Safety and Tolerability of Thrombin Inhibition in Scleroderma-Associated Interstitial Lung Disease

Objective

Interstitial lung disease (ILD) is a frequent complication of systemic sclerosis (SSc) (scleroderma) and the leading cause of scleroderma‐related deaths. There exists an unmet need for a new drug therapy for ILD‐complicated SSc. Substantial evidence supports an important role for thrombin in the pathogenesis of SSc‐associated ILD (hereafter SSc‐ILD), and targeting thrombin with a direct thrombin inhibitor could prove to be a novel and effective treatment strategy. As a first step toward designing a clinical trial to test the efficacy of thrombin inhibition in SSc‐ILD, we conducted this study to test the safety and tolerability of dabigatran in patients with SSc‐ILD.

Methods

We performed a prospective, single‐center, open‐label treatment trial with the direct thrombin inhibitor, dabigatran, in patients with SSc‐ILD. Any patient with a history of gastrointestinal hemorrhage or gastric antral vascular ectasia was excluded. Blood monitoring was performed monthly, and patient‐reported outcomes, pulmonary function tests, and skin scores were obtained at baseline and at 3‐ and 6‐month visits. Bronchoscopy with bronchoalveolar lavage (BAL) was performed at baseline and at 6 months for measurement of lung thrombin activity.

Results

Of 15 patients with SSc‐ILD, 14 completed 6 months of treatment with dabigatran at 75 mg taken orally twice daily. Adverse events were uncommon and usually mild or unrelated to the study medication. No serious adverse event was observed. Dabigatran was well tolerated, and we observed no significant gastrointestinal, pulmonary, or other safety issues or intolerability. BAL fluid thrombin activity decreased or remained stable in 13 of 14 (92.8%) subjects.

Conclusion

Dabigatran appears to be safe and well tolerated in patients with SSc‐ILD. A larger randomized controlled trial to test the efficacy of direct thrombin inhibition with dabigatran can be considered.

An In Vitro Biomechanical Investigation of Compression Plating with Cable Cerclage for Repair of Oblique Osteotomies in Foal Femurs

Long oblique diaphyseal osteotomies were created in 14 pairs of femurs from cadaver foals less than six months of age. One bone from each pair was repaired using two dynamic compression plates (DP), and the other was repaired using a dynamic compression plate with cable cerclage (CC). Seven pairs were tested in compression and seven pairs in craniolateral-caudomedial (CrL-CdM) three-point bending.

A difference was not found in mean (± SD) breaking strength in compression between the DP (7257.19 ± 2004.08 N) and CC (7761.41 ± 2552.91 N) techniques. Nor was there a difference in mean stiffness in compression between the DP (2533.83 ± 1777.38 N/mm) and CC (3177.98 ± 1694.70 N/mm) techniques. There was no difference in mean stiffness in three-point bending between the DP (244.60 ± 60.80 N/mm) and CC (195.50 ± 80.90 N/mm) techniques. The mean bending breaking strength and bending moment for the DP technique (2839.36 ± 199.46 N and 124,932.00 ± 8776.38 N mm) was significantly (P = 0.02) greater than the CC technique (1940.39 ± 732.80 N and 85,377.72 ± 32243.34 N mm).

The CC system was inferior to the DP technique in CrL-CdM three-point bending strength and moment, but provided equal bending stiffness and equal compressive strength and stiffness.

The use of compression plating with cable cerclage was compared to double plating for repair of long oblique osteotomies in foal femurs. The repairs were tested in compression and 3-point bending. The compression plate with cable cerclage was inferior to double plating in bending strength and moment, but provided equal compressive strength and stiffness.

Developmental Ethanol-Induced Sleep Fragmentation, Behavioral Hyperactivity, Cognitive Impairment and Parvalbumin Cell Loss are Prevented by Lithium Co-treatment

Developmental ethanol exposure is a well-known cause of lifelong cognitive deficits, behavioral hyperactivity, emotional dysregulation, and more. In healthy adults, sleep is thought to have a critical involvement in each of these processes. Our previous work has demonstrated that some aspects of cognitive impairment in adult mice exposed at postnatal day 7 (P7) to ethanol (EtOH) correlate with slow-wave sleep (SWS) fragmentation (Wilson et al., 2016). We and others have also previously demonstrated that co-treatment with LiCl on the day of EtOH exposure prevents many of the anatomical and physiological impairments observed in adults. Here we explored cognitive function, diurnal rhythms (activity, temperature), SWS, and parvalbumin (PV) and perineuronal net (PNN)-positive cell densities in adult mice that had received a single day of EtOH exposure on P7 and saline-treated littermate controls. Half of the animals also received a LiCl injection on P7. The results suggest that developmental EtOH resulted in adult behavioral hyperactivity, cognitive impairment, and reduced SWS compared to saline controls. Both of these effects were reduced by LiCl treatment on the day of EtOH exposure. Finally, developmental EtOH resulted in decreased PV/PNN-expressing cells in retrosplenial (RS) cortex and dorsal CA3 hippocampus at P90. As with sleep and behavioral activity, LiCl treatment reduced this decrease in PV expression. Together, these results further clarify the long-lasting effects of developmental EtOH on adult behavior, physiology, and anatomy. Furthermore, they demonstrate the neuroprotective effects of LiCl co-treatment on this wide range of developmental EtOH's long-lasting consequences.

