A report on virtual ‘Can’t intubate, can’t oxygenate’ conference workshops at the 2021 Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists

The COVID-19 pandemic has had profound implications for continuing medical education. Travel restrictions, lockdowns and social distancing in an effort to curb spread have meant that medical conferences have been postponed or cancelled. When the Australian and New Zealand College of Anaesthetists made the decision to commit to a fully virtual 2021 Annual Scientific Meeting, the organising committee investigated the viability of presenting a virtual ‘Can’t intubate, can’t oxygenate’ workshop. A workshop was designed comprising a lecture, case scenario discussion and demonstration of emergency front-of-neck access techniques broadcast from a central hub before participants separated into Zoom® (Zoom Video Communications, San Jose, CA, USA) breakout rooms for hands-on practice, guided by facilitators working virtually from their own home studios. Kits containing equipment including a 3D printed larynx, cannula, scalpel and bougie were sent to workshop participants in the weeks before the meeting. Participants were asked to complete pre- and post-workshop surveys. Of 42 participants, 32 responded, with the majority rating the workshop ‘better than expected’. All except two respondents felt the workshop met learning objectives. Themes of positive feedback included being impressed with the airway model, the small group size, content and delivery. Feedback focused on previously unperceived advantages of virtual technical skills workshops, including convenience, equitable access and the reusable airway model. Disadvantages noted by respondents included lack of social interaction, inability to trial more expensive airway equipment, and some limitations of the ability of facilitators to review participants’ technique. Despite limitations, in our experience, virtual workshops can be planned with innovative solutions to deliver technical skills education successfully.

NAIAD-2020: Characteristics of Motor Evoked Potentials After 3-Day Exposure to Dry Immersion in Women

As female astronauts participate in space flight more and more frequently, there is a demand for research on how the female body adapts to the microgravity environment. In particular, there is very little research on how the neuromuscular system reacts to gravitational unloading in women. We aimed to estimate changes in motor evoked potentials (MEPs) in the lower leg muscles in women after 3-day exposure to Dry Immersion (DI), which is one of the most widely used ground models of microgravity. Six healthy female volunteers (mean age 30.17 ± 5.5 years) with a natural menstrual cycle participated in this experiment. MEPs were recorded from the gastrocnemius and soleus muscles twice before DI, on the day of DI completion, and 3 days after DI, during the recovery period. To evoke motor responses, transcranial and trans-spinal magnetic stimulation was applied. We showed that changes in MEP characteristics after DI exposure were different depending on the stimulation site, but were similar for both muscles. For trans-spinal stimulation, MEP thresholds decreased compared to baseline values, and amplitudes, on the contrary, increased, resembling the phenomenon of hypogravitational hyperreflexia. This finding is in line with data observed in other experiments on both male and female participants. MEPs to transcranial stimulation had an opposing dynamic, which may have resulted from the small group size and large inter-subject variability, or from hormonal fluctuations during the menstrual cycle. Central motor conduction time remained unchanged, suggesting that pyramidal tract conductibility was not affected by DI exposure. More research is needed to explore the underlying mechanisms.

Altruism as an Explanation for Human Consanguinity

<b><i>Background:</i></b> Human inbreeding is a sociobiological puzzle. Despite widespread knowledge of its potential for genetic disorders, human consanguinity remains surprisingly common. The current reasons explaining its continued persistence in today’s modern world have major shortcomings. <b><i>Summary:</i></b> We propose that the Neolithic Agrarian revolution modified the structure of populations. It increased competition for the limited resources in which a larger group had better chances of survival. As a result, small, drifting, socially open bands of hunter-gatherers were transformed into bigger, less mobile, and more powerful kinship groups (tribes). In this transformation, a central role was played by human trust – an aspect of human altruism which is a universal sociobiological principle of behavior. Altruism (and trust) is an essential premise of social contracts such as economic cooperation, marriage arrangement, and creation of alliances between people. In kinship groups, human trust is limited to kin, so tribes remain small, economically poor, and consanguineous due to lack of nonkin mates. The expanding of trust from kin to that of nonbiological relatives increases the size of human groups, fosters economic wealth, and decreases the rate of consanguinity. <b><i>Key Messages:</i></b> The lack of nonkin altruism leads to: (a) poverty (due to poor economic cooperation with nonkin), (b) maintaining small group size, and (c) inbreeding.

Visual hallucinations in Gentington's disease: ophthalmic validation of ‘North-East Visual Hallucinations Interview

Huntington's disease (HD) is a steadily progressive neurodegenerative disease caused by a mutation in the huntingtin gene, with progressive motor, cognitive and mental impairments.The aim of the study is to determine the validity of the North‑East Visual Hallucinations Interview (NEVHI) in a Russian sample of patients.Materials and methods. 78 subjects were examined: 26 patients at the manifest stage of HD, 21 pre‑manifest carriers of the HD gene and 31 volunteers of the control group.Results. The low incidence of visual hallucinations according to the NEVHI does not allow us to conclude about their specificity for HD. Failure to achieve the level of statistical significance in this case suggests a high risk of type II error associated with the low occurrence of the symptom and the relatively small group size.Conclusion. The study showed that the NEVHI questionnaire can serve as an adequate method for the diagnosis of visual hallucinations in HD.

