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1. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Thompson, Annemarie, Fleischmann, Kirsten E., Smilowitz, Nathaniel R., de las Fuentes, Lisa, Mukherjee, Debabrata, Aggarwal, Niti R., Ahmad, Faraz S., Allen, Robert B., Altin, S. Elissa, Auerbach, Andrew, Berger, Jeffrey S., Chow, Benjamin, Dakik, Habib A., Eisenstein, Eric L., Gerhard-Herman, Marie, Ghadimi, Kamrouz, Kachulis, Bessie, Leclerc, Jacinthe, Lee, Christopher S., Macaulay, Tracy E., Mates, Gail, Merli, Geno J., Parwani, Purvi, Poole, Jeanne E., Rich, Michael W., Ruetzler, Kurt, Stain, Steven C., Sweitzer, BobbieJean, Talbot, Amy W., Vallabhajosyula, Saraschandra, Whittle, John, and Williams, Kim Allan, Sr.

Published
2024
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6. Patient- and Ventilator-Specific Modeling to Drive the Use and Development of 3D Printed Devices for Rapid Ventilator Splitting During the COVID-19 Pandemic

Author

Bishawi, Muath, Kaplan, Michael, Chidyagwai, Simbarashe, Cappiello, Jhaymie, Cherry, Anne, MacLeod, David, Gall, Ken, Evans, Nathan, Kim, Michael, Shaha, Rajib, Whittle, John, Hollidge, Melanie, Truskey, George, Randles, Amanda, Goos, Gerhard, Founding Editor, Hartmanis, Juris, Founding Editor, Bertino, Elisa, Editorial Board Member, Gao, Wen, Editorial Board Member, Steffen, Bernhard, Editorial Board Member, Yung, Moti, Editorial Board Member, Groen, Derek, editor, de Mulatier, Clélia, editor, Paszynski, Maciej, editor, Krzhizhanovskaya, Valeria V., editor, Dongarra, Jack J., editor, and Sloot, Peter M. A., editor

Published
2022
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10. The 'like' generation : an exploration of social networking's influence on adolescents' productions of gender, identity, (virtual) capital and technological practices

Author

Whittle, John J.

Subjects
302.3
Abstract

This thesis explores how social networking platforms influence the production of identity, status and capital amongst adolescents. This includes an exploration of how some digital communication platforms have negatively impacted on the social experiences of some teenagers and resulted in these users adapting their digital communicative practices to overcome communicative challenges. The study draws upon data collected via 9 semi-structured interviews, 9 focus groups and 84 surveys with boys and girls aged 11-16 from three schools in England. It explores specific social norms which relate to gender, and how they are negotiated within both masculine and feminine interactions through the respective practices of banter and gossip or stalking. These interactional processes are used as a means of negotiating status and of in-group inclusion and out-group rejection (Goffman, 1963). Furthermore they are important elements in the formation of relationships, identity and social capital. For Bourdieu social capital is the aggregate of the actual or potential resources which are linked to possession of a durable network of more or less institutionalized relationships of mutual acquaintance and recognition (1980, 2). The production of social capital is linked to an individual s capacity to manage group norms and approved values. This study demonstrates that online displays of gender are part of adolescents attempts to generate social capital through gaining positive public affirmations (for example in the form of likes). This has led to a new form of capital which has been titled virtual capital , and which is revealed to be a crucial element in adolescents self-worth and status. Although social networking sites can facilitate the creation of these capitals, they can also simultaneously hinder their creation. Facebook s system of widespread automatic information sharing, alongside a lack user of control in managing the flow of data which is received and shared, has led to many teens experiencing challenges in how they produce identity and gain popularity. This has led to negative social experiences, a growing disillusionment with Facebook, and increased use of more contemporary platforms such as Snap Chat which offer a solution to these problems. Therefore this thesis presents findings on how adolescents use social networking to negotiate gender and identity, produce social status and how these attempts can be confounded by the very technology that facilitates their production.

