Evaluation of the analytical variability of dipstick protein pads in canine urine

BackgroundThe dipstick is a first-line and inexpensive test that can exclude the presence of proteinuria in dogs. However, no information is available about the analytical variability of canine urine dipstick analysis. ObjectivesThe aim of this study was to assess the analytical variability in 2 dipsticks and the inter-operator variability in dipstick interpretation. MethodsCanine urine supernatants (n = 174) were analyzed with 2 commercially available dipsticks. Two observers evaluated each result blinded to the other observer and to the results of the other dipstick. Intra- and inter-assay variability was assessed in 5 samples (corresponding to the 5 different semi-quantitative results) tested 10 consecutive times over 5 consecutive days. The agreement between observers and between dipsticks was evaluated with Cohen's k test. ResultsIntra-assay repeatability was good (3/10 errors), whereas inter-assay variability was higher (from 1/5 to 4/5 discordant results). The concordance between the operators (k = 0.68 and 0.79 for the 2 dipsticks) and that of the dipsticks (k = 0.66 and 0.74 for the 2 operators) was good. However, 1 observer and 1 dipstick overestimated the results compared with the second observer or dipstick. In any case, discordant results accounted for a single unit of the semi-quantitative scale. ConclusionsAs for any other method, analytic variability may affect the semi-quantitation of urinary proteins when using the dipstick method. Subjective interpretation of the pad and, to a lesser extent, intrinsic staining properties of the pads could affect the results. Further studies are warranted to evaluate the effect of this variability on clinical decisions

Tumour-induced osteomalacia: 18 months of 2-weekly burosumab treatment

Summary: Tumour-induced osteomalacia (TIO) is due to an overproduction of fibroblast growth factor 23 (FGF23) by mesenchymal tumours, causing hypophosphatemia, osteomalacia and muscle weakness. TIO is usually cured by tumour resection, but neoplasms may be unidentifiable and unresectable or the patient may refuse surgery. In these cases, medical treatment with oral phosphate and calcitriol is mandatory, but it is not fully effective and it is associated with low compliance. Burosumab, a human MAB against FGF23 employed to treat X-linked hypophosphatemia (XLH), has recently been approved for TIO in the USA. Maximum burosumab dose in XLH is 90 mg administered for 2 weeks; there are no data on clinical efficacy and safety of this dose in TIO. We reported the case of a 73 years old male with multiple non-traumatic fractures, low bone mineral density, pain and reduced independence of activities of daily living. Biochemical evaluation showed hypophosphatemia, high alkaline phosphatase (ALP) and C-terminal telopeptide (CTX) and normal albumin-corrected total calcium and parathyroid hormone. Tubular phosphate reabsorption was low (80%), whereas C-terminal tail of FGF23 (cFGF23) was elevated. A 68Ga-DOTATOC PET was performed, identifying a lesion in the first left rib. The patient refused surgery; therefore, burosumab therapy was started. After 18 months of treatment (maximum dose: 60 mg administered for 2 weeks), plasma phosphate normalized and ALP levels improved (138 U/L). Patient clinical symptoms as well as pain severity and fatigue improved. Neither adverse events nor tumour progression was reported during follow-up except for a painless fracture of the second right rib. Learning points: Our case shows efficacy and safety of burosumab treatment administered every 2 weeks in a tumour-induced osteomalacia (TIO) patient. After 18 months of treatment at a maximum dose of 60 mg every 2 weeks, we found plasma phosphate normalization and ALP reduction as well as improvement in clinical symptoms and fatigue. Neither adverse events nor tumour progression was reported during follow-up, except for a painless fracture of the second right rib

Development of a measurement platformon a light airplane and analysis of airborne measurementsin the atmospheric boundary layer

In the present paper we provide an overview of a long term research project aimed at setting up a suitable platform for measurements in the atmospheric boundary layer on a light airplane along with some preliminary results obtained from fi eld campaigns at selected sites. Measurements of air pressure, temperature and relative humidity have been performed in various Alpine valleys up to a height of about 2500 m a.m.s.l. By means of GPS resources and specifi c post-processing procedures careful positioning of measurement points within the explored domain has been achieved. The analysis of collected data allowed detailed investigation of atmospheric vertical structures and dynamics typical of valley environment, such as morning transition from ground based inversion to fully developed well mixed convective boundary layer. Based on data collected along fl ights, 3D fi elds of the explored variables have been detected and identifi ed through application of geostatistical techniques (Kriging). The adopted procedures allowed evaluation of the intrinsic statistical structure of the spatial distribution of measured quantities and the estimate of the values of the same variable at unexplored locations by suitable weighted average of data recorded at close locations. Results thus obtained are presented and discussed

