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1.
Meat Sci ; 216: 109567, 2024 Jun 08.
Article in English | MEDLINE | ID: mdl-38865792

ABSTRACT

This study examined the effects of constant current electrical stimulation (CCES) compared to constant voltage electrical stimulation (CVES), when applied within the same beef carcass (n = 79), on longissimus thoracis et lumborum (LTL) quality and palatability. There was a stimulation method × time interaction for pH, with CCES reducing the 3 h post-mortem pH, but increasing the 72 h post-mortem pH compared to CVES (P < 0.001). The CCES decreased the meat subjective Japanese Meat Grading Agency (JMGA) colour scores (P < 0.05) and increased the objective L⁎ (P < 0.01), a⁎ (P < 0.05) and b⁎ (P < 0.05) colour values at 3 d post-mortem and L⁎ and b⁎ values (P < 0.05) during retail display compared to CVES, although the objective values from both stimulation methods were above established consumer acceptability thresholds. Additionally, CCES reduced the purge (P < 0.05) and drip (P < 0.01) losses, and tended to reduce shear force values (P = 0.089) compared to CVES, although these did not translate into differences in juiciness or tenderness evaluated by trained panelists (P > 0.1). Regarding flavour, the CCES meat had greater bloody/serumy flavour (P < 0.05) and corn aroma (P < 0.05), less unidentified aroma (P < 0.05), and tended to have greater corn flavour (P = 0.077) and less barnyard aroma (P = 0.079) than CVES meat. There were also increased concentrations of flavour-related volatile compounds including 2-methyl-butanal, 3-methyl-butanal and 2-5-dimethyl pyrazine levels (P < 0.05) with CCES. Overall, the CCES system slightly improved meat quality and flavour compared to CVES when applied to the same beef carcasses. Further consumer studies would be warranted to determine whether these differences translate into more acceptable meat.

2.
Meat Sci ; 213: 109508, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38593728

ABSTRACT

This study investigated the effects of a novel steak fabrication method, involving removal of both subcutaneous and intermuscular fats between the longissimus thoracis (LT) and spinalis dorsi (SD) muscles before cooking, on beef ribeye steak palatability and calorie content. Canada AA (n = 10) and AAA (n = 10) ribeyes were fabricated into steaks either with (fat-on) or without (fat-off) subcutaneous and intermuscular fats. Fat-on steaks had shorter cooking times and lower cooking losses than fat-off steaks (P < 0.001), regardless of quality grade. There were treatment × quality grade interactions for initial (P < 0.01) and sustainable juiciness (P < 0.05) of the LT samples and initial juiciness (P < 0.05) of the SD samples, with the fat-on AA samples being more juicy than the fat-off AA samples, but the AAA treatments were not different from each other. Regardless of quality grade, fewer panelist responses indicated livery flavour (P < 0.05) for fat-on compared to fat-off LT samples. Regardless of fat-on/fat-off treatment, AA compared to AAA samples had more responses for bloody/serumy (P < 0.01) and unidentified off-flavours (P < 0.05) in LT samples. However, AAA samples had more responses for metallic off-flavour in LT (P = 0.059) and SD (P < 0.05). There were no differences in calorie content between fat-on compared to fat-off steaks (P > 0.1) regardless of quality grade and muscle type, or between AA and AAA steaks regardless of cooking with fat-on or off (P > 0.1). Maintaining the subcutaneous and intermuscular fats while cooking will improve ribeye steak palatability without increasing calorie content, especially for leaner steaks.


Subject(s)
Cooking , Muscle, Skeletal , Red Meat , Taste , Animals , Cattle , Red Meat/analysis , Cooking/methods , Muscle, Skeletal/chemistry , Humans , Consumer Behavior , Food Handling/methods , Dietary Fats/analysis , Male , Canada , Adipose Tissue
3.
BMC Public Health ; 24(1): 294, 2024 01 25.
Article in English | MEDLINE | ID: mdl-38267914

