Publications
2252 results found
Monfort Sánchez E, Avery J, Gan J, et al., 2023, A compact fluorescence sensor for low-cost non-invasive monitoring of gut permeability in undernutrition, Optics and Biophotonics in Low-Resource Settings IX, Publisher: SPIE, Pages: 1-7, ISSN: 1605-7422
Undernutrition is associated with approximately 45% of deaths among children under the age of 5. Furthermore, in 2020, around 149 million children suffered impaired physical/cognitive development due to lack of adequate nutrition. Environmental enteropathy (EE) is associated with undernutrition and is characterized by a multifaceted breakdown in gut function, including an increase in intestinal permeability that can lead to inflammatory responses. However, the role and mechanisms associated with EE (particularly gut permeability) are not well understood. This is partly because current techniques to assess changes in gut permeability, such as endoscopic biopsies, histopathology and chemical tests such as Lactulose:Mannitol assays, are either highly invasive, unreliable or difficult to perform on specific groups of patients (such as infants and patients with urine retention problems). Therefore, low-cost, non-invasive and reliable diagnostic tools are urgently needed for better evaluation of intestinal permeability. Here, we present a compact transcutaneous fluorescence spectroscopy sensor for non-invasive evaluation of gut permeability and report the first in vivo data collected from volunteers in an undernutrition trial. Using this technique and device, fluorescence signals are detected transcutaneously after oral ingestion of a fluorescent solution. Preliminary results demonstrate the potential use of the presented sensor for clinical assessment of gut permeability in low-income settings.
Bakri NAC, Kwasnicki R, Tenang L, et al., 2023, Objective Comparison of Post-operative Activity after Sentinel Lymph Node Biopsy versus Axillary Lymph Node Dissection Using Wearable Activity Monitors - The 'BRACELET' Study, CANCER RESEARCH, Vol: 83, ISSN: 0008-5472
Sivananthan A, Ahmed J, Kogkas A, et al., 2023, Eye tracking technology in endoscopy: Looking to the future, DIGESTIVE ENDOSCOPY, Vol: 35, Pages: 314-322, ISSN: 0915-5635
Nazarian S, 2023, The future of endoscopy – what are the thoughts on artificial intelligence?, Journal of Experimental and Theoretical Artificial Intelligence, Pages: 1-10, ISSN: 0952-813X
There is an emerging role of artificial intelligence (AI) in endoscopy with studies on early systems showing promising results. However, various limitations inhibit widespread use. The aim of this study was to ascertain the sentiments of endoscopists and understand the benefits and barriers towards adoption of AI systems into healthcare. An anonymous online 18-question survey was disseminated to gastroenterology and surgical departments across UK. A total of 75 endoscopists completed the questionnaire. The majority felt that AI would increase adenoma detection rate (ADR) (72.8%) and aid lesion characterisation (78.6%). However, only a quarter of respondents were either moderately or very familiar with AI, and there was no consensus on necessity of AI in endoscopy. The key barriers identified were cost, accessibility and lack of guidelines. Endoscopists believe AI systems will have a positive impact on endoscopy; however, these systems must provide quality assurance through large clinical trials before adoption.
Atchison C, Moshe M, Brown J, et al., 2023, Validity of self-testing at home with rapid SARS-CoV-2 antibody detection by lateral flow immunoassay, Clinical Infectious Diseases, Vol: 76, Pages: 658-666, ISSN: 1058-4838
Background: We explore severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody lateral flow immunoassay (LFIA) performance under field conditions compared to laboratory-based ELISA and live virus neutralisation. Methods: In July 2021, 3758 participants performed, at home, a self-administered LFIA on finger-prick blood, reported and submitted a photograph of the result, and provided a self-collected capillary blood sample for assessment of IgG antibodies using the Roche Elecsys® Anti-SARS-CoV-2 assay. We compared the self-reported LFIA result to the quantitative Roche assay and checked the reading of the LFIA result with an automated image analysis (ALFA). In a subsample of 250 participants, we compared the results to live virus neutralisation. Results: Almost all participants (3593/3758, 95.6%) had been vaccinated or reported prior infection. Overall, 2777/3758 (73.9%) were positive on self-reported LFIA, 2811/3457 (81.3%) positive by LFIA when ALFA-reported, and 3622/3758 (96.4%) positive on Roche (using the manufacturer reference standard threshold for positivity of 0.8 U ml−1). Live virus neutralisation was detected in 169 of 250 randomly selected samples (67.6%); 133/169 were positive with self-reported LFIA (sensitivity 78.7%; 95% CI 71.8, 84.6), 142/155 (91.6%; 86.1, 95.5) with ALFA, and 169 (100%; 97.8, 100.0) with Roche. There were 81 samples with no detectable virus neutralisation; 47/81 were negative with self-reported LFIA (specificity 58.0%; 95% CI 46.5, 68.9), 34/75 (45.3%; 33.8, 57.3) with ALFA, and 0/81 (0%; 0.0, 4.5) with Roche. Conclusions: Self-administered LFIA is less sensitive than a quantitative antibody test, but the positivity in LFIA correlates better than the quantitative ELISA with virus neutralisation.
