A narrative review of occupational scheduling that impacts fatigue and recovery relevant to veterinarian well-being.

Background: Sleep insufficiency is a worldwide affliction with serious implications for mental and physical health. Occupational factors play a large role in determining sleep habits. Healthcare workers are particularly susceptible to job-mediated sleep insufficiency and inadequate rest in general. Little is published on sleep practices among veterinarians, and overall recognition of the impacts of inadequate rest within the veterinary profession is poor. Objectives and procedures: This review describes occupational factors affecting sufficiency of rest and recovery, reviews veterinary-specific and relevant adjacent literature pertaining to sleep patterns, and discusses potential solutions for addressing occupational schedules contributing to sleep insufficiency and inadequate rest. Online databases were searched to extract contemporary literature pertaining to sleep, insufficient rest, and occupational factors, with a focus on veterinary medicine and other healthcare sectors. Results: Occupational factors leading to inadequate rest among healthcare workers include excessive workloads, extended workdays, cumulative days of heavy work hours, and after-hours on-call duty. These factors are prevalent within the veterinary profession and may contribute to widespread insufficient rest and the resulting negative impacts on health and well-being among veterinarians. Conclusion and clinical relevance: Sufficient sleep quantity and quality are critical to physical and mental health and are negatively affected by many aspects of the veterinary profession. Critical review of current strategies employed in clinical practice is essential to promote professional fulfillment, health, and well-being among veterinarians.

Un examen narratif des horaires de travail qui ont un impact sur la fatigue et la récupération en rapport avec le bien-être des vétérinaires. Mise en contexte: L'insuffisance de sommeil est une affection mondiale avec de graves implications pour la santé mentale et physique. Les facteurs liés à l'emploi jouent un rôle important dans la détermination des habitudes de sommeil. Les travailleurs de la santé sont particulièrement sensibles à l'insuffisance de sommeil liée au travail et au repos inadéquat en général. Il y a peu de publications sur les pratiques de sommeil chez les vétérinaires, et la reconnaissance globale des impacts d'un repos inadéquat au sein de la profession vétérinaire est faible. Objectifs et procédures: Cette revue décrit les facteurs professionnels affectant la quantité suffisante de repos et de la récupération, passe en revue la littérature spécifique aux vétérinaires ainsi que celle adjacente pertinente concernant les habitudes de sommeil, et discute des solutions potentielles pour traiter les horaires professionnels contribuant à l'insuffisance de sommeil et au repos inadéquat. Des bases de données en ligne ont été consultées pour extraire la littérature contemporaine relative au sommeil, au repos insuffisant et aux facteurs liés à l'emploi, en mettant l'accent sur la médecine vétérinaire et d'autres secteurs de la santé. Résultats: Les facteurs liés à l'emploi entraînant un repos insuffisant chez les travailleurs de la santé comprennent les charges de travail excessives, les journées de travail prolongées, les jours cumulés d'heures de travail pénibles et les gardes après les heures normales de travail. Ces facteurs sont répandus au sein de la profession vétérinaire et peuvent contribuer à un repos insuffisant généralisé et aux impacts négatifs qui en résultent sur la santé et le bien-être des vétérinaires. Conclusion et pertinence clinique: Une quantité et une qualité de sommeil suffisantes sont essentielles à la santé physique et mentale et sont négativement affectées par de nombreux aspects de la profession vétérinaire. L'examen critique des stratégies actuelles utilisées dans la pratique clinique est essentiel pour promouvoir l'épanouissement professionnel, la santé et le bien-être des vétérinaires.(Traduit par Dr Serge Messier).

Veterinarian burnout demographics and organizational impacts: a narrative review.

Burnout is a work-related syndrome of physical and emotional exhaustion secondary to prolonged, unresolvable occupational stress. Individuals of different demographic cohorts may have disparate experiences of workplace stressors and burnout impacts. Healthcare organizations are adversely affected by burnt out workers through decreased productivity, low morale, suboptimal teamwork, and potential impacts on the quality of patient care. In this second of two companion reviews, the demographics of veterinary burnout and the impacts of burnout on affected individuals and work environments are summarized, before discussing mitigation concepts and their extrapolation for targeted strategies within the veterinary workplace and profession.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors.

