Sligo University Hospital

Future flood dynamics in a lowland karst catchment draining into Galway Bay, Ireland, have been assessed under climate-change scenarios. Bayesian neural network model (BNN) was calibrated on 1980-2015 observations of rainfall, tides, and turlough flood volumes, yielding correlations of R = 0.95 (training) and R = 0.78 (overall). Projections driven by CORDEX under RCP 4.5 and 8.5 for 2016-2100 reveal ensemble-mean rainfall increases of 1.2mm decade-1 and 2.5mm decade-1, respectively, corresponding to flood-volume growth rates of 5 × 10⁶ m3 decade-1 and 1.1 × 107 m3 decade-1. Wavelet coherence indicated high-frequency coupling (> 0.7) between rainfall and floods under RCP 8.5 versus < 0.5 under RCP 4.5. Extreme-event analysis showed a 40% rise in joint 95th -percentile rainfall and flood-volume events under RCP 8.5 (p < 0.05). Generalized extreme-value fits to annual maxima for 2018-2037 versus 2080-2099 project that a historical 100-year storm becomes 1-in-16-year event under RCP 8.5. 10-year rolling 90th -percentile analysis revealed rapid intensification of upper-tail floods under RCP 8.5 than RCP 4.5. These findings demonstrated that high-emission pathways substantially amplify flood magnitudes and frequencies and underscores the utility of integrated statistical and machine-learning frameworks for robust flood-risk assessment and climate-adaptation planning.

Background/Objective: Percutaneous coronary intervention (PCI) has a pivotal role in the treatment of coronary artery disease (CAD). Although PCI is generally guided only angiographically, advancements in intravascular imaging, particularly in optical coherence tomography (OCT), may offer significant advantages. OCT provides high-resolution cross-sectional images that allow for a more detailed assessment of lesion characteristics and procedural outcomes, which are not fully available with angiography. These findings are associated with or predictive of major adverse cardiovascular events (MACE), encouraging the use of OCT in PCI procedures. This study sought to characterize the role of post-PCI OCT imaging in PCI optimization in patients with CAD. Methods: This retrospective study includes patients who underwent OCT-guided PCI. A total of 64 patients with various types of CAD were included. The primary endpoint was the identification of suboptimal stent implantation as evaluated with OCT after stent implantation, and the secondary endpoint was the assessment of the possibility to achieve optimal stent implantation after further OCT-guided optimization based on standard definitions of optimal PCI. Results: In total, 73 vessels were studied, 42.46% (31) had a stent expansion index (SEI) of < 80%, 31.51% (23) had an SEI between 80-90%, and 26.03% (19) had an SEI of more than 90%. Minimum stent area (MSA) of more than 4.5 mm2 was found in 82.19% (60) of vessels, while 17.80% (13) had an MSA below the cut-off value. Suboptimal stent implantation was identified in 35.61% (26) of vessels, including underexpansion 9.58% (7), malapposition 15.06% (11), stent edge dissection 6.85% (5), plaque burden or lipid-rich pool in the stent edges 2.73% (2), and tissue protrusion 1.36% (1). Post-PCI OCT optimization resulted in significant improvements, with only 6.84% (5) of the vessels still not achieving all OCT criteria for optimal stent implantation. Conclusions: In patients with CAD, post-PCI OCT evaluation provided useful information, otherwise unavailable by angiography alone. We identified that 35.61% (26) of the targeted vessels, were suboptimally stented. OCT imaging was able to provide procedural and strategic guidance for optimization until the appropriate results, based on our criteria, were achieved in most of the lesions.

Screening tools for attention-deficit/hyperactivity disorder (ADHD) help to identify individuals likely to have ADHD. Several screening scales are used for identifying adults with ADHD, based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The ADHD symptoms described in the DSM were originally developed to describe the behaviours of children, not adults, and focus on the triad of symptoms of inattention, hyperactivity, and impulsivity. Clinical research and experience, however, have revealed additional dimensions of adult ADHD, such as hyperfocus, racing thoughts, emotional lability, impaired sleep, and differences in time perception. Commensurate with the conditions' growing recognition, the adult ADHD presentation requires rethinking. To understand better the ADHD symptomatology experienced by adults, qualitative interviews were conducted with 11 diagnosed adults. Using thematic analysis, nine themes of adult ADHD symptoms were identified. The first three themes map to the original triad of symptoms - attentional difficulties, hyperactivity, and impulsivity. A further three themes identified are briefly mentioned in the DSM - disorganisation, forgetfulness, and reduced activation. The final three themes are covered to some degree in the current rating scales but are absent from the DSM 5 - emotional lability, sleep difficulties, and time perception difficulties. This study highlights nine themes relevant to adult ADHD, six of which are absent from the DSM 5's triad. This research highlights gaps in current assessment tools and suggests symptoms that are more reflective of the adult experience of having ADHD.

