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Ssemmondo E, Deshmukh H, Wilmot EG, Adeleke KA, Shah N, Walton C, Barnes D, Ryder REJ, Sathyapalan T. Effect of intermittently scanned continuous glucose monitoring in people with diabetes with a psychosocial indication for initiation. Diabetes Obes Metab 2024; 26:1340-1345. [PMID: 38228571 DOI: 10.1111/dom.15435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 01/18/2024]
Abstract
AIM To understand the effect of intermittently scanned continuous glucose monitoring (isCGM) in people with diabetes with a 'psychosocial' indication for access. METHODS The study utilized baseline and follow-up data from the Association of British Clinical Diabetologists nationwide audit of people with diabetes in the UK. Diabetes-related distress (DRD) was assessed using the two-item diabetes-related distress scale (DDS). Participants were categorized into two groups: high DRD (DDS score ≥ 3) and lower DRD (DDS score < 3). The t-test was used to assess the difference in the pre- and post-isCGM continuous variables. RESULTS The study consisted of 17 036 people with diabetes, with 1314 (7%) using isCGM for 'psychosocial' reasons. Follow-up data were available for 327 participants, 322 (99%) of whom had type 1 diabetes with a median diabetes duration of 15 years; 75% (n = 241) had high levels of DRD. With the initiation of isCGM, after a mean follow-up period of 6.9 months, there was a significant reduction in DDS score; 4 at baseline versus 2.5 at follow-up (P < .001). The prevalence of high DRD reduced from 76% to 38% at follow-up (50% reduction in DRD, P < .001). There was also a significant reduction in HbA1c (78.5 mmol/mol [9.3%] at baseline vs. 66.5 mmol/mol [8.2%] at follow-up; P < .001). This group also experienced an 87% reduction in hospital admissions because of hyperglycaemia/diabetic ketoacidosis (P < .001). CONCLUSION People with diabetes who had isCGM initiated for a psychosocial indication had high levels of DRD and HbA1c, which improved with the use of isCGM.
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Affiliation(s)
- Emmanuel Ssemmondo
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Harshal Deshmukh
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Emma G Wilmot
- University Hospitals of Derby & Burton NHS FT, Derby, UK
- University of Nottingham, Nottingham, UK
| | - Kazeem A Adeleke
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Najeeb Shah
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Chris Walton
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | | | | | - Thozhukat Sathyapalan
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
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Deshmukh H, Adeleke K, Wilmot EG, Folwell A, Barnes D, Walker N, Saunders S, Ssemmondo E, Walton C, Patmore J, Ryder REJ, Sathyapalan T. Clinical features of type 1 diabetes in older adults and the impact of intermittently scanned continuous glucose monitoring: An Association of British Clinical Diabetologists (ABCD) study. Diabetes Obes Metab 2024; 26:1333-1339. [PMID: 38164758 DOI: 10.1111/dom.15434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
AIMS To evaluate the clinical features and impact of flash glucose monitoring in older adults with type 1 diabetes (T1D) across age groups defined as young-old, middle-old, and old-old. MATERIALS AND METHODS Clinicians were invited to submit anonymized intermittently scanned continuous glucose monitoring (isCGM) user data to a secure web-based tool within the National Health Service secure network. We collected baseline data before isCGM initiation, such as demographics, glycated haemoglobin (HbA1c) values from the previous 12 months, Gold scores and Diabetes Distress Scale (DDS2) scores. For analysis, people with diabetes were classified as young-old (65-75 years), middle-old (>75-85 years) and old-old (>85 years). We compared baseline clinical characteristics across the age categories using a t test. All the analyses were performed in R 4.1.2. RESULTS The study involved 1171 people with diabetes in the young-old group, 374 in the middle-old group, and 47 in the old-old group. There were no significant differences in baseline HbA1c and DDS2 scores among the young-old, middle-old, and old-old age groups. However, Gold score increased with age (3.20 [±1.91] in the young-old vs. 3.46 [±1.94] in the middle-old vs. 4.05 [±2.28] in the old-old group; p < 0.0001). This study showed reduced uptake of insulin pumps (p = 0.005) and structured education (Dose Adjustment For Normal Eating [DAFNE] course; p = 0.007) in the middle-old and old-old populations compared to the young-old population with T1D. With median isCGM use of 7 months, there was a significant improvement in HbA1c in the young-old (p < 0.001) and old-old groups, but not in the middle-old group. Diabetes-related distress score (measured by the DDS2) improved in all three age groups (p < 0.001) and Gold score improved (p < 0.001) in the young-old and old-old populations but not in the middle-old population. There was also a significant improvement in resource utilization across the three age categories following the use of is CGM. CONCLUSION This study demonstrated significant differences in hypoglycaemia awareness and insulin pump use across the older age groups of adults with T1D. The implementation of isCGM demonstrated significant improvements in HbA1c, diabetes-related distress, hypoglycaemia unawareness, and resource utilization in older adults with T1D.
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Affiliation(s)
- Harshal Deshmukh
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Kazeem Adeleke
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Emma G Wilmot
- University Hospitals of Derby & Burton NHS FT, Derby, UK
- University of Nottingham, Nottingham, UK
| | - Anna Folwell
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | | | - Neil Walker
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Simon Saunders
- Mersey and West Lancashire Teaching Hospitals NHS Trust, Rainhill, UK
| | - Emmanuel Ssemmondo
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Chris Walton
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Jane Patmore
- Allam Diabetes Centre, University of Hull, Hull, UK
| | | | - Thozhukat Sathyapalan
- Allam Diabetes Centre, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
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Mark-Wagstaff C, Deshmukh H, Wilmot EG, Walker N, Barnes D, Parfitt V, Saunders S, Gregory R, Choudhary P, Patmore J, Walton C, Ryder REJ, Sathyapalan T. Intermittently scanned continuous glucose monitoring and hypoglycaemia awareness in drivers with diabetes: Insights from the Association of British Clinical Diabetologists Nationwide audit. Diabetes Obes Metab 2024; 26:46-53. [PMID: 37718554 DOI: 10.1111/dom.15283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023]
Abstract
AIM Frequent hypoglycaemia results in disruption to usual hypoglycaemic autonomic responses leading to impaired awareness of hypoglycaemia, which is associated with an increased risk of severe hypoglycaemia requiring third-party assistance (SH). The UK Driving and Vehicle Licensing Agency (DVLA) does not permit car driving if they have either a complete loss of hypoglycaemia awareness or more than one SH event a year. METHODS The FreeStyle Libre (FSL) Association of British Clinical Diabetologists (ABCD) Nationwide Audit consists of data collected by clinicians during routine clinical work, submitted into a secure web-based tool held within the National Health Service (NHS) N3 network. Analysis of paired baseline and follow-up data for people with type 1 diabetes who also held a driving licence was undertaken. RESULTS The study consisted of 6304 people who had data recorded about driving status from 102 UK specialist diabetes centres, of which 4218 held a driving licence: 4178 a group 1, standard licence, 33 a group 2, large lorries and buses, seven a taxi licence; 1819 did not drive. Paired baseline and follow-up data were available for a sub-cohort of 1606/4218. At a mean follow-up of 6.9 months [95% CI (6.8, 7.1)], the Gold score had improved (2.3 ± 1.5 vs. 2.0 ± 1.3 p < .001), and the number of people who experienced an SH episode was also significantly lower (12.1% vs. 2.7%, p < .001). CONCLUSION This study suggests that intermittently scanned continuous glucose monitoring may improve impaired awareness of hypoglycaemia and reduce the number of people with type 1 diabetes with a driving licence experiencing a severe hypoglycaemic episode.
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Affiliation(s)
| | - Harshal Deshmukh
- Hull University Teaching Hospitals NHS Trust, Hull, UK
- University of Hull, Hull, UK
| | - Emma G Wilmot
- University of Nottingham, Nottingham, UK
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Neil Walker
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Dennis Barnes
- Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK
| | | | | | - Rob Gregory
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Jane Patmore
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Chris Walton
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Robert E J Ryder
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Thomas J, Chen Q, Malas J, Barnes D, Peiris A, Premananthan C, Krishnan A, Rowe G, Gill G, Emerson D, Rampolla R, Chikwe J, Catarino P, Megna D. Minimally Invasive Lung Transplantation Improves Post-Operative Pulmonary Function and Reduces Opiate Requirements. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1512] [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: 04/05/2023] Open
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5
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Martin D, Barnes D, Marte L, Rhoades J, Rampolla R, Zaffiri L. Lung Transplant Outcomes in Hiv-Infected Patients: A Single Center Case Series. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1094] [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: 04/05/2023] Open
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6
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Deshmukh H, Adeleke KA, Ssemmondo E, Wilmot EG, Shah N, Pieri B, Gregory R, Kilvert A, Lumb A, Christian P, Barnes D, Patmore J, Walton C, Ryder REJ, Sathyapalan T. Ethnic disparities in people accessing Free-Style Libre in the United Kingdom: Insights from the Association of British Clinical Diabetologists audit. Diabet Med 2023:e15095. [PMID: 36995354 DOI: 10.1111/dme.15095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/15/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023]
Affiliation(s)
- Harshal Deshmukh
- Allam Diabetes Center, University of Hull UK
- Hull University teaching hospitals NHS trust, UK
| | - Kazeem A Adeleke
- Allam Diabetes Center, University of Hull UK
- Hull University teaching hospitals NHS trust, UK
| | - Emmanuel Ssemmondo
- Allam Diabetes Center, University of Hull UK
- Hull University teaching hospitals NHS trust, UK
| | - Emma G Wilmot
- University Hospitals of Derby & Burton
- University of Nottingham
| | - Najeeb Shah
- Allam Diabetes Center, University of Hull UK
- Hull University teaching hospitals NHS trust, UK
| | - Beatrice Pieri
- Allam Diabetes Center, University of Hull UK
- Hull University teaching hospitals NHS trust, UK
| | | | - Anne Kilvert
- Northampton General Hospital NHS Trust, Northampton, U.K
| | | | | | | | - Jane Patmore
- Hull University teaching hospitals NHS trust, UK
| | - Chris Walton
- Hull University teaching hospitals NHS trust, UK
| | | | - Thozhukat Sathyapalan
- Allam Diabetes Center, University of Hull UK
- Hull University teaching hospitals NHS trust, UK
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Goodall RJ, Roberts J, Correia MD, Frew Q, Barnes D, Dziewulski P, Shelley O, El-Muttardi N. Management of purpura fulminans skin loss at a regional burns centre: Sixteen-year experience. J Plast Reconstr Aesthet Surg 2023; 79:23-29. [PMID: 36842284 DOI: 10.1016/j.bjps.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 08/18/2022] [Accepted: 01/29/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Purpura fulminans (PF) is a rare syndrome of cutaneous purpura which is the consequence of severe circulatory shock causing intravascular thrombosis, haemorrhagic necrosis, and consequent tissue loss. The aim of this study was to present our 16-year experience of managing PF in a regional burns centre. METHODS We performed a single-centre retrospective case series of all patients admitted to the St Andrews Burns Centre at Broomfield Hospital, Chelmsford, Essex, UK, between June 2006 and July 2022 with a diagnosis of PF. Data were extracted by retrospectively searching hospital case notes. RESULTS Thirteen individuals were identified [five children (mean age 5, range 1-14) and eight adults (mean age 39, range 24-54)]. The total body surface area of cutaneous necrosis ranged from 5% to 80%, with a mean of 27.2%. Patients were treated with an established surgical sequence of total wound debridement and immediate coverage with a cadaveric allograft, followed by staged wound autografting. The mean time from disease onset to wound autografting was 37.3 days (range 20-64 days). Eight individuals (61.6%) required major amputation of at least one limb (proximal to the ankle or wrist joint). Only one mortality (of 80% total body surface area skin loss) was observed in the identified cohort. CONCLUSIONS The large body surface areas often involved in PF cases make management of these wounds well suited for burns centres, wherein established facilities and multidisciplinary teams exist that are familiar with managing large cutaneous burns. We provide a suggested algorithm to aid the management of PF.
