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Article: Roadblocks and solutions to planning surgical care for a billion Indians.

Zadey, Siddhesh / Sonal, Swati / Iyer, Himanshu / Baxy, Himani / Smith, Emily R / Staton, Catherine A / Fitzgerald, Tamara N / Nickenig Vissoci, Joao Ricardo

BMJ global health

2022 Volume 7, Issue 11

MeSH term(s)	Humans ; India ; Patient Care Planning ; Surgical Procedures, Operative
Language	English
Publishing date	2022-11-17
Publishing country	England
Document type	Journal Article
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2022-010292
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Article ; Online: Using machine learning to model older adult inpatient trajectories from electronic health records data.

Herrero-Zazo, Maria / Fitzgerald, Tomas / Taylor, Vince / Street, Helen / Chaudhry, Afzal N / Bradley, John R / Birney, Ewan / Keevil, Victoria L

iScience

2022 Volume 26, Issue 1, Page(s) 105876

Abstract: Electronic Health Records (EHR) data can provide novel insights into inpatient trajectories. Blood tests and vital signs from de-identified patients' hospital admission episodes (AE) were represented as multivariate time-series (MVTS) to train ... ...

Abstract	Electronic Health Records (EHR) data can provide novel insights into inpatient trajectories. Blood tests and vital signs from de-identified patients' hospital admission episodes (AE) were represented as multivariate time-series (MVTS) to train unsupervised Hidden Markov Models (HMM) and represent each AE day as one of 17 states. All HMM states were clinically interpreted based on their patterns of MVTS variables and relationships with clinical information. Visualization differentiated patients progressing toward stable '
Language	English
Publishing date	2022-12-24
Publishing country	United States
Document type	Journal Article
ISSN	2589-0042
ISSN (online)	2589-0042
DOI	10.1016/j.isci.2022.105876
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Article ; Online: Evaluating the status of the Lancet Commission on Global Surgery indicators for India.

Zadey, Siddhesh / Iyer, Himanshu / Nayan, Anveshi / Shetty, Ritika / Sonal, Swati / Smith, Emily R / Staton, Catherine A / Fitzgerald, Tamara N / Nickenig Vissoci, Joao Ricardo

The Lancet regional health. Southeast Asia

2023 Volume 13, Page(s) 100178

Abstract: For universal surgical, obstetric, trauma, and anesthesia care by 2030, the Lancet Commission on Global Surgery (LCoGS) suggested tracking six indicators. We reviewed academic and policy literature to investigate the current state of LCoGS indicators in ... ...

Abstract	For universal surgical, obstetric, trauma, and anesthesia care by 2030, the Lancet Commission on Global Surgery (LCoGS) suggested tracking six indicators. We reviewed academic and policy literature to investigate the current state of LCoGS indicators in India. There was limited primary data for access to timely essential surgery, risk of impoverishing and catastrophic health expenditures due to surgery, though some modeled estimates are present. Surgical specialist workforce estimates are heterogeneous across different levels of care, urban and rural areas, and diverse health sectors. Surgical volumes differ widely across demographic, socio-economic, and geographic cohorts. Perioperative mortality rates vary across procedures, diagnoses, and follow-up time periods. Available data suggest India falls short of achieving global targets. This review highlights the evidence gap for India's surgical care planning. India needs a systematic subnational mapping of indicators and adaptation of targets as per the country's health needs for equitable and sustainable planning.
Language	English
Publishing date	2023-04-05
Publishing country	England
Document type	Journal Article ; Review
ISSN	2772-3682
ISSN (online)	2772-3682
DOI	10.1016/j.lansea.2023.100178
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Article ; Online: The clinical implication of the association between hypoxaemia and postoperative troponin I: a reply.

Bojesen, R D / Fitzgerald, P / Munk-Madsen, P / Eriksen, J R / Kehlet, H / Gögenur, I

Anaesthesia

2019 Volume 75, Issue 1, Page(s) 128–129

MeSH term(s)	Humans ; Hypoxia ; Postoperative Period ; Troponin I
Chemical Substances	Troponin I
Language	English
Publishing date	2019-12-03
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	80033-8
ISSN	1365-2044 ; 0003-2409
ISSN (online)	1365-2044
ISSN	0003-2409
DOI	10.1111/anae.14917
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Article ; Online: Hypoxaemia during recovery after surgery for colorectal cancer: a prospective observational study.

Bojesen, R D / Fitzgerald, P / Munk-Madsen, P / Eriksen, J R / Kehlet, H / Gögenur, I

Anaesthesia

2019 Volume 74, Issue 8, Page(s) 1009–1017

Abstract: ... 38]) days. Thirty-six percent of patients spent more than 1 h below an oxygen saturation of 90% (4.2 ...

