Use of virtual reality to remotely train healthcare professionals in paediatric emergency tracheostomy skills: protocol for a multi-centre, non-inferiority educational interventional study with historical controls.

Background: The insertion of a tracheostomy is an established technique used to wean patients off ventilatory support, manage secretions in complex conditions, and as a potentially life-saving procedure to bypass upper airway obstruction. Life-threatening complications during aftercare are not uncommon and may be influenced by a lack of education of carers or healthcare providers of children and young people living with a tracheostomy. Education programmes designed and supported by the National Tracheostomy Safety Project are effective, but resources are not available to educate the workforce at scale.

Exploring the barriers to cervical screening and perspectives on new self-sampling methods amongst under-served groups.

Background: Cervical screening rates have fallen in recent years in the UK, representing a health inequity for some under-served groups. Self-sampling alternatives to cervical screening may be useful where certain barriers prohibit access to routine cervical screening. However, there is limited evidence on whether self-sampling methods address known barriers to cervical screening and subsequently increase uptake amongst under-screened groups.

Optimizing Achilles Tendon Rupture Care: The Efficacy of Physiotherapy-Led Conservative Management in a District General Hospital.

Introduction Achilles tendon rupture (ATR) represents a significant musculoskeletal injury that can affect many patients' mobility and quality of life. Treatment of ATR consists of both conservative and surgical options, with the traditional belief being that surgical intervention reduces the risk of re-rupture. However, with the introduction of physiotherapy-led functional rehabilitation strategies with early mobilization, it has been shown that re-rupture rates are equal among surgical and non-surgical patients.

Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry.

Background And Aims: Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear.

Methods: Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD.

A survey of NHS nurses' delivery of treatments to prevent recurrence of venous leg ulcers.

Preventing recurrence of venous leg ulcers can be achieved through strongest tolerated compression and endo-venous ablation surgery, but it is not clear how often this is done in practice. This study explores (1) nurses' awareness of strongest tolerated compression and endo-venous ablation surgery as prophylactic treatments for venous leg ulcer, (2) how often these treatments are offered, and (3) assessment of the barriers and enablers to deploying those treatments using the capabilities, opportunities and motivations model of behaviour change. An online cross-sectional survey was conducted among nurses who treat and manage venous leg ulcers across the United Kingdom.

DNA-binding affinity and specificity determine the phenotypic diversity in BCL11B-related disorders.

BCL11B is a Cys2-His2 zinc-finger (C2H2-ZnF) domain-containing, DNA-binding, transcription factor with established roles in the development of various organs and tissues, primarily the immune and nervous systems. BCL11B germline variants have been associated with a variety of developmental syndromes. However, genotype-phenotype correlations along with pathophysiologic mechanisms of selected variants mostly remain elusive.

Age and biologic survival in patients with moderate-to-severe psoriasis: A cohort study from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR).

Background: The current management of psoriasis does not differentiate between young and old patients in selecting the safest and/or most effective biologic.

Objectives: To explore the effect of age at treatment initiation in response to biologics in patients with moderate-to-severe psoriasis in the UK and Eire.

Methods: Data from patients registering to the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) from 2007-2024 on first course of Tumour Necrosis Factor (TNF), interleukin (IL) 12/13, IL-17 and IL-23 inhibitors (i) with at least 6 months' follow-up were included.

Standardising lipid testing and reporting in the United Kingdom; a joint statement by HEART UK and The Association for Laboratory Medicine.

Atherosclerotic cardiovascular disease remains a major cause of premature death in the UK. Lipid testing is a key tool used to assess cardiovascular risk and guide clinical management decisions. There are currently no national guidelines to provide evidence-based recommendations on lipid testing and reporting for UK laboratories and clinicians.

Evaluating the diagnostic accuracy of fetal scalp blood sampling: A retrospective cohort study.

Introduction: Fetal scalp blood sampling (FSBS) can be used as an adjunctive test, in the presence of a pathological intrapartum fetal heart rate trace, to provide evidence of fetal acidaemia. The role of FSBS remains controversial, this study evaluates the diagnostic accuracy of FSBS at determining various adverse neonatal outcomes.

Method: A retrospective cohort analysis of FSBS undertaken < 1 h from birth in a single UK centre in 2016 and 2017.

Association of Anaesthetists guidelines: the use of blood components and their alternatives 2024.

Background: The administration of blood components and their alternatives can be lifesaving. Anaemia, bleeding and transfusion are all associated with poor peri-operative outcomes. Considerable changes in the approaches to optimal use of blood components and their alternatives, driven by the findings of large randomised controlled trials and improved haemovigilance, have become apparent over the past decade.

Focal Scleral Nodules: Retrospective Case Series and Novel Insight.

Purpose: The objective of this study was to add to the limited literature of Focal Scleral Nodule (FSN).

Methods: This study was a single-centre, retrospective, observational case series performed at Manchester Royal Eye Hospital (United Kingdom). Nineteen eyes from nineteen patients over a thirteen year period (January 2011 to January 2024) were included.

Impact of Timing Surgical Fixation on Complications and Functional Outcomes in Ankle Fractures.

