bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Safety Culture in 2 Public Hospitals in Vietnam
Authors: Tran Ha Thi Nhi , Pham Thanh Quoc , Tran Huong Lien , Nguyen Hung Dinh , Nguyen Tu Minh , Bui Ha Thi Thu
Published: September 2021

Background:

Patient safety culture is an important measure in assessing the quality of care. There is a growing need to establish a patient safety culture in hospitals. This study explored the perception of health professionals on patient safety culture in 2 public hospitals in Hanoi, Vietnam.

Method:

A mixed-methods study with an online Hospital Survey on Patient Safety Culture (HSOPSC) and qualitative data collection was conducted in Hanoi. The HSOPSC was validated in Vietnam before using it.

Results:

A total of 626 health professionals, including physicians and nurses, were involved in the survey, and 49 of them participated in in-depth interviews and focus group discussions. The average positive response of patient safety culture composites was high at 85.2% and varied from 49.4% to 97.9%. The strongest areas were teamwork within units (91.3%) and organizational learning/continuous improvement (88.4%), and the areas that needed improvement were staffing (49.4%) and nonpunitive response to error (53.1%).

Conclusion:

The centralized incident reporting, management with peer involvement on event reporting, and continuous quality improvement should be routinely embedded by hospital leaders down to unit managers and all staff.
General estimates of the energy cost of walking in people with different levels and causes of lower-limb amputation: a systematic review and meta-analysis
Authors: Ettema Sanne , Kal Elmar , Houdijk Han
Published: September 2021

Background:

Energy cost of walking (ECw) is an important determinant of walking ability in people with a lower-limb amputation. Large variety in estimates of ECw has been reported, likely because of the heterogeneity of this population in terms of level and cause of amputation and walking speed.

Objectives:

To assess (1) differences in ECw between people with and without a lower-limb amputation, and between people with different levels and causes of amputation, and (2) the association between ECw and walking speed.

Study design:

Systematic review and meta-analysis.

Methods:

We included studies that compared ECw in people with and without a lower-limb amputation. A meta-analysis was done to compare ECw between both groups, and between different levels and causes of amputation. A second analysis investigated the association between self-selected walking speed and ECw in people with an amputation.

Results:

Out of 526 identified articles, 25 were included in the meta-analysis and an additional 30 in the walking speed analysis. Overall, people with a lower-limb amputation have significantly higher ECw compared to people without an amputation. People with vascular transfemoral amputations showed the greatest difference (+102%) in ECw. The smallest difference (+12%) was found for people with nonvascular transtibial amputations. Slower self-selected walking speed was associated with substantial increases in ECw.

Conclusion:

This study provides general estimates on the ECw in people with a lower-limb amputation, quantifying the differences as a function of level and cause of amputation, as well as the relationship with walking speed.
Exploring the interaction of knee and ankle component use on mobility test performance in people with unilateral transfemoral amputation
Authors: Barnett Cleveland T. , Hughes Liam D. , Sullivan Amy E. , Strutzenberger Gerda , Levick Jodie L. , Bisele Maria , De Asha Alan R.
Published: September 2021

Background:

Ankle-foot and knee components are important determinants of mobility for individuals with transfemoral amputation. Individually, advanced ankle-foot and knee components have been shown to benefit mobility in this group of people. However, it is not clear what effect a variety of combinations of ankle-foot and knee components have on mobility test performance.

Objectives:

To assess whether outcomes from mobility tests in people with unilateral transfemoral amputation are influenced by varying combinations of ankle-foot and knee components.

Study Designs:

Repeated measures.

Methods:

Nine adults with unilateral transfemoral amputation completed the two-minute walk test, the timed up-and-go test, the L-test, and a custom locomotion course in four randomized prosthetic conditions. These conditions were each a combination of an ankle-foot component (rigid, nonarticulating [RIG] or hydraulically articulating [HYD]) and a knee component (non–microprocessor-controlled [NMPK] or microprocessor-controlled [MPK]). The test-retest reliability and concurrent validity of the custom locomotion course were also established.

Results:

The best performance in all mobility tests was associated with the MPK + HYD combination, followed by the MPK + RIG, NMPK + HYD, and NMPK + RIG combinations. This effect was statistically significant for the two-minute walk test (P = 0.01,

= 0.36) and on threshold for the L-test (P = 0.05,

= 0.36), but not statistically significant for the locomotion course (P = 0.07,

= 0.38) or the timed up-and-go test (P = 0.12,

= 0.22). Locomotion course performance had good to excellent test-retest reliability and strong concurrent validity.

Conclusion:

Using a combination of a HYD ankle-foot and a MPK knee resulted in the highest performance in mobility tests. This was observed in contrast to combinations of prosthetic components that included a rigid ankle-foot component and/or a NMPK knee component.
Functional outcomes and user preferences of individuals with transfemoral amputations using two types of knee joints in under-resourced settings
Authors: Andrysek Jan , Michelini Alexandria , Eshraghi Arezoo , Kheng Sisary , Heang Thearith , Thor Phearsa
Published: September 2021

Background:

Information relating to prosthetic performance can inform clinical practice and improve patient outcomes in under-resourced countries.