Abstract	Episodic and ongoing hypoxaemia are well-described after surgery, but, to date, no studies have investigated the occurrence of episodic hypoxaemia following minimally-invasive colorectal surgery performed in an enhanced recovery setting. We aimed to describe the occurrence of postoperative hypoxaemia after minimally-invasive surgery in an enhanced recovery setting, and the association with morphine use, incision site, fluid intake and troponin increase. We performed a prospective observational study of 85 patients undergoing minimally-invasive surgery for colorectal cancer between 25 August 2016 and 17 August 2017. We applied a pulse oximeter with a measurement rate of 1 Hz immediately after surgery either until discharge or until two days after surgery, and recorded the oxygen saturation. We measured troponin I during the first four days after surgery, or until discharge. The median (IQR [range]) length of stay was 3 (2-4 [1-38]) days. Thirty-six percent of patients spent more than 1 h below an oxygen saturation of 90% (4.2% of the day), and with a median (IQR [range]) proportion of 1.3 (0.2-11.1 [0.0-21.4])% of the day spent with an oxygen saturation below 88%. We found no associations between time spent below an oxygen saturation of 88% and morphine use (p = 0.215), fluid intake (p = 0.446), complications (p = 0.808) or extraction site (p = 0.623). Postoperative increases in troponin I were associated both with time spent below an oxygen saturation of 88% (p = 0.026) and hypopnoea episodes (p = 0.003). Even with minimally-invasive surgery and enhanced recovery after surgery, episodic hypoxaemia and hypopnoea episodes are common, but are not associated with morphine use, fluid intake or incision site. Further studies should investigate the relationship between hypoxaemia and troponin increase.
MeSH term(s)	Aged ; Colorectal Neoplasms/surgery ; Female ; Humans ; Hypoxia/etiology ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/adverse effects ; Morphine/administration & dosage ; Oxygen/blood ; Postoperative Complications/etiology ; Prospective Studies
Chemical Substances	Morphine (76I7G6D29C) ; Oxygen (S88TT14065)
Language	English
Publishing date	2019-05-17
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	80033-8
ISSN	1365-2044 ; 0003-2409
ISSN (online)	1365-2044
ISSN	0003-2409
DOI	10.1111/anae.14691
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Article ; Online: The relationship between social isolation, social support, and loneliness with cardiovascular disease and shared risk factors: A narrative review.

Teshale, Achamyeleh Birhanu / Htun, Htet Lin / Hu, Jessie / Dalli, Lachlan L / Lim, Michelle H / Neves, Barbara Barbosa / Baker, J R / Phyo, Aung Zaw Zaw / Reid, Christopher M / Ryan, Joanne / Owen, Alice J / Fitzgerald, Sharyn M / Freak-Poli, Rosanne

Archives of gerontology and geriatrics

2023 Volume 111, Page(s) 105008

Abstract: Background: Cardiovascular disease (CVD) is the greatest contributor to global morbidity and mortality. Poor social health plays a critical role in CVD incidence. Additionally, the relationship between social health and CVD may be mediated through CVD ... ...

Abstract	Background: Cardiovascular disease (CVD) is the greatest contributor to global morbidity and mortality. Poor social health plays a critical role in CVD incidence. Additionally, the relationship between social health and CVD may be mediated through CVD risk factors. However, the underlying mechanisms between social health and CVD are poorly understood. Certain social health constructs (social isolation, low social support and loneliness) have complicated the characterisation of a causal relationship between social health and CVD. Aim: To provide an overview of the relationship between social health and CVD (and its shared risk factors). Method: In this narrative review, we examined published literature on the relationship between three social health constructs (social isolation, social support, and loneliness) and CVD. Evidence was synthesised in a narrative format, focusing on the potential ways in which social health affects CVD, including shared risk factors. Results: The current literature highlights an established relationship between social health and CVD with a likelihood for bi-directionality. However, there is speculation and varied evidence regarding how these relationships may be mediated through CVD risk factors. Conclusions: Social health can be considered an established risk factor for CVD. However, the potential bi-directional pathways of social health with CVD risk factors are less established. Further research is needed to understand whether targeting certain constructs of social health may directly improve the management of CVD risk factors. Given the health and economic burdens of poor social health and CVD, improvements to addressing or preventing these interrelated health conditions would have societal benefits.
MeSH term(s)	Humans ; Loneliness ; Cardiovascular Diseases/epidemiology ; Social Isolation ; Risk Factors ; Social Support
Language	English
Publishing date	2023-03-23
Publishing country	Netherlands
Document type	Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603162-6
ISSN	1872-6976 ; 0167-4943
ISSN (online)	1872-6976
ISSN	0167-4943
DOI	10.1016/j.archger.2023.105008
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Zs.A 1729: Show issues

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Article ; Online: Inhaled anti-TSLP antibody fragment, ecleralimab, blocks responses to allergen in mild asthma.

