Cystic ovary disease (COD) alters structure and function of the bovine oviduct

Cystic ovary disease (COD) is a common cause of subfertility in dairy cattle. Therefore, the aim of this study was to provide novel concepts for cyst classification and to investigate the effects of COD on tubal microarchitecture, oviductal metabolic function, and the formation of the sperm reservoir. Bovine Fallopian tubes affected by follicular cysts, follicular cysts with luteinization and luteal cysts were investigated by a variety of microscopic and histological techniques and compared to control cows in metestrus and diestrus. We defined three types of cysts involved in COD, each of which had a characteristic wall thickness, inner wall appearance and cellular pattern within the cyst aspirate. Regarding the Fallopian tube, each cyst type was associated with a characteristic morphology, specifically the microarchitecture of the folds in ampulla, epithelial cell ratios, and ciliated/secretory cell size and form. Furthermore, each cyst type showed different patterns of tubal glycoprotein and acidic mucopolysaccharide synthesis, which was highly variable as compared to the controls. Our studies are the first to characterize the effects of COD on the Fallopian tube, which promotes the establishment of novel, cyst-specific therapeutic concepts in cattle and helps gain a holistic view of the causes of subfertility in cows with COD.

An audit of antibiotic prescribing in primary care 2019-2020 in Dunmanway Primary Care Centre

INTRODUCTION

Antibiotics are often the most common medication prescribed by general practitioners (GPs) and are often expected by patients despite campaigns such as Under the Weather. Antibiotic resistance is increasing in the community. The Health Service Executive (HSE) has issued 'Guidelines for Antimicrobial Prescribing in Primary Care in Ireland' aiming to optimise safe prescribing. This audit aims to analyse change in quality of prescribing after educational intervention.

METHODS

GP prescribing patterns were analysed over a week in October 2019 and re-audited in February 2020. Anonymous questionnaires detailed demographics, condition and antibiotic details. Educational intervention included texts, information and review of current guidelines. Data were analysed on a password protected spreadsheet. The HSE Guidelines for Antimicrobial Prescribing in Primary Care were taken as reference standard. A standard of 90% compliance for choice of antibiotic and 70% compliance for dose and course was agreed.

RESULTS

FindingsAuditRe-AuditNumber prescriptions4024Number delayed scripts4/40=10%1/24=4.2%Adult37/40=92.5%19/24=79.2%Child3/40=7.5%5/24=20.8%IndicationURTI22.50%25%LRTI10%4%Other RTI37.50%42%UTI20%29%Skin12.50%0%Gynaecological2.50%0%2+ Infections 5%0%Co-amoxiclav17.50%12.50%AdherenceChoice37/40=92.5%22/24=91.7%Dose28/39=71.8%17/24=70.8%Course28/40=70%12/24=50%Discussion: Excellent antibiotic choice and dose concordance with guidelines was noted, with both phases meeting the set standards. Suboptimal course compliance with guidelines occurred in the re-audit. Potential causes include concerns regarding resistance and patient factors not included. This audit included unequal number of prescriptions in each phase but are still of significance and addresses a clinically relevant topic.

Emerging from emergency pandemic pedagogy: A survey of anatomical educators in the United Kingdom and Ireland

It is critical that academic opinion of pandemic pedagogy is comprehensively quantified in order to inform future practices. Thus, this study examines how anatomists in the United Kingdom (UK) and Republic of Ireland (ROI) perceive the teaching adaptations made in response to COVID-19, and how these adaptations have impacted their experiences teaching, their online work environment and community. Data was collected via a questionnaire from 24 anatomists across 15 universities in the UK (11) and ROI (4). With regards to teaching, 95.6% of academics have upskilled in new technologies to meet the demands of distance teaching. Academics (95.8%) preferred face-to-face delivery of practical sessions. Most universities (80.0%) reported that practical sessions will continue in a new form that ensures social distancing. However, 50.0% of academics are uncertain if these adaptations will improve student learning. Many anatomists believe that the new adaptations may hinder student-student (66.7%) and student-tutor (45.8%) interactions. Regarding assessment, 52.6% of academics preferred traditional methods to online. Remote online assessment was difficult to protect against collusion, but provided time saving opportunities for academics. Finally, in terms of working environment, 83.3% of academics stated that their workload increased; 54.2% preferred working on site rather than remotely and 79.2% think that staff interactions are better when working on site. These results demonstrate a widespread concern amongst anatomists regarding the pandemic-induced adaptations to teaching, assessment and working environment. However, important opportunities were also identified that could ultimately serve to benefit students and educators alike.

