Thermal ablation versus surgical resection of small-size colorectal liver metastases (COLLISION): an international, randomised, controlled, phase 3 non-inferiority trial.

Background: For patients with small-size colorectal liver metastases, growing evidence suggests thermal ablation to be associated with fewer adverse events and faster recovery than resection while also challenging resection in terms of local control and overall survival. This study assessed the potential non-inferiority of thermal ablation compared with surgical resection in patients with small-size resectable colorectal liver metastases.

Methods: Adult patients (aged ≥18 years) from 14 centres in the Netherlands, Belgium, and Italy with ten or fewer small-size (≤3 cm) colorectal liver metastases, no extrahepatic metastases, and an Eastern Cooperative Oncology Group performance status of 0-2, were stratified per centre, and according to their disease burden, into low, intermediate, and high disease burden subgroups and randomly assigned 1:1 to receive either thermal ablation (experimental group) or surgical resection (control group) of all target colorectal liver metastases using the web-based module Castor electronic data capture with variable block sizes of 4, 6, and 8.

Expert decision-making in clinicians: An auto-analytic ethnographic study of operational decision-making in urgent care.

Objective: To conceptualise the cognitive processes of early expert decision-making in urgent care.

Background: Expert clinicians in the UK frequently determine suitable urgent care patient pathways via telephone triage. This strategy is promoted by policymakers but how it is performed, and its effectiveness has not been evaluated.

The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study.

Background: Home spirometers have been widely implemented in the treatment of people with cystic fibrosis (CF). Frequent spirometry measurements at home could lead to earlier detection of exacerbations. However, previous research indicates that the long-term use of home spirometry is not well maintained by people with CF.

Diagnostic Performance of the Maximal Systolic Acceleration for Detecting a Significant Stenosis in the Aortoiliac and Popliteal Pathway: A Retrospective Cohort Study.

Introduction: Identifying peripheral arterial disease (PAD) remains challenging with currently used bedside tests. The maximal systolic acceleration (ACC) is a promising noninvasive parameter measured by duplex ultrasonography and reflects the arterial perfusion proximal to its measurement point. The principal aim of this study was to analyze the diagnostic accuracy of the ACC for detecting significant stenosis in different arterial segments, which could be useful in clinical decision-making.

Clinical attachment loss may serve as a more precise, suitable, and pragmatic grading instrument for periodontitis: A clinical and radiographic validation study.

Objective: The present study was aimed at assessing the sensitivity and accuracy of using clinical attachment loss (CAL) as a substitute tool for grading periodontitis, instead of the interdental bone loss (BL) percentage derived from two-dimensional radiographs.

Methods: One hundred patients diagnosed with periodontitis were included in the study. Periodontitis was graded according to the American Academy of Periodontology (AAP) 2017 classification.