ABSTRACT

BACKGROUND: The implementation of cost-effective surveillance systems is essential for tracking the emerging risk of tick-borne diseases. In Canada, where Lyme disease is a growing public health concern, a national sentinel surveillance network was designed to follow the epidemiological portrait of this tick-borne disease across the country. The surveillance network consists of sentinel regions, with active drag sampling carried out annually in all regions to assess the density of Ixodes spp. ticks and prevalence of various tick-borne pathogens in the tick population. The aim of the present study was to prioritize sentinel regions by integrating different spatial criteria relevant to the surveillance goals. METHODS: We used spatially-explicit multi-criteria decision analyses (MCDA) to map priority areas for surveillance across Canada, and to evaluate different scenarios using sensitivity analyses. Results were shared with stakeholders to support their decision making for the selection of priority areas to survey during active surveillance activities. RESULTS: Weights attributed to criteria by decision-makers were overall consistent. Sensitivity analyses showed that the population criterion had the most impact on rankings. Thirty-seven sentinel regions were identified across Canada using this systematic and transparent approach. CONCLUSION: This novel application of spatial MCDA to surveillance network design favors inclusivity of nationwide partners. We propose that such an approach can support the standardized planning of spatial design of sentinel surveillance not only for vector-borne disease BDs, but more broadly for infectious disease surveillance where spatial design is an important component.


Subject(s)
Lyme Disease , Tick-Borne Diseases , Humans , Tick-Borne Diseases/epidemiology , Canada/epidemiology , Public Health , Decision Support Techniques
4.
Meat Sci ; 205: 109297, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37544261

ABSTRACT

This study evaluated the effects of a constant current electrical stimulation (CCES) system and hormonal growth-promoting (HGP) implants on the quality and palatability of the longissimus thoracis et lumborum (LTL) from yearling-finished steers. The experiment used a total of 46 Angus cross steers, which were either non-implanted (n = 20) or implanted with trenbolone acetate and estradiol benzoate (n = 26). The CCES was applied to one side of each carcass during the slaughter process, whereas the other side remained unstimulated. Regardless of the application of HGP implants, the CCES reduced pH at 3 and 72 h post-mortem and shear force at all ageing times (P < 0.05), improved colour at 72 h post-mortem and during the retail display (P < 0.05), increased initial and overall tenderness (P < 0.01), and decreased the amount of perceived connective tissue and the proportion of trained panelists detecting spongy texture (P < 0.05) compared to meat from unstimulated carcass sides. Although CCES increased meat purge losses and reduced moisture content (P < 0.05), this did not affect meat juiciness (P > 0.10). CCES interacted with HGP to prevent increase in drip loss (P > 0.10), increase frequency of panelists detecting bloody/serumy flavour and typical texture, and reduce the proportion of panelists detecting rubbery texture in meat (P < 0.05). Regardless of stimulation treatment, meat from implanted animals had a more pronounced pH decline at 72 h post-mortem (P < 0.05) and a higher proportion of panelists finding no off-flavours (P < 0.05) or bloody/serumy flavour (P < 0.01) than non-implanted cattle. The CCES system tested in this study improved LTL quality and palatability of heavier beef carcasses.


Subject(s)
Anabolic Agents , Muscle, Skeletal , Cattle , Animals , Muscle, Skeletal/physiology , Meat , Trenbolone Acetate/pharmacology , Anabolic Agents/pharmacology , Electric Stimulation
5.
Meat Sci ; 202: 109219, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37172551

ABSTRACT

This study evaluated the effects of in-the-bag dry-ageing (BDA) (21 and 42 d) on meat quality, palatability, and volatile compounds of clod heart, brisket, and flat iron cuts from steers. In all cuts, BDA increased moisture losses (P < 0.05), but this did not reduce the juiciness of 21 d BDA versus wet-aged (WA) steaks. In clod heart, BDA increased overall tenderness at 21 d compared to 21 d WA (P < 0.01). Regardless of ageing period, BDA of clod heart increased beef flavour and salty taste and decreased sour-dairy and stale/cardboard flavours and concentrations of volatile compounds derived from lipid oxidation compared to WA (P < 0.05). In brisket, BDA increased salty taste and fatty aroma and reduced bloody/serumy flavour, whereas decreased beef and buttery flavours and intensified some unpleasant aromas/flavours (P < 0.05) for both ageing periods. The BDA of flat iron increased several undesirable aromas/flavours and decreased sweet taste and beef and buttery flavours (P < 0.05), regardless of ageing period. Overall, BDA for 42 d decreased meat quality and palatability and increased concentrations of volatile compounds from lipid oxidation, especially in flat iron cuts. Value could be recovered by customizing BDA periods by cut.


