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Article ; Online: Breast Implant Surgery: An Overview of the Risks and Health Complications.

Prothe, Jessica / Rozovics, Paul / Sykes, Robyn / Taccona, Michael

2023 Volume 43, Issue 2, Page(s) 68–71

Abstract: We present an overview of the risks and health complications associated with breast implant surgery with a focus on breast implant illness (BII), breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), and breast implant-associated squamous ... ...

Abstract	We present an overview of the risks and health complications associated with breast implant surgery with a focus on breast implant illness (BII), breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), and breast implant-associated squamous cell carcinoma (BIA-SCC). BII is a constellation of systemic symptoms that can occur after breast implant devices are surgically implanted into the human body. BIA-ALCL is a T-cell lymphoma associated with the implantation of textured breast implant devices. BIA-SCC is a potentially aggressive epithelial-based tumor that can occur following implantation with smooth or textured breast implant devices. Nurses may lack awareness and knowledge regarding BII, BIA-ALCL, and BIA-SCC, and this can negatively affect patient safety. Therefore, it is essential that all nurses, especially members of the plastic and aesthetic nursing community, understand these disease processes. Currently, it is not standard practice to screen every patient for the presence of an implantable device at every health care encounter. However, by not doing so, health care professionals may miss the opportunity to identify illness, disease, or cancer that could be related to an implanted device; therefore, practice changes to increase patient safety are both necessary and warranted. To identify those individuals at greatest risk for implant-related illness, disease, or cancer, we propose implementing universal screening of all individuals for implantable devices. We define universal screening for implantable devices as assessing all patients for the presence or absence of an implantable device at every health care encounter. We recommend using the IOWA model to guide our proposed evidence-based practice update.
MeSH term(s)	Humans ; Female ; Breast Implants/adverse effects ; Breast Implantation/adverse effects ; Mastectomy/adverse effects ; Breast Neoplasms/epidemiology ; Lymphoma, Large-Cell, Anaplastic/epidemiology
Language	English
Publishing date	2023-04-01
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	3144666-8
ISSN	2770-3517
ISSN (online)	2770-3517
DOI	10.1097/PSN.0000000000000486
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Article ; Online: Increasing health care providers' knowledge of tracheostomy and laryngectomy.

Sykes, John J / Edwards, Kaitlyn / Danan, Deepa

Head & neck

2023 Volume 46, Issue 3, Page(s) 609–614

Abstract: ... improving to 83.8% post-lecture (p < 0.001). Nursing staff from the Otolaryngology ICU, and OR staff, had ... significant improvement in knowledge base (p < 0.001). Anesthesia providers showed improvement ... but the difference was not statistically significant (p = 0.052).: Conclusions: Didactic lectures are a simple and ...

Abstract	Background: The differences between tracheostomy and total laryngectomy are frequently misunderstood by healthcare professionals. Insufficient knowledge can potentially result in life-threatening consequences in the event of an emergent airway situation. Methods: A seven-question assessment of providers' anatomical knowledge and airway management was completed prior to and following a standardized one-hour didactic lecture. Results: Forty-six participants completed the pre- and post-assessment. There were 20 (43.5%) ENT ICU/IMC Staff (EBU), 20 (43.5%) Florida Surgical Center Staff (FSC), and 6 (13%) Anesthesia providers (Anes). Pre-lecture score average was 44.7% across all providers, significantly improving to 83.8% post-lecture (p < 0.001). Nursing staff from the Otolaryngology ICU, and OR staff, had significant improvement in knowledge base (p < 0.001). Anesthesia providers showed improvement, but the difference was not statistically significant (p = 0.052). Conclusions: Didactic lectures are a simple and low-cost option with significant potential in improving provider knowledge on these critical topics and improve patient care by non-otolaryngology providers.
MeSH term(s)	Humans ; Tracheostomy ; Laryngectomy ; Health Personnel ; Patient Care ; Florida
Language	English
Publishing date	2023-12-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.27616
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Article ; Online: Increasing the Safety of Patients Undergoing Breast Implant Surgery Using an Electronic Health Record Enhancement.

Prothe, Jessica / Kozak, Brenda / Rozovics, Paul / Sykes, Robyn / Taccona, Michael

Plastic and aesthetic nursing

2023 Volume 43, Issue 4, Page(s) 198–202

Abstract: Breast implant surgery is a popular plastic surgery procedure performed worldwide. Despite its global popularity, patients undergoing breast implant surgery are at risk for systemic illness and more than one form of cancer. We conducted a nursing ... ...

