Supporting long-term condition management: a workflow framework for the co-development and operationalization of machine learning models using electronic health record data insights.

The prevalence of long-term conditions such as cardiovascular disease, chronic obstructive pulmonary disease (COPD), asthma, and diabetes mellitus is rising. These conditions are leading sources of premature mortality, hospital admission, and healthcare expenditure. Machine learning approaches to improve the management of these conditions have been widely explored, with data-driven insights demonstrating the potential to support earlier diagnosis, triage, and treatment selection.

Development, validation and application of a high-performance liquid chromatography method for the detection of ibuprofen in elephant plasma.

A simple and accurate method for the determination of ibuprofen concentrations in elephant plasma was developed and validated using reverse phase high-performance liquid chromatography (HPLC). Utilizing a liquid-liquid extraction with ethyl acetate, methanol, and phosphoric acid, samples were separated on an XBridge C column. The mobile phase consisted of 0.

IMMOBILIZATION OF BLACK HOWLER MONKEYS () USING BUTORPHANOL, AZAPERONE, MEDETOMIDINE IS SAFE AND EFFECTIVE FOR NONINVASIVE PROCEDURES.

Administration of butorphanol, azaperone, and medetomidine (BAM) for immobilization of black howler monkeys () has not been previously reported. In this observational study, 0.02 ml/kg of compounded BAM (butorphanol 27.

A novel tool using social and environmental determinants of health to assess pediatric asthma in the emergency department.

Asthma, the most common chronic disease in children, affects more than 4 million children in the United States, disproportionately affecting those who are economically disadvantaged and racial and ethnic minorities. Studies have shown that the racial and ethnic disparities in asthma outcomes can be largely explained by environmental, socioeconomic and other social determinants of health (SDoH). Utilizing new approaches to stratify disease severity and risk, which focus on the underlying SDoH that lead to asthma disparity, provides an opportunity to disentangle race and ethnicity from its confounding social determinants.

FIELD TECHNIQUES FOR VASECTOMY IN BLACK HOWLER MONKEYS ().

Three adult black howler monkeys () were vasectomized for the purpose of population control. Two different surgical approaches (inguinal and pelvic) were used to vasectomize the animals under general anesthesia. One monkey was vasectomized with a pelvic approach, and the other two monkeys were vasectomized with an inguinal approach.

Spinal disease in a captive population of species: Review of 86 cases (2003-2021).

This retrospective study aimed to characterize and determine the prevalence of spinal disease in nondomestic felids within a sanctuary population. A review of 304 postmortem examination reports in species from 2003 to 2021 revealed that 86/304 (28%) were diagnosed with spinal disease. Spinal lesions were categorized according to pathologic process: degenerative (78/86, 91%), developmental (8/86, 9%), inflammatory (6/86, 7%), or neoplastic (8/86, 9%).

INTERVERTEBRAL DISC DISEASE IN THREE LARGE FELIDS ( SPP.) TREATED SURGICALLY.

Intervertebral disc disease (IVDD) in captive large felids is a commonly encountered syndrome that is usually treated medically, with surgical cases only sparsely documented in the literature. This case series describes the diagnosis, surgical treatment, and postoperative care of three cases of IVDD in large felids: an 8-yr-old male Bengal tiger () with acute paraplegia, a 10-yr-old male tiger of unknown subspecies () with progressive tetraparesis, and a 17-yr-old female African lion () with mild paraparesis. Two cases were diagnosed via magnetic resonance imaging (MRI) and the third was diagnosed with computed tomography myelography.

Long-Term Usage and Improved Clinical Outcomes with Adoption of a COPD Digital Support Service: Key Findings from the RECEIVER Trial.

Purpose: Digital tools may improve chronic obstructive pulmonary disease (COPD) management, but further evidence of significant, persisting benefits are required. The RECEIVER trial was devised to evaluate the Lenus COPD support service by determining if people with severe COPD would continue to utilize the co-designed patient web application throughout study follow-up and to explore the impact of this digital service on clinical outcomes with its adoption alongside routine care.

Patients And Methods: The prospective observational cohort hybrid implementation-effectiveness study began in September 2019 and included 83 participants.

UTILITY OF URINE ANTIGEN TESTING FOR DIAGNOSIS OF BLASTOMYCOSIS IN NONDOMESTIC FELIDS.

Blastomycosis caused by the fungus has been reported to cause disease in numerous species of nondomestic felids. Diagnosis of blastomycosis in domestic species often relies on the combination of clinical signs, radiographic findings, and commercial urinary antigen testing. In this report, the sensitivity, specificity, and positive and negative predictive values for urine blastomyces antigen testing for use in nondomestic felids were examined and compared with findings on postmortem examination.

ECHOCARDIOGRAPHIC MEASUREMENTS IN ANESTHETIZED CAPTIVE RED PANDAS ().

A recent review of mortality in captive red pandas () listed cardiac pathology as the most common cause of death in the adult age group. The aim of this study was to describe the standard echocardiographic variables in 13 captive, healthy, adult red pandas that underwent an elective health examination. In addition, differences between the two subspecies of red panda, than in , and association of these echocardiographic variables with age, sex, and body condition score, were examined.

