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ElHawary H, Watt A, Chartier C, Gorgy A, Gilardino MS. Pocket Predictors: Are Smartphones the Future of Artificial Intelligence in Plastic Surgery. Plast Surg (Oakv) 2023; 31:415-416. [PMID: 37915351 PMCID: PMC10617461 DOI: 10.1177/22925503221078687] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- Hassan ElHawary
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
- Co-First Authors, contributed equally to this work
| | - Ayden Watt
- Department of Experimental Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Co-First Authors, contributed equally to this work
| | | | - Andrew Gorgy
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Mirko S. Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
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Watt A, Lee J, Toews M, Gilardino MS. Smartphone Integration of Artificial Intelligence for Automated Plagiocephaly Diagnosis. Plast Reconstr Surg Glob Open 2023; 11:e4985. [PMID: 37197011 PMCID: PMC10184988 DOI: 10.1097/gox.0000000000004985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/17/2023] [Indexed: 05/19/2023]
Abstract
Positional plagiocephaly is a pediatric condition with important cosmetic implications affecting ∼40% of infants under 12 months of age. Early diagnosis and treatment initiation is imperative in achieving satisfactory outcomes; improved diagnostic modalities are needed to support this goal. This study aimed to determine whether a smartphone-based artificial intelligence tool could diagnose positional plagiocephaly. Methods A prospective validation study was conducted at a large tertiary care center with two recruitment sites: (1) newborn nursery, (2) pediatric craniofacial surgery clinic. Eligible children were aged 0-12 months with no history of hydrocephalus, intracranial tumors, intracranial hemorrhage, intracranial hardware, or prior craniofacial surgery. Successful artificial intelligence diagnosis required identification of the presence and severity of positional plagiocephaly. Results A total of 89 infants were prospectively enrolled from the craniofacial surgery clinic (n = 25, 17 male infants [68%], eight female infants [32%], mean age 8.44 months) and newborn nursery (n = 64, 29 male infants [45%], 25 female infants [39%], mean age 0 months). The model obtained a diagnostic accuracy of 85.39% compared with a standard clinical examination with a disease prevalence of 48%. Sensitivity was 87.50% [95% CI, 75.94-98.42] with a specificity of 83.67% [95% CI, 72.35-94.99]. Precision was 81.40%, while likelihood ratios (positive and negative) were 5.36 and 0.15, respectively. The F1-score was 84.34%. Conclusions The smartphone-based artificial intelligence algorithm accurately diagnosed positional plagiocephaly in a clinical environment. This technology may provide value by helping guide specialist consultation and enabling longitudinal quantitative monitoring of cranial shape.
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Affiliation(s)
- Ayden Watt
- From the Department of Experimental Surgery, McGill University, Montreal, Canada
| | - James Lee
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Canada
| | - Matthew Toews
- École de Technologie Supérieure, Department of Systems Engineering, Montréal, Canada
| | - Mirko S. Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Canada
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Yule H, Perham N, Watt A, Hodgetts H. COMPARISON OF READER PERFORMANCE IN MAMMOGRAPHIC INTERPRETATIONS IN A WORK VS HOME ENVIRONMENT: OBSERVATIONS BY NOVICE PARTICIPANTS. J Med Imaging Radiat Sci 2022. [DOI: 10.1016/j.jmir.2022.10.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Jeffries S, Watt A, Harutyunyan R, Cyr S, Denis R, Hemmerling TM. The Development of a Novel Bariatric Laparoscopic Simulator. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:633-636. [PMID: 36085639 DOI: 10.1109/embc48229.2022.9871246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Bariatric surgery presents a specific challenge in surgical education; simulators need to take into account the specific technical difficulties related to the patient population but also to various types of surgery. We interviewed several leaders in the fields of bariatric and general surgery with experience in laparoscopic surgery and developed a bariatric-specific laparoscopic simulator. This novel simulator was constructed using a variety of silicone-based materials and 3D printing techniques to be reusable and adjustable for a variety of procedures, with no essential components being disposed of following each use. Expert surgeons (n=4) with knowledge on bariatric procedures were recruited and asked to perform a simple simulated laparoscopic procedure. Following testing, participants were asked to complete a survey and rate the simulator based on its physical attributes, global realism, usefulness in improving surgical skills, and overall surgical experience. Face and content validation outcomes based on the questionnaire evaluations completed by expert surgeons showed very good results, with an overall mean score of 4.3 out of 5 (86%). These preliminary results highlight the potential for the simulator's application as a tool to improve bariatric surgical education and patient outcomes.
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Chartier C, ElHawary H, Watt A, Chandawarkar A, Hall-Findlay E, Lee J. 122. Using Breastgan V2.0 to Improve Patient Selection in Single- Stage Augmentation/ Mastopexy. Plastic and Reconstructive Surgery - Global Open 2022. [DOI: 10.1097/01.gox.0000842804.68521.7b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Watt A, Alabdulkarim A, Lee J, Gilardino M. Practical Review of the Cost of Diagnosis and Management of Positional Plagiocephaly. Plast Reconstr Surg Glob Open 2022; 10:e4328. [PMID: 35702535 PMCID: PMC9187200 DOI: 10.1097/gox.0000000000004328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/01/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Positional plagiocephaly has garnered increased research interest since the introduction of the Back to Sleep campaign in the 1990s, and the subsequent increase in infants with cranial deformity. Research has focused on treatment outcomes and developing new modalities to address asymmetric heads. Little attention has been given to the cost of treatment and diagnosis. This study aimed to summarize the literature and provide an overview of the costs associated with a diagnosis of positional plagiocephaly. METHODS A literature review was performed by searching PubMed and Ovid Embase to identify studies pertaining to the "cost" of plagiocephaly diagnosis or treatment through direct financial factors, disturbance to daily routines (ie, through treatment prolongation), or related stress. RESULTS Twenty-nine peer-reviewed studies were included. Treatment options for plagiocephaly are stratified by severity and age of diagnosis, with different pathways available to treat different stages of asymmetry. The common factor across all treatment modalities is that earlier diagnosis unequivocally leads to better aesthetic outcomes and shorter treatment times. This leads to lower costs for treatment, a lower stress burden for parents, and lower costs for the healthcare system in the future through reduction of long-term effects. Our theoretical cost model suggests that early diagnosis at 4 months can lead to a treatment cost of $1495, when compared with $5195 for detection of deformity at or after 6 months. CONCLUSION The dramatic cost disparity between early and late diagnosis highlights the need for reliable methods to accurately detect cranial deformity early in an infant's life.
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Affiliation(s)
- Ayden Watt
- Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Abdulaziz Alabdulkarim
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Quebec, Canada
- Plastic Surgery, General Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - James Lee
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Mirko Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Quebec, Canada
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Lee J, Aoude A, Alhalabi B, Watt A, Lessard L. Can an Emergency Surgery Scheduling Software Improve Residents’ Time Management and Quality of Life? Mcgill J Med 2022. [DOI: 10.26443/mjm.v20i2.893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Operating room efficiency is invaluable. Particularly in public health systems, where resources are limited and patient loads are high, efficient systems underpin the continued delivery of high quality care. In addition to impacting patients, the implementation of efficient healthcare tools has the potential to improve staff quality of life. In the face of growing surgical resident attrition and healthcare worker burnout, developments in standard practice, such as the implementation of the 80-hour work week, are necessary to improve quality of life.
