Scoping review of review methodologies used for guiding evidence-based practice in critical care: a protocol.

Introduction: A literature review provides a synthesis on a selection of papers about a specific topic. This is used by health practitioners in critical care as in other specialities when making clinical practice decisions. The task of knowledge transfer through the review process of scientific papers involves a variety of methodologies with differing expectations on the quality and rigour that is applied.

Solid tumor immunotherapy using NKG2D-based adaptor CAR T cells.

NKG2D ligands (NKG2DLs) are broadly expressed in cancer. To target these, we describe an adaptor chimeric antigen receptor (CAR) termed NKG2D/Dap10-12. Herein, T cells are engineered to co-express NKG2D with a fusion protein that comprises Dap10 joined to a Dap12 endodomain.

Explorations of strategies for inclusion for newly qualified physiotherapists from racially minoritised groups in a large, urban NHS Trust, UK.

Objectives: The study aimed to i) understand the experiences of newly qualified physiotherapists from racially minoritised backgrounds in a large hospital physiotherapy department and ii) co-create and implement inclusive strategies to affect work culture.

Design: The project used an action research design with co-creation principles and was in 3 phases. Phase 1 explored the experiences of inclusion for newly qualified racially minoritised staff, using focus groups and transcripts analysed thematically.

UKHCDO gene therapy taskforce: Guidance for implementation of haemophilia gene therapy into routine clinical practice for adults.

Introduction: 2022 was a landmark year with two adeno-associated viral vectors (AAVs) receiving conditional marketing authorization from EMA for the treatment of persons with severe haemophilia A and severe to moderately severe haemophilia B and a third in 2024. Gene therapy is a transformative, irreversible treatment with long-lasting effects, necessitating development of new clinical pathways to ensure optimal outcomes.

Aim: To develop a consensus framework and service specification for delivery of AAV gene therapy for haemophilia in adults within the UK using the hub-and-spoke model proposed by the European Association of Haemophilia and Allied Disorders and the European Haemophilia Consortium.

Self-Induced Nasal Septal Perforation: Rhinotillexomania-A Different Entity From Nose Picking.

Background: Nose picking is a common habit that rarely leads to mutilating self-injury. It is important to distinguish between rhinotillexomania (compulsive nose picking) as a disease and nose picking that results in or contributes to nasal septal perforation (NSP). The aim of this study is to investigate the impact of rhinotillexomania and NSP repair on sinonasal symptoms and quality of life (QoL).

External validation of a multimodality deep-learning normal tissue complication probability model for mandibular osteoradionecrosis trained on 3D radiation distribution maps and clinical variables.

Background And Purpose: While the inclusion of spatial dose information in deep learning (DL)-based normal-tissue complication probability (NTCP) models has been the focus of recent research studies, external validation is still lacking. This study aimed to externally validate a DL-based NTCP model for mandibular osteoradionecrosis (ORN) trained on 3D radiation dose distribution maps and clinical variables.

Methods And Materials: A 3D DenseNet-40 convolutional neural network (3D-mDN40) was trained on clinical and radiation dose distribution maps on a retrospective class-balanced matched cohort of 184 subjects.

Discharging the duty of candor following delayed post-endoscopy cancer diagnosis.

Endoscopic examination is not risk free. Not only are there well-known complications associated with the procedure, but malignant and pre-malignant lesions can be missed due to human factors or failures in organizational process. Duty of candor (DoC) is a legal requirement if significant harm occurs in delivery of healthcare.

The Role of Active Brown Adipose Tissue in Patients With Pheochromocytoma or Paraganglioma.

Objectives: Metabolically-active brown adipose tissue (aBAT) is a common finding on fluorodeoxyglucose positron emission tomography (FDG-PET) imaging in patients with pheochromocytoma or paraganglioma (PPGL). In addition to its clinical significance, we aimed to explore the prevalence of this finding on FDG-PET imaging in patients with PPGL.

