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Background: To evaluate the effects of a web-based, personalized avatar intervention conveying the concept of community immunity (herd immunity) on risk perception (perceptions of the risk of infection spreading (to self, family, community, and vulnerable individuals)) and other cognitive and emotional responses across 4 vaccine-preventable disease contexts: measles, pertussis, influenza, and an unnamed "vaccine-preventable disease.", Methods: Through a robust user-centered design process, we developed a web application, " herdimm ," showing how community immunity works. In our application, people personalize a virtual community by creating avatars (themselves, 2 vulnerable people in their community, and 6 other people around them; e.g., family members or co-workers.) Herdimm integrates these avatars in a 2-minute narrated animation showing visually how infections spread with and without the protection of community immunity. The present study was a 2×4 factorial randomized controlled trial to assess herdimm 's effects. We recruited 3883 adults via Qualtrics living in Canada who could complete an online study in English or French. We pre-registered our study, including depositing our questionnaire and pre-scripted statistical code on Open Science Framework (https://osf.io/hkysb/). The trial ran from March 1 to July 1, 2021. We compared the web application to no intervention (i.e. control) on primary outcome risk perception, divided into objective risk perception (accuracy of risk perception) and subjective risk perception (subjective sense of risk), and on secondary outcomes-emotions (worry, anticipated guilt), knowledge, and vaccination intentions-using analysis of variance for continuous outcomes and logistic regression for dichotomous outcomes. We conducted planned moderation analyses using participants' scores on a validated scale of individualism and collectivism as moderators., Results: Overall, herdimm had desirable effects on all outcomes. People randomized to herdimm were more likely to score high on objective risk perception (58.0%, 95% confidence interval 56.0%-59.9%) compared to those assigned to the control condition (38.2%, 95% confidence interval 35.5%-40.9%). Herdimm increased subjective risk perception from a mean of 5.30 on a scale from 1 to 7 among those assigned to the control to 5.54 among those assigned to herdimm . The application also increased emotions (worry, anticipated guilt) (F(1,3875)=13.13, p<0.001), knowledge (F(1,3875)=36.37, p<0.001) and vaccination intentions (Chi-squared(1)=9.4136, p=0.002). While objective risk perception did not differ by disease (Chi-squared(3)=6.94, p=0.074), other outcomes did (subjective risk perception F(3,3875) = 5.6430, p<0.001; emotions F(3,3875)=78.54, p<0.001; knowledge (F(3,3875)=5.20, p=0.001); vaccination intentions Chi-squared (3)=15.02, p=0.002). Moderation models showed that many findings were moderated by participants' individualism and collectivism scores. Overall, whereas outcomes tended not to vary by individualism and collectivism among participants in the control condition, the positive effects of herdimm were larger among participants with more collectivist orientations and effects were sometimes negative among participants with more individualist orientations., Conclusions: Conveying the concept of community immunity through a web application using personalized avatars increases objective and subjective risk perception and positively influences intentions to receive vaccines, particularly among people who have more collectivist worldviews. Including prosocial messages about the collective benefits of vaccination in public health campaigns may increase positive effects among people who are more collectivist while possibly backfiring among those who are more individualistic., Competing Interests: Conflict of interest None

Measuring the kyphotic angle (KA) and lordotic angle (LA) on lateral radiographs is important to truly diagnose children with adolescent idiopathic scoliosis. However, it is a time-consuming process to measure the KA because the endplate of the upper thoracic vertebra is normally difficult to identify. To save time and improve measurement accuracy, a machine learning algorithm was developed to automatically extract the KA and LA. The accuracy and reliability of the T1-T12 KA, T5-T12 KA, and L1-L5 LA were reported. A convolutional neural network was trained using 100 radiographs with data augmentation to segment the T1-L5 vertebrae. Sixty radiographs were used to test the method. Accuracy and reliability were reported using the percentage of measurements within clinical acceptance (≤9°), standard error of measurement (SEM), and inter-method intraclass correlation coefficient (ICC 2,1 ). The automatic method detected 95 % (57/60), 100 %, and 100 % for T1-T12 KA, T5-T12 KA, and L1-L5 LA, respectively. The clinical acceptance rate, SEM, and ICC 2,1 for T1-T12 KA, T5-T12 KA, and L1-L5 LA were (98 %, 0.80°, 0.91), (75 %, 4.08°, 0.60), and (97 %, 1.38°, 0.88), respectively. The automatic method measured quickly with an average of 4 ± 2 s per radiograph and illustrated how measurements were made on the image, allowing verifications by clinicians., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: Ultrasonography for scoliosis is a novel imaging method that does not expose children with adolescent idiopathic scoliosis (AIS) to radiation. A single ultrasound scan provides 3D spinal views directly. However, measuring ultrasonograph parameters is challenging, time-consuming, and requires considerable training. This study aimed to validate a machine learning method to measure the coronal curve angle on ultrasonographs automatically., Methods: A total of 144 3D spinal ultrasonographs were extracted to train and validate a machine learning model. Among the 144 images, 70 were used for training, and 74 consisted of 144 curves for testing. Automatic coronal curve angle measurements were validated by comparing them with manual measurements performed by an experienced rater. The inter-method intraclass correlation coefficient (ICC 2,1 ), standard error of measurement (SEM), and percentage of measurements within clinical acceptance (≤ 5°) were analyzed., Results: The automatic method detected 125/144 manually measured curves. The averages of the 125 manual and automatic coronal curve angle measurements were 22.4 ± 8.0° and 22.9 ± 8.7°, respectively. Good reliability was achieved with ICC 2,1  = 0.81 and SEM = 1.4°. A total of 75% (94/125) of the measurements were within clinical acceptance. The average measurement time per ultrasonograph was 36 ± 7 s. Additionally, the algorithm displayed the predicted centers of laminae to illustrate the measurement., Conclusion: The automatic algorithm measured the coronal curve angle with moderate accuracy but good reliability. The algorithm's quick measurement time and interpretability can make ultrasound a more accessible imaging method for children with AIS. However, further improvements are needed to bring the method to clinical use., (© 2024. The Author(s).)

Kryptolebias marmoratus (Kmar), a teleost fish of the order Cyprinodontiformes, has a suite of unique phenotypes and behaviors not observed in other fishes. Many of these phenotypes are discrete and highly plastic-varying over time within an individual, and in some cases reversible. Kmar and its interfertile sister species, K. hermaphroditus, are the only known self-fertile vertebrates. This unusual sexual mode has the potential to provide unique insights into the regulation of vertebrate sexual development, and also lends itself to genetics. Kmar is easily adapted to the lab and requires little maintenance. However, its internal fertilization and small clutch size limits its experimental use. To support Kmar as a genetic model, we compared alternative husbandry techniques to maximize recovery of early cleavage-stage embryos. We find that frequent egg collection enhances yield, and that protease treatment promotes the greatest hatching success. We completed a forward mutagenesis screen and recovered several mutant lines that serve as important tools for genetics in this model. Several will serve as useful viable recessive markers for marking crosses. Importantly, the mutant kissylips lays embryos at twice the rate of wild-type. Combining frequent egg collection with the kissylips mutant background allows for a substantial enhancement of early embryo yield. These improvements were sufficient to allow experimental analysis of early development and the successful mono- and bi-allelic targeted knockout of an endogenous tyrosinase gene with CRISPR/Cas9 nucleases. Collectively, these tools will facilitate modern developmental genetics in this fascinating fish, leading to future insights into the regulation of plasticity., (© 2023 The Authors. Journal of Experimental Zoology Part B: Molecular and Developmental Evolution published by Wiley Periodicals LLC.)

Captive breeding programs are an important pillar in biodiversity conservation, aiming to prevent the extinction of threatened species. However, the establishment of self-sustaining populations in the wild through the release of captive-bred animals is often hampered by a high mortality upon release. In this study, we investigated how a 2-week confinement period within a large field enclosure affected the anti-predator behaviour of 'naive' captive-bred hamsters and how potential modifications persisted over time. During three consecutive tests, hamsters were confronted with a moving predator model (a red fox mount, Vulpes vulpes ) and their behaviour was filmed. After the initial round of confrontation with the predator model, one group of hamsters (field group) was released into a field enclosure protected from predators, while the other group (control) remained in their individual laboratory cages. After 2 weeks, hamsters from the field group were recaptured and individuals of both groups underwent a second confrontation test. A total of 1 month after their return from the field enclosure, field hamsters were subjected to a last confrontation test. Video analysis, investigating four behavioural variables, revealed that field hamsters significantly modified their behavioural response following the 2 weeks confinement in the enclosure, while this was not the case for control hamsters. In addition, most behavioural modifications in field hamsters persisted over 1 month, while others started to revert. We suggest that an appropriate pre-release period inside a field enclosure will enable naive (captive-bred) hamsters to develop an adequate anti-predator behaviour that will increase their immediate survival probability upon release into the wild. We believe that such measure will be of great importance for hamster conservation programs., Competing Interests: Jonathan Jumeau is an employee of Collectivité européenne d’Alsace., (© 2023 Fleitz et al.)

