Total Length Research Articles

Thermal transfer rate is slower in bigger fish: How does body size affect response time of small, implantable temperature recording tags?

AbstractThe recent miniaturisation of implantable temperature recording tags has made measuring the water temperatures fish experience in the wild possible, but there may be a body size‐dependent delay in implanted tag response time to changes in external temperature. To determine whether fish body size affects the response rate of implanted temperature tags, we implanted 20 Salvelinus fontinalis (127–228 mm fork length (FL), 15.1–120.4 g) with temperature recording tags and subjected them to rapid temperature changes (±8°C in less than 2 seconds) in the laboratory. We found that thermal transfer rates, and the lag in temperature tag response rate, was positively correlated with fish size, but the direction of temperature change (colder or warmer) had no significant effect. In fish exposed to a slower rate of temperature change (2°C h−1) implanted tags did not show a response lag. Understanding the limitations of this important technology is crucial to determining the utility of the data it produces and its ability to accurately measure fish thermal experience in the wild.

Oxynoemacheilus fatmae, a new species from the Güzelhisar Stream in the Aegean Sea basin, Türkiye (Teleostei: Nemacheilidae).

Oxynoemacheilus fatmae, a new species, is found in the Güzelhisar Stream in the northern Aegean Sea basin. It is differentiated from all other species of Oxynoemacheilus in the northern Aegean Sea and adjacent basins by having four to eight irregularly shaped narrow black bars on the posterior part of flank, and anterior parts of the flank with a marbled pattern. O. fatmae is differentiated from the closest species Oxynoemacheilus theophilii by having 14 fixed diagnostic nucleotide substitution sites, and the pair-wise genetic distance is 2.22%. It further differs from O. theophilii by having a slenderer body (body at dorsal-fin origin: 15%-17% standard length [SL] vs. 17%-18%), a slenderer caudal peduncle (10%-12% SL vs. 12%-13%), a more forked caudal fin (length of middle caudal-fin lope: 16%-19% SL vs. 19%-23%), and the absence the dorsal and ventral adipose crests on the caudal peduncle behind the vertical of the posterior anal-fin base (vs. present). Three species delimitation tests (assemble species by automatic partitioning (ASAP), automatic barcode gap discovery (ABGD) and generalized mixed yule-coalescent (GMYC)) and phylogenetic analyses reinforce the validity of O. fatmae as a distinct species.

Cost Optimization in Cloud Computing: Capacity Reservation for Intermittent Random Demand Surges

The adoption of cloud computing has been accelerating over the last decade, while enterprise cloud users (“firms”) are struggling to manage their growing cloud expenditures in the face of intermittent digital demand surges caused by planned or random events. To deal with such challenges, a firm can employ reserved instances with the standard contract length (e.g., one year) to meet the stationary base demand, which we refer to as the base contracts, complemented by additional reserved instances with either standard or shorter contract lengths, which we refer to as the supplementary contracts, to cope with the demand surges. We first analyze a model whereby the surge and inter-surge durations are deterministic, demand magnitude is random, and cancellation of the reservations is allowed. We develop a capacity management plan for the firm including not only the optimal capacity levels, which follow a newsvendor-type solution, but also the optimal policy for managing the purchase, renewal, cancellation, or expiration of the supplementary contracts, which can be characterized as a two-threshold policy. Due to the complexity of the structure of the optimal policy, we also construct an effective heuristic policy by excluding the renewal option from the action space, which can be applied to a more general setting where the surge and inter-surge durations are random. We examine two model extensions: (1) when trades of reserved instances are allowed in a secondary marketplace; (2) when the firm does not have exact information about the distributions of the surge magnitude and duration while it can adjust the capacity levels as data unveils. Our analysis shows that the optimal policy for managing the supplementary contracts depends on the relative magnitude of the surge and inter-surge durations in relationship to the cancellation fee. Moreover, our numerical results show that cloud platforms that offer a secondary marketplace are more attractive to firms from a cost standpoint than those that allow cancellation only. The latter, without the secondary marketplace, however, can achieve parity with the former by offering a deeper discount rate for the reserved instances, thereby bypassing the cost of administering the secondary marketplace.

