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Article ; Online: Informed non-dissent for brain death testing in children: ethical and legal perspectives.

Wilkinson, Dominic / Miller, Christopher / Turner, Stephen W

2024 Volume 109, Issue 5, Page(s) 359–360

MeSH term(s)	Child ; Humans ; Brain Death/diagnosis ; Withholding Treatment ; Informed Consent
Language	English
Publishing date	2024-04-18
Publishing country	England
Document type	Editorial
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2023-325635
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Article ; Online: Racial disparities in

Warren, Bobby G / Burch, Christopher D / Barrett, Aaron / Graves, Amanda / Gettler, Erin / Turner, Nicholas A / Moehring, Rebekah W / Anderson, Deverick J

Infection control and hospital epidemiology

2023 Volume 45, Issue 4, Page(s) 429–433

Abstract: Objective: To analyze : Methods: We completed a retrospective analysis of inpatient : Results: In total, 35,160 : Conclusion: White patients received ... ...

Abstract	Objective: To analyze Methods: We completed a retrospective analysis of inpatient Results: In total, 35,160 Conclusion: White patients received more
MeSH term(s)	Humans ; Clostridioides difficile ; Retrospective Studies ; Hospitals ; Comorbidity ; White
Language	English
Publishing date	2023-11-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.244
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Article ; Online: Surface Landmarks in the Lateral Decubitus Position Are Unreliable for Thoracic Epidural Catheter Placement: A Case Series.

Dobson, Sean W / Weller, Robert S / Turner, James D / Lack, Christopher M / Henshaw, Daryl S

A&A practice

2022 Volume 16, Issue 12, Page(s) e01649

Abstract: Thoracic epidurals remain the optimal method for providing postoperative analgesia after complex open abdominal and thoracic surgeries. However, they can be challenging to both place and maintain, as evidenced by a failure rate that exceeds 30%.1 Proper ... ...

Abstract	Thoracic epidurals remain the optimal method for providing postoperative analgesia after complex open abdominal and thoracic surgeries. However, they can be challenging to both place and maintain, as evidenced by a failure rate that exceeds 30%.1 Proper identification of the epidural space and accurate placement of the catheter are critical in order to deliver effective postoperative analgesia and avoid failure.2,3 This case series investigated the difficulty in correctly identifying the proper vertebral level for thoracic epidural catheter procedures when performed in the lateral decubitus position.
MeSH term(s)	Humans ; Analgesia, Epidural/methods ; Anesthesia, Epidural/methods ; Epidural Space ; Catheters ; Thoracic Surgical Procedures
Language	English
Publishing date	2022-12-21
Publishing country	United States
Document type	Journal Article
ISSN	2575-3126
ISSN (online)	2575-3126
DOI	10.1213/XAA.0000000000001649
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Article ; Online: Efficient inference and identifiability analysis for differential equation models with random parameters.

Browning, Alexander P / Drovandi, Christopher / Turner, Ian W / Jenner, Adrianne L / Simpson, Matthew J

PLoS computational biology

2022 Volume 18, Issue 11, Page(s) e1010734

Abstract: Heterogeneity is a dominant factor in the behaviour of many biological processes. Despite this, it is common for mathematical and statistical analyses to ignore biological heterogeneity as a source of variability in experimental data. Therefore, methods ... ...

Abstract	Heterogeneity is a dominant factor in the behaviour of many biological processes. Despite this, it is common for mathematical and statistical analyses to ignore biological heterogeneity as a source of variability in experimental data. Therefore, methods for exploring the identifiability of models that explicitly incorporate heterogeneity through variability in model parameters are relatively underdeveloped. We develop a new likelihood-based framework, based on moment matching, for inference and identifiability analysis of differential equation models that capture biological heterogeneity through parameters that vary according to probability distributions. As our novel method is based on an approximate likelihood function, it is highly flexible; we demonstrate identifiability analysis using both a frequentist approach based on profile likelihood, and a Bayesian approach based on Markov-chain Monte Carlo. Through three case studies, we demonstrate our method by providing a didactic guide to inference and identifiability analysis of hyperparameters that relate to the statistical moments of model parameters from independent observed data. Our approach has a computational cost comparable to analysis of models that neglect heterogeneity, a significant improvement over many existing alternatives. We demonstrate how analysis of random parameter models can aid better understanding of the sources of heterogeneity from biological data.
MeSH term(s)	Bayes Theorem ; Likelihood Functions ; Research Design
Language	English
Publishing date	2022-11-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2193340-6
ISSN	1553-7358 ; 1553-734X
ISSN (online)	1553-7358
ISSN	1553-734X
DOI	10.1371/journal.pcbi.1010734
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Article ; Online: Improved empiric antibiotic prescribing for acute cystitis with use of local urinary antibiogram and clinical decision support system.

