Healthcare utilization and clinical characteristics of genetic epilepsy in electronic health records.

Understanding the clinical characteristics and medical treatment of individuals affected by genetic epilepsies is instrumental in guiding selection for genetic testing, defining the phenotype range of these rare disorders, optimizing patient care pathways and pinpointing unaddressed medical need by quantifying healthcare resource utilization. To date, a matched longitudinal cohort study encompassing the entire spectrum of clinical characteristics and medical treatment from childhood through adolescence has not been performed. We identified individuals with genetic and non-genetic epilepsies and onset at ages 0-5 years by linkage across the Cleveland Clinic Health System. We used natural language processing to extract medical terms and procedures from longitudinal electronic health records and tested for cross-sectional and temporal associations with genetic epilepsy. We implemented a two-stage design: in the discovery cohort, individuals were stratified as being 'likely genetic' or 'non-genetic' by a natural language processing algorithm, and controls did not receive genetic testing. The validation cohort consisted of cases with genetic epilepsy confirmed by manual chart review and an independent set of controls who received negative genetic testing. The discovery and validation cohorts consisted of 503 and 344 individuals with genetic epilepsy and matched controls, respectively. The median age at the first encounter was 0.1 years and 7.9 years at the last encounter, and the mean duration of follow-up was 8.2 years. We extracted 188,295 Unified Medical Language System annotations for statistical analysis across 9659 encounters. Individuals with genetic epilepsy received an earlier epilepsy diagnosis and had more frequent and complex encounters with the healthcare system. Notably, the highest enrichment of encounters compared with the non-genetic groups was found during the transition from paediatric to adult care. Our computational approach could validate established comorbidities of genetic epilepsies, such as behavioural abnormality and intellectual disability. We also revealed novel associations for genitourinary abnormalities (odds ratio 1.91, 95% confidence interval: 1.66-2.20, P = 6.16 × 10-19) linked to a spectrum of underrecognized epilepsy-associated genetic disorders. This case-control study leveraged real-world data to identify novel features associated with the likelihood of a genetic aetiology and quantified the healthcare utilization of genetic epilepsies compared with matched controls. Our results strongly recommend early genetic testing to stratify individuals into specialized care paths, thus improving the clinical management of people with genetic epilepsies.

Long-term exclusion of invasive ungulates alters tree recruitment and functional traits but not total forest carbon.

Forests are major carbon (C) sinks, but their ability to sequester C and thus mitigate climate change, varies with the environment, disturbance regime, and biotic interactions. Herbivory by invasive, nonnative ungulates can have profound ecosystem effects, yet its consequences for forest C stocks remain poorly understood. We determined the impact of invasive ungulates on C pools, both above- and belowground (to 30 cm), and on forest structure and diversity using 26 paired long-term (>20 years) ungulate exclosures and adjacent unfenced control plots located in native temperate rainforests across New Zealand, spanning 36-41° S. Total ecosystem C was similar between ungulate exclosure (299.93 ± 25.94 Mg C ha-1 ) and unfenced control (324.60 ± 38.39 Mg C ha-1 ) plots. Most (60%) variation in total ecosystem C was explained by the biomass of the largest tree (mean diameter at breast height [dbh]: 88 cm) within each plot. Ungulate exclusion increased the abundance and diversity of saplings and small trees (dbh ≥2.5, <10 cm) compared with unfenced controls, but these accounted for ~5% of total ecosystem C, demonstrating that a few, large trees dominate the total forest ecosystem C but are unaffected by invasive ungulates at a timescale of 20-50 years. However, changes in understory C pools, species composition, and functional diversity did occur following long-term ungulate exclusion. Our findings suggest that, although the removal of invasive herbivores may not affect total forest C at the decadal scale, major shifts in the diversity and composition of regenerating species will have longer term consequences for ecosystem processes and forest C.

Contrasting responses of soil nematode communities to native and non-native woody plant expansion.

