Quantifying Induced Dipole Effects in Small Molecule Permeation in a Model Phospholipid Bilayer.

The cell membrane functions as a semipermeable barrier that governs the transport of materials into and out of cells. The bilayer features a distinct dielectric gradient due to the amphiphilic nature of its lipid components. This gradient influences various aspects of small molecule permeation and the folding and functioning of membrane proteins. Here, we employ polarizable molecular dynamics simulations to elucidate the impact of the electronic environment on the permeation process. We simulated eight distinct amino-acid side chain analogs within a 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine bilayer using the Drude polarizable force field (FF). Our approach includes both unbiased and umbrella sampling simulations. By using a polarizable FF, we sought to investigate explicit dipole responses in relation to local electric fields along the membrane normal. We evaluate molecular dipole moments, which exhibit variation based on their localization within the membrane, and compare the outcomes with analogous simulations using the nonpolarizable CHARMM36 FF. This comparative analysis aims to discern characteristic differences in the free energy surfaces of permeation for the various amino-acid analogs. Our results provide the first systematic quantification of the impact of employing an explicitly polarizable FF in this context compared to the fixed-charge convention inherent to nonpolarizable FFs, which may not fully capture the influence of the membrane dielectric gradient.

Spring and fall blood concentrations of adrenocorticotropic hormone, insulin, and thyroxine in healthy horses in Saskatchewan.

Objective: To characterize concentrations of adrenocorticotropic hormone (ACTH), insulin, and thyroxine (T4) at 2 times of the year in healthy horses in Saskatchewan. Animals and procedure: A prospective, observational study was carried out in 52 healthy, client-owned horses. Inclusion criteria were no recent travel outside of Saskatchewan, normal physical examination findings, and no history or evidence of ongoing illness. Blood concentrations of ACTH, insulin and T4 were determined by chemiluminescence. Samples were collected in spring and fall and compared using the paired Student's t-test or Wilcoxon signed-rank test. Generalized estimating equations were used to assess the associations between ACTH, T4, and insulin concentrations and gender, age, season, body condition score, glucose concentration, and breed. Results: There were increases in both ACTH and insulin concentrations in the fall compared to spring (P < 0.001 and P = 0.001, respectively). Other than season, insulin concentration was associated with breed, whereas ACTH concentration was associated with age. Finally, T4 concentration was associated with breed and glucose concentration, but not with season. Conclusion and clinical relevance: These results highlighted the differences between spring and fall concentrations of both ACTH and insulin in healthy horses residing in the Canadian prairie provinces, which are known for extreme differences in summer and winter temperatures as well as day length. Geographically adjusted reference values are necessary to account for these variations, to improve diagnostic accuracy. This is the first published Canadian study evaluating these factors and their associations with hormone concentrations in clinically healthy animals.

Concentrations sanguines printanières et automnales d'hormone adrénocorticotrope, d'insuline et de thyroxine chez des chevaux en bonne santé en Saskatchewan. Objectif: Caractériser les concentrations d'hormone adrénocorticotrope (ACTH), d'insuline et de thyroxine (T4) à 2 moments de l'année chez des chevaux en bonne santé en Saskatchewan. Animaux et procédure: Une étude observationnelle prospective a été réalisée auprès de 52 chevaux en bonne santé appartenant à des clients. Les critères d'inclusion étaient l'absence de voyage récent à l'extérieur de la Saskatchewan, les résultats normaux de l'examen physique et l'absence d'antécédents ou de signes de maladie persistante. Les concentrations sanguines d'ACTH, d'insuline et de T4 ont été déterminées par chimiluminescence. Des échantillons ont été collectés au printemps et à l'automne et comparés à l'aide du test de Student apparié ou du test du rang de signe de Wilcoxon. Des équations d'estimation généralisées ont été utilisées pour évaluer les associations entre les concentrations d'ACTH, de T4 et d'insuline et le sexe, l'âge, la saison, l'état corporel, la concentration de glucose et la race. Résultats: Il y avait une augmentation des concentrations d'ACTH et d'insuline à l'automne par rapport au printemps (P < 0,001 et P = 0,001, respectivement). Hormis la saison, la concentration d'insuline était associée à la race, alors que la concentration d'ACTH était associée à l'âge. Enfin, la concentration de T4 était associée à la race et à la concentration en glucose, mais pas à la saison. Conclusion et pertinence clinique: Ces résultats ont mis en évidence les différences entre les concentrations printanières et automnales d'ACTH et d'insuline chez les chevaux en bonne santé résidant dans les provinces des Prairies canadiennes, reconnues pour leurs différences extrêmes de températures estivales et hivernales ainsi que de durée du jour. Des valeurs de référence géographiquement ajustées sont nécessaires pour tenir compte de ces variations et améliorer la précision du diagnostic. Il s'agit de la première étude canadienne publiée évaluant ces facteurs et leurs associations avec les concentrations d'hormones chez des animaux cliniquement sains.(Traduit par Dr Serge Messier).

