β-alanine supplementation in adults with overweight and obesity: a randomized controlled feasibility trial.

Objective: Overweight and obesity are characterized by excess adiposity and systemic, chronic, low-grade inflammation, which is associated with several metabolic disorders. The aim of this study was to assess the feasibility and tolerability of β-alanine supplementation and to explore the effects on cardiometabolic health and cardiovascular, hepatic, and renal function in adults with overweight and obesity.

Methods: A total of 27 adults (44% female; mean [SD], age: 58 [10] years, BMI: 31.

Same-day emergency care: a retrospective observational study of the incidence and predictors of venous thromboembolism following hospital-based acute ambulatory medical care.

Background: Same-day emergency care (SDEC) is an expanding area of hospital acute medical care. It aims to minimize delays and manage medical emergency patients within the same day, enabling hospitalization to be avoided; the expectation is that the patients would have required inpatient hospitalization in the absence of the SDEC service. Venous thromboembolism (VTE) prevention is a key medical inpatient safety measure.

Evaluation of Colon Capsule Utilisation in Europe-CAPTURE EU Survey Findings.

Colon capsule endoscopy (CCE) is a non-invasive method for visualising the colon, but its clinical adoption has been slow. Although the COVID-19 pandemic reignited interest in CCE, its role in conventional gastrointestinal investigations remains unclear, leading to varied practices across Europe. This highlights the need for a comprehensive understanding of diverse approaches to CCE in clinical practice.

Preoperative smoking cessation interventions: a systematic review and meta-analysis.

Background: Smoking is the leading single cause of preventable death in England and also increases the risk of postoperative complications. The preoperative period is a potential opportunity to introduce smoking cessation interventions to smokers to reduce the risk of postoperative complications. A systematic search was conducted to find all studies that investigated the effectiveness of preoperative smoking cessation interventions.

Diabetic foot ulcer photography study: a study within a trial to assess the reliability of two-dimensional (2D) photography for the assessment of ulcer healing in patients with diabetes-related foot ulcers-protocol paper.

Background: The primary endpoint in diabetes-related foot ulcer (DFU) trials is often time to healing, defined as complete re-epithelialisation with absence of drainage, requiring clinical expert assessment as the gold standard. Central blinded photograph review for confirmation of healing is increasingly being undertaken for internal validity. The Diabetic Foot Ulcer Photography study aims to determine the agreement between blinded independent review panel members for assessing ulcer healing status in patients with DFUs.

Computerized adaptive testing for PRWHE measurements using domains of pain and motor function.

The Patient-Rated Wrist and Hand Evaluation is an outcome measure for patients with conditions affecting the wrist or hand. We evaluated the structural validity of the Patient-Rated Wrist and Hand Evaluation using psychometric techniques, then developed computerized adaptive testing algorithms. Factor analysis found two health constructs consistent with 'Pain' and 'Motor Function'.

Airway pressures generated by high flow nasal cannula in patients with acute hypoxemic respiratory failure: a computational study.

Introduction And Objectives: High flow nasal cannula (HFNC) therapy is an increasingly popular mode of non-invasive respiratory support for the treatment of patients with acute hypoxemic respiratory failure (AHRF). Previous experimental studies in healthy subjects have established that HFNC generates flow-dependent positive airway pressures, but no data is available on the levels of mean airway pressure (mP) or positive end-expiratory pressure (PEEP) generated by HFNC therapy in AHRF patients. We aimed to estimate the airway pressures generated by HFNC at different flow rates in patients with AHRF, whose functional lung volume may be significantly reduced compared to healthy subjects due to alveolar consolidation and/or collapse.

SPEED (SPlEnic Embolisation Decisions) study-Decision to treat acute traumatic splenic artery injury in the context of trauma protocol.

Background: The spleen is commonly injured in trauma and this may be managed with a conservative approach, embolisation or splenectomy. There is uncertainty how splenic embolisation fits into the treatment paradigm and the delivery of IR services remains variable.

