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1. What Do We Know about Medication Adherence Interventions in Inflammatory Bowel Disease, Multiple Sclerosis and Rheumatoid Arthritis? A Scoping Review of Randomised Controlled Trials

Author: King K, McGuinness S, Watson N, Norton C, Chalder T, and Czuber-Dochan W
Subjects: ibd, ms, ra, treatment, medicine, drug, concordance., Medicine (General), R5-920
Abstract: Kathryn King,1 Serena McGuinness,1 Natalie Watson,1 Christine Norton,1 Trudie Chalder,2 Wladyslawa Czuber-Dochan1 1Florence Nightingale Faculty Nursing, Midwifery and Palliative Care, King’s College London, London, UK; 2Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UKCorrespondence: Kathryn King, Email Kathryn.king@kcl.ac.ukPurpose: Between 53% and 75% of people with inflammatory bowel disease, 30%– 80% with rheumatoid arthritis, and up to 50% with multiple sclerosis do not take medications as prescribed to maintain remission. This scoping review aimed to identify effective adherence interventions for inflammatory bowel disease, but with few studies found, multiple sclerosis and rheumatoid arthritis were included to learn lessons from other conditions.Methods: Full and pilot randomised controlled trials testing medication adherence interventions for inflammatory bowel disease, multiple sclerosis, and rheumatoid arthritis conducted between 2012 and 2021 were identified in six electronic databases.Results: A total of 3024 participants were included from 24 randomised controlled trials: 10 pilot and 14 full studies. Eight investigated inflammatory bowel disease, 12 rheumatoid arthritis, and four multiple sclerosis. Nine studies (37.5%) reported significantly improved medication adherence, all involving tailored, personalised education, advice or counselling by trained health professionals, with five delivered face-to-face and 1:1. Quality of effective interventions was mixed: five rated high quality, two medium and two low quality. Interventions predominantly using technology were likely to be most effective. Secondary tools, such as diaries, calendars and advice sheets, were also efficient in increasing adherence. Only 10 interventions were based on an adherence theory, of which four significantly improved adherence.Conclusion: Tailored, face-to-face, 1:1 interactions with healthcare professionals were successful at providing personalised adherence support. Accessible, user-friendly technology-based tools supported by calendars and reminders effectively enhanced adherence. Key components of effective interventions should be evaluated and integrated further into clinical practice if viable, whilst being tailored to inflammatory conditions.Plain Language Summary: Introduction: Inflammatory bowel disease (IBD), multiple sclerosis (MS), and rheumatoid arthritis (RA) are inflammatory diseases where the immune system causes inflammation by mistakenly attacking itself. These lifelong conditions cannot be cured, but can usually be controlled by medication. Medication is most effective when taken as prescribed, called “adherence”. For multiple reasons, between five and eight in 10 people with IBD, RA, and MS do not take medications as advised. This review aimed to identify research that tested ways to help people living with IBD, MS, and RA take medications as prescribed. Identifying and understanding what helps can increase patient well-being and improve quality of life through better controlled inflammatory conditions.Methods: Studies testing medication adherence interventions for IBD, MS, and RA conducted between 2012 and 2021 were identified from six electronic databases.Results: A total of 3024 people with inflammatory conditions took part in 24 studies (eight on IBD, four on MS, and 12 on RA). Nine studies reported significantly improved medication adherence, all involving personalised education, advice or counselling by trained health professionals, with five delivered face-to-face and individually. Interventions predominantly using technology were the most effective. Diaries, calendars, and advice sheets also increased adherence. Ten of the interventions were based on an adherence theory, of which four improved adherence.Conclusions: Personalised adherence support was successful when:tailored to patient,one-to-one and face-to-face,with healthcare professionals,involving technology-based tools, andsupported by calendars/reminders.Components of effective interventions should be used in clinical practice where possible, made specific to each inflammatory condition.Keywords: IBD, MS, RA, treatment, medicine, drug, concordance
Published: 2023

2. The Single-Phase ProtoDUNE Technical Design Report

Author: Abi, B., Acciarri, R., Acero, M. A., Adamowski, M., Adams, C., Adams, D. L., Adamson, P., Adinolfi, M., Ahmad, Z., Albright, C. H., Alion, T., Anderson, J., Anderson, K., Andreopoulos, C., Andrews, M. P., Andrews, R. A., Anjos, J. dos, Ankowski, A., Anthony, J., Antonello, M., Fernandez, A. Aranda, Ariga, A., Ariga, T., Diaz, E. Arrieta, Asaadi, J., Ascencio, M., Asner, D. M., Athar, M. S., Auger, M., Aurisano, A., Aushev, V., Autiero, D., Azfar, F., Back, J. J., Back, H. O., Backhouse, C., Bai, X., Baird, M., Balantekin, A. B., Balasubramanian, S., Baller, B., Ballett, P., Bambah, B., Band, H., Bansal, M., Bansal, S., Barker, G. J., Barr, G., Monarca, J. Barranco, Barros, N., Bashyal, A., Bass, M., Bay, F., Bazo, J. L., Beacom, J. F., Behera, B. R., Bellettini, G., Bellini, V., Beltramello, O., Benekos, N., Benetti, P. A., Bercellie, A., Berman, E., Berns, H., Bernstein, R., Bertolucci, S., Bhatnagar, V., Bhuyan, B., Bian, J., Biery, K., Bishai, M., Bitadze, A., Blackburn, T., Blake, A., Blaszczyk, F. d. M., Blaufuss, E., Blazey, G. C., Blennow, M., Blucher, E., Bocean, V., Boffelli, F., Boissevain, J., Bolognesi, S., Bolton, T., Bonesini, M., Boone, T., Booth, C., Bordoni, S., Bour, P., Bourguille, B., Boyd, S. B., Boyden, D., Brailsford, D., Brandt, A., Bremer, J., Brice, S. J., Bromberg, C., Brooijmans, G., Brown, G., Brunetti, G., Buchanan, N., Budd, H., Calafiura, P., Calatayud, A., Calligarich, E., Calvo, E., Camilleri, L., Campanelli, M., Cantini, C., Carls, B., Cascella, M., Catano-Mur, E., Cavaili-Sforza, M., Cavanna, F., Centro, S., Villanueva, A. Cervera, Cervi, T., Chalifour, M., Chappuis, A., Chatterjee, A., Chattopadhyay, S., Chaussard, L., Chembra, S., Chen, H., Chen, M., Cherdack, D., Chi, C., Childress, S., Choubey, S., Choudhary, B. C., Christodoulou, G., Christofferson, C., Church, E., Coan, T. E., Cocco, A., Cole, P., Collin, G., Conrad, J. M., Convery, M., Corey, R., Corwin, L., Crespo-Anadón, J. I., Prats, J. Creus, Crivelli, P., Cronin-Hennessy, D., Crowley, C., Curioni, A., Cussans, D., da Motta, H., Dale, D., Davenne, T., Davies, G. S., Davies, J., Dawson, J., De, K., De Bonis, I., De Gouvea, A., de Holanda, P. C., De Jong, P., De Lurgio, P., de Vries, J. J., Decowski, M. P., Dedin-Neto, P., Delbart, A., Delepine, D., Delgado, M., Demuth, D., Dennis, S., Densham, C., Dharmapalan, R., Dhingra, N., Diamantopoulou, M., Diaz, J. S., Bautista, G. Diaz, Ding, P., Diwan, M., Djurcic, Z., Dolinski, M. J., Drake, G., Duchesneau, D., Dutta, D., Duvernois, M., Duyang, H., Dwyer, D. A., Dye, S., Dyshkant, A. S., Dytman, S., Eads, M., Eberly, B., Edmunds, D., Elliott, S., Ellsworth, W. M., Elnimr, M., Emery, S., Eno, S., Ereditato, A., Escobar, C. O., Sanchez, L. Escudero, Evans, J. J., Fahey, K., Falcone, A., Falk, L., Farbin, A., Farnese, C., Farzan, Y., Fasoli, M., Fava, A., Felix, J., Menendez, P. Fernandez, Fernandez-Martinez, E., Fields, L., Filthaut, F., Finch, A., Fitton, M., Fleming, B. T., Forest, T., Fowler, J., Fox, W., Freeman, J., Freestone, J., Friant, D., Fried, J., Friedland, A., Fuess, S., Fujikawa, B., Gago, A., Gallagher, H., Galvin, S., Galymov, S., Gamble, T., Gandhi, R., Gao, S., Garcia-Gamez, D., Gardiner, S., Gastler, D., Gendotti, A., Gibin, D., Gil-Botella, I., Gill, R., Giri, A. K., Goeldi, D., Gold, M., Gollapinni, S., Gomes, R. A., Cadenas, J. J. Gomez, Goodman, M. C., Gorbunov, D., Goswami, S., Graf, N., Graham, M., Gramelini, E., Gran, R., Grant, C., Grant, N., Greco, V., Greenlee, H., Greenler, L., Groh, M., Grzelak, K., Guardincerri, E., Guarino, V., Guedes, G. P., Guenette, R., Guglielmi, A., Guthikonda, K. K., Guzzo, M. M., Habig, A. T., Hackenburg, A., Hackenburg, R. W., Hadavand, H., Haenni, R., Hahn, A., Haigh, M. D., Haines, T., Hamernik, T., Hamilton, P., Handler, T., Hans, S., Harris, D., Hartnell, J., Hasegawa, T., Hatcher, R., Hatzikoutelis, A., Hays, S., Hazen, E., Headley, M., Heavey, A., Heeger, K. M., Heise, J., Hennessy, K., Henry, S., Hernandez-Garcia, J., Hewes, V, Higuera, A., Hill, T., Himmel, A., Holin, A., Hoppe, E. W., Horikawa, S., Horton-Smith, G., Hostert, M., Hourlier, A., Howard, B., Howell, J., Hugon, J., Hurh, P., Huston, J., Hylen, J., Insler, J., Introzzi, G., Ioannisian, A., Izmaylov, A., Jaffe, D. E., James, C., James, E., Jang, C. H., Jediny, F., Jen, C., Jhingan, A., Jiménez, S., Johnson, M., Johnson, R., Johnstone, J., Joshi, J., Jostlein, H., Jung, C. K., Junk, T., Kaboth, A., Kadenko, I., Kamyshkov, Y., Karagiorgi, G., Karasavvas, D., Karyotakis, Y., Kaur, P., Kayser, B., Kazaryan, N., Kearns, E., Keener, P. T., Kemp, E., Kendziora, C., Ketchum, W., Kettell, S. H., Khabibullin, M., Khotjantsev, A., Kirby, B., Kirby, M., Klein, J., Ko, Y. J., Kobilarcik, T., Kocaman, B., Koerner, L. W., Kohn, S., Koizumi, G., Kopylov, A., Kordosky, M., Kormos, L., Kose, U., Kostelecký, V. A., Kramer, M., Kreslo, I., Kriesel, K., Kropp, W., Kudenko, Y., Kudryavtsev, V. A., Kulagin, S., Kumar, A., Kumar, J., Kumar, L., Kus, V., Kutter, T., Lande, K., Lane, C., Lang, K., Langford, T., Lanni, F., Laundrie, A., Le, T., Learned, J., Lebrun, P., Lee, D., Lee, W. M., de Oliveira, M. A. Leigui, Li, Q. Z., Li, S., Li, S. W., Li, X., Li, Y., Li, Z., Lin, C. S., Lin, S., Linehan, R., Link, J., Liptak, Z., Lissauer, D., Littenberg, L., Littlejohn, B. R., Liu, J., Liu, Q., Liu, T., Lockwitz, S., Lockyer, N., Loew, T., Lokajicek, M., LoMonaco, L., Long, K., Loo, K., Lopez, J. P., Lorca, D., LoSecco, J. M., Louis, W., Luethi, M., Luk, K. B., Lundin, T., Luo, X., Lux, T., Lykken, J., Maalampi, J., Machado, A. A., Macias, C. T., Macier, J. R., MacLellan, R., Magill, S., Mahler, G., Mahn, K., Malek, M., Mammoliti, F., Mandal, S. K., Mandodi, S., Manly, S., Mann, A., Marchionni, A., Marciano, W., Marfatia, D., Mariani, C., Maricic, J., Marino, A. D., Marshak, M., Marshall, C. M., Marshall, J., Marteau, J., Martin-Albo, J., Caicedo, D. A. Martinez, Masud, M., Matsuno, S., Matthews, J., Mauger, C., Mavrokoridis, K., Mazza, R., Mazzacane, A., Mazzucato, E., McCauley, N., McCluskey, E., McConkey, N., McDonald, K. T., McFarland, K. S., McGivern, C., McGowan, A. M., McGrew, C., McGuinness, S. R., McKeown, R., McNulty, D., McTaggart, R., Mefodiev, A., Mehta, P., Mei, D., Mena, O., Menary, S., Mendez, D. P., Mendez, H., Menegolli, A., Meng, G., Messier, M., Metcalf, W., Mewes, M., Meyer, H., Miao, T., Milincic, R., Miller, W., Mills, G., Mineev, O., Miranda, O. G., Mishra, C. S., Mishra, S. R., Mitrica, B., Mladenov, D., Mocioiu, I., Moffat, K., Mohanta, R., Mokhov, N., Bueno, L. Molina, Montanari, C., Montanari, D., Moon, J., Mooney, M., Moore, C. D., Morgan, B., Morris, C., Morse, W., Mossey, C., Moura, C. A., Mousseau, J., Mualem, L., Muether, M., Mufson, S., Murphy, S., Musser, J., Nakajima, Y., Naples, D., Navarro, J., Navas-Nicolás, D., Nelson, J., Nessi, M., Newbold, D., Newcomer, M., Nguyen, K. T. T., Nichol, R., Nicholls, T. C., Niner, E., Norman, A., Norris, B., Novakova, P., Novella, P., Nowak, E., Nowak, J., Nunes, M. S., O'Keeffe, H., Del Campo, A. Olivares, Oliveira, R., Olivier, A., Onishchuk, Y., Ovsjannikova, T., Pakvasa, S., Palamara, O., Paley, J., Palomares, C., Pantic, E., Paolone, V., Papadimitriou, V., Paramesvaran, S., Park, J., Parke, S., Parsa, Z., Pascoli, S., Pasternak, J., Pater, J., Patterson, R. B., Patton, S. J., Patzak, T., Paulos, B., Paulucci, L., Pavlovic, Z., Pawloski, G., Payne, D., Peeters, S. J. M., Pennacchio, E., Perdue, G. N., Peres, O. L. G., Periale, L., Perkin, J. D., Petridis, K., Petti, R., Petukhov, A., Picchi, P., Pietropaolo, F., Plonski, P., Plunkett, R., Poling, R., Popovic, M., Pordes, R., Pordes, S., Potekhin, M., Potenza, R., Potukuchi, B., Poudel, S., Pozimski, J., Prokofiev, O., Pruthi, N., Przewlocki, P., Pumulo, N., Pushka, D., Qian, X., Raaf, J. L., Raboanary, R., Radeka, V., Rademacker, J., Radics, B., Radovic, A., Rakhno, I., Rakotondramanana, H. T., Rakotondravohitra, L., Ramachers, Y. A., Rameika, R., Ramsey, J., Rappoldi, A., Raselli, G., Ratoff, P., Rebel, B., Regenfus, C., Reichenbacher, J., Reitzner, S. D., Remoto, A., Renshaw, A., Rescia, S., Rice, L., Rielage, K., Riesselmann, K., Rivera, D., Robinson, M., Rochester, L., Rodrigues, O. B., Rodrigues, P., Roe, B., Roser, R. M., Ross-Lonergan, M., Rossella, M., Rout, J., Roy, S., Rubbia, A., Rubbia, C., Rucinski, R., von Rohr, C. Rudolph, Russell, B., Ruterbories, D., Saakyan, R., Sachdev, K., Sahu, N., Sala, P., Samios, N., Sanchez, F., Sanchez, M. C., Sands, W. R., Santana, S., Santorelli, R., Santos, L. M., Santucci, G., Saoulidou, N., Savage, G., Scaramelli, A., Scarpelli, A., Schaffer, T., Schellman, H., Schlabach, P., Schmitz, D., Schneps, J., Scholberg, K., Schukraft, A., Segreto, E., Sehrawat, S., Sepulveda-Quiroz, J. A., Sergiampietri, F., Sexton, K., Sexton-Kennedy, L., Shaevitz, M. H., Shahi, J., Shahsavarani, S., Shanahan, P., Sharma, R., Sharma, R. K., Shaw, T., Shooltz, D., Shrock, R., Simos, N., Sinclair, J., Sinev, G., Singh, I., Singh, J., Singh, V., Sippach, F. W., Siyeon, K., Smith, A., Smith, P., Smolik, J., Smy, M., Snider, E., Snopok, P., Sobczyk, J., Sobel, H., Soderberg, M., Solomey, N., Sondheim, W., Sorel, M., Sousa, A., Soustruznik, K., Spanu, M., Spitz, J., Spooner, N. J. C., Stancari, M., Stefan, D., Stefanik, A., Steiner, H. M., Stewart, J., Stock, J., Stoica, S., Stone, J., Strait, J., Strait, M., Strauss, T., Striganov, S., Sulej, R., Sullivan, G., Sun, Y., Suter, L., Sutera, C. M., Svoboda, R., Szczerbinska, B., Szelc, A. M., Söldner-Rembold, S., Talaga, R., Tariq, S., Tatar, E., Tayloe, R., Terao, K., Thiesse, M., Thompson, L. F., Thomson, M., Thorn, C., Thorpe, M., Tian, X., Tiedt, D., Timm, S. C., Todd, J., Tonazzo, A., Tope, T., Torres, F. R., Torti, M., Tortola, M., Tortorici, F., Toups, M., Touramanis, C., Trevor, J., Tripathi, M., Tropin, I., Trzaska, W. H., Tsai, Y., Tsang, K. V., Tsaris, A., Tsenov, R., Tufanli, S., Tull, C., Turner, J., Tzanov, M., Tziaferi, E., Uchida, Y., Sankar, S. Uma, Urheim, J., Usher, T., Vagins, M. R., Vahle, P., Valdiviesso, G. A., Valerio, L., Vallari, Z., Valle, J., Van Berg, R., Van de Water, R., Varanini, F., Varner, G., Vasseur, G., Vaziri, K., Velev, G., Ventura, S., Verdugo, A., Vermeulen, M. A., Vernon, E., Viant, T., Vieira, T. V., Vignoli, C., Vihonen, S., Vilela, C., Viren, B., Vokac, P., Vrba, T., Wachala, T., Wahl, D., Wallbank, M., Wang, B., Wang, H., Wang, T., Warburton, T. K., Warner, D., Wascko, M., Waters, D., Weber, A., Weber, M., Wei, W., Weinstein, A., Wenman, D., Wetstein, M., White, A., Whitehead, L. H., Whittington, D., Wilking, M. J., Willhite, J., Wilson, P., Wilson, R. J., Wittich, P., Wolcott, J., Wong, H. H., Wongjirad, T., Wood, K., Wood, L. S., Worcester, E., Worcester, M., Wu, S., Xu, W., Yanagisawa, C., Yang, S., Yang, T., Ye, J., Yeh, M., Yershov, N., Yonehara, K., Yu, B., Yu, J., Zalesak, J., Zambelli, L., Zamorano, B., Zang, L., Zani, A., Zaremba, K., Zeller, G. P., Zhang, C., Zhou, Y., Zimmerman, E. D., Zito, M., Zuklin, J., Zutshi, V., and Zwaska, R.
Subjects: Physics - Instrumentation and Detectors, High Energy Physics - Experiment
Abstract: ProtoDUNE-SP is the single-phase DUNE Far Detector prototype that is under construction and will be operated at the CERN Neutrino Platform (NP) starting in 2018. ProtoDUNE-SP, a crucial part of the DUNE effort towards the construction of the first DUNE 10-kt fiducial mass far detector module (17 kt total LAr mass), is a significant experiment in its own right. With a total liquid argon (LAr) mass of 0.77 kt, it represents the largest monolithic single-phase LArTPC detector to be built to date. It's technical design is given in this report., Comment: 165 pages, fix references, author list and minor numbers
Published: 2017

