West Health

Canine hepatozoonosis is caused by the tick-borne protozoans Hepatozoon canis and Hepatozoon americanum (Apicomplexa, Hepatozoidae). While H. americanum is widespread in the south-central and south-eastern United States, H. canis is documented in Europe, Africa, Asia, and South America, and is transmitted to dogs by ingesting infected ticks, primarily Rhipicephalus sanguineus. In Europe, this vector is mainly distributed in the Mediterranean region but endemic areas within Central Europe have also been reported, possibly facilitated by climate change. A mixed-breed male puppy, ∼3-7months-old, evacuated from Kherson City, Ukraine, was admitted to a private veterinary clinic in Kyiv in August 2023. There was no information about the owner and history of the animal. Physical examination evidenced fever, anorexia, lethargy, mild dehydration, and pale mucous membranes. Alopecia, purulent skin ulcers, and pruritus were also observed. On day 1 of admission, a 34% hematocrit and elevated leukocyte counts, particularly granulocytes and lymphocytes, were observed. H. canis gamonts were detected in stained blood smears and confirmed by specific PCR. Treatment was initiated with imidocarb at 6.6mg/kg i.m. at 15-day intervals for six weeks, and doxycycline 10mg/kg orally once daily for two weeks. Blood counts improved between towards day 16, with initial increase and subsequent normalization of hematological parameters. Hepatozoon-PCR was still positive on day 16. The dog made a full recovery, and no further tests were done thereafter. The systemic clinical signs were likely parasite-induced. H. canis and its vector R. sanguineus are being increasingly reported in Europe outside of their original geographical distribution, the Mediterranean basin. This case confirms the geographical expansion of this protozoan parasite.

Artificial intelligence (AI) is now embedded across many aspects of healthcare, yet most implementations remain fragmented, task-specific, and layered onto legacy workflows. This paper does not review AI applications in healthcare per se; instead, it examines what an AI-first healthcare system would look like, one in which AI functions as a foundational organizing principle of care delivery rather than an adjunct technology. We synthesize evidence across ambulatory, inpatient, diagnostic, post-acute, and population health settings to assess where AI capabilities are sufficiently mature to support system-level integration and where critical gaps remain. Across domains, the literature demonstrates strong performance for narrowly defined tasks such as imaging interpretation, documentation support, predictive surveillance, and remote monitoring. However, evidence for longitudinal orchestration, cross-setting integration, and sustained impact on outcomes, costs, and equity remains limited. Key barriers include data fragmentation, workflow misalignment, algorithmic bias, insufficient governance, and lack of prospective, multi-site evaluations. We argue that advancing toward AI-first healthcare requires shifting evaluation from accuracy-centric metrics to system-level outcomes, emphasizing human-enabled AI, interoperability, continuous learning, and equity-aware design. Using hypertension management and patient journey exemplars, we illustrate how AI-first systems can enable proactive risk stratification, coordinated intervention, and continuous support across the care continuum. We further outline architectural and governance requirements, including cloud-enabled infrastructure, interoperability, operational machine learning practices, and accountability frameworks—necessary to operationalize AI-first care safely and at scale, subject to prospective validation, regulatory oversight, and post-deployment surveillance. This review contributes a system-level framework for understanding AI-first healthcare, identifies priority research and implementation gaps, and offers practical considerations for clinicians, health systems, researchers, and policymakers. By reframing AI as infrastructure rather than isolated tools, the AI-first approach provides a pathway toward more proactive, coordinated, and equitable healthcare delivery while preserving the central role of human judgment and trust.

Objective: The coronavirus disease 2019 (COVID-19) pandemic accelerated the shift towards online learning in psychology higher education. It is important to investigate the factors that impacted student success in online learning, both in preparation for future emergencies in education, and to investigate the drivers of online course engagement in general. This study aims to identify factors impacting students’ online academic behaviors and success by testing an integrated social cognition model. Method: A sample of 279 psychology undergraduates from an Australian university completed surveys at the beginning and mid-point of a 12-week term, and had their academic behaviors and final grades assessed via registrar data. Results: Structural equation modeling revealed that attitudes and perceived behavioral control predicted intention and, indirectly, course grades via intention, planning, self-monitoring, and academic behaviors. Intentions predicted academic behaviors through planning and self-monitoring, and course grades via lecture attendance and worksheet completion, but not tutorial attendance. Baseline habit predicted follow-up habit, which influenced lecture attendance, tutorial attendance, and worksheet completion, and indirectly predicted course grades via lecture attendance. Conclusions: Results highlight that motivational, volitional, and nonconscious variables significantly contribute to psychology students’ online academic behaviors and success. Future research should explore interventions targeting these processes to enhance higher education.

