Parathyroid gland detection using an intraoperative autofluorescence handheld imager – early feasibility study

IntroductionParathyroid glands may be compromised during thyroid surgery which can lead to hypoparathyroidism and hypocalcemia. Identifying the parathyroid glands relies on the surgeon’s experience and the only way to confirm their presence was through tissue biopsy. Near infrared autofluorescence technology offers an opportunity for real-time, non-invasive identification of the parathyroid glands.MethodsWe used a new research prototype (hANDY-I) developed by Optosurgical, LLC. It offers coaxial excitation light and a dual-Red Green Blue/Near Infrared sensor that guides anatomical landmarks and can aid in identification of parathyroid glands by showing a combined autofluorescence and colored image simultaneously.ResultsWe tested the imager during 23 thyroid surgery cases, where initial clinical feasibility data showed that out of 75 parathyroid glands inspected, 71 showed strong autofluorescence signal and were correctly identified (95% accuracy) by the imager.ConclusionsThe hANDY-I prototype demonstrated promising results in this feasibility study by aiding in real-time visualization of the parathyroid glands. However, further testing by conducting randomized clinical trials with a bigger sample size is required to study the effect on levels of hypoparathyroidism and hypocalcemia

Atlantic bottlenose dolphin (Tursiops truncatus) whistle rates and blood cortisol levels durning periods of precieved stress

The study was conducted at Island Dolphin Care and Dolphins Plus Bayside in Key Largo, Florida and entails an analysis of Atlantic bottlenose dolphins (Tursiops truncatus) cortisol concentrations and whistle rates during periods of perceived stress. Continuous activation of the physiological stress response can have detrimental health effects; therefore ways to detect and measure stress are crucial for marine mammal management. Blood parameters were utilized in the study as a measure of the physiological stress response. Baseline blood cortisol concentrations for each individual were compared to levels measured during the extractions. Whistle rate, defined as the number of whistles per minute, was measured during extractions for various individuals and was compared to a baseline whistle rate. Extractions included medical procedures and transports where the subjects were removed from the water for a period of time. Both blood cortisol concentration and whistle rate increased significantly during extractions, indicating that whistle rate can be used as a non-invasive measure of stress in Atlantic bottlenose dolphins.</p

Five members of a mixed-sex group of bottlenose dolphins share a stereotyped whistle contour in addition to maintaining their individually distinctive signature whistles.

Most commonly, animal communication systems are driven by shared call repertoires, with some individual distinctiveness encoded as a byproduct of voice cues. We provide evidence that bottlenose dolphins produce both individually distinctive whistles, and a shared whistle type. A stereotyped whistle contour (termed the group whistle) is shared by five bottlenose dolphins that have lived, worked, and traveled together for at least 21 years. These five dolphins are members of a group of eight dolphins that work as a specialized team for the Navy Marine Mammal Program. Each dolphin is routinely recorded during periods when an individual is isolated from the others in above ground pools as part of their routine training. Each of the eight dolphins has an individually distinctive signature whistle. In addition, at least five of these dolphins share a distinct non-signature whistle type. This shared whistle contour was produced an average of 22.4% +/- 9.0% of the time during periods in which individuals were isolated. During these isolations the signature whistle was produced an average of 42.9% +/- 11.9% of the time. This is consistent with decades of signature whistle research. A group of 10 naïve observers rated the similarity of the different whistle contours. The observers rated the group whistle contour produced by all five dolphins as highly similar (P < 0.01). Their ratings further showed that the signature whistles of the five dolphins were very different (P < 0.01). These findings were further supported by discriminant function analyses. That said, the shared whistle contours still exhibited individual differences which may allow conspecifics to identify the producer even when a whistle contour is shared among multiple dolphins. This is the first in-depth analysis of a non-signature whistle type shared among multiple conspecifics

A system for monitoring acoustics to supplement an animal welfare plan for Bottlenose dolphins

The authors are extremely grateful to the Office of Naval Research (ONR) for their support of Sound as Indicators of Health and Welfare of the Navy’s Dolphin; ONR Grant# N00014-18-1-2643.Animal sounds are commonly used by humans to infer information about their motivations and their health, yet, acoustic data is an underutilized welfare biomarker especially for aquatic animals. Here, we describe an acoustic monitoring system that is being implemented at the U.S. Navy Marine Mammal Program where dolphins live in groups in ocean enclosures in San Diego Bay. A four-element bottom mounted hydrophone array is used to continuously record, detect and localize acoustic detections from this focal group. Software provides users an automated comparison of the current acoustic behavior to group historical data which can be used to identify periods of normal, healthy thriving dolphins, and allows rare instances of deviations from typical behavior to stand out. Variations in a group or individual’s call rates can be correlated with independent veterinary examinations and behavioral observations in order to better assess dolphin health and welfare. Additionally, the monitoring system identifies time periods in which a sound source from San Diego Bay is of high-enough amplitude that the received level at our array is considered a potential concern for the focal animals. These time stamps can be used to identify and potentially mitigate exposures to acoustic sources that may otherwise not be obvious to human listeners. We hope this application inspires zoos and aquaria to innovate and create ways to incorporate acoustic information into their own animal welfare management programs.Publisher PDFPeer reviewe

The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry

Background: Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement. Methods/design: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls. Results: Overall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year. Conclusion: The PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice. Trial registration: Registered in DRKS register, ID number: DRKS0000479