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Article ; Online: 'I don't belong anywhere': Identity and professional development in SAS doctors.

Page, Michael / Jackson, Dawn / Carty, Elizabeth

2024 Volume 24, Issue 1, Page(s) 100003

Abstract: Specialist, associate specialist and specialty (SAS) doctors constitute a marginalised professional group who can struggle to achieve the professional development they desire. Our primary objective was to understand, from a theoretically informed ... ...

Abstract	Specialist, associate specialist and specialty (SAS) doctors constitute a marginalised professional group who can struggle to achieve the professional development they desire. Our primary objective was to understand, from a theoretically informed perspective, the ways in which the professional identity of SAS doctors influences their professional development opportunities, including through appraisal. Ten UK SAS doctors participated in in-depth, narrative interviews. Participants were drawn from six medical specialities, and ranged in experience (2.5-15 years) and country of primary medical qualification. Interview transcripts were analysed via critical discourse analysis using Figured Worlds theory. The position of SAS doctors within the Figured World was at times unstable, ambiguous and context dependent. They were often relative outsiders, not immediately trusted by colleagues. Some found their development needs eclipsed by the priorities of colleagues, typically consultants and postgraduate trainees. Appraisal was often not perceived to have successfully addressed these issues. This study enhances our understanding of the lived experience of SAS doctors, which is often in stark contrast to formal policy on the range of roles that they can fulfil. The struggles and successes of SAS doctors described here suggest that there is scope to improve the professional status and professional development opportunities for SAS doctors, including through appraisal.
MeSH term(s)	Humans ; Consultants ; Medicine ; Trust
Language	English
Publishing date	2024-01-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2048646-7
ISSN	1473-4893 ; 1470-2118
ISSN (online)	1473-4893
ISSN	1470-2118
DOI	10.1016/j.clinme.2023.100003
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Article ; Online: Benchmarking Thermodynamic Models for Optimization of PSA Oxygen Generators

Michael L. Carty / Stephane Bilodeau

J, Vol 6, Iss 23, Pp 318-

2023 Volume 341

Abstract: In this review, the authors conducted benchmarks for three thermodynamic models to analyze PSA-based medical oxygen concentrator (MOC) systems to allow for optimization and operational flexibility. PSA oxygen generator plants are good medical-grade ... ...

Abstract	In this review, the authors conducted benchmarks for three thermodynamic models to analyze PSA-based medical oxygen concentrator (MOC) systems to allow for optimization and operational flexibility. PSA oxygen generator plants are good medical-grade oxygen sources, a crucial tool in healthcare from the primary to the tertiary level. However, they must be designed accordingly and properly operated, considering key design goals such as improving adsorbent productivity, improving oxygen recovery, and innovating to reduce unit size and weight. The importance of mapping the performance of various design and operating requirements or designs themselves on outlet product specifications and production effectiveness is outlined. Emphasizing optimal PSA design and operation, the authors suggest considering simulation-based optimization frameworks or high-fidelity modeling for the optimal layout and operation conditions of adsorption-based MOC systems. Notwithstanding, a simplified first-principles-based model with additional assumptions and simplifications generates a large volume of scenarios faster. Therefore, it represents a good approach for a feasibility study dealing with many options and designs or even the real-time monitoring of PSA operating conditions. All this paved the way for efficient translation into machine learning models and even deep learning networks that might be better suited to simulate the complex PSA process. The conclusion outlines that PSA-based plants can be flexible and effective units using any of the three models when properly optimized.
Keywords	oxygen generator ; pressure swing adsorption ; medical oxygen ; COVID-19 ; PSA ; thermodynamic ; Science ; Q
Subject code	670 ; 660
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The 2023 CMBE Young Innovators: ChatGPT Gets the Final Word.

Clyne, Alisa Morss / McCarty, Owen J T / King, Michael R

Cellular and molecular bioengineering

2023 Volume 16, Issue 5-6, Page(s) 427–429

Language	English
Publishing date	2023-10-30
Publishing country	United States
Document type	Editorial
ZDB-ID	2416037-4
ISSN	1865-5033 ; 1865-5025
ISSN (online)	1865-5033
ISSN	1865-5025
DOI	10.1007/s12195-023-00788-6
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Article: The 2023 Young Innovators of Cellular and Molecular Bioengineering.