Published
2017

11. Patient- and Ventilator-Specific Modeling to Drive the Use and Development of 3D Printed Devices for Rapid Ventilator Splitting During the COVID-19 Pandemic

Author

Bishawi, Muath, primary, Kaplan, Michael, additional, Chidyagwai, Simbarashe, additional, Cappiello, Jhaymie, additional, Cherry, Anne, additional, MacLeod, David, additional, Gall, Ken, additional, Evans, Nathan, additional, Kim, Michael, additional, Shaha, Rajib, additional, Whittle, John, additional, Hollidge, Melanie, additional, Truskey, George, additional, and Randles, Amanda, additional

Published
2022
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13. Early elevation in plasma high-sensitivity troponin T and morbidity after elective noncardiac surgery: prospective multicentre observational cohort study

Author

Pearse, Rupert, Niebrzegowska, Edyta, Wragg, Andrew, Archbold, Andrew, Kam, Elisa, Everingham, Kirsty, Bodger, Phoebe, Creary, Thais, Bloom, Ben, Carter, Alice, MacDonald, Neil, Abbott, Tom E.F., Shah, Nirav, Mrozek, Katarzyna, Richardson, Amy, Fowler, Alex, Rob, Zakaria, Ackland, Gareth, Stephens, Robert, Reyes, Anna, Paredes, Laura Gallego, Sultan, Pervez, Cain, David, Whittle, John, Edwards, Mark, Woldman, Simon, Gutierrez del Arroyo, Ana, Karmali, Shamir, Williams, Colin, Rushton, A., Welters, I., Leuwer, Martin, Parker, Jane, Sapsford, Robert J., Barth, Julian, Scott, Julian, Hall, Alistair, Howell, Simon, Lobley, Michaela, Woods, Janet, Howard, Susannah, Fletcher, Joanne, Dewhirst, Nikki, Ackland, Gareth L., Jones, Timothy F., and Pearse, Rupert M.

Published
2020
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15. Featured Cover

Author

Tracey, Robert, primary, Elisseev, Vadim, additional, Smyrnakis, Michalis, additional, Hoang, Lan, additional, Fellows, Mark, additional, Ackers, Michael, additional, Laughton, Andrew, additional, Hill, Stephen, additional, Folkes, Phillip, additional, and Whittle, John, additional

Published
2023
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18. Early dynamic changes to monocytes following major surgery are associated with subsequent infections.

Author

Snow, Timothy Arthur Chandos, Waller, Alessia V., Loye, Richard, Ryckaert, Francis, Cesar, Antonio, Saleem, Naveed, Roy, Rudra, Whittle, John, Al-Hindawi, Ahmed, Das, Abhishek, Singer, Mervyn, Brealey, David, and Arulkumaran, Nishkantha

Subjects
GASTROINTESTINAL surgery, MONONUCLEAR leukocytes, RECEIVER operating characteristic curves, ENZYME-linked immunosorbent assay, MONOCYTES, FALSE discovery rate
Abstract

Background: Post-operative infections are a common cause of morbidity following major surgery. Little is understood about how major surgery perturbs immune function leading to heightened risk of subsequent infection. Through analysis of paired blood samples obtained immediately before and 24 h following surgery, we evaluated changes in circulating immune cell phenotype and function across the first 24 h, to identify early immune changes associated with subsequent infection. Methods: We conducted a prospective observational study of adult patients undergoing major elective gastrointestinal, gynecological, or maxillofacial surgery requiring planned admission to the post-anesthetic care unit. Patients were followed up to hospital discharge or death. Outcome data collected included mortality, length of stay, unplanned intensive care unit admission, and post-operative infections (using the standardized endpoints in perioperative medicine-core outcome measures for perioperative and anesthetic care criteria). Peripheral blood mononuclear cells were isolated prior to and 24 h following surgery from which cellular immune traits including activation and functional status were assessed by multi-parameter flow cytometry and serum immune analytes compared by enzyme-linked immunosorbent assay (ELISA). Results: Forty-eight patients were recruited, 26 (54%) of whom developed a post-operative infection. We observed reduced baseline pre- and post-operative monocyte CXCR4 and CD80 expression (chemokine receptors and costimulation markers, respectively) in patients who subsequently developed an infection as well as a profound and selective post-operative increase in CD4+ lymphocyte IL-7 receptor expression in the infection group only. Higher postoperative monocyte count was significantly associated with the development of post-operative infection (false discovery rate < 1%; adjusted p-value = 0.001) with an area under the receiver operating characteristic curve of 0.84 (p < 0.0001). Conclusion: Lower monocyte chemotaxis markers, higher post-operative circulating monocyte counts, and reduced co-stimulatory signals are associated with subsequent post-operative infections. Identifying the underlying mechanisms and therapeutics to reverse defects in immune cell function requires further exploration. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Perioperative Quality Initiative (POQI) consensus statement on fundamental concepts in perioperative fluid management: fluid responsiveness and venous capacitance

Author

Martin, Greg S., Kaufman, David A., Marik, Paul E., Shapiro, Nathan I., Levett, Denny Z. H., Whittle, John, MacLeod, David B., Chappell, Desiree, Lacey, Jonathan, Woodcock, Tom, Mitchell, Kay, Malbrain, Manu L. N. G., Woodcock, Tom M., Martin, Daniel, Imray, Chris H. E., Manning, Michael W., Howe, Henry, Grocott, Michael P. W., Mythen, Monty G., Gan, Tong J., and Miller, Timothy E.

