The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study.

Importance: Rapid digitalization of health care and a dearth of digital health education for medical students and junior physicians worldwide means there is an imperative for more training in this dynamic and evolving field.

Objective: To develop an evidence-informed, consensus-guided, adaptable digital health competencies framework for the design and development of digital health curricula in medical institutions globally.

Evidence Review: A core group was assembled to oversee the development of the Digital Health Competencies in Medical Education (DECODE) framework.

Bringing Young People, Health and Social Care Professionals, Transition Champions and Policymakers Together Through Hybrid Methods of Participation: Creating a Space for Shared Understanding of What Is Required to Improve Young People's Healthcare Transition.

Introduction: A multi-stakeholder conference was held in 2023, celebrating the achievements of the Burdett National Transition Nursing Network (BNTNN). The BNTNN had been implemented across England in 2020 to map the current state of young people's healthcare transition into adult services across England, and work with key stakeholders to coach them through making sustainable quality improvements to young people's transition services. This work was funded by the Burdett Trust for Nursing, following the success of an exemplar Model for Quality Improvement (QI) for Transition, which had been developed at a Teaching Hospital in England.

Efficacy and Safety of Four Weeks of Moderately Hypofractionated Chemoradiation for Unresectable, Stage 3 Non-Small Cell Lung Cancer: A Systematic Review.

Shortening treatment time with moderately hypofractionated radiotherapy benefits patients by reducing inconvenience and costs, but its use in the definitive treatment of unresectable Stage 3 non-small cell lung cancer is controversial due to lack of level one evidence and toxicity concerns. Pivotal systemic therapy trials utilize conventionally fractionated chemoradiation at 2 Gy per fraction given over 6 weeks. In practice, 4 weeks of chemoradiation at 2.

Barriers and Enablers for Accessing Rehabilitation Services: Findings From the Rehabilitation Choices Study, Part 1-Healthcare Professionals' Perspectives.

Introduction: Globally, there is an increasing demand for quality medical rehabilitation services. This is the first article of a two-part series showing the findings from the Rehabilitation Choices study in which the main aim was to understand the current landscape of decision-making, enablers and barriers to access appropriate rehabilitation services in the Australian setting. In Part 1, these insights were sought from a healthcare professionals' perspective.

An Audit of Sport Nutrition Services Within Male and Female International Rugby Union: Implications for Research and Practice.

To critically evaluate sport nutrition services available to male and female international rugby unions. Fifteen participants, representing 16 international rugby unions, including nine female and seven male teams (one participant worked with both a female and male union), responded to an online survey. Twelve of the unions recruited were ranked in the top 10 globally by World Rugby.

Interventions to reduce energy usage in an adult intensive care unit: A study protocol.

Background: Energy usage is one of the largest contributors to health care carbon emissions. By taking a strategic, targeted approach in one of the most energy-intensive units of a hospital, the potential for energy savings is real and significant.

Aim: To develop a protocol for the implementation of interventions to reduce the environmental impact of carbon emissions generated by an adult intensive care unit (AICU) in a London-based hospital setting.

Trends in tricyclic antidepressant prescribing and poisoning in England and Wales 2016-2020.

Aims: Tricyclic antidepressants (TCAs) are commonly prescribed despite no longer being a NICE-recommended first-line treatment for depression and their recognized toxicity in overdose. This study examined prescribing, mortality, hospital admissions and clinical TCA data to quantify the use and impact of TCAs in England and Wales.

Methods: Primary care prescription data for the eight TCAs currently licensed in England and Wales were analysed alongside hospital admission and mortality data relating to TCAs over the study period (January 2016-December 2020 inclusive).

Recorded Loneliness and Adverse Outcomes in Older Acute Care Inpatients Receiving Psychiatric Assessment.

Objectives: We investigated the prevalence of loneliness recorded during assessment of general hospital inpatients by older adult liaison psychiatry services and its associations with level of subsequent hospitalisation, emergency presentation and mortality.

Methods: Data were drawn from a large south London mental healthcare provider of older adult liaison psychiatry services to four acute general hospitals. The sample comprised all patients receiving assessments from these services from 2007-2017.

Quantitative analysis of 'virtual' SSP assessment clinics in the NHS bowel cancer screening programme in England.

Background: Bowel cancer screening in England is initially carried out using a home testing kit, with those who require further testing first being referred to an assessment clinic. During COVID-19, these assessment clinics became 'virtual' (telephone or video-call) where previously they had only been held face-to-face.

Methodology: A before and after study design was constructed to examine the impact of this change in clinic type on key programme metrics.

Intersectionality of inequalities in revascularisation and outcomes for acute coronary syndrome in England: nationwide linked cohort study.

Background: Inequalities in access to care for women, people of non-white ethnicity, who live in areas of social deprivation, and with multiple long-term conditions lead to inequity of outcomes. We investigated the intersectionality of these causes of health inequality on coronary revascularisation and clinical outcomes for admissions with acute coronary syndrome (ACS).

