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OBJECTIVE To describe the anatomic structures of the canine middle ear visible during endoscopic examination through ventral and lateral surgical approaches. SAMPLE 5 cadaveric canine heads representing 4 breeds. PROCEDURES A descriptive study was performed. For each head, a lateral approach was performed on one side and a ventral approach was performed on the opposite side. Images were obtained with a 2.7-mm, 30° telescope. RESULTS Captured images were reviewed, and anatomic structures visualized through the lateral and ventral approaches were identified. The optimal approach, telescope position, and light post orientation to identify each anatomic structure were subjectively determined. CLINICAL RELEVANCE Middle ear evaluation with a telescope was technically straightforward and allowed identification of middle ear structures not typically visible with an open surgical approach. Findings may serve as an anatomic reference guide for future video-assisted surgical procedures of the middle ear. A better understanding of the location of anatomic structures in the middle ear may help to prevent unnecessary damage to fragile middle ear structures, such as nerves or blood vessels, during surgical procedures.

To assess the feasibility and mechanical stability of sacroiliac (SI) joint stabilization using 2 short 3.5 mm cortical screws, each spanning an average of 23% of the width of the sacral body.Cadaveric experimental study.Twenty-four canine pelvis specimens.Pelvis specimens were prepared by disarticulation of the left SI joint and osteotomy of the left pubis and left ischium, and stabilized using a single long lag screw (LLS), 2 short lag screws (SLS) or 2 short positional screws (SPS). Computed tomography (CT) imaging was used to determine standardized screw lengths for each group and was repeated following implant insertion. Specimens were secured within a servohydraulic test frame and loaded through the acetabulum to simulate weight bearing under displacement control at 4 mm/min for 20 mm total displacement. Group mechanical testing data were compared.Peak load, yield load, and stiffness were more than 2 times greater in both the SLS and SPS groups when compared with the LLS group. No mechanical difference was identified between the short-screw groups.Sacroiliac luxation fixation using 2 short screws created a stronger, stiffer construct when compared with fixation using a single lag screw spanning 60% of the width of the sacral body. No mechanical advantage was observed between short screws inserted in positional vs. lag fashion.Sacroiliac luxation fixation using 2 short screws creates a mechanically superior construct with a larger region of acceptable implant positioning and potentially reduced risk of iatrogenic injury compared with conventional fixation.

The dispersion and influence of soluble and particulate trace elements (TEs) present in the materials from abandoned mines is an imminent problem on terrestrial and aquatic environments. The goal of this research is to provide a broader view of such transport, assessing particle size distribution and TE interactions (e.g., scavenging) with mine tailings and locally derived sediments transported by water in arid region. Sand grains from wash sediment were collected from a dry ephemeral wash in Nelson, Nevada where the Techatticup Mine and Mill worked between 1850 and 1960. Samples were evaluated to determine the association and behavior of certain metals and metalloids including aluminum, arsenic, barium, cadmium, copper, chromium, iron, manganese, lead, selenium, vanadium, and zinc to rock varnish laminated sediments. Results show that some metals and metalloids were more concentrated on larger particles whereas others indicated the opposite tendency. For example, As was greatest on silt fractions and least on coarse fractions, while Se was detected only on silts. Cr, Cu, Fe, Mn, Pb, and Zn concentrations all increased with decreasing particle size (silt > sand > coarse), whereas Al, Ba, and V showed the opposite trend (silt

