1
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Murali M, Charlesworth M. How to write pilot and feasibility studies. Anaesthesia 2024. [PMID: 38489827 DOI: 10.1111/anae.16283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Affiliation(s)
- M Murali
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
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2
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Oliver C, Charlesworth M, Pratt O, Sutton R, Metodiev Y. Anaesthetic subspecialties and sustainable healthcare: a narrative review. Anaesthesia 2024; 79:301-308. [PMID: 38207014 DOI: 10.1111/anae.16169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 01/13/2024]
Abstract
The principles of environmentally sustainable healthcare as applied to anaesthesia and peri-operative care are well documented. Associated recommendations focus on generic principles that can be applied to all areas of practice. These include reducing the use of inhalational anaesthetic agents and carbon dioxide equivalent emissions of modern peri-operative care. However, four areas of practice have specific patient, surgical and anaesthetic factors that present barriers to the implementation of some of these principles, namely: neuroanaesthesia; obstetric; paediatric; and cardiac anaesthesia. This narrative review describes these factors and synthesises the available evidence to highlight areas of sustainable practice clinicians can address today, as well as posing several unanswered questions for the future. In neuroanaesthesia, improvements can be made by undertaking awake surgery, moving towards more reusables and embracing telemedicine in quaternary services. Obstetric anaesthesia continues to present questions regarding how services can move away from nitrous oxide use or limit its release to the environment. The focus for paediatric anaesthesia is addressing the barriers to total intravenous and regional anaesthesia. For cardiac anaesthesia, a significant emphasis is determining how to focus the substantial resources required on those who will benefit from cardiac interventions, rather than universal implementation. Whilst the landscape of evidence-based sustainable practice is evolving, there remains an urgent need for further original evidence in healthcare sustainability targeting these four clinical areas.
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Affiliation(s)
- C Oliver
- Department of Anaesthesia, University Hospital of Wales, Cardiff, UK
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - O Pratt
- Department of Anaesthesia, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - R Sutton
- Department of Anaesthesia, Royal Manchester Children's Hospital, Manchester, UK
| | - Y Metodiev
- Department of Anaesthesia, University Hospital of Wales, Cardiff, UK
- School of Medicine, Cardiff University, Cardiff, UK
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3
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Charlesworth M, Laycock H. Driving down the carbon cost of peri-operative care: old controversies, new topics, fresh perspectives and the future. Anaesthesia 2024; 79:223-225. [PMID: 38205582 DOI: 10.1111/anae.16217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/12/2024]
Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - H Laycock
- Department of Anaesthesia, Great Ormond Street Hospital, London, UK
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4
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Keane E, Charlesworth M. Data-driven decision-making for extreme-risk emergency laparotomy: a national success story? Anaesthesia 2023; 78:1431-1434. [PMID: 37772614 DOI: 10.1111/anae.16136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 09/30/2023]
Affiliation(s)
- E Keane
- Department of Anaesthesia and Critical Care, University Hospital Limerick, Limerick, Ireland
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
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5
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Pollin G, De Assuncao T, Doria Jorge S, Chi YI, Charlesworth M, Madden B, Iovanna J, Zimmermann M, Urrutia R, Lomberk G. Writers and readers of H3K9me2 form distinct protein networks during the cell cycle that include candidates for H3K9 mimicry. Biosci Rep 2023; 43:BSR20231093. [PMID: 37782747 PMCID: PMC10611923 DOI: 10.1042/bsr20231093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 10/04/2023] Open
Abstract
Histone H3 lysine 9 methylation (H3K9me), which is written by the Euchromatic Histone Lysine Methyltransferases EHMT1 and EHMT2 and read by the heterochromatin protein 1 (HP1) chromobox (CBX) protein family, is dysregulated in many types of cancers. Approaches to inhibit regulators of this pathway are currently being evaluated for therapeutic purposes. Thus, knowledge of the complexes supporting the function of these writers and readers during the process of cell proliferation is critical for our understanding of their role in carcinogenesis. Here, we immunopurified each of these proteins and used mass spectrometry to define their associated non-histone proteins, individually and at two different phases of the cell cycle, namely G1/S and G2/M. Our findings identify novel binding proteins for these writers and readers, as well as corroborate known interactors, to show the formation of distinct protein complex networks in a cell cycle phase-specific manner. Furthermore, there is an organizational switch between cell cycle phases for interactions among specific writer-reader pairs. Through a multi-tiered bioinformatics-based approach, we reveal that many interacting proteins exhibit histone mimicry, based on an H3K9-like linear motif. Gene ontology analyses, pathway enrichment, and network reconstruction inferred that these comprehensive EHMT and CBX-associated interacting protein networks participate in various functions, including transcription, DNA repair, splicing, and membrane disassembly. Combined, our data reveals novel complexes that provide insight into key functions of cell cycle-associated epigenomic processes that are highly relevant for better understanding these chromatin-modifying proteins during cell cycle and carcinogenesis.
