1
|
Cullen LA, Grange Z, Antal K, Waugh L, Alsina MS, Gibbons CL, MacDonald LE, Robertson C, Cameron JC, Stockton D, O'Leary MC. COVID-19 vaccine safety in Scotland - background rates of adverse events of special interest. Public Health 2023; 224:1-7. [PMID: 37688806 DOI: 10.1016/j.puhe.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Mass COVID-19 vaccination commenced in December 2020 in Scotland. Monitoring vaccine safety relies on accurate background incidence rates (IRs) for health outcomes potentially associated with vaccination. This study aimed to quantify IRs in Scotland of adverse events of special interest (AESI) potentially associated with COVID-19 vaccination. STUDY DESIGN AND METHODS IRs and 95% confidence intervals (CIs) for 36 AESI were calculated retrospectively for the pre-COVID-19 pandemic period (01 January 2015-31 December 2019) and the COVID-19 pandemic period (01 April 2020-30 November 2020), with age-sex stratification, and separately by calendar month and year. Incident cases were determined using International Classification of Diseases-10th Revision (ICD-10)-coded hospitalisations. RESULTS Prepandemic population-wide IRs ranged from 0.4 (0.3-0.5 CIs) cases per 100,000 person-years (PYRS) for neuromyelitis optica to 478.4 (475.8-481.0 CIs) cases per 100,000 PYRS for acute renal failure. Pandemic population-wide IRs ranged from 0.3 (0.2-0.5 CIs) cases per 100,000 PYRS for Kawasaki disease to 483.4 (473.2-493.7 CIs) cases per 100,000 PYRS for acute coronary syndrome. All AESI IRs varied by age and sex. Ten AESI (acute coronary syndrome, acute myocardial infarction, angina pectoris, heart failure, multiple sclerosis, polyneuropathies and peripheral neuropathies, respiratory failure, rheumatoid arthritis and polyarthritis, seizures and vasculitis) had lower pandemic than prepandemic period IRs overall. Only deep vein thrombosis and pulmonary embolism had a higher pandemic IR. CONCLUSION Lower pandemic IRs likely resulted from reduced health-seeking behaviours and healthcare provision. Higher IRs may be associated with SARS-CoV-2 infections. AESI IRs will facilitate future vaccine safety studies in Scotland.
Collapse
|
2
|
Gardner Yelton SE, Williams MA, Young M, Fields J, Pearl MS, Casella JF, Lawrence CE, Felling RJ, Jackson EM, Robertson C, Scafidi S, Lee JK, Cohen AR, Sun LR. Perioperative Management of Pediatric Patients with Moyamoya Arteriopathy. J Pediatr Intensive Care 2023; 12:159-166. [PMID: 37565017 PMCID: PMC10411150 DOI: 10.1055/s-0041-1731667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022] Open
Abstract
Pediatric patients with moyamoya arteriopathy are at high risk for developing new onset transient or permanent neurologic deficits secondary to cerebral hypoperfusion, particularly in the perioperative period. It is therefore essential to carefully manage these patients in a multidisciplinary, coordinated effort to reduce the risk of new permanent neurologic deficits. However, little has been published on perioperative management of pediatric patients with moyamoya, particularly in the early postoperative period during intensive care unit admission. Our pediatric neurocritical care team sought to create a multidisciplinary periprocedural evidence- and consensus-based care pathway for high-risk pediatric patients with moyamoya arteriopathy undergoing anesthesia for any reason to decrease the incidence of periprocedural stroke or transient ischemic attack (TIA). We reviewed the literature to identify risk factors associated with perioperative stroke or TIA among patients with moyamoya and to gather data supporting specific perioperative management strategies. A multidisciplinary team from pediatric anesthesia, neurocritical care, nursing, child life, neurosurgery, interventional neuroradiology, neurology, and hematology created a care pathway for children with moyamoya undergoing anesthesia, classifying them as either high or standard risk, and applying an individualized perioperative management plan to high-risk patients. The incidence of neurologic sequelae before and after pathway implementation will be compared in future studies.
