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3. Can self-testing be enhanced to hasten safe return of healthcare workers in pandemics? Random order, open label trial using two manufacturers’ SARS-CoV-2 lateral flow devices concurrently and nested viral culture study

Author

Zhang, Xingna, Cheyne, Christopher P., Jones, Christopher, Humann, Michael, Leeming, Gary, Smith, Claire, Hughes, David M., Burnside, Girvan, Dodd, Susanna, Penrice-Randal, Rebekah, Dong, Xiaofeng, Semple, Malcolm G., Neal, Tim, Tunkel, Sarah, Fowler, Tom, Turtle, Lance, García-Fiñana, Marta, and Buchan, Iain E. more...

Published
2024
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14. Calculation of standard bodyweights for dogs, cats, rabbits, and guinea pigs.

Author

Becker, Stuart D., O'Neill, Dan G., Frosini, Siân-Marie, Stapleton, Laura E., Hughes, David M., and Brodbelt, Dave C.

Subjects
GUINEA pigs, ANIMAL young, PETS, FIX-point estimation, MEDICAL records, RABBITS
Abstract

Standard bodyweights are an essential component of calculations that summarise many population-level measures in companion animals, including the defined daily doses for veterinary species (DDDVet) reporting antimicrobial usage. Standard species bodyweights may originate from data derived from clinical records, but current methods to obtain these values risk inaccuracy because they exclude measurements obtained from juvenile animals and consider only individuals that have achieved stable adult bodyweight. This study aimed to improve the accuracy of standard population level species bodyweights through the development of a prediction modelling approach to estimate point mean population bodyweight in dogs, cats, rabbits, and guinea pigs. Data were obtained from the VetCompass database and included bodyweight measurements from approximately three million dogs, two million cats, 220,000 rabbits and 62,000 guinea pigs across 1,800 veterinary practices in the United Kingdom. Initially, Loess models were used to identify the age at which juvenile animals transitioned from growth to stable adult bodyweight. Linear mixed effects models were developed to predict juvenile growth, calibrated such that predicted cessation of growth matched that observed in the Loess models. The prediction models were then used to adjust bodyweight measurements obtained from clinical records of juvenile patients, allowing historical measurements to be included for estimation of a point mean population bodyweight on a subsequent specified target date. Juvenile growth transitioned to stable adult bodyweight at approximately 14 months in dogs, and 13 months in cats, rabbits, and guinea pigs. Point mean whole-population bodyweights estimated on 31st December for each year 2014 – 2023 found that the mean bodyweight of cats, rabbits, and guinea pigs was approximately 4.2 kg, 2.3 kg, and 1.0 kg respectively and changed little over this time period. However, dogs showed a trend to lower mean bodyweight over time, with a mean value of 17.6 kg in 2014, reducing to 16.1 kg by 2023. [ABSTRACT FROM AUTHOR] more...

Published
2025
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15. Long-Term Outcomes of Patients with Poor Prognostic Factors Following Transanal Endoscopic Microsurgery (TEMS) for Early Rectal Cancer.

Author

Haq, Muneeb Ul, Noureldin, Khaled, Pritchard, David Mark, Myint, Arthur Sun, Duckworth, Carrie A., Than, Ngu Wah, Hughes, David M., Ahmed, Shakil, and Javed, Muhammad Ahsan

Subjects
RECTAL cancer, SURGICAL excision, WATCHFUL waiting, PROGNOSIS, CANCER patients
Abstract

Background: Transanal endoscopic microsurgery (TEMS) is an organ-preserving approach for treatment of early rectal cancer (ERC). However, adverse histopathological features identified post-TEMS often necessitate adjuvant therapy. This study aims to compare the long-term oncological outcomes of patients who underwent TEMS and were offered adjuvant treatments with total mesorectal excision (TME), chemoradiotherapy (CRT), radiotherapy (RT), active surveillance, or dose escalation with contact X-ray brachytherapy (CXB). Methods: This study included patients treated with TEMS for ERC between September 2012 and December 2022, with follow-up until December 2023. Patients with adverse histopathological features (extra-mural venous invasion, lympho-vascular invasion, R1 margins, tumour budding) were assigned to adjuvant treatments. Inverse probability of treatment weighting (IPTW) was applied to mitigate selection bias. Results: Of the 117 patients, 24 underwent TME, 17 received CRT, 25 received RT, 14 underwent active surveillance, and 37 patients received CXB boost along with CRT. The median follow-up was 60 months (IQR 52–73). During this time, 29 patients developed recurrence, and 15 died. The 5-year overall survival (OS) was 78.6%, and disease-free survival (DFS) was 70.9%. Compared to CXB, the mortality risk for CRT (HR = 0.81; 95% CI: 0.20–3.28; p = 0.77) and TME (HR = 3.68; 95% CI: 0.46–29.79; p = 0.22) was not significantly different. However, TME was associated with a significantly higher recurrence risk compared to CXB (HR = 7.57; 95% CI: 1.23–46.84; p = 0.029). Conclusions: An organ-preserving strategy with CRT or CRT combined with a CXB boost may offer comparable long-term outcomes and reduced recurrence risks for patients undergoing TEMS for ERC with poor prognostic features. Further research with larger cohorts is needed to validate these results. [ABSTRACT FROM AUTHOR] more...