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Affiliation(s)
- R J Goodall
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK.
| | - J Roberts
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK
| | - M D Correia
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK
| | - Q Frew
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK
| | - D Barnes
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK
| | - P Dziewulski
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK
| | - O Shelley
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK
| | - N El-Muttardi
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK
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Pieri B, Deshmukh H, Wilmot EG, Choudhary P, Shah N, Gregory R, Barnes D, Saunders S, Patmore J, Walton C, Ryder REJ, Sathyapalan T. Impaired awareness of hypoglycaemia: Prevalence and associated factors before and after FreeStyle Libre use in the Association of British Clinical Diabetologists audit. Diabetes Obes Metab 2023; 25:302-305. [PMID: 35979897 DOI: 10.1111/dom.14841] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Beatrice Pieri
- Academic Diabetes and Endocrinology, Hull University Teaching Hospitals NHS Trust, Hull, UK
- York Hospitals NHS Foundation Trust, York, UK
| | - Harshal Deshmukh
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Emma G Wilmot
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Najeeb Shah
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | | | - Dennis Barnes
- Department of Diabetes and Endocrinology, Tunbridge Wells Hospital, Royal Tunbridge Wells, UK
| | - Simon Saunders
- Warrington and Halton Hospitals NHS Foundation Trust, Warrington, UK
| | - Jane Patmore
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Chris Walton
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Robert E J Ryder
- Department of Diabetes, Sandwell and West Birmingham Hospitals NHS Trust, West Midlands, UK
| | - Thozhukat Sathyapalan
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
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9
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Deshmukh H, Wilmot E, Pieri B, Choudhary P, Shah N, Gregory R, Kilvert A, Lumb A, Christian P, Barnes D, Patmore J, Walton C, Ryder REJ, Sathyapalan T. Time in range following flash glucose monitoring: Relationship with glycaemic control, diabetes-related distress and resource utilisation in the Association of British Clinical Diabetologists national audit. Diabet Med 2022; 39:e14942. [PMID: 36054655 DOI: 10.1111/dme.14942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/20/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022]
Abstract
AIMS The aim of this study was to understand the relationship between time in range (TIR) achieved using the isCGM with changes in glycaemic control, diabetes-related distress (DRD) and resource utilisation in people living with diabetes. METHODS Clinicians from 106 National Health System (NHS) UK hospitals submitted isCGM user baseline and follow-up data in a web-based tool held within the UK NHS network. Linear regression analysis was used to identify the relationship between follow-up glucose TIR (3.9-10 mmol/L) categories (TIR% 50-70 and TIR% >70) with change in haemoglobin A1c (HbA1c), DRD and Gold score (measure of hypoglycaemia unawareness, where a score ≥4 suggests impaired awareness of hypoglycaemia). RESULTS Of 16,427 participants, 1241 had TIR follow-up data available. In this cohort, the mean TIR was 44.8% (±22.5). With the use of isCGM, at 7.9 months mean follow-up, improvements were observed in HbA1c (-6.9 [13.5] mmol/mol, p < 0.001), Gold score (-0.35 [1.5], p < 0.001) and Diabetes Distress Screening (-0.73 [1.23], p < 0.001). In the regression analysis restricted to people living with type 1 diabetes, TIR% 50-70 was associated with a -8.9 mmol/mol (±0.6, p < 0.001) reduction in HbA1c; TIR% >70 with a -14 mmol/mol (±0.8, p < 0.001) reduction in HbA1c. Incremental improvement in TIR% was also associated with significant improvements in Gold score and DRD. TIR% >70 was associated with no hospital admissions due to hypoglycaemia, hyperglycaemia/diabetic ketoacidosis, and a 60% reduction in the paramedic callouts and 77% reduction in the incidence of severe hypoglycaemia. CONCLUSION In a large cohort of UK isCGM users, we demonstrate a significant association of higher TIR% with improvement in HbA1c, hypoglycaemia awareness, DRD and resource utilisation.
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Affiliation(s)
- Harshal Deshmukh
- Department of Academic Diabetes and Endocrinology, University of Hull, Hull, UK
- Allam Diabetes Centre, Hull University Teaching Hospital NHS Trust, Hull, UK
| | - Emma Wilmot
- University Hospitals Derby and Burton NHS Foundation Trust, Derby, UK
- University of Nottingham, Nottingham, UK
| | - Beatrice Pieri
- Department of Academic Diabetes and Endocrinology, University of Hull, Hull, UK
- Allam Diabetes Centre, Hull University Teaching Hospital NHS Trust, Hull, UK
| | - Pratik Choudhary
- Leicester Diabetes Centre Leicester General Hospital, Leicester, UK
| | - Najeeb Shah
- Department of Academic Diabetes and Endocrinology, University of Hull, Hull, UK
- Allam Diabetes Centre, Hull University Teaching Hospital NHS Trust, Hull, UK
| | - Robert Gregory
- Leicester Diabetes Centre Leicester General Hospital, Leicester, UK
| | - Anne Kilvert
- Northampton General Hospital NHS Trust, Northampton, UK
| | - Alistair Lumb
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | - Jane Patmore
- Allam Diabetes Centre, Hull University Teaching Hospital NHS Trust, Hull, UK
| | - Chris Walton
- Allam Diabetes Centre, Hull University Teaching Hospital NHS Trust, Hull, UK
| | | | - Thozhukat Sathyapalan
- Department of Academic Diabetes and Endocrinology, University of Hull, Hull, UK
- Allam Diabetes Centre, Hull University Teaching Hospital NHS Trust, Hull, UK
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Kling T, Barnes D. 138 The Effect of Changes in Physician Shift Times and Physical Patient Coverage Areas on Resident Sign-out Burden in an Academic Emergency Department. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.162] [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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Crabtree TSJ, Adamson K, Reid H, Barnes D, Sivappriyan S, Bickerton A, Gallen IW, Field BCT, Idris I, Ryder REJ. Injectable semaglutide and reductions in HbA1c and weight in the real world in people switched from alternative glucagon-like peptide-1 receptor agonists. Diabetes Obes Metab 2022; 24:1398-1401. [PMID: 35322528 PMCID: PMC9322019 DOI: 10.1111/dom.14701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/09/2022] [Accepted: 03/22/2022] [Indexed: 11/30/2022]
Abstract
The ABCD semaglutide audit was designed to capture the routine clinical outcomes of people commenced on semaglutide in the UK. Previous work showed differential reductions in HbA1c and weight dependent on previous glucagon-like peptide-1 receptor agonist (GLP-1RA) exposure. The analysis, in this research letter, shows that decreases in HbA1c and weight associated with semaglutide occur irrespective of previous GLP-1RA use. However, HbA1c reductions were less if switched from dulaglutide or liraglutide and weight changes were attenuated if switched from dulaglutide or exenatide, potentially suggesting differing potencies between GLP-1RAs. Dedicated studies with head-to-head comparisons are needed to confirm these findings.
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Affiliation(s)
- Thomas S. J. Crabtree
- City HospitalSandwell & West Birmingham Hospitals NHS TrustBirminghamUK
- School of MedicineUniversity of NottinghamNottinghamUK
- Royal Derby HospitalUniversity Hospitals of Derby and Burton NHS TrustDerbyUK
| | | | | | | | | | | | | | - Benjamin C. T. Field
- Department of Clinical & Experimental Medicine, Faculty of Health & Medical SciencesUniversity of SurreyGuildfordUK
- Surrey & Sussex Healthcare NHS TrustGuildfordUK
| | - Iskandar Idris
- School of MedicineUniversity of NottinghamNottinghamUK
- Royal Derby HospitalUniversity Hospitals of Derby and Burton NHS TrustDerbyUK
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Barnes D, Malkhasian Y, Pyarali F, Rampolla R. Description and Characterization of Intraoperative Bacterial Cultures During Lung Transplant Surgery. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1554] [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: 10/18/2022] Open
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13
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Kim P, Olymbios M, Siu A, Pinzon O, Adler E, Liang N, Swenerton R, Sternberg J, Kaur N, Ahmed E, Butskova A, Barnes D, Fehringer G, Demko Z, Billings P, Stehlik J. Absolute Quantification of Donor Derived Cell Free DNA in Heart Transplant Patients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.270] [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] Open
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Garcia-Pertierra S, Das S, Burton C, Barnes D, Murgia D, Anderson D, Kulendra N, Harris K, Forster K. Surgical management of intrathoracic wooden skewers migrating from the stomach and duodenum in dogs: 11 cases (2014-2020). J Small Anim Pract 2022; 63:403-411. [PMID: 35083753 PMCID: PMC9303292 DOI: 10.1111/jsap.13474] [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: 07/12/2021] [Revised: 10/08/2021] [Accepted: 10/31/2021] [Indexed: 11/30/2022]
Abstract
Objectives To describe the clinical presentation, management and outcome of cases presenting with intrathoracic wooden skewers originating from the abdominal gastrointestinal tract. Materials and Methods Clinical records of dogs presented and treated for an intrathoracic wooden skewer were reviewed from June to August 2020. Data included signalment, clinical presentation, duration of clinical signs, haematological and biochemical abnormalities, diagnostic imaging findings, surgical procedure, postoperative complications and outcome. Results Eleven dogs were included in the study. In all cases, the foreign body was identified as a wooden skewer. The most common clinical signs were anorexia/hyporexia (n=7), vomiting/regurgitation (n=7), lethargy (n=6), pyrexia (n=4) and gait abnormalities/lameness (n=3). CT correctly identified a wooden skewer in all cases when performed (n=7). A coeliotomy combined with transdiaphragmatic thoracotomy was performed in six of 11 cases (55%), a coeliotomy combined with median sternotomy in four of 11 cases (36%) and a median sternotomy alone was performed in one case. Foreign bodies penetrated from the stomach (n=10) or the duodenum (n=1). Intrathoracic trauma was most commonly identified to the lungs (n=3) and pericardium (n=3). Complications occurred in three of 11 cases (27%), two minor and one resulting in death. Ten of the 11 cases (91%) survived to discharge. Long‐term outcome was available for seven of 11 cases (66%), all of them excellent. Clinical Significance Despite the challenges of managing wooden skewers penetrating the thoracic cavity from the abdominal gastrointestinal tract, the majority of the patients are stable to undergo diagnostic procedures, surgical exploration and management with low morbidity and excellent short‐ and long‐term prognosis.
