Social and physical environment independently affect oviposition decisions in Drosophila.

In response to environmental stimuli, including variation in the presence of conspecifics, genotypes show highly plastic responses in behavioral and physiological traits influencing reproduction. Although extensively documented in males, such female responses are rather less studied. We expect females to be highly responsive to environmental variation and to differentially allocate resources to increase offspring fitness, given the major contribution of mothers to offspring number, size, and developmental conditions. Using Drosophila melanogaster, we (a) manipulate exposure to conspecific females, which mothers could use to anticipate the number of potential mates and larval density, and; (b) test how this interacts with the spatial distribution of potential oviposition sites, with females from higher densities expected to prefer clustered resources that can support a larger number of larvae. We found that high density females were slower to start copulating and reduced their copulation duration, the opposite effect to that observed in males. There was a parallel, perhaps related, effect on egg production: females previously housed in groups laid fewer eggs than those housed in solitude. Resource patchiness also influenced oviposition behavior: females preferred aggregated substrate, which attracted more females to lay eggs. However, we found no interaction between prior housing conditions and resource patchiness, indicating that females did not perceive the value of different resource distributions differently when exposed to environments that could signal expected levels of larval competition. We show that, although exposure to consexual competition changes copulatory behaviors of females, the distribution of oviposition resources has a greater effect on oviposition decisions.

Purposeful Remote Radiology Education: Strategies and Recommendations.

The COVID-19 global pandemic has presented new challenges to radiology educators and their learners. As a specialty that is accustomed to adapting to continual technologic innovation, as well as one with the capacity for remote work, radiology is uniquely positioned to meet these challenges by taking advantage of online remote educational strategies. This represents an opportunity to not only leverage new methods and technologies but also reexamine the most effective way to implement established ones. The authors review the benefits of taking a purposeful goal-oriented approach to these challenges, provide a corresponding qreview of the general categories of resources that are currently available, and explore educational strategies by using broad categories of software solutions. An invited commentary by Awan is available online. Online supplemental material is available for this article. ©RSNA, 2021.

Parkinson's Disease-Related Motor and Nonmotor Symptoms in the Lancaster Amish.

INTRODUCTION: Previous research has suggested that the Amish may experience a relatively high prevalence of Parkinson's disease (PD) and/or parkinsonian motor signs. METHODS: In a large sample from the Amish community in Lancaster County, Pennsylvania, age ≥18 years, we assessed the prevalence of self-reported PD diagnosis. For those without self-reported PD diagnosis, we assessed the frequency of PD-related motor symptoms using a 9-item questionnaire that was designed by the PD Epidemiology Research Group. Lastly, we queried study participants for the presence of 2 nonmotor symptoms that have been commonly linked to PD: bowel movement frequency and daytime sleepiness. RESULTS: Among 2,025 subjects who answered the PD questionnaire, 430 were older than 60 years. Of 430 participants ≥60 years, 5 (1.2%) reported a PD diagnosis. Of those without a PD diagnosis, 10.5% reported ≥1 and 1.2% ≥ 4 motor symptoms for the 9-item PD screening questionnaire. Of the 3,789 subjects who answered the question about bowel movement frequency, 0.7% reported ≤3 bowel movements per week. Among 1,710 subjects who answered the question about daytime sleepiness, 8.1% of the participants reported "always" sleepy during the day. DISCUSSION: These data neither support a markedly higher PD prevalence in the older Lancaster Amish nor do they show dramatically higher motor and/or selected nonmotor symptoms than the general population. Future studies that employ more rigorous procedures for case identification and PD-specific preclinical symptoms/tests are needed to determine the potential differences and similarities among different Amish populations and between Amish and non-Amish populations.

Use of a Graphic Memoir to Enhance Clinicians' Understanding of and Empathy for Patients with Parkinson Disease.

CONTEXT: Parkinson disease (PD) can be physically, emotionally, and financially burdensome. Understanding its impact from the patient's perspective is an important way to sensitize clinicians to the challenges of living with PD. OBJECTIVE: To evaluate whether a book-length graphic memoir (an illness story in comic form) can help clinicians appreciate PD from the patient's perspective. DESIGN: A convergent mixed-methods study of clinicians working in a multidisciplinary movement disorders clinic. Participants read My Degeneration and completed preintervention and post-intervention questionnaires. They also attended a book group discussion. Quantitative findings were compared before and after the intervention, and qualitative data were analyzed for themes. MAIN OUTCOME MEASURES: Clinicians': 1) confidence in understanding patients' experiences with PD, 2) knowledge about PD, and 3) empathy toward patients and families. RESULTS: After reading the book, participants' confidence in understanding patients' experiences with PD increased significantly in the areas of stigma and disease impact on patients and families. Clinical knowledge was unchanged. Qualitative analysis revealed 3 main themes: 1) the book provides a meaningful way for clinicians to learn about the experience of living with PD; 2) the medium of comics engages clinicians in ways different from other mediums; and 3) benefits of the book may extend beyond the clinical team. CONCLUSION: Clinicians who read My Degeneration gained insight into the psychosocial effects of PD on patients and their loved ones. The book helped facilitate deeper understanding of patients' experiences living with PD and fostered greater empathy and self-reflection.

