Lan Kelly

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Verified

Lan verified their affiliation via an institutional email.

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• PhD
• Statistician at University of South Australia

Background: In this COVID-19 Critical Care Consortium (CCCC) sub-study, we qualified neurological complications associated with SARS-CoV2 infection. Methods: The CCCC is an international, multicenter study. Eligible patients were COVID-19 patients admitted to intensive care units (ICU) across 23 centers between 1/7/2020 to 6/23/2022. Incidence of...

OBJECTIVES: Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. DESIGN: Retrospective analysis of prospectively c...

Purpose We aimed to compare the incidence of stroke in low-and middle-income countries (LMICs) versus high-income countries (HICs) in critically ill patients with COVID-19 and its impact on in-hospital mortality. Methods International observational study conducted in 43 countries. Stroke and mortality incidence rates and rate ratios (IRR) were cal...

Aims The aim of this study was to evaluate the healthcare costs and benefits of enoxaparin compared to aspirin in the prevention of symptomatic venous thromboembolism (VTE) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) using data from the CRISTAL trial. Methods This trial-based economic analysis reports value for money as inc...

Objective Examine the temporal trends in medical device implant procedures in the Australian population. Methods We used data from the Australian Institute of Health and Welfare from the financial years 2007–08 to 2021–22 and chose the most frequently performed medical device implant procedures. We estimated the annual change in volume of procedure...

Mesh implant surgery, commonly used for various medical conditions, has been linked to a range of negative effects, significantly impacting patient experiences and outcomes. Additionally, the growing volume of medical data, especially text-based reports, presents challenges in deriving meaningful insights for informed healthcare decisions. To addre...

Purpose Medicine dispensing data require extensive preparation when used for research and decisions during this process may lead to results that do not replicate between independent studies. We conducted an experiment to examine the impact of these decisions on results of a study measuring discontinuation, intensification, and switching in a cohort...

Implantable medical devices are commonly used to treat various medical conditions. These devices, however, may cause serious adverse events, including repeated surgical intervention and death. Prolonged use of some implantable medical devices can shorten life expectancy and significantly decrease a person’s quality of life. Large adverse event data...

( BJOG . 2023;130:15–23) The most common nutritional disorder worldwide is iron deficiency (ID). Iron is vital for many bodily functions, so when women who are pregnant suffer from ID they are more likely to experience complications during pregnancy as well as deliver babies at risk for neonatal complications. It is estimated that about 47% of wome...

Purpose: The weighted cumulative exposure (WCE) method has been used in a number of fields including pharmacoepidemiology where it can account for intensity, duration and timing of exposures on the risk of an outcome. The method uses a data driven approach with flexible cubic B-splines to assign weights to past doses and select an aetiologically a...

( Aust N Z J Obstet Gynaecol . 2022;62:910–914) During the initial wave of the COVID-19 pandemic, the common option for laboring women in Australia to receive nitrous oxide (N 2 O) for analgesia was discontinued to prevent viral transmission. While there is insufficient data in the literature to define the second stage of labor as an aerosol-genera...

(300/300) Background: In this COVID-19 Critical Care Consortium (CCCC) sub-study, we qualified neurological complications associated with COVID-19 infection, including incidence and outcomes across many countries. Methods: The CCCC is an international, multicenter study. Eligible patients were COVID-19 patients admitted to intensive care units (ICU...

Introduction Frailty is increasingly recognised as a dynamic syndrome, with multiple causes, dimensions and consequences. There is little understanding of how those frailty assessment metrics interact over time. The aim of this study was to describe the longitudinal correlation between five frailty metrics, namely multimorbidity, muscular strength,...

Introduction: Stroke in Regional Australia may have worse outcomes due to difficulties accessing optimal care. The South Australian Regional Telestroke service aimed to improve telestroke neurologist access, supported by improved ambulance triage. Objective: To assess stroke care quality and patient mortality pre- and postimplementation of a vas...

Importance: Ischemic heart disease remains the leading cause of mortality following hip and knee arthroplasty. Due to its antiplatelet and cardioprotective properties, aspirin has been proposed as an agent that could reduce mortality when used as venous thromboembolism (VTE) prophylaxis following these procedures. Objective: To compare aspirin w...

