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3,664 results on '"WILKINSON, D. A."'

201. European Resuscitation Council Guidelines 2021: Executive summary

Author

Perkins, Gavin D., primary, Gräsner, Jan-Thorsen, additional, Semeraro, Federico, additional, Olasveengen, Theresa, additional, Soar, Jasmeet, additional, Lott, Carsten, additional, Van de Voorde, Patrick, additional, Madar, John, additional, Zideman, David, additional, Mentzelopoulos, Spyridon, additional, Bossaert, Leo, additional, Greif, Robert, additional, Monsieurs, Koen, additional, Svavarsdóttir, Hildigunnur, additional, Nolan, Jerry P., additional, Ainsworth, S., additional, Akin, S., additional, Alfonzo, A., additional, Andres, J., additional, Attard Montalto, S., additional, Barelli, A., additional, Baubin, M., additional, Behringer, W., additional, Bein, B., additional, Biarent, D., additional, Bingham, R., additional, Blom, M., additional, Boccuzzi, A., additional, Borra, V., additional, Bossaert, L., additional, Böttiger, B.W., additional, Breckwoldt, J., additional, Brissaud, O., additional, Burkart, R., additional, Cariou, A., additional, Carli, P., additional, Carmona, F., additional, Cassan, P., additional, Castren, M., additional, Christophides, T., additional, Cimpoesu, C.D., additional, Clarens, C., additional, Conaghan, P., additional, Couper, K., additional, Cronberg, T., additional, De Buck, E., additional, de Lucas, N., additional, De Roovere, A., additional, Deakin, C.D., additional, Delchef, J., additional, Dirks, B., additional, Djakow, J., additional, Djarv, T., additional, Druwe, P., additional, Eldin, G., additional, Ersdal, H., additional, Friberg, H., additional, Genbrugge, C., additional, Georgiou, M., additional, Goemans, E., additional, Gonzalez-Salvado, V., additional, Gradisek, P., additional, Graesner, J.T., additional, Greif, R., additional, Handley, A.J., additional, Hassager, C., additional, Haywood, K., additional, Heltne, J.K., additional, Hendrickx, D., additional, Herlitz, J., additional, Hinkelbein, J., additional, Hoffmann, F., additional, Hunyadi Anticevic, S., additional, Johannesdottir, G.B., additional, Khalifa, G., additional, Klaassen, B., additional, Koppl, J., additional, Kreimeier, U., additional, Kuzovlev, A., additional, Lauritsen, T., additional, Lilja, G., additional, Lippert, F., additional, Lockey, A., additional, Lott, C., additional, Lulic, I., additional, Maas, M., additional, Maconochie, I., additional, Madar, J., additional, Martinez-Mejias, A., additional, Masterson, S., additional, Mentzelopoulos, S.D., additional, Meyran, D., additional, Monsieurs, K.G., additional, Morley, C., additional, Moulaert, V.R.M., additional, Mpotos, N., additional, Nikolaou, N., additional, Nolan, J.P., additional, Olasveengen, T.M., additional, Oliver, E., additional, Paal, P., additional, Pellis, T., additional, Perkins, G.D., additional, Pflanzl-Knizacek, L., additional, Pitches, K., additional, Poole, K., additional, Raffay, V., additional, Renier, W., additional, Ristagno, G., additional, Roehr, C.C., additional, Rosell-Ortiz, F., additional, Rudiger, M., additional, Safri, A., additional, Sanchez Santos, L., additional, Sandroni, C., additional, Sari, F., additional, Scapigliati, A., additional, Schilder, S., additional, Schlieber, J., additional, Schnaubelt, S., additional, Semeraro, F., additional, Shammet, S., additional, Singletary, E.M., additional, Skare, C., additional, Skrifvars, M.B., additional, Smyth, M., additional, Soar, J., additional, Svavarsdottir, H., additional, Szczapa, T., additional, Taccone, F., additional, Tageldin Mustafa, M., additional, Te Pas, A., additional, Thies, K.C., additional, Tjelmeland, I.B.M., additional, Trevisanuto, D., additional, Truhlar, A., additional, Trummer, G., additional, Turner, N.M., additional, Urlesberger, B., additional, Vaahersalo, J., additional, Van de Voorde, P., additional, Van Grootven, H., additional, Wilkinson, D., additional, Wnent, J., additional, Wyllie, J.P., additional, Yeung, J., additional, and Zideman, D.A., additional

