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Background: Congenital sensorineural deafness (CSD) is the most common type of deafness in Dalmatian dogs. Objectives: To use results of CSD screening in Dalmatian dogs in the United Kingdom in genetic analysis and to determine any changes in the prevalence of CSD in this breed over time. Animals A total of 8955 Dalmatian puppies undergoing hearing function screening using brainstem auditory evoked response (BAER) between July 1992 and February 2019. Methods: Results of BAER testing and pigmentation phenotypic data were linked to the UK Kennel Club Dalmatian pedigree database. Mixed model analysis was used to estimate variance parameters. Results: The overall prevalence of CSD was 17.8% (13.4%, unilateral; 4.4%, bilateral). Heritability of CSD was approximately 0.3 (across models) and significantly >0. Genetic correlations between CSD and blue irises (+0.6) and pigmented head patch (−0.86) were large in magnitude and significantly different form 0. Significant improving phenotypic and genetic trends were identified, likely as the result of selection against deafness, equivalent to avoiding breeding with the 4% to 5% of animals with the highest genetic risk of CSD. Conclusions and Clinical Importance: A decrease in the prevalence and genetic risk of CSD implies breeders have been selecting for hearing dogs. Selective breeding based on estimated breeding values (EBVs) can help further decrease the prevalence of CSD in Dalmatians in the future. [ABSTRACT FROM AUTHOR]

Background: Data about congenital sensorineural deafness (CSD) in white blue‐eyed cats derive mainly from research colonies, and information about client‐owned cats is limited. Objectives: To describe the prevalence of CSD in a client‐owned population of white purebred kittens and colored littermates in the United Kingdom. Animals: One hundred thirty‐two solid white client‐owned purebred kittens and 61 colored littermates, 6 to 21 weeks of age. Methods: Retrospective (56 cases) and prospective (137 cases) study. Hearing was assessed by brainstem auditory evoked response testing, and the entire litter was tested. Results: Congenital sensorineural deafness was diagnosed only in solid white kittens, with a prevalence of 30.3% (15.9% bilateral, 14.4% unilateral). The prevalence of CSD was significantly higher in white kittens with 1 (44.4%) or 2 (50%) blue irises than in those without blue irises (22.2%). Kittens with at least 1 blue iris were 3.2 times more likely to have CSD than kittens without blue irises. In solid white kittens, CSD was diagnosed in 7 of 15 (46.7%) Turkish Vankedisi, 8 of 18 (44.0%) Maine Coon, 18 of 41 (43.9%) Norwegian Forest, 3 of 11 (27.3%) British Shorthair, 2 of 12 (16.7%) Devon Rex, 2 of 12 (8.3%) Persian, 1 of 21 (4.8%) Russian, and 0 of 2 Sphinx. The prevalence of CSD was significantly different in Norwegian Forest, Maine Coon, and Turkish Vankedisi kittens compared with Persian or Russian kittens. Conclusion and Clinical Importance: We identified a high prevalence of CSD in a population of client‐owned purebred white kittens in the United Kingdom and suggest differences in breed‐specific prevalence of CSD. [ABSTRACT FROM AUTHOR]

The author comments on a study published within the issue which reviewed literature relating to home oxygen and home nasogastric feeding for infants and toddlers with bronchiolitis. Topics covered include the review's identification of studies that demonstrated the feasibility, acceptability and safety of home oxygen therapy (HOT) among high-altitude population, data on health care cost-savings highlighted by the study, and the feasibility of HOT as an alternative to hospitalization.

