Digital Commons Network^™

Patient-Reported Outcomes, Postoperative Pain And Pain Relief After Day Case Surgery (Poppy): Methodology For A Prospective, Multicentre Observational Study*, William M. Hare, Martha Belete, Adam B. Brayne, Harriet Daykin, Matthew Everson, Anna Ratcliffe, Katie Samuel, Lexy Sorrell, Mark Rockett

Peninsula Medical School

Background: In the UK, approximately 70% of surgical procedures are undertaken as day-cases. Little information exists about recovery from day-case surgery, yet international data highlights patients are at risk of developing significant longer-term health problems including chronic post-surgical pain and persistent postoperative opioid use. The Patient-reported Outcomes, Postoperative Pain and pain relief after daY case surgery (POPPY) study was a national prospective multicentre observational study, measuring short- and longer-term patient-reported outcomes, postoperative pain and pain relief after day-case surgery. Methods: This was a collaborative project led by resident anaesthetists under the Research and Audit Federation of Trainees umbrella. Adult day-case …

Mortality Prediction After Major Surgery In A Mixed Population Through Machine Learning: A Multi-Objective Symbolic Regression Approach, Pietro Arina, Davide Ferrari, Nicholas Tetlow, Amy Dewar, Robert Stephens, Daniel Martin, Ramani Moonesinghe, Vasa Curcin, Mervyn Singer, John Whittle, Evangelos B Mazomenos

Peninsula Medical School

INTRODUCTION: Understanding 1-year mortality following major surgery offers valuable insights into patient outcomes and the quality of peri-operative care. Few models exist that predict 1-year mortality accurately. This study aimed to develop a predictive model for 1-year mortality in patients undergoing complex non-cardiac surgery using a novel machine-learning technique called multi-objective symbolic regression.

METHODS: A single-institution database of patients undergoing major elective surgery with previous cardiopulmonary exercise testing was divided into three datasets: pre-operative clinical data; cardiorespiratory and physiological data; and combined. A multi-objective symbolic regression model was developed and compared against existing models. Model performance was evaluated using the …

Serious Games For Constipation Management For People With Intellectual Disabilities: A Scoping Review And Narrative Synthesis, Serena Daniel, Ruth Bishop, Ellie Killner, Alison Whight, Sarah Lennard, Stephen Howard, Richard Laugharne, Rohit Shankar

Peninsula Medical School

Introduction: People with intellectual disability (PwID) are 2% of the UK population. Constipation and bowel movement (BM) problems (diarrhoea/faecal incontinence etc.) affects over a third of PwID and is a serious cause of morbidity and mortality. Pw ID rely heavily on outside support (family/professional carers/healthcare professionals), many of whom are ignorant to bowel related harms. There is significant stigma to discuss BM particularly constipation. Serious Games (SG) are increasingly used for education of health needs. This review examines if game-based technology can assist improving knowledge and reducing stigma of BM problems particularly constipation. Objective: To identify and gain evidence of …

Desain Dan Konstitusionalitas Penerapan Pilkada Asimetris Di Indonesia, Lalu Aria Nata Kusuma

Jurnal Hukum & Pembangunan

The idea of implementing asymmetric regional elections (Pilkada) in Indonesia is not a new concept. However, to date, there has been no effort to provide a design for the implementation of Pilkada in an asymmetric manner, considering the specific needs of each region and its alignment with the 1945 Constitution. This article aims to implement Pilkada in an asymmetric manner by first mapping the asymmetry models of each region based on their specific needs. This research uses a doctrinal and socio-legal approach. The results of this research indicate a need to implement Pilkada asymmetrically in Indonesia. This urgency arises due …

Digital Constitutionalism: Resistensi Kebebasan Berpendapat Di Indonesia Dalam Hegemoni Algoritma Ruang Digital, Yuniar Prehatini, Linda Noviana Mita Devi