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

A narrative review of the pathophysiology and impacts of insufficient and disrupted sleep.

Background: Despite substantial ramifications of insufficient sleep on mental and physical health and general well-being, many individuals are unaware of what constitutes sufficient sleep, or of the short- and long-term extent of sleep deficiency effects, including those that may not be perceived as fatigue. Objectives and procedures: This review describes the physiology of sleep, defines healthy standards, reviews the pathophysiology and health hazards of acute and chronic sleep insufficiency, and offers concepts for improving individual sleep hygiene. Online databases were searched to extract literature pertaining to sleep, sleep insufficiency, fatigue, and health, with emphasis on literature published in the preceding 5 years. Results: The detrimental effects of acute and chronic sleep loss vary in their range and impact. Individuals often obtain a substandard quantity of sleep, a problem that is poorly recognized by individuals and society. This lack of recognition perpetuates a culture in which sleep insufficiency is accepted, resulting in serious and substantial negative impacts on mental and physical health. Conclusion and clinical relevance: Sleep management is one of the most fundamental and changeable aspects of personal health. Improving awareness of the important physiological roles of sleep, healthy sleep habits, and the consequence of insufficient sleep is essential in promoting general well-being and mental and physical health.

Un examen narratif de la physiopathologie et des impacts d'un sommeil insuffisant et perturbé. Contexte: Malgré les ramifications importantes d'un manque de sommeil sur la santé mentale et physique et le bien-être général, de nombreuses personnes ignorent ce qui constitue un sommeil suffisant ou l'étendue à court et à long terme des effets du manque de sommeil, y compris ceux qui peuvent ne pas être perçus comme de la fatigue. Objectifs et procédures: Cette revue décrit la physiologie du sommeil, définit des normes de santé, passe en revue la physiopathologie et les risques pour la santé de l'insuffisance de sommeil aiguë et chronique et propose des concepts pour améliorer l'hygiène individuelle du sommeil. Des bases de données en ligne ont été consultées pour extraire la littérature relative au sommeil, à l'insuffisance de sommeil, à la fatigue et à la santé, en mettant l'accent sur la littérature publiée au cours des 5 années précédentes. Résultats: Les effets néfastes de la perte de sommeil aiguë et chronique varient dans leur portée et leur impact. Les individus obtiennent souvent une quantité de sommeil inférieure aux normes, un problème mal reconnu par les individus et la société. Ce manque de reconnaissance perpétue une culture dans laquelle l'insuffisance de sommeil est acceptée, entraînant des impacts négatifs graves et substantiels sur la santé mentale et physique. Conclusion et pertinence clinique: La gestion du sommeil est l'un des aspects les plus fondamentaux et les plus imprévisibles de la santé personnelle. Améliorer la prise de conscience des rôles physiologiques importants du sommeil, des habitudes de sommeil saines et des conséquences d'un sommeil insuffisant est essentiel pour promouvoir le bien-être général et la santé mentale et physique.(Traduit par Dr Serge Messier).

Validation of a novel 3D printed positioning device and dynamic radiographic technique to quantify rotational laxity of the stifle in dogs.

Cranial cruciate ligament deficiency (CCLD) results in internal rotational instability of the stifle (RLS). By contrast, tibial torsion (TT) is an anatomical feature of the tibia along its longitudinal axis. The objective of this study was to validate a dynamic radiographic technique to measure internal rotational laxity of the stifle and differentiate it from TT. Models included transection of the CCL for RLS and an osteotomy for TT. One limb within eight pairs of canine cadaveric hind limbs was randomly assigned to CCLD. The contralateral limb underwent TT, followed by CCLD. Neutral and stress radiographs were taken with the limb in a custom rotating 3-D printed positioning device before and after each modification. The position of the calcaneus on neutral views and the magnitude of its displacement under standardized torque were compared within limbs and between groups. Transection of the CCL increased the magnitude of displacement of the calcaneus by 1.6 mm (0.3-3.1 mm, p < 0.05) within limbs. The lateral calcaneal displacement (dS-dN) tended to be greater when CCLD limbs were compared to limbs with intact CCL. A magnitude of calcaneal displacement of 3.45 mm differentiated limbs with RLS from intact limbs with 87.5% sensitivity and 68.7% specificity. The calcaneus was displaced further laterally by about 3 mm on neutral radiographs (dN) when limbs with experimental TT were compared to those without TT (p < 0.05). A calcaneus located at least 3.25 mm from the sulcus differentiated limbs with TT from intact limbs with 87.5% sensitivity and 87.5% specificity. The technique reported here allowed detection of RLS, especially within limbs. A calcaneus located at least 3.25 mm on neutral radiographs of large dogs should prompt a presumptive diagnosis of TT.

