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Background: During development or regeneration, neurons extend processes (i.e., neurites) via mechanisms that can be readily analyzed in culture. However, defining the impact of a drug or genetic manipulation on such mechanisms can be challenging due to the complex arborization and heterogeneous patterns of neurite growth in vitro. New Method: NeuriteNet is a Convolutional Neural Network (CNN) sorting model that uses a novel adaptation of the XRAI saliency map overlay, which is a region-based attribution method. NeuriteNet compares neuronal populations based on differences in neurite growth patterns, sorts them into respective groups, and overlays a saliency map indicating which areas differentiated the image for the sorting procedure., Results: In this study, we demonstrate that NeuriteNet effectively sorts images corresponding to dissociated neurons into control and treatment groups according to known morphological differences. Furthermore, the saliency map overlay highlights the distinguishing features of the neuron when sorting the images into treatment groups. NeuriteNet also identifies novel morphological differences in neurons cultured from control and genetically modified mouse strains. Comparison with Existing Methods: Unlike other neurite analysis platforms, NeuriteNet does not require manual manipulations, such as segmentation of neurites prior to analysis, and is more accurate than experienced researchers for categorizing neurons according to their pattern of neurite growth., Conclusions: NeuriteNet can be used to effectively screen for morphological differences in a heterogeneous group of neurons and to provide feedback on the key features distinguishing those groups via the saliency map overlay., (Copyright © 2021. Published by Elsevier B.V.)

Ethically challenging situations (ECS) are commonly encountered in veterinary settings. The number of ECS encountered by some veterinary team members may increase during a crisis, such as the COVID-19 pandemic. This study aimed to determine the risk factors for experiencing an increase in the frequency of ECS in the months following the beginning of the COVID-19 pandemic, utilizing data from a global survey of veterinarians, veterinary nurses and animal health technicians collected from May to July 2020. In this study, descriptive analyses were performed to characterize veterinary team members who responded to the survey ( n = 540). Binomial logistic regression analyses were performed to determine factors associated with an increase in ECS encountered since the beginning of the COVID-19 pandemic. Being a veterinary nurse or animal health technician, working with companion animals, working in the USA or Canada, and being not confident or underconfident in dealing with ECS in the workplace were factors associated with an increase in ECS encountered since the beginning of the COVID-19 pandemic. Results suggest a need to explore the ECS encountered by veterinary team members, particularly veterinary nurses and animal health technicians working in companion animal practice, in depth. Identification of risk factors may facilitate better preparation of veterinary team members for managing ECS, and minimizing the negative impact of ECS on the well-being of those who care for animals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Quain, Mullan and Ward.)

Advanced veterinary care (AVC) of companion animals may yield improved clinical outcomes, improved animal welfare, improved satisfaction of veterinary clients, improved satisfaction of veterinary team members, and increased practice profitability. However, it also raises ethical challenges. Yet, what counts as AVC is difficult to pinpoint due to continuing advancements. We discuss some of the challenges in defining advanced veterinary care (AVC), particularly in relation to a standard of care (SOC). We then review key ethical challenges associated with AVC that have been identified in the veterinary ethics literature, including poor quality of life, dysthanasia and caregiver burden, financial cost and accessibility of veterinary care, conflicts of interest, and the absence of ethical review for some patients undergoing AVC. We suggest some strategies to address these concerns, including prospective ethical review utilising ethical frameworks and decision-making tools, the setting of humane end points, the role of regulatory bodies in limiting acceptable procedures, and the normalisation of quality-of-life scoring. We also suggest a role for retrospective ethical review in the form of ethics rounds and clinical auditing. Our discussion reenforces the need for a spectrum of veterinary care for companion animals.

A range of welfare outcome measures relating to on-farm welfare are monitored in UK slaughterhouses to check compliance with the European Broiler Directive. A national dataset from 438,155 batches of chickens between 2010 and 2014 and from 228,795 batches between 2016 and 2018 was analysed. The data contained information about 3.1 billion chickens. The highest mean proportion for a single condition was for ascites/oedema in 2016-2018 at 0.384%, affecting 3.9 million chickens/year sent to slaughter during that time, followed by abnormal colour/fevered at 0.324%, affecting 3.4 million chickens/year. Identifying farms most likely to have poor welfare is an important strategy for improving animal welfare overall, and for maximising the capacity for checking regulatory compliance when resources are limited. We found a greater proportion of broiler farms overall remained consistently in the best quartile (16.4%) rather than the worst quartile (6.6%). Farms that exceeded a Government 'trigger' threshold for poor welfare were significantly more likely to subsequently improve than 'non-trigger' farms, although they usually remained in the worst performing quartile of farms.

In March 2020, the World Health Organisation called for countries to take urgent and aggressive action against a global pandemic caused by COVID-19. Restrictions were introduced in many countries to reduce transmission of COVID-19 and ultimately deaths. Such restrictions have been colloquially referred to as "lockdown". Anecdotal evidence of the beneficial practices that facilitated safe veterinary treatment and equine care had been reported together with an increase in the use of electronic communication and information technologies during the first "lockdown". Thus, the aim of this qualitative study was to capture any beneficial changes to racehorse veterinary care that were implemented during the first "lockdown" period in the UK that lasted from 23 March to 12 May 2020. Ten equine veterinary surgeons who primarily treat racehorses and 10 racehorse trainers were interviewed either by telephone or by videoconferencing. After using thematic analysis from a critical realist social constructionist perspective, four themes were identified. These were, firstly, according to our participants, the trainer-vet relationship is predicated upon a good working relationship, secondly, there had been little or no change in the vet-trainer relationship during the first "lockdown" period. Thirdly, when COVID-19 restrictions were in force, more remote consultations took place using images or videos as well as telephone consults, viewed favourably by both trainers and vets, and finally, intermittent connectivity and poor-quality images and videos limited their effectiveness. In order to fully benefit from the positive changes employed by some vets and trainers in their working relationships, we recommend that rural connectivity is prioritised.