Purpose Intraoperative cell salvage is central to Patient Blood Management including for lower segment caesarean section. Prior to April 2020, we initiated intraoperative cell salvage during caesarean section based on risk assessment for hemorrhage and patient factors. As the pandemic broadened, we mandated intraoperative cell salvage to prevent pe...

Background: KRAS and BRAF testing is currently recommended in metastatic colorectal cancer. There is evidence that KRAS and BRAF mutation status may act as a prognostic biomarker in patients with non-metastatic colorectal cancer. Data is limited on whether KRAS and BRAF mutation status impacts recurrence and mortality in patients with non-metastat...

The case-crossover study has been proposed as a suitable design when a brief exposure causes a transient change in risk of an acute-onset disease. In pharmacoepidemiology, the condition of "brief exposure" is rarely satisfied because drug use is often chronic or successive, which may result in bias due to within-subject exposure dependency. We desc...

Background: Aged care residents are vulnerable to the harmful effects of medicines; however, data on the prevalence and preventability of adverse medicine events in aged care residents are scarce. Aim: To determine the prevalence and preventability of adverse medicine events in Australian aged care residents. Methods: A secondary analysis of d...

Objectives: Evidence of cerebrovascular complications in COVID-19 requiring venovenous extracorporeal membrane oxygenation (ECMO) is limited. Our study aims to characterize the prevalence and risk factors of stroke secondary to COVID-19 in patients on venovenous ECMO. Design: We analyzed prospectively collected observational data, using univaria...

Purpose Intraoperative cell salvage is central to Patient Blood Management including for lower segment caesarean section. Prior to April 2020, we initiated intraoperative cell salvage during caesarean section based on risk assessment for hemorrhage and patient factors. As the pandemic broadened, we mandated intraoperative cell salvage to prevent pe...

Background: Objective measures for screening, prioritizing, and planning care for frail individuals are essential for appropriate aged care provision. This study evaluates metrics derived from actigraphy measures (captured by wrist accelerometer) as a digital biomarker to identify frail individuals at risk of adverse outcomes, including death, hos...

Background: Residents of aged-care facilities have high rates of adverse drug events. This study aimed to identify risk factors for adverse drug events in aged-care residents. Method: This was a secondary study using data from a multicentre randomised controlled trial. Data from 224 residents for whom there was 6 months of baseline information w...

Objectives Large population-based studies examining frailty trajectory found a linear increase in frailty over time. The pattern in which frailty changes over time for an individual person is less well-described. We examined the frailty trajectory of older adults living in aged-care in Australia. Materials and methods This secondary study used dat...

Introduction Hip fractures treated with total hip arthroplasty (THA) are at high risk of prosthesis instability, and dislocation is the most common indication for revision surgery. This study aims to determine whether dual mobility THA implants reduce the risk of dislocation compared with conventional THA in patients with hip fracture suitable to b...

Objective: To test equivalence of two doses of intravenous iron (ferric carboxymaltose) in pregnancy. Design: Parallel, two-arm equivalence randomised controlled trial with an equivalence margin of 5%. Setting: Single centre in Australia. Population: 278 pregnant women with iron deficiency. Methods: Participants received either 500 mg (n=1...

Background: Stroke in Regional Australia may have worse outcome due to difficulties accessing optimal care. The South Australian Regional Telestroke project aimed to improve telestroke neurologist access, supported by improved ambulance triage. Aims: To assess stroke care quality and patient mortality pre- and postimplementation date 4 June 2018. M...

Aim: To examine the incidence and nature of medicine-related problems over time experienced by nursing home residents. Method: We analyzed records collected in the Reducing Medicine-Induced Deterioration and Adverse Events (ReMInDAR) trial. The trial pharmacists provided services to reduce medicine-induced deterioration and adverse reactions for re...

Question Is aspirin monotherapy noninferior to enoxaparin in preventing symptomatic venous thromboembolism (VTE) within 90 days following primary total hip or knee arthroplasty performed for osteoarthritis? Findings In this cluster-randomized, crossover trial that included 9711 patients, treatment with aspirin vs enoxaparin resulted in symptomatic...

