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AIMS: To identify farm-level risk factors for dairy cow lameness, and to describe lameness treatment protocols used on New Zealand dairy farms. METHODS: One hundred and nineteen farms from eight veterinary clinics within the major dairying regions of New Zealand were randomly enrolled into a cross-sectional lameness prevalence study. Each farmer completed a questionnaire on lameness risk factors and lameness treatment and management. Trained observers lameness scored cattle on two occasions, between October-December (spring, coinciding with peak lactation for most farms) and between January-March (summer, late lactation for most farms). A four-point (0-3) scoring system was used to assess lameness, with animals with a lameness score (LS) ≥2 defined as lame. At each visit, all lactating animals were scored including animals that had previously been identified lame by the farmer. Associations between the farmer-reported risk factors and lameness were determined using mixed logistic regression models in a Bayesian framework, with farm and score event as random effects. RESULTS: A lameness prevalence of 3.5% (2,113/59,631) was reported at the first LS event, and 3.3% (1,861/55,929) at the second LS event. There was a median prevalence of 2.8% (min 0, max 17.0%) from the 119 farms. Most farmers (90/117; 77%) relied on informal identification by farm staff to identify lame animals. On 65% (75/116) of farms, there was no external provider of lame cow treatments, with the farmer carrying out all lame cow treatments. Most farmers had no formal training (69/112; 62%). Animals from farms that used concrete stand-off pads during periods of inclement weather had 1.45 times the odds of lameness compared to animals on farms that did not use concrete stand-off pads (95% equal-tailed credible interval 1.07-1.88). Animals from farms that reported peak lameness incidence from January to June or all year-round, had 0.64 times odds of lameness compared to animals from farms that reported peak lameness incidence from July to December (95% equal-tailed credible interval 0.47-0.88). CONCLUSIONS: Lameness prevalence was low amongst the enrolled farms. Use of concrete stand-off pads and timing of peak lameness incidence were associated with odds of lameness. CLINICAL RELEVANCE: Veterinarians should be encouraging farmers to have formal lameness identification protocols and lameness management plans in place. There is ample opportunity to provide training to farmers for lame cow treatment. Management of cows on stand-off pads should consider the likely impact on lameness.
Subject(s)
Cattle Diseases , Dairying , Lameness, Animal , Animals , Lameness, Animal/epidemiology , Lameness, Animal/therapy , Cattle , New Zealand/epidemiology , Risk Factors , Cattle Diseases/epidemiology , Cattle Diseases/therapy , Cross-Sectional Studies , Female , Prevalence , Surveys and Questionnaires , Farms , FarmersABSTRACT
BACKGROUND: The introduction of rituximab significantly improved the prognosis of diffuse large B-cell lymphoma (DLBCL), emphasizing the importance of evaluating the long-term consequences of exposure to radiotherapy, alkylating agents and anthracycline-containing (immuno)chemotherapy among DLBCL survivors. METHODS: Long-term risk of subsequent malignant neoplasms (SMNs) was examined in a multicenter cohort comprising 2373 5-year DLBCL survivors treated at ages 15-61 years in 1989-2012. Observed SMN numbers were compared with expected cancer incidence to estimate standardized incidence ratios (SIRs) and absolute excess risks (AERs/10 000 person-years). Treatment-specific risks were assessed using multivariable Cox regression. RESULTS: After a median follow-up of 13.8 years, 321 survivors developed one or more SMNs (SIR 1.5, 95% CI 1.3-1.8, AER 51.8). SIRs remained increased for at least 20 years after first-line treatment (SIR ≥20-year follow-up 1.5, 95% CI 1.0-2.2, AER 81.8) and were highest among patients ≤40 years at first DLBCL treatment (SIR 2.7, 95% CI 2.0-3.5). Lung (SIR 2.0, 95% CI 1.5-2.7, AER 13.4) and gastrointestinal cancers (SIR 1.5, 95% CI 1.2-2.0, AER 11.8) accounted for the largest excess risks. Treatment with >4500 mg/m2 cyclophosphamide/>300 mg/m2 doxorubicin versus ≤2250 mg/m2/≤150 mg/m2, respectively, was associated with increased solid SMN risk (hazard ratio 1.5, 95% CI 1.0-2.2). Survivors who received rituximab had a lower risk of subdiaphragmatic solid SMNs (hazard ratio 0.5, 95% CI 0.3-1.0) compared with survivors who did not receive rituximab. CONCLUSION: Five-year DLBCL survivors have an increased risk of SMNs. Risks were higher for survivors ≤40 years at first treatment and survivors treated with >4500 mg/m2 cyclophosphamide/>300 mg/m2 doxorubicin, and may be lower for survivors treated in the rituximab era, emphasizing the need for studies with longer follow-up for rituximab-treated patients.
