A5071562926- Chronic Obstructive Pulmonary Disease (COPD) Research
- Hormonal Regulation and Hypertension
- Adrenal and Paraganglionic Tumors
- Health Systems, Economic Evaluations, Quality of Life
- Radiomics and Machine Learning in Medical Imaging
- Head and Neck Cancer Studies
- Cancer, Hypoxia, and Metabolism
- Respiratory Support and Mechanisms
- Tuberculosis Research and Epidemiology
- Obesity, Physical Activity, Diet
- Emergency and Acute Care Studies
- Delphi Technique in Research
- Nursing Diagnosis and Documentation
- Liver Disease Diagnosis and Treatment
- Innovations in Medical Education
- Adrenal Hormones and Disorders
- Atrial Fibrillation Management and Outcomes
- Medical Education and Admissions
- Cardiac Health and Mental Health
- Meta-analysis and systematic reviews
- Global Maternal and Child Health
- Health, psychology, and well-being
- Chronic Disease Management Strategies
- Primary Care and Health Outcomes
- Chronic Kidney Disease and Diabetes
University of Birmingham
2016-2025
NIHR Birmingham Biomedical Research Centre
2018-2025
University Hospitals Birmingham NHS Foundation Trust
2018-2025
National Institute for Health Research
2019-2024
University of Groningen
2021
Creative Commons
2021
Max Planck Institute for Metabolism Research
2021
Mayo Clinic in Arizona
2021
National Health Service
2019
Cluster randomised controlled trials (CRCTs) are frequently used in health service evaluation. Assuming an average cluster size, required sample sizes readily computed for both binary and continuous outcomes, by estimating a design effect or inflation factor. However, where the number of clusters fixed advance, but it is possible to increase individuals within each cluster, as case evaluation, size formulae have been less well studied. We systematically outline (including randomisation...
Adrenal aldosterone excess is the most common cause of secondary hypertension and associated with increased cardiovascular morbidity. However, adverse metabolic risk in primary aldosteronism extends beyond hypertension, rates insulin resistance, type 2 diabetes, osteoporosis, which cannot be easily explained by excess.We performed mass spectrometry-based analysis a 24-hour urine steroid metabolome 174 newly diagnosed patients (103 unilateral adenomas, 71 bilateral adrenal hyperplasias)...
Cross-sectional imaging regularly results in incidental discovery of adrenal tumours, requiring exclusion adrenocortical carcinoma (ACC). However, differentiation is hampered by poor specificity characteristics. We aimed to validate a urine steroid metabolomics approach, using profiling as the diagnostic basis for ACC.
BackgroundTackling tuberculosis requires testing and treatment of latent in high-risk groups. The aim this study was to estimate the predictive values tuberculin skin test (TST) two interferon-γ release assays (IGRAs) for development active groups—ie, people recent contact with cases from high-burden countries.MethodIn prospective cohort study, we recruited participants 54 centres (eg, clinics, community settings) London, Birmingham, Leicester UK. Participants were eligible if they aged 16...
Background: Benign adrenal tumors are commonly discovered on cross-sectional imaging. Mild autonomous cortisol secretion (MACS) is regularly diagnosed, but its effect cardiometabolic disease in affected persons ill defined. Objective: To determine burden and steroid excretion with benign without MACS. Design: Cross-sectional study. Setting: 14 endocrine secondary tertiary care centers (recruitment from 2011 to 2016). Participants: 1305 prospectively recruited tumors. Measurements: Cortisol...
SummaryBackgroundPoor mental health in adolescents can negatively affect sleep, physical activity and academic performance, is attributed by some to increasing mobile phone use. Many countries have introduced policies restrict use schools improve educational outcomes. The SMART Schools study evaluated the impact of school comparing outcomes who attended that permit use.MethodsWe conducted a cross-sectional observational with from 30 English secondary schools, comprising 20 restrictive...
Background Androgen excess is a defining feature of polycystic ovary syndrome (PCOS), which affects 10% women and represents lifelong metabolic disorder, with increased risk type 2 diabetes, hypertension, cardiovascular events. Previous studies have suggested an nonalcoholic fatty liver disease (NAFLD) in individuals PCOS implicated androgen as potential driver. Methods findings We carried out retrospective longitudinal cohort study utilizing large primary care database the United Kingdom,...
Adrenocortical carcinoma (ACC) has an aggressive but variable clinical course. Prognostic stratification based on the European Network for Study of Adrenal Tumours stage and Ki67 index is limited. We aimed to demonstrate prognostic role a points-based score (S-GRAS) in large cohort patients with ACC.This multicentre, retrospective study ACC who underwent adrenalectomy.The S-GRAS was calculated as sum following points: tumour (1-2 = 0; 3 1; 4 2), grade (Ki67 0-9% 10-19% ≥20% 2 points),...
