Publications by authors named "David Singleton"

Background: Medication error (MedE) is a leading global cause of harm in human healthcare with significance both in patient morbidity and mortality, and consequent legal and financial issues. Despite this, MedEs are a poorly explored area in veterinary medicine. Research has so far focussed on survey work and errors spontaneously reported to third parties, such as professional indemnity providers.

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Background: The of walking that people with COPD do is reduced. However, data on their of walking ( gait) are still lacking. We characterised real-world gait in COPD by assessing levels and distributions of gait parameters, and comparing them across COPD severity and with healthy peers.

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Wearable and lightweight devices facilitate real-world physical activity (PA) assessments. MX metrics, as a cut-point-free parameter, evaluate acceleration above which the most active X minutes are accumulated. It provides insights into the intensity of PA over specific durations.

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Spontaneous reporting of adverse events (AEs) by veterinary professionals and the public is the cornerstone of post-marketing safety surveillance for veterinary medicinal products (VMPs). However, studies suggest that most veterinary AEs remain unreported. Veterinary medicine regulators, including the United Kingdom Veterinary Medicines Directorate and the European Medicines Agency, have included the exploration of big data utilization to support pharmacovigilance efforts in their regulatory strategies.

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Objective: To determine the influence of fixation method (internal vs. external) on short-term postoperative complications of closed diaphyseal tibial fractures in skeletally immature dogs.

Study Design: Retrospective observational multicenter study.

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Article Synopsis
  • The study assessed the effectiveness of the Vitros® PCT assay in evaluating procalcitonin (PCT) levels for guiding antibiotic therapy and assessing risk in patients with lower respiratory infections or sepsis.
  • Results showed that Vitros PCT closely matched the KRYPTOR PCT assay, with a high correlation and precision, indicating reliable performance for clinical decision-making regarding sepsis.
  • Findings suggested that changes in PCT levels over the first four days could predict 28-day mortality rates in patients with severe sepsis, highlighting the assay's value in clinical risk assessment.
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Introduction: Veterinary clinical microbiology laboratories play a key role in antimicrobial stewardship, surveillance of antimicrobial resistance and prevention of healthcare associated-infections. However, there is a shortage of international harmonized guidelines covering all steps of veterinary bacterial culture from sample receipt to reporting.

Methods: In order to gain insights, the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) designed an online survey focused on the practices and interpretive criteria used for bacterial culture and identification (C&ID), and antimicrobial susceptibility testing (AST) of animal bacterial pathogens.

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Background: Vaccination of dogs and cats is considered a mainstay of preventive health, providing benefit to individual animals and the population. This study aimed to assess temporal trends in vaccination and factors associated with vaccination uptake in a large veterinary visiting population of UK cats and dogs.

Methods: The electronic health records (EHRs) of 712,266 dogs and 306,888 cats (voluntarily contributed by 201 veterinary practices) were used to determine the proportion that had record of any type of veterinary vaccination either within one-year or within three-years of attending a participating veterinary practice.

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Objectives: Antimicrobial resistance (AMR) is a vital One Health issue; the rational use of antimicrobials is essential to preserve their efficacy. Veterinarians cite pressure from pet owners as a contributor to antimicrobial prescription. Engaging pet owners in antimicrobial stewardship could reduce this pressure.

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Background: Wrist-worn inertial sensors are used in digital health for evaluating mobility in real-world environments. Preceding the estimation of spatiotemporal gait parameters within long-term recordings, gait detection is an important step to identify regions of interest where gait occurs, which requires robust algorithms due to the complexity of arm movements. While algorithms exist for other sensor positions, a comparative validation of algorithms applied to the wrist position on real-world data sets across different disease populations is missing.

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Background: Ticks are an important driver of veterinary health care, causing irritation and sometimes infection to their hosts. We explored epidemiological and geo-referenced data from > 7 million electronic health records (EHRs) from cats and dogs collected by the Small Animal Veterinary Surveillance Network (SAVSNET) in Great Britain (GB) between 2014 and 2021 to assess the factors affecting tick attachment in an individual and at a spatiotemporal level.

Methods: EHRs in which ticks were mentioned were identified by text mining; domain experts confirmed those with ticks on the animal.

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Article Synopsis
  • - The study evaluated the accuracy of a wearable device designed to estimate walking speed in individuals, including those with various health conditions and healthy older adults, over a 2.5-hour period in both laboratory and real-world settings.
  • - Results showed that the device's walking speed estimates had a mean absolute error ranging from 0.06 to 0.13 m/s, indicating good to excellent agreement with a multi-sensor reference system, particularly for participants without significant gait impairments.
  • - The findings underscore the importance of validating technology for clinical use, as accuracy varied with factors like task complexity and walking duration, suggesting the need for thorough testing before implementation in real-world mobility assessments.
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Introduction: Systemically-administered antimicrobials are often prescribed in canine and feline gastrointestinal clinical presentations. Responsible use of antimicrobials, particularly those considered Highest Priority Critically Important Antimicrobials (HPCIAs) is vital to tackle antimicrobial resistance. Although practice-level prescription guidance is available, further strategies based on a greater understanding of antimicrobial prescription at the population-level are needed.

