Double outlet right atrium in a dog.

Double outlet right atrium is a rare congenital cardiac abnormality that has been previously reported in humans and cats, but not in dogs. A double outlet right atrium is typically characterized by the presence of a leftward deviation of the interatrial septum and atrial septal defect. Therefore, the right atrium drains into both ventricles. The unique features consistent with double outlet right atrium were identified by transthoracic echocardiography and computed tomography in a puppy. This case report describes the clinical, echocardiographic, and tomographic findings of a five-month-old Cocker Spaniel diagnosed with this rare congenital abnormality.

Knowledge and attitudes towards TB among healthcare workers in Yogyakarta, Indonesia.

SETTING: Healthcare workers (HCWs) are at an increased risk of TB worldwide. Individual knowledge and attitudes may influence HCW behaviour, and subsequently, TB risk. Indonesia has the second highest case-load globally. OBJECTIVE: To measure TB knowledge and attitudes among a subsection of HCWs in Yogyakarta, Indonesia, and to explore factors associated with knowledge. DESIGN: A cross-sectional study using an online survey targeting all HCW staff was conducted among HCWs from four pre-selected healthcare facilities in Yogyakarta. Descriptive analysis and a multivariable linear regression were undertaken. RESULTS: Of 792 HCWs, 290 (37%) completed the survey; 64% (n = 185) were medical staff, 33% (n = 95) reported previously being tested for active TB and 8% (n = 24) for latent TB. The mean knowledge score was 7.2/11 (SD 1.5): this was higher among medical staff and those with university education (average score increase: 0.53, 95% CI 0.15 to 0.90; and 0.38, 95% CI 0.01 to 0.74, respectively). Participants agreed that free access to TB screening (93%) and treatment (93%) should be available, and 57% of medical and 77% of non-medical staff would take preventive therapy if eligible. CONCLUSION: Participants had practical understanding of TB; however, gaps were identified in knowledge about TB disease progression and prevention. Prevention programmes were viewed positively. We suggest further TB education and engagement programmes for HCWs.

CONTEXTE: Les travailleurs de la santé (HCW) sont exposés à un risque accru de TB dans le monde entier. Les connaissances et les attitudes individuelles peuvent influencer le comportement des HCW et, par conséquent, le risque de TB. L'Indonésie a le deuxième plus grand nombre de cas dans le monde. OBJECTIF: Mesurer les connaissances et les attitudes à l'égard de la TB parmi un sous-groupe de HCW à Yogyakarta, en Indonésie, et explorer les facteurs associés aux connaissances de la TB. MÉTHODE: Une étude transversale a été menée à l'aide d'un sondage en ligne ciblant tous les HCW de quatre établissements de santé présélectionnés à Yogyakarta. Une analyse descriptive et une régression linéaire multivariable ont été effectuées. RÉSULTATS: Sur 792 HCW, 290 (37%) ont répondu à l'enquête ; 62% (n = 181) étaient des membres du personnel médical, 33% (n = 95) ont déclaré avoir déjà été testés pour la TB active et 8% (n = 24) pour la TB latente. Le score moyen de connaissances était de 7,2/11 (SD 1,5) : il était plus élevé parmi le personnel médical et les personnes ayant une formation universitaire (augmentation moyenne du score : 0,53 ; IC 95% 0,11­0,93 et 0,38 ; IC 95% 0,01­0,74, respectivement). Les participants étaient d'accord pour dire que l'accès au dépistage (93%) et au traitement (93%) de la TB devrait être gratuit, et 57% du personnel médical et 77% du personnel non médical suivraient un traitement préventif s'ils étaient éligibles. CONCLUSION: Les participants avaient une compréhension pratique de la TB ; cependant, des lacunes ont été identifiées dans les connaissances sur la progression de la maladie et la prévention de la TB. Les programmes de prévention ont été perçus positivement. Nous suggérons d'autres programmes d'éducation et d'engagement sur la TB pour les HCW.

Does Maintenance of Pulmonary Blood Flow Pulsatility at the Time of the Fontan Operation Improve Hemodynamic Outcome in Functionally Univentricular Hearts?

It is unclear whether residual anterograde pulmonary blood flow (APBF) at the time of Fontan is beneficial. Pulsatile pulmonary flow may be important in maintaining a compliant and healthy vascular circuit. We, therefore, wished to ascertain whether there was hemodynamic evidence that residual pulsatile flow at time of Fontan promotes clinical benefit. 106 consecutive children with Fontan completion (1999-2018) were included. Pulmonary artery pulsatility index (PI, (systolic pressure-diastolic pressure)/mean pressure)) was calculated from preoperative cardiac catheterization. Spectral analysis charted PI as a continuum against clinical outcome. The population was subsequently divided into three pulsatility subgroups to facilitate further comparison. Median PI prior to Fontan was 0.236 (range 0-1). 39 had APBF, in whom PI was significantly greater (median: 0.364 vs. 0.177, Mann-Whitney p < 0.0001). There were four early hospital deaths (3.77%), and PI in these patients ranged from 0.214 to 0.423. There was no correlation between PI and standard cardiac surgical outcomes or systemic oxygen saturation at discharge. Median follow-up time was 4.33 years (range 0.0273-19.6), with no late deaths. Increased pulsatility was associated with higher oxygen saturations in the long term, but there was no difference in reported exercise tolerance (Ross), ventricular function, or atrioventricular valve regurgitation at follow-up. PI in those with Fontan-associated complications or the requiring pulmonary vasodilators aligned with the overall population median. Maintenance of pulmonary flow pulsatility did not alter short-term outcomes or long-term prognosis following Fontan although it tended to increase postoperative oxygen saturations, which may be beneficial in later life.

