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1. Current and future genomic applications for surgeons

Author: Alkhatib, O, primary, Miles, T, additional, Jones, RP, additional, Mair, R, additional, Palmer, R, additional, Winter, H, additional, and McDermott, FD, additional
Published: 2024
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2. Postoperative surveillance after surgery for colorectal liver metastasis: a cross-sectional study

Author: Nzenwa, IC, primary, Pathak, S, additional, Knight, SR, additional, Mowbray, NG, additional, O’Reilly, D, additional, and Jones, RP, additional
Published: 2024
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3. Understanding family use of a universal early childhood education program in Tasmanian communities experiencing disadvantage

Author: Jones, RP
Abstract: Access to high quality early childhood education appears to be particularly important for children from low SES backgrounds who receive proportionately greater benefits than children from less disadvantaged backgrounds. Launching into Learning (LiL) is a Tasmanian Department of Education program that provides universal school-based education services to support families and young children aged 0-5 years. At LiL sessions, children and their parents/carers engage in a range of indoor and outdoor play-based learning activities under the guidance of an early childhood educator. The research presented in this thesis explores how Tasmanian parents living in two communities experiencing disadvantage use and experience LiL and the factors shaping their use and experiences. In addition, policy and other documents related to LiL are analysed to identify the intended purpose of LiL and how LiL users are framed and positioned. Research was conducted between April 2017 and December 2018. Participants were 39 parents/carers (‘families’), 32 early childhood education professionals. Over 100 naturalistic observations were collected during an extensive period of fieldwork at LiL sites and a range of other early childhood settings. Policy documents relevant to LiL were analysed using Bacchi’s (2009) ‘What is the Problem Represented to Be’ approach. Parent information brochures were analysed using thematic analysis. Parents’ use and experiences of LiL were investigated using participant observation (PO) of LiL sessions, and interviews with parents and early childhood educators. Between 2017-2019, 39 parents with one or more children aged under five years, and 20 educators (teachers and aides) were recruited into the study from two Tasmanian communities. PO and interview data underwent a thematic analysis that included theoretically informed coding derived from Bourdieusian concepts including cultural and social capital. The analysis of policy documents found that the intended purpose of LiL is to create school readiness, ease transitions of children and their parents into schooling, and to support improved learning outcomes amongst Tasmania’s children. Parents who were viewed as ‘less engaged’ in schooling or LiL were often problematised in policy documents. Analysis of interview and PO data found that key factors shaping parents’ use of LiL are social and geographic isolation, family life complexity, and aspects of services that helped them to feel either at ease, or as ‘fish out of water’. Parents who made less use of LiL often described multiple barriers to engagement. Parents and early childhood teachers generally shared similar understandings of LiL. Both saw LiL as supporting school readiness, transition into schooling, and early social and academic skills. Differences in how teachers and parents viewed appropriate engagement with LiL sometimes created tensions between them. Bourdieu’s concepts of social and cultural capitals were useful in understanding how parents use and experience LiL. Participating in LiL helped parents who were socially isolated by expanding their social capital. It also provided opportunities for diversification of family level cultural capital. Engagement with LiL was more likely to be precarious amongst families whose cultural capital resources were likely to be of less socially dominant forms. The influence of social class was strongly evident. Parents who used LiL reported a range of benefits to them and their children. Transitions into schooling were eased, with LiL building familiarity with the school setting, routines ad expectations. This thesis also highlights a paradoxical relationship that exists between schools and families living with disadvantage. Families residing in low SES communities are less likely to belong to dominant social class groups, and therefore tend to possess differing levels of capitals from those who occupy the middle and upper classes. It was evident in this study that the benefits of LiL were also accompanied by some drawbacks. Families using services such as LiL can experience a delegitimisation of their capitals, and symbolic violence. In this study, some parents were observed to respond to this with a passive resistance to LiL messaging, non-engagement, or withdrawal from the program. This study points to the need to further address the lived realities of symbolic violence in early childhood education, which can occur in the process of enacting the well-intentioned goal of building school readiness. Programs such as LiL are still novel and little is known about how they are being experienced and used by parents. This thesis provides valuable information to support service providers and policy makers in the design of early childhood education services. In addition, the findings make an empirical and theoretical contribution to the sociology of education that help explain why families living in lower SES communities may be less likely to engage with early childhood education programs than families from more affluent areas and how parents and children appear to benefit from participating in LiL.
Published: 2023
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4. Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Author: Khatri, C, Ward, AE, Nepogodiev, D, Ahmed, I, Chaudhry, D, Dhaif, F, Bankhad-Kendall, B, Kaafarani, H, Bretherton, C, Mahmood, A, Marais, L, Parsons, N, Bhangu, A, Metcalfe, A, Siaw-Acheampong, K, Dawson, BE, Evans, JP, Glasbey, JC, Gujjuri, RR, Heritage, E, Jones, CS, Kamarajah, SK, Keatley, JM, Lawday, S, Li, E, Mckay, SC, Pellino, G, Tiwari, A, Simoes, JFF, Trout, IM, Venn, ML, Wilkin, RJW, Ademuyiwa, AO, Agarwal, A, Al Ameer, E, Alderson, D, Alser, O, Arnaud, AP, Augestad, KM, Bankhead-Kendall, B, Benson, RA, Chakrabortee, S, Blanco-Colino, R, Brar, A, Bravo, A Minaya, Breen, KA, Buarque, I Lima, Caruana, E, Cunha, MF, Davidson, GH, Desai, A, Di Saverio, S, Edwards, J, Elhadi, M, Farik, S, Fiore, M, Fitzgerald, JE, Ford, S, Gallo, G, Ghosh, D, Gomes, GMA, Griffiths, E, Halkias, C, Harrison, EM, Hutchinson, P, Isik, A, Kolias, A, Lawani, I, Lederhuber, H, Leventoglu, S, Loffler, MW, Martin, J, Mashbari, H, Mazingi, D, Mohan, H, Moore, R, Moszkowicz, D, Ng-Kamstra, JS, Metallidis, S, Moug, S, Niquen, M, Ntirenganya, F, Outani, O, Pata, F, Pinkney, TD, Pockney, P, Radenkovic, D, Ramos-De la Medina, A, Roberts, K, Santos, I, Schache, A, Schnitzbauer, A, Stewart, GD, Shaw, R, Shu, S, Soreide, K, Spinelli, A, Sundar, S, Tabiri, S, Townend, P, Tsoulfas, G, van Ramshorst, G, Vidya, R, Vimalachandran, D, Wright, N, Mak, JKC, Kulkarni, R, Sharma, N, Nankivell, P, Tirotta, F, Parente, A, Breik, O, Kisiel, A, Cato, LD, Saeed, S, Pathanki, AM, Almond, M, Kamal, M, Chebaro, A, Lecolle, K, Truant, S, El Amrani, M, Zerbib, P, Pruvot, FR, Mathieu, D, Surmei, E, Mattei, L, Marin, H, Dudek, J, Singhal, T, El-Hasani, S, Nehra, D, Walters, A, Cuschieri, J, Ho, M, Wade, RG, Johnstone, J, Bourke, G, Brunelli, A, Elkadi, H, Otify, M, Pompili, C, Burke, JR, Bagouri, E, Chowdhury, M, Abual-Rub, Z, Kaufmann, A, Munot, S, Lo, T, Young, A, Kowal, M, Wall, J, Peckham-Cooper, A, Winter, SC, Belcher, E, Stavroulias, D, Di Chiara, F, Wallwork, K, Qureishi, A, Lami, M, Sravanam, S, Mastoridis, S, Shah, K, Chidambaram, S, Smillie, R, Shaw, AV, Bandyopadhyay, S, Cernei, C, Jeyaretna, D, Ganau, M, Piper, RJ, Duck, E, Brown, S, Jelley, C, Tucker, SC, Bond-Smith, G, Griffin, XL, Tebala, GD, Neal, N, Vatish, M, Noton, TM, Ghattaura, H, Maher, M, Fu, H, Risk, OBF, Majd, Soleymani H, Sinha, S, Shankar, S, Aggarwal, A, Kharkar, H, Lakhoo, K, Verberne, C, Senent-Boza, A, Sanchez-Arteaga, A, Benitez-Linero, I, Manresa-Manresa, F, Tallon-Aguilar, L, Melero-Cortes, L, Fernandez-Marin, MR, Duran-Munoz-Cruzado, VM, Ramallo-Solis, I, Beltran-Miranda, P, Pareja-Ciuro, F, Anton-Eguia, BT, Dawson, AC, Drane, A, Oliva Mompean, F, Gomez-Rosado, J, Reguera-Rosal, J, Valdes-Hernandez, J, Capitan-Morales, L, del Toro Lopez, MD, Patel, M, Shabana, A, Alanbuki, A, Usman, O, Tang, A, Beamish, AJ, Price, C, Bosanquet, D, Magowan, D, Solari, F, Williams, G, Nassa, H, Smith, L, Elliott, L, Mccabe, G, Holroyd, D, Jamieson, NB, Mariani, NM, Nicastro, V, Li, Z, Parkins, K, Spencer, N, Harries, R, Egan, RJ, Motter, D, Jenvey, C, Mahoney, R, Fine, N, Minto, T, Henry, A, Gill, C, Dunne, N, Sarma, DR, Godbole, C, Carlos, W, Tewari, N, Jeevan, D, Naredla, P, Khajuria, A, Connolly, H, Robertson, S, Sweeney, C, Di Taranto, G, Shanbhag, S, Dickson, K, McEvoy, K, Skillman, J, Sait, M, Al-omishy, H, Baig, M, Heer, B, Lunevicius, R, Sheel, ARG, Sundhu, M, Santini, AJA, Fathelbab, MSAT, Hussein, KMA, Nunes, QM, Jones, RP, Shahzad, K, Haq, I, Baig, MMAS, Hughes, JL, Kattakayam, A, Rajput, K, Misra, N, Shah, SB, Clynch, AL, Georgopoulou, N, Sharples, HM, Apampa, AA, Nzenwa, IC, Sud, A, Podolsky, D, Coleman, NL, Callahan, MP, Dunstan, M, Beak, P, Gerogiannis, I, Ebrahim, A, Alwadiya, A, Goyal, A, Phillips, A, Bhalla, A, Demetriou, C, Grimley, E, Theophilidou, E, Ogden, E, Malcolm, FL, Davies-Jones, G, Ng, JCK, Mirza, M, Hassan, M, Elmaleh, N, Daliya, P, Williams, S, Bateman, A, Chia, Z, A'Court, J, Konarski, A, Faulkner, G, Talwar, R, Patel, K, Askari, A, Jambulingam, PS, Shaw, S, Maity, A, Hatzantonis, C, Sagar, J, Kudchadkar, S, Cirocchi, N, Chan, CH, Eberbach, H, Bayer, J, Erdle, B, Sandkamp, R, Breen, K, Velmahos, G, Maurer, LR, El Moheb, M, Gaitanidis, A, Naar, L, Christensen, MA, Kapoen, C, Langeveld, K, El Hechi, M, Mokhtari, A, Main, B, Maccabe, T, Newton, C, Blencowe, NS, Fudulu, DP, Bhojwani, D, Baquedano, M, Caputo, M, Rapetto, F, Flannery, O, Hassan, A, Ward, A, Tadross, D, Majkowski, L, Blundell, C, Forlani, S, Nair, R, Guha, S, Brown, SR, Steele, C, Kelty, CJ, Newman, T, Lee, M, Chetty, G, Lye, G, Balasubramanian, SP, Shah, Sureshkumar N, Sherif, M, Al-mukhtar, A, Whitehall, E, Giblin, A, Wells, F, Sharkey, A, Adamec, A, Madan, S, Konsten, J, Van Heinsbergen, M, Sou, A, Simpson, D, Hamilton, E, Blair, J, Jimeno Fraile, J, Morales-Garcia, D, Carrillo-Rivas, M, Toledo Martinez, E, Pascual, A, Landaluce-Olavarria, A, Gonzalez De Miguel, M, Gomez Cruzado, Fernandez L, Begona, E, Lecumberri, D, Calvo Rey, A, Prada Hervella, GM, Dos Santos Carregal, L, Rodriguez, Fernandez MI, Freijeiro, M, El Drubi Vega, S, Van den Eynde, J, Oosterlinck, W, Van den Eynde, R, Sermon, A, Boeckxstaens, A, Cordonnier, A, De Coster, J, Jaekers, J, Politis, C, Miserez, M, Galipienso Eri, M, Garcia