Fecal identification markers impact the feline fecal microbiota.

Fecal diagnostics are a mainstay of feline medicine, and fecal identification markers help to distinguish individuals in a multi-cat environment. However, the impact of identification markers on the fecal microbiota are unknown. Given the increased interest in using microbiota endpoints to inform diagnosis and treatment, the objective of this study was to examine the effects of orally supplemented glitter and crayon shavings on the feline fecal microbiota (amplicon sequencing of 16S rRNA gene V4 region). Fecal samples were collected daily from six adult cats that were randomized to receive oral supplementation with either glitter or crayon for two weeks, with a two-week washout before receiving the second marker. No adverse effects in response to marker supplementation were seen for any cat, and both markers were readily identifiable in the feces. Microbiota analysis revealed idiosyncratic responses to fecal markers, where changes in community structure in response to glitter or crayon could not be readily discerned. Given these findings, it is not recommended to administered glitter or crayon shavings as a fecal marker when microbiome endpoints are used, however their clinical use with other diagnostics should still be considered.

Between-day reliability of trunk orientation measured with smartphone sensors during sit-to-stand in asymptomatic individuals.

BACKGROUND: Trunk kinematics during sit-to-stand is often impaired in individuals with musculoskeletal disorders. Trunk kinematics is commonly assessed in laboratories using motion capture; however, this equipment is often not available outside research centers. Smartphones are widely available and may be a suitable alternative to assess trunk orientation during sit-to-stand remotely. OBJECTIVES: We investigated whether trunk orientation in the sagittal plane during sit-to-stand can be measured reliably between days when collected remotely using smartphones. DESIGN: Cross-sectional study. METHOD: Forty-three asymptomatic participants performed 15 sit-to-stand movements in two separate sessions remotely over videoconferencing. Trunk orientation was measured using each participant's smartphone. Absolute peak trunk orientation in the sagittal plane was extracted during standing, sitting, stand up and sit down. Relative trunk orientation was calculated as the difference between sitting and stand up, or sitting and sit down. Reliability was assessed using Intraclass Correlation Coefficient (ICC2,k), Standard Error of Measurement (SEM) and Minimal Detectable change (MDC). Between day bias and between-gender differences were assessed using T tests. RESULTS: All measures showed good reliability (ICC2,k > 0.80; SEM < 5.6°; MDC < 13.6°) and no between-day bias (p > 0.31). Relative measures were more consistent (ICC2,k > 0.88; SEM < 3.6°; MDC < 9.9°). No between-gender differences were observed for relative orientation (p > 0.75). CONCLUSIONS: Sagittal trunk orientation during sitting, standing, and sit-to-stand can be measured reliably when asymptomatic individuals use their own smartphones supervised over videoconferencing. These findings support the use of smartphone sensors for assessing how trunk orientation changes over time, which may assist physiotherapists assess movement patterns of individuals with musculoskeletal disorders remotely.

Facet joint cyst haematoma: a rare cause of cauda equina syndrome.

Facet joint cysts are a feature of lumbar spondylosis and are an uncommon cause of radiculopathy. Facet joint cyst haematoma is a very rare entity and has previously been reported as a subacute cause of leg pain, back pain, sensory deficit and lower limb weakness. We present the unique case of facet joint cyst haematoma presenting as cauda equina syndrome. An 81 year old lady presented with a 7 day history of back pain and left foot drop, a 1 day history of perineal numbness and urinary retention with absent rectal tone, perianal anaesthesia and left leg hypoaesthesia. Emergency MRI scan demonstrated spinal canal stenosis as the aetiology of her cauda equina syndrome. She was taken to theatre for emergency lumbar decompression. At operation a facet joint haematoma compressing the cauda equina was found and extirpated with complete resolution of symptoms. In this case, the aetiology of cauda equina compression was not demonstrated effectively on pre-operative MRI scanning.

Novel Multicentric Hepatic Lymphoma with Extrahepatic Biliary Obstruction Associated with Duodenal Perforation in a Cat.

An 11-year-old male castrated domestic shorthair cat was presented for evaluation due to clinical deterioration and potential extrahepatic biliary obstruction (EHBO). Further investigations confirmed EHBO and revealed severe and previously unreported comorbidities. On initial examination, the cat was markedly icteric with a poor body condition score and severe muscle wasting. Serum chemistry and complete blood count showed evidence of cholestasis and anemia. Primary diagnostics and therapeutics targeted these abnormalities. Abdominal ultrasound revealed peritoneal effusion, multifocal mixed echogenic hepatic and splenic foci, small intestinal thickening, cholelithiasis, choledocholithiasis, and common bile duct and pancreatic duct dilation with evidence of obstruction. Peritoneal effusion cytology confirmed septic peritonitis. Hepatic and splenic cytology was consistent with lymphoma. Based on these results, euthanasia was elected by the owners of the animal. Necropsy confirmed the ultrasound diagnoses, septic peritoneal effusion associated with a duodenal perforation, multiorgan lymphoma, and common bile duct carcinoma. Flow cytometry classified the lymphoma as a double-negative phenotype of T-cell lymphoma (CD3+ and CD5+, but CD4- and CD8-) present in the duodenum and liver and suspected in the spleen which has previously not been reported in cats. This case report documents a cat with EHBO caused by multiple disease processes including a novel T-cell lymphoma phenotype, biliary carcinoma, duodenal perforation and septic abdomen, and choleliths, as well as inflammatory hepatobiliary disease.