Classification of portosystemic shunts entering the caudal vena cava at the omental foramen in dogs.

OBJECTIVE: To re-evaluate the anatomy and classification of congenital extrahepatic portosystemic shunts entering the caudal vena cava at the level of the omental foramen. MATERIAL AND METHODS: A retrospective review of a consecutive series of dogs undergoing CT angiography as part of the diagnostic work-up for a congenital extrahepatic portosystemic shunt. RESULTS: In total, 53 dogs met the inclusion criteria revealing four anatomically distinct omental foramen shunt types; one of which (32 of 53 dogs) showed no shunting blood flow through the right gastric vein and three of which (21 of 53 dogs) involved shunting flow through this vessel. The anatomy of these four distinct shunt types, as defined by CT angiography, was found to be highly consistent. In all cases, regardless of the tributary vessels, the left gastric vein was the final vessel that communicated with the caudal vena cava. Using these findings, a more accurate naming classification for congenital portosystemic shunts entering the caudal vena cava at the level of the omental foramen was proposed. CLINICAL SIGNIFICANCE: A precise pre-treatment anatomical classification of congenital extrahepatic portosystemic shunts entering the caudal vena cava at the level of the omental foramen is important for a more complete understanding of the severity of clinical signs and prognosis, and for the better communication between clinicians and researchers in this clinical field.

Microscopic determination of correlations in the fluid interfacial region in the presence of liquid-gas asymmetry.

In a recent article, we showed how the properties of the density-density correlation function and its integral, the local structure factor, in the fluid interfacial region, in systems with short-ranged forces, can be understood microscopically by considering the resonances of the local structure factor [A. O. Parry and C. Rascón, Nat. Phys. 15, 287 (2019)NPAHAX1745-247310.1038/s41567-018-0361-z]. Here, we illustrate, using mean-field square-gradient theory and the more microscopic Sullivan density functional model, and how this approach generalizes when there is liquid-gas asymmetry, i.e., when the bulk correlation lengths of the coexisting liquid and gas phases are different. In particular, we are able to express the correlation function exactly as a simple average of contributions arising from two effective Ising-symmetric systems referred to as the symmetric gas and symmetric liquid. When combined with our earlier results, this generates analytical approximations for the correlation function and the local structure factor, which are near indistinguishable from the numerical solution to the Ornstein-Zernike equations over the whole range of wave vectors. Our results highlight how asymmetry affects the correlation function structure and describes the crossover from a long-ranged Goldstone mode to short-ranged properties determined by the local density as the wave vector increases.

Correlation-function structure in square-gradient models of the liquid-gas interface: Exact results and reliable approximations.

In a recent article, we described how the microscopic structure of density-density correlations in the fluid interfacial region, for systems with short-ranged forces, can be understood by considering the resonances of the local structure factor occurring at specific parallel wave vectors q [Nat. Phys. 15, 287 (2019)1745-247310.1038/s41567-018-0361-z]. Here we investigate this further by comparing approximations for the local structure factor and pair correlation function against three new examples of analytically solvable models within square-gradient theory. Our analysis further demonstrates that these approximations describe the pair correlation function and structure factor across the whole spectrum of wave vectors, encapsulating the crossover from the Goldstone mode divergence (at small q) to bulklike behavior (at larger q). As shown, these approximations are exact for some square-gradient model potentials and never more than a few percent inaccurate for the others. Additionally, we show that they describe very accurately the correlation function structure for a model describing an interface near a tricritical point. In this case, there are no analytical solutions for the correlation functions, but the approximations are nearly indistinguishable from the numerical solutions of the Ornstein-Zernike equation.

Effect of caffeinated gum on a battery of rugby-specific tests in trained university-standard male rugby union players.