Montesino, JD, Dellonder Frigole, J, Noriego Munoz, D, Lizzi, V, Vovola, F, Arminio, A, Cotoia, A, Sarni, AL, Bekheit, M, Kamera, BS, Elhusseini, M, Sharma, P, Ahmeidat, A, Gradinariu, G, Cymes, W, Hannah, A, Mignot, G, Shaikh, S, Agilinko, J, Sgro, A, Rashid, MM, Milne, K, McIntyre, J, Akhtar, MA, Turnbull, A, Brunt, A, Stewart, KE, Wilson, MSJ, Rutherford, D, McGivern, K, Massie, E, Duff, S, Moura, F, Brown, BC, Khan, A, Asaad, P, Wadham, B, Aneke, IA, Collis, J, Warburton, H, Thomas, M, Pearce, L, Fountain, DM, Laurente, R, Sigamoney, KV, Dasa, M, George, K, Naqui, Z, Galhoum, M, Lipede, C, Gabr, A, Radhakrishnan, A, Hasan, MT, Kalenderov, R, Pathmanaban, O, Colombo, F, Chelva, R, Subba, K, Abou-Foul, AK, Khalefa, M, Hossain, F, Moores, T, Pickering, L, Shah, J, Anthoney, J, Emmerson, O, Bevan, K, Makin-Taylor, R, Ong, CS, Callan, R, Bloom, O, Chauhan, G, Kaur, J, Burahee, A, Bleibleh, S, Pigadas, N, Snee, D, Bhasin, S, Crichton, A, Habeebullah, A, Bodla, AS, Yassin, N, Mondragon, M, Dewan, V, Giuffrida, MC, Marano, A, Palagi, S, Grimaldi, Di Maria S, Testa, V, Peluso, C, Borghi, F, Simonato, A, Puppo, A, D'Agruma, M, Chiarpenello, R, Pellegrino, L, Maione, F, Cianflocca, D, Pruiti, Ciarello V, Giraudo, G, Gelarda, E, Dalmasso, E, Abrate, A, Daniele, A, Ciriello, V, Rosato, F, Garnero, A, Leotta, L, Chiozza, M, Anania, G, Urbani, A, Radica, Koleva M, Carcoforo, P, Portinari, M, Sibilla, M, Archer, JE, Odeh, A, Siddaiah, N, Baumber, R, Parry, J, Carmichael, H, Velopulos, CG, Wright, FL, Urban, S, McIntyre, Jr RC, Schroeppel, TJ, Hennessy, EA, Dunn, J, Zier, L, Parmar, C, Mccluney, S, Shah, S, Munoz Vives, JM, Osorio, A, Gomez Diaz, CJ, Guariglia, CA, Soto Montesinos, C, Sanchon, L, Xicola Martinez, M, Guardia, N, Collera, P, Diaz Del Gobbo, R, Sanchez Jimenez, R, Farre Font, R, Flores Clotet, R, Brathwaite, CEM, Liu, H, Petrone, P, Hakmi, H, Sohail, AH, Baltazar, G, Heckburn, R, Aujayeb, A, Townshend, D, McLarty, N, Shenfine, A, Jackson, K, Johnson, C, Madhvani, K, Hampton, M, Hormis, AP, Young, R, Miu, V, Sheridan, K, MacDonald, L, Green, S, Onos, L, Dean, B, Luney, C, Myatt, R, Williams, MA, McVeigh, J, Alqallaf, A, Ben-Sassi, A, Mohamed, I, Mellor, K, Joshi, P, Joshi, Y, Crichton, R, Sonksen, J, Aldridge, K, Layton, GR, Karki, B, Jeong, H, Pankhania, S, Asher, S, Folorunso, A, Mistry, S, Singh, B, Winyard, J, Mangwani, J, Babu, BHB, Liyanage, ASD, Newman, S, Blake, I, Weerasinghe, C, Ballabio, M, Bisagni, P, Longhi, M, Armao, T, Madonini, M, Gagliano, A, Pizzini, P, Alga, A, Nordberg, M, Sandblom, G, Jallad, S, Lord, J, Anderson, C, El Kafsi, J, Logishetty, K, Saadya, A, Midha, R, Ip, M, Ponniah, Subbiah H, Stockdale, T, Bacarese-Hamilton, T, Foster, L, James, A, Anjarwalla, N, Henriques, Marujo D, Hettige, R, Baban, C, Tenovici, A, Salerno, G, Hardie, J, Page, S, Anazor, F, King, SD, Luck, J, Kazzaz, S, HKruijff, S, De Vries, JPPM, Steinkamp, PJ, Jonker, PKC, Van der Plas, WY, Bierman, W, Janssen, Y, Borgstein, ABJ, Gisbertz, SS, Henegouwen, van Berge MI, Enjuto, D, Perez Gonzalez, M, Diaz Pena, P, Gonzalez, J, Marqueta De Salas, M, Martinez Pascual, P, Rodriguez Gomez, L, Garces Garcia, R, Ramos Bonilla, A, Herrera-Merino, N, Fernandez Bernabe, P, Cagigal Ortega, EP, Hernandez, I, de Castro Rubio, Garcia E, Cervera, I, Kashora, F, Siddique, MH, Singh, A, Barmpagianni, C, Basgaran, A, Basha, A, Okechukwu, V, Bartsch, A, Gallagher, P, Maqsood, A, Sahnan, K, Leo, CA, Lewis, SE, Ubhi, HK, Exley, R, Khan, U, Shah, P, Saxena, S, Zafar, N, Abdul-Jabar, H, Mongelli, F, Bernasconi, M, Di Giuseppe, M, Christoforidis, D, La Regina, D, Arigoni, M, Liew, I, Al-Sukaini, A, Mediratta, S, Saxena, D, Brown, O, Boal, M, Dean, H, Higgs, S, Stanger, S, Abdalaziz, H, Constable, J, Ishii, H, Preece, R, Dovell, G, Reddy, Gopi R, Dehal, A, Shah, HB, Cross, GWV, Seyed-Safi, P, Smart, YW, Kuc, A, Al-Yaseen, M, Jayasankar, B, Balasubramaniam, D, Abdelsaid, K, Mundkur, N, Gallagher, B, Hine, T, Keeler, B, Soulsby, RE, Taylor, A, Davies, E, Ryska, O, Raymond, T, Rogers, S, Tong, A, Hawkin, P, Kinnaman, G, Meagher, A, Sharma, I, Holler, E, Dunning, J, Viswanath, Y, Freystaetter, K, Dixon, J, Hadfield, JN, Hilley, A, Egglestone, A, Smith, B, Arkani, S, Freedman, J, Youssef, M, Sreedharan, L, Baskaran, D, Shaikh, I, Seebah, K, Reid, J, Watts, D, Kouritas, V, Chrastek, D, Maryan, G, Gill, DF, Khatun, F, Ranjit, S, Parakh, J, Sarodaya, V, Daadipour, A, Khalifa, M, Bosch, KD, Bashkirova, V, Dvorkin, LS, Kalidindi, VK, Choudhry, A, Marx, W, Espino Segura-Illa, M, Sanchez Aniceto, G, Castano-Leon, AM, Jimenez-Roldan, L, Delgado Fernandez, J, Perez Nunez, A, Lagares, A, Garcia Perez, D, Santas, M, Paredes, I, Esteban Sinovas, O, Moreno-Gomez, L, Rubio, E, Vega, V, Vivas Lopez, A, Labalde Martinez, M, Garcia Villar, O, Pelaez Torres, PM, Garcia-Borda, J, Ferrero Herrero, E, Gomez, P, Eiriz Fernandez, C, Ojeda-Thies, C, Pardo Garcia, JM, Jones, Wynn H, Divecha, H, Whelton, C, Board, T, Hardie, C, Powell-Smith, E, Alotaibi, M, Maashi, A, Zowgar, A, Alsakkaf, M, Izquierdo, O, Ventura, D, Castellanos, J, Lara, A, Escobar, D, Arrieta, M, Garcia de Cortazar, U, Villamor Garcia, I, Cioci, A, Ruiz, G, Allen, M, Rakoczy, K, Pavlis, W, Saberi, R, Sobti, A, Khaleel, A, Unnithan, A, Memon, K, Bhaskar, Pala RR, Maqboul, F, Kamel, F, Al-Samaraee, A, Madani, R, Kumar, L, Nisar, P, Agrawal, S, Llaquet Bayo, H, Duchateau, N, De Gheldere, C, Cheng, D, Yang, H, Fayad, A, Wood, ML, Persad, A, Groot, G, Pham, H, Hakami, I, Boeker, C, Mall, J, Smith, H, Haugstvedt, AF, Jonsson, M, Caja Vivancos, P, Villalabeitia Ateca, I, Prieto Calvo, M, Martin Playa, P, Gainza, A, Aragon Achig, EJ, Rodriguez Fraga, A, Melchor Corcostegui, I, Mallabiabarrena Ormaechea, G, Garcia Gutierrez, JJ, Barbier, L, Pesantez Peralta, MA, Jimenez Jimenez, M, Municio Martin, JA, Gomez Suarez, J, Garcia Opere, G, Pascua Gomez, LA, Onate Aguirre, M, Fernandez-Colorado, A, De la Rosa-Estadella, M, Gasulla-Rodriguez, A, Serrano-Martin, M, Peig-Font, A, Junca-Marti, S, Juarez-Pomes, M, Garrido-Ondono, S, Blasco-Torres, L, Molina-Corbacho, M, Maldonado-Sotoca, Y, Gasset-Teixidor, A, Blasco-Moreu, J, Turrado-Rodriguez, V, Lacy, AM, de Lacy, FB, Morales, X, Carreras-Castaner, A, Torner, P, Jornet-Gibert, M, Balaguer-Castro, M, Renau-Cerrillo, M, Camacho-Carrasco, P, Vives-Barquiel, M, Campuzano-Bitterling, B, Gracia, I, Pujol-Muncunill, R, Estaire Gomez, M, Padilla-Valverde, D, Sanchez-Garcia, S, Sanchez-Pelaez, D, Jimenez Higuera, E, Picon Rodriguez, R, Fernandez Camunas, A, Martinez-Pinedo, C, Garcia Santos, EP, Munoz-Atienza, V, Moreno Perez, A, de la Manzanara Cano, Lopez CA, Crego-Vita, D, Huecas-Martinez, M, Domenech, J, Rosello Anon, A, Sanguesa, MJ, Bernal-Sprekelsen, JC, Catala Bauset, JC, Renovell Ferrer, P, Martinez Perez, C, Gil-Albarova, O, Gilabert Estelles, J, Aghababyan, K, Rivas, R, Rivas, F, Escartin, J, Blas Laina, JL, Nogues, A, Cros, B, Talal El-Abur, I, Garcia Egea, J, Yanez, C, Kauppila, JH, Sarjanoja, E, Tzedakis, S, Bouche, PA, Gaujoux, S, Gossot, D, Seguin-Givelet, A, Fuks, D, Grigoroiu, M, Salas, Sanchez R, Cathelineau, X, Macek, P, Barbe, Y, Rozet, F, Barret, E, Mombet, A, Cathala, N, Brian, E, Zadegan, F, Conso, C, Baldwin, AJ, West, R, Gammeri, E, Catton, A, Kouris, Marinos S, Pereca, J, Singh, J, Patel, P, Handa, S, Kaushal, M, Kler, A, Reghuram, V, Tezas, S, Oktseloglou, V, Mosley, F, Monroy, De La Cruz MFI, Bobak, P, Omar, I, Ahad, S, Langlands, F, Brown, V, Hashem, M, Williams, A, Ridgway, A, Pournaras, D, Britton, E, Lostis, E, Ambler, GK, Chu, H, Hopkins, J, Manara, J, Chan, M, Doe, M, Moon, RDC, Jichi, T, Singleton, W, Mannion, R, Ramzi, J, Mohan, M, Singh, AA, Ashcroft, J, Baker, OJ, Coughlin, P, Davies, RJ, Durst, AZED, Abood, A, Habeeb, A, Hudson, VE, Lamb, B, Luke, L, 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Abdeh, L, Jones, D, Zeiton, M, Ismail, O, Naseem, H, Advani, R, Fell, A, Smith, A, Nikolaou, S, English, C, Kristinsson, S, Oni, T, Ilahi, N, Ballantyne, K, Woodward, Z, Merh, R, Robertson-Smith, B, Mahmoud, A, Ameerally, P, Finch, JG, Gnanachandran, C, Pop, I, Rogers, M, Yousef, Y, Woods, R, Zahid, H, Mundy, G, Dass, D, Ford, D, Khan, J, Thiruchandran, G, Toh, SKC, Ahmad, Y, Allana, A, Bellis, C, Babawale, O, Phan, YC, Lokman, U, Ismail, M, Koc, T, Witek, A, Duggleby, L, Shamoon, S, Stefan, S, Clancy, H, Singh, S, Mukherjee, S, Ferguson, D, Mansuri, A, Thakrar, A, Wickramarachchi, L, Cuthbert, R, Sivayoganathan, S, Chui, K, Karam, E, Dott, C, Singh, R, Lane, J, Colvin, HV, Badran, A, Cadersa, A, Cumpstey, A, Hamady, Z, Aftab, R, Wensley, F, Byrne, J, Morrison-Jones, V, Sekhon, GK, Shields, H, Shakoor, Z, Yener, A, Talbot, T, Alzetani, A, Cresner, R, Johnson, D, Hughes, I, Hall, J, Rooney, J, Chatterji, S, Zhang, Y, Owen, R, Rudic, M, Hunt, J, Zakai, D, Aladeojebi, A, Ali, M, Gaunt, A, 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Poggio, J, Sanserino, K, Rae, L, Philp, M, Metro, M, McNelis, P, Petrov, R, Pazionis, T, Quintana, M, Jackson, H, Lumenta, DB, Nischwitz, SP, Richtig, E, Pau, M, Srekl-Filzmaier, P, Eibinger, N, Michelitsch, B, Fediuk, M, Papinutti, A, Seidel, G, Kahn, J, Cohnert, TU, Kantor, E, Kahiu, J, Hossain, N, Hosny, S, Sultana, A, Taggarsi, M, Vitone, L, Lambert, J, Vaz, OP, Sarantitis, I, Shrestha, D, Timbrell, S, Shugaba, A, Jones, GP, Gardner, A, Tripathi, SS, Greenhalgh, MS, Emerson, H, Vejsbjerg, K, McCormick, W, Fisher, A, Singisetti, K, Aawsaj, Y, Barry, C, Blanco, J, Vanker, R, Ghobrial, M, Jones, G, Kanthasamy, S, Fawi, H, Awadallah, M, Chen, F, Cheung, J, Tingle, S, Abbadessa, F, Sachdeva, A, Rai, B, Chan, CD, McPherson, I, Booth, K, Ali, FM, Pandanaboyana, S, Grainger, T, Nandhra, S, Patience, A, Rogers, A, Roy, C, Williams, T, Dawe, N, McCaffer, C, Riches, J, Bhattacharya, S, Moir, J, Kalson, NS, Ahmed, HE, Mellor, C, Saleh, C, Koshy, RM, Hammond, J, Sanderson, L, Wahed, S, Phillips, AW, Ghosh, K, Rogers, LJ, Labib, PL, Miller, D, Minto, G, Hope, N, Marchbank, A, Emslie, K, Panahi, P, Ho, B, Perkins, C, Clough, E, Roy, H, Enemosah, I, Campbell, R, Natale, J, Gohil, K, Rela, M, Raza, N, Menakaya, C, Webb, JI, Antar, M, Modi, N, Sofat, R, Noel, J, Nunn, R, Adegbola, S, Eriberto, F, Sharma, V, Tanna, R, Lodhia, S, Carvalho, L, Osorio, C, Antunes, J, Lourenco, S, Balau, P, Godinho, M, Pereira, A, Keller, DS, Smart, NJ, Apollo - University of Cambridge Repository, Collaborative, COVIDSurg, and Robotics and image-guided minimally-invasive surgery (ROBOTICS)
Subjects: Male, medicine.medical_specialty, Multivariate analysis, MORTALITY-RATES, hip, SURGERY, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MULTICENTER, COVIDSurg Collaborative, 1117 Public Health and Health Services, Cohort Studies, Medicine, General & Internal, Internal medicine, General & Internal Medicine, medicine, Dementia, Humans, Prospective Studies, Aged, 80 and over, COMPLICATIONS, Science & Technology, HIP-FRACTURES, business.industry, Hip Fractures, SARS-CoV-2, COVID-19, 1103 Clinical Sciences, General Medicine, Femoral fracture, Perioperative, medicine.disease, Heart failure, trauma management, Medicine, Surgery, business, Life Sciences & Biomedicine, Femoral Fractures, Kidney disease, Cohort study, 1199 Other Medical and Health Sciences
Abstract: ObjectivesStudies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
Published: 2021

