Pastern dermatitis outbreak associated with toxigenic and non-toxigenic Corynebacterium diphtheriae and non-toxigenic Corynebacterium ulcerans at a horse stable in Finland, 2021.

AIMS: Corynebacterium diphtheriae and Corynebacterium ulcerans, when producing toxin, are the cause of diphtheria, a potentially life-threatening illness in humans. Horses (Equus ferus caballus) are known to be susceptible to infection that may manifest clinically on rare occasions. In late 2021 and early 2022, specimens from five horses suffering from pastern dermatitis were cultured at the Laboratory of Clinical Microbiology at the Faculty of Veterinary Medicine, University of Helsinki, Finland. C. diphtheriae and/or C. ulcerans were recovered from all of these. This study aimed to (1) analyse the bacterial isolates and (2) describe the outbreak and identify possible sources of the infection and infection routes in the stable. METHODS AND RESULTS: Susceptibility testing, PCR for the tox gene, and Elek test for toxin production in PCR-positive isolates were performed. Whole genome sequencing was also conducted to achieve high-resolution strain typing. An epidemiological survey was done by means of a semi-structured interview of horses' caretaker, and contact tracing was done among people at the stable. Two tox gene-positive, toxin-producing C. diphtheriae belonged to sequence type (ST) 822. Other C. diphtheriae (n = 2, ST828) and C. ulcerans (n = 2, ST325 and ST838) isolates did not carry the tox gene. The epidemiological investigation explored numerous possible routes of transmission, but the definite source of infection was not identified. All established human contacts tested negative for diphtheriae. All horses recovered after antimicrobial treatment. CONCLUSIONS: Our study shows that C. diphtheriae and C. ulcerans may readily spread among horses at the same stable and complicate pastern dermatitis infections. These potentially zoonotic bacteria can cause outbreaks even in a country with a very low prevalence. Caretakers should be encouraged to wear gloves and practice good hand hygiene when treating infected skin lesions in horses.

A detection dog for obstructive sleep apnea: could it work in diagnostics?

PURPOSE: We have previously demonstrated that dogs can be trained to distinguish the urine of patients with obstructive sleep apnea (OSA) from that of healthy controls based on olfaction. Encouraged by these promising results, we wanted to investigate if a detection dog could work as a screening tool for OSA. The objective of this study was to prospectively assess the dogs' ability to identify sleep apnea in patients with OSA suspicion. METHODS: Urine samples were collected from 50 patients suspected of having OSA. The urine sample was classified as positive for OSA when the patient had a respiratory event index of 5/h or more. The accuracy of two trained dogs in identifying OSA was tested in a prospective blinded setting. RESULTS: Both of the dogs correctly detected approximately half of the positive and negative samples. There were no statistically significant differences in the dogs' ability to recognize more severe cases of OSA, as compared to milder cases. CONCLUSION: According to our study, dogs cannot be used to screen for OSA in clinical settings, most likely due to the heterogenic nature of OSA.

A detection dog for obstructive sleep apnea.

PURPOSE: We sought to assess whether a dog can be trained to distinguish obstructive sleep apnea patients from healthy controls based on the olfactory detection of urine. METHODS: Urine samples were collected from 23 adult male obstructive sleep apnea patients and from 20 voluntary adult male volunteers. Three dogs were trained through reinforced operant conditioning. RESULTS: Two of the three dogs correctly detected two thirds of obstructive sleep apnea patients (p < 0.000194 and p < 0.000003, respectively). CONCLUSIONS: We found that dogs can be trained to distinguish obstructive sleep apnea patients from healthy controls based on the smell of urine. Potentially, dogs could be utilized to identify novel biomarkers or possibly screen for obstructive sleep apnea.

Hearing loss among classical-orchestra musicians.

This study intended to evaluate classical musicians' risk of hearing loss. We studied 63 musicians from four Helsinki classical orchestras. We measured their hearing loss with an audiometer, found their prior amount of exposure to sound and some individual susceptibility factors with a questionnaire, measured their present sound exposure with dosimeters, and tested their blood pressure and cholesterol levels, then compared their hearing loss to ISO 1999-1990's predictions. The musicians' hearing loss distribution corresponded to that of the general population, but highly exposed musicians had greater hearing loss at frequencies over 3 kHz than less-exposed ones. Their individual susceptibility factors were low. Music deteriorates hearing, but by less than what ISO 1999-1990 predicted. The low number of individual susceptibility factors explained the difference, but only reduced hearing loss and not the prevalence of tinnitus.

Social interactions between veterinary medical students and their teachers in an ambulatory clinic setting in Finland.

In this study, the social interactions between students and their teachers in an ambulatory clinic setting were investigated using Bales's interaction process analysis framework. Observational data were collected during five small-group sessions. The observations were quantified, and the behaviors of students and teachers were compared statistically. This study demonstrated that the interaction between students and their teachers was for the most part equal and could be characterized as "positively task oriented." The study has implications for veterinary educators wishing to use social psychology frameworks to assess the quality of learning in small-group clinical setting.

