A Comprehensive Exploration of Digital Twinning in Spine Surgery.

One recent innovation in the health care landscape is the integration of Digital Twin (DT) in the field of spine surgery. DT, first used in 2002 is defined as the replication of physical entities in a virtual environment. It has emerged as a transformative tool for optimizing complex systems.

Re-irradiation for recurrent glioblastoma: a pattern of care analysis.

Background: 90% of glioblastomas (GBM) relapse within two years of diagnosis. In contrast to the initial setting, there is no standard management for recurrent disease and options include hypofractionated stereotactic re-irradiation (re-mHSRT). The aims of this study were to investigate re-mHSRT practice in Swiss neuro-oncology centres.

Preoperative radiosurgery for brain metastases (PREOP-1): A feasibility trial.

Purpose: Preoperative radiosurgery (SRS) of brain metastases (BM) aims to achieve cavity local control with a reduction in leptomeningeal relapse (LMD) and without additional radionecrosis compared to postoperative SRS. We present the final results of a prospective feasibility trial of linac-based stereotactic radiosurgery (SRS) prior to neurosurgical resection of a brain metastasis (PREOP-1).

Methods: Eligibility criteria included a BM up to 4 cm in diameter for elective resection.

Evaluating the influence of taxation and social security policies on psychological distress: A microsimulation study of the UK during the COVID-19 economic crisis.

Economic determinants are important for population health, but actionable evidence of how policies can utilise these pathways remains scarce. This study employs a microsimulation framework to evaluate the effects of taxation and social security policies on population mental health. The UK economic crisis caused by the COVID-19 pandemic provides an informative context involving an economic shock accompanied by one of the strongest discretionary fiscal responses amongst OECD countries.

Estimating quality-adjusted life expectancy (QALE) for local authorities in Great Britain and its association with indicators of the inclusive economy: a cross-sectional study.

Objectives: Quantifying area-level inequalities in population health can help to inform policy responses. We describe an approach for estimating quality-adjusted life expectancy (QALE), a comprehensive health expectancy measure, for local authorities (LAs) in Great Britain (GB). To identify potential factors accounting for LA-level QALE inequalities, we examined the association between inclusive economy indicators and QALE.

Dynamic calibration with approximate Bayesian computation for a microsimulation of disease spread.

The global COVID-19 pandemic brought considerable public and policy attention to the field of infectious disease modelling. A major hurdle that modellers must overcome, particularly when models are used to develop policy, is quantifying the uncertainty in a model's predictions. By including the most recent available data in a model, the quality of its predictions can be improved and uncertainties reduced.

Guidance on the use of complex systems models for economic evaluations of public health interventions.

To help health economic modelers respond to demands for greater use of complex systems models in public health. To propose identifiable features of such models and support researchers to plan public health modeling projects using these models. A working group of experts in complex systems modeling and economic evaluation was brought together to develop and jointly write guidance for the use of complex systems models for health economic analysis.

Optimized workflow to minimise intra-fractional motion during stereotactic body radiotherapy of spinal metastases.

Background And Purpose: This study evaluated translational and rotational intra-fractional patient movement during spinal stereotactic body radiotherapy (SBRT) using 6D positioning based on 3D cone beam computerized tomography (CBCT) and stereoscopic kilovoltage imaging (ExacTrac). The aim was to determine whether additional intra-fractional image verification reduced intra-fractional motion without significantly prolonging treatment time, whilst maintaining acceptable imaging related dose.

Materials And Methods: A retrospective analysis of 38 patients with 41 primary tumour volumes treated with SBRT between September 2018 and May 2021 was performed.

Objectively measuring the association between the built environment and physical activity: a systematic review and reporting framework.

Background: Objective measures of built environment and physical activity provide the opportunity to directly compare their relationship across different populations and spatial contexts. This systematic review synthesises the current body of knowledge and knowledge gaps around the impact of objectively measured built environment metrics on physical activity levels in adults (≥ 18 years). Additionally, this review aims to address the need for improved quality of methodological reporting to evaluate studies and improve inter-study comparability though the creation of a reporting framework.

Targeted policy intervention for reducing red meat consumption: conflicts and trade-offs.

Background: There are a range of policies and guidelines focused on meat consumption which aim to tackle health and environmental issues. Policies are often siloed in nature and propose universal limits on consumption. Despite this, there will be a number of conflicts and trade-offs between interest groups.

Radiosurgery for Five to Fifteen Brain Metastases: A Single Centre Experience and a Review of the Literature.

Purpose: Stereotactic radiosurgery (SRS) is now mainstream for patients with 1-4 brain metastases however the management of patients with 5 or more brain metastases remains controversial. Our aim was to evaluate the clinical outcomes of patients with 5 or more brain metastases and to compare with published series as a benchmarking exercise.

Methods: Patients with 5 or more brain metastases treated with a single isocentre dynamic conformal arc technique on a radiosurgery linac were identified from the institutional database.

A foresight whole systems obesity classification for the English UK biobank cohort.

Background: The number of people living with obesity or who are overweight presents a global challenge, and the development of effective interventions is hampered by a lack of research which takes a joined up, whole system, approach that considers multiple elements of the complex obesity system together. We need to better understand the collective characteristics and behaviours of those who are overweight or have obesity and how these differ from those who maintain a healthy weight.

Methods: Using the UK Biobank cohort we develop an obesity classification system using k-means clustering.

