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Virtual reality (VR) is a promising tool for training life skills in people with intellectual disabilities. However, there is a lack of evidence surrounding the implementation, suitability, and effectiveness of VR training in this population. The present study investigated the effectiveness of VR training for people with intellectual disabilities by assessing (1) their ability to complete basic tasks in VR, (2) real-world transfer and skill generalisation, and (3) the individual characteristics of participants able to benefit from VR training. Thirty-two participants with an intellectual disability of varying severity completed a waste management training intervention in VR that involved sorting 18 items into three bins. Real-world performance was measured at pre-test, post-test, and delayed time points. The number of VR training sessions varied as training ceased when participants met the learning target (≈ 90% correct). A survival analysis assessed training success probability as a function of the number of training sessions with participants split by their level of adaptive functioning (as measured on the Adaptive Behaviour Assessment System Third Edition). The learning target was met by 19 participants (59.4%) within ten sessions (Mdn = 8.5, IQR 4–10). Real-world performance significantly improved from pre- to post-test and pre- to delayed test. There was no significant difference from post- to delayed test. Further, there was a significant positive relationship between adaptive functioning and change in the real-world assessment from the pre-test to the post- and delayed tests. VR facilitated the learning of most participants, which led to demonstrations of real-world transfer and skill generalisation. The present study identified a relationship between adaptive functioning and success in VR training. The survival curve may assist in planning future studies and training programs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to prospectively evaluate the clinical and radiological results of double level osteotomy (distal femoral lateral closed wedge and proximal tibial medial open wedge) in medial osteoarthritis and varus malalignment due to bifocal deformity of femur and tibia. Methods: From 2017 to 2019 all cases of DLO in osteoarthritic varus malaligned knees with bifocal deformity (femoral and tibial deformity) were prospectively enrolled into this observational therapeutic study. Evaluation was performed preoperatively, at six, twelve, 18 and 24 months with regard to survival (not requiring arthroplasty), functional outcome [subjective International Knee Documentation Committee score (IKDC), Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome score (KOOS) and Tegner Activity Scale], pain level (numeric rating scale), subjective satisfaction (rating 1–5), radiographic parameters on a pre-and postoperative full leg x-rays (mechanical axis, mechanical proximal tibial and distal femoral angles) and complications. For statistical evaluation student's t test, Mann–Whitney U test and Wilcoxon-signed-rank test were used. Results: Fifty-two consecutive cases in 48 patients were enrolled in the study. Three cases were excluded, resulting in a follow-up rate of 94%. No arthroplasties were performed within follow-up. All functional outcome scores substantially and significantly increased as early as six months after the index procedure and further increased until final follow-up (p < 0.001). Pain level significantly decreased (p < 0.001). At final follow-up all patients stated that they would retrospectively undergo the operation again, and rated the result with 4.5 ± 0.6 out of 5 (3–5). Radiographic parameters were within physiological limits postoperatively. No severe complications occurred. Conclusions: Double level osteotomy has excellent short-term results while maintaining physiological radiographic parameters. Therefore, it should be an integral part and standard procedure in realignment surgery for monocompartimental osteoarthritis. Level of evidence: IV (prospective observational therapeutic study). [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of an "increased posterior tibial slope (PTS)" (PTS ≥ 12°) in a population with one, two or ≥ three anterior cruciate ligament (ACL) graft insufficiencies. Furthermore, to investigate whether the prevalence of an increased PTS and the absolute PTS increases with an increasing number of ACL graft insufficiencies, as well as to determine the survival time of the first ACL graft. Methods: Patients diagnosed with an ACL graft insufficiency between January 2021 and March 2022 were included. The PTS was measured using the proximal anatomical tibial axis on long lateral knee radiographs. Patients were divided into 3 groups depending on the number of ACL graft insufficiencies: group A (1 graft insufficiency), group B (2 graft insufficiencies) and group C (≥ 3 graft insufficiencies). The prevalence of increased PTS and absolute PTS between groups was compared alongside the survival of the first ACL graft between patients with or without increased PTS. Results: Two-hundred and six patients (147 males/59 females) met the inclusion criteria. 73 patients showed an increased PTS [prevalence 35% [95% confidence interval (CI) (29%; 42%)]. 155 patients were found in category A, 42 patients in B and 9 patients in C. The prevalence of increased PTS for group A, B and C was, 32% [95% CI (25%; 40%)], 38% [95% CI (23%; 53%)] and 78% [95% CI (51%; 100%)], respectively. The prevalence of increased PTS and mean PTS did not increase significantly between group A and B. However, both parameters increased significantly between group A and C, and group B and C (p < 0.05). The survival time of the first ACL graft in patients with or without an increased PTS was 3 (interquartile range (IQR) 5) and 6 years (IQR 9), respectively (p < 0.05). Conclusion: There is a 35% prevalence of increased PTS in the studied ACL graft insufficient patient cohort. The survival of the first ACL graft is shorter in patients with an increased PTS. Surgeons should be aware of the high prevalence of increased PTS when consulting patients for revision ACL reconstruction as it is an important risk factor for recurrent instability. Level of evidence: 3. [ABSTRACT FROM AUTHOR]