New insights into the reproduction and migration of the porbeagle shark Lamna nasus (Bonnaterre 1788) in the Southwest Atlantic Ocean.

The objective of this study was to estimate the reproductive parameters of porbeagle shark in the Southwest Atlantic Ocean and thus characterize the adult fraction of this population. Therefore, 1012 specimens were measured by scientific observers on board the commercial trawl fleet operating south of 50° S. The size range of the specimens was from 77 to 292 cm fork length (LF). The mean size at maturity was estimated to be 153 cm LF for males and 172 cm LF for females. Porbeagle shark catches were recorded throughout the year, with the highest frequency occurring between November and June. The presence of pregnant females was observed from December to July, along with an increase in the average size of embryos in each litter. The information presented in this study improves the knowledge of the reproductive biology and allows to propose a migratory pattern of adult porbeagle females in the Southwest Atlantic Ocean. The likely seasonal increase in vulnerability of this shark to austral trawl fishery, despite all conservation management measures established in Argentina, underscores the importance of promoting its proper management and conservation given the need to improve understanding of porbeagle population dynamics in the Southern Hemisphere.

Prevention of malnutrition after one anastomosis gastric bypass: value of the common channel limb length

PurposeHypoalbuminemia and anemia are commonly observed indications for one anastomosis gastric bypass (OAGB) reversal and remain significant concerns following the procedure. Sufficient common channel limb length (CCLL) is crucial to minimize nutritional complications. However, limited literature exists regarding the impact of CCLL on OAGB outcomes. This study aimed to assess the effect of CCLL on weight loss and nutritional status in patients who underwent OAGB.MethodsA prospective cohort study was conducted from August 2021 to July 2022, involving 64 patients with a body mass index of 40–50 kg/m2. The standardized length of the biliopancreatic limb (BPLL) for all patients in this study was set at 175 cm. Additionally, the measurement of the common channel limb length (CCLL) was performed consistently by the same surgeon for all included patients.ResultsThe mean age and BMI of the patients were 39.91 ± 10.03 years and 43.13 ± 2.43 kg/m2, respectively, at the time of surgery. There was a statistically significant negative correlation between CCLL and percent total weight loss (%TWL) at the 12-month mark after OAGB (P = 0.02). Hypoalbuminemia was observed in one patient (1.6%), while anemia was present in 17 patients (26.6%) at the one-year follow-up. Statistical analysis revealed no significant difference in the incidence of anemia and hypoalbuminemia between patients with CCLL < 4 m and those with CCLL ≥ 4 m.ConclusionA CCLL of 4 m does not appear to completely prevent nutritional complications following OAGB. However, maintaining a CCLL of at least 4 m may be associated with a reduced risk of postoperative nutritional deficiencies.

A new species of Liobagrus Hilgendorf, 1878 (Teleostei, Siluriformes, Amblycipitidae) from the lower Changjiang River basin in southeast China

A new catfish species, Liobagrus chenhaojuni Chen, Guo &amp; Wu, sp. nov., is described from the Tiaoxi River, a tributary of Taihu Lake, located in Zhejiang Province, China. This description is based on morphological characteristics and phylogenetic analysis. This species belongs to a group defined by the presence of a smooth posterior edge of the pectoral-fin spine and can be distinguished from other species in the group by a unique combination of characteristics, including: an upper jaw longer than the lower jaw; maxillary barbels reaching the middle of the pectoral fin; irregular blotches present on the lateral body; a rounded caudal-fin with a length ranging from 16.5% to 19.9% of the standard length; 39 to 41 post-Weberian vertebrae; and 15 to 17 anal-fin rays. The validity of this new species is further supported by the molecular phylogenetic analysis based on Cytb sequences.

