Online patient safety education programme for junior doctors: is it worthwhile?

Background: Increasing demand exists for blended approaches to the development of professionalism. Trainees of the Royal College of Physicians of Ireland participated in an online patient safety programme.

Aims: Study aims were: (1) to determine whether the programme improved junior doctors' knowledge, attitudes and skills relating to error reporting, open communication and care for the second victim and (2) to establish whether the methodology facilitated participants' learning.

Surgical therapy of ground-glass opacities.

Ground glass opacities, also known as GGOs, are detected on computed tomography (CT) scans as hazy areas if increased attenuation in the lung, and my represent a variety of pulmonary processes. Natural history of GGOs and their clinical implications are not yet fully understood. Controversies associated with the management of GGOs surround their histological classification, malignant potential, indications, timing, and type of intervention.

Global proteome analysis identifies active immunoproteasome subunits in human platelets.

The discovery of new functions for platelets, particularly in inflammation and immunity, has expanded the role of these anucleate cell fragments beyond their primary hemostatic function. Here, four in-depth human platelet proteomic data sets were generated to explore potential new functions for platelets based on their protein content and this led to the identification of 2559 high confidence proteins. During a more detailed analysis, consistently high expression of the proteasome was discovered, and the composition and function of this complex, whose role in platelets has not been thoroughly investigated, was examined.

Synergy of aggregation pheromone with methyl (E,E,Z) -2,4,6-decatrienoate in attraction of Halyomorpha halys (Hemiptera: Pentatomidae).

The reported male-produced aggregation pheromone of the brown marmorated stink bug, Halyomorpha halys (Stål) (Hemiptera: Pentatomidae), identified as a mixture of (3S,6S,7R,10S)-10,11-epoxy-1-bisabolen-3-ol and (3R, 6S, 7R, 10S)-10,11-epoxy-1-bisabolen-3-ol, offers new opportunities for its management. We found that black pyramid traps deployed along crop borders in Maryland and West Virginia, containing lures with both stereoisomers of this reported aggregation pheromone combined with methyl (E,E,Z)-2,4,6-decatrienoate (MDT) lures, attracted more adult and nymphal H. halys than either the aggregation pheromone or MDT alone.

Pulmonary adenocarcinoma T1N0M0 and its classification.

Over the last decade, use of the term bronchioloalveolar carcinoma (BAC) has come under constant scrutiny as some consider it an anachronism or a term that provides incorrect information about this neoplasm. To that extent, it has recently been suggested to replace the term BAC with that of in situ adenocarcinoma (AIS) or minimally invasive adenocarcinoma (MIA) for small solitary adenocarcinomas with either pure bronchioloalveolar growth (AIS) or predominant bronchioloalveolar growth and ≤5-mm invasion (MIA). However, as of today, there is no comprehensive study of these tumors, and most of what has been published in this context is based on a review of the literature that focused on scattered short series of cases describing either small adenocarcinomas or BAC.

Eosinophil overview: structure, biological properties, and key functions.

The eosinophil is an enigmatic cell with a continuing ability to fascinate. A considerable history of research endeavor on eosinophil biology stretches from the present time back to the nineteenth century. Perhaps one of the most fascinating aspects of the eosinophil is how accumulating knowledge has changed the perception of its function from passive bystander, modulator of inflammation, to potent effector cell loaded with histotoxic substances through to more recent recognition that it can act as both a positive and negative regulator of complex events in both innate and adaptive immunity.

Trastuzumab beyond progression for HER2 positive metastatic breast cancer: progression-free survival on first-line therapy predicts overall survival impact.

Trastuzumab beyond first progression in the metastatic setting has been adopted based on limited data suggesting improved outcomes compared to second-line chemotherapy alone although predictive factors for preferential benefit remain elusive. We conducted a retrospective review of all patients receiving trastuzumab for HER2 + metastatic disease between Jan 1, 1999-June 15, 2011. Univariate and time to event analyses described treatment and survival patterns.

Thoracoscopic lobectomy is associated with improved short-term and equivalent oncological outcomes compared with open lobectomy for clinical Stage I non-small-cell lung cancer: a propensity-matched analysis of 963 cases.

Objectives: Previous literature has reported lower morbidity for video-assisted thoracoscopic surgery lobectomy (VL) compared with open lobectomy (OL); however, most comparative studies have been retrospective and have failed to compare well-matched patient groups, therefore allowing selection bias to influence results. Furthermore, oncological adequacy of VL has recently been questioned, particularly with respect to lymphadenectomy. This study aimed to evaluate short- and long-term outcomes of a large cohort of consecutive patients with c-stage I non-small-cell lung cancer (NSCLC) that underwent either VL or OL.

The relationship between BNP, NTproBNP and echocardiographic measurements of systemic blood flow in very preterm infants.

Objective: Preterm infants are at risk of circulatory compromise following birth. Functional neonatal echocardiography including superior vena cava (SVC) flow is increasingly used in neonatal medicine, and low SVC flow has been associated with adverse outcome. However, echocardiography is not readily available in many neonatal units and B-type natriuretic peptides (BNPs) may be useful in guiding further cardiovascular assessment.

Photonic-plasmonic-coupled nanoantennas for polarization-controlled multispectral nanofocusing.

We report on the design and experimental demonstration of array-enhanced nanoantennas for polarization-controlled multispectral nanofocusing in the near-IR spectral range. We design plasmonic double bow-tie nanoantennas-coupled to multiple-periodic nanoparticle arrays to harvest radiation of designed wavelengths from a large spatial area and to focus it into a targeted nanoscale region. Near-field calculations were performed on a gold nanoantenna array using three-dimensional finite difference time domain simulations.