Jurnal Hukum & Pembangunan

Era digital membawa transformasi dalam segala aspek kehidupan. Perkembangan teknologi menghadirkan perkembangan zaman pada sisi positif dan negatif dimana penggunaan ruang digital yang dapat diakses tanpa batasan wilayah. Kebebasan diartikan melalui teknologi dengan adanya akses ruang digital memberikan kemudahan akses kepada siapa pun. Melalui algoritma digital, segala hal baik dari aspek budaya, politik, maupun ekonomi dapat diketahui sehingga hal ini juga dapat menimbulkan keresahan apabila tidak diatur batasan akan keberadaannya. Penelitian ini menggunakan penelitian normatif yang fokus pada analisis terhadap norma, asas, doktrin, dan teori hukum yang berkaitan dengan perlindungan hak asasi manusia di ruang digital. Hasil penulisan ini menunjukkan …

Nanobody Screening And Machine Learning Guided Identification Of Cross-Variant Anti-Sars-Cov-2 Neutralizing Heavy-Chain Only Antibodies, Peter R. Mcilroy, Zhuoming Liu, Sean Whelan, Et Al.

2020-Current year OA Pubs

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to persist, demonstrating the risks posed by emerging infectious diseases to national security, public health, and the economy. Development of new vaccines and antibodies for emerging viral threats requires substantial resources and time, and traditional development platforms for vaccines and antibodies are often too slow to combat continuously evolving immunological escape variants, reducing their efficacy over time. Previously, we designed a next-generation synthetic humanized nanobody (Nb) phage display library and demonstrated that this library could be used to rapidly identify highly specific and potent neutralizing heavy chain-only antibodies (HCAbs) with prophylactic and …

Overview Of Molecular Prognostication For Common Solid Tumor Histologies - What The Surgeon Should Know, C Rory Goodwin, Matthew L Goodwin, Et Al.

2020-Current year OA Pubs

STUDY DESIGN: Narrative Literature review.

OBJECTIVE: To provide a general overview of important molecular markers and targeted therapies for the most common neoplasms (lung, breast, prostate and melanoma) that metastasize to the spine and offer guidance on how to best incorporate them in the clinical setting.

METHODS: A narrative review of the literature was performed using PubMed, Google Scholar, Medline databases, as well as the histology-specific National Comprehensive Cancer Network guidelines to identify relevant articles limited to the English language. Relevant articles were reviewed for commonly described molecular mutations or targeted therapeutics, as well as associated clinical outcomes, and surgery-related …

Aav Gene Therapy For Duchenne Muscular Dystrophy: The Embark Phase 3 Randomized Trial, Jerry R Mendell, Craig M Zaidman, Et Al.

2020-Current year OA Pubs

Duchenne muscular dystrophy (DMD) is a rare, X-linked neuromuscular disease caused by pathogenic variants in the DMD gene that result in the absence of functional dystrophin, beginning at birth and leading to progressive impaired motor function, loss of ambulation and life-threatening cardiorespiratory complications. Delandistrogene moxeparvovec, an adeno-associated rh74-viral vector-based gene therapy, addresses absent functional dystrophin in DMD. Here the phase 3 EMBARK study aimed to assess the efficacy and safety of delandistrogene moxeparvovec in patients with DMD. Ambulatory males with DMD, ≥4 years to <8 years of age, were randomized and stratified by age group and North Star Ambulatory Assessment (NSAA) score to single-administration intravenous delandistrogene moxeparvovec (1.33 × 10

Cancer-Targeted Pro-Theranostic Bi-Metallic Organo-Coordination Nanoparticles, Hengbo Huang, Lei Fang, Janaka Wansapura, Julie L Prior, Brad Manion, Baogang Xu, Cody Hongsermeier, Nisha Gamadia, Nicole Blasi, Rui Tang, Christopher Egbulefu, Monica Shokeen, James D Quirk, Samuel Achilefu

2020-Current year OA Pubs

No abstract provided.

Location And Extent Of Disease Predicts Outcome Of Neurofibromatosis Type 1-Related Pediatric Low-Grade Gliomas, Sneha M Chaturvedi, Arohi Saxena, Ahmad Hassan, Ali Mian, Chelsea Kotch, Nicole M Brossier

2020-Current year OA Pubs

No abstract provided.

