Complex high-risk indicated PCI (CHIP-PCI): is it safe to let fellows-in-training perform it as primary operators?

Background: Training in complex high-risk indicated percutaneous coronary intervention (CHIP-PCI) has frequently been reserved for established operators (consultants/attending) with trainees (fellows-in-training or FIT) being often discouraged from carrying out such procedures as a primary operator due to their high-risk nature. Whether the outcomes of these cases differ if the primary operator is a supervised FIT compared with a consultant is unknown.

Methods: Using multicentre PCI data from three cardiac centres in South Wales, UK (2018-2022), we identified 2295 CHIP-PCI cases with a UK-BCIS CHIP Score of 3 or more.

Safety and efficacy of filgotinib in patients with rheumatoid arthritis: final results of the DARWIN 3 long-term extension study.

Objectives: DARWIN 3 (ClinicalTrials.gov: NCT02065700) assessed the safety and efficacy of filgotinib in a long-term extension (LTE) of two phase II randomised controlled rheumatoid arthritis (RA) trials.

Methods: Eligible patients completing the 24-week DARWIN 1 (filgotinib plus methotrexate) and DARWIN 2 (filgotinib monotherapy) trials could enrol.

Systematic literature review on Calcium Pyrophosphate Deposition (CPPD) nomenclature: condition elements and clinical states- A Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus project.

Objectives: The Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) has developed a calcium pyrophosphate deposition (CPPD) nomenclature project. This systematic literature review constituted its first step and aimed to provide a state-of-the-art analysis of the medical literature of the last 20 years.

Methods: A systematic literature search was undertaken in the , and databases between 2000 and 2022, restricted to studies on humans and in the English language.

Implications of conflict on vaccination in the Sahel region.

The Sahel region is a geographical belt in Africa that stretches from the Atlantic Ocean to the Red Sea, between the Sahara Desert in the north and the Savannah in the south. It is characterised by challenging environmental crises and conflicts. This analysis highlights the potential implications of conflict on vaccination across five Sahel countries, including Burkina Faso, Chad, Mali, Niger and Sudan, from 2019 to 2023.

Impact of introducing transnasal endoscopy on expanding diagnostic endoscopy services.

Introduction: Demand for endoscopic services is outstripping capacity in the UK. Transnasal endoscopy (TNE) utilises a narrow calibre endoscope to pass through the nasal passages, thereby reducing retching and discomfort. It is better tolerated compared with standard transoral endoscopy (TOE) but is still rarely used as a diagnostic modality.

Qualitative study exploring the views and perceptions of parents/carers of young children with CF regarding the introduction of CFTR modulator therapy (The REVEAL study; PaRents pErspectiVEs of KAftrio in chiLdren aged 2-5).

Background: Cystic fibrosis (CF) is associated with a historically high treatment burden which causes anxiety and exhaustion for parents of children with CF, especially in the early years of a child's life. Recently, a new medication, elexacaftor/tezacaftor/ivacaftor (ETI), has become available to some people with CF, which has had a significant impact on the quality of life of older children and adults. This medication will soon be available for children ages 2-5 in the UK.

Cross-National Validation of the WHO-5 Well-Being Index Within Adolescent Populations: Findings From 43 Countries.

The five-item World Health Organization Well-Being Index (WHO-5) is among the most frequently used brief standard measures to assess hedonic well-being. Numerous studies have investigated different facets of its psychometric properties in adult populations. However, whether these results apply to adolescents is uncertain, and only few psychometric studies employed adolescent populations.

Factors associated with link workers considering leaving their role: a cross-sectional survey.

Background: Social prescribing (SP) link workers (LWs) listen to patients' concerns and difficulties, and connect them to relevant community assets (groups/organisations/charities) that can help with their non-medical issues (eg, loneliness, debt, housing). LW retention is key to sustaining SP within primary care.

Aim: To examine occupational self-efficacy, job discrepancy and other factors as potential predictors of LWs' intentions to leave or remain in their post.

Conflicts of interest in the International Agency for Research on Cancer process of identifying carcinogenic hazards to humans.

Managing conflicts of interest (COIs) in scientific decision-making is important for minimizing bias and fostering public trust in science. Proper management of COIs has added significance when scientists are making decisions that impact public policy, such as assessing substances for carcinogenicity. The International Agency for Research on Cancer (IARC) organizes expert working groups to identify putative carcinogens and determine whether or not the hazard is likely to present significant potential harm to humans.

The effect of dietary supplements on core temperature and sweating responses in hot environmental conditions: a meta-analysis and meta-regression.

Dietary supplements are widely used among individuals exposed to hot environments, but whether their consumption confers any thermoregulatory effect is unclear. Therefore, we systematically evaluated the effect of dietary supplementation on key aspects of thermoregulation (core temperature [T] and sweating responses) in the heat. Three databases were searched in April 2024.

