Consistent effect of eating rate on food and energy intake across twenty-four ad libitum meals.

Foods consumed at lower eating rates (ER) lead to reductions in energy intake. Previous research has shown that texture-based differences in eating rateER can reduce meal size. The effect size and consistency of these effects across a wide range of composite and complex meals differing considerably in texture and varying in meal occasion have not been reported. We determined how consistently texture-based differences in ER can influence food and energy intake across a wide variety of meals. In a crossover design, healthy participants consumed twelve breakfast and twelve lunch meals that differed in texture to produce a fast or slow ER. A breakfast group (n = 15) and lunch group (n = 15) completed twelve ad libitum meal sessions each (six 'fast' and six 'slow' meals), where intake was measured and behavioural video annotation was used to characterise eating behaviour. Liking did not differ significantly between fast and slow breakfasts (P = 0·44) or lunches (P = 0·76). The slow meals were consumed on average 39 % ± 9 % (breakfast) and 45 % ± 7 % (lunch) slower than the fast meals (both P < 0·001). Participants consumed on average 22 % ± 5 % less food (84 g) and 13 % ± 6 % less energy (71 kcal) from slow compared with fast meals (mean ± SE; P < 0·001). Consuming meals with a slower ER led to a reduction in food intake, where an average decrease of 20 % in ER produced an 11 % ± 1 % decrease in food intake (mean ± SE). These findings add to the growing body of evidence showing that ER can be manipulated using food texture and that this has aits consistent effect on food and energy intake across a wide variety of Hedonically equivalent meals.

Cracking the code: using educational gaming for high-level thinking in physiology education.

The multidisciplinary nature of physiology requires students to acquire, retain, apply, and evaluate knowledge from different scientific disciplines. Optimal learning techniques, such as active learning, interleaving topics and conditions, and recall, can greatly enhance the speed and effectiveness with which students achieve this type of higher-order thinking. However, developing and implementing optimal learning techniques in the classroom can be both time-intensive and challenging for the instructor. In addition, students may be resistant or slow to accept novel learning processes. One way to potentially introduce these learning techniques in a fun and engaging way is through educational gaming, or using a game or game elements intentionally to support learning. In this article we present an easy-to-implement adaptation of the Codenames board game for the physiology classroom. The activity requires minimal preparation while addressing high-level learning outcomes. Postintervention surveys of students were collected in three different health-related academic programs, both graduate and undergraduate, at two different institutions. Results suggest that participating in the activity both actively engaged the students and pushed them toward high-level, integrative thinking regardless of class level.NEW & NOTEWORTHY An easy-to-implement word game (Codenames) was used to engage students in higher-level Bloom's thinking about physiology. The gameplay required students to recall, apply, evaluate, and debate as they developed and guessed clues as part of the game. Students found the activity fun, engaging, and challenging. The activity is relatively easy to implement both online and in person, requiring at minimum a simple list of vocabulary terms.

ATQ: alert time quality, an evaluation metric for assessing timely epidemic detection models within a school absenteeism-based surveillance system.

BACKGROUND: Wellington-Dufferin-Guelph Public Health (WDGPH) has conducted an absenteeism-based influenza surveillance program in the WDG region of Ontario, Canada since 2008, using a 10% absenteeism threshold to raise an alert for the implementation of mitigating measures. A recent study indicated that model-based alternatives, such as distributed lag seasonal logistic regression models, provided improved alerts for detecting an upcoming epidemic. However model evaluation and selection was primarily based on alert accuracy, measured by the false alert rate (FAR), and failed to optimize timeliness. Here, a new metric that simultaneously evaluates epidemic alert accuracy and timeliness is proposed. The alert time quality (ATQ) metric is investigated as a model selection criterion on both a simulated and real data set. METHODS: The ATQ assessed alerts on a gradient, where alerts raised incrementally before or after an optimal day were considered informative, but were penalized for lack of timeliness. Summary statistics of ATQ, average alert time quality (AATQ) and first alert time quality (FATQ), were used for model evaluation and selection. Alerts raised by ATQ and FAR selected models were compared. Daily elementary school absenteeism and laboratory-confirmed influenza case data collected by WDGPH were used for demonstration and evaluation of the proposed metric. A simulation study that mimicked the WDG population and influenza demographics was conducted for further evaluation of the proposed metric. RESULTS: The FATQ-selected model raised acceptable first alerts most frequently, while the AATQ-selected model raised first alerts within the ideal range most frequently. CONCLUSIONS: Models selected by either FATQ or AATQ would more effectively predict community influenza activity with the local community than those selected by FAR.

