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Veterinary paraprofessional training and business environment needs assessment:Lessons learned
Get PDFThrough an innovative continuous professional development (CPD) training programme, “Growing your business through preventive livestock healthcare”, the Food and Agriculture Organization of the United Nations (FAO) has aimed to address private sector veterinary paraprofessionals’ skills gaps and support them to develop successful businesses providing preventive livestock health services to small-scale farmers and pastoralists. This document details the methodology of the needs assessment process and the key findings, including content on the legal frameworks, curricula, priority subjects, existing CPD, and design considerations
Hormone correction of dysfunctional metabolic gene expression in stem cell-derived liver tissue
Get PDFThe increase in metabolic dysfunction-associated steatotic liver disease (MASLD) and its progression to metabolic dysfunction-associated steatohepatitis (MASH) is a worldwide healthcare challenge. Heterogeneity between men and women in the prevalence and mechanisms of MASLD and MASH is related to differential sex hormone signalling within the liver, and declining hormone levels during aging. In this study we used biochemically characterised pluripotent stem cell derived 3D liver spheres to model the protective effects of testosterone and estrogen signalling on metabolic liver disease ‘in the dish’. We identified sex steroid-dependent changes in gene expression which were protective against metabolic dysfunction, fibrosis, and advanced cirrhosis patterns of gene expression, providing new insight into the pathogenesis of MASLD and MASH, and highlighting new druggable targets. Additionally, we highlight gene targets for which drugs already exist for future translational studies.</p
Processing appositive relative clauses:Effects of information structure and sentence structure
Get PDFIn a self-paced reading experiment, we investigate the processing of complex sentences containing a matrix clause and a subordinate clause, specifically, an appositive relative clause (ARC), which has been posited to have distinct information structural properties. We test the predictions made by three long-standing ordering principles: the given-new principle (given before new information ordering facilitates processing), the clause structure principle (matrix clause before subordinate clause ordering facilitates processing) and the clause-type mapping of information principle (given information in subordinate clause and new information in matrix clause facilitates processing). Our results show that predictions made by the given-new principle and the clause structure principle hold for sentences with an ARC. We do not find evidence for the clause-type mapping of information principle. Instead, our findings suggest that the matrix clause in sentences with an ARC has a function usually associated with subordinate clauses, namely grounding, whereby its content serves as the thematic ground that supports understanding of what follows in the next clause. We suggest this is due to the matrix clause-like nature of ARCs with respect to both their syntactic structure and their expected information status
Accelerated Diagnostic Pathways for Myocardial Infarction Using a Siemens High-Sensitivity Cardiac Troponin I Assay
Get PDFBackground: Few studies have comprehensively examined high-sensitivity cardiac troponin I (hs-cTnI) based diagnostic pathways for myocardial infarction (MI) in early presenters using a Siemens ADVIA Centaur hs-cTnI assay.Methods: We conducted a prospective multicenter cohort study in Emergency Departments involving 414 patients suspected of MI within 6 hours of symptom onset. We evaluated three hs-cTnI-based pathways (High-STEACS, ESC 0/1-h, 0/2-h); and four pathways incorporating medical history and physical findings (ADAPT, EDACS, HEART, GRACE). We evaluated negative predictive value (NPV) and sensitivity as safety measures, and percentage ruled out as an efficiency measure for a primary outcome of type 1 myocardial infarction or cardiac death within 30 days.Results: Median age was 72 years (interquartile range 58-82), and 30.4% (126/414) of patients were over 80. Females comprised 44.2% (183/414) of patients, 87.7% (363/414) had chest pain, and the primary outcome occurred in 9.2% (38/414). The High-STEACS pathway ruled out 62.0% of patients without missing a case of an MI. The ESC 0/1-h and 0/2-h pathways showed high NPV and sensitivities; however, they ruled out fewer patients (35.9% and 45.2%, respectively). The ADAPT, EDACS, and HEART pathways demonstrated high NPV and sensitivities but ruled out fewer patients (15-27%). The GRACE pathway missed 2 cases with primary clinical outcomes. Among patients over 80 without MI, initial hs-cTnI concentration was ≥3 ng/L in 99.1% and ≥5 ng/L in 84.1%.Conclusions: The High-STEACS pathway was the most efficient among the hs-cTnI-based pathways while maintaining excellent safety performance in early presenters. <br/