Objectives:

The main goal of this study was to compare functional outcomes and user preferences of individuals with transfemoral amputations using common types of knee joints in an under-resourced country.

Study design:

Prospective, longitudinal, before and after trial.

Methods:

Twenty individuals with unilateral transfemoral amputations from a center in Cambodia transitioned from a commonly used single-axis manually locking knee International Committee of the Red Cross (ICRC) to a more advanced multiaxis knee joint with stance control All-Terrain Knee (ATK). Data were collected for the ICRC knee joint and the ATK immediately after fitting, after acclimation, and as part of a long-term follow-up. A timed walk test assessed walking distance and efficiency. Mobility and user-preferences were evaluated through questionnaires.

Results:

Distance during the timed walk test was significantly higher for the ATK compared with ICRC (P < 0.001), with functional gains retained at follow-up. No differences were found for gait efficiency and the mobility questionnaires. All participants, except one, preferred the ATK prosthesis. Benefits included greater knee stability and fewer perceived knee collapses; however, some disliked the appearance of the ATK.

Conclusions:

The findings suggest positive outcomes with prosthetic services in under-resourced regions and the ICRC system, as well as the potential for improved functional outcomes with more advanced multiaxis knee components.
Computed Tomography Findings Suggestive of Connective Tissue Disease in the Setting of Usual Interstitial Pneumonia
Authors: Chung Jonathan H. , Montner Steven M. , Thirkateh Prahasit , Cannon Brenna , Barnett Scott D. , Nathan Steven D.
Published: September 2021

Purpose

A usual interstitial pneumonia (UIP) pattern is common in idiopathic pulmonary fibrosis (IPF) and connective tissue disease–related interstitial lung disease (CTD-ILD). The purpose of the study was to validate imaging findings differentiating CTD-ILD from IPF in UIP.

Methods

Patients with a multidisciplinary diagnosis of CTD-ILD or IPF and a UIP pattern on computed tomography and/or pathology were included in this study. Prevalence of 3 computed tomography findings shown to be associated with CTD-ILD (the straight edge sign [SES], the exuberant honeycombing sign, and the anterior upper lobe sign [AULS]) were tabulated in CTD-ILD and IPF subjects. The ability of each of these signs to discriminate between CTD-ILD and IPF was evaluated. Survival analysis was also performed using log-rank analysis.

Results

The study cohort included 50 CTD-ILD and 100 IPF subjects with UIP. The SES and the AULS were more common in CTD-ILD than IPF (prevalence, 36.0% and 34.9% in CTD-ILD vs 8.3% and 17.2% in IPF, respectively [P = 0.0105 − <0.001]). The highest specificity (95.7%) of CTD-ILD diagnosis was seen with bilateral SES. Moreover, the SES was associated with improved survival (P = 0.0383), which appeared to be largely because of improvement in survival in IPF subjects. The presence of AULS was associated with pulmonary functional abnormalities.

Conclusions

A radiographic UIP pattern with evidence of SES or the AULS should raise suspicion for CTD-ILD rather than IPF. Patients with IPF and SES have an attenuated disease course and might represent a different phenotype than those without the SES.
Emissary Foramina of the External Occipital Protuberance: A Magnetic Resonance Imaging Study
Authors: Tsutsumi Satoshi , Ono Hideo , Ishii Hisato
Published: September 2021

Objective

The posterior interparietal region is known to be a distinct area of the skull, predisposing to a variety of bony variants and congenital anomalies. The bony canals in this region have not yet been explored in detail. This study aimed to characterize them.

Patients and Methods

Overall, 82 patients underwent thin-slice contrast magnetic resonance imaging. Coronal and sagittal images were used for the analysis.

Results

At the rostral limit of the posterior interparietal region, the parietal foramen (PF) and transmitting emissary vessels were identified in 84% of cases, mostly delineated as single channels. They were located in the left parasagittal region (PS) in 26%, lateral to the left PS in 33%, right PS in 40%, lateral to the right PS in 12%, and midline in 16% of the cases. In 4% of the cases, the PF presented an obstruction around the outer opening. In the more caudal part of the posterior interparietal region, 51% of the patients presented with fine bony canals and transmitting emissary vessels, lying in the midline and parasagittal levels.

Conclusions

The frequency of PFs may be underestimated for superficially hidden outer openings of the canals. The midline posterior interparietal region may present fine bony canals for transmitting emissary vessels that function complementarily with PFs.
Hourglass-Like Constriction Neuropathy of the Upper Limb Nerve: Diffusion-Weighted Magnetic Resonance Neurography Imaging Findings
Authors: Wu Chao , Bao Hongjing , Xu Qiang
Published: September 2021

Objective

The purposes of this study were to determine reliable diffusion-weighted magnetic resonance neurography (DW-MRN) features of hourglass-like constriction of the upper limb nerve and to evaluate the application value of DW-MRN compared with ultrasonography (US).

Methods

We retrospectively reviewed MRN studies of 13 patients. Qualitative and quantitative image analyses were carried out. The number of constrictions based on DW-MRN and US findings was compared.

