158 results on '"Mark Little"'
Search Results
2. Effects of stopping criterion on the growth of trees in regression random forests
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Aryana Arsham, Philip Rosenberg, and Mark Little
- Abstract
Random forests are a powerful machine learning tool that capture complex relationships between independent variables and an outcome of interest. Trees built in a random forest are dependent on several hyperparameters, one of the more critical being the node size. The original algorithm of Breiman, controls for node size by limiting the size of the parent node, so that a node cannot be split if it has less than a specified number of observations. We propose that this hyperparameter should instead be defined as the minimum number of observations in each terminal node. The two existing random forest approaches are compared in the regression context based on estimated generalization error, bias-squared, and variance of resulting predictions in a number of simulated datasets. Additionally the two approaches are applied to type 2 diabetes data obtained from the National Health and Nutrition Examination Survey. We have developed a straightforward method for incorporating weights into the random forest analysis of survey data. Our results demonstrate that generalization error under the proposed approach is competitive to that attained from the original random forest approach when data have large random error variability. The R code created from this work is available and includes an illustration.
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- 2022
3. Use of clonidine in the treatment of Irukandji syndrome: A 4‐year retrospective cohort study on safety, efficacy and clinical utility
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Ari Isman, Jamie Seymour, and Mark Little
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Analgesics, Opioid ,Analgesics ,Cnidarian Venoms ,Emergency Medicine ,Humans ,Bites and Stings ,Syndrome ,Clonidine ,Retrospective Studies - Abstract
Irukandji syndrome (IS) is an extremely painful condition that causes a significant catecholamine surge and sympathetic autonomic response related to the envenomation from certain types of jellyfish. Current management involves intravenous fluids, magnesium sulphate and large doses of opioids for symptom control. Clonidine, a centrally acting alpha-2 agonist, is often used as an analgesic adjunct to reduce opioid requirements in acute pain. The present study explores the safety and efficacy of clonidine in reducing opioid requirements in IS.All patients diagnosed with IS at Cairns Hospital between 1 March 2016 and 30 April 2020, and participants from the Magnesium in Irukandji Study Trial, were included in this retrospective study (n = 114). Cases were separated into two groups depending on whether or not they received clonidine, and subsequently analysed according to pre- and post-intervention opioid requirements, clonidine dose administered and adverse effects.Notably, 39 patients with IS received ≥1 mcg/kg clonidine and the remaining 75 did not. There was no difference in oral morphine equivalent daily dose (oMEDD) between groups before clonidine administration; however, there was a significant reduction in oMEDD required after patients received clonidine (26.1 mg; 95% CI 4.6-47.7) compared with those who did not (66.6 mg; 95% CI 56.9-86.1) (F = 8.722, df = 1 × 224, P = 0.003). One episode of hypotension occurred following the intervention.Patients with IS who received clonidine required significantly lower opioid requirements than those who did not receive clonidine. Clonidine was safe to administer and should be considered early when treating IS. The optimal clonidine dose remains unclear and requires prospective studies to validate our findings.
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- 2022
4. STRETCH: Stinging tree exposures to Cairns Hospital
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Ruth Young, Angela Jackson, Fiona Ryan, and Mark Little
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Emergency Medicine - Published
- 2023
5. Coral Reef Arks: An In Situ Mesocosm and Toolkit for Assembling Reef Communities
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Forest Rohwer, Aaron C. Hartmann, Andreas F. Haas, Jose Castillo, Pei-Fang Wang, Gunther Rosen, Xiaofeng Liu, Jared Brzenski, Mark Little, Ashton Ballard, Jenna Aquino, William Barnes, Yun Scholten, Anneke van der Geer, Mark Hatay, Bart Chadwick, Jessica Carilli, and Jason L. Baer
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General Immunology and Microbiology ,General Chemical Engineering ,General Neuroscience ,General Biochemistry, Genetics and Molecular Biology - Published
- 2023
6. Case Report: Rotational Thromboelastometry in Taipan Envenomation
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Catherine Tacon, Azhar Mohamed Munas, and Mark Little
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biology ,Snake envenomation ,business.industry ,Case Report ,Consumption Coagulopathy ,biology.organism_classification ,Clot formation ,Taipan ,Thromboelastometry ,Infectious Diseases ,Virology ,Anesthesia ,Medicine ,Parasitology ,Envenomation ,business - Abstract
Venom-induced consumption coagulopathy (VICC) is one of the most dangerous syndromes caused by snake envenomation and can be caused by several snake species worldwide, including the Australian coastal taipan. Rotational thromboelastometry (ROTEM) provides real-time point-of-care information on all stages of clot formation; however, it has yet to be formally evaluated in the assessment of VICC. We report three cases of Taipan envenomation causing VICC and the associated ROTEM results. The implications for future use of ROTEM in the assessment, management, and further research of VICC are discussed.
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- 2022
7. Is D-dimer the new test for venom-induced consumption coagulopathy after snakebite?
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Mark Little
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Fibrin Fibrinogen Degradation Products ,Antivenins ,Venoms ,Humans ,Snake Bites ,General Medicine ,Disseminated Intravascular Coagulation - Published
- 2022
8. Risk Stratification to Predict Renal Survival in Anti-GBM Disease
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Lauren, Floyd, Sebastian, Bate, Abdul, Kafagi, Nina, Brown, Jennifer, Scott, Mukunthan, Srikantharajah, Marek, Mysilvecek, Graeme, Reid, Faten, Aqeel, Doubravka, Frausova, Marek, Kollar, Phuong Le, Kieu, Bilal, Khurshid, Ajay, Dhaygude, Vladimir, Tesar, Stephen, McAdoo, Mark, Little, Duvuru, Geetha, and Silke, Brix
- Abstract
Anti-glomerular basement membrane (GBM) disease is a rare, aggressive vasculitis with no validated prediction tools to assist its management. We investigated a retrospective multicenter international cohort with the aim to transfer the Renal Risk Score (RRS) and to identify patients that benefit from rescue immunosuppressive therapy. Of a total 191 patients, 174 patients were included in the final analysis (57% female, median age 59 years). Using Cox and Kaplan-Meier methods, the RRS was found to be a strong and effective predictor for end stage kidney disease (ESKD) with a model concordance of C=0.760. The 36-month renal survival was 100%, 62.4%, and 20.7% in the low-, moderate-, and high-risk groups, respectively (P0.001). The need for renal replacement therapy (RRT) at diagnosis and the percentage of normal glomeruli in the biopsy were independent predictors of ESKD (P0.001, P0.001). Considering the 129 patients initially requiring RRT, the best predictor for renal recovery was the percentage of normal glomeruli (C=0.622; P0.001), a split either side of 10% providing good stratification. A model with the predictors RRT and normal glomeruli (N) achieved superior discrimination (C=0.840, P0.001). Dividing patients into four risk groups led to a 36-month renal survival of 96.4% (no RRT, N≥10%), 74.0% (no RRT, N10%), 42.3% (RRT, N≥10%) and 14.1% (RRT, N10%), respectively. In summary, we demonstrate that the RRS concept is transferrable to anti-GBM disease. Stratifying patients according to the need for RRT at diagnosis and renal histology improves prediction, highlighting the importance of normal glomeruli. Here, we propose a stratification to assist in the management of anti-GBM disease.
