Long-Lasting Chews Elicit Positive Emotional States in Dogs during Short Periods of Social Isolation.

Dogs may experience negative emotional states when isolated from human caregivers and conspecifics. This study aimed to evaluate how dogs interact with different enrichments during a short period of social isolation, as a first step towards identifying methods for improving their emotional wellbeing. Using a cross-over design, dogs (n = 20) at the Waltham Petcare Science Institute were exposed to four different food-based enrichments while left alone in a familiar room for 20 min: long-lasting chew (Chew), kibble in a treat-dispensing toy (Toy), and kibble dispensed through a smart treat-dispensing device with (Device + Voice) and without (Device) a person talking to the dog. Time spent engaging with each enrichment item and emotional valence and arousal (7-point scale collected every 5-min) were scored from videos. The results of linear mixed models indicated Chew was the most successful enrichment, with dogs having lower arousal scores (p < 0.05 vs. Device and Toy) during the first five minutes of isolation, higher positive valence scores (p < 0.05 vs. all) during the second five minutes of isolation, and spending the most total time engaged (p < 0.01 vs. all). Based on these findings, long-lasting chews should be further explored to assess their impact on dog emotional wellbeing.

Quality Improvement Initiative to Improve Time and Adherence to Revaccination after Hematopoietic Cell Transplantation: Implementation of a Revaccination Clinic within the Transplantation Program.

Revaccination after hematopoietic cell transplantation (HCT) is critical to prevent morbidity and mortality from vaccine-preventable illnesses. The global aim of our quality improvement initiative was to enhance timely, correct, and effective revaccination after pediatric HCT. The SMART aim of our project was to decrease median unvaccinated time by 4 months by decreasing the time to vaccine eligibility, time from eligibility to vaccine initiation, and time to completion of the vaccine series. A multidisciplinary group performed a cross-sectional quantitative and qualitative evaluation of revaccination practices at our institution. We identified factors associated with delayed, incorrect, or incomplete revaccination. Several plan-do-study-act interventions were implemented to address these drivers, including revising immune readiness criteria, increasing auditing of primary care administered immunizations, and, importantly, establishing a dedicated revaccination clinic within the HCT clinic at our center. The time to vaccine eligibility decreased from 12.6 months to 10 months (a 20% decrease), and the time to complete the vaccine series decreased from 19.3 months to 15.7 months (a 19% decrease). With a quality improvement initiative, we addressed the many causes of delayed or incomplete revaccination post-HCT and through a team-based approach successfully decreased the time to vaccine start and time to vaccine completion at our center.

Nonmetric Cranial Trait Variation and Ancestry Estimation in Asian and Asian-Derived Groups.

Traditionally, precontact Native Americans and Asian groups have been conflated for aspects of the biological profile due to their distantly shared genetic history, although this grouping remains largely unexplored. This study examines craniomorphic variability to ascertain whether Asian groups can be differentiated from each other and from Asian-derived groups using more fine-tuned models. Cranial and mandibular data for 35 nonmetric traits were recorded on precontact Native Americans (n = 150) and modern Japanese (n = 150) and Thai (n = 150) individuals. Chi-square analyses indicate that all groups exhibit statistically significant differences in most traits. Additionally, cross-validated binary logistic regression equations resulted in correct classification rates in the range of 65.0-93.3% and demonstrate that sex does not contribute to statistical models. Therefore, numerous traits provide discriminatory resolution that detects differences between the samples, thus highlighting the potential utility of nonmetric traits in identifying individuals beyond the traditional African, European, and Asian forensic ancestry groupings.

Electronic tool helps anaesthesia trainee handovers.

BACKGROUND: Handovers in patient care are increasingly common occurrences in medicine and are highly susceptible to communication failures. Intraoperative anaesthesiology handovers are especially challenging because of concurrent management of the patient. Our goal was to develop and use an electronic handover checklist as an educational tool to teach anaesthesiology trainees a standardised method of handing over a case intraoperatively. We hypothesised that the use of the checklist would systematically enhance the transfer of accurate and complete information. METHODS: Thirty-four anaesthesia trainees were observed giving an intraoperative handover without the checklist, and then again with the checklist at a later time. An observational handover assessment tool was used by investigators to mark each item as either spontaneously relayed by the giver, elicited by the receiver, not discussed or not applicable to the case. After the use of the checklist, each handover giver filled out a survey related to his or her perceptions of the checklist. RESULTS: The proportion of items spontaneously relayed increased from 54% without the checklist to 98% when using the checklist (p < 0.0001). More than 90% of participants felt that the checklist increased handover efficiency and communication skills. All participants stated that the handovers were more thorough with the checklist and that they would incorporate it into their daily practice. Intraoperative anaesthesiology handovers are especially challenging because of concurrent management of the patient DISCUSSION: With the intervention of the checklist, our results show that the use of a standardised intraoperative checklist improved the transfer of important patient information among anaesthesia trainees.

A Proof-of-Mechanism Study to Test Effects of the NMDA Receptor Antagonist Lanicemine on Behavioral Sensitization in Individuals With Symptoms of PTSD.

Background: Individuals with post-traumatic stress disorder (PTSD) have a heightened sensitivity to subsequent stressors, addictive drugs, and symptom recurrence, a form of behavioral sensitization. N-methyl-D-aspartate receptors (NMDARs) are involved in the establishment and activation of sensitized behavior. Objective: We describe a protocol of a randomized placebo-controlled Phase 1b proof-of-mechanism trial to examine target engagement, safety, tolerability, and possible efficacy of the NMDAR antagonist lanicemine in individuals with symptoms of PTSD (Clinician Administered PTSD Scale [CAPS-5] score ≥ 25) and evidence of behavioral sensitization measured as enhanced anxiety-potentiated startle (APS; T-score ≥ 2.8). Methods: Subjects (n = 24; age range 21-65) receive three 60-min intravenous infusions of placebo or 100 mg lanicemine over 5 non-consecutive days. Primary endpoint is change in APS from pre-treatment baseline to after the third infusion. NMDAR engagement is probed with resting state EEG gamma band power, 40 Hz auditory steady state response, the mismatch negativity amplitude, and P50 sensory gating. Change in CAPS-5 scores is an exploratory clinical endpoint. Bayesian statistical methods will evaluate endpoints to determine suitability of this agent for further study. Conclusion: In contrast to traditional early-phase trials that use symptom severity to track treatment efficacy, this study tracks engagement of the study drug on expression of behavioral sensitization, a functional mechanism likely to cut across disorders. This experimental therapeutics design is consistent with recent NIMH-industry collaborative studies, and could serve as a template for testing novel pharmacological agents in psychiatry. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03166501.