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Affiliation(s)
- Gareth Pollin
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Division of Research, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI Center, Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - Thiago M. De Assuncao
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Division of Research, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI Center, Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - Salomao Doria Jorge
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - Young-In Chi
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Division of Research, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI Center, Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | | | - Benjamin Madden
- Medical Genome Facility, Proteomics Core, Mayo Clinic, Rochester, MN, U.S.A
| | - Juan Iovanna
- Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France
| | - Michael T. Zimmermann
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Clinical and Translational Sciences Institute, Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - Raul Urrutia
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Division of Research, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI Center, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - Gwen Lomberk
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Division of Research, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI Center, Medical College of Wisconsin, Milwaukee, WI, U.S.A
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, U.S.A
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6
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Agarwal S, Charlesworth M, Elrakhawy M. How to write a narrative review. Anaesthesia 2023. [PMID: 37010983 DOI: 10.1111/anae.16016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/04/2023]
Affiliation(s)
- S Agarwal
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
- Manchester University, Manchester, UK
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - M Elrakhawy
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
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7
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Charlesworth M, Williams B, Ray S. Infective endocarditis. BJA Educ 2023; 23:144-152. [PMID: 36960439 PMCID: PMC10028394 DOI: 10.1016/j.bjae.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/04/2023] [Indexed: 02/24/2023] Open
Affiliation(s)
- M. Charlesworth
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - B.G. Williams
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - S. Ray
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
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8
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Gardner AL, Charlesworth M. How to write a retrospective observational study. Anaesthesia 2023; 78:521-525. [PMID: 35918805 DOI: 10.1111/anae.15831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- A L Gardner
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
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9
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Hughes C, Wiles MD, Charlesworth M. How to visually represent data. Anaesthesia 2023. [PMID: 36756697 DOI: 10.1111/anae.15969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 02/10/2023]
Affiliation(s)
- C Hughes
- Unit of Academic Anaesthesia, Critical Care and Peri-operative Medicine, University of Glasgow, UK
| | - M D Wiles
- Department of Critical Care, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.,University of Sheffield Medical School, Sheffield, UK
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
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10
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Charlesworth M, Carlisle J. How to design and interpret a randomised controlled trial using Bayesian statistics. Anaesthesia 2023; 78:119-124. [PMID: 35793093 DOI: 10.1111/anae.15800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 12/13/2022]
Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - J Carlisle
- Department of Anaesthesia, Peri-operative Medicine and Intensive Care, Torbay Hospital, Devon, UK
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11
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Agarwal S, El‐Boghdadly K, Bailey CR, Carlisle JB, Charlesworth M, Duggan LV, Irwin MG, Klein AA, Laycock H, Mariano ER, Moppett IK, Morton B, Savic L, Smith AF, Vercueil AE, Wiles MD. Position statement from the Editors of
Anaesthesia
on equity, diversity and inclusion. Anaesthesia 2022; 77:1018-1022. [DOI: 10.1111/anae.15763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2022] [Indexed: 01/02/2023]
Affiliation(s)
- S. Agarwal
