College of Medicine - B.Sc. (Med) Projects

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Open Access
The Aboriginal Youth Mentorship Program (AYMP): a peer-led health living after school program for achieving healthy weights and creating mentorship skills among First Nations children living in a northern isolated setting.
(2012-11-26) Villeneuve, Stephanie; Medicine; Dr. Jonathan McGavock (Department of Pediatrics)
Objective: To assess the efficacy of a peer-led healthy living program on weight gain, and body composition, as well as knowledge of healthy foods and activities when run in a remote isolated community. Design: A non-randomized experimental trial with a parallel non-equivalent control group performed with two student cohorts between January and May in 2011 and 2012 school years. Setting: Kistiganwacheeng Elementary School, Garden Hill First Nation. Participants: A total of 151 students in grades 4 and 5 (41.72% girls). Intervention: The intervention was offered to grade 4 students as a weekly after school program facilitated independently by the high school mentors. Weekly lesson plans focused on four different areas of wellbeing that contribute to health weight: knowledge of healthy living, physical activity, health eating, and social support. Outcome Measures: The primary outcome measures studied were the change in waist circumference and body mass index z-score (BMI z-score). Secondary outcome measures include healthy living knowledge, self efficacy, and body image. Results: Within the entire cohort, 72.67% of the children were overweight or obese. Using a linear mixed effects model with repeated measures (adjusted for weight and time), the increase in waist circumference was significantly less in the intervention group, relative to the control group (+3.4 +/- 1.37 cm vs. 0.39 +/- 0.66 cm; p=0.0001). The BMI z-score increased significantly in the control group (0.07 +/- 0.2 vs. -0.05 +/- 0.03, p=0.199), but was unchanged within the intervention group. There was no significant difference between the groups in post measurement.
Open Access
The Accuracy of Clinical Criteria to Predict Mutations in BRCA1- and BRCA2-Related Hereditary Breast and Ovarian Cancer Syndrome
(2012-03-12) Colizza, Kate; Medicine; Dr. Elizabeth Spriggs (Department of Biochemistry and Medical Genetics) and Dr. Sandra Marles (Department of Biochemistry and Medical Genetics).
The Hereditary Breast and Ovarian Cancer (HBOC) Clinic located in Winnipeg accepts province-wide referrals to assess cancer risk and provide testing for mutations in BRCA1 and BRCA2 when indicated. Given the economic realities of public health care, a limited number of patients can be offered full gene testing. Manitoba has developed fourteen eligibility criteria based on personal and family history of breast and ovarian cancer that are thought to identify patients with at least a 10% chance of having a mutation. In this retrospective clinic-based study, we evaluate the association between these criteria and mutation frequency to determine which characteristics are statistically associated with BRCA1 and BRCA2 mutations. Information from hospital and lab records was collected for 429 probands tested between 1995 and 2010. Twenty-one percent of probands tested through the HBOC Clinic were found to have a disease-causing BRCA1 or BRCA2 mutation. Consistent with other studies, multiple tumor diagnoses and a strong family history of breast/ovarian cancer were the characteristics most strongly associated with the finding of mutations. Ethnicity of the Manitoba population in relation to BRCA1 or BRCA2 mutation frequency was also explored. The recurrent mutations found in the study population partially reflected the ethnic composition of the Manitoba population. All of the criteria examined in this study are achieving ≥10% mutation detection rate, but some re-evaluation is recommended to explore broadening criteria based on personal history of tumors and to adjust ethnic-specific screening by adding a Mennonite and dropping one of the Eastern European founder mutations.
