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Pharmacy data reveal that 70% of patients were missing one or more days worth of drops out of five. Adopting approaches to behavior change and management skills used for people with diabetes may provide insight to improve self-management of glaucoma. Every person who is diagnosed with a chronic health condition such as glaucoma has unique life circumstances that may present barriers to behavior change. An accurate diagnosis and a treatment plan are useless if patients do not use their prescribed eye drops. Active listening and effective communication can result in persons who are more engaged in their self-care behaviors. Collaborative communication using person-centered and strengths-based messages could help eye care providers identify challenges and concerns for people with glaucoma who are experiencing inconsistencies with their eye drops. In an atmosphere where patients can discuss their challenges with treatment recommendations without judgment or fear, they are more likely to trust their provider and therefore share their situation openly and honestly. This is accomplished by choosing language that communicates mutually-agreed-upon self-management goals and addresses and strengthens individual and clinical outcomes. The eye care professional is then seen by the patient as a resource who can empathize when setbacks occur and reinforce the patient's self-management goals. Open-ended questions and tell-ask-tell approaches for identifying barriers to care are keys to more effective communication and trusting relationships. This includes recognizing that glaucoma is associated with increased rates of anxiety or depression that may be an overlooked barrier to self-management. By adopting language recommendations from diabetes care and education, eye care practitioners may be better equipped to help people with glaucoma improve their self-care.

Artelle et al. (2018) conclude that "hallmarks of science" are largely missing from North American wildlife management based on a desk review of selected hunting management plans and related documents found through Internet searches and email requests to state and provincial wildlife agencies. We highlight three fundamental problems that compromise the validity of the conclusions posited: missing information to support selection of "hallmarks of science," confusion about the roles and nature of science and management, and failure to engage effectively with the scientists and managers actively managing wildlife populations in North America.

Understanding spatiotemporal variability in prey accessibility is important for disentangling predator-prey interactions and is relevant to management interventions to reduce predation. Recently, caribou (Rangifer tarandus) in Newfoundland declined by 66%, with calf predation by black bears (Ursus americanus) implicated as a major proximate mechanism of the decline. Most predation occurs when calves are aggregated on calving grounds. We used telemetry data from 271 caribou and 45 black bears in 2 caribou herd ranges to examine spatial variability in calf accessibility, identify the distribution of potentially predatory bears, and assess the aggregative response of bears to the calf resource. We predicted whether a bear was a visitor to a calving ground during the calving season (a potentially predatory bear) based upon its sex, the herd range it occupied, its distance to the calving grounds, and the season. The distribution of potentially predatory bears and their degree of segregation from non-predatory bears varied seasonally. The probability of a bear visiting the calving grounds during calving decreased with increasing distance from the calving grounds, and was greater for males than for females in all seasons at distances beyond 2.4 km from the calving grounds. Residency time of bears increased in the calving grounds of 1 herd during calving, suggesting an aggregative response to neonates in that area. For both herds, the estimated distribution of potentially predatory bears was much larger than the calving grounds, illustrating that the relevant scale of predator-prey interactions may extend far beyond the area where lethal encounters occur. Our work highlights the value of examining spatiotemporal dynamics of predator movements prior to implementing ecosystem manipulations designed to reduce predation and provides a modeling framework that can be used to guide management interventions in systems with aggregated prey. © 2015 The Wildlife Society.

The use of day beds for extended periods during the transition into and out of the physiological state of hibernation has been documented in many bear populations, but has never been quantifi ed. Additionally, den abandonment by black bears Ursus americanus has rarely been observed at northern latitudes except after den visits by researchers. In three areas on the northern island of Newfoundland, where male and female black bears spent an average of 158 and 178 d denning, respectively, we identified den sites and extended-use day beds (occupied continuously for 6–26 d) remotely using GPS collars, and here provide the first systematic description of the use of these day beds by bears. We documented den abandonment in 6 (9%; 3 F, 3 M) of 67 bear-winters (6 [14%] of 44 radio-collared bears) and the use of extended-use transitional day beds in 16 (24%) of 67 bear-winters (15 [34%] of 44 radio-collared bears, 8 F, 7 M). In 5 of 10 instances bears left their fall day beds on days with > 15 mm of rain (mean = 28...

