Influence of cycle stage, age and endometrial biopsy score on oxytocin receptor distribution and gene expression in the cervix and uterus of non-pregnant mares

Persistent breeding-induced endometritis (PBIE) or delayed uterine clearance (DUC) are major causes of mare subfertility. Oxytocin and its receptor are thought to play significant roles in the pathogenesis of DUC but the specific roles of oxytocin receptor (OR) distribution and gene expression remain undefined. In this study both OR distribution and gene expression in the endometrium, myometrium and cervix during both luteal and non-luteal phases in non-pregnant mares (n = 27) of differing age (young: 2–9 years, n = 17; old: > 10 years, n = 10) and endometrial biopsy score were described using immunohistochemistry (IHC) and quantitative reverse-transcription polymerase chain reaction (RT-qPCR), respectively. Immunohistochemistry showed a similar pattern of OR distribution in uterus and cervix, with the exception of the glandular epithelium, absent in the cervix. Uterine ORs were localized in endometrial luminal and glandular epithelia, transmural vascular endothelium, sub-epithelial and peri-glandular stromal cells and myometrial smooth muscle cells. The OR labeling intensity was consistently greatest in the vascular endothelium. Real-time qPCR showed a higher OR gene expression in myometrium compared to cervix (P = 0.001) and endometrium (P = 0.009). There was no difference in OR gene expression between cervix and endometrium (P = 1.0). Oxytocin receptor gene expression was significantly higher during the non-luteal phase in both combined uterine tissues (endometrium and myometrium) and myometrium. Oxytocin receptor distribution and gene expression were not influenced by a mare's age or endometrial biopsy score. As endometrial biopsy score and mare age were not predictors of OR gene expression, deficient OR gene expression is unlikely to be associated with DUC.http://www.theriojournal.com2019-10-15gl2018Companion Animal Clinical StudiesParaclinical SciencesProduction Animal StudiesVeterinary Tropical Disease

Thinking differently about clinical skills training: The bovine pregnancy diagnosis via transrectal palpation showcase

Clinical hands-on training is an integral part of veterinary education. Skills acquisition opportunities are however limited by welfare and ethical concerns around the use of live animals for training purposes, large student cohort sizes and budget constraints, amongst others. The same holds true for bovine trans-rectal palpation (TRP) and pregnancy diagnosis (PD) training and is furthermore challenging since extensive exposure to TRP in live cows is required to ensure competency. At the same time, it is an important competency for veterinary graduates as bovine PD by TRP is one of the most frequently performed procedures in large animal practice and of economic importance. The main aim of this thesis was to investigate alternative and improved undergraduate veterinary training methods for bovine trans-rectal palpation (TRP) and pregnancy diagnosis (PD) skills. The second aspiration of this thesis was that thinking differently about clinical skills training for bovine TRP and PD as an example might lead to an alternative approach to traditional skills training in general that has the potential to overcome some of the training constraints at teaching institutions. This led to a number of studies describing and evaluating TRP and PD assessment methods, identifying predictors and factors affecting students’ TRP and PD accuracy, developing and implementing research-based innovative teaching ideas, including optimised simulator training, in-training assessment methods, additional training opportunities linked to or not directly linked to the TRP skill itself and the use of technology to improve skills training. The series of studies described in this thesis demonstrate how training innovations, such as the “mini Cow Palpation Box” and the “Bovine Pregnancy Diagnosis Improvement Exercise Programme” (http://icarus.up.ac.za/vetmlp/), can be combined with traditional training to improve overall TRP and PD training and to optimise limited live animal exposure to practice these skills. The findings of this thesis can be implemented to respect and maintain high ethical standards for the use of teaching animals. The thesis leads to a description of practical implications for undergraduate bovine TRP and PD skills training methods which summarises the teaching strategies and interventions for bovine TRP and PD training. The practical recommendations described can be used to design or improve bovine TRP and PD training programmes at veterinary teaching institutions. Furthermore, this thesis describes a new concept to teach clinical hands-on skills (The “Predictor Micro-Skills Concept”) which is based on the TRP and PD skills training investigations done as part of this PhD thesis and which are considered to be applicable to many other clinical skills. Lastly, an approach to blending a fun student project and research while teaching is outlined

Thinking differently about clinical skills training: The bovine pregnancy diagnosis via transrectal palpation showcase

