Publications by authors named "Watkins A"

The double-lumen endotracheal tube (DLT) was introduced by Carlens in 1949 and became widely used for single-lung ventilation. DLTs have since become standard for most pulmonary resections. Although the use of DLTs is routine and safe in experienced hands, it is not without risk.

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Plastic bronchitis is a rare disease with serious morbidity. We report a case of a 48-year-old male smoker with a past medical history of diabetes, emphysema, recurrent respiratory infections, a worsening productive cough, and increased oxygen requirement over the past 3 months. Often described in the pediatric population, it is important to maintain plastic bronchitis in the differential when considering unresolving pulmonary conditions with chronic sputum production.

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Background: This study evaluated the impact of 2015/2016 prescribing guidance on antidepressant prescribing choices in children.

Methods: A retrospective e-cohort study of whole population routine electronic healthcare records was conducted. Poisson regression was undertaken to explore trends over time for depression, antidepressant prescribing, indications and secondary care contacts.

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Introduction: The aim of this trial was to investigate the impact of early thoracic and shoulder girdle exercises on chronic pain and Health-Related Quality of Life in patients with blunt chest wall trauma, when compared to normal care.

Methods: A multi-centre, parallel, randomised controlled trial, in which adult patients presenting to hospital with blunt chest wall trauma were allocated to either control or intervention group. The intervention was an exercise programme consisting of four simple thoracic and shoulder girdle exercises, completed for one week.

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Article Synopsis
  • - RNA-Puzzles is a collaborative project focused on improving the prediction of RNA three-dimensional structures, with predictions made by modeling groups before experimental structures are published.
  • - A significant set of predictions was made by 18 groups for 23 different RNA structures, including various elements like ribozymes and aptamers.
  • - The study highlights key challenges in RNA modeling, such as identifying helix pairs and ensuring proper stacking, and notes that some top-performing groups also excelled in a separate competition (CASP15).
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Background: Ex-Situ Lung Perfusion (ESLP) employs a membrane deoxygenator and mixed (N/O/CO) or pure sweep gas (CO) to target venous blood gas composition with physiologic pCO and pH. Clinically, mild permissive alkalosis counteracts elevated pulmonary vascular resistance (PVR) to improve perfusion. Increased PVR and pulmonary artery pressure (PAP) during ESLP mirrors rising pro-inflammatory cytokines.

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  • This study examines the long-term outcomes and changes in collateral blood circulation following intentional celiac artery embolization (CAE) during complex endovascular aortic repairs.
  • Researchers analyzed data from 70 patients over 12 years, focusing on complications related to the mesenteric area and how they correlate with changes in collateral vessel size.
  • Findings showed a significant rate of gastrointestinal complications within 90 days post-CAE, with a notable decrease in 2-year survival for patients experiencing these complications compared to those who did not.
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Objectives: To appraise and synthesise qualitative literature identifying: (a) fathers' concerns and challenges during the transition to fatherhood that may be impacting mental health and well-being experiences; and (b) fathers' experiences of antenatal programmes, and psychological and social support, to understand how we can better support fathers in addressing these concerns.

Design: International, qualitative evidence synthesis, scoping review.

Data Sources: Six electronic databases (Medline, Embase, PsycINFO, CINAHL, Scopus, ASSIA) alongside 'grey' and supplementary searches were conducted March 2024.

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Background: Opioids kill more people than any other drug. Naloxone is an opioid antagonist which can be distributed in take-home 'kits' for peer administration (take-home naloxone).

Aim: To determine the feasibility of carrying out a definitive randomised controlled trial of take-home naloxone in emergency settings.

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  • Humans combine visual and sensory information to perceive gravity, which is challenging in Mixed/Augmented Reality (MR/AR) due to the need for realistic integration of virtual elements with real ones.
  • *Current force feedback devices struggle with MR/AR experiences, but minimal haptic feedback can enhance the perception of weight in virtual environments, improving user experience.
  • *The research developed a compensation scheme for virtual weights to improve accuracy in mixed real-virtual environments, showing promising results for future MR/AR designs that align with human sensory perceptions.*
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Objective: The rising prevalence of mental health symptoms brought on by the COVID19 pandemic led to the inception and development of EMERging Anxiety, Loneliness, Depression (EMERALD) well-being programme. EMERALD was designed to improve psychological well-being of the general population who had not previously sought mental health support. The programme incorporated a focus on lifestyle medicine and was underpinned by solution focused health coaching.

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Background: Early assessment of patients with suspected transient ischaemic attack (TIA) is crucial to provision of effective care, including initiation of preventive therapies and identification of stroke mimics. Many patients with TIA present to emergency medical services (EMS) but may not require hospitalisation. Paramedics could identify and refer patients with low-risk TIA, without conveyance to the ED.

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Introduction: Gender bias has been reported by women surgeons, but its impact on communication in the operating room (OR) is unclear. OR communication is critical to understand, as it directly impacts patient outcomes. The current study evaluates potential gender bias in the type and quality of communication between surgeons and OR nursing and anesthesia providers.