Published
2021
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205. Propensity-Adjusted Comparative Analysis of Radial Versus Femoral Access for Neurointerventional Treatments

Author

Catapano, Joshua S, primary, Ducruet, Andrew F, additional, Nguyen, Candice L, additional, Majmundar, Neil, additional, Wilkinson, D Andrew, additional, Cole, Tyler S, additional, Baranoski, Jacob F, additional, Cavalcanti, Daniel D, additional, Fredrickson, Vance L, additional, Srinivasan, Visish M, additional, Rutledge, Caleb, additional, Lawton, Michael T, additional, and Albuquerque, Felipe C, additional

Published
2021
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207. Selectivity Study of Direct Seawater Electrolyzer Anode Catalysts Using the Rotating Ring-Disc Electrode Method

Author

Horner, O., Wilkinson, D. P., and Gyenge, E. L.

Abstract

Seawater electrolysis suffers from many issues that must be resolved before the technology can be scaled. The corrosive hypochlorite formation at the anode can damage the electrode and other electrolyzer components. Furthermore, hypochlorite is unstable and can decay, particularly when exposed to heat and metal ions, which could lead to erroneously high oxygen evolution reaction (OER) selectivity calculations in catalyst benchmarking experiments, resulting in poor catalyst and electrolyzer component selection. In this study, we used the rotating ring-disc electrode (RRDE) technique for the characterization of IrO2, NiO, Co3O4, RuO2, Pt/C, and PtRu electrocatalysts at near-neutral pH (8.4) in 0.5 M NaCl. The RRDE can overcome the challenge posed by thermocatalytic hypochlorite decay. IrO2and PtRu were also studied over a range of chloride concentrations from 0.1 to 1 M. Our findings reveal that elevated temperatures (313 and 333 K) are conducive to higher OER selectivity, as the OER faradaic efficiency (FE) on IrO2increased by 23% at 1.22 V vs SHE when the temperature was increased from 293 to 333 K. Increasing the chloride concentration from 0.1 to 1 M increased the OER current density by 40% and 200% on IrO2and PtRu, respectively, indicating a synergistic relationship.

Published
2024
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208. Sleep softly: Schubert, ethics and the value of dying well

Author

Wilkinson, D

Subjects
Value (ethics), Health (social science), Palliative care, media_common.quotation_subject, 0603 philosophy, ethics and religion, quality/value of life/personhood, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Arts and Humanities (miscellaneous), death, Quality (business), 030212 general & internal medicine, Parallels, media_common, palliative care, Poetry, Health Policy, Feature Article, 06 humanities and the arts, 3. Good health, Issues, ethics and legal aspects, Aesthetics, Value of life, 060301 applied ethics, Sleep (system call), Psychology
Abstract

Ethical discussions about medical treatment for seriously ill babies or children often focus on the ‘value of life’ or on ‘quality of life’ and what that might mean. In this paper, I look at the other side of the coin—on the value of death, and on the quality of dying. In particular, I examine whether there is such a thing as a good way to die, for an infant or an adult, and what that means for medical care. To do that, I call on philosophy and on personal experience. However, I will also make reference to art, poetry and music. That is partly because the topic of mortality has long been reflected on by artists as well as philosophers and ethicists. It is also because, as we will see, there may be some useful parallels to draw.

