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UCL University College London Eprints (411.123 recursos)

UCL Eprints collects the work of UCL researchers and makes it freely available over the web, helping the worldwide scholarly community to discover UCL research. Institutional repositories like UCL Eprints complement the traditional academic publishing and scholarly communications processes. They raise the visibility of research and help to maximise its impact. UCL researchers are encouraged to deposit a copy of each journal article, conference paper, working paper, and any other research output, in the UCL Eprints at the earliest opportunity, ensuring that their research reaches as wide an audience as possible.

Mostrando recursos 61 - 80 de 62.481





  3. Pain Assessment in INTensive care (PAINT): an observational study of physician-documented pain assessment in 45 intensive care units in the United Kingdom

    Kemp, HI; Bantel, C; Gordon, F; Brett, SJ; Laycock, HC; Bampoe, S; Bantel, C; Gooneratne, M; Highton, D; Hopkins, P; Johnston, C; Odor, P; Kemp, H; Laycock, H; Martin, D; O'Carroll, J; Phillips, S; Visram, A; Siddique, O; Burdett, E; May, R; Renwick, S; Gray, M; Spiro, M; Luoma, V; Chamarette, H; Young, T; Wagstaff, D; Lewith, H; Gowrie, S; Bramall, J; Collison, L; Mansell, J; Hamilton, K; Leigh, A; Dawson, J; Morkane, C; Balla, P; Shukla, B; Rublotta, F; Cousins, J; Magee, D; Cashell, C; Kooner, G; Arnold, G; Garnelo Ray, V; Clancy, O; Whitehead, N; Kooner, G; Handy, J; Vizcaychipi, M; Edwards, Z; Davis-Hall, M; Addy, M; Jhanji, S; Wigmore, T; Christie, L; Sidon, L; Grover, M; Panagoda, P; Howells, L; Cartwright, C; Doyle, R; Griffith, M; Casely, E; Holdgate, A; Rich, S; Henriksson, M; Jaggar, S; Tatham, K; Kadry, M; Finlay, C; Pandit, A; Mehdipour, S; Ong, C; Bidd, H; Ramessur, S; Anwar, S; Blunt, N; Williams, H; Tosini, C; Parini, A; Kumar, R; Ferrier, V; Gupta, A; Canavan, A; Dickinson, M; Carey, B; Somasundaram, K; De Silva, S; Moghulm, A; Dua, K; McHugh, B; Chapman, R; Peck, M; Sangam, A; Al-Sahaf, H; Gowripalann, T; Kunnumpurath, S
    © 2017 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland.Pain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines. This observational service evaluation considered all pain and analgesia-related entries in patients’ records over a 24-h period, in 45 adult intensive care units (ICUs) in London and the...

  4. Unreliability of putative fMRI biomarkers during emotional face processing.

    Nord, CL; Gray, A; Charpentier, CJ; Robinson, OJ; Roiser, JP
    There is considerable need to develop tailored approaches to psychiatric treatment. Numerous researchers have proposed using functional magnetic resonance imaging (fMRI) biomarkers to predict therapeutic response, in particular by measuring task-evoked subgenual anterior cingulate (sgACC) and amygdala activation in mood and anxiety disorders. Translating this to the clinic relies on the assumption that blood-oxygen-level dependent (BOLD) responses in these regions are stable within individuals. To test this assumption, we scanned a group of 29 volunteers twice (mean test-retest interval=14.3 days) and calculated the within-subject reliability of the amplitude of the amygdalae and sgACC BOLD responses to emotional faces using three...

  5. Chronic Stroke Survivors Improve Reaching Accuracy by Reducing Movement Variability at the Trained Movement Speed.

    Hammerbeck, U; Yousif, N; Hoad, D; Greenwood, R; Diedrichsen, J; Rothwell, JC
    BACKGROUND: Recovery from stroke is often said to have "plateaued" after 6 to 12 months. Yet training can still improve performance even in the chronic phase. Here we investigate the biomechanics of accuracy improvements during a reaching task and test whether they are affected by the speed at which movements are practiced. METHOD: We trained 36 chronic stroke survivors (57.5 years, SD ± 11.5; 10 females) over 4 consecutive days to improve endpoint accuracy in an arm-reaching task (420 repetitions/day). Half of the group trained using fast movements and the other half slow movements. The trunk was constrained allowing only...