The effect of renal diet in association with enalapril or benazepril on proteinuria in dogs with proteinuric chronic kidney disease

Treating proteinuria in dogs reduces the progression of chronic kidney disease (CKD); renal diets and angiotensin - converting enzyme (ACE)-inhibitors are cornerstones of treatment. Whether different ACE-inhibitors have distinct kidney protective effects is unknown; it is therefore hypothesized that renal diets and enalapril or benazepril have different beneficial effects in proteinuric CKD dogs. Forty-four dogs with proteinuric CKD (IRIS stages 1-4) were enrolled in the study and were fed renal diet for 30 days. Thereafter, they were randomly assigned to one of 2 groups. Dogs in group A (n=22) received enalapril (0.5 mg/kg, q12h) and in group B (n=22) benazepril (0.5 mg/kg, q24h); in both groups, dogs were fed the same renal diet. After randomization, dogs were monitored for 120 days. Body weight and body condition score (BCS), serum concentrations of creatinine, blood urea nitrogen (BUN), albumin and total proteins, and urine protein-to-creatinine (UPC) ratio were compared at different time-points. After 30 days of renal diet, creatinine, BUN and UPC ratio decreased significantly (p<0.0001). Compared to randomization, body weight, BCS, albumin, total proteins, creatinine and BUN did not vary during follow-up in the 44 dogs and differences between group A and B were not observed. However, the UPC ratio of group A at day 60, 90 and 150 was significantly lower than in group B and compared to randomization (p<0.05). In group B it did not vary overtime. It is concluded that the renal diet is beneficial to decrease creatinine, BUN and UPC ratio in proteinuric CKD dogs. Enalapril further ameliorates proteinuria if administered along with renal diet

Object-based image analysis for historic maps classification

Heritage maps represent fundamental information for the study of the evolution of a region, especially in terms of landscape and ecologic features. Historical maps present two kinds of hurdle before they can be used in a modern GIS: they must be geometrically corrected to correspond to the datum in use and they must be classified to exploit the information they contain. This study deals the latter problem: the Historical Cadaster Map, created between 1851 and 1861, for the Trentino region in the North of Italy is available as a collection of maps in the ETRS89/UTM 32N datum. The map is a high resolution scan (230 DPI, 24 bit) of the original map and has been used in several ecological studies, since it provides detailed information not only about land property but also about land use. In the past the cadaster map has been manually digitized and for each area a set of attributes has been recorded. Since this approach is time consuming and prone to errors, automatic and semi-automatic procedures have been tested. Traditional image classification techniques, such as maximum likelihood classification, supervised or un-supervised, pixelwise and contextual, do not provide satisfactory results for many reasons: map colors are very variable within the same area, symbols and characters are used to identify cadaster parcels and locations, lines, drawn by hand on the original map, have variable thickness and colors. The availability of FOSS tools for the Object-based Image Analysis (OBIA) has made possible the application of this technique to the cadaster map. This paper describes the use of GRASS GIS and R for the implementation of the OBIA approach for the supervised classification of the historic cadaster map. It describes the determination of the optimal segments, the choice of their attributes and relevant statistics, and their classification. The result has been evaluated with respect to a manually digitized map using Cohens Kappa and the analysis of the confusion matrix. The result of the OBIA classification has also been compared to the classification of the same map using maximum likelihood classification, un-supervised and supervised, both pixelwise and contextual. The OBIA approach has provided very satisfactory results with the ability to automatically remove the background and symbols and characters, creating a ready to be used classified map. This study highlights the effectiveness of the OBIA processing chain available in the FOSS4G ecosystem, and in particular the added value of the interoperability between GRASS GIS and R

