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Article ; Online: Predicting Blood Pressure After Nitroglycerin Infusion Dose Titration in Critical Care Units: A Multicenter Retrospective Study.

Kamboj, Navpreet / Metcalfe, Kelly / Chu, Charlene H / Conway, Aaron

2024 Volume 42, Issue 4, Page(s) 259–266

Abstract: Critical care nurses use physiological indicators, such as blood pressure, to guide their decision-making regarding the titration of nitroglycerin infusions. A retrospective study was conducted to determine the accuracy of systolic blood pressure ... ...

Abstract	Critical care nurses use physiological indicators, such as blood pressure, to guide their decision-making regarding the titration of nitroglycerin infusions. A retrospective study was conducted to determine the accuracy of systolic blood pressure predictions during nitroglycerin infusions. Data were extracted from the publicly accessible eICU program database. The accuracy of a linear model, least absolute shrinkage and selection operator, ridge regression, and a stacked ensemble model trained using the AutoGluon-Tabular framework were investigated. A persistence model, where the future value in a time series is predicted as equal to its preceding value, was used as the baseline comparison for model accuracy. Internal-external validation was used to examine if heterogeneity among hospitals could contribute to model performance. The sample consisted of 827 patients and 2541 nitroglycerin dose titrations with corresponding systolic blood pressure measurements. The root-mean-square error on the test set for the stacked ensemble model developed using the AutoGluon-Tabular framework was the lowest of all models at 15.3 mm Hg, equating to a 22% improvement against the baseline. Internal-external validation revealed consistent accuracy across hospitals. Further studies are needed to determine the impact of using systolic blood pressure predictions to inform nurses' clinical decision-making regarding nitroglycerin infusion titration in critical care.
MeSH term(s)	Humans ; Blood Pressure ; Nitroglycerin/therapeutic use ; Retrospective Studies ; Critical Care
Chemical Substances	Nitroglycerin (G59M7S0WS3)
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	2078463-6
ISSN	1538-9774 ; 1538-2931
ISSN (online)	1538-9774
ISSN	1538-2931
DOI	10.1097/CIN.0000000000001086
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Article: Patient Outcomes after Fat Grafting to the Radiated Chest Wall before Delayed Two-stage Alloplastic Breast Reconstruction.

Wenger, Robert / Retrouvey, Helene / Metcalfe, Kelly / Semple, John L

Plastic and reconstructive surgery. Global open

2023 Volume 11, Issue 7, Page(s) e5119

Abstract: Two-stage alloplastic breast reconstruction in patients having received mastectomy and radiation is associated with a high rate of complications. Fat grafting has been shown to mitigate the effects of radiation on the chest wall to allow for alloplastic ... ...

Abstract	Two-stage alloplastic breast reconstruction in patients having received mastectomy and radiation is associated with a high rate of complications. Fat grafting has been shown to mitigate the effects of radiation on the chest wall to allow for alloplastic reconstruction. In this study, we assess the outcomes (after a mean follow-up of 28 months), including complications and revisional procedures, of women who had fat grafting to the radiated chest wall before two-stage implant-based breast reconstruction. Methods: A retrospective chart review was performed on consecutive patients seeking delayed implant-based reconstruction after simple mastectomy and postmastectomy radiation therapy between 2011 and 2015. All patients underwent two sessions of fat grafting to the radiated chest wall before inserting a tissue expander and subsequent exchange to a silicone implant. Results: Twenty patients were included in the study. No reconstructive failures were recorded. The short-term complication rate was 5%, with one hematoma leading to a revisional procedure. The mean follow-up after reconstruction was 28 months. During follow-up, two patients (10%) developed capsular contracture grade IV with implant malposition, leading to capsular revision and implant exchange. Four patients (20%) underwent additional fat grafting for contour deformities. Conclusions: Fat grafting before two-stage alloplastic breast reconstruction in patients treated with mastectomy and postmastectomy radiation therapy may provide an alternate method of alloplastic reconstruction in a select group of patients who are not suitable for autogenous reconstruction. Follow-up data show that additional surgery may be required for correction of implant malposition and capsular contracture.
Language	English
Publishing date	2023-07-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000005119
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Psychological and health behaviour outcomes following multi-gene panel testing for hereditary breast and ovarian cancer risk: a mini-review of the literature.

