155 results on '"Parker SG"'
Search Results
2. An established abdominal wall multidisciplinary team improves patient care and aids surgical decision making with complex ventral hernia patients
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Parker, SG, primary, Blake, H, additional, Zhao, S, additional, van Dellen, J, additional, Mohamed, S, additional, Albadry, W, additional, Akhtar, H, additional, Franczak, B, additional, Jakkalasaibaba, R, additional, Rothnie, A, additional, and Thomas, Rhys, additional
- Published
- 2023
- Full Text
- View/download PDF
3. Age and Ageing to introduce a new category of paper: healthcare improvement science
- Author
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Parker, SG, Downes, T, Godfrey, M, Matthews, R, and Martin, FC
- Abstract
Age and Ageing is now inviting papers on healthcare improvement for older people. In this article we outline the nature and scope of healthcare improvement and reference improvement models and the tools and methods of improvement science. We emphasise the issues of sustainability, including scale and spread; evaluation - including associated ethical consideration and the involvement of patients and the public in healthcare improvement and associated research. Throughout we refer to resources the authors have found useful in their own work, and provide a bibliography of sources and web-links which will provide essential guidance and support for potential contributors to this new category of submission to Age and Ageing.
- Published
- 2019
4. Forming Ferrocenyl Self-Assembled Monolayers on Si(100) Electrodes with Different Alkyl Chain Lengths for Electron Transfer Studies
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Ahmad, SAA, Ciampi, S, Parker, SG, Gonçales, VR, Gooding, JJ, Ahmad, SAA, Ciampi, S, Parker, SG, Gonçales, VR, and Gooding, JJ
- Abstract
The reaction of hydrogen-terminated Si(100) with 1,8-nonadiyne was previously shown to afford robust surfaces where oxidation of the substrate is not evident. Here, the experimental conditions required for reacting hydrogen-terminated Si(100) with α,ω-diynes of different lengths is explored via thermal hydrosilylation of 1,6-heptadiyne, 1,8-nonadiyne, 1,10-undecadiyne and 1,15-hexadecadiyne. X-ray photoelectron spectroscopy indicated monolayers were successfully formed with oxide levels below the XPS detection limit for molecules with lengths varying from 7 to 11 carbons. It was observed that the apparent rate of electron transfer (ket) was affected not only by the SAM thickness, but also by hopping between ferrocene moieties where the presence of tiny oxidative defects act as electron transfer hotspots.
- Published
- 2019
5. Amorphous silicon on indium tin oxide: a transparent electrode for simultaneous light activated electrochemistry and optical microscopy
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Lian, J, Yang, Y, Wang, W, Parker, SG, Gonçales, VR, Tilley, RD, Gooding, JJ, Lian, J, Yang, Y, Wang, W, Parker, SG, Gonçales, VR, Tilley, RD, and Gooding, JJ
- Abstract
Herein is reported a new type of transparent electrode, prepared by depositing a thin layer of amorphous silicon film on indium tin oxide, which enables photoswitchable electrochemistry and optical imaging to be performed simultaneously. This offers the opportunity to visualise a spatially controlled electrochemical event on an unstructured electrode surface.
- Published
- 2019
6. DNA-Hybridization Detection on Si(100) Surfaces Using Light-Activated Electrochemistry: A Comparative Study between Bovine Serum Albumin and Hexaethylene Glycol as Antifouling Layers
- Author
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Zarei, L, Tavallaie, R, Choudhury, MH, Parker, SG, Bakthavathsalam, P, Ciampi, S, Gonçales, VR, Gooding, JJ, Zarei, L, Tavallaie, R, Choudhury, MH, Parker, SG, Bakthavathsalam, P, Ciampi, S, Gonçales, VR, and Gooding, JJ
- Abstract
Light can be used to spatially resolve electrochemical measurements on a semiconductor electrode. This phenomenon has been explored to detect DNA hybridization with light-addressable potentiometric sensors and, more recently, with light-addressable amperometric sensors based on organic-monolayer-protected Si(100). Here, a contribution to the field is presented by comparing sensing performances when bovine serum albumin (BSA) and hexaethylene glycol (OEG 6 ) are employed as antifouling layers that resist nonspecific adsorption to the DNA-modified interface on Si(100) devices. What is observed is that both sensors based on BSA or OEG 6 initially allow electrochemical distinction among complementary, noncomplementary, and mismatched DNA targets. However, only surfaces based on OEG 6 can sustain electroactivity over time. Our results suggest that this relates to accelerated SiO x formation occasioned by BSA proteins adsorbing on monolayer-protected Si(100) surfaces. Therefore, DNA biosensors were analytically explored on low-doped Si(100) electrodes modified on the molecular level with OEG 6 as an antifouling layer. First, light-activated electrochemical responses were recorded over a range of complementary DNA target concentrations. A linear semilog relation was obtained from 1.0 × 10 -11 to 1.0 × 10 -6 mol L -1 with a correlation coefficient of 0.942. Then, measurements with three independent surfaces indicated a relative standard deviation of 4.5%. Finally, selectivity tests were successfully performed in complex samples consisting of a cocktail mixture of four different DNA sequences. Together, these results indicate that reliable and stable light-activated amperometric DNA sensors can be achieved on Si(100) by employing OEG 6 as an antifouling layer.
- Published
- 2018
7. A photoelectrochemical platform for the capture and release of rare single cells
- Author
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Parker, SG, Yang, Y, Ciampi, S, Gupta, B, Kimpton, K, Mansfeld, FM, Kavallaris, M, Gaus, K, Justin Gooding, J, Parker, SG, Yang, Y, Ciampi, S, Gupta, B, Kimpton, K, Mansfeld, FM, Kavallaris, M, Gaus, K, and Justin Gooding, J
- Abstract
For many normal and aberrant cell behaviours, it is important to understand the origin of cellular heterogeneity. Although powerful methods for studying cell heterogeneity have emerged, they are more suitable for common rather than rare cells. Exploring the heterogeneity of rare single cells is challenging because these rare cells must be first pre-concentrated and undergo analysis prior to classification and expansion. Here, a versatile capture & release platform consisting of an antibody-modified and electrochemically cleavable semiconducting silicon surface for release of individual cells of interest is presented. The captured cells can be interrogated microscopically and tested for drug responsiveness prior to release and recovery. The capture & release strategy was applied to identify rare tumour cells from whole blood, monitor the uptake of, and response to, doxorubicin and subsequently select cells for single-cell gene expression based on their response to the doxorubicin.
- Published
- 2018
8. Proposal for a national triage system for the management of ventral hernias
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Parker, SG, primary, Reid, TH, additional, Boulton, R, additional, Wood, C, additional, Sanders, D, additional, and Windsor, AJC, additional
- Published
- 2018
- Full Text
- View/download PDF
9. Light-activated electrochemistry without surface-bound redox species
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Kashi, MB, Silva, SM, Yang, Y, Gonçales, VR, Parker, SG, Barfidokht, A, Ciampi, S, Gooding, JJ, Kashi, MB, Silva, SM, Yang, Y, Gonçales, VR, Parker, SG, Barfidokht, A, Ciampi, S, and Gooding, JJ
- Abstract
Semiconducting electrodes that are in depletion, can support appreciable electron transfer only when illuminated. This phenomenon has been implemented on silicon electrodes passivated by a protective organic self-assembled monolayer (SAM) to confine electrochemistry to microscale regions on an unstructured electrode surface by shining light only on those regions. This method, referred to as light-activated electrochemistry (LAE), has so far only been studied using electrodes with surface-bound redox mediators that are either covalently or electrostatically attached to a SAM-modified silicon electrode. In the current report, we extend LAE to redox species in solution using gold nanoparticles (AuNPs) attached to the SAM-modified silicon electrodes. Cyclic voltammetry showed that faradaic electron transfer to redox species in solution can be switched on/off using light. Furthermore, the modified silicon electrodes were stable to more than 650 redox cycles, even when scanning to anodic potentials, with negligible oxide growth and no noticeable change in the voltammograms. Using a variety of redox species in solution, it was shown that with n−-Si-SAM-AuNP electrodes negligible current was observed in the dark but appreciable faradaic electrochemistry was observed upon illumination. It was also shown that to ensure electron transfer proceeded via the AuNPs only, nonspecific adsorption of the redox species to the monolayer surface needed to be avoided.