Aims And Objectives: The primary objectives are to determine if service design significantly affects splenic embolisation (SE) rates in AAST grade 2-5 acute traumatic splenic injuries (ATSI) across the Major Trauma Centres (MTCs) in England and to determine if variation in treatment affects SE outcomes in ATSI.

Clinical validation of an artificial intelligence-based decision support system for diagnosis and risk stratification of heart failure (STRATIFYHF): a protocol for a prospective, multicentre longitudinal study.

Introduction: Heart failure (HF) is a complex clinical syndrome. Accurate risk stratification and early diagnosis of HF are challenging as its signs and symptoms are non-specific. We propose to address this global challenge by developing the STRATIFYHF artificial intelligence-driven decision support system (DSS), which uses novel analytical methods in determining the risk, diagnosis and prognosis of HF.

Extrication following a motor vehicle collision: a consensus statement on behalf of The Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh.

Background: Road traffic injury is the leading cause of death among young people globally, with motor vehicle collisions often resulting in severe injuries and entrapment. Traditional extrication techniques focus on limiting movement to prevent spinal cord injuries, but recent findings from the EXIT project challenge this approach. This paper presents updated recommendations from the Faculty of Pre-Hospital Care (FPHC) that reflect the latest evidence on extrication practices.

Evaluating the pathological and clinical implications of errors made by an artificial intelligence colon biopsy screening tool.

Objective: Artificial intelligence (AI) tools for histological diagnosis offer great potential to healthcare, yet failure to understand their clinical context is delaying adoption. IGUANA (Interpretable Gland-Graphs using a Neural Aggregator) is an AI algorithm that can effectively classify colonic biopsies into normal versus abnormal categories, designed to automatically report normal cases. We performed a retrospective pathological and clinical review of the errors made by IGUANA.

Evaluation of Magnetic Ureteric Stents: A Systematic Review and Meta-Analysis.

Magnetic ureteric stents offer a novel approach for simplifying stent removal, minimizing patient discomfort, and reducing procedural burdens. This systematic review and meta-analysis synthesized evidence from 12 studies involving 1,297 patients to evaluate the efficacy and safety of magnetic stent removal compared to conventional methods. Key outcomes included reductions in procedural pain scores, shorter removal times, and high patient satisfaction.

Assessing the Utility of a National Conference on Non-surgical Facial Aesthetics as an Educational Tool: A Survey-based Pilot Study.

Objective: Non-surgical facial aesthetics (NSFA) is a rapidly growing field involving the use of dermal fillers and botulinum toxin for aesthetic enhancement. The aesthetic injectables market is expanding, attracting interest from individuals seeking NSFA procedures. There has also been marked interest among healthcare professionals (HCPs) aspiring to become aesthetic practitioners.

Palliative care management of head and neck cancer patients amongst oral and maxillofacial surgeons: A novel national survey assessing knowledge, decision making, perceived confidence, and training in the UK.

Palliative care strives to improve the quality of life of patients experiencing life-limiting conditions by providing personalised holistic care. Head and neck cancer patients may require palliation at different stages of their disease, thus timely recognition and management is vital when considering supportive care. This study assesses the awareness, perceived confidence, and knowledge of palliative care management of UK-based oral and maxillofacial surgery (OMFS) head and neck surgeons.

Ethical Use of Cadaveric Images in Anatomical Textbooks, Atlases, and Journals: A Consensus Response From Authors and Editors.

Nowadays, consent to use donor bodies for medical education and research is obtained from the body donors and their families before the donation. Recently, the International Federation of Associations of Anatomists (IFAA) published guidelines that could restrict the appearance of cadaveric images in commercial anatomical resources such as textbooks and other educational products. These guidelines state that the donor must expressly consent to using such images for this purpose.

Label credibility correction based on cell morphological differences for cervical cells classification.

Cervical cancer is one of the deadliest cancers that pose a significant threat to women's health. Early detection and treatment are commonly used methods to prevent cervical cancer. The use of pathological image analysis techniques for the automatic interpretation of cervical cells in pathological slides is a prominent area of research in the field of digital medicine.

Intraosseous and intravenous vascular access during adult cardiac arrest: A systematic review and meta-analysis.