Published
2020

210. The Evolutionary History of Ephs and Ephrins: Toward Multicellular Organisms

Author

Arcas A, Wilkinson D, and Nieto M

Subjects
RTK pathways, cell segregation, multicellularity, phylogeny, Eph receptor, cell-cell contact
Abstract

Eph receptor (Eph) and ephrin signaling regulate fundamental developmental processes through both forward and reverse signaling triggered upon cell-cell contact. In vertebrates, they are both classified into classes A and B, and some representatives have been identified in many metazoan groups, where their expression and functions have been well studied. We have extended previous phylogenetic analyses and examined the presence of Eph and ephrins in the tree of life to determine their origin and evolution. We have found that 1) premetazoan choanoflagellates may already have rudimental Eph/ephrin signaling as they have an Eph-/ephrin-like pair and homologs of downstream-signaling genes; 2) both forward- and reverse-downstream signaling might already occur in Porifera since sponges have most genes involved in these types of signaling; 3) the nonvertebrate metazoan Eph is a type-B receptor that can bind ephrins regardless of their membrane-anchoring structure, glycosylphosphatidylinositol, or transmembrane; 4) Eph/ephrin cross-class binding is specific to Gnathostomata; and 5) kinase-dead Eph receptors can be traced back to Gnathostomata. We conclude that Eph/ephrin signaling is of older origin than previously believed. We also examined the presence of protein domains associated with functional characteristics and the appearance and conservation of downstream-signaling pathways to understand the original and derived functions of Ephs and ephrins. We find that the evolutionary history of these gene families points to an ancestral function in cell-cell interactions that could contribute to the emergence of multicellularity and, in particular, to the required segregation of cell populations.

Published
2020

213. FLOOD-PREPARED: A NOWCASTING SYSTEM for REAL-TIME IMPACT ADAPTION to SURFACE WATER FLOODING in CITIES

Author

Barr, SL, Johnson, S, Ming, X, Peppa, M, Dong, N, Wen, Z, Robson, C, Smith, L, James, P, Wilkinson, D, Heaps, S, Laing, Q, Xiao, W, Dawson, R, Ranjan, R, Barr, SL, Johnson, S, Ming, X, Peppa, M, Dong, N, Wen, Z, Robson, C, Smith, L, James, P, Wilkinson, D, Heaps, S, Laing, Q, Xiao, W, Dawson, R, and Ranjan, R

Abstract

Extreme rainfall events pose an ever increasing threat to cities due to the potential for surface water flooding resulting in damage to properties and major disruption of transport systems. Modern sensor networks offer enormous potential for the real-time monitoring of urban systems and potentially allow improved situational awareness of impeding hazards and their impacts such as flooding. However, monitoring in itself is not enough if we are to be able to adapt in in real-time to hazards. Systems are required that allow analytics and models, that feed of real-time observations, to make predictions of impacts and suggest adaption options ahead of the hazard event. The Flood-PREPARED project is developing a system for real-time adaption to surface water flooding. The system comprises of advanced spatiotemporal models of rainfall, surface water flooding and road traffic impacts. These models are linked and orchestrated within into a Big Data workflow that allows events to be simulated using emerging rainfall data recorded by a short range weather radar. This approach allows nowcasting to be undertaken where predictions of surface water inundation and impacts on the road network can be predicted ahead of the rainfall event reaching the city; thus providing the ability for an improved adaptive response to the actual event.

Published
2020

214. Which factors should be included in triage? An online survey of the attitudes of the UK general public to pandemic triage dilemmas

Author

Wilkinson, D, Zohny, H, Kappes, A, Sinnott-Armstrong, W, Savulescu, J, Wilkinson, D, Zohny, H, Kappes, A, Sinnott-Armstrong, W, and Savulescu, J

Abstract

OBJECTIVE: As cases of COVID-19 infections surge, concerns have renewed about intensive care units (ICUs) being overwhelmed and the need for specific triage protocols over winter. This study aimed to help inform triage guidance by exploring the views of lay people about factors to include in triage decisions. DESIGN, SETTING AND PARTICIPANTS: Online survey between 29th of May and 22nd of June 2020 based on hypothetical triage dilemmas. Participants recruited from existing market research panels, representative of the UK general population. Scenarios were presented in which a single ventilator is available, and two patients require ICU admission and ventilation. Patients differed in one of: chance of survival, life expectancy, age, expected length of treatment, disability and degree of frailty. Respondents were given the option of choosing one patient to treat or tossing a coin to decide. RESULTS: Seven hundred and sixty-three participated. A majority of respondents prioritised patients who would have a higher chance of survival (72%-93%), longer life expectancy (78%-83%), required shorter duration of treatment (88%-94%), were younger (71%-79%) or had a lesser degree of frailty (60%-69%, all p<0.001). Where there was a small difference between two patients, a larger proportion elected to toss a coin to decide which patient to treat. A majority (58%-86%) were prepared to withdraw treatment from a patient in intensive care who had a lower chance of survival than another patient currently presenting with COVID-19. Respondents also indicated a willingness to give higher priority to healthcare workers and to patients with young children. CONCLUSION: Members of the UK general public potentially support a broadly utilitarian approach to ICU triage in the face of overwhelming need. Survey respondents endorsed the relevance of patient factors currently included in triage guidance, but also factors not currently included. They supported the permissibility of reallocating treat

