The use of the 19Fr. Intrauterine BIGATTI Shaver in operative hysteroscopy for benign intracavitary lesions: A feasibility study.

Background: Treatment of common benign intracavitary lesions of the uterus, such as endometrial polyps, submucosal myomas, and retained products of conception (RPOC) has evolved significantly over the past decades. Hysteroscopic tissue removal (morcellation) was introduced as an alternative to the traditional operative hysteroscopy with bipolar resectoscopic excision, due to concerns regarding thermal damage and impaired visibility. Recently, with the aim of promoting a minimally invasive approach and the possibility of use in an office setting, smaller diameter hysteroscopic tissue removal systems were designed, such as the reusable 19 Fr.

Igniting the fire and seeing through the smoke: Enabling medical students to see themselves as future clinical academics.

Purpose: Lack of recruitment to clinical academic careers is of concern, and may be linked to lack of awareness and promotion of this pathway in undergraduate medical education. Our study explored undergraduate experiences which support academic career progression and potential barriers to pursuing Specialised Foundation roles in the United Kingdom.

Methods: We adopted a constructivist lens and conducted interviews with specialised foundation programme (SFP) doctors and final year students who had applied for SFP positions.

Approaches for hysterectomy and implementation of robot-assisted surgery in benign gynaecological disease: A cost analysis study in a large university hospital.

Background: As a minimally invasive technique, robot-assisted hysterectomy (RAH) offers surgical advantages and significant reduction in morbidity compared to open surgery. Despite the increasing use of RAH in benign gynaecology, there is limited data on its cost-effectiveness, especially in a European context. Our goal is to assess the costs of the different hysterectomy approaches, to describe their clinical outcomes, and to evaluate the impact of introduction of RAH on the rates of different types of hysterectomy.

Validation of ADNEX and IOTA two-step strategy and estimation of risk of complications during follow-up of adnexal masses in low-risk population.

Objectives: To evaluate the ability of the Assessment of Different NEoplasias in the adneXa (ADNEX) model and the International Ovarian Tumour Analysis (IOTA) two-step strategy to predict malignancy in adnexal masses detected in an outpatient low-risk setting, and to estimate the risk of complications in masses with benign ultrasound morphology managed using clinical and ultrasound follow-up.

Methods: This single-center study was performed at Hospital Universitari Dexeus, Barcelona, Spain, using interim data from the ongoing prospective observational IOTA Phase-5 (IOTA5) study. The primary aim of the IOTA5 study is to describe the cumulative incidence of complications during follow-up of adnexal masses classified as benign on ultrasound examination.

ADNEX risk prediction model for diagnosis of ovarian cancer: systematic review and meta-analysis of external validation studies.

Objectives: To conduct a systematic review of studies externally validating the ADNEX (Assessment of Different Neoplasias in the adnexa) model for diagnosis of ovarian cancer and to present a meta-analysis of its performance.

Design: Systematic review and meta-analysis of external validation studies.

Data Sources: Medline, Embase, Web of Science, Scopus, and Europe PMC, from 15 October 2014 to 15 May 2023.

Multiclass risk models for ovarian malignancy: an illustration of prediction uncertainty due to the choice of algorithm.

Background: Assessing malignancy risk is important to choose appropriate management of ovarian tumors. We compared six algorithms to estimate the probabilities that an ovarian tumor is benign, borderline malignant, stage I primary invasive, stage II-IV primary invasive, or secondary metastatic.

Methods: This retrospective cohort study used 5909 patients recruited from 1999 to 2012 for model development, and 3199 patients recruited from 2012 to 2015 for model validation.

Remote Determination of Critical Speed and Critical Power in Recreational Runners.

Purpose: This study aimed to compare estimations of critical speed (CS) and work completed above CS (D'), and their analogies for running power (critical power [CP] and W'), derived from raw data obtained from habitual training (HAB) and intentional maximal efforts in the form of time trials (TTs) and 3-minute all-out tests (3MTs) in recreational runners. The test-retest reliability of the 3MT was further analyzed.