  6. Has the SPRINT trial introduced a new blood-pressure goal in hypertension?

    Ruiz-Hurtado, G; Banegas, JR; Sarafidis, PA; Volpe, M; Williams, B; Ruilope, LM
    SPRINT is the first randomized, controlled trial showing that a systolic blood-pressure goal of <120 mmHg can be attained with cardiovascular benefits in a select group of patients with hypertension and an elevated cardiovascular risk with different origins. Although the patient population with characteristics like those in SPRINT makes up only 20-30% of the total hypertensive population, SPRINT is a landmark study that highlights the need to consider lower blood- pressure goals in the treatment of hypertension. Extending this study to include other patient populations and geographical areas is the next step for evaluating the benefits of strict blood-pressure targets...

  7. A microscopic mechanism of dielectric breakdown in SiO2 films: An insight from multi-scale modeling

    Padovani, A; Gao, DZ; Shluger, AL; Larcher, L

  8. Derived neutrophil to lymphocyte ratio as a prognostic factor in patients with advanced colorectal cancer according to RAS and BRAF status: a post-hoc analysis of the MRC COIN study

    Wood, G; Grenader, T; Nash, S; Adams, R; Kaplan, R; Fisher, D; Maughan, T; Bridgewater, J

  9. Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review.

    Stansfeld, J; Stoner, CR; Wenborn, J; Vernooij-Dassen, M; Moniz-Cook, E; Orrell, M
    BACKGROUND: Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and psychometric properties of existing positive psychology measures for family caregivers of people living with dementia to determine their potential utility in research and practice. METHOD: A systematic review of positive psychology outcome measures for family caregivers of people with dementia was conducted. The databases searched were as follows: PsychINFO, CINAHL, MEDLINE, EMBASE, and PubMed. Scale development papers were...

  10. Terlipressin for haemodynamic support in septic patients: a double-edged sword?

    Westphal, M; Bone, H-G; Van Aken, H; Sielenkämper, AW

  11. The use of oxygen in acute exacerbations of chronic obstructive pulmonary disease: a prospective audit of pre-hospital and hospital emergency management.

    O'Driscoll, R

  12. Randomised trial of glutamine, selenium, or both, to supplement parenteral nutrition for critically ill patients.

    Andrews, PJD; Avenell, A; Noble, DW; Campbell, MK; Croal, BL; Simpson, WG; Vale, LD; Battison, CG; Jenkinson, DJ; Cook, JA; Scottish Intensive care Glutamine or seleNium Evaluative Trial T,
    OBJECTIVE: To determine whether inclusion of glutamine, selenium, or both in a standard isonitrogenous, isocaloric preparation of parenteral nutrition influenced new infections and mortality among critically ill patients. DESIGN: Randomised, double blinded, factorial, controlled trial. SETTING: Level 2 and 3 (or combined) critical care units in Scotland. All 22 units were invited, and 10 participated. PARTICIPANTS: 502 adults in intensive care units and high dependency units for ≥ 48 hours, with gastrointestinal failure and requiring parenteral nutrition. INTERVENTIONS: Parenteral glutamine (20.2 g/day) or selenium (500 μg/day), or both, for up to seven days. MAIN OUTCOME MEASURES: Primary outcomes were participants...

  13. Comparison of stroke volume measurement between non-invasive bioreactance and esophageal Doppler in patients undergoing major abdominal-pelvic surgery.

    De Pascale, G; Singer, M; Brealey, D
    PURPOSE: Bioreactance is a non-invasive technology for measuring stroke volume (SV) in the operating room and critical care setting. We evaluated how the NICOM(®) bioreactance device performed against the CardioQ(®) esophageal Doppler monitor in patients undergoing major abdominal-pelvic surgery, focusing on the effect of different hemodynamic interventions. METHODS: SVNICOM and SVODM were simultaneously measured intraoperatively, including before and after interventions including fluid challenge, vasopressor boluses, peritoneal gas insufflation/removal, and Trendelenburg/reverse Trendelenburg patient positioning. RESULTS: A total of 768 values were collected from 21 patients. Pre- and post-intervention measures were recorded on 155 occasions. Bland-Altman analysis revealed a bias of 8.6 ml...

