Recurring pulmonary hamartomas: cause for concern?

We report the case of a well-controlled female asthmatic who developed \u27multiple pulmonary hamartomas\u27 on three separate occasions over a period of 25 years that necessitated surgical resection. To our knowledge, this is the first report of recurrent hamartomas in a single individual necessitating multiple thoracotomies

Increased platelet counts and platelet activation in early symptomatic versus asymptomatic carotid stenosis and relationship with microembolic status: Results from the Platelets And Carotid Stenosis (PACS) Study

Background: Cerebral microembolic signals (MES) may predict increased stroke risk in carotid stenosis. However, the relationship between platelet counts or platelet activation status and MES in symptomatic versus asymptomatic carotid stenosis has not been comprehensively assessed. Setting: University teaching hospitals. Methods: This prospective, pilot observational study assessed platelet counts and platelet activation status, and the relationship between platelet activation and MES in asymptomatic versus early (≤4 weeks after TIA/stroke) and late phase (≥3 months) symptomatic moderate or severe (≥50%) carotid stenosis patients. Full blood count measurements were performed, and whole blood flow cytometry was used to quantify platelet surface activation marker expression (CD62P and CD63) and circulating leucocyte-platelet complexes. Bilateral simultaneous transcranial Doppler ultrasound monitoring of the middle cerebral arteries was performed for 1 hour to classify patients as MES-positive or MES-negative. Results: Data from 31 asymptomatic patients were compared with 46 symptomatic patients in the early phase, and 35 of these patients followed up to the late phase after symptom onset. The median platelet count (211 vs. 200 x 109/L; p=0.03) and the median % lymphocyte-platelet complexes were higher in early symptomatic than asymptomatic patients (2.8 vs. 2.4%, p=0.001). The % lymphocyte-platelet complexes was higher in early symptomatic than asymptomatic patients with ≥70% carotid stenosis (p=0.0005), and in symptomatic patients recruited within 7 days of symptom onset (p=0.028). Complete TCD data were available in 25 asymptomatic and 31 early phase symptomatic, and 27 late phase symptomatic patients. 12% of asymptomatic versus 32% of early phase symptomatic (p=0.02) and 19% of late phase symptomatic patients (p=0.2) were MES-positive. Early symptomatic MES-negative patients had ahigher % lymphocyte-platelet complexes than asymptomatic MES-negative patients (2.8 vs. 2.3%; p=0.0085). Discussion: Recently symptomatic carotid stenosis patients have higher platelet counts (potentially reflecting increased platelet production, mobilisation or reduced clearance) and platelet activation status than asymptomatic patients. MES were more frequently detected in early symptomatic than asymptomatic patients, but the differences between late symptomatic and asymptomatic groups were not significant. Increased lymphocyte-platelet complex formation in recently symptomatic vs. asymptomatic MES-negative patients indicates enhanced platelet activation in this early symptomatic subgroup. Platelet biomarkers, in combination with TCD, have the potential to aid risk-stratification in asymptomatic and symptomatic carotid stenosis patients

Kinetic Studies of the Photo-Degradation of Poly Arylene Vinylenes

The kinetics of the degradation of a homologous series of Poly phenylene vinylenes in which the phenylene units of the PPV structure are systematically substituted by naphthyl and anthyrl units is presented. Degradation is monitored according to the decay of the long wavelength absorption maximum upon illumination with UV radiation. Compared to Toluene solution, the photo-degradation is seen to be accelerated in Chloroform solution. All decays are fitted with first order kinetics. It is found that all substitutions improve the stability of the vinylene polymers against decay. In particular the highly electro-negative naphthyl group serves to drastically increase the stability due to electron depletion across the vinyl bond. The decay rate is shown to correlate well with the variation of the electronic properties of the backbone and with the reduction of vinylene bond strength as measured using Raman spectroscopy

The interplay of solvation and polarization effects on ion pairing in nanoconfined electrolytes

The nature of ion-ion interactions in electrolytes confined to nanoscale pores has important implications for energy storage and separations technologies. However, the physical effects dictating the structure of nanoconfined electrolytes remain debated. Here we employ machine learning-based molecular dynamics simulations to investigate ion-ion interactions with density functional theory-level accuracy in a prototypical confined electrolyte, aqueous NaCl within graphene slit pores. We find that the free energy of ion pairing in highly confined electrolytes deviates substantially from that in bulk solutions, observing a decrease in contact ion pairing but an increase in solvent-separated ion pairing. These changes arise from an interplay of ion solvation effects and graphene\u27s electronic structure. Notably, the behavior observed from our first-principles-level simulations is not reproduced even qualitatively with the classical force fields conventionally used to model these systems. The insight provided in this work opens new avenues for predicting and controlling the structure of nanoconfined electrolytes

Blow the Wind

David Mooney (arranger) writes This arrangement for choir, harp and treble solo combines two well-know folk tunes relating to the subject of the wind. It has been written specially for this project. The North Wind Doth Blow and Blow the Wind Southerly provide the principal thematic material. The two beautiful melodies are woven into the setting while the harp provides a descriptive underlay and word-painting . The performers are Dr. Cliona Doris (concert harp), Max O\u27Neill (treble solo), The DIT Junior Choirs (dir. by Dr. Lorraine O\u27Connell), Niamh McCormack (soprano), Aoife Moore (soprano) and Sheena Styles (alto)

Using body mass index to estimate individualised patient radiation dose in abdominal computed tomography