Shoff, Christopher J / Townsend, Mary L / Tillekeratne, L Gayani / Schulteis, Ryan D / Yarrington, Michael E / Turner, Nicholas A / Woods, Christopher W / Hostler, Christopher J

Infection control and hospital epidemiology

2020 Volume 41, Issue 11, Page(s) 1351–1353

MeSH term(s)	Acute Disease ; Anti-Bacterial Agents/therapeutic use ; Cystitis/drug therapy ; Decision Support Systems, Clinical ; Drug Prescriptions ; Humans ; Microbial Sensitivity Tests
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2020-08-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2020.357
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Article ; Online: Optimizing reflex urine cultures: Using a population-specific approach to diagnostic stewardship.

Advani, Sonali D / Turner, Nicholas A / Schmader, Kenneth E / Wrenn, Rebekah H / Moehring, Rebekah W / Polage, Christopher R / Vaughn, Valerie M / Anderson, Deverick J

Infection control and hospital epidemiology

2023 Volume 44, Issue 2, Page(s) 206–209

Abstract: Background: Clinicians and laboratories routinely use urinalysis (UA) parameters to determine whether antimicrobial treatment and/or urine cultures are needed. Yet the performance of individual UA parameters and common thresholds for action are not well ...

Abstract	Background: Clinicians and laboratories routinely use urinalysis (UA) parameters to determine whether antimicrobial treatment and/or urine cultures are needed. Yet the performance of individual UA parameters and common thresholds for action are not well defined and may vary across different patient populations. Methods: In this retrospective cohort study, we included all encounters with UAs ordered 24 hours prior to a urine culture between 2015 and 2020 at 3 North Carolina hospitals. We evaluated the performance of relevant UA parameters as potential outcome predictors, including sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). We also combined 18 different UA criteria and used receiver operating curves to identify the 5 best-performing models for predicting significant bacteriuria (≥100,000 colony-forming units of bacteria/mL). Results: In 221,933 encounters during the 6-year study period, no single UA parameter had both high sensitivity and high specificity in predicting bacteriuria. Absence of leukocyte esterase and pyuria had a high NPV for significant bacteriuria. Combined UA parameters did not perform better than pyuria alone with regard to NPV. The high NPV ≥0.90 of pyuria was maintained among most patient subgroups except females aged ≥65 years and patients with indwelling catheters. Conclusion: When used as a part of a diagnostic workup, UA parameters should be leveraged for their NPV instead of sensitivity. Because many laboratories and hospitals use reflex urine culture algorithms, their workflow should include clinical decision support and or education to target symptomatic patients and focus on populations where absence of pyuria has high NPV.
MeSH term(s)	Female ; Humans ; Pyuria/diagnosis ; Bacteriuria/diagnosis ; Urinary Tract Infections/diagnosis ; Retrospective Studies ; Urinalysis ; Reflex ; Urine
Language	English
Publishing date	2023-01-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2022.315
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Article ; Online: Evaluating residual anti-Xa levels following discontinuation of treatment-dose enoxaparin in patients presenting for elective surgery: a prospective observational trial.

Henshaw, Daryl S / Edwards, Christopher J / Dobson, Sean W / Jaffe, Doug / Turner, James D / Reynolds, J Wells / Thompson, Garrett R / Russell, Greg / Weller, Robert

Regional anesthesia and pain medicine

2024 Volume 49, Issue 2, Page(s) 94–101

Abstract: Introduction: Prior studies have demonstrated that patients presenting for elective surgery may have higher-than-expected residual anti-Xa level activity at or beyond 24 hours following their last treatment dose of enoxaparin. Given that 24 hours of ... ...

