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Medium-term mortality after hip fractures and COVID-19:A prospective multicentre UK study

Chinese Journal of Traumatology 2022年第3期25卷 161-165页

作者： Gareth Chan Ashish Narang Arash Aframian Zaid Ali Joseph Bridgeman Alastair Carr Laura Chapman Henry Goodier Catrin Morgan Chang Park Sarah Sexton Kapil Sugand Thomas Walton Michael Wilson Ajay Belgaumkar kieran gallagher Koushik Ghosh Charles Gibbons Joshua Jacob Andrew Keightley Zuhair Nawaz Khaled Sarraf Christopher Wakeling William Kieffer Benedict Rogers Brighton&Sussex University Hospitals NHS Trust Brighton&Sussex Medical SchoolFainter CampusBrighton UK Surrey&Sussex Healthcare NHS Trust Canada&venueRedhillUK Chelsea&Westminster Hospital NHS Foundation Trust LondonUK Ashford&St frier's Hospital NHS Foundation TrustChertseyUK Western Sussex Hospitals NHS Foundation Trust(Sr Richard's Hospital)ChichesterUK Poole General Hospital&the Royal Bournemouth Hospital froleUK Imperial College Healthcare NHS Trust LondonUK Western Sussex Hospitals NHS Foundation Trust(Worthing Hospital) WorthingUK Royal Surrey Hospital NHS Foundation Trust GuildfordUK Frimley Health NHS Foundation Trust FrimleyUK

Purpose:The COVID-19 pandemic has caused 1.4 million deaths globally and is associated with a 3-4 times increase in 30-day mortality after a fragility hip fracture with concurrent COVID-19 ***,death from COVID-19 infection occurs between 15 and 22 days after the onset of symptoms,but this period can extend up to 8 *** study aimed to assess the impact of concurrent COVID-19 infection on 120-day mortality after a fragility hip ***:A multi-centre prospective study across 10 hospitals treating 8%of the annual burden of hip fractures in England between 1st March and 30th April,2020 was *** whose surgical treatment was payable through the National Health Service Best Practice Tariff mechanism for"fragility hip fractures"were included in the ***'120-day mortality was assessed relative to their perioperative COVID-19 *** analysis was performed using SPSS version ***:A total of 746 patients were included in this study,of which 87(11.7%)were COVID-19 *** rates at 30-and 120-day were significantly higher for COVID-19 positive patients relative to COVID-19 negative patients(p<0.001).However,mortality rates between 31 and 120-day were not significantly different(p=0.107),16.1%and 9.4%respectively for COVID-19 positive and negative patients,odds ratio 1.855(95%CI 0.865-3.978).Conclusion:Hip fracture patients with concurrent COVID-19 infection,provided that they are alive at day-31 after injury,have no significant difference in 120-day *** the growing awareness and concern of "long-COVID"and its widespread prevalence,this does not appear to increase mediumterm mortality rates after a hip fracture.

关键词： Hip fractures Femoral fractures COVID-19 Coronavirus Mortality

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Impact of community-based interventions on HIV: the next steps

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Infectious Diseases of Poverty 2014年第1期3卷 308-309页

作者： kieran Walsh BMJ Learning BMA HouseTavistock SquareLondon WC1H 9JRUK

Community based interventions increase knowledge scores and also have an impact of sexual behaviours with regard to *** the problem remains as to how best to scale up these interventions and how best to overcome real or perceived barriers to their *** based interventions have multiple components and some will be more difficult to widen out than *** that involve face to face or one to one sessions will be most expensive and so most difficult to scale *** some interventions can be implemented by means of custom computerized risk reduction programmes,then roll out on a large scale should be less problematic.

关键词： Community Education HIV

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The Effect of Laser Ablation Pulse Width and Feed Speed on Necrosis and Surface Damage of Cortical Bone

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Chinese Journal of Mechanical Engineering 2022年第3期35卷 106-122页

作者： Jose A.Robles‑Linares kieran Winter Zhirong Liao Faculty of Engineering University of NottinghamNottingham NG72RDUK

Bone cutting is of importance in orthopaedic surgery but is also challenging due to its nature of brittleness—where severe mechanical and thermal damages can be introduced easily in conventional *** machining is a new technology that can allow for complex cut geometries whilst minimising surface defects i.e.,smearing,which occur in mechanical ***,comparative studies on the influence of lasers with different pulse characteristics on necrotic damage and surface integrity have not been reported *** paper for the first time investigates the effects of laser type on the necrotic damage and surface integrity in fresh bovine cortical bone after ex-situ laser *** lasers of different pulse widths,i.e.,picosecond,nanosecond and continuous wave lasers have been investigated with different feed speeds tested to study the machining *** cutting temperature,and geometrical outputs have been measured to investigate the thermal influence on the cooling behaviour of the bone samples while high-speed imaging was used to compare the material removal mechanisms between a pulsed and continuous wave ***,an in-depth histological analysis of the subsurface has revealed that the nanosecond laser caused the largest necrotic depth,owing to the high pulse frequency limiting the dissipation of *** has also been observed that surface cracks positioned perpendicular to the trench direction were produced after machining by the picosecond laser,indicative of the photomechanical effect induced by plasma ***,the choice of laser type(i.e.,in terms of its pulse width and frequency)needs to be critically considered for appropriate application during laser osteotomy with minimum damage and improved healing.