Continuous digital hypothermia for prevention and treatment of equine acute laminitis: A practical review.

Laminitis is a severely debilitating and life-threatening condition that occurs as a consequence of different primary triggering factors. Continuous digital hypothermia (CDH) is recommended in horses at risk of, or diagnosed with, acute laminitis due to its several physiological and biochemical alterations that may be positive for the prevention and early treatment of the condition, representing a low risk of adverse effects. Modulation of the inflammatory response, profound vasoconstriction, and prevention of tissue damage are the most notable protective effects of cryotherapy on the lamellae. This practical review aims to summarize the published literature evaluating CDH efficacy in the prevention and early treatment of acute laminitis in horses, highlighting the most important clinical findings and discussing the best methods to provide cryotherapy. Nineteen publications evaluated different CDH methods, including the use of commercially available ice boots or fluid bags filled with iced water or crushed ice, as well as alternatives to immersion in ice, e.g., frozen gel packs and a perfused cuff prototype. Although some techniques were effective for cooling and maintaining the hooves below the optimal temperature of 10 °C, relevant limitations such as labor intensiveness, reliance on an ice source and price make its use impractical in some clinical situations. Twelve experimental studies assessed the efficacy of CDH on the prevention or early treatment of laminitis, finding multiple positive effects in terms of clinical improvement, immunological and inflammatory modulation, and histological protection. After the analysis of the literature, the clinical importance of CDH in different stages of laminitis remains clear. However, it also highlights the need for a safer, more user-friendly, and more effective method of cryotherapy that can be used both in a hospital and an ambulatory setting.

Effects of Familial Alzheimer's Disease Mutations on the Folding Free Energy and Dipole-Dipole Interactions of the Amyloid ß-Peptide.

Familial Alzheimer's disease (FAD) mutations of the amyloid ß-peptide (Aß) are known to lead to early onset and more aggressive Alzheimer's disease. FAD mutations such as "Iowa" (D23N), "Arctic" (E22G), "Italian" (E22K), and "Dutch" (E22Q) have been shown to accelerate Aß aggregation relative to the wild-type (WT). The mechanism by which these mutations facilitate increased aggregation is unknown, but each mutation results in a change in the net charge of the peptide. Previous studies have used nonpolarizable force fields to study Aß, providing some insight into how this protein unfolds. However, nonpolarizable force fields have fixed charges that lack the ability to redistribute in response to changes in local electric fields. Here, we performed polarizable molecular dynamics simulations on the full-length Aß42 of WT and FAD mutations and calculated folding free energies of the Aß15-27 fragment via umbrella sampling. By studying both the full-length Aß42 and a fragment containing mutations and the central hydrophobic cluster (residues 17-21), we were able to systematically study how these FAD mutations impact secondary and tertiary structure and the thermodynamics of folding. Electrostatic interactions, including those between permanent and induced dipoles, affected side-chain properties, salt bridges, and solvent interactions. The FAD mutations resulted in shifts in the electronic structure and solvent accessibility at the central hydrophobic cluster and the hydrophobic C-terminal region. Using umbrella sampling, we found that the folding of the WT and E22 mutants is enthalpically driven, whereas the D23N mutant is entropically driven, arising from a different unfolding pathway and peptide-bond dipole response. Together, the unbiased, full-length, and umbrella sampling simulations of fragments reveal that the FAD mutations perturb nearby residues and others in hydrophobic regions to potentially alter solubility. These results highlight the role electronic polarizability plays in amyloid misfolding and the role of heterogeneous microenvironments that arise as conformational change takes place.