Poor Sleep Is Common In Treatment-Resistant Late-Life Depression And Associated With Poorer Antidepressant Response: Findings From The Optimum Clinical Trial, Michael S B Mak, Marie Anne Gebara, Eric J Lenze, Daniel M Blumberger, Patrick J Brown, Pilar Cristancho, Alastair J Flint, Jordan F Karp, Helen Lavretsky, J Philip Miller, Charles F Reynolds 3rd, Steven P Roose, Benoit H Mulsant, Sarah T Stahl

2020-Current year OA Pubs

BACKGROUND: Adults with treatment-resistant late-life depression (TRLLD) have high rates of sleep problems; however, little is known about the occurrence and change in sleep during pharmacotherapy of TRLLD. This analysis examined: (1) the occurrence of insufficient sleep among adults with TRLLD; (2) how sleep changed during pharmacotherapy; and (3) whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep.

METHODS: Secondary analysis of data from 634 participants age 60+ years in the OPTIMUM clinical trial for TRLLD. Sleep was assessed using the sleep item from the Montgomery-Asberg Depression Rating Scale at the …

Reliability Of Wrist Arthroscopy In The Diagnosis And Treatment Of Triangular Fibrocartilage Complex Tears, Elizabeth A Graesser, Lindley B Wall, Sanjeev Kakar, Jeffrey Yao, Marc J Richard, R Glenn Gaston, Charles A Goldfarb

2020-Current year OA Pubs

PURPOSE: Wrist arthroscopy is considered the gold standard for diagnosis of intra-articular wrist conditions including triangular fibrocartilage complex (TFCC) tears; however, the ability to reliably diagnose TFCC pathology during wrist arthroscopy is unclear. The purpose of this study was to assess the reliability of the diagnosis of TFCC tears on wrist arthroscopy videos.

METHODS: Five hand surgeons reviewed 43 cases on a secure web-based platform at two time points separated by 4-6 weeks. Each case included a deidentified clinical vignette and wrist radiographs with ulnar variance measurements and an arthroscopy video of ulnar wrist pathology, averaging 42 seconds. Surgeons were …

Costs Of Non-Metastatic Prostate Cancer Treatment Among Privately Insured Men In The United States, Ashley J. Housten, Su-Hsin Chang, Hannah E. Rice, Allison J. L'Hotta, Eric H. Kim, Bettina F. Drake, Joanna L. Buss, Mary C. Politi

2020-Current year OA Pubs

BACKGROUND: Our objective was to quantify the cumulative total and out-of-pocket (OOP) costs for 3 non-metastatic prostate cancer treatment modalities: radiation, surgery, and conservative management at intervals of 1-, 3-, and 5-years post-diagnosis. We predicted these cumulative costs for a typical patient to improve cost transparency, facilitate conversations about potential costs, and to help advance non-metastatic prostate cancer cost evaluation.

METHODS: We used Merative™ MarketScan® Commercial Database data from 2007-2020. The cumulative total costs evaluated from the healthcare sector perspective were patient, clinician, and system/facility costs. We used descriptive statistics to summarize the sociodemographic characteristics of the cohort and a …

A Holistic Ecosystem Model To Diversify The Physician Workforce And Enhance Health, Erik J Porfeli, Sunny Nakae, Leila Amiri, Leila E Harrison, Will Ross

2020-Current year OA Pubs

IMPORTANCE: The U.S. medical education system attracts and trains the next generation of physicians to advance the health care needs of a growing and increasingly diverse nation. This system can be credited for supplying a physician workforce achieving remarkable growth and innovation, yielding one of the world's most technologically advanced health care systems on the planet. This system, unfortunately, also contributes to educational, workforce, and health disparities.

OBSERVATIONS: The successes and challenges of the medical education and health care system align with broader economic, health, and educational patterns in the United States. An ecological model can be employed to unite …

Concomitant Traumatic Brain Injury Exacerbates Endotheliopathy In Patients With Spinal Cord Injury, Shahab Hafezi, Miguel A. Ruiz-Cardozo, Sarbani Ghosh, Sravanthi Bandla, Matthew N. Montoya Rush, Anand Dharmarajan, Mark H. Hoofnagle, Isaiah R. Turnbull, Camilo A. Molina, Grace M. Niziolek

2020-Current year OA Pubs

No abstract provided.