Modeling of forest landscape evolution at regional level: a FOSS4G approach

In the last decades the Alpine landscape has dramatically changed due to social and economic factors. The most visible impact has been the reduction of the population for mid and high altitude villages and the shrinking of the part of the land used for agriculture and grazing, with a progressive reduction of pastures and meadows and the expansion of the forested areas. For these reasons, a dataset describing the forest, meadows and pasture coverage for the Trentino region, in the eastern Italian Alps, has been created. A set of heterogeneous sources has been selected so that maps and images cover the longest possible time span on the whole Trentino region with comparable quality, creating a Land Use/Land Cover (LULC) map based on historical maps from 1859 to 1936 and aerial images from 1954 to 2015. The achieved accuracy ranges from 98% for historical maps to 94% for aereal imagery. The analysis of selected landscape metrics provided preliminary results about the forest distribution and patterns of recolonization during the last 155 years. It has been possible to create future scenarios for the forest evolution for the next 85 years. Given the large number of maps involved, the great flexibility provided by FOSS for spatial analysis, such as GRASS, R, QGIS and GAMA and the possibility of scripting all the operations have played a pivotal role in the success both in the creation of the dataset and in the extraction and modeling of land use change

Development of a measurement platformon a light airplane and analysis of airborne measurementsin the atmospheric boundary layer

In the present paper we provide an overview of a long term research project aimed at setting up a suitable platform for measurements in the atmospheric boundary layer on a light airplane along with some preliminary results obtained from fi eld campaigns at selected sites. Measurements of air pressure, temperature and relative humidity have been performed in various Alpine valleys up to a height of about 2500 m a.m.s.l. By means of GPS resources and specifi c post-processing procedures careful positioning of measurement points within the explored domain has been achieved. The analysis of collected data allowed detailed investigation of atmospheric vertical structures and dynamics typical of valley environment, such as morning transition from ground based inversion to fully developed well mixed convective boundary layer. Based on data collected along fl ights, 3D fi elds of the explored variables have been detected and identifi ed through application of geostatistical techniques (Kriging). The adopted procedures allowed evaluation of the intrinsic statistical structure of the spatial distribution of measured quantities and the estimate of the values of the same variable at unexplored locations by suitable weighted average of data recorded at close locations. Results thus obtained are presented and discussed

Neck paraganglioma and follicular lymphoma: A case report

Background: Paragangliomas and pheochromocytomas are sympathetic or parasympathetic tumors derived from the paraganglia and the adrenal medulla, respectively. Paragangliomas and pheochromocytomas can be sporadic or familial, the latter frequently being multifocal and possibly due to succinate dehydrogenase complex genes mutations. In addition, 12% of sporadic paragangliomas are related to covered succinate dehydrogenase complex mutations. The importance of identifying succinate dehydrogenase complex mutations is related to the risk for these patients of developing multiple tumors, including non-endocrine ones, showing an aggressive clinical presentation. Case presentation: We report the case of a 45-year-old Caucasian man with an indolent mass in his neck. Ultrasound of his neck, magnetic resonance imaging, and 1,4,7,10-tetraazacyclododecane-N(I),N(II),N(III),N(IIII)-tetraacetic acid(D)-Phe(1)-thy(3)-octreotide (68Ga-DOTATOC) positron emission tomography-computed tomography and endocrine work-up were consistent with a carotid body paraganglioma with concomitant nodal enlargement in several body regions, which turned out to be a follicular lymphoma at histology. He was found to carry a germline Succinate dehydrogenase subunit B gene (SDHB) mutation. Conclusion: It is crucial to look for a second malignancy in the case of a paraganglioma demonstrating succinate dehydrogenase complex germline mutations

MAPPING COVID-19 EPIDEMIC DATA USING FOSS

The recognition of spatial and temporal patterns in the distribution of a pandemic plays a pivotal role in guiding policy approaches to its management, containment and elimination. For this purpose, a database has been built for the COVID-19 pandemic in the Trentino Province, in the eastern Italian alps, near the border between Italy and Austria. The database management system and the WebGIS mapping these data is based on Free and Open Source Software. The Data Base Management System (DBMS) runs on MySQL, available under the GNU General Public License, storing and processing geographic data. A custom procedure has been created to update the dataset, with the capability to import data from suitably formatted spreadsheets by an authenticated administrator. To ensure flexibility and responsiveness on desktop and mobile devices, the WebGIS has been created with a client-side approach, using the Leaflet and Bootstrap JavaScript language libraries, available with Open Source Licenses. These libraries, with additional custom scripts, create the user interface and render geographic data into maps. The exchange of data between the DBMS server and the client is performed using geojson tables. To protect the privacy of the patients, WebGIS users cannot access the source data even though maps and graphs can be downloaded as pictures. Geo-statistical analysis aimed at the detection of spatial and temporal patters is underway