Clinical hands-on training is an integral part of veterinary education. Skills acquisition opportunities are however limited by welfare and ethical concerns around the use of live animals for training purposes, large student cohort sizes and budget constraints, amongst others. The same holds true for bovine trans-rectal palpation (TRP) and pregnancy diagnosis (PD) training and is furthermore challenging since extensive exposure to TRP in live cows is required to ensure competency. At the same time, it is an important competency for veterinary graduates as bovine PD by TRP is one of the most frequently performed procedures in large animal practice and of economic importance. The main aim of this thesis was to investigate alternative and improved undergraduate veterinary training methods for bovine trans-rectal palpation (TRP) and pregnancy diagnosis (PD) skills. The second aspiration of this thesis was that thinking differently about clinical skills training for bovine TRP and PD as an example might lead to an alternative approach to traditional skills training in general that has the potential to overcome some of the training constraints at teaching institutions. This led to a number of studies describing and evaluating TRP and PD assessment methods, identifying predictors and factors affecting students’ TRP and PD accuracy, developing and implementing research-based innovative teaching ideas, including optimised simulator training, in-training assessment methods, additional training opportunities linked to or not directly linked to the TRP skill itself and the use of technology to improve skills training. The series of studies described in this thesis demonstrate how training innovations, such as the “mini Cow Palpation Box” and the “Bovine Pregnancy Diagnosis Improvement Exercise Programme” (http://icarus.up.ac.za/vetmlp/), can be combined with traditional training to improve overall TRP and PD training and to optimise limited live animal exposure to practice these skills. The findings of this thesis can be implemented to respect and maintain high ethical standards for the use of teaching animals. The thesis leads to a description of practical implications for undergraduate bovine TRP and PD skills training methods which summarises the teaching strategies and interventions for bovine TRP and PD training. The practical recommendations described can be used to design or improve bovine TRP and PD training programmes at veterinary teaching institutions. Furthermore, this thesis describes a new concept to teach clinical hands-on skills (The “Predictor Micro-Skills Concept”) which is based on the TRP and PD skills training investigations done as part of this PhD thesis and which are considered to be applicable to many other clinical skills. Lastly, an approach to blending a fun student project and research while teaching is outlined

InVeST proceedings, 10-12 April 2017

Bovine tuberculosis caused by Mycobacterium bovis, is a chronic debilitating disease of mostly domestic cattle with infections reported in a wide range of domestic and wild animal species and also in humans. Due to its trade and public health implications, bovine tuberculosis is a controlled disease in many countries. The prescribed diagnostic test is the intradermal tuberculin test (skin test) which involves the evaluation of the host’s hypersensitivity reaction 72 hours after the intradermal injection of purified derivatives of mycobacterial proteins (bovine and avian tuberculin). Interpretation of skin test reactions is based on measuring the increase in skin thickness, as well as the subjective evaluation of any clinical signs observed such as edema and necrosis. The quality of the test outcome is highly dependent on the operator’s skills and experience in performing this test. Practical training of veterinary students in the correct execution and interpretation of the skin test is therefore a critical Day 1 competency. Live animal training for intradermal tuberculin testing is limited and no skin test models are commercially available. Therefore, bovine skin models made of dragon skin and platinum-cure silicon placed on aluminum clipper frames measuring 20x30cm and covered with artificial hair were developed. Each of the five models represents a different common test outcome: edema, diffuse or circumscribed swellings, necrosis and adhesion of the skin. The models are used to evaluate the different skin reactions by palpation, measuring skin thickness, and visual evaluation. A step-by-step manual is available to guide students through the procedure and interpretation of the skin reactions.Poster presented at the 5th International Veterinary Simulation in Teaching Conference, 10-12 April 2017, held at the Intundla Conference Venue, Pretoria, South Africa.Sponsored by Virtalis, South Africa. Dept. of Higher Education & Training, Anatomoulds, Veterinary Simulator Industries, National Research Foundation, University of Pretoria. Faculty of Veterinary Science, Zoetis and Breed 'n Betsyab201

Training method and other factors affecting student accuracy in bovine pregnancy diagnosis