Materials and methods: A new online scheduling software (ORNET.CA) was created, installed, and piloted in a Level I Trauma Center after instructing users (physicians and nurses) on its use. A 20-item survey was then distributed to all users to assess the effect implementation of the software had on their quality of life.
Results: ORnet was shown to improve communication between hospital staff and physicians, reduce workflow interruptions, and improve the quality of the working environment. The survey showed that 60% of residents and 50% of attending staff believed that ORNET.CA improved their quality of life.
Conclusions: We present data from a novel emergency operating room scheduling system that allowed surgical residents and attending physicians to better plan their on-call shifts. Staff (resident and physician) reported survey results suggest that implementation of this system resulted in an improved quality of life and a decrease in stress and anxiety levels.
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8
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Watt A, Zammit D, Lee J, Gilardino M. Novel Screening and Monitoring Techniques for Deformational Plagiocephaly: A Systematic Review. Pediatrics 2022; 149:184526. [PMID: 35059723 DOI: 10.1542/peds.2021-051736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
This article summarizes the current state of diagnostic modalities for infant craniofacial deformities and highlights capable diagnostic tools available currently to pediatricians.
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Affiliation(s)
- Ayden Watt
- Department of Experimental Surgery, McGill University, Montreal, QC, Canada
| | - Dino Zammit
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - James Lee
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Mirko Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, QC, Canada
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9
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Chartier C, Watt A, Lin O, Chandawarkar A, Lee J, Hall-Findlay E. BreastGAN: Artificial Intelligence-Enabled Breast Augmentation Simulation. Aesthet Surg J Open Forum 2021; 4:ojab052. [PMID: 35072073 PMCID: PMC8781773 DOI: 10.1093/asjof/ojab052] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Managing patient expectations is important to ensuring patient satisfaction in aesthetic medicine. To this end, computer technology developed to photograph, digitize, and manipulate three-dimensional (3D) objects has been applied to the female breast. However, the systems remain complex, physically cumbersome, and extremely expensive. OBJECTIVES The authors of the current study wish to introduce the plastic surgery community to BreastGAN, a portable, artificial intelligence (AI)-equipped tool trained on real clinical images to simulate breast augmentation outcomes. METHODS Charts of all patients who underwent bilateral breast augmentation performed by the senior author were retrieved and analyzed. Frontal before and after images were collected from each patient's chart, cropped in a standardized fashion, and used to train a neural network designed to manipulate before images to simulate a surgical result. AI-generated frontal after images were then compared with the real surgical results. RESULTS Standardizing the evaluation of surgical results is a timeless challenge which persists in the context of AI-synthesized after images. In this study, AI-generated images were comparable to real surgical results. CONCLUSIONS This study features a portable, cost-effective neural network trained on real clinical images and designed to simulate surgical results following bilateral breast augmentation. Tools trained on a larger dataset of standardized surgical image pairs will be the subject of future studies.
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Affiliation(s)
- Christian Chartier
- Corresponding Author: Mr Christian Chartier, McGill University Faculty of Medicine, 3605 Rue de la Montagne, Montréal, QC H3G 2M1, Canada. E-mail: ; Instagram: @chrischarts8
| | - Ayden Watt
- Department of Experimental Surgery, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - Owen Lin
- McGill University, Montreal, QC, Canada
| | | | - James Lee
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, QC, Canada
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10
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Lee J, Aoude A, Alhalabi B, Watt A, Lessard L. Can an Emergency Surgery Scheduling Software Improve Residents’ Time Management and Quality of Life? Mcgill J Med 2021. [DOI: 10.26443/mjm.v20i1.893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Operating room efficiency is invaluable. Particularly in public health systems, where resources are limited and patient loads are high, efficient systems underpin the continued delivery of high quality care. In addition to impacting patients, the implementation of efficient healthcare tools has the potential to improve staff quality of life. In the face of growing surgical resident attrition and healthcare worker burnout, developments in standard practice, such as the implementation of the 80-hour work week, are necessary to improve quality of life.
Materials and methods: A new online scheduling software (ORNET.CA) was created, installed, and piloted in a Level I Trauma Center after instructing users (physicians and nurses) on its use. A 20-item survey was then distributed to all users to assess the effect implementation of the software had on their quality of life.
Results: ORnet was shown to improve communication between hospital staff and physicians, reduce workflow interruptions, and improve the quality of the working environment. The survey showed that 60% of residents and 50% of attending staff believed that ORNET.CA improved their quality of life.
Conclusions: We present data from a novel emergency operating room scheduling system that allowed surgical residents and attending physicians to better plan their on-call shifts. Staff (resident and physician) reported survey results suggest that implementation of this system resulted in an improved quality of life and a decrease in stress and anxiety levels.
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11
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Lam C, Watt A, Isenring E, de van der Schueren M, van der Meij B. The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Abstract
Tetrahymena rostrata is a ciliated protist which can parasitize the gray field slug, Deroceras reticulatum. Here, we report the sequence of the mitochondrial genome (mt genome) of a strain of T. rostrata that was isolated from the egg of D. reticulatum. Whole cell genomic DNA was sequenced using Illumina® MiSeq and the mitochondrial DNA sequence reads were extracted and assembled. The resulting 47,235 bp assembly contained rRNAs, tRNAs, and 45 protein coding DNA sequences of which 21 encoded proteins of unknown function. Phylogenetic analysis showed T. rostrata clustered with Tetrahymena thermophila, Tetrahymena pigmentosa, Tetrahymena pyriformis, Tetrahymena paravorax, and Tetrahymena malaccensis.
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Affiliation(s)
- A Watt
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Parkville, Australia
| | - R Haites
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Parkville, Australia
| | - N Young
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Parkville, Australia
| | - H Billman-Jacobe
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Parkville, Australia
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13
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Mistry H, Poles D, Watt A, Bolton-Maggs PHB. Human errors in manual techniques for ABO/D grouping are associated with potentially lethal outcomes. Transfus Med 2019; 29:262-267. [PMID: 31309638 DOI: 10.1111/tme.12616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 05/17/2018] [Accepted: 06/06/2019] [Indexed: 11/30/2022]
Abstract
AIMS/OBJECTIVES To review if ABO/D grouping errors are more likely to occur with manual intervention compared to automation. BACKGROUND Human errors in manual pre-transfusion testing may result in ABO/D-incompatible transfusions and catastrophic outcomes. Accurate ABO/D grouping is a critical part of pre-transfusion testing. METHODS This was a retrospective analysis of reports made to Serious Hazards of Transfusion (SHOT) between January 2004 and December 2016 where ABO/D grouping errors led to the transfusion of an incorrect blood component to review if errors are more likely to occur with manual intervention compared to automation. RESULTS In 148 of 158 (93%) ABO/D grouping errors, manual intervention took place. In the remaining 10, causes were not reported. No errors occurred with full automation. Interpretation errors occurred in 86 of 148 (58%) and 42 of 148 (28%) transcription errors, and in 20 of 148, wrong or no samples were selected. Of 148 errors, 21 (14%) resulted in ABO-incompatible transfusion, with one death in 2004 due to an interpretation error in a manual ABO group. In 30 of 148 (20%), D-positive red cells were given to D-negative recipients, where three women of child-bearing potential became sensitised and developed anti-D. ABO grouping errors have reduced from 18 of 539 (3%) of total reports analysed in 2004 (3·3%) to 3 of 3091 (0·10%) in 2016. CONCLUSIONS Where manual testing cannot be avoided, results should be confirmed using automated techniques as soon as possible, and a back-up process should be available 24/7. SHOT data confirm that manual interventions are prone to human error, especially in transcription and interpretation, and demonstrate a continuing need for appropriate serological knowledge and understanding by transfusion laboratory staff to underpin safety provided by automation and information technology (IT).
