Publications by authors named "Downey P"

Article Synopsis
  • The study evaluates a proposed ultrasound checklist for detecting placenta accreta spectrum (PAS) in patients with a high likelihood of the condition, aiming to see how effective it is in identifying confirmed PAS cases.
  • Conducted over five years, the research included patients who had ultrasound assessments for PAS suspicion, with diagnoses confirmed through surgical and histopathological findings.
  • Results showed an 80.7% PAS diagnosis among participants, with the third-trimester ultrasound displaying a sensitivity of 84% and specificity of 73%, highlighting key ultrasound features—abnormal placental lacunae and myometrial thinning—as strongly associated with PAS.
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In severe Placenta Accreta Spectrum (PAS), trophoblasts gain deep access in the myometrium (placenta increta). This study investigated alterations at the fetal-maternal interface in PAS cases using a systems biology approach consisting of immunohistochemistry, spatial transcriptomics and proteomics. We identified spatial variation in the distribution of CD4, CD3 and CD8 T-cells at the maternal-interface in placenta increta cases.

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Objectives: We previously demonstrated the potential of radiomics for the prediction of severe histological placenta accreta spectrum (PAS) subtypes using T2-weighted MRI. We aim to validate our model using an additional dataset. Secondly, we explore whether the performance is improved using a new approach to develop a new multivariate radiomics model.

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Placenta accreta spectrum (PAS) is a relatively new obstetric condition which, until recently, was poorly understood. The true incidence is unknown because of the poor quality and heterogeneous diagnostic criteria. Classification systems have attempted to provide clarity on how to grade and diagnose PAS, but these are no longer reflective of our current understanding of PAS.

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Introduction: Traumatic cardiac injury (TCI) poses a significant risk of morbidity and mortality, yet there is a lack of population-based outcomes data for these patients.

Methods: The authors examined national yearly trends, demographics, and in-hospital outcomes of TCI using the National Inpatient Sample from 2007 to 2014. We focused on adult patients with a primary discharge diagnosis of TCI, categorizing them into blunt (BTCI) and penetrating (PTCI) cardiac injury.

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Patients with end-stage kidney disease (ESKD) on dialysis have an increased burden of coronary artery disease (CAD). This study assessed the trend and outcomes for coronary artery bypass surgery (CABG) in patients with ESKD and stable CAD. We conducted a longitudinal study using the United States Renal Data System of patients with ESKD and stable CAD who underwent CABG from the years 2009 to 2017.

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Aims: This study aimed to re-evaluate the incidence of hydatidiform mole (HM) and determine gestational trophoblastic disease (GTD) registration rates in Ireland following the establishment of the National GTD Registry in 2017.

Methods: We performed a 3-year retrospective audit of HM cases (January 2017 to December 2019) reported in our centre. In 2019, we surveyed Irish pathology laboratories to determine the number of HMs diagnosed nationally and compared this data to that recorded in the National GTD Registry.

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Article Synopsis
  • Protein misfolding and aggregation into complex structures are common in neurodegenerative diseases, affecting conditions like Parkinson's.
  • Single-molecule techniques have improved the study of these rare protein aggregates, but they often require tagged proteins or non-specific dyes.
  • The researchers developed a method using high-affinity antibodies and advanced microscopy to specifically detect α-synuclein aggregates in low concentrations within biological samples.
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Chiral organic molecules possessing high quantum yields, circular dichroism, and circularly polarized luminescence values have great potential as optically active materials for future applications. Recently, the identification of a promising class of inherently chiral compounds was reported, namely macrocyclic 1,3-butadiyne-linked pseudo-meta[2.2]paracyclophanes, displaying high circular dichroism and related g values albeit modest quantum yields.

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Objective: Since its inception in the early 2000s, hybrid arch repair (HAR) has evolved from novel approach to well-established treatment modality for aortic arch pathology in appropriately selected patients. Despite this nearly 20-year history of use, long-term results of HAR remain to be determined. As such, objectives of this study are to detail the long-term outcomes for HAR within an expanded classification scheme.

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Objectives: The Hemispherical Aortic Annuloplasty Reconstructive Technology (HAART) ring is a rigid, internal and geometric device. The objective of this article is to assess the mid-term outcomes of aortic valve repair (AVr) using this prosthesis.

Methods: A prospectively maintained database was used to obtain outcomes for adult patients undergoing AVr using the HAART ring between September 2017 and June 2023.