Carlsson, Lindsay / Thain, Emily / Gillies, Brittany / Metcalfe, Kelly

Hereditary cancer in clinical practice

2022 Volume 20, Issue 1, Page(s) 25

Abstract: Introduction: Knowledge of the genetic mechanisms driving hereditary breast and ovarian cancer (HBOC) has recently expanded due to advances in gene sequencing technologies. Genetic testing for HBOC risk now involves multi-gene panel testing, which ... ...

Abstract	Introduction: Knowledge of the genetic mechanisms driving hereditary breast and ovarian cancer (HBOC) has recently expanded due to advances in gene sequencing technologies. Genetic testing for HBOC risk now involves multi-gene panel testing, which includes well characterized high-penetrance genes (e.g. BRCA1 and BRCA2), as well as moderate- and low-penetrance genes. Certain moderate and low penetrance genes are associated with limited data to inform cancer risk estimates and clinical management recommendations, which create new sources of genetic and clinical uncertainty for patients. Purpose: The aim of this review is to evaluate the psychological and health behaviour outcomes associated with multi-gene panel testing for HBOC risk. The search was developed in collaboration with an Information Specialist (Princess Margaret Cancer Centre) and conducted in the following databases: MEDLINE, EMBASE, EMCare, PsycINFO, Epub Ahead of Publication. Results: Similar to the BRCA1/2 literature, individuals with a pathogenic variant (PV) reported higher levels of testing-related concerns and cancer-specific distress, as well as higher uptake of prophylactic surgery in both affected and unaffected individuals compared to those with variant of uncertain significance (VUS) or negative result. A single study demonstrated that individuals with a PV in a moderate penetrance gene reported higher rates of cancer worry, genetic testing concerns and cancer-related distress when compared to women with high penetrance PV. Analysis of cancer screening and prevention outcomes based upon gene penetrance were limited to two studies, with conflicting findings. Conclusion: The findings in this review emphasize the need for studies examining psychological and health behavior outcomes associated with panel testing to include between group differences based upon both variant pathogenicity and gene penetrance. Future studies evaluating the impact of gene penetrance on patient-reported and clinical outcomes will require large samples to be powered for these analyses given that a limited number of tested individuals are found to have a PV.
Language	English
Publishing date	2022-06-22
Publishing country	Poland
Document type	Journal Article ; Review
ZDB-ID	2252512-9
ISSN	1897-4287 ; 1731-2302
ISSN (online)	1897-4287
ISSN	1731-2302
DOI	10.1186/s13053-022-00229-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Building prevention research science communication and knowledge translation capacity through multidisciplinary collaboration.

Naughton, Shaan S / Kuswara, Konsita / Burgess, Ainsley E / Dinmore, Helen C / Jones, Cindy / Metcalfe, Karen / Turon, Heidi / Signy, Helen

Public health research & practice

2024 Volume 34, Issue 1

Abstract: Objective: To document the outcomes of a dedicated Science Communication Community of Practice (CoP) for increasing prevention-focused knowledge translation (KT) and evidence uptake. Type of program: Shared priorities and a united vision to communicate ... ...

Abstract	Objective: To document the outcomes of a dedicated Science Communication Community of Practice (CoP) for increasing prevention-focused knowledge translation (KT) and evidence uptake. Type of program: Shared priorities and a united vision to communicate the value of prevention research led to the formation of a dedicated Science Communication CoP within an Australian public health prevention-focused research collaboration. Members of the CoP included science communication experts and early- and mid-career researchers (EMCRs) with KT-focused roles. Methods: The CoP met monthly, with semi-structured meetings led by an experienced science communication professional. A priority of the CoP was to develop resources that could help members and external parties to communicate their findings, especially EMCRs and those working on low-resourced projects. Insights from CoP members were synthesised to document if, and how, the CoP increased communication and KT capacity. Results: CoP members found that participatory dialogue - dialogue that involves sharing perspectives and listening to others in order to develop a shared understanding - helped promote a greater understanding of science communication techniques and led to KT being embedded within projects. The CoP itself resulted in shared narratives and communication outputs that could not have been produced by individual members, primarily due to a lack of dedicated resourcing. Members found that engaging in the CoP increased their use of a range of science communication skills, tactics, and methods (e.g., targeted messaging for policy and practice, use of media and social media, and event management to engage audiences and build trust). Lessons learnt: The CoP helped build a greater working knowledge of science communication among its members, leading to increased KT activities. Within an environment of low resourcing for science communication, bringing researchers together with science communication experts can help promote the communication of synthesised evidence and unified messaging on 'what works for prevention'.
MeSH term(s)	Humans ; Translational Science, Biomedical ; Australia ; Communication ; Community Health Services ; Health Services Research ; Capacity Building
Language	English
Publishing date	2024-04-04
Publishing country	Australia
Document type	Journal Article
ISSN	2204-2091
ISSN (online)	2204-2091
DOI	10.17061/phrp3412409
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Rise and fall of an avian oasis: Tracking the impacts of land use change in a key coastal wetland in the world's largest megalopolis.