Collapse
|
3
|
van Dongen J, Prokhorov L, Cooper SJ, Barton MA, Bonilla E, Dooley KL, Driggers JC, Effler A, Holland NA, Huddart A, Kasprzack M, Kissel JS, Lantz B, Mitchell AL, O'Dell J, Pele A, Robertson C, Mow-Lowry CM. Publisher's Note: "Reducing control noise in gravitational wave detectors with interferometric local damping of suspended optics" [Rev. Sci. Instrum. 94, 054501 (2023)]. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2023; 94:069901. [PMID: 37862549 DOI: 10.1063/5.0159530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Indexed: 10/22/2023]
|
4
|
van Dongen J, Prokhorov L, Cooper SJ, Barton MA, Bonilla E, Dooley KL, Driggers JC, Effler A, Holland NA, Huddart A, Kasprzack M, Kissel JS, Lantz B, Mitchell AL, O'Dell J, Pele A, Robertson C, Mow-Lowry CM. Reducing control noise in gravitational wave detectors with interferometric local damping of suspended optics. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2023; 94:054501. [PMID: 37191465 DOI: 10.1063/5.0144865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/26/2023] [Indexed: 05/17/2023]
Abstract
Control noise is a limiting factor in the low-frequency performance of the Advanced Laser Interferometer Gravitational-Wave Observatory (LIGO). In this paper, we model the effects of using new sensors called Homodyne Quadrature Interferometers (HoQIs) to control the suspension resonances. We show that if we were to use HoQIs, instead of the standard shadow sensors, we could suppress resonance peaks up to tenfold more while simultaneously reducing the noise injected by the damping system. Through a cascade of effects, this will reduce the resonant cross-coupling of the suspensions, allow for improved stability for feed-forward control, and result in improved sensitivity of the detectors in the 10-20 Hz band. This analysis shows that improved local sensors, such as HoQIs, should be used in current and future detectors to improve low-frequency performance.
Collapse
|
5
|
Robertson C, Johnson N, Bird R, Key J. Using Early Exam Results to Predict Online MLS Program Success. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
The objective of this effort is to demonstrate the impact of early didactic exam results for potential early intervention for students in an online medical laboratory science bridge program.
Methods/Case Report
For this study, we took retrospective data of 299 students from 2018 to 2021 who took MLSC 4312, Hematology, in their first semester. We then analyzed their first exam score and then used this data to evaluate its potential use as an early predictor of overall student success in both this course and the program. Specifically, the exam one score in the course was used to evaluate progression to the second semester, graduation, UAMS GPA, and ASCP Board of Certification total score and Hematology sub-score. Descriptive statistics and 2-sample T-tests were calculated using Number Cruncher Statistical System. Fisher’s exact test was performed using Graphpad software.
Results (if a Case Study enter NA)
Of the 296 students whose records were examined, 49 scored below a 76% on Hematology exam 1. 247 students scored above 75%.35 students who scored below 76% progressed to the second semester and of those, 33 (94.2%) graduated on time. 14 students were dismissed from the program after the first semester. The overall graduation rate of students who started the program and scored less than 76% on the first hematology exam was 67%. Of the 247 students who scored above 76% on exam 1, 229 (93%) progressed to the second semester and of those, 214 graduated on time (93.4%). 18 of these students were dismissed from the program. The overall graduation rate of students who started the program and scored greater than 76% on the first hematology exam was 86.70%. The overall ASCP Board of Certification pass rate was almost 19 percent higher, 81.7% vs. 62.9% in those who scored greater than 76% on the first hematology exam. Each of the comparisons was statistically significant (P=<0.05) using a 2-sample T-test or Fisher’s exact test as appropriate.
Conclusion
This study revealed the importance of doing well on the first major didactic exam in the Medical Laboratory Sciences program. Students who score < 76% on their first exam fail to progress to the second semester at four times the rate of those who score >76%. In addition, those who score <76% and progress fail the ASCP Board of Certification Exam at almost double the rate of those who score >76% on the first hematology exam. In the future, we will reach out earlier and offer targeted help to these students.