This study aimed to investigate the consequences of early-life microbiota transplantation using different caecal content sources in broiler chicks. We hypothesized that chicks receiving at-hatch microbiota from organic hens would harbour a distinct microbiota from chicks receiving industry-raised broiler microbiota after six weeks of age. Three hundred Cobb broilers eggs were randomly assigned to one of four groups according to the caecal content received: organic laying hens (Organic); autoclaved caecal content of organic laying hens (Autoclaved); conventionally grown broilers (Conventional); and sterile saline (Control). caecal microbiota transplantation was given by gavage on day 1. Ten birds/group were euthanized on days 2, 7, 14, 28, and 42. The caecal tonsils and contents were collected for cytokines and microbiota analyses. The microbiota from chicks receiving live inocula resembled the donors' microbiota from day seven until day 42. The microbiota composition from the chickens who received the Organic inoculum remained markedly different. Starting on day 7, the Organic group had higher richness. Simpson and Shannon's indices were higher in the Conventional group on days 2 and 7. Chickens in the Conventional group presented higher production of IL-1β and IL-6 in plasma on days 2 and 28, increased IL-6 expression in the caecal tonsils at days 7 and 42, and increased IL-12 expression on day 7. However, the Conventional group was infected with Eimeria spp., which likely caused inflammation. In conclusion, microbiota transplantation using different microbiota profiles persistently colonized newly hatched broiler chicks. Future studies evaluating the importance of microbiota composition during infections with common enteropathogens are necessary. This study also highlights the need for a strict screening protocol for pathogens in the donors' intestinal content.

Forecasting invasive-pathogen dynamics is paramount to anticipate eradication and containment strategies. Such predictions can be obtained using a model grounded on partial differential equations (PDE; often exploited to model invasions) and fitted to surveillance data. This framework allows the construction of phenomenological but concise models relying on mechanistic hypotheses and real observations. However, it may lead to models with overly rigid behavior and possible data-model mismatches. Hence, to avoid drawing a forecast grounded on a single PDE-based model that would be prone to errors, we propose to apply Bayesian model averaging (BMA), which allows us to account for both parameter and model uncertainties. Thus, we propose a set of different competing PDE-based models for representing the pathogen dynamics, we use an adaptive multiple importance sampling algorithm (AMIS) to estimate parameters of each competing model from surveillance data in a mechanistic-statistical framework, we evaluate the posterior probabilities of models by comparing different approaches proposed in the literature, and we apply BMA to draw posterior distributions of parameters and a posterior forecast of the pathogen dynamics. This approach is applied to predict the extent of Xylella fastidiosa in South Corsica, France, a phytopathogenic bacterium detected in situ in Europe less than 10 years ago (Italy 2013, France 2015). Separating data into training and validation sets, we show that the BMA forecast outperforms competing forecast approaches., (© 2023. The Author(s), under exclusive licence to Society for Mathematical Biology.)

Background: Adolescent idiopathic scoliosis and its treatments can severely impact health-related quality of life. The Italian Spine Youth Quality of Life (ISYQOL) questionnaire, initially developed in Italian and tested on Italian people, was created to measure quality of life in young persons with spine changes. ISYQOL was created using the Rasch analysis, a modern psychometric technique for questionnaires' assessment and development, which showed that the ordinal scores of the ISYQOL Italian version provide sound quality of life measures., Aim: The current work aims to evaluate the cross-cultural equivalence of the ISYQOL questionnaire in seven different countries., Design: Cross-sectional, international, multi-centre study., Setting: Outpatient clinic., Population: Five hundred fifty persons with adolescent idiopathic scoliosis from English Canada, French Canada, Greece, Italy, Spain, Poland, and Türkiye., Methods: The ISYQOL Italian version was translated into six languages with the forward-backwards procedure. The conceptual equivalence of the items' content was verified, and any inconsistency was resolved by consensus. The Rasch analysis was used here to evaluate that ISYQOL translations retained the good measurement properties of the Italian version of the questionnaire. In addition, the Differential Item Functioning (DIF) was checked to assess the psychometric equivalence of the ISYQOL items in patients from different countries., Results: Four items of the translated ISYQOL were dropped from the questionnaire since they did not contribute to measuring due to their poor fit to the model of Rasch. Seven items were affected by DIF for nationality, a finding pointing out that these items do not work the same (i.e. are not equivalent) in the different countries. Thanks to the Rasch analysis, the DIF for nationality was amended, and ISYQOL International was eventually obtained., Conclusions: ISYQOL International returns interval quality of life measures in people with adolescent idiopathic scoliosis with high cross-cultural equivalence in the tested countries., Clinical Rehabilitation Impact: Rigorous testing showed that ISYQOL International ordinal scores return quality of life measures cross-culturally equivalent in English and French Canada, Greece, Italy, Spain, Poland, and Türkiye. A new, psychometrically sound patient-reported outcome measure is thus available in rehabilitation medicine to measure health-related quality of life in idiopathic scoliosis.

Background: Clostridium perfringens, the causative agent of necrotic enteritis (NE) in chickens, has an enormous economic impact on global broiler production. The non-medically important antibiotic avilamycin was approved in Canada in 2014 to prevent and control NE in broiler chickens., Objectives: To compare avilamycin susceptibility in C. perfringens isolates collected pre- and 7 years post-avilamycin approval in Canada and determine the avilamycin resistance mutation frequency rate in C. perfringens., Methods: The MICs of avilamycin were determined for 89 strains of C. perfringens recovered from clinically relevant NE field cases pre-avilamycin approval between 2003 and 2013 (n = 50) and post-avilamycin approval between 2014 and 2021 (n = 39) across Canada. For determining the mutant prevention concentration (MPC) of avilamycin for C. perfringens strains, a strain with avilamycin MIC of 1 mg/L was randomly selected., Results: MIC studies showed no difference in avilamycin susceptibility in pre-avilamycin and post-avilamycin isolates (MIC50/90: pre-avilamycin approval 2/2 mg/L and post-avilamycin approval 1/2 mg/L). The MPC was 8 × MIC (8 mg/L) for the selected strain., Conclusions: These findings suggest that the susceptibility of C. perfringens strains to avilamycin was not impacted by its continued use in the 7 years following its approval in Canada. Avilamycin, a non-medically important antibiotic, poses no threat to human health regarding cross-resistance or co-selection of other medically important antibiotics. These factors make avilamycin an appropriate choice for continued use in broiler chickens to prevent and control NE without increased antimicrobial resistance concerns., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: To reduce the transmission of SARS-CoV-2 and the associated spread of COVID-19, many jurisdictions around the world imposed mandatory or recommended social or physical distancing. As a result, at the beginning of the pandemic, various communication materials appeared online to promote distancing. Explanations of the science underlying these mandates or recommendations were either highly technical or highly simplified., Objective: This study aimed to understand the effects of a dynamic visualization on distancing. Our overall aim was to help people understand the dynamics of the spread of COVID-19 in their community and the implications of their own behavior for themselves, those around them, the health care system, and society., Methods: Using Scrum, which is an agile framework; JavaScript (Vue.js framework); and code already developed for risk communication in another context of infectious disease transmission, we rapidly developed a new personalized web application. In our application, people make avatars that represent themselves and the people around them. These avatars are integrated into a 3-minute animation illustrating an epidemiological model for COVID-19 transmission, showing the differences in transmission with and without distancing. During the animation, the narration explains the science of how distancing reduces the transmission of COVID-19 in plain language in English or French. The application offers full captions to complement the narration and a descriptive transcript for people using screen readers. We used Google Analytics to collect standard usage statistics. A brief, anonymous, optional survey also collected self-reported distancing behaviors and intentions in the previous and coming weeks, respectively. We launched and disseminated the application on Twitter and Facebook on April 8, 2020, and April 9, 2020., Results: After 26 days, the application received 3588 unique hits from 82 countries. The optional survey at the end of the application collected 182 responses. Among this small subsample of users, survey respondents were nearly (170/177, 96%) already practicing distancing and indicated that they intended to practice distancing in the coming week (172/177, 97.2%). Among the small minority of people (n=7) who indicated that they had not been previously practicing distancing, 2 (29%) reported that they would practice distancing in the week to come., Conclusions: We developed a web application to help people understand the relationship between individual-level behavior and population-level effects in the context of an infectious disease spread. This study also demonstrates how agile development can be used to quickly create personalized risk messages for public health issues like a pandemic. The nonrandomized design of this rapid study prevents us from concluding the application's effectiveness; however, results thus far suggest that avatar-based visualizations may help people understand their role in infectious disease transmission., (©Doriane Etienne, Patrick Archambault, Donovan Aziaka, Selma Chipenda-Dansokho, Eve Dubé, Catherine S Fallon, Hina Hakim, Jason Kindrachuk, Dan Krecoum, Shannon E MacDonald, Ruth Ndjaboue, Magniol Noubi, Jean-Sébastien Paquette, Elizabeth Parent, Holly O Witteman. Originally published in JMIR Formative Research (https://formative.jmir.org), 25.04.2023.)