Strength, Weakness, Opportunity, Threat (SWOT) Analysis of the Adaptations to Anatomical Education in the United Kingdom and Republic of Ireland in Response to the Covid-19 Pandemic

The Covid-19 pandemic has driven the fastest changes to higher education across the globe, necessitated by social distancing measures preventing face-to-face teaching. This has led to an almost immediate switch to distance learning by higher education institutions. Anatomy faces some unique challenges. Intrinsically, anatomy is a three-dimensional subject that requires a sound understanding of the relationships between structures, often achieved by the study of human cadaveric material, models, and virtual resources. This study sought to identify the approaches taken in the United Kingdom and Republic of Ireland to deliver anatomical education through online means. Data were collected from 14 different universities in the United Kingdom and Republic of Ireland and compared adopting a thematic analysis approach. Once themes were generated, they were collectively brought together using a strength, weakness, opportunity, threat (SWOT) analysis. Key themes included the opportunity to develop new online resources and the chance to engage in new academic collaborations. Academics frequently mentioned the challenge that time constrains could place on the quality and effectiveness of these resources; especially as in many cases the aim of these resources was to compensate for a lack of exposure to cadaveric exposure. Comparisons of the actions taken by multiple higher education institutions reveal the ways that academics have tried to balance this demand. Discussions will facilitate decisions being made by higher education institutions regarding adapting the curriculum and assessment methods in anatomy.

Automatic Clinical Procedure Detection for Emergency Services

Understanding a patient's state is critical to providing optimal care. However, information loss occurs during patient hand-offs (e.g., emergency services (EMS) transferring patient care to a receiving hospital), which hinders care quality. Augmenting the information flow from an EMS vehicle to a receiving hospital may reduce information loss and improve patient outcomes. Such augmentation requires a noninvasive system that can automatically recognize clinical procedures being performed and send near real-time information to a receiving hospital. An automatic clinical procedure detection system that uses wearable sensors, video, and machine-learning to recognize clinical procedures within a controlled environment is presented. The system demonstrated how contextual information and a majority vote method can substantially improve procedure recognition accuracy. Future work concerning computer vision techniques and deep learning are discussed.

5 Transport and cholinergic innervation in the bovine oviduct are dysregulated in cystic ovary disease

Cystic ovary disease (COD) is one of the most common causes of bovine infertility and affects 7-14% of cows in European herds. The morphological and molecular causes of this disease are largely unknown. Because the oviduct is pivotal to gamete transport, fertilization, and early embryonic development, the aim of this study was to analyse the effects of COD on the function of the oviduct. Oviducts were excised from cows affected by COD (n=29) as well as from healthy cows in mid diestrus (n=20) immediately after slaughter. A unique digital live cell imaging system established in our laboratory was used to capture real-time videos of ciliary beat and tubal fluid flow under near invivo conditions. For ciliary beat frequency, the differences in grayscale of beating cilia were transformed into frequencies using ImageJ (National Institutes for Health) and AutoSignal (SyStat Software Inc.). For particle transport speed (PTS), polystyrene beads were added to the buffer media and were automatically tracked using ImagePro (Media Cybernetics). Additionally, smooth muscle contraction and epithelial ion transport were investigated using organ baths and Ussing chambers. Our results showed that PTS was significantly decreased in oviducts from cows affected by COD as compared with controls (P=0.01, unpaired t-test). Further, in healthy control cows, PTS was consistently increased in the oviduct ipsilateral to ovulation as compared with the contralateral oviduct (P=0.03, paired t-test). This was not the case in cows affected by COD (P=0.47, paired t-test). Reduced PTS in oviducts from cows with COD was not due to changes in ciliary beat frequency. Although smooth muscle contraction was similar in oviducts from healthy and COD cows, the contractile response (mN) to the cholinomimetic drug carbachol (10−7-10−4 M) was significantly reduced in COD as compared with the controls (P<0.0001, nonlinear regression best fit analysis). Active epithelial ion transport, as measured by the change in short circuit current (μA cm−2), was stimulated by carbachol. Carbachol-induced active ion transport in the oviducal epithelium of COD cows was significantly decreased as compared with controls (P=0.03, unpaired t-test of area under the curve). These results suggest, for the first time, that the transport of the gametes and the early embryo might be impaired in COD. Further, inadequate or insufficient cholinergic innervation may result in dysregulated fluid flow, which might be associated with alterations in oviducal metabolism and gamete or embryo nutrition. This knowledge is pivotal to establish novel therapeutic concepts for successful treatment of infertility in individuals affected by COD.

