The effect of an acute aspirin challenge on intestinal permeability in healthy adults with and without prophylactic probiotic consumption: a double-blind, placebo-controlled, randomized trial.

BACKGROUND: Healthy individuals may experience increases in intestinal permeability after chronic or acute use of non-steroidal anti-inflammatory drugs, which may be attenuated by probiotics. This study investigates the effects of an acute aspirin challenge on gastroduodenal barrier function with or without prophylactic probiotic consumption. METHODS: Twenty-nine generally healthy participants (26 ± 6 years) completed a 14-week randomized, double-blind, crossover trial. A probiotic containing 2 Lactobacilli strains or placebo was administered for 3 weeks, with a 4-week washout period between crossover phases. Daily and weekly questionnaires assessing gastrointestinal function were completed for 2 weeks before until 2 weeks after each intervention to assess gastrointestinal function. Gastroduodenal permeability was assessed by urinary excretion of orally administered sucrose after 1, 2, and 3 weeks of each intervention with a 1950 mg-aspirin challenge after 2 weeks of supplementation. Stool samples were collected weekly during supplementation for detection of species of interest. RESULTS: Gastroduodenal permeability increased with aspirin challenge (Week 1: 3.4 ± 0.6 µmol vs Week 2: 9.9 ± 1.0 µmol urinary sucrose; p < 0.05). There were no differences in the change in permeability after the aspirin challenge or gastrointestinal function between interventions. CONCLUSION: The acute aspirin challenge significantly increased intestinal permeability similarly in both groups, and prophylactic probiotic consumption was unable to prevent the loss in this particular model.

Environmental Factors Influencing Stem Rot Development in Peanut: Predictors and Action Thresholds for Disease Management.

Peanuts grown in tropical, subtropical, and temperate regions are susceptible to stem rot, which is a soilborne disease caused by Athelia rolfsii. Due to the lack of reliable environmental-based scheduling recommendations, stem rot control relies heavily on fungicides that are applied at predetermined intervals. We conducted inoculated field experiments for six site-years in North Florida to examine the relationship between germination of A. rolfsii sclerotia: the inoculum, stem rot symptom development in the peanut crop, and environmental factors such as soil temperature (ST), soil moisture, relative humidity (RH), precipitation, evapotranspiration, and solar radiation. Window-pane analysis with hourly and daily environmental data for 5- to 28-day periods before each disease assessment were evaluated to select model predictors using correlation analysis, regularized regression, and exhaustive feature selection. Our results indicated that within-canopy ST (at 0.05 m belowground) and RH (at 0.15 m aboveground) were the most important environmental variables that influenced the progress of mycelial activity in susceptible peanut crops. Decision tree analysis resulted in an easy-to-interpret one-variable model (adjusted R2 = 0.51, Akaike information criterion [AIC] = 324, root average square error [RASE] = 14.21) or two-variable model (adjusted R2 = 0.61, AIC = 306, RASE = 10.95) that provided an action threshold for various disease scenarios based on number of hours of canopy RH above 90% and ST between 25 and 35°C in a 14-day window. Coupling an existing preseason risk index for stem rot, such as Peanut Rx, with the environmentally based predictors identified in this study would be a logical next step to optimize stem rot management. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

Complications and outcome following staphylectomy and folded flap palatoplasty in dogs with brachycephalic obstructive airway syndrome.

OBJECTIVE: To compare the prevalence of pre-, intra-, and postoperative variables and complications associated with staphylectomy (S) and folded flap palatoplasty (FFP). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Client-owned dogs (n = 124). METHODS: Medical records of S and FFP dogs from a veterinary teaching hospital were reviewed between July 2012 and December 2019. Signalment, clinical pre-, intra-, and postoperative data were collected and reviewed. Median (interquartile range) was reported. RESULTS: A total of 124 dogs among 14 breeds underwent surgical treatment for an elongated soft palate with either a S (n = 64) or FFP (60). FFP dogs without concurrent non-airway procedures were associated with longer duration of surgery (p = .02; n = 63; S, median = 51 min [34-85]; FFP, median = 75 min [56.25-94.5]) and anesthesia (p = .02; n = 63; S, median = 80 min [66-125]; FFP, median = 111 min [91-140.8]). Neither soft palate surgery was associated with the occurrence of anesthetic complications (p = .30; 99/120; S, 49; FFP, 50), postoperative regurgitation (p = .18; 27/124; S, 17; FFP, 10), or with hospitalization duration (p = .94; n = 124; S, median = 1 day [1]; FFP, median = 1 [1]). Postoperative aspiration pneumonia (9/124; S, 4; FFP, 5) and major complications were rare (5/124; S, 3; FFP, 2). CONCLUSION: S and FFP had similar anesthetic and perioperative complications, although FFP dogs had longer anesthetic and operative times. CLINICAL SIGNIFICANCE: Although FFP took longer, no other clinically significant differences were appreciated between S and FFP procedures. Because of limitations inherent in study design, surgeons should continue to use clinical judgment when deciding on a procedure.

