The Use of Biodegradable Implants in the Fixation of Small Animal Cancellous Bone Fractures

In this study the cancellous bone fractures of 10 dogs and 2 cats were surgically treated with biodegradable implants to fixate the fractures. The implants were made of selfreinforced PGA homopolymers. The patients were allowed to walk on their operated limbs immediately after the fixation and they started to use them within one week. All patients except one used their operated limbs without lameness in 6 weeks and the twelfth case in 8 weeks, due to a postoperative periosteal infection. Radiographically, the fractures of 10 patients healed in 6 weeks and in 12 weeks in 2 cases. No other pathological reactions in the bone could be seen in the radiographs than the periosteal infection. Because the implants resolved spontaneously there was no need for a second operation to remove them.     

The incidence and PCR detection of Campylobacter upsaliensis in dogs and cats

A study was made of the incidence of Campylobacter upsaliensis among dogs and cats suffering from acute or chronic diarrhoea; 225 dogs and cats were examined and 51 strains were identified, 16 (7%) of which were Camp. upsaliensis. When rectal swabs were taken from a control group of 126 dogs and cats without clinical symptoms, 19 Campylobacter spp. and four Camp. upsaliensis were identified. All the Camp. upsaliensis strains were isolated in dogs. The Campylobacter strains were identified on the basis of their biochemical characteristics and by PCR (polymerase chain reaction).     

Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures

The locking plate and percutaneous crossing metallic screws and crossing absorbable screws have been used clinically to treat intra-articular calcaneal fractures, but little is known about the biomechanical differences between them. This study compared the biomechanical stability of calcaneal fractures fixed using a locking plate and crossing screws. Three-dimensional finite-element models of intact and fractured calcanei were developed based on the CT images of a cadaveric sample. Surgeries were simulated on models of Sanders type III calcaneal fractures to produce accurate postoperative models fixed by the three implants. A vertical force was applied to the superior surface of the subtalar joint to simulate the stance phase of a walking gait. This model was validated by an in vitro experiment using the same calcaneal sample. The intact calcaneus showed greater stiffness than the fixation models. Of the three fixations, the locking plate produced the greatest stiffness and the highest von Mises stress peak. The micromotion of the fracture fixated with the locking plate was similar to that of the fracture fixated with the metallic screws but smaller than that fixated with the absorbable screws. Fixation with both plate and crossing screws can be used to treat intra-articular calcaneal fractures. In general, fixation with crossing metallic screws is preferable because it provides sufficient stability with less stress shielding.     

Occurrence and Population Size of <Emphasis Type="Italic">Malassezia</Emphasis> spp. in the External Ear Canal of Dogs and Cats Both Healthy and with Otitis

Malassezia yeasts are commensal organisms of human and animal skin that occasionally act as pathogens; lipid-dependent species are associated with human skin disorders. The aim of this work was to evaluate the occurrence, risk factors and population size of different species of Malassezia in the external ear canal of dogs and cats with and without otitis externa. Between 2001 and 2003, 107 healthy animals (25 cats and 82 dogs) and 123 animals with chronic otitis exteirna (48 cats and 75 dogs) were clinically examined. Sterile cotton swabs were used to collect specimens from the external ear canal and culture tests and cytological examinations were performed to detect the presence and population size of Malassezia yeasts. Malassezia yeasts were isolated from 72.9% and 40% of the cats and from 57.3% and 28.0% of the dogs, with and without otitis externa, respectively. Malassezia was frequently isolated from animals under 5 years of age. The highest prevalence of positive samples was reported in winter for cats and in autumn for dogs. Dogs with pendulous ears showed a higher incidence of infection than dogs with erect ears. More Malassezia yeasts were recovered from animals with otitis (i.e. 59.6 colony forming units – CFUs – for cats and 66.0 CFUs for dogs) than healthy animals. Out of the 413 isolates obtained from animals with and without otitis, 403 (97.6%) were identified as M. pachydermatis and 10 (2.4%) as M. globosa. A statistical evaluation of the occurrence of Malassezia yeasts in dogs and cats revealed that predisposing factors for Malassezia infections are sampling period for cats, and type of ear for dogs. The largest population of Malassezia yeasts was detected in animals with otitis, suggesting a role in the occurrence of lesions.     