Shaping polymersomes into predictable morphologies via out-of-equilibrium self-assembly

Polymersomes are bilayer vesicles, self-assembled from amphiphilic block copolymers. They are versatile nanocapsules with adjustable properties, such as flexibility, permeability, size and functionality. However, so far no methodological approach to control their shape exists. Here we demonstrate a mechanistically fully understood procedure to precisely control polymersome shape via an out-of-equilibrium process. Carefully selecting osmotic pressure and permeability initiates controlled deflation, resulting in transient capsule shapes, followed by reinflation of the polymersomes. The shape transformation towards stomatocytes, bowl-shaped vesicles, was probed with magnetic birefringence, permitting us to stop the process at any intermediate shape in the phase diagram. Quantitative electron microscopy analysis of the different morphologies reveals that this shape transformation proceeds via a long-predicted hysteretic deflation-inflation trajectory, which can be understood in terms of bending energy. Because of the high degree of controllability and predictability, this study provides the design rules for accessing polymersomes with all possible different shapes.

Epidemiology of systemic lupus erythematosus in rural Wisconsin

We investigated the epidemiology of systemic lupus erythematosus (SLE) in the Marshfield Epidemiologic Study Area (MESA), a defined rural region where nearly all residents obtain their health care from a large clinic system. Computerized medical records were searched to identify MESA residents diagnosed with SLE from 1991 through 2001. Medical records were manually reviewed for all selected patients to identify cases of SLE using the 1982 revised American College of Rheumatology criteria. Patients with 4 criteria were classified as definite SLE. Age- and gender- specific SLE incidence rates (1991-2001), the population prevalence rate of SLE on 31 December 2001 and survival rates were calculated. We identified 117 MESA residents with definite SLE. The average age-adjusted incidence of definite SLE was 5.1 per 100 000 per year (95% CI: 3.6, 6.6) and the age-adjusted population prevalence was 78.5 per 100 000 (95% CI: 59.0, 98.0). The mean age at diagnosis among the 44 incident cases was 51.7 years (range: 14-90 years). Positive anti-nuclear antibody (ANA), hematologic abnormalities, arthritis and renal disease were common at diagnosis. Five- and 10-year survival rates were 88% and 76%, respectively. Epidemiologic characteristics of SLE in this rural Caucasian population are generally similar to those reported by other US studies. One notable difference is a relatively high incidence of SLE in older adults.

Plasticity in the Olfactory System: Lessons for the Neurobiology of Memory

We are rapidly advancing toward an understanding of the molecular events underlying odor transduction, mechanisms of spatiotemporal central odor processing, and neural correlates of olfactory perception and cognition. A thread running through each of these broad components that define olfaction appears to be their dynamic nature. How odors are processed, at both the behavioral and neural level, is heavily dependent on past experience, current environmental context, and internal state. The neural plasticity that allows this dynamic processing is expressed nearly ubiquitously in the olfactory pathway, from olfactory receptor neurons to the higher-order cortex, and includes mechanisms ranging from changes in membrane excitability to changes in synaptic efficacy to neurogenesis and apoptosis. This review will describe recent findings regarding plasticity in the mammalian olfactory system that are believed to have general relevance for understanding the neurobiology of memory.

Developmental ethanol exposure-induced sleep fragmentation predicts adult cognitive impairment

Developmental ethanol (EtOH) exposure can lead to long-lasting cognitive impairment, hyperactivity, and emotional dysregulation among other problems. In healthy adults, sleep plays an important role in each of these behavioral manifestations. Here we explored circadian rhythms (activity, temperature) and slow-wave sleep (SWS) in adult mice that had received a single day of EtOH exposure on postnatal day 7 and saline littermate controls. We tested for correlations between slow-wave activity and both contextual fear conditioning and hyperactivity. Developmental EtOH resulted in adult hyperactivity within the home cage compared to controls but did not significantly modify circadian cycles in activity or temperature. It also resulted in reduced and fragmented SWS, including reduced slow-wave bout duration and increased slow-wave/fast-wave transitions over 24-h periods. In the same animals, developmental EtOH exposure also resulted in impaired contextual fear conditioning memory. The impairment in memory was significantly correlated with SWS fragmentation. Furthermore, EtOH-treated animals did not display a post-training modification in SWS which occurred in controls. In contrast to the memory impairment, sleep fragmentation was not correlated with the developmental EtOH-induced hyperactivity. Together these results suggest that disruption of SWS and its plasticity are a secondary contributor to a subset of developmental EtOH exposure's long-lasting consequences.

Distinct neurobehavioral dysfunction based on the timing of developmental binge-like alcohol exposure

Gestational exposure to alcohol can result in long-lasting behavioral deficiencies generally described as fetal alcohol spectrum disorder (FASD). FASD-modeled rodent studies of acute ethanol exposure typically select one developmental window to simulate a specific context equivalent of human embryogenesis, and study consequences of ethanol exposure within that particular developmental epoch. Exposure timing is likely a large determinant in the neurobehavioral consequence of early ethanol exposure, as each brain region is variably susceptible to ethanol cytotoxicity and has unique sensitive periods in their development. We made a parallel comparison of the long-term effects of single-day binge ethanol at either embryonic day 8 (E8) or postnatal day 7 (P7) in male and female mice, and here demonstrate the differential long-term impacts on neuroanatomy, behavior and in vivo electrophysiology of two systems with very different developmental trajectories. The significant long-term differences in odor-evoked activity, local circuit inhibition, and spontaneous coherence between brain regions in the olfacto-hippocampal pathway that were found as a result of developmental ethanol exposure, varied based on insult timing. Long-term effects on cell proliferation and interneuron cell density were also found to vary by insult timing as well as by region. Finally, spatial memory performance and object exploration were affected in P7-exposed mice, but not E8-exposed mice. Our physiology and behavioral results are conceptually coherent with the neuroanatomical data attained from these same mice. Our results recognize both variable and shared effects of ethanol exposure timing on long-term circuit function and their supported behavior.