5. Impact of Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 infection

Author: Tabiri, Stephen, Kamarajah, Sivesh K, Nepogodiev, Dmitri, Li, Elizabeth, Simoes, Joana, Sravanam, Sanskrithi, Owusu, Sheila Agyeiwaa, Mahama, Haruna, Agyeman, Yaa Nyarko, Arthur, Joshua, Kunfah, Sheba Mary, Gyamfi, Frank Enoch, Owusu, Emmanuel Abem, Loffler, Markus W, Wandoh, Paul, Bhangu, Aneel, Siaw-Acheampong, Kwabena, Argus, Leah, Chaudhry, Daoud, Dawson, Brett E, Glasbey, James C, Gujjuri, Rohan R, Jones, Conor S, Khatri, Chetan, Keatley, James M, Lawday, Samuel, Mann, Harvinder, Marson, Ella J, Mclean, Kenneth A, Picciochi, Maria, Taylor, Elliott H, Tiwari, Abhinav, Simoes, Joana FF, Trout, Isobel M, Venn, Mary L, Wilkin, Richard JW, Dajti, Irida, Gjata, Arben, Boccalatte, Luis, Modolo, Maria Marta, Cox, Daniel, Pockney, Peter, Townend, Philip, Aigner, Felix, Kronberger, Irmgard, Hossain, Kamral, VanRamshorst, Gabrielle, Lawani, Ismail, Ataide, Gustavo, Baiocchi, Glauco, Buarque, Igor, Gohar, Muhammad, Slavchev, Mihail, Agarwal, Arnav, Brar, Amanpreet, Martin, Janet, Olivos, Maricarmen, Calvache, Jose, Perez Rivera, Carlos Jose, Hadzibegovic, Ana Danic, Kopjar, Tomislav, Mihanovic, Jakov, Klat, Jaroslav, Novysedlak, Rene, Christensen, Peter, El-Hussuna, Alaa, Batista, Sylvia, Lincango, Eddy, Emile, Sameh H, Mengesha, Mengistu Gebreyohanes, Hailu, Dr Samuel, Tamiru, Hailu, Kauppila, Joonas, Arnaud, Alexis, Albertsmeiers, Markus, Lederhuber, Hans, Loffler, Markus, Metallidis, Symeon, Tsoulfas, Georgios, Lorena, Maria Aguilera, Grecinos, Gustavo, Mersich, Tamas, Wettstein, Daniel, Ghosh, Dhruv, Kembuan, Gabriele, Brouk, Peiman, Khosravi, Mohammad, Mozafari, Masoud, Adil, Ahmed, Mohan, Helen M, Zmora, Oded, Fiore, Marco, Gallo, Gaetano, Pata, Francesco, Pellino, Gianluca, Satoi, Sohei, Ayasra, Faris, Chaar, Mohammad, Fakhradiyev, Ildar R, Jamal, Mohammad, Elhadi, Muhammed, Gulla, Aiste, Roslani, April, Martinez, Laura, Ramos De la Medina, Antonio, Outani, Oumaima, Jonker, Pascal, Kruijff, Schelto, Noltes, Milou, Steinkamp, Pieter, van der Plas, Willemijn, Ademuyiwa, Adesoji, Osinaike, Babatunde, Seyi-olajide, Justina, Williams, Emmanuel, Pejkova, Sofija, Augestad, Knut Magne, Soreide, Kjetil, Al Balushi, Zainab, Qureshi, Ahmad, Sayyed, Raza, Daraghmeh, Mustafa Abu Mohsen, Abukhalaf, Sadi, Cukier, Moises, Gomez, Hugo, Shu, Sebastian, Vasquez, Ximena, Parreno-Sacdalan, Marie Dione, Major, Piotr, Azevedo, Jose, Cunha, Miguel, Santos, Irene, Zarour, Ahmad, Bonci, Eduard-Alexandru, Negoi, Ionut, Efetov, Sergey, Litvin, Andrey, Ntirenganya, Faustin, AlAmeer, Ehab, Radenkovic, Dejan, Xiang, Frederick Koh Hong, Hoe, Chew Min, Yong, James Ngu Chi, Moore, Rachel, Nhlabathi, Ncamsile, Colino, Ruth Blanco, Bravo, Ana Minaya, Minaya-Bravo, Ana, Jayarajah, Umesh, Wickramasinghe, Dakshitha, Elmujtaba, Mohammed, Jebril, William, Rutegard, Martin, Sund, Malin, Isik, Arda, Leventoglu, Sezai, Abbott, Tom EF, Benson, Ruth, Caruna, Ed, Chakrabortee, Sohini, Demetriades, Andreas, Desai, Anant, Drake, Thomas D, Edwards, John G, Evans, Jonathan P, 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Imam, SMB, Kalavrezos, N, Sinha, D, Green, Chand ML, Beech, N, McEwen, R, Kiconco, H, Andreani, SM, Bath, MF, Sahni, A, Judkins, N, Springford, Rigueros L, Bacarese-Hamilton, J, Taylor, FG, Parmar, C, Mccluney, S, Shah, S, Talwar, R, Patel, K, Askari, A, Jambulingam, PS, Shaw, S, Maity, A, Hatzantonis, C, Sagar, J, Kudchadkar, S, Cirocchi, N, Chan, CH, Reynolds, J, Alexander, ME, Smart, CJ, Jayasankar, B, Balasubramaniam, D, Abdelsaid, K, Mundkur, N, Gallagher, B, Shah, J, Anthoney, J, Emmerson, O, Stylianides, N, Abdalla, M, Newton, K, Bhatia, K, Edmondson, R, Abdeh, L, Jones, D, Zeiton, M, Ismail, O, Naseem, H, Advani, R, Duff, S, Moura, F, Brown, BC, Khan, A, Asaad, P, Wadham, B, Aneke, IA, Collis, J, Warburton, H, Fell, A, Smith, A, Halkias, C, Nikolaou, S, English, C, Kristinsson, S, Oni, T, Ilahi, N, Ballantyne, K, Woodward, Z, Merh, R, Dunning, J, Viswanath, Y, Freystaetter, K, Dixon, J, Hadfield, JN, Hilley, A, Egglestone, A, Smith, B, Hine, T, Keeler, B, Soulsby, RE, Taylor, A, Davies, E, Ryska, O, Raymond, T, Rogers, S, Tong, A, Hawkin, P, Tingle, S, Abbadessa, F, Sachdeva, A, Rai, B, Chan, CD, McPherson, I, Booth, K, Ali, Mahmoud F, Pandanaboyana, S, Grainger, T, Nandhra, S, Patience, A, Roy, C, Williams, T, Dawe, N, McCaffer, C, Riches, J, Bhattacharya, S, Moir, J, Kalson, NS, Ahmed, Elamin H, Mellor, C, Saleh, C, Koshy, RM, Hammond, J, Sanderson, L, Wahed, S, Phillips, AW, Ghosh, K, Tang, A, Beamish, AJ, Price, C, Bosanquet, D, Magowan, D, Solari, F, Williams, G, Nassa, H, Smith, L, Robertson-Smith, B, Mahmoud, A, Ameerally, P, Finch, JG, Gnanachandran, C, Pop, I, Rogers, M, Yousef, Y, Mohamed, I, Woods, R, Zahid, H, Mundy, G, Sreedharan, L, Baskaran, D, Shaikh, I, Seebah, K, Reid, J, Watts, D, Kouritas, V, Chrastek, D, Maryan, G, Gill, DF, Khatun, F, Gajjar, K, Williamson, K, Bratt, D, Konstantinidi, K, Walton, T, Burnside, N, Weaver, H, Hawari, M, Addae-Boateng, E, Rollett, RA, Collins, ML, Tamimy, MS, Riyat, H, Wen, J, Neil-Dwyer, J, Brewer, H, Humes, D, Worku, D, Chowdhury, A, Oyende, O, Lewis-Lloyd, C, Adiamah, A, Koh, A, Jackman, J, Vohra, R, Navarro, A, Reilly, J, Aujayeb, A, Townshend, D, McLarty, N, Shenfine, A, Jackson, K, Johnson, C, Dass, D, Ford, D, Winter, SC, Belcher, E, Stavroulias, D, Di Chiara, F, Wallwork, K, Qureishi, A, Lami, M, Sravanam, S, Mastoridis, S, Shah, K, Chidambaram, S, Smillie, R, Shaw, AV, Bandyopadhyay, S, Cernei, C, Bretherton, C, Jeyaretna, D, Ganau, M, Piper, RJ, Duck, E, Brown, S, Jelley, C, Tucker, SC, Bond-Smith, G, Griffin, XL, Tebala, GD, Neal, N, Vatish, M, Noton, TM, Ghattaura, H, Maher, M, Fu, H, Risk, OBF, Majd, Soleymani H, Sinha, S, Shankar, S, Aggarwal, A, Khatkar, H, Lakhoo, K, Verberne, C, Dean, B, Luney, C, Myatt, R, Williams, MA, McVeigh, J, Rogers, LJ, Labib, PL, Miller, D, Minto, G, Hope, N, Marchbank, A, Emslie, K, Panahi, P, Ho, B, Perkins, C, Clough, E, Roy, H, Enemosah, I, Campbell, R, Natale, J, Gohil, K, Rela, M, Raza, N, Biliatis, I, Khan, J, Thiruchandran, G, Toh, SKC, Ahmad, Y, Allana, A, Bellis, C, Babawale, O, Phan, YC, Lokman, U, Ismail, M, Koc, T, Witek, A, Duggleby, L, Shamoon, S, Stefan, S, Clancy, H, Chadha, R, Middleton, SB, Wilmott, K, Hayden, C, Mclaren, C, Sutton, J, Whyte, A, Belgaumkar, A, Day, A, Gilbert, C, Oyewole, B, Narayan, P, Dent, H, Sandhya, A, De Silva, T, Waheed, S, Kapoor, K, Belgaumkar, AP, Fahim, M, Gala, T, Mithany, R, Morgan, R, Abdelkarim, M, Maw, A, Asqalan, A, Venkatesan, Sundaram G, Singh, S, Mukherjee, S, Ferguson, D, Mansuri, A, Thakrar, A, Wickramarachchi, L, Cuthbert, R, Sivayoganathan, S, Chui, K, Karam, E, Dott, C, Madhvani, K, Hampton, M, Hormis, AP, Fountain, DM, Laurente, R, Sigamoney, KV, Dasa, M, George, K, Naqui, Z, Galhoum, M, Lipede, C, Gabr, A, Radhakrishnan, A, Hasan, MT, Kalenderov, R, Pathmanaban, O, Chelva, R, Branagan, G, Longstaff, L, Ding, D, Barlow, C, Foster, J, Edwards, J, Ward, A, Tadross, D, Majkowski, L, Blundell, C, Forlani, S, Nair, R, Guha, S, Brown, SR, Steele, C, Kelty, CJ, Newman, T, Lee, M, Chetty, G, Lye, G, Balasubramanian, SP, Shah, Sureshkumar N, Sherif, M, Al-mukhtar, A, Whitehall, E, Giblin, A, Sharkey, A, Adamec, A, Madan, S, Narice, B, Sterrenburg, M, Thompson, A, Varley, I, Stavrakas, M, Rominiyi, O, Ray, J, Crank, M, Bacon, A, Al-Tamimi, Y, Catto, J, Saad, S, Abd Kahar, NN, Sou, A, Simpson, D, Hamilton, E, Blair, J, Jallad, S, Lord, J, Anderson, C, El Kafsi, J, Logishetty, K, Saadya, A, Midha, R, Ip, M, Ponniah, Subbiah H, Stockdale, T, Bacarese-Hamilton, T, Foster, L, James, A, Anjarwalla, N, Henriques, Marujo D, Hettige, R, Baban, C, Tenovici, A, Salerno, G, Lane, J, Colvin, HV, Badran, A, Cadersa, A, Cumpstey, A, Hamady, Z, Aftab, R, Wensley, F, Byrne, J, Morrison-Jones, V, Sekhon, GK, Shields, H, Shakoor, Z, Yener, A, Talbot, T, Alzetani, A, Cresner, R, Babu, BHB, Liyanage, ASD, Newman, S, Blake, I, Weerasinghe, C, Baumber, R, Parry, J, Menakaya, C, Webb, JI, Antar, M, Modi, N, Sofat, R, Noel, J, Nunn, R, Adegbola, S, Eriberto, F, Sharma, V, Tanna, R, Lodhia, S, Johnson, D, Hughes, I, Hall, J, Rooney, J, Chatterji, S, Zhang, Y, Owen, R, Rudic, M, Hunt, J, Zakai, D, Aladeojebi, A, Ali, M, Gaunt, A, Barmayehvar, B, Kitchen, M, Gowda, M, Mansour, F, Jarvis, M, Halliday, E, Lefroy, R, Nanjaiah, P, Lin, DJ, Rajgor, AD, Scurrah, RJ, Kang, C, Watson, LJ, Harris, G, Royle, T, Cunningham, Y, Steel, B, Luk, ACO, Boulton, AJ, Khan, T, Bakolas, G, Herrod, P, Gemmill, E, Boyd-Carson, H, Jibreel, M, Lenzi, E, Saafan, T, Sapre, D, Li, Z, Parkins, K, Spencer, N, Harries, R, Egan, RJ, Motter, D, Jenvey, C, Mahoney, R, Fine, N, Minto, T, Henry, A, Hollyman, M, Grieco, C, Gemmell, C, Whitmore, H, Babar, MS, Goodrum, S, Scott, R, Collard, B, Lau, K, Thomas, E, Patel, A, Allison, J, Bowen, J, Dias, A, Mahendran, B, Gopalswamy, S, Patil, S, Scott, L, Sarveswaran, J, Michel, M, Ravindran, S, Subba, K, Abou-Foul, AK, Khalefa, M, Hossain, F, Moores, T, Pickering, L, Stables, G, Doorgakant, A, Thiruvasagam, VG, Carter, J, Reid, S, Mohammed, R, Marlow, W, Ferguson, H, Wilkin, R, Konstantinou, C, Yershov, D, Vatish, J, Denning, A, Shah, HB, Cross, GWV, Seyed-Safi, P, Smart, YW, Kuc, A, Al-Yaseen, M, Olivier, J, Hanna, M, Eskander, P, Duncan, R, Halaseh, S, Das, R, Jones, Wynn H, Divecha, H, Whelton, C, Board, T, Powell, S, Magee, C, Agarwal, K, Mangos, E, Nambirajan, T, Vidya, R, Chauhan, G, Kaur, J, Burahee, A, Bleibleh, S, Pigadas, N, Snee, D, Bhasin, S, Crichton, A, Habeebullah, A, Bodla, AS, Yassin, N, Mondragon, M, Dewan, V, Flindall, I, Mahendran, V, Hanson, A, Jenner, E, Richards, J, Thomas-Fernandez, K, Wall, R, Alqallaf, A, Ben-Sassi, A, Mellor, K, Joshi, P, Joshi, Y, Young, R, Miu, V, Sheridan, K, MacDonald, L, Green, S, Onos, L, Wong, JJ, Napolitano, L, Hemmila, M, Amin, D, Abramowicz, S, Roser, SM, Olson, KA, Riley, C, Heron, C, Cardenas, T, Leede, E, Thornhill, M, Haynes, AB, McElhinney, K, Roward, S, Trust, MD, Hill, CE, Teixeira, PG, Etchill, E, Stevens, K, Ladd, MR, Long, C, Rose, J, Kent, A, Yesantharao, P, Vervoort, D, Jenny, H, Gabre-Kidan, A, Margalit, A, Tsai, L, Malapati, H, Yesantharao, L, Abdou, H, Diaz, J, Richmond, M, Clark, J, OMeara, L, Hanna, N, Ying, Y, Fleming, J, Ovaitt, A, Gigliotti, J, Fuson, A, Cooper, Z, Salim, A, Hirji, SA, Chung, C, Hansen, L, Okafor, BU, Roxo, V, Raut, CP, Jolissaint, JS, Mahvi, DA, Kaafarani, H, Breen, K, Bankhead-Kendall, B, Alser, O, Mashbari, H, Velmahos, G, Maurer, LR, El Moheb, M, Gaitanidis, A, Naar, L, Christensen, MA, Kapoen, C, Langeveld, K, El Hechi, M, Mokhtari, A, Haqqani, MH, Drake, FT, Goldenberg-Sandau, A, Galbreath, B, Reinke, C, Ross, S, Thompson, K, Manning, D, Perkins, R, Evans, H, Masrur, M, Giulianotti, P, Benedetti, E, Chang, G, Ourieff, J, Dehart, D, Dorafshar, A, Price, T, Bhama, AR, Torquati, A, Cherullo, E, Kennedy, R, Myers, J, Rubin, K, Ban, VS, Aoun, SG, Batjer, HH, Caruso, J, Carmichael, H, Velopulos, CG, Wright, FL, Urban, S, McIntyre, Jr RC Jr, Schroeppel, TJ, Hennessy, EA, Dunn, J, Zier, L, Burlew, C, Coleman, J, Colling, KP, Hall, B, Rice, HE, Hwang, ES, Olson, SA, Moris, D, Verma, R, Hassan, R, Volpe, A, Merola, S, OBanion, LA, Lilienstein, J, Dirks, R, Marwan, H, Almasri, M, Kulkarni, G, Mehdi, M, Abouassi, A, Abdallah, M, San Andres, M, Eid, J, Aigbivbalu, E, Sundaresan, J, George, B, Ssentongo, A, Ssentongo, P, Oh, JS, Hazelton, J, Maines, J, Gusani, N, Garner, M, Horvath, S, Zheng, F, Ujiki, M, Kinnaman, G, Meagher, A, Sharma, I, Holler, E, McKenzie, K, Chan, J, Fretwell, K, III, Nugent Iii W, Khalil, A, Chen, D, Post, N, Rostkowski, T, Brahmbhatt, D, Huynh, K, Hibbard, ML, Schellenberg, M, Martin, RCG, Bhutiani, N, Giorgakis, E, Laryea, J, Bhavaraju, A, Sexton, K, Kost, M, Kimbrough, M, Burdine, L, Kalkwarf, K, Robertson, R, Gosain, A, Camp, L, Lewit, R, Kronenfeld, JP, Urrechaga, E, Goel, N, Rattan, R, Hart, V, Gilna, G, Cioci, A, Ruiz, G, Rakoczy, K, Pavlis, W, Saberi, R, Morris, R, Karam, BS, Brathwaite, CEM, Liu, H, Petrone, P, Hakmi, H, Sohail, AH, Baltazar, G, Heckburn, R, Nygaard, RM, Colonna, ET, Endorf, FW, Hill, MJ, Maiga, A, Dennis, B, Levin, JH, Lallemand, M, Choron, R, Peck, G, Soliman, F, Rehman, S, Glass, N, Juthani, B, Deisher, D, Ruzgar, NM, Ullrich, SJ, Sion, M, Paranjape, C, Kar, AR, Gillezeau, C, Rapp, J, Taioli, E, Miles, BA, Alpert, N, Podolsky, D, Coleman, NL, Callahan, MP, Ganly, I, Brown, L, Monson, JRT, Dehal, A, Abbas, A, Soliman, A, Kim, B, Jones, C, Dauer, Md, E, Renza-Stingone, E, Hernandez, E, Gokcen, E, Kropf, E, Sufrin, H, Hirsch, H, Ross, H, Engel, J, Sewards, J, Poggio, J, Sanserino, K, Rae, L, Philp, M, Metro, M, McNelis, P, Petrov, R, Pazionis, T, Till, B, Lamm, R, Rios-Diaz, AJ, Palazzo, F, Rosengart, M, Nicholson, K, Carrick, MM, Rodkey, K, Suri, A, Callcut, R, Nicholson, S, Talathoti, N, Klaristenfeld, D, Biffl, W, Marsh, C, Schaffer, K, Berndtson, AE, Averbach, S, Curry, T, Kwan-Feinberg, R, Consorti, E, Gonzalez, R, Grolman, R, Liu, T, Merzlikin, O, Abel, MK, Ozgediz, D, Boeck, M, Kornblith, LZ, Nunez-Garcia, B, Robinson, B, Park, P, Utria, AF, Rice-Townsend, SE, Javid, P, Hauptman, J, Kieran, K, Nehra, D, Walters, A, Cuschieri, J, Davidson, GH, Cosker, R, Eckhouse, S, Choudhry, A, Marx, W, Jamil, T, Seegert, S, Al-Embideen, S, Quintana, M, Jackson, H, Wexner, SD, Kent, I, Martins, PN, Alshehari, M, Al-Naggar, H, Alsayadi, M, Alyazidi, M, Shream, S, Alhaddad, W, Maqus, A, Abu Hamraa, M, Alsayadi, R, Ghannam, R, Al-Maqtari, S, Masdoos, S, Al-Harazi, Y, Bajjah, H, Al-ameri, S, Aldawbali, M, Gwini, GP, Mazingi, D, da Silva, AMR, DAragon, F, D'Agruma, M, D'Andrea, G, Angel, J, Zatecky, J, von Ahnen, T, ter Brugge, FM, Henegouwen, van Berge MI, van der Oest, MJW, van Petersen, AS, van der Meij, W, den Boer, FC, de Lacy, FB, Alga, A, von Fluee, M, ESCP, European Soc Coloproctology, SICCR, Italian Soc Colorectal Surg, ASiT, Assoc Surg Training, ISRC, Irish Surg Res Collaborative, Collaborative, COVIDSurg, European Soc Coloproctology ESCP, Italian Soc Colorectal Surg SICCR, Assoc Surg Training ASiT, Irish Surg Res Collaborative ISRC, COVIDSurg Collaborative, Meister, P. (Beitragende*r), Gallinat, Anja (Beitragende*r), Paul, Andreas (Beitragende*r), Collaborative, COVID Surg, Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche sur les Maladies Virales et Hépatiques (IVH), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), COVID Surg Collaborative, Guided Treatment in Optimal Selected Cancer Patients (GUTS), and Robotics and image-guided minimally-invasive surgery (ROBOTICS)
Subjects: Science & Technology, AcademicSubjects/MED00910, SARS-CoV-2, SARS-CoV-2 infection, fungi, Medizin, Bjs/2, COVID-19, General Medicine, vaccination, mortality, Bacillus Calmette-Guérin, body regions, COVID Surg Collaborative, Research Letter, BCG Vaccine, Surgery, Human medicine, skin and connective tissue diseases, AcademicSubjects/MED00010, humans, Life Sciences & Biomedicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: There is little evidence around the potentially protective role of previous Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 vaccination. Prior BCG vaccination did not protect SARS-CoV-2 infected patients against postoperative pulmonary complications and 30-day mortality. ispartof: BJS OPEN vol:5 issue:6 ispartof: location:England status: published
Published: 2021