Background: Congenital sensorineural deafness (CSD) is the most common type of deafness in dogs and it occurs in numerous canine breeds including the English bull terrier. This study estimates prevalence, heritability and genetic correlations of CSD and coat pigmentation phenotypes in the English bull terrier in England. Results: Hearing status was assessed by brainstem auditory evoked response in 1060 English bull terrier puppies tested at 30-78 (mean 43.60) days of age as complete litters. Gender, coat and iris colour and parental hearing status were recorded. The prevalence of CSD in all 1060 puppies was 10.19 % with 8.21 % unilaterally deaf and 1.98 % bilaterally deaf. The coat was predominately coloured in 49.15 % puppies and white with or without a patch in 50.85 % puppies. The majority (96.29 %) of deaf puppies had a white coat (with or without a patch); 19.29 % of the puppies with a white coat (with or without a patch) were deaf. Heritability and genetic correlations were estimated using residual maximum likelihood. Heritability of hearing status as a trichotomous trait (bilaterally normal/unilaterally deaf/bilaterally deaf) was estimated at 0.15 to 0.16 and was significantly different to zero (P < 0.01). Heritability of coat pigmentation phenotype (all white/white with patches/ coloured) was 0.49 (standard error 0.077). Genetic correlation of CSD with coat pigmentation phenotype was estimated at -0.36 to -0.37 (CSD associated with all white coat), but was not significantly larger than zero (P > 0.05). Analysis of CSD in all white and white patched puppies only estimated the heritability of CSD as 0.25 and was significantly greater than zero (P < 0.01), and the heritability of coat colour (all white/white with patches) as 0.20 (standard error 0.096). The genetic correlation was estimated at -0.53 to -0.54 (CSD associated with all white coat) but was just above the statistical threshold determining significant difference to zero (P = 0.06). Conclusions: These results indicate that CSD occurs predominantly in white English bull terriers and there is genetic variation in CSD beyond that associated with coat colour. [ABSTRACT FROM AUTHOR]

Objective. Home O2 has been shown to reduce hospitalizations for bronchiolitis but data on outpatient management of home O2 are lacking. We aim to describe outpatient management and challenges to home O2 for bronchiolitis. Methods. We surveyed Colorado and Utah (where home O2 use is prevalent) chapter members of the American Academy of Pediatrics regarding bronchiolitis home O2 management. Results. A total of 1030 providers were surveyed. The response rate was 21% (n = 214). Ninety percent of practicing primary care providers reported experience with home O2. Of those, 46% see patients on postdischarge day 1. Most providers see patients 1 to 3 times before stopping O2. Eighty percent continue O2 for 3 to 7 days. Weaning procedures vary and 56% practice more than 1 method. Most (41%) do not use continuous pulse oximetry. Challenges include parental noncompliance (51%) and difficulty knowing when to stop the O2 (57%). Conclusions. Management of home O2 in patients with bronchiolitis is a common in UT and CO. Weaning practices vary. Further research is needed. [ABSTRACT FROM PUBLISHER]

This article uses comparative analyses of both US and EU regulations to understand the evolution of Indian policies aimed at regulating genetically engineered agriculture (primarily cotton). India initially borrowed extensively from OECD regulations, predictably emphasizing human health and environmental impacts. Over time, however, India's biosafety regulations have evolved to reflect the twin imperatives of development and democracy. India expanded biosafety initially to address the economic security of farmers and later, and to a lesser extent, to increase citizen participation and consultation. Much of this reconstitution has been realized through public interest litigation critical of agri-biotech regulation brought about by urban civil society groups, a legal tool that may no longer be applied under India's proposed National Biotechnology Regulatory Authority. [ABSTRACT FROM AUTHOR]

The article focuses on the teaching of geography in the Australian Capital Territory (ACT). Geography has been integrated into the Studies of Society and Environment (SOSE) in the current school curriculum of ACT. The key learning areas of SOSE would include anthropology, ecology, history, multicultural studies, sociology and others. Each subject in the SOSE is considered as a separate unit and the quantity of time allocated varies according to governmental and non-governmental schools. The quality of secondary level geography curriculum has been improved with the help of integrated technologies and geographic information systems.

