Emergency and postoperative access to critical and enhanced care: a multicentre prospective observational study.

Introduction: The ability to admit patients to enhanced or critical care may be limited by bed availability. In a network with low provision of critical and enhanced care beds, we aimed to assess the proportion of patients having surgery with moderate (1%-< 5%) or high (≥ 5%) predicted risk of 30-day postoperative mortality and their postoperative care location. We also aimed to study referral and admission outcomes to critical care.

Is there an association between birth characteristics and fractures in young adults? The HUNT Study, Norway.

Unlabelled: This population study investigated the association between birth characteristics and fracture risk in 11,099 young adults (aged 19-54 years). Our findings indicate that birth weight, gestational age, and birth weight for gestational age were not associated with fractures in the wrist, humerus, hip, and spine in this population.

Purpose: Skeletal development starts during fetal life, and it is estimated that most bone formation occurs in the 3rd trimester.

Optimisation of the patient having oncological surgical through prehabilitation: a narrative review.

Introduction: Prehabilitation aims to improve physiological reserve and psychological resilience, enabling patients to better tolerate the physiological stress of major surgery, thereby reducing the risk of complications and improving surgical outcomes. In this review, we provide an update of the development of prehabilitation in patients having cancer surgery.

Methods: We searched databases of peer-reviewed research to identify appropriate papers.

Safety and efficacy of laser lithotripsy for treatment of bladder calculi: evidence from a systematic literature review.

Purpose Of Review: Bladder stones account for 5% of all urinary tract calculi. Contributing factors include bladder outflow obstruction, infections, foreign bodies, or neurogenic voiding dysfunction. This necessitates an effective treatment modality, and with advances in medical technology, minimally invasive techniques using lasers are being widely adopted.

Cohort profile: creation of the SAIL MELD-B e-cohort (SMC) and SAIL MELD-B children and young adult e-cohort (SMYC) to investigate the lived experience of the 'burdensomeness' of multimorbidity.

Purpose: We have established the SAIL MELD-B electronic cohort (e-cohort SMC) and the SAIL MELD-B children and Young adults e-cohort (SMYC) as a part of the Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) project. Each cohort has been created to investigate and develop a deeper understanding of the lived experience of the 'burdensomeness' of multimorbidity by identifying new clusters of burdensomeness concepts, exploring early life risk factors of multimorbidity and modelling hypothetical prevention scenarios.

Participants: The SMC and SMYC are longitudinal e-cohorts created from routinely collected individual-level population-scale anonymised data sources available within the Secure Anonymised Information Linkage (SAIL) Databank.

Myocardial Fibroblast Activation After Acute Myocardial Infarction: A Positron Emission Tomography and Magnetic Resonance Study.

Background: Myocardial fibrosis is a key healing response after myocardial infarction driven by activated fibroblasts. Gallium-68-labeled fibroblast activation protein inhibitor ([Ga]-FAPI) is a novel positron-emitting radiotracer that binds activated fibroblasts.

Objectives: The aim of this study was to investigate the intensity, distribution, and time-course of fibroblast activation after acute myocardial infarction.

Mitrofanoff Appendicovesicostomy in Robotic Paediatric Surgery-A Systematic Review.

Introduction: Proper bladder drainage is crucial. Children with bladder dysfunction may require alternative methods like clean intermittent catheterisation (CIC). However, CIC can be challenging for individuals with impairments.

Network-based biomarkers in background electroencephalography in childhood epilepsies-A scoping review and narrative synthesis.

Background: Brain network analysis is an emerging field of research that could lead to the development, testing and validation of novel biomarkers for epilepsy. This could shorten the diagnostic uncertainty period, improve treatment, decrease seizure risk and lead to better management. This scoping review summarises the current state of electroencephalogram (EEG)-based network abnormalities for childhood epilepsies.

Critical Time Points for Assessing Long-Term Clinical Response After Sleeve Gastrectomy-A Retrospective Study of Patients with 13-Year Follow-Up.

Background: Weight loss after sleeve gastrectomy (SG) demonstrates significant diversity in the long term and the implicated mechanisms behind suboptimal clinical response (SCR) or recurrent weight gain (RWG) need to be scrutinized. This study retrospectively examines weight-loss trajectories, aiming to identify critical time points to optimize follow-up strategies and guide future prospective research.

Methods: This is a single-center, retrospective study of 104 patients that underwent SG.

Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?

Background: There is a lack of information on the current healthcare systems for children with kidney diseases across Europe. The aim of this study was to explore the different national approaches to the organization and delivery of pediatric nephrology services within Europe.

Methods: In 2020, the European society for Paediatric Nephrology (ESPN) conducted a cross-sectional survey to identify the existing pediatric nephrology healthcare systems in 48 European countries covering a population of more than 200 million children.