Eales O, Page AJ, Tang SN, et al., 2023, The use of representative community samples to assess SARS-CoV-2 lineage competition: Alpha outcompetes Beta and wild-type in England from January to March 2021., Microbial Genomics, Vol: 9, Pages: 1-14, ISSN: 2057-5858
Genomic surveillance for SARS-CoV-2 lineages informs our understanding of possible future changes in transmissibility and vaccine efficacy and will be a high priority for public health for the foreseeable future. However, small changes in the frequency of one lineage over another are often difficult to interpret because surveillance samples are obtained using a variety of methods all of which are known to contain biases. As a case study, using an approach which is largely free of biases, we here describe lineage dynamics and phylogenetic relationships of the Alpha and Beta variant in England during the first 3 months of 2021 using sequences obtained from a random community sample who provided a throat and nose swab for rt-PCR as part of the REal-time Assessment of Community Transmission-1 (REACT-1) study. Overall, diversity decreased during the first quarter of 2021, with the Alpha variant (first identified in Kent) becoming predominant, driven by a reproduction number 0.3 higher than for the prior wild-type. During January, positive samples were more likely to be Alpha in those aged 18 to 54 years old. Although individuals infected with the Alpha variant were no more likely to report one or more classic COVID-19 symptoms compared to those infected with wild-type, they were more likely to be antibody-positive 6 weeks after infection. Further, viral load was higher in those infected with the Alpha variant as measured by cycle threshold (Ct) values. The presence of infections with non-imported Beta variant (first identified in South Africa) during January, but not during February or March, suggests initial establishment in the community followed by fade-out. However, this occurred during a period of stringent social distancing. These results highlight how sequence data from representative community surveys such as REACT-1 can augment routine genomic surveillance during periods of lineage diversity.
Marecos J, Shattock E, Bartlett O, et al., 2023, Health misinformation and freedom of expression: considerations for policymakers, HEALTH ECONOMICS POLICY AND LAW, ISSN: 1744-1331
Teixeira F, Li E, Laranjo L, et al., 2023, Digital maturity and its determinants in General Practice: a cross- sectional study in 20 countries, Frontiers in Public Health, Vol: 10, Pages: 1-10, ISSN: 2296-2565
Background: The extent to which digital technologies are employed to promote the delivery of high-quality healthcare is known as Digital Maturity. Individual and systemic digital maturity are both necessary to ensure a successful, scalable and sustainable digital transformation in healthcare. However, digital maturity in primary care has been scarcely evaluated.Objectives: This study assessed the digital maturity in General Practice (GP) globally and evaluated its association with participants' demographic characteristics, practice characteristics and features of Electronic Health Records (EHRs) use.Methods: GPs across 20 countries completed an online questionnaire between June and September 2020. Demographic data, practice characteristics, and features of EHRs use were collected. Digital maturity was evaluated through a framework based on usage, resources and abilities (divided in this study in its collective and individual components), interoperability, general evaluation methods and impact of digital technologies. Each dimension was rated as 1 or 0. The digital maturity score was calculated as the sum of the six dimensions and ranged between 0 to 6 (maximum digital maturity). Multivariable linear regression was used to model the total score, while multivariable logistic regression was used to model the probability of meeting each dimension of the score.Results: One thousand six hundred GPs (61% female, 68% Europeans) participated. GPs had a median digital maturity of 4 (P25–P75: 3–5). Positive associations with digital maturity were found with: male gender [B = 0.18 (95% CI 0.01; 0.36)], use of EHRs for longer periods [B = 0.45 (95% CI 0.35; 0.54)] and higher frequencies of access to EHRs [B = 0.33 (95% CI 0.17; 0.48)]. Practicing in a rural setting was negatively associated with digital maturity [B = −0.25 (95%CI −0.43; −0.08)]. Usage (90%) was the most acknowledged dimension while interoperability (47%) and use of best practice gen