Published
2020
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29. Supplement to: A multinational trial of prasugrel for sickle cell vasoocclusive events.

Author

Van Damme, An, Dupont, Sophie, Philippet, Pierre, de Castro Lobo, Clarisse Lopes, Robitaille, Nancy, Tantawy, Azza AG, Mansour, Ahmed K, Al-Tonbary, Youssef, Badr, Mohamed, Elgawhary, Somaya, Ragab, Lamis, Hassab, Hoda, Mohamed El-Sayed, Hesham AF, Agbenyega, Tsiri E., Segbefia, Catherine I, Colombatti, Raffaella, Forni, Gian L, Masera, Nicoletta, Palazzi, Giovanni, Cesaro, Simone, Ogutu, Bernhards R, Oyieko, Janet N, Nduba, Videlis, Githanga, Jessie N, Abboud, Miguel R., Inati, Adlette, Alkindi, Salam S, Al Jaouni, Soad K., Unal, Selma, Sasmaz, Ilgen, Antmen, Ali B, Alzoebie, Azzam, Inusa, Baba, Rees, David, Will, Andrew, Dampier, Carlton, Heeney, Matthew M., Irwin, Robert G., Cohen, Debra, Quinn, Charles T., Krishnamurti, Lakshmanan, Rana, Sohail, Sarnaik, Sharada A., Smith-Whitley, Kim, Hoppe, Carolyn, Thompson, Alexis A., Boruchov, Donna M., Estepp, Jeremie Heath, Redding-Lallinger, Rupa, Strunk, Crawford, Piccone, Connie, Jeng, Michael, Whittle, John, Eng, Jennifer, Manwani, Deepa, Woods, Gerald, and Kanter, Julie

Published
2016

30. Validation of the Hospital Frailty Risk Score in older surgical patients : A population-based retrospective cohort study

Author

Gunnarsdottir, Gudrun M., Helgadottir, Solveig, Einarsson, Sveinn G., Hreinsson, Kari, Whittle, John, Karason, Sigurbergur, Sigurdsson, Martin I., Gunnarsdottir, Gudrun M., Helgadottir, Solveig, Einarsson, Sveinn G., Hreinsson, Kari, Whittle, John, Karason, Sigurbergur, and Sigurdsson, Martin I.

Abstract

Background: There is a need for standardized and cost-effective identification of frailty risk. The objective was to validate the Hospital Frailty Risk Score which utilizes International Classification Diagnoses in a cohort of older surgical patients, assess the score as an independent risk factor for adverse outcomes and compare discrimination properties of the frailty risk score with other risk stratification scores. Methods: Data were analysed from all patients >= 65 years undergoing primary surgical procedures from 2006-2018. Patients were categorized based on the frailty risk score. The primary outcomes were 30-day mortality and 180-day risk of readmission. Results: Of 16 793 patients evaluated, 7480 (45%), 7605 (45%) and 1708 (10%) had a low, intermediate and high risk of frailty. There was a higher incidence of 30-day mortality for individuals with intermediate (2.9%) and high (8.3%) compared with low (1.4%) risk of frailty (P < .001 for both comparisons). Similarly, the hazard of readmission within the first 180 days was higher for intermediate (HR 1.25; 95% CI: 1.16-1.34) and high (HR 1.84; 95% CI: 1.66-2.03) compared with low (HR 1.00, P < .001 for both comparisons) risk of frailty. The hazard of long-term mortality was higher for intermediate (HR 1.70; 95% CI: 1.61-1.80) and high (HR 4.16; 95% CI: 3.84-4.49) compared with low (HR 1.00, P < .001 for both comparisons) risk of frailty. Finally, long length of primary hospitalization occurred for 9.3%, 15.0% and 27.3% of individuals with low, intermediate and high frailty risk (P < .001 for all comparisons). A model including age and ASA classification had the best discrimination for 30-day mortality (AUC 0.862; 95% CI: 0.847-0.877). Conclusion: Our findings suggest that the Hospital Frailty Risk Score might be used to screen older surgical patients for risk of frailty. While only slightly improving prediction of 30-day mortality using the ASA classification, the Hospital Frailty Risk Score can

Published
2021
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38. Assessments of frailty in bladder cancer

Author

Grimberg, Dominic C., primary, Shah, Ankeet, additional, Molinger, Jeroen, additional, Whittle, John, additional, Gupta, Rajan T., additional, Wischmeyer, Paul E., additional, McDonald, Shelley R., additional, and Inman, Brant A., additional