Collapse
|
6
|
Chen Y, Tiddens H, Byrnes C, Carlin J, Cheney J, Cooper P, Grimwood K, Kemner-van de Corput M, Massie J, Robertson C, Sly P, Vidmar S, Wainwright C. 183 Chest computed tomography assessment to monitor cystic fibrosis structural lung disease progression in bronchiectasis during late childhood and adolescence. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00873-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
7
|
Mainali S, Aiyagari V, Alexander S, Bodien Y, Boerwinkle V, Boly M, Brown E, Brown J, Claassen J, Edlow BL, Fink EL, Fins JJ, Foreman B, Frontera J, Geocadin RG, Giacino J, Gilmore EJ, Gosseries O, Hammond F, Helbok R, Claude Hemphill J, Hirsch K, Kim K, Laureys S, Lewis A, Ling G, Livesay SL, McCredie V, McNett M, Menon D, Molteni E, Olson D, O'Phelan K, Park S, Polizzotto L, Javier Provencio J, Puybasset L, Venkatasubba Rao CP, Robertson C, Rohaut B, Rubin M, Sharshar T, Shutter L, Sampaio Silva G, Smith W, Stevens RD, Thibaut A, Vespa P, Wagner AK, Ziai WC, Zink E, Suarez JI. Correction to: Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness. Neurocrit Care 2022; 37:608-609. [PMID: 35715614 PMCID: PMC9519697 DOI: 10.1007/s12028-022-01536-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
8
|
Mainali S, Aiyagari V, Alexander S, Bodien Y, Boerwinkle V, Boly M, Brown E, Brown J, Claassen J, Edlow BL, Fink EL, Fins JJ, Foreman B, Frontera J, Geocadin RG, Giacino J, Gilmore EJ, Gosseries O, Hammond F, Helbok R, Claude Hemphill J, Hirsch K, Kim K, Laureys S, Lewis A, Ling G, Livesay SL, McCredie V, McNett M, Menon D, Molteni E, Olson D, O'Phelan K, Park S, Polizzotto L, Javier Provencio J, Puybasset L, Venkatasubba Rao CP, Robertson C, Rohaut B, Rubin M, Sharshar T, Shutter L, Sampaio Silva G, Smith W, Stevens RD, Thibaut A, Vespa P, Wagner AK, Ziai WC, Zink E, I Suarez J. Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness. Neurocrit Care 2022; 37:326-350. [PMID: 35534661 PMCID: PMC9283342 DOI: 10.1007/s12028-022-01505-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/29/2022] [Indexed: 12/21/2022]
Abstract
This proceedings article presents actionable research targets on the basis of the presentations and discussions at the 2nd Curing Coma National Institutes of Health (NIH) symposium held from May 3 to May 5, 2021. Here, we summarize the background, research priorities, panel discussions, and deliverables discussed during the symposium across six major domains related to disorders of consciousness. The six domains include (1) Biology of Coma, (2) Coma Database, (3) Neuroprognostication, (4) Care of Comatose Patients, (5) Early Clinical Trials, and (6) Long-term Recovery. Following the 1st Curing Coma NIH virtual symposium held on September 9 to September 10, 2020, six workgroups, each consisting of field experts in respective domains, were formed and tasked with identifying gaps and developing key priorities and deliverables to advance the mission of the Curing Coma Campaign. The highly interactive and inspiring presentations and panel discussions during the 3-day virtual NIH symposium identified several action items for the Curing Coma Campaign mission, which we summarize in this article.
Collapse
|
9
|
Robertson C, Mortimer A. Quantitative EEG (qEEG) guided transcranial magnetic stimulation (TMS) treatment for depression and anxiety disorders: An open, observational cohort study of 210 patients. J Affect Disord 2022; 308:322-327. [PMID: 35439465 DOI: 10.1016/j.jad.2022.04.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Major depression and anxiety disorders represent a substantial burden of morbidity. Neither antidepressant medication nor psychological interventions are fully effective, the former beset with side effects, interactions and compliance issues, and the latter requiring patient engagement, effort and a degree of psychological mindedness. Both treatments are lengthy. TMS by contrast is virtually free of side effects and compliance issues, relatively brief, and requires no patient effort. Nevertheless, remission rates are only about 1 in 3 with standard left frontal rapid (rTMS) stimulation, and up to 30 treatment sessions may be required. Our aim was to improve the effectiveness of TMS treatment using bespoke as opposed to standard left frontal rTMS, including theta burst stimulation (TBS). METHODS 210 male and female patients were treated: regions and frequencies of TMS were guided by quantitative EEG analysis (qEEG) to elicit recognisable phenotypes, neuromarkers integral to the genesis of major depression and anxiety disorder, dictating treatment parameters. RESULTS 98 patients (47%) achieved at least 50% reduction in Hamilton depression rating scale scores, while a further 60 (29%) patients achieved a 30-50% reduction, over a mean of 7.03 ± 0.3 treatment sessions. Theta burst stimulation (TBS) almost halved treatment time within session compared to rTMS. The effect size (Cohen's d) for both treatments was large (>0.8) with rTMS at 1.43 (1.16-1.70) and TBS at 1.87 (1.48-2.25). CONCLUSIONS qEEG guided TMS treatment is a safe and effective treatment in depression and anxiety disorders.