The recently diminished caribou (Rangifer tarandus) population in insular Newfoundland, Canada, has been severely limited by predation on newborn calves. These neonates are patchily distributed on the landscape; therefore, to adequately understand predator–prey interactions, the temporal and geographic extent of the distribution of caribou calves must be identified so that current areas with calves can be differentiated from areas without calves. We used telemetry locations of 309 caribou calves and 100 adult females from 4 herds, 2008– 2010, to estimate the spatiotemporal distribution of caribou calves during the time when they were most vulnerable to predation, to evaluate the predictability of the calf resource among years, and to assess the degree of aggregation during calving. Patterns of calf distribution were predictable in time and space from year to year, with an average distributional overlap of 68% between years. The dispersion of female caribou during calving varied among herds from highly aggregated (8% and 20% of herd range) to more dispersed (50–70% of herd range). Postcalving (up to 9 weeks) distributions also varied among herds; the 2 more-dispersed herds remained sedentary, whereas both highly aggregated herds migrated away from their calving grounds at the end of June. The most-aggregated herd remained so as it migrated from its calving ground, whereas the less-aggregated herd spread out and moved in a variety of predictable directions. Dispersion and movement patterns varied with forest cover; herds with less forest cover in their range were more aggregated and migratory than herds with more forest cover.

Previous studies report professional athletes return to play following arthroscopic microfracture of the hip for chondral defects. Our hypothesis is that professional hockey players undergoing arthroscopic microfracture for chondral defects of the hip achieve the same performance they had pre-injury and compared to matched controls. Seventeen professional hockey players underwent arthroscopic microfracture for an Outerbridge grade IV chondral lesion. Concomitant procedures for labral pathology or FAI were included. Performance data for the full season preceding and following index procedure were analysed, in addition to two matched control players per subject. Data were collected at two points, 2 years apart. Eighty-two per cent (14/17) of players who underwent arthroscopic microfracture returned to play. The year prior to injury for the 14 players who returned was compared to the average of their individual controls. There was no statistical difference between the groups for age, number of seasons in the league, games played, time on ice, points, save percentage, and shots against goal. Post-operatively, there was no statistical difference between the treatment and control groups regarding performance measures. There was a trend towards a decrease in games played and points post-operatively compared with controls. The treatment group decreased 11 games played, while the controls decreased five games. The treatment group also decreased 14 points, while the controls decreased three points for the season. Professional hockey players with a discrete, full-thickness chondral defect of the hip are able to return to elite performance level following an arthroscopic microfracture procedure when compared to pre-injury outcomes and controls. III.

We monitored 142 radiocollared adult (≥1.0 yr old) white-tailed deer (Odocoileus virginianus) in 3 study areas of Massachusetts, USA, to estimate annual survival and mortality due to legal hunting. We then applied these rates to deer harvest information to estimate deer population trends over time, and compared these to trends derived solely from harvest data estimates. Estimated adult female survival rates were similar (0.82–0.86), and uniformly high, across 3 management zones in Massachusetts that differed in landscape composition, human density, and harvest regulations. Legal hunting accounted for 16–29% of all adult female mortality. Estimated adult male survival rates varied from 0.55 to 0.79, and legal hunting accounted for 40–75% of all mortality. Use of composite hunting mortality rates produced realistic estimates for adult deer populations in 2 zones, but not for the third, where estimation was hindered by regulatory restrictions on antlerless deer harvest. In addition, the population estimates we calculated were generally higher than those derived from population reconstruction, likely due to relatively low harvest pressure. Legal harvest may not be the dominant form of deer mortality in developed landscapes; thus, estimates of populations or trends that rely solely on harvest data will likely be underestimates. © 2011 The Wildlife Society.

Multiligament knee injuries pose a challenging clinical situation to even experienced orthopedic surgeons. Although nonoperative treatment of mild varus instability without a cruciate injury has been shown to have acceptable outcomes, it is now accepted that operative management of multiligament inj

