Navigating the challenges in radiology training expansion: costs and benefits.

Clinical and interventional radiology services play a vital role in the provision of modern healthcare, but there is a widening gap between the capacity of the imaging workforce and increasing demand. In recent years there has been a programme of training expansion in England supported by tariff level funding from NHS England (Workforce Training and Education Directorate), enhancing long-term radiology workforce sustainability and bringing quality benefits for patients, departments, and trusts. Expansion is a multifaceted and challenging process in the current NHS climate, involving coordination of funding, capacity, and sustained educational quality.

Impact of cardiac rehabilitation on erectile dysfunction in cardiovascular patients: a systematic review and meta-analysis.

Background: Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals.

Aim: To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis.

Methods: This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease.

Effects of milk replacer powder added to pasteurized whole milk over different durations on dairy calves fed ground starter diet with alfalfa hay.

Adding milk replacer powder (MRP) to whole milk during the entire preweaning period can increase growth but raises concern because of low starter feed intake and slumps in ADG at weaning and postweaning. In the current study, effects of adding MRP to pasteurized whole milk (PWM) during d 10 to 41 or d 10 to 59 of age were investigated in comparison with PWM. Calves (24 females and 21 males; 39.

A 30-year trend of dairy consumption and its determinants among income groups in Iranian households.

Introduction: Milk and dairy products provide essential nutrients and have the potential to prevent chronic diseases, thus reducing healthcare costs. However, there is a lack of consistent and updated data on dairy consumption trends in Iran. This study aims to analyze the trends in dairy consumption among Iranian households from 1991 to 2021, focusing on household-level determinants across different expense groups.

Association of triglyceride glucose index with cardiovascular events: insights from the Isfahan Cohort Study (ICS).

Background: There is limited evidence regarding the evaluation of the association between the triglyceride glucose (TyG) index, an indicator of insulin resistance, and the incident risk of cardiovascular disease (CVD). Therefore, we aimed to examine the relationship between the TyG index and CVD incidence in a cohort of Iranian adults.

Methods: This study was performed in the framework of the Isfahan Cohort Study (ICS).

Self-rated health and its determinants in patients with hypertension in Isfahan in 2019.

Background And Objectives: Self-rated health (SRH) serves as an assessment of contentment regarding one's social, mental, and physical well-being and has been linked to both cardiovascular mortality and morbidity. Nonetheless, the relationship between SRH and medical outcomes in individuals with hypertension unsettled. This research endeavors to pinpoint the determinants that affect SRH in Iranian patients with hypertension.

Association of the triglyceride glucose index with all-cause and cardiovascular mortality in a general population of Iranian adults.

Background: The triglyceride glucose (TyG) index is a new and low-cost marker to determine insulin resistant which may be a predictor of cardiovascular disease (CVD). Although available evidence showed that its association with CVD mortality (CVM) and all-cause mortality (ACM) may differ in different populations, scarce data are available in this regard specially in low and middle-income countries.

Purpose: To examine the association between TyG index and risk of CVM and ACM in Iranians.

Medication Adherence With Polypill in Cardiovascular Disease and High-Risk Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Involving 7364 Participants.

Considering the worldwide mortality and morbidity of cardiovascular diseases (CVDs), the necessity of using multiple pills due to the chronicity of this condition, and the importance of medication adherence in these patients, we conducted this systematic review and meta-analysis to assess the polypill effect on adherence in patients with established CVD and at high risk. To accomplish this review, we searched various databases to access grey literature and several electronic databases to find randomized controlled trials (RCTs) assessing polypills compared to individual pills from January 2000 to October 2022. The outcomes were primarily medication adherence, secondarily systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C) serum level, and serious adverse events (SAEs).

24-Hour postnatal total serum protein concentration affects the health and growth performance of female Holstein dairy calves.

Background: Total serum protein (TSP) within the first few days of life in the neonatal calf has predictive value for subsequent growth and production in calves before and after weaning.

Introduction: The objective of this study was to evaluate the effect of TSP concentration 24-h after birth (24-h) on the performance and health of Holstein dairy calves.

Methods: A total of 152 female calves were enrolled in this study.

Adjusting for 30-hour undigested neutral detergent fiber in substitution of wheat straw and beet pulp for alfalfa hay and corn silage in the dairy cow diet: Chewing activities, diurnal feed intake, and ruminal fermentation.

This experiment investigated the effects of replacing alfalfa hay (AH) and corn silage (CS) with wheat straw (WS) and beet pulp (BP) in diets with similar forage 30-h undigested neutral detergent fiber (uNDF) on chewing behavior and ruminal fermentation of lactating cows. Twelve multiparous Holstein cows (51 ± 3 kg/d of milk; days in milk = 97 ± 13; mean ± standard error) were housed in individual stalls and used in a replicated 3 × 3 Latin square design with 28-d periods. Experimental diets were (1) 0% forage uNDF from WS (WS0, contained 2% BP); (2) 50% forage uNDF from WS (WS50, contained 7.

Trace minerals source in calf starters interacts with birth weights to affect growth performance.

The present study was conducted to investigate the effects of partial replacement of inorganic minerals (IM) with trace minerals in advance chelate components form in starter diets for calves of different birth weights on performance, health, and behavior of Holstein calves. Fifty-two calves were assigned to 1 of 4 treatments in a 2 × 2 factorial arrangement with two mineral sources (IM or advanced chelated minerals (ACMS)) and two birth weights (low or normal birth weight; LBW or NBW). Calves were weaned on d 56 and remained until d 71 of the study.

