Publications by authors named "Cornelius V"

Background: In the United Kingdom, it is estimated that 5,000 patients sustain eye injuries or ocular trauma requiring hospital admission annually, of which 250 patients will be permanently blinded. This study explores the cost-effectiveness of Adjunctive Steroid Combination in Ocular Trauma (ASCOT) given during surgery versus standard treatment in vitreoretinal surgery in patients with open globe trauma.

Methods: This economic evaluation was embedded alongside the ASCOT RCT (ClinicalTrials.

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Background: The burden of over 300 million individuals living with hypertension in India is increasing steadily. Most current guidelines recommend initial combination therapy for effective blood pressure (BP) control. However, there is no randomised evidence to inform which combinations to use in the South Asian population, who account for over one-quarter of the world's population.

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  • Randomised controlled trials (RCTs) are essential for assessing the effects of interventions, but there is inconsistency in how researchers describe harmful effects, leading to confusion in terminology.
  • A study was conducted with public partners in London and Aberdeen to gather opinions on the terminology used for harmful effects in clinical trials and how these impacts are communicated in both academic and public materials.
  • The results showed that public partners preferred the term "side-effect" for all contexts and suggested reserving the term "harm" for more severe adverse events, highlighting a need for clearer communication in the scientific literature.
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Introduction: Digital mental health interventions (DMHIs) overcome traditional barriers enabling wider access to mental health support and allowing individuals to manage their treatment. How individuals engage with DMHIs impacts the intervention effect. This review determined whether the impact of user engagement was assessed in the intervention effect in Randomised Controlled Trials (RCTs) evaluating DMHIs targeting common mental disorders (CMDs).

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Introduction: A minority of school-aged children with asthma have persistent poor control and experience frequent asthma attacks despite maximal prescribed maintenance therapy. These children have higher morbidity and risk of death. The first add-on biologic therapy, omalizumab, a monoclonal antibody that blocks immunoglobulin (Ig)E, was licensed for children with severe asthma in 2005.

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Diabetes mellitus is a central driver of multiple long-term conditions (MLTCs), but population-based studies have not clearly characterized the burden across the life course. We estimated the age of onset, years of life spent and loss associated with diabetes-related MLTCs among 46 million English adults. We found that morbidity patterns extend beyond classic diabetes complications and accelerate the onset of severe MLTCs by 20 years earlier in life in women and 15 years earlier in men.

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Vascular organoids (VOs), derived from induced pluripotent stem cells (iPSCs), hold promise as in vitro disease models and drug screening platforms. However, their ability to faithfully recapitulate human vascular disease and cellular composition remains unclear. In this study, we demonstrate that VOs derived from iPSCs of donors with diabetes (DB-VOs) exhibit impaired vascular function compared to non-diabetic VOs (ND-VOs).

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  • The COMET trial aims to determine if whole-body hypothermia can improve cognitive development in neonates with mild hypoxic ischemic encephalopathy, a condition linked to learning difficulties.
  • It is a phase III multicenter randomized controlled trial involving 426 neonates, comparing hypothermia treatment (33.5°C) to normothermia (37.0°C) within the first six hours of birth.
  • The primary goal is to evaluate cognitive outcomes at two years using the Bayley scales, while also ensuring the trial's safety and assessing healthcare resource utilization.
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  • The study investigates "spin," which is the misleading representation of research findings, particularly focusing on harmful outcomes in systematic reviews of interventions.
  • Researchers created a framework to spot and analyze twelve specific types of spin related to harms, categorizing them into reporting, interpretation, and extrapolation.
  • Through their analysis of 100 systematic reviews, they found significant instances of spin, notably in inappropriate extrapolation, and provided revised examples and guidance for improving harm reporting accuracy in research publications.
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Background And Objectives: Statistical methods for signal detection of adverse drug reactions (ADRs) in electronic health records (EHRs) need information about optimal significance levels and sample sizes to achieve sufficient power. Sauzet and Cornelius proposed tests for signal detection based on the hazard functions of Weibull type distributions (WSP tests) which use the time-to-event information available in EHRs. Optimal significance levels and sample sizes for the application of the WPS tests are derived.

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Objectives: Assess understanding of impactibility modelling definitions, benefits, challenges and approaches.

Design: Qualitative assessment.

Setting: Two workshops were developed.

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Background: Fibrotic interstitial lung diseases (fILDs) are a heterogeneous group of lung diseases associated with significant morbidity and mortality. Despite a large increase in the number of clinical trials in the last 10 years, current regulatory-approved management approaches are limited to two therapies that prevent the progression of fibrosis. The drug development pipeline is long and there is an urgent need to accelerate this process.