Subject(s)
Meat , Taste , Animals , Cattle , Meat/analysis , Flavoring Agents , Aging , Lipids
6.
Meat Sci ; 188: 108800, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35305444

ABSTRACT

This study evaluated the effects of in-the-bag dry-ageing on eating quality and volatile compounds of longissimus lumborum from cows and steers. Compared to wet-ageing, in-the-bag dry-ageing increased purge loss (P < 0.0001), cooking time (P < 0.0001), salty taste (P < 0.05) and sour-dairy flavour (P < 0.01), whereas decreased cooking loss (P < 0.0001), amount of perceptible connective tissue (P < 0.05) and livery flavour (P < 0.05) in both cow and steer meat. This dry-ageing technology also increased juiciness (P < 0.01) and brown-roasted aroma (P < 0.05) in steer meat, whereas decreased the juiciness (P < 0.01) of cow meat. Regardless of the ageing method, cow meat was tougher (P < 0.0001), less juicy (P < 0.001) and sweeter (P < 0.05) and presented higher amount of perceived connective tissue (P < 0.0001) than steer meat, whereas steer meat had higher ratings for beef (P < 0.05) and brown-roasted (P < 0.01) flavours. Volatile compounds were largely affected (P < 0.05) by animal-type, most of them being higher in cow than steer meat. In contrast, in-the-bag dry-ageing affected a few volatile compounds such as alcohols, aldehydes and ketones.


Subject(s)
Food Handling , Muscle, Skeletal , Animals , Cattle , Cooking , Female , Food Handling/methods , Meat/analysis , Taste
8.
Br J Dermatol ; 185(5): 921-934, 2021 11.
Article in English | MEDLINE | ID: mdl-34050935

ABSTRACT

BACKGROUND: Although hidradenitis suppurativa (HS) is known to affect quality of life, little summative knowledge exists on how HS impacts people living with the condition. OBJECTIVES: To synthesize experiences of people with HS within published qualitative research. METHODS: Searches on databases MEDLINE, PsycINFO, Embase and CINAHL were conducted on 17 April 2020. Two independent reviewers screened 5512 publications. Study quality was assessed using the National Institute for Health and Care Excellence quality appraisal checklist for qualitative studies. Thematic synthesis generated descriptive and analytic themes. RESULTS: Fourteen studies were included: four studies fulfilled most quality criteria, eight fulfilled some quality criteria, and two fulfilled few quality criteria. There were three final themes. (i) Putting the brakes on life. The physical, psychological and social consequences of HS resulted in people missing out on multiple life events. This could have a cumulative effect that influences the trajectory of someone's life. (ii) A stigmatized identity: concealed and revealed. People try to conceal their HS, visually and verbally, but this results in anticipation and fear of exposure. Social support and psychological acceptance helped people cope. Connecting to others with HS may have a specific role in preserving a positive self-identity. (iii) Falling through the cracks. Delayed diagnosis, misdiagnosis and lack of access to care were reported. People felt unheard and misunderstood by healthcare professionals, and healthcare interactions could enhance feelings of shame. CONCLUSIONS: There need to be improvements to clinical care to allow people with HS to live their life more fully.


Subject(s)
Hidradenitis Suppurativa , Adaptation, Psychological , Humans , Qualitative Research , Quality of Life , Social Support
9.
Clin Ophthalmol ; 15: 347-356, 2021.
Article in English | MEDLINE | ID: mdl-33542618