Exploring the effects of dietary lysine and tryptophan on the social behaviour of pigs
Get PDFNegative social behaviors between pigs can cause stress, which can compromise welfare. There has been significant interest in exploring the effect of diet on negative social behaviors and the wider social behavior repertoire of pigs. The aim of this study was to determine the effects of dietary Lysine (Lys) and Tryptophan (Trp) levels on the social behavior of commercially housed pigs. A total of 2,293 PIC Camborough barrows with a mean starting weight of 11.87 ± 1.35 kg were used in a randomized complete block design with a 2 × 3 factorial arrangement, with 16 replicates per treatment, of the following factors: 1) Standardized ileal digestible Lys levels: 100% Lys = diets with 100% PIC requirement at the midpoint of the growth phase (Lys 100) vs 80% Lys = diets with 80% PIC requirement at the midpoint of the growth phase (Lys 80); and 2) Trp to Lys ratio of 0.210, 0.185, or 0.160. Pigs were randomly allocated across the 6 treatments over 2 starting dates. Behavior and lesion data were collected. There was an effect of Lys (P = 0.032) on ear-biting behavior, with pigs on the Lys 80 treatments showing a higher level of ear-biting behavior. We also found an effect of the Lys score week interaction on the proportion of pens showing ear lesions (P < 0.001) and an effect of the Lys Trp interaction (P = 0.030) and the Lys score week interaction (P = 0.0104) on the proportion of pens showing severe ear lesions. In conclusion, the lysine content of feed can affect the social behavior of pigs, specifically ear biting, in commercial conditions.</p
Clinical outcomes and complications of tracheal resection and anastomosis in dogs and cats: 20 cases (2009-2022)
Get PDFOBJECTIVES: To report clinical presentation, short-term outcome and complications of tracheal resection and anastomosis in dogs and cats.MATERIALS AND METHODS: Clinical records of pets treated with tracheal resection and anastomosis in seven UK-based veterinary referral centres were retrospectively reviewed (2009 to 2022).RESULTS: Twenty client-owned pets (eight dogs; 12 cats) were included. Clinical signs comprised dyspnoea (n = 15), stridor (n = 5), subcutaneous emphysema (n = 3), pneumothorax and pneumomediastinum (n = 1), coughing (n = 3), regurgitation (n = 1) and exercise intolerance (n = 1). Indication for surgery was traumatic tracheal rupture (n = 5), tracheal avulsion (n = 7), neoplasia (n = 5) and stenosis (n = 3). Complications occurred in 15 patients (75%). Non-anastomotic complications occurred in nine patients and consisted of cough (n = 5), self-resolving laryngeal paralysis (n = 1), surgical site infection (n = 1) and septic shock (n = 2). Anastomotic complications occurred in seven patients and consisted of anastomotic dehiscence (n = 1), tracheal stenosis (n = 4) and fatal respiratory failure (n = 2). Revision surgery was performed in two dogs due to anastomotic dehiscence and stenosis, and tracheal stenting was performed in one cat due to stenosis. Sixteen patients survived to hospital discharge and 14 survived to latest follow-up (median: 119 days; range: 14 to 1744). Outcome was scored as excellent in five, good in seven, fair in two and poor in six patients.CLINICAL SIGNIFICANCE: Tracheal resection and anastomosis is the surgical technique of choice to reconstruct tracheal defects. Although more than half of the patients recovered well, high morbidity and mortality rates were documented. This may be due to the severe comorbidities affecting most tracheal resection and anastomosis patients, as well as the client's decision against further treatment when facing serious post-operative complications.</p
Foundations of anonymous signatures:Formal definitions, simplified requirements, and a construction based on general assumptions
Get PDFIn today’s systems, privacy is often at odds with utility: users that reveal little information about themselves get restricted functionality, and service providers mistrust them. In practice, systems tip to either full anonymity (e.g. Monero), or full utility (e.g. Bitcoin). Well-known cryptographic primitives for bridging this gap exist: anonymous credentials (AC) let users disclose a subset of their credentials’ attributes, revealing to service providers “just what they need”; group signatures (GS) allow users to authenticate anonymously, to be de-anonymized “just when deemed necessary”. However, these primitives are hard to deploy.Current AC and GS variants reach specific points in the privacy-utility tradeoff, which we point as counter-productive engineering-wise, as it requires full and error-prone re-engineering to adjust the tradeoff. Also, so far, GS and AC have been studied separately by theoretical research.We take the first steps toward unifying and generalizing both domains, with the goal of bringing their benefits to practice, in a flexible way. We give a common model capturing their core properties, and use functional placeholders to subsume intermediate instantiations of the privacy-utility tradeoff under the same model. To prove its flexibility, we show how concrete variants of GS, AC (and others, like ring signatures) can be seen as special cases of our scheme – to which we refer as universal anonymous signatures (UAS). In practice, this means that instantiations following our construction can be configured to behave as variant X of a GS scheme, or as variant Y of an AC scheme, by tweaking a few functions