Protracted release of the LHRH agonist avorelin (MF 6001) from two depot formulations in dogs and men

Summary Avorelin is a new superagonist of natural luteinizing-hormone-releasing-hormone. Avorelin has been formulated in high molecular weight polylactic glycolic acid to afford protracted and continuous release of the peptide from subcutaneous implants. Two different formulations (10 and 15 mg) were tested first in dogs and then in men during a clinical phase II trial. Chemical castration was maintained for at least 6 months in dogs with both formulations. A similar duration of activity (approximately 6 months) was observed in men.     

Diverse and atypical genotypes identified in Toxoplasma gondii from dogs in São Paulo, Brazil

The prevalence of Toxoplasma gondii in 118 unwanted dogs from S?o Paulo City, S?o Paulo State, Brazil, was determined. Antibodies to T. gondii were assayed by the modified agglutination test and found in 42 (35.8%) dogs, with titers of 1:20 in 10, 1:40 in 6, 1:80 in 5, 1:160 in 5, 1:320 in 6, 1:640 in 7, and 1:1,280 or higher in 3. Hearts and brains of 36 seropositive dogs were bioassayed in mice, or cats, or both. Tissues from 20 seropositive dogs were fed to 20 T. gondii-free cats. Feces of cats were examined for oocysts. Toxoplasma gondii was isolated from 15 dogs by a bioassay in mice, from the brain alone of 1, from the heart alone of 4, and from both brains and hearts of 10. All infected mice from 5 of 15 isolates died of toxoplasmosis during primary infection. Four additional isolates were obtained by bioassay in cats. Genotyping of these 19 T. gondii isolates using polymorphisms at 10 nuclear markers including SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and a new SAG2 (an apicoplast marker Apico) revealed 12 genotypes. One isolate had Type III alleles at all 11 loci, and the remaining 18 isolates contained a combination of different alleles and were divided into 11 genotypes. The absence of Type II in Brazil was confirmed. The result supports previous findings that T. gondii population genetics is highly diverse in Brazil.     

Acoustic rhinometry in dog and cat compared with a fluid-displacement method and magnetic resonance imaging.

An increasing number of studies have used acoustic rhinometry (AR) for study of pharmacological interventions on nasal cavity dimensions in dogs and cats, but there have been no attempts to validate AR in these species. This is done in the present study. We compared area-distance relationships of nasal cavities from five decapitated dogs (3.5-41 kg) and cats (3.8-6 kg). AR was compared with magnetic resonance (MR) imaging and a fluid-displacement method (FDM) using perfluorocarbon. AR measured 88% (98-79%) (mean and 95% confidence interval) of nasal cavity volume in dogs determined by FDM and 71% (83-59%) in cats. AR markedly underestimated nasal cavity dimensions when minimum areas were below 0.1 cm2 in dogs and 0.05 cm2 in cats. AR underestimation increased with the severity of the constriction and with distance. Cross-sectional areas in the deeper parts of the cavity measured 76% (99-54%) of FDM in dogs and 52% (66-39%) in cats. AR agreed well with MR, especially in the deeper part of the cavity. MR images showed that the nasal cavities had a very complex structure not expected to be reproduced by AR. MR could not be considered a "gold standard" because definition of the cross-sectional area of the lumen depended critically on subjective choices. FDM produced repeatable measurements and possibly offers the most adequate reference in future evaluation of AR. AR underestimated what we believed were the most correct cross-sectional areas determined by FDM, especially in the deeper part of the dog and cat nasal cavities. Despite these difficulties, AR has been shown to be useful to describe qualitative changes in cross-sectional area.     

Dermatophytes isolated from symptomatic dogs and cats in Tuscany,Italy during a 15-year-period