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- 2022
9. MO214: Health-Related Quality of Life Among Patients With Anca Vasculitis
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Eithne Nic an Riogh, Eoin Gogarty, Brian Reedy, Alyssa Verrelli, Elhussein Elhassan, Jennifer Scott, Arthur White, and Mark Little
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Transplantation ,Nephrology - Abstract
BACKGROUND AND AIMS Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a debilitating disease that can have a significant impact on a patient's quality of life. The aim of this study was to assess the longitudinal quality of life amongst those diagnosed with AAV using the EQ-5D instrument, which allows for calculation of quality-adjusted life years (QALYs.) METHOD A total of 343 patients with AAV participated in this study, of which 191 (55.7%) were male, resulting in 2746 episodes. The EQ-5D-5L standardised instrument was used to evaluate health-related quality of life in the domains of mobility, self-care, usual activities, pain/discomfort, anxiety/depression and to generate a summary index score. Overall health was also rated using a visual analogue scale (0–100). EQ-5D questionnaires were completed during routine nephrology clinic attendances and through a vasculitis patient support smartphone app. We used a random effects model to control for multiple entries relating to individual patients. RESULTS A lower quality of life was seen amongst those with AAV (median index value 0.80, overall population average 0.856). The mean visual analogue scale score was 75.6 ± 17.3 (overall population average 82.8, Fig. 1). Patients’ pain and discomfort level (mean 1.95) was most affected while self-care (mean 1.33) was least affected (Fig. 1). An increase in BVAS tightly correlated with a reduction in quality of life. Using the random effects model, the index score was seen to decrease with increasing age with a 2.7% reduction in index score per decade. A 7% reduction in index score was seen during periods of disease activity compared with periods of remission. Patients with end-stage kidney disease requiring dialysis had an 8% reduction in index score. A reduced quality of life was seen following COVID-19 lockdown with a 5% reduction in index score seen. Using a median survival rate of 6.16 years for patients with small vessel vasculitis, we calculated the QALYs for this population as 4.9 years. CONCLUSION We have defined for the first time the EQ-5D index value over the full disease course in patients with AAV. Notably, we have identified a reduction in quality of life during periods of disease activity. Other studies have demonstrated a reduction in quality of life during active disease using the AAV–PRO questionnaire and the Medical Outcomes Study Short Form-36. A decrease in work productivity has also been noted. Previously reported mean index values of 0.72 and 0.76 were lower than our observed values, although both are significantly reduced compared with population norms. In conclusion, this research highlights the negative impact of AAV on patients’ lives.
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- 2022
10. Oro-Naso-Sino-Orbital-Cutaneous Fistula From Prolonged Cocaine Use
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Boyle S, Hussain M, Kirby C, Brennan S, Clarke L, Mullan R, Halpenny D, Conlon N, Mark Little, Bj, Conlon, and Abdulrahman S
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Male ,Cocaine-Related Disorders ,Cocaine ,Cutaneous Fistula ,Humans ,Autoimmunity ,Middle Aged - Abstract
Presentation We present the case of a 48-year-old man with nasal cellulitis and subsequent oro-naso-sino-orbital-cutaneous fistula from prolonged cocaine use. Diagnosis Initial laboratory investigations reported a raised white cell count (WBC) and C-Reactive Protein (CRP) and subsequently a positive atypical anti-neutrophil cytoplasm antibodies (ANCA) and positive anti-proteinase (PR3). Perihilar lung nodularity on chest imaging raised the possibility of a systemic autoimmune response. His urinalysis was positive for cocaine. Treatment He was commenced on Augmentin, Amphotericin B and Prednisolone. An obturator was created to manage the oro-nasal fistula. A subsequent naso-cutaneous defect was re-approximated. Daily nasal saline douche and abstinence of cocaine were recommended. Discussion Cocaine use in the community is rising and poses a challenge to multiple facets of our health care system.
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- 2022
11. Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis
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Archie Speirs, P. Yoong, Mark Little, C. McLaren, E. Tayton, S. MacGill, N. Davies, Richard Harrison, S. Tavares, James Briggs, T. Ariyanayagam, and Matthew Gibson
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Male ,medicine.medical_specialty ,Genicular artery ,Knee Joint ,Visual analogue scale ,medicine.medical_treatment ,Pilot Projects ,Osteoarthritis ,030218 nuclear medicine & medical imaging ,Embolization ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Knee ,Radiology, Nuclear Medicine and imaging ,Clinical Investigation ,Prospective Studies ,Adverse effect ,Aged ,Genicular ,Aged, 80 and over ,030222 orthopedics ,Groin ,medicine.diagnostic_test ,business.industry ,Correction ,Magnetic resonance imaging ,Arteries ,Middle Aged ,Osteoarthritis, Knee ,Interim analysis ,medicine.disease ,Embolization, Therapeutic ,Magnetic Resonance Imaging ,Microspheres ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Purpose Planned interim analysis of GENESIS; a prospective pilot study investigating the role of genicular artery embolization (GAE) in patients with mild to moderate osteoarthritis of the knee using permanent microspheres. Methods Thirty-eight patients, median age = 60 (45–83), attended for GAE using 100–300 μm permanent microspheres. All patients had mild to moderate knee OA, resistant to conservative treatments over 6 months. Knee MRI was performed at baseline, and 12 months, enabling semi-quantitative analysis using Whole-Organ Magnetic Resonance Imaging Score (WORMS). Knee Injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS) (0–100 mm) were completed at baseline, 6 weeks, 3 months (n = 32), and 1-year (n = 16). Adverse events were recorded prospectively. Results Technical success of accessing and embolizing the target genicular arteries was 84%. Six patients were not embolized: four due to a presumed risk of non-target embolization, and two due to a lack of hyperaemic target. Mean VAS improved from 60 (SD = 20, 95% CI 53–66) at baseline to 36 (SD = 24, 95% CI 28–44) at 3 months (p p p = 0.06) at 1-year. Four patients experienced mild self-limiting skin discoloration over the embolized territory. One patient experienced a small self-limiting groin haematoma. WORMS scores at 1-year follow-up showed significant improvement in synovitis (p Conclusion GAE using permanent microspheres in patients with mild to moderate knee OA is safe, with potential efficacy at early follow-up.
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- 2021
12. A hard‐won success – but the work continues
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Mark Little
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General Veterinary ,General Medicine - Published
- 2023
13. Approach to Handling Atypical Field Blood Transfusion Scenarios
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Richard Neading, Tyler Scarborough, Michael O'Connell, John Leasiolagi, Mark Little, John Burgess, Maxwell Hargrove, Amelia Goodfellow, Christopher Scheiber, Andrew P Cap, and Mark H Yazer
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General Medicine - Published
- 2023
14. Musculoskeletal Embolotherapy: Past, Present, and Future
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Mark Little
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Arteriovenous Malformations ,medicine.medical_specialty ,business.industry ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Cardiology and Cardiovascular Medicine ,business ,Embolization, Therapeutic - Published
- 2021
15. The STREAM Trial (Prostatic Artery Embolization for the Treatment of Benign Prostatic Hyperplasia) 24-Month Clinical and Radiological Outcomes
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Daniel J Kearns, Mark Little, Phil Boardman, Tina Mackinnon, Jeremy Crew, Ruth MacPherson, Charles R Tapping, and Andrew Macdonald
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Male ,medicine.medical_specialty ,animal structures ,Prostatic Hyperplasia ,Urology ,urologic and male genital diseases ,030218 nuclear medicine & medical imaging ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Refractory ,Prostate ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Ultrasound ,Arteries ,Middle Aged ,Hyperplasia ,medicine.disease ,Embolization, Therapeutic ,Magnetic Resonance Imaging ,Prostatic artery embolization ,Treatment Outcome ,medicine.anatomical_structure ,Radiological weapon ,Quality of Life ,Cardiology and Cardiovascular Medicine ,business - Abstract
To establish factors predictive of success prior to Prostate Artery Embolization (PAE) with MRI imaging. A prospective cohort study of 50 patients with Benign Prostatic Hyperplasia (BPH) were treated with PAE in a single institution. Patients had moderate to severe symptoms of BPH refractory to medical management for at least 6 months. Patients were imaged with multiparametric MRI imaging pre-PAE and at 3 months, 12 months and 24 months post-PAE. Clinical success was measured with IPSS, IIEF and EQ-5D-5L quality of life questionnaires. The technical success was 48/50 (96%).The mean age of the group was 67 (range 54–83). The mean IPSS score pre-PAE was 21 and at 24 months was 8 (p
- Published
- 2020
16. Non-invasive assessment of the cardiac effects of Chironex fleckeri and Carukia barnesi venoms in mice, using pulse wave doppler
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Silvia L. Saggiomo, Peter Pereira, Willis Lam, Jamie Seymour, and Mark Little
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Cardiac function curve ,Chronotropic ,medicine.medical_specialty ,Cardiomyopathy ,Diastole ,Toxicology ,Mice ,Cnidarian Venoms ,Internal medicine ,Heart rate ,medicine ,Animals ,Myocytes, Cardiac ,Heart Failure ,biology ,business.industry ,medicine.disease ,Carukia barnesi ,biology.organism_classification ,medicine.anatomical_structure ,Ventricle ,Heart failure ,Cubozoa ,cardiovascular system ,Cardiology ,business - Abstract
Both Chironex fleckeri venom (CFV) and Carukia barnesi venoms (CBV) are known to cause significant cardiac morbidity and mortality. Many animal studies have demonstrated cardiac dysfunction with these venoms. This study specifically examines the systolic and diastolic cardiac functions using non-invasive pulse wave doppler. Mitral and aortic doppler sonograms of anaesthetised mice were obtained utilising a 10 MHz doppler probe. These continuous sonograms were analysed to ascertain changes in cardiac function before and after the parenteral administration of the test venoms. We found that CFV administration causes rapid cardiac dysfunction without a change in heart rate. Analysis of the resulting sonograms shows both systolic and diastolic dysfunction which together is suggestive of a progressively poorly compliant, contracted left ventricle. Additionally, the rapidity of cardiac dysfunction suggests a direct effect of CFV on myocardial cells. In contrast CBV showed a moderate immediate inotropic and chronotropic effect that was sustained until precipitous cardiac decompensation. This is consistent with the hypotheses of a toxin induced stress cardiomyopathy from sustained catecholaminergic activity.