ABSTRACT

PURPOSE: Musculoskeletal pain issues are prevalent in ophthalmic surgeons and can impact surgeon well-being and productivity. Heads-up displays (HUD) can improve upon conventional microscopes by reducing ergonomic stress. This study compared ergonomic outcomes between HUD and a conventional optical microscope in the operating room, as reported by ophthalmic surgeons in the US. METHODS: An online questionnaire was distributed to a sample of surgeons who had experience operating with HUD. The questionnaire captured surgeon-specific variables, the validated Nordic Musculoskeletal Questionnaire, and custom questions to compare HUD and conventional microscope. A multivariable model was built to identify variables that were likely to predict improvement in pain-related issues. RESULTS: Analysis was conducted on 64 surgeons (37 posterior-segment, 25 anterior-segment, and two mixed) with a mean 14.9 years of practice and 2.3 years using HUD. Most surgeons agreed or strongly agreed that HUD reduced the severity (64%) and frequency (63%) of pain and discomfort, improved posture (73%), and improved overall comfort (77%). Of respondents who experienced headaches, or pain and discomfort during operation, 12 (44%) reported their headaches improved and 45 (82%) reported feeling less pain and discomfort since they started using HUD. The multivariable model indicated the odds of reporting an improvement in pain since introducing the HUD in the operating room were 5.12-times greater for those who used HUD in >50% of their cases (P=0.029). CONCLUSION: This study indicates that heads-up display may be an important tool for wellness in the operating room as it can benefit ophthalmic surgeons across several ergonomic measures.

13.
BMC Med Res Methodol ; 20(1): 46, 2020 02 27.
Article in English | MEDLINE | ID: mdl-32106827

ABSTRACT

BACKGROUND: Trials are at risk of contamination bias which can occur when participants in the control group are inadvertently exposed to the intervention. This is a particular risk in rehabilitation studies where it is easy for trial interventions to be either intentionally or inadvertently adopted in control settings. The Falls in Care Homes (FinCH) trial is used in this paper as an example of a large randomised controlled trial of a complex intervention to explore the potential risks of contamination bias. We outline the FinCH trial design, present the potential risks from contamination bias, and the strategies used in the design of the trial to minimise or mitigate against this. The FinCH trial was a multi-centre randomised controlled trial, with embedded process evaluation, which evaluated whether systematic training in the use of the Guide to Action Tool for Care Homes reduced falls in care home residents. Data were collected from a number of sources to explore contamination in the FinCH trial. Where specific procedures were adopted to reduce risk of, or mitigate against, contamination, this was recorded. Data were collected from study e-mails, meetings with clinicians, research assistant and clinician network communications, and an embedded process evaluation in six intervention care homes. During the FinCH trial, there were six new falls prevention initiatives implemented outside the study which could have contaminated our intervention and findings. Methods used to minimise contamination were: cluster randomisation at the level of care home; engagement with the clinical community to highlight the risks of early adoption; establishing local collaborators in each site familiar with the local context; signing agreements with NHS falls specialists that they would maintain confidentiality regarding details of the intervention; opening additional research sites; and by raising awareness about the importance of contamination in research among participants. CONCLUSION: Complex rehabilitation trials are at risk of contamination bias. The potential for contamination bias in studies can be minimized by strengthening collaboration and dialogue with the clinical community. Researchers should recognise that clinicians may contaminate a study through lack of research expertise.


Subject(s)
Accident Prevention/methods , Accidental Falls/prevention & control , Exercise Therapy/methods , Homes for the Aged/statistics & numerical data , Nursing Homes/statistics & numerical data , Aged , Humans , Outcome Assessment, Health Care/methods , Outcome Assessment, Health Care/statistics & numerical data , Randomized Controlled Trials as Topic , Risk Factors
14.
Eye (Lond) ; 34(2): 335-343, 2020 02.
Article in English | MEDLINE | ID: mdl-31383993

ABSTRACT

BACKGROUND: To generate a practical and clinically useful consensus definition of 'stable glaucoma' to aid provision of glaucoma services in the UK and to provide guidance for the criteria that should be used for monitoring of glaucoma patients in primary care services. METHODS: A Delphi exercise was undertaken to derive consensus through an online questionnaire. Participants were asked to score their strength of agreement for a series of clinical parameters. Results and comments from each round were used to inform subsequent rounds. A total of 3 rounds were undertaken. RESULTS: Thirty-two glaucoma experts participated in the study with over 90% completion rate achieved over three rounds. The consensus was reached for the following parameters: IOP levels to be used for defining stability, visual field-testing techniques to define stability, the number of medication changes acceptable to define stability and the number of treatment medications allowed to define stability. No consensus was reached on the period of time over which stability was defined, however, there was considerable agreement that longer durations of follow up (36-48 months) were required. A combination of optic disc photos and ocular coherence topography (OCT) retinal nerve fibre layer (RNFL) assessment/ OCT disc structural evaluation are the preferred imaging methods for the assessment of structural stability. Oversight by a glaucoma consultant was considered important for glaucoma monitoring schemes. CONCLUSION: The consensus definition of glaucoma stability generated through this Delphi exercise provides guidance for allocation of patients suitable for monitoring in primary care glaucoma monitoring schemes.


