Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Vocal Learning and Behaviors in Birds and Human Bilinguals: Parallels, Divergences and Directions for Research

Comparisons between the communication systems of humans and animals are instrumental in contextualizing speech and language into an evolutionary and biological framework and for illuminating mechanisms of human communication. As a complement to previous work that compares developmental vocal learning and use among humans and songbirds, in this article we highlight phenomena associated with vocal learning subsequent to the development of primary vocalizations (i.e., the primary language (L1) in humans and the primary song (S1) in songbirds). By framing avian &ldquo;second-song&rdquo; (S2) learning and use within the human second-language (L2) context, we lay the groundwork for a scientifically-rich dialogue between disciplines. We begin by summarizing basic birdsong research, focusing on how songs are learned and on constraints on learning. We then consider commonalities in vocal learning across humans and birds, in particular the timing and neural mechanisms of learning, variability of input, and variability of outcomes. For S2 and L2 learning outcomes, we address the respective roles of age, entrenchment, and social interactions. We proceed to orient current and future birdsong inquiry around foundational features of human bilingualism: L1 effects on the L2, L1 attrition, and L1&lt;&ndash;&gt;L2 switching. Throughout, we highlight characteristics that are shared across species as well as the need for caution in interpreting birdsong research. Thus, from multiple instructive perspectives, our interdisciplinary dialogue sheds light on biological and experiential principles of L2 acquisition that are informed by birdsong research, and leverages well-studied characteristics of bilingualism in order to clarify, contextualize, and further explore S2 learning and use in songbirds

Vocal Learning and Behaviors in Birds and Human Bilinguals: Parallels, Divergences and Directions for Research

Comparisons between the communication systems of humans and animals are instrumental in contextualizing speech and language into an evolutionary and biological framework and for illuminating mechanisms of human communication. As a complement to previous work that compares developmental vocal learning and use among humans and songbirds, in this article we highlight phenomena associated with vocal learning subsequent to the development of primary vocalizations (i.e., the primary language (L1) in humans and the primary song (S1) in songbirds). By framing avian “second-song” (S2) learning and use within the human second-language (L2) context, we lay the groundwork for a scientifically-rich dialogue between disciplines. We begin by summarizing basic birdsong research, focusing on how songs are learned and on constraints on learning. We then consider commonalities in vocal learning across humans and birds, in particular the timing and neural mechanisms of learning, variability of input, and variability of outcomes. For S2 and L2 learning outcomes, we address the respective roles of age, entrenchment, and social interactions. We proceed to orient current and future birdsong inquiry around foundational features of human bilingualism: L1 effects on the L2, L1 attrition, and L1L2 switching. Throughout, we highlight characteristics that are shared across species as well as the need for caution in interpreting birdsong research. Thus, from multiple instructive perspectives, our interdisciplinary dialogue sheds light on biological and experiential principles of L2 acquisition that are informed by birdsong research, and leverages well-studied characteristics of bilingualism in order to clarify, contextualize, and further explore S2 learning and use in songbirds

Matheson_Sakata_Data

Spreadsheet containing identified branch points and their measured transition probabilities, durations of silent intervals (gaps), and syllable amplitudes. Includes recordings as young (~6 months) and older (~23 months) adults and across social contexts

Data from: Relationship between the sequencing and timing of vocal motor elements in birdsong

