"PrEP a double-edged sword": Integrating implementation science methodology with Photovoice to guide culturally-tailored pre-exposure prophylaxis (PrEP) programs for Latino/a and non-Latino/a men who have sex with men in South Florida.

BACKGROUND: DiversiPrEP is a culturally-tailored PrEP program for LMSM offered in South Florida. DiversiPrEP navigates LMSM through their PrEP journey, including education, deciding if PrEP is relevant for them, payment, and accessing/maintaining PrEP use. DiversiPrEP includes five ERIC strategies (Increase Demand, Promote Adaptability, Alter Client Fees, Intervene with Clients to Enhance Uptake and Adherence, and Tailor Strategies). DESCRIPTION: Photovoice was used to conduct five two-part focus groups with LMSM (n = 12) and Non-LMSM (n = 12). In the first session, trainers provided guidance on selecting and contextualizing photos to generate CFIR themes. Then, participants captured photos that embodied their lived experiences accessing PrEP. In the second session, using SHOWeD, participants discussed photos, identifiedhow photos relate to culturally relevant issues. Triangulation approaches compared/contrasted themes between LMSM and Non-LMSM. RESULTS: Five central themes emerged around barriers and facilitators to PrEP services: 1) the need for normalizing PrEP messages within the MSM community, 2) the need for normalizing PrEP messages outside the MSM community, 3) the need for expanding PrEP knowledge, 4) different motivations for using PrEP, and 5) the presence of structural barriers that limit PrEP access. This study compared similarities and differences of barriers and facilitators to PrEP use between Latino/a and non-Latino/a MSM. Similarities included the built environment (outer setting) as a barrier, the need for normalizing PrEP messaging within and outside of the MSM community, and the need to expand PrEP knowledge. Differences between Latino/a and non-Latino/a MSM were found in assessing the motivation and personal drivers (inner setting) for initiating PrEP associated with how participants viewed their responsibilities to self or others. CONCLUSIONS: Photovoice with focus groups identified CFIR constructs that can guide the large-scale implementation of a client-centered PrEP service model with telehealth for both Latino/a and non-Latino/a MSM. Implementing client-centered accessible PrEP programs is an essential step to promoting sexual-health equity.

Prevention is a privilege: Implementing drug-free community coalitions in Black communities.

Community-based interventions for youth substance use prevention require high levels of capacity to organize and coordinate community resources to support youth development and create opportunities to prevent youth substance use. This project aimed to better understand what Black prevention practitioners perceive as the requirements for a successful drug-free community coalition. Black prevention practitioners, who were engaged in drug-free community funded coalitions, had discussions about coalitions as a strategy for youth substance use prevention in Black communities. These facilitated discussions resulted in consensus over a set of nine core principles regarding successful youth substance use prevention coalition building in these communities.

Increasing provider awareness of PrEP on HBCU campuses and beyond: A case study of the HBCU HIV prevention project (H2P).

BACKGROUND: The HBCU-HIV Prevention Project (H2P) is a culturally-tailored, targeted intervention at Historically Black Colleges and Universities (HBCUs) aimed at training health care providers as key players in reducing HIV infections and improving healthcare outcomes among HBCU students. METHODS: A cross-sectional purposive sample of health care providers at health centers on HBCU campuses and invited health care professionals from partnering organizations in their surrounding communities participated in an 11-module series on the CDC's evidence-based HIV prevention strategy for high-risk individuals, pre-exposure prophylaxis (PrEP). The intervention was aimed at increasing provider awareness and knowledge about PrEP and the importance of HIV testing and counseling as well as promoting provider intentions to use PrEP (initiating discussions with students and prescribing). Pre- and post-module quizzes served as awareness and knowledge assessments and providers also received online surveys about their intentions and uses of PrEP at 30 and 60 days post-training. RESULTS: Both on-campus and off-campus providers showed trending gains in awareness and knowledge for information in all modules. The off-campus providers appear to be more willing to use the information for initiating discussions and prescribing PrEP; however, HBCU providers also expressed similar intentions, although at lower rates. CONCLUSIONS: The project successfully increased provider awareness of pre-exposure prophylaxis (PrEP), effective HIV testing, and strategies for reducing HIV infection among HBCU college students. Findings highlight the project's impact on enhancing provider training and the potential of this impact on addressing HIV disparities among African Americans on HBCU campuses and their surrounding communities. The success of the H2P Project provides valuable insights for future interventions, reinforcing the importance of targeted, systems-level approaches in mitigating health disparities among marginalized populations. Implications are also drawn as to the potential for expanding such provider-level interventions to address other health conditions and informing policy development in African American communities.