Simulation to improve medical student confidence and preparedness to care for the dying: a feasibility study.

BACKGROUND: Undergraduate teaching currently fails to adequately prepare doctors to deliver 'end-of-life' care. Despite much evidence supporting simulation-based teaching, its use in medical undergraduate palliative and 'end-of-life' care curricula remain low. AIM: This study assesses whether simulation can improve the confidence and preparedness of medical students to provide holistic care to dying patients and their families, from clinical assessment to symptom management, communication and care after death. METHODS: Six fourth-year medical students undertook individual simulations involving a dying patient (high-fidelity simulator) and family member (actor). Intentional patient death occurred in four of the six scenarios (although unexpected by students). Pre-simulation/post-simulation thanatophobia questionnaires measured student attitudes towards providing care to dying patients. Thematic analysis of post-simulation focus group transcripts generated qualitative data regarding student preparedness, confidence and value of the simulations. RESULTS: Thematic analysis revealed that students felt the simulations were realistic, and left them better prepared to care for dying patients. Students coveted the 'safe' exposure to dying patient scenarios afforded by the simulations. Observed post-simulation reduction in mean thanatophobia scores was not found to be statistically significant (p=0.07). CONCLUSIONS: Results suggest a feasible potential for simulations to influence undergraduate medical student teaching on the care of a dying patient and their family. We believe that this study adds to the limited body of literature exploring the value of simulation in improving the confidence and preparedness of medical students to provide 'end-of-life' care. Further research into the cost-effectiveness of simulation is required to further support its application in this setting.

Morphometric, metabolic, and inflammatory markers across a cohort of client-owned horses and ponies on the insulin dysregulation spectrum.

In human metabolic syndrome and type II diabetes, methylglyoxal (MG), D-lactate, and several cytokines have been recognized as biomarkers of important metabolic and inflammatory processes. Equine metabolic syndrome (EMS) shares many similarities with these human counterparts. The objectives of this cross-sectional study were to compare body condition score (BCS), cresty neck score (CNS), resting insulin, MG, D-lactate, L-lactate, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1) between horses with and without insulin dysregulation, as classified via combined glucose and insulin test (CGIT). 32 client-owned horses were included. History and morphometric data such as BCS and CNS were recorded. Subjects with abnormalities on physical examination or CBC, elevated ACTH or incomplete information were excluded. Baseline serum or plasma concentrations of biomarkers were tested via commercial ELISA or colorimetric assays. Characteristics of insulin dysregulated and insulin sensitive horses were compared by univariate analysis and forward logistic regression. 12 (38%) of the 32 horses were classified as insulin dysregulated. No significant difference between the 2 groups was found for age, BCS, baseline glucose, triglycerides, MG, D-lactate, L-lactate, TNF-α, IL-6, and MCP-1. Baseline insulin was significantly associated with insulin dysregulation in univariate analysis (P = 0.02), but not in the final model. Horses with CNS ≥ 3 had 11.3 times higher odds of having insulin dysregulation (OR 11.3, 95% C.I. 2.04 - 63.08, P = 0.006). In this population, horses with mild-moderate signs of EMS presented similar metabolic and inflammatory profiles to non-insulin dysregulated controls.

Accelerometry-Based Step Count Validation for Horse Movement Analysis During Stall Confinement.