- Published
- 2017
10. Light-Induced Hydrogel Based on Tumor-Targeting Mesoporous Silica Nanoparticles as a Theranostic Platform for Sustained Cancer Treatment
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Chen, X, Liu, Z, Parker, SG, Zhang, X, Gooding, JJ, Ru, Y, Liu, Y, Zhou, Y, Chen, X, Liu, Z, Parker, SG, Zhang, X, Gooding, JJ, Ru, Y, Liu, Y, and Zhou, Y
- Abstract
Herein, we report a facile fabrication of a polymer (azobenzene and α-cyclodextrin-functionalized hyaluronic acid) and gold nanobipyramids (AuNBs) conjugated mesoporous silica nanoparticles (MSNs) to be used as an injectable drug delivery system for sustained cancer treatment. Because of the specific affinity between the hyaluronic acid (HA) on MSNs and the CD44 antigen overexpressed on tumor cells, the MSNs can selectively attach to tumor cells. The nanocomposite material then exploits thermoresponsive interactions between α-cyclodextrin and azobenzene, and the photothermal properties of gold nanobipyramids, to in situ self-assemble into a hydrogel under near-infrared (NIR) radiation. Upon gelation, the drug (doxorubicin)-loaded MSNs carriers were enclosed in the HA network of the hydrogel, whereas further degradation of the HA in the hydrogel due to the upregulation of hyaluronidase (HAase) around the tumor tissue will result in the release of MSNs from the hydrogel, which can then be taken by tumor cells and deliver their drug to the cell nuclei. This design is able to provide a microenvironment with rich anticancer drugs in, and around, the tumor tissue for time periods long enough to prevent the recrudescence of the disease. The extra efficacy that this strategy affords builds upon the capabilities of conventional therapies.
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- 2016
11. An antifouling electrode based on electrode–organic layer–nanoparticle constructs: Electrodeposited organic layers versus self-assembled monolayers
- Author
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Taufik, S, Barfidokht, A, Alam, MT, Jiang, C, Parker, SG, Gooding, JJ, Taufik, S, Barfidokht, A, Alam, MT, Jiang, C, Parker, SG, and Gooding, JJ
- Abstract
Electrodes modified with organic layers and nanoparticles are promising tools for analytical devices. A major challenge however is how to make electrodes that resist the nonspecific protein adsorption from biological media? Herein, we report gold electrode–organic layer-gold nanoparticle constructs as a platform for electrochemical biosensing. This study focuses on the fabrication of antifouling electrodes with the organic layers formed by two different approaches; self-assembled monolayer (SAM) procedure and electrochemical reduction of aryl diazonium salts, followed by the attachment of gold nanoparticle (AuNP) to allow the electrochemistry to proceed. The results show that the electrodes modified with ethylene oxide-based SAM enable a better antifouling behaviour with less adsorption of human serum albumin (HSA) as compared to the electrodes modified with ethylene oxide-based aryl diazonium-derived layer. Furthermore, findings suggest such distinction could be due to the surface packing and/or conformation of organic film on Au electrodes.
- Published
- 2016
12. Electric Field Modulation of Silicon upon Tethering of Highly Charged Nucleic Acids. Capacitive Studies on DNA-modified Silicon (111)
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Gebala, M, La Mantia, F, Michaels, PE, Ciampi, S, Gupta, B, Parker, SG, Tavallaie, R, Gooding, JJ, Gebala, M, La Mantia, F, Michaels, PE, Ciampi, S, Gupta, B, Parker, SG, Tavallaie, R, and Gooding, JJ
- Abstract
We provide complex capacitance studies which show that the tethering of negatively-charged DNA molecules to p-doped silicon (111), without intervening oxide layer, leads to changes of the electric field in the underlying silicon. We proposed, that the tethering of the DNA leads to the formation of surface states that, from the electronic point of view, resemble the major carriers of p-type silicon, i.e. holes. This effect is enhanced by the formation of double-stranded (ds)DNA molecules and hence is the premise to label-free detection of the DNA hybridization. Overall, our studies provide a promising alternative to design a biosensor to detect the hybridization of DNA molecules on the silicon surface.
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- 2016
13. Exome-wide analysis of rare coding variation identifies novel associations with COPD and airflow limitation in MOCS3, IFIT3 and SERPINA12
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Jackson, VE, Ntalla, I, Sayers, I, Morris, R, Whincup, P, Casas, J-P, Amuzu, A, Choi, M, Dale, C, Kumari, M, Engmann, J, Kalsheker, N, Chappell, S, Guetta-Baranes, T, McKeever, TM, Palmer, CNA, Tavendale, R, Holloway, JW, Sayer, AA, Dennison, EM, Cooper, C, Bafadhel, M, Barker, B, Brightling, C, Bolton, CE, John, ME, Parker, SG, Moffat, MF, Wardlaw, AJ, Connolly, MJ, Porteous, DJ, Smith, BH, Padmanabhan, S, Hocking, L, Stirrups, KE, Deloukas, P, Strachan, DP, Hall, IP, Tobin, MD, Wain, LV, Jackson, VE, Ntalla, I, Sayers, I, Morris, R, Whincup, P, Casas, J-P, Amuzu, A, Choi, M, Dale, C, Kumari, M, Engmann, J, Kalsheker, N, Chappell, S, Guetta-Baranes, T, McKeever, TM, Palmer, CNA, Tavendale, R, Holloway, JW, Sayer, AA, Dennison, EM, Cooper, C, Bafadhel, M, Barker, B, Brightling, C, Bolton, CE, John, ME, Parker, SG, Moffat, MF, Wardlaw, AJ, Connolly, MJ, Porteous, DJ, Smith, BH, Padmanabhan, S, Hocking, L, Stirrups, KE, Deloukas, P, Strachan, DP, Hall, IP, Tobin, MD, and Wain, LV
- Abstract
BACKGROUND: Several regions of the genome have shown to be associated with COPD in genome-wide association studies of common variants. OBJECTIVE: To determine rare and potentially functional single nucleotide polymorphisms (SNPs) associated with the risk of COPD and severity of airflow limitation. METHODS: 3226 current or former smokers of European ancestry with lung function measures indicative of Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2 COPD or worse were genotyped using an exome array. An analysis of risk of COPD was carried out using ever smoking controls (n=4784). Associations with %predicted FEV1 were tested in cases. We followed-up signals of interest (p<10(-5)) in independent samples from a subset of the UK Biobank population and also undertook a more powerful discovery study by meta-analysing the exome array data and UK Biobank data for variants represented on both arrays. RESULTS: Among the associated variants were two in regions previously unreported for COPD; a low frequency non-synonymous SNP in MOCS3 (rs7269297, pdiscovery=3.08×10(-6), preplication=0.019) and a rare SNP in IFIT3, which emerged in the meta-analysis (rs140549288, pmeta=8.56×10(-6)). In the meta-analysis of % predicted FEV1 in cases, the strongest association was shown for a splice variant in a previously unreported region, SERPINA12 (rs140198372, pmeta=5.72×10(-6)). We also confirmed previously reported associations with COPD risk at MMP12, HHIP, GPR126 and CHRNA5. No associations in novel regions reached a stringent exome-wide significance threshold (p<3.7×10(-7)). CONCLUSIONS: This study identified several associations with the risk of COPD and severity of airflow limitation, including novel regions MOCS3, IFIT3 and SERPINA12, which warrant further study.