Open Access
Accurate bedside clinical assessment of hypertensive and 'symptomatic' hypotensive patient's intravascular volume status with hand-carried ultrasound devices in hemodialysis clinic
(2012-11-26) Zhang, Yiyang; Medicine; Dr. Paul Komenda (Nephrology)
The number of people diagnosed and living with kidney failure requiring dialysis in Canada has tripled in the last two decades. In center hemodialysis is a thrice-weekly treatment that attempts to remove fluid and toxins rapidly and in a short time. One of the major difficulties is determining how much fluid to remove from a patient in a given treatment as the bedside physical exam is often inaccurate. Therefore the aim of this study is to assess volume status in chronic dialysis patients by measuring the IVC diameter employing a hand-carried ultrasound. Patients with kidney failure were recruited to the study and each was scanned three times on three different dialysis sessions. Measurements of the inferior vena cava were taken pre, mid, and post dialysis sessions. Measurements of the inferior vena cava were compared to clinical surrogates of volume, which include blood pressure, symptoms, and ultrafiltration removed. The student learnt ultrasound techniques to scan for the inferior vena cava, as well, he learnt basic research and statistical skills in order to assess the reliability and feasibility of using hand-carried ultrasound in clinical practice.
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Activity of Bendamustine in Chronic Lymphocytic Leukemia
(2014-08-11) Liang, William Siyuan
Chronic lymphocytic leukemia (CLL) is a common leukemia, with a heterogeneous clinical course. When treatment is required, patients usually receive an alkylating agent, such as chlorambucil, or a nucleoside analogue, such as fludarabine, or a combination of the two types of drug. Bendamustine is a promising new agent for CLL and is believed to have the properties of an alkylating agent, with some features of a nucleoside analogue. In the present study, we have compared the activity of bendamustine with chlorambucil and fludarabine in primary CLL cells, to determine whether bendamustine is more typical of an alkylating agent or a nucleoside analogue. In addition, we investigated whether bendamustine retains activity against cells that are resistant to the other agents. Cell viability studies using the MTT assay demonstrated that bendamustine produced a linear dose-response curve and a narrow range of effective drug concentrations, between sensitive- and resistant-cases. This is very similar to that seen with chlorambucil, but not with fludarabine. Using annexin V/7-ADD staining and flow cytometry, we demonstrated that the three drugs induced apoptosis in CLL cells, that they had equivalent antitumor activities and that there appeared to be cross-resistance between the drugs. Finally, using y-H2AX staining to measure DNA double-strand breaks (DSB), we demonstrated that with equivalent drug doses, bendamustine and chlorambucil produced few DSB whereas fludarabine produced a high number of DSB. In summary, our study suggests that bendamustine has equivalent antitumor activity as chlorambucil or fludarabine against CLL cells in vitro, with properties that are more typical of an alkylating agent.
Metadata only
Analysis of predictors and clinical outcomes of seminal vesicle invasion at time of radical prostatectomy with curative intent - A contemporary cohort
(2014-07-23) Rittberg, Rebekah
Retrospective analysis was conducted on men who underwent radical prostatectomy (RP) between January of 2003 and April of 2014 by two academic urologic-oncologists in Winnipeg, Manitoba. RP database was created using Manitoba Prostate Center electronic records and Caisis, a web based oncology data manager. Of the 479 RP patients entered 94 (19.7%) had seminal vesicle invasion (SVI). SV positive patients were more likely to have higher preoperative PSA, higher clinical staging, higher Gleason scores and increased cancer total linear distance per core. Many predictors on univariate and multivariate analysis were identified, including but not limited to age at surgery, preoperative PSA, highest Gleason score, percent linear cancer distance and percent cores positive. · Patients with SVI had an increased rate of biochemical failure as compared to SV negative patients (p<0.0001), with a biochemical progression free survival at 1, 3 and 5-years of 78.2%, 60.3% and 45.3% respectively. When SV positive patients were sub-stratified based on pathologic findings it was found that lymph node metastasis was a negative prognostic markers with increased rates of biochemical recurrence (p=O.OOOB). Here we present new data indicating that patients with unilateral SVI compared to patients with bilateral SVI have an increased rate of biochemical progression free survival (p=0.022). Neither positive margins nor extracapsular extension were found to be independent predictors of biochemical recurrence.