King, Michael R / McCarty, Owen J T / Clyne, Alisa Morss

Cellular and molecular bioengineering

2023 Volume 16, Issue 4, Page(s) 241–242

Language	English
Publishing date	2023-09-22
Publishing country	United States
Document type	Editorial
ZDB-ID	2416037-4
ISSN	1865-5033 ; 1865-5025
ISSN (online)	1865-5033
ISSN	1865-5025
DOI	10.1007/s12195-023-00785-9
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Article ; Online: 'I brought that up in my appraisal ... and my consultant said no.' Structure and agency in specialty and associate specialist (SAS) doctors' experiences of appraisal.

Carty, Elizabeth / Page, Michael

Clinical medicine (London, England)

2021 Volume 21, Issue 3, Page(s) e252–e256

Abstract: Background: Specialty and associate specialist (SAS) doctors comprise a significant proportion of the UK medical workforce.Appraisal has the potential to support professional development, as well as being vital for revalidating a doctor's licence to ... ...

Abstract	Background: Specialty and associate specialist (SAS) doctors comprise a significant proportion of the UK medical workforce.Appraisal has the potential to support professional development, as well as being vital for revalidating a doctor's licence to practise.Early research indicated that SAS doctors experienced difficulties engaging with appraisal. It is not clear if the situation has improved over recent years, and SAS doctors' voices are largely absent from the literature. Research question: What are SAS doctors' understanding and experiences of appraisal and how do they make sense of them? Findings: Our qualitative, phenomenological case study identified four interrelated themes: development, compliance, recognition and wellbeing. The lived experiences of SAS doctors included compliance with organisational processes (including redundant processes) and structures that diminish agency (including unhelpful hierarchies). Positive experiences included support for development and recognition of unacknowledged work. Implication for practice: Our research reveals the importance of enhancing the professional status and agency of SAS doctors. There should be structured support and career guidance for new SAS doctors or those changing specialty and an expectation of support for professional exams. SAS doctors may benefit from explicit discussions around wellbeing. Some of these needs may be better addressed by having SAS doctors as appraisers, but this is likely to be insufficient in itself.
MeSH term(s)	Attitude of Health Personnel ; Consultants ; Humans ; Medicine ; Physicians ; Qualitative Research ; Specialization
Language	English
Publishing date	2021-05-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2048646-7
ISSN	1473-4893 ; 1470-2118
ISSN (online)	1473-4893
ISSN	1470-2118
DOI	10.7861/clinmed.2020-0976
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Article: DNA Damage Tolerance Pathways in Human Cells: A Potential Therapeutic Target.

Ler, Ashlynn Ai Li / Carty, Michael P

Frontiers in oncology

2022 Volume 11, Page(s) 822500

Abstract: DNA lesions arising from both exogenous and endogenous sources occur frequently in DNA. During DNA replication, the presence of unrepaired DNA damage in the template can arrest replication fork progression, leading to fork collapse, double-strand break ... ...

Abstract	DNA lesions arising from both exogenous and endogenous sources occur frequently in DNA. During DNA replication, the presence of unrepaired DNA damage in the template can arrest replication fork progression, leading to fork collapse, double-strand break formation, and to genome instability. To facilitate completion of replication and prevent the generation of strand breaks, DNA damage tolerance (DDT) pathways play a key role in allowing replication to proceed in the presence of lesions in the template. The two main DDT pathways are translesion synthesis (TLS), which involves the recruitment of specialized TLS polymerases to the site of replication arrest to bypass lesions, and homology-directed damage tolerance, which includes the template switching and fork reversal pathways. With some exceptions, lesion bypass by TLS polymerases is a source of mutagenesis, potentially contributing to the development of cancer. The capacity of TLS polymerases to bypass replication-blocking lesions induced by anti-cancer drugs such as cisplatin can also contribute to tumor chemoresistance. On the other hand, during homology-directed DDT the nascent sister strand is transiently utilised as a template for replication, allowing for error-free lesion bypass. Given the role of DNA damage tolerance pathways in replication, mutagenesis and chemoresistance, a more complete understanding of these pathways can provide avenues for therapeutic exploitation. A number of small molecule inhibitors of TLS polymerase activity have been identified that show synergy with conventional chemotherapeutic agents in killing cancer cells. In this review, we will summarize the major DDT pathways, explore the relationship between damage tolerance and carcinogenesis, and discuss the potential of targeting TLS polymerases as a therapeutic approach.
Language	English
Publishing date	2022-02-07
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2021.822500
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Article ; Online: Heterocyclic Iminoquinones and Quinones from the National Cancer Institute (NCI, USA) COMPARE Analysis.