Methods: We included hospital admissions in England for types of acute coronary syndrome from April 2015 to April 2018 and linked Hospital Episode Statistics to the Office for National Statistics mortality data.

Evaluating low NO hydrogen engines designed for off-road and construction applications.

Hydrogen internal combustion engines offer a near-term decarbonisation pathway for hard to electrify sectors such as non-road mobile machinery (NRMM). However, few hydrogen-specific engines have ever been developed with the twin-goals of maximising low carbon energy efficiency and delivering air quality co-benefits. We present analyses of dynamometer-derived nitrogen oxides (NO) tailpipe emissions from four variants of a ∼55 kW four-cylinder port fuelled injection spark ignition hydrogen internal combustion engine (H2ICE) suitable for a range of uses within the NRMM industry.

Evaluating Differences in Baseline Knee Hyperextension and Postoperative Stiffness Between Patients With Tibial Spine Fracture Versus ACL Tear.

Background: While generalized ligamentous laxity is a risk factor for anterior cruciate ligament (ACL) reconstruction failure, there is a paucity of literature evaluating underlying dynamic risk factors predisposing pediatric and adolescent patients to ACL tears or tibial spine fractures.

Purpose: To (1) evaluate differences in baseline knee hyperextension and postoperative knee stiffness between patients who sustained tibial spine fractures versus ACL tears and (2) determine whether there were other demographic and dynamic injury differences between these patients.

Study Design: Cross-sectional study; Level of evidence, 3.

Surgical management of skull base chordomas and chondrosarcomas: insights from a national cohort study.

Objective: Skull base chordoma and chondrosarcoma are distinct sarcomas of the skull base but share significant therapeutic challenges due to their proximity to critical neurovascular structures, making surgical resection difficult. We sought to establish factors associated with outcome predictors in a national cohort of patients.

Methods And Analysis: Data for all patients referred with a diagnosis of skull base chordoma or chondrosarcoma from April 2017 to December 2022 were obtained.

Association of pre-existing cardiovascular disease with administration of fluoropyrimidine chemotherapy in patients with gastrointestinal malignancies.

Objective: Fluoropyrimidine chemotherapy is a first-line treatment for many gastrointestinal (GI) cancers, however, cardiotoxicity concerns may limit administration in patients with pre-existing cardiovascular disease (CVD). This study investigated the association of pre-existing CVD with use of fluoropyrimidine chemotherapy in tumour-eligible GI cancer patients.

Methods And Analysis: National cancer registry data from the Virtual Cardio-Oncology Research Initiative from England between 2014 and 2018 was used to identify GI cancer patients eligible to receive fluoropyrimidine chemotherapy.

Assessing chatbots ability to produce leaflets on cataract surgery: Bing AI, chatGPT 3.5, chatGPT 4o, ChatSonic, Google Bard, Perplexity and Pi.

Purpose: This study aimed to evaluate leaflets on cataract surgery produced by seven common free chatbots.

Setting: Usage of conversational artificial intelligence services (chatbots) is becoming more prevalent in all aspects of life, including healthcare. Cataract surgery is the most commonly performed operation in the world, with numbers set to increase.

The challenges faced by early-career international medical graduates in general practice and the opportunities for support: a mixed methods study.

Background: Recruiting and retaining International Medical Graduates (IMGs) has been identified as a key component in addressing the ongoing workforce crisis in general practice. However, research shows IMG General Practitioners (GPs) face unique challenges compared to their UK-trained counterparts, impacting their welfare, retention in the workforce, and ability to provide patient care.

Aim: This study examined the challenges facing early-career IMG GPs, the help and support they access and want to access, and their perceptions and utilisation of the help and support available.

Protocol for a feasibility study evaluating a supported self-management intervention for stroke survivors with aphasia (StarStep study).

Background: There is a growing evidence base to support the use of self-management interventions for improving quality of life after stroke. However, stroke survivors with aphasia have been underrepresented in research to date. It is therefore unclear if self-management is an appropriate or effective approach for this group.

Patterns of physical activity in hunter-gatherer children compared with US and UK children.

Contemporary hunter-gatherers are highly active, but little is known about physical activity levels in hunter-gatherer children. We analysed 150 days of accelerometer data from 51 BaYaka hunter-gatherer children (aged 3-18) in the Republic of Congo, comparing it with British and American children using samples from Millennium Cohort Study (MCS) and National Health and Nutrition Examination Survey (NHANES). BaYaka children were highly active, engaging in over 3 h of moderate-to-vigorous physical activity (MVPA) daily, surpassing British adolescents by over 70 min.

Xanthomatous hypophysitis relapsing and remitting over two decades.

Inflammation of the pituitary gland can be primary (without another underlying cause) or secondary (associated with a systemic inflammatory condition). Primary hypophysitis is very rare, among which xanthomatous hypophysitis as a histological type is extremely unusual. A woman in her late 50s presented with recurrent pituitary lesions over 20 years.