6. lntergrating Monitoring and Control at Queensland Electricity Commission Power Stations

Author: Electric Energy Conference (1992 : Brisbane, Qld.), Jones, RP, Chisholm, JC, and Craven, RH
Published: 1992

7. PWE-418 Endoscopy training in the uk; the joint advisory group on gastrointestinal endoscopy national survey

Author: Jones, RP, Stylianides, NA, Robertson, AG, Yip, VS, and Chadwick, G
Published: 2015
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8. The Nrf2 inhibitor brusatol is a potent antitumour agent in an orthotopic mouse model of colorectal cancer

Author: Evans, JP, Winiarski, BK, Sutton, PA, Jones, RP, Ressel, L, Duckworth, CA, Pritchard, DM, Lin, ZX, Vicky, FL, Tweedle, EM, Costello, E, Goldring, CE, Copple, IM, Park, BK, Palmer, DH, and Kitteringham, NR
Subjects: respiratory system, neoplasms, digestive system, environment and public health, digestive system diseases
Abstract: © Evans et al. Nrf2 is a transcription factor that regulates cellular stress response and irinotecan-metabolising pathways. Its aberrant activity has been reported in a number of cancers, although relatively few studies have explored a role for Nrf2 in colorectal cancer (CRC). This study assessed the expression of Nrf2 in patient CRC tissues and explored the effect of Nrf2 modulation alone, or in combination with irinotecan, in human (HCT116) and murine (CT26) cell lines in vitro and in an orthotopic syngeneic mouse model utilising bioluminescent imaging. Using a tissue microarray, Nrf2 was found to be overexpressed (p < 0.01) in primary CRC and metastatic tissue relative to normal colon, with a positive correlation between Nrf2 expression in matched primary and metastatic samples. In vitro experiments in CRC cell lines revealed that Nrf2 siRNA and brusatol, which is known to inhibit Nrf2, decreased viability and sensitised cells to irinotecan toxicity. Furthermore, brusatol effectively abrogated CRC tumour growth in subcutaneously and orthotopicallyallografted mice, resulting in an average 8-fold reduction in luminescence at the study end-point (p=0.02). Our results highlight Nrf2 as a promising drug target in the treatment of CRC.
Published: 2018

9. Niche divergence promotes rapid diversification of East African sky island white-eyes (Aves: Zosteropidae)

Author: Cox, SC, Prys-Jones, RP, Habel, JC, Amakobe, BA, and Day, JJ
Subjects: biodiversity hotspot, AFLPs, Molecular Sequence Data, Original Articles, Biodiversity, Sequence Analysis, DNA, Africa, Eastern, DNA, Mitochondrial, montane diversification, Evolution, Molecular, Phylogeography, Plio-Pleistocene, Animals, Afromontane, Passeriformes, Amplified Fragment Length Polymorphism Analysis, molecular dating, Phylogeny
Abstract: The Eastern Afromontane biodiversity hotspot composed of highly fragmented forested highlands (sky islands) harbours exceptional diversity and endemicity, particularly within birds. To explain their elevated diversity within this region, models founded on niche conservatism have been offered, although detailed phylogeographic studies are limited to a few avian lineages. Here, we focus on the recent songbird genus Zosterops, represented by montane and lowland members, to test the roles of niche conservatism versus niche divergence in the diversification and colonization of East Africa's sky islands. The species-rich white-eyes are a typically homogeneous family with an exceptional colonizing ability, but in contrast to their diversity on oceanic islands, continental diversity is considered depauperate and has been largely neglected. Molecular phylogenetic analysis of ~140 taxa reveals extensive polyphyly among different montane populations of Z. poliogastrus. These larger endemic birds are shown to be more closely related to taxa with divergent habitat types, altitudinal distributions and dispersal abilities than they are to populations of restricted endemics that occur in neighbouring montane forest fragments. This repeated transition between lowland and highland habitats over time demonstrate that diversification of the focal group is explained by niche divergence. Our results also highlight an underestimation of diversity compared to morphological studies that has implications for their taxonomy and conservation. Molecular dating suggests that the spatially extensive African radiation arose exceptionally rapidly (1-2.5 Ma) during the fluctuating Plio-Pleistocene climate, which may have provided the primary driver for lineage diversification.
Published: 2014

10. Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Author: Vohra, RS, Pasquali, S, Kirkham, AJ, Marriott, P, Johnstone, M, Spreadborough, P, Alderson, D, Griffiths, EA, Fenwick, S, Elmasry, M, Nunes, Q, Kennedy, D, Khan, RB, Khan, MAS, Magee, CJ, Jones, SM, Mason, D, Parappally, CP, Mathur, P, Saunders, M, Jamel, S, Ul Haque, S, Zafar, S, Shiwani, MH, Samuel, N, Dar, F, Jackson, A, Lovett, B, Dindyal, S, Winter, H, Fletcher, T, Rahman, S, Wheatley, K, Nieto, T, Ayaani, S, Youssef, H, Nijjar, RS, Watkin, H, Naumann, D, Emeshi, S, Sarmah, PB, Lee, K, Joji, N, Heath, J, Teasdale, RL, Weerasinghe, C, Needham, PJ, Welbourn, H, Forster, L, Finch, D, Blazeby, JM, Robb, W, McNair, AGK, Hrycaiczuk, A, Kadirkamanathan, S, Tang, C-B, Jayanthi, NVG, Noor, N, Dobbins, B, Cockbain, AJ, Nilsen-Nunn, A, de Siqueira, J, Pellen, M, Cowley, JB, Ho, W-M, Miu, V, White, TJ, Hodgkins, KA, Kinghorn, A, Tutton, MG, Al-Abed, YA, Menzies, D, Ahmad, A, Reed, J, Khan, S, Monk, D, Vitone, LJ, Murtaza, G, Joel, A, Brennan, S, Shier, D, Zhang, C, Yoganathan, T, Robinson, SJ, McCallum, IJD, Jones, MJ, Elsayed, M, Tuck, L, Wayman, J, Carney, K, Aroori, S, Hosie, KB, Kimble, A, Bunting, DM, Fawole, AS, Basheer, M, Dave, RV, Sarveswaran, J, Jones, E, Kendal, C, Tilston, MP, Gough, M, Wallace, T, Singh, S, Downing, J, Mockford, KA, Issa, E, Shah, N, Chauhan, N, Wilson, TR, Forouzanfar, A, Wild, JRL, Nofal, E, Bunnell, C, Madbak, K, Rao, STV, Devoto, L, Siddiqi, N, Khawaja, Z, Hewes, JC, Gould, L, Chambers, A, Rodriguez, DU, Sen, G, Robinson, S, Bartlett, F, Rae, DM, Stevenson, TEJ, Sarvananthan, K, Dwerryhouse, SJ, Higgs, SM, Old, OJ, Hardy, TJ, Shah, R, Hornby, ST, Keogh, K, Frank, L, Al-Akash, M, Upchurch, EA, Frame, RJ, Hughes, M, Jelley, C, Weaver, S, Roy, S, Sillo, TO, Galanopoulos, G, Cuming, T, Cunha, P, Tayeh, S, Kaptanis, S, Heshaishi, M, Eisawi, A, Abayomi, M, Ngu, WS, Fleming, K, Bajwa, DS, Chitre, V, Aryal, K, Ferris, P, Silva, M, Lammy, S, Mohamed, S, Khawaja, A, Hussain, A, Ghazanfar, MA, Bellini, MI, Ebdewi, H, Elshaer, M, Gravante, G, Drake, B, Ogedegbe, A, Mukherjee, D, Arhi, C, Iqbal, LGN, Watson, NF, Aggarwal, SK, Orchard, P, Villatoro, E, Willson, PD, Wa, K, Mok, J, Woodman, T, Deguara, J, Garcea, G, Babu, BI, Dennison, AR, Malde, D, Lloyd, D, Satheesan, S, Al-Taan, O, Boddy, A, Slavin, JP, Jones, RP, Ballance, L, Gerakopoulos, S, Jambulingam, P, Mansour, S, Sakai, N, Acharya, V, Sadat, MM, Karim, L, Larkin, D, Amin, K, Khan, A, Law, J, Jamdar, S, Smith, SR, Sampat, K, O'Shea, KM, Manu, M, Asprou, FM, Malik, NS, Chang, J, Lewis, M, Roberts, GP, Karavadra, B, Photi, E, Hewes, J, Rodriguez, D, O'Reilly, DA, Rate, AJ, Sekhar, H, Henderson, LT, Starmer, BZ, Coe, PO, Tolofari, S, Barrie, J, Bashir, G, Sloane, J, Madanipour, S, Halkias, C, Trevatt, AEJ, Borowski, DW, Hornsby, J, Courtney, MJ, Seymour, K, Hawkins, H, Bawa, S, Gallagher, PV, Reid, A, Wood, P, Finch, JG, Parmar, J, Stirland, E, Gardner-Thorpe, J, Al-Muhktar, A, Peterson, M, Majeed, A, Bajwa, FM, Martin, J, Choy, A, Tsang, A, Pore, N, Andrew, DR, Al-Khyatt, W, Taylor, C, Bhandari, S, Subramanium, D, Toh, SKC, Carter, NC, Mercer, SJ, Knight, B, Tate, S, Pearce, B, Wainwright, D, Vijay, V, Alagaratnam, S, Sinha, S, El-Hasani, SS, Hussain, AA, Bhattacharya, V, Kansal, N, Fasih, T, Jackson, C, Siddiqui, MN, Chishti, IA, Fordham, IJ, Siddiqui, Z, Bausbacher, H, Geogloma, I, Gurung, K, Tsavellas, G, Basynat, P, Shrestha, AK, Basu, S, Harilingam, ACM, Rabie, M, Akhtar, M, Kumar, P, Jafferbhoy, SF, Hussain, N, Raza, S, Haque, M, Alam, I, Aseem, R, Patel, S, Asad, M, Booth, MI, Ball, WR, Wood, CPJ, Pinho-Gomes, AC, Kausar, A, Obeidallah, MR, Varghase, J, Lodhia, J, Bradley, D, Rengifo, C, Lindsay, D, Gopalswamy, S, Finlay, I, Wardle, S, Bullen, N, Iftikhar, SY, Awan, A, Ahmed, J, Leeder, P, Fusai, G, Bond-Smith, G, Psica, A, Puri, Y, Hou, D, Noble, F, Szentpali, K, Broadhurst, J, Date, R, Hossack, MR, Goh, YL, Turner, P, Shetty, V, Riera, M, Macano, CAW, Sukha, A, Preston, SR, Hoban, JR, Puntis, DJ, Williams, SV, Krysztopik, R, Kynaston, J, Batt, J, Doe, M, Goscimski, A, Jones, GH, Hall, C, Carty, N, Panteleimonitis, S, Gunasekera, RT, Sheel, ARG, Lennon, H, Hindley, C, Reddy, M, Kenny, R, Elkheir, N, McGlone, ER, Rajaganeshan, R, Hancorn, K, Hargreaves, A, Prasad, R, Longbotham, DA, Vijayanand, D, Wijetunga, I, Ziprin, P, Nicolay, CR, Yeldham, G, Read, E, Gossage, JA, Rolph, RC, Ebied, H, Phull, M, Khan, MA, Popplewell, M, Kyriakidis, D, Henley, N, Packer, JR, Derbyshire, L, Porter, J, Appleton, S, Farouk, M, Basra, M, Jennings, NA, Ali, S, Kanakala, V, Ali, H, Lane, R, Dickson-Lowe, R, Zarsadias, P, Mirza, D, Puig, S, Al Amari, K, Vijayan, D, Sutcliffe, R, Marudanayagam, R, Hamady, Z, Prasad, AR, Patel, A, Durkin, D, Kaur, P, Bowen, L, Byrne, JP, Pearson, KL, Delisle, TG, Davies, J, Tomlinson, MA, Johnpulle, MA, Slawinski, C, Macdonald, A, Nicholson, J, Newton, K, Mbuvi, J, Farooq, A, Mothe, BS, Zafrani, Z, Brett, D, Francombe, J, Barnes, J, Cheung, M, Al-Bahrani, AZ, Preziosi, G, Urbonas, T, Alberts, J, Mallik, M, Patel, K, Segaran, A, Doulias, T, Sufi, PA, Yao, C, Pollock, S, Manzelli, A, Wajed, S, Kourkulos, M, Pezzuto, R, Wadley, M, Hamilton, E, Jaunoo, S, Padwick, R, Sayegh, M, Newton, RC, Hebbar, M, Farag, SF, Spearman, J, Hamdan, MF, D'Costa, C, Blane, C, Giles, M, Peter, MB, Hirst, NA, Hossain, T, Pannu, A, El-Dhuwaib, Y, Morrison, TEM, Taylor, GW, Thompson, RLE, McCune, K, Loughlin, P, Lawther, R, Byrnes, CK, Simpson, DJ, Mawhinney, A, Warren, C, Mckay, D, McIlmunn, C, Martin, S, MacArtney, M, Diamond, T, Davey, P, Jones, C, Clements, JM, Digney, R, Chan, WM, McCain, S, Gull, S, Janeczko, A, Dorrian, E, Harris, A, Dawson, S, Johnston, D, McAree, B, Ghareeb, E, Thomas, G, Connelly, M, McKenzie, S, Cieplucha, K, Spence, G, Campbell, W, Hooks, G, Bradley, N, Hill, ADK, Cassidy, JT, Boland, M, Burke, P, Nally, DM, Khogali, E, Shabo, W, Iskandar, E, McEntee, GP, O'Neill, MA, Peirce, C, Lyons, EM, O'Sullivan, AW, Thakkar, R, Carroll, P, Ivanovski, I, Balfe, P, Lee, M, Winter, DC, Kelly, ME, Hoti, E, Maguire, D, Karunakaran, P, Geoghegan, JG, Martin, ST, McDermott, F, Cross, KS, Cooke, F, Zeeshan, S, Murphy, JO, Mealy, K, Mohan, HM, Nedujchelyn, Y, Ullah, MF, Ahmed, I, Giovinazzo, F, Milburn, J, Prince, S, Brooke, E, Buchan, J, Khalil, AM, Vaughan, EM, Ramage, MI, Aldridge, RC, Gibson, S, Nicholson, GA, Vass, DG, Grant, AJ, Holroyd, DJ, Jones, MA, Sutton, CMLR, O'Dwyer, P, Nilsson, F, Weber, B, Williamson, TK, Lalla, K, Bryant, A, Carter, CR, Forrest, CR, Hunter, DI, Nassar, AH, Orizu, MN, Knight, K, Qandeel, H, Suttie, S, Belding, R, McClarey, A, Boyd, AT, Guthrie, GJK, Lim, PJ, Luhmann, A, Watson, AJM, Richards, CH, Nicol, L, Madurska, M, Harrison, E, Boyce, KM, Roebuck, A, Ferguson, G, Pati, P, Wilson, MSJ, Dalgaty, F, Fothergill, L, Driscoll, PJ, Mozolowski, KL, Banwell, V, Bennett, SP, Rogers, PN, Skelly, BL, Rutherford, CL, Mirza, AK, Lazim, T, Lim, HCC, Duke, D, Ahmed, T, Beasley, WD, Wilkinson, MD, Maharaj, G, Malcolm, C, Brown, TH, Shingler, GM, Mowbray, N, Radwan, R, Morcous, P, Wood, S, Kadhim, A, Stewart, DJ, Baker, AL, Tanner, N, Shenoy, H, Hafiz, S, De Marchi, JA, Singh-Ranger, D, Hisham, E, Ainley, P, O'Neill, S, Terrace, J, Napetti, S, Hopwood, B, Rhys, T, Kanavati, O, Coats, M, Aleksandrov, D, Kallaway, C, Yahya, S, Templeton, A, Trotter, M, Lo, C, Dhillon, A, Heywood, N, Aawsaj, Y, Hamdan, A, Reece-Bolton, O, McGuigan, A, Shahin, Y, Ali, A, Luther, A, Nicholson, JA, Rajendran, I, Boal, M, Ritchie, J, Grp, CS, and Collaborative, WMR
Subjects: Male, medicine.medical_treatment, 030230 surgery, outcomes, 0302 clinical medicine, Postoperative Complications, 80 and over, Prospective Studies, Prospective cohort study, Aged, 80 and over, education.field_of_study, Middle Aged, Conversion to Open Surgery, medicine.anatomical_structure, Treatment Outcome, Cholecystectomy, Laparoscopic, Centre for Surgical Research, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Cohort, Female, Elective Surgical Procedure, Adult, medicine.medical_specialty, Population, Gallbladder disease, Gallbladder Diseases, Aged, Ambulatory Surgical Procedures, Cholecystectomy, Emergency Treatment, Humans, Ireland, Patient Readmission, Time-to-Treatment, United Kingdom, Surgery, benign disease, 03 medical and health sciences, Laparoscopic, medicine, education, business.industry, General surgery, Gallbladder, medicine.disease, business, Complication
Abstract: Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all-cause 30-day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics.
Published: 2016

11. National survey on endoscopy training in the UK

Author: Jones, RP, primary, Stylianides, NA, additional, Robertson, AG, additional, Yip, VSK, additional, and Chadwick, G, additional
Published: 2015
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12. Intermittent small bowel obstruction caused by Meckel’s enterolith

Author: McWhirter D and Jones Rp
Subjects: Male, medicine.medical_specialty, Enterolith, medicine.medical_treatment, Calculi, Laparotomy, Intestine, Small, Humans, Medicine, Meckel's diverticulum, Small bowel resection, business.industry, digestive, oral, and skin physiology, General Medicine, Middle Aged, medicine.disease, digestive system diseases, Surgery, Meckel Diverticulum, Bowel obstruction, Online Case Reports, Tomography, X-Ray Computed, business, Intestinal Obstruction, Diverticulum
Abstract: A 56-year-old man presented with small bowel obstruction after a 6-week history of intermittent resolving subacute small bowel obstruction. After investigations, he underwent laparotomy. A mobile, narrow-necked Meckel’s diverticulum packed with enteroliths pressing against proximal small bowel was discovered. A small bowel resection was performed.
Published: 2010

13. Intermittent small bowel obstruction caused by Meckel’s enterolith

Author: Jones, RP, primary and McWhirter, D, additional
Published: 2010
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14. The Effect of Electromagnetic Interference on Mechanical Ventilators

Author: Conway, DH, primary and Jones, RP, additional
Published: 2005
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15. STEERING OF 4WD VEHICLES WITH INDEPENDENT WHEEL TORQUE CONTROL

Author: LI, W, primary, POTTER, TEC, additional, and JONES, RP, additional
Published: 1998
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16. The Relationship between Urinary Kallikrein, Aldosterone and Glomerular Filtration Rate (GFR) in Pregnancy

Author: Platts, JK, primary, Meadows, P, additional, Jones, RP, additional, and Harvey, JN, additional
Published: 1997
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17. Preparation of epidural solutions

Author: Jones, RP, primary and Shaw, EM, additional
Published: 1996
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18. Quality of travel health advice in higher-education establishments in the United Kingdom and its relationship to the demographic background of the provider.

Author: Porter JFH, Knill-Jones RP, Porter, J F Hugh, and Knill-Jones, Robin P
Abstract: Background: The number of international trips undertaken by residents of the United Kingdom has risen dramatically over the past 50 years. Likewise, the numbers studying in higher education have also shown a huge increase. This study aimed to assess the appropriateness of advice given to traveling students by higher education-based health services and to relate this to the demography and experience of the professionals involved.Methods: A postal questionnaire describing three hypothetical groups of students traveling to different parts of the world was sent to 335 doctors and nurses. These clinicians belonged to the British Association of Health Services in Higher Education. They worked in 105 practices that serve higher-educational establishments in the United Kingdom. Main outcome measures included whether appropriate immunizations were advised and given correctly through the National Health Service (NHS) or privately, and whether appropriate advice was given regarding malaria, human immunodeficiency virus (HIV), and miscellaneous risks. The sources of information used to advise travelers were also asked, and the effect of demographic characteristics of the respondents on the quality of advice was investigated.Results: Two hundred fifteen (64%) questionnaires were returned. The mean score for whether the correct immunizations were advised was 77%, and for whether these were given correctly through the NHS or privately was 79.6%. For malaria, HIV, and miscellaneous risks, the scores were lower at 65%, 38%, and 32%, respectively. The score for correct immunizations was significantly affected by sex, with females respondents scoring higher (p = .036). Previous training in travel medicine improved scores for immunizations (p = .034) and for the correct choice being given through the NHS or privately (p = .006). Age, hours worked, role, and size of practice had no influence on scores. Charts in the general practice free newspapers were the most popular source of information.Conclusions: Practices serving higher-education establishments usually give appropriate advice to travelers in terms of the immunizations required, whether these are available through the NHS or privately, and about reducing risks of malaria. This is not the case regarding advice pertaining to HIV and miscellaneous risks. Previous training in travel medicine seems to correlate with the giving of more appropriate advice. [ABSTRACT FROM AUTHOR]
Published: 2004

19. A Formal Approach to Symptoms in Dyspepsia

Author: Knill-Jones Rp
Subjects: Duodenal ulcer, medicine.medical_specialty, business.industry, Esophageal disease, Internal medicine, Diagnostico diferencial, Colonic Diseases, Gastroenterology, Medicine, Differential diagnosis, business, medicine.disease
Published: 1985

20. Case review. ACL grafts accelerate recovery.

Author: Jones RP
Published: 1998
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21. Technical section

Author: Jones, RP, primary
Published: 1989
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22. A New Approach for Understanding International Hospital Bed Numbers and Application to Local Area Bed Demand and Capacity Planning.

Author: Jones RP
Subjects: Humans, Bed Occupancy statistics & numerical data, Health Services Needs and Demand, England, United States, Australia, Models, Theoretical, Hospital Bed Capacity statistics & numerical data
Abstract: Three models/methods are given to understand the extreme international variation in available and occupied hospital bed numbers. These models/methods all rely on readily available data. In the first, occupied beds (rather than available beds) are used to measure the expressed demand for hospital beds. The expressed occupied bed demand for three countries was in the order Australia > England > USA. Next, the age-standardized mortality rate (ASMR) has dual functions. Less developed countries/regions have low access to healthcare, which results in high ASMR, or a negative slope between ASMR versus available/occupied beds. In the more developed countries, high ASMR can also be used to measure the 'need' for healthcare (including occupied beds), a positive slope among various social (wealth/lifestyle) groups, which will include Indigenous peoples. In England, a 100-unit increase in ASMR (European Standard population) leads to a 15.3-30.7 (feasible range) unit increase in occupied beds per 1000 deaths. Higher ASMR shows why the Australian states of the Northern Territory and Tasmania have an intrinsic higher bed demand. The USA has a high relative ASMR (for a developed/wealthy country) because healthcare is not universal in the widest sense. Lastly, a method for benchmarking the whole hospital's average bed occupancy which enables them to run at optimum efficiency and safety. English hospitals operate at highly disruptive and unsafe levels of bed occupancy, manifesting as high 'turn-away'. Turn-away implies bed unavailability for the next arriving patient. In the case of occupied beds, the slope of the relationship between occupied beds per 1000 deaths and deaths per 1000 population shows a power law function. Scatter around the trend line arising from year-to-year fluctuations in occupied beds per 1000 deaths, ASMR, deaths per 1000 population, changes in the number of persons hidden in the elective, outpatient and diagnostic waiting lists, and local area variation in births affecting maternity, neonatal, and pediatric bed demand. Additional variation will arise from differences in the level of local funding for social care, especially elderly care. The problems associated with crafting effective bed planning are illustrated using the English NHS as an example.
Published: 2024
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23. Quantifying postoperative recovery using wearable activity monitors following abdominal wall surgery: The AbTech trial.