Purpose: This case report aims to explore a rare combination of findings in a cadaver donor: variant ansa cervicalis, vagus (CN X) and hypoglossal (CN XII) nerve fusion, and extracranial hypoglossal neurofibroma., Background: The type of ansa cervicalis variation presented in this report has been documented in less than 1% of described cases. The CN X-CN XII fusion has been reported in one prior study. Additionally, hypoglossal neurofibromas are benign neoplasms of the peripheral nerve sheath. There are only two known cases of extracranial hypoglossal neurofibroma described in the literature., Case Report: The study investigated a swelling of the right CN XII in a 90-year-old female cadaver donor. Detailed dissection, examination of the region, and histopathological analysis of the mass followed. The entire course of CN XII and other cranial nerves were examined to exclude concurrent pathology. A fusiform enlargement of the right CN XII was observed in the submandibular region, measuring ~ 1.27 × 1.27 cm. The superior portion of the right CN XII was fused to the right CN X, exiting the jugular foramen. The superior root of ansa cervicalis, normally a branch of CN XII, was found to arise from CN X on the right side. The left CN XII and CN X were unremarkable. Histopathological examination revealed benign neurofibroma., Conclusion: The anatomical variation and rare location of the tumor necessitate further investigation to better understand pathogenesis, clinical correlation, and surgical implications. This study furthers knowledge of this condition and contributes to the currently limited body of research., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Background Context: Idiopathic scoliosis (IS) can significantly alter the quality of life of adolescents. Some of the available questionnaires in French measuring the quality of life in this population show weak psychometric properties. The newly developed Italian Spine Youth Quality of Life (ISYQOL) questionnaire promises better properties., Purpose: To provide a French-Canadian version of the ISYQOL and to verify its psychometric characteristics., Study Design: Prospective validation of a cross-cultural adaptation of the ISYQOL questionnaire., Patient Sample: A total of 111 participants with idiopathic scoliosis (77.5% female, 10-18 years old, mean Cobb angle=28°) were included in the study., Outcome Measure: The French-Canadian version of the Italian Spine Youth Quality of Life (ISYQOL-F) questionnaire., Materials and Methods: The ISYQOL was translated into French using a forward-backward approach. We then verified the understanding of the translated items with two scoliosis experts and 10 adolescents. Afterward, 111 adolescents with IS were recruited by convenience at the scoliosis clinic and they completed the ISYQOL on three occasions (before seeing the specialist, 1 week, and 2 weeks after). Cronbach's alpha, intra-class (ICC), and Pearson correlation coefficients were used to respectively determine internal consistency, test-retest reliability, and concurrent validity with the SRS-22r and SF-12. The standard error of measurement (SEM) and 95% confidence minimal detectable change (MDC 95 ) were also calculated. The ceiling effect was quantified as the percentage of participants who scored the maximum on ISYQOL-F., Results: The ISYQOL-F showed good internal consistency with a Cronbach alpha of 0.81 and 0.85 respectively for items 1-13 (n=55; ISYQOL-F mean score ± SD = 63.9±13.5) and 1-20 (n=56; ISYQOL-F mean score ± SD=60.7±10.3). Test-retest reliability was excellent (ICC 3,1 =0.94). The SEM is 3.1 and the MDC 95 is 8.6. Correlations between ISYQOL-F and SRS-22r and between ISYQOL-F and SF-12 were moderate for total scores (r=0.56 and 0.50 respectively, p<.001), but low for each domain (between 0.20 and 0.48, p<.05). No significant ceiling effects were observed for ISYQOL-F (≤2.5%). In contrast, ceiling effects ranged from 3.6% to 30.6% for SRS-22r and 0%-68.5% for SF-12., Conclusions: The internal consistency and reliability of ISYQOL-F are good. The total score correlates moderately with the SRS-22r and SF-12. Unlike SRS-22r, the ISYQOL-F does not appear to have a ceiling effect. The ISYQOL-F may thus be suitable to assess quality of life in a population of French-Canadian adolescents with IS., Competing Interests: Declaration of competing interest The authors have no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Reporting individual clinical and patient-reported outcomes to patients during consultations may add to patients' disease knowledge and activation and stimulate Shared Decision Making (SDM). These outcomes can be presented over time in a clear way by the means of dashboarding. We aimed to systematically develop a Chronic Kidney Disease (CKD) dashboard designed to support consultations, test its usability and explore conditions for optimal use in practice., Methods: For development a participatory approach with patients and healthcare professionals (HCPs) from three hospitals was used. Working groups and patient focus groups were conducted to identify needs and inform the dashboard's design. Usability was tested in patient interviews. A focus group with HCPs was held to identify conditions for optimal use of the dashboard in daily practice., Results: A dashboard was developed for CKD patients stage 3b-4 visualizing both clinical and patient-reported outcomes over time for use during consultations and accessible for patients at home. Both HCPs and patients indicated that the dashboard can: motivate patients in their treatment by providing feedback on outcomes over time; improve consultation conversations by enhanced preparation of both HCPs and patients; better inform patients, thereby facilitating shared decision making. HCPs and patients both stated that setting a topic agenda for the consultation together is important in effectively discussing the dashboard during consultations. Moreover, the dashboard should not dominate the conversation. Lastly, findings of the usability tests provided design requirements for optimal user-friendliness and clarity., Conclusions: Dashboarding can be a valuable way of reporting individual outcome information to patients and their clinicians as findings suggest it may stimulate patient activation and facilitate decision making. Co-creation with patients and HCPs was essential for successful development of the dashboard. Gained knowledge from the co-creation process can inform others wishing to develop similar digital tools for use in clinical practice., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Patient decision aids (PtDAs) support patients and clinicians in shared decision-making (SDM). Real-world outcome information may improve patients' risk perception, and help patients make decisions congruent with their expectations and values. Our aim was to develop an online PtDA to support kidney failure treatment modality decision-making, that: 1) provides patients with real-world outcome information, and 2) facilitates SDM in clinical practice., Methods: The International Patient Decision Aids Standards (IPDAS) development process model was complemented with a user-centred and convergent mixed-methods approach. Rapid prototyping was used to develop the PtDA with a multidisciplinary steering group in an iterative process of co-creation. The results of an exploratory evidence review and a needs-assessment among patients, caregivers, and clinicians were used to develop the PtDA. Seven Dutch teaching hospitals and two national Dutch outcome registries provided real-world data on selected outcomes for all kidney failure treatment modalities. Alpha and beta testing were performed to assess the prototype and finalise development. An implementation strategy was developed to guide implementation of the PtDA in clinical practice., Results: The 'Kidney Failure Decision Aid' consists of three components designed to help patients and clinicians engage in SDM: 1) a paper hand-out sheet, 2) an interactive website, and 3) a personal summary sheet. A 'patients-like-me' infographic was developed to visualise survival probabilities for each treatment modality on the website. Other treatment outcomes were incorporated as event rates (e.g. hospitalisation rates) or explained in text (e.g. the flexibility of each treatment modality). No major revisions were needed after alpha and beta testing. During beta testing, some patients ignored the survival probabilities because they considered these too confronting. Nonetheless, patients agreed that every patient has the right to choose whether they want to view this information. Patients and clinicians believed that the PtDA would help patients make informed decisions, and that it would support values- and preferences-based decision-making. Implementation of the PtDA has started in October 2020., Conclusions: The 'Kidney Failure Decision Aid' was designed to facilitate SDM in clinical practice and contains real-world outcome information on all kidney failure treatment modalities. It is currently being investigated for its effects on SDM in a clinical trial., (© 2022. The Author(s).)

Background. Despite the abundance and proximity of edible marine resources, coastal communities along the St. Lawrence in Eastern Québec rarely consume these resources. Within a community-based food sovereignty project, Manger notre Saint-Laurent ("Sustenance from our St. Lawrence"), members of participating communities (3 non-Indigenous, 1 Indigenous) identified a need for a web-based decision tool to help make informed consumption choices. Methods. We thus aimed to co-design a prototype website that facilitates informed choices about consuming local edible marine resources based on seasonal and regional availability, food safety, nutrition, and sustainability, with community members, regional stakeholders, and experts in user experience design and web development. We conducted 48 interviews with a variety of people over 3 iterative cycles, assessing the prototype's ease of use with a validated measure, the System Usability Scale. Results. Community members, regional stakeholders, and other experts identified problematic elements in initial versions of the website (e.g., confusing symbols). We resolved issues and added features people identified as useful. Usability scores reached "best imaginable" for both the second and the third versions and did not differ significantly between sociodemographic groups. The final prototype includes a tool to explore each species and index cards to regroup accurate evidence relevant to each species. Conclusions. Engaging co-designers with different sociodemographic characteristics brought together a variety of perspectives. Several components would not have been included without co-designers' input; other components were greatly improved thanks to their feedback. Co-design approaches in research and intervention development are preferable to foster the inclusion of a variety of people. Once the prototype is programmed and available online, we hope to evaluate the website to determine its effects on food choices., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support for this study was provided entirely by the Sustenance from our St. Lawrence project, which was funded by Réseau Québec Maritime (principal investigator Lemire), by the Littoral Research Chair (Sentinel North Partnership Research Chair in Ecosystem Approaches to Health funded by Sentinel North and the Northern Contaminant Program of the Crown-Indigenous Relations and Northern Affairs Canada [CIRNAC], chairholder Lemire), and the Canadian Institutes of Health Research Foundation grant FDN-148426 (principal investigator Witteman). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report. ML receives salary support from the Fonds de recherche en santé du Québec. HOW receives salary support from a Tier 2 Canada Research Chair in Human-Centred Digital Health., (© The Author(s) 2022.)

