Roscommon University Hospital

Abstract The Tomorrow.io microwave sounder (TMS) builds on a heritage of passive microwave sounders (PMWSs) that have well‐established value in numerical weather prediction (NWP). The TMS constellation of CubeSats uses a combination of sun‐synchronous and inclined orbits to fill gaps in current public PMWS data. This work establishes a data assimilation methodology for the TMS and demonstrates its real global weather forecast impacts with observing system experiments. Our assimilation methodology for the TMS encompasses all‐sky error modeling and quality control, and novel variational bias correction predictors. The all‐sky error model is based on techniques in earlier literature, and a new cloud impact filter enables more effective assimilation of surface‐sensitive TMS channels. TMSs in inclined orbits are exposed to a transient thermal environment that causes periodic biases in the current level 1 calibrated brightness temperatures. In response, we develop variational bias correction predictors related to the unique night–day cycle of each satellite. The new predictors partially mitigate the transient instrument biases and improve verification scores for upper‐level temperature forecasts. However, this is a partial solution, and remains an active area of investigation. In our research‐quality NWP setting, assimilating two TMS instruments in January 2025 achieves 6‐hr forecast accuracy improvements similar to two advanced technology microwave sounder instruments for water vapor, and 50% of two advanced technology microwave sounders for tropospheric temperature. Statistically significant forecast accuracy improvements from the TMS persist for water vapor up to 3 days, and for temperature and winds up to 2 days. The TMS provides complementary information content to public PMWSs. Additional efforts at operational forecasting centers are ongoing to conduct more complete investigations.

Introduction We present a case study of a 19-year old Ukrainian refugee presenting with delirious mania, with no personal or family psychiatric history. Delirious mania is a complex and severe neuropsychiatric condition that remains under-recognised in diagnostic manuals. Delirious mania describes a neuropsychiatric state where a patient is exhibits signs and symptoms of mania, delirium and often catatonia. Most of the patients described in past case reports are older in age than our patient and have a personal or family history of a mood disorder. Objectives Our objectives were to investigate the signs and symptoms of delirious mania in this this 19 year-old patient. We sought to compare his presentation to the existing diagnoses in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition and International Classification of Diseases 11th Revision. These include delirium, mania and catatonia. In addition, we aimed to study existing literature on delirious mania as well as cross-cultural factors in formulation of this complex case. Methods We assessed this patient daily as part of the Liaison Psychiatry team and compared his presentation to existing diagnostic criteria of delirium, mania and catatonia. We performed a literature review of delirious mania to identify suggested diagnostic criteria, management strategies and cultural considerations. Results Our patient presented to the Emergency Department with a four-day history of bizarre behaviour and poor sleep. He had no past psychiatric history. He was admitted to the general medical ward for a medical work-up, which ultimately yielded no organic pathology. During this time, our patient fulfilled separate diagnostic criteria for delirium, manic episode and catatonia. We found that there was no overarching diagnosis within international diagnostic manuals that encompassed this patient’s presentation. However, delirious mania has been described in the literature since 1849. There are various suggested diagnostic criteria for delirious mania suggested in the literature, such as those by Bond (1980) and Fink (1999). This patient was successfully treated with intramuscular lorazepam. In our discussion, we considered various unique factors in the formulation. These included the cultural considerations given that the patient had recently entered the country as a Ukrainian refugee, difficulties in assessment and treatment due to language and cultural barriers and the limitations of psychiatric treatment on a general medical ward. Conclusions Delirious mania continues to be unrepresented in diagnostic manuals, which in turn leads to confusion over diagnosis and treatment. Given the complexity of this neuropsychiatric condition, early recognition is key in providing effective treatment before progression into a malignant state. This would be aided by having delirious mania recognised in international classifications. Disclosure of Interest None Declared

Herein we report the efficient synthesis of β-aminoketones via addition of a vinyl Grignard reagent into amides followed by trapping of the vinyl ketone intermediate with the magnesium-amide by-product. The reaction was successfully translated from a batch process into continuous flow mode to increase its efficiency, safety and scalability. Different set-ups were evaluated to minimize/overcome clogging issues arising from magnesium salt precipitates. Ultimately, the resulting β-aminoketones were obtained in high yields and productivities with residence times of less than 90 seconds at elevated temperatures of 50 °C. Importantly, the β-aminoketone products are valuable building blocks that can be unmasked to reactive vinyl ketones via a Cope elimination process.

Background: While leg ulceration is common, data regarding long-term is limited. Historical data indicate that approximately 50% of leg ulcer patients die within 5years of presentation. However, little is known regarding survival outcomes in contemporary patient populations. This retrospective study aimed to assess 5-year survival in patients attending a vascular leg ulcer clinic. Objectives: To evaluate 5-year survival among patients with leg ulcers and to analyse the effect of ulcer aetiology and patient co-morbidities on survival. Methods: Over 30months (2016 to 2018), 119 new patients were assessed at the leg ulcer clinic and followed over 5years. Baseline co-morbidities, ulcer type, interventions performed, and 5-year survival were recorded. Survival was calculated using Kaplan-Meier curves. Co-morbid burden and survival were compared between venous and arterial/mixed patients. Results: Overall 5-year survival was 74%. Venous patients fared better than arterial/mixed patients (5-year mortality 16/88 vs 15/31; p < .01 log-rank test). Arterial/mixed patients had a greater burden of co-morbidities. In multivariate regression modelling, the presence of three or more co-morbidities at presentation was the only significant predictor of mortality. Conclusions: Overall, 5-year survival for leg ulcer patients has improved compared to historical data but remains static for arterial/mixed patients.

