Abstract Myodural bridges have been described in various species as connective tissue structures “bridging” small cranio-cervical muscles to the dura. Myodural bridges are thought to stabilize the dural sac during head and neck movements and promote cerebrospinal fluid motion; however, their role in neurological diseases has not yet been established. We report ultrasonographic visualization, necropsy, histopathologic and ultrastructural findings of myodural bridges in horses with hereditary equine regional dermal asthenia (HERDA), an equine model of Ehlers-Danlos syndromes. Five HERDA and 5 control horses were studied. Post-mortem examination and ultrasonographic studies (3 HERDA and 4 controls) demonstrated that the atlanto-occipital and atlanto-axial myodural bridges are dynamic structures “moving” the dura. En block resection of the myodural bridges (4 HERDA and 5 controls) was accomplished and histopathology showed myofiber degeneration in 3 HERDA horses and 1 control. Ultrastructural examination revealed loosely packed collagen fibrils with abnormal orientation in all HERDA horses compared to mild abnormalities in 2 controls. Our study provides necropsy and ultrasonographic evidence of the dynamic aspect of the myodural bridges as dural sac stabilizers. Myodural bridges may be pathologically altered in connective tissue disease as evidenced by the ultrastructural morphology in the HERDA myodural bridge.
<p> </p> <p>The tabular and visual dataset focuses on South African basic education and provides insights into the distribution of schools and basic population statistics across the country. This tabular and visual data are stratified across different quintiles for each provincial and district boundary. The quintile system is used by the South African government to classify schools based on their level of socio-economic disadvantage, with quintile 1 being the most disadvantaged and quintile 5 being the least disadvantaged. The data was joined by extracting information from the debarment of basic education with StatsSA population census data. Thereafter, all tabular data and geo located data were transformed to maps using GIS software and the Python integrated development environment. The dataset includes information on the number of schools and students in each quintile, as well as the population density in each area. The data is displayed through a combination of charts, maps and tables, allowing for easy analysis and interpretation of the information.</p>
"Epilogue: New Psychoanalysts Speak – Reflections on Personal and Professional Transformations." Psychoanalytic Inquiry, 43(4), pp. 308–309 Disclosure statementNo potential conflict of interest was reported by the authors.Additional informationNotes on contributorsJohn R. PaddockJohn R. Paddock, Ph.D., ABPP, is a licensed psychologist based in Atlanta, Georgia (see: www.johnrpaddockphd.com). He is Adjunct Professor of Psychology in the Emory University Department of Psychology and Adjunct Professor in the Department of Psychiatry and Behavioral Sciences, also at Emory. He teaches courses on the Analyst’s Use of Self and Psychoanalytic Approaches to Psychopathology in the Emory University Psychoanalytic Institute. He is a graduate of the psychoanalytic training program at the Institute of Contemporary Psychotherapy + Psychoanalysis (ICP+P) in Washington, DC. Dr. Paddock is on the Editorial Board of Psychoanalytic Inquiry.Elizabeth CarrElizabeth M. Carr, APRN, MSN, BC, is a Board-Certified Advanced Practice Registered Nurse and a Psychoanalyst practicing in the District of Columbia, Maryland, and Virginia. She is Co-Chair of the Psychoanalytic Training at the Institute for Contemporary Psychotherapy and Psychoanalysis and a Training and Supervising Analyst there. She is a faculty member at the George Washington University School of Medicine and an Associate Editor of Psychoanalytic Inquiry.