Deep venous thrombosis and septic pulmonary embolism are known to occur in association with pediatric musculoskeletal infections. The authors of recent studies have reported an apparent increase in the incidence of this phenomenon, which appears to be related to the rising occurrence of infections caused by methicillin-resistant Staphylococcus aureus 1. Some authors have suggested that the Panton-Valentine leukocidin gene, which may be expressed by methicillin-resistant Staphylococcus aureus , is responsible for severe consequences of infection including necrotizing pneumonia, deep venous thrombosis, septic pulmonary embolism, and an enhanced local inflammatory response leading to abscess formation in tissues adjacent to the site of infection2-5. We previously reported on thirteen children with deep venous thrombosis that occurred in association with osteomyelitis (eleven), septic arthritis (one), or pyomyositis (one), and we identified characteristics of these children that may help to guide clinicians in assessing the relative propensity of a child with musculoskeletal infection to develop deep venous thrombosis6. In that report, 25% of the children above the age of eight years who had osteomyelitis caused by methicillin-resistant Staphylococcus aureus and who presented with a C-reactive protein level of >6 mg/dL were noted to have deep venous thrombosis, but none of the children with deep venous thrombosis in that report had an upper-extremity infection. The majority of the infections occurred adjacent to the knee, involving either the proximal part of the tibia or the distal part of the femur, with the deep venous thrombosis located in the popliteal or femoral vein. We present here the case of a child with acute osteomyelitis of the humerus associated with a deep venous thrombosis in the ipsilateral upper extremity and septic pulmonary embolism. The parents of the patient were informed that data concerning the case would be submitted for publication, and …

Moose have recently re-colonized the temperate forests of southern New England, raising questions about this herbivore's effect on forest dynamics in the region. We quantifi ed Moose foraging selectivity and intensity on tree species in rela- tion to habitat features in central Massachusetts. Acer rubrum (Red Maple) and Tsuga canadensis (Eastern Hemlock) were disproportionately browsed; Pinus strobus (White Pine) was avoided. Foraging intensity correlated positively with elevation, distance to development, and watershed type and negatively with time since forest harvest, explaining 26% of the variation. Moose may interact with forest harvest- ing to contribute to a decline in Red Maple and Eastern Hemlock and an increase in White Pine in intensively browsed patches. Nonetheless, foraging impacts may diminish over time, as increasing temperatures and sprawling development increas- ingly restrict suitable Moose habitat.

Purpose of review Total hip replacement is one of the safest and most clinically efficacious operations in orthopedic surgery. It has been extended to more and more patient populations over the past four decades. The purpose of this review is to present the contemporary data of total hip replacement in two unique patient populations: obese patients and geriatric patients older than 75 years of age. Recent findings There are unique clinical challenges in these patients. In addition, the clinical outcome and complications are different from more routine total hip replacement populations. Summary The recent research has shown that total hip replacement in the obese and elderly populations can be successful, and should not be denied solely based on these two criteria. There is a need for more research to investigate postoperative instability in the obese patient population, and perioperative mental confusion and cognitive function deterioration in the elderly patient population.

Controlled public hunts have been used in a variety of settings to reduce overabundant white-tailed deer (Odocoileus virginianus) herds. We present the results of a large-scale (160 km2) controlled hunt at Quabbin Reservation (QR) in central Massachusetts, USA. The QR was divided into 5 hunt zones. Hunting was initiated in each zone from 1991 to 1994 and continued through 2004. The management goal was to achieve posthunt deer densities of 4 deer/km2. Initial estimated deer densities in each zone ranged from 11.4 deer/km2 to 27.6 deer/km2. The management goals were reached in each zone after 2–4 years of hunting. Posthunt populations were maintained at or below the goal even though total hunter effort was reduced. Hunters were not required to harvest antlerless deer, but antlerless deer comprised 55–83% of the harvest each year. We simulated the effects of 5 years without hunting on deer populations. The simulated deer population exceeded management goals after 2 years. Our results demonstrate tha...

We surveyed 52 jurisdictions across continental North America to gather comparative information on management strategies for American black bear (Ursus americanus) for the late 1980s and the start of the 21st century. Specifically, we asked about: population estimates and targets, harvest objectives and hunting methods (spring hunt, use of bait, use of dogs), hunter and harvest data, and trends in human–bear conflicts. Most population estimates were derived through a subjective process of extrapolation and expert opinion and were used as the basis for adjusting management practices. In 17 jurisdictions that had spring hunts, estimated black bear populations increased by 6%, compared to a 51% increase in the 21 jurisdictions with fall-only seasons. Estimated populations increased by 87% in the 14 jurisdictions without hunting seasons. Another 10 jurisdictions had reports of occasional transient bears but no resident population. Jurisdictions with liberal hunting regimes tended to maintain human–bear conflict at stable levels, whereas those with more restrictive regimes appeared to experience a growing trend. We suggest that the goal of management should be to balance the goals of maintaining viable black bear populations, safeguarding human welfare and property, and satisfying the needs of stakeholders in a cost-effective manner. Hunting and proactive education and awareness programs are keys to achieving that balance. By setting appropriate harvest objectives and hunting methods to regulate the density and distribution of black bears, in conjunction with measures to deter bears from associating people and dwellings with food, agencies should be better able to manage for human–bear conflict in the 21st century.

