Effect of screening abdominal ultrasound examination on the decision to pursue advanced diagnostic tests and treatment in dogs with neurologic disease.

BackgroundAbdominal ultrasound examinations (AUS) are commonly performed before advanced neurodiagnostics to screen for diseases that might affect diagnostic plans and prognosis.ObjectivesDescribe the type and frequency of abnormalities found by AUS in dogs presenting with a neurological condition, identify risk factors associated with abnormalities, and evaluate treatment decisions based on findings.AnimalsSeven hundred and fifty-nine hospitalized dogs.MethodsRetrospective study. Medical records of dogs presented from 2007 to 2009 for neurologic disease were searched for signalment, neuroanatomic localization, and AUS findings. Whether dogs had advanced neurodiagnostics and treatment was analyzed.ResultsFifty-eight percent of dogs had abnormal findings on AUS. Probability of abnormalities increased with age (P < 0.001). Nondachshund breeds had higher probability of abnormal AUS than dachshunds (odds ratio [OR] = 1.87). Eleven percent of dogs did not have advanced neurodiagnostics and in 1.3%, this was because of abnormal AUS. Dogs with ultrasonographic abnormalities were less likely than dogs without to have advanced neurodiagnostics (OR = 0.3 [95% confidence interval [CI]: 0.17, 0.52]), however, the probability of performing advanced diagnostics was high regardless of normal (OR = 0.95 [95% CI: 0.92, 0.97]) or abnormal (OR = 0.85 [95% CI: 0.81, 0.88]) AUS. Treatment was more often pursued in small dogs and less often in dogs with brain disease.Conclusions and clinical importanceFindings from screening AUS had a small negative effect on the likelihood of pursuing advanced neurodiagnostics. Although it should be included in the extracranial diagnostic workup in dogs with significant history or physical examination abnormalities, AUS is considered a low-yield diagnostic test in young dogs and dachshunds

Recent advances in opioid therapy

Recent advances in opioid therapy regarding routes of delivery, long-acting preparations, and sequential trials are described. Specifically, the advantages and disadvantages of transdermal therapeutic system fentanyl, transmucosal fentanyl citrate, Kapanol (sustained-release morphine) and individual variability in the responses to different opioids are discussed in detail. Pain and the fear of pain are perhaps the greatest source of suffering. It is common sense to accept that many diseases still cannot be cured, yet the accompanying suffering real. Hence relief is very important. Very few medications surpass opioids in terms of their therapeutic efficacy, ease of application, and lack of organic toxicity. The question is not whether opioids are effective but how to use them rationally. Many patients fail to have adequate analgesia, simply because doctors under-prescribe opioids as a result of lack of knowledge about their optimal usage.published_or_final_versio

Anode modification of polyfluorene-based polymer light-emitting devices

A glycerol-modified poly(3,4-ethylene dioxythiophene) (PEDOT): poly(styrene sulfonate) (PSS) layer was used as an anode buffer layer in polymer light-emitting devices using poly(9,9-dioctylfluorene) (F8) as the emitter. Devices with a configuration of indium tin oxide/PEDOT:PSS (with or without glycerol)/F8/CsF/Al were fabricated. It was found that the glycerol-modified device showed a much larger current density than the unmodified device. At an operating voltage of 6 V, the glycerol-modified device showed a luminance of 1300Cd/m 2 and a current efficiency of 1.7 Cd/A compared to the corresponding values of 500Cd/m 2 and 1.3 Cd/A in the unmodified device. Analysis by ultraviolet spectroscopy suggests that the two devices have the same energy level structure and the performance improvement should not be due to change in the PEDOT/polymer interface. It was further found that incorporating a suitable amount of glycerol into the PEDOT:PSS layer can increase its conductivity by six times. This leads to a better balance in the hole and electron currents and thus improved device efficiency. © 2002 American Institute of Physics.published_or_final_versio

Climate Variability and Ross River Virus Transmission in Townsville Region, Australia 1985 to 1996

Background How climate variability affects the transmission of infectious diseases at a regional level remains unclear. In this paper, we assessed the impact of climate variation on the Ross River virus (RRv) transmission in the Townsville region, Queensland, north-east Australia. Methods Population-based information was obtained on monthly variations in RRv cases, climatic factors, sea level, and population growth between 1985 and 1996. Cross-correlations were computed for a series of associations between climate variables (rainfall, maximum temperature, minimum temperature, relative humidity and high tide) and the monthly incidence of RRv disease over a range of time lags. The impact of climate variability on RRv transmission was assessed using the seasonal auto-regressive integrated moving average (SARIMA) model. Results There were significant correlations of the monthly incidence of RRv to rainfall, maximum temperature, minimum temperature and relative humidity, all at a lag of 2 months, and high tide in the current month. The results of SARIMA models show that monthly average rainfall (β=0.0012, p=0.04) and high tide (β=0.0262, p=0.01) were significantly associated with RRv transmission, although temperature and relative humidity did not seem to have played an important role in the Townsville region. Conclusions Rainfall, and high tide were likely to be key determinants of RRv transmission in the Townsville region