Results

Of the 13 cases, there were 7 cases with radial nerve abnormalities, 4 with median nerve abnormalities, and 2 with radial and median nerve abnormalities. Diffusion-weighted MRN showed a single-segmental constriction in 7 of 13 cases and multisegmental constrictions in 6 of 13 cases; the hourglass-like constriction appeared in all cases (13 of 13). Thirty-three nerve constrictions were found in DW-MRN, and 29 nerve constrictions were found in US.

Conclusions

Diffusion-weighted MRN is a noninvasive and helpful diagnostic for hourglass-like constriction of the upper limb nerve.
MRI and Sonography of the Knee in Acute Reactive Arthritis
Authors: Thomas Koshy Nithin , Jain Neeraj , Mohindra Namita , Misra Durga , Agarwal Vikas , Gupta Latika
Published: September 2021

Introduction

Reactive arthritis (ReA) is a unique subgroup of spondyloarthritis with acute presentation and tendency to develop chronicity. Magnetic resonance imaging (MRI) has enabled identification of sensitive markers of response to therapy.

Methods

A longitudinal pilot study of acute ReA with knee joint involvement satisfying the Braun's criteria was undertaken. Magnetic resonance imaging of the knee was assessed at baseline, and agreement with ultrasonography was assessed. Clinical details were recorded using a detailed and structured case record form. Patients were followed up, and MRI predictors of transition to chronic arthritis were looked for.

Results

In 25 patients with ReA, synovial thickening was the most common feature. Enthesitis was observed on MRI in 20%. Urethritis-related and HLA-B27–positive ReA had higher synovial thickening scores (p = 0.007). Agreement was poor between MRI and ultrasonography (synovial hypertrophy: k = 0.04). On follow-up, 34% (n = 7/21 for >12 months) continued to have active disease. None of the clinical or radiological features were predictive of chronicity.

Conclusions

Posturethritis and B27-positive ReA was more severe than postenteritis ReA and RA on MRI. One third develop chronic disease on follow-up. Magnetic resonance imaging is superior to sonography, although baseline imaging is not predictive of chronicity. The results of this pilot exploratory study argue for larger studies on MRI in ReA.
Precision Pharyngeal Flap: An Individualized, Patient-Specific Surgery for the Treatment of Velopharyngeal Insufficiency
Authors: Baek Rong-Min , Kim Ji-Young , Kwon Heeyeon , Ahn Taeseon , Kim Baek-Kyu , Myung Yujin
Published: September 2021

Background:

The pharyngeal flap is one of the most common secondary surgeries for the correction of velopharyngeal insufficiency (VPI) for patients with cleft palate and/or cleft lip and palate. This study aimed to demonstrate the effectiveness of the precision pharyngeal flap surgery performed by the senior author.

Materials and Methods:

Children with VPI, who underwent precision pharyngeal flap, were retrospectively examined. All surgical procedures were performed by the senior author. The flap size was individually configured based on the patients’ preoperative nasopharyngoscopic analysis and speech function evaluation. Pre- and post-operative velopharyngeal functions were assessed using perceptual speech evaluation and nasometric analysis; factors affecting surgical outcomes were determined.

Results:

Of 138 patients, 112 (women: 53, men: 59) were included in analyses, according to the inclusion and exclusion criteria. The median follow-up period was 21 months (range: 9–120). Postoperative perceptual speech evaluation revealed improved velopharyngeal function in 108 (96.4%). There were no reports of postoperative hyponasality (preoperative, 1.8% versus postoperative, 0%; P = 0.053). Other parameters of perceptual speech evaluation (hypernasality, nasal emission, articulation error, and intelligibility) showed significant improvement postoperatively (P < 0.01). Postoperative nasalance scores revealed sufficient postoperative resonance rating in 96% of patients. No patients experienced postoperative complications (bleeding, airway obstruction, and surgical wound dehiscence).

Conclusions:

Individually configured pharyngeal flaps designed based on preoperative nasopharyngoscopic examination coupled with precise surgical techniques led to the high surgery success rate for VPI treatment.
Using Active-Phonation Cone-Beam Computed Tomography to Evaluate Pediatric Patients With Suspected Velopharyngeal Dysfunction, a Pilot Study
Authors: Tessler Karen , Wiegmann Aaron Lee , Esmaeeli Shooka , Skertich Nicholas J. , Jeffe Jill S. , Figueroa Alvaro , Tragos Christina
Published: September 2021

Velopharyngeal dysfunction (VPD) is described as the incomplete closure of the velopharyngeal port during a speech production. Nasopharyngoscopy and/or multiplanar videofluoroscopy have been utilized for decades to assess the degree and nature of the dysfunction. Cone-beam computed tomography (CBCT) is presented as an additional diagnostic tool, allowing for clear visualization of the affected structures and the ability to obtain accurate measurements (within 100 microns) of the involved anatomy and defect. This prospective pilot study aims to test the feasibility of using “active-phonation” CBCT to assess suspected VPD in the pediatric and young adult populations and compare the results to nasopharyngoscopy; the current standards of care.

Six patients, ages 6 to 26 years, with suspected VPD, defined as the inability to completely close off the nasal airway during an oral speech, seen at an urban medical outpatient craniofacial care center, served as subjects for this pilot study. Each patient received a comprehensive speech evaluation and participated in both active-phonation CBCT and nasopharyngoscopy.