Published
2020
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39. Rapid Ventilator Splitting During COVID-19 Pandemic Using 3D Printed Devices and Numerical Modeling of 200 Million Patient Specific Air Flow Scenarios

Author

Bishawi, Muath, primary, Kaplan, Michael, additional, Chidyagwai, Simbarashe, additional, Cappiello, Jhaymie, additional, Cherry, Anne, additional, MacLeod, David, additional, Gall, Ken, additional, Evans, Nathan, additional, Kim, Michael, additional, Shaha, Rajib, additional, Whittle, John, additional, Hollidge, Melanie, additional, Truskey, George, additional, and Randles, Amanda, additional

Published
2020
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40. Early elevation in plasma high-sensitivity troponin T and morbidity after elective noncardiac surgery: prospective multicentre observational cohort study

Author

Ackland, Gareth L., primary, Abbott, Tom E.F., additional, Jones, Timothy F., additional, Leuwer, Martin, additional, Pearse, Rupert M., additional, Pearse, Rupert, additional, Niebrzegowska, Edyta, additional, Wragg, Andrew, additional, Archbold, Andrew, additional, Kam, Elisa, additional, Everingham, Kirsty, additional, Bodger, Phoebe, additional, Creary, Thais, additional, Bloom, Ben, additional, Carter, Alice, additional, MacDonald, Neil, additional, Shah, Nirav, additional, Mrozek, Katarzyna, additional, Richardson, Amy, additional, Fowler, Alex, additional, Rob, Zakaria, additional, Ackland, Gareth, additional, Stephens, Robert, additional, Reyes, Anna, additional, Paredes, Laura Gallego, additional, Sultan, Pervez, additional, Cain, David, additional, Whittle, John, additional, Edwards, Mark, additional, Woldman, Simon, additional, Gutierrez del Arroyo, Ana, additional, Karmali, Shamir, additional, Williams, Colin, additional, Rushton, A., additional, Welters, I., additional, Parker, Jane, additional, Sapsford, Robert J., additional, Barth, Julian, additional, Scott, Julian, additional, Hall, Alistair, additional, Howell, Simon, additional, Lobley, Michaela, additional, Woods, Janet, additional, Howard, Susannah, additional, Fletcher, Joanne, additional, and Dewhirst, Nikki, additional

Published
2020
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42. Prospective Investigation of Markers of Elevated Delirium Risk (PRIMED Risk) study protocol: a prospective, observational cohort study investigating blood and cerebrospinal fluid biomarkers for delirium and cognitive dysfunction in older patients

Author

Whitby, Jonathan, primary, Bampoe, Sohail, additional, Fullerton, James N, additional, Smaje, Ashley, additional, Hornby, Joanna, additional, Hajdu, Bence, additional, Schofield, Nick, additional, Stafford, Ronnie, additional, Zetterberg, Henrik, additional, McAuley, Daniel F, additional, Passmore, Peter, additional, Cunningham, Emma, additional, Whittle, John, additional, Walker, David, additional, and Davis, Daniel, additional

Published
2020
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43. Dose-Dependent Association of Gabapentinoids with Pulmonary Complications After Total Hip and Knee Arthroplasties

Author

Ohnuma, Tetsu, primary, Raghunathan, Karthik, additional, Moore, Sean, additional, Setoguchi, Soko, additional, Ellis, Alan R., additional, Fuller, Matthew, additional, Whittle, John, additional, Pyati, Srinivas, additional, Bryan, William E., additional, Pepin, Marc J., additional, Bartz, Raquel R., additional, Haines, Krista L., additional, and Krishnamoorthy, Vijay, additional

Published
2019
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44. Studies in terpenoid synthesis

Author

Whittle, John Anthony

Subjects
547
Abstract

The various types of sesquiterpenoids are discussed in terms of their structural and biogenetic relationships. Possible biosynthetic pathways are proposed for all types, and some existing proposals are modified or extended. Emphasis is placed on the small number of different initial cyclisations of farnesyl pyrophosphate required to explain the biogenesis of the various skeletal types, and the key role of intermediates of the bisabolene and germacrane types is stressed. The published experimental studies on sesquiterpenoid biogenesis are reviewed and discussed. Experimental work on the biosynthesis in Artemisia maritima of the sesquiterpenoid bitter principle, santonin, is described. On the basis of the incorporations obtained, it is necessary to postulate two pathways for the later oxidative steps in its biosynthesis. These differ at the stage at which the first hydroxylation occurs. The incorporation of the ten-membered ring compound, 11,12-dihydrocostunolide suggests that this lactone is cyclised to a decalin system in the biosynthetic pathway. The incorporation of mevalonic acid lactone into santonin is shown to have occurred with scrambling of the label. Farnesyl pyrophosphate was not incorporated, while a very low incorporation of farnesol is recorded. The occurrence of 1,2—dihydrosantonin in Artemisia stellariana is proved. The isolation of the triterpenoid bitter principle, limonin,from the roots of Dictamnus albus is described. A low incorporation of mevalonic acid lactone into limonin is recorded.

