A metastatic secretory gastric plasmacytoma with aberrant CD3 expression in a dog

A 10-year-old crossbred dog was presented with a 6-week history of hematemesis, melena, anorexia, and lethargy. Clinical evaluation revealed a gastric mass with a regional lymphadenomegaly as well as a monoclonal gammopathy manifesting as hyperglobulinemia. Cytologic and histopathologic analyses were consistent with a round cell neoplasm; neoplastic cells showed nuclear immunoreactivity for MUM1 and diffuse cytoplasmic reactivity for CD3. Polymerase chain reactions performed on fixed and fresh tissue identified a clonal rearrangement with an IgH primer set. An extramedullary plasmacytoma (EMP) was confirmed by cellular morphology and molecular diagnostics. Following an objective response to chemotherapy, the dog was euthanized 8 months after diagnosis, and a postmortem examination confirmed the clinical findings. This is the first reported case of a monoclonal gammopathy secondary to a gastric EMP coupled with aberrant expression of CD3 in an aggressive plasmacytic tumor, and highlights the utility of molecular diagnostics for classifying atypical hemolymphoid neoplasms

Workforce Development in a Post-COVID World: a Grassroots Approach

As the world slowly emerges from COVID 19 both the virus and the lingering effects on the economy will be in the spotlight. There is a real urgency to get businesses up and running and employees working again. Some businesses may be able to flip a switch and up to speed while other may need to ramp up more slowly and will only be able to turn up the dial. In both situations, there are implications for the local workforce and for the community

Mineral-water-energy nexus: implications of localized production and consumption for industrial ecology

[21th International Sustainable Development Research Society (ISDRS15)] 10-12 July 2015; Deakin University, Geelong Waterfront CampusUrban and remote areas are increasingly using decentralised systems for renewable energy productionand storage, as well as for water harvesting and recycling and to a lesser extent for productmanufacture via 3D printing. This paper asks two questions – how will these developments affect (i)the end-uses of minerals, including critical minerals and (ii) the implications for industrial ecologyand the development of a sound materials cycle society. We find a trade-off between using higherperformancecritical minerals in low concentrations which are complex to recycle, and unalloyed, standardised materials for increased effectiveness across multiple reuse cycles. Design andoperational challenges for managing decentralised infrastructure are also discussed as their uptakeapproaches a tipping point

Mineral-Water-Energy Nexus: Implications of Localized Production and Consumption for Industrial Ecology

Urban and remote areas are increasingly using decentralised systems for renewable energy production and storage, as well as for water harvesting and recycling and to a lesser extent for product manufacture via 3D printing. This paper asks two questions – how will these developments affect (i) the end-uses of minerals, including critical minerals and (ii) the implications for industrial ecology and the development of a sound materials cycle society. We find a trade-off between using higherperformance critical minerals in low concentrations which are complex to recycle, and unalloyed, standardised materials for increased effectiveness across multiple reuse cycles. Design and operational challenges for managing decentralised infrastructure are also discussed as their uptake approaches a tipping point

"Slowing" and "narrowing" the flow of metals for consumer goods: Evaluating opportunities and barriers

© 2018 by the authors. Metal resources are essential materials for many consumer products, including vehicles and a wide array of electrical and electronic goods. These metal resources often cause adverse social and environmental impacts from their extraction, supply and disposal, and it is therefore important to increase the sustainability of their production and use. A broad range of strategies and actions to improve the sustainability of resources are increasingly being discussed within the evolving concept of the circular economy. This paper uses this lens to evaluate the opportunities and barriers to improve the sustainability of metals in consumer products in Australia, with a focus on strategies that "slow" and "narrow" material flow loops. We have drawn on Allwood's characterisation of material efficiency strategies, as they have the potential to reduce the total demand for metals. These strategies target the distribution, sale, and use of products, which have received less research attention compared to the sustainability of mining, production, and recycling, yet it is vitally important for changing patterns of consumption in a circular economy. Specifically, we have considered the strategies of product longevity (life extension, intensity of use, repair, and resale), remanufacturing, component reuse, and using less material for the same product or service (digitisation, servicisation, and light-weighting). Within the Australian context, this paper identifies the strategies that have the greatest opportunity to increase material efficiency for metal-containing products (such as mobility, household appliances, and personal electronics), by evaluating current implementation of these strategies and identifying the material, economic, and social barriers to and opportunities for expanding these strategies. We find that many of these strategies have been successfully implemented for mobility, while applying these strategies to personal electronics remains the biggest challenge. Product longevity emerged as the strategy with the most significant opportunity for further implementation in Australia, as it is the most broadly applicable across product types and has significant potential for material efficiency benefits. The barriers to material efficiency strategies highlight the need for policies that broaden the focus beyond closing the loop to "slowing" and "narrowing" material loops