Feeding corn germ instead of corn grain on the performance of Holstein dairy cows fed low-forage diet and human-edible feed conversion efficiency.

Using corn germ (CG) instead of corn grain could maintain dairy cow performance and might increase the efficiency of human food production. The primary objective of this study was to evaluate the effects of replacing corn grain with CG on the performance, nutrient intake, and digestibility of dairy cows. It also aimed to investigate the effect of CG on the efficiency of human food production in high-producing Holstein dairy cows in early lactation.

Performance, structural growth, and digestibility by Holstein calves fed different amounts of milk through step-up/step-down or conventional methods.

Early life milk intake can influence the survival and future productivity of replacement heifers. The present study determined the effects of different amounts of milk through step-up/step-down or conventional feeding methods on the performance of dairy calves. Thirty-nine Holstein calves (18 male and 21 female) were used in a completely randomized design.

Lessons of the month: Acute liver failure: a case close to the heart.

The differential diagnosis of an acute liver injury is extremely broad and can often change following initial investigations. We describe the case of a 54-year-old woman whose liver function derangement was initially attributed to alcohol excess, but in fact turned out to be cardiac in origin. We describe the underlying mechanisms and features of cardiac-related liver injury, and how the pattern of liver tests alongside appropriate imaging can help obtain the diagnosis.

Beet pulp substituted for corn silage and barley grain in diets fed to dairy cows in the summer months: feed intake, total-tract digestibility, and milk production.

The responses of dairy cows to the substitution of beet pulp (BP) for grain or forage are not consistent, and heat stress may affect the response of dairy cows to this substitution. The effects of substituted BP for corn silage and barley grain on feed intake, performance, and ruminal parameters were evaluated using eight multiparous Holstein cows in a duplicated 4 × 4 Latin square design with 21-day periods. Cows were in mid-lactation (45.

Effects of starter protein content and alkali processing of wheat straw on growth, ruminal fermentation, and behavior in Holstein calves.

The present study was conducted to investigate the effects of crude protein (CP) content of starter feed and wheat straw (WS) processing on growth performance, digestibility, ruminal fermentation, and behavior of Holstein calves. Sixty calves (28 male and 32 female) were randomly assigned to 1 of 4 treatments in a randomized complete block design. Treatments in a 2 × 2 factorial arrangement were (1) lower-CP ground starter feed mixed with alkali-processed WS (LP-PWS), (2) lower-CP ground starter feed mixed with unprocessed WS (LP-WS), (3) higher-CP ground starter feed mixed with alkali-processed WS (HP-PWS), and (4) higher-CP ground starter feed mixed with unprocessed WS (HP-WS).

Fermented soybean meal affects the ruminal fermentation and the abundance of selected bacterial species in Holstein calves: a multilevel analysis.

The effect of soybean meal (SBM) replacement with fermented SBM (FSBM) on ruminal fermentation and bacterial abundance in Holstein calves was investigated in this study. Thirty nine calves were randomized to: (1) control: 27% SBM + 0% FSBM (FSBM0, n = 13); (2) 18% SBM + 9% FSBM (FSBM9, n = 13); and (3) 13.5% SBM + 13.

Substitution of wheat straw with sugarcane bagasse in low-forage diets fed to mid-lactation dairy cows: Milk production, digestibility, and chewing behavior.

Sugarcane bagasse (SB) is a low-quality roughage source that is often plentiful during times of forage shortage. It is generally less costly compared with other conventional sources of forage. We hypothesized that SB could be used as a source of roughage for dairy cattle by replacing wheat straw (WS), another low-quality forage.

Performance and feeding behavior of dairy cows fed high-concentrate diets containing steam-flaked or ground corn varying in particle size.

Steam-flaked corn (SFC) and ground corn (GC) of different particle sizes were evaluated for their effects on dry matter intake (DMI), milk yield and components, chewing activity, ration sorting, ruminal fermentation, and digestibility in lactating dairy cows. Eight multiparous Holstein cows in mid-lactation (46.6 ± 3.

Isolated caecal necrosis-a case study.

A patient with right iliac fossa pain underwent CT angiography which demonstrated isolated caecal necrosis with associated superior mesenteric artery (SMA) stenosis. This was supported by colonoscopic findings and histopathological analysis. Isolated caecal necrosis is a rare presentation of ischaemic colitis.

Diagnostic accuracy of whole-body MRI versus standard imaging pathways for metastatic disease in newly diagnosed non-small-cell lung cancer: the prospective Streamline L trial.

Background: Whole-body magnetic resonance imaging (WB-MRI) could be an alternative to multi-modality staging of non-small-cell lung cancer (NSCLC), but its diagnostic accuracy, effect on staging times, number of tests needed, cost, and effect on treatment decisions are unknown. We aimed to prospectively compare the diagnostic accuracy and efficiency of WB-MRI-based staging pathways with standard pathways in NSCLC.

Methods: The Streamline L trial was a prospective, multicentre trial done in 16 hospitals in England.

Diagnostic accuracy of whole-body MRI versus standard imaging pathways for metastatic disease in newly diagnosed colorectal cancer: the prospective Streamline C trial.

Background: Whole-body MRI (WB-MRI) could be an alternative to multimodality staging of colorectal cancer, but its diagnostic accuracy, effect on staging times, number of tests needed, cost, and effect on treatment decisions are unknown. We aimed to prospectively compare the diagnostic accuracy and efficiency of WB-MRI-based staging pathways with standard pathways in colorectal cancer.

Methods: The Streamline C trial was a prospective, multicentre trial done in 16 hospitals in England.