Using syndromic surveillance to estimate baseline rates for healthcare-associated infections in critical care units of small animal referral hospitals

BACKGROUND

Expected rates of healthcare-associated infections (HCAI) have not been established in veterinary hospitals. Baseline rates are critically needed as benchmarks for quality animal care.

OBJECTIVE

To estimate the occurrence of events related to HCAI identified using a standardized syndromic surveillance system in small animals in critical care cases at referral hospitals.

ANIMALS

Weaned dogs and cats (n = 1,951) that were hospitalized in the critical care unit of referral teaching hospitals during a 12-week period.

METHODS

Multicenter, prospective longitudinal study. A survey was completed for all enrolled animals to record basic demographics, information about procedures and treatments that animals received, and to document the occurrence of defined nosocomial syndromes. Data were analyzed to identify risk factors associated with the occurrence of these nosocomial syndromes.

RESULTS

Controlling for hospital of admission, 16.3% of dogs (95% confidence intervals [CI], 14.3-18.5) and 12% of cats (95% CI, 9.3-15.5) were reported to have had ≥ 1 nosocomial syndrome occur during hospitalization. Risk factors found to have a positive association with the development of a nosocomial syndrome were longer hospital stays, placement of a urinary catheter, surgical procedures being performed, and the administration of antiulcer medications and antimicrobial drugs excluding those given perioperatively.

CONCLUSIONS AND CLINICAL IMPORTANCE

Syndromic surveillance systems can be successfully standardized for use across multiple hospitals to effectively collect data pertinent to HCAI rates and risk factors for occurrence.

Neurobiology of secure infant attachment and attachment despite adversity: a mouse model

Attachment to an abusive caregiver has wide phylogenetic representation, suggesting that animal models are useful in understanding the neural basis underlying this phenomenon and subsequent behavioral outcomes. We previously developed a rat model, in which we use classical conditioning to parallel learning processes evoked during secure attachment (odor-stroke, with stroke mimicking tactile stimulation from the caregiver) or attachment despite adversity (odor-shock, with shock mimicking maltreatment). Here we extend this model to mice. We conditioned infant mice (postnatal day (PN) 7-9 or 13-14) with presentations of peppermint odor and either stroking or shock. We used (14) C 2-deoxyglucose (2-DG) to assess olfactory bulb and amygdala metabolic changes following learning. PN7-9 mice learned to prefer an odor following either odor-stroke or shock conditioning, whereas odor-shock conditioning at PN13-14 resulted in aversion/fear learning. 2-DG data indicated enhanced bulbar activity in PN7-9 preference learning, whereas significant amygdala activity was present following aversion learning at PN13-14. Overall, the mouse results parallel behavioral and neural results in the rat model of attachment, and provide the foundation for the use of transgenic and knockout models to assess the impact of both genetic (biological vulnerabilities) and environmental factors (abusive) on attachment-related behaviors and behavioral development.

Capacitance and optical studies of elastic and dielectric properties in an organosiloxane tetrapode exhibiting a N(B) phase

Biaxial (N(B)) and uniaxial nematic (N(U)) phase behavior was detected and confirmed for an organosiloxane tetrapode material using capacitance and birefringence measurements. Elastic constants, permittivities at two distinct low frequencies, and birefringencies were determined as a function of temperature over both the N(U) and the N(B) phase ranges. The N(U)-N(B) transition is clearly observed in the birefringencies and conoscopy data. A temperature dependent cross-over frequency is also detected in this material for the permittivities, allowing the electrical switching of both planar and homeotropic aligned samples.

Odor-evoked activity in the mouse lateral entorhinal cortex

The entorhinal cortex is a brain area with multiple reciprocal connections to the hippocampus, amygdala, perirhinal cortex, olfactory bulb and piriform cortex. As such, it is thought to play a large role in the olfactory memory process. The present study is the first to compare lateral entorhinal and anterior piriform cortex odor-evoked single-unit and local field potential activity in mouse. Recordings were made in urethane-anesthetized mice that were administered a range of three pure odors and three overlapping odor mixtures. Results show that spontaneous as well as odor-evoked unit activity was lower in lateral entorhinal versus piriform cortex. In addition, units in lateral entorhinal cortex were responsive to a more restricted set of odors compared to piriform. Conversely, odor-evoked power change in local field potential activity was greater in the lateral entorhinal cortex in the theta band than in piriform. The highly odor-specific and restricted firing in lateral entorhinal cortex suggests that it may play a role in modulating odor-specific, experience- and state-dependent olfactory coding.

Global cost of correcting vision impairment from uncorrected refractive error

OBJECTIVE

To estimate the global cost of establishing and operating the educational and refractive care facilities required to provide care to all individuals who currently have vision impairment resulting from uncorrected refractive error (URE).