Teixeira F, Li E, Laranjo L, et al., 2023, Digital maturity and its determinants in General Practice: A cross-sectional study in 20 countries, Frontiers in Public Health, Vol: 10
<jats:sec><jats:title>Background</jats:title><jats:p>The extent to which digital technologies are employed to promote the delivery of high-quality healthcare is known as Digital Maturity. Individual and systemic digital maturity are both necessary to ensure a successful, scalable and sustainable digital transformation in healthcare. However, digital maturity in primary care has been scarcely evaluated.</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>This study assessed the digital maturity in General Practice (GP) globally and evaluated its association with participants' demographic characteristics, practice characteristics and features of Electronic Health Records (EHRs) use.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>GPs across 20 countries completed an online questionnaire between June and September 2020. Demographic data, practice characteristics, and features of EHRs use were collected. Digital maturity was evaluated through a framework based on usage, resources and abilities (divided in this study in its collective and individual components), interoperability, general evaluation methods and impact of digital technologies. Each dimension was rated as 1 or 0. The digital maturity score was calculated as the sum of the six dimensions and ranged between 0 to 6 (maximum digital maturity). Multivariable linear regression was used to model the total score, while multivariable logistic regression was used to model the probability of meeting each dimension of the score.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>One thousand six hundred GPs (61% female, 68% Europeans) participated. GPs had a median digital maturity of 4 (P25–P75: 3–5). Positive associations with digital maturity were found with: male gender [<jats:italic>B</jats:italic> = 0.
Danielli S, Radyte E, Donnelly P, et al., 2023, Improving health in London: reflections from three mini case studies (HIV, mental health, healthcare estate), Cities and Health, Vol: 7, Pages: 312-317, ISSN: 2374-8834
Global health will increasingly be determined by cities and therefore city-wide transformation of health and care is crucially important. Reflections from our experiences in London suggest some critical ingredients for city-wide transformation, including: having a shared aim; robust engagement with the citizens, service users and providers of services; setting aside organisational priorities and effective incentives to do so; a focus on enablers; strong city-wide leadership. Rather than working ‘together but separately’, health and care partners must work ‘together, together’ if cities are to meet the health and care challenges of the next decade.
Athanasiou T, Patel V, Darzi A, 2023, Patient Reported Outcomes and Quality of Life in Surgery, ISBN: 9783031275968
This book provides a guide to the assessment of quality of life and patient reported outcomes measures in general surgery. The rapidly emerging field helps contextualise patients and helps the decision-making process within health economics, bedside medicine, public health, and health policy. All subspecialties of general surgery are covered, as well as the core principles of quality of life. The book aims to demonstrate how clinicians and policymakers can easily get access to a single source of patient reported outcomes measures and quality of life evidence to help them make the best-informed decisions in the field of general surgery. This book is relevant to healthcare managers, doctors, allied health professionals, healthcare scientists, consultants, healthcare economists, and medical statisticians working in healthcare.