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The intersection of human, animal, and ecosystem health at One Health interfaces is recognised as being of key importance in the evolution and spread of antimicrobial resistance (AMR) and represents an important, and yet rarely realised opportunity to undertake vital AMR surveillance. A working group of international experts in pathogen genomics, AMR, and One Health convened to take part in a workshop series and online consultation focused on the opportunities and challenges facing genomic AMR surveillance in a range of settings. Here we outline the working group's discussion of the potential utility, advantages of, and barriers to, the implementation of genomic AMR surveillance at One Health interfaces and propose a series of recommendations for addressing these challenges.

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Article Synopsis
  • The study highlights a shift in gait analysis from traditional supervised tests to unsupervised monitoring using inertial measurement units (IMUs), improving ecological validity.
  • A deep learning algorithm was developed to accurately detect gait events (like initial and final contacts) in diverse populations by analyzing data from pressure insoles and IMUs over 2.5 hours.
  • The algorithm demonstrated high accuracy in detecting these events and produced gait parameters closely aligned with established pressure insole references, suggesting its effectiveness in real-world settings.
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Background: Although digital mobility outcomes (DMOs) can be readily calculated from real-world data collected with wearable devices and ad-hoc algorithms, technical validation is still required. The aim of this paper is to comparatively assess and validate DMOs estimated using real-world gait data from six different cohorts, focusing on gait sequence detection, foot initial contact detection (ICD), cadence (CAD) and stride length (SL) estimates.

Methods: Twenty healthy older adults, 20 people with Parkinson's disease, 20 with multiple sclerosis, 19 with proximal femoral fracture, 17 with chronic obstructive pulmonary disease and 12 with congestive heart failure were monitored for 2.

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Accurately assessing people's gait, especially in real-world conditions and in case of impaired mobility, is still a challenge due to intrinsic and extrinsic factors resulting in gait complexity. To improve the estimation of gait-related digital mobility outcomes (DMOs) in real-world scenarios, this study presents a wearable multi-sensor system (INDIP), integrating complementary sensing approaches (two plantar pressure insoles, three inertial units and two distance sensors). The INDIP technical validity was assessed against stereophotogrammetry during a laboratory experimental protocol comprising structured tests (including continuous curvilinear and rectilinear walking and steps) and a simulation of daily-life activities (including intermittent gait and short walking bouts).

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Introduction: Vaccination is a potentially critical component of efforts to arrest development and dissemination of antimicrobial resistance (AMR), though little is known about vaccination impact within low-income and middle-income countries. This study will evaluate the impact of vaccination on reducing carriage prevalence of resistant and extended spectrum beta-lactamase-producing and species. We will leverage two large ongoing cluster-randomised vaccine evaluations in Malawi assessing; first, adding a booster dose to the 13-valent pneumococcal conjugate vaccine (PCV13) schedule, and second, introduction of the RTS,S/AS01 malaria vaccine.

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Polycyclic aromatic hydrocarbons (PAHs) are major environmental pollutants in a number of point source contaminated sites, where they are found embedded in complex mixtures containing different polyaromatic compounds. The application of bioremediation technologies is often constrained by unpredictable end-point concentrations enriched in recalcitrant high molecular weight (HMW)-PAHs. The aim of this study was to elucidate the microbial populations and potential interactions involved in the biodegradation of benz(a)anthracene (BaA) in PAH-contaminated soils.

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Fleas in the genus Ctenocephalides are the most clinically important parasitic arthropods of dogs and cats worldwide yet risk factors that might increase the risk of infestation in small animals remains unclear. Here we developed a supervised text mining approach analysing key aspects of flea epidemiology using electronic health records from domestic cats and dogs seen at a sentinel network of 191 voluntary veterinary practices across Great Britain between March 2014 and July 2020. Our methods identified fleas as likely to have been present during 22,276 of 1,902,016 cat consultations (1.

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Background: Measuring mobility in daily life entails dealing with confounding factors arising from multiple sources, including pathological characteristics, patient specific walking strategies, environment/context, and purpose of the task. The primary aim of this study is to propose and validate a protocol for simulating real-world gait accounting for all these factors within a single set of observations, while ensuring minimisation of participant burden and safety.

Methods: The protocol included eight motor tasks at varying speed, incline/steps, surface, path shape, cognitive demand, and included postures that may abruptly alter the participants' strategy of walking.

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Background: The development of optimal strategies to treat impaired mobility related to ageing and chronic disease requires better ways to detect and measure it. Digital health technology, including body worn sensors, has the potential to directly and accurately capture real-world mobility. Mobilise-D consists of 34 partners from 13 countries who are working together to jointly develop and implement a digital mobility assessment solution to demonstrate that real-world digital mobility outcomes have the potential to provide a better, safer, and quicker way to assess, monitor, and predict the efficacy of new interventions on impaired mobility.

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