Leung, Felix / Doherty, Philip D / Liu, Mingfeng / Metcalfe, Kristian / Godley, Brendan / Lee, Shing Yip

The Science of the total environment

2023 Volume 906, Page(s) 167231

Abstract: Tropical estuaries support wetlands with high biodiversity value and provide essential ecosystem services. Many of these systems, however, are global hotspots for urbanization, particularly in Asia, where this process has resulted in rapid conversion, ... ...

Abstract	Tropical estuaries support wetlands with high biodiversity value and provide essential ecosystem services. Many of these systems, however, are global hotspots for urbanization, particularly in Asia, where this process has resulted in rapid conversion, fragmentation, and degradation of 80 % of the wetlands along the East Asian-Australasian Flyway (EAAF) for migratory birds. However, the impact of such landscape scale changes on migratory birds at a key stopover site along the EAAF has not been evaluated. Here, we used long-term data (> 40 years) from Deep Bay (Hong Kong), a shallow embayment in the Pearl River estuary (PRE) in south China, to investigate the impact of urbanization on (1) catchment land use and water quality, and (2) its impact on the capacity of the wetland to support populations of migratory waterbirds. Deep Bay supports the largest remnants of mangrove forests and tidal mudflats in the PRE and is an important refueling ground along the EAAF. It is also part of the Greater Bay Area (GBA, population 86 million), the world's largest megalopolis. The principal component analysis highlighted the nutrient loading and cleansing effect from seasonal flushing as characterizing variation in water quality in Deep Bay over four decades. Major shifts in water quality during the study period were accompanied by contemporaneous changes in wintering waterbirds numbers. Prior to 2003, the main drivers of water quality were organic nutrients from animal husbandry. Following large-scale reclamation and increases in impervious surface cover post-2003, primarily due to the development of the megacity of Shenzhen (population 17.7 million), the hydrodynamics of Deep Bay have changed, with knock-on effects of sedimentation, input of pollutants, and changes in the macrobenthos. The wintering waterbirds community responded to these changes both in total numbers and the relative importance of feeding guilds. Where total bird counts are positively influenced by benthic biomass, and the benthic biomass is positively correlated to the water quality that is driven by the cleansing effect of tidal flushing. These anthropogenic drivers have negatively impacted migratory birds that use Deep Bay as a refueling station. This study highlights the need for policymakers to control these drivers and limit the level to which sensitive coastlines are urbanized.
MeSH term(s)	Animals ; Wetlands ; Ecosystem ; Birds ; China ; Hong Kong ; Conservation of Natural Resources/methods
Language	English
Publishing date	2023-09-21
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2023.167231
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Article ; Online: Understanding the role of oncogenic human papillomavirus (HPV) status on adherence behaviors among women with abnormal cervical cytology.

Buick, Catriona / Murphy, K Joan / Howell, Doris / Metcalfe, Kelly

BMC women's health

2021 Volume 21, Issue 1, Page(s) 29

Abstract: Background: With the introduction of oncogenic Human Papillomavirus (HPV) testing into cervical screening there is a renewed focus on primary prevention among high-risk groups. To date, little is known about the effectiveness of this program, and the ... ...