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Affiliation(s)
- H Mistry
- Serious Hazards of Transfusion Office, Manchester, UK
| | - D Poles
- Serious Hazards of Transfusion Office, Manchester, UK
| | - A Watt
- Serious Hazards of Transfusion Office, Manchester, UK
| | - P H B Bolton-Maggs
- Serious Hazards of Transfusion Office, Manchester, UK.,Pathology Department, University of Manchester, Manchester, UK
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14
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Oates A, Halliday K, Offiah AC, Landes C, Stoodley N, Jeanes A, Johnson K, Chapman S, Stivaros SM, Fairhurst J, Watt A, Paddock M, Giles K, McHugh K, Arthurs OJ. Shortage of paediatric radiologists acting as an expert witness: position statement from the British Society of Paediatric Radiology (BSPR) National Working Group on Imaging in Suspected Physical Abuse (SPA). Clin Radiol 2019; 74:496-502. [PMID: 31126587 DOI: 10.1016/j.crad.2019.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/12/2019] [Indexed: 11/29/2022]
Abstract
One of the most challenging areas of radiological imaging in children is the diagnosis of physical abuse. There is a dearth of paediatric radiologists willing to act as expert witnesses, particularly in the family courts. There are a number of reasons why radiologists may not be interested or willing to put themselves forward to work as expert witnesses in this field. A group of imaging experts recently formed the "British Society of Paediatric Radiology (BSPR) Working Group on Imaging in Suspected Physical Abuse (SPA)". The group comprises radiologists and neuroradiologists with current or previous experience of providing expert witness reports to the court in cases of SPA. The group met in January 2019 to explore pragmatic solutions to the chronic inefficiencies in both medical and legal practices and the challenges that arise from working in a legal arena with different structures, goals, and assessment criteria. Key issues concerned organisational inefficiencies, variable support from National Health Service Trusts and the Royal College of Radiologists to conduct this work, and the risk/benefit of involvement. This work is important for the patient, parents, and society in general, and highly rewarding for clinical practitioners who are involved, but there are several issues with current practices that discourage active participation. With several members of the group either retired or close to retirement, the shortage of experts is becoming a pressing issue within the UK, which requires an engaged multidisciplinary group to come up with creative solutions. Here, the group provide a consensus opinion highlighting the current barriers and potential facilitators to increasing the number of radiologists willing to provide opinions to the court.
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Affiliation(s)
- A Oates
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - K Halliday
- Nottingham Children's Hospital, Nottingham, UK
| | - A C Offiah
- Academic Unit of Child Health, University of Sheffield, UK
| | - C Landes
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - N Stoodley
- Bristol Children's Hospital, Bristol, UK
| | - A Jeanes
- Leeds Children's Hospital, Leeds Teaching Hospital's NHS Trust, Leeds, UK
| | - K Johnson
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - S Chapman
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - S M Stivaros
- Academic Unit of Paediatric Radiology, Royal Manchester Children's Hospital, Central Manchester University Hospitals, NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK; Division of Informatics, Imaging & Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - J Fairhurst
- Southampton Children's Hospital, Southampton, UK
| | - A Watt
- The Royal Hospital for Children, Glasgow, Scotland, UK
| | - M Paddock
- Barnsley Hospital NHS Foundation Trust, Barnsley, UK
| | - K Giles
- Torbay and South Devon NHS Foundation Trust, UK
| | - K McHugh
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - O J Arthurs
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; NIHR UCL GOS Institute of Child Health Biomedical Research Centre, London, UK.
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Abstract
One hundred and four patients with peripheral vascular disease requiring operation were reviewed retrospectively with respect to age, sex, preoperative haemoglobin, smoking habits and diabetic status. The preoperative haemoglobin levels and smoking status in 63 non-diabetic male patients with peripheral vascular disease were compared with a matched group of individuals treated for inguinal hernia. For all patients there was a significant correlation between smoking habits, preoperative haemoglobin level and the presence of peripheral vascular disease. The mechanisms by which smoking may damage the vascular tree are reviewed.
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Kakinuma Y, Goldsmith CE, Watt A, Elborn JS, Maeda Y, Rendall JC, Hall V, McCaughan J, Reid A, Millar BC, Matsuda M, Moore JE. Molecular conservation within LES9F and PS21 Liverpool epidemic strain (LES) markers in wild-type clinical Pseudomonas aeruginosa isolated from the sputum of adult patients with cystic fibrosis. Br J Biomed Sci 2018; 67:87-8. [DOI: 10.1080/09674845.2010.11978193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Y. Kakinuma
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, Northern Ireland
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa, Japan
| | - C. E. Goldsmith
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, Northern Ireland
| | - A. Watt
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, Northern Ireland
| | - J. S. Elborn
- Regional Adult Cystic Fibrosis Unit, Belfast City Hospital, Belfast
- Department of Respiratory Medicine, The Queen’s University of Belfast, Respiratory Medicine, Belfast City Hospital, Belfast
| | - Y. Maeda
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, Northern Ireland
- School of Biomedical Sciences, Centre for Molecular Biosciences, University of Ulster, Coleraine
| | - J. C. Rendall
- Regional Adult Cystic Fibrosis Unit, Belfast City Hospital, Belfast
| | - V. Hall
- Regional Adult Cystic Fibrosis Unit, Belfast City Hospital, Belfast
| | - J. McCaughan
- Department of Medical Microbiology, Kelvin Building, The Royal Group of Hospitals, Belfast
| | - A. Reid
- The Royal Belfast Hospital for Sick Children, Royal Group of Hospitals, Grosvenor Road, Belfast, Northern Ireland
| | - B. C. Millar
- Children’s Medical Centre Hospital, Tehran University of Medical Sciences
| | - M. Matsuda
- Laboratory of Molecular Biology, School of Environmental Health Sciences, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa, Japan
| | - J. E. Moore
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, Northern Ireland
- The Royal Belfast Hospital for Sick Children, Royal Group of Hospitals, Grosvenor Road, Belfast, Northern Ireland
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17
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Huotari P, Heikinaro-Johansson P, Watt A, Jaakkola T. Fundamental movement skills in adolescents: Secular trends from 2003 to 2010 and associations with physical activity and BMI. Scand J Med Sci Sports 2018; 28:1121-1129. [PMID: 29197119 DOI: 10.1111/sms.13028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 12/01/2022]
Abstract
The aim of this study was to examine the secular trends in fundamental movement skills (FMS) among 15- to 16-year-old adolescents at 2 assessment points scheduled in 2003 and 2010 and to investigate the associations between FMS, physical activity (PA), and body mass index (BMI). In 2003, self-reported PA, weight and height, and objective FMS scores were collected from 2390 students, and in 2010, similar data were generated from a second sample of 1346 students. FMS were assessed during both assessment phases using 3 identical objective FMS tests that were figure 8 dribbling, jumping laterally, and coordination track tests. This study indicated that the sum index of FMS did not change among the boys and the girls between 2 data collection points. However, findings demonstrated a secular decline in coordination test scores in both gender groups between 2 measurement points but an improvement in girls' object control skills between 2003 and 2010. The results also showed that FMS had a significant main effect on BMI in both gender groups, whereas the main effect of PA on BMI was not significant for either gender group. Results also demonstrated that there was no significant interaction effect between FMS and PA on BMI in either of the girls' or the boys' groups.
