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Background: Both open cranial vault remodeling (CVR) and endoscopic suturectomy are effective in treating the anatomical deformity of craniosynostosis. While parents are increasingly knowledgeable about these 2 treatment options, information regarding the perioperative outcomes remains qualitative. This makes preoperative counseling regarding surgical choices difficult. The purpose of this study was to evaluate the outcomes in patients with craniosynostosis who underwent traditional CVR versus endoscopic suturectomy. Methods: Open and endoscopic craniosynostosis surgeries performed at our institution from January 2014 through December 2018 were retrospectively reviewed and perioperative data, including operative time, estimated blood loss, transfusion rate and length of stay, was analyzed. A student t test was used with significance determined at P < 0.05. Results: CVR was performed for 51 children while 33 underwent endoscopic procedures. Endoscopic suturectomy was performed on younger patients (3.8 versus 14.0 months, P < 0.001), had shorter operative time (70 versus 232 minutes, P < 0.001), shorter total anesthesia time (175 versus 352 minutes, P < 0.001), lower estimated blood loss (10 versus 28 ml/kg, P < 0.001), lower percentage transfused (42% versus 98%, P < 0.001), lower transfusion volume (22 versus 48 ml/kg, P < 0.001), and shorter length of stay (1.8 versus 4.1 days, P < 0.001) when compared to open CVR. Conclusion: Both open CVR and endoscopic suturectomy are effective in treating deformities due to craniosynostosis. The endoscopic suturectomy had significantly shorter operative and anesthesia time as well as overall and PICU length of stay. CVR was associated with greater intraoperative blood loss and more frequently required higher rates of blood transfusions.

This report on the September 1985 earthquakes in Mexico describes the earthquakes themselves, their effects and the resulting damage in considerably more detail than did the preliminary report of the reconnaissance team.

Depressed runway performance of rats to varied large and small reward following consistent high-incentive training was found . Ss shifted to var ied reward displayed a de pression effect following both large' and small-reward trials, a finding particularly nonsupportive of Capaldi's stimul us aftereffect theory and supportive of Amsel 's fru stration theory .Depressed performance to small reward following high-incentive training is a reliable finding, occurring with several parameters of preshift reward (cf. Black, 1968). More recently, postshift reward conditions have received attention in an attempt to relate the depression effect to other literature (e.g., extinction) employing reward shifts in simple instrumental conditioning (Gonzales & Bitterman, 1969). The present study provides further information on the generality of the depression effect with respect to postshift reward by employing a previously neglected postshift incentive value, varied large and small reward. Theoretically, depressed postshift performance following a shift from continuous to varied reward is expected by several interpretations of reward shift effects (e.g., Amsel , 1958: Capaldi, 1967.According to Amsel's (1958) conditioned frustration theory , Ss shifted from continuous large magnitude of reward to varied large and small magnitude of reward should run more slowly during postshift training than a control group maintained on varied large and small magnitude of reward. The experimental Ss should show depressed postshift speeds as a consequence of conditioned interfering responses elicited by frustration stimuli, which, in turn , result from the small magnitude of reward experienced following preshift training. Control Ss, however, should have learned to run in the presence of frustration cues (rf-sf) that result from repeated experience with large and small magnitude of reward during the preshift period.Capaldi's (1967) stimulus aftereffect theory would also predict a "depression" effect in the present study. According to Capaldi (1967). the reward magnitude received on any trial provides magnitude-specific stimuli present when the organism responds on the next trial. Ss shifted from consistent large magnitude of reward to 'This paper is sponsored by James H . McH os e. who takes full editorial responsibility for it.Bull. Psychon . Soc., 1973, Vol. 2 (2) varied large and small magnitude of reward should run more slowly than control Ss, because the novel aftereffect of the new reward for experimental Ss has not had as much habit strength accrued to it as has the small-reward aftereffect present for control Ss. METHODThe Ss were 20 experimentally naive male albino rats. approximately 90 days old at the beginning of the experiment and bred at West Virginia Wesleyan College.The runwa y apparatus was essentially the same as that employed by Ludvigson & Gay (1966) , except that only one of the multiple parallel alleys was used. The alley compri sed a 33.02-cm white startbox, a 66.04-cm white run section . and a 33.48-cm white goalbox . T...

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