Adapting to Change: The Evolution of the Specialty Training Level 3 (ST3) Trauma and Orthopaedics Selection Process Before, During, and After the COVID-19 Pandemic.

The selection process for Specialty Training Level 3 (ST3) in trauma and orthopaedics is a pivotal yet challenging step for aspiring orthopaedic surgeons. Drawing on personal experience and research, this paper aims to provide a comprehensive analysis of the ST3 selection process, outlining the key stages, including application submission, portfolio evaluation, and interview performance. With recent changes, such as evolving self-assessment scoring criteria and the introduction of a communication station in 2024, candidates face an increasingly dynamic and competitive landscape.

BENNETT'S FRACTURE: A NARRATIVE REVIEW OF CURRENT LITERATURE.

Background: Bennett's fracture, a fracture-dislocation of the base of the first metacarpal, poses significant challenges due to the unique biomechanics of the thumb's carpometacarpal (CMC) joint. Effective management is critical to restoring thumb function and preventing long-term complications such as arthritis and instability.

Objective: This article provides a comprehensive overview of Bennett's fracture, including its mechanism of injury, diagnostic considerations, and management strategies, with a focus on conservative and surgical options.

Genotype-Guided Asthma Treatment Reduces Exacerbations in Children: Meta-Analysis of Two RCTs.

Background: Long-acting beta2-agonists (LABA) in combination with inhaled corticosteroids (ICS) are commonly used to treat asthma, however, some children lack response to the addition of LABA. This might be partially due to the presence of the Arg16Gly polymorphism, encoded by rs1042713 G>A in the ADRB2 gene. Carrying the A allele (Arg16) at this variant has been associated with an increased risk of exacerbations despite LABA treatment.

Experience of conductive hearing loss and impacts of hearing aid use throughout life.

Introduction: Hearing loss and Deafness/deafness affects as much as 5% of the world's population and has a considerable health and economic burden. We explored the relationship with hearing and hearing aids as well as other assistive technology for health in general with a cohort of UK adults who have conductive hearing loss. We anticipated that insights could lead to greater understanding for the delivery of assistive technology (AT) for conductive hearing loss and the participant's lived experience related to technology and society.

The impact of psoriatic arthritis on quality of life: a systematic review.

Background: Psoriatic arthritis (PsA) is a chronic inflammatory condition that can affect individuals of all ages. Patients may experience a range of physical and psychological issues.

Objective: To examine the impact of PsA on an individual's quality of life (QoL) and physical function.

Evaluating the Role of Maximal Expiratory Flow at 25% (MEF-25) in Detecting and Managing Patients With Small Airway Disease in the United Arab Emirates.

Middle Eastern countries, such as the United Arab Emirates and Oman, are affected by frequent dust storms and extreme hot climatic conditions, which can exacerbate respiratory conditions. These environmental factors are particularly injurious to asthmatic patients, as they can aggravate small airway disease (SAD), leading to increased morbidity and healthcare challenges. The evaluation of maximal mid-expiratory flow (MEF-25) as a diagnostic and therapeutic tool for early-stage small airway dysfunction is of significant clinical importance, particularly in hot and arid metropolitan environments where dusty conditions exacerbate pulmonary issues.

A Retrospective Audit of Osteoporosis Management Following Fragility Fractures in a Hospital Setting.

Background Fragility fractures, often caused by osteoporosis, are a major public health concern among the growing population of the United Kingdom (UK). In addition to being a major source of illness and mortality, the rising incidence of osteoporosis places a heavy strain on healthcare systems if it is not adequately managed. In order to lower the risk of additional fractures, current guidelines place a strong emphasis on the timely evaluation and treatment of fragility fractures.

The microbiome and the eye: a new era in ophthalmology.

The human microbiome has progressively been recognised for its role in various disease processes. In ophthalmology, complex interactions between the gut and distinct ocular microbiota within each structure and microenvironment of the eye has advanced our knowledge on the multi-directional relationships of these ecosystems. Increasingly, studies have shown that modulation of the microbiome can be achieved through faecal microbiota transplantation and synbiotics producing favourable outcomes for ophthalmic diseases.

Evaluating the home-based intervention strategy (HIS-UK) to reduce new chlamydia infection among young men aged 16-25 years by promoting correct and consistent condom use: findings from a randomised controlled trial.

Background: Correct and consistent condom use is the most effective method to reduce transmission of sexually transmitted infections (STIs).

Objective: To compare the HIS-UK intervention to usual condom information and distribution care for effect on chlamydia test positivity.

Methods: Trial design A 3-parallel arm randomised controlled trial (1:1:1 allocation, two intervention arms vs.

Neurophobia amongst medical students: Hype or reality.

Introduction: 'Neurophobia' is a well reported phenomenon in the literature where in medical students and junior doctors have an inherent nervousness or 'fear' of neurology and neurosurgery

Research Question: Why do less medical students choose neurology and neurosurgery as a career and identify if neurophobia is an ingrained belief or learned behaviour?