Gastrointestinal thickness, duration, and leak pressure of five intestinal anastomosis techniques in cats.

OBJECTIVE: To compare time to construct completion and resistance to leakage for five intestinal anastomosis techniques in cats and to report normal feline gastrointestinal thickness. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Grossly normal intestinal segments (n = 120) from 10 fresh cat cadavers. METHODS: A total of 8 cm segments of fresh feline cadaveric intestine were collected, and mural thickness was recorded. Segments were randomly allocated between a control group (n = 20 segments) and five treatment groups (20 segments/group with 2 segments/construct = 10 constructs per group): (1) hand-sewn anastomosis - simple interrupted (HSA-SI), (2) hand-sewn anastomosis - simple continuous (HSA-SC), (3) functional end-to-end stapled anastomosis (FEESA), (4) functional end-to-end stapled anastomosis with oversew (FEESA-O), (5) skin stapled anastomosis (SS). Time to construct completion, leakage location, initial leak pressure (ILP), and maximum intraluminal pressure (MIP) were compared. RESULTS: Mean mural thickness ± SD (mm) for the stomach, duodenum, jejunum, and ileum were 1.66 ± 0.28, 2.05 ± 0.18, 2.28 ± 0.30, and 2.11 ± 0.39, respectively. ILPs (mean ± SD) for HSA-SI (165 ± 122 mmHg), HSA-SC (149 ± 83), FEESA-O (63 ± 25, FEESA (84 ± 59), SS (77 ± 56), and control segments (>500) were compared. There was no statistically significant difference in ILP (p > .08) or MIP (p > .084) between any treatment groups. Nonoversewn FEESAs were 2.4 times faster to perform compared to oversewn FEESA and SS groups, and 4.7 times faster than HSA (p < .001). CONCLUSION: All anastomosis techniques provide resistance to leakage that is supraphysiological to that of the normal maximum intraluminal pressure. HSA take longer to complete than stapled anastomoses. CLINICAL SIGNIFICANCE: All anastomotic techniques may be appropriate in cats. Hand-sewn anastomoses result in a longer surgical time.

Performance time and leak pressure of hand-sewn and skin staple intestinal anastomoses and enterotomies in cadaveric cats.

OBJECTIVE: To compare time to construct completion and leak testing between hand-sewn and skin staple anastomoses and enterotomies in cats. STUDY DESIGN: Ex vivo, randomized study. ANIMALS: Fresh feline cadavers (n = 20). METHODS: Jejunal segments (8 cm) were harvested and tested on the same day as euthanasia. From each cadaver, one segment was randomly assigned to control (C), hand-sewn enterotomy (HSE), and skin staple enterotomy (SSE) groups, and two segments were randomly assigned to hand-sewn anastomosis (HSA) and skin staple anastomosis (SSA) groups. Construct completion time, initial leak pressure (ILP), and maximum intraluminal pressure were compared. Leakage location was reported. RESULTS: Mean time (s) ± SD was longer (p < .001) for HSA (317.0 ± 50.9) than SSA (160.8 ± 13.1) and for HSE (172.0 ± 36.5) than SSE (20.3 ± 5.0). ILP (mean ± SD) for C (600.0 mmHg ±0.0) was higher (p < .001) than all constructs. ILP (mean ± SD) for SSA (124.2 mmHg ±83.7) was not different (p = .49) than HSA (86.1 ± 51.9), but HSE (200.3 ± 114.7) was higher (p < .001) than SSE (32.2 ± 39.7). Immediate leakage from the center of enterotomy closure was observed in 7/20 SSE. CONCLUSIONS: HSA construct completion took twice as long as SSA with no difference in intraluminal pressures. Although HSE construct completion took 8x as long as SSE, HSE had higher intraluminal pressures. CLINICAL SIGNIFICANCE: In cats, SSA may be an alternative to HSA for intestinal anastomosis, but SSE is not recommended as an alternative to HSE for intestinal enterotomy closure.