We investigated the role of changing abundance of spring foods on female American black bear (Ursus americanus) diet, milk composition, and cub survival in western Massachusetts. We hypothesized that diets would change, percentage milk fat would be higher, and cub survival would be higher in a year when overwintered hard mast was more abundant. We obtained paired samples of milk from 7 adult female bears across consecutive reproductive cycles during which spring diets differed; 1 year followed a bumper acorn (Quercus rubra) crop and estimated spring diets were >25% acorns; the other year followed an extremely poor acorn crop and spring diets were estimated to be 99% skunk cabbage (Symplocarpus foetidus). Postdenning milk was higher in fat (26.7% versus 18.2%; P = 0.0557) during the spring when acorns were abundant, but we did not identify any carryover affect to cub survival. We suggest that adult female black bears compensate for changes in food availability by eating greater volumes of alternative foods, and perhaps allocate resources primarily to milk production; the bears appear to be able to produce milk of adequate quality to sustain cubs, regardless of spring diet.

Background [Pro 11 D -Ala 12 ] angiotensin I is an ACE-resistant substrate specific for chymase. We used this peptide to determine whether a functionally significant non-ACE angiotensin (Ang) II–generating pathway exists in human dorsal hand veins. Methods and Results Using a modified Aellig technique, we studied the response to Ang I and [Pro 11 D -Ala 12 ] Ang I in dorsal hand veins in vivo in patients with coronary heart disease. We measured the venoconstrictor effect of each peptide given before and after a 6.25-mg oral dose of the ACE inhibitor captopril or matching placebo. Placebo or captopril was given in a double-blind, randomized fashion. Ang I induced a mean±SEM venoconstrictor response of 45±11%, 40±10%, 55±8%, and 4±4% before placebo, after placebo, before captopril, and after captopril, respectively. Hence, the response to Ang I was reproducible and was reduced significantly only after treatment with captopril ( P =0.002). [Pro 11 D -Ala 12 ] Ang I induced a mean venoconstrictor response of 42±9%, 49±9%, 48±10%, and 54±11% before placebo, after placebo, before captopril, and after captopril, respectively. Hence, captopril had no significant effect on the response to [Pro 11 D -Ala 12 ] Ang I. Conclusions We have demonstrated that [Pro 11 D -Ala 12 ] Ang I is able to induce venoconstriction in humans in vivo. With this specific pharmacological probe, we have shown that a non-ACE pathway capable of generating Ang II exists in human veins in vivo and is potentially functionally important. This pathway is likely to involve the enzyme chymase.

Aims Adrenomedullin is a newly described peptide that has widespread tissue distribution. Its presence in cardiovascular (including vascular endothelial cells, smooth muscle cells, and cardiac atria and ventricles) and renal tissues, together with its vasodilatory and natriuretic properties, suggest a role in blood pressure regulation and fluid and electrolyte balance. Methods Nine normal volunteers were studied to determine whether or not adrenomedullin influenced plasma atrial natriuretic peptide and arginine vasopressin concentrations during systemic angiotensin II infusion. Results A significant (P = 0.02) augmentation of atrial natriuretic peptide concentrations, but no suppression of arginine vasopressin concentrations, was found with coinfusion of adrenomedullin and angiotensin II when compared with vehicle and angiotensin II. Conclusions Despite its vasodilator and natriuretic action, adrenomedullin significantly augmented angiotensin II-stimulated plasma atrial natriuretic peptide concentrations in healthy humans. This provides further evidence of a synergistic interaction between adrenomedullin and atrial natriuretic peptide and suggests that adrenomedullin may have a role in fluid and electrolyte balance and blood pressure regulation.

