Clinical findings associated with blunt ocular trauma in horses: a retrospective analysis.

OBJECTIVE: Identify ocular findings associated with blunt ocular trauma to aid in differentiation from other equine ocular diseases. STUDY DESIGN: Retrospective case-control study. METHODS: Medical records of horses at the Equine Clinic Munich-Riem, Munich, Germany and Auburn University, College of Veterinary Medicine were reviewed. Age, sex, breed, laterality, and clinical findings on ophthalmic examination, as well as an observed (confirmed) or unobserved (suspected) history of trauma, were recorded. Statistical analysis was performed to identify any correlation between clinical signs and blunt ocular trauma. Fifty-nine clinical signs were evaluated, and their association with blunt ocular trauma and non-traumatic uveitis was determined. The frequency of clinical signs associated with non-traumatic uveitis was also reported. RESULTS: Fifty-five eyes affected with blunt trauma were included. The comparison group consisted of 233 eyes (168 horses) diagnosed with non-traumatic uveitis. The most frequent ocular findings after BOT included cataract (36/55, 65.5%), corneal edema (26/55, 47.2%), decreased intraocular pressure (23/55, 41.8%), aqueous flare (19/55, 34.5%), lens subluxation, luxation, or lens loss (18/55, 32.7%), fibrin in the anterior chamber (18/55, 32.7%), hyphema (16/55, 29.1%), peripapillary depigmentation ("butterfly lesion") (16/55, 29.1%), conjunctival hyperemia (16/55, 29.1%), corneal fibrosis (15/55, 27.3%), corpora nigra avulsion (14/55, 25.5%), blepharospasm (13/55, 23.6%), and iridodialysis (11/55, 20.0%). CONCLUSIONS: The characteristic pattern of ocular signs associated with blunt ocular trauma may assist in differentiation from other types of uveitis and may improve interpretation of ocular lesions identified during pre-purchase examinations. This study also represents the first peer-reviewed documented and photographed cases of iridodialysis in the horse.

Are we prepared for the next influenza pandemic? Lessons from modelling different preparedness policies against four pandemic scenarios.

In the event of a novel influenza strain that is markedly different to the current strains circulating in humans, the population have little/no immunity and infection spreads quickly causing a global pandemic. Over the past century, there have been four major influenza pandemics: the 1918 pandemic ("Spanish Flu"), the 1957-58 pandemic (the "Asian Flu"), the 1967-68 pandemic (the "Hong Kong Flu") and the 2009 pandemic (the "Swine flu"). To inform planning against future pandemics, this paper investigates how different is the net-present value of employing pre-purchase and responsive- purchased vaccine programmes in presence and absence of anti-viral drugs to scenarios that resemble these historic influenza pandemics. Using the existing literature and in discussions with policy decision makers in the UK, we first characterised the four past influenza pandemics by their transmissibility and infection-severity. For these combinations of parameters, we then projected the net-present value of employing pre-purchase vaccine (PPV) and responsive-purchase vaccine (RPV) programmes in presence and absence of anti-viral drugs. To differentiate between PPV and RPV policies, we changed the vaccine effectiveness value and the time to when the vaccine is first available. Our results are "heat-map" graphs displaying the benefits of different strategies in pandemic scenarios that resemble historic influenza pandemics. Our results suggest that immunisation with either PPV or RPV in presence of a stockpile of effective antiviral drugs, does not have positive net-present value for all of the pandemic scenarios considered. In contrast, in the absence of effective antivirals, both PPV and RPV policies have positive net-present value across all the pandemic scenarios. Moreover, in all considered circumstances, vaccination was most beneficial if started sufficiently early and covered sufficiently large number of people. When comparing the two vaccine programmes, the RPV policy allowed a longer timeframe and lower coverage to attain the same benefit as the PPV policy. Our findings suggest that responsive-purchase vaccination policy has a bigger window of positive net-present value when employed against each of the historic influenza pandemic strains but needs to be rapidly available to maximise benefit. This is important for future planning as it suggests that future preparedness policies may wish to consider utilising timely (i.e. responsive-purchased) vaccines against emerging influenza pandemics.

Long-term monitoring of opioid, sedative and anti-inflammatory drugs in horse hair using a selective and sensitive LC-MS/MS procedure.

