Publications by authors named "H Hughes"

Many neonatal intensive care units (NICUs) lack access to subspecialist consultants and may transfer patients requiring subspecialty care to referral facilities or seek informal consultation. The objective of this work was to evaluate the feasibility, acceptability, and impact of extending pediatric subspecialty services from a children's hospital to a level III NICU via teleconsultation and describe processes, facilitators, and challenges. Monitored consultations for 1 year and surveyed clinicians regarding feasibility, perceived benefits, and challenges.

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Article Synopsis
  • The audit aimed to assess and improve the completeness and accuracy of the National Joint Registry (NJR) dataset specifically for elbow arthroplasty surgeries.
  • In a two-phase approach, Phase 1 compared NJR data with NHS England Hospital Episode Statistics (HES), identifying thousands of unmatched and inaccurate records, particularly for radial head arthroplasties (RHAs).
  • Phase 2 involved collaboration among 142 NHS hospitals to correct and update records, resulting in an improved completeness of the NJR dataset from 63% to 93% and accuracy from 94% to 98%.
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Powassan virus (POWV) is an emerging tick-borne virus that causes severe meningoencephalitis in the United States, Canada, and Russia. Serology is generally the preferred diagnostic modality, but PCR on cerebrospinal fluid, blood, or urine has an important role, particularly in immunocompromised patients who are unable to mount a serologic response. Although the perceived poor sensitivity of PCR in the general population may be due to the biology of infection and health-seeking behavior (with short viremic periods that end before hospital presentation), limitations in assay design may also contribute.

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The 2014 chikungunya outbreak in the Dominican Republic resulted in intense local transmission, with high postoutbreak seroprevalence. The resulting population immunity will likely minimize risk for another large outbreak through 2035, but changes in population behavior or environmental conditions or emergence of different virus strains could lead to increased transmission.

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Cache Valley virus (CVV), a mosquito-borne orthobunyavirus, causes epizootics in ruminants characterized by congenital malformations and fetal death in North America. Only seven human infections have been identified; limited information exists on its potential as a human teratogen. Diagnosis of CVV infections relies on the plaque reduction neutralization test (PRNT), which requires live virus, is time-consuming, and cannot differentiate between recent and past infections.

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