Published
2025
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16. Endothelial thrombomodulin downregulation caused by hypoxia contributes to severe infiltration and coagulopathy in COVID-19 patient lungs

Author

Won, Taejoon, Wood, Megan K., Hughes, David M., Talor, Monica V., Ma, Zexu, Schneider, Jowaly, Skinner, John T., Asady, Beejan, Goerlich, Erin, Halushka, Marc K., Hays, Allison G., Kim, Deok-Ho, Parikh, Chirag R., Rosenberg, Avi Z., Coppens, Isabelle, Johns, Roger A., Gilotra, Nisha A., Hooper, Jody E., Pekosz, Andrew, and Čiháková, Daniela more...

Published
2022
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20. Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective observational cohort study using the WHO Clinical Characterisation Protocol UK

Author

Baillie, J Kenneth, Semple, Malcolm G, Openshaw, Peter JM, Carson, Gail, Alex, Beatrice, Bach, Benjamin, Barclay, Wendy S, Bogaert, Debby, Chand, Meera, Cooke, Graham S, Docherty, Annemarie B, Dunning, Jake, da Silva Filipe, Ana, Fletcher, Tom, Green, Christopher A, Harrison, Ewen M, Hiscox, Julian A, Ho, Antonia YW, Horby, Peter W, Ijaz, Samreen, Khoo, Say, Klenerman, Paul, Law, Andrew, Lim, Wei Shen, Mentzer, Alexander J, Merson, Laura, Meynert, Alison M, Noursadeghi, Mahdad, Moore, Shona C, Palmarini, Massimo, Paxton, William A, Pollakis, Georgios, Price, Nicholas, Rambaut, Andrew, Robertson, David L, Russell, Clark D, Sancho-Shimizu, Vanessa, Scott, Janet T, de Silva, Thushan, Sigfrid, Louise, Solomon, Tom, Sriskandan, Shiranee, Stuart, David, Summers, Charlotte, Tedder, Richard S, Thomson, Emma C, Thompson, AA Roger, Thwaites, Ryan S, Turtle, Lance CW, Gupta, Rishi K, Palmieri, Carlo, Zambon, Maria, Hardwick, Hayley, Donohue, Chloe, Lyons, Ruth, Griffiths, Fiona, Oosthuyzen, Wilna, Norman, Lisa, Pius, Riinu, Drake, Thomas M, Fairfield, Cameron J, Knight, Stephen R, Mclean, Kenneth A, Murphy, Derek, Shaw, Catherine A, Dalton, Jo, Girvan, Michelle, Saviciute, Egle, Roberts, Stephanie, Harrison, Janet, Marsh, Laura, Connor, Marie, Halpin, Sophie, Jackson, Clare, Gamble, Carrol, Leeming, Gary, Wham, Murray, Clohisey, Sara, Hendry, Ross, Scott-Brown, James, Greenhalf, William, Shaw, Victoria, McDonald, Sarah E, Keating, Seán, Ahmed, Katie A, Armstrong, Jane A, Ashworth, Milton, Asiimwe, Innocent G, Bakshi, Siddharth, Barlow, Samantha L, Booth, Laura, Brennan, Benjamin, Bullock, Katie, Catterall, Benjamin WA, Clark, Jordan J, Clarke, Emily A, Cole, Sarah, Cooper, Louise, Cox, Helen, Davis, Christopher, Dincarslan, Oslem, Dunn, Chris, Dyer, Philip, Elliott, Angela, Evans, Anthony, Finch, Lorna, Fisher, Lewis WS, Foster, Terry, Garcia-Dorival, Isabel, Gunning, Philip, Hartley, Catherine, Jensen, Rebecca L, Jones, Christopher B, Jones, Trevor R, Khandaker, Shadia, King, Katharine, Kiy, Robyn T, Koukorava, Chrysa, Lake, Annette, Lant, Suzannah, Latawiec, Diane, Lavelle-Langham, Lara, Lefteri, Daniella, Lett, Lauren, Livoti, Lucia A, Mancini, Maria, McDonald, Sarah, McEvoy, Laurence, McLauchlan, John, Metelmann, Soeren, Miah, Nahida S, Middleton, Joanna, Mitchell, Joyce, Murphy, Ellen G, Penrice-Randal, Rebekah, Pilgrim, Jack, Prince, Tessa, Reynolds, Will, Ridley, P. Matthew, Sales, Debby, Shaw, Victoria E, Shears, Rebecca K, Small, Benjamin, Subramaniam, Krishanthi S, Szemiel, Agnieska, Taggart, Aislynn, Tanianis-Hughes, Jolanta, Thomas, Jordan, Trochu, Erwan, van Tonder, Libby, Wilcock, Eve, Zhang, J. Eunice, Flaherty, Lisa, Maziere, Nicole, Cass, Emily, Doce Carracedo, Alejandra, Carlucci, Nicola, Holmes, Anthony, Massey, Hannah, Murphy, Lee, Wrobel, Nicola, McCafferty, Sarah, Morrice, Kirstie, MacLean, Alan, Adeniji, Kayode, Agranoff, Daniel, Agwuh, Ken, Ail, Dhiraj, Aldera, Erin