NOVEL SIMPLEXVIRUS (SIMPLEXVIRUS DOLICHOTINEALPHA1) ASSOCIATED WITH FATALITY IN FOUR PATAGONIAN MARA (DOLICHOTIS PATAGONUM).

Four of seven Patagonian maras (Dolichotis patagonum) at a zoological institution developed acute neurologic signs that progressed to tetraparesis and death. All affected were young adult females (10 mon-5 yr old) that presented over 11 d. Clinical signs were rapidly progressive and unresponsive to supportive therapies. Two of the four individuals were found deceased 4 d after hospitalization. Two individuals were euthanized due to poor prognosis and decline after 6 and 8 d, respectively. Simultaneously, an additional mara developed mild and self-resolving clinical signs, including a kyphotic gait and paraparesis. On gross examination, there were widespread petechiae and ecchymoses of the skeletal muscle, myocardium, skin, pericardium, urinary bladder mucosa, and spinal cord. On histopathology, all animals had necrotizing myelitis and rhombencephalitis, with intranuclear viral inclusions in three individuals. Electron microscopy confirmed herpesviral replication and assembly complexes in neurons and oligodendrocytes. Consensus PCR performed on spinal cord, brainstem, or cerebellum revealed a novel Simplexvirus most closely related to Simplexvirus leporidalpha 4. The virus was amplified and sequenced and is referred to as Simplexvirus dolichotinealpha1. It is unknown whether this virus is endemic in Patagonian mara or whether it represents an aberrant host species. Clinicians should be aware of this virus and its potential to cause severe, rapidly progressive, life-threatening disease in this species.

Dermatitis, cellulitis, and osteomyelitis caused by Aspergillus nidulans in a horse with pituitary pars intermedia dysfunction.

Clinical and histologic examination of a 12-y-old client-owned Quarter Horse gelding with pituitary pars intermedia dysfunction revealed dermatitis, cellulitis, and osteomyelitis caused by Aspergillus nidulans, confirmed by a PCR assay. This novel presentation of a fungal disease in a horse was characterized by aggressive local invasion and failure to respond to all medical therapy attempted over a 1-y period. Treatments included systemic and topical antifungals, anti-inflammatories, and use of cellular matrices. Surgical excision was not attempted but should be strongly considered early in the disease process in similar cases if clean margins can be achieved. Postmortem findings were of locally aggressive disease with no dissemination.

Disseminated Aspergillus citrinoterreus and concurrent localized dermal phaeohyphomycosis in an immunosuppressed dog.

Key Clinical message: We report on a dog with immune-mediated hemolytic anemia (IMHA) treated with immunomodulatory therapy that developed phaeohyphomycosis and Aspergillus citrinoterreus infections. This is the first reported case of A. citrinoterreus in dogs. It details cytological and microbiological findings leading to diagnosis and highlights the importance of investigating new lesions in immunocompromised patients. Abstract: A 5-year-old Staffordshire terrier mix treated with immunosuppressive therapy for IMHA was diagnosed with concurrent disseminated A. citrinoterreus and localized Curvularia lunata infections. This case highlights the potential development of multiple concurrent opportunistic fungal infections and is the first reported case of A. citrinoterreus infection in a dog.

IMU-Based Energy Expenditure Estimation for Various Walking Conditions Using a Hybrid CNN-LSTM Model.

