Klinefelter Syndrome: A Review.

Background: Klinefelter syndrome (KS) is an uncommonly recognised condition typified by gynaecomastia, small testes and aspermatogenesis. It is caused by a supernumerary X chromosome, resulting in a 47 XXY karyotype. Since its first description, the phenotype of KS has evolved and there is a much greater appreciation of the subtle features of the condition.

Elective Aortic Surgery for Prevention of Aortic Dissection in Turner Syndrome: The Potential Impact of Updated European Society of Cardiology and International Turner Syndrome Consensus Group Guidelines on Referrals to the Heart Team.

Objective: The risk of aortic dissection is increased in Turner Syndrome (TS). Aortic dilation is thought to contribute to this risk and may be managed with elective aortic surgery. New TS guidance has lowered the aortic size thresholds for consideration of aortic surgery.

Investigating Cell Wall Diffusion in Wood Modified with Phenol Urea Formaldehyde Resin in Different Length Scales.

Wood modification using low molecular weight thermosetting resins improves the biological durability and dimensional stability of wood while avoiding increasingly regulated biocides. During the modification process, resin monomers diffuse from the cell lumen to the cell wall, occupying micropore spaces before curing at 150 °C. This study investigated the mechanism of cell wall diffusion at multiple scales, comparing two test groups where diffusion was either facilitated or restricted.

Public Involvement to Enhance Care Home Research; Collaboration on a Minimum Data Set for Care Homes.

Introduction: Information on care home residents in England is captured in numerous data sets (care home records, General Practitioner records, community nursing, etc.) but little of this information is currently analysed in a way that is useful for care providers, current or future residents and families or that realises the potential of data to enhance care provision. The DACHA study aimed to develop and test a minimum data set (MDS) which would bring together data that is useful to support and improve care and facilitate research.

Recent Advances on Characterization Techniques for the Composition-Structure-Property Relationships of Solid Electrolyte Interphase.

The Solid Electrolyte Interphase (SEI) is a nanoscale thickness passivation layer that forms as a product of electrolyte decomposition through a combination of chemical and electrochemical reactions in the cell and evolves over time with charge/discharge cycling. The formation and stability of SEI directly determine the fundamental properties of the battery such as first coulombic efficiency (FCE), energy/power density, storage life, cycle life, and safety. The dynamic nature of SEI along with the presence of spatially inhomogeneous organic and inorganic components in SEI encompassing crystalline, amorphous, and polymeric nature distributed across the electrolyte to the electrolyte-electrode interface, highlights the need for advanced in situ/operando techniques to understand the formation and structure of these materials in creating a stable interface in real-world operating conditions.

Long-Term Real-World Survival of Immunotherapy Compared to Chemotherapy for Metastatic Nonsmall Cell Lung Cancer: A Propensity Score-Matched Analysis.

Background: The long-term real-world effect of immunotherapy (IO) is uncertain in metastatic nonsmall cell lung cancer (mNSCLC). This retrospective observational study aimed to describe treatment patterns following the introduction of IO, estimate real-world treatment effects of IO compared to standard of care, and evaluate the impact of introduction of IO on a real-world population, based on a large dataset of over 10 000 patients with several years of follow-up.

Methods: Data from routine care of lung cancer patients were extracted from Flatiron Health including those who received either IO or platinum-based doublet chemotherapy (PBDC) in the first line (1L), or either IO or chemotherapy (CT) in the second line (2L).

Advances in the Design of Photoactivatable Metallodrugs: Excited State Metallomics.

Photoactivatable metal complexes offer the prospect of novel drugs with low side effects and new mechanisms of action to combat resistance to current therapy. We highlight recent progress in the design of platinum, ruthenium, iridium, gold and other transition metal complexes, especially for applications as anticancer and anti-infective agents. In particular, understanding excited state chemistry related to identification of the bioactive species (excited state metallomics/pharmacophores) is important.

Increased neutrophil elastase in affected lobes of bronchiectasis and correlation of its levels between sputum and bronchial lavage fluid.

