Publications by authors named "Graham Morgan"

12 Publications

  • Page 1 of 1

Preventing sepsis; how can artificial intelligence inform the clinical decision-making process? A systematic review.

Int J Med Inform 2021 Apr 10;150:104457. Epub 2021 Apr 10.

School of Pharmacy, Newcastle University, King George VI Building, Newcastle upon Tyne, NE1 7RU, UK. Electronic address:

Background And Objectives: Sepsis is a life-threatening condition that is associated with increased mortality. Artificial intelligence tools can inform clinical decision making by flagging patients at risk of developing infection and subsequent sepsis. This systematic review aims to identify the optimal set of predictors used to train machine learning algorithms to predict the likelihood of an infection and subsequent sepsis.

Methods: This systematic review was registered in PROSPERO database (CRD42020158685). We conducted a systematic literature review across 3 large databases: Medline, Cumulative Index of Nursing and Allied Health Literature, and Embase. Quantitative primary research studies that focused on sepsis prediction associated with bacterial infection in adults in all care settings were eligible for inclusion.

Results: Seventeen articles met our inclusion criteria. We identified 194 predictors that were used to train machine learning algorithms, with 13 predictors used on average across all included studies. The most prevalent predictors included age, gender, smoking, alcohol intake, heart rate, blood pressure, lactate level, cardiovascular disease, endocrine disease, cancer, chronic kidney disease (eGFR<60 mL/min), white blood cell count, liver dysfunction, surgical approach (open or minimally invasive), and pre-operative haematocrit < 30 %. All included studies used artificial intelligence techniques, with average sensitivity 75.7 ± 17.88, and average specificity 63.08 ± 22.01.

Conclusion: The type of predictors influenced the predictive power and predictive timeframe of the developed machine learning algorithm. Predicting the likelihood of sepsis through artificial intelligence can help concentrate finite resources to those patients who are most at risk. Future studies should focus on developing more sensitive and specific algorithms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijmedinf.2021.104457DOI Listing
April 2021

ASTEROID: A New Clinical Stereotest on an Autostereo 3D Tablet.

Transl Vis Sci Technol 2019 Jan 28;8(1):25. Epub 2019 Feb 28.

Institute of Neuroscience, Newcastle University, Framlington Place, Newcastle upon Tyne, UK.

Purpose: To describe a new stereotest in the form of a game on an autostereoscopic tablet computer designed to be suitable for use in the eye clinic and present data on its reliability and the distribution of stereo thresholds in adults.

Methods: Test stimuli were four dynamic random-dot stereograms, one of which contained a disparate target. Feedback was given after each trial presentation. A Bayesian adaptive staircase adjusted target disparity. Threshold was estimated from the mean of the posterior distribution after 20 responses. Viewing distance was monitored via a forehead sticker viewed by the tablet's front camera, and screen parallax was adjusted dynamically so as to achieve the desired retinal disparity.

Results: The tablet must be viewed at a distance of greater than ∼35 cm to produce a good depth percept. Log thresholds were roughly normally distributed with a mean of 1.75 log arcsec = 56 arcsec and SD of 0.34 log arcsec = a factor of 2.2. The standard deviation agrees with previous studies, but ASTEROID thresholds are approximately 1.5 times higher than a similar stereotest on stereoscopic 3D TV or on Randot Preschool stereotests. Pearson correlation between successive tests in same observer was 0.80. Bland-Altman 95% limits of reliability were ±0.64 log arcsec = a factor of 4.3, corresponding to an SD of 0.32 log arcsec on individual threshold estimates. This is similar to other stereotests and close to the statistical limit for 20 responses.

Conclusions: ASTEROID is reliable, easy, and portable and thus well-suited for clinical stereoacuity measurements.

Translational Relevance: New 3D digital technology means that research-quality psychophysical measurement of stereoacuity is now feasible in the clinic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1167/tvst.8.1.25DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396686PMC
January 2019

Legal capacity, mental capacity and supported decision-making: Report from a panel event.