A recent innovation in scoliosis monitoring is the use of ultrasonography, which provides true 3D information in one scan and does not emit ionizing radiation. Measuring the severity of scoliosis on ultrasonographs requires identifying lamina pairs on the most tilted vertebrae, which is difficult and time-consuming. To expedite and automate measurement steps, this paper detailed an automatic convolutional neural network-based algorithm for identifying the laminae on 3D ultrasonographs. The predicted laminae were manually paired to measure the lateral spinal curvature on the coronal view, called the Cobb angle. In total, 130 spinal ultrasonographs of adolescents with idiopathic scoliosis recruited from a scoliosis clinic were selected, with 70 for training and 60 for testing. Data augmentation increased the effective training set size to 140 ultrasonographs. Semi-automatic Cobb measurements were compared to manual measurements on the same ultrasonographs. The semi-automatic measurements demonstrated good inter-method reliability (ICC 3,1 = 0.87) and performed better on thoracic (ICC 3,1 = 0.91) than lumbar curves (ICC 3,1 = 0.81). The mean absolute difference and standard deviation between semi-automatic and manual was 3.6° ± 3.0°. In conclusion, the semi-automatic method to measure the Cobb angle on ultrasonographs is feasible and accurate. This is the first algorithm that automates steps of Cobb angle measurement on ultrasonographs., (© 2022. The Author(s) under exclusive licence to Biomedical Engineering Society.)

Purpose: Posterior spinal fusion surgery is required to correct severe idiopathic scoliosis. The surgery involves insertion of screws which requires high accuracy to prevent neurologic damage to the spinal cord. Although conventional CT navigation can reduce this risk, 3D-ultrasound-based navigation could achieve this without added ionizing radiation and usage of expensive and bulky equipment. This study aimed to evaluate the accuracy of a 3D ultrasound navigation system for posterior spine surgery., Methods: A custom 3D ultrasound (3DUS) with model-to-surface registration algorithm was developed and integrated into a 3D navigation environment. A CT scan of an adolescent spine (T3-T11) was segmented and 3D printed for experiments. A probe with reflective markers was placed in vertebral pedicles 684 times in varying levels, positions in the capture space and orientation of vertebra, and the entrypoint and trajectory accuracies were measured., Results: Among 684 probe placements in vertebral levels T3 to T11 in the phantom spine, 95.5% were within 1 mm and 5° of accuracy, with an average accuracy of 0.4 ± 0.4 mm and 2.1 ± 0.9°, requiring 8.8 s to process. Accuracies were statistically significantly affected by vertebral orientation and position in the capture volume, though this was still within the targeted accuracies of 1 mm and 5°., Conclusion: This preliminary ultrasound-based navigation system is accurate and fast enough for guiding placement of pedicle screws into the spine in posterior fusion surgery. The current results are limited to phantom spines, and future study in animal or human cadavers is needed to investigate soft tissue effects on registration accuracy., (© 2021. CARS.)

Background: mRNA COVID-19 vaccines are known to provide an immune response seen on FDG PET studies. However, the time course of this metabolic response is unknown. We here present a temporal metabolic response to mRNA COVID-19 vaccination in oncology patients undergoing standard of care FDG PET., Methods: 262 oncology patients undergoing standard of care FDG PET were included in the analysis. 231 patients had at least one dose of mRNA COVID-19 vaccine while 31 patients had not been vaccinated. The SUVmax of the lymph nodes ipsilateral to the vaccination was compared to the contralateral to obtain an absolute change in SUVmax (ΔSUVmax)., Results: ΔSUVmax was more significant at shorter times between FDG PET imaging and COVID-19 mRNA vaccination, with a median ΔSUVmax of 2.6 (0-7 days), 0.8 (8-14 days), and 0.3 (> 14 days), respectively., Conclusion: Consideration should be given to performing FDG PET at least 2 weeks after the COVID-19 vaccine., (© 2021. The Author(s).)

Purpose: To investigate the test-retest, intra- and inter-rater reliabilities of an ultrasound (US) reflection coefficient (RC) index measured in a lumbar vertebra to reflect bone strength on children with AIS., Methods: Fifty-eight participants (47F; 11M) were scanned by an US imager in standing position. Twenty-four were scanned twice for a test-retest study. The RC index measures the US signal reflected from L5 to indicate bone strength. Five measurements were obtained using three different methods: (i) the maximum RC (MRC) values on the left and right sides, (ii) the average RC (ARC) values on left and right sides, and (iii) the combined average RC (CARC) from both sides. Only rater 1 measured the 24 repeated US scans once. Raters 1 and 2 measured the RC index twice on all 58 images in 1 week apart. The intraclass correlation coefficient ICC [3, 1] for test-retest and ICC [2, 1] for intra- and inter-rater reliabilities as well as the standard error of measurements (SEM) were reported., Results: The means of scan 1 versus scan 2 were 0.16 ± 0.08 versus 0.16 ± 0.07 for left-MRC, 0.17 ± 0.11 versus 0.18 ± 0.11 for right-MRC, 0.08 ± 0.04 versus 0.09 ± 0.04 for left-ARC, 0.09 ± 0.04 versus 0.09 ± 0.05 for right-ARC and 0.08 ± 0.04 versus 0.09 ± 0.03 for CARC and all ICC[3, 1] ≥ 0.77. Among these 5 approaches, the CARC provided the best intra-rater and inter-rater reliabilities with ICC [2, 1] ≥ 0.84 and SEM ≤ 0.01., Conclusions: The RC index could be measured repeatably and reliably. The high RC value may reduce the risk of progression of scoliosis., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Scoliosis significantly impacts Quality of Life (QOL). Current quality of life questionnaires for adolescents with idiopathic scoliosis (AIS) have limitations. A new questionnaire for measuring QOL in AIS called the Italian Spine Youth Quality of Life (ISYQOL) has been developed to address these limitations but the English translation has not yet been validated. To determine the ceiling and floor effects, and the convergent validity of the ISYQOL questionnaire against established QOL questionnaires and Cobb angle in AIS. One hundred consecutive females with AIS, (10-18 years old), treated non-operatively. The English translation of the ISYQOL was compared to the following established questionnaires: Scoliosis Research Society-22r and the Spinal Appearance Questionnaire. The participants were 100 females (13.89+/-1.8 years) with 28.75+/-13.9° curve angles. The convergent validity of the ISYQOL score (60.3+/-12.44) was supported by significant correlation with the SRS-22r total score, function, pain, self-image, and mental health scores (r = 0.70, 0.54, 0.57, 0.52 and 0.50, respectively), and with the SAQ general, waist, and expectations domains (r = -0.6. -.52, and -0.56, respectively). Correlation with the Cobb angle was (r = -.37)(see Table 1). No ceiling effect was observed in the ISYQOL. Ceiling effects were observed for the SRS-22r and the SAQ. The ISYQOL demonstrated evidence of convergent validity. This study supports its suitability for QOL research in AIS. ISYQOL appears more likely to detect changes in evaluative studies than the SRS- 22r and the SAQ.

Severe adolescent idiopathic scoliosis (AIS) requires surgery to halt curve progression. Accurate insertion of pedicle screws is important. This study reports a newly developed 3D ultrasound (3DUS) to localize pedicles intraoperatively and register a pre-op 3D vertebral model to the surface to be displayed for navigation. The objective was to determine speed of the custom 3DUS navigator and accuracy of pedicle probe placement. The developed 3DUS navigator integrated an ultrasound scanner with motion capture cameras. Two adolescent 3D printed spine models T2-T8 and T7-T11 were modified to include pedicle holes with known trajectory and be mounted on a high precision LEGO pegboard in a water bath for imaging. Calibration of the motion cameras and the 3DUS were conducted prior to the study. A total of 27 scans from T3 to T11 vertebrae with 3 individual scans were performed to validate the repeatability. Three accuracy tests that varied vertebral a) orientation, b) position and c) a combination of location and orientation were completed. Based on all experiments, the acquisition-to-display time was 18.9±3.1s. The repeatability of the trajectory error and positional error were 0.5±0.2° and 0.3±0.1mm, respectively. The a) center orientation, b) position and c) orientation/position on trajectory and positional error were for a) 1.4±0.9° and 0.5±0.4mm, b) 1.4±0.8° and 0.3±0.3mm and c) 2.0±0.8° and 0.5±0.5mm, respectively. These results demonstrated that a high precision real-time 3DUS navigator for screw placement in scoliosis surgery is feasible. The next step will study the effect of surrounding soft tissues on navigation accuracy.

