Operating rooms (ORs) are critical for hospital revenue and cost management, with utilization efficiency directly affecting financial outcomes. Traditional surgical scheduling often results in suboptimal OR use. We aim to build a machine learning (ML) model to predict incision times for robotic-assisted hysterectomies, enhancing scheduling accuracy and hospital finances. A retrospective study was conducted using data from robotic-assisted hysterectomy cases performed between January 2017 and April 2021 across 3 hospitals within a large academic health system. Cases were filtered for surgeries performed by high-volume surgeons and those with an incision time of under 3 hours (n = 2,702). Features influencing incision time were extracted from electronic medical records and used to train 5 ML models (linear ridge regression, random forest, XGBoost, CatBoost, and explainable boosting machine [EBM]). Model performance was evaluated using a dynamic monthly update process and novel metrics such as wait-time blocks and excess-time blocks. The EBM model was selected for its superior performance compared to the other models. The model reduced the number of excess-time blocks from 1,113 to 905 (P < .001, 95% CI [-329 to -89]), translating to approximately 52-hours over the 51-month study period. The model predicted more surgeries within a 15% range of the true incision time compared to traditional methods. Influential features included surgeon experience, number of additional procedures, body mass index (BMI), and uterine size. The ML model enhanced the prediction of incision times for robotic-assisted hysterectomies, providing a potential solution to reduce OR underutilization and increase surgical throughput and hospital revenue.
Extreme asymmetric morphologies are hypothesized to serve an adaptive function that counteracts sexual selection for symmetry. However direct tests of function for asymmetries are lacking, particularly in the context of animal weapons. The weapon of the maritime earwig, Anisolabis maritima, exhibits sizeable variation in the extent of directional asymmetry within and across body sizes, making it an ideal candidate for investigating the function of asymmetry. In this study, we characterized the extent of weapon asymmetry, characterized the manner in which asymmetric weapons are used in contests, staged dyadic contests between males of different size classes and analyzed the correlates of fighting success. In contests between large males, larger individuals won more fights and emerged as the dominant male. In contests between small males, however, weapon asymmetry was more influential in predicting overall fighting success than body size. This result reveals an advantage of asymmetric weaponry among males that are below the mean size in the population. A forceps manipulation experiment suggests that asymmetry may be an indirect, correlate of a morphologically independent factor that affects fighting ability.
Heterospecific eavesdropping on alarm calls is well documented, but less is known about the factors influencing asymmetry in the reliability of heterospecific alarm calls. Partial overlap of predators between heterospecifics has been hypothesized as 1 possible mechanism driving asymmetric eavesdropping. We tested the responses of common mynas (Acridotheres tristis) and red-vented bulbuls (Pycnonotus cafer) to reciprocal playbacks of alarm and social calls by measuring changes from baseline in the rates of fly-bys near the speaker and in rates of singing. We found an asymmetric communication network between bulbuls and mynas: bulbuls only responded to conspecific alarm calls, whereas mynas responded to both bulbul and conspecific alarm calls. This communication asymmetry may be due to a partial overlap in predators between species. Mynas were observed to spend time in both trees and on the ground and may be susceptible to both aerial and ground predators. We observed bulbuls primarily in trees and therefore may be susceptible primarily to aerial predators. If this is the case, then the alarm calls of mynas are less reliable to bulbuls compared with the reliability of alarm calls of bulbuls to mynas. However, further studies into the predators of each species are necessary before drawing a definitive conclusion. Our study demonstrates a differential responsiveness of 1 species on the alarm calls from another species for predator information and underscores the importance in considering heterospecific communication networks in the removal of species from a community.
Summary Although adolescents seeking mental health services may not consider them related, the prevalent co-morbidity of substance use and mental health problems makes it imperative that practitioners find ways of engaging troubled youth about substance issues. Based on their responses to a clinical self-assessment questionnaire (Adquest), this study shows that mental health service applicants are willing to disclose their substance use behaviors and are open to talking about them to intake workers. Age and gender differences in substance use patterns and willingness to talk are explored.
Previous studies have demonstrated that bird song is influenced by infection. We investigated how mounting an immune response by mountain white-crowned sparrows (Zonotrichia leucophrys oriantha) affects specific aspects of territorial song and behavior. We used song playback to simulate a territorial intrusion and elicit baseline song and behavioral responses. Individuals were then either injected with a saline control or with a lipopolysaccharide (LPS) solution to induce an acute immune response, and posttreatment territorial song and behaviors in response to playback were recorded 1 day and 7 days later. The immune challenge significantly reduced the number of birds that sang compared with control individuals on Day 1. All birds that sang on Day 1 produced abnormal songs with fewer terminal notes, exhibited elevated alarm behavior, and tended to sing at slower rates. By Day 7, LPS treatment had no effect on the likelihood of singing, and song rates had returned to baseline levels, though songs were still sung with fewer terminal notes. Thus, our study shows that simply mounting an immune response to infection, as opposed to the actual infection per se is sufficient to impact avian song production. This study also suggests that for the most sensitive assessment of immune status, familiarity with an individual's song and behavior is necessary.
Animals must use cues from smells, sounds, and sights to reduce uncertainty about the environment. Despite the ecological relevance of multisensory perception in helping animals cope with uncertainty, empirical support from natural systems is rarely placed within an adaptive framework. The field of psychophysics provides a model for the study of cognitive processes by studying behavior. Using this as a foundation, we develop a framework that can be used to understand the evolutionary significance of multimodal perception. We develop predictions about the conditions under which multiple stimuli combine differently. A key outcome of our analysis is that the ecological context can influence the processes by which animals perceive multisensory stimuli. In addition to its theoretical importance, this framework predicts that anthropogenic activities can affect how animals perceive their environment, which may have profound ecological consequences.
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