Ollscoil na Gaillimhe – University of Galway

The decision to initiate wound debridement and the choice of method depends on patient and treatment goals, available resources, and the knowledge, skills, and expertise of the attending clinician. The nurse, working at an advanced level of practice can perform the skills of debridement but importantly has the knowledge and understanding to assess the situation and make decisions as to the appropriateness of debridement and the choice of method and initiate treatment in consultation with the patient. Moving from novice to expert in the field of wound care and specifically debridement is achieved through further education, learning from others and being increasingly exposed to the situation at hand. The ‘expert’ nurse, most often seen as the tissue viability specialist has this advanced knowledge.

The complexity and scale of IT systems is increasing dramatically, posing many challenges to real-world anomaly detection. Over the years, there have been extensive studies toward deep learning-based methods focusing on feature learning and anomaly scoring, achieving tremendous success in this area. However, little work has been done on the thresholding problem despite it being a critical factor for detecting anomalies effectively. The commonly used static or expert-defined thresholds have shown a lack of adaptability to non-stationary and evolving time series. In this paper, we model thresholding in anomaly detection as a Markov decision process and propose an agent-based dynamic thresholding (ADT) framework based on a deep Q-network. First, an anomaly scorer such as an autoencoder is employed to obtain feature representations and produce anomaly scores for complex input data. Afterward, by analyzing anomaly scores and other useful environmental information, ADT can automatically provide appropriate binary thresholds, thereby achieving self-adaptive anomaly detection. Additionally, we introduce a rigorous mathematical approach to convert the binary thresholds into more fine-grained continuous thresholds that can adapt to different user requirements and practical situations. The properties of ADT are studied through comprehensive experiments on three real-world datasets and compared with baseline methods, hence demonstrating its thresholding capability, data-efficient learning, stability, and robustness, leading to significantly improved detection performance. Our research underscores the transformative role of reinforcement learning (RL) in providing adaptive anomaly detection, achieving remarkable results with minimal labels for training, and even in scenarios where labels are partially observable or contaminated with noise. To the best of our knowledge, we are the first to exhibit the application of RL for optimal thresholding control, for both binary and continuous thresholding scenarios, within the domain of time series anomaly detection.

Introduction Older people (people aged 65 years and older) have high rates of death by suicide, and self-harm is a major risk factor for suicide. While rates of self-harm decrease with age, rates of suicide increase among this age group. The overall aim of this research project is to identify real-life evidence of the characteristics associated with older people who present with self-harm and suicidal ideation to emergency departments in Ireland. In examining the variables associated with self-harm, we may be better able to identify the characteristics of older adults who are at highest risk, including those presenting with high lethality attempts. Methods and analysis Our data are a cohort study of older people in Ireland involving two workstreams. The first will use a 5-year cohort of data from the National Clinical Programme for Self-Harm and Suicide-related Ideation (NCPSHI) which comprises over 70 000 presentations. The second workstream will use a 15-year cohort of electronic patient records from the Mater Misericordiae University Hospital (MMUH) comprising over 30 491 presentations (900 aged 65 years and older) to collect more detailed information on characteristics of older people presenting with self-harm and suicidal ideation. Ethics and dissemination This study has received full ethical approval. The Clinical Research Ethics Committee of the MMUH approved the MMUH workstream—Reference number: 1/378/2327 TMR. Ethical approval for the NCPSHI workstream has been granted by the University College Dublin’s Office of Research Ethics. Our findings will be disseminated via peer-review publications and presentations to the scientific community, along with reports for clinicians and policymakers.

Location-based services have been increasingly used to support various decisions in retail such as coupon recommendation, indoor advertisement, smart targeting, etc. However, effectively tracking user’s position to provide extra value embeds several challenges ranging from technical and infrastructure to business, user acceptance and social. This paper presents a location-based coupon recommendation service deployed in a retail store, using Bluetooth Low Energy (BLE) Beacons technology to track the customers. We aim to share the challenges we encountered, and the factors that affected our system’s quality and performance; and show how we handled the issues that arose. Our study moves beyond the technical challenges and discusses the business and user acceptance challenges, highlighting the role of the application context. This paper aspires to provide realistic and more holistic, not just technical, guidelines on prospective researchers and designers of location-based services for retail stores and other contexts. The outcome of the paper highlights new directions for existing challenges and introduces new ones related to beacon configuration, the choice of the unit of analysis, the definition of areas of interest, and acceptance by employees.

