Deriving GENERIC from a generalized fluctuation symmetry

Much of the structure of macroscopic evolution equations for relaxation to equilibrium can be derived from symmetries in the dynamical fluctuations around the most typical trajectory. For example, detailed balance as expressed in terms of the Lagrangian for the path-space action leads to gradient zero-cost flow. We find a new such fluctuation symmetry that implies GENERIC, an extension of gradient flow where a Hamiltonian part is added to the dissipative term in such a way as to retain the free energy as Lyapunov function

First report of multinodular pulmonary fibrosis associated with equine herpesvirus 5 in Belgium

A 20-year-old horse was evaluated for symptoms of weight loss, anorexia, fever and lethargy. Clinical examination revealed tachypnea, poor body condition and increased breath sounds on auscultation. Ultrasound showed multiple consolidations on the lungs. Thoracic radiography revealed a severe nodular pattern. The horse was treated with antibiotics, corticoids and supportive medication. Since no improvement was observed, the horse was euthanized. At necropsy, numerous coalescing fibrous nodules were present in the lungs. Histology revealed diffuse interstitial fibrosis and macrophages containing abundant eosinophilic cytoplasm and oval eosinophilic to amphophilic intranuclear inclusion bodies. Tissue samples tested positive for the presence of equine herpes virus 5 (EHV 5) on the basis of the polymerase chain reaction (PCR) test. A diagnosis of equine multinodular pulmonary fibrosis (EMPF) was made. This is the first report of EMPF in Belgium. EMPF can be suspected based on the ultrasonographic, radiographic and histological changes. EMPF is associated with EHV 5, but the etiological role of EHV 5 still remains to be proven

Chytridiomycosis related mortality in a midwife toad (Alytes obstetricans) in Belgium

Chytridiomycosis, caused by the fungus Batrachochytrium dendrobatidis, contributes to amphibian declines worldwide. Recently, the fungus has shown to be widely distributed in Belgium and the Netherlands, although no clinical cases of the disease have been diagnosed yet. This case report describes the first case of mortality due to chytridiomycosis in Belgium in a wild population of midwife toads (Alytes obstetricans). The presence of clinical chytridiomycosis, combined with the relatively high prevalence of the fungus in Belgium, emphasizes the urgent need for a thorough study on the impact of infection on the native amphibian populations in Belgium

Transitional cell carcinoma of suspected ureteral origin, with intra-abdominal and distant metastases in two horses

The present paper describes two cases of suspected urothelial carcinomas with local lymphatic metastases, and distant metastases in the lungs. In one case, liver metastases were also present. Both cases are documented with an extensive clinical report, using bloodwork, rectal examination, ultrasonography, cytology of abdominal fluid and, in one case, also urine analysis, radiography and transrectal biopsy to come to a diagnosis of abdominal malignancy. Subsequently, the post-mortem exam, histopathology and immunohistochemistry are described and illustrated

Advance request in euthanasia and assisted suicide of patients with severe dementia.

Background - To permit euthanasia or assisted suicide (EAS( the medical ‘due care criteria’ of the Termination of Life on Request and Assisted Suicide Act (TLRASA) should be met, i.e., the request should be (1) voluntary and well considered and (2) expressed after informed consent about diagnosis and prognosis. (3) Suffering should be unbearable, with no prospect of improvement and (4) no reasonable alternatives should be available. Aim - To explore key elements influencing the RTE’s judgement on whether the due care criteria have been met of EAS cases in severe dementia based on written advance euthanasia requests. Methods - Qualitative study of reports of the RTE published online (n=21) in which a written euthanasia directive was mentioned and considered incompetent to make a decision regarding EAS. Two independent researchers (AvdB, GM) extracted factual data independently of one another (see appendix) and judged the due care criterion 'competence to make a decision regarding EAS'. Results & conclusion - Examination of the RTE’s judgment underlines the need for a clear euthanasia directive in advance request cases, as in 2 cases the criteria voluntary and well considered were not met because of this. Additionally, it becomes apparent that it is essential that the patient confirms their request after writing the directive. The RTE did not consider consulting an independent expert to establish the patient’s decision-making capacity essential for the due care criteria to be met. However, this solely applied when physicians acted diligently. Recommendations – We would recommend updating a written directive at least every year