Cost efficiency of inpatient rehabilitation following acquired brain injury: the first international adaptation of the UK approach.

Objectives: To adapt and apply a model for evaluating the functional benefits and cost efficiency of specialist inpatient rehabilitation to the Australian context, comparing functional outcomes and savings in the cost of ongoing care after acquired brain injury.

Design: An observational cohort analysis of prospectively collected clinical data from admission to discharge, with follow-up to 3 years.

Setting: A newly established state-wide inpatient postacute rehabilitation unit in Victoria, Australia for patients with moderate to severe acquired brain injury.

Modified Delphi expert elicitation of the clinical and economic burden of obstructive hypertrophic cardiomyopathy in England and Northern Ireland.

Objective: To estimate the resource use of patients with obstructive hypertrophic cardiomyopathy (HCM), stratified by New York Heart Association (NYHA) class, in the English and Northern Irish healthcare systems via expert elicitation.

Design: Modified Delphi framework methodology.

Setting: UK HCM secondary care centres (n=24).

Heart-brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain.

Introduction: Ischaemic heart disease (IHD) and cerebrovascular disease are leading causes of morbidity and mortality worldwide. Cerebral small vessel disease (CSVD) is a leading cause of dementia and stroke. While coronary small vessel disease (coronary microvascular dysfunction) causes microvascular angina and is associated with increased morbidity and mortality.

The implementation of safer drug consumption facilities in Scotland: a mixed methods needs assessment and feasibility study for the city of Edinburgh.

Background: Scotland currently has amongst the highest rates of drug-related deaths in Europe, leading to increased advocacy for safer drug consumption facilities (SDCFs) to be piloted in the country. In response to concerns about drug-related harms in Edinburgh, elected officials have considered introducing SDCFs in the city. This paper presents key findings from a feasibility study commissioned by City of Edinburgh Council to support these deliberations.

Association between triglyceride-glucose (TyG) related indices and cardiovascular diseases and mortality among individuals with metabolic dysfunction-associated steatotic liver disease: a cohort study of UK Biobank.

Background: Triglyceride-glucose (TyG) related indices, which serve as simple markers for insulin resistance, have been closely linked to metabolic dysfunction-associated steatotic liver disease (MASLD), cardiovascular disease (CVD), and mortality. However, the prognostic utility of TyG-related indices in predicting the risk of CVD and mortality among patients with MASLD remains unclear.

Methods: Data of 97,331 MASLD patients, with a median age of 58.

Improving care experiences for premenstrual symptoms and disorders in the United Kingdom (UK): a mixed-methods approach.

Background: Poor care experiences are reported for premenstrual disorders, which may result in negative outcomes such as distress, reduced healthcare engagement, and delays to diagnosis. This research aimed to explore healthcare experiences for premenstrual symptoms in the United Kingdom and identify areas for potential improvements based on participant responses.

Method: An online survey was delivered, with participants recruited via social media.

Using group model building to frame the commercial determinants of dietary behaviour in adolescence - findings from online system mapping workshops with adolescents, policymakers and public health practitioners in the Southwest of England.

Background: In England, 23% of children aged 11 start their teenage years living with obesity. An adolescent living with obesity is five times more likely to live with obesity in adult life. There is limited research and policy incorporating adolescents' views on how they experience the commercial determinants of dietary behaviour and obesity, which misses an opportunity to improve services and policies that aim to influence the prevalence of childhood obesity.

A systemic approach to identifying sustainable community-based interventions for improving adolescent mental health: a participatory group model building and design protocol.

Background: The deteriorating mental health of children and young people in the United Kingdom poses a challenge that services and policy makers have found difficult to tackle. Kailo responds to this issue with a community-based participatory and systemically informed strategy, perceiving mental health and well-being as a dynamic state shaped by the interplay of broader health determinants. The initiative works to explore, define and implement locally relevant solutions to challenges shaping the mental health and well-being of young people.

The cost of perspective switching: Constraints on simultaneous activation.

Visual perspective taking often involves transitioning between perspectives, yet the cognitive mechanisms underlying this process remain unclear. The current study draws on insights from task- and language-switching research to address this gap. In Experiment 1, 79 participants judged the perspective of an avatar positioned in various locations, observing either the rectangular or the square side of a rectangular cube hanging from the ceiling.

Dung predicts the global distribution of herbivore grazing pressure in drylands.

Dryland grazing sustains millions of people worldwide but, when poorly managed, threatens food security. Here we combine livestock and wild herbivore dung mass data from surveys at 760 dryland sites worldwide, representing independent measurements of herbivory, to generate high-resolution maps. We show that livestock and wild herbivore grazing is globally disconnected, and identify hotspots of herbivore activity across Africa, the Eurasian grasslands, India, Australia and the United States.

Investigating misclassification of type 1 diabetes in a population-based cohort of British Pakistanis and Bangladeshis using polygenic risk scores.

Correct classification of type 1 (T1D) and type 2 diabetes (T2D) is challenging due to overlapping clinical features and the increasingly early onset of T2D, particularly in South Asians. Polygenic risk scores (PRSs) for T1D and T2D have been shown to work relatively well in South Asians, despite being derived from largely European-ancestry samples. Here we used PRSs to investigate the rate of potential misclassification of diabetes amongst British Bangladeshis and Pakistanis.