Reducing loneliness in the community. More Together ('Flere i Fællesskaber')-a complex intervention in Denmark.

The mounting evidence that loneliness is a determinant of poor health and well-being underpins the need for effective interventions and community action. 'More Together' (MoTo) is a large-scale, complex, multi-component and multi-level intervention for community change that addresses loneliness among young people and older adults in Silkeborg Municipality, Denmark. The intervention is inspired by the Collective Impact framework, and it is practice driven and rooted in an extensive cross-sector partnership. This article outlines (i) the organization of the cross-sector partnership, (ii) the structure of the intervention programme, (iii) the key components and activities of the programme and, finally, (iv) the intervention setting and target population. MoTo aims to create new ways to develop, implement and evaluate loneliness interventions. Experiences gained from MoTo hold the potential to transform our understanding of loneliness interventions and may inform and guide future interventions.

Parents' age at birth and daughters' time to pregnancy: a study within the Norwegian Mother, Father and Child Cohort.

STUDY QUESTION: Is parents' age at birth associated with daughters' fecundability? SUMMARY ANSWER: Daughters born to mothers <25 years or fathers ≥35 years had slightly lower fecundability. WHAT IS KNOWN ALREADY: Two recent studies reported lower fecundability in women born to mothers <20 years, which may be partly due to daughters of young mothers being less likely to plan their pregnancies. STUDY DESIGN, SIZE, DURATION: A retrospective cohort study of 58 496 pregnancy planners (4290 of whom conceived with treatment) and 14 194 non-planners enrolled in the Norwegian Mother, Father and Child Cohort Study (MoBa) between 2000 and 2008, linked with the Medical Birth Registry of Norway. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were born in Norway between 1967 and 1990. We estimated fecundability ratios (FRs) and 95% CI as a function of both parents' (F1) age at the daughter's (F2) birth among non-treated planners and the relative risk of time to pregnancy (TTP) ≥12 months or treatment among all planners. We explored whether daughters of young mothers were under-represented among planners, compared with the underlying population. Finally, we estimated FRs after adding non-planners, randomly assigned to conceiving in the first cycle with probabilities of 0.60 and 0.70. MAIN RESULTS AND THE ROLE OF CHANCE: For both mother and father, the reference category was 25-29 years. Fecundability was slightly lower among daughters of older fathers (FRs (95% CI): 0.95 (0.92, 0.98) for F1 father's age 35-39 years and 0.93 (0.89, 0.97) for ≥40 years) and daughters of young mothers (0.92 (0.89, 0.96) for F1 mother's age <20 years and 0.97 (0.95, 0.99) for 20-24 years). Results were similar for the composite outcome TTP ≥ 12 months or treatment, although driven by TTP ≥ 12. Compared with Norwegian-born women with ≥1 pregnancy, planners born to mothers <20 years were underrepresented. Including non-planners with very high fecundability weakened the association with mother's age <20 years. LIMITATIONS, REASONS FOR CAUTION: This was a pregnancy cohort with retrospectively reported information on planning and TTP. Selection bias appears unlikely to fully explain the association with mother's age <20 years. WIDER IMPLICATIONS OF THE FINDINGS: Daughters of young mothers or older fathers may have slightly lower fecundability. If corroborated, the finding about older paternal age is relevant, given the widespread tendency to delay childbearing. STUDY FUNDING/COMPETING INTEREST(S): This work was partly funded by the Research Council of Norway (project no. 320656), and through its Centres of Excellence funding scheme (project no. 262700). M.C.M. has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement no. 947684). No competing interests. TRIAL REGISTRATION NUMBER: N/A.

The association between miscarriage and fecundability: the Norwegian Mother, Father and Child Cohort Study.

