Iatrogenic kindness.

Iatrogenesis is a recognised aspect of healthcare. But could kindness, a prized ingredient in such work, be implicated in some of the iatrogenic harm? In a recent paper, I noted how healthcare professionals and institutions that appear to value and vaunt kindness can, in practice, fall not just occasionally short, but often systemically so. Rather than insisting on these as aberrations, I wondered whether, our practice of kindness may, as with use of antibiotics or X-rays, have its own less considered but nonetheless harmful side effects.

Cystatin C is associated with osteoporosis and fractures: An observational study based on Mendelian randomization analysis.

Objectives: Osteoporosis is characterized by decreased bone mass and damaged bone microstructure, often leading to fragility fractures. Low bone mineral density is a key risk factor for fractures. Serum cystatin C (CysC), an endogenous marker of glomerular filtration rate, is negatively correlated with bone mineral density and may be a potential risk factor for osteoporosis.

Provision of peri-operative patient blood management strategies in the UK: a national survey of practice.

Introduction: In UK hospitals, it is unclear how organisational structures are arranged to support effective implementation of peri-operative blood management practice strategies. The aim of this study was to conduct a national survey of organisations to describe local practices of peri-operative patient blood management and infrastructure availability in the UK.

Methods: A series of benchmarking standards was developed using recommendations informed by national standards, relevant literature and an expert panel.

Optimization of Cyclophilin B-Targeted Tri-vector Inhibitors for Novel MASH Treatments.

Cyclophilins have been implicated in the pathophysiology of metabolic dysfunction-associated steatohepatitis (MASH). Pharmacological inhibition of the cyclophilin B isoform has the potential to attenuate liver fibrosis in MASH, but current cyclophilin inhibitors in clinical trials lack isoform selectivity. We previously reported the novel tri-vector small-molecule inhibitor that exhibited improved subtype selectivity by simultaneously engaging three pockets on the surface of cyclophilins.

The impact of paramedics working in primary care teams on other professionals and patient experiences: a qualitative study.

Background: Paramedics are among the professional groups identified in recent policy initiatives aimed at addressing the unsustainable workload and workforce crises in primary care. Their support aims to enhance patient access to care and alleviate the burden of workload pressures.

Aim: To explore the impact of paramedics working in primary care on primary care teams and the experiences of patients who have a clinical consultation with a paramedic in primary care.

Barriers to conversations about deceased organ donation among adults living in the UK: a systematic review with narrative synthesis.

Objectives: To explore the barriers to conversations about deceased organ donation among adults living in the UK.

Design: Systematic review with narrative synthesis.

Data Sources: PubMed, MEDline via OVID, APA PsycInfo via EBSCO, Web of Science via Clarivate and Scopus via Elsevier, covering studies that were published between January 2006 and December 2023.

Cohort profile: the Norwegian Neck and Back Registry (NNRR): a medical quality registry for patients with neck and back complaints.

Purpose: The Norwegian Neck and Back Registry (Norsk Nakke og Rygg Register, NNRR) was established to improve the quality of diagnosis and treatment in patients with neck and back complaints at Departments of Physical Medicine and Rehabilitation (PMR) in Norwegian hospitals. The purpose of this cohort profile is to describe the data from registered patients from 2016 to 2022 and linkage opportunities.

Participants: The registry includes adult patients with neck and back complaints referred to PMR multidisciplinary neck and back outpatient clinics in Norwegian hospitals.

Prioritising community-defined interventions to address the health and well-being impact of the COVID-19 pandemic on racially minoritised communities in East London: results from an adapted James Lind Alliance priority setting partnership.

Objectives: Racially minoritised communities (RMCs) were disproportionately affected by COVID-19, experiencing among the highest mortality rates of the UK's pandemic. We sought to understand the priorities for action to address the impact of the COVID-19 pandemic on the health and well-being of RMCs in the ethnically diverse and socioeconomically unequal area of East London, located in the northeastern part of London, England.

Design: Prospective surveys and a consensus meeting following the established James Lind Alliance priority setting partnership (PSP) methodology, adapted for a specific geographic location and ethnic groups.

Enhancing the experience and outcomes of children with complex care needs in acute paediatric settings: a realist review protocol.

Introduction: The number of babies, children and young people with complex care needs (henceforth children with complex care needs (CCCN)) in England has increased in recent decades, and this has also been recognised globally. CCCN may have frequent and lengthy hospital admissions, but during these episodes, their needs are not always met, potentially resulting in suboptimal experiences and outcomes. Despite increased numbers of CCCN accessing acute care and displaying greater complexity, much of the contemporary literature has focused on primary care coordination between health, education and social care.

Outcome measurement for gender-affirming care in Canada: a systematic review.

Introduction: Gender-affirming care (GAC) includes interventions aimed at supporting an individual's gender identity. Canada is experiencing an increase in referrals for GAC, higher than any other health service; therefore, there is a need for a systematic approach to health outcome measurement to effectively evaluate care. This review aims to analyse health outcome measurement in Canadian GAC, focusing on what is measured, how it is measured and associated barriers and enablers.

Homocysteine levels and cardiovascular disease risk factors in chronic kidney disease (CKD), hypertensive and healthy Nigerian adults: a comparative retrospective study.