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Affiliation(s)
- P Huotari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - A Watt
- College of Arts and Education, Victoria University, Melbourne, Australia
| | - T Jaakkola
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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18
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Evered A, Watt A, Perham N. Are sound abatement measures necessary in the cytology reading room? A study of auditory distraction. Cytopathology 2017; 29:84-89. [PMID: 28884486 DOI: 10.1111/cyt.12457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Listening to music and other auditory material during microscopy work is common practice among cytologists. While many cytologists would claim several benefits of such activity, research in other fields suggests that it might adversely affect diagnostic performance. Using a cross-modal distraction paradigm, the aim of the present study was to investigate the effect of auditory stimulation on the visual interpretation of cell images. METHODS Following initial training, 34 participants undertook cell interpretation tests under four auditory conditions (liked music, disliked music, speech and silence) in a counterbalanced repeated-measures study. Error rate, area under the receiver operating characteristic curve, criterion and response time were measured for each condition. RESULTS There was no significant effect of auditory stimulation on the accuracy or speed with which cell images were interpreted, mirroring the results of a previous visual distraction study. CONCLUSION To the extent that the experiment reflects clinical practice, listening to music or other forms of auditory material whilst undertaking microscopy duties is unlikely to be a source of distraction in the cytopathology reading room. From a cognitive perspective, the results are consistent with the notion that high focal-task engagement may have blocked any attentional capture the sound may otherwise have produced.
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Affiliation(s)
- A Evered
- Cytology Department, Cervical Screening Wales Laboratory, Cardiff, UK.,Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
| | - A Watt
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
| | - N Perham
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
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Abstract
OBJECTIVE Visual distraction in cytopathology has not been investigated previously as a source of diagnostic error, presumably because the viewing field of a conventional light microscope is considered to be large enough to minimise interference from peripheral visual stimuli. Virtual microscopy, which involves the examination of digitised images of pathology specimens on computer screens, is beginning to challenge the central role of light microscopy as a diagnostic tool in cytopathology. The relatively narrow visual angle offered by virtual microscopy makes it conceivable that users of these systems will be more vulnerable to visual interference. Using a variant of a visual distraction paradigm (the Eriksen flanker task), the aim of this study was to determine whether the accuracy and speed of the interpretation of cells on a central target screen are affected by images of cells and text displayed on neighbouring monitors under realistic reading room conditions. METHODS Following a brief period of training, 31 cytology novices undertook four cell interpretation tests under different conditions of visual distraction. Error rates were measured under each condition. RESULTS There was no effect of visual distraction on diagnostic accuracy. CONCLUSIONS To the extent that the results from cytology novices extend to experienced practitioners, visual distraction is an unlikely source of error in virtual microscopy. Efficient visual selection and spatial attention, coupled with the high perceptual load of target images and the peripheral location of distractors, provide plausible explanations for the observed results.
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Affiliation(s)
- A Evered
- Cervical Screening Wales, Cardiff, UK. .,Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK.
| | - D Walker
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
| | - A Watt
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
| | - N Perham
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
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Ghamdi AA, Samarji A, Watt A. Essential Considerations in Distance Education in KSA: Teacher Immediacy in a Virtual Teaching and Learning Environment. ACTA ACUST UNITED AC 2016. [DOI: 10.7763/ijiet.2016.v6.651] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Jaakkola T, Yli-Piipari S, Huotari P, Watt A, Liukkonen J. Fundamental movement skills and physical fitness as predictors of physical activity: A 6-year follow-up study. Scand J Med Sci Sports 2015; 26:74-81. [PMID: 25644386 DOI: 10.1111/sms.12407] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2014] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to examine the extent to which fundamental movement skills and physical fitness scores assessed in early adolescence predict self-reported physical activity assessed 6 years later. The sample comprised 333 (200 girls, 133 boys; M age = 12.41) students. The effects of previous physical activity, sex, and body mass index (BMI) were controlled in the main analyses. Adolescents' fundamental movement skills, physical fitness, self-report physical activity, and BMI were collected at baseline, and their self-report energy expenditure (metabolic equivalents: METs) and intensity of physical activity were collected using the International Physical Activity Questionnaire 6 years later. Results showed that fundamental movement skills predicted METs, light, moderate, and vigorous intensity physical activity levels, whereas fitness predicted METs, moderate, and vigorous physical activity levels. Hierarchical regression analyses also showed that after controlling for previous levels of physical activity, sex, and BMI, the size of the effect of fundamental movement skills and physical fitness on energy expenditure and physical activity intensity was moderate (R(2) change between 0.06 and 0.15), with the effect being stronger for high intensity physical activity.
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Affiliation(s)
- T Jaakkola
- Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - S Yli-Piipari
- Department of Health and Sport Sciences, College of Education, Health and Human Sciences, University of Memphis, Memphis, Tennessee, USA
| | - P Huotari
- Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - A Watt
- College of Education and Institute for Sport Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
| | - J Liukkonen
- Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland
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Flanagan DE, Fulford J, Krishnan B, Benattayallah A, Watt A, Summers IR. Functional MRI of the hypothalamic response to an oral glucose load. Diabetologia 2012; 55:2080-2. [PMID: 22538360 DOI: 10.1007/s00125-012-2559-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 03/09/2012] [Indexed: 10/28/2022]
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23
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Masters C, Robert B, Ryan T, Lind M, Li QX, Watt A, Cherny R, Barnham K. 49 Aβ oligomers as diagnostic and therapeutic targets for Alzheimer's disease. Neurobiol Aging 2012. [DOI: 10.1016/j.neurobiolaging.2012.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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24
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Webb L, Whiting J, Watt A, Hill T, Wigg F, Dunn G, Needs S, Barlow EW. Managing Grapevines through Severe Heat: A Survey of Growers after the 2009 Summer Heatwave in South-eastern Australia. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/09571264.2010.530106] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Smithson R, Irvine N, Hutton C, Doherty L, Watt A. Spotlight on measles 2010: Ongoing measles outbreak in Northern Ireland following an imported case, September-October 2010. Euro Surveill 2010; 15. [DOI: 10.2807/ese.15.43.19698-en] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report an ongoing outbreak of measles with five laboratory-confirmed and four epidemiologically linked cases in Northern Ireland as at 26 October 2010. The index case was an unvaccinated non-Northern Ireland resident with subsequent genotyping suggesting that infection originated in the usual country of residence of this case. Confirmed cases include one patient with a history of two measles-mumps-rubella vaccine doses.