Open Access
Analysis of Short- and Long Term Outcomes of Medically Treated Isolated Left Sided Endocarditis Patients: A 5 Year Longitudinal Follow-Up Study
(2018-08-23) Mabilangan, Carmichael
Infective endocarditis (IE) is the bacterial or fungal infection of heart valves with an incidence of 1.5 to 11.6 per 100,000 people per year in Western countries. Left-sided IE (LSIE) can be managed medically with antimicrobial therapy alone, or surgically through valve repair or replacement with additional antimicrobial therapy guided by North American and European guidelines. Several multicenter studies have identified predictors of mortality in patients with IE. However, these consisted of mixed populations of medically and surgically treated patients with heterogenous healthcare delivery. At present, therefore, a knowledge gap exists on the predictors of short- and long-term outcomes in medically treated patients with IE. This information is important for identifying patients that are more likely to benefit from medical treatment versus surgical valve repair/replacement, as current Society guidelines have provided minimal guidance on this issue. The aim of this study was to provide a comprehensive analysis of medically treated isolated LSIE in a single tertiary care center over a 12-year period. Specifically, we sought to identify patient characteristics that were associated with acceptable outcomes from medical (i.e. never surgical) treatment. We hypothesized that certain patient and/or IE valvular characteristics would predict poor outcomes with medical only therapy.
Open Access
Anti-estrogen Use, Estrogen Receptor Expression, Smoking Patterns, and Survival of Women with Non-Small-Cell Lung Cancer: A Manitoba Perspective
(2012-03-12) Lother, Sylvain; Medicine; Dr. Gary Harding (CancerCare Manitoba) and Dr. Marshall Pitz (CancerCare Manitoba).
Lung cancer is the leading cause of cancer death worldwide. Gender differences in lung cancer outcomes are known. When compared to men, women have significantly better survival and women are more likely to develop lung cancer when nonsmokers. Research suggests estrogen plays a key role in the risk of development and outcomes of lung cancer. Accordingly, anti-estrogen use should also influence survival in female non-small cell lung cancer (NSCLC) patients. In this study we compared mortality among anti-estrogen users and non-users. METHODS: This population-based study had a retrospective study design. Using the Manitoba Cancer Registry (MCR) we identified all women diagnosed with NSCLC from 2000-2007. The Drug Program Information Network (DPIN) was accessed to establish patients that received anti-estrogens. Demographic data (e.g. smoking patterns, stage, histology) was gathered by chart review. Mortality rates for anti-estrogen users and non-users were compared using Kaplan-Meier survival functions and Cox regression models. RESULTS: 2320 women fit our patient criteria, of which 156 had received prior anti-estrogens. A positive smoking history was documented in 88%, 62% being former vs. 26% current smokers. A history of 30+ packyears was seen in 55%. Exposure to anti-estrogen was associated with a significantly decreased mortality (HR 0.718, p = 0.0031). Overall survival with anti-estrogen vs. none resulted in median survival of 1.89 vs. 0.93 years, respectively (p < 0.0001). CONCLUSIONS: Our results demonstrate that anti-estrogens are associated with decreased mortality from NSCLC. These findings supplement and reinforce past evidence that estrogen plays a key factor in the biology and outcomes of NSCLC.
Open Access
Antibiotic prescription patterns amongst children residing in remote Northern Manitoba communities
(2015-08-07) Soufi, Youcef
In recent years, there has been growing concerns with respect to health care providers in relation to over-prescription of antibiotics in a primary care setting, compounding the rising concerns of antibiotic resistance. There currently is a deficit in the literature with respect to prescription patterns being quantified and reported as it pertains to children and adolescents residing in remote northern Manitoba communities. We sought to address this discrepancy in the literature via evaluating trending data regarding antibiotic prescription patterns in select remote northern communities in Manitoba in children aged 0 to 19. We attempted to address this discrepancy in the literature via evaluating trending data regarding antibiotic prescription patterns in select remote northern communities in Manitoba in children aged 0 to 19. Our results show preliminary evidence of decreasing rates of antibiotic prescriptions in remote northern Manitoba communities. More work is necessary to get a broader picture of past and current antibiotic prescription patterns in order to serve as a catalyst for clinical guideline reforms when necessary, to give us a better picture of the overall quality of care these patients receive and ultimately to improve the health outcomes of patients in these communities
Open Access
Antihypertensive medications and cancer patient survival: A populationbased retrospective cohort study
(2012-03-12) Holmes, Signy; Medicine; Dr. Gerald Minuk (Department of Internal Medicine).