This study evaluated the efficacy and acceptability of Ireland's National Clinical Programme for ADHD in Adults (NCPAA), providing public assessment and supports for adults with ADHD. Overall, 249 adults (51% women, 42% men, 4% non-binary, 1% other gender) were recruited from three NCPAA services usingconsecutive sampling. Participants completed the Adult Self-Report Scale (ASRS) and the Weiss Functional Impairment Rating Scale (WFIRS-S) at baseline, 6, and 12 months; service satisfaction was measured with the Service Satisfaction Scale (SSS). Reflexive thematic analysis explored responses to two open-ended questions. Service users presented with high baseline symptomatology and life challenges. Significant improvements were observed in ASRS and WFIRS-S (except education) in the first six months. Improvements were retained at 12 months in ASRS and WFIRS-S domains of work, life skills, self-concept and social. but not family, risk or education. Service satisfaction was high, particularly among those diagnosed with ADHD. Thematic analysis identified three positive themes: feeling affirmed, benefits of supports, and person-centred care; and three improvement areas: access barriers, resource gaps, and need for ongoing support. Engagement with NCPAA services is associated with improvements in ADHD symptoms and life challenges and is acceptable to adults with ADHD in the short term. Service limitations, particularly staffing constraints, warrant attention. Recommendations include strengthening resources, improving communication and appointment systems, and enhancing links to external supports. Given the absence of a control group, findings should be considered preliminary.

Geographic distribution of healthcare workers is an issue most countries are challenged with. Regionalisation of surgical training in Ireland has emerged as a hot topic over the past number of years in an effort to address the balance between professional progression, adequacy of surgical training and personal responsibility/circumstance. This issue has been reported on within the NHS, but the way in which it may apply to Irish surgical specialties is now being considered. Our aim was to examine the sentiments of Irish Trauma and Orthopaedic trainees towards a number of issues as they pertain to regionalisation of training. We distributed a questionnaire amongst the HST Trauma and Orthopaedic group of trainees and assimilated the results. We found that 69.1% of trainees felt the current structure of the Irish Trauma and Orthopaedic training system was fit for purpose. Ninety percent of respondents said the current structure of the training scheme puts strain on their personal life and work-life balance. When asked if trainees felt that regionalisation of the training programme would benefit their training, 43.9% replied no, 31% yes and 26.2% were unsure. When asked if, overall, the trainee would be in favour of a regionalised training structure for Trauma and Orthopaedics, 43% said 'No', 40% said 'Yes' and 17% were unsure. An equilibrium of professional surgical progression, optimal patient care and work-life balance is a goal held in the highest regard amongst key stakeholders of Irish surgical training. The solution amongst the various surgical subspecialties may not be a one-size-fits-all approach in pursuit of the optimisation of this balance. Further engagement of key stakeholders in how surgical training will evolve over time is crucial in order to achieve this.

We present a genome assembly from an individual male Xyphosia miliaria (tephritid fruit fly; Arthropoda; Insecta; Diptera; Tephritidae). The assembly contains two haplotypes with total lengths of 806.98 megabases and 799.90 megabases. Most of haplotype 1 (97.34%) is scaffolded into 7 chromosomal pseudomolecules, including the X and Y sex chromosomes. Most of haplotype 2 (83.09%) is scaffolded into 5 chromosomal pseudomolecules. The mitochondrial genome has also been assembled, with a length of 19.41 kilobases. This assembly was generated as part of the Darwin Tree of Life project, which produces reference genomes for eukaryotic species found in Britain and Ireland.