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Background: Aortic valve disease(AVD) accounts for 33 % of valvular heart disease(VHD) but causes over 60 % of VHD mortality. For surgical AVR, mechanical valves are recommended for patients <50 years old and bioprosthetic valves for those >70 years old.

Objectives: To investigate the long-term differences following AV replacement(AVR) comparing bioprosthetic and mechanical valves in patients aged 50-70.

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Introduction: Research has found differences in processes and outcomes of care between people in ethnic minorities and White British populations in some clinical conditions, although findings have been mixed. The Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries study is investigating differences in presentation, experience and health outcomes between people from ethnic minorities and White British people who seek emergency health care for injury.

Objective: Our aim was to consult with stakeholders to define measurable outcomes available in routine ambulance and emergency department data; to assess the appropriateness of existing outcome measures for ethnic minorities and White British people; and to identify any gaps.

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  • Octogenarians (patients aged 80-90) often face limitations in undergoing mitral valve surgery due to fears of complications, prompting this study to analyze their outcomes after mitral valve repair (MVr) and replacement (MVR).
  • The study reviewed data from 139 patients who underwent these procedures between 2004 and 2018, with follow-up lasting up to 15.8 years, revealing various metrics of morbidity and long-term survival rates.
  • Findings showed that while short-term mortality rates were relatively low, long-term mortality was significant; however, patients experienced positive cardiovascular improvements post-surgery, suggesting that mitral valve surgery can be a safe and effective option for octogenarians.
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We describe a process for rapid antibody affinity optimization by repertoire mining to identify clones across B cell clonal lineages based on convergent immune responses where antigen-specific clones with the same heavy (V) and light chain germline segment pairs, or parallel lineages, bind a single epitope on the antigen. We use this convergence framework to mine unique and distinct V lineages from rat anti-triggering receptor on myeloid cells 2 (TREM2) antibody repertoire datasets with high diversity in the third complementarity-determining loop region (CDR H3) to further affinity-optimize a high-affinity agonistic anti-TREM2 antibody while retaining critical functional properties. Structural analyses confirm a nearly identical binding mode of anti-TREM2 variants with subtle but significant structural differences in the binding interface.

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Background: Parenteral nutrition (PN) without enteral nutrition (EN) leads to marked atrophy of gut-associated lymphoid tissue (GALT), causing mucosal defense failure in both the gut and the extraintestinal mucosal system. We evaluated the effects of beta-hydroxy-beta-methylbutyrate (HMB) on GALT and gut morphology in PN-fed mice.

Methods: Experiment 1: male Institute of Cancer Research mice were assigned to the Chow (n = 12), Control (standard PN: n = 10), or H600 and H2000 (PN containing 600 mg/kg or H2000 mg/kg body weight of Ca-HMB: n = 12 and 10, respectively) groups.

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Introduction: Spontaneous pneumothorax is a common thoracic surgical problem. To prevent recurrence, surgical options include blebectomy, mechanical or chemical pleurodesis, pleurectomy, or a combination of these operations. Pleurectomy is associated with lower recurrence rates but may be technically challenging via video-assisted thoracoscopic surgery.

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Background: Emergency admissions are costly, increasingly numerous, and associated with adverse patient outcomes. Policy responses have included the widespread introduction of emergency admission risk stratification (EARS) tools in primary care. These tools generate scores that predict patients' risk of emergency hospital admission and can be used to support targeted approaches to improve care and reduce admissions.

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  • Globally, while people are living longer, many experience a decline in health due to age-related diseases, highlighting the need for better classification systems to address these issues.
  • A consensus meeting with 150 experts established criteria for identifying ageing-related pathologies, requiring a 70% agreement for approval among participants.
  • The agreed criteria focus on conditions that progress with age, contribute to functional decline, and are backed by human studies, setting a foundation for future classification and staging efforts.
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Background: The importance of parental diet in relation to eventual offspring health is increasing in prominence due to the increased frequency of parents of reproductive age consuming poor diets. Whilst maternal health and offspring outcome have been studied in some detail, the paternal impacts are not as well understood. A father's poor nutritional status has been shown to have negative consequences on foetal growth and development and ultimately impact the long-term adult health of the offspring.

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Minimally invasive thoracic surgery has advanced the treatment of lung cancer since its introduction in the 1990s. Video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracic surgery (RATS) offer the advantage of smaller incisions without compromising patient outcomes. These techniques have been shown to be safe and effective in standard pulmonary resections (lobectomy and sub-lobar resection) and in complex pulmonary resections (sleeve resection and pneumonectomy).

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Lipid metabolism is recognised as being central to growth, disease and health. Lipids, therefore, have an important place in current research on globally significant topics such as food security and biodiversity loss. However, answering questions in these important fields of research requires not only identification and measurement of lipids in a wider variety of sample types than ever before, but also hypothesis-driven analysis of the resulting 'big data'.

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Background: Full-flow perfusion during prolonged ex situ lung perfusion (ESLP) results in unacceptable pulmonary edema formation. Clinical ESLP at 30% to 50% predicted cardiac output (CO) supports acceptable physiologic outcomes; however, progressive pulmonary edema still develops. Lower flow rates may provide equivalent physiologic preservation with less edema formation due to reduced hydrostatic pressures.

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