L, Alegria, Ana, Angus, Brian, Ashish, Abdul, Atkinson, Dougal, Bari, Shahedal, Barlow, Gavin, Barnass, Stella, Barrett, Nicholas, Bassford, Christopher, Basude, Sneha, Baxter, David, Beadsworth, Michael, Bernatoniene, Jolanta, Berridge, John, Best, Nicola, Bothma, Pieter, Chadwick, David, Brittain-Long, Robin, Bulteel, Naomi, Burden, Tom, Burtenshaw, Andrew, Caruth, Vikki, Chambler, Duncan, Chee, Nigel, Child, Jenny, Chukkambotla, Srikanth, Clark, Tom, Collini, Paul, Cosgrove, Catherine, Cupitt, Jason, Cutino-Moguel, Maria-Teresa, Dark, Paul, Dawson, Chris, Dervisevic, Samir, Donnison, Phil, Douthwaite, Sam, DuRand, Ingrid, Dushianthan, Ahilanadan, Dyer, Tristan, Evans, Cariad, Eziefula, Chi, Fegan, Chrisopher, Finn, Adam, Fullerton, Duncan, Garg, Sanjeev, Garg, Atul, Gkrania-Klotsas, Effrossyni, Godden, Jo, Goldsmith, Arthur, Graham, Clive, Hardy, Elaine, Hartshorn, Stuart, Harvey, Daniel, Havalda, Peter, Hawcutt, Daniel B, Hobrok, Maria, Hodgson, Luke, Hormis, Anil, Jacobs, Michael, Jain, Susan, Jennings, Paul, Kaliappan, Agilan, Kasipandian, Vidya, Kegg, Stephen, Kelsey, Michael, Kendall, Jason, Kerrison, Caroline, Kerslake, Ian, Koch, Oliver, Koduri, Gouri, Koshy, George, Laha, Shondipon, Laird, Steven, Larkin, Susan, Leiner, Tamas, Lillie, Patrick, Limb, James, Linnett, Vanessa, Little, Jeff, Lyttle, Mark, MacMahon, Michael, MacNaughton, Emily, Mankregod, Ravish, Masson, Huw, Matovu, Elijah, McCullough, Katherine, McEwen, Ruth, Meda, Manjula, Mills, Gary, Minton, Jane, Mirfenderesky, Mariyam, Mohandas, Kavya, Mok, Quen, Moon, James, Moore, Elinoor, Morgan, Patrick, Morris, Craig, Mortimore, Katherine, Moses, Samuel, Mpenge, Mbiye, Mulla, Rohinton, Murphy, Michael, Nagel, Megan, Nagarajan, Thapas, Nelson, Mark, O'Shea, Matthew K, Otahal, Igor, Ostermann, Marlies, Pais, Mark, Panchatsharam, Selva, Papakonstantinou, Danai, Paraiso, Hassan, Patel, Brij, Pattison, Natalie, Pepperell, Justin, Peters, Mark, Phull, Mandeep, Pintus, Stefania, Singh Pooni, Jagtur, Post, Frank, Price, David, Prout, Rachel, Rae, Nikolas, Reschreiter, Henrik, Reynolds, Tim, Richardson, Neil, Roberts, Mark, Roberts, Devender, Rose, Alistair, Rousseau, Guy, Ryan, Brendan, Saluja, Taranprit, Shah, Aarti, Shanmuga, Prad, Sharma, Anil, Shawcross, Anna, Sizer, Jeremy, Shankar-Hari, Manu, Smith, Richard, Snelson, Catherine, Spittle, Nick, Staines, Nikki, Stambach, Tom, Stewart, Richard, Subudhi, Pradeep, Szakmany, Tamas, Tatham, Kate, Thomas, Jo, Thompson, Chris, Thompson, Robert, Tridente, Ascanio, Tupper-Carey, Darell, Twagira, Mary, Ustianowski, Andrew, Vallotton, Nick, Vincent-Smith, Lisa, Visuvanathan, Shico, Vuylsteke, Alan, Waddy, Sam, Wake, Rachel, Walden, Andrew, Welters, Ingeborg, Whitehouse, Tony, Whittaker, Paul, Whittington, Ashley, Papineni, Padmasayee, Wijesinghe, Meme, Williams, Martin, Wilson, Lawrence, Sarah, Sarah, Winchester, Stephen, Wiselka, Martin, Wolverson, Adam, Wooton, Daniel G, Workman, Andrew, Yates, Bryan, Young, Peter, Mulholland, Rachel H, Lone, Nazir I, Cheyne, Christopher P, De Angelis, Daniela, Diaz-Ordaz, Karla, Donegan, Cara, Funk, Sebastian, García-Fiñana, Marta, Hardwick, Hayley E, Ho, Antonia, Hughes, David M, Keogh, Ruth H, Kirwan, Peter D, Nguyen Van-Tam, Jonathan S, Spencer, Rebecca G, Tom, Brian DM, and Turtle, Lance more...

Published
2021
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23. The predictive accuracy of cardiovascular disease risk prediction tools in inflammatory arthritis and psoriasis: an observational validation study using the Clinical Practice Research Datalink.