METHODS

The global cost of correcting URE was estimated using data on the population, the prevalence of URE and the number of existing refractive care practitioners in individual countries, the cost of establishing and operating educational programmes for practitioners and the cost of establishing and operating refractive care facilities. The assumptions made ensured that costs were not underestimated and an upper limit to the costs was derived using the most expensive extreme for each assumption.

FINDINGS

There were an estimated 158 million cases of distance vision impairment and 544 million cases of near vision impairment caused by URE worldwide in 2007. Approximately 47 000 additional full-time functional clinical refractionists and 18 000 ophthalmic dispensers would be required to provide refractive care services for these individuals. The global cost of educating the additional personnel and of establishing, maintaining and operating the refractive care facilities needed was estimated to be around 20 000 million United States dollars (US$) and the upper-limit cost was US$ 28 000 million. The estimated loss in global gross domestic product due to distance vision impairment caused by URE was US$ 202 000 million annually.

CONCLUSION

The cost of establishing and operating the educational and refractive care facilities required to deal with vision impairment resulting from URE was a small proportion of the global loss in productivity associated with that vision impairment.

Comparison of an inertial sensor system of lameness quantification with subjective lameness evaluation

REASONS FOR PERFORMING STUDY

Subjective evaluation of mild lameness has been shown to have poor interobserver reliability. Traditional methods of objective lameness evaluation require specialised conditions and equipment. Wireless inertial sensor systems have been developed to allow for simple, rapid, objective lameness detection in horses trotted over ground.

OBJECTIVE

The purpose of this study was to compare the sensitivities of an inertial sensor system and subjective evaluation performed by experienced equine practitioners at detecting lameness in horses. We hypothesised that the inertial sensor system would identify lameness at a lower level of sole pressure than a consensus of 3 experienced equine veterinarians.

METHODS

Fifteen horses were fitted with special shoes that allowed for lameness induction via sole pressure. Horses were simultaneously evaluated by 3 equine veterinarians and a wireless inertial sensor system. Horses were subjected to multiple trials: 1) before inserting the screw; 2) after inserting the screw to just touch the sole; and 3) after tightening the screw in half turn increments. The number of screw turns required for lameness identification in the correct limb by the inertial sensors and by consensus of 3 equine veterinarians was compared using the Wilcoxon test.

RESULTS

The inertial sensor system selected the limb with the induced lameness after fewer screw turns than did the 3 veterinarians (P<0.0001). The inertial sensor system selected the correct limb before the 3 veterinarians in 35 trials (58.33%), the evaluators selected the correct limb before the inertial sensors in 5 trials (8.33%), and in 20 trials (33.33%) they selected the correct limb at the same time.

POTENTIAL RELEVANCE

The inertial sensor system was able to identify lameness at a lower level of sole pressure than the consensus of 3 equine veterinarians. The inertial sensor system may be an effective aid to lameness localisation in clinical cases.

Complex mixture discrimination and the role of contaminants

Rats were trained in a 2-alternative odor choice task to discriminate between a 10-component odor mixture and the same mixture with one component removed and replaced with 1 of 3 concentrations of a different monomolecular odor (contaminant). All stimuli were presented within a training session, thus the rat essentially had to learn to discriminate the 10-component mixture from "not" the 10-component mixture. Rats performed most poorly discriminating the complete mixture from the mixture with one component removed and no contaminant added. As the concentration of the contaminant increased from 10 ppm to a concentration equal to the other components (100 ppm), discrimination improved linearly. In analyses of individual differences, rats that spent more time in the sampling port (sampling and making a decision) were more accurate than rats that spent less time. Together, these results emphasize the balance between perceptual stability and perceptual discrimination expressed by the olfactory system dealing with dynamic mixtures and the robust effects of contamination on those processes. In addition, they provide further support that modification of sampling/decision time is a strategy used by rats to deal with difficult discriminations of complex odors.

Lithium prevents long-term neural and behavioral pathology induced by early alcohol exposure

Fetal alcohol exposure can cause developmental defects in offspring known as fetal alcohol spectrum disorder (FASD). FASD symptoms range from obvious facial deformities to changes in neuroanatomy and neurophysiology that disrupt normal brain function and behavior. Ethanol exposure at postnatal day 7 in C57BL/6 mice induces neuronal cell death and long-lasting neurobehavioral dysfunction. Previous work has demonstrated that early ethanol exposure impairs spatial memory task performance into adulthood and perturbs local and interregional brain circuit integrity in the olfacto-hippocampal pathway. Here we pursue these findings to examine whether lithium prevents anatomical, neurophysiological, and behavioral pathologies that result from early ethanol exposure. Lithium has neuroprotective properties that have been shown to prevent ethanol-induced apoptosis. Here we show that mice co-treated with lithium on the same day as ethanol exposure exhibit dramatically reduced acute neurodegeneration in the hippocampus and retain hippocampal-dependent spatial memory as adults. Lithium co-treatment also blocked ethanol-induced disruption in synaptic plasticity in slice recordings of hippocampal CA1 in the adult mouse brain. Moreover, long-lasting dysfunctions caused by ethanol in olfacto-hippocampal networks, including sensory-evoked oscillations and resting state coherence, were prevented in mice co-treated with lithium. Together, these results provide behavioral and physiological evidence that lithium is capable of preventing or reducing immediate and long-term deleterious consequences of early ethanol exposure on brain function.

