Avoiding never events in orthopaedics theatres: a quality improvement project.

Never events in the operating room are a surgeon's nightmare, with an incidence rate of 54%. These events are highly stressful for theatre staff and significantly compromise patient safety. The aim of this project is to avoid never events in trauma and orthopaedic theatres by ensuring that theatre staff adhere to the surgical pause and imaging pause protocols through regular audits.

Long-Term Improvements in Glycemia and User-Reported Outcomes Associated with Open-Source Automated Insulin Delivery Systems in Adults with Type 1 Diabetes in the United Kingdom: A Real-World Observational Study.

To evaluate real-world outcomes in adults with type 1 diabetes initiating open-source automated insulin delivery systems (OS-AID). Adults with type 1 diabetes who commenced OS-AID, between May 2016 and April 2021, across 12 centers in the United Kingdom were included. Anonymized clinical data, collected during routine clinical care between December 2019 and November 2023, were submitted to a secure web-based tool within the National Health Service network.

Imaging tests as predictors of progression to rheumatoid arthritis in clinically suspect arthralgia: A systematic review & meta-analysis.

Objectives: To determine and compare the diagnostic accuracy of imaging tests for the prediction of RA progression in people with inflammatory joint pain or CSA.

Methods: We searched MEDLINE, Embase and Web of Science from 1987 to March 2024. Studies evaluating any imaging tests in participants with inflammatory joint pain or CSA, without clinical synovitis were eligible.

Cystic fibrosis in Pakistan: population harbouring rare variants non-responsive to CFTR modulators and the dilemma of poor health facilities.

Background: Pathogenic mutations in the CFTR gene disrupt the normal function of the chloride ion channel CFTR protein, resulting in Cystic Fibrosis (C.F.).

Acute management of massive pulmonary embolism in pregnancy.

Key Content: •Massive pulmonary embolism (PE) during pregnancy or the postpartum period is a rare but potentially lethal event.•Physiological changes in the coagulation system during pregnancy and puerperium would lead to a hypercoagulable state.•Diagnosis of PE in pregnancy remains a challenge due to physiological changes in pregnancy.

EXamining the feasibility of exerCisE to manage symptoms of Lupus (EXCEL): a protocol for a randomised controlled pilot study.

Introduction: SLE is a chronic autoimmune disease that results in sustained hyperactivation of innate and adaptive immune cells and widespread inflammatory damage. Regular exercise reduces SLE symptoms including fatigue and joint pain and improves patient quality of life. However, most individuals with SLE are not sufficiently active to achieve these benefits, and guidance on the optimal approach to exercise is limited.

Laser hair depilation therapy for pilonidal sinus disease: A 5-year, retrospective experience in a University Teaching Hospital in the UK, 2017-2023.

Background: Pilonidal sinus disease (PSD) is a chronic debilitating condition predominantly affecting young men. Laser hair depilation is an established adjunct to surgical treatment for PSD and can lead to reduced rates of recurrence, and post-surgical interventions.This study aimed to assess the outcome of laser hair depilation therapy on disease progression in pilonidal sinus disease patients at the Birmingham Skin Regional Laser Centre.

Ethnicity-specific patterns of epigenetic age acceleration in rheumatoid arthritis.

Rheumatoid arthritis (RA) is an age-related chronic inflammatory disease which may include accelerated biological ageing processes in its pathogenesis. To determine if increased biological age is associated with risk of RA and/or is present once disease is established. We used DNA methylation to compare biological age (epigenetic age) of immune cells in adults at risk of RA and those with confirmed RA, including twins discordant for RA.

British Society of Gastroenterology National Evaluation of Colonoscopy Quality: Findings from the National Endoscopy Database.

Background And Aims: Analysis of national colonoscopy quality using automatically uploaded data from a national database, including exploring performance variation.

Methods: Data on all colonoscopies performed in the UK 01/03/2019-29/02/2020 and recorded in the National Endoscopy Database were analysed. Unadjusted key performance indicators were calculated and proportions of endoscopists achieving national standards were determined.

Identifying the Black Country's Top Mental Health Research Priorities Using a Collaborative Workshop Approach: Community Connexions.

The Black Country (BC) is an area of the United Kingdom covering Dudley, Sandwell, Walsall, and Wolverhampton. The area is ethnically, culturally and religiously diverse. One-fifth of the total population is in the lowest socioeconomic quintile, with an uneven distribution of wealth.

Maternal and neonatal outcomes following resuscitative hysterotomy for out of hospital cardiac arrest: A systematic review.

Objective: To examine maternal and neonatal outcomes following Resuscitative Hysterotomy for out of hospital cardiac arrest (OHCA) and to compare with timing from cardiac arrest to delivery.