A narrative review of the impact of work hours and insufficient rest on job performance.

OBJECTIVE: This review discusses the scientific evidence regarding effects of insufficient rest on clinical performance and house officer training programs, the associations of clinical duty scheduling with insufficient rest, and the implications for risk management. STUDY DESIGN: Narrative review. METHODS: Several literature searches using broad terms such as "sleep deprivation," "veterinary," "physician," and "surgeon" were performed using PubMed and Google scholar. RESULTS: Sleep deprivation and insufficient rest have clear and deleterious effects on job performance, which in healthcare occupations impacts patient safety and practice function. The unique requirements of a career in veterinary surgery, which may include on-call shifts and overnight work, can lead to distinct sleep challenges and chronic insufficient rest with resultant serious but often poorly recognized impacts. These effects negatively impact practices, teams, surgeons, and patients. The self-assessment of fatigue and performance effect is demonstrably untrustworthy, reinforcing the need for institution-level protections. While the issues are complex and there is no one-size-fits-all approach, duty hour or workload restrictions may be an important first step in addressing these issues within veterinary surgery, as it has been in human medicine. CONCLUSION: Systematic re-examination of cultural expectations and practice logistics are needed if improvement in working hours, clinician well-being, productivity, and patient safety are to occur. CLINICAL SIGNIFICANCE (OR IMPACT): A more comprehensive understanding of the magnitude and consequence of sleep-related impairment better enables surgeons and hospital management to address systemic challenges in veterinary practice and training programs.

Applications of 3-dimensional printing in small-animal surgery: A review of current practices.

Three-dimensional (3D) printing, also called rapid prototyping or additive manufacturing, transforms digital images into 3D printed objects, typically by layering consecutive thin films of material. This technology has become increasingly accessible to the public, prompting applications in veterinary surgery. Three-dimensional prints provide direct visualization of complex 3D structures and also haptic feedback relevant to surgery. The main objective of this review is to report current applications of 3D printing in small-animal surgery, including surgical education, preoperative planning, and treatment of tissue defects. The reported uses of 3D prints, their proposed advantages, and current limitations are discussed considering published evidence. Aspects of the manufacturing process specific to each application are described, along with current practices in veterinary surgery.

Veterinarians' perceptions of COVID-19 pandemic-related influences on veterinary telehealth and on pet owners' attitudes toward cats and dogs.

OBJECTIVE: To gather and evaluate veterinarians' perspectives about the impacts of the COVID-19 pandemic on the use of veterinary telehealth and on cat owners' versus dog owners' attitudes toward transmission of the SARS-CoV-2 virus from their pets. SAMPLE: 93 respondent veterinarians (47 in primary care practice and 46 in specialty practice). PROCEDURES: An online survey was conducted between June 15 and July 15, 2020, and included 21 questions concerning demographics, use of telehealth before and after the onset of the pandemic (before March 15, 2020, and between March 15 and June 15, 2020, respectively), changes in caseloads, and perception of clients' concerns about potential for transmission of the SARS-CoV-2 virus from pets. Reported zip codes informed the collection of census data. RESULTS: The level of poverty was significantly lower in zip code areas for respondents who reported telehealth services were (vs were not) offered before the pandemic. The percentage of respondents who reported their practice offered telehealth services increased from 12% (11/93) before the pandemic to 38% (35/93) between March 15 and June 15, 2020. Although most respondents reported owner-expressed concerns over SARS-CoV-2 virus transmission from their pets, most also reported increased caseloads, seeing newly adopted pets, and few discussions of surrender of pets for reasons related to the SARS-CoV-2 virus. CONCLUSIONS AND CLINICAL RELEVANCE: Findings indicated that caseloads increased and telehealth services expanded during the pandemic but that there was no evidence of differences in respondent-reported owner concern for SARS-CoV-2 virus transmission from cats versus dogs.

