Navicular bone fracture and severe deep digital flexor tendinopathy after palmar digital neurectomy in two horses.

Background: Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of which are debilitating. Case Description: This report describes two cases of navicular bone fracture with severe DDF tendinopathy and distal interphalangeal joint subluxation/hyperextension that occurred 12 and 19 weeks after bilateral forelimb PDN. Conclusion: These two cases highlight the importance of proper patient selection before PDN due to the high incidence of undiagnosed soft tissue pathology in conjunction with radiographic evidence of navicular syndrome. Advanced imaging of the digit is recommended to identify and characterize any soft tissue pathology associated with the navicular apparatus before pursuing PDN to avoid disease progression and catastrophic injury.

Case report: Use of penicillin G potassium in poloxamer 407 gel to aid in healing of an equine sublingual abscess.

The use of poloxamer 407 gels have been reported in several studies to prolong the release of drugs at the injection site. Oral lesions unrelated to dental disease are rare but may result in ulceration and sequestration of bone. To date, there have been no reports on the use of penicillin G potassium poloxamer 407 gel and its effect on wound healing. The present case report describes the use of a penicillin G potassium poloxamer 407 gel for the treatment of a sublingual abscess involving the mandible in a 20 year old Arabian mare who initially presented with acute onset of dysphagia, hypersalivation, and a mass under the tongue. A presumptive diagnosis of lingual cellulitis was made, and a sublingual abscess ruptured on day 7 of hospitalization. In this case, poloxamer 407 gel was used to decrease wound contamination, protect the exposed mandible, and potentially prolong the release of penicillin G potassium into the wound.

Implementation of SARS-CoV2 Screening in K-12 Schools Using In-School Pooled Molecular Testing and Deconvolution by Rapid Antigen Test.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) testing is one component of a multilayered mitigation strategy to enable safe in-person school attendance for the K-12 school population. However, costs, logistics, and uncertainty about effectiveness are potential barriers to implementation. We assessed early data from the Massachusetts K-12 public school pooled SARS-CoV2 testing program, which incorporates two novel design elements: in-school "pod pooling" for assembling pools of dry anterior nasal swabs from 5 to 10 individuals and positive pool deconvolution using the BinaxNOW antigen rapid diagnostic test (Ag RDT), to assess the operational and analytical feasibility of this approach. Over 3 months, 187,597 individual swabs were tested across 39,297 pools from 738 schools. The pool positivity rate was 0.8%; 98.2% of pools tested negative and 0.2% inconclusive, and 0.8% of pools submitted could not be tested. Of 310 positive pools, 70.6% had an N1 or N2 probe cycle threshold (CT) value of ≤30. In reflex testing (performed on specimens newly collected from members of the positive pool), 92.5% of fully deconvoluted pools with an N1 or N2 target CT of ≤30 identified a positive individual using the BinaxNOW test performed 1 to 3 days later. However, of 124 positive pools with full reflex testing data available for analysis, 32 (25.8%) of BinaxNOW pool deconvolution testing attempts did not identify a positive individual, requiring additional reflex testing. With sufficient staffing support and low pool positivity rates, pooled sample collection and reflex testing were feasible for schools. These early program findings confirm that screening for K-12 students and staff is achievable at scale with a scheme that incorporates in-school pooling, primary testing by reverse transcription-PCR (RT-PCR), and Ag RDT reflex/deconvolution testing.

Functional Effectiveness of Inpatient Rehabilitation After Heart Transplantation.

BACKGROUND: Heart transplantation (HT) is the treatment of choice for many patients with end-stage heart failure who remain symptomatic despite optimal medical therapy, but no study has looked directly into functional improvement of HT patients after an inpatient rehabilitation program. OBJECTIVE: To determine functional improvement in HT patients who completed an inpatient rehabilitation program. DESIGN: Retrospective study. SETTING: An inpatient rehabilitation facility (IRF) associated with a tertiary care hospital. PATIENTS: Seventeen patients admitted between March 2011 and September 2014 after HT. METHODS: Demographic, clinical, and functional data (admission and discharge Functional Independence Measure [FIM] scores) were recorded. Change in FIM scores and FIM efficiency (change in FIM score/length of stay) were analyzed. FIM outcomes for HT patients were compared with regional and national averages for patients undergoing an inpatient rehabilitation program for cardiac debility. As a secondary outcome, we evaluated whether body mass index of HT patients had an impact on FIM gains in an IRF. Individual FIM items were analyzed for trends. Results are reported as mean ± SD. RESULTS: Twelve male and 5 female patients with mean age of 61.2 ± 4.5 years were identified. Three patients were readmitted to acute hospital because of complications. For those 14 patients who completed the IRF stay, the mean admission and discharge motor FIM were 51.5 (±14.6) and 74.7 (±12.0), respectively. The mean admission and discharge cognition FIM were 30.9 (±3.2) and 32.9 (±1.7), respectively. The mean total FIM gain was 26.9 ± 13.3 (P < .05). The mean FIM efficiency was 3.2 (±2.0). After admission to an IRF, 82% were discharged home with statistically significant improvement in their functional ability. In addition, all individual FIM items improved from admission to discharge. There was positive relationship between body mass index and FIM gain but this was not statistically significant. CONCLUSIONS: An inpatient rehabilitation program appears to positively impact optimal outcomes (functional recovery and discharge to home) for selected patients with HT and is comparable with regional and national FIM gain and efficiency for patients admitted to IRFs with other cardiac conditions.