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- 2016
14. A Ruthenium Based Organometallic Complex for Biosensing that is both a Stable Redox Label and a Homobifunctional Linker
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Lee, YY, Parker, SG, Barfidokht, A, Alam, MT, Walker, DB, Messerle, BA, Gooding, JJ, Lee, YY, Parker, SG, Barfidokht, A, Alam, MT, Walker, DB, Messerle, BA, and Gooding, JJ
- Abstract
A stable ruthenium-based redox label, Ru(acetylacetonate)2(bipyridine-NH2), has been synthesized with the target of circumventing the problem associated with the use of ferrocene for biosensing in solutions containing chloride ions. The redox species was shown to be highly stable with repeated cycling in biological buffers as well as being amenable to surface coupling reactions. To demonstrate the latter, the redox label was anchored onto a self-assembled monolayer of 6-mercaptohexanoic acid, using carbodiimide coupling, followed by binding of a pentapeptide to the redox label.
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- 2015
15. Switching 'on and off' faradaic electrochemistry at an otherwise passivated electrode using gold-coated magnetic nanoparticles
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Carter, L, Chuah, K, Tavallaie, R, Barfidokht, A, Parker, SG, Gooding, JJ, Carter, L, Chuah, K, Tavallaie, R, Barfidokht, A, Parker, SG, and Gooding, JJ
- Abstract
Herein we combined the use of self-assembled monolayer (SAM) modified electrodes and gold coated magnetic nanoparticles (Au@MNPs) to modulate faradaic electrochemistry when nanoparticles are absorbed on and removed from, a passivated electrode using an external magnetic field. Substantial faradaic electrochemistry of potassium ferricyanide in solution is first prevented by modifying gold electrodes with 11-mercaptoundecanoic acid to form a passivating SAM. Restoration of the faradaic electrochemistry is then achieved by introducing Au@MNPs which are brought to the surface using an external magnetic field. The faradaic electrochemistry can again be suppressed by removing Au@MNPs from the SAM using another external magnetic field.
- Published
- 2015
16. Single-cell isolation devices: Understanding the behaviour of cells
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Parker, SG, Gooding, JJ, Parker, SG, and Gooding, JJ
- Abstract
Practical usefulness in biological and clinical settings has become an important focus during the development and implementation of new instrumentation and assays. These developments have allowed it to become possible to determine gene- and protein-content, as well as mutations within the transcriptome of a single cell. In order to be able to reach the full potential of the available instrumentation and assays, it is required to develop a method to first isolate an individual cell. This review serves as an overview of available techniques for single-cell isolation by describing the biological information about a single cell that can be obtained from each technique.
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- 2015
17. Zwitterionic Phenyl Phosphorylcholine on Indium Tin Oxide: A Low-Impedance Protein-Resistant Platform for Biosensing
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Jiang, C, TanzirulAlam, M, Parker, SG, Gooding, JJ, Jiang, C, TanzirulAlam, M, Parker, SG, and Gooding, JJ
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In this study we have modified indium tin oxide (ITO) by electrografting phenylphosphorylcholine (PPC) and evaluated its protein-resistance performance using electrochemical impedance spectroscopy. During electrografting, significant amounts of PPC gets physically adsorbed on the surface, which cannot be removed by simply rinsing with water or buffer, and as a consequence the electrochemical response of such electrode is quite unstable. We have developed a simple protocol to remove the physically adsorbed PPC such that a stable interface is produced. It was found that such a stable surface, with appropriate amount of PPC, can dramatically reduce nonspecific adsorption of protein, giving us a platform of performing both electrochemical and spectroscopic studies in biological fluids.
- Published
- 2015
18. Variables Affecting Radiation Exposure in Patients under Going Endo-Urological Procedures
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Ahmed M, Parker Sg, and Kommu Ss
- Subjects
medicine.medical_specialty ,business.industry ,Triage Status ,Perioperative ,Omics ,Diagnostic modalities ,Surgery ,Radiation exposure ,Increased risk ,Patient harm ,Emergency medicine ,Medicine ,In patient ,business - Abstract
Introduction: Previously we have published data showing how clinician awareness surrounding radiation doses from common diagnostic modalities is poor. Evidence suggests that radiation exposure, from diagnostic and interventional procedures is placing patients at a small but significant increased risk of malignancy. As the usage of radiation in endourological surgery increases, urologists need to have an understanding of the variables affecting perioperative radiation exposure. Here we look at how the operating consultant, the patient triage status (elective vs. emergency admission) and the endourological procedure performed impacts upon perioperative radiation exposure. Method: One hundred patients, who had undergone an endourological procedure in 2012 were randomly selected. The image intensifiers were interrogated for stored data of radiation dose and screening times. Computerised patient records provided the consultant’s identity (A-D), the patient’s triage status and the exact endourological procedure performed. Results: There was no difference in radiation exposure when comparing elective and emergency patients. Endourological procedures requiring therapeutic intervention led to higher levels of radiation exposure when compared with diagnostic endourological procedures (p value
- Published
- 2013
19. Molecularly engineered surfaces for cell biology: From static to dynamic surfaces
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Gooding, JJ, Parker, SG, Lu, Y, Gaus, K, Gooding, JJ, Parker, SG, Lu, Y, and Gaus, K
- Abstract
Surfaces with a well-defined presentation of ligands for receptors on the cell membrane can serve as models of the extracellular matrix for studying cell adhesion or as model cell surfaces for exploring cell-cell contacts. Because such surfaces can provide exquisite control over, for example, the density of these ligands or when the ligands are presented to the cell, they provide a very precise strategy for understanding the mechanisms by which cells respond to external adhesive cues. In the present feature article, we present an overview of the basic biology of cell adhesion before discussing surfaces that have a static presentation of immobile ligands. We outline the biological information that such surfaces have given us, before progressing to recently developed switchable surfaces and surfaces that mimic the lipid bilayer, having adhesive ligands that can move around the membrane and be remodeled by the cell. Finally, the feature article closes with some of the biological information that these new types of surfaces could provide. © 2013 American Chemical Society.