Dual Pandemics: Race-Related COVID Stress and Mental Health Outcomes in Black Individuals.

Black individuals have been disproportionately affected by the COVID-19 pandemic, likely due in part to historically rooted stressors that lie at the intersection of the COVID-19 pandemic and racism. We used secondary data from The Association of Black Psychologists' multi-state needs assessment of 2480 Black adults to examine the link between race-related COVID stress (RRCS) and mental health outcomes. We also examined the moderating roles of everyday discrimination, cultural mistrust, Black activism, Black identity, and spirituality/religiosity in these associations. T-tests revealed that several demographic and cultural factors are associated with RRCS endorsement. A series of regression analyses showed that endorsement of RRCS is associated with higher psychological distress and lower well-being, above and beyond several sociodemographic characteristics. While traditional cultural protective factors did not buffer against the effects of RRCS on mental health, cultural mistrust strengthened the positive association between RRCS and psychological distress; nonetheless, the association of cultural mistrusts with psychological distress was only seen in those who endorsed RRCS. We provide recommendations for policymakers, clinicians, and researchers to consider the impact of RRCS when addressing Black mental health and well-being in the age of COVID-19.

Applying culturalist methodologies to discern COVID-19's impact on communities of color.

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted communities of color (CoC) amid increasing incidents of racial injustices and racism. In this article, we describe our culturalist methodologies for designing and implementing a multi-ethnic, interdisciplinary national needs assessment developed in partnership with CoC. Instead of a typical western-centric social science approach that typically ignores and perpetuates structural racism and settler colonialism, the research team implemented culturalist and community-partnered approaches that were further contextualized to the context of structural racism and settler colonialism. The culturalist approach yielded two sets of themes both related to the impact of the pandemic on CoC. The first set involved syndemic factors that contribute to the adverse impact of COVID-19. These include historical trauma; racism, racial stress, and discrimination; and cultural mistrust. The second set consisted of factors that potentially mitigate the impact of the COVID-19. These include cultural protective factors; community engagement; communal ethos, and data disaggregation. Our methodologies and the resulting findings encourage research praxis that uplifts the shared effects of the social determinants of health while honoring unique cultural and contextual experiences-a lesson that social science researchers largely have yet to learn.

Peer-Led Focus Groups Identify Barriers to Healthy Lifestyle in African American Adolescents from Baltimore City.

Objectives: Black youth are disproportionately affected by the US obesity epidemic. Early-age obesity often continues into adulthood and is associated with a higher risk of diabetes, cardiovascular disease, and premature death. Few studies have incorporated community-based participatory research (CBPR) facilitated by youth to provide frank discussions among teens living in inner cities about challenges and facilitators in maintaining a healthy weight and to design teen-identified interventions. Design: Black youth (n=10) were recruited from a Baltimore City high school during the 2019 to 2020 academic year and were trained by seasoned investigators and mentored by graduate and undergraduate students on qualitative methods using CBPR. These youth then implemented focus groups with their peers aged 15 to 18 years (10 focus groups of 10 teens each). Topics included healthy lifestyle knowledge, behaviors, attitudes, and suggested interventions. Content analyses were conducted using dual-rater techniques. Results: Focus group themes yielded strengths and challenges of weight maintenance for Black youth at various levels, including in their personal lives, families, school, and community. Themes also suggested several technology-based possibilities using social media to reach Black youth about healthy living practices. Conclusions: Engagement of Black youth in CBPR projects can yield valuable data to design more culturally responsive and developmentally appropriate interventions. Youth are competent collectors of information to identify needed changes in their schools/communities and about the use of technology/social media to facilitate improved health practices among their peers and should be involved early in the process of developing targeted obesity prevention interventions and/or programs.

HBCUs' preparedness planning and responses to reopening campuses safely during the COVID-19 pandemic: Needs, assets, and insights for future emergencies and disasters.

