Renal fibrosis in feline chronic kidney disease: known mediators and mechanisms of injury

Chronic kidney disease (CKD) is a common medical condition of ageing cats. In most cases the underlying aetiology is unknown, but the most frequently reported pathological diagnosis is renal tubulointerstitial fibrosis. Renal fibrosis, characterised by extensive accumulation of extra-cellular matrix within the interstitium, is thought to be the final common pathway for all kidney diseases and is the pathological lesion best correlated with function in both humans and cats. As a convergent pathway, renal fibrosis provides an ideal target for the treatment of CKD and knowledge of the underlying fibrotic process is essential for the future development of novel therapies. There are many mediators and mechanisms of renal fibrosis reported in the literature, of which only a few have been investigated in the cat. This article reviews the process of renal fibrosis and discusses the most commonly cited mediators and mechanisms of progressive renal injury, with particular focus on the potential significance to feline CKD

Hypertension, retinopathy, and acute kidney injury in dogs: A prospective study

Background Systemic hypertension (SH) is a potential complication of acute kidney injury (AKI) in dogs. Objective To describe the prevalence of SH and hypertensive retinopathy in dogs with AKI, to investigate the relationship between SH and severity of AKI and to assess possible factors associated with SH. Animals Fifty‐two dogs with AKI. Methods Prospective observational study of dogs presenting to a tertiary referral center that fulfilled the International Renal Interest Society (IRIS) guidelines for the diagnosis of AKI. Systolic blood pressure measurement, urine protein/creatinine ratio (UPCR), urine output, presence of hypertensive retinopathy and fluid overload (FO), survival to discharge and duration of hospitalization were subsequently assessed. The prevalence of SH was calculated and the relationship between SH and recorded factors was examined by nonparametric statistics. Results The prevalence of SH (≥160 mm Hg) on admission or during hospitalization was 75% (39/52) and in 56% (22/39) of cases this was severe (≥180 mm Hg). Sixteen percent (7/43) of dogs had evidence of hypertensive retinopathy and 77% (24/31) dogs had UPCR >0.5. Forty‐two percent (22/52) dogs had FO on admission or during hospitalization. There was no association between SH and IRIS AKI grade, oligo/anuria, survival to discharge, duration of hospitalization or proteinuria. Dogs with FO on presentation were more likely to be hypertensive at admission compared to dogs without FO (P = .02). Dogs that did not survive to discharge were more likely to have FO (P = .007). Conclusions and Clinical Importance Systemic hypertension is common in dogs with AKI. Systemic hypertension might be associated with FO, which itself is associated with nonsurvival. Monitoring for SH and FO is therefore warranted in dogs with AKI

Identification of Novel Cetacean Poxviruses in Cetaceans Stranded in South West England

Poxvirus infections in marine mammals have been mainly reported through their clinical lesions and electron microscopy (EM). Poxvirus particles in association with such lesions have been demonstrated by EM and were previously classified as two new viruses, cetacean poxvirus 1 (CePV-1) and cetacean poxvirus 2 (CePV-2). In this study, epidermal pox lesions in cetaceans stranded in South West England (Cornwall) between 2008 and 2012 were investigated by electron microscopy and molecular analysis. PCR and sequencing of a highly conserved region within the viral DNA polymerase gene ruled out both parapoxand orthopoxviruses. Moreover, phylogenetic analysis of the PCR product clustered the sequences with those previously described as cetacean poxviruses. However, taking the close genetic distance of this gene fragment across the family of poxviridae into account, it is reasonable to postulate further, novel cetacean poxvirus species. The nucleotide similarity within each cluster (tentative species) detected ranged from 98.6% to 100%, whilst the similarity between the clusters was no more than 95%. The detection of several species of poxvirus in different cetacean species confirms the likelihood of a heterogeneous cetacean poxvirus genus, comparable to the heterogeneity observed in other poxvirus genera

Stakeholder involvement in systematic reviews: a protocol for a systematic review of methods, outcomes and effects

Background There is an expectation for stakeholders (including patients, the public, health professionals, and others) to be involved in research. Researchers are increasingly recognising that it is good practice to involve stakeholders in systematic reviews. There is currently a lack of evidence about (A) how to do this and (B) the effects, or impact, of such involvement. We aim to create a map of the evidence relating to stakeholder involvement in systematic reviews, and use this evidence to address the two points above. Methods We will complete a mixed-method synthesis of the evidence, first completing a scoping review to create a broad map of evidence relating to stakeholder involvement in systematic reviews, and secondly completing two contingent syntheses. We will use a stepwise approach to searching; the initial step will include comprehensive searches of electronic databases, including CENTRAL, AMED, Embase, Medline, Cinahl and other databases, supplemented with pre-defined hand-searching and contacting authors. Two reviewers will undertake each review task (i.e., screening, data extraction) using standard systematic review processes. For the scoping review, we will include any paper, regardless of publication status or study design, which investigates, reports or discusses involvement in a systematic review. Included papers will be summarised within structured tables. Criteria for judging the focus and comprehensiveness of the description of methods of involvement will be applied, informing which papers are included within the two contingent syntheses. Synthesis A will detail the methods that have been used to involve stakeholders in systematic reviews. Papers from the scoping review that are judged to provide an adequate description of methods or approaches will be included. Details of the methods of involvement will be extracted from included papers using pre-defined headings, presented in tables and described narratively. Synthesis B will include studies that explore the effect of stakeholder involvement on the quality, relevance or impact of a systematic review, as identified from the scoping review. Study quality will be appraised, data extracted and synthesised within tables. Discussion This review should help researchers select, improve and evaluate methods of involving stakeholders in systematic reviews. Review findings will contribute to Cochrane training resources