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Affiliation(s)
- R Smithson
- Health Protection Service, Public Health Agency, Belfast, Northern Ireland
| | - N Irvine
- Health Protection Service, Public Health Agency, Belfast, Northern Ireland
| | - C Hutton
- Health Protection Service, Public Health Agency, Belfast, Northern Ireland
| | - L Doherty
- Health Protection Service, Public Health Agency, Belfast, Northern Ireland
| | - A Watt
- Regional Virology Service, Royal Victoria Hospital, Belfast, Northern Ireland
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26
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Barber C, Watt A, Pham C, Humphreys K, Penington A, Mutimer K, Edwards M, Maddern G. Influence of bioengineered skin substitutes on diabetic foot ulcer and venous leg ulcer outcomes. J Wound Care 2008; 17:517-27. [PMID: 19052516 DOI: 10.12968/jowc.2008.17.12.31766] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C. Barber
- ASERNIP-S, Royal Australasian College of Surgeons, Stepney, Australia
| | - A. Watt
- ASERNIP-S, Royal Australasian College of Surgeons, Stepney, Australia
| | - C. Pham
- ASERNIP-S, Royal Australasian College of Surgeons, Stepney, Australia
| | - K. Humphreys
- ASERNIP-S, Royal Australasian College of Surgeons, Stepney, Australia
| | - A. Penington
- Department of Surgery, St Vincent’s Hospital and University of Melbourne, Australia
| | - K. Mutimer
- Brighton Plastic Surgery Centre, Royal Children’s Hospital Victoria, Australia
| | | | - G. Maddern
- ASERNIP-S, Royal Australasian College of Surgeons, Stepney, Australia; Department of Surgery, University of Adelaide and The Queen Elizabeth Hospital, Adelaide, Australia
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27
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Courtney JM, Kelly MG, Watt A, Garske L, Bradley J, Ennis M, Elborn JS. Quality of life and inflammation in exacerbations of bronchiectasis. Chron Respir Dis 2008; 5:161-8. [DOI: 10.1177/1479972308091823] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with bronchiectasis often have impaired quality of life (QoL), which deteriorates with exacerbations. The aim of this study was to investigate changes in QoL and how these were influenced by changes in airway physiology and inflammation in patients with bronchiectasis before and after resolution of an exacerbation. Sputum induction and a QoL questionnaire were undertaken on the first day, day 14, and 4 weeks after completion of intravenous antibiotics (day 42). Eighteen patients (12 female) were recruited, median (IQ range) age of 54 (47–60) years. There was a trend towards an improvement in lung function from visit 1 to visit 2, but this was not statistically significant. C-reactive protein (CRP) [mean (SEM)] reduced between visit 1 and visit 2 [55.4 (21.5) vs 9.4 (3.1) mg/L, P = 0.03] but did not increase significantly on visit 3 [44.4 (32.9) mg/L, P = 0.27]. The median (interquartile range) sputum cell count (×106 cells/g of sputum) decreased from visit 1 to visit 2 [21.6 (11.8–37.6)–13.3 (6.7–22.9) × 106 cells/g, respectively, P = 0.008] and increased from visit 2 to visit 3 [26.3 (14.1–33.6) × 106 cells/g, P = 0.03]. All soluble markers of inflammation significantly reduced from visit 1 to visit 2 but increased on visit 3 with the exception of TNF-α. Regarding QoL, three of the four domains (dyspnoea, emotional, mastery) significantly improved from visit 1 to visit 2 but did not change between visit 2 and visit 3. The improvements in QoL scores could not be explained by the improvements in lung function or inflammatory markers.
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Affiliation(s)
- JM Courtney
- Respiratory Research Centre, Belfast City Hospital, Belfast, Northern Ireland; Respiratory Medicine Research Cluster, Queen’s University Belfast, Belfast, Northern Ireland
| | - MG Kelly
- Respiratory Research Centre, Belfast City Hospital, Belfast, Northern Ireland; Respiratory Medicine Research Cluster, Queen’s University Belfast, Belfast, Northern Ireland
| | - A Watt
- Respiratory Medicine Research Cluster, Queen’s University Belfast, Belfast, Northern Ireland
| | - L Garske
- Respiratory Research Centre, Belfast City Hospital, Belfast, Northern Ireland
| | - J Bradley
- Health and Rehabilitation Sciences Research Institute, University of Ulster, Belfast, Northern Ireland
| | - M Ennis
- Respiratory Medicine Research Cluster, Queen’s University Belfast, Belfast, Northern Ireland
| | - JS Elborn
- Respiratory Research Centre, Belfast City Hospital, Belfast, Northern Ireland; Respiratory Medicine Research Cluster, Queen’s University Belfast, Belfast, Northern Ireland
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28
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Taylor RS, Watt A, Dalal HM, Evans PH, Campbell JL, Read KLQ, Mourant AJ, Wingham J, Thompson DR, Pereira Gray DJ. Home-based cardiac rehabilitation versus hospital-based rehabilitation: A cost effectiveness analysis. Int J Cardiol 2007; 119:196-201. [PMID: 17084927 DOI: 10.1016/j.ijcard.2006.07.218] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2006] [Revised: 07/21/2006] [Accepted: 07/29/2006] [Indexed: 11/20/2022]
Abstract
BACKGROUND Home-based cardiac rehabilitation offers an alternative to traditional, hospital-based cardiac rehabilitation. AIM To compare the cost effectiveness of home-based cardiac rehabilitation and hospital-based cardiac rehabilitation. METHODS 104 patients with an uncomplicated acute myocardial infarction and without major comorbidity were randomized to receive home-based rehabilitation (n=60) i.e. nurse facilitated, self-help package of 6 weeks' duration (the Heart Manual) or hospital-based rehabilitation for 8-10 weeks (n=44). Complete economic data were available in 80 patients (48 who received home-based rehabilitation and 32 who received hospital-based rehabilitation). Healthcare costs, patient costs, and quality of life (EQ-5D4.13) were assessed over the 9 months of the study. RESULTS The cost of running the home-based rehabilitation programme was slightly lower than that of the hospital-based programme (mean (95% confidence interval) difference - 30 pounds sterling (- 45 pounds sterling to - 12 pounds sterling) [-44 euro, -67 euro to -18 euro] per patient. The cost difference was largely the result of reduced personnel costs. Over the 9 months of the study, no significant difference was seen between the two groups in overall healthcare costs (78 pounds sterling, - 1102 pounds sterling to 1191 pounds sterling [-115 euro, -1631 euro to -1763 euro] per patient) or quality adjusted life-years (-0.06 (-0.15 to 0.02)). The lack of significant difference between home-based rehabilitation and hospital-based rehabilitation did not alter when different costs and different methods of analysis were used. CONCLUSIONS The health gain and total healthcare costs of the present hospital-based and home-based cardiac rehabilitation programmes for patients after myocardial infarction appear to be similar. These initial results require affirmation by further economic evaluations of cardiac rehabilitation in different settings.