Background: Neutrophil elastase (NE) has been proposed as a potential biomarker for evaluating the severity and prognosis of bronchiectasis. This study aimed to compare bronchial lavage quantification of NE levels and activities with those of sputum.

Methods: A cross-sectional study was conducted in which 24 Vietnamese adults with bronchiectasis were enrolled from June 2023 to August 2023.

Identifying genetic differences between bipolar disorder and major depression through multiple genome-wide association analyses.

Background: Accurate diagnosis of bipolar disorder (BPD) is difficult in clinical practice, with an average delay between symptom onset and diagnosis of about 7 years. A depressive episode often precedes the first manic episode, making it difficult to distinguish BPD from unipolar major depressive disorder (MDD).

Aims: We use genome-wide association analyses (GWAS) to identify differential genetic factors and to develop predictors based on polygenic risk scores (PRS) that may aid early differential diagnosis.

Prosocial Intentions and Subsequent Cognitive Health: A Prospective Cohort Study.

Objectives: Prosociality, defined as positive other-regarding intentions and behaviors, is a modifiable factor demonstrated to be associated with better mental, physical, and cognitive health in older adults. Prior studies have largely focused on individual prosocial behaviors, especially volunteering. This study examines whether prosocial intentions are associated with maintaining cognitive health over time.

Meta-analysis of longitudinal comparison of transcatheter versus surgical aortic valve replacement in patients at low to intermediate surgical risk.

Background: Surgical aortic valve replacement (SAVR) is the commonly used approach for aortic valve replacement (AVR) in patients with aortic stenosis at low or intermediate surgical risk. However, transcatheter aortic valve replacement (TAVR) has emerged as an alternative to SAVR for AVR. This meta-analysis aims to assess the comparative efficacy and safety of TAVR versus SAVR in low-to-intermediate surgical risk patients by analyzing temporal trends in the outcomes of TAVR and SAVR at various follow-up intervals, providing a more detailed understanding.

Understanding barriers and facilitators to non-pharmaceutical chronic pain research engagement among people living with chronic pain in the UK: a two-phase mixed-methods approach.

Objectives: Chronic pain treatment engagement is dominated by pharmaceutical methods, while previous research has assessed barriers to uptake of non-pharmaceutical treatments, there has not been research one step earlier in the treatment development pipeline; assessing barriers to take part in research that develops non-pharmaceutical chronic pain treatment methods.

Design: A two-phase approach was used to assess barriers and facilitators to research participation for people living with chronic pain. Online focus groups were run in phase 1, generating qualitative data, while phase 2 used the themes identified within phase 1 to assess agreement and disagreement.

Exploring aspects of mentoring for black and minoritised healthcare professionals in the UK: a nominal group technique study.

Objective: Mentoring plays a crucial role in career development, particularly for black and minoritised ethnic (BME) professionals. However, existing literature lacks clarity on the impact of mentoring and how best to deliver for career success. This study aimed to ascertain perceptions and build consensus on what is important in mentoring for BME healthcare professionals.

Conceptualising Centres of Clinical Excellence: A Scoping Review.

Objectives: Centres of clinical excellence (CoCE) are healthcare facilities that provide excellent healthcare. However, despite their increasing prevalence, it is unclear how CoCE are identified and monitored. This paper explores how CoCE has been described in the literature, including its defining characteristics and selection and monitoring processes.

Impact of mindfulness-based tri-modal prehabilitation on functional recovery and selected surgical outcomes of patients with colorectal cancer admitted to surgical hospital wards: the first international randomised control trial for mindfulness-based tri-modal prehabilitation.

Introduction: Colorectal cancer (CRC) is the third most common and second most deadly cancer worldwide, with significant morbidity and mortality risks. Despite advancements in surgical care, postoperative complications and recovery challenges persist. The severity of these issues is linked to preoperative functional capacity and emotional distress.

Stakeholder perspectives to inform the implementation of a community health worker-delivered home management of hypertension intervention in Zimbabwe.

