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Article ; Online: A Multi-Site, Multi-Wavelength PPG Platform for Continuous Non-Invasive Health Monitoring in Hospital Settings.

Karolcik, Stefan / Ming, Damien K / Yacoub, Sophie / Holmes, Alison H / Georgiou, Pantelis

IEEE transactions on biomedical circuits and systems

2023 Volume 17, Issue 2, Page(s) 349–361

Abstract: This article presents a novel PPG acquisition platform capable of synchronous multi-wavelength signal acquisition from two measurement locations with up to 4 independent wavelengths from each in parallel. The platform is fully configurable and operates ... ...

Abstract	This article presents a novel PPG acquisition platform capable of synchronous multi-wavelength signal acquisition from two measurement locations with up to 4 independent wavelengths from each in parallel. The platform is fully configurable and operates at 1ksps, accommodating a wide variety of transmitters and detectors to serve as both a research tool for experimentation and a clinical tool for disease monitoring. The sensing probes presented in this work acquire 4 PPG channels from the wrist and 4 PPG channels from the fingertip, with wavelengths such that surrogates for pulse wave velocity and haematocrit can be extracted. For conventional PPG sensing, we have achieved the mean error of 4.08 ± 3.72 bpm for heart-rate and a mean error of 1.54 ± 1.04% for SpO
MeSH term(s)	Male ; Humans ; Female ; Pulse Wave Analysis ; Photoplethysmography ; Oximetry ; Oxygen ; Fingers ; Heart Rate
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2023-05-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1940-9990
ISSN (online)	1940-9990
DOI	10.1109/TBCAS.2023.3254453
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Cryptococcal meningitis.

Ming, Damien K / Harrison, Thomas S

British journal of hospital medicine (London, England : 2005)

2017 Volume 78, Issue 8, Page(s) C125–C127

MeSH term(s)	Amphotericin B/administration & dosage ; Antifungal Agents/administration & dosage ; Brain/diagnostic imaging ; Cryptococcus gattii/isolation & purification ; Cryptococcus neoformans/isolation & purification ; Deoxycholic Acid/administration & dosage ; Diagnosis, Differential ; Drug Combinations ; Early Diagnosis ; Fluconazole/administration & dosage ; HIV Infections/complications ; HIV Infections/diagnosis ; Humans ; Immunocompromised Host ; Meningitis, Cryptococcal/diagnosis ; Meningitis, Cryptococcal/etiology ; Meningitis, Cryptococcal/physiopathology ; Meningitis, Cryptococcal/therapy ; Patient Care Management/methods
Chemical Substances	Antifungal Agents ; Drug Combinations ; Deoxycholic Acid (005990WHZZ) ; Amphotericin B (7XU7A7DROE) ; amphotericin B, deoxycholate drug combination (87687-70-5) ; Fluconazole (8VZV102JFY)
Language	English
Publishing date	2017-08-03
Publishing country	England
Document type	Journal Article
ISSN	1750-8460
ISSN	1750-8460
DOI	10.12968/hmed.2017.78.8.C125
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Article ; Online: Continuous Measurement of Lactate Concentration in Human Subjects through Direct Electron Transfer from Enzymes to Microneedle Electrodes.

Freeman, David M E / Ming, Damien K / Wilson, Richard / Herzog, Peter L / Schulz, Christopher / Felice, Alfons K G / Chen, Yu-Chih / O'Hare, Danny / Holmes, Alison H / Cass, Anthony E G

ACS sensors

2023 Volume 8, Issue 4, Page(s) 1639–1647

Abstract: Microneedle lactate sensors may be used to continuously measure lactate concentration in the interstitial fluid in a minimally invasive and pain-free manner. First- and second-generation enzymatic sensors produce a redox-active product that is ... ...

Abstract	Microneedle lactate sensors may be used to continuously measure lactate concentration in the interstitial fluid in a minimally invasive and pain-free manner. First- and second-generation enzymatic sensors produce a redox-active product that is electrochemically sensed at the electrode surface. Direct electron transfer enzymes produce electrons directly as the product of enzymatic action; in this study, a direct electron transfer enzyme specific to lactate has been immobilized onto a microneedle surface to create lactate-sensing devices that function at low applied voltages (0.2 V). These devices have been validated in a small study of human volunteers; lactate concentrations were raised and lowered through physical exercise and subsequent rest. Lactazyme microneedle devices show good agreement with concurrently obtained and analyzed serum lactate levels.
MeSH term(s)	Humans ; Lactic Acid ; Electrons ; Electrodes ; Electron Transport ; Research Subjects
Chemical Substances	Lactic Acid (33X04XA5AT)
Language	English
Publishing date	2023-03-26
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2379-3694
ISSN (online)	2379-3694
DOI	10.1021/acssensors.2c02780
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Article: Multidrug-resistant bacteria.