The prevalence of sexual assault cases and increasingly sensitive DNA analysis methods have resulted in sexual assault kit backlogs in the United States. Although traditional DNA extraction and purification utilizing detergents, proteinase K, and DTT have been the primary technique for lysing sperm cell fractions from these samples, it is labor-intensive and inefficient regarding time and sperm DNA recovery - hindering the ability of forensic analysts to keep pace with evidence submissions. Thus, this study examined seven alternative sperm cell lysis techniques to develop a method that could efficiently lyse sperm and consistently generate high-quality profiles while also reducing time, labor, and cost requirements. Microscopic examination of lysates indicated only Casework Direct and alkaline techniques could lyse all spermatozoa within samples, while quantification results demonstrated all methods performed comparably to the control method of forensicGEM™ Sperm (p 0.06). Amplification with 0.25 ng DNA revealed that unpurified lysates from Casework Direct, alkaline, and NP-40 techniques produced DNA profiles with acceptable mean STR peak heights and interlocus balance, both of which were similar to or better than the control. Overall, this study demonstrated the ability of Casework Direct, alkaline, and NP-40 methods to efficiently lyse spermatozoa and provide high-quality STR profiles despite the absence of a purification step. Ultimately, based on the data reported herein, alkaline lysis is the recommended alternative sperm lysis approach given its ability to generate high-quality profiles, save time, and decrease the cost per reaction when compared to traditional sperm cell lysis methods.

Rapid serial visual presentation (RSVP) tasks have been frequently used to assess attentional control in psychiatric samples; however, it is unclear whether RSVP tasks exhibits the psychometric properties necessary to assess these individual differences. In the current study, we examined the reliability and validity of single-target computerized RSVP task outcomes in a sample of 63 participants with moderate to severe psychiatric illness. At the group level, we observed the classical attentional blink phenomenon. At the individual level, conventional indices of attentional blink magnitude exhibited poor internal consistency. We empirically evaluated a novel index for assessing attentional blink magnitude using a single-target RSVP task that involves collapsing across experimental trials in which the attentional blink phenomenon occurs and disregarding performance on control trials, which suffer from ceiling effects. We found that this new index resulted in much improved reliability estimates. Both novel and conventional indices provided evidence of convergent validity. Consequently, this novel index may be worth examining and adopting for researchers interested in assessing individual differences in attentional blink magnitude.

OBJECTIVE To determine whether muscle-sparing laryngoplasty results in fewer changes in swallowing function compared to standard surgical treatment for laryngeal paralysis. ANIMALS 12 clinically normal sexually intact male Beagles. PROCEDURES Group A dogs (n = 4) had a standard approach to the larynx, with left arytenoid cartilage lateralization. Group B dogs (n = 4) had a muscle-sparing laryngoplasty performed with the thyropharyngeus muscle fibers bluntly separated, and the cricoarytenoideus dorsalis muscle spared. Pre- and 24-hour postoperative fluoroscopic swallowing studies were performed and graded. Larynges were harvested after humane euthanasia, and glottic area was measured. Group C dogs (n = 4) acted as controls, with surgical dissection ending lateral to the thyropharyngeus muscle, arytenoid lateralization not performed, and the dogs not euthanized. The study was performed between October 15, 2011 and May 15, 2021. RESULTS Changes in pharyngeal and upper esophageal sphincter function were not detected in any group. There was no difference in glottic area between treatment groups. Aspiration of liquid was not a consistent finding. Two dogs in each treatment group developed moderate to severe cervical esophageal paresis. This did not occur in control dogs. CLINICAL RELEVANCE We found no evidence to support our hypothesis that muscle-sparing laryngoplasty results in less severe changes in swallowing function compared to a standard technique. The cervical esophageal paresis identified in both treatment groups could increase the risk of postoperative aspiration pneumonia in dogs treated for laryngeal paralysis via a lateral approach to the larynx. Further study to determine the frequency, cause, and duration of esophageal dysfunction is warranted.

Intraindividual change over time is commonly used to estimate treatment effectiveness. However, patients may not respond similarly to a scale after treatment, rendering pre–post change an unreliable metric. The current objective was to investigate longitudinal measurement invariance of the Patient Health Questionnaire–9 and Generalized Anxiety Disorder Scale–7 among 4,323 patients completing a partial hospital program. We used confirmatory factor analysis to determine (1) factor structure at pretreatment and posttreatment and (2) longitudinal invariance, accounting for dependent observations, using both classical and approximate measurement invariance approaches. Results indicated a two-factor solution for both scales. Longitudinal invariance was not established for either scale, thus, using raw score differences from the Patient Health Questionnaire–9 and Generalized Anxiety Disorder Scale–7 for measuring symptom change over time may be problematic. The most longitudinally consistent items captured somatic as opposed to affective/cognitive symptoms. We discuss the potential use of these measures for diagnostic screening and between-group comparisons and suggest alternative ways to monitor client progress over time. Limitations included a majority White sample and uniqueness of a partial hospital setting.

