Brain abscess caused by trauma of the rhinobasis: an endoscopic challenge

Brain abscess is a rare but life-threatening infection of the brain. It often occurs as a complication of infection, trauma, or surgery. This case presents a brain abscess in a 22-month-old boy that developed after a transnasal injury with a foreign body. A minimal-invasive, transnasal, endoscopic-controlled technique was used, during which the foreign object was removed and the abscess drained. Bacteriological samples were obtained and the abscess cavity irrigated. Postoperative care included antibiotics and daily irrigation of the abscess cavity. Follow-up MRI scans showed reduction in abscess size. A spinal drain was inserted temporarily to address rhino-liquorrhoea. The patient remained asymptomatic during one-year of follow-up. This case report highlights the occurrence of a brain abscess in childhood following a transnasal injury and demonstrates a minimal-invasive, transnasal, endoscopic-controlled surgical technique. The findings underscore the importance of considering brain abscess as a potential complication in cases of head trauma, particularly in atypical presentations

Large spatial extension of the zero-energy Yu-Shiba-Rusinov state in a magnetic field

Various promising qubit concepts have been put forward recently based on engineered superconductor (SC) subgap states like Andreev bound states, Majorana zero modes or the Yu-Shiba-Rusinov (Shiba) states. The coupling of these subgap states via a SC strongly depends on their spatial extension and is an essential next step for future quantum technologies. Here we investigate the spatial extension of a Shiba state in a semiconductor quantum dot coupled to a SC for the first time. With detailed transport measurements and numerical renormalization group calculations we find a remarkable more than 50 nm extension of the zero energy Shiba state, much larger than the one observed in very recent scanning tunneling microscopy (STM) measurements. Moreover, we demonstrate that its spatial extension increases substantially in magnetic field.Comment: 11 pages, 7 figure

Mixed methods evaluation of the Getting it Right First Time programme in elective orthopaedic surgery in England: an analysis from the National Joint Registry and Hospital Episode Statistics

OBJECTIVE: To evaluate the impact of the 'Getting it Right First Time' (GIRFT) national improvement programme in orthopaedics, which started in 2012. DESIGN: Mixed-methods study comprising statistical analysis of linked national datasets (National Joint Registry; Hospital Episode Statistics; Patient-Reported Outcomes); economic analysis and qualitative case studies in six National Health Service (NHS) Trusts. SETTING: NHS elective orthopaedic surgery in England. PARTICIPANTS: 736 088 patients who underwent primary hip or knee replacement at 126 NHS Trusts between 1 April 2009 and 31 March 2018, plus 50 NHS staff. INTERVENTION: Improvement bundle including 'deep dive' visits by senior clinician to NHS Trusts, informed by bespoke set of routine performance data, to discuss how improvements could be made locally. MAIN OUTCOME MEASURES: Number of procedures conducted by low volume surgeons; use of uncemented hip implants in patients >65; arthroscopy in year prior to knee replacement; hospital length of stay; emergency readmissions within 30 days; revision surgery within 1 year; health-related quality of life and functional status. RESULTS: National trends demonstrated substantial improvements beginning prior to GIRFT. Between 2012 and 2018, there were reductions in procedures by low volume surgeons (ORs (95% CI) hips 0.58 (0.53 to 0.63), knees 0.77 (0.72 to 0.83)); uncemented hip prostheses in >65 s (OR 0.56 (0.51 to 0.61)); knee arthroscopies before surgery (OR 0.48 (0.41 to 0.56)) and mean length of stay (hips -0.90 (-1.00 to -0.81), knees -0.74 days (-0.82 to -0.66)). The additional impact of visits was mixed and comprised an overall economic saving of £431 848 between 2012 and 2018, but this was offset by the costs of the visits. Staff reported that GIRFT's influence ranged from procurement changes to improved regional collaboration. CONCLUSION: Nationally, we found substantial improvements in care, but the specific contribution of GIRFT cannot be reliably estimated due to other concurrent initiatives. Our approach enabled additional analysis of the discrete impact of GIRFT visits

Improving the Final Liveweight and Growing Ability of TETRA-H a Dual Purpose Chicken Type by Using a New Experimental Sire Line

Our study was carried out with the pure, crossed and reciprocal crossed off spring of TETRA-H hybrid, a coloured slow-growing broiler genotype which was developed in the 1980’s by Babolna TETRA Ltd. In this project the potential of a new, improved sire line was also investigated. Experiments were carried out in the Poultry Test Station of the Kaposvar University in 2008 - 2010. In the first stage, growing ability of TETRA-H and a commercial genotype (standard control=Shaver Redbro) had been compared. In stages two and three the LL line, which was previously used as sire line, the newly selected sire Line EE, and the off spring came from the combination of those lines have been centrally tested. A total number of 6453 birds were used. The following traits were investigated: live weight, body composition evaluated by CT, carcass yield, meat quality, etc. The positive impact of the newly developed sire line (EE) in their off spring was confirmed. Lower slaughter weight of the F1 off spring has improved by 10.1-10.8%, making the newly developed hybrid highly competitive on the market. Furthermore, the crossing method was incompetent (LL♂xEE♀ or EE♂xLL♀) in the birds live weight and growing ability