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Affiliation(s)
- S Garcia-Pertierra
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Midlothian, EH25 9RG, UK
| | - S Das
- Davies Veterinary Specialists, Hertfordshire, SG5 3HR, UK
| | - C Burton
- Davies Veterinary Specialists, Hertfordshire, SG5 3HR, UK
| | - D Barnes
- Dick White Referrals, Cambridge, CB8 0UH, UK
| | - D Murgia
- Dick White Referrals, Cambridge, CB8 0UH, UK
| | - D Anderson
- Anderson Moores Veterinary Specialists, Hampshire, SO21 2LL, UK
| | - N Kulendra
- North Downs Specialist Referrals, Bletchingley, RH1 4QP, UK
| | - K Harris
- Southern Counties Veterinary Specialists, Hampshire, BH24 3JW, UK
| | - K Forster
- North Downs Specialist Referrals, Bletchingley, RH1 4QP, UK
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Deshmukh H, Wilmot EG, Choudhary P, Narendran P, Shah N, Barnes D, Kamruddin S, Banatwalla R, Christian P, Saunders S, Lumb A, Herring R, Patmore J, Walton C, Ryder REJ, Sathyapalan T. Impaired Awareness of Hypoglycemia and Severe Hypoglycemia in Drivers With Diabetes: Insights From the Association of British Clinical Diabetologists Nationwide Audit. Diabetes Care 2021; 44:e190-e191. [PMID: 34526308 PMCID: PMC8546285 DOI: 10.2337/dc21-1181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/31/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Harshal Deshmukh
- Hull University Teaching Hospitals NHS Trust and University of Hull, Hull, U.K
| | - Emma G Wilmot
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, U.K.,University of Nottingham, Nottingham, U.K
| | - Pratik Choudhary
- Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
| | - Parth Narendran
- Queen Elizabeth Hospital Birmingham and University of Birmingham, Birmingham, U.K
| | - Najeeb Shah
- Hull University Teaching Hospitals NHS Trust and University of Hull, Hull, U.K
| | | | | | | | - Peter Christian
- East Kent Hospitals University NHS Foundation Trust, Canterbury, U.K
| | - Simon Saunders
- Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, U.K
| | | | | | - Jane Patmore
- Hull University Teaching Hospitals NHS Trust and University of Hull, Hull, U.K
| | - Chris Walton
- Hull University Teaching Hospitals NHS Trust and University of Hull, Hull, U.K
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Deshmukh H, Wilmot EG, Gregory R, Barnes D, Narendran P, Saunders S, Furlong N, Kamaruddin S, Banatwalla R, Herring R, Kilvert A, Patmore J, Walton C, Ryder REJ, Sathyapalan T. Predictors of diabetes-related distress before and after FreeStyle Libre-1 use: Lessons from the Association of British Clinical Diabetologists nationwide study. Diabetes Obes Metab 2021; 23:2261-2268. [PMID: 34142425 DOI: 10.1111/dom.14467] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 02/05/2023]
Abstract
AIM To identify the baseline demographic and clinical characteristics associated with diabetes-related distress (DRD) and factors associated with improvement in DRD after initiating use of the FreeStyle Libre (FSL) in people living with type 1 diabetes (T1D). METHODS The study was performed using baseline and follow-up data from the Association of British Clinical Diabetologists nationwide audit of people with diabetes who initiated use of the FSL in the United Kingdom. DRD was assessed using the two-item diabetes-related distress scale (DDS; defined as the average of the two-item score ≥3). People living with T1D were categorized into two groups: those with high DRD, defined as an average DDS score ≥3 and those with lower DRD, defined as a DDS score <3. We used a gradient-boosting machine-learning (GBM) model to identify the relative influence (RI) of baseline variables on average DDS score. RESULTS The study population consisted of 9159 patients, 96.6% of whom had T1D. The median (interquartile range [IQR]) age was 45.1 (32-56) years, 50.1% were women, the median (IQR) baseline body mass index was 26.1 (23.2-29.6) kg/m2 and the median (IQR) duration of diabetes was 20 (11-32) years. The two components of the DDS were significantly correlated (r2 = 0.73; P < 0.0001). Higher DRD was prevalent in 53% (4879/9159) of people living with T1D at baseline. In the GBM model, the top baseline variables associated with average DDS score were baseline glycated haemoglobin (HbA1c; RI = 51.1), baseline Gold score (RI = 23.3), gender (RI = 7.05) and fear of hypoglycaemia (RI = 4.96). Follow-up data were available for 3312 participants. The top factors associated with improvement in DDS score following use of the FSL were change in Gold score (RI = 28.2) and change in baseline HbA1c (RI = 19.3). CONCLUSIONS In this large UK cohort of people living with T1D, diabetes distress was prevalent and associated with higher HbA1c, impaired awareness of hypoglycaemia and female gender. Improvement in glycaemic control and hypoglycaemia unawareness with the use of the FSL was associated with improvement in DRD in people living with T1D.
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Affiliation(s)
- Harshal Deshmukh
- Hull University Teaching Hospitals NHS Trust and the University of Hull, Hull, UK
| | - Emma G Wilmot
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | | | | | - Parth Narendran
- Queen Elizabeth Hospital Birmingham and University of Birmingham, Birmingham, UK
| | - Simon Saunders
- Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, UK
| | - Niall Furlong
- St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, UK
| | | | | | | | - Anne Kilvert
- Northampton General Hospital NHS Trust, Northampton, UK
| | - Jane Patmore
- Hull University Teaching Hospitals NHS Trust and the University of Hull, Hull, UK
| | - Chris Walton
- Hull University Teaching Hospitals NHS Trust and the University of Hull, Hull, UK
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Crabtree TSJ, Bickerton A, Elliott J, Raghavan R, Barnes D, Sivappriyan S, Phillips S, Evans A, Sennik D, Rohilla A, Gallen I, Ryder REJ, - ABCDEAC. Effect of empagliflozin on albuminuria, eGFR and serum creatinine: updated results from the ABCD nationwide empagliflozin audit. Br J Diabetes 2021. [DOI: 10.15277/bjd.2021.288] [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: 11/10/2022]
Abstract
Introduction: Evidence from phase III and the EMPA-REG OUTCOME trials have demonstrated improvements in renal endpoints with empagliflozin use. The EMPA-KIDNEY trial is currently underway and is assessing whether there are benefits of empagliflozin in improving renal outcomes in people both with and without diabetes, and the mechanism has been suggested to be similar to that of ACE inhibitors with the haemodynamic effects of sodium-glucose co-transporter-2 inhibition reducing intraglomerular pressure.Aim: To assess the impacts of empagliflozin use on albuminuria and estimated glomerular filtration rate (eGFR) in a real-world UK-based audit.Methods: Data were collated via the ABCD nationwide audit programme, with analyses performed using either t-tests/ ANOVA or Wilcoxon signed rank/Kruskal–Wallis tests. Pre-specified stratified subgroup analyses by baseline eGFR and baseline albuminuria levels were also performed.Results: Our results demonstrated significant reductions in albuminuria across the population as a whole. When stratified by baseline albuminuria levels, those with microalbuminuria (30–300 μg/mg) or macroalbuminuria (>300 μg/mg) had significant improvements in urine albumin levels at 6-month (3–9-month) follow-up, with median changes of −17.7 μg/mg (p<0.0001; 95% CI −17.4 to −23.7) and 379.4 μg/mg (p=0.03; 95% CI −269.9 to −725.4), respectively. Across the population as a whole, eGFR reduced initially (at 6 months, −1.26 mL/min/1.73 m3; p<0.0001; 95% CI −0.87 to −1.64) before recovering to baseline by 24 months. When stratified by baseline eGFR, those with reduced renal function (eGFR <90) recovered quickest, with improvements in eGFR noted from baseline by 24 months.Conclusion: In this real-world analysis, the results are comparable to those in randomised controlled trials and are likely more generalisable to UK clinical practice. Unfortunately, we do not have clinical endpoints such as end-stage renal failure, renal death or dialysis as part of our dataset. Future audits could consider including these data to establish clinical as well as biochemical outcomes.
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Anderson T, Beever L, Hall J, Moores A, Llanos C, Adams R, Meakin L, Coppola M, Bowlt-Blacklock K, Holmes MA, Barnes D. Outcome following surgery to treat septic peritonitis in 95 cats in the United Kingdom. J Small Anim Pract 2021; 62:744-749. [PMID: 33999425 DOI: 10.1111/jsap.13346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To review the cause, management and outcome in cats with septic peritonitis within the United Kingdom (2008 to 2018) and to identify if previously identified prognostic factors were associated with survival in this population. MATERIALS AND METHODS Clinical records from 10 referral hospitals in United Kingdom were reviewed. Data collected included signalment, clinicopathological data and management techniques. Serum albumin, glucose, lactate and ionised calcium concentration; presence of intraoperative hypotension and correct empirical antibiosis were analysed via logistic regression for association with survival. RESULTS Ninety-five cats were included. The overall survival rate was 66%. Lethargy (89%) and anorexia (75%) were the most common clinical signs, with abdominal pain and vomiting in 44% and 27% of cases, respectively. Gastro-intestinal leakage was the most common source of contamination. The presence of an abdominal mass on clinical examination was not strongly predictive of the presence of neoplasia on histology and did not confer a worse prognosis. Cats presenting with dehiscence of a previous enterotomy/enterectomy did not have a worse prognosis than those presenting with other aetologies. Intraoperative hypotension (adjusted odds ratio 0.173, 95% confidence intervals 0.034 to 0.866, P=0.033) was associated with non-survival. Cats that survived beyond 1 day postoperatively had an improved likelihood of survival (87.5%). All cats that survived beyond 6 days were successfully discharged. CLINICAL SIGNIFICANCE This study describes the largest group of cats with septic peritonitis with an overall survival rate of 66%. The presence of an abdominal mass on clinical examination or having dehiscence of a previous gastrointestinal surgery did not confer a worse prognosis.
