Machine Learning Techniques for Canine Myxomatous Mitral Valve Disease Classification: Integrating Anamnesis, Quality of Life Survey, and Physical Examination.

Myxomatous mitral valve disease (MMVD) is a prevalent canine cardiac disease typically diagnosed and classified using echocardiography. However, accessibility to this technique can be limited in first-opinion clinics. This study aimed to determine if machine learning techniques can classify MMVD according to the ACVIM classification (B1, B2, C, and D) through a structured anamnesis, quality of life survey, and physical examination. This report encompassed 23 veterinary hospitals and assessed 1011 dogs for MMVD using the FETCH-Q quality of life survey, clinical history, physical examination, and basic echocardiography. Employing a classification tree and a random forest analysis, the complex model accurately identified 96.9% of control group dogs, 49.8% of B1, 62.2% of B2, 77.2% of C, and 7.7% of D cases. To enhance clinical utility, a simplified model grouping B1 and B2 and C and D into categories B and CD improved accuracy rates to 90.8% for stage B, 73.4% for stages CD, and 93.8% for the control group. In conclusion, the current machine-learning technique was able to stage healthy dogs and dogs with MMVD classified into stages B and CD in the majority of dogs using quality of life surveys, medical history, and physical examinations. However, the technique faces difficulties differentiating between stages B1 and B2 and determining between advanced stages of the disease.

Anaesthetic mortality in dogs: A worldwide analysis and risk assessment.

BACKGROUND: Ensuring patient safety during small animal anaesthesia is crucial. This study aimed to assess anaesthetic-related deaths in dogs globally, identify risks and protective factors and inform clinical practice. METHODS: This prospective cohort multicentric study involved 55,022 dogs from 405 veterinary centres across various countries. Data on anaesthesia-related deaths from premedication to 48 hours post-extubation were collected. Logistic regression was used to analyse patient demographics, American Society of Anesthesiologists (ASA) classification, procedure type and anaesthetic drugs used. RESULTS: Anaesthetic-related mortality was 0.69%. Most deaths occurred postoperatively (81%). Age, obesity and a higher ASA classification score were associated with increased mortality. Urgent procedures, non-urgent but unscheduled anaesthesias and short procedures also had higher mortality. Some sedatives, systemic analgesics, hypnotics and the use of locoregional anaesthesia were linked to a decrease in mortality. LIMITATIONS: The limitations of the study include the non-randomised sample, potential selection bias, lack of response rate quantification, variable data quality control, subjectivity in classifying causes of death and limited analysis of variables. CONCLUSION: Careful patient evaluation, drug selection and monitoring can be associated with reduced mortality. These findings can be used to develop guidelines and strategies to improve patient safety and outcomes. Further research is needed to refine protocols, enhance data quality systems and explore additional risk mitigation measures.

Embracing Leadership: How Junior Medical Officers Shape the Future.

Transitioning from medical residency to an operational role challenges junior medical officers as their leadership skills are put to the test. In the multifaceted role of Military Medical Corps Officers, patient care remains paramount, and effective leadership hinges on core values. From clinical competence and mentorship to modeling behavior and fostering adaptability, this article underscores the importance of leadership development for junior officers as they transition from the training centers into the operational environment. Effective junior officer leaders become force multipliers, empowering their teams and cultivating future leaders to uphold the values essential to mission success.

Haemodynamic Effects of Pimobendan during General Anaesthesia in Healthy Senior Dogs: A Prospective, Randomised, Triple-Blinded, Placebo-Controlled Clinical Study.

Pimobendan is an inotropic and vasodilator drug with no sympathomimetic effects. This study aimed to evaluate the haemodynamic effects of pimobendan during anaesthesia in healthy senior dogs. A prospective, randomised, triple-blinded, placebo-controlled clinical study was conducted. Thirty-three dogs (median [range]: 9 [7, 12] years) were anaesthetised for surgical procedures. The dogs were randomly allocated into two groups: eighteen dogs received intravenous pimobendan at a dose of 0.15 mg/kg (PIMOBENDAN), and fifteen dogs received intravenous saline solutions at a dose of 0.2 mL/kg (PLACEBO). Data were recorded before, 1 min, 10 min, and 20 min after injection. Velocity-time integral (VTI), peak-velocity (PV), and mean-acceleration (MA) were measured using an oesophageal Doppler monitor (ODM). Heart rate and mean arterial pressure were also registered. The data were analysed using a two-way ANOVA for trimmed means. Statistical differences were considered if p < 0.05. Twenty minutes after injection, the VTI (13.0 cm [10.4, 22.3]), PV (95.0 [83.0, 160] m/s), and MA (12.6 [9.40, 17.0] m/s2) were significantly higher in the PIMOBENDAN group compared to the PLACEBO group (VTI: 10.5 [6.50, 17.4] cm, PV: 80.0 [62.0, 103] m/s and MA: 10.2 [7.00, 16.0] ms2). No significant differences were observed in the rest of the variables. Using pimobendan during anaesthesia increases VTI, PV, and MA, as measured by an ODM.