Managing the health and safety risks surrounding COVID-19 in congregate settings, such as on college campuses, and minimizing viral transmission should be on the dashboard of Higher Education Leadership. Understanding that the risk will not be zero, like other academic institutions, Historically Black Colleges and Universities (HBCUs) have given great thought to making their campuses, which are considered high-risk settings, safe enough to warrant returning to campus. We queried HBCU leadership via an online survey sent to all 102 HBCUs about their safety plan for the fall 2020 resumption of on-campus activities. While data show that there are 102 HBCUs, we were informed that two HBCUs were permanently closed during our data gathering period. Thus, the sample size was 100. Specific areas queried included risks management plans, mitigation steps, policy changes, and human capacity resources. We also asked these leaders to identify vulnerabilities and other factors they considered in planning a safe reopening. Findings indicated that as these academic institutions grappled with balancing between risks and benefits of reopening, they also had to recognize the numerous scenarios and multifaceted approaches required. Recommendations are presented for supporting HBCUs in the future to surmount obstacles and implement culturally responsive solutions that best serve their campuses and surrounding communities in which these academic institutions are anchored.

Feasibility, Acceptability, and Barriers to Implementing Select Non-Pharmaceutical Interventions to Reduce the Transmission of Pandemic Influenza - United States, 2019.

OBJECTIVES: This study aimed to assess the feasibility and acceptability of implementing non-pharmaceutical interventions (NPIs) reserved for influenza pandemics (voluntary home quarantine, use of face masks by ill persons, childcare facility closures, school closures, and social distancing at schools, workplaces, and mass gatherings). METHODS: Public health officials in all 50 states (including Washington, DC) and 8 territories, and a random sample of 822 local health departments (LHDs), were surveyed in 2019. RESULTS: The response rates for the states/ territories and LHDs were 75% (44/ 59) and 25% (206/ 822), respectively. Most of the state/ territorial respondents stated that the feasibility and acceptability of implementing NPIs were high, except for K-12 school closures lasting up to 6 weeks or 6 months. The LHD respondents also indicated that feasibility and acceptability were lowest for prolonged school closures. Compared to LHD respondents in suburban or urban areas, those in rural areas expressed lower feasibility and acceptability. Barriers to implementing NPIs included financial impact, compliance and difficulty in enforcement, perceived level of disease threat, and concerns regarding political implications. CONCLUSION: Proactive strategies to systematically address perceived barriers and promote disease prevention ahead of a new pandemic are needed to increase receptivity and consistent adoption of NPIs and other evidence-based countermeasures.

Prospective study of dilated cardiomyopathy in dogs eating nontraditional or traditional diets and in dogs with subclinical cardiac abnormalities.

BACKGROUND: Recent studies have investigated dogs with presumed diet-associated dilated cardiomyopathy (daDCM), but prospective studies of multiple breeds are needed. HYPOTHESIS/OBJECTIVES: To evaluate baseline features and serial changes in echocardiography and cardiac biomarkers in dogs with DCM eating nontraditional diets (NTDs) or traditional diets (TDs), and in dogs with subclinical cardiac abnormalities (SCA) eating NTD. ANIMALS: Sixty dogs with DCM (NTD, n = 51; TDs, n = 9) and 16 dogs with SCA eating NTDs. METHODS: Echocardiography, electrocardiography, and measurement of taurine, cardiac troponin I, and N-terminal pro-B-type natriuretic peptide were performed in dogs with DCM or SCA. Diets were changed for all dogs, taurine was supplemented in most, and echocardiography and cardiac biomarkers were reassessed (3, 6, and 9 months). RESULTS: At enrollment, there were few differences between dogs with DCM eating NTDs or TDs; none had low plasma or whole blood taurine concentrations. Improvement in fractional shortening over time was significantly associated with previous consumption of a NTD, even after adjustment for other variables (P = .005). Median survival time for dogs with DCM was 611 days (range, 2-940 days) for the NTD group and 161 days (range, 12-669 days) for the TD group (P = .21). Sudden death was the most common cause of death in both diet groups. Dogs with SCA also had significant echocardiographic improvements over time. CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with DCM or SCA previously eating NTDs had small, yet significant improvements in echocardiographic parameters after diet changes.

The COVID-19/racial injustice syndemic and mental health among Black Americans: The roles of general and race-related COVID worry, cultural mistrust, and perceived discrimination.