The freshwater amphipod species Gammarus pulex (Linnaeus, 1758) is widespread across Europe and Asia and is able to live in a broad range of environmental conditions. Yet, it is of great interest to which degree it is able to tolerate and adapt to the current rapid anthropogenic environmental changes affecting its habitat, such as pollution, changes in river morphology, and invasions of alien gammarid species. Microsatellite primers for genetic population studies with G. pulex have been developed but due to the existence of several genetically different lineages within the species, the application of these primers is not always successful. In order to investigate the impacts of anthropogenic environmental changes on the spatio-genetic patterns of G. pulex lineage E in streams in the Saale river catchment in Germany, we designed eleven novel polymorphic microsatellites for this lineage using a high-throughput sequencing approach. These microsatellites enabled highly specific characterization of three closely related populations. The results show genetically distinct populations reflected by both a principal coordinates analysis and an analysis of molecular variance. Several of the newly designed microsatellite primers also enabled successful cross-amplification of the respective microsatellites in specimens of G. pulex lineage C, while only two microsatellites were amplified successfully and showed polymorphisms for all of the analyzed specimens of G. fossarum Koch, 1836. The microsatellites identified here are suitable for future assessments of micro-evolutionary dynamics of G. pulex from central Germany. [ABSTRACT FROM AUTHOR]

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In Central Europe, the genus Platanthera traditionally comprised two species, P. chlorantha Cust. ex Rchb. (Pc) and P. bifolia (L.) Rich. (Pb). They are morphologically characterized by a wide and narrow separation of anthers, respectively. However, a third form with intermediate anther distance has repeatedly been hypothesized but only hesitantly accepted. In addition, intermediate morphology has been also used as the main character of P. × hybrida. However, the status of some purported hybrid populations is challenged by the local lack of parental species, their successful reproduction and non-intermediate traits. Despite this unclear situation, detailed genetic and morphological analyses are lacking. Here, we studied morphology and molecular markers within the P. chlorantha/ bifolia group in Central Europe. Three morphological groups emerged representing Pc, Pb and a third form, here informally referred to as non-hybrid intermediates (Pn). The latter is characterized, among other trait differences, by intermediate distance between anthers [(0.7)-1-2.2 mm] and long spurs (28-40 mm). Three gene pools were identified, which largely corresponded to the three morphological groups. The Pn gene pool had several high-frequency private alleles substantiating its genetic independence. Some of the Pn populations were previously interpreted as P. × hybrida suggesting that Pn was overlooked hitherto and mistaken to represent hybrids. The non-perfect fit between morphological and genetic groups highlights the potential for fast morphological evolution. Overall, the finding of three distinct lineages within the bifolia/chlorantha group necessitates a thorough reanalysis of reported taxa and a reevaluation of our understanding of their distribution, ecology and evolution. [ABSTRACT FROM AUTHOR]

The effects of species loss on ecosystems depend on the community's functional diversity (FD). However, how FD responds to environmental changes is poorly understood. This applies particularly to higher trophic levels, which regulate many ecosystem processes and are strongly affected by human-induced environmental changes. We analyzed how functional richness (FRic), evenness (FEve), and divergence (FDiv) of important generalist predators-epigeic spiders-are affected by changes in woody plant species richness, plant phylogenetic diversity, and stand age in highly diverse subtropical forests in China. FEve and FDiv of spiders increased with plant richness and stand age. FRic remained on a constant level despite decreasing spider species richness with increasing plant species richness. Plant phylogenetic diversity had no consistent effect on spider FD. The results contrast with the negative effect of diversity on spider species richness and suggest that functional redundancy among spiders decreased with increasing plant richness through non-random species loss. Moreover, increasing functional dissimilarity within spider assemblages with increasing plant richness indicates that the abundance distribution of predators in functional trait space affects ecological functions independent of predator species richness or the available trait space. While plant diversity is generally hypothesized to positively affect predators, our results only support this hypothesis for FD-and here particularly for trait distributions within the overall functional trait space-and not for patterns in species richness. Understanding the way predator assemblages affect ecosystem functions in such highly diverse, natural ecosystems thus requires explicit consideration of FD and its relationship with species richness. [ABSTRACT FROM AUTHOR]