An Ultrasound-Guided Latero-Ventral Approach to Perform the Quadratus Lumborum Block in Dog Cadavers.

The QL block is a high-level locoregional anesthesia technique, which aims to provide analgesia to the abdomen. Several approaches of the QL block have been studied to find out which one allows a greater distribution of the injectate. The aim of this study is to compare the traditional interfascial QL block (IQL) with a new latero-ventral approach (LVQL). We hypothesize that this new approach could be safer and easier to perform, since the injectate is administered more superficially and further away from vital structures. Our second objective is to assess whether a higher volume of injectate (0.6 mL/kg) could reach the ventral branches of the last thoracic nerves, leading to a blockade of the cranial abdomen. Six thawed canine cadavers (12 hemiabdomens) were used for this purpose. Both approaches were performed in all cadavers. A combination of methylene blue/iopromide was administered to each hemiabdomen, randomly assigned to the LVQL or IQL. No differences were found regarding the ease of perform the LVQL with respect to IQL. The results show that both techniques reached the ventral branches from L1 to L3, although only the IQL consistently stained the sympathetic trunk (5/6 IQL vs. 1/6 LVQL). The use of a higher volume did not enhance a more cranial distribution of the injectate.

Ocular Manifestations of Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) is a chronic disease connected to the immune system, with a predilection for the gastrointestinal tract. However, a large proportion of the patients have extraintestinal manifestations (EIM), and the ocular system is affected in some patients. The clinical presentation of ocular pathology is broad, ranging from asymptomatic cases to blindness, leading to high morbidity. Ocular complications can be primary and, in general, are associated with episodes of acute flare-ups that subside with immunological management of the digestive disease. Secondary complications arise from the primary ones and as adverse effects of immunological treatment. In addition, on many occasions, the ocular manifestation may appear prior to the presentation of digestive symptoms. The presence of a multidisciplinary team that includes a gastroenterologist and an ophthalmologist is important in order to achieve early diagnosis of ocular complications, thereby preventing, treating, and avoiding unfavorable and irreversible long-term ocular sequelae.

Impact of the pre-drying process on the volatile profile of on-farm processed Ecuadorian bulk and fine-flavour cocoa varieties.

Aiming to improve the quality of cocoa, preconditioning of cocoa after harvesting and before fermentation has become an on-farm processing step of great interest in recent times. The present work aimed to evaluate the influence of a pre-drying process on the volatile composition of Ecuadorian bulk (Forastero and CCN-51) and fine-flavour (ETT103 and LR14) cocoa at the end of primary processing. A total of 63 volatile compounds including aldehydes, alcohols, acids, ketones, esters, terpenes, lactones and other miscellaneous compounds were identified in cocoa samples by HS-SPME-GC-MS. The use of a pre-drying step revealed a varietal homogenization and a reduction in the fermentation time, making this preconditioning step an inexpensive and attractive option for farmers. Moreover, different varietal behaviour was observed after pre-drying, the fine-flavour varieties obtaining a clear improvement in aromatic quality with higher levels of compounds imparting positive notes.

Effect of Drying Technique on the Volatile Content of Ecuadorian Bulk and Fine-Flavor Cocoa.

