In utero exposure to breast cancer treatment: a population-based perinatal outcome study

© 2019, Cancer Research UK. Chemotherapy during a viable pregnancy may be associated with adverse perinatal outcomes. We conducted a prospective cohort study to examine the perinatal outcomes of babies born following in utero exposure to chemotherapy in Australia and New Zealand. Over 18 months we identified 24 births, of >400 g and/or >20-weeks’ gestation, to women diagnosed with breast cancer in the first or second trimesters. Eighteen babies were exposed in utero to chemotherapy. Chemotherapy commenced at a median of 20 weeks gestation, for a mean duration of 10 weeks. Twelve exposed infants were born preterm with 11 by induced labour or pre-labour caesarean section. There were no perinatal deaths or congenital malformations. Our findings show that breast cancer diagnosed during mid-pregnancy is often treated with chemotherapy. Other than induced preterm births, there were no serious adverse perinatal outcomes

Renal angiomyolipoma presenting with massive retroperitoneal haemorrhage due to deranged clotting factors: a case report

BACKGROUND: Angiomyolipomata of the kidney are unusual lesions composed of abnormal vasculature, smooth muscle, and adipose elements. They may be associated with tuberous sclerosis and occasionally present with flank pain, a palpable mass, and gross haematuria. As angiomyolipomata grow their risk of bleeding increases, with a greater than 50% chance of significant bleeding in lesions > 4 cm; anticoagulant therapy accentuates this risk. CASE PRESENTATION: A case of massive retroperitoneal haemorrhage in a patient on warfarin is presented. The underlying diagnosis of renal angiomyolipoma was diagnosed based on CT findings. Emergency resuscitation and selective interpolar arterial embolization was performed which saved the patient's life as well as his kidney. CONCLUSION: This case illustrates the clinical scenario of massive retroperitoneal haemorrhage in an anticoagulated patient with renal angiomyolipomata. In the emergent situation, adequate resuscitation along ABC principles, as well as control of haemorrhage with either nephrectomy (partial or radical), non-selective renal arterial embolization, or selective embolization of the feeding vessel(s), is necessary. For this to occur, it is imperative to consider the diagnosis early in warfarinized patients (and others at risk of bleeding) who present with abdominal pain. The authors hope this case report highlights to readers the clinical scenario of massive retroperitoneal haemorrhage in anticoagulated patients with renal angiomyolipomata so that they can deal appropriately with such presentations

The influences and consequences of being digitally connected and/or disconnected to travellers

© 2017, The Author(s).Technological progress and tourism have worked in tandem for many years. Connectivity is the vehicle that drove the goal of technologically enhanced tourism experiences forward. This study, through an exploratory qualitative research identifies the factors that boost and/or distract travellers from obtaining a digitally enhanced tourism experience. Four factors can boost and/or distract travellers from being connected: (1) hardware and software, (2) needs and contexts, (3) openness to usage, and (4) supply and provision of connectivity. The research also analyses the positive and/or negative consequences that arise from being connected or disconnected. A Connected/Disconnected Consequences Model illustrates five forms of positive and/or negative consequences: (1) availability, (2) communication, (3) information obtainability, (4) time consumption, and (5) supporting experiences. A better understanding of the role and consequence of connectivity during the trip can enhance traveller experience

Rapture of renal angiomyolipoma during pregnancy: a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Improving the robustness to input errors on touch-based self-service kiosks and transportation apps

acceptedVersio

Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study.

National Coordinating Centre for Research Methodology; Medical Research Council, UK Department of Health; Chief Scientist OfficeNot peer reviewedPublisher PD

Validity and reliability of a novel 3D scanner for assessment of the shape and volume of amputees’ residual limb models

Objective assessment methods to monitor residual limb volume following lower-limb amputation are required to enhance practitioner-led prosthetic fitting. Computer aided systems, including 3D scanners, present numerous advantages and the recent Artec Eva scanner, based on laser free technology, could potentially be an effective solution for monitoring residual limb volumes. The aim of this study was to assess the validity and reliability of the Artec Eva scanner (practical measurement) against a high precision laser 3D scanner (criterion measurement) for the determination of residual limb model shape and volume. Three observers completed three repeat assessments of ten residual limb models, using both the scanners. Validity of the Artec Eva scanner was assessed (mean percentage error <2%) and Bland-Altman statistics were adopted to assess the agreement between the two scanners. Intra and inter-rater reliability (repeatability coefficient <5%) of the Artec Eva scanner was calculated for measuring indices of residual limb model volume and shape (i.e. residual limb cross sectional areas and perimeters). Residual limb model volumes ranged from 885 to 4399 ml. Mean percentage error of the Artec Eva scanner (validity) was 1.4% of the criterion volumes. Correlation coefficients between the Artec Eva and the Romer determined variables were higher than 0.9. Volume intra-rater and inter-rater reliability coefficients were 0.5% and 0.7%, respectively. Shape percentage maximal error was 2% at the distal end of the residual limb, with intra-rater reliability coefficients presenting the lowest errors (0.2%), both for cross sectional areas and perimeters of the residual limb models. The Artec Eva scanner is a valid and reliable method for assessing residual limb model shapes and volumes. While the method needs to be tested on human residual limbs and the results compared with the current system used in clinical practice, it has the potential to quantify shape and volume fluctuations with greater resolution

Timing of crystallization of the lunar magma ocean constrained by the oldest zircon

The Moon is thought to have formed through the consolidationof debris from the collision of a Mars-sized body with the Earthmore than 4,500 million years ago. The primitive Moon wascovered with a thick layer of melt known as the lunar magmaocean1, the crystallization of which resulted in the Moon?ssurface as it is observed today. There is considerable debate,however, over the precise timing and duration of the processof magma ocean crystallization. Here we date a zircon fromlunar breccias to an age of 4,4176 million years. This dateprovides a precise younger age limit for the solidification ofthe lunar magma ocean. We propose a model that suggestsan exponential rate of lunar crystallization, based on acombination of this oldest known lunar zircon and the age of theMoon-forming giant impact. We conclude that the formationof the Moon?s anorthositic crust followed the solidification of80?85% of the original melt, within about 100 million years ofthe collision. The existence of younger zircons2 is indicative ofthe continued solidification of a small percentage of melt for anextra 200?400 million years