Quantitative tracking of equine movement during stall confinement has the potential to detect subtle changes in mobility due to injury. These changes may warn of potential complications, providing vital information to direct rehabilitation protocols. Inertial measurement units (IMUs) are readily available and easily attached to a limb or surcingle to objectively record step count in horses. The objectives of this study were: (1) to compare IMU-based step counts to a visually-based criterion measure (video) for three different types of movements in a stall environment, and (2) to compare three different sensor positions to determine the ideal location on the horse to assess movement. An IMU was attached at the withers, right forelimb and hindlimb of six horses to assess free-movement, circles, and figure-eights recorded in 5 min intervals and to determine the best location, through analysis of all three axes of the triaxial accelerometer, for step count during stall confinement. Mean step count difference, absolute error (%) and intraclass correlation coefficients (ICCs) were determined to assess the sensor's ability to track steps compared to the criterion measure. When comparing sensor location for all movement conditions, the right-forelimb vertical-axis produced the best results (ICC = 1.0, % error = 6.8, mean step count difference = 1.3) followed closely by the right-hindlimb (ICC = 0.999, % error = 15.2, mean step count difference = 1.8). Limitations included the small number of horse participants and the lack of random selection due to limited availability and accessibility. Overall, the findings demonstrate excellent levels of agreement between the IMU's vertical axis and the video-based criterion at the forelimb and hindlimb locations for all movement conditions.

Septic fibrinous pericarditis in 4 horses in Saskatchewan following an outbreak of forest tent caterpillars in 2017.

In the summer of 2017, 4 horses were diagnosed with septic fibrinous pericarditis at the Western College of Veterinary Medicine, Saskatoon. This case series occurred after a significant outbreak of forest tent caterpillars (Malacosoma disstria) in the province during that spring. Three horses were immediately euthanized, and treatment was attempted in 1 mare. This is the first case series of pericarditis possibly associated with the ingestion of forest tent caterpillars to be reported in western Canada. Although cause-effect is not proven, it is prudent to prevent the ingestion of caterpillars by horses. Key clinical message: Septic fibrinous pericarditis, a rare condition in horses, has previously been linked to outbreaks of eastern tent caterpillars. A similar link might exist in this case series.

Péricardites fibrineuses septiques chez quatre chevaux saskatchewanais consécutive à une infestation de chenilles de livrée des forêts en 2017. Au cours de l'été 2017, quatre chevaux ont été diagnostiqués avec une péricardite fibrineuse septique au Western College of Veterinary Medicine de Saskatoon. Ces cas ont été présentés après une sévère infestation printanière de chenilles de livrée de forêts (Malacosoma disstria) dans la province de la Saskatchewan, reportée au printemps. Trois chevaux ont été immédiatement euthanasiés et une jument a été hospitalisée pour traitement. Ceci est le premier rapport décrivant la possible association entre des cas de péricardite chez des chevaux et l'ingestion de chenilles de livrée de forêts dans l'Ouest canadien. Même si le lien de cause à effet n'est pas prouvé, il est prudent d'éviter l'ingestion de ces chenilles processionnaires par les chevaux.Message clinique clé :La péricardite fibrineuse septique, une condition rare chez les chevaux, a précédemment été liée à des flambées de livrées des forêts. Un lien similaire pourrait exister dans la présente série de cas.(Traduit par les auteurs).

Investigation of a Yersinia enterocolitica outbreak in a commercial alpaca farm in Saskatchewan.

An outbreak of enterocolitis and sudden deaths occurred in an alpaca herd in Saskatchewan (mortality rate: 18.6%). Yersinia enterocolitica was isolated from the intestine, liver, and spleen of the index case, the kidney of a second case, and the feces of affected animals. The initial source of infection could not be identified. Treatment with oxytetracycline was followed by resolution of diarrhea and arrest of fatalities. The end of the outbreak was determined by absence of new cases and negative fecal cultures. This is the first report of a presumed herd outbreak of yersiniosis in camelids in North America.

Enquête à la suite d'une épidémie due à Yersinia enterocolitica dans une ferme commerciale d'alpagas en Saskatchewan. Une épidémie d'entérocolite et de mortalités soudaines est survenue dans un troupeau d'alpaga en Saskatchewan (taux de mortalité : 18,6 %). Yersinia enterocolitica fut isolé à partir de l'intestin, du foie et de la rate du cas index, du rein d'un second cas, et des fèces des animaux affectés. La source initiale d'infection ne put être identifiée. Un traitement avec de l'oxytétracycline fut suivi d'une résolution de la diarrhée et un arrêt des mortalités. La fin de l'épidémie fut déterminée par l'absence de nouveaux cas et des cultures de fèces négatives. Ceci constitue le premier rapport d'une épidémie présumée de yersiniose chez des camélidés en Amérique du Nord.(Traduit par Dr Serge Messier).