Laryngeal hemangiomas in adults are uncommon. We report four such cases seen at our clinic during an 18-month period in 1996 and 1997. All masses were detected by endoscopy, and all were biopsied and ablated uneventfully with a CO2 laser. All four patients recovered without incident. We feel that laryngeal hemangiomas that affect only the glottic area can be treated endoscopically with a CO2 laser without consequences.

Ruffed grouse (Bonasa umbellus) occupy many areas of the eastern and southeastern United States where oak (Quercus sp.) is the dominant forest type. However, most research on grouse habitat requirements and populations has taken place in Lake States aspen (Populus sp.) forests. We captured and radiotagged male grouse to determine spring and summer home range sizes and habitat use on a 1120 ha experimental forest management area in central Pennsylvania. The dominant forest types were aspen-black cherry and mixed oak. The management area was divided into two sections, one which was managed with a short-rotation clearcutting scheme and one that was left unmanaged. Breeding season and summer home ranges of male ruffed grouse were similar to those observed in the Midwest (5.0–9.4 ha), and did not appear to differ between managed and unmanaged habitats. However, habitats used differed between the managed and unmanaged areas. Male grouse on the managed area used aspen-black cherry and mixed oak sapling stands more than expected during both the breeding season and summer. Pole-sized and sawtimber aspen stands in the unmanaged area were used more than expected during breeding and summer seasons. Male ruffed grouse avoided mixed oak sawtimber stands, which comprised 62% and 47% of the available habitat in the unmanaged area and managed area, respectively. Our results demonstrated that southern mixed oak stands can be managed effectively for ruffed grouse with small (1 ha) clearcuts.

Rhinophyma is an acne rosacea which primarily affects the midface of elderly men, and causes disfigurement as well as obstruction. There are numerous ways of treating this condition and, in our institution, a CO2 laser is the treatment of choice.

Purpose The purpose of this study was to compare elite athletes who underwent hip arthroscopy with and without microfracture with respect to their ability to return to sport at the professional level. Methods All elite male athletes who underwent hip arthroscopy between 1999 and 2010 were identified. Inclusion criteria were hip arthroscopy with treatment of labrum, femoroacetabular impingement, cartilage, ligamentum teres, capsule, and/or loose body removal. Exclusion criteria were diffuse degenerative joint disease, previous surgery, plans to retire, labral reconstruction, soft tissue release, and concomitant lower extremity injury. Thirty-nine athletes underwent hip arthroscopy with microfracture and were assigned to the microfracture treatment group. Eighty-one elite athletes (94 hips) underwent hip arthroscopy without microfracture and were assigned to the control group. Sports played included hockey, soccer, football, baseball, tennis, and golf. Results Seventy-seven percent (30 of 39) of athletes in the microfracture treatment group and 84% (79 of 94) in the control group returned to play. There was no statistical difference in rate of return to play between groups (odds ratio = 1.6; 95% confidence interval, 0.633 to 4.049). Those players who did return were followed for an average of 3 years (range, 2 to 12). Athletes in the microfracture treatment group who returned have averaged 3 seasons thus far, and 73% are still playing. We found no significant difference in the microfracture group in age, time from injury to surgery, number of seasons played preoperatively, or size of lesion for return versus no return. We also found no increased risk of not returning because of contact sport, multiple lesions, or lesion on weightbearing surface. Conclusions There was no detectable statistically significant difference in return to play rate after hip arthroscopy with microfracture and hip arthroscopy without microfracture. Professional athletes who underwent hip arthroscopy with microfracture procedure were able to return to the same high level of competition after surgery at a high rate. Level of Evidence Level III, retrospective comparative study.

A medial meniscal tear is a common diagnosis for an orthopaedic surgeon, and a partial meniscectomy is commonly performed to treat these tears. However, because of recent literature supporting increased tibiofemoral contact and increased contact stress after a partial or subtotal meniscectomy1, there has been a heightened interest in repairing meniscal tears. However, the biomechanical effects of complex repairs are poorly understood. Muriuki and colleagues evaluated both a vertically oriented medial meniscus tear that extended to the posterior horn as well as a radial tear that extended only to the peripheral one-third of the meniscus and assessed their subsequent repairs. It is intriguing to note that although the repair potential of inner margin, radial tears is extremely poor and that most orthopaedic surgeons would perform a saucerization of this tear, leaving as much native meniscus as possible, there is little change in the maximum tibiofemoral …