3. Combined Single Session EUS and ERCP Procedures; The Challenges of Conscious Sedation

Author: Keating, E., additional, Bennett, G., additional, Campion, J. R., additional, Mcguinness, S., additional, Martir, H., additional, Kelleher, B., additional, Stewart, S., additional, Ramlaul, N., additional, and Leyden, J., additional
Published: 2024
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4. P089 Development and preliminary evaluation of a suicidal risk assessment protocol in a research trial using the Patient Health Questionnaire (PHQ-9)

Author: Wileman, V, primary, McGuinness, S, additional, Sweeney, L, additional, Miller, L, additional, Stagg, I, additional, O'Carroll, R, additional, Moss-Morris, R, additional, and Norton, C, additional
Published: 2024
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5. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Author: Pham, T, Heunks, L, Bellani, G, Madotto, F, Aragao, I, Beduneau, G, Goligher, E, Grasselli, G, Laake, J, Mancebo, J, Penuelas, O, Piquilloud, L, Pesenti, A, Wunsch, H, van Haren, F, Brochard, L, Laffey, J, Abrough, F, Acharya, S, Amin, P, Arabi, Y, Bauer, P, Beitler, J, Berkius, J, Bugedo, G, Camporota, L, Cerny, V, Cho, Y, Clarkson, K, Estenssoro, E, Gritsan, A, Hashemian, S, Hermans, G, Jovanovic, B, Kurahashi, K, Matamis, D, Moerer, O, Molnar, Z, Ozyilmaz, E, Panka, B, Papali, A, Perbet, S, Qiu, H, Razek, A, Rittayamai, N, Roldan, R, Serpa Neto, A, Szuldrzynski, K, Talmor, D, Tomescu, D, Villagomez, A, Zeggwagh, A, Abe, T, Aboshady, A, Acampo-de Jong, M, Adderley, J, Adiguzel, N, Agrawal, V, Aguilar, G, Aguirre, G, Aguirre-Bermeo, H, Ahlstrom, B, Akbas, T, Akker, M, Al Sadeh, G, Alamri, S, Algaba, A, Ali, M, Aliberti, A, Allegue, J, Alvarez, D, Amador, J, Andersen, F, Ansari, S, Apichatbutr, Y, Apostolopoulou, O, Arellano, D, Arica, M, Arikan, H, Arinaga, K, Arnal, J, Asano, K, Asin-Corrochano, M, Avalos Cabrera, J, Avila Fuentes, S, Aydemir, S, Aygencel, G, Azevedo, L, Bacakoglu, F, Badie, J, Baedorf Kassis, E, Bai, G, Balaraj, G, Ballico, B, Banner-Goodspeed, V, Banwarie, P, Barbieri, R, Baronia, A, Barrett, J, Barrot, L, Barrueco-Francioni, J, Barry, J, Bawangade, H, Beavis, S, Beck, E, Beehre, N, Belenguer Muncharaz, A, Belliato, M, Bellissima, A, Beltramelli, R, Ben Souissi, A, Benitez-Cano, A, Benlamin, M, Benslama, A, Bento, L, Benvenuti, D, Bernabe, L, Bersten, A, Berta, G, Bertini, P, Bertram-Ralph, E, Besbes, M, Bettini, L, Beuret, P, Bewley, J, Bezzi, M, Bhakhtiani, L, Bhandary, R, Bhowmick, K, Bihari, S, Bissett, B, Blythe, D, Bocher, S, Boedjawan, N, Bojanowski, C, Boni, E, Boraso, S, Borelli, M, Borello, S, Borislavova, M, Bosma, K, Bottiroli, M, Boyd, O, Bozbay, S, Briva, A, Bruel, C, Bruni, A, Buehner, U, Bulpa, P, Burt, K, Buscot, M, Buttera, S, Cabrera, J, Caccese, R, Caironi, P, Canchos Gutierrez, I, Canedo, N, Cani, A, Cappellini, I, Carazo, J, Cardonnet, L, Carpio, D, Carriedo, D, Carrillo, R, Carvalho, J, Caser, E, Castelli, A, Castillo Quintero, M, Castro, H, Catorze, N, Cengiz, M, Cereijo, E, Ceunen, H, Chaintoutis, C, Chang, Y, Chaparro, G, Chapman, C, Chau, S, Chavez, C, Chelazzi, C, Chelly, J, Chemouni, F, Chen, K, Chena, A, Chiarandini, P, Chilton, P, Chiumello, D, Chou-Lie, Y, Chudeau, N, Cinel, I, Cinnella, G, Clark, M, Clark, T, Clementi, S, Coaguila, L, Codecido, A, Collins, A, Colombo, R, Conde, J, Consales, G, Cook, T, Coppadoro, A, Cornejo, R, Cortegiani, A, Coxo, C, Cracchiolo, A, Crespo Ramirez, M, Crova, P, Cruz, J, Cubattoli, L, Cukurova, Z, Curto, F, Czempik, P, D'Andrea, R, da Silva Ramos, F, Dangers, L, Danguy des Deserts, M, Danin, P, Dantas, F, Daubin, C, Dawei, W, de Haro, C, de Jesus Montelongo, F, De Mendoza, D, de Pablo, R, De Pascale, G, De Rosa, S, Decavele, M, Declercq, P, Deicas, A, del Carmen Campos Moreno, M, Dellamonica, J, Delmas, B, Demirkiran, O, Demirkiran, H, Dendane, T, di Mussi, R, Diakaki, C, Diaz, A, Diaz, W, Dikmen, Y, Dimoula, A, Doble, P, Doha, N, Domingos, G, Dres, M, Dries, D, Duggal, A, Duke, G, Dunts, P, Dybwik, K, Dykyy, M, Eckert, P, Efe, S, Elatrous, S, Elay, G, Elmaryul, A, Elsaadany, M, Elsayed, H, Elsayed, S, Emery, M, Ena, S, Eng, K, Englert, J, Erdogan, E, Ergin Ozcan, P, Eroglu, E, Escobar, M, Esen, F, Esen Tekeli, A, Esquivel, A, Esquivel Gallegos, H, Ezzouine, H, Facchini, A, Faheem, M, Fanelli, V, Farina, M, Fartoukh, M, Fehrle, L, Feng, F, Feng, Y, Fernandez, I, Fernandez, B, Fernandez-Rodriguez, M, Ferrando, C, Ferreira da Silva, M, Ferreruela, M, Ferrier, J, Flamm Zamorano, M, Flood, L, Floris, L, Fluckiger, M, Forteza, C, Fortunato, A, Frans, E, Frattari, A, Fredes, S, Frenzel, T, Fumagalli, R, Furche, M, Fusari, M, Fysh, E, Galeas-Lopez, J, Galerneau, L, Garcia, A, Garcia, M, Garcia, E, Garcia Olivares, P, Garlicki, J, Garnero, A, Garofalo, E, Gautam, P, Gazenkampf, A, Gelinotte, S, Gelormini, D, Ghrenassia, E, Giacomucci, A, 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L., Seckin Yucesoy F., Seely A., Seiler F., Seker Tekdos Y., Seok Chan K., Serano L., Serednicki W., Setten M., Shah A., Shah B., Shang Y., Shanmugasundaram P., Shapovalov K., Shebl E., Shiga T., Shime N., Shin P., Short J., Shuhua C., Siddiqui S., Silesky Jimenez J. I., Silva D., Silva Sales B., Simons K., Sjobo B. A., Slessor D., Smiechowicz J., Smischney N., Smith P., Smith T., Smith M., Snape S., Snyman L., Soetens F., Sook Hong K., Sosa Medellin M. A., Soto G., Souloy X., Sousa E., Sovatzis S., Sozutek D., Spadaro S., Spagnoli M., Spangfors M., Spittle N., Spivey M., Stapleton A., Stefanovic B., Stephenson L., Stevenson E., Strand K., Strano M. T., Straus S., Sun C., Sun R., Sundaram V., SunPark T., Surlemont E., Sutherasan Y., Szabo Z., Tainter C., Takaba A., Tallott M., Tamasato T., Tang Z., Tangsujaritvijit V., Taniguchi L., Taniguchi D., Tarantino F., Teerapuncharoen K., Temprano S., Terragni P., Terzi N., Thakur A., Theerawit P., Thille A. W., Thomas M., Thungtitigul P., Thyrault M., Tilouch N., Timenetsky K., Tirapu J., Todeschini M., Tomas R., Tomaszewski C., Tonetti T., Tonnelier A., Trinder J., Trongtrakul K., Truwit J., Tsuei B., Tulaimat A., Turan S., Turkoglu M., Tyagi S., Ubeda A., Vagginelli F., Valenti M. F., Vallverdu I., Van Axel A., van den Hul I., van der Hoeven H., Van Der Meer N., Vanhoof M., Vargas-Ordonez M., Vaschetto R., Vascotto E., Vatsik M., Vaz A., Vazquez-Sanchez A., Ventura S., Vermeijden J. W., Vidal A., Vieira J., Vilela Costa Pinto B., Villagra A., Villegas Succar C., Vinorum O. G., Vitale G., Vj R., Vochin A., Voiriot G., Volta C. A., von Seth M., Wajdi M., Walsh D., Wang S., Wardi G., Ween-Velken N. 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M., Zerman A., Zetterquist H., Zhang J., Zhang H., Zhang W., Zhang G., Zhao H., Zheng J., Zhu B., Zumaran R., Pham, T, Heunks, L, Bellani, G, Madotto, F, Aragao, I, Beduneau, G, Goligher, E, Grasselli, G, Laake, J, Mancebo, J, Penuelas, O, Piquilloud, L, Pesenti, A, Wunsch, H, van Haren, F, Brochard, L, Laffey, J, Abrough, F, Acharya, S, Amin, P, Arabi, Y, Bauer, P, Beitler, J, Berkius, J, Bugedo, G, Camporota, L, Cerny, V, Cho, Y, Clarkson, K, Estenssoro, E, Gritsan, A, Hashemian, S, Hermans, G, Jovanovic, B, Kurahashi, K, Matamis, D, Moerer, O, Molnar, Z, Ozyilmaz, E, Panka, B, Papali, A, Perbet, S, Qiu, H, Razek, A, Rittayamai, N, Roldan, R, Serpa Neto, A, Szuldrzynski, K, Talmor, D, Tomescu, D, Villagomez, A, Zeggwagh, A, Abe, T, Aboshady, A, Acampo-de Jong, M, Adderley, J, Adiguzel, N, Agrawal, V, Aguilar, G, Aguirre, G, Aguirre-Bermeo, H, Ahlstrom, B, Akbas, T, Akker, M, Al Sadeh, G, Alamri, S, Algaba, A, Ali, M, Aliberti, A, Allegue, J, Alvarez, D, Amador, J, Andersen, F, 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F., Fartoukh M., Fehrle L., Feng F., Feng Y., Fernandez I., Fernandez B., Fernandez-Rodriguez M. L., Ferrando C., Ferreira da Silva M. J., Ferreruela M., Ferrier J., Flamm Zamorano M. J., Flood L., Floris L., Fluckiger M., Forteza C., Fortunato A., Frans E., Frattari A., Fredes S., Frenzel T., Fumagalli R., Furche M. A., Fusari M., Fysh E., Galeas-Lopez J. L., Galerneau L. -M., Garcia A., Garcia M. F., Garcia E., Garcia Olivares P., Garlicki J., Garnero A., Garofalo E., Gautam P., Gazenkampf A., Gelinotte S., Gelormini D., Ghrenassia E., Giacomucci A., Giannoni R., Gigante A., Glober N., Gnesin P., Gollo Y., Gomaa D., Gomero Paredes R., Gomes R., Gomez R. 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Abstract: Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 d
Published: 2023

6. Correction: Epidemiology and outcomes of early-onset AKI in COVID-19-related ARDS in comparison with non-COVID-19-related ARDS: insights from two prospective global cohort studies (Critical Care, (2023), 27, 1, (3), 10.1186/s13054-022-04294-5)

Author: McNicholas B. 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M., Nacpil N., Ruck K., Bakken R., Jara C., Felton T., Tharwat S., Berra L., Shah B., Chakraborty A., Cardona M., Capatos G., Akkanti B., Orija A., Jain H., Ito A., Muftah M., Housni B., Aldhalia A., Low S., Iihara K., Chavez J., Ramanathan K., Naidoo K., Seppelt I., VanDyk M., MacDonald S., Hafez W., McGregor R., Siebenaler T., Flynn H., Lofton K., Aokage T., Kvirkvelia B., Shigemitsu K., Moscatelli A., Fiorentino G., Baumgaertel M., Mba S. E., Assy J., Hutahaean A., Roush H., Sichting K. A., Alessandri F., Burns D., Alkhubouli T. H., Nasrallah A., Salt G., Garabedian C. P., Millar J., Sim M., Mattke A., McAuley D., Tadili J., Frenzel T., Bar-Lavie Y., Ortiz A. B., Stone J., Attokaran A., Farquharson M., Patel B., Gunning D., Baillie K., Adem S., Watson P., Tamai K., Sajinadiyasa G. K., Kanyawati D., Salgado M., Sassine A., Yudo B., McCaul S., Lee B., Lee S. M., Afek A., Iwashita Y., Fadlalmola H., Semedi B. P., Mansour N. M., Metiva J., Van Belle N., Martin-Loeches I., Al-Sadawi M., Kirakli C., Shimaa A. -T., Abdurraouf A., Ivatt L., Moharam S., Woon C. Y., Kang H. M., Smith T., James E., Al-Rawas N., Almjersah A., Iwasaki Y., Ashour H., Embarek H., King-Chung K. C., Gudzenko V., Taccone F., Perdhana F., Lamarche Y., Ribeiro J. M., Bradic N., Van den Bossche K., Lansink O., Singh G., Debeuckelaere G., Stelfox H. T., Yi C., Elia J., Tribble T., Shankar S., Padmanabhan R., Hallinan B., Paoletti L., Leyva Y., Fykuda T., Badulak J., Koch J., Janowaik L., Hackman A., Hernandez D., Osofsky J., Donadello K., Lawang A., Fine J., Davidson B., Vazquez A. O. R., and Abdehaleem I.
Abstract: Following publication of the original article [1], the authors identified that the collaborating authors part of the collaborating author group CCCC Consortium was missing. The collaborating author group is available and included as Additional file 1 in this article.
Published: 2023

7. Tranexamic acid in coronary artery surgery: One-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial

Author: Myles, Paul, Smith, Julian, Cooper, D. James, Silbert, Brendan, McNeil, John, Marasco, Silvana, Esmore, Donald, Krum, Henry, Tonkin, A., Buxton, B., Heritier, S., Merry, A., Liew, D., McNeil, J., Forbes, A., Cooper, D.J., Wallace, S., Meehan, A., Myles, P., Galagher, W., Farrington, C., Ditoro, A., Wutzlhofer, L., Story, D., Peyton, P., Baulch, S., Sidiropoulos, S., Potgieter, D., Baker, R.A., Pesudovs, B., O'Loughlin J Wells, E., Coutts, P., Bolsin, S., Osborne, C., Ives, K., Smith, J., Hulley, A., Christie-Taylor, G., Painter, T., Lang, S., Mackay, H., Cokis, C., March, S., Bannon, P.G., Wong, C., Turner, L., Scott, D., Silbert, B., Said, S., Corcoran, P., de Prinse, L., Bussières, J.S., Gagné, N., Lamy, A., Semelhago, L., Chan, M.T.V., Underwood, M., Choi, G.S.Y., Fung, B., Landoni, G., Lembo, R., Monaco, F., Simeone, F., Marianello, D., Alvaro, G., De Vuono, G., van Dijk, D., Dieleman, J., Numan, S., McGuinness, S., Parke, R., Raudkivi, P., Gilder, E., Byrne, K., Dunning, J., Termaat, J., Mans, G., Jayarajah, M., Alderton, J., Waugh, D., Platt, M.J., Pai, A., Sevillano, A., Lal, A., Sinclair, C., Kunst, G., Knighton, A., Cubas, G.M., Saravanan, P., Millner, R., Vasudevan, V., Patteril, M., Lopez, E., Basu, R., Lu, J., Myles, Paul S., Smith, Julian A., Kasza, Jessica, Jayarajah, Mohandas, Painter, Thomas, Bussières, Jean S., McGuinness, Shay, Byrne, Kelly, Chan, Matthew T.V., Landoni, Giovanni, Wallace, Sophie, and Forbes, Andrew
Published: 2019
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8. Provision of COVID-19 treatments to non-hospitalised patients in Northern Ireland: an evaluation

Author: Patterson, L, primary, McGuinness, S, additional, Bradley, D T, additional, and Corrigan, D, additional
Published: 2023
Full Text: View/download PDF

9. Improving aircraft stress-loads interface and evaluation procedures

Author: McGuinness, S. H. M.
Subjects: 629.13
Published: 2012

10. Graduate overeducation and the Northern Ireland labour market

Author: McGuinness, S.
Subjects: 331.11423509416
Published: 2004

11. Indirect measurement of the 3He3H(n,p)3He3H reaction cross section at Big Bang energies

Author: Pizzone, R. G., Spampinato, C., Spartá, R., Couder, M., Tan, W., Burjan, V., D’Agata, G., Guardo, G. L., La Cognata, M., Lamia, L., Mrazek, J., Palmerini, S., Typel, S., Tumino, A., Wiescher, M., Anguilar, S., Bardayan, D., Blankstein, D., Boccioli, L., Callahan, L., Cha, S. M., Chae, K. Y., Clark, A. M., Frentz, B., Hall, M. R., Gula, A., Henderson, S., Kelmar, R., Kwag, M. S., Indelicato, I., La Commara, M., Lattuada, D., Liu, Q., Long, J., Mazzocco, M., Majumdar, A., McGuinness, S., Nelson, A., Oliva, A. A., O’Malley, P., Prajapati, P. M., Rapisarda, G. G., Romano, S., Sergi, M. L., Seymour, C., Skulski, M., Spitaleri, C., and Wilkinson, J.
Published: 2020
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12. Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis

Author: Li Bassi, G, Gibbons, K, Suen, J, Dalton, H, White, N, Corley, A, Shrapnel, S, Hinton, S, Forsyth, S, Laffey, J, Fan, E, Fanning, J, Panigada, M, Bartlett, R, Brodie, D, Burrell, A, Chiumello, D, Elhazmi, A, Esperatti, M, Grasselli, G, Hodgson, C, Ichiba, S, Luna, C, Marwali, E, Merson, L, Murthy, S, Nichol, A, Ogino, M, Pelosi, P, Torres, A, Ng, P, Fraser, J, Al-Dabbous, T, Alfoudri, H, Shamsah, M, Elapavaluru, S, Berg, A, Horn, C, Mayasi, Y, Schroll, S, Meyer, D, Velazco, J, Ploskanych, L, Fikes, W, Bagewadi, R, Dao, M, White, H, Ehlers, A, Shalabi-McGuire, M, Witt, T, Grazioli, L, Lorini, L, Grandin, E, Nunez, J, Reyes, T, Obriain, D, Hunter, S, Ramanan, M, Affleck, J, Veerendra, H, Rai, S, Russell-Brown, J, Nourse, M, Joseph, M, Mitchell, B, Tenzer, M, Abe, R, Cho, H, Jeong, I, Rahman, N, Kakar, V, Brozzi, N, Mehkri, O, Krishnan, S, Duggal, A, Houltham, S, Graf, J, Diaz, R, Orrego, R, Delgado, C, Gonzalez, J, Sanchez, M, Piagnerelli, M, Sarrazin, J, Zabert, A, Espinosa, L, Delgado, P, Delgado, V, Rincon, D, Yanten, A, Duque, M, Al-Hudaib, A, Callahan, M, Taufik, M, Wardoyo, E, Gunawan, M, Trisnaningrum, N, Irawany, V, Rayhan, M, Pesenti, A, Zanella, A, Leone, M, Coppola, S, Colombo, S, Antonelli, M, Carelli, S, Grieco, D, Asaki, M, Hoshino, K, Salazar, L, Duarte, L, Mcnicholas, B, Cosgrave, D, Mccaffrey, J, Bone, A, Hakeem, Y, Winearls, J, Tallott, M, Thomson, D, Arnold-Day, C, Cupido, J, Miller, M, Seymore, L, van Straaten, D, Hssain, A, Aliudin, J, Alqahtani, A, Mohamed, K, Mohamed, A, Tan, D, Villanueva, J, Zaqout, A, Kurtzman, E, Ademi, A, Dobrita, A, El Aoudi, K, Segura, J, Giwangkancana, G, Ohshimo, S, Hitoshi, S, Osatnik, J, Joosten, A, Yang, M, Motos, A, Arancibia, F, Williams, V, Noel, A, Luque, N, Trung, T, Yacoub, S, Fantini, M, Garcia, R, Alvarez, E, Greti, A, Ceccato, A, Sanchez, A, Vazquez, A, Roche-Campo, F, Franch-Llasat, D, Tuazon, D, Amato, M, Cassimiro, L, Pola, F, Ribeiro, F, Fonseca, G, Desai, M, Osborn, E, Deeb, H, Arcadipane, A, Martucci, G, Panarello, G, Vitiello, C, Bianco, C, Occhipinti, G, Rossetti, M, Cuffaro, R, Cho, S, Shimizu, H, Moriyama, N, Kim, J, Kitamura, N, Gebauer, J, Yokoyama, T, Al-Fares, A, Buabbas, S, Alamad, E, Alawadhi, F, Alawadi, K, Tanaka, H, Hashimoto, S, Yamazaki, M, Oh, T, Epler, M, Forney, C, Kruse, L, Feister, J, Williamson, J, Grobengieser, K, Gnall, E, Golden, S, Caroline, M, Shapiro, T, Karaj, C, Thome, L, Sher, L, Vanderland, M, Welch, M, Mcdermott, S, Brain, M, Mineall, S, Kimura, D, Brazzi, L, Sales, G, Ogston, T, Nagpal, D, Fischer, K, Lorusso, R, Rangappa, R, Appu, A, Carton, E, Sen, A, Palacios, A, Rainey, D, Samoukoviv, G, Campisi, J, Durham, L, Neumann, E, Seefeldt, C, Falcucci, O, Emmrich, A, Guy, J, Johns, C, Potzner, K, Zimmermann, C, Espinal, A, Buchtele, N, Schwameis, M, Stecher, S, Singh, D, Barnikel, M, Arenz, L, Zaaqoq, A, Galloway, L, Merley, C, Csete, M, Quesada, L, Saba, I, Kasugai, D, Hiraiwa, H, Tanaka, T, Purnama, Y, Dewayanti, S, Ardiyan, Juzar, D, Siagian, D, Chen, Y, Ratsep, I, Oigus, G, Erikson, K, Post, A, Enneveer, L, Sillaots, P, Manetta, F, Mihelis, E, Sarmiento, I, Narasimhan, M, Varrone, M, Komats, M, Garcia-Diaz, J, Harmon, C, Satyapriya, S, Bhatt, A, Mokadam, N, Uribe, A, Gonzalez, A, Shi, H, Mckeown, J, Pasek, J, Fiorda, J, Echeverria, M, Moreno, R, Zakhary, B, Cavana, M, Cucino, A, Foti, G, Giani, M, Russotto, V, Castagna, V, Dellamore, A, Navalesi, P, Shum, H, Vuysteke, A, Usman, A, Acker, A, Smood, B, Mergler, B, Sertic, F, Subramanian, M, Sperry, A, Rizer, N, Burhan, E, Rasmin, M, Akmal, E, Sitompul, F, Lolong, N, Naivedh, B, Erickson, S, Barrett, P, Dean, D, Daugherty, J, Loforte, A, Khan, I, Abraar Quraishi, M, Desantis, O, So, D, Kandamby, D, Mandei, J, Natanael, H, Yudhalantang, E, Lantang, A, Wijaya, S, Jung, A, Ng, G, Ng, W, Fang, S, Tabah, A, Ratcliffe, M, Duroux, M, Adachi, S, Nakao, S, Blanco, P, Prieto, A, Sanchez, J, Nicholson, M, Butt, W, Serratore, A, Delzoppo, C, Janin, P, Yarad, E, Totaro, R, Coles, 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Y., Dalton H. J., White N., Corley A., Shrapnel S., Hinton S., Forsyth S., Laffey J. G., Fan E., Fanning J. P., Panigada M., Bartlett R., Brodie D., Burrell A., Chiumello D., Elhazmi A., Esperatti M., Grasselli G., Hodgson C., Ichiba S., Luna C., Marwali E., Merson L., Murthy S., Nichol A., Ogino M., Pelosi P., Torres A., Ng P. Y., Fraser J. F., Al-Dabbous T., Alfoudri H., Shamsah M., Elapavaluru S., Berg A., Horn C., Mayasi Y., Schroll S., Meyer D., Velazco J., Ploskanych L., Fikes W., Bagewadi R., Dao M., White H., Ehlers A., Shalabi-McGuire M., Witt T., Grazioli L., Lorini L., Grandin E. W., Nunez J., Reyes T., OBriain D., Hunter S., Ramanan M., Affleck J., Veerendra H. H., Rai S., Russell-Brown J., Nourse M., Joseph M., Mitchell B., Tenzer M., Abe R., Cho H. J., Jeong I. S., Rahman N., Kakar V., Brozzi N., Mehkri O., Krishnan S., Duggal A., Houltham S., Graf J., Diaz R., Orrego R., Delgado C., Gonzalez J., Sanchez M. S., Piagnerelli M., Sarrazin J. V., Zabert A. /P. G., Espinosa L., Delgado P., Delgado V., Rincon D. F. B., Yanten A. M. M., Duque M. B., Al-Hudaib A., Callahan M., Taufik M. A., Wardoyo E. Y., Gunawan M., Trisnaningrum N. S., Irawany V., Rayhan M., Pesenti A., Zanella A., Leone M., Coppola S., Colombo S., Antonelli M., Carelli S., Grieco D. L., Asaki M., Hoshino K., Salazar L., Duarte L., McNicholas B., Cosgrave D., McCaffrey J., Bone A., Hakeem Y., Winearls J., Tallott M., Thomson D., Arnold-Day C., Cupido J., Miller M., Seymore L., van Straaten D., Hssain A. A., Aliudin J., Alqahtani A. -R., Mohamed K., Mohamed A., Tan D., Villanueva J., Zaqout A., Kurtzman E., Ademi A., Dobrita A., El Aoudi K., Segura J., Giwangkancana G., Ohshimo S., Hitoshi S., Osatnik J., Joosten A., Yang M., Motos A., Arancibia F., Williams V., Noel A., Luque N., Trung T. H., Yacoub S., Fantini M., Garcia R. N. J., Alvarez E. C., Greti A., Ceccato A., Sanchez A., Vazquez A. 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M., Nacpil N., Ruck K., Bakken R., Jara C., Felton T., Berra L., Shah B., Chakraborty A., Cardona M., Capatos G., Akkanti B., Orija A., Jain H., Ito A., Housni B., Low S., Iihara K., Chavez J., Ramanathan K., Zabert G., Naidoo K., Seppelt I., VanDyk M., MacDonald S., McGregor R., Siebenaler T., Flynn H., Lofton K., Aokage T., Shigemitsu K., Moscatelli A., Fiorentino G., Baumgaertel M., Mba S. E., Assy J., Hutahaean A., Roush H., Sichting K. A., Alessandri F., Burns D., Salt G., Garabedian C. P., Millar J., Sim M., Mattke A., McAuley D., Tadili J., Frenzel T., Bar-Lavie Y., Ortiz A. B., Stone J., Attokaran A., Farquharson M., Patel B., Gunning D., Baillie K., Watson P., Tamai K., Sajinadiyasa G. K., Kanyawati D., Salgado M., Sassine A., Yudo B., McCaul S., Lee B., Lee S. M., Afek A., Iwashita Y., Semedi B. P., Metiva J., Van Belle N., Martin-Loeches I., Ivatt L., Woon C. Y., Kang H. M., Smith T., James E., Al-Rawas N., Iwasaki Y., King-Chung K. 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Abstract: Background: The role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis. Methods: We analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 h from commencement of IMV were compared with subjects who did not receive NMBAs or only upon commencement of IMV (control). The primary objective in the PS-matched cohort was comparison between groups in 90-day in-hospital mortality, assessed through Cox proportional hazard modeling. Secondary objectives were comparisons in the numbers of ventilator-free days (VFD) between day 1 and day 28 and between day 1 and 90 through competing risk regression. Results: Data from 1953 patients were included. After propensity score matching, 210 cases from each group were well matched. In the PS-matched cohort, mean (± SD) age was 60.3 ± 13.2 years and 296 (70.5%) were male and the most common comorbidities were hypertension (56.9%), obesity (41.1%), and diabetes (30.0%). The unadjusted hazard ratio (HR) for death at 90 days in the NMBA treatment vs control group was 1.12 (95% CI 0.79, 1.59, p = 0.534). After adjustment for smoking habit and critical therapeutic covariates, the HR was 1.07 (95% CI 0.72, 1.61, p = 0.729). At 28 days, VFD were 16 (IQR 0–25) and 25 (IQR 7–26) in the NMBA treatment and control groups, respectively (sub-hazard ratio 0.82, 95% CI 0.67, 1.00, p = 0.055). At 90 days, VFD were 77 (IQR 0–87) and 87 (IQR 0–88) (sub-hazard ratio 0.86 (95% CI 0.69, 1.07; p =
Published: 2022

13. Dexmedetomidine and Propofol Sedation in Critically Ill Patients and Dose-associated 90-Day Mortality: A Secondary Cohort Analysis of a Randomized Controlled Trial (SPICE III)

Author: Shehabi, Yahya, primary, Serpa Neto, Ary, additional, Bellomo, Rinaldo, additional, Howe, Belinda D., additional, Arabi, Yaseen M., additional, Bailey, Michael, additional, Bass, Frances E., additional, Bin Kadiman, Suhaini, additional, McArthur, Colin J., additional, Reade, Michael C., additional, Seppelt, Ian M., additional, Takala, Jukka, additional, Wise, Matt P., additional, Webb, Steve A., additional, Mashonganyika, C., additional, McKee, H., additional, Tonks, A., additional, Donnelly, A., additional, Hemmings, N., additional, O’Kane, S., additional, Blakemore, A., additional, Butler, M., additional, Cowdrey, K., additional, Dalton, J., additional, Gilder, E., additional, Long, S., additional, McCarthy, L., additional, McGuinness, S., additional, Parke, R., additional, Chen, Y., additional, McArthur, C., additional, McConnochie, R., additional, Newby, L., additional, Bellomo, R., additional, Eastwood, G., additional, Peck, L., additional, Young, H., additional, Boschert, C., additional, Edington, J., additional, Fletcher, J., additional, Smith, J., additional, Nand, K., additional, Raza, A., additional, Sara, T., additional, Bennett-Britton, J., additional, Bewley, J., additional, Bodenham, V., additional, Cole, L., additional, Driver, K., additional, Grimmer, L., additional, Howie, L., additional, Searles, C., additional, Sweet, K., additional, Webster, D., additional, van Berkel, A., additional, Connor, H., additional, Dennett, J., additional, van Der Graaff, M., additional, Henderson, S., additional, Mehrtens, J., additional, Miller, K., additional, Minto, E., additional, Morris, A., additional, Noble, S., additional, Parker, K., additional, Bulfin, L., additional, Hart, N., additional, Shepherd, K., additional, Vij, S., additional, Dickson, S., additional, Elloway, E., additional, Ferguson, C., additional, Jackson, R., additional, MacNaughton, P., additional, Marner, M., additional, Squire, R., additional, Waddy, S., additional, Wafer, P., additional, Welbourne, J., additional, Ashcroft, P., additional, Chambler, D., additional, Dukes, S., additional, Harris, A., additional, Horton, S., additional, Sharpe, S., additional, Williams, P., additional, Williams, S., additional, Bailey, M., additional, Blazquez, E., additional, France, D., additional, Hutchison, R., additional, O’Connor, A., additional, Comadira, G., additional, Gough, M., additional, Tallott, M., additional, Bastick, M., additional, Cameron, R., additional, Donovan, S., additional, Ellis, K., additional, Gaur, A., additional, Gregory, R., additional, Naumoff, J., additional, Turner, E., additional, White, M., additional, Au, K. F. J., additional, Fratzia, J., additional, Treloar, S., additional, Lim, C. H., additional, Maseeda, Y., additional, Tan, A. P., additional, Tang, C. L., additional, Yong, C. Y., additional, Akaltan, M., additional, Berger, S., additional, Blaser, D., additional, Fazlija, L., additional, Jong, M. L., additional, Lensch, M., additional, Ludwig, R., additional, Merz, T., additional, Nettelbeck, K., additional, Roth, M., additional, Schafer, M., additional, Takala, J., additional, Wehr, A., additional, Zacharias, D., additional, Amran, R., additional, Ashraf, H. N., additional, Azmi, N., additional, Basri, N., additional, Burhanuddin, H., additional, Hadinata, Y., additional, Hamdan, A., additional, Kadiman, S., additional, Rashid, A. I. Y. M., additional, Sabran, I. N., additional, Sulaiman, S., additional, Zabidi, I. N., additional, Al-Dawood, A., additional, Aljuaid, M., additional, Anizi, H. Al, additional, Saeedi, A. Al, additional, Arabi, Y., additional, Dbsawy, M., additional, Deeb, A., additional, Hegazy, M., additional, Magdi, I., additional, Clarey, E., additional, Corcoran, E., additional, Finney, C., additional, Harris, C., additional, Hopkins, P., additional, Noble, H., additional, Thompson, L., additional, Williams, T., additional, Dumlao, L. A., additional, Bassam, R., additional, Hassan, M. A., additional, Naseem, N., additional, Al-Kurdi, M. H., additional, Al-Harthy, A. M., additional, Bernard, S., additional, Sebafundi, L., additional, Serban, C., additional, Lim, S. K., additional, Mazidah, N., additional, Saidin, N., additional, Sjamsuddin, N., additional, Tan, I. T. A., additional, Zabidi, N., additional, Brain, M., additional, Mineall, S., additional, Kanhere, M., additional, Soar, N., additional, Kadir, N. Abd, additional, Abdullah, N. H., additional, Awang, R., additional, Emperan, Z., additional, Husin, N. S., additional, Ismail, N. I., additional, Ismail, S. Z., additional, Khadzali, F. N. A. Mohd, additional, Norddin, M. F., additional, Aguila, J., additional, Bold, C., additional, Clatworthy, B., additional, Dias, A., additional, Hogan, C., additional, Kazemi, A., additional, Lai, V., additional, Song, R., additional, Williams, A., additional, Bhatia, D., additional, Elliot, S., additional, Galt, P., additional, Lavrans, K., additional, Ritchie, P., additional, Wang, A., additional, Gresham, R., additional, Lowrey, J., additional, Masters, K., additional, Palejs, P., additional, Seppelt, I., additional, Symonds, F., additional, Weisbrodt, L., additional, Whitehead, C., additional, Babio-Galan, M., additional, Calder, V., additional, Clement, I., additional, Harrison, A., additional, McCullagh, I., additional, Scott, C., additional, Bevan, R., additional, Caniba, S., additional, Hacking, D., additional, Maher, L., additional, Azzolini, M. L., additional, Beccaria, P., additional, Colombo, S., additional, Landoni, G., additional, Leggieri, C., additional, Luca, C., additional, Mamo, D., additional, Moizo, E., additional, Monti, G., additional, Mucci, M., additional, Zangrillo, A., additional, Albania, M., additional, Arora, S., additional, Shi, Y., additional, Abudayah, A., additional, Almekhlafi, G., additional, Al Amodi, E., additional, Al Samarrai, S., additional, Badawi, M., additional, Caba, R. Cubio, additional, Elffaki, O., additional, Mandourah, Y., additional, Valerio, J., additional, Joyce, C., additional, Meyer, J., additional, Saylor, E., additional, Venkatesh, B., additional, Venz, E., additional, Walsham, J., additional, Wetzig, K., additional, Khoo, T. M., additional, Liew, J. E. S., additional, Sakthi, A. N., additional, Zulkurnain, A., additional, Bamford, A., additional, Bergin, C., additional, Carrera, R., additional, Cooper, L., additional, Despy, L., additional, Harkett, S., additional, Mee, L., additional, Reeves, E., additional, Snelson, C., additional, Spruce, E., additional, Cooper, G., additional, Hodgson, R., additional, Pearson, D., additional, Rosbergen, M., additional, Ali, M. N., additional, Bahar, N. I., additional, Ismail, A., additional, Ismail, W. N. W., additional, Samat, N. M., additional, Piah, N. S. M., additional, Rahman, R. Abd, additional, Duroux, M., additional, Ratcliffe, M., additional, Warhurst, T., additional, Buehner, U., additional, Williams, E., additional, Jacques, N., additional, Keating, L., additional, Macgill, S., additional, Tamang, K. L., additional, Tolan, N., additional, Walden, A., additional, Bower, R., additional, Cranshaw, J., additional, Molloy, K., additional, Pitts, S., additional, Butler, J., additional, Dunlop, R., additional, Fourie, C., additional, Jarrett, P., additional, Lassig-Smith, M., additional, Livermore, A., additional, O’Donoghue, S., additional, Reade, M., additional, Starr, T., additional, Stuart, J., additional, Campbell, L., additional, Phillips, M., additional, Stephens, D., additional, Thomas, J., additional, Cooper, D., additional, McAllister, R., additional, Andrew, G., additional, Barclay, L., additional, Dawson, H., additional, Griffith, D. M., additional, Hope, D., additional, Wojcik, G., additional, McCulloch, C., additional, Paterson, R., additional, Ascough, L., additional, Paisley, C., additional, Patrick-Heselton, J., additional, Shaw, D., additional, Waugh, V., additional, Williams, K., additional, Welters, I., additional, Barge, D., additional, Jordan, A., additional, MacIsaac, C., additional, Rechnitzer, T., additional, Bass, F., additional, Gatward, J., additional, Hammond, N., additional, Janin, P., additional, Stedman, W., additional, Yarad, E., additional, Razak, N. A., additional, Dzulkipli, N., additional, Jong, S. L., additional, Asen, K., additional, Voon, W. L., additional, Liew, S., additional, Ball, J., additional, Barnes, V., additional, Dalton, C., additional, Farnell-Ward, S., additional, Farrah, H., additional, Maher, K., additional, Mellinghoff, J., additional, Ryan, C., additional, Shirley, P., additional, Conlon, L., additional, Glover, A., additional, Martin-Loeches, I., additional, O’Toole, E., additional, Ewan, J., additional, Ferrier, J., additional, Litton, E., additional, Webb, S. A., additional, Berry, W., additional, Blanco Alonso, U., additional, Bociek, A., additional, Campos, S., additional, Jawara, S., additional, Hanks, F., additional, Kelly, A., additional, Lei, K., additional, McKenzie, C., additional, Ostermann, M., additional, Wan, R., additional, Al-Soufi, S., additional, Leow, S., additional, McCann, K., additional, Reynolds, C., additional, Brickell, K., additional, Fahey, C., additional, Hays, L., additional, Hyde, N., additional, Nichol, A., additional, Ryan, D., additional, Brailsford, J., additional, Buckley, A., additional, Forbes, L., additional, Maguire, T., additional, Moore, J., additional, Murray, L., additional, Ghosh, A., additional, Park, M., additional, Said, S., additional, Visser, A., additional, Abidin, H. Z., additional, Ali, S., additional, Hassan, M. H., additional, Omar, S. C., additional, Shukeri, W. F. W., additional, Brealey, D., additional, Bercades, G., additional, Blackburn, E., additional, Macallum, N., additional, Macklin, A., additional, Ryu, J. H., additional, Tam, K., additional, Smyth, D., additional, Arif, A., additional, Bassford, C., additional, Morgan, C., additional, Swann, C., additional, Ward, G., additional, Wild, L., additional, Bone, A., additional, Elderkin, T., additional, Green, D., additional, Sach, D., additional, Salerno, T., additional, Simpson, N., additional, Brohi, F., additional, Clark, M., additional, Williams, L., additional, Brooks, J., additional, Cocks, E., additional, Cole, J., additional, Curtin, J., additional, Davies, R., additional, Hill, H., additional, Morgan, M., additional, Palmer, N., additional, Whitton, C., additional, Wise, M., additional, Baskaran, P., additional, Hasan, M. S., additional, Tham, L. Y., additional, Sol Cruz, R., additional, Dinsdale, D., additional, Edney, S., additional, Firkin, C., additional, FitzJohn, F., additional, Hill, G., additional, Hunt, A., additional, Hurford, S., additional, Jones, G., additional, Judd, H., additional, Latimer-Bell, C., additional, Lawrence, C., additional, Lesona, E., additional, Navarra, L., additional, Robertson, Y., additional, Smellie, H., additional, Vucago, A. M., additional, Young, P., additional, Clark, P., additional, Kong, J., additional, Ho, J., additional, Nayyar, V., additional, and Skelly, C., additional
Published: 2023
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14. Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest

Author: Eastwood, G, Nichol, AD, Hodgson, C, Parke, RL, McGuinness, S, Nielsen, N, Bernard, S, Skrifvars, MB, Stub, D, Taccone, FS, Archer, J, Kutsogiannis, D, Dankiewicz, J, Lilja, G, Cronberg, T, Kirkegaard, H, Capellier, G, Landoni, G, Horn, J, Olasveengen, T, Arabi, Y, Chia, YW, Markota, A, Haenggi, M, Wise, MP, Grejs, AM, Christensen, S, Munk-Andersen, H, Granfeldt, A, Andersen, GO, Qvigstad, E, Flaa, A, Thomas, M, Sweet, K, Bewley, J, Backlund, M, Tiainen, M, Iten, M, Levis, A, Peck, L, Walsham, J, Deane, A, Ghosh, A, Annoni, F, Chen, Y, Knight, D, Lesona, E, Tlayjeh, H, Svensek, F, McGuigan, PJ, Cole, J, Pogson, D, Hilty, MP, During, JP, Bailey, MJ, Paul, E, Ady, B, Ainscough, K, Hunt, A, Monahan, S, Trapani, T, Fahey, C, Bellomo, R, Eastwood, G, Nichol, AD, Hodgson, C, Parke, RL, McGuinness, S, Nielsen, N, Bernard, S, Skrifvars, MB, Stub, D, Taccone, FS, Archer, J, Kutsogiannis, D, Dankiewicz, J, Lilja, G, Cronberg, T, Kirkegaard, H, Capellier, G, Landoni, G, Horn, J, Olasveengen, T, Arabi, Y, Chia, YW, Markota, A, Haenggi, M, Wise, MP, Grejs, AM, Christensen, S, Munk-Andersen, H, Granfeldt, A, Andersen, GO, Qvigstad, E, Flaa, A, Thomas, M, Sweet, K, Bewley, J, Backlund, M, Tiainen, M, Iten, M, Levis, A, Peck, L, Walsham, J, Deane, A, Ghosh, A, Annoni, F, Chen, Y, Knight, D, Lesona, E, Tlayjeh, H, Svensek, F, McGuigan, PJ, Cole, J, Pogson, D, Hilty, MP, During, JP, Bailey, MJ, Paul, E, Ady, B, Ainscough, K, Hunt, A, Monahan, S, Trapani, T, Fahey, C, and Bellomo, R
Abstract: BACKGROUND: Guidelines recommend normocapnia for adults with coma who are resuscitated after out-of-hospital cardiac arrest. However, mild hypercapnia increases cerebral blood flow and may improve neurologic outcomes. METHODS: We randomly assigned adults with coma who had been resuscitated after out-of-hospital cardiac arrest of presumed cardiac or unknown cause and admitted to the intensive care unit (ICU) in a 1:1 ratio to either 24 hours of mild hypercapnia (target partial pressure of arterial carbon dioxide [Paco2], 50 to 55 mm Hg) or normocapnia (target Paco2, 35 to 45 mm Hg). The primary outcome was a favorable neurologic outcome, defined as a score of 5 (indicating lower moderate disability) or higher, as assessed with the use of the Glasgow Outcome Scale-Extended (range, 1 [death] to 8, with higher scores indicating better neurologic outcome) at 6 months. Secondary outcomes included death within 6 months. RESULTS: A total of 1700 patients from 63 ICUs in 17 countries were recruited, with 847 patients assigned to targeted mild hypercapnia and 853 to targeted normocapnia. A favorable neurologic outcome at 6 months occurred in 332 of 764 patients (43.5%) in the mild hypercapnia group and in 350 of 784 (44.6%) in the normocapnia group (relative risk, 0.98; 95% confidence interval [CI], 0.87 to 1.11; P = 0.76). Death within 6 months after randomization occurred in 393 of 816 patients (48.2%) in the mild hypercapnia group and in 382 of 832 (45.9%) in the normocapnia group (relative risk, 1.05; 95% CI, 0.94 to 1.16). The incidence of adverse events did not differ significantly between groups. CONCLUSIONS: In patients with coma who were resuscitated after out-of-hospital cardiac arrest, targeted mild hypercapnia did not lead to better neurologic outcomes at 6 months than targeted normocapnia. (Funded by the National Health and Medical Research Council of Australia and others; TAME ClinicalTrials.gov number, NCT03114033.).
Published: 2023

15. Perceptions of travel-related health risks and pre-travel health-seeking behaviour among students: A qualitative analysis

Author: Sohail, A, Akritidis, J, McGuinness, S, Leder, K, Sohail, A, Akritidis, J, McGuinness, S, and Leder, K
Abstract: BACKGROUND: The impact of the COVID-19 pandemic on travel risk perceptions and pre-travel healthcare attendance is unknown. We aimed to explore barriers and enablers to engagement in and uptake of pre-travel advice (PTA) among university students, a recognised at-risk group for travel-related morbidity and poor PTA uptake. Additionally, we aimed to explore whether the COVID-19 pandemic has influenced attitudes towards future PTA. METHODS: Semi-structured interviews were conducted with university students (October-December 2021). Thematic analysis of the data was conducted using the Health Belief Model (HBM) framework. RESULTS: We interviewed 18 students (11 male, median age 24). Students' risk perceptions relating to travel-related illnesses were influenced by past experiences, travel destination, vaccination status and knowledge. Barriers to seeking PTA included a lack of perceived need and concerns about accessibility/availability, whereas potential benefits included reduced health risks, vaccine-induced protection, and knowledge gain. Cues to seeking future PTA were perceived risks of travel-related illness, perceived high-risk destination, itinerary-related vaccine requirements, perceived benefits of advice and concerns about COVID-19 infection. COVID-19 risk perceptions did not consistently align with those of other travel-related illness. We used findings to inform recommendations. CONCLUSION: The current COVID-19 pandemic offers an opportunity to increase students' risk awareness and promote preventive travel health behaviours. Recommendations to improve students' future engagement in PTA include: 1) increasing awareness of risks associated with travel, 2) emphasising PTA benefits, and 3) ensuring PTA is convenient, accessible and affordable.
Published: 2023

16. Securing success for the Nature Restoration Law

Author: Hering, D., Schürings, C., Wenskus, F., Blackstock, K., Borja, A., Birk, S., Bullock, C., Carvalho, L., Bou Dagher Kharrat, M., Lakner, S., Lovrić, N., McGuinness, S., Nabuurs, G.-J., Sánchez-Arcilla, A., Settele, Josef, Pe'er, Guy, Hering, D., Schürings, C., Wenskus, F., Blackstock, K., Borja, A., Birk, S., Bullock, C., Carvalho, L., Bou Dagher Kharrat, M., Lakner, S., Lovrić, N., McGuinness, S., Nabuurs, G.-J., Sánchez-Arcilla, A., Settele, Josef, and Pe'er, Guy
Abstract: In an attempt to halt and reverse biodiversity losses, the European Commission has proposed a new regulation, the Nature Restoration Law (NRL). It could become a cornerstone of Europe’s ambitions to restore biodiversity and ecosystem services for decades to come (1) and demonstrate global leadership in addressing ongoing environmental crises. The draft of the law, which is a first globally, has been under political pressure from various sides, and scientists have contributed intensively to the discussion (2). After trilogue negotiations among the European Parliament, the Council of Europe, and the European Commission, the final text of the NRL has been agreed on (see the box). However, it will still be subject to final votes within the Council and Parliament. Here, we assess the potential for the NRL to overcome problems associated with implementation of related European Union (EU) legislation, strategies, and policies and what can be learned for implementation of the NRL. The NRL acknowledges that existing EU legislation and policies have so far failed to halt biodiversity losses (1) and consequently, without new instruments, cannot meet the targets of international agreements, such as the Kunming-Montreal Global Biodiversity Framework. Although some of the NRL’s aims and approaches overlap with other EU directives, strategies, and policies, in particular with the EU Biodiversity Strategy for 2030, the NRL is distinct in terms of its coverage targeting the majority of European ecosystem types, its strong focus on restoration, and its provision of binding targets and clear timelines. This potential for regulatory power may largely explain the contested nature of its passage into legislation.
Published: 2023

17. DOP59 What is the relationship between fatigue, pain and urgency in people with inflammatory bowel disease? Results of the IBD-BOOST survey in 8486 participants

Author: Hart, A, primary, Miller, L, additional, Hamborg, T, additional, Stagg, I, additional, McGuinness, S, additional, Wileman, V, additional, Tzorovili, E, additional, Mihaylova, B, additional, Roukas, C, additional, Aziz, Q, additional, Czuber-Dochan, W, additional, Dibley, L, additional, Moss-Morris, R, additional, Pollok, R, additional, Saxena, S, additional, Winsor, G, additional, and Norton, C, additional
Published: 2023
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18. EPRI distribution protection analysis toolkit

Author: Ovalle, A., primary, McGuinness, S., additional, Padmanabhan, A., additional, Rocha, C., additional, Bannon, J., additional, Kistler, M., additional, and Doodnauth, A., additional
Published: 2023
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19. Study of 3He(n,p)3H reaction at cosmological energies with trojan horse method

Author: Spampinato C., Pizzone R.G., Spartà R., Couder M., Tan W., Burian V., Chae K.Y., D’Agata G., Guardo G.L., Indelicato I., Cognata M. La, Lamia L., Lattuada D., Mrazek J., Oliva A., Palmerini S., Prajapati P.M., Rapisarda G.G., Romano S., Sergi M.L., Spitaleri C., Tumino A., Wiescher M., Anguilar S., Bardyan D., Blankstein D., Boccioli L., Callahan L., Clark A., Frentz B., Hall M., Gula A., Henderson S., Kelmar R., Liu Q., Long J., Majumdar A., McGuinness S., Nelson A., O’Malley P., Seyymour C., Skulski M., and Wilkinson J.
Subjects: Physics, QC1-999
Abstract: In the network of reactions present in the Big Bang nucleosynthesis, the 3He(n, p)3H has an important role which impacts the final 7Li abundance. The Trojan Horse Method (THM) has been applied to the 3He(d, pt)H reaction in order to extract the astrophysical S(E)-factor of the 3He(n, p)3H in the Gamow energy range. The experiment will be described in the present work together with the first preliminary results.
Published: 2020
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20. Higher risk breast screening: cancer detection rates, recall rates, and attendance rates in Northern Ireland

Author: Gibson, E., Gracey, G., Ng, C., O'Neill, T., Smyth, R., Rocks, G., Hall, C., Briggs, G., Bane, C., Bennett, D., and McGuinness, S.
Published: 2019
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21. Towards a carbon credit & blue credit scheme for peatlands: white paper

Author: Sechi, V., Ó Brolcháin, N., Belle, van, J., Fritz, C., Tilak, A., Geurts, J., Roehrig, N., Nailon, P., Cartmell-Done, K., Liu, W., Smits, A.J.M., De Boever, M., Morley, T., Field, C., Kennedy, J., Johnson, S., Caporn, S., Halevy, C., Ryan, J., Eakin, M., Fernandez, F., Bain, C., Domegan, C., McGuinness, S., McCorry, M., and Crushell, P.
Subjects: Veenweidegebieden
Abstract: The aim of this document is to outline the preliminary requirements and steps needed to fully establish frameworks for certification systems across Europe, specifically to support and incentivize the restoration of peatlands and to provide a framework for reducing GHG emissions from degraded and mismanaged peatlands on a large scale. This will ensure that peatlands across Europe fulfil their potential to become a net carbon sink by 2050, while optimizing ecosystem service provision in a way that is fully consistent with all the relevant European policies. This report covers the following topics: - Analysis of current Carbon Credit systems and other incentives to support wet peatlands. - Economic land use analysis relating to peatlands. - Outline of a framework to support rewetting and peatland restoration. - Recommendations for an Eco-Credit system across Europe.
Published: 2022

22. Protocol summary and statistical analysis plan for Intensive Nutrition Therapy comparEd to usual care iN criTically ill adults (INTENT): a phase II randomised controlled trial

Author: Ridley, EJ, Bailey, M, Chapman, M, Chapple, L-AS, Deane, AM, Hodgson, C, King, VL, Marshall, A, Miller, EG, McGuinness, S, Parke, R, Udy, AA, Ridley, EJ, Bailey, M, Chapman, M, Chapple, L-AS, Deane, AM, Hodgson, C, King, VL, Marshall, A, Miller, EG, McGuinness, S, Parke, R, and Udy, AA
Abstract: INTRODUCTION: It is plausible that a longer duration of nutrition intervention may have a greater impact on clinical and patient-centred outcomes. The Intensive Nutrition care Therapy comparEd to usual care iN criTically ill adults (INTENT) trial will determine if a whole hospital nutrition intervention is feasible and will deliver more total energy compared with usual care in critically ill patients with at least one organ system failure. METHODS AND ANALYSIS: This study is a prospective, multicentre, unblinded, parallel-group, phase II randomised controlled trial (RCT) conducted in 23 hospitals in Australia and New Zealand. Mechanically ventilated critically ill adult patients with at least one organ failure who have been in intensive care unit (ICU) for 72-120 hours and meet all of the inclusion and none of the exclusion criteria will be randomised to receive either intensive or usual nutrition care. INTENT started recruitment in October 2018 and a sample size of 240 participants is anticipated to be recruited in 2022. The study period is from randomisation to hospital discharge or study day 28, whichever occurs first, and the primary outcome is daily energy delivery from nutrition therapy. Secondary outcomes include daily energy and protein delivery during ICU and in the post-ICU period, duration of ventilation, ventilator-free days, total bloodstream infection rate and length of hospital stay. All other outcomes are considered tertiary and results will be analysed on an intention-to-treat basis. ETHICS AND DISSEMINATION: Ethics approval has been received in Australia (Alfred Hospital Ethics Committee (HREC/18/Alfred/101) and Human Research Ethics Committee of the Northern Territory Department of Health (2019-3372)) and New Zealand (Northern A Health and Disability Ethics Committee (18/NTA/222). Results will be disseminated in an international peer-reviewed journal(s), at scientific meetings and via social media. TRIAL REGISTRATION NUMBER: NCT03292237.
Published: 2022

23. Cryopreserved platelets compared with liquid-stored platelets for the treatment of surgical bleeding: protocol for two multicentre randomised controlled blinded non-inferiority trials (the CLIP-II and CLIPNZ-II trials)

Author: Reade, MC, Marks, DC, Howe, B, McGuinness, S, Parke, R, Navarra, L, Charlewood, R, Johnson, L, McQuilten, Z, Reade, MC, Marks, DC, Howe, B, McGuinness, S, Parke, R, Navarra, L, Charlewood, R, Johnson, L, and McQuilten, Z
Abstract: INTRODUCTION: Cryopreservation at -80°C in dimethylsulphoxide extends platelet shelf-life from 7 days to 2 years. Only limited comparative trial data supports the safety and effectiveness of cryopreserved platelets as a treatment for surgical bleeding. Cryopreserved platelets are not currently registered for civilian use in most countries. METHODS AND ANALYSIS: CLIP-II and CLIPNZ-II are harmonised, blinded, multicentre, randomised, controlled clinical non-inferiority trials comparing bleeding, transfusion, safety and cost outcomes associated with cryopreserved platelets versus conventional liquid platelets as treatment for bleeding in cardiac surgery. CLIP-II is planning to enrol patients in 12 tertiary hospitals in Australia; CLIPNZ-II will recruit in five tertiary hospitals in New Zealand. The trials use near-identical protocols aside from details of cryopreserved platelet preparation. Patients identified preoperatively as being at high risk of requiring a platelet transfusion receive up to three units of study platelets if their treating doctor considers platelet transfusion is indicated. The primary endpoint is blood loss through the surgical drains in the 24 hours following intensive care unit (ICU) admission after surgery. Other endpoints are blood loss at other time points, potential complications, adverse reactions, transfusion and fluid requirement, requirement for procoagulant treatments, time to commencement of postoperative anticoagulants, delay between platelet order and commencement of infusion, need for reoperation, laboratory and point-of-care clotting indices, cost, length of mechanical ventilation, ICU and hospital stay, and mortality. Transfusing 202 (CLIP-II) or 228 (CLIPNZ-II) patients with study platelets will provide 90% power to exclude the possibility of greater than 20% inferiority in the primary endpoint. If cryopreserved platelets are not inferior to liquid-stored platelets, the advantages of longer shelf-life would justify rapid change i
Published: 2022

24. Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis

Author: Li Bassi, G., Gibbons, K., Suen, J. Y., Dalton, H. J., White, N., Corley, A., Shrapnel, S., Hinton, S., Forsyth, S., Laffey, J. G., Fan, E., Fanning, J. P., Panigada, M., Bartlett, R., Brodie, D., Burrell, A., Chiumello, D., Elhazmi, A., Esperatti, M., Grasselli, G., Hodgson, C., Ichiba, S., Luna, C., Marwali, E., Merson, L., Murthy, S., Nichol, A., Ogino, M., Pelosi, P., Torres, A., P. Y., Ng, Fraser, J. F., Al-Dabbous, T., Alfoudri, H., Shamsah, M., Elapavaluru, S., Berg, A., Horn, C., Mayasi, Y., Schroll, S., Meyer, D., Velazco, J., Ploskanych, L., Fikes, W., Bagewadi, R., Dao, M., White, H., Ehlers, A., Shalabi-McGuire, M., Witt, T., Grazioli, L., Lorini, L., Grandin, E. W., Nunez, J., Reyes, T., Obriain, D., Hunter, S., Ramanan, M., Affleck, J., Veerendra, H. H., Rai, S., Russell-Brown, J., Nourse, M., Joseph, M., Mitchell, B., Tenzer, M., Abe, R., Cho, H. J., Jeong, I. S., Rahman, N., Kakar, V., Brozzi, N., Mehkri, O., Krishnan, S., Duggal, A., Houltham, S., Graf, J., Diaz, R., Orrego, R., Delgado, C., Gonzalez, J., Sanchez, M. S., Piagnerelli, M., Sarrazin, J. V., Zabert, A. /P. G., Espinosa, L., Delgado, P., Delgado, V., Rincon, D. F. B., Yanten, A. M. M., Duque, M. B., Al-Hudaib, A., Callahan, M., Taufik, M. A., Wardoyo, E. Y., Gunawan, M., Trisnaningrum, N. S., Irawany, V., Rayhan, M., Pesenti, A., Zanella, A., Leone, M., Coppola, S., Colombo, S., Antonelli, M., Carelli, S., Grieco, D. L., Asaki, M., Hoshino, K., Salazar, L., Duarte, L., Laffey, J., Mcnicholas, B., Cosgrave, D., Mccaffrey, J., Bone, A., Hakeem, Y., Winearls, J., Tallott, M., Thomson, D., Arnold-Day, C., Cupido, J., Fanie, Z., Miller, M., Seymore, L., van Straaten, D., Hssain, A. A., Aliudin, J., Alqahtani, A. -R., Mohamed, K., Mohamed, A., Tan, D., Villanueva, J., Zaqout, A., Kurtzman, E., Ademi, A., Dobrita, A., El Aoudi, K., Segura, J., Giwangkancana, G., Ohshimo, S., Hitoshi, S., Osatnik, J., Joosten, A., Yang, M., Motos, A., Arancibia, F., Williams, V., Noel, A., Luque, N., Trung, T. H., Yacoub, S., Fantini, M., Garcia, R. N. J., Alvarez, E. C., Greti, A., Ceccato, A., Sanchez, A., Vazquez, A. L., Roche-Campo, F., Franch-Llasat, D., Tuazon, D., Amato, M., Cassimiro, L., Pola, F., Ribeiro, F., Fonseca, G., Dalton, H., Desai, M., Osborn, E., Deeb, H., Arcadipane, A., Martucci, G., Panarello, G., Vitiello, C., Bianco, C., Occhipinti, G., Rossetti, M., Cuffaro, R., Cho, S. -M., Shimizu, H., Moriyama, N., Kim, J. -B., Kitamura, N., Gebauer, J., Yokoyama, T., Al-Fares, A., Buabbas, S., Alamad, E., Alawadhi, F., Alawadi, K., Tanaka, H., Hashimoto, S., Yamazaki, M., T. -H., Oh, Epler, M., Forney, C., Kruse, L., Feister, J., Williamson, J., Grobengieser, K., Gnall, E., Golden, S., Caroline, M., Shapiro, T., Karaj, C., Thome, L., Sher, L., Vanderland, M., Welch, M., Mcdermott, S., Brain, M., Mineall, S., Kimura, D., Brazzi, L., Sales, G., Ogston, T., Nagpal, D., Fischer, K., Lorusso, R., Rangappa, R., Appu, A., Carton, E. G., Sen, A., Palacios, A., Rainey, D., Samoukoviv, G., Campisi, J., Durham, L., Neumann, E., Seefeldt, C., Falcucci, O., Emmrich, A., Guy, J., Johns, C., Potzner, K., Zimmermann, C., Espinal, A., Buchtele, N., Schwameis, M., Stecher, S. -S., Singh, D., Barnikel, M., Arenz, L., Zaaqoq, A., Galloway, L. A., Merley, C., Csete, M., Quesada, L., Saba, I., Kasugai, D., Hiraiwa, H., Tanaka, T., Purnama, Y., Dewayanti, S. R., Ardiyan, Juzar, D. A., Siagian, D., Chen, Y. -S., Ratsep, I., Oigus, G., Erikson, K., Post, A. -M., Enneveer, L., Sillaots, P., Manetta, F., Mihelis, E., Sarmiento, I. C., Narasimhan, M., Varrone, M., Komats, M., Garcia-Diaz, J., Harmon, C., Satyapriya, S. V., Bhatt, A., Mokadam, N. A., Uribe, A., Gonzalez, A., Shi, H., Mckeown, J., Pasek, J., Fiorda, J., Echeverria, M., Moreno, R., Zakhary, B., Cavana, M., Cucino, A., Foti, G., Giani, M., Russotto, V., Castagna, V., Dellamore, A., Navalesi, P., Shum, H. -P., Vuysteke, A., Usman, A., Acker, A., Smood, B., Mergler, B., Sertic, F., Subramanian, M., Sperry, A., Rizer, N., Burhan, E., Rasmin, M., Akmal, E., Sitompul, F., Lolong, N., Naivedh, B., Erickson, S., Barrett, P., Dean, D., Daugherty, J., Loforte, A., Khan, I., Abraar Quraishi, M., Desantis, O., So, D., Kandamby, D., Mandei, J. M., Natanael, H., Yudhalantang, E., Lantang, A., Wijaya, S. O., Jung, A., Ng, G., W. Y., Ng, Fang, S., Tabah, A., Ratcliffe, M., Duroux, M., Adachi, S., Nakao, S., Blanco, P., Prieto, A., Sanchez, J., Nicholson, M., Butt, W., Serratore, A., Delzoppo, C., Janin, P., Yarad, E., Totaro, R., Coles, J., Pujo, B., Balk, R., Vissing, A., Kapania, E., Hays, J., Fox, S., Yantosh, G., Mishin, P., Yuliarto, S., Hari Santoso, K., Djajalaksana, S., Fatoni, A. Z., Fukuda, M., Liu, K., Battaglini, D., Jimenez, J. F. M., Bastos, D., Gaiao, S., Rusmawatiningtyas, D., Buchner, J., Cho, Y. -J., Lee, S. H., Kawasaki, T., Munshi, L., Sakiyalak, P., Nitayavardhana, P., Seitz, T., Arora, R., Kent, D., Marino, D., Parwar, S., Cheng, A., Miller, J., Fujitani, S., Shimizu, N., Madhok, J., Owyang, C., Buscher, H., Reynolds, C., Maasikas, O., Beljantsev, A., Mihnovits, V., Akimoto, T., Aizawa, M., Horibe, K., Onodera, R., Young, M., George, T., Shekar, K., Mcguinness, N., Irvine, L., Flynn, B., Endo, T., Sugiyama, K., Shimizu, K., Exconde, K., Lussier, L., Lotz, G., Malfertheiner, M., Maier, L., Dreier, E., Kusumastuti, N. P., Mccloskey, C., Dabaliz, A. -A., Elshazly, T. B., Smith, J., Szuldrzynski, K. S., Bielanski, P., Wille, K., Parhar, K. K. S., Fiest, K. M., Codan, C., Shahid, A., Fayed, M., Evans, T., Garcia, R., Gutierrez, A., Song, T., Rose, R., Bennett, S., Richardson, D., Peek, G., Arora, L., Rappapport, K., Rudolph, K., Sibenaller, Z., Stout, L., Walter, A., Herr, D., Vedadi, N., Thompson, S., Sindt, L., Rajnic, S., Ewald, C., Hoffman, J., Ying, X., Kennedy, R., Griffee, M., Ciullo, A., Kida, Y., Roca, R. F., Riera, J. I., Contreras, S., Alegre, C., Kay, C., Fischer, I., Renner, E., Taniguci, H., Fraser, J., Bassi, G. L., Suen, J., Barnett, A., Pearse, I., Abbate, G., Hassan, H., Heinsar, S., Karnik, V. A., Ki, K., Oneill, H. F., Obonyo, N., Pimenta, L. P., Reid, J. D., Sato, K., Vuorinen, A., Wildi, K. S., Wood, E. S., Yerkovich, S., Lee, J., Plotkin, D., Citarella, B. W., Hartley, E., Lubis, B., Ikeyama, T., Bhaskar, B., Jung, J. -S., Mcguinness, S., Eastwood, G., Marta, S. R., Guarracino, F., Gerle, S., Coxon, E., Claro, B., Loverde, D., Patil, N., Parrini, V., Mcbride, A., Negaard, K., Ratsch, A., Abdelaziz, A., Uribe, J. D., Peris, A., Sanders, M., Emerson, D., Kamal, M., Povoa, P., Francis, R., Cherif, A., Joseph, S., Di Nardo, M., Heard, M., Kyle, K., Blackwell, R. A., Biston, P., Jeong, H. W., Smith, R., Prawira, Y., Montrucchio, G., Garcia, A. H., Salterain, N., Meyns, B., Moreno, M., Walia, R., Mehta, A., Schweda, A., Supriatna, M., Kirakli, C., Williams, M., Kim, K. H., Assad, A., Giraldo, E., Karolak, W., Balik, M., Pocock, E., Gajkowski, E., Masafumi, K., Barrett, N., Takeyama, Y., Park, S., Amin, F., Andriyani, F. M., Sudakevych, S., Vera, M., Cornejo, R., Schwarz, P., Mardini, A. C., de Paula, T., Neto, A. S., Villoldo, A., Colafranceschi, A. S., Iglesias, A. U., Granjean, J., Melro, L. M. G., Romualdo, G. F., Gaia, D., Souza, H., Galas, F., Mendiluce, R. M., Sosa, A., Martinez, I., Kurosawa, H., Salgado, J., Hugi-MayrCharbonneau, B. E., Barzilai, V. S., Monteiro, V., de Souza, R. R., Harper, M., Suzuki, H., Adams, C., Brieva, J., Nyale, G., Eltatar, F. S., Fatani, J., Baeissa, H., Masri, A. A., Rabie, A., Hui, M. Y., Yamane, M., Jung, H., Margaret, A. M., Nacpil, N., Ruck, K., Bakken, R., Jara, C., Felton, T., Berra, L., Shah, B., Chakraborty, A., Cardona, M., Capatos, G., Akkanti, B., Orija, A., Jain, H., Ito, A., Housni, B., Low, S., Iihara, K., Chavez, J., Ramanathan, K., Zabert, G., Naidoo, K., Seppelt, I., Vandyk, M., Macdonald, S., Mcgregor, R., Siebenaler, T., Flynn, H., Lofton, K., Aokage, T., Shigemitsu, K., Moscatelli, A., Fiorentino, G., Baumgaertel, M., Mba, S. E., Assy, J., Hutahaean, A., Roush, H., Sichting, K. A., Alessandri, F., Burns, D., Salt, G., Garabedian, C. P., Millar, J., Sim, M., Mattke, A., Mcauley, D., Tadili, J., Frenzel, T., Bar-Lavie, Y., Ortiz, A. B., Stone, J., Attokaran, A., Farquharson, M., Patel, B., Gunning, D., Baillie, K., Watson, P., Tamai, K., Sajinadiyasa, G. K., Kanyawati, D., Salgado, M., Sassine, A., Yudo, B., Mccaul, S., Lee, B., Lee, S. M., Afek, A., Iwashita, Y., Semedi, B. P., Metiva, J., Van Belle, N., Martin-Loeches, I., Ivatt, L., Woon, C. Y., Kang, H. M., Smith, T., James, E., Al-Rawas, N., Iwasaki, Y., King-Chung, K. C., Gudzenko, V., Hugi-Mayr, B., Taccone, F., Perdhana, F., Lamarche, Y., Ribeiro, J. M., Bradic, N., Van den Bossche, K., Lansink, O., Singh, G., Debeuckelaere, G., Stelfox, H. T., Yi, C., Elia, J., Tribble, T., Shankar, S., Padmanabhan, R., Hallinan, B., Paoletti, L., Leyva, Y., Fykuda, T., Badulak, J., Koch, J., Hackman, A., Janowaik, L., Hernandez, D., Osofsky, J., Donadello, K., Lawang, A., Fine, J., Davidson, B., Vazquez, A. O. R., COVID-19 Critical Care Consortium, and Consortium, COVID-19 Critical Care
Subjects: Male, Respiratory Distress Syndrome, COVID-19, Intensive care unit, Mechanical ventilation, Neuromuscular blocking agent, SARS-CoV-2, Aged, Female, Humans, Intensive Care Units, Middle Aged, Propensity Score, Respiration, Artificial, Neuromuscular Blocking Agents, Respiration, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Settore MED/41 - Anestesiologia, Critical Care and Intensive Care Medicine, COVID-19 Drug Treatment, Artificial, Human medicine
Abstract: Background The role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis. Methods We analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 h from commencement of IMV were compared with subjects who did not receive NMBAs or only upon commencement of IMV (control). The primary objective in the PS-matched cohort was comparison between groups in 90-day in-hospital mortality, assessed through Cox proportional hazard modeling. Secondary objectives were comparisons in the numbers of ventilator-free days (VFD) between day 1 and day 28 and between day 1 and 90 through competing risk regression. Results Data from 1953 patients were included. After propensity score matching, 210 cases from each group were well matched. In the PS-matched cohort, mean (± SD) age was 60.3 ± 13.2 years and 296 (70.5%) were male and the most common comorbidities were hypertension (56.9%), obesity (41.1%), and diabetes (30.0%). The unadjusted hazard ratio (HR) for death at 90 days in the NMBA treatment vs control group was 1.12 (95% CI 0.79, 1.59, p = 0.534). After adjustment for smoking habit and critical therapeutic covariates, the HR was 1.07 (95% CI 0.72, 1.61, p = 0.729). At 28 days, VFD were 16 (IQR 0–25) and 25 (IQR 7–26) in the NMBA treatment and control groups, respectively (sub-hazard ratio 0.82, 95% CI 0.67, 1.00, p = 0.055). At 90 days, VFD were 77 (IQR 0–87) and 87 (IQR 0–88) (sub-hazard ratio 0.86 (95% CI 0.69, 1.07; p = 0.177). Conclusions In patients with COVID-19 and moderate-to-severe ARDS, short course of NMBA treatment, applied early, did not significantly improve 90-day mortality and VFD. In the absence of definitive data from clinical trials, NMBAs should be indicated cautiously in this setting.
Published: 2022
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25. Research Ethics Committees: The Role of Ethics in a Regulatory Authority

Author: McGuinness, S.
Published: 2008
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26. Indirect measurement of the 3He (n,p) 3H reaction cross section at Big Bang energies

Author: Pizzone R. G., Spampinato C., Sparta R., Couder M., Tan W., Burjan V., D'Agata G., Guardo G. L., La Cognata M., Lamia L., Mrazek J., Palmerini S., Typel S., Tumino A., Wiescher M., Anguilar S., Bardayan D., Blankstein D., Boccioli L., Callahan L., Cha S. M., Chae K. Y., Clark A. M., Frentz B., Hall M. R., Gula A., Henderson S., Kelmar R., Kwag M. S., Indelicato I., La Commara M., Lattuada D., Liu Q., Long J., Mazzocco M., Majumdar A., McGuinness S., Nelson A., Oliva A. A., O'Malley P., Prajapati P. M., Rapisarda G. G., Romano S., Sergi M. L., Seymour C., Skulski M., Spitaleri C., Wilkinson J., Pizzone, R. G., Spampinato, C., Sparta, R., Couder, M., Tan, W., Burjan, V., D'Agata, G., Guardo, G. L., La Cognata, M., Lamia, L., Mrazek, J., Palmerini, S., Typel, S., Tumino, A., Wiescher, M., Anguilar, S., Bardayan, D., Blankstein, D., Boccioli, L., Callahan, L., Cha, S. M., Chae, K. Y., Clark, A. M., Frentz, B., Hall, M. R., Gula, A., Henderson, S., Kelmar, R., Kwag, M. S., Indelicato, I., La Commara, M., Lattuada, D., Liu, Q., Long, J., Mazzocco, M., Majumdar, A., Mcguinness, S., Nelson, A., Oliva, A. A., O'Malley, P., Prajapati, P. M., Rapisarda, G. G., Romano, S., Sergi, M. L., Seymour, C., Skulski, M., Spitaleri, C., and Wilkinson, J.
Abstract: Nuclear reactions play a key role in the framework of the Big Bang Nucleosynthesis. A network of 12 principal reactions has been identified as the main path that drove the elemental nucleosynthesis in the first 20 min of the history of the Universe. Among them an important role is played by neutron-induced reactions, which, from an experimental point of view, are usually a difficult task to be measured directly. Nevertheless big efforts in the last decades have led to a better understanding of their role in the primordial nucleosynthesis network. In this work we apply the Trojan Horse Method to extract the cross section at astrophysical energies for the 3He (n,p)3H reaction after a detailed study of the 2H (3He ,pt)H three-body process. Data extracted from the present measurement are compared with other published sets.
Published: 2020

27. A Randomised feasibility study to assess a novel strategy to rationalise fluid in patients after cardiac surgery

Author: Parke, R L., McGuinness, S. P., Gilder, E., McCarthy, L. W., and Cowdrey, K.-A. L.
Published: 2015
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28. Consensus guidelines for the treatment of invasive mould infections in haematological malignancy and haemopoietic stem cell transplantation, 2014

Author: Blyth, C. C., Gilroy, N. M., Guy, S. D., Chambers, S. T., Cheong, E. Y., Gottlieb, T., McGuinness, S. L., and Thursky, K. A.
Published: 2014
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29. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19 – Preliminary report

Author: The REMAP-CAP Investigators, Gordon, A, Mouncey, P, Al-Beidh, F, Rowan, K, Nichol, A, Arabi, Y, Annane, D, Beane, A, Van Bentum-Puijk, W, Berry, L, Bhimani, Z, Bonten, MJM, Bradbury, C, Brunkhorst, F, Buzgau, A, Cheng, A, Detry, M, Duffy, E, Estcourt, L, Fitzgerald, M, Goossens, H, Haniffa, R, Higgins, A, Hills, T, Horvat, C, Lamontagne, F, Lawler, P, Leavis, H, Linstrum, K, Litton, E, Lorenzi, E, Marshall, J, Mayr, F, McAuley, D, McGlothlin, A, McGuinness, S, McVerry, B, Montgomery, S, Morpeth, S, Murthy, S, Orr, K, Parke, R, Parker, J, Patanwala, A, Pettilä, V, Rademaker, E, Santos, M, Saunders, C, Seymour, C, Shankar-Hari, M, Sligl, W, Turgeon, A, Turner, A, Van de Veerdonk, F, Zarychanski, R, Green, C, Lewis, R, Angus, D, McArthur, C, Berry, S, Webb, S, and Derde, LPG
Subjects: The REMAP-CAP Investigators
Abstract: Background The efficacy of interleukin-6 receptor antagonists in critically ill patients with coronavirus disease 2019 (Covid-19) is unclear. Methods We evaluated tocilizumab and sarilumab in an ongoing international, multifactorial, adaptive platform trial. Adult patients with Covid-19, within 24 hours of commencing organ support in an intensive care unit, were randomized to receive either tocilizumab (8mg/kg) or sarilumab (400mg) or standard care (control). The primary outcome was an ordinal scale combining in-hospital mortality (assigned −1) and days free of organ support to day 21. The trial uses a Bayesian statistical model with pre-defined triggers to declare superiority, efficacy, equivalence or futility. Results Tocilizumab and sarilumab both met the pre-defined triggers for efficacy. At the time of full analysis 353 patients had been assigned to tocilizumab, 48 to sarilumab and 402 to control. Median organ support-free days were 10 (interquartile range [IQR] −1, 16), 11 (IQR 0, 16) and 0 (IQR −1, 15) for tocilizumab, sarilumab and control, respectively. Relative to control, median adjusted odds ratios were 1.64 (95% credible intervals [CrI] 1.25, 2.14) for tocilizumab and 1.76 (95%CrI 1.17, 2.91) for sarilumab, yielding >99.9% and 99.5% posterior probabilities of superiority compared with control. Hospital mortality was 28.0% (98/350) for tocilizumab, 22.2% (10/45) for sarilumab and 35.8% (142/397) for control. All secondary outcomes and analyses supported efficacy of these IL-6 receptor antagonists. Conclusions In critically ill patients with Covid-19 receiving organ support in intensive care, treatment with the IL-6 receptor antagonists, tocilizumab and sarilumab, improved outcome, including survival. (ClinicalTrials.gov number: NCT02735707) Competing Interest Statement Dr. Gordon reports grants from NIHR, grants from NIHR Research Professorship (RP-2015-06-18), non-financial support from NIHR Clinical Research Network, non-financial support from Roche Products Ltd, non-financial support from Sanofi (Aventis Pharma Ltd), during the conduct of the study; personal fees from GlaxoSmithKline, personal fees from Bristol Myers Squibb, personal fees from 30 Respiratory, outside the submitted work Clinical Trial NCT02735707 Clinical Protocols https://www.remapcap.org/protocol-documents
Published: 2021

30. Effect of Convalescent Plasma on Organ Support-Free Days in Critically Ill Patients With COVID-19: A Randomized Clinical Trial