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Affiliation(s)
- T Anderson
- Surgery Department, Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - L Beever
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hertfordshire, AL9 7TA, UK
| | - J Hall
- Surgery Department, Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK.,Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Midlothian, Edinburgh, EH25 9RG, UK
| | - A Moores
- Surgery Department, Anderson Moores Veterinary Specialists, Winchester, Hampshire, SO21 2LL, UK
| | - C Llanos
- Surgery Department, Willows Referral Service, Solihull, West Midlands, B90 4NH, UK
| | - R Adams
- Surgery Department, Northern Ireland Veterinary Specialists, Hillsborough, Co. Down, NI, BT26 6 PB, UK.,Surgery Department, Davies Veterinary Specialists, Higham Gobion, Hitchin, SG5 3HR, UK
| | - L Meakin
- Surgery Department, Langford Vets, Langford, BS40 5DU, UK
| | - M Coppola
- Surgery Department, University of Glasgow, Glasgow, G61 1QH, UK
| | - K Bowlt-Blacklock
- Surgery Department, Animal Health Trust, Newmarket, Suffolk, CB8 7UU, UK
| | - M A Holmes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - D Barnes
- Surgery Department, Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
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20
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Smith ACD, Miranda BH, Strong B, Jica RCI, Pinto-Lopes R, Khan W, Martin NA, El-Muttardi N, Barnes D, Shelley OP. St Andrew's COVID-19 surgery safety (StACS) study: The Burns Centre experience. Burns 2021; 47:1547-1555. [PMID: 33549394 PMCID: PMC7847194 DOI: 10.1016/j.burns.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/02/2021] [Accepted: 01/20/2021] [Indexed: 12/24/2022]
Abstract
Background The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has the potential to significantly impact burns patients both directly through infective complications of an immunocompromised cohort, and indirectly through disruption of care pathways and resource limitations. The pandemic presents new challenges that must be overcome to maintain patient safety; in particular, the potential increased risks of surgical intervention, anaesthesia and ventilation. This study comprehensively reviews the measures implemented to adapt referral pathways and mitigate the risk posed by COVID-19 during the height of the pandemic, within a large Burns Centre. Methods A prospective cohort study was designed to assess patients treated at the Burns Centre during the UK COVID-19 pandemic peak (April–May 2020), following implementation of new safety measures. All patients were analysed for 30-day mortality. In addition, a prospective controlled cohort study was undertaken on all inpatients and a random sample of outpatients with telephone follow-up at 30 days. These patients were divided into three groups (operative inpatients, non-operative inpatients, outpatients). COVID-19 related data collected included test results, contact with proven cases, isolation status and symptoms. The implemented departmental service COVID-19 safety adaptations are described. Results Of 323 patients treated at the Burns Centre during the study period, no 30-day COVID-19 related deaths occurred (0/323). Of the 80 patients analysed in the prospective controlled cohort section of the study, 51 underwent COVID-19 testing, 3.9% (2/51) were positive. Both cases were in the operative group, however in comparison to the non-operative and outpatient groups, there was no significant increase in COVID-19 incidence in operative patients. Conclusions We found no COVID-19 related mortality during the study period. With appropriate precautions, burns patients were not exposed to an increased COVID-19 risk. Similarly, burns patients undergoing operative management were not at a significantly increased risk of contracting COVID-19 in comparison to non-operative groups.
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Affiliation(s)
- A C D Smith
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK.
| | - B H Miranda
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - B Strong
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - R C I Jica
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - R Pinto-Lopes
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - W Khan
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - N A Martin
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK; Centre for Trauma Sciences, Queen Mary University of London, UK
| | - N El-Muttardi
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - D Barnes
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - O P Shelley
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
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21
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Phillips G, Nizamoglu M, Wakure A, Barnes D, El-Muttardi N, Dziewulski P. The Use Of Dermal Regeneration Templates For Primary Burns Surgery In A UK Regional Burns Centre. Ann Burns Fire Disasters 2020; 33:245-252. [PMID: 33304216 PMCID: PMC7680195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/09/2020] [Indexed: 06/12/2023]
Abstract
The gold standard of treatment for major burns is early burn excision and autografting. In major burns this is complicated by a lack of donor site availability. Another challenge after burn injury is achieving optimal cosmetic and functional outcomes. Dermal regeneration templates (DRT) are biomatrices that help to address these problems. Within our centre the most commonly used are two-stage Integra® and single-stage Matriderm®. We review the use and outcomes of DRT in primary burns reconstruction within our regional burns centre. All patients undergoing primary burn reconstruction using Integra® (n=59) or Matriderm® (n=35) over a 13-year period were included. Integra® was used in patients with significantly larger burns (20.4% TBSA vs 1.7% TBSA). Comparable levels of graft take were seen in both groups. Major infections were significantly higher in the Integra® group (11/35 compared to 3/59). There was no significant difference in haematoma development, hypertrophic scarring or the need for secondary reconstructive surgery. Burn contractures developed in 15 patients treated with Matriderm® and 21 with Integra®. DRT have been used safely and effectively and have played an increasingly important role in our service over the last 13 years. Integra® is used primarily in large burns with limited donor sites and Matriderm® in smaller burns in cosmetically sensitive areas.
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Affiliation(s)
- G.S.A. Phillips
- Georgina Phillips
St. Andrews Centre for Plastic Surgery and Burns, Broomfield HospitalCourt Rd, Chelmsford, CM1 7ETUnited Kingdom+44 7876744074
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Deshmukh H, Wilmot EG, Gregory R, Barnes D, Narendran P, Saunders S, Furlong N, Kamaruddin S, Banatwalla R, Herring R, Kilvert A, Patmore J, Walton C, Ryder REJ, Sathyapalan T. Effect of Flash Glucose Monitoring on Glycemic Control, Hypoglycemia, Diabetes-Related Distress, and Resource Utilization in the Association of British Clinical Diabetologists (ABCD) Nationwide Audit. Diabetes Care 2020; 43:2153-2160. [PMID: 32669277 PMCID: PMC7440900 DOI: 10.2337/dc20-0738] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/03/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The FreeStyle Libre (FSL) flash glucose-monitoring device was made available on the U.K. National Health Service (NHS) drug tariff in 2017. This study aims to explore the U.K. real-world experience of FSL and the impact on glycemic control, hypoglycemia, diabetes-related distress, and hospital admissions. RESEARCH DESIGN AND METHODS Clinicians from 102 NHS hospitals in the U.K. submitted FSL user data, collected during routine clinical care, to a secure web-based tool held within the NHS N3 network. The t and Mann-Whitney U tests were used to compare the baseline and follow-up HbA1c and other baseline demographic characteristics. Linear regression analysis was used to identify predictors of change in HbA1c following the use of FSL. Within-person variations of HbA1c were calculated using [Formula: see text]. RESULTS Data were available for 10,370 FSL users (97% with type 1 diabetes), age 38.0 (±18.8) years, 51% female, diabetes duration 16.0 (±49.9) years, and BMI of 25.2 (±16.5) kg/m2 (mean [±SD]). FSL users demonstrated a -5.2 mmol/mol change in HbA1c, reducing from 67.5 (±20.9) mmol/mol (8.3%) at baseline to 62.3 (±18.5) mmol/mol (7.8%) after 7.5 (interquartile range 3.4-7.8) months of follow-up (n = 3,182) (P < 0.0001). HbA1c reduction was greater in those with initial HbA1c ≥69.5 mmol/mol (>8.5%), reducing from 85.5 (±16.1) mmol/mol (10%) to 73.1 (±15.8) mmol/mol (8.8%) (P < 0.0001). The baseline Gold score (score for hypoglycemic unawareness) was 2.7 (±1.8) and reduced to 2.4 (±1.7) (P < 0.0001) at follow-up. A total of 53% of those with a Gold score of ≥4 at baseline had a score <4 at follow-up. FSL use was also associated with a reduction in diabetes distress (P < 0.0001). FSL use was associated with a significant reduction in paramedic callouts and hospital admissions due to hypoglycemia and hyperglycemia/diabetic ketoacidosis. CONCLUSIONS We show that the use of FSL was associated with significantly improved glycemic control and hypoglycemia awareness and a reduction in hospital admissions.
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Affiliation(s)
- Harshal Deshmukh
- Hull University Teaching Hospitals NHS Trust and University of Hull, Hull, U.K
| | - Emma G Wilmot
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, U.K
| | | | | | - Parth Narendran
- Queen Elizabeth Hospital Birmingham and University of Birmingham, Birmingham, U.K
| | - Simon Saunders
- Warrington and Halton Teaching Hospitals NHS Foundation Trust Warrington, U.K
| | - Niall Furlong
- St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, U.K
| | | | | | | | - Anne Kilvert
- Northampton General Hospital NHS Trust, Northampton, U.K
| | - Jane Patmore
- Hull University Teaching Hospitals NHS Trust and University of Hull, Hull, U.K
| | - Chris Walton
- Hull University Teaching Hospitals NHS Trust and University of Hull, Hull, U.K
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Stockbridge A, Agarwal S, Sudhir R, Perkins T, Savory S, Pinglay P, Rao P, Das I, Brozik J, Machin R, Deshpande A, Bajaj A, Barnes D, Agrawal S, Bennett J, Tufail M. Optimal lung cancer pathway implementation in a tertiary care centre and its impact on reducing emergency presentations. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30046-5] [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: 10/25/2022]
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Mazza D, Lin X, Emery J, Walter F, Young J, Barnes D, Mitchell P, Brijnath B, Martin A, O’Byrne K. MA22.06 Longer Lung Cancer Time Intervals Amongst Culturally and Linguistically Diverse Patient Than Anglo-Australian Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.686] [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: 10/25/2022]
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Nones K, Johnson J, Newell F, Patch AM, Thorne H, Kazakoff SH, de Luca XM, Parsons MT, Ferguson K, Reid LE, McCart Reed AE, Srihari S, Lakis V, Davidson AL, Mukhopadhyay P, Holmes O, Xu Q, Wood S, Leonard C, Beesley J, Harris JM, Barnes D, Degasperi A, Ragan MA, Spurdle AB, Khanna KK, Lakhani SR, Pearson JV, Nik-Zainal S, Chenevix-Trench G, Waddell N, Simpson PT. Whole-genome sequencing reveals clinically relevant insights into the aetiology of familial breast cancers. Ann Oncol 2019; 30:1071-1079. [PMID: 31090900 PMCID: PMC6637375 DOI: 10.1093/annonc/mdz132] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Whole-genome sequencing (WGS) is a powerful method for revealing the diversity and complexity of the somatic mutation burden of tumours. Here, we investigated the utility of tumour and matched germline WGS for understanding aetiology and treatment opportunities for high-risk individuals with familial breast cancer. PATIENTS AND METHODS We carried out WGS on 78 paired germline and tumour DNA samples from individuals carrying pathogenic variants in BRCA1 (n = 26) or BRCA2 (n = 22) or from non-carriers (non-BRCA1/2; n = 30). RESULTS Matched germline/tumour WGS and somatic mutational signature analysis revealed patients with unreported, dual pathogenic germline variants in cancer risk genes (BRCA1/BRCA2; BRCA1/MUTYH). The strategy identified that 100% of tumours from BRCA1 carriers and 91% of tumours from BRCA2 carriers exhibited biallelic inactivation of the respective gene, together with somatic mutational signatures suggestive of a functional deficiency in homologous recombination. A set of non-BRCA1/2 tumours also had somatic signatures indicative of BRCA-deficiency, including tumours with BRCA1 promoter methylation, and tumours from carriers of a PALB2 pathogenic germline variant and a BRCA2 variant of uncertain significance. A subset of 13 non-BRCA1/2 tumours from early onset cases were BRCA-proficient, yet displayed complex clustered structural rearrangements associated with the amplification of oncogenes and pathogenic germline variants in TP53, ATM and CHEK2. CONCLUSIONS Our study highlights the role that WGS of matched germline/tumour DNA and the somatic mutational signatures can play in the discovery of pathogenic germline variants and for providing supporting evidence for variant pathogenicity. WGS-derived signatures were more robust than germline status and other genomic predictors of homologous recombination deficiency, thus impacting the selection of platinum-based or PARP inhibitor therapy. In this first examination of non-BRCA1/2 tumours by WGS, we illustrate the considerable heterogeneity of these tumour genomes and highlight that complex genomic rearrangements may drive tumourigenesis in a subset of cases.