Adsorption using covalent organic frameworks (COFs) is very effective and favoured for removing per- and polyfluoroalkyl substances (PFAS) from various matrices. The prominent classes of COF, their synthesis methods, and their application in COF-based technologies for PFAS adsorption in myriad environments are discussed. Furthermore, the influencing PFAS adsorption characteristics of the distinct COF classes are also examined. COFs have large specific surface areas and porosity, offering PFASs a host of adsorption sites and thus high adsorption capabilities. β-Cyclodextrin-based COFs (β-CD-COFs), ionic COFs (iCOFs), amine-functionalised COFs, porphyrin-based COFs and hydrophobic COFs are some of the most notable examples of COFs and as such have been employed for large-scale PFAS remediation. Direct and post-synthetic modification are the two main COF design methodologies. The general approach in constructing various frameworks involves the reaction of ion monomers with other neutral monomers. For COFs, solvothermal synthesis is currently the main direct synthetic method. The process used to synthesise COFs tremendously impacts how effectively they adsorb PFAS. High-performance materials for PFAS remediation are created by researchers by customising COF characteristics and using suitable synthesis techniques. The authors’ objective is to give readers and researchers alike a broad overview of the current status of COF research and development, including numerous challenges and prospects associated with the adsorption of PFASs by COFs. Graphical abstract Application of Cement Stabilized OB dump, BOF slag, Fly Ash Mixes as Sustainable Pavement Material

During microbial surveillance of the Mars 2020 spacecraft assembly facility, two novel bacterial strains, potentially capable of producing lasso peptides, were identified. Characterization using a polyphasic taxonomic approach, whole-genome sequencing and phylogenomic analyses revealed a close genetic relationship among two strains from Mars 2020 cleanroom floors (179-C4-2-HS, 179-J1A1-HS), one strain from the Agave plant (AT2.8), and another strain from wheat-associated soil (V4I25). All four strains exhibited high 16S rRNA gene sequence similarity (>99.2%) and low average nucleotide identity (ANI) with Neobacillus niacini NBRC 15566 T , delineating new phylogenetic branches within the genus. Detailed molecular analyses, including gyr B (90.2%), ANI (86.4%), average amino acid identity (87.8%) phylogenies, digital DNA–DNA hybridization (32.6%), and percentage of conserved proteins (77.7%) indicated significant divergence from N. niacini NBRC 15566 T . Consequently, these strains have been designated Neobacillus driksii sp. nov., with the type strain 179-C4-2-HS T (DSM 115941 T = NRRL B-65665 T ). N. driksii grew at 4°C to 45°C, pH range of 6.0 to 9.5, and 0.5% to 5% NaCl. The major cellular fatty acids are iso-C 15:0 and anteiso-C 15:0 . The dominant polar lipids include diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, and an unidentified aminolipid. Metagenomic analysis within NASA cleanrooms revealed that N. driksii is scarce (17 out of 236 samples). Genes encoding the biosynthesis pathway for lasso peptides were identified in all N. driksii strains and are not commonly found in other Neobacillus species, except in 7 out of 26 recognized species. This study highlights the unique metabolic capabilities of N. driksii , underscoring their potential in antimicrobial research and biotechnology. IMPORTANCE The microbial surveillance of the Mars 2020 assembly cleanroom led to the isolation of novel N. driksii with potential applications in cleanroom environments, such as hospitals, pharmaceuticals, semiconductors, and aeronautical industries. N. driksii genomes were found to possess genes responsible for producing lasso peptides, which are crucial for antimicrobial defense, communication, and enzyme inhibition. Isolation of N. driksii from cleanrooms, Agave plants, and dryland wheat soils, suggested niche-specific ecology and resilience under various environmentally challenging conditions. The discovery of potent antimicrobial agents from novel N. driksii underscores the importance of genome mining and the isolation of rare microorganisms. Bioactive gene clusters potentially producing nicotianamine-like siderophores were found in N. driksii genomes. These siderophores can be used for bioremediation to remove heavy metals from contaminated environments, promote plant growth by aiding iron uptake in agriculture, and treat iron overload conditions in medical applications.

Hydrogen-atom tunnelling is an important component in some chemical reactions particularly at low temperatures ≤ 300 K. Recent experiments by Rostkowska et al. [PCCP 2024, 26, 23944–23950] showed that higher...

