Foot health and prevalence of Dichelobacter nodosus in 11 ungulate species at Berne Animal Park.

INTRODUCTION: Dichelobacter nodosus (D. nodosus) is the etiological agent of ovine footrot affecting mainly sheep worldwide, but also free-ranging wild ungulates such as Alpine ibex (Capra ibex ibex) and mufflon (Ovis orientalis orientalis). A nationwide ovine footrot eradication program is planned for the years to come, based on polymerase chain reaction (PCR)-testing of interdigital swab samples and regular footbathing. In this cross-sectional study, we clinically evaluated the foot health and analysed presence of D. nodosus in 11 different even-toed ungulate species (mainly European species) during a 13 months (2018-2019) period in Berne Animal Park. The foot lesions were scored for any clinical signs of pathologies as described in cattle and simultaneously for clinical signs of footrot as described for sheep, using a scale from 0 to 5 (while 0 describes clinically healthy feet and 5 loss of the horn capsule). From a total of 53 animals, 4-feet swab samples were taken from the interdigital cleft and subjected to real-time PCR assays to detect D. nodosus at animal level. Foot lesions were detected in five different species. In 3/5 muskoxen (Ovibos moschatus wardi), 7/12 Cretan wild goats (Capra hircus cretica) and 2/3 dwarf goats (Capra hircus aegagrus), they mainly consisted of white line disease, whereas in 9/10 European bison, dermatitis of the interdigital cleft was diagnosed. 1/3 alpaca was diagnosed with chorioptic mange of the heel area. None of the examined animals showed clinical signs of footrot (score 0), and neither benign (aprB2-positive) nor virulent (aprV2-positive) D. nodosus were detected in any of the samples. This study provides additional information to facilitate an efficient ovine footrot control program in Switzerland and suggests that captive wild even-toed ungulates do not pose a risk to the planned footrot control program.

INTRODUCTION: Dichelobacter nodosus (D. nodosus) est l'agent étiologique du piétin chez les ruminants, qui affecte principalement les moutons dans le monde, mais aussi les ongulés sauvages en liberté tels que les bouquetins (Capra ibex ibex) et les mouflons (Ovis orientalis orientalis). Un programme d'éradication du piétin ovin à l'échelle Nationale, basé sur des tests PCR (réaction de polymérisation en chaîne) d'écouvillons de l'espace interdigité et des pédiluves réguliers, est prévu dans les années à venir en Suisse. Dans cette étude transversale, nous avons évalué cliniquement la santé des onglons et recherché la présence de D. nodosus chez 11 espèces différentes d'animaux biongulés (principalement des espèces européennes) pendant une période de 13 mois (2018­2019) au Parc animalier de Berne. Les lésions des onglons ont été notées pour tout signe clinique de pathologie et de présence de piétin, comme cela est décrit chez les bovins et les moutons et en utilisant une échelle de 0 à 5 (où 0 décrit des pieds cliniquement sains et 5 la perte de la boîte cornée). Des écouvillons ont été prélevés dans l'espace interdigité des 4 pieds sur un total de 53 animaux et soumis à des tests PCR en temps réel pour détecter D. nodosus. Des lésions aux onglons ont été détectées chez cinq espèces différentes. Chez 3 boeufs musqués (Ovibos moschatus wardi) sur 5, 7 chèvres sauvages crétoises (Capra hircus cretica) sur 12 et 2 chèvres naines (Capra hircus aegagrus) sur 3, il s'agissait principalement de lésions de la ligne blanche, alors que dans 9 bisons sur 10, le diagnostic était une dermatite interdigitale. Un alpaga sur 3 a été diagnostiqué avec une gale chorioptique de la zone du paturon. Aucun des animaux examinés n'a montré de signes cliniques de piétin (score 0) et aucun D. nodosus bénin (aprB2-positif) ou virulent (aprV2-positif ) n'a été mis en évidence dans les échantillons. Cette étude fournit des informations supplémentaires pour améliorer l'efficacité du programme d'éradication du piétin ovin et suggère que les biongulés sauvages détenus dans les parcs zoologiques ne présentent pas de risque pour le programme d'éradication prévu en Suisse.

Phosphorus nutrition in Proteaceae and beyond.