To optimize bovine pregnancy diagnosis (PD) training, factors influencing student performance were investigated. The objective was to determine whether training method, gender, background (farm, urban, or mixed), previous experience in bovine PD, and current career interest influenced the accuracy of bovine PD by trans-rectal palpation (TRP). Fourth-year (of a 6-year program) veterinary students (n=138) received one PD training session in groups using either simulator training on Breed'n Betsy (BB) or training on live cows (C). Students completed a questionnaire on gender, background, and career interest. Students' PD accuracy (pregnancy status and stage) was determined after training when each student palpated six cows with known pregnancy status. Students' accuracy in determining pregnancy status was measured as sensitivity and specificity (the ability to correctly identify the presence and absence of pregnancy respectively). Factors that influenced overall accuracy with a higher student sensitivity of bovine PD by TRP were training method, farming background, an interest in a mixed animal career, and stage of gestation. Gender of students and previous experience in bovine PD did not have an influence. Training on BB simulators was associated with lower student sensitivity for pregnancy detection in cows 6 months pregnant was similar for training on BB simulators and live cows. No evaluated factors were significantly associated with specificity of PD. Teaching efforts focusing on specificity of PD and repeated simulator-based training in conjunction with live cow exposure are recommended.http://jvme.utpjournals.press/loi/jvme2019-11-29hj2018Production Animal Studie

Ability of a bovine transrectal palpation objective structured clinical examination to predict veterinary students’ pregnancy diagnosis accuracy

Bovine pregnancy diagnosis (PD) by transrectal palpation (TRP) is one of the most frequently performed procedures in bovine practice, and an important competency for veterinary graduates. It is currently not known if pre-existing TRP skills on non-pregnant cows can be used to predict students’ future PD accuracy. The study objective was to evaluate if TRP objective structured clinical examination (OSCE) scores can predict students’ future PD accuracy. Fourth year (of a six-year programme) veterinary students (n=128) received TRP and PD training on Breed’n Betsy (BB) simulators and live cows. Students’ TRP skills were assessed using a live cow TRP OSCE after completion of the fourth year training. The same students received additional TRP (BB and live cows) and PD (BB) training sessions in the first semester of their fifth year. PD accuracy was assessed after the additional TRP and PD training, five months after the TRP OSCE assessment and measured as sensitivity and specificity (the ability to correctly identify the presence and absence of pregnancy, respectively). Each student palpated six cows transrectally to diagnose pregnancy status and stage for the PD assessment. The TRP OSCE results were analysed as predictors for students’ PD accuracy. Students with ‘competent palpation skills’ on the TRP OSCE had higher PD specificity. The individual OSCE components that were predictive of higher PD accuracy were students’ ability to estimate ovarian size, identify uterine position and exclude intrauterine fluid. It was concluded that a TRP OSCE has the ability to predict students’ future PD accuracy.https://veterinaryrecord.bmj.comhj2019Production Animal Studie

Ability of a bovine transrectal palpation objective structured clinical examination to predict veterinary students’ pregnancy diagnosis accuracy

Bovine pregnancy diagnosis (PD) by transrectal palpation (TRP) is one of the most frequently performed procedures in bovine practice, and an important competency for veterinary graduates. It is currently not known if pre-existing TRP skills on non-pregnant cows can be used to predict students’ future PD accuracy. The study objective was to evaluate if TRP objective structured clinical examination (OSCE) scores can predict students’ future PD accuracy.Fourth year (of a six-year programme) veterinary students (n=128) received TRP and PD training on Breed’n Betsy (BB) simulators and live cows. Students’ TRP skills were assessed using a live cow TRP OSCE after completion of the fourth year training. The same students received additional TRP (BB and live cows) and PD (BB) training sessions in the first semester of their fifth year. PD accuracy was assessed after the additional TRP and PD training, five months after the TRP OSCE assessment and measured as sensitivity and specificity (the ability to correctly identify the presence and absence of pregnancy, respectively). Each student palpated six cows transrectally to diagnose pregnancy status and stage for the PD assessment. The TRP OSCE results were analysed as predictors for students’ PD accuracy.Students with ‘competent palpation skills’ on the TRP OSCE had higher PD specificity. The individual OSCE components that were predictive of higher PD accuracy were students’ ability to estimate ovarian size, identify uterine position and exclude intrauterine fluid. It was concluded that a TRP OSCE has the ability to predict students’ future PD accuracy

Influence of an Exercise Program, Muscle Strength, Proprioception, and Arm Length on Veterinary Students' Bovine Pregnancy Diagnosis Accuracy