A multi-centre UK-based survey on angioedema secondary to acquired C1 inhibitor deficiency.

Background: Acquired angioedema due to C1-inhibitor deficiency (AAE-C1-INH) is very rare compared to its prototype, hereditary angioedema. An updated characterisation of the AAE-C1-INH cohort in UK is required to inform management.

Objectives: To describe the disease burden of AAE-C1-INH, long-term prophylaxis (LTP) and the clinical, immunochemical and treatment profiles of AAE-associated diseases in UK.

Being "resilient" and achieving "resilience": From governmental discourses to the national research agenda in the contexts of food insecurity and cost of living.

The concept of 'resilience' is pervasive, permeating academic disciplines and political discourses. This paper considers (i) the construal of 'resilience' in the contexts of food insecurity and cost-of-living in governmental discourses in the United Kingdom (UK); (ii) to what extent the political representations are reflected in research funding calls of UK national funding bodies, thus showing possibility of shaping research agendas; and (iii) to what extent official uses of 'resilience' reflect lay understandings. We are combining a corpus-based discourse analysis of UK governmental discourses and research funding calls with a study of focus group discussions.

Does enteral nutrition protect against stress ulceration in the critically ill?

Purpose Of Review: Critically ill patients are at risk of gastrointestinal bleeding (GIB) due to stress ulceration. Strategies to reduce the risk include administration of prophylactic ulcer healing medications. Enteral nutrition (EN) may be favourably associated with GIB risks.

Navigating the challenges in radiology training expansion: costs and benefits.

Clinical and interventional radiology services play a vital role in the provision of modern healthcare, but there is a widening gap between the capacity of the imaging workforce and increasing demand. In recent years there has been a programme of training expansion in England supported by tariff level funding from NHS England (Workforce Training and Education Directorate), enhancing long-term radiology workforce sustainability and bringing quality benefits for patients, departments, and trusts. Expansion is a multifaceted and challenging process in the current NHS climate, involving coordination of funding, capacity, and sustained educational quality.

Psychological Impact of Hospital Discharge on the Older Person: A Systematic Review.

Hospitalisation and prolonged length of stay is associated with deconditioning that risks adverse outcomes after discharge. Less is known about the psychological impact on older people after hospital discharge. The purpose of this systematic review was to elucidate factors contributing to psychological stress in older patients post-discharge to inform better discharge planning.

Medical ambivalence and Long Covid: The disconnects, entanglements, and productivities shaping ethnic minority experiences in the UK.

Structural violence - related to 'isms' like racism, sexism, and ableism - pertains to the ways in which social institutions harm certain groups. Such violence is critical to institutional indifference to the plight of ethnic minority people living with long-term health conditions. With only emergent literature on the lived experiences of ethnic minorities with Long Covid, we sought to investigate experiences around the interplay of illness and structural vulnerabilities.

Distinct virologic trajectories in chronic hepatitis B identify heterogeneity in response to nucleos(t)ide analogue therapy.

Background & Aims: The dynamics of HBV viral load (VL) in patients with chronic hepatitis B (CHB) on nucleos(t)ide analogue (NA) treatment and its relationship with liver disease are poorly understood. We aimed to study longitudinal VL patterns and their associations with CHB clinical outcomes.

Methods: Utilising large scale, routinely collected electronic health records from six centres in England, collated by the National Institute for Health and Care Research Health Informatics Collaborative (NIHR HIC), we applied latent class mixed models to investigate VL trajectory patterns in adults receiving NA treatment.

Paramedics providing end-of-life care: an online survey of practice and experiences.

Background: Global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this. Despite this growing demand on the paramedic workforce, little large-scale or detailed empirical research has evaluated current practice and paramedic experiences of attending this patient group. Therefore, as part of a wider study evaluating paramedic delivery of end-of-life care, a large-scale survey in England describing paramedics' current practice and experiences providing end-of-life care was undertaken.

Longer-term survival, quality of life, and cost-effectiveness of conservative versus liberal oxygenation targets in critically ill children: a pre-specified analysis from Oxy-PICU, a multicentre, open, parallel-group, randomised controlled trial.

Background: Peripheral oxygen saturation (SpO) above 94% is typical in children in paediatric intensive critical care units (PICUs) who are receiving invasive ventilation and supplemental oxygen. In a previous report from the Oxy-PICU trial, we showed that lower (conservative) oxygenation targets (SpO 88-92%) are beneficial, showing small but statistically significant differences in duration of organ support and large but non-significant cost reductions at 30 days. In this pre-specified analysis of the Oxy-PICU trial, we compare longer-term outcomes and cost-effectiveness of conservative versus liberal (SpO >94%) oxygenation targets in children with emergency PICU admission.