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- 2020
17. Study protocol for the St James's Hospital, Tallaght University Hospital, Trinity College Dublin Allied Researchers' (STTAR) Bioresource for COVID-19
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Laura O'Doherty, Stuart Hendricken Phelan, Nicole Wood, Sorcha O'Brien, Jacklyn Sui, Cian Mangan, Fergal Howley, Siobhan O'Regan, Noor Adeebah Mohamed Razif, Ciara Conlan, Ruth Argue, Samuel Holohan, Adam Dyer, Fara Salleh, Liam Townsend, Gerard Hughes, Colm Kerr, Derval Reidy, Alberto Sanz, Emma Connolly, Andrea Kelly, Emma Leacy, Conor Reddy, Siobhan Gargan, Eamon Breen, Heike Hawerkamp, Jean Dunne, Ignacio Martin-Loeches, Anne Marie McLaughlin, Aideen Long, Orla Shiels, Padraic Fallon, Martina Hennessy, Roman Romero-Ortuno, Ciaran Bannan, Anna Rose Prior, Ana Rakovac, William McCormack, Ross McManus, Seamus Donnelly, Colm Bergin, Mark Little, Clíona Ní Cheallaigh, and Niall Conlon
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General Medicine - Abstract
Background: The current coronavirus disease 2019 (COVID-19) pandemic began in Ireland with the first confirmed positive case in March 2020. In the early stages of the pandemic clinicians and researchers in two affiliated Dublin hospitals identified the need for a COVID-19 biobanking initiative to support and enhance research into the disease. Through large scale analysis of clinical, regional, and genetic characteristics of COVID-19 patients, biobanks have helped identify, and so protect, at risk patient groups The STTAR Bioresource has been created to collect and store data and linked biological samples from patients with SARS-CoV-2 infection and healthy and disease controls. Aim: The primary objective of this study is to build a biobank, to understand the clinical characteristics and natural history of COVID-19 infection with the long-term goal of research into improved disease understanding, diagnostic tests and treatments. Methods: This is a prospective dual-site cohort study across two tertiary acute university teaching hospitals. Patients are recruited from inpatient wards or outpatient clinics. Patients with confirmed COVID-19 infection as well as healthy and specific disease control groups are recruited. Biological samples are collected and a case report form detailing demographic and medical background is entered into the bespoke secure online Dendrite database. Impact: The results of this study will be used to inform national and international strategy on health service provision and disease management related to COVID-19. In common with other biobanks, study end points evolve over time as new research questions emerge. They currently include patient survival, occurrence of severe complications of the disease or its therapy, occurrence of persistent symptoms following recovery from the acute illness and vaccine responses.
- Published
- 2022
18. Electronic intravenous N‐acetyl cysteine ordering tool: A retrospective review
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Mark Little and Angela Jackson
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Discharge diagnosis ,Retrospective review ,Acetyl cysteine ,business.industry ,030208 emergency & critical care medicine ,Paracetamol overdose ,Acetylcysteine ,Acetaminophen ,03 medical and health sciences ,0302 clinical medicine ,Anesthesia ,Chart review ,Emergency Medicine ,Humans ,Medicine ,030212 general & internal medicine ,Drug Overdose ,Electronics ,Medical prescription ,business ,Retrospective Studies ,medicine.drug - Abstract
Objectives To examine if the electronic N-acetyl cysteine (NAC) order reduced prescribing errors. Methods This was a retrospective chart review of all patients presenting over 2 years to Cairns Hospital ED with a discharge diagnosis of 'paracetamol overdose'. Data were collected for any patient who received i.v. NAC. Any error, and a description of the error such as dose, volume of fluid, time of infusion and incorrect patient weight was recorded. Results There were 172 presentations with paracetamol poisoning with 86 receiving i.v. NAC. In the 75 (87%) where the electronic NAC order was used, there were no errors in dose of NAC, volume of i.v. fluid and length of time of infusion. In the 11 presentations where the manual NAC order was used, there were multiple errors identified. Conclusion The use of this electronic NAC order removed errors in NAC prescription and should be considered for prescribing and administering i.v. NAC.
- Published
- 2019
19. Case of small eyed snake envenoming
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Ruth Young and Mark Little
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Emergency Medicine - Published
- 2022
20. FAIRVASC: A semantic web approach to rare disease registry integration
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Karl Gisslander, Mark Little, Lucy Hederman, Declan O'Sullivan, Kris McGlinn, and Matthew Rutherford
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Vasculitis ,Rare Diseases ,Humans ,Systematized Nomenclature of Medicine ,Health Informatics ,Registries ,Computer Science Applications ,Semantic Web - Abstract
Rare disease data is often fragmented within multiple heterogeneous siloed regional disease registries, each containing a small number of cases. These data are particularly sensitive, as low subject counts make the identification of patients more likely, meaning registries are not inclined to share subject level data outside their registries. At the same time access to multiple rare disease datasets is important as it will lead to new research opportunities and analysis over larger cohorts. To enable this, two major challenges must therefore be overcome. The first is to integrate data at a semantic level, so that it is possible to query over registries and return results which are comparable. The second is to enable queries which do not take subject level data from the registries. To meet the first challenge, this paper presents the FAIRVASC ontology to manage data related to the rare disease anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV), which is based on the harmonisation of terms in seven European data registries. It has been built upon a set of key clinical questions developed by a team of experts in vasculitis selected from the registry sites and makes use of several standard classifications, such as Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) and Orphacode. It also presents the method for adding semantic meaning to AAV data across the registries using the declarative Relational to Resource Description Framework Mapping Language (R2RML). To meet the second challenge a federated querying approach is presented for accessing aggregated and pseudonymized data, and which supports analysis of AAV data in a manner which protects patient privacy. For additional security the federated querying approach is augmented with a method for auditing queries (and the uplift process) using the provenance ontology (PROV-O) to track when queries and changes occur and by whom. The main contribution of this work is the successful application of semantic web technologies and federated queries to provide a novel infrastructure that can readily incorporate additional registries, thus providing access to harmonised data relating to unprecedented numbers of patients with rare disease, while also meeting data privacy and security concerns.