Ethically challenging situations (ECS) are common in veterinary settings and can lead to moral stress. However, there is no published information about how a global pandemic affects the frequency and types of ECS encountered by veterinary team members. An online mixed methods survey was developed to determine the frequency, stressfulness and types of ECS experienced by veterinarians, animal health technicians and veterinary nurses since the advent of the global COVID-19 pandemic in March 2020. Responses from 540 veterinary team members from 22 countries were analyzed. With the advent of the COVID-19 pandemic, the median frequency of ECS encountered by respondents increased from several times per month to several times per week (Spearman Rank Correlation 0.619, P < 0.0001). The most common ECS (encountered at least several times per week) were: challenging decisions about how to proceed when clients have limited finances (64.4%), conflict between personal well-being and professional role (64.3%), conflict between the interests of clients and the interests of their animals (59.6%). These were followed by challenging decisions about what counts as an essential veterinary service (48.1%); conflict between well-being of family/household members and professional role (46.3%); and challenging decisions about whether to perform non-contact veterinary visits (46.3%). The most stressful ECS (reported to be very or maximally stressful) were: conflicts between the interests of clients and the interests of their animals (50.2%), other (42.9%), conflicts between the interests of my employer and my own interests (42.5%), challenging decisions about how to proceed when clients have limited finances (39.4%), conflict between personal well-being and professional role (38.0%), and conflict between well-being of family/household members and professional role (33.6%). Thematic analysis of free-text responses revealed biosecurity, client financial limitations, animal welfare, working conditions, and client relations as prominent themes. This is, to the best of our knowledge, the first study to describe the impacts of the pandemic on ECS experienced by veterinary teams globally. It identifies an increase in the frequency of ECS associated with the COVID-19 pandemic, and a number of stressors unique to the pandemic. We identified a number of resources and strategies that may help veterinary team members navigate ethical challenges that may emerge in their daily work, as well as in the context of global crises., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Quain, Mullan, McGreevy and Ward.)

Understanding the behaviour of grazing animals at pasture is crucial in order to develop management strategies that will increase the potential productivity of grazing systems and simultaneously decrease the negative impact on the environment. The objective of this review was to summarize and analyse the scientific literature that has addressed the site use preference of grazing cattle using global positioning systems (GPS) collars in the past 21 years (2000-2020) to aid the development of more sustainable grazing livestock systems. The 84 studies identified were undertaken in several regions of the world, in diverse production systems, under different climate conditions and with varied methodologies and animal types. This work presents the information in categories according to the main findings reviewed, covering management, external and animal factors driving animal movement patterns. The results showed that some variables, such as stocking rate, water and shade location, weather conditions and pasture (terrain and vegetation) characteristics, have a significant impact on the behaviour of grazing cattle. Other types of bio-loggers can be deployed in grazing ruminants to gain insights into their metabolism and its relationship with the landscape they utilise. Changing management practices based on these findings could improve the use of grasslands towards more sustainable and productive livestock systems.

There is increasing evidence that nonalcoholic steatohepatitis (NASH) is a risk factor for hepatocellular carcinoma (HCC) in the absence of cirrhosis, a phenomenon termed noncirrhotic HCC. Early diagnosis of HCC is critical to a favorable prognosis. We tested the hypothesis that hydroxyproline content of liver biopsy samples is diagnostic for HCC in murine models of NASH induced by diet or by diet and chemicals. The training set comprised mice fed a standard diet or a fast-food diet with or without administration of thioacetamide. At harvest, livers from the modified diet cohort exhibited NASH with a subset of NASH livers exhibiting HCC. Hydroxyproline content was measured in liver biopsy samples with tissue in the NASH+HCC cohort sampled from the remote, nontumor parenchyma. Plotting the receiver operating characteristics (ROC) with hydroxyproline as the continuous variable against the absence or presence of HCC yielded an area under ROC of 0.87, a threshold of >0.18 μg hydroxyproline/mg liver and sensitivity of 91% with a specificity of 83.3%. The use of liver hydroxyproline content as a diagnostic for HCC in a test set comprising healthy, NASH and NASH+HCC livers proved 87% accurate.

Broiler chicken welfare is under increasing scrutiny due to welfare concerns regarding growth rate and stocking density. This farm-based study explored broiler welfare in four conditions representing commercial systems varying in breed and planned maximum stocking density: (1) Breed A, 30 kg/m 2 ; (2) Breed B, 30 kg/m 2 ; (3) Breed B, 34 kg/m 2 ; (4) Breed C, 34 kg/m 2 . Breeds A and B were 'slow-growing' breeds (< 50 g/day), and Breed C was a widely used 'fast-growing' breed. Indicators of negative welfare, behavioural indicators of positive welfare and environmental outcomes were assessed. Clear differences between conditions were detected. Birds in Condition 4 experienced the poorest health (highest mortality and post-mortem inspection rejections, poorest walking ability, most hock burn and pododermatitis) and litter quality. These birds also displayed lower levels of behaviours indicative of positive welfare (enrichment bale occupation, qualitative 'happy/active' scores, play, ground-scratching) than birds in Conditions 1-3. These findings provide farm-based evidence that significant welfare improvement can be achieved by utilising slow-growing breeds. There are suggested welfare benefits of a slightly lower planned maximum stocking density for Breed B and further health benefits of the slowest-growing breed, although these interventions do not offer the same magnitude of welfare improvement as moving away from fast-growing broilers.