Ecomorphology of yellowtail lambari (Characiformes: Characidae) in the neotropical semi-arid region, Brazil

The ecomorphological patterns of the Astyanax lacustris in different environments (lotic and lentic) of the semiarid region of Pernambuco were analyzed using 25 linear morphometric measurements on 240 specimens (120 males and 120 females), with standard lengths ranging from 24.25 to 91.50 mm. These data were converted into 16 ecomorphological attributes and correlated with environmental characteristics. The principal component analysis (PCA) explained 81.64% (first and second components) of the data variation, highlighting sexual dimorphism in specimen size and noticeable variation among individuals of the same sex in different environments. Specimens from lotic environments showed higher caudal peduncle compression index (CPCI) values, while the pectoral fin aspect ration (PFAR) was more pronounced in lentic environments. Overall, females exhibited a wide morphometric variation. Analysis of linear morphometry in different water bodies indicated an intrinsic variation related to hydrodynamics linked to sexual dimorphism and water flow speed. Further studies are suggested to investigate whether factors such as macrophytes and different levels of water depth and flow contribute to this morphometric variation of species in the semi-arid region.

Range extension of Blackstripe Lizardfish, Synodus nigrotaeniatus Allen, Erdmann &amp;amp; Peristiwady, 2017 (Actinopterygii, Aulopiformes, Synodontidae), from Jakarta Bay, Indonesia

Three specimens (194.4&amp;ndash;203.8 mm standard lengths) of the lizard&amp;#64257;sh Synodus nigrotaeniatus Allen, Erdmann &amp; Peristiwady, 2017, collected from Jakarta Bay, western Indonesia, represent a signi&amp;#64257;cant range extension for the species, which was previously known from only six specimens collected in Lembeh Strait, North Sulawesi, eastern Indonesia. Morphological comparisons with available data from the type specimens and molecular data from the mitochondrial cytochrome oxidase subunit I (COI) gene are presented. The COI sequence data show a 4% genetic difference from the related Synodus sageneus Waite, 1905.

Changes in Digestive Enzyme Activities during Larval Development of Spotted Seatrout (Cynoscion nebulosus)

The spotted seatrout (Cynoscion nebulosus)—an important commercial species—has a high potential for aquaculture in the Gulf of Mexico. To optimize its feeding during larval rearing, this study aims to evaluate the primary gastric (pepsin), intestinal (leucine aminopeptidase and alkaline phosphatase), and pancreatic (alkaline protease, trypsin, chymotrypsin, amylase, and lipase) enzyme activities from hatching to day 30. A multivariate analysis identified three digestive enzyme development stages during the spotted seatrout larval transformation. The first stage occurred between 1 (mean ± standard error (SE) = 1.73 ± 0.14 millimeter (mm) standard length (SL)) and 3 (2.14 ± 0.07 mm SL) days after hatching (DAH); a period of digestive stability showed the highest activity in amylase and bile salt-dependent lipase. The second stage (from 4 (2.53 ± 0.09 mm SL) to 20 (10.92 ± 0.51 mm SL) DAH) was a period of digestive transition, during which leucine aminopeptidase, chymotrypsin, and alkaline proteases were identified as the predominant enzymes from 4 to 5 DAH. In the third stage—a period of digestive stability—pepsin was the major enzyme that occurred between 25 (16.51 ± 0.81 mm SL) and 30 (25.91 ± 0.82 mm SL) DAH. These results indicate that the spotted seatrout larvae have a digestive system adapted to lipids and carbohydrates at the onset of feeding, with an immediate transition to protein digestion when exogenous feeding begins. Additionally, the digestive system of the spotted seatrout may be considered mature at 25 DAH. Further research is needed to elucidate the mechanisms of digestive tract development in the spotted seatrout larvae.