- Published
- 2021
21. Cadaveric and Angiographic Anatomical Considerations in the Genicular Arterial System: Implications for Genicular Artery Embolisation in Patients with Knee Osteoarthritis
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James Briggs, Aiden O’Grady, Matthew Gibson, Luke Welsh, Archie Speirs, and Mark Little
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medicine.medical_specialty ,Genicular artery ,Inferior lateral genicular artery ,medicine.diagnostic_test ,Descending genicular artery ,Knee Joint ,business.industry ,Angiography ,Anastomosis ,Osteoarthritis, Knee ,Surgery ,medicine.anatomical_structure ,Lower Extremity ,medicine.artery ,medicine ,Cadaver ,Humans ,Radiology, Nuclear Medicine and imaging ,Popliteal Artery ,Middle genicular artery ,Cardiology and Cardiovascular Medicine ,Tibial nerve ,business ,Sural arteries - Abstract
PURPOSE Genicular artery embolisation (GAE) is a novel treatment for patients with knee osteoarthritis (OA). Cadaveric dissection was undertaken to provide a complete description of the relevant arterial anatomy in order to perform safe and effective GAE. MATERIALS Twenty human lower limb specimens were dissected. The morphology of the genicular arteries and presence of anastomotic connections was recorded and compared with angiographic images from patients having undergone GAE. Vessels were measured to investigate the risk of non-target embolisation (NTE), taking a diameter of 300 microns as the threshold for significance. RESULTS The descending genicular artery (DGA) is the dominant vessel in medial OA, with 95% of cases revealing vessel division into muscular, saphenous and osteoarticular branches from a single pedicle. The superior medial genicular artery (SMGA) had a shared origin with the middle genicular artery (MGA) in 25% of cases. NTE to the MGA may damage the cruciate ligaments. In 85% of cases, there was an anastomosis between the DGA and SMGA, often encountered at angiography. The mean diameter of the anastomoses was 850 micron, presenting a risk for NTE. An anastomosis between the Inferior Medial Genicular Artery (IMGA) and medial sural artery was found in 5% of cases; the medial sural artery supplies blood to the tibial nerve and should be avoided. The IMGA and inferior lateral genicular artery provided supply to the patellofemoral joint in 69% and 88% of cases, respectively. CONCLUSION An in-depth knowledge of genicular artery anatomy is required for interventional radiologists to perform safe and effective GAE in patients with knee osteoarthritis.
- Published
- 2021
22. Pain-free day surgery? Evaluating pain and pain assessment during hysteroscopy
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Richard Harrison, Atul Kapila, Deepak Ravindran, Carien M. van Reekum, Mark Little, William Kuteesa, Tim V. Salomons, and Wiebke Gandhi
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Adult ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Hysteroscopy ,Pain free ,Middle Aged ,Surgery ,Anesthesiology and Pain Medicine ,Ambulatory Surgical Procedures ,Pain assessment ,medicine ,Humans ,Female ,Day case surgery ,business ,Aged ,Pain Measurement - Published
- 2020
23. Response to ‘Further information about the latest study of UK nuclear test veterans’ by Susie Boniface (2022 J. Radiol. Prot. 42 024505)
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Mark Little and Gerald Kendall
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Public Health, Environmental and Occupational Health ,General Medicine ,Waste Management and Disposal - Published
- 2022
24. Swabbing the Urban Environment - A Pipeline for Sampling and Detection of SARS-CoV-2 From Environmental Reservoirs
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Isabella Livingston, Brandie White, Jason Baer, Ana G Cobián-Güemes, Rafael Baron, Maria Isabel Rojas, Steven S. Giles, Taylor R. T. Dagenais, Mark Little, and Forest Rohwer
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Aerosols ,General Immunology and Microbiology ,business.industry ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,General Chemical Engineering ,General Neuroscience ,Environmental resource management ,Sampling (statistics) ,Sample (statistics) ,Pipeline (software) ,General Biochemistry, Genetics and Molecular Biology ,Specimen Handling ,Disinfection ,Workflow ,Pandemic ,Citizen science ,Global health ,Environmental Microbiology ,Humans ,business - Abstract
To control community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the 2020 global pandemic, most countries implemented strategies based on direct human testing, face covering, and surface disinfection. Under the assumption that the main route of transmission includes aerosols and respiratory droplets, efforts to detect SARS-CoV-2 in fomites have focused on locations suspected of high prevalence (e.g., hospital wards, cruise ships, and mass transportation systems). To investigate the presence of SARS-CoV-2 on surfaces in the urban environment that are rarely cleaned and seldomly disinfected, 350 citizens were enlisted from the greater San Diego County. In total, these citizen scientists collected 4,080 samples. An online platform was developed to monitor sampling kit delivery and pickup, as well as to collect sample data. The sampling kits were mostly built from supplies available in pandemic-stressed stores. Samples were processed using reagents that were easy to access despite the recurrent supply shortage. The methods used were highly sensitive and resistant to inhibitors that are commonly present in environmental samples. The proposed experimental design and processing methods were successful at engaging numerous citizen scientists who effectively gathered samples from diverse surface areas. The workflow and methods described here are relevant to survey the urban environment for other viruses, which are of public health concern and pose a threat for future pandemics.
- Published
- 2021
25. Polaron spin dynamics in high-mobility polymeric semiconductors
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Uday Chopra, Cameron Jellett, Sam Schott, David Beljonne, Vincent Lemaur, Anton Melnyk, Mark Little, Christopher R. McNeill, Remington Carey, Xuechen Jiao, Henning Sirringhaus, Igor Romanov, Riccardo Di Pietro, Denis Andrienko, Jairo Sinova, Yoan Olivier, Erik R. McNellis, Adam Marks, and Iain McCulloch
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Physics ,Spintronics ,business.industry ,Relaxation (NMR) ,General Physics and Astronomy ,Polaron ,01 natural sciences ,010305 fluids & plasmas ,Semiconductor ,Chemical physics ,0103 physical sciences ,Spin diffusion ,Condensed Matter::Strongly Correlated Electrons ,010306 general physics ,Wave function ,business ,Hyperfine structure ,Spin-½ - Abstract
Polymeric semiconductors exhibit exceptionally long spin lifetimes, and recently observed micrometre spin diffusion lengths in conjugated polymers demonstrate the potential for organic spintronics devices. Weak spin–orbit and hyperfine interactions lie at the origin of their long spin lifetimes, but the coupling mechanism of a spin to its environment remains elusive. Here, we present a systematic study of polaron spin lifetimes in field-effect transistors with high-mobility conjugated polymers as an active layer. We demonstrate how spin relaxation is governed by the charges’ hopping motion at low temperatures, whereas an Elliott–Yafet-like relaxation due to a transient localization of the carrier wavefunctions is responsible for spin relaxation at high temperatures. In this regime, charge, spin and structural dynamics are intimately related and depend sensitively on the local conformation of polymer backbones and the crystalline packing of the polymer chains. The long spin lifetimes observed in polymeric semiconductors hold promise for potential applications. A careful study untangles the main mechanism behind them.
- Published
- 2019
26. The impact of the introduction of a toxicology service on the intensive care unit
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Angus Carter, Mark Little, Susan P. Jacups, Yu-Hsuan Liu, Ian Humble, Nick Trott, and Shaun Parish
- Subjects
Adult ,Male ,Clinical toxicology ,Toxicology ,Patient Readmission ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Intensive care ,Health care ,Humans ,Medicine ,Hospital Mortality ,030212 general & internal medicine ,APACHE ,Aged ,Retrospective Studies ,Service (business) ,Medical treatment ,business.industry ,Poisoning ,030208 emergency & critical care medicine ,General Medicine ,Length of Stay ,Middle Aged ,Respiration, Artificial ,Intensive care unit ,humanities ,body regions ,Intensive Care Units ,Female ,Chart audit ,Queensland ,Drug Overdose ,business - Abstract
Objective: To examine the impact of a clinical toxicology service on toxicology patients admitted to an intensive care departmentMethods: The authors performed a retrospective chart audit of all pa...