Darzi A, Harling L, 2023, Principles of minimal access surgery, Bailey and Love’s: Short Practice of Surgery: 28th Edition, Pages: 162-176, ISBN: 9781003106852
Cacciamani GE, Chu TN, Sanford DI, et al., 2023, PRISMA AI reporting guidelines for systematic reviews and meta-analyses on AI in healthcare, NATURE MEDICINE, Vol: 29, Pages: 14-15, ISSN: 1078-8956
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- Citations: 6
Breda J, Darzi A, Ashrafian H, et al., 2023, Editorial: Innovations in quality of care., Front Health Serv, Vol: 3
Wang C, Cartucho J, Elson D, et al., 2022, Towards autonomous control of surgical instruments using adaptive-fusion tracking and robot self-calibration, IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS), Publisher: IEEE, Pages: 2395-2401, ISSN: 2153-0858
The ability to track surgical instruments in realtime is crucial for autonomous Robotic Assisted Surgery (RAS). Recently, the fusion of visual and kinematic data has been proposed to track surgical instruments. However, these methods assume that both sensors are equally reliable, and cannot successfully handle cases where there are significant perturbations in one of the sensors' data. In this paper, we address this problem by proposing an enhanced fusion-based method. The main advantage of our method is that it can adjust fusion weights to adapt to sensor perturbations and failures. Another problem is that before performing an autonomous task, these robots have to be repetitively recalibrated by a human for each new patient to estimate the transformations between the different robotic arms. To address this problem, we propose a self-calibration algorithm that empowers the robot to autonomously calibrate the transformations by itself in the beginning of the surgery. We applied our fusion and selfcalibration algorithms for autonomous ultrasound tissue scanning and we showed that the robot achieved stable ultrasound imaging when using our method. Our performance evaluation shows that our proposed method outperforms the state-of-art both in normal and challenging situations.
Che Bakri NA, Kwasnicki RM, Dhillon K, et al., 2022, ASO author reflections: Improving management of upper limb complications after breast cancer treatments, Annals of Surgical Oncology, Vol: 29, Pages: 566-567, ISSN: 1068-9265
Naik R, Kogkas A, Ashrafian H, et al., 2022, The Measurement of Cognitive Workload in Surgery Using Pupil Metrics: A Systematic Review and Narrative Analysis, JOURNAL OF SURGICAL RESEARCH, Vol: 280, Pages: 258-272, ISSN: 0022-4804
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- Citations: 4
Gilbert A, Homer V, Brock K, et al., 2022, Quality-of-life outcomes in older patients with early-stage rectal cancer receiving organ-preserving treatment with hypofractionated short-course radiotherapy followed by transanal endoscopic microsurgery (TREC): non-randomised registry of patients unsuitable for total mesorectal excision, The Lancet Healthy Longevity, Vol: 3, Pages: e825-e838, ISSN: 2666-7568
BackgroundOlder patients with early-stage rectal cancer are under-represented in clinical trials and, therefore, little high-quality data are available to guide treatment in this patient population. The TREC trial was a randomised, open-label feasibility study conducted at 21 centres across the UK that compared organ preservation through short-course radiotherapy (SCRT; 25 Gy in five fractions) plus transanal endoscopic microsurgery (TEM) with standard total mesorectal excision in adults with stage T1–2 rectal adenocarcinoma (maximum diameter ≤30 mm) and no lymph node involvement or metastasis. TREC incorporated a non-randomised registry offering organ preservation to patients who were considered unsuitable for total mesorectal excision by the local colorectal cancer multidisciplinary team. Organ preservation was achieved in 56 (92%) of 61 non-randomised registry patients with local recurrence-free survival of 91% (95% CI 84–99) at 3 years. Here, we report acute and long-term patient-reported outcomes from this non-randomised registry group.MethodsPatients considered by the local colorectal cancer multidisciplinary team to be at high risk of complications from total mesorectal excision on the basis of frailty, comorbidities, and older age were included in a non-randomised registry to receive organ-preserving treatment. These patients were invited to complete questionnaires on patient-reported outcomes (the European Organisation for Research and Treatment of Cancer Quality of Life [EORTC-QLQ] questionnaire core module [QLQ-C30] and colorectal cancer module [QLQ-CR29], the Colorectal Functional Outcome [COREFO] questionnaire, and EuroQol-5 Dimensions-3 Level [EQ-5D-3L]) at baseline and at months 3, 6, 12, 24, and 36 postoperatively. To aid interpretation, data from patients in the non-randomised registry were compared with data from those patients in the TREC trial who had been randomly assigned to organ-preserving therapy, and an additional reference c