Between January, 1, 1986 and December, 31, 2000, dermatological specimens from 10.678 animals (7.650 cats and 3.028 dogs) were examined for dermatophytes. All the animals presented clinical signs of ringworm. Two thousand-four hundred fifty-six of the 10.678 (23%) examined animals scored positive for dermatophytes, 566 out of 3.028 canine (18.7%) and 1890 out of 7.650 feline specimens (24.7%). Microsporum canis constituted 83% and 97% of the isolated dermatophytes respectively in dogs and cats, M. gypseum represented 13% and 2.6% and T. mentagrophytes 5.5% and 0.2%. A sexual predisposition for mycotic infections was not observed. The animals with less than 1 year of age were more frequently infected. Canine toy breeds showed a significantly higher (P < 0.001) prevalence of infections by M. canis. Microsporum gypseum was mostly recorded from sporting (hunting) breeds [such as T. mentagrophytes (6.7%)]. Microsporum canis was isolated from long-haired cats with a ratio of 2:1 versus short-haired cats, while M. gypseum and T. mentagrophytes were never recovered from Persian cats. The annual distribution of the infections in dogs showed a significantly higher incidence for M. gypseum in summer versus winter and spring, while the recovery rate of M. canis from cats was very significantly higher in fall and winter than in summer and spring. Trichophyton mentagrophytes did not show a similar seasonal distribution.     

Animal models of primary myocardial diseases

Feline and canine cardiomyopathies (primary myocardial diseases) were reviewed and divided into three groups based on the clinical, hemodynamic, angiocardiographic, and pathologic findings: (1) feline and canine hypertrophic cardiomyopathy, (2) feline and canine congestive (dilated) cardiomyopathy, and (3) feline restrictive cardiomyopathy. All three groups consisted predominantly of mature adult male cats and dogs. Cardiomyopathy in the hamster and turkey was also reviewed. The most common presenting signs were dyspnea and/or thromboembolism in the cat, systolic murmurs with gallop rhythms on auscultation, cardiomegaly with (groups 1 and 3) or without (group 2) pulmonary edema, abnormal electrocardiograms, elevated left ventricular end-diastolic pressures, and angiocardiographic evidence of mitral regurgitation with left ventricular concentric hypertrophy (group 1), left ventricular dilatation (group 2), or midventricular stenosis (group 3). Some cats in groups 1 and 3 also had evidence of left ventricular outflow obstruction. The principal pathologic findings in all of the cats and dogs were left atrial dilation, hypertrophy, increased septal:left ventricular free wall thickness ratio with disorganization of cardiac muscle cells (group 1); dilatation of the four chambers with degeneration of cardiac muscle cells (group 2); and extensive endocardial fibrosis and adhesion of the left ventricle (group 3). Aortic thromboembolism was commonly observed in the cats of all three groups. These clinical and pathologic findings indicate that cardiomyopathy in the cat or dog is similar to the three forms of cardiomyopathy in humans (hypertrophic, congestive, and restrictive).     

Massive parallel 16S rRNA gene pyrosequencing reveals highly diverse fecal bacterial and fungal communities in healthy dogs and cats

This study evaluated the fecal microbiota of 12 healthy pet dogs and 12 pet cats using bacterial and fungal tag-encoded FLX-Titanium amplicon pyrosequencing. A total of 120,406 pyrosequencing reads for bacteria (mean 5017) and 5359 sequences (one pool each for dogs and cats) for fungi were analyzed. Additionally, group-specific 16S rRNA gene clone libraries for Bifidobacterium spp. and lactic acid-producing bacteria (LAB) were constructed. The most abundant bacterial phylum was Firmicutes, followed by Bacteroidetes in dogs and Actinobacteria in cats. The most prevalent bacterial class in dogs and cats was Clostridia, dominated by the genera Clostridium (clusters XIVa and XI) and Ruminococcus. At the genus level, 85 operational taxonomic units (OTUs) were identified in dogs and 113 OTUs in cats. Seventeen LAB and eight Bifidobacterium spp. were detected in canine feces. Ascomycota was the only fungal phylum detected in cats, while Ascomycota, Basidiomycota, Glomeromycota, and Zygomycota were identified in dogs. Nacaseomyces was the most abundant fungal genus in dogs; Saccharomyces and Aspergillus were predominant in cats. At the genus level, 33 different fungal OTUs were observed in dogs and 17 OTUs in cats. In conclusion, this study revealed a highly diverse bacterial and fungal microbiota in canine and feline feces.     

Experimental Isospora canis and Isospora felis Infection in Mice,Cats, and Dogs*

SYNOPSIS. Two 6-month-old gnotobiotic dogs and 4 five-day-old dogs became infected but did not shed oocysts within 15 days after ingesting the feline coccidian, Isospora felis. Infection of the dogs was evidenced by the shedding of I. felis oocysts by cats consuming extra-intestinal organs of dogs fed I. felis. Likewise, cats became infected with the canine coccidian, Isospora canis, without producing oocysts. Dogs also became infected after ingesting mice previously fed I. canis oocysts. The prcpatent period for I. canis was slightly shorter in dogs fed infected mice (8–9 days) than in those fed oocysts (9–11 days).     

