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1. Creating effective teaching and learning environments: Building a positive behavioural support (PBS) model for UK special schools

Author

Denne, Louise D., primary, Grindle, Corinna F., additional, Sapiets, Suzi J., additional, Blandford‐Elliott, Millie, additional, Hastings, Richard P., additional, Hoerger, Marguerite, additional, Lambert‐Lee, Katy, additional, Paris, Andreas, additional, Nicholls, Gemma, additional, and Hughes, J. Carl, additional

Published
2023
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2. Suspected tick‐borne flavivirus meningoencephalomyelitis in dogs from the UK: six cases (2021)

Author

Gonzalo‐Nadal, V., primary, Kohl, A., additional, Rocchi, M., additional, Brennan, B., additional, Hughes, J., additional, Nichols, J., additional, Da Silva Filipe, A., additional, Dunlop, J. I., additional, Fares, M., additional, Clark, J. J., additional, Tandavanitj, R., additional, Patel, A. H., additional, Cloquell‐Miro, A., additional, Bongers, J., additional, Deacon, J., additional, Kaczmarska, A., additional, Stalin, C., additional, Liatis, T., additional, Irving, J., additional, and Gutierrez‐Quintana, R., additional

Published
2023
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5. The GOES-R Solar UltraViolet Imager

Author

DARNEL, JONATHAN, primary, Seaton, Daniel B, additional, Bethge, Christian, additional, Rachmeler, Laurel, additional, Jarvis, Alison, additional, Hill, Steven, additional, Peck, Courtney, additional, Hughes, J. Marcus, additional, Shapiro, Jason, additional, Riley, Allyssa, additional, Vasudevan, Gopal, additional, Shing, Lawrence, additional, Koener, George, additional, Edwards, Chris, additional, Mathur, Dnyanesh, additional, and Timothy, Shelbe, additional

Published
2022
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8. Attitudes, barriers and facilitators of hospital pharmacists conducting practice-based research: a systematic review

Author

Reali, S, Lee, T, Bishop, J, Mirkov, S, Johnson, J, McCourt, E, Hughes, J, Pont, L, Page, AT, Penm, J, Reali, S, Lee, T, Bishop, J, Mirkov, S, Johnson, J, McCourt, E, Hughes, J, Pont, L, Page, AT, and Penm, J

Abstract

Introduction Practice‐based research is essential in enhancing medication knowledge, quality use of medicines, the scope of the pharmacy profession and improving patient outcomes. This systematic review aims to uncover the attitudes of hospital pharmacists towards practice‐based research and their perceptions of the barriers and facilitators to undertaking practice‐based research. Methods A systematic search of MEDLINE, Embase, International Pharmaceutical Abstracts and Cumulative Index to Nursing and Allied Health Literature databases from 1 January 2000 to 11 March 2021 was conducted. Peer‐reviewed empirical studies exploring hospital pharmacists’ perceptions of – as well as barriers and facilitators to – practice‐based research were included and a descriptive synthesis used to identify common themes. Results Nine studies were included in this review. Barriers and facilitators across four broad themes were related to pharmacist capacity and capability, workplace environment, research resources, and research culture. Hospital pharmacists had a high interest in conducting research, but limited research experience. Common barriers identified were lack of time, workplace support, funding, research culture, and competing priorities. Having a post‐graduate qualification and a positive attitude towards research facilitated research participation. Departmental support, designated research time and creation of research networks and forums were seen as facilitators for practice‐based research. Conclusion Hospital pharmacists recognise the importance of practice‐based research in improving knowledge, patient care and advancing pharmacy practice. However, large variation has been reported for their confidence and experience in practice‐based research. Building research capacity and capability by supporting post‐graduate research qualification, providing designated time and creating research networks may strengthen the research culture amongst hospital pharmacists.

Published
2021

9. Calculation algorithms and penumbra: Underestimation of dose in organs at risk in dosimetry audits

Author

Hughes, J, Lye, JE, Kadeer, F, Alves, A, Shaw, M, Supple, J, Keehan, S, Gibbons, F, Lehmann, J, Kron, T, Hughes, J, Lye, JE, Kadeer, F, Alves, A, Shaw, M, Supple, J, Keehan, S, Gibbons, F, Lehmann, J, and Kron, T