Abstract	Introduction: Prior studies have demonstrated that patients presenting for elective surgery may have higher-than-expected residual anti-Xa level activity at or beyond 24 hours following their last treatment dose of enoxaparin. Given that 24 hours of abstinence is currently recommended by both European and American societies before the performance of neuraxial or deep anesthetic/analgesic procedures, determining the actual timeframe at which residual anti-Xa level activity reliably falls below 0.2 IU/mL, the lower limit of the target range for thromboprophylaxis, is critical. Methods: This was a prospective observational trial. Consenting patients on treatment-dose enoxaparin were randomized to either a 24-hour group (last dose at 07:00 the day prior to surgery) or a 36-hour group (last dose at 19:00 2 days prior to surgery). On arrival for surgery, blood samples were obtained to assess residual anti-Xa level activity and renal function. The primary outcome was residual anti-Xa level activity following the last treatment dose of enoxaparin. Incorporating all patients, linear regression modeling was performed to predict the timepoint at which the level of anti-Xa activity reliably fell below 0.2 IU/mL. Results: 103 patients were analyzed. Time from the last dose at which residual anti-Xa activity fell below 0.2 IU/mL, based on the upper bound of the 95% CI, was 31.5 hours. No correlation overall between age, renal function, or sex was found. Conclusion: Residual levels of anti-Xa activity do not reliably fall below 0.2 IU/mL 24 hours following discontinuation of treatment-dose enoxaparin. Therefore, current time-based guidelines are not conservative enough. Routine anti-Xa testing should be strongly considered, or current time-based guidelines should be reassessed. Trial registration number: NCT03296033.
MeSH term(s)	Humans ; Enoxaparin/adverse effects ; Anticoagulants/adverse effects ; Venous Thromboembolism/prevention & control ; Elective Surgical Procedures/adverse effects
Chemical Substances	Enoxaparin ; Anticoagulants
Language	English
Publishing date	2024-02-05
Publishing country	England
Document type	Randomized Controlled Trial ; Observational Study ; Journal Article
ZDB-ID	1425299-5
ISSN	1532-8651 ; 1098-7339 ; 0146-521X
ISSN (online)	1532-8651
ISSN	1098-7339 ; 0146-521X
DOI	10.1136/rapm-2023-104571
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Article ; Online: Evolutionary structure and timing of major habitat shifts in Crocodylomorpha.

Wilberg, Eric W / Turner, Alan H / Brochu, Christopher A

Scientific reports

2019 Volume 9, Issue 1, Page(s) 514

Abstract: Extant crocodylomorphs are semiaquatic ambush predators largely restricted to freshwater or estuarine environments, but the group is ancestrally terrestrial and inhabited a variety of ecosystems in the past. Despite its rich ecological history, little ... ...

Abstract	Extant crocodylomorphs are semiaquatic ambush predators largely restricted to freshwater or estuarine environments, but the group is ancestrally terrestrial and inhabited a variety of ecosystems in the past. Despite its rich ecological history, little effort has focused on elucidating the historical pattern of ecological transitions in the group. Traditional views suggested a single shift from terrestrial to aquatic in the Early Jurassic. However, new fossil discoveries and phylogenetic analyses tend to imply a multiple-shift model. Here we estimate ancestral habitats across a comprehensive phylogeny and show at least three independent shifts from terrestrial to aquatic and numerous other habitat transitions. Neosuchians first invade freshwater habitats in the Jurassic, with up to four subsequent shifts into the marine realm. Thalattosuchians first appear in marine habitats in the Early Jurassic. Freshwater semiaquatic mahajangasuchids are derived from otherwise terrestrial notosuchians. Within nearly all marine groups, some species return to freshwater environments. Only twice have crocodylomorphs reverted from aquatic to terrestrial habitats, both within the crown group. All living non-alligatorid crocodylians have a keratinised tongue with salt-excreting glands, but the lack of osteological correlates for these adaptations complicates pinpointing their evolutionary origin or loss. Based on the pattern of transitions to the marine realm, our analysis suggests at least four independent origins of saltwater tolerance in Crocodylomorpha.
MeSH term(s)	Alligators and Crocodiles/anatomy & histology ; Alligators and Crocodiles/genetics ; Alligators and Crocodiles/physiology ; Animals ; Biological Evolution ; Ecosystem ; Fossils/anatomy & histology ; Phylogeny
Language	English
Publishing date	2019-01-24
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-018-36795-1
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Article ; Online: Pre-exposure cognitive performance variability is associated with severity of respiratory infection.

