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Introduction: This cadaveric study describes the collateral ligament constraints on the feline tarsocrural joint using stress radiography. Methods: Thirty‐six feline cadaveric hindlimbs free of orthopaedic disease were placed in a custom‐made jig and controlled stress radiography was performed before and after transection of one, or both collateral ligaments. Changes in varus and valgus deviation and pronation and supination were measured at three limb angles (extension, 120o flexion and 90o flexion). Results: There was a significant positive percentage change in the mean angle of varus deviation after transection of the fibulocalcaneal ligament at all limb positions (extension: 41%, 120°: 78%, 90°: 63%). There was a significant positive percentage change in the mean angle of varus deviation after transection of the fibulotalar ligament at extension (14%). There was a significant positive percentage change in the mean angle of varus deviation after transection of both fibulocalcaneal and fibulotalar ligaments at all limb positions (extension: 58%, 120°: 67%, 90°: 67%), and in the mean angle of valgus deviation (100%) and supination (89%) at 90 degrees flexion. There was a significant positive percentage change in the mean angle of valgus deviation after transection of the tibiocentral ligament at all limb positions (extension: mean 79%, 120°: 43%, 90°: 49%) and the mean angle of pronation at 120 degrees flexion (10%). There was a significant positive percentage change in the mean angle of varus deviation after transection of the tibiotalar ligament at extension (11%) and at 90 degrees flexion (54%) and in the mean angle of pronation at all limb positions (extension: 11%, 120°: 19%, 90°: 32%). There was a significant positive percentage change in the mean angle of valgus deviation (extension: 255%, 120°: 172%, 90°: 176%) and pronation (extension: 58%, 120°: 134%, 90°: 76%) after transection of the tibiocentral and tibiotalar ligaments at all limb positions and in the mean angle of varus deviation at extension (13%) and 90 degrees flexion (69%). Conclusion: The medial collateral ligaments prevent against excessive valgus deviation and pronation, and the lateral collateral ligaments prevent against excessive varus deviation and supination. At 90 degrees flexion subluxation of the talus occurs on the ipsilateral side of the ligament injury resulting in an additional direction of instability. [ABSTRACT FROM AUTHOR]

The article describes the case of a 45-year-old white women who presented with a two-day history of anorexia, nausea, vomiting, and severe gastro-esophageal reflux symptoms but denied melena or hematemesis. Endoscopy was performed and the endoscopic appearance was consistent with a diagnosis of esophagitis dissecans superficialis (EDS). The risk factors of EDS include malnutrition and medications such as central nervous system depressants.

An abstract of the conference paper "Ultrasound features of an anomaly of the umbilico-portal system-a case report," by T. Foo, and colleagues is presented.

Purpose. The objectives of this study were to describe perceptions of disability among South Asian immigrant mothers of children with disabilities in a large multicultural urban centre in Ontario, Canada, and to explore how these perceptions influence rehabilitation services. The study was built on our previous work conducted with mothers in South Asia. Methods. A descriptive qualitative research design was employed. Semi-structured interviews were conducted with five mothers who had immigrated to Canada from South Asia in the last decade, and whose children were receiving outpatient rehabilitation services. Results. Three primary themes were identified: (1) perceptions of disability reflected a mix of traditional and western beliefs; (2) mothers experienced physical, emotional and social suffering related to socio-cultural and material barriers and (3) mothers' primary goal for their children was the achievement of independent walking, which was linked to notions of achieving a ''normal'' life and the desire for more rehabilitation interventions. Conclusions. South Asian immigrant mothers' perceptions of their children's disabilities had important similarities and differences to mothers living in South Asia. Healthcare professionals can assist families in managing and coping with their child's disabilities by exploring their unique values and beliefs and identifying achievable outcomes together. [ABSTRACT FROM AUTHOR]

Online adaptive radiotherapy has been clinically feasible through decades of research and development and is now available in the clinical routine with dedicated platforms using CBCT-LINAC or MR-LINAC. The quality assurance (QA) of online plans has become a bottleneck in the clinical workflow as it often requires manual data export/import through third party software, lengthy wait for the secondary dose calculation, and tedious work on report generation and checking, etc. The QA bottleneck not only impedes clinical workflow but also risks plan and treatment quality due to the time pressure with the patient waiting on the treatment table. We have developed and implemented in-house solutions to address such a bottleneck. We developed dedicated in-house infrastructure to facilitate online adaptive plan QA and clinical workflow: 1) RT-PACK with SQLite database, which receives and organizes DICOM-RT data from any DICOM sender (e.g., clinical TPS); 2) a general purpose dose calculation server powered by the in-house GPU-based Monte Carlo particle transport engine with electromagnetic field modelling; 3) a report generator that automatically generates reports for secondary dose and plan quality check; 4) a web-portal that allows clinicians to review and sign the report anywhere with a network and VPN connection, even from a mobile phone. The reports and related documents will be automatically sent to the Record & Verify system after obtaining both physician and physicist signatures. An auto-commissioner was also developed to facilitate beam modeling based on water-tank measurements, which serves the purpose of fully independent verification. The dose calculation was performed on the whole patient volume with grid resolution of 2 mm x 2 mm x 2 mm. The 3D dose volume, treatment fields, point dose, Gamma Index with global 3%, 2mm criteria, three orthogonal dose profiles, dose volume histograms, and dosimetric constraints are metrics to compare the plan retrieved from TPS to the secondary dose verification and reported for clinicians' review. The whole in-house infrastructure went through extensive unit tests, dosimetric accuracy verifications, and alpha and beta tests before adopted for clinical use. The secondary dose and plan check infrastructure went live for CBCT-LINAC and MR-LINAC in our clinic and has since performed secondary check for every plan generated (846 plans and 622 plans, respectively, in less than 6 months.) The average processing time, from DICOM receiving to report generation, was 62 seconds for CBCT-LINAC and 130 seconds for MR-LINAC, which was 3-5 minutes shorter compared to using commercial software. More than 95% of CBCT-LINAC (MR-LINAC) plans had Gamma passing rates >99% (>95%). The in-house developed software, through strict verification and validation, has been integrated into the clinical system. It has greatly improved online adaptive quality assurance with efficient and streamlined clinical workflow. [ABSTRACT FROM AUTHOR]

An abstract of the conference paper "Report of a case of right ductus arteriosus in a fetus with right aortic arch" by X. Zhang and colleagues is presented.