This study explored intersecting concerns about COVID-19 and racial injustice against Black people in the United States using a syndemic perspective. Findings from a multistate COVID-19 needs assessment project examined the association of general and race-related concerns about COVID-19 and concerns about police violence against Black people with mental health symptoms in a sample of 2480 Black Americans. The role of cultural mistrust in vaccination status was also examined. Concerns about COVID-19 were positively associated with concerns about police violence and associated with worse mental health. Nonvaccinated individuals were higher in cultural mistrust but lower in perceived discrimination than vaccinated individuals. Perceived discrimination partially mediated the relationship between race-related concerns about COVID-19 and mental health symptoms. Findings can inform the development of culturally responsive strategies to address the syndemic effects of COVID-19 and racial injustice.

Potassium and Phosphorus Fertilizer Impacts on Alfalfa Taproot Carbon and Nitrogen Reserve Accumulation and Use During Fall Acclimation and Initial Growth in Spring.

Phosphorus (P) and potassium (K) impact alfalfa (Medicago sativa L.) performance, but how these nutrients alter taproot physiology during fall acclimation and subsequent growth in spring is unclear. Our objectives were to: (1) determine seasonal patterns for taproot P and K concentrations during fall acclimation and during initial shoot growth in spring; (2) determine how P and K nutrition impacts accumulation of taproot C and N reserves during fall and their subsequent use when shoot growth resumes in spring; and (3) assess how addition of P and K fertilizer impacts survival and shoot growth in spring. Two P (0 and 75 kg ha-1) and two K (0 and 400 kg ha-1) treatments were applied and taproots were sampled between September and December, and again from March to May over 2 years. Concentrations of taproot sugar, starch, buffer-soluble protein, amino-N, and RNA pools were determined. While P and K fertilizer application increased taproot P and K concentrations two- to three-fold, concentrations of P and K in taproots over time did not change markedly during cold acclimation in fall, however, taproot P declined in spring as plant growth resumed. Compared to the 0K-0P treatment, taproots of plants fertilized with 400K-75P had higher starch, protein, amino-N, and RNA, but reduced sugar concentrations in fall. Concentrations of all these pools, except starch, declined during the initial 2 weeks of sampling beginning in late March as shoot growth resumed in spring. Herbage yield in May was highest for the 400K-75P treatment and least for the 0K-0P treatment, differences that were associated with variation in mass shoot-1 and not shoots m-2. High yield of the 400K-75P plants in May was consistently associated with greater concentrations and use of amino-N, soluble protein, and RNA pools in taproots, and not with accumulation and use of starch and sugar pools. Understanding factors leading to the accumulation of taproot N reserves and RNA during cold acclimation in fall and their use during the initial growth in spring should enhance efforts to improve alfalfa growth and herbage yield in spring.

Retrospective study of dilated cardiomyopathy in dogs.

BACKGROUND: The United States Food and Drug Administration is investigating possible diet-associated dilated cardiomyopathy (DCM) in dogs and cats. OBJECTIVES: To retrospectively review DCM cases for signalment, diet information, echocardiographic changes, and survival. ANIMALS: Client-owned dogs (n = 71). METHODS: Medical records of dogs diagnosed with DCM between January 1, 2014 and September 30, 2018 were reviewed. Dogs were grouped into "traditional" or "nontraditional" diet categories and whether or not diet was changed after diagnosis. RESULTS: For dogs eating nontraditional diets, those that had their diets changed had a larger percentage decrease in normalized systolic left ventricular internal dimension (P = .03) and left atrial:aorta ratio (P < .001) compared to those that did not have their diets changed. Survival time was significantly longer for dogs with DCM eating nontraditional diets that had their diets changed (median survival, 337 days; range, 9-1307 days) compared to dogs eating nontraditional diets that did not have their diets changed (median survival, 215 days; range, 1-852 days; P = .002). CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with DCM eating nontraditional diets can experience improvement in cardiac function after diet change but additional research is needed to examine possible associations between diet and DCM.

Evaluating Research Centers in Minority Institutions: Framework, Metrics, Best Practices, and Challenges.

