Frontier Hospital

BackgroundAn increasing number of dogs are presented with suspected canine cognitive dysfunction (CCD), and a subset also exhibits myoclonus.ObjectivesBecause CCD shares multiple pathological and pathophysiological features with Alzheimer's disease in humans, and myoclonus has been linked to neurodegenerative disorders in people, the aim of the study was to describe myoclonus in dogs with clinical signs of CCD.Material and methodsAn anonymous online survey for owners of geriatric dogs (over 7 years of age), consisting of 46 questions, was conducted. The survey included items on signalment, the Canine Dementia Scale (CADES), and myoclonus. CCD was defined based on a CADES score of >8. It was available online in both German and English from April to June 2024.ResultsOf the 401 participants, 148 dogs were excluded due their young age, under 7 years and incomplete CADES-Score. Among the remaining respondents, 89% of owners reported that their dog showed signs of CCD. Overall, 146/164 (89.0%) dogs exhibited both CADES-defined CCD and myoclonus. However, no statistical significance was found between the co-occurrence of CCD screen status and the presence of myoclonus (p = 0.45). Predominantly, myoclonus occurred spontaneously (72.6%, n = 119), stress-induced (15.2%, n = 25), and light-induced (11.6%, n = 19). Noise-induced and feeding-induced myoclonus were the least common trigger (3.0%, n = 5 each), as well as no answer given (0.6%, n = 1). Ten dogs had multiple trigger causes.Clinical significanceMyoclonus was commonly co-reported alongside CADES-defined CCD by respondents. Although no statistically significant association between CCD and myoclonus was detected, CCD should be considered among the differential diagnosis in geriatric dogs presenting with myoclonus, particularly in the context of concurrent cognitive decline.

Cardiovascular disorders are the leading cause of death worldwide, so it is crucial that we develop innovative, rapid and precise methods of diagnosing them. The hybrid deep learning model proposed in this study combines the most effective elements of sparse autoencoders (SAEs), multilayer perceptrons (MLPs) and convolutional neural networks (CNNs). To properly display the input attributes, this method employs categorical encoding and normalisation on the UCI Heart Disease dataset. This hybrid architecture facilitates the development of an AI system that retains crucial physiological characteristics while handling large amounts of abstract data. Furthermore, it has been demonstrated that the proposed hybrid architecture outperforms the other techniques investigated, including Learning Vector Quantification and Logistic Regression with Boruta feature selection. The hybrid design achieved a recall rate of 93.8%, an accuracy rate of 95.1%, a precision rate of 94.6% and an F1 score of 94.2%. Substantial statistical evidence supports the idea that the CNN–MLP + SAE architecture will be effective as an early detection method for heart disease.

The Asian tiger mosquito (Aedes albopictus) is an important vector of arboviruses, including dengue, chikungunya, and Zika. Its rapid global expansion has been facilitated by climate change and human activities. Phylogenetic studies of Ae. albopictus have largely relied on mitochondrial cytochrome c oxidase subunit 1 (COX1) and NADH dehydrogenase subunit 5 (ND5) markers, while the utility of cytochrome b (CYTB) remains underexplored. We collected Ae. albopictus from 13 sites in seven provinces of South Korea and analyzed COX1, ND5, and CYTB sequences. Genetic diversity indices were calculated, and phylogenetic relationships were reconstructed using maximum-likelihood trees and haplotype networks with a dataset obtained from GenBank. COX1 revealed 46 haplotypes, including six novel variants, with the highest diversity in southern coastal regions such as Busan and Suncheon. ND5 showed limited variation, with only two haplotypes. CYTB revealed three haplotypes, including region-specific variants in Busan and Wonju, supporting its role as a complementary marker. The Busan haplotype H41 bridged domestic and international lineages, suggesting Busan as a likely entry point. This study demonstrates that integrating COX1, ND5, and CYTB improves the resolution of Ae. albopictus phylogeography in Korea and highlights the need for continued molecular surveillance to guide vector control strategies.