Objective: Implementing evidence-based innovations often fails to translate into meaningful outcomes in practice due to dynamic real-world contextual factors. Identifying these influencing factors is pivotal to implementation success. This study aimed to determine the barriers and facilitators of implementing a community health worker (CHW)-delivered home management of hypertension (HoMHyper) intervention from a stakeholder's perspective using the Consolidated Framework for Implementation Research (CFIR).

Study protocol for Adaptive ChemoTherapy for Ovarian cancer (ACTOv): a multicentre phase II randomised controlled trial to evaluate the efficacy of adaptive therapy (AT) with carboplatin, based on changes in CA125, in patients with relapsed platinum-sensitive high-grade serous or high-grade endometrioid ovarian cancer.

Introduction: Adaptive ChemoTherapy for Ovarian cancer (ACTOv) is a phase II, multicentre, randomised controlled trial, evaluating an adaptive therapy (AT) regimen with carboplatin in women with relapsed, platinum-sensitive high-grade serous or high-grade endometrioid cancer of the ovary, fallopian tube and peritoneum whose disease has progressed at least 6 months after day 1 of the last cycle of platinum-based chemotherapy. AT is a novel, evolutionarily informed approach to cancer treatment, which aims to exploit intratumoral competition between drug-sensitive and drug-resistant tumour subpopulations by modulating drug dose according to a patient's own response to the last round of treatment. ACTOv is the first clinical trial of AT in this disease setting.

Acute effect of a Mediterranean-style dietary pattern (MDP) on mood, anxiety and cognition in UK adults with mild to moderate anxiety and depression: the MediMood randomised controlled trial protocol.

Introduction: Psychological disorders including depression and anxiety are significant public health concerns. A Mediterranean-style dietary pattern (MDP) has been associated with improved mental well-being in observational studies. Evidence of the acute (defined as postprandial to 1 week) effects of an MDP on brain function, mood, cognition and important modulators, including sleep and the gut microbiota is limited.

Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey.

Aim: As heart failure (HF) with preserved ejection fraction (HFpEF) prevalence increases, it remains frequently underdiagnosed and poorly managed. Recent positive pharmacological trials have increased interest in HFpEF but challenges of diagnosis and management remain. The survey aim was to examine consensus between primary and secondary care providers regarding HFpEF diagnosis and management.

Understanding the scale and nature of avoidable healthcare-associated harm for prisoners in England: protocol for a retrospective cross-sectional study.

Introduction: Around 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.

AI-assisted detection for chest X-rays (AID-CXR): a multi-reader multi-case study protocol.

Introduction: A chest X-ray (CXR) is the most common imaging investigation performed worldwide. Advances in machine learning and computer vision technologies have led to the development of several artificial intelligence (AI) tools to detect abnormalities on CXRs, which may expand diagnostic support to a wider field of health professionals. There is a paucity of evidence on the impact of AI algorithms in assisting healthcare professionals (other than radiologists) who regularly review CXR images in their daily practice.

What strategies are used to select patients for direct admission under acute medicine services? A protocol paper for a systematic review of the literature.

Introduction: Despite unprecedented pressures on urgent and emergency care services, there is no clear consensus on how to provide acute medical care delivery in the UK. These pressures can lead to significant delays in care for patients presenting with emergencies when admitted via traditional routes through the emergency department. Historically, a separate pathway has existed where patients are directly admitted to acute medicine services without attending the emergency department.

Cohort profile: Health and Attainment of Pupils in a Primary Education National Cohort (HAPPEN) - a hybrid total population cohort in Wales, UK.

Purpose: Health and Attainment of Pupils in a Primary Education National (HAPPEN) is a primary school national cohort which brings together education, health and well-being research in line with the Curriculum for Wales framework. Health, education and social care data are linked and held in the Secure Anonymised Information Linkage (SAIL) Databank. In addition, school-aged children complete the HAPPEN Survey to inform the design and implementation of the Health and Well-being curriculum.

Impact of the COVID-19 pandemic on primary care for hypertension in the UK: a population-based cohort study.

Objectives: To describe the impact of the COVID-19 pandemic on hypertension diagnosis and management in UK primary care.

Design: Population-based cohort study.

Setting: Over 2000 general practices across the UK contributing to the Clinical Practice Research Datalink.