Foreword.

Vascular Nurse Consultant, Mid Yorkshire Hospitals NHS Trust and University of Huddersfield.

Introducing a new approach to debridement and wound bed preparation.

Debridement of devitalised tissue and wound biofilm is vital to promote healing. This article introduces an innovative debridement product, ChloraSolv Wound Debridement Gel, which is as effective as a blade but also selective, atraumatic and fast-acting and does not require specialist training. Its ease of use makes it suitable for all settings and staff.

Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study.

Objective: To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection.

Methods: Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant.

A Large Cluster of New Onset Autoimmune Myositis in the Yorkshire Region Following SARS-CoV-2 Vaccination.

Background: The novel SARS-CoV-2 vaccines partially exploit intrinsic DNA or RNA adjuvanticity, with dysregulation in the metabolism of both these nucleic acids independently linked to triggering experimental autoimmune diseases, including lupus and myositis.

Methods: Herein, we present 15 new onset autoimmune myositis temporally associated with SARS-CoV-2 RNA or DNA-based vaccines that occurred between February 2021 and April 2022. Musculoskeletal, pulmonary, cutaneous and cardiac manifestations, laboratory and imaging data were collected.

The Learning Curve of Third-Generation Percutaneous Chevron and Akin Osteotomy (PECA) for Hallux Valgus.

The learning curve to reach technical proficiency for third-generation percutaneous or minimally invasive chevron and Akin osteotomies (PECA/MICA) is recognized to be steep however it is poorly defined in the literature. This study is a retrospective review of the first 58 consecutive PECA cases of a single surgeon. The primary outcome was the number of cases required to reach technical proficiency as defined by the operation time.

Association of genetic variants with patient reported quality of life and pain experience in patients in the UK NCRI Myeloma X Relapse [Intensive]) trial; an exploratory study.

The Myeloma X trial provided a platform to explore genetics in relation to systematic assessment of patient-reported outcomes at key points during salvage treatment in multiple myeloma (MM) patients. Blood DNA was obtained in 191 subjects for single nucleotide polymorphism (SNP) genotyping. By univariable analysis, the non-coding rs2562456 SNP, upstream of LINC00664, was associated with several relevant pain and health-related quality-of-life (HRQoL) scores at 100 days after allocation to consolidation with autologous stem cell transplantation or weekly cyclophosphamide.

Uncovering the burden of hidden ciliopathies in the 100 000 Genomes Project: a reverse phenotyping approach.

Background: The 100 000 Genomes Project (100K) recruited National Health Service patients with eligible rare diseases and cancer between 2016 and 2018. PanelApp virtual gene panels were applied to whole genome sequencing data according to Human Phenotyping Ontology (HPO) terms entered by recruiting clinicians to guide focused analysis.

Methods: We developed a reverse phenotyping strategy to identify 100K participants with pathogenic variants in nine prioritised disease genes (), representative of the full phenotypic spectrum of multisystemic primary ciliopathies.

The natural history of low-risk non-muscle-invasive bladder cancer: a collaborative multi-centre study.

Background: International guidelines vary in terms of their definition and recommendation for management of low-risk non-muscle-invasive bladder cancer (LRNMIBC). The ideal management for this large subset of bladder cancer patient remains unclear.

Objective: To evaluate long-term outcomes of patients with LRNMIBC.

Valgus Second Toe Deformity Treated With a Percutaneous Extracapsular Closing-Wedge Osteotomy of the Proximal Phalanx.

Background: Coronal and sagittal plane deformities of the lesser toes are common yet challenging to treat. Traditional open releases and translational Weil osteotomies can be unpredictable and lead to postoperative stiffness. We present the results of a percutaneous closing wedge extracapsular osteotomy of the proximal phalanx to treat valgus deformity of the second toe.

Factors Influencing COVID-19 Vaccine Uptake among Nepali People in the UK: A Qualitative Study.

Vaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the United Kingdom (UK). This qualitative study included in-depth interviews with 20 people from Nepal living in the UK.

Exploring the Perceptions Surrounding Hospital Chaplains in Patient Care and Healing.