Existing animal welfare standards for legislation and food certification programmes are primarily designed to avoid harms to the livestock, with minimal consideration given to their behavioural freedoms. Recent research has shown, however, that animal welfare should not only be evaluated by the absence of negative states but also by the presence of "good life" or positive experiences enjoyed by animals. The objective of the present study is to investigate the scientific validity and on-farm cost implications of utilising potential input-based measures of positive welfare as part of evaluation criteria for farm assurance schemes. Building upon the Farm Animal Welfare Council's concept of good life opportunities, an assessment was undertaken on 49 noncaged laying hen farms across the UK by measuring on-farm resources to facilitate positive experiences alongside commonly measured metrics for welfare outcomes. The financial cost of providing these resources on each enterprise was also estimated using a farm-scale costing tool. The results suggested that 63% of resource needs that facilitate the behaviour opportunities of laying hens are already being provided by these producers, far above legal and commercial requirements. This practice attracts no reward mechanism or direct financial benefit under the current market structure. Additional provision of opportunities was positively associated with behavioural outcomes, but only limited impact was observed on health and productivity measures. Economic modelling indicated that significant room exists to further improve welfare scores on these farms, on average by 97%, without incurring additional costs. Together we argue that these results can be seen as evidence of market failure since producers are providing positive welfare value to society that is not being currently recognised. It is therefore contended that measuring and rewarding the supply of good life opportunities could be a novel policy instrument to create an effective marketplace that appropriately recognises high welfare production.

India has the largest population of dairy cattle in the world at over 48 million animals, yet there has been little formal assessment of their welfare reported. Through observations of dairy cows on 38 farms in Kerala, India, we aimed to investigate the welfare of these animals and the practicality of animal-based assessments within common farming systems. Substantial welfare challenges were identified. All cows were close-tied (less than 1 m length) via a halter that pierced the nasal septum when housed, which was for the entire day (50% of farms) or part thereof. When outside access was available, it was also usually restricted by close-tying, longline tether, or hobbling. Ad libitum water was only available on 22% of farms and food access was also restricted (mean of 4.3 h/day). Future work should focus on encouraging dairy farmers in India to improve the welfare of their dairy cattle by: ceasing to tie and tether cattle (or at least providing tied and tethered cattle with exercise opportunities); providing unlimited access to drinking water and a readier supply of food (especially quality green forage/fodder); cleaning housing more frequently; providing strategies to prevent heat stress; breeding cattle suited to environmental conditions and with increased resistance to heat stress; and carrying out welfare assessments more regularly using a validated protocol and rectifying the causes of poor welfare. Such changes could substantially improve the welfare of tens of millions of cattle.

The number of broilers slaughtered globally is increasing. Ensuring acceptable welfare conditions for birds at the time of slaughter is paramount in meeting legislative and retailer specifications, and in producing high quality meat. There is knowledge that welfare training programs for members of the farming and red meat slaughter industry can improve animal welfare measures and product quality, however there is little evidence of the effects of welfare training in poultry processing plants. In our study, a comprehensive welfare training program was introduced to a Costa Rican and a British commercial broiler primary processing plant, both of which slaughter birds by way of neck cut post electrical water bath stunning. The effects of this program on some welfare and product quality measures were investigated, both immediately and six months post training. The welfare measures that showed significant improvements post training included; flapping at shackling, pre-stun shocks, stun parameters and effective neck cut. Product quality measures including broken wings and red pygostyles also improved, however the positive effect of training was not seen in all quality measures. Welfare training does have the potential to improve broiler welfare and product quality at slaughter, and these data could help the development and targeting of future welfare training courses and encourage the uptake of welfare training in the poultry slaughter industry.

The purpose of this paper is to highlight some of the key challenges to racehorse welfare as perceived by racing industry stakeholders. The paper draws upon statements and transcripts from 10 focus group discussions with 42 participants who were taking part in a larger study investigating stakeholders' perceptions of racehorse welfare, which participants recognised as maintaining the physical and mental well-being of a performance animal. Analysis of the 68 statements participants identified as challenges produced nine themes. Among these, 26% (18 statements) of the challenges were health related, whilst 41% (28 statements) focused on the effect staff shortages were having on the racing industry. Staff shortages were perceived as affecting standards of racehorse care and the opportunity to develop a human-horse relationship. Poor employee relations due to a lack of recognition, communication and respect were perceived as having a detrimental effect on employee attitudes, behaviour and staff retention which, in turn, can have a sequential effect on the welfare and health of horses in training. Although the number of challenges produced is small (68), they emphasise the perceptions of stakeholders closely associated with the racing industry.