宠物犬和猫流感病毒感染

近十年来犬和猫流感病毒感染报道迅速增多,不仅威胁到犬和猫的健康,也对公共卫生造成了影响。自2004年首次发生H3N8亚型流感病毒感染赛犬事件以来,犬流感一直在美国的赛犬和宠物犬中流行。在韩国和我国南方的犬群中出现了因H3N2亚型禽流感感染引起的肺炎病例。亚洲和欧洲均报道了猫H5N1亚型高致病性禽流感致死性感染病例,还通过实验研究发现H5N1亚型流感病毒可在猫与猫之间水平传播。这些现象预示着流感病毒进一步获得了感染哺乳动物的能力,其公共卫生意义需引起关注。为此,本文对犬和猫流感病毒感染的流行病学、临床症状、发病机制、诊断和防控措施进行了综述。     

The effects of implementing a feral cat spay/neuter program in a Florida county animal control service

In 1995, a county animal control service implemented a feral cat sterilization program with the goal of reducing the number of healthy cats euthanized, complaints, and the county's costs. The service collected data from a 6-year period both before and after the program's implementation. The service totaled the numbers of both cat and dog impoundments, surgeries, adoptions, euthanasias, and complaints for each year; standardized both sets of numbers on a per- 10,000-person basis to compare trends between dogs and cats; and calculated estimated costs for neutering versus impounding and euthanizing the feral cats. Changing from a policy of euthanasia of feral cats to support for trap-neuter-return did not result in an increase in the number of complaints or cat impoundments. The percentage of impounded cats euthanized decreased between the periods before and after the program began, and the percentage adopted increased. The ratio of complaints to impounds decreased between the 2 periods, and the ratio of surgeries to impounds increased. Impoundments of cats were relatively steady in spite of the continually increasing human population. Euthanasias decreased for both cats and dogs since 1997. Since 1996, complaints decreased for both. Surgeries for both cats and dogs increased over the 12 years. Adoptions for cats and dogs increased greatly in fiscal year 1998/1999.     

Demographics and economic burden of un-owned cats and dogs in the UK: results of a 2010 census

ABSTRACT: BACKGROUND: The population of dogs and cats passing through rescue shelters may be subject to compromised welfare and increased susceptibility to disease. Little information exists to describe this population, its dynamics and associated management practices. The aim of this study was to carry out a census of un-owned cats and dogs in the UK in 2010, and to document the origins, destinations, husbandry and costs associated with the care of these animals. RESULTS: A sampling frame was constructed by searching the databases of publicly registered charities for England, Scotland and Wales, registers of breed rescues, and by internet searches of animal welfare websites. Overall, 2,352 contacts for 1,380 organisations were identified. All were sent a postal questionnaire asking for data on the number of dogs and cats housed, their origins and eventual outcomes, and details of husbandry between January 1st and December 31st 2010. For those which were registered charities (595), financial records were also obtained. A response rate of 38.8 % was obtained. Overall, in 2010, 89,571 dogs and 156,826 cats entered the care of the participating organisations. Approximately half of these animals were relinquished by their owners. Other origins included being found as strays or confiscated for welfare purposes. Seventy-five per cent of dogs and 77.1 % of cats were rehomed. The next most common outcome was euthanasia, accounting for 10.4 % of dogs and 13.2 % cats. For dogs and cats, 44.3 % and 62 % of participants respectively reported having a waiting list, which frequently exceeded the actual capacity of the facility. Over 19,000 people were involved in the care of these animals, on a paid or voluntary basis. Financial records were available for 519/595 (87.2 %) of the registered charities, and their total expenditure in 2010 was GBP340 million. CONCLUSIONS: This study showed that a large number of animals become un-owned each year, which could have considerable implications for their welfare. Despite the resources expended, demand still exceeds capacity for many organisations, and a substantial number of both cats and dogs are euthanased, suggesting that further understanding of how and why these animals become un-owned is essential in order to target interventions.     