Background: The size-specific dose estimate (SSDE) is a dose-related metrics that incorporates patient size into its calculation. It is usually derived from the volume computed tomography dose index (CTDIvol) by applying a conversion factor determined from manually measured anteroposterior and lateral skin-to-skin patient diameters at the midslice level on computed tomography (CT) localiser images, an awkward, time-consuming, and not highly reproducible technique. The objective of this study was to evaluate the potential for the use of body mass index (BMI) as a size-related metrics alternative to the midslice effective diameter (DE) to obtain a size-specific dose (SSDE) in abdominal CT. Methods: In this retrospective study of patients who underwent abdominal CT for the investigation of inflammatory bowel disease, the DE was measured on the midslice level on CT-localiser images of each patient. This was correlated with patient BMI and the linear regression equation relating the quantities was calculated. The ratio between the internal and the external abdominal diameters (DRATIO) was also measured to assess correlation with radiation dose. Pearson correlation analysis and linear regression models were used. Results: There was good correlation between DE and patient BMI (r = 0.88). An equation allowing calculation of DE from BMI was calculated by linear regression analysis as follows: DE = 0.76 (BMI) + 9.4. A weak correlation between radiation dose and DRATIO was demonstrated (r = 0.45). Conclusions: Patient BMI can be used to accurately estimate DE, obviating the need to measure anteroposterior and lateral diameters in order to calculate a SSDE for abdominal CT

A Collagen Cardiac Patch Incorporating Alginate Microparticles Permits the Controlled Release of HGF and IGF-1 to Enhance Cardiac Stem Cell Migration and Proliferation

A major weakness in existing therapies for myocardial infarction is their inability to regenerate the resulting damaged cardiac muscle. Thus, the goal of current experimental strategies is finding the means for attenuation of the progressive processes leading to tissue destruction, while inducing myocardial tissue regeneration (1, 2).Regenerative cardiology’s Holy Grail has been the development of procedures to either replace lost myocytes with transplanted stem cells or to use stem cells to mediate functional repair through paracrine effects (3-6). The most primitive undifferentiated population of stem cells in the heart, the c-KitPOS Cardiac Stem Cell (CSC) pool which was the first stem cell identified in the rat heart and, up to date, this CSC pool is still the most extensively characterised (7, 8). CSCs are a heterogenic group of cells and they are concentrated in specific areas of the heart, such as the atria or pericardium (9). They represent a logical source to exploit in myocardial regeneration because of their likelihood to be intrinsically programmed to generate viable cardiac tissues in vitro and increase its viability in vivo (10-13). The ideal replacement for the lost myocardium after myocardial infarction is functional autologous myocardial tissue, which can bypass issues around immunosuppression associated with allogenic therapies (14). However, as presently practiced, the isolation and expansion of endogenous cardiac stem cells (eCSCs) for autologous cell transplantation is slow and expensive. In addition, endomyocardial biopsies are difficult to attain (12, 15). Thus, there is need for strategies to specifically activate in situ the intrinsic cardiac regenerative potential represented by the eCSCs using combinations of growth factors, cytokines and drugs, obviating the need for cell transplantation (15, 16). As presently practiced, the isolation and expansion of CSCs for autologous cell transplantation is slow, expensive and difficult to attain. Thus, there is need for strategies to specifically activate in situ the intrinsic cardiac regenerative potential represented by the CSCs using combinations of growth factors obviating the need for cell transplantation. By favouring the natural regenerative capability of CSCs, it is hypothesised that the cardiac patch presented here will result in positive therapeutic outcomes in myocardial infarction and heart failure patients in the future

The PROCESS 2020 guideline: Updating consensus preferred reporting Of case series in surgery (PROCESS) guidelines

Introduction: The PROCESS Guidelines were first published in 2016 and were last updated in 2018. They provide a structure for reporting surgical case series in order to increase reporting robustness and transparency, and are used and endorsed by authors, journal editors and reviewers alike. In order to drive forwards reporting quality, they must be kept up to date. As such, we have updated these guidelines via a DELPHI consensus exercise.Methods: The updated guidelines were produced via a DELPHI consensus exercise. Members from the previous DELPHI group were again invited, alongside editorial board members and peer reviewers of the International Journal of Surgery and the International Journal of Surgery Case Reports. An online survey was completed by this expert group to indicate their agreement with proposed changes to the checklist items.Results: A total of 53 surgical experts agreed to participate and 49 (92%) completed the survey. The responses and suggested modifications were incorporated into the previous 2018 guidelines. There was a high degree of agreement amongst the PROCESS Group, with all but one of the PROCESS items receiving over 70% of scores ranging 7-9.Conclusion: A DELPHI consensus exercise was completed and an updated and improved PROCESS Checklist is now presented

Low-dose carotid computed tomography angiography using pure iterative reconstruction

The aim of this study was to assess if a low-dose carotid computed tomography angiography (CTA) performed with pure iterative reconstruction (IR) is comparable to a conventional dose CTA protocol. Methods: Twenty patients were included. Radiation dose was divided into a low-dose acquisition reconstructed with pure IR and a conventional dose acquisition reconstructed with 40% hybrid IR. Dose, image noise, contrast resolution, spatial resolution, and carotid artery stenosis were measured. Results: Mean effective dose was significantly lower for low-dose than conventional dose studies (1.84 versus 3.71 mSv; P < 0.001). Subjective image noise, contrast resolution, and spatial resolution were significantly higher for the low-dose studies. There was excellent agreement for stenosis grading accuracy between low- and conventional dose studies (Cohen κ = 0.806). Conclusions: A low-dose carotid CTA protocol reconstructed with pure IR is comparable to a conventional dose CTA protocol in terms of image quality and diagnostic accuracy while enabling a dose reduction of 49.6%