The purpose of the study was to explore the perceptions held by British racing industry stakeholders of factors influencing racehorse welfare. Ten focus groups were held across the UK with a total of 42 stakeholders from a range of roles within racehorse care including trainers, stable staff and veterinarians. Participants took part in three exercises. Firstly, to describe the scenarios of a 'best life' and the minimum welfare standards a horse in training could be living under. Secondly, to identify the main challenges for racehorse welfare and thirdly, to recall any innovative or uncommon practices to improve welfare they had witnessed. Using thematic analysis, eight themes emerged from the first exercise. Two strands, factors that contribute to maintaining health and the horse-human relationship ran through all eight themes. Across all themes horses living the 'best life' were perceived as being treated as individuals rather than being part of a 'one size fits all' life when kept under minimum welfare standards. Health was both perceived as the main challenge to welfare as well as one open to innovative practices such as improved veterinary treatments. Data obtained, informed by the knowledge and expertise of experienced stakeholders, combined with practical animal welfare science will be used to develop the first British racehorse welfare assessment protocol.

Objective: The aim of this study was to examine the use of outcome-based observations within Assured Dairy Farm scheme (ADF), Soil Association Organic Standards (SA), and cross compliance (CC) farm assessment reports., Methods: A total of 449 ADF reports, 37 SA reports and 26 CC reports were analyzed and their objective comments categorized as either resource-based or outcome-based., Results: A mean of 61.0% of ADF questions were responded to with comments, in comparison to 25.0% of SA and, 21.0% of CC report questions. The SA and CC reports had significantly more outcome-based comments than the ADF (p<0.001). The assessors' tendency of choosing resource-based approach was revealed in the questionnaire results., Conclusion: Generally, the comments were comprehensive and contained professional judgements. Large numbers of comments provided in the ADF reports were mostly compliant and resource-based evidence, which serves as proof of assessment rather than aiding the certifying process. The inclusion of specific welfare outcome measures in the SA inspection likely increased the use of outcome-based comments in the reports, irrespective of whether the farm achieved compliance with a given standards. The CC scheme, on the other hand, focused on providing outcome-based evidence to justify noncompliant decisions.

Ethically challenging situations are common in veterinary practice, and they may be a source of moral stress, which may in turn impact the welfare of veterinarians. Despite recognition of the importance of ethical reasoning, some veterinary students may struggle to apply theoretical ethical frameworks. Fraser developed a &ldquo;practical&rdquo; ethic consisting of four principles that can be applied to ethically challenging situations. We apply Fraser&rsquo;s &ldquo;practical&rdquo; ethic to three cases that veterinarians may encounter: animal hoarding, animal neglect, and treatment of wildlife. We argue that Fraser&rsquo;s &ldquo;practical&rdquo; ethic is consistent with a One Welfare framework, and may have increasing currency for veterinarians in the light of the World Animal Health Organisation&rsquo;s Global Animal Welfare Strategy. Both Fraser&rsquo;s &ldquo;practical&rdquo; ethic and a One Welfare framework require veterinarians to consider the impacts of animal ethics decisions on a broader scale than most other ethical frameworks have prepared them for. We discuss the strengths and limitations of Fraser&rsquo;s &ldquo;practical&rdquo; ethic when applied in veterinary contexts and recommend additional support and training to enable veterinarians to effectively apply these frameworks in real-world settings.

Lameness is one of the most serious economic and welfare issues in the dairy industry. Early detection of lameness can be difficult, but provision of early treatment is crucial. Previous studies have used infrared thermography to show that increased foot temperature (FT) is associated with lameness and foot lesions. However, poor accuracy has limited the management application potential. This study analysed ambient-temperature (AT)-adjusted foot-surface temperatures and temperature differences between the hind feet of individual cows to enhance lameness detection. Cow FTs were recorded on a 990-cow farm using an infrared thermometer fortnightly for 6 months. Additionally, mobility level was scored using the AHDB Dairy 4-point scale. The averages of FTs and ATs were 23.83 ± 0.03°C and 13.99 ± 1.60°C, respectively. The FT of cows with lameness was significantly higher than that of cows without lameness (P < 0.001). Increases in FTs correlated with the mobility score (MS) (P < 0.001). According to receiver operating characteristic (ROC) curves, the optimal threshold based on actual FTs was 23.3°C with 78.5% sensitivity and 39.2% specificity. However, the ROC curve for the AT-adjusted FT and FT difference parameters showed minimal improvements over the FT in detecting lameness. In conclusion, the infrared thermometer results demonstrated the association between elevated FTs and lameness, but further improvements to this detection technique will be required before it can be implemented as a management tool for detecting cows that could benefit from treatment. With additional validation, the technique could be used as a screening device to identify cows in need of further assessment., (© 2018 The Authors. Veterinary Medicine and Science Published by John Wiley & Sons Ltd.)

The selection and field application of animal-based welfare measures for pigs, sheep, dairy cows and broilers was the first step towards the future development of welfare improvement schemes for Serbia - a country that is applying for EU accession. The aim of this pilot study was to: (1) test the feasibility of a protocol for monitoring farm animal welfare in Serbia, (2) ascertain preliminary data on animal-based outcomes of farm welfare and (3) gain insight into Serbian farmers' understanding of animal welfare as part of a wider project working towards inclusion of animal-based assessments in a 'higher welfare' voluntary assurance scheme. This study encompasses the first national survey of farm animal welfare in which animal-based outcomes were tested on 105 farms by a total of ten trained assessors. Data on the views and aspirations of the farmers from these 105 farms were also systematically gathered during face-to-face interviews. Existing animal-based measures for pigs, sheep, dairy cows and broilers that have been successfully applied and identified as valid, reliable and feasible measures in other countries, were found to be largely transferable. However, some on-farm protocols, previously used in other countries, had to be shortened for logistical reasons when used in Serbia. Our findings suggest that further refinement may be needed in order to allow local application of all measures. While the term 'animal welfare' has only recently been introduced into the Serbian language, seventy-three percent of farmers had heard of it. Overall, few positive associations were found between farmer satisfaction with animals' living conditions and animal-based data. Many farmers had aspirations to develop and expand their farms, which may potentially enhance animal welfare, but these farmers identified that financial and technical advice and support would be needed in order to achieve these goals.