- Department of Anaesthesia Manchester University Hospitals NHS Trust Manchester UK
- Manchester University Manchester UK
| | - K. El‐Boghdadly
- Department of Anaesthesia and Peri‐operative Medicine Guy's and St Thomas' NHS Foundation Trust London UK
- King's College London London UK
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12
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Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - T Selak
- Department of Anaesthesia, Wollongong Hospital, Wollongong, NSW, Australia
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13
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Nicholls J, Leonard A, Garcia M, Sadasivam N, Charlesworth M. Sickle cell-related fat embolism syndrome: the need for venovenous extracorporeal membrane oxygenation with exchange transfusion, renal replacement therapy and plasma exchange. J Cardiothorac Vasc Anesth 2022; 36:3859-3862. [DOI: 10.1053/j.jvca.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/11/2022]
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14
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Zochios V, Charlesworth M. Protecting the right ventricle in COVID-19 pneumonitis: a missing piece of the puzzle? Anaesthesia 2022; 77:739-742. [PMID: 35315056 PMCID: PMC9111229 DOI: 10.1111/anae.15720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Affiliation(s)
- V Zochios
- Department of Cardiothoracic Critical Care Medicine and ECMO, Glenfield Hospital, University Hospitals of Leicester National Health Service Trust, University of Leicester, UK
| | - M Charlesworth
- Department of Cardiothoracic Critical Care Medicine and ECMO, Wythenshawe Hospital, Manchester, UK
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15
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Charlesworth M, Grossman R. Pre-operative SARS-CoV-2 testing, isolation, vaccination and remote prehabilitation - the road to 'COVID-19 secure' elective surgery. Anaesthesia 2021; 76:1439-1441. [PMID: 34541657 PMCID: PMC8653181 DOI: 10.1111/anae.15590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 12/11/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Critical Care, Anaesthesia and ECMOWythenshawe HospitalManchester University NHS Foundation TrustManchesterUK
| | - R. Grossman
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
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16
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Charlesworth M, Williams BG, Buch MH. Advances in transcatheter aortic valve implantation, part 2: perioperative care. BJA Educ 2021; 21:264-269. [PMID: 34178383 DOI: 10.1016/j.bjae.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- M Charlesworth
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - B G Williams
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - M H Buch
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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17
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Charlesworth M, Williams BG, Buch MH. Advances in transcatheter aortic valve implantation, part 1: patient selection and preparation. BJA Educ 2021; 21:232-237. [PMID: 34026277 DOI: 10.1016/j.bjae.2021.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2021] [Indexed: 10/21/2022] Open
Affiliation(s)
- M Charlesworth
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - B G Williams
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - M H Buch
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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18
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Charlesworth M, Hayes T, Erdoes G. Reversal Agents for the Management of Direct Oral Anticoagulant-Related Bleeding in Cardiac Surgical Patients: The Emperor's New Clothes? J Cardiothorac Vasc Anesth 2021; 35:2480-2482. [PMID: 33985882 DOI: 10.1053/j.jvca.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 12/19/2022]
Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - T Hayes
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - G Erdoes
- Adult and Paediatric Cardiovascular Anaesthesia, Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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19
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Charlesworth M, Klein AA. Celebrating 75 years of Anaesthesia: our past, present and future. The science of neuromusclar blockade, 75 years on. Anaesthesia 2021; 76:128-131. [PMID: 33295655 DOI: 10.1111/anae.15287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - A A Klein
- Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK
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20
