Cooling and physiology during parent cuddling infants with neonatal encephalopathy in usual care: CoolCuddle-2 study.

Aim: CoolCuddle, enabling parents to cuddle their babies with neonatal encephalopathy (NE) during therapeutic hypothermia and intensive care (TH), was developed in research settings. To determine the impact of implementing CoolCuddle in usual care in six diverse neonatal intensive care units on the cooling process and intensive care.

Methods: This vital sign cohort study embedded within the CoolCuddle implementation study enrolled 36 infants receiving TH for NE.

Findings of the British Association of Dermatologists Career Survey of Dermatologists in Training and New Consultant Dermatologists 2023.

Previous surveys of UK dermatology trainees have identified key patterns regarding future career intentions that can help to inform workforce planning as consultant vacancies continue to grow. We invited all doctors training in dermatology, as well as all dermatology doctors who have completed training between 2018-2023 to complete separate surveys over a six-week period. These surveys explored: career locations, working patterns, pull factors towards particular posts, and push factors away from NHS consultant posts.

F-Difluoromethyl(ene) Motifs via Oxidative Fluorodecarboxylation with [F]Fluoride.

Herein, we report that α-fluorocarboxylic acids undergo manganese-mediated oxidative F-fluorodecarboxylation with [F]fluoride affording biologically relevant F-difluoromethyl(ene)-containing molecules. This no-carrier added process provides a solution to a known challenge in radiochemistry and expands the radiochemical space available for positron emission tomography (PET) ligand discovery. Scalability on a fully automated radiosynthetic platform is exemplified with the production of [F]4,4-difluoropiperidine that, we demonstrate, is amenable to postlabeling functionalization including -heteroarylation and amide as well as sulfonamide bond formation.

Is the presence of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children related to the optic disc area, scleral canal diameter and refractive status?

Purpose: Peripapillary hyperreflective ovoid mass-like structures (PHOMS) have been recently described on optical coherence tomography (OCT) scans of the optic nerve. We aim to determine if there is a causal relationship between OCT measurements of the optic disc area (DA), scleral canal diameter (SCD) and refractive error (spherical equivalent, SE) on the presence of PHOMS.

Methods: Retrospective analysis of OCT scans which were graded for the presence or absence of PHOMS in children with suspected papilledema was undertaken.

Safety and performance of the ultrathin sirolimus-eluting coronary stent in an all-comer patient population: the S-FLEX UK-II registry.

Objective: We evaluated the clinical safety and performance of the ultrathin strut biodegradable polymer-coated Supraflex Cruz (Sahajanand Medical TechnologiesLtd., Surat, India) sirolimus-eluting stent (SES) in an all-comer patient population requiring coronary stent implantation.

Study Design: The study was a prospective, observational, multicentre, single-arm registry.

Oral and maxillofacial surgery and dental health education in undergraduate medicine: a systematic review.

Undergraduates in medicine should receive a basic education to ensure understanding of dental concepts, including oral cancer, basic dental health advice, and oral and maxillofacial surgery (OMFS). This review aims to explore the exposure of OMFS and dental education in the UK medical undergraduate curriculum and follows PRISMA protocols. Four databases were used to search for literature: MEDLINE, EMBASE, SCOPUS, and Google Scholar.

Embedding the 'CoolCuddle' intervention for infants undergoing therapeutic hypothermia for hypoxic-ischaemic encephalopathy in NICU: an evaluation using normalisation process theory.

Objectives: Newborn infants exposed to lack of oxygen and blood flow to the brain around birth may develop brain dysfunction (hypoxic-ischaemic encephalopathy-HIE). These infants undergo 72 hours of cooling therapy and most are not held by their parents in the UK. We examined the implementation of 'CoolCuddle', identifying factors that impact embedding of this complex intervention in neonatal intensive care units (NICUs) across England.

Predictive Ability of the Pedal Medial Arterial Calcification Score for Major Adverse Limb Events Among Patients with Chronic Limb-Threatening Ischemia.

