Translational Echocardiography: The Dog as a Clinical Research Model of Cardiac Dysfunction

Heart disease is a major contributor to mortality and disability on a global scale. Hence, there is a need for research to improve non-invasive diagnostic techniques. Diseases in dogs with characteristics very similar to those of human pathologies hold promise as a source of data for evaluating and developing echocardiographic techniques and devices. Methods: We conducted a structured literature search from June 2022 to January 2023 to evaluate the relevance of dogs as a translational model for echocardiographic clinical research. We searched various academic databases, including PubMed Central (PMC), Core, DIGITAL.CSIC, DOAB, DOAJ, EBSCO host, Elsevier B.V, Redib, Scopus, and Web of Science, available through the Academic Information System of the Autonomous University of Baja California. Results: Out of the 243 articles initially screened, we identified 119 relevant articles that met our inclusion criteria for further analysis. This review is an introduction to the canine model by analyzing the cardiovascular anatomical similarities between the two species, the pathophysiological overlaps in some diseases, the parallels in echocardiographic techniques in dogs compared to humans, and the suitability of dogs with a naturally occurring cardiac disease as a model for translational clinical research compared to other animal species. Conclusions: This review emphasizes the importance of canine patients as an ideal cardiac disease symmetrical clinical model since they share common heart diseases with humans. Furthermore, dogs have a shorter lifespan, leading to the relatively rapid evolution of these diseases, which makes studying these pathologies and developing echocardiographic techniques more feasible. The results strongly indicate the need for interdisciplinary collaboration and translational medical research to create innovative echocardiographic technologies and improve the connection between veterinary and human cardiac imaging research

Canine thoracic radiographic images as an educational dataset for distance learning and research on vertebral heart score

Distance learning is a rapidly spreading form of education worldwide and it plays a crucial role to provide access to millions of people in developing countries. However, the benefits of online learning extend far beyond and became increasingly popular also in medical schools, including veterinary medicine [1,2]. In these new teaching settings, high-quality, validated and easily accessible multimedia materials are of great importance, especially in specific fields, such as radiology, where graphic resources can greatly support learning [3].The dataset presented along with this article reviews examples of 153 canine latero-lateral thoracic radiographic medical images taken and collected at the Small Animal Veterinary Teaching Hospital, Veterinary Sciences Research Institute, Autonomous University of Baja California. serves as a basis for teaching VHS calculation. Images on this dataset contain all relevant anatomical structures in the determination of VHS, which makes them optimal images for practice in calculating VHS and teaching this procedure. The number of cardiothoracic radiographic images presented here can be a great support in learning the calculation of VHS, especially when combined with distance competency-based educators' support.Acquired heart diseases in the dog are very common, clinical evidence of degenerative valvular disease is detected in approximately 30% of dogs aged 13 years and older [4]. The prevalence of Dilated Cardiomyopathy (DCM) is remarkably high in certain breeds, approximately 25% of Irish Wolfhounds, 33% of female Doberman Pinschers, and 50% of male Doberman Pinschers are diagnosed with DCM [5]. Thoracic radiography is a key component in cardiovascular evaluation, which is used to calculate the vertebral heart score (VHS). VHS measurement has been described as one of the most objective methods for assessing cardiomegaly in dogs. VHS, in addition to thorough patient history and physical examination, can be very efficient to raise clinical suspicion of underlying heart disease. The measurement is based on cardiac height and width and is normalized to overall body size by comparison to vertebral body length. ln addition to the initial assessment of heart size, the VHS method is also useful for monitoring changes in heart size in response to treatment or to assess the progression of cardiomegaly over time in canine patients [6] Fig. 1. Importantly, considerable breed and individual variation exist with VHS and dogs can have values that fall outside of the normal range even without any cardiac disease. Thus, while the VHS method is a very informative tool, it should not be used as the only means of diagnosing cardiac disease in any given patient [7]

Proyecto De Tesis I - CI186 - 202101

Descripción: Curso de especialidad en la carrera de ingeniería civil de carácter teórico-práctico dirigido a los estudiantes del 9no ciclo. El curso Proyecto de Tesis I busca que los estudiantes de Ingeniería Civil apliquen sus capacidades adquiridas durante todos sus estudios, en completar una investigación, que plantea resolver una problemática en una de las líneas de la carrera. Con la ayuda de un docente asesor especialista en el tema lograran redactar el informe de tesis al 50%, este informe será revisado por otro docente especialista que proporciona sugerencias de mejoras a la investigación. Por último, los estudiantes exponen ante un jurado especialista sus resultados quienes evalúan y también hacen sugerencia de mejoras a la investigación. Propósito: En el Perú actualmente existe un gran número de estudiantes de Ingeniería Civil que no cuentan con el título profesional, por no realizar la tesis de investigación, lo cual disminuye significativamente su desarrollo profesional y sus oportunidades laborales. El curso de proyecto de Tesis 1 permite que los estudiantes puedan desarrollar el 50% de la Tesis de investigación, siendo la misma certificada por un asesor y un jurado evaluador. Contribuye con el desarrollo de las competencias generales de Pensamiento Crítico, Razonamiento Cuantitativo, Pensamiento Innovador y las competencias específicas 1, 4 y 7 de ABET, todas a nivel de logro 3

Proyecto de Tesis II - CI189 - 202102

DESCRIPCIÓN Curso de especialidad en la carrera de ingeniería civil de carácter teórico-práctico dirigido a los estudiantes del 10mo ciclo. El curso Proyecto de Tesis II busca que los estudiantes de Ingeniería Civil apliquen sus capacidades adquiridas durante todos sus estudios, en completar una investigación, que plantea resolver una problemática en una de las líneas de la carrera. Con la ayuda de un docente asesor especialista en el tema lograran redactar el informe de tesis al 100%, este informe será revisado por otro docente especialista que proporciona sugerencias de mejoras a la investigación. Por último, los estudiantes exponen ante un jurado especialista sus resultados quienes evalúan y también hacen sugerencia de mejoras a la investigación. PROPÓSITO En el Perú actualmente existe un gran número de estudiantes de Ingeniería Civil que no cuentan con el título profesional, por no realizar la tesis de investigación, lo cual disminuye significativamente su desarrollo profesional y sus oportunidades laborales. Adicionalmente las leyes Peruanas exigen que para el obtener el bachillerato los estudiantes deben redactar un trabajo de investigación. El curso de proyecto de Tesis 2 permite que los estudiantes puedan desarrollar el 100% de la Tesis y un trabajo de investigación, siendo ambos certificados por un asesor y un jurado evaluador. Este curso contribuye con el desarrollo de las competencias generales de comunicación escrita, comunicación oral, manejo de la información y ciudadanía y las competencias específicas 2, 3, 5 y 6 de ABET, todas a nivel de logro 3. Cuenta con el prerrequisito de Proyecto de Tesis 1

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P<0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P<0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally