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"Zimmermann, Elke"
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Touchscreen-Based Cognitive Tasks Reveal Age-Related Impairment in a Primate Aging Model, the Grey Mouse Lemur (Microcebus murinus)
Mouse lemurs are suggested to represent promising novel non-human primate models for aging research. However, standardized and cross-taxa cognitive testing methods are still lacking. Touchscreen-based testing procedures have proven high stimulus control and reliability in humans and rodents. The aim of this study was to adapt these procedures to mouse lemurs, thereby exploring the effect of age. We measured appetitive learning and cognitive flexibility of two age groups by applying pairwise visual discrimination (PD) and reversal learning (PDR) tasks. On average, mouse lemurs needed 24 days of training before starting with the PD task. Individual performances in PD and PDR tasks correlate significantly, suggesting that individual learning performance is unrelated to the respective task. Compared to the young, aged mouse lemurs showed impairments in both PD and PDR tasks. They needed significantly more trials to reach the task criteria. A much higher inter-individual variation in old than in young adults was revealed. Furthermore, in the PDR task, we found a significantly higher perseverance in aged compared to young adults, indicating an age-related deficit in cognitive flexibility. This study presents the first touchscreen-based data on the cognitive skills and age-related dysfunction in mouse lemurs and provides a unique basis to study mechanisms of inter-individual variation. It furthermore opens exciting perspectives for comparative approaches in aging, personality, and evolutionary research.
Journal Article
Vocal greeting during mother-infant reunions in a nocturnal primate, the gray mouse lemur (Microcebus murinus)
In human societies, ritualized greeting behavior includes gestural and vocal displays to signal the social acceptance of an encountering person. These displays are universal across cultures suggesting a pre-human origin. Vocal greeting displays are only reported for monkeys and apes with complex social systems, but none of these studies confirmed that greeting signals fulfill all criteria characterizing human greeting behavior. In this study, we analyzed for the first time whether vocal exchanges between mother and infants in a non-human primate fulfill the criteria of human greeting behavior and whether vocal greeting behavior is present in a basal primate with a less complex social system, the gray mouse lemur. By comparing spontaneous leave-takings and reunions, we found that vocal exchanges during mother-infant reunions fulfilled all six criteria characterizing human greeting behavior. Thus, predictable reciprocal vocal exchanges occurred at the start of the reunion (but not during leave-taking), when mother and infant had visual contact to each other. Thus, we argued that mother-infant vocal exchanges governing reunions are essential to establish social bonds and to ritualize the greeting function. Our findings suggest that ritualized vocal greeting has its origins deeply rooted in mammalian phylogeny and derives from vocal exchanges during parent-infant reunions.
Journal Article
First experimental evidence for olfactory species discrimination in two nocturnal primate species (Microcebus lehilahytsara and M. murinus)
Olfactory communication is highly important for nocturnal mammals, especially for solitary foragers, but knowledge is still limited for nocturnal primates. Mouse lemurs (
Microcebus
spp.) are nocturnal solitary foragers with a dispersed lifestyle and frequently use chemo-sensory signalling behaviour for governing social interactions. Different mouse lemur species can co-occur in a given forest but it is unknown whether olfaction is involved in species recognition. We first screened 24 captive mouse lemurs (9
M. murinus
, 15
M. lehilahytsara
) for their olfactory learning potential in an experimental arena and then tested the species discrimination ability with urine odour in an operant conditioning paradigm in four individuals. The majority of the screened animals (75%) did not pass the screening criteria within a 2-week test period. However, all four final test animals, two
M. murinus
and two
M. lehilahytsara
, were successfully trained in a 5-step-conditioning process to reliably discriminate conspecific from heterospecific urine odour (requiring an overall median of 293 trials). Findings complement previous studies on the role of acoustic signalling and suggest that olfaction may be an important additional mechanism for species discrimination.
Journal Article
Digitalised multidisciplinary conferences effectively identify and prevent imaging-related medical error in intensive care patients during the COVID-19 pandemic
This study aims to assess the effectiveness of digital multidisciplinary conferences (MDCs) in preventing imaging-related quality management (QM) events during the coronavirus-disease-19 (COVID-19) pandemic. COVID-19 challenged interdisciplinary exchange and QM measures for patient safety. Regular MDCs between radiologists and intensive care unit (ICU) physicians, introduced in our hospital in 2018, enable re-evaluation of imaging examinations and bilateral feedback. MDC protocols from 2020 to 2021 were analysed regarding imaging-related QM events. Epidemiological data on COVID-19 were matched with MDCs. 333 MDCs including 1324 radiological examinations in 857 patients (median age = 64 (IQR = 55–73) years, 66.7% male) were analysed. MDCs were held within a median of 1 day after imaging (IQR = 1–3). QM events were identified in 2.7% (
n
= 36/1324) of examinations. This represented a significant decrease compared to a control group from 2018/2019 (QM events identified in 14.0%,
p
< 0.001). QM incidence remained consistent in the pandemic cohort (regression coefficient estimate = -0.01, 95% confidence interval = [0.000, 0.000],
p
= 0.68). 81% (
n
= 29/36) of QM events were report-related, 19% process-related (
n
= 6/36), and 2.8% indication-related (
n
= 1/36). In 7.3% (
n
= 97/1324) of examinations, the patient was affected by COVID-19. With MDCs as an effective feedback mechanism in place, the challenges of the COVID-19 pandemic led to no increase in QM incidence. Notably, COVID status did not impact QM event occurrence.
Journal Article
Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation
ObjectivesTo evaluate ESR eGUIDE—the European Society of Radiology (ESR) e-Learning tool for appropriate use of diagnostic imaging modalities—for learning purposes in different clinical scenarios.MethodsThis anonymized evaluation was performed after approval of ESR Education on Demand leadership. Forty clinical scenarios were developed in which at least one imaging modality was clinically most appropriate, and the scenarios were divided into sets 1 and 2. These sets were provided to medical students randomly assigned to group A or B to select the most appropriate imaging test for each scenario. Statistical comparisons were made within and across groups.ResultsOverall, 40 medical students participated, and 31 medical students (78%) answered both sets. The number of correctly chosen imaging methods per set in these 31 paired samples was significantly higher when answered with versus without use of ESR eGUIDE (13.7 ± 2.6 questions vs. 12.1 ± 3.2, p = 0.012). Among the students in group A, who first answered set 1 without ESR eGUIDE (11.1 ± 3.2), there was significant improvement when set 2 was answered with ESR eGUIDE (14.3 ± 2.5, p = 0.013). The number of correct answers in group B did not drop when set 2 was answered without ESR eGUIDE (12.4 ± 2.6) after having answered set 1 first with ESR eGUIDE (13.0 ± 2.7, p = 0.66).ConclusionThe clinical decision support tool ESR eGUIDE is suitable for training medical students in choosing the best radiological imaging modality in typical scenarios, and its use in teaching radiology can thus be recommended.Key Points• ESR eGUIDE improved the number of appropriately selected imaging modalities among medical students.• This improvement was also seen in the group of students which first selected imaging tests without ESR eGUIDE.• In the student group which used ESR eGUIDE first, appropriate selection remained stable even without the teaching tool.
Journal Article
Noise reduction and motion elimination in low-dose 4D myocardial computed tomography perfusion (CTP): preliminary clinical evaluation of the ASTRA4D algorithm
ObjectivesTo propose and evaluate a four-dimensional (4D) algorithm for joint motion elimination and spatiotemporal noise reduction in low-dose dynamic myocardial computed tomography perfusion (CTP).MethodsThirty patients with suspected or confirmed coronary artery disease were prospectively included and underwent dynamic contrast-enhanced 320-row CTP. A novel deformable image registration method based on the principal component analysis (PCA) of the ante hoc temporally smoothed voxel-wise time-attenuation curves (ASTRA4D) is presented. Quantitative (standard deviation, signal-to-noise ratio (SNR), temporal variation, volumetric deformation) and qualitative (motion, contrast, contour sharpness [1, poor; 5, excellent]) measures of CTP quality were assessed for the original and motion-compensated sequences (without and with temporal filtering, PCA/ASTRA4D). Following myocardial perfusion deficit detection by two readers, diagnostic accuracy was evaluated using magnetic resonance myocardial perfusion imaging (MR-MPI) as the reference standard in 15 patients.ResultsRegistration using ASTRA4D was successful in all 30 patients and resulted in comparison with the benchmark PCA in significantly (p < 0.001) reduced noise over time (− 83%, 178.5 vs 29.9) and spatially (− 34%, 21.4 vs 14.1) as well as improved SNR (+ 47%, 3.6 vs 5.3) and subjective image quality (motion, contrast, contour sharpness [+ 1.0, + 1.0, + 0.5]). ASTRA4D had significantly improved per-segment sensitivity of 91% (58/64) and similar specificity of 96% (429/446) compared with PCA (52%, 33/64; 98%, 435/446; p = 0.011) in the visual detection of perfusion deficits.ConclusionsThe ASTRA4D registration algorithm improved the spatiotemporal noise profile and CTP sequence image quality, resulting in significantly improved sensitivity of 4D CTP in the detection of myocardial ischemia.Key Points• ASTRA4D combines local temporal regression and deformable image registration.• Quantitative and qualitative measures of CTP quality are improved compared to PCA.• Improved spatiotemporal differentiation of ischemic regions leads to an excellent perfusion deficit concordance of ASTRA4D with MRI.