Efficiency and safety of varying the frequency of whole blood donation (INTERVAL): a randomised trial of 45 000 donors

Background: Limits on the frequency of whole blood donation exist primarily to safeguard donor health. However, there is substantial variation across blood services in the maximum frequency of donations allowed. We compared standard practice in the UK with shorter inter-donation intervals used in other countries. Methods: In this parallel group, pragmatic, randomised trial, we recruited whole blood donors aged 18 years or older from 25 centres across England, UK. By use of a computer-based algorithm, men were randomly assigned (1:1:1) to 12-week (standard) versus 10-week versus 8-week inter-donation intervals, and women were randomly assigned (1:1:1) to 16-week (standard) versus 14-week versus 12-week intervals. Participants were not masked to their allocated intervention group. The primary outcome was the number of donations over 2 years. Secondary outcomes related to safety were quality of life, symptoms potentially related to donation, physical activity, cognitive function, haemoglobin and ferritin concentrations, and deferrals because of low haemoglobin. This trial is registered with ISRCTN, number ISRCTN24760606, and is ongoing but no longer recruiting participants. Findings: 45 263 whole blood donors (22 466 men, 22 797 women) were recruited between June 11, 2012, and June 15, 2014. Data were analysed for 45 042 (99·5%) participants. Men were randomly assigned to the 12-week (n=7452) versus 10-week (n=7449) versus 8-week (n=7456) groups; and women to the 16-week (n=7550) versus 14-week (n=7567) versus 12-week (n=7568) groups. In men, compared with the 12-week group, the mean amount of blood collected per donor over 2 years increased by 1·69 units (95% CI 1·59–1·80; approximately 795 mL) in the 8-week group and by 0·79 units (0·69–0·88; approximately 370 mL) in the 10-week group (p<0·0001 for both). In women, compared with the 16-week group, it increased by 0·84 units (95% CI 0·76–0·91; approximately 395 mL) in the 12-week group and by 0·46 units (0·39–0·53; approximately 215 mL) in the 14-week group (p<0·0001 for both). No significant differences were observed in quality of life, physical activity, or cognitive function across randomised groups. However, more frequent donation resulted in more donation-related symptoms (eg, tiredness, breathlessness, feeling faint, dizziness, and restless legs, especially among men [for all listed symptoms]), lower mean haemoglobin and ferritin concentrations, and more deferrals for low haemoglobin (p<0·0001 for each) than those observed in the standard frequency groups. Interpretation: Over 2 years, more frequent donation than is standard practice in the UK collected substantially more blood without having a major effect on donors' quality of life, physical activity, or cognitive function, but resulted in more donation-related symptoms, deferrals, and iron deficiency. Funding: NHS Blood and Transplant, National Institute for Health Research, UK Medical Research Council, and British Heart Foundation

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Realist evaluation of an enhanced health visiting programme

The health visitors' role in many countries is changing. In Scotland, the role has undergone substantial changes through the introduction of an enhanced health visiting programme, which includes increased, structured home visits. This evaluation was conducted within NHS Ayrshire and Arran, one of the 14 Scottish Health Boards. Our aim was to understand and explain how, and why, the programme could contribute to improving health and wellbeing outcomes for children and families.We used a realist evaluation approach, conducted in three phases. In phase one, eight managerial staff involved in developing and implementing the programme provided data, which were used to develop initial programme theories. In phase two, the programme theories were tested using qualitative data from 25 health visitors and 22 parents. The programme theories were refined through analyses and interpretation of data in phase three.The home visiting context provided by the programme interacted with the mechanisms of the programme and produced outcomes such as early identification of health and wellbeing issues amongst families who needed more support, leading to referral and engagement with sources of additional help. The home visits facilitated development of parent-health visitor relationships, and parents considered health visitors as their first point of contact on children's wellbeing and developmental-related issues. Moreover, the programme provided more clarity to health visitors' role, which in turn enhanced partnership working. However, there were aspects of the programme that may require further development. For instance, both parents and health visitors were concerned about the wide gaps between some home visits.The enhanced health visiting programme increased opportunities for monitoring and early identification of health and wellbeing concerns. It created structures for a more efficient partnership working and ensured that the needs of children and families were supported. These benefits need to be evaluated further in an effectiveness study