Abstract

PURPOSE: The aim of this study is to investigate overdose to organs at risk (OARs) observed in dosimetry audits in Monte Carlo (MC) algorithms and Linear Boltzmann Transport Equation (LBTE) algorithms. The impact of penumbra modeling on OAR dose was assessed with the adjustment of MC modeling parameters and the clinical relevance of the audit cases was explored with a planning study of spine and head and neck (H&N) patient cases. METHODS: Dosimetric audits performed by the Australian Clinical Dosimetry Service (ACDS) of 43 anthropomorphic spine plans and 1318 C-shaped target plans compared the planned dose to doses measured with ion chamber, microdiamond, film, and ion chamber array. An MC EGSnrc model was created to simulate the C-shape target case. The electron cut-off energy Ecut(kinetic) was set at 500, 200, and 10 keV, and differences between 1 and 3 mm voxel were calculated. A planning study with 10 patient stereotactic body radiotherapy (SBRT) spine plans and 10 patient H&N plans was calculated in both Acuros XB (AXB) v15.6.06 and Anisotropic Analytical Algorithm (AAA) v15.6.06. The patient contour was overridden to water as only the penumbral differences between the two different algorithms were under investigation. RESULTS: The dosimetry audit results show that for the SBRT spine case, plans calculated in AXB are colder than what is measured in the spinal cord by 5%-10%. This was also observed for other audit cases where a C-shape target is wrapped around an OAR where the plans were colder by 3%-10%. Plans calculated with Monaco MC were colder than measurements by approximately 7% with the OAR surround by a C-shape target, but these differences were not noted in the SBRT spine case. Results from the clinical patient plans showed that the AXB was on average 7.4% colder than AAA when comparing the minimum dose in the spinal cord OAR. This average difference between AXB and AAA reduced to 4.5% when using the more clinically relevant metric of maximum dose in t

Published
2021

10. Electronic personal assessment questionnaire for vascular patients (ePAQ-VAS): development and validity

Author

Aber, A., Phillips, P., Hughes, J., Keetharuth, A.D., Rooney, G., Radley, S., Walters, S., Nawaz, S., Jones, G., and Michaels, J.

Abstract

Background\ud This paper describes the development and validation of an electronic personal assessment questionnaire for vascular conditions (ePAQ‐VAS) that captures the symptomatology, quality of life and clinically relevant data of patients presenting to vascular services.\ud \ud Methods\ud A two‐stage survey was conducted in patients attending a tertiary vascular department. Patients completed the ePAQ‐VAS remotely online, or on site using an electronic tablet. In the first stage of the survey, the responses were used to perform confirmatory factor analysis to assess the construct validity and remove redundant items. The internal reliability of disease‐specific scales was investigated. In the second stage of the survey, the acceptability, known‐group validity, test–retest reliability, and responsiveness of ePAQ‐VAS was assessed.\ud \ud Results\ud In total, 721 patients completed ePAQ‐VAS. Their mean(s.d.) age was 63·5(15·7) years and 468 (64·9 per cent) were men. Some 553 patients (76·7 per cent) completed the questionnaire in clinic and the remainder completed the questionnaire online. The results of the confirmatory factor analysis confirmed the conceptual model for ePAQ‐VAS structure and eliminated six items. Internal reliability was acceptable for all the scales (Cronbach's α greater than 0·7). The test–retest reliability measured by the intraclass correlation coefficient ranged from 0·65 to 0·99. The results showed that the instrument was responsive over time with the standardized response mean ranging from 0·69 to 1·60.\ud \ud Conclusion\ud ePAQ‐VAS is a holistic data‐collection process that is relevant to vascular service users and has potential to contribute to patient‐focused care and the collection of aggregate data for service evaluation. A demonstration version of the final version of ePAQ can be viewed at http://demo‐questionnaire.epaq.co.uk/home/project?id=aaa_1.0&page=1.

Published
2020

11. Electronic personal assessment questionnaire for vascular conditions (ePAQ-VAS): development and validity

Author

Jones, G, Aber, A, Phillips, P, Hughes, J, Rooney, G, Keetharuth, A, Radley, S, Stephen, W, Nawaz, S, and Michaels, J

Abstract

Background\ud This paper describes the development and validation of an electronic personal assessment questionnaire for vascular conditions (ePAQ‐VAS) that captures the symptomatology, quality of life and clinically relevant data of patients presenting to vascular services.\ud \ud Methods\ud A two‐stage survey was conducted in patients attending a tertiary vascular department. Patients completed the ePAQ‐VAS remotely online, or on site using an electronic tablet. In the first stage of the survey, the responses were used to perform confirmatory factor analysis to assess the construct validity and remove redundant items. The internal reliability of disease‐specific scales was investigated. In the second stage of the survey, the acceptability, known‐group validity, test–retest reliability, and responsiveness of ePAQ‐VAS was assessed.\ud \ud Results\ud In total, 721 patients completed ePAQ‐VAS. Their mean(s.d.) age was 63·5(15·7) years and 468 (64·9 per cent) were men. Some 553 patients (76·7 per cent) completed the questionnaire in clinic and the remainder completed the questionnaire online. The results of the confirmatory factor analysis confirmed the conceptual model for ePAQ‐VAS structure and eliminated six items. Internal reliability was acceptable for all the scales (Cronbach's α greater than 0·7). The test–retest reliability measured by the intraclass correlation coefficient ranged from 0·65 to 0·99. The results showed that the instrument was responsive over time with the standardized response mean ranging from 0·69 to 1·60.\ud \ud Conclusion\ud ePAQ‐VAS is a holistic data‐collection process that is relevant to vascular service users and has potential to contribute to patient‐focused care and the collection of aggregate data for service evaluation. A demonstration version of the final version of ePAQ can be viewed at http://demo‐questionnaire.epaq.co.uk/home/project?id=VASC_1.7&page=1.