Bovine pregnancy diagnosis (PD) by transrectal palpation (TRP) is an important skill for veterinary graduates. Factors influencing students' PD accuracy were investigated to optimize bovine PD by TRP training without increasing live animal exposure. The objective was to determine whether arm length and strength, proprioception, and exposure to a 6-week exercise training program were significantly associated with students' PD accuracy. Veterinary students (n = 128) who had previously received formal theoretical and practical training in bovine TRP and PD (live cows and TRP simulators) were assessed for PD accuracy on live cows. Prior to assessment, arm muscle strength measurement, an exercise program, and additional TRP sessions on Breed'n Betsy¯ simulators and live cows were offered to the students. Seventy-eight students volunteered to participate in the arm length measurement, muscle strength, and proprioception testing. Of these, 35 randomly allocated students completed a 6-week exercise program, after which muscle strength was reassessed. Each student performed PDs on six cows of which the pregnancy status, ranging from 6 weeks to 9 months pregnant or not pregnant, was predetermined by an experienced veterinarian. PD accuracy was measured as sensitivity and specificity, being defined as the proportion of pregnant or nonpregnant cows, respectively, correctly identified by the student. It is concluded that hand grip strength and participation in an exercise program are significant predictors of veterinary students' PD accuracy. Implementation of an exercise program aimed at improving grip strength in the veterinary curriculum is a novel approach to improve bovine TRP and PD training

Electromyographic Analysis of Muscle Activation Patterns During Bovine Transrectal Palpation and the Development of the Bovine Pregnancy Diagnosis Improvement Exercise Program

The unusual and tiring physical activity of bovine transrectal palpation (TRP) requires a novel approach to improve students' TRP and pregnancy diagnosis (PD) skills. It has been shown that students who participated in an exercise program and students who had a grip strength (GS) of more than 30 kilograms performed better in bovine PDs. Participation in the exercise program increased students' sensitivity (ability to identify pregnant cows) but did not increase total arm muscle strength. To identify which muscles are used during TRPs and to improve the exercise program, an electromyographic (EMG) analysis was used to identify muscle activation patterns and muscle activity levels during bovine TRPs. Eight subject matter experts (SMEs) each palpated two live cows and one Breed'n Betsy ® rectal examination simulator while an EMG Triggered Stimulator recorded muscle activity. Muscle activation was higher for forearm muscles compared with all other examined muscle groups ( p < .001); was higher during retraction of the uterus and palpation of left and right uterine horn, compared with palpation of cervix, uterine body, left ovary, and right ovary ( p < .001); and showed an endurance pattern. Findings have been used to modify the previously developed exercise program in effort to improve students' TRP and PD skills. The Bovine PD Improvement Exercise Program is available to students through an online application (http://icarus.up.ac.za/vetmlp/) and aims to not only improve GS and TRP accuracy but also stamina and well-being while adding fun to busy study schedules

Electromyographic Analysis of Muscle Activation Patterns During Bovine Transrectal Palpation and the Development of the Bovine Pregnancy Diagnosis Improvement Exercise Program

The unusual and tiring physical activity of bovine transrectal palpation (TRP) requires a novel approach to improve students' TRP and pregnancy diagnosis (PD) skills. It has been shown that students who participated in an exercise program and students who had a grip strength (GS) of more than 30 kilograms performed better in bovine PDs. Participation in the exercise program increased students' sensitivity (ability to identify pregnant cows) but did not increase total arm muscle strength. To identify which muscles are used during TRPs and to improve the exercise program, an electromyographic (EMG) analysis was used to identify muscle activation patterns and muscle activity levels during bovine TRPs. Eight subject matter experts (SMEs) each palpated two live cows and one Breed'n Betsy ® rectal examination simulator while an EMG Triggered Stimulator recorded muscle activity. Muscle activation was higher for forearm muscles compared with all other examined muscle groups ( p < .001); was higher during retraction of the uterus and palpation of left and right uterine horn, compared with palpation of cervix, uterine body, left ovary, and right ovary ( p < .001); and showed an endurance pattern. Findings have been used to modify the previously developed exercise program in effort to improve students' TRP and PD skills. The Bovine PD Improvement Exercise Program is available to students through an online application (http://icarus.up.ac.za/vetmlp/) and aims to not only improve GS and TRP accuracy but also stamina and well-being while adding fun to busy study schedules