Published
2020

215. 'Your country needs you': the ethics of allocating staff to high-risk clinical roles in the management of patients with COVID-19

Author

Dunn, M, Sheehan, M, Hordern, J, Turnham, HL, Wilkinson, D, Dunn, M, Sheehan, M, Hordern, J, Turnham, HL, and Wilkinson, D

Abstract

As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of ethical issues associated with changes to staff allocation processes in the face of COVID-19. In line with a dominant view in the medical ethics literature, we claim, first, that no individual health professional has a specific, positive obligation to treat a patient when doing so places that professional at risk of harm, and so there is a clear ethical tension in any reallocation process in this context. Next, we argue that the changing asymmetries of health needs in hospitals means that careful consideration needs to be given to a stepwise process for deallocating staff from their usual duties. We conclude by considering how a justifiable process of reallocating professionals to high-risk clinical roles should be configured once those who are 'fit for reallocation' have been identified. We claim that this process needs to attend to three questions that we consider in detail: (1) how the choice to make reallocation decisions is made, (2) what justifiable models for reallocation might look like and (3) what is owed to those who are reallocated.

Published
2020

216. SBML Level 3: an extensible format for the exchange and reuse of biological models

Author

Keating, S, Waltemath, D, König, M, Zhang, F, Dräger, A, Chaouiya, C, Bergmann, F, Finney, A, Gillespie, C, Helikar, T, Hoops, S, Malik-Sheriff, R, Moodie, S, Moraru, I, Myers, C, Naldi, A, Olivier, B, Sahle, S, Schaff, J, Smith, L, Swat, M, Thieffry, D, Watanabe, L, Wilkinson, D, Blinov, M, Begley, K, Faeder, J, Gómez, H, Hamm, T, Inagaki, Y, Liebermeister, W, Lister, A, Lucio, D, Mjolsness, E, Proctor, C, Raman, K, Rodriguez, N, Shaffer, C, Shapiro, B, Stelling, J, Swainston, N, Tanimura, N, Wagner, J, Meier-Schellersheim, M, Sauro, H, Palsson, B, Bolouri, H, Kitano, H, Funahashi, A, Hermjakob, H, Doyle, J, Hucka, M, Adams, R, Allen, N, Angermann, B, Antoniotti, M, Bader, G, Červený, J, Courtot, M, Cox, C, Dalle Pezze, P, Demir, E, Denney, W, Dharuri, H, Dorier, J, Drasdo, D, Ebrahim, A, Eichner, J, Elf, J, Endler, L, Evelo, C, Flamm, C, Fleming, R, Fröhlich, M, Glont, M, Gonçalves, E, Golebiewski, M, Grabski, H, Gutteridge, A, Hachmeister, D, Harris, L, Heavner, B, Henkel, R, Hlavacek, W, Hu, B, Hyduke, D, Jong, H, Juty, N, Karp, P, Karr, J, Kell, D, Keller, R, Kiselev, I, Klamt, S, Klipp, E, Knüpfer, C, Kolpakov, F, Krause, F, Kutmon, M, Laibe, C, Lawless, C, Li, L, Loew, L, Machne, R, Matsuoka, Y, Mendes, P, Mi, H, Mittag, F, Monteiro, P, Natarajan, K, Nielsen, P, Nguyen, T, Palmisano, A, Jean-Baptiste, P, Pfau, T, Phair, R, Radivoyevitch, T, Rohwer, J, Ruebenacker, O, Saez-Rodriguez, J, Scharm, M, Schmidt, H, Schreiber, F, Schubert, M, Schulte, R, Sealfon, S, Smallbone, K, Soliman, S, Stefan, M, Sullivan, D, Takahashi, K, Teusink, B, Tolnay, D, Vazirabad, I, Kamp, A, Wittig, U, Wrzodek, C, Wrzodek, F, Xenarios, I, Zhukova, A, Zucker, J, Keating, SM, Bergmann, FT, Gillespie, CS, Malik-Sheriff, RS, Moodie, SL, Moraru, II, Myers, CJ, Olivier, BG, Schaff, JC, Smith, LP, Swat, MJ, Wilkinson, DJ, Blinov, ML, Faeder, JR, Gómez, HF, Hamm, TM, Lister, AL, Proctor, CJ, Shaffer, CA, Shapiro, BE, Sauro, HM, Doyle, JC, Adams, RR, Allen, NA, Angermann, BR, Bader, GD, Cox, CD, Denney, WS, Evelo, CT, Fleming, RM, Harris, LA, Heavner, BD, Hlavacek, WS, Hyduke, DR, Karp, PD, Karr, JR, Kell, DB, Loew, LM, Monteiro, PT, Natarajan, KN, Nielsen, PM, Phair, RD, Rohwer, JM, Ruebenacker, OA, Sealfon, SC, Stefan, MI, Sullivan, DP, Keating, S, Waltemath, D, König, M, Zhang, F, Dräger, A, Chaouiya, C, Bergmann, F, Finney, A, Gillespie, C, Helikar, T, Hoops, S, Malik-Sheriff, R, Moodie, S, Moraru, I, Myers, C, Naldi, A, Olivier, B, Sahle, S, Schaff, J, Smith, L, Swat, M, Thieffry, D, Watanabe, L, Wilkinson, D, Blinov, M, Begley, K, Faeder, J, Gómez, H, Hamm, T, Inagaki, Y, Liebermeister, W, Lister, A, Lucio, D, Mjolsness, E, Proctor, C, Raman, K, Rodriguez, N, Shaffer, C, Shapiro, B, Stelling, J, Swainston, N, Tanimura, N, Wagner, J, Meier-Schellersheim, M, Sauro, H, Palsson, B, Bolouri, H, Kitano, H, Funahashi, A, Hermjakob, H, Doyle, J, Hucka, M, Adams, R, Allen, N, Angermann, B, Antoniotti, M, Bader, G, Červený, J, Courtot, M, Cox, C, Dalle Pezze, P, Demir, E, Denney, W, Dharuri, H, Dorier, J, Drasdo, D, Ebrahim, A, Eichner, J, Elf, J, Endler, L, Evelo, C, Flamm, C, Fleming, R, Fröhlich, M, Glont, M, Gonçalves, E, Golebiewski, M, Grabski, H, Gutteridge, A, Hachmeister, D, Harris, L, Heavner, B, Henkel, R, Hlavacek, W, Hu, B, Hyduke, D, Jong, H, Juty, N, Karp, P, Karr, J, Kell, D, Keller, R, Kiselev, I, Klamt, S, Klipp, E, Knüpfer, C, Kolpakov, F, Krause, F, Kutmon, M, Laibe, C, Lawless, C, Li, L, Loew, L, Machne, R, Matsuoka, Y, Mendes, P, Mi, H, Mittag, F, Monteiro, P, Natarajan, K, Nielsen, P, Nguyen, T, Palmisano, A, Jean-Baptiste, P, Pfau, T, Phair, R, Radivoyevitch, T, Rohwer, J, Ruebenacker, O, Saez-Rodriguez, J, Scharm, M, Schmidt, H, Schreiber, F, Schubert, M, Schulte, R, Sealfon, S, Smallbone, K, Soliman, S, Stefan, M, Sullivan, D, Takahashi, K, Teusink, B, Tolnay, D, Vazirabad, I, Kamp, A, Wittig, U, Wrzodek, C, Wrzodek, F, Xenarios, I, Zhukova, A, Zucker, J, Keating, SM, Bergmann, FT, Gillespie, CS, Malik-Sheriff, RS, Moodie, SL, Moraru, II, Myers, CJ, Olivier, BG, Schaff, JC, Smith, LP, Swat, MJ, Wilkinson, DJ, Blinov, ML, Faeder, JR, Gómez, HF, Hamm, TM, Lister, AL, Proctor, CJ, Shaffer, CA, Shapiro, BE, Sauro, HM, Doyle, JC, Adams, RR, Allen, NA, Angermann, BR, Bader, GD, Cox, CD, Denney, WS, Evelo, CT, Fleming, RM, Harris, LA, Heavner, BD, Hlavacek, WS, Hyduke, DR, Karp, PD, Karr, JR, Kell, DB, Loew, LM, Monteiro, PT, Natarajan, KN, Nielsen, PM, Phair, RD, Rohwer, JM, Ruebenacker, OA, Sealfon, SC, Stefan, MI, and Sullivan, DP