Both active-phonation CBCT and nasopharyngoscopy revealed incomplete closure of the velopharyngeal port during a speech in all 6 patients (100%). Two patients (33%) were unable to tolerate a complete nasendoscopic examination. There was no difference between CBCT or nasopharyngoscopy in determining the presence of VPD and noting the severity on a 3-point scale, (P = 0.61) as judged by 4 experienced clinicians.

As a functional imaging modality, active-phonation CBCT is a useful adjunct tool for accurate diagnosis of VPD and may be more easily tolerated during a thorough VPD assessment than nasopharyngoscopy. It also provides quantitative data that is useful to augment treatment optimization and surgical planning in this population. Further studies are needed to validate these results.
A Volumetric and Morphological Analysis of Recurrent Odontogenic Keratocysts by Semiautomatic Segmentation
Authors: Lentzen Max-Philipp , Riekert Maximilian , Zirk Matthias , Nickenig Hans-Joachim , Zoller Joachim E. , Kreppel Matthias
Published: September 2021

Purpose:

The authors conducted this study to provide morphological and volumetric data of recurrent odontogenic keratocysts of the upper and lower jaw to emphasize risk factors in accordance with their radiological appearance and guide clinical decisions for jeopardized patients.

Methods:

By applying the open-source software “ITK-Snap” on cone-beam computed tomography images, volumetric measurements of histopathologically diagnosed recurrent odontogenic keratocysts could be performed. For statistical investigations, descriptive statistics and independent Student t test were performed. The intraclass correlation coefficient was used to assess intra- and inter-rater reliabilities. P values P 
< 0.05 were considered significant.

Results:

Forty patients (24 male and 16 female) were included in this study. Recurrent odontogenic keratocysts had a mean maximum diameter of 28.91 mm ± 12.00 mm and a mean volume of 4.48 cm3 ± 4.29 cm3. According to morphology, irregular shape (P = 0.001; P = 0.005), unclear margin (P = 0.001; P = 0.001), multilocular morphology (P = 0.001; P = 0.001), and cortical bone exceedance (P = 0.001; P = 0.007) are statistically significantly associated with a larger cyst diameter and volume. Furthermore, significant differences by diameter and volume could be shown between patients with and without iliac crest graft reconstruction (P = 0.001; P = 0.001).

Conclusions:

Volumetric analysis reveals that recurrent odontogenic keratocysts show large diametric and volumetric extension that leads to complex reconstruction by iliac crest grafts, adding an argument that special attention should be paid to this entity and its recurrence. in case of difficult histopathological examination, lesions with irregular shape and margin, multilocular morphology, cortical bone exceedance, and clinically visible symptoms should be considered for close morphological and volumetric clinico- radiological follow-up.
Effect of the “Time to Surgery” on Civil Cranial Gunshot Injuries: Syria War
Authors: Cingoz Ilker Deniz , Kaya Ismail , Sahin Meryem Cansu , Ozyoruk Safak , Goksu Ethem Taner
Published: September 2021

Studies on cranial gunshot injuries in the Syrian war are present in the literature. However, the effect of surgical timing on the clinical outcomes of patients undergoing surgical treatment has not been discussed extensively. In this study, the time from injury to surgery is called “time to surgery.” Kilis, a city close to Aleppo, Afrin, and Azez, where the conflicts in Syria are intense, is one of the cities where the first emergency treatments were administered. This study aimed to evaluate patients who underwent surgery in Kilis State Hospital due to cranial gunshot injury in the Syrian war and to investigate the effect of surgical timing on mortality and Glasgow Outcome Score.

Surgical treatment was applied to 42 (32.8%) patients in the first 4 hours, 64 (50%) patients within 4 to 24 hours, and 22 (17.2%) patients between 24 hours and 3 days. As the time to surgery decreased, the good Glasgow Outcome Score (GOS) (4-5) outcome rates increased. The differences in surgical timing and GOS results of patients with Glasgow Coma Score (GCS) <8 and >8 were found to be significant for good GOS results. As the time to surgery decreased for patients with a GCS <8 and >8, mortality rates decreased equally. This result was statistically significant.

Our study showed that surgical timing is as important as early intubation, aggressive resuscitation, and admission GCS for both survey and GOS.
The Volume Difference Along the External Surface of the Zygomatic Bone: A Novel Method of Measuring Zygomatic Bone Asymmetry
Authors: Rahbin Samin , Toufani Tina , Al-Khabbaz Anna-Maria , Lindblom Julius , Sunnergren Ola , Darabi Hatef , Qureshi Abdul Rashid , Alinasab Babak
Published: September 2021

This study introduced the volume difference along the external surface (VDAES) of the zygomatic bone as a novel approach to assess zygomatic bone asymmetry and was the first to describe a distinctive, 4-step method of measuring it. VDAES has a potential to be used as an objective tool to evaluate dislocation and can assist surgeons in predicting risks of long-term cosmetic complications in patients with zygomaticomaxillary complex fractures. After having measured 100 healthy study participants, the observed median VDAES was 1.48 cm3 for all study participants, 2.02 cm3 for males, and 1.09 cm3 for females, with the gender difference being significant (P = 0.003). Additional studies are needed to test the hypothesis of whether VDAES is more relevant than conventional methods of clinically evaluating zygomatic bone asymmetry.
Clinical Features and the Use of Three-Dimensional Imaging for Unilateral Lambdoid Synostosis
Authors: Diab Jason , Fowler Adam , Gates Robert , Marucci Damian D.
Published: September 2021

Introduction:

True isolated lambdoid craniosynostosis is rare. It requires corrective surgery to prevent intracranial pressure and aesthetic stigma by significant dyscrania. We summarize our case series for lambdoid craniosynostosis outlining the pathophysiology, clinical findings and surgical approaches and outcomes.

