Urinalysis and culture results of free-catch urine samples in dogs: a randomised controlled trial.

OBJECTIVES: To evaluate the prevalence of bacterial presence in free-catch urine samples preceded by either a standardised prepped ("clean-catch") protocol versus unprepped (non-cleaned) voiding. MATERIALS AND METHODS: The study was a single-centre prospective single-blinded randomised controlled trial. Urine samples were obtained from 100 client-owned dogs presenting for routine evaluation. Dogs were randomly assigned to either the prepped group (preputial or peri-vulvar area cleaned with sterile saline before collection) or the unprepped group (no preliminary cleansing) stratified by sex. Urinalysis and urine culture (blood and MacConkey agar) were performed on all samples. Significant bacterial presence on urine culture was defined as >104 colony forming units (CFU)/mL. RESULTS: There were no statistically significant associations between prepped versus unprepped collection method or sex with a urinalysis positive for bacteriuria. However, on culture, significant bacterial growth was almost five times more likely to be associated with males relative to females (odds ratio 4.59, 95% confidence interval 1.61 to 13.10). The probability of finding a positive culture was not statistically associated with prep method (odds ratio 1.43, 95% confidence interval 0.50 to 4.08). CLINICAL SIGNIFICANCE: For the majority of dogs without clinical signs of urinary tract infection, free-catch urine collection does not result in significant bacteriuria found on analysis or culture. The presence of bacteria found in free-catch samples may be secondary to sample contamination or subclinical bacteriuria. Sample contamination or subclinical bacteriuria may be more prevalent in male dogs.

Assessing the impact of rurality on oesophagogastric cancer survival in the North-East of Scotland- a prospective population cohort study.

INTRODUCTION: Despite advances in oncology therapies and surgical techniques, survival from oesophagogastric cancer remains low. Poorer cancer outcomes and survival for rural dwellers is documented worldwide and has been an area of focus in Scotland since 2007 when changes to suspected cancer national referral guidelines and governmental mandates on delivering remote and rural healthcare occurred. Whether these changes in clinical practice has impacted upon upper gastrointestinal cancer remains unclear. METHODS: A prospective, single-centre observation study was performed. Data from the regional oesophagogastric cancer MDT between 2013 and 2019 were included. The Scottish Index of Multiple Deprivation 2020 tool provided a rurality code (1 or 2) based on patient postcode at time of referral. Survival outcomes for urban and rural patients were compared across demographic factors, disease factors and stage at presentation. RESULTS: A total of 1038 patients were included in this study. There was no significant difference between rural and urban groups in terms of sex of patient, age at diagnosis, cancer location, or tumour stage. Furthermore, no difference was identified between those commenced on a radical therapy with other treatment plans. Despite this, rurality predicted for an improved outcome on survival analysis (p = 0.012) and this was independent of other factors on multivariable analysis (HR = 0.78, 95%CI 0.66-0.98; p = 0.032). DISCUSSION: The difference in survival demonstrated here between urban and rural groups is not easily explained but may represent improvements to rural access to healthcare delivered as a result of Scottish Government reports.

Dexterous magnetic manipulation of conductive non-magnetic objects.

Dexterous magnetic manipulation of ferromagnetic objects is well established, with three to six degrees of freedom possible depending on object geometry1. There are objects for which non-contact dexterous manipulation is desirable that do not contain an appreciable amount of ferromagnetic material but do contain electrically conductive material. Time-varying magnetic fields generate eddy currents in conductive materials2-4, with resulting forces and torques due to the interaction of the eddy currents with the magnetic field. This phenomenon has previously been used to induce drag to reduce the motion of objects as they pass through a static field5-8, or to apply force on an object in a single direction using a dynamic field9-11, but has not been used to perform the type of dexterous manipulation of conductive objects that has been demonstrated with ferromagnetic objects. Here we show that manipulation, with six degrees of freedom, of conductive objects is possible by using multiple rotating magnetic dipole fields. Using dimensional analysis12, combined with multiphysics numerical simulations and experimental verification, we characterize the forces and torques generated on a conductive sphere in a rotating magnetic dipole field. With the resulting model, we perform dexterous manipulation in simulations and physical experiments.

Stress in client-owned dogs related to clinical exam location: a randomised crossover trial.

