalition with synchronous talocalcaneal coalition and stress response within the intermediate cuneiform.

Biracial Faces Offer Visual Cues of Successful Intergroup Contact: Genetic Admixture and Coalition Detection.

This research explores how biracial facial cues affect racial perception and social judgment. We tested a coalition-signaling hypothesis of biracial cues in two studies conducted in the United States (n = 227) and China (n = 116). From the perspective of intergroup and interpersonal relations theories in social psychology, biracial features would likely be perceived as cues of threat or resource competition. In contrast, we propose an evolutionary hypothesis that biracial facial cues reveal the ancestral history of intergroup alliances between members of two races or ethnic groups. When racial cues are mixed, we predict that biracial individuals may be viewed more positively than other-race or even own-race members who often compete for limited ingroup resources. The participants observed facial images that ranged from 100% Asian to 100% Caucasian, including morphed biracial composites of 30%, 40%, 50%, 60%, and 70% Caucasian or Asian. The participants evaluated each image regarding perceived Caucasianness (Asianness), attractiveness, trustworthiness, health, intelligence, and career prospects. The US and Chinese samples yielded a similar pattern of own-race bias in racial perception and biracial favoritism in social judgment. The social judgment ratings were not correlated with the racial perception scores and were independent of the sex of the participants or biracial images, indicating a coalitional motive, instead of a mating motive, underlying social perception of biracial individuals. Overall, the results suggest that biracial facial features signal a successful genetic admixture and coalition in parental generations and thus increase the trustworthiness and cooperative potential of a biracial person.

Resection of Calcaneonavicular and Talocalcaneal Coalitions With Surgical Correction of the Hindfoot Valgus Deformity in One Step.

Background: Calcaneonavicular (CNC) and talocalcaneal (TCC) coalitions are the most common cause of rigid flatfoot in children. After resection, correction of the most frequent valgus-hindfoot deformity usually requires a second-step surgery. We report results of a retrospective study of patients treated with a one-step correction. Methods: Between 2008 and 2019, data were collected on 26 patients (19 male, 7 female) affected by CNC (n = 18) and TCC (n = 13), all with rigid symptomatic flatfeet. Average age at surgery was 12.5 ± 1.1 (SD) years (range, 9.8-15.2). All patients (26/26) underwent resection, 20 of 26 underwent at the same time subtalar extraarticular screw arthroereisis (SESA) for correction of residual hindfoot valgus deformity. Pre- and postoperative talocalcaneal angle according to Costa Bartani and Talar inclination angle in weightbearing were measured. Twenty-five of 26 patients had postoperative American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Results: Pre- and postoperative talocalcaneal average angle for CNC was respectively 141.5 ± 7.7 degrees and 130.5 ± 5.2 degrees (P < .0001) and 143.7 ± 7.7 degrees and 129.7 ± 7.0 degrees (P < .0001) for TCC. Talar inclination average angle for CNC was 29.2 ± 5.3 degrees and 19.3 ± 1.6 degrees (P < .0001) and 31.2 ± 6.4 degrees and 21.4 ± 3.4 degrees (P < .0001) for TCC. Average follow-up (FU) was 4.7 ± 3.0 years (range, 6 months-11.9 years, median 4.9 years), with a mean age at FU of 17.2 ± 5.8 (SD) years (min 12.1, max 25.3, median 16.8 years). The mean AOFAS ankle-hindfoot score for CNC and for TCC was 96.6 (range 83-100) for resection and valgus correction as one-step procedure with no statistical difference (P = .5) between CNC and TCC. No patients had additional surgery for complications or recurrence. Conclusion: Symptomatic rigid flatfeet affected by CNC and TCC treated with coalition resection and minimally invasive subtalar arthroereisis (SESA) for residual hindfoot valgus correction in one step in adolescent age achieved good to excellent results in all cases. Further surgery to correct malalignment was avoided. Level of Evidence: Level IV, retrospective study.

100 Years of the American Public Health Association's Public Health Education and Health Promotion Section: Celebrating the Past, Forging the Future.

The American Public Health Association's Public Health Education and Health Promotion (APHA PHEHP) Section celebrates its 100th anniversary by reflecting on its humble beginnings and early contributions to the field of health education. This article highlights the often-unsung history of our field and its fledgling beginnings, which is important to scholars and students alike. First codified as the Health Education and Publicity Section in the early 1920s, we trace the history and challenges of using new modes of publicity such as motion pictures and innovative exhibits to help curb the spread of infectious diseases (e.g., tuberculosis, venereal disease). Evart G. Routzahn, credited as the Section's father, worked tirelessly to increase the Section's visibility (renamed the Health Education Section in 1927 and the Public Health Education and Health Promotion Section in 1990) and in advancing the professionalization of health education during a time when there were no formal professional preparation programs in health education. Over the years, the Section has played significant roles in strengthening the practice of health education and communication; advancing APHA's overall leadership, infrastructure, and governance; and contributing to the unified voice and advocacy for the health education profession and health equity. We conclude by describing contemporary initiatives that reflect the continued spirit and vibrancy of the Section in setting the stage for the next 100 years.