Methodology:

A retrospective analysis of our data from 2010 to 2020 summarized our cases of true lambdoid synostosis. We have used the medical notes and the radiological findings from computed tomography scans to summarize a case series of isolated lambdoid synostosis.

Results:

Our case series demonstrated 7 patients with true isolated lambdoid craniosynostosis. In most cases surgical intervention in the form of posterior cranial vault remodeling utilizing a bandeau, based on occipital advancement techniques, has demonstrated the most consistently favorable aesthetic outcome.

Conclusions:

Surgical referral to a craniofacial center should be sought early in difficult to diagnose cases. Although rare, surgical intervention is indicated to correct potentially increased intracranial pressure and to ameliorate cranial dyscrania.
Performance of Dual-tracer PET-CT for Staging Post–Liver Transplant Hepatocellular Carcinoma Recurrence
Authors: Au Kin-Pan , Dai Wing-Chiu , Chi-Yan Chan Albert , Cheung Tan-To , Lo Chung-Mau , Chok Kenneth Siu-Ho
Published: September 2021

Background.

Precise staging is essential in the management of patients with recurrent hepatocellular carcinoma (HCC) after liver transplantation. There is no current consensus on the optimal staging strategy. We conducted this study to evaluate the performance of dual-tracer positron emission tomography-computed tomography (PET-CT) for this purpose and to investigate whether the results of dual-tracer PET-CT affected patient management.

Methods.

A retrospective study was conducted. Patients who underwent dual-tracer PET-CT for suspected or confirmed HCC recurrence after liver transplant were included. The lesion-based sensitivity and positive predictive value of dual-tracer PET-CT were determined.

Results.

Fifty-six patients and 189 recurrent tumors were included. The lesion-based sensitivity and positive predictive value of dual-tracer PET-CT were 94.7% and 90.4%, respectively. The sensitivity of dual-tracer PET-CT was better than the standard imaging in the surveillance protocol (82.5% versus 94.7%, P < 0.001), especially for detecting liver recurrence (71.0% versus 96.8%, P < 0.001). Half of the dual-tracer PET-CT detected additional recurrence (n = 26, 46.4%) and one-third led to a change in management (n = 19, 33.9%). Ten patients (17.9%) with inconclusive standard imaging had metabolic recurrence confirmed on PET-CT and treatment was commenced early. Four patients (7.1%) had revised locoregional treatment, and 5 (8.9%) had to withdraw from locoregional treatment after the detection of additional metastatic disease.

Conclusions.

Dual-tracer PET-CT is effective for staging posttransplant HCC recurrence. It often provides valuable information to guide clinical management.
Behavioral and Cognitive Response to Selective Serotonin Reuptake Inhibitors in Frontotemporal Lobar Degeneration: A Systematic Review and Meta-analysis
Authors: Nisar Maheen , Abubaker Zohaib Jawed , Nizam Muhammad Abdullah , Shaikh Hafsa Tahir , Abbasi Iqra , Rehman Mohammad Obaid Ur , Sarfaraz Munira , Shah Asim
Published: September 2021

Objective

This article systematically reviews current literature on the efficacy and efficiency of selective serotonin reuptake inhibitors (SSRIs) in the treatment of patients with frontotemporal lobar degeneration (FTLD), with a particular focus on behavior and cognitive functions.

Methods

A search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using CENTRAL, MEDLINE, and Cochrane Library databases. Eleven randomized controlled trials and open-label studies looking at the effects of SSRIs on FTLD patients were included. A random-effects meta-analysis was performed, consisting of 3 randomized and controlled studies that used the neuropsychiatric inventory to assess SSRI intervention.

Results

The meta-analysis shows a combined mean reduction of 10.17 points (95% confidence interval, 18.14–2.19; P = 0.01) on the neuropsychiatric inventory with SSRI treatment in FTLD patients. The I
2 calculated for this study was 62% (P = 0.07), which represents moderate heterogeneity among the studies. The Egger regression test (P = 0.526) did not show a publication bias. Sensitivity analysis showed no significant change.