Aim Gestational diabetes (GDM) poses risks of short‐ and long‐term complications for mother and infant, emphasising the importance of antenatal and postpartum education and support. We aimed to understand the experiences and views of women with GDM in the Republic of Ireland. Methods Women with current or previous GDM were invited to complete an online cross‐sectional survey (April–June 2022). Recruitment utilised social media, local media and personal networks. The survey addressed demographics, GDM knowledge and experiences, breastfeeding and weight management during pregnancy and post‐pregnancy GDM support needs. Descriptive statistics were conducted, and between‐group comparisons were undertaken using the chi‐square test. Content analysis was applied to free text data. Results Amongst 231 respondents, most were aged 35–39 (42%); 70% experienced a single GDM pregnancy. Only 6% correctly identified their increased level of risk for developing type 2 diabetes. Under half (44.5%) of respondents reported sufficient time with health professionals to address GDM‐related questions. Just over half (54.3%) reported attending for diabetes screening at 6–12 weeks postpartum. The majority (66%) expressed a desire for postpartum information, particularly on healthy eating and physical activity. Having a more recent GDM experience was associated with a stronger preference for weaning ( p ≤ 0.001) and weight management information ( p = 0.025). Qualitative analysis identified inconsistencies in healthcare messaging, significant concerns about a GDM diagnosis' impact on the pregnancy experience, and financial costs of diagnosis. Conclusions The findings underscore women's desire for appropriate information and support during and after pregnancy with GDM. Future interventions should address these needs to effectively promote chronic disease prevention after GDM.

Peroxiredoxin 6 (PRDX6) is a multifunctional enzyme involved in phospholipid peroxide repair and metabolism. In this study we investigated the global lipid composition of a human hepatocarcinoma cell line SNU475 lacking PRDX6 and lipid related cellular processes. There was a general decrease in multiple lipids species upon loss of PRDX6, in particular sphingomyelins and acylcarnitines, consistent with previously observed alterations in cell signaling pathways and mitochondrial dysfunction. Deprivation of docosahexaenoic acid and related species was also evident. However, a few striking exceptions are worth highlighting: 1) Three specific arachidonic acid (AA) containing phophatidylcholines (PC) increased significantly. The increase of sn1-stearic/sn2-PUFA containing PC and sn2-AA containing plasmenyls are indicative of a preference of PRDX6 iPLA2 activity for these AA storage glycerophospholipids. 2) Several polyunsaturated fatty acids (PUFA) and PUFA containing triacylglycerols accumulated together with increased formation of lipid droplets, an indication of altered FA flux and PUFA sequestration in PRDX6 knockout cells. Loss of PRDX6 resulted in increased sensitivity to erastin-induced ferroptosis, independent of selenium and GPX4, as a consequence of increased levels of lipid hydroperoxides, that reverted to normal levels upon rescue with PRDX6. The results presented demonstrate that all three enzymatic activities of PRDX6 contribute to the role of this multifunctional enzyme in diverse cellular processes, including membrane phospholipid remodeling and glycerophospholipid functional diversity, resulting in altered lipid peroxides and modulation of AA disposition and traffic. These contributions highlight the complexity of the changes that loss of PRDX6 exerts on cell functionality.

Carbapenemase-producing Enterobacterales (CPE) is a diverse group of often multidrug-resistant organisms. Surveillance and control of infections are complicated due to the inter-species spread of carbapenemase-encoding genes (CEGs) on mobile genetic elements (MGEs), including plasmids and transposons. Due to wastewater discharges, urban water ecosystems represent a known reservoir of CPE. However, the dynamics of carbapenemase-bearing MGE dissemination between Enterobacterales in humans and environmental waters are poorly understood. We carried out whole-genome sequencing, combining short- and long-sequencing reads to enable complete characterization of CPE isolated from patients, wastewaters, and natural waters between 2018 and 2020 in Galway, Ireland. Isolates were selected based on their carriage of Class A bla KPC-2 ( n = 6), Class B bla NDM-5 ( n = 12), and Class D bla OXA-48 ( n = 21) CEGs. CEGs were plasmid-borne in all but two isolates. OXA-48 dissemination was associated with a 64 kb IncL plasmid (62%), in a broad range of Enterobacterales isolates from both niches. Conversely, bla KPC-2 and bla NDM-5 genes were usually carried on larger and more variable multireplicon IncF plasmids in Klebsiella pneumoniae and Escherichia coli , respectively. In every isolate, each CEG was surrounded by a gene-specific common genetic environment which constituted part, or all, of a transposable element that was present in both plasmids and the bacterial chromosome. Transposons Tn 1999 and Tn 4401 were associated with bla OXA-48 and bla KPC-2 , respectively, while bla NDM-5 was associated with variable IS 26 bound composite transposons, usually containing a class 1 integron. IMPORTANCE Since 2018, the Irish National Carbapenemase-Producing Enterobacterales (CPE) Reference Laboratory Service at University Hospital Galway has performed whole-genome sequencing on suspected and confirmed CPE from clinical specimens as well as patient and environmental screening isolates. Understanding the dynamics of CPE and carbapenemase-encoding gene encoding mobile genetic element (MGE) flux between human and environmental reservoirs is important for One Health surveillance of these priority organisms. We employed hybrid assembly approaches for improved resolution of CPE genomic surveillance, typing, and plasmid characterization. We analyzed a diverse collection of human ( n = 17) and environmental isolates ( n = 22) and found common MGE across multiple species and in different ecological niches. The conjugation ability and frequency of a subset of these plasmids were demonstrated to be affected by the presence or absence of necessary conjugation genes and by plasmid size. We characterize several MGE at play in the local dissemination of carbapenemase genes. This may facilitate their future detection in the clinical laboratory.