Karanvir S Aulakh,1 Mandi J Lopez,1 Caleb Hudson,2 Lorrie Gaschen,1 Michelle Fabiani,2 Brian Beale,2 Frank M Andrews,1 Chin-Chi Liu,1 Jimmy Lattimer3 1School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA; 2Gulf Coast Veterinary Specialists, Houston, TX, USA; 3College of Veterinary Medicine, University of Missouri, Columbia, MO, USACorrespondence: Karanvir S AulakhSchool of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, 70803, USATel +1 217-722-2937Email kaulakh@lsu.eduPurpose: To evaluate the clinical effects of an intra-articular injection of 117mSn-colloid for management of canine grade 1 or 2 elbow osteoarthritis (OA).Patients and Methods: This was a prospective study in 23 dogs with grade 1 or 2 elbow OA. An orthopedic examination and elbow radiographs were performed to confirm the presence of OA. Dogs were randomly assigned to receive unilateral intra-articular (IA) injection of low-dose (LD: 1.0mCi, n =8), medium-dose (MD: 1.75mCi, n =6), or high-dose (HD: 2.5mCi, n =9) of 117mSn-colloid. The primary outcome measure was peak vertical force (PVF) from force-plate gait analysis and secondary outcome measures included the Canine Brief Pain Inventory score (CBPI) and elbow goniometry. The CBPI was evaluated at pretreatment and then monthly post treatment for 1 year, and goniometry and PVF were evaluated at pretreatment, and at 1, 3, 6, 9 and 12 months post treatment.Results: PVF improved at 3, and 9 months compared to pretreatment values in the HD group. CBPI scores improved at most of the time points in all dose groups. There was no significant difference in elbow goniometry between treated and untreated elbows. There were no self-reports of any adverse effects of the injection by the owners and none were noted by the examining veterinarian at the time of regularly scheduled re-evaluations.Conclusion: 117mSn IA injection was free of any obvious adverse effects, improved CBPI scores, and increased weight bearing in limbs with elbow OA providing preliminary evidence that 117mSn may be beneficial in the management of elbow OA in dogs. Although 17mSn appeared to be effective for management of elbow OA in these dogs, this pilot study has inherent limitations; therefore, future studies with larger numbers and with placebo group are needed.Keywords: osteoarthritis, Radiosynoviorthesis, Tin-117m (117mSn), CBPI, goniometry, peak vertical force

Introduction Preliminary evidence suggests dialectical behaviour therapy (DBT) may be beneficial for persons with intellectual disabilities. This pilot randomized controlled trial aimed to determine the feasibility of adapted DBT for adults with intellectual disabilities and co-morbid psychiatric disorders in the community. Methods An adapted DBT programme (aDBT-ID) was delivered to adults with mild-to-moderate intellectual disability (n = 20) and their caregivers (n = 20). A single-blind, mixed-methods design was employed with treatment (n = 10) and control (n = 10). In addition to feasibility, pre-post-measures of emotional regulation, anger and mental health were taken from clients and caregivers. Results Results suggest it was feasible and beneficial to deliver adapted DBT in the community. Qualitative findings found both participants and caregivers were satisfied with the treatment delivery. No differences between conditions were found. Conclusion This pilot study highlights the feasibility of adapted DBT for individuals with intellectual disabilities and the practicalities of delivering community-based inclusive research.

