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Background Associations of diet with dilated cardiomyopathy are under investigation. Objectives That cardiac assessment would show abnormalities in healthy dogs eating grain‐free (GF) diets or diets with Food and Drug Administration (FDA)‐listed ingredients of concern (peas, lentils, or potatoes) as top 10 ingredients (FDA‐PLP), but not in dogs eating grain‐inclusive (GI) diets or diets without FDA‐listed ingredients of concern (PLP) in the top 10 ingredients (NoFDA‐PLP). Animals One hundred eighty‐eight healthy Doberman Pinschers, Golden Retrievers, Miniature Schnauzers, and Whippets. Methods This study was an observational cross‐sectional study. Echocardiograms, cardiac biomarkers, and blood and plasma taurine concentrations were compared between dogs eating GF (n = 26) and GI (n = 162) diets, and between FDA‐PLP (n = 39) and NoFDA‐PLP (n = 149) diets, controlling for age and breed. Demographic characteristics, murmurs, genetic status, and ventricular premature complexes (VPCs) during examination were compared between dogs eating different diet types. Results No differences in echocardiographic variables, N‐terminal pro‐B‐type natriuretic peptide or whole blood taurine were noted between dogs eating different diet types. Dogs eating GF diets had higher median high‐sensitivity cardiac troponin I (hs‐cTnI) (GF 0.076 ng/mL [Interquartile range (IQR), 0.028‐0.156] vs. GI 0.048 [IQR, 0.0026‐0.080]; P

OBJECTIVETo investigate the predictive value of right axis deviation of the mean electrical axis (MEA) in assessing the severity of pulmonic stenosis (PS) in dogs.ANIMALSRecords for 218 client-owned dogs diagnosed between 2014 and 2020 with PS as determined by Doppler echocardiography.PROCEDURESUniversity of Florida Small Animal Clinic medical records were reviewed, and signalment and clinical risk variables (murmur grade and clinical signs) were extracted. MEA was determined from ECG records by use of leads I and III. Predictive potential of MEA and associated risk factors to diagnose PS severity (mild [< 50 mm Hg], moderate, or severe [> 75 mm Hg]) were assessed by receiver-operating characteristic curve analysis and quantile regression.RESULTSRecords for 88 dogs were eligible for analysis. Greater PS severity was associated with smaller breeds presenting with ECG abnormalities, overt clinical signs, and high-category murmur grades (IV and V). Mean MEA increased with stenosis severity category, with an average of 62° for mild, 113° for moderate, and 157° for severe. Each 10° increase in MEA corresponded to an approximately 5–mm Hg increase in PG. Increasing PS severity was associated with MEA right axis deviation > 100° and the more severe cases (PG > 75 mm Hg) with MEA right axis deviation > –180°.CLINICAL RELEVANCEMean electrical axis right axis deviation may be a useful screening metric for dogs with suspected moderate to severe PS.

Gambling has a long history in Japan. From their earliest mentions in legal codes during the Asuka period (538-710), through to the Meiji period (1868-1912), igo 囲碁, sugoroku 双六 and chōhan 丁半 have all enjoyed the patronage of Japanese emperors, aristocrats, warriors and monks. This thesis explores these gambling games through primary sources. Setsuwa説話, collections of didactic and secular stories, were popular in medieval Japan and can be mined for factual history when analyzed critically along with secondary sources. Through an analysis of tales in Kokon chomonjū (古今著聞集 “A Collection of Notable Tales Old and New”), Konjaku Monogatarishū (今昔物語 “Anthology of Tales from the Past”) and Uji shūi monogatari (宇治拾遺物語 “Gleanings from Uji Dainagon Monogatari”) this thesis proposes that gambling was an important form of leisure (asobi 遊び) in classical Japan. It was also a way to win sumptuous wagers, to the extent that gambling games were repeatedly proscribed by the military government during the Kamakura period (1185-1333)., Chapter I: Introduction ............................................................................................. 1 Methodology, Definitions and Sources ................................................................. 7 Chapter 2: The Emperor’s Game of Go: Gambling and the Aristocracy ............... 10 Raising The Stakes .............................................................................................. 14 House Wins ― The Formalization of Go ............................................................. 21 Chapter 3: Roll the Dice: Sugoroku, Chōhan and Gambling Gangs ..................... 28 Feelin’ Lucky? ― The Gambler in Heian Japan................................................... 39 Quit While You’re Ahead ― Proscriptions, Warnings and Gambling Gangs...... 44 Chapter 4: Fortune Favors the Brave: Wagering and Gamblers in Everyday Life 50Conclusion: When the Chips Are Down ................................................................ 59Bibliography ........................................................................................................ 64, 指導教員 : Professor Karl Friday

