Identification and management of cardiopulmonary risk in patients with COPD: a multidisciplinary consensus and modified Delphi study.

Background: Cardiovascular disease is a common comorbidity in chronic obstructive pulmonary disease (COPD). Yet cardiovascular disease and risk is under diagnosed in COPD and is often undertreated, increasing the risk of cardiopulmonary events.

Methods: We formed a Global Working Group of experts in COPD and cardiovascular disease to produce a consensus statement detailing the identification and management of cardiopulmonary risk in patients with COPD.

Research priorities for the most premature babies born <25 weeks' gestation: results of an international priority setting partnership.

Objective: The James Lind Alliance (JLA) Most Premature Babies Priority Setting Partnership aimed to identify the most important areas for research for infants born <25 weeks' gestation.

Design: Employing standardised JLA methodology, questions for research were sought from stakeholders via an online survey. Summary questions were formed and checked against existing evidence, with unanswered questions compiled into a second shortlisting survey for prioritisation by stakeholders.

Perceptions of healthcare professionals on the use of a risk prediction model to inform atrial fibrillation screening: qualitative interview study in English primary care.

Objectives: There is increasing interest in guiding atrial fibrillation (AF) screening by risk rather than age. The perceptions of healthcare professionals (HCPs) towards the implementation of risk prediction models to target AF screening are unknown. We aimed to explore HCP perceptions about using risk prediction models for this purpose, and how models could be implemented.

The Role of Lactate Metabolism in Heart Failure and Cardiogenic Shock: Clinical Insights and Therapeutic Implications.

Heart failure (HF) is associated with poor prognosis, especially when it progresses to cardiogenic shock (CS), where survival rates substantially decline. A key area of interest is the role of blood lactate as a biomarker in these conditions. Lactate is produced under normal physiological conditions but increases with impaired tissue perfusion, a hallmark of HF and CS.

Intersectionality of inequalities in revascularisation and outcomes for acute coronary syndrome in England: nationwide linked cohort study.

Background: Inequalities in access to care for women, people of non-white ethnicity, who live in areas of social deprivation, and with multiple long-term conditions lead to inequity of outcomes. We investigated the intersectionality of these causes of health inequality on coronary revascularisation and clinical outcomes for admissions with acute coronary syndrome (ACS).

Methods: We included hospital admissions in England for types of acute coronary syndrome from April 2015 to April 2018 and linked Hospital Episode Statistics to the Office for National Statistics mortality data.

European Society of Cardiology quality indicators for the management of acute coronary syndrome.

Background: Closing the evidence-practice gap for the treatment of acute coronary syndrome (ACS) is central to improving quality of care. Under the European Society of Cardiology (ESC) framework, we aimed to develop updated quality indicators (QIs) for the evaluation of quality of care and outcomes for patients with ACS.

Methods: A Working Group of experts including members of the ESC Clinical Practice Guidelines Task Force for ACS, Acute CardioVascular Care Association and European Association of Percutaneous Cardiovascular Interventions followed the ESC methodology for QI development.

Prediction of atrial fibrillation after a stroke event: A systematic review with meta-analysis.

Background: Detecting atrial fibrillation (AF) after stroke is a key component of secondary prevention, but indiscriminate prolonged cardiac monitoring is costly and burdensome. Multivariable prediction models could be used to inform selection of patients.

Objective: This study aimed to determine the performance of available models for predicting AF after a stroke.

Intraventricular Hemorrhage and Survival, Multimorbidity, and Neurodevelopment.

Importance: Intraventricular hemorrhage (IVH) has proven to be a challenging and enduring complication of prematurity. However, its association with neurodevelopment across the spectrum of IVH severity, independent of prematurity, and in the context of contemporary care remains uncertain.

Objective: To evaluate national trends in IVH diagnosis and the association with survival and neurodevelopmental outcomes at 2 years of age.

Differences between neonatal units with high and low rates of breast milk feeding for very preterm babies at discharge: a qualitative study of staff experiences.

Background: Breast milk has significant benefits for preterm babies, but 'very preterm' babies are unable to feed directly from the breast at birth. Their mothers have to initiate and sustain lactation through expressing milk for tube feeding until their babies are developmentally ready to feed orally. There are wide disparities between neonatal units in England in rates of breast milk feeding at discharge.

Transition from neonatal to paediatric intensive care of very preterm-born children: a cohort study of children born between 2013 and 2018 in England and Wales.

Objective: Following very preterm birth, some children require ongoing intensive care after the neonatal period and transition directly from neonatal units (NNUs) to paediatric intensive care units (PICUs) around term-corrected age.We aimed to understand, at a national level, characteristics and outcomes of children born very preterm who transitioned directly from NNUs to PICUs.

Design: Retrospective cohort study, using data linkage of National Neonatal Research Database, Paediatric Intensive Care Audit Network and Office for National Statistics datasets.

Timing of Neonatal Discharge and Unplanned Readmission to PICUs Among Infants Born Preterm.

Importance: Children born very preterm (<32 weeks) are at risk of ongoing morbidity and admission to pediatric intensive care units (PICUs) in childhood. However, the influence of the timing of neonatal discharge on unplanned PICU admission has not been established.

Objective: To examine whether the timing of neonatal discharge (postmenstrual age and season) is associated with subsequent unplanned PICU admission.

Metformin associates with higher myocardial perfusion reserve and survival in type 2 diabetes mellitus patients.

Metformin is an antihyperglycemic used to treat type 2 diabetes mellitus (T2DM). Patients with T2DM are at increased risk of cardiovascular disease. We explored the association between metformin use and cardiovascular magnetic resonance (CMR) derived stress myocardial blood flow (MBF), myocardial perfusion reserve (MPR) and major adverse cardiovascular events (MACE; all cause death, MI, stroke, heart failure hospitalisation and coronary revascularisation) in patients with T2DM.

Timing of Stoma Closure in Neonates: the ToSCiN mixed-methods study.

Background: Neonates undergoing emergency abdominal surgery frequently require a stoma; closing this stoma with a second operation is an essential part of recovery. Timing of closure varies. Optimal timing is unclear and would be best resolved through a randomised controlled trial; such a trial is likely to be challenging.

PRECIOUS study (PREterm Caesarean/vaginal birth and IVH/OUtcomeS): does mode of birth reduce the risk of death or brain injury in very preterm babies? A cohort and emulated target trial protocol.

Introduction: Very preterm babies are at risk of poor neurodevelopmental outcomes and death. Intraventricular haemorrhage (IVH) after birth is the most prevalent cause of this. Birth by caesarean section may protect against IVH in very preterm babies, but the evidence is limited.