Evaluation of severe traumatic brain injury referrals to the National Tertiary Neurosurgical Centre in the Republic of Ireland.

Background: Transfer of all severe TBI patients to a neurosurgical unit (NSU) has been advocated irrespective of levels of complexity and prognostic factors. Previous publications have suggested that only 50% of severe TBI patients in Ireland were managed in NSUs.

Aims: This study aims to audit severe TBI referrals to the National Neurosurgical Centre, to evaluate reasons for nonacceptance, assess for differences in the transferred and not transferred cohorts and to analyse observed and expected mortality rates.

Timing of Martian Core Formation from Models of Hf-W Evolution Coupled with -body Simulations.

Determining how and when Mars formed has been a long-standing challenge for planetary scientists. The size and orbit of Mars are difficult to reproduce in classical simulations of planetary accretion, and this has inspired models of inner solar system evolution that are tuned to produce Mars-like planets. However, such models are not always coupled to geochemical constraints.

Complications of Cranioplasty in Relation to Material: Systematic Review, Network Meta-Analysis and Meta-Regression.

Background: Cranioplasty is a ubiquitous neurosurgical procedure consisting of reconstruction of a pre-existing calvarial defect. Many materials are available, including polymethylmethacrylate in hand-moulded (hPMMA) and prefabricated (pPMMA) form, hydroxyapatite (HA), polyetheretherketone (PEEK) and titanium (Ti).

Objective: To perform a network meta-analysis (NMA) to assess the relationship between materials and complications of cranioplasty.

Complications of cranioplasty following decompressive craniectomy for traumatic brain injury: systematic review and meta-analysis.

Background: Decompressive craniectomy (DC) is a common neurosurgical intervention for severe traumatic brain injury (TBI), as well as malignant stroke, malignancy and infection. DC necessitates subsequent cranioplasty. There are significant demographic differences between TBI and non-TBI patients undergoing cranioplasty, which may influence their relative risk profiles for infection, aseptic bone flap resorption (aBFR) and re-operation.

Traumatic brain injury in the Republic of Ireland twenty-five years on: a comparison of two cohorts from a neurosurgical unit.

Objective: We assessed for change in the number of admissions, demographics, mechanism, severity, operative management, length of stay, and in-hospital mortality of Traumatic Brain Injury (TBI) in patients admitted to a Neurosurgical Unit (NSU) in the Republic of Ireland in 2017 compared to 25 years previously.

Method: We performed a retrospective cohort study of TBI admissions during 2017 and compared the results with a prospective cohort study covering a one-year period across 1992 and 1993.

Results: In 2017, 184 patients (5.

Highly siderophile elements in Earth's mantle as a clock for the Moon-forming impact.

According to the generally accepted scenario, the last giant impact on Earth formed the Moon and initiated the final phase of core formation by melting Earth's mantle. A key goal of geochemistry is to date this event, but different ages have been proposed. Some argue for an early Moon-forming event, approximately 30 million years (Myr) after the condensation of the first solids in the Solar System, whereas others claim a date later than 50 Myr (and possibly as late as around 100 Myr) after condensation.

Color and albedo heterogeneity of Vesta from Dawn.

Multispectral images (0.44 to 0.98 μm) of asteroid (4) Vesta obtained by the Dawn Framing Cameras reveal global color variations that uncover and help understand the north-south hemispherical dichotomy.

The geologically recent giant impact basins at Vesta's south pole.

Dawn's global mapping of Vesta reveals that its observed south polar depression is composed of two overlapping giant impact features. These large basins provide exceptional windows into impact processes at planetary scales. The youngest, Rheasilvia, is 500 kilometers wide and 19 kilometers deep and finds its nearest morphologic analog among large basins on low-gravity icy satellites.

Polyps in the ileal pouch.

Total proctocolectomy and ileal pouch-anal anastomosis is the operation of choice for patients with familial adenomatous polyposis. With this operation comes the risk of developing ileal pouch polyps. Although rare, ileal pouch carcinomas may also occur within the pouch.

Predictors and outcome of readmission after laparoscopic intestinal surgery.

Background: Previous studies have failed to identify predictors of early readmission after major intestinal operations. The objectives of this study were to determine readmission rates, outcomes, and predictors of readmission for patients undergoing laparoscopic colon and rectal operations.