PomBase: a Global Core Biodata Resource-growth, collaboration, and sustainability.

PomBase (https://www.pombase.org), the model organism database (MOD) for fission yeast, was recently awarded Global Core Biodata Resource (GCBR) status by the Global Biodata Coalition (GBC; https://globalbiodata.org/) after a rigorous selection process. In this MOD review, we present PomBase's continuing growth and improvement over the last 2 years. We describe these improvements in the context of the qualitative GCBR indicators related to scientific quality, comprehensivity, accelerating science, user stories, and collaborations with other biodata resources. This review also showcases the depth of existing connections both within the biocuration ecosystem and between PomBase and its user community.

Cubonavicular Coalition in a Pediatric Patient: A Case Report.

Cubonavicular coalition is a rare congenital anomaly involving fibrous or osseous fusion between the cuboid and navicular bones. This case report presents a comprehensive analysis of a 10-year-old female patient with cubonavicular coalition, detailing the diagnostic challenges and tailored therapeutic interventions. The patient presented with persistent left foot pain and restricted range of motion. Clinical examination, radiographic studies, and magnetic resonance imaging confirmed cubonavicular coalition. Laboratory investigations ruled out systemic inflammatory processes. A multidisciplinary approach was adopted, initially employing nonsteroidal anti-inflammatory drugs and physical therapy. Surgical resection of the coalition was performed due to persistent symptoms, leading to successful outcomes. This case report contributes valuable insights into the clinical presentation, diagnosis, and management of cubonavicular coalition in pediatric patients. The successful outcome underscores the importance of a comprehensive and individualized approach, providing a basis for informed decision-making in similar cases. Continued research is essential to refine therapeutic algorithms and enhance understanding of rare musculoskeletal anomalies.

Imaging characteristics of too-long anterior process syndrome in children and adolescents.

BACKGROUND: In the presence of pain over the lateral aspect of the foot or recurrent ankle sprain in children, medical imaging is often employed to investigate potential causes, such as a calcaneonavicular coalition or a too-long anterior process (TLAP) of the calcaneus. Diagnosis and categorization of calcaneonavicular coalitions (synostosis, synchondrosis, or synfibrosis) is generally facilitated through imaging, in contrast to TLAP, which lacks well-defined semiological characteristics, apart from a calcaneonavicular space measurement of less than 5 mm. However, this measurement initially performed on an oblique view radiograph can be subject to a lack of precision due to positional variations of the foot and overlapping bones. Furthermore, the differentiation between TLAP as an anatomical variant and TLAP syndrome (characterized by symptomatic presentation), remains a subject of uncertainty. OBJECTIVE: The objective of our retrospective study was to investigate the imaging diagnosis of TLAP syndrome. MATERIALS AND METHODS: A retrospective unmatched case-control study was conducted, covering data from February 2014 to January 2021. All patients, included retrospectively and consecutively, were initially managed in our hospital with radiography and/or computed tomography (CT) and/or magnetic resonance imaging (MRI). Two radiologists independently reviewed the images taken (radiographs, CT scans, and MRIs) of patients undergoing treatment in pediatric orthopedics for TLAP syndrome and control subjects, utilizing a standardized questionnaire. The control group consisted of subjects with no features suggestive of TLAP syndrome. The questionnaire included measurements of the calcaneonavicular space and identification of indirect signs associated with calcaneonavicular coalitions, as described in the related literature. RESULTS: A total of 128 patients who met the inclusion criteria were included in the analysis, including 38 patients and 90 controls. The prevalence of TLAP was 71.5% in the study population and 62.6% among controls. A threshold measurement of the calcaneonavicular space at 3.2 mm favored TLAP syndrome (sensitivity=97%, specificity=70%, area under the curve [95% confidence interval] =0.881[0.812-0.949]), with better precision using CT. Three indirect signs were significant: the "anteater nose" sign, the talar beak, and the tapered anterior calcaneal process. These signs demonstrated an even stronger association with TLAP syndrome when observed in conjunction with a reduction in the calcaneonavicular space, particularly in CT scans. CONCLUSION: TLAP is common among control subjects. Therefore, a variant appears to be the most plausible explanation and it can be considered a mild form of calcaneonavicular coalition. However, in conjunction with symptoms suggestive of TLAP syndrome, the diagnosis is further supported by imaging, specifically with a calcaneonavicular space measurement of less than 3.2 mm. This measurement is most accurately obtained using CT with 2-dimensional reconstructions in all three planes. The simultaneous presence of the "anteater nose" sign, the talar beak, or the tapered anterior calcaneal process provides additional diagnostic evidence. In the diagnostic approach of calcaneonavicular coalition, oblique foot radiography seems useful in initially detecting abnormal coalition (bony or not), and complementarily, CT emerges as the best modality to characterize TLAP syndrome.