In ubiquitous healthcare systems, energy expenditure estimation based on wearable sensors such as inertial measurement units (IMUs) is important for monitoring the intensity of physical activity. Although several studies have reported data-driven methods to estimate energy expenditure during activities of daily living using wearable sensor signals, few have evaluated the performance while walking at various speeds and inclines. In this study, we present a hybrid model comprising a convolutional neural network (CNN) and long short-term memory (LSTM) to estimate the steady-state energy expenditure under various walking conditions based solely on IMU data. To implement and evaluate the model, we performed level/inclined walking and level running experiments on a treadmill. With regard to the model inputs, the performance of the proposed model based on fixed-size sequential data was compared with that of a method based on stride-segmented data under different conditions in terms of the sensor location, input sequence format, and neural network model. Based on the experimental results, the following conclusions were drawn: (i) the CNN-LSTM model using a two-second sequence from the IMU attached to the lower body yielded optimal performance, and (ii) although the stride-segmented data-based method showed superior performance, the performance difference between the two methods was not significant; therefore, the proposed model based on fixed-size sequential data may be considered more practical as it does not require heel-strike detection.

Effects of Data Augmentation on the Nine-Axis IMU-Based Orientation Estimation Accuracy of a Recurrent Neural Network.

The nine-axis inertial and measurement unit (IMU)-based three-dimensional (3D) orientation estimation is a fundamental part of inertial motion capture. Recently, owing to the successful utilization of deep learning in various applications, orientation estimation neural networks (NNs) trained on large datasets, including nine-axis IMU signals and reference orientation data, have been developed. During the training process, the limited amount of training data is a critical issue in the development of powerful networks. Data augmentation, which increases the amount of training data, is a key approach for addressing the data shortage problem and thus for improving the estimation performance. However, to the best of our knowledge, no studies have been conducted to analyze the effects of data augmentation techniques on estimation performance in orientation estimation networks using IMU sensors. This paper selects three data augmentation techniques for IMU-based orientation estimation NNs, i.e., augmentation by virtual rotation, bias addition, and noise addition (which are hereafter referred to as rotation, bias, and noise, respectively). Then, this paper analyzes the effects of these augmentation techniques on estimation accuracy in recurrent neural networks, for a total of seven combinations (i.e., rotation only, bias only, noise only, rotation and bias, rotation and noise, and rotation and bias and noise). The evaluation results show that, among a total of seven augmentation cases, four cases including 'rotation' (i.e., rotation only, rotation and bias, rotation and noise, and rotation and bias and noise) occupy the top four. Therefore, it may be concluded that the augmentation effect of rotation is overwhelming compared to those of bias and noise. By applying rotation augmentation, the performance of the NN can be significantly improved. The analysis of the effect of the data augmentation techniques presented in this paper may provide insights for developing robust IMU-based orientation estimation networks.

Inertial Motion Capture-Based Wearable Systems for Estimation of Joint Kinetics: A Systematic Review.

In biomechanics, joint kinetics has an important role in evaluating the mechanical load of the joint and understanding its motor function. Although an optical motion capture (OMC) system has mainly been used to evaluate joint kinetics in combination with force plates, inertial motion capture (IMC) systems have recently been emerging in joint kinetic analysis due to their wearability and ubiquitous measurement capability. In this regard, numerous studies have been conducted to estimate joint kinetics using IMC-based wearable systems. However, these have not been comprehensively addressed yet. Thus, the aim of this review is to explore the methodology of the current studies on estimating joint kinetic variables by means of an IMC system. From a systematic search of the literature, 48 studies were selected. This paper summarizes the content of the selected literature in terms of the (i) study characteristics, (ii) methodologies, and (iii) study results. The estimation methods of the selected studies are categorized into two types: the inverse dynamics-based method and the machine learning-based method. While these two methods presented different characteristics in estimating the kinetic variables, it was demonstrated in the literature that both methods could be applied with good performance for the kinetic analysis of joints in different daily activities.

Wearable IMMU-Based Relative Position Estimation between Body Segments via Time-Varying Segment-to-Joint Vectors.