Sample Ascertainment And Recruitment Sources In The Accelerating Medicines Partnership Schizophrenia Program, Jean Addington, Daniel Mamah, Et Al.

2020-Current year OA Pubs

BACKGROUND: This paper presents the recruitment sources of clinical high-risk (CHR) and community controls (CC) from the Accelerating Medicines Partnership Schizophrenia (AMP SCZ) program, which aims to study various clinical variables and biomarkers in 2040 CHR and 652 CC participants.

METHODS: A total of 1640 CHR and 514 CC had recruitment source data. The Positive Symptoms and Diagnostic Criteria for the Comprehensive Assessment of At-Risk Mental States Harmonized with the SIPS was utilized to assess CHR criteria and severity of attenuated psychotic symptoms (APSs), and the Global Functioning: Social Scale was used for social functioning. Participants were recruited through various …

An Explainable Ai Approach For Mapping Multivariate Regional Brain Age And Clinical Severity Patterns In Alzheimer's Disease, Gauri Darekar, Taslim Murad, Hui-Yuan Miao, Deepa S Thakuri, Alzheimer’S Disease Neuroimaging Initiative, Ganesh B Chand

2020-Current year OA Pubs

Age is a significant risk factor for mild cognitive impairment (MCI) and Alzheimer's disease (AD) and identifying brain age patterns is critical for comprehending the normal aging and MCI/AD processes. Prior studies have widely established the univariate relationships between brain regions and age, while multivariate associations remain largely unexplored. Herein, various artificial intelligence (AI) models were used to perform brain age prediction using an MRI dataset (

Sociodemographic Factors Predict Outcomes And Reveal Spatial Tumor Patterns In Glioblastoma, Patrick H Luckett, Michael Olufawo, Noah Naddaff-Slocum, Ki Yun Park, Bidhan Lamichhane, Donna Dierker, Gabriel Trevino Verastegui, John J Lee, Peter Yang, Albert Kim, Omar H Butt, Milan G Chheda, Abraham Z Snyder, Joshua S Shimony, Eric C Leuthardt

2020-Current year OA Pubs

BACKGROUND: Glioblastoma (GBM) is the deadliest malignant glioma of the central nervous system. Postsurgical functional impairment correlates with survival and is estimated using metrics such as extent and location of resection. This study uses machine learning to evaluate the predictive ability of baseline sociodemographic and lifestyle factors for forecasting postoperative functional outcomes in GBM patients.

METHODS: Glioblastoma patients (

RESULTS: Utilizing decision trees with age, SVI/SES, sex, tobacco use, alcohol use, obesity, and race as predictors, we achieved 88% accuracy in classifying median KPS and 85% accuracy in classifying KPS slope. Socioeconomic factors were the strongest predictors. Age, sex, and …

Preliminary Investigation Of Obstructive Sleep Apnea And Alzheimer's Disease In Down Syndrome, Dasoo M Yoon, David T Plante, Victoria Fleming, Benjamin Handen, Patrick Lao, Jamie Peven, Bradley Christian, Ozioma Okonkwo, Charles Laymon, Beau Ances, Christy Hom, Brian Helsel, Sigan L Hartley

2020-Current year OA Pubs

This study provided a preliminary examination of indices of obstructive sleep apsnea (OSA) and sleep disruptions in adults with Down syndrome (DS), and their associations with Alzheimer's disease (AD) pathology and symptomatology. A total of 93 adults with DS (aged 25-61 years) from the Alzheimer Biomarker Consortium-DS completed cognitive assessments, MRI and positron emission tomography (PET) scans (assessing amyloid-beta [Aβ] and tau), and a one-night home sleep study using the WatchPAT-300 device. Study partners also reported on depressive symptoms and diagnoses. Correlational analyses examined relationships between sleep variables, PET biomarkers, and AD symptomatology (cognitive functioning and depressive mood), controlling for …