Abstract	Background: With the introduction of oncogenic Human Papillomavirus (HPV) testing into cervical screening there is a renewed focus on primary prevention among high-risk groups. To date, little is known about the effectiveness of this program, and the extent to which individual-level factors, such as psychosocial health and agency, may play a role. In particular, it is unclear if knowledge of one's oncogenic HPV status impacts on adherence behaviors amongst women with screening abnormalities. The purpose of this study was to identify if clinical, demographic or psychosocial factors predict non-adherence with recommended colposcopy follow-up. Methods: This prospective pilot study included 145 women referred to a large Toronto colposcopy clinic between December, 2013 and September, 2014. Demographic, clinical and psychosocial characteristics were collected at three points in time: (1) at initial colposcopy consultation; (2) 4-6 weeks following initial consultation, and; (3) at time of follow-up appointment (within 12 months of initial consultation). Results: Overall, 13% (n = 145) of the women were classified as non-adherent. Older women (OR = 0.73, p < 0.01) and those with higher-grade lesions (OR = 0.10, p < 0.01) were less likely to be non-adherent, whereas current smokers (OR = 22.46, p < 0.01) were more likely to be non-adherent. While not statistically significant, variation in rates of non-adherence amongst the various HPV status groups (untested; 15.3%, HPV positive; 5.3%, HPV negative; 6.7%) warrants further study. Conclusion: Findings of this study indicate that younger women, those with higher-grade lesions and current smokers were more likely to be non-adherent to recommended colposcopy follow-up. While HPV status did not reach statistical significance, the direction of this finding suggests that testing for HPV may have a positive reinforcing role on adherence to follow-up. The direction of this finding warrants further study, and potentially a practical clinical goal as HPV testing for women becomes standard of care.
MeSH term(s)	Aged ; Alphapapillomavirus ; Cervical Intraepithelial Neoplasia ; Colposcopy ; Early Detection of Cancer ; Female ; Humans ; Mass Screening ; Papillomaviridae ; Papillomavirus Infections/complications ; Papillomavirus Infections/diagnosis ; Pilot Projects ; Pregnancy ; Prospective Studies ; Uterine Cervical Neoplasms/diagnosis ; Vaginal Smears
Language	English
Publishing date	2021-01-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1472-6874
ISSN (online)	1472-6874
DOI	10.1186/s12905-020-01168-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Tracking the global reduction of marine traffic during the COVID-19 pandemic.

March, David / Metcalfe, Kristian / Tintoré, Joaquin / Godley, Brendan J

Nature communications

2021 Volume 12, Issue 1, Page(s) 2415

Abstract: The COVID-19 pandemic has resulted in unparalleled global impacts on human mobility. In the ocean, ship-based activities are thought to have been impacted due to severe restrictions on human movements and changes in consumption. Here, we quantify and map ...

Abstract	The COVID-19 pandemic has resulted in unparalleled global impacts on human mobility. In the ocean, ship-based activities are thought to have been impacted due to severe restrictions on human movements and changes in consumption. Here, we quantify and map global change in marine traffic during the first half of 2020. There were decreases in 70.2% of Exclusive Economic Zones but changes varied spatially and temporally in alignment with confinement measures. Global declines peaked in April, with a reduction in traffic occupancy of 1.4% and decreases found across 54.8% of the sampling units. Passenger vessels presented more marked and longer lasting decreases. A regional assessment in the Western Mediterranean Sea gave further insights regarding the pace of recovery and long-term changes. Our approach provides guidance for large-scale monitoring of the progress and potential effects of COVID-19 on vessel traffic that may subsequently influence the blue economy and ocean health.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; Ecosystem ; Human Activities ; Humans ; Oceans and Seas ; SARS-CoV-2 ; Ships/classification ; Ships/economics ; Ships/statistics & numerical data
Language	English
Publishing date	2021-04-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-021-22423-6
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Article ; Online: Cost-effectiveness of pembrolizumab for previously treated MSI-H/dMMR solid tumours in the UK.

McCarthy, Grant / Young, Kate / Madin-Warburton, Matthew / Mantaian, Tyler / Brook, Elizabeth / Metcalfe, Kaylie / Mikelson, Jan / Xu, Ruifeng / Seyla-Hammer, Carl / Aguiar-Ibáñez, Raquel / Amonkar, Mayur

Journal of medical economics

2024 Volume 27, Issue 1, Page(s) 279–291

Abstract: Objectives: Patients with previously treated microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) tumours have limited chemotherapeutic treatment options. Pembrolizumab received approval from the EMA in 2022 for the treatment of ... ...

