Publications by authors named "Warden G"

High purity natural quartz is used as raw material for the manufacture of quartz glass crucibles for solar-grade silicon ingots production. One key challenge for cost-effective ingot pulling is to maximise the ability of the crucible to withstand the process conditions (, silicon load and temperature about 1500 °C) without deformation. In order to improve this glass property, aluminium was coated into the raw quartz materials.

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Introduction: Urologists observed reduced cancer consultations and surgeries during the SARS-CoV-2 pandemic, raising concern about treatment delays. Testicular cancer serves as a particularly sensitive marker of this phenomenon, as the clinical stage of testicular cancer at presentation is predictive of cancer-specific survival. We aimed to investigate whether COVID-related restrictions to primary care access resulted in increased incidence of metastatic germ cell testis cancer.

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Introduction: Renal cell carcinoma (RCC) is often associated with significant morbidity and mortality, with overall survival contingent on multiple factors - most importantly, disease stage at diagnosis. Disruptions in healthcare delivery during the COVID-19 pandemic have resulted in various reported diagnostic and treatment delays, which have had detrimental impacts on malignancies such as RCC.

Methods: Surgically managed cases of RCC at our center were identified using a retrospective chart review of all nephrectomies conducted from March 1, 2018, to February 28, 2023.

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In this chapter, a catalog of the various types of bias that can affect the validity of clinical epidemiologic studies is presented. The biases are classified by stage of research: literature review and publication, design of the study and selection of subjects, execution of the intervention, measurement of exposures and outcomes, data analysis , and interpretation and publication. Definitions are provided for each type of bias listed.

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The spectrum of the neurological effects of high-altitude exposure can range from high-altitude headache and acute mountain sickness, to the more severe end of the spectrum with high-altitude cerebral edema. In general, patients with known unstable preexisting neurological conditions and those patients with residual neurological deficits from a preexisting neurological condition are discouraged from climbing to high altitudes because of the risk of exacerbation or worsening of symptoms. Although multiple sclerosis exacerbations can be triggered by environmental factors, high-altitude exposure has not been reported as a potential trigger.

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Background: Multiple surgical procedures required by patients with extensive thermal injuries impedes delivery of adequate nutrition support, leading to caloric deficits, weight loss, delayed wound healing, and increased length of stay. The standard practice at our institution for >20 years has been to continuously infuse postpyloric enteral nutrition (EN) during surgery. The purpose of this review was to examine the safety and efficacy of intraoperative EN support.

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Background: Hereditary Non-Polyposis Colorectal cancer is caused by Lynch Syndrome (LS; an autosomal dominant condition) or by Familial Colorectal Cancer Type-X (FCCTX; a condition of high family risk that fulfills Amsterdam criteria). The lifetime risk of developing colorectal cancer (CRC) in FCCTX family members is high and CRC occurs later than in LS.

Methods: To determine the impact of primary prevention colonoscopic screening in asymptomatic first-degree relatives of incident CRC cases in 20 families with FCCTX, we compared cancer incidence and survival in 79 males and 83 females, assumed to be at 50% risk of inheriting a genetic CRC susceptibility factor, who entered screening to an unscreened control group from the families, matched for age at entry into screening and for sex.

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Importance: Patient-reported outcomes serving as benchmarks for recovery of pediatric burn survivors are lacking, and new approaches using longitudinal cohorts for monitoring their expected recovery based on statistical models are needed for patient management during the early years following the burn.

Objective: To describe multidimensional patient-reported outcomes among pediatric burn survivors younger than 5 years to establish benchmarks using recovery curve methods.

Design, Setting, And Participants: Prospective cohort study of pediatric burn survivors younger than 5 years at 12 burn centers.

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In this chapter a catalog of the various types of bias that can affect the validity of clinical epidemiologic studies is presented. The biases can be grouped into those associated with selection of subjects, misclassification or misinformation, and finally confounding. Definitions are provided for each type of bias listed.

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Purpose: To test the hypothesis that patient size can be accurately calculated from axial computed tomographic (CT) images, including correction for the effects of anatomy truncation that occur in routine clinical CT image reconstruction.

Materials And Methods: Institutional review board approval was obtained for this HIPAA-compliant study, with waiver of informed consent. Water-equivalent diameter (D(W)) was computed from the attenuation-area product of each image within 50 adult CT scans of the thorax and of the abdomen and pelvis and was also measured for maximal field of view (FOV) reconstructions.