Subject(s)
Lymphoma, Large B-Cell, Diffuse , Neoplasms, Second Primary , Humans , Rituximab/adverse effects , Neoplasms, Second Primary/epidemiology , Neoplasms, Second Primary/etiology , Survivors , Cyclophosphamide , Doxorubicin , Lymphoma, Large B-Cell, Diffuse/epidemiologyABSTRACT
To understand the current impact of lameness on a system, it is important to define lameness prevalence across a range of dairy farms in that system. Prevalence estimates from dairy systems where cows are permanently managed at pasture are uncommon, although the limited data suggest that they have a lower lameness prevalence than housed cattle. One hundred and 20 farms from eight of the major dairying regions of New Zealand were randomly enrolled into a cross-sectional lameness prevalence study. On each of the farms, trained observers lameness scored cattle on two occasions, between October-December (spring, coinciding with peak lactation for most farms) and between January-March (summer, late lactation for most farms). At each visit, all lactating animals were scored using a four-point 0-3 scoring system, and included animals that had previously been identified as lame by the farmer. Animals with a lameness score (LS) ≥2 were defined as lame. Mixed logistic regression models assessed the interaction between region and season and island and season, respectively, and differences between the lameness prevalence within farm across the two seasons reported descriptively. A total of 116,317 locomotion scores over two events were conducted across the 120 farms. At the spring scoring event, 2128/60,007 (3.5 %) cows had a LS ≥2 and 1868/56,310 (3.3 %) cows had a LS ≥ 2 at the summer scoring event. At the farm level, across both scoring events, median lameness prevalence was 2.8 (interquartile range 1.5 - 4.5) %, with a range of 0.0-17.0 %. The median farm-level prevalence of LS = 3 was 0.5 % with a range of 0-4.6 %. The effect of timing of scoring was modified by region (p < 0.001), and island (p = 0.006) and at the individual farm level, differences between spring and summer farm level lameness prevalence were generally small (interquartile range: -1.8 to 1.0 %) but potentially large on individual farms (range from -12.3 % to 7.6 %). The median farm-level lameness prevalence estimate of 2.8 % across a random representative sample of New Zealand dairy farms give confidence that the overall prevalence of cattle lameness on New Zealand dairy farms is low. This adds to the growing evidence that pasture is a good management system with respect to hoof health. The evidence of strong seasonality of lameness was lacking. Instead of using lameness scoring to identify farms with large lameness problems, lameness scoring should be encouraged to farmers as a tool to improve the identification of lame animals.
Subject(s)
Cattle Diseases , Lactation , Female , Animals , Cattle , Farms , Prevalence , New Zealand/epidemiology , Lameness, Animal/epidemiology , Lameness, Animal/etiology , Cross-Sectional Studies , Cattle Diseases/epidemiology , Dairying/methodsABSTRACT
Background: For cancer patients to effectively engage in decision making, they require comprehensive and understandable information regarding treatment options and their associated outcomes. We developed an online prediction tool and supporting communication skills training to assist healthcare providers (HCPs) in this complex task. This study aims to assess the impact of this combined intervention (prediction tool and training) on the communication practices of HCPs when discussing treatment options. Methods: We conducted a multicenter intervention trial using a pragmatic stepped wedge design (NCT04232735). Standardized Patient Assessments (simulated consultations) using cases of esophageal and gastric cancer patients, were performed before and after the combined intervention (March 2020 to July 2022). Audio recordings were analyzed using an observational coding scale, rating all utterances of treatment outcome information on the primary outcome-precision of provided outcome information-and on secondary outcomes-such as: personalization, tailoring and use of visualizations. Pre vs. post measurements were compared in order to assess the effect of the intervention. Findings: 31 HCPs of 11 different centers in the Netherlands participated. The tool and training significantly affected the precision of the overall communicated treatment outcome information (p = 0.001, median difference 6.93, IQR (-0.32 to 12.44)). In the curative setting, survival information was significantly more precise after the intervention (p = 0.029). In the palliative setting, information about side effects was more precise (p < 0.001). Interpretation: A prediction tool and communication skills training for HCPs improves the precision of treatment information on outcomes in simulated consultations. The next step is to examine the effect of such interventions on communication in clinical practice and on patient-reported outcomes. Funding: Financial support for this study was provided entirely by a grant from the Dutch Cancer Society (UVA 2014-7000).