Abstract	Breast implant surgery is a popular plastic surgery procedure performed worldwide. Despite its global popularity, patients undergoing breast implant surgery are at risk for systemic illness and more than one form of cancer. We conducted a nursing workflow analysis at our facility and determined that it is not standard practice to screen patients for the presence or absence of breast implant devices at every health care encounter. This lack of screening for breast implant devices may adversely affect patient safety by hindering the rapid identification of systemic illness or cancer related to breast implant devices and delaying effective medical intervention. Based on the results of the workflow analysis, we initiated a formal call for nursing action. We identified a nursing workflow process to increase patient safety and developed a universal screening tool for implantable devices. We defined universal screening for implantable devices as assessing all patients for the presence or absence of an implantable device, specifically breast implant devices, at every health care encounter. Implementing a universal process for screening patients for implantable devices at every health care encounter can be easily formulated into a policy and procedure and/or an electronic health record (EHR) update or enhancement. This article discusses how we utilized a workflow process map to translate universal screening for implantable devices into an EHR enhancement.
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	3144666-8
ISSN	2770-3517
ISSN (online)	2770-3517
DOI	10.1097/PSN.0000000000000522
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Article ; Online: A comparative study of the cutting efficiency of diamond rotary instruments with different grit sizes with a low-speed electric handpiece against zirconia specimens.

van Aswegen, Ane / Jagathpal, Avish J / Sykes, Leanne M / Schoeman, Herman

The Journal of prosthetic dentistry

2023 Volume 131, Issue 1, Page(s) 101.e1–101.e8

Abstract: ... with a mean cutting depth of 5.79 mm compared with 4.54 mm for the coarse-grit instrument (P=.032 ...

Abstract	Statement of problem: The use of zirconia in dentistry has increased. However, little attention has been given to the difficulty experienced by clinicians when cutting zirconia restorations intraorally. Evidence for which grit size and type of rotary instrument is best for cutting zirconia intraorally is lacking. Purpose: The purpose of this in vitro study was to identify the most efficient diamond rotary instrument grit size for cutting zirconia intraorally. Material and methods: Efficiency was measured by comparing the cutting depth of each rotary instrument into zirconia, analyzing zirconia specimens for surface damage after cutting, and measuring instrument deterioration. Thirty zirconia specimens of the same measurements were used as test specimens and cut with 30 diamond rotary instruments with different grit sizes. An electric handpiece was used with constant force (1.7 N), speed (40 000 rpm), time (1 min), and water flow rate (25 mL/min) to produce comparative data. The mean cutting efficiency values were compared by analysis, and the median values were compared by the nonparametric Kruskal-Wallis test (α=.05). Each test was followed up with pair wise comparisons of the mean or median values if significance was indicated. Results: The greatest cutting depth was achieved with a fine-grit instrument with a mean cutting depth of 5.79 mm compared with 4.54 mm for the coarse-grit instrument (P=.032). The greatest damage to zirconia was done by the coarse- and supercoarse-grit instruments (both 33%), with no substrate damage by the superfine-, fine-, and medium-grit instruments. The greatest instrument deterioration was found on the supercoarse rotary instruments (9.05%). With only 3 exceptions, the power calculations were all sufficient and above 83%. Conclusions: The fine grit rotary instrument (between 40 and 50 µm) was the most efficient, achieving the greatest cutting depth, with no detectable macroscopic damage to the zirconia and minimal instrument deterioration.
MeSH term(s)	Diamond ; Zirconium ; Surface Properties ; Materials Testing
Chemical Substances	zirconium oxide (S38N85C5G0) ; Diamond (7782-40-3) ; Zirconium (C6V6S92N3C)
Language	English
Publishing date	2023-11-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	218157-5
ISSN	1097-6841 ; 0022-3913
ISSN (online)	1097-6841
ISSN	0022-3913
DOI	10.1016/j.prosdent.2023.10.004
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Article ; Online: Involving lived experience in regional efforts to address gambling-related harms: going beyond 'window dressing' and 'tick box exercises'.

Jenkins, Catherine L / Mills, Thomas / Grimes, James / Bland, Colin / Reavey, Paula / Wills, Jane / Sykes, Susie

BMC public health

2024 Volume 24, Issue 1, Page(s) 384

Abstract: Background: Lived Experience (LE) involvement has been shown to improve interventions across diverse sectors. Yet LE contributions to public health approaches to address gambling-related harms remain underexplored, despite notable detrimental health and ...

