Assessment of misdiagnosis in small animal intensive care patients using the Modified Goldman criteria

The postmortem examination can be used as a means of quality control for clinical diagnoses. A retrospective study on 300 dogs and cats that had been admitted to a small animal intensive care unit was performed comparing the clinical and postmortem findings, using the Modified Goldman criteria. All patient files were reevaluated for clinical diagnoses and all postmortem material was reevaluated for pathological diagnoses. After this, the Modified Goldman criteria were applied to score the discrepancies between them, and factors associated with the occurrence of an undiagnosed major unexpected finding were analyzed. The postmortem examination revealed additional findings in 65% of the cases. Major discrepancies, defined as those affecting treatment and possibly outcome of the patient, were present in 21.3% of the cases. The most frequently missed diagnoses detected at necropsy were pneumonia of various etiologies, meningitis/meningoencephalitis, myocarditis and generalized vasculitis. A shorter ICU stay was associated with increased odds of a major discrepancy. Conditions affecting the urinary or gastrointestinal system were negatively associated with major discrepancy

Generation of human memory stem T cells after haploidentical T-replete hematopoietic stem cell transplantation

Memory stem T cells (TSCM) have been proposed as key determinants of immunologic memory. However, their exact contribution to a mounting immune response, as well as the mechanisms and timing of their in vivo generation, are poorly understood. We longitudinally tracked TSCM dynamics in patients undergoing haploidentical hematopoietic stem cell transplantation (HSCT), thereby providing novel hints on the contribution of this subset to posttransplant immune reconstitution in humans. We found that donor-derived TSCM are highly enriched early after HSCT. We showed at the antigen-specific and clonal level that TSCM lymphocytes can differentiate directly from naive precursors infused within the graft and that the extent of TSCM generation might correlate with interleukin 7 serum levels. In vivo fate mapping through T-cell receptor sequencing allowed defining the in vivo differentiation landscapes of human naive T cells, supporting the notion that progenies of single naive cells embrace disparate fates in vivo and highlighting TSCM as relevant novel players in the diversification of immunological memory after allogeneic HSCT

Pathophysiologic Aspects of Feline Hepatic Lipidosis

Feline hepatic lipidosis (FHL) is considered the most common hepatobiliary disease in cats. It is characterized by the excessive accumulation of fat, in the form of triglycerides, in more than 80% of the hepatocytes resulting in secondary impairment of liver function, and intrahepatic cholestasis. Feline hepatic lipidosis presents as an acute critical syndrome that can result in the animal’s death due to severe liver dysfunction and failure if therapeutic measures are not taken expeditiously. The pathophysiologic mechanisms leading to the accumulation of fat in hepatocytes and FHL are not yet completely understood. Most likely, they consist of disturbances in the pathways that regulate uptake, synthesis, degradation, and secretion of fatty acids. The aim of this thesis is to unravel the characteristics of the different pathways of lipid mobilisation, hepatic lipid metabolism and de novo lipid synthesis in healthy cats and cats with FHL. The effect of sex hormones on the lipid metabolism of healthy cats, and the lipid profile and the activation of progenitor cells in cats affected with hepatic lipidosis have been evaluated. Considering the results from our studies and data derived from experimental studies of overweight cats undergoing rapid weight loss and induction of hepatic lipidosis, we can argue that both limitations in lipid mobilisation from the liver and increased de novo hepatic lipid synthesis are unlikely to be important causes of hepatic lipid accumulation in FHL. The most likely pathophysiologic pathway appears an insufficient increase in the rate of fatty-acid oxidation in the face of increased peripheral lipid mobilization

Pathophysiologic Aspects of Feline Hepatic Lipidosis

Feline hepatic lipidosis (FHL) is considered the most common hepatobiliary disease in cats. It is characterized by the excessive accumulation of fat, in the form of triglycerides, in more than 80% of the hepatocytes resulting in secondary impairment of liver function, and intrahepatic cholestasis. Feline hepatic lipidosis presents as an acute critical syndrome that can result in the animal’s death due to severe liver dysfunction and failure if therapeutic measures are not taken expeditiously. The pathophysiologic mechanisms leading to the accumulation of fat in hepatocytes and FHL are not yet completely understood. Most likely, they consist of disturbances in the pathways that regulate uptake, synthesis, degradation, and secretion of fatty acids. The aim of this thesis is to unravel the characteristics of the different pathways of lipid mobilisation, hepatic lipid metabolism and de novo lipid synthesis in healthy cats and cats with FHL. The effect of sex hormones on the lipid metabolism of healthy cats, and the lipid profile and the activation of progenitor cells in cats affected with hepatic lipidosis have been evaluated. Considering the results from our studies and data derived from experimental studies of overweight cats undergoing rapid weight loss and induction of hepatic lipidosis, we can argue that both limitations in lipid mobilisation from the liver and increased de novo hepatic lipid synthesis are unlikely to be important causes of hepatic lipid accumulation in FHL. The most likely pathophysiologic pathway appears an insufficient increase in the rate of fatty-acid oxidation in the face of increased peripheral lipid mobilization

