'Tailception': using neural networks for assessing tail lesions on pictures of pig carcasses.

Tail lesions caused by tail biting are a widespread welfare issue in pig husbandry. Determining their prevalence currently involves labour intensive, subjective scoring methods. Increased societal interest in tail lesions requires fast, reliable and cheap systems for assessing tail status. In the present study, we aimed to test the reliability of neural networks for assessing tail pictures from carcasses against trained human observers. Three trained observers scored tail lesions from automatically recorded pictures of 13 124 pigs. Nearly all pigs had been tail docked. Tail lesions were classified using a 4-point score (0=no lesion, to 3=severe lesion). In addition, total tail loss was recorded. Agreement between observers was tested prior and during the assessment in a total of seven inter-observer tests with 80 pictures each. We calculated agreement between observer pairs as exact agreement (%) and prevalence-adjusted bias-adjusted κ (PABAK; value 1=optimal agreement). Out of the 13 124 scored pictures, we used 80% for training and 20% for validating our neural networks. As the position of the tail in the pictures varied (high, low, left, right), we first trained a part detection network to find the tail in the picture and select a rectangular part of the picture which includes the tail. We then trained a classification network to categorise tail lesion severity using pictures scored by human observers whereby the classification network only analysed the selected picture parts. Median exact agreement between the three observers was 80% for tail lesions and 94% for tail loss. Median PABAK for tail lesions and loss were 0.75 and 0.87, respectively. The agreement between classification by the neural network and human observers was 74% for tail lesions and 95% for tail loss. In other words, the agreement between the networks and human observers were very similar to the agreement between human observers. The main reason for disagreement between observers and thereby higher variation in network training material were picture quality issues. Therefore, we expect even better results for neural network application to tail lesions if training is based on high quality pictures. Very reliable and repeatable tail lesion assessment from pictures would allow automated tail classification of all pigs slaughtered, which is something that some animal welfare labels would like to do.

Genetic testing and genetic counseling for deafness: the future is here.

Today, genetic testing is an option for individuals who have deafness and hard-of-hearing conditions (D/HOH) and their families for diagnosis and carrier detection. As more and more D/HOH genes are identified, genetic testing will become commonplace. However, genetic testing is different from other tests that physicians commonly order and therefore should be conducted differently. The objective of this study was to determine the best manner in which to conduct genetic testing for individuals who have D/HOH. Numerous studies have shown that pretest and post-test genetic counseling is beneficial for patients and families undergoing genetic testing for a variety of conditions. The need for counseling was emphasized by our recently completed study in which we found that the majority of individuals whose children had genetic testing for D/HOH had a poor understanding of many genetic issues concerning recurrence risks for D/HOH and the meaning of the test results. We think that genetic counseling should be an integral part of genetic testing for individuals who have D/HOH.

Parental attitudes toward genetic testing for pediatric deafness.

Recent molecular genetic advances have resulted in genetic testing becoming an option for deaf individuals and their families. However, there is little information about the interest in such testing. To investigate this issue, parents with normal hearing who have one or more deaf children were surveyed about their attitudes toward diagnostic, carrier, and prenatal genetic testing for deafness. This population was chosen because it represents the majority of individuals who are encountered in clinical practice, given that 90%-95% of deaf individuals are born to persons with normal hearing. Of 328 surveys distributed, 96 were completed and returned. Of the respondents, 96% recorded a positive attitude toward genetic testing for deafness, including prenatal testing, although none would use this information to terminate an affected pregnancy. All respondents had a poor understanding of genetics, with 98% both incorrectly estimating the recurrence risk of deafness and misunderstanding the concept of inheritance. Notably, these findings were similar in the group who had had genetic testing for their children and in the group who had not, suggesting either that the parents who received genetic testing did not receive genetic counseling or that the counseling was not effective. On the basis of these results, it was concluded that this population is interested in the use of genetic testing and that testing should not be done without first providing formal genetic counseling. Appropriate counseling can help parents to understand the risks, benefits, and limitations of genetic testing.

The young chronic client in mental health today.

Due to the nature of the work with this demanding population, who, in spite of all efforts, demonstrates only minimal changes at best, nurses need aggressive management of their own lives. Burnout is rampant. Work with this type of client is not for everyone. Programs need to offer staff the opportunity to work with these clients only if the staff is capable and desires the challenge. It is necessary to set realistic goals and expectations with clients and to learn to accept tiny changes. Nurses must help the client become more realistic in their expectations of what will be achieved. It is important to note that the therapist may scare the client into regressed behavior by being too hopeful, by pushing them too far too fast, and by allowing them to go too fast. Caution should be taken with respect to encouragement and expectations of normalcy. If goals are too high and the client "fails," the therapist perceives that he/she is the one who failed. The patient who manages to achieve a level of functioning that enables him to interface with the outside often finds a world that is cold, demanding, and cruel--one that is easier to escape from than to deal with. One must be flexible and accessible to the client--involved with honest detachment. For the nurse therapist to serve this population requires sophistication in the theories of child and adolescent suicide, crisis intervention, aggression management, chemical abuse and use, and the ability to negotiate housing, money, food, services--things which have previously been the domain of others.(ABSTRACT TRUNCATED AT 250 WORDS)

[Exogenous allergic alveolitis during childhood (author's transl)]. / Die exogene allergische Alveolitis im Kindesalter.

Four children aged 31/2 to 13 years, who developed allergic alveolitis as a result of antigenic exposure in a domestic situation are described. The clinical symptoms consisted of gradual onset of increasing dyspnoea, chronic cough and weight loss. Lung function tests showed characteristic reduction in vital and diffusion capacity. Serologically, antibodies against animal antigens were demonstrated in all patients. Radiologically there were pronounced reticular changes in both lungs affecting mostly the middle and lower zones. Occasionally there were miliary and sometimes confluent shadows. In differential diagnosis, virus infections, pneumocystis carinii, fungus infections, dermatomyositis, sarcoidosis and tuberculosis had to be considered. Apart from a short course of steroid treatment, it is necessary to make certain that the children are no longer exposed to the causal antigen. Under these conditions the prognosis is good, but otherwise the disease, as in adults who are continuously exposed to the antigen, results in pulmonary fibrosis.

[Indication and examination technique of voiding cystourethrography in children (author's transl)]. / Indikationen und Untersuchungstechnik bei den Miktionscystourethrographien im Kindesalter.

Roentgen diagnosis in children with urological disease are of special interest in pediatric radiology. These examinations are more frequent than those of the gastrointestinal tract. Voiding cystourethrography is an important diagnostic procedure in chronic relapsing urinary infections. Indications and performance of voiding cystourethrographies in children is described. All precautions reducing x-ray exposure have to be taken into consideration. New technical standards enhance higher accuracy in diagnosis at lowest x-ray exposure to the patients.