Welcome to The Royal Devon Research Repository
The Royal Devon Research Repository contains research outputs from staff at the Royal Devon University Healthcare NHS Foundation Trust.
You can browse items by Title, Author, Subject or Community/Collection, or use the search function to find specific topics.
The repository contains details of published, peer-reviewed journal articles, reviews, book chapters, conference abstracts and posters. Full-text of journal articles have been included where publisher's permissions allow.
If you are a member of Royal Devon University Healthcare NHS Foundation Trust and you'd 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 admin team: rde-tr.ResearchRepository@nhs.net.
For more information or help, please contact The Royal Devon Research Repository admin team:
Email: rde-tr.ResearchRepository@nhs.net
Telephone: Exeter Health Library, 01392 406800
Recent Submissions
Item Exploring the application of deep learning methods for polygenic risk score estimation(IOP Publishing, 2025-03-13)Background. Polygenic risk scores (PRS) summarise genetic information into a single number with clinical and research uses. Deep learning (DL) has revolutionised multiple fields, however, the impact of DL on PRSs has been less significant. We explore how DL can improve the generation of PRSs.Methods. We train DL models on known PRSs using UK Biobank data. We explore whether the models can recreate human programmed PRSs, including using a single model to generate multiple PRSs, and DL difficulties in PRS generation. We investigate how DL can compensate for missing data and constraints on performance.Results. We demonstrate almost perfect generation of multiple PRSs with little loss of performance with reduced quantity of training data. For an example set of missing SNPs the DL model produces predictions that enable separation of cases from population samples with an area under the receiver operating characteristic curve of 0.847 (95% CI: 0.828-0.864) compared to 0.798 (95% CI: 0.779-0.818) for the PRS.Conclusions. DL can accurately generate PRSs, including with one model for multiple PRSs. The models are transferable and have high longevity. With certain missing SNPs the DL models can improve on PRS generation; further improvements would likely require additional input data.Item Factors associated with flexible cystoscope longevity: an analysis of supplier and health service datasets(John Wiley & Sons Ltd, 2025-12-23)OBJECTIVES: To investigate the associations between how reusable flexible cystoscopes (FCs) are managed during their functioning lifetime and their longevity. PATIENTS AND METHODS: This was an exploratory retrospective analysis of administrative data collected by a medical supplies company (KARL STORZ Endoscopy (UK) Ltd) on FC usage linked at a National Health Service (NHS) hospital trust level to data from NHS England's Hospital Episodes Statistics dataset on the number of FCs performed each year in the NHS in England. Number of uses before failure (defined as user-determined need for FC return to the supplier) were analysed descriptively and using a negative binomial regression model. RESULTS: Data were available for 1918 FCs across 70 hospitals. The median (interquartile range) number of uses and min of use before failure were 58 (20-147.75) and 706.5 (208.25-1718), respectively. Eighty-five percent of returned FCs were exchanged (i.e. replaced with a new FC), at a median of 66 uses. The two most common reasons for failure - damage to the working channel and control handle housing - were observed in 76.3% and 63.8% of returned FCs, respectively. A greater number of uses before failure was significantly associated with recency, same-site same-complex decontamination, on-site endoscopic specialist availability, decontamination in a general endoscopy unit, and drying cabinet or bowl storage rather than vacuum packaging. Top-quintile-volume units were associated with a significantly higher number of uses before failure, however, there was otherwise no clear independent volume-longevity association. CONCLUSION: This exploratory analysis generates mechanistically plausible hypotheses regarding factors that could promote FC longevity. These findings are of relevance as we seek to understand how to optimise the cost, resilience and environmental sustainability of healthcare. A prospectively designed study could investigate whether there is a causal link between the key factors identified and longevity of FC usage.Item Patient facing resources: a review of their readability in urology journals(John Wiley & Sons Ltd., 2026-01-01)Item Two-Year Outcomes of Simultaneous Double Lamellar Keratoplasty: A Novel Alternative to Repeat Penetrating Keratoplasty(Wolters Kluwer Health, 2025-12-12)PURPOSE: To evaluate the outcomes of Simultaneous Double Lamellar Keratoplasty (SDLK) as a surgical alternative to repeat penetrating keratoplasty (PK) for cases involving both stromal pathology and endothelial graft failure. METHODS: Three patients with failed PK and evidence of both stromal and endothelial pathology underwent SDLK. The procedure combined deep anterior lamellar keratoplasty (DALK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in a single operation. Outcome measures included uncorrected and corrected distance visual acuity (UDVA and CDVA), topographic astigmatism, and postoperative complications, assessed over a 24-month follow-up period. RESULTS: All patients achieved significant improvements in visual acuity and reduced astigmatism. Final CDVA ranged from 0.04 to 0.30 logMAR. One patient had an intraoperative microperforation, which was successfully managed. Postoperative complications included 1 case of partial DSAEK detachment, resolved with rebubbling. No graft rejections were observed. The combination of DALK and DSAEK restored corneal clarity and improved astigmatism while minimizing the risks associated with open-sky surgery. CONCLUSIONS: SDLK offers a viable alternative to repeat PK for managing combined stromal and endothelial failure. This approach preserves structural integrity, provides superior refractive outcomes, and facilitates future lamellar interventions. Further studies are warranted to validate these findings in larger cohorts.
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