Journal Article
The Voice of Emotion across Species: How Do Human Listeners Recognize Animals' Affective States?
Voice-induced cross-taxa emotional recognition is the ability to understand the emotional state of another species based on its voice. In the past, induced affective states, experience-dependent higher cognitive processes or cross-taxa universal acoustic coding and processing mechanisms have been discussed to underlie this ability in humans. The present study sets out to distinguish the influence of familiarity and phylogeny on voice-induced cross-taxa emotional perception in humans. For the first time, two perspectives are taken into account: the self- (i.e. emotional valence induced in the listener) versus the others-perspective (i.e. correct recognition of the emotional valence of the recording context). Twenty-eight male participants listened to 192 vocalizations of four different species (human infant, dog, chimpanzee and tree shrew). Stimuli were recorded either in an agonistic (negative emotional valence) or affiliative (positive emotional valence) context. Participants rated the emotional valence of the stimuli adopting self- and others-perspective by using a 5-point version of the Self-Assessment Manikin (SAM). Familiarity was assessed based on subjective rating, objective labelling of the respective stimuli and interaction time with the respective species. Participants reliably recognized the emotional valence of human voices, whereas the results for animal voices were mixed. The correct classification of animal voices depended on the listener's familiarity with the species and the call type/recording context, whereas there was less influence of induced emotional states and phylogeny. Our results provide first evidence that explicit voice-induced cross-taxa emotional recognition in humans is shaped more by experience-dependent cognitive mechanisms than by induced affective states or cross-taxa universal acoustic coding and processing mechanisms.
Journal Article
Detection of relevant extracardiac findings on coronary computed tomography angiography vs. invasive coronary angiography
Objectives
To compare the detection of relevant extracardiac findings (ECFs) on coronary computed tomography angiography (CTA) and invasive coronary angiography (ICA) and evaluate the potential clinical benefit of their detection.
Methods
This is the prespecified subanalysis of ECFs in patients presenting with a clinical indication for ICA based on atypical angina and suspected coronary artery disease (CAD) included in the prospective single-center randomized controlled Coronary Artery Disease Management (CAD-Man) study. ECFs requiring immediate therapy and/or further workup including additional imaging were defined as clinically relevant. We evaluated the scope of ECFs in 329 patients and analyzed the potential clinical benefit of their detection.
Results
ECFs were detected in 107 of 329 patients (32.5%; CTA: 101/167, 60.5%; ICA: 6/162, 3.7%;
p
< .001). Fifty-nine patients had clinically relevant ECFs (17.9%; CTA: 55/167, 32.9%; ICA: 4/162, 2.5%;
p
< .001). In the CTA group, ECFs potentially explained atypical chest pain in 13 of 101 patients with ECFs (12.9%). After initiation of therapy, chest pain improved in 4 (4.0%) and resolved in 7 patients (6.9%). Follow-up imaging was recommended in 33 (10.0%; CTA: 30/167, 18.0%; ICA: 3/162, 1.9%) and additional clinic consultation in 26 patients (7.9%; CTA: 25/167, 15.0%; ICA: 1/162, 0.6%). Malignancy was newly diagnosed in one patient (0.3%; CTA: 1/167, 0.6%; ICA: 0).
Conclusions
In this randomized study, CTA but not ICA detected clinically relevant ECFs that may point to possible other causes of chest pain in patients without CAD. Thus, CTA might preclude the need for ICA in those patients.
Trial registration
NCT Unique ID:
00844220
Key Points
• CTA detects ten times more clinically relevant ECFs than ICA.
• Actionable clinically relevant ECFs affect patient management and therapy and may thus improve chest pain.
• Detection of ECFs explaining chest pain on CTA might preclude the need for performing ICA.
Journal Article