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Affiliation(s)
- K Nones
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J Johnson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - F Newell
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - A M Patch
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - H Thorne
- kConFab Investigators, The Peter MacCallum Cancer Centre, Melbourne, VIC; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC
| | - S H Kazakoff
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - X M de Luca
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - M T Parsons
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - K Ferguson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - L E Reid
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - A E McCart Reed
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD
| | - S Srihari
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD; Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD
| | - V Lakis
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - A L Davidson
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD; Faculty of Medicine, The University of Queensland, Brisbane, QLD
| | - P Mukhopadhyay
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - O Holmes
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - Q Xu
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S Wood
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - C Leonard
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J Beesley
- Cancer Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - J M Harris
- Faculty of Health, School Biomedical Science - Queensland University of Technology, Brisbane, QLD, Australia
| | - D Barnes
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge
| | - A Degasperi
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge; Department of Medical Genetics, The Clinical School, University of Cambridge, Cambridge, UK
| | - M A Ragan
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD
| | - A B Spurdle
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - K K Khanna
- Signal Transduction Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S R Lakhani
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD; Royal Brisbane & Women's Hospital, Pathology Queensland, Brisbane, QLD, Australia
| | - J V Pearson
- Genome Informatics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - S Nik-Zainal
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge; Department of Medical Genetics, The Clinical School, University of Cambridge, Cambridge, UK
| | - G Chenevix-Trench
- Cancer Genetics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - N Waddell
- Medical Genomics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD.
| | - P T Simpson
- Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Brisbane, QLD.
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Barnes D, Chesney M, Duffy J, Yaffe K, Abrams G, Whitmer R, Mehling W. PREVENTING LOSS OF INDEPENDENCE THROUGH EXERCISE (PLIÉ) AND PAIRED PLIÉ: RESULTS TO DATE. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Barnes
- University of California, San Francisco, and San Francisco VA Health Care System
| | - M Chesney
- University of California, San Francisco
| | - J Duffy
- Kaiser Permanente Northern California
| | - K Yaffe
- University of California, San Francisco
| | - G Abrams
- University of California, San Francisco, and San Francisco VA Health Care System
| | | | - W Mehling
- University of California, San Francisco
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Fennell D, Danson S, Forster M, Talbot D, Woll P, Child J, Ngai Y, Farrelly L, Hackshaw A, Sharkey A, Busacca S, Hastings R, Barnes D, Nicolson M, Taylor P, Ahmed S, Wheeler G. MA12.05 Phase 1 Study of HSP90 Inhibitor Ganetespib with Pemetrexed and Cisplatin/Carboplatin Chemotherapy for Pleural Mesothelioma. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.415] [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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Barnes D, Rivera R, Gibson S, Craig C, Cragun J, Monk B, Chase D. The utility of patient reported data in a gynecologic oncology clinic. Gynecol Oncol Res Pract 2018; 5:4. [PMID: 30009038 PMCID: PMC6044081 DOI: 10.1186/s40661-018-0062-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/27/2018] [Indexed: 12/04/2022]
Abstract
BACKGROUND Measuring QoL is essential to the field of gynecologic oncology but there seems to be limited standardized data regarding collecting QoL assessments throughout a patient's cancer treatment especially in non-clinical trial patients. The aim of this study is to explore patient characteristics that may be associated with poor quality of life (QoL) in women with gynecologic cancers at two University of Arizona Cancer Center (UACC) sites. METHODS A cross-sectional survey was conducted among English speaking women with gynecologic malignancies at the University of Arizona Cancer Centers in Phoenix and Tucson from April 2012 to July 2015. The survey was a paper packet of questions that was distributed to cancer patients at the time of their clinic visit. The packet contained questions on demographic information, treatment, lifestyle characteristics, pelvic pain and Health-related quality of life (HRQoL). Measures included the generic and cancer-specific scores on the Functional Assessment of Cancer Therapy-General (FACT-G) and the Female Genitourinary Pain Index (GUPI). The total scores and subdomains were compared with descriptive variables (age, body mass index (BMI), diet, exercise, disease status, treatment and support group attendance) using Cronbach alpha (α), Spearman rank correlations (ρ), and Holm's Bonferroni method. RESULTS One-hundred and forty-nine women completed the survey; 55% (N = 81) were older than 60 years, 38% (N = 45) were obese (BMI > 30), 46% (N = 66) exercised daily, and 84% (N = 111) ate one or more daily serving of fruit and vegetables. Women in remission, those who exercised daily and ate fruits/vegetables were less likely to have their symptoms impact their QoL. Younger women were more likely to report genitourinary issues (p = - 0.22) and overall problems with QoL (p = - 0.29) than older women. Among FACT-G support group responses, we found those that did not attend support groups had a significantly higher emotional wellbeing (p = 0.05). CONCLUSIONS This study identified potential areas of clinical focus, which aid in understanding our approach to caring for gynecologic cancer patients and improvement of their HRQoL. We identified that age, pelvic pain, and lifestyle characteristics have indicators to poor QoL in women with gynecologic cancers. In this population, younger women and those with pelvic pain complaints, poor diet and exercise habits should be targeted early for supportive care interventions to improve QoL throughout both treatment and survivorship.
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Affiliation(s)
- D. Barnes
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
| | - R. Rivera
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
| | - S. Gibson
- University of Arizona Cancer Center, Tucson, AZ USA
| | - C. Craig
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
| | - J. Cragun
- University of Arizona Cancer Center, Tucson, AZ USA
| | - B. Monk
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
| | - D. Chase
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
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Nizamoglu M, Frew Q, Tan A, Band H, Band B, Barnes D, El-Muttardi N, Dziewulski P. The ten-year experience of firework injuries treated at a uk regional burns & plastic surgery unit. Ann Burns Fire Disasters 2018; 31:13-16. [PMID: 30174565 PMCID: PMC6116645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/31/2018] [Indexed: 06/08/2023]
Abstract
Fireworks are used worldwide to celebrate national, religious, cultural festivals and holidays. However the use of fireworks is associated with preventable injuries. We aim to review cases of burns and trauma caused by fireworks presenting to a regional burns and plastic surgery unit in the United Kingdom. We hope our findings will help to guide future firework-related safety practices in the UK. A retrospective review was performed of all patients presenting to our tertiary burns and plastic surgery unit with burns and/or trauma sustained from fireworks over a ten-year period from October 2004 to October 2014. A total of 93 patients were identified. Medical case notes were reviewed, patient demographics, aetiology of injury, management and patient outcomes were recorded. A cohort of 93 patients with burn injuries caused by fireworks were identified from our database. A total of 74% injuries occurred in October and November. Mechanism of injury included contact, flash, flame burns and injury secondary to blast force. Most injuries sustained were to the hands, followed by head and neck, torso, limbs and perineum in descending order of frequency. A total of 38.7% of patients required surgery for their wounds. Fireworks not only result in significant burn injuries, but also eye injuries, soft tissue defects and fractures requiring a spectrum of plastic surgical interventions. The number and severity of accidents can be minimised by raising awareness regarding safety precautions.
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Affiliation(s)
- M. Nizamoglu
- Metin Nizamoglu
St Andrew’s Centre for Plastic Surgery & Burns, Broomfield HospitalCourt Rd, Broomfield, Chelmsford, CM1 7ETUK+44 (0)7702225711
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Affiliation(s)
- P Garrard
- Southmead Hospital NHS Trust, London, England
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Bickerton S, Nizamoglu M, Frew Q, Borrows E, Bangalore H, Martin N, Barnes D, El-Muttardi N, Dziewulski P. What are the Intensive Care Requirements for Paediatric Burns in a Regional Burns Service? Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.066] [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: 11/24/2022]
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Beckerman R, Barnes D, Supina D, Krishnarajah G. P158 Physician perspectives on long-term prophylaxis of hereditary angioedema: a pragmatic review. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.145] [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: 11/30/2022]
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Möstl C, Isavnin A, Boakes PD, Kilpua EKJ, Davies JA, Harrison RA, Barnes D, Krupar V, Eastwood JP, Good SW, Forsyth RJ, Bothmer V, Reiss MA, Amerstorfer T, Winslow RM, Anderson BJ, Philpott LC, Rodriguez L, Rouillard AP, Gallagher P, Nieves-Chinchilla T, Zhang TL. Modeling observations of solar coronal mass ejections with heliospheric imagers verified with the Heliophysics System Observatory. Space Weather 2017; 15:955-970. [PMID: 28983209 PMCID: PMC5601179 DOI: 10.1002/2017sw001614] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/18/2017] [Accepted: 06/30/2017] [Indexed: 06/07/2023]
Abstract
We present an advance toward accurately predicting the arrivals of coronal mass ejections (CMEs) at the terrestrial planets, including Earth. For the first time, we are able to assess a CME prediction model using data over two thirds of a solar cycle of observations with the Heliophysics System Observatory. We validate modeling results of 1337 CMEs observed with the Solar Terrestrial Relations Observatory (STEREO) heliospheric imagers (HI) (science data) from 8 years of observations by five in situ observing spacecraft. We use the self-similar expansion model for CME fronts assuming 60° longitudinal width, constant speed, and constant propagation direction. With these assumptions we find that 23%-35% of all CMEs that were predicted to hit a certain spacecraft lead to clear in situ signatures, so that for one correct prediction, two to three false alarms would have been issued. In addition, we find that the prediction accuracy does not degrade with the HI longitudinal separation from Earth. Predicted arrival times are on average within 2.6 ± 16.6 h difference of the in situ arrival time, similar to analytical and numerical modeling, and a true skill statistic of 0.21. We also discuss various factors that may improve the accuracy of space weather forecasting using wide-angle heliospheric imager observations. These results form a first-order approximated baseline of the prediction accuracy that is possible with HI and other methods used for data by an operational space weather mission at the Sun-Earth L5 point.
