Eliminating first trimester combined testing: Consequences for early detection of significant fetal anomalies.

OBJECTIVE: To determine whether implementation of cell-free DNA (cfDNA) testing for aneuploidy as a first-tier test and subsequent abolition of first trimester combined testing (FCT) affected the first trimester detection (<14 weeks) of certain fetal anomalies. METHODS: We performed a geographical cohort study in two Fetal Medicine Units between 2011 and 2020, including 705 fetuses with prenatally detected severe brain, abdominal wall and congenital heart defects. Cases were divided into two groups: before (n = 396) and after (n = 309) cfDNA introduction. The primary outcome was the first trimester detection rate (<14 weeks) overall and for non-chromosomal anomalies solely. RESULTS: Overall, gastroschisis, AVSD and HLHS were detected more often in the first trimester in the before group compared to the after group, respectively 54.5% versus 18.5% (p = 0.004), 45.9% versus 26.9% (p = 0.008) and 30% versus 3.4% (p = 0.005). After exclusion of chromosomal anomalies identifiable through cfDNA testing, the detection of AVSD remained higher in the before group (43.3% vs. 9.5%, p = 0.02), leading to a possible earlier gestation at termination. The termination of pregnancy (TOP) rate did not differ among the groups. In the after group, referrals for suspected anomalies following a dating scan between 11 and 14 weeks significantly increased from 17.4% to 29.1% (p < 0.001). CONCLUSION: This study underscores the value of a scan dedicated to fetal anatomy in the first trimester as we observed a decline in the early detection of certain fetal anomalies (detectable in the first trimester) subsequent to the abolition of FCT.

Congenital small bowel obstruction: Prenatal detection and outcome.

OBJECTIVE: To evaluate and compare the outcome of fetuses and neonates with congenital small bowel obstructions (SBO), evaluate the screening performance of prenatal ultrasound for SBO and identify possible risk factors for adverse outcomes. METHODS: All cases referred to the Amsterdam University Medical Centers between 2007 and 2021 for a prenatal suspected SBO, supplemented by cases of postnatal diagnosis of SBO, were included. The primary outcome was survival after 24 weeks of gestation until the first year of life. RESULTS: 147 cases of SBO were included with a survival rate of 86.2% (119/138) after 24 weeks of gestation until the first year of age. Additional structural or chromosomal anomalies were found to have an increased risk of adverse outcomes. Intrauterine fetal demise occurred in 10/147 (6.8%) cases and 9/147 (6.1%) cases died during postnatal follow-up. The overall positive predictive value of all prenatally diagnosed cases was 91.5%. Surgical correction was performed in 123/128 (96.0%) of the live-born cases. CONCLUSIONS: Congenital SBO has an overall favorable prognosis, but the outcome is negatively impacted by the possible presence of additional structural or chromosomal anomalies. Fetal monitoring in the early third trimester should be considered, since all cases of Intrauterine fetal demise occurred between 30 and 35 weeks of gestation.

General lighting can overcome accidental viewing.

When seeing an object in a scene, the presumption of seeing that object from a general viewpoint (as opposed to an accidental viewpoint) is a useful heuristic to decide which of many interpretations of this object is correct. Similar heuristic assumptions on illumination quality might also be used for scene interpretation. Here we tested that assumption and asked if illumination information helps determine object properties when seen from an accidental viewpoint. Test objects were placed on a flat surface and illumination was varied while keeping the objects' images constant. Observers judged the shape or rigidity of static or moving simple objects presented in accidental view. They also chose which of two seemingly very similar faces was familiar. We found: (1) Objects might appear flat without shadow information but were perceived to be volumetric objects or non-planar in the presence of cast shadows. (2) Apparently non-rigid objects became rigid with shadow information. (3) Shading and shadows helped to infer which of two face was the familiar one. Previous results had shown that cast shadows help determine spatial layout of objects. Our study shows that other properties of objects like rigidity or 3D-shape can be disambiguated by shadow information.

