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Article ; Online: The Royal Surgical Colleges' ingenious adaptation during the COVID-19 pandemic kept surgeons training and progressing.

Williams, Rebecca Charlene / Enoch, Stuart

2021 Volume 98, Issue 1161, Page(s) e6

MeSH term(s)	COVID-19 ; Humans ; Pandemics ; Surgeons ; Universities
Language	English
Publishing date	2021-10-21
Publishing country	England
Document type	Letter
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2021-141026
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Article: Investigating the role of preference variation in the perceptions of railway passengers in Great Britain.

Monsuur, Fredrik / Enoch, Marcus / Quddus, Mohammed / Meek, Stuart

Transportation

2023 , Page(s) 1–27

Abstract: This study explores the factors associated with passenger satisfaction on the UK railways. To uncover taste variation, the data was segmented into three homogeneous groups of passengers through a latent class ordered logit model, whereby the class ... ...

Abstract	This study explores the factors associated with passenger satisfaction on the UK railways. To uncover taste variation, the data was segmented into three homogeneous groups of passengers through a latent class ordered logit model, whereby the class allocation was based on observed personal and trip characteristics. The findings suggest that there is significant variation in the impact of service attributes on overall satisfaction across the segments, 'class a', 'class b' and 'class c'. Class a (15% of the sample) consists of moderately dissatisfied to highly dissatisfied passengers, for whom 'punctuality/reliability' is most impactful on overall satisfaction. Respondents in this class are much more likely to experience adverse service conditions such as delays or crowding conditions. Class b (32% of the sample) consists of passenger who are quite critical and moderately satisfied, for whom 'hedonic' factors such as 'upkeep and repair of the train' and 'seat comfort' were most impactful. Finally, class c (53% of the sample) consists of passengers that are generally satisfied, and for whom the 'value for money of the ticket price' is most impactful on overall satisfaction. Interestingly, for both 'class b' and 'class c', 'punctuality/reliability' plays a more limited role in determining overall satisfaction compared to 'class a'. This suggests that the role of 'punctuality/reliability' in determining overall satisfaction is more complex than presented in the literature thus far. Finally, unobserved taste variation plays an important role in the model, as the class allocation is not always easily linked to observed groups in the data. This paper thus highlights the importance of accounting for unobserved and systematic sources of heterogeneity in the data and could provide useful insights for analysts, policy makers and practitioners, to provide more targeted strategies to improve passenger satisfaction.
Language	English
Publishing date	2023-06-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2015868-3
ISSN	1572-9435 ; 0049-4488
ISSN (online)	1572-9435
ISSN	0049-4488
DOI	10.1007/s11116-023-10397-x
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Article ; Online: The Mexico Summit on Health Research 2004: medical community in developing countries has duty to promote healthcare research.

Enoch, Stuart

BMJ (Clinical research ed.)

2005 Volume 330, Issue 7488, Page(s) 421

MeSH term(s)	Budgets ; Developing Countries ; Financing, Government ; Health Services Research
Language	English
Publishing date	2005-02-19
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.330.7488.421-a
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Article: Role of Enzymic Antioxidants in Mediating Oxidative Stress and Contrasting Wound Healing Capabilities in Oral Mucosal/Skin Fibroblasts and Tissues.

Lohana, Parkash / Suryaprawira, Albert / Woods, Emma L / Dally, Jordanna / Gait-Carr, Edward / Alaidaroos, Nadia Y A / Heard, Charles M / Lee, Kwok Y / Ruge, Fiona / Farrier, Jeremy N / Enoch, Stuart / Caley, Matthew P / Peake, Matthew A / Davies, Lindsay C / Giles, Peter J / Thomas, David W / Stephens, Phil / Moseley, Ryan

Antioxidants (Basel, Switzerland)

2023 Volume 12, Issue 7

Abstract: Unlike skin, oral mucosal wounds are characterized by rapid healing and minimal scarring, attributable to the "enhanced" healing properties of oral mucosal fibroblasts (OMFs). As oxidative stress is increasingly implicated in regulating wound healing ... ...