Effect of lighting programs during the pullet phase on skeletal integrity of egg-laying strains of chickens

Egg-laying strains of chickens are highly susceptible to osteoporosis, a noninfectious disease characterized by a decrease in structural bone as hens age. To minimize the onset of osteoporosis, it was hypothesized that a delay in sexual maturity may allow a pullet to develop a stronger skeletal frame before egg laying, leading to improved skeletal mineralization at end of lay. One management tool that can easily be implemented by pullet growers to delay sexual maturity is length of photoperiod. The objective of the current study was to determine whether lighting programs used during the pullet phase of egg-laying strains of chickens can be manipulated to allow for improved skeletal mineralization in laying hens at end of lay. Two experiments were conducted in which 1,000 pullets/experiment were exposed to 1 of 3 varying step-down lighting programs (2 to 17 wk of age), referred to as rapid, moderate, and slow. For both experiments, 2 strains of chickens were used. Experiment 1 compared the Hy-Line W-36 with the Hy-Line W-98, and experiment 2 compared the Hy-Line Brown with the Hy-Line W-98. At 66 wk of age, all hens remaining in the study were weighed individually and the drum stick and wing were retrieved for determination of bone mineralization and bone size traits. Bone data were analyzed using an analysis of covariance with BW as the covariant, and BW was analyzed as an ANOVA. Skeletal frame development was affected by lighting regimen. Pullets exposed to the slow lighting photoperiod had longer bones and more bone area (experiment 2) than those exposed to the rapid photoperiod, most likely because of a delay in bone growth plate closure, which occurs at sexual maturity. However, this delay in sexual maturity, as indicated by longer bones, did not improve bone mineralization at 66 wk of age. It was concluded that pullet lighting regimen had little effect on bone mineralization at end of lay.

State-dependent functional connectivity of rat olfactory system assessed by fMRI

Functional connectivity between the piriform cortex and limbic and neocortical areas was assessed using functional magnetic resonance imaging (fMRI) of urethane anesthetized rats that spontaneously cycled between slow-wave and fast-wave states. Slow-wave and fast-wave states were determined indirectly through monitoring of respiration rate, which was confirmed to co-vary with state as determined by electrophysiological recordings. Previous electrophysiological data have suggested that the piriform cortex shifts between responsiveness to afferent odor input during fast-wave states and enhanced functional connectivity with limbic areas during slow-wave state. The present results demonstrate that fMRI-based resting state functional connectivity between the piriform cortex and both limbic and neocortical areas is enhanced during slow-wave state compared to fast-wave state using respiration as an indirect measure of state in urethane anesthetized rats. This state-dependent shift in functional connectivity may be important for sleep-dependent odor memory consolidation.

Repeatability of subjective evaluation of lameness in horses

REASONS FOR PERFORMING STUDY

Previous studies have suggested that agreement between equine veterinarians subjectively evaluating lameness in horses is low. These studies were limited to small numbers of horses, evaluating movement on the treadmill or to evaluating previously-recorded videotape.

OBJECTIVES

To estimate agreement between equine practitioners performing lameness evaluations in horses in the live, over ground setting.

METHODS

131 mature horses were evaluated for lameness by 2-5 clinicians (mean 3.2) with a weighted-average of 18.7 years of experience. Clinicians graded each limb using the AAEP lameness scale by first watching the horse trot in a straight line only and then after full lameness evaluation. Agreement was estimated by calculation of Fleiss' (kappa). Evaluators agreed if they picked the same limb as lame or not lame regardless of the severity of perceived lameness.

RESULTS

After only evaluating the horse trot in a straight line clinicians agreed whether a limb was lame or not 76.6% of the time (kappa= 0.44). After full lameness evaluation clinicians agreed whether a limb was lame or not 72.9% of the time (kappa= 0.45). Agreement on forelimb lameness was slightly higher than on hindlimb lameness. When the mean AAEP lameness score was >1.5 clinicians agreed whether or not a limb was lame 93.1% of the time (kappa= 0.86), but when the mean score was < or = 1.5 they agreed 61.9% (kappa= 0.23) of the time. When given the task of picking whether or not the horse was lame and picking the worst limb after full lameness evaluation, clinicians agreed 51.6% (kappa= 0.37) of the time.

CONCLUSIONS

For horses with mild lameness subjective evaluation of lameness is not very reliable.

POTENTIAL RELEVANCE

A search for and the development of more objective and reliable methods of lameness evaluation is justified and should be encouraged and supported.

Detecting columnar deformations in a supermesogenic octapode by proton NMR relaxometry

We used proton ( (1)H nuclear magnetic relaxation (NMR) dispersions to study the molecular dynamics in the isotropic phase and mesophases (nematic and columnar hexagonal) of a supermesogenic octapode formed by laterally connecting calamitic mesogens to an inorganic silsesquioxane cube through flexible spacers. The dispersions of the spin-lattice relaxation time (T(1)) are interpreted through relaxation mechanisms used for the study of molecular dynamics in low-molar-mass liquid crystals but adapted to the case of liquid crystalline supermolecules. At high frequencies (above 10MHz) the behaviour of the T(1) with the Larmor frequency is similar for all phases and is ascribed to local reorientations and/or rotations. At intermediate and low frequencies (below 10MHz) our results show notable differences in the T(1) behaviour with respect to the mesophases. The nematic (N) and isotropic (Iso) phases' low-frequency results are similar and are interpreted for both phases in terms of order director fluctuations (ODF), revealing that even in the isotropic phase local nematic order is detected by proton NMR relaxometry. Local nematic order in the Iso phase is interpreted in terms of the presence of nematic cybotactic clusters induced by the interdigitation of mesogens that is promoted by the silsesquioxane octapode molecular structure. In the columnar hexagonal (Col (h) phase, the T(1) dispersions show that elastic columnar deformations (ECD) dominate the nuclear magnetic relaxation below 10MHz. This result shows that the columnar packing of the octapode clearly restricts the collective fluctuations of the mesogenic units inspite of their local nematic order.