关键词： Bone cutting Necrosis Surface damage Laser machining Histology

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Controversies in the pathological assessment of colorectal cancer

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World Journal of Gastroenterology 2014年第29期20卷 9850-9861页

作者： Aoife Maguire kieran Sheahan Department of Histopathology and Centre for Colorectal Disease St.Vincent’s University Hospital School of Medicine and Medical Science University College Dublin

Pathologic assessment of colorectal cancer specimens plays an essential role in patient management,informing prognosis and contributing to therapeutic decision *** tumor-node-metastasis(TNM)staging system is a key component of the colorectal cancer pathology report and provides important prognostic *** there is significant variation in outcome of patients within the same tumor *** other histological features such as tumor budding,vascular invasion,perineural invasion,tumor grade and rectal tumor regression grade that may be of prognostic value are not part of TNM *** of extramural tumor deposits and peritoneal involvement contributes to TNM staging but there are some difficulties with the definition of both of these *** in colorectal cancer pathology reporting include the subjective nature of some of the elements assessed,poor reporting rates and reproducibility and the need for standardized examination protocols and *** pathology is becoming increasingly important in prognostication and prediction of response to targeted therapies but accurate morphology still has a key role to play in colorectal cancer pathology reporting.

关键词： Colorectal cancer Staging Prognosis Histopathology Tumor-node-metastasis

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Liver transplantation and multivisceral transplantation in the management of patients with advanced neuroendocrine tumours

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World Journal of Gastroenterology 2018年第20期24卷 2152-2162页

作者： Ashley kieran Clift Andrea Frilling Department of Surgery and Cancer Imperial College London

Orthotopic liver transplantation(OLT) represents a generally accepted albeit somewhat controversially discussed therapeutic strategy in highly selected patients with non-resectable hepatic metastases from neuroendocrine tumours(NET). Whilst there are some exclusion criteria, these are not universally followed, and the optimal set of inclusion parameters for deeming patients eligible has not yet been elucidated. This is due to heterogeneity in the study populations, as well differing approaches employed and also divergences in selection criteria between centres. Recent data have suggested that OLT may represent the most efficacious approach in terms of overall and disease-free survival to the management of NET metastatic to the liver when conducted in accordance with the modified Milan criteria. Therefore, a consensus set of selection criteria requires definition to facilitate stringent and fair allocation of deceased-donor organs, as well as consideration for living-donor organs. In the context of classically non-resectable metastatic tumour bulk, multivisceral transplantation with or without the liver may also be indicated, yet experience is very limited. In this review, we discuss the diagnostic work-up of patients in whom the aforementioned transplantation approaches are being considered, critically analyse the published experience and also anticipate future developments in this field, including a discussion of immediate and longer-term research priorities.

关键词： neuroendocrine transplantation metastases liver multivisceral

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Willingness to pay in medical education

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The Journal of Biomedical Research 2014年第2期28卷 151-152页

作者： kieran Walsh FRCPI FHEA BMJ Learning BMJ Publishing Group BMA House Tavistock Square

Dear Editor： In the UK and in many other countries throughout the world, medical students are paying for their med- ical education~. They might be paying the entire fee or a sizable proportion of it - but many of the... 详细信息

关键词：《生物医学研究杂志》期刊编辑工作发行工作

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A combination of density-based clustering method and DEM to numerically investigate the breakage of bonded pharmaceutical granules in the ball milling process

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Particuology 2021年第5期19卷 153-168页

作者： Alexander Krok Peter Peciar kieran Coffey Keith Bryan Sandra Lenihan Department of Process Energy and Transport EngineeringMunster Technological UniversityBishopstownCork T12 P928Ireland Department of Mechanical Biomedical and Manufacturing EngineeringMunster Technological UniversityBishopstownCork T12 P928Ireland Pfizer Newbridge LittleconnellNewbridgeCo.Kildare W12 HX57Ireland Institute of Process Engineering Faculty of Mechanical EngineeringSlovak University of TechnologyNam.Slobody 1781231 BratislavaSlovakia

Ball milling is widely used in industry to mill particulate *** primary purpose of this process is to attain an appropriate product size with the least possible energy *** process is also extensively utilised in pharmaceuticals for the comminution of the excipients or ***,for ball mill,little is known concerning the mechanism of size *** prediction approaches are not deemed useful to provide significant insights into the operation or facilitate radical step changes in ***,the discrete element method(DEM)as a computational modelling approach has been used in this *** previous research,DEM has been applied to simulate breaking behaviour through the impact energy of all ball collisions as the driving force for ***,the nature of pharmaceutical material fragmentation during ball milling is more *** functional equations which link broken media and applied energy do not consider the collision of particulate media of different shapes or collisions of particulate media(such as granules)with balls and rotating mill *** could have a significant impact on ***,this paper aimed to investigate the fragmentation of bounded particles into DEM granules of different shape/size during the ball milling process.A systematic study was undertaken to explore the effect of milling speed on breakage ***,in this study,a combination of a density-based clustering method and discrete element method was employed to numerically investigate the number and size of the fragments generated during the ball milling process over *** was discovered that the collisions of the ball increased proportionally with rotation speed until reaching the critical rotation ***,results illustrate that with an increase of rotation speed,the mill power increased *** caratacting motion of mill material together with balls was identified as the most