Sowole, Luciana / Ming, Damien K / Davies, Frances

British journal of hospital medicine (London, England : 2005)

2018 Volume 79, Issue 5, Page(s) C66–C69

MeSH term(s)	Animals ; Anti-Bacterial Agents/classification ; Anti-Bacterial Agents/therapeutic use ; Bacteria/classification ; Bacteria/drug effects ; Drug Resistance, Multiple, Bacterial ; Global Health ; Humans ; Infection/drug therapy ; Infection/microbiology ; Infection Control/methods ; Infection Control/organization & administration ; Practice Patterns, Physicians'/standards ; Preventive Health Services/methods ; Preventive Health Services/organization & administration ; Quality Improvement/organization & administration
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2018-05-04
Publishing country	England
Document type	Journal Article
ISSN	1750-8460
ISSN	1750-8460
DOI	10.12968/hmed.2018.79.5.C66
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Article ; Online: Correction to: Informing antimicrobial management in the context of COVID-19: understanding the longitudinal dynamics of C-reactive protein and procalcitonin.

Ming, Damien K / Myall, Ashleigh C / Hernandez, Bernard / Weiße, Andrea Y / Peach, Robert L / Barahona, Mauricio / Rawson, Timothy M / Holmes, Alison H

BMC infectious diseases

2021 Volume 21, Issue 1, Page(s) 988

Language	English
Publishing date	2021-09-21
Publishing country	England
Document type	Published Erratum
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-021-06696-2
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Article ; Online: Treatment and long term safety outcomes of Peptide Receptor Radionuclide Therapy for metastatic neuroendocrine tumours: an Asian experience.

Tham, Wei Ying / Huang, Hian Liang / Tai, David Wai Meng / Allen, John C / Hwang, Jacqueline S G / Loh, Lih Ming / Goh, Brian K P / Ong, Simon Y K / Kek, Peng Chin / Tan, Damien M Y / Ng, David C E / Loke, Kelvin S H

Neuroendocrinology

2024

Abstract: Peptide-receptor radionuclide therapy (PRRT) is a targeted molecular therapy used to treat neuroendocrine tumours (NET). It has been shown to be effective and well-tolerated in patients with metastatic neuroendocrine tumours in several centres in United ... ...

Abstract	Peptide-receptor radionuclide therapy (PRRT) is a targeted molecular therapy used to treat neuroendocrine tumours (NET). It has been shown to be effective and well-tolerated in patients with metastatic neuroendocrine tumours in several centres in United States (US), Europe and Australia. Tolerability and efficacy data emerging from Asian centres remain few. Epidemiological evidence suggests that there are differences in neuroendocrine neoplasms between the population groups. We aim to describe the treatment and safety outcomes of PRRT in the Asian population. Methods One hundred and seven (107) patients with metastatic neuroendocrine tumour who had undergone PRRT treatment from January 2012 to March 2019 were included in this retrospective study. The response rates using RECIST1.1 and qualitative analysis were examined. The overall and progression free survival curves were also evaluated. Results The median progression free survival was 49 months. Response assessment after completion of treatment showed that 33(37.9%) of 87 patients had partial or complete response. Subgroup analysis comparing high- and low-grade NET showed that there was a significant difference in the time to progression curves. Comparison of the number of cycles and progression free and overall survival also showed a significant difference. Ten patients (9%) had grade 3 or more haematological toxicities. Four patients (4%) had grade 3/4 hepatobiliary toxicities, although the presence of extensive liver metastases was a confounding factor. None of the patients had grade 3/4 acute kidney injury. Conclusion Our results show that PRRT is safe and effective in the treatment of metastatic neuroendocrine tumour in the Asian population. There was a significant difference in the progression free survival curves between low-grade and high-grade NET, and in the progression free and overall survival comparing the number of cycles received.
Language	English
Publishing date	2024-03-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	123303-8
ISSN	1423-0194 ; 0028-3835
ISSN (online)	1423-0194
ISSN	0028-3835
DOI	10.1159/000538523
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Article ; Online: Informing antimicrobial management in the context of COVID-19: understanding the longitudinal dynamics of C-reactive protein and procalcitonin.