Ethnicity and social deprivation independently influence metabolic control in children with type 1 diabetes

AIMS/HYPOTHESIS

This study was performed to evaluate the influence of ethnicity and socioeconomic status (SES) on metabolic control in a population-based cohort of children with type 1 diabetes mellitus, and to evaluate whether any relationship between ethnicity and HbA(1c) is mediated by SES.

METHODS

We performed a retrospective review of all patients under age 16 years with type 1 diabetes (n = 555) from 1995 to 2005 in the greater Auckland region, New Zealand. Diabetes care variables and HbA(1c) values were collected prospectively, during clinic visits.

RESULTS

The mean population HbA(1c) was 8.3 +/- 1.3%. Maori and Pacific patients had poorer metabolic control than their European counterparts (9.1% and 9.3% vs 8.1%, p < 0.001) and higher rates of moderate to severe hypoglycaemia (31.1 and 24.8 vs 14.9 events/100 patient-years, p = 0.03). In multiple linear regression analysis, both ethnicity and SES were independently associated with HbA(1c) (p < 0.001). Other factors associated with higher HbA(1c) level were longer duration of diabetes, higher insulin dose, lower BMI z score and less frequent blood glucose monitoring (p < 0.001).

CONCLUSIONS/INTERPRETATION

Both ethnicity and SES independently influenced metabolic control in a large, unselected population of children with type 1 diabetes. Irrespective of SES, Maori and Pacific youth with type 1 diabetes were at greater risk of both moderate to severe hypoglycaemia and long-term complications associated with poor metabolic control.

Minocycline increases quality and longevity of chronic neural recordings

Brain/machine interfaces could potentially be used in the treatment of a host of neurological disorders ranging from paralysis to sensory deficits. Insertion of chronic micro-electrode arrays into neural tissue initiates a host of immunological responses, which typically leads to the formation of a cellular sheath around the implant, resulting in the loss of useful signals. Minocycline has been shown to have neuroprotective and neurorestorative effects in certain neural injury and neurodegenerative disease models. This study examined the effects of minocycline administration on the quality and longevity of chronic multi-channel microwire neural implants 1 week and 1 month post-implantation in auditory cortex. The mean signal-to-noise ratio for the minocycline group stabilized at the end of week 1 and remained above 4.6 throughout the following 3 weeks. The control group signal-to-noise ratio dropped throughout the duration of the study and at the end of 4 weeks was 2.6. Furthermore, 68% of electrodes from the minocycline group showed significant stimulus-driven activity at week 4 compared to 12.5% of electrodes in the control group. There was a significant reduction in the number of activated astrocytes around the implant in minocycline subjects, as well as a reduction in total area occupied by activated astrocytes at 1 and 4 weeks.

Use of partial 16S rRNA gene sequencing for identification of Legionella pneumophila and non-pneumophila Legionella spp

We examined 49 Legionella species, 26 L. pneumophila and 23 non-pneumophila Legionella spp., using partial 16S rRNA gene sequencing. This approach accurately identified all the L. pneumophila isolates, characterized all non-pneumophila Legionella isolates as such within this genus, and classified most (20/23; 87%) of the non-pneumophila Legionella isolates to the species level.

World at work: hospital pharmacy clean-rooms

An overview of potential hazards and preventive measures

APOE-epsilon4 predisposes to cognitive dysfunction following uncomplicated carotid endarterectomy

BACKGROUND

Between 9% and 23% of patients undergoing otherwise uncomplicated carotid endarterectomy (CEA) develop subtle cognitive decline 1 month postoperatively. The APOE-epsilon4 allele has been associated with worse outcome following stroke.

OBJECTIVE

To investigate the ability of APOE-epsilon4 to predict post-CEA neurocognitive dysfunction.

METHODS

Seventy-five patients with CEA undergoing elective CEA were prospectively recruited in this nested cohort study and demographic variables were recorded. Patients were evaluated before and 1 month after surgery with a standard battery of five neuropsychological tests. APOE genotyping was performed by restriction fragment length polymorphism analysis in all patients. Neuropsychological deficits were identified by comparing changes (before to 1 month post-operation) in individual performance on the test battery. Logistic regression was performed for APOE-epsilon4 and previously identified risk factors.

RESULTS

Twelve of 75 (16%) CEA patients possessed the APOE-epsilon4 allele. Eight of 75 (11%) patients experienced neurocognitive dysfunction on postoperative day 30. One month post-CEA, APOE-epsilon4-positive patients were more likely to be cognitively injured (42%) than APOE-epsilon4-negative patients (5%) (p = 0.002). In multivariate analysis, the presence of the APOE-epsilon4 allele increased the risk of neurocognitive dysfunction at 1 month 62-fold (62.28, 3.15 to 1229, p = 0.007). Diabetes (51.42, 1.94 to 1363, p = 0.02), and obesity (24.43, 1.41 to 422.9, p = 0.03) also predisposed to injury.