Social Networking Sites (SNS) have close to 3 billion users worldwide. Recently, however, SNS have come under media scrutiny for their potential association with depression. Two previous meta-analyses failed to find evidence for a robust concurrent association between SNS use and depression symptoms. However, these analyses focused primarily on the time spent using SNS. The current meta-analysis is the first to consider the multi-dimensional nature of SNS use, and examines separately the quantitative associations of depression symptoms to SNS use in three types of SNS studies examining three distinct constructs of SNS use: time spent using SNS, intensity of SNS use, and problematic SNS use. Sixty-two studies (N = 451, 229) met inclusion criteria. Depression symptoms were significantly, but weakly, associated with time spent using SNS (r = 0.11) and intensity of SNS use (r = 0.09). However, the association of depression symptoms to problematic SNS use was moderate (r = 0.29), was significantly higher than for time spent using SNS (Qbetween = 35.85, p

Despite a proliferation of virtual partial hospital programs (PHP) during the COVID-19 pandemic, there is a dearth of research on such programs. In the current study, we compared treatment outcomes and patient satisfaction between an in-person and a virtual PHP. Further, we examined patients' qualitative feedback about the virtual PHP.Participants included 282 patients attending a virtual PHP during the COVID-19 pandemic and 470 patients attending an in-person PHP one year prior. Patients completed daily measures of symptom severity, and post-treatment measures of patient satisfaction and treatment outcomes. Patients in the virtual PHP provided feedback about virtual care. Quantitative data were analyzed using multilevel modeling, and qualitative data were analyzed using the principles of inductive analysis.Patients experienced a reduction in depression (Our results suggest that virtual PHPs should be explored as an ongoing model of care that may help to systematically reduce barriers to accessing mental health services.

Background An osteotomy procedure option for stabilization of the CrCL deficient stifle is the Center of Rotation of Angulation (CORA) Based Leveling Osteotomy (CBLO). The CBLO procedure involves a proximal tibial plateau leveling osteotomy based on the magnitude of the CORA. Correction of the CORA magnitude results in the desired postoperative tibial plateau angle (TPA) without secondary translation. If translation is prevented, the amount of bone contact across the osteotomy is maximized. This coupled with the ability to apply compression across the osteotomy with a cannulated compression screw (CCS) and tension band increases the strength of the construct. The objectives of this descriptive case series is to assess osseous bridging of the osteotomy at 35 days following a CBLO stabilized with a bone plate, CCS, and tension band. A second objective is to determine if there is a shift of the postoperative TPA when compared to TPA at final radiographic evaluation. Results Forty-seven dogs (49 stifles) met the inclusion criteria. Multiple breeds were represented with a mean age of 6 years and mean body mass of 32kg. All dogs had incompetent partial or complete CrCL tears. There was approximately 50% incidence of medial meniscal pathology with remaining intra-articular structures appearing normal. No intraoperative complications occurred; there were two postoperative complications including a late onset medial meniscal tear and an implant removal due to infection. At a mean time of 35 days (range 25–39 days) postoperatively, osseous bridging of the osteotomy was Grade 4 in 38 stifles (78%) and Grade 3 in 11 stifles (22%). There was no difference between postoperative TPA and final TPA. Conclusions Stabilization of a CBLO osteotomy with a bone plate, CSS, and tension band resulted in the majority of dogs (78%) exhibiting Grade 4 healing and the remainder of dogs (22%) showing Grade 3 healing of the osteotomy at a median of 35 days (range 25days to 39 days) postoperatively. Further, there was no TPA shift recognized at final radiographic assessment.

Teenage dating abuse, rape, and violence are considered major public health problems that affect the lives of millions of teenagers in the United States. Dermatologists have traditionally become involved in these cases when confronted with patients who have unexplained bruising or other skin injuries and/or sexually transmitted diseases that raise the possibility that they could be victims of sexual abuse and violence. This contribution explores the role of the dermatologist in the diagnosis and management of teen dating abuse. We suggest some screening questions that might help to broach these serious issues with teen patients when the suspicion of dating abuse arises. We also provide a list of resources and hotlines that offer advice on how best to handle teen dating abuse. Some legal issues concerning the physician's role in managing teen dating abuse, rape, and violence are also discussed.