Hearing loss is one of the leading causes of disability worldwide, affecting individuals across all age groups. Its impact extends beyond auditory function, influencing overall health-related quality of life (HRQoL) and presenting significant social, emotional, and communication challenges. Understanding the interplay between hearing loss, its determinants, and HRQoL is critical for developing effective interventions, particularly in underserved rural settings. A cross-sectional study was conducted from May 2019 to August 2019 in the rural Eastern Cape, South Africa, involving 210 adults with hearing loss. Data were collected using the RAND 36-Item Health Survey 1.0, administered in English or IsiXhosa, to assess HRQoL. Additional data on socio-demographic characteristics, audiological profiles (including degree of hearing loss and hearing aid use), and communication status were collected. Descriptive statistics, bivariate analyses, and multivariate linear regression models were employed to analyse the data, with significance set at p < 0.05. Key determinants of better HRQoL included younger age, male gender, and higher income, with older participants (age 58 years and above) showing significantly reduced odds of good health (OR 0.38, 95% CI 0.16–0.91, p = 0.033). Hearing aid use (OR 1.59, 95% CI 0.87–2.94, p = 0.135) was not associated with improved overall HRQoL. The current research showed that both biological and social factors significantly impact the quality of life of patients living with hearing loss in the rural Eastern Cape. While physical health was relatively preserved, social and emotional health were impaired. These findings emphasise the urgent need for further research to confirm the associations to provide targeted health interventions for individuals with hearing loss in rural settings. This study promotes the rights of people with disabilities by highlighting factors affecting the quality of life for deaf or hard of hearing patients in rural South Africa, a group with little research available. It shows the need to focus on resource allocation in public healthcare to improve services for people with hearing loss, which can enhance their communication, relationships, and quality of life. It supports policies for the inclusivity of deaf or hard of hearing individuals in the economic activities of the country to enhance their quality of life.

This paper develops an automated approach for conjunctival hyperemia grading from slit-lamp images using semisupervised learning. We conducted a retrospective study including slit-lamp images from two study sites. Two independent graders assessed the severity of hyperemia according to the Efron Grading Scales. Segmentation of the conjunctiva and its vessels was performed using semisupervised segmentation with limited labeled data. Conjunctival vessel densities were estimated from the model outputs and compared against the manual clinical Efron gradings. Three hundred and seventeen slit-lamp images from the primary site and 164 from an external site were included. The semisupervised models with unlabeled data demonstrated significantly improved segmentation compared to a baseline fully supervised model using only the labeled data (p < 0.001). Calculated conjunctival vessel densities showed correlations of 0.86 [0.76, 0.93] with ground truth vessel densities. Comparisons of vessel densities against mean manual clinical Efron gradings showed correlations of 0.83 and 0.80 for the test and external datasets, which were comparable to the inter-rater agreements of 0.82 [0.68, 0.90] and 0.75 [0.67, 0.81] in the datasets, respectively. Conjunctival vessel densities obtained with semisupervised learning showed good agreement with clinical grading of conjunctival hyperemia. This approach may be applied toward an automatic, objective assessment of the conjunctiva.

Altermagnetism has been proposed as a new type of magnetism, simultaneously exhibiting compensated spin moments in real space and spin-split electronic bands in reciprocal space. Alternating chiral magnon splitting is considered a unique feature of altermagnets. In this paper, utilizing linear spin-wave theory (LSWT), which is based on a localized spin picture and itinerant linear-response time-dependent density functional theory (LR-TDDFT), we investigate the spin fluctuation spectra of altermagnetic CrSb. Along the $L\text{\ensuremath{-}}\mathrm{\ensuremath{\Gamma}}\text{\ensuremath{-}}{L}^{\ensuremath{'}}$ path, the LSWT provides a chiral magnon splitting of up to 9 meV, located at high excitation energies around 140 meV, which is identified to be primarily driven by the splitting of two long-range exchange interactions, with exchange paths along the body diagonal lines of the unit cell. On the other hand, the more realistic LR-TDDFT obtains more significant splitting of $\ensuremath{\sim}30\phantom{\rule{0.28em}{0ex}}\mathrm{meV}$ at maximum. However, the splitting is severely smeared out due to strong Landau damping from the Stoner continuum, which may make it difficult to observe experimentally, e.g., through inelastic neutron scattering. We further provide a brief discussion on the connection between the Stoner excitations and the chiral magnon splitting.