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This study is aimed to determine whether postoperative low dose computed tomography (LDCT) imaging is necessary after percutaneous nephrolithotomy (PCNL), or the surgeon's intraoperative assessment of residual fragments (RF) is sufficient and avoidance of postoperative imaging with reduction of radiation exposure can be achieved. Data of all 610 patients who underwent PCNL in prone position in our institution from February 2009 to September 2020 was collected. Parameters such as age, gender, BMI, ASA-Classification, stone related parameters and the surgeon's assessment of stone-free status were analyzed. The LDCT performed postoperatively was compared to the intraoperative assessment of the surgeon regarding RF. The mean age of patients was 52.82 years; the mean BMI was 28.18 kg/m2. In 418 cases, the surgeon made a clear statement about the presence of RF and postoperative LDCT was carried out. The discrepancy between the two methods (surgeon´s assessment vs. LDCT) was significant at p < 0.0001. The sensitivity, specificity, positive and negative predictive value of the surgeon when assessing RF were 24.05%, 99.45%, 98.28% and 50%. Stone free rate (SFR) after primary PCNL was 45.57%. The overall SFR at discharge was 96.23%. Although the surgeon´s assessment of RF was reliable, postoperative LDCT imaging should still be performed if endoscopic stone clearance is suspected due to the high false negative rate and the low negative predictive value. The optimal timing of postoperative imaging following PCNL remains unclear.
Subject(s)
Kidney Calculi , Nephrolithotomy, Percutaneous , Nephrostomy, Percutaneous , Humans , Middle Aged , Nephrolithotomy, Percutaneous/adverse effects , Nephrolithotomy, Percutaneous/methods , Retrospective Studies , Kidney Calculi/diagnostic imaging , Kidney Calculi/surgery , Kidney Calculi/etiology , Tomography, X-Ray Computed , Predictive Value of Tests , Treatment Outcome , Nephrostomy, Percutaneous/adverse effects , Nephrostomy, Percutaneous/methodsABSTRACT
Molecular characterisation of testicular cells is a pivotal step towards a profound understanding of spermatogenesis and developing assisted reproductive techniques (ARTs) based on germline preservation. To enable the identification of testicular somatic and spermatogenic cell types in felids, we investigated the expression of five molecular markers at the protein level in testes from domestic cats (Felis catus) at different developmental phases (prepubertal, pubertal I and II, postpubertal I and II) classified by single-cell ploidy analysis. Our findings indicate a prominent co-labelling for two spermatogonial markers, UCHL1 and FOXO1, throughout postnatal testis development. Smaller subsets of UCHL1 or FOXO1 single-positive spermatogonia were also evident, with the FOXO1 single-positive spermatogonia predominantly observed in prepubertal testes. As expected, DDX4+ germ cells increased in numbers beginning in puberty, reaching a maximum at adulthood (post-pubertal phase), corresponding to the sequential appearance of labelled spermatogonia, spermatocytes and spermatids. Furthermore, we identified SOX9+ Sertoli cells and CYP17A1+ Leydig cells in all of the developmental groups. Importantly, testes of African lion (Panthera leo), Sumatran tiger (Panthera tigris sumatrae), Chinese leopard (Panthera pardus japonesis) and Sudan cheetah (Acinonyx jubatus soemmeringii) exhibited conserved labelling for UCHL1, FOXO1, DDX4, SOX9 and CYP17A1. The present study provides fundamental information about the identity of spermatogenic and somatic testicular cell types across felid development that will be useful for developing ART approaches to support endangered felid conservation.