Published
2020

12. Implementation of multimodal computed tomography in a telestroke network: Five-year experience

Author

Garcia-Esperon, C, Dinkelspiel, FS, Miteff, F, Gangadharan, S, Wellings, T, O'Brien, B, Evans, J, Lillicrap, T, Demeestere, J, Bivard, A, Parsons, M, Levi, C, Spratt, NJ, Peake, R, Hughes, J, Dark, L, Ryan, N, Shepherd, M, Ali, O, Wills, J, Minett, F, Birnie, J, Buzio, A, Bruce, I, Tankel, A, Parrey, K, Kinchington, M, Pepper, E, Loiselle, A, Waller, S, Chew, A, Russell, M, Royan, A, Roworth, B, Garcia-Esperon, C, Dinkelspiel, FS, Miteff, F, Gangadharan, S, Wellings, T, O'Brien, B, Evans, J, Lillicrap, T, Demeestere, J, Bivard, A, Parsons, M, Levi, C, Spratt, NJ, Peake, R, Hughes, J, Dark, L, Ryan, N, Shepherd, M, Ali, O, Wills, J, Minett, F, Birnie, J, Buzio, A, Bruce, I, Tankel, A, Parrey, K, Kinchington, M, Pepper, E, Loiselle, A, Waller, S, Chew, A, Russell, M, Royan, A, and Roworth, B

Abstract

AIMS: Penumbral selection is best-evidence practice for thrombectomy in the 6-24 hour window. Moreover, it helps to identify the best responders to thrombolysis. Multimodal computed tomography (mCT) at the primary centre-including noncontrast CT, CT perfusion, and CT angiography-may enhance reperfusion therapy decision-making. We developed a network with five spoke primary stroke sites and assessed safety, feasibility, and influence of mCT in rural hospitals on decision-making for thrombolysis. METHODS: Consecutive patients assessed via telemedicine from April 2013 to June 2018. Clinical outcomes were measured, and decision-making compared using theoretical models for reperfusion therapy applied without mCT guidance. Symptomatic intracranial hemorrhage (sICH) was assessed according to Safe Implementation of Treatments in Stroke Thrombolysis Registry criteria. RESULTS: A total of 334 patients were assessed, 240 received mCT, 58 were thrombolysed (24.2%). The mean age of thrombolysed patients was 70 years, median baseline National Institutes of Health Stroke Scale was 10 (IQR 7-18) and 23 (39.7%) had a large vessel occlusion. 1.7% had sICH and 3.5% parenchymal hematoma. Three months poststroke, 55% were independent, compared with 70% in the non-thrombolysed group. CONCLUSION: Implementation of CTP in rural centers was feasible and led to high thrombolysis rates with low rates of sICH.

Published
2020

13. The potential of the solitary parasitoid Microctonus brassicae for the biological control of the adult cabbage stem flea beetle, Psylliodes chrysocephala

Author

Jordan, A, Broad, G, Stigenberg, J, Hughes, J, Stone, J, Bedford, I, Penfield, S, Wells, R, Jordan, A, Broad, G, Stigenberg, J, Hughes, J, Stone, J, Bedford, I, Penfield, S, and Wells, R

Abstract

The cabbage stem flea beetle (CSFB), Psylliodes chrysocephala L. (Coleoptera: Chrysomelidae), is a major pest of oilseed rape, Brassica napus L. (Brassicaceae), within the UK and continental Europe. Following the withdrawal of many broad‐spectrum pesticides, most importantly neonicotinoids, and with increased incidence of pyrethroid resistance, few chemical control options remain, resulting in the need for alternative pest management strategies. We identified the parasitoid wasp Microctonus brassicae (Haeselbarth) (Hymenoptera: Braconidae) within CSFB collected from three independent sites in Norfolk, UK. Parasitism of adult CSFB was confirmed, and wasp oviposition behaviour was described. Moreover, we show that within captive colonies parasitism rates are sufficient to generate significant biological control of CSFB populations. A sequence of the M. brassicae mitochondrial cytochrome oxidase 1 (MT‐CO1) gene was generated for rapid future identification. Moroccan specimens of Microctonus aethiopoides (Loan), possessing 90% sequence similarity, were the closest identified sequenced species. This study represents the first description published in English of this parasitoid of the adult cabbage stem flea beetle.

Published
2020

18. Paroxysmal and cognitive phenotypes in Prrt2 mutant mice.

Author

Robertson, L, Featherby, T, Howell, S, Hughes, J, Thomas, P, Robertson, L, Featherby, T, Howell, S, Hughes, J, and Thomas, P

Abstract

Mutations in proline-rich transmembrane protein 2 (PRRT2) cause a range of episodic disorders that include paroxysmal kinesigenic dyskinesia and benign familial infantile epilepsy. Mutations are generally loss of function and include the c649dupC frameshifting mutation that is present in around 80% of affected individuals. To investigate how Prrt2 loss of function mutations causes disease, we performed a phenotypic investigation of a transgenic Prrt2 knockout (Prrt2 KO) mouse. We observed spontaneous paroxysmal episodes with behavioural features of both seizure and movement disorders, as well as unexplained deaths in KO and HET animals. KO mice showed spatial learning deficits in the Morris water maze, as well as gait abnormalities in the quantitative Digigait analysis; both of which may be representative of the more severe phenotypes experienced by homozygous patients. These findings extend the described phenotypes of Prrt2 mutant mice, further confirming their utility for in vivo investigation of the role of Prrt2 mutations in episodic diseases.

