CT-Guided Drainage of Fluid Collections Following Liver Resection: Technical and Clinical Outcome of 143 Patients during a 14-Year Period

PURPOSE To retrospectively evaluate the technical and clinical outcome of patients with symptomatic postoperative fluid collections following liver resection treated with CT-guided drainage (CTD). METHODS 143 suitable patients were examined between 2004 and 2017. Technical success was defined as (a) sufficient drainage of the fluid collection and (b) the non-occurrence of peri-interventional complications requiring surgical treatment with minor or prolonged hospitalization. Clinical success was defined as (a) decreasing or normalization of specific blood parameters within 30 days after intervention and (b) no surgical revision in addition to intervention required. C-reactive protein (CRP), leukocytes and Total Serum Bilirubin (TSB) were assessed. Dose length product (DLP) for the intervention parts was determined. RESULTS Technical success was achieved in 99.5% of 189 performed interventions. Clinical success was reached in 74% for CRP, in 86.7% for Leukocytes and in 62.1% for TSB. The median of successful decrease was 6.0 days for CRP, 3.5 days for Leukocytes and 5.5 days for TSB. In 90.2%, no surgical revision was necessary. Total DLP was significantly lower in the second half of the observation period (median 536.0 mGy*cm between years 2011 and 2017 vs. median 745.5 mGy*cm between years 2004 and 2010). CONCLUSIONS Technical success rate of CTD was very high, and clinical success rate was fair to good. Reduction of the radiation dose reflects developments of CT technology and increased experience of the interventional radiologists

Aestipascuomyces dupliciliberans gen. nov, sp. nov., the First Cultured Representative of the Uncultured SK4 Clade from Aoudad Sheep and Alpaca

We report on the isolation of the previously-uncultured Neocallimastigomycota SK4 lineage, by two independent research groups, from a wild aoudad sheep rumen sample (Texas, USA) and an alpaca fecal sample (Baden-Württemberg, Germany). Isolates from both locations showed near-identical morphological and microscopic features, forming medium-sized (2–5 mm) white filamentous colonies with a white center of sporangia, on agar roll tubes and a heavy biofilm in liquid media. Microscopic analysis revealed monocentric thalli, and spherical polyflagellated zoospores with 7–20 flagella. Zoospore release occurred through an apical pore as well as by sporangial wall rupturing, a duality that is unique amongst described anaerobic gut fungal strains. Isolates were capable of growing on a wide range of mono-, oligo-, and polysaccharide substrates as the sole carbon source. Phylogenetic assessment based on the D1–D2 28S large rRNA gene subunit (D1–D2 LSU) and internal transcribed spacer-1 (ITS-1) regions demonstrated high sequence identity (minimum identity of 99.07% and 96.96%, respectively) between all isolates; but low sequence identity (92.4% and 86.7%, respectively) to their closest cultured relatives. D1–D2 LSU phylogenetic trees grouped the isolates as a new monophyletic clade within the Orpinomyces–Neocallimastix–Pecoramyces–Feramyces–Ghazallamyces supragenus group. D1–D2 LSU and ITS-1 sequences recovered from the obtained isolates were either identical or displayed extremely high sequence similarity to sequences recovered from the same aoudad sheep sample on which isolation was conducted, as well as several sequences recovered from domestic sheep and few other herbivores. Interestingly, members of the SK4 clade seem to be encountered preferably in animals grazing on summer pasture. We hence propose accommodating these novel isolates in a new genus, Aestipascuomyces (derived from the Latin word for “summer pasture”), and a new species, A. dupliciliberans. The type strain is Aestipascuomycesdupliciliberans strain R4

The state of play in European coaching & mentoring

This report provides an overview of the main findings from the 2017 European Coaching and Mentoring Research Project, undertaken by Jonathan Passmore and Hazel Brown, in partnership with the EMCC and the wider European coaching and mentoring industry. The study was planned in 2016 and undertaken during a 12-week period, between March and May 2017. This is one of a number reports published. This Executive Report is available free of charge, along with a National Report in countries that achieved over 50 coach or mentor participants. Each National Report is published in the language chosen by of the respective national coaching community. The aim of these national reports is to deepen understanding of coaching and mentoring and to widen engagement with coaching and mentoring.peer-reviewe