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AIMS: To evaluate, in a pasture-based dairy herd, the response to a three-time point hoof trimming regime on lameness incidence and time from calving to observation of an elevated locomotion score (LS). METHODS: This study was conducted on a 940-cow spring-calving herd in New Zealand's North Island between May 2018 and May 2019. Cows (n = 250) were randomly allocated to the hoof trimming group, with the remainder assigned to the non-trim cohort. One trained professional hoof trimmer used the five-step Dutch method to trim the hind feet of the trimming group. Throughout the subsequent production season, the whole herd was locomotion-scored fortnightly using the 4-point (0-3) Dairy NZ lameness score. Kaplan-Meier survival curves were used to assess the univariable effect of trimming on the interval between calving and first LS of ≥ 2 and first LS ≥ 1. A multivariable Cox proportional hazards regression was used to further evaluate the effect of trimming on time to elevated LS. RESULTS: Mean lameness (LS ≥ 2) prevalence was 2.6%, with 30% of cows having ≥ 4 observations during the study period when at least one LS was ≥ 2. For LS ≥ 1, mean prevalence was 40%, with 98.6% of cows having ≥ 4 observations during the study period when at least one LS was ≥ 1 during lactation. Hoof trimming had no apparent effect on the incidence of clinical lameness (LS ≥ 2) (trimmed vs. non-trimmed: 33.2% vs. 28.8%, respectively), but for LS ≥ 1, there was a small decrease in the incidence of LS ≥ 1 (trimmed vs. non-trimmed: 96.9% vs. 99.3%, respectively). The hazard of a cow having a first observed LS ≥ 2 in the control group was 0.87 (95% CI = 0.66-1.14) times that of the trimmed group; however, the hazard of a cow having a first LS ≥ 1 was 1.60 (95% CI = 1.37-1.88) times higher in the control than in the trimmed group. CONCLUSION AND CLINICAL RELEVANCE: On this farm, prophylactic hoof trimming had no clinically relevant impact on the incidence of clinical lameness and was not associated with clinically beneficial reductions in time to first observed LS ≥ 2. This may be because claw horn imbalance was not pronounced on this farm, with 53% of cows needing no trim on either hind limb on the first trimming occasion. Further research on the response to prophylactic trimming in pasture-based dairy cattle is required.
Subject(s)
Cattle Diseases , Foot Diseases , Lameness, Animal , Animals , Cattle , Female , Cattle Diseases/epidemiology , Cattle Diseases/prevention & control , Dairying/methods , Foot Diseases/epidemiology , Foot Diseases/prevention & control , Foot Diseases/veterinary , Lactation , Lameness, Animal/epidemiology , Lameness, Animal/prevention & control , LocomotionABSTRACT
Instantaneous and peak frequency changes in neural oscillations have been linked to many perceptual, motor, and cognitive processes. Yet, the majority of such studies have been performed in sensor space and only occasionally in source space. Furthermore, both terms have been used interchangeably in the literature, although they do not reflect the same aspect of neural oscillations. In this paper, we discuss the relation between instantaneous frequency, peak frequency, and local frequency, the latter also known as spectral centroid. Furthermore, we propose and validate three different methods to extract source signals from multichannel data whose (instantaneous, local, or peak) frequency estimate is maximally correlated to an experimental variable of interest. Results show that the local frequency might be a better estimate of frequency variability than instantaneous frequency under conditions with low signal-to-noise ratio. Additionally, the source separation methods based on local and peak frequency estimates, called LFD and PFD respectively, provide more stable estimates than the decomposition based on instantaneous frequency. In particular, LFD and PFD are able to recover the sources of interest in simulations performed with a realistic head model, providing higher correlations with an experimental variable than multiple linear regression. Finally, we also tested all decomposition methods on real EEG data from a steady-state visual evoked potential paradigm and show that the recovered sources are located in areas similar to those previously reported in other studies, thus providing further validation of the proposed methods.