- Published
- 2014
20. Investigation of the Antifouling Properties of Phenyl Phosphorylcholine-Based Modified Gold Surfaces
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Parviz, M, Darwish, N, Alam, MT, Parker, SG, Ciampi, S, Gooding, JJ, Parviz, M, Darwish, N, Alam, MT, Parker, SG, Ciampi, S, and Gooding, JJ
- Abstract
Low impedance, antifouling coatings on gold electrodes based on three new zwitterionic phenyl phosphorylcholine (PPC)-based layers namely 1) reductively adsorbed PPC diazonium salt, 2) dithiocarbamate PPC SAM and 3) lipoamide PPC SAM (PPC coupled to α-lipoic acid) were evaluated. The layers were assessed for their ability to limit nonspecific adsorption of proteins to electrode surface with some significant differences observed compared with previously studied PPC diazonium salts reductively adsorbed on glassy carbon. Fluorescence microscopy and electrochemical impedance spectroscopy results suggest that protein adsorption is sensitive to the difference in the structure of the PPC molecules and the charge neutrality of the layers. The lipoamide PPC SAM was shown to be the most effective at resisting nonspecific protein adsorption and this layer was as effective as the 'gold standard' of oligo(ethylene oxide) SAMs on gold and PPC diazonium salts reductively adsorbed on glassy carbon. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
- Published
- 2014
21. Biointerfaces on indium-tin oxide prepared from organophosphonic acid self-assembled monolayers
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Chockalingam, M, Magenau, A, Parker, SG, Parviz, M, Vivekchand, SRC, Gaus, K, Gooding, JJ, Chockalingam, M, Magenau, A, Parker, SG, Parviz, M, Vivekchand, SRC, Gaus, K, and Gooding, JJ
- Abstract
Herein we show the development of biointerfaces on indium-tin oxide (ITO) surfaces prepared from organophosphonate self-assembled monolayers. The interfaces were prepared in a stepwise fabrication procedure containing a base monolayer modified with oligo(ethylene oxide) species to which biological recognition ligands were attached. The density of ligands was controlled by varying the ratio of two oligo(ethylene oxide) species such that only one is compatible with further coupling. The final biointerface on ITO was assessed using cell adhesion studies, which showed that the biointerfaces prepared on ITO performed similarly to equivalent monolayers on gold or silicon. © 2014 American Chemical Society.
- Published
- 2014
22. Ultrasensitive electrochemical detection of prostate-specific antigen (PSA) using gold-coated magnetic nanoparticles as 'dispersible electrodes'
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Chuah, K, Lai, LMH, Goon, IY, Parker, SG, Amal, R, Gooding, JJ, Chuah, K, Lai, LMH, Goon, IY, Parker, SG, Amal, R, and Gooding, JJ
- Published
- 2012
23. Are memory clinics effective? The odds are in favour of their benefit, but conclusive evidence is not yet available
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Melis, RJF, primary, Meeuwsen, EJ, additional, Parker, SG, additional, and Olde Rikkert, MGM, additional
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- 2009
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24. Nutrition following Acute Stroke
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Gariballa, SE, primary, Parker, SG, additional, and Castleden, CM, additional
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- 1996
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25. Changes in Serum Lipid following Acute Stroke
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Gariballa, SE, primary, Fotherby, MD, additional, Parker, SG, additional, and Castleden, CM, additional
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- 1996
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26. Understanding service context: development of a service pro forma to describe and measure elderly peoples' community and intermediate care services.
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Nancarrow SA, Moran AM, and Parker SG
- Abstract
The purpose of this paper was to develop a pro forma which classifies the components of service delivery and organization which may impact on the outcomes of elderly peoples' community and intermediate care services. The resulting analytic template provides a basis for comparison between services and may help guide service commissioning and development. A qualitative approach was used in which key evaluations and reports were selected on the basis that they described elderly peoples' community and intermediate care services. These were analysed systematically using a qualitative (template) approach to draw out the key themes used to describe services. Themes were then structured hierarchically into an analytic template. Seventeen key documents were analysed. The initial coding framework classified 334 themes describing intermediate care services. These items were then clustered into 78 categories, which were reduced to 17 subcategories, then six overall groupings to describe the services, namely; (1) context; (2) reason for the service; (3) service-users; (4) access to the service; (5) service structure; and (6) the organization of care. The resulting analytic template has been developed into a 'service pro forma' which can be used as a basis to describe and compare a range of services. We propose that all service evaluations should describe, in detail, their context in a comparable way, so that other services can learn from and/or apply the findings from these studies. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
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27. Nutritional status of hospitalized acute stroke patients.
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Gariballa SE, Parker SG, Taub N, and Castleden M
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- 1998
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28. A randomized, controlled, a single-blind trial of nutritional supplementation after acute stroke.
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Gariballa SE, Parker SG, Taub N, Castleden CM, Gariballa, S E, Parker, S G, Taub, N, and Castleden, C M
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- 1998
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29. What is intermediate care? An international consensus on what constitutes intermediate care is needed.
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Melis RJF, Rikkert MGM, Parker SG, and van Eijken MIJ
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- 2004
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30. Recruiting older people to a randomised controlled dietary intervention trial--how hard can it be?
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Forster SE, Jones L, Saxton JM, Flower DJ, Foulds G, Powers HJ, Parker SG, Pockley AG, Williams EA, Forster, Sarah E, Jones, Laura, Saxton, John M, Flower, Daniel J, Foulds, Gemma, Powers, Hilary J, Parker, Stuart G, Pockley, A Graham, and Williams, Elizabeth A
- Abstract
Background: The success of a human intervention trial depends upon the ability to recruit eligible volunteers. Many trials fail because of unrealistic recruitment targets and flawed recruitment strategies. In order to predict recruitment rates accurately, researchers need information on the relative success of various recruitment strategies. Few published trials include such information and the number of participants screened or approached is not always cited.Methods: This paper will describe in detail the recruitment strategies employed to identify older adults for recruitment to a 6-month randomised controlled dietary intervention trial which aimed to explore the relationship between diet and immune function (The FIT study). The number of people approached and recruited, and the reasons for exclusion, will be discussed.Results: Two hundred and seventeen participants were recruited to the trial. A total of 7,482 letters were sent to potential recruits using names and addresses that had been supplied by local Family (General) Practices. Eight hundred and forty three potential recruits replied to all methods of recruitment (528 from GP letters and 315 from other methods). The eligibility of those who replied was determined using a screening telephone interview, 217 of whom were found to be suitable and agreed to take part in the study.Conclusion: The study demonstrates the application of multiple recruitment methods to successfully recruit older people to a randomised controlled trial. The most successful recruitment method was by contacting potential recruits by letter on NHS headed note paper using contacts provided from General Practices. Ninety percent of recruitment was achieved using this method. Adequate recruitment is fundamental to the success of a research project, and appropriate strategies must therefore be adopted in order to identify eligible individuals and achieve recruitment targets. [ABSTRACT FROM AUTHOR]- Published
- 2010
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31. Quality of Life in Older Patients. The SF-36 in Practice.
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Parker, SG, Peet, SM, Jagger, C, and Fahran, M
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- 1995
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32. Anatomical Variation of Abdominal Wall Musculature: An Objective Assessment Using Cross-Sectional Imaging.
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Parker SG, Blake H, Halligan S, Ishak A, Mahrous H, Abdelgelil M, Windsor ACJ, Shanmuganandan A, Jakkalasaibaba R, and Thomas R
- Abstract
Purpose: To determine normal anatomical variation of abdominal wall musculature. Methods: A retrospective analysis of CT scans was performed on adults (>18 years) with normal abdominal wall muscles. Two radiologists analysed the images independently. Distances from three fixed points in the midline were measured. The fixed points were; P1, mid-way between xiphoid and umbilicus, P2, at the umbilicus, and P3, mid-way between umbilicus and pubic symphysis. From these three fixed points the following measurements were recorded; midline to lateral innermost border of the abdominal wall musculature, midline to lateral edge of rectus abdominis muscle, and midline to medial edges of all three lateral abdominal wall muscles. To obtain aponeurotic width, rectus abdominis width was subtracted from the distance to medial edge of lateral abdominal wall muscle. Results: Fifty normal CT scan were evaluated from between March 2023 to August 2023. Mean width of external oblique aponeurosis at P1 was 16.2 mm (IQR 9.2 mm to 20.7 mm), at P2 was 23.5 mm (IQR 14 mm to 33 mm), and at P3 no external oblique muscle was visible. Mean width of the internal oblique aponeurosis at P1 was 32.1 mm (IQR 17.5 mm to 45 mm), at P2 was 10.13 (IQR 1 mm to 17.5 mm), and at P3 was 9.2 mm (IQR 3.0 mm to 13.7 mm). Mean width of the transversus abdominis aponeurosis at P1 was -25.1 mm (IQR 37.8 mm to -15.0 mm), at P2 was 29.4 mm (IQR 20 mm to 39.8 mm), and at P3 was 20.3 mm (IQR 12 mm to 29 mm). Conclusion: In this study we describe normal anatomical variation of the abdominal wall muscles. Assessing this variability on the pre-operative CT scans of ventral hernia patients allows for detailed operative planning and decision making., Competing Interests: RT and ACJW declare conflicts of interest not directly related to the submitted work: both are consultant advisers for TELA BIO. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Parker, Blake, Halligan, Ishak, Mahrous, Abdelgelil, Windsor, Shanmuganandan, Jakkalasaibaba and Thomas.)
