Evaluation of serum vitamin D metabolites, phagocytosis, and biomarkers of inflammation in dogs with naturally occurring diabetes mellitus.

Naturally occurring diabetes mellitus (NODM) is one of the most common endocrine disorders in dogs and its etiology closely resembles type 1 diabetes mellitus (T1DM) in people. Human patients with T1DM commonly have cellular derangements consistent with inflammation, impaired immune function, and hypovitaminosis D. There is little information available regarding inflammatory biomarkers, immune function, and vitamin D status in diabetic dogs. Therefore, our objectives were to assess inflammatory biomarkers, vitamin D metabolites, and phagocytic capacity in diabetic dogs and determine whether associations exist with these variables and the level of clinical control or vitamin D metabolites. This was a prospective case-control study that included 20 otherwise healthy diabetic dogs (clinically controlled, n = 10; uncontrolled, n = 10) and 20 non-diabetic, healthy, age (± 2 years), breed, and sex matched controls. Complete blood count, biochemical panel, urinalysis, and fructosamine were performed at a single commercial reference laboratory. Basal plasma tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, and IL-10 were measured using a canine-specific multiplex bead-based assay. Serum C-reactive protein (CRP) was measured using a commercially available ELISA kit. Serum 25-hydroxyvitamin (OH)D3 and 24,25-dihydroxyvitamin (OH)2D3 were measured with HPLC. Phagocytosis of opsonized-Escherichia coli (E. coli) was evaluated with flow cytometry. Diabetic dogs had higher serum CRP concentrations than controls (p = 0.02). Plasma IL-8 concentrations were higher in diabetic dogs with uncontrolled clinical disease compared to controls (p = 0.02). Diabetic dogs had a lower percentage of leukocytes that phagocytized opsonized-E. coli (p = 0.02), but an increased number of bacteria phagocytized per cell (p < 0.001) compared to controls. No between-group differences were identified in vitamin D metabolites, nor were associations found between vitamin D and any variables. Fructosamine had a positive association with serum CRP concentration (rho = 0.35, p = 0.03) and number of bacteria phagocytized per cell (rho = 0.45, p = 0.004) in our cohort (n = 40). Like people with T1DM, diabetic dogs have a proinflammatory phenotype and phagocytic dysregulation that may be correlated with glycemic control.

Ex Vivo Immune Function and Modulatory Effects of Calcitriol in Dogs with Naturally Occurring Diabetes Mellitus.

Human patients with type 1 diabetes mellitus (T1DM) are susceptible to several long-term complications that are related to glycemic control and immune dysregulation. Immune function remains relatively unexplored in dogs with naturally occurring diabetes mellitus (NODM). Calcitriol improves various aspects of immune function in a variety of species, but its effect in diabetic dogs remains unexplored. Therefore, the objectives of this study were to (i) evaluate immune function in dogs with NODM and determine if differences exist based on the level of clinical control and (ii) assess the immunomodulatory effects of calcitriol. Twenty diabetic dogs (clinically controlled, n = ten, not controlled, n = ten) and 20 non-diabetic, healthy control dogs were included in this prospective, case-control study. Whole blood was incubated with calcitriol (10-7 M) or negative control, after which the samples were divided for phagocytosis and leukocyte cytokine response experiments. The phagocytosis of opsonized Escherichia coli (E. coli) was evaluated with flow cytometry. The samples for leukocyte cytokine response evaluations were stimulated with lipopolysaccharide (LPS), lipoteichoic acid (LTA), or phosphate buffer solution (PBS; negative control), and tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, and IL-10 were measured in supernatant using a canine-specific multiplex bead-based assay. The leukocytes from diabetic dogs produced higher concentrations of IL-10 (p = 0.01), IL-6 (p < 0.0001), and IL-8 (p < 0.0001) than the control dogs while controlling for the intervention and stimulant. Calcitriol decreased the supernatant concentrations of TNF-α (p < 0.001) and IL-8 (p = 0.04) with concomitant increases in IL-6 (p = 0.005). Diabetic dogs had a lower percentage of leukocytes undergoing phagocytosis (p < 0.0001) but a higher number of bacteria phagocytized per cell (p = 0.001) when compared to the control dogs. Calcitriol had no effect on phagocytic capacity. Lastly, the status of clinical control in diabetic dogs did not yield differences in immune function. These results support that dogs with NODM exhibit immune dysregulation and warrant additional investigation.

A Systematic Review of Vaccination Guidance for Humanitarian Responses.