Use of real-time near-infrared fluorescence to assess gastric viability in dogs with gastric dilatation volvulus: A case-control study.

OBJECTIVE: To describe near-infrared fluorescence (NIRF) for assessment of gastric viability and describe NIRF's influence on the surgeon's operative strategy in dogs with gastric dilatation and volvulus (GDV). STUDY DESIGN: Prospective clinical trial. ANIMALS: Twenty dogs with GDV and 20 systemically healthy dogs. METHODS: Following gastric derotation, the surgeon's subjective assessment of gastric viability was recorded prior to near-infrared imaging. Changes in the surgeon's initial assessment of viability based on the visual pattern of gastric fluorescence was recorded. If nonviable (lack of defined vessels), a partial gastrectomy was performed and submitted for histopathology. The stapled gastrectomy line was imaged. Viable (defined vessels) and nonviable fluorescence intensities were compared with healthy dogs undergoing surgery for nongastrointestinal disease. RESULTS: Subjective assessment diagnosed 17 viable and three nonviable GDVs (2 fundi; 1 cardia). Near-infrared imaging demonstrated nonviable gastric fluorescence in 4 dogs (3 fundi/cardia; 1 fundus). The surgeon's margins for resection were altered in 3/20 dogs. Fluorescence intensity (cardia, fundus, body, pylorus) was lower in GDV viable (30.59%, p = .04; 38.17%, p < .01; 51.18%, p < .01; 44.12%, p= .01) and nonviable (11.00%, p < .01; 4.33%, p < .01; 57.67%, p = .22; 54.33%, p = .72) dogs compared to healthy controls (44.7%, 70.05%, 84.00%, 63.95%). Fundic fluorescence was less in nonviable gastric tissue in comparison with viable gastric tissue (p = .03). Fluorescence of the gastrectomy staple line approximated that of viable tissue. CONCLUSION: Near-infrared fluorescence can identify histologically confirmed nonviable gastric tissue. CLINICAL SIGNIFICANCE: These results provide enough evidence to support the implementation of NIRF as an adjunct to gross examination of the gastric wall in dogs with GDV.

Cooled feline intestine and fresh intestine did not differ in enterotomy leak pressure testing or in gross wall thickness measurement.

OBJECTIVE: To report gross anatomical gastrointestinal measurements and compare enterotomy leak pressures between fresh and cooled feline cadavers. STUDY DESIGN: Ex vivo, randomized study. ANIMALS: Fresh feline cadavers (n = 20). METHODS: Jejunal segments (8 cm) were harvested on the same day as euthanasia. From each cadaver, one segment was randomly assigned to control (C), fresh enterotomy (FE), and cooled enterotomy (CE) groups. Enterotomy construction and leak testing were performed within 12 h of euthanasia for the C and FE groups and after 17-29 h of cooling for the CE group. Initial leak pressure (ILP) and maximum intraluminal pressure (MIP) were compared. Gastrointestinal wall thickness and intraluminal diameter were measured on harvested applicable gastrointestinal divisions at up to three time points: day 1 fresh, day 2 cooled, and day 3 cooled. RESULTS: The mean (± SD) ILPs for the C, FE, and CE constructs were 600 (± 0.0), 200.3 (± 114.7), and 131.3 (± 92.6) mmHg, respectively. The C ILP was higher (p < .001) than the FE and CE ILP. The ILP (p = .11) and the MIP (p = .21) did not differ between the FE and CE constructs. Wall thickness (measured in mm) did not differ between duodenum day 1 fresh and day 2 cooled groups (p = .18) or between any jejunum day groups (p = .86). The intraluminal diameters (mean ± SD) for the duodenum, jejunum, and ileum were 5.7 (± 0.7), 5.8 (± 0.8), and 7.2 (± 2.2) mm, respectively. CONCLUSION: No difference was appreciated between FE and CE ILP and MIP. Wall thickness measurements did not differ between days for duodenum or jejunum. CLINICAL RELEVANCE: Cadaveric feline intestine cooled for up to 29 h may be used for determining intestinal leak pressures.

Improved Persistence of Bacteriophage Formulation with Nano N-Acetylcysteine-Zinc Sulfide and Tomato Bacterial Spot Disease Control.