Abstract	Objectives: Patients with previously treated microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) tumours have limited chemotherapeutic treatment options. Pembrolizumab received approval from the EMA in 2022 for the treatment of colorectal, endometrial, gastric, small intestine, and biliary MSI-H/dMMR tumour types. This approval was supported by data from the KEYNOTE-164 and KEYNOTE-158 clinical trials. This study evaluated the cost-effectiveness of pembrolizumab compared with standard of care (SoC) for previously treated MSI-H/dMMR solid tumours in line with the approved EMA label from a UK healthcare payer perspective. Methods: A multi-tumour partitioned survival model was built consisting of pre-progression, progressed disease, and dead health states. Pembrolizumab survival outcomes were extrapolated using Bayesian hierarchical models (BHMs) fitted to pooled data from KEYNOTE-164 and KEYNOTE-158. Comparator outcomes were informed by published sources. Tumour sites were modelled independently and then combined, weighted by tumour site distribution. A SoC comparator was used to formulate the overall cost-effectiveness result with pembrolizumab as the intervention. SoC comprised a weighted average of the comparators by tumour site based on market share. Drug acquisition, administration, adverse events, monitoring, subsequent treatment, end-of-life costs, and testing costs were included. Sensitivity and scenario analyses were performed, including modelling pembrolizumab efficacy using standard parametric survival models. Results: Pembrolizumab, at list price, was associated with £129,469 in total costs, 8.30 LYs, and 3.88 QALYs across the pooled tumour sites. SoC was associated with £28,222 in total costs, 1.14 LYs, and 0.72 QALYs across the pooled tumour sites. This yields an incremental cost-effectiveness ratio (ICER) of £32,085 per QALY. Results were robust to sensitivity and scenario analyses. Conclusions: This model demonstrates pembrolizumab provides a valuable new alternative therapy for UK patients with MSH-H/dMMR cancer at the cost of £32,085 per QALY, with confidential discounts anticipated to improve cost-effectiveness further.
MeSH term(s)	Humans ; Cost-Benefit Analysis ; Microsatellite Instability ; Bayes Theorem ; Antineoplastic Agents, Immunological ; Colorectal Neoplasms/drug therapy ; United Kingdom ; Brain Neoplasms ; Neoplastic Syndromes, Hereditary ; Antibodies, Monoclonal, Humanized
Chemical Substances	pembrolizumab (DPT0O3T46P) ; Antineoplastic Agents, Immunological ; Antibodies, Monoclonal, Humanized
Language	English
Publishing date	2024-02-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2270945-9
ISSN	1941-837X ; 1369-6998
ISSN (online)	1941-837X
ISSN	1369-6998
DOI	10.1080/13696998.2024.2311507
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Article: Utility Analyses of AVITI Sequencing Chemistry.

Liu, Silvia / Obert, Caroline / Yu, Yan-Ping / Zhao, Junhua / Ren, Bao-Guo / Wiseman, Kelly / Krajacich, Benjamin J / Wang, Wenjia / Metcalfe, Kyle / Smith, Mat / Ben-Yehezkel, Tuval / Luo, Jian-Hua

bioRxiv : the preprint server for biology

2024

Abstract: Background: DNA sequencing is a critical tool in modern biology. Over the last two decades, it has been revolutionized by the advent of massively parallel sequencing, leading to significant advances in the genome and transcriptome sequencing of various ... ...

Abstract	Background: DNA sequencing is a critical tool in modern biology. Over the last two decades, it has been revolutionized by the advent of massively parallel sequencing, leading to significant advances in the genome and transcriptome sequencing of various organisms. Nevertheless, challenges with accuracy, lack of competitive options and prohibitive costs associated with high throughput parallel short-read sequencing persist. Results: Here, we conduct a comparative analysis using matched DNA and RNA short-reads assays between Element Biosciences AVITI chemistry and Illumina NextSeq 550. Similar comparisons were evaluated for synthetic long-read sequencing for RNA and targeted single-cell transcripts between the AVITI and Illumina NovaSeq 6000. For both DNA and RNA short-read applications, the study found that the AVITI produced significantly higher per sequence quality scores. For PCR-free DNA libraries, we observed up to a 10-fold lower experimentally determined error rate for using the AVITI chemistry compared to the NextSeq 550. For short-read RNA quantification, both AVITI and the NextSeq 550 demonstrated comparable accuracy. With regards to synthetic long-read mRNA and targeted synthetic long read single cell mRNA sequencing, both platforms respective chemistries performed comparably in quantification of genes and isoforms. The AVITI displayed a marginally lower error rate for long reads, with fewer chemistry-specific errors and a higher mutation detection rate. Conclusion: These results point to the potential of the AVITI platform as a competitive candidate in high-throughput short read sequencing analyses when juxtaposed with the Illumina NextSeq 550.
Language	English
Publishing date	2024-04-22
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.04.18.590136
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Article: Tracking foraging green turtles in the Republic of the Congo: insights into spatial ecology from a data poor region

Metcalfe, K. / Bréheret, N. / Bal, G. / Chauvet, E. / Doherty, P. D. / Formia, A.

Oryx

2020 Volume 54, Issue 3, Page(s) 299

Language	English
Document type	Article
ZDB-ID	417337-5
ISSN	0030-6053
Database	Current Contents Nutrition, Environment, Agriculture

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Z 7627: Show issues

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