Radial fractures are relatively uncommon (0-1%) injuries in postmortem studies of racehorses, and few cases have been published. We describe here a series of 42 cases of radial fractures observed in California racehorses. Autopsy findings from all racehorses submitted for postmortem examination between 2006 July 1 and 2022 June 30 that had a recorded radial fracture were evaluated. We included 42 horses (30 Thoroughbreds, 12 Quarter Horses), most of which were 3-5-y-old. Catastrophic radial fracture was observed in 30 (71%) horses; in the remaining 12 (29%) horses, the fracture of the radius was considered an incidental finding. All of the catastrophic radial fractures were complete, displaced, and comminuted; 70% were articular and 30% were non-articular; 61% were open and 39% were closed; 83% were diaphyseal to distal epiphyseal and 17% were proximal epiphyseal. Nine of the 30 horses with catastrophic fracture had a preexisting periosteal callus associated with the main line of fracture. Among Quarter Horse racehorses, the frequency of callus in radial fractures tended to be higher (p = 0.083) in 3-y-olds compared with other ages. In 6 of these 9 cases, the callus was located along the cranial aspect of the distal third of the diaphysis. All incidental cases consisted of osteochondral fragmentations, which occurred most frequently on the cranial border of the intermediate facet of the distal articular surface of the radius. Knowledge of the common sites of stress fractures or osteochondral stress remodeling in the radius can help to focus autopsies and to improve the characterization and interpretation of those lesions.

Gaucher disease is an autosomal recessive spirochete disease caused by a deficiency of the enzyme glucocerebrosidase. A mutation in the GBA1 gene induces the accumulation of abnormal products in macrophages resulting in the transformation into Gaucher cells in many organs. There are three main types of the disease, 1 being the most common type (non-neuropathic). The 2nd and 3rd types of the disease are neuropathic types and these occur mainly in childhood. Among paediatric patients, Gaucher's disease manifests mainly with enlargement of the liver, spleen, thrombocytopenia, anaemia, but skeletal, ocular and central nervous system symptoms may be present. Diagnosis based on enzymatic and genetic tests - analysis of the GBA1 gene mutation - is essential to prolong patients' lives, improve their quality of life and select an appropriate form of treatment. Currently, care for patients with this disease is based on ERT (enzyme replacement therapy), SRT (substrate replacement therapy). The disease is characterised by rather non-specific symptoms and course, and can be interpreted by physicians as a haematological-proliferative disease due to frequent changes in the structure of the liver, spleen and changes in blood morphological parameters. Increased awareness among doctors of the symptoms of this disease would allow earlier detection and implementation of treatment. This paper presents the current diagnostic and therapeutic methods and the characteristic symptoms any paediatrician may encounter. The challenges of diagnosing this disease are also highlighted.

IntroductionCardiovascular events are the most common cause of mortality worldwide. Various studies have shown the relationship between serum 25-hydroxyvitamin D [25(OH)Vit D] levels and cardiovascular events. The purpose of this study is to investigate the meta-analysis of the relationship between serum 25(OH)Vit D levels and the risk of cardiovascular diseases (CVD), including stroke, coronary heart disease, peripheral arterial disease, and aortic disease in the population.MethodUsing valid keywords and searching the Medline, Science Direct, Scopus, and Web of Science databases, 22 papers were compiled. Data analysis was performed in the group of people with low serum 25(OH)Vit D levels (<75 nmol/L). The data were analyzed using a random-effects meta-analysis model with R and Stata Version 17.0 software.ResultsIn this study, 22 papers were included. This meta-analysis of 12 cohort studies (n = 39,396) found that lower serum vitamin D levels were significantly associated with increased risk of cardiovascular disease (HR = 1.38, 95 % CI: 1.24–1.53) and all-cause mortality (HR = 1.64, 95 % CI: 1.33–2.03). Dose-response analysis showed that each 10 nmol/L increase in vitamin D reduced CVD risk by 8.2 % (HR = 0.992, 95 % CI: 0.990–0.993). A non-linear inverse association was observed for all-cause mortality, with stronger protective effects at lower vitamin D levels. These results, in addition to most of the studies included in the systematic review, support a potential protective role of higher vitamin D concentrations.ConclusionThe results of this study showed a relationship between serum 25(OH)Vit D levels and cardiovascular outcomes; the lower the serum 25(OH)Vit D level, the higher the risk of cardiovascular disease.

We aim to investigate the benefit of hyperbaric oxygen therapy (HBOT) in patients with central retinal artery occlusion (CRAO) compared to conservative management.