Bacteriophages are biocontrol agents used to manage bacterial diseases. They have long been used against plant pathogenic bacteria; however, several factors impede their use as a reliable disease management strategy. Short-lived persistence on plant surfaces under field conditions results mainly from rapid degradation by exposure to ultraviolet (UV) light. Currently, there are no effective commercial formulations that protect phages from UV. The phage ΦXp06-02-1, which lyses strains of the tomato bacterial spot pathogen Xanthomonas perforans, was mixed with different concentrations of the nanomaterial N-acetylcysteine surface-coated manganese-doped zinc sulfide (NAC-ZnS; 3.5 nm). In vitro, NAC-ZnS at 10,000 µg/ml formulated phage, when exposed to UV for 1 min, provided statistically equivalent plaque-forming unit (PFU) recovery as phages that were not exposed to UV. NAC-ZnS had no negative effect on the phage's ability to lyse bacterial cells under in vitro conditions. NAC-ZnS reduced phage degradation over time in comparison with the nontreated control, whereas N-acetylcysteine-zinc oxide (NAC-ZnO) had no effect. In fluorescent light, without UV exposure, NAC-ZnO-formulated phages were more infective than NAC-ZnS-formulated phages. The nanomaterial-phage mixture did not cause any phytotoxicity when applied to tomato plants. Following exposure to sunlight, the NAC-ZnS formulation improved phage persistence in the phyllosphere by 15 times compared with nonformulated phages. NAC-ZnO-formulated phage populations were undetectable within 32 h, whereas NAC-ZnS-formulated phage populations were detected at 103 PFU/g. At 4 h of sunlight exposure, NAC-ZnS-formulated phages at 1,000 µg/ml significantly reduced tomato bacterial spot disease severity by 16.4% compared with nonformulated phages. These results suggest that NAC-ZnS can be used to improve the efficacy of phages for bacterial diseases.

A quantitative evaluation of the effect of foreign body obstruction and enterectomy technique on canine small intestinal microvascular health.

OBJECTIVE: To investigate sidestream dark field (SDF) videomicroscopy as an objective measure of intestinal viability and determine the effects of enterectomy techniques on intestinal microvasculature in dogs with foreign body obstructions. STUDY DESIGN: Prospective, randomized, clinical trial. ANIMALS: A total of 24 dogs with an intestinal foreign body obstruction and 30 systemically healthy dogs. METHODS: An SDF videomicroscope imaged the microvasculature at the site of the foreign body. Subjectively viable intestine received an enterotomy whereas nonviable intestine received an enterectomy using a handsewn (4-0 polydioxanone, simple continuous) or a functional end-to-end stapled technique (GIA 60 blue, TA 60 green) was used on an alternating basis. The microvasculature adjacent to the enterectomy was interrogated. Quantitative measures of microvascular health were calculated for each site and compared with healthy dogs. RESULTS: Microvascular density (mean ± SD) at the site of obstruction (140.84 ± 77.40) was lower than healthy controls (251.72 ± 97.10, p < .01). There was no difference in microvascular parameters (density or perfused boundary region, PBR) between obstructed dogs with subjectively viable and nonviable intestine (p > .14). The density (p = .66) and PBR of microvessels (p = .76) adjacent to the sutured enterectomy or TA green staple line did not differ. CONCLUSION: Sidestream dark field videomicroscopy can identify obstructed intestine and quantitate the severity of microvascular compromise. Handsewn and stapled enterectomies equally preserve perfusion. CLINICAL SIGNIFICANCE: Stapled enterectomies do not lead to greater vascular compromise than handsewn enterectomies.

Effect of water temperature on frog virus 3 disease in hatchery-reared pallid sturgeon Scaphirhynchus albus.

Ranaviruses are large double-stranded DNA viruses within the genus Ranavirus (family Iridoviridae) that are being detected with increasing frequency among aquacultured and wild fishes. In the USA, multiple sturgeon hatcheries have experienced ranavirus epizootics resulting in significant morbidity and mortality in young-of-year (YOY). Significant economic losses have resulted from repeated outbreaks of frog virus 3 (FV3), the type species for the genus Ranavirus, in YOY pallid sturgeon Scaphirhynchus albus reared at a hatchery within the Missouri River Basin. Water temperature and stocking density are known to influence the severity of ranavirus disease in ectothermic vertebrates. To determine the effect of water temperature on ranavirus disease in hatchery-raised S. albus, we conducted FV3 challenges at 2 temperatures (17 and 23°C) and compared cumulative survival over a 28 d study period. A mean (±SE) survival rate of 57.5 ± 13.2% was observed in replicate tanks of sturgeon maintained at 23°C, whereas no mortality was observed among sturgeon maintained at 17°C. In a second challenge study, we compared the effect of water temperature on disease progression by regularly sampling fish over the study period and evaluating lesions by histopathology and in situ hybridization, and by assessing viral titer and load in external and internal tissues using virus isolation and qPCR, respectively. Results suggest that temperature manipulation may be an effective mitigation strategy that sturgeon hatcheries can employ to minimize ranavirus-associated disease.