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- 2024
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33. A Ventral Hernia Management Pathway; A "Getting It Right First Time" approach to Complex Abdominal Wall Reconstruction.
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Parker SG, Joyner J, Thomas R, Van Dellen J, Mohamed S, Jakkalasaibaba R, Blake H, Shanmuganandan A, Albadry W, Panascia J, Gray W, and Vig S
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- Humans, Quality Improvement, Plastic Surgery Procedures methods, Hernia, Ventral surgery, Herniorrhaphy methods, Abdominal Wall surgery, Critical Pathways
- Abstract
Introduction: Abdominal wall reconstruction (AWR) is an emerging specialty, involving complex multi-stage operations in patients with high medical and surgical risk. At our hospital, we have developed a growing interest in AWR, with a commitment to improving outcomes through a regular complex hernia MDT. An MDT approach to these patients is increasingly recognized as the path forward in management to optimize patients and improve outcomes., Methods: We conducted a literature review and combined this with our experiential knowledge of managing these cases to create a pathway for the management of our abdominal wall patients. This was done under the auspices of GIRFT (Getting It Right First Time) as a quality improvement project at our hospital., Results: We describe, in detail, our current AWR pathway, including the checklists and information documents we use with a stepwise evidence and experience-based approach to identifying the multiple factors associated with good outcomes. We explore the current literature and discuss our best practice pathway., Conclusion: In this emerging specialty, there is limited guidance on the management of these patients. Our pathway, the "Complex Hernia Bundle," currently provides guidance for our abdominal wall team and may well be one that could be adopted/adapted by other centers where challenging hernia cases are undertaken., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Thomas R declares conflicts of interest not directly related to the submitted work: consultant adviser for TELA BIO.
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- 2024
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34. X-Ray Visible Protein Scaffolds by Bulk Iodination.
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Flechas Becerra C, Barrios Silva LV, Ahmed E, Bear JC, Feng Z, Chau DYS, Parker SG, Halligan S, Lythgoe MF, Stuckey DJ, and Patrick PS
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- Mice, Animals, Cattle, Swine, X-Rays, Halogenation, Biocompatible Materials chemistry, Tissue Scaffolds chemistry, Tissue Engineering methods
- Abstract
Protein-based biomaterial use is expanding within medicine, together with the demand to visualize their placement and behavior in vivo. However, current medical imaging techniques struggle to differentiate between protein-based implants and surrounding tissue. Here a fast, simple, and translational solution for tracking transplanted protein-based scaffolds is presented using X-ray CT-facilitating long-term, non-invasive, and high-resolution imaging. X-ray visible scaffolds are engineered by selectively iodinating tyrosine residues under mild conditions using readily available reagents. To illustrate translatability, a clinically approved hernia repair mesh (based on decellularized porcine dermis) is labeled, preserving morphological and mechanical properties. In a mouse model of mesh implantation, implants retain marked X-ray contrast up to 3 months, together with an unchanged degradation rate and inflammatory response. The technique's compatibility is demonstrated with a range of therapeutically relevant protein formats including bovine, porcine, and jellyfish collagen, as well as silk sutures, enabling a wide range of surgical and regenerative medicine uses. This solution tackles the challenge of visualizing implanted protein-based biomaterials, which conventional imaging methods fail to differentiate from endogenous tissue. This will address previously unanswered questions regarding the accuracy of implantation, degradation rate, migration, and structural integrity, thereby accelerating optimization and safe translation of therapeutic biomaterials., (© 2023 The Authors. Advanced Science published by Wiley-VCH GmbH.)
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- 2024
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35. Reporting guideline for interventional trials of primary and incisional ventral hernia repair.
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Parker SG, Halligan S, Berrevoet F, de Beaux AC, East B, Eker HH, Jensen KK, Jorgensen LN, Montgomery A, Morales-Conde S, Miserez M, Renard Y, Sanders DL, Simons M, Slade D, Torkington J, Blackwell S, Dames N, Windsor ACJ, and Mallett S
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- Abdominal Wall surgery, Female, Humans, Male, Recurrence, Treatment Outcome, Clinical Trials as Topic standards, Hernia, Ventral surgery, Herniorrhaphy methods, Incisional Hernia surgery, Laparoscopy methods, Practice Guidelines as Topic, Surgical Mesh
- Abstract
Background: Primary and incisional ventral hernia trials collect unstandardized inconsistent data, limiting data interpretation and comparison. This study aimed to create two minimum data sets for primary and incisional ventral hernia interventional trials to standardize data collection and improve trial comparison. To support these data sets, standardized patient-reported outcome measures and trial methodology criteria were created., Methods: To construct these data sets, nominal group technique methodology was employed, involving 15 internationally recognized abdominal wall surgeons and two patient representatives. Initially a maximum data set was created from previous systematic and panellist reviews. Thereafter, three stages of voting took place: stage 1, selection of the number of variables for data set inclusion; stage 2, selection of variables to be included; and stage 3, selection of variable definitions and detection methods. A steering committee interpreted and analysed the data., Results: The maximum data set contained 245 variables. The three stages of voting commenced in October 2019 and had been completed by July 2020. The final primary ventral hernia data set included 32 variables, the incisional ventral hernia data set included 40 variables, the patient-reported outcome measures tool contained 25 questions, and 40 methodological criteria were chosen. The best known variable definitions were selected for accurate variable description. CT was selected as the optimal preoperative descriptor of hernia morphology. Standardized follow-up at 30 days, 1 year, and 5 years was selected., Conclusion: These minimum data sets, patient-reported outcome measures, and methodological criteria have allowed creation of a manual for investigators aiming to undertake primary ventral hernia or incisional ventral hernia interventional trials. Adopting these data sets will improve trial methods and comparisons., (© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2021
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36. Hospitalisation without delirium is not associated with cognitive decline in a population-based sample of older people-results from a nested, longitudinal cohort study.
