Galway Clinic

Elizabeth Casson Trust Research Grant_2022 (UK); Health Research Board (Ireland) & HSC Public Health Agency (Grant ESI-2021-001) through Evidence Synthesis/Cochrane Ireland REGISTRATION: Protocol DOI 10.1002/14651858.CD015371.

Abstract Analytical and numerical modelling of heat transfer in soft tissues can help improve the safety and efficacy of thermal therapies and aid in characterizing the extent of tissue thermal effects such as thermal damage. Modelling of tissue temperatures requires several thermophysical properties as well as description of the thermal contribution of blood flow or perfusion, as appropriate. One of the essential properties is the thermal conductivity of the tissue for which no suitable standard measurement method exists. Thermal conductivity varies with the type of tissue and its composition in terms of water content, fat, and protein. Because these constituents vary from sample to sample and with time, measuring tissue thermal conductivity poses significant challenges and standardized methods have yet to emerge. This review critically examines common and emerging methods that have been used to determine thermal conductivity of tissue. Although some of the techniques (e.g., the guarded hotplate) are standardized for use with inorganic materials, extending their application to measuring tissues is not straightforward. Some of the methods are applicable only to ex vivo tissue samples, which may be advantageous as they avoid uncertainties associated with blood perfusion. Methods applicable to in vivo tissues require description of the contribution of the blood perfusion to estimate the thermal conductivity accurately.

Background: Excessive scarring remains a frequent complication in plastic surgery, yet standardized preventive strategies are lacking. Type I collagen-based biomaterials may support regenerative processes and improve scar outcomes. Methods: This case series includes six female patients (ages 24–52) undergoing wound management after trauma and procedures including blepharoplasty, abdominoplasty, and revision mammaplasty. Native collagen type I (7% or 15%) was injected along wound margins or into hypertrophic scars at 3–4 week intervals. Outcomes were assessed through patient-reported symptoms and Antera 3D imaging (vascularity, pigmentation, surface topography). Results: Patients reported reduced tightness, pruritus, and scar stiffness after initial sessions. Antera 3D imaging showed decreased vascular and pigment indices, and a reduction in surface elevation over follow-up (up to 14 months). No adverse effects such as atrophy or infection were observed. Conclusions: Native type I collagen was well tolerated and may be a useful adjunct for wound healing and scar modulation following plastic surgery.

Research on traumatic experiences and post-traumatic stress within Lithuanian prisons has been scarcely conducted so far. International studies indicate a significantly higher prevalence of adverse childhood experiences and various mental health difficulties, including post-traumatic stress-related disorders, among the prison population compared to the general population. Furthermore, a connection has been observed between prolonged and repetitive childhood adversity and an increased risk of offending. Thus, existing empirical data support theoretical assumptions that adverse childhood experiences may play a significant etiological role in explaining dynamic risk factors. This, in turn, provides a foundation for the application of trauma-informed practice within the criminal justice system. The primary aim of this article is to highlight the need for trauma-informed practice, to introduce its conceptual framework, and to explore potential avenues for its implementation in the Lithuanian criminal justice system. The article concludes with recommendations grounded in research evidence and international best practice.

Neural crest cells (NCCs) are multipotent and are attributed to the combination of complex multimodal gene regulatory mechanisms. Cardiac neural crest (CNC) cells, originating from the dorsal neural tube, are pivotal architects of the cardio-neuro-vascular domain, which orchestrates the embryogenesis of critical cardiac and vascular structures. Remarkably, while the scientific community compiled a comprehensive inventory of neural crest derivatives by the early 1980s, our understanding of the CNC's role in various cardiovascular disease processes still needs to be explored. This review delves into the differentiation of NCC, specifically the CNC cells, and explores the diverse facets of non-syndromic cardiovascular neurocristopathies. A systematic review was conducted as per the PRISMA Statement. Three prominent databases, PubMed, Scopus, and Embase, were searched, which yielded 1,840 studies. We excluded 1,796 studies, and the final selection of 44 studies formed the basis of this comprehensive review. Neurocristopathies are a group of genetic disorders that affect the development of cells derived from the NC. Cardiovascular neurocristopathy, i.e., cardiopathy and vasculopathy, associated with the NCC could occur in the form of (1) cardiac septation disorders, mainly the aortico-pulmonary septum; (2) great vessels and vascular disorders; (3) myocardial dysfunction; and (4) a combination of all three phenotypes. This could result from abnormalities in NCC migration, differentiation, or proliferation leading to structural abnormalities and are attributed to genetic, familial, sporadic or acquired causes. Phenotypic characteristics of cardiovascular neurocristopathies, such as bicuspid aortic valve and thoracic aortic aneurysm, share a common embryonic origin and are surprisingly prevalent in the general population, necessitating further research to identify the underlying pathogenic and genetic factors responsible for these cardiac anomalies. Such discoveries are essential for enhancing diagnostic screening and refining therapeutic interventions, ultimately improving the lives of individuals affected by these conditions.

Background: Readmissions following colorectal surgery (CRS) have negative clinical, psychological and financial implications. Identifying patients at risk of readmission remains challenging. To determine factors predictive of those likely to require readmission at 40 days following major CRS and to identify novel strategies capable of reducing readmissions.

This is the protocol for a Campbell evidence and gap map. The objectives are as follows: identify and map all existing primary studies, systematic reviews (published and unpublished), guidelines and policies on education during the Covid‐19 pandemic, creating a live, searchable and publicly available evidence and gap map.