CONCLUSION

The APOE-epsilon4 allele is a robust independent predictor of neurocognitive decline 1 month following CEA.

Multicenter evaluation of a Candida albicans peptide nucleic acid fluorescent in situ hybridization probe for characterization of yeast isolates from blood cultures

We evaluated aliquots from 244 clinical blood culture bottles that demonstrated yeasts on Gram stain using a Candida albicans peptide nucleic acid (PNA) fluorescent in situ hybridization (FISH) probe. The sensitivity, specificity, positive predictive value, and negative predictive value of the C. albicans PNA FISH test in this study were 99%, 100%, 100%, and 99.3%, respectively.

Obesity, macrophage migration inhibitory factor, and weight loss

OBJECTIVE

Elevated macrophage migration inhibitory factor (MIF) has been implicated as a causal mechanism in a number of disease conditions including cardiovascular disease (CVD), diabetes, and cancer. Excess body fat is associated with an increased risk of numerous health conditions including CVD, diabetes, and cancer. To our knowledge, the association between MIF and obesity status and the effect of weight loss on serum MIF concentrations have not been reported. In this study, we examined the effects of participation in a behavior-based weight loss program on MIF concentrations in obese individuals.

SUBJECTS

Study participants were 71 men and women enrolled in The Cooper Institute Weight Management Program. Participants were predominantly female (68%, n=48), middle-aged (46.5+/-9.8 y), and severely obese (BMI=43.0+/-8.6).

METHOD

Plasma MIF concentrations and other standard risk factors were measured before and after participation in a diet and physical activity based weight management program.

RESULTS

The mean follow-up was 8.5+/-3.0 months with an average weight loss of 14.4 kg (P<0.001). The majority of clinical risk factors significantly improved at follow-up. Median levels of plasma MIF concentration were significantly lower at follow-up (median [IQR]; 5.1[3.6-10.3]) compared to baseline (8.4 [4.3-48.8]; P=0.0005). The percentage of participants with plasma MIF concentration > or =19.5 mg/nl (highest tertile at baseline) decreased from 33.8 to 5.6% (P<0.001). Further, elevated baseline plasma MIF concentration was associated with markers of beta-cell dysfunction and reductions in MIF were associated with improvements in beta-cell function.

CONCLUSIONS

Circulating MIF concentrations are elevated in obese but otherwise healthy individuals; however, this elevation in MIF is not uniform across individuals. In obese individuals with elevated circulating MIF concentrations, participation in physical activity and a dietary-focused weight management program resulted in substantial reduction in MIF.

Simultaneous detection of Staphylococcus aureus and coagulase-negative staphylococci in positive blood cultures by real-time PCR with two fluorescence resonance energy transfer probe sets

A real-time PCR assay that uses two fluorescence resonance energy transfer probe sets and targets the tuf gene of staphylococci is described here. One probe set detects the Staphylococcus genus, whereas the other probe set is specific for Staphylococcus aureus. One hundred thirty-eight cultured isolates, which contained 41 isolates of staphylococci representing at least nine species, and 100 positive blood cultures that contained gram-positive cocci in clusters were tested. This assay was 100% sensitive and 100% specific for the detection of the Staphylococcus genus and of S. aureus.

Detection of spinal ataxia in horses using fuzzy clustering of body position uncertainty

REASONS FOR PERFORMING STUDY

Subjective neurological evaluation in horses is prone to bias. An objective method of spinal ataxia detection is not subject to these limitations and could be of use in equine practice and research.

HYPOTHESIS

Kinematic data in the walking horse can differentiate normal and spinal ataxic horses.

METHODS

Twelve normal and 12 spinal ataxic horses were evaluated by kinematic analysis walking on a treadmill. Each body position signal was reduced to a scalar measure of uncertainty then fuzzy clustered into normal or ataxic groups. Correct classification percentage (CCP) was then calculated using membership values of each horse in the 2 groups. Subsequently, a guided search for measure combinations with high CCP was performed.

RESULTS

Eight measures of body position resulted in CCP > or = 70%. Several combinations of 4-5 measures resulted in 100% CCP. All combinations with 100% CCP could be obtained with one body marker on the back measuring vertical and horizontal movement and one body marker each on the right fore- and hindlimb measuring vertical movement.

CONCLUSIONS AND POTENTIAL RELEVANCE

Kinematic gait analysis using simple body marker combinations can be used objectively to detect spinal ataxia in horses.

A perinatal psychiatric service audit in New Zealand: patient characteristics and outcomes

As part of a clinical audit, data were collected on all patients assessed and offered treatment by the Christchurch 'Mothers and Babies' Service between 1-7-98 and 30-6-2000. At assessment and discharge a comprehensive psychiatric interview and the Marcé Checklist were completed by clinicians and self-rating questionnaires were completed by the patient. Univariate analysis and logistic regression were performed on the variables collected. A significant proportion of women suffered from chronic recurrent psychiatric disorders. Pure 'postnatal depression' was uncommon. Thirty-eight percent of women were pregnant at assessment. Risk factors for poor maternal outcomes included history of chronic illness, high symptomatic scores at assessment, the presence of more than one Axis I diagnosis (excluding nicotine dependence) or an Axis II diagnosis, and poor interpersonal relationships. Perinatal psychiatric services need resources to treat women with a range of severe and chronic disorders and should pay attention to interpersonal issues in treatment.