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  • The study explores whether reducing the frequency of bathing infants in the first six months can help prevent eczema, proposing the need for a well-designed intervention to support parents in this approach.* -
  • It involved interviews with families to identify challenges and motivators, which were then integrated into effective behavior change strategies and materials through collaboration with experts and families.* -
  • Key findings highlighted that social influences, emotional rewards, and family support can encourage adherence to the intervention, while hygiene concerns and fear of judgment may hinder participation.*
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Peyer's patches (PPs) are part of the gut-associated lymphatic tissue (GALT) and represent the first line of the intestinal immunological defense. They consist of follicles with lymphocytes and an overlying subepithelial dome with dendritic cells and macrophages, and they are covered by the follicle-associated epithelium (FAE). A sealed paracellular pathway in the FAE is crucial for the controlled uptake of luminal antigens.

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The leading cause of death worldwide and a significant factor in decreased quality of life are the cardiovascular diseases. Endovascular operations like angioplasty, stent placement, or atherectomy are often used in vascular surgery to either dilate a narrowed blood artery or remove a blockage. As an alternative, a vascular transplant may be utilised to replace or bypass a dysfunctional or blocked blood vessel.

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Background: Needle visualization is essential to avoid vascular puncture and nerve injury in ultrasound-guided regional anesthesia. Several factors that statistically influence needle visibility have been described but the dimensions of their individual impact remain unclear. This study aimed to quantify the impact of various independent factors on ultrasound needle visibility.

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  • The study aimed to evaluate the prevalence of multiple long-term conditions (MLTC) among the entire English population, considering factors such as age, sex, socioeconomic status, and ethnicity.
  • Out of over 60 million registered individuals, the overall MLTC prevalence was found to be 14.8%, with significant variation across age groups—0.9% in those aged 0-19 and 68.2% in those aged 80 and over.
  • Results indicated higher odds of MLTC among men, the most deprived socioeconomic groups, and those of Asian ethnicity, while lower odds were found for Black, mixed, and other ethnicities, with different prevalent conditions observed at various age ranges.
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Background: Adaptive clinical trials are growing in popularity as they are more flexible, efficient and ethical than traditional fixed designs. However, notwithstanding their increased use in assessing treatments for COVID-19, their use in critical care trials remains limited. A better understanding of the relative benefits of various adaptive designs may increase their use and interpretation.

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Background: Eyes sustaining open globe trauma are at high risk of severe visual impairment. Proliferative vitreoretinopathy is the most common cause of retinal detachment and visual loss in eyes with open globe trauma. There is evidence from experimental studies and pilot clinical trials that the use of adjunctive steroid medication triamcinolone acetonide can reduce the incidence of proliferative vitreoretinopathy and improve outcomes of surgery for open globe trauma.

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  • Understanding cardiovascular risk factors like diabetes in vascular cells is challenging due to limited disease models.
  • The review discusses the development of advanced 3D in vitro disease models using patient-derived stem cells, which better mimic human vascular issues compared to traditional 2D cultures.
  • It highlights the importance of including various cell types in these models to accurately represent conditions like diabetic vasculopathy and suggests strategies for creating organ-specific models to study different vascular complications.
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Organoids are powerful experimental models for studying the ontogeny and progression of various diseases including cancer. Organoids are conventionally cultured in bulk using an extracellular matrix mimic. However, bulk-cultured organoids physically overlap, making it impossible to track the growth of individual organoids over time in high throughput.

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  • Vascular complications are the leading cause of health issues and death related to diabetes, stemming from oxidative stress and metabolic problems.
  • Mitochondrial dysfunction significantly contributes to issues in heart function and energy metabolism in diabetes, with non-coding RNAs and RNA-binding proteins potentially playing a role, though their specific impacts remain unclear.
  • Using stem cell-based models can help researchers explore the relationship between non-coding RNAs, RNA-binding proteins, and mitochondrial dysfunction, which may lead to better treatments for diabetic vascular complications.
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Objectives: It is important to be able to detect symptoms of common mental disorders (CMDs) in pregnant women. However, the expression of these disorders can differ across cultures and depend on the specific scale used. This study aimed to (a) compare Gambian pregnant women's responses to the Edinburgh Postnatal Depression Scale (EPDS) and Self-reporting Questionnaire (SRQ-20) and (b) compare responses to the EPDS in pregnant women in The Gambia and UK.

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Background: The assessment of language and cognition in children at risk of impaired neurodevelopment following neonatal care is a UK standard of care but there is no national, systematic approach for obtaining these data. To overcome these challenges, we developed and evaluated a digital version of a validated parent questionnaire to assess cognitive and language development at age 2 years, the Parent Report of Children's Abilities-Revised (PARCA-R).

Methods: We involved clinicians and parents of babies born very preterm who received care in north-west London neonatal units.

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