Abstract	Background: Lived Experience (LE) involvement has been shown to improve interventions across diverse sectors. Yet LE contributions to public health approaches to address gambling-related harms remain underexplored, despite notable detrimental health and social outcomes linked to gambling. This paper analyses the potential of LE involvement in public health strategy to address gambling-related harms. It focuses on the example of a UK city-region gambling harms reduction intervention that presented multiple opportunities for LE input. Methods: Three focus groups and 33 semi-structured interviews were conducted to hear from people with and without LE who were involved in the gambling harms reduction intervention, or who had previous experience of LE-informed efforts for addressing gambling-related harms. People without LE provided reflections on the value and contributions of others' LE to their work. Data analysis combined the Framework Method with themes developed inductively (from people's accounts) and deductively (from the literature, including grey literature). Results: Four themes were identified: (1) personal journeys to LE involvement; (2) the value added by LE to interventions for addressing gambling-related harms; (3) emotional impacts on people with LE; and (4) collective LE and diverse lived experiences. Two figures outlining LE involvement specific to gambling harms reduction in the UK, where public health efforts aimed at addressing gambling-related harms coexist with industry-funded programmes, are proposed. Conclusions: Integrating a range of LE perspectives in a public health approach to gambling harms reduction requires local access to involvement for people with LE via diverse routes that are free from stigma and present people with LE with options in how they can engage and be heard in decision-making, and how they operate in relation to industry influence. Involving LE in gambling harms reduction requires enabling people to develop the affective and critical skills necessary to navigate complex emotional journeys and a challenging commercial and policy environment.
MeSH term(s)	Humans ; Gambling/psychology ; Public Health ; Exercise Therapy ; Focus Groups ; Bandages
Language	English
Publishing date	2024-02-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-024-17939-7
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Article ; Online: Evaluation of dual energy CT and iterative metal artefact reduction (iMAR) for artefact reduction in radiation therapy.

Lim, P / Barber, J / Sykes, J

Australasian physical & engineering sciences in medicine

2019 Volume 42, Issue 4, Page(s) 1025–1032

Abstract: Metal artefacts pose a common problem in single energy computed tomography (SECT) images used for radiotherapy. Virtual monoenergetic (VME) images constructed with dual energy computed tomography (DECT) scans can be used to reduce beam hardening ... ...

Abstract	Metal artefacts pose a common problem in single energy computed tomography (SECT) images used for radiotherapy. Virtual monoenergetic (VME) images constructed with dual energy computed tomography (DECT) scans can be used to reduce beam hardening artefacts. Dual energy metal artefact reduction is compared and combined with iterative metal artefact reduction (iMAR) to determine optimal imaging strategies for patients with metal prostheses. SECT and DECT scans were performed on a Siemens Somatom AS-64 Slice CT scanner. Images were acquired of a modified CIRS pelvis phantom with 6, 12, 20 mm diameter stainless steel rods and VME images reconstructed at 100, 120, 140 and 190 keV. These were post-reconstructed with and without the iMAR algorithm. Artefact reduction was measured using: (1) the change in Hounsfield Unit (HU) with and without metal artefact reduction (MAR) for 4 regions of interest; (2) the total number of artefact pixels, defined as pixels with a difference (between images with metal rod and without) exceeding a threshold; (3) the difference in the mean pixel intensity of the artefact pixels. DECT, SECT + iMAR and DECT + iMAR were compared. Both SECT + iMAR and DECT + iMAR offer successful MAR for phantom simulating unilateral hip prosthesis. DECT gives minimal artefact reduction over iMAR alone. Quantitative metrics are advantageous for MAR analysis but have limitations that leave room for metric development.
MeSH term(s)	Algorithms ; Artifacts ; Hip Prosthesis ; Humans ; Metals/chemistry ; Phantoms, Imaging ; Tomography, X-Ray Computed
Chemical Substances	Metals
Language	English
Publishing date	2019-10-10
Publishing country	Netherlands
Document type	Evaluation Study ; Journal Article
ZDB-ID	46226-3
ISSN	1879-5447 ; 0158-9938
ISSN (online)	1879-5447
ISSN	0158-9938
DOI	10.1007/s13246-019-00801-1
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Article ; Online: Fundamental insights into heterogeneous single-atom catalysis.