The conservation of endangered species critically depends on the understanding to which degree short-term fitness and long-term trends are affected by intrinsic local conditions and external global dynamics. However, studies combining long-term demographic data with population level analyses of site conditions, genetic variation, and reproduction as well as with climatic data are still rare. Here we studied the endangered orchid Anacamptis morio, representative for species with a sub-mediterranean distribution. For populations at the northern range edge, we combined long-term monitoring data (1977-2010) with climatic data and analyzed reproductive fitness components, genetic variation, and abiotic site conditions. Reproduction was generally low as expected from the deceptive pollination system, and was positively influenced by population size and xerothermic site quality. The majority of populations showed a positive population trend, which was paralleled by an increase in spring temperature and positively affected by site quality. High levels of genetic variation were found in the populations which were at gene flow-drift equilibrium. A. morio may profit from increasing spring temperatures because of increased reproductive output. Nevertheless, whether climate change results in fitness increase or not may depend on the maintenance and provision of optimal site quality, i.e., xerothermic and nutrient poor conditions. [ABSTRACT FROM AUTHOR]

The use of local provenances in restoration, agriculture and forestry has been identified and widely implemented as a measure for species and community conservation. In practice, provenances are often delineated based on climate, geomorphology and correlated spatial descriptors following the boundaries of larger natural regions. They are thought to comprise genetically homogenous plant material. Here we investigate genetic variation at AFLP loci in 26 natural populations of the regionally common grassland species Geranium pratense, which is often used in seed mixtures. Most studied populations are located in one previously delineated provenance in Germany. We assess within- and among provenance differentiation patterns and aspects of gene flow by investigating the mating system, the genetic structure at regional and local scale, gene dispersal and potential selective mechanisms that may have contributed to differentiation patterns found. Compared to other herbaceous, insect-pollinated grassland species and despite being outcrossed (mean t = 0.88), G. pratense showed low genetic diversity (mean H = 0.15), considerable genetic differentiation among populations within provenances (mean pairwise F = 0.20) and a pronounced within-population spatial genetic structure (mean Sp = 0.064). A genome scan approach identified three potentially adaptive loci. However, their allelic frequencies were only weakly related to climatic parameters thus providing little evidence for adaptive divergence. Nevertheless, the distribution of genetic diversity and derived gene dispersal estimates indicate limited dispersal ability, suggesting that gene flow at distances larger than 10 km is negligible. Our findings may question the approach of delineating provenances by general criteria, and highlight the importance of species-specific studies on differentiation and adaptation patterns. [ABSTRACT FROM AUTHOR]

The fragrant orchid Gymnadenia conopsea s.l. is a controversial taxon with two commonly distinguished species, G. conopsea s.str. and G. densiflora. Despite morphological similarity, differentiation between the taxa has been reported for several characters; however, character variation within taxa has obviated a clear consensus. We assessed ITS sequences, microsatellite variation and chromosome numbers on the European scale (1,420 samples) and conducted morphological analyses for 626 samples from Germany. ITS analysis revealed a 2% nucleotide divergence between the taxa, similar to the divergence between other Gymnadenia species. The ITS sequences of G. densiflora form a well-supported monophyletic group sharing a most recent common ancestor with G. nigra and G. austriaca. Thus, G. conopsea and G. densiflora are not sister species, and a species rank is supported for G. densiflora (Wahlenb.) Dietrich and G. conopsea (L.) R.B r. s.str. This was confirmed by the microsatellite analysis, which revealed a strong genetic differentiation between the taxa because of largely non-overlapping sets of alleles. Chromosome numbers showed that G. conopsea was either diploid or tetraploid, whereas G. densiflora was diploid throughout. Morphologically, the taxa differed significantly in the mean value of a number of diagnostic characters. However, a discriminant analysis showed that the morphological variability is substantial, and on the individual level an unequivocal assignment is not possible as 96% of G. conopsea, but only 77% of G. densiflora could be assigned correctly. Further studies are needed on character variation within and among species and ploidy levels to allow for a better identification of the genetically differentiated but morphologically similar taxa. [ABSTRACT FROM AUTHOR]