Evaluation of a laparoscopic abdominal simulator assessment to test readiness for laparoscopic ovariectomy in live dogs.

OBJECTIVE: To predict readiness for laparoscopic ovariectomy of live dogs on the basis of performance on a high-fidelity laparoscopic abdominal simulator and to determine interrater reliability of the assessment. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Seventeen fourth-year veterinary students. METHODS: After a standardized laparoscopic training course, each participant performed a laparoscopic ovariectomy with a simulator. This performance was scored in real time by two evaluators using a rubric. Participants achieving a score of 112 of 160 performed a laparoscopic ovariectomy in a live dog, supervised by an instructor in the room. Two evaluators scored video recordings of each procedure using the rubric. Participants' opinions about the simulator were collected with a survey. RESULTS: All participants scored above the threshold (range, 126-151) and successfully completed laparoscopic ovariectomy in a live dog, with an average of 10 of 17 participants requiring verbal guidance and 5 of 17 participants requiring intervention from the instructor. Interrater concordance was excellent for the rubrics used to score performance on the simulator (R = 0.91) and in vivo (R = 0.81). All participants agreed that the simulator should be used to assess trainee readiness prior to surgery in a live dog. CONCLUSION: Participants achieving a score of at least 126 of 160 on the simulator were able to perform a laparoscopic ovariectomy in a live dog under supervision. The scoring system for the simulator had excellent interrater concordance. CLINICAL SIGNIFICANCE: This simulator and scoring system can be used in laparoscopic training programs to assess readiness for progression to the operative setting.

Prospective evaluation of the influence of sampling method on bacterial culture results and antimicrobial selection in 52 dogs with infected wounds.

OBJECTIVE: To determine the influence of sampling methods on culture results and selection of antimicrobials for treating infected wounds in dogs. DESIGN: Prospective study from January to July 2016. SETTING: Three private multispecialty referral centers. ANIMALS: Fifty-two client-owned dogs with infected wounds. INTERVENTIONS: Each wound was sampled for culture by 3 methods: swabbing prior to preparation (dirty swabs), swabbing after debridement and sterile lavage (clean swabs), and biopsy. Bacterial species and phenotypes were compared. Three clinicians unaware of patient, wound, and sampling information selected antimicrobial drugs based on culture and sensitivity reports. Antimicrobials were divided into class I, II, or III based on established guidelines. The number, highest class of antimicrobial chosen, and inter-investigator agreement were examined. MEASUREMENTS AND MAIN RESULTS: Identical populations of bacteria were isolated for all 3 sampling techniques in only 31% of wounds. Significantly fewer bacterial species were isolated from biopsy samples (1.87 bacterial species per wound ± 1.14) than from clean swab samples (2.29 ± 1.18; P = 0.009) but not dirty swab samples (2.29 ± 1.29; P = 0.06). The recovery frequency for gram-positive bacteria was lower for biopsy compared to either swabbing technique (P = 0.001 for both comparisons). No difference was observed between clean and dirty swabbing techniques for any parameter examined. Sampling technique did not affect the proportion of wounds with anaerobic, gram-negative, or multi-drug resistant bacteria. The number (P = 0.28) and highest class of antimicrobial (P = 0.9) selected per wound did not differ between the 3 sampling techniques (P = 0.28). Clinician agreement was 83-90% depending on sampling technique. CONCLUSION: Although there were some differences in bacteria isolated from biopsy samples compared to swab samples from infected wounds, technique did not influence the number and highest class of antimicrobial selected by clinicians. Wound debridement prior to sampling by swabbing did not alter the number or type of bacteria isolated, nor the number or the highest class of antimicrobial selected by clinicians.

Biocompatibility of allogenic canine fascia lata: In vitro evaluation and small case series.