OBJECTIVES: To quantify the effects of wellness examinations conducted in the common treatment area on fear, anxiety and stress indicators in client-owned dogs. MATERIALS AND METHODS: The study was a prospective, non-blinded, randomised, two-period two-treatment crossover trial. Client-owned healthy adult dogs presenting for wellness or dental evaluations at a single veterinary teaching hospital received three consecutive rapid assessment exams; a baseline exam (owner present), followed by two identical physical exams differing in location and presented in random order (isolated exam room with owner present versus common treatment area, owner absent). Primary endpoints were a cumulative fear, anxiety and stress score for five standardised behaviours and heart rate (bpm) measured for each exam. RESULTS: Forty-four dogs were enrolled. Modal fear, anxiety and stress score at baseline was 1 of 5, indicating none to mild stress. Both fear, anxiety and stress and heart rates measured in the common treatment area were clinically elevated relative to assessments conducted in the exam room. Relative to baseline, animals examined in the common treatment area showed increased fear, anxiety and stress (+2.6 units, se 0.5; P<0.0001) and heart rate (20 bpm, 95% confidence interval 13, 28; P<0.0001. Twenty-eight dogs (64%) exhibited fear, anxiety and stress scores ≥3 of 5 (moderate to severe stress) in the common treatment area, compared to 19 (43%) during exam room assessments. CLINICAL SIGNIFICANCE: Stress assessments in this study may have been biased by inability to blind assessors to location. However, stress metrics showed clinically significant, consistent and directionally symmetrical increases when dogs were examined in the common treatment area. When physical exam locations are highly stimulating, dogs may experience increased stress and anxiety, with detrimental effects on clinical assessments and behavioural welfare. Whenever possible, physical exams and procedures should take place in low-stress environments with the owner present.

Length-Dependent Evolution of Type II Heterojunctions in Bottom-Up-Synthesized Graphene Nanoribbons.

The ability to tune the band-edge energies of bottom-up graphene nanoribbons (GNRs) via edge dopants creates new opportunities for designing tailor-made GNR heterojunctions and related nanoscale electronic devices. Here we report the local electronic characterization of type II GNR heterojunctions composed of two different nitrogen edge-doping configurations (carbazole and phenanthridine) that separately exhibit electron-donating and electron-withdrawing behavior. Atomically resolved structural characterization of phenanthridine/carbazole GNR heterojunctions was performed using bond-resolved scanning tunneling microscopy and noncontact atomic force microscopy. Scanning tunneling spectroscopy and first-principles calculations reveal that carbazole and phenanthridine dopant configurations induce opposite upward and downward orbital energy shifts owing to their different electron affinities. The magnitude of the energy offsets observed in carbazole/phenanthridine heterojunctions is dependent on the length of the GNR segments comprising each heterojunction with longer segments leading to larger heterojunction energy offsets. Using a new on-site energy analysis based on Wannier functions, we find that the origin of this behavior is a charge transfer process that reshapes the electrostatic potential profile over a long distance within the GNR heterojunction.

Atomically precise graphene nanoribbon heterojunctions from a single molecular precursor.

The rational bottom-up synthesis of atomically defined graphene nanoribbon (GNR) heterojunctions represents an enabling technology for the design of nanoscale electronic devices. Synthetic strategies used thus far have relied on the random copolymerization of two electronically distinct molecular precursors to yield GNR heterojunctions. Here we report the fabrication and electronic characterization of atomically precise GNR heterojunctions prepared through late-stage functionalization of chevron GNRs obtained from a single precursor. Post-growth excitation of fully cyclized GNRs induces cleavage of sacrificial carbonyl groups, resulting in atomically well-defined heterojunctions within a single GNR. The GNR heterojunction structure was characterized using bond-resolved scanning tunnelling microscopy, which enables chemical bond imaging at T = 4.5 K. Scanning tunnelling spectroscopy reveals that band alignment across the heterojunction interface yields a type II heterojunction, in agreement with first-principles calculations. GNR heterojunction band realignment proceeds over a distance less than 1 nm, leading to extremely large effective fields.

Preventing Thin Film Dewetting via Graphene Capping.