The reproductive biology of wind-pollinated species in terms of pollen and ovule production is rarely studied compared with zoophilous species, despite available hypotheses on the effect of growth form and life-history traits on reproductive investment. Here, we use published data and new data for species of Juncus and Luzula (Juncaceae) to test the hypotheses that, in wind-pollinated species, woody perennials should exhibit larger pollen–ovule (P/O) ratios than herbaceous species and that species with separate sexes have larger P/O ratios than homoecious species. In total, we report pollen and ovule production for 291 wind-pollinated species, including 19 Juncus and 5 Luzula species. Compared with other wind-pollinated species, Juncus exhibits unusually low P/O ratios (log P/O = 2.06 ± 0.46) because of high ovule production. We argue that the high ovule and seed production in Juncus, associated with frequent self-fertilization, may be beneficial in habitats preferred by the genus. In general, we found higher P/O ratios in woody perennials (log P/O = 4.37 ± 1.18) or in species with separate sexes (log P/O = 4.28 ± 1.12) than in herbaceous (log P/O = 3.51 ± 0.77) or homoecious (log P/O = 3.52 ± 0.80) species, respectively. However, when we analyzed woody perennials separately, we found no significant difference in P/O ratios between homoecious and nonhomoecious species. We argue that woody perennials, independent of dicliny, may be preferentially outcrossed and therefore exhibit decreased variation in mating systems compared with herbs. Because the degree of outcrossing correlates with P/O ratios, differences between homoecious and nonhomoecious woody perennials could be less pronounced. [ABSTRACT FROM AUTHOR]

The use of local provenances in restoration, agriculture and forestry has been identified as measure to sustain biological diversity and to improve local productivity. However, the delineation of regional provenances is challenging because it requires the identification of well-defined groups based on spatiogenetic differentiation and/or the evidence of local adaptation. In this study, we investigate genetic variation at 186 AFLP loci in 46 European accessions of the important grassland species Arrhenatherum elatius and ask (1) whether genetic variation within accessions differs between European geographical regions; (2) at which spatial scale populations are structured across Europe and (3) whether putatively adaptive markers contribute to this pattern and whether these markers can be related to climatic site conditions. Basic expectations of population genetics are likely to be altered in autotetraploid species, thus, we adopted a band-based approach to estimate genetic diversity and structuring. Compared to other grasses A. elatius showed high genetic diversity and considerable differentiation among accessions (ΦST = 0.24). Accessions separated in a Western European and a Central/Eastern European group, without further structure within groups. A genome scan approach identified four potentially adaptive loci, whose band frequencies correlated significantly with climatic parameters, suggesting that genetic differentiation in A. elatius is also the result of adaptive processes. Knowledge on adaptive loci might in the long run also help to adapt ecosystems to adverse climate change effects through assisted migration of ecotypes rather than introduction of new species. [ABSTRACT FROM AUTHOR]

Clinically, the immunosuppressive drug sirolimus, used in organ transplantation, appears to impair wound healing. Little is known about the mechanisms of action. We investigated the effect of sirolimus on wound healing, and we analyzed the expression of stimulating mediators of angiogenesis (VEGF, vascular endothelial growth factor) and collagen synthesis (nitric oxide) in wounds. Groups of ten rats underwent dorsal skin incision, and polyvinyl alcohol sponges were implanted subcutaneously. Beginning at the day of wounding, rats were treated with 0.5, 2.0, or 5.0 mg sirolimus/kg/day. Animals were killed 10 days later to determine wound breaking strength and reparative collagen deposition. Expression of VEGF and nitric oxide was studied in wounds. Splenic lymphocyte proliferative activity was significantly decreased by sirolimus ( p < 0.05). Sirolimus levels in wound fluid were found to be approximately two- to fivefold higher than blood levels ( p < 0.01). Sirolimus (2.0 and 5.0 mg kg−1 day−1) reduced wound breaking strength ( p < 0.01) and wound collagen deposition ( p < 0.05). This was paralleled by decreased expression of VEGF and nitric oxide in wounds. Experimentally, our data show that sirolimus impairs wound healing, and this is reflected by diminished expression of VEGF and nitric oxide in the wound. [ABSTRACT FROM AUTHOR]