Author: Estcourt, L.J., Turgeon, A.F., McQuilten, Z.K., McVerry, B.J., Al-Beidh, F., Annane, D., Arabi, Y.M., Arnold, D.M., Beane, A., Bégin, P., Bentum-Puijk, W. van, Berry, L.R., Bhimani, Z., Birchall, J.E., Bonten, M.J.M., Bradbury, C.A., Brunkhorst, F.M., Buxton, M., Callum, J.L., Chassé, M., Cheng, A.C., Cove, M.E., Daly, J., Derde, L., Detry, M.A., Jong, Menno de, Evans, A., Fergusson, D.A., Fish, M., Fitzgerald, M., Foley, C., Goossens, H., Gordon, A.C., Gosbell, I.B., Green, C., Haniffa, R., Harvala, H., Higgins, A.M., Hills, T.E., Hoad, V.C., Horvat, C., Huang, D.T., Hudson, C.L., Ichihara, N., Laing, E., Lamikanra, A.A., Lamontagne, F., Lawler, P.R., Linstrum, K., Litton, E., Lorenzi, E., MacLennan, S., Marshall, J., McAuley, D.F., McDyer, J.F., McGlothlin, A., McGuinness, S., Miflin, G., Montgomery, S., Mouncey, P.R., Murthy, S., Nichol, A., Parke, R., Parker, J.C., Priddee, N., Purcell, D.F.J., Reyes, L.F., Richardson, P., Robitaille, N., Rowan, K.M., Rynne, J., Saito, H., Santos, M., Saunders, C.T., Neto, A. Serpa, Seymour, C.W., Silversides, J.A., Tinmouth, A.A., Triulzi, D.J., Turner, A.M., Veerdonk, F.L. van de, Walsh, T.S., Wood, E.M., Berry, S., Lewis, R.J., Menon, D.K., McArthur, C., Zarychanski, R., Angus, D.C., Webb, S.A., Roberts, D.J., Shankar-Hari, M., Estcourt, L.J., Turgeon, A.F., McQuilten, Z.K., McVerry, B.J., Al-Beidh, F., Annane, D., Arabi, Y.M., Arnold, D.M., Beane, A., Bégin, P., Bentum-Puijk, W. van, Berry, L.R., Bhimani, Z., Birchall, J.E., Bonten, M.J.M., Bradbury, C.A., Brunkhorst, F.M., Buxton, M., Callum, J.L., Chassé, M., Cheng, A.C., Cove, M.E., Daly, J., Derde, L., Detry, M.A., Jong, Menno de, Evans, A., Fergusson, D.A., Fish, M., Fitzgerald, M., Foley, C., Goossens, H., Gordon, A.C., Gosbell, I.B., Green, C., Haniffa, R., Harvala, H., Higgins, A.M., Hills, T.E., Hoad, V.C., Horvat, C., Huang, D.T., Hudson, C.L., Ichihara, N., Laing, E., Lamikanra, A.A., Lamontagne, F., Lawler, P.R., Linstrum, K., Litton, E., Lorenzi, E., MacLennan, S., Marshall, J., McAuley, D.F., McDyer, J.F., McGlothlin, A., McGuinness, S., Miflin, G., Montgomery, S., Mouncey, P.R., Murthy, S., Nichol, A., Parke, R., Parker, J.C., Priddee, N., Purcell, D.F.J., Reyes, L.F., Richardson, P., Robitaille, N., Rowan, K.M., Rynne, J., Saito, H., Santos, M., Saunders, C.T., Neto, A. Serpa, Seymour, C.W., Silversides, J.A., Tinmouth, A.A., Triulzi, D.J., Turner, A.M., Veerdonk, F.L. van de, Walsh, T.S., Wood, E.M., Berry, S., Lewis, R.J., Menon, D.K., McArthur, C., Zarychanski, R., Angus, D.C., Webb, S.A., Roberts, D.J., and Shankar-Hari, M.
Abstract: Item does not contain fulltext, IMPORTANCE: The evidence for benefit of convalescent plasma for critically ill patients with COVID-19 is inconclusive. OBJECTIVE: To determine whether convalescent plasma would improve outcomes for critically ill adults with COVID-19. DESIGN, SETTING, AND PARTICIPANTS: The ongoing Randomized, Embedded, Multifactorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) enrolled and randomized 4763 adults with suspected or confirmed COVID-19 between March 9, 2020, and January 18, 2021, within at least 1 domain; 2011 critically ill adults were randomized to open-label interventions in the immunoglobulin domain at 129 sites in 4 countries. Follow-up ended on April 19, 2021. INTERVENTIONS: The immunoglobulin domain randomized participants to receive 2 units of high-titer, ABO-compatible convalescent plasma (total volume of 550 mL ± 150 mL) within 48 hours of randomization (n = 1084) or no convalescent plasma (n = 916). MAIN OUTCOMES AND MEASURES: The primary ordinal end point was organ support-free days (days alive and free of intensive care unit-based organ support) up to day 21 (range, -1 to 21 days; patients who died were assigned -1 day). The primary analysis was an adjusted bayesian cumulative logistic model. Superiority was defined as the posterior probability of an odds ratio (OR) greater than 1 (threshold for trial conclusion of superiority >99%). Futility was defined as the posterior probability of an OR less than 1.2 (threshold for trial conclusion of futility >95%). An OR greater than 1 represented improved survival, more organ support-free days, or both. The prespecified secondary outcomes included in-hospital survival; 28-day survival; 90-day survival; respiratory support-free days; cardiovascular support-free days; progression to invasive mechanical ventilation, extracorporeal mechanical oxygenation, or death; intensive care unit length of stay; hospital length of stay; World Health Organization ordinal scale score at day 14; venous thromb
Published: 2021

31. Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial

Author: Arabi, Y.M., Gordon, A.C., Derde, L.P.G., Nichol, A.D., Murthy, S., Beidh, F.A., Annane, D., Swaidan, L.A., Beane, A., Beasley, R., Berry, L.R., Bhimani, Z., Bonten, M.J.M., Bradbury, C.A., Brunkhorst, F.M., Buxton, M., Buzgau, A., Cheng, A., Jong, Menno de, Detry, M.A., Duffy, E.J., Estcourt, L.J., Fitzgerald, M., Fowler, R., Girard, T.D., Goligher, E.C., Goossens, H., Haniffa, R., Higgins, A.M., Hills, T.E., Horvat, C.M., Huang, D.T., King, A.J., Lamontagne, F., Lawler, P.R., Lewis, R., Linstrum, K., Litton, E., Lorenzi, E., Malakouti, S., McAuley, D.F., McGlothlin, A., McGuinness, S., McVerry, B.J., Montgomery, S.K., Morpeth, S.C., Mouncey, P.R., Orr, K., Parke, R., Parker, J.C., Patanwala, A.E., Rowan, K.M., Santos, M.S., Saunders, C.T., Seymour, C.W., Shankar-Hari, M., Tong, S.Y.C., Turgeon, A.F., Turner, A.M., Veerdonk, F.L. van de, Zarychanski, R., Green, C., Berry, S., Marshall, J.C., McArthur, C., Schouten, J.A., Angus, D.C., Webb, S.A., Arabi, Y.M., Gordon, A.C., Derde, L.P.G., Nichol, A.D., Murthy, S., Beidh, F.A., Annane, D., Swaidan, L.A., Beane, A., Beasley, R., Berry, L.R., Bhimani, Z., Bonten, M.J.M., Bradbury, C.A., Brunkhorst, F.M., Buxton, M., Buzgau, A., Cheng, A., Jong, Menno de, Detry, M.A., Duffy, E.J., Estcourt, L.J., Fitzgerald, M., Fowler, R., Girard, T.D., Goligher, E.C., Goossens, H., Haniffa, R., Higgins, A.M., Hills, T.E., Horvat, C.M., Huang, D.T., King, A.J., Lamontagne, F., Lawler, P.R., Lewis, R., Linstrum, K., Litton, E., Lorenzi, E., Malakouti, S., McAuley, D.F., McGlothlin, A., McGuinness, S., McVerry, B.J., Montgomery, S.K., Morpeth, S.C., Mouncey, P.R., Orr, K., Parke, R., Parker, J.C., Patanwala, A.E., Rowan, K.M., Santos, M.S., Saunders, C.T., Seymour, C.W., Shankar-Hari, M., Tong, S.Y.C., Turgeon, A.F., Turner, A.M., Veerdonk, F.L. van de, Zarychanski, R., Green, C., Berry, S., Marshall, J.C., McArthur, C., Schouten, J.A., Angus, D.C., and Webb, S.A.
Abstract: Item does not contain fulltext, PURPOSE: To study the efficacy of lopinavir-ritonavir and hydroxychloroquine in critically ill patients with coronavirus disease 2019 (COVID-19). METHODS: Critically ill adults with COVID-19 were randomized to receive lopinavir-ritonavir, hydroxychloroquine, combination therapy of lopinavir-ritonavir and hydroxychloroquine or no antiviral therapy (control). The primary endpoint was an ordinal scale of organ support-free days. Analyses used a Bayesian cumulative logistic model and expressed treatment effects as an adjusted odds ratio (OR) where an OR > 1 is favorable. RESULTS: We randomized 694 patients to receive lopinavir-ritonavir (n = 255), hydroxychloroquine (n = 50), combination therapy (n = 27) or control (n = 362). The median organ support-free days among patients in lopinavir-ritonavir, hydroxychloroquine, and combination therapy groups was 4 (- 1 to 15), 0 (- 1 to 9) and-1 (- 1 to 7), respectively, compared to 6 (- 1 to 16) in the control group with in-hospital mortality of 88/249 (35%), 17/49 (35%), 13/26 (50%), respectively, compared to 106/353 (30%) in the control group. The three interventions decreased organ support-free days compared to control (OR [95% credible interval]: 0.73 [0.55, 0.99], 0.57 [0.35, 0.83] 0.41 [0.24, 0.72]), yielding posterior probabilities that reached the threshold futility (≥ 99.0%), and high probabilities of harm (98.0%, 99.9% and > 99.9%, respectively). The three interventions reduced hospital survival compared with control (OR [95% CrI]: 0.65 [0.45, 0.95], 0.56 [0.30, 0.89], and 0.36 [0.17, 0.73]), yielding high probabilities of harm (98.5% and 99.4% and 99.8%, respectively). CONCLUSION: Among critically ill patients with COVID-19, lopinavir-ritonavir, hydroxychloroquine, or combination therapy worsened outcomes compared to no antiviral therapy.
Published: 2021

32. Early sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial.

Author: Abidin H.Z., Hassan M.H., Omar S.C., Shukeri W.F.W., Brealey D., Bercades G., Blackburn E., Macallum N., Macklin A., Ryu J.H., Tam K., Smyth D., Arif A., Bassford C., Morgan C., Swann C., Ward G., Wild L., Bone A., Elderkin T., Green D., Sach D., Salerno T., Simpson N., Brohi F., Clark M., Williams L., Brooks J., Cocks E., Cole J., Curtin J., Davies R., Hill H., Morgan M., Palmer N., Whitton C., Wise M., Baskaran P., Hasan M.S., Tham L.Y., Cruz R.S., Dinsdale D., Edney S., Firkin C., FitzJohn F., Hill G., Hunt A., Hurford S., Jones G., Judd H., Latimer-Bell C., Lawrence C., Lesona E., Navarra L., Robertson Y., Smellie H., Vucago A.M., Young P., Dawson H., Griffith D.M., Paterson R., Clark P., Kong J., Ho J., Nayyar V., Skelly C., Shehabi Y., Serpa Neto A., Howe B.D., Arabi Y.M., Bass F.E., Kadiman S.B., McArthur C.J., Reade M.C., Seppelt I.M., Wise M.P., Mashonganyika C., McKee H., Tonks A., Donnelly A., Hemmings N., O'Kane S., Blakemore A., Butler M., Cowdrey K., Dalton J., Gilder E., Long S., McCarthy L., McGuinness S., Parke R., Chen Y., McArthur C., McConnochie R., Newby L., Bellomo R., Eastwood G., Peck L., Young H., Boschert C., Edington J., Fletcher J., Nand K., Raza A., Sara T., Bennett-Britton J., Bewley J., Bodenham V., Cole L., Driver K., Grimmer L., Howie L., Searles C., Sweet K., Webster D., van Berkel A., Connor H., Dennett J., van Der Graaff M., Henderson S., Mehrtens J., Miller K., Minto E., Morris A., Noble S., Parker K., Hart N., Shepherd K., Vij S., Dickson S., Elloway E., Ferguson C., Jackson R., MacNaughton P., Marner M., Squire R., Waddy S., Wafer P., Welbourne J., Ashcroft P., Chambler D., Dukes S., Harris A., Horton S., Sharpe S., Williams P., Williams S., Bailey M., Blazquez E., France D., Hutchison R., Comadira G., Gough M., Tallott M., Bastick M., Cameron R., Donovan S., Gaur A., Gregory R., Naumoff J., Turner E., White M., Au K.F.J., Fratzia J., Treloar S., Lim C.H., Maseeda Y., Tan A.P., Tang C.L., Yong C.Y., Akaltan M., Berger S., Blaser D., Fazlija L., Jong M.L., Lensch M., Ludwig R., Merz T., Nettelbeck K., Roth M., Schafer M., Takala J., Wehr A., Zacharias D., Amran R., Ashraf H.N., Azmi N., Basri N., Burhanuddin H., Hadinata Y., Hamdan A., Kadiman S., Rashid A.I.Y.M., Sabran I.N., Sulaiman S., Zabidi I.N., Al-Dawood A., Aljuaid M., Al Anizi H., Al Saeedi A., Arabi Y., Dbsawy M., Deeb A., Hegazy M., Magdi I., Corcoran E., Finney C., Dumlao L.A., Bassam R., Hassan M.A., Naseem N., Al-Kurdi M.H., Al-Harthy A.M., Bernard S., Sebafundi L., Serban C., Lim S.K., Mazidah N., Saidin N., Sjamsuddin N., Tan I.T.A., Zabidi N., Brain M., Mineall S., Kanhere M., Soar N., Kadir N.A., Abdullah N.H., Awang R., Emperan Z., Husin N.S., Ismail N.I., Ismail S.Z., Khadzali F.N.A.M., Norddin M.F., Aguila J., Bold C., Clatworthy B., Dias A., Hogan C., Kazemi A., Lai V., Song R., Williams A., Bhatia D., Bulfin L., Elliot S., Galt P., Lavrans K., Ritchie P., Wang A., Gresham R., Lowrey J., Masters K., Palejs P., Seppelt I., Symonds F., Weisbrodt L., Whitehead C., Babio-Galan M., Calder V., Clement I., Harrison A., McCullagh I., Scott C., Bevan R., Caniba S., Hacking D., Maher L., Azzolini M.L., Beccaria P., Colombo S., Landoni G., Leggieri C., Luca C., Mamo D., Moizo E., Monti G., Mucci M., Zangrillo A., Albania M., Arora S., Shi Y., Abudayah A., Almekhlafi G., Al Amodi E., Al Samarrai S., Badawi M., Caba R.C., Elffaki O., Mandourah Y., Valerio J., Joyce C., Meyer J., Saylor E., Venkatesh B., Venz E., Walsham J., Wetzig K., Clarey E., Harris C., Hopkins P., Noble H., Thompson L., Williams T., Khoo T.M., Liew J.E.S., Sakthi A.N., Zulkurnain A., Bamford A., Bergin C., Carrera R., Cooper L., Despy L., Ellis K., Harkett S., Mee L., Reeves E., Snelson C., Spruce E., Cooper G., Hodgson R., Pearson D., Rosbergen M., Ali M.N., Bahar N.I., Ismail A., Ismail W.N.W., Samat N.M., Piah N.S.M., Rahman R.A., Duroux M., Ratcliffe M., Warhurst T., Buehner U., Williams E., Jacques N., Keating L., Macgill S., Tamang K.L., Tolan N., Walden A., Bower R., Cranshaw J., Molloy K., Pitts S., Butler J., Dunlop R., Fourie C., Jarrett P., Lassig-Smith M., Livermore A., O'Donoghue S., Reade M., Starr T., Stuart J., Campbell L., Phillips M., Stephens D., Thomas J., Cooper D., McAllister R., Andrew G., Barclay L., Hope D., Wojcik G., McCulloch C., Ascough L., Paisley C., Patrick-Heselton J., Shaw D., Waugh V., Williams K., Welters I., Barge D., Jordan A., MacIsaac C., Rechnitzer T., Bass F., Gatward J., Hammond N., Janin P., O'Connor A., Stedman W., Yarad E., Razak N.A., Dzulkipli N., Jong S.L., Asen K., Voon W.L., Liew S., Ball J., Barnes V., Dalton C., Farnell-Ward S., Farrah H., Maher K., Mellinghoff J., Ryan C., Shirley P., Conlon L., Glover A., Martin-Loeches I., O'Toole E., Ewan J., Ferrier J., Litton E., Webb S.A., Berry W., Alonso U.B., Bociek A., Campos S., Jawara S., Hanks F., Kelly A., Lei K., McKenzie C., Ostermann M., Wan R., Al-Soufi S., Leow S., McCann K., Reynolds C., Brickell K., Fahey C., Hays L., Hyde N., Nichol A., Ryan D., Brailsford J., Buckley A., Forbes L., Maguire T., Moore J., Murray L., Ghosh A., Park M., Said S., Smith J., Visser A., Ali S., Abidin H.Z., Hassan M.H., Omar S.C., Shukeri W.F.W., Brealey D., Bercades G., Blackburn E., Macallum N., Macklin A., Ryu J.H., Tam K., Smyth D., Arif A., Bassford C., Morgan C., Swann C., Ward G., Wild L., Bone A., Elderkin T., Green D., Sach D., Salerno T., Simpson N., Brohi F., Clark M., Williams L., Brooks J., Cocks E., Cole J., Curtin J., Davies R., Hill H., Morgan M., Palmer N., Whitton C., Wise M., Baskaran P., Hasan M.S., Tham L.Y., Cruz R.S., Dinsdale D., Edney S., Firkin C., FitzJohn F., Hill G., Hunt A., Hurford S., Jones G., Judd H., Latimer-Bell C., Lawrence C., Lesona E., Navarra L., Robertson Y., Smellie H., Vucago A.M., Young P., Dawson H., Griffith D.M., Paterson R., Clark P., Kong J., Ho J., Nayyar V., Skelly C., Shehabi Y., Serpa Neto A., Howe B.D., Arabi Y.M., Bass F.E., Kadiman S.B., McArthur C.J., Reade M.C., Seppelt I.M., Wise M.P., Mashonganyika C., McKee H., Tonks A., Donnelly A., Hemmings N., O'Kane S., Blakemore A., Butler M., Cowdrey K., Dalton J., Gilder E., Long S., McCarthy L., McGuinness S., Parke R., Chen Y., McArthur C., McConnochie R., Newby L., Bellomo R., Eastwood G., Peck L., Young H., Boschert C., Edington J., Fletcher J., Nand K., Raza A., Sara T., Bennett-Britton J., Bewley J., Bodenham V., Cole L., Driver K., Grimmer L., Howie L., Searles C., Sweet K., Webster D., van Berkel A., Connor H., Dennett J., van Der Graaff M., Henderson S., Mehrtens J., Miller K., Minto E., Morris A., Noble S., Parker K., Hart N., Shepherd K., Vij S., Dickson S., Elloway E., Ferguson C., Jackson R., MacNaughton P., Marner M., Squire R., Waddy S., Wafer P., Welbourne J., Ashcroft P., Chambler D., Dukes S., Harris A., Horton S., Sharpe S., Williams P., Williams S., Bailey M., Blazquez E., France D., Hutchison R., Comadira G., Gough M., Tallott M., Bastick M., Cameron R., Donovan S., Gaur A., Gregory R., Naumoff J., Turner E., White M., Au K.F.J., Fratzia J., Treloar S., Lim C.H., Maseeda Y., Tan A.P., Tang C.L., Yong C.Y., Akaltan M., Berger S., Blaser D., Fazlija L., Jong M.L., Lensch M., Ludwig R., Merz T., Nettelbeck K., Roth M., Schafer M., Takala J., Wehr A., Zacharias D., Amran R., Ashraf H.N., Azmi N., Basri N., Burhanuddin H., Hadinata Y., Hamdan A., Kadiman S., Rashid A.I.Y.M., Sabran I.N., Sulaiman S., Zabidi I.N., Al-Dawood A., Aljuaid M., Al Anizi H., Al Saeedi A., Arabi Y., Dbsawy M., Deeb A., Hegazy M., Magdi I., Corcoran E., Finney C., Dumlao L.A., Bassam R., Hassan M.A., Naseem N., Al-Kurdi M.H., Al-Harthy A.M., Bernard S., Sebafundi L., Serban C., Lim S.K., Mazidah N., Saidin N., Sjamsuddin N., Tan I.T.A., Zabidi N., Brain M., Mineall S., Kanhere M., Soar N., Kadir N.A., Abdullah N.H., Awang R., Emperan Z., Husin N.S., Ismail N.I., Ismail S.Z., Khadzali F.N.A.M., Norddin M.F., Aguila J., Bold C., Clatworthy B., Dias A., Hogan C., Kazemi A., Lai V., Song R., Williams A., Bhatia D., Bulfin L., Elliot S., Galt P., Lavrans K., Ritchie P., Wang A., Gresham R., Lowrey J., Masters K., Palejs P., Seppelt I., Symonds F., Weisbrodt L., Whitehead C., Babio-Galan M., Calder V., Clement I., Harrison A., McCullagh I., Scott C., Bevan R., Caniba S., Hacking D., Maher L., Azzolini M.L., Beccaria P., Colombo S., Landoni G., Leggieri C., Luca C., Mamo D., Moizo E., Monti G., Mucci M., Zangrillo A., Albania M., Arora S., Shi Y., Abudayah A., Almekhlafi G., Al Amodi E., Al Samarrai S., Badawi M., Caba R.C., Elffaki O., Mandourah Y., Valerio J., Joyce C., Meyer J., Saylor E., Venkatesh B., Venz E., Walsham J., Wetzig K., Clarey E., Harris C., Hopkins P., Noble H., Thompson L., Williams T., Khoo T.M., Liew J.E.S., Sakthi A.N., Zulkurnain A., Bamford A., Bergin C., Carrera R., Cooper L., Despy L., Ellis K., Harkett S., Mee L., Reeves E., Snelson C., Spruce E., Cooper G., Hodgson R., Pearson D., Rosbergen M., Ali M.N., Bahar N.I., Ismail A., Ismail W.N.W., Samat N.M., Piah N.S.M., Rahman R.A., Duroux M., Ratcliffe M., Warhurst T., Buehner U., Williams E., Jacques N., Keating L., Macgill S., Tamang K.L., Tolan N., Walden A., Bower R., Cranshaw J., Molloy K., Pitts S., Butler J., Dunlop R., Fourie C., Jarrett P., Lassig-Smith M., Livermore A., O'Donoghue S., Reade M., Starr T., Stuart J., Campbell L., Phillips M., Stephens D., Thomas J., Cooper D., McAllister R., Andrew G., Barclay L., Hope D., Wojcik G., McCulloch C., Ascough L., Paisley C., Patrick-Heselton J., Shaw D., Waugh V., Williams K., Welters I., Barge D., Jordan A., MacIsaac C., Rechnitzer T., Bass F., Gatward J., Hammond N., Janin P., O'Connor A., Stedman W., Yarad E., Razak N.A., Dzulkipli N., Jong S.L., Asen K., Voon W.L., Liew S., Ball J., Barnes V., Dalton C., Farnell-Ward S., Farrah H., Maher K., Mellinghoff J., Ryan C., Shirley P., Conlon L., Glover A., Martin-Loeches I., O'Toole E., Ewan J., Ferrier J., Litton E., Webb S.A., Berry W., Alonso U.B., Bociek A., Campos S., Jawara S., Hanks F., Kelly A., Lei K., McKenzie C., Ostermann M., Wan R., Al-Soufi S., Leow S., McCann K., Reynolds C., Brickell K., Fahey C., Hays L., Hyde N., Nichol A., Ryan D., Brailsford J., Buckley A., Forbes L., Maguire T., Moore J., Murray L., Ghosh A., Park M., Said S., Smith J., Visser A., and Ali S.
Abstract: Purpose: To quantify potential heterogeneity of treatment effect (HTE), of early sedation with dexmedetomidine (DEX) compared with usual care, and identify patients who have a high probability of lower or higher 90-day mortality according to age, and other identified clusters. Method(s): Bayesian analysis of 3904 critically ill adult patients expected to receive invasive ventilation > 24 h and enrolled in a multinational randomized controlled trial comparing early DEX with usual care sedation. Result(s): HTE was assessed according to age and clusters (based on 12 baseline characteristics) using a Bayesian hierarchical models. DEX was associated with lower 90-day mortality compared to usual care in patients > 65 years (odds ratio [OR], 0.83 [95% credible interval [CrI] 0.68-1.00], with 97.7% probability of reduced mortality across broad categories of illness severity. Conversely, the probability of increased mortality in patients = 65 years was 98.5% (OR 1.26 [95% CrI 1.02-1.56]. Two clusters were identified: cluster 1 (976 patients) mostly operative, and cluster 2 (2346 patients), predominantly non-operative. There was a greater probability of benefit with DEX in cluster 1 (OR 0.86 [95% CrI 0.65-1.14]) across broad categories of age, with 86.4% probability that DEX is more beneficial in cluster 1 than cluster 2. Conclusion(s): In critically ill mechanically ventilated patients, early sedation with dexmedetomidine exhibited a high probability of reduced 90-day mortality in older patients regardless of operative or non-operative cluster status. Conversely, a high probability of increased 90-day mortality was observed in younger patients of non-operative status. Further studies are needed to confirm these findings.Copyright © 2021, Crown.
Published: 2021