A monolayer 2D capping layer with high Young's modulus is shown to be able to effectively suppress the dewetting of underlying thin films of small organic semiconductor molecule, polymer, and polycrystalline metal, respectively. To verify the universality of this capping layer approach, the dewetting experiments are performed for single-layer graphene transferred onto polystyrene (PS), semiconducting thienoazacoronene (EH-TAC), gold, and also MoS2 on PS. Thermodynamic modeling indicates that the exceptionally high Young's modulus and surface conformity of 2D capping layers such as graphene and MoS2 substantially suppress surface fluctuations and thus dewetting. As long as the uncovered area is smaller than the fluctuation wavelength of the thin film in a dewetting process via spinodal decomposition, the dewetting should be suppressed. The 2D monolayer-capping approach opens up exciting new possibilities to enhance the thermal stability and expands the processing parameters for thin film materials without significantly altering their physical properties.

The role of adhesion junctions in the biomechanical behaviour and osteogenic differentiation of 3D mesenchymal stem cell spheroids.

Osteogenesis of mesenchymal stem cells (MSC) can be regulated by the mechanical environment. MSCs grown in 3D spheroids (mesenspheres) have preserved multi-lineage potential, improved differentiation efficiency, and exhibit enhanced osteogenic gene expression and matrix composition in comparison to MSCs grown in 2D culture. Within 3D mesenspheres, mechanical cues are primarily in the form of cell-cell contraction, mediated by adhesion junctions, and as such adhesion junctions are likely to play an important role in the osteogenic differentiation of mesenspheres. However the precise role of N- and OB-cadherin on the biomechanical behaviour of mesenspheres remains unknown. Here we have mechanically tested mesenspheres cultured in suspension using parallel plate compression to assess the influence of N-cadherin and OB-cadherin adhesion junctions on the viscoelastic properties of the mesenspheres during osteogenesis. Our results demonstrate that N-cadherin and OB-cadherin have different effects on mesensphere viscoelastic behaviour and osteogenesis. When OB-cadherin was silenced, the viscosity, initial and long term Young's moduli and actin stress fibre formation of the mesenspheres increased in comparison to N-cadherin silenced mesenspheres and mesenspheres treated with a scrambled siRNA (Scram) at day 2. Additionally, the increased viscoelastic material properties correlate with evidence of calcification at an earlier time point (day 7) of OB-cadherin silenced mesenspheres but not Scram. Interestingly, both N-cadherin and OB-cadherin silenced mesenspheres had higher BSP2 expression than Scram at day 14. Taken together, these results indicate that N-cadherin and OB-cadherin both influence mesensphere biomechanics and osteogenesis, but play different roles.

Control of bovine tuberculosis in a farmed red deer herd in England.

This report describes how Mycobacterium bovis infection was controlled and eventually eradicated in a farmed red deer herd in the north of England, following sustained tuberculin skin testing supplemented with serological (antibody) tests over a period of approximately two years. By taking advantage of the anamnestic antibody response produced by the skin test to detect skin test-negative, antibody-positive infected individuals, a total of 35 additional animals were identified, including 2 with gross visible lesions typical of bovine tuberculosis (BTB). Without detection and removal, these animals would have posed a continued risk of BTB persistence within the herd and potentially contributed to the spread of infection from deer into wildlife and surrounding cattle farms in an area of low BTB incidence. This case supports the use of ancillary diagnostic serological tests to speed up the resolution of incidents of BTB caused by M bovis in captive deer herds.

Molecular Self-Assembly in a Poorly Screened Environment: F4TCNQ on Graphene/BN.

We report a scanning tunneling microscopy and noncontact atomic force microscopy study of close-packed 2D islands of tetrafluorotetracyanoquinodimethane (F4TCNQ) molecules at the surface of a graphene layer supported by boron nitride. While F4TCNQ molecules are known to form cohesive 3D solids, the intermolecular interactions that are attractive for F4TCNQ in 3D are repulsive in 2D. Our experimental observation of cohesive molecular behavior for F4TCNQ on graphene is thus unexpected. This self-assembly behavior can be explained by a novel solid formation mechanism that occurs when charged molecules are placed in a poorly screened environment. As negatively charged molecules coalesce, the local work function increases, causing electrons to flow into the coalescing molecular island and increase its cohesive binding energy.

Fabrication of Gate-tunable Graphene Devices for Scanning Tunneling Microscopy Studies with Coulomb Impurities.