关键词： Ball milling Granular pharmaceutical lactose Density-based clustering Discrete element method Breakage Mill rotation speed ABAQUS

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Parameter-Free Search of Time-Series Discord

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Journal of Computer Science & Technology 2013年第2期28卷 300-310页

作者： Wei Luo Marcus gallagher Janet Wiles School of Information Technology Deakin University School of Information Technology and Electrical Engineering University of Queensland

Time-series discord is widely used in data mining applications to characterize anomalous subsequences in time series. Compared to some other discord search algorithms, the direct search algorithm based on the recurrence plot shows the advantage of being fast and parameter free. The direct search algorithm, however, relies on quasi-periodicity in input time series, an assumption that limits the algorithm＇s applicability. In this paper, we eliminate the periodicity assumption from the direct search algorithm by proposing a reference function for subsequences and a new sampling strategy based on the reference function. These measures result in a new algorithm with improved efficiency and robustness, as evidenced by our empirical evaluation.

关键词： time series anomaly detection recurrence structure direct discord search parameter-free algorithm

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Bioactive potential of natural biomaterials: identification, retention and assessment of biological properties

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Signal Transduction and Targeted Therapy 2021年第4期6卷 1171-1198页

作者： kieran Joyce Georgina Targa Fabra Yagmur Bozkurt Abhay Pandit School of Medicine National University of IrelandGalwayIreland CURAM SFI Research Centre for Medical DevicesNational University of IrelandGalwayIreland

Biomaterials have had an increasingly important role in recent decades,in biomedical device design and the development of tissue engineering solutions for cell delivery,drug delivery,device integration,tissue replacement,and *** is an increasing trend in tissue engineering to use natural substrates,such as macromolecules native to plants and animals to improve the biocompatibility and biodegradability of delivered *** the same time,these materials have favourable mechanical properties and often considered to be biologically *** importantly,these macromolecules possess innate functions and properties due to their unique chemical composition and structure,which increase their bioactivity and therapeutic potential in a wide range of *** much focus has been on integrating these materials into these devices via a spectrum of cross-linking mechanisms,little attention is drawn to residual bioactivity that is often hampered during isolation,purification,and production ***,we discuss methods of initial material characterisation to determine innate bioactivity,means of material processing including cross-linking,decellularisation,and purification techniques and finally,a biological assessment of retained bioactivity of a final *** review aims to address considerations for biomaterials design from natural polymers,through the optimisation and preservation of bioactive components that maximise the inherent bioactive potency of the substrate to promote tissue regeneration.

关键词： biomaterials linking potential

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Tranexamic acid for major trauma patients in Ireland

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World Journal of Emergency Medicine 2022年第1期13卷 11-17页

作者： kieran Walsh Francis O’Keeff e Louise Brent Biswadev Mitra National Trauma Research Institute the Alfred HospitalMelbourne 3004Australia Critical Care Research School of Public Health and Preventive MedicineMonash UniversityMelbourne 3004Australia Emergency&Trauma Centre Alfred HealthMelbourne 3004Australia Emergency Department Mater Misericordiae University HospitalDublin D07 R2WYIreland National Offi ce for Clinical Audit Ardilaun HouseDublin D02 VN51Ireland

BACKGROUND:The Clinical Randomisation of an Anti-fibrinolytic in Significant Hemorrhage-2(CRASH-2)is the largest randomized control trial(RCT)examining circulatory resuscitation for trauma patients to date and concluded a statistically significant reduction in all-cause mortality in patients administered tranexamic acid(TXA)within 3 hours of *** the publication of CRASH-2,significant geographical variance in the use of TXA for trauma patients *** study aims to assess TXA use for major trauma patients with hemorrhagic shock in Ireland after the publication of ***:A retrospective cohort study was conducted using data derived from the Trauma Audit and Research Network(TARN).All injured patients in Ireland between January 2013 and December 2018 who had evidence of hemorrhagic shock on presentation(as defined by systolic blood pressure[SBP]1(70.68%vs.57.43%)and higher Injury Severity Score(ISS>25;49.62%vs.23.76%).Administration of TXA was not associated with mortality at hospital discharge(odds ratio[OR]0.86,95%CI 0.31–2.38).CONCLUSIONS:Among injured Irish patients presenting with hemorrhagic shock,TXA was administered to 56.8%of *** administered with TXA were on average more severely ***,a mortality benefit could not be demonstrated.

关键词： Tranexamic acid Shock Ireland Hemorrhage

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