Subject(s)
Electroencephalography , Magnetoencephalography , Humans , Electroencephalography/methods , Magnetoencephalography/methods , Evoked Potentials, Visual , Signal-To-Noise Ratio , AlgorithmsABSTRACT
AIMS: To compare the retention by New Zealand dairy cows kept at pasture in a lame cow group, of three hoof block products commonly used in the remediation of lameness. METHODS: Sixty-seven farmer-presented Friesian and Friesian x Jersey dairy cows from a single herd in the Manawatu region (New Zealand) suffering from unilateral hind limb lameness attributable to a claw horn lesion (CHL) were randomly allocated to one of three treatments: foam block (FB), plastic shoe (PS) and a standard wooden block (WB). Blocks were applied to the contralateral healthy claw and checked daily by the farm staff (present/not present) and date of loss was recorded. Blocks were reassessed on Day 14 and Day 28 and then removed unless further elevation was indicated. Daily walking distances were calculated using a farm map and measurement software. Statistical analyses included a linear marginal model for distance walked until block loss and a Cox regression model for the relative hazard of a block being lost. RESULTS: Random allocation meant that differences between products in proportion used on left or right hind foot or lateral or medial claw were small. Mean distance walked/cow/day on farm tracks whilst the block was present was 0.32 (min 0.12, max 0.45) km/day; no biologically important difference between products in the mean distance walked was identified. Compared to PS, cows in the WB group were five times more likely to lose the block (HR = 4.8 (95% CI = 1.8-12.4)), while cows in the FB group were 9.5 times more likely to lose the block (HR = 9.5 (95% CI = 3.6-24.4)). CONCLUSIONS: In this study, PS were retained for much longer than either FB or WB. As cows were managed in a lame cow group for the study duration, walking distances were low and did not impact on the risk of block loss. More data are needed to define ideal block retention time. CLINICAL RELEVANCE: In cows with CHL the choice of block could be based on the type of lesion present and the expected re-epithelisation times.
Subject(s)
Cattle Diseases , Foot Diseases , Hoof and Claw , Orthopedics , Female , Cattle , Animals , Hoof and Claw/pathology , Lameness, Animal/therapy , Cattle Diseases/drug therapy , Cattle Diseases/prevention & control , Cattle Diseases/pathology , Gait , Foot Diseases/therapy , Foot Diseases/veterinaryABSTRACT
OBJECTIVE: To evaluate the efficacy and safety of the anti-catabolic ADAMTS-5 inhibitor S201086/GLPG1972 for the treatment of symptomatic knee osteoarthritis. DESIGN: ROCCELLA (NCT03595618) was a randomized, double-blind, placebo-controlled, dose-ranging, phase 2 trial in adults (aged 40-75 years) with knee osteoarthritis. Participants had moderate-to-severe pain in the target knee, Kellgren-Lawrence grade 2 or 3 and Osteoarthritis Research Society International joint space narrowing (grade 1 or 2). Participants were randomized 1:1:1:1 to once-daily oral S201086/GLPG1972 75, 150 or 300 mg, or placebo for 52 weeks. The primary endpoint was change from baseline to week 52 in central medial femorotibial compartment (cMFTC) cartilage thickness assessed quantitatively by magnetic resonance imaging. Secondary endpoints included change from baseline to week 52 in radiographic joint space width, Western Ontario and McMaster Universities Osteoarthritis Index total and subscores, and pain (visual analogue scale). Treatment-emergent adverse events (TEAEs) were also recorded. RESULTS: Overall, 932 participants were enrolled. No significant differences in cMFTC cartilage loss were observed between placebo and S201086/GLPG1972 therapeutic groups: placebo vs 75 mg, P = 0.165; vs 150 mg, P = 0.939; vs 300 mg, P = 0.682. No significant differences in any of the secondary endpoints were observed between placebo and treatment groups. Similar proportions of participants across treatment groups experienced TEAEs. CONCLUSIONS: Despite enrolment of participants who experienced substantial cartilage loss over 52 weeks, during the same time period, S201086/GLPG1972 did not significantly reduce rates of cartilage loss or modify symptoms in adults with symptomatic knee osteoarthritis.
Subject(s)
Osteoarthritis, Knee , Adult , Humans , Double-Blind Method , Knee Joint/diagnostic imaging , Knee Joint/pathology , Osteoarthritis, Knee/diagnostic imaging , Osteoarthritis, Knee/drug therapy , Pain/pathology , Treatment OutcomeABSTRACT
INTRODUCTION: Reports on bovine colon polyps are rare. The present report demonstrates macro- and microscopically hyperplastic colon polyps of a seven-year-old German Simmental cow. Differential diagnoses (adenoma and adenocarcinoma) and aetiology are discussed. Even in cattle, intestinal polyps should be considered as a cause of intussusception.
INTRODUCTION: Les rapports concernant des polypes du colon chez les bovins sont rares. Le présent rapport fait état de polypes du côlon macro- et microscopiquement hyperplasiques chez une vache Simmental allemande de sept ans. Les diagnostics différentiels (adénome et adénocarcinome) et l'étiologie sont discutés. Même chez les bovins, les polypes intestinaux doivent être considérés comme une cause d'invagination.
Subject(s)
Adenocarcinoma , Adenoma , Cattle Diseases , Colonic Polyps , Cattle , Animals , Colonic Polyps/diagnosis , Colonic Polyps/veterinary , Colonic Polyps/pathology , Hyperplasia/veterinary , Hyperplasia/pathology , Adenoma/diagnosis , Adenoma/veterinary , Adenoma/pathology , Adenocarcinoma/diagnosis , Adenocarcinoma/veterinary , Adenocarcinoma/pathology , Colon/pathology , Cattle Diseases/diagnosis , Cattle Diseases/pathologyABSTRACT
Background: The probability of undergoing treatment with curative intent for esophagogastric cancer has been shown to vary considerately between hospitals of diagnosis. Little is known about the factors that attribute to this variation. Since clinical decision making (CDM) partially takes place during an MDTM, the aim of this qualitative study was to assess clinician's perspectives regarding facilitators and barriers associated with CDM during MDTM, and second, to identify factors associated with CDM during an MDTM that may potentially explain differences in hospital practice. Methods: A multiple case study design was conducted. The thematic content analysis of this qualitative study, focused on 16 MDTM observations, 30 semi-structured interviews with clinicians and seven focus groups with clinicians to complement the collected data. Interviews were transcribed ad verbatim and coded. Results: Factors regarding team dynamics that were raised as aspects attributing to CDM were clinician's personal characteristics such as ambition and the intention to be innovative. Clinician's convictions regarding a certain treatment and its outcomes and previous experiences with treatment outcomes, and team dynamics within the MDTM influenced CDM. In addition, a continuum was illustrated. At one end of the continuum, teams tended to be more conservative, following the guidelines more strictly, versus the opposite in which hospitals tended towards a more invasive approach maximizing the probability of curation. Conclusion: This study contributes to the awareness that variation in team dynamics influences CDM during an MDTM.
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The emergence of antimicrobial-resistantfood-borne bacteria is a great challenge to public health. This study was conducted to characterize and determine the resistance profile of Salmonella strains isolated from foods including sesames, ready-to-eat (RTE) salads, mango juices, and lettuce in Burkina Faso. One hundred and forty-eight biochemically identified Salmonella isolates were characterized by molecular amplification of Salmonella marker invA and spiC, misL, orfL, and pipD virulence genes. After that, all confirmed strains were examined for susceptibility to sixteen antimicrobials, and PCR amplifications were used to identify the following resistance genes: bla TEM, temA, temB, StrA, aadA, sul1, sul2, tet(A), and tet(B). One hundred and eight isolates were genetically confirmed as Salmonella spp. Virulence genes were observed in 57.4%, 55.6%, 49.1%, and 38% isolates for pipD, SpiC, misL, and orfL, respectively. Isolates have shown moderate resistance to gentamycin (26.8%), ampicillin (22.2%), cefoxitin (19.4%), and nalidixic acid (18.5%). All isolates were sensitive to six antibiotics, including cefotaxime, ceftazidime, aztreonam, imipenem, meropenem, and ciprofloxacin. Among the 66 isolates resistant to at least one antibiotic, 11 (16.7%) were multidrug resistant. The Multiple Antimicrobial Resistance (MAR) index of Salmonella serovars ranged from 0.06 to 0.53. PCR detected 7 resistance genes (tet(A), tet(B), bla TEM, temB, sul1, sul2, and aadA) in drug-resistant isolates. These findings raise serious concerns because ready-to-eat food in Burkina Faso could serve as a reservoir for spreading antimicrobial resistance genes worldwide.
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Reconfigurable linear optical networks are a key component for the development of optical quantum information processing platforms in the NISQ era and beyond. We report the implementation of such a device based on an innovative design that uses the mode mixing of a multimode fiber in combination with the programmable wavefront shaping of a SLM. The capabilities of the platform are explored in the classical regime. For up to 8 inputs and a record number of 38 outputs, we achieve fidelities in excess of 93%, and losses below 6.5dB. The device was built inside a standard server rack to allow for real world use and shows consistent performance for 2x8 circuits over a period of 10 days without re-calibration.