Drivers of taxonomic bias in conservation research : a global analysis of terrestrial mammals

Scientific knowledge of species and the ecosystems they inhabit is the cornerstone of modern conservation. However, research effort is not spread evenly among taxa (taxonomic bias), which may constrain capacity to identify conservation risk and to implement effective responses. Addressing such biases requires an understanding of factors that promote or constrain the use of a particular species in research projects. To this end, we quantified conservation science knowledge of the world's extant non-marine mammal species (n = 4108) based on the number of published documents in journals indexed on Clarivate Analytics' Web of Science (TM). We use an innovative hurdle model approach to assess the relative importance of several ecological, biogeographical and cultural factors for explaining variation in research production between species. The most important variable explaining the presence/absence of conservation research was scientific capacity of countries within the range of the species, followed by body mass and years since the taxonomic description. Research volume (more than one document) was strongly associated with number of years since the data describing on that species, followed by scientific capacity within the range of species, high body mass and invasiveness. The threat status was weakly associated to explain the presence/absence and research volume in conservation research. These results can be interpreted as a consequence of the dynamic interplay between the perceived need for conservation research about a species and its appropriateness as a target of research. As anticipated, the scientific capacity of the countries where a species is found is a strong driver of conservation research bias, reflecting the high variation in conservation research funding and human resources between countries. Our study suggests that this bias could be most effectively reduced by a combination of investing in pioneering research, targeted funding and supporting research in countries with low scientific capacity and high biodiversity.Peer reviewe

Urinary tract infections in healthy women: a revolution in management?

<p>Abstract</p> <p>Background</p> <p>Urinary infection in otherwise healthy women has largely been a straightforward matter of diagnosis by identifying bacteria in the urine, and then cure by appropriate antibiotics. Recent research has shown this to be over-simplified. Evaluation of methods of self-management of symptoms has been neglected.</p> <p>Discussion</p> <p>Firstly trial data show that women with what used to called 'urethral syndrome' (urinary symptoms but sterile urine) obtain relief from antibiotics. Other trial data have shown a surprisingly large placebo effect from the resolution of symptoms among women who feel their care has been 'positive'. In addition, data published this month in <it>BMC Medicine </it>show that non-steroidal anti-inflammatory (NSAID) drugs provide symptom relief to women with conventional infections (positive urine bacteriology) as much as antibiotics.</p> <p>Conclusions</p> <p>These recent findings provide an opportunity to consider how clinicians might change practice, and sets a new research agenda. We need to know (1) whether the effect of NSAIDs is replicable; (2) why some women in previous trials have had more symptoms if not treated with antibiotics sooner; (3) whether NSAIDs and antibiotics have an additive effect on relieving symptoms; (4) how we can harness the placebo effect better to assist out patients with this distressing and common complaint.</p> <p>See research article <url>http://www.biomedcentral.com/1741-7015/8/30</url></p

More than sense of place? Exploring the emotional dimension of rural tourism experiences

It is widely suggested that participation in rural tourism is underpinned by a sense of rural place or “rurality”. However, although nature and the countryside have long been recognised as a source of spiritual or emotional fulfilment, few have explored the extent to which tourism, itself often claimed to be a sacred experience, offers an emotional/spiritual dimension in the rural context. This paper addresses that literature gap. Using in-depth interviews with rural tourists in the English Lake District, it explores the extent to which, within respondents’ individual understanding of spirituality, a relationship exists between sense of place and deeper, emotional experiences and, especially, whether participation in rural tourism may induce spiritual or emotional responses. The research revealed that all respondents felt a strong attachment to the Lake District; similarly, and irrespective of their openness to spirituality, engaging in rural tourism activities resulted in highly emotive experiences for all respondents, the description/interpretation of such experiences being determined by individual “beliefs”. However, sense of place was not a prerequisite to emotional or spiritual experiences. Being in and engaging with the landscape � effectively becoming part of it � especially through physical activity is fundamental to emotional responses

Core reconstruction in pseudopotential calculations

A new method is presented for obtaining all-electron results from a pseudopotential calculation. This is achieved by carrying out a localised calculation in the region of an atomic nucleus using the embedding potential method of Inglesfield [J.Phys. C {\bf 14}, 3795 (1981)]. In this method the core region is \emph{reconstructed}, and none of the simplifying approximations (such as spherical symmetry of the charge density/potential or frozen core electrons) that previous solutions to this problem have required are made. The embedding method requires an accurate real space Green function, and an analysis of the errors introduced in constructing this from a set of numerical eigenstates is given. Results are presented for an all-electron reconstruction of bulk aluminium, for both the charge density and the density of states.Comment: 14 pages, 5 figure

The processes of transport and public health policy change: 20mph speed limits in Edinburgh and Belfast

Background: In 2016, large scale 20mph speed limits were implemented in the cities of Edinburgh (Scotland) and Belfast (Northern Ireland). The fact that both cities succeeded in implementing 20mph speed limit interventions is important. They illustrate the processes of transport and public health policy change. This paper describes how 20mph speed limit interventions became a reality in the two cities. Methods: We adopted a qualitative case study method. Data were collected from available documents and interviews with stakeholders involved in the pre-implementation processes. Documents and interviews were analysed inductively using thematic analysis, and separately for each city. Results: Five main themes were generated through the analysis: the national policy context of the two cities; political leadership; support for 20mph; opposition; and the key actions involved prior to implementation. Conclusions: In both cities the process took place over at least a ten year period and was piecemeal. However, the gradualist approach proved successful in gaining support for the schemes and minimising political and public backlash. These examples of policy success in Edinburgh and Belfast provide useful learning for other jurisdictions planning or thinking about similar transport and public health policy changes