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Affiliation(s)
- C Möstl
- Space Research Institute Austrian Academy of Sciences Graz Austria
- IGAM-Kanzelhöhe Observatory, Institute of Physics University of Graz Graz Austria
| | - A Isavnin
- Department of Physics University of Helsinki Helsinki Finland
| | - P D Boakes
- Space Research Institute Austrian Academy of Sciences Graz Austria
- IGAM-Kanzelhöhe Observatory, Institute of Physics University of Graz Graz Austria
| | - E K J Kilpua
- Department of Physics University of Helsinki Helsinki Finland
| | - J A Davies
- RAL Space Rutherford Appleton Laboratory Harwell UK
| | - R A Harrison
- RAL Space Rutherford Appleton Laboratory Harwell UK
| | - D Barnes
- RAL Space Rutherford Appleton Laboratory Harwell UK
- University College London London UK
| | - V Krupar
- Institute of Atmospheric Physics CAS Prague Czech Republic
| | - J P Eastwood
- Blackett Laboratory Imperial College London London UK
| | - S W Good
- Blackett Laboratory Imperial College London London UK
| | - R J Forsyth
- Blackett Laboratory Imperial College London London UK
| | - V Bothmer
- Institute for Astrophysics University of Göttingen Göttingen Germany
| | - M A Reiss
- IGAM-Kanzelhöhe Observatory, Institute of Physics University of Graz Graz Austria
| | - T Amerstorfer
- Space Research Institute Austrian Academy of Sciences Graz Austria
| | - R M Winslow
- Institute for the Study of Earth, Oceans, and Space University of New Hampshire Durham New Hampshire USA
| | - B J Anderson
- Applied Physics Laboratory The Johns Hopkins University Laurel Maryland USA
| | - L C Philpott
- Department of Earth, Ocean and Atmospheric Sciences University of British Columbia Vancouver British Columbia Canada
| | - L Rodriguez
- Solar Terrestrial Center of Excellence-SIDC Royal Observatory of Belgium Brussels Belgium
| | - A P Rouillard
- Institut de Recherche en Astrophysique et Planétologie Université de Toulouse (UPS) Toulouse France
- Centre National de la Recherche Scientifique Toulouse France
| | - P Gallagher
- School of Physics Trinity College Dublin Ireland
| | | | - T L Zhang
- Space Research Institute Austrian Academy of Sciences Graz Austria
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Gota H, Tuszewski M, Trask E, Garate E, Binderbauer MW, Tajima T, Schmitz L, Deng BH, Guo HY, Aefsky S, Allfrey I, Barnes D, Bolte N, Bui DQ, Ceccherini F, Clary R, Conroy KD, Cordero M, Dettrick SA, Douglass JD, Feng P, Granstedt E, Gupta D, Gupta S, Hooper C, Kinley JS, Knapp K, Korepanov S, Longman A, Magee R, Mendoza R, Mok Y, Necas A, Primavera S, Putvinski S, Onofri M, Osin D, Rath N, Roche T, Romero J, Rostoker N, Schroeder JH, Sevier L, Sibley A, Smirnov A, Song Y, Steinhauer LC, Thompson MC, Valentine T, Van Drie AD, Walters JK, Waggoner W, Yang X, Yushmanov P, Zhai K. Improved Confinement of C-2 Field-Reversed Configuration Plasmas. Fusion Science and Technology 2017. [DOI: 10.13182/fst14-871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- H. Gota
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - M. Tuszewski
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - E. Trask
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - E. Garate
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - M. W. Binderbauer
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - T. Tajima
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - L. Schmitz
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
- University of California, Los Angeles, Department of Physics and Astronomy Los Angeles, California 90095
| | - B. H. Deng
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - H. Y. Guo
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - S. Aefsky
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - I. Allfrey
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - D. Barnes
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - N. Bolte
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - D. Q. Bui
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - F. Ceccherini
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - R. Clary
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - K. D. Conroy
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - M. Cordero
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - S. A. Dettrick
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - J. D. Douglass
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - P. Feng
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - E. Granstedt
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - D. Gupta
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - S. Gupta
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - C. Hooper
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - J. S. Kinley
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - K. Knapp
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - S. Korepanov
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - A. Longman
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - R. Magee
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - R. Mendoza
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - Y. Mok
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - A. Necas
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - S. Primavera
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - S. Putvinski
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - M. Onofri
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - D. Osin
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - N. Rath
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - T. Roche
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - J. Romero
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - N. Rostoker
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - J. H. Schroeder
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - L. Sevier
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - A. Sibley
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - A. Smirnov
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - Y. Song
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - L. C. Steinhauer
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - M. C. Thompson
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - T. Valentine
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - A. D. Van Drie
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - J. K. Walters
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - W. Waggoner
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - X. Yang
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - P. Yushmanov
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
| | - K. Zhai
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688
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Rob D, Špunda R, Lindner J, Šmalcová J, Šmíd O, Kovárník T, Linhart A, Bìlohlávek J, Marinoni MM, Cianchi G, Trapani S, Migliaccio ML, Gucci L, Bonizzoli M, Cramaro A, Cozzolino M, Valente S, Peris A, Grins E, Kort E, Weiland M, Shresta NM, Davidson P, Algotsson L, Fitch S, Marco G, Sturgill J, Lee S, Dickinson M, Boeve T, Khaghani A, Wilton P, Jovinge S, Ahmad AN, Loveridge R, Vlachos S, Patel S, Gelandt E, Morgan L, Butt S, Whitehorne M, Kakar V, Park C, Hayes M, Willars C, Hurst T, Best T, Vercueil A, Auzinger G, Adibelli B, Akovali N, Torgay A, Zeyneloglu P, Pirat A, Kayhan Z, Schmidbauer SS, Herlitz J, Karlsson T, Friberg H, Knafelj R, Radsel P, Duprez F, Bonus T, Cuvelier G, Mashayekhi S, Maka M, Ollieuz S, Reychler G, Mosaddegh R, Abbasi S, Talaee S, Zotzmann VZ, Staudacher DS, Wengenmayer TW, Dürschmied DD, Bode CB, Nelskylä A, Nurmi J, Jousi M, Schramko A, Mervaala E, Ristagno G, Skrifvars M, Ozsoy G, Kendirli T, Azapagasi E, Perk O, Gadirova U, Ozcinar E, Cakici M, Baran C, Durdu S, Uysalel A, Dogan M, Ramoglu M, Ucar T, Tutar E, Atalay S, Akar R, Kamps M, Leeuwerink G, Hofmeijer J, Hoiting O, Van der Hoeven J, Hoedemaekers C, Konkayev A, Kuklin V, Kondratyev T, Konkayeva M, Akhatov N, Sovershaev M, Tveita T, Dahl V, Wihersaari L, Skrifvars MB, Bendel S, Kaukonen KM, Vaahersalo J, Romppanen J, Pettilä V, Reinikainen M, Lybeck A, Cronberg T, Nielsen N, Friberg H, Rauber M, Steblovnik K, Jazbec A, Noc M, Kalasbail P, Garrett F, Kulstad E, Bergström DJ, Olsson HR, Schmidbauer S, Friberg H, Mandel I, Mikheev S, Podoxenov Y, Suhodolo I, Podoxenov A, Svirko J, Sementsov A, Maslov L, Shipulin V, Vammen LV, Rahbek SR, Secher NS, Povlsen JP, Jessen NJ, Løfgren BL, Granfeldt AG, Grossestreuer A, Perman S, Patel P, Ganley S, Portmann J, Cocchi M, Donnino M, Nassar Y, Fathy S, Gaber A, Mokhtar S, Chia YC, Lewis-Cuthbertson R, Mustafa K, Sabra A, Evans A, Bennett P, Eertmans W, Genbrugge C, Boer W, Dens J, De Deyne C, Jans F, Skorko A, Thomas M, Casadio M, Coppo A, Vargiolu A, Villa J, Rota M, Avalli L, Citerio G, Moon JB, Cho JH, Park CW, Ohk TG, Shin MC, Won MH, Papamichalis P, Zisopoulou V, Dardiotis E, Karagiannis S, Papadopoulos D, Zafeiridis T, Babalis D, Skoura A, Staikos I, Komnos A, Passos SS, Maeda F, Souza LS, Filho AA, Granjeia TAG, Schweller M, Franci D, De Carvalho Filho M, Santos TM, De Azevedo P, Wall R, Welters I, Tansuwannarat P, Sanguanwit P, Langer T, Carbonara M, Caccioppola A, Fusarini CF, Carlesso E, Paradiso E, Battistini M, Cattaneo E, Zadek F, Maiavacca R, Stocchetti N, Pesenti A, Ramos A, Acharta F, Toledo J, Perezlindo M, Lovesio L, Dogliotti A, Lovesio C, Schroten N, Van der Veen B, De Vries MC, Veenstra J, Abulhasan YB, Rachel S, Châtillon-Angle M, Alabdulraheem N, Schiller I, Dendukuri N, Angle M, Frenette C, Lahiri S, Schlick K, Mayer SA, Lyden P, Akatsuka M, Arakawa J, Yamakage M, Rubio J, Mateo-Sidron JAR, Sierra R, Celaya M, Benitez L, Alvarez-Ossorio S, Rubio J, Mateo-Sidron JAR, Sierra R, Fernandez A, Gonzalez O, Engquist H, Rostami E, Enblad P, Toledo J, Ramos A, Acharta F, Canullo L, Nallino J, Dogliotti A, Lovesio C, Perreault M, Talic J, Frenette AJ, Burry L, Bernard F, Williamson DR, Adukauskiene D, Cyziute J, Adukauskaite A, Malciene L, Luca L, Rogobete A, Bedreag O, Papurica M, Sarandan M, Cradigati C, Popovici S, Vernic C, Sandesc D, Avakov V, Shakhova I, Trimmel H, Majdan M, Herzer GH, Sokoloff CS, Albert M, Williamson D, Odier C, Giguère J, Charbonney E, Bernard F, Husti Z, Kaptás T, Fülep Z, Gaál Z, Tusa M, Donnelly J, Aries M, Czosnyka M, Robba C, Liu M, Ercole A, Menon D, Hutchinson P, Smielewski P, López R, Graf J, Montes JM, Kenawi M, Kandil A, Husein K, Samir A, Heijneman J, Huijben J, Abid-Ali F, Stolk M, Van Bommel J, Lingsma H, Van der Jagt M, Cihlar RC, Mancino G, Bertini P, Forfori F, Guarracino F, Pavelescu D, Grintescu I, Mirea L, Alamri S, Tharwat M, Kono N, Okamoto H, Uchino H, Ikegami T, Fukuoka T, Simoes M, Trigo E, Coutinho P, Pimentel J, Franci A, Basagni D, Boddi M, Cozzolino M, Anichini V, Cecchi A, Peris A, Markopoulou D, Venetsanou K, Papanikolaou I, Barkouri T, Chroni D, Alamanos I, Cingolani E, Bocci MG, Pisapia L, Tersali A, Cutuli SL, Fiore V, Palma A, Nardi G, Antonelli M, Coke R, Kwong A, Dwivedi DJ, Xu M, McDonald E, Marshall JC, Fox-Robichaud AE, Charbonney E, Liaw PC, Kuchynska I, Malysh IR, Zgrzheblovska LV, Mestdagh L, Verhoeven