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29
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Dalal HM, Evans PH, Campbell JL, Taylor RS, Watt A, Read KLQ, Mourant AJ, Wingham J, Thompson DR, Pereira Gray DJ. Home-based versus hospital-based rehabilitation after myocardial infarction: A randomized trial with preference arms--Cornwall Heart Attack Rehabilitation Management Study (CHARMS). Int J Cardiol 2006; 119:202-11. [PMID: 17196274 DOI: 10.1016/j.ijcard.2006.11.018] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Revised: 10/06/2006] [Accepted: 11/02/2006] [Indexed: 11/29/2022]
Abstract
BACKGROUND Participation in cardiac rehabilitation after acute myocardial infarction is sub-optimal. Offering home-based rehabilitation may improve uptake. We report the first randomized study of cardiac rehabilitation to include patient preference. AIM To compare the clinical effectiveness of a home-based rehabilitation with hospital-based rehabilitation after myocardial infarction and to determine whether patient choice affects clinical outcomes. DESIGN Pragmatic randomized controlled trial with patient preference arms. SETTING Rural South West England. METHODS Patients admitted with uncomplicated myocardial infarction were offered hospital-based rehabilitation classes over 8-10 weeks or a self-help package of six weeks' duration (the Heart Manual) supported by a nurse. Primary outcomes at 9 months were mean depression and anxiety scores on the Hospital Anxiety Depression scale, quality of life after myocardial infarction (MacNew) score and serum total cholesterol. RESULTS Of the 230 patients who agreed to participate, 104 (45%) consented to randomization and 126 (55%) chose their rehabilitation programme. Nine month follow-up data were available for 84/104 (81%) randomized and 100/126 (79%) preference patients. At follow-up no difference was seen in the change in mean depression scores between the randomized home and hospital-based groups (mean difference: 0; 95% confidence interval, -1.12 to 1.12) nor mean anxiety score (-0.07; -1.42 to 1.28), mean global MacNew score (0.14; -0.35 to 0.62) and mean total cholesterol levels (-0.18; -0.62 to 0.27). Neither were there any significant differences in outcomes between the preference groups. CONCLUSIONS Home-based cardiac rehabilitation with the Heart Manual was as effective as hospital-based rehabilitation for patients after myocardial infarction. Choosing a rehabilitation programme did not significantly affect clinical outcomes.
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Affiliation(s)
- H M Dalal
- Royal Cornwall Hospital, Truro, Cornwall, UK.
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30
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Meneses-Lorente G, Watt A, Salim K, Gaskell SJ, Muniappa N, Lawrence J, Guest PC. Identification of early proteomic markers for hepatic steatosis. Chem Res Toxicol 2006; 19:986-98. [PMID: 16918237 DOI: 10.1021/tx060007f] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The identification of biomarkers for disease state, drug efficacy, and toxicity is becoming increasingly important for drug discovery and development. We have used two-dimensional differential in-gel electrophoresis and mass spectrometry to identify proteomic markers associated with hepatocellular steatosis in rats after dosing with a compound (CDA) in preclinical development. Rats were dosed daily for up to 5 days with CDA for measurement of blood biochemical parameters, histological, and proteomic analysis. Alterations in plasma glucose and liver transaminases were detected from dosing day 3 onward, and livers showed trace levels of hepatocellular vacuolation from 6 h which increased in extent and severity over the 5 day time course. The number of significantly altered protein spots increased over the 5 day time course, and Ingenuity Pathway Analysis showed that the predominant functions altered by CDA treatment were cell death and cellular assembly and organization. This included alterations in secreted proteins, endoplasmic reticulum and mitochondrial chaperones, antioxidant proteins, and enzymes involved in fatty acid biosynthesis. Comparative in vitro dosing studies showed similar alterations to the proteome, neutral lipid accumulation, and mitochondrial dehydrogenase activity in response to CDA treatment of cultured rat hepatocytes. The finding that several proteins showed significant changes in abundance before the onset of overt toxicity in vivo suggested that these could serve as predictive biomarkers of compounds with a propensity to induce liver steatosis. These markers underwent further direct analysis in the in vitro hepatocyte toxicity model to determine their utility in the development of high throughput assays for drug-induced steatosis.
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Affiliation(s)
- G Meneses-Lorente
- Merck Sharp & Dohme Neuroscience Research Centre, Terlings Park, Harlow, Essex, CM20 2QR, United Kingdom.
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Grosset KA, Grosset DG, Macphee G, Pal G, Stewart D, Watt A, Davie J. Dopamine agonists and pathological gambling. Parkinsonism Relat Disord 2006; 13:259; author reply 260. [PMID: 17049451 DOI: 10.1016/j.parkreldis.2006.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Accepted: 08/04/2006] [Indexed: 11/26/2022]
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Abstract
AIMS To assess the spontaneous resolution of neonatal nephrocalcinosis and its long term effects on renal function. METHODS Fourteen very low birthweight preterm babies with nephrocalcinosis were followed up at 5-7 years of age; 14 controls were matched for sex, gestation, and birth weight. Height, weight, blood pressure, and renal symptomatology were recorded, and a renal ultrasound scan was performed. Early morning urine osmolality and creatinine ratios of albumin, phosphate, calcium, oxalate and beta microglobulin were determined. Urea and electrolytes in the study group were determined, and glomerular filtration rate (GFR) and TmP/GFR (tubular reabsorption of phosphate per GFR) were calculated. Statistical analysis was performed on a group basis using the Mann-Whitney confidence interval. RESULTS Mean age was 6.9 years (range 5.81-7.68). An early morning urine osmolality >700 mOsm/kg was achieved in all cases. In two cases and four controls, the calcium/creatinine ratio was >0.7 mmol/mmol. In all cases, the GFR was normal (median 132.6 ml/min/1.73 m(2) (range 104.1-173.1)). Median TmP/GFR was 1.22 mmol/l (0.73-1.61), with two having levels below the normal range. These did not have persisting nephrocalcinosis. Nephrocalcinosis was found in three of the 12 cases scanned and one control. There were no significant differences in urine biochemistry. CONCLUSIONS Resolution of nephrocalcinosis occurred in 75% of cases. No evidence was found to suggest that nephrocalcinosis is associated with renal dysfunction in the long term. There was evidence of hypercalciuria in the cases and controls, suggesting that prematurity may be a risk factor.
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Affiliation(s)
- E Porter
- Southern General Hospital, Govan Road, Govan, Glasgow G51 4TF, Scotland, UK.
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Affiliation(s)
- U Theilen
- Royal Hospital for Sick Children, 1 Sciennes Road, Edinburgh EH9 1LF, Scotland, UK.
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Abstract
Recent evidence indicates that there are significant numbers of cases of malignant melanoma in the UK. In order to assess the current position with regard to sun awareness in Cornwall, a questionnaire survey of all state primary school heads (n = 123) and a survey of a random sample of GP practices (n = 9) was carried out. The data obtained were supported by visits to libraries and Tourist Information Centres at urban and rural centres--this enabled the identification of sun awareness literature. Key health professionals who worked within the field of health promotion were also contacted. The findings showed that in Cornwall public campaigns organized around the issue of sun protection took place only sporadically, although GP surgeries usually organize a display at the appropriate time of the year. None of the public places (e.g. Tourist Information Centres, libraries) surveyed had sun protection messages on display. It is concluded that insufficient sun awareness initiatives were being undertaken in Cornwall. Although most primary schools included sun awareness education in their curriculum in a form based on the Sun Awareness Guidelines produced by the Department of Health in 1995, few schools considered further measures to protect pupils on hot and sunny days. In particular the provision of shade, the scheduling of outdoor activities and the use of sunscreen and protective clothing were not standard.