- Published
- 2019
27. The new study of UK nuclear test veterans
- Author
-
Mark Little and Gerald Kendall
- Subjects
Leukemia, Radiation-Induced ,Public Health, Environmental and Occupational Health ,Humans ,General Medicine ,Waste Management and Disposal ,United Kingdom ,Nuclear Warfare ,Veterans - Published
- 2022
28. Inpatient toxicology services improve resource utilization for intoxicated patients: a systematic review
- Author
-
Robert G. Legg and Mark Little
- Subjects
Poison Control Centers ,Target population ,Cochrane Library ,Clinical toxicology ,030226 pharmacology & pharmacy ,Toxicology ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,Humans ,Medicine ,Pharmacology (medical) ,Hospital Mortality ,030212 general & internal medicine ,Service efficiency ,Health policy ,Pharmacology ,Health economics ,Systematic Review and Meta‐analysis ,business.industry ,Poisoning ,Length of Stay ,business ,Delivery of Health Care ,Equipment and Supplies Utilization ,Resource utilization - Abstract
Aims Presentations of intoxicated patients to hospital are frequent and increasing. We aimed to review the existing evidence that the presence of inpatient clinical toxicology services reduces use of resources without impacting on the care of these patients. Methods We conducted a literature search using the Cochrane Library, PubMed, and Embase for articles that measured length of stay (and other outcomes) for the target population, with toxicology services as an intervention. The articles were reviewed with respect to the ROBINS-I tool. Results Seven relevant articles were identified. Six of these studies demonstrated reduced hospital length of stay for intoxicated patients in hospitals with inpatient toxicology services. None of the articles demonstrated a detriment in morbidity or mortality. There were also improvements in other resource-related outcomes. Conclusions The presence of inpatient toxicology services appears to improve resource utilization, in reduction of length of stay, as well as a number of other related outcomes. It does this without compromising on patient morbidity or mortality. Thus, it should be considered as a potential model of care for future toxicology services, especially with current trends of increasing demand for service efficiency.
- Published
- 2018
29. Crystal Engineering of Dibenzothiophenothieno[3,2-b]thiophene (DBTTT) Isomers for Organic Field-Effect Transistors
- Author
-
Andrew J. P. White, Jean-Luc Brédas, Samuel J. Cryer, Guillaume Schweicher, Cameron Jellett, Hung-Yang Chen, Henning Sirringhaus, Sean M. Ryno, Katharina Broch, Iain McCulloch, Mark Little, Dimitrios Simatos, Michael Hurhangee, Adam Marks, and Miquel Planells
- Subjects
chemistry.chemical_classification ,Materials science ,General Chemical Engineering ,Benzothiophene ,02 engineering and technology ,General Chemistry ,010402 general chemistry ,021001 nanoscience & nanotechnology ,Crystal engineering ,01 natural sciences ,Medicinal chemistry ,3. Good health ,0104 chemical sciences ,chemistry.chemical_compound ,chemistry ,Materials Chemistry ,Thiophene ,Field-effect transistor ,0210 nano-technology ,Isomerization ,Alkyl - Abstract
Three thiophene ring-terminated benzothieno[3,2-b]benzothiophene (BTBT) derivatives, C-C6-DBTTT, C-C12-DBTTT, and L-C12-DBTTT, were designed and synthesized, differing in the isomerization of alkyl...
- Published
- 2018
30. Differences in Cardiac Effects of Venoms from Tentacles and the Bell of Live
- Author
-
Mark, Little, Peter, Pereira, and Jamie, Seymour
- Subjects
Mice, Inbred BALB C ,Heart Diseases ,Carukia barnesi ,Doppler ,venom ,Article ,tentacle ,Mice ,Cnidarian Venoms ,Cubozoa ,Animals ,Humans ,Female ,Irukandji ,Bites and Stings - Abstract
Carukia barnesi was the first in an expanding list of cubozoan jellyfish whose sting was identified as causing Irukandji syndrome. Nematocysts present on both the bell and tentacles are known to produce localised stings, though their individual roles in Irukandji syndrome have remained speculative. This research examines differences through venom profiling and pulse wave Doppler in a murine model. The latter demonstrates marked measurable differences in cardiac parameters. The venom from tentacles (CBVt) resulted in cardiac decompensation and death in all mice at a mean of 40 min (95% CL: ± 11 min), whereas the venom from the bell (CBVb) did not produce any cardiac dysfunction nor death in mice at 60 min post-exposure. This difference is pronounced, and we propose that bell exposure is unlikely to be causative in severe Irukandji syndrome. To date, all previously published cubozoan venom research utilised parenterally administered venom in their animal models, with many acknowledging their questionable applicability to real-world envenomation. Our model used live cubozoans on anaesthetised mice to simulate normal envenomation mechanics and actual expressed venoms. Consequently, we provide validity to the parenteral methodology used by previous cubozoan venom research.
- Published
- 2020
31. Bacteriophage can drive virulence in marine pathogens
- Author
-
Forest Rohwer, Maria Isabel Rojas, and Mark Little
- Subjects
Bacteriophage ,Virulence ,Biology ,biology.organism_classification ,Microbiology - Abstract
The roles of prophages in disease have mainly considered human pathogens, while their role in marine pathogens has only recently been considered. This chapter reviews the relevant literature on what is known of prophages in marine ecosystems and provides a meta-analysis of the abundance and function of prophages in marine pathogenic bacteria. According to these results, bacterial pathogens in marine environments contain a significantly higher abundance of prophage DNA in their genomes than host-associated bacteria, which are non-pathogenic. The authors also surveyed the genetic content of the prophages that were associated with known pathogens and compared their functions to non-pathogens. Their findings suggest that horizontally acquired prophage-encoded DNA may play a large role in the ecology and evolution of marine diseases
- Published
- 2020
32. A case of acute hypogonadism following taipan (Oxyuranus scutellatus) envenomation
- Author
-
Ebonney Van Der Meer, Mark Little, Josh Hanson, and Luke Conway
- Subjects
0106 biological sciences ,Adult ,Male ,endocrine system ,Anemia, Hemolytic ,Thrombotic microangiopathy ,Physiology ,Snake Bites ,Venom-induced consumption coagulopathy ,urologic and male genital diseases ,Toxicology ,01 natural sciences ,03 medical and health sciences ,Oxyuranus scutellatus ,Follicle-stimulating hormone ,Ischemia ,hemic and lymphatic diseases ,Testis ,medicine ,Animals ,Humans ,Elapidae ,Envenomation ,Elapid Venoms ,0303 health sciences ,Testicular atrophy ,biology ,urogenital system ,business.industry ,010604 marine biology & hydrobiology ,Hypogonadism ,030302 biochemistry & molecular biology ,Acute kidney injury ,medicine.disease ,biology.organism_classification ,Thrombocytopenia ,Taipan ,business - Abstract
A previously well man developed acute, marked tender bilateral gynaecomastia two months after confirmed taipan (Oxyuranus scutellatus) envenomation. He had had laboratory evidence of thrombotic microangiopathy (TMA) including microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Scrotal ultrasound revealed bilateral testicular atrophy, his serum testosterone was repeatedly low, while his luteinising and follicle stimulating hormone were elevated. It is hypothesised that TMA-related testicular ischaemia was responsible for his primary gonadal failure and dramatic clinical presentation.