The effect of Lactobacillus acidophilus on the growth of Candida albicans and Escherichia coli was investigated in the presence of aqueous extract of garlic. L. acidophilus , a homofermentative organism, produced lactic acid that lowered the pH of the culture medium, resulting in a reduction in numbers of C. albicans and E. coli in mixed culture. When the extract of garlic was added at a concentration of 2.56 μg total thiosulphinate/ml for C. albicans in mixed culture and at a concentration of 5.12 μg total thiosulphinate/ml for E. coli in mixed culture, the reduction in cell numbers of both C. albicans and E. coli was accelerated. After 4 h no C. albicans cells were countable, while E. coli cells were absent after 24 h. Several commercial preparations of garlic, which included oil macerates, pastes, tablets and powders, were examined for their anticandidal activity and for their ability to inhibit platelet aggregation. The activity of the preparations was assayed by determining the concentration of total thiosulphinates present in each brand. Only the garlic tablet formulation exhibited good anticandidal and antiplatelet activity, whereas all the other preparations possessed virtually no anticandidal and antiplatelet properties. [ABSTRACT FROM AUTHOR]

Discusses the effect of cardiac arrest on the brain of patients in the U.S. Importance of preserving the function of the brain; Details on the primary goal of all cardiopulmonary resuscitation; Association of cognitive dysfunction with global cerebral atrophy. INSET: Nursing Interventions..

The author narrates her experience of writing for the newsletter of the American Association of Critical Care Nurses (AACN) for the first time. One day in early 2002, while browsing through the newsletter, she happened upon the call for applications to the 2003 AACN-Wyeth Nursing Fellows Program. The author decided to apply. Upon submission, the manuscript was sent out for peer review, and she heard nothing for three months. The peer reviewers, all critical care experts, dissected the manuscript down to the bone to determine whether it was accurate and reflected current practice and research. The author felt the spirit of her hard work had been annihilated when her original eight word title was edited down to four words, "Postresuscitation Management: Creating a Nonhostile Brain Environment" became "Cardiac Arrest: Postresuscitation Management." INSET: What's she doing in coach?.

Kathleen Duffy, an Irish nurse a, who is also an adjunct professor of botanical medicine at Springfield Technical Community College in Massachusetts, first learned of the plight of the Chernobyl children in March 2000. She read an article about Irish carpenters who built a solarium for an orphanage in Belarus for children so adversely affected by radiation caused birth defects that they are too fragile to go outside. Duffy, outraged that these children never enjoyed sunshine, vowed to become involved.

The objective of this study is to determine predictors of resource use among pediatric providers for common respiratory illnesses. We surveyed pediatric primary care, emergency department (ED)/urgent care (UC), and hospital medicine providers at a free-standing children's hospital system. Five clinical vignettes assessed factors affecting resource use for upper respiratory infections, bronchiolitis, and pneumonia, including provider-type, practice location, tolerance to uncertainty, and medical decision-making behaviors. The response rate was 75.3% (168/223). The ED/UC and primary care providers had higher vignette scores, indicating higher resource use, compared with inpatient providers; advanced practice providers (APPs) had higher vignette scores compared with physicians. In multivariate analysis, being an ED/UC provider, an APP, and greater concern for bad outcomes were associated with higher vignette scores. Overall, provider type and location of practice may predict resource use for children with respiratory illnesses. Interventions targeted at test-maximizing providers may improve quality of care and reduce resource burden. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Describe the clinical presentation, prevalence of concurrent serious bacterial infection (SBI), and outcomes among infants with omphalitis. METHODS: Within the Pediatric Emergency Medicine Collaborative Research Committee, 28 sites reviewed records of infants ≤90 days of age with omphalitis seen in the emergency department from January 1, 2008, to December 31, 2017. Demographic, clinical, laboratory, treatment, and outcome data were summarized. RESULTS: Among 566 infants (median age 16 days), 537 (95%) were well-appearing, 64 (11%) had fever at home or in the emergency department, and 143 (25%) had reported fussiness or poor feeding. Blood, urine, and cerebrospinal fluid cultures were collected in 472 (83%), 326 (58%), and 222 (39%) infants, respectively. Pathogens grew in 1.1% (95% confidence interval [CI], 0.3%-2.5%) of blood, 0.9%(95%CI, 0.2%-2.7%) of urine, and 0.9%(95% CI, 0.1%-3.2%) of cerebrospinal fluid cultures. Cultures from the site of infection were obtained in 320 (57%) infants, with 85% (95% CI, 80%-88%) growing a pathogen, most commonly methicillin-sensitive Staphylococcus aureus (62%), followed by methicillin-resistant Staphylococcus aureus (11%) and Escherichia coli (10%). Four hundred ninety-eight (88%)were hospitalized, 81 (16%) to an ICU. Twelve (2.1%[95%CI, 1.1%-3.7%]) had sepsis or shock, and 2 (0.4% [95% CI, 0.0%-1.3%]) had severe cellulitis or necrotizing soft tissue infection. There was 1 death. Serious complications occurred only in infants aged<28 days. CONCLUSIONS: In this multicenter cohort, mild, localized disease was typical of omphalitis. SBI and adverse outcomes were uncommon. Depending on age, routine testing for SBI is likely unnecessary in most afebrile, well-appearing infants with omphalitis. [ABSTRACT FROM AUTHOR]