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Affiliation(s)
- J M Morris
- Faculty of Health and Social Work, University of Plymouth, Truro, Cornwall, UK.
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Rupniak NMJ, Fisher A, Boyce S, Clarke D, Pike A, O'Connor D, Watt A. P-Glycoprotein efflux reduces the brain concentration of the substance P (NK1 receptor) antagonists SR140333 and GR205171: a comparative study using mdr1a-/- and mdr1a+/+ mice. Behav Pharmacol 2004; 14:457-63. [PMID: 14501258 DOI: 10.1097/01.fbp.0000087734.21047.ae] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Investigation of the antidepressant-like actions of substance P (NK1 receptor) antagonists has been hindered by the few available compounds that bind with high affinity to the rat and mouse NK1 receptor, as these are the most commonly used preclinical species. The best available compounds for such studies are SR140333 and GR205171. However, SR140333 does not penetrate the central nervous system (CNS) after systemic administration, and GR205171 is active only at high doses, where unspecific pharmacological effects occur, so that changes in behaviour cannot be attributed to selective NK1 receptor blockade. These compounds may be substrates for P-glycoprotein (P-gp) and hence are actively excluded from the brain. The present studies used mdr1a-/- mice, a spontaneously occurring mutant that is deficient in P-gp, to examine the CNS penetration of SR140333 and GR205171. Following systemic administration of SR140333 and GR205171 (0.01-10 mg/kg i.v.), considerably higher drug concentrations were achieved in the brains of mdr1a-/- than in mdr1a+/+ mice, and this corresponded with a greater ability to inhibit NK1-agonist-induced behaviours in the mdr1a-/- mutants. Moreover, an NK1-receptor-specific inhibition of aggressive behaviour by GR205171 (10 mg/kg) could be demonstrated in mdr1a-/-, but not mdr1a+/+, mice. These findings suggest that P-gp deficient mice may have useful applications in behavioural pharmacology studies, especially when highly brain-penetrant compounds are not yet available.
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Affiliation(s)
- N M J Rupniak
- Department of Pharmacology, Merck Sharp and Dohme Research Laboratories, Neuroscience Research Centre, Harlow, Essex, UK.
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Pravinkumar E, Watt A, Cuthbertson B, Galley H, Webster N. Crit Care 2004; 8:P108. [DOI: 10.1186/cc2575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Walker GM, Kasem KF, O'Toole SJ, Watt A, Skeoch CH, Davis CF. Early perfluorodecalin lung distension in infants with congenital diaphragmatic hernia. J Pediatr Surg 2003; 38:17-20; discussion 17-20. [PMID: 12592611 DOI: 10.1053/jpsu.2003.50002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE Pulmonary hypoplasia contributes to mortality in infants with severe congenital diaphragmatic hernia (CDH). Accelerated postnatal lung growth with perfluorocarbon lung distension has been demonstrated in animals. The authors present a study measuring perfluorodecalin distension in neonates with severe CDH on extracorporeal membrane oxygenation (ECMO) support. METHODS Six consecutive neonates with CDH requiring ECMO support were recruited. The lungs were filled with perfluorodecalin, and continuous positive airway pressure was applied for 6 to 10 days (mean, 7.7 days +/- 0.7). The perfluorodecalin was exchanged 4 times a day. Radiographic lung projections were measured, and from 2-dimensional measurements an estimated lung volume was calculated using the ECMO cannula as reference. RESULTS Perfluorodecalin instillation started soon after starting ECMO support (mean, 13.5 +/- 5.3 hours). The volume required to fill the lungs increased significantly (P <.02). The radiographic dimension of the affected lung increased significantly (mean percentage increase, 272%; P <.02). The contralateral lung dimension also increased (mean percentage increase 51%; P <.02). CDH repair was undertaken on ECMO in all cases. All patients survived (follow-up, 3 to 42 months). CONCLUSIONS This protocol of early perfluorodecalin lung distension in infants with severe CDH on ECMO support resulted in significant radiographic lung enlargement. Clinical outcomes are encouraging. Possible mechanisms include alveolar recruitment, alveolar dilatation, and accelerated postnatal lung growth.
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Affiliation(s)
- G M Walker
- Department of Surgical Paediatrics, Royal Hospital for Sick Children, Yorkhill NHS Trust, Glasgow, Scotland
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Abstract
AIM To assess the role of follow-up imaging in paediatric blunt abdominal trauma. METHOD All children who underwent CT scanning of their abdomen at our institution following acute blunt injury between January 1997 and December 2000 were included in the study. Case notes where researched for details regarding mechanism of injury, initial clinical presentation, acute management, complications and follow-up until discharge. Reports of imaging investigations were retrieved from the RIS database. RESULTS In the study period 75 children underwent CT scanning of their abdomen as a primary investigation for acute blunt abdominal trauma. Of these, 12 were normal, 52 showed evidence of intra-abdominal organ injury and 11 showed findings other than abdominal organ injury. Of the 52 children that sustained intra-abdominal organ injury, 48 (92 percent) were treated conservatively. 4 (8 percent) underwent emergency surgery, 3 for bowel injury and 1 for renal trauma. Of the 48 that were treated conservatively, 9 had a complicated clinical course with 7 showing complications on follow-up imaging. The remaining 39 children had an uneventful clinical course with follow-up imaging by CT or US in 34. None showed complications that required a change in management. CONCLUSION In our series, follow-up imaging did not contribute to further management in children with an uncomplicated clinical course following blunt abdominal trauma.
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Affiliation(s)
- A Mizzi
- The Royal Hospital for Sick Children, Glasgow, UK
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Raymond B, Vanbergen A, Watt A, Hartley SE, Cory JS, Hails RS. Escape from pupal predation as a potential cause of outbreaks of the winter moth, Operophtera brumata. OIKOS 2002. [DOI: 10.1034/j.1600-0706.2002.980204.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Karras JG, Maier MA, Lu T, Watt A, Manoharan M. Peptide nucleic acids are potent modulators of endogenous pre-mRNA splicing of the murine interleukin-5 receptor-alpha chain. Biochemistry 2001; 40:7853-9. [PMID: 11425312 DOI: 10.1021/bi010263l] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Antisense oligonucleotides (ASOs) that bind target pre-mRNA with high affinity have been shown to alter splicing patterns and offer promise as therapeutics. Previous studies have shown that ASOs fully modified with 2'-O-methoxyethyl (2'-O-MOE) sugar residues redirect constitutive and alternative splicing of the murine interleukin-5 receptor-alpha (IL-5Ralpha) chain pre-mRNA in cells, resulting in inhibition of the membrane-bound isoform and enhanced expression of the soluble isoform. Here, we show that antisense peptide nucleic acids (PNAs) alter splicing of the IL-5Ralpha pre-mRNA in a fashion similar to their 2'-O-MOE-modified counterparts of the same sequence. Moreover, using PNA as the splicing modulator, the length of the antisense oligomer could be shortened from 20 to 15 nucleobase units to obtain a comparable effect. Treatment of cells with antisense PNA resulted in dose-dependent, specific downregulation of IL-5Ralpha membrane isoform mRNA expression and enhanced levels of the soluble IL-5Ralpha isoform transcript, with an EC50 equivalent to that observed in parallel with the corresponding 2'-O-MOE ASO. The pronounced activity of antisense PNAs in modulating IL-5Ralpha mRNA splicing observed in our study identifies these compounds as a promising new class of lower molecular weight splicing modulators.
