Reliability of Vestibular Perceptual Threshold Testing About the Yaw Axis.

OBJECTIVES: Vestibular reflexes have traditionally formed the cornerstone of vestibular evaluation, but perceptual tests have recently gained attention for use in research studies and potential clinical applications. However, the unknown reliability of perceptual thresholds limits their current importance. This is addressed here by establishing the test-retest reliability of vestibular perceptual testing. DESIGN: Perceptual detection thresholds to earth-vertical, yaw-axis rotations were collected in 15 young healthy people. Participants were tested at two time intervals (baseline, 5 to 14 days later) using an adaptive psychophysical procedure. RESULTS: Thresholds to 1 Hz rotations ranged from 0.69 to 2.99°/s (mean: 1.49°/s; SD: 0.63). They demonstrated an excellent intraclass correlation (0.92; 95% confidence interval: 0.77 to 0.97) with a minimum detectable difference of 0.45°/s. CONCLUSIONS: The excellent test-retest reliability of perceptual vestibular testing supports its use as a research tool and motivates further exploration for its use as a novel clinical technique.

Hemodialysis Procedure-Associated Autonomic Imbalance and Cardiac Arrhythmias: Insights From Continuous 14-Day ECG Monitoring.

Background In patients with end-stage kidney disease, sudden cardiac death is more frequent after a long interdialytic interval, within 6 hours after the end of a hemodialysis session. We hypothesized that the occurrence of paroxysmal arrhythmias is associated with changes in heart rate and heart rate variability in different phases of hemodialysis. Methods and Results We conducted a prospective ancillary study of the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease cohort. Continuous ECG monitoring was performed using an ECG patch, and short-term heart rate variability was measured for 3 minutes every hour (by root mean square of the successive normal-to-normal intervals, spectral analysis, Poincaré plot, and entropy), up to 300 hours. Out of enrolled participants (n=28; age 54±13 years; 57% men; 96% black; 33% with a history of cardiovascular disease; left ventricular ejection fraction 70±9%), arrhythmias were detected in 13 (46%). Nonsustained ventricular tachycardia occurred more frequently during/posthemodialysis than pre-/between hemodialysis (63% versus 37%, P=0.015). In adjusted for cardiovascular disease time-series analysis, nonsustained ventricular tachycardia was preceded by a sudden heart rate increase (by 11.2 [95% CI 10.1-12.3] beats per minute; P<0.0001). During every-other-day dialysis, root mean square of the successive normal-to-normal intervals had a significant circadian pattern (Mesor 10.6 [ 95% CI 0.9-11.2] ms; amplitude 1.5 [95% CI 1.0-3.1] ms; peak at 02:01 [95% CI 20:22-03:16] am; P<0.0001), which was replaced by a steady worsening on the second day without dialysis (root mean square of the successive normal-to-normal intervals -1.41 [95% CI -1.67 to -1.15] ms/24 h; P<0.0001). Conclusions Sudden increase in heart rate during/posthemodialysis is associated with nonsustained ventricular tachycardia. Every-other-day hemodialysis preserves circadian rhythm, but a second day without dialysis is characterized by parasympathetic withdrawal.

Importance of the heart vector origin point definition for an ECG analysis: The Atherosclerosis Risk in Communities (ARIC) study.

AIM: Our goal was to investigate the effect of a global XYZ median beat construction and the heart vector origin point definition on predictive accuracy of ECG biomarkers of sudden cardiac death (SCD). METHODS: Atherosclerosis Risk In Community study participants with analyzable digital ECGs were included (n = 15,768; 55% female, 73% white, mean age 54.2 ±â€¯5.8 y). We developed an algorithm to automatically detect the heart vector origin point on a median beat. Three different approaches to construct a global XYZ beat and two methods to locate origin point were compared. Global electrical heterogeneity was measured by sum absolute QRST integral (SAI QRST), spatial QRS-T angle, and spatial ventricular gradient (SVG) magnitude, azimuth, and elevation. Adjudicated SCD served as the primary outcome. RESULTS: There was high intra-observer (kappa 0.972) and inter-observer (kappa 0.984) agreement in a heart vector origin definition between an automated algorithm and a human. QRS was wider in a median beat that was constructed using R-peak alignment than in time-coherent beat (88.1 ±â€¯16.7 vs. 83.7 ±â€¯15.9 ms; P < 0.0001), and on a median beat constructed using QRS-onset as a zeroed baseline, vs. isoelectric origin point (86.7 ±â€¯15.9 vs. 83.7 ±â€¯15.9 ms; P < 0.0001). ROC AUC was significantly larger for QRS, QT, peak QRS-T angle, SVG elevation, and SAI QRST if measured on a time-coherent median beat, and for SAI QRST and SVG magnitude if measured on a median beat using isoelectric origin point. CONCLUSION: Time-coherent global XYZ median beat with physiologically meaningful definition of the heart vector's origin point improved predictive accuracy of SCD biomarkers.

An epidemiological investigation to determine the prevalence and clinical manifestations of slow-moving finished cattle presented to slaughter facilities.