MELANOCYTIC NEOPLASIA IN SPECIES: CLINICAL PRESENTATIONS, PATHOLOGIC FINDINGS AND RESPONSES TO TREATMENT.

Neoplasia is a common cause of morbidity and mortality in captive nondomestic felids. Seven tigers (), two African lions (), and two snow leopards () were diagnosed with melanocytic neoplasia (10 malignant melanomas, two benign melanocytomas) over a 20-yr period. Animals were 10-19 yr old and 5/7 tigers were phenotypically white.

RABIES DIAGNOSIS AND RESPONSE TO VACCINATION IN SOUTHERN TAMANDUA ().

Rabies has rarely been described in Xenarthra, and rabies vaccine response has not been documented. A southern tamandua () presented with nonspecific clinical signs and was euthanatized. Subsequently, immunohistochemistry and RT-PCR confirmed a rabies diagnosis.

EVALUATION OF AGREEMENT BETWEEN OSCILLOMETRIC AND DIRECT BLOOD PRESSURE MEASUREMENTS IN ANESTHETIZED TIGERS ().

Noninvasive blood pressure measurement is commonly performed with oscillometry; however, this technique provides clinically helpful information only if it is representative of the gold standard. Agreement between direct and oscillometric blood pressure measurements were performed in 14 anesthetized, captive tigers (). A cuff, placed around the tail base and connected to a multiparameter monitor, was used to measure arterial blood pressure oscillometrically and provided systolic, mean, and diastolic pressures.

Mental Health Revisits at US Pediatric Emergency Departments.

Importance: Pediatric emergency department (ED) visits for mental health crises are increasing. Patients who frequently use the ED are of particular concern, as pediatric mental health ED visits are commonly repeat visits. Better understanding of trends and factors associated with mental health ED revisits is needed for optimal resource allocation and targeting of prevention efforts.

Geospatial data in pediatric asthma in the United States: a scoping review protocol.

Objective: The objective of this scoping review is to identify and describe the literature on the use of geospatial data in pediatric asthma research.

Introduction: Asthma is one of the most common pediatric chronic diseases in the United States, disproportionately affecting low-income patients. Asthma exacerbations may be triggered by local environmental factors, such as air pollution or exposure to indoor allergens.

RETROSPECTIVE REVIEW OF MORBIDITY AND MORTALITY IN A POPULATION OF CAPTIVE BUDGERIGARS ().

This retrospective study reviews the diseases associated with morbidity and mortality in 221 budgerigars () from a captive population from 2013 to 2019. The study aimed to evaluate the health status of a flock of budgerigars typical of today's zoologic collections. Based on previous literature, it was hypothesized that age-related conditions such as neoplasia would be common, whereas metabolic and nutritional disorders would be less common.

MORBIDITY AND MORTALITY OF FREE-RANGING AMERICAN BLACK BEARS (URSUS AMERICANUS) UNDERGOING REHABILITATION IN EASTERN TENNESSEE, USA, 1996-2021.

Free-ranging American black bears (Ursus americanus) often share habitat with humans and domestic animals, predisposing them to anthropogenic conflicts. Rehabilitation under professional care is a management option for orphaned, injured, and/or ill bears. Across several southeastern states, rescued bears are assessed and treated at the University of Tennessee and rehabilitated at Appalachian Bear Rescue (ABR).

Experiences of simulated patients in providing feedback in communication skills teaching for undergraduate medical students.

Background: Simulated Patients (SPs) are commonplace in the teaching of communication skills in medical education and can provide immediate feedback to students from the patient's perspective. The experiences of SPs and their perspective on providing feedback is an under-studied area. This study aims to explore SP experiences and views on feedback, factors influencing their feedback and implications for training.

Translocation of an Anteater (Tamandua tetradactyla) Infected with Rabies from Virginia to Tennessee Resulting in Multiple Human Exposures, 2021.

On August 16, 2021, the Tennessee Department of Health (TDH) was notified of a positive rabies test result from a South American collared anteater (Tamandua tetradactyla) in Washington County, Tennessee. Tamanduas, or lesser anteaters, are a species of anteater in which rabies has not previously been reported. The animal was living at a Tennessee zoo and had been recently translocated from a zoo in Virginia.

Blood concentration of symmetric dimethylarginine correlates with kidney damage as assessed with a proposed histologic grading system for chronic kidney disease in tigers (Panthera tigris).

Objective: To determine the utility of blood symmetric dimethylarginine (SDMA) concentration measurement as a diagnostic tool for chronic kidney disease (CKD) in tigers (Panthera tigris) by comparing results for SDMA with those for traditional renal biomarkers and investigating correlations between these biomarkers and histopathologic kidney changes in tigers with CKD.

Sample: Blood, urine, and kidney samples from 35 tigers with CKD from 2 sanctuaries.

Procedures: Blood (serum or plasma) and urine samples were collected antemortem.

Comparison of steroid and thyroid hormone concentrations in blood serum and plasma of captive tigers.

Analysis of steroid and thyroid hormones is often performed in blood serum. Occasionally though, plasma samples are submitted in lieu of serum for exotic species such as tigers. However, blood tube anticoagulants may affect hormone values.