The Protocol for the Multi-Ethnic, multi-centre raNdomised controlled trial of a low-energy Diet for improving functional status in heart failure with Preserved ejection fraction (AMEND Preserved).

Introduction: Heart failure with preserved ejection fraction (HFpEF) is characterised by severe exercise intolerance, particularly in those living with obesity. Low-energy meal-replacement plans (MRPs) have shown significant weight loss and potential cardiac remodelling benefits. This pragmatic randomised trial aims to evaluate the efficacy of MRP-directed weight loss on exercise intolerance, symptoms, quality of life and cardiovascular remodelling in a multiethnic cohort with obesity and HFpEF.

Analytical approaches to evaluate risk factors of multimorbidity: a systematic scoping review protocol.

Introduction: Understanding causal risk factors that contribute to the development of multimorbidity is essential for designing and targeting effective preventive strategies. Despite a large body of research in this field, there has been little critical discussion about the appropriateness of the various analytical approaches used. This proposed scoping review aims to summarise and appraise the analytical approaches used in the published literature that evaluated risk factors of multimorbidity and to provide guidance for researchers conducting analyses in this field.

Differential attainment at national selection for higher surgical training: a retrospective cohort study.

Objectives: National selection for higher surgical specialty training (HST) in the UK is a high-stakes gatekeeping assessment. If barriers, such as differential attainment, exist at HST selection for some groups and not others, then this will have a significant and lasting impact on trainees' career progression and the diversity of the workforce, which should reflect the population it provides care for. The objective of this study was to characterise the relationship between candidate sociodemographic factors and performance at National Selection for HST in the UK.

Improving the diagnostic accuracy of referrals for papilloedema (DIPP) study: protocol for a mixed-methods study.

Introduction: Papilloedema can be the first sign of life-threatening disease, for example, brain tumours. Due to the potential seriousness of this clinical sign, the detection of papilloedema would normally prompt urgent hospital referral for further investigation. The problem is that many benign structural variations of optic nerve anatomy can be mistaken for papilloedema, so-called pseudopapilloedema.

Barriers and enablers encountered by bereaved informal motor neuron disease (MND) caregivers when trying to access bereavement support: a qualitative cross-sectional thematic analysis of semistructured interviews with 6-36 months postbereavement informal MND caregivers in the UK.

Background: Caregivers of people with motor neuron disease (MND) face more negative consequences of caregiving than other terminal illnesses. The impact of this caregiver burden can negatively influence bereavement outcomes.

Objectives: This study aims to explore the support needs of caregivers of people with MND, the types of bereavement services they use, or the reasons for not using bereavement services, and understanding the opportunities and barriers to accessing bereavement services.

Starfield's 4Cs of NCD management in primary healthcare: a conceptual framework development from a case study of 19 countries.

Introduction: Faced with a backdrop of an increasing chronic disease burden from an ageing global population compounded with rising healthcare costs, health systems are required to implement cost-effective, safe and equitable care through efficient service delivery models. One approach to achieving this is through Starfield's 4Cs of primary healthcare (PHC), which delineates the key attributes of a high-performing PHC system that upholds the pillars of care coordination, first contact of care, continuity of care and comprehensive care. Therefore, this study aims to explore and elucidate the key themes and subthemes related to and extending beyond Starfield's 4Cs of PHC by integrating findings from a comprehensive literature review and a qualitative study.

Controlins I-X, Resin Glycosides from the Seeds of and Their Biological Activities.

Ten new resin glycosides, controlins I-X (-), were isolated from the seeds of . Their structures were established by spectroscopic analysis as well as by chemical means. Compounds were identified as glycosidic acid methyl esters, considered as artifacts generated via transesterification with MeOH from natural resin glycosides.

A survey of prescribing philosophy in childhood hyperopia among optometrists in Ghana.