In biomechanics, estimating the relative position between two body segments using inertial and magnetic measurement units (IMMUs) is important in that it enables the capture of human motion in unconstrained environments. The relative position can be estimated using the segment orientation and segment-to-joint center (S2J) vectors where the S2J vectors are predetermined as constants under the assumption of rigid body segments. However, human body segments are not rigid bodies because they are easily affected by soft tissue artifacts (STAs). Therefore, the use of the constant S2J vectors is one of the most critical factors for the inaccurate estimation of relative position. To deal with this issue, this paper proposes a method of determining time-varying S2J vectors to reflect the deformation of the S2J vectors and thus to increase the estimation accuracy, in IMMU-based relative position estimation. For the proposed method, first, reference S2J vectors for learning needed to be collected. A regression method derived a function outputting S2J vectors based on specific physical quantities that were highly correlated with the deformation of S2J vectors. Subsequently, time-varying S2J vectors were determined from the derived function. The validation results showed that, in terms of the averaged root mean squared errors of four tests performed by three subjects, the proposed method (15.08 mm) provided a higher estimation accuracy than the conventional method using constant vectors (31.32 mm). This indicates the proposed method may effectively compensate for the effects of STAs and ultimately estimate more accurate relative positions. By providing STA-compensated relative positions between segments, the proposed method applied in a wearable motion tracking system can be useful in rehabilitation or sports sciences.

Case Report: Giant Multiloculated Pseudocystic Jejunal Leiomyosarcoma in a Dog: Atypical Morphologic Features of Canine Intestinal Leiomyosarcoma.

A 10-year-old intact female Rottweiler dog weighing 29 kg presented with 2 days history of vomiting, anorexia, and lethargy to KonKuk University Teaching Hospital, Seoul, South Korea. Ultrasonography and computed tomography (CT) scannings revealed a well-demarcated, large mass (29 × 19 × 11 cm) with numerous fluid-filled cavities. Metastases to adjacent lymph nodes were also identified on CT. This large mass and the affected intestinal segments were excised for palliative purposes. Postoperatively, the dog recovered uneventfully without any complications. The cut surface of the mass showed an exophytic growth pattern of multiloculated cystic lesions filled with serosanguineous fluid, large cavities filled with necrotic exudate, and fistulous connections between the intestinal lumen and the necrotic cavity in the mass. On histopathology, the mass was a spindle cell neoplasm expanding from the jejunal muscular layer and with pseudocystic changes. Additional immunohistochemical analysis using antibodies against smooth muscle actin, desmin, and CD-117 demonstrated that the mass was consistent with a leiomyosarcoma. Six months post-operatively, plain radiography revealed an abdominal mass, suspected to be recurrence from jejunal leiomyosarcoma. The owner decided to euthanize the dog due to financial constraints. This case report describes the atypical morphology and clinical progression of a large canine jejunal leiomyosarcoma, which had similar clinical features as those of human leiomyoma and leiomyosarcoma.

Effects of a low-FODMAP enteral formula on diarrhea on patients in the intensive care unit.

BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than ß-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the low-FODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS: Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0005660.

Bile Acid Regulates the Colonization and Dissemination of Candida albicans from the Gastrointestinal Tract by Controlling Host Defense System and Microbiota.

Candida albicans (CA), a commensal and opportunistic eukaryotic organism, frequently inhabits the gastrointestinal (GI) tract and causes life-threatening infections. Antibiotic-induced gut dysbiosis is a major risk factor for increased CA colonization and dissemination from the GI tract. We identified a significant increase of taurocholic acid (TCA), a major bile acid in antibiotic-treated mice susceptible to CA infection. In vivo findings indicate that administration of TCA through drinking water is sufficient to induce colonization and dissemination of CA in wild-type and immunosuppressed mice. Treatment with TCA significantly reduced mRNA expression of immune genes ang4 and Cxcr3 in the colon. In addition, TCA significantly decreased the relative abundance of three culturable species of commensal bacteria, Turicibacter sanguinis, Lactobacillus johnsonii, and Clostridium celatum, in both cecal contents and mucosal scrapings from the colon. Taken together, our results indicate that TCA promotes fungal colonization and dissemination of CA from the GI tract by controlling the host defense system and intestinal microbiota that play a critical role in regulating CA in the intestine.