The authors distributed a questionnaire to various hospital staff to explore perceptions surrounding the role of chaplains in patient care and healing through assessing opinions, beliefs, and knowledge. Results revealed a poor understanding of the role of the hospital chaplain in the UK. The authors therefore advocate education programs to increase awareness of the varied role of the hospital chaplain in fulfilling patient spiritual needs to increase referral practices, leading to improved patient outcomes.

A Longitudinal Evaluation of Computed Tomography Radiation Incidents Within a Multisite NHS Trust.

Objectives: This single-center review explores trends in computed tomography "radiation incidents" and suggests strategies for improvement.

Method: A retrospective mixed-methods approach was used in this longitudinal evaluation of radiation incidents within a multisite NHS Trust in northern England. DATIX was interrogated at the Trust level to identify all records linked to radiation incident in computed tomography departments between January 1, 2015, and December 31, 2018.

Patient expectations of cosmetic appearance after complex facial surgery in a low-income country.

Managing aesthetic expectations for patients post facial operations can be challenging in the high-income countries, yet alone in low-income countries. This cohort study involved patients undergoing facial operations during the October 2018 Facing Africa charitable surgical trip at the Nordic Medical Centre in Addis Ababa, Ethiopia. Twenty-one patients were shown pre and postoperative photographs of patients who had operations for similar facial pathologies on a prior surgical mission.

Histamine-2 (H ) antagonists can be safely removed from standard paclitaxel premedication regimens.

Aims: The aim of this study is to investigate the rates of hypersensitivity reactions (HSRs) in patients receiving paclitaxel chemotherapy, with and without a histamine-2 (H ) antagonists.

Method: This prospective, multi-centre, cohort study compared patients receiving paclitaxel treated with premedication regimens containing chlorphenamine, dexamethasone and an H antagonist vs patients treated without an H antagonist. Rates of HSRs were described and logistic multivariable regression was used to investigate any associations with H antagonist treatment, adjusting for confounding variables.

Embedding Wound Hygiene into a proactive wound healing strategy.

Since a panel published the first consensus document on Wound Hygiene in March 2020, there has been a flurry of activity in support of this newly established concept in proactive wound healing. The document concluded that all wounds, particularly hard-to-heal ones, will benefit from Wound Hygiene, which should be initiated at the first referral, following a full holistic assessment to identify the wound aetiology and comorbidities, and then implemented at every dressing change until full healing occurs. The consensus has since been bolstered by educational webinars; competency-based skills training and support; development of international Wound Hygiene ambassadors; a survey of 1478 respondents, published in July 2021; and a case study supplement, published in January 2022, featuring a range of wound types, anatomies and underlying conditions on the improvements in wound-healing progress that can be achieved.

Markers of tumor inflammation as prognostic factors for overall survival in patients with advanced pancreatic cancer receiving first-line FOLFIRINOX chemotherapy.

Background: Identifying pretreatment blood markers that distinguish prognostic groups of patients with advanced pancreatic ductal adenocarcinoma (PDAC) under first-line FOLFIRINOX chemotherapy has the potential to improve management of this condition. Aim of this study was to determine the prognostic utility of a range of pretreatment, inflammation-related, blood cell markers in this group of patients.

Material And Methods: Data from a training cohort were analyzed to identify potential pretreatment blood markers correlating to survival outcomes.

The British Orthopaedic Surgery Surveillance study: slipped capital femoral epiphysis: the epidemiology and two-year outcomes from a prospective cohort in Great Britain.

Aims: The aim of this study was to inform the epidemiology and treatment of slipped capital femoral epiphysis (SCFE).

Methods: This was an anonymized comprehensive cohort study, with a nested consented cohort, following the the Idea, Development, Exploration, Assessment, Long-term study (IDEAL) framework. A total of 143 of 144 hospitals treating SCFE in Great Britain participated over an 18-month period.

The British Orthopaedic Surgery Surveillance study: Perthes' disease: the epidemiology and two-year outcomes from a prospective cohort in Great Britain.

Aims: The aim of this study was to evaluate the epidemiology and treatment of Perthes' disease of the hip.

Methods: This was an anonymized comprehensive cohort study of Perthes' disease, with a nested consented cohort. A total of 143 of 144 hospitals treating children's hip disease in the UK participated over an 18-month period.