Rationale: The relationship between antihypertensive medications and cancer development has been widely studied. There is extensive in vitro evidence for a beneficial effect for beta-blocker drugs in particular. Population-based research has until recently focused on the associations between antihypertensive use and cancer incidence, and there is a need for further study of the influence of these drugs on cancer patient survival. Hypotheses: Antihypertensive use was expected to be associated with increased mortality relative to nonuse. Beta-blockers were expected to provide a survival benefit relative to other classes of antihypertensive. Methods: Patient information from the Manitoba Cancer Registry was linked with prescription information from Manitoba’s Drug Product Information Network for patients diagnosed between 2004 and 2008 with new lung (n = 4241), colorectal (n = 3967), breast (n = 4019), prostate (n = 3355) and liver (n = 244) cancer primaries. Cox proportional-hazards regression analysis was used to evaluate all-cause mortality for users of four classes of medication (betablockers, calcium channel blockers, diuretics, and ACE inhibitors / ARBs) relative to nonusers. A separate set of analyses was then conducted on single drug category users to permit direct comparison between beta-blockers and other classes of antihypertensive. Results: Antihypertensive medication use was associated with increased cancer mortality. There is no significant evidence that beta-blocker use results in improved survival relative to other classes of antihypertensive. There is a significant association between calcium channel blocker use and improved lung cancer survival relative to beta-blocker users (HR = 0.79, 95% CI = 0.64, 0.98), warranting further study.
Open Access
Assessing digital tomosynthesis for paediatric sacroiliac joint imaging
(2012-11-23) Nirula, Gina; Medicine; Dr. Idris Elbakri (Department of Radiology)
Objective: To assess the use of digital tomosynthesis (DT) as an alternative imaging modality to radiography for the imaging of paediatric sacroiliac (SI) joints. Methods: Three anthropomorphic pelvis phantoms were imaged using DT at three dose levels: equivalent to the dose incurred in radiography (tube current-time product of 0.32 mAs), almost double the dose incurred in radiography (0.63 mAs) and the default dose setting of the DT system (1.6 mAs). Radiographs of the phantoms were also acquired for comparison. Six radiologists were asked to compare DT images to radiographs and rate DT as either better, the same or worse than radiography. Results: An exact Chi-square test was performed on the data and showed no significant difference in preference for DT between the three phantoms (exact p-value = 0.3389). There was a significant difference in preference for DT between radiologists as well as between the three dose settings (exact p-value = 0.0095 and 0.0001, respectively). At a mAs of 0.32 there is no clear preference for DT, however as mAs increases so does preference for DT. Conclusions: DT shows promise as a possible imaging alternative to radiography, although at dose levels higher than radiography. DT may prove advantageous in SI joints imaging if it reduces the need for subsequent computed tomography imaging which is typically used when radiography yields equivocal results.
Open Access
Assessing mechanisms of small cell lung cancer drug resistance in circulating tumour cells
(2017-08-06) Elzayat, Rami
SCLC is the most aggressive subtype of lung cancer and accounts for 13% of lung cancer diagnoses. Median survival, even with treatment, is under 10 months and 5-year survival is <5%. Most patients are treated with chemotherapy and radiation. The limited role of surgery means few biological specimens are available for research. In the clinic, 70% of patient tumours initially respond to chemotherapy, but almost all will relapse within months with resistant disease. Understanding the mechanism leading to treatment resistance will be important to improving patient outcomes in SCLC. A consequence of SCLC being an aggressive disease is that cancer cells disperse into the bloodstream of patients. Modern methods can detect these cells in peripheral blood. These “circulating tumor cells”, if successfully captured, can provide insight into the biology of this disease. This study analyzes the CTCs from two pairs of cell lines, NCI-H69/H69AR and MAR/MARV6. Each pair consists of the parental cell line and its drug-resistant counterpart. We performed a lyoplate biomarker screening assay to determine the variation in biomarker expression between the cell lines. We then used flow cytometry to validate the findings of the lyoplate assay for CD9, CD49b, CD56, and CD99 which have been postulated to be associated with drug-resistance. Although the biomarkers tested did not correlate with drug-resistance across cell lines, we identified biomarkers which were consistent and provide future opportunities for research.