Methods: Patients readmitted (PR) to the hospital within 30 days of discharge after laparoscopic colon and rectal operations were identified from a prospectively maintained database.

Predictors and outcome of readmission after laparoscopic intestinal surgery.

Background: Previous studies have failed to identify predictors of early readmission after major intestinal operations. The objectives of this study were to determine readmission rates, outcomes, and predictors of readmission for patients undergoing laparoscopic colon and rectal operations.

Methods: Patients readmitted (PR) to the hospital within 30 days of discharge after laparoscopic colon and rectal operations were identified from a prospectively maintained database.

Rectal prolapse.

Despite the innovation of more than 100 surgical procedures for the treatment of complete rectal prolapse, no one procedure is best and applicable to all patients. Traditionally, procedures have been divided into abdominal and perineal approaches. The application of the laparoscopic approach to colon and rectal disease has allowed an additional less invasive method of therapy to treat rectal prolapse successfully.

Iron meteorites as remnants of planetesimals formed in the terrestrial planet region.

Iron meteorites are core fragments from differentiated and subsequently disrupted planetesimals. The parent bodies are usually assumed to have formed in the main asteroid belt, which is the source of most meteorites. Observational evidence, however, does not indicate that differentiated bodies or their fragments were ever common there.

Enterocyte apoptosis after enterectomy in mice is activated independent of the extrinsic death receptor pathway.

Intestinal adaptation following small bowel resection (SBR) is associated with greater rates of enterocyte apoptosis by unknown mechanism(s). Because postresection adaptation is associated with increased translocation of luminal bacteria, we sought to characterize the role for the extrinsic, death receptor pathway for the activation of enterocyte apoptosis after massive SBR. We first performed SBR or sham operations in mice, and the temporal expression of caspases 8, 9, and 3, death receptors tumor necrosis factor receptor-1 (TNFR1) and Fas and corresponding ligands (TNF and Fas ligand) was determined in the remnant intestine at various postoperative time points.

Pelvic fracture in the elderly is associated with increased mortality.

Objective: The elderly population is currently the fastest growing sector in America. The purpose of this study was to examine the age-related outcome in patients after blunt pelvic injury.

Methods: All patients admitted with a pelvic fracture during a 5-year period were identified from the trauma registry.

A serum factor after intestinal resection stimulates epidermal growth factor receptor signaling and proliferation in intestinal epithelial cells.

Background: In vivo, intestinal adaptation after massive small bowel resection (SBR) requires a functional epidermal growth factor (EGF) receptor (EGFR). In vitro studies have shown that serum from mice after SBR induces rat intestinal epithelial cells to proliferate. This study tested the hypothesis that the proliferative response to SBR serum is mediated by EGFR signaling.

Selective inhibition of the epidermal growth factor receptor impairs intestinal adaptation after small bowel resection.

Background: Prior indirect studies have suggested that a functional epidermal growth factor receptor (EGFR) appears to be indispensable for the adaptive response of the remnant intestine to massive small bowel resection (SBR). The recent availability of a specific pharmacologic EGFR inhibitor enabled us to more directly test the hypothesis that EGFR signaling is required for postresection intestinal adaptation.

Methods: Mice (C57B1/6, n = 26) underwent a 50% SBR or sham operation and were then given orogastric EGFR inhibitor (ZD1839, 50 mg/kg/day) or vehicle.

Intestinal and hepatic response to combined partial hepatectomy and small bowel resection in mice.

Background: Both partial-hepatectomy (PHx) and massive small bowel resection (SBR) are strong mitogenic signals to the remnant liver and intestine, respectively. This study tested the hypothesis that PHx was an additive signal for intestinal adaptation after massive SBR.

Methods: Male mice underwent either sham SBR or 50% proximal SBR.

Intestinal permeability and bacterial translocation are uncoupled after small bowel resection.

Background/purpose: Gut barrier failure and bacterial translocation have been proposed to cause infection and sepsis in patients with the short bowel syndrome. This study tested the hypothesis that permeability is increased in the adapting remnant ileum after massive small bowel resection (SBR).

Methods: Male ICR mice underwent a 50% proximal SBR or sham operation.