Assessing the contribution of active somatosensory stimulation to self-acceleration perception in dynamic driving simulators.

In dynamic driving simulators, the experience of operating a vehicle is reproduced by combining visual stimuli generated by graphical rendering with inertial stimuli generated by platform motion. Due to inherent limitations of the platform workspace, inertial stimulation is subject to shortcomings in the form of missing cues, false cues, and/or scaling errors, which negatively affect simulation fidelity. In the present study, we aim at quantifying the relative contribution of an active somatosensory stimulation to the perceived intensity of self-motion, relative to other sensory systems. Participants judged the intensity of longitudinal and lateral driving maneuvers in a dynamic driving simulator in passive driving conditions, with and without additional active somatosensory stimulation, as provided by an Active Seat (AS) and Active Belts (AB) integrated system (ASB). The results show that ASB enhances the perceived intensity of sustained decelerations, and increases the precision of acceleration perception overall. Our findings are consistent with models of perception, and indicate that active somatosensory stimulation can indeed be used to improve simulation fidelity.

Individual motion perception parameters and motion sickness frequency sensitivity in fore-aft motion.

Previous literature suggests a relationship between individual characteristics of motion perception and the peak frequency of motion sickness sensitivity. Here, we used well-established paradigms to relate motion perception and motion sickness on an individual level. We recruited 23 participants to complete a two-part experiment. In the first part, we determined individual velocity storage time constants from perceived rotation in response to Earth Vertical Axis Rotation (EVAR) and subjective vertical time constants from perceived tilt in response to centrifugation. The cross-over frequency for resolution of the gravito-inertial ambiguity was derived from our data using the Multi Sensory Observer Model (MSOM). In the second part of the experiment, we determined individual motion sickness frequency responses. Participants were exposed to 30-minute sinusoidal fore-aft motions at frequencies of 0.15, 0.2, 0.3, 0.4 and 0.5 Hz, with a peak amplitude of 2 m/s2 in five separate sessions, approximately 1 week apart. Sickness responses were recorded using both the MIsery SCale (MISC) with 30 s intervals, and the Motion Sickness Assessment Questionnaire (MSAQ) at the end of the motion exposure. The average velocity storage and subjective vertical time constants were 17.2 s (STD = 6.8 s) and 9.2 s (STD = 7.17 s). The average cross-over frequency was 0.21 Hz (STD = 0.10 Hz). At the group level, there was no significant effect of frequency on motion sickness. However, considerable individual variability was observed in frequency sensitivities, with some participants being particularly sensitive to the lowest frequencies, whereas others were most sensitive to intermediate or higher frequencies. The frequency of peak sensitivity did not correlate with the velocity storage time constant (r = 0.32, p = 0.26) or the subjective vertical time constant (r = - 0.37, p = 0.29). Our prediction of a significant correlation between cross-over frequency and frequency sensitivity was not confirmed (r = 0.26, p = 0.44). However, we did observe a strong positive correlation between the subjective vertical time constant and general motion sickness sensitivity (r = 0.74, p = 0.0006). We conclude that frequency sensitivity is best considered a property unique to the individual. This has important consequences for existing models of motion sickness, which were fitted to group averaged sensitivities. The correlation between the subjective vertical time constant and motion sickness sensitivity supports the importance of verticality perception during exposure to translational sickness stimuli.

Endogenous social distancing and its underappreciated impact on the epidemic curve.

