Failure to Rescue Pediatric Recipients of Living Donor Liver Transplantation: A Single-Center Study of Technical Complications in 500 Primary Grafts.

Background: The concept of failure to rescue (FTR) has been used to evaluate the quality of care in several surgical specialties but has not been well-studied after living donor liver transplantation (LDLT) in children.

Methods: This study retrospectively reviewed 500 pediatric LDLT performed at a single center between 1993 and 2022. The recipient outcomes were assessed by means of patient and graft survival rates, retransplantation rates, and arterial/portal/biliary complication rates.

The carbon footprint of cataract surgery pathways in England: an observational study using administrative data.

Background: The National Health Service (NHS) in England has set a target to be net zero for carbon emissions by 2045. The aim of this study was to investigate the estimated difference between the carbon footprint of the Getting It Right First Time (GIRFT) High Volume Low Complexity (HVLC) pathway for cataract surgery and current practice.

Methods: Retrospective analysis of administrative data.

Carbon savings associated with changing surgical trends in total knee arthroplasty in England: a retrospective observational study using administrative data.

Background: Best practice pathways for common surgical procedures, including total knee arthroplasty (TKA), have the potential to improve patient outcomes and reduce carbon emissions. We aimed to estimate the reduction in carbon emissions due to changing trends in the care of patients undergoing TKA in England.

Methods: This was a retrospective analysis of Hospital Episode Statistics data from 1 April 2013 to 31 March 2022 on adults undergoing elective primary TKA in England.

Cross-National Strategic Aeromedical Evacuation at the European Air Transport Command.

The European Air Transport Command (EATC) is a seven-nation integrated command. One of its core capabilities is strategic aeromedical evacuation (AE). During the global COVID-19 pandemic and Ukrainian crisis, EATC proved that acting in concert is a valuable, effective, and reliable option.

Engineered SPIONs functionalized with endothelin a receptor antagonist ameliorate liver fibrosis by inhibiting hepatic stellate cell activation.

Endothelin-1/endothelin A receptor (ET-1/ETAR) pathway plays an important role in the progression of liver fibrosis by activating hepatic stellate cells (HSCs) - a key cell type involved in the pathogenesis of liver fibrosis. Inactivating HSCs by blocking the ET-1/ETAR pathway using a selective ETAR antagonist (ERA) represents a promising therapeutic approach for liver fibrosis. Unfortunately, small-molecule ERAs possess limited clinical potential due to poor bioavailability, short half-life, and rapid renal clearance.

Evaluating inhaler technique, patient preferences and opportunities for improvement in hospitals in the UK.

Inhalers are a key aspect of managing airways disease. With effective use, they can reduce symptoms, reduce the frequency of exacerbations and thus reduce usage of healthcare services. Inhalers are associated with a significant carbon footprint, accounting for 3% of NHS' carbon emissions.

Unwarranted variation and the goal of net zero for the NHS in England: exploring the link between efficiency working, patient outcomes and carbon footprint.

In 2020 the NHS in England set a target of reaching net zero carbon emissions by 2040. Progress has already been made towards this goal, with substantial reductions in the use of environmentally harmful anaesthetic gases, such as desflurane, in recent years. Where an effective replacement already exists, changing practice to use low carbon alternatives is relatively easy to achieve, but much greater challenges lie ahead.

Role of public health professionals in the climate and ecological crisis: a qualitative study.

Background: The climate and ecological emergency is the single biggest health threat facing humanity, yet it is not clear to what extent the public health workforce have been involved in work on this topic. This research aimed to establish what public health consultants working in local authorities in England perceive their role to be, whether the climate crisis is seen as a core component of public health and to identify barriers to action.

Methods: Semi-structured interviews were undertaken with a purposive sample (n=11) of local authority public health consultants in England.

Trends Over Time in the Use, Carbon Footprint and Costs of Facet Joint Injections and Medial Branch Blocks to Manage Lumbar Pain in England: Retrospective Analysis of an Administrative Dataset.

Study Design: Retrospective analysis of an administrative dataset.

Objective: This study aims to investigate changing practice over a six-year period in the use of repeated lumbar facet joint injections/medial branch blocks in England.

Methods: Patient data were extracted from the Hospital Episodes Statistics database for the period 1st April 2015 to 31st March 2021 for the index lumbar injection and for repeat lumbar injections performed within one year of the first.

Vital role of clinicians in reducing the NHS carbon footprint through smarter procurement decisions.

Background: The NHS' impact on the environment is significant, accounting for 5.9% of the national carbon footprint of the UK and 20 million tonnes of carbon dioxide equivalent (Mt COe) emissions a year.The procurement of goods and services is responsible for 72% of the NHS carbon footprint-equivalent to 15.