Delivering vaccines in humanitarian response requires rigourous and continuous analysis of evidence. This systematic review mapped the normative landscape of vaccination guidance on vaccine-preventable diseases in crisis-affected settings. Guidance published between 2000 and 2022 was searched for, in English and French, on websites of humanitarian actors, Google, and Bing. Peer-reviewed database searches were performed in Global Health and Embase. Reference lists of all included documents were screened. We disseminated an online survey to professionals working in vaccination delivery in humanitarian contexts. There was a total of 48 eligible guidance documents, including technical guidance (n = 17), descriptive guidance (n = 16), operational guidance (n = 11), evidence reviews (n = 3), and ethical guidance (n = 1). Most were World Health Organization documents (n = 21) targeting children under 5 years of age. Critical appraisal revealed insufficient inclusion of affected populations and limited rigour in guideline development. We found limited information on vaccines including, yellow fever, cholera, meningococcal, hepatitis A, and varicella, as well as human papilloma virus (HPV). There is a plethora of vaccination guidance for vaccine-preventable diseases in humanitarian contexts. However, gaps remain in the critical and systematic inclusion of evidence, inclusion of the concept of "zero-dose" children and affected populations, ethical guidance, and specific recommendations for HPV and non-universally recommended vaccines, which must be addressed.

Twenty Eight Days in the Life of a Vocal Pathology: A Case Study of Videolaryngostroboscopy, Acoustic, and Perceptual Variability.

The purpose of this investigation was to observe laryngeal tissue and vocal function changes over the course of 28 days in a single participant diagnosed by a laryngologist with bilateral nodules. Laryngeal imaging, acoustic variables and perceptual assessments of voice quality, and perceived vocal effort were obtained every morning for 28 consecutive days. A daily journal of occupational and recreational voice use as well as menstruation and alcohol consumption was maintained each day. It was hypothesized that the laryngeal pathology would appear more extensive and the vocal function measures obtained would be worse following extensive voice use. Laryngeal imaging, acoustic variables, and perceptual measures quantified provided evidence to support the study hypotheses. The size, extent, and asymmetry of the bilateral vocal pathologies observed were more extensive on days following occupational and recreational vocal loading. Acoustic and perceptual measures obtained correlated with the laryngeal tissue changes observed. Study findings support a more holistic approach to laryngeal pathology diagnosis that is based on a more thorough understanding of vocal loading considerations up to 48 hours prior to laryngeal endoscopy to better understand the pathophysiology of the observed lesion(s) for most accurate clinical diagnosis.

Vocal Function Differences Before and After Sorority Recruitment.

PURPOSE: Participation in sorority recruitment often results in acute vocal impairment. The purpose of this investigation was to characterize the extent to which voice function and laryngeal appearance may be altered by participation in this social phenomenon. METHODS: Using a within-participant repeated measures design, nine women participating as sorority recruiters completed the study protocol. The following data were collected at two time points, immediately before and after the completion of two weeks of sorority recruitment: stroboscopic laryngeal imaging, vocal acoustic measures, and perceptual measures of vocal effort and voice quality. RESULTS: Perceived phonatory effort and overall severity of voice quality were significantly impaired following sorority recruitment. All participants had evidence of mucosal changes in the form of one or more the following: observed edema, erythema, increased vascularity, glottic margin changes. No significant differences in acoustic measures were identified. CONCLUSIONS: Increased perceived vocal effort, increased overall severity ratings of voice quality, and deleterious vocal fold tissue changes observed support the hypothesis that the acute vocal loading that is characteristic of the sorority recruitment process contributes to a decline in voice function in the short term. Acoustic measures taken either lacked the sensitivity for the perceived decline in voice function or the participants, who were otherwise healthy, managed to adapt the acoustic signal to the tissue changes observed. The extent to which these acute changes may be mitigated with vocal hygiene and voice training is an area for future study.

Irritant-Induced Chronic Cough Triggers: A Scoping Review and Clinical Checklist.

Purpose The primary aim of this review was to identify environmental irritants known to trigger chronic cough through the life span and develop a comprehensive clinically useful irritant checklist. Method A scoping review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews, checklist, and explanation. English-language, full-text resources were identified through Medline, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertations and Theses Global. Results A total of 1,072 sources were retrieved; of these, 109 were duplicates. Titles of abstracts of 963 articles were screened, with 295 selected for full-text review. Using the exclusion and inclusion criteria listed, 236 articles were considered eligible and 214 different triggers were identified. Triggers were identified from North America, Europe, Africa, Asia, and Australia. Occupational exposures were also delineated. Conclusions A clinically useful checklist of both frequently encountered triggers and idiosyncratic or rare triggers was developed. The clinical checklist provides a unique contribution to streamline and standardize clinical assessment of irritant-induced chronic cough. The international scope of this review extends the usefulness of the clinical checklist to clinicians on most continents.

Vocal Dose for Rhythm-Based Indoor Cycling Instructors: With and Without Amplification.