Ventilator-associated pneumonia (VAP) is a prevalent and serious infection in intensive care units (ICUs), with timely and accurate diagnosis being crucial for patient outcomes. Conventional diagnostic methods, primarily culture-based, are hampered by long turnaround times and limited sensitivity. Multiplex polymerase chain reaction (PCR) (mPCR) offers rapid detection of multiple pathogens and resistance genes, potentially revolutionizing VAP diagnosis and antimicrobial stewardship. This systematic review aims to compare the diagnostic performance and clinical impact of mPCR versus conventional methods for diagnosing VAP in ICU settings. This review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search of PubMed/MEDLINE, Embase, Web of Science, Scopus, and the Cochrane Library was performed for studies published between 2020 and 2025. Eligible studies compared mPCR with conventional culture in ICU patients with suspected VAP and reported diagnostic accuracy metrics. Study quality was assessed using the QUADAS-2 tool. A qualitative synthesis was performed due to significant heterogeneity among the included studies. Fifteen studies were included. mPCR demonstrated high pooled sensitivity and specificity, with a consistently high negative predictive value (NPV) frequently approaching 100%. This high NPV provides a strong rationale for discontinuing unnecessary antibiotics when results are negative. However, positive predictive value (PPV) was more variable and often lower, reflecting the challenge of differentiating true infection from colonization. The most significant advantage of mPCR was its drastically reduced turnaround time compared to conventional culture. This rapidity facilitated earlier antibiotic modifications, including de-escalation and targeted therapy, as demonstrated in several studies. mPCR represents a significant advancement for the rapid microbiological diagnosis of VAP, offering high NPV and dramatically faster results than conventional culture. These attributes make it a powerful tool for enhancing antimicrobial stewardship in ICUs. However, its optimal use requires integration into clinical practice with careful interpretation of positive results within the context of clinical signs to distinguish infection from colonization. mPCR should be viewed as a complementary diagnostic tool that augments, rather than replaces, conventional microbiology. Limitations include potential omission of relevant studies due to database restrictions, language barriers, and paywalled articles, which may have influenced the comprehensiveness of study retrieval. Future research should focus on measuring its impact on hard clinical outcomes and conducting formal cost-effectiveness analyses.

The rapid expansion of Internet of Things (IoT) deployments across smart environments introduces critical security challenges, particularly at the device identity and physical layers. Traditional cryptographic methods and Distributed Ledger Technologies (DLTs), while valuable, often fail to account for the constrained resources of IoT devices and their susceptibility to physical-layer attacks. This paper proposes a scalable, lightweight security framework that integrates Physical Unclonable Functions (PUFs), Zero-Knowledge Proofs (ZKPs), and a permissioned blockchain to establish end-to-end trust in distributed IoT ecosystems. PUFs act as hardware-rooted trust anchors, enabling secure key generation and unclonable device identity without relying on non-volatile memory. ZKPs facilitate mutual authentication by allowing devices to prove legitimacy without revealing any identifying information. A permissioned blockchain acts as a decentralised verification and audit layer, immutably recording authentication events and ensuring tamper resistance with controlled governance. The proposed architecture is designed to counteract physical tampering, spoofing, and identity forgery while remaining computationally viable for resource-constrained IoT devices. This work presents the foundation for a robust, privacy-preserving, and decentralised security model, bridging the gap between hardware-level assurance and scalable trust in future IoT deployments.

To estimate the coexistence of autism spectrum disorder (ASD) traits in an adult sample diagnosed with attention-deficit/hyperactivity disorder (ADHD); to compare individuals with ASD traits to those without, in terms of functionality, quality life and clinical outcomes; to explore the effects of ADHD medication on three main outcomes (clinical, quality of life, and functionality) in those with only ADHD and in those with coexistence of ASD and ADHD. Prospective longitudinal study of an adult sample diagnosed with ADHD. Data were collected on age, gender, medications and on scales: Autism Spectrum Quotient (AQ-10); Adult ADHD Clinical Outcome Scale; Adult ADHD Quality of Life Questionnaire; Weiss Functional Impairment Rating Scale. A sample of 165 participants was recruited. The AQ-10 showed that almost half, n = 74 (44.8%) of the participants had traits of ASD. Longitudinal analyses demonstrated that people with ADHD and ASD traits have worse clinical outcomes, quality of life, social skills, and family functioning, compared to those with ADHD only. The study shows a high rate of co-existence of ASD in adults with ADHD. Comorbid ASD traits were associated with poorer overall clinical and functional outcomes, quality of life, social skills, and family functioning. Study limitations with particular reference to dropout rate are considered. Implications for improving services are discussed.