Wisconsin and Quebec are the world leading cranberry-producing regions. Cranberries are grown in acidic, naturally low-fertility sandy beds. Cranberry fertilization is guided by general soil and tissue nutrient tests in addition to yield target and vegetative biomass. However, other factors such as cultivar, location, and carbon and nutrient storage impact cranberry nutrition and yield. The objective of this study was to customize nutrient diagnosis and fertilizer recommendation at local scale and for next-year cranberry production after accounting for local factors and carbon and nutrient carryover effects. We collected 1768 observations from on-farm surveys and fertilizer trials in Quebec and Wisconsin to elaborate a machine learning model using minimum datasets. We tested carryover effects in a 5-year Quebec fertilizer experiment established on permanent plots. Micronutrients contributed more than macronutrients to variation in tissue compositions. Random Forest model related accurately current-year berry yield to location, cultivars, climatic indices, fertilization, and tissue and soil tests as features (classification accuracy of 0.83). Comparing compositions of defective and successful tissue compositions in the Euclidean space of tissue compositions, the general across-factor diagnosis differed from the local factor-specific diagnosis. Nutrient standards elaborated in one region could hardly be transposed to another and, within the same region, from one bed to another due to site-specific characteristics. Next-year yield and nutrient adjustment could be predicted accurately from current-year yield and tissue composition and other features, with R2 value of 0.73 in regression mode and classification accuracy of 0.85. Compositional and machine learning methods proved to be effective to customize nutrient diagnosis and predict site-specific measures for nutrient management of cranberry stands. This study emphasized the need to acquire large experimental and observational datasets to capture the numerous factor combinations impacting current and next-year cranberry yields at local scale., Competing Interests: LEP received funding from Les Atocas de l’Érable Inc., Les Atocas Blandford Inc., La Cannebergière Inc., and the Natural Sciences and Engineering Research Council of Canada (CRDPJ 469358 – 14 and CG-2254, LEP). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

The formulation of variable selection has been widely developed in the Bayesian literature by linking a random binary indicator to each variable. This Bayesian inference has the advantage of stochastically exploring the set of possible sub-models, whatever their dimension. Bayesian selection approaches, appropriate for categorical predictors, are generally beyond the scope of the standard Bayesian selection of regressors in the linear model since all levels of a categorical variable should be jointly handled in the selection procedure. For categorical covariates, new strategies have been developed to detect the effect of grouped covariates rather than the single effect of a quantitative regressor. In this paper, we review three Bayesian selection methods for categorical predictors: Bayesian Group Lasso with Spike and Slab priors, Bayesian Sparse Group Selection and Bayesian Effect Fusion using model-based clustering. The motivation behind this paper is to provide detailed information about the implementation of the three Bayesian selection methods mentioned above, appropriate for categorical predictors, using the JAGS software. Selection performance and sensitivity analysis of the hyperparameters tuning for prior specifications are assessed under various simulated scenarios. JAGS helps user implement these three Bayesian selection methods for more complex model structures such as hierarchical ones with latent layers., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2021 Informa UK Limited, trading as Taylor & Francis Group.)

Posterior spinal fusion surgery requires careful insertion of screws into the spine to avoid neurologic injury. While current systems use CT-scans, three-dimensional ultrasound (3DUS) could provide guidance by reconstructing the vertebral surface, and then registering a pre-operative vertebral model to that surface for localization. The aim of this study was to evaluate the accuracy and processing time of a custom CT-3DUS registration algorithm. A phantom human vertebra was 3D-printed and scanned with a motion capture-based 3D ultrasound (3DUS) system. Image registration was performed that included a pre-alignment phase using vertebral symmetry information, and then comparing Gaussian pyramid intensity-based registration with iterative-closest-point registration for final transformations. Image registration was performed 192 times while surgical registration between CT and real-world position was performed 84 times. The accuracy of image registration (CT-to-3DUS) was 0.3 ± 0.2 mm and 0.9 ± 0.8° completed in 13.3 ± 2.9 s. The surgical navigation accuracy (CT model to real-world position) of the system was 1.2 ± 0.5 mm and 2.2 ± 2.0° completed in 16.2 ± 3.0 s. Both meet accuracy thresholds of < 2 mm and < 5° required for the surgery. A feasibility study on porcine spine qualitatively showed appropriate overlapping anatomy in CT-3DUS registrations. The usage of 3D ultrasound for navigation has demonstrated accuracy to provide radiation-free image guidance for spine surgery.

Abstract: Clear reporting on rehabilitation treatments is critical for interpreting and replicating study results and for translating treatment research into clinical practice. This article reports the recommendations of a working group on improved reporting on rehabilitation treatments. These recommendations are intended to be combined with the efforts of other working groups, through a consensus process, to arrive at a reporting guideline for randomized controlled trials in physical medicine and rehabilitation (Randomized Controlled Trials Rehabilitation Checklist). The work group conducted a scoping review of 156 diverse guidelines for randomized controlled trial reporting, to identify themes that might be usefully applied to the field of rehabilitation. Themes were developed by identifying content that might improve or enhance existing items from the Template for Intervention Description and Replication. Guidelines addressing broad research domains tended to define reporting items generally, from the investigator's perspective of relevance, whereas those addressing more circumscribed domains provided more specific and operationalized items. Rehabilitation is a diverse field, but a clear description of the treatment's separable components, along with distinct treatment theories for each, can improve reporting of relevant information. Over time, expert consensus groups should develop more specific guideline extensions for circumscribed research domains, around coalescing bodies of treatment theory., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Accurate clinical decision support tools may help clinicians select appropriate interventions for patients with spinal conditions. The Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) is a screening questionnaire extensively studied as a predictive tool. The Work Assessment Triage Tool (WATT) is a clinical decision support tool developed to help select interventions for injured workers., Objective: To compare the classification accuracy of the ÖMPQ and WATT to clinician recommendations for selecting interventions leading to a successful return to work in patients with spinal conditions., Methods: A secondary analysis was undertaken of data from injured workers with spinal conditions assessed between 2013 and 2016. We considered it a success if the workers did not receive wage replacement benefits 30 days after assessment. Analysis included positive likelihood ratio (LR+) as an indicator of predictive accuracy., Results: Within the database, 2,872 patients had complete data on the ÖMPQ, WATT, and clinician recommendations. At 30 days, the ÖMPQ was most accurate for identifying treatments that lead to successful outcomes with a LR+= 1.51 (95% Confidence Interval 1.26-1.82) compared to 1.05 (95% Confidence Interval 1.02-1.09) for clinicians, and 0.85 (95% Confidence Interval 0.79-0.91) for the WATT., Conclusions: All tool recommendations had poor accuracy, however the ÖMPQ demonstrated significantly better results.

Understanding the processes shaping population structure and reproductive isolation of marine organisms can improve their management and conservation. Using genomic markers combined with estimation of individual ancestries, assignment tests, spatial ecology, and demographic modeling, we (i) characterized the contemporary population structure, (ii) assessed the influence of space, fishing depth, and sampling years on contemporary distribution, and (iii) reconstructed the speciation history of two cryptic redfish species, Sebastes mentella and S. fasciatus . We genotyped 860 individuals in the Northwest Atlantic Ocean using 24,603 filtered single nucleotide polymorphisms (SNPs). Our results confirmed the clear genetic distinctiveness of the two species and identified three ecotypes within S. mentella and five populations in S. fasciatus . Multivariate analyses highlighted the influence of spatial distribution and depth on the overall genomic variation, while demographic modeling revealed that secondary contact models best explained inter- and intragenomic divergence. These species, ecotypes, and populations can be considered as a rare and wide continuum of genomic divergence in the marine environment. This acquired knowledge pertaining to the evolutionary processes driving population divergence and reproductive isolation will help optimizing the assessment of demographic units and possibly to refine fishery management units., (© 2020 Her Majesty the Queen in Right of Canada. Evolutionary Applications published by John Wiley & Sons Ltd. Reproduced with the permission of the Minister of Fishers and Ocean.)