Materials And Methods: We developed a questionnaire to assess medical student views and beliefs in connection with a career in neurosurgery. Specifically we examined the following domains: considering a career in neurology and neurosurgery, confidence with neuro anatomy and pathology, traits associated with neurosurgeons and neurologists and finally, their perceived barriers to a neuro career.

Results: 264 medical students completed the survey.

Bilateral Urrets-Zavalia syndrome after uneventful Descemet membrane endothelial keratoplasty.

Urrets-Zavalia syndrome (UZS) stands out as a rare yet clinically consequential complication associated with ophthalmic surgery, marked by the emergence of a fixed and dilated pupil. While it was originally described post-penetrating keratoplasty (PKP) in patients with keratoconus and its prevalence is notably higher following PKP, instances of UZS have been documented in the context of other procedures, including intraocular lens implantation, Descemet-stripping endothelial keratoplasty and Descemet membrane endothelial keratoplasty (DMEK). We report a unique case of bilateral UZS after uneventful DMEK surgeries, highlighting a rare but potential complication after DMEK.

Lenacapavir: Patient and healthcare provider perceptions and the potential role for a twice-yearly injectable HIV treatment.

Background: The twice-yearly, long-acting lenacapavir (LA LEN) antiretroviral therapy (ART), when combined with an optimised background regimen, provides a subcutaneous injectable treatment option for people with HIV. This study aimed to understand the preferences, barriers and facilitators for uptake and implementation of LA LEN, with a view to informing clinical implementation.

Methods: In-depth qualitative interviews and focus groups with purposively sampled people with HIV and healthcare workers (HCWs) from UK HIV services were conducted.

Gastrointestinal in men who have sex with men: A systematic review.

Objective: This systematic review aimed to explore any demographic, biological and behavioural characteristics of men who have sex with men (MSM) with diarrhoeagenic .

Design/methods: We searched MEDLINE, EMBASE, and CINAHL for manuscripts published to March 2024. One author screened manuscript abstracts; two authors independently conducted a full text review.

The role of the gut microbiome in regulating the response to immune checkpoint inhibitor therapy.

Immune checkpoint inhibitors (ICIs) have revolutionised cancer therapy, yet the proportion of patients who achieve long-term disease control remain suboptimal. Over the past decade, the gut microbiome has been shown to influence immune-mediated tumour suppression as well as responses to ICI therapies. Compositional differences in gut microbiome may account for the differences in outcomes from immune checkpoint blockade.

Sunscreens: A narrative review.

Sunscreens are topical formulations incorporating filters that protect our skin against ultraviolet radiation (UVR) emitted by the sun. Sunscreen use has been increasingly encouraged to protect against sunburn, skin cancer and photoaging that can occur because of prolonged and cumulative sun exposure. However, sunscreens and their constituent UVR filters have been purported to be problematic themselves.

Greater Trochanteric Pain Syndrome and the Efficacy of Platelet-Rich Plasma Injections: A Systematic Review.

Greater trochanteric pain syndrome (GTPS) is one of the most prevalent causes of lateral hip pain. The incidence rate is as high as 1.8 patients per 1000 annually, with females predominantly affected.

Understanding the effectiveness and quality of virtual cancer multidisciplinary team meetings (MDTMs): a systematic scoping review.

Introduction: Cancer multi-disciplinary team meetings (MDTM) assemble clinical experts to make diagnostic and treatment recommendations. MDTMs can take place in person, virtually, or in a hybrid format. Virtual and hybrid MDTMs have been in use for over two decades.

Managing cognitive impairment in people with HIV.

Purpose Of Review: To describe patient-centred multiciplinary management and care of people with HIV presenting with cognitive disorders.

Recent Findings: In the era of effective antiretroviral therapy a comprehensive, multifactorial approach to assessing and managing cognitive impairment in people with HIV is required. The complexity of cognitive disorders in this population demands more than current guidelines offer, which focus primarily on HIV management, overlooking broader clinical, psychological, and social factors.

Neurological complications of immune checkpoint inhibitors: a practical guide.

Immune checkpoint inhibition unleashes the power of the immune system against tumour cells. Immune checkpoint inhibitors (ICIs) block the inhibitory effects of cytotoxic T-lymphocyte associated protein 4, programmed death protein 1, programmed death ligand 1 and lymphocyte activation gene 3 molecules on T-cells, and so enhance physiological cytotoxic effects. ICIs can significantly improve survival from cancers, including those previously associated with poor treatment response, such as metastatic melanoma.

Correction to "Effectiveness of an unguided modular online intervention for highly anxious parents in preventing anxiety in their children: a parallel group randomised controlled trial" [The Lancet Regional Health - Europe, Volume 45, October 2024, 101038].

[This corrects the article DOI: 10.1016/j.lanepe.