STUDY QUESTION: Is fecundability associated with miscarriage history and future miscarriage risk? SUMMARY ANSWER: Prior miscarriage was associated with lower fecundability, and participants with a history of subfertility (time-to-pregnancy (TTP) ≥12 months) were at a higher risk of subsequent miscarriage. WHAT IS KNOWN ALREADY: Although miscarriage and low fecundability share common risk factors, prior studies have reported both lower and higher fecundability after miscarriage. STUDY DESIGN, SIZE, DURATION: In this study, we examined two related associations: one, between miscarriage history and subsequent fecundability and, two, between fecundability and miscarriage risk in the subsequent pregnancy. The study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). In addition, the outcome of the pregnancy after the MoBa index pregnancy was obtained by linking information from three national health registries: the Medical Birth Registry of Norway, the Norwegian Patient Registry and the general practice database. PARTICIPANTS/MATERIALS, SETTING, METHODS: We examined the association between number of prior miscarriages and fecundability in 48 537 naturally conceived, planned pregnancies in participants with at least one prior pregnancy. We estimated fecundability ratios (FRs) and 95% CIs using proportional probability regression. We further estimated the relative risk (RR) of miscarriage in the subsequent pregnancy as a function of TTP in the MoBa index pregnancy for 7889 pregnancies using log-binomial regression. Multivariable analyses adjusted for maternal age, pre-pregnancy maternal BMI, smoking status, cycle regularity, income level and highest completed or ongoing education. MAIN RESULTS AND THE ROLE OF CHANCE: Fecundability decreased as the number of prior miscarriages increased. The adjusted FRs among women with one, two and three or more prior miscarriages were 0.83 (95% CI: 0.80-0.85), 0.79 (95% CI: 0.74-0.83) and 0.74 (95% CI: 0.67-0.82), respectively, compared with women with no prior miscarriages. Compared to women with a TTP of <3 months, the adjusted RR of miscarriage in the subsequent pregnancy was 1.16 (0.99-1.35) with TTP of 3-6 months, 1.18 (0.93-1.49) with TTP of 7-11 months and 1.43 (1.13-1.81) with TTP of 12 or more months. LIMITATIONS, REASONS FOR CAUTION: Information on TTP and prior miscarriages was obtained retrospectively, and TTP was self-reported. MoBa is a pregnancy cohort, and findings may not be generalizable to all women. We were unable to examine the effect of changing partners between pregnancies, as well as other paternal factors such as seminal parameters. We also did not know what proportion of our participants had changed partners between their prior pregnancies and the index pregnancy. Furthermore, it is likely that many early miscarriages are not recognized. WIDER IMPLICATIONS OF THE FINDINGS: The association between miscarriage and fecundability may reflect a contribution of occult pregnancy losses to TTP, as well as shared underlying causes for reduced fecundability and miscarriage. STUDY FUNDING/COMPETING INTEREST(S): The study was funded by the Research Council of Norway through its Medical Student Research Program funding scheme (project number 271555/F20), its Centres of Excellence funding scheme (project number 262700) and through the project 'Women's fertility - an essential component of health and well-being' (project number 320656). M.C.M. has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement number 947684). A.J.W. is supported by the Intramural Program of the National Institute of Environmental Health Sciences at the National Institutes of Health, USA. The authors report no competing interests. TRIAL REGISTRATION NUMBER: N/A.

Benthic studies adjacent to Sakhalin Island, Russia, 2015 I: benthic biomass and community structure in the nearshore gray whale feeding area.

Okhotsk or western gray whales feed in summer along the northeastern coast of Sakhalin Island, Russia, a region with oil and gas extraction facilities. Seismic surveys increased sound levels in the nearshore feeding area in 2015 for part of the summer, potentially displacing whales from preferred foraging habitat or reducing foraging efficiency. Since lost foraging opportunities might lead to vital rate effects on this endangered species, detailed benthic surveys were conducted to characterize benthic community biomass patterns and spatial and temporal differences. Benthic biomass demonstrated strong spatial-temporal interactions indicating that prey biomass differences among locations were dependent on sampling period. Of greatest interest, Amphipoda biomass declined from June to October in the northern and southern portions of the nearshore study area but increased in the middle and Actinopterygii biomass increased in the northern area in mid-summer. Water depth and sediment type were significant covariates with community structure, and water depth strongly covaried with bivalve biomass. Total average prey biomass was ~ 100 g/m2 within the nearshore feeding area with no evidence of reduced biomass among sampling periods or locations, although there were fewer amphipods in the south. Multi-prey investigations provide a stronger basis for inferences than single-prey studies of amphipods when gray whales feed on diverse prey. Benthic community-level variability was moderate to high as would be expected for a shallow-water nearshore area. Overall, spatial and temporal changes in dominant macrofauna biomass reflected small to medium-sized effects that were well within the natural boundaries expected for benthic communities.