The objectives of this study were to estimate prevalence, heritability and genetic correlations of congenital sensorineural deafness (CSD) and pigmentation phenotypes in the Border Collie. Entire litters of Border Collies that presented to the Animal Health Trust (1994-2008) for assessment of hearing status by brain stem auditory evoked response (BAER) at 4-10 weeks of age were included. Heritability and genetic correlations were estimated using residual maximum likelihood (REML). Of 4143 puppies that met the inclusion criteria, 97.6g had normal hearing status, 2.0% were unilaterally deaf and 0.4g were bilaterally deaf. Heritability of deafness as a trichotomous trait (normal/unilaterally deaf/bilaterally deaf) was estimated at 0.42 using multivariate analysis. Genetic correlations of deafness with iris colour and merle coat colour were 0.58 and 0.26, respectively. These results indicate that there is a significant genetic effect on CSD in Border Collies and that some of the genes determining deafness also influence pigmentation phenotypes. [ABSTRACT FROM AUTHOR]

Objective--To estimate the heritability of atopic dermatitis in Golden and Labrador Retrievers. Animals--429 dogs related to 13 dogs with atopic dermatitis. Procedure--Atopic dermatitis was defined on the basis of the type and frequency of clinical signs recorded in the clinical records, and each dog was classified with atopic dermatitis or probable atopic dermatitis or as nonatopic. By use of data from atopic and nonatopic dogs, regression analyses of parental status on offspring status were performed to estimate heritability. Results--There was no difference in the frequency of atopic dermatitis between sexes or between breeds. There was a marked association between the atopic status of the parent and that of the offspring, particularly for sires. By use of data from 32 litters in which the status of both parents was known and considering only those dogs classified with atopic dermatitis or as nonatopic, the heritability (± SE) of atopic dermatitis was estimated to be 0.47 (± 0.17). Conclusions and Clinical Relevance--Atopic dermatitis has a strong genetic component, and breeding of dogs with clinical signs of atopic dermatitis should be discouraged. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Describe the clinical presentation, prevalence, and outcomes of concurrent serious bacterial infection (SBI) among infants with mastitis. METHODS: Within the Pediatric Emergency Medicine Collaborative Research Committee, 28 sites reviewed records of infants aged #90 days with mastitis who were seen in the emergency department between January 1, 2008, and December 31, 2017. Demographic, clinical, laboratory, treatment, and outcome data were summarized. RESULTS: Among 657 infants (median age 21 days), 641 (98%) were well appearing, 138 (21%) had history of fever at home or in the emergency department, and 63 (10%) had reported fussiness or poor feeding. Blood, urine, and cerebrospinal fluid cultures were collected in 581 (88%), 274 (42%), and 216 (33%) infants, respectively. Pathogens grew in 0.3% (95% confidence interval [CI] 0.04-1.2) of blood, 1.1% (95% CI 0.2-3.2) of urine, and 0.4% (95% CI 0.01-2.5) of cerebrospinal fluid cultures. Cultures from the site of infection were obtained in 335 (51%) infants, with 77% (95% CI 72-81) growing a pathogen, most commonly methicillin-resistant Staphylococcus aureus (54%), followed by methicillin-susceptible S aureus (29%), and unspecified S aureus (8%). A total of 591 (90%) infants were admitted to the hospital, with 22 (3.7%) admitted to an ICU. Overall, 10 (1.5% [95% CI 0.7-2.8]) had sepsis or shock, and 2 (0.3% [95% CI 0.04-1.1]) had severe cellulitis or necrotizing soft tissue infection. None received vasopressors or endotracheal intubation. There were no deaths. CONCLUSIONS: In this multicenter cohort, mild localized disease was typical of neonatal mastitis. SBI and adverse outcomes were rare. Evaluation for SBI is likely unnecessary in most afebrile, well-appearing infants with mastitis. [ABSTRACT FROM AUTHOR]