Published
2019

19. Periodontal and chronic kidney disease association: A systematic review and meta-analysis

Author

Kapellas, K, Singh, A, Bertotti, M, Nascimento, GG, Jamieson, LM, Hughes, J, Sajiv, C, Fernandes, D, Pawar, B, Harris, D, Hoy, W, Cass, A, Maple-Brown, L, Brown, A, Skilton, M, Askie, L, Bartold, PM, Arrow, P, Kapellas, K, Singh, A, Bertotti, M, Nascimento, GG, Jamieson, LM, Hughes, J, Sajiv, C, Fernandes, D, Pawar, B, Harris, D, Hoy, W, Cass, A, Maple-Brown, L, Brown, A, Skilton, M, Askie, L, Bartold, PM, and Arrow, P

Abstract

AIM: Chronic kidney disease (CKD) and kidney failure is increasing globally and evidence from observational studies suggest periodontal disease may contribute to kidney functional decline. METHODS: Electronic searches of the PubMed, EMBASE, Web of Science, Scopus and Cochrane Library databases were conducted for the purposes of conducting a systematic review. Hand searching of reference lists was also performed. Meta-analysis of observational studies involving periodontal disease and chronic kidney disease in adults was performed. RESULTS: A total of 17 studies was selected from an initial 4055 abstracts. Pooled estimates indicated the odds of having CKD were 60% higher among patients with periodontitis: pooled OR 1.60 (95% CI 1.44-1.79, I2 35.2%, P = 0.11) compared to those without. Conversely, a similar magnitude but non-significant higher odds of having periodontal disease was found among people with CKD 1.69 (95% CI: 0.84, 3.40, I2 = 89.8%, P < 0.00) versus non-CKD. Meta-regression revealed study quality based on the Newcastle-Ottawa Scale and statistical adjustment for potential confounders explained almost 35% of the heterogeneity in the studies investigating the association between CKD and periodontitis. CONCLUSIONS: Moderate evidence for a positive association between periodontitis and CKD exists. Evidence for the opposite direction is extremely weak based on significant heterogeneity between studies.

Published
2019

20. Association between peri-operative angiotensin-converting enzyme inhibitors and angiotensin-2 receptor blockers and acute kidney injury in major elective non-cardiac surgery: a multicentre, prospective cohort study

Author

Drake, T.M., Cheung, L.K., Gaba, F., Glasbey, J., Griffiths, N., Helliwell, R.J., Huq, T., Khaw, R., Mayes, J., Khan, S., Rafiq, N., Woin, E., Fitzgerald, J.E., Harrison, E.M., Nepogodiev, D., Bath, M., Borakati, A., Burke, J., Claireaux, H., Deekonda, P., Gundogan, B., Joyce, H., Kamarajah, S., Khatri, C., Kong, C., McLean, K.A., Mcnamee, L., Mohan, M., Bhangu, A., Arulkumaran, N., Bell, S., Duthie, F., Hughes, J., Prowle, J., Richards, T., Dynes, K., Patel, P., Wigley, C., Suresh, R., Shaw, A., Klimach, S., Jull, P., Evans, D., Preece, R., Ibrahim, I., Manikavasagar, V., Brown, F.S., Teo, R., Sim, D.P.Y., Logan, A.E., Barai, I., Amin, H., Suresh, S., Sethi, R., Bolton, W., Corbridge, O., Horne, L., Attalla, M., Morley, R., Hoskins, T., McAllister, R., Lee, S., Dennis, Y., Nixon, G., Heywood, E., Wilson, H., Ng, L., Samaraweera, S., Mills, A., Doherty, C., Belchos, J., Phan, V., Chouari, T., Gardner, T., Goergen, N., Hayes, J.D.B., MacLeod, C.S., McCormack, R., McKinley, A., McKinstry, S., Milligan, W., Ooi, L., Rafiq, N.M., Sammut, T., Sinclair, E., Smith, M., Baker, C., Boulton, A.P.R., Collins, J., Copley, H.C., Fearnhead, N., Fox, H., Mah, T., McKenna, J., Naruka, V., and STARSurg Collaborative, .

Abstract

The peri-operative use of angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers is thought to be associated with an increased risk of postoperative acute kidney injury. To reduce this risk, these agents are commonly withheld during the peri-operative period. This study aimed to investigate if withholding angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers peri-operatively reduces the risk of acute kidney injury following major non-cardiac surgery. Patients undergoing elective major surgery on the gastrointestinal tract and/or the liver were eligible for inclusion in this prospective study. The primary outcome was the development of acute kidney injury within seven days of operation. Adjusted multi-level models were used to account for centre-level effects and propensity score matching was used to reduce the effects of selection bias between treatment groups. A total of 949 patients were included from 160 centres across the UK and Republic of Ireland. From this population, 573 (60.4%) patients had their angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers withheld during the peri-operative period. One hundred and seventy-five (18.4%) patients developed acute kidney injury; there was no difference in the incidence of acute kidney injury between patients who had their angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers continued or withheld (107 (18.7%) vs. 68 (18.1%), respectively; p = 0.914). Following propensity matching, withholding angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers did not demonstrate a protective effect against the development of postoperative acute kidney injury (OR (95%CI) 0.89 (0.58–1.34); p = 0.567).