Echocardiographically identified pulmonary hypertension is an independent predictor of poor outcome in dogs affected by myxomatous valvular degeneration (MMVD). Systolic pulmonary arterial pressure is routinely estimated based on its relationship with the Doppler-determined velocity of tricuspid regurgitation as defined by the simplified Bernoulli equation (sPAP_D). Experimental studies suggest that the method is imperfect, but its accuracy in dogs with MMVD is not known.Twenty dogs affected by MMVD that had cardiac remodeling and measurable tricuspid regurgitation.A flow-directed thermodilution monitoring catheter was percutaneously placed in the right external jugular vein and advanced to the main pulmonary artery. Pulmonary arterial systolic pressure was recorded (systolic pulmonary arterial pressure obtained by right heart catheterization [sPAP_C]). A second operator contemporaneously acquired tricuspid regurgitant velocity spectra to calculate sPAP_D. Each operator was blinded to the result of the other techniques.Technical difficulties prevented the analysis of catheterization data in two dogs. Eighteen measurement pairs were therefore used for comparison of sPAP_C and sPAP_D through correlation and Bland-Altman analysis. A statistically significant bias between sPAP_C and sPAP_D (mean difference = 0.5 mmHg; confidence interval = -6.5 mmHg, +7.5 mmHg) was not detected. The interval of agreement between the techniques was wide (-27.3 mmHg, +28.2 mmHg). A significant linear association between the two techniques was not identified (r = 0.11, p=0.17).Echocardiographically estimated pulmonary artery pressure poorly agrees with sPAP_C measurement in dogs affected by MMVD and cardiac remodeling with or without previously diagnosed congestive heart failure. In these dogs, sPAP_D could under- or over-estimate sPAP_C by more than 20 mmHg, and therefore caution should be used when interpreting sPAP_D.

Background: Myxomatous mitral valve disease (MMVD) is more prevalent in Cavalier King Charles Spaniels (CKCSs) compared to dogs of other breeds at a given age. Abnormal valvular stress is thought to contribute to the development and progression of MMVD, and a relationship exists between mitral valve (MV) morphology and stress acting on the valve. Objectives: To determine whether the MV morphology of healthy adult CKCSs differs from the morphology of healthy adult dogs of other breeds determined by RT-3DTTE. Animals: Thirty-five healthy CKCSs and 41 healthy dogs of other breeds. Methods: Prospective cross-sectional study. Dogs underwent physical examination, conventional echocardiography, and RT-3DTTE. RT–3DTTE datasets were analyzed using dedicated software for MV morphologic analysis. Morphologic variables were compared between CKCSs and dogs of other breeds. Results: The MV of healthy CKCSs had a smaller annulus height (0.46 ± 0.11 vs. 0.56 ± 0.17; P =.0021), tenting height (0.26 ± 0.12 vs. 0.42 ± 0.18; P