Pathogen displacement during intermittent catheter insertion: a novel in vitro urethra model

AIM

To develop a novel in vitro urethra model and use it to determine if insertion of an intermittent urinary catheter (IC) displaces pathogenic bacteria from the urethral meatus along the urethra.

METHODS

Displacement of microbial growth after catheter insertion was assessed using a novel in vitro urethra model. The in vitro urethra model utilized chromogenic agar and was inoculated with bacteria at one side of the artificial urethra channel, to act as a contaminated urethral meatus, before an IC was inserted into the channel. Three ICs types were used to validate the in vitro urethra model and methodology.

RESULTS

When compared to the bacterial growth control, a significant difference in bacterial growth was found after insertion of the uncoated (P ≤ 0·001) and hydrophilic coated (P ≤ 0·009) catheters; no significant difference when a prototype catheter was inserted into the in vitro urethra model with either bacterial species tested (P ≥ 0·423).

CONCLUSION

The results presented support the hypothesis that a single catheter insertion can initiate a catheter-associated urinary tract infection.

SIGNIFICANCE AND IMPACT OF THE STUDY

The in vitro urethra model and associated methodology were found to be reliable and reproducible (P ≥ 0·265) providing new research tool for the development and validation of emerging technologies in urological healthcare.

Platelet biology in regenerative medicine of skeletal muscle

Platelet-based applications such as platelet-rich plasma (PRP) and platelet releasate have gained unprecedented attention in regenerative medicine across a variety of tissues as of late. The rationale behind utilizing PRP originates in the delivery of key cytokines and growth factors from α-granules to the targeted area, which in turn act as cell cycle regulators and promote the healing process across a variety of tissues. The aim of the present review is to assimilate current experimental evidence on the role of platelets as biomaterials in tissue regeneration, particularly in skeletal muscle, by integrating findings from human, animal and cell studies. This review is composed of 3 parts: firstly, we review key aspects of platelet biology that precede the preparation and use of platelet-related applications for tissue regeneration. Secondly, we critically discuss relevant evidence on platelet-mediated regeneration in skeletal muscle focusing on findings from (i) clinical trials, (ii) experimental animal studies and (iii) cell culture studies; and thirdly, we discuss the application of platelets in the regeneration of several other tissues including tendon, bone, liver, vessels and nerve. Finally, we review key technical variations in platelet preparation that may account for the large discrepancy in outcomes from different studies. This review provides an up-to-date reference tool for biomedical and clinical scientists involved in platelet-mediated tissue regenerative applications.

High-throughput high-volume nuclear imaging for preclinical in vivo compound screening§

Background

Preclinical single-photon emission computed tomography (SPECT)/CT imaging studies are hampered by low throughput, hence are found typically within small volume feasibility studies. Here, imaging and image analysis procedures are presented that allow profiling of a large volume of radiolabelled compounds within a reasonably short total study time. Particular emphasis was put on quality control (QC) and on fast and unbiased image analysis.

Methods

2–3 His-tagged proteins were simultaneously radiolabelled by ^99mTc-tricarbonyl methodology and injected intravenously (20 nmol/kg; 100 MBq; n = 3) into patient-derived xenograft (PDX) mouse models. Whole-body SPECT/CT images of 3 mice simultaneously were acquired 1, 4, and 24 h post-injection, extended to 48 h and/or by 0–2 h dynamic SPECT for pre-selected compounds. Organ uptake was quantified by automated multi-atlas and manual segmentations. Data were plotted automatically, quality controlled and stored on a collaborative image management platform. Ex vivo uptake data were collected semi-automatically and analysis performed as for imaging data.

Results

>500 single animal SPECT images were acquired for 25 proteins over 5 weeks, eventually generating >3500 ROI and >1000 items of tissue data. SPECT/CT images clearly visualized uptake in tumour and other tissues even at 48 h post-injection. Intersubject uptake variability was typically 13% (coefficient of variation, COV). Imaging results correlated well with ex vivo data.

Conclusions

The large data set of tumour, background and systemic uptake/clearance data from 75 mice for 25 compounds allows identification of compounds of interest. The number of animals required was reduced considerably by longitudinal imaging compared to dissection experiments. All experimental work and analyses were accomplished within 3 months expected to be compatible with drug development programmes. QC along all workflow steps, blinding of the imaging contract research organization to compound properties and automation provide confidence in the data set. Additional ex vivo data were useful as a control but could be omitted from future studies in the same centre. For even larger compound libraries, radiolabelling could be expedited and the number of imaging time points adapted to increase weekly throughput. Multi-atlas segmentation could be expanded via SPECT/MRI; however, this would require an MRI-compatible mouse hotel. Finally, analysis of nuclear images of radiopharmaceuticals in clinical trials may benefit from the automated analysis procedures developed.

Electronic supplementary material

The online version of this article (doi:10.1186/s13550-017-0281-4) contains supplementary material, which is available to authorized users.

Hypoxia promotes production of neural crest cells in the embryonic head

Hypoxia is encountered in either pathological or physiological conditions, the latter of which is seen in amniote embryos prior to the commencement of a functional blood circulation. During the hypoxic stage, a large number of neural crest cells arise from the head neural tube by epithelial-to-mesenchymal transition (EMT). As EMT-like cancer dissemination can be promoted by hypoxia, we investigated whether hypoxia contributes to embryonic EMT. Using chick embryos, we show that the hypoxic cellular response, mediated by hypoxia-inducible factor (HIF)-1α, is required to produce a sufficient number of neural crest cells. Among the genes that are involved in neural crest cell development, some genes are more sensitive to hypoxia than others, demonstrating that the effect of hypoxia is gene specific. Once blood circulation becomes fully functional, the embryonic head no longer produces neural crest cells in vivo, despite the capability to do so in a hypoxia-mimicking condition in vitro, suggesting that the oxygen supply helps to stop emigration of neural crest cells in the head. These results highlight the importance of hypoxia in normal embryonic development.

Difficulties associated with diabetes management during the Junior Certificate examination

The aim of this study was to describe the adherence to recommended diabetes care during the Junior Certificate, and the utilisation of available allowances for children with type 1 diabetes. Questionnaires were sent within 3 months of the examination to all adolescents and their families attending our service completing the Junior Certificate in June of 2012. Fifteen of the 25 (60%) patients/parents completed the questionnaires. Five (33%) had higher than usual glucose readings during the examination period and three (20%) experienced hypoglycaemia during at least one exam. Nine (60%) never checked capillary glucose levels during the exams. No patients left the examination area to perform diabetes related tasks. Thirteen (86%) brought fast acting glucose into the examination centre while only six (40%) brought a glucometer. Just four (27%) patients availed of the rest breaks allowed and six (40%) felt that their diabetes affected their examination performance.

Physical exercise and psychological well being: a critical review

The relation between physical exercise and psychological health has increasingly come under the spotlight over recent years. While the message emanating from physiological research has extolled the general advantages of exercise in terms of physical health, the equivalent psychological literature has revealed a more complex relation. The paper outlines the research evidence, focusing on the relation between physical exercise and depression, anxiety, stress responsivity, mood state, self esteem, premenstrual syndrome, and body image. Consideration is also given to the phenomena of exercise addiction and withdrawal, and implications for exercise prescription are discussed.

Community mental health centers and the decreasing use of state mental hospitals

To test the success of the Community Mental Health Centers Program goal of reducing state hospital utilization, changes in state mental hospital resident and admission rates were calculated, using 16 states, for counties wholly within or outside of catchment areas served by operating, federally funded community mental health centers. There was no consistent relationship between the opening of centers and changes in state hospital resident rates. However, counties with centers tended to decrease more (or increase less) in state hospital admission rates than areas without centers.