11-oxygenated androgens significantly contribute to the circulating androgen pool. Understanding physiological variation of and their determinants is essential for clinical interpretation, example, in excess conditions. We quantified classic serum saliva across adult age body mass index (BMI) range, also analyzing diurnal menstrual cycle-dependent variation.
To determine whether new programmes developed to widen access medicine in the United Kingdom have produced more diverse student populations.Population based cross sectional analysis.31 UK universities that offer medical degrees.34,407 students admitted university 2002-6.Age, sex, socioeconomic status, and ethnicity of traditional courses newer (graduate entry (GEC) foundation) designed increase diversity.The demographics foundation were markedly different from traditional, graduate entry,...
Visual Abstract Export Background and objectives Fluid overload intradialytic hypotension are associated with cardiovascular events mortality in patients on hemodialysis. We investigated associations between hemodialysis facility practices related to fluid volume patient outcomes. Design, setting, participants, & measurements Data were analyzed from 10,250 273 facilities across 12 countries, phase 4 of the Dialysis Outcomes Practice Patterns Study (DOPPS; 2009–2012). Cox regression models...
Abstract Objective To test the effectiveness of a brief behavioural intervention to prevent weight gain over Christmas holiday period. Design Two group, double blinded randomised controlled trial. Setting Recruitment from workplaces, social media platforms, and schools pre-Christmas 2016 2017 in Birmingham, UK. Participants 272 adults aged 18 years or more with body mass index 20 more: 136 were leaflet on healthy living (comparator). Baseline assessments conducted November December follow-up...
Abstract Aims The risk of developing atrial fibrillation (AF) and its complications continues to increase, despite good progress in preventing AF-related strokes. Methods results This article summarizes the outcomes 7th Consensus Conference Atrial Fibrillation NETwork (AFNET) European Heart Rhythm Association (EHRA) held Lisbon March 2019. Sixty-five international AF specialists met present new data find consensus on pressing issues prevention, management future research improve care for...
Summary Background There remains a lack of consensus on how to assess functional exercise capacity and physical frailty in patients with advanced chronic liver disease (CLD) being assessed for transplantation (LT). Aim To investigate prospectively the utility Duke Activity Status Index (DASI) Liver Frailty (LFI) ambulatory CLD. Methods We recruited from outpatient clinics at University Hospitals Birmingham, UK (2018–2019). collated DASI LFI identify prevalence of, respectively, frailty,...
Aim Early warning scores (EWS) are widely used in well-resourced healthcare settings to identify patients at risk of mortality. The Modified Warning Score (MEWS) is a well-known EWS comprehensively the United Kingdom. HOTEL score (Hypotension, Oxygen saturation, Temperature, ECG abnormality, Loss independence) was developed and tested European cohort; however, its validity unknown resource limited settings. This study compared performance both suggested modifications enhance accuracy....
Abstract Objectives To investigate the proportion of lateral flow tests (LFTs) that produce negative results in those with a high risk infectiousness from SARS-CoV-2, to impact stage and severity disease, compare predictions made by influential mathematical models findings empirical studies. Design Linked data analysis combining evidence accuracy Innova LFT, probability positive viral culture or transmission secondary cases, distribution loads SARS-CoV-2 individuals different settings....
Background. Acute kidney injury (AKI) recognition by clinicians has been shown to be suboptimal. Little work focused on the use of an automated warning a rise in patient's creatinine, indicating AKI. Methods. Over 3 months 2008 we ran prospective observational study 'alerts' sent our Integrated Clinical Environment pathology system, identifying all patients with ≥ 75% their creatinine from its previous value. Information was collected subsequent renal function, comorbidities and other...
Rationale: Development of diagnostic tools with improved predictive value for tuberculosis (TB) is a global research priority.Objectives: We evaluated whether implementing higher thresholds than currently recommended QuantiFERON Gold-in-Tube (QFT-GIT), T-SPOT.TB, and the tuberculin skin test (TST) might improve prediction incident TB.Methods: Follow-up UK cohort 9,610 adult TB contacts recent migrants was extended by relinkage to national surveillance records (median follow-up 4.7 yr)....
Minor salivary gland (MSG) biopsy has an important role in Sjögren's disease diagnosis and research. MSGs show within-patient variation number of lymphocytic foci per unit area, but the optimal required to balance reproducibility clinical acceptability not been determined. Monte Carlo simulations were performed investigate impact MSG on (i) based focus score (FS) ≥1; (ii) reproducibility, defined as extent which 2 FS measurements obtained from biopsies are same, assuming no systematic...