Description and evaluation of a novel transoral endoscopic arytenopexy in canine cadavers.

OBJECTIVE: To describe the transoral endoscopic arytenopexy (TEA) and evaluate its effects on the rima glottis area (RGA) and laryngeal epiglottic-glottic seal (LEGS). We hypothesize the TEA will be a feasible surgical technique and the TEA will provide a significant increase in RGA with minimal change to the LEGS. STUDY DESIGN: Canine cadaveric model. ANIMALS: Fifteen medium- to large-breed canine cadavers. METHODS: Endoscopic photos of the larynx were taken with the epiglottis open for baseline RGA measurement and closed for baseline measurement of exposed RGA and LEGS. A custom endoscopic gag port (EGP) facilitated the TEA, performed by suturing the lateral aspect of the left arytenoid soft tissues to adjacent pharyngeal wall across the piriform recess. Endoscopic photos were repeated to measure changes in RGA and LEGS. A computerized planimetric analysis program was used to calculate baseline RGA and LEGS. The RGA was reported in % change from baseline. The LEGS was reported as intact or altered. A nonparametric Wilcoxon signed-rank test was used to compare baseline to post-TEA RGA. RESULTS: The mean baseline RGA was 0.52 ± 0.28 cm3 and mean post-TEA RGA was 0.78 ± 0.37 cm3 (p-value < .0001). The LEGS remained intact post-TEA in all cadavers. CONCLUSIONS: The TEA was technically feasible and resulted in an increase in RGA while maintaining the LEGS. CLINICAL SIGNIFICANCE: The TEA may provide a minimally invasive addition to the established techniques for reducing airway resistance while minimizing the impact on the LEGS.

Instrumental and sensory analyses of fruit quality attributes of grafted grape tomatoes in high tunnel organic production systems.

BACKGROUND: 'Vegetative' and 'generative' tomato rootstock types have been proposed based on their different effects on tomato scion growth performance; however, their impacts on fruit quality have not been characterized. No study has been conducted in which the effects of rootstock on grape tomato quality attributes were assessed using sensory and instrumental methods of evaluation. Here, we conducted two experiments to examine the influence of 'DR0141TX', 'Estamino', and 'Multifort' rootstocks (vegetative, generative, and uncharacterized, respectively) on fruit quality properties of determinate and indeterminate grape tomato scions under organic production in high tunnels, including color, size, firmness, dry matter content, soluble solids content (SSC), titratable acidity (TA), pH, and consumer sensory attributes. RESULTS: In both experiments, grafting 'Sweet Hearts' indeterminate grape tomato onto 'DR0141TX', 'Estamino', or 'Multifort' increased fruit size and led to negligible effects on sensory attributes and instrumental measurements of fruit quality attributes. For 'BHN 1022' determinate grape tomato, rootstocks did not exhibit any major impact on fruit quality attributes in Experiment 1. However, fruit quality was compromised by grafting per se and rootstocks, especially 'Multifort', in Experiment 2, as reflected by reduced SSC, TA, and SSC/TA and lower scores for overall appearance, overall acceptability, tomato flavor, overall texture, and sweetness. CONCLUSION: In general, 'vegetative' and 'generative' rootstocks showed comparable effects on sensory evaluations and instrumental measurements of grape tomato quality attributes for both indeterminate and determinate scions. More research is needed to better characterize rootstock effects on fruit quality, including the flavor-related compounds under different growing conditions. © 2022 Society of Chemical Industry.

Need for speed: bacterial effector XopJ2 is associated with increased dispersal velocity of Xanthomonas perforans.

Bacterial spot caused by Xanthomonas perforans (Xp) is an economically important disease in tomato. Previous studies have shown that the recently isolated Xp strains have acquired and retained the effector gene, xopJ2, which has been reported to increase fitness of the pathogen in the field. To elucidate the fitness benefit of xopJ2, we quantified the effect of xopJ2 on the dispersal and evolution of Xp populations on tomato. We compared movement of two wild-type Xp strains expressing xopJ2 to their respective xopJ2 mutants when co-inoculated in the field. We developed a binary logistic model to predict the presence of Xp over spatial and temporal dimensions with or without xopJ2. Based on the model, wild-type bacteria were dispersed approximately three times faster than the xopJ2 mutants. In a simulation experiment, the selective advantage due to increased dispersal velocity led to an increase in the frequency of xopJ2 gene in the Xp population and its apparent fixation within 10 to 12 cropping seasons of the tomato crop. Our results show that the presence of a single gene can affect the dispersal of a bacterial pathogen and significantly alter its population dynamics.