Int J Law Psychiatry 2019 Jan - Feb;62:160-168. Epub 2018 Oct 31.

Mental Welfare Commission for Scotland, Thistle House, 91 Haymarket Terrace, Edinburgh EH12 5HE, UK.

Against a backdrop of the UN Convention on the Rights of Persons with Disabilities having been in place for over a decade, discussions about legal capacity, the relevance of mental capacity and the shift to supported decision-making, continue to develop. A panel event was held at the King's Transnational Law Summit in 2018 with the aim of understanding the contours of the dialogue around these issues. This paper presents the contributions of the panel members, a summary of the discussion that took place and a synthesis of the views expressed. It suggests that divergent conclusions in this area turn on disagreements about: the consequences of sometimes limiting legal capacity for people with mental disabilities; the emphasis placed on particular values; the basis for mental capacity assessments; and the scope for supported decision-making. It also highlights the connection between resources, recognition and freedoms for people with mental disabilities, and therefore the issues that arise when discussion in this area is limited to legal capacity in the context of decision-making.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijlp.2018.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372113PMC
January 2020

What we talk about when we talk about investment in mental health.

Authors:
Graham Morgan

Lancet Psychiatry 2018 09;5(9):695-696

HUG (Action for Mental Health), Inverness IV1 1ST, Scotland, UK. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S2215-0366(18)30210-4DOI Listing
September 2018

Deep learning-based artificial vision for grasp classification in myoelectric hands.

J Neural Eng 2017 06 3;14(3):036025. Epub 2017 May 3.

School of Electrical and Electronic Engineering, Newcastle University, Newcastle-upon-Tyne NE1 7RU, United Kingdom.

Objective: Computer vision-based assistive technology solutions can revolutionise the quality of care for people with sensorimotor disorders. The goal of this work was to enable trans-radial amputees to use a simple, yet efficient, computer vision system to grasp and move common household objects with a two-channel myoelectric prosthetic hand.

Approach: We developed a deep learning-based artificial vision system to augment the grasp functionality of a commercial prosthesis. Our main conceptual novelty is that we classify objects with regards to the grasp pattern without explicitly identifying them or measuring their dimensions. A convolutional neural network (CNN) structure was trained with images of over 500 graspable objects. For each object, 72 images, at [Formula: see text] intervals, were available. Objects were categorised into four grasp classes, namely: pinch, tripod, palmar wrist neutral and palmar wrist pronated. The CNN setting was first tuned and tested offline and then in realtime with objects or object views that were not included in the training set.

Main Results: The classification accuracy in the offline tests reached [Formula: see text] for the seen and [Formula: see text] for the novel objects; reflecting the generalisability of grasp classification. We then implemented the proposed framework in realtime on a standard laptop computer and achieved an overall score of [Formula: see text] in classifying a set of novel as well as seen but randomly-rotated objects. Finally, the system was tested with two trans-radial amputee volunteers controlling an i-limb Ultra prosthetic hand and a motion control prosthetic wrist; augmented with a webcam. After training, subjects successfully picked up and moved the target objects with an overall success of up to [Formula: see text]. In addition, we show that with training, subjects' performance improved in terms of time required to accomplish a block of 24 trials despite a decreasing level of visual feedback.

Significance: The proposed design constitutes a substantial conceptual improvement for the control of multi-functional prosthetic hands. We show for the first time that deep-learning based computer vision systems can enhance the grip functionality of myoelectric hands considerably.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1088/1741-2552/aa6802DOI Listing
June 2017

Twenty-four hour human urine and serum profiles of bisphenol a during high-dietary exposure.

Toxicol Sci 2011 Sep 24;123(1):48-57. Epub 2011 Jun 24.

Fundamental and Computational Sciences, Pacific Northwest National Laboratory, Richland, Washington 99352, USA.