Study of cathode materials from spent Lithium-ion batteries

Batteries are becoming key to the energy transition towards a more sustainable future because of their role in the electrification of transport, industry, and homes. Their use will eliminate vehicular emissions of CO2 and NO2 in a world struggling with climate change. Electric vehicle (EV) technology seems to be progressing faster than expected and industry forecasts are regularly revised upwards. However, the growth in demand for batteries has raised raw material prices and given rise to concerns about potential shortages of cobalt, nickel, manganese, and lithium. Indeed, the technology behind electric vehicles is the lithium-ion battery (LIB), particularly NMC (LiNi1/3Mn1/3Co1/3O2). The continuous demand for EVs must be supported by adequate recycling facilities in order not to lose the ecological benefits of switching to electric mobility. In this thesis work we will focus on the waste hydrometallurgical process, in particular on the leaching and coprecipitation steps. For the first step, the objective will be to analyze the effect of four factors (sulphuric acid concentration, hydrogen peroxide concentration, solid-to-liquid ratio (S/L) and time) on the leaching of NMC 111. The study will be carried out using the Design of Experiment software, which will make it possible to establish the optimum conditions for this phase. This study will lead to the understanding that yields of about 100% can be achieved when operating under appropriate conditions. The most appropriate conditions for leaching NMC 111 are a slight excess of sulphuric acid and hydrogen peroxide (3.06 M and 2.5 vol.% respectively) with an S/L ratio of 99.8 g/L and time of 62 minutes. This will be followed by the coprecipitation phase, which will lead to the formation of ternary hydroxide of nickel, manganese, and cobalt. The aim will be to study the factors influencing this process, starting with a solution replicating our leachate. Through analysis of the precipitate, we will try to understand the influence of these factors on the structural morphology and chemical composition. The study has yielded encouraging results in that by comparing the tests carried out we have understood which factors are most influential on this process (concentration of metal sulphate, concentration of chelating agent and time)

Assessment of misdiagnosis in small animal intensive care patients using the Modified Goldman criteria

AbstractThe postmortem examination can be used as a means of quality control for clinical diagnoses. A retrospective study on 300 dogs and cats that had been admitted to a small animal intensive care unit was performed comparing the clinical and postmortem findings, using the Modified Goldman criteria. All patient files were reevaluated for clinical diagnoses and all postmortem material was reevaluated for pathological diagnoses. After this, the Modified Goldman criteria were applied to score the discrepancies between them, and factors associated with the occurrence of an undiagnosed major unexpected finding were analyzed. The postmortem examination revealed additional findings in 65% of the cases. Major discrepancies, defined as those affecting treatment and possibly outcome of the patient, were present in 21.3% of the cases. The most frequently missed diagnoses detected at necropsy were pneumonia of various etiologies, meningitis/meningoencephalitis, myocarditis and generalized vasculitis. A shorter ICU stay was associated with increased odds of a major discrepancy. Conditions affecting the urinary or gastrointestinal system were negatively associated with major discrepancy

The research on family reunification: A review

Studies highlight that the recomposing of migrant families and the appearance of second generation in the host society need to be supported by specific actions. The article presents the various forms of family reunification and considers the different variables involved in such a challenging process. Accompanying and bearing this extensive practice, a society can convert an uncertain passage into a chance of strengthen the social cohesion and the integration of migrants

Public Staff Empowerment in e-Government: A Human Work Interaction Design Approach

Human Work Interaction Design (HWID) studies the integration of work analysis and interaction design methods to foster new strategies aimed at designing systems that may effectively and efficiently change the way people work. Pervasive technologies and smart places deeply influence traditional physical boundaries and operational modes, leading to important changes in work practice. The goal of this paper is to provide the basis for an improved co-operation and mutual inspiration among public employees by using End-User Development (EUD). EUD in the e-Government context provides non-professional software developers with methods, techniques, and tools for configuring services that citizens can use to interact with public offices. The paper describes how, by using EUD-enabled tools, the work practice of the public staff changes, and how this transformation allows public employees with limited technical background to create services according to their expertise and expectations, and to share them