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Nwaejike N, Strang T, Garcia M, Charlesworth M, Shaw SM, Barnard JB. Emergency biventricular assist device implantation in a patient with suspected COVID-19 disease. Anaesth Rep 2020; 8:196-199. [PMID: 33392511 DOI: 10.1002/anr3.12079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 12/11/2022] Open
Abstract
Severe coronavirus disease 2019 (COVID-19) is a multisystem inflammatory disorder and knowledge and experience with severe acute respiratory failure in infected patients has grown considerably since reports of the first few cases. Little is known about the effect of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus on the heart, and it has been suggested that fulminant cardiac failure, with or without respiratory failure, may occur several weeks following infection. A young man presented after a recent viral illness. He was in severe cardiogenic shock and was implanted with an emergency biventricular assist device, which also incorporated an extracorporeal membrane oxygenator. He stabilised soon after and, despite an intracerebral haemorrhage which resolved and bleeding into the trachea following percutaneous tracheostomy, he survived to explant and was successfully stepped down to a rehabilitation unit on postoperative day 50. He tested positive for SARS-CoV-2 antibodies when the test became available on postoperative day 33. We envisage there will be many more such presentations of acute COVID-19-associated cardiogenic shock and we recommend clinicians consider this diagnosis when presented with an acutely unwell patient with an unclear diagnosis following a viral illness. These patients should be discussed as early as possible with a transplant/mechanical circulatory support team.
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Affiliation(s)
- N Nwaejike
- Department of Cardiothoracic Surgery Wythenshawe Hospital Manchester University Foundation Trust Manchester UK
| | - T Strang
- Department of Cardiothoracic Anaesthesia Critical Care and ECMO Wythenshawe Hospital Manchester University Foundation Trust Manchester UK
| | - M Garcia
- Department of Cardiothoracic Anaesthesia Critical Care and ECMO Wythenshawe Hospital Manchester University Foundation Trust Manchester UK
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia Critical Care and ECMO Wythenshawe Hospital Manchester University Foundation Trust Manchester UK
| | - S M Shaw
- Department of Cardiology Wythenshawe Hospital Manchester University Foundation Trust Manchester UK
| | - J B Barnard
- Department of Cardiothoracic Surgery Wythenshawe Hospital Manchester University Foundation Trust Manchester UK
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21
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Charlesworth M, Deng C. Pilot randomised controlled trial reporting should be focused: a reply. Anaesthesia 2020; 75:1551. [DOI: 10.1111/anae.15199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | - C. Deng
- Auckland City Hospital Auckland New Zealand
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22
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Charlesworth M, Pandit JJ. Rational performance metrics for operating theatres, principles of efficiency, and how to achieve it. Br J Surg 2020; 107:e63-e69. [PMID: 31903597 DOI: 10.1002/bjs.11396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/18/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Several performance metrics are commonly used by National Health Service (NHS) organizations to measure the efficiency and productivity of operating lists. These include: start time, utilization, cancellations, number of operations and gap time between operations. The authors describe reasons why these metrics are flawed, and use clinical evidence and mathematics to define a rational, balanced efficiency metric. METHODS A narrative review of literature on the efficiency and productivity of elective NHS operating lists was undertaken. The aim was to rationalize how best to define and measure the efficiency of an operating list, and describe strategies to achieve it. RESULTS There is now a wealth of literature on how optimally to measure the performance of elective surgical lists. Efficiency may be defined as the completion of all scheduled operations within the allocated time with no over- or under-runs. CONCLUSION Achieving efficiency requires appropriate scheduling using specific procedure mean (or median) times and their associated variance (standard deviation or interquartile range) to calculate the probability they can be completed on time. The case mix may be adjusted to yield better time management. This review outlines common misconceptions applied to managing scheduled operating theatre lists and the challenges of measuring unscheduled operations in emergency settings.