Social distancing is an effective strategy to mitigate the impact of infectious diseases. If sick or healthy, or both, predominantly socially distance, the epidemic curve flattens. Contact reductions may occur for different reasons during a pandemic including health-related mobility loss (severity of symptoms), duty of care for a member of a high-risk group, and forced quarantine. Other decisions to reduce contacts are of a more voluntary nature. In particular, sick people reduce contacts consciously to avoid infecting others, and healthy individuals reduce contacts in order to stay healthy. We use game theory to formalize the interaction of voluntary social distancing in a partially infected population. This improves the behavioral micro-foundations of epidemiological models, and predicts differential social distancing rates dependent on health status. The model's key predictions in terms of comparative statics are derived, which concern changes and interactions between social distancing behaviors of sick and healthy. We fit the relevant parameters for endogenous social distancing to an epidemiological model with evidence from influenza waves to provide a benchmark for an epidemic curve with endogenous social distancing. Our results suggest that spreading similar in peak and case numbers to what partial immobilization of the population produces, yet quicker to pass, could occur endogenously. Going forward, eventual social distancing orders and lockdown policies should be benchmarked against more realistic epidemic models that take endogenous social distancing into account, rather than be driven by static, and therefore unrealistic, estimates for social mixing that intrinsically overestimate spreading.

Beyond sensory conflict: The role of beliefs and perception in motion sickness.

Illusory self-motion often provokes motion sickness, which is commonly explained in terms of an inter-sensory conflict that is not in accordance with previous experience. Here we address the influence of cognition in motion sickness and show that such a conflict is not provocative when the observer believes that the motion illusion is indeed actually occurring. Illusory self-motion and motion sickness were elicited in healthy human participants who were seated on a stationary rotary chair inside a rotating optokinetic drum. Participants knew that both chair and drum could rotate but were unaware of the actual motion stimulus. Results showed that motion sickness was correlated with the discrepancy between participants' perceived self-motion and participants' beliefs about the actual motion. Together with the general motion sickness susceptibility, this discrepancy accounted for 51% of the variance in motion sickness intensity. This finding sheds a new light on the causes of visually induced motion sickness and suggests that it is not governed by an inter-sensory conflict per se, but by beliefs concerning the actual self-motion. This cognitive influence provides a promising tool for the development of new countermeasures.

Efficacy of augmented visual environments for reducing sickness in autonomous vehicles.

The risk of motion sickness is considerably higher in autonomous vehicles than it is in human-operated vehicles. Their introduction will therefore require systems that mitigate motion sickness. We investigated whether this can be achieved by augmenting the vehicle interior with additional visualizations. Participants were immersed in motion simulations on a moving-base driving simulator, where they were backward-facing passengers of an autonomous vehicle. Using a Head-Mounted Display, they were presented either with a regular view from inside the vehicle, or with augmented views that offered additional cues on the vehicle's present motion or motion 500ms into the future, displayed on the vehicle's interior panels. In contrast to the hypotheses and other recent studies, no difference was found between conditions. The absence of differences between conditions suggests a ceiling effect: providing a regular view may limit motion sickness, but presentation of additional visual information beyond this does not further reduce sickness.

Changes in the perception of upright body orientation with age.

To determine own upright body orientation the brain creates a sense of verticality by a combination of multisensory inputs. To test whether this process is affected by aging, we placed younger and older adults on a motion platform and systematically tilted the orientation of their visual surroundings by using an augmented reality setup. In a series of trials, participants adjusted the orientation of the platform until they perceived themselves to be upright. Tilting the visual scene around the roll axis induced a bias in subjective postural vertical determination in the direction of scene tilt in both groups. In the group of older participants, however, the observed peak bias was larger and occurred at larger visual tilt angles. This indicates that the susceptibility to visually induced biases increases with age, possibly caused by a reduced reliability of sensory information.

Cortical Representation of Tactile Stickiness Evoked by Skin Contact and Glove Contact.

Even when we are wearing gloves, we can easily detect whether a surface that we are touching is sticky or not. However, we know little about the similarities between brain activations elicited by this glove contact and by direct contact with our bare skin. In this functional magnetic resonance imaging (fMRI) study, we investigated which brain regions represent stickiness intensity information obtained in both touch conditions, i.e., skin contact and glove contact. First, we searched for neural representations mediating stickiness for each touch condition separately and found regions responding to both mainly in the supramarginal gyrus and the secondary somatosensory cortex. Second, we explored whether surface stickiness is encoded in common neural patterns irrespective of how participants touched the sticky stimuli. Using a cross-condition decoding method, we tested whether the stickiness intensities could be decoded from fMRI signals evoked by skin contact using a classifier trained on the responses elicited by glove contact, and vice versa. Our results found shared neural encoding patterns in the bilateral angular gyri and the inferior frontal gyrus (IFG) and suggest that these areas represent stickiness intensity information regardless of how participants touched the sticky stimuli. Interestingly, we observed that neural encoding patterns of these areas were reflected in participants' intensity ratings. This study revealed common and distinct brain activation patterns of tactile stickiness using two different touch conditions, which may broaden the understanding of neural mechanisms related to surface texture perception.