EF, Hubloue I, Ruel-laliberte J, Zarychanski R, Lauzier F, Bonaventure PL, Green R, Griesdale D, Fowler R, Kramer A, Zygun D, Walsh T, Stanworth S, Léger C, Turgeon AF, Baron DM, Baron-Stefaniak J, Leitner GC, Ullrich R, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Pérez AG, Silva J, Artemenko V, Bugaev A, Tokar I, Konashevskaya S, Kolesnikova IM, Roitman EV, Kiss TR, Máthé Z, Piros L, Dinya E, Tihanyi E, Smudla A, Fazakas J, Ubbink R, Boekhorst te P, Mik E, Caneva L, Ticozzelli G, Pirrelli S, Passador D, Riccardi F, Ferrari F, Roldi EM, Di Matteo M, Bianchi I, Iotti GA, Zurauskaite G, Voegeli A, Meier M, Koch D, Haubitz S, Kutz A, Bargetzi M, Mueller B, Schuetz P, Von Meijenfeldt G, Van der Laan M, Zeebregts C, Christopher KB, Vernikos P, Melissopoulou T, Kanellopoulou G, Panoutsopoulou M, Xanthis D, Kolovou K, Kypraiou T, Floros J, Broady H, Pritchett C, Marshman M, Jannaway N, Ralph C, Lehane CL, Keyl CK, Zimmer EZ, Trenk DT, Ducloy-Bouthors AS, Jonard MJ, Fourrier F, Piza F, Correa T, Marra A, Guerra J, Rodrigues R, Vilarinho A, Aranda V, Shiramizo S, Lima MR, Kallas E, Cavalcanti AB, Donoso M, Vargas P, Graf J, McCartney J, Ramsay S, McDowall K, Novitzky-Basso I, Wright C, Medic MG, Bielen L, Radonic V, Zlopasa O, Vrdoljak NG, Gasparovic V, Radonic R, Narváez G, Cabestrero D, Rey L, Aroca M, Gallego S, Higuera J, De Pablo R, González LR, Chávez GN, Lucas JH, Alonso DC, Ruiz MA, Valarezo LJ, De Pablo Sánchez R, Real AQ, Wigmore TW, Bendavid I, Cohen J, Avisar I, Serov I, Kagan I, Singer P, Hanison J, Mirza U, Conway D, Takasu A, Tanaka H, Otani N, Ohde S, Ishimatsu S, Coffey F, Dissmann P, Mirza K, Lomax M, Dissmann P, Coffey F, Mirza K, Lomax M, Miner JR, Leto R, Markota AM, Gradišek PG, Aleksejev VA, Sinkovič AS, Romagnoli S, Chelazzi C, Zagli G, Benvenuti F, Mancinelli P, Boninsegni P, Paparella L, Bos AT, Thomas O, Goslar T, Knafelj R, Perreault M, Martone A, Sandu PR, Rosu VA, Capilnean A, Murgoi P, Frenette AJ, Lecavalier A, Jayaraman D, Rico P, Bellemare P, Gelinas C, Williamson D, Nishida T, Kinoshita T, Iwata N, Yamakawa K, Fujimi S, Maggi L, Sposato F, Citterio G, Bonarrigo C, Rocco M, Zani V, De Blasi RA, Alcorn D, Barry L, Riedijk MA, Milstein DM, Caldas J, Panerai R, Camara L, Ferreira G, Bor-Seng-Shu E, Lima M, Galas F, Mian N, Nogueira R, de Oliveira GQ, Almeida J, Jardim J, Robinson TG, Gaioto F, Hajjar LA, Zabolotskikh I, Musaeva T, Saasouh W, Freeman J, Turan A, Saseedharan S, Pathrose E, Poojary S, Messika J, Martin Y, Maquigneau N, Henry-Lagarrigue M, Puechberty C, Stoclin A, Martin-Lefevre L, Blot F, Dreyfuss D, Dechanet A, Hajage D, Ricard J, Almeida E, Almeida J, Landoni G, Galas F, Fukushima J, Fominskiy E, De Brito C, Cavichio L, Almeida L, Ribeiro U, Osawa E, Boltes R, Battistella L, Hajjar L, Fontela P, Lisboa T, Junior LF, Friedman GF, Abruzzi F, Primo JAP, Filho PM, de Andrade JS, Brenner KM, boeira MS, Leães C, Rodrigues C, Vessozi A, Machado AS, Weiler M, Bryce H, Hudson A, Law T, Reece-Anthony R, Molokhia A, Abtahinezhadmoghaddam F, Cumber E, Channon L, Wong A, Groome R, Gearon D, Varley J, Wilson A, Reading J, Wong A, Zampieri FG, Bozza FA, Ferez M, Fernandes H, Japiassú A, Verdeal J, Carvalho AC, Knibel M, Salluh JI, Soares M, Gao J, Ahmadnia E, Patel B, McCartney J, MacKay A, Binning S, Wright C, Pugh RJ, Battle C, Hancock C, Harrison W, Szakmany T, Mulders F, Vandenbrande J, Dubois J, Stessel B, Siborgs K, Ramaekers D, Soares M, Silva UV, Homena WS, Fernandes GC, Moraes AP, Brauer L, Lima MF, De Marco F, Bozza FA, Salluh JI, Maric N, Mackovic M, Udiljak N, Bosso CE, Caetano RD, Cardoso AP, Souza OA, Pena R, Mescolotte MM, Souza IA, Mescolotte GM, Bangalore H, Borrows E, Barnes D, Ferreira V, Azevedo L, Alencar G, Andrade A, Bierrenbach A, Buoninsegni LT, Bonizzoli M, Cecci L, Cozzolino M, Peris A, Lindskog J, Rowland K, Sturgess P, Ankuli A, Molokhia A, Rosa R, Tonietto T, Ascoli A, Madeira L, Rutzen W, Falavigna M, Robinson C, Salluh J, Cavalcanti A, Azevedo L, Cremonese R, Da Silva D, Dornelles A, Skrobik Y, Teles J, Ribeiro T, Eugênio C, Teixeira C, Zarei M, Hashemizadeh H, Eriksson M, Strandberg G, Lipcsey M, Larsson A, Lignos M, Crissanthopoulou E, Flevari K, Dimopoulos P, Armaganidis A, Golub JG, Markota AM, Stožer AS, Sinkovič AS, Rüddel H, Ehrlich C, Burghold CM, Hohenstein C, Winning J, Sellami W, Hajjej Z, Bousselmi M, Gharsallah H, Labbene I, Ferjani M, Sattler J, Steinbrunner D, Poppert H, Schneider G, Blobner M, Kanz KG, Schaller SJ, Apap K, Xuereb G, Xuereb G, Apap K, Massa L, Xuereb G, Apap K, Massa L, Delvau N, Penaloza A, Liistro G, Thys F, Delattre IK, Hantson P, Roy PM, Gianello P, Hadîrcă L, Ghidirimschi A, Catanoi N, Scurtov N, Bagrinovschi M, Sohn YS, Cho YC, Golovin B, Creciun O, Ghidirimschi A, Bagrinovschi M, Tabbara R, Whitgift JZ, Ishimaru A, Yaguchi A, Akiduki N, Namiki M, Takeda M, Tamminen JN, Reinikainen M, Uusaro A, Taylor CG, Mills ED, Mackay AD, Ponzoni C, Rabello R, Serpa A, Assunção M, Pardini A, Shettino G, Corrêa T, Vidal-Cortés PV, Álvarez-Rocha L, Fernández-Ugidos P, Virgós-Pedreira A, Pérez-Veloso MA, Suárez-Paul IM, Del Río-Carbajo L, Fernández SP, Castro-Iglesias A, Butt A, Alghabban AA, Khurshid SK, Ali ZA, Nizami IN, Salahuddin NS, Alshahrani M, Alsubaie AW, Alshamsy AS, Alkhiliwi BA, Alshammari HK, Alshammari MB, Telmesani NK, Alshammari RB, Asonto LP, Zampieri FG, Damiani LP, Bozza F, Salluh JI, Cavalcanti AB, El Khattate A, Bizrane M, Madani N, Belayachi J, Abouqal R, Ramnarain D, Gouw-Donders B, Benstoem C, Moza A, Meybohm P, Stoppe C, Autschbach R, Devane D, Goetzenich A, Taniguchi LU, Araujo L, Salgado G, Vieira JM, Viana J, Ziviani N, Pessach I, Lipsky A, Nimrod A, O´Connor M, Matot I, Segal E, Kluzik A, Gradys A, Smuszkiewicz P, Trojanowska I, Cybulski M, De Jong A, Sebbane M, Chanques G, Jaber S, Rosa R, Robinson C, Bessel M, Cavalheiro L, Madeira L, Rutzen W, Oliveira R, Maccari J, Falavigna M, Sanchez E, Dutra F, Dietrich C, Balzano P, Rezende J, Teixeira C, Sinha S, Majhi K, Gorlicki JG, Pousset FP, Kelly J, Aron J, Gilbert AC, Urankar NP, Knafelj R, Irazabal M, Bosque M, Manciño J, Kotsopoulos A, Jansen N, Abdo W, Casey ÚM, O’Brien B, Plant R, Doyle B. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3). Crit Care 2017. [PMCID: PMC5374552 DOI: 10.1186/s13054-017-1630-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Tan A, Pedrini FA, Oni G, Frew Q, Philp B, Barnes D, Dziewulski P. Spectrophotometric intracutaneous analysis for the assessment of burn wounds: A service evaluation of its clinical application in 50 burn wounds. Burns 2017; 43:549-554. [PMID: 28190540 DOI: 10.1016/j.burns.2016.06.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 01/25/2016] [Revised: 05/17/2016] [Accepted: 06/12/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The assessment of burn depth can be challenging even to the experienced burn clinician. Clinical assessment is most widely used to determine burn depth. Because of this subjective nature, various imaging modalities have been invented. The use of photospectometry as a novel technique in burn wound depth analysis has been previously described but the literature is very limited. METHODOLOGY We carried out a single blinded non-randomized comparative study of healing potential of 50 burn wounds between tissue spectrophotometry analysis versus clinical evaluation. RESULTS ScanOSkin™ technology has an overall sensitivity of 75% and specificity of 86% in predicting healing potential of wounds. Analysis of Inter Rater Agreement (IRA) using Kappa calculations showed strengths of agreement varied from fair to moderate in perfusion and burn depth. IRA for assessing pigmentation however, was poor and this was reflected in user feedback. CONCLUSION There is a potential role for ScanOSkin™ tissue spectrophotometric analysis in burn depth assessment. Future studies comparing several imaging modalities with ScanOSkin®, taking into account costs comparison may be useful for future health resources planning.
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Affiliation(s)
- A Tan
- St Andrew Centre for Plastics and Burns, CM1 7ET, United Kingdom; St Andrews Anglia Ruskin Plastics and Burns Research Unit, Department of Health Sciences, Bishop Hall Lane, CM1 1SQ, United Kingdom.
| | - F A Pedrini
- St Andrew Centre for Plastics and Burns, CM1 7ET, United Kingdom; Scuola di Medicina e Chirurgia, Polo didattico Murri, Via Massarenti 9, 40138 Bologna, Italy
| | - G Oni
- St Andrew Centre for Plastics and Burns, CM1 7ET, United Kingdom
| | - Q Frew
- St Andrew Centre for Plastics and Burns, CM1 7ET, United Kingdom; St Andrews Anglia Ruskin Plastics and Burns Research Unit, Department of Health Sciences, Bishop Hall Lane, CM1 1SQ, United Kingdom
| | - B Philp
- St Andrew Centre for Plastics and Burns, CM1 7ET, United Kingdom
| | - D Barnes
- St Andrew Centre for Plastics and Burns, CM1 7ET, United Kingdom
| | - P Dziewulski
- St Andrew Centre for Plastics and Burns, CM1 7ET, United Kingdom
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Gibson S, Center K, Gunn J, Craig C, Cragun J, Chase D, Barnes D. Using Quality of Life Data to Redesign Interventions and Allocate Resources toward Treatment and Survivorship in a Gynecologic Oncology Program. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.253] [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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Hussain T, Stephenson J, Das B, Naqvi S, Verma R, Barnes D. Investigation of unprovoked venous thromboembolism: a case for a tempered approach? Clin Radiol 2016; 71:1005-1009. [DOI: 10.1016/j.crad.2016.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/20/2016] [Accepted: 02/23/2016] [Indexed: 11/30/2022]
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Delikonstantinou I, Philp B, Kamel D, Barnes D, Dziewulski P. A major burn injury in a liver transplant patient. Ann Burns Fire Disasters 2016; 29:206-208. [PMID: 28149251 PMCID: PMC5266239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/19/2016] [Indexed: 06/06/2023]
Abstract
Immunosuppressive therapy may aggravate the clinical course of a burned patient, primarily affecting wound healing and thus complicating permanent wound coverage. We hereby present the successful management of a 48-year-old female liver transplant recipient with a major burn injury, aiming to elucidate the effects of the patient's immunosuppression on surgical treatment. After admission to the Burns ITU, the patient underwent serial debridement of the burn and coverage with cryopreserved allografts. Despite immunosuppression, no prolonged survival of the allo-epidermis was documented. Nevertheless, a variable degree of vascularized allo-dermis was clinically identified. She subsequently underwent skin autografting and was discharged home with most of the wounds healed. Although there are isolated reports of survival of skin allografts in immunocompromised patients, in our case the allografted skin did not provide permanent wound coverage. However, it permitted a staged surgical management, allowing the immunosuppressive regime to change, the skin donor sites to heal and it also provided a dermal scaffold for successful skin autografting.