33. Effect of Convalescent Plasma on Organ Support-Free Days in Critically Ill Patients with COVID-19: A Randomized Clinical Trial.

Author: Estcourt L.J., Turgeon A.F., McQuilten Z.K., McVerry B.J., Al-Beidh F., Annane D., Arabi Y.M., Arnold D.M., Beane A., Begin P., Van Bentum-Puijk W., Berry L.R., Bhimani Z., Birchall J.E., Bonten M.J.M., Bradbury C.A., Brunkhorst F.M., Buxton M., Callum J.L., Chasse M., Cheng A.C., Cove M.E., Daly J., Derde L., Detry M.A., De Jong M., Evans A., Fergusson D.A., Fish M., Fitzgerald M., Foley C., Goossens H., Gordon A.C., Gosbell I.B., Green C., Haniffa R., Harvala H., Higgins A.M., Hills T.E., Hoad V.C., Horvat C., Huang D.T., Hudson C.L., Ichihara N., Laing E., Lamikanra A.A., Lamontagne F., Lawler P.R., Linstrum K., Litton E., Lorenzi E., Maclennan S., Marshall J., McAuley D.F., McDyer J.F., McGlothlin A., McGuinness S., Miflin G., Montgomery S., Mouncey P.R., Murthy S., Nichol A., Parke R., Parker J.C., Priddee N., Purcell D.F.J., Reyes L.F., Richardson P., Robitaille N., Rowan K.M., Rynne J., Saito H., Santos M., Saunders C.T., Serpa Neto A., Seymour C.W., Silversides J.A., Tinmouth A.A., Triulzi D.J., Turner A.M., Van De Veerdonk F., Walsh T.S., Wood E.M., Berry S., Lewis R.J., Menon D.K., McArthur C., Zarychanski R., Angus D.C., Webb S.A., Roberts D.J., Shankar-Hari M., Estcourt L.J., Turgeon A.F., McQuilten Z.K., McVerry B.J., Al-Beidh F., Annane D., Arabi Y.M., Arnold D.M., Beane A., Begin P., Van Bentum-Puijk W., Berry L.R., Bhimani Z., Birchall J.E., Bonten M.J.M., Bradbury C.A., Brunkhorst F.M., Buxton M., Callum J.L., Chasse M., Cheng A.C., Cove M.E., Daly J., Derde L., Detry M.A., De Jong M., Evans A., Fergusson D.A., Fish M., Fitzgerald M., Foley C., Goossens H., Gordon A.C., Gosbell I.B., Green C., Haniffa R., Harvala H., Higgins A.M., Hills T.E., Hoad V.C., Horvat C., Huang D.T., Hudson C.L., Ichihara N., Laing E., Lamikanra A.A., Lamontagne F., Lawler P.R., Linstrum K., Litton E., Lorenzi E., Maclennan S., Marshall J., McAuley D.F., McDyer J.F., McGlothlin A., McGuinness S., Miflin G., Montgomery S., Mouncey P.R., Murthy S., Nichol A., Parke R., Parker J.C., Priddee N., Purcell D.F.J., Reyes L.F., Richardson P., Robitaille N., Rowan K.M., Rynne J., Saito H., Santos M., Saunders C.T., Serpa Neto A., Seymour C.W., Silversides J.A., Tinmouth A.A., Triulzi D.J., Turner A.M., Van De Veerdonk F., Walsh T.S., Wood E.M., Berry S., Lewis R.J., Menon D.K., McArthur C., Zarychanski R., Angus D.C., Webb S.A., Roberts D.J., and Shankar-Hari M.
Abstract: Importance: The evidence for benefit of convalescent plasma for critically ill patients with COVID-19 is inconclusive. Objective(s): To determine whether convalescent plasma would improve outcomes for critically ill adults with COVID-19. Design, Setting, and Participant(s): The ongoing Randomized, Embedded, Multifactorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) enrolled and randomized 4763 adults with suspected or confirmed COVID-19 between March 9, 2020, and January 18, 2021, within at least 1 domain; 2011 critically ill adults were randomized to open-label interventions in the immunoglobulin domain at 129 sites in 4 countries. Follow-up ended on April 19, 2021. Intervention(s): The immunoglobulin domain randomized participants to receive 2 units of high-titer, ABO-compatible convalescent plasma (total volume of 550 mL +/- 150 mL) within 48 hours of randomization (n = 1084) or no convalescent plasma (n = 916). Main Outcomes and Measures: The primary ordinal end point was organ support-free days (days alive and free of intensive care unit-based organ support) up to day 21 (range, -1 to 21 days; patients who died were assigned -1 day). The primary analysis was an adjusted bayesian cumulative logistic model. Superiority was defined as the posterior probability of an odds ratio (OR) greater than 1 (threshold for trial conclusion of superiority >99%). Futility was defined as the posterior probability of an OR less than 1.2 (threshold for trial conclusion of futility >95%). An OR greater than 1 represented improved survival, more organ support-free days, or both. The prespecified secondary outcomes included in-hospital survival; 28-day survival; 90-day survival; respiratory support-free days; cardiovascular support-free days; progression to invasive mechanical ventilation, extracorporeal mechanical oxygenation, or death; intensive care unit length of stay; hospital length of stay; World Health Organization ordinal scale score at day 14; veno
Published: 2021

34. Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial

Author: Arabi, YM, Gordon, AC, Derde, LPG, Nichol, AD, Murthy, S, Beidh, FA, Annane, D, Swaidan, LA, Beane, A, Beasley, R, Berry, LR, Bhimani, Z, Bonten, MJM, Bradbury, CA, Brunkhorst, FM, Buxton, M, Buzgau, A, Cheng, A, De Jong, M, Detry, MA, Duffy, EJ, Estcourt, LJ, Fitzgerald, M, Fowler, R, Girard, TD, Goligher, EC, Goossens, H, Haniffa, R, Higgins, AM, Hills, TE, Horvat, CM, Huang, DT, King, AJ, Lamontagne, F, Lawler, PR, Lewis, R, Linstrum, K, Litton, E, Lorenzi, E, Malakouti, S, McAuley, DF, McGlothlin, A, Mcguinness, S, McVerry, BJ, Montgomery, SK, Morpeth, SC, Mouncey, PR, Orr, K, Parke, R, Parker, JC, Patanwala, AE, Rowan, KM, Santos, MS, Saunders, CT, Seymour, CW, Shankar-Hari, M, Tong, SYC, Turgeon, AF, Turner, AM, Van de Veerdonk, FL, Zarychanski, R, Green, C, Berry, S, Marshall, JC, McArthur, C, Angus, DC, Webb, SA, Orford, Neil, Arabi, YM, Gordon, AC, Derde, LPG, Nichol, AD, Murthy, S, Beidh, FA, Annane, D, Swaidan, LA, Beane, A, Beasley, R, Berry, LR, Bhimani, Z, Bonten, MJM, Bradbury, CA, Brunkhorst, FM, Buxton, M, Buzgau, A, Cheng, A, De Jong, M, Detry, MA, Duffy, EJ, Estcourt, LJ, Fitzgerald, M, Fowler, R, Girard, TD, Goligher, EC, Goossens, H, Haniffa, R, Higgins, AM, Hills, TE, Horvat, CM, Huang, DT, King, AJ, Lamontagne, F, Lawler, PR, Lewis, R, Linstrum, K, Litton, E, Lorenzi, E, Malakouti, S, McAuley, DF, McGlothlin, A, Mcguinness, S, McVerry, BJ, Montgomery, SK, Morpeth, SC, Mouncey, PR, Orr, K, Parke, R, Parker, JC, Patanwala, AE, Rowan, KM, Santos, MS, Saunders, CT, Seymour, CW, Shankar-Hari, M, Tong, SYC, Turgeon, AF, Turner, AM, Van de Veerdonk, FL, Zarychanski, R, Green, C, Berry, S, Marshall, JC, McArthur, C, Angus, DC, Webb, SA, and Orford, Neil
Published: 2021

35. Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke

Author: Whitlock, RP, Belley-Cote, EP, Paparella, D, Healey, JS, Brady, K, Sharma, M, Reents, W, Budera, P, Baddour, AJ, Fila, P, Devereaux, PJ, Bogachev-Prokophiev, A, Boening, A, Teoh, KHT, Tagarakis, GI, Slaughter, MS, Royse, AG, McGuinness, S, Alings, M, Punjabi, PP, Mazer, CD, Folkeringa, RJ, Colli, A, Avezum, A, Nakamya, J, Balasubramanian, K, Vincent, J, Voisine, P, Lamy, A, Yusuf, S, Connolly, SJ, Whitlock, RP, Belley-Cote, EP, Paparella, D, Healey, JS, Brady, K, Sharma, M, Reents, W, Budera, P, Baddour, AJ, Fila, P, Devereaux, PJ, Bogachev-Prokophiev, A, Boening, A, Teoh, KHT, Tagarakis, GI, Slaughter, MS, Royse, AG, McGuinness, S, Alings, M, Punjabi, PP, Mazer, CD, Folkeringa, RJ, Colli, A, Avezum, A, Nakamya, J, Balasubramanian, K, Vincent, J, Voisine, P, Lamy, A, Yusuf, S, and Connolly, SJ
Abstract: BACKGROUND: Surgical occlusion of the left atrial appendage has been hypothesized to prevent ischemic stroke in patients with atrial fibrillation, but this has not been proved. The procedure can be performed during cardiac surgery undertaken for other reasons. METHODS: We conducted a multicenter, randomized trial involving participants with atrial fibrillation and a CHA2DS2-VASc score of at least 2 (on a scale from 0 to 9, with higher scores indicating greater risk of stroke) who were scheduled to undergo cardiac surgery for another indication. The participants were randomly assigned to undergo or not undergo occlusion of the left atrial appendage during surgery; all the participants were expected to receive usual care, including oral anticoagulation, during follow-up. The primary outcome was the occurrence of ischemic stroke (including transient ischemic attack with positive neuroimaging) or systemic embolism. The participants, research personnel, and primary care physicians (other than the surgeons) were unaware of the trial-group assignments. RESULTS: The primary analysis population included 2379 participants in the occlusion group and 2391 in the no-occlusion group, with a mean age of 71 years and a mean CHA2DS2-VASc score of 4.2. The participants were followed for a mean of 3.8 years. A total of 92.1% of the participants received the assigned procedure, and at 3 years, 76.8% of the participants continued to receive oral anticoagulation. Stroke or systemic embolism occurred in 114 participants (4.8%) in the occlusion group and in 168 (7.0%) in the no-occlusion group (hazard ratio, 0.67; 95% confidence interval, 0.53 to 0.85; P = 0.001). The incidence of perioperative bleeding, heart failure, or death did not differ significantly between the trial groups. CONCLUSIONS: Among participants with atrial fibrillation who had undergone cardiac surgery, most of whom continued to receive ongoing antithrombotic therapy, the risk of ischemic stroke or systemic embolism was
Published: 2021

36. Open-label, phase II study of routine high-flow nasal oxygen therapy in cardiac surgical patients

Author: Parke, R., McGuinness, S., Dixon, R., and Jull, A.
Published: 2013
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37. The randomized embedded multifactorial adaptive platform for community-acquired pneumonia (REMAP-CAP) study: rationale and design

Author: Angus, DC, Berry, S, Lewis, RJ, Al-Beidh, F, Arabi, Y, Van Bentum-Puijk, W, Bhimani, Z, Bonten, M, Broglio, K, Brunkhorst, F, Cheng, AC, Chiche, J-D, De Jong, M, Detry, M, Goossens, H, Gordon, A, Green, C, Higgins, AM, Hullegie, SJ, Kruger, P, Lamontagne, F, Litton, E, Marshall, J, McGlothlin, A, McGuinness, S, Mouncey, P, Murthy, S, Nichol, A, O'Neill, GK, Parke, R, Parker, J, Rohde, G, Rowan, K, Turner, A, Young, P, Derde, L, McArthur, C, Webb, SA, and NIHR
Subjects: Respiratory System, 1103 Clinical Sciences
Abstract: There is broad interest in improved methods to generate robust evidence regarding best practice, especially in settings where patient conditions are heterogenous and require multiple concomitant therapies. Here, we present the rationale and design of a large, international trial that combines features of adaptive platform trials with pragmatic point-of-care trials to determine best treatment strategies for patients admitted to an intensive care unit with severe community-acquired pneumonia (CAP). The trial uses a novel design entitled a randomized embedded multifactorial adaptive platform (REMAP). The design has 5 key features: i.) randomization, allowing robust causal inference; ii.) embedding of study procedures into routine care processes, facilitating enrollment, trial efficiency, and generalizability; iii.) a multifactorial statistical model comparing multiple interventions across multiple patient subgroups; iv.) response-adaptive randomization with preferential assignment to those interventions that appear most favorable, and v.) a platform structured to permit continuous, potentially perpetual enrollment beyond the evaluation of the initial treatments. The trial randomizes patients to multiple interventions within 4 treatment domains: antibiotics, antiviral therapy for influenza, host immunomodulation with extended macrolide therapy, and alternative corticosteroid regimens, representing 240 treatment regimens. The trial generates estimates of superiority, inferiority and equivalence between regimens on the primary outcome of 90-day mortality, stratified by presence or absence of concomitant shock and proven or suspected influenza infection. The trial will also compare ventilatory and oxygenation strategies and has capacity to address additional questions rapidly during pandemic respiratory infections. As of January 2020, REMAP-CAP was approved and enrolling patients in 52 ICUs in 13 countries in 3 continents. In February, it transitioned into pandemic mode with several design adaptations for COVID-19 disease. Lessons learned from the design and conduct of this trial should aid in dissemination of similar platform initiatives in other disease areas. Clinical trial registered with ClinicalTrials.gov (NCT02735707)
Published: 2020

38. A pilot randomized controlled trial of 7 versus 14 days of antibiotic treatment for bloodstream infection on non-intensive care versus intensive care wards.