Abstract

Systems biology has experienced dramatic growth in the number, size, and complexity of computational models. To reproduce simulation results and reuse models, researchers must exchange unambiguous model descriptions. We review the latest edition of the Systems Biology Markup Language (SBML), a format designed for this purpose. A community of modelers and software authors developed SBML Level 3 over the past decade. Its modular form consists of a core suited to representing reaction-based models and packages that extend the core with features suited to other model types including constraint-based models, reaction-diffusion models, logical network models, and rule-based models. The format leverages two decades of SBML and a rich software ecosystem that transformed how systems biologists build and interact with models. More recently, the rise of multiscale models of whole cells and organs, and new data sources such as single-cell measurements and live imaging, has precipitated new ways of integrating data with models. We provide our perspectives on the challenges presented by these developments and how SBML Level 3 provides the foundation needed to support this evolution.

Published
2020

218. Artificial Gestation

Author

Wilkinson, D, Distefano, L, Boyle, E, and Cusack, J

Abstract

The idea of an “artificial womb” has been explored in literature, science fiction, and film for almost a century. Full ‘ectogenesis’ – growing a human from an embryo entirely within an artificial environment – might have profound implications for society, but is far from reality. However, recently published work with an animal model has described a technique for supporting extremely premature newborn lambs (equivalent to 23 weeks of human gestation) in a liquid environment with an artificial placenta for a period of up to four weeks. The apparent success of this model has led to suggestions that it could be trialled in humans in the near future. If it were successful, artificial gestation might represent a paradigm shift in neonatal care. It could radically improve the prospects for infants born around the current borderline of viability. It may also shift the current threshold of viability and make it possible to save infants who could not be saved with current technology. However, artificial gestation will raise considerable ethical challenges – both during the first stages of its evaluation in humans, and,if successful in its application to neonatal care.

Published
2019

220. Geodesy Results Obtainable with Lunar Retroreflectors

Author

Faller, J. E., primary, Bender, P. L., additional, Alley, C. O., additional, Currie, D. G., additional, Dicke, R. H., additional, Kaula, W. M., additional, Macdonald, G. J. F., additional, Mulholland, J. D., additional, Plotkin, H. H., additional, Silverberg, E. C., additional, and Wilkinson, D. T., additional

Published
2013
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221. The NOAA Goes-12 Solar X-Ray Imager (SXI) 1. Instrument, Operations, and Data

Author

Hill, S. M., Pizzo, V. J., Balch, C. C., Biesecker, D. A., Bornmann, P., Hildner, E., Lewis, L. D., Grubb, R. N., Husler, M. P., Prendergast, K., Vickroy, J., Greer, S., Defoor, T., Wilkinson, D. C., Hooker, R., Mulligan, P., Chipman, E., Bysal, H., Douglas, J. P., Reynolds, R., Davis, J. M., Wallace, K. S., Russell, K., Freestone, K., Bagdigian, D., Page, T., Kerns, S., Hoffman, R., Cauffman, S. A., Davis, M. A., Studer, R., Berthiaume, F. E., Saha, T. T., Berthiume, G. D., Farthing, H., and Zimmermann, F.