The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators' Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual Model presents a practical ongoing approach to document RCMIs' impacts on health disparities. Survey results identified 37 common metrics under four primary categories. Evaluation challenges were issues related to limited human resources, data collection, decision-making, defining metrics, cost-sharing, and revenue-generation. There is a need for further collaborative efforts across RCMI sites to engage program leadership and community stakeholders in addressing the identified evaluation challenges and measurement. Program leadership should be engaged to apply the Evaluation Conceptual Framework and common metrics to allow for valid inter-institutional comparisons and consortium-wide evaluations. Stakeholders could ensure evaluation metrics are used to facilitate community impacts.

Standards in Regulating Quality of Adult Community Health and Social Care: Systematic Narrative Review.

PURPOSE: The growing range and complexity of community care services require robust approaches to ensuring quality. METHOD: This review collated studies on the use of standards in regulating community health and social care using Social Care Online, MEDLINE and CINAHL databases. Studies were appraised by two reviewers and synthesized by study themes. RESULTS: Sixteen studies were synthesized under three themes: standards in quality assurance and quality improvement; effectiveness of standards; and design of regulatory standards. Standards facilitate providers in self-regulation and enable regulators to support and monitor improvement. Effectiveness of standards depends on their language and interpretation, and on organizational factors. There was little evidence of scales within quality standards. DISCUSSION: There is continuing debate about self-regulation versus external regulation. Social care service regulation requires more research. CONCLUSION: Regulatory organizations should take note of wider initiatives toward evidence-based practice in the design of quality standards.

Mutations in sorghum SBEIIb and SSIIa affect alkali spreading value, starch composition, thermal properties and flour viscosity.

KEY MESSAGE: Seven novel alleles of SBEIIb and one allele of SSIIa co-segregated with the ASV phenotype and contributed to distinct starch quality traits important for food-processing applications. Sorghum is an important food crop for millions of people in Africa and Asia. Whole-genome re-sequencing of sorghum EMS mutants exhibiting an alkali spreading value (ASV) phenotype revealed candidate SNPs in Sobic.004G163700 and Sobic.010G093400. Comparative genomics identified Sobic.010G093400 as a starch synthase IIa and Sobic.004G163700 as a starch branching enzyme IIb. Segregation analyses showed that mutations in Sobic.010G093400 or Sobic.004G163700 co-segregated with the ASV phenotype. Mutants in SSIIa exhibited no change in amylose content but expressed lower final viscosity and lower starch gelatinization temperature (GT) than starches from non-mutant plants. The sbeIIb mutants exhibited significantly higher amylose levels and starch GT and lower viscosity compared to non-mutant starches and ssIIa mutants. Mutations in SBEIIb had a dosage-dependent effect on amylose content. Double mutants of sbeIIb and ssIIa resembled their sbeIIb parent in amylose content, starch thermal properties and viscosity profiles. These variants will provide opportunities to produce sorghum varieties with modified starch end-use qualities important for the beer brewing and baking industries and specialty foods for humans with diabetes.

Retrospective evaluation of canine heart base tumours treated with toceranib phosphate (Palladia): 2011-2018.

Heart base tumours (HBT) occur commonly in older, brachycephalic dogs. A presumptive diagnosis is made based on location and appearance of the tumour via echocardiogram. Effective treatment options are limited to surgery (when feasible) or radiation therapy. Benefit of medical management is presently unknown. The goal of this retrospective study was to assess the efficacy and tolerability of toceranib phosphate for dogs with HBT. Twenty-eight dogs with histologically, cytologically confirmed or presumed HBT were evaluated retrospectively. Twenty-seven dogs were treated with single agent toceranib. One dog received combination therapy with concurrent metronomic chemotherapy. This dog was not included in response or survival analysis. Factors assessed included clinical signs, hematologic/biochemical parameters and response to treatment. For the 27 dogs receiving single agent toceranib, an overall response rate of 10% was found. Overall median survival time was 823 days (range, 68-1190 days). The overall response rate for the dogs presenting with metastasis was 28.5%, with a median survival time of 532 days (range, 77-679 days). This was not significantly different than the median survival time of 796 days for dogs who did not present with metastasis. Of the dogs displaying clinical signs at the time of diagnosis, 90% had improvement and 81% had complete resolution of signs after starting toceranib. Toxicity was seen in 54% of dogs with gastrointestinal distress as the most common toxicity but dose reductions were infrequent required. Results demonstrate that toceranib phosphate is a well-tolerated and effective treatment for inoperable canine heart base tumours including dogs with advanced or metastatic disease.