- Published
- 2020
33. Carborane‐Induced Excimer Emission of Severely Twisted Bis‐ o ‐Carboranyl Chrysene
- Author
-
Andrew J. P. White, Matthew J. Dyson, Adam V. Marsh, Martin Heeney, Mark Little, Colin N. Warriner, Paul N. Stavrinou, Nathan J. Cheetham, Anthony C. Swain, Peter Beavis, Engineering and Physical Sciences Research Council, EPSRC, and Molecular Materials and Nanosystems
- Subjects
Chrysene ,carboranes ,aggregation-induced emission ,Photoluminescence ,Materials science ,Ab initio ,010402 general chemistry ,Photochemistry ,Excimer ,01 natural sciences ,Catalysis ,chemistry.chemical_compound ,Molecule ,Singlet state ,Aggregation‐Induced Emission ,Excimers ,010405 organic chemistry ,Communication ,Organic Chemistry ,General Medicine ,General Chemistry ,Communications ,0104 chemical sciences ,chemistry ,Excited state ,Carborane ,Intramolecular charge transfer ,03 Chemical Sciences - Abstract
The synthesis of a highly twisted chrysene derivative incorporating two electron deficient o‐carboranyl groups is reported. The molecule exhibits a complex, excitation‐dependent photoluminescence, including aggregation‐induced emission (AIE) with good quantum efficiency and an exceptionally long singlet excited state lifetime. Through a combination of detailed optical studies and theoretical calculations, the excited state species are identified, including an unusual excimer induced by the presence of o‐carborane. This is the first time that o‐carborane has been shown to induce excimer formation ab initio, as well as the first observation of excimer emission by a chrysene‐based small molecule in solution. Bis‐o‐carboranyl chrysene is thus an initial member of a new family of o‐carboranyl phenacenes exhibiting a novel architecture for highly‐efficient multi‐luminescent fluorophores.
- Published
- 2018
34. Synthesis and properties of isoindigo and benzo[1,2-b:4,5-b′]bis[b]benzothiophene oligomers
- Author
-
Zhaohui Wang, Zhengke Li, Iain McCulloch, Ada Onwubiko, Mahesh Kumar Ravva, Chengyi Xiao, Yazhou Wang, Hailiang Liao, Wan Yue, Mark Little, Jean-Luc Brédas, and Maud V. C. Jenart
- Subjects
Stereochemistry ,Chemistry ,Metals and Alloys ,Benzothiophene ,02 engineering and technology ,General Chemistry ,010402 general chemistry ,021001 nanoscience & nanotechnology ,01 natural sciences ,Catalysis ,0104 chemical sciences ,Surfaces, Coatings and Films ,Electronic, Optical and Magnetic Materials ,chemistry.chemical_compound ,Materials Chemistry ,Ceramics and Composites ,0210 nano-technology - Abstract
A well-defined series of long and soluble isoindigo thienoacene oligomers have been synthesized from a novel electron deficient building block: benzo[1,2-b:4,5-b']bis[b]benzothiophene bislactams. Extension of the π-conjugated systems facilitates control of the optical, electronic and device characteristics.
- Published
- 2018
35. Abstract No. 44 Factors predicting re-intervention after uterine fibroid embolization: a retrospective case control study
- Author
-
J. Briggs, Mark Little, A. Speirs, and T. Turlejski
- Subjects
medicine.medical_specialty ,Uterine fibroid embolization ,business.industry ,medicine ,Case-control study ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Re intervention ,Surgery - Published
- 2021
36. Biological chlorine cycling in the Arctic Coastal Plain
- Author
-
Robert Edwards, Theodore K. Raab, David A. Lipson, Mark Little, and Jaime Zlamal
- Subjects
010504 meteorology & atmospheric sciences ,Environmental Chemistry ,010501 environmental sciences ,01 natural sciences ,0105 earth and related environmental sciences ,Earth-Surface Processes ,Water Science and Technology - Published
- 2017
37. Highly Efficient and Reproducible Nonfullerene Solar Cells from Hydrocarbon Solvents
- Author
-
Sebastian Pont, James R. Durrant, Andrew Wadsworth, Iain McCulloch, Maged Abdelsamie, Maximilian Moser, Mark Little, Derya Baran, Raja Shahid Ashraf, Weimin Zhang, Zeinab Hamid, Aram Amassian, Marios Neophytou, Commission of the European Communities, and Engineering and Physical Sciences Research Council
- Subjects
Technology ,02 engineering and technology ,01 natural sciences ,7. Clean energy ,chemistry.chemical_compound ,Electrochemistry ,Materials Chemistry ,Mesitylene ,chemistry.chemical_classification ,Chemistry, Physical ,Chemistry ,BANDGAP POLYMER ,GAP ,Polymer ,021001 nanoscience & nanotechnology ,Environmentally friendly ,Solvent ,Fuel Technology ,Hydrocarbon ,Chemistry (miscellaneous) ,Physical Sciences ,Engineering and Technology ,Science & Technology - Other Topics ,CAST ,Fullerenes ,0210 nano-technology ,CONJUGATED POLYMERS ,Solar cells ,Energy & Fuels ,Organic solar cell ,Materials Science ,Inorganic chemistry ,FABRICATION ,Energy Engineering and Power Technology ,Materials Science, Multidisciplinary ,010402 general chemistry ,ACCEPTOR ,Nanoscience & Nanotechnology ,Science & Technology ,ORGANIC PHOTOVOLTAICS ,STABILITY ,Renewable Energy, Sustainability and the Environment ,Mechanical Engineering ,Energy conversion efficiency ,Materials Engineering ,DEGRADATION ,0104 chemical sciences ,Chlorobenzene ,Organic photovoltaics ,MORPHOLOGY - Abstract
With chlorinated solvents unlikely to be permitted for use in solution-processed organic solar cells in industry, there must be a focus on developing nonchlorinated solvent systems. Here we report high-efficiency devices utilizing a low-bandgap donor polymer (PffBT4T-2DT) and a nonfullerene acceptor (EH-IDTBR) from hydrocarbon solvents and without using additives. When mesitylene was used as the solvent, rather than chlorobenzene, an improved power conversion efficiency (11.1%) was achieved without the need for pre- or post-treatments. Despite altering the processing conditions to environmentally friendly solvents and room-temperature coating, grazing incident X-ray measurements confirmed that active layers processed from hydrocarbon solvents retained the robust nanomorphology obtained with hot-processed chlorinated solvents. The main advantages of hydrocarbon solvent-processed devices, besides the improved efficiencies, were the reproducibility and storage lifetime of devices. Mesitylene devices showed better reproducibility and shelf life up to 4000 h with PCE dropping by only 8% of its initial value.
