IPEM topical report: guidance on 3D printing in radiotherapy.

There has been an increase in the availability and utilization of commercially available 3D printers in radiotherapy, with applications in phantoms, brachytherapy applicators, bolus, compensators, and immobilization devices. Additive manufacturing in the form of 3D printing has the advantage of rapid production of personalized patient specific prints or customized phantoms within a short timeframe. One of the barriers to uptake has been the lack of guidance.

Patient-oriented unsupervised learning to uncover the patterns of multimorbidity associated with stroke using primary care electronic health records.

Background: We aimed to identify and characterise the longitudinal patterns of multimorbidity associated with stroke.

Methods: We used an unsupervised patient-oriented clustering approach to analyse primary care electronic health records (EHR) of 30 common long-term conditions (LTC) in patients with stroke aged over 18, registered in 41 general practices in south London between 2005 and 2021.

Results: Of 849,968 registered patients, 9,847 (1.

Machine Learning Algorithms to Predict the Risk of Rupture of Intracranial Aneurysms: a Systematic Review.

Purpose: Subarachnoid haemorrhage is a potentially fatal consequence of intracranial aneurysm rupture, however, it is difficult to predict if aneurysms will rupture. Prophylactic treatment of an intracranial aneurysm also involves risk, hence identifying rupture-prone aneurysms is of substantial clinical importance. This systematic review aims to evaluate the performance of machine learning algorithms for predicting intracranial aneurysm rupture risk.

Access to psychological therapies amongst patients with a mental health diagnosis in primary care: a data linkage study.

Purpose: Significant numbers of people in England have fallen into a gap between primary care psychological therapies and specialist mental health services. We aim to examine pathways to care by looking at demographic variation in detection and referral to primary and secondary psychological services in south London.

Methods: Longitudinal descriptive study using a record linkage between a primary care database (Lambeth DataNet) and a secondary care mental health database (CRIS).

RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth.

Background: Perinatal anxiety is common: up to 40% of pregnant women and new mothers experience high levels of anxiety. Given its prevalence, interventions that are low-intensity, highly accessible and cost-efficient, and target modifiable risk factors for anxiety are needed. Repetitive negative thinking (RNT)-such as worrying about ways things will go wrong in the future or ruminating about past negative events-is a risk factor for the development of anxiety.

A survey of digital access, digital confidence and rehabilitation delivery preferences of patients referred for CR.

Remote delivery of cardiovascular rehabilitation (CR) has been vital during the COVID pandemic when restrictions have been placed on face-to- face services. In the future, CR services are likely to offer alternatives to centre- based CR, including digital options. However, little is known about the digital access and confidence of CR service users, or their CR delivery preferences.

Acute and Chronic Ilio-Femoral Venous Reconstruction.

Ilio-femoral venous reconstruction has progressed from being only performed by a limited number of pioneers (often using equipment repurposed from other areas of interventional radiology) to a discrete subspecialty of endovascular practice with a dedicated range of tools and increasingly evolved techniques to secure optimal results. This review is intended to reflect the modern practice of ilio-femoral stenting in the acute and chronic settings, from initial patient assessment to completion of procedure and follow-up care.

The effects of field strength on stimulated echo and motion-compensated spin-echo diffusion tensor cardiovascular magnetic resonance sequences.

Background: In-vivo diffusion tensor cardiovascular magnetic resonance (DT-CMR) is an emerging technique for microstructural tissue characterization in the myocardium. Most studies are performed at 3T, where higher signal-to-noise ratio (SNR) should benefit this signal-starved method. However, a few studies have suggested that DT-CMR is possible at 1.

Why do children under 5 years go to the GP in Lambeth: a cross-sectional study.

Objectives: This study identifies the most common recorded reason for attendance to primary care for children under 5 years old, including a breakdown via age, ethnicity, deprivation quintile and sex.

Design: Cross-sectional.

Setting: 39 of 40 general practices in Lambeth, London, UK.

How can patient experience of abortion care be improved? Evidence from the SACHA study.

Background: Models of abortion care have changed significantly in the last decade, most markedly during the COVID-19 pandemic, when home management of early medical abortion with telemedical support was approved in Britain.

Objective: Our study aimed to examine women's satisfaction with abortion care and their suggestions for improvements.