Haji, Naemah / Faizi, Masoma / Koutentis, Panayiotis A / Carty, Michael P / Aldabbagh, Fawaz

Molecules (Basel, Switzerland)

2023 Volume 28, Issue 13

Abstract: This review uses the National Cancer Institute (NCI) COMPARE program to establish an extensive list of heterocyclic iminoquinones and quinones with similarities in differential growth inhibition patterns across the 60-cell line panel of the NCI ... ...

Abstract	This review uses the National Cancer Institute (NCI) COMPARE program to establish an extensive list of heterocyclic iminoquinones and quinones with similarities in differential growth inhibition patterns across the 60-cell line panel of the NCI Developmental Therapeutics Program (DTP). Many natural products and synthetic analogues are revealed as potential NAD(P)H:quinone oxidoreductase 1 (NQO1) substrates, through correlations to dipyridoimidazo[5,4-
MeSH term(s)	United States ; National Cancer Institute (U.S.) ; Quinones/chemistry ; Indolequinones ; Oxidoreductases ; NAD(P)H Dehydrogenase (Quinone)/metabolism ; Antineoplastic Agents/pharmacology ; Antineoplastic Agents/chemistry ; Neoplasms
Chemical Substances	iminoquinone ; quinone (3T006GV98U) ; Quinones ; Indolequinones ; Oxidoreductases (EC 1.-) ; NAD(P)H Dehydrogenase (Quinone) (EC 1.6.5.2) ; Antineoplastic Agents
Language	English
Publishing date	2023-07-04
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	1413402-0
ISSN	1420-3049 ; 1431-5165 ; 1420-3049
ISSN (online)	1420-3049
ISSN	1431-5165 ; 1420-3049
DOI	10.3390/molecules28135202
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Article ; Online: "It's Not Only the Injury but Also the Kind of Head." Factors Influencing Outcome After Traumatic Brain Injury.

Ponsford, Jennie L / Carty, Meagan / Olver, John / Ponsford, Michael / Acher, Rose / McKenzie, Dean / Downing, Marina G

Archives of physical medicine and rehabilitation

2024

Abstract: Objective: Given the high variability in traumatic brain injury (TBI) outcomes and relative lack of examination of the influence of noninjury factors on outcome, this study aimed to examine factors associated with functional outcome at 1 and 2 years ... ...

Abstract	Objective: Given the high variability in traumatic brain injury (TBI) outcomes and relative lack of examination of the influence of noninjury factors on outcome, this study aimed to examine factors associated with functional outcome at 1 and 2 years after moderate to severe TBI, including both preinjury and injury-related factors. Design: Observational cohort study. Setting: Inpatient hospital recruitment with outpatient follow-up at 1 and 2 years post injury. Participants: Individuals with moderate to severe TBI were recruited prospectively into a Longitudinal Head Injury Outcome Study. Of the eligible 3253 individuals who were eligible, 1899 participants consented to the study (N=1899). Main outcome measure: Functional outcome was measured using the Glasgow Outcome Scale-Extended (GOS-E). Results: 1476 participants (73.6% males) and 1365 participants (73% males) completed the GOS-E at 1 and 2 years post injury. They had a mean age at injury of 40 years and mean duration of post-traumatic amnesia (PTA) of 26 days. Good recovery, representing return to previous activities on the GOS-E (score 7-8), was present in 31% of participants at 1 year post injury and 33.5% at 2 years post injury. When predictor variables were entered into regression together, good outcome was significantly associated with not being from a culturally and linguistically diverse background and not having preinjury mental health or alcohol treatment, shorter PTA duration, and absence of limb injuries at both 1 and 2 years; higher education was also a significant predictor at 1 year post injury. Conclusions: Alongside consideration of injury severity, consideration of preinjury factors is important to inform prognostication and rehabilitation planning.
Language	English
Publishing date	2024-03-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2024.03.003
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Article ; Online: The impact of age on outcome 2 years after traumatic brain injury: Case control study.