Lateral Extra-Articular Tenodesis with Indirect Femoral Fixation Using an Anterior Cruciate Ligament Reconstruction Suspensory Device.

BACKGROUND: The lateral extra-articular tenodesis (LET) procedure associated with anterior cruciate ligament (ACL) reconstruction can be considered in selected patients to diminish the risk of persistent rotatory instability and achieve a protective effect on the graft. Several techniques have been described in the literature to treat rotatory instability. Usually, a strip of the iliotibial band (ITB) is harvested from its middle while leaving the distal insertion, then passed underneath the lateral collateral ligament and fixed on the lateral aspect of the distal femur with various fixation methods such as staples, screws, anchors or extracortical suspensory devices. Despite their effectiveness, these fixation methods may be associated with complications such as lateral pain, over-constraint and tunnel convergence. METHODS: This study presents a detailed surgical description of a new technique to perform an LET during ACL reconstruction with any type of graft fixing the ITB strip with the sutures of the ACL femoral button, comparing its pros and cons in relation to similar techniques found in the literature. CONCLUSIONS: This technique represents a reproducible, easy to learn and inexpensive solution to perform a lateral extra-articular tenodesis associated with an ACL reconstruction using the high-resistance sutures of the femoral button.

Self-Interested Coalitional Crowdsensing for Multi-Agent Interactive Environment Monitoring.

As a promising paradigm, mobile crowdsensing (MCS) takes advantage of sensing abilities and cooperates with multi-agent reinforcement learning technologies to provide services for users in large sensing areas, such as smart transportation, environment monitoring, etc. In most cases, strategy training for multi-agent reinforcement learning requires substantial interaction with the sensing environment, which results in unaffordable costs. Thus, environment reconstruction via extraction of the causal effect model from past data is an effective way to smoothly accomplish environment monitoring. However, the sensing environment is often so complex that the observable and unobservable data collected are sparse and heterogeneous, affecting the accuracy of the reconstruction. In this paper, we focus on developing a robust multi-agent environment monitoring framework, called self-interested coalitional crowdsensing for multi-agent interactive environment monitoring (SCC-MIE), including environment reconstruction and worker selection. In SCC-MIE, we start from a multi-agent generative adversarial imitation learning framework to introduce a new self-interested coalitional learning strategy, which forges cooperation between a reconstructor and a discriminator to learn the sensing environment together with the hidden confounder while providing interpretability on the results of environment monitoring. Based on this, we utilize the secretary problem to select suitable workers to collect data for accurate environment monitoring in a real-time manner. It is shown that SCC-MIE realizes a significant performance improvement in environment monitoring compared to the existing models.

Cubonavicular Coalition: Magnetic Resonance Imaging Findings and Associated Pathology of a Rarely Reported Condition in 27 Patients.

RATIONALE AND OBJECTIVES: (1) Describe multimodality imaging of cubonavicular coalition (CNC) with magnetic resonance imaging (MRI) focus, (2) evaluate CNC associated foot and ankle pathology, (3) examine clinical presentation/symptoms associated with CNC, (4) record CNC treatment. MATERIALS AND METHODS: Retrospective Institutional Review Board (IRB) approved study. Picture Archiving and Communication System (PACS) databases searched for CNC. Final study population: 34 cases in 27 patients. Each CNC was reviewed for: coalition type (osseous versus non-osseous- cartilaginous versus fibrous), tendon and ligament pathology, bone marrow edema at CNC and adjacent joints, presence and severity of degenerative changes at CNC and adjacent joints, fractures, additional coalitions, laterality, and pes planus. MRI planes and radiographic views on which coalitions were best identified were recorded. Each CNC EMR was reviewed for: symptoms, trauma, management, patient demographics. Inter-reader reliability was performed for type of non-osseous coalition. RESULTS: Final cohort included 34 cases in 27 patients (average age: 34.7, range: 10-76; 71% female). No CNC was completely osseous. On MRI, 89.5% of coalitions were non-osseous and 5.3% were partially osseous. 76.5% of patients had referable symptoms including pain, limited motion, inability to bear weight. 23.5% of patients were surgically managed/pathologically proven. On MRI, 36.8% of patients had tendon pathology, 52.6% had ligamentous pathology, 100% had bone marrow edema-like signal abnormality about the CNC, and 88.2% had CNC degenerative changes. There was bone marrow edema-like signal abnormality at bones adjacent to the CNC in 52.6% and adjacent joint degenerative disease present in 50%. CNC was best identified on oblique radiographs and axial MRI. Inter-reader reliability for non-osseous coalition type was poor, Cronbach's alpha 0.554. CONCLUSION: CNC is subtle and findings of osteoarthritis or bone marrow edema-like about the cubonavicular articulation should raise suspicion for underlying coalition.