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Background: Renal injury accounts for 1-5% of all traumatic injuries. Non-operative management (NOM) of renal trauma has demonstrated higher renal salvage rates and reduced morbidity.Aims: The aim of this review is to clarify the indications of early follow up CT scan for adult patients, with NOM, renal trauma, with a view to avoiding unnecessary CT scanning and radiation exposure in this cohort of patients.Methods: A systematic search was conducted using PubMed (MEDLINE), Web of Science, Embase, and Cochrane library, with references from relevant articles also evaluated. Inclusion criteria were defined as studies reporting outcomes of patients ≥12 years of age, with NOM, renal trauma and early CT re-imaging. The outcomes of interest were renal complications requiring intervention, specifically collecting system and vascular complications.Results: Five studies met the inclusion criteria. In total, 542 patients were included in this analysis; study sizes ranged from 48 to 207 patients. Early re-imaging was performed for 510 patients, including 489 CTs and 31 Ultrasounds (US). Mean time to re-imaging ranged from 1 - 35.9 days. Twenty three patients required intervention following re-imaging, all of which were for injuries grade ≥ 3 and presented with clinical deterioration prior to re-imaging, had a collecting system injury identified on initial CT scan or both. The number needed to re-image, in order to change the management of one patient, was 22.Conclusions: Although the findings of this review are based on retrospective data, they suggest routine early re-imaging can be safely omitted for all NOM, renal injuries which remain asymptomatic, with no collecting system injury diagnosed on initial CT, provided appropriate delayed phase imaging is available. Future prospective studies are required to further clarify the indications of early re-imaging, specifically for NOM penetrating injuries, and the appropriate modality and timing of early re-imaging for all NOM renal trauma. [ABSTRACT FROM AUTHOR]

Intelligent and active packaging technologies have gained attention in recent time due to increased demand by the consumers and manufacturers for sustaining the quality and safety of food products, improved shelf-life as well as real time monitoring of the packaging, storage and handling processes. In this context, phosphorescence based sensors for molecular oxygen (O 2 ) are important tools for monitoring of packaged products, new product development and optimisation. They allow fast, reversible, real-time and quantitative monitoring of residual O 2 levels in a non-destructive manner, being superior over alternative systems. In this review, we describe the main types of phosphorescent O 2 -sensitive materials, fabrication methods and general requirements for sensors for food packaging applications. The main developments and representative examples are provided which illustrate the application of such sensors for monitoring of gaseous and dissolved O 2 in various types of packaged foods and beverages. We also compare commercial O 2 sensing instrumentation and disposable O 2 sensors currently in use. [ABSTRACT FROM AUTHOR]

Dielectric barrier discharge plasma treatment of two different types of phosphorescent oxygen sensors under different in-package gas mixture has been studied. Commercial Optech™-O 2 platinum and microporous polypropylene (PP) membrane sensors impregnated with platinum benzoporphyrin (PtBP) dye were found effective for oxygen sensing when DBD plasma treated under modified atmospheric conditions. When treated under DBD air plasma, PP sensors were largely degraded and found incompatible with the plasma processing. Although some changes in the lifetime signals were observed after air plasma treatment, Optech™-O 2 platinum sensors were found effective as oxygen sensors. This study indicates that in-package gas composition of food products plays an important role in selection of right intelligent optochemical sensors for plasma processing. Industrial Relevance In-package cold plasma processing is emerging as a novel and innovative approach for the decontamination of food products with significant potential for commercial application. This paper studies the compatibility of phosphorescent oxygen sensors with this technology. This study demonstrates that the package gas composition has huge impact on the accuracy and usability of sensors. The work described in this research is relevant to all food industries which uses intelligent sensors for monitoring gas composition. [ABSTRACT FROM AUTHOR]