Clinical Relevance: Hyperopia is a common refractive error in young children and has the potential to affect their visual, educational and general development. Management of childhood hyperopia presents significant intra-and inter-professional differences partly because evidence-based guidelines to inform when and how to prescribe for hyperopia are insufficient.

Purpose: This study investigated the prescribing philosophy in childhood hyperopia among optometrists in Ghana and the challenges faced in managing childhood hyperopia.

Post-exercise myofibrillar protein synthesis rates do not differ following 1.5 g essential amino acids compared to 15 and 20 g of whey protein in young females.

Optimal adaptation to resistance exercise requires maximal rates of myofibrillar protein synthesis (MyoPS), which can be achieved by postexercise consumption of >20 g of protein or ~2 g of the essential amino acid (EAA) leucine. These nutritional recommendations are based on studies in males. The aim of the present study was to compare the postexercise MyoPS response to nutrition in young females.

Wireless Stimulation of Barium Titanate@PEDOT Nanoparticles Toward Bioelectrical Modulation in Cancer.

Cancer cells possess distinct bioelectrical properties, yet therapies leveraging these characteristics remain underexplored. Herein, we introduce an innovative nanobioelectronic system combining a piezoelectric barium titanate nanoparticle core with a conducting poly(3,4-ethylenedioxythiophene) shell (BTO@PEDOT NPs), designed to modulate cancer cell bioelectricity through noninvasive, wireless stimulation. Our hypothesis is that acting as nanoantennas, BTO@PEDOT NPs convert mechanical inputs provided by ultrasound (US) into electrical signals, capable of interfering with the bioelectronic circuitry of two human breast cancer cell lines, MCF-7 and MDA-MB-231.

Preexisting multimorbidity predicts greater mortality risks related to long-term PM exposure.

Long-term health risk assessments related to ambient fine particulate matter (PM) exposure have been more limited to general population but not towards individuals suffering from multimorbidity. While both multimorbidity and PM are independently linked to elevated mortality risk, their combined effects and interactions remain practically unexplored. A cross-cohort analysis was undertaken on data from 3 prospective cohorts, initially enrolling 869038 adults aged ≥18 years followed up during 2005-2022.

Geographic heterogeneity of polycyclic aromatic hydrocarbons in Yangtze River sediments: Evidence from the longest river in Asia.

This work is the first comprehensive survey of the Yangtze River, covering its origin to the estuary mouth. It focuses on the geographical and industrial factors influencing the distribution of polycyclic aromatic hydrocarbons (PAHs) in sediments, along with their contamination levels, sources, and ecological risks. The total concentrations of PAHs ranged from 2.

Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report.

Background: The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN) anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization (WAO) published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.

TOS UK (Thoracic Outlet Syndrome, United Kingdom): A Retrospective Review of Practice.

Objective: Thoracic outlet syndrome (TOS) is caused by compression of the neurovascular bundle at the thoracic outlet which often poses a diagnostic challenge. Patient management is often based on surgeon choice and experience. This study aims to describe practices relating to the diagnosis and management of TOS in the UK over a 1-year period.

Behavioral evidence that repetitive responses in a Free-Movement Pattern Y-maze are associated with ageing-related deficit in working memory.

Visuospatial working memory (VSWM) is crucial for navigating complex environments and is known to decline with ageing. The Free-Movement Pattern (FMP) Y-maze, used in animal studies, provides a robust paradigm for assessing VSWM via analyses of individual differences in repeated alternating sequences of left (L) and right (R) responses (LRLR, etc.), the predominant search pattern in many species.

A UK value set for the WAItE.

Objectives: The Weight-Specific Adolescent Instrument for Economic Evaluation (WAItE) is a weight-specific patient reported outcome measure for use in adolescence, consisting of seven domains, each with five response levels. The objective of this study was to generate a UK value set for the WAItE, enabling the calculation of utility values.

Methods: An online Discrete Choice Experiment (DCE) completed by an adult sample representative to the working population of the UK was used to estimate the preferences for the five levels of the seven domains.