From Table to Stable: A Comparative Review of Selected Aspects of Human and Equine Metabolic Syndrome.

Obesity data in people and companion animals are depicting a future of increasing morbidity, cost for society, and significant health and welfare concerns. Between 25 and 50% of cats, dogs, and horses in developed countries are overweight or obese, which mirrors the situation in humans. Equine metabolic syndrome (EMS) was named after human metabolic syndrome (MetS), which has about 30 years of lead in research efforts. Even though the complications of the two syndromes seem to grossly differ (cardiac vs. laminitis risk), a number of similar disease mechanisms are worthy of investigation. Since the first EMS consensus statement by the American College of Veterinary Internal Medicine in 2010, numerous studies have confirmed the link between insulin dysregulation and laminitis, even though the mechanisms are not fully understood. After the discovery of the role of adipokines in MetS, evidence about inflammatory mechanisms related to adiposity in rodent models, companion animals, horses, and humans is constantly increasing. Oxidative and dicarbonyl stress have been correlated with insulin dysregulation, obesity, and recently with laminitis. Vascular actions of insulin through nitric oxide, endothelin-1, and other mechanisms are being studied in horses and can provide a better understanding of laminitis pathophysiology. More research is needed on neuropathic mechanisms in insulin-dysregulated horses, which could be important in the pathogenesis of laminitis and laminitic pain. Human literature can provide viable material for novel studies in areas that have received limited attention, in addition to being valuable information for clients about the consequences of unhealthy management of their horses.

Why are UK junior doctors taking time out of training and what are their experiences? A qualitative study.

OBJECTIVES: The number of doctors directly entering UK specialty training after their foundation year 2 (F2) has steadily declined from 83% in 2010 to 42.6% in 2017. The year following F2, outside the UK training pathway, is informally termed an 'F3' year. There is a paucity of qualitative research exploring why increasingly doctors are taking F3s. The aim of this study is to explore the reasons why F2 doctors are choosing to take a year out of training and the impact upon future career choices. DESIGN: This is an exploratory qualitative study, using in-depth interviews and content analysis. SETTING: UK. PARTICIPANTS: Fourteen participants were interviewed from one foundation school. Participants included five doctors who commenced their F3 in 2015, five who started in 2016 and finally four recently starting this in 2017. MAIN OUTCOME MEASURES: Content analysis was conducted to distill the themes which exemplified the totality of the experience of the three groups. RESULTS: There were four predominant themes arising within the data set which can be framed as 'unmet needs' arising within foundation years, sought to be fulfilled by the F3 year. First, doctors describe exhaustion and stress resulting in a need for a 'break'. Second, doctors required more time to make decisions surrounding specialty applications and prepare competitive portfolios. Third, participants felt a loss of control which was (partially) regained during their F3s. The final theme was the impact of taking time out upon return to training (for those participants who had completed their F3 year). When doctors returned to NHS posts they brought valuable experience. CONCLUSIONS: This study provides evidence to support the important ongoing initiatives from Health Education England and other postgraduate bodies, exploring approaches to further engage, retain and support the junior doctor workforce.

Tumor necrosis factor-alpha protein concentrations in bronchoalveolar lavage fluid from healthy horses and horses with severe equine asthma.