Collapse
|
10
|
Gregory L, Garikipati S, Thornton J, Tahir B, White S, Foran B, Robertson C. The length of time taken from gastrostomy tube insertion to removal and the factors influencing this following curative head and neck cancer treatment: a service evaluation at a single tertiary oncology centre. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
11
|
Bradley DT, Murphy S, McWilliams P, Arnold S, Lavery S, Murphy J, de Lusignan S, Hobbs R, Tsang RSM, Akbari A, Torabi F, Beggs J, Chuter A, Shi T, Vasileiou E, Robertson C, Sheikh A, Reid H, O'Reilly D. Investigating the association between COVID-19 vaccination and care home outbreak frequency and duration. Public Health 2022; 203:110-115. [PMID: 35038629 PMCID: PMC8683272 DOI: 10.1016/j.puhe.2021.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES At the end of 2020, many countries commenced a vaccination programme against SARS-CoV-2. Public health authorities aim to prevent and interrupt outbreaks of infectious disease in social care settings. We aimed to investigate the association between the introduction of the vaccination programme and the frequency and duration of COVID-19 outbreaks in Northern Ireland (NI). STUDY DESIGN We undertook an ecological study using routinely available national data. METHODS We used Poisson regression to measure the relationship between the number of RT-PCR confirmed COVID-19 outbreaks in care homes, and as a measure of community COVID-19 prevalence, the Office for National Statistics COVID-19 Infection Survey estimated the number of people testing positive for COVID-19 in NI. We estimated the change in this relationship and estimated the expected number of care home outbreaks in the absence of the vaccination programme. A Cox proportional hazards model estimated the hazard ratio of a confirmed COVID-19 care home outbreak closure. RESULTS Care home outbreaks reduced by two-thirds compared to expected following the introduction of the vaccination programme, from a projected 1625 COVID-19 outbreaks (95% prediction interval 1553-1694) between 7 December 2020 and 28 October 2021 to an observed 501. We estimated an adjusted hazard ratio of 2.53 of the outbreak closure assuming a 21-day lag for immunity. CONCLUSIONS These findings describe the association of the vaccination with a reduction in outbreak frequency and duration across NI care homes. This indicates probable reduced harm and disruption from COVID-19 in social care settings following vaccination. Future research using individual level data from care home residents will be needed to investigate the effectiveness of the vaccines and the duration of their effects.
Collapse
|
12
|
Malerba L, Caturla M, Gaganidze E, Kaden C, Konstantinović M, Olsson P, Robertson C, Rodney D, Ruiz-Moreno A, Serrano M, Aktaa J, Anento N, Austin S, Bakaev A, Balbuena J, Bergner F, Boioli F, Boleininger M, Bonny G, Castin N, Chapman J, Chekhonin P, Clozel M, Devincre B, Dupuy L, Diego G, Dudarev S, Fu CC, Gatti R, Gélébart L, Gómez-Ferrer B, Gonçalves D, Guerrero C, Gueye P, Hähner P, Hannula S, Hayat Q, Hernández-Mayoral M, Jagielski J, Jennett N, Jiménez F, Kapoor G, Kraych A, Khvan T, Kurpaska L, Kuronen A, Kvashin N, Libera O, Ma PW, Manninen T, Marinica MC, Merino S, Meslin E, Mompiou F, Mota F, Namburi H, Ortiz C, Pareige C, Prester M, Rajakrishnan R, Sauzay M, Serra A, Simonovski I, Soisson F, Spätig P, Tanguy D, Terentyev D, Trebala M, Trochet M, Ulbricht A, M.Vallet, Vogel K, Yalcinkaya T, Zhao J. Multiscale modelling for fusion and fission materials: The M4F project. NUCLEAR MATERIALS AND ENERGY 2021. [DOI: 10.1016/j.nme.2021.101051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
13
|
Robertson C, Al-Moasseb Z, Noonan Z, Boyle JG. The 3-D Skills Model: a Randomised Controlled Pilot Study Comparing a Novel 1-1 Near-Peer Teaching Model to a Formative OSCE with Self-regulated Practice. MEDICAL SCIENCE EDUCATOR 2021; 31:1789-1801. [PMID: 34950527 PMCID: PMC8651955 DOI: 10.1007/s40670-021-01369-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Near-peer teaching is a popular pedagogical teaching tool, with well-recognised benefits for students and tutors. There are multiple existing models to structure these interventions, but it is often unclear how they translate to academic attainment. We designed a novel near-peer teaching model that expands on previous research. METHODS Our model was piloted in a formative Objective Structured Clinical Examination (OSCE) setting, trialled on 22 pre-clinical medical students to establish feasibility, acceptability and descriptive outcomes that could inform the design of a larger study. Students were randomly assigned to intervention or control cohorts. Each cohort undertook 5 min formative OSCE assessments with either 3 additional minutes of structured teaching or 3 min of self-regulated practice before reattempting the first OSCE station. Checklist marking sheets for 1st and 2nd sittings were collected by independent external markers, in addition to a global assessment rating in which we used the Borderline Regression Method to establish the station pass mark. RESULTS A quantitative and qualitative result analysis was performed, demonstrating that students gained on average 3 additional marks after teaching with this model. Students and student-tutors reported increased confidence, high course satisfaction and evidence of reflective practice. DISCUSSION We established acceptability and feasibility outcomes. The descriptive outcomes will support the design of a larger, adequately powered study required to demonstrate translation to summative exam performance. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01369-w.