Aim To understand the extent and type of evidence that exists related to nurses' and midwives' experiences of participating in clinical supervision and ascertain how clinical supervision is defined in the literature. Design A scoping review of peer reviewed research. Data Sources CINAHL Complete (EBSCOhost), MEDLINE (Ovid), PsycINFO (EBSCO), Embase (Elsevier) and the Cochrane Library were searched for relevant articles published between 2010 and 2024. Review Methods The scoping review followed the JBI methodology. Reporting Method PRISMA‐ScR. Results Forty‐three articles were included, qualitative, quantitative, mixed methods studies and three reviews were found describing nurses' and midwives' experiences of clinical supervision. The studies identified were carried out across 15 countries and reported on experiences of group clinical supervision, one to one clinical supervision or both, more recent studies included a focus on group clinical supervision. All definitions found are reported, and although these varied, there were frequently used terms common in many. Conclusion Although some evidence exists on how nurses and midwives experience clinical supervision gaps in evidence and detail of supervision practices remain. Inconsistencies of approach to this practice remain and specific detail relating to clinical supervision explored in existing research is frequently lacking. The lack of a universally accepted definition highlighted may influence inconsistences in clinical supervision, key terms identified in this review may assist in the development of a definition. Further research into this support is required to establish its value in practice. Impact This scoping review progresses the ongoing debate that clinical supervision is a valuable support for nurses' and midwives' but the absence of evidence is an indication that clinical supervision is not fully understood nor is visible in practice. To this end, this review highlights that the lack of consensus on a clinical supervision definition causes ambiguity thus reducing the use of this support for nurses and midwives. Patient or Public Contribution There was no patient or public contribution to this paper as it is a review paper that seeks information on research available on a professional support. Protocol registration@ Open science Framework: identifier 10.17605/OSF.IO/QNKUR

Background Engaging people in advance care planning is a challenging systemic problem that requires a social innovation approach and a conceptual framework to guide behavioural and social change efforts. Aim To identify stakeholders' perspectives on barriers to advance care planning engagement, options for overcoming these barriers, and user needs. The findings will inform the design of a health behaviour change intervention for engaging older adults (50+) in advance care planning. Design To advance co‐production and intervention design goals, the study used collective intelligence and scenario‐based design methods. Methods Following a systematic stakeholder analysis, 22 participants were recruited to three online collective intelligence sessions. The socioecological perspective informed framing of integrated findings and specifying factors at the individual, interpersonal, service, and system levels. Results Identified barriers ( n = 109) were grouped into seven categories: (i) Psychological, (ii) Advance Care Planning Literacy, (iii) Interpersonal and Interprofessional, (iv) Service‐Related, (v) Resources and Supports, (vi) Advance Care Planning Process and Methods, (vii) Cultural and Societal. Stakeholders generated 222 options for overcoming these barriers and specified 230 service user needs. The need to change perceptions of advance care planning, increase psychological readiness, and target advance care planning literacy was highlighted (individual‐level). Timely, focused, and meaningful interaction between the key ACP actors must be facilitated using creative strategies (interpersonal‐level). Need‐ and value‐based services, including high quality resources, support systems, and infrastructure, should be co‐designed (service‐level). Cultural and societal transformation is required (system‐level). Conclusion Findings integration offered insight into the complexity of the design context and problem situation and identified directions for context‐specific advance care planning intervention development. The use of design thinking methodologies is recommended for the next phase of complex intervention development. Implications The study presents a roadmap of actions required from policy‐makers, practitioners, and researchers to ensure the design of adequate advance care planning interventions. Reporting Method Quality of reporting was assured by adherence to Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines ( International Journal for Quality in Health Care , 19 , 2007, 349). Patient or Public Contribution Patient and public representatives participated in the collective intelligence sessions. Members of the All Ireland Institute of Hospice and Palliative Care Voices4Care facilitated that process. Findings from the first CI session (involving patients and caregivers) informed the content, format, and methods used in subsequent CI sessions.