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Richardson SJ, Lawson R, Davis DHJ, Stephan BCM, Robinson L, Matthews FE, Brayne C, Barnes LE, Taylor JP, Parker SG, and Allan LM
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- Aged, Cohort Studies, Hospitalization, Humans, Longitudinal Studies, Cognitive Dysfunction, Delirium diagnosis, Delirium epidemiology
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Background: Acute hospitalisation and delirium have individually been shown to adversely affect trajectories of cognitive decline but have not previously been considered together. This work aimed to explore the impact on cognition of hospital admission with and without delirium, compared to a control group with no hospital admissions., Methods: The Delirium and Cognitive Impact in Dementia (DECIDE) study was nested within the Cognitive Function and Ageing Study II (CFAS II)-Newcastle cohort. CFAS II participants completed two baseline interviews, including the Mini-Mental State Examination (MMSE). During 2016, surviving participants from CFAS II-Newcastle were recruited to DECIDE on admission to hospital. Participants were reviewed daily to determine delirium status.During 2017, all DECIDE participants and age, sex and years of education matched controls without hospital admissions during 2016 were invited to repeat the CFAS II interview. Delirium was excluded in the control group using the Informant Assessment of Geriatric Delirium Scale (i-AGeD). Linear mixed effects modelling determined predictors of cognitive decline., Results: During 2016, 82 of 205 (40%) DECIDE participants had at least one episode of delirium. At 1 year, 135 of 205 hospitalised participants completed an interview along with 100 controls. No controls experienced delirium (i-AGeD>4). Delirium was associated with a faster rate of cognitive decline compared to those without delirium (β = -2.2, P < 0.001), but number of hospital admissions was not (P = 0.447)., Conclusions: These results suggest that delirium during hospitalisation rather than hospitalisation per se is a risk factor for future cognitive decline, emphasising the need for dementia prevention studies that focus on delirium intervention., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society.)
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- 2021
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37. Corrigendum to: Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis.
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Parker SG, Mallett S, Quinn L, Wood CPJ, Boulton RW, Jamshaid S, Erotocritou M, Gowda S, Collier W, Plumb AAO, Windsor ACJ, Archer L, and Halligan S
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- 2021
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38. Recurrent delirium over 12 months predicts dementia: results of the Delirium and Cognitive Impact in Dementia (DECIDE) study.
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Richardson SJ, Davis DHJ, Stephan BCM, Robinson L, Brayne C, Barnes LE, Taylor JP, Parker SG, and Allan LM
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- Cognition, Humans, Prospective Studies, Cognitive Dysfunction, Delirium diagnosis, Delirium epidemiology, Dementia diagnosis, Dementia epidemiology
- Abstract
Background: Delirium is common, distressing and associated with poor outcomes. Previous studies investigating the impact of delirium on cognitive outcomes have been limited by incomplete ascertainment of baseline cognition or lack of prospective delirium assessments. This study quantified the association between delirium and cognitive function over time by prospectively ascertaining delirium in a cohort aged ≥ 65 years in whom baseline cognition had previously been established., Methods: For 12 months, we assessed participants from the Cognitive Function and Ageing Study II-Newcastle for delirium daily during hospital admissions. At 1-year, we assessed cognitive decline and dementia in those with and without delirium. We evaluated the effect of delirium (including its duration and number of episodes) on cognitive function over time, independently of baseline cognition and illness severity., Results: Eighty two of 205 participants recruited developed delirium in hospital (40%). One-year outcome data were available for 173 participants: 18 had a new dementia diagnosis, 38 had died. Delirium was associated with cognitive decline (-1.8 Mini-Mental State Examination points [95% CI -3.5 to -0.2]) and an increased risk of new dementia diagnosis at follow up (OR 8.8 [95% CI 1.9-41.4]). More than one episode and more days with delirium (>5 days) were associated with worse cognitive outcomes., Conclusions: Delirium increases risk of future cognitive decline and dementia, independent of illness severity and baseline cognition, with more episodes associated with worse cognitive outcomes. Given that delirium has been shown to be preventable in some cases, we propose that delirium is a potentially modifiable risk factor for dementia., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society.)
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- 2021
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39. Measuring quality of life in patients with abdominal wall hernias: a systematic review of available tools.
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Grove TN, Muirhead LJ, Parker SG, Brogden DRL, Mills SC, Kontovounisios C, Windsor ACJ, and Warren OJ
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- Herniorrhaphy, Humans, Quality of Life, Recurrence, Surgical Mesh, Abdominal Wall surgery, Hernia, Ventral surgery
- Abstract
Introduction: Abdominal wall herniation (AWH) is an increasing problem for patients, surgeons, and healthcare providers. Surgical-site specific outcomes, such as infection, recurrence, and mesh explantation, are improving; however, successful repair still exposes the patient to what is often a complex major operation aimed at improving quality of life. Quality-of-life (QOL) outcomes, such as aesthetics, pain, and physical and emotional functioning, are less often and less well reported. We reviewed QOL tools currently available to evaluate their suitability., Methods: A systematic review of the literature in compliance with PRISMA guidelines was performed between 1st January 1990 and 1st May 2019. English language studies using validated quality-of-life assessment tool, whereby outcomes using this tool could be assessed were included., Results: Heterogeneity in the QOL tool used for reporting outcome was evident throughout the articles reviewed. AWH disease-specific tools, hernia-specific tools, and generic tools were used throughout the literature with no obviously preferred or dominant method identified., Conclusion: Despite increasing acknowledgement of the need to evaluate QOL in patients with AWH, no tool has become dominant in this field. Assessment, therefore, of the impact of certain interventions or techniques on quality of life remains difficult and will continue to do so until an adequate standardised outcome measurement tool is available.
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- 2021
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40. Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis.
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Parker SG, Mallett S, Quinn L, Wood CPJ, Boulton RW, Jamshaid S, Erotocritou M, Gowda S, Collier W, Plumb AAO, Windsor ACJ, Archer L, and Halligan S
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- Herniorrhaphy instrumentation, Humans, Randomized Controlled Trials as Topic, Recurrence, Treatment Outcome, Hernia, Ventral surgery, Herniorrhaphy methods, Laparoscopy, Surgical Mesh, Suture Techniques
- Abstract
Background: Ventra hernias are increasing in prevalence and many recur despite attempted repair. To date, much of the literature is underpowered and divergent. As a result there is limited high quality evidence to inform surgeons succinctly which perioperative variables influence postoperative recurrence. This systematic review aimed to identify predictors of ventral hernia recurrence., Methods: PubMed was searched for studies reporting prognostic data of ventral hernia recurrence between 1 January 1995 and 1 January 2018. Extracted data described hernia type (primary/incisional), definitions of recurrence, methods used to detect recurrence, duration of follow-up, and co-morbidity. Data were extracted for all potential predictors, estimates and thresholds described. Random-effects meta-analysis was used. Bias was assessed with a modified PROBAST (Prediction model Risk Of Bias ASsessment Tool)., Results: Screening of 18 214 abstracts yielded 274 individual studies for inclusion. Hernia recurrence was defined in 66 studies (24.1 per cent), using 41 different unstandardized definitions. Three patient variables (female sex, age 65 years or less, and BMI greater than 25, 30, 35 or 40 kg/m2), five patient co-morbidities (smoking, diabetes, chronic obstructive pulmonary disease, ASA grade III-IV, steroid use), two hernia-related variables (incisional/primary, recurrent/primary), six intraoperative variables (biological mesh, bridged repair, open versus laparoscopic surgery, suture versus mesh repair, onlay/retrorectus, intraperitoneal/retrorectus), and six postoperative variables (any complication, surgical-site occurrence, wound infection, seroma, haematoma, wound dehiscence) were identified as significant prognostic factors for hernia recurrence., Conclusion: This study summarized the current evidence base for predicting ventral hernia recurrence. Results should inform best practice and future research., (© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.)
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- 2021
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41. Definitions for Loss of Domain: An International Delphi Consensus of Expert Surgeons.
