Idiopathic True Aneurysm of the Radial Artery: A Rare Entity

AbstractIntroductionTrue aneurysms of the radial artery are extremely rare. Most cases of Radial artery aneurysm are the result of iatrogenic trauma, however other rare causes such as vascular tumours, connective tissue diseases and occupational injury have also been reported.Case reportA 60-year-old man presented with a pulsating mass in the anatomical snuffbox of the left hand. He underwent distal radial artery ligation and excision of the aneurysm. Histopathology demonstrated this to be a true aneurysm in continuation with the vessel wall.DiscussionThere are only a few cases of true distal radial artery aneurysm described in the literature. Careful examination and pre-operative imaging will help determine the most appropriate surgical management, including the need for vascular reconstruction

Spinal Cord Ischaemia Following Endovascular Repair of Abdominal Aortic Aneurysm: Result of Spinal Drain Insertion in a Rare Complication

IntroductionSpinal cord ischaemia (SCI) is a devastating complication of endovascular abdominal aortic aneurysm repair (EVAR), with a reported incidence of 0.2%. Interventions for SCI are largely derived from thoracic and thoracoabdominal aortic repairs.ReportWe report a case of acute neurological injury complicating an EVAR that was altered by spinal drain insertion and removal.DiscussionThis case highlights the need for appropriate consent of EVAR patients and the early utilisation of a spinal drain in the management of SCI

Chapter 4 Health security as a public good in the era of the Fourth Industrial Revolution in Poland

The fourth industrial revolution, characterized by digitization, artificial intelligence and augmented reality, and megatrends such as globalization, urbanization, demographic changes and the knowledge-based economy, will trigger a series of profound technological, economic, social and environmental changes that will permanently and irreversibly change the role of the state in meeting social needs. Industry 4.0 will also change the type, nature, and scope of public goods and how they are produced, financed, delivered, and consumed. This book redefines the current paradigm of public goods. It proposes a model of production and distribution of public goods that acknowledges the participation of entities from the public, private, and nonprofit sectors. The authors argue that these entities would participate in the production, financing, distribution, and consumption of such goods. From a theoretical point of view, such an inclusive approach involving the expansion of the classical state - market dichotomy with new entities, including citizens themselves, leads to a new conceptualization and approach towards public goods. The model assumes shared responsibility, subsidiarity, and paternalistic libertarianism, and it allows the state to create new entities of an educational or fiscal nature, while remaining the regulator of public services and distribution. Additionally, the book analyzes changes regarding the perception of public goods, in the era of the fourth industrial revolution, across selected sectors such as healthcare and pension systems, education, local public goods, and public utility services. The book is primarily addressed to researchers, scholars and students across social and technical sciences, and it will also be a useful guide for central and local administration bodies responsible for public policy

Temporally correlated fluctuations drive epileptiform dynamics

Published onlineJournal ArticleMacroscopic models of brain networks typically incorporate assumptions regarding the characteristics of afferent noise, which is used to represent input from distal brain regions or ongoing fluctuations in non-modelled parts of the brain. Such inputs are often modelled by Gaussian white noise which has a flat power spectrum. In contrast, macroscopic fluctuations in the brain typically follow a 1/f(b) spectrum. It is therefore important to understand the effect on brain dynamics of deviations from the assumption of white noise. In particular, we wish to understand the role that noise might play in eliciting aberrant rhythms in the epileptic brain. To address this question we study the response of a neural mass model to driving by stochastic, temporally correlated input. We characterise the model in terms of whether it generates "healthy" or "epileptiform" dynamics and observe which of these dynamics predominate under different choices of temporal correlation and amplitude of an Ornstein-Uhlenbeck process. We find that certain temporal correlations are prone to eliciting epileptiform dynamics, and that these correlations produce noise with maximal power in the δ and θ bands. Crucially, these are rhythms that are found to be enhanced prior to seizures in humans and animal models of epilepsy. In order to understand why these rhythms can generate epileptiform dynamics, we analyse the response of the model to sinusoidal driving and explain how the bifurcation structure of the model gives rise to these findings. Our results provide insight into how ongoing fluctuations in brain dynamics can facilitate the onset and propagation of epileptiform rhythms in brain networks. Furthermore, we highlight the need to combine large-scale models with noise of a variety of different types in order to understand brain (dys-)function.This work was supported by the European Commission through the FP7 Marie Curie Initial Training Network 289146 (NETT: Neural Engineering Transformative Technologies), by the Spanish Ministry of Economy and Competitiveness and FEDER (project FIS2012-37655-C02-01). J.G.O. also acknowledges support from the ICREA Academia programme, the Generalitat de Catalunya (project 2014SGR0947), and the “María de Maeztu” Programme for Units of Excellence in R&D (Spanish Ministry of Economy and Competitiveness, MDM-2014-0370) M.G. gratefully acknowledges the financial support of the EPSRC via grant EP/N014391/1. The contribution of M.G. was generously supported by a Wellcome Trust Institutional Strategic Support Award (WT105618MA)

