The medical doctor (degree) apprenticeship.

In this article we explore the United Kingdom context of apprenticeships and the history of development of the use of the term apprentice in medicine. We describe the development of the Medical Doctor Degree Apprenticeship (MDDA) in England and how Anglia Ruskin University (ARU) has approached the development of the MDDA. We explore the rationale for developing the MDDA in Essex, the structure of the apprenticeship at ARU (which comprises 20% of employed time in NHS work and 80% in education undertaking the medical degree), the challenges and issues we encountered and mitigations we put in place.

Obstetric management for pregnant women with Klippel-Trenaunay syndrome: A UK case report and review of the literature.

Klippel-Trenaunay Syndrome (KTS) is a rare congenital vascular disorder characterized by extensive capillary and venous malformations that pose unique challenges during pregnancy. This case report discusses the successful management of a 34-year-old pregnant woman with KTS who had two caesarean sections, resulting in the birth of two healthy babies. Despite the lack of evidence-based guidelines for obstetrical management in KTS, a multidisciplinary team collaborated to devise a high-risk thrombosis management plan, involving the use of compression stocking and low molecular weight heparin prophylaxis.

Neurodiversity in the healthcare profession.

The term neurodiversity was coined in the 1990s to describe a diversity in thinking, learning, and processing the world around us, and is associated with strengths as well as challenges. Rates of diagnosis of neurodivergent conditions are rising rapidly amongst patients and healthcare professionals, largely due to a recent surge in awareness and understanding of neurodiverse conditions and more inclusive diagnostic criteria. Societal adaptation, however, has lagged, and likely explains some of the psychosocial comorbidities of neurodiversity, as individuals are forced to adapt their personality and how they display their emotions to fit societal norms.

A mixed methods study to understand perinatal mental healthcare referral decisions among midwives and health visitors in the UK.

Background: In the UK approximately half of women requiring perinatal mental health (PNMH) care do not receive treatment despite having routine contact with midwives (MWs) and health visitors (HVs). Limited research has been undertaken regarding MWs'/HVs' decision-making around referring women for secondary PNMH care. In particular, the impact that the level of local secondary PNMH services may have on MWs'/HVs' referral decisions is unexplored.

The impact of the COVID-19 pandemic on the lifestyle and behaviours, mental health and education of students studying healthcare-related courses at a British university.

Background: The COVID-19 pandemic has affected most industries, including health education. In this study, we surveyed students studying healthcare-related courses at our university on how their lifestyles and behaviours, mental health and education had been affected by the pandemic.

Methods: Mixed methods cross-sectional study.

Running a paediatric ambulatory sleep service in a pandemic and beyond.

Objectives: In response COVID-19, re-establishing safe elective services was prioritised in the UK. We assess the impact on face-to-face hospital attendance, cost and efficiency of implementing a virtual sleep clinic (intervention 1) to screen for children requiring level 3 ambulatory sleep studies using newly implemented ENT-UK guidelines for obstructive sleep apnoea (OSA) investigation (intervention 2).

Objectives: (1) compare the proportion of children attending sleep clinic undertaking a sleep study before and after implementation of these interventions; (2) compare clinic cancellations and first-time success rates of sleep studies before and after intervention.

Reinventing Undergraduate Clinical Placements with a Switch to Delivery by Clinical Teaching Fellows.

Purpose: Undergraduate clinical placements have the potential for significant improvement. Previous research has shown the growing value of clinical teaching fellows (CTFs) within medical education. Changing traditional placements to a model whereby CTFs have defined roles and lead the majority of teaching can positively reinvent undergraduate clinical teaching.

A Distributed Whole Genome Sequencing Benchmark Study.

Population sequencing often requires collaboration across a distributed network of sequencing centers for the timely processing of thousands of samples. In such massive efforts, it is important that participating scientists can be confident that the accuracy of the sequence data produced is not affected by which center generates the data. A study was conducted across three established sequencing centers, located in Montreal, Toronto, and Vancouver, constituting Canada's Genomics Enterprise (www.

Acheron/Larp6 Is a Survival Protein That Protects Skeletal Muscle From Programmed Cell Death During Development.

The term programmed cell death (PCD) was coined in 1965 to describe the loss of the intersegmental muscles (ISMs) of moths at the end of metamorphosis. While it was subsequently demonstrated that this hormonally controlled death requires gene expression, the signal transduction pathway that couples hormone action to cell death is largely unknown. Using the ISMs from the tobacco hawkmoth , we have found that mRNA is induced ∼1,000-fold on the day the muscles become committed to die.

Factors affecting the embedding of integrated primary-secondary care into a health district.

With the aging population, the tide of chronic disease is rising with attendant increases in health service need. Integrated care and patient-centred approaches, which established partnerships between a regional Hospital and health service (HHS), the local primary health network and local general practitioners (GPs), were identified as exemplars of an approach needed to support growing community health needs. This paper summarises the findings from a process evaluation of four GP-specialist care integration programs with the aim of identifying recommendations for embedding integrated GP-specialist care into routine practice within the HHS.

A dated molecular phylogeny of mite harvestmen (Arachnida: Opiliones: Cyphophthalmi) elucidates ancient diversification dynamics in the Australian Wet Tropics.

Austropurcellia, a genus of dispersal-limited arachnids endemic to isolated patches of coastal rainforest in Queensland, Australia, has a remarkable biogeographic history. The genus is a member of the family Pettalidae, which has a classical temperate Gondwanan distribution; previous work has suggested that Austropurcellia is an ancient lineage, with an origin that predates Gondwanan rifting. Subsequently, this lineage has persisted through major climatic fluctuations, such as major aridification during the Miocene and contraction and fragmentation of forest habitats during the Last Glacial Maximum (LGM).