Ming, Damien K / Myall, Ashleigh C / Hernandez, Bernard / Weiße, Andrea Y / Peach, Robert L / Barahona, Mauricio / Rawson, Timothy M / Holmes, Alison H

BMC infectious diseases

2021 Volume 21, Issue 1, Page(s) 932

Abstract: Background: To characterise the longitudinal dynamics of C-reactive protein (CRP) and Procalcitonin (PCT) in a cohort of hospitalised patients with COVID-19 and support antimicrobial decision-making.: Methods: Longitudinal CRP and PCT concentrations ... ...

Abstract	Background: To characterise the longitudinal dynamics of C-reactive protein (CRP) and Procalcitonin (PCT) in a cohort of hospitalised patients with COVID-19 and support antimicrobial decision-making. Methods: Longitudinal CRP and PCT concentrations and trajectories of 237 hospitalised patients with COVID-19 were modelled. The dataset comprised of 2,021 data points for CRP and 284 points for PCT. Pairwise comparisons were performed between: (i) those with or without significant bacterial growth from cultures, and (ii) those who survived or died in hospital. Results: CRP concentrations were higher over time in COVID-19 patients with positive microbiology (day 9: 236 vs 123 mg/L, p < 0.0001) and in those who died (day 8: 226 vs 152 mg/L, p < 0.0001) but only after day 7 of COVID-related symptom onset. Failure for CRP to reduce in the first week of hospital admission was associated with significantly higher odds of death. PCT concentrations were higher in patients with COVID-19 and positive microbiology or in those who died, although these differences were not statistically significant. Conclusions: Both the absolute CRP concentration and the trajectory during the first week of hospital admission are important factors predicting microbiology culture positivity and outcome in patients hospitalised with COVID-19. Further work is needed to describe the role of PCT for co-infection. Understanding relationships of these biomarkers can support development of risk models and inform optimal antimicrobial strategies.
MeSH term(s)	Anti-Bacterial Agents ; C-Reactive Protein ; COVID-19 ; Humans ; Procalcitonin ; SARS-CoV-2
Chemical Substances	Anti-Bacterial Agents ; Procalcitonin ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2021-09-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-021-06621-7
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Article ; Online: Mapping patient pathways and understanding clinical decision-making in dengue management to inform the development of digital health tools.

Nguyen, Quang Huy / Ming, Damien K / Luu, An Phuoc / Chanh, Ho Quang / Tam, Dong Thi Hoai / Truong, Nguyen Thanh / Huy, Vo Xuan / Hernandez, Bernard / Van Nuil, Jennifer Ilo / Paton, Chris / Georgiou, Pantelis / Nguyen, Nguyet Minh / Holmes, Alison / Tho, Phan Vinh / Yacoub, Sophie

BMC medical informatics and decision making

2023 Volume 23, Issue 1, Page(s) 24

Abstract: Background: Dengue is a common viral illness and severe disease results in life-threatening complications. Healthcare services in low- and middle-income countries treat the majority of dengue cases worldwide. However, the clinical decision-making ... ...

Abstract	Background: Dengue is a common viral illness and severe disease results in life-threatening complications. Healthcare services in low- and middle-income countries treat the majority of dengue cases worldwide. However, the clinical decision-making processes which result in effective treatment are poorly characterised within this setting. In order to improve clinical care through interventions relating to digital clinical decision-support systems (CDSS), we set out to establish a framework for clinical decision-making in dengue management to inform implementation. Methods: We utilised process mapping and task analysis methods to characterise existing dengue management at the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. This is a tertiary referral hospital which manages approximately 30,000 patients with dengue each year, accepting referrals from Ho Chi Minh city and the surrounding catchment area. Initial findings were expanded through semi-structured interviews with clinicians in order to understand clinical reasoning and cognitive factors in detail. A grounded theory was used for coding and emergent themes were developed through iterative discussions with clinician-researchers. Results: Key clinical decision-making points were identified: (i) at the initial patient evaluation for dengue diagnosis to decide on hospital admission and the provision of fluid/blood product therapy, (ii) in those patients who develop severe disease or other complications, (iii) at the point of recurrent shock in balancing the need for fluid therapy with complications of volume overload. From interviews the following themes were identified: prioritising clinical diagnosis and evaluation over existing diagnostics, the role of dengue guidelines published by the Ministry of Health, the impact of seasonality and caseload on decision-making strategies, and the potential role of digital decision-support and disease scoring tools. Conclusions: The study highlights the contemporary priorities in delivering clinical care to patients with dengue in an endemic setting. Key decision-making processes and the sources of information that were of the greatest utility were identified. These findings serve as a foundation for future clinical interventions and improvements in healthcare. Understanding the decision-making process in greater detail also allows for development and implementation of CDSS which are suited to the local context.
MeSH term(s)	Humans ; Clinical Decision-Making ; Dengue/diagnosis ; Dengue/therapy ; Decision Support Systems, Clinical ; Risk Factors ; Referral and Consultation
Language	English
Publishing date	2023-02-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2046490-3
ISSN	1472-6947 ; 1472-6947
ISSN (online)	1472-6947
ISSN	1472-6947
DOI	10.1186/s12911-023-02116-4
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Article ; Online: The Diagnosis of Dengue in Patients Presenting With Acute Febrile Illness Using Supervised Machine Learning and Impact of Seasonality