Conclusions

The current meta-analysis supports SSRIs as an intervention for management of behavioral symptoms of FTLD. Marked improvements were seen in disinhibition, irritability, aggression, and aberrant motor activity across studies. However, apathy/loss of empathy did not show similarly promising results. A deteriorative effect on cognition was seen associated with SSRI use.
Identifying co-phylogenetic hotspots for zoonotic disease
Authors: Pfenning-Butterworth Alaina C. , Davies T. Jonathan , Cressler Clayton E.
Published: September 2021

The incidence of zoonotic diseases is increasing worldwide, which makes identifying parasites likely to become zoonotic and hosts likely to harbour zoonotic parasites a critical concern. Prior work indicates that there is a higher risk of zoonotic spillover accruing from closely related hosts and from hosts that are infected with a high phylogenetic diversity of parasites. This suggests that host and parasite evolutionary history may be important drivers of spillover, but identifying whether host–parasite associations are more strongly structured by the host, parasite or both requires co-phylogenetic analyses that combine host–parasite association data with host and parasite phylogenies. Here, we use host–parasite datasets containing associations between helminth taxa and free-range mammals in combination with phylogenetic models to explore whether host, parasite, or both host and parasite evolutionary history influences host–parasite associations. We find that host phylogenetic history is most important for driving patterns of helminth-mammal association, indicating that zoonoses are most likely to come from a host's close relatives. More broadly, our results suggest that co-phylogenetic analyses across broad taxonomic scales can provide a novel perspective for surveying potential emerging infectious diseases.

This article is part of the theme issue ‘Infectious disease macroecology: parasite diversity and dynamics across the globe’.
Drivers of parasite β-diversity among anuran hosts depend on scale, realm and parasite group
Authors: Martins Paulo Mateus , Poulin Robert , Gonçalves-Souza Thiago
Published: September 2021

A robust understanding of what drives parasite β-diversity is an essential step towards explaining what limits pathogens' geographical spread. We used a novel global dataset (latitude −39.8 to 61.05 and longitude −117.84 to 151.49) on helminths of anurans to investigate how the relative roles of climate, host composition and spatial distance to parasite β-diversity vary with spatial scale (global, Nearctic and Neotropical), parasite group (nematodes and trematodes) and host taxonomic subset (family). We found that spatial distance is the most important driver of parasite β-diversity at the global scale. Additionally, we showed that the relative effects of climate concerning distance increase at the regional scale when compared with the global scale and that trematodes are generally more responsive to climate than nematodes. Unlike previous studies done at the regional scale, we did not find an effect of host composition on parasite β-diversity. Our study presents a new contribution to parasite macroecological theory, evidencing spatial and taxonomic contingencies of parasite β-diversity patterns, which are related to the zoogeographical realm and host taxonomic subset, respectively.

This article is part of the theme issue ‘Infectious disease macroecology: parasite diversity and dynamics across the globe’.
Paraburkholderia dioscoreae sp. nov., a novel plant associated growth promotor
Authors: Herpell Johannes B. , Vanwijnsberghe Sarah , Peeters Charlotte , Schindler Florian , Fragner Lena , Bejtović Mersad , Weckwerth Wolfram , Vandamme Peter
Published: September 2021

A novel bacterium, designated strain Msb3T, was recently isolated from leaves of the yam family plant Dioscorea bulbifera (Dioscoreaceae). Phylogenetic analysis based on the 16S rRNA gene sequence indicated that this strain belonged to the genus

Paraburkholderia

with

Paraburkholderia xenovorans

as nearest validly named neighbour taxon (99.3 % sequence similarity towards the

P. xenovorans

type strain). Earlier genome sequence analysis revealed a genome of 8.35 Mb in size with a G+C content of 62.5 mol%, which was distributed over two chromosomes and three plasmids. Here, we confirm that strain Msb3T represents a novel

Paraburkholderia

species. In silico DNA–DNA hybridization and average nucleotide identity (OrthoANIu) analyses towards

P. xenovorans

LB400T yielded 58.4 % dDDH and 94.5 % orthoANIu. Phenotypic and metabolic characterization revealed growth at 15 °C on tryptic soy agar, growth in the presence of 1 % NaCl and the lack of assimilation of phenylacetic acid as distinctive features. Together, these data demonstrate that strain Msb3T represents a novel species of the genus Paraburkholderia, for which we propose the name Paraburkholderia dioscoreae sp. nov. The type strain is Msb3T (=LMG 31881T, DSM 111632T, CECT 30342T).
Large herbivore impact on plant biomass along multiple resource gradients in the Serengeti
Authors: Mohanbabu Neha , Ritchie Mark E.
Published: September 2021

Herbivores form an important link in the transfer of energy within a food web and are strongly influenced by bottom-up trophic cascades. Current hypotheses suggest that herbivore consumption and impact on plants should scale positively with plant resource availability. However, depending on the effect of resources on plant quantity and quality, herbivore impact may vary with different types of resources. We test four alternative hypotheses for the relationship between plant biomass, herbivore impact on plant biomass, and plant resource gradients, each based on how resources might affect plant abundance and quality to herbivores. We measured plant biomass for four non-consecutive years in a long-term grazing exclosure experiment in the Serengeti National Park that includes seven sites that vary substantially in rainfall and soil and plant nitrogen (N) and phosphorus (P). Our data supported the hypothesis that herbivore impact is controlled by plant quality, in this case driven by plant P, as herbivore effects on biomass decreased with higher rainfall but increased with greater plant P, but not N content. To our knowledge, this is the first experimental study to indicate that wild mammalian herbivory is associated with P availability rather than N. Our results suggest that P, in addition to water and N, may play a more important role in driving trophic interactions in terrestrial systems than previously realized.
The evolutionary pathways for local adaptation in mountain hares
Authors: Giska Iwona , Pimenta João , Farelo Liliana , Boursot Pierre , Hackländer Klaus , Jenny Hannes , Reid Neil , Montgomery W. Ian , Prodöhl Paulo A. , Alves Paulo C. , Melo-Ferreira José
Published: September 2021