Proteaceae in southwestern Australia have evolved on some of the most phosphorus-impoverished soils in the world. They exhibit a range of traits that allow them to both acquire and utilize phosphorus highly efficiently. This is in stark contrast with many model plants such as Arabidopsis thaliana and crop species, which evolved on soils where nitrogen is the major limiting nutrient. When exposed to low phosphorus availability, these plants typically exhibit phosphorus-starvation responses, whereas Proteaceae do not. This Review explores the traits that account for the very high efficiency of acquisition and use of phosphorus in Proteaceae, and explores which of these traits are promising for improving the phosphorus efficiency of crop plants.

A binocular iPad treatment for amblyopic children.

PURPOSE: Monocular amblyopia treatment (patching or penalization) does not always result in 6/6 vision and amblyopia often recurs. As amblyopia arises from abnormal binocular visual experience, we evaluated the effectiveness of a novel home-based binocular amblyopia treatment. METHODS: Children (4-12 y) wore anaglyphic glasses to play binocular games on an iPad platform for 4 h/w for 4 weeks. The first 25 children were assigned to sham games and then 50 children to binocular games. Children in the binocular group had the option of participating for an additional 4 weeks. Compliance was monitored with calendars and tracking fellow eye contrast settings. About half of the children in each group were also treated with patching at a different time of day. Best-corrected visual acuity, suppression, and stereoacuity were measured at baseline, at the 4- and 8-week outcome visits, and 3 months after cessation of treatment. RESULTS: Mean (±SE) visual acuity improved in the binocular group from 0.47±0.03 logMAR at baseline to 0.39±0.03 logMAR at 4 weeks (P<0.001); there was no significant change for the sham group. The effect of binocular games on visual acuity did not differ for children who were patched vs those who were not. The median stereoacuity remained unchanged in both groups. An additional 4 weeks of treatment did not yield additional visual acuity improvement. Visual acuity improvements were maintained for 3 months after the cessation of treatment. CONCLUSIONS: Binocular iPad treatment rapidly improved visual acuity, and visual acuity was stable for at least 3 months following the cessation of treatment.

[Tonsillotomy and adenotonsillectomy in childhood. Study on postoperative pain therapy]. / Tonsillotomien und Adenotomien im Kindesalter. Studie zu postoperativen Schmerztherapie.

BACKGROUND: The primary aim of this study was to determine whether the combination of i.v. ketoprofen and i.v. paracetamol provides superior postoperative analgesia in children undergoing adenoidectomy or tonsillotomy compared to either drug alone. The secondary goal was to assess the time until rescue analgesia was needed, propofol requirements and the incidence of vomiting and time of discharge from the postanaesthesia recovery unit (PARU). METHODS: This double-blinded study included 120 children (aged 3-13 years) scheduled for elective tonsillectomy, adenoidectomy or adenotonsillectomy. The children were randomly assigned to one of 3 groups of 40 children each, using the sealed envelope method. The children received i.v. ketoprofen 2 mg/kgBW (group 1) or paracetamol 15 mg/kgBW (group 2) or the combination of these 2 drugs (group 3) after induction of anaesthesia. Standardized general anaesthesia consisted of sevoflurane and fentanyl at a dose of 2-3 µg/kgBW. Pain was assessed using a 5-point scoring system based on the Smiley scale. The Smiley scale shows various faces from a laughing face which corresponds to the state of no pain to a very unhappy face which corresponds to the situation of worst pain (1: no pain, 2: mild pain, 3: moderate pain, 4: severe pain, 5: worst pain). Pain was assessed at 30 min, 1 h, 2 h, 3 h and 4 h after arriving in the PACU. If the pain score exceeded 2 an i.v. dose of 0.1 mg/kgBW morphine was administered as rescue analgesia. RESULTS: During the stay in the PACU the children in the combination group required significantly less supplementary rescue analgesia than children in the ketoprofen and paracetamol groups (17.5% versus 30.8% versus 45%, respectively, χ(2) analysis <0.05). Pain scoring was highest after paracetamol, however, this difference was only significant when compared to the group receiving the combination of paracetamol and ketoprofen (U-test p<0.05). Rescue analgesia was administered earliest in group 2 (paracetamol) reaching statistical significance, however, only when compared to group 3 (logrank test p<0.05). Propofol requirements and time to discharge from the PACU did not differ significantly between the 3 groups (χ(2) analysis; U-test; p>0.05). The overall incidence of vomiting was very low in this study with 6.4% (9/139). Significantly more children in the paracetamol group compared to ketoprofen group and combination group suffered from vomiting (17.5% versus 2.6% versus 2.5%; χ(2) analysis; p<0.05). The time to discharge from PACU did not differ significantly between the 3 groups (U-test: p>0.05). CONCLUSION: The combination of i.v. paracetamol and i.v. ketoprofen provides superior postoperative analgesia compared to the single use of paracetamol.