Objective To assess differences in morphology of the mitral valve (MV) between healthy dogs and dogs affected by myxomatous mitral valve disease (MMVD) using real-time transthoracic three-dimensional echocardiography (RT3DE). Animals Thirty-four were normal dogs and 79 dogs were affected by MMVD. Methods Real-time transthoracic three-dimensional echocardiography mitral datasets were digitally recorded and analyzed using dedicated software. The following variables were obtained and compared between healthy dogs and dogs with MMVD at different stages: antero-posterior annulus diameter, anterolateral-posteromedial annulus diameter, commissural diameter, annulus height, annulus circumference, annulus area, anterior leaflet length, anterior leaflet area, posterior leaflet length, posterior leaflet area, non-planar angle, annulus sphericity index, tenting height, tenting area, tenting volume, the ratio of annulus height and commissural diameter. Results Dogs with MMVD had a more circular MV annulus compared to healthy dogs as demonstrated by an increased annulus sphericity index (p=0.0179). Affected dogs had a less saddle-shaped MV manifest as a decreased annulus height to commissural width ratio (p=0.0004). Tenting height (p

Objective Mitral valve (MV) regurgitation due to degenerative MV disease is the leading cause of cardiac death in dogs. We carried out preliminary experiments to determine the feasibility and short-term effects of beating-heart MV repair using an expanded polytetrafluorethylene (ePTFE) chordal implantation device (Harpoon TSD-5) in dogs. Animals This study involved six healthy purpose-bred Beagles (weight range 8.9–11.4 kg). Material and methods Following a mini-thoracotomy performed under general anesthesia, the TSD-5 was used to place 1 or 2 artificial ePTFE cords on the anterior MV leaflet or the posterior MV leaflet via a left-ventricular transapical approach. The procedure was guided and monitored by transesophageal echocardiography. Postoperative antithrombotic treatment consisted of clopidogrel or a combination of clopidogrel and apixaban. Dogs were serially evaluated by transthoracic echocardiography at day 1, 7, 14, 21, and 30. The hearts were then examined for evaluation of tissues reactions and to detect signs of endothelialization. Results One or two chords were successfully implanted in five dogs. Four dogs completed the 30 days follow-up. One dog died intra-operatively because of aortic perforation. One dog died early post-operatively from a hemorrhagic pleural effusion attributed to overly aggressive antithrombotic treatment. One dog developed a thrombus surrounding both the knot and the synthetic cord. Postmortem exam confirmed secure placement of ePTFE knots in the mitral leaflets in all dogs and the presence of endothelialization of the knots and chords. Conclusions These preliminary results demonstrate the feasibility of artificial chordal placement using an ePTFE cordal implantation device in dogs.

PurposeThe purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge‐management strategies have scaled‐up learning and development in rural, remote and other resource‐constrained Canadian delivery settings.Design/methodology/approachIntervention design was realized through a one‐time, collaborative, national capacity‐building project. A project portfolio of 72 sub‐projects, initiatives and strategic activities was used to improve access, enhance quality and create capacity for palliative and end‐of‐life care services. Evaluation was multifaceted, including participatory action research, variance analysis and impact analysis. This has been supplemented by post‐intervention critical reflection and integration of relevant literature.FindingsThe purposeful use of collaboration, innovation and knowledge‐management strategies have been successfully used to support a rapid scaling‐up of learning and development interventions. This has enabled enhanced and new pan‐Canadian health delivery capacity implemented at the local service delivery catchment‐level.Research limitations/implicationsThe intervention is bounded by a Canada‐specific socio‐cultural/political context. Design variables and antecedent conditions may not be present and/or readily replicated in other nation‐state contexts. The findings suggest opportunities for future integrative and applied health services and policy research, including collaborative inquiry that weaves together concepts from adult learning, social science and industrial engineering.Practical implicationsScaling‐up for new capacity is ideally approached as a holistic, multi‐faceted process which considers the total assets within delivery systems, service catchments and communities as potentially being engaged and deployed.Originality/valueThe Pallium Integrated Capacity‐building Initiative offers model elements useful to others seeking theory‐informed practices to rapidly and effectively scale‐up learning and development efforts.