Gauvreau, Gail M / Hohlfeld, Jens M / FitzGerald, J Mark / Boulet, Louis-Philippe / Cockcroft, Donald W / Davis, Beth E / Korn, Stephanie / Kornmann, Oliver / Leigh, Richard / Mayers, Irvin / Watz, Henrik / Grant, Sarah S / Jain, Monish / Cabanski, Maciej / Pertel, Peter E / Jones, Ieuan / Lecot, Jean R / Cao, Hui / O'Byrne, Paul M

The European respiratory journal

2023 Volume 61, Issue 3

Abstract: Background: Thymic stromal lymphopoietin (TSLP) is a key upstream regulator driving allergic inflammatory responses. We evaluated the efficacy and safety of ecleralimab, a potent inhaled neutralising antibody fragment against human TSLP, using allergen ... ...

Abstract	Background: Thymic stromal lymphopoietin (TSLP) is a key upstream regulator driving allergic inflammatory responses. We evaluated the efficacy and safety of ecleralimab, a potent inhaled neutralising antibody fragment against human TSLP, using allergen inhalation challenge (AIC) in subjects with mild atopic asthma. Methods: This was a 12-week, randomised, double-blind, placebo-controlled, parallel-design, multicentre allergen bronchoprovocation study conducted at 10 centres across Canada and Germany. Subjects aged 18-60 years with stable mild atopic asthma were randomised (1:1) to receive 4 mg once-daily inhaled ecleralimab or placebo. Primary end-points were the allergen-induced change in forced expiratory volume in 1 s (FEV Results: 28 subjects were randomised to ecleralimab (n=15) or placebo (n=13). On day 84, ecleralimab significantly attenuated LAR AUC Conclusion: Ecleralimab significantly attenuated allergen-induced bronchoconstriction and airway inflammation, and was safe in subjects with mild atopic asthma.
MeSH term(s)	Humans ; Administration, Inhalation ; Allergens/adverse effects ; Asthma ; Bronchial Provocation Tests ; Cross-Over Studies ; Cytokines ; Double-Blind Method ; Forced Expiratory Volume ; Hypersensitivity, Immediate ; Immunoglobulin Fragments/therapeutic use ; Sputum ; Thymic Stromal Lymphopoietin ; Adolescent ; Young Adult ; Adult ; Middle Aged
Chemical Substances	Allergens ; Cytokines ; Immunoglobulin Fragments ; Thymic Stromal Lymphopoietin (GT0IL38SP4)
Language	English
Publishing date	2023-03-09
Publishing country	England
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/13993003.01193-2022
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Zs.A 2322: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Mapping of a N-terminal α-helix domain required for human PINK1 stabilization, Serine228 autophosphorylation and activation in cells.

Kakade, Poonam / Ojha, Hina / Raimi, Olawale G / Shaw, Andrew / Waddell, Andrew D / Ault, James R / Burel, Sophie / Brockmann, Kathrin / Kumar, Atul / Ahangar, Mohd Syed / Krysztofinska, Ewelina M / Macartney, Thomas / Bayliss, Richard / Fitzgerald, Julia C / Muqit, Miratul M K

Open biology

2022 Volume 12, Issue 1, Page(s) 210264

Abstract: Autosomal recessive mutations in ... ...

Abstract	Autosomal recessive mutations in the
MeSH term(s)	Enzyme Activation ; Humans ; Phosphorylation ; Protein Conformation, alpha-Helical ; Protein Kinases/genetics ; Protein Kinases/metabolism ; Ubiquitin/metabolism ; Ubiquitin-Protein Ligases/metabolism
Chemical Substances	Ubiquitin ; Ubiquitin-Protein Ligases (EC 2.3.2.27) ; Protein Kinases (EC 2.7.-) ; PTEN-induced putative kinase (EC 2.7.11.1)
Language	English
Publishing date	2022-01-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2630944-0
ISSN	2046-2441 ; 2046-2441
ISSN (online)	2046-2441
ISSN	2046-2441
DOI	10.1098/rsob.210264
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Article ; Online: Diagnosis, clinical characteristics, and outcomes of COVID-19 patients from a large healthcare system in northern New Jersey.