The equine industry in Great Britain has not been subject to the same pressures as the farming industry to engage with welfare assessment, but this may change as concern about equine welfare increases. Stakeholder attitudes toward welfare assessment may impact the implementation of welfare assessment practices. Focus-group discussions regarding welfare assessment were conducted with 6 equine stakeholder groups: leisure horse owners (caregivers; n = 4), grooms (n = 5), veterinary surgeons (n = 3), welfare scientists (n = 4), welfare charity workers (n = 5), and professional riders (n = 4). Three themes emerged from the discussions: (a) Participants predominantly interpreted welfare assessment as a means of identifying and correcting poor welfare in an immediate way; (b) participants believed that horse welfare varied over time; and (c) attributes of the assessor were viewed as an important consideration for equine welfare assessment. The views of equine industry members give insight into the value welfare assessments may have to the industry and how equine welfare assessment approaches can achieve credibility within the industry and increase the positive impact of welfare assessments on equine welfare.

Investigating how those responsible for the care of nonhuman animals understand the concept of animal welfare is important for animal welfare improvement. In-depth interviews with 31 equine stakeholders were used to explore their perceptions and understanding of welfare. The results showed the stakeholders understood the concept of welfare in 4 ways. Firstly, welfare was understood in terms of the provision of resources-for example, food. Secondly, a "horse-centered" understanding of welfare was articulated; this understanding included the horses' mental state and was linked to natural behavior. Thirdly, the word welfare had negative connotations, and for some, good welfare was achieved through avoidance of negative states. Finally, interviewees discussed incidents that occurred in their own familiar contexts but suggested that these were not welfare problems. Evidence indicated that the ways in which equine stakeholders understood the concept of welfare might have been acting as a barrier to the alleviation of some equine welfare problems. There is a need for strategies aimed at improving equine welfare to consider stakeholder constructs of welfare and the ways in which these constructs are generated and acted upon.

Introduction: Various diagnostic methods like Microscopic Agglutination Test (MAT), IgM ELISA, Isolation of Leptospira from the clinical specimen, Rapid leptocheck tests etc., are available for diagnosis of leptospirosis. Polymerase Chain Reaction (PCR) is used for diagnosis of various diseases of infectious origin including leptospirosis but there is paucity of data about comparison of PCR with other available method of diagnosis of leptospirosis., Aim: The aim of the study was to detect the leptospiral DNA by PCR method and to compare the results of PCR with other available diagnostic methods used for diagnosis of suspected leptospirosis cases in acute phase of illness., Materials and Methods: A total of 207 blood samples were obtained from suspected patients of leptospirosis admitted in New Civil Hospital, a tertiary care hospital in South Gujarat, during the period of July 2008 to November 2008. These blood samples were subjected to Rapid leptocheck, IgM ELISA, MAT test to detect (IgG or IgM) antibody level, Leptospira culture and PCR., Results: In early phase of the disease, Rapid leptocheck test gave 44% detection, but along with PCR seropositivity reached upto 71%. Detection rate by IgM ELISA was 59% which increased to 80% with PCR. By MAT seropositivity was 57% but combined seropositivity of MAT with PCR was 78%. Sensitivity and specificity of PCR as compared to MAT (Gold standard) was 52% and 79% respectively. Leptospira was not growing in culture., Conclusion: In present study, PCR picked up to 50% of cases which were negative by other serological tests so these finding suggest that PCR should be used routinely in acute phase of disease.

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively.

Background: Decision coaching is individualized, nondirective facilitation of patient preparation for shared decision making., Purpose: To explore characteristics and effectiveness of decision coaching evaluated within trials of patient decision aids (PtDAs) for health decisions., Data Sources: A subanalysis of trials included in the 2011 Cochrane Review of PtDAs., Study Selection: Eligible trials allowed the effectiveness of decision coaching to be compared with another intervention and/or usual care., Data Extraction: Two reviewers independently screened 86 trials, extracted data, and appraised quality., Data Synthesis: Ten trials were eligible. Decision coaching was provided by genetic counselors, nurses, pharmacists, physicians, psychologists, or health educators. Coaching compared with usual care (n = 1 trial) improved knowledge. Coaching plus PtDA compared with usual care (n = 4) improved knowledge and participation in decision making without reported dissatisfaction. Coaching compared with PtDA alone (n = 4) increased values-choice agreement and improved satisfaction with the decision-making process without any difference in knowledge or participation in decision making. Coaching plus PtDA compared with PtDA alone (n = 4) had no difference in knowledge, values-choice agreement, participation in decision making, or satisfaction with the process. Decision coaching plus PtDA was more cost-effective compared with PtDA alone or usual care (n = 1)., Limitations: Methodological quality, number of trials, and description of decision coaching., Conclusions: Compared with usual care, decision coaching improved knowledge. However, the improvement in knowledge was similar when coaching was compared with PtDA alone. Outcomes for other comparisons are more variable, some trials showing positive effects and other trials reporting no difference. Given the small number of trials and variability in results, further research is required to determine the effectiveness of decision coaching.