Abstract	Unlike skin, oral mucosal wounds are characterized by rapid healing and minimal scarring, attributable to the "enhanced" healing properties of oral mucosal fibroblasts (OMFs). As oxidative stress is increasingly implicated in regulating wound healing outcomes, this study compared oxidative stress biomarker and enzymic antioxidant profiles between patient-matched oral mucosal/skin tissues and OMFs/skin fibroblasts (SFs) to determine whether superior oral mucosal antioxidant capabilities and reduced oxidative stress contributed to these preferential healing properties. Oral mucosa and skin exhibited similar patterns of oxidative protein damage and lipid peroxidation, localized within the lamina propria/dermis and oral/skin epithelia, respectively. SOD1, SOD2, SOD3 and catalase were primarily localized within epithelial tissues overall. However, SOD3 was also widespread within the lamina propria localized to OMFs, vasculature and the extracellular matrix. OMFs were further identified as being more resistant to reactive oxygen species (ROS) generation and oxidative DNA/protein damage than SFs. Despite histological evaluation suggesting that oral mucosa possessed higher SOD3 expression, this was not fully substantiated for all OMFs examined due to inter-patient donor variability. Such findings suggest that enzymic antioxidants have limited roles in mediating privileged wound healing responses in OMFs, implying that other non-enzymic antioxidants could be involved in protecting OMFs from oxidative stress overall.
Language	English
Publishing date	2023-06-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox12071374
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Article ; Online: Role of Enzymic Antioxidants in Mediating Oxidative Stress and Contrasting Wound Healing Capabilities in Oral Mucosal/Skin Fibroblasts and Tissues

Lohana, Parkash / Suryaprawira, Albert / Woods, Emma L. / Dally, Jordanna / Gait-Carr, Edward / Alaidaroos, Nadia Y. A. / Heard, Charles M. / Lee, Kwok Y. / Ruge, Fiona / Farrier, Jeremy N. / Enoch, Stuart / Caley, Matthew P. / Peake, Matthew A. / Davies, Lindsay C. / Giles, Peter J. / Thomas, D. W. / Stephens, Phil / Moseley, Ryan

Antioxidants. 2023 June 30, v. 12, no. 7

2023

Abstract: Unlike skin, oral mucosal wounds are characterized by rapid healing and minimal scarring, attributable to the “enhanced” healing properties of oral mucosal fibroblasts (OMFs). As oxidative stress is increasingly implicated in regulating wound healing ... ...

Abstract	Unlike skin, oral mucosal wounds are characterized by rapid healing and minimal scarring, attributable to the “enhanced” healing properties of oral mucosal fibroblasts (OMFs). As oxidative stress is increasingly implicated in regulating wound healing outcomes, this study compared oxidative stress biomarker and enzymic antioxidant profiles between patient-matched oral mucosal/skin tissues and OMFs/skin fibroblasts (SFs) to determine whether superior oral mucosal antioxidant capabilities and reduced oxidative stress contributed to these preferential healing properties. Oral mucosa and skin exhibited similar patterns of oxidative protein damage and lipid peroxidation, localized within the lamina propria/dermis and oral/skin epithelia, respectively. SOD1, SOD2, SOD3 and catalase were primarily localized within epithelial tissues overall. However, SOD3 was also widespread within the lamina propria localized to OMFs, vasculature and the extracellular matrix. OMFs were further identified as being more resistant to reactive oxygen species (ROS) generation and oxidative DNA/protein damage than SFs. Despite histological evaluation suggesting that oral mucosa possessed higher SOD3 expression, this was not fully substantiated for all OMFs examined due to inter-patient donor variability. Such findings suggest that enzymic antioxidants have limited roles in mediating privileged wound healing responses in OMFs, implying that other non-enzymic antioxidants could be involved in protecting OMFs from oxidative stress overall.
Keywords	DNA ; biomarkers ; catalase ; dermis ; extracellular matrix ; fibroblasts ; histology ; lipid peroxidation ; mucosa ; oxidative stress ; reactive oxygen species
Language	English
Dates of publication	2023-0630
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article ; Online
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox12071374
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Article ; Online: Propensity-matched analysis of minimally invasive approach versus sternotomy for mitral valve surgery.

Grant, Stuart W / Hickey, Graeme L / Modi, Paul / Hunter, Steven / Akowuah, Enoch / Zacharias, Joseph

Heart (British Cardiac Society)

2018 Volume 105, Issue 10, Page(s) 783–789

Abstract: Objective: The objective of this multicentre study was to compare short-term and midterm outcomes between sternotomy and minimally invasive approaches for mitral valve surgery.: Methods: Data for all mitral valve procedures with or without ... ...