Author: Whitlock R., Reynolds S., Rogers B.A., Shehabi Y., Shin P., Fowler R.A., Daneman N., Rishu A.H., Pinto R., Arabi Y., Belley-Cote E.P., Cirone R., Downing M., Cook D.J., Hall R., McGuinness S., McIntyre L., Muscedere J., Parke R., Whitlock R., Reynolds S., Rogers B.A., Shehabi Y., Shin P., Fowler R.A., Daneman N., Rishu A.H., Pinto R., Arabi Y., Belley-Cote E.P., Cirone R., Downing M., Cook D.J., Hall R., McGuinness S., McIntyre L., Muscedere J., and Parke R.
Abstract: Background: The optimal treatment duration for patients with bloodstream infection is understudied. The Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness (BALANCE) pilot randomized clinical trial (RCT) determined that it was feasible to enroll and randomize intensive care unit (ICU) patients with bloodstream infection to 7 versus 14 days of treatment, and served as the vanguard for the ongoing BALANCE main RCT. We performed this BALANCE-Ward pilot RCT to examine the feasibility and impact of potentially extending the BALANCE main RCT to include patients hospitalized on non-ICU wards. Method(s): We conducted an open pilot RCT among a subset of six sites participating in the ongoing BALANCE RCT, randomizing patients with positive non-Staphylococcus aureus blood cultures on non-ICU wards to 7 versus 14 days of antibiotic treatment. The co-primary feasibility outcomes were recruitment rate and adherence to treatment duration protocol. We compared feasibility outcomes, patient/pathogen characteristics, and overall outcomes among those enrolled in this BALANCE-Ward and prior BALANCE-ICU pilot RCTs. We estimated the sample size and non-inferiority margin impacts of expanding the BALANCE main RCT to include non-ICU patients. Result(s): A total of 134 patients were recruited over 47 site-months (mean 2.9 patients/site-month, median 1.0, range 0.1-4.4 patients/site-month). The overall recruitment rate exceeded the BALANCE-ICU pilot RCT (mean 1.10 patients/site-month, p < 0.0001). Overall protocol adherence also exceeded the adherence in the BALANCE-ICU pilot RCT (125/134, 93% vs 89/115, 77%, p = 0.0003). BALANCE-Ward patients were older, with lower Sequential Organ Failure Assessment scores, and higher proportions of infections caused by Escherichia coli and genito-urinary sources of bloodstream infection. The BALANCE-Ward pilot RCT patients had an overall 90-day mortality rate of 17/133 (12.8%), which was comparable to the 90-day mortality rate in the I
Published: 2020

39. Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness (BALANCE) randomised clinical trial: Study protocol.

Author: Shehabi Y., Muscedere J., Parke R., Reynolds S., Rogers B., Fowler R.A., Daneman N., Rishu A.H., Pinto R.L., Arabi Y.M., Cook D.J., Hall R., McGuinness S., Shehabi Y., Muscedere J., Parke R., Reynolds S., Rogers B., Fowler R.A., Daneman N., Rishu A.H., Pinto R.L., Arabi Y.M., Cook D.J., Hall R., and McGuinness S.
Abstract: Introduction Bloodstream infections are a leading cause of mortality and morbidity; the duration of treatment for these infections is understudied. Methods and analysis We will conduct an international, multicentre randomised clinical trial of shorter (7 days) versus longer (14 days) antibiotic treatment among hospitalised patients with bloodstream infections. The trial will include 3626 patients across 60 hospitals and 6 countries. We will include patients with blood cultures confirming a pathogenic bacterium after hospital admission. Exclusion criteria will include patient factors (severe immunosuppression), infection site factors (endocarditis, osteomyelitis, undrained abscesses, infected prosthetic material) and pathogen factors (Staphylococcus aureus, Staphylococcus lugdunensis, Candida and contaminant organisms). We will leave the selection of specific antibiotics, doses and route of delivery to the discretion of treating physicians; no placebo control will be used given the diversity of pathogens and sources of bacteraemia. The intervention will be assignment of treatment duration to be 7 versus 14 days. We will minimise selection bias via central randomisation with variable block sizes, with concealed allocation until day 7 of adequate antibiotic treatment. The primary outcome is 90-day survival; we will test whether 7 days is non-inferior to 14 days of treatment, with a non-inferiority margin of 4% absolute mortality. Secondary outcomes include hospital and intensive care unit (ICU) mortality, relapse rates of bacteraemia, hospital and ICU length of stay, mechanical ventilation and vasopressor duration, antibiotic-free days, Clostridium difficile infection, antibiotic allergy and adverse events and colonisation/infection with antibiotic-resistant organisms. Ethics and dissemination The study has been approved by the ethics review board at each participating site. Sunnybrook Health Sciences Centre is the central ethics committee. We will disseminate study re
Published: 2020

40. Effect of hydrocortisone on mortality and organ support in patients with severe COVID-19: the REMAP-CAP COVID-19 corticosteroid domain randomized clinical trial

Author: Angus, DC, Derde, L, Al-Beidh, F, Annane, D, Arabi, Y, Beane, A, Van Bentum-Puijk, W, Berry, L, Bhimani, Z, Bonten, M, Bradbury, C, Brunkhorst, F, Buxton, M, Buzgau, A, Cheng, AC, De Jong, M, Detry, M, Estcourt, L, Fitzgerald, M, Goossens, H, Green, C, Haniffa, R, Higgins, AM, Horvat, C, Hullegie, SJ, Kruger, P, Lamontagne, F, Lawler, PR, Linstrum, K, Litton, E, Lorenzi, E, Marshall, J, McAuley, D, McGlothin, A, McGuinness, S, McVerry, B, Montgomery, S, Mouncey, P, Murthy, S, Nichol, A, Parke, R, Parker, J, Rowan, K, Sanil, A, Santos, M, Saunders, C, Seymour, C, Turner, A, Van De Veerdonk, F, Venkatesh, B, Zarychanski, R, Berry, S, Lewis, RJ, McArthur, C, Webb, SA, Gordon, AC, Orford, Neil, Angus, DC, Derde, L, Al-Beidh, F, Annane, D, Arabi, Y, Beane, A, Van Bentum-Puijk, W, Berry, L, Bhimani, Z, Bonten, M, Bradbury, C, Brunkhorst, F, Buxton, M, Buzgau, A, Cheng, AC, De Jong, M, Detry, M, Estcourt, L, Fitzgerald, M, Goossens, H, Green, C, Haniffa, R, Higgins, AM, Horvat, C, Hullegie, SJ, Kruger, P, Lamontagne, F, Lawler, PR, Linstrum, K, Litton, E, Lorenzi, E, Marshall, J, McAuley, D, McGlothin, A, McGuinness, S, McVerry, B, Montgomery, S, Mouncey, P, Murthy, S, Nichol, A, Parke, R, Parker, J, Rowan, K, Sanil, A, Santos, M, Saunders, C, Seymour, C, Turner, A, Van De Veerdonk, F, Venkatesh, B, Zarychanski, R, Berry, S, Lewis, RJ, McArthur, C, Webb, SA, Gordon, AC, and Orford, Neil
Published: 2020

41. Conservative oxygen therapy for mechanically ventilated adults with sepsis: a post hoc analysis of data from the intensive care unit randomized trial comparing two approaches to oxygen therapy (ICU-ROX)

Author: Young, P, Mackle, D, Bellomo, R, Bailey, M, Beasley, R, Deane, A, Eastwood, G, Finfer, S, Freebairn, R, King, V, Linke, N, Litton, E, McArthur, C, McGuinness, S, Panwar, R, Young, P, Mackle, D, Bellomo, R, Bailey, M, Beasley, R, Deane, A, Eastwood, G, Finfer, S, Freebairn, R, King, V, Linke, N, Litton, E, McArthur, C, McGuinness, S, and Panwar, R
Abstract: PURPOSE: Sepsis is a common reason for intensive care unit (ICU) admission and mortality in ICU patients. Despite increasing interest in treatment strategies limiting oxygen exposure in ICU patients, no trials have compared conservative vs. usual oxygen in patients with sepsis. METHODS: We undertook a post hoc analysis of the 251 patients with sepsis enrolled in a trial that compared conservative oxygen therapy with usual oxygen therapy in 1000 mechanically ventilated ICU patients. The primary end point for the current analysis was 90-day mortality. Key secondary outcomes were cause-specific mortality, ICU and hospital length of stay, ventilator-free days, vasopressor-free days, and the proportion of patients receiving renal replacement therapy in the ICU. RESULTS: Patients with sepsis allocated to conservative oxygen therapy spent less time in the ICU with an SpO2 ≥ 97% (23.5 h [interquartile range (IQR) 8-70] vs. 47 h [IQR 11-93], absolute difference, 23 h; 95% CI 8-38), and more time receiving an FiO2 of 0.21 than patients allocated to usual oxygen therapy (20.5 h [IQR 1-79] vs. 0 h [IQR 0-10], absolute difference, 20 h; 95% CI 14-26). At 90-days, 47 of 130 patients (36.2%) assigned to conservative oxygen and 35 of 120 patients (29.2%) assigned to usual oxygen had died (absolute difference, 7 percentage points; 95% CI - 4.6 to 18.6% points; P = 0.24; interaction P = 0.35 for sepsis vs. non-sepsis). There were no statistically significant differences between groups for secondary outcomes but point estimates of treatment effects consistently favored usual oxygen therapy. CONCLUSIONS: Point estimates for the treatment effect of conservative oxygen therapy on 90-day mortality raise the possibility of clinically important harm with this intervention in patients with sepsis; however, our post hoc analysis was not powered to detect the effects suggested and our data do not exclude clinically important benefit or harm from conservative oxygen therapy in this patient grou
Published: 2020

42. Conservative Oxygen Therapy during Mechanical Ventilation in the ICU

Author: Mackle, D, Bellomo, MNR, Bailey, M, Beasley, R, Deane, A, Eastwood, G, Finfer, S, Freebairn, R, King, V, Linke, N, Litton, E, McArthur, C, McGuinness, S, Panwar, R, Young, P, Mackle, D, Bellomo, MNR, Bailey, M, Beasley, R, Deane, A, Eastwood, G, Finfer, S, Freebairn, R, King, V, Linke, N, Litton, E, McArthur, C, McGuinness, S, Panwar, R, and Young, P
Abstract: BACKGROUND: Patients who are undergoing mechanical ventilation in the intensive care unit (ICU) often receive a high fraction of inspired oxygen (Fio2) and have a high arterial oxygen tension. The conservative use of oxygen may reduce oxygen exposure, diminish lung and systemic oxidative injury, and thereby increase the number of ventilator-free days (days alive and free from mechanical ventilation). METHODS: We randomly assigned 1000 adult patients who were anticipated to require mechanical ventilation beyond the day after recruitment in the ICU to receive conservative or usual oxygen therapy. In the two groups, the default lower limit for oxygen saturation as measured by pulse oximetry (Spo2) was 90%. In the conservative-oxygen group, the upper limit of the Spo2 alarm was set to sound when the level reached 97%, and the Fio2 was decreased to 0.21 if the Spo2 was above the acceptable lower limit. In the usual-oxygen group, there were no specific measures limiting the Fio2 or the Spo2. The primary outcome was the number of ventilator-free days from randomization until day 28. RESULTS: The number of ventilator-free days did not differ significantly between the conservative-oxygen group and the usual-oxygen group, with a median duration of 21.3 days (interquartile range, 0 to 26.3) and 22.1 days (interquartile range, 0 to 26.2), respectively, for an absolute difference of -0.3 days (95% confidence interval [CI], -2.1 to 1.6; P = 0.80). The conservative-oxygen group spent more time in the ICU with an Fio2 of 0.21 than the usual-oxygen group, with a median duration of 29 hours (interquartile range, 5 to 78) and 1 hour (interquartile range, 0 to 17), respectively (absolute difference, 28 hours; 95% CI, 22 to 34); the conservative-oxygen group spent less time with an Spo2 exceeding 96%, with a duration of 27 hours (interquartile range, 11 to 63.5) and 49 hours (interquartile range, 22 to 112), respectively (absolute difference, 22 hours; 95% CI, 14 to 30). At 180 days, mo
Published: 2020

43. Conservative oxygen therapy for mechanically ventilated adults with suspected hypoxic ischaemic encephalopathy

Author: Young, P, Mackle, D, Bellomo, R, Bailey, M, Beasley, R, Deane, A, Eastwood, G, Finfer, S, Freebairn, R, King, V, Linke, N, Litton, E, McArthur, C, McGuinness, S, Panwar, R, Young, P, Mackle, D, Bellomo, R, Bailey, M, Beasley, R, Deane, A, Eastwood, G, Finfer, S, Freebairn, R, King, V, Linke, N, Litton, E, McArthur, C, McGuinness, S, and Panwar, R
Abstract: PURPOSE: Liberal use of oxygen may contribute to secondary brain injury in patients with hypoxic-ischaemic encephalopathy (HIE). However, there are limited data on the effect of different oxygen regimens on survival and neurological disability in HIE patients. METHODS: We undertook a post-hoc analysis of the 166 patients with suspected HIE enrolled in a trial comparing conservative oxygen therapy with usual oxygen therapy in 1000 mechanically ventilated ICU patients. The primary endpoint for the current analysis was death or unfavourable neurological outcome at day 180. Key secondary outcomes were day 180 mortality, and cause-specific mortality. RESULTS: Patients with HIE allocated to conservative oxygen spent less time in the ICU with an SpO2 ≥ 97% (26 h [interquartile range (IQR) 13-45 vs. 35 h [IQR 19-70], absolute difference, 9 h; 95% CI - 21.4 to 3.4). A total of 43 of 78 patients (55.1%) assigned to conservative oxygen and 49 of 72 patients (68.1%) assigned to usual oxygen died or had an unfavourable neurological outcome at day 180; odds ratio 0.58; 95% CI 0.3-1.12; P = 0.1 adjusted odds ratio 0.54; 95% CI 0.23-1.26; P = 0.15. A total of 37 of 86 patients (43%) assigned to conservative oxygen and 46 of 78 (59%) assigned to usual oxygen had died by day 180; odds ratio 0.53; 95% CI 0.28-0.98; P = 0.04; adjusted odds ratio 0.56; 95% CI 0.25-1.23; P = 0.15. Cause-specific mortality was similar by treatment group. CONCLUSIONS: Conservative oxygen therapy was not associated with a statistically significant reduction in death or unfavourable neurological outcomes at day 180. The potential for important benefit or harm from conservative oxygen therapy in HIE patients is not excluded by these data.
Published: 2020

44. Conscience, Abortion and Jurisdiction

Author: McGuinness, S, Thomson, M, McGuinness, S, and Thomson, M
Abstract: Abstract Conscientious objection has achieved a particular place in contemporary law and culture. Lawyers, political theorists, ethicists, health professionals and others have debated how we best negotiate the tensions that can exist between professional obligations and private beliefs. Conscientious objection to abortion care has been a particular focus of these discussions. In this article, we draw on theoretical work on ‘jurisdiction’ to provide an account of what is embedded in claims to conscience and what the effects of such claims are. We focus specifically on refusals of abortion care enabled by section 4 of the Abortion Act 1967. We argue that legitimating narratives on conscience seek to achieve seemingly contradictory goals: entrenching abortion as morally ambiguous while securing it as part of medicine’s monopolistic practice. While section 4 provides the focus, our concerns extend to the wider landscape and impact of claims to conscience. Through our jurisdictional analysis, we seek to better understand such claims and dramatically reorient thinking by grounding the conscience clause squarely in the politics of ‘task areas’, professional domains, market control and claims of epistemological authority.
Published: 2020

45. Progression of otitis media with effusion in the Cavalier King Charles spaniel

Author: McGuinness, S. J., Friend, E. J., Knowler, S. P., Jeffery, N. D., and Rusbridge, C.
Published: 2013
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46. Intensity of a weak 519-keV γ ray following β decay of the superallowed emitter Ar34 determined via the S33 ( p,γ ) Cl34 reaction

Author: Park, H. I., primary, Hardy, J. C., additional, Bencomo, M., additional, Iacob, V. E., additional, Towner, I. S., additional, Macon, K. T., additional, Tan, W. P., additional, Brodeur, M., additional, Boeltzig, A., additional, Frentz, B., additional, Henderson, S. L., additional, Long, J., additional, McGuinness, S., additional, Olivas-Gomez, O., additional, O'Malley, P., additional, Seymour, G., additional, Vande Kolk, B., additional, and Kayani, A., additional
Published: 2020
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47. Indirect study of the 3He(n, p)3H reaction at cosmological energies

Author: Spampinato, C., primary, Pizzone, R.G., additional, Spart`a, R., additional, Couder, M., additional, Tan, W., additional, Burian, V., additional, Chae, K.Y., additional, D’Agata, G., additional, Guardo, G.L., additional, La Cognata, M., additional, Lamia, L., additional, Lattuada, D., additional, Mrazek, J., additional, Oliva, A., additional, Palmerini, S., additional, Prajapati, P., additional, Rapisarda, G.G., additional, Romano, S., additional, Sergi, M.L., additional, Spitaleri, C., additional, Tumino, A., additional, Wiescher, M., additional, Anguilar, S., additional, Bardayan, D.W., additional, Blankstein, D., additional, Boccioli, L., additional, Callahan, L., additional, Clark, A., additional, Frentz, B., additional, Hall, M., additional, Gula, A., additional, Henderson, S., additional, Kelmar, R., additional, Liu, Q., additional, Long, J., additional, Majumdar, A., additional, McGuinness, S., additional, Nelson, A., additional, O’Malley, P.D., additional, Seymour, C., additional, Skulski, M., additional, and Wilkinson, J., additional
Published: 2020
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48. Indirect measurement of the $$^3\hbox {He}$$(n,p)$$^3\hbox {H}$$ reaction cross section at Big Bang energies

Author: Pizzone, R. G., primary, Spampinato, C., additional, Spartá, R., additional, Couder, M., additional, Tan, W., additional, Burjan, V., additional, D’Agata, G., additional, Guardo, G. L., additional, La Cognata, M., additional, Lamia, L., additional, Mrazek, J., additional, Palmerini, S., additional, Typel, S., additional, Tumino, A., additional, Wiescher, M., additional, Anguilar, S., additional, Bardayan, D., additional, Blankstein, D., additional, Boccioli, L., additional, Callahan, L., additional, Cha, S. M., additional, Chae, K. Y., additional, Clark, A. M., additional, Frentz, B., additional, Hall, M. R., additional, Gula, A., additional, Henderson, S., additional, Kelmar, R., additional, Kwag, M. S., additional, Indelicato, I., additional, La Commara, M., additional, Lattuada, D., additional, Liu, Q., additional, Long, J., additional, Mazzocco, M., additional, Majumdar, A., additional, McGuinness, S., additional, Nelson, A., additional, Oliva, A. A., additional, O’Malley, P., additional, Prajapati, P. M., additional, Rapisarda, G. G., additional, Romano, S., additional, Sergi, M. L., additional, Seymour, C., additional, Skulski, M., additional, Spitaleri, C., additional, and Wilkinson, J., additional
Published: 2020
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49. A Survey of Extracorporeal Membrane Oxygenation Practice in 23 Australian Adult Intensive Care Units

Author: Hodgson, C.L., primary, Linke, N., additional, Fulcher, B., additional, Engeler, D., additional, Anderson, S., additional, Bernard, S., additional, Board, J., additional, Brodie, D., additional, Buhr, H., additional, Burrell, A., additional, Cooper, D.J., additional, Fan, E., additional, Higgins, A., additional, Fraser, J., additional, Gattas, D., additional, Hopper, I., additional, Huckson, S., additional, Litton, E., additional, Nair, P., additional, Orford, N., additional, McGuinness, S., additional, Parke, R., additional, Pilcher, D., additional, Sheldrake, J., additional, Udy, A., additional, Reddi, B., additional, Trapani, A., additional, Stub, D., additional, and Pellegrino, V., additional
Published: 2020
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50. Greenstart: protection challenges with integrating wind power parks into system restoration

Author: McGuinness, S., primary, Kelly, A., additional, and Singhvi, V., additional
Published: 2020
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