Consistency of assessment is essential to the farm assurance process. This study evaluated the inter-observer reliability of 31 farm assurance assessors, six veterinarians and four researchers for five pig welfare outcome measures proposed for inclusion into the UK pig farm assurance schemes. These were (1) tail lesions, (2) body lesions, (3) lameness, (4) pigs requiring hospitalisation and (5) oral behaviour. The following inter-observer reliability testing methods against a gold standard Trainer were used: a comparison of farm prevalence and the numbers of affected pigs in each pen identified by observers, Cohen's kappa (κ), Kendall's W, proportional agreement, sensitivity, and specificity. All measures achieved potentially high levels of inter-observer reliability and it was concluded that none should be excluded from farm assurance at this stage. However, across all the measures, 45% of observers did not record an overall farm prevalence 'close' to that of the gold standard Trainer. With the level of training and testing that took place in this study there would be a danger of significant bias occurring in a national assessment scheme. The data collected enabled some comparison of the methods used to assess inter-observer reliability. It is suggested that when the aim is to achieve agreement between observers on the overall farm prevalence the inter-observer reliability testing should focus on the closeness of the overall farm prevalence recorded by observers, but that other types of analysis may be helpful during training., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

In vivo imaging methodologies allow for serial measurement of tumor size, circumventing the need for sacrificing mice at given time points. In orthotopically transplanted murine models of brain tumors, cross-section micro-MRI allows for visualization and measurement of the physically inaccessible tumors. To allow for long resident times of a contrast agent in the tumor, intraperitoneal administration was used as a route of injection for contrast-enhanced micro-MRI, and a simple method for relative tumor volume measurements was examined. A strategy for visualizing the variability of the delayed tumor enhancement was developed. These strategies were applied to monitor the growth of brain tumors xenotransplanted into nude mice and either treated with the antiangiogenic peptide EMD 121974 or an inactive control peptide. Each mouse was used as its own control. Serial imaging was done weekly, beginning at Day 7 after tumor cell implantation and continued for 7 weeks. Images obtained were reconstructed on the MRI instrument. The image files were transferred off line to be postprocessed to assess tumor growth (volume) and variability in enhancement (three-dimensional [3-D] intensity models). In a small study, tumor growth and response to treatment were followed using this methodology and the high-resolution images displayed in 3-D allowed for straightforward qualitative assessment of variable enhancement related to vascular factors and tumor age.

Objective: This study used quantitative radiological imaging to determine the effect of surgical resection on postoperative survival of patients with malignant astrocytomas. Previous studies relied on the surgeons' impressions of the amount of tumor removed, which is a less reliable measure of the extent of resection., Methods: Information concerning possible prognostic factors was collected for 75 patients undergoing magnetic resonance imaging or computed tomography preoperatively and within 10 days postoperatively. Image analysis of the neuroradiological studies was conducted to quantify pre- and postoperative total tumor volumes and enhancing volumes. Univariate and multivariate proportional hazards models were used to analyze the regression of survival regarding 22 covariates that might affect survival. The covariates that were entered included age, gender, tumor grade, cumulative radiation dose, chemotherapy, seizures as a first symptom, Karnofsky performance status at presentation, pre- and postoperative total and enhancing tumor volumes, ratio of pre- to postoperative total and enhancing tumor volumes, tumor location, surgeon's impression of the degree of resection, and subsequent surgery., Results: There were 23 patients with anaplastic astrocytomas and 52 with glioblastomas multiforme. The estimated mean survival time was 27 months for patients undergoing gross total resection, 33 months for subtotal resection, and 13 months for open or stereotactic biopsy. Five factors that were significant predictors of survival in multivariate analysis were tumor grade, age, Karnofsky performance status, radiation dose, and postoperative complications (P < 0.05). In univariate analysis, tumor grade, radiation dose, age, Karnofsky status, complications, presence of enhancing tumor in postoperative imaging, and postoperative volume of enhancing tumor were significantly associated with survival (P < 0.05)., Conclusion: We conclude that the most important prognostic factors affecting survival of patients with anaplastic astrocytomas and glioblastomas multiforme are tumor grade, age, preoperative performance status, and radiation therapy. Postoperative complications adversely affect survival. Aggressive surgical resection did not impart a significant increase in survival time. Surgical resection may improve survival, but its importance is less than that of other factors and may be demonstrable only by larger studies.

The current members of the faculty at the University of Chicago are acutely aware of the great historic tradition they have inherited. Like all academic medical centers, they are challenged by the current socioeconomic climate, but with the vast intellectual resources of the University of Chicago and its secure place in the community, both locally and nationally, we are confident of our ability to make a continuing contribution to the development of neurosurgery.

The literature on the formation of cerebral veins is reviewed to obtain a better understanding of some cerebrovascular anomalies. Clinical observations such as the entry of the superior ophthalmic vein into the cavernous sinus through the inferior rather than the superior orbital fissure, the relative infrequency of middle cerebral vein backflow in the presence of an extensive cavernous fistula, and the relative infrequency of hemorrhage in relation to the inferior petrosal fistula all relate to the persistence of an older venous pathway. The frequent occurrence of hemorrhage in association with the superior petrosal sinus fistula and the frequent failure of the superior petrosal sinus to connect to the cavernous sinus similarly have an embryological explanation. The frequent association of the vein of Galen aneurysm and an absent or deformed straight sinus probably relates to the time at which the paired internal cerebral veins fuse into one channel. It is speculated that the origins of cerebral venous malformations (CVMs) and arteriovenous malformations (AVMs) probably relate to sequential formation and absorption of surface veins, which occur in human embryonic development mainly in the 40- to 80-mm length interval, although persistent AVM growth is possible even after birth. The frequent absence or anomaly of the middle cerebral vein and its failure to communicate with the cavernous sinus in the presence of both CVMs and AVMs are linked to the late development of that vein and to its even later connection to the cavernous sinus.

