From data to decisions: Empowering brownfield redevelopment with a novel decision support system.

This research evaluates a novel decision support system (DSS) for planning brownfield redevelopment. The DSS is implemented within a web-based geographical information system that contains the spatial data informing three modules comprising land use suitability, economic viability, and ground risk. Using multi-criteria decision analysis, an evaluation was conducted on 31,942 ha of post-industrial land and around Liverpool, UK. The representativeness and credibility of the DSS outputs were evaluated through user trials with fifteen land-use planning and development stakeholders from the Liverpool City Region Comined Authority. The DSS was used to explore land use planning scenarios and it could be used to support decision making. Our research reveals that the DSS has the potential to positively inform the identification of brownfield redevelopment opportunities by offering a reliable, carefully curated, and user-driven digital evidence base. This expedites the traditionally manual process of conducting assessments of land suitability and viability. This research has important implications for assessing the impact of current and future planning policy and the potential for the use of digital tools for land use planning and sustainability in the UK and globally.

Standardizing the surgical management of benign ovarian tumors in children and adolescents: A best practice Delphi consensus statement.

AIM: No widely agreed consensus protocols exist for the management of benign ovarian tumors (BOT) in children. This presents a substantial risk for suboptimal management. We aimed to generate multispecialty consensus guidance to standardize surgical management and provide a clear follow-up protocol for children with BOTs. METHODS: Prospective two-round confidential e-Delphi consensus survey distributed among multispecialty expert panel; concluded by two semistructured videoconferences. MAIN RESULTS: Consensus was generated on these core outcome sets: preoperative/intraoperative management; follow-up; adolescent gynecology referral. (1) Children with BOTs should receive the same management as other patients with potentially neoplastic lesions: Preoperative discussion at a pediatric oncology multidisciplinary meeting to risk stratify tumors, and management by health professionals with expertise in ovarian-sparing surgery and laparoscopy. (2) Ovarian-sparing surgery for BOTs should be performed wherever possible to maximize fertility preservation. (3) Ovarian masses detected during emergency laparoscopy/laparotomy should be left in situ wherever feasible and investigated appropriately (imaging/tumor markers) before resection. (4) Follow-up should be undertaken for all patients after BOT resection. Patients should be offered referral to adolescent gynecology to discuss fertility implications. CONCLUSION: This best practice Delphi consensus statement emphasizes the importance of managing children with BOTs through a well-defined oncological MDT strategy, in order to optimize risk stratification and allow fertility preservation by ovarian-sparing surgery wherever possible.

A severe bleeding diathesis in a 6-year-old girl secondary to a composite diagnosis of splenic hemangiomatosis and small bowel lymphangiomatosis.

A 6-year-old girl presented with presumed relapse of childhood immune thrombocytopenia. Investigations revealed deranged coagulation parameters, abnormal small bowel thickening, and splenomegaly. A clinically significant bleeding diathesis emerged which was refractory to most hemostatic interventions. Laparatomy revealed a composite diagnosis of splenic hemangiomatosis and small bowel lymphangiomatosis. Splenectomy resulted in complete resolution of the coagulopathy. The diagnosis and management of these conditions is inherently complex and without clear guidance. We discuss our perioperative management of the bleeding diathesis. There is a need for long-term follow-up of the underlying pathologies particularly as potentially useful therapeutic agents have emerged.

Tripartite esophagus.

Esophageal atresia can exhibit many variations as a result of embryological derangements. We present a variation not previously described.

Multidetector-row computed tomography three-dimensional volume reformatted 'transparency' images to define an upper pouch fistula in oesophageal atresia.

Oesophageal atresia (OA) is an important congenital malformation in which prompt diagnosis and appropriate management can significantly improve outcome. The surgical approach to repair of OA and associated tracheo-oesophageal fistulae (TOF) depends upon correct evaluation of the tracheobronchial tree. Three-dimensional imaging of the tracheobronchial tree using CT data to produce shaded surface displays and virtual bronchoscopy has been reported in paediatric and neonatal patients with OA and TOF and is described as accurate and helpful, non-invasively facilitating the appreciation of complex anatomy prior to surgery. We describe the technique of reconstructing 3D volume-reformatted 'transparency' images using insufflated air as a negative contrast medium. This technique is fast, accurate and produces high-quality images that are easy to reproduce.