Welcome to the RWT Staff Publications Repository

The repository contains the records of published and unpublished research authored by NHS staff working for the Royal Wolverhampton NHS Trust and its partners. The repository is managed by the Library and Knowledge Services of the Trust and supported by the Non-Medical Research Leads Network Group and the Research and Development Directorate.

If you are a member of RWT staff and you would like to submit an item to the repository, please fill in this online form.

If you have a list of publications you'd like to submit, please e-mail the repository rwh-tr.rwtrepository@nhs.net admin team.

For more information contact the library on 01902 695322 or email or take a look at our website. You will also find guidance on the webpage about publishing your work.

Recent Submissions

  • Item
    Variation in proliferative and cell cycle markers in Barrett's esophagus in relation to circumferential and axial location in the esophagus.
    (Wolters Kulwer, 2024-01-22) Muzaffar, Suhail; Zanetto, Ulises
    Background: Adenocarcinoma in Barrett’s esophagus (BE) occurs more frequently between 12 and 3 o’clock at the gastroesophageal junction (GEJ). Methods: BE patients were prospectively recruited from December 2013 to July 2016. Expression of p53, Ki-67, cyclin-D1, COX-2 and p21 was assessed in quadrantic biopsies from the proximal and distal margins of the BE segments. Cell cycle marker association with current or subsequent dysplasia or adenocarcinoma was examined. Results: 110 patients: median age 64 (IQR, 56–71) years; median BE segment length C4M6; and a median follow-up of 4.7 (IQR, 3.6–5.7) years. In total 13 (11.8%) had evidence of dysplasia or neoplasia (2.7% indefinite for dysplasia, 5.5% low grade, 1.8% high grade and 1.8% adenocarcinoma) at index endoscopy. Six (7%) developed dysplasia or neoplasia (1 low grade, 2 high grade and 3 adenocarcinoma) during follow-up. Ki-67 expression was highest at 3 o’clock, and overall was 49.6% higher in the 12-6 o’clock position compared to 6-12 o’clock [odds ratio (OR), 1.42 (95% confidence interval (CI), 1.00–2.12)]. A similar pattern was found with p21 [1.82 (1.00–3.47)]. There was increased expression of several markers in distal BE biopsies; cyclin-D1 [1.74 (1.29–2.34)]; Cyclo-oxygenase 2 [2.03 (1.48–2.78]) and p21 [2.06 (1.16–3.68)]. Expression of Ki-67 was lower in distal compared to proximal biopsies [0.58 (0.43–0.78)]. P53 expression had high specificity (93.8%) for subsequent low-grade dysplasia, high-grade dysplasia or adenocarcinoma. Conclusion: Increased cellular proliferation was seen at 12-6 o’clock at the GEJ. Cell-cycle marker expression was increased at the GEJ compared to the proximal BE segment. These findings mirror reflux esophagitis and suggest ongoing reflux contributes to the progression of dysplasia and malignancy in BE.
  • Item
    Are displaced distal clavicle fractures associated with inferior clinical outcomes following non-operative management? a systematic review.
    (Elsevier, 2024-01-26) Thurston, Daniel
    Background: Management of displaced distal clavicle fractures remains a topic of discussion due to notoriously high non-union rates, but there is little documented in the literature as to what effect this may have on patient-reported function. The aim of this systematic review was to look at non-operative management following displaced distal clavicle fractures to determine union rates, complications and patient reported outcome measures. Method: A review of the online databases MEDLINE and Embase was conducted, according to PRISMA guidelines. Clinical studies which included a cohort of non-operatively managed displaced distal clavicle fractures, and reported on union rate, complications, and patient-reported functional scores, were included. Results: 11 studies were eligible for inclusion (2 randomized controlled trials, 1 prospective non-comparative cohort study, 5 retrospective comparative cohort studies, and 3 case series) with a total of 779 patients included in this review. Average union rate was 63.2% (22.2% - 94.4%) in non-operatively managed patients, compared with 96.3% (87.9% - 100%) in operatively managed patients. The Constant-Murley Score, and Disabilities of Arm, Shoulder & Hand Score were the most frequently used outcome measure tools. No study demonstrated any significant difference in any outcome measure when comparing non-operative with operative treatment. Complication rate (including non-union) in non-operatively managed patients was 45.1%, with 11.1% requiring delayed surgery. Average complication rate in the operatively managed groups was 41.2%, with 40.1% requiring a second operation. Conclusion: Non-operative management of displaced distal clavicle fractures results in higher non-union rates, but shoulder function remains excellent, and risk of complications and delayed surgery are low. Decision-making must take into account patient factors and expectations to provide high-quality, individualized care.
  • Item
    COVID-19 breakthrough infections in type 1 diabetes mellitus: a cross-sectional study by the COVID-19 Vaccination in Autoimmune Diseases (COVAD) Group.