Eales O, Wang H, Haw D, et al., 2022, Trends in SARS-CoV-2 infection prevalence during England’s roadmap out of lockdown, January to July 2021, PLoS Computational Biology, Vol: 18, Pages: 1-16, ISSN: 1553-734X
Background:Following rapidly rising COVID-19 case numbers, England entered a national lockdown on 6 January 2021, with staged relaxations of restrictions from 8 March 2021 onwards.Aim:We characterise how the lockdown and subsequent easing of restrictions affected trends in SARS-CoV-2 infection prevalence.Methods:On average, risk of infection is proportional to infection prevalence. The REal-time Assessment of Community Transmission-1 (REACT-1) study is a repeat cross-sectional study of over 98,000 people every round (rounds approximately monthly) that estimates infection prevalence in England. We used Bayesian P-splines to estimate prevalence and the time-varying reproduction number (Rt) nationally, regionally and by age group from round 8 (beginning 6 January 2021) to round 13 (ending 12 July 2021) of REACT-1. As a comparator, a separate segmented-exponential model was used to quantify the impact on Rt of each relaxation of restrictions.Results:Following an initial plateau of 1.54% until mid-January, infection prevalence decreased until 13 May when it reached a minimum of 0.09%, before increasing until the end of the study to 0.76%. Following the first easing of restrictions, which included schools reopening, the reproduction number Rt increased by 82% (55%, 108%), but then decreased by 61% (82%, 53%) at the second easing of restrictions, which was timed to match the Easter school holidays. Following further relaxations of restrictions, the observed Rt increased steadily, though the increase due to these restrictions being relaxed was offset by the effects of vaccination and also affected by the rapid rise of Delta. There was a high degree of synchrony in the temporal patterns of prevalence between regions and age groups.Conclusion:High-resolution prevalence data fitted to P-splines allowed us to show that the lockdown was effective at reducing risk of infection with school holidays/closures playing a significant part.
Lear R, Freise L, Kybert M, et al., 2022, Perceptions of Quality of Care Among Users of a Web-Based Patient Portal: Cross-sectional Survey Analysis, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 24, ISSN: 1438-8871
Nazarian S, Gkouzionis I, Kawka M, et al., 2022, Real-time tracking and classification of tumour and non-tumour tissue in upper gastrointestinal cancers using diffuse reflectance spectroscopy for resection margin assessment, JAMA Surgery, ISSN: 2168-6254
Importance:Cancers of the upper gastrointestinal tract remain a major contributor to the global cancer burden. The accurate mapping of tumour margins is of particular importance for curative cancer resection and improvement in overall survival. Current mapping techniques preclude a full resection margin assessment in real-time.Objective:We aimed to use diffuse reflectance spectroscopy on gastric and oesophageal cancer specimens to differentiate tissue types and provide real-time feedback to the operator.Design:This was a prospective ex vivo validation study. Patients undergoing oesophageal or gastric cancer resection were prospectively recruited into the study between July 2020 and July 2021 at Hammersmith Hospital in London, United Kingdom.Setting:This was a single-centre study based at a tertiary hospital.Participants:Tissue specimens were included for patients undergoing elective surgery for either oesophageal carcinoma (adenocarcinoma or squamous cell carcinoma) or gastric adenocarcinoma.Exposure:A hand-held diffuse reflectance spectroscopy probe and tracking system was used on freshly resected ex vivo tissue to obtain spectral data. Binary classification, following histopathological validation, was performed using four supervised machine learning classifiers. Main Outcomes and Measures:Data were divided into training and testing sets using a stratified 5-fold cross-validation method. Machine learning classifiers were evaluated in terms of sensitivity, specificity, overall accuracy, and the area under the curve.Results:A total of 14,097 mean spectra for normal and cancerous tissue were collected from 37 patients. The machine learning classifier achieved an overall normal versus cancer diagnostic accuracy of 93.86±0.66 for stomach tissue and 96.22±0.50 for oesophageal tissue, and sensitivity and specificity of 91.31% and 95.13% for stomach and 94.60% and 97.28% for oesophagus, respectively. Real-time tissue tracking and classification was achieved a