Published
2005
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227. Embolization of Spinal Dural Arteriovenous Fistula

Author

Baranoski, Jacob F, primary, Catapano, Joshua, additional, Cole, Tyler S, additional, Majmundar, Neil J, additional, Hendricks, Benjamin K, additional, Wilkinson, D. Andrew, additional, Cavalcanti, Daniel D, additional, See, Alfred P, additional, Flores, Bruno C, additional, Ducruet, Andrew F, additional, and Albuquerque, Felipe, additional

Published
2020
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229. Middle Meningeal Artery Embolization for Chronic Subdural Hematoma

Author

Catapano, Joshua, primary, Nguyen, Candice, additional, Baranoski, Jacob F, additional, Cole, Tyler S, additional, Majmundar, Neil J, additional, Wilkinson, D. Andrew, additional, Fredrickson, Vance, additional, Cavalcanti, Daniel D, additional, Ducruet, Andrew F, additional, and Albuquerque, Felipe, additional

Published
2020
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230. Endovascular Treatment of Dissecting Vertebral Artery Aneurysms

Author

Catapano, Joshua, primary, Cadigan, Megan, additional, Farhadi, Dara, additional, Nguyen, Candice, additional, Cole, Tyler S, additional, Baranoski, Jacob F, additional, Majmundar, Neil J, additional, Wilkinson, D. Andrew, additional, Fredrickson, Vance, additional, Albuquerque, Felipe, additional, and Ducruet, Andrew F, additional

Published
2020
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240. Transradial cerebral angiography becomes more efficient than transfemoral angiography: lessons from 500 consecutive angiograms.

Author

Wilkinson, D. Andrew, Majmundar, Neil, Catapano, Joshua S., Fredrickson, Vance L., Cavalcanti, Daniel D., Baranoski, Jacob F., Rutledge, Caleb, Ducruet, Andrew F., and Albuquerque, Felipe C.

Subjects
CEREBRAL angiography, TREATMENT duration, CORONARY angiography, FLUOROSCOPY, COMPARATIVE studies, DESCRIPTIVE statistics, DECISION making in clinical medicine, CARDIOVASCULAR disease diagnosis
Abstract

Background Transradial arterial access (TRA) for cerebral diagnostic angiography is associated with fewer access site complications than transfemoral access (TFA). However, concerns about increased procedure time and radiation exposure with TRA may slow its adoption. Our objective was to measure TRA rates of success and fluoroscopy time per vessel after 'radial-first' adoption and to compare these rates to those obtained with TFA. Methods We examined 500 consecutive cerebral angiograms on an intent-to-treat basis during the first full year of radial-first adoption, recording patient and procedural characteristics and outcomes. Results Over a 9-month period at a single center, 457 of 500 angiograms (91.4%) were performed with intent-to-treat via TRA, and 431 cases (86.2%) were ultimately performed via TRA. One patient (0.2%) experienced a temporary neurologic deficit in the TRA group, and none (0%) did in the TFA group (p=0.80). The mean±SD fluoroscopy time per vessel decreased significantly from the first half of the study to the second half for TRA (5.0±3.8 vs 3.4±3.5 min/vessel; p<0.001), while TFA time remained unchanged (3.7±1.8 vs 3.5±1.4 min/vessel; p=0.69). The median fluoroscopy time per vessel for TRA became faster than that for TFA after 150 angiograms. Conclusion Of 500 consecutive angiograms performed during the first full year of radial-first implementation, 86.2% were performed successfully using TRA. TRA efficiency exceeded that of TFA after 150 angiograms. Concerns about the length of procedure or radiation exposure should not be barriers to TRA adoption. [ABSTRACT FROM AUTHOR]

Published
2022
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241. Sacrococcygeal teratomas: midline reconstruction improves cosmesis without compromising outcomes.

Author

O'Shea, K. M., Sanders, E., Farrelly, P. J., Wilkinson, D. J., Minshull, K., and Craigie, R. J.