Owing to its relativistic low-energy charge carriers, the interaction between graphene and various impurities leads to a wealth of new physics and degrees of freedom to control electronic devices. In particular, the behavior of graphene's charge carriers in response to potentials from charged Coulomb impurities is predicted to differ significantly from that of most materials. Scanning tunneling microscopy (STM) and scanning tunneling spectroscopy (STS) can provide detailed information on both the spatial and energy dependence of graphene's electronic structure in the presence of a charged impurity. The design of a hybrid impurity-graphene device, fabricated using controlled deposition of impurities onto a back-gated graphene surface, has enabled several novel methods for controllably tuning graphene's electronic properties. Electrostatic gating enables control of the charge carrier density in graphene and the ability to reversibly tune the charge and/or molecular states of an impurity. This paper outlines the process of fabricating a gate-tunable graphene device decorated with individual Coulomb impurities for combined STM/STS studies. These studies provide valuable insights into the underlying physics, as well as signposts for designing hybrid graphene devices.

Detection of adverse events in surgical patients using the Trigger Tool approach.

BACKGROUND: Most studies of healthcare complications identify surgery as a major contributor to the overall burden of complicated care that leads to injury or death. Indeed, surgical adverse events account for one-half to three-quarters of all adverse events in these studies. Despite the intensive current focus on improving medical quality and safety, only a minority of quality improvement efforts are focused on surgery. This study reports on the development and testing of a Trigger Tool to detect adverse events among patients undergoing inpatient surgery. METHODS: Rather than relying on traditional voluntary reporting for safety outcome measures such as incident reports, surgical peer review, or morbidity and mortality conferences, the Institute for Healthcare Improvement (IHI) has employed a new method for the detection of surgical adverse events (SAEs). This approach, commonly referred to as the "Trigger Tool", identifies adverse events using a form of retrospective record review that has been developed and implemented in many areas of care. RESULTS: During a 12-month IHI Perioperative Safety Collaborative, 11 hospitals voluntarily submitted data from surgical inpatient record reviews. In 854 patients, 138 SAEs were detected in 125 records for a rate of 16 SAEs per 100 patients or 14.6% of patients; 61 (44%) of these events contributed to increased length of stay or readmission and 12 (8.7%) events required life-saving intervention or resulted in permanent harm or death. Hospital review teams reported verbally that most of the events identified during the Trigger Tool review process had not been detected or reported via any other existing mechanism. CONCLUSIONS: The IHI Surgical Trigger Tool may offer a practical, easy-to-use approach to detecting safety problems in patients undergoing surgery; it can be the basis not only for estimating the frequency of adverse events in an organisation, but also determining the impact of interventions that focus on reducing adverse events in surgical patients.

Viral, parasitic and prion diseases of farmed deer and bison.

The most important viral disease of farmed deer and bison is malignant catarrhal fever. The other herpesviruses which have been isolated from these species are briefly described. Other viral agents that are recognised in these animals, including adenovirus, parapox, foot and mouth disease, bluetongue, epizootic haemorrhagic disease, bovine virus diarrhoea, rotavirus and coronavirus, are also discussed. Ectoparasites of importance in this group in various parts of the world include a variety of ticks, as well as lice, keds, Oestridae, mange mites and fire ants. Helminth parasites include liver flukes (Fascioloides and Fasciola), gastrointestinal nematodes of the family Trichostrongylidae, pulmonary lungworms of the genus Dictyocaulus and extra-pulmonary lungworms of the family Protostrongylidae. Chronic wasting disease is principally important in North America, where the disease occurs in wild cervids in a limited area and has been reported in farmed deer in a small number of states in the United States of America and one province in Canada. These diseases are summarised in terms of their classification, epidemiology, clinical signs, pathology, diagnosis, treatment and control.

Bacterial diseases of farmed deer and bison.

The most important aerobic bacterial diseases of farmed deer and bison include bovine tuberculosis, Johne's disease (paratuberculosis), yersiniosis, leptospirosis, brucellosis, pasteurellosis, anthrax, salmonellosis and colibacillosis. Anaerobic bacterial infections affecting the same animals include necrobacillosis and a number of clostridial diseases such as tetanus, blackleg, malignant oedema and pulpy kidney. The relative importance of these diseases will vary throughout the world according to timing and circumstance, but bovine tuberculosis and Johne's disease are likely to present the most significant problems with respect to diagnosis, control, trade in live animals and the establishment of wildlife reservoirs of infection. The authors summarise the aetiology, the principal species of animal affected, geographical distribution, transmission, clinical signs, pathology, diagnosis, treatment and control of these diseases.

Accuracy of soft tissue balancing in total knee arthroplasty.