Author

Hughes, David M, Coronado, Jose Ignacio Cuitun, Schofield, Pieta, Yiu, Zenas Z N, and Zhao, Sizheng Steven

Subjects
*RISK assessment, *ANKYLOSING spondylitis, *PSORIASIS, *PREDICTION models, *PSORIATIC arthritis, *RESEARCH funding, *RHEUMATOID arthritis, *RESEARCH methodology evaluation, *SCIENTIFIC observation, *CARDIOVASCULAR diseases risk factors, *DESCRIPTIVE statistics, *RESEARCH methodology, *CONFIDENCE intervals
Abstract

Objectives Cardiovascular risk prediction tools developed for the general population often underperform for individuals with RA, and their predictive accuracy are unclear for other inflammatory conditions that also have increased cardiovascular risk. We investigated the performance of QRISK-3, the Framingham Risk Score (FRS) and the Reynolds Risk Score (RRS) in RA, psoriatic disease (PsA and psoriasis) and AS. We considered OA as a non-inflammatory comparator. Methods We utilized primary care records from the Clinical Practice Research Datalink (CPRD) Aurum database to identify individuals with each condition and calculated 10-year cardiovascular risk using each prediction tool. The discrimination and calibration of each tool was assessed for each disease. Results The time-dependent area under the curve (AUC) for QRISK3 was 0.752 for RA (95% CI 0.734–0.777), 0.794 for AS (95% CI 0.764–0.812), 0.764 for PsA (95% CI 0.741–0.791), 0.815 for psoriasis (95% CI 0.789–0.835) and 0.698 for OA (95% CI 0.670–0.717), indicating reasonably good predictive performance. The AUCs for the FRS were similar, and slightly lower for the RRS. The FRS was reasonably well calibrated for each condition but underpredicted risk for patients with RA. The RRS tended to underpredict CVD risk, while QRISK3 overpredicted CVD risk, especially for the most high-risk individuals. Conclusion CVD risk for individuals with RA, AS and psoriatic disease was generally less accurately predicted using each of the three CVD risk prediction tools than the reported accuracies in the original publications. Individuals with OA also had less accurate predictions, suggesting inflammation is not the sole reason for underperformance. Disease-specific risk prediction tools may be required. [ABSTRACT FROM AUTHOR] more...

Published
2024
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24. Lower hepatocellular carcinoma surveillance in metabolic dysfunction‐associated steatotic liver disease: Impact on treatment eligibility.

Author

Henry‐Blake, Connor, Balachandrakumar, Vinay, Kassab, Mohamed, Devonport, Joshua, Matthews, Charmaine, Fox, James, Baggus, Elisabeth, Henney, Alexander, Stern, Nicholas, Cuthbertson, Daniel J, Palmer, Daniel, Johnson, Philip J, Hughes, David M, Hydes, Theresa J, and Cross, Timothy J S more...

Subjects
FATTY liver, PROPORTIONAL hazards models, EARLY detection of cancer, FISHER exact test, LIVER cancer
Abstract

Background and Aim: This study aimed to compare the determinants and impact of hepatocellular carcinoma (HCC) surveillance rates for people with metabolic dysfunction‐associated steatotic liver disease (MASLD) versus other chronic liver diseases. Methods: A dataset of HCC patients from a UK hospital (2007–2022) was analyzed. The Mann–Whitney U‐test compared continuous variables. The χ2 and two‐tailed Fisher exact tests compared categorical data. Regression modeling analyzed the impact of MASLD on the size and number of HCC nodules and curative treatment. The Cox proportional hazards model assessed the influence of MASLD on overall survival. Results: A total of 176 of 687 (25.6%) HCC patients had MASLD. Fewer people with MASLD HCC were enrolled in HCC surveillance compared to non‐MASLD HCC (38 [21.6%] vs 215 [42.1%], P < 0.001). Patients with MASLD HCC were less likely to have been under secondary care (n = 57 [32.4%] vs 259 [50.7%], P < 0.001) and less likely to have cirrhosis (n = 113 [64.2%] vs 417 [81.6%], P < 0.001). MASLD was associated with a 12.3‐mm (95% confidence interval [CI] 10.8–14.0 mm) greater tumor diameter compared to people without MASLD (P = 0.002). Patients with MASLD HCC had 0.62 reduced odds (95% CI 0.43–0.91) of receiving curative treatment compared to non‐MASLD HCC (P = 0.014). Overall survival was similar for patients with MASLD HCC versus non‐MASLD HCC (hazard ratio 1.03, 95% CI 0.85–1.25, P = 0.748). Conclusion: Patients with MASLD are less likely to have been enrolled in HCC surveillance due to undiagnosed cirrhosis or presenting with non‐cirrhotic HCC. Patients with MASLD HCC present with larger tumors and are less likely to receive curative treatment. [ABSTRACT FROM AUTHOR] more...