Background: Pharmacological management of migraine can be ineffective for some patients. We previously demonstrated that exposure to green light resulted in antinociception and reversal of thermal and mechanical hypersensitivity in rodent pain models. Given the safety of green light emitting diodes, we evaluated green light as a potential therapy in patients with episodic or chronic migraine. Material and methods: We recruited (29 total) patients, of whom seven had episodic migraine and 22 had chronic migraine. We used a one-way cross-over design consisting of exposure for 1–2 hours daily to white light emitting diodes for 10 weeks, followed by a 2-week washout period followed by exposure for 1–2 hours daily to green light emitting diodes for 10 weeks. Patients were allowed to continue current therapies and to initiate new treatments as directed by their physicians. Outcomes consisted of patient-reported surveys. The primary outcome measure was the number of headache days per month. Secondary outcome measures included patient-reported changes in the intensity and frequency of the headaches over a two-week period and other quality of life measures including ability to fall and stay asleep, and ability to perform work. Changes in pain medications were obtained to assess potential reduction. Results: When seven episodic migraine and 22 chronic migraine patients were analyzed as separate cohorts, white light emitting diodes produced no significant change in headache days in either episodic migraine or chronic migraine patients. Combining data from the episodic migraine and chronic migraine groups showed that white light emitting diodes produced a small, but statistically significant reduction in headache days from (days ± SEM) 18.2 ± 1.8 to 16.5 ± 2.01 days. Green light emitting diodes resulted in a significant decrease in headache days from 7.9 ± 1.6 to 2.4 ± 1.1 and from 22.3 ± 1.2 to 9.4 ± 1.6 in episodic migraine and chronic migraine patients, respectively. While some improvement in secondary outcomes was observed with white light emitting diodes, more secondary outcomes with significantly greater magnitude including assessments of quality of life, Short-Form McGill Pain Questionnaire, Headache Impact Test-6, and Five-level version of the EuroQol five-dimensional survey without reported side effects were observed with green light emitting diodes. Conclusions regarding pain medications reduction with green light emitting diode exposure were not possible. No side effects of light therapy were reported. None of the patients in the study reported initiation of new therapies. Discussion: Green light emitting diodes significantly reduced the number of headache days in people with episodic migraine or chronic migraine. Additionally, green light emitting diodes significantly improved multiple secondary outcome measures including quality of life and intensity and duration of the headache attacks. As no adverse events were reported, green light emitting diodes may provide a treatment option for those patients who prefer non-pharmacological therapies or may be considered in complementing other treatment strategies. Limitations of this study are the small number of patients evaluated. The positive data obtained support implementation of larger clinical trials to determine possible effects of green light emitting diode therapy. This study is registered with clinicaltrials.gov under NCT03677206. [ABSTRACT FROM AUTHOR]