The role of acceleration and jerk in perception of above-threshold surge motion.

Inertial motions may be defined in terms of acceleration and jerk, the time-derivative of acceleration. We investigated the relative contributions of these characteristics to the perceived intensity of motions. Participants were seated on a high-fidelity motion platform, and presented with 25 above-threshold 1 s forward (surge) motions that had acceleration values ranging between 0.5 and 2.5 [Formula: see text] and jerks between 20 and 60 [Formula: see text], in five steps each. Participants performed two tasks: a magnitude estimation task, where they provided subjective ratings of motion intensity for each motion, and a two-interval forced choice task, where they provided judgments on which motion of a pair was more intense, for all possible combinations of the above motion profiles. Analysis of the data shows that responses on both tasks may be explained by a single model, and that this model should include acceleration only. The finding that perceived motion intensity depends on acceleration only appears inconsistent with previous findings. We show that this discrepancy can be explained by considering the frequency content of the motions, and demonstrate that a linear time-invariant systems model of the otoliths and subsequent processing can account for the present data as well as for previous findings.

Multisensory Interactions in Head and Body Centered Perception of Verticality.

Percepts of verticality are thought to be constructed as a weighted average of multisensory inputs, but the observed weights differ considerably between studies. In the present study, we evaluate whether this can be explained by differences in how visual, somatosensory and proprioceptive cues contribute to representations of the Head In Space (HIS) and Body In Space (BIS). Participants (10) were standing on a force plate on top of a motion platform while wearing a visualization device that allowed us to artificially tilt their visual surroundings. They were presented with (in)congruent combinations of visual, platform, and head tilt, and performed Rod & Frame Test (RFT) and Subjective Postural Vertical (SPV) tasks. We also recorded postural responses to evaluate the relation between perception and balance. The perception data shows that body tilt, head tilt, and visual tilt affect the HIS and BIS in both experimental tasks. For the RFT task, visual tilt induced considerable biases (≈ 10° for 36° visual tilt) in the direction of the vertical expressed in the visual scene; for the SPV task, participants also adjusted platform tilt to correct for illusory body tilt induced by the visual stimuli, but effects were much smaller (≈ 0.25°). Likewise, postural data from the SPV task indicate participants slightly shifted their weight to counteract visual tilt (0.3° for 36° visual tilt). The data reveal a striking dissociation of visual effects between the two tasks. We find that the data can be explained well using a model where percepts of the HIS and BIS are constructed from direct signals from head and body sensors, respectively, and indirect signals based on body and head signals but corrected for perceived neck tilt. These findings show that perception of the HIS and BIS derive from the same sensory signals, but see profoundly different weighting factors. We conclude that observations of different weightings between studies likely result from querying of distinct latent constructs referenced to the body or head in space.

A Biologically-Inspired Model to Predict Perceived Visual Speed as a Function of the Stimulated Portion of the Visual Field.

Spatial orientation relies on a representation of the position and orientation of the body relative to the surrounding environment. When navigating in the environment, this representation must be constantly updated taking into account the direction, speed, and amplitude of body motion. Visual information plays an important role in this updating process, notably via optical flow. Here, we systematically investigated how the size and the simulated portion of the field of view (FoV) affect perceived visual speed of human observers. We propose a computational model to account for the patterns of human data. This model is composed of hierarchical cells' layers that model the neural processing stages of the dorsal visual pathway. Specifically, we consider that the activity of the MT area is processed by populations of modeled MST cells that are sensitive to the differential components of the optical flow, thus producing selectivity for specific patterns of optical flow. Our results indicate that the proposed computational model is able to describe the experimental evidence and it could be used to predict expected biases of speed perception for conditions in which only some portions of the visual field are visible.

