Epidemiology of diabetes mellitus among 193,435 cats attending primary-care veterinary practices in England

BACKGROUND: Diabetes mellitus (DM) is a common endocrine disease of cats. The prevalence of DM in cats in England is not well‐defined. HYPOTHESIS/OBJECTIVES: To estimate the prevalence and identify risk factors for DM in a large population of cats attending primary‐care practices. ANIMALS: A cohort of 193,563 cats in the VetCompass Programme attending 118 primary‐care practices in England. METHODS: Cross‐sectional analysis of cohort clinical data. Data were extracted covering September 1st 2009 and August 31st 2014. Period prevalence of DM was calculated. Associations between risk factors and DM were assessed using logistic regression modelling. RESULTS: Of 1,128 DM cases were identified among 194,563 cats (period prevalence 0.58%; 95% confidence interval [CI] 0.54–0.61). Multivariable modelling indicated that Tonkinese (OR 4.1; 95% CI 1.8–9.6; P = .001), Norwegian Forest (odds ratio [OR] 3.5; 95% CI 1.3–9.6; P = .001) and Burmese (OR 3.0; 95% CI 2.0–4.4; P < .001) cats had increased odds of DM compared with crossbred cats. DM odds increased as bodyweight categories increased above 4 kg (P < .001), as cats aged beyond 6 years old (P < .001) and in insured cats (OR 2.0; 95% CI 1.6–2.4; P < .001) but sex was not significantly associated with DM. CONCLUSIONS AND CLINICAL IMPORTANCE: Diabetes mellitus is an important component of the primary‐care practice caseload with 1‐in‐200 cats affected. An increased risk of DM in certain cat breeds supports a genetic predisposition. These results can guide future research and preventative healthcare

Neglected Achilles tendon rupture with central insertional plantaris tendon hypertrophy: two cases

A neglected Achilles tendon rupture is often characterized by muscle weakness and an overlengthened repair by scar tissue. Reconstructive surgery is usually performed taking into account the patient’s required level of function. Two surgical cases of neglected Achilles tendon rupture are presented in this article. In both instances it was expected that central fibrosis, possibly after neglected tendon rupture, would be found. However, after longitudinal opening of the tendons, a thickened plantaris tendon was evident at the insertion on the calcaneus in both cases. This hypertrophic tendon occupied most of the diameter of the Achilles tendon. Due to partial or complete rupture of the Achilles tendon, there was notable weakening and tendon transfer-augmentation was performed. A thickened plantaris tendon as a reaction to a neglected rupture of the Achilles tendon is a rare presentation. It can be detected preoperatively by MRI and subsequently preoperative planning can be optimized

The effect of stress fracture occurring within the first 12 months of training on subsequent race performance in Thoroughbreds in Hong Kong

BACKGROUND Racehorses are at an increased risk of stress fracture within the first 12 months of racing and when resuming training after a break. Research in these high-risk periods and on the effect of performance post-recovery is limited. OBJECTIVES To describe the occurrence of stress fractures, diagnosed by nuclear scintigraphy (NS), in racehorses' first 12 months training in Hong Kong, and their impact on racing performance and career length. STUDY DESIGN Retrospective 1:2 matched case-control study. METHODS Clinical records of horses with NS-diagnosed stress fractures within 365 days of import between 2006 and 2018 were collated. Cases and controls were matched on import date. Univariable conditional logistic regression compared signalment, pre-fracture training and post-recovery racing performance between cases and matched controls. Shared Frailty Cox regression analysed time from import to fracture and total career length. RESULTS Eighty-seven horses sustained a NS-diagnosed fracture within their first year in Hong Kong (incidence risk 1.7% (95% confidence interval (CI) 1.4-2.1%; N=5,180)). The humerus (42.0%; 95% CI 31.8-52.6%; n=39) and tibia (28.0%; 95% CI 19.1-38.2%; n=26) were most common stress fracture sites. Cases missed a median of 63 days (Interquartile range (IQR) 49-82) of training because of fracture. Within the 12 months following diagnosis, case horses had a median of four (IQR 2-4, p<0.0001) fewer race starts and were down HK$206,188 (IQR HK$0-436,800, p=0.007) in race earnings compared to controls. Career length did not significantly differ between cases and controls (median 2 years and 3 months; IQR 15.3-39.1 months; p=0.2). MAIN LIMITATIONS Only stress fractures diagnosed by NS were included, hence, the study is not representative of all stress fractures occurring in racehorses in Hong Kong. CONCLUSIONS Racehorses sustaining a stress fracture within one year of entering Hong Kong lost significant time in training, earnings and race starts. However, overall career length was unaffected