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Parker SG, Halligan S, Liang MK, Muysoms FE, Adrales GL, Boutall A, de Beaux AC, Dietz UA, Divino CM, Hawn MT, Heniford TB, Hong JP, Ibrahim N, Itani KMF, Jorgensen LN, Montgomery A, Morales-Conde S, Renard Y, Sanders DL, Smart NJ, Torkington JJ, and Windsor ACJ
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- Consensus, Delphi Technique, Hernia, Ventral surgery, Humans, Incisional Hernia pathology, Surveys and Questionnaires, Abdominal Cavity pathology, Hernia, Ventral pathology, Surgeons, Terminology as Topic
- Abstract
Background: No standardized written or volumetric definition exists for 'loss of domain' (LOD). This limits the utility of LOD as a morphological descriptor and as a predictor of peri- and postoperative outcomes. Consequently, our aim was to establish definitions for LOD via consensus of expert abdominal wall surgeons., Methods: A Delphi study involving 20 internationally recognized abdominal wall reconstruction (AWR) surgeons was performed. Four written and two volumetric definitions of LOD were identified via systematic review. Panelists completed a questionnaire that suggested these definitions as standardized definitions of LOD. Consensus on a preferred term was pre-defined as achieved when selected by ≥80% of panelists. Terms scoring <20% were removed., Results: Voting commenced August 2018 and was completed in January 2019. Written definition: During Round 1, two definitions were removed and seven new definitions were suggested, leaving nine definitions for consideration. For Round 2, panelists were asked to select all appealing definitions. Thereafter, common concepts were identified during analysis, from which the facilitators advanced a new written definition. This received 100% agreement in Round 3. Volumetric definition: Initially, panelists were evenly split, but consensus for the Sabbagh method was achieved. Panelists could not reach consensus regarding a threshold LOD value that would preclude surgery., Conclusions: Consensus for written and volumetric definitions of LOD was achieved from 20 internationally recognized AWR surgeons. Adoption of these definitions will help standardize the use of LOD for both clinical and academic activities.
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- 2020
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42. What exactly is meant by 'loss of domain' for ventral hernia? A survey of 100 surgeons.
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Parker SG, Halligan S, Erotocritou M, Plumb AAO, Warren OJ, and Windsor ACJ
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- Humans, Surveys and Questionnaires, Terminology as Topic, Hernia, Ventral pathology, Hernia, Ventral surgery, Herniorrhaphy
- Published
- 2020
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43. International classification of abdominal wall planes (ICAP) to describe mesh insertion for ventral hernia repair.
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Parker SG, Halligan S, Liang MK, Muysoms FE, Adrales GL, Boutall A, de Beaux AC, Dietz UA, Divino CM, Hawn MT, Heniford TB, Hong JP, Ibrahim N, Itani KMF, Jorgensen LN, Montgomery A, Morales-Conde S, Renard Y, Sanders DL, Smart NJ, Torkington JJ, and Windsor ACJ
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- Humans, Recurrence, Retrospective Studies, Abdominal Wall surgery, Consensus, Hernia, Ventral surgery, Herniorrhaphy methods, Prostheses and Implants classification, Surgical Mesh classification
- Abstract
Background: Nomenclature for mesh insertion during ventral hernia repair is inconsistent and confusing. Several terms, including 'inlay', 'sublay' and 'underlay', can refer to the same anatomical planes in the indexed literature. This frustrates comparisons of surgical practice and may invalidate meta-analyses comparing surgical outcomes. The aim of this study was to establish an international classification of abdominal wall planes., Methods: A Delphi study was conducted involving 20 internationally recognized abdominal wall surgeons. Different terms describing anterior abdominal wall planes were identified via literature review and expert consensus. The initial list comprised 59 possible terms. Panellists completed a questionnaire that suggested a list of options for individual abdominal wall planes. Consensus on a term was predefined as occurring if selected by at least 80 per cent of panellists. Terms scoring less than 20 per cent were removed., Results: Voting started August 2018 and was completed by January 2019. In round 1, 43 terms (73 per cent) were selected by less than 20 per cent of panellists and 37 new terms were suggested, leaving 53 terms for round 2. Four planes reached consensus in round 2, with the terms 'onlay', 'inlay', 'preperitoneal' and 'intraperitoneal'. Thirty-five terms (66 per cent) were selected by less than 20 per cent of panellists and were removed. After round 3, consensus was achieved for 'anterectus', 'interoblique', 'retro-oblique' and 'retromuscular'. Default consensus was achieved for the 'retrorectus' and 'transversalis fascial' planes., Conclusion: Consensus concerning abdominal wall planes was agreed by 20 internationally recognized surgeons. Adoption should improve communication and comparison among surgeons and research studies., (© 2019 BJS Society Ltd Published by John Wiley & Sons Ltd.)
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- 2020
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44. Frailty, hospital use and mortality in the older population: findings from the Newcastle 85+ study.
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Keeble E, Parker SG, Arora S, Neuburger J, Duncan R, Kingston A, Hanratty B, Jagger C, Robinson L, and Kirkwood T
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- Aged, 80 and over, England epidemiology, Female, Frail Elderly statistics & numerical data, Frailty epidemiology, Hospital Costs statistics & numerical data, Humans, Kaplan-Meier Estimate, Male, Patient Acceptance of Health Care statistics & numerical data, Proportional Hazards Models, Prospective Studies, Frailty mortality, Hospitalization statistics & numerical data
- Abstract
Background: Frailty is a significant determinant of health care utilisation and associated costs, both of which also increase with proximity to death. What is not known is how the relationships between frailty, proximity to death, hospital use and costs develop in a population aged 85 years and over., Methods: This study used data from a prospective observational cohort, the Newcastle 85+ Study, linked with hospital episode statistics and death registrations. Using the Rockwood frailty index (cut off <0.25), we analysed the relationship between frailty and mortality, proximity to death, hospital use and hospital costs over 2, 5 and 7 years using descriptive statistics, Kaplan-Meier survival curves, Cox's proportional hazards and negative binomial regression models., Results: Baseline frailty was associated with a more than two-fold increased risk of mortality after 7 years, compared to people who were non-frail. Participants classified as frail spent more time in hospital over 7 years than the non-frail, but this difference declined over time. Baseline frailty was not associated with increased time spent in hospital during the last 90 days of life., Conclusion: Evidence continues to accrue on the impact of frailty on emergency health care use. Hospital and community services need to adapt to meet the challenge of introducing new proactive and preventative approaches, designed to achieve benefits in clinical and/or cost effectiveness of frailty management., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
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45. A systematic methodological review of non-randomised interventional studies of elective ventral hernia repair: clear definitions and a standardised minimum dataset are needed.
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Parker SG, Halligan S, Erotocritou M, Wood CPJ, Boulton RW, Plumb AAO, Windsor ACJ, and Mallett S
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- Humans, Recurrence, Hernia, Ventral surgery, Herniorrhaphy adverse effects, Herniorrhaphy methods, Herniorrhaphy standards, Outcome Assessment, Health Care methods, Outcome Assessment, Health Care standards, Research Design standards
- Abstract
Background: Ventral hernias (VHs) often recur after surgical repair and subsequent attempts at repair are especially challenging. Rigorous research to reduce recurrence is required but such studies must be well-designed and report representative and comprehensive outcomes., Objective: We aimed to assesses methodological quality of non-randomised interventional studies of VH repair by systematic review., Methods: We searched the indexed literature for non-randomised studies of interventions for VH repair, January 1995 to December 2017 inclusive. Each prospective study was coupled with a corresponding retrospective study using pre-specified criteria to provide matched, comparable groups. We applied a bespoke methodological tool for hernia trials by combining relevant items from existing published tools. Study introduction and rationale, design, participant inclusion criteria, reported outcomes, and statistical methods were assessed., Results: Fifty studies (17,608 patients) were identified: 25 prospective and 25 retrospective. Overall, prospective studies scored marginally higher than retrospective studies for methodological quality, median score 17 (IQR: 14-18) versus 15 (IQR 12-18), respectively. For the sub-categories investigated, prospective studies achieved higher median scores for their, 'introduction', 'study design' and 'participants'. Surprisingly, no study stated that a protocol had been written in advance. Only 18 (36%) studies defined a primary outcome, and only 2 studies (4%) described a power calculation. No study referenced a standardised definition for VH recurrence and detection methods for recurrence varied widely. Methodological quality did not improve with publication year or increasing journal impact factor., Conclusion: Currently, non-randomised interventional studies of VH repair are methodologically poor. Clear outcome definitions and a standardised minimum dataset are needed.
