Physiology of bridging stent grafts after fenestrated/branched endovascular aortic repair: Where translational science meets the clinical profile.

Fenestrated/branched endovascular aortic repair emerges as the primary therapeutic modality for intricate aortic pathologies encompassing the paravisceral and thoracoabdominal segments, where bridging stent grafts (BSGs) play a vital role in linking the primary aortic endograft with target vessels. Bridging stent grafts can be categorized mainly into self-expanding stent grafts (SESGs) and balloon-expandable stent grafts (BESGs). Physiological factors significantly influence post-complex endovascular aortic repair BSG behaviour, impacting clinical outcomes of SESGs and BESGs in different but overlapping ways.

Echocardiographic assessment of aortic regurgitation: a practical guideline from the British Society of Echocardiography.

Aortic regurgitation is the third most common valve lesion with increasing prevalence secondary to an ageing population. Transthoracic echocardiography plays a vital role in the identification and assessment of aortic regurgitation and proves essential in monitoring severity and determining the timing of intervention. Building on the foundations of previous British Society of Echocardiography (BSE) recommendations, this BSE guideline presents an update on how to approach an echocardiographic assessment of aortic regurgitation.

Molecular dynamics of chemotactic signalling orchestrates dental pulp stem cell fibrosis during aging.

Aging often triggers dental pulp fibrosis, resulting in clinical repercussions such as increased susceptibility to dental infections, compromised tooth vitality, and reduced responsiveness to dental interventions. Despite its prevalence, the precise molecular mechanisms underlying this condition remains unclear. Leveraging single-cell transcriptome analysis from both our own and publicly available datasets, we identified Ccrl2 macrophages as particularly vulnerable during the early stages of aging.

Lunate prosthetic arthroplasty for the treatment of Kienbock's disease: A systematic review.

Purpose: Prosthetic replacement of the fragmented, collapsed and unreconstructable lunate is a treatment option in Kienbock's disease. The objective of this study is to assess the effectiveness, safety and outcomes of prosthetic lunate arthroplasty for the treatment of Kienbock's disease.

Methods: We conducted a PRISMA-P compliant systematic review PROSPERO (CRD 42021283996) searching Cochrane, Medline, PubMed and Embase databases for the outcomes of prosthetic lunate arthroplasty.

Remote management of anaemia in patients with end-stage kidney disease using a wearable, non-invasive sensor.

Anaemia is a prevalent complication in patients with end-stage kidney disease (ESKD) undergoing haemodialysis. This study evaluates the accuracy of the Alio SmartPatch™, a non-invasive remote monitoring device, in measuring haemoglobin (Hb) and haematocrit (Hct) levels in haemodialysis patients by comparing its results with standard blood-based laboratory methods. The results from 116 patients across multiple sites in the USA and the Kingdom of Jordan show that SmartPatch measurements align closely with standard blood-based laboratory methods, meeting clinically acceptable limits of agreement.

Persistent effect of salt reduction in schoolchildren and their families: 1-year follow-up after an application-based cluster randomized controlled trial.

Background: A 12-month cluster randomized controlled trial (RCT) demonstrated the effectiveness of an application-based education program in reducing the salt intake and systolic blood pressure (SBP) of schoolchildren's adult family members. This study aimed to assess whether the effect at 12 months persisted at 24 months.

Methods: Fifty-four schools were randomly assigned to either the intervention or control group.

Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening.

Background: Worldwide, lung cancer (LC) is the second most frequent cancer and the leading cause of cancer related mortality. Low-dose CT (LDCT) screening reduced LC mortality by 20-24% in randomised trials of high-risk populations. A significant proportion of those screened have nodules detected that are found to be benign.

Should All Doctors Undergo Mandatory Life Support Training?

Advanced life support certification has traditionally been the gold standard of resuscitation training for doctors and has been shown to improve outcomes from cardiac arrest. In 2021, Health Education England removed named courses from mandatory Foundational Programme competencies, which has resulted in capping of reimbursement and reduced access to courses. This represents a drop in educational standards which is particularly concerning when the medical school curriculum has been shown to deliver inconsistent, poor-quality resuscitation training.