Objective: To summarise evidence on the clinical effectiveness of initial vascular attempts via the intraosseous route compared to the intravenous route in adult cardiac arrest.

Methods: We searched MEDLINE and Embase (OVID platform), the Cochrane library, and the International Clinical Trials Registry Platform from inception to September 4th 2024 for randomised clinical trials comparing the intraosseous route with the intravenous route in adult cardiac arrest. Our primary outcome was 30-day survival.

DREAM: an adaptive, randomised, placebo-controlled trial of duloxetine for reducing leg pain in people with chronic sciatica-trial protocol.

Introduction: Sciatica is a debilitating condition that often becomes chronic, and for which there are few effective treatment options. Treatments such as the anti-depressant duloxetine have shown promise, but the evidence is inconclusive. We are describing a high quality, definitive trial to investigate the efficacy, safety and cost-effectiveness of duloxetine in chronic sciatica.

General Practice chest x-ray rate is associated with earlier lung cancer diagnosis and reduced all-cause mortality: a retrospective observational study.

Background: Evidence on whether general practice rates of investigation in symptomatic patients using chest x-ray (CXR) affects outcomes is equivocal.

Aim: Determine if there is an association between rates of general practice (GP) requested CXR and lung cancer outcomes.

Design And Setting: Retrospective observational study (England) Methods: Cancer registry data for patients diagnosed with lung cancer 2014-2018 was linked to data on GP CXRs 2013-2017.

Haemodynamic measurements during hip hemiarthroplasty surgery for hip fracture.

Aims: There is compelling evidence for the use of cemented hip hemiarthroplasty for displaced intracapsular hip fractures; however, the risks of cement are well reported and in rare cases may be associated with haemodynamic collapse. It is therefore important to improve our understanding of haemodynamic instability, intraoperative monitoring, and strategies to reduce the risk to patients.

Methods: We measured arterial blood pressure using the LiDCO Continuous Non-invasive Arterial Pressure (CNAP) finger cuff during surgery in patients enrolled in the WHiTE 5 trial randomized to cemented or modern uncemented hip hemiarthroplasty at a single recruiting site.

Knee-Related Patient-Reported Outcome Measures for Young Adults: A Scoping Meta-Review.

Background: There is a lack of patient-reported outcome measures (PROMs) research on young adults and knee disorders. This scoping meta-review examined a young adult population and aimed to (1) provide an overview of knee-related PROMs research and (2) evaluate the measurement properties of the five most evaluated knee-related PROMs relevant for individual care and group-level analysis.

Methods: A systematic search of the PubMed and COSMIN databases was conducted on 18 September 2023 and updated on 25 November 2024 to identify systematic reviews of knee-related PROMs in young adults.

Maternal and neonatal outcomes following resuscitative hysterotomy for out of hospital cardiac arrest: a systematic review.

Objective: To examine maternal and neonatal outcomes following Resuscitative Hysterotomy for out of hospital cardiac arrest (OHCA) and to compare with timing from cardiac arrest to delivery.

Methods: The review was registered with PROSPERO (CRD42023445064). Studies included pregnant women with out of hospital cardiac arrest and resuscitative hysterotomy performed (in any setting) during cardiac arrest.

A Micro-CT Based Cadaveric Study Investigating Bone Density Changes During Hip Arthroplasty Surgery.

The impact of broaching and uncemented implantation on bone density during total hip arthroplasty (THA) remains unclear. Previous studies have typically examined extracted bone sections, which may not directly correlate with outcomes in human hip systems. This study aimed to evaluate bone density changes resulting from broaching and uncemented implantation using micro-computed tomography (μCT) on cadaveric samples.

Femoral tunnel enlargement after medial patellofemoral ligament reconstruction is common and can be monitored using plain radiographs.

Introduction: medial patellofemoral ligament reconstruction (MPFLr) is a common surgical procedure for treating patellar instability. Grafts can be fixed to the femur using a bone-tunnel technique with an interference screw. However, this may lead to femoral tunnel enlargement (FTE) post-operatively.