Collapse
|
14
|
Chantreau Majerus R, Robertson C, Habershon S. Assessing and rationalizing the performance of Hessian update schemes for reaction path Hamiltonian rate calculations. J Chem Phys 2021; 155:204112. [PMID: 34852478 DOI: 10.1063/5.0064685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The reaction path Hamiltonian (RPH) can be used to calculate chemical reaction rate constants, going beyond transition-state theory in taking account of recrossing by providing an approximation to the dynamic transmission coefficient. However, the RPH necessitates the calculation of the Hessian matrix at a number of points along the minimum energy path; the associated computational cost stands as a bottleneck in RPH calculations, especially if one is interested in using high-accuracy electronic structure methods. In this work, four different Hessian update schemes (symmetric rank-1, Powell-symmetric Broyden, Bofill, and TS-BFGS updates) are assessed to see whether or not they reliably reproduce calculated transmission coefficients for three different chemical reactions. Based on the reactions investigated, the symmetric rank-1 Hessian update was the least appropriate for RPH construction, giving different transmission coefficients from the standard analytical Hessian approach, as well as inconsistent frequencies and coupling properties. The Bofill scheme, the Powell-symmetric Broyden scheme, and the TS-BFGS scheme were the most reliable Hessian update methods, with transmission coefficients that were in good agreement with those calculated by the standard RPH calculations. The relative accuracy of the different Hessian update schemes is further rationalized by investigating the approximated Coriolis and curvature coupling terms along the reaction-path, providing insight into when these schemes would be expected to work well. Furthermore, the associated computational cost associated with the RPH calculations was substantially reduced by the tested update schemes. Together, these results provide useful rules-of-thumb for using Hessian update schemes in RPH simulations.
Collapse
|
15
|
O’Connor J, Wagner B, Harris J, Robertson C, Laguna T. 452: Contribution of fungus to the airway microbiome in children with and without cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01876-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Singh K, Robertson C, Bhaduri A. Irradiation in BCC materials: Defect-induced changes of the effective dislocation mobility and their relation with the dose-dependent fracture response. PROGRESS IN NUCLEAR ENERGY 2021. [DOI: 10.1016/j.pnucene.2021.103926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
17
|
McAuley A, Gousias P, Hasan T, Rashid L, Richardson C, Reid G, Templeton K, McGuire J, Wise H, McVicar L, Jenks S, Gunn R, Dickson E, Stock SJ, Stockton A, Waugh C, Wood R, McMenamin J, Robertson C, Goldberg DJ, Palmateer NE. National population prevalence of antibodies to SARS-CoV-2 among pregnant women in Scotland during the second wave of the COVID-19 pandemic: a prospective national serosurvey. Public Health 2021; 199:17-19. [PMID: 34517289 PMCID: PMC8364809 DOI: 10.1016/j.puhe.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study aimed to determine SARS-CoV-2 seroprevalence among pregnant women in the Scottish population during the second wave of the COVID-19 pandemic. STUDY DESIGN Prospective national serosurvey. METHODS We tested 13,428 residual samples retrieved from pregnant women participating in the first trimester combined ultrasound and biochemical screening for fetal trisomy across Scotland for SARS-CoV-2 antibodies over a 6-month period from November 2020 to April 2021. Seroprevalence estimates were adjusted for the sensitivity and specificity of the assays and weighted to reference populations. RESULTS Seroprevalence rates in the antenatal samples significantly increased from 5.5% (95% confidence interval [CI] 4.7%-6.5%) in the 5-week period up to and including International Organization for Standardization (ISO) Week 51 (w/b Monday 14 December 2020) to 11.3% (95% CI 10.1%-12.6%) in the 5-week period up to and including ISO Week 14 (w/b Monday 5 April 2021). Increasing seroprevalence trends across the second wave were observed among all age groups. CONCLUSIONS By the end of the second wave of the COVID-19 pandemic, approximately one in 10 women tested around the end of the first trimester of pregnancy had antibodies to SARS-CoV-2, suggesting that the vast majority were still susceptible to COVID-19 as they progressed to the later stages of pregnancy, when risks from infection are elevated for both mother and baby.