Objective: To describe and illustrate a novel technique of uretero-ileal anastomosis for use in urinary diversion - the Pull-through Anastomosis of Ureter To Enteric Conduit (PAUTEC). A second objective was to evaluate the surgical outcomes of the PAUTEC anastomosis.Materials and Methods: Our novel anastomotic technique was described step-by-step and visually depicted with illustrations and the accompanying narrated video. Additionally, to evaluate safety and efficacy, a retrospective review of a prospectively maintained database was performed. Patients who underwent radical cystectomy alone or during pelvic exenteration, with ileal conduit diversion incorporating PAUTEC, 2016-2020 with ≥6 months follow-up were included. Surgical outcomes and renal function were analysed.Results: PAUTEC anastomosis was performed on 43 ureters in 23 patients. Mean age was 66 years [50-80] and 21 of 23 patients were male. One patient had a conservatively-managed small urine leak. No ureteric strictures have been identified to date. Mean serum creatinine was 1.15 mg/dL [0.69-2.08] (102umol/L, range 61-184 umol/L) preoperatively, and 1.09 mg/dL [0.61-2.59] (96.3 umol/L, range 54-229 umol/L) at follow-up, demonstrating no significant change (P= .26, paired t-test). Mean follow-up was 15 months [6-44].Conclusion: A PAUTEC technique of uretero-ileal anastomosis is feasible and technically straightforward, with satisfactory outcomes observed to date. [ABSTRACT FROM AUTHOR]

Patients with glioblastoma who are older or have poor performance status (PS) experience particularly poor clinical outcomes. At the time of study initiation, these patients were treated with short-course radiation therapy (40 Gy in 15 fractions). Olaparib is an oral inhibitor of the DNA repair enzyme poly (ADP-ribose) polymerase (PARP) that is well tolerated as a single agent but exacerbates acute radiation toxicity in extracranial sites. Preclinical data predicted that PARP inhibitors would enhance radiosensitivity in glioblastoma without exacerbating adverse effects on the normal brain. Phase 1 of the PARADIGM trial was a 3+3 dose-escalation study testing olaparib in combination with radiation therapy (40 Gy 15 fractions) in patients with newly diagnosed glioblastoma who were unsuitable for radical treatment either because they were aged 70 years or older (World Health Organization PS 0-1) or aged 18 to 69 years with PS 2. The primary outcome was the recommended phase 2 dose of olaparib. Secondary endpoints included safety and tolerability, overall survival, and progression-free survival. Effects on cognitive function were assessed via the Mini Mental State Examination. Of 16 eligible patients (56.25% male; median age, 71.5 years [range, 44-78]; 75% PS 0-1), 1 dose-limiting toxicity was reported (grade 3 agitation). Maximum tolerated dose was not reached and the recommended phase 2 dose was determined as 200 mg twice daily. Median overall survival and progression-free survival were 10.8 months (80% CI, 7.3-11.4) and 5.5 months (80% CI, 3.9-5.9), respectively. Mini Mental State Examination plots indicated that cognitive function was not adversely affected by the olaparib–radiation therapy combination. Olaparib can be safely combined with hypofractionated brain radiation therapy and is well tolerated in patients unsuitable for radical chemoradiation. These results enabled initiation of a randomized phase 2 study and support future trials of PARP inhibitors in combination with radiation therapy for patients with brain tumors. [ABSTRACT FROM AUTHOR]

In patients with advanced ovarian cancer, the modelled CA-125 ELIMination rate constant K (KELIM) is an early indicator of the tumour intrinsic chemosensitivity. We assessed the prognostic and surrogate values of KELIM with respect to those of surgery outcome (based on post-operative residual lesions) in the Gynaecologic Cancer Intergroup (GCIG) individual patient data meta-analysis MAOV (Meta-Analysis in OVarian cancer) built before the emergence of poly(ADP-ribose) polymerase (PARP) inhibitors. The dataset was split into learning and validation cohorts (ratio 1:2). The individual modelled KELIM values were estimated, standardised by the median value, then scored as unfavourable (<1.0) or favourable (≥1.0). Overall survival (OS) and progression-free survival (PFS) analyses were performed with a two-step meta-analytic approach and surrogacy through a two-level meta-analytic model. KELIM was assessed in 5884 patients from eight first-line trials (learning, 1962; validation, 3922). A favourable KELIM score was significantly associated with longer OS (validation set, median, 78.8 versus 28.4 months, hazard-ratios [HR] 0.46, 95% confidence interval [CI], 0.41–0.50, C-index 0.68), and longer PFS (validation set, median 30.5 versus 9.8 months, HR 0.49, 95% CI, 0.45–0.54, C-index 0.68), as were International Federation of Gynaecology and Obstetrics (FIGO) stage and debulking surgery outcome. Three prognostic groups were identified based on the surgery outcome and KELIM score, with large differences in OS (105.1, ∼45.0, and 22.1 months) and PFS (58.1, ∼15.0, and 8.0 months). Surrogacy for OS and for PFS was not established. KELIM is an independent prognostic biomarker for survival, complementary to surgery outcome, representing a new determinant of first-line treatment success. • Indicators of the tumour primary chemosensitivity in ovarian cancer are needed. • The KELIM score is a significant and independent prognostic factor for PFS and OS. • Combining KELIM and surgery outcome delineates three prognostic groups of patients. [ABSTRACT FROM AUTHOR]