Introduction: This study aimed to assess whether adherence to the British Orthopaedic Association Standards for Trauma (BOAST) and National Institute for Health and Care Excellence (NICE) guidelines for ankle fractures is associated with reduced complication rates and improved functional outcomes.  Methods: A retrospective analysis was conducted of all patients who underwent surgical fixation for ankle fractures in August 2023 to January 2024 from an acute hospital. Statistical analyses were performed using IBM SPSS Statistics software, version 29 (IBM Corp.

High-resolution whole-genome DNA methylation revealed unique signatures of painful diabetic neuropathy.

The aim of this work was to describe the DNA methylation signature and to identify genes associated with neuropathic pain in type 2 diabetes mellitus. We analyzed two independent diabetic neuropathy cohorts: PROPGER consisting of 72 painful and 67 painless patients recruited at the German Diabetes Center in Düsseldorf (DE), and PROPENG comprising 27 painful and 65 painless diabetic neuropathy patients recruited at the University of Manchester (UK). Genome-wide methylation data was generated using Illumina Infinium Methylation EPIC v1.

Musculoskeletal Computed Tomography: How to Add Value When Reporting Adult Lower Limb Trauma.

Computed tomography plays an ever-increasing role in the management of fractures and dislocations due to its capability in efficiently providing multiplanar reformats and 3-dimensional volume rendered images. It can reveal findings that are occult on plain radiography and therefore allow for more accurate decision making with regard to fracture classification and management. Clinical radiologists play a critical role in facilitating the processing of imaging to provide adequate image reformats in the desired planes, producing 3 dimensional images but most crucially identifying pertinent findings, which will contribute between the selection of nonoperative and operative management and potentially influence surgical technique.

Impact and cost-effectiveness of scaling up HCV testing and treatment strategies for achieving HCV elimination among people who inject drugs in England: a mathematical modelling study.

Background: England aims to reach the World Health Organization (WHO) elimination target of decreasing HCV incidence among people who inject drugs (PWID) to <2 per 100 person-years (/100pyrs) by 2030. We assessed what testing and treatment strategies will achieve this target and whether they are cost-effective.

Methods: A dynamic deterministic HCV transmission model among PWID was developed for four England regions, utilising data on the scale-up of HCV treatment among PWID in prisons, drug treatment centres (DTC, where opioid agonist therapy is provided), and any other setting (e.

Assessing the Utility of a National Conference on Non-surgical Facial Aesthetics as an Educational Tool: A Survey-based Pilot Study.

Objective: Non-surgical facial aesthetics (NSFA) is a rapidly growing field involving the use of dermal fillers and botulinum toxin for aesthetic enhancement. The aesthetic injectables market is expanding, attracting interest from individuals seeking NSFA procedures. There has also been marked interest among healthcare professionals (HCPs) aspiring to become aesthetic practitioners.

A multi-centre UK-based survey on angioedema secondary to acquired C1 inhibitor deficiency.

Background: Acquired angioedema due to C1-inhibitor deficiency (AAE-C1-INH) is very rare compared to its prototype, hereditary angioedema. An updated characterisation of the AAE-C1-INH cohort in UK is required to inform management.

Objectives: To describe the disease burden of AAE-C1-INH, long-term prophylaxis (LTP) and the clinical, immunochemical and treatment profiles of AAE-associated diseases in UK.

Social media-based Health Education plus Exercise Program (SHEEP) to improve muscle function among young-old adults with possible sarcopenia in the community: A feasibility study protocol.

Background: Despite the comparatively high prevalence of possible sarcopenia among young-old adults in the community, there is currently no available and effective social media-based intervention to increase the awareness and change the behavior of the target population to prevent sarcopenia. Using co-design methodology, we developed a multicomponent intervention strategy of health education and exercise for sarcopenia prevention utilizing the TikTok platform.

Objectives: The primary purpose of this study is to examine the feasibility and acceptability of the social media-based intervention to enhance muscle function in community-dwelling young-old adults with possible sarcopenia.

Emerging Antifungal Resistance in : Insights from Susceptibility Profiling and Genetic Mutation Analysis.

species, the leading cause of dermatophytosis globally, are increasingly resistant to antifungal treatments, concerns about effective management strategies. In light of the absence of established resistance criteria for terbinafine and azoles, coupled with a dearth of research on resistance mechanisms in , antifungal susceptibility and drug resistance gene diversity were analyzed across 64 , 65 , and 2  isolates collected in China between 2001 and 2024 and 101 published strains. Analyses of the minimum inhibitory concentrations (MICs) of terbinafine, itraconazole, voriconazole, posaconazole, and isavuconazole revealed a concerning increase in with terbinafine resistance, including two novel isolates from China.

Paracrine role of endothelial IGF-1 receptor in depot-specific adipose tissue adaptation in male mice.

During recent decades, changes in lifestyle have led to widespread nutritional obesity and its related complications. Remodelling adipose tissue as a therapeutic goal for obesity and its complications has attracted much attention and continues to be actively explored. The endothelium lines all blood vessels and is close to all cells, including adipocytes.