DNA extractions of semen samples commonly utilize dithiothreitol (DTT) to reduce and disrupt disulfide bonds. Although traditional extraction techniques remove DTT before downstream analyses, the forensic DNA community has recently explored Y-screening, direct amplification, and direct cell lysis assays that omit purification but employ reducing agents to lyse spermatozoa. This study examined the impact of residual DTT on downstream processes involving fluorescent dyes. Quantification using Investigator® Quantiplex HYres revealed a significant increase in the male DNA yield (p = 0.00056) and a >150,000,000-fold increase in the male:human DNA ratio when DTT remained in extracts versus when it was filtered out using a traditional purification method. When DTT was present with Quantifiler™ Trio, the true mean DNA yield for the large autosomal target significantly increased (p = 0.038) and the average reported DNA yields increased 1.1-fold, >9.5-fold, and 1.3-fold for the small autosomal, large autosomal, and male targets, respectively. DTT-spiked DNA standards from both kits were impacted similarly to samples with residual DTT, demonstrating that observed effects were related to DTT and not the extraction method. This study corroborates other reports that DTT adversely affects multiple dyes (e.g., Cy5, Quasar 670, SYBR Green I, TMR, and Mustang Purple® ). Overall, DTT causes inaccurate quantities and, consequently, inaccurate calculated male:female ratios when used in conjunction with these kits. Thus, implementation of newer direct-to-PCR assays incorporating DTT should either be avoided or used only with carefully evaluated, compatible dyes.

Objective The aim of this study was to retrospectively evaluate the clinical application of the Fixin mini 1.9 to 2.5 system for the treatment of long bone fractures in cats. We proposed that the Fixin mini system would successfully stabilize long bone fractures in cats with a healing time and complication rate similar to those previously reported for feline fractures using other locking bone plate systems. Materials and Methods Medical records and radiographs of cats with long bone fractures stabilized with the Fixin mini 1.9 to 2.5 system were retrospectively reviewed. Signalment, body weight, bone(s) fractured, region of bone fractured, fracture classification, concurrent orthopaedic injuries, complications, time to functional union, if minimally invasive plate osteosynthesis techniques were used, plate size, number of plates, bone graft use and ancillary methods of fixation were recorded. Results Fifty-six fractures in 54 cats were included. Mean time to radiographic union was 8.8 weeks. Complications were recorded in 8 out of 56 fractures. Major complications occurred in 4 of 56 fractures and minor complications occurred in 4 of 56 fractures. Conclusion The Fixin mini 1.9 to 2.5 system had an overall complication rate and time to functional union similar to that of other implant systems used to treat feline long bone fractures and it appears suitable for repair of a wide variety of long bone fracture configurations in cats.

To evaluate the effect of sedation or general anesthesia (GA) on elbow goniometry and thoracic limb circumference (TLC) measurements in dogs with elbow osteoarthritis (OA).Prospective study.Twenty-four client-owned dogs with radiographically confirmed elbow OA.Elbow goniometry and TLC measurements were made before and after either sedation or GA by using a hand-held goniometer and spring tension measuring tape, respectively. Observers were not allowed to review their pre-sedation or pre-GA measurements at the time of obtaining measurements on dogs under sedation or GA. Mixed analysis of variance models were used to compare elbow goniometry and TLC measurements before and after sedation or GA.Eleven and thirteen dogs were included in the sedation and GA groups, respectively. Mean elbow flexion decreased by 5° and 3° and mean elbow extension increased by 6° and 2° under sedation and GA, respectively. Total range of motion increased by 11° under sedation and by 5° under GA. Each of these changes was statistically significant (P .05) except elbow extension under GA (P = .129). Sedation and GA did not influence TLC measurements (P .05).Sedation or GA led to slight and similar increase in elbow flexion and extension but did not influence TLC measurements in dogs with elbow OA.Sedation or GA can cause slight alterations to goniometric measurements in canine elbows with OA. The protocols used in this study for sedation and GA seem interchangeably acceptable for goniometry and TLC measurements in dogs with elbow OA.