Damien K. Ming / Nguyen M. Tuan / Bernard Hernandez / Sorawat Sangkaew / Nguyen L. Vuong / Ho Q. Chanh / Nguyen V. V. Chau / Cameron P. Simmons / Bridget Wills / Pantelis Georgiou / Alison H. Holmes / Sophie Yacoub

Frontiers in Digital Health, Vol

2022 Volume 4

Abstract: BackgroundSymptomatic dengue infection can result in a life-threatening shock syndrome and timely diagnosis is essential. Point-of-care tests for non-structural protein 1 and IgM are used widely but performance can be limited. We developed a supervised ... ...

Abstract	BackgroundSymptomatic dengue infection can result in a life-threatening shock syndrome and timely diagnosis is essential. Point-of-care tests for non-structural protein 1 and IgM are used widely but performance can be limited. We developed a supervised machine learning model to predict whether patients with acute febrile illnesses had a diagnosis of dengue or other febrile illnesses (OFI). The impact of seasonality on model performance over time was examined.MethodsWe analysed data from a prospective observational clinical study in Vietnam. Enrolled patients presented with an acute febrile illness of <72 h duration. A gradient boosting model (XGBoost) was used to predict final diagnosis using age, sex, haematocrit, platelet, white cell, and lymphocyte count collected on enrolment. Data was randomly split 80/20% into a training and hold-out set, respectively, with the latter not used in model development. Cross-validation and hold out set testing was used, with performance over time evaluated through a rolling window approach.ResultsWe included 8,100 patients recruited between 16th October 2010 and 10th December 2014. In total 2,240 (27.7%) patients were diagnosed with dengue infection. The optimised model from training data had an overall median area under the receiver operator curve (AUROC) of 0.86 (interquartile range 0.84–0.86), specificity of 0.92, sensitivity of 0.56, positive predictive value of 0.73, negative predictive value (NPV) of 0.84, and Brier score of 0.13 in predicting the final diagnosis, with similar performances in hold-out set testing (AUROC of 0.86). Model performances varied significantly over time as a function of seasonality and other factors. Incorporation of a dynamic threshold which continuously learns from recent cases resulted in a more consistent performance throughout the year (NPV >90%).ConclusionSupervised machine learning models are able to discriminate between dengue and OFI diagnoses in patients presenting with an early undifferentiated febrile illness. These models ...
Keywords	dengue ; supervised machine learning ; diagnosis ; seasonality ; climate change ; Medicine ; R ; Public aspects of medicine ; RA1-1270 ; Electronic computers. Computer science ; QA75.5-76.95
Subject code	610 ; 006
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Continuous physiological monitoring using wearable technology to inform individual management of infectious diseases, public health and outbreak responses

Damien K. Ming / Sorawat Sangkaew / Ho Q. Chanh / Phung T.H. Nhat / Sophie Yacoub / Pantelis Georgiou / Alison H. Holmes

International Journal of Infectious Diseases, Vol 96, Iss , Pp 648-

2020 Volume 654

Abstract: Optimal management of infectious diseases is guided by up-to-date information at the individual and public health levels. For infections of global importance, including emerging pandemics such as COVID-19 or prevalent endemic diseases such as dengue, ... ...

Abstract	Optimal management of infectious diseases is guided by up-to-date information at the individual and public health levels. For infections of global importance, including emerging pandemics such as COVID-19 or prevalent endemic diseases such as dengue, identifying patients at risk of severe disease and clinical deterioration can be challenging, considering that the majority present with a mild illness. In our article, we describe the use of wearable technology for continuous physiological monitoring in healthcare settings. Deployment of wearables in hospital settings for the management of infectious diseases, or in the community to support syndromic surveillance during outbreaks, could provide significant, cost-effective advantages and improve healthcare delivery. We highlight a range of promising technologies employed by wearable devices and discuss the technical and ethical issues relating to implementation in the clinic, focusing on low- and middle- income countries. Finally, we propose a set of essential criteria for the rollout of wearable technology for clinical use.
Keywords	Infectious and parasitic diseases ; RC109-216 ; covid19
Subject code	610
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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