Endoparasite Infections in Pet and Zoo Birds in Italy

Faecal samples were individually collected from pet (n = 63) and zoo (n = 83) birds representing 14 orders and 63 species. All the samples were examined by faecal flotation technique. In a subgroup of samples (n = 75), molecular assays were also used to detect Cryptosporidium oocysts and Giardia duodenalis cysts. Overall, 35.6% of the birds harboured parasites (42.2% of zoo birds and 27% of pet birds), including Strongyles-Capillarids (8.9%), Ascaridia (6.8%), Strongyles (5.5%), G. duodenalis Assemblage A (5.3%), Coccidia (4.1%), Cryptosporidium (4%), Porrocaecum (2.7%), Porrocaecum-Capillarids (2%), and Syngamus-Capillarids (0.7%). The zoonotic G. duodenalis Assemblage A and Cryptosporidium were exclusively found in Psittaciformes, with prevalences of 10.3% and 7.7% within this bird group. Zoo birds were more likely to harbor mixed infections (OR = 14.81) and symptomatic birds to be parasitized (OR = 4.72). Clinicians should be aware of the public health implications posed by zoonotic G. duodenalis Assemblages and Cryptosporidium species in captive birds

Pituitary hyperplasia secondary to acquired hypothyroidism: case report

<p>Abstract</p> <p>Objective and Importance</p> <p>despite recent progress in imaging, it is still difficult to distinguish between pituitary adenoma and hyperplasia, even using Magnetic Resonance Imaging (MRI) with gadolinium injection. We describe an example of reactive pituitary hyperplasia from primary hypothyroidism that mimicked a pituitary macroadenoma in a child.</p> <p>Clinical Presentation</p> <p>a 10 year old boy presented with headache and statural growth arrest. MRI revealed an intrasellar and suprasellar pituitary mass. Endocrine evaluation revealed primary hypothyroidism.</p> <p>Intervention</p> <p>the patient was started on levothyroxine with resolution of the mass effect.</p> <p>Conclusion</p> <p>primary hypothyroidism should be considered in the differential diagnosis of solid mass lesions of the pituitary gland. Examination of thyroid function in patients with sellar and suprasellar masses revealed by MRI may avoid unnecessary operations which can cause irreversible complications.</p

The effects of presenting oncologic information in terms of opposites in a medical context

Background: An extensive body of literature has demonstrated that many patients who have been asked to participate in clinical trials do not fully understand the informed consent forms. A parallel independent study has demonstrated that opposites have a special status in human cognitive organization: they are common to all-natural languages and are intuitively and naturally understood and learnt. Purpose: The study investigates whether, and how, the use of opposites impacts on doctor\u2013patient communication: does using the terms \u201csmall\u2013large\u201d to describe a nodule (ie, bipolar communication) rather than speaking in terms of centimeters (ie, unipolar communication) affect a patient\u2019s understanding of the situation? And is it better to speak of \u201ccommon\u2013rare\u201d side effects (ie, bipolar communication) instead of the number of people who have suffered from particular side effects (ie, unipolar communication)? Methods: Two questionnaires were created and used, one presenting the information in terms of opposites (ie, bipolar communication) and another using unipolar communication. Results: The participants\u2019 perception of their situation (in terms of feeling healthy\u2013ill, being at high\u2013low risk, and their treatment requiring high\u2013low commitment) varied in the two conditions. Moreover, self-reported levels of understanding and satisfaction with how the information was communicated were higher when opposites were used. Limitations: Since this is the first study that addresses the merits of using bipolar structures versus unipolar structures in doctor\u2013patient communication, further work is needed to consolidate and expand on the results, involving not only simulated but also real diagnostic contexts. Conclusion: The encouraging results imply that further testing of the use of opposites in informed consent forms and in doctor\u2013patient communication is strongly advisable. Keywords: opposites, bipolar, unipolar, informed consent, doctor\u2013patient communication, understanding, satisfactio

Two-dimensional plane for multi-scale quantification of corneal subbasal nerve tortuosity

Purpose To assess the performance of a novel system for automated tortuosity estimation and interpretation. Methods: A supervised strategy (driven by observers' grading) was employed to automatically identify the combination of tortuosity measures (i.e., tortuosity representation) leading to the best agreement with the observers. We investigated 18 tortuosity measures including curvature and density of inflection points, computed at multiple spatial scales. To leverage tortuosity interpretation, we propose the tortuosity plane (TP) onto which each image is mapped. Experiments were carried out on 140 images of subbasal nerve plexus of the central cornea, covering four levels of tortuosity. Three experienced observers graded each image independently. Results: The best tortuosity representation was the combination of mean curvature at spatial scales 2 and 5. These tortuosity measures were the axes of the proposed TP (interpretation). The system for tortuosity estimation revealed strong agreement with the observers on a global and per-level basis. The agreement with each observer (Spearman's correlation) was statistically significant (αs = 0.05, P < 0.0001) and higher than that of at least one of the other observers in two out of three cases (ρOUR = 0.7594 versus ρObs3 = 0.7225; ρOUR = 0.8880 versus ρObs1 = 0.8017, ρObs3 = 0.7315). Based on paired-sample t-tests, these improvements were significant (P < 0.001). Conclusions: Our automated system stratifies images by four tortuosity levels (discrete scale) matching or exceeding the accuracy of experienced observers. Of importance, the TP allows the assessment of tortuosity on a two-dimensional continuous scale, thus leading to a finer discrimination among images

Tortuosity classification of corneal nerves images using a multiple-scale-multiple-window approach

Classify in vivo confocal microscopy corneal images by tortuosity is complicated by the presence of variable numbers of fibres of different tortuosity level. Instead of designing a function combining manually selected features into a single coefficient, as done in the literature, we propose a supervised approach which selects automatically the most relevant combination of shape features from a pre-defined dictionary. To our best knowledge, we are the first to consider features at different spatial scales and show experimentally their relevance in tortuosity modelling. Our results, obtained with a set of 100 images and 20 fold cross-validation, suggest that multinomial logistic ordinal regression, trained on consensus ground truth from 3 experts, yields an accuracy indistinguishable, overall, from that of experts when compared against each other

Reset dynamics and latching in niobium superconducting nanowire single-photon detectors

We study the reset dynamics of niobium (Nb) superconducting nanowire single-photon detectors (SNSPDs) using experimental measurements and numerical simulations. The numerical simulations of the detection dynamics agree well with experimental measurements, using independently determined parameters in the simulations. We find that if the photon-induced hotspot cools too slowly, the device will latch into a dc resistive state. To avoid latching, the time for the hotspot to cool must be short compared to the inductive time constant that governs the resetting of the current in the device after hotspot formation. From simulations of the energy relaxation process, we find that the hotspot cooling time is determined primarily by the temperature-dependent electron-phonon inelastic time. Latching prevents reset and precludes subsequent photon detection. Fast resetting to the superconducting state is therefore essential, and we demonstrate experimentally how this is achieved