Gareth Kitchen

The University of Manchester · Centre for Endocrinology and Diabetes

Aims: The incidence of in hospital cardiac arrest (IHCA) varies throughout the day. This study aimed to report the variation in incidence of IHCA, presenting rhythm and outcome based on the hour in which IHCA occurred. Methods: We conducted a retrospective analysis of the National Cardiac Arrest Audit (NCAA) including patients who suffered an IH...

Background: Assessing circadian rhythmicity from infrequently sampled data is challenging, however this type of data is often encountered when measuring circadian transcripts in hospitalised patients. Methods: We present ClinCirc. This method combines two existing mathematical methods (Lomb-Scargle periodogram and cosinor) sequentially, and is d...

The circadian clock controls the physiological function of tissues through the regulation of thousands of genes in a cell‐type‐specific manner. The core cellular circadian clock is a transcription–translation negative feedback loop, which can recruit epigenetic regulators to facilitate temporal control of gene expression. Histone methyltransferase,...

Circadian rhythms are 24-h oscillating variations in physiology generated by the core circadian clock. There is now a wide body of evidence showing circadian regulation of the immune system. Innate immune cells contain the molecular circadian clock which drives rhythmic responses, from the magnitude of the inflammatory response to the numbers of ci...

Robust inflammatory responses are critical to survival following respiratory infection, with current attention focused on the clinical consequences of the Coronavirus pandemic. Epigenetic factors are increasingly recognized as important determinants of immune responses, and EZH2 is a prominent target due to the availability of highly specific and e...

Natural language processing (NLP) is a form of machine learning which enables the processing and analysis of free text. When used with medical notes, it can aid in the prediction of patient outcomes, augment hospital triage systems, and generate diagnostic models that detect early-stage chronic disease. These applications may be particularly useful...

Mucosal immunity is critical to survival, with huge attention at present due to the Coronovirus pandemic. Epigenetic factors are increasingly recognized as important determinants of immune responses, and EZH2 closest to application due to the availability of highly-specific and efficacious antagonists. However, very little is known about the role o...

Glucocorticoids (GCs) act through the glucocorticoid receptor (GR, also known as NR3C1) to regulate immunity, energy metabolism and tissue repair. Upon ligand binding, activated GR mediates cellular effects by regulating gene expression, but some GR effects can occur rapidly without new transcription. Here, we show that GCs rapidly inhibit cell mig...

The circadian clock regulates many aspects of immunity. Bacterial infections are affected by time of day, but the mechanisms involved remain undefined. Here we show that loss of the core clock protein BMAL1 in macrophages confers protection against pneumococcal pneumonia. Infected mice show both reduced weight loss and lower bacterial burden in cir...

Pulmonary inflammatory responses lie under circadian control; however, the importance of circadian mechanisms in the underlying fibrotic phenotype is not understood. Here, we identify a striking change to these mechanisms resulting in a gain of amplitude and lack of synchrony within pulmonary fibrotic tissue. These changes result from an infiltrati...

Pulmonary inflammatory responses lie under circadian control; however the importance of circadian mechanisms in fibrosis is not understood. Here, we identify a striking change to these mechanisms resulting in a gain of amplitude and lack of synchrony within pulmonary fibrotic tissue. These changes result from an infiltration of mesenchymal cells, a...

The glucocorticoid receptor (GR) is a major drug target in inflammatory disease. However, chronic glucocorticoid (GC) treatment leads to disordered energy metabolism, including increased weight gain, adiposity, and hepatosteatosis — all programs modulated by the circadian clock. We demonstrated that while antiinflammatory GC actions were maintained...

The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.tacc.2014.04.011. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

We used a validated questionnaire to explore the views of patients regarding receiving intensive care and life-sustaining technology. Data was obtained from 38 patients. A score was obtained for ‘general attitude towards use of life-sustaining/prolonging technology’ that varied from 18.9 to 48.5 out of 52, the higher score reflecting a more positiv...

We describe the development and laboratory assessment of a refined prototype tactile feedback device for the safe and accurate application of cricoid pressure. We recruited 20 operating department practitioners and compared their performance of cricoid pressure on a training simulator using both the device and a manual unaided technique. The device...

Abstract The problem of comparing the deviation from a target of two or more treatments or procedures arises now and again in medicine. Practitioners usually carry out a t-test on a loss function such as absolute error. We have adapted and developed statistical methods to give a normative methodology for deviation-from-target problems and exemplify...

As a medical professional we have committed ourselves to a career of lifelong learning, and although one can never underestimate the importance of experience, there are some situations that may happen less than once in an anaesthetists career, such as the management of malignant hyperthermia or anaphylaxis. Nonetheless as doctors in anaesthesia we...

Personal development plans are an essential requirement for progression in undergraduate and postgraduate medical education. It is also a prerequisite for the appraisal and revalidation process. The important steps in a PDP are setting specific objectives based on learning and development needs, careful planning for its achievement and monitoring o...