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Protein misfolding and aggregation is a characteristic of many neurodegenerative disorders, including Alzheimer's and Parkinson's disease. The oligomers generated during aggregation are likely involved in disease pathogenesis and present promising biomarker candidates. However, owing to their small size and low concentration, specific tools to quantify and characterize aggregates in complex biological samples are still lacking.

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Hydatidiform moles are rare and thus most pathologists and geneticists have little experience with their diagnosis. It is important to promptly and correctly identify hydatidiform moles given that they are premalignant disorders associated with a risk of persistent gestational trophoblastic disease and gestational trophoblastic neoplasia. Improvement in diagnosis can be achieved with uniformization of diagnostic criteria and establishment of algorithms.

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Background: Placenta accreta spectrum (PAS) is a rare, life-threatening complication of pregnancy. Predicting PAS severity is critical to individualise care planning for the birth. We aim to explore whether radiomic analysis of T2-weighted magnetic resonance imaging (MRI) can predict severe cases by distinguishing between histopathological subtypes antenatally.

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Air pollutants from poultry production, such as ammonia (NH) and particulate matter (PM), have raised concerns due to their potential negative impacts on human health and the environment. Vegetative environmental buffers (VEBs), consisting of trees and/or grasses planted around poultry houses, have been investigated as a mitigation strategy for these emissions. Although previous research demonstrated that VEBs can reduce NH and PM emissions, these studies used a limited number of samplers and did not examine concentration profiles.

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Background: Using a nationally representative database, the present study evaluated the degree of center-level variation in the cost of transcatheter aortic valve replacement (TAVR).

Methods: All adults undergoing elective, isolated TAVR were identified in the 2016 to 2018 Nationwide Readmissions Database. Multilevel mixed-effects models were used to identify patient and hospital characteristics associated with hospitalization costs.

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Background: Inflammation is associated with many disorders of preterm infants including periventricular leukomalacia, chronic lung disease, and necrotizing enterocolitis. Activated protein c (APC) has shown positive immunomodulatory effects.

Objectives: We aimed to study neutrophil and monocyte function in response to lipopolysaccharide (LPS) and APC stimulation in preterm infants <32 weeks gestation over the first week of life compared to neonatal and adult controls.

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Article Synopsis
  • Parkinson's disease (PD) exhibits a wide variety of symptoms and progression speeds, complicating the creation of effective treatment trials.
  • By clustering patients based on their progression patterns using AI, researchers identified distinct groups with varying symptoms and treatment responses.
  • This research enhances the understanding of PD's heterogeneity and suggests specific biological mechanisms and genetic factors that could explain differences among patient subgroups.
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Article Synopsis
  • Protein misfolding and aggregation into structures like oligomers and fibrils are linked to various neurodegenerative diseases.
  • Traditional methods for studying these aggregates often lack specificity and rely on labeled proteins or non-specific stains.
  • The researchers developed a new technique using a high-affinity antibody with unique fluorophores and advanced microscopy to specifically identify and analyze α-synuclein aggregates in low concentrations, relevant to biological samples.
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Objective: The utilization of transcatheter aortic valve replacement (TAVR) technology has exceeded that of traditional surgical aortic valve replacement (SAVR). In addition, the role of minimum surgical volume requirements for TAVR centers has recently been disputed. The present work evaluated the association of annual institutional SAVR caseload on outcomes following TAVR.

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Objective: Although patients with significant coronary artery disease and aortic stenosis have traditionally undergone open valve replacement and bypass grafting, percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR) are increasingly considered. Because of the lack of data regarding timing of PCI/TAVR, in the present study we evaluated associations of staged and concomitant PCI/TAVR on outcomes in a nationally representative cohort.

Methods: Adults who underwent TAVR and PCI were identified using the 2016 to 2018 Nationwide Readmissions Database.

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Objective: to evaluate fetal growth in pregnancies complicated by placenta accreta spectrum (PAS) and to compare fetal growth between cases stratified by ultrasound stage of PAS.

Methods: This was a prospective multicenter cohort study of women diagnosed with PAS between January 2018 and December 2021. We grouped participants into cases by ultrasound stage (PAS stage 1-3) and controls (PAS0).

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Patients with type B aortic dissection (TBAD) often present as an emergency. Operative repair of TBAD can be indicated for selected patients in the setting of hemodynamic instability or rupture. Thoracic endovascular aortic repair of TBAD has achieved significant popularity.

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