Sykes, E Charles H / Christopher, Phillip / Li, Jun

The Journal of chemical physics

2021 Volume 155, Issue 21, Page(s) 210401

Language	English
Publishing date	2021-12-08
Publishing country	United States
Document type	Editorial
ZDB-ID	3113-6
ISSN	1089-7690 ; 0021-9606
ISSN (online)	1089-7690
ISSN	0021-9606
DOI	10.1063/5.0073628
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Article ; Online: Randomized, double-blind, placebo-controlled, crossover trial of oral doxycycline for epistaxis in hereditary hemorrhagic telangiectasia.

Thompson, K P / Sykes, J / Chandakkar, P / Marambaud, P / Vozoris, N T / Marchuk, D A / Faughnan, M E

Orphanet journal of rare diseases

2022 Volume 17, Issue 1, Page(s) 405

Abstract: ... was no significant difference in the change in weekly epistaxis duration (p = 0.136) or frequency (p ... VEGF, ANG-2, IL-6 or ENG with treatment. Hemoglobin levels were significantly higher (p = 0.0499 ... was no significant difference in RBC transfusions between treatment periods (p = 0.299).: Conclusion ...

Abstract	Background: Vascular malformations in hereditary hemorrhagic telangiectasia (HHT) lead to chronic recurrent bleeding, hemorrhage, stroke, heart failure, and liver disease. There is great interest in identifying novel therapies for epistaxis in HHT given its associated morbidity and impact on quality of life. We aimed to measure the effectiveness of oral doxycycline for the treatment of epistaxis and explore mechanisms of action on angiogenic, inflammatory and pathway markers in HHT using a randomized controlled trial. Methods: 13 HHT patients with epistaxis were recruited from the Toronto HHT Center at St. Michael's Hospital. Recruitment was stopped early due to COVID-19-related limitations. The study duration was 24 months. Patients were randomly assigned to the treatment-first or placebo-first study arm. We compared the change in weekly epistaxis duration and frequency, biomarkers, blood measurements, and intravenous iron infusion and blood transfusion requirements between treatment and placebo. Results: There was no significant difference in the change in weekly epistaxis duration (p = 0.136) or frequency (p = 0.261) between treatment and placebo. There was no significant difference in the levels of MMP-9, VEGF, ANG-2, IL-6 or ENG with treatment. Hemoglobin levels were significantly higher (p = 0.0499) during treatment. Ferritin levels were not significantly different between treatment and placebo. There was no significant difference in RBC transfusions between treatment periods (p = 0.299). Conclusion: Overall, our study did not demonstrate effectiveness of doxycycline as a treatment for epistaxis in patients with HHT, though the study was underpowered. Secondary analyses provided new observations which may help guide future trials in HHT. Trial Registration ClinicalTrials.gov, NCT03397004. Registered 11 January 2018 - Prospectively registered, https://clinicaltrials.gov/ct2/show/NCT03397004.
MeSH term(s)	Humans ; Telangiectasia, Hereditary Hemorrhagic/complications ; Telangiectasia, Hereditary Hemorrhagic/drug therapy ; Epistaxis/drug therapy ; Epistaxis/etiology ; Doxycycline/therapeutic use ; Cross-Over Studies ; Quality of Life ; Treatment Outcome ; COVID-19
Chemical Substances	Doxycycline (N12000U13O)
Language	English
Publishing date	2022-11-07
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, Non-U.S. Gov't
ZDB-ID	2225857-7
ISSN	1750-1172 ; 1750-1172
ISSN (online)	1750-1172
ISSN	1750-1172
DOI	10.1186/s13023-022-02539-8
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Article ; Online: Federated Learning Survival Model and Potential Radiotherapy Decision Support Impact Assessment for Non-small Cell Lung Cancer Using Real-World Data.

Field, M / Vinod, S / Delaney, G P / Aherne, N / Bailey, M / Carolan, M / Dekker, A / Greenham, S / Hau, E / Lehmann, J / Ludbrook, J / Miller, A / Rezo, A / Selvaraj, J / Sykes, J / Thwaites, D / Holloway, L

Clinical oncology (Royal College of Radiologists (Great Britain))

2024

Abstract: ... with survival times not significantly different (p = 0.87 and 0.061) from patients treated with curative ... indicated treatment, there was an estimated 11% increase in survival rate at two years (p < 0.01 ...

