Survey-based pilot study into the chosen therapy and prophylaxis used by UK primary care veterinary surgeons against canine angiostrongylosis

Canine Angiostrongylosis (CA), a gastropod-borne parasitic infection caused by the metastrongyloid nematode Angiostrongylus vasorum, is an important cause of significant morbidity to domestic dogs across the UK as well as in other European countries. This study aimed to ascertain the frequency at which particular drugs were used by primary care practitioners in the UK for therapy against and prophylaxis for CA. Primary care veterinary clinicians were surveyed using an online questionnaire and face-to-face or telephone interviews. Eighty-six veterinary surgeons responded. The majority of practices (n = 52) included lungworm in their standard anthelmintic protocols; moxidectin was the most common drug used for prophylaxis (n = 71). Fenbendazole was the most frequently selected drug, by 45% of vets, for treatment of confirmed cases of CA despite it being unlicensed for this purpose in the UK and the absence of a clear treatment protocol. The results of this pilot study provide an initial insight into the approach taken by primary care practitioners in their approach to CA. This provides an important starting point for future studies investigating the decision-making for CA amongst UK veterinary surgeons, particularly to clarify whether in a larger cohort an unlicensed drug remains the treatment of choice. The absence of a clear protocol for fenbendazole means that treatment of dogs affected by CA may be suboptimal, increasing the risk of morbidity and mortality

Divergent evolution of protein conformational dynamics in dihydrofolate reductase.

Molecular evolution is driven by mutations, which may affect the fitness of an organism and are then subject to natural selection or genetic drift. Analysis of primary protein sequences and tertiary structures has yielded valuable insights into the evolution of protein function, but little is known about the evolution of functional mechanisms, protein dynamics and conformational plasticity essential for activity. We characterized the atomic-level motions across divergent members of the dihydrofolate reductase (DHFR) family. Despite structural similarity, Escherichia coli and human DHFRs use different dynamic mechanisms to perform the same function, and human DHFR cannot complement DHFR-deficient E. coli cells. Identification of the primary-sequence determinants of flexibility in DHFRs from several species allowed us to propose a likely scenario for the evolution of functionally important DHFR dynamics following a pattern of divergent evolution that is tuned by cellular environment

An Examination of Concussion Legislation in the United States

There is legislation in the United States designed to protect children and adolescents from the risks associated with concussion. The scope and reach of these laws vary greatly. Purpose: It is important that health care professionals are aware of the limitations of each law. Since 2009, every state in the nation and the District of Columbia passed legislation designed to protect student-athletes who suffer from concussions resulting from participation in sport. Method: Therefore, select components of state policies were identified including: 1) Affected entities, 2) Stipulations for concussion awareness/education, 3) Requirements for removal/return to play, and 4) Requirements for return to the classroom. Results: There is significant variance between the laws and not all children/adolescents are protected equally. Conclusion: Concussion policies are a minimum standard and, when available, best practices should be followed

Measuring agreement between decision support reminders: the cloud vs. the local expert

Background: A cloud-based clinical decision support system (CDSS) was implemented to remotely provide evidence-based guideline reminders in support of preventative health. Following implementation, we measured the agreement between preventive care reminders generated by an existing, local CDSS and the new, cloud-based CDSS operating on the same patient visit data. Methods: Electronic health record data for the same set of patients seen in primary care were sent to both the cloud-based web service and local CDSS. The clinical reminders returned by both services were captured for analysis. Cohen’s Kappa coefficient was calculated to compare the two sets of reminders. Kappa statistics were further adjusted for prevalence and bias due to the potential effects of bias in the CDS logic and prevalence in the relative small sample of patients. Results: The cloud-based CDSS generated 965 clinical reminders for 405 patient visits over 3 months. The local CDSS returned 889 reminders for the same patient visit data. When adjusted for prevalence and bias, observed agreement varied by reminder from 0.33 (95% CI 0.24 – 0.42) to 0.99 (95% CI 0.97 – 1.00) and demonstrated almost perfect agreement for 7 of the 11 reminders. Conclusions: Preventive care reminders delivered by two disparate CDS systems show substantial agreement. Subtle differences in rule logic and terminology mapping appear to account for much of the discordance. Cloud-based CDSS therefore show promise, opening the door for future development and implementation in support of health care providers with limited resources for knowledge management of complex logic and rules