Cocoa (Theobroma cacao L.) is one of the most widely consumed edible seeds in the world affected by on-farm processing. This study investigated the effect of different drying techniques, namely oven drying (OD), sun drying (SD), and a modification of sun drying using black plastic sheeting (SBPD), on the volatile profile of fine-flavor and bulk cocoa varieties analyzed by HS-SPME-GC-MS. A total of sixty-four volatile compounds were identified in fresh and dried cocoa. As expected, the volatile profile was clearly modified after the drying step, showing strong differences among cocoa varieties, this factor and its interaction with the drying technique having greater influence according to the ANOVA simultaneous component analysis. A principal component analysis revealed a close relationship between the volatile content of bulk cocoa samples dried by the OD and SD techniques, whereas slight volatile modifications were perceived among fine-flavor samples dried using the three different techniques under study. Overall, the results provide the basis for the potential application of the simplest inexpensive SBPD technique in order to accelerate the drying process of sun drying and produce cocoa with similar (fine-flavor cocoa) or improved (bulk cocoa) aromatic quality to that formed using the traditional SD or the small-scale OD.

Vasovagal Electrophysiology on 12-Lead ECG After Venipuncture.

Vasovagal syncope is the most common form of syncope seen in young and otherwise healthy active duty service members. Although self-limiting, syncopal events often produce a significant drain of medical resources because of their sudden and often dramatic presentation, which can be associated with traumatic injuries secondary to loss in postural tone. Malignant differential pathologies associated with syncopal presentation need to be ruled out, which in turn further diminishes resources, especially in a deployed environment that is often in austere, remote locations with a lack of readily available medical supplies. We present a case of vasovagal syncope experienced by a 20-year-old sailor shortly after venipuncture and the 12-lead electrocardiogram captured shortly after presentation. This case highlights the unique electrophysiology during a vasovagal episode and the impact a relatively benign condition has on medical operations in the operational setting.

Aging: working memory capacity and spatial strategies in a virtual orientation task.

Brain networks involved in working and spatial memory are closely intertwined, outlining a potential relation between these processes, which are also affected in non-pathological aging. Working memory is a pre-requisite for other complex cognitive processes. The main aim of this study is to explore how working memory capacity (WMC) can influence the asymmetrical decline in spatial orientation strategies in an older segment of population compared to young participants. Forty-eight older adults and twelve young students took part in the study. Working memory and spatial memory were assessed using the Change Localization Task and The Boxes Room Task, respectively. In The Boxes Room Task, two different configurations assessed the use of egocentric and allocentric reference frames. Results showed that older adults with better WMC outperformed those with lower WMC in several tasks. Independently of WMC capacity, older participants performed better in the allocentric condition of The Boxes Room. In addition, young participants outscored low WMC older participants, but did not differ from high WMC older adults. Overly, these findings support the important relationship between working memory capacity and spatial orientations abilities. Thus, basic cognitive mechanisms engaged in information processing could inform about other brain processes more complex in nature, like spatial orientation skills.

Power from Geothermal Resources as a Co-product of the Oil and Gas Industry: A Review.

The increase in the global demand for energy and fossil fuel dependency is hindering efforts to reduce greenhouse gas (GHG) emissions. Geothermal resources supplement this increase in energy demand with reduced emissions because of their availability, base-load production profile, and climatic independence. Despite these advantages, the development of geothermal energy is limited because of different reasons such as subsurface exploration risk and high upfront capital cost for drilling and facility construction. However, similarities in infrastructure and operations between the oil and gas industry and the geothermal industry can optimize expense and development when exploiting geothermal resources. Thus, in this review, we present recent advances and applications of geothermal power systems in the oil and gas industry starting from the fundamentals and basic principles of geothermal energy and the organic Rankine cycle (ORC). These applications include the use of geothermal resources via abandoned wells, active wells, and paired thermal enhanced oil recovery processes with injection for fluid heating and energy production. Abandoned wells are alternatives that reduce costs in geothermal energy-use projects. The use of geothermal resources via active wells allows the valorization of a resource, such as the production of water, which is considered a byproduct of production activities in an oilfield. The use of thermally enhanced oil recovery processes enhances the energy conditions of fluids produced in the field, improving geothermal systems with fluids at higher temperatures. Finally, an overview is presented of the challenges and opportunities of geothermal energy in the oil industry where the requirement to improve the usage of technologies, such as the ORCs, with the working fluids used in the cycles, is highlighted. Furthermore, the importance of environmental studies and use of novel tools, such as nanotechnology, to improve the efficiency of geothermal energy usage is highlighted.

Cranial thoracic myelopathies (T1-T6 vertebrae): Retrospective evaluation of the signalment, clinical presentation, and, presumptive or final diagnoses in 84 dogs.