Published
2018

21. Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study

Author

Nepogodiev, D, Walker, K, Glasbey, JC, Drake, TM, Borakati, A, Kamarajah, S, McLean, K, Khatri, C, Arulkumaran, N, Harrison, EM, Fitzgerald, JE, Cromwell, D, Prowle, J, Bhangu, A, Bath, MF, Claireaux, HA, Gundogan, B, Mohan, M, Deekonda, P, Kong, C, Joyce, H, Mcnamee, L, Woin, E, Burke, J, Bell, S, Duthie, F, Hughes, J, Pinkney, TD, Richards, T, Thomas, M, Dynes, K, Patel, P, Wigley, C, Suresh, R, Shaw, A, Klimach, S, Jull, P, Evans, D, Preece, R, Ibrahim, I, Manikavasagar, V, Brown, FS, Teo, R, Sim, DPY, Logan, AE, Barai, I, Amin, H, Suresh, S, Sethi, R, Bolton, W, Corbridge, O, Horne, L, Attalla, M, Morley, R, Hoskins, T, McAllister, R, Lee, S, Dennis, Y, Nixon, G, Heywood, E, Wilson, H, Ng, L, Samaraweera, S, Mills, A, Doherty, C, Belchos, J, Phan, V, Chouari, T, Gardner, T, Goergen, N, Hayes, JDB, MacLeod, CS, McCormack, R, McKinley, A, McKinstry, S, Milligan, W, Ooi, L, Rafiq, NM, Sammut, T, Sinclair, E, Smith, M, Baker, C, Boulton, APR, Collins, J, Copley, HC, Fearnhead, N, Fox, H, Mah, T, McKenna, J, Naruka, V, Nigam, N, Nourallah, B, Perera, S, Qureshi, A, Saggar, S, Sun, L, Wang, X, Yang, DD, Caroll, P, Doyle, C, Elangovan, S, Falamarzi, A, Perai, KG, Greenan, E, Jain, D, Lang-Orsini, M, Lim, S, O'Byrne, L, Ridgway, P, Van der Laan, S, Wong, J, Arthur, J, Barclay, J, Bradley, P, Edwin, C, Finch, E, Hayashi, E, Hopkins, M, Kelly, D, Kelly, M, McCartan, N, Ormrod, A, Pakenham, A, Hayward, J, Hitchen, C, Kishore, A, Martins, T, Philomen, J, Rao, R, Rickards, C, Burns, N, Copeland, M, Durand, C, Dyal, A, Ghaffar, A, Gidwani, A, Grant, M, Gribbon, C, Gruhn, A, Leer, M, Ahmad, K, Beattie, G, Beatty, M, Campbell, G, Donaldson, G, Graham, S, Holmes, D, Kanabar, S, Liu, H, McCann, C, Stewart, R, Vara, S, Ajibola-Taylor, O, Andah, EJE, Ani, C, Cabdi, NMO, Ito, G, Jones, M, Komoriyama, A, Titu, L, Basra, M, Gallogly, P, Harinath, G, Leong, SH, Pradhan, A, Siddiqui, I, Zaat, S, Ali, A, Galea, M, Looi, WL, Ng, JCK, Atkin, G, Azizi, A, Cargill, Z, China, Z, Elliot, J, Jebakumar, R, Lam, J, Mudalige, G, Onyerindu, C, Renju, M, Babu, VS, Hussain, M, Joji, N, Lovett, B, Mownah, H, Ali, B, Cresswell, B, Dhillon, AK, Dupaguntla, YS, Hungwe, C, Lowe-Zinola, JD, Tsang, JCH, Bevan, K, Cardus, C, Duggal, A, Hossain, S, McHugh, M, Scott, M, Chan, F, Evans, R, Gurung, E, Haughey, B, Jacob-Ramsdale, B, Kerr, M, Lee, J, McCann, E, O'Boyle, K, Reid, N, Hayat, F, Hodgson, S, Johnston, R, Jones, W, Khan, M, Linn, T, Long, S, Seetharam, P, Shaman, S, Smart, B, Anilkumar, A, Davies, J, Griffith, J, Hughes, B, Islam, Y, Kidanu, D, Mushaini