Published
2024
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25. The use of parent‐completed questionnaires to investigate developmental outcomes in large populations of children exposed to antiseizure medications in pregnancy

Author

Bluett‐Duncan, Matthew, primary, Bullen, Philip, additional, Campbell, Ellen, additional, Clayton‐Smith, Jill, additional, Craig, John, additional, García‐Fiñana, Marta, additional, Hughes, David M., additional, Ingham, Amy, additional, Irwin, Beth, additional, Jackson, Cerian, additional, Kelly, Teresa, additional, Morrow, James, additional, Rushton, Sarah, additional, Winterbottom, Janine, additional, Wood, Amanda G., additional, Yates, Laura M., additional, and Bromley, Rebecca L., additional more...

Published
2024
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26. Can self-testing be enhanced to hasten safe return of healthcare workers in pandemics? Random order, open label trial using two manufacturers’ SARS-CoV-2 lateral flow devices concurrently

Author

Zhang, Xingna, primary, Cheyne, Christopher P, additional, Jones, Christopher, additional, Humann, Michael, additional, Leeming, Gary, additional, Smith, Claire, additional, Hughes, David M, additional, Burnside, Girvan, additional, Dodd, Susanna, additional, Penrice-Randal, Rebekah, additional, Dong, Xiaofeng, additional, Semple, Malcolm G, additional, Neal, Tim, additional, Tunkel, Sarah, additional, Fowler, Tom, additional, Turtle, Lance, additional, Garcia-Finana, Marta, additional, and Buchan, Iain E, additional more...

Published
2024
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28. Contact X-ray Brachytherapy as a sole treatment in selected patients with early rectal cancer - Multi-centre study

Author

Than, Ngu Wah, Pritchard, D. Mark, Hughes, David M., Yu, Kai Shing, Minnaar, Helen S., Dhadda, Amandeep, Mills, Jamie, Folkesson, Joakim, Radu, Calin, Duckworth, C. A., Wong, Helen, Ul Haq, Muneeb, Sripadam, Rajaram, Halling-Brown, Mark D., Stewart, Alexandra J., Myint, Arthur Sun, Than, Ngu Wah, Pritchard, D. Mark, Hughes, David M., Yu, Kai Shing, Minnaar, Helen S., Dhadda, Amandeep, Mills, Jamie, Folkesson, Joakim, Radu, Calin, Duckworth, C. A., Wong, Helen, Ul Haq, Muneeb, Sripadam, Rajaram, Halling-Brown, Mark D., Stewart, Alexandra J., and Myint, Arthur Sun more...

Abstract

Background and purpose: Radical surgery is the standard of care for early rectal cancer. However, alternative organ-preserving approaches are attractive, especially in frail or elderly patients as these avoid surgical complications. We have assessed the efficacy of sole Contact X-ray Brachytherapy (CXB) treatment in stage-1 rectal cancer patients who were unsuitable for or declined surgery. Materials and methods: This retrospective multi-centre study (2009-2021) evaluated 76 patients with T1/2-N0- M0 rectal adenocarcinomas who were treated with CXB alone. Outcomes were assessed for the entire cohort and sub-groups based on the T-stage and the criteria for receiving CXB alone; Group A: patients who were fit enough for surgery but declined, Group B: patients who were high-risk for surgery and Group C: patients who had received prior pelvic radiation for a different cancer. Results: With a median follow-up of 26(IQR:12-49) months, initial clinical Complete Response (cCR) was 82 (70-93)% with rates of local regrowth 18(8-29)%, 3-year actuarial local control (LC) 84(75-95)%, distant relapse 3 %, and no nodal relapse. 5-year disease-free survival (DFS) and overall survival (OS) were 66(48-78)% and 58(44-75)%. Lower OS was observed in Groups B [HR:2.54(95 %CI:1.17, 5.59), p = 0.02] and C [HR:2.75 (95 %CI:1.15, 6.58), p = 0.03]. Previous pelvic radiation predicted lower cCR and OS. The main toxicity was G12 rectal bleeding (26 %) and symptoms of impaired anal sphincter function were not reported in any patients. Conclusion: CXB treatment alone achieved a high cCR rate with satisfactory LC and DFS. Inferior oncological outcomes were observed in patients who had received prior pelvic radiotherapy. CXB alone, with its favourable toxicity profile and avoidance of general anaesthesia and surgery risks, therefore, can be considered for patients who are unsuitable for or refuse surgery. more...

Published
2024
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34. Bayesian estimation of the prevalence of antimicrobial resistance: a mathematical modelling study.

Author

Howard, Alex, Green, Peter L, Velluva, Anoop, Gerada, Alessandro, Hughes, David M, Brookfield, Charlotte, Hope, William, and Buchan, Iain

Subjects
ANTIMICROBIAL stewardship, INFECTION prevention, DRUG resistance in microorganisms, BAYESIAN analysis
Abstract