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Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - J J Pandit
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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23
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Charlesworth M, Ashworth AD. The evolution of evidence-based medicine in critical care: have we left 'time to defecation' behind? Anaesthesia 2020; 76:161-164. [PMID: 32662063 DOI: 10.1111/anae.15183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 01/16/2023]
Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - A D Ashworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
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24
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Fawcett WJ, Charlesworth M, Cook TM, Klein AA. Education and scientific dissemination during the COVID-19 pandemic. Anaesthesia 2020; 76:301-304. [PMID: 32557593 PMCID: PMC7323131 DOI: 10.1111/anae.15185] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2020] [Indexed: 12/15/2022]
Affiliation(s)
- W J Fawcett
- Department of Anaesthesia, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia, Intensive Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care, Royal United Hospitals, Bath, UK
| | - A A Klein
- Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK
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Charlesworth M, Daly Guris RJ, Dalay S. Novel presentations, rare complications and educational content: cases in clinical practice. Anaesth Rep 2020; 8:73-75. [PMID: 32656534 DOI: 10.1002/anr3.12056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Critical Care, Anaesthesia and ECMO Wythenshawe Hospital Manchester UK
| | - R J Daly Guris
- Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia and University of Pennsylvania Philadelphia PA USA
| | - S Dalay
- Department of Anaesthesia Worcestershire Acute Hospitals NHS Trust Worcester UK
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Gardiner D, Charlesworth M, Rubino A, Madden S. The rise of organ donation after circulatory death: a narrative review. Anaesthesia 2020; 75:1215-1222. [PMID: 32430909 DOI: 10.1111/anae.15100] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Abstract
Solid organ transplantation saves and transforms lives. The original type of organ donation from deceased patients was controlled donation after circulatory death, previously referred to as non-heart beating organ donation. The rise of donation after circulatory death in the UK came about through advances in critical care and transplant medicine and support from several key organisations in developing a robust ethical, legal and professional framework. The transplant waiting list reached a historic peak in 2009-2010 of 8000 patients, but fell by 25% to 6000 in 2017-2018. There has also been a steady rise in the number of deceased donors and the number of donations after circulatory death. The contribution of donation after circulatory death to the total number of donations rose steadily between 2000 and 2012 and has remained about 40% since. Although the situation has improved for patients waiting for a transplant, deaths and long waits remain common. Changes to legislative, technical and peri-mortem procedures may greatly change future practices in donation after circulatory death in the UK.
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Affiliation(s)
- D Gardiner
- National Clinical Lead for Organ Donation, NHS Blood and Transplant, Nottingham, UK
| | - M Charlesworth
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Rubino
- Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Royal Papworth Hospital, Cambridge, UK
| | - S Madden
- NHS Blood and Transplant, Bristol, UK
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Zochios V, Brodie D, Charlesworth M, Parhar KK. Delivering extracorporeal membrane oxygenation for patients with COVID-19: what, who, when and how? Anaesthesia 2020; 75:997-1001. [PMID: 32319081 PMCID: PMC7264794 DOI: 10.1111/anae.15099] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 01/08/2023]
Affiliation(s)
- V Zochios
- Department of Cardiothoracic Critical Care and ECMO, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.,University of Birmingham, Institute of Inflammation and Ageing, Birmingham, UK
| | - D Brodie
- Columbia University College of Physicians and Surgeons, New York, NY, USA.,Centre for Acute Respiratory Failure, New York-Presbyterian Hospital, New York, NY, USA
| | - M Charlesworth
- Department of Cardiothoracic Critical Care and ECMO, Wythenshawe Hospital, Manchester, UK
| | - K K Parhar
- Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