Nitrous oxide is commonly used in Australia for labour analgesia. Its use in labour is potentially associated with aerosol generation. During the first wave of the COVID‐19 pandemic of 2020, nitrous oxide was suspended on many birthing units to reduce the risk of transmission. We aimed to determine the impact of withholding nitrous oxide for labour...

Objective To test equivalence of two doses of intravenous iron (ferric carboxymaltose) in pregnancy. Design Parallel, two-arm equivalence randomised controlled trial with an equivalence margin of 5%. Setting Single centre in Australia. Population 278 pregnant women with iron deficiency. Methods Participants received either 500 mg (n=152) or 1000mg...

Background: Evidence of cerebrovascular complications in Coronavirus disease 2019 (COVID-19) requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO) is limited. The aim of our study is to characterize the prevalence and risk factors of stroke secondary to COVID-19 in patients on V-V ECMO. Methods: We analyzed prospectively collected ob...

Background In elderly populations, paracetamol may be used regularly for conditions such as osteoarthritis. Paracetamol has been associated with respiratory disease through a proposed mechanism of glutathione depletion and oxidative stress. Given that chronic obstructive pulmonary disease (COPD) is frequently co-morbid with osteoarthritis, this stu...

Objective: To assess the effectiveness of a pharmacist-led intervention using validated tools to reduce medicine-induced deterioration and adverse reactions. Design and setting: Multicenter, open-label parallel randomised controlled trial involving 39 Australian aged-care facilities. Participants: Residents on ≥4 medicines or ≥1 anticholinergi...

Background Case-crossover studies have been widely used in various fields including pharmacoepidemiology. Vines and Farrington indicated in 2001 that when within-subject exposure dependency exists, conditional logistic regression can be biased. However, this bias has not been well studied. Methods We have extended findings by Vines and Farrington...

Background This a priori statistical analysis plan describes the analysis for CRISTAL. Methods CRISTAL (cluster-randomised, crossover, non-inferiority trial of aspirin compared to low molecular weight heparin for venous thromboembolism prophylaxis in hip or knee arthroplasty, a registry nested study) aims to determine whether aspirin is non-inferi...

Background: Case-crossover studies have been widely used in various fields including pharmacoepidemiology. Vines and Farrington indicated in 2001 that when within-subject exposure dependency exists, conditional logistic regression can be biased. However, this bias has not been well studied. Methods: We have extended findings by Vines and Farrington...

Background: The Birmingham Hip Resurfacing (BHR) prosthesis is the most commonly used metal-on-metal hip resurfacing arthroplasty device. The current manufacturer-recommended target demographic for the BHR is male patients, younger than 65 years requiring a femoral head size of ≥ 50 mm. Female patients, older patients, and individuals with smaller...

Background An accurate measure of the impact of COVID-19 is the infection fatality ratio, or the proportion of deaths among those infected, which does not depend on variable testing rates between nations. The risk of mortality from COVID-19 depends strongly on age and current estimates of the infection fatality ratio do not account for differences...

Introduction Many medicines have adverse effects which are difficult to detect and frequently go unrecognised. Pharmacist monitoring of changes in signs and symptoms of these adverse effects, which we describe as medicine-induced deterioration, may reduce the risk of developing frailty. The aim of this trial is to determine the effectiveness of a 1...

Introduction Venous thromboembolism (VTE) is a serious complication following hip arthroplasty (HA) and knee arthroplasty (KA). This study aims to determine whether aspirin is non-inferior to low molecular weight heparin (LMWH) in preventing symptomatic VTE following HA and KA. Methods and analysis This is a cluster randomised, crossover, non-infe...

Background: Residents of rural and regional areas, compared to those in urban regions, are more likely to experience geographical difficulties in accessing healthcare, particularly specialist services. We investigated associations between region of residence, socioeconomic status (SES) and utilisation of all-cause revision hip replacement or revis...

Girardeau, Ravaud and Donner in 2008 presented a formula for sample size calculations for cluster randomised crossover trials, when the intracluster correlation coefficient, interperiod correlation coefficient and mean cluster size are specified in advance. However, in many randomised trials, the number of clusters is constrained in some way, but t...

