ORCID Profile
0000-0001-6858-6659
Current Organisations
University of Arizona
,
University of Oxford
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Publisher: Oxford University Press (OUP)
Date: 22-03-2023
DOI: 10.1093/BJS/ZNAD031
Abstract: Surgery for nail bed injuries in children is common. One of the key surgical decisions is whether to replace the nail plate following nail bed repair. The aim of this RCT was to assess the clinical effectiveness and cost-effectiveness of nail bed repair with fingernail replacement/substitution compared with repair without fingernail replacement. A two-arm 1 : 1 parallel-group open multicentre superiority RCT was performed across 20 secondary-care hospitals in the UK. The co-primary outcomes were surgical-site infection at around 7 days after surgery and cosmetic appearance summary score at a minimum of 4 months. Some 451 children presenting with a suspected nail bed injury were recruited between July 2018 and July 2019 224 were allocated to the nail-discarded arm, and 227 to the nail-replaced arm. There was no difference in the number of surgical-site infections at around 7 days between the two interventions or in cosmetic appearance. The mean total healthcare cost over the 4 months after surgery was €84 (95 per cent c.i. 34 to 140) lower for the nail-discarded arm than the nail-replaced arm (P & 0.001). After nail bed repair, discarding the fingernail was associated with similar rates of infection and cosmesis ratings as replacement of the finger nail, but was cost saving. Registration number: ISRCTN44551796 (www.controlled-trials.com).
Publisher: Elsevier BV
Date: 10-2017
Publisher: Elsevier BV
Date: 2021
Publisher: BMJ
Date: 12-2019
DOI: 10.1136/BMJOPEN-2019-031552
Abstract: Trauma to the nail bed is the most common surgically treated paediatric hand injury. The majority of surgeons replace the nail plate after repairing the nail bed despite a lack of evidence to do so. Replacing the nail plate may be associated with increased postoperative infection. We will investigate the impact of replacing or discarding the nail plate on infection, cosmetic appearance, pain and subsequent healthcare use. The Nail bed INJury Analysis trial (NINJA) aims to answer the question of whether the nail plate should be replaced or discarded after surgical nail bed repair in children. A two-arm parallel group open multicentre randomised control trial of replacing the nail plate or not, as part of a nail bed repair, will be undertaken in children presenting within 48 hours of a nail bed injury requiring surgical repair. The coprimary outcomes are: cosmetic appearance summary score at a minimum of 4 months and surgical site infection at around 7 days following surgery. Secondary outcomes are EuroQol EQ-5D-(Y) the pain intensity experienced at first dressing change child arent satisfaction with nail healing and healthcare resource use. We will recruit a minimum of 416 patients (208 in each group) over 3 years. Children and their parents/carers will be reviewed in clinic around 7 days after their operation and will be assessed for surgical site infection or other problems. The children, or depending on age, their parents/carers, will also be asked to complete a questionnaire and send in photos of their fingernail at a minimum of 4 months postsurgery to assess cosmetic appearance. The South Central Research Ethics Committee approved this study on 4 June 2019 (18/SC/0024). A manuscript to a peer-reviewed journal will be submitted on completion of the trial as per National Institute for Health Research publication policy. The results of this trial will substantially inform clinical practice and provide evidence on whether the practice of replacing the nail plate should continue at the time of nail bed repair. ISRCTN44551796 .
Publisher: ZappyLab, Inc.
Date: 02-09-2019
DOI: 10.17504/PROTOCOLS.IO.6Z9HF96
Abstract: Background:Development ofanentry-level physiotherapy curriculum in ChinacurrentlyfollowstheWorld Confederation for Physical Therapy (WCPT) guidelines,howeverthere is nostandard,validated,assessment tool for physiotherapy practicein usein China. This article reports the process of translation of the “Assessment ofPhysiotherapy Practice”,a validated assessment instrument adopted by all universities in Australia and New Zealand(APP-ANZ),into Chinese (APP-Chinese) anditsimplementationby Chinese physiotherapyclinical educators andstudents duringclinical placements. Feedbackfrom both clinical educators and studentswassolicited.Methods: The process of forward and backward translation of the APP was undertaken by a team of academics from universities in Shanghai, Hong Kong and Australia. An APP-Chineseversionwas produced and used for assessment of the clinical performance of 4thyear studentsata university in Shanghai. Feedback on theimplementationof theAPP-Chinese was solicited from students and clinical educators (CEs)usingthe sametwo questionnaires(translated into Chinese)used to assessimplementation ofthe original APP-ANZ.Results: All CEs agreed that the rulesused to scorethe APP-Chinese were helpfulin assessingstudent performance. Over 90%of the CEsconsidered the APP-Chinese waspragmaticin the clinical environment in China. All students agreed with the ratingof theirperformanceonthe APP-Chinese marked by their educators, and that the performance indicators were useful in guiding their expected performance behaviour.Conclusions: The APP-Chinese is the first standardised assessment toolforphysiotherapy student clinical performanceusedin China andwas shownto be well accepted by both students and CEs.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Wiley
Date: 03-06-2013
DOI: 10.1111/PCE.12129
Abstract: During daylight hours, the isotope composition of leaf water generally approximates steady-state leaf water isotope enrichment model predictions. However, until very recently there was little direct confirmation that isotopic steady-state (ISS) transpiration in fact exists. Using isotope ratio infrared spectroscopy (IRIS) and leaf gas exchange systems we evaluated the isotope composition of transpiration and the rate of change in leaf water isotopologue storage (isostorage) when leaves were exposed to variable environments. In doing so, we developed a method for controlling the absolute humidity entering the gas exchange cuvette for a wide range of concentrations without changing the isotope composition of water vapour. The measurement system allowed estimation of (18)O enrichment both at the evaporation site and for bulk leaf water, in the steady state and the non-steady state. We show that non-steady-state effects dominate the transpiration isoflux even when leaves are at physiological steady state. Our results suggest that a variable environment likely prevents ISS transpiration from being achieved and that this effect may be exacerbated by lengthy leaf water turnover times due to high leaf water contents.
Publisher: Elsevier BV
Date: 2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2019
Publisher: SAGE Publications
Date: 16-06-2017
Abstract: The epidemiology of abdominal aortic aneurysm (AAA) is changing. Outcomes for aortic surgery have improved. However, the accepted guideline for the management of AAAs has remained unchanged over the last 2 decades. We aimed to gain insight into the patients’ experience while they are managed under the traditional clinical pathway. With the help of a patient focus group, we designed a survey to assess the patients’ perception of the disease and their experience during different stages of the AAA clinical care pathway (surveillance, perioperative care, postoperative follow-up). An invitation to participate in the survey was sent to all patients with AAA who were receiving care at the Oxford Regional Vascular Services Unit, part of the Oxford University Hospitals NHS Trust. We received 194 responses from patients with AAA. One hundred seventy-seven were male, with a median age of 75 to 79 years. Just over a third had undergone surgery already, and the remaining 63% were either in surveillance or awaiting surgery. Their experience during the AAA management pathway was mostly positive. Of the issues that were most important to them in terms of their medical care, the provision of explanation and regularity of monitoring stood out as the most common considerations. Patients are generally satisfied with the care they received, but there is room for improvement. They have also highlighted key areas that are most important to them in terms of their medical care. These should guide the future direction for quality improvement and research.
Publisher: Elsevier BV
Date: 06-2017
Publisher: Elsevier BV
Date: 10-2017
Location: United States of America
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Jia Hu.