Equine Protozoal Myeloencephalitis associated with Neospora caninum in a USA captive bred zebra (Equus zebra).

A 6-year-old female captive zebra (Equus zebra) had a three-year history of slow progressive neurologic signs that recently worsened with hind limb ataxia, head tilt, and circling. Gross examination including the brain and spinal cord were unremarkable. On histopathology, the brain and brainstem had multiple random areas of severe lymphoplasmacytic meningoencephalitis associated with numerous 15-25 µm in diameter protozoal cysts with a discernible outer wall containing numerous 2 × 4 µm oval to crescent-shaped organisms. Immunohistochemistry and PCR identified the presence of Neospora organisms associated with the lesions. Equine protozoal myeloencephalitis (EPM) is generally associated with Sarcocystis neurona or less commonly Neospora hughesi. Molecular characterization revealed the first case of EPM associated with Neospora caninum in an equid as confirmed by DNA analysis.

Correction: Serum 25-hydroxyvitamin D concentrations in dogs with gallbladder mucocele.

[This corrects the article DOI: 10.1371/journal.pone.0244102.].

Meningoencephalitis, Vasculitis, and Abortions Caused by Chlamydia pecorum in a Herd of Cattle.

A cow dairy (n = 2000) in close proximity to a sheep flock had third-trimester abortions and fatalities in cows and calves over a 14-month period. Eighteen of 33 aborted fetuses (55%) had multifocal random suppurative or mononuclear meningoencephalitis with vasculitis. Seventeen of these affected fetuses had intracytoplasmic bacteria in endothelial cells, and 1 fetus with pericarditis had similar bacteria within mesothelial cells or macrophages. Immunohistochemistry for Chlamydia spp. or polymerase chain reaction (PCR) for Chlamydia pecorum or both, performed on brain or pooled tissue, were positive in all 14 tested fetuses that had meningoencephalitis and in 4/4 calves and in 3/4 tested cows that had meningoencephalitis and thrombotic vasculitis. In 1 calf and 11/11 fetuses, C. pecorum PCR amplicon sequences were 100% homologous to published C. pecorum sequences. Enzootic chlamydiosis due to C. pecorum was the identified cause of the late term abortions and the vasculitis and meningoencephalitis in fetuses, calves, and cows. C. pecorum, an uncommon bovine abortogenic agent, is a differential diagnosis in late-term aborted fetuses with meningoencephalitis, vasculitis, and polyserositis.

Treadmill-to-Overground Mapping of Marker Trajectory for Treadmill-Based Continuous Gait Analysis.

A treadmill was used to perform continuous walking tests in a limited space that can be covered by marker-based optical motion capture systems. Most treadmill-based gait data are analyzed based on gait cycle percentage. However, achieving continuous walking motion trajectories over time without time normalization is often required, even if tests are performed under treadmill walking conditions. This study presents a treadmill-to-overground mapping method of optical marker trajectories for treadmill-based continuous gait analysis, by adopting a simple concept of virtual origin. The position vector from the backward moving virtual origin to a targeted marker within a limited walking volume is the same as the position vector from the fixed origin to the forward moving marker over the ground. With the proposed method, it is possible (i) to observe the change in physical quantity visually during the treadmill walking, and (ii) to obtain overground-mapped gait data for evaluating the accuracy of the inertial-measurement-unit-based trajectory estimation. The accuracy of the proposed method was verified from various treadmill walking tests, which showed that the total travel displacement error rate was 0.32% on average.

A chimeric porcine reproductive and respiratory syndrome virus (PRRSV)-2 vaccine is safe under international guidelines and effective both in experimental and field conditions.