Methods: We conducted a systematic review and meta-analysis of prospective and retrospective studies.

Treatment Intensification With Either Fludarabine, AraC, G-CSF and Idarubicin, or Cladribine Plus Daunorubicin and AraC on the Basis of Residual Disease Status in Older Patients With AML: Results From the NCRI AML18 Trial.

Purpose: To evaluate the survival benefit of chemotherapy intensification in older patients with AML who have not achieved a measurable residual disease (MRD)-negative remission.

Methods: Five hundred twenty-three patients with AML (median age, 67 years; range, 51-79) without a flow cytometric MRD-negative remission response after a first course of daunorubicin and AraC (DA; including 165 not in remission) were randomly assigned between up to two further courses of DA or intensified chemotherapy-either fludarabine, cytarabine, granulocyte colony-stimulating factor and idarubicin (FLAG-Ida) or DA with cladribine (DAC).

Results: Overall survival (OS) was not improved in the intensification arms (DAC DA: hazard ratio [HR], 0.

Profiling serum immunodominance following SARS-CoV-2 primary and breakthrough infection reveals distinct variant-specific epitope usage and immune imprinting.

Over the course of the COVID-19 pandemic, variants have emerged with increased mutations and immune evasive capabilities. This has led to breakthrough infections (BTI) in vaccinated individuals, with a large proportion of the neutralizing antibody response targeting the receptor binding domain (RBD) of the SARS-CoV-2 Spike glycoprotein. Immune imprinting, where prior exposure of the immune system to an antigen can influence the response to subsequent exposures, and its role in a population with heterogenous exposure histories has important implications in future vaccine design.

Familial chylomicronaemia syndrome in pregnancy - report of two cases managed with plasma exchange.

Familial chylomicronaemia syndrome (FCS) is a rare genetic disorder characterised by significantly elevated triglyceride levels which increases the risk of acute pancreatitis. Due to the changes in lipid metabolism during pregnancy, triglyceride levels may rise further, particularly in the third trimester, and cause challenges in the management of these patients. Apart from strict dietary restriction of all fats, there is limited evidence on the efficacy of pharmacological treatment with omega-3 fatty acids and fibrates in maintaining triglyceride levels below the desired threshold of 10 mmol/L.

Innovative Nanotechnological Approaches in Trauma and Orthopaedic Surgery: A Comprehensive Review.

The application of nanotechnology to health has been one of the revolutionizing factors in the field of trauma and orthopaedic surgery over the last decade. Advances in nanomedicine, in comparison to conventional modes of treatment, have influenced immensely the approach towards trauma and orthopaedic surgery and provided some unique answers to some very complex problems like bone reconstruction, soft tissue repair, and prevention of infection. The current narrative review intends to underpin an extensive analysis of modern applications and recent advances in nanotechnology-driven therapies in orthopaedics.

Comprehensive Analysis of Purpura Fulminans as an Uncommon Postoperative Complication: A Case Series.

Background: Acute infectious purpura fulminans (AIPF) is a rare but potentially fatal postoperative complication characterised by rapidly progressing disseminated intravascular coagulation (DIC), widespread purpura, and multi-organ dysfunction. Despite its severe and critical outcomes, the literature on this condition in the postoperative context is limited.

Objectives: This study aimed to analyse and evaluate the incidence, clinical presentation, laboratory findings, management strategies, and outcomes of postoperative AIPF in patients who underwent various surgical procedures.

Percutaneous Pulmonary Valve Implantation With Self-Expanding Valves for Carcinoid Heart Diseases.

Carcinoid heart disease is an important complication of neuroendocrine tumors that may lead to significant morbidity and mortality. Right-sided heart valve involvement with consequent valve dysfunction is one of the common manifestations. Patients often have multiple, significant comorbidities with advanced metastatic disease and, as such, may not be suitable for surgical valve replacement due to excessive risk.