Objectives: To investigate homocysteine (Hcy) levels in individuals with chronic kidney disease (CKD), hypertension and a healthy Nigerian population, and to assess their association with cardiovascular disease (CVD) risk.

Setting: The study was conducted using data from the Ibadan CRECKID (Cardiovascular and Renal Event in People with Chronic Kidney Disease) study in Nigeria.

Participants: A total of 420 adults (aged 18+) categorised into three groups: individuals with stage 2 CKD or higher, hypertensive non-CKD individuals and normotensive individuals.

Association of occupational noise exposure and shift work with non-alcoholic fatty liver disease: a cross-sectional study of male workers in the Chinese automobile manufacturing industry.

Objective: This study aimed to determine the relationship between occupational noise, shift work and non-alcoholic fatty liver disease (NAFLD) in male workers in the automobile manufacturing industry.

Design: Cross-sectional study.

Setting: This study was carried out at the Guangzhou Twelfth People's Hospital using data from April to September 2022.

Improving peer review of systematic reviews and related review types by involving librarians and information specialists as methodological peer reviewers: a randomised controlled trial.

Objective: To evaluate the impact of adding librarians and information specialists (LIS) as methodological peer reviewers to the formal journal peer review process on the quality of search reporting and risk of bias in systematic review searches in the medical literature.

Design: Pragmatic two-group parallel randomised controlled trial.

Setting: Three biomedical journals.

Wearable device-measured physical activity and incident cardiovascular disease in cancer survivors.

Objective: To explore the association of wearable device-measured moderate-to-vigorous intensity physical activity (MVPA) with cardiovascular disease (CVD) risk in long-term cancer survivors.

Methods: This retrospective analysis involved a prospective cohort of 6109 cancer survivors without CVD from the UK Biobank accelerometry subsample. The MVPA volume is categorised into four groups based on guideline recommendations (0-75 min/week, 75-150 min/week, 150-300 min/week, ≥300 min/week).

Internal structure, reliability and cross-cultural validity of the Warwick-Edinburgh Mental Wellbeing Scale in three European populations.

Background: The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), a questionnaire designed for the assessment of mental well-being, is widely used in different countries and cultures worldwide. However, there is a lack of studies examining its metric performance and measurement invariance across countries.

Objective: This study aims to examine the internal structure, reliability and cross-country validity of the WEMWBS in three European populations.

Electrophysiological analysis of paraventricular thalamic neurons co-expressing kappa and mu opioid receptors.

The paraventricular thalamus (PVT) is a central node in the integration of stress- and reward-related information that may serve as a pivotal site for opioid receptors to exert their effects. Kappa opioid receptors (KOPrs) and mu opioid receptors (MOPrs) have dissociable and opposing roles in circuits of stress and reward. Interestingly, both are highly expressed in the PVT, however it is not known how aversive KOPr and rewarding MOPr signalling converges to dictate PVT activity and, by proxy, whole brain effects.

Fat absorption and metabolism after Roux-en-Y gastric bypass surgery.

Background: Triacylglycerol (TAG) plasma excursions after a high-fat meal are blunted after Roux-en-Y gastric bypass (RYGB), but underlying mechanisms are poorly understood. We studied TAG absorption and metabolism in 12 RYGB-operated individuals and 12 unoperated controls (CON) matched on sex, age, and BMI.

Methods: Participants followed a 7-day controlled diet and on day 4 underwent H-MR Spectroscopy of liver TAG and a high-fat liquid meal with oral and intravenous labeled stable isotope metabolites, subcutaneous abdominal fat biopsies, and indirect calorimetry.

Small-angle vertical strabismus treatment in the elderly.

Small vertical fusion amplitudes complicate the management of small-angle vertical strabismus in the elderly, and innovative procedures have the potential to facilitate effective treatment options in these patients. To identify and evaluate alternative procedures for the treatment of small-angle vertical strabismus in the elderly, we conducted a comprehensive literature search in PubMed and Google Scholar. Here, we identify and evaluate new surgical techniques that target small-angle vertical strabismus, including graded partial tenotomy, partial tendon recession, minitenotomy, and miniplication.

Greenhouse gas emissions in relation to micronutrient intake and implications of energy intake: A comparative analysis of different modelling approaches.

Background: Human diets account for 30% of greenhouse gas emissions (GHGE). Reporting dietary GHGE with or without energy standardization yields different outcomes, often resulting in conflicting conclusions regarding associations with micronutrient intake.

Objectives: To compare methods of reporting dietary GHGE, with and without consideration of energy intake, and their respective associations with micronutrient intake.

Enhancing Martini3 for Protein Self-Interaction Simulations.

Coarse-grained molecular dynamics simulations are highly valuable for studying protein-protein interactions. Unfortunately, commonly used force fields often overestimate these interactions. Here, we investigate the performance of the Martini 3 force field in predicting the self-interaction behavior of lysozyme and subtilisin using Metadynamics.

Treatable Trait Guided Asthma Management: A Feasibility Study.

Background And Objectives: Treatable trait-based personalised medicine improves outcomes in severe asthma clinics. We assessed the feasibility of a randomised controlled trial (RCT) of protocolised treatable trait-guided asthma management in patients not under a severe asthma clinic.

Methods: Ten week single-group cohort study.