To live with a wagging tailed assistant – Service and hearing dog ownership from the perspective of Swedish owners

Individuals who have a functional or health impairment, are often in great need of conventional healthcare, social care and support, as well as help from family and friends. The use of dogs may be an important assistive support for this population. Assistance dogs are trained to assist with their owners’ specific needs. The aim of this study is to explore service and hearing dog ownership from the owner´s perspective, by examining the owner's expectations before training a dog, and experiences after having a certified dog. This study was designed as a longitudinal intervention study with pre-post design. The participants included in the study trained their own dogs to become service or hearing dogs. A number of open-ended questions were answered by the participants before the training of the dog started, three months after the dog was certified, and 1–3 years after the first follow-up. Data were analysed using thematic content analysis. The participants’ expectations of what the dog would contribute after being certified was high. Their perceived experiences in many ways reflected their expectations. For example, they perceived that the dog contributed to improved health status, a more active lifestyle, improved ability to feel secure, and that they had become more independent. They also felt that the dog had strengthened their social relationships. Negative experiences were also identified. Not being allowed to bring their dog into public places and negative attitudes from other people were examples of this. This study shows that individuals being supported by an assistance dog experience the dog as an invaluable help in their everyday life. By improving the owners’ lives in many ways, a certified service or hearing dog is a novel and important assistive support for people with a functional or health impairment.     

Stroke volume determination using transcardiopulmonary thermodilution and arterial pulse contour analysis in severe aortic valve disease

Purpose

Transcardiopulmonary thermodilution (TPTD, SV_TD) as well as calibrated (SV_{PC CAL}) and uncalibrated (SV_{PC UNCAL}) arterial pulse contour analysis (PC) are increasingly promoted as less-invasive technologies to measure stroke volume (SV) but their reliability in aortic valve disease was unknown. The objective of this prospective study was to investigate the validity of three less-invasive techniques to assess SV in conditions involving aortic stenosis (AS) and valvuloplasty-induced aortic insufficiency (AI) compared with transesophageal echocardiography.

Methods

In 18 patients undergoing transcatheter aortic valve implantation, SV_TD and SV_{PC CAL} were determined using a central pressure signal via the brachial artery and SV_{PC UNCAL} using a peripheral radial signal.

Results

In aortic valve dysfunction TPTD achieved adequate reproducibility (concordance correlation coefficient (CCC): AS 0.84; AI 0.82) and agreement (percentage error (PE): AS 26.3 %; AI 26.2 %) with the reference technique. In severe AS, SV_{PC CAL} (PE 25.7 %; CCC 0.85) but not SV_{PC UNCAL} (PE 50.4 %; CCC 0.38) was reliable. Neither calibrated nor uncalibrated PC (SV_{PC CAL}: PE 51.5 %; CCC 0.49; SV_{PC UNCAL}: PE 61.9 %; CCC 0.22) was valid in AI. Trending ability to hemodynamic changes, quantified by the ΔSV vector and the angle θ, was acceptable for each measurement modality.

Conclusions

Transcardiopulmonary thermodilution is valid in aortic valve dysfunction. Calibration of PC substantially improves reliability in aortic valve disease. Calibrated PC is valid in severe AS. Valvuloplasty-induced AI seriously confounds PC measurements. In uncalibrated PC approaches, the relative SV trend is superior to single absolute values.     

A randomized,open‐label,phase I/II trial to investigate the maximum tolerated dose of the Polo‐like kinase inhibitor BI 2536 in elderly patients with refractory/relapsed acute myeloid leukaemia

Polo‐like kinases (Plks) play an important role in cell cycle checkpoint controls and are over‐expressed in acute myeloid leukaemia (AML). BI 2536, a novel Plk inhibitor, induces mitotic arrest and apoptosis. In this phase I/II trial of BI 2536 in 68 elderly patients with relapsed/refractory AML, three schedules were investigated (day 1, days 1–3, and days 1 + 8). Maximum tolerated dose was 350 and 200 mg in the day 1 and days 1 + 8 schedules, respectively. The day 1–3 schedule appeared equivalent to the day 1 schedule and was discontinued early. BI 2536 exhibited multi‐compartmental pharmacokinetic behaviour. The majority of patients showed an increase of bone marrow cells in G2/M with a characteristic pattern of mitotic catastrophe. The overall response rate in the day 1 and day 1 + 8 schedules was 9% (5/54) with 2 complete and 3 partial responses. The majority of drug‐related adverse events grade ≥3 were haematological. Taken together, Plk inhibition induced cell cycle arrest in AML blasts in vivo and BI 2536 monotherapy showed modest clinical activity in this poor prognosis patient group.     

