Publications by authors named "Gough A"

Background: Anxiety disorders are prevalent amongst older adults and negatively impact their quality-of-life and health. Anxiety disorders often go undetected or are misattributed to age-related changes. The aim of this systematic review of reviews, was to synthesize existing evidence on risk factors associated with anxiety in older adults to improve opportunities for early detection and intervention.

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Background: C-reactive protein (CRP) and high-sensitivity C-reactive protein (hsCRP) are measures of inflammation used in diagnosis, to guide treatment decisions, and in disease prediction. Variability in measured CRP and hsCRP may affect their clinical utility but estimates of within-subject variability are based on limited data.

Methods: A systematic review and meta-analysis was performed to estimate longitudinal within-subject variability of CRP and hsCRP over any time period.

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  • The study suggests that insulin resistance in the liver is a key factor leading to dysfunction in pancreatic islets, which is linked to Type 2 Diabetes Mellitus (T2DM) and Metabolic Associated Steatotic Liver Disease (MASLD).
  • Researchers developed a microphysiological system combining liver and pancreatic models to better understand how these organ dysfunctions relate to each other. This system allows for the investigation of changes that occur when metabolic syndrome is present.
  • Results showed that under metabolic syndrome conditions, the liver-pancreas system exhibited altered insulin secretion and signaling, indicating a direct connection between liver issues and islet dysfunction, which could help in developing personalized treatment strategies for affected patients.
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  • - MASLD is a global health issue affecting around 30% of the population, caused by a mix of genetics, lifestyle, and environmental factors, posing challenges for treatment development due to patient variability.
  • - Creating effective therapeutic models is difficult because existing systems and animal models fail to fully reflect the complexities of MASLD progression, prompting the need for more precise experimental approaches.
  • - The study utilized a liver acinus microphysiology system (LAMPS) with patient-derived cells to explore the effects of the PNPLA3 genetic variant on MASLD and tested the drug resmetirom, revealing significant changes in liver cell behavior indicative of disease progression.
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  • * Out of 112 respondents, which included both surgeons and hand therapists, the study found significant variability in surgical decision-making and imaging practices, with most centers favoring ligament reconstruction using a bone anchor.
  • * Findings suggest that there is inconsistency in the treatment approaches for UCL ruptures and a strong interest among medical professionals for future clinical trials to standardize management practices.
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The understanding of how central metabolism and fermentation pathways regulate antimicrobial susceptibility in the anaerobic pathogen Bacteroides fragilis is still incomplete. Our study reveals that B. fragilis encodes two iron-dependent, redox-sensitive regulatory pirin protein genes, pir1 and pir2.

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Necrotising fasciitis is an uncommon life-threatening surgical emergency. While most commonly seen in the lower limb it can also affect the upper limb. This article reviews and summarises the current literature on necrotising fasciitis in the upper limb, covering common predisposing factors, clinical presentations, scoring systems, common organism types and the timing of surgical treatment.

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  • Metabolic dysfunction-associated steatotic liver disease (MASLD) affects about 30% of the global population, driven by a mix of genetic, lifestyle, and environmental factors, complicating treatment and clinical trial design.* -
  • The study utilized a liver acinus microphysiology system (LAMPS) made from patient-derived cells to explore the effects of the PNPLA3 rs738409 genetic variant on MASLD progression, replicating various metabolic conditions.* -
  • Results showed that the PNPLA3 GG variant led to increased liver fat, immune activation, and pro-fibrotic factor secretion compared to wild type cells, providing insights for future treatments like resmetirom.*
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  • Researchers found that problems in the liver can lead to issues in the pancreas, which affects blood sugar levels and can cause diabetes and a liver disease called MASLD.
  • They created a special system that mimics human organs to study how these two organs affect each other when things go wrong, like during early metabolic syndrome.
  • The results showed that when the liver is not working properly, it can send confusing signals to the pancreas, making it harder for the body to control insulin and blood sugar, which could help doctors understand these diseases better and create personalized treatments.
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: Gestational diabetes mellitus (GDM) is known to be associated with pregnancy complications but there is limited evidence about the strength of these associations in recent clinical practice, especially after the introduction of strict guidelines for the management of pregnancies with GDM in a multidisciplinary team setting. The objectives of our study were to first compare the rates of complications in pregnancies with GDM with those that had pre-existing diabetes mellitus and those without diabetes; and second, to derive measures of effect size expressed as odds ratios after adjustment for confounding factors to assess the independent association of GDM in prediction of these pregnancy complications. : This was a prospective cohort study undertaken at a large maternity unit in the United Kingdom between January 2010 and June 2022.