Development Of A High-Throughput Platform For Quantitation Of Histone Modifications On A New Qtof Instrument, Emily Zahn, Yixuan Xie, Xingyu Liu, Rashmi Karki, Richard M Searfoss, Francisca N De Luna Vitorino, Joanna K Lempiäinen, Joanna Gongora, Zongtao Lin, Chenfeng Zhao, Zuo-Fei Yuan, Benjamin A Garcia

2020-Current year OA Pubs

Histone post-translational modifications (PTMs) regulate gene expression patterns through epigenetic mechanisms. The five histone proteins (H1, H2A, H2B, H3, and H4) are extensively modified, with over 75 distinct modification types spanning more than 200 sites. Despite strong advances in mass spectrometry (MS)-based approaches, identification and quantification of modified histone peptides remains challenging because of factors, such as isobaric peptides, pseudo-isobaric PTMs, and low stoichiometry of certain marks. Here, we describe the development of a new high-throughput method to identify and quantify over 150 modified histone peptides by LC-MS. Fast gradient microflow liquid chromatography and variable window sequential windows acquisition of …

A Clinical Practice Review Of Optimizing The Approach For Correction Of Thoracolumbar Deformity— When And How To Perform Anterior Releases And Fusion, Brian M. Phelps, Munish C. Gupta

2020-Current year OA Pubs

No abstract provided.

Caregiver Worry About Covid-19 As A Predictor Of Social Mitigation Behaviours And Sars-Cov-2 Infection In A 12-City U.S. Surveillance Study Of Households With Children, Steven M Brunwasser, Katherine Rivera-Spoljaric, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Understanding compliance with COVID-19 mitigation recommendations is critical for informing efforts to contain future infectious disease outbreaks. This study tested the hypothesis that higher levels of worry about COVID-19 illness among household caregivers would predict lower (a) levels of overall and discretionary social exposure activities and (b) rates of household SARS-CoV-2 infections.

METHODS: Data were drawn from a surveillance study of households with children (

RESULTS: Caregivers with high enrollment levels of worry about COVID-19 illness were more likely to reduce direct social contact outside the household, particularly during the U.S.'s most deadly pandemic wave. Households of caregivers with …

Disclosing Disabilities: Barriers For Medical School Applicants, Sarah Leah Solomon, Aitan E. Magence, Harry Haran, Fern R. Juster, Kristina H. Petersen

2020-Current year OA Pubs

This study investigated the availability of accommodation request procedures for medical school admissions interviews and the accessibility of Technical Standards (TS) for candidates with disabilities (CWD) across Liaison Committee on Medical Education (LCME)-accredited institutions in the United States and Canada. Utilizing a cross-sectional study methodology, surveys were distributed to Deans of Admissions and Disabilities Resource Professionals (DRP) at all LCME-accredited US and Canadian MD programs. Surveys gathered data about interview formats, interview accommodation procedures, and TS accessibility during the 2018-2019 academic year. We received responses from 71 institutions (41.3%), with 56.3% survey completion rate (n = 40). Among respondents, interview …

Comparison And Clinical Applicability Analysis Of All-Posterior, Combined Anterior-Posterior, And Combined Lateral-Posterior Approaches In Adult Spinal Deformities: A Narrative Review, Garrison P. Bentz, Christopher Diaz, Nicholas A. Pollatta, Mark J. Lambrechts

2020-Current year OA Pubs

No abstract provided.

Vagus Nerve Stimulation In Treatment-Resistant Depression: A One-Year, Randomized, Sham-Controlled Trial, Charles R Conway, Christopher L Kriedt, Et Al.

2020-Current year OA Pubs

BACKGROUND: Few treatments are available for individuals with marked treatment-resistant depression (TRD).

OBJECTIVE: Evaluate the safety and effectiveness of FDA-approved adjunctive vagus nerve stimulation (VNS) in patients with marked TRD.

METHODS: This 12-month, multicenter, double-blind, sham-controlled trial included 493 adults with marked treatment-resistant major depression who were randomized to active or no-stimulation sham VNS for 12 months. The primary outcome was percent time in response across months 3-12, with response defined as a ≥50 % change from baseline on the Montgomery-Åsberg Depression Rating Scale (MADRS). Several secondary endpoints were evaluated.