Abstract	Aims: The objective of this study was to develop a two-year overall survival model for inoperable stage I-III non-small cell lung cancer (NSCLC) patients using routine radiation oncology data over a federated (distributed) learning network and evaluate the potential of decision support for curative versus palliative radiotherapy. Methods: A federated infrastructure of data extraction, de-identification, standardisation, image analysis, and modelling was installed for seven clinics to obtain clinical and imaging features and survival information for patients treated in 2011-2019. A logistic regression model was trained for the 2011-2016 curative patient cohort and validated for the 2017-2019 cohort. Features were selected with univariate and model-based analysis and optimised using bootstrapping. System performance was assessed by the receiver operating characteristic (ROC) and corresponding area under curve (AUC), C-index, calibration metrics and Kaplan-Meier survival curves, with risk groups defined by model probability quartiles. Decision support was evaluated using a case-control analysis using propensity matching between treatment groups. Results: 1655 patient datasets were included. The overall model AUC was 0.68. Fifty-eight percent of patients treated with palliative radiotherapy had a low-to-moderate risk prediction according to the model, with survival times not significantly different (p = 0.87 and 0.061) from patients treated with curative radiotherapy classified as high-risk by the model. When survival was simulated by risk group and model-indicated treatment, there was an estimated 11% increase in survival rate at two years (p < 0.01). Conclusion: Federated learning over multiple institution data can be used to develop and validate decision support systems for lung cancer while quantifying the potential impact of their use in practice. This paves the way for personalised medicine, where decisions can be based more closely on individual patient details from routine care.
Language	English
Publishing date	2024-03-16
Publishing country	England
Document type	Journal Article
ZDB-ID	1036844-9
ISSN	1433-2981 ; 0936-6555
ISSN (online)	1433-2981
ISSN	0936-6555
DOI	10.1016/j.clon.2024.03.008
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Article ; Online: Impact of Adjuvant Radiotherapy Setting on Quality-of-Life in Head and Neck Squamous Cell Carcinoma.

Alapati, Rahul / Wagoner, Sarah F / Lawrence, Amelia / Bon Nieves, Antonio / Desai, Atharva / Shnayder, Yelizaveta / Hamill, Chelsea / Kakarala, Kiran / Neupane, Prakash / Gan, Gregory / Sykes, Kevin J / Bur, Andrés M

The Laryngoscope

2024

Abstract: ... with those treated at AMCs (95% CI: -13.96 to -0.35, p = 0.040) up to 12 months post-treatment. Additionally ... patients who were treated at CMCs had a 5.77-point (-11.86-0.31, p = 0.063) lower soc-QoL score compared ...

Abstract	Objective: To determine differences in post-treatment QoL across treatment settings in patients receiving adjuvant radiation therapy for head and neck squamous cell carcinoma (HNSCC). Methods: This was a prospective observational cohort study of patients with HNSCC initially evaluated in a head and neck surgical oncologic and reconstructive clinic at an academic medical center (AMC). Participants were enrolled prior to treatment in a prospective registry collecting demographic, social, and clinical data. Physical and social-emotional QoL (phys-QoL and soc-QoL, respectively) was measured using the University of Washington-QoL questionnaire at pre-treatment and post-treatment visits. Results: A cohort of 177 patients, primarily male and White with an average age of 61.2 ± 11.2 years, met inclusion criteria. Most patients presented with oral cavity tumors (n = 132, 74.6%), had non-HPV-mediated disease (n = 97, 61.8%), and were classified as Stage IVa (n = 72, 42.8%). After controlling for covariates, patients treated at community medical centers (CMCs) reported a 7.15-point lower phys-QoL compared with those treated at AMCs (95% CI: -13.96 to -0.35, p = 0.040) up to 12 months post-treatment. Additionally, patients who were treated at CMCs had a 5.77-point (-11.86-0.31, p = 0.063) lower soc-QoL score compared with those treated at an AMC, which was not statistically significant. Conclusion: This study revealed that HNSCC patients treated with radiation at AMCs reported significantly greater phys-QoL in their first-year post-treatment compared to those treated at CMCs, but soc-QoL did not differ significantly. Further observational studies are needed to explore potential factors, including treatment planning and cancer resource engagement, behind disparities between AMCs and CMCs. Level of evidence: Step 3 Laryngoscope, 2024.
Language	English
Publishing date	2024-03-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.31382
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