Large language models as a diagnostic support tool in neuropathology.

The WHO guidelines for classifying central nervous system (CNS) tumours are changing considerably with each release. The classification of CNS tumours is uniquely complex among most other solid tumours as it incorporates not just morphology, but also genetic and epigenetic features. Keeping current with these changes across medical fields can be challenging, even for clinical specialists.

Assessing Patient Understanding and Satisfaction in Orthopedic Trauma and Elective Surgery Admissions.

Background When seeking healthcare, patients often struggle to understand the information provided by healthcare professionals regarding their condition and treatment plan. Additionally, patient satisfaction with their experience can vary widely. Improved patient understanding and satisfaction are linked to better outcomes.

Lipid Priming of Adipose Mesenchymal Stromal Cells with Docosahexaenoic Acid: Impact on Cell Differentiation, Senescence and the Secretome Neuroregulatory Profile.

Background: Priming strategies that improve the functionality of MSCs may be required to address issues limiting successful clinical translation of MSC therapies. For conditions requiring high trophic support such as brain and spinal cord injuries, priming MSCs to produce higher levels of trophic factors may be instrumental to facilitate translation of current MSC therapies. We developed and tested a novel molecular priming paradigm using docosahexaenoic acid (DHA) to prime adipose tissue-derived mesenchymal stromal cells (ASCs) to enhance the secretome neuroregulatory potential.

Large-Scale Pharmacogenomics Analysis of Patients With Cancer Within the 100,000 Genomes Project Combining Whole-Genome Sequencing and Medical Records to Inform Clinical Practice.

Purpose: As part of the 100,000 Genomes Project, we set out to assess the potential viability and clinical impact of reporting genetic variants associated with drug-induced toxicity for patients with cancer recruited for whole-genome sequencing (WGS) as part of a genomic medicine service.

Methods: Germline WGS from 76,805 participants was analyzed for pharmacogenetic (PGx) variants in four genes (, , , ) associated with toxicity induced by five drugs used in cancer treatment (capecitabine, fluorouracil, mercaptopurine, thioguanine, irinotecan). Linking genomic data with prescribing and hospital incidence records, a phenome-wide association study (PheWAS) was performed to identify whether phenotypes indicative of adverse drug reactions (ADRs) were enriched in drug-exposed individuals with the relevant PGx variants.

Contemporary epidemiology of hospitalised heart failure with reduced versus preserved ejection fraction in England: a retrospective, cohort study of whole-population electronic health records.

Background: Heart failure is common, complex, and often associated with coexisting chronic medical conditions and a high mortality. We aimed to assess the epidemiology of people admitted to hospital with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), including the period covering the COVID-19 pandemic, which was previously not well characterised.

Methods: In this retrospective, cohort study, we used whole-population electronic health records with 57 million individuals in England to identify patients hospitalised with heart failure as the primary diagnosis in any consultant episode of an in-patient admission to a National Health Service (NHS) hospital.

The Use of Virtual Patients to Provide Feedback on Clinical Reasoning: A Systematic Review.

Purpose: Virtual patients (VPs) are increasingly used in health care professions education to support clinical reasoning (CR) development. However, the extent to which feedback is given across CR components is unknown, and guidance is lacking on how VPs can optimize CR development. This systematic review sought to identify how VPs provide feedback on CR.

E-Professionalism's Impact on Dental Professionalism: A Rapid Scoping Review.

Background: Dental regulators and educational institutions are increasingly concerned about the influence of digital platforms used by the profession for social, business, digital interaction with the public/patients and its impact on the professionalism in practice now and going forward. However, academic knowledge and research within dentistry are relevant to e-professionalism at a level of engagement and approach in delivering guidance to students through the current dental curriculum. The question therefore asked was what breadth of academic material, research, debate and discourse is available to inform our understanding, guidance and teaching on this ever-evolving topic.

Disease Burden and Access to Biologic Therapy in Patients with Severe Asthma, 2017-2022: An Analysis of the International Severe Asthma Registry.

Introduction: Patients with severe asthma may be prescribed biologic therapies to improve disease control. The EVEREST study aimed to characterize the global disease burden of patients with severe asthma without access to biologics and those who have access but do not receive biologics, as well as the remaining unmet need despite use of these therapies.

Methods: This was a historical cohort study of patients with severe asthma (aged ≥18 years) in the International Severe Asthma Registry receiving Global Initiative for Asthma (GINA) 2018 step 5 treatment, or with uncontrolled disease at GINA step 4.

Role of dietary potassium and salt substitution in the prevention and management of hypertension.