RESULTS: Overall, 88.4 % of participants completed the trial. Percent …

Effects Of Vagus Nerve Stimulation On Daily Function And Quality Of Life In Markedly Treatment-Resistant Major Depression: Findings From A One-Year, Randomized, Sham-Controlled Trial, A John Rush, Charles R Conway, Et Al.

2020-Current year OA Pubs

BACKGROUND: Depression treatments aim to minimize symptom burden and optimize quality of life (QoL) and psychosocial function.

OBJECTIVE: Compare the effects of adjunctive versus sham vagus nerve stimulation (VNS) on QoL and function in markedly treatment-resistant depression (TRD).

METHODS: In this multicenter, double-blind, sham-controlled trial, 493 adults with TRD and ≥4 adequate but unsuccessful antidepressant treatment trials (current episode) were randomized to active (n = 249) or sham (n = 244) VNS (plus treatment as usual) over a 12-month observation period. Quarterly outcomes included QoL with the Q-LES-Q, Mini-Q-LES-Q, and EQ-5D-5L, and function with the WHODAS 2.0 and Work Productivity …

Improving Training On Hepatitis B Research In Nigeria: Findings From An Innovation Bootcamp To Strengthen Capacity, Maria A. Afadapa, Olufunto A. Olusanya, Peter Kalulu, Nkiruka Obodoechina, Temitope Ojo, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

We organized an Innovation Bootcamp for young people in Nigeria to develop strategies promoting the uptake of the hepatitis B birth dose vaccine among newborns, which remains low, with an estimated coverage of 52%. This event was a collaborative, cross-disciplinary capacity-building platform to generate creative solutions addressing barriers to Hepatitis B vaccine uptake. The purpose of this study was to describe the bootcamp activities that address this gap and evaluate the impact of an Innovation Bootcamp designed to build research capacity among young Nigerians. The bootcamp was informed by Participatory Action Research focused at engaging young people as co-researchers to …

Tourette Syndrome Research Highlights From 2024 [Version 3; Peer Review: 2 Approved, 1 Approved With Reservations], Andreas Hartmann, Per Andrén, Cyril Atkinson-Clement, Virginie Czernecki, Cécile Delorme, Simon Morand-Beaulieu, Nanette Mol Debes, Kirsten Müller-Vahl, Peristera Paschou, Natalia Szejko, Apostolia Topaloudi, Kevin J Black

2020-Current year OA Pubs

We summarize research reports from 2024 relevant to Tourette syndrome, which the authors consider the most important or interesting. This working draft aims to submit this content for publication around the beginning of 2025 in the yearly Tourette Syndrome Research Highlights series on F1000Research. The authors welcome article suggestions and thoughtful feedback from readers, who can add a comment by clicking on the rectangular comment box icon to the left of the LOG IN link at the top of this page. For private comments, you can reach us by email ( [email protected] or [email protected]).

Tracking The Evolving Role Of Artificial Intelligence In Implementation Science: Protocol For A Living Scoping Review Of Applications, Evaluation Approaches And Outcomes [Version 2; Peer Review: 2 Approved], Guillaume Fontaine, Byron J Powell, Et Al.

2020-Current year OA Pubs

BACKGROUND: Artificial intelligence (AI) offers significant opportunities to improve the field of implementation science by supporting key activities such as evidence synthesis, contextual analysis, and decision-making to promote the adoption and sustainability of evidence-based practices. This living scoping review aims to: (1) map applications of AI in implementation research and practice; (2) identify evaluation approaches, reported outcomes, and potential risks; and (3) synthesize reported research gaps and opportunities for advancing the use of AI in implementation science.

METHODS: This scoping review will follow the Joanna Briggs Institute (JBI) methodology and the Cochrane guidance for living systematic reviews. A living scoping …

Whole Genome Sequence Analysis Of Low-Density Lipoprotein Cholesterol Across 246 K Individuals, Margaret Sunitha Selvaraj, Lisa De Las Fuentes, Susan K. Dutcher, Et Al.

2020-Current year OA Pubs

No abstract provided.