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The objectives of this systematic review were to investigate the association between nonsteroidal anti-inflammatory drug (NSAID) use during the treatment of claw horn lameness in dairy cattle and locomotion score (LS), nociceptive threshold, and lying times. A total of 229 studies were initially identified and had their title and abstract screened. From this, we screened the full text of 23 articles, identifying 6 articles for inclusion in the systematic review. Of these 6, 5 reported LS, 2 reported nociceptor thresholds, and 1 reported lying times. The quality of evidence was assessed using a Cochrane risk-of-bias tool and CONSORT items reported for each included study. Due to heterogeneity between the studies, data were reported following Cochrane's Synthesis without meta-analysis guidelines. Identified heterogeneity between the studies included differences in LS systems and statistical analyses, length of time from enrollment to outcome reported, the NSAID used, concomitant treatments administered, and severity and chronicity of lameness. Recommendations are made with respect to consistency of LS reporting and analysis, along with improvements that may be noted with compulsory reporting guidelines. There were at least some concerns over the risk of bias in 4 of the studies, with risks of bias present in missing outcome data between the study groups. Within the 5 studies included with LS outcomes, there were 22 different pairwise comparisons with either NSAID or NSAID + block as the intervention, with measures of association with presence or absence of lameness as the outcome available for 20 of these comparisons. Animals in the NSAID intervention groups had a lower point estimate lameness risk than animals in the comparison groups in 3 of 8 and 9 of 14 analyses for LS outcomes <10 and ≥10 d post-treatment, respectively. However, there was no difference identified between animals in the NSAID intervention groups compared with the animals in the control group in any of these pairwise comparisons with lameness as the outcome. Twelve pairwise comparisons were reported in the 2 studies with nociceptor threshold as an outcome. Animals in the NSAID intervention groups had a greater nociceptor threshold point estimate compared with animals in the comparison groups in 6 of 6 and 1 of 6 analyses for outcomes <10 and ≥10 d post-treatment, respectively. However, no differences were identified between animals in the NSAID intervention groups and those in the comparison groups. All 4 pairwise comparisons reported in the study with lying times as an outcome found no differences between animals in the NSAID groups and those in the comparison groups. Despite the widespread use of NSAID in the treatment of claw horn lameness, there is a lack of studies of NSAID association with LS, nociceptive thresholds, or lying times. The limited evidence is consistent with no association with NSAID use and those parameters, but comparability across studies was limited by heterogeneity.
Subject(s)
Cattle Diseases , Hoof and Claw , Cattle , Animals , Humans , Lameness, Animal/diagnosis , Cattle Diseases/diagnosis , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , StudentsABSTRACT
Building performant and robust artificial intelligence (AI)-based applications for dentistry requires large and high-quality data sets, which usually reside in distributed data silos from multiple sources (e.g., different clinical institutes). Collaborative efforts are limited as privacy constraints forbid direct sharing across the borders of these data silos. Federated learning is a scalable and privacy-preserving framework for collaborative training of AI models without data sharing, where instead the knowledge is exchanged in form of wisdom learned from the data. This article aims at introducing the established concept of federated learning together with chances and challenges to foster collaboration on AI-based applications within the dental research community.
Subject(s)
Artificial Intelligence , DentistryABSTRACT
OBJECTIVE: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a viral outbreak that started in December 2019, eventually lead to a worldwide pandemic. COVID-19 usually presents with flu-like symptoms, such as headaches, dry cough, fever, fatigue, myalgia, shortness of breath, diarrhea and loss of smell or taste. However, it can also have major effects on the cardiovascular system. Based on the available relevant literature, we aimed to elaborate the possible mechanisms influencing cardiovascular damage, myocardial injury and thromboembolic disease process in particular. MATERIALS AND METHODS: After considering our inclusion and exclusion criteria, the systematic review included 8 studies in total. RESULTS: In general, underlying cardiovascular diseases were associated with poorer clinical outcomes. This may be due to immunological dysregulation. The disease outcomes were also positively correlated with the severity of the disease, especially with myocardial injury. Thus, cardiac biomarkers, such as Troponin T, CK-MB and myoglobin could be utilized in prediction algorithms for deciphering the clinical outcome in COVID-19 patients. CONCLUSIONS: Venous thromboembolisms were commonly encountered complications despite the administration of thromboprophylaxis, and they mostly presented as pulmonary embolisms, warranting the need for relevant investigations in hemodynamically unstable patients. However, more studies need to be conducted to better understand the mechanisms at play and the ensuing complications, to better treat COVID-19 patients.