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Affiliation(s)
- I. Delikonstantinou
- St Andrew’s Centre for Plastic Surgery and Burns, Broomfield Hospital and Anglia Ruskin University (StAAR), Chelmsford, Essex, UK
| | - B. Philp
- St Andrew’s Centre for Plastic Surgery and Burns, Broomfield Hospital and Anglia Ruskin University (StAAR), Chelmsford, Essex, UK
| | - D. Kamel
- Department of Pathology, Broomfield Hospital, Chelmsford, Essex, UK
| | - D. Barnes
- St Andrew’s Centre for Plastic Surgery and Burns, Broomfield Hospital and Anglia Ruskin University (StAAR), Chelmsford, Essex, UK
| | - P. Dziewulski
- St Andrew’s Centre for Plastic Surgery and Burns, Broomfield Hospital and Anglia Ruskin University (StAAR), Chelmsford, Essex, UK
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Barnes D, Vande Slunt E, Wilfert M, Welch K, Jakubowski S, Aguilar BSN J, Timm Z, Bonlender K, Proulx M, Roessler A, Scheuerlein K, Dembny H, Anderson N, Weithaus M, Strycker A, Rodriguez E, White S. Cost effective management of short-dated inventory in interventional radiology. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.693] [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: 11/26/2022] Open
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Caine PL, Tan A, Barnes D, Dziewulski P. Self-inflicted Burns: 10 year review and comparison to national guidelines. Burns 2015; 42:215-221. [PMID: 26603912 DOI: 10.1016/j.burns.2015.09.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 07/27/2015] [Revised: 08/27/2015] [Accepted: 09/23/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is an increasing trend of self-inflicted burns noted in the literature, often seen in patients with complex psychosocial backgrounds. These patients are challenging to manage as the recovery from the acute burn may be compounded by difficult rehabilitation and suboptimal coping strategies. We aimed to review patients presenting to our burns unit with self-inflicted burns, the management strategies and examine the complexities surrounding their management. We assessed patient outcomes with a particular interest in psychosocial support given. METHODS A retrospective review of all patients presenting with self-inflicted burns over a 10 year period (2005-2014 inclusive) was conducted. Patients were identified through IBID database coded as either 'self-inflicted' or 'suicidal.' We reviewed patient and burn demographics, the clinical management, psychosocial management and patient outcomes such as wound healing, re-admission rates, and survival. RESULTS We identified 118 self-inflicted burns in total. 50/118 (42%) were admitted. 64 (54%) were male and the total body surface burn area ranged from <0.5% to 99% with a median of 14%. 60/118 (51%) had TBSA <10% and 58/118 (49%) had TBSA >10%. 24 (48%) underwent admission to the Burn Intensive Care Unit (BITU). All patients admitted to BITU had TBSA >10%. Of those admitted to BITU 6 were palliative, 18 had full resuscitation and surgical management. Of those 18 patients who had active treatment, 10/18 (56%) died. Mean total length of stay was 31 days, range 1-130 days. 9% of patients sustained injuries whilst being a current inpatient at a psychiatric institution. Of all patients reviewed, 16% (n=19) had a previous history of deliberate self-harm through burns. Of those patients admitted, 98% of were reviewed by the mental health team during their admission with time to psychological review varying depending on fitness for assessment. The overall mean length of stay for all admitted patients who were actively treated but who subsequently died was 53 days. 84% of admitted patients were managed surgically. CONCLUSION Self-inflicted burns patients would benefit from a more complex pathway of treatment as their management aims to achieve not only physical health but also psychological health. They would benefit from enhanced care to manage the acute burn but also psychiatric support to ensure patients do not re-offend.
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Affiliation(s)
- P L Caine
- St Andrew Centre for Burns and Plastic Surgery, Chelmsford, United Kingdom.
| | - A Tan
- St Andrew Centre for Burns and Plastic Surgery, Chelmsford, United Kingdom
| | - D Barnes
- St Andrew Centre for Burns and Plastic Surgery, Chelmsford, United Kingdom
| | - P Dziewulski
- St Andrew Centre for Burns and Plastic Surgery, Chelmsford, United Kingdom
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Danielson A, Barnes D, Nishijima D, Barton J. 15 Management of Cardiac Arrest Is Influenced By the Use of an End-Tidal Carbon Dioxide Monitor. Ann Emerg Med 2014. [DOI: 10.1016/j.annemergmed.2014.07.040] [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: 10/24/2022]
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Aiken M, Barnes D. Are the fabellae bisected by the femoral cortices in a true craniocaudal pelvic limb radiograph? J Small Anim Pract 2014; 55:465-70. [DOI: 10.1111/jsap.12253] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 06/11/2014] [Accepted: 06/12/2014] [Indexed: 11/29/2022]
Affiliation(s)
- M. Aiken
- Anderson Abercromby Veterinary Referrals; Ockley Surrey RH5 5RR
| | - D. Barnes
- Anderson Abercromby Veterinary Referrals; Ockley Surrey RH5 5RR
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Abou-Saleh A, Haq M, Barnes D. Inpatient management of diabetes in adults: safety and good practice. Br J Hosp Med (Lond) 2014; 75:258-63. [PMID: 25040269 DOI: 10.12968/hmed.2014.75.5.258] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patients with diabetes typically occupy 15–20% of all inpatient hospital beds at any one time. The hospital physician therefore requires a good understanding of the safe and effective management of such patients in both the emergency and ward setting.
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Grant P, Dworakowska D, DeZoysa N, Barnes D. Erratum to “The impact of anxiety and depression on patients within a large type 1 diabetes insulin pump population. An observational study” [Diabetes Metab. 29 (2013) 439–44]. Diabetes & Metabolism 2014. [DOI: 10.1016/j.diabet.2014.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Terrault N, Reddy KR, Poordad F, Curry M, Schiano T, Johl J, Shaikh O, Dove L, Shetty K, Millis M, Schiff E, Regenstein F, Barnes D, Barin B, Peters M, Roland M, Stock P. Peginterferon and ribavirin for treatment of recurrent hepatitis C disease in HCV-HIV coinfected liver transplant recipients. Am J Transplant 2014; 14:1129-35. [PMID: 24636466 DOI: 10.1111/ajt.12668] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 09/26/2013] [Revised: 11/13/2013] [Accepted: 12/11/2013] [Indexed: 01/25/2023]
Abstract
Achievement of a sustained virologic response (SVR) with antiviral therapy significantly improves graft survival in hepatitis C virus (HCV) monoinfected liver transplant (LT) patients. Risks and benefits of HCV therapy in HCV-human immunodeficiency virus (HIV) coinfected LT recipients are not well established. Among 89 HCV-HIV LT recipients in the HIVTR cohort, 39 (23% Black, 79% genotype 1, 83% fibrosis stage ≤ 1) were treated with peginterferon-a2a or a2b plus ribavirin for a median 363 days (14-1373). On intent-to-treat basis, 22% (95% CI: 10-39) and 14% (95% CI: 5-30) achieved an end-of-treatment response (EOTR) and SVR, respectively. By per-protocol analysis (completed 48 weeks of therapy ± dose reductions), 42% and 26% had EOTR and SVR, respectively. Severe adverse events occurred in 85%, with 26% hospitalized with infections and 13% developing acute rejection. Early discontinuations and dose reductions occurred in 38% and 82%, respectively, despite use of growth factors in 85%. Eighteen of 39 treated patients (46%) subsequently died/had graft loss, with 10 (26%) attributed to recurrent HCV. In conclusion, SVR rates are low and tolerability is poor in HCV-HIV coinfected transplant recipients treated with peginterferon and ribavirin. These results highlight the critical need for better tolerated and more efficacious HCV therapies for HCV-HIV coinfected transplant recipients.
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Affiliation(s)
- N Terrault
- Department of Medicine, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA
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Anderson D, Goodyear M, Burnell M, Dolan S, Wasi P, Barnes D, Macleod D, Burton E, Andreou P, Couban S. A randomized double-blind placebo-controlled study of low dose warfarin for the prevention of symptomatic central venous catheter-associated thrombosis in patients with cancer. J Thromb Haemost 2014. [DOI: 10.1111/j.1538-7836.2003.tb05632.x] [Citation(s) in RCA: 3] [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: 11/26/2022]
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Gota H, Tuszewski M, Smirnov A, Korepanov S, Akhmetov T, Ivanov A, Voskoboynikov R, Binderbauer MW, Guo HY, Barnes D, Aefsky S, Brown R, Bui DQ, Clary R, Conroy KD, Deng BH, Dettrick SA, Douglass JD, Garate E, Glass FJ, Gupta D, Gupta S, Kinley JS, Knapp K, Hollins M, Longman A, Li XL, Luo Y, Mendoza R, Mok Y, Necas A, Primavera S, Osin D, Rostoker N, Ruskov E, Schmitz L, Schroeder JH, Sevier L, Sibley A, Song Y, Sun X, Tajima T, Thompson MC, Trask E, Van Drie AD, Walters JK, Wyman MD, Zhai K. A High Performance Field-Reversed Configuration Regime in the C-2 Device. Fusion Science and Technology 2013. [DOI: 10.13182/fst13-a16890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- H. Gota
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - M. Tuszewski
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - A. Smirnov
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - S. Korepanov
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - T. Akhmetov
- Budker Institute of Nuclear Physics, Novosibirsk, 630090, Russia
| | - A. Ivanov
- Budker Institute of Nuclear Physics, Novosibirsk, 630090, Russia
| | - R. Voskoboynikov
- Budker Institute of Nuclear Physics, Novosibirsk, 630090, Russia
| | - M. W. Binderbauer
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - H. Y. Guo
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - D. Barnes
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - S. Aefsky
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - R. Brown
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - D. Q. Bui
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - R. Clary
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - K. D. Conroy
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - B. H. Deng
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - S. A. Dettrick
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - J. D. Douglass
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - E. Garate
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - F. J. Glass
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - D. Gupta
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - S. Gupta
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - J. S. Kinley
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - K. Knapp
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - M. Hollins
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - A. Longman
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - X. L. Li
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - Y. Luo
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - R. Mendoza
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - Y. Mok
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - A. Necas
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - S. Primavera
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - D. Osin
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - N. Rostoker
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - E. Ruskov
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - L. Schmitz
- Department of Physics and Astronomy, UCLA, Los Angeles, CA 90095, USA
| | - J. H. Schroeder
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - L. Sevier
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - A. Sibley
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - Y. Song
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - X. Sun
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - T. Tajima
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - M. C. Thompson
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - E. Trask
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - A. D. Van Drie
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - J. K. Walters
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - M. D. Wyman
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
| | - K. Zhai
- Tri Alpha Energy Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688, USA
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Barnes D, Shirahata S. Hiroki Murakami Memorial Issue, preface by the Editors. Cytotechnology 2012; 23:1-2. [PMID: 22358513 DOI: 10.1023/a:1007976006970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Barnes
- Dept. of Biochemistry and Biophysics Environmental Health Sciences Centre, Oregon State University, Corvallis, Oregon
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