Traditional and nontraditional evaluations of student outcomes in a practical final examination of veterinary radiology.

The Faculty of Veterinary Medicine at the University of Helsinki recognized the lack of systems to measure the quality of education. At the department level, this meant lack of systems to measure the quality of students' outcomes. The aim of this article was to compare the quality of outcomes of a final examination in veterinary radiology by calculating the correlations between traditional (quantitative scores traditionally given by veterinary teachers) and nontraditional (qualitative Structure of the Observed Learning Outcome, or SOLO, method) grading results. Evaluation of the quality of the questions is also included. The results indicate that SOLO offers criteria for quality evaluation, especially for questions. A correlation of 0.60 (p<0.01) existed between qualitative and quantitative estimations, and a correlation of 0.79 (p<0.01) existed between evaluators, both using traditional scores. Two suggestions for a better system to evaluate quality in the future: First, development of problem-solving skills during the learning process should also be assessed. Second, both the scoring of factual correctness of answers (knowledge) and the grammatical structure of an answer and the quality of presentation should be included in the quality evaluation process.

Facilities for music education and their acoustical design.

Good rehearsal facilities for musicians are essential. Directive 2003/10/EC necessitates that musicians are protected from noise exposure. A code of conduct gives the guidelines how this should be done. This study examines room acoustics recommendations provided by the Finnish code of conduct, and discusses whether they are adequate. Small teaching facilities were measured after renovation and compared to earlier measurements. Teachers' opinions were inquired about the facilities before and after. The renovation did not decrease the noise exposure of the teachers. However, the majority preferred the facilities after the renovation. The Finnish code of conduct is not sufficient for facilities where loud instruments are played, or band practise. Good facilities can be designed but they must be specified at the designing stage for their intended use.

Evaluation of radiographic interpretation competence of veterinary students in Finland.

In the evaluation of the clinical competence of veterinary students, many different definitions and methods are approved. Due to the increasing discussion of the quality of outcomes produced by newly graduated veterinarians, methods for the evaluation of clinical competencies should also be evaluated. In this study, this was done by comparing two qualitative evaluation schemes: the well-known structure of observed learning outcome (SOLO) taxonomy and a modification of this taxonomy. A case-based final radiologic examination was selected and the investigation was performed by classifying students' outcomes. These classes were finally put next to original (quantitative) scores and the statistical calculations were initiated. Significant correlations between taxonomies (0.53) and the modified taxonomy and original scores (0.66) were found and some qualitative similarities between evaluation methods were observed. In addition, some supplements were recommended for the structure of evaluation schemes, especially for the structure of the modified SOLO taxonomy.

Evaluation of the level of difficulty of patient cases for veterinary problem-solving examination: a preliminary comparison of three taxonomies of learning.

An important issue that has received insufficient attention in the use of problem-based learning in the medical curriculum is the mode of assessing the level of difficulty of patient cases. In the present study, the level of difficulty of case-based questions in a veterinary degree final examination in reproduction was evaluated. First, cognitive taxonomies were evaluated to clarify whether qualitative methods such as Bloom's taxonomy, the Structure of the Observed Learning Outcome (SOLO) taxonomy, and the Amsterdam Clinical Challenge Scale (ACCS) differed from each other as evaluation tools for problem-based cases. Using these taxonomies, 30 case-based questions from the final examination in reproduction in the Helsinki veterinary program were initially evaluated to determine which one was best suited to the evaluation of the difficulty of cases. In follow-up, the same cases were also evaluated by an experienced veterinary instructor in reproduction, with the aim of gaining insight into using these approaches to evaluating difficulty. It would appear, from this preliminary assessment, that the SOLO taxonomy may be the most suitable for evaluating the difficulty of patient cases, since the instructor's quality rating resembled more closely the SOLO than the Bloom taxonomy or the ACCS. It is to be emphasized that the purpose of this study was to provide a preliminary evaluation of possible approaches that might be used to assess patient-case difficulty. Resolving all issues will require a greater number of evaluations of all components.

Solid-contact ion-selective electrodes for aromatic cations based on pi-coordinating soft carriers.

Ion-selective electrodes (ISEs) based on pi-coordinating carriers were prepared and investigated as potentiometric sensors for aromatic cations, using N-methylpyridinium as a model aromatic cation. Derivatives of tetraphenylborate were studied as charged carriers in plasticized poly(vinyl chloride) membranes. Furthermore, neutral compounds containing pi-coordinating anthryl groups were studied as neutral carriers. Bis(2-ethylhexyl)sebacate (DOS) and 2-nitrophenyl octyl ether (o-NPOE) were used as non-polar and polar plasticizer, respectively. ISEs were constructed by using poly(3,4-ethylenedioxythiophene) (PEDOT) as solid-contact material. Conventional ISEs with internal filling solution were used for comparison. The potentiometric responses of the ISEs were investigated using N-methylpyridinium as primary ion. The results show that the selectivity of the ISEs is influenced significantly by both the plasticizer and the charged carriers, while the neutral carriers studied have only a minor influence on the selectivity. The role of cation-pi interactions between aromatic cations and the membrane components is discussed.