, N, Qamar, I, Robinson, H, Schramm, M, Tan, CY, Apperley, H, Billyard, C, Blazeby, JM, Cannon, SP, Carse, S, Gopfert, A, Loizidou, A, Parkin, J, Sanders, E, Sharma, S, Slade, G, Telfer, R, Huppatz, IW, Worley, E, Chandramoorthy, L, Friend, C, Harris, L, Jain, P, Karim, MJ, Killington, K, McGillicuddy, J, Rafferty, C, Rahunathan, N, Rayne, T, Varathan, Y, Verma, N, Zanichelli, D, Arneill, M, Brown, F, Campbell, B, Crozier, L, Henry, J, McCusker, C, Prabakaran, P, Wilson, R, Asif, U, Connor, M, Dindyal, S, Math, N, Pagarkar, A, Saleem, H, Seth, I, Standfield, N, Swartbol, T, Adamson, R, Choi, JE, El Tokhy, O, Ho, W, Javaid, NR, Mehdi, AS, Menon, D, Plumptre, I, Sturrock, S, Turner, J, Warren, O, Crane, E, Ferris, B, Gadsby, C, Smallwood, J, Vipond, M, Wilson, V, Amarnath, T, Doshi, A, Gregory, C, Kandiah, K, Powell, B, Spoor, H, Toh, C, Vizor, R, Common, M, Dunleavy, K, Harris, S, Luo, C, Mesbah, Z, Kumar, AP, Redmond, A, Skulsky, S, Walsh, T, Daly, D, Deery, L, Epanomeritakis, E, Harty, M, Kane, D, Khan, K, Mackey, R, McConville, J, McGinnity, K, Ang, A, Kee, JY, Leung, E, Norman, S, Palaniappan, S, Sarathy, PP, Yeoh, T, Frost, J, Hazeldine, P, Jones, L, Karbowiak, M, Macdonald, C, Mutarambirwa, A, Omotade, A, Runkel, M, Ryan, G, Sawers, N, Searle, C, Vig, S, Ahmad, A, McGartland, R, Sim, R, Song, A, Wayman, J, Brown, R, Chang, LH, Concannon, K, Crilly, C, Arnold, TJ, Burgin, A, Cadden, F, Choy, CH, Coleman, M, Lim, D, Luk, J, Mahankali-Rao, P, Prudence-Taylor, AJ, Ramakrishnan, D, Russell, J, Fawole, A, Gohil, J, Green, B, Hussain, A, McMenamin, L, Tang, M, Azmi, F, Benchetrit, S, Cope, T, Haque, A, Harlinska, A, Holdsworth, R, Ivo, T, Martin, J, Nisar, T, Patel, A, Sasapu, K, Trevett, J, Vernet, G, Aamir, A, Bird, C, Durham-Hall, A, Gibson, W, Hartley, J, May, N, Maynard, V, Johnson, S, Wood, CM, O'Brien, M, Orbell, J, Stringfellow, TD, Tenters, F, Tresidder, S, Cheung, W, Grant, A, Tod, N, Bews-Hair, M, Lim, ZH, Lim, SW, Vella-Baldacchino, M, Auckburally, S, Chopada, A, Easdon, S, Goodson, R, McCurdie, F, Narouz, M, Radford, A, Rea, E, Taylor, O, Yu, T, Alfa-Wali, M, Amani, L, Auluck, I, Bruce, P, Emberton, J, Kumar, R, Lagzouli, N, Mehta, A, Murtaza, A, Raja, M, Dennahy, IS, Frew, K, Given, A, He, YY, Karim, MA, MacDonald, E, McDonald, E, McVinnie, D, Ng, SK, Pettit, A, Berthaume-Hawkins, SD, Charnley, R, Fenton, K, Jones, D, Murphy, C, Ng, JQ, Reehal, R, Seraj, SS, Shang, E, Tonks, A, 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Subjects
COMPLICATIONS, Science & Technology, RENAL-FAILURE, STARSurg Collaborative, MORTALITY, RISK-FACTORS, Surgery, Life Sciences & Biomedicine
Abstract