Non-Hypertensive Effects of Aldosterone.

Aldosterone, the primary adrenal mineralocorticoid hormone, as an integral part of the renin-angiotensin-aldosterone system (RAAS), is crucial in blood pressure regulation and maintaining sodium and potassium levels. It interacts with the mineralocorticoid receptor (MR) expressed in the kidney and promotes sodium and water reabsorption, thereby increasing blood pressure. However, MRs are additionally expressed in other cells, such as cardiomyocytes, the endothelium, neurons, or brown adipose tissue cells.

The Role of Cytoreductive Surgery in Platinum-Resistant Ovarian Cancer (PROC): A Systematic Review.

Background/objective: Platinum-resistant ovarian cancer (PROC) has limited therapeutic options, and the role of cytoreductive surgery (CRS) in improving survival outcomes remains uncertain. We performed a systematic review to evaluate the oncological benefit of CRS on PROC patients and the associated surgical morbidity and mortality.

Methods: We followed a prospective protocol according to PRISMA guidelines.

Comparison of Different Molecular Weights of Intra-Articular Hyaluronic Acid Injections for Knee Osteoarthritis: A Level I Bayesian Network Meta-Analysis.

The present Bayesian network meta-analysis compared the efficacy of intra-articular injections of different molecular weights of hyaluronic acid (HA) in patients with knee osteoarthritis. In November 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All randomised controlled trials investigating the efficacy of intra-articular HA injections for knee osteoarthritis were accessed.

Pattern of injury in polytrauma compared to single limb related Lisfranc joint fractures.

Background: Midfoot fractures in polytrauma patients are often an underappreciated injury relative to their other major injuries sustained. In this study, our aim was to explore the mechanisms and patterns of injury in polytrauma related midfoot fractures as compared to single limb injuries.

Setting: Multicentre observational study.

A Call for a Neoadjuvant Kidney Cancer Consortium: Lessons Learned from Other Cancer Types.

Neoadjuvant systemic treatment strategies have improved outcomes in several solid tumour types. This success has not yet been replicated in renal cell carcinoma (RCC). A consensus and international collaboration are urgently needed for the development of adaptive perioperative immunotherapy strategies for patients with RCC at high risk of recurrence.

The effects of the SARS-CoV-2 pandemic on self-reported interoception and mental health.

Background: Atypical interoception has been observed across multiple mental health conditions, including anxiety disorders and depression. Evidence suggests that not only pathological anxiety, but also heightened levels of state anxiety and stress are associated with interoceptive functioning. This study aimed to investigate the effects of the recent Coronavirus SARS-CoV-2 pandemic on self-reported interoception and mental health, and their relationship.

Robotic Surgery from a Gynaecological Oncology Perspective: A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study (GO SOAR3).

Background/objectives: For healthcare institutions developing a robotic programme, delivering value for patients, clinicians, and payers is key. However, the impact on the surgeon, training pathways, and logistics are often overlooked. We conducted a study on the impact of robotic surgery on surgeons, access to robotic surgical training, and factors associated with developing a successful robotic programme.

The Application of Terahertz Technology in Corneas and Corneal Diseases: A Systematic Review.

Terahertz (THz) waves reside in the electromagnetic spectrum between the microwave and infrared bands. In recent decades, THz technology has demonstrated its potential for biomedical applications. With the highly unique characteristics of THz waves, such as the high sensitivity to water and optimal spatial resolution coupled with the characteristics of the human cornea, such as its high water content, THz technology has been explored as a potential modality to assess corneas and corneal diseases.

Analysis of orthopaedic private healthcare patterns in England: A potential emerging two-tier system.

Objectives: Private healthcare is a rapidly growing industry in the UK, particularly for surgical procedures, due to extensive waiting times in publicly funded health care. The NHS also commissions private healthcare to provide procedures for NHS patients to alleviate waiting times. We aimed to explore the trends and geographical variations between the North and South of England in privately funded and NHS-funded privately delivered orthopaedic procedures compared to NHS waiting times.