Understanding the evolution of local adaptations is a central aim of evolutionary biology and key for the identification of unique populations and lineages of conservation relevance. By combining RAD sequencing and whole-genome sequencing, we identify genetic signatures of local adaptation in mountain hares (Lepus timidus) from isolated and distinctive habitats of its wide distribution: Ireland, the Alps and Fennoscandia. Demographic modelling suggested that the split of these mountain hares occurred around 20 thousand years ago, providing the opportunity to study adaptive evolution over a short timescale. Using genome-wide scans, we identified signatures of extreme differentiation among hares from distinct geographic areas that overlap with area-specific selective sweeps, suggesting targets for local adaptation. Several identified candidate genes are associated with traits related to the uniqueness of the different environments inhabited by the three groups of mountain hares, including coat colour, ability to live at high altitudes and variation in body size. In Irish mountain hares, a variant ofASIP, a gene previously implicated in introgression-driven winter coat colour variation in mountain and snowshoe hares (L. americanus), may underlie brown winter coats, reinforcing the repeated nature of evolution atASIPmoulding adaptive seasonal colouration. Comparative genomic analyses across several hare species suggested that mountain hares’ adaptive variants appear predominantly species-specific. However, using coalescent simulations we also show instances where the candidate adaptive variants have been introduced via introgressive hybridization. Our work shows that standing adaptive variation, including that introgressed from other species, was a crucial component of the post-glacial dynamics of species.
Hybrid EEG-EMG system to detect steering actions in car driving settings
Authors: Vecchiato Giovanni , Del Vecchio Maria , Ambeck-Madsen Jonas , Ascari Luca , Avanzini Pietro
Published: September 2021

Understanding mental processes in complex human behaviour is a key issue in the context of driving, representing a milestone for developing user-centred assistive driving devices. Here we propose a hybrid method based on electroencephalographic (EEG) and electromyographic (EMG) signatures to distinguish left from right steering in driving scenarios. Twenty-four participants took part in the experiment consisting of recordings 128-channel EEG as well as EMG activity from deltoids and forearm extensors in non-ecological and ecological steering tasks. Specifically, we identified the EEG mu rhythm modulation correlates with motor preparation of self-paced steering actions in the non-ecological task, while the concurrent EMG activity of the left (right) deltoids correlates with right (left) steering. Consequently, we exploited the mu rhythm de-synchronization resulting from the non-ecological task to detect the steering side by means of a cross-correlation analysis with the ecological EMG signals. Results returned significant cross-correlation values showing the coupling between the non-ecological EEG feature and the muscular activity collected in ecological driving conditions. Moreover, such cross-correlation patterns discriminate left from right steering with an earlier dynamic with respect to the single EMG signal. This hybrid system overcomes the limitation of the EEG signals collected in ecological settings such as low reliability, accuracy and adaptability, thus adding to the EMG the characteristic predictive power of the cerebral data. These results are a proof of concept of how it is possible to complement different physiological signals to control the level of assistance needed by the driver.
RECIPROCALLY INHIBITORY CIRCUITS OPERATING WITH DISTINCT MECHANISMS ARE DIFFERENTLY ROBUST TO PERTURBATION AND MODULATION
Authors: Morozova Ekaterina O. , Newstein Peter , Marder Eve
Published: September 2021

What features are important for circuit robustness? Reciprocal inhibition is a building block in many circuits. We used dynamic clamp to create reciprocally inhibitory circuits from pharmacologically isolated neurons of the crab stomatogastric ganglion by injecting artificial synaptic (ISyn) and hyperpolarization-activated inward (IH) currents. There are two mechanisms of antiphase oscillations in these circuits: “escape” and “release”. In release, the active neuron primarily controls the off/on transitions. In escape, the inhibited neuron controls the transitions. We characterized the robustness of escape and release circuits to alterations in circuit parameters, temperature, and neuromodulation. We found that escape circuits rely on tight correlations between synaptic and H conductances to generate bursting but are resilient to temperature increase. Release circuits are robust to variations in synaptic and H conductances but fragile to temperature increase. The modulatory current (IMI) restores oscillations in release circuits but has little effect in escape circuits. Thus, the same perturbation can have dramatically different effects depending on the circuits’ mechanism of operation that may not be observable from basal circuit activity.
Deciphering PD1 activation mechanism from molecular docking and molecular dynamic simulations
Authors: Ponce Luis F. , Ramirez-Echemendia Daniel P. , Leon Kalet , Valiente Pedro A.
Published: September 2021