Objective Increasingly unpredictable shifts in climate are triggering public health crises globally. Southern Madagascar is particularly vulnerable to climate impacts, despite contributing to only 0.2% of global emissions. Though endemic in Madagascar, climate impacts such as below average rainfall have increased the severity of droughts, putting over half of the population in southern regions at risk of being food insecure in 2022. The following review examines: How can interventions surrounding the current food emergency in southern Madagascar center community-based knowledge in their strategies? Through a social-ecological approach, this review aims to holistically discuss the complexity of the climate and food crises in this region, which is a topic that has not been widely covered in published review articles thus far. Methods We took a comprehensive and social-ecological approach by analyzing research pertaining to the impacts of colonial history, politics, economy, and culture on the current climate, ecology, and food systems of southern Madagascar. Main findings Many current strategies to mitigate climate impacts and food security fail to incorporate community-based knowledge, leading to inequitable and ineffective interventions. Researchers who prioritize historical and cultural context illustrate how local knowledge may serve as a protective factor against climate impacts. Conclusions As climate shifts exacerbate public health crises, aid organizations must center community perspectives in their interventions to foster equitable and sustainable outcomes.
Background: Equid herpesvirus‐1 (EHV‐1) reactivation and shedding can occur in latently infected, asymptomatic animals. Risk factors for reactivation include stress and illness. The risk of asymptomatic shedding in hospitalized, critically ill horses with acute abdominal disease is unknown. This information is important to assess the need for additional biosecurity protocols to prevent spread of EHV‐1 in hospitalized critically ill horses with acute abdominal disorders. Objectives: To determine the frequency of reactivation and nasal shedding of EHV‐1 in hospitalized critically ill horses. Animals: One hundred twenty‐four client‐owned horses admitted to the Veterinary Teaching Hospital with acute abdominal disorders were included in the study. Methods: Cross‐sectional study examining the risk of reactivation of EHV‐1 in horses admitted with acute, severe, gastrointestinal disease. Whole blood and nasal secretions were collected throughout hospitalization. In addition, mandibular lymph nodes were collected from 9 study horses and 26 other Michigan horses. All samples were tested for the presence of EHV‐1 nucleic acid by real‐time PCR assays targeting the glycoprotein B gene and the polymerase (ORF 30) gene. Results: One hundred and twenty‐four horses met the inclusion criteria. None of the samples were positive for EHV‐1 DNA. Conclusion and Clinical Importance: These results suggest that nasal shedding and viremia of EHV‐1 in hospitalized critically ill horses with acute abdominal disorder is extremely rare. Implementation of additional biosecurity protocols to limit aerosol spread of EHV‐1 among horses with acute abdominal disease and other hospitalized horses is not necessary.
Abstract Introduction Enhanced care units (ECU) are a novel concept, targeting the gap between ward-level and critical care. They care for patients requiring intensive medical or nursing care, who may not require, desire, or be suitable for, escalation above ward care (Society of Acute Medicine and Intensive Care Society, 2022). The ECU at Barnet Hospital opened in March 2022, and, because of the local population demographic, admits a high number of older patients living with frailty. We aimed to assess the performance of the ECU for this subset of patients. Methods A retrospective audit of electronic records of 75 randomly selected patients admitted to ECU between March and August 2023. Data were gathered on Clinical Frailty Score (CFS) at baseline, comorbidity, escalation status, APACHE II illness severity score, and outcome measures. Results The majority of patients in the sample, 52 of 75 (69.3%), were over 65 years of age with an average of 69.1 years. Baseline frailty score was high, with a modal CFS of 6. Of these patients, 32 (61.5%) had a DNACPR, and 17 (32.7%) had treatment ceiling at ECU level. Illness severity was similar across CFS groups, with a mean APACHE II score of 15.2 (representing a 25% mortality risk). Overall mortality in the over 65 s was 23.1% (12/52), without significant change when stratified by CFS. Mortality in the under 65 s was 8.7% (2/23). Conclusions Acutely unwell patients with frailty may benefit from ECU level care. In our centre, we found no significant increase in mortality linked to a higher frailty score. We suggest that this may represent good case selection by clinicians experienced in working with frailty: admitting patients with more reversibility and targeting therapies towards reversible causes. Limitations remain, especially in assessing illness severity, as the assessment tools are not targeted to this cohort.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)