Collapse
|
18
|
Boyers D, Retat L, Jacobsen E, Avenell A, Aveyard P, Corbould E, Jaccard A, Cooper D, Robertson C, Aceves-Martins M, Xu B, Skea Z, de Bruin M. Cost-effectiveness of bariatric surgery and non-surgical weight management programmes for adults with severe obesity: a decision analysis model. Int J Obes (Lond) 2021; 45:2179-2190. [PMID: 34088970 PMCID: PMC8455321 DOI: 10.1038/s41366-021-00849-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To determine the most cost-effective weight management programmes (WMPs) for adults, in England with severe obesity (BMI ≥ 35 kg/m2), who are more at risk of obesity related diseases. METHODS An economic evaluation of five different WMPs: 1) low intensity (WMP1); 2) very low calorie diets (VLCD) added to WMP1; 3) moderate intensity (WMP2); 4) high intensity (Look AHEAD); and 5) Roux-en-Y gastric bypass (RYGB) surgery, all compared to a baseline scenario representing no WMP. We also compare a VLCD added to WMP1 vs. WMP1 alone. A microsimulation decision analysis model was used to extrapolate the impact of changes in BMI, obtained from a systematic review and meta-analysis of randomised controlled trials (RCTs) of WMPs and bariatric surgery, on long-term risks of obesity related disease, costs, quality adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) measured as incremental cost per QALY gained over a 30-year time horizon from a UK National Health Service (NHS) perspective. Sensitivity analyses explored the impact of long-term weight regain assumptions on results. RESULTS RYGB was the most costly intervention but also generated the lowest incidence of obesity related disease and hence the highest QALY gains. Base case ICERs for WMP1, a VLCD added to WMP1, WMP2, Look AHEAD, and RYGB compared to no WMP were £557, £6628, £1540, £23,725 and £10,126 per QALY gained respectively. Adding a VLCD to WMP1 generated an ICER of over £121,000 per QALY compared to WMP1 alone. Sensitivity analysis found that all ICERs were sensitive to the modelled base case, five year post intervention cessation, weight regain assumption. CONCLUSIONS RYGB surgery was the most effective and cost-effective use of scarce NHS funding resources. However, where fixed healthcare budgets or patient preferences exclude surgery as an option, a standard 12 week behavioural WMP (WMP1) was the next most cost-effective intervention.
Collapse
|
19
|
Khoury M, Hajihosseini M, Joffe A, Bond G, Dinu I, Makarchuk S, Robertson C, Atallah J. EVALUATING THE PREVALENCE AND FACTORS ASSOCIATED WITH AN OPTIMAL NEURODEVELOPMENTAL OUTCOME IN CHILDREN WITH FONTAN CIRCULATION. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
20
|
Stewart S, Robertson C, Pan J, Kennedy S, Haahr L, Manoukian S, Mason H, Kavanagh K, Graves N, Dancer SJ, Cook B, Reilly J. Impact of healthcare-associated infection on length of stay. J Hosp Infect 2021; 114:23-31. [PMID: 34301393 DOI: 10.1016/j.jhin.2021.02.026] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Increased length of stay (LOS) for patients is an important measure of the burden of healthcare-associated infection (HAI). AIM To estimate the excess LOS attributable to HAI. METHODS This was a one-year prospective incidence study of HAI observed in one teaching hospital and one general hospital in NHS Scotland as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. All adult inpatients with an overnight stay were included. HAI was diagnosed using European Centres for Disease Prevention and Control definitions. A multi-state model was used to account for the time-varying nature of HAI and the competing risks of death and discharge. FINDINGS The excess LOS attributable to HAI was 7.8 days (95% confidence interval (CI): 5.7-9.9). Median LOS for HAI patients was 30 days and for non-HAI patients was 3 days. Using a simple comparison of duration of hospital stay for HAI cases and non-cases would overestimate the excess LOS by 3.5 times (27 days compared with 7.8 days). The greatest impact on LOS was due to pneumonia (16.3 days; 95% CI: 7.5-25.2), bloodstream infections (11.4 days; 5.8-17.0) and surgical site infection (SSI) (9.8 days; 4.5-15.0). It is estimated that 58,000 bed-days are occupied due to HAI annually. CONCLUSION A reduction of 10% in HAI incidence could make 5800 bed-days available. These could be used to treat 1706 elective patients in Scotland annually and help reduce the number of patients awaiting planned treatment. This study has important implications for investment decisions in infection prevention and control interventions locally, nationally, and internationally.