Direct digital control of an efficient silicon+lequid crystal phase shifter

We demonstrate a phase shifter based on a silicon slot waveguide infiltrated with liquid crystal. We achieve a phase shift of 73 pi for a 5V drive voltage, with a voltage-length product of 0.022V.mm around 1V. We can drive the phase shifter directly with a 1V, duobinary pulse-width-modulated signal, allowing direct digital CMOS control of an analog optical phase shifter

Excellent results with the cemented Lubinus SP II 130-mm femoral stem at 10 years of follow-up

Background and purpose - The Lubinus SP II stem is well documented in both orthopedic registries and clinical studies. Worldwide, the most commonly used stem lengths are 150 mm and 170 mm. In 1995, the 130-mm stem was introduced, but no outcome data have been published. We assessed the long-term survival of the Lubinus SP II 130-mm stem in primary total hip arthroplasty.Patients and methods - In a retrospective cohort study, we evaluated 829 patients with a Lubinus SP II primary total hip arthroplasty (932 hips). The hips were implanted between 1996 and 2001. The primary endpoint was revision for any reason. The mean follow-up period was 10 (5-15) years.Results - Survival analysis showed an all-cause 10-year survival rate of the stem of 98.7% (95% CI: 99.7-97.7), and all-cause 10-year survival of the total hip arthroplasty was 98.3% (95% CI: 99.3-97.3).Interpretation - Excellent long-term results can be achieved with the cemented Lubinus SP II with the relatively short 130-mm stem. This stem has potential advantages over its 150-mm and 170-mm siblings such as bone preservation distal to the stem, better proximal filling around the prosthesis, and easier removal.</p

Multivariable analysis to determine risk factors associated with early pregnancy loss in thoroughbred broodmares

Early pregnancy loss (EPL) between days 15–65 after breeding has been shown to occur in 7.9% of equine pregnancies with substantial economical, welfare and safety implications. Whilst maternal age has been recognised as an important risk factor in relation to the incidence of EPL, few other risk factors have been conclusively identified. Further, multivariable data analysis of risk factors for EPL is sparse. A prospective cohort investigation of thoroughbred broodmares in the United Kingdom was conducted over the 2013 and 2014 breeding seasons. Information relating to 28 factors including mare, stallion, pregnancy and therapeutic interventions was collected using questionnaires and entered into a custom-designed Microsoft Access database. Mixed effects logistic regression was used to determine risk factors for EPL, including ‘mare’ as a random effect to account for repeat pregnancies in the same mare. Stallion, stud and veterinarian were also evaluated as random effects. Variables with a p-value of <0.25 in univariable analysis were taken forward for consideration in the multivariable model which was built using a forward stepwise approach. Data were collected on 2245 pregnancies in 1753 mares. Increasing mare age (OR = 1.11, 95% confidence interval (CI) = 1.04, 1.18, p = 0.001), having had one previous foal (OR = 3.52, 95% CI = 1.56, 7.95, p = 0.002) and presence of uterine cysts (OR = 1.76, 95% CI = 1.07, 2.91, p = 0.03) were all associated with increased odds of EPL following multivariable analysis. Increasing day 15/16 scan vesicle size (OR = 0.24, 95% CI = 0.16, 0.38, p < 0.001) and the use of ovulatory induction agents (OR = 0.31, 95% CI = 0.17, 0.55, p < 0.001) were negatively associated with EPL. Stallion, stud and veterinarian were not significantly associated with EPL. Analysis of a subpopulation of 344 multiple (twin and triplet) pregnancies found that the use of flunixin meglumine at the time of manual reduction of a multiple pregnancy resulted in reduced odds of EPL (OR = 0.34, 95% CI = 0.14, 0.84, p = 0.02). Results from this study can be used by stud farm personnel when assessing their broodmare population and by clinicians when deciding upon therapeutic strategies. Additional work can be focused around these risk factors to further our understanding of the pathophysiology of EPL