Methods: The review was registered with PROSPERO (CRD42023445064). Studies included pregnant women with out of hospital cardiac arrest and resuscitative hysterotomy performed (in any setting) during cardiac arrest.

Evaluating the Impact of a Virtual Skin Cancer Awareness Workshop for 16-19-Year-Olds.

Introduction  The incidence of malignant melanoma (MM) in the United Kingdom (UK) has significantly increased in recent years and is expected to continue to rise over the next decade. Despite the preventable nature of most MM cases, existing evidence suggests that public health education around skin cancer and sun safety is often suboptimal, particularly for secondary school populations. Unlike primary school curricula, there is no national guidance to mandate the teaching of this topic in secondary school.

Surgical Versus Conservative Management of Delayed Presentation of Acute Biliary Disease: A Systematic Literature Review.

Biliary sepsis, characterized by contamination and infection of the biliary tract, poses a serious medical issue with detrimental effects on the patients. While cholecystectomy is the usual treatment for symptomatic gallstones, the most desirable management approach for biliary sepsis remains debated, prompting a scientific evaluation of the long-term effects of cholecystectomy. To compare the long-term outcomes of biliary sepsis in patients undergoing cholecystectomy versus conservative management (CM), this study will systematically review the existing literature to clarify differences in recurrence rates, complication rates, and overall survival.

Significant variation in the assessment and management of screen-detected colorectal polyp cancers.

Purpose: Endoscopic resection is appropriate for selected colorectal polyp cancers, but significant variation exists in treatment. This study aims to investigate variation in management of screen-detected polyp cancers (T1), factors predicting primary endoscopic polypectomy and threshold for subsequent surgical resection.

Method: Patients with polyp cancers (T1) diagnosed by the bowel cancer screening programme (BCSP) were investigated at two screening centres (5 individual sites and 4 MDTs, 2012-2022).

Understanding Medical Students' Perceptions of Failure in Medical School.

This paper explores medical students' perceptions of failure through a qualitative approach, using semi-structured interviews to gather insights from six students across different academic years at Queen Mary University of London. The study aims to understand how students define failure, its causes, and its impact on their academic and personal lives. Key findings reveal that failure is perceived as multifaceted, influenced by internal and external expectations, and evolves throughout medical school.

Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review.

Aim: Diabetic Charcot neuro-osteoarthropathy carries a significant worldwide disease burden including diabetic foot infection, ulceration and amputation. The current accepted standard of treatment during the active phase of Charcot neuro-osteoarthropathy is offloading with total contact casting; however, controversy remains regarding weight-bearing status during this period.

Methods: A systematic review was performed following PRISMA guidelines of Pubmed, EMBASE, MEDLINE and the Cochrane central register of controlled trials for clinical studies from inception until June 2024 investigating weight-bearing and non-weight-bearing total contact casting for active Charcot neuro-osteoarthropathy.

Comparative Efficacy and Safety of Endoscopic Modalities for Colorectal Cancer Screening in Inflammatory Bowel Disease: A Systematic Review and Network Meta-analysis.

Background & Aims: Long-standing inflammatory bowel disease (IBD) increases the risk of colonic neoplasia, necessitating effective screening strategies. This network meta-analysis compared the efficacy and safety between different endoscopic modalities in the high-definition (HD) era.

Methods: We searched CENTRAL, ClinicalTrials.

Abyssal marine tectonics from the SWOT mission.

The global ocean covers 71% of Earth's surface, yet the seafloor is poorly charted compared with land, the Moon, Mars, and Venus. Traditional ocean mapping uses ship-based soundings and nadir satellite radar altimetry-one limited in spatial coverage and the other in spatial resolution. The joint NASA-CNES (Centre National d'Etudes Spatiales) Surface Water and Ocean Topography (SWOT) mission uses phase-coherent, wide-swath radar altimetry to measure ocean surface heights at high precision.

Development and Implementation of an Evidence-Based Electronic Request Bundle for Metabolic Screening in Patients With Urinary Tract Calculi.

Introduction Kidney stone disease is a global health issue, with a well-known high recurrence rate after a first stone episode. Metabolic screening is a cost-effective tool for identifying patients at risk of recurrence due to a secondary disease. Our study aimed to assess compliance in a District General Hospital (DGH) and lay out a framework for the implementation of an electronic request bundle to improve screening levels in line with National Institute for Health and Care Excellence (NICE) guidelines.

Cutaneous vasculitis in systemic lupus erythematosus: epidemiology and risk factors over a 20-year follow-up.

Objectives: Cutaneous vasculitis (CV) is common in SLE, but the epidemiology and risk factors remain unclear. We aimed to identify the trends and risk factors for CV in patients with SLE over a period of 20 years.

Methods: The Birmingham Lupus Cohort is an observational longitudinal cohort of SLE patients.