Background: Herd immunity or community immunity refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving the understanding of community immunity may increase intentions to get vaccinated., Objective: This study aims to design a web application about community immunity and optimize it based on users' cognitive and emotional responses., Methods: Our multidisciplinary team developed a web application about community immunity to communicate epidemiological evidence in a personalized way. In our application, people build their own community by creating an avatar representing themselves and 8 other avatars representing people around them, for example, their family or coworkers. The application integrates these avatars in a 2-min visualization showing how different parameters (eg, vaccine coverage, and contact within communities) influence community immunity. We predefined communication goals, created prototype visualizations, and tested four iterative versions of our visualization in a university-based human-computer interaction laboratory and community-based settings (a cafeteria, two shopping malls, and a public library). Data included psychophysiological measures (eye tracking, galvanic skin response, facial emotion recognition, and electroencephalogram) to assess participants' cognitive and affective responses to the visualization and verbal feedback to assess their interpretations of the visualization's content and messaging., Results: Among 110 participants across all four cycles, 68 (61.8%) were women and 38 (34.5%) were men (4/110, 3.6%; not reported), with a mean age of 38 (SD 17) years. More than half (65/110, 59.0%) of participants reported having a university-level education. Iterative changes across the cycles included adding the ability for users to create their own avatars, specific signals about who was represented by the different avatars, using color and movement to indicate protection or lack of protection from infectious disease, and changes to terminology to ensure clarity for people with varying educational backgrounds. Overall, we observed 3 generalizable findings. First, visualization does indeed appear to be a promising medium for conveying what community immunity is and how it works. Second, by involving multiple users in an iterative design process, it is possible to create a short and simple visualization that clearly conveys a complex topic. Finally, evaluating users' emotional responses during the design process, in addition to their cognitive responses, offers insights that help inform the final design of an intervention., Conclusions: Visualization with personalized avatars may help people understand their individual roles in population health. Our app showed promise as a method of communicating the relationship between individual behavior and community health. The next steps will include assessing the effects of the application on risk perception, knowledge, and vaccination intentions in a randomized controlled trial. This study offers a potential road map for designing health communication materials for complex topics such as community immunity., (©Hina Hakim, Julie A Bettinger, Christine T Chambers, S Michelle Driedger, Eve Dubé, Teresa Gavaruzzi, Anik M C Giguere, Éric Kavanagh, Julie Leask, Shannon E MacDonald, Rita Orji, Elizabeth Parent, Jean-Sébastien Paquette, Jacynthe Roberge, Beate Sander, Aaron M Scherer, Martin Tremblay-Breault, Kumanan Wilson, Daniel Reinharz, Holly O Witteman. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.10.2020.)

Clostridium perfringens, a commensal of the intestinal tract of many animal species, has been associated with necrotic enteritis (NE), an economically significant poultry disease. Clostridium perfringens is known to survive in the environment for extended periods of time through the formation of spores. These spores have the potential to be transmitted to subsequent flocks. Persistence of a single C. perfringens strain in a broiler chicken farm environment has, however, been poorly documented. The aim of this study was to compare multiple isolates of C. perfringens collected over time in a single farm with recurrent episodes of NE. Isolates were recovered from the intestines of chickens affected with NE (2014 and 2016 outbreaks) and from healthy chickens (2017), as well as from environmental samples (2016). PCR characterization of those isolates showed that all sampling groups contained netB-positive isolates except for the environmental samples. Moreover, results showed that all environmental isolates were positive for the cna adhesin whereas other groups had lower numbers of cna-positive isolates. Biofilm formation assays showed that most of the isolates were able to form biofilm. Pulsed-field gel electrophoresis analysis showed that one clone was present in every sampling group, with the exception of the 2014 outbreak. However, one clone found in the latter group was highly similar, having 94% similarity with the persistent C. perfringens clone. This study describes for the first time the persistence of a C. perfringens strain on a broiler chicken house over a 3-yr period.

Increasing efforts have been made in recent years to reduce antimicrobial use in animal production. The objective of this prospective study was to evaluate, in commercial broiler chicken farms, 2 antibiotic reduction strategies that eliminated the use of antibiotics important for human medicine, in comparison with the conventional use of antibiotics. On 7 broiler chicken farms, a house was allocated to the antibiotic reduction treatments for 6 consecutive flocks, whereas a similar house on the same premises was assigned to the conventional use of antibiotics (CONV) for 6 consecutive flocks. The antibiotic reduction strategies consisted of continuous in-feed use of ionophores (TX1) and continuous in-feed use of ionophores with butyric acid (TX2). In the 84 flocks, zootechnical performance was recorded, lesion scoring at 21 and 28 D of age was performed, and fecal samples were recovered during grow out for Eimeria spp. oocysts counts. There was no statistical difference between TX1, TX2, and CONV for weights at slaughter, feed conversion ratios, average daily gains, age at slaughter, total mortalities, and condemnations. The probability of identifying oocysts in the fecal samples significantly increased with the age of the flock, but there was no significant treatment effect between 7 and 16 D of age. At 19 D of age, the probability of a sample containing oocysts was higher in TX1 than in CONV, but TX2 was not statistically different from TX1 and CONV. Predicted oocysts per gram in CONV flocks were significantly lower between 22 and 34 D of age than in TX1 and TX2 flocks, whereas there were no significant differences between TX1 and TX2 for all ages. Lesion scoring of the gastrointestinal system showed no differences for coccidiosis scores between TX1, TX2, and CONV. No lesions of necrotic enteritis were observed. In conclusion, it was possible to adequately control intestinal diseases and maintain zootechnical performances by relying exclusively on ionophores, when compared with broiler chicken flocks using standard shuttle programs with antibiotic growth promoters., (Copyright © 2020. Published by Elsevier Inc.)

The discovery of a radioactively powered kilonova associated with the binary neutron-star merger GW170817 remains the only confirmed electromagnetic counterpart to a gravitational-wave event 1,2 . Observations of the late-time electromagnetic emission, however, do not agree with the expectations from standard neutron-star merger models. Although the large measured ejecta mass 3,4 could be explained by a progenitor system that is asymmetric in terms of the stellar component masses (that is, with a mass ratio q of 0.7 to 0.8) 5 , the known Galactic population of merging double neutron-star systems (that is, those that will coalesce within billions of years or less) has until now consisted only of nearly equal-mass (q > 0.9) binaries 6 . The pulsar PSR J1913+1102 is a double system in a five-hour, low-eccentricity (0.09) orbit, with an orbital separation of 1.8 solar radii 7 , and the two neutron stars are predicted to coalesce in [Formula: see text] million years owing to gravitational-wave emission. Here we report that the masses of the pulsar and the companion neutron star, as measured by a dedicated pulsar timing campaign, are 1.62 ± 0.03 and 1.27 ± 0.03 solar masses, respectively. With a measured mass ratio of q = 0.78 ± 0.03, this is the most asymmetric merging system reported so far. On the basis of this detection, our population synthesis analysis implies that such asymmetric binaries represent between 2 and 30 per cent (90 per cent confidence) of the total population of merging binaries. The coalescence of a member of this population offers a possible explanation for the anomalous properties of GW170817, including the observed kilonova emission from that event.

Infection of the oviduct by an infectious bronchitis virus (IBV) in laying hens has been associated with the false layer syndrome. Because the diagnostic procedure for the detection of cystic oviducts by postmortem examinations in IBV-positive replacement pullet flocks could involve the unnecessary sacrifice of numerous healthy pullets without reproductive tract anomalies, the development of a noninvasive and nonlethal diagnostic procedure would be desirable. The first objective of the study was to evaluate the diagnostic accuracy of a transcutaneous ultrasonography method to predict the presence of cystic oviducts compared to postmortem examinations in a commercial pullet flock positive for an IBV genotype Delmarva (DMV) variant. The second objective was to evaluate the performance of the same ultrasonography method to later detect false layers in the same flock in sexually mature hens by identifying the presence of an egg in the oviduct due to the presence of atretic oviducts undetectable by ultrasonography and the absence of cystic oviducts at that age. In replacement pullets, the sensitivity (Se) and specificity (Sp) of the ultrasonography (index test) compared to the postmortem examination (reference standard test) were 73% and 91%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 67% and 93%. The ultrasonography technique showed a positive likelihood ratio (LR+) of 7.82 and a negative likelihood ratio (LR-) of 0.30. In sexually mature hens, the Se, Sp, PPV, and NPV of the ultrasonography compared to the laying status were 98%. The LR+ was 49.00 and the LR- was 0.02 when compared to the laying status. In conclusion, the ultrasonography could replace postmortem examinations to detect cystic oviducts in commercial flocks of replacement pullets previously infected with an IBV-DMV 1639 variant. Although the test accuracy of ultrasonography was excellent for the hens at production peak to identify laying and nonlaying hens based on the presence of an egg in the reproductive tract, its practicality was limited due to atretic oviducts being not detectable.