Distribution of the usp gene in uropathogenic Escherichia coli isolated from companion animals and correlation with serotypes and size-variations of the pathogenicity island

Uncomplicated urinary tract infection (UTI) caused by uropathogenic Escherichia coli(UPEC) is a serious problem not only among humans but also in companion animals such as dogs and cats. The uropathogenic specific protein gene (usp ) is preferentially distributed in UPEC isolates from dogs and cats compared with the distribution of usp in E. coli strains from feces of healthy dogs and cats and this pattern of distribution resembles that observed in human UPEC strains. The UPEC strains from companion animals share common O serotypes like O1, O2, O4, O6, O16, O18, O22, O25 and O75 as those reported for human UPEC. The size variation of the pathogenicity island that includes usp in UPEC from dogs and cats was almost similar to those seen in human UPEC. We propose that dogs and cats are the alternative reservoirs for UPEC strains that are associated with human UTI.     

Animal dermatophytosis. Recent advances

The proportion of positive samples in relation to the number of samples examined from cases of dog and cat dermatophytosis varies considerably from one investigation to another. In dogs, it ranges between 4% and 10% and few studies show higher prevalences. On the other hand, the percentages of positive cultures cited in the reviewed literature from dogs with or without suspected dermatophytosis are quite similar. In dogs with suspected lesions of dermatophytosis, with few exceptions, Microsporum canis is the most common species isolated. Trichophyton mentagrophytes and Microsporum gypseum are less frequently isolated. In cats the prevalence of dermatophytes is usually higher than in dogs, and it is usually higher than 20%. However the frequency of positive findings is higher in cats with suspected dermatophytosis than in cats without visible lesions, with the exception of asymptomatic infected cats and transient carrier cats. Cats are accepted as the principal reservoir for M. canis. Griseofulvin is the drug of choice in canine and feline dermatophytosis.     

Echinococcus multilocularis coproantigen detection by enzyme-linked immunosorbent assay in fox, dog, and cat populations

A sandwich enzyme-linked immunosorbent assay (ELISA) for the detection of Echinococcus multilocularis coproantigens (EM-ELISA) was developed with polyclonal rabbit (solid phase) and chicken egg (catching) antibodies that were directed against E. multilocularis coproantigens and somatic worm antigens, respectively. In experimentally infected dogs and cats, coproantigens were first detectable 6-17 days postinfection (PI) in samples of 8 dogs (worm burdens at necropsy: 6,330-43,200) and from 11 days PI onward in samples of 5 cats infected with 20-6,833 worms. After anthelmintic treatment of 4 dogs and 5 cats at day 20 PI, coproantigen excretion disappeared within 3-5 days. The sensitivity of the ELISA was 83.6% in 55 foxes infected with 4-60,000 E. multilocularis, but reached 93.3% in the 45 foxes harboring more than 20 worms. The EM-ELISA was used in surveys of "normal" dog and cat populations in Switzerland. Among 660 dogs and 263 cats, 5 dogs and 2 cats exhibited a positive reaction. In 2 of these dogs (0.30%) and 1 cat (0.38%), intestinal E. multilocularis infections were confirmed by necropsy, polymerase chain reaction PCR, or both. The specificites of the ELISA in these groups were found to be 99.5% and 99.6%, respectively, if positive ELISA results that could not be confirmed by other methods were classified as "false positive" reactions.     

Comparison of iron chelator efficacy in iron-overloaded beagle dogs and monkeys (Cebus apella)

Rodents and dogs are frequently used for preclinical toxicologic assessment of candidate iron chelators. Although the iron-clearing profile of a ligand often is known in rodents, and sometimes in primates, such information in dogs is rarely, if ever, available. Because of this, toxicity studies in dogs could be misleading; chelators that may otherwise be suitable for human clinical studies may be abandoned as being unacceptably toxic, simply because, unknown to the investigator, these drugs remove more iron in this species than would have been expected on the basis of iron clearance results in other species. This is a scenario that we encountered during toxicity trials of (S)-beta,beta-dimethyl-4'-hydroxydesazadesmethyldesferrithiocin in dogs. Thus, we developed an iron-overloaded dog model in which it is possible to evaluate iron-clearing efficiencies of potential therapeutic ligands. Seven deferration agents have been screened in this model, and the results were compared with the iron-clearing efficiency of the same ligands in an iron-loaded Cebus apella monkey model. The data suggest that while the iron-clearing efficiencies of most of the drugs were similar between the two species, there can be profound differences. This is consistent with the idea that caution needs to be exercised when carrying out preclinical toxicity evaluations of a chelator in dogs without first measuring the drug's iron-clearing efficiency in this species.     