Subject(s)
Consultants , Glaucoma , Consensus , Glaucoma/diagnosis , Humans , Intraocular Pressure , Nerve Fibers , Surveys and Questionnaires , Tomography, Optical Coherence , United Kingdom , Visual Fields
15.
Res Involv Engagem ; 5: 24, 2019.
Article in English | MEDLINE | ID: mdl-31452934

ABSTRACT

PLAIN ENGLISH SUMMARY: Cystic fibrosis (CF) is the commonest life-limiting inherited disorder in the UK. It affects many parts of the body including the lungs and gut leading to increased infection and problems digesting food. People with CF need to undergo many treatments each day throughout their whole lives. These include tablets, inhalers and breathing exercises, which are a huge burden, taking up several hours every dayIt is therefore, really important that the treatments we give are supported by good evidence, usually gathered from clinical trials. Unfortunately, we do not have good evidence for many of the CF treatments. We recently ran an exercise known as a James Lind Alliance Priority Setting Partnership (JLA PSP) to find out which the CF community feel are the top priority research questions. People with CF and those who look after them suggested questions to be answered by clinical trials. Through a series of online surveys and workshops these were then shortlisted to give a final top ten.Due to infection risk people with CF are advised not to mix, this meant we had to do things differently to the usual way JLA PSPs are carried out. We used videoconferencing to enable multiple people with CF to participate. Surveys were accessible online and promoted through social media. ABSTRACT: Background The James Lind Alliance (JLA) method is well recognised for setting research priorities. The JLA approach involves a combination of surveys and workshop interactions between patients, carers and health care professionals to identify and agree on a "top ten" list of research questions. Respiratory infection is one of the hallmarks of cystic fibrosis (CF). To avoid cross infection, patients are advised not to meet face to face, preventing us following standard JLA methodology. Here we describe adaptations made during our recent JLA Priority Setting Partnership (PSP) in CF. Methods We elicited and prioritised research questions, using sequential online surveys, promoted through social media. People with CF participated in steering committee meetings and the final workshop, using videoconferencing. Alterations to workshop methodology enabled participants attending in person and those joining remotely, to contribute equally. We also altered the JLA methodology to include "lone" questions, asked by only one survey respondent. We are now working with the CF community to co-produce research projects that answer these top ten. Results There were 482 respondents, from 23 countries, who submitted 1080 questions. Increases in the number of responses occurred just after promotion on social media. Use of videoconferencing enabled participation of multiple people with CF and ensured participation from anywhere in the world, including hospital inpatients. Inclusion of lone questions resulted in one being included in our top ten. Conclusions There is no "one-size-fits-all" for patient involvement methodologies. Through altering the JLA methods to fit our patient group we achieved wide participation. We believe that methods used in our project may also be applied to future partnerships to increase participation, especially where people may be hospitalised or be unable to travel. The methodology we are developing through the JLA PSP CF2 project may be useful for other PSPs to follow.

16.
Can Commun Dis Rep ; 45(4): 83-89, 2019 Apr 04.
Article in English | MEDLINE | ID: mdl-31285697

ABSTRACT

Climate warming and other environmental changes have contributed to the expansion of the range of several tick species into higher latitudes in North America. As temperatures increase in Canada, the environment becomes more suitable for ticks and the season suitable for tick activity lengthens, so tick-borne diseases are likely to become more common in Canada. In addition to Lyme disease, four other tick-borne diseases (TBDs) have started to emerge and are likely to increase: Anaplasmosis; Babesiosis; Powassan virus; and Borrelia miyamotoi disease. Increased temperature increases the survival and activity period of ticks, increases the range of both reservoir and tick hosts (e.g. mice and deer) and increases the duration of the season when people may be exposed to ticks. Other ticks and TBDs may spread into Canada as the climate changes. The public health strategies to mitigate the impact of all TBDs include surveillance to detect current and emerging TBDs, and public health actions to prevent infections by modifying environmental and social-behavioral risk factors through increasing public awareness. Clinical care strategies include patient education, early detection, laboratory testing, and treatment.

