Cut-Off Values For Gait Variables To Detect Forelimb Lameness In Individual Dogs

The objective of this study was to characterize kinetic and kinematic variables in dogs with forelimb lameness and determine lameness cutoff values of gait variables using ROC analysis with observational gait analysis (OGA) as reference. Twenty client-owned dogs with unilateral lameness were included. Dogs underwent orthopedic exam, including OGA, and instrumented gait analysis (IGA; kinetic and kinematic analysis). Kinetic variables with the highest accuracy were PVF and %WD with an area under the curve (AUC) of 0.73 and 0.92, respectively. Optimal cutoff value for PVF and %WD were ≤ 10.6 (sensitivity 70% and specificity 75%) and ≤ 29.7 (sensitivity 90% and specificity 85%), respectively. Results of the ROC analysis indicate that KVs were most useful in determining lameness

Social fragmentation, deprivation and urbanicity: relation to first-admission rates for psychoses

<i>Declaration</i> <i>of</i> <i>interest</i>: None. <i>Background</i>: Social disorganisation, fragmentation and isolation have long been posited as influencing the rate of psychoses at area level. Measuring such societal constructsis difficult. A census-based index measuring social fragmentation has been proposed. <i>Aims</i>: To investigate the association between first-admission rates for psychosis and area-based measures of social fragmentation, deprivation and urban/rural index. <i>Method</i>: We used indirect standardisation methods and logistic regression models to examine associations of social fragmentation, deprivation and urban/rural categories with first admissions for psychoses in Scotland for the 5-year period 1989–1993. <i>Results</i>: Areas characterised by high social fragmentation had higher first-ever admission rates for psychosis independent of deprivation and urban/rural status. There was a dose–response relationship between social fragmentation category and first-ever admission rates for psychosis. There was no statistically significant interaction between social fragmentation, deprivation and urban/rural index. <i>Conclusions</i>: First-admission rates are strongly associated with measures of social fragmentation, independent of material deprivation and urban/rural category

International cooperation for Mars exploration and sample return

The National Research Council's Space Studies Board has previously recommended that the next major phase of Mars exploration for the United States involve detailed in situ investigations of the surface of Mars and the return to earth for laboratory analysis of selected Martian surface samples. More recently, the European space science community has expressed general interest in the concept of cooperative Mars exploration and sample return. The USSR has now announced plans for a program of Mars exploration incorporating international cooperation. If the opportunity becomes available to participate in Mars exploration, interest is likely to emerge on the part of a number of other countries, such as Japan and Canada. The Space Studies Board's Committee on Cooperative Mars Exploration and Sample Return was asked by the National Aeronautics and Space Administration (NASA) to examine and report on the question of how Mars sample return missions might best be structured for effective implementation by NASA along with international partners. The committee examined alternatives ranging from scientific missions in which the United States would take a substantial lead, with international participation playing only an ancillary role, to missions in which international cooperation would be a basic part of the approach, with the international partners taking on comparably large mission responsibilities. On the basis of scientific strategies developed earlier by the Space Studies Board, the committee considered the scientific and technical basis of such collaboration and the most mutually beneficial arrangements for constructing successful cooperative missions, particularly with the USSR

Differential Regulation of Drosha and Dicer Homologues by Stress in Tetrahymena thermophila

Tetrahymena thermophila are free-living ciliated protozoans that possess two nuclei; a diploid micronucleus used only for mating, and a polyploid macronucleus which governs gene regulation and cellular homeostasis. When environmental conditions are favorable, the micronucleus exists as heterochromatin and the macronucleus is active. However, when conditions are unfavorable, Tetrahymena will attempt to conjugate with another mating type of the same species, in order to obtain new genetic information. During conjugation, the old macronucleus breaks down and a new polyploid macronucleus is regenerated. Macronuclear breakdown in Tetrahymena is governed by small RNAs, similar to miRNAs in multicellular eukaryotes. Our previous research, using the Tetrahymena Genome Database, along with the findings of other scientists, indicates that Tetrahymena possess a number of enzymes homologous to the miRNA processing enzymes, Drosha and Dicer. In our current study, we immunolocalized these enzymes in the presence and absence of cellular stress. Our immunofluorescence data indicate that Dicer-like proteins were expressed at a higher level in stressed cells than in our control cells, while Drosha-like proteins remained at the same level in both cell types

Advanced Triage Protocol: The Role of an Automated Lactate Order in Expediting Rapid Identification of Patients at Risk of Sepsis in the Emergency Department