Research Ethics Education in the STEM Disciplines: The Promises and Challenges of a Gaming Approach.

While education in ethics and the responsible conduct of research (RCR) is widely acknowledged as an essential component of graduate education, particularly in the STEM disciplines (science, technology, engineering, and math), little consensus exists on how best to accomplish this goal. Recent years have witnessed a turn toward the use of games in this context. Drawing from two NSF-funded grants (one completed and one on-going), this paper takes a critical look at the use of games in ethics and RCR education. It does so by: (a) setting the development of research and engineering ethics games in wider historical and theoretical contexts, which highlights their promise to solve important pedagogical problems; (b) reporting on some initial results from our own efforts to develop a game; and (c) reflecting on the challenges that arise in using games for ethics education. In our discussion of the challenges, we draw out lessons to improve this nascent approach to ethics education in the STEM disciplines .

Videos to influence: a systematic review of effectiveness of video-based education in modifying health behaviors.

This systematic review examines the effectiveness of videos in modifying health behaviors. We searched PubMed (1975-2012), PsycINFO (1975-2012), EMBASE (1975-2012), and CINAHL (1983-2012) for controlled clinical trials that examined the effectiveness of video interventions in changing health behaviors. Twenty-eight studies comprised of 12,703 subjects were included in the systematic review. Video interventions were variably effective for modifying health behaviors depending on the target behaviors to be influenced. Video interventions appear to be effective in breast self-examination, prostate cancer screening, sunscreen adherence, self-care in patients with heart failure, HIV testing, treatment adherence, and female condom use. However, videos have not shown to be effective in influencing addiction behaviors when they are not tailored. Compared to loss-framing, gain-framed messages may be more effective in promoting certain types of health behavior change. Also, video modeling may facilitate learning of new behaviors and can be an important consideration in future video interventions.

Amb a 1-linked CpG oligodeoxynucleotides reverse established airway hyperresponsiveness in a murine model of asthma.

BACKGROUND: Recently, it has been demonstrated that immunostimulatory DNA sequences (ISS) containing CpG motifs prevent the development of allergic airway responses in murine models of disease. However, few studies have addressed the issue of whether these agents will reverse established Tm(H)2-driven allergic airway responses. OBJECTIVE: The aim of this study was to determine whether intradermal delivery of an immunogenic protein of ragweed pollen linked to an immunostimulatory DNA sequence could reverse an established allergic response in the mouse lung. METHODS: Mice sensitized and challenged with ragweed pollen extract were treated intradermally twice at 1-week intervals with an ISS chemically linked to Amb a 1 (Amb a 1-ISS). One week after the Amb a 1-ISS treatment, mice were rechallenged intratracheally with ragweed extract, and airway responses were assessed. RESULTS: Amb a 1-ISS treatment of ragweed-sensitized and ragweed-challenged mice significantly reversed allergen-induced airway hyperresponsiveness and suppressed the total number of eosinophils in bronchoalveolar lavage fluid. The inhibitory effect of Amb a 1-ISS was associated with a marked increase in IFN-gamma levels by Amb a 1-stimulated splenocytes and a shift in the antibody profile from a T(H)2-directed IgG1 response to a T(H)1-directed IgG2a response. Interestingly, the inhibitory effect of Amb a 1-ISS on allergen-driven airway hyperresponsiveness was independent of suppression of T(H)2 cytokine production. CONCLUSION: These results demonstrate that intradermal delivery of allergen-specific DNA conjugates can reverse established allergic responses in the murine lung, supporting their potential use in the treatment of human asthma.