Stabilisation Agriculture: Reviewing an Emerging Concept with Case Studies from Afghanistan and Iraq

Stabilisation Agriculture has been defined as a focus on enhancing the ecological and social resilience of agricultural communities to withstand and respond to adverse conditions in countries affected by disasters, ranging from climate events to conflict and complex emergencies. However, in this review paper, rather than taking a broad disaster risk management approach to the topic, a focus is made on the nexus between agriculture, food security and conflict. Food insecurity, for example, can trigger instability and conflict, leading to the collapse of agricultural infrastructure, the loss of farm labour, and local farming knowledge through loss of life and forced migration. This cycle becomes endemic and reinforcing, often resulting in chronic food shortages and eventually conflict-driven famine. Hence, why an emphasis on post-conflict "stabilisation" is made in this examination of the emerging concept of Stabilisation Agriculture. Case studies from Afghanistan and Iraq are used to illustrate the benefits of elevating agriculture as a critical response tool in post-conflict and stabilisation settings, and following a subsequent discussion that explores the critical synergies in this emerging field, a redefined definition of Stabilisation Agriculture is proposed along with recommendations for future development through policy inclusion and mainstreaming, post-conflict programming and applied research

Hubble Space Telescope Spectroscopy of Brown Dwarfs Discovered with the Wide-field Infrared Survey Explorer

We present a sample of brown dwarfs identified with the {\it Wide-field Infrared Survey Explorer} (WISE) for which we have obtained {\it Hubble Space Telescope} ({\it HST}) Wide Field Camera 3 (WFC3) near-infrared grism spectroscopy. The sample (twenty-two in total) was observed with the G141 grism covering 1.10$-$1.70 $\mu$m, while fifteen were also observed with the G102 grism, which covers 0.90$-$1.10 $\mu$m. The additional wavelength coverage provided by the G102 grism allows us to 1) search for spectroscopic features predicted to emerge at low effective temperatures (e.g.\ ammonia bands) and 2) construct a smooth spectral sequence across the T/Y boundary. We find no evidence of absorption due to ammonia in the G102 spectra. Six of these brown dwarfs are new discoveries, three of which are found to have spectral types of T8 or T9. The remaining three, WISE J082507.35$+$280548.5 (Y0.5), WISE J120604.38$+$840110.6 (Y0), and WISE J235402.77$+$024015.0 (Y1) are the nineteenth, twentieth, and twenty-first spectroscopically confirmed Y dwarfs to date. We also present {\it HST} grism spectroscopy and reevaluate the spectral types of five brown dwarfs for which spectral types have been determined previously using other instruments.Comment: Accepted for publication in the Astrophysical Journal. 20 pages, 18 figures, 7 table

Age and diet shape the genetic architecture of body weight in diversity outbred mice.

Understanding how genetic variation shapes a complex trait relies on accurately quantifying both the additive genetic and genotype-environment interaction effects in an age-dependent manner. We used a linear mixed model to quantify diet-dependent genetic contributions to body weight measured through adulthood in diversity outbred female mice under five diets. We observed that heritability of body weight declined with age under all diets, except the 40% calorie restriction diet. We identified 14 loci with age-dependent associations and 19 loci with age- and diet-dependent associations, with many diet-dependent loci previously linked to neurological function and behavior in mice or humans. We found their allelic effects to be dynamic with respect to genomic background, age, and diet, identifying several loci where distinct alleles affect body weight at different ages. These results enable us to more fully understand and predict the effectiveness of dietary intervention on overall health throughout age in distinct genetic backgrounds