Woody plant expansion into grasslands is widespread, driven by both successions to dominance by native woody species or invasion by non-native woody species. These shifts from grass- to woody-dominated systems also have profound effects on both above- and belowground communities and ecosystem processes. Woody-plant expansion should also alter the functional composition of the soil biota, including that of nematodes, which are major drivers of soil food-web structure and belowground processes, but such belowground impacts are poorly understood. We determined whether succession by a widespread native (Kunzea ericoides) and invasion by a non-native woody species (Pinus nigra) into tussock grasslands affect the composition of nematode functional guilds and the structure of nematode-based food webs. Although increasing dominance by woody species in both systems altered the functional guild composition of the nematode community, we found contrasting responses of nematode functional guilds to the different dominant plant species. Specifically, nematode communities reflected conditions of resource enrichment with increasing K. ericoides tree cover, whereas communities became structurally simplified and dominated by stress-tolerant nematode families with increasing P. nigra tree cover. Because nematodes regulate both bacterial- and fungal-dominated food webs in soils, these shifts could in turn alter multiple ecosystem processes belowground such as nutrient cycling. Incorporating species' functional traits into the assessment of habitat-change impacts on communities can greatly improve our understanding of species responses to environmental changes and their consequences in ecosystems.

Burrowing seabird effects on invertebrate communities in soil and litter are dominated by ecosystem engineering rather than nutrient addition.

Vertebrate consumers can be important drivers of the structure and functioning of ecosystems, including the soil and litter invertebrate communities that drive many ecosystem processes. Burrowing seabirds, as prevalent vertebrate consumers, have the potential to impact consumptive effects via adding marine nutrients to soil (i.e. resource subsidies) and non-consumptive effects via soil disturbance associated with excavating burrows (i.e. ecosystem engineering). However, the exact mechanisms by which they influence invertebrates are poorly understood. We examined how soil chemistry and plant and invertebrate communities changed across a gradient of seabird burrow density on two islands in northern New Zealand. Increasing seabird burrow density was associated with increased soil nutrient availability and changes in plant community structure and the abundance of nearly all the measured invertebrate groups. Increasing seabird densities had a negative effect on invertebrates that were strongly influenced by soil-surface litter, a positive effect on fungal-feeding invertebrates, and variable effects on invertebrate groups with diverse feeding strategies. Gastropoda and Araneae species richness and composition were also influenced by seabird activity. Generalized multilevel path analysis revealed that invertebrate responses were strongly driven by seabird engineering effects, via increased soil disturbance, reduced soil-surface litter, and changes in trophic interactions. Almost no significant effects of resource subsidies were detected. Our results show that seabirds, and in particular their non-consumptive effects, were significant drivers of invertebrate food web structure. Reductions in seabird populations, due to predation and human activity, may therefore have far-reaching consequences for the functioning of these ecosystems.

Belowground legacies of Pinus contorta invasion and removal result in multiple mechanisms of invasional meltdown.

Plant invasions can change soil biota and nutrients in ways that drive subsequent plant communities, particularly when co-invading with belowground mutualists such as ectomycorrhizal fungi. These effects can persist following removal of the invasive plant and, combined with effects of removal per se, influence subsequent plant communities and ecosystem functioning. We used field observations and a soil bioassay with multiple plant species to determine the belowground effects and post-removal legacy caused by invasion of the non-native tree Pinus contorta into a native plant community. Pinus facilitated ectomycorrhizal infection of the co-occurring invasive tree, Pseudotsuga menziesii, but not conspecific Pinus (which always had ectomycorrhizas) nor the native pioneer Kunzea ericoides (which never had ectomycorrhizas). Pinus also caused a major shift in soil nutrient cycling as indicated by increased bacterial dominance, NO3-N (17-fold increase) and available phosphorus (3.2-fold increase) in soils, which in turn promoted increased growth of graminoids. These results parallel field observations, where Pinus removal is associated with invasion by non-native grasses and herbs, and suggest that legacies of Pinus on soil nutrient cycling thus indirectly promote invasion of other non-native plant species. Our findings demonstrate that multi-trophic belowground legacies are an important but hitherto largely unconsidered factor in plant community reassembly following invasive plant removal.

Organic nutrient uptake by mycorrhizal fungi enhances ecosystem carbon storage: a model-based assessment.