Improved YOLOv8-Pose Algorithm for Albacore Tuna (Thunnus alalunga) Fork Length Extraction and Weight Estimation

Aiming at the problems of large statistical error and the poor real-time performance of catch weight in the ocean fishing tuna industry, an algorithm based on improved YOLOv8-Pose for albacore tuna (Thunnus alalunga) fork length extraction and weight estimation is proposed, with reference to the human body’s pose estimation algorithm. Firstly, a lightweight module constructed using a heavy parameterization technique is used to replace the backbone network, and secondly, a weighted bidirectional feature pyramid network BIFPN is utilized. Finally, the upper and lower jaw and tail feature points of the albacore tuna (Thunnus alalunga) were extracted using the key point detection algorithm, and the weight of the albacore tuna (Thunnus alalunga) was estimated based on the fitted relationship between fork length and weight. The experimental results show that the improved YOLOv8-Pose algorithm reduces the number of model parameters by 13.63% and the number of floating-point operations by 14.03% compared with the baseline model without decreasing the accuracy of the target detection and key point detection and improves the model inference speed by 374%. At the same time, it reduces the drift of the key point detection, and the error of the comparison with the actual albacore tuna (Thunnus alalunga) body weight is not more than 10%. The improved key point detection algorithm has high detection accuracy and inference speed, which provides accurate yield data for pelagic fishing and is expected to solve the existing statistical problems and improve the accuracy and real-time performance of data in the fishing industry.

Assessment of body metrics, weight, and carcass yields in dusky grouper (Epinephelus marginatus) through correlation and path analysis: Implications for optimizing genetic breeding programs

One of the objectives of aquaculture selective breeding programs is to enhance body conformation traits, often by using indirect criteria like correlation between live body measurements and carcass traits. This research investigated the relationship between live body measurements and carcass traits in dusky grouper (Epinephelus marginatus). We assessed the relationship between body measurements and carcass traits in 150 farmed dusky groupers with an average weight of 680 ± 221 g. The fish were measured for length, width, height, and length of head, and then processed to obtain weights (body, fillet, steaks, head, and residues) and yields (carcass, fillet, steaks, head, and residues). Path analysis was employed to estimate direct and indirect effects, with body part weight and yields as dependent variables and morphometric measurements and relationships as explanatory variables. The findings indicate that morphometric measurements can be used to estimate farmed dusky grouper body weights and carcass yields. Among the morphometric measurements and relationships examined, fish body height and standard length were identified as the main factors influencing variation in body weights and carcass yields.

Comparative evaluations on the canal-centering ability of novel heat-treated retreatment file system using nano-computed tomography

Abstract Introduction: The main goal of instrumentation during retreatment is to maintain the original curvature of the canal during retrieval of gutta-percha. The present study evaluates the canal-centering ability of two different retreatment file systems. Materials and Methods: Forty extracted single-rooted teeth were decoronated and obturated at the standardized root length of 16 mm. Samples were divided into two groups of each 20 single root teeth and they were instrumented using Solite RS3 Retreatment and ProTaper Retreatment files, respectively. Both pre- and postoperative nano-computed tomography scans were taken, and three-dimensional reconstruction was done for analysis. Sections of both the pre- and postoperative samples were taken at 7 mm, 5 mm, and 3 mm from the apex to calculate the canal-centering ratio. Independent t-test was used for statistical analysis between the two groups. Results: Solite RS3 retreatment files showed a significant difference at the 3 levels (P &lt; 0.000) compared to ProTaper retreatment files. Conclusion: From the above results, we can conclude that Solite RS3 caused minimal canal transportation and produced a relatively centered preparation in comparison to the ProTaper Retreatment system.