The aim of the study was to describe the signalment, clinical presentation and presumptive or final diagnoses of dogs with cranial thoracic spinal cord lesions identified on advanced imaging. Retrospective evaluation of the databases of three veterinary specialty centres, between 2009 and 2021, was performed to identify dogs with a lesion affecting the cranial thoracic vertebral column (T1-T6 vertebrae) as the primary cause for presenting signs of myelopathy and/or spinal pain. Eighty-four dogs were included in the study, with the majority (n = 76) presenting with a progressive history of over 4-weeks' duration. On neurologic examination, most dogs were ambulatory (n = 64), and the most common neuroanatomic localisation was the T3-L3 spinal cord segments (n = 63). Twelve dogs (14%) showed a short-strided thoracic limb gait on clinical examination. The most common diagnosis was neoplasia (n = 33), followed by anomalies (n = 22, including vertebral body malformations in 14 dogs) and degenerative disorders (n = 16, with intervertebral disc protrusion diagnosed in 9 dogs). The most common vertebrae affected were T3 and T5. Most dogs with degenerative conditions showed asymmetric clinical signs, and the majority of dogs with neoplasia showed signs of spinal hyperaesthesia on examination. The findings of this study describe the clinical signs and presumptive or final diagnoses associated with lesions affecting the cranial thoracic spinal cord. When combined with the signalment and clinical history, this information can assist in both the recognition of and problem-based approach to these cases.

Clinical Assessment of Introducing Locoregional Anaesthesia Techniques as Part as the Intraoperative Analgesia Management for Canine Ovariohysterectomy in a Veterinary Teaching Hospital.

This study compared four methods to provide intraoperative analgesia during canine ovariohysterectomy in a veterinary teaching hospital. A retrospective study was designed to assess the nociceptive response, cardiorespiratory stability, quality of recovery and complications of four analgesic protocols: epidural analgesia (EPIDURAL group), Quadratus Lumborum block (QLB group), Transversus Abdominis Plane block (TAP group), and just systemic analgesia (GENERAL group). Undergraduate students carried out all the loco-regional techniques under the direct supervision of a qualified anaesthetist. A total of 120 cases met the inclusion criteria and were included in the study and were distributed as follows: 22, 27, 32 and 39 cases with EPIDURAL, GENERAL, QLB and TAP groups, respectively. Data were analysed with statistical software R using different statistical methods. Significant differences among groups were defined as p < 0.05. Based on our results, all the groups needed the same number of rescue analgesia during the intra-operative period. The use of loco-regional techniques anticipated a better quality of recovery compared with the general group. The EPIDURAL group showed a statistically lower expired fraction of sevoflurane. No differences were found regarding complications. In conclusion, these four analgesic methods are suitable and safe to be performed for canine ovariohysterectomy, although loco-regional techniques might have some advantages.

Improved Joint Health Following Oral Administration of Glycosaminoglycans with Native Type II Collagen in a Rabbit Model of Osteoarthritis.

A prospective, experimental, randomized, double blinded study was designed to evaluate the effects of glycosaminoglycans, with or without native type II collagen (NC), in an osteoarthritis model induced by cranial cruciate ligament transection. The following compounds were tested: chondroitin sulfate (CS), glucosamine hydrochloride (GlHCl), hyaluronic acid (HA) and NC. Fifty-four female 12-week-old New Zealand rabbits were classified into three groups: CTR (control-no treatment), CGH (CS + GlHCl + HA) and CGH-NC (CS + GlHCl + HA + NC). Each group was subdivided into three subgroups according to survival times of 24, 56 and 84 days. Over time, all rabbits developed degenerative changes associated with osteoarthritis. CGH-NC showed significantly improved values on macroscopic evaluation, compared to CTR and CGH. Microscopically, significantly better results were seen with CGH and CGH-NC, compared to CTR, and synovial membrane values were significantly better with CGH-NC compared to CGH. A significant improvement in magnetic resonance imaging biomarkers was also observed with CGH-NC in cartilage transversal relaxation time (T2) and subchondral bone D2D fractal dimension in the lateral condyle. In conclusion, our results show beneficial effects on joint health of CGH and CGH-NC and also supports that adding NC to CGH results in even greater efficacy.

Applying color recognition techniques to achieve low-cost portable digital board functionalities.