Consecutive, prospective case series of a new method for ultrasound-guided supraclavicular approach to the brachiocephalic vein in children.

BACKGROUND: During ultrasound (US)-guided cannulation of the subclavian vein (SCV) via an infraclavicular route, the view of the needle behind the clavicle may be obscured. This study describes the US-guided supraclavicular cannulation of the brachiocephalic vein (BCV). METHODS: The 25 mm broadband linear array US probe was placed in the supraclavicular region to obtain a longitudinal view of the BCV beginning at the junction of the internal jugular vein and SCV. Using the in-plane technique, the needle was directed under US guidance into the BCV. RESULTS: Forty-two cannulations in 35 patients (aged 26 months-8 yr, weight range 0.96-21 kg) were included. Central venous catheter placement was successful in all children. In 31 patients (73.8%), the BCV was successfully punctured on the first attempt, in six patients (14.2%) after two attempts, and in five patients (11.9%) after three attempts. Significantly more puncture attempts were needed in the smaller weight and younger children, whereas the time course of the study had no significant impact on the success rate. CONCLUSIONS: This US-guided method offers a new possibility for central venous line placement in small children. It provides good needle guidance without any disturbing US shadow caused by bony structures.

Size of internal jugular vs subclavian vein in small infants: an observational, anatomical evaluation with ultrasound.

BACKGROUND: The primary goal of this study was to compare the size and depth of the internal jugular vein (IJV) and the subclavian vein (SCV) in infants under general anaesthesia. A secondary goal was to determine the correlation of weight, height, head circumference, and age to the size and depth of these veins. METHODS: Sixty small infants weighing from 1.4 to 4.5 kg were included. Using ultrasound, the diameters via short-axis (SAX) and long-axis (LAX) views, cross-sectional area (CSA), and depth of the left and right IJV and SCV were measured. RESULTS: The diameter of the IJV was 7.9% larger on average than that of the SCV as measured via the SAX and LAX views (mean: 3.1 vs 2.9 mm; Wilcoxon's signed-rank test: P<0.01). The CSA of the IJV was 27% larger on average than that of the SCV (mean: 10.2 vs 8.0 mm(2); Wilcoxon's signed-rank test: P<0.01). Seventy-five per cent of the neonates showed a larger CSA of the IJV. The SCV was 8.4% deeper on average from the skin surface than the IJV (mean: 6.4 vs 5.9 mm; Wilcoxon's signed-rank test: P<0.01). There was a significant positive correlation between weight, height, head circumference, and age to the size and depth of the veins (Spearman's rank correlation: P<0.01). CONCLUSIONS: Because of its most likely larger size, the IJV can be recommended as the better choice for cannulation in comparison with the SCV. However, other factors should also be considered.

Psychosocial outcome following genetic risk counselling for familial colorectal cancer. A comparison of affected patients and family members.

Few studies have reported prospective data on psychosocial outcomes after genetic counselling in families with suspected hereditary non-polyposis colorectal cancer (HNPCC). This prospective study examines the impact of multidisciplinary risk counselling on the psychosocial outcome of 139 affected cancer patients and 233 family members without cancer at risk for HNPCC. Participants completed questionnaires specific to HNPCC before and 8 weeks after attending the familial cancer clinic. Affected patients' levels of distress were closely related to their health status and exceeded that of unaffected individuals, as did worry regarding their relatives' risk. A significant reduction in general anxiety (Hospital Anxiety and Depression Scale), distress specific to familial CRC (Impact of Events Scale) and general cancer worry (Distress Hereditary Disorder) was demonstrated after counselling in both affected patients and unaffected individuals. Reduction in distress was more pronounced in affected patients given a high risk of HNPCC compared with those at intermediate risk. Among unaffected individuals, distress declined regardless of what clinical risk they were assigned. Their perceptions of risk and cancer-related threat declined, while confidence in effective surveillance increased. These results suggest the beneficial effects of multidisciplinary counselling even when high-risk information is conveyed. A patient's previous cancer experience is likely to contribute to clinically relevant distress (15% of those patients), indicating the need for appropriate counselling.