The activation of T cells is normally accompanied by inhibitory mechanisms within which the PD1 receptor stands out. Upon binding the ligands PDL1 and PDL2, PD1 drives T cells to an unresponsive state called exhaustion characterized by a markedly decreased capacity to exert effector functions. For this reason, PD1 has become one of the most important targets in cancer immunotherapy. Despite the numerous studies about PD1 signaling modulation, how the PD1 signaling is activated upon the ligands’ binding remains an open question. Several experimental facts suggest that the activation of the PD1-PLD1 pathway depends on the interaction with an unknown partner at the cellular membrane. In this work, we investigate the possibility that the target of PD1-PDL1 is the same PD1-PDL1 complex. We combined molecular docking to explore different binding modes with molecular dynamics and umbrella sampling simulations to assess the complexes’ stability. We found a high molecular weight complex that explains the activation of PD1 upon PDL1 binding. This complex has an affinity comparable to the PD1-PDL1 interaction and resembles the form of a linear lattice.
Sensorimotor feedback loops are selectively sensitive to reward
Authors: Codol Olivier , Kashefi Mehrdad , Forgaard Christopher J. , Galea Joseph M. , Pruszynski J. Andrew , Gribble Paul L.
Published: September 2021

Although it is well established that motivational factors such as earning more money for performing well improve motor performance, how the motor system implements this improvement remains unclear. For instance, feedback-based control, which uses sensory feedback from the body to correct for errors in movement, improves with greater reward. But feedback control encompasses many feedback loops with diverse characteristics such as the brain regions involved and their response time. Which specific loops drive these performance improvements with reward is unknown, even though their diversity makes it unlikely that they are contributing uniformly. We systematically tested the effect of reward on the latency (how long for a corrective response to arise?) and gain (how large is the corrective response?) of seven distinct sensorimotor feedback loops in humans. Only the fastest feedback loops were insensitive to reward, and the earliest reward-driven changes were consistently an increase in feedback gains, not a reduction in latency. Rather, a reduction of response latencies only tended to occur in slower feedback loops. These observations were similar across sensory modalities (vision and proprioception). Our results may have implications regarding feedback control performance in athletic coaching. For instance, coaching methodologies that rely on reinforcement or “reward shaping” may need to specifically target aspects of movement that rely on reward-sensitive feedback responses.
Behavioral prioritization enhances working memory precision and neural population gain
Authors: Yoo Aspen H. , Bolaños Alfredo , Hallenbeck Grace E. , Rahmati Masih , Sprague Thomas C. , Curtis Clayton E.
Published: September 2021

Humans allocate visual working memory (WM) resource according to behavioral relevance, resulting in more precise memories for more important items. Theoretically, items may be maintained by feature-tuned neural populations, where the relative gain of the populations encoding each item determines precision. To test this hypothesis, we compared the amplitudes of delay-period activity in the different parts of retinotopic maps representing each of several WM items, predicting amplitude would track with behavioral priority. Using fMRI, we scanned participants while they remembered the location of multiple items over a WM delay, then reported the location of one probed item using a memory-guided saccade. Importantly, items were not equally probable to be probed (0.6, 0.3, 0.1, 0.0), which was indicated with a pre-cue. We analyzed fMRI activity in ten visual field maps in occipital, parietal, and frontal cortex known to be important for visual WM. In early visual cortex, but not association cortex, the amplitude of BOLD activation within voxels corresponding to the retinotopic location of visual WM items increased with the priority of the item. Interestingly, these results were contrasted with a common finding that higher-level brain regions had greater delay-period activity, demonstrating a dissociation between the absolute amount of activity in a brain area, and the activity of different spatially-selective populations within it. These results suggest that the distribution of WM resources according to priority sculpts the relative gains of neural populations that encode items, offering a neural mechanism for how prioritization impacts memory precision.
Benchmarking statistical methods for analyzing parent-child dyads in genetic association studies
Authors: Ray Debashree , Vergara Candelaria , Taub Margaret A. , Wojcik Genevieve , Ladd-Acosta Christine , Beaty Terri H. , Duggal Priya
Published: September 2021

Genetic association studies of child health outcomes often employ family-based designs. One of the most popular family-based designs is the case-parent trio design that considers the smallest possible nuclear family consisting of two parents and their affected child. This trio design is particularly advantageous for studying relatively rare disorders because it is less prone to type 1 error inflation due to population stratification compared to population-based study designs (e.g., case-control studies). However, obtaining genetic data from both parents is difficult, from a practical perspective, and many large studies predominantly measure genetic variants in mother-child dyads. While some statistical methods for analyzing parent-child dyad data (most commonly involving mother-child pairs) exist, it is not clear if they provide the same advantage as trio methods in protecting against population stratification, or if a specific dyad design (e.g., case-mother dyads vs. case-mother/control-mother dyads) is more advantageous. In this article, we review existing statistical methods for analyzing genome-wide data on dyads and perform extensive simulation experiments to benchmark their type I errors and statistical power under different scenarios. We extend our evaluation to existing methods for analyzing a combination of case-parent trios and dyads together. We apply these methods on genotyped and imputed data from multi-ethnic mother-child pairs only, case-parent trios only or combinations of both dyads and trios from the Gene, Environment Association Studies consortium (GENEVA), where each family was ascertained through a child affected by nonsyndromic cleft lip with or without cleft palate. Results from the GENEVA study corroborate the findings from our simulation experiments. Finally, we provide recommendations for using statistical genetic association methods for dyads.