Collapse
|
21
|
Manoukian S, Stewart S, Graves N, Mason H, Robertson C, Kennedy S, Pan J, Kavanagh K, Haahr L, Adil M, Dancer SJ, Cook B, Reilly J. Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK. J Hosp Infect 2021; 114:43-50. [PMID: 34301395 DOI: 10.1016/j.jhin.2020.12.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Healthcare-associated infection (HAI) is associated with increased morbidity and mortality resulting in excess costs. AIM To investigate the impact of all types of HAI on the inpatient cost of HAI using different approaches. METHODS The incidence, types of HAI, and excess length of stay were estimated using data collected as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. Scottish NHS reference costs were used to estimate unit costs for bed-days. Variable (cash) costs associated with infection prevention and control (IPC) measures and treatment were calculated for each HAI type and overall. The inpatient cost of HAI is presented in terms of bed-days lost, bed-day costs, and cash costs. FINDINGS In Scotland 58,010 (95% confidence interval: 41,730-74,840) bed-days were estimated to be lost to HAI during 2018/19, costing £46.4 million (19m-129m). The total annual cost in the UK is estimated to be £774 million (328m-2,192m). Bloodstream infection and pneumonia were the most costly HAI types per case. Cash costs are a small proportion of the total cost of HAI, contributing 2.4% of total costs. CONCLUSION Reliable estimates of the cost burden of HAI management are important for assessing the cost-effectiveness of IPC programmes. This unique study presents robust economic data, demonstrating that HAI remains a burden to the UK NHS and bed-days capture the majority of inpatient costs. These findings can be used to inform the economic evaluation and decision analytic modelling of competing IPC programmes at local and national level.
Collapse
|
22
|
Stewart S, Robertson C, Pan J, Kennedy S, Dancer S, Haahr L, Manoukian S, Mason H, Kavanagh K, Cook B, Reilly J. Epidemiology of healthcare-associated infection reported from a hospital-wide incidence study: considerations for infection prevention and control planning. J Hosp Infect 2021; 114:10-22. [PMID: 34301392 DOI: 10.1016/j.jhin.2021.03.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/22/2021] [Accepted: 03/04/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND The measure of disease frequency most widely used to report healthcare-associated infection (HAI) is the point-prevalence survey. Incidence studies are rarely performed due to time and cost constraints; they show which patients are affected by HAI, when and where, and inform planning and design of infection prevention and control (IPC) measures. AIM To determine the epidemiology of HAI within a general and a teaching hospital in Scotland. METHODS A prospective observational incidence study was undertaken for one year from April 2018 using data collected as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. A novel, robust approach was undertaken, using record linkage to national administrative data to provide full admission and discharge information. Cases were recorded if they met international HAI definitions. FINDINGS Incidence of HAI for the combined hospitals was 250 HAI cases per 100,000 acute occupied bed-days (AOBD). Highest frequency was in urinary tract (51.2 per 100,000 AOBD), bloodstream (44.7), and lower respiratory tract infection (42.2). The most frequently reported organisms were Escherichia coli, Staphylococcus aureus, and norovirus. Incidence of HAI was higher in older people and emergency cases. There was an increase in the rate of HAI in summer months (pneumonia, respiratory, surgical, and gastrointestinal infection) and in winter months norovirus gastrointestinal infection (P < 0.0001). The highest incidence specialties were intensive care, renal medicine, and cardiothoracic surgery. HAI occurred at a median of 9 days (interquartile range: 4-19) after admission. Incidence data were extrapolated to provide an annual national estimate of HAI in NHS Scotland of 7437 (95% confidence interval: 7021-7849) cases. CONCLUSION This study provides a unique overview of incidence of HAI and identifies the burden of HAI at the national level for the first time. Understanding the incidence in different clinical settings, at different times, will allow targeting of IPC measures to those patients who would benefit the most.