Differing effects of age and starvation on reproductive performance in Drosophila melanogaster.

Successful reproduction requires the completion of many, often condition-dependent, stages, from mate searching and courtship through to sperm transfer, fertilisation and offspring production. Animals can plastically adjust their investment in each stage according to the physical and social environment, their own condition, their future reproductive potential, and the condition of their partner. Here we manipulate age and condition, through a nutritional challenge early or late in life, of both male and female Drosophila melanogaster and measure the effects on courtship, mating, and fitness when paired with a standardized (unmanipulated) partner. Older males were slower to start courting and mating, and courted at a slower rate, but males were indifferent to female age or condition despite older females laying and hatching fewer eggs. Female condition had a substantial effect on mating acceptance rate, which dropped dramatically after starvation, and particularly recent starvation experience. In contrast, male condition had little effect on any of the components of reproductive performance we measured. Intriguingly, we found no evidence for additive or multiplicative effects of ageing and starvation: the only significant interaction between these variables was on male latency to initiate courtship - older males were slower to start courting unless they had experienced starvation early in life. These results indicate that the immediate costs of mating differ between males and females, and that the sexes differ in their perception of the opportunity cost sustained by refusing a mating opportunity. Our results support the idea that ageing has more wide-ranging impact on reproductive behaviours than does nutritional challenge.

The value of full-body skin examination: Poland syndrome diagnosed as an incidental finding.

Poland syndrome is a rare congenital disorder characterized by agenesis of the pectoralis major muscle. It is generally unilateral, right-sided, and can be associated with a myriad of thoracic and upper limb defects. Knowledge of this disorder can lead the astute clinician to prompt diagnosis and referral to surgical specialists for further workup. Surgery is often performed for either esthetic or functional concerns.

Graphic Pathographies and the Ethical Practice of Person-Centered Medicine.

Graphic medicine is a swiftly growing movement that explores, theoretically and practically, the use of comics in medical education and patient care. At the heart of graphic medicine are graphic pathographies, stories of illness conveyed in comic form. These stories are helpful tools for health care professionals who seek new insight into the personal, lived experience of illness and for patients who want to learn more about their disease from others who have actually experienced it. Featuring excerpts from five graphic pathographies, this essay illustrates how the medium can be used to educate patients and enhance empathy in health care professionals, particularly with regard to informed consent and end-of-life issues.

Development and Assessment of Pictorial Guide for Improved Accuracy of Visual Blood Loss Estimation in Cesarean Delivery.

INTRODUCTION: Estimated blood loss for surgical procedures performed via visual estimation is known to be an inaccurate method. Blood loss estimation is further complicated during cesarean delivery (CD) by a large volume loss for a short period as well as the presence of amniotic fluid. We hypothesized that a pictorial guide depicting premeasured blood volumes and materials commonly used in a CD would improve clinician accuracy in estimated blood loss. METHODS: A simulated CD scene was used to assess the ability of clinicians to estimate the amount of blood lost by a CD patient. Accuracy of the estimates was assessed before and after they had access to the pictorial guide created for the study. RESULTS: Before the intervention, 52% of participants estimated more than 25% above or below actual blood loss volume. With use of the guide, clinicians became more accurate at blood loss estimation. After the intervention, the number of participants estimating within 5% of the actual volume increased from 7% before to 24% (P = 0.033). CONCLUSIONS: An institution-specific pictorial guide is effective at improving the accuracy of visual blood loss estimation in a simulation and may help improve clinical care in CD.

Sperm production responds to perceived sperm competition risk in male Drosophila melanogaster.

Postcopulatory sexual selection arising from female multiple mating leads to the evolution of ejaculates that maximize a male's reproductive success under sperm competition. Where the risk of sperm competition is variable, optimal fitness may be achieved by plastically altering ejaculate characteristics in response to the prevailing sperm competition environment. In the model species Drosophila melanogaster, males expecting to encounter sperm competition mate for longer and transfer more accessory proteins and sperm. Here we show that after being housed with a single rival for one week, the seminal vesicles of male D. melanogaster contain a significantly greater proportion of live sperm than those of males maintained alone, indicating adaptive adjustment of sperm quality in response to the perceived risk of sperm competition. This effect is due to an increase in the number of live sperm produced, indicating that males upregulate sperm production in response to the presence of rivals. Our data suggest that males show plasticity in the rate of spermatogenesis that is adaptive in the context of a fluctuating sperm competition environment.

Baculum morphology predicts reproductive success of male house mice under sexual selection.

BACKGROUND: Diversity in penile morphology is characterised by extraordinary variation in the size and shape of the baculum (penis bone) found in many mammals. Although functionally enigmatic, diversity in baculum form is hypothesised to result from sexual selection. According to this hypothesis, the baculum should influence the outcome of reproductive competition among males within promiscuous mating systems. However, a test of this key prediction is currently lacking. RESULTS: Here we show that baculum size explains significant variation in the reproductive success of male house mice under competitive conditions. After controlling for body size and other reproductive traits, the width (but not length) of the house mouse baculum predicts both the mean number of offspring sired per litter and total number of offspring sired. CONCLUSIONS: By providing the first evidence linking baculum morphology to male reproductive success, our results support the hypothesis that evolutionary diversity in baculum form is driven by sexual selection.