Purpose: Surgical treatment of severe adolescent idiopathic scoliosis (AIS) with posterior spinal instrumentation and fusion with pedicle screws is common, requiring careful screw insertion to prevent pedicle breaches and neurologic complications. Image guidance has been suggested to improve breach rates, though the radiation risk for AIS precludes its common usage. The purpose of this systematic review and meta-analysis was to compare the breach rates and screw-related complications for AIS patients undergoing spine surgery with pedicle screws between freehand screw insertion and image guidance methods., Methods: A comprehensive search of MEDLINE, EMBASE, CINAHL, CENTRAL and Web of Science databases was conducted. Two reviewers independently screened abstracts, full-texts, extracted data and performed risk of bias assessment using the QUIPS quality appraisal tool. Level of evidence summary statements were formulated based on consistency and quality of reporting., Results: Ninety-four studies were found, with 18 studies of moderate risk of bias or better. Moderate evidence from two head-to-head studies shows CT guidance has lower breach rates than freehand methods (OR 0.28 [0.20-0.40, I 2  = 1%]), with no complications in either study. From individual studies, moderate evidence showed lower breach rates for image guidance versus freehand methods (13%, I 2  = 98% vs. 20%, I 2  = 95%). Complication rates were conflicting (0-1.6% for image guidance, 0-1.7% for freehand). Moderate evidence showed increased surgical time for image guidance versus freehand (257.7 min vs. 226.8 min)., Conclusions: Meta-analyzed breach rates show moderate evidence of decreased breaches with CT navigation compared with freehand methods. Complication rates remain unknown due to the low complication rates from small sample sizes. These slides can be retrieved under Electronic Supplementary Material.

Invasion of new territories by alien organisms is of primary concern for environmental and health agencies and has been a core topic in mathematical modeling, in particular in the intents of reconstructing the past dynamics of the alien organisms and predicting their future spatial extents. Partial differential equations offer a rich and flexible modeling framework that has been applied to a large number of invasions. In this article, we are specifically interested in dating and localizing the introduction that led to an invasion using mathematical modeling, post-introduction data and an adequate statistical inference procedure. We adopt a mechanistic-statistical approach grounded on a coupled reaction-diffusion-absorption model representing the dynamics of an organism in an heterogeneous domain with respect to growth. Initial conditions (including the date and site of the introduction) and model parameters related to diffusion, reproduction and mortality are jointly estimated in the Bayesian framework by using an adaptive importance sampling algorithm. This framework is applied to the invasion of Xylella fastidiosa, a phytopathogenic bacterium detected in South Corsica in 2015, France.

Background: Few, if any, patient reported symptoms have been shown to be related to objective measures of spine function. Recently, patient-reported measures of disability following spinal manipulative therapy have been associated with an immediate decrease in spinal stiffness obtained by instrumented L3 indentation. Given this novel relation, we anticipate that stiffness measures obtained from locations in addition to L3 may yield valuable information. As such, our research team has developed a new technique to acquire stiffness data continuously over an entire spinal region. The reliability of stiffness measurements obtained by this new technique has yet to be quantified., Methods: Continuous stiffness testing employs a weighted roller that moves uninterrupted over the spine while measuring the resulting spinal deflection along a subject-specific, laser-defined trajectory. A volunteer sample of asymptomatic participants were assessed in 2 sessions occurring 1 to 4 days apart, with each session scheduled at the same time of day. Each session consisted of 3 trials each beginning at a baseline of ~ 17 N then progressing to a maximally tolerable load as defined from pre-test familiarization trials (~ 61, 72 or 83 N). Reliability was evaluated with the intraclass correlation coefficient, the standard error of measurement and Bland & Altman analysis., Results: A total of 17 asymptomatic participants (mean age 29.2 +/- 6 years, 53% female) took part in the study. Overall, the within and between-session reliability of lumbar spine stiffness measures at the maximal tolerable load was excellent ranging from 0.95-1.00 and good to excellent ranging from 0.82-0.93, respectively. Trial averaging was found to reduce standard error of measurement by a mean of 35.2% over all measurement conditions compared to a single trial. Bland and Altman plots for agreement in lumbar spine stiffness measurements varied from - 0.3 +/- 1.2 at unloaded condition to - 0.2 +/- 1.2 at loaded condition. Data from two participants were removed due to the development of back pain between two sessions., Conclusion: This study introduced a new technique for measuring spinal stiffness over an entire spinal region in asymptomatic human participants. The new technique produced reliable measurements quantifying the load-displacement values for within-session and between-session assessments.

Purpose: Determine the positional, rotational and reconstruction accuracy of a 3D ultrasound system to be used for image registration in navigation surgery., Methods: A custom 3D ultrasound for spinal surgery image registration was developed using Optitrack Prime 13-W motion capture cameras and a SonixTablet Ultrasound System. Temporal and spatial calibration was completed to account for time latencies between the two systems and to ensure accurate motion tracking of the ultrasound transducer. A mock operating room capture volume with a pegboard grid was set up to allow phantoms to be placed at a variety of predetermined positions to validate accuracy measurements. Five custom-designed ultrasound phantoms were 3D printed to allow for a range of linear and angular dimensions to be measured when placed on the pegboard., Results: Temporal and spatial calibration was completed with measurement repeatabilities of 0.2 mm and 0.5° after calibration. The mean positional accuracy was within 0.4 mm, with all values within 0.5 mm within the critical surgical regions and 96% of values within 1 mm within the full capture volume. All orientation values were within 1.5°. Reconstruction accuracy was within 0.6 mm and 0.9° for geometrically shaped phantoms and 0.5 and 1.9° for vertebrae-mimicking phantoms., Conclusions: The accuracy of the developed 3D ultrasound system meets the 1 mm and 5° requirements of spinal surgery from this study. Further repeatability studies and evaluation on vertebrae are needed to validate the system for surgical use.

Necrotic enteritis was studied in chickens using various in vivo infection models. Most of these use a combination of predisposing factors, such as coccidiosis and diet, with gavage or administration via the feed using Clostridium perfringens. In these models, the comparison of multiple C. perfringens strains for virulence studies requires a large number of hosts to obtain significant results. Mortality during the course of the study can be high depending on the experimental model, hence raising ethical concerns regarding animal welfare in research. The development of new infection models requiring fewer animals to study pathogenesis, yet providing statistically significant and valid results, is important in reducing animal use in research. Intestinal ligated loop models have been used to study clostridial infections in various species such as mice, rabbits and calves. Following surgical procedures to create ligated loop segments, C. perfringens strains are injected directly into the loops to establish a close contact between the bacteria and the intestinal mucosa. Samples of the small intestine and luminal contents are taken at the termination of the procedures after a few hours. Multiple bacterial strains can be inoculated in each animal, hence reducing the number of required subjects in the experiments. Also, procedures are performed under general anesthesia to reduce animal pain. In chickens, this model would be more appropriate than oral administration to compare C. perfringens strain pathogenicity because fewer animals are needed, no predisposing factors are required to induce the disease, and pain is controlled by analgesics. The intestinal ligated loop model is poorly described in chickens and standardization is essential for its optimal use. This manuscript provides all the necessary steps to create numerous intestinal ligated loops in chickens and brings information on the critical points to obtain valid results.

The objectives were to compare the effects of an antibiotic-free (ABF) program in commercial broiler chicken flocks using a live non-attenuated coccidiosis vaccine on fecal Eimeria spp. excretion and growth performances with those of conventionally raised commercial broiler chicken flocks. Fecal samples were collected every 3 d from 7 d of age to slaughter in 44 flocks of 7 participating farms for oocyst counts by the McMaster method. A live non-attenuated anticoccidial vaccine was administered by spray cabinet at the hatchery in ABF flocks only. Shuttle programs in conventional flocks consisted of in-feed chemical anticoccidials from 0 to 20 d of age, followed by polyether ionophores until slaughter. In-feed antibiotic growth promoters were included from the starter to finisher diets in conventional flocks only. Age of the flock at the oocyst excretion peak (AGE&#95;PEAK) and the number of oocysts at that excretion peak (OPG&#95;PEAK) were recorded. There was a significant difference of 2.7 d (P = 0.0001) for the AGE&#95;PEAK, from 26.4 d in the conventional treatment to 23.7 d in the ABF program. There was no significant difference for the OPG&#95;PEAK between the 2 treatments (P = 0.626). There was a significant decrease of 2.28 g in the average daily gain (P = 0.004) and increase of 0.08 for the feed conversion ratio (P < 0.0001) in the ABF program compared to the conventional program. There were no significant differences for body weights at slaughter (P = 0.0563), livability (P = 0.2694), and condemnations (P = 0.6775). From this study, it can be concluded that an ABF program using a live non-attenuated vaccine will show an earlier oocyst excretion peak compared to a shuttle program, but no significant effect was observed on the total number of oocysts at that excretion peak between the 2 programs.