BACKGROUND: Currently, the issue of using means of automation in various ways is widely studied in the worldwide industry. Use of the automatized systems at various stages of manufacturing leads to significant increase of labor productivity in various indicators and ensures solution of multiple problems related to cost reduction during manufacturing, increase of equipment performance and increase of quality of final products. AIM: Formalization of the process of development of the control program for the CNC by means of creation of the postprocessors for the AksiOMA Control CNC. METHODS: Key objects of study and interaction during operation are various means of automation (computer-aided design and the software which is necessary for work with postprocessors) necessary for development of products and describing the technology of machining of them with the consequent postprocessing to obtain the control program. RESULTS: The result of the study is the development of the postprocessors for the consequent postprocessing of the control program has begun on the basis of the problem related to the development of the postprocessor for the AksiOMA Control CNC. In the manual of the CNC programmer, the base notation about the language syntax, control commands for the machining station and the CNC is given. The decision to begin the development of the postprocessor for the three-axial machining by means of editing the Siemens 840 basic postprocessor is made, because the control program syntax of it was similar to the syntax of the AksiOMA Control CNC system. CONCLUSION: As the result of the conducted study, the role of the automatized systems in the process of design and development of control programs was considered. For solving the problem of the development of the postprocessors for the AksiOMA Control CNC, the IMSpost package for automatized postprocessor development was chosen.

Fluphenazine decanoate licenced as a long-acting injectable (LAI) first-generation antipsychotic (FGA) was withdrawn from sale in 2018. This study evaluates if its withdrawal resulted in increased relapse rates of psychosis in an Irish patient cohort and examines which prescribed alternative antipsychotic medications were associated with more optimal outcomes. Fifteen participants diagnosed with a psychotic disorder were included. A mirror-image study over 24-months' pre-and post-withdrawal of fluphenazine was conducted. Kaplan-Meier survival and proportional hazards analyses were conducted. The impact of alternate antipsychotic agents (LAI flupenthixol compared to other antipsychotic medications) was evaluated. Semi-structured interviews with participants examined subjective opinions regarding the change in their treatment. Seven participants (46.7%) relapsed in the 24-month period subsequent to fluphenazine discontinuation compared to one individual (6.7%) in the previous identical time-period (p = 0.035). Flupenthixol treatment was associated with reduced relapse rates compared to other antipsychotics (χ2 = 5.402, p = 0.02). Thematic analysis revealed that participants believed that the discontinuation of fluphenazine deleteriously impacted the stability of their mental disorder. The withdrawal of fluphenazine was associated with increased relapse rate in individuals previously demonstrating stability of their psychotic disorder. While acknowledging the limitation of small sample size, preliminary evidence from this study suggests that treatment with the first-generation antipsychotic (FGA) flupenthixol was associated with a lower risk of relapse compared to SGAs. Reasons for this lower risk of relapse are not fully clear but could be related to dopamine hypersensitivity with this treatment change.

Herein a rapid continuous flow method for the conversion of aryl ketones to nitriles is presented, which features advantages such as improved safety, substrate scope and scalability.

BackgroundAlcohol is a leading cause of morbidity and mortality worldwide. Adolescence is when alcohol use typically begins. Harmful patterns of alcohol consumption, such as binge drinking, may emerge during adolescence and become established. This study aimed to examine potential risk and protective factors for binge drinking among 15–16-year-old adolescents in the West of Ireland.MethodsThis was a cross-sectional secondary analysis of 4473 participants from the Planet Youth 2020 Survey. The outcome was ever binge drinking, defined as ever consumption of five or more drinks in a two-hour period or less. Independent variables were selected a priori following review of peer-reviewed literature and were grouped as individual, parents and family, peer group, school, leisure time and local community factors. Statistical analysis was completed using SPSS version 27. Differences in medians and means for continuous variables were examined using the Mann–Whitney U test and Independent Samples t-test respectively. Multivariable logistic regression was used to examine independent associations between potential risk and protective factors and ever binge drinking. A p-value of < 0.05 was deemed statistically significant.ResultsThe prevalence of ever binge drinking was 34.1%. Self-rated ‘bad/very bad’ mental health (adjusted Odds Ratio (aOR) 1.61, 95% CI 1.26–2.06, p < 0.001), current cigarette use (aOR 4.06, 95% CI 3.01–5.47, p < 0.001) and current cannabis use (aOR 2.79, 95% CI 1.80–4.31, p < 0.001) increased odds of ever binge drinking.Parental supervision (aOR 0.80, 95% CI 0.73–0.88, p < 0.001) and negative parental reaction to adolescent drunkenness (aOR 0.51, 95% CI 0.42–0.61, p < 0.001) reduced odds of ever binge drinking. Getting alcohol from parents increased odds of ever binge drinking (aOR 1.79, 95% CI 1.42–2.25, p < 0.001).Adolescents with friends who drink alcohol had almost five times higher odds of ever binge drinking (aOR 4.59, 95% CI 2.65–7.94, p < 0.001). Participating in team/club sports also increased odds of ever binge drinking (aOR 1.30, 95% CI 1.07–1.57, p = 0.008 for 1–4 times/week, aOR 1.52, 95% CI 1.07–2.16, p = 0.020 for ≥ 5 times/week).ConclusionThis study identifies individual and social environment factors associated with adolescent binge drinking in the West of Ireland. This can inform intersectoral action to protect adolescents from alcohol-related harm.