Culture of airway epithelial cells from neonates sampled within 48-hours of birth.

Introduction: Little is known about how neonatal airway epithelial cell phenotype impacts on respiratory disease in later life. This study aimed to establish a methodology to culture and characterise neonatal nasal epithelial cells sampled from healthy, non-sedated infants within 48 hours of delivery.

Methods: Nasal epithelial cells were sampled by brushing both nostrils with an interdental brush, grown to confluence and sub-cultured.

An update on biologic-based therapy in asthma.

Although it is recognized that airway inflammation is key to asthma pathogenesis, the marked heterogeneity in its clinical course and variations in response to treatment make it a challenging condition for the development of novel and effective biologic-based therapies. Biopharmaceutical approaches have identified new therapies that target key cells and mediators that drive inflammatory responses in the asthmatic lung. Such an approach resulted in the development of biologics targeted at inhibiting IL-4, IL-5 and IL-13.

Serious postoperative infections following resection of common solid tumors: outcomes, costs, and impact of hospital surgical volume.

Purpose: Unlike infections related to chemotherapy-induced neutropenia, postoperative infections occurring in patients with solid malignancy remain largely understudied. Our aim is to evaluate the outcomes and the volume-outcomes relationship associated with postoperative infections following resection of common solid tumors.

Methods: We used Texas Discharge Data to study patients undergoing resection of cancer of the lung, esophagus, stomach, pancreas, colon, or rectum from 01/2002 to 11/2006.

Inhibitory effects of Montelukast on mediator release by nasal epithelial cells from asthmatic subjects with or without allergic rhinitis.

Aims: This study tested inhibitory effects of in vitro Montelukast treatment on nasal airway epithelial cells (AEC) cultured from asthmatic patients treated with Montelukast with and without concomitant allergic rhinitis. We further examined the effect of Montelukast withdrawal in these patients on cytokine release from cultured nasal AEC.

Methods: Nasal AEC were collected by brushings from subjects with a history of stable (no exacerbations or change in medication for ≥ 1 month) physician confirmed mild/moderate asthma whose asthma symptoms were documented to benefit from Montelukast treatment (NCT01230437).

Enhanced second harmonic generation from InAs nano-wing structures on silicon.

We demonstrate morphology-dependent second-harmonic generation (SHG) from InAs V-shaped nanomembranes. We show SHG correlation with the nano-wing shape and size, experimentally quantify the SHG efficiency, and demonstrate a maximum SHG enhancement of about 500 compared to the bulk. Experimental data are supported by rigorous calculations of local electromagnetic field spectra.

The influence of histopathologic tumor viability on long-term survival and recurrence rates following neoadjuvant therapy for esophageal adenocarcinoma.

Objective: Our aim was to validate the effect of histopathologic tumor viability (HTV) on extended survival outcomes and assess the prognostic ability of the current staging system in patients receiving preoperative chemoradiotherapy (CRT).

Background: The American Joint Committee on Cancer, 7th Edition, esophageal carcinoma staging system is derived from patients treated with surgery alone and does not account for the treatment effect of CRT. The extent of HTV after CRT is based on response to neoadjuvant therapy and has been shown to correlate with patient outcome.

A phase II randomized trial of induction chemotherapy versus no induction chemotherapy followed by preoperative chemoradiation in patients with esophageal cancer.

Background: The contribution of induction chemotherapy (IC) before preoperative chemoradiation for esophageal cancer (EC) is not known. We hypothesized that IC would increase the rate of pathologic complete response (pathCR).

Methods: Trimodality-eligibile patients were randomized to receive no IC (Arm A) or IC (oxaliplatin/FU; Arm B) before oxaliplatin/FU/radiation.

Enhanced second harmonic generation from Au nanoparticle arrays by femtosecond laser irradiation.

Ultrafast laser irradiation of planar Au nanoparticle arrays is shown to double the particle plasmon quality factor and to enhance second harmonic generation 40-fold. It is found that the irradiation induces a morphological change of nano-cylinders into asymmetric droplet-like shapes with reduced surface roughness without altering their lithographically defined locations. These findings can be used to improve the performance of linear and nonlinear plasmonic devices.

Diaphragmatic hernia after esophagectomy in 440 patients with long-term follow-up.

Background: Postesophagectomy diaphragmatic hernia (PDH) is a recognized but severely under-reported and potentially hazardous event. Information regarding the natural course of this condition and guidelines regarding indications for reoperative intervention are lacking. In this study we aim to describe the frequency, predictors of incidence, and indications for repair.

Enhanced second harmonic generation by photonic-plasmonic Fano-type coupling in nanoplasmonic arrays.

In this communication, we systematically investigate the effects of Fano-type coupling between long-range photonic resonances and localized surface plasmons on the second harmonic generation from periodic arrays of Au nanoparticles arranged in monomer and dimer geometries. Specifically, by scanning the wavelength of an ultrafast tunable pump laser over a large range, we measure the second harmonic excitation spectra of these arrays and demonstrate their tunability with particle size and separation. Moreover, through a comparison with linear optical transmission spectra, which feature asymmetric Fano-type lineshapes, we demonstrate that the second harmonic generation is enhanced when coupled photonic-plasmonic resonances of the arrays are excited at the fundamental pump wavelength, thus boosting the intensity of the electromagnetic near-fields.