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Charlesworth M, Pandit JJ. Negative outcomes in critical care trials: applying the wrong statistics – or asking the wrong questions? Anaesthesia 2020; 75:1284-1288. [DOI: 10.1111/anae.15028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2020] [Indexed: 12/16/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust Manchester UK
| | - J. J. Pandit
- Nuffield Department of Anaesthesia Oxford University Hospitals NHS Foundation Trust Oxford UK
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Charlesworth M, El‐Boghdadly K. Time for consensus on rapid sequence intubation? Anaesthesia 2020; 75:298-300. [DOI: 10.1111/anae.14906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2019] [Indexed: 11/29/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust Manchester UK
| | - K. El‐Boghdadly
- Department of Anaesthesia Guy's and St. Thomas’ NHS Foundation Trust and Honorary Senior Lecturer King's College London UK
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Charlesworth M, Shelton CL, Dalay S. Airway management, regional anaesthesia and critical incidents: reports in anaesthesia. Anaesth Rep 2020; 8:1-3. [DOI: 10.1002/anr3.12036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2020] [Indexed: 11/07/2022] Open
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust Manchester UK
| | - C. L. Shelton
- Department of Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust Manchester UK
| | - S. Dalay
- Department of Anaesthesia Worcestershire Acute Hospitals NHS Trust Worcester UK
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Charlesworth M, Shelton CL. Should intravenous gelatins have a role in contemporary peri‐operative and critical care? Anaesthesia 2019; 75:266-269. [DOI: 10.1111/anae.14936] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2019] [Indexed: 12/12/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust Manchester UK
| | - C. L. Shelton
- Department of Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust Manchester UK
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Charlesworth M, Klein AA, White SM. A bibliometric analysis of the conversion and reporting of pilot studies published in six anaesthesia journals. Anaesthesia 2019; 75:247-253. [DOI: 10.1111/anae.14817] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2019] [Indexed: 12/17/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia Critical Care and ECMO Wythenshawe Hospital ManchesterUK
| | - A. A. Klein
- Department of Cardiothoracic Anaesthesia and Intensive Care Royal Papworth Hospital CambridgeUK
| | - S. M. White
- Department of Anaesthesia Royal Sussex County Hospital Brighton UK
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Charlesworth M. Evidence for harms of high tidal volumes from systematic reviews and meta-analysis - a reply. Anaesthesia 2019; 74:1071. [PMID: 31282574 DOI: 10.1111/anae.14762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Critical Care, ECMO and Cardiothoracic Anaesthesia, Wythenshawe Hospital, Manchester, UK
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Affiliation(s)
- S. Dalay
- Department of AnaesthesiaWorcestershire Acute Hospitals NHS TrustUK
| | - R. J. Daly Guris
- Children's Hospital of Philadelphia and University of PennsylvaniaUSA
| | - C. L. Shelton
- Department of AnaesthesiaWythenshawe HospitalManchester University Hospitals NHS Foundation TrustManchesterUK
| | - M. Charlesworth
- Department of Cardiothoracic AnaesthesiaWythenshawe HospitalManchester University Hospitals NHS Foundation TrustManchesterUK
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Charlesworth M, Feddy L, Wisely N. Sodium‐glucose co‐transporter type‐2 inhibitors: is the message getting through? Anaesthesia 2019; 74:679. [DOI: 10.1111/anae.14619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - L. Feddy
- Wythenshawe Hospital Manchester UK
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Charlesworth M, van Zundert AAJ. Digital dystopias: will the electronic health record ever fulfil its potential? Anaesthesia 2019; 74:1361-1364. [DOI: 10.1111/anae.14683] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2019] [Indexed: 12/17/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust ManchesterUK
| | - A. A. J. van Zundert
- Discipline of Anaesthesiology Department of Anaesthesia and Peri‐operative Medicine Royal Brisbane and Women's Hospital The University of Queensland Brisbane QLD Australia
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Charlesworth M, Agarwal S. Recycling old data – an ethical and pragmatic way to generate new evidence? Anaesthesia 2019; 74:1087-1090. [DOI: 10.1111/anae.14648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 12/14/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust ManchesterUK
| | - S. Agarwal
- Department of Cardiothoracic Anaesthesia Manchester Royal Infirmary Manchester University Hospitals NHS Foundation Trust Manchester UK
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Affiliation(s)
- M Charlesworth