Zhai, Yaya / Doraiswamy, P Murali / Woods, Christopher W / Turner, Ronald B / Burke, Thomas W / Ginsburg, Geoffrey S / Hero, Alfred O

Scientific reports

2022 Volume 12, Issue 1, Page(s) 22589

Abstract: Using data from a longitudinal viral challenge study, we find that the post-exposure viral shedding and symptom severity are associated with a novel measure of pre-exposure cognitive performance variability (CPV), defined before viral exposure occurs. ... ...

Abstract	Using data from a longitudinal viral challenge study, we find that the post-exposure viral shedding and symptom severity are associated with a novel measure of pre-exposure cognitive performance variability (CPV), defined before viral exposure occurs. Each individual's CPV score is computed from data collected from a repeated NeuroCognitive Performance Test (NCPT) over a 3 day pre-exposure period. Of the 18 NCPT measures reported by the tests, 6 contribute materially to the CPV score, prospectively differentiating the high from the low shedders. Among these 6 are the 4 clinical measures digSym-time, digSym-correct, trail-time, and reaction-time, commonly used for assessing cognitive executive functioning. CPV is found to be correlated with stress and also with several genes previously reported to be associated with cognitive development and dysfunction. A perturbation study over the number and timing of NCPT sessions indicates that as few as 5 sessions is sufficient to maintain high association between the CPV score and viral shedding, as long as the timing of these sessions is balanced over the three pre-exposure days. Our results suggest that variations in cognitive function are closely related to immunity and susceptibility to severe infection. Further studying these relationships may help us better understand the links between neurocognitive and neuroimmune systems which is timely in this COVID-19 pandemic era.
MeSH term(s)	Humans ; Pandemics ; COVID-19 ; Cognition ; Reaction Time ; Respiratory Tract Infections
Language	English
Publishing date	2022-12-30
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-26081-6
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Article ; Online: Nickel-catalyzed ester carbonylation promoted by imidazole-derived carbenes and salts.

Yoo, Changho / Bhattacharya, Shrabanti / See, Xin Yi / Cunningham, Drew W / Acosta-Calle, Sebastian / Perri, Steven T / West, Nathan M / Mason, Dawn C / Meade, Chris D / Osborne, Christopher W / Turner, Phillip W / Kilgore, Randall W / King, Jeff / Cowden, Jeffrey H / Grajeda, Javier M / Miller, Alexander J M

Science (New York, N.Y.)

2023 Volume 382, Issue 6672, Page(s) 815–820

Abstract: Millions of tons of acetyl derivatives such as acetic acid and acetic anhydride are produced each year. These building blocks of chemical industry are elaborated into esters, amides, and eventually polymer materials, pharmaceuticals, and other consumer ... ...

Abstract	Millions of tons of acetyl derivatives such as acetic acid and acetic anhydride are produced each year. These building blocks of chemical industry are elaborated into esters, amides, and eventually polymer materials, pharmaceuticals, and other consumer products. Most acetyls are produced industrially using homogeneous precious metal catalysts, principally rhodium and iridium complexes. We report here that abundant nickel can be paired with imidazole-derived carbenes or the corresponding salts to catalyze methyl ester carbonylation with turnover frequency (TOF) exceeding 150 hour
Language	English
Publishing date	2023-11-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	128410-1
ISSN	1095-9203 ; 0036-8075
ISSN (online)	1095-9203
ISSN	0036-8075
DOI	10.1126/science.ade3179
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