Methods: Twenty-three recreational runners (4 female) used a foot pod to record speed, altitude, and power output for 8 consecutive weeks.

Updating M6 pregnancy of unknown location risk-prediction model including evaluation of clinical factors.

Objectives: Ectopic pregnancy (EP) is a major high-risk outcome following a pregnancy of unknown location (PUL) classification. Biochemical markers are used to triage PUL as high vs low risk to guide appropriate follow-up. The M6 model is currently the best risk-prediction model.

Implementation of robot-assisted myomectomy in a large university hospital: a retrospective descriptive study.

Background: Background: Myomectomy is often the preferred treatment for symptomatic patients with myomas who wish to preserve their fertility, with a shift from open surgery towards minimally invasive techniques.

Objectives: Retrospective study assessing patient and surgery characteristics, follow-up, and outcomes of robot-assisted myomectomy (RAM) and abdominal myomectomy (AM) in women treated between January 1, 2018, and February 28, 2022, in a Belgian tertiary care hospital.

Materials And Methods: A descriptive analysis was conducted on consecutive patients who underwent myomectomies.

Medical students' experiences of health inequalities and inclusion health education.

Background: Inclusion health groups experience a significantly larger burden of morbidity and mortality than the general public. Despite this, undergraduate medical education is often limited in its approach to inclusion health curricula, leaving students disengaged and lacking understanding.

Methods: We conducted two research studies to explore medical students' experiences of inclusion health education.

Expansive learning in medical education: Putting Change Laboratory to work.

This paper explores the purposeful use of conceptual and methodological tools provided by Cultural Historical Activity Theory (CHAT) to transform learning cultures and practices within and across diverse clinical learning environments. We describe how Change Laboratory methodology helped clinicians and others who support student, intern, and resident education to make changes collaboratively. A case study in undergraduate medical education shows how this created new forms of medical student placement and a postgraduate study shows how it addressed supervisors' undermining behaviour towards Obstetrics and Gynaecology residents.

Starting work as a doctor: challenge is essential.

Background: Previous research on the transition from student to doctor has indicated that new doctors are 'ill prepared' to start work. Subsequent efforts to improve preparation in the UK have involved increasing practical experience for final-year students through an assistantship period. This study further explored new doctors' experiences of transition in light of recent critiques of preparedness and the first author's own experience of the transition.

"A huge part of my life": Exploring links between music, medical education, and students' developing identities as doctors.

This article was migrated. The article was marked as recommended. This paper explores the place of music in the development of future doctors, through the lens of a mixed method, longitudinal evaluation of a two-week music and medicine special studies project for second and third year medical students.

Quantitative evaluation of contrast agent uptake in standard fat-suppressed dynamic contrast-enhanced MRI examinations of the breast.

Purpose: To propose a method to quantify T and contrast agent uptake in breast dynamic contrast-enhanced (DCE) examinations undertaken with standard clinical fat-suppressed MRI sequences and to demonstrate the proposed approach by comparing the enhancement characteristics of lobular and ductal carcinomas.

Methods: A standard fat-suppressed DCE of the breast was performed at 1.5 T (Siemens Aera), followed by the acquisition of a proton density (PD)-weighted sequence, also fat suppressed.

Learning ideals: Critical reflections on a near-peer initiative at Leeds.

This article was migrated. The article was marked as recommended. Previous definitions of peer-assisted learning portray the peer-teacher as a non-expert in teaching content and delivery.

Ultrasound Tomography Evaluation of Breast Density: A Comparison With Noncontrast Magnetic Resonance Imaging.

Objectives: Ultrasound tomography (UST) is an emerging whole-breast 3-dimensional imaging technique that obtains quantitative tomograms of speed of sound of the entire breast. The imaged parameter is the speed of sound which is used as a surrogate measure of density at each voxel and holds promise as a method to evaluate breast density without ionizing radiation. This study evaluated the technique of UST and compared whole-breast volume averaged speed of sound (VASS) with MR percent water content from noncontrast magnetic resonance imaging (MRI).