BACKGROUND: Compared to blood or urine, drugs can be detected for much longer periods in the long hair of horses. The aim of this study was to establish and validate a highly sensitive liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the detection and quantification of frequently prescribed opioids, sedatives and non-steroidal anti-inflammatory agents in the mane and tail hair of horses. Based on an average growth rate of about 2 cm per month, times of administration reported by horse owners or veterinary physicians were related to drug localizations in hair. Hair samples were collected from ten horses that received drug treatments and analyzed in segments of 2, 4 or 6 cm in length. Hair segments were decontaminated, cut into fragments and methanol-extracted under sonication. The extracts were analyzed by LC-MS/MS for 13 commonly used drugs using the validated procedure. Deuterated analogs were included as internal standards. RESULTS: Analytes were detected in hair samples with a length of up to 70 cm. Fourteen out of 16 hair samples were positive for at least one of the tested drugs. Segmentation allowed for time-resolved monitoring of periods of 1 to 3 months of drug administration. Concentrations in dark hair reached a maximum of 4.0 pg/mg for butorphanol, 6.0 pg/mg for tramadol, 1.4 pg/mg for morphine, 1.8 pg/mg for detomidine, 1.2 pg/mg for acepromazine, 39 pg/mg for flunixin, 5.0 pg/mg for firocoxib, and 3'600 pg/mg for phenylbutazone. Only trace amounts of meloxicam were detected. Drug detection correlated well with the reported period of medical treatment. No analytes were detected in the light-colored mane and tail hair samples from one horse despite preceding administrations of acepromazine and phenylbutazone. CONCLUSION: This study describes a sensitive and selective technique suitable for the validated detection and quantification of frequently prescribed veterinary drugs in horse hair. The segmental method can be applied for time-resolved long-term retrospective drug monitoring, for example in prepurchase examinations of horses as drug detection in hair can prove preceding medical treatments.

What information do consumers consider, and how do they look for it, when shopping for groceries online?

Previous research investigating what information shoppers seek when purchasing groceries has used either lab-experiments or observed shoppers in supermarkets. The present research investigates this question in a relatively naturalistic online-grocery environment. Forty participants completed their weekly shopping online while their eye-movements were recorded. Ten of the participants were subsequently interviewed to gain insight into their information seeking behaviour. We found that, when looking for products, 95% of participants navigated through the 'virtual departments', 80% used the 'search' facility, and 68% browsed the special offer pages. Once on the product pages, participants tended to look at the pictures of products, rather than examine detailed product information. To explain these findings, we suggest that online grocery sites simulate familiar supermarket environments, which may explain why consumers prefer to browse categories of products rather than use search terms. We also suggest that additional strategies are needed if consumers are to be encouraged to view detailed product information.

Prejudicial findings regarding suitability for intended purpose during pre-purchase examinations in a mixed horse population-A retrospective observational study in the United Kingdom.

BACKGROUND: Pre-purchase examinations (PPEs) are performed for prospective purchasers of horses to identify prejudicial findings that could make animals unsuitable for an intended use. Although this examination process is often standardised, PPEs remain, in large parts, a subjective procedure. In the United Kingdom, PPEs generally consist of either a two stage (two stage vetting [2SV], i.e., general physical examination at rest and basic trot in-hand) or a five stage-examination (five stage vetting [5SV], i.e., general physical exam at rest and after exercise, lameness evaluation including strenuous exercise with re-evaluation after a period of recovery). OBJECTIVES: To identify the proportion of PPEs with prejudicial findings in a mixed horse population in the United Kingdom and to determine those findings. STUDY DESIGN: Retrospective observational study. METHODS: PPE certificates from three first opinion equine practices were reviewed. Data collected included practice identity, examination format (i.e., 2SV or 5SV), PPE outcome, radiographs obtained (yes/no), purchase price, animal signalment, intended use and prejudicial PPE findings, if indicated. Prejudicial findings were grouped in 10 subcategories. Descriptive statistics were obtained for all parameters. Non-normally distributed numeric data between groups were compared using Wilcoxon rank-sum test. Categorical data were compared between groups using Pearson's chi-squared test or Fisher's exact test. RESULTS: Overall, 133 pre-purchase examination certificates were analysed. Seventy-six horses (57.1%) had prejudicial findings: Sixty-one (68.5%) horses undergoing 5SV and 15 (34.1%) of horses undergoing 2SV. Most horses had lameness as the primary prejudicial finding. Horses with a higher purchase price were more likely to undergo 5SV, undergo pre-purchase radiography, and were more likely to have prejudicial findings identified. MAIN LIMITATIONS: Data were obtained retrospectively from PPE certificates from a single mixed horse population and different results may have been obtained by analysing a larger number of animals or PPEs of horses intended for different uses, from different geographical regions or undergoing a different PPE format. The level of competition in the intended discipline for horses was not recorded. Analysed data were limited to the information recorded on the PPE certificates, and the original radiographs, ultrasonography images and other additional diagnostic data were not reviewed. CONCLUSIONS: Lameness was the most common prejudicial PPE finding. More expensive horses were more likely to undergo a 5SV, have pre-purchase radiographs obtained and have prejudicial findings identified. These results may help inform prospective studies examining the merits of 5SV versus 2SV formats and the value of inclusion of additional diagnostic imaging in PPEs in the general horse population.