Phosphorus and potassium effects on taproot C and N reserve pools and long-term persistence of alfalfa (Medicago sativa L.).

Improved P and K nutrition can enhance yield and persistence of alfalfa (Medicago sativa L.) grown on low fertility soils, but it is unknown if the improved agronomic performance is associated with greater taproot N and C reserves. Our objective was to use cluster analysis to determine how alfalfa plant persistence is altered by P and K fertilization, and determine if changes in specific taproot C and/or N reserves were associated with alfalfa plant death. Taproots were dug and plants counted in May and December of each year and taproots analyzed for P, K, starch, sugar, amino-N, and soluble protein. K-means clustering was used to create six clusters that were subsequently compared using two-sample t-tests. Low K in herbage and taproots was associated with low yield and poor persistence of the Low and Very Low clusters and taproots of these plants generally had low starch, protein, and amino-N concentrations. Plants died primarily between May and December. Plant persistence of the low yielding, P-deficient Medium cluster was high and associated with high starch concentrations. Low amino-N concentrations in taproots may provide an early indication of potential plant death because these were evident in poor-persisting Low and Very Low clusters early in the study.

Clinical Features of English Bulldogs with Presumed Arrhythmogenic Right Ventricular Cardiomyopathy: 31 Cases (2001-2013).

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden death in people and boxer dogs that has recently been described in English bulldogs. The objective of this retrospective study was to describe the clinical characteristics of English bulldogs with presumed ARVC. The medical records were searched for English bulldogs examined between 2001 and 2013 with a clinical diagnosis of ARVC. The average age of the 31 dogs identified was 9.2 ± 1.6 yr (range 7-13 yr). Males were overrepresented by a factor of 2.9 to 1. At initial presentation, 5 dogs had subclinical arrhythmia, 10 dogs had clinical signs attributable to arrhythmia, and 16 dogs had congestive heart failure. Eighteen dogs (58%) had ventricular tachycardia and five (16%) also had supraventricular arrhythmias. Four dogs experienced sudden death, 2 dogs died from congestive heart failure, 11 dogs were euthanized for cardiac causes, and 2 dogs died or were euthanized for noncardiac causes. Kaplan-Meier analysis showed a median survival time of 8.3 mo. This is the first study to describe the clinical characteristics of a population of English bulldogs with presumed ARVC. Further studies are needed to better characterize the clinical features of the disease in this breed.

Comparison of a computed tomographic pulmonary trunk to aorta diameter ratio with echocardiographic indices of pulmonary hypertension in dogs.

There are limited criteria for the detection of pulmonary hypertension in dogs undergoing computed tomography (CT) for pulmonary disease. This retrospective analytical exploratory study compared a CT pulmonary trunk to aorta ratio with echocardiographic estimates of pulmonary hypertension. Dogs having both a contrast thoracic CT and echocardiogram were selected and maximal pulmonary trunk and descending aorta diameters were measured by two observers on a single transverse CT image. Computed tomographic diameter ratios were compared with the echocardiographic parameters of tricuspid regurgitation gradient, right ventricular acceleration time-to-ejection time ratio, pulmonary insufficiency gradient, and pulmonary artery to aorta diameter. A total of 78 dogs were sampled, with 44 dogs having one or more finding suggestive of pulmonary hypertension. A moderate positive correlation was shown between tricuspid regurgitation gradient and CT pulmonary trunk to aorta ratio (r = 0.61, P-value < 0.0001). Mean CT pulmonary trunk to aorta ratio of dogs with moderate (P = 0.0132) and severe (P < 0.0003) pulmonary hypertension were significantly higher than normal dogs. There was no significant difference in mean CT pulmonary trunk to aorta ratio between normal and mild pulmonary hypertension dogs (P = 0.4244). The intraclass correlation coefficient (0.72) showed good reproducibility of the ratio. Findings indicated that CT pulmonary trunk to aorta ratio is a reproducible and potentially useful method to predict moderate and severe pulmonary hypertension in dogs, but not mild pulmonary hypertension. In dogs undergoing thoracic CT for pulmonary disease, an increased ratio should prompt follow up echocardiography.