AHNAK2: a potential diagnostic biomarker for pancreatic cancer related to cellular motility.

Pancreatic ductal adenocarcinoma lacks suitable biomarkers for early diagnosis of disease. In gene panels developed for early diagnosis of pancreatic cancer, high AHNAK2 mRNA expression was one possible biomarker. In silico analysis of published human sample datasets (n = 177) and ex vivo analysis of human plasma samples (n = 30 PDAC with matched 30 healthy control) suggested AHNAK2 could be a diagnostic biomarker.

Diagnostic accuracy of point-of-care ultrasound of the posterior fatpad in elbow fractures.

Background: Point-of-care ultrasound (POCUS) can potentially be used in the triage of patients with elbow injuries. However, the diagnostic accuracy of POCUS performed by non-radiologists for the exclusion of elbow fractures is yet unknown. This study aimed to investigate the diagnostic potential of POCUS of the posterior fatpad performed by non-radiologists in the workup of adult patients presenting with elbow injuries.

Analysis of Acute Cerebrovascular Accidents following Cardiovascular Surgical Procedures: A Comprehensive 17-year study involving 24,412 patients at a leading Tertiary care institution in the United Kingdom.

Objective: The primary objective of this study is to quantify the incidence of stroke following cardiac surgery over 17 years at our centre. Additionally, we evaluated the potential risk factors leading to postoperative stroke in these patients.

Methods: Patient characteristics and perioperative data were collected for 24,412 patients undergoing surgery at our centre between January 2005 and December 2021.

Effect of siponimod on retinal thickness, a marker of neurodegeneration, in participants with SPMS: Findings from the EXPAND OCT substudy.

Background: People with MS show abnormal thinning of the retinal layers, which is associated with clinical disability and brain atrophy, and is a potential surrogate marker of neurodegeneration and treatment effects.

Objective: To evaluate the utility of retinal thickness as a surrogate marker of neurodegeneration and treatment effect in participants with secondary progressive MS (SPMS) from the optical coherence tomography (OCT) substudy of the EXPAND Phase 3 clinical trial (siponimod versus placebo).

Methods: In the OCT substudy population (n = 159), treatment effects on change in the average thickness of the retinal layer, peripapillary retinal nerve fiber layer (pRNFL), and combined macular ganglion cell and inner plexiform layers (GCIPL) were analyzed by high-definition spectral domain OCT at months 3, 12, and 24.

Co-design of a novel rehabilitation intervention for patients after ankle fracture surgery: establishing healthcare professional consensus.

Post-surgical rehabilitation advice after ankle fracture surgery, particularly regarding weight-bearing, varies significantly, leading to patient frustration and inconsistent recovery outcomes. This study aimed to establish a consensus for ankle fracture rehabilitation advice and identify content and implementation options for future interventions through consultation with healthcare professionals (HCPs). This study was part of the weight-bearing in ankle fractures (WAX) trial, a multicentre, randomised controlled trial.

Machine learning for refining interpretation of magnetic resonance imaging scans in the management of multiple sclerosis: a narrative review.

Multiple sclerosis (MS) is an autoimmune disease of the brain and spinal cord with both inflammatory and neurodegenerative features. Although advances in imaging techniques, particularly magnetic resonance imaging (MRI), have improved the process of diagnosis, its cause is unknown, a cure remains elusive and the evidence base to guide treatment is lacking. Computational techniques like machine learning (ML) have started to be used to understand MS.

Total cell N-glycosylation is altered during differentiation of induced pluripotent stem cells to neural stem cells and is disturbed by trisomy 21.

Down syndrome (DS), a genetic condition caused by trisomy 21 (T21), manifests various neurological symptoms, including intellectual disability, early neurodegeneration, and early-onset dementia. N-glycosylation is a protein modification that plays a critical role in numerous neurobiological processes and whose dysregulation is associated with a range of neurological disorders. However, whether N-glycosylation of neural glycoproteins is affected in DS has not been studied.