OBJECTIVE: To evaluate the biocompatibility of canine fascia lata (FL) in vitro and after FL allograft implantation in dogs with clinical disease. STUDY DESIGN: In vitro experiment and small case series. SAMPLE POPULATION: Six dogs treated with allogenic freeze-dried FL. METHODS: Fibroblasts were cultured on disks of FL, polypropylene mesh (PM; negative control), and porcine small intestinal submucosa (SIS; positive control). Constructs were compared at 3, 7, and 14 days for water content, DNA amounts, scanning electron microscopy, and histology. Records of dogs treated with FL allografts with follow-up examination were reviewed for signalment, indication for surgery, surgical procedure, and outcomes. All owners were invited to complete a standardized questionnaire for long-term follow-up. RESULTS: Water content was greater in FL and SIS than in PM (P = .03). Fascia lata constructs contained more DNA compared with PM constructs at days 7 and 14 (P < .05), whereas SIS constructs did not differ from FL or PM. Fibroblasts appeared spherical and distributed throughout FL constructs, whereas they appeared stellate and remained on the surface of SIS and PM. Fascia lata allografts were implanted in six dogs with surgical conditions. No incisional complications were noted. All dogs had good to excellent long-term outcomes, except one that experienced recurrence of a perineal hernia 2 years after repair. CONCLUSION: In vitro, canine FL allowed attachment and proliferation of fibroblasts throughout layers of the graft. Canine allogenic FL was clinically well tolerated in this small population of dogs. CLINICAL SIGNIFICANCE: Allogenic FL is biocompatible and can be considered an alternative to SIS for soft tissue augmentation in dogs.

Influence of Donor's Age on Immunomodulatory Properties of Canine Adipose Tissue-Derived Mesenchymal Stem Cells.

Osteoarthritis challenges traditional therapies and remains a leading cause of lameness in older dogs. Regenerative medicine offers new strategies, typically involving the injection of autologous adipose-derived mesenchymal stem cells (MSCs). Conversely, allogenic MSCs are appealing candidates to palliate patient morbidity and cell preparation time. Regardless of the source of cells, identifying critical donor characteristics, such as age, is essential to obtain the most competent MSCs. The objectives of this study were to determine the influence of donor's age on proliferation, gene expression, and immunomodulatory properties of MSCs in dogs. Canine adipose tissue-derived MSCs (cAD-MSCs) were isolated from the falciform-ligament adipose tissues of nine pairs of gender-matched young (<2 years) or old (>7 years) client-owned dogs undergoing abdominal surgery. Growth kinetics, transcriptome before and after stimulation by tumor necrosis factor alpha and interferon gamma, MSC-induced lymphocyte suppression assay, and secretion of prostaglandin E2 (PGE2) and indoleamine 2,3-dioxygenase (IDO) were compared between cells obtained from young or old dogs. The doubling times at passages 2 and 3 were shorter when MSCs were isolated from young (34.8 ± 1.8 h and 46.3 ± 2.3 h) rather than old dogs (56.5 ± 8.0 h and 123.8 ± 46.7 h, P < 0.05). The MSC transcriptomes from both populations were similar without stimulation, while stimulation resulted in a 3-fold greater expression of osteogenic gene, fibroblast growth factor 10, in cells from old dogs. cAD-MSCs from young dogs suppressed proliferation of activated T cells more strongly (P < 0.05), although secretion of PGE2 and IDO did not differ between groups. In conclusion, donors' age affected proliferation, immunomodulatory properties of cAD-MSCs, and increased expression of osteogenic gene under proinflammatory conditions in our population of dogs. Collectively, our results provide evidence to support further evaluation of allogenic MSC therapies derived from young donors as alternatives to autologous MSC therapy in older dogs.

The effect of body condition on postoperative recovery of dachshunds with intervertebral disc disease treated with postoperative physical rehabilitation.

