University of Illinois Year of Cyberinfrastructure Final Report

The University of Illinois at Urbana-Champaign is a leader in computing and information technology (IT). Our leadership role has both produced and been produced by a culture of innovation. Many efforts have arisen over the years that have been the product of this culture. While the university’s commitment to developing digital infrastructure, resources, and support services has served campus researchers well, it has become clear that a more coherent and unified approach to assessing and addressing the IT services and support needs of campus researchers is imperative. With the support of the Vice Chancellor for Research and the Chief Information Officer, we embarked on the Year of Cyberinfrastructure (Year of CI). Through this effort, we engaged researchers across disciplines to gain an understanding of the challenges they face in order to inform how we, as a campus, should move together to address these needs. We confirmed that researchers tend to assemble needed resources and services on their own, often out of necessity. While this practice has allowed those with the ambition or, more frequently, the absolute need, to advance their fields, it has primarily benefitted only those researchers and their collaborators. Providers of resources and services have brought value to the research process, but this value has been accrued in a largely disjointed manner that has tended to favor the power users of technology. The Year of CI effort has made clear that our research support landscape is not only lacking coherence but is also very uneven across academic and research units. To support modern research practices and to be competitive and preeminent in the academic community and the world, the 21st century research university must provide a foundation of research IT infrastructure and services that are accessible by all disciplines. Our campus needs a strong vision for how IT supports research, along with the ability to realize and evolve that vision in lockstep with the changing needs of the research community and the technologies available to meet those needs. Though Illinois faces significant financial challenges, it is time to be bold and make an investment to allow the university to emerge from these challenges as the premier destination for faculty, postdocs, graduate students, undergraduate students, and research staff who seek to work in a world-class modern research environment. It is time to provide the infrastructure that will grow the campus research portfolio to new heights. The Year of CI has provided the initial assessment of the campus and indicates the steps we must take to develop the digital support ecosystem that will allow the campus to realize its vision of preeminence in research.Ope

Cancer centre supportive oncology service: health economic evaluation

Objectives: There have been many models of providing oncology and palliative care to hospitals. Many patients will use the hospital non-electively or semielectively, and a large proportion are likely to be in the last years of life. We describe our multidisciplinary service to treatable but not curable cancer patients at University Hospitals Sussex. The team was a mixture of clinical nurse specialists and a clinical fellow supported by dedicated palliative medicine consultant time and oncology expertise. / Methods: We identified patients with cancer who had identifiable supportive care needs and record activity with clinical coding. We used a baseline 2019/2020 dataset of national (secondary uses service) data with discharge code 79 (patients who died during that year) to compare a dataset of patients seen by the service between September 2020 and September 2021 in order to compare outcomes. While this was during COVID-19 this was when the funding was available. / Results: We demonstrated a reduction in length of stay by an average of 1.43 days per admission and a reduction of 0.95 episodes of readmission rates. However, the costs of those admissions were found to be marginally higher. Even with the costs of the service, there is a clear return on investment with a benefit cost ratio of 1.4. / Conclusions: A supportive oncology service alongside or allied to acute oncology but in conjunction with palliative care is feasible and cost-effective. This would support investment in such a service and should be nationally commissioned in conjunction with palliative care services seeing all conditions

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar