A study on the use of thermal imaging as a diagnostic tool for the detection of digital dermatitis in dairy cattle

Our aims were to (1) determine how interdigital skin temperature (IST), measured using infrared thermography, was associated with different stages of digital dermatitis (DD) lesions and (2) develop and validate models that can use IST measurements to identify cows with an active DD lesion. Between March 2019 and March 2020, infrared thermographic images of hind feet were taken from 2,334 Holstein cows across 4 farms. We recorded the maximum temperature reading from infrared thermographic images of the interdigital skin between the heel bulbs on the hind feet. Pregnant animals were enrolled approximately 1 to 2 mo precalving, reassessed 1 wk after calving, and again at approximately 50 to 100 d postpartum. At these time points, IST and the clinical stage of DD (M-stage scoring system: M1-M4.1) were recorded in addition to other data such as the ambient environmental temperature, height, body condition score, parity, and the presence of other foot lesions. A mixed effect linear regression model with IST as the dependent variable was fitted. Interdigital skin temperature was associated with DD lesions; compared to healthy feet, IST was highest in feet with M2 lesions, followed by M1 and M4.1 lesions. Subsequently, the capacity of IST measurements to detect the presence or absence of an active DD lesion (M1, M2, or M4.1) was explored by fitting logistic regression models, which were tested using 10-fold validation. A mixed effect logistic regression model with the presence of active DD as the dependent variable was fitted first. The average area under the curve for this model was 0.80 when its ability to detect presence of active DD was tested on 10% of the data that were not used for the model's training; an average sensitivity of 0.77 and an average specificity of 0.67 was achieved. This model was then restricted so that only explanatory variables that could be practically recorded in a nonresearch, external setting were included. Validation of this model demonstrated an average area under the curve of 0.78, a sensitivity of 0.88, and a specificity of 0.66 for 1 of the time points (precalving). Lower sensitivity and specificity were achieved for the other 2 time points. Our study adds further evidence to the relationship between DD and foot skin temperature using a large data set with multiple measurements per animal. Additionally, we highlight the potential for infrared thermography to be used for routine on-farm diagnosis of active DD lesions.

Rider reported factors influencing choice of stirrup length in dressage, showjumping and eventing, and para equestrianism

The main functions of a saddle are to improve rider stability and comfort, with the stirrups providing support for the rider’s legs. The criteria upon which riders base their choice of stirrup length for different equestrian disciplines does not appear to have been reported. Therefore, this study was designed to investigate the factors that play a role in a rider’s choice of stirrup length for different equestrian and para-equestrian disciplines. An online questionnaire consisting of open and closed demographic questions, and 28 Likert scale questions related to factors which are anecdotally associated with stirrup length was distributed via social media horse pages. Respondents were asked to identify factors that influenced their decision making when setting their stirrup length in dressage, showjumping and eventing (dressage, showjumping and cross-country phases). 2,183 participants took part in this study, the majority were female (97%; n=2,131). 8% of the sample (n=184) categorised themselves as para-equestrians. Most respondents (n=1,200) identified themselves as dressage riders (amateur: 89%, n=1,068; professional: 11%, n=132), 665 riders engaged in showjumping (amateur: 87%, n=579; professional: 13%, n=86) and a further 393 riders selected eventing as their primary discipline (amateur: 89%, n= 350; professional: 11%, n=43). All riders consistently ranked feel of stirrups once mounted, how stable stirrups feel once moving and type of saddle being used as the three most important factors when deciding stirrup length across the disciplines. Dressage riders were more greatly influenced by the factors investigated when setting stirrup length then either showjumping or event riders (Kruskal Wallis: P<0.04). For eventing participants, exercise type, safety, saddle type and rider stability were key factors influencing stirrup length selection between different phases of the competition. These factors were generally ranked as more important for the dressage/flatwork phase compared to showjumping or cross country schooling (Kruskal Wallis: P<0.01). Stirrup length is likely to affect rider comfort, performance and safety while having relatively less effect on the horse’s well-being, therefore it is not surprising that riders from all disciplines placed high emphasis on factors related to the rider and saddle.

Characterization of infectious bursal disease virus isolates from Indonesia indicates the existence ofvery virulent strains with unique genetic changes

Sequencing of the hypervariable region of viral protein VP2 of infectious bursal disease virus (IBDV) isolates obtained from non-vaccinated chickens in Indonesia showed that the majority (16/17) were closely related to published very virulent (vv)IBDV strains. Four isolates contained identical amino acid sequences to Asian and European vvIBDVs, sharing vv-specific amino acid residues 222(Ala), 256(Ile), and 294(Ile). Eight isolates differed by one amino acid at position 222(Ala-->Ser); however, this change did not alter the pathogenicity or antigenicity of these strains. Two isolates, with amino acid substitutions at positions 272(Ile-->Thr) and 279(Asp-->Asn), did not cause clinical disease or mortality, and were therefore considered to be naturally occurring, attenuated mutants of vvIBDV. The results illustrate variability that might occur among vvIBDV strains.

Diascopy: a clinical technique for the diagnosis of vascular lesions

Dentists can quickly determine the vascular nature of many intraoral lesions by applying a clinical test for blanchability. Such a clinical test is called a diascopy. Described here are the circumstances in which diascopy can be used in a dental practice and what useful information is provided by performing diascopy on oral mucosal lesions.

Focal, flat pigmentations of the oral mucosa: a clinical approach to the differential diagnosis

The purpose of this article is to assist the clinician in establishing a clinical approach to the diagnosis of focal, flat pigmentations of the oral mucosa. These pigmentations include lesions that may be blue, purple, red, black, or brown. The etiopathogenesis may be variable and the pigment may originate from an exogenous (extrinsic) or endogenous (intrinsic) source. Exogenous pigmentations are of a traumatic or iatrogenic origin. Intrinsic pigmentations are either vascular or melanocytic. Clinical approaches include a thorough history and physical exam coupled with diascopy (blanchability), radiographs, and tissue examination (biopsies). An algorithm is presented to clarify the diagnostic approach. The diagnosis may vary from pathologic entities that require no treatment to others that may involve malignancies and their associated management. It is therefore extremely important that these lesions are identified and properly managed in an expeditious manner.

Visible persistence and form correspondence in Ternus apparent motion

Visual stimuli remain visible for some time after their physical offset (visible persistence). Visible persistence has been hypothesized to play an important role in determining the pattern of correspondence matching in the Ternus apparent-motion display. In this display, one or more elements reappears in overlapping locations at different times, whereas another element appears alternately to the right or the left of these elements. Usually either the elements are perceived to move coherently as a group (group motion), or one element may be perceived to hop over one or more other elements (element motion). According to the visible-persistence account of the perceptual organization of the Ternus display, element motion is seen when the temporal gap between elements in overlapping locations is small enough to be bridged by visible persistence; if it is not, group motion is seen. We conducted four experiments to test this visible-persistence account. In Experiments 1 and 2, a form correspondence cue (line length) was introduced to bias the visual system toward the element-motion interpretation, while visible persistence was either reduced or eliminated. The element-motion percept dominated despite the elimination of visible persistence. In Experiments 3 and 4, we found that Ternus elements presented without interruption, and thus presumably persisting over time, can be perceived in group motion. Together, the results indicate that visible persistence is neither necessary nor sufficient to account for the pattern of correspondence matches in the Ternus display.

Laparoscopic anterior resection: a consecutive series of 84 patients

Laparoscopic colorectal surgery is in its infancy. From a series of over 200 colorectal procedures undertaken over the last 30 months, we have performed 84 anterior resections. In 55 women and 29 men, median age 64 years (range 32-86), median weight 72 kg (range 36-125), surgery was undertaken for benign pathology (n = 57) and adenocarcinoma (n = 27). Anterior resection was completed laparoscopically in 75 cases (89%) with a median operating time of 210 min (range 85-420). Minor morbidity occurred in 17 patients (20%) with major morbidity in 10 cases (12%). There was one post-operative death. Flatus was passed a median of two days (range 1-7) after surgery and feces at a median of four days (range 2-9). Total hospital stay was six days (range 2-33). Delayed morbidity during a maximum of 30 months' follow-up included two anastomotic strictures but no evidence of malignant seeding. Laparoscopic anterior resection appears both feasible and safe for both benign and malignant disease, with the caveat that long-term outcome in malignant disease is not yet available.

Laparoscopic splenectomy and lymph node biopsy for hematologic disorders

OBJECTIVE

The authors audit the introduction of laparoscopic splenectomy and laparoscopic intra-abdominal lymph node biopsy and compare outcomes with a parallel cohort of patients undergoing open splenectomy.

SUMMARY BACKGROUND DATA

Laparoscopic splenectomy was first reported in 1992. It was introduced into clinical practice at the Royal Brisbane Hospital in 1991. Between June 1991 and March 1994, 24 patients have undergone laparoscopic splenectomies and 23 patients have had laparoscopic intra-abdominal lymph node biopsies.

METHODS

Laparoscopic splenectomy was performed using a four- or five-port technique. The splenic hilum was secured using a linear stapler cutter, and the spleen was removed after placing it in a laparoscopic bag. Lymph node biopsy was performed using a three- or four-port technique, depending on the site and size of the lymphadenopathy.

RESULTS

Laparoscopic splenectomy was completed in 22 patients (92%). Median hospital stay was 3 days (range 2-7 days) and morbidity occurred in two patients (8%). Lymph node biopsy was completed laparoscopically in 21 of 23 patients (91%), with morbidity in two cases (9%). Median hospital stay was 2 days (range 1-6 days), with a diagnostic accuracy of 90%. Comparison with open splenectomy revealed that the laparoscopic approach took significantly longer to perform (p = 0.0002), but resulted in a significantly shorter hospital stay (p = 0.0005).

CONCLUSIONS

Both laparoscopic splenectomy and laparoscopic lymph node biopsy currently are used as the treatments of choice for hematologic disease in our institution.

Microscope and hot wire cautery management of 100 consecutive patients with acute epistaxis--a superior method to traditional packing

The technique of microscope examination and hot wire cautery in a prospective study of 100 consecutive patients with acute epistaxis is described. The method was successful in arresting haemorrhage in 94 per cent of patients bleeding at the time of examination, and in 86 per cent, discharge home within one hour was possible. Due to improved illumination, magnification and control of the cautery instrument, nasal packing was required in only nine per cent of cases. By achieving this and by reducing the overall need for admission to 20 per cent, we recommend this method of treatment both as a successful cost saving measure, as well as advantageous to the patient.

Can psychologists recognize neurological disorders in their patients?

A variety of insidious neurological disorders may present initially as psychological difficulties. In an effort to determine whether psychologists could recognize these disorders in their patients and refer them to a neurologist or nonneurological physician, a questionnaire containing four clinical vignettes was sent to a total of 566 members of the Los Angeles Psychological Association. Each vignette contained a salient description of an underlying neurological disorder with a psychological presentation. No explicit indication was made that the psychological problem represented an underlying neurological disorder. Each psychologist was instructed to read each vignette carefully and to decide what to recommend for each patient. Analysis of the data revealed that nearly one-third of the psychologists failed to recognize the underlying neurological disorder.

Metacontrast investigations of sustained-transient channel inhibitory interactions

The metacontrast paradigm was exploited to study possible inhibitory interactions between sustained and transient channels. Variations and measures of target disinhibition or target recovery. The former type of target recovery is taken as evidence for interchannel sustained-on-transient inhibition; the latter, as evidence for intrachannel transient-on-transient inhibition.

Electrophysiologic delineation of the specialized atrioventricular conduction system in two patients with corrected transposition of the great arteries in situs inversus (I,D,D)

Electrophysiologic delineation of the atrioventricular conduction system at surgery is described in two patients with corrected transpostion of the great arteries in situs inversus. Intra-atrial electrograms were recorded in one patient from sites immediately adjacent to the coronary sinus located in the left-sided right atrium. The intraventricular portion of the atrioventricular conduction system was identified in both patients along the posterior and inferior margin of the ventricular septal defect, in contrast to the superior and anterior location found in corrected transposition of the great arteries in situs solitus. In contrast to the superior and anterior location found in corrected transposition of the great arteries in situs solitus. The course of the conduction system in the hearts of these two patients and a possible relationship to the cardiac loop and dual origin of the atrioventricular node is discussed. These cases illustrate the usefulness of segmental diagnosis of congenital heart disease and of electrophysiologic identification of the specialized atrioventricular conduction system at surgery.

Echocardiographic features of endocardial cushion defects

The echocardiographic features of endocardial cushion defects were defined in 28 patients. Two basic characteristics, common to both complete and incomplete forms of endocardial cushion defects, were found. First, the mitral valve excursion was not seen best in the usual location as defined by intraventricular landmarks. Secondly, the mitral valve echoes in cases where there are dense attachments of the mitral leaflet to the crest of the interventricular septum may be traced to the rightward and anterior border of the left ventricular outflow tract. This is the echocardiographic representation of the characteristic "goose-neck" deformity seen angiographically.

Two additional paterns were recognized in patients with complete atrioventricular (A-V) canal. In Pattern I, a large, single, A-V valve was found occupying a central location between the two ventricles. During diastole, the superior segment moved anteriorly into the right ventricle and the inferior segment posteriorly into the left ventricle. In Pattern II, a large single A-V valve moved from the left ventricle in systole into the right ventricle in diastole. This pattern was specific to patients with common A-V valve leaflets.