OBJECTIVE: To determine the impact of obesity on postoperative recovery from thoracolumbar hemilaminectomy in dachshunds treated with rehabilitation. STUDY DESIGN: Prospective observational trial. ANIMALS: Thirty-two dachshunds with thoracolumbar intervertebral disk disease and pain perception. METHODS: Dachshunds were entered into the study after unilateral thoracolumbar hemilaminectomy. Lean muscle and fat contents were measured with dual-energy x-ray absorptiometry (DEXA) at the beginning and at week 12 of the study. Aggressive rehabilitation was performed 1, 2, 4, and 6 weeks after surgery. Logistic regressions were used to determine the odds ratios between potential risk factors (age, duration of clinical signs, weight, body condition score, percentage body fat, percentage lean muscle mass, and disability index [DI] score at presentation) and return benchmarks of recovery. RESULTS: Body condition score, percentage body fat, percentage lean muscle mass, weight, and age did not influence the odds ratio for recovery. An increase in preoperative DI score was associated with increased risk of a slow postoperative recovery (P < .05). The odds ratios were 2.5, 4.8, and 1.8 for >7 days until standing, > 30 days until strong ambulation, and failure to return to normal within the study period, respectively. On average, dogs lost weight (2.2 kg) and body fat (2.4%) but gained muscle mass (3.0%) over the study period (P < .05). CONCLUSION: Preoperative disability but not body condition was a risk factor for a slow recovery after thoracolumbar hemilaminectomy in dachshunds with rehabilitation. CLINICAL SIGNIFICANCE: A slower recovery is likely with increased preoperative disability, but body condition does not seem to affect the postoperative prognosis of dachshunds treated with rehabilitation.

Effect of Short- Versus Long-Term Video Game Playing on Basic Laparoscopic Skills Acquisition of Veterinary Medicine Students.

The objective of this study was to investigate the effect of playing video games on the performance of basic laparoscopic skills. The study was an experimental pre-test-post-test comparison group design. Fifty-two students (31 from the Western University of Health Sciences College of Veterinary Medicine and 21 from the Colorado State University College of Veterinary Medicine) completing their first or second year of the veterinary curriculum were randomized into two intervention groups. The intervention consisted of playing the video game Marble Mania on a Nintendo Wii. group L (long) played 18 hours over 6 weeks and group S (short) played 3 hours during the last week of the 6-week intervention period. Before and after the intervention, basic laparoscopic skills for both groups were assessed using a modified McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) instrument. Participants performed two laparoscopic tasks. Results showed that the performance of students improved in both group S and L (p < .05) on both laparoscopic tasks. Both groups showed statistically significant improvement in their post-intervention scores (group L, N = 25, z = -3.711, p < .001, r = 0.742; group S, N = 27, z = -3.016, p < .003, r = 0.580). There was no significant difference in the degree of improvement between group S and group L. The results suggest that playing Marble Mania on a Wii for any time duration could be an effective method for veterinary medicine students to improve basic laparoscopic skills, and indicate the needs for additional studies.

Evaluation of Stem Cell Therapies in a Bilateral Patellar Tendon Injury Model in Rats.

Regenerative medicine provides novel alternatives to conditions that challenge traditional treatments. The prevalence and morbidity of tendinopathy across species, combined with the limited healing properties of this tissue, have prompted the search for cellular therapies and propelled the development of experimental models to study their efficacy. Umbilical cord matrix-derived mesenchymal stem cells (UCM-MSC) are appealing candidates because they are abundant, easy to collect, circumvent the ethical concerns and risk of teratoma formation, yet resemble primitive embryonic stem cells more closely than adult tissue-derived MSCs. Significant interest has focused on chitosan as a strategy to enhance the properties of MSCs through spheroid formation. This paper details techniques to isolate UCM-MSCs, prepare spheroids on chitosan film, and analyze the effect of spheroid formation on surface marker expression. Consequently, creation of a bilateral patellar tendon injury model in rats is described for in vivo implantation of UCM-MSC spheroids formed on chitosan film. No complication was observed in the study with respect to morbidity, stress rising effects, or tissue infection. The total functional score of the operated rats at 7 days was lower than that of normal rats, but returned to normal within 28 days after surgery. Histological scores of tissue-healing confirmed the presence of a clot in treated defects evaluated at 7 days, absence of foreign body reaction, and progressing healing at 28 days. This bilateral patella tendon defect model controls inter-individual variation via creation of an internal control in each rat, was associated with acceptable morbidity, and allowed detection of differences between untreated tendons and treatments.

Influence of radiographic techniques on the measurement of femoral anteversion angles and a conformation score of pelvic limbs in Labrador retrievers.