Subject(s)
COVID-19 , Venous Thromboembolism , Anticoagulants , COVID-19/complications , Humans , SARS-CoV-2 , Troponin TABSTRACT
Precise control of the properties of semiconductor quantum dots (QDs) is vital for creating novel devices for quantum photonics and advanced opto-electronics. Suitable low QD-densities for single QD devices and experiments are challenging to control during epitaxy and are typically found only in limited regions of the wafer. Here, we demonstrate how conventional molecular beam epitaxy (MBE) can be used to modulate the density of optically active QDs in one- and two- dimensional patterns, while still retaining excellent quality. We find that material thickness gradients during layer-by-layer growth result in surface roughness modulations across the whole wafer. Growth on such templates strongly influences the QD nucleation probability. We obtain density modulations between 1 and 10 QDs/µm2 and periods ranging from several millimeters down to at least a few hundred microns. This method is universal and expected to be applicable to a wide variety of different semiconductor material systems. We apply the method to enable growth of ultra-low noise QDs across an entire 3-inch semiconductor wafer.
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BACKGROUND: The integration of general practitioners into specialist outpatient clinics is associated with improved access to care; however, little is understood about the organisation-level factors that affect successful implementation. We aimed to identify factors that were facilitators or barriers to the implementation of a General Practitioner with Special Interest (GPwSI) model of care across a range of specialties. METHODS: Semi-structured, in-depth interviews were conducted with 25 stakeholders at 13 GPwSI clinics in operation within a Queensland public health service. A deductive content analysis was conducted using the Consolidated Framework for Implementation Research (CFIR). RESULTS: Stakeholders generally supported the GPwSI model and saw advantages to patients and specialist medical practitioners in terms of waiting lists, workload, and improving clinician self-efficacy and knowledge. A number of factors were identified as being crucial to the success of the program, such as adequate support and planning for the implementation, appropriate funding and advocacy. CONCLUSIONS: Our evaluation indicates that a GPwSI model can be a beneficial resource for improving care to patients and reducing wait lists, dependent upon adequate planning, training, and support.
Subject(s)
General Practitioners , Ambulatory Care Facilities , Humans , Qualitative Research , Queensland , Specialization , Waiting ListsABSTRACT
The influence of ionic strength up to 3 mol kg-1 (background electrolytes NaCl or CaCl2) on U(VI) sorption onto montmorillonite was investigated as function of pHc in absence and presence of CO2. A multi-method approach combined batch sorption experiments with spectroscopic methods (time-resolved laser-induced fluorescence spectroscopy (TRLFS) and in situ attenuated total reflection Fourier-transform infrared spectroscopy (ATR FT-IR)). In the absence of atmospheric carbonate, U(VI) sorption was nearly 99% above pHc 6 in both NaCl and CaCl2 and no significant effect of ionic strength was found. At lower pH, cation exchange was strongly reduced with increasing ionic strength. In the presence of carbonate, U(VI) sorption was reduced above pHc 7.5 in NaCl and pHc 6 in CaCl2 system due to formation of aqueous UO2(CO3)x(2-2x) and Ca2UO2(CO3)3 complexes, respectively, as verified by TRLFS. A significant ionic strength effect was observed due to the formation of Ca2UO2(CO3)3(aq), which strongly decreases U(VI) sorption with increasing ionic strength. The joint analysis of determined sorption data together with literature data (giving a total of 213 experimental data points) allowed to derive a consistent set of surface complexation reactions and constants based on the 2SPNE SC/CE approach, yielding log K°≡SSOUO2+ = 2.42 ± 0.04, log K°≡SSOUO2OH = -4.49 ± 0.7, and log K°≡SSOUO2(OH)32- = -20.5 ± 0.4. Ternary uranyl carbonate surface complexes were not required to describe the data. With this reduced set of surface complexes, an improved robust sorption model was obtained covering a broad variety of geochemical settings over wide ranges of ionic strengths and groundwater compositions, which subsequently was validated by an independent original dataset. This model improves the understanding of U(VI) retention by clay minerals and enables now predictive modeling of U(VI) sorption processes in complex clay rich natural environments.