Evaluation of the clinical efficacy of Gonazon implants in the treatment of reproductive pathologies, behavioral problems, and suppression of reproductive function in the male dog

Efficacy of a slow-release gonadotropin-releasing hormone (GnRH)-agonist implant (Gonazon) was assessed in 53 male dogs presented with benign prostatic hyperplasia (BPH), hypersexuality, aggressive behavior (either alone or in combination), excessive micturition, or to suppress fertility. Changes in testosterone (T) and estradiol (E2) concentrations and size of testes and prostate were monitored on Weeks 0, +8, and +26 after implantation. Additional measurements during and after this period were performed in 35 dogs. Clinical signs were assessed by the owners. All implants except one were retained throughout the study. Full downregulation of testicular function (T < 0.35 nmol/L) was achieved in 46 dogs, five dogs showed partial downregulation (T = 0.36 to 0.47 nmol/L), one dog did not respond, and another one displayed a transient downregulation on Week +18. On Week +8, mean T and E2 levels were reduced by 96% and 62%, respectively, and did not further decrease. Full downregulation (T < 0.35 nmol/L) lasted between 6 to >22 mo in most dogs except two. Compared with pretreatment values, mean testicular and prostatic size was reduced (P < 0.00001) by 54% and 52%, respectively, on Week +8 and by 68% and 64%, respectively, on Week +26. Relative reduction of prostatic size was more marked in dogs with BPH than in healthy ones on Week +8 (P < 0.05) and Week +26 (P < 0.02), and clinical signs of BPH disappeared rapidly after implantation. Dogs affected with BPH were significantly older (P < 0.001) than nonaffected ones (9.7 vs. 2.5 yr). Hypersexuality was more common in dogs < 3 yr of age, and treatment clearly improved clinical signs. Age significantly affected the response to treatment in aggressive dogs; 75% of the cases responded with an improvement. The only minor and possibly treatment-related events observed were a short-lasting exacerbation of clinical signs of BPH (two dogs), increased weight gain (three dogs), and anxiety (three dogs) with one of these dogs developing a blunt coat. These results demonstrate the clinical efficacy and overall safety of the Gonazon implants.     

High prevalence of Opisthorchis viverrini infection in reservoir hosts in four districts of Khon Kaen Province, an opisthorchiasis endemic area of Thailand

Khon Kaen, a northeastern province of Thailand, has been considered as one of the human opisthorchiasis endemic areas with continuing high prevalence. Unsuccessful eradication of the disease is probably from the culture of eating raw and undercooked fish of local residence and the parasitic persistency in animal reservoir hosts, such as cats and dogs. In cooperation with the other human opisthorchiasis control programs in an endemic area of 29 villages in Ban Haet, Ban Phai, Chonnabot and Muncha Khiri Districts, Khon Kaen, this study investigated the prevalence of Opisthorchis viverrini infection using a formalin-ether sedimentation method as the gold standard, and hematology and blood chemistry of the reservoir hosts in this endemic area. The results showed that cats had much higher prevalence (76 of 214, 35.51%) than dogs (3 of 821, 0.37%). Hematology between the infected and uninfected cats was not different. Complete blood count and biochemistry reflected some altered hepatic functions. However, only severely infected cats showed apparent clinical signs, including lethargy, diarrhea, ocular and nasal discharges. Moreover, the ultrasonogram of infected cats with very high egg per gram (> 1500 EPG) showed apparent thickening of the gall bladder wall with hyperechoicity of hepatic parenchyma. This study suggests that cat is the most important animal reservoir of human opisthorchiasis, especially in this endemic area. It is also interesting that villages with infection are mostly located in the vicinity of Chi River and two large water reservoirs (Lawa and Nong Kongkaew Lakes), but people without infection were away from Chi River, on the south of Kudkhow Lake. Further investigation on this particular geofactor is essential for effective opisthorchiasis control programs.