- Published
- 2017
38. Insights into the Scholl Coupling Reaction: A Key Transformation of Relevance to the Synthesis of Graphenes and Related Systems
- Author
-
Adam V. S. Parry, Mark Little, Alyn C. Edwards, James Raftery, Peter Quayle, Kane W. J. Heard, Aula A Alwattar, and Stephen G. Yeates
- Subjects
010405 organic chemistry ,Chemistry ,Organic Chemistry ,Key (cryptography) ,Relevance (information retrieval) ,Nanotechnology ,Physical and Theoretical Chemistry ,010402 general chemistry ,01 natural sciences ,Coupling reaction ,Transformation (music) ,0104 chemical sciences - Published
- 2017
39. Re: Review article: Let us talk about snakebite management: A discussion on many levels
- Author
-
Mark Little
- Subjects
medicine.medical_specialty ,business.industry ,Family medicine ,Emergency Medicine ,medicine ,MEDLINE ,Humans ,Snake Bites ,medicine.disease ,business ,Snake bites ,Review article - Published
- 2019
40. The Virome of Cerebrospinal Fluid: Viruses Where We Once Thought There Were None
- Author
-
Chandrabali Ghose, Melissa Ly, Leila K. Schwanemann, Ji Hyun Shin, Katayoon Atab, Jeremy J. Barr, Mark Little, Robert T. Schooley, Jessica Chopyk, and David T. Pride
- Subjects
Microbiology (medical) ,Saliva ,Environmental Science and Management ,lcsh:QR1-502 ,CSF ,Biology ,Breast milk ,Microbiology ,lcsh:Microbiology ,cerebrospinal fluid ,Virus ,03 medical and health sciences ,Clinical Research ,microbiota ,Human virome ,cerebral spinal fluid ,Feces ,Virus classification ,Original Research ,030304 developmental biology ,Body fluid ,virome ,0303 health sciences ,030306 microbiology ,Human microbiome ,human microbiome ,Infectious Diseases ,Good Health and Well Being ,Soil Sciences ,Infection ,virobiota ,body fluids - Abstract
Traditionally, medicine has held that some human body sites are sterile and that the introduction of microbes to these sites results in infections. This paradigm shifted significantly with the discovery of the human microbiome and acceptance of these commensal microbes living across the body. However, the central nervous system (CNS) is still believed by many to be sterile in healthy people. Using culture-independent methods, we examined the virome of cerebrospinal fluid (CSF) from a cohort of mostly healthy human subjects. We identified a community of DNA viruses, most of which were identified as bacteriophages. Compared to other human specimen types, CSF viromes were not ecologically distinct. There was a high alpha diversity cluster that included feces, saliva, and urine, and a low alpha diversity cluster that included CSF, body fluids, plasma, and breast milk. The high diversity cluster included specimens known to have many bacteria, while other specimens traditionally assumed to be sterile formed the low diversity cluster. There was an abundance of viruses shared among CSF, breast milk, plasma, and body fluids, while each generally shared less with urine, feces, and saliva. These shared viruses ranged across different virus families, indicating that similarities between these viromes represent more than just a single shared virus family. By identifying a virome in the CSF of mostly healthy individuals, it is now less likely that any human body site is devoid of microbes, which further highlights the need to decipher the role that viral communities may play in human health.
- Published
- 2019
41. Before platelets: the production of platelet-activating factor during growth and stress in a basal marine organism
- Author
-
Kevin Green, Louis-Félix Nothias, Steven D. Quistad, Forest Rohwer, Brandon Reyes, Dimitri D. Deheyn, Robert A. Quinn, Heather Maughan, Mark Little, Clifford A. Kapono, Ana Cobian, Pieter C. Dorrestein, Jennifer E. Smith, Matthieu Leray, Aaron C. Hartmann, and Ines Galtier d'Auriac
- Subjects
0301 basic medicine ,platelet-activating factor ,Ultraviolet Rays ,Coral ,Biology ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Basal (phylogenetics) ,chemistry.chemical_compound ,Biosynthesis ,Immunity ,Stress, Physiological ,Ultraviolet light ,Animals ,Platelet ,14. Life underwater ,Multiple Polyps ,Platelet Activating Factor ,phospholipids ,General Environmental Science ,General Immunology and Microbiology ,Platelet-activating factor ,Ecology ,fungi ,technology, industry, and agriculture ,General Medicine ,respiratory system ,Anthozoa ,metabolomics ,Cell biology ,Aggression ,Phospholipases A2 ,030104 developmental biology ,chemistry ,coral reef ecology ,lipids (amino acids, peptides, and proteins) ,General Agricultural and Biological Sciences ,geographic locations ,Research Article - Abstract
Corals and humans represent two extremely disparate metazoan lineages and are therefore useful for comparative evolutionary studies. Two lipid-based molecules that are central to human immunity, platelet-activating factor (PAF) and Lyso-PAF were recently identified in scleractinian corals. To identify processes in corals that involve these molecules, PAF and Lyso-PAF biosynthesis was quantified in conditions known to stimulate PAF production in mammals (tissue growth and exposure to elevated levels of ultraviolet light) and in conditions unique to corals (competing with neighbouring colonies over benthic space). Similar to observations in mammals, PAF production was higher in regions of active tissue growth and increased when corals were exposed to elevated levels of ultraviolet light. PAF production also increased when corals were attacked by the stinging cells of a neighbouring colony, though only the attacked coral exhibited an increase in PAF. This reaction was observed in adjacent areas of the colony, indicating that this response is coordinated across multiple polyps including those not directly subject to the stress. PAF and Lyso-PAF are involved in coral stress responses that are both shared with mammals and unique to the ecology of cnidarians.
- Published
- 2018
42. Critical review of the molecular design progress in non-fullerene electron acceptors towards commercially viable organic solar cells
- Author
-
Nicola Gasparini, Iain McCulloch, Andrew Wadsworth, Adam Marks, Maximilian Moser, Christoph J. Brabec, Mark Little, Derya Baran, Engineering and Physical Sciences Research Council, Engineering & Physical Science Research Council (E, and Commission of the European Communities
- Subjects
Materials science ,Fullerene ,Organic solar cell ,CROSS-LINKING ,Chemistry, Multidisciplinary ,EXCITON DIFFUSION ,Nanotechnology ,02 engineering and technology ,010402 general chemistry ,VERSATILE BUILDING-BLOCKS ,01 natural sciences ,HIGHLY EFFICIENT ,PHOTOVOLTAIC PERFORMANCE ,POWER CONVERSION EFFICIENCY ,Flexibility (engineering) ,chemistry.chemical_classification ,Science & Technology ,General Chemistry ,Electron acceptor ,021001 nanoscience & nanotechnology ,0104 chemical sciences ,Chemistry ,chemistry ,3D STRUCTURE ,HIGH-PERFORMANCE ,Physical Sciences ,MORPHOLOGY ,0210 nano-technology ,03 Chemical Sciences ,CONJUGATED POLYMERS - Abstract
Fullerenes have formed an integral part of high performance organic solar cells over the last 20 years, however their inherent limitations in terms of synthetic flexibility, cost and stability have acted as a motivation to develop replacements; the so-called non-fullerene electron acceptors. A rapid evolution of such materials has taken place over the last few years, yielding a number of promising candidates that can exceed the device performance of fullerenes and provide opportunities to improve upon the stability and processability of organic solar cells. In this review we explore the structure-property relationships of a library of non-fullerene acceptors, highlighting the important chemical modifications that have led to progress in the field and provide an outlook for future innovations in electron acceptors for use in organic photovoltaics.
- Published
- 2018
43. Comment on: A novel glucocorticoid-free maintenance regimen for anti-neutrophil cytoplasm antibody–associated vasculitis: reply
- Author
-
Ruth Pepper, David Jayne, Mark Little, Charles Pusey, Alan D Salama, Jayne, David [0000-0002-1712-0637], and Apollo - University of Cambridge Repository
- Subjects
Cytoplasm ,Science & Technology ,1103 Clinical Sciences ,Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ,1117 Public Health and Health Services ,Arthritis & Rheumatology ,Rheumatology ,1107 Immunology ,Humans ,Pharmacology (medical) ,RITUXIMAB ,Life Sciences & Biomedicine ,Cyclophosphamide ,Glucocorticoids - Published
- 2019
44. The role of intravascular ultrasound in lower limb revascularization in patients with peripheral arterial disease
- Author
-
Gregory C. Makris, Susan Anthony, Mark Little, Rafiuddin Patel, Raman Uberoi, Andrew Wigham, Pavlina Chrysafi, and Mark Bratby
- Subjects
medicine.medical_specialty ,Cost effectiveness ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Revascularization ,Amputation, Surgical ,030218 nuclear medicine & medical imaging ,Atherectomy ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,Angioplasty ,Intravascular ultrasound ,Humans ,Medicine ,cardiovascular diseases ,Ultrasonography, Interventional ,medicine.diagnostic_test ,business.industry ,Disease Management ,equipment and supplies ,Surgery ,Peripheral ,surgical procedures, operative ,Lower Extremity ,Amputation ,Angiography ,cardiovascular system ,Stents ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction The aim of this review is to explore the safety and effectiveness of intravascular ultrasound (IVUS) during lower limb endovascular interventions in patients with peripheral arterial disease (PAD). Evidence acquisition A systematic review of the PubMed and Scopus databases was performed according to PRISMA guidelines. Clinical studies evaluating IVUS as an adjunct to angiography during revascularization procedures in patients with PAD were included. Evidence synthesis Thirteen studies were identified, with a total number of 2258 patients having had IVUS for PAD intervention. Seven investigated the role of IVUS for angioplasty and stenting, with the majority being retrospective cohorts. Technical success and patency rates ranged from 90-100% and 45-100%, respectively, with a follow-up that ranged from 4.3-63 months. Three of these studies compared IVUS and non-IVUS guided angioplasty and demonstrated a significant difference in the events of amputations or re-interventions in favor of the IVUS group. Furthermore, five studies evaluated IVUS use in true-lumen re-entry, with the technical success ranging between 97-100%. In one study, where IVUS was used for atherectomy, the technical success was 100% and the long-term patency was 90% during a 12-month follow-up. Overall, no significant peri/postoperative IVUS related complications were reported, whereas, 2 studies suggested an IVUS-associated increase in procedure costs that ranged from $1080-$1333. Conclusions There is limited and heterogeneous evidence regarding the use of IVUS for the management of PAD. Further research is required to elucidate the optimal role of IVUS in PAD as well as the cost effectiveness of this approach for routine use in the management of PAD.