Potential Carbon Savings with Day-case Compared to Inpatient Transurethral Resection of Bladder Tumour Surgery in England: A Retrospective Observational Study Using Administrative Data.

Background: The National Health Service (NHS) in England has set a net-zero target for carbon emissions by 2040. Increasing use of day-case surgery pathways may help in meeting this target.

Objective: To investigate the estimated difference in carbon footprint between day-case and inpatient transurethral resection of bladder tumour (TURBT) surgery in England.

Symptom change prior to treatment discontinuation (dropout) from a naturalistic Veterans Affairs evidence-based psychotherapy clinic for PTSD and depression.

Dropout or treatment discontinuation from evidence-based psychotherapies (EBPs) has been a concern for clinicians as it is thought that such discontinuation prevents patients from achieving a full course of therapy and obtaining maximum benefit. Recent studies, however, suggest that treatment discontinuation may sometimes be due to symptom improvement. The purpose of the current evaluation was to examine change in self-reported symptoms in participants who completed versus did not complete treatment in a Veterans Affairs outpatient clinic offering EBPs for both depression and posttraumatic stress disorder (PTSD).

Identification of over- and undertreatment in the Dutch national cervical cancer screening program: A data linkage study at the hospital level.

Research into the quality of cancer screening programs often lacks the perspective of clinicians, missing insights into the performance of individual hospitals. This retrospective cohort study aimed to identify guideline deviation (specifically, overtreatment and undertreatment) related to the cervical cancer screening program in Dutch hospitals by deterministically linking nationwide insurance data with pathology data for cervical intraepithelial neoplasia (CIN). We then constructed quality indicators using the Dutch CIN guideline and National Health Care Institute recommendations to assess compliance with CIN management, treatment outcomes, and follow-up, using an empirical Bayes shrinkage model to correct for case-mix variation and hospitals with few observations.

Rotations of F-ATPase and V-ATPase analyzed by a torque approach.

F-type ATP synthase (F-ATPase) and vacuolar ATP hydrolase (V-ATPase) are well-known biomolecular motors, which play significant catalytic roles in ATP synthesis and ATP hydrolysis reactions. Their rotational torques are important factors involved in their rotational behavior that can be measured experimentally but with considerable difficulty. To overcome this difficulty and thereby provide an in-depth understanding of their operation mechanism, we herein carry out simple and fast computer modelling to study the two proteins, using our torque approach that relies on interatomic forces and coordinates of unequilibrated configurations taken from brief molecular dynamics (MD) simulations.

Recommendations for improving the working conditions and cultures of distressed junior doctors, based on a qualitative study and stakeholder perspectives.

Background: Doctors, including junior doctors, are vulnerable to greater levels of distress and mental health difficulties than the public. This is exacerbated by their working conditions and cultures. While this vulnerability has been known for many years, little action has been taken to protect and support junior doctors working in the NHS.

Undetectable very-low frequency sound increases dancing at a live concert.

Does low frequency sound (bass) make people dance more? Music that makes people want to move tends to have more low frequency sound, and bass instruments typically provide the musical pulse that people dance to. Low pitches confer advantages in perception and movement timing, and elicit stronger neural responses for timing compared to high pitches, suggesting superior sensorimotor communication. Low frequency sound is processed via vibrotactile and vestibular (in addition to auditory) pathways, and stimulation of these non-auditory modalities in the context of music can increase ratings of groove (the pleasurable urge to move to music), and modulate musical rhythm perception.

An outbreak of linked to pasteurised milk from a vending machine in England: a descriptive study, March 2021.

We describe the investigations and management of a outbreak of linked to consumption of pasteurised milk from a vending machine. Multiple locus variable number of tandem repeats analysis was newly used, confirming that detected in human cases was indistinguishable from that in a calf on the farm. This strengthened the evidence for milk from an on-farm vending machine as the source of the outbreak because of post-pasteurisation contamination.

Surface-Mounted Dipolar Molecular Rotors Driven by External Electric Field, As Revealed by Torque Analyses.

Driven by a high-speed rotating electric field (-field), molecular motors with polar groups may perform a unidirectional, repetitive, and GHz frequency rotation and thus offer potential applications as nanostirrers. To drive the unidirectional rotation of molecular motors, it is crucial to consider factors of internal charge flow, thermal noise, molecular flexibility, and so forth before selecting an appropriate frequency of a rotating -field. Herein, we studied two surface-mounted dipolar rotors of a "caltrop-like" molecule and a "sandwich" molecule by using quantum-mechanical computations in combination with torque analyses.