Understanding the factors that drive soil carbon (C) accumulation is of fundamental importance given their potential to mitigate climate change. Much research has focused on the relationship between plant traits and C sequestration, but no studies to date have quantitatively considered traits of their mycorrhizal symbionts. Here, we use a modelling approach to assess the contribution of an important mycorrhizal fungal trait, organic nutrient uptake, to soil C accumulation. We show that organic nutrient uptake can significantly increase soil C storage, and that it has a greater effect under nutrient-limited conditions. The main mechanism behind this was an increase in plant C fixation and subsequent increased C inputs to soil through mycorrhizal fungi. Reduced decomposition due to increased nutrient limitation of saprotrophs also played a role. Our results indicate that direct uptake of nutrients from organic pools by mycorrhizal fungi could have a significant effect on ecosystem C cycling and storage.

Are soil mite assemblages structured by the identity of native and invasive alien grasses?

Associations between plants and animals in aboveground communities are often predictable and specific. This has been exploited for the purposes of estimating the diversity of animal species based on the diversity of plant species. The introduction of invasive alien plants into an ecosystem can result in dramatic changes in both the native plant and animal assemblages. Few data exist at the species level to determine whether belowground animal assemblages share the same degree of association to plants. The hypotheses that soil mites (Acari) form assemblages specifically associated with different native grass species in an unmanipulated natural ecosystem and that invasive alien grasses will impact soil mite assemblage composition in this setting were tested. Soil mites sampled beneath five native and two invasive alien species of grasses at the Konza Prairie Biological Station, Kansas, USA, were similarly abundant, species rich, diverse, and taxonomically distinct. No mite species had affinities for a specific grass species. There was no evidence from analysis of similarity, canonical correspondence analysis, or a nonparametric assemblage analysis that the assemblage composition of soil mites was specific to grass species. Results suggest that soil mite assemblages were more related to characteristics of the plant assemblage as a whole or prevailing soil conditions. The most recent invasive alien grass did not support a successionally younger mite fauna, based on the ratio of mesostigmatid to oribatid mites, and neither of the two invasive grasses influenced mite assemblage structure, possibly because they had not yet substantially altered the soil environment. Our results suggest that extrapolations of soil mite diversity based on assumptions of plant specificity would be invalid.

Does plant species co-occurrence influence soil mite diversity?

Few studies have considered whether plant taxa can be used as predictors of belowground faunal diversity in natural ecosystems. We examined soil mite (Acari) diversity beneath six grass species at the Konza Prairie Biological Station, Kansas, USA. We tested the hypotheses that soil mite species richness, abundance, and taxonomic diversity are greater (1) beneath grasses in dicultures (different species) compared to monocultures (same species), (2) beneath grasses of higher resource quality (lower C:N) compared to lower resource quality, and (3) beneath heterogeneous mixes of grasses (C3 and C4 grasses growing together) compared to homogeneous mixes (C3 or C4 grasses) using natural occurrences of plant species as treatments. This study is the first to examine the interaction between above- and belowground diversity in a natural setting with species-level resolution of a hyper-diverse taxon. Our results indicate that grasses in diculture supported a more species and phylogenetically rich soil mite fauna than was observed for monocultures and that this relationship was significant at depth but not in the upper soil horizon. We noted that mite species richness was not linearly related to grass species richness, which suggests that simple extrapolations of soil faunal diversity based on plant species inventories may underestimate the richness of associated soil mite communities. The distribution of mite size classes in dicultures was considerably different than those for monocultures. There was no difference in soil mite richness between grass combinations of differing resource quality, or resource heterogeneity.

Heuristic automation for decluttering tactical displays.

Tactical displays can quickly become cluttered with large numbers of symbols that can compromise effective monitoring. Here, we studied how heuristic automation can aid users by intelligently "decluttering" the display. In a realistic simulated naval air defense task, 27 experienced U.S. Navy users monitored a cluttered airspace and executed defensive responses against significant threats. An algorithm continuously evaluated aircraft for their levels of threat and decluttered the less threatening ones by dimming their symbols. Users appropriately distrusted and spot-checked the automation's assessments, and decluttering had very little effect on which aircraft were judged as significantly threatening. Nonetheless, decluttering improved the timeliness of responses to threatening aircraft by 25% as compared with a baseline display with no decluttering; it was especially beneficial for threats in more peripheral locations, and 25 of 27 participants preferred decluttering. Heuristic automation, when properly designed to guide users' attention by decluttering less important objects, may prove valuable in many cluttered monitoring situations, including air traffic management, crisis team management, and tactical situation awareness in general.