Research question: Does the addition of human growth hormone (HGH) to an IVF cycle improve the live birth rate in previously documented poor responders to FSH? Design: Double-blind, placebo-controlled, randomized clinical trial comparing HGH to placebo in maximal stimulation in an IVF cycle. The study was stopped after 4 years. Women receiving o...

Background: Oxidized zirconium (Oxinium) was introduced as an alternative bearing surface to cobalt-chromium (CoCr) in an attempt to reduce polyethylene wear and decrease aseptic mechanical failure of total knee replacements. While noncomparative reports have been described as promising, we were aware of no short or long-term clinical studies show...

Introduction Alternative bearings surfaces to Cobalt Chrome (Co-Cr), such as Oxidised have been introduced in an attempt to reduce polyethylene wear and hence decrease TKA loosening and lysis. While non-comparative reports have been described as promising, no short or long term clinical studies exists showing the superiority of Oxinium on a polyeth...

To determine factors influencing penetrating corneal graft survival in patients receiving repeat grafts in the same eye after a failed first graft for keratoconus. Large cohort study from a national register of corneal grafts, in which data were recorded prospectively and analyzed retrospectively. Follow-up extended to 23 years. Follow-up was avail...

To determine factors influencing long-term graft survival and visual acuity in 4834 eyes of 4060 patients receiving their first penetrating corneal graft for keratoconus. A large cohort study was performed from a national register of corneal grafts in which data were recorded prospectively and analyzed retrospectively. Main outcome measures were gr...

We investigated whether a rejection episode in one graft was associated with rejection in the other graft, in recipients with bilateral corneal transplants. In a prospectively maintained, national register of 14 865 followed corneal grafts, 1476 patients with bilateral penetrating corneal grafts were identified. Occurrence of rejection was a risk f...

We investigated whether a rejection episode in one graft was associated with rejection in the other graft, in recipients with bilateral corneal transplants. In a prospectively maintained, national register of 14,865 followed corneal grafts, 1476 patients with bilateral penetrating corneal grafts were identified. Occurrence of rejection was a risk f...

A bstract To present the outcomes of various retinal conditions treated with the sutureless 25‐gauge (25G) vitrectomy technique. Retrospective case review of 232 eyes of 228 patients who underwent 25G vitrectomy from January 2003 to August 2006. Follow‐up was a minimum of 3 months. Indications for surgery included idiopathic macular hole, rhegmatog...

To document the evolution of geographic atrophy in the peripherin/RDS Arg172Trp substitution, provide age-related estimates of visual acuity, and compare with other missense mutations with a similar phenotype (Arg142Trp, Arg172Gln, and Arg195Leu). Total area of geographic atrophy in 18 affected individuals with the peripherin/RDS Arg172Trp substitu...

Our aims were to examine graft survival and visual outcome after full-thickness corneal transplantation. Records of 18,686 penetrating corneal grafts, 14,622 with archival follow-up from 1 to 22 years, were examined within a national database. Kaplan-Meier survival analysis indicated variables of interest for Cox proportional hazards regression ana...

We describe a Hartmann sensor with a sensitivity of λ/15,500 at λ=820nm. We also demonstrate its application to the measurement of an ultra small change in wavefront and show that the result agrees with that expected to within λ/3,300.

A novel differential Hartmann sensor is described. It can be used to determine the characteristics of an optic accurately, precisely, and simply without detailed knowledge of the wavefront used to illuminate the optical system or of the geometry of the measurement system. We demonstrate the application of this sensor to both zonal and modal optical...

We describe a tomographic Hartmann sensor with sensitivity of lambda/1100 that can measure optical distortions in gravitational wave interferometers. Using an off-axis geometry we demonstrate reconstruction of on-axis optical distortions to a precision of lambda/100.

We describe a novel off-axis Hartmann wavefront sensor, developed for the measurement of wavefront distortions induced in the mirrors (test masses) of advanced gravitational wave interferometers by residual absorption of the circulating laser power.

The High Optical Power Test Facility for Advanced Interferometry has been built by the Australian Consortium for Interferometric Gravitational Astronomy north of Perth in Western Australia. An 80 m suspended cavity has been prepared in collaboration with LIGO, where a set of experiments to test suspension control and thermal compensation will soon...