Identification of Konosirus punctatus (Temminic and Schlegel, 1846) stocks in Korean waters via otolith shape analysis and comparison of growth parameters

Accurate identification of fish stocks is essential for the successful management of fishery resources. In this study, the populations of dotted gizzard shad, Konosirus punctatus, which is listed on the International Union for Conservation of Nature red list of the threatened species, were identified by combining two phenotypic methods: otolith shape analysis and comparison of growth parameters. Otolith shape analysis revealed two types of otoliths, pointing to the presence of two gizzard shad stocks in two areas along the Korean coast: the East Sea and the Yellow Sea + western Korean Strait. It is also supported by the result that the two stocks are significantly different in the shape indices (SI), and asymptotic fork length (FL∞). These results may be due to the influence of several environmental factors, such as temperature, salinity, and food availability. Overall, our findings suggest that there are two phenotypic stocks of K. punctatus in the Korean coastal waters and they should be managed differently.

Codon Usage Characteristics and Evolutionary Analysis of Mitochondrial Genome of Winter Squash (Cucurbita maxima Duch.)

Mitochondrial genomes are essential components of eukaryotic cells, understanding their structural characteristics and codon usage bias is critical. Winter squash (Cucurbita maxima Duch ex Poiret) is an economically important cucurbit crop. To clarify its structural characteristics and codon usage bias of mitochondrial genome, as well as the evolutionary characteristics in the Cucurbitaceae family, whole genome sequencing analysis of C. maxima mitochondrial genome was carried out. The results revealed that the total length of the C. maxima mitochondrial genome was 640,814 bp, containing 9,162,318,300 bp of bases. There were 68 annotated genes identified. The mitochondrial coding genes of C. maxima exhibited an average GCall content of 42.57%, with the last position enriched in A/T bases. Codon usage analysis indicated weak codon bias, with the effective codon number (ENC) ranging from 44.22 to 61.00. Correlation analysis and neutrality plot analysis demonstrated a nonsignificant correlation between GC3 and GC12. PR2-plot and ENC-plot analysis further supported the influence of natural selection on the codon preference in the C. maxima mitochondrial genome. Relative synonymous codon usage (RSCU) analysis identified 19 optimal codons, with a preference for U or A as the final base. The analysis of scattered repeat sequences in the genome indicated a high frequency of forward and palindromic repeats in the C. maxima mitochondrial genome. Nucleic acid diversity analysis highlighted rpl5 as the gene with the highest variability. Comparative analysis of mitochondrial structure and phylogenetic tree analysis revealed a close evolutionary relationship between C. maxima and Cucurbita pepo, showing synteny in evolution. Homologous fragment analysis demonstrated a similarity of over 70% between the C. maxima mitochondrial genome and chloroplast genome fragments. These findings provide a foundation for C. maxima identification and phylogenetic studies.

Queen Triggerfish Balistes vetula Age-Based Population Demographics and Reproductive Biology for Waters of the North Caribbean

Queen triggerfish Balistes vetula is an important reef-associated species for commercial fisheries in the U.S. Caribbean. It exhibits a relatively unique reproductive strategy as a nesting benthic spawner, investing substantial energy in territorial defense, building and maintaining nests, and caring for fertilized eggs during the reproductive season. Prior to this study, no comprehensive life history information existed in the literature for queen triggerfish. This study provides the first comprehensive documentation of age, growth, size/age at sexual maturity, reproductive seasonality, and reproductive output for a Balistes species in the Caribbean. From 2013 to 2023, we collected 2190 fish samples from fisheries-dependent and -independent sources from the waters of Puerto Rico and the U.S. Virgin Islands. Fish ranged from 67 to 477 mm fork length (FL). We documented that queen triggerfish is sexually dimorphic with males attaining larger mean sizes-at-age compared to females and the species is characterized by a moderately young age at median sexual maturity (A50 = 3.3 y). The maximum age for our U.S. Caribbean samples was 23 y based on increment counts from otoliths. Spawning season encompassed the months of December to August in the region, and female spawning frequency ranged from an estimated 2 to 84 times per year; female spawning frequency increased with increasing size and age of fish. We documented that commercial fishers in the U.S. Caribbean mainly target “plate-size” individuals, defined in our study as 235–405 mm FL, which appears to act as a self-imposed slot size range limit and results in the fishery not removing individuals in the smallest and largest size groups at high rates. The percentage of immature fish from fisheries-dependent sources was close to 0 (0.8%). Commercial fishing for queen triggerfish in the region currently appears to be sustainable, but monitoring of the population should continue.