We undertook a process improvement initiative to expedite rapid identification of potential sepsis patients based on triage chief complaint, vital signs, and initial lactate level. Design: Prospective cohort study. Setting: Seven hundred-bed tertiary care hospital with ≅65,000 patient visits/yr. Patients: Patients presenting to emergency department (ED) triage who met the following criteria: greater than or equal to two of the three systemic inflammatory response syndrome criteria assessable in triage, a chief complaint suggestive of infection, emergency severity index 2 or 3, and ambulatory to ED. Interventions: A computer-generated lactate order was created, staff education and resources increased, and point-of-care lactate testing was introduced. Measurements and main results: Primary endpoints include the following: percent of patients having a lactate level drawn, percent of lactate samples resulting before room placement, and time intervals from triage to lactate blood draw and to lactate result. Secondary endpoints were percentage of patients admitted to the hospital, percentage admitted to the ICU, and in-hospital mortality. Six thousand nine hundred six patients were included: 226 historic controls (HCs) and 6,680 intervention group patients. The mean serum lactate level was 1.77 ± 1.18 mmol/L. The percentage of patients having a lactate resulted increased from 27.4% in the HC period to 79.6%. The percentage of these lactate results available while the patient was still in the waiting room increased from 0.4% during the HC period to 33.7% during Phase 5 (p \u3c 0.0001). In the intervention period, time from triage to lactate result decreased (78.1-63.4 min; p \u3c 0.0001) and time to treatment room decreased (59.3-39.6 min; p \u3c 0.0001). Conclusions: Implementation of a computerized lactate order using readily available data obtained during ED triage, combined with point-of-care lactate testing, improves time to lactate blood draw and lactate result in patients at risk for severe sepsis. Initial lactate levels correlated with admission to the hospital, admission to the ICU, and in-hospital mortality

Society for Cardiovascular Magnetic Resonance (SCMR) guidance for the practice of cardiovascular magnetic resonance during the COVID-19 pandemic

The aim of this document is to provide general guidance and specific recommendations on the practice of cardiovascular magnetic resonance (CMR) in the era of the COVID-19 pandemic. There are two major considerations. First, continued urgent and semi-urgent care for the patients who have no known active COVID-19 should be provided in a safe manner for both patients and staff. Second, when necessary, CMR on patients with confirmed or suspected active COVID-19 should focus on the specific clinical question with an emphasis on myocardial function and tissue characterization while optimizing patient and staff safety

Design of a Microsphere-Based High-Throughput Gene Expression Assay to Determine Estrogenic Potential

Recently gene expression studies have been multiplied at an accelerated rate by the use of high-density microarrays. By assaying thousands of transcripts at a time, microarrays have led to the discovery of dozens of genes involved in particular biochemical processes, for example, the response of a tissue/organ to a given chemical with therapeutic or toxic properties. The next step in these studies is to focus on the response of a subset of relevant genes to verify or refine potential therapeutic or toxic properties. We have developed a sensitive, high-throughput gene expression assay for this purpose. In this assay, based on the Luminex xMAP system, carefully selected oligonucleotides were covalently linked to fluorescently coded microspheres that are hybridized to biotinylated cRNA followed by amplification of the signal, which results in a rapid, sensitive, multiplexed assay platform. Using this system, we have developed an RNA expression profiling assay specific for 17 estrogen-responsive transcripts and three controls. This assay can evaluate up to 100 distinct analytes simultaneously in a single sample, in a 96-well plate format. This system has improved sensitivity versus existing microsphere-based assays and has sensitivity and precision comparable with or better than microarray technology. We have achieved detection levels down to 1 amol, detecting rare messages in complex cRNA samples, using as little as 2.5 μg starting cRNA. This assay offers increased throughput with decreased costs compared with existing microarray technologies, with the trade-off being in the total number of transcripts that can be analyzed

The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses

<p>Background: Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice.</p> <p>Methods: A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data.</p> <p>Results: The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task.</p> <p>Conclusions: If health practitioners are to be effective at communicating research evidence, we suggest that more research and resources need to be focused on contextual factors, such as how research evidence is negotiated, appraised and communicated within the dynamic patient-practitioner relationship.</p&gt

Morality and progress:IR narratives on international revisionism and the status quo

Scholars debate the ambitions and policies of today’s ‘rising powers’ and the extent to which they are revising or upholding the international status quo. While elements of the relevant literature provide valuable insight, this article argues that the concepts of revisionism and the status quo within mainstream International Relations (IR) have always constituted deeply rooted, autobiographical narratives of a traditionally Western-dominated discipline. As ‘ordering narratives’ of morality and progress, they constrain and organize debate so that revisionism is typically conceived not merely as disruption, but as disruption from the non-West amidst a fundamentally moral Western order that represents civilizational progress. This often makes them inherently problematic and unreliable descriptors of the actors and behaviours they are designed to explain. After exploring the formations and development of these concepts throughout the IR tradition, the analysis is directed towards narratives around the contemporary ‘rise’ of China. Both scholarly and wider political narratives typically tell the story of revisionist challenges China presents to a US/Western-led status quo, promoting unduly binary divisions between the West and non-West, and tensions and suspicions in the international realm. The aim must be to develop a new language and logic that recognize the contingent, autobiographical nature of ‘revisionist’ and ‘status quo’ actors and behaviours

Society for Cardiovascular Magnetic Resonance (SCMR) guidance for re-activation of cardiovascular magnetic resonance practice after peak phase of the COVID-19 pandemic

During the peak phase of the COVID-19 pandemic, alterations of standard operating procedures were necessary for health systems to protect patients and healthcare workers and ensure access to vital hospital resources. As the peak phase passes, re-activation plans are required to safely manage increasing clinical volumes. In the context of cardiovascular magnetic resonance (CMR), re-activation objectives include continued performance of urgent CMR studies and resumption of CMR in patients with semi-urgent and elective indications in an environment that is safe for both patients and health care workers