17.
BMC Public Health ; 19(1): 849, 2019 Jun 28.
Article in English | MEDLINE | ID: mdl-31253135

ABSTRACT

BACKGROUND: Lyme disease is emerging in Canada due to expansion of the range of the tick vector Ixodes scapularis from the United States. National surveillance for human Lyme disease cases began in Canada in 2009. Reported numbers of cases increased from 144 cases in 2009 to 2025 in 2017. It has been claimed that few (< 10%) Lyme disease cases are reported associated with i) supposed under-diagnosis resulting from perceived inadequacies of serological testing for Lyme disease, ii) expectation that incidence in Canadian provinces and neighbouring US states should be similar, and iii) analysis of serological responses of dogs to the agent of Lyme disease, Borrelia burgdorferi. We argue that performance of serological testing for Lyme disease is well studied, and variations in test performance at different disease stages are accounted for in clinical diagnosis of Lyme disease, and in surveillance case definitions. Extensive surveillance for tick vectors has taken place in Canada providing a clear picture of the emergence of risk in the Canadian environment. This surveillance shows that the geographic scope of I. scapularis populations and Lyme disease risk is limited but increasing in Canada. The reported incidence of Lyme disease in Canada is consistent with this pattern of environmental risk, and the differences in Lyme disease incidence between US states and neighbouring Canadian provinces are consistent with geographic differences in environmental risk. Data on serological responses in dogs from Canada and the US are consistent with known differences in environmental risk, and in numbers of reported Lyme disease cases, between the US and Canada. CONCLUSION: The high level of consistency in data from human case and tick surveillance, and data on serological responses in dogs, suggests that a high degree of under-reporting in Canada is unlikely. We speculate that approximately one third of cases are reported in regions of emergence of Lyme disease, although prospective studies are needed to fully quantify under-reporting. In the meantime, surveillance continues to identify and track the ongoing emergence of Lyme disease, and the risk to the public, in Canada.


Subject(s)
Lyme Disease/epidemiology , Population Surveillance , Animals , Borrelia burgdorferi/immunology , Canada/epidemiology , Dogs/immunology , Humans , Incidence
18.
Curr Probl Diagn Radiol ; 48(4): 415-422, 2019.
Article in English | MEDLINE | ID: mdl-29428181

ABSTRACT

INTRODUCTION: We came across 3 cases of Balo's concentric sclerosis (BCS). The first of these patients presented to an outside hospital and was transferred to our institution due to complications resulting from a biopsy. The other 2 patients, despite having a characteristic imaging appearance and despite insistence on our part on the diagnosis of BCS, underwent a surgical procedure, which could have been prevented. This led us to review the available literature on BCS. MATERIAL AND METHODS: A total of 68 patients diagnosed with BCS between 1995 and 2015 were studied and the data collected for the clinical presentation and course, imaging, spinal fluid analysis, treatment, and clinical and imaging outcome. CONCLUSIONS: A 25% surgery rate (biopsy or resection) was found in the study. We concluded that this relatively high surgery rate in this auntminnie nonsurgical disease is multifactorial; and includes factors like nonfamiliarity with the disease, anxiety on the part of patients and physicians, due to a sometimes rapidly deteriorating clinical picture; and resemblance of the disease with other entities such as tumor and infection. However, characteristic imaging appearance combined with acute or subacute presentation and dramatic improvement in clinical status after high-dose steroid chemotherapy; are highly suggestive of the disease, and can prevent unnecessary surgery.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Diffuse Cerebral Sclerosis of Schilder/diagnostic imaging , Diffuse Cerebral Sclerosis of Schilder/therapy , Magnetic Resonance Imaging/methods , Adolescent , Adult , Biopsy, Needle , Child , Female , Hemiplegia/diagnosis , Hemiplegia/etiology , Humans , Immunohistochemistry , Male , Middle Aged , Neurosurgical Procedures/methods , Prognosis , Rare Diseases , Risk Assessment , Severity of Illness Index , Survival Rate , Treatment Outcome , Young Adult
19.
Int J Parasitol Parasites Wildl ; 7(3): 391-397, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30370219