S100A9 protein activates microglia and stimulates phagocytosis, resulting in synaptic and neuronal loss.

S100 calcium-binding protein A9 (S100A9, also known as calgranulin B) is expressed and secreted by myeloid cells under inflammatory conditions, and S100A9 can amplify inflammation. There is a large increase in S100A9 expression in the brains of patients with neurodegenerative diseases, such as Alzheimer's disease, and S100A9 has been suggested to contribute to neurodegeneration, but the mechanisms are unclear. Here we investigated the effects of extracellular recombinant S100A9 protein on microglia, neurons and synapses in primary rat brain neuronal-glial cell cultures.

SERCA2 dysfunction accelerates angiotensin II-induced aortic aneurysm and atherosclerosis by induction of oxidative stress in aortic smooth muscle cells.

Background And Aim: Our previous research indicates that sarcoplasmic/endoplasmic reticulum calcium ATPase 2 (SERCA2) dysfunction facilitates the phenotypic transformation of aortic smooth muscle cells (ASMCs) and intensifies aortic aneurysm through the regulation of calcium-dependent pathways and endoplasmic reticulum stress. Our hypothesis is that additional mechanisms are involved in aortic aneurysm and atherosclerosis induced by SERCA2 dysfunction from the perspective of ASMC phenotypic transformation.

Methods & Results: In SERCA2 dysfunctional mice and their control littermates, ASMCs were isolated to analyze protein expression and cell functions, and angiotensin II was infused into these mice that were backcrossed into LDL receptor deficient background to induce aortic aneurysm and atherosclerosis.

Impact of an urban city-wide Bradford Clean Air Plan on health service use and nitrogen dioxide 24 months after implementation: An interrupted time series analysis.

There is limited evidence of the health impact of Low Emission Zones (also known as Clean Air Zones, CAZ). This study examines the impact of the Bradford Clean Air Plan (CAP), including a CAZ, on health and nitrogen dioxide (NO) in the first two years of implementation using an interrupted time series design. Primary care and emergency department visits for respiratory and cardiovascular illness in Bradford were recorded between January 2018 to September 2023 with diabetic footcare and head injury visits as controls.

Understanding Local Thermal Comfort and Physiological Responses in Older People Under Uniform Thermal Environments.

The ageing population has increased the attention on care services for older people, particularly concerning their health and thermal comfort. However, most existing studies focus on the overall thermal comfort of older people, with insufficient research into their local thermal needs for different body parts, impeding precise thermal adjustments and optimal thermal satisfaction. This study investigated the local thermal comfort and skin temperature of older people under various environmental conditions.

Assessing the potential role of deer in the dissemination of Mycobacterium bovis infection to cattle in Northern Ireland.

Mycobacterium bovis, the causative agent of animal tuberculosis, exhibits a broad host range - infecting, inducing pathology and transmitting from both bovine and wildlife hosts. Considerable effort has been extended to understanding the role wildlife may play in persistence and spread of infection. Infected cervids can spread infection to conspecifics and sympatric livestock as observed in the white-tailed deer (Odocoileus virginanus) population of Michigan, USA.

Antimicrobial susceptibility testing of Clostridioides difficile: a dual-site study of three different media and three therapeutic antimicrobials.

Objectives: Increasing resistance to antimicrobials used for the treatment of Clostridioides difficile infections necessitates reproducible antimicrobial susceptibility testing. Current guidelines take a one-size-fits-all approach and/or offer limited guidance. We investigated how the choice of medium affects measured MIC values across two sites.

Assessing the Utilization of HIV Genotype Resistance Testing: Insight from Italian Infectious Diseases Units.

Purpose: We aimed to assess the utilization of Genotype Resistance Testing (GRT) by Infectious Diseases Units across Italy.

Methods: A cross-sectional study was conducted involving a questionnaire distributed to the Infectious Diseases Unit in Italy. A web-based survey using Google Forms software was utilized and spread via email or cellphone.

Significant Radiation Reduction Using Cloud-Based AI Imaging in Manually Matched Cohort of Complex Aneurysm Repair.

Objective: Cloud-based, surgical augmented intelligence (Cydar Medical, Cambridge, UK) can be used for surgical planning and intraoperative imaging guidance during complex endovascular aortic procedures. We aim to evaluate radiation exposure, operative safety metrics, and post-operative renal outcomes following implementation of Cydar imaging guidance using a manually matched cohort of aortic procedures.

Methods: We retrospectively reviewed our prospectively maintained database of endovascular aortic cases.

The impact of childhood stressful life events on atopic dermatitis disease activity and severity.

Atopic dermatitis (AD) is a prevalent condition that has been associated with stress, but epidemiologic data on the impact of both common and severe childhood stressors are limited. Our objective was to evaluate the impact of stressful life events throughout early childhood on AD activity and severity. We conducted a longitudinal cohort study of 13,972 children ages 1 to 8.