Background: Noninvasively predicting early response to therapy in recurrent pediatric brain tumors provides a challenge. 3,4-dihydroxy-6-[ 18 F]fluoro-L-phenylalanine ( 18 F-FDOPA) PET/MRI has not been previously studied as a tool to evaluate early response to antiangiogenic therapy in children. The purpose of this study was to evaluate the safety and feasibility of using 18 F-FDOPA PET/MRI to assess response to bevacizumab in children with relapsed brain tumors., Materials and Methods: Six patients with recurrent gliomas (5 low-grade, 1 high-grade) planned to undergo treatment with bevacizumab were enrolled. 18 F-FDOPA PET/MRI scans were obtained prior to and 4 weeks following the start of treatment, and these were compared with the clinical response determined at the 3-month MRI. The primary PET measure was metabolic tumor volume (MTV) at 10 to 15 min after 18 F-FDOPA injection. For each tumor, the MTV was determined by manually defining initial tumor volumes of interest (VOI) and then applying a 1.5-fold threshold relative to the mean standardized uptake value (SUV) of a VOI in the frontal lobe contralateral to the tumor., Results: 18 F-FDOPA PET/MRI was well tolerated by all patients. All tumors were well visualized with 18 F-FDOPA on the initial study, with peak tumor uptake occurring approximately 10 min after injection. Maximum and mean SUVs as well as tumor-to-brain ratios were not predictors of response at 3 months. Changes in MTVs after therapy ranged from 23% to 98% (n = 5). There is a trend towards the percent MTV change seen on the 4-week scan correlating with progression-free survival., Conclusion: 18 F-FDOPA PET/MRI was well tolerated in pediatric patients and merits further investigation as an early predictor of response to therapy.

Background: The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) produced its first guidelines in 2005 and renewed them in 2011. Recently published high-quality clinical trials on the effect of conservative treatment approaches (braces and exercises) for idiopathic scoliosis prompted us to update the last guidelines' version. The objective was to align the guidelines with the new scientific evidence to assure faster knowledge transfer into clinical practice of conservative treatment for idiopathic scoliosis (CTIS)., Methods: Physicians, researchers and allied health practitioners working in the area of CTIS were involved in the development of the 2016 guidelines. Multiple literature reviews reviewing the evidence on CTIS (assessment, bracing, physiotherapy, physiotherapeutic scoliosis-specific exercises (PSSE) and other CTIS) were conducted. Documents, recommendations and practical approach flow charts were developed using a Delphi procedure. The process was completed with the Consensus Session held during the first combined SOSORT/IRSSD Meeting held in Banff, Canada, in May 2016., Results: The contents of the new 2016 guidelines include the following: background on idiopathic scoliosis, description of CTIS approaches for various populations with flow-charts for clinical practice, as well as literature reviews and recommendations on assessment, bracing, PSSE and other CTIS. The present guidelines include a total of 68 recommendations divided into following topics: bracing ( n  = 25), PSSE to prevent scoliosis progression during growth ( n  = 12), PSSE during brace treatment and surgical therapy ( n  = 6), other conservative treatments ( n  = 2), respiratory function and exercises ( n  = 3), general sport activities ( n  = 6); and assessment ( n  = 14). According to the agreed strength and level of evidence rating scale, there were 2 recommendations on bracing and 1 recommendation on PSSE that reached level of recommendation "I" and level of evidence "II". Three recommendations reached strength of recommendation A based on the level of evidence I (2 for bracing and one for assessment); 39 recommendations reached strength of recommendation B (20 for bracing, 13 for PSSE, and 6 for assessment).The number of paper for each level of evidence for each treatment is shown in Table 8., Conclusion: The 2016 SOSORT guidelines were developed based on the current evidence on CTIS. Over the last 5 years, high-quality evidence has started to emerge, particularly in the areas of efficacy of bracing (one large multicentre trial) and PSSE (three single-centre randomized controlled trials). Several grade A recommendations were presented. Despite the growing high-quality evidence, the heterogeneity of the study protocols limits generalizability of the recommendations. There is a need for standardization of research methods of conservative treatment effectiveness, as recognized by SOSORT and the Scoliosis Research Society (SRS) non-operative management Committee., Competing Interests: Not applicable.Not applicable.All Commission Members are physicians, orthothists and physiotherapists who earn from their own work. The conflict of interests declared by the authors are as follows: ✓ Stefano Negrini has a stock of ISICO (Italian Scientific Spine Institute), Italy. ✓ Manuel Rigo is advisor of Ortholutions, Germany. ✓ Michele Romano has a stock of ISICO (Italian Scientific Spine Institute), Italy. ✓ James H. Wynne is an employee of Boston Brace Corp., USA: ✓ No other conflict of interests have been declared.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background Context: Severe adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity requiring surgery to stop curve progression. Posterior spinal instrumentation and fusion with pedicle screws is the standard surgery for AIS curve correction. Vascular and neurologic complications related to screw malpositioning are concerns in surgeries for AIS. Breach rates are reported at 15.7%, implant-related complications at 1.1%, and neurologic deficit at 0.8%. Free-hand screw insertion remains the prevailing method of screw placement, whereas image guidance has been suggested to improve placement accuracy., Purpose: This study aimed to systematically review the screw-related complication and breach rates from posterior spinal instrumentation and fusion with pedicle screws for patients with AIS when using free-hand methods for screw insertion compared with image guidance methods., Study Design: This is a systematic review of prognosis, comparing image guidance with no image guidance in surgery., Patient Sample: One randomized controlled trial and multiple prospective cohort studies that reported complication or breach rates in posterior spinal instrumentation and fusion with pedicle screws for AIS., Outcome Measures: Number of complications and breaches reported in databases or recorded from postoperative imaging., Methods: Databases searched included MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science. Studies of Level 3 evidence or greater as defined by the Centre for Evidence-Based Medicine were included. Articles were screened to focus on patients with AIS undergoing posterior fusion with pedicle screws or hybrid systems. Two independent reviewers screened abstracts, full texts, and extracted data. The Quality in Prognostic Studies (QUIPS) appraisal tool was used to determine studyrisk of bias (ROB). Level of evidence summary statements were formulated based on consistency and quality of reporting., Results: Seventy-nine cohort studies were identified, including four comparing computed tomography (CT) guidance with free-hand methods head-to-head, eight on image guidance, and 671. on free-hand methods alone. Moderate evidence from individual head-to-head studies show CT guidance has lower breach rates than free-hand methods. No complications were found in these studies. From individual cohort studies, moderate evidence shows CT guidance has lower point estimates of breach rates than free-hand methods at 7.9% compared with 9.7%-17.1%. Screw-related complication rates are conflicting at 0% in CT navigation compared with 0%-1.7% in 13 low- and moderate-quality studies., Conclusions: Although point estimates on breach rates are decreased with CT navigation compared with free-hand methods, complication rates remain conflicting between the two methods. Current evidence is limited by small sample sizes, lack of comparison groups, and poorly predefined complications. Randomized controlled trials with larger samples with standardized definitions and recording of predefined breach and complication occurrences are recommended., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Necrotic enteritis (NE) is a major problem in antibiotic-free (ABF) chicken flocks and specific strains of Clostridium perfringens are known to induce NE. The objective of this study was to develop a chicken intestinal ligated loop model in order to compare the virulence of various C. perfringens strains recovered from consecutive ABF flocks with and without NE. Intestinal loops were surgically prepared in 10 anaesthetized specific-pathogen-free chickens and alternately inoculated with C. perfringens isolates or brain heart infusion (BHI) media. Histological lesion scoring was performed for each loop. All strains from NE-affected flocks induced histological lesions compatible with NE whereas inoculation of loops with a commensal C. perfringens strain or BHI did not. Among inoculated strains, CP0994 (netB-positive and cpb2-positive) and CP-2003-1256 (netB-positive) demonstrated mean histological lesion scores significantly higher (P < 0.01) than those obtained with a commensal strain or BHI whereas strain CP1073 (netB-negative and cpb2-positive) induced intestinal lesions without significantly higher scores. In loops where villi were colonized by Gram-positive rods, significantly higher (P < 0.01) mean histological lesion scores were observed. This result supports the hypothesis that colonization of the intestinal mucosa by C. perfringens is a critical step in the pathogenesis of NE. Finally, we demonstrated the importance of controlling virulent C. perfringens strains in ABF chicken flocks as a highly virulent strain can be present in consecutive flocks with NE and possibly affect multiple flocks.

Following the pattern of phase I clinical trials for cytotoxic drugs, dose-finding clinical trials in oncology of molecularly targeted agents (MTA) aim at determining the maximum tolerated dose (MTD). In classical phase I clinical trials, MTD is generally defined by the number of patients with short-term major treatment toxicities (usually called dose-limiting toxicities, DLT), occurring during the first cycle of study treatment (e.g. within the first 3weeks of treatment). However, S. Postel-Vinay (2011) highlighted that half of grade 3 to 4 toxicities, usually considered as DLT, occur after the first cycle of MTA treatment. In addition, MTAs could induce other moderate (e.g. grade 2) toxicities which could be taken into account depending on their clinical importance, chronic nature and duration. Ignoring these late toxicities may lead to an underestimation of the drug toxicity and to wrong dose recommendations for phase II and III clinical trials. Some methods have been proposed, such as the time-to-event continuous reassessment method (Cheung 2000 and Mauguen 2011), to take into account the late toxicities. We suggest approaches based on longitudinal models (Doussau 2013). We compare several models for longitudinal data, such as transitional or marginal models, to take into account all relevant toxicities occurring during the entire length of the patient treatment (and not just the events within a predefined short-term time-window). These models allow the statistician to benefit from a larger amount of safety data which could potentially improve that accuracy in MTD assessment., (Copyright © 2015 John Wiley & Sons, Ltd.)