Background Acute illness, existing co‐morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2‐week blocks over a continuous 3‐month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30‐day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30‐day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin‐converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c‐statistic 0·65). Discussion Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability.

Published
2018

22. Clinical, biochemical, and genetic features of four patients with short-chain enoyl-CoA hydratase (ECHS1) deficiency.

Author

Fitzsimons, PE, Alston, CL, Bonnen, PE, Hughes, J, Crushell, E, Geraghty, MT, Tetreault, M, O'Reilly, P, Twomey, E, Sheikh, Y, Walsh, R, Waterham, HR, Ferdinandusse, S, Wanders, RJA, Taylor, RW, Pitt, JJ, Mayne, PD, Fitzsimons, PE, Alston, CL, Bonnen, PE, Hughes, J, Crushell, E, Geraghty, MT, Tetreault, M, O'Reilly, P, Twomey, E, Sheikh, Y, Walsh, R, Waterham, HR, Ferdinandusse, S, Wanders, RJA, Taylor, RW, Pitt, JJ, and Mayne, PD

Abstract

Short-chain enoyl-CoA hydratase (SCEH or ECHS1) deficiency is a rare inborn error of metabolism caused by biallelic mutations in the gene ECHS1 (OMIM 602292). Clinical presentation includes infantile-onset severe developmental delay, regression, seizures, elevated lactate, and brain MRI abnormalities consistent with Leigh syndrome (LS). Characteristic abnormal biochemical findings are secondary to dysfunction of valine metabolism. We describe four patients from two consanguineous families (one Pakistani and one Irish Traveler), who presented in infancy with LS. Urine organic acid analysis by GC/MS showed increased levels of erythro-2,3-dihydroxy-2-methylbutyrate and 3-methylglutaconate (3-MGC). Increased urine excretion of methacrylyl-CoA and acryloyl-CoA related metabolites analyzed by LC-MS/MS, were suggestive of SCEH deficiency; this was confirmed in patient fibroblasts. Both families were shown to harbor homozygous pathogenic variants in the ECHS1 gene; a c.476A > G (p.Gln159Arg) ECHS1variant in the Pakistani family and a c.538A > G, p.(Thr180Ala) ECHS1 variant in the Irish Traveler family. The c.538A > G, p.(Thr180Ala) ECHS1 variant was postulated to represent a Canadian founder mutation, but we present SNP genotyping data to support Irish ancestry of this variant with a haplotype common to the previously reported Canadian patients and our Irish Traveler family. The presence of detectable erythro-2,3-dihydroxy-2-methylbutyrate is a nonspecific marker on urine organic acid analysis but this finding, together with increased excretion of 3-MGC, elevated plasma lactate, and normal acylcarnitine profile in patients with a Leigh-like presentation should prompt consideration of a diagnosis of SCEH deficiency and genetic analysis of ECHS1. ECHS1 deficiency can be added to the list of conditions with 3-MGA.

Published
2018

28. The incidence of surgical site dehiscence following full‐thickness gastrointestinal biopsy in dogs and cats and associated risk factors

Author

Swinbourne, F., primary, Jeffery, N., additional, Tivers, M.S., additional, Artingstall, R., additional, Bird, F., additional, Charlesworth, T., additional, Doran, I., additional, Freeman, A., additional, Hall, J., additional, Hattersley, R., additional, Henken, J., additional, Hughes, J., additional, de la Puerta, B., additional, Rutherford, L., additional, Ryan, T., additional, Williams, H., additional, Woods, S., additional, and Nicholson, I., additional

Published
2017
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29. Masculinity and Class in the Context of Dirty Work

Author

Uygur, S, Simpson, R, Slutskaya, N, and Hughes, J

Abstract

Through an ethnographic study of ‘dirty work’ and drawing on an orientation to gender as an active construction, this article explore show gender and class intersect in two occupations (refuse collection and street cleaning) . Our findings demonstrate how masculinity and class are mutually constitutive, producing attitudes and practices, strengths and vulnerabilities which are shaped by shifting relations of privilege and power and are largely specific to this group . Class and status subordination, in the con text of this study, are resisted by adherence to traditional forms of masculinity , and by taking advantage of social comparison in order to diffuse the negative implications of low status group membership. In addition, as a form of resistance of devaluation, men evoked powerful nostalgic themes - a lament for the loss of jobs and political power ; the passing of the time of closer communities and more traditional values could be read as a response to current experiences of vulnerability and devaluation.

Published
2015

30. Evaluation of an immunochemical fecal occult blood test with automated reading in screening for colorectal cancer in a general average-risk population

Author

Emile R. Caces, Hughes J. Bertrand, Guy Launoy, Véronique Bouvier, Célia Berchi, Anne Valérie N. Guizard, and Vincent Y. Talbourdet

Subjects
Male, China, Cancer Research, medicine.medical_specialty, Colorectal cancer, Population, Colonoscopy, Immunologic Tests, Sensitivity and Specificity, Hemoglobins, Internal medicine, Epidemiology, Humans, Mass Screening, Medicine, Risk factor, education, Mass screening, Aged, education.field_of_study, medicine.diagnostic_test, business.industry, Cancer, Middle Aged, medicine.disease, Surgery, Oncology, Occult Blood, Population study, Female, Colorectal Neoplasms, business
Abstract

Colorectal cancer screening is a high public health priority in all industrialized countries. However, the low sensitivity of the common guaiac screening test (HemoccultII) makes practitioners and public health decision makers reluctant to set up a national screening program. In recent years, immunochemical tests based on the use of a specific antibody have been found to be more sensitive than the HemoccultII test. However, for screening purposes, any gain in sensitivity is of interest only if specificity and positive predictive value are satisfactory. Our aim was to assess the performance of an immunochemical test with an automated reading technique (Magstream 1000) for different hemoglobin content cut-off points. The study was carried out in the general population aged 50-74 years in the geographic area of Cotentin (Normandy, France). From 1 January 2001 to 31 December 2002, 7,421 one-time screening tests (Magstream) were administered by general practitioners and occupational physicians to patients at the end of regular consultations. Colonoscopy was proposed to the 434 people with a positive test. All cancers occurring in the study population between 1 January 2001 and 31 December 2003 were collected by general practitioners, gastroenterologists and the local registry. At the usual positivity threshold (20 ng hemoglobin/ml), screening sensitivity and specificity at 2 years of follow-up with 95% CIs were, respectively, 0.85 (0.72-0.98) and 0.94 (0.94-0.95). If the hemoglobin content cut-off point had been set at 50 ng/ml instead of the usual cut-off, positivity would have been 3.1% and positive predictive value for a cancer or a large adenoma would have been 0.49, with sensitivity of 0.68-0.83 and specificity of 0.97. Our results suggest that use of an immunochemical test with an automated reading technique could improve the prospects for mass-screening for colorectal cancer since it offers a promising alternative to guaiac tests.