Design: Qualitative, in-depth, semi-structured interviews.

Cost-effectiveness of the children and young People's health partnership (CYPHP) model of integrated care versus enhanced usual care: analysis of a pragmatic cluster randomised controlled trial in South London.

Background: Integration of paediatric health services across primary and secondary care holds great promise for the management of chronic conditions, yet limited evidence exists on its cost-effectiveness. This paper reports the results of the economic evaluation of the Children and Young People's Health Partnership (CYPHP) aimed at integrating care for children with common chronic conditions (asthma, eczema, and constipation).

Methods: Cost-effectiveness, cost-utility and cost-benefit analyses were conducted alongside a pragmatic cluster randomised controlled trial involving 97,970 children in 70 general practices in South London, including 1,731 participants with asthma, eczema and or constipation with self-reported health-related quality of life measures.

Evaluation of deep learning estimation of whole heart anatomy from automated cardiovascular magnetic resonance short- and long-axis analyses in UK Biobank.

Aims: Standard methods of heart chamber volume estimation in cardiovascular magnetic resonance (CMR) typically utilize simple geometric formulae based on a limited number of slices. We aimed to evaluate whether an automated deep learning neural network prediction of 3D anatomy of all four chambers would show stronger associations with cardiovascular risk factors and disease than standard volume estimation methods in the UK Biobank.

Methods And Results: A deep learning network was adapted to predict 3D segmentations of left and right ventricles (LV, RV) and atria (LA, RA) at ∼1 mm isotropic resolution from CMR short- and long-axis 2D segmentations obtained from a fully automated machine learning pipeline in 4723 individuals with cardiovascular disease (CVD) and 5733 without in the UK Biobank.

A systematic review on the effects of non-pharmacological interventions for fatigue among people with upper and/or lower limb osteoarthritis.

Objectives: To identify non-pharmacological fatigue interventions and determine the effectiveness of these non-pharmacological interventions in reducing fatigue immediately and over time in OA.

Methods: A review protocol (CRD42020163730) was developed and registered with the PROSPERO database. Included studies comprised peer-reviewed randomized controlled trials (RCTs) that examined the effects of conservative interventions on fatigue in people with upper and lower limb OA.

Ethnicity differences in geometric remodelling and myocardial composition in hypertension unveiled by cardiovascular magnetic resonance.

Aims: Hypertensive patients of African ancestry (Afr-a) have higher incidences of heart failure and worse clinical outcomes than hypertensive patients of European ancestry (Eu-a), yet the underlying mechanisms remain misunderstood. This study investigated right (RV) and left (LV) ventricular remodelling alongside myocardial tissue derangements between Afr-a and Eu-a hypertensives.

Methods And Results: 63 Afr-a and 47 Eu-a hypertensives underwent multi-parametric cardiovascular magnetic resonance.

Evaluating the dynamics of hospital COVID-19 contacts and subsequent conversion to SARS-CoV-2 infection: a multi-centre retrospective cohort study.

We investigated the dynamics of COVID-19 contacts subsequent conversion to SARS-CoV-2 infection in an inpatient setting across three National Health Service (NHS) Trusts. 9.2% (476/5,156) COVID-19 contacts met inclusion criteria, were typable and tested positive for COVID-19.

Vitamin D metabolism in critically ill patients with acute kidney injury: a prospective observational study.

Background: Vitamin D deficiency in critically ill patients is associated with poor outcomes, and vitamin D supplementation is recommended for patients with chronic kidney disease. Whether acute kidney injury (AKI) is associated with altered Vitamin D metabolism is unknown. We aimed to compare the longitudinal profiles of serum 25(OH)D and 1,25(OH)D concentrations in critically ill patients with and without moderate to severe AKI and explore the impact of renal recovery and parathyroid hormone (PTH).

Rates of venous thromboembolism associated with acute psychiatric admission: A retrospective cohort study.

The present study aimed to identify rates of venous thromboembolism (VTE) amongst patients treated in inpatient mental health units using linked primary care and mental health care records. Patients resident in the London Borough of Lambeth admitted to mental health units in Southeast London between January 2008 and March 2019 were included, as well as a control group of patients being treated in the community for mental illness. The primary outcome measure was a diagnosis of VTE being recorded in GP records during or within 3 months of an admission to a mental health unit.