Climate change has led to major changes in the phenology (the timing of seasonal activities, such as flowering) of some species but not others. The extent to which flowering-time response to temperature is shared among closely related species might have important consequences for community-wide patterns of species loss under rapid climate change. Henry David Thoreau initiated a dataset of the Concord, Massachusetts, flora that spans approximately 150 years and provides information on changes in species abundance and flowering time. When these data are analyzed in a phylogenetic context, they indicate that change in abundance is strongly correlated with flowering-time response. Species that do not respond to temperature have decreased greatly in abundance, and include among others anemones and buttercups [Ranunculaceae pro parte (p.p.)], asters and campanulas (Asterales), bluets (Rubiaceae p.p.), bladderworts (Lentibulariaceae), dogwoods (Cornaceae), lilies (Liliales), mints (Lamiaceae p.p.), orchids (Orchidaceae), roses (Rosaceae p.p.), saxifrages (Saxifragales), and violets (Malpighiales). Because flowering-time response traits are shared among closely related species, our findings suggest that climate change has affected and will likely continue to shape the phylogenetically biased pattern of species loss in Thoreau's woods.

This is case report of extramedullary plasmacytoma occurring in the nasal cavity. These are unusual tumors especially in the nasal area. Patients present mainly with nasal symptoms on the same side of the tumors. The treatment consists of surgery resection, or, radiation, or both. There is a fifty percent survival rate in five years.

Objectives: Hypertropic lingual tonsils are a known obstruction in the upper airway. Enlarged linguals are responsible for obstructive sleep apnea, potential infections, and difficult intubations for routine surgeries. In our institution all patients were treated with protection of the airway, and ablation of lingual tonsils with a CO 2 laser. Methods: The patients were diagnosed with direct visualization and a CT scan of the neck. All patients were intubated with a laser reinforced endotracheal tube and fire precautions were taken when draping patient. One patient had a tracheotmy performed before being treated for hypertrophic lingual tonsils. A wide funnell larynscope was suspended. The CO 2 laser was used at 15 watts continuous along with an operating microscope to ablate the tissue. Results: All patients were admitted for a 23-hour stay. Postoperatively, no patient required intubation to protect the airway. Three of the 50 patients required a revision surgery to completely ablate all the lingual tonsils. The patient with the tracheotomy was decannulated. All patients were relieved and asymptomatic after surgery. Conclusion: CO 2 laser is a safe and acceptable method for lingual tonsillectomy. All patients in our institution had no complications and were free of all symptoms. The laser compleletly ablated the lingual tonsils removing the obstruction in the airway.

(Editorial Comment: The authors describe a rare entity that may mimic a common benign parotid neoplasm. The clinical presentation, work-up, and treatment are summarized.) Preauricular masses are usually parotid tumors. Rarely, they are temporomandibular joint cysts. These cysts are divided between ganglion cysts and synovial cysts. Twelve temporomandibular joint cysts have been reported. Eight have been ganglion cysts and 4 have been synovial cysts. 1 This is the 5th synovial cyst reported as a temporomandibular joint cyst. Treatment is uncertain; however, surgical excision of the temporomandibular joint cyst has the highest success rate. CASE REPORT A 47-year-old woman presented to the Ear, Nose, and Throat Clinic with a preauricular mass. She admitted to the mass growing slowly and being present for approximately 1 year. She had left preauricular pain and discomfort when chewing. The pain had become worse before her visit. She had a history of temporomandibular joint dysfunction and was being treated by her dentist. Her past medical history was basically unremarkable. Her physical examination showed a 2-cm mass in the left preauricular region. The mass was tender to the touch and mobile. There was no facial nerve paralysis or paresis. The rest of her head and neck examination was unremarkable. A fine-needle aspiration was performed. The results were nondiagnostic. Epithelial cells were obtained, but we could not make a diagnosis. She was offered an additional fine-needle aspiration, even with the use of ultrasound needle-guided aspiration, but she refused. Therefore, a computed tomography (CT) scan was obtained, which showed a cystic lesion near the parotid gland but did not involve the parotid gland (Fig 1). Because the pain was becoming unbearable and there was no diagnosis of this cystic lesion, she was offered surgery. She was taken to the operating room where a superficial parotidectomy was performed for exposure. The cystic lesion involved the left temporomandibular joint. The cystic lesion was removed, and the entire joint and capsule of the temporomandibular joint was reconstructed at the time of surgery. Pathological examination showed that this was a synovial ganglion cyst of the left temporomandibular joint. She was followed up in 1 week with no complications. She admitted her pain was gone. Postoperatively, she had no pain on chewing. Six months postoperatively, she only complained of occasional temporomandibular joint problems, which were very mild compared with her past history.

