Contemporary management of phyllodes tumours of the breast: proposal for recommendations from the UK Association of Breast Surgery.

Phyllodes tumours of the breast are rare fibroepithelial neoplasms classified histologically into benign, borderline, or malignant; each requiring different treatment strategies. The infrequency of presentation can result in diagnostic and management variability. The aim is to provide evidence-based or expert consensus recommendations for multidisciplinary teams managing patients with phyllodes tumours.

Assessment of complications and success rates of Percutaneous nephrolithotomy: single tract . multi tract approaches.

Purpose: The objective of this study was to assess the success and complication rates of single-tract access . multi-tract percutaneous nephrolithotomy (PNL).

Material And Methods: The medical records of consecutive patients who underwent PNL for staghorn, partial staghorn, and complex kidney stones between 2014 and 2022 were retrospectively reviewed.

Incorporating ethics into infectious disease clinical practice guidelines.

Background: Incorporating ethics into clinical practice guidelines (CPGs) can be challenging. This is particularly evident for infectious diseases (ID) CPGs due to the complexity of ID ethics (IDE) and the multiplicity of populations at-risk for infections.

Objectives: The OPENING project (IncOrPorating Ethics iN ClINical Guidelines: Practical Indications) was initiated by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Ethics Advisory Committee (EEAC) in collaboration with the ESCMID Guidelines Subcommittee to generate guidelines for the systematic inclusion of ethics principles into ID CPGs.

International Expert-Based Consensus Definition, Classification Criteria, and Minimum Data Elements for Osteoradionecrosis of the Jaw: An Inter-Disciplinary Modified Delphi Study.

Purpose: Osteoradionecrosis of the jaw (ORNJ) is a severe iatrogenic disease characterized by bone death after radiation therapy (RT) to the head and neck. With over 9 published definitions and at least 16 classification systems, the true incidence and severity of ORNJ are obscured by lack of a standard for disease definition and severity assessment, leading to inaccurate estimation of incidence, reporting ambiguity, and likely under-diagnosis worldwide. This study aimed to achieve consensus on an explicit definition and phenotype of ORNJ and related precursor states through data standardization to facilitate effective diagnosis, monitoring, and multidisciplinary management of ORNJ.

Central venous pressure as a method of optimising atrio-ventricular delay after cardiac surgery.

Introduction: Haemodynamic atrioventricular delay (AVD) optimisation has primarily focussed on signals that are not easy to acquire from a pacing system itself, such as invasive left ventricular catheterisation or arterial blood pressure (ABP). In this study, standard clinical central venous pressure (CVP) signals are tested as a potential alternative.

Methods: Sixteen patients with a temporary pacemaker after cardiac surgery were studied.

How I diagnose and treat systemic mastocytosis with an associated hematologic neoplasm.

Over the last decade significant advances have been made by honing in on the diagnostic evaluation and the significance of molecular profiles in patients with systemic mastocytosis (SM), non-advanced and advanced.This is reflected in the 2022 iterations of the World Health Organization Edition 5 and International Consensus Criteria classifications.The impact of targeted KIT inhibitor therapies on patients treated within global trials has demonstrated significant improvements in the prognosis and overall survival for patients, leading to a change the treatment paradigm.

Surgical Technique and Perioperative Outcomes of the "Sapienza" Urology Residency Program's Trocar Placement Configuration During Robotic-Assisted Radical Prostatectomy (RARP): A Retrospective, Single-Centre Observational Study Comparing Experienced Attendings vs. Post-Graduate Year I-III Residents as Bedside Assistants.

: Robot-assisted radical prostatectomy (RARP) for the treatment of prostate cancer (PCa) has been standardized over the last 20 years. At our institution, only n = 3 rob arms are used for RARP. In addition, n = 2, 12 mm lap trocars are placed for the bedside assistant symmetrically at the midclavicular lines, which allows for direct pelvic triangulation and greater involvement of the assisting surgeon.

Transforming undergraduate dental education: the impact of artificial intelligence.

Artificial intelligence (AI) is a rapidly evolving area, having had a transformative effect within some areas of medicine and dentistry. In dentistry, AI systems are contributing to clinical decision-making, diagnostics and treatment planning. Ongoing advances in AI technology will lead to further expansion of its existing applications and more widespread use within the field of dentistry.

Antibiotic prophylaxis for patients undergoing dental care: a multi-centre evaluation in community and hospital dental services.

Background Infective endocarditis (IE) is a life-threatening condition known to be associated with transient bacteraemia, the source of which can be the oral cavity. Scottish Dental Clinical Effectiveness Programme (SDCEP) 2018 implementation advice was introduced to provide practical guidance on National Institute for Health and Care Excellence Clinical Guideline 64 (2016) for management of patients at risk of IE undergoing dental treatment.Aims To assess current compliance with SDCEP's Antibiotic prophylaxis against infective endocarditis in six UK special care dentistry services.

Capacity and Capability for Nursing, Midwifery and Allied Health Professional Principal Investigator Roles in Healthcare Research: A National Survey.

Aims: To understand the current capacity and capability for nursing, midwifery and allied health professional (NMAHP) principal investigator roles in England.

Design: Quantitative online survey.

Methods: Online national quantitative survey across England analysed using descriptive statistics.

The attraction of evil. An investigation of factors explaining women's romantic parasocial relationships with bad guys in movies and series.

The attractiveness of bad boys can be seen as a cultural phenomenon that can be found in different areas of society and art. In the media, too, the bad boy fulfills social expectations in terms of masculinity and is often portrayed as dominant, violent, hard, unemotional and aggressive. Women may feel attracted to this male dominance under certain conditions.