Three cases of cerebral venous malformation (CVM) are presented to demonstrate the triad that characterizes CVM: abnormal surface venous drainage, a "star-cluster" system of deep collecting veins, and a deep draining vein. Four other cases are introduced that illustrate this triad and show an additional feature, namely arterial fistulization; these cases represent arteriovenous malformations (AVMs). A final case demonstrates a CVM within an AVM. Both of these structures have a common draining vein and an identical venous core. On the basis of the cases described and of others less suitable for illustration, it is postulated that an AVM is a fistulized CVM and that both relate to a failure in the development of the cortical venous mantle. This proposition is based on the authors' observations and their assessment of the "best possible fit."

The clinical course of three patients who had combined sagittal and lateral sinus dural fistulae is described. One patient, with impending blindness and a short life span, underwent right lateral sinus thrombosis in one stage. The second patient underwent sagittal and right lateral sinus thrombosis in four stages, and her remaining lateral sinus spontaneously occluded. A small untreated fistula persists in the right lower sigmoid. The third patient underwent sagittal sinus, left lateral sinus, and left parietal sinus thrombosis in six stages. A small untreated far-anterior fistula persists. All "satellite" fistulae have spontaneously disappeared. The small asymptomatic untreated residual fistulae have no demonstrable retrograde venous drainage and, therefore, require no treatment at this time.

Evidence is presented that dural fistulae are preceded by sinus thrombosis and that their danger lies in arterialized venous pressure within the cranium or the orbit. Arterial side occlusion leads to recurrence, while venous side occlusion leads to permanent cure. Vein of Galen aneurysms embrace some features of cerebral arteriovenous malformations (AVM's), namely a reticulum, and some features of dural fistulae, namely evidence of previous sinus anomaly and direct drainage into a sinus. These aneurysms are also permanently cured by venous side thrombosis, although the dangers inherent in their reticulum demand that this be done in stages or preceded by arterial side embolization. A very limited experience with venous end occlusion of cerebral (and spinal) AVM's suggests that they, too, can be permanently cured by venous side occlusion without excision. Their reticulum demands maximum, multistage, preliminary arterial side embolization together with intraoperative hypotension during the venous occlusion stage in order to minimize intracerebral hemorrhage or swelling. Schematic models of both fistulae and malformations are presented, together with reasons why particulate embolization is safer than glue embolization. The theory is advanced that dural fistulae, vein of Galen aneurysms, and AVM's are venous- rather than arterial-based lesions, which is consistent with the experience that permanent cure has been effected by venous side occlusion without excision in all three anomalies. It is speculated that there may be a developmental link between AVM and the venous malformation, the AVM being essentially a fistulized venous malformation.

A case is presented in which a giant intracranial vertebral artery aneurysm gave rise to an associated ipsilateral posterior inferior cerebellar artery (PICA) from its waist. Proximal vertebral artery ligation at C-1 was achieved. The aneurysm filled from the opposite vertebrobasilar junction. Direct intracranial trapping of the right vertebral aneurysm was followed by successful anastomosis of the proximally sectioned right PICA to the adjacent left PICA in an end-to-end fashion.

A series of 103 consecutive cases admitted to the University of Chicago Hospitals with a recently ruptured supratentorial aneurysm were medically managed by antifibrinolytic medication, and, when applicable, by hypotension, intracranial pressure control, and respiratory support. Nine patients deteriorated and died, and six rebled and died before they were judged fit for surgical treatment. Four were treated by carotid occlusion. Nine, because of refusal or medical judgment, did not have surgical treatment. Sixty-nine of these patients and a further 33, electively admitted, underwent craniotomy. In these 102 patients, there was no mortality. Seven developed postoperative hemiparesis or hemiplegia. Six recovered. One has a residual monoparesis.

The effects of dimethyl sulfoxide therapy were studied in rhesus monkeys following a standardized occipitofrontal missile injury. This therapy resulted in substantially higher blood pressure, cerebral perfusion pressure, blood flow, and oxidative metabolism than those of a group of monkeys that had been treated similarly with mannitol, and than those of an untreated group.

Ten rhesus monkeys were subjected to detailed cerebral and cardiac monitoring over a period of 90 minutes following an experimental gunshot wound. Bradycardia, decreased cardiac output, and decreased pulmonary and systemic blood pressures were observed in the presence of normal preloading (right and left atrial pressures) and afterloading (pulmonary and systemic vascular resistances). Defective cardiac output, autoregulation and cerebrovascular resistance were associated with low perfusion pressures, low cerebral blood flow, and low CMRO2.

An experimental model of cerebal missile injury in rhesus monkey is described. The main objective was to create a "clean" wound devoid of bleeding from major vessels and complications due to bone fragments. There was a correlation between the wounding energy and the physiological signs, although we underestimated the actual energy level. After the right parietooccipital to right frontal injury, there was bradycardia, changes in blood pressure, and, in high-energy wounds, a marked alternation in resperation. This suggests that the missile's energy produces direct brain-stem damage, the extent of which can be related to the wounding energy.