Exposure to sperm competition risk improves survival of virgin males.

Sperm competition between the ejaculates of multiple males for the fertilization of a given set of ova is taxonomically widespread. Males have evolved remarkable adaptations to increase their reproductive success under postcopulatory sexual selection, which in many species includes the ability to modify behaviour and ejaculate characteristics plastically to match the perceived level of sperm competition. Males of the model species Drosophila melanogaster increase mating duration and modify seminal fluid composition in response to short-term changes in sperm competition risk. If these responses increase a male's total investment in reproduction, he must either trade-off this cost against other life-history traits or suffer reduced survival. We tested whether mounting a plastic sperm competition response bears an instantaneous survival cost, and instead found that male D. melanogaster exposed to a high risk of sperm competition survive 12 per cent longer than those at low risk, equating to a 49 per cent reduction in the hourly hazard of death. This striking effect was found only among virgins: the high cost of mating in this species eliminates any such benefit among non-virgin males. Our results suggest that the improvement in survival found among virgins may be a product of males' tactical responses to sperm competition.

Female choosiness leads to the evolution of individually distinctive males.

Individual recognition is a taxonomically widespread ability that underlies a diverse suite of behaviors including the identification of individual nest-mates, agonistic opponents, and mating partners. However, as yet relatively little is known about the circumstances under which the requisite signal diversity can evolve. Here, we develop a model describing a novel mechanism of individual identity evolution via sexual selection. Females choose among a subset of males, but can select the most attractive male only when he bears a unique identity signal. This mimics a species in which mate assessment and choice are temporally separate, such as when females observe males in direct conflict and must subsequently locate the winner. When females in our model are choosy at least 10% of the time, diversity at individuality signaling loci evolves as a by-product of selection on male attractiveness more rapidly than does diversity at equivalent loci evolving only under neutral processes. Even at lower discrimination rates, drifting signal diversity gives the female choice mechanism sufficient traction to drive up average male attractiveness. The mechanism we describe here can significantly increase signal diversity at even low rates of discrimination by females.

Developmental delay in children: assessment with proton MR spectroscopy.

BACKGROUND AND PURPOSE: The cause of developmental delay frequently is unknown, and clinicians and families can be frustrated by the lack of neuroimaging correlation especially when considering therapeutic options and long-term prognosis. We sought to determine if proton MR spectroscopy can depict abnormalities in patients with developmental delay who have structurally normal brain MR images. METHODS: Children with developmental delay who were older than 2 years (mean age, 5.0 years; range, 3.0-10.0 years) and those aged 2 years or younger (mean age, 1.5 years; range, 0.5-2.0 years) and age-matched control subjects for each patient group underwent brain MR imaging and proton MR spectroscopy. A point-resolved spectroscopy sequence (2000/144 [TR/TE]) was used. Voxels (8 cm(3)) were placed in the subcortical white matter of the frontal and parieto-occipital lobes bilaterally. N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios were assessed. RESULTS: All patients had normal brain MR images. In children with developmental delay who were aged 2 years or younger, no statistically significant differences were detected in the NAA/Cr or Cho/Cr ratios compared with those of the control subjects. In children with developmental delay who were older than 2 years, decreases in the NAA/Cr ratio were observed in frontal (P <.001) and parieto-occipital (P <.017) subcortical white matter, and elevations in the Cho/Cr ratio were detected in the frontal (P <.24) and parieto-occipital (P <.002) subcortical white matter compared with age-matched control subjects. CONCLUSIONS: In children with developmental delay who are older than 2 years, proton MR spectroscopy depicted abnormalities in the NAA/Cr and Cho/Cr ratios. Proton MR spectroscopy should be performed as part of the neuroimaging evaluation of developmental delay. Further studies will be needed to determine if abnormalities detected with proton MR spectroscopy can be used as a diagnostic tool and neuroimaging marker to assess long-term functional outcome.

Age-related differences in pharmacokinetics of phosphonoformate in cats.

Phosphonoformate (PFA) is a simple PPi analog which inhibits the activities of a variety of viral DNA polymerase, RNA polymerase, and reverse transcriptase enzymes. PFA is a topical and parenteral treatment for human herpesvirus infections and is currently in phase I trials for treatment of acquired immunodeficiency syndrome. Pharmacokinetic properties of PFA in young (growing) and adult specific-pathogen-free cats were compared. Mean PFA clearance from plasma was twofold higher in young cats (7.52 ml/min per kg of body weight) than in adult cats (3.70 ml/min per kg). Higher PFA clearance from plasma observed in young cats may result from higher renal clearance or enhanced accumulation of PFA in bone tissue of young versus adult cats. No plasma protein binding of PFA was observed. Mean oral bioavailability was 35% in young cats. These data indicate that age-related differences in PFA clearance from plasma occur in cats.