Improvement in overactive bladder symptoms in patients using functional electrical stimulation of the common peroneal nerve for walking.

Objective: Functional electrical stimulation is used to improve walking speed and reduces falls in people with upper motor neurone foot-drop. Following anecdotal observations of changes in bladder symptoms, an observational study was performed to explore this association further.

Design: A total of 47 consecutive patients attending for setup with functional electrical stimulation during a six-month period were asked to complete a questionnaire assessing bladder symptoms (ICIQ-OAB (International Consultation on Incontinence Questionnaire Overactive Bladder)) at baseline and three  months during routine appointments.

Fank1 and Jazf1 promote multiciliated cell differentiation in the mouse airway epithelium.

The airways are lined by secretory and multiciliated cells which function together to remove particles and debris from the respiratory tract. The transcriptome of multiciliated cells has been extensively studied, but the function of many of the genes identified is unknown. We have established an assay to test the ability of over-expressed transcripts to promote multiciliated cell differentiation in mouse embryonic tracheal explants.

A revised dated phylogeny of scorpions: Phylogenomic support for ancient divergence of the temperate Gondwanan family Bothriuridae.

The scorpion family Bothriuridae occupies a subset of landmasses formerly constituting East and West temperate Gondwana, but its relationship to other scorpion families is in question. Whereas morphological data have strongly supported a sister group relationship of Bothriuridae and the superfamily Scorpionoidea, a recent phylogenomic analysis recovered a basal placement of bothriurids within Iurida, albeit sampling only a single exemplar. Here we reexamined the phylogenetic placement of the family Bothriuridae, sampling six bothriurid exemplars representing both East and West Gondwana, using transcriptomic data.

Human embryonic lung epithelial tips are multipotent progenitors that can be expanded in vitro as long-term self-renewing organoids.

The embryonic mouse lung is a widely used substitute for human lung development. For example, attempts to differentiate human pluripotent stem cells to lung epithelium rely on passing through progenitor states that have only been described in mouse. The tip epithelium of the branching mouse lung is a multipotent progenitor pool that self-renews and produces differentiating descendants.

Breast Cancer Risk and Progressive Histology in Serial Benign Biopsies.

Background: More than 1 million women per year in the United States with benign breast biopsies are known to be at elevated risk for breast cancer (BC), with risk stratified on histologic categories of epithelial proliferation. Here we assessed women who had serial benign biopsies over time and how changes in the histologic classification affected BC risk.

Methods: In the Mayo Clinic Benign Breast Disease Cohort of 13 466 women, 1414 women had multiple metachronous benign biopsies (10.

SOX2 Drives Bronchial Dysplasia in a Novel Organotypic Model of Early Human Squamous Lung Cancer.

Rationale: Improving the early detection and chemoprevention of lung cancer are key to improving outcomes. The pathobiology of early squamous lung cancer is poorly understood. We have shown that amplification of sex-determining region Y-box 2 (SOX2) is an early and consistent event in the pathogenesis of this disease, but its functional oncogenic potential remains uncertain.

An FGFR1-SPRY2 Signaling Axis Limits Basal Cell Proliferation in the Steady-State Airway Epithelium.

The steady-state airway epithelium has a low rate of stem cell turnover but can nevertheless mount a rapid proliferative response following injury. This suggests a mechanism to restrain proliferation at steady state. One such mechanism has been identified in skeletal muscle in which pro-proliferative FGFR1 signaling is antagonized by SPRY1 to maintain satellite cell quiescence.

Breast cancer after prophylactic mastectomy (bilateral or contralateral prophylactic mastectomy), a clinical entity: presentation, management, and outcomes.

Contralateral prophylactic mastectomy (CPM) and bilateral prophylactic mastectomy (BPM) markedly decrease the possibility of new breast cancer (BC) ipsilateral to the prophylactic mastectomy (PM). Given its relative infrequency, little is known about the clinical characteristics, presentation, and management of BC after PM. Between 1960 and 1993, 1065 women underwent BPM and 1643 women with unilateral BC treated with therapeutic mastectomy underwent CPM at our institution.

Impact of reconstruction and reoperation on long-term patient-reported satisfaction after contralateral prophylactic mastectomy.

Background: Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort.

Methods: 621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960 and 1993 were surveyed regarding quality of life (QOL) and satisfaction with CPM at two time points (approximately 10 and 20 years after CPM).

Dental hygienists' role in practice based research: PEARL Network evaluation.

Purpose: The goal of this paper is to evaluate the PEARL Network's satisfaction with training/support and assess the relationship between practice research coordinators (PRCs) involvement and study participation.

Methods: At the PEARL Network 2011 Annual Meeting, an evaluation form was completed by practitioner-investigators and PRCs who attended the annual meeting. Results from the paper evaluation form were entered into an Excel database, and analyzed using the statistical analysis software SPSS.

Contralateral prophylactic mastectomy: long-term consistency of satisfaction and adverse effects and the significance of informed decision-making, quality of life, and personality traits.

Purpose: This study aims to evaluate the long-term consistency of satisfaction with contralateral prophylactic mastectomy (CPM) and adverse psychosocial effects as well as to explore the effect of informed decision-making, personality traits, and quality of life (QOL) on satisfaction.

Methods: A previously established cohort of women with unilateral breast cancer who had undergone CPM between 1960 and 1993 were surveyed using study-specific and standardized questionnaires at two follow-up time points. The first survey was a mean of 10.