- Department of Cardiothoracic Anaesthesia, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - A A J van Zundert
- Discipline of Anaesthesiology, Royal Brisbane and Women's Hospital, Department of Anaesthesia and Peri-operative Medicine, The University of Queensland, Brisbane, QLD, Australia
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Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia and Intensive Care; Wythenshawe Hospital; Manchester University Hospitals; Manchester UK
| | - M. D. Wiles
- Department of Anaesthesia; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
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Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia; Wythenshawe Hospital; Manchester University Hospitals NHS Foundation Trust; Manchester UK
| | - R. Arya
- Department of Haematological Medicine; King's College Hospital NHS Foundation Trust; London UK
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Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia and Intensive Care; Wythenshawe Hospital; Manchester University Hospitals; Manchester UK
| | - S. W. Choi
- Department of Anaesthesiology; The University of Hong Kong; Hong Kong HKSAR
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Affiliation(s)
- M. Charlesworth
- Department of Anaesthesia; Wythenshawe Hospital; Manchester UK
| | - A. J. Glossop
- Department of Anaesthesia and Intensive Care Medicine; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
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Affiliation(s)
- S. W. Choi
- Department of Anaesthesiology; The University of Hong Kong; Hong Kong HKSAR
| | - M. Charlesworth
- Wythenshawe Hospital; Manchester University Hospitals; Manchester UK
| | - G. T. C. Wong
- Department of Anaesthesiology; Queen Mary Hospital; Hong Kong HKSAR
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Charlesworth M, Ashworth AD, Barker JM. Decision-making in response to respiratory veno-venous extracorporeal membrane oxygenation referrals: is current practice precise enough? Anaesthesia 2017; 73:154-159. [DOI: 10.1111/anae.14155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia; University Hospital South Manchester; Manchester UK
| | - A. D. Ashworth
- Department of Cardiothoracic Anaesthesia; University Hospital South Manchester; Manchester UK
| | - J. M. Barker
- Department of Cardiothoracic Anaesthesia; University Hospital South Manchester; Manchester UK
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Charlesworth M, Venkateswaran R, Feddy L. When traditional research fails - the case for veno-arterial ECMO in postcardiotomy cardiogenic shock. Anaesthesia 2017; 72:1425-1426. [DOI: 10.1111/anae.14097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - L. Feddy
- University Hospital South Manchester; Manchester UK
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Charlesworth M, Ashworth AD. Inadvertent carotid catheterisation. Anaesthesia 2017; 72:269. [DOI: 10.1111/anae.13791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Charlesworth M, Mort M, Smith AF. An observational study of critical care physicians' assessment and decision-making practices in response to patient referrals. Anaesthesia 2016; 72:80-92. [DOI: 10.1111/anae.13667] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 01/27/2023]
Affiliation(s)
- M. Charlesworth
- Lancaster Medical School; Lancaster University; Lancaster UK
| | - M. Mort
- Department of Sociology; Lancaster University; Lancaster UK
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Abstract
The possibilities opened up by human genome analysis appear to provide support for quasi-deterministic views of human nature but an analysis of the debate over sociobiology shows that we cannot derive a theory of human nature directly from biological and genetic evidence. From this perspective human genome analysis and the forms of human genetic engineering that it makes possible cannot alter our concept of human nature although they make us more aware of the 'plasticity' of the human. The possibility envisaged by some neo-eugenicists (and often accepted by their opponents) of a radical reshaping of human nature is as misconceived as the view of some sociobiologists that human nature is biologically determined. Human genome analysis raises formidable ethical, social and legal problems and we need to develop criteria that will enable us to decide which kinds of genetic manipulation will help to enhance human life and which will not. This will involve having a clear concept of human nature and the values it implies. But we shall not derive this concept of human nature from genetics itself.
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Affiliation(s)
- M Charlesworth
- School of Humanities, Deakin University, Geelong, Victoria, Australia
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