Sulfur-enhanced defence: effects of sulfur metabolism, nitrogen supply, and pathogen lifestyle.

Evidence from field experiments indicates differential roles of sulfur and nitrogen supply for plant resistance against pathogens. Dissection of these observations in defined pathosystems and controlled nutritional conditions indicates an activation of plant sulfur metabolism in several incompatible and compatible interactions. Contents of cysteine and glutathione as markers of primary sulfate assimilation and stress response show increases in ARABIDOPSIS THALIANA upon infection, coinciding with the synthesis of sulfur-containing defence compounds. Similar increases of thiols were observed with necrotrophic, biotrophic, and hemibiotrophic pathogens. Sulfate supply was found to be neutral or beneficial for tolerance against fungal but neutral for bacterial pathogens under IN VITRO conditions. According to various reports and own observations the effects of nitrogen supply appeared to be neutral or harmful, depending on the pathogen. The activation of sulfur metabolism was a consequence of activation of gene expression as revealed by macroarray analysis of an A. THALIANA/ALTERNARIA BRASSICICOLA pathosystem. This activation appeared to be largely independent from sufficient or optimal sulfate supply and from the established sulfate deficiency response. The data suggest that plant-pathogen interactions and sulfur metabolism are linked by jasmonic acid as signal.

[Propofol infusion syndrome]. / Propofolinfusionssyndrom.

The propofol infusion syndrome is a rare but potentially lethal complication resulting from a prolonged continuous administration of propofol. It was first described in the beginning of the 1990's and in recent years there have been frequent reports of problems in association with the use of propofol sedation. The cardinal signs and symptoms of the propofol infusion syndrome are metabolic acidosis, rhabdomyolysis, renal failure, cardiac arrhythmias and a progressive, often therapy-resistant cardiac failure. The pathophysiology of this syndrome appears to involve a disturbance of mitochondrial metabolism induced by propofol. Our report involves a case of propofol infusion syndrome in a patient having undergone cardiac surgery.

Comparison of rovibronic density of asymmetric versus symmetric NO2 isotopologues at dissociation threshold: broken symmetry effects.

We have measured the rovibronic densities of four symmetric (C2v) and two asymmetric (Cs) isotopologues of nitrogen dioxide just below their photodissociation threshold. At dissociation threshold and under jet conditions the laser-induced fluorescence abruptly disappears because the dissociation into NO(2pi(1/2)) + O(3P2) is much faster than the radiative decay. As a consequence, in a narrow energy range below D0, the highest bound rovibronic energy levels of J=1/2 and J=3/2 can be observed and sorted. A statistical analysis of the corresponding rovibronic density, energy spacing, and rovibronic transition intensities has been made. The observed intensity distributions are in agreement with the Porter-Thomas distribution. This distribution allows one to estimate the number of missing levels, and therefore to determine and compare the rovibronic and the vibronic densities. The four symmetric NO2 isotopologues, 16O14N16O, 18O14N18O, 16O15N16O, and 18O15N18O, have, respectively, a sum of J=1/2 and J=3/2 rovibronic densities of 18+/-0.8, 18.3+/-1.4, 18.4+/-2.7, and 19.8+/-3.5 cm(-1), while for the two asymmetric isotopologues, 18O14N16O and 18O15N16O, the corresponding densities are 20.9+/-4.5 and 23.6+/-5.6 cm(-1). The corresponding vibronic densities are in agreement only if we include both the merging of symmetry species (from those of C2v to those of Cs) and the contribution of the long-range tail(s) of the potential-energy surface along the dissociation coordinate. The effects of isotopic substitution on dissociation rates and the possible relation to mass-independent isotopic fractionation are discussed.

Results of the 2004 survey of the American Association of Academic Chief Residents in Radiology.