Objectives To evaluate the feasibility of real time transthoracic three-dimensional echocardiography (RT3DE) for evaluation of normal canine mitral valves (MVs), and to provide reference values for this technique. Animals Forty-three cardiologically healthy, not sedated dogs. Methods Transthoracic RT3DE mitral datasets were acquired during two consecutive 6-month periods. The datasets were analyzed using commercially available software. An MV model was drawn using a semiautomated procedure and MV variables were obtained and calculated. The ratio between annulus height and commissural diameter was used as an index of the annulus' saddle-shaped non-planarity. After evaluation of associations between measured variables and body size, the datasets were used to generate reference intervals. Coefficients of variation (CVs), variance components, and repeatability coefficients were calculated for the evaluation of intra-observer, inter-observer, and day-to-day variability. Results Datasets could be analyzed in 34 of 43 (79%) dogs. 68 percent of datasets obtained during the first 6-month period could be analyzed and 90% obtained during the second period could be analyzed. An allometric relationship was identified for most MV variables. The MV annulus appeared elliptical and saddle-shaped. Inter- and intra-observer CVs were less than 20%. Coefficient of variation greater than 20% was calculated for the inter-day variation for some variables. Operator and observer were primarily responsible for the variation of most of the variables. Conclusions Evaluation of canine mitral valves by transthoracic RT3DE is feasible. Canine MVs of healthy dogs analyzed using RT3DE are elliptical and saddle-shaped. Reference intervals for the measured MV variables are proposed.

The purpose of this study was to determine the learning styles and problem-solving ability of physiotherapy students. The subjects were 158 students from years 2 to 4 of a baccalaureate physiotherapy programme. All subjects completed the Kolb Learning Style Inventory (LSI) and were classified into one of four learning styles. They also completed the Heppner Problem Solving Inventory (PSI), for which a total score and three subscale scores were calculated. Chi-square and one-way analyses of variance were used to determine differences between years for the LSI and PSI respectively. The association between the PSI and LSI was determined with an eta coefficient. The majority of students had the preferred learning style of assimilator' or converger'. The scores on the PSI were similar to those reported for other undergraduate students, and were not related to learning style. There were no significant differences between years for the LSI or the PSI score. We conclude that physiotherapy students in a baccalaure...

th , 2010, USC’s first cubesat rode into orbit on the SpaceX Falcon 9 Dragon mission. The cubesat was a joint venture between USC and Northrop Grumman. USC’s portion is named “Caerus”. This paper describes the requirements, design and implementation, test, flight and lessons learned of the vehicle. Particular attention is given to the deployable antenna, antenna sharing, beacon radio, main radio, store-and-forward software, a spacecraft state of health/state of flight system including MEMs gyroscopes, and mobile ground station dish with helical feed. Additional logistical hurdles we surmounted include: firewalls for ITAR and non-ITAR students, handling proprietary commercial information, RF spectrum licensing and coordination and finally, managing separate locations for: dish, commercial and academic mission control stations, commercial and academic and international beacon stations. The mission succeeded in attaining all Level One goals for Northrop Grumman NovaWorks. In all, it became a mission whose 11 month arc covered more aspects of spaceflight than most people are lucky enough to see in a career.

The Canadian Hospice Palliative Care Association (2002) identifies spiritual care of the dying and their families as a core service for Hospice Palliative Care programs. Yet, until the Spiritual Care Development Initiative of the Canadian Pallium Project, there was no published literature indicating systematic profiling of occupationally relevant core competencies or competency-based training programs specific to this specialized field of practice. This article describes a Canadian Community of Practice process to develop an occupational analysis-based competency profile for the Professional Hospice Palliative Care Spiritual Care Provider utilizing a modified Developing a Curriculum (DACUM) methodology. Competency profiles are important contributions to the development of curricula to train care providers who are recognized by other professions and by institutions as possessing the requisite theoretical and clinical expertise, particularly in academic tertiary care settings.