Substantial variability exists in the interpretation of survey radiographs among equine veterinarians.

BACKGROUND: Radiographs are a common diagnostic tool utilised during pre-purchase examinations, yet differences surround their interpretation among equine veterinarians. OBJECTIVES: (1) To determine veterinarians' subjective impressions of a spectrum of radiographic abnormalities regarding suitability for purchase; (2) To determine how veterinarians' years in practice, primary discipline or board certification status influence their subjective impression of radiographic abnormalities, and (3) To determine how horses' discipline, current level of work (working at intended level vs. future prospect) and buyer intent (sell vs. retain ownership) influence veterinarians' subsequent recommendation. STUDY DESIGN: Worldwide electronic survey of veterinary professionals. METHODS: Four radiographic series of navicular bones, tarsi, and stifles, representing varying degrees of pathological change (normal, mild, moderate and marked) were presented. Respondents (n = 211) graded their level of concern from 1 (no concern) to 10 (very concerned) based on the radiographs and case scenarios presented. RESULTS: Overall, as the grade of pathological change increased for each anatomical location, so did the level of veterinarian concern, but a wide range of answers were submitted for all grades of pathology. Board certified practitioners had a higher level of concern over marked radiographic changes of the navicular bone for both western performance and English sport horses as well as prospect horses (mean = 7.2 vs. 6.1; P = 0.009; 95% CI for difference = [0.3, 2.0]). Board certified respondents had a lower level of concern over marked radiographic changes of the tarsus regardless of the performance status of the horse (mean = 7.1 vs. 8.0; P = 0.008; 95% CI for difference = [-1.5, -0.2]). Western performance horse practitioners had a lower level of concern over mild radiographic changes of the tarsus regardless of the performance status of the horse (mean = 3.3 vs. 4.2; P = 0.009; 95% CI for difference = [-1.6, -0.2]). MAIN LIMITATIONS: Only one example of each pathological grade per anatomical region was presented. CONCLUSIONS: On survey radiographs, the perceived clinical relevance of radiographic abnormalities among equine practitioners differs widely, making purchase recommendations highly variable.

What Do We Know about Dog Owners? Exploring Associations between Pre-Purchase Behaviours, Knowledge and Understanding, Ownership Practices, and Dog Welfare.

Despite many dogs living in homes in the UK, there is still more to know about the welfare of those individual animals. Past research has shown that owners' thoughts and behaviours have a substantial impact on their dog's welfare. This study aimed to better understand owners' pre-purchase behaviours, knowledge and understanding, and ownership practices, and explore any associations between these factors and their dog's welfare. We conducted further analysis of the data collected by People's Dispensary for Sick Animals (PDSA) for their 2017 PDSA Animal Welfare (PAW) Report (n = 1814). We extracted variables to describe owner demographics (7), pre-purchase behaviours (1), knowledge and understanding (4), welfare indicators, (2) and ownership practices (4), and we tested for an association between these variables. We found more pre-purchase research was carried out by younger respondents and those with a higher education level. Also, more research was associated with feeling more informed about the five welfare needs and knowing to seek help for behaviour from appropriate sources. Overall, the study found several novel and significant results worthy of note and further exploration but did not find any strong connections between the variables.

'All I do is fight fires': Qualitative exploration of UK veterinarians' attitudes towards and experiences of pre-purchase consultations regarding brachycephalic dogs.

BACKGROUND: Demand for brachycephalic dogs has dramatically increased over the past decade, despite growing evidence of strong associations between brachycephaly and severe, chronic disease. Positive post-purchase attitudes of owners towards brachycephalic dogs are highly intractable, facilitated by normalisation of breed-related disease and strong dog-owner bonds. Veterinarian-led pre-purchase consultations (PPCs) have been promoted as an opportunity to influence acquisition decisions regarding brachycephalic dogs. METHODS: Using reflexive thematic analysis, this qualitative study investigated veterinarians' attitudes towards, and experiences of, engaging in PPCs for brachycephalic dogs. RESULTS: Veterinarians described significant structural barriers, such as lack of time and staff, and perceptual barriers, such as perceived futility, negative outcomes of PPCs and public distrust in the profession, that combine to inhibit many veterinarians from offering or delivering brachycephalic PPCs. Some of these barriers are intractable at an individual-veterinarian level and lead to moral distress due to conflicts between veterinarians' responsibilities to animal welfare versus clients' and business needs, with resultant censorship of authentic views on brachycephalic ownership compromising professional integrity and autonomy. LIMITATIONS: Wider views and/or experiences may exist outside of the sampled population. CONCLUSION: Stronger veterinary leadership, including from the RCVS, BVA and veterinary corporates, is now urgently required to build profession-wide solutions that overcome the barriers identified to create public-facing consensus and innovative solutions to the 'brachycephalic crisis'.