Quads or quins? Atraumatic restricted knee flexion due to accessory quadriceps bands in children.

BACKGROUND: Recent anatomical investigations have emphasized the variability in the knee extensor apparatus, with particular attention to a fifth component of the quadriceps femoris termed the tensor vastus intermedius or accessory "quinticeps femoris." Disorders of this structure have not been described in the pediatric imaging literature. OBJECTIVE: To review the clinical features, pathoanatomy and imaging findings of children presenting with derangement of the accessory quadriceps femoris, with a particular emphasis on the utility of early magnetic resonance imaging (MRI) of the thigh. MATERIALS AND METHODS: This is a retrospective analysis of 3 children, ages 3-10 years at presentation, who underwent imaging evaluation with subsequent surgically proven accessory quadriceps femoris muscles. Their clinical histories, including duration of symptoms, MRI findings, intervention and surgical outcomes, are reported. RESULTS: All patients presented with progressive unilateral restricted knee flexion and had multiple imaging studies targeting the knee before diagnosis. Diagnosis in all patients was made on MRI of the thighs, which demonstrated a fusiform low signal intensity structure with muscle-like architecture arising from the anterior or anterolateral proximal femur and blending with the common quadriceps tendon distally. All patients underwent surgical release of the anomalous band with significant functional improvement. CONCLUSION: In cases of progressive limited knee flexion without intrinsic pathology, an accessory quadriceps muscle should be considered as an extrinsic cause. Our experience demonstrated this to be readily identifiable on MRI, with symptomatic improvement following surgical release. Early recognition of this condition should prevent unnecessary intervention such as knee arthroscopy and the debilitating loss of flexion due to delayed diagnosis.

Tele-Echocardiography for Congenital Heart Disease Screening in a Level II Neonatal Intensive Care Unit with Hybrid Telemedicine System.

Introduction: The nationwide shortage of pediatric cardiologists in medically underserved areas poses a challenge to congenital heart disease (CHD) screening requiring echocardiography, resulting in transfer of neonates to regional Level III/IV Neonatal Intensive Care Units (NICUs). This study aimed to evaluate the accuracy, safety, and cost-effectiveness of tele-echocardiography for advanced CHD screening at a Level II NICU managed by a hybrid telemedicine system. Methods: Retrospective chart review of infants requiring tele-echocardiography at a Level II NICU. Patient demographics, echocardiography indications, and findings were analyzed. Agreement between tele-echocardiography and conventional echocardiography findings was assessed. Transport cost savings were calculated based on preventable transfers to Level IV NICU. Descriptive statistics were computed for demographic and clinical variables. Results: Over 5 years, 52 infants were screened for CHD. Thirty-two infants (62%) had findings consistent with minor CHD or normal neonatal transitional physiology. Twenty infants (38%) had abnormal findings requiring follow-up with either a conventional echocardiography as inpatient at the regional Level IV NICU or as outpatient after discharge. Only 5 infants (10%) required transfer to a Level IV NICU for CHD management, whereas 15 infants (29%) were scheduled for outpatient follow-up. Strong agreement was noted between tele-echocardiography and conventional echocardiography findings. No case of critical congenital heart disease (CCHD) was missed. Tele-echocardiography saved $260,000 in transport costs. Conclusions: Tele-echocardiography can be accurate, safe, and effective in CHD screening, preventing unnecessary transfer of most infants to regional Level III/IV NICUs, saving transfer costs.

Investigating the current knowledge and needs concerning a follow-up for long-term cardiovascular risks in Dutch women with a preeclampsia history: a qualitative study.