Background Estimates of the prevalence of antimicrobial resistance (AMR) underpin effective antimicrobial stewardship, infection prevention and control, and optimal deployment of antimicrobial agents. Typically, the prevalence of AMR is determined from real-world antimicrobial susceptibility data that are time delimited, sparse, and often biased, potentially resulting in harmful and wasteful decision-making. Frequentist methods are resource intensive because they rely on large datasets. Objectives To determine whether a Bayesian approach could present a more reliable and more resource-efficient way to estimate population prevalence of AMR than traditional frequentist methods. Methods Retrospectively collected, open-source, real-world pseudonymized healthcare data were used to develop a Bayesian approach for estimating the prevalence of AMR by combination with prior AMR information from a contextualized review of literature. Iterative random sampling and cross-validation were used to assess the predictive accuracy and potential resource efficiency of the Bayesian approach compared with a standard frequentist approach. Results Bayesian estimation of AMR prevalence made fewer extreme estimation errors than a frequentist estimation approach [ n  = 74 (6.4%) versus n  = 136 (11.8%)] and required fewer observed antimicrobial susceptibility results per pathogen on average [mean = 28.8 (SD = 22.1) versus mean = 34.4 (SD = 30.1)] to avoid any extreme estimation errors in 50 iterations of the cross-validation. The Bayesian approach was maximally effective and efficient for drug–pathogen combinations where the actual prevalence of resistance was not close to 0% or 100%. Conclusions Bayesian estimation of the prevalence of AMR could provide a simple, resource-efficient approach to better inform population infection management where uncertainty about AMR prevalence is high. [ABSTRACT FROM AUTHOR] more...

Published
2024
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43. Neurodevelopment of babies born to mothers with epilepsy: A prospective observational cohort study

Author

Bromley, Rebecca, Bullen, Philip, Campbell, Ellen, Craig, John, Ingham, Amy, Irwin, Beth, Jackson, Cerain, Kelly, Teresa, Morrow, James, Rushton, Sarah, García-Fiñana, Marta, Hughes, David M., Winterbottom, Janine, Wood, Amanda, Yates, Laura M., Clayton-Smith, Jill, the NaME Study Group, Bromley, Rebecca, Bullen, Philip, Campbell, Ellen, Craig, John, Ingham, Amy, Irwin, Beth, Jackson, Cerain, Kelly, Teresa, Morrow, James, Rushton, Sarah, García-Fiñana, Marta, Hughes, David M., Winterbottom, Janine, Wood, Amanda, Yates, Laura M., Clayton-Smith, Jill, and the NaME Study Group more...

Abstract

Objective: Despite widespread monotherapy use of lamotrigine or levetiracetam during pregnancy, prospectively collected, blinded child development data are still limited. The NaME (Neurodevelopment of Babies Born to Mothers With Epilepsy) Study prospectively recruited a new cohort of women with epilepsy and their offspring for longitudinal follow-up. Methods: Pregnant women of <21 weeks gestation (n = 401) were recruited from 21 hospitals in the UK. Data collection occurred during pregnancy (recruitment, trimester 3) and at 12 and 24 months of age. The primary outcome was blinded assessment of infant cognitive, language, and motor development on the Bayley Scales of Infant and Toddler Development (3rd edition) at 24 months of age with supplementary parent reporting on the Vinelands Adaptive Behavior Scales (2nd edition). Results: There were 394 live births, with 277 children (70%) completing the Bayley assessment at 24 months. There was no evidence of an association of prenatal exposure to monotherapy lamotrigine (−.74, SE = 2.9, 95% confidence interval [CI] = −6.5 to 5.0, p =.80) or levetiracetam (−1.57, SE = 3.1, 95% CI = −4.6 to 7.7, p =.62) with poorer infant cognition, following adjustment for other maternal and child factors in comparison to nonexposed children. Similar results were observed for language and motor scores. There was no evidence of an association between increasing doses of either lamotrigine or levetiracetam. Nor was there evidence that higher dose folic acid supplementation (≥5 mg/day) or convulsive seizure exposure was associated with child development scores. Continued infant exposure to antiseizure medications through breast milk was not associated with poorer outcomes, but the number of women breastfeeding beyond 3 months was low. Significance: These data are reassuring for infant development following in utero exposure to monotherapy lamotrigine or levetiracetam, but child development is dynamic, and future follow-up is required to rule o more...

Published
2023

44. COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region.

Author

Burnside, Girvan, Cheyne, Christopher P, Leeming, Gary, Humann, Michael, Darby, Alistair, Green, Mark A, Crozier, Alexander, Maskell, Simon, O'Halloran, Kay, Musi, Elena, Carmi, Elinor, Khan, Naila, Fisher, Debra, Corcoran, Rhiannon, Dunning, Jake, Edmunds, W John, Tharmaratnam, Kukatharmini, Hughes, David M, Malki-Epshtein, Liora, and Cook, Malcolm more...