Vaccination is currently the most effective strategy to control porcine reproductive and respiratory syndrome (PRRS). New-generation PRRS vaccines are required to be safe and broadly cross-protective. We have recently created the chimeric PRRS virus K418DM which proved to be a good vaccine candidate under field conditions. In the present study, we designed safety and efficacy tests under experimental and field conditions for further evaluation of K418DM1.1, a plaque-purified K418DM. In the homologous challenge study, K418DM1.1 induced high serum virus neutralization (SVN) antibody titers (i.e., 4.2 log2 ± 1.7) at 21 days post-challenge (dpc) and provided protection as demonstrated by the significantly lower levels of viremia at 3 and 7 dpc and significantly lower microscopic lung lesion scores compared to the unvaccinated group. K418DM1.1 was also protective in the heterologous challenge study, with vaccinated pigs showing significantly lower levels of viremia at 14 dpc compared to the unvaccinated pigs. A field study was performed to evaluate the efficacy of K418DM1.1 against heterologous exposure and vaccinated pigs presented significantly lower viremia than unvaccinated pigs. According to the safety test for the examination of virulence reversion, no infectivity was observed in tissue homogenate filtrate both in the vaccinated and comingled groups. Thus, the risk of virulence, as well as transmission, appeared negligible. These overall results indicate that K418DM1.1 is a good vaccine candidate based on its safety and protective efficacy.

Treatment of lower urinary tract dysfunction facilitates awakening and affects the cure rate in patients with nonmonosymptomatic enuresis.

PURPOSE: Poor awakening in patients with enuresis has been assumed to be an adaptation to the chronic influence of arousal stimuli like lower urinary tract dysfunction (LUTD). This study aimed to examine the effect of controlling LUTD on improvement of awakening and cure of enuresis. MATERIALS AND METHODS: Data for 119 enuretic patients with overactive bladder were retrospectively analyzed. The patients received urotherapy, laxatives, and anticholinergic agents. LUTD symptoms and enuresis were regularly monitored every 3 months. History of waking up because of bedwetting (ability to awaken, AA) was used as a surrogate marker of arousal and was graded at baseline and every 3 months of treatment. Changing distribution of each grade of AA was associated with other LUTD symptoms. Multivariate analysis was applied to understand whether the lack of improvement in AA might harbor any prognostic implications regarding cure of enuresis. RESULTS: Decreasing number of LUTD with treatment corresponded to increasing number of better AA. Enuresis was resolved completely in 88 patients in a median time of 7 months. Failure to show even single episode of awakening before bedwetting within 6 months of treatment and persistent daytime incontinence were identified as risk factors for treatment resistance until 18 months of treatment. CONCLUSIONS: Controlling LUTD symptoms in the management of nonmonosymptomatic enuresis was crucial for not only the treatment of enuresis but also for allowing the patients to obtain better arousal. AA tended to improve subsequent to bladder control and may contribute to the cure of enuresis.

Association of acute myocardial infarction with seropositive rheumatoid arthritis in Korea: A nationwide longitudinal cohort study.

BACKGROUND: The aim of this nationwide age- and sex matched longitudinal follow up study is to determine the risk of acute myocardial infarction (AMI) associated with the seropositive rheumatoid arthritis (RA) population in Korea. METHODS: Patient data were collected from the National Health Insurance Service Health Screening cohort. RA was identified using the International Classification of Diseases code M05 (seropositive RA), with a prescription of any disease-modifying anti-rheumatic drug (DMARD). A total of 2,765 patients were enrolled in the seropositive RA group from January 1, 2004 to December 31, 2015 from the NHIS. The control group consisted of 13,825 subjects. The 12-years AMI incidence rate for each group was calculated using the Kaplan-Meier method. A Cox proportional-hazards regression analysis was used to estimate the hazard ratio of AMI. RESULTS: During the follow-up period, 39 patients (1.41%) in the seropositive RA group and 111 (0.80%) in the control group experienced AMI (P = 0.003). The hazard ratio of AMI in the seropositive RA group was 3.879 (95% confidence interval (CI): 2.64-5.68) after adjusting for age and sex. The adjusted hazard ratio of AMI in the seropositive RA group was 4.212 (95% CI: 2.86-6.19) after adjusting for demographics and comorbid medical disorders. According to subgroup analysis, in male and female and the non-diabetes and non-hypertension and hypertension and dyslipidemia and non-dyslipidemia subgroups, AMI incidence rates were significantly higher in the seropositive RA group than in the control group. CONCLUSION: Our nationwide longitudinal study suggests an increased risk of AMI in seropositive RA patients.