A Comparison of the Performance of Six Surrogacy Models, Including Weighted Linear Regression, Meta-regression, and Bivariate Meta-Analysis.

Objectives: Several trial-level surrogate methods have been proposed in the literature. However, often only one method is presented in practice. By plotting trial-level associations between surrogate and final outcomes with prediction intervals and by presenting results from cross-validation procedures, this research demonstrates the value of comparing a range of model predictions.

Screening for Type 2 Diabetes Mellitus: A Systematic Review of Recent Economic Evaluations.

Objectives: To examine recent economic evaluations, whether any type 2 diabetes mellitus (T2DM) screening designs may represent better value for money, and to rate their methodological qualities.

Methods: We systematically searched three concepts (economic evaluations (EEs), T2DM, screening) in three databases (Medline, Embase, and EconLit) for EEs published between 2010 and 2023. Two independent reviewers screened for and rated their methodological quality (using CHEC-Extended).

Rare Disease Policy in High-Income Countries: An Overview of Achievements, Challenges, and Solutions.

Objectives: To provide an overview of policy initiatives in high-income countries aimed at supporting the development and accessibility of treatments for rare diseases.

Methods: We examine how legislative, research, and pricing policies in high-income countries address barriers that have historically hindered innovation and access to rare disease treatments. By analysing examples from the EU, UK, US, Canada, Japan, and Australia, the article identifies ongoing initiatives, outlines current challenges, and explores proposed solutions to foster a sustainable, innovative, and accessible rare disease treatment ecosystem.

Social Return on Investment analysis: A Mixed Methods Approach to Assessing the Value of Adult Hospice Services.

Objectives Hospice services offer invaluable support to individuals facing life-limiting illnesses, however, quantifying their positive impact presents a challenge. As the demand for palliative care rises due to complex illnesses and an aging population, hospices face the need to prove their value. With funding primarily reliant on charitable donations and limited statutory support, they must demonstrate their effectiveness to secure additional resources in a competitive landscape.

A Comparison of International Modelling Methods to Evaluate Health Economics of Colorectal Cancer Screening: A Systematic Review.

Objectives: Cost-effectiveness analysis (CEA) is an accepted approach to evaluate cancer screening programmes. CEA estimates partially depend on modelling methods and assumptions used. Understanding common practice when modelling cancer relies on complete, accessible descriptions of prior work.

Fetal fibroblast heterogeneity defines dermal architecture during human embryonic skin development.

To investigate heterogeneity of fibroblasts in human fetal skin, we analysed published single-cell RNA sequencing data (8 and 16 post conception weeks (PCW)) and performed single-molecule fluorescence in situ hybridisation to map their spatial distribution and predicted dynamic interactions. Clustering revealed 8 fibroblast populations with developmental stage-specific abundance changes. Proliferative cells (MKI67+) were present at all stages.

Investigation of aerosol jet printing for the preparation of solid dosage forms.

Oral drug delivery remains the preferred method of drug administration but due to poor solubility many active pharmaceutical ingredients (APIs) are ill suited to this. A number of methods to improve solubility of poorly soluble Biopharmaceutical Classification System (BCS) Class II drugs already exist but there is a lack of scalable, flexible methods. As such the current study applies the innovative technique of aerosol jet printing to increase the dissolution capabilities of a Class II drug in a manner which permits flexibility to allow dosage form tailoring.

Agreement between Color, Fluorescein Angiography, and SD-OCT in the Detection of Macular Fibrosis in Neovascular AMD.

Purpose: Color imaging is the accepted reference standard for detection of macular fibrosis in neovascular age-macular degeneration. Other imaging modalities of fluorescein angiography (FA) and spectral domain optical coherence tomography (SD-OCT) are also used but no formal agreement studies exist. We evaluated the agreement between fibrosis on colour, FA and SD-OCT-detected hyperreflective material (HRM) and their clinical relevance.