Development of new all-optical signal regeneration technique

All-optical signal regeneration have been the active research area since last decade due to evolution of nonlinear optical signal processing. Existing all-optical signal regeneration techniques are agitated in producing low Bit Error Rate (BER) of 10-10 at below than -10 dBm power received. In this paper, a new all-optical signal regeneration technique is developed by using phase sensitive amplification and designed optical phase locked signal mechanism. The developed all-optical signal regeneration technique is tested for different 10 Gb/s Differential Phase Shift Keying degraded signals. It is determined that the designed all-optical signal regeneration technique is able to provide signal regeneration with noise mitigation for degraded signals. It is analyzed that overall, for all degraded test signals, average BER of 10-13 is achieved at received power of -14 dBm. The designed technique will be helpful to enhance the performance of existing signal regeneration systems in the presence of severe noise by providing minimum BER at low received power

Monopoles and Holography

We present a holographic theory in AdS_4 whose zero temperature ground state develops a crystal structure, spontaneously breaking translational symmetry. The crystal is induced by a background magnetic field, but requires no chemical potential. This lattice arises from the existence of 't Hooft-Polyakov monopole solitons in the bulk which condense to form a classical object known as a monopole wall. In the infra-red, the magnetic field is screened and there is an emergent SU(2) global symmetry.Comment: 33 pages, 16 figures; v2: ref adde

Identification of sVSG117 as an immunodiagnostic antigen and evaluation of a dual-antigen lateral flow test for the diagnosis of human african trypanosomiasis

The diagnosis of human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense relies mainly on the Card Agglutination Test for Trypanosomiasis (CATT). There is no immunodiagnostic for HAT caused by T. b. rhodesiense. Our principle aim was to develop a prototype lateral flow test that might be an improvement on CATT.Pools of infection and control sera were screened against four different soluble form variant surface glycoproteins (sVSGs) by ELISA and one, sVSG117, showed particularly strong immunoreactivity to pooled infection sera. Using individual sera, sVSG117 was shown to be able to discriminate between T. b. gambiense infection and control sera by both ELISA and lateral flow test. The sVSG117 antigen was subsequently used with a previously described recombinant diagnostic antigen, rISG65, to create a dual-antigen lateral flow test prototype. The latter was used blind in a virtual field trial of 431 randomized infection and control sera from the WHO HAT Specimen Biobank.In the virtual field trial, using two positive antigen bands as the criterion for infection, the sVSG117 and rISG65 dual-antigen lateral flow test prototype showed a sensitivity of 97.3% (95% CI: 93.3 to 99.2) and a specificity of 83.3% (95% CI: 76.4 to 88.9) for the detection of T. b. gambiense infections. The device was not as good for detecting T. b. rhodesiense infections using two positive antigen bands as the criterion for infection, with a sensitivity of 58.9% (95% CI: 44.9 to 71.9) and specificity of 97.3% (95% CI: 90.7 to 99.7). However, using one or both positive antigen band(s) as the criterion for T. b. rhodesiense infection improved the sensitivity to 83.9% (95% CI: 71.7 to 92.4) with a specificity of 85.3% (95% CI: 75.3 to 92.4). These results encourage further development of the dual-antigen device for clinical use

Neurobehavioral consequences of chronic intrauterine opioid exposure in infants and preschool children: a systematic review and meta-analysis

<b>Background</b><p></p> It is assumed within the accumulated literature that children born of pregnant opioid dependent mothers have impaired neurobehavioral function as a consequence of chronic intrauterine opioid use.<p></p> <b>Methods</b><p></p> Quantitative and systematic review of the literature on the consequences of chronic maternal opioid use during pregnancy on neurobehavioral function of children was conducted using the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We searched Cinahl, EMBASE, PsychINFO and MEDLINE between the periods of January 1995 to January 2012.<p></p> <b>Results</b><p></p> There were only 5 studies out of the 200 identified that quantitatively reported on neurobehavioral function of children after maternal opioid use during pregnancy. All 5 were case control studies with the number of exposed subjects within the studies ranging from 33–143 and 45–85 for the controls. This meta-analysis showed no significant impairments, at a non-conservative significance level of p < 0.05, for cognitive, psychomotor or observed behavioural outcomes for chronic intra-uterine exposed infants and pre-school children compared to non-exposed infants and children. However, all domains suggested a trend to poor outcomes in infants/children of opioid using mothers. The magnitude of all possible effects was small according to Cohen’s benchmark criteria.<p></p> <b>Conclusions</b><p></p> Chronic intra-uterine opioid exposed infants and pre-school children experienced no significant impairment in neurobehavioral outcomes when compared to non-exposed peers, although in all domains there was a trend to poorer outcomes. The findings of this review are limited by the small number of studies analysed, the heterogenous populations and small numbers within the individual studies. Longitudinal studies are needed to determine if any neuropsychological impairments appear after the age of 5 years and to help investigate further the role of environmental risk factors on the effect of ‘core’ phenotypes

No More Free Drug Samples?

Susan Chimonas and Jerome Kassirer argue that giving out “free” drug samples is not effective in improving drug access for the indigent, does not promote rational drug use, and raises the cost of care