BACKGROUND: There is increasing evidence that a history of preeclampsia is an important risk factor for future cardiovascular events. Awareness of this risk could provide opportunities for identification of women at risk, with opportunities for prevention and / or early intervention. A standardized follow-up has not yet been implemented in the north of the Netherlands. The objective of this qualitative study was to explore the opinions and wishes among women and physicians about the follow-up for women with a history of preeclampsia. METHODS: Semi-structured interviews with 15 women and 14 physicians (5 obstetricians, 4 general practitioners, 3 vascular medicine specialists and 2 cardiologists) were performed and addressed topics about knowledge on CVR, current - and future follow-up. Women were approached through the HELLP foundation and their physicians. Physicians were approached by email. The interviews were recorded, typed and coded using ATLAS.ti software. A theoretical-driven thematic analysis was performed. RESULTS: Women had some knowledge about the association between preeclampsia and the increased CVR, but missed information from their health care providers. Specialists were aware of the association, but the information and advice they provided to their patients was minimal and inconsistent according to themselves. Whereas some general practitioners regarded their own knowledge as limited. There was a clear desire among women for a more extensive follow-up with specific attention to both emotional and physical consequences of preeclampsia. Physicians indicated that they preferred to see a follow up program concerning the CVR at the general practitioner as part of the already existent cardiovascular risk management (CVRM) program. CONCLUSION: Women and medical specialists consider it important to improve aftercare for women after a pregnancy complicated by preeclampsia. Introducing these women into the CVRM program at the general practitioner is regarded as a preferred first step. Further research is warranted to establish an evidence-based guideline for the follow-up of these women.

Examining the factors related to bacteriological testing of private wells in Southern Ontario.

The incidence of infectious waterborne disease in Canada continues to be a public health issue and can be associated with the source of drinking water. Millions of Canadians relying on unregulated private well water are at increased risk of disease. This study examined relationships between well and owner characteristics and the frequency of microbial testing of private wells in two southern-Ontario counties. Using multi-level logistic regression models, testing frequency (i.e., at least once per year vs. less) was modeled, as both self-reported and laboratory-validated, for associations with owner and well characteristics. For the self-reported outcome, a previous adverse test result significantly increased the odds of being classified as a frequent tester, and owners with a well-head more than 16 inches (40.6 cm) above the ground were at significantly higher odds of being classified as frequent testers compared to those with well-heads less than 16 inches above the ground and those below ground level. For the model based on the laboratory-validated outcome, the odds of an owner being a frequent tester significantly varied with the length of occupancy and the occurrence of a previous adverse result. The absence of associations between other well characteristics and testing frequency suggests that well safety education could benefit these communities.

Methods for detecting seasonal influenza epidemics using a school absenteeism surveillance system.

BACKGROUND: School absenteeism data have been collected daily by the public health unit in Wellington-Dufferin-Guelph, Ontario since 2008. To date, a threshold-based approach has been implemented to raise alerts for community-wide and within-school illness outbreaks. We investigate several statistical modelling approaches to using school absenteeism for influenza surveillance at the regional level, and compare their performances using two metrics. METHODS: Daily absenteeism percentages from elementary and secondary schools, and report dates for influenza cases, were obtained from Wellington-Dufferin-Guelph Public Health. Several absenteeism data aggregations were explored, including using the average across all schools or only using schools of one type. A 10% absence threshold, exponentially weighted moving average model, logistic regression with and without seasonality terms, day of week indicators, and random intercepts for school year, and generalized estimating equations were used as epidemic detection methods for seasonal influenza. In the regression models, absenteeism data with various lags were used as predictor variables, and missing values in the datasets used for parameter estimation were handled either by deletion or linear interpolation. The epidemic detection methods were compared using a false alarm rate (FAR) as well as a metric for alarm timeliness. RESULTS: All model-based epidemic detection methods were found to decrease the FAR when compared to the 10% absence threshold. Regression models outperformed the exponentially weighted moving average model and including seasonality terms and a random intercept for school year generally resulted in fewer false alarms. The best-performing model, a seasonal logistic regression model with random intercept for school year and a day of week indicator where parameters were estimated using absenteeism data that had missing values linearly interpolated, produced a FAR of 0.299, compared to the pre-existing threshold method which at best gave a FAR of 0.827. CONCLUSIONS: School absenteeism can be a useful tool for alerting public health to upcoming influenza epidemics in Wellington-Dufferin-Guelph. Logistic regression with seasonality terms and a random intercept for school year was effective at maximizing true alarms while minimizing false alarms on historical data from this region.

Rebound Deformity After Growth Modulation in Patients With Coronal Plane Angular Deformities About the Knee: Who Gets It and How Much?