Congenital deafness in the domestic dog is usually related to the presence of white pigmentation, which is controlled primarily by the piebald locus on chromosome 20 and also by merle on chromosome 10. Pigment-associated deafness is also seen in other species, including cats, mice, sheep, alpacas, horses, cows, pigs, and humans, but the genetic factors determining why some piebald or merle dogs develop deafness while others do not have yet to be determined. Here we perform a genome-wide association study (GWAS) to identify regions of the canine genome significantly associated with deafness in three dog breeds carrying piebald: Dalmatian, Australian cattle dog, and English setter. We include bilaterally deaf, unilaterally deaf, and matched control dogs from the same litter, phenotyped using the brainstem auditory evoked response (BAER) hearing test. Principal component analysis showed that we have different distributions of cases and controls in genetically distinct Dalmatian populations, therefore GWAS was performed separately for North American and UK samples. We identified one genome-wide significant association and 14 suggestive (chromosome-wide) associations using the GWAS design of bilaterally deaf vs. control Australian cattle dogs. However, these associations were not located on the same chromosome as the piebald locus, indicating the complexity of the genetics underlying this disease in the domestic dog. Because of this apparent complex genetic architecture, larger sample sizes may be needed to detect the genetic loci modulating risk in piebald dogs. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. METHODS: This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis. The team used a multidisciplinary kickoff event to understand the problem and develop interventions, including sharing provider-specific data and asking providers to sign a pledge to reduce use. We used a novel, real-time data dashboard to collect and analyze data. RESULTS: Special cause variation on control charts indicated improvement for all outcomes for inpatients during the intervention season. Pre- and postanalyses in which we compared baseline to intervention values for all admitted patients and patients who were discharged from the emergency department or urgent care revealed a significant reduction in the ordering of chest radiographs (from 22.7% to 13.6%; P ≤ .001), respiratory viral testing (from 12.5% to 9.8%; P = .001), and bronchodilators (from 17.5% to 10.3%; P = .001) without changes in balancing measures (eg, hospital readmission within 7 days [1.7% (preanalysis) and 1.0% (postanalysis); P = .21]) for bronchiolitis. CONCLUSIONS: This multidisciplinary improvement initiative resulted in a significant reduction in use for bronchiolitis care at our institution. Our approach, which included a novel, real-time data dashboard and interventions such as individual providers pledging to reduce use, may have the potential to reduce overuse in other settings and diseases. [ABSTRACT FROM AUTHOR]

Background Episodic muscular hypertonicity in Norwich terrier dogs was first reported in a brief communication in 1984. Since then, the condition has remained poorly characterized. Objectives The aims of this study were to characterize the phenomenology, clinical course, and family history of paroxysmal dyskinesia in the Norwich terrier and to estimate its prevalence in the United Kingdom. Methods The owners of Norwich terrier dogs born since January 1, 2000 were invited to complete a specifically designed questionnaire aimed at identifying affected and unaffected dogs and investigating the clinical characteristics of this paroxysmal dyskinesia. Pedigrees were collected and reviewed. Results The questionnaire was returned for 198 Norwich terrier dogs. Of these, 26 (13%) were classified as affected by paroxysmal dyskinesia after revision of the questionnaires and after obtaining videos of the episodes, veterinary medical records, and telephone interviews with the owners. All dogs were neurologically normal between episodes. No significant abnormalities were detected on diagnostic investigations. Mean age at the first episode was 3 years. The episodes were characterized by sustained muscular hypertonicity in the pelvic limbs, lumbar region, and thoracic limbs, impairing posture and locomotion without loss of consciousness. Episode frequency varied both between and within individuals. Stress, anxiety, excitement, and variation in daily routine were recognized as episode triggers in 13 dogs. Episode duration generally was from 2 to 5 minutes (range, from < 2 to 30 minutes). The majority of affected dogs were related. Conclusions Paroxysmal dyskinesia segregates in an extended pedigree of Norwich terrier dogs and thus is potentially an inherited disorder in this breed. [ABSTRACT FROM AUTHOR]