Spatial and temporal distribution of juvenile Gulf Sturgeon in the Pearl River, Louisiana, and adjacent estuaries of the Gulf of Mexico

AbstractObjectiveAcoustic telemetry was used to examine the spatial‐temporal distribution and anadromous migration pattern of juvenile Gulf Sturgeon Acipenser desotoi within the Pearl River and associated coastal estuaries of Louisiana and Mississippi.MethodsAcoustic transmitters were surgically implanted in 52 juvenile Gulf Sturgeon (&lt;890 mm fork length) from the Pearl River between 2016 and 2019. Sturgeon were monitored on 247 acoustic receivers in the lower Pearl River and adjacent estuaries across numerous partnering arrays.ResultJuveniles were detected on receivers from Lake Pontchartrain, Louisiana, east to Bay St. Louis, and Biloxi Bay, Mississippi. The 3‐year study found that juvenile Gulf Sturgeon migration in the Pearl River occurred on cycles similar to those reported from other populations. Juveniles were rarely observed in the estuary and nearshore marine environments from May through mid‐October of each year, during which time most sturgeon inhabited the Pearl River. Conversely, most of the juveniles inhabited coastal estuaries from December through February of each year and were rarely observed in freshwater environments during this period. Migration from the river into the estuary occurred during late‐October through November, and migration from the estuary into the river occurred in March and April. Distribution patterns varied spatially within the river and estuary ecosystems during each phase of migration. Tagged juveniles occupied the lowest 40 km of the Pearl River while in freshwater, and they occupied the northeastern shoreline of Lake Pontchartrain and Bay St. Louis while in the estuary. Interestingly, juveniles seemed to target specific areas in the estuary during winter that were farther away from the mouth of natal rivers than has been previously reported.ConclusionThis study provides a new assessment of juvenile Gulf Sturgeon migration and seasonal distribution for the Pearl River and provides important information for designing and assessing the potential benefits and challenges of habitat restoration for Gulf Sturgeon.

Assessment of Long-Term Success and Survival Rates of Different Types of Intracanal Medicaments

ABSTRACT Background: Antimicrobial endodontic intracanal medicaments play a vital role along with biomechanical preparation in the elimination of bacteria present in the pulp area to achieve success in endodontic therapy. Aim: The present research was conducted with the objective of evaluating and comparing intracanal medicaments regarding antibacterial properties against Enterococcus faecalis. Materials and Methods: One hundred and twenty healthy human premolars of the mandible were used. All premolar crowns were removed, keeping the standardized length of the root as 15 mm. Category 1 received triple antibiotic paste (TAP) (n = 30), Category 2 received double antibiotic paste (DAP) (n = 30), Category 3 received augmentin (n = 30), and Category 4 received calcium hydroxide (n = 30). Hygienic paper points were placed in each root canal, then they were moved to a tube containing 1 mL of brain-heart infusion medium and left there for bacteriological testing. Colony-forming units (CFUs) of E. faecalis were then observed and counted after the plates had been incubated overnight at a temperature of 37°C. Results: During intracategory comparisons, there was a significant reduction in colonies of E. feacilis in each category (P ≤ 0.001). When there were intercategory comparisons, there was a maximum reduction in CFU in specimens of Category 1 (TAP) followed by Category 3 (Augmentin) and Category 2 (DAP). Conclusion: Intracanal medicaments like TAP, DAP, and augmentin are effective against root canal E. faecalis.