Published
1967

46. Combining Model-driven and Schema-based Program Synthesis

Author

Denney, Ewen and Whittle, John

Subjects
Cybernetics, Artificial Intelligence And Robotics
Abstract

We describe ongoing work which aims to extend the schema-based program synthesis paradigm with explicit models. In this context, schemas can be considered as model-to-model transformations. The combination of schemas with explicit models offers a number of advantages, namely, that building synthesis systems becomes much easier since the models can be used in verification and in adaptation of the synthesis systems. We illustrate our approach using an example from signal processing.

Published
2004

47. Surgical Prehabilitation

Author

Whittle, John, primary, Wischmeyer, Paul E., additional, Grocott, Michael P.W., additional, and Miller, Timothy E., additional

Published
2018
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49. The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Author

VanDusen, Keith W., Eleswarpu, Sarada, Moretti, Eugene W., Devinney, Michael J., Crabtree, Donna M., Laskowitz, Daniel T., Woldorff, Marty G., Roberts, Kenneth C., Whittle, John, Browndyke, Jeffrey N., Cooter, Mary, Rockhold, Frank W., Anakwenze, Oke, Bolognesi, Michael P., Easley, Mark E., Ferrandino, Michael N., Jiranek, William A., Berger, Miles, MARBLE Study Investigators, and Adams, Samuel B.

Subjects
ENCEPHALITIS, RESEARCH, NONSTEROIDAL anti-inflammatory agents, INDUSTRIES, MEDICAL cooperation, EVALUATION research, TREATMENT effectiveness, COMPARATIVE studies, NEUROPROTECTIVE agents, APOLIPOPROTEINS, DELIRIUM, RESEARCH funding
Abstract

Background: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the Alzheimer's disease (AD) genetic risk factor APOE4. APOE4 is thought to elevate AD risk partly by increasing neuroinflammation, which is also a theorized mechanism for PND. Yet, it is unclear whether modulating apoE4 protein signaling in older surgical patients would reduce PND risk or severity.Objective: MARBLE is a randomized, blinded, placebo-controlled phase II sequential dose escalation trial designed to evaluate perioperative administration of an apoE mimetic peptide drug, CN-105, in older adults (age≥60 years). The primary aim is evaluating the safety of CN-105 administration, as measured by adverse event rates in CN-105 versus placebo-treated patients. Secondary aims include assessing perioperative CN-105 administration feasibility and its efficacy for reducing postoperative neuroinflammation and PND severity.Methods: 201 patients undergoing non-cardiac, non-neurological surgery will be randomized to control or CN-105 treatment groups and receive placebo or drug before and every six hours after surgery, for up to three days after surgery. Chart reviews, pre- and postoperative cognitive testing, delirium screening, and blood and CSF analyses will be performed to examine effects of CN-105 on perioperative adverse event rates, cognition, and neuroinflammation. Trial results will be disseminated by presentations at conferences and peer-reviewed publications.Conclusion: MARBLE is a transdisciplinary study designed to measure CN-105 safety and efficacy for preventing PND in older adults and to provide insight into the pathogenesis of these geriatric syndromes. [ABSTRACT FROM AUTHOR]

Published
2020
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50. Arterial pulse pressure and postoperative morbidity in high-risk surgical patients

Author

Ackland, G.L., primary, Abbott, T.E.F., additional, Pearse, R.M., additional, Karmali, S.N., additional, Whittle, J., additional, Minto, G., additional, Minto, Gary, additional, King, Angela, additional, Pollak, Claire, additional, Williams, Claire, additional, Patrick, Abigail, additional, West, Claire, additional, Vickers, Emma, additional, Green, Richard, additional, Clark, Martin, additional, Ackland, Gareth, additional, Whittle, John, additional, Paredes, Laura Gallego, additional, Stephens, Robert C.M., additional, Jones, Amy, additional, Otto, James, additional, Lach, Anna, additional, del Arroyo, Ana Gutierrez, additional, Toner, Andrew, additional, Williams, Alexandra, additional, Owen, Thomas, additional, Pradhu, Pradeep, additional, Hull, Daniel, additional, and Montague, Laura, additional

Published
2018
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