Open Access
Assessing the relationship between maternal peanut consumption during pregnancy and the prevalence of peanut allergy in a birth cohort
(2014-08-08) Paletta, Antonio
Allergy is one of the most common chronic diseases of childhood and often presents early in life. Food allergies are typically the initial presentation of allergic disease. In the past, many medical/pediatric societies recommended avoidance or delayed introduction of certain foods, especially peanuts, in an attempt to reduce the risk of food allergy in children. However, it is now realized that this may not be the correct advice to give all mothers. The Canadian Healthy Infant Longitudinal Development (CHILD) study is a national, general population-based, longitudinal birth cohort study across four different centres in Canada: Vancouver, Edmonton, Winnipeg and Toronto. Data including maternal food frequency questionnaires and results of skin prick testing (SPT) to foods were collected. This data from the CHILD study was analyzed using a statistical analysis system (SAS) in order to determine the relationship between maternal consumption of peanut during pregnancy and the outcome of peanut sensitization as defined by SPT. Two mean wheal diameter cut-off points at 2 mm or greater or 3 mm or greater, which are commonly used in epidemiological studies, were used to indicate sensitization in this study. An unadjusted association was only found between maternal consumption of peanuts, other nuts and seeds and sensitization to peanut as indicated by development of a wheal measuring 3 mm or greater in diameter in response to skin prick testing.
Open Access
Assessing Trans People's Experiences of Health Care in Winnipeg
(2015-08-06) Rountree-James, Marina
Open Access
Association of sex hormones and DMPA use with HIV-1 resistance and acquisition: An analysis of the Pumwani Sex Worker Cohort and the CAPRISA-004 Trial
(2014-08-08) Arcinas, Liane
Open Access
Associations of Human Leukocyte Antigen G with Resistance and Susceptibility to HIV-Ilnfection in the Pumwani Sexworker Cohort
(2012-03-12) Turk, William John Russell; Medicine; Dr. Ma Luo (Medical Microbiology).
HlV/AIDS is currently a global pandemic with an estimated 33.3 million persons living with HlV / AIDS worldwide. One of the best hopes for eliminating the spread of HIV is in developing an effective vaccine. A group of sex trade workers in Pumwani, Kenya are resistant to HIV -1 infection despite frequent exposure and provide an example of natural protective irrununity. Human leukocyte antigens (HLA) class I and II molecules have been shown to be associated with resistance/susceptibility in this cohort. HLA-G is a non-classical class I allele that is primarily involved in mucosal and inflammatory defence. In this study, we examined the influence of HLA-G genotypes on the resistance to HlV -1 infection using a sequenced based method. The G*O 1:0 1:01 genotype was significantly associated with resistance to HIV-I infection (p-value 0.002, OR = 2.11, 95% CIO.259-0.976). The G*01:04:04 genotype was significantly associated with susceptibility to HlV-I infection (p-value 0.039, OR = 0.502, 95% CI 0.259-0.976). Kaplan-Meier survival analysis correlated with these results. G*01:01:01 genotype was associated with significantly slower rate of seroconversion. Alternatively, G*OI :04:04 genotype was significantly associated with an increased rate of seroconversion. Our study showed that functionally active HLA-G alleles play an important role in resistance/susceptibility to HIV -1 infection. Since HLA-G is important in mucosal and inflammatory responses further studies need to be conducted to better understand it's functional significance in HlV -1 transmission.