BACKGROUND: Caffeine has been shown to enhance strength, power and endurance, characteristics that underpin performance in rugby. Caffeinated gum has attracted interest as a novel vehicle for delivering caffeine, because absorption of caffeine from gum is quick. Rapid absorption of caffeine may be useful during rugby matches when there is limited time for supplementation such as at half-time or when substitutes enter play. The purpose of this study was to determine whether a low dose of caffeine in gum improves performance in a battery of rugby-specific tests. METHODS: In a double-blind, randomized, placebo-controlled, crossover design, 17 male university-standard rugby players (mass: 85.6 ± 6.3 kg; height: 179.4 ± 6.2 cm; age: 20.4 ± 1.2 years) chewed caffeinated gum (200 mg caffeine) or a placebo gum on two occasions separated by a week. After a standardized warm-up, gum was chewed for 5 min. Subsequently, participants performed three countermovement jumps, followed by an Illinois agility test, 6 × 30 m repeated sprints, and the Yo-Yo IR-2 test; each test was separated by short rest periods. RESULTS: Caffeinated gum enhanced countermovement jump by 3.6% (caffeine: 43.7 ± 7.6 cm vs. placebo: 42.2 ± 6.2 cm; d = 0.22, 95% CI [0.006, 0.432]; p = 0.044). There was a greater resistance to fatigue during the 6 × 30 m repeated sprint test (fatigue index caffeine: 102.2 ± 0.9% vs. placebo: 103.3 ± 1.2%; d = 1.03, 95% CI [0.430, 1.613]; p = 0.001), and performance on the Yo-Yo IR2 was improved by 14.5% (caffeine: 426 ± 105 m, placebo: 372 ± 91 m; d = 0.55, 95% CI [0.130, 0.957]; p = 0.010). Caffeine gum had no significant effect on the Illinois agility test (caffeine 16.22 ± 1.08 s vs. placebo 15.88 ± 1.09 s; d = - 0.31, 95% CI [- 0.855, 0.240]; p = 0.271). CONCLUSIONS: In university-standard rugby players, a low dose of caffeine (200 mg) supplied in chewing gum enhanced performance on the Yo-Yo IR-2 test and the countermovement jump test and reduced fatigue index during repeated sprints. These improvements in a battery of rugby-specific tests may transfer to enhanced performance in rugby matches.

A cost-effective colourimetric assay for quantifying hydrogen peroxide in honey.

Honey is a natural product with many beneficial properties including antimicrobial action. Production of hydrogen peroxide (H2O2) in diluted honey is central to this action. Here, we describe an optimized method for measuring levels of H2O2 in honey. This method is based on established methods, with the level of dilution, the time between dilution and reading the assay, and aeration of the samples during the assay identified as critical points for ensuring reliability and reproducibility. The method is cost-effective and easy to perform using common laboratory equipment. Using this method, we quantified the hydrogen peroxide content of five different, unprocessed polyfloral honeys collected in NC, USA. Our results show that H2O2 production by these honeys varies greatly, with some samples producing negligible levels of H2O2. We assessed the effect of colour on the assay by measuring the recovery of spiked H2O2 from light and dark honey and from serially diluted dark corn syrup, and found the amount of H2O2 that could be detected was lower in dark corn syrup and darker honey samples.

Implications of shunt morphology for the surgical management of extrahepatic portosystemic shunts.

OBJECTIVE: To describe the implications of extrahepatic portosystemic shunt morphology for the chosen site of shunt closure in dogs and cats. METHODS: A retrospective review of a consecutive series of dogs and cats managed for congenital extrahepatic portosystemic shunts. RESULTS: In total, 54 dogs and 10 cats met the inclusion criteria, revealing five distinct shunt types: left gastrophrenic, right gastrocaval (types Ai, Aii and Aiii), splenocaval, colocaval and left gastro-azygos. Without exception, findings of computed tomography angiography and direct gross observations at the time of surgery confirmed four consistent sites of communication between the anomalous shunting vessel and the systemic venous system: the caudal vena cava at the level of the epiploic foramen; the left phrenic vein at the level of the oesophageal hiatus; the azygos vein at the level of the aortic hiatus; and the caudal vena cava or iliac vein at the level of the 6th or 7th lumbar vertebrae. The use of intraoperative mesenteric portography was effective for confirming that at the time of surgery all portal tributary vessels were proximal to the point of shunt attenuation. CONCLUSIONS: Findings confirmed that for the common types of extrahepatic portosystemic shunts there were only four consistent sites of communication between the shunt and the systemic venous system. This information supports the use of a systematic approach for the location and attenuation of shunts in dogs and cats.

First-order wedge wetting revisited.

We consider a fluid adsorbed in a wedge made from walls that exhibit a first-order wetting transition and revisit the argument as to why and how the pre-filling and pre-wetting coexistence lines merge when the opening angle is increased approaching the planar geometry. We clarify the nature of the possible surface phase diagrams, pointing out the connection with complete pre-wetting, and show that the merging of the coexistence lines lead to new interfacial transitions. These occur along the side walls and are associated with the unbinding of the thin-thick interface, rather than the liquid-gas interface (meniscus), from the wedge apex. When fluctuation effects, together with the influence of dispersion forces are included, these transitions display strong non-universal critical singularities that depend on the opening angle itself. Similar phenomena are also shown to occur for adsorption near an apex tip.