BACKGROUND: With observed success and increased popularity of growth modulation techniques, there has been a trend toward use in progressively younger patients. Younger age at growth modulation increases the likelihood of complete deformity correction and need for implant removal before skeletal maturity introducing the risk of rebound deformity. The purpose of this study was to quantify magnitude and identify risk factors for rebound deformity after growth modulation. METHODS: We performed a retrospective review of all patients undergoing growth modulation with a tension band plate for coronal plane deformity about the knee with subsequent implant removal. Exclusion criteria included completion epiphysiodesis or osteotomy at implant removal, ongoing growth modulation, and <1 year radiographic follow-up without rebound deformity. Mechanical lateral distal femoral angle, mechanical medial proximal tibial angle, hip-knee-ankle angle (HKA), and mechanical axis station were measured before growth modulation, before implant removal, and at final follow-up. RESULTS: In total, 67 limbs in 45 patients met the inclusion criteria. Mean age at growth modulation was 9.8 years (range, 3.4 to 15.4 y) and mean age at implant removal was 11.4 years (range, 5.3 to 16.4 y). Mean change in HKA after implant removal was 6.9 degrees (range, 0 to 23 degrees). In total, 52% of patients had >5 degrees rebound and 30% had >10 degrees rebound in HKA after implant removal. Females below 10 years and males below 12 years at time of growth modulation had greater mean change in HKA after implant removal compared with older patients (8.4 vs. 4.7 degrees, P=0.012). Patients with initial deformity >20 degrees had an increased frequency of rebound >10 degrees compared with patients with less severe initial deformity (78% vs. 22%, P=0.002). CONCLUSIONS: Rebound deformity after growth modulation is common. Growth modulation at a young age and large initial deformity increases risk of rebound. However, rebound does not occur in all at risk patients, therefore, we recommend against routine overcorrection. LEVEL OF EVIDENCE: Level IV-retrospective study.

Cortico-Cortical Interactions during Acquisition and Use of a Neuroprosthetic Skill.

A motor cortex-based brain-computer interface (BCI) creates a novel real world output directly from cortical activity. Use of a BCI has been demonstrated to be a learned skill that involves recruitment of neural populations that are directly linked to BCI control as well as those that are not. The nature of interactions between these populations, however, remains largely unknown. Here, we employed a data-driven approach to assess the interaction between both local and remote cortical areas during the use of an electrocorticographic BCI, a method which allows direct sampling of cortical surface potentials. Comparing the area controlling the BCI with remote areas, we evaluated relationships between the amplitude envelopes of band limited powers as well as non-linear phase-phase interactions. We found amplitude-amplitude interactions in the high gamma (HG, 70-150 Hz) range that were primarily located in the posterior portion of the frontal lobe, near the controlling site, and non-linear phase-phase interactions involving multiple frequencies (cross-frequency coupling between 8-11 Hz and 70-90 Hz) taking place over larger cortical distances. Further, strength of the amplitude-amplitude interactions decreased with time, whereas the phase-phase interactions did not. These findings suggest multiple modes of cortical communication taking place during BCI use that are specialized for function and depend on interaction distance.

PROSPECTIVE COMPARISON OF TUMOR STAGING USING COMPUTED TOMOGRAPHY VERSUS MAGNETIC RESONANCE IMAGING FINDINGS IN DOGS WITH NASAL NEOPLASIA: A PILOT STUDY.

Identification of nasal neoplasia extension and tumor staging in dogs is most commonly performed using computed tomography (CT), however magnetic resonance imaging (MRI) is routinely used in human medicine. A prospective pilot study enrolling six dogs with nasal neoplasia was performed with CT and MRI studies acquired under the same anesthetic episode. Interobserver comparison and comparison between the two imaging modalities with regard to bidimensional measurements of the nasal tumors, tumor staging using historical schemes, and assignment of an ordinal scale of tumor margin clarity at the tumor-soft tissue interface were performed. The hypotheses included that MRI would have greater tumor measurements, result in higher tumor staging, and more clearly define the tumor soft tissue interface when compared to CT. Evaluation of bone involvement of the nasal cavity and head showed a high level of agreement between CT and MRI. Estimation of tumor volume using bidimensional measurements was higher on MRI imaging in 5/6 dogs, and resulted in a median tumor volume which was 18.4% higher than CT imaging. Disagreement between CT and MRI was noted with meningeal enhancement, in which two dogs were positive for meningeal enhancement on MRI and negative on CT. One of six dogs had a higher tumor stage on MRI compared to CT, while the remaining five agreed. Magnetic resonance imaging resulted in larger bidimensional measurements and tumor volume estimates, along with a higher likelihood of identifying meningeal enhancement when compared to CT imaging. Magnetic resonance imaging may provide integral information for tumor staging, prognosis, and treatment planning.

Distributed cortical adaptation during learning of a brain-computer interface task.