Next generation space structures need on-orbit assembly due to volume limitations on launch vehicles. Many assembly strategies exist; one such is the notion of autonomous Micro-satellites used to grab, transport, and a ssemble individual structures. The University of Southern California’s (USC) new Micro-satellite Dynamic Test Facility (MDTF) is demonstrating full scale assembly techniques using independent and autonomous microsatellite prototypes with five fo ot passive beams. All testing is performed on a frictionless 3DOF hyper flat surface platen, with both inertial and relative positioning systems. The micro-satellites are independent spacecraft prototypes capable of attitude control that provide a test bed for space based operations. Designed to reduce cost and maximize simplicity, micro-satellites have been used to test spacecraft maneuvers at the MDTF. Their wireless communication ability has been used to produce teams for formation flying or collaborative operations. USC’s current research focused upon the technologies necessary for one element of autonomous assembly is showcased here with beam assembly.

/ Cet article decrit les resultats d'un sondage transcanadien conduit sur Internet aupres des medecins travaillant en medecine palliative, afin de connaitre l'usage qu'ils faisaient de l'ordinateur de poche (OP). Soixante-douze medecins ont repondu a notre questionnaire au cours des mois d'avril a juillet 2005. Notre sondage revele que 58.3 % des repondants utilisaient l'OP sur une base journaliere afin surtout de planifier leur pratique, ou encore pour faire des recherches bibliographiques. Certains utilisent l'OP pour noter des informations medicales sur leurs patients, ou encore pour acceder a la centrale des dossiers-patients informatises. L'OP offre plusieurs possibilites d'utilisation en soins palliatifs dont: la recherche de references bibliographiques, l'acces aux dossiers-patients electroniques, la facon de se maintenir au courant, la productivite personnelle, la recherche clinique et les preoccupations s'y rattachant. Les gestionnaires en sante devraient prevoir l'integration d'une technologie mobile, comme faisant partie integrante de l'informatisation de leur etablissement. On devrait se pencher beaucoup sur les possibilites qu'offre l'OP pour la medecine palliative, car une approche basee sur l'information technologique pourrait faire avancer la medecine palliative au Canada.

PurposeThis paper situates a large‐scale learning and service development capacity‐building initiative for hospice palliative care services within the current Canadian policy context for use by international readers.Design/methodology/approachIn 2000 a national initiative using action research as its design was crafted to support continuing professional development and knowledge management in primary‐health care environments.FindingsThe Canadian health policy context is complex and requires innovative solutions to achieve desired changes in response to emerging population health demands for quality end‐of‐life care. Employment of educational and social science constructs, including complexity theory, communities of practice, transformative learning theory, and workplace learning methods, has proven helpful in supporting the creation of national capacity for hospice palliative care.Research limitations/implicationsThere is a significant contribution for social scientists to make in aiding a better understanding of the complexity in health systems. At the same time, an aging population in industrial countries demands more active engagement of legal and bioethical scholars in a range of emerging policy and legislative questions about quality end‐of‐life care. Educational research is also required to understand better and reform curricula to prepare an emerging generation of health science practitioners for the demands of an aging population.Practical implicationsChanging health service delivery environments demand rethinking of the knowledge and skills leaders require to influence desired change. A broader understanding of where and how learning takes place is essential for enhancing the quality of patient care.Originality/valueThe Pallium Project represents a generative response to facilitating learning and building longer‐term system capacity. The journey of project development to date illustrates some important lessons that can be adopted from hospice palliative care to inform other primary‐health care initiatives, including, potentially, mental health, cardiology, diabetes, geriatrics, where productive change can result from productively linking specialists and primary‐care colleagues.

Continuing medical education (CME) program development and needs assessment have historically been practiced within the tradition of Ralph Tyler's education model. In light of transformational social, political, economic, and technical forces that demand greater account-ability and responsiveness from physicians, CME units are challenged to transform their cultures and structures from models that deliver education to models that support the facilitation of learning for enhanced competence and performance. This article describes key change forces for physicians and brings program development and needs assessment into focus for the discussion. The impact of change forces on program development and needs assessment are examined, and some techniques to move beyond the traditional approach of felt needs are presented as a way of enabling strategic administrative planning and change management.