Downing, Marina G / Carty, Meagan / Olver, John / Ponsford, Michael / Acher, Rose / Mckenzie, Dean / Ponsford, Jennie L

Annals of physical and rehabilitation medicine

2024 Volume 67, Issue 5, Page(s) 101834

Abstract: Background: Age is associated with outcome after traumatic brain injury (TBI). However, there are mixed findings across outcome domains and most studies lack controls.: Objectives: This cross-sectional study examined the association between age group ...

Abstract	Background: Age is associated with outcome after traumatic brain injury (TBI). However, there are mixed findings across outcome domains and most studies lack controls. Objectives: This cross-sectional study examined the association between age group (15-24 years, 25-34 years, 35-44 years, 45-54 years, 55-64 years, and 65 years or more) and outcomes 2 years after TBI in independence in daily activities, driving, public transportation use, employment, leisure activities, social integration, relationships and emotional functioning, relative to healthy controls. It was hypothesized that older individuals with TBI would have significantly poorer outcomes than controls in all domains except anxiety and depression, for which it was expected they would show better outcomes. Global functional outcome (measured using the Glasgow Outcome Scale-Extended) was also examined, and we hypothesized that older adults would have poorer outcomes than younger adults. Methods: Participants were 1897 individuals with TBI (mean, SD age 36.7, 17.7 years) who completed measures 2 years post-injury and 110 healthy controls (age 38.3, 17.5 years). Results: Compared to controls, individuals with TBI were less independent in most activities of daily living, participated less in leisure activities and employment, and were more socially isolated, anxious and depressed (p < 0.001). Those who were older in age were disproportionately less likely to be independent in light domestic activities, shopping and driving; and participated less in occupational activities relative to controls. Functional outcome was significantly higher in the youngest age group than in all older age groups (p < 0.001), but the younger groups were more likely to report being socially isolated (p < 0.001), depressed (p = 0.005) and anxious (p = 0.02), and less likely to be married or in a relationship (p < 0.001). Conclusion: A greater focus is needed on addressing psychosocial issues in younger individuals with TBI, whereas those who are older may require more intensive therapy to maximise independence in activities of daily living and return to employment.
Language	English
Publishing date	2024-03-21
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2480363-7
ISSN	1877-0665 ; 1877-0657
ISSN (online)	1877-0665
ISSN	1877-0657
DOI	10.1016/j.rehab.2024.101834
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Article ; Online: Infant massage as a stress management technique for parents of hospitalized extremely preterm infants.

McCarty, Dana / Silver, Rachel / Quinn, Lauren / Dusing, Stacey / O'Shea, Thomas Michael

Infant mental health journal

2023 Volume 45, Issue 1, Page(s) 11–21

Abstract: Mothers of infants born extremely preterm requiring prolonged medical intervention in the Neonatal Intensive Care Unit (NICU) are at high risk of developing stress. Parent-administered infant massage is a well-established, safe intervention for preterm ... ...

Abstract	Mothers of infants born extremely preterm requiring prolonged medical intervention in the Neonatal Intensive Care Unit (NICU) are at high risk of developing stress. Parent-administered infant massage is a well-established, safe intervention for preterm infants with many developmental benefits, but the published literature has mostly examined its impact on infants and parents through self-reported or observational measures of stress. The aim of this study was to measure salivary cortisol, a biomarker for stress, in extremely preterm infants and their mothers immediately pre and post parent-administered infant massage in order to detect potential changes in physiologic stress. Twenty-two mother-infant dyads completed massage education with a physical or occupational therapist. All dyads provided salivary cortisol samples via buccal swab immediately pre- and post-massage at the second session. Of mothers determined to be "cortisol responders" (15/22), salivary cortisol levels were lower after massage (pre-minus post-level: -26.47 ng/dL, [CI = -4.40, -48.53], p = .016, paired t-test). Our primary findings include a clinically significant decrease (as measured by percent change) in maternal cortisol levels immediately post parent-administered massage, indicating decreased physiological stress. Integration of infant massage into NICU clinical practice may support maternal mental health, but further powered studies are necessary to confirm findings.
MeSH term(s)	Infant ; Female ; Infant, Newborn ; Humans ; Infant, Extremely Premature ; Hydrocortisone ; Parents/psychology ; Mothers/psychology ; Intensive Care Units, Neonatal ; Massage/methods
Chemical Substances	Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2023-12-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	225602-2
ISSN	1097-0355 ; 0163-9641
ISSN (online)	1097-0355
ISSN	0163-9641
DOI	10.1002/imhj.22095
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