A synthetic population dataset for estimating small area health and socio-economic outcomes in Great Britain.

In order to understand the health outcomes for distinct sub-groups of the population or across different geographies, it is advantageous to be able to build bespoke groupings from individual level data. Individuals possess distinct characteristics, exhibit distinct behaviours and accumulate their own unique history of exposure or experiences. However, in most disciplines, not least public health, there is a lack of individual level data available outside of secure settings, especially covering large portions of the population.

Clustering Accelerometer Activity Patterns from the UK Biobank Cohort.

Many researchers are beginning to adopt the use of wrist-worn accelerometers to objectively measure personal activity levels. Data from these devices are often used to summarise such activity in terms of averages, variances, exceedances, and patterns within a profile. In this study, we report the development of a clustering utilising the whole activity profile.

Characterisation of Temporal Patterns in Step Count Behaviour from Smartphone App Data: An Unsupervised Machine Learning Approach.

The increasing ubiquity of smartphone data, with greater spatial and temporal coverage than achieved by traditional study designs, have the potential to provide insight into habitual physical activity patterns. This study implements and evaluates the utility of both K-means clustering and agglomerative hierarchical clustering methods in identifying weekly and yearlong physical activity behaviour trends. Characterising the demographics and choice of activity type within the identified clusters of behaviour.

Geodemographic Patterns of Meat Expenditure in Great Britain.

The future of the meat industry will require the management of important trade-offs between economic, environmental and health aspects of both humans and animals. Understanding the patterns and trends of meat expenditure and consumption is crucial for assessing the current resilience of the system and for economic, planning, health and environmental applications. Here, we show how the technique of geodemographic classification, combined with fine scale expenditure estimates can be used to explore temporal and spatial patterns of meat expenditure in Great Britain between 2008 and 2017.

A dynamic microsimulation model for epidemics.

A large evidence base demonstrates that the outcomes of COVID-19 and national and local interventions are not distributed equally across different communities. The need to inform policies and mitigation measures aimed at reducing the spread of COVID-19 highlights the need to understand the complex links between our daily activities and COVID-19 transmission that reflect the characteristics of British society. As a result of a partnership between academic and private sector researchers, we introduce a novel data driven modelling framework together with a computationally efficient approach to running complex simulation models of this type.

Five fraction stereotactic radiotherapy after brain metastasectomy: a single-institution experience and literature review.

Purpose: The outcomes of five fraction stereotactic radiotherapy (hfSRT) following brain metastasectomy were evaluated and compared with published series.

Methods: 30 Gy in 5 fractions HfSRT prescribed to the surgical cavity was reduced to 25 Gy if the volume of 'brain-GTV' receiving 20 Gy exceeded 20 cm. Endpoints were local recurrence, nodular leptomeningeal recurrence, new brain metastases and radionecrosis.

Successful salvage of recurrent leptomeningeal disease in large cell neuroendocrine lung cancer with stereotactic radiotherapy.

A 70-year old male with stage I large cell neuroendocrine carcinoma (LCNEC) of the lung underwent resection of a metachronous 5 cm brain metastasis and received postoperative hypofractionated stereotactic radiotherapy (hfSRT). Five sequential nodular leptomeningeal metastases up to 5.3 cm in diameter were diagnosed on MRI within 10 months and were treated with SRT.

Socio-demographic determinants of physical activity and app usage from smartphone data.

The increasing ubiquity of smartphones provides a potential new data source to capture physical activity behaviours. Though not designed as a research tool, these secondary data have the potential to capture a large population over a more extensive spatial area and with longer temporality than current methods afford. This paper uses one such secondary data source from a commercial app designed to incentivise activity.

Can a data driven obesity classification system identify those at risk of severe COVID-19 in the UK Biobank cohort study?

COVID-19 is a disease that has been shown to have outcomes that vary by certain socio-demographic and socio-economic groups. It is increasingly important that an understanding of these outcomes should be derived not from the consideration of one aspect, but by a more multi-faceted understanding of the individual. In this study use is made of a recent obesity driven classification of participants in the United Kingdom Biobank (UKB) to identify trends in COVID-19 outcomes.

The SIPHER Consortium: Introducing the new UK hub for systems science in public health and health economic research.

The conditions in which we are born, grow, live, work and age are key drivers of health and inequalities in life chances. To maximise health and wellbeing across the whole population, we need well-coordinated action across government sectors, in areas including economic, education, welfare, labour market and housing policy. Current research struggles to offer effective decision support on the cross-sector strategic alignment of policies, and to generate evidence that gives budget holders the confidence to change the way major investment decisions are made.

Local level estimates of food, drink and tobacco expenditure for Great Britain.

We present expenditure estimates for 106 product categories across Great Britain for the years 2008-2016. Estimates are at the Local Authority District level (n = 380) and the categories cover all food, drink and tobacco commodities. Reliable, local level expenditure estimates are crucial for understanding broader market trends, assessing economic stability and for projections.

Early results and volumetric analysis after spot-scanning proton therapy with concomitant hyperthermia in large inoperable sacral chordomas.

Objective: Large inoperable sacral chordomas show unsatisfactory local control rates even when treated with high dose proton therapy (PT). The aim of this study is assessing feasibility and reporting early results of patients treated with PT and concomitant hyperthermia (HT).

Methods:: Patients had histologically proven unresectable sacral chordomas and received 70 Gy (relative biological effectiveness) in 2.