    (2024-01-01) Gupta, Latika
    To investigate the frequency, profile, and severity of COVID-19 breakthrough infections (BI) in patients with type I diabetes mellitus (T1DM) compared to healthy controls (HC) after vaccination. The second COVID-19 Vaccination in Autoimmune Diseases (COVAD-2) survey is a multinational cross-sectional electronic survey which has collected data on patients suffering from various autoimmune diseases including T1DM. We performed a subgroup analysis on this cohort to investigate COVID-19 BI characteristics in patients with T1DM. Logistic regression with propensity score matching analysis was performed. A total of 9595 individuals were included in the analysis, with 100 patients having T1DM. Among the fully vaccinated cohort, 16 (16%) T1DM patients had one BI and 2 (2%) had two BIs. No morbidities or deaths were reported, except for one patient who required hospitalization with oxygen without admission to intensive care. The frequency, clinical features, and severity of BIs were not significantly different between T1DM patients and HCs after adjustment for confounding factors. Our study did not show any statistically significant differences in the frequency, symptoms, duration, or critical care requirements between T1DM and HCs after COVID-19 vaccination. Further research is needed to identify factors associated with inadequate vaccine response in patients with BIs, especially in patients with autoimmune diseases.
  • Item
    The national profile of the prosthetic and orthotic workforce in the UK: sociodemographics and employment characteristics.
    (International Society for Prosthetics and Orthotics, 2024-01-30) Eddison, Nicola
    Prosthetists and orthotists (POs) are essential members of the health care workforce and one of the United Kingdom’s (UK’s) allied health professions. There is a paucity of information on their demographics, which is essential for the development of the profession. To fill this void, this study has attempted to comprehensively explore the sociodemographics and work-related characteristics of the entire workforce. Methods: Data were collected in 2022 through multiple sources, including surveys of POs, private companies employing POs, and freedom of information requests to National Health Service Trusts/Health Boards and higher education institutes offering programs leading to registration as a prosthetist/orthotist. Results: The workforce survey had 641 respondents (74% response rate). The estimated national ratio of POs per million population was 13, with all bar of the 12 regions below the World Health Organization minimum recommendation of 15 POs per million population. Most of the survey respondents were female (47.6%) and younger than male respondents, were British (75.8%), and in the White ethnic group (74.3%). Most of them were employed by private companies (59.9% vs. 31.4% employed by the National Health Service) and had clinical duties (94%), permanent contracts (90%), worked full-time (75%), and treated a wide range of clinical conditions. Conclusions: The national UK prosthetist and orthotist ratio falls below the recommended international standards. The versatility and broad skill set of POs highlight their crucial role in multidisciplinary teams. Establishing a centralized prosthetist and orthotist workforce database system is recommended for data-driven strategic planning.
  • Item
    Comorbidities in idiopathic inflammatory myopathies: data from the MyoCite cohort.
    (2024-01-01) Gupta, Latika Gupta
    No abstract is available for this article.

Communities in RWT Staff Repository

Select a community to browse its collections.

Now showing 1 - 5 of 13
  • 00- All RWT Publications by Year
    This community lists all the RWT research outputs, collated by year of publication/issue.
  • 01- Division 1 Surgical Division
    This community includes all the groups within the surgical division as of April 2020. Including: Critical Care Services; Cardiology/Cardiothoracic Services; Surgical and Patient Services; Ophthalmology; Womens and Neonatal Group; Trauma and Orthopaedics Group; Head and Neck Group.
  • 02- Division 2 Emergency and Medical Services Division
    This community includes all the groups within the emergency and medical services division as of April 2020. Including: patient access group; rehabilitation and ambulatory group; medical group; emergency services group; oncology and haematology group.
  • 03- Division 3 Community, Childrens and Support Services Division
    This community includes all the groups within the community, childrens and support division as of April 2020. Including: childrens young people and sexual health; adult community and primary care services; diagnostics; pharmacy; therapies and ambulatory care group.
  • 04- Division 4 Corporate Services
    This community includes all the groups within the Division 4 as of May 2021. Including Service efficiency and delivery team; Emergency planning team; Corporate outpatients and Cancer tracking and improvement team.