Information sourcing by dog owners in the UK: Resource selection and perceptions of knowledge.

BACKGROUND: Dogs are a popular pet in the UK. Information resources utilised by dog owners can influence welfare at acquisition and throughout a dog's lifetime. This study determined where UK dog owners source information, and how perceptions relating to pedigree dog breeding and health may influence this process. METHODS: This cross-sectional study used online questionnaires to explore the information resources used by dog owners and their perceptions of veterinary surgeons' and dog breeders' knowledge. RESULTS: Overall, 1336 responses were collected (useable responses: 1167). Data indicated most owners conducted research before getting a dog, with the internet, books, breeders and friends or family among the most popular resources used. Preferred sources of information during a dogs' lifetime included the internet, talking to veterinary surgeons and reading books. Veterinary surgeons were the most popular source for health advice. Pedigree dog owners perceived veterinary surgeons and breeders to be equally knowledgeable on canine inherited diseases. However, veterinary surgeons were perceived as being more knowledgeable on inherited disease screening programmes and breeders more knowledgeable on dog breeding. CONCLUSION: This study highlights the information resources preferred by dog owners, providing an opportunity to maximise access to reliable sources of information to improve dog welfare.

Abnormalities detected at pre-purchase examination of National Hunt racehorses presented at sale.

BACKGROUND: Few studies are available concerning prevalences of abnormalities in the Thoroughbred horse population. OBJECTIVES: Determine the prevalence of commonly observed abnormalities in a National Hunt Thoroughbred population using results of pre-purchase examinations conducted at Thoroughbred sales venues. STUDY DESIGN: Retrospective cross-sectional study. METHODS: Veterinary pre-purchase examination certificates for 13,603 3- and 4-year-old Thoroughbred National Hunt horses from Tattersalls Ireland, Goffs Ireland and Doncaster Bloodstock Sales Ltd. (DBS) Sales were analysed. All conditions noted by the veterinarians were recorded to determine the prevalence of abnormalities. RESULTS: Abnormalities were recorded in 73.6% of horses; 12.0% had abnormalities likely to prejudice their use for racing. Metacarpal/metatarsal exostoses and tarsal-plantar desmitis affected 17.1 and 19.4% of the sample respectively, while 9.9% were found to make abnormal respiratory noises and 5.3% had recurrent laryngeal neuropathy. Age, year of birth and sex significantly affected the prevalence of many abnormalities (P<0.001). The proportions of horses sold differed significantly between horses with and without some abnormalities, with unaffected horses significantly more likely to be sold (e.g., prejudicial findings present vs. non-prejudicial/none, 38.1% vs. 77.6% respectively, P<0.001). A range of abnormalities significantly negatively affected the price at sale (P<0.001). Significantly higher proportions of horses in the lower price categories had multiple abnormalities (P<0.001). MAIN LIMITATIONS: The study consisted only of horses entered into store horse sales and presented for sale. Horses kept for racing or breeding purposes or horses withdrawn prior to the panel veterinary pre-purchase examination were not included. The upper respiratory tract was only examined endoscopically in horses found to have an abnormal respiratory noise. CONCLUSIONS: A large proportion of 3- and 4-year-old Thoroughbred National Hunt horses intended for sale are affected by abnormalities. The prevalence of many abnormalities increases with age and certain abnormalities are viewed negatively by purchasers, affecting sale of the horse and achieved sale price.

Role of Clinical Engineers in Quality Control of Respirator / 医疗卫生装备

Respirator is one of medical equipment in the first-aid, the clinical risk of it is much higher than the general medical equipment and diagnostic or patient monitor equipment. As a result, the quality control of it is particularly important. Several issues of the quality control of the respirator, such as the pre -purchase technical feasibility study, acceptance and installation after arrival, respirator use and management, respirator-reported loss demonstration and cost- benefit analysis of it are discussed from the angle of clinical engineers and technical personnel.