Comparison of Dixon Sequences for Estimation of Percent Breast Fibroglandular Tissue.

Objectives: To evaluate sources of error in the Magnetic Resonance Imaging (MRI) measurement of percent fibroglandular tissue (%FGT) using two-point Dixon sequences for fat-water separation.

Methods: Ten female volunteers (median age: 31 yrs, range: 23-50 yrs) gave informed consent following Research Ethics Committee approval. Each volunteer was scanned twice following repositioning to enable an estimation of measurement repeatability from high-resolution gradient-echo (GRE) proton-density (PD)-weighted Dixon sequences.

Performative, Arts-Based, or Arts-Informed? Reflections on the Development of Arts-Based Research in Music Therapy.

Arts-based research (ABR) has emerged in music therapy in diverse ways, employing a range of interpretive paradigms and artistic media. It is notable that no consensus exists as to when and where the arts are included in the research process, or which music therapy topics are most suited to arts-based study. This diversity may pose challenges for music therapists who are developing, reading, and evaluating arts-based research.

Alternative screening for dense breasts: MRI.

OBJECTIVE. The purpose of this article is to review the use of MRI in breast density measurement and breast cancer risk estimation and to discuss the role of MRI as an alternative screening to mammography for screening women with dense breasts. CONCLUSION.

Can the tools of activity theory help us in advancing understanding and organisational change in undergraduate medical education?

Continued changes to healthcare delivery in the UK, and an increasing focus on patient safety and quality improvement, require a radical rethink on how we enable graduates to begin work in challenging, complex environments. Professional regulatory bodies now require undergraduate medical schools to implement an 'assistantship' period in the final year of study, where senior medical students 'shadow' the work of junior doctors, with an expectation that they will be better 'prepared' for work. However, there is little guidance about what an 'assistantship' entails and the current emphasis on preparedness of students arguably underplays the importance of contextualised learning within the workplace environment.

Investigating the influence of flip angle and k-space sampling on dynamic contrast-enhanced MRI breast examinations.

Rationale And Objectives: To retrospectively investigate the effect of flip angle (FA) and k-space sampling on the performance of dynamic contrast-enhanced (DCE-) magnetic resonance imaging (MRI) breast sequences.

Materials And Methods: Five DCE-MRI breast sequences were evaluated (10°, 14°, and 18° FAs; radial or linear k-space sampling), with 7-10 patients in each group (n = 45). All sequences were compliant with current technical breast screening guidelines.

Developing understandings of clinical placement learning in three professions: work that is critical to care.

Background: This study contributes further evidence that healthcare students' learning is affected by underlying assumptions about knowledge, learning and work.

Aims: To explore educators and students' understandings of early clinical placement learning in three professions (medicine, nursing and audiology) and examine the profound impacts of these understandings on students' learning and healthcare work.

Methods: Narrative interviews were undertaken with 40 medicine, nursing, and audiology students and 19 educators involved in teaching these student cohorts.

Runx2 is a novel regulator of mammary epithelial cell fate in development and breast cancer.

Regulators of differentiated cell fate can offer targets for managing cancer development and progression. Here, we identify Runx2 as a new regulator of epithelial cell fate in mammary gland development and breast cancer. Runx2 is expressed in the epithelium of pregnant mice in a strict temporally and hormonally regulated manner.

A change management perspective on the introduction of music therapy to interprofessional teams.

Purpose: The purpose of this paper is to demonstrate how a change management perspective contributes new understandings about music therapy implementation processes.

Design/methodology/approach: Narrative inquiry, ethnography, and arts-based research methods were used to explore the experiences of 12 music therapists who developed new services in healthcare settings. These experiences were interpreted using insights from the field of change management.