Magnesium Oxide Nanomaterial, an Alternative for Commercial Copper Bactericides: Field-Scale Tomato Bacterial Spot Disease Management and Total and Bioavailable Metal Accumulation in Soil.

Copper (Cu) is the most extensively used bactericide worldwide in many agricultural production systems. However, intensive application of Cu bactericide have increased the selection pressure toward Cu-tolerant pathogens, including Xanthomonas perforans, the causal agent of tomato bacterial spot. However, alternatives for Cu bactericides are limited and have many drawbacks including plant damage and inconsistent effectiveness under field conditions. Also, potential ecological risk on nontarget organisms exposed to field runoff containing Cu is high. However, due to lack of alternatives for Cu, it is still widely used in tomato and other crops around the world in both conventional and organic production systems. In this study, a Cu-tolerant X. perforans strain GEV485, which can tolerate eight tested commercial Cu bactericides, was used in all the field trials to evaluate the efficacy of MgO nanomaterial. Four field experiments were conducted to evaluate the impact of intensive application of MgO nanomaterial on tomato bacterial spot disease severity, and one field experiment was conducted to study the impact of soil accumulation of total and bioavailable Cu, Mg, Mn, and Zn. In the first two field experiments, twice-weekly applications of 200 µg/mL MgO significantly reduced disease severity by 29-38% less in comparison to a conventional Cu bactericide Kocide 3000 and 19-30% less in comparison to the water control applied at the same frequency (p = 0.05). The disease severity on MgO twice-weekly was 12-32% less than Kocide 3000 + Mancozeb treatment. Single weekly applications of MgO had 13-19% higher disease severity than twice weekly application of MgO. In the second set of two field trials, twice-weekly applications of MgO at 1000 µg/mL significantly reduced disease severity by 32-40% in comparison to water control applied at the same frequency (p = 0.05). There was no negative yield impact in any of the trials. The third field experiment demonstrated that application of MgO did not result in significant accumulation of total and bioavailable Mg, Mn, Cu, or Zn in the root-associated soil and in soil farther away from the production bed compared to the water control. However, Cu bactericide contributed to significantly higher Mn, Cu, and Zn accumulation in the soil compared to water control (p = 0.05). This study demonstrates that MgO nanomaterial could be an alternative for Cu bactericide and have potential in reducing risks associated with development of tolerant strains and for reducing Cu load in the environment.

Ex vivo comparison of leak testing of canine jejunal enterotomies: Saline infusion versus air insufflation.

OBJECTIVE: To compare the ability to detect leakage of enterotomy closures by intraluminal injection of saline or air. STUDY DESIGN: Ex vivo study. ANIMALS: Grossly normal jejunal segments (n = 60) from five fresh canine cadavers. METHODS: Eight-centimeter jejunal segments were randomly assigned to two control (saline control [n = 5], air control [5]) and two treatment groups (injection of saline [n = 25] or air [25] after enterotomies were closed in a simple continuous pattern using 4-0 glycomer 631). Initial leak pressure (ILP, mean ± SD), maximum intraluminal pressure (MIP), and leakage location were compared. For all air insufflation constructs, the volume of air insufflated at the time of initial leakage was recorded. RESULTS: The ILPs of control segments did not differ whether injected with saline (405.71 ± 56.97 mmHg) or air (376.84 ± 42.54, p = 1.00). Enterotomy closures leaked at lower pressures when injected with air (ILP: 68.52 ± 6.56) compared to saline (87.76 ± 5.20, p = .03). Similar results were obtained when comparing MIPs. A moderate association (r = .51) was identified between volume of air infused and ILPs. The strength of the association improved when stratified by cadaver. The location of leakage-most commonly suture tracks-was identified for all air constructs and for 14 of 25 saline constructs. CONCLUSION: Enterotomy closures leaked at lower pressures after intraluminal injection of air compared to saline. CLINICAL SIGNIFICANCE: Intraoperative leak testing of small intestinal enterotomy closures may be rendered more sensitive and precise by the use of air instead of saline as the infusate.

Interpretation of cardiac chamber size on canine thoracic radiographs is limited and may result in the false identification of right-sided cardiomegaly in the presence of severe left-sided cardiomegaly.