The future for sport officiating research:An expert statement
Get PDFResearch, coverage, and understanding in sport officiating related scholarly activity has increased markedly in the last decade. Sport officials (referees, judges, umpires) have been historically underrepresented in the sport management, psychology, and physiology literature, but this collection of experts provide avenues for collaboration and exploration that can contribute to understanding systems, individuals, and initiate real-world changes for sporting organisations, policy makers, and officials themselves. Focused and organised around the key research areas and priorities of physiology, decision making, psychology, mental health, management, and training and development, this statement offers detail on the development of the research and associated literature and provides proposals for future scholarship linked to each of the key research areas
Delirium on presentation with a hip fracture is associated with adverse outcomes: a multicentre observational study of 18,040 patients using national clinical registry data
Get PDFAimsDelirium is common in hip fracture patients, but large-scale routine data studies examining the prevalence and associations of delirium at the time of initial presentation with a hip fracture are rare. This study aimed to describe the prevalence and outcomes of delirium on initial presentation with a hip fracture in a large national population sample.MethodsThis study analysed routinely collected national clinical registry data for all people in Scotland aged 50 years and over presenting with a hip fracture between July 2019-December 2021. Delirium was assessed prospectively by clinicians as part of routine care using the 4 ‘A’s Test (4AT; www.the4AT.com), a validated two-minute tool. Associations of 4AT score with mortality and return home within 30 days were analysed using logistic regression models, adjusted for confounders.ResultsOf 18,040 patients (mean age 80 years; 70% women), 16,476 (91%) had a 4AT assessment on presentation and of these, 3,386 (21%) had a score ≥4, suggestive of delirium. Patients with delirium were older, more likely residing in care homes and had higher American Society of Anesthesiologists (ASA) grades (p’s<0.001). Delirium was independently associated with a two-fold increased risk of inpatient mortality (adjusted odds ratio (aOR) 2.26, 95% confidence interval (CI) 1.79-2.84) and one-year mortality (aOR 2.05, 95%CI 1.83-2.29) and a lower likelihood of returning home within 30 days (aOR 0.27, 95%CI 0.24-0.30). ConclusionDelirium affects around 20% of patients presenting with a hip fracture and is associated with important adverse outcomes. Integrating delirium assessment into the initial clinical assessment of hip fracture patients is feasible at national scale and should be considered as part of care for all hip fracture patients. <br/
Pathways to a Diagnosis of Trigeminal Neuralgia: a Qualitative Study of Patients’ Experiences
Get PDFBackgroundTrigeminal Neuralgia (TN) is a rare disorder which causes episodes of intense facial pain and has been described as the ‘suicide disease’. Hence, prompt diagnosis and timely initiation of treatment is vital. However, delays to diagnosis and high rates of misdiagnosis are common, particularly within primary care. To date, most research has focused upon treatment options rather than improving diagnostic experiences. This study sought to explore patients’ experiences of the events leading up to their TN diagnosis and their views about the care and support they received when they were diagnosed to provide recommendations for improving the TN diagnostic pathway.MethodsThis was a qualitative, exploratory study using in-depth interviews. Interviews were conducted with (n=25) UK-based people with TN recruited via online forums. Data were analysed thematically.ResultsFollowing the onset of their TN pain, most participants described an arduous and uncertain journey to diagnosis, with many encountering significant delays, misdiagnoses and receiving inappropriate referrals and treatment. As a consequence, participants reported experiencing profound distress, anxiety, depression and, in extreme cases, suicidal ideation; some also described drug and alcohol misuse during this time. Most participants conveyed relief upon finally receiving a diagnosis. However, this was often by eclipsed by what they saw as poor and insensitive communication and inadequate information provisioning. ConclusionsThe present study highlights the importance of developing bespoke training for primary care and other professionals to facilitate timely recognition of TN symptomatology and ensure that they deliver a TN diagnosis in clear, sensitive and empathetic ways
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