Author: Kwasnicki RM, Giannas E, Rizk C, Kungwengwe G, Dutta T, Dunne J, Dex E, Gokani V, Henry FP, Hunter JE, Williams G, Abela C, Warren O, Jones RP, and Wood SH
Subjects: Humans, Middle Aged, Male, Female, Prospective Studies, Adult, Exercise physiology, Postoperative Period, Wearable Electronic Devices, Abdominal Wall surgery, Recovery of Function
Abstract: Purpose: This work aimed to investigate the validity of wearable activity monitors (WAMs) as an objective tool to measure the return toward normal functional mobility following abdominal wall surgery. This was achieved by quantifying and comparing pre- and postoperative physical activity (PA)., Methods: A multicenter, prospective, observational cohort study was designed. Patients undergoing abdominal wall surgery were assessed for eligibility and consent for study participation was obtained. Participants were asked to wear a WAM (AX3, Axivity) on the wrist of their dominant hand at least 48 hours pre-operatively, for up to 2 weeks postop, and again after 6 months postop for 48 hours., Results: A cohort of 20 patients were recruited in this validation study with a mean age of 47.3 ± 13.0 years. Postoperation, the percentage median PA (±IQR) dropped to 32.6% (20.1), whereas on day 14, PA had reached 64.6% (22.7) of the preoperative value providing construct validity. Activity levels at >6 months postop increased by 16.4% on an average when compared to baseline preoperative PA (p = 0.046)., Conclusion: This study demonstrates that WAMs are valid markers of postoperative recovery following abdominal wall surgery. This was achieved by quantifying the reduction in PA postoperation, which has not been previously shown. In addition, this study suggests that abdominal wall surgery may improve the patient's quality of life via increased functional mobility at 6 months postop. In the future, this technology could be used to identify the patient and surgical factors that are predictors of outcome following abdominal wall surgery., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
Published: 2024
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24. Leg Lymphoedema After Inguinal and Ilio-Inguinal Lymphadenectomy for Melanoma: Results from a Prospective, Randomised Trial.

Author: Lee TS, Li I, Peric B, Saw RPM, Duprat JP, Bertolli E, Spillane JB, van Leeuwen BL, Moncrieff M, Sommariva A, Allan CP, de Wilt JHW, Jones RP, Geh JLC, Howle JR, and Spillane AJ
Subjects: Humans, Female, Male, Prospective Studies, Middle Aged, Follow-Up Studies, Prognosis, Survival Rate, Leg, Aged, Adult, Postoperative Complications etiology, Neoplasm Staging, Melanoma surgery, Melanoma pathology, Lymphedema etiology, Lymph Node Excision adverse effects, Skin Neoplasms surgery, Skin Neoplasms pathology, Inguinal Canal surgery, Inguinal Canal pathology
Abstract: Background: The Evaluation of Groin Lymphadenectomy Extent for Melanoma (EAGLE FM) study sought to address the question of whether to perform inguinal (IL) or ilio-inguinal lymphadenectomy (I-IL) for patients with inguinal nodal metastatic melanoma who have no clinical or imaging evidence of pelvic disease. Primary outcome measure was disease-free survival at 5 years, and secondary endpoints included lymphoedema., Methods: EAGLE FM was designed to recruit 634 patients but closed with 88 patients randomised because of slow recruitment and changes in melanoma management. Lymphoedema assessments occurred preoperatively and at 6, 12, 18, and 24 months postoperatively. Lymphoedema was defined as Inter-Limb Volume Difference (ILVD) > 10%, Lymphoedema Index (L-Dex ® ) > 10 or change of L-Dex ® > 10 from baseline., Results: Prevalence of leg lymphoedema between the two groups was similar but numerically higher for I-IL at all time points in the first 24 months of follow-up; highest at 6 months (45.9% IL [CI 29.9-62.0%], 54.1% I-IL [CI 38.0-70.1%]) and lowest at 18 months (18.8% IL [CI 5.2-32.3%], 41.4% I-IL [CI 23.5-59.3%]). Median ILVD at 24 months for those affected by lymphoedema was 14.5% (IQR 10.6-18.7%) and L-Dex ® was 12.6 (IQR 9.0-17.2). There was not enough statistical evidence to support associations between lymphoedema and extent of surgery, radiotherapy, or wound infection., Conclusions: Despite a trend for patients who had I-IL to have greater lymphoedema prevalence than IL in the first 24 months after surgery, our study's small sample did not have the statistical evidence to support an overall difference between the surgical groups., (© 2024. Crown.)
Published: 2024
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25. Lesional liver biopsies: better treatments, better studies, better science.

Author: Jones RP
Subjects: Humans, Biopsy methods, Liver Diseases pathology, Liver pathology
Published: 2024
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26. Author Correction: Efferocytosis reprograms the tumor microenvironment to promote pancreatic cancer liver metastasis.

Author: Astuti Y, Raymant M, Quaranta V, Clarke K, Abudula M, Smith O, Bellomo G, Chandran-Gorner V, Nourse C, Halloran C, Ghaneh P, Palmer D, Jones RP, Campbell F, Pollard JW, Morton JP, Mielgo A, and Schmid MC
Published: 2024
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27. Efferocytosis reprograms the tumor microenvironment to promote pancreatic cancer liver metastasis.

Author: Astuti Y, Raymant M, Quaranta V, Clarke K, Abudula M, Smith O, Bellomo G, Chandran-Gorner V, Nourse C, Halloran C, Ghaneh P, Palmer D, Jones RP, Campbell F, Pollard JW, Morton JP, Mielgo A, and Schmid MC
Subjects: Humans, Animals, Mice, Cell Line, Tumor, CD8-Positive T-Lymphocytes immunology, CD8-Positive T-Lymphocytes metabolism, Apoptosis, Lysosomes metabolism, Arginase metabolism, Efferocytosis, Tumor Microenvironment, Pancreatic Neoplasms pathology, Pancreatic Neoplasms metabolism, Liver Neoplasms secondary, Liver Neoplasms metabolism, Liver Neoplasms pathology, Macrophages metabolism, Carcinoma, Pancreatic Ductal pathology, Carcinoma, Pancreatic Ductal metabolism, Phagocytosis
Abstract: Pancreatic ductal adenocarcinoma is a highly metastatic disease and macrophages support liver metastases. Efferocytosis, or engulfment of apoptotic cells by macrophages, is an essential process in tissue homeostasis and wound healing, but its role in metastasis is less well understood. Here, we found that the colonization of the hepatic metastatic site is accompanied by low-grade tissue injury and that efferocytosis-mediated clearance of parenchymal dead cells promotes macrophage reprogramming and liver metastasis. Mechanistically, progranulin expression in macrophages is necessary for efficient efferocytosis by controlling lysosomal acidification via cystic fibrosis transmembrane conductance regulator and the degradation of lysosomal cargo, resulting in LXRα/RXRα-mediated macrophage conversion and upregulation of arginase 1. Pharmacological blockade of efferocytosis or macrophage-specific genetic depletion of progranulin impairs macrophage conversion, improves CD8 + T cell functions, and reduces liver metastasis. Our findings reveal how hard-wired functions of macrophages in tissue repair contribute to liver metastasis and identify potential targets for prevention of pancreatic ductal adenocarcinoma liver metastasis., (© 2024. The Author(s).)
Published: 2024
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28. Molecular biology of cholangiocarcinoma and its implications for targeted therapy in patient management.

Author: Gilbert TM, Randle L, Quinn M, McGreevy O, O'leary L, Young R, Diaz-Neito R, Jones RP, Greenhalf B, Goldring C, Fenwick S, Malik H, and Palmer DH
Abstract: Cholangiocarcinoma (CCA) remains a devastating malignancy and a significant challenge to treat. The majority of CCA patients are diagnosed at an advanced stage, making the disease incurable in most cases. The advent of high-throughput genetic sequencing has significantly improved our understanding of the molecular biology underpinning cancer. The identification of 'druggable' genetic aberrations and the development of novel targeted therapies against them is opening up new treatment strategies. Currently, 3 targeted therapies are approved for use in CCA; Ivosidenib in patients with IDH1 mutations and Infigratinib/Pemigatinib in those with FGFR2 fusions. As our understanding of the biology underpinning CCA continues to improve it is highly likely that additional targeted therapies will become available in the near future. This is important, as it is thought up to 40 % of CCA patients harbour a potentially actionable mutation. In this review we provide an overview of the molecular pathogenesis of CCA and highlight currently available and potential future targeted treatments., Competing Interests: Declaration of competing interest Palmer has grant funding from BMS, Nucana, Astra Zeneca, Sirtex, honoraria from Boston Scientific and Sirtex, and support for travel from Nucana. Randle reports a relationship with National Centre for the Replacement Refinement and Reduction of Animals in Research (NC3Rs) that includes grant funding and membership of the NC3RS PhD studentship assessment board. Goldring reports financial support by the University of Liverpool. Jones, Young, Diaz-Neito, O’leary, McGreevy, Gilbert, Quinn, Fenwick and Malik declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)
Published: 2024
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29. Addressing the Knowledge Deficit in Hospital Bed Planning and Defining an Optimum Region for the Number of Different Types of Hospital Beds in an Effective Health Care System.

Author: Jones RP
Subjects: Humans, Aged, Hospital Bed Capacity, Hospitals, Delivery of Health Care, State Medicine, Bed Occupancy
Abstract: Based upon 30-years of research by the author, a new approach to hospital bed planning and international benchmarking is proposed. The number of hospital beds per 1000 people is commonly used to compare international bed numbers. This method is flawed because it does not consider population age structure or the effect of nearness-to-death on hospital utilization. Deaths are also serving as a proxy for wider bed demand arising from undetected outbreaks of 3000 species of human pathogens. To remedy this problem, a new approach to bed modeling has been developed that plots beds per 1000 deaths against deaths per 1000 population. Lines of equivalence can be drawn on the plot to delineate countries with a higher or lower bed supply. This method is extended to attempt to define the optimum region for bed supply in an effective health care system. England is used as an example of a health system descending into operational chaos due to too few beds and manpower. The former Soviet bloc countries represent a health system overly dependent on hospital beds. Several countries also show evidence of overutilization of hospital beds. The new method is used to define a potential range for bed supply and manpower where the most effective health systems currently reside. The method is applied to total curative beds, medical beds, psychiatric beds, critical care, geriatric care, etc., and can also be used to compare different types of healthcare staff, i.e., nurses, physicians, and surgeons. Issues surrounding the optimum hospital size and the optimum average occupancy will also be discussed. The role of poor policy in the English NHS is used to show how the NHS has been led into a bed crisis. The method is also extended beyond international benchmarking to illustrate how it can be applied at a local or regional level in the process of long-term bed planning. Issues regarding the volatility in hospital admissions are also addressed to explain the need for surge capacity and why an adequate average bed occupancy margin is required for an optimally functioning hospital.
Published: 2023
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30. Follow up after surgery for colorectal liver metastases: A systematic review.

Author: Jones A, Findlay A, Knight SR, Rees J, O'Reilly D, Jones RP, and Pathak S
Subjects: Humans, Follow-Up Studies, Retrospective Studies, Prospective Studies, Hepatectomy, Neoplasm Recurrence, Local surgery, Colorectal Neoplasms pathology, Liver Neoplasms secondary
Abstract: Introduction: Recurrence post hepatectomy for colorectal liver metastases (CRLM) occurs in 70 % of patients within two years. No established guidance on the method or intensity of follow-up currently exists. The aim of this systematic review was to summarise literature and determine whether it is possible to identify an optimal follow up regime. To this date there are no randomised prospective studies investigating this., Methods: A systematic review was performed according to PRISMA guidelines. Outcomes included general demographics, method, frequency and duration of follow up, survival and recurrence data. Quality assessment of the papers was performed., Results: Twenty-five articles published between 1994 and 2022 were included, including 9945 patients. CT was the most common imaging modality (n = 14) and CEA most common blood test (n = 11). Intensity of follow up was higher in the first two years post resection and only two papers continued follow up post 5 years resection. There was wide variation in outcome measures - Overall survival (OS) was most commonly reported. Nine papers reported OS ranging between 39 and 78.1 %., Conclusions: There is wide variation in follow up methods and outcome reporting. There is no strong evidence to support intensive follow up, and the benefits of long term follow up are also unknown due to the lack of patient centred data. High quality, prospective studies should be the focus of future research as further retrospective data is unlikely to resolve uncertainties around optimal follow up., Competing Interests: Declaration of competing interest Nil., (© 2023 Published by Elsevier Ltd.)
Published: 2023
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31. Individualized cancer vaccines versus surveillance after adjuvant chemotherapy for surgically resected high-risk stage 2 and stage 3 colorectal cancer: protocol for a randomized trial.

Author: Jones RP, Lee LYW, Corrie PG, Danson S, and Vimalachandran D
Subjects: Humans, Chemotherapy, Adjuvant methods, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Neoplasm Staging, Cancer Vaccines therapeutic use, Colonic Neoplasms pathology, Colorectal Neoplasms drug therapy, Colorectal Neoplasms surgery, Colorectal Neoplasms pathology
Published: 2023
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32. COVID-19-Related Age Profiles for SARS-CoV-2 Variants in England and Wales and States of the USA (2020 to 2022): Impact on All-Cause Mortality.