Zhao, Yanan / Cunningham, Marcus H / Mediavilla, Jose R / Park, Steven / Fitzgerald, Sean / Ahn, Hee Sang / Li, Xiangyang / Zhan, Caixin / Hong, Tao / Munk, Gary / Chow, Kar Fai / Perlin, David S

Scientific reports

2021 Volume 11, Issue 1, Page(s) 4389

Abstract: New Jersey was an early epicenter for the COVID-19 pandemic in the United States, yet information on hospitalized COVID-19 patients from this area is scarce. This study aimed to provide data on demographics and clinical features of a hospitalized patient ...

Abstract	New Jersey was an early epicenter for the COVID-19 pandemic in the United States, yet information on hospitalized COVID-19 patients from this area is scarce. This study aimed to provide data on demographics and clinical features of a hospitalized patient population who were confirmed with infection by our in-house (CDI) real-time reverse-transcription polymerase chain reaction (RT-PCR) test. We included consecutive patients who were admitted to Hackensack Meridian Health system hospitals with laboratory-confirmed diagnoses of COVID-19 at Hackensack University Medical Center by the CDI virus test between March 12, 2020, and April 8, 2020. Clinical data and viral testing results were collected and analyzed for characteristics associated with outcomes, as well as the correlation with viral load. A total of 722 patients were included in the study, with a median age of 63 (interquartile range (IQR), 51-75) and 272 (37.7%) females. Mortality of this case series was 25.8%, with a statistically significant linear increase observed from age 40 to ≥ 80 by 10-year intervals. Viral load, as indicated by the cycle of threshold (Ct) values from the RT-PCR test, was significantly higher in the oldest patient group (≥ 80), and inversely correlated with survival. This is the first report to describe the clinical characteristics and outcomes in a large hospitalized COVID-19 patient series from New Jersey. Findings from this study are valuable to the ongoing response of both nationwide healthcare networks and the medical research community.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19/mortality ; Clinical Laboratory Techniques ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; New Jersey ; Retrospective Studies ; Serologic Tests
Language	English
Publishing date	2021-02-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-83959-7
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Article ; Online: Supporting doctors as healthcare quality and safety advocates: Recommendations from the Association of Surgeons in Training (ASiT).

Fleming, C A / Humm, G / Wild, J R / Mohan, H M / Hornby, S T / Harries, R L / Fitzgerald, J E F / Beamish, A J

International journal of surgery (London, England)

2018 Volume 52, Page(s) 349–354

Abstract: Background: As front-line healthcare staff, doctors in surgical training occupy a unique organisational space rotating through hospitals and services in which they witness first hand both good and bad practice. This puts trainees in a clear position to ... ...

Abstract	Background: As front-line healthcare staff, doctors in surgical training occupy a unique organisational space rotating through hospitals and services in which they witness first hand both good and bad practice. This puts trainees in a clear position to identify and raise patient safety issues, and to contribute to discussions regarding quality and safety improvement. However, there are a number of real and perceived barriers to trainees doing so. These include concerns about the impact on training assessments and career progression, and uncertainty about the appropriate route. Methods: Paper-based survey of delegates attending the Association of Surgeons in Training (ASiT) conference (response rate 73%; 479/652). Results: 288 (60%) of trainees reported previous concerns over practices and behaviour of colleagues that might pose risks to patient care including concerns over poor performance (n = 243; 84%), bullying (n = 45; 16%), alcohol and drug abuse (n = 15; 5%) and mental health problems (n = 8; 3%). However, 53% (n = 153) did not escalate these concerns. 178 (37%) of trainees also reported concerns over hospital policies, protocols or systems that might pose a risk to patient care, with 46% (n = 82) not escalating such concerns. Respondents highlighted fear of personal vilification or reprisal (n = 224; 47%), fear of impact on career (n = 206; 43%) and a lack of confidence in the process (n = 170; 36%) as barriers to whistleblowing. More senior trainees were significantly more likely to raise concerns than more junior grades (p < 0.0001). Conclusion: These results highlight worrying issues around reporting concerns, with trainees often "silent witnesses" to poor performance in healthcare. Adverse events must provide opportunities for learning to improve future outcomes. Herein, ASiT proposes 14 recommendations to improve protection for trainees in raising patient safety concerns. These include the creation of a positive workplace culture, promoting the active involvement of trainees in quality improvement discussions, with clear mechanisms for trainees to raise concerns.
MeSH term(s)	Female ; Humans ; Internship and Residency/statistics & numerical data ; Male ; Patient Safety/statistics & numerical data ; Practice Patterns, Physicians'/statistics & numerical data ; Quality of Health Care/statistics & numerical data ; Surgeons ; Surveys and Questionnaires ; Whistleblowing/psychology ; Workplace
Language	English
Publishing date	2018-02-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2018.02.002
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