Abstract	Objective: The objective of this multicentre study was to compare short-term and midterm outcomes between sternotomy and minimally invasive approaches for mitral valve surgery. Methods: Data for all mitral valve procedures with or without concomitant tricuspid atrial fibrillation surgery were analysed from three UK hospitals between January 2008 and December 2016. To account for selection bias between minimally invasive approach and sternotomy, one-to-one propensity score calliper matching without replacement was performed. The main outcome measure was midterm reintervention free survival that was summarised by the Kaplan-Meier estimator and compared between treatment arms using the stratified log-rank test. Results: A total of 2404 procedures (1757 sternotomy and 647 minimally invasive) were performed during the study period. Propensity score matching resulted in 639 matched pairs with improved balance postmatching in all 31 covariates (absolute standardised mean differences <10%). Despite longer procedural times patients who underwent minimally invasive surgery had a lower need for transfusion (20.5%vs14.4%, p=0.005) and reduced median postoperative length of stay (7 vs 6 days, p<0.001). There were no statistically significant differences in the rates of in-hospital mortality or postoperative stroke. Reintervention-free survival at 8 years was estimated as 86.1% in the minimally invasive group and 84.1% in the sternotomy group (p=0.40). Conclusions: Minimally invasive surgery is associated with excellent short-term outcomes and comparable midterm outcomes for patients undergoing mitral valve surgery. A minimally invasive approach should be considered for all patients who require mitral valve intervention and should be the standard against which transcatheter mitral techniques are compared.
MeSH term(s)	Aged ; Cardiac Surgical Procedures/methods ; Female ; Follow-Up Studies ; Hospital Mortality/trends ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Mitral Valve/surgery ; Mitral Valve Insufficiency/mortality ; Mitral Valve Insufficiency/surgery ; Operative Time ; Propensity Score ; Retrospective Studies ; Sternotomy/methods ; Survival Rate/trends ; Treatment Outcome ; United Kingdom/epidemiology
Language	English
Publishing date	2018-12-12
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study
ZDB-ID	1303417-0
ISSN	1468-201X ; 1355-6037
ISSN (online)	1468-201X
ISSN	1355-6037
DOI	10.1136/heartjnl-2018-314049
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Article ; Online: Association of medical student burnout with residency specialty choice.

Enoch, Lindsey / Chibnall, John T / Schindler, Debra L / Slavin, Stuart J

Medical education

2013 Volume 47, Issue 2, Page(s) 173–181

Abstract: Context: Given the trend among medical students away from primary care medicine and toward specialties that allow for more controllable lifestyles, the identification of factors associated with specialty choice is important. Burnout is one such factor. ... ...

Abstract	Context: Given the trend among medical students away from primary care medicine and toward specialties that allow for more controllable lifestyles, the identification of factors associated with specialty choice is important. Burnout is one such factor. The purpose of this study was to examine the associations between burnout and residency specialty choice in terms of provision for a less versus more controllable lifestyle (e.g. internal medicine versus dermatology) and a lower versus higher income (e.g. paediatrics versus anaesthesiology). Methods: A survey was sent to 165 Year 4 medical students who had entered the residency matching system. Students answered questions about specialty choice, motivating factors (lifestyle, patient care and prestige) and perceptions of medicine as a profession. They completed the Maslach Burnout Inventory-Human Services (MBI), which defines burnout in relation to emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Burnout and other variables were tested for associations with specialty lifestyle controllability and income. Results: A response rate of 88% (n = 145) was achieved. Experiences of MBI-EE, MBI-DP and MBI-PA burnout were reported by 42 (29%), 26 (18%) and 30 (21%) students, respectively. Specialties with less controllable lifestyles were chosen by 87 (60%) students and lower-income specialties by 81 (56%). Adjusted odds ratios (ORs) indicated that the choice of a specialty with a more controllable lifestyle was associated with higher MBI-EE burnout (OR = 1.77, 95% confidence interval [CI] 1.06-2.96), as well as stronger lifestyle- and prestige-related motivation, and weaker patient care-related motivation. The choice of a higher-income specialty was associated with lower MBI-PA burnout (OR = 0.56, 95% CI 0.32-0.98), weaker lifestyle- and patient care-related motivation, and stronger prestige-related motivation. Conclusions: Specialty choices regarding lifestyle controllability and income were associated with the amount and type of medical school burnout, as well as with lifestyle-, prestige- and patient care-related motivation. Given that burnout may influence specialty choice, particularly with regard to the primary care specialties, medical schools may consider the utility of burnout prevention strategies.
MeSH term(s)	Adult ; Burnout, Professional/psychology ; Career Choice ; Choice Behavior ; Cross-Sectional Studies ; Data Collection ; Education, Medical/statistics & numerical data ; Female ; Humans ; Internship and Residency ; Life Style ; Male ; Specialization/statistics & numerical data ; Students, Medical/psychology ; Students, Medical/statistics & numerical data
Language	English
Publishing date	2013-02
Publishing country	England
Document type	Journal Article
ZDB-ID	195274-2
ISSN	1365-2923 ; 0308-0110
ISSN (online)	1365-2923
ISSN	0308-0110
DOI	10.1111/medu.12083
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Article ; Online: An outbreak of meticillin-resistant Staphylococcus aureus colonization in a neonatal intensive care unit: use of a case-control study to investigate and control it and lessons learnt.