NUTRITIONAL ENCEPHALOMALACIA IN CHICKS : INFLUENCE OF AGE,GROWTH, AND BREED UPON SUSCEPTIBILITY

1. Nutritional encephalomalacia may be induced in chicks up to the age of approximately 2 months. As the preliminary feeding period on a natural foods diet is increased, the percentage incidence of the disease becomes progressively less. The average time between institution of diet and appearance of the disease tends to diminish. 2. There is no correlation between growth and incidence of the disease. 3. White Leghorns, Barred Plymouth Rocks, Rhode Island Reds, and White Wyandottes are equally susceptible.     

Analysis of recruitment in a pragmatic observational study on C-reactive protein point-of-care testing in primary care

Introduction: Failure to recruit all eligible study patients can lead to biased results. Little is known on selective patient recruitment in studies on implementation of diagnostic devices.

Objectives: The aim of this observational study was to measure recruitment of patients in an implementation study in primary care on use of point-of-care (POC) C-reactive protein (CRP) and to evaluate recruitment bias and its impact on the study endpoint.

Methods: In a cross-sectional observational study on POC CRP implementation and related antibiotics prescribing, we compared included patients with all eligible patients to assess the representativeness of the included subjects. Eligible patients were adults presenting with acute cough in primary care between March and September 2012. The frequency of POC CRP testing and the proportion of prescribed antibiotics were compared between recruited and non-recruited patients. As measure of bias, odds ratios (ORs) with accompanying 95% confidence intervals (CIs) for the association between CRP level (<20?mg/l or not) and antibiotic prescribing were computed.

Results: Of all 1473 eligible patients 348 (24%) were recruited. In recruited patients, POC CRP tests were conducted and antibiotics prescribed more frequently as compared to non-recruited patients (81% versus 6% and 44% versus 29%, respectively). The ORs were 18.2 (95%CI: 9.6–34.3), 30.5 (95%CI: 13.2–70.3) and 3.8 (95%CI: 0.9–14.8) respectively in all eligible patients, the recruited and the non-recruited patients.

Conclusion: Selective recruitment resulted in an overestimation of POC CRP test use and antibiotic prescribing.     

Determination of the optical properties of anisotropic biological media using an isotropic diffusion model

We investigate anisotropic light propagation in biological tissue in steady-state and time domains. Monte Carlo simulations performed for tissue that consists of aligned cylindrical and spherical scatterers show that steady-state and time-resolved reflectance depends strongly on the measurement direction relative to the alignment of the cylinder axis. We examine the determination of optical properties using an isotropic diffusion model and find that in the time domain, in contrast to steady-state spatially resolved reflectance measurements, the obtained absorption coefficient does not depend on the measurement direction and is close to the true value. Contrarily, the derived reduced scattering coefficient depends strongly on the measurement direction in both domains. Measurements of the steady-state and time-resolved reflectance from bovine tendon confirm the theoretical findings.     

Centrosome aberrations in acute myeloid leukemia are correlated with cytogenetic risk profile

Genetic instability is a common feature in acute myeloid leukemia (AML). Centrosome aberrations have been described as a possible cause of aneuploidy in many human tumors. To investigate whether centrosome aberrations correlate with cytogenetic findings in AML, we examined a set of 51 AML samples by using a centrosome-specific antibody to pericentrin. All 51 AML samples analyzed displayed numerical and structural centrosome aberrations (36.0% +/- 16.6%) as compared with peripheral blood mononuclear cells from 21 healthy volunteers (5.2% +/- 2.0%; P <.0001). In comparison to AML samples with normal chromosome count, the extent of numerical and structural centrosome aberrations was higher in samples with numerical chromosome changes (50.5% +/- 14.2% versus 34.3% +/- 12.2%; P <.0001). When the frequency of centrosome aberrations was analyzed within cytogenetically defined risk groups, we found a correlation of the extent of centrosome abnormalities to all 3 risk groups (P =.0015), defined as favorable (22.5% +/- 7.3%), intermediate (35.3% +/- 13.1%), and adverse (50.3% +/- 15.6%). These results indicate that centrosome defects may contribute to the acquisition of chromosome aberrations and thereby to the prognosis in AML.