Qualitative assessment of individual cardiac chamber enlargement on thoracic radiographs was assessed using echocardiography as the gold standard in dogs. Using this method, the presence of severe left-sided cardiomegaly was hypothesized to contribute to the false identification of right-sided cardiomegaly on radiographs. 175 dogs with three-view thoracic radiographs were retrospectively included in this diagnostic accuracy study if echocardiography was done within 24 h, and no rescue therapy was provided in the interim. All radiographic studies were reviewed by two groups of five board-certified veterinary radiologists with greater and less than 10 years of experience for grading of cardiac chamber enlargement as normal or mildly, moderately, or severely enlarged. The agreement, sensitivity, and specificity of the radiologists' interpretation of cardiac chamber size on thoracic radiographs to measured echocardiographic grades were evaluated. A total of 147 cases had complete echocardiographic data available for analysis. Intragroup agreement was moderate for the evaluation of left atrial enlargement and slight to fair for all other cardiac chambers. Between the mode of the radiologists' responses in the two groups and the echocardiographic grades, there was slight agreement for all cardiac chambers with higher severity grades reported using echocardiography. When moderate to severe left-sided cardiomegaly was identified on echocardiography, the sensitivity, specificity, and accuracy of radiographs were low, identifying dogs with radiographic evidence of right-sided cardiomegaly in the absence of corresponding right-sided cardiomegaly on echocardiography. Therefore, thoracic radiographs should be used with caution for the evaluation of cardiac chamber enlargement, particularly in the presence of severe left-sided cardiomegaly.

Effect of a Spay Simulator on Student Competence and Anxiety.

Spay simulation has gained attention at colleges of veterinary medicine that seek to utilize low-cost models in lieu of more cost-prohibitive high-fidelity devices or cadaveric specimens. A spay simulator was developed to provide veterinary students at the University of Florida College of Veterinary Medicine a reusable, inexpensive, and error-enabled device for self-practice in anticipation of a live canine ovariohysterectomy. Seventy-four students were recruited, half of whom participated in spay simulation training. A survey was designed to capture students' state and trait anxiety, as well as their self-assessed perceived levels of competence, confidence, and knowledge of anatomy, before and after their live animal surgery. During the live surgical laboratories, surgical competencies were assessed using the Objective Structured Assessment of Technical Skills (OSATS) for operative performance. We hypothesized that the spay simulation training group would have higher reported levels of competence, confidence, and knowledge of anatomy. Additionally, students enrolled in spay simulation training were expected to exhibit a lower level of post-operative anxiety and higher OSATS scores compared with the control group. Results demonstrated a significant increase in perceived anatomical knowledge and improvement in perceived competence level following spay simulation training as compared with the control group. Areas of no difference included perceived confidence, OSATS scores, and overall level of anxiety. The results of this study demonstrate that this low-fidelity spay simulator has a unique place in student surgical training, producing novice surgeons with increased perceived competence and knowledge of anatomy following spay simulation training and live animal surgery.

Dietary Intake and Diet Quality of Hematopoietic Stem Cell Transplantation Survivors.

Hematopoietic stem cell transplantation (HCT) survivors are burdened by a high prevalence and early onset of chronic diseases. Healthy dietary patterns have been associated with lower risks of chronic health conditions in the general population. HCT survivors are susceptible to multiple complications that may result in chronic illness. Unfortunately, no study to date has comprehensively documented the adherence of HCT survivors to the Dietary Guidelines for Americans (DGA), which are designed specifically to provide guidance for making healthy food choices. The primary aim of this study was to evaluate diet quality and nutrient intake adequacy of HCT survivors. A secondary aim was to assess these survivors' willingness to take part in a future dietary intervention. The dietary intake of adults who had undergone autologous or allogeneic HCT for a hematologic disease and were at least 1 year post-transplantation was assessed using the Block 2014 food frequency questionnaire, and diet quality was estimated using the Healthy Eating Index 2015. Nutrient intake adequacies of the group were estimated by the estimated average requirement cutpoint method. Survivors' (n = 90) HEI-2015 scores averaged 61.6 ± 1.1. Adherence to a good-quality diet was reported by only 10% of survivors. Intakes of vitamins A, C, and D, as well as magnesium and calcium, suggested inadequacy. Fiber intake at 8.9 g per 1000 kcal/day fell below the recommended adequate intake. "Change in taste" was associated with lower quality of diet (P = .02). HCT survivors within 2 years post-transplantation were more receptive than survivors beyond 2 years to participating in a dietary intervention (95% versus 65%; P = .0013). Adult HCT survivors reported less-than-optimal adherence to the 2015-2020 DGA and had numerous shortfall nutrient intakes; however, their willingness to participate in a dietary intervention was relatively high. These findings reinforce the need to incorporate nutrition into HCT survivor care.