Background: Pedal medial arterial calcification (pMAC) is a potential predictor of major adverse limb events (MALEs) among patients with critical limb-threatening ischemia (CLTI). This study aims to validate the prognostic value of the pMAC score in predicting major lower-limb amputation (MLLA) and need for redo revascularisation.

Methods: A single-center study involving 196 patients diagnosed with CLTI, reviewed between 2012 and 2022.

Innovation in Catheter-Directed Therapy for Intermediate-High-Risk and High-Risk Pulmonary Embolism.

Although anticoagulation remains the cornerstone treatment for patients with acute pulmonary embolism (PE), catheter-directed therapy (CDT) has generated great interest as an adjunctive option for those presenting with hemodynamic decompensation or high risk for deterioration and in whom systemic thrombolysis has failed or is contraindicated. However, randomized controlled data supporting the efficacy and safety of CDT in addition to antithrombotic therapy in patients with high-risk and intermediate- to high-risk PE compared with anticoagulation and systemic thrombolysis alone are lacking. This paucity of high-quality data hampers guideline recommendations regarding the optimal therapeutic approach in such patients with PE.

Hypothermia versus normothermia in patients with cardiac arrest and shockable rhythm: a secondary analysis of the TTM-2 study.

Background: The aim of this study was to assess whether hypothermia increased survival and improved functional outcome when compared with normothermia in out-of-hospital cardiac arrest (OHCA) patients with similar characteristics than in previous randomized studies showing benefits for hypothermia.

Methods: Post hoc analysis of a pragmatic, multicenter, randomized clinical trial (TTM-2, NCT02908308). In this analysis, the subset of patients included in the trial who had similar characteristics to patients included in one previous randomized trial and randomized to hypothermia at 33 °C or normothermia (i.

Evaluation of Surgical Site Infection Rates in Traumatic Surgical Fixation and Arthroplasty Performed in Laminar Flow Versus Non-laminar Flow Theatres During the COVID Pandemic.

Introduction Laminar flow (LF) in theatres has become the standard of care in orthopaedic implant surgery. Most of the evidence for laminar flow use is based on arthroplasty surgery, with early studies showing a significant reduction in infections. We conducted a retrospective comparative study to assess surgical site infection (SSI) rates in consecutive patients undergoing surgery for trauma in LF and non-laminar flow (NLF) theatres.

Considering best practice standards for routine whole-genome sequencing for TB care and control.

TB is a priority pathogen for the application of whole-genome sequencing (WGS) into routine public health practice. In low-incidence settings, a growing number of services have begun to incorporate routine WGS into standard practice. The increasing availability of real-time genomic information supports a variety of aspects of the public health response, including the detection of drug resistance, monitoring of laboratory and clinical practices, contact tracing investigations and active case finding.

The recurrence of disease activity after ocrelizumab discontinuation in multiple sclerosis.

Introduction: Ocrelizumab (OCR) is a highly effective treatment of multiple sclerosis (MS), and B cell repopulation profiles suggest that it might be used as an immune reconstitution therapy. However, data on disease recurrence after stopping treatment with OCR are scarce. Our objective was to evaluate the recurrence of disease activity after OCR discontinuation.

Cost-effectiveness of surgical interventions in low-income and middle-income countries: a systematic review and critical analysis of recent evidence.

Background: Cost-effectiveness evidence is a critical tool to support resource allocation decisions. There is growing recognition that the development of benefit packages for surgical care should be guided by such evidence, particularly in resource-constraint settings.

Methods: We conducted a systematic review of evidence (Medline, Embase, Global Health, EconLit and grey literature) on the cost-effectiveness of surgery across low-income and middle-income countries published between January 2013 and January 2023.

Resistance- and endurance-trained young men display comparable carotid artery strain parameters that are superior to untrained men.

Purpose: Central arterial stiffness, a predictor of cardiovascular risk, attenuates with endurance-exercise in ageing populations. However, in young individuals, this effect is inconsistent and emerging evidence suggests resistance-exercise may increase arterial stiffness. Two-dimensional (2D)-Strain imaging of the common carotid artery (CCA) is more sensitive at detecting endurance-training induced alterations in CCA stiffness than conventional methods, but has not been used to examine CCA stiffness in young resistance-trained individuals.