Brown, N M / Reacher, M / Rice, W / Roddick, I / Reeve, L / Verlander, N Q / Broster, S / Ogilvy-Stuart, A L / D'Amore, A / Ahluwalia, J / Robinson, S / Thaxter, R / Moody, C / Kearns, A / Greatorex, J / Martin, H / Török, M E / Enoch, D A

The Journal of hospital infection

2019 Volume 103, Issue 1, Page(s) 35–43

Abstract: Aim: To describe the investigation and management of a meticillin-resistant Staphylococcus aureus (MRSA) outbreak on a neonatal intensive care unit (NICU) and the lessons learnt.: Methods: This was an outbreak report and case-control study conducted ... ...

Abstract	Aim: To describe the investigation and management of a meticillin-resistant Staphylococcus aureus (MRSA) outbreak on a neonatal intensive care unit (NICU) and the lessons learnt. Methods: This was an outbreak report and case-control study conducted in a 40-cot NICU in a tertiary referral hospital and included all infants colonized/infected with gentamicin-resistant MRSA. Intervention: Standard infection-control measures including segregation of infants, barrier precautions, enhanced cleaning, assessment of staff practice including hand hygiene, and increased MRSA screening of infants were implemented. Continued MRSA acquisitions led to screening of all NICU staff. A case-control study was performed to assess staff contact with colonized babies and inform the management of the outbreak. Findings: Eight infants were colonized with MRSA (spa type t2068), one of whom subsequently developed an MRSA bacteraemia. MRSA colonization was significantly associated with lower gestational age; lower birthweight and with being a twin. Three nurses were MRSA colonized but only one nurse (45) was colonized with MRSA spa type t2068. Multivariable logistic regression analysis identified being cared for by nurse 45 as an independent risk factor for MRSA colonization. Conclusions: Lack of accurate recording of which nurses looked after which infants (and when) made identification of the risk posed by being cared for by particular nurses difficult. If this had been clearer, it may have enabled earlier identification of the colonized nurse, avoiding subsequent cases. This study highlights the benefit of using a case-control study, which showed that most nurses had no association with colonized infants.
MeSH term(s)	Carrier State/epidemiology ; Carrier State/microbiology ; Carrier State/prevention & control ; Carrier State/transmission ; Case-Control Studies ; Disease Outbreaks ; Disease Transmission, Infectious/prevention & control ; Female ; Humans ; Infant ; Infant, Newborn ; Infection Control/methods ; Intensive Care Units, Neonatal ; Male ; Methicillin-Resistant Staphylococcus aureus/classification ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Staphylococcal Infections/epidemiology ; Staphylococcal Infections/microbiology ; Staphylococcal Infections/prevention & control ; Staphylococcal Infections/transmission ; Tertiary Care Centers
Language	English
Publishing date	2019-05-24
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2019.05.009
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Article ; Online: Emergency and early management of burns and scalds.

Enoch, Stuart / Roshan, Amit / Shah, Mamta

BMJ (Clinical research ed.)

2009 Volume 338, Page(s) b1037

MeSH term(s)	Burn Units ; Burns/etiology ; Burns/pathology ; Burns/therapy ; Cicatrix/psychology ; Cicatrix/therapy ; Emergencies ; Emergency Treatment/methods ; Fluid Therapy ; Humans ; Nutritional Support ; Prognosis ; Referral and Consultation ; Resuscitation ; Skin Transplantation/methods ; Terminology as Topic
Language	English
Publishing date	2009-04-08
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.b1037
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Article ; Online: Pressure ulcers.

Grey, Joseph E / Harding, Keith G / Enoch, Stuart

BMJ (Clinical research ed.)

2006 Volume 332, Issue 7539, Page(s) 472–475

MeSH term(s)	Bandages ; Beds ; Debridement ; Equipment Design ; Humans ; Pressure Ulcer/etiology ; Pressure Ulcer/physiopathology ; Pressure Ulcer/prevention & control ; Risk Assessment ; Risk Factors ; Wound Healing/physiology
Language	English
Publishing date	2006-02-25
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.332.7539.472
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