Acharya A, Judah G, Ashrafian H, et al., 2022, Investigating the implementation of mobile messaging in population screening programmes: a modified Delphi study., Lancet, Vol: 400 Suppl 1
BACKGROUND: Mobile messaging is an increasingly important health-care communication tool. Screening programmes pose unique challenges because of the large, diverse populations invited, who might have not interacted with services previously. This study aimed to provide guidance on how screening programmes in England can effectively implement mobile messaging services. METHODS: Experts based in England, from public health, policy, screening provision, communications, and academia were recruited to this Delphi study. Recommendations were derived from an evidence synthesis involving a literature review, expert scoping questionnaire, public consultation, and discussion with relevant national organisations. Experts voted upon the importance and feasibility of recommendations across two consensus rounds, using a five-point Likert scale. Items reaching consensus, defined a priori at 70%, on importance and feasibility formed core recommendations. Those reaching this threshold on importance only, were labelled desirable. All items were discussed at an expert meeting to determine suitability. Ethical approval was obtained (20IC6088), and participants provided informed consent. FINDINGS: 33 experts representing all 11 screening programmes were enrolled, with 100% retention across rounds. Of the initial 101 items, 23 (23%) reached consensus. These core recommendations were divided across six domains: message content, timing, delivery, evaluation, security, and research. They included the use of general practitioner endorsement and limiting message length to 320 characters. A further 17 items were considered desirable; for example, introducing greater functionality such as bidirectional and tailored messaging. INTERPRETATION: Findings will facilitate the effective use of mobile messaging across screening and will form national guidance for services. This guidance will enable programmes to overcome implementation challenges and facilitate uptake of screening invitations. As repres
Huf SW, Woldmann L, Crespo RF, et al., 2022, Implementing behavioural science informed letter interventions to increase COVID-19 vaccination uptake in uncontactable London residents: a difference-in-difference study in London, UK., Lancet, Vol: 400 Suppl 1
BACKGROUND: The UK COVID-19 vaccination programme began in December, 2020. By February, 2021, eight North West London Clinical Commissioning Groups (CCGs) had the lowest vaccination rates nationally. This study evaluated the impact of behavioural science-informed (BI) letters on vaccination uptake. METHODS: Unvaccinated residents of the Central London CCG who were deemed uncontactable (through text messaging and phone calls) were identified with the whole systems integrated care database. BI letters were sent to residents in the intervention CCG between May and June, 2021. Three neighbouring CCGs in London with similar non-responder data were used as control groups. A linear difference-in-difference analysis was undertaken to assess change in vaccine uptake rate across all four CCGs. Percentage point change was adjusted for selected covariates including ethnicity, age, gender, and index of multiple deprivation (IMD) quintiles. Approval was obtained from the quality improvement and audit office of Imperial College Healthcare NHS Trust (London, UK). FINDINGS: Within the intervention Central London CCG, 10 161 residents received the BI letter. The control CCGs contained 27 383 uncontactable residents. All CCGs showed an increase in vaccination rates in this population. The linear difference-in-difference analysis showed an increase in vaccination uptake in the intervention CCG (relative change 31·9% (95% CI 30·5-33·3; p<0·0001). Residents in IMD quintile 5 (least deprived) showed the largest rate of change (4·1%; p<0·0001). Residents with a mixed or multiple ethnic background were less likely to receive a COVID-19 vaccine (-4·1%, p<0·0001). INTERPRETATION: BI letters improved the rate of vaccine uptake. The percentage point increase of 31·9% equates to 436 additional previously uncontactable residents being vaccinated. Our data highlighted differences in the effect of BI-informed interventions in p
Huf SW, Woldmann L, Crespo RF, et al., 2022, Implementing behavioural science informed letter interventions to increase COVID-19 vaccination uptake in uncontactable London residents: a difference-in-difference study in London, UK, LANCET, Vol: 400, Pages: 41-41, ISSN: 0140-6736
Ravindran S, Thomas-Gibson S, Bano M, et al., 2022, National census of UK endoscopy services 2021, FRONTLINE GASTROENTEROLOGY, Vol: 13, Pages: 463-470, ISSN: 2041-4137