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Background: There is a high rate of surgical fixation of displaced Colles' type distal radial wrist fractures despite fracture manipulation in the ED. Point-of-care ultrasound has been used to guide ED manipulations but its effect on the quality of fracture reduction or subsequent need for surgical fixation is unknown. This study aims to assess the feasibility of conducting a definitive randomised controlled trial to assess the use of ultrasound to guide these fracture manipulations.

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Background: The need to engage boys in gender-transformative relationships and sexuality education (RSE) to reduce adolescent pregnancy is endorsed by the World Health Organization and the United Nations Educational, Scientific and Cultural Organization.

Objectives: To evaluate the effects of on the avoidance of unprotected sex and other sexual health outcomes.

Design: A cluster randomised trial, incorporating health economics and process evaluations.

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: COVID-19 pandemic has caused more than 6 million deaths worldwide. Co-morbid conditions such as Type 2 Diabetes (T2D) have increased mortality in COVID-19. With limited translatability of and small animal models to human disease, human organ-on-a-chip models are an attractive platform to model disease conditions and test potential therapeutics.

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Objectives: To compare pregnancy complications in pregnancies with and without pre-gestational diabetes mellitus (DM) managed in a multidisciplinary high-risk diabetes antenatal clinic.

Methods: This screening cohort study was undertaken at a large maternity unit in the United Kingdom between January 2010 and December 2022. We included singleton pregnancies that booked at our unit at 11-13 weeks' gestation.

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Background: Enhanced recovery protocols are becoming standard practice after major colorectal surgery. An increasing body of evidence suggests that early feeding should be encouraged; however, whether a clear liquid diet or solid diet should be given immediately after surgery is undetermined.

Objective: Evaluate whether regular diet was superior to clear liquid diet beginning on postoperative day 0 after major colorectal surgery.

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The case report describes the presentation of a 42-year-old male ultimately diagnosed with FTD-ALS caused by a genetic mutation, who initially presented with atypical psychiatric symptoms. Given that the initial clinical manifestations of FTD-ALS can be quite variable, the diagnosis is often challenging; the case report aims to highlight several key considerations in the diagnostic assessment, including genetic testing in order to guide clinicians in more timely diagnosis and ultimately improve patient care.

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Background: Glycosylated haemoglobin (HbA1c) measurement is used to diagnose and to guide treatment of diabetes mellitus. Within-subject variability in measured HbA1c affects its clinical utility and interpretation, but no comprehensive systematic review has described within-subject variability.

Methods: A systematic review and meta-analysis was performed of within-subject variability of HbA1c.

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Biologics address a range of unmet clinical needs, but the occurrence of biologics-induced liver injury remains a major challenge. Development of cimaglermin alfa (GGF2) was terminated due to transient elevations in serum aminotransferases and total bilirubin. Tocilizumab has been reported to induce transient aminotransferase elevations, requiring frequent monitoring.

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The purpose of our study was to explore how people with epilepsy fared during two of the most stringent 4-month society-wide COVID-19-related pandemic restrictions in Ireland, in 2020 and one year later in 2021. This was in the context of their seizure control, lifestyle factors, and access to epilepsy-related healthcare services. A 14-part questionnaire was administered to adults with epilepsy during virtual specialist epilepsy clinics in a University Hospital in Dublin, Ireland at the end of the two lockdowns.

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Background: Instagram's popularity among young adults continues to rise, and previous work has identified diffusion of unhealthy messages and misinformation throughout the platform. However, we know little about how to use Instagram to promote health messages. This study aims to assess the feasibility and acceptability of using Instagram to engage post-graduate students in a mass communication social media (SM)-based health intervention.

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Background: The need to engage boys in gender-transformative relationships and sexuality education (RSE) to reduce adolescent pregnancy is endorsed by WHO. We aimed to test an intervention which used a gender-transformative approach to engage adolescents in RSE to prevent unprotected sex.

Methods: This cluster-randomised trial with process and economic evaluations tested a school-based intervention entitled If I Were Jack versus standard RSE (control) for students (aged 14-15 years) in UK schools.

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Non-alcoholic fatty liver disease (NAFLD) has a high global prevalence with a heterogeneous and complex pathophysiology that presents barriers to traditional targeted therapeutic approaches. We describe an integrated quantitative systems pharmacology (QSP) platform that comprehensively and unbiasedly defines disease states, in contrast to just individual genes or pathways, that promote NAFLD progression. The QSP platform can be used to predict drugs that normalize these disease states and experimentally test predictions in a human liver acinus microphysiology system (LAMPS) that recapitulates key aspects of NAFLD.

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