RATIONALE AND OBJECTIVE: Every year, the American Association of Academic Chief Residents in Radiology (A3CR2) conducts a survey of the chief residents in accredited radiology programs in the United States and Canada. The purpose of the survey is to evaluate current residents' opinions regarding a number of different issues pertaining to their educational experience, work responsibilities, and benefits. This information is useful in monitoring patterns of change in resident attitudes toward their experiences within their residency training programs. MATERIALS AND METHODS: Online surveys were made available to the chief residents from 193 training programs in North America. For the most part, the questions were presented in a multiple-choice format, with additional space for elaboration or comments provided for many of the items. Some questions are repeated annually, addressing general topics such as salary and hospital size. However, new questions are incorporated each year. In particular, this year's survey included questions pertaining to Armed Forces Institute of Pathology course funding, and advanced cardiac life support (ACLS) /basic life support certification and changes in duty work hour and call requirements in the face of changing ACGME (Accreditation Council for Graduate Medical Education) regulations. RESULTS: The results of the survey were then tabulated, and responses to several of the repeated questions were compared with those from prior surveys dating back to 1996. This year's response rate was 55%, with 106 unique responses received. This represents an improvement since last year's survey, when the response rate was 41%. In some cases, more than one response was generated by a given residency program, in which case the questionnaire that was more thoroughly completed was used for statistical analysis. Responses were received from chief residents in 37 states and in Canada. The largest number of respondents was from New York, and 80% percent of respondents were from programs affiliated with a university. Forty-two percent were incoming chief residents with less than 3 months' experience, whereas 58% were outgoing chief residents with less than 9 months remaining in their tenure. CONCLUSION: The majority of respondents report that changes made by their respective programs as the result of new ACGME maximum duty hour standards have been viewed favorably by radiology residents. Many training programs have moved toward a night float based call system in order to maintain compliance. Nearly all programs have overnight in-house radiology resident coverage, but there has been a slight decline in the percentage of programs that provide in-house attending coverage at night. The majority of residents, however, have access to attendings after-hours by pager. Finally, resident salaries and benefits continue to increase, as has been the trend over the past several years.

Dissociation energies of six NO2 isotopologues by laser induced fluorescence spectroscopy and zero point energy of some triatomic molecules.

We have measured the rotationless photodissociation threshold of six isotopologues of NO2 containing 14N, 15N, 16O, and 18O isotopes using laser induced fluorescence detection and jet cooled NO2 (to avoid rotational congestion). For each isotopologue, the spectrum is very dense below the dissociation energy while fluorescence disappears abruptly above it. The six dissociation energies ranged from 25 128.56 cm(-1) for 14N16O2 to 25 171.80 cm(-1) for 15N18O2. The zero point energy for the NO2 isotopologues was determined from experimental vibrational energies, application of the Dunham expansion, and from canonical perturbation theory using several potential energy surfaces. Using the experimentally determined dissociation energies and the calculated zero point energies of the parent NO2 isotopologue and of the NO product(s) we determined that there is a common De = 26 051.17+/-0.70 cm(-1) using the Born-Oppenheimer approximation. The canonical perturbation theory was then used to calculate the zero point energy of all stable isotopologues of SO2, CO2, and O3, which are compared with previous determinations.

Bone metabolism in patients with differentiated thyroid carcinoma receiving suppressive levothyroxine treatment.