By virtue of its binding to steroid hormone receptors, bisphenol A (BPA, the unconjugated bioactive monomer) is hypothesized to be estrogenic when present in sufficient quantities in the body, raising concerns that widespread exposure to BPA may impact human health. To better understand the internal exposure of adult humans to BPA and the relationship between the serum and urinary pharmacokinetics of BPA, a clinical exposure study was conducted. Blood and urine samples were collected approximately hourly over a 24-h period from 20 adult volunteers who ingested 100% of one of three specified meals comprising standard grocery store food items for breakfast, lunch, and dinner. The volunteers' average consumption of BPA, estimated from the urinary excretion of total BPA ((TOT)BPA = conjugated BPA + BPA), was 0.27 μg/kg body weight (range, 0.03-0.86), 21% greater than the 95th percentile of aggregate exposure in the adult U.S. population. A serum time course of (TOT)BPA was observable only in individuals with exposures 1.3-3.9 times higher than the 95th percentile of aggregate U.S. exposure. The (TOT)BPA urine concentration T(max) was 2.75 h (range, 0.75-5.75 h) post-meal, lagging the serum concentration T(max) by ∼1 h. Serum (TOT)BPA area under the curve per unit BPA exposure was between 21.5 and 79.0 nM•h•kg/μg BPA. Serum (TOT)BPA concentrations ranged from less than or equal to limit of detection (LOD, 1.3 nM) to 5.7 nM and were, on average, 42 times lower than urine concentrations. During these high dietary exposures, (TOT)BPA concentrations in serum were undetectable in 83% of the 320 samples collected and BPA concentrations were determined to be less than or equal to LOD in all samples.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/toxsci/kfr160DOI Listing
September 2011

The impact of pre-entry study skills training programmes on students' first year experience in health and social care programmes.

Nurse Educ Pract 2008 Jan 18;8(1):20-30. Epub 2007 Apr 18.

School of Nursing, Faculty of Health and Social Care Sciences, Kingston University and St. George's, University of London, Grosvenor Wing, Cranmer Terrace, London SW17 0RE, United Kingdom.

The Faculty of Health and Social Care Sciences at Kingston University and St. George's, University of London has provided a pre-entry study skills course since July 2001. The course runs over one weekend and although short, is comprehensive. An evaluative research study, using case study methodology was undertaken to examine the impact of this pre-entry initiative on the first year student experience. Data were obtained through focus groups with students and semi-structured interviews with both students and staff. The findings show that the study skills weekend programmes prepare students realistically for their first year university experience. In addition, the evaluation helped to develop insight into the first year experience which have informed a number of academic initiatives.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nepr.2007.02.003DOI Listing
January 2008

Help us do it our way.

Authors:
Graham Morgan

Ment Health Today 2006 Jul-Aug:31-3

Highland Users Group.

View Article and Find Full Text PDF

Download full-text PDF

Source
September 2006

Tackling stigma in schools.

Ment Health Today 2006 Apr:30-2

View Article and Find Full Text PDF

Download full-text PDF

Source
April 2006

We want to be able to work.

Authors:
Graham Morgan

Ment Health Today 2005 Oct:32-4

Highland Users Group.

View Article and Find Full Text PDF

Download full-text PDF

Source
October 2005

Another view of patient focused care.

Nurs Stand 1994 May;8(34):37

Central Middlesex Hospital NHS Trust.

In her article, 'Patient focused care without the upheaval' (Features, April 13), Sue Johnson expresses views which are contrary to our understanding of the patient focused care (PFC) concept.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7748/ns.8.34.37.s39DOI Listing
May 1994

In praise of the RCN's plea for involvement.

Authors:
Graham Morgan

Nurs Stand 1993 Jul;7(42):42-43

Central Middlesex Hospital NHS Trust.

I should like to challenge the assumptions Ann Catlow made in arguing against the training of health care assistants under the patient focused hospitals initiative to perform tasks normally undertaken by 'skilled professionals such as phlebotomists'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7748/ns.7.42.42.s45DOI Listing
July 1993