- Published
- 2017
45. Skin contact with a stinging tree requiring intensive care unit admission
- Author
-
Danit, Maor and Mark, Little
- Subjects
Adult ,Male ,Critical Care ,Humans ,Female ,Dermatitis, Contact ,Urticaceae ,Trees - Published
- 2017
46. The kidney
- Author
-
Mark Little and Alan Salama
- Subjects
urogenital system ,urologic and male genital diseases - Abstract
Kidney dysfunction is common in patients with rheumatological disease, be it secondary to renal (usually glomerular) involvement by a multisystem rheumatological disorder, renal impairment due to nephrotoxic medication use, or incidentally noted during a rheumatological work-up. It is therefore important for the rheumatologist to know how to assess kidney function biochemically and radiologically, to appreciate when an organ-threatening process is present, and to understand the basic steps to take in the event of acute kidney injury. This chapter reviews assessment of kidney function with respect to estimating excretory function, and the degree of proteinuria and haematuria. It provides an in-depth review of the causes, assessment, and management of acute kidney injury as encountered in rheumatological practice, and a summary of the causes and approach to chronic kidney disease.
- Published
- 2016
47. Review article: Evacuating hospitals in Australia: What lessons can we learn from the world literature?
- Author
-
Amanda Rojek and Mark Little
- Subjects
business.industry ,Trauma center ,Vulnerability ,Staffing ,Public policy ,medicine.disease ,World literature ,Emergency Shelter ,Emergency Medicine ,Medicine ,Medical emergency ,Natural disaster ,business ,Disaster medicine - Abstract
The creation of hospitals safe from disaster is an area of increasing public policy. The vulnerability of hospitals to damage and destruction during an event has profound implications for the health of a community. Although hospital evacuations do occur in Australia, their prevalence is unknown and what leads to a successful evacuation is poorly understood. This article reviewed the worldwide hospital evacuation literature to determine the prevalence of hospital evacuations and common precipitants for evacuation. Factors leading to safe evacuation and areas of ongoing challenge were identified. The findings highlight the need for more structured and detailed reporting of hospital responses to disaster. A number of lessons can be learned from hospitals that have experienced evacuation. Most critically, all hospitals must have a practised, detailed hospital evacuation plan existing before an impending threat. There are also areas for improvement in the areas of assessing the risk to the facility, communications, leadership, logistics, staffing and planning. These lessons should be included into comprehensive, detailed evacuation plans for all Australian hospitals, supported by a national framework that standardises planning and response.
- Published
- 2013
48. An Approach to the Synthesis of Functionalized Polycyclic Aromatic Hydrocarbons
- Author
-
Joseph J. W. McDouall, Peter Quayle, Mark Little, He Lan, Stephen G. Yeates, James Raftery, and John J. Morrison
- Subjects
Displacement reactions ,Chemistry ,Stereochemistry ,Radical ,Organic Chemistry ,Halogen ,Physical and Theoretical Chemistry ,Combinatorial chemistry - Abstract
The application of a new benzannulation reaction for the regiocontrolled synthesis of functionalized chrysenes is reported. The initial benzannulation and the subsequent halogen displacement reactions are both highly regiospecific, which thereby enables the regiocontrolled synthesis of a variety of 4,10-disubstituted chrysenes from commercially available 1,5-dihydroxynaphthalene.
- Published
- 2013
49. Successful use of heat as first aid for tropical Australian jellyfish stings
- Author
-
Mark Little, Jamie Seymour, and Richard Fitzpatrick
- Subjects
0301 basic medicine ,Jellyfish ,Hot Temperature ,biology ,Australia ,Toxicology ,Carukia barnesi ,biology.organism_classification ,Fishery ,Jellyfish stings ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Cnidarian Venoms ,Chironex fleckeri ,Water immersion ,biology.animal ,Tropical australia ,First Aid ,Humans ,030212 general & internal medicine ,Limited evidence ,Bites and Stings ,First aid - Abstract
Currently the Australian Resuscitation Council (ARC) recommends dousing with vinegar followed by ice as first aid for jellyfish stings in tropical Australia, with limited evidence to support this recommendation (Li et al., 2013). We report our successful experience in using hot water immersion as first aid in treating two people stung by venomous tropical Australian jellyfish, one by Chironex fleckeri and one by Carukia barnesi.
- Published
- 2016
50. Closure Devices for Iatrogenic Thoraco-Cervical Vascular Injuries
- Author
-
Susan Anthony, Carina S.B. Tyrrell, Kader Allouni, James Sutcliffe, Gregory C. Makris, Raman Uberoi, Rafiuddin Patel, Mark Little, and Mark Bratby
- Subjects
Male ,medicine.medical_specialty ,Catheterization, Central Venous ,Iatrogenic Disease ,Review ,030204 cardiovascular system & hematology ,Vascular injury ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Vascular closure device ,Closure (psychology) ,Aged ,Interventional radiology ,medicine.diagnostic_test ,business.industry ,Central venous line ,Arteries ,Vascular System Injuries ,Surgery ,Radiology Nuclear Medicine and imaging ,Iatrogenic ,Female ,business ,Cardiology and Cardiovascular Medicine ,Vascular Closure Devices ,Closure device - Abstract
Introduction The unintentional arterial placement of a central venous line can have catastrophic complications. The purpose of this systematic review is to assess and analyse the available evidence regarding the use of the various vascular closure devices (VCDs) for the management of iatrogenic thoraco-cervical arterial injuries (ITCAI). Methods A systematic review was performed according to PRISMA guidelines. Results Thirty-two relevant case series and case reports were identified with a total of 69 patients having being studied. In the majority of the studies, plug-based VCDs were used (81%) followed by suture-based devices (19%). The majority of studies reported successful outcomes from the use of VCDs in terms of achieving immediate haemostasis without any acute complications. Long-term follow-up data were only available in nine studies with only one case of carotid pseudoaneurysm being reported after 1-month post-procedure. All other cases had no reported long-term complications. Five studies performed direct or indirect comparisons between VCDs and other treatments (open surgery or stent grafting) suggesting no significant differences in safety or effectiveness. Conclusion Although there is limited evidence, VCDs appear to be safe and effective for the management of ITCAIs. Further research is warranted regarding the effectiveness of this approach in comparison to surgery and in order to identify those patients who are more likely to benefit from this minimally invasive approach.
- Published
- 2016
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