To the best of our knowledge, this is the first study to assess the accuracy of balancing of the flexion and extension gaps in total knee arthroplasty (TKA). Measurements of the heights of the flexion and extension gaps were obtained during 104 consecutive primary, posterior-stabilized TKAs in osteoarthritic patients. Clinically, all knees appeared to be well balanced intraoperatively. Rectangular flexion and extension gaps almost always were obtained within 1 mm (84%-89%). None of the knees was >3 mm from being perfectly rectangular. Equality of the flexion and extension gaps was more difficult to obtain (47%-57% were within 1 mm). With meticulous attention, perfect soft tissue balance is not always achieved in TKA.

The effects of diffusible creosote-derived compounds on development in Pacific herring (Clupea pallasi).

The effects of diffusible creosote-derived compounds from weathered creosote-treated pilings on embryonic development in the Pacific herring were investigated. Parameters used to evaluate toxicity included embryonic development, cardiac function, embryo/larval activity (movement of developing embryos), hatching success, and larval morphology at hatch. For acute exposures, embryos were incubated in seawater containing either creosote-treated wood (creosote) or untreated wood (wood control), or seawater alone (control). All embryos adhering directly to creosote-treated wood and 40-50% of embryos not adhering to the creosote-treated wood failed to develop beyond the first few days of incubation. For surviving embryos, a 93% reduction in heart rate, and moderate to marked arrhythmia was observed. Surviving embryos also exhibited both an increase in frequency and an alteration in pattern of embryo/larval movement, with most embryos exhibiting tremors as compared with the vigorous movements of the control embryos. Cardiac function and embryo/larval movements of embryos exposed to untreated wood were not significantly different from controls. The hatching rate of embryos exposed to creosote was 90% lower than control embryos and 72.4% lower than embryos exposed to untreated wood, and the LC(50) for hatching success was 0.05 mg/l. Partial hatching (incomplete hatch) was observed in 15-20% of embryos exposed to creosote. All of the hatched larvae exposed as embryos to creosote exhibited morphological deformities, including scoliosis, pericardial edema and/or ascites. Similar effects were observed in embryos collected from creosoted pilings in San Francisco Bay, with a 72% decrease in hatching success compared with embryos collected from the Bay and severely deformed larvae. To investigate the combined effects of creosote and salinity on hatching success, larval morphology, and cardiac function, embryos were exposed to a sublethal concentration of creosote (0.003 mg/l) at three salinities; sub-optimal (8 parts per thousand (ppt)), optimal (16 ppt), and high salinity (28 ppt). The presence of creosote decreased hatching success at all three salinities, but the effect was greatest at 8 ppt (34% reduction) and the least in 28 ppt (14% reduction). The increased incidence of morphological abnormalities was also smallest at the high salinity (10% compared with 24 and 33% in 8 and 16 ppt). While exposure to creosote resulted in reduced heart rates at all three salinities, no additive effect of creosote and salinity was observed.

Anatomy of the epicondyles of the distal femur: MRI analysis of normal knees.

Knowledge of precise anatomic landmarks and relationships of the distal femur can be helpful in knee surgery, especially primary and revision total knee arthroplasty. We analyzed 104 consecutive routine knee magnetic resonance imaging studies to define useful landmarks and relationships. The epicondyles are described, and the relationship of the epicondyles to the joint line is defined in multiple planes. Some significant gender differences were noted. The distance from the epicondyles to the joint line correlates with the transepicondylar width of the distal femur. This information can be helpful in determining appropriate joint line position intraoperatively. The posterior condylar angle averaged 3.11 degrees for all patients, and a tendency for the posterior condylar angle to increase with age was noted, but further study of this tendency is needed.

The posterior condylar angle in osteoarthritic knees.

The posterior condylar angle is formed by the transepicondylar axis and the tangent line to the posterior condyles. It is an important relationship to determine rotational alignment of the femoral component in total knee arthroplasty. We measured this angle directly in 107 osteoarthritic knees undergoing total knee arthroplasty. The posterior condylar angle was significantly greater in valgus knees than in other osteoarthritic knees. Given the standard deviations and ranges of values noted, the posterior condyles are potentially unreliable references for femoral component rotation in some knees.

Osteolysis associated with cemented total knee arthroplasty.

Osteolysis has not been mentioned as a complication or cause of failure of cemented total knee arthroplasties in long-term follow-up studies. We are aware of a single case report of osteolysis after cemented total knee arthroplasty. We report the case of an 87-year-old woman with massive osteolysis beneath a cemented tibial component.