The objective of this study was to determine if TNF-α protein concentration differs in bronchoalveolar lavage fluid (BALF) obtained from healthy horses, horses with naturally occurring exacerbations of severe equine asthma and horses in remission from severe equine asthma. Tumor necrosis factor-alpha (TNF- α) protein concentrations were determined in BALF by commercial equine ELISA. Horses with naturally occurring exacerbation of severe equine asthma were found to have significantly lower BALF TNF-α protein concentrations than healthy horses (p = 0.0026). There was no significant difference in BALF TNF-α concentration between horses in exacerbation and remission from disease, but there was a decrease in median TNF-α concentration between healthy horses and horses with clinical exacerbation of severe equine asthma. These findings suggest, that similar to human asthma, the role of TNF-α in chronic lower airway inflammation of horses may differ between disease phenotypes and disease state. Furthermore, the method with which TNF-α is measured (mRNA expression vs. protein concentration) may affect results when studying the role of TNF-α in horses with severe equine asthma.

Does antimicrobial therapy improve outcomes in horses with severe equine asthma and a positive tracheal wash bacterial culture?

The objective of this study was to observe the outcomes of adding an antimicrobial treatment to a conventional treatment regime in horses with severe equine asthma in a clinical setting. Eleven client-owned horses with a history consistent with severe equine asthma, increased respiratory effort and nostril flaring, ≥ 20% neutrophils on bronchoalveolar lavage (BAL), and a positive tracheal wash (TW) bacterial culture were treated with environmental management, corticosteroids, and bronchodilators. Six horses were also treated with an antimicrobial (principal group), while the other 5 were administered saline as a placebo (control group). Treatment with antimicrobials significantly improved the post-treatment clinical score of the principal group compared with the pre-treatment score, whereas no significant difference occurred in the control group. The principal group also had significantly less neutrophil myeloperoxidase (MPO) activity post-treatment than pre-treatment, with a median difference of -0.39 units/[protein] in the principal group and a median difference of -0.21 units/[protein] in the controls. There was no difference in MPO activity pre- versus post-treatment in the control group. No differences were noted in the intra-group comparisons of pre- versus post-treatment BAL neutrophil counts, mucus scores, and concentrations of interleukin-8 (IL-8) or tumor necrosis factor-alpha (TNF-α) in bronchoalveolar lavage fluid (BALF) in either group. There were no differences found in the inter-group comparisons of the principal versus controls for each of the pre- and post-treatment time periods for BAL neutrophil count, mucus score, clinical scores, MPO activity, and IL-8 or TNF-α concentrations. The role of airway bacteria in horses with severe equine asthma requires further investigation as antimicrobial therapy improved post-treatment clinical scores and decreased MPO activity in the group of horses studied, but did not affect other measures of airway inflammation.

L'objectif de la présente étude était d'observer dans un contexte clinique les résultats de l'ajout d'un traitement antimicrobien au traitement conventionnel de chevaux souffrant d'asthme sévère. Onze chevaux appartenant à des propriétaires et ayant une histoire correspondant avec de l'asthme sévère, un effort inspiratoire augmenté et un élargissement des narines, ≥ 20 % de neutrophiles dans le lavage bronchoalvéolaire (LBA), et une culture bactérienne positive à partir du lavage trachéal (LT) ont été traités par gestion de leur environnement, des corticostéroïdes, et des broncho-dilatateurs. Six chevaux ont également été traités avec un antimicrobien (groupe principal) alors que les cinq autres chevaux ont reçu de la saline à titre de placebo (groupe témoin). Le traitement avec les antimicrobiens améliora de manière significative le score clinique post-traitement du groupe principal comparativement au score pré-traitement, alors qu'aucune différence significative ne fut notée dans le groupe témoin. Dans le groupe principal on nota également qu'il y avait significativement moins d'activité myéloperoxydase (MPO) des neutrophiles post-traitement comparativement à pré-traitement, avec une différence médiane de −0,39 unités/[protéine] dans le groupe principal et une différence médiane de −0,21 unités/[protéine] dans le groupe témoin. Il n'y avait pas de différence de l'activité MPO pré- versus post-traitement dans le groupe témoin. Aucune différence ne fut notée dans les comparaisons intra-groupe pré- versus posttraitement du dénombrement de neutrophiles dans les LAB, du score de mucus, et des concentrations d'interleukine-8 (IL-8) ou du facteuralpha nécrosant des tumeurs (TNF-α) dans les liquides de lavage broncho-alvéolaire (LLBA) d'un groupe ou l'autre. Aucune différence ne fut trouvée dans les comparaisons inter-groupes du principal versus les témoins pour chacune des périodes de temps pré- et post-traitement pour le dénombrement des neutrophiles des LAB, le score de mucus, les scores cliniques, l'activité MPO, et les concentrations d'IL-8 ou de TNF-α. Le rôle des bactéries dans les voies respiratoires des chevaux souffrant d'asthme sévère nécessite des études supplémentaires étant donné que les thérapies antimicrobiennes ont améliorés les scores cliniques post-traitement et ont diminué l'activité MPO dans le groupe de chevaux étudiés, mais n'affecta pas d'autres mesures de l'inflammation des voies respiratoires.(Traduit par Docteur Serge Messier).