Digital teaching support devices, like digital boards, are becoming increasingly popular to improve concept learning, as they allow manipulating represented objects in new and very innovative ways if compared with traditional boards. However, their acquisition cost (device, software licenses, additional hardware), and the lack of deployment flexibility to adapt to certain classroom configurations, are the main problems that prevents them to be used in a substantial number of educational environments or slow their adoption rate. This research shows that a color recognition algorithm, applied to projected images captured by consumer-grade webcams, can successfully provide functionalities equivalent to typical digital boards on low-budget educational environments. This way, a pointer object is recognized by its color, and its actions are interpreted at real time to be converted to standard UI actions in the computer screen, as a standard input device. The prototype has been also designed to be usable in classroom environments of different sizes, available space, or configuration, maximizing reutilization of existing elements in the classroom. The research prototype was successfully deployed in a real classroom using modest hardware, inexpensive requirements, and very flexible setup options, adapting both to student and teacher needs.

Chronic Administration of Cannabinoid Receptor 2 Agonist (JWH-133) Increases Ectopic Ovarian Tumor Growth and Endocannabinoids (Anandamide and 2-Arachidonoyl Glycerol) Levels in Immunocompromised SCID Female Mice.

Cannabinoid-based therapies are increasingly being used by cancer patients to treat chemotherapy-induced nausea and vomiting. Recently, cannabinoids have gained increased attention for their effects on cancer growth. Indeed, the effect of CB2 (JWH-015, JWH-133) agonists on breast cancer models have shown to reduce the size of breast cancer tumors. However, these studies assessing breast cancer progression were using CB2 agonist administered early into the cancer progression therefore assessing their effects on already established tumors is a critical need. In our study, we evaluate tumor growth using an ectopic xenograft ovarian (SKOV-3 and OVCAR-5) cancer model. The impact of chronic (30 days) administration of CB2 (JWH-133) agonist will be evaluated and started on 30 days of ectopic ovarian tumors. We will then evaluate and determine the mechanisms involved in ovarian cancer tumor growth by measuring levels of anandamide and 2-arachidonoyl glycerol as well as protein levels of CB1, CB2, ERα, ERß, GPER, TNFα, IL-1ß and IL-6 in ovarian and tumor tissues. Our results demonstrate a significant increase in ectopic ovarian tumor growth following chronic administration of JWH-133. Ovarian cancer tumor tissues chronically (30 days) treated with JWH-133 in comparison to vehicle treated groups showed an increase in endocannabinoid (AEA and 2-AG) and protein (CB2 and TNFα) levels with a decrease in GPER protein levels. Interestingly, our study emphasizes the importance of studying the impact of cannabinoid compounds on already established tumors to improve our understanding of cannabinoid-based therapies and, therefore better address clinical needs in cancer patients.

Evaluation of Quadratus Lumborum Block as Part of an Opioid-Free Anaesthesia for Canine Ovariohysterectomy.

Quadratus lumborum block (QLB) is used to provide analgesia for abdominal surgery in humans. The aim of this study was to assess an anaesthetic protocol involving the QLB for canine ovariohysterectomy. Ten dogs were included. Anaesthetic protocol consisted of premedication with IM medetomidine (20 µg kg-1) and SC meloxicam (0.1 mg kg-1), induction with propofol to effect, and maintenance with sevoflurane in oxygen/medical air. QLB was performed injecting 0.4 mL kg-1 of 0.25% bupivacaine/iohexol per side. Computed Tomography (CT) was performed before and after surgery. Fentanyl was administered as rescue analgesia during surgery. The Short Form of The Glasgow Composite Pain Scale and thermal threshold (TT) at the level of the elbow, T10, T13 and L3 were assessed before premedication and every hour postoperatively. Methadone was given as rescue analgesia postoperatively when pain score was >3. A Yuen's test on trimmed means for dependent samples was used to analyse the data (p < 0.05). CT images showed spreading of the contrast/block for a median (range) of 3 (2-5) vertebrae, without differences between preoperative and postoperative images. One dog needed rescue analgesia during surgery. Pain score was less than 4/24 in all the animals during the first 4 h after surgery. TT showed a significant increased signal in all the areas tested, apart from the humerus, 30 min after surgery. The QLB may provide additional analgesia for canine ovariohysterectomy. Further studies are needed to assess the specific contribution of the QLB in abdominal analgesia.