Cases of nontuberculous Mycobacterium (NTM) are on the rise across North America. This is the first clinical description of a 31-year old male patient in North America with Mycobacterium kansasii who met DSM-5 diagnostic criteria for anorexia nervosa (AN) and obsessive compulsive disorder (OCD), and who was engaged in specialized outpatient treatment of an eating disorder. The patient did not disclose at intake assessment that he was experiencing symptoms of a persistent cough, blood in his sputum, or that he was simultaneously being assessed outside of the eating disorders program for NTM until he had a positive smear for Mycobacterium kansasii in March 2017. The patient made progress in treatment in his weight status and some psychological symptoms despite the concurrent NTM symptoms. However, later treatment attendance was negatively impacted by the side effects of his medication regime for NTM and careful follow-up was required to monitor for potential interactions between his treatment for NTM and psychiatric medication. This case report provides an initial window into clinicians' ability to treat a patient with a concurrent eating disorder and an NTM infection and lessons learned in the process. LEVEL OF EVIDENCE: Level V: Opinions of respected authorities, based on descriptive studies, clinical experience, or reports of expert committees.

The Reading the Mind in the Eyes task (RMET; Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001) is commonly used to assess theory of mind abilities in adults. In the task, participants pair one of four mental state descriptors with a picture of the eye region of a face. The items have varying emotional valence, and nearly 100 studies have examined whether performance on this task varies with item valence. However, efforts to address this question have been hampered by cross-study inconsistencies in how item valence is assessed. Thus, the goal of this study was to establish reference ratings for the valence of RMET items. In Study 1, we recorded valence ratings for each RMET item with a large sample of raters (n = 164). We illustrated how valence categories are essentially arbitrary and largely influenced by sample size. In addition, valence ratings were continuously distributed, further questioning the validity of imposing categorical distinctions. In Study 2, we used an archival dataset to demonstrate how the different categorization schemes resulted in conflicting conclusions about the association between item valence and RMET performance. However, when we examined the association between item valence and performance in a continuous manner, a clear U-shaped pattern emerged: Items that had more extreme valence ratings (negative or positive) were associated with better performance than items with more neutral ratings. We conclude that using the item valence ratings we report, and treating item valence as a continuous rather than categorical predictor, will help bring consistency to the study of the association between item valence and performance in the RMET. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Minimally invasive plate osteosynthesis (MIPO) is a biologically friendly approach to fracture reduction and stabilization that is applicable to many radius and ulna fractures in small animals. An appropriate knowledge of the anatomy of the antebrachium and careful preoperative planning are essential. This article describes the MIPO technique, which entails stabilization of the fractured radius with a bone plate and screws that are applied without performing an extensive open surgical approach. This technique results in good outcomes, including a rapid time to union and return of function.

BackgroundSARS-CoV-2 can spread rapidly on maritime platforms. Several outbreaks of SARS-CoV-2 have been reported on warships at sea, where transmission is facilitated by living and working in close quarters. Core components of infection control measures such as social distancing, patient isolation and quarantine of exposed persons are extremely difficult to implement. Whole genome sequencing (WGS) of SARS-CoV-2 has facilitated epidemiological investigations of outbreaks, impacting on outbreak management in real time by identifying transmission patterns, clusters of infection and guiding control measures. We suggest such a capability could mitigate against the impact of SARS-CoV-2 in maritime settings.MethodsWe set out to establish SARS-CoV-2 WGS using miniaturised nanopore sequencing technology aboard the Royal Fleet Auxiliary ARGUS while at sea. Objectives included designing a simplified protocol requiring minimal reagents and processing steps, the use of miniaturised equipment compatible for use in limited space, and a streamlined and standalone data analysis capability to allow rapid in situ data acquisition and interpretation.ResultsEleven clinical samples with blinded SARS-CoV-2 status were tested at sea. Following viral RNA extraction and ARTIC sequencing library preparation, reverse transcription and ARTIC PCR-tiling were performed. Samples were subsequently barcoded and sequenced using the Oxford Nanopore MinION Mk1B. An offline version of the MinKNOW software was used followed by CLC Genomics Workbench for downstream analysis for variant identification and phylogenetic tree construction. All samples were correctly classified, and relatedness identified.ConclusionsIt is feasible to establish a small footprint sequencing capability to conduct SARS-CoV-2 WGS in a military maritime environment at sea with limited access to reach-back support. This proof-of-concept study has highlighted the potential of deploying such technology in the future to military environments, both maritime and land-based, to provide meaningful clinical data to aid outbreak investigations.