The ethical debate on the moral consideration of non-human animals (hereafter animals) is currently centred on the evidence of sentience in these individuals. Legal protection for vertebrates and cephalopods (and decapods in the UK) has resulted from the recognition of sentience in these animals. Although one should celebrate the significant advances in the legal protection of animals in recent decades, current animal legislation is modulated by an instrumental viewpoint, remaining speciesist and anthropocentric. A sentient being is here understood as one who has the phenomenological experience of awareness, which is the most basic sense of phenomenal consciousness that implies the existence of a subject who is not indifferent to what happens to itself. This paper demonstrates, with reasonable assumptions, that this concept of sentience would apply to many invertebrate species, thus deeming them worthy of increased moral consideration and legal protection. In cases in which sentience cannot be demonstrated clearly, one should assume the precautionary principle and consider the intrinsic value of each animal to designate moral consideration. In considering sentience as the primary condition for moral consideration, science must expand who is recognized as sentient rather than being reductionist. Animal ethics must review to whom the moral consideration should be given. Animal legislation must include legislative innovations and invertebrates in its protective scope. Thereby, a significant improvement in the current political and legislative decisions would be rooted in animal ethics. Opening the ethical perception and broadening the debate are urgent, as moral consideration should be given to all animals.

Species distribution modelling is a valuable tool for understanding and managing protected areas globally. This study used MaxEnt modelling with high-resolution environmental data and extensive in-situ observations to create habitat suitability maps for 16 reptile species in the highly biodiverse Souss-Massa National Park (SMNP), Morocco. The study examined the influence of environmental variables on species distribution and identified ecologically significant areas (species-rich areas). The results indicated that 94% of the models exhibited excellent predictive performance (AUC >0.9). Habitat types emerged as the most influential environmental variable for 75% of species, while the remaining taxa were primarily affected by soil type, vegetation density, and ocean proximity. Habitat suitability maps revealed distinct habitat preferences among species. The potential species richness map revealed variations within SMNP. Fenced reserves and undisturbed habitats both had a greater composition of highly diverse areas compared to unfenced and disturbed areas, respectively. The substantial proportion of disturbed areas with low species richness further supports the findings from a recent study conducted in the same area, which indicated that habitat disturbance can lead to the loss or decline of reptile populations. Priority for conservation should shift towards less protected areas to better safeguard reptile biodiversity, as most areas needing attention are outside wellprotected reserves.

Chronic limb-threatening ischaemia (CLTI), the most severe manifestation of peripheral arterial disease (PAD), is associated with a poor prognosis and high amputation rates. Despite novel therapeutic approaches being investigated, no significant clinical benefits have been observed yet. Understanding the molecular pathways of skeletal muscle dysfunction in CLTI is crucial for designing successful treatments. This study aimed to identify miRNAs dysregulated in muscle biopsies from PAD cohorts. Using MIcroRNA ENrichment TURned NETwork (MIENTURNET) on a publicly accessible RNA-sequencing dataset of PAD cohorts, we identified a list of miRNAs that were over-represented among the upregulated differentially expressed genes (DEGs) in CLTI. Next, we validated the altered expression of these miRNAs and their targets in mice with hindlimb ischaemia (HLI). Our results showed a significant downregulation of miR-1, miR-133a, and miR-29b levels in the ischaemic limbs versus the contralateral non-ischaemic limb. A miRNA target protein-protein interaction network identified extracellular matrix components, including collagen-1a1, -3a1, and -4a1, fibronectin-1, fibrin-1, matrix metalloproteinase-2 and -14, and Sparc, which were upregulated in the ischaemic muscle of mice. This is the first study to identify miR-1, miR-133a, and miR-29b as potential contributors to fibrosis and vascular pathology in CLTI muscle, which supports their potential as novel therapeutic agents for this condition.