Objective: To determine the association of pre-operative risk factors with abdominal wound dehiscence. Study Design: Quasi-experimental study. Place and Duration of study: Surgical Unit 1 of Combined Military Hospital, Rawalpindi, Pakistan from, Aug 2019 - Jan 2020. Methodology: A total of 130 cases and 130 controls with ages 20 to 70 yrs were included. Patients with neurological or psychological disorders or who underwent a laparoscopic procedure were excluded. All surgeries were performed by a single team with the assistance of a researcher. Patients were divided into two groups, i.e., Cases with abdominal wound dehiscence and controls without abdominal wound dehiscence. Patients were evaluated for risk factors, i.e., advanced age, male gender, anemia, emergency surgery, diabetes, and hypertension. Results: Mean age of patients in case group was 46.69±10.16 years, and in control group was 44.57±10.35 years. Preoperative risk factors for abdominal wound dehiscence in cases and controls were as follows; advanced age (7.69% vs. 3.08%), male gender (37.69% vs. 32.31%), hypertension (40% vs. 21.54%), diabetes (30.77% vs. 20.0%), anemia (83.08% vs. 50.0%) and emergency surgery (70.77% v. 48.46%). Conclusion: Risk factors like hypertension, diabetes mellitus, anemia and emergency surgery are the major risk factors for abdominal wound dehiscence.

Castleman disease is a rare type of lymph node hyperplasia primarily affecting the mediastinum, with mesenteric localization being extremely uncommon. It is classified into solitary and multicentric forms. In this case report, we present the case of a 46-year-old female patient in whom an incidental mesenteric mass was discovered during the workup for a ventral hernia. The mass was completely excised, and the histopathological examination confirmed the diagnosis of mixed-type Castleman disease. Surgery is the treatment of choice for localized forms of this condition, and histological examination is crucial in confirming the diagnosis.

Liver biochemistries are commonly ordered in the primary care setting, and they may return abnormal even in an asymptomatic patient. Primary care physicians need to have a systematic way of interpreting any derangement in these tests so that further investigations, referrals, and management can be arranged appropriately. This review dwells into patterns of liver biochemistry derangement, common aetiologies to consider, history and examinations that are required, initial investigations to order, and when to refer urgently to the emergency department.

The COVID-19 pandemic changed the way people lived, worked, and studied around the world, with direct consequences for domestic energy use. This study assesses the impact of COVID-19 lockdowns in the first two years of the pandemic on household electricity and gas use in England and Wales. Using data for 508 (electricity) and 326 (gas) homes, elastic net regression, neural network and extreme gradient boosting predictive models were trained and tested on pre-pandemic data. The most accurate model for each household was used to create counterfactuals (predictions in the absence of COVID-19) against which observed pandemic energy use was compared. Median monthly model error (CV(RMSE)) was 3.86% (electricity) and 3.19% (gas) and bias (NMBE) was 0.21% (electricity) and -0.10% (gas). Our analysis showed that on average (electricity; gas) consumption increased by (7.8%; 5.7%) in year 1 of the pandemic and by (2.2%; 0.2%) in year 2. The greatest increases were in the winter lockdown (January – March 2021) by 11.6% and 9.0% for electricity and gas, respectively. At the start of 2022 electricity use remained 2.0% higher while gas use was around 1.9% lower than predicted. Households with children showed the greatest increase in electricity consumption during lockdowns, followed by those with adults in work. Wealthier households increased their electricity consumption by more than the less wealthy and continued to use more than predicted throughout the two-year period while the less wealthy returned to pre-pandemic or lower consumption from summer 2021. Low dwelling efficiency was associated with a greater increase in energy consumption during the pandemic. Additionally, this study shows the value of different machine learning techniques for counterfactual modelling at the individual-dwelling level, and our approach can be used to robustly estimate the impact of other events and interventions.