Published
2005

31. Reply: To PMID 24797101

Author

Abdelrahman, T, Hughes, J, Main, J, McLauchlan, J, Thursz, M, Thomson, E, and Wellcome Trust

Subjects
Male, Viral Proteins, Neurology & Neurosurgery, Gastroenterology & Hepatology, 1101 Medical Biochemistry And Metabolomics, Humans, HIV Infections, 1103 Clinical Sciences, Hepacivirus, 1702 Cognitive Science, 1109 Neurosciences, Antiviral Agents, Hepatitis C
Published
2014

37. The role of vegetables and legumes in assuring food, nutrition, and income security for vulnerable groups in Sub-Saharan Africa

Author

Ojiewo, C., Keatinge, D.J.D.H., Hughes, J., Tenkouano, A., Nair, R., Varshney, R., Siambi, M., Monyo, E., Ganga-Rao, N.V.P.R., Silim, S., Ojiewo, C., Keatinge, D.J.D.H., Hughes, J., Tenkouano, A., Nair, R., Varshney, R., Siambi, M., Monyo, E., Ganga-Rao, N.V.P.R., and Silim, S.

Abstract

Rising food and nutritional insecurity threatens the livelihoods of millions of poor people, particularly in sub-Saharan Africa. Vegetable and legume production and consumption are a potent mechanism for small-scale, disadvantaged farmers to obtain the required nutrients in their diets and to generate much-needed income through trade. Vegetables and legumes are key sources of nutrients and health-promoting phytochemicals, providing higher micronutrient contents and a wider spectrum of essential compounds to meet nutritional and health needs than other food sources. Diversifying diets with vegetables and legumes is a cheaper, surer, and more sustainable way to supply a range of nutrients to the body and combat malnutrition and associated health problems than other approaches that target only a single or a few nutritional factors. Furthermore, vegetables and legumes often accompany staple crops in meals, and most staple crops are less palatable without vegetable or legume accompaniments. As a growing world population demands more and higher quality foods, and as environmental problems such as soil degradation, water scarcity, biodiversity loss, and climate change become more acute, the need for innovative vegetable and legume research solutions to improve food and nutritional security cannot be overemphasized.

Published
2015

38. The impact of surgery for vulval cancer upon health-related quality of life and pelvic floor outcomes during the first year of treatment: A longitudinal, mixed methods study

Author

Jones, GL, Jacques, RM, Thompson, J, Wood, HJ, Hughes, J, Ledger, W, Alazzam, M, Radley, SC, Tidy, JA, Jones, GL, Jacques, RM, Thompson, J, Wood, HJ, Hughes, J, Ledger, W, Alazzam, M, Radley, SC, and Tidy, JA

Abstract

© 2015 The Authors.Objective: To measure the long-term impact of surgical treatment for vulval cancer upon health-related quality of life and pelvic floor outcomes during the first year of therapy. Methods: Prospective, longitudinal, mixed-methods study. Twenty-three women aged >18 years with a new diagnosis of vulval cancer were recruited. The EORTC QLQ C30, SF-36 and an electronic pelvic floor assessment questionnaire (ePAQ-PF) were administered at baseline (pre-treatment) and 3, 6, 9 and 12 months post-treatment. Mixed effects repeated measures models (all adjusted for age and BMI) were used to investigate changes over time and differences between cancer stage. Qualitative interviews were carried out with 11 of the women and analysed using a thematic approach. Results: Mean age was 59.9 years (SD=15.3; range=23.8-86.6 yrs). Mean BMI was 30.0 (SD=4.5; range=24.4-38.2). Sixteen women had early (Stage 1 to 2B), and seven women had advanced stage disease (Stage 3 to 4B). Questionnaire scores revealed that physical and social functioning, fatigue, pain and general sex life were significantly worse at 12 months than pre-treatment (p=< 0.05). Qualitative analysis revealed multiple treatment side effects which were perceived as severe and enduring. Women with advanced vulval cancer had significantly worse SF-36 mental health scores at 12 months compared to women with early stage disease (p=0.037). Conclusions: Surgery for vulval cancer has long-term implications which can be persistent 12 months post-treatment. High rates of morbidity relating to lymphoedema and sexual function re-enforce the need for specialist clinics to support women who suffer these complications.

Published
2015

46. Cold-pool formation in a narrow valley

Author

Vosper, S. B., primary, Hughes, J. K., additional, Lock, A. P., additional, Sheridan, P. F., additional, Ross, A. N., additional, Jemmett-Smith, B., additional, and Brown, A. R., additional

Published
2013
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49. RAGE: a new frontier in chronic airways disease

Author

Sukkar, Maria B, primary, Ullah, Md Ashik, additional, Gan, Wan Jun, additional, Wark, Peter AB, additional, Chung, Kian Fan, additional, Hughes, J Margaret, additional, Armour, Carol L, additional, and Phipps, Simon, additional

Published
2012
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