Cardiovascular diseases (CVD) continue to be the leading cause of deaths and disability worldwide and the major contributor is hypertension. Despite all the improvements in detecting hypertension together with technological advances and affordable, efficacious and relatively free of adverse effects anti-hypertensive agents, we continue to struggle to prevent the onset of hypertension and to control blood pressure (BP) to acceptable targets. The poor control of hypertension is commonly due to non-adherence to medications.

A novel training session: mixed reality evisceration surgery webinar.

Background: Evisceration surgery is an important part of an ophthalmologist's skillset but is an uncommon procedure. Therefore, it is important for training ophthalmologists to have adequate knowledge and confidence in this procedure to maximise learning opportunities. Mixed reality involves the intertwining of real and virtual environments and has been used successfully in surgical training.

Antibiotic Resistance in the Elderly: Mechanisms, Risk Factors, and Solutions.

Antibiotic resistance presents a critical challenge in healthcare, particularly among the elderly, where multidrug-resistant organisms (MDROs) contribute to increased morbidity, mortality, and healthcare costs. This review focuses on the mechanisms underlying resistance in key bacterial pathogens and highlights how aging-related factors like immunosenescence, frailty, and multimorbidity increase the burden of infections from MDROs in this population. Novel strategies to mitigate resistance include the development of next-generation antibiotics like teixobactin and cefiderocol, innovative therapies such as bacteriophage therapy and antivirulence treatments, and the implementation of antimicrobial stewardship programs to optimize antibiotic use.

Manipulation of signaling pathways in bone tissue engineering and regenerative medicine: Current knowledge, novel strategies, and future directions.

During osteogenesis, a large number of bioactive molecules, macromolecules, cells, and cellular signals are activated to induce bone growth and development. The activation of molecular pathways leads to the occurrence of cellular events, ultimately resulting in observable changes. Therefore, in the studies of bone tissue engineering and regenerative medicine, it is essential to target fundamental events to exploit the mechanisms involved in osteogenesis.

Impact of Multidirectional Pacing on Activation and Repolarization Parameters to Localize Ischemic Ventricular Tachycardia Circuits.

Background: In ventricular tachycardia (VT), optimal substrate mapping strategies identifying arrhythmogenic sites are not established.

Objectives: This study sought to evaluate multidirectional pacing on the distribution of specific conduction and repolarization metrics to localize re-entrant VT sites in a porcine infarct model.

Methods: Substrate maps were created in 13 pigs with chronic myocardial infarction using the Advisor HD Grid (Abbott) during right ventricular (RV), left ventricular, biventricular pacing (BIV), and sinus rhythm (SR).

Addressing abdominal trauma from conflict and warfare in under-resourced regions: A critical narrative review.

Introduction: The prevalence of abdominal injuries in war and conflict zones, particularly in low- and middle-income countries (LMICs), presents a significant healthcare challenge. These injuries, often resulting from explosive devices, firearms, and shrapnel, lead to high morbidity and mortality rates due to delayed diagnoses, inadequate medical infrastructure, and limited access to specialised care. This review aims to summarise the literature on conflict-related abdominal injuries in LMICs, highlighting the impact of such trauma on healthcare systems and patient outcomes, and suggesting strategies for improvement.

An evaluation by dental clinicians of cutting characteristics and haptic perceptions in 3D-printed typodont teeth: A pilot study.

Objectives: This study aimed to compare the haptic perception of clinicians to the cutting response of 3D-printed typodont teeth and commercial typodont teeth and human extracted teeth.

Methods: Twenty clinicians were asked to perform a Class I cavity preparation on commercial typodont teeth, 3D-printed typodont teeth, and human extracted teeth, while the forces were recorded via a three-axis load cell. The haptic perception of clinicians was also evaluated through a response questionnaire comparing commercial and 3D-printed typodont teeth.

HBV Biomarkers and Their Role in Guiding Treatment Decisions.

Over 300 million individuals worldwide are chronically infected with hepatitis B virus and at risk for progressive liver disease. Due to the lack of a therapy that reliably achieves viral elimination and the variability of liver disease progression, treatment decisions are guided by the degree of liver disease and viral biomarkers as the viral life-cycle is well characterized and largely conserved between individuals. In contrast, the immunological landscape is much more heterogeneous and diverse and the measurement of its components is less well standardized.

Combined MRI, high-resolution manometry and a randomised trial of bisacodyl versus hyoscine show the significance of an enlarged colon in constipation: the RECLAIM study.

Background: Colonic motility in constipation can be assessed non-invasively using MRI.

Objective: To compare MRI with high-resolution colonic manometry (HRCM) for predicting treatment response.

Design: Part 1: 44 healthy volunteers (HVs), 43 patients with irritable bowel syndrome with constipation (IBS-C) and 37 with functional constipation (FC) completed stool diaries and questionnaires and underwent oral macrogol (500-1000 mL) challenge.