Open Access
Asthma and Epinephrine Administration Prior to Emergency Department Presentation for Suspected Anaphylaxis in Pediatric Patients
(2022-07-30) Hong, Billy; Protudjer , Jennifer; Simons, Elinor
Anaphylaxis is a potentially life-threatening systemic allergic reaction that involves at least two organs or systems and may result in hypotension. The mainstay of anaphylaxis treatment is epinephrine, and as such, individuals with severe allergies are recommended to carry epinephrine auto-injectors (EAIs). However, there is a substantial underutilization of EAIs for the management of anaphylaxis. One of the challenges that hinders early anaphylaxis diagnosis and management is its similarity to asthma with respect to immunopathology, clinical presentation, response to therapies, and natural history. While asthma and anaphylaxis frequently coexist and mimic each other, the exact influence of the two conditions on each other has yet to be fully explained. In the current study using data from the Cross-Canada Anaphylaxis registry (C-CARE), univariable and multivariable logistic regressions were performed to examine the association between comorbid asthma and both pre-hospital and overall epinephrine treatment. It was identified that the presence of comorbid asthma asthma was not associated with the use of pre-hospital epinephrine in the treatment of anaphylaxis and is associated with a decreased likelihood of receiving epinephrine overall. Given this finding, and the current substantial underutilization of EAIs, it is more important than ever to improve EAI prescribing practices and educate patients with allergies and relevant caregivers on prompt and safe EAI use.
Open Access
Avastin and Sutent Induced Cardiotoxicity Study (ASICS): Early Detection of Bevacizumab and Sunitinib Mediated Cardiotoxicity
(2014-06-01) Cheung, Matthew
BACKGROUND: Bevacizumab (BVZ) and Sunitinib (SNT) are two novel treatments which are used in the setting of colorectal cancer and renal cell carcinoma, respectively. While both agents are known to suppress tumour cell progression, they have been associated with the onset of drug-induced cardiotoxicity. Early, non-invasive methods of detecting cardiac dysfunction would be useful for preventing end stage heart failure. OBJECTIVE: To determine if cardiac biomarkers and/or tissue Doppler echocardiographic techniques may allow for early detection of BVZ and SNT induced LV systolic dysfunction in an acute murine model. METHODS: A total of 75 wild type (WT) C57BI/6 male mice were treated with either 0.9% saline, BVZ, or SNT and followed for a total of 14 days. Serial echocardiography, hemodynamic monitoring, and cardiac biomarkers were performed over the study period after which all mice were euthanized for histological and biochemical analyses. RESULTS: In WT mice receiving BVZ or SNT, left ventricular ejection fraction (LVEF) values decreased from 75±3% at baseline to 52±2% and 49±1% at day 13, respectively. In contrast, there was a significant decrease in tissue Doppler imaging (TDI) parameters by day 8, indicative of early LV systolic dysfunction. Hemodynamic monitoring at day 14 indicated the development of hypertension following BVZ or SNT treatment. Histological and biochemical analyses demonstrated loss of cell integrity and elevated caspase-3, a marker of cell apoptosis, in mice receiving BVZ or SNT. CONCLUSION: In an acute murine model, TDI echocardiographic indices were earlier indicators of BVZ and SNT mediated cardiotoxicity.