- Published
- 2019
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46. Developing an objective structured clinical examination in comprehensive geriatric assessment - A pilot study.
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Vassallo M, Grey J, Hemsley A, Chris L, and Parker SG
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- Aged, Education, Medical, Graduate, Female, Humans, Male, Pilot Projects, United Kingdom, Clinical Competence, Educational Measurement methods, Geriatric Assessment methods, Geriatrics education
- Abstract
Background: Acquiring medical competencies alone does not necessarily lead to the delivery of quality clinical care. Many UK training programs are soon to be based on the curricula of entrustable professional capabilities (EPCs). These are tasks carried out in practice requiring proficiency in several competencies for quality practice. Assessments to evaluate EPCs for independent practice are needed. Comprehensive geriatric assessment (CGA) is an EPC in geriatric medicine. We describe the development of an assessment of CGA as an example of examining EPCs., Methods: A CGA station was introduced in the Diploma in Geriatric Medicine clinical examination. Candidates rotate through four stations: three single competency-based stations (history, communication/ethics and physical examination) and an EPC-based station in CGA., Results: One hundred and seventy-eight (female: 96 [53.9%]) candidates took it. There was a weak but significantly positive correlation between the score at CGA and the total score in the other stations (r = 0.46; P < 0.001). Most candidates passing the station passed the examination. Correlation with other stations similarly showed weak significant correlations (Station 1: r = 0.38; P < 0.001, Station 3: r = 0.28; P < 0.001, and Station 4: r = 0.37; P < 0.001). There was 61.4% (kappa: 0.61; P = 0.000) agreement between examiners whether a candidate passed or failed. Agreement was higher for the other stations, i.e. Station 1 (kappa: 0.85; P < 0.001), Station 3 (kappa: 0.72; P < 0.001), and Station 4 (kappa: 0.85; P < 0.001)., Discussion: Performance on the station correlated positively with overall performance, suggesting that it has discriminatory value in differentiating candidates with varying ability and the more able candidates pass the examination., Competing Interests: None
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- 2019
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47. Priorities for research in multiple conditions in later life (multi-morbidity): findings from a James Lind Alliance Priority Setting Partnership.
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Parker SG, Corner L, Laing K, Nestor G, Craig D, Collerton J, Frith J, Roberts HC, Sayer AA, Allan LM, Robinson L, and Cowan K
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- Accidental Falls prevention & control, Aged, 80 and over, Exercise Therapy, Geriatrics, Health Priorities, Humans, Independent Living, Interviews as Topic, Surveys and Questionnaires, Multimorbidity, Research
- Abstract
Introduction: multiple conditions in later life (multi-morbidity) is a major challenge for health and care systems worldwide, is of particular relevance for older people, but has not (until recently) received high priority as a topic for research. We have identified the top 10 research priorities from the perspective of older people, their carers, and health and social care professionals using the methods of a James Lind Alliance Priority Setting Partnership., Methods: in total, 354 participants (162 older people and carers, 192 health professionals) completed a survey and 15 older people and carers were interviewed to produce 96 'unanswered questions'. These were further refined by survey and interviews to a shortlist of 21 topics, and a mix of people aged 80+ living with three or more conditions, carers and health and social care providers to prioritised the top 10., Results: the key priorities were about the prevention of social isolation, the promotion of independence and physical and emotional well-being. In addition to these broad topics, the process also identified detailed priorities including the role of exercise therapy, the importance of falls (particularly fear of falling), the recognition and management of frailty and Comprehensive Geriatric Assessment., Conclusion: these topics provide a unique perspective on research priorities on multiple conditions in later life and complement existing UK and International recommendations about the optimisation of health and social care systems to deliver essential holistic models of care and the prevention and treatment of multiple co-existing conditions., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2019
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48. Age and Ageing to introduce a new category of paper: healthcare improvement science.
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Parker SG, Downes T, Godfrey M, Matthews R, and Martin FC
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- Aged, Health Services Research, Humans, Periodicals as Topic, Health Services for the Aged, Quality Improvement
- Abstract
Age and Ageing is now inviting papers on healthcare improvement for older people. In this article we outline the nature and scope of healthcare improvement and reference improvement models and the tools and methods of improvement science. We emphasise the issues of sustainability, including scale and spread; evaluation - including associated ethical consideration and the involvement of patients and the public in healthcare improvement and associated research. Throughout we refer to resources the authors have found useful in their own work, and provide a bibliography of sources and web-links which will provide essential guidance and support for potential contributors to this new category of submission to Age and Ageing., (© The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
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49. What Exactly is Meant by "Loss of Domain" for Ventral Hernia? Systematic Review of Definitions.
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Parker SG, Halligan S, Blackburn S, Plumb AAO, Archer L, Mallett S, and Windsor ACJ
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- Abdominal Cavity surgery, Humans, Hernia, Ventral surgery
- Abstract
Large ventral hernias are a significant surgical challenge. "Loss of domain" (LOD) expresses the relationship between hernia and abdominal volume, and is used to predict operative difficulty and success. This systematic review assessed whether different definitions of LOD are used in the literature. The PubMed database was searched for articles reporting large hernia repairs that explicitly described LOD. Two reviewers screened citations and extracted data from selected articles, focusing on the definitions used for LOD, study demographics, study design, and reporting surgical specialty. One hundred and seven articles were identified, 93 full-texts examined, and 77 were included in the systematic review. Sixty-seven articles were from the primary literature, and 10 articles were from the secondary literature. Twenty-eight articles (36%) gave a written definition for loss of domain. These varied and divided into six broad groupings; four described the loss of the right of domain, six described abdominal strap muscle contraction, five described the "second abdomen", five describing large irreducible hernias. Six gave miscellaneous definitions. Two articles gave multiple definitions. Twenty articles (26%) gave volumetric definitions; eight used the Tanaka method [hernia sac volume (HSV)/abdominal cavity volume] and five used the Sabbagh method [(HSV)/total peritoneal volume]. The definitions used for loss of domain were not dependent on the reporting specialty. Our systematic review revealed that multiple definitions of loss of domain are being used. These vary and are not interchangeable. Expert consensus on this matter is necessary to standardise this important concept for hernia surgeons.
- Published
- 2019
- Full Text
- View/download PDF
50. Amorphous silicon on indium tin oxide: a transparent electrode for simultaneous light activated electrochemistry and optical microscopy.
- Author
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Lian J, Yang Y, Wang W, Parker SG, Gonçales VR, Tilley RD, and Gooding JJ
- Abstract
Herein is reported a new type of transparent electrode, prepared by depositing a thin layer of amorphous silicon film on indium tin oxide, which enables photoswitchable electrochemistry and optical imaging to be performed simultaneously. This offers the opportunity to visualise a spatially controlled electrochemical event on an unstructured electrode surface.
- Published
- 2018
- Full Text
- View/download PDF
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