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The objective of this study is to evaluate a natural language processing (NLP) algorithm that determines American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) final assessment categories from radiology reports. This HIPAA-compliant study was granted institutional review board approval with waiver of informed consent. This cross-sectional study involved 1,165 breast imaging reports in the electronic medical record (EMR) from a tertiary care academic breast imaging center from 2009.

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Hereditary non-polyposis colorectal cancer (HNPCC) may be the result of Lynch syndrome (LS) caused by mutations in mismatch repair (MMR) genes, a syndrome of unknown etiology called familial colorectal cancer type-X (FCCTX), or familial serrated neoplasia associated with the colorectal cancer (CRC) somatic BRAF mutation. To determine the cause of HNPCC in the founder population of the island of Newfoundland, we studied 37 families with LS and 29 families without LS who fulfilled the Amsterdam I criteria. In non-LS, four index CRCs were BRAF mutation positive, one of which was microsatellite instable.

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Purpose: To develop and validate an informatics toolkit that extracts anatomy-specific computed tomography (CT) radiation exposure metrics (volume CT dose index and dose-length product) from existing digital image archives through optical character recognition of CT dose report screen captures (dose screens) combined with Digital Imaging and Communications in Medicine attributes.

Materials And Methods: This institutional review board-approved HIPAA-compliant study was performed in a large urban health care delivery network. Data were drawn from a random sample of CT encounters that occurred between 2000 and 2010; images from these encounters were contained within the enterprise image archive, which encompassed images obtained at an adult academic tertiary referral hospital and its affiliated sites, including a cancer center, a community hospital, and outpatient imaging centers, as well as images imported from other facilities.

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Purpose: To develop and validate an open-source informatics toolkit capable of creating a radiation exposure data repository from existing nuclear medicine report archives and to demonstrate potential applications of such data for quality assurance and longitudinal patient-specific radiation dose monitoring.

Materials And Methods: This study was institutional review board approved and HIPAA compliant. Informed consent was waived.

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Introduction: Communication of critical imaging findings is an important component of medical quality and safety. A fundamental challenge includes retrieval of radiology reports that contain these findings. This study describes the expressiveness and coverage of existing medical terminologies for critical imaging findings and evaluates radiology report retrieval using each terminology.

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Bardet-Biedl Syndrome (BBS) is an autosomal recessive, multisystem, genetically heterogeneous, ciliopathic condition caused by mutations in multiple genes. Here we sought to determine if inheritance of a single BBS mutation increased the risks of frequent disorders of this syndrome such as obesity, hypertension, and diabetes. Various metabolic and renal diseases in a cohort of 46 patients with BBS, prospectively followed for up to 28 years, were compared to recent assessments of these factors in 96 relatives with a heterozygote mutation (carriers) and 37 relatives without a contributing mutation (non-carriers).

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Introduction: Previous work demonstrated reduced stage 3+4 and rapid eye movement (REM) sleep following burn injury. This study evaluated the hormonal effects of drug intervention on measures of endocrine status. A secondary objective examined the relationship between hormones and sleep stage distribution.

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During the past decade, there has been a growing interest in competency-based performance systems for enhancing both individual and organizational performance in health professions education and the varied healthcare industry sectors. In 2003, the Institute of Medicine's report Health Professions Education: A Bridge to Quality called for a core set of competencies across the professions to ultimately improve the quality of healthcare in the United States. This article reviews the processes and outcomes associated with the development of the Health Leadership Competency Model (HLCM), an evidence-based and behaviorally focused approach for evaluating leadership skills across the professions, including health management, medicine, and nursing, and across career stages.

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An increasing number of bacteria are resistant to multiple systemic antibiotics. The purpose of this study was to determine if topical antimicrobials are still effective against multi-drug resistant organisms (MDROs). MDROs, including Acinetobacter, Pseudomonas, Klebsiella, Staphylococcus, and Enterococcus, were collected from four burn hospitals.

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Background: Children with giant congenital nevomelanocytic nevi (CNN) are referred to our pediatric burn center for the surgical management of this disfiguring and potentially malignant skin disorder. Use of tissue expanders has contributed significantly in limiting donor site morbidity associated with treatment of giant CNN. Cultured skin substitutes (CSS) have also shown promise as an alternative wound coverage.

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Children with burn injuries often require hospital treatment where they are subjected to stimuli likely to produce sleep deprivation. Previously demonstrated sleep fragmentation and significantly reduced sleep stage 3/4 and rapid eye movement in this population led to a search for sleep-enhancing interventions. The purpose of this study was to evaluate the effects of selected therapeutic interventions on sleep architecture.

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