Is there an application for wireless capsule endoscopy in horses?

This pilot study assessed wireless capsule endoscopy in horses. Image transmission was achieved with good image quality. Time to exit the stomach was variable and identified as one limitation, together with gaps in image transmission, capsule tumbling, and inability to accurately locate the capsule. Findings demonstrate usefulness and current limitations.

Existe-t-il une application pour l'endoscopie par capsule sans fil chez les chevaux? Cette étude pilote a évalué l'endoscopie par capsule chez les chevaux. La transmission d'images a permis d'obtenir une bonne qualité d'image. Le temps jusqu'à la sortie de l'estomac était variable et identifié comme une limitation, de même que les lacunes dans la transmission de l'image, le culbutage de la capsule et l'incapacité de situer l'emplacement exact de la capsule. Les résultats démontrent l'utilité et les limitations actuelles.(Traduit par Isabelle Vallières).

Exploring medical student learning in the large group teaching environment: examining current practice to inform curricular development.

BACKGROUND: Lectures continue to be an efficient and standardised way to deliver information to large groups of students. It has been well documented that students prefer interactive lectures, based on active learning principles, to didactic teaching in the large group setting. Despite this, it is often the case than many students do not engage with active learning tasks and attempts at interaction. By exploring student experiences, expectations and how they use lectures in their learning we will provide recommendations for faculty to support student learning both in the lecture theatre and during personal study time. METHODS: This research employed a hermeneutic phenomenological approach. Three focus groups, consisting of 19 students in total, were used to explore the experiences of second year medical students in large group teaching sessions. Using generic thematic data analysis, these accounts have been developed into a meaningful account of experience. RESULTS: This study found there to be a well-established learning culture amongst students and with it, expectations as to the format of teaching sessions. Furthermore, there were set perceptions about the student role within the learning environment which had many implications, including the way that innovative teaching methods were received. Student learning was perceived to take place outside the lecture theatre, with a large emphasis placed on creating resources that can be taken away to use in personal study time. CONCLUSIONS: Presented here is a constructive review of reasons for student participation, interaction and engagement in large group teaching sessions. Based on this are recommendations constructed with the view to aid educators in engaging students within this setting. Short term, educators can implement strategies that monopolise on the established learning culture of students to encourage engagement with active learning strategies. Long term, it would be beneficial for educators to consider ways to shift the current student learning culture to one that embraces an active learning curriculum.

Peritoneal fluid immunocytochemistry used for the diagnosis of a possible case of equine gastrointestinal B-cell lymphoma.

After physical examination, ultrasonographic evaluation of thorax and abdomen, and peritoneal fluid analysis, gastrointestinal neoplasia with suspected diffuse peritoneal metastasis was diagnosed in a 17-year-old Arabian gelding. The owner elected euthanasia and declined postmortem examination. Immunocytochemistry analysis of the peritoneal fluid resulted in a diagnosis of B-cell lymphoma.

Immunocytochimie du liquide péritonéal utilisée pour le diagnostic d'un cas possible de lymphome gastro-intestinal à cellules B. Après un examen physique, une évaluation échographique du thorax et de l'abdomen et une analyse du liquide péritonéal, une néoplasie gastro-intestinale avec métastase péritonéale diffuse suspectée a été diagnostiquée chez un hongre arabe âgé de 17 ans. Le propriétaire a choisi l'euthanasie et a refusé l'examen postmortem. L'analyse par immunohistochimie du liquide péritonéal a donné lieu à un diagnostic de lymphome à cellules B.(Traduit par Isabelle Vallières).