Survey of Instruments and Techniques for Endoscopic Retrieval of Esophageal and Gastric Foreign Bodies in Cats and Dogs.

Esophageal and gastric foreign bodies (EFB and GFB) are a common occurrence in cats and dogs. The objective of this study is to evaluate the endoscopic instruments and techniques used for foreign body retrieval by internists or criticalists based on type and location of the foreign body. An online, anonymous survey was created using a commercial software. The survey was distributed to diplomates of the ACVIM (SAIM) and ACVECC through each college's listserv. Data obtained included specialty, years in practice, practice type, available instruments, and preferred instrument for various foreign bodies by location and type. Two hundred sixty-eight surveys were completed with 74% from private referral practice and 21% from academic practice. For EFB, laparoscopic or endoscopic grasping forceps were used most commonly. For GFB, grasping forceps or loop snares were used most commonly. Fifty percent of respondents reported attempting duodenal FB removal. In practices with limited financial resources, endoscopic grasping forceps and loop snares may be prioritized for purchase as these instruments may have the most application for foreign body retrieval from the esophagus and stomach.

Parental perception of FIRES outcomes, emotional states, and social media usage.

OBJECTIVE: To investigate parental perception of FIRES outcomes, assess emotional states and related social media usage. METHODS: A survey-based study of parents of children with FIRES participating in a FIRES-specific Facebook group was performed. The survey collected information on medical aspects of their child's course in the acute, subacute, and chronic periods, emotional states, and social media usage. Child outcome was assessed utilizing the pediatric extended Glasgow outcome scale (GOS-E). Parental emotional states were assessed utilizing the Depression, Anxiety and Stress Scale (DASS). Descriptive statistics were performed. Associations were described using the Spearman rank correlation. Open-ended questions were included. Thematic analysis was performed. RESULTS: Twenty-nine surveys were analyzed. All children were in the chronic phase at time of survey response, except for two who died. Mothers answered 22 surveys, and fathers answered seven. Median age at FIRES presentation was 5.6 years [IQR 4.2-8.95], with a median number of 3 seizures per week [IQR 0-10, range 0-50], 4 daily anti-seizure medicines [IQR 3-5], and chronic GOS-E of 6 [IQR 2-8 range 2-8]. Most parents reported none to mild levels of depression, anxiety, and stress. Higher seizure burden positively correlated with parental depression symptoms (r = .41 (95% CI 0.01, 0.70), P = .045). Most parents found social media helpful with coping and 96% desired FIRES research advertised. Twenty-five parents shared their recommendations to fellow parents and the medical team in an open-ended format. Themes included support, expertise, and medical advice. SIGNIFICANCE: Despite their children's significantly impaired functional outcome after FIRES and high rates of medically refractory epilepsy, the cohort demonstrated remarkable emotional resilience. They perceive social media as beneficial, are interested in social media-advertised research, and share valuable advice. Social media may serve as an introductory platform to enhance the physician-scientist-parent/patient relationship.

Language regression, hemichorea and focal subclinical seizures in a 6-year-old girl with GLUT-1 deficiency.

•A 6 year old girl with progressive speech difficulties, new abnormal movements, olfactory hallucinations•Choreiform movement of her right hemibody along with her face and tongue•Seizures were noted during sleep without clinical correlate, progressing to awake subclinical seizures.

Is privacy privacy?

This position paper observes how different technical and normative conceptions of privacy have evolved in parallel and describes the practical challenges that these divergent approaches pose. Notably, past technologies relied on intuitive, heuristic understandings of privacy that have since been shown not to satisfy expectations for privacy protection. With computations ubiquitously integrated in almost every aspect of our lives, it is increasingly important to ensure that privacy technologies provide protection that is in line with relevant social norms and normative expectations. Similarly, it is also important to examine social norms and normative expectations with respect to the evolving scientific study of privacy. To this end, we argue for a rigorous analysis of the mapping from normative to technical concepts of privacy and vice versa. We review the landscape of normative and technical definitions of privacy and discuss specific examples of gaps between definitions that are relevant in the context of privacy in statistical computation. We then identify opportunities for overcoming their differences in the design of new approaches to protecting privacy in accordance with both technical and normative standards.This article is part of a discussion meeting issue 'The growing ubiquity of algorithms in society: implications, impacts and innovations'.