Characterization of sound production by the pot-bellied seahorse (Hippocampus abdominalis) during feeding.

Sound production during feeding by the pot-bellied seahorse, Hippocampus abdominalis, was quantified with an observation of clicks (acoustic signal) and snicks (visual behavior). Female, male, and juvenile seahorses had feeding sounds characterized for peak (dominant) frequency (Hz), sound pressure level (SPL), and duration (ms). Subject body size and condition was estimated by standard length (SL, cm), to determine an estimate of body condition index (BCI). An inverse correlation between mean peak frequency (Hz) of clicks and SL was found for females. A negative correlation between peak frequency (Hz) of clicks and a residual BCI was determined for both males and females, suggesting that acoustic signals may contain information regarding fitness.

Seeing further into the early steps of the endangered atlantic goliath grouper (Epinephelus itajara): Eye lenses high resolution isotopic profiles reveal ontogenetic trophic and habitat shifts

Estuarine mangroves are often considered nurseries for the Atlantic Goliath grouper juveniles. Yet, the contributions of different estuarine primary producers and habitats as sources of organic matter during early ontogenetic development remain unclear. Given the species’ critically endangered status and protection in Brazil, obtaining biological samples from recently settled recruits in estuaries is challenging. In this study, we leveraged a local partnership with fishers and used stable isotope (C and N) profiles from the eye lenses of stranded individuals or incidentally caught by fishery to reconstruct the trophic and habitat changes of small juveniles. The eye lens grows by the apposition of protein-rich layers. Once these layers are formed, they become inert, allowing to make inferences on the trophic ecology and habitat use along the development of the individual until its capture. We used correlations between fish size and the entire eye lens size, along with estuarine baselines, to reconstruct the fish size and trophic positions for each of the lens layers obtained. We then used dominant primary producers and basal sources from mangrove sheltered, exposed estuarine and marine habitats to construct an ontogenetic model of trophic and habitat support changes since maternal origins. Our model revealed marine support before the juveniles reached 25 mm (standard length), followed by a rapid increase in reliance on mangrove sheltered sources, coinciding with the expected size at settlement. After reaching 60 mm, individuals began to show variability. Some remained primarily supported by the mangrove sheltered area, while others shifted to rely more on the exposed estuarine area around 150 mm. Our findings indicate that while mangroves are critical for settlement, as Goliath grouper juveniles grow, they can utilize organic matter produced throughout the estuary. This underscores the need for conservation strategies that focus on seascape connectivity, as protecting just one discrete habitat may not be sufficient to preserve this endangered species and safeguard its ecosystem functions.

The true complexities of "standard" family practice visits unmasked: an observational cross-sectional study in Regina.

Many patients present to their family medicine clinic with more than one health concern, placing an increased demand on family physicians. Research into the average number of concerns per regular family medicine visit is limited. Recognition of the frequency that family physicians address more than one concern per visit and adapting practices accordingly is important for improving patient care. To examine whether family physicians routinely address multiple different patient concerns during a single visit and if this is influenced by patient demographics. This study was conducted at a multi-physician family medicine clinic in Regina, Saskatchewan, Canada. Five physicians contributed their 500 most recent charts, extending retrospectively from 1 June 2023, from in-person visits by patients over 18 years of age and billed as regular appointments without billed procedures. Each chart was reviewed for the number of concerns addressed in the visit. Fifty percent of visits addressed more than 1 concern (range = 1-8). A generalized linear mixed model using Poisson distribution showed certain physicians (incident rate ratio [IRR]: 1.192, 95% CI: 1.087-1.307, P < 0.001) and adults older than 65 years compared to adults less than 40 years (IRR 1.151, 95% CI: 1.069-1.239, P < 0.001) were more likely to present with multiple concerns, but patient sex was not a significant predictor. Family physicians routinely address more than one concern per visit. Standard visit length and billing practices should be adapted to reflect this complexity.