Phase modulators ands splitting network on Si PIC coherent fiber beam combining

Coherent beam combining (CBC) of fiber lasers provide an attractive mean of reaching high output laser power by scaling up the available energy while keeping fiber intrinsic advantages of compactness, reliability, efficiency, and beam quality. In CBC architectures, the power of a master oscillator (MO) is divided into N fibers that are amplified individually. The phase perturbations between channels can be measured using various techniques [1-3] and are corrected by individual phase modulators placed on each fiber before the amplification. In this Communication, we present a Silicon PIC integrating a 1:16 channels splitting network and thermal phase modulators array with low electrical power consumption and a bandwidth compatible with CBC requirements. In our CBC system, a 1.55µm CW master oscillator directly feeds the Silicon chip through a grating coupler, as shown in Fig.1(a). The power of the master oscillator is first split on chip into 16 channels, each of which including a thermal phase modulator. The outputs of the 16 waveguides are collectively out-coupled from the chip using a PM optical fiber array aligned and glued onto the PIC’s output grating couplers array [4]. At the other end of fiber array, the 16 fiber outputs are arranged in a 4 by 4 squared lattice, and collimated by a microlens array to form 16 collimated and parallel beamlets. The phase distribution from channel to channel is derived from the fringe pattern resulting from the collimated beamlets interfering with a reference plane wave on a camera. This signal is fed back to drive the PIC’s phase modulators in order to phase lock the 16 fiber

An in vivo culture system for human embryos using an encapsulation technology: a pilot study

BACKGROUND Animal studies have demonstrated better embryo development in vivo than in vitro. This pilot study tested the feasibility of using a novel in utero culture system (IUCS) to obtain normal human fertilization and embryo development. METHODS The IUCS device comprised a perforated silicone hollow tube. The study included 13 patients (<36 years) undergoing a first intracytoplasmic sperm injection (ICSI) treatment and 167 metaphase II oocytes in three groups. In Group 1, 1-2 h after ICSI, sibling oocytes were assigned to IUCS or conventional in vitro culture. The device was retrieved on Day 1, and all zygotes were cultured in vitro till Day 5. In Group 2, fertilized oocytes were assigned on Day 1, embryos retrieved on Day 3 and all embryos cultured till Day 5. In Group 3, after Day 0 assignment, embryos were retrieved on Day 3 for blastomere biopsy and fluorescence in situ hybridization (FISH) and cultured until Day 5. The highest quality blastocysts were transferred on Day 5. RESULTS Fertilization and embryo development were comparable in the in vitro and IUCS arms, with a tendency towards better embryo quality in the IUCS. FISH analysis in Group 3 revealed more normal embryos using the IUCS (P = 0.049). Three clinical pregnancies and live births were obtained: two from the IUCS arm and one from the in vitro arm. CONCLUSIONS Our pilot study shows that this new IUCS appears to be feasible and safe, supporting normal fertilization, embryo development and normal chromosomal segregation. Furthermore, live births are possible after the transient presence of a silicone device in the uterus.Clinicaltrials.gov: NCT0048010

Quantitative analysis of orthopedic metal artefact reduction in 64-slice computed tomography scans in large head metal-on-metal total hip replacement, a phantom study

Purpose: Quantification of the effect of O-MAR on decreasing metal artefacts caused by large head metal on metal total hip arthroplasty (MoM THA) in a dedicated phantom setup of the hip. Background: Pathological reactions of the hip capsule on Computed tomography (CT) can be difficult to diagnose due to different metal artefacts. The O-MAR algorithm deploys an iterative loop where the metal sinogram is identified, extracted, and subsequently serves as a mask to correct the measured sinogram. Main goal of this study is to quantify the ability of the O-MAR technique to correct deviation in medullary bone attenuation caused by streak artefacts from the large-head MoM THA embedded in a phantom. Secondary goal is to evaluate the influence of O-MAR on CNR. Methods: The phantom was designed as a Perspex box (PMMA) containing water and a supplementary MOM THA surrounded by Perspex columns comprising calibrated calcium pellets. Each column contains 200 mg of hydroxyapatite/calcium carbonate to simulate healthy bone tissue. Scans were obtained with and without a MoM THA at different dose levels. Different reconstructions were made with filter A, iDose(4) level 5 and with and without O-MAR. The scans without the prosthesis were used as the baseline. Information about the attenuation in Hounsfield units, image noise in standard deviation within the ROI's were extracted and the CNR was calculated. Results: Pellet L0 and R0 (proximal of the MoM THA) were defined as reference, lacking any disturbance by metal artefacts; L5, L6 and L8 were respectively visually categorized as 'light' 'medium' and 'heavy disturbance'. Significant improvements in attenuation deviation caused by metal artefact were 43, 68 and 32 %, for respectively pellet L5, L6 and L8 (p <0.001). Significant CNR improvements were present for L5 and L6 and were respectively 72 and 52 % (p <0.001). O-MAR showed no improvement on CNR for L8. Conclusion: This phantom study significantly increases image quality by the use of O-MAR in the presence of metal artefacts by significantly reducing metal artefacts subsequently and increasing CNR on a 64 slice CT system in light and medium disturbance of the imag