Advanced laser interferometer detectors utilizing more than 100 W of laser power and with ~106 W circulating laser power present many technological problems. The Australian Consortium for Interferometric Gravitational Astronomy (ACIGA) is developing a high power research facility in Gingin, north of Perth, Western Australia, which will test techniq...

An enormous effort is underway worldwide to attempt to detect gravitational waves. If successful, this will open a new frontier in astronomy. An essential portion of this effort is being carried out in Australia by the Australian Consortium for Interferometric Gravitational Astronomy (ACIGA), with research teams working at the Australia National Un...

How can multi-layer atmospheric turbulence be emulated in order to test multi-conjugate adaptive optics? In this paper we will describe our work on using liquid crystal devices to generate turbulence, from two perspectives. Firstly in the laboratory, in order to test the general principle of MCAO, and secondly as a device to feed light into a real...

Conventional adaptive optics systems using a single wavefront corrector suffer from a limited field of view. Multi-conjugate adaptive optics use two or more corrector to improve off-axis correction. We describe an experimental system which simulates dual-layer turbulence, and present results using a single corrector showing anisoplanatic effects. F...

We present results of the isoplanatic performance of an astronomical adaptive optics system in the laboratory, by using a dual layer turbulence simulator. We describe how the performance of adaptive correction degrades with off-axis angle. These experiments demonstrate that it is now possible to produce quantifiable multi-layer turbulence in the la...

Beta dose rates on the surfaces of cylindrical vessels containing radioactive solutions are calculated using an empirically based Monte Carlo method. Interior source random path length distributions are derived for the container, and energy deposition in a thin surface layer is determined from empirical formulae used by Charlton and Cormack and oth...

An experimental liquid crystal compensator of laser diode astigmatism is described. This compensator consists of two adaptive liquid crystal lenses. The compensator performs focusing of an astigmatic laser beam from infinity to 0.5 m. Numerical and experimental results of focusing for laser diode beam with 0.82 μm wavelength are represented. Disper...

Liquid crystal spatial light modulators have recently been used to generate aberrated wavefronts. We have used two ferroelectric liquid crystal devices to simulate turbulence from two layers of the atmosphere, which will be used in future work to test multi-conjugate adaptive optics systems.© (1999) COPYRIGHT SPIE--The International Society for Opt...

Liquid crystal spatial light modulators have recently been used to generate aberrated wavefronts. We have used two ferroelectric liquid crystal devices to simulate turbulence from two layers of the atmosphere, which will be used in future work to test multi-conjugate adaptive optics systems.

The broadband performance of a polarization-insensitive liquid-crystal phase modulator is analyzed, and its effect on an adaptive optics system is quantified.

A single twisted nematic liquid crystal spatial light modulator may suffer from coupled amplitude modulation and a phase modulation capability of less than 2, although almost all panels can achieve . Two twisted nematic liquid crystal panels can be combined in an optical system to produce a total phase modulation of at least 2, and a minimal couple...

Many twisted nematic liquid crystal spatial light modulators suffer from limited phase modulation capability and coupled amplitude modulation. In particular, a phase modulation capability of less than 2π radians is a severe limitation. Phase modulation is wavelength dependent. We examine the effect of changing the operating wavelength on the phase...

A phase-aberration-correction system that uses high-resolution, twisted nematic liquid-crystal spatial light modulators in a Mach–Zehnder interferometer is presented. A correction algorithm is described and experimentally verified by use initially of one liquid-crystal panel. Phase aberrations are successfully removed by a single liquid-crystal pan...

A novel method of encoding a phase hologram that uses less than (pi) radians of phase is described. The technique is based on Lee's delayed sampling method for amplitude holograms. It was devised for use with liquid crystal spatial light modulators with limited phase modulation capability. Results are compared with Lee's method and binary phase hol...

The International Commission on Radiation Protection have recently recommended an annual dose limit for the skin of radiation workers of 500 mSv at a depth of 20-100 microns averaged over any 1 cm2 regardless of the area exposed. It has previously been shown by the authors that beta dose rates on the outer surfaces of typical laboratory containers...