A Relativistic Quantum-Chemical Analysis of the trans Influence on ¹H NMR Hydride Shifts in Square-Planar Platinum(II) Complexes

Empirical correlations between characteristic ¹H NMR shifts in Pt­(II) hydrides with trans ligand influence series, Pt–H distances, and ¹⁹⁵Pt shifts are analyzed at various levels of including relativistic effects into density-functional calculations. A close examination of the trans ligand effects on hydride NMR shifts is shown to be dominated by spin–orbit shielding σ^SO. A rather complete understanding of the trends has been obtained by detailed molecular orbital (MO)-by-MO and localized MO analyses of the paramagnetic and spin–orbit (SO) contributions to the chemical shifts, noting that it is the perpendicular shift-tensor components that determine the trend of the ¹H hydride shifts. In contrast to previous assumptions, the change of the Pt–H distance in given complexes does not allow correlations between hydride shifts and metal–hydrogen bond length to be understood. Instead, variations in the polarization of metal 5d orbitals by the trans ligand affects the SO (and partly paramagnetic) shift contributions, as well as the Pt–H distances and the covalency of the metal–hydrogen bond (quantified, e.g., by natural atomic charges and delocalization indices from quantum theory atoms-in-molecules), resulting in a reasonable correlation of these structural/electronic quantities with hydride σ^SO shieldings. Our analysis also shows that specific σ^p- and σ^SO-active MOs are not equally important across the entire series. This explains some outliers in the correlation for limited ranges of trans-influence ligands. Additionally, SO effects from heavy-halide ligands may further complicate trends, indicating some limitations of the simple one-parameter correlations. Strikingly, σ-donating/π-accepting ligands with a very strong trans influence are shown to invert the sign of the usually shielding σ^SO contribution to the ¹H shifts, by a substantial reduction of the metal 5d orbital involvement in Pt–H bonding, and by involvement of metal 6p-type orbitals in the magnetic couplings, in violation of the Buckingham–Stephens “off-center ring-current” picture

Technical and Clinical Outcome of Low-Milliampere CT Fluoroscopy-Guided Percutaneous Drainage Placement in Abdominal Fluid Collections after Liver Transplantation: A 16-Year Retrospective Analysis of 50 Consecutive Patients

Purpose: Evaluation of the effectiveness of CT-guided drainage (CTD) placement in managing symptomatic postoperative fluid collections in liver transplant patients. The assessment included technical success, clinical outcomes, and the occurrence of complications during the peri-interventional period. Methods: Analysis spanned the years 2005 to 2020 and involved 91 drain placement sessions in 50 patients using percutaneous transabdominal or transhepatic access. Criteria for technical success (TS) included (a) achieving adequate drainage of the fluid collection and (b) the absence of peri-interventional complications necessitating minor or prolonged hospitalization. Clinical success (CS) was characterized by (a) a reduction or normalization of inflammatory blood parameters within 30 days after CTD placement and (b) the absence of a need for surgical revision within 60 days after the intervention. Inflammatory markers in terms of C-reactive protein (CRP), leukocyte count and interleukin-6, were evaluated. The dose length product (DLP) for various intervention steps was calculated. Results: The TS rate was 93.4%. CS rates were 64.3% for CRP, 77.8% for leukocytes, and 54.5% for interleukin-6. Median time until successful decrease was 5.0 days for CRP and 3.0 days for leukocytes and interleukin-6. Surgical revision was not necessary in 94.0% of the cases. During the second half of the observation period, there was a trend (p = 0.328) towards a lower DLP for the entire intervention procedure (median: years 2013 to 2020: 623.0 mGy·cm vs. years 2005 to 2012: 811.5 mGy·cm). DLP for the CT fluoroscopy component was significantly (p = 0.001) lower in the later period (median: years 2013 to 2020: 31.0 mGy·cm vs. years 2005 to 2012: 80.5 mGy·cm). Conclusions: The TS rate of CT-guided drainage (CTD) placement was notably high. The CS rate ranged from fair to good. The reduction in radiation exposure over time can be attributed to advancements in CT technology and the growing expertise of interventional radiologists