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Affiliation(s)
- J G Karras
- Department of Molecular and Cellular Pharmacology, ISIS Pharmaceuticals, Incorporated, 2292 Faraday Avenue, Carlsbad, California 92008, USA
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Watt A. Caring for patients with phantom limb sensation. Prof Nurse 2001; 16:1350-3. [PMID: 12026828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Phantom limb pain is increasingly perceived as a complex condition that is likely to have multifactorial causes. Although acknowledgement of the existence of the condition is more prevalent than it was, its treatment remains elusive. Nurses caring for people with phantom limb pain have a unique role to play in the overall holistic therapy of the amputee.
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Affiliation(s)
- A Watt
- Department of Nursing Studies, University of Edinburgh
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Cole BJ, Watt A, Whitehead RR. Shell-model calculations in the sd shell. II. Mass excesses and energy spectra of exotic nuclei. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0305-4470/7/12/004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Affiliation(s)
- A Watt
- Neuroscience Research Centre, Merck, Sharpe and Dohme Research Laboratories, Eastwick Rd, Harlow, CM20 2QR, Essex, UK
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Abstract
OBJECTIVE to obtain intervention-condition-specific investment and disinvestment recommendations which optimise the potential for health gain from existing respiratory diseases resource expenditure; and to trial a health economics technique for this purpose, assessing its usefulness as a means of prioritising health services resource allocation. DESIGN a programme budgeting and marginal analysis (PBMA) exercise drawing upon the expertise of an advisory group of clinicians, managers and consumer advocates, supported by health authority staff. SETTING the Southern and Midland health regions in New Zealand which have populations of one million and seven hundred thousand respectively. HEALTH SYSTEM CONTEXT: publicly funded secondary care sector in which regional health authority (RHA) purchasers contract for services with health care providers. METHODS available evidence on the marginal costs and benefits of services for respiratory diseases was examined by an advisory group who produced investment and disinvestment recommendations by consensus using agreed prioritisation criteria. RESULTS A list of specific investment and disinvestment proposals. Implementation plans for a number of investments formed part of the business plans for both RHAs in 1997/1998. No disinvestments were planned. CONCLUSIONS prioritisation methods like PBMA, which are explicit and rational, can produce defensible evidence-based recommendations with the additional benefit of the credibility and support of an expert advisory group. The process encourages co-operative working and may itself have enduring benefits. However, preparation and conduct of such exercises is resource intensive and requires careful planning. This exercise has provided valuable lessons for the conduct of future prioritisation work.
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Affiliation(s)
- P Bohmer
- Southern Regional Health Authority, P.O. Box 3877, Christchurch, New Zealand.
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Abstract
BACKGROUND The present study was designed to investigate the feasibility of using the corpus cavernosum as an alternative means of intravenous access in the emergency setting. METHODS The feasibility of achieving the infusion flow rates was first ascertained using direct intracavernous infusion of normal saline. The effect of atropine and adrenaline when given via this route was then studied. Hypovolaemic shock was then induced in dogs who were then actively resuscitated via this route using normal saline, Haemaccel and whole blood. RESULTS Infusion flow rates were achieved for normal saline of 32.3, 50.3 and 67.3 mL per min at 100, 200 and 300 mmHg pressure, respectively. The peak effects of atropine and adrenaline via this route were seen at approximately 1 min after injection. Resuscitation using this method was uniformly successful in all dogs via the corpus cavernosum, with all reaching or exceeding their premorbid central venous pressure (CVP), and approaching or reaching their premorbid mean arterial pressure (MAP). In comparison the control dog's CVP and MAP did not rise during the period of observation after it was bled. CONCLUSIONS The corpus cavernosum is a practical alternative means of intravenous access in the emergency setting in the dog model.
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Affiliation(s)
- D Nicol
- Department of Surgery, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia
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Abstract
Graded compression stockings are commonly used to prevent deep-vein thrombosis (DVT) after stroke, but their efficacy in this setting has not been evaluated. Extrapolation of effectiveness from trials in patients undergoing elective surgery may be inappropriate. We undertook a randomized, controlled trial, with blinded data review, in a University hospital Acute Stroke Unit. Patients were allocated to graded compression stockings or to standard care alone. DVT incidence was determined at baseline and at day 7+/-2 by colour-flow Doppler ultrasound. Ninety-eight patients with acute, immobilizing stroke were randomized; 97 had full outcome data. One patient had clinically manifest DVT, and no patient had pulmonary thromboembolism. DVT was detected in 7/65 patients allocated stockings, and 7/32 controls (odds ratio 0.43, 95% CI 0.14-1.36); DVT involving femoral veins was detected in 3/65 and 2/32. In the first week after stroke, radiologically-detected DVT remains common, but is usually clinically silent. Proximal DVT is less common. Graded compression stockings produced a reduction in DVT incidence comparable to that in other patient groups, but the reduction was not statistically significant, and the magnitude of effect size requires confirmation. There is greater doubt over efficacy in early prevention of proximal DVT.
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Affiliation(s)
- K W Muir
- Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK.
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Billon N, Carlisi D, Datto MB, van Grunsven LA, Watt A, Wang XF, Rudkin BB. Cooperation of Sp1 and p300 in the induction of the CDK inhibitor p21WAF1/CIP1 during NGF-mediated neuronal differentiation. Oncogene 1999; 18:2872-82. [PMID: 10362258 DOI: 10.1038/sj.onc.1202712] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Addition of nerve growth factor (NGF) to PC12 cells promotes neuronal differentiation while inhibiting cell proliferation. In order to understand how NGF exerts its antimitogenic effect during differentiation, we have studied the mechanism by which this factor activates the promoter of the CDK inhibitor p21W4F1/CIP1. The minimal region of the p21 promoter required for the NGF-induction was mapped to a contiguous stretch of 10 bp located 83 bases upstream of the transcription initiation site. This GC-rich region was shown to interact specifically with the transcription factor Sp1 and the related protein Sp3, in either exponentially-growing or NGF-treated PC12 cells. The addition of NGF resulted in an accumulation of the transcriptional co-activator p300 in complexes associated with the NGF-responsive region. Transcriptional activity of Sp1, Sp3 and p300 was specifically induced by NGF in a Gal4-fusion assay, indicating that induction of p21 during neuronal differentiation may involve regulation of the activity of these factors by NGF. Furthermore, p300 was able to act as a co-activator for Sp1-mediated transcriptional activation in PC12 cells, suggesting that p300 and Sp1 may cooperate in activating p21 transcription during the withdrawal of neuronal precursors from the cell cycle. This hypothesis is supported by experiments showing that p300 and Sp1 form complexes in PC12 cells.
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Affiliation(s)
- N Billon
- Differentiation & Cell Cycle Group, Laboratoire de Biologie Moleculaire et Cellulaire, UMR 49 CNRS/Ecole Normale Supérieure de Lyon, France
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50
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