Assessment of upper respiratory and gut bacterial microbiomes during COVID-19 infection in adults: potential aerodigestive transmission.

SARS-CoV-2 is the viral pathogen responsible for COVID-19. Although morbidity and mortality frequently occur as a result of lung disease, the gastrointestinal (GI) tract is recognized as a primary location for SARS-CoV-2. Connections and interactions between the microbiome of the gut and respiratory system have been linked with viral infections via what has been referred to as the 'gut-lung axis' with potential aerodigestive communication in health and disease.

Strong immune responses and robust protection following a novel protein in adjuvant tuberculosis vaccine candidate.

BCG remains the only licensed vaccine for tuberculosis (TB), but its efficacy wanes over time. Subunit vaccines, aim to improve BCG immunity and protection, by inducing responses to a few mycobacterial antigens delivered with a specific platform. Since the platform shapes the immune response induced, selecting the right platform has been challenging due to the lack of immune correlates of protection.

Genome-wide association study unravels mechanisms of brain glymphatic activity.

Brain glymphatic activity, as indicated by diffusion-tensor imaging analysis along the perivascular space (ALPS) index, is involved in developmental neuropsychiatric and neurodegenerative diseases, but its genetic architecture is poorly understood. Here, we identified 17 unique genome-wide significant loci and 161 candidate genes linked to the ALPS-indexes in a discovery sample of 31,021 individuals from the UK Biobank. Seven loci were replicated in two independent datasets.

Is Any ABCDE Stress Echocardiography Score Equivalent to Stress-Induced Ischaemia? Reply With a Modified 2-Stage Approach.

Stress echocardiography has evolved from the sole assessment of regional wall motion abnormalities (RWMAs) to the ABCDE protocol, as recommended by the recent clinical consensus statement from the European Association of Cardiovascular Imaging, reflecting the need for a more systematic patient assessment. Steps A, B, C, D, and E assess RWMAs, lung B-lines, left ventricular contractile reserve, coronary flow velocity reserve (CFVR) in mid-distal left anterior descending artery, and heart rate reserve, respectively. Impairment of CFVR is considered as the earliest abnormality in the ischaemic cascade.

Refining PREVENT prediction models for 10-year risk of cardiovascular disease using measures of anxiety and depression.

Background: Anxiety and depression are associated with cardiovascular disease (CVD). We aimed to investigate whether adding measures of anxiety and depression to the American Heart Association Predicting Risk of Cardiovascular Disease Events (PREVENT) predictors improves the prediction of CVD risk.

Methods: We developed and internally validated risk prediction models using 60% and 40% of the cohort data from the UK Biobank, respectively.

Comparing analog and 3D measurements of vertical dimension in edentulous subjects.

Objective: This study aimed to explore the feasibility and reliability of measuring the vertical dimension of occlusion/rest (OVD/RVD) on 3D facial scans of edentulous patients.

Methods: Nineteen edentulous participants rehabilitated with complete removable dental prostheses (CDs) participated in this study. Analog measurements (control) were obtained directly on the face for each participant with the jaws positioned at the rest position (without CDs, RVD) and at central occlusion (OVD), between the facial landmarks: Glabella (G) and Soft Pogonion (SP), Pronasale (PN) and SP, and Subnasale (SN) and SP.

Automated system for diagnosing pulmonary fibrosis using crackle analysis in recorded lung sounds based on iterative envelope mean fractal dimension filter.

Patients with pulmonary fibrosis (PF) often experience long waits before getting a correct diagnosis, and this delay in reaching specialized care is associated with increased mortality, regardless of the severity of the disease. Early diagnosis and timely treatment of PF can potentially extend life expectancy and maintain a better quality of life. Crackles present in the recorded lung sounds may be crucial for the early diagnosis of PF.

Rebound tonometry intraocular pressure reference values for conscious adult Egyptian vultures (Neophron percnopterus).

Objective: To obtain standard reference values of intraocular pressure measured with rebound tonometry in conscious healthy Egyptian vultures (Neophron percnopterus).

Methods: 17 Egyptian vultures presented for a routine health check, involving a full physical examination, blood film examination, Hct, manual total leukocyte count, and plasma biochemistry. 15 animals considered healthy and with no signs of stress underwent an ophthalmic examination, including observation of facial symmetry, adnexa, and direct fundoscopy to screen for ocular disease.

Generative adversarial networks with fully connected layers to denoise PPG signals.

Objective: The detection of arterial pulsating signals at the skin periphery with Photoplethysmography (PPG) are easily distorted by motion artifacts. This work explores the alternatives to the aid of PPG reconstruction with movement sensors (accelerometer and/or gyroscope) which to date have demonstrated the best pulsating signal reconstruction.

Approach: A generative adversarial network with fully connected layers (FC-GAN) is proposed for the reconstruction of distorted PPG signals.

Clinicians' perspectives on the use of artificial intelligence to triage MRI brain scans.

Artificial intelligence (AI) tools can triage radiology scans to streamline the patient pathway and also relieve clinician workload. Validated AI tools can mitigate the delays in reporting scans by flagging time-sensitive and actionable findings. In this study, we aim to investigate current stakeholder perspectives and identify obstacles to integrating AI in clinical pathways.