The southern extent of the range of Canada lynx (Lynx canadensis) extends into the contiguous United States in locations from Washington State in the West to northern Maine in the East. Lynx persist in various habitats across this range from high-elevation wilderness to intensively managed industrial forests. Lynx habitat use at the species' southern range boundary was poorly understood before the species was listed as Threatened under the Endangered Species Act in 2000, because most research had been conducted in boreal forest. The papers in this special section outline a variety of questions regarding lynx populations at the southern extent of their range, address topics on lynx space use and denning habitat, and provide generally consistent results in terms of features important to lynx habitat use despite the wide variation in specific habitats among the study areas.

Introduction Microfracture technique has become increasingly popular among orthopaedic surgeons for the treatment of chondral defects in several joints due to its effectiveness, low cost, and ease of performance. Arthroscopic microfracture for full thickness chondral defects of the knee has been reported in elite athletes with good clinical outcomes and adequate return to sport percentages. Very few data have been reported regarding return to sport following arthroscopic microfracture in the hip in elite level athletes. Methods Forty-one elite level athletes were initially identified who underwent arthroscopic microfracture performed by a single surgeon (MJP) between 1999 and 2008. Thirty-four elite level athletes met the inclusion criteria of a discrete Outerbridge grade IV chondral lesion either on the femoral head (N=3), acetabulum (N=27), or both (N=4), which was amenable to microfracture, and had a desire to return to a professional career. Sports played at the elite level included hockey, soccer, football, baseball, tennis, and golf. All patients underwent concomitant labral debridement (N=8), repair (N=23), or reconstruction (N=3). Data were obtained including number of games played and number of seasons played at an elite level following arthroscopic microfracture. Results Seventy-nine percent (27 of 34) of elite athletes who underwent microfracture surgery returned to play at an elite level. Twenty-seven athletes returned to play for an average of 4 seasons following the index procedure (range: 1-11 seasons). Twenty-six (96%) athletes returned to play the same season or the season following the index procedure. The six of the seven athletes (2 soccer, 3 hockey, 1 baseball, 1 football) who did not return to play underwent a concomitant labral repair, and one underwent a labral reconstruction. Conclusion Professional athletes with a discrete, full thickness chondral defect of the hip are able to return to the elite level following an arthroscopic microfracture procedure.

Canada lynx (Lynx canadensis) were listed as threatened in the contiguous United States under the Endangered Species Act in March 2000. Little information on lynx ecology at the southern extent of their range was available at the time of listing, and no ecological studies had been conducted in the eastern USA. Between 1999 and 2004, we investigated habitat selection at natal dens in northern Maine to address questions on the importance of forest conditions to denning requirements. We compared within-stand characteristics of 26 den sites to general characteristics of the stands containing dens. We used logistic regression to identify components within stands that distinguished natal dens from the residual stand and used the information-theoretic approach to select models that best explained lynx den-site selection. The top-ranked model had 2 variables: tip-up mounds of blown-down trees and visual obscurity at 5 m from the den (wi = 0.92). Within-stand structure was useful for predicting lynx den-site selection in managed forests in Maine and suitable denning habitat did not appear to be limiting.

Long-term research or monitoring studies involving radiomarked Black Bears (Ursus americanus) conducted in areas with high human and road densities may require that radiocollars be replaced or bears recaptured for other purposes. The use of trained bear hounds is particularly suited to recapturing specific bears. However, in certain situations, hounds may not be used safely or bears may seek refuge in difficult locations. Effectiveness of two methods to capture bears via remote darting and chemical immobilization are described: (1) stalking and rushing females with cubs; and (2) allowing treed bears to descend. Both methods rely on assumptions about Black Bear behavior. Nine captures of eight individual bears are discussed; one bear drowned after being immobilized, and all others survived >5 months after capture.