Objectives Contrast-enhanced computed tomography (CT) provides essential cross-sectional imaging data in patients with suspected pleural malignancy (PM). The performance of CT in routine practice may be lower than in previously reported research. We assessed this relative to ‘real-life’ factors including use of early arterial-phase contrast enhancement (by CT pulmonary angiography (CTPA)) and non-specialist radiology reporting. Materials and methods Routinely acquired and reported CT scans in patients recruited to the DIAPHRAGM study (a prospective, multi-centre observational study of mesothelioma biomarkers) between January 2014 and April 2016 were retrospectively reviewed. CT reports were classified as malignant if they included specific terms e.g. “suspicious of malignancy”, “stage M1a” and benign if others were used e.g. “indeterminate”, “no cause identified”. All patients followed a standard diagnostic algorithm. The diagnostic performance of CT (overall and based on the above factors) was assessed using 2 × 2 Contingency Tables. Results 30/345 (9%) eligible patients were excluded (non-contrast (n = 13) or non-contiguous CT (n = 4), incomplete follow-up (n = 13)). 195/315 (62%) patients studied had PM; 90% were cyto-histologically confirmed. 172/315 (55%) presented as an acute admission, of whom 31/172 (18%) had CTPA. Overall, CT sensitivity was 58% (95% CI 51–65%); specificity was 80% (95% CI 72–87%). Sensitivity of CTPA (performed in 31/315 (10%)) was lower (27% (95% CI 9–53%)) than venous-phase CT (61% (95% CI 53–68%) p = 0.0056). Sensitivity of specialist thoracic radiologist reporting was higher (68% (95% CI 55–79%)) than non-specialist reporting (53% (95% CI 44–62%) p = 0.0488). Specificity was not significantly different. Conclusion The diagnostic performance of CT in routine clinical practice is insufficient to exclude or confirm PM. A benign CT report should not dissuade pleural sampling where the presence of primary or secondary pleural malignancy would alter management. Sensitivity is lower with non-thoracic radiology reporting and particularly low using CTPA. [ABSTRACT FROM AUTHOR]

Abstract: Although intensive forestry practices have greatly reduced the biodiversity of native woodland, sympathetic management offers much potential to reverse these negative trends. We tested, using a species-rich group, whether woodland conservation management practices could be of overall benefit, for threatened generalists and specialists alike. Our landscape-scale light-trap experiment compared presence/absence, abundance and species richness of macro-moths at 36 repeatedly sampled sites from six experimental ‘woodland management’ treatments. We recorded 11,670 individuals from 265 species. Our results show that the sheltered, dark, humid, late-successional, high deciduous forest biotope is characterised by high numbers of both individuals and species of moth, and is especially important for some scarce and specialist species of conservation concern. Coppicing and ride widening, which open up dense forest structures, are also valuable woodland conservation tools for macro-moths. Specifically, we show that the mechanism behind the pattern of increased species richness at the woodland-scale involved an increased structural and hence increased micro-climatic and resource diversity for species with an affinity for more open biotopes. This benefits generalist species of conservation concern. Additionally, we show that woodland area is an important factor affecting both moth abundance and species richness in coppiced plots, especially so for nationally declining and severely declining species, suggesting that larger woodlands offer the best opportunities to increase biodiversity through active coppice management. Based on these complementary findings we recommend zoning woodland conservation management practices to take into account the differential value of successional stages for different ecological groups of Lepidoptera. [Copyright &y& Elsevier]