Collapse
|
23
|
Stewart S, Robertson C, Kennedy S, Kavanagh K, Haahr L, Manoukian S, Mason H, Dancer S, Cook B, Reilly J. Personalized infection prevention and control: identifying patients at risk of healthcare-associated infection. J Hosp Infect 2021; 114:32-42. [PMID: 34301394 DOI: 10.1016/j.jhin.2021.03.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/22/2021] [Accepted: 03/25/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Few healthcare-associated infection (HAI) studies focus on risk of HAI at the point of admission. Understanding this will enable planning and management of care with infection prevention at the heart of the patient journey from the point of admission. AIM To determine intrinsic characteristics of patients at hospital admission and extrinsic events, during the two years preceding admission, that increase risk of developing HAI. METHODS An incidence survey of adults within two hospitals in NHS Scotland was undertaken for one year in 2018/19 as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. The primary outcome measure was developing any HAI using recognized case definitions. The cohort was derived from routine hospital episode data and linkage to community dispensed prescribing data. FINDINGS The risk factors present on admission observed as being the most significant for the acquisition of HAI were: being treated in a teaching hospital, increasing age, comorbidities of cancer, cardiovascular disease, chronic renal failure and diabetes; and emergency admission. Relative risk of developing HAI increased with intensive care unit, high-dependency unit, and surgical specialties, and surgery <30 days before admission and a total length of stay of >30 days in the two years to admission. CONCLUSION Targeting patients at risk of HAI from the point of admission maximizes the potential for prevention, especially when extrinsic risk factors are known and managed. This study proposes a new approach to infection prevention and control (IPC), identifying those patients at greatest risk of developing a particular type of HAI who might be potential candidates for personalized IPC interventions.
Collapse
|
24
|
Conway D, Culshaw S, Edwards M, Clark C, Watling C, Robertson C, Braid R, O’Keefe E, McGoldrick N, Burns J, Provan S, VanSteenhouse H, Hay J, Gunson R. SARS-CoV-2 Positivity in Asymptomatic-Screened Dental Patients. J Dent Res 2021; 100:583-590. [PMID: 33779355 PMCID: PMC8138329 DOI: 10.1177/00220345211004849] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Enhanced community surveillance is a key pillar of the public health response to coronavirus disease 2019 (COVID-19). Asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potentially significant source of transmission, yet remains relatively poorly understood. Disruption of dental services continues with significantly reduced capacity. Ongoing precautions include preappointment and/or at appointment COVID-19 symptom screening and use of enhanced personal protective equipment (PPE). This study aimed to investigate SARS-CoV-2 infection in dental patients to inform community surveillance and improve understanding of risks in the dental setting. Thirty-one dental care centers across Scotland invited asymptomatic-screened patients aged over 5 y to participate. Following verbal consent and completion of sociodemographic and symptom history questionnaire, trained dental teams took a combined oropharyngeal and nasal swab sample using standardized Viral Transport Medium-containing test kits. Samples were processed by the Lighthouse Lab and patients informed of their results by SMS/email with appropriate self-isolation guidance in the event of a positive test. All positive cases were successfully followed up by the national contact tracing program. Over a 13-wk period (from August 3, 2020, to October 31, 2020), 4,032 patients, largely representative of the population, were tested. Of these, 22 (0.5%; 95% CI, 0.5%-0.8%) tested positive for SARS-CoV-2. The positivity rate increased over the period, commensurate with uptick in community prevalence identified across all national testing monitoring data streams. To our knowledge, this is the first report of a COVID-19 testing survey in asymptomatic-screened patients presenting in a dental setting. The positivity rate in this patient group reflects the underlying prevalence in community at the time. These data are a salient reminder, particularly when community infection levels are rising, of the importance of appropriate ongoing infection prevention control and PPE vigilance, which is relevant as health care team fatigue increases as the pandemic continues. Dental settings are a valuable location for public health surveillance.
Collapse
|
25
|
Flook M, Jackson C, Vasileiou E, Simpson CR, Muckian MD, Agrawal U, McCowan C, Jia Y, Murray JLK, Ritchie LD, Robertson C, Stock SJ, Wang X, Woolhouse MEJ, Sheikh A, Stagg HR. Informing the public health response to COVID-19: a systematic review of risk factors for disease, severity, and mortality. BMC Infect Dis 2021; 21:342. [PMID: 33845766 PMCID: PMC8040367 DOI: 10.1186/s12879-021-05992-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 03/16/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. METHODS Medline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. RESULTS One thousand two hundred and thirty-eight papers were identified post-deduplication. Thirty-three met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. CONCLUSIONS The volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected. REGISTRATION This review was registered on PROSPERO as CRD42020177714 .
Collapse
|