Cattle mobility is routinely measured at commercial slaughter facilities. However, the clinical signs and underlying causes of impaired mobility of cattle presented to slaughter facilities are poorly defined. As such, the objectives of this study were 1) to determine the prevalence of impaired mobility in finished cattle using a 4-point mobility scoring system and 2) to observe clinical signs in order to provide clinical diagnoses for this subset of affected cattle. Finished beef cattle (n = 65,600) were observed by a veterinarian during the morning shift from six commercial abattoirs dispersed across the United States; the veterinarian assigned mobility scores (MS) to all animals using a 1-4 scale from the North American Meat Institute's Mobility Scoring System, with 1 = normal mobility and 4 = extremely limited mobility. Prevalence of MS 1, 2, 3, and 4 was 97.02%, 2.69%, 0.27%, and 0.01%, respectively. Animals with an abnormal MS (MS > 1) were then assigned to one of five clinical observation categories: 1) lameness, 2) poor conformation, 3) laminitis, 4) Fatigued Cattle Syndrome (FCS), and 5) general stiffness. Of all cattle observed, 0.23% were categorized as lame, 0.20% as having poor conformation, 0.72% as displaying signs of laminitis, 0.14% as FCS, and 1.68% as showing general stiffness. The prevalence of lameness and general stiffness was greater in steers than heifers, whereas the prevalence of laminitis was the opposite (P < 0.05). FCS prevalence was higher in dairy cattle than in beef cattle (0.31% vs. 0.22%, respectively; P ≤ 0.05). These data indicate the prevalence of cattle displaying abnormal mobility at slaughter is low and causes of abnormal mobility are multifactorial.

Beef Quality Assurance in Feedlots.

This article discusses the Beef Quality Assurance (BQA) program, which was created by beef producers and veterinarians. The program has evolved from antibiotic residue avoidance to include animal handling, cattle comfort, food safety, and much more. It provides guidance to producers and veterinarians on best management practices and allows the beef industry to be transparent about the practices used. Veterinarians are key to helping producers implement BQA in their beef operations.

Obesity and diabetes cause cognitive dysfunction in the absence of accelerated ß-amyloid deposition in a novel murine model of mixed or vascular dementia.

Mid-life obesity and type 2 diabetes mellitus (T2DM) confer a modest, increased risk for Alzheimer's disease (AD), though the underlying mechanisms are unknown. We have created a novel mouse model that recapitulates features of T2DM and AD by crossing morbidly obese and diabetic db/db mice with APPΔNL/ΔNLx PS1P264L/P264L knock-in mice. These mice (db/AD) retain many features of the parental lines (e.g. extreme obesity, diabetes, and parenchymal deposition of ß-amyloid (Aß)). The combination of the two diseases led to additional pathologies-perhaps most striking of which was the presence of severe cerebrovascular pathology, including aneurysms and small strokes. Cortical Aß deposition was not significantly increased in the diabetic mice, though overall expression of presenilin was elevated. Surprisingly, Aß was not deposited in the vasculature or removed to the plasma, and there was no stimulation of activity or expression of major Aß-clearing enzymes (neprilysin, insulin degrading enzyme, or endothelin-converting enzyme). The db/AD mice displayed marked cognitive impairment in the Morris Water Maze, compared to either db/db or APPΔNLx PS1P264L mice. We conclude that the diabetes and/or obesity in these mice leads to a destabilization of the vasculature, leading to strokes and that this, in turn, leads to a profound cognitive impairment and that this is unlikely to be directly dependent on Aß deposition. This model of mixed or vascular dementia provides an exciting new avenue of research into the mechanisms underlying the obesity-related risk for age-related dementia, and will provide a useful tool for the future development of therapeutics.

Restricted nutrient intake does not alter serum-mediated measures of implant response in cell culture.

BACKGROUND: During nutritional stress, reduced intake may reduce the efficacy of anabolic implants. This study was conducted to evaluate basic cellular responses to a growth promotant implant at two intake levels. METHODS: Sixteen crossbred steers (293 ± 19.3 kg) were used to evaluate the impact of anabolic implants in either an adequate or a restricted nutritional state. Steers were trained to individual Calan gates, and then randomly assigned to 1 of 4 treatments in a 2 × 2 factorial arrangement. Treatments consisted of: presence or absence of an anabolic growth implant (Revalor-XS, 200 mg TBA and 40 mg estradiol; IMPLANT or CONTROL) and a moderate energy, pelleted, starting cattle diet fed at either 2.0 × or 1.0 × maintenance energy (NEM) requirements (HIGH or LOW). Serum (d 0, 14, and 28) was used for application to bovine muscle satellite cells. After treatment with the serum (20% of total media) from the trial cattle, the satellite cells were incubated for 72 h. Protein abundance of myosin heavy chain (MHC), phosphorylated extracellular signal-related kinase (phospho-ERK), and phosphorylated mammalian target of rapamycin (phospho-mTOR) were analyzed to determine the effects of implant, intake, and their interaction (applied via the serum). RESULTS: Intake had no effect on MHC (P = 0.85) but IMPLANT increased (P < 0.01) MHC abundance vs. CONTROL. Implant status, intake status, and the interaction had no effect on the abundance of phospho-ERK (P ≥ 0.23). Implanting increased phospho-mTOR (P < 0.01) but there was no effect (P ≥ 0.51) of intake or intake × implant. CONCLUSIONS: The nearly complete lack of interaction between implant and nutritional status indicates that the signaling molecules measured herein respond to implants and nutritional status independently. Furthermore, results suggest that the muscle hypertrophic effects of anabolic implants may not be mediated by circulating IGF-1.