Subjects
SCARS, PSYCHOLOGICAL adjustment testing, PATIENT satisfaction, DISEASES, TERATOMA, BACK, PELVIC tumors
Abstract

Aim: Several studies have addressed the long-term functional, psychosexual and psychosocial outcomes following sacrococcygeal teratoma (SCT) excision. It is well reported that the classical chevron incision and reconstruction can leave a cosmetically unsatisfactory result; however, there is little in the literature focussed on improving this outcome. In our institution the preference is to perform a midline reconstruction, where possible, this is felt to improve appearance without compromising the oncological or functional outcome. The aim of this study was to evaluate patient-perceived cosmetic outcomes of the midline reconstruction.Methods: All patients undergoing surgery for SCT between 2007 and 2020 were included in the study. Patient demographics, operation type, functional outcome and recurrence were all recorded. The primary outcome measure was patient/parent satisfaction with the cosmetic appearance. This was assessed using both qualitative and quantitative methodologies. Following ethical approval parents were asked questions from two existing validated patient outcome questionnaires: "Patient and Observer Scar Assessment Scale" (POSAS) v2.0 and the "Patient Scar Assessment Questionnaire".Results: Thirty-two patients underwent surgery at our institution for SCT during the study period. Twenty-four had a posterior approach with midline reconstruction, two laparotomy and excision (excluded from this study) and six had a combined approach. Median follow-up was 35 months (8.5-96 months). There were no recurrences. 4/30 (13%) have persistent urological symptoms, and 1/30 (3%) has constipation requiring bowel management. Questionnaires were sent to 26/30 families with a 77% return rate. Median total score was 11 (7.4-17.5) on a 60-point scale (6, as normal skin, 60, worst imaginable scar). Twenty (95%) reported that the scar never affects the child's activities and 15 (71%) said they are "not at all" conscious of the scar.Conclusion: Scars can lead to an array of cosmetic, functional, and psychological consequences and as such consideration needs to be given to scarring following surgery for sacrococcygeal teratomas. This study demonstrates that a midline reconstruction produces a cosmetically favourable outcome. We, therefore, recommend where appropriate a midline reconstruction should be considered for SCT. [ABSTRACT FROM AUTHOR]

Published
2022
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243. Endovascular treatment of vertebral artery dissecting aneurysms : a 20-year institutional experience.

Author

Catapano, Joshua S., Ducruet, Andrew F., Cadigan, Megan S., Farhadi, Dara S., Majmundar, Neil, Nguyen, Candice L., Baranoski, Jacob F., Cole, Tyler S., Wilkinson, D. Andrew, Fredrickson, Vance L., Srinivasan, Visish M., and Albuquerque, Felipe C.

Subjects
ACQUISITION of data methodology, RETROSPECTIVE studies, SURGERY, PATIENTS, SURGICAL complications, TREATMENT effectiveness, MEDICAL records, DESCRIPTIVE statistics, VERTEBRAL artery dissections, ENDOVASCULAR surgery, EVALUATION
Abstract

Background The ideal treatment for unruptured vertebral artery dissecting aneurysms (VADAs) and ruptured dominant VADAs remains controversial. We report our experience in the management and endovascular treatment of patients with VADAs. Methods Patients treated endovascularly for intradural VADAs at a single institution from January 1, 1999, to December 31, 2019, were retrospectively reviewed. Primary neurological outcomes were assessed using modified Rankin Scale (mRS) scores, with mRS >2 considered a poor neurological outcome. Additionally, any worsening (increase) in the mRS score from the preoperative neurological examination was considered a poor outcome. Results Ninety-one patients of mean (SD) age 53 (11.6) years (48 (53%) men) underwent endovascular treatment for VADAs. Fifty-four patients (59%) presented with ruptured VADAs and 44 VADAs (48%) involved the dominant vertebral artery. Forty-seven patients (51%) were treated with vessel sacrifice of the parent artery, 29 (32%) with flow diversion devices (FDDs), and 15 (17%) with stent-assisted coil embolization (stent/coil). Rates of procedural complications and retreatment were significantly higher with stent/coil treatment (complications 4/15; retreatment 6/15) than with vessel sacrifice (complications 1/47; retreatment 2/47) or FDD (complications 2/29; retreatment 4/29) (p=0.008 and p=0.002, respectively). Of 37 patients with unruptured VADAs treated, only two (5%) had mRS scores >2 on follow-up. Conclusion Endovascular FDD treatment of VADAs appears to be associated with lower retreatment and complication rates than stenting/coiling, although further study is required for confirmation. Endovascular treatment of unruptured VADAs was safe and was associated with favorable angiographic and neurological outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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