The purpose of this research was to characterize the voice physiology requirements of indoor cycling instructors as measured by vocal dose (distance the vocal folds travel and average voice intensity) and perceived phonatory effort with and without amplification. Using a within-participant repeated measures design, eight rhythm-based cycling instructors were consented and scheduled to teach two ecologically valid cycling fitness classes, one amplified and one without amplification. Objective measures included vocal dosimetry and ambient sound level. Perceived phonatory effort and participant demographic information were also collected. Trials were counterbalanced to avoid an order effect. Data analyses indicated a significant difference in perceived phonatory effort between trials (P = 0.005) with the amplified trial resulting in a lower effort. Statistically significant differences between vocal distance dose were not found, with an unexpected finding of increased distance dose with use of amplification. Average voice intensity for female participants was 99.6 dB with amplification and 96.1 dB without amplification. This investigation highlights the importance of occupation specific study of voice use requirements and the difficulty in generalizing the findings from one occupational voice user group to another.

Sand crickets (Gryllus firmus) have low susceptibility to entomopathogenic nematodes and their pathogenic bacteria.

The entomopathogenic nematode, Steinernema scapterisci, a specialist parasite of crickets, has been successfully used to combat the southern mole cricket, Neoscapteriscus borellii, which is an invasive pest of turf grass. As an entomopathogenic nematode, S. scapterisci causes rapid death of the insects it infects and uses bacteria to facilitate its parasitism. However, our understanding of the relative contributions of the nematode, S. scapterisci, and its bacterial symbiont, Xenorhabdus innexi, to parasitism remains limited. Here we utilized the sand cricket, Gryllus firmus, as a model host to evaluate the contributions of the EPNs S. scapterisci and S. carpocapsae, as well as their symbiotic bacteria, X. innexi and X. nematophila, respectively, to the virulence of the nematode-bacterial complex. We found that G. firmus has reduced susceptibility to infection from both S. scapterisci and the closely related generalist parasite S. carpocapsae, but that S. scapterisci is much more virulent than S. carpocapsae. Further, we found that N. borellii has reduced susceptibility to X. nematophila, and that G. firmus has reduced susceptibility to X. nematophila, X. innexi, and Serratia marcescens, much more so than other insects that have been studied. We found that the reduced susceptibility of G. firmus to bacterial infection is dependent on development, with adults being less susceptible to infection than nymphs. Our data provide evidence that unlike other EPNs, the virulence of S. scapterisci to crickets is dependent on the nematode rather than the bacterial symbiont that it carries and we speculate that S. scapterisci may be evolving independence from X. innexi.

Establishing a Long-Term Model for Analysis and Improvement of Underfilled Blood Culture Volumes.

Objectives: Underfilling of blood culture bottles decreases the sensitivity of the culture. We attempt to increase average blood culture fill volumes (ABCFVs) through an educational program. Methods: Partnerships were established with four hospital units (surgical intensive care unit [SICU], medical intensive care unit [MICU], medical intermediate care unit [MIMCU], and hematology and oncology unit [HEME/ONC]). ABCFVs were continuously tracked and communicated to each unit monthly. Educational sessions were provided to each unit. Results: ABCFVs for the SICU, MICU, MIMCU, and HEME/ONC were 4.8, 5.0, 5.0, and 6.3 mL/bottle, respectively. After the final education session, the SICU, MICU, MIMCU, and HEME/ONC were able to maintain an ABCFV of 6.8, 8.1, 7.9, and 8.2 mL/bottle, respectively. Conclusions: Partnering with a specific unit and providing monthly volume reports with educational sessions has a direct positive correlation on increasing ABCFVs. Increasing ABCFVs has the potential to decrease false-negative blood cultures, time to detection of positive blood cultures, and time to appropriate and specific antimicrobial therapy, as well as improve patient outcomes in high-acuity patient care units.

The Importance of Trust in the Adoption and Use of Intelligent Assistive Technology by Older Adults to Support Aging in Place: Scoping Review Protocol.

BACKGROUND: Intelligent assistive technologies that complement and extend human abilities have proliferated in recent years. Service robots, home automation equipment, and other digital assistant devices possessing artificial intelligence are forms of assistive technologies that have become popular in society. Older adults (>55 years of age) have been identified by industry, government, and researchers as a demographic who can benefit significantly from the use of intelligent assistive technology to support various activities of daily living. OBJECTIVE: The purpose of this scoping review is to summarize the literature on the importance of the concept of "trust" in the adoption of intelligent assistive technologies to assist aging in place by older adults. METHODS: Using a scoping review methodology, our search strategy will examine the following databases: ACM Digital Library, Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, PsycINFO, Scopus, and Web of Science. Two reviewers will independently screen the initial titles obtained from the search, and these results will be further inspected by other members of the research team for inclusion in the review. RESULTS: This review will provide insights into how the concept of trust is actualized in the adoption of intelligent assistive technology by older adults. Preliminary sensitization to the literature suggests that the concept of trust is fluid, unstable, and intimately tied to the type of intelligent assistive technology being examined. Furthermore, a wide range of theoretical lenses that include elements of trust have been used to examine this concept. CONCLUSIONS: This review will describe the concept of trust in the adoption of intelligent assistive technology by older adults, and will provide insights for practitioners, policy makers, and technology vendors for future practice.