Abstract

Objectives: To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risks, perceived risks and the feasibility of risk mitigations from experimental mass cultural events before coronavirus disease 2019 (COVID-19) restrictions were lifted. Design: Prospective, population-wide observational study. Setting: Four events (two nightclubs, an outdoor music festival and a business conference) open to Liverpool City Region UK residents, requiring a negative lateral flow test (LFT) within the 36 h before the event, but not requiring social distancing or face-coverings. Participants: A total of 12,256 individuals attending one or more events between 28 April and 2 May 2021. Main outcome measures: SARS-CoV-2 infections detected using audience self-swabbed (5–7 days post-event) polymerase chain reaction (PCR) tests, with viral genomic analysis of cases, plus linked National Health Service COVID-19 testing data. Audience experiences were gathered via questionnaires, focus groups and social media. Indoor CO2 concentrations were monitored. Results: A total of 12 PCR-positive cases (likely 4 index, 8 primary or secondary), 10 from the nightclubs. Two further cases had positive LFTs but no PCR. A total of 11,896 (97.1%) participants with scanned tickets were matched to a negative pre-event LFT: 4972 (40.6%) returned a PCR within a week. CO2 concentrations showed areas for improving ventilation at the nightclubs. Population infection rates were low, yet with a concurrent outbreak of >50 linked cases around a local swimming pool without equivalent risk mitigations. Audience anxiety was low and enjoyment high. Conclusions: We observed minor SARS-CoV-2 transmission and low perceived risks around events when prevalence was low and risk mitigations prominent. Partnership between audiences, event organisers and public health services, supported by information systems with real-time linked data, can improve health security for mass cultural events. [ABSTRACT FROM AUTHOR] more...

Published
2024
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46. sj-pdf-3-jrs-10.1177_01410768231182389 - Supplemental material for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region

Author

Burnside, Girvan, Cheyne, Christopher P, Leeming, Gary, Humann, Michael, Darby, Alistair, Green, Mark A, Crozier, Alexander, Maskell, Simon, O’Halloran, Kay, Musi, Elena, Carmi, Elinor, Khan, Naila, Fisher, Debra, Corcoran, Rhiannon, Dunning, Jake, Edmunds, W John, Tharmaratnam, Kukatharmini, Hughes, David M, Malki-Epshtein, Liora, Cook, Malcolm, Roberts, Ben M, Gallagher, Eileen, Howell, Kate, Chand, Meera, Kemp, Robin, Boulter, Matthew, Fowler, Tom, Semple, Malcolm G, Coffey, Emer, Ashton, Matt, García-Fiñana, Marta, and Buchan, Iain E more...

Subjects
Medicine
Abstract

Supplemental material, sj-pdf-3-jrs-10.1177_01410768231182389 for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region by Girvan Burnside, Christopher P Cheyne, Gary Leeming, Michael Humann, Alistair Darby, Mark A Green, Alexander Crozier, Simon Maskell, Kay O’Halloran, Elena Musi, Elinor Carmi, Naila Khan, Debra Fisher, Rhiannon Corcoran, Jake Dunning, W John Edmunds, Kukatharmini Tharmaratnam, David M Hughes, Liora Malki-Epshtein, Malcolm Cook, Ben M Roberts, Eileen Gallagher, Kate Howell, Meera Chand, Robin Kemp, Matthew Boulter, Tom Fowler, Malcolm G Semple, Emer Coffey, Matt Ashton, The COVID-19 Genomics UK (COG-UK) Consortium, Marta García-Fiñana and Iain E Buchan in Journal of the Royal Society of Medicine more...

Published
2023
Full Text
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47. sj-pdf-2-jrs-10.1177_01410768231182389 - Supplemental material for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region

Author

Burnside, Girvan, Cheyne, Christopher P, Leeming, Gary, Humann, Michael, Darby, Alistair, Green, Mark A, Crozier, Alexander, Maskell, Simon, O’Halloran, Kay, Musi, Elena, Carmi, Elinor, Khan, Naila, Fisher, Debra, Corcoran, Rhiannon, Dunning, Jake, Edmunds, W John, Tharmaratnam, Kukatharmini, Hughes, David M, Malki-Epshtein, Liora, Cook, Malcolm, Roberts, Ben M, Gallagher, Eileen, Howell, Kate, Chand, Meera, Kemp, Robin, Boulter, Matthew, Fowler, Tom, Semple, Malcolm G, Coffey, Emer, Ashton, Matt, García-Fiñana, Marta, and Buchan, Iain E more...

Subjects
Medicine
Abstract

Supplemental material, sj-pdf-2-jrs-10.1177_01410768231182389 for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region by Girvan Burnside, Christopher P Cheyne, Gary Leeming, Michael Humann, Alistair Darby, Mark A Green, Alexander Crozier, Simon Maskell, Kay O’Halloran, Elena Musi, Elinor Carmi, Naila Khan, Debra Fisher, Rhiannon Corcoran, Jake Dunning, W John Edmunds, Kukatharmini Tharmaratnam, David M Hughes, Liora Malki-Epshtein, Malcolm Cook, Ben M Roberts, Eileen Gallagher, Kate Howell, Meera Chand, Robin Kemp, Matthew Boulter, Tom Fowler, Malcolm G Semple, Emer Coffey, Matt Ashton, The COVID-19 Genomics UK (COG-UK) Consortium, Marta García-Fiñana and Iain E Buchan in Journal of the Royal Society of Medicine more...

Published
2023
Full Text
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48. sj-pdf-4-jrs-10.1177_01410768231182389 - Supplemental material for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region

Author

Burnside, Girvan, Cheyne, Christopher P, Leeming, Gary, Humann, Michael, Darby, Alistair, Green, Mark A, Crozier, Alexander, Maskell, Simon, O’Halloran, Kay, Musi, Elena, Carmi, Elinor, Khan, Naila, Fisher, Debra, Corcoran, Rhiannon, Dunning, Jake, Edmunds, W John, Tharmaratnam, Kukatharmini, Hughes, David M, Malki-Epshtein, Liora, Cook, Malcolm, Roberts, Ben M, Gallagher, Eileen, Howell, Kate, Chand, Meera, Kemp, Robin, Boulter, Matthew, Fowler, Tom, Semple, Malcolm G, Coffey, Emer, Ashton, Matt, García-Fiñana, Marta, and Buchan, Iain E more...