Prediction of breeding values for group-recorded traits including genomic information and an individually recorded correlated trait

Records on groups of individuals could be valuable for predicting breeding values when a trait is difficult or costly to measure on single individuals, such as feed intake and egg production. Adding genomic information has shown improvement in the accuracy of genetic evaluation of quantitative traits with individual records. Here, we investigated the value of genomic information for traits with group records. Besides, we investigated the improvement in accuracy of genetic evaluation for group-recorded traits when including information on a correlated trait with individual records. The study was based on a simulated pig population, including three scenarios of group structure and size. The results showed that both the genomic information and a correlated trait increased the accuracy of estimated breeding values (EBVs) for traits with group records. The accuracies of EBV obtained from group records with a size 24 were much lower than those with a size 12. Random assignment of animals to pens led to lower accuracy due to the weaker relationship between individuals within each group. It suggests that group records are valuable for genetic evaluation of a trait that is difficult to record on individuals, and the accuracy of genetic evaluation can be considerably increased using genomic information. Moreover, the genetic evaluation for a trait with group records can be greatly improved using a bivariate model, including correlated traits that are recorded individually. For efficient use of group records in genetic evaluation, relatively small group size and close relationships between individuals within one group are recommended.

New Classification of Collective Animal Behaviour as an Autonomous System

Integrated information theory (IIT) was initially proposed to describe human consciousness in terms of intrinsic-causal brain network structures. This theory could potentially be used for conceptualising complex living systems. In a previous study, we analysed collective behaviour in {\it Plecoglossus altivelis}. We found that IIT 3.0 exhibits qualitative discontinuity between three and four schools of fish in terms of $\Phi$ values (i.e., group integrity). Other measures, such as mutual information, did not show such characteristics. In this study, we follow up on our previous findings and introduce two new factors. First, we define the global parameter settings to determine a different kind of group integrity. Second, we set several timescales (from $\Delta t =5/120$ s to $\Delta t =120/120$ s). The results showed that we succeeded in classifying fish school according to their group size in terms of the degree of group integrity, despite the small group size. The concrete classification includes the followership for a two-fish school, fission--fusion for a three-fish school, emergence of leadership for a four-fish school, and emergence of Boid-like behaviour for a five-fish school. These minute classifications have never been revealed before. Finally, we discuss one of the longstanding paradoxes in collective behaviour, known as the heap paradox, for which two tentative answers could be provided through our IIT analysis.

Autophagy of Sensory Neurons in the Trigeminal and Dorsal Root Ganglia of Cynomolgus Monkeys (Macaca fascicularis)

Although necrosis and apoptosis are uncommon, autophagy of sensory neurons (ASN) in trigeminal and dorsal root ganglia is a very common, spontaneous finding in cynomolgus monkeys ( Macaca fascicularis). Data from one author’s (Butt) laboratory showed 12 of 22 studies (year range 2017 to 2019) that included the evaluation of sensory ganglia from cynomolgus monkeys had at least one control animal with ASN. Autophagy of sensory neurons is characterized by a distinct cell membrane, cytoplasm filled with autolysosomes, disintegrated nuclear membrane, and/or globules of degraded chromatin. Since these changes are consistent with autophagy and indicate an irreversible state, a diagnosis of autophagy is preferred instead of necrosis or degeneration. Sensory ganglia are not commonly evaluated in nonclinical toxicology investigations so many pathologists may be unaware of this common change. Especially due to the typically small group size of monkey studies, the observation of this change in sensory ganglia may lead to a faulty interpretation that this change is due to the test article. This article describes the light microscopic and ultrastructural characteristics of neuronal autophagy in trigeminal and dorsal root ganglia and provides historical control data of the incidence of this change in cynomolgus monkeys.

Hunting High and Low: Postglacial Colonization Strategies in Central Norway between 9500 and 8000 cal BC

In this article, we examine aspects of the Postglacial colonization processes that took place in central Norway during the Early Mesolithic (c. 9500–8000 cal bc). The distribution of sites from this period shows that the colonizers approached and exploited two very different landscapes and resource situations—from archipelagic to alpine. Based on twelve artefact assemblages from central Norway we investigate how colonizing populations met the challenge posed by varying ecozones. Did they organize their settlements and technologies in similar ways or did they modify sites and activities in relation to the different locations? The aspects studied are site organization, artefact composition, projectiles, and lithic raw material use. It appears that the sites are of a similar size and structure across ecozones. Apart from some variations in tool composition, there is no evidence in the lithic material for any technical adaptation towards specific ecozones. We conclude that using a standard, generalized lithic technology, combined with high mobility and small group size, enabled the colonizing groups to overcome the risks and difficulties associated with settling and seeking out resources in new and unknown landscapes.