Fifty patients were treated for trigeminal neuralgia by percutaneous microcompression of the trigeminal ganglion. A No. 4 Fogarty balloon catheter was inserted under brief general anesthesia, using biplane fluoroscopy. This procedure is essentially a percutaneous simplication of the older Taarnhøj-Sheldon-Pudenz operation. The follow-up period ranged from 0.5 to 4.5 years. Pain recurred in 12% of cases during that time, and it is anticipated that within 5 years the recurrence rate will reach 20%, which is approximately the same rate as for the alternative established procedures. The advantages of this technique are freedom from discomfort on the part of the patient, a remarkable ease of performance on the part of the operator, absence of associated mortality, and a minimal morbidity rate.

Beta-Endorphin-like immunoreactivity in cerebrospinal fluid was assayed in 11 patients receiving electrical stimulation of the brain for chronic pain. Immunoreactivity increased dramatically after contrast ventriculography prior to stimulation. No further elevations were observed after stimulation. The magnitude and time course of elevations were identical after placement of electrodes either in the thalamus or in the periventricular gray matter. These results suggest that previous findings of stimulation-induced elevation of beta-endorphin-like immunoreactivity in cerebrospinal fluid are attributable to an artifact of contrast ventriculography.

Examples are presented of the use of a compression balloon to treat trigeminal neuralgia, of a dilating balloon to release a web obstruction of the internal carotid artery, of detachable balloons to seal carotid-cavernous and vertebral-venous fistulas, of a temporary occlusive balloon to aid in thrombogenic treatment of a giant aneurysm, and of a temporary occlusive balloon with double or triple-lumen capacity to assist in angiographic diagnosis and to provide reversible carotid occlusion.

Three patients with severe postoperative hemiplegia and one with hemiplegia following a subarachnoid hemorrhage are presented. None had hematomas. All were treated with dopamine-induced hypertension, mannitol, and large quantities of intravascular fluids. All showed a remarkable degree of clinical improvement, presumably secondary to an increase in cerebral blood flow.

The authors describe cerebrovascular and cerebral metabolic changes in monkeys, subjected to cerebral missile injury. After injury with BB pellet at 90 m/sec, there is a rapid rise in intracranial pressure (ICP), which reaches a peak 2 to 5 minutes posttrauma, and then falls to about 20 to 30 mm Hg. This, with a fall in mean blood pressure (MBP), results in a 50% reduction in cerebral perfusion pressure (CPP), Cerebral blood flow (CBF) is also reduced, although acutely there is no close relationship with (CPP). Cerebrovascular resistance falls initially and then at 30 minutes rises to very high values. Cerebral metabolic rates (CMR's) for oxygen fall after injury and remain low for the rest of the animal's life; CMR's for lactate rise immediately after injury and persists for 5 hours, then fall. After injury with a faster missile (180 m/sec), the ICP rises higher and faster, and the peak is shorter. The CCP is reduced in this injury to approximately 30 mm Hg, and only one animal survived more than 1 hour. With the conventional forms of data analysis, the length of survival after injury correlates well with MBP, ICP, and CBF, but separately they were completely unsatisfactory for prediction of an individuals prognosis. With the technique of multiple linear regression analysis, the survival of individual animals could be predicted with great accuracy. This is possible also when two postinjury parameters,CBF and MBP, are used.

Partially purified protein from washed and artificially hemolyzed erythrocytes, known to cause significant contractions of isolated canine cerebral vessels in vitro, was injected into the cisterna magna of intact anesthetized dogs. Cerebral blood flow, measured by the xenon-133 washout technique, decreased from a control value of 49.5 +/- 1.17 ml/100 gm/min to an experimental value of 34.1 +/- 1.65 ml/100 gm/min at 2 hours. Cerebral vascular resistance rose from a control value of 2.05 +/- 0.17 PRU (peripheral resistance units) to an experimental value of 2.91 +/- 0.25 PRU at 2 hours. Mean arterial blood pressure, heart rate, intracranial pressure, and cerebral perfusion pressure remained stable. Cardiac output also fell significantly (in 2-hour control animals it was 2.89 +/- 0.37 liter/min, and in 2-hour experimental animals 1.43 +/- 0.13 liter/min) and peripheral vascular resistance rose. These changes were evident by 10 minutes after the cisternal injection of the hemolysate protein, and remained for the duration of the 2-hour monitoring period. Serial vertebrobasilar angiograms demonstrated marked narrowing of the intracranial basilar artery when compared to control values. The narrowing persisted for several days in most animals, and tended to increase with time. Relaxation occurred by the 10th through the 14th day. The authors conclude that this experimental preparation may be a useful model for both in vitro and in vivo investigation of chronic cerebral vasospasm.

Antifibrinolytic drugs and subtotal occulusion of carotid artery have been investigated in a series of 168 patients with recently ruptured intracranial aneursyms. It is concluded that epsilon-aminocaproic acid offers effective treatment, that aggressive hypotensive therapy is dangerous in the severely obtunded patient, and that epsilon-aminocaproic acid plus subtotal carotid occlusion (supplemented by a moderate hypotensive regime) offer the best treatment, in this experience, in the prevention of recurrent hemmorrhages.

Hemispheric cerebral blood flow was measured in 14 patients prior to and after the injection of sodium nitroprusside. The intracarotid method of Xenon was utilized, and flow was calculated by the flow initial technique. With a small reduction in blood pressure during the administration of sodium nitroprusside, the cerebral blood flow fell significantly by 15.9+/- 5.6%.