AIM: Patients with differentiated thyroid carcinoma (DTC) must receive suppressive levothyroxine (LT(4)) therapy for the rest of their lives. The literature, however, presents conflicting results on how this affects bone metabolism. The aim of this study was to assess the influence of the estrogen status and LT(4) therapy, in particular LT(4) dosage in micrograms per kilograms (microg/kg), on bone metabolism in female patients with DTC. MATERIAL AND METHODS: Three markers of bone metabolism (C-terminal telopeptide of type I collagen in serum [SCTx]; N-terminal telopeptide of type I collagen in urine [U-NTx]; and osteocalcin [OC]) were investigated in four groups: group REF (healthy premenopausal female controls), group DTC-ES (premenopausal women with DTC and normal estrogen levels), group DTC-ED (postmenopausal women with DTC and estrogen deficiency), and group DTC-HRT (postmenopausal women with DTC undergoing hormone replacement therapy [HRT]). All patients with DTC were on a well-adjusted suppressive LT(4) therapy with TSH levels 0.1 mU/L or less. RESULTS: In group DTC-ES bone turnover was comparable to group REF, whereas in group DTC-ED, all three markers were significantly increased as compared to groups REF and DTC-ES. In group DTC-HRT, the HRT normalized U-NTx and OC. However, in this group S-CTx was not completely normalized by HRT in all patients, although also significantly lowered compared to group DTC-ED. The analysis of LT(4 )dosage per kilogram showed that premenopausal DTC-patients had increased markers of bone metabolism if LT(4) dosage exceeded 2.6 microg/kg. Estrogen-deficient patients with DTC, however, had a much lower critical LT(4) dosage, above which increased markers of bone metabolism were seen. CONCLUSION: A well-adjusted suppressive LT(4) therapy of less than 2.6 microg/kg and normal estrogen levels do not seem to increase bone metabolism in estrogen-sufficient patients with DTC. The normalization of an estrogen deficiency by HRT or other antiresorptive therapies and minimal suppressive dosages of LT(4) are attempts to optimize the care of patients with DTC. In postmenopausal patients with DTC and patients with DTC who require LT(4) dosages in excess of 2.6 microg/kg, the information provided by markers of bone metabolism may help to prevent bone damage.

Enhanced interfaces for web-based enterprise-wide image distribution.

Modern Web browsers support image distribution with two shortcomings: (1) image grayscale presentation at client workstations is often sub-optimal and generally inconsistent with the presentation state on diagnostic workstations and (2) an Electronic Patient Record (EPR) application usually cannot directly access images with an integrated viewer. We have modified our EPR and our Web-based image-distribution system to allow access to images from within the EPR. In addition, at the client workstation, a grayscale transformation is performed that consists of two components: a client-display-specific component based on the characteristic display function of the class of display system, and a modality-specific transformation that is downloaded with every image. The described techniques have been implemented in our institution and currently support enterprise-wide clinical image distribution. The effectiveness of the techniques is reviewed.

Molecular and biochemical analysis of the enzymes of cysteine biosynthesis in the plant Arabidopsis thaliana.

Among the amino acids produced by plants cysteine plays a special role as a mediator between assimilatory sulfate reduction and provision of reduced sulfur for cell metabolism. Part of this characteristic feature is the presence of cysteine synthesis in plastids, mitochondria and cytosol. Plants are the major source of reduced sulfur for human and animal nutrition. Cysteine biosynthesis deserves special attention, since reduced sulfur is channelled from cysteine into many sulfur-containing compounds in food and feed. Recent investigations are reviewed that focus on structure and regulation of cysteine synthesis in the model plant Arabidopsis thaliana. These data indicate that cysteine synthesis is not just an intermediate reaction step but that it is part of a regulatory network that mediates between inorganic sulfur supply and the demand for reduced sulfur during plant growth and in response to environmental changes.

Results of the 2001 survey of the American Association of Academic Chief Residents in Radiology.

RATIONALE AND OBJECTIVES: The American Association of Academic Chief Residents in Radiology (A3CR2) conducts an annual survey of residency training programs. The survey data allow comparative analyses to be performed among training programs regarding resident education, benefits, clinical demands, and other resident-related issues. MATERIALS AND METHODS: Questionnaires were mailed to all accredited programs registered in the A3CR2 database (150 total programs). The yearly questions address demographic information concerning the individual programs including academic affiliation, number of radiologic examinations performed per resident, changes in the number of residents per program, and financial compensation. The rotating questions, which are revisited every 4 years, focused on preparation for the American Board of Radiology examinations, educational issues, and employment outlook. RESULTS: Completed surveys were received from 55 programs (37.3%). Among the responses, three issues prevailed: (a) increased number of examinations performed per resident, with resultant decrease in educational time, (b) decreased quality of education in all sections of radiology and decreased number of educational conferences, and (c) improved employment outlook, but continued trend of fewer residents choosing a career in academics. CONCLUSION: The current boom in the radiology job market and the increased number of radiologic examinations performed annually appear to adversely affect radiologic education through a decreased number of conferences and an increased number of radiologic examinations performed per resident.