Intradiploic epidermoid cyst in a dog.

CASE DESCRIPTION: A 10-year-old 7-kg (15.4-lb) neutered male Shih Tzu was referred for evaluation because of a sudden onset of dullness and intermittent vomiting of 1 to 2 weeks' duration. Two days prior to evaluation, clinical signs had worsened and 1 seizure was reported. CLINICAL FINDINGS: A 3.5 × 2.5-cm soft, dome-shaped mass of the right occipital region of the head was noted on physical examination. Radiography and CT confirmed the presence of the mass and indicated its intra- and extracranial expansion. The MRI images showed compression of the cerebellum by the mass, with distinct margins of hypointensity on both T1- and T2-weighted images. TREATMENT AND OUTCOME: Surgery was performed, and the mass was completely excised. The dog had mild ataxia, hypermetria, and head tremors after surgery. Histologic examination of the mass yielded a diagnosis of intradiploic epidermoid cyst. On examination 3 weeks after surgery, the previous neurologic signs had resolved. On examination 25 months after surgery, the dog remained free of clinical signs. CLINICAL RELEVANCE: The present report described the clinical signs, diagnostic imaging results, and successful surgical removal of an intradiploic epidermoid cyst in a dog. Long-term prognosis may be good with complete removal of intradiploic epidermoid cysts in dogs.

FIRST REPORT OF ADENOVIRAL HEMORRHAGIC DISEASE IN THREE MULE DEER (ODOCOILEUS HEMIONUS) IN ARIZONA.

This study presents the gross and histopathological findings of adenoviral hemorrhagic disease (AHD) in two yearling and one adult mule deer (Odocoileus hemionus). These cases represent the first known outbreak of deer adenovirus (Odocoileus adenovirus 1) in Arizona. Over the span of a month, three female captive mule deer were submitted to Midwestern University's Animal Health Institute for postmortem examination. All of these deer were from the same deer farm and historical findings were similar, consisting of acute presentation of hemorrhagic diarrhea and sudden death. Grossly and histopathologically, all cases had severe pulmonary edema and hemorrhagic enteritis. Additionally, two of the three cases had low numbers of large amphophilic intranuclear inclusions expanding endothelial cells within the small intestine and lungs. Viral PCR of pooled small intestine, lung, and spleen from each of the three cases were positive for deer adenovirus and negative for blue tongue and epizootic hemorrhagic disease.

Multiple cutaneous plasmacytosis with multilobated (clover-leaf shaped) nuclei cells in a dog.

A 12-year-old female Shih-tzu dog was presented with a 2-month history of cutaneous non-pruritic multiple ulcerated or crusted nodules of less than 1.5 cm in diameter on eyelids, lips, abdomen, groin, thighs and perianal region. Several diagnostic tests were performed, including fine needle aspiration and skin biopsy of the cutaneous nodules. Cytologic interpretation was round cell neoplasm with multilobated (clover-leaf shaped) nuclei. Histopathology revealed round neoplastic cells with prominent anisocytosis and anisokaryosis, and numerous mitotic figures; however, the origin of the cells was not identified. Immunohistochemical evaluation indicated that these cells were positive for CD79a and MUM-1, but negative for CD3, CD20 and Pax 5. The patient was treated with chemotherapy, and the skin condition improved. Despite good response to chemotherapy, the patient was euthanized due to poor general health.