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- Citations: 5
Lam K, Lo FP-W, An Y, et al., 2022, Deep Learning for Instrument Detection and Assessment of Operative Skill in Surgical Videos, IEEE TRANSACTIONS ON MEDICAL ROBOTICS AND BIONICS, Vol: 4, Pages: 1068-1071
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- Citations: 1
Acharya A, Judah G, Ashrafian H, et al., 2022, Investigating the implementation of mobile messaging in population screening programmes: a modified Delphi study, LANCET, Vol: 400, Pages: 15-15, ISSN: 0140-6736
Soukup T, Lamb BW, Bali A, et al., 2022, Sometimes we discuss up to seventy patients…Would you want to be number seventy?” Communication and decision-making in cancer multidisciplinary team meetings, Forthcoming in Frontiers in Psychology
Eales O, Haw D, Wang H, et al., 2022, Quantifying changes in the IFR and IHR over 23 months of the SARS-CoV-2 pandemic in England
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>The relationship between prevalence of infection and severe outcomes such as hospitalisation and death changed over the course of the COVID-19 pandemic. The REal-time Assessment of Community Transmission-1 (REACT-1) study estimated swab positivity in England approximately monthly from May 2020 to 31 March 2022. This period covers widespread circulation of the original strain, the emergence of the Alpha, Delta and Omicron variants and the rollout of England’s mass vaccination campaign.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Here, we explore this changing relationship between prevalence of swab positivity and the infection fatality rate (IFR) and infection hospitalisation rate (IHR) over 23 months of the pandemic in England, using publicly available data for the daily number of deaths and hospitalisations, REACT-1 swab positivity data, time-delay models and Bayesian P-spline models. We analyse data for all age groups together, as well as in two sub-groups: those aged 65 and over and those aged 64 and under.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>During 2020, we estimated the IFR to be 0.67% and the IHR to be 2.6%. By late-2021/early-2022 the IFR and IHR had both decreased to 0.097% and 0.76% respectively. Continuous estimates of the IFR and IHR of the virus were observed to increase during the periods of Alpha and Delta’s emergence. During periods of vaccination rollout, and the emergence of the Omicron variant, the IFR and IHR of the virus decreased. During 2020, we estimated a time-lag of 19 days between hospitalisation and swab positivity, and 26 days between deaths and swab positivity. By late-2021/early-2022 these time-lags had decreased to 7 days for hospitalisations, and 18 days for deaths.</jats:
Penney N, Yeung K, Garcia Perez I, et al., 2022, Multi-omic phenotyping reveals host-microbe responses to bariatric surgery, glycaemic control and obesity, communications medicine, Vol: 2, Pages: 1-18, ISSN: 2730-664X
Background: Resolution of type 2 diabetes (T2D) is common following bariatric surgery, particularly Roux-en-Y gastric bypass. However, the underlying mechanisms have not been fully elucidated.Methods: To address this we compare the integrated serum, urine and faecal metabolic profiles of participants with obesity +/- T2D (n=80, T2D=42) with participants who underwent Roux-en-Y gastric bypass or sleeve gastrectomy (pre and 3-months post-surgery; n=27), taking diet into account. We co-model these data with shotgun metagenomic profiles of the gut microbiota to provide a comprehensive atlas of host-gut microbe responses to bariatric surgery, weight-loss and glycaemic control at the systems level.Results: Here we show that bariatric surgery reverses several disrupted pathways characteristic of T2D. The differential metabolite set representative of bariatric surgery overlaps with both diabetes (19.3% commonality) and body mass index (18.6% commonality). However, the percentage overlap between diabetes and body mass index is minimal (4.0% commonality), consistent with weight-independent mechanisms of T2D resolution. The gut microbiota is more strongly correlated to body mass index than T2D, although we identify some pathways such as amino acid metabolism that correlate with changes to the gut microbiota and which influence glycaemic control.Conclusion: We identify multi-omic signatures associated with responses to surgery, body mass index, and glycaemic control. Improved understanding of gut microbiota - host co-metabolism may lead to novel therapies for weight-loss or diabetes. However, further experiments are required to provide mechanistic insight into the role of the gut microbiota in host metabolism and establish proof of causality.
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