Theoretical validity and reliability of Vespide Quality of Life Questionnaire in Polish adolescents with Hymenoptera venom allergy

Measurement of health-related quality of life is mostly used with advanced measurement tools, such as scales. The use of a certain scale in different cultural settings or in age groups other than those it was designed for needs conducting the adaptation process and assessment of psychometric properties of the adapted scale. This paper presents the results of theoretical validity and reliability analysis of the Polish adaptation of the VQLQ scale for adolescents with Hymenoptera venom allergy. The study sample consisted of 78 adolescents aged 14-19 years, who were treated with venom immunotherapy in Polish allergological centers in 2008 year. Theoretical validity of the scale was analyzed with exploratory factor analysis using the principal components method. Reliability analysis was assessed in terms of internal consistency with Cronbach's α coefficient and by testing Kline's criterion. The results showed satisfactory validity of the scale: factor analysis revealed a 3-factor structure of the scale - extracted factors were described as anxiety, caution and discomfort. All the scale items contributed to unique factors, except for one item concerning limitation in summer due to allergy, which was identified as a separate dimension of health-related quality of life of Polish adolescents with Hymenoptera venom allergy. All the extracted subscales were characterized by values of α coefficient equal or higher than 0.8, what is usually considered as a high-level reliability coefficient. The adapted scale is a valid and reliable tool measuring health-related quality of life in Polish adolescents treated with venom-specific immunotherapy

Health-related quality of life in Polish adolescents with "Hymenoptera" venom allergy treated with venom immunotherapy

Introduction: Venom allergy, though rare, may seriously influence health-related quality of life (HRQoL). There is a paucity of research on HRQoL of adolescents and young adults with Hymenoptera venom allergy. The aim was to assess the level of HRQoL and to evaluate its independent predictors in Polish adolescents and young adults treated with venom immunotherapy. Material and methods: A multicenter cross-sectional study based on the Vespid Allergy Quality of Life Questionnaire (VQLQ) adapted for Polish adolescents was used. The study sample included 87 patients (14-21 years) studied at different stages of venom immunotherapy (VIT). Statistical analysis was done with multivariate linear regression. Results: Anxiety level was higher in patients with 4th grade of Mueller’s classification (anaphylactic shock) than in those with 3rd grade (B = 0.84, 95% CI = 0.07-1.61, p = 0.03). Caution increased along with an increase of anxiety of adolescents treated with VIT (B = 0.54, 95% CI = 0.39-0.68, p < 0.01). Level of limitations increased with increasing caution of adolescents (B = 0.63, 95% CI = 0.35-0.91, p < 0.01). Discomfort increased along with a rise of caution of patients (B = 0.38, 95% CI = 0.22-0.55, p < 0.01). Similarly, it increased with an increase of their feeling of limitations (B = 0.37, 95% CI = 0.23-0.51, p < 0.01). The level of discomfort in adolescents treated with VIT was lower in those who were treated with conventional protocol in comparison to those treated with rush or ultrarush ones (B = –0.47, 95% CI = –0.90 - –0.03, p = 0.04). Conclusions: Severity of anaphylactic reaction is an independent determinant of anxiety level in adolescents treated with VIT. The VIT protocol affects HRQoL of treated patients

Experimental and Theoretical Challenges in the Search for the Quark Gluon Plasma: The STAR Collaboration's Critical Assessment of the Evidence from RHIC Collisions

We review the most important experimental results from the first three years of nucleus-nucleus collision studies at RHIC, with emphasis on results from the STAR experiment, and we assess their interpretation and comparison to theory. The theory-experiment comparison suggests that central Au+Au collisions at RHIC produce dense, rapidly thermalizing matter characterized by: (1) initial energy densities above the critical values predicted by lattice QCD for establishment of a Quark-Gluon Plasma (QGP); (2) nearly ideal fluid flow, marked by constituent interactions of very short mean free path, established most probably at a stage preceding hadron formation; and (3) opacity to jets. Many of the observations are consistent with models incorporating QGP formation in the early collision stages, and have not found ready explanation in a hadronic framework. However, the measurements themselves do not yet establish unequivocal evidence for a transition to this new form of matter. The theoretical treatment of the collision evolution, despite impressive successes, invokes a suite of distinct models, degrees of freedom and assumptions of as yet unknown quantitative consequence. We pose a set of important open questions, and suggest additional measurements, at least some of which should be addressed in order to establish a compelling basis to conclude definitively that thermalized, deconfined quark-gluon matter has been produced at RHIC.Comment: 101 pages, 37 figures; revised version to Nucl. Phys.