Subjects
Medicine
Abstract

Supplemental material, sj-pdf-4-jrs-10.1177_01410768231182389 for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region by Girvan Burnside, Christopher P Cheyne, Gary Leeming, Michael Humann, Alistair Darby, Mark A Green, Alexander Crozier, Simon Maskell, Kay O’Halloran, Elena Musi, Elinor Carmi, Naila Khan, Debra Fisher, Rhiannon Corcoran, Jake Dunning, W John Edmunds, Kukatharmini Tharmaratnam, David M Hughes, Liora Malki-Epshtein, Malcolm Cook, Ben M Roberts, Eileen Gallagher, Kate Howell, Meera Chand, Robin Kemp, Matthew Boulter, Tom Fowler, Malcolm G Semple, Emer Coffey, Matt Ashton, The COVID-19 Genomics UK (COG-UK) Consortium, Marta García-Fiñana and Iain E Buchan in Journal of the Royal Society of Medicine more...

Published
2023
Full Text
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49. sj-pdf-6-jrs-10.1177_01410768231182389 - Supplemental material for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region

Author

Burnside, Girvan, Cheyne, Christopher P, Leeming, Gary, Humann, Michael, Darby, Alistair, Green, Mark A, Crozier, Alexander, Maskell, Simon, O’Halloran, Kay, Musi, Elena, Carmi, Elinor, Khan, Naila, Fisher, Debra, Corcoran, Rhiannon, Dunning, Jake, Edmunds, W John, Tharmaratnam, Kukatharmini, Hughes, David M, Malki-Epshtein, Liora, Cook, Malcolm, Roberts, Ben M, Gallagher, Eileen, Howell, Kate, Chand, Meera, Kemp, Robin, Boulter, Matthew, Fowler, Tom, Semple, Malcolm G, Coffey, Emer, Ashton, Matt, García-Fiñana, Marta, and Buchan, Iain E more...

Subjects
Medicine
Abstract

Supplemental material, sj-pdf-6-jrs-10.1177_01410768231182389 for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region by Girvan Burnside, Christopher P Cheyne, Gary Leeming, Michael Humann, Alistair Darby, Mark A Green, Alexander Crozier, Simon Maskell, Kay O’Halloran, Elena Musi, Elinor Carmi, Naila Khan, Debra Fisher, Rhiannon Corcoran, Jake Dunning, W John Edmunds, Kukatharmini Tharmaratnam, David M Hughes, Liora Malki-Epshtein, Malcolm Cook, Ben M Roberts, Eileen Gallagher, Kate Howell, Meera Chand, Robin Kemp, Matthew Boulter, Tom Fowler, Malcolm G Semple, Emer Coffey, Matt Ashton, The COVID-19 Genomics UK (COG-UK) ConsortiumMarta García-Fiñana and Iain E Buchan in Journal of the Royal Society of Medicine more...

Published
2023
Full Text
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50. sj-pdf-5-jrs-10.1177_01410768231182389 - Supplemental material for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region

Author

Burnside, Girvan, Cheyne, Christopher P, Leeming, Gary, Humann, Michael, Darby, Alistair, Green, Mark A, Crozier, Alexander, Maskell, Simon, O’Halloran, Kay, Musi, Elena, Carmi, Elinor, Khan, Naila, Fisher, Debra, Corcoran, Rhiannon, Dunning, Jake, Edmunds, W John, Tharmaratnam, Kukatharmini, Hughes, David M, Malki-Epshtein, Liora, Cook, Malcolm, Roberts, Ben M, Gallagher, Eileen, Howell, Kate, Chand, Meera, Kemp, Robin, Boulter, Matthew, Fowler, Tom, Semple, Malcolm G, Coffey, Emer, Ashton, Matt, García-Fiñana, Marta, and Buchan, Iain E more...

Subjects
Medicine
Abstract

Supplemental material, sj-pdf-5-jrs-10.1177_01410768231182389 for COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region by Girvan Burnside, Christopher P Cheyne, Gary Leeming, Michael Humann, Alistair Darby, Mark A Green, Alexander Crozier, Simon Maskell, Kay O’Halloran, Elena Musi, Elinor Carmi, Naila Khan, Debra Fisher, Rhiannon Corcoran, Jake Dunning, W John Edmunds, Kukatharmini Tharmaratnam, David M Hughes, Liora Malki-Epshtein, Malcolm Cook, Ben M Roberts, Eileen Gallagher, Kate Howell, Meera Chand, Robin Kemp, Matthew Boulter, Tom Fowler, Malcolm G Semple, Emer Coffey, Matt Ashton, The COVID-19 Genomics UK (COG-UK) Consortium, Marta García-Fiñana and Iain E Buchan in Journal of the Royal Society of Medicine more...

Published
2023
Full Text
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