Neuroinflammatory processes are augmented in mice overexpressing human heat-shock protein B1 following ethanol-induced brain injury

Background: Heat-shock protein B1 (HSPB1) is among the most well-known and versatile member of the evolutionarily conserved family of small heat-shock proteins. It has been implicated to serve a neuroprotective role against various neurological disorders via its modulatory activity on inflammation, yet its exact role in neuroinflammation is poorly understood. In order to shed light on the exact mechanism of inflammation modulation by HSPB1, we investigated the effect of HSPB1 on neuroinflammatory processes in an in vivo and in vitro model of acute brain injury. Methods: In this study, we used a transgenic mouse strain overexpressing the human HSPB1 protein. In the in vivo experiments, 7-day-old transgenic and wild-type mice were treated with ethanol. Apoptotic cells were detected using TUNEL assay. The mRNA and protein levels of cytokines and glial cell markers were examined using RT-PCR and immunohistochemistry in the brain. We also established primary neuronal, astrocyte, and microglial cultures which were subjected to cytokine and ethanol treatments. TNF alpha and hHSPB1 levels were measured from the supernates by ELISA, and intracellular hHSPB1 expression was analyzed using fluorescent immunohistochemistry. Results: Following ethanol treatment, the brains of hHSPB1-overexpressing mice showed a significantly higher mRNA level of pro-inflammatory cytokines (Tnf, Il1b), microglia (Cd68, Arg1), and astrocyte (Gfap) markers compared to wild-type brains. Microglial activation, and 1 week later, reactive astrogliosis was higher in certain brain areas of ethanol-treated transgenic mice compared to those of wild-types. Despite the remarkably high expression of pro-apoptotic Tnf, hHSPB1-overexpressing mice did not exhibit higher level of apoptosis. Our data suggest that intracellular hHSPB1, showing the highest level in primary astrocytes, was responsible for the inflammation-regulating effects. Microglia cells were the main source of TNF alpha in our model. Microglia isolated from hHSPB1-overexpressing mice showed a significantly higher release of TNF alpha compared to wild-type cells under inflammatory conditions. Conclusions; Our work provides novel in vivo evidence that hHSPB1 overexpression has a regulating effect on acute neuroinflammation by intensifying the expression of pro-inflammatory cytokines and enhancing glial cell activation, but not increasing neuronal apoptosis. These results suggest that hHSPB1 may play a complex role in the modulation of the ethanol-induced neuroinflammatory response.Peer reviewe

3D printing metals like thermoplastics: Fused filament fabrication of metallic glasses

Whereas 3D printing of thermoplastics is highly advanced and can readily create complex geometries, 3D printing of metals is still challenging and limited. The origin of this asymmetry in technological maturity is the continuous softening of thermoplastics with temperature into a readily formable state, which is absent in conventional metals. Unlike conventional metals, bulk metallic glasses (BMGs) demonstrate a supercooled liquid region and continuous softening upon heating, analogous to thermoplastics. Here we demonstrate that, in extension of this analogy, BMGs are also amenable to extrusion-based 3D printing through fused filament fabrication (FFF). When utilizing the BMGs’ supercooled liquid behavior, 3D printing can be realized under similar conditions to those in thermoplastics. Fully dense and amorphous BMG parts are 3D printed in ambient environmental conditions resulting in high-strength metal parts. Due to the similarity between FFF of thermoplastics and BMGs, this method may leverage the technology infrastructure built by the thermoplastic FFF community to rapidly realize and proliferate accessible and practical printing of metals

Addressing the challenges of knowledge co-production in quality improvement:learning from the implementation of the researcher-in-residence model

The concept of knowledge co-production is used in health services research to describe partnerships (which can involve researchers, practitioners, managers, commissioners or service users) with the purpose of creating, sharing and negotiating different knowledge types used to make improvements in health services. Several knowledge co-production models have been proposed to date, some involving intermediary roles. This paper explores one such model, researchers-in-residence (also known as ‘embedded researchers’). In this model, researchers work inside healthcare organisations, operating as staff members while also maintaining an affiliation with academic institutions. As part of the local team, researchers negotiate the meaning and use of research-based knowledge to co-produce knowledge, which is sensitive to the local context. Even though this model is spreading and appears to have potential for using co-produced knowledge to make changes in practice, a number of challenges with its use are emerging. These include challenges experienced by the researchers in embedding themselves within the practice environment, preserving a clear focus within their host organisations and maintaining academic professional identity. In this paper, we provide an exploration of these challenges by examining three independent case studies implemented in the UK, each of which attempted to co-produce relevant research projects to improve the quality of care. We explore how these played out in practice and the strategies used by the researchers-in-residence to address them. In describing and analysing these strategies, we hope that participatory approaches to knowledge co-production can be used more effectively in the future

Challenges, solutions and future directions in the evaluation of service innovations in health care and public health

HeadlineEvaluating service innovations in health care and public health requires flexibility, collaboration and pragmatism; this collection identifies robust, innovative and mixed methods to inform such evaluations.This is the final version of the article. It first appeared from the National Institute for Helath Research via http://dx.doi.org/10.3310/hsdr0416