  14. Experience using high-dose glucose-insulin-potassium (GIK) in critically ill patients.

    Slob, EMA; Shulman, R; Singer, M
    PURPOSE: To audit the use of GIK in terms of safety, haemodynamic effects, and impact on catecholamine dosage. MATERIALS AND METHODS: A retrospective, descriptive, evaluative audit of GIK use within the adult ICU of a London teaching hospital was conducted. Rescue therapy of GIK (up to 1.0Unitsinsulin/kg/h) was administered to improve cardiac function. Outcomes were ICU survival, change in cardiac index (CI) and blood lactate levels, events of hypoglycaemia, hyperglycaemia, hypokalaemia and hyperkalaemia, and discontinuation time of catecholamine inotropes. RESULTS: Of 85 patients treated with GIK, 13 (15.3%) survived their ICU stay and 9 (10.5%) were discharged home. In patients...

  15. The intensive care medicine research agenda on septic shock.

    Perner, A; Gordon, AC; Angus, DC; Lamontagne, F; Machado, F; Russell, JA; Timsit, J-F; Marshall, JC; Myburgh, J; Shankar-Hari, M; Singer, M
    Septic shock remains a global health challenge with millions of cases every year, high rates of mortality and morbidity, impaired quality of life among survivors and relatives, and high resource use both in developed and developing nations. Care and outcomes are improving through organisational initiatives and updated clinical practice guidelines based on clinical research mainly carried out by large collaborative networks. This progress is likely to continue through the collaborative work of the established and merging trials groups in many parts of the world and through refined trial methodology and translational work. In this review, international experts summarize the current...

  16. Exploring the Dynamics of Propeller Loops in Human Telomeric DNA Quadruplexes Using Atomistic Simulations.

    Islam, B; Stadlbauer, P; Gil-Ley, A; Pérez-Hernández, G; Haider, S; Neidle, S; Bussi, G; Banas, P; Otyepka, M; Sponer, J
    We have carried out a series of extended unbiased molecular dynamics (MD) simulations (up to 10 μs long, ∼162 μs in total) complemented by replica-exchange with the collective variable tempering (RECT) approach for several human telomeric DNA G-quadruplex (GQ) topologies with TTA propeller loops. We used different AMBER DNA force-field variants and also processed simulations by Markov State Model (MSM) analysis. The slow conformational transitions in the propeller loops took place on a scale of a few μs, emphasizing the need for long simulations in studies of GQ dynamics. The propeller loops sampled similar ensembles for all GQ topologies and...

  17. The emergency airway.

    Goon, SSH; Stephens, RCM; Smith, H
    The 'can't intubate, can't ventilate' scenario is a nightmare for all clinicians who manage airways. Cricothyroidotomy is one of several emergency airway management techniques. Cricothyroidotomy is a short-term solution which provides oxygenation, not ventilation, and is not a definitive airway. Although there are tests which can help predict whether an intubation will be difficult, they are not always good predictors. As the can't intubate, can't ventilate scenario is rare, cricothyroidotomy is an unfamiliar procedure to many. In this situation, expert help must be called for early on. In the meantime, it is vital that all other simple airway manoeuvres have...

  18. An introduction to anaesthesia.

    Donohue, C; Hobson, B; Stephens, RC

  19. Big Data: A Cheerleader for Translational Perioperative Medicine.

    Ackland, GL; Stephens, RCM

  20. Vagal determinants of exercise capacity.

    Machhada, A; Trapp, S; Marina, N; Stephens, RCM; Whittle, J; Lythgoe, MF; Kasparov, S; Ackland, GL; Gourine, AV
    Indirect measures of cardiac vagal activity are strongly associated with exercise capacity, yet a causal relationship has not been established. Here we show that in rats, genetic silencing of the largest population of brainstem vagal preganglionic neurons residing in the brainstem's dorsal vagal motor nucleus dramatically impairs exercise capacity, while optogenetic recruitment of the same neuronal population enhances cardiac contractility and prolongs exercise endurance. These data provide direct experimental evidence that parasympathetic vagal drive generated by a defined CNS circuit determines the ability to exercise. Decreased activity and/or gradual loss of the identified neuronal cell group provides a neurophysiological basis...

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