Author: Jones RP and Ponomarenko A
Abstract: Since 2020, COVID-19 has caused serious mortality around the world. Given the ambiguity in establishing COVID-19 as the direct cause of death, we first investigate the effects of age and sex on all-cause mortality during 2020 and 2021 in England and Wales. Since infectious agents have their own unique age profile for death, we use a 9-year time series and several different methods to adjust single-year-of-age deaths in England and Wales during 2019 (the pre-COVID-19 base year) to a pathogen-neutral single-year-of-age baseline. This adjusted base year is then used to confirm the widely reported higher deaths in males for most ages above 43 in both 2020 and 2021. During 2020 (+COVID-19 but no vaccination), both male and female population-adjusted deaths significantly increased above age 35. A significant reduction in all-cause mortality among both males and females aged 75+ could be demonstrated in 2021 during the widespread COVID-19 vaccination period; however, deaths below age 75 progressively increased. This finding arises from a mix of vaccination coverage and year-of-age profiles of deaths for the different SARS-CoV-2 variants. In addition, specific effects of age around puberty were demonstrated, where females had higher deaths than males. There is evidence that year-of-birth cohorts may also be involved, indicating that immune priming to specific pathogen outbreaks in the past may have led to lower deaths for some birth cohorts. To specifically identify the age profile for the COVID-19 variants from 2020 to 2023, we employ the proportion of total deaths at each age that are potentially due to or 'with' COVID-19. The original Wuhan strain and the Alpha variant show somewhat limited divergence in the age profile, with the Alpha variant shifting to a moderately higher proportion of deaths below age 84. The Delta variant specifically targeted individuals below age 65. The Omicron variants showed a significantly lower proportion of overall mortality, with a markedly higher relative proportion of deaths above age 65, steeply increasing with age to a maximum around 100 years of age. A similar age profile for the variants can be seen in the age-banded deaths in US states, although they are slightly obscured by using age bands rather than single years of age. However, the US data shows that higher male deaths are greatly dependent on age and the COVID variant. Deaths assessed to be 'due to' COVID-19 (as opposed to 'involving' COVID-19) in England and Wales were especially overestimated in 2021 relative to the change in all-cause mortality. This arose as a by-product of an increase in COVID-19 testing capacity in late 2020. Potential structure-function mechanisms for the age-specificity of SARS-CoV-2 variants are discussed, along with potential roles for small noncoding RNAs (miRNAs). Using data from England, it is possible to show that the unvaccinated do indeed have a unique age profile for death from each variant and that vaccination alters the shape of the age profile in a manner dependent on age, sex, and the variant. The question is posed as to whether vaccines based on different variants carry a specific age profile.
Published: 2023
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33. PINCER (A Platform Study for solId orgaN CancERs): an agile pan-network platform study to deliver high-quality translational research.

Author: Jones RP, Mielgo A, Schmid M, Bury D, Andrews T, Burdak-Rothkamm S, Shackcloth M, J S Cross T, Fenwick S, Malik HZ, Diaz-Nieto R, Ottensmeier C, Palmer DH, and Vimalachandran D
Subjects: Humans, Translational Research, Biomedical, Neoplasms genetics, Neoplasms therapy
Published: 2023
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34. Impact of COVID-19 on 1-Year Survival Outcomes in Hepatocellular Carcinoma: A Multicenter Cohort Study.

Author: De Souza S, Kahol de Jong J, Perone Y, Shetty S, Qurashi M, Vithayathil M, Shah T, Ross P, Temperley L, Yip VS, Banerjee A, Bettinger D, Sturm L, Reeves HL, Geh D, Orr J, Allen B, Jones RP, and Sharma R
Abstract: Introduction: The COVID-19 pandemic has caused severe disruption of healthcare services worldwide and interrupted patients' access to essential services. During the first lockdown, many healthcare services were shut to all but emergencies. In this study, we aimed to determine the immediate and long-term indirect impact of COVID-19 health services utilisation on hepatocellular cancer (HCC) outcomes., Methods: A prospective cohort study was conducted from 1 March 2020 until 30 June 2020, correlating to the first wave of the COVID-19 pandemic. Patients were enrolled from tertiary hospitals in the UK and Germany with dedicated HCC management services. All patients with current or past HCC who were discussed at a multidisciplinary meeting (MDM) were identified. Any delay to treatment (DTT) and the effect on survival at one year were reported., Results: The median time to receipt of therapy following MDM discussion was 49 days. Patients with Barcelona Clinic Liver Cancer (BCLC) stages-A/B disease were more likely to experience DTT. Significant delays across all treatments for HCC were observed, but delay was most marked for those undergoing curative therapies. Even though severe delays were observed in curative HCC treatments, this did not translate into reduced survival in patients., Conclusion: Interruption of routine healthcare services because of the COVID-19 pandemic caused severe delays in HCC treatment. However, DTT did not translate to reduced survival. Longer follow is important given the delay in therapy in those receiving curative therapy.
Published: 2023
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35. Efficacy of Electrochemotherapy in Breast Cancer Patients of Different Receptor Status: The INSPECT Experience.

Author: Di Prata C, Mascherini M, Ross AM, Silvestri B, Kis E, Odili J, Fabrizio T, Jones RP, Kunte C, Orlando A, Clover J, Kumar S, Russano F, Matteucci P, Muir T, Terlizzi F, Gehl J, and Grischke EM
Abstract: Electrochemotherapy has been proven to be an efficient treatment for cutaneous metastases of various cancers. Data on breast cancer (BC) patients with cutaneous metastases were retrieved from the INSPECT database. Patients were divided by their receptor status: HER2+, HR+ (ER/PgR+), and TN (triple negative). Groups were similar for histological subtype and location of the nodules. Most patients were previously treated with surgery/systemic therapy/radiotherapy. We found no differences in the three groups in terms of response ratio (OR per patient 86% HER2+, 80% HR+, 76% TN, p = 0.8664). The only factor positively affecting the complete response rate in all groups was small tumor size (<3 cm, p = 0.0105, p = 0.0001, p = 0.0266, respectively). Local progression-free survival was positively impacted by the achievement of complete response in HER2+ ( p = 0.0297) and HR+ ( p = 0.0094), while overall survival was affected by time to local progression in all groups ( p = 0.0065 in HER2+, p < 0.0001 in HR+, p = 0.0363 in TN). ECT treatment is equally effective among groups, despite different receptor status. Response and local tumor control seem to be better in multiple small lesions than in big armor-like lesions, suggesting that treating smaller, even multiple, lesions at the time of occurrence is more effective than treating bigger long-lasting armor-like cutaneous lesions.
Published: 2023
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36. Protocol for the CoNoR Study: A prospective multi-step study of the potential added benefit of two novel assessment tools in colorectal liver metastases technical resectability decision-making.

Author: Parmar KL, O'Reilly D, Valle J, Braun M, Malcomson L, Jones RP, Balaa F, Rees M, Welsh FKS, Filobbos R, and Renehan AG
Subjects: Humans, Prospective Studies, State Medicine, Systematic Reviews as Topic, Colorectal Neoplasms surgery, Liver Neoplasms surgery, Liver Neoplasms secondary
Abstract: Introduction: Liver resection is the only curative treatment for colorectal liver metastases (CLM). Resectability decision-making is therefore a key determinant of outcomes. Wide variation has been demonstrated in resectability decision-making, despite the existence of criteria. This paper summarises a study protocol to evaluate the potential added value of two novel assessment tools in assessing CLM technical resectability: the Hepatica preoperative MR scan (MR-based volumetry, Couinaud segmentation, liver tissue characteristics and operative planning tool) and the LiMAx test (hepatic functional capacity)., Methods and Analysis: This study uses a systematic multistep approach, whereby three preparatory workstreams aid the design of the final international case-based scenario survey:Workstream 1: systematic literature review of published resectability criteria.Workstream 2: international hepatopancreatobiliary (HPB) interviews.Workstream 3: international HPB questionnaire.Workstream 4: international HPB case-based scenario survey.The primary outcome measures are change in resectability decision-making and change in planned operative strategy, resulting from the novel test results. Secondary outcome measures are variability in CLM resectability decision-making and opinions on the role for novel tools., Ethics and Dissemination: The study protocol has been approved by a National Health Service Research Ethics Committee and registered with the Health Research Authority. Dissemination will be via international and national conferences. Manuscripts will be published., Registration Details: The CoNoR Study is registered with ClinicalTrials.gov (registration number NCT04270851). The systematic review is registered on the PROSPERO database (registration number CRD42019136748)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Published: 2023
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37. Identification of flucloxacillin-modified hepatocellular proteins: implications in flucloxacillin-induced liver injury.

Author: Ali SE, Waddington JC, Lister A, Sison-Young R, Jones RP, Rehman AH, Goldring CEP, Naisbitt DJ, and Meng X
Subjects: Humans, Floxacillin toxicity, Liver metabolism, Albumins, Carcinoma, Hepatocellular, Chemical and Drug Induced Liver Injury, Chronic, Liver Neoplasms, Chemical and Drug Induced Liver Injury etiology
Abstract: Flucloxacillin is a β-lactam antibiotic associated with a high incidence of drug-induced liver injury. Although expression of HLA-B*57:01 is associated with increased susceptibility, little is known of the pathological mechanisms involved in the induction of the clinical phenotype. Irreversible protein modification is suspected to drive the reaction through the provision of flucloxacillin-modified peptides that are presented to T-cells by the protein encoded by the risk allele. In this study, we have shown that flucloxacillin binds to multiple proteins within human primary hepatocytes, including major hepatocellular proteins (hemoglobin and albumin) and mitochondrial proteins. Inhibition of membrane transporters multidrug resistance-associated protein 2 (MRP2) and P-glycoprotein (P-gp) appeared to reduce the levels of covalent binding. A diverse range of proteins with different functions was found to be targeted by flucloxacillin, including adaptor proteins (14-3-3), proteins with catalytic activities (liver carboxylesterase 1, tRNA-splicing endonuclease subunit Sen2, All-trans-retinol dehydrogenase ADH1B, Glutamate dehydrogenase 1 mitochondrial, Carbamoyl-phosphate synthase [ammonia] mitochondrial), and transporters (hemoglobin, albumin, and UTP-glucose-1-phosphate uridylyltransferase). These flucloxacillin-modified intracellular proteins could provide a potential source of neoantigens for HLA-B*57:01 presentation by hepatocytes. More importantly, covalent binding to critical cellular proteins could be the molecular initiating events that lead to flucloxacillin-induced cholestasis Data are available via ProteomeXchange with identifier PXD038581., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Published: 2023
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38. SARS-CoV-2 in the abdomen or pelvis: SAFE SURGERY study.

Author: Vimalachandran D, Jones RP, Dickson E, Seehra J, Acheson A, Griffiths EA, Kamarajah S, Leung E, Torrance A, Ottensmeier C, Beggs AD, Whiteside E, Sanna H, Bury D, Youd E, Leopold G, Pugh M, Sundar S, and Taylor GS
Subjects: Humans, Abdomen surgery, Pelvis surgery, SARS-CoV-2, COVID-19
Published: 2023
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39. Long-term morbidity after surgery for perihilar cholangiocarcinoma: A cohort study.

Author: Gilbert TM, Hackett J, Holt L, Bird N, Quinn M, Gordon-Weeks A, Diaz-Nieto R, Fenwick SW, Malik HZ, and Jones RP
Subjects: Humans, Cohort Studies, Morbidity, Klatskin Tumor surgery, Cholestasis, Bile Duct Neoplasms surgery
Abstract: Background: Surgery for perihilar cholangiocarcinoma (pCCA) offers the only possibility of long-term survival, but remains a formidable undertaking. Traditionally, 90-day post-operative complications and death are used to define operative risk. However, there is concern that this metric may not accurately capture long-term morbidity after such complex surgery., Methods: A retrospective review of a prospective database of patients undergoing surgery for pCCA at a Western centre between January 2009-2020., Results: Eighty-five patients underwent surgical resection for pCCA with a median overall survival of 36.3 months. Post-op (<90day) morbidity rates were high with 46% of patients developing a major complication (Clavien-Dindo grade 3-4). Post-op mortality rate was 13%. In total 38% (28/74) of patients experienced at least 1 episode of delayed morbidity (>90-days of surgery) resulting in 53 separate admissions with a median LOS of 7 days (IQR 2-15). These episodes were predominately secondary to biliary obstruction with the majority requiring radiological intervention (Clavien-Dindo grade 3). The development of long-term morbidity was associated with increased recurrence rates and correlated with poorer OS (27.6 months vs. 65.7 months HR 2.2 CI 1.63-2.77)., Conclusions: Routinely cited 90-day morbidity and mortality does not accurately capture the patient morbidity experienced following surgery for pCCA. Surgery clearly offers a survival benefit and should be pursued in selected patients, but they must be fully counselled on the potential for long-term morbidity before embarking on this strategy., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
Published: 2022
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40. Roles for Pathogen Interference in Influenza Vaccination, with Implications to Vaccine Effectiveness (VE) and Attribution of Influenza Deaths.

Author: Jones RP and Ponomarenko A
Abstract: Pathogen interference is the ability of one pathogen to alter the course and clinical outcomes of infection by another. With up to 3000 species of human pathogens the potential combinations are vast. These combinations operate within further immune complexity induced by infection with multiple persistent pathogens, and by the role which the human microbiome plays in maintaining health, immune function, and resistance to infection. All the above are further complicated by malnutrition in children and the elderly. Influenza vaccination offers a measure of protection for elderly individuals subsequently infected with influenza. However, all vaccines induce both specific and non-specific effects. The specific effects involve stimulation of humoral and cellular immunity, while the nonspecific effects are far more nuanced including changes in gene expression patterns and production of small RNAs which contribute to pathogen interference. Little is known about the outcomes of vaccinated elderly not subsequently infected with influenza but infected with multiple other non-influenza winter pathogens. In this review we propose that in certain years the specific antigen mix in the seasonal influenza vaccine inadvertently increases the risk of infection from other non-influenza pathogens. The possibility that vaccination could upset the pathogen balance, and that the timing of vaccination relative to the pathogen balance was critical to success, was proposed in 2010 but was seemingly ignored. Persons vaccinated early in the winter are more likely to experience higher pathogen interference. Implications to the estimation of vaccine effectiveness and influenza deaths are discussed., Competing Interests: The authors declare no conflict of interest.
Published: 2022
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41. A Model to Compare International Hospital Bed Numbers, including a Case Study on the Role of Indigenous People on Acute 'Occupied' Bed Demand in Australian States.

Author: Jones RP
Subjects: Adult, Australia, Child, Critical Care, Female, Hospitals, Humans, Pregnancy, Bed Occupancy, Indigenous Peoples
Abstract: Comparing international or regional hospital bed numbers is not an easy matter, and a pragmatic method has been proposed that plots the number of beds per 1000 deaths versus the log of deaths per 1000 population. This method relies on the fact that 55% of a person's lifetime hospital bed utilization occurs in the last year of life-irrespective of the age at death. This is called the nearness to death effect. The slope and intercept of the logarithmic relationship between the two are highly correlated. This study demonstrates how lines of equivalent bed provision can be constructed based on the value of the intercept. Sweden looks to be the most bed-efficient country due to long-term investment in integrated care. The potential limitations of the method are illustrated using data from English Clinical Commissioning Groups. The main limitation is that maternity, paediatric, and mental health care do not conform to the nearness to death effect, and hence, the method mainly applies to adult acute care, especially medical and critical care bed numbers. It is also suggested that sensible comparison can only be made by comparing levels of occupied beds rather than available beds. Occupied beds measure the expressed bed demand (although often constrained by access to care issues), while available beds measure supply. The issue of bed supply is made complex by the role of hospital size on the average occupancy margin. Smaller hospitals are forced to operate at a lower average occupancy; hence, countries with many smaller hospitals such as Germany and the USA appear to have very high numbers of available beds. The so-called 85% occupancy rule is an "urban myth" and has no fundamental basis whatsoever. The very high number of "hospital" beds in Japan is simply an artefact arising from "nursing home" beds being counted as a "hospital" bed in this country. Finally, the new method is applied to the expressed demand for occupied acute beds in Australian states. Using data specific to acute care, i.e., excluding mental health and maternity, a long-standing deficit of beds was identified in Tasmania, while an unusually high level of occupied beds in the Northern Territory (NT) was revealed. The high level of demand for beds in the NT appears due to an exceptionally large population of indigenous people in this state, who are recognized to have elevated health care needs relative to non-indigenous Australians. In this respect, indigenous Australians use 3.5 times more occupied bed days per 1000 deaths (1509 versus 429 beds per 1000 deaths) and 6 times more occupied bed days per 1000 population (90 versus 15 beds per 1000 population) than their non-indigenous counterparts. The figure of 1509 beds per 1000 deaths (or 4.13 occupied beds per 1000 deaths) for indigenous Australians is indicative of a high level of "acute" nursing care in the last months of life, probably because nursing home care is not readily available due to remoteness. A lack of acute beds in the NT then results in an extremely high average bed occupancy rate with contingent efficiency and delayed access implications., Competing Interests: The author declares no conflict of interest.
Published: 2022
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42. A pragmatic method to compare international critical care beds: Implications to pandemic preparedness and non-pandemic planning.