Publisher Correction: Past and future spread of the arbovirus vectors Aedes aegypti and Aedes albopictus.

This Article was mistakenly not made Open Access when originally published; this has now been amended, and information about the Creative Commons Attribution 4.0 International License has been added into the 'Additional information' section.

Perceiving animacy purely from visual motion cues involves intraparietal sulcus.

Distinguishing animate from inanimate objects is fundamental for social perception in humans and animals. Visual motion cues indicative of self-propelled object motion are useful for animacy perception: they can be detected over a wide expanse of visual field, at distance and in low visibility conditions, can attract attention and provide clues about object behaviour. However, the neural correlates of animacy perception evoked exclusively by visual motion cues, i.e. not relying on form, background or visual context, are unclear. We aimed to address this question in four psychophysical experiments in humans, two of which performed during neuroimaging. The stimulus was a single dot with constant form that moved on a blank background and evoked controlled degrees of perceived animacy through parametric variations of self-propelled motion cues. BOLD signals reflecting perceived animacy in a graded manner irrespective of eye movements were found in one intraparietal region. Additional whole-brain and region-of-interest analyses revealed no comparable effects in brain regions associated with social processing or other areas. Our study shows that animacy perception evoked solely by visual motion cues, a basic perceptual process in social cognition, engages brain regions not primarily associated with social cognition.

Publisher Correction: Past and future spread of the arbovirus vectors Aedes aegypti and Aedes albopictus.

In the version of this Article originally published, the affiliation for author Catherine Linard was incorrectly stated as '6Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK'. The correct affiliation is '9Spatial Epidemiology Lab (SpELL), Universite Libre de Bruxelles, Brussels, Belgium'. The affiliation for author Hongjie Yu was also incorrectly stated as '11Department of Statistics, Harvard University, Cambridge, MA, USA'. The correct affiliation is '15School of Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China'. This has now been amended in all versions of the Article.

Past and future spread of the arbovirus vectors Aedes aegypti and Aedes albopictus.

The global population at risk from mosquito-borne diseases-including dengue, yellow fever, chikungunya and Zika-is expanding in concert with changes in the distribution of two key vectors: Aedes aegypti and Aedes albopictus. The distribution of these species is largely driven by both human movement and the presence of suitable climate. Using statistical mapping techniques, we show that human movement patterns explain the spread of both species in Europe and the United States following their introduction. We find that the spread of Ae. aegypti is characterized by long distance importations, while Ae. albopictus has expanded more along the fringes of its distribution. We describe these processes and predict the future distributions of both species in response to accelerating urbanization, connectivity and climate change. Global surveillance and control efforts that aim to mitigate the spread of chikungunya, dengue, yellow fever and Zika viruses must consider the so far unabated spread of these mosquitos. Our maps and predictions offer an opportunity to strategically target surveillance and control programmes and thereby augment efforts to reduce arbovirus burden in human populations globally.

A protein-interaction network of interferon-stimulated genes extends the innate immune system landscape.

Interferon-stimulated genes (ISGs) form the backbone of the innate immune system and are important for limiting intra- and intercellular viral replication and spread. We conducted a mass-spectrometry-based survey to understand the fundamental organization of the innate immune system and to explore the molecular functions of individual ISGs. We identified interactions between 104 ISGs and 1,401 cellular binding partners engaging in 2,734 high-confidence interactions. 90% of these interactions are unreported so far, and our survey therefore illuminates a far wider activity spectrum of ISGs than is currently known. Integration of the resulting ISG-interaction network with published datasets and functional studies allowed us to identify regulators of immunity and processes related to the immune system. Given the extraordinary robustness of the innate immune system, this ISG network may serve as a blueprint for therapeutic targeting of cellular systems to efficiently fight viral infections.