Showing papers by "William B. Armstrong published in 2015"

Drosophila Muller F Elements Maintain a Distinct Set of Genomic Properties Over 40 Million Years of Evolution

Abstract: The Muller F element (4.2 Mb, ~80 protein-coding genes) is an unusual autosome of Drosophila melanogaster; it is mostly heterochromatic with a low recombination rate. To investigate how these properties impact the evolution of repeats and genes, we manually improved the sequence and annotated the genes on the D. erecta, D. mojavensis, and D. grimshawi F elements and euchromatic domains from the Muller D element. We find that F elements have greater transposon density (25–50%) than euchromatic reference regions (3–11%). Among the F elements, D. grimshawi has the lowest transposon density (particularly DINE-1: 2% vs. 11–27%). F element genes have larger coding spans, more coding exons, larger introns, and lower codon bias. Comparison of the Effective Number of Codons with the Codon Adaptation Index shows that, in contrast to the other species, codon bias in D. grimshawi F element genes can be attributed primarily to selection instead of mutational biases, suggesting that density and types of transposons affect the degree of local heterochromatin formation. F element genes have lower estimated DNA melting temperatures than D element genes, potentially facilitating transcription through heterochromatin. Most F element genes (~90%) have remained on that element, but the F element has smaller syntenic blocks than genome averages (3.4–3.6 vs. 8.4–8.8 genes per block), indicating greater rates of inversion despite lower rates of recombination. Overall, the F element has maintained characteristics that are distinct from other autosomes in the Drosophila lineage, illuminating the constraints imposed by a heterochromatic milieu.

Using Google Glass to solve communication and surgical education challenges in the operating room.

Abstract: The Laryngoscope C 2015 The American Laryngological, V Rhinological and Otological Society, Inc. How I Do It Using Google Glass to Solve Communication and Surgical Education Challenges in the Operating Room Omid Moshtaghi, BS; Kanwar S. Kelley, MD, JD; William B. Armstrong, MD; Yaser Ghavami, MD; Jeffery Gu, BS; Hamid R. Djalilian, MD Key Words: Google glass, otolaryngology, surgery, wearable technology, camera. Laryngoscope, 125:2295–2297, 2015 INTRODUCTION Although the use of video recording became popu- larized in otolaryngology beginning in 1959, a new generation of wearable technology has evolved. 1 One of these technologies includes a device called Google Glass (Google, Inc., Mountain View, CA), hereafter referred to simply as Glass. This device allows the capture of video from the perspective of the wearer. In addition, it provides an interface to access the Inter- net, communicate with others, and use applications hands free—relying mostly on voice commands. Google is not the only company developing wearable technol- ogy; other products such as Vuzix Smart Glasses M100 (Rochester, NY) have similar features to Glass. 2 Despite the many existing products, none is as popular and as widely implemented for use in medicine as Glass, which has been used experimentally in special- ties including primary care, dermatology, and pediatric surgery. 3–5 With this in mind, we set out to demon- strate the utility of this technology specifically within the context of otolaryngologic surgery. Furthermore, we utilized Glass to assess the potential to augment surgical education and enhance communication with the surgical team. MATERIALS AND METHODS Patient Population Three different physicians were tracked as they performed a wide range of otolaryngologic procedures to demonstrate the efficacy of Glass in various operative settings. A neurotologist, head and neck surgeon, and a general otolaryngologist were fol- lowed. Written consent was obtained from every patient before Glass was used. Procedures involving only endoscopes and microscopes were not included in this study. Device Glass connects to a computer or smartphone via Bluetooth or a wireless network, providing users with the ability to access the Internet in a hands-free manner. By means of a 720p high- definition camera and microphone, Glass records video and audio while giving the user control via various voice commands. 6 Addi- tionally, a bone-conduction speaker conveys sound to the user (Fig. 1). The device requires a wireless network in the hospital for fast streaming of video; however, an additional battery pack was used for this study to allow for longer usage during surgery. In addition, the device in our study was stripped of the inte- grated social media software to prevent accidental upload of sur- gical video on social media sites. Currently, Glass is sold only in the Explorer edition, a beta version of the product, which is being sold for $1,500 on the Google Play store. 7 RESULTS Benefits of Glass: Real-Time Intraoperative Uses Additional Supporting Information may be found in the online version of this article. From the Division of Neurotology and Skull base Surgery, Department of Otolaryngology–Head and Neck Surgery ( O . M ., K . S . K ., W . B . A ., Y . G ., J . G ., H . R . D .); and the Department of Biomedical Engineering ( H . R . D .), University of California, Irvine, Irvine, California, U.S.A. Editor’s Note: This Manuscript was accepted for publication February 12, 2015. The authors have no funding, financial relationships, or conflicts of interest to disclose. Send correspondence to Hamid R. Djalilian, MD, Director of Otology, Neurotology, and Skull Base Surgery, University of California Irvine, 101 City Drive South, Bldg 56, Ste 500, Orange, CA 92868. E-mail: hdjalili@uci.edu DOI: 10.1002/lary.25249 Laryngoscope 125: October 2015 Communication. During head-and-neck cancer surgery, Glass proved to be useful to the surgeon. As an example, during one procedure involving a laryngeal cancer, the surgeon utilized Glass to speak to another physician at a remote location for an intraoperative con- sultation. Despite proving its use for communication, in this instance the physician at the remote location was not able to visualize the epiglottis through the video feed. Further follow-up studies are necessary to explore how much anatomy the viewer can distinguish. During another case involving an auricular squa- mous cell carcinoma and an application called Pristine, Moshtaghi et al.: Using Google Glass in the Operating Room

Improving applicant selection: identifying qualities of the unsuccessful otolaryngology resident.

Abstract: Objectives/Hypothesis To identify the prevalence and management of problematic residents. Additionally, we hope to identify the factors associated with successful remediation of unsuccessful otolaryngology residents. Study Design Self-reported Internet and paper-based survey. Methods An anonymous survey was distributed to 152 current and former program directors (PDs) in 2012. The factors associated with unsuccessful otolaryngology residents and those associated with the successful remediation of problematic residents were investigated. An unsuccessful resident is defined as one who quit or was removed from the program for any reason, or one whose actions resulted in criminal action or citation against their medical license after graduation from residency. Remediation is defined as an individualized program implemented to correct documented weaknesses. Results The overall response rate was 26% (40 PDs). Seventy-three unsuccessful or problematic residents were identified. Sixty-six problematic or unsuccessful residents were identified during residency, with 58 of 66 (88%) undergoing remediation. Thirty-one (47%) residents did not graduate. The most commonly identified factors of an unsuccessful resident were: change in specialty (21.5%), interpersonal and communication skills with health professionals (13.9%), and clinical judgment (10.1%). Characteristics of those residents who underwent successful remediation include: poor performance on in-training examination (17%, P < .01) and inefficient use of time (11.4%, P = .02). Conclusions A large proportion of otolaryngology PDs in this sample identified at least one unsuccessful resident. Improved methods of applicant screening may assist in optimizing otolaryngology resident selection. Level of Evidence NA Laryngoscope, 125:842–847, 2015