Open Access
Avastin, Sutent and Votrient induced cardiotoxicity Study (ASICS): Early detection of Bevacizumab and Sunitinib mediated cardiotoxicity in cancer patients:
(2016) Best, Ryan
Cancer is a significant health concern in Canada, where it is expected that approximately 2 in 5 Canadians will develop cancer during their lifetime. Although current anti-cancer therapies may be effective in leading remission in cancer patients, it has been shown that conventional chemotherapeutic drugs, including Doxorubicin (DOX), are associated with an increased risk of cardiotoxicity. As new anti-cancer drugs including Bevacizumab (BVZ) and Sunitinib (SNT) are introduced, we must seek to develop cardiac safety profiles for these drugs. Cardiac dysfunction in cancer patients is typically monitored using non-invasive cardiac imaging to assess left ventricular ejection fraction (LVEF). Unfortunately, once a reduced LVEF has been identified, irreversible cardiac injury may have already occurred. In an effort to recognize cardiotoxic side effects before a reduction in traditional LVEF parameters, early indices of LV systolic dysfunction that include cardiac biomarkers, tissue velocity imaging (TVI), and strain imaging have been evaluated in the breast cancer setting. It is yet to be determined, however, whether these same non-invasive indicators can accurately detect early manifestations of cardiotoxicity in colorectal and renal cell cancer patients treated with BVZ or SNT when conventional LVEF parameters remains normal. The objective of this clinical research study is to evaluate whether early indices of cardiotoxicity can be detected before LVEF is reduced in colorectal and renal cell cancer patients treated with BVZ or SNT. In a study population of 30 individuals with either colorectal or renal cell cancer, we will examine serial cardiac biomarkers and novel echocardiographic techniques for the early identification of cardiotoxicity. If these markers are found to be accurate predictors of cardiotoxicity, future applications may enable the prevention of irreversible cardiac damage in cancer patients treated with BVZ or SNT. Proposed preventative measures may include: i) modifying the dosage of chemotherapeutic agents (specifically BVZ and SNT); and/or ii) prophylactic administration of cardioprotective agents.
Open Access
Biceps Tenodesis versus Tenotomy in the Treatment of Lesions of the Long Head of Biceps Brachii : Randomized Clinical Trial - An Interim Analysis
(2014-08-08) Nassar, Mark
Background: Both biceps tenotomy and tenodesis have been shown to produce comparable, effective results in treatment of lesions of the long head of biceps tendon (LHBT). The aim of this study was to provide an interim analysis of a level I prospective, randomized, clinical trial comparing subjective patient-reported outcomes and objective clinical results between biceps tenotomy and tenodesis. Methods: Fifty-nine patients have consented to participate in the study, the current interim analysis was performed for twenty-six patients.The primary outcome measure was the American Shoulder and Elbow Surgeons (ASES) shoulder assessment form. Secondary outcome measures included the Western Ontario Rotator Cuff (WORC) index, strength, cosmetic appearance, pain and cramping pain and operative time. Outcome measures were completed pre-operatively and at 3 and 6 months after surgery. Results: ASES scores improved in the tenotomy group post-op over time, scores in the tenodesis group improved at 3 months but not at 6 months. There were no differences found between the groups in ASES scores, WORC scores, elbow flexion or supination strength, pain, cramping pain, operative time and the incidence of a Popeye deformity at any time point. However at 6 months post-op a difference in elbow flexion strength was approached (p=.061) with the tenodesis group appearing stronger. Conclusion: The results of this interim analysis suggest that there is no difference in clinical or functional outcomes between tenodesis or tenotomy for treatment of lesions to the LHBT. However, tenodesis may preserve some elbow flexion strength and appears to be technically more difficult. Further analysis of a larger sample size and longer follow-up time is required to yield any definitive, evidence based conclusions for treating lesions of the LHBT.
Open Access
Biogeography and genetic population structure of the buckeye butterflies (genus Junonia) in the Western Hemisphere: patterns of hybridization, dispersal, and speciation
(2016) Lalonde, Melanie; Worley, Anne (Biological Sciences) Westwood, Richard (University of Winnipeg); Marcus, Jeffrey (Biological Sciences)
The New World buckeye butterflies (genus Junonia) are a valuable experimental model organisms, but the taxonomy of this group has been problematic and contentious. I have clarified the taxonomy of the Junonia species in North America using molecular and morphological data from contemporary and museum collections, focusing on Florida, the American Southwest, and Mexico. Junonia populations in Florida have been assigned to different species and J. coenia grisea in the American Southwest has been elevated to full species status. Using this framework, I reconstructed the invasion history of the tropical buckeye (J. zonalis) into South Florida. For the species that occur in the American Southwest and Mexico, I have plotted the contemporary distributions of the five species that occur in this region. Evidence of hybridization was documented and a cryptic species pair was identified (J. coenia and J. grisea). An improved taxonomy will encourage and support further comparative biology research.

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