Tracking non-genetic evolution from primary to metastatic ccRCC: TRACERx Renal.

While the key aspects of genetic evolution and their clinical implications in clear cell renal-cell carcinoma (ccRCC) are well-documented, how genetic features co-evolve with the phenotype and tumor microenvironment (TME) remains elusive. Here, through joint genomic-transcriptomic analysis of 243 samples from 79 patients recruited to the TRACERx Renal study, we identify pervasive non-genetic intratumor heterogeneity, with over 40% not attributable to genetic alterations. By integrating tumor transcriptomes and phylogenetic structures, we observe convergent evolution to specific phenotypic traits, including cell proliferation, metabolic reprogramming and overexpression of putative cGAS-STING repressors amid high aneuploidy.

Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current Practices.

Transoral robotic surgery (TORS) for tongue base reduction (TBR) and/or epiglottic surgery is an effective treatment option for selected patients with moderate to severe obstructive sleep apnoea (OSA). This systematic review aims to provide an up-to-date overview of current practices and challenges associated with TORS for OSA. PubMed and Embase databases were searched up to December 2022 following PRISMA guidelines.

Effects of Route Complexity and Lighting on Route Following in Alzheimer's Disease and Posterior Cortical Atrophy.

Objective: Visual processing deficits arising in dementia are associated with particular functional disability. This study aimed to investigate the effects of the built environment on mobility and navigation in people with dementia-related visual loss.

Methods: Participants with posterior cortical atrophy (PCA; "visual-variant Alzheimer's"; n = 11), typical Alzheimer's disease (tAD; N = 10), and controls (n = 13) repeatedly walked down routes within a simplified real-world setting.

A Retrospective Study Reviewing Timing to Onset of Habitual Psychogenic Non-Epileptic Seizures in a Home Video Telemetry Cohort.

Objectives: This study aimed to investigate the onset time to habitual psychogenic non-epileptic seizures (PNES) in adults referred to Guy's and St Thomas' Neurophysiology Department for home video telemetry (HVT) with a clinical question of PNES. The primary objective was to determine the optimal time window for HVT recording for patients with suspected PNES to try to improve the allocation of clinical resources. The secondary objective was to explore any potential association between time to habitual PN ES onset and demographic indexes and other clinical, neuro-radiological and semiological findings.

Testing Polynomial (Non-Linear) Effects of Neurological and Physical Disability on Sexual Well-Being in Multiple Sclerosis.

Background: Multiple sclerosis (MS) is among the most prevalent chronic autoimmune disorders affecting the central nervous system. In Poland, the MS incidence rate is 6.3 per 100,000 patients.

Sexual Health Advocacy for Guys (SHAG): a randomized trial of the impact of a text-messaging program on HIV incidence and STI testing among a national sample of sexual minority cisgender adolescent and young adult men.

Background: Disparities in sexually transmitted infections (STI) including human immunodeficiency virus (HIV) among sexual minority boys and young men are substantial. Effective HIV and STI prevention programs that include access to pre-exposure prophylaxis (PrEP) medication do not consistently include younger sexual minority men. Text-messaging programs for HIV prevention have been associated with increases in HIV testing among sexual minority adolescent boys, but these programs have not incorporated a focus on PrEP or STIs beyond HIV.

Identifying the body mass index of children awaiting dental surgery under general anaesthetic: an audit.

Children with overweight or obesity are at risk of experiencing perioperative complications during general anaesthesia (GA). At Guy's and St Thomas' NHS Foundation Trust in London, children who require dental surgery under GA are placed on a waiting list for the Dental Day Surgery Unit (DDSU) or the Evelina London Children's Hospital (ELCH), which has inpatient beds and a paediatric intensive care unit, depending on their body mass index (BMI) and centile thresholds. The waiting list for the ELCH is longer than for the DDSU.

Clinical outcomes of closed versus open simple ankle fractures patterns requiring soft tissue reconstruction: A prospective comparative observational study.

Background: Contemporary guidelines advocate for initial debridement and single-stage definitive fixation with immediate soft tissue reconstruction for open fractures. This study aims to evaluate the effectiveness of single-stage stabilization and immediate definitive soft tissue coverage in open ankle fractures compared to closed fractures.

Methods: We compared all isolated open ankle fractures (OF) treated between January 2017 and June 2019 to a control group of operatively managed closed ankle fractures (CF).

Implant waste and associated costs in trauma and orthopaedic surgery: a systematic review.

Purpose: Trauma and orthopaedic (T&O) surgery relies on medical implants and materials, often resulting in metalwork wastage (prosthesis, screws, nails, and plates). This places an economic strain on healthcare services and the environment. Our primary outcome is to quantify the implant wastage across the literature, and secondarily investigate the associated costs in this specialty.

Myocardial ischaemia following COVID-19: a cardiovascular magnetic resonance study.

The pathophysiology of myocardial injury following COVID-19 remains uncertain. COVID-HEART was a prospective, multicentre study utilising cardiovascular magnetic resonance (CMR) to characterise COVID-related myocardial injury. In this pre-specified analysis, the objectives were to examine (1) the frequency of myocardial ischaemia following COVID-19, and (2) the association between ischaemia and myocardial injury.

T* relaxometry of fetal brain structures using low-field (0.55T) MRI.

Purpose: Human brain development during gestation is complex, as both structure and function are rapidly forming. Structural imaging methods using MRI are well developed to explore these changes, but functional imaging tools are lacking. Low-field MRI is a promising modality to bridge this gap.