A postnatal sensitive period for plasticity of cortical afferents but not cortical association fibers in rat piriform cortex

Male and female rats underwent unilateral naris occlusion or sham surgery on either post-natal day (PN) 1 or after PN30. Following at least 30 days of unilateral olfactory deprivation, rats were urethane anesthetized and recordings were made from anterior piriform cortex (aPCX). Shock stimulation of afferent fibers (lateral olfactory tract) and association/commissural fibers evoked field potentials in aPCX that were analyzed across groups and between ages. The results demonstrate that early-onset unilateral olfactory deprivation depresses field potentials evoked by stimulation of the deprived cortical afferent, while late-onset deprivation did not. In contrast, intracortical association fiber mediated field potentials in the deprived cortex were enhanced after both early-onset and late-onset deprivation. These results suggest differential developmental plasticity of afferent and association fiber pathways in paleocortex that mirrors that previously described in neocortical sensory systems.

Laparoscopic ovariectomy using sequential electrocoagulation and sharp transection of the equine mesovarium

OBJECTIVE

To describe in horses and ponies a laparoscopic ovariectomy technique facilitated by electrosurgical instrumentation.

STUDY DESIGN

Elective ovariectomy was performed in 23 mares using laparoscopic electrosurgical instrumentation.

ANIMALS OR SAMPLE POPULATION

Twenty-three mares (13 horses, 10 ponies), aged from 2 to 21 years and weighing 90 to 545 kg.

METHODS

Food was withheld for a minimum of 12 hours. Mares were sedated with detomidine hydrochloride (0.02 to 0.03 mg/kg) or xylazine hydrochloride (0.5 to 1.0 mg/kg). Excluding the pony mares, all other mares were restrained in stocks. Portal sites in the paralumbar fossa region were desensitized with 2% mepivacaine. Abdominal insufflation was achieved through a teat cannula positioned in the ventral abdomen or a Verres-type needle placed through the paralumbar fossa. After trocar and laparoscope insertion, the ipsilateral ovary and mesovarium were identified, and the mesovarium, tubal membrane, and proper ligament were infiltrated with 2% mepivacaine. The mesovarium was coagulated using bipolar or monopolar electrosurgical forceps and transected sequentially from cranial to caudal until the ovary was completely freed and then removed. The contralateral ovary was removed in a similar fashion through the opposite paralumbar fossa.

RESULTS

Bipolar and monopolar electrosurgical forceps were easy to use and provided adequate coagulation of vessels within the mesovarium. Two mares were euthanatized after the procedure for unrelated reasons. One mare had mild signs of colic 24 hours after ovariectomy. In 1 pony mare, the incision used to remove one ovary dehisced on the 5th postoperative day and was allowed to heal by second-intention. No long-term complications had occurred in 11 horses and 10 ponies, 6 to 24 months after surgery.

CONCLUSION

Laparoscopic ovariectomy and hemostasis of the mesovarium can be easily accomplished using electrosurgical instrumentation.

CLINICAL RELEVANCE

Standing laparoscopic ovariectomy, using electrosurgical instrumentation, is an effective and safe technique to provide hemostasis of the mesovarium in mares.

Ontogeny of odor discrimination: a method to assess novel odor discrimination in neonatal rats

Recent research using molecular and functional imaging techniques has demonstrated a highly precise spatial representation of odor quality in the rodent olfactory bulb, which is enhanced by extensive lateral inhibitory circuitry. Much of this olfactory bulb circuitry develops postnatally in the rat, leading to the prediction that behavioral discrimination of odor quality may also emerge postnatally. However, currently no behavioral paradigm has been identified to test this prediction. The present report describes the expression and habituation of odor-evoked heart rate-orienting responses in neonatal rats. The results demonstrate that odor-evoked-orienting responses can be observed at least as early as postnatal day 4 (PN 4), and in those animals showing orienting responses, habituation is constant throughout the postnatal period. Furthermore, the results suggest that examination of cross-habituation using this paradigm can be used to explore odor discrimination ability in neonates. These results lay the foundation for future studies of precise mapping of the ontogeny of novel odor discrimination.

Scopolamine enhances generalization between odor representations in rat olfactory cortex

Acetylcholine (ACh) has a critical, modulatory role in plasticity in many sensory systems. In the rat olfactory system, both behavioral and physiological data indicate that ACh may be required for normal odor memory and synaptic plasticity. Based on these data, neural network models have hypothesized that ACh muscarinic receptors reduce interference between learned cortical representations of odors within the piriform cortex. In this study, odor receptive fields of rat anterior piriform cortex (aPCX) single-units for alkane odors were mapped before and after either a systemic injection of the muscarinic receptor antagonist scopolamine (0.5 mg/kg) or aPCX surface application of 500 microM scopolamine (or saline/ACSF controls). Cross-habituation between alkanes differing by two to four carbons was then examined following a 50-sec habituating stimulus. The results demonstrate that neither aPCX spontaneous activity nor odor-evoked activity (receptive field) was affected by scopolamine, but that cross-habituation in aPCX neurons was enhanced significantly by either systemic or cortical scopolamine. These results indicate that scopolamine selectively enhances generalization between odor representations in aPCX in a simple memory task. Given that ACh primarily affects intracortical association fibers in the aPCX, the results support a role for the association system in odor memory and discrimination and indicate an important ACh modulatory control over this basic sensory process.