Accurate coordination of the sequencing and timing of motor gestures is important for the performance of complex and evolutionarily relevant behaviors. However, the degree to which motor sequencing and timing are related remains largely unknown. Birdsong is a communicative behavior that consists of discrete vocal motor elements (‘syllables’) that are sequenced and timed in a precise manner. To reveal the relationship between syllable sequencing and timing, we analyzed how variation in the probability of syllable transitions at branch points, nodes in song with variable sequencing across renditions, correlated with variation in the duration of silent gaps between syllable transitions (‘gap durations’) for adult Bengalese finch song. We observed a significant negative relationship between transition probability and gap duration: more prevalent transitions were produced with shorter gap durations. We then assessed the degree to which long-term age-dependent changes and acute context-dependent changes to syllable sequencing and timing followed this inverse relationship. Age- but not context-dependent changes to syllable sequencing and timing were inversely related. On average, gap durations at branch points decreased with age, and the magnitude of this decrease was greater for transitions that increased in prevalence than for transitions that decreased in prevalence. In contrast, there was no systematic relationship between acute context-dependent changes to syllable sequencing and timing. Gap durations at branch points decreased when birds produced female-directed courtship song compared to when they produced undirected song, and the magnitude of this decrease was not related to the direction and magnitude of changes to transition probabilities. These analyses suggest that neural mechanisms that regulate syllable sequencing could similarly control syllable timing but also highlight mechanisms that can independently regulate syllable sequencing and timing

Relationship between the Sequencing and Timing of Vocal Motor Elements in Birdsong

<div><p>Accurate coordination of the sequencing and timing of motor gestures is important for the performance of complex and evolutionarily relevant behaviors. However, the degree to which motor sequencing and timing are related remains largely unknown. Birdsong is a communicative behavior that consists of discrete vocal motor elements (‘syllables’) that are sequenced and timed in a precise manner. To reveal the relationship between syllable sequencing and timing, we analyzed how variation in the probability of syllable transitions at branch points, nodes in song with variable sequencing across renditions, correlated with variation in the duration of silent gaps between syllable transitions (‘gap durations’) for adult Bengalese finch song. We observed a significant negative relationship between transition probability and gap duration: more prevalent transitions were produced with shorter gap durations. We then assessed the degree to which long-term age-dependent changes and acute context-dependent changes to syllable sequencing and timing followed this inverse relationship. Age- but not context-dependent changes to syllable sequencing and timing were inversely related. On average, gap durations at branch points decreased with age, and the magnitude of this decrease was greater for transitions that increased in prevalence than for transitions that decreased in prevalence. In contrast, there was no systematic relationship between acute context-dependent changes to syllable sequencing and timing. Gap durations at branch points decreased when birds produced female-directed courtship song compared to when they produced undirected song, and the magnitude of this decrease was not related to the direction and magnitude of changes to transition probabilities. These analyses suggest that neural mechanisms that regulate syllable sequencing could similarly control syllable timing but also highlight mechanisms that can independently regulate syllable sequencing and timing.</p></div

Data from: Ability to modulate birdsong across social contexts develops without imitative social learning

Many important behaviours are socially learned. For example, the acoustic structure of courtship songs in songbirds is learned by listening to and interacting with conspecifics during a sensitive period in development. Signalers modify the spectral and temporal structures of their vocalizations depending on the social context, but the degree to which this modulation requires imitative social learning remains unknown. We found that zebra finches that were not exposed to context-dependent song modulations throughout development significantly modulated their song in ways that were typical of socially-reared birds. Furthermore, the extent of these modulations was not significantly different between finches that could or could not observe these modulations during tutoring. These data suggest that this form of vocal flexibility develops without imitative social learning in male zebra finches

Bengalese finch song.

<p>Bengalese finch song consists of distinct acoustic elements (‘syllables’) that are arranged into stereotyped sequences as well as sequences that vary in transitions from rendition to rendition (‘branch points’). Depicted is a spectrogram (frequency on the y-axis, time on the x-axis, color as intensity) of a single rendition of an adult Bengalese finch song, with letters labeling individual syllables in the song. In this example, the sequences ‘bcd’ and ‘ghj’ are stereotyped sequences. The sequence ‘ea’ is a branch point because transitions from ‘ea’ vary across renditions: the bird transitions to ‘f’ 90% of the time and ‘k’ 10% of the time. We analyzed how the probabilities of individual syllable transitions co-varied with the duration of silent gaps between syllable transitions (e.g., gaps between ‘a’ and ‘k’ and between ‘a’ and ‘f’).</p