Stool frequency and form and gastrointestinal symptoms differ by day of the menstrual cycle in healthy adult women taking oral contraceptives: a prospective observational study.

BACKGROUND: Little is known about how the menstrual cycle affects gastrointestinal function and self-reported stress in young, healthy women taking oral contraceptives (OC). This study prospectively characterized gastrointestinal function and symptoms on each day throughout the menstrual cycle. METHODS: Healthy women aged 18-35 years (n = 78) who took OC participated in the 5-week observational study. Stool frequency, self-reported stress, stool form measured by the Bristol Stool Form Scale (BSFS), and gastrointestinal symptoms measured by a modified version of the Gastrointestinal Symptom Rating Scale (GSRS) were assessed daily. GSRS scores were reported (1 = no discomfort at all, 7 = very severe discomfort) and were averaged for individual syndrome scores or summed for the total score. The validated, weekly version of the GSRS was completed at two time points to reflect menstruation and 1 week prior to menstruation (n = 72). Outcomes were analyzed in linear mixed models with the Dunnett's post hoc test against day 1 of menstrual bleeding or with nonparametric tests. RESULTS: Daily stress (P = 0.0018), BSFS score (P = 0.0493), stool frequency (P = 0.0241), abdominal pain (P < 0.0001), diarrhea (P = 0.0022), constipation (P = 0.0446), reflux (P = 0.0193), and indigestion (P < 0.0001) all varied significantly by the day of the menstrual cycle. Dunnett's post hoc tests showed that scores (mean ± SEM) on the first day of bleeding (day 1) for daily abdominal pain (2.6 ± 0.2), diarrhea (1.7 ± 0.1), and indigestion (2.1 ± 0.2) symptoms were higher than scores on all other days of the menstrual cycle (P < 0.05) with scores not on day 1 falling under 1.5, or between no discomfort at all and slight discomfort. Reflux, stool frequency, BSFS, self-reported stress, and constipation were higher on day 1 (P < 0.05) than on 12, 8, 6, 4, and 2 other days of the menstrual cycle, respectively. The median (IQR) GSRS score was higher during the week of menstruation than the week prior to menstruation for diarrhea [1.50 (1.00-2.33) vs 1.33 (1.00-2.00), P = 0.002] and abdominal pain [2.00 (1.33-2.67) vs 1.67 (1.33-2.33), P = 0.011] syndrome scores. CONCLUSION: Bowel habits appear to vary across the menstrual cycle and suggest more gastrointestinal discomfort on day 1 of menstrual bleeding in healthy women taking OC. Future interventional studies could identify ways to improve gastrointestinal symptoms in healthy women during menstruation.

Effectiveness of video-assisted, self-directed, and peer-guided learning in the acquisition of surgical skills by veterinary students.

OBJECTIVE: To determine the influence of self-directed learning, peer feedback, or expert feedback on suturing technique of novice veterinary student surgeons. STUDY DESIGN: Prospective, blinded, video feedback study. SAMPLE POPULATION: Three groups of surgery naïve veterinary students, two groups of 37 students and one group with 36 students. METHODS: Each student completed three cruciate sutures in SynDaver skin. Student performance was video recorded and scored with a validated pro forma. Students were randomly divided into three groups: (1) students critically evaluated their own performance, (2) students critically evaluated peer's performance, and (3) students received a peer's evaluation. Each student repeated the surgical task and assessed his or her own performance, guided by the pro forma. Each student received a video with individualized feedback from an expert prior to repeating the task. Scores and times were analyzed. Student and expert evaluations were compared. RESULTS: Task composite score, time to completion, and completion rate did not differ between groups. Student self-assessed scores did not correlate with expert scores. Forty-three percent and 62% of students stated that self-feedback and peer feedback, respectively, were acceptable forms of learning, and 96% of students felt expert feedback was superior to both. CONCLUSION: Video-based self-evaluation and peer-assisted learning were as effective as expert feedback after didactic lecture in teaching suturing technique to novice veterinary surgeons. CLINICAL SIGNIFICANCE: Video-based self-evaluation and peer feedback were viable alternative teaching strategies to didactic lecture and expert feedback alone for instructing novice veterinary surgeons.