Author: Jones RP
Subjects: Critical Care, Hospital Bed Capacity, Humans, Pandemics, Ventilators, Mechanical, COVID-19
Abstract: Background: The current method for assessing critical care (CCU) bed numbers between countries is unreliable., Methods: A pragmatic method is presented using a logarithmic relationship between CCU beds per 1000 deaths and deaths per 1000 population, both of which are readily available. The method relies on the importance of the nearness to death effect, and on the effect of population size., Results: The method was tested using CCU bed numbers from 65 countries. A series of logarithmic relationships can be seen. High versus low countries can be distinguished by adjusting all countries to a common crude mortality rate. Hence at 9.5 deaths per 1000 population 'high' CCU bed countries average of around 30 CCU beds per 1000 deaths, while 'very low' countries only average 3 CCU beds per 1000 deaths. The United Kingdom falls among countries with low critical care provision with an average of 8 CCU beds per 1000 deaths, and during the COVID-19 epidemic UK industry intervened to rapidly manufacture various types of ventilators to avoid a catastrophe. CCU bed numbers in India are around 8.1 per 1000 deaths, which places it in the low category. However, such beds are inequitably distributed with the poorest states all in the 'very low' category. In India only around 50% of CCU beds have a ventilator., Conclusion: A feasible region is defined for the optimum number of CCU beds., (© 2022 John Wiley & Sons Ltd.)
Published: 2022
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43. The dilemma of the disappeared colorectal liver metastasis: systematic review of reviews and evidence gap map.

Author: Nassar A, Cimpean S, Abdelhamid A, Jones RP, Wahba R, Fiorentini G, Aldrighetti L, Teh C, Alikhanov R, Hammond J, Silva M, Abdelmabod A, Truant S, Ferrero A, Sturesson C, Ahmed I, Ghazanfar M, Takemura N, Pawlik TM, and Bekheit M
Subjects: Humans, Review Literature as Topic, Colorectal Neoplasms, Liver Neoplasms
Published: 2022
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44. System Complexity in Influenza Infection and Vaccination: Effects upon Excess Winter Mortality.

Author: Jones RP and Ponomarenko A
Abstract: Unexpected outcomes are usually associated with interventions in complex systems. Excess winter mortality (EWM) is a measure of the net effect of all competing forces operating each winter, including influenza(s) and non-influenza pathogens. In this study over 2400 data points from 97 countries are used to look at the net effect of influenza vaccination rates in the elderly aged 65+ against excess winter mortality (EWM) each year from the winter of 1980/81 through to 2019/20. The observed international net effect of influenza vaccination ranges from a 7.8% reduction in EWM estimated at 100% elderly vaccination for the winter of 1989/90 down to a 9.3% increase in EWM for the winter of 2018/19. The average was only a 0.3% reduction in EWM for a 100% vaccinated elderly population. Such outcomes do not contradict the known protective effect of influenza vaccination against influenza mortality per se-they merely indicate that multiple complex interactions lie behind the observed net effect against all-causes (including all pathogen causes) of winter mortality. This range from net benefit to net disbenefit is proposed to arise from system complexity which includes environmental conditions (weather, solar cycles), the antigenic distance between constantly emerging circulating influenza clades and the influenza vaccine makeup, vaccination timing, pathogen interference, and human immune diversity (including individual history of host-virus, host-antigen interactions and immunosenescence) all interacting to give the observed outcomes each year. We propose that a narrow focus on influenza vaccine effectiveness misses the far wider complexity of winter mortality. Influenza vaccines may need to be formulated in different ways, and perhaps administered over a shorter timeframe to avoid the unanticipated adverse net outcomes seen in around 40% of years.
Published: 2022
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45. Trends in Excess Winter Mortality (EWM) from 1900/01 to 2019/20-Evidence for a Complex System of Multiple Long-Term Trends.

Author: Jones RP and Ponomarenko A
Subjects: Humans, Mortality, Obesity epidemiology, Pandemics, Seasons, Influenza Pandemic, 1918-1919, Influenza Vaccines, Influenza, Human epidemiology
Abstract: Trends in excess winter mortality (EWM) were investigated from the winter of 1900/01 to 2019/20. During the 1918-1919 Spanish flu epidemic a maximum EWM of 100% was observed in both Denmark and the USA, and 131% in Sweden. During the Spanish flu epidemic in the USA 70% of excess winter deaths were coded to influenza. EWM steadily declined from the Spanish flu peak to a minimum around the 1960s to 1980s. This decline was accompanied by a shift in deaths away from the winter and spring, and the EWM calculation shifted from a maximum around April to June in the early 1900s to around March since the late 1960s. EWM has a good correlation with the number of estimated influenza deaths, but in this context influenza pandemics after the Spanish flu only had an EWM equivalent to that for seasonal influenza. This was confirmed for a large sample of world countries for the three pandemics occurring after 1960. Using data from 1980 onward the effect of influenza vaccination on EWM were examined using a large international dataset. No effect of increasing influenza vaccination could be discerned; however, there are multiple competing forces influencing EWM which will obscure any underlying trend, e.g., increasing age at death, multimorbidity, dementia, polypharmacy, diabetes, and obesity-all of which either interfere with vaccine effectiveness or are risk factors for influenza death. After adjusting the trend in EWM in the USA influenza vaccination can be seen to be masking higher winter deaths among a high morbidity US population. Adjusting for the effect of increasing obesity counteracted some of the observed increase in EWM seen in the USA. Winter deaths are clearly the outcome of a complex system of competing long-term trends.
Published: 2022
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46. Surgical management of suspected gallbladder cancer: The role of intraoperative frozen section for diagnostic confirmation.

Author: Chan BKY, Carrion-Alvarez L, Telfer R, Rehman AH, Bird N, Mann K, Jones RP, Malik HZ, Fenwick SW, and Diaz-Nieto R
Subjects: Aged, Carcinoma mortality, Female, Gallbladder Neoplasms mortality, Humans, Lymphoma mortality, Lymphoma pathology, Lymphoma surgery, Male, Melanoma mortality, Melanoma pathology, Melanoma surgery, Middle Aged, Neoplasm Staging, Operative Time, Retrospective Studies, Sensitivity and Specificity, Survival Rate, Carcinoma pathology, Carcinoma surgery, Cholecystectomy, Frozen Sections, Gallbladder Neoplasms pathology, Gallbladder Neoplasms surgery
Abstract: Background: Preoperative diagnosis for suspected gallbladder cancers is challenging, with a risk of overtreating benign disease, for example, xanthogranulomatous cholecystitis, with radical cholecystectomies. We retrospectively evaluated the surgeon's intraoperative assessment alone, and with the addition of intraoperative frozen sections, for suspected gallbladder cancers from a tertiary hepatobiliary multidisciplinary team (MDT)., Methods: MDT patients with complex gallbladder disease were included. Collated data included demographics, MDT discussion, operative details, and patient outcomes., Results: A total of 454 patients with complex gallbladder disease were reviewed, 48 (10.6%) were offered radical surgery for suspected cancer. Twenty-five underwent frozen section that led to radical surgery in 6 (25%). All frozen sections were congruent with final histopathology but doubled the operating time (p < 0.0001). Both the surgeon's subjective and additional frozen section's objective assessment, allowed for de-escalation of unnecessary radical surgery, comparing favourably to a 13.0% cancer diagnosis among radical surgery historically., Conclusions: The MDT process was highly sensitive in identifying gallbladder cancers but lacked specificity. The surgeon's intraoperative assessment is paramount in suspected cancers, and deescalated unnecessary radical surgery. Intraoperative frozen section was a safe and viable adjunct at a cost of resources and operative time., (© 2021 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.)
Published: 2022
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47. A simple method to validate medical bed number calculations.

Author: Jones RP
Subjects: Humans, Bed Occupancy, Hospitals
Abstract: Doctors are often asked to make input into bed calculations but are often not provided with the necessary background to the potential flaws in such calculations. A simple method is presented which allows both inter- and intra-national comparison of bed numbers which are sensitive to both population age structure and the role of nearness-to-death in medical bed demand. Local adjustment will be required to account for the additional demand arising for hospitals servicing more deprived populations., (Copyright © 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)
Published: 2021
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48. Combination of Pembrolizumab with Electrochemotherapy in Cutaneous Metastases from Melanoma: A Comparative Retrospective Study from the InspECT and Slovenian Cancer Registry.

Author: Campana LG, Peric B, Mascherini M, Spina R, Kunte C, Kis E, Rozsa P, Quaglino P, Jones RP, Clover AJP, Curatolo P, Giorgione R, Cemazar M, Terlizzi F, Bosnjak M, and Sersa G
Abstract: Electrochemotherapy (ECT) is an effective locoregional therapy for cutaneous melanoma metastases and has been safely combined with immune checkpoint inhibitors in preliminary experiences. Since ECT is known to induce immunogenic cell death, its combination with immune checkpoint inhibitors might be beneficial. In this study, we aimed to investigate the effectiveness of ECT on cutaneous melanoma metastases in combination with pembrolizumab. We undertook a retrospective matched cohort analysis of stage IIIC-IV melanoma patients, included in the International Network for sharing practices of ECT (InspECT) and the Slovenian Cancer Registry. We compared the outcome of patients who received the following treatments: (a) pembrolizumab alone, (b) pembrolizumab plus ECT, and (c) ECT. The groups were matched for age, sex, performance status, and size of skin metastases. The local objective response rate (ORR) was higher in the pembrolizumab-ECT group than in the pembrolizumab group (78% and 39%, p < 0.001). The 1 year local progression-free survival (LPFS) rates were 86% and 51% ( p < 0.001), and the 1 year systemic PFS rates were 64% and 39%, respectively ( p = 0.034). The 1 year overall survival (OS) rates were 88% and 64%, respectively ( p = 0.006). Our results suggest that skin-directed therapy with ECT improves superficial tumor control in melanoma patients treated with pembrolizumab. Interestingly, we observed longer PFS and OS in the pembrolizumab-ECT group than in the pembrolizumab group. These findings warrant prospective confirmation.
Published: 2021
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49. Synthetic glycolipid-based TLR4 antagonists negatively regulate TRIF-dependent TLR4 signalling in human macrophages.

Author: Palmer C, Facchini FA, Jones RP, Neumann F, Peri F, and Pirianov G
Subjects: Anti-Inflammatory Agents pharmacology, Chemokine CXCL10 metabolism, Drug Discovery, Glycolipids pharmacology, Humans, Interferon Regulatory Factor-3 metabolism, Interferon-beta metabolism, Phosphorylation, Signal Transduction, THP-1 Cells, Toll-Like Receptor 4 antagonists & inhibitors, Adaptor Proteins, Vesicular Transport metabolism, Anti-Inflammatory Agents therapeutic use, Glycolipids therapeutic use, Inflammation immunology, Macrophages immunology, Monocytes immunology, Toll-Like Receptor 4 metabolism
Abstract: TLRs, including TLR4, play a crucial role in inflammatory-based diseases, and TLR4 has been identified as a therapeutic target for pharmacological intervention. In previous studies, we investigated the potential of FP7, a novel synthetic glycolipid active as a TLR4 antagonist, to inhibit haematopoietic and non-haematopoietic MyD88-dependent TLR4 pro-inflammatory signalling. The main aim of this study was to investigate the action of FP7 and its derivative FP12 on MyD88-independent TLR4 signalling in THP-1 derived macrophages. Western blotting, Ab array and ELISA approaches were used to explore the effect of FP7 and FP12 on TRIF-dependent TLR4 functional activity in response to LPS and other endogenous TLR4 ligands in THP-1 macrophages. A different kinetic in the inhibition of endotoxin-driven TBK1, IRF3 and STAT1 phosphorylation was observed using different LPS chemotypes. Following activation of TLR4 by LPS, data revealed that FP7 and FP12 inhibited TBK1, IRF3 and STAT1 phosphorylation which was associated with down-regulation IFN-β and IP-10. Specific blockage of the IFN type one receptor showed that these novel molecules inhibited TRIF-dependent TLR4 signalling via IFN-β pathways. These results add novel information on the mechanism of action of monosaccharide FP derivatives. The inhibition of the TRIF-dependent pathway in human macrophages suggests potential therapeutic uses for these novel TLR4 antagonists in pharmacological interventions on inflammatory diseases.
Published: 2021
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50. Prognosis and Circumferential Margin in Patients with Resected Hilar Cholangiocarcinoma.

Author: Stremitzer S, Stift J, Laengle J, Schwarz C, Kaczirek K, Jones RP, Quinn LM, Fenwick SW, Diaz-Nieto R, Poston GJ, and Malik HZ
Subjects: Adult, Aged, Aged, 80 and over, Female, Humans, Male, Margins of Excision, Middle Aged, Neoplasm Recurrence, Local surgery, Prognosis, Retrospective Studies, Survival Rate, Treatment Outcome, Bile Duct Neoplasms surgery, Cholangiocarcinoma surgery, Klatskin Tumor surgery
Abstract: Background: Resection margin status is a known prognosticator in patients who undergo resection for hilar cholangiocarcinoma. However, the influence of an isolated positive circumferential margin on clinical outcome is unclear., Methods: Patients with resected de novo hilar cholangiocarcinoma from two European hepatobiliary centres (Medical University of Vienna and Aintree University Hospital, 2006-2016) were classified according to resection margin status (negative, surgically positive, isolated circumferentially positive) and investigated with respect to overall survival (OS), recurrence-free survival (RFS) and recurrence pattern., Results: Eighty-three (48 male/35 female) patients were enrolled. The median age was 64 years (range 33-80). The median follow-up was 21.7 months (range 0.3-92.4). Forty (48%) patients had negative resection margins, 25 (30%) had an isolated positive circumferential margin and 18 (22%) had a positive surgical margin. The 5-year OS rates in patients with negative, isolated positive circumferential and positive surgical resection margins were 47%, 33% and 0%, respectively. Median OS was 45.6, 32.7 and 14.5 months, respectively (log rank, P = 0.011). Upon multivariable Cox regression analysis, resection margin status and lymph node status remained statistically significant (P < 0.05). No difference with respect to RFS and recurrence pattern was found between the groups (P > 0.05)., Conclusion: Our data show that these three resection margin types were associated with different clinical outcomes. Circumferential margin status may therefore serve as a novel prognostic biomarker.
Published: 2021
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