ABSTRACT

Outbreaks of Toxoplasma gondii and Trichinella spp. have been recurring for decades among Inuit of Nunavik, northeastern Canada. Contact with wildlife has been identified as a risk factor for Inuit exposure to T. gondii, but reservoirs have yet to be confirmed based on direct detection of DNA or organism. Similarly, little is known about the occurrence of Trichinella spp. in wildlife species of Nunavik other than walrus (Odobenus rosmarus) and bears (Ursus americanus, Ursus maritimus). Foxes (Vulpes vulpes) were targeted as possible sentinels for T. gondii and Trichinella spp. because of their high trophic position within the Arctic food chain as carnivorous scavengers. A total of 39 red foxes were sampled from four communities in southern and western Nunavik between November 2015 and September 2016. For the first time in wildlife, a novel magnetic capture DNA extraction and real-time PCR technique was used to isolate and detect T. gondii DNA from the heart and brain of foxes. A double separatory funnel digestion method followed by multiplex PCR was used to recover and genotype larvae of Trichinella spp. from tongues of foxes. Seroprevalence based on detection of antibodies to T. gondii was 41% (95% CI: 27-57%) using a commercially available modified agglutination test (MAT). Detection of DNA of T. gondii and larvae of Trichinella nativa (T2) occurred in 44% (95% CI: 28-60%) and 36% (95% CI: 21-51%) of foxes, respectively. Coinfection with both T. nativa and T. gondii occurred among 23% (95%CI: 13-38%) of foxes which can be attributed to co-transmission from prey and scavenged species in their diet. There was only moderate agreement between T. gondii serology and direct detection of T. gondii DNA using the MC-PCR technique (Kappa test statistic: 0.321), suggesting that using both methods in tandem can increase the sensitivity of detection for this parasite. These findings show that foxes are good sentinels for circulation of parasitic zoonoses in terrestrial northern ecosystems since they are highly exposed, show measurable indicators of infection and do not serve as exposure sources for humans.

20.
World Neurosurg ; 117: e215-e220, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29913296

ABSTRACT

BACKGROUND: Although recent work has focused on characterizing quantitative magnetic resonance imaging (MRI) markers that may predict outcome among patients with cervical degenerative conditions, little is known about their reliability. Measurement and reporting of these markers is time-consuming and nonstandardized, preventing routine use in clinical care. METHODS: We retrospectively analyzed cervical MRI among subjects prospectively enrolled in a health outcomes study of elective surgery for degenerative cervical spine conditions. Two radiologists independently reviewed MRI for presence or absence and length of cord signal change, level of worst cord compression, axial anteroposterior (AP) and lateral spinal cord diameter, midsagittal AP diameter, and kyphosis. Interobserver reliability was compared using kappa and intraclass correlation coefficient (ICC). RESULTS: Inclusion criteria were met by 209 patients who had MRI available for review. Most patients were female (58%) and middle-aged (mean age 51 years), and 54% had a diagnosis of myelopathy. Reliability was fair for cord signal change on T1 (κ = 0.33) and good on T2 (κ = 0.74) images. Among patients with T2 change (n = 22), reliability for signal change length was good (ICC = 0.67). For level of worst compression, reliability was good (κ = 0.79). For AP cord diameter, reliability was very good (ICC = 0.82; T2/midsagittal) and good (ICC = 0.66; T2/axial). Reliability was moderate for lateral cord diameter (ICC = 0.55; T2/axial) and good for kyphosis (κ = 0.76). CONCLUSIONS: Good and very good reliability observed in measuring T2-weighted spinal cord signal change, level of worst compression, AP cord diameter, and kyphosis support use of these markers in standardized reporting, which could be incorporated into routine clinical use.


Subject(s)
Cervical Vertebrae/surgery , Kyphosis/pathology , Spinal Cord Diseases/pathology , Female , Humans , Intervertebral Disc Degeneration/pathology , Intervertebral Disc Degeneration/surgery , Kyphosis/surgery , Magnetic Resonance Imaging , Male , Middle Aged , Observer Variation , Prospective Studies , Retrospective Studies , Spinal Cord Compression/pathology , Spinal Cord Compression/surgery , Spinal Cord Diseases/surgery , Treatment Outcome
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