OBJECTIVE: To determine repeatability of and correlation between 2 radiographic measurements of femoral anteversion angles (FAA) and to determine their influence on a score derived from tibial plateau angle (TPA) and FAA to predict the risk of cranial cruciate ligament disease (CCLD). STUDY DESIGN: Prospective clinical study. ANIMALS: Forty-eight Labrador retrievers with or without CCLD. METHODS: FAA and CCLD scores were calculated for each limb from extended pelvic radiographs (t-FAA) or angled (a-FAA) projections of the femur by 3 investigators. One investigator repeated measurements twice. Data were analyzed for repeatability, correlation between t-FAA and a-FAA, and their influence on CCLD scores. RESULTS: FAA correlated most strongly with the distance between the femoral head and the femoral axis on mediolateral radiographs, a measurement with excellent repeatability. t-FAA and a-FAA correlated with each other (r > 0.79, P < .0001), although t-FAA were about 1° greater than a-FAA (P = .01). Intrainvestigator and interinvestigator repeatability of the CCLD score was fair when derived from t-FAA and good to excellent when derived from a-FAA. CCLD scores differed between radiographic techniques but led to different predictions in only 9 (10%) limbs, all with lower TPA and CCLD scores than the rest of the population. CONCLUSION: a-FAA correlated strongly with t-FAA and improved the repeatability of CCLD scores within and between investigators. CLINICAL SIGNIFICANCE: A craniocaudal angled beam projection of the femur is a suitable alternative to a ventrodorsal pelvic radiograph when measuring FAA and may improve the repeatability and positive predictive value of CCLD scores.

Radiographic, computed tomographic, and arthroscopic diagnosis of radioulnar incongruence in dogs with medial coronoid disease.

OBJECTIVE: To characterize radioulnar incongruence (RUI) in large dogs with medial coronoid disease (MCD) and determine the agreement between radiography, computed tomography (CT), and arthroscopy. STUDY DESIGN: Prospective observational case series. ANIMALS: Twenty-four large-breed dogs under 3 years of age with confirmed MCD. METHODS: MCD and incongruence were evaluated by radiographs and CT. RUI was measured along the ulnar commissure, mid-body, and apex of the medial coronoid process (MCP) by CT and arthroscopy. Joints with RUI ≥ 2 mm were considered incongruent. Variables recorded during arthroscopic treatment included type of MCD, RUI, and modified Outerbridge score. Agreement between the 3 diagnostic imaging techniques was evaluated, and the association between RUI and cartilage damage was analyzed. RESULTS: Single fragmentation was the most common MCD according to CT and arthroscopy. RUI was associated with degenerative joint disease according to CT and with cartilage damage according to arthroscopy. RUI was diagnosed in 26% of elbows by radiography, in 35% of elbows by CT, in 78% of elbows according to CT measurements of RUI ≥ 2 mm, and in 57% of joints by arthroscopy. RUI was most commonly detected at the ulnar commissure with CT and at the apex of the MCP with arthroscopy. Imaging modalities were in poor to fair agreement with arthroscopy when evaluating RUI. CONCLUSION: CT and arthroscopy provided similar detection of MCD and cartilage disease but disagreed in the assessment and localization of RUI. CLINICAL SIGNIFICANCE: CT does not reliably predict arthroscopic assessment of RUI and associated treatment decisions for MCD.

Influence of hypoxia on the stemness of umbilical cord matrix-derived mesenchymal stem cells cultured on chitosan films.

Chitosan is attractive as a substrate for stem cell expansion because it improves stemness through formation of spheroids. Hypoxia has also been proposed as a strategy to enhance stemness and survival of stem cells after in vivo implantation. This study was therefore designed to evaluate the influence of hypoxia on chitosan-induced behavior of stem cells. Umbilical cord matrix-derived stem cells were cultured on chitosan film or standard plate under normoxia and hypoxia, for 3 and 7 days. Based on immunophenotyping, chitosan strongly suppresses the expression of CD90 and CD105 cell surface markers, changes partially reversed by combined exposure to hypoxia. Hypoxia generally increased the volume and number of spheroids formed on chitosan, but the cellularity of cultures on chitosan films remained lower than that of standard plates. After 7 days of culture, the expression of stemness related genes (Oct4, Sox2, and Nanog) was best stimulated by combined exposure to chitosan and hypoxia. Based on our results, conditioning stem cells for 7 days on chitosan films under hypoxic conditions is recommended to enhance the stemness of stem cells, and minimize cell loss due to lack of attachment on chitosan. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 501-511, 2018.