Qualitative study of the impact of an authentic electronic portfolio in undergraduate medical education.

BACKGROUND: Portfolios are increasingly used in undergraduate and postgraduate medical education. Four medical schools have collaborated with an established NHS electronic portfolio provider to develop and implement an authentic professional electronic portfolio for undergraduate students. We hypothesized that using an authentic portfolio would have significant advantages for students, particularly in familiarizing them with the tool many will continue to use for years after graduation. This paper describes the early evaluation of this undergraduate portfolio at two participating medical schools. METHODS: To gather data, a questionnaire survey with extensive free text comments was used at School 1, and three focus groups were held at School 2. This paper reports thematic analysis of students' opinions expressed in the free text comments and focus groups. RESULTS: Five main themes, common across both schools were identified. These concerned the purpose, use and acceptability of the portfolio, advantages of and barriers to the use of the portfolio, and the impacts on both learning and professional identity. CONCLUSIONS: An authentic portfolio mitigated some of the negative aspects of using a portfolio, and had a positive effect on students' perception of themselves as becoming past of the profession. However, significant barriers to portfolio use remained, including a lack of understanding of the purpose of a portfolio and a perceived damaging effect on feedback.

Successful collaboration in education: the UMeP.

BACKGROUND: As the health care education landscape in the UK changes rapidly and dramatically, collaboration across institutions bridging undergraduate and postgraduate fields is increasingly necessary. Collaboration entails both risks and benefits. There is a paucity of advice on how to ensure collaborative projects in medical education are effective. There is a paucity of advice on how to ensure collaborative projects in medical education are effective CONTEXT: In 2011 three medical schools began a collaborative project along with NHS Education for Scotland (NES) to modify, develop and deliver a medical school version of the NES foundation programme ePortfolio, called UMeP. The underlying principal was the introduction of an authentic ePortfolio early in undergraduate life. The challenge of three diverse medical schools with significantly different curricula and assessment approaches working together with a single postgraduate ePortfolio was complex and demanding. DISCUSSION: We reveal the complexities of collaboration on education projects and draw on our experiences to provide illustrative examples of collaboration. Despite the increased complexity and need for compromise, we argue that successful collaborative partnerships are key to maximising the circumstances in which education innovation can be successful, and create the potential for robust evaluation and research.

Morphometric examination of the equine adult and foal lung.

To understand the mechanisms of airway inflammation associated with equine diseases such as Rhodococcus equi infection, we must identify baseline "normal" structural characteristics of the horse lung. To develop a detailed understanding of the morphology of the horse lung, we adapted and applied stereological methods to the lungs from healthy adult horses (N = 4) and 1-day (N = 5) and 30-day (N = 5) old foals. The left lung was fixed in situ by intrabronchial instillation of glutaraldehyde/paraformaldehyde fixative at 25 cm H2 O column and sampled using a fractionator design followed by embedding in glycol methacrylate. The lung was characterized into parenchyma and non-parenchyma, where median parenchymal density was 81.0% in 1-day-old foals, 84.4% in 30-day-old foals and 93.7% in adult lungs. The median volume density of alveolar airspace per lung was 45.9% in 1-day-old, 55.5% in 30-day and 66.9% in adult horse lungs. The median alveolar surface area increased with age, from 205.3 m(2) , 258.2 m(2) , and 629.9 m(2) in 1-day-old foals, 30-day-old foals, and adults, respectively. While the median alveolar surface density decreased with age, the mean linear intercept (mean free distance within acinar airspaces) increased with age. Alveolar surface area was greater than endothelial surface area within each lung. The ratio between alveolar and endothelial surface density remains unchanged with age. The median endothelium surface area was 106.2 m(2) in 1-day, 147.5 m(2) in 30-day, and 430 m(2) in adult lungs. The data suggest the foal lung is functionally developed and postnatal lung development and remodelling is driven by alveolar expansion paralleled with angiogenesis.