The majority of subjects who attempt to learn control of a brain-computer interface (BCI) can do so with adequate training. Much like when one learns to type or ride a bicycle, BCI users report transitioning from a deliberate, cognitively focused mindset to near automatic control as training progresses. What are the neural correlates of this process of BCI skill acquisition? Seven subjects were implanted with electrocorticography (ECoG) electrodes and had multiple opportunities to practice a 1D BCI task. As subjects became proficient, strong initial task-related activation was followed by lessening of activation in prefrontal cortex, premotor cortex, and posterior parietal cortex, areas that have previously been implicated in the cognitive phase of motor sequence learning and abstract task learning. These results demonstrate that, although the use of a BCI only requires modulation of a local population of neurons, a distributed network of cortical areas is involved in the acquisition of BCI proficiency.

Sleep spindles are locally modulated by training on a brain-computer interface.

The learning of a motor task is known to be improved by sleep, and sleep spindles are thought to facilitate this learning by enabling synaptic plasticity. In this study subjects implanted with electrocorticography (ECoG) arrays for long-term epilepsy monitoring were trained to control a cursor on a computer screen by modulating either the high-gamma or mu/beta power at a single electrode located over the motor or premotor area. In all trained subjects, spindle density in posttraining sleep was increased with respect to pretraining sleep in a remarkably spatially specific manner. The pattern of increased spindle activity reflects the functionally specific regions that were involved in learning of a highly novel and salient task during wakefulness, supporting the idea that sleep spindles are involved in learning to use a motor-based brain-computer interface device.

[Acute vulvar pain after covid-19]. / Acute vulvaire pijn na covid-19.

This case describes a 36-year-old woman who presents with acute painful ulcers of the vulva four days after a covid-19 infection. Extensive additional examination ruled out sexually transmitted diseases and auto-immune diseases, leaving acute vulvar ulcers, triggered by a covid-19 infection, as likely diagnosis. The ulcers healed spontaneously without scarring.

All-hazards dataset mined from the US National Incident Management System 1999-2020.

This paper describes a dataset mined from the public archive (1999-2020) of the US National Incident Management System Incident Status Summary (ICS-209) forms (a total of 187,160 reports for 35,170 incidents, including 34,478 wildland fires). This system captures detailed daily/regular information on incident development and response, including social and economic impacts. Most (98.4%) reports are wildland fire-related, with other incident types including hurricane, hazardous materials, flood, tornado, search and rescue, civil unrest, and winter storms. The archive, although publicly available, has been difficult to use for research due to multiple record formats, inconsistent data entry, and no clean pathway from individual reports to high-level incident analysis. Here, we describe the open-source, reproducible methods used to produce a science-grade version of the data, including formal connections made to other published wildland fire data products. Among other applications, this integrated and spatially augmented dataset enables exploration of the daily progression of the most costly, damaging, and deadly environmental-hazard events in recent US history.

Shifting social-ecological fire regimes explain increasing structure loss from Western wildfires.

Structure loss is an acute, costly impact of the wildfire crisis in the western conterminous United States ("West"), motivating the need to understand recent trends and causes. We document a 246% rise in West-wide structure loss from wildfires between 1999-2009 and 2010-2020, driven strongly by events in 2017, 2018, and 2020. Increased structure loss was not due to increased area burned alone. Wildfires became significantly more destructive, with a 160% higher structure-loss rate (loss/kha burned) over the past decade. Structure loss was driven primarily by wildfires from unplanned human-related ignitions (e.g. backyard burning, power lines, etc.), which accounted for 76% of all structure loss and resulted in 10 times more structures destroyed per unit area burned compared with lightning-ignited fires. Annual structure loss was well explained by area burned from human-related ignitions, while decadal structure loss was explained by state-level structure abundance in flammable vegetation. Both predictors increased over recent decades and likely interacted with increased fuel aridity to drive structure-loss trends. While states are diverse in patterns and trends, nearly all experienced more burning from human-related ignitions and/or higher structure-loss rates, particularly California, Washington, and Oregon. Our findings highlight how fire regimes-characteristics of fire over space and time-are fundamentally social-ecological phenomena. By resolving the diversity of Western fire regimes, our work informs regionally appropriate mitigation and adaptation strategies. With millions of structures with high fire risk, reducing human-related ignitions and rethinking how we build are critical for preventing future wildfire disasters.