Development, implementation, and evaluation of an innovative clinical trial operations training program for Africa (ClinOps).

Background: Africa's involvement in clinical trials remains very low. Although the crucial role of training initiatives in building clinical trial capacity in Africa has been documented, current efforts fall short as they lack alignment with local contexts. This study aimed to design, develop, implement, and evaluate an innovative clinical trial operations training program for Africa.

A systematic in vitro study of the effect of normoglycaemic and hyperglycaemic conditions on the biochemical and cellular interactions of clinically-available wound dressings with different physicochemical properties.

Diabetic foot, leg ulcers and decubitus ulcers affect millions of individuals worldwide leading to poor quality of life, pain and in several cases to limb amputations. Despite the global dimension of this clinical problem, limited progress has been made in developing more efficacious wound dressings, the design of which currently focusses on wound protection and control of its exudate volume. The present in vitro study systematically analysed seven types of clinically-available wound dressings made of different biomaterial composition and engineering.

The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer.

Biliary tract cancers (BTC) are a highly heterogeneous group of cancers at the genomic, epigenetic and molecular levels. The vast majority of patients initially present at an advanced (unresectable) disease stage due to a lack of symptoms and an aggressive tumour biology. Chemotherapy has been the mainstay of treatment in patients with advanced BTC but the survival outcomes and prognosis remain poor.

Vanillic acid as a promising intervention for metabolic syndrome: Preclinical studies.

Metabolic syndrome is a clustering of metabolic abnormalities and anthropometric factors that increase the risk of cardiovascular disease and type 2 diabetes mellitus. As the search for effective treatments intensifies, attention has turned towards natural substances with potential medicinal benefits. Among them, vanillic acid, a phenolic acid present in many plants, has attracted some attention due to its wide range of biological activities.

Mediation of the effect of prenatal maternal smoking on time to natural menopause in daughters by birthweight-for-gestational-age z-score and breastfeeding duration: analysis of two UK birth cohorts born in 1958 and 1970.

Background: Prenatal maternal smoking, lower birthweight, and shorter breastfeeding duration have all been associated with an earlier age at menopause in daughters. We estimated the extent to which birthweight-for-gestational-age z-score and breastfeeding duration mediate the effect of prenatal maternal smoking on time to natural menopause in daughters.

Methods: Using pooled data from two prospective birth cohort studies - the 1970 British Cohort Study (n = 3,878) followed-up to age 46 years and the 1958 National Child Development Study (n = 4,822) followed-up to age 50 years - we perform mediation analysis with inverse odds weighting implemented in Cox proportional-hazards models.

Asylum seekers' and refugees' experiences of violence and accessing healthcare in the UK: a systematic review.

Background: This systematic review aimed to characterize the violence, explore the experiences of accessing health services, and highlight any strategies used to improve the access and experiences of healthcare for asylum seekers and refugees in the UK.

Methods: EMBASE, EMCARE, MEDLINE, CINAHL, and Web of Science were searched in February 2024. We included manuscripts that included asylum seekers or refugees who had accessed healthcare settings in the UK.

Development and application of a machine learning-based antenatal depression prediction model.

Background: Antenatal depression (AND), occurring during pregnancy, is associated with severe outcomes. However, there is a lack of objective and universally applicable prediction methods for AND in clinical practice. We leveraged sociodemographic and pregnancy-related data to develop and validate a machine learning-based AND prediction model.

Consent and violence amongst men in the context of sexualised drug use: A systematic scoping review.

Sexualised drug use (SDU) is a highly prevalent phenomenon of increasing public health significance in communities of men who have sex with men (MSM). This prospectively registered PRISMA-ScR-adherent systematic scoping review examines the current state of knowledge surrounding violence amongst MSM in the context of SDU. A broad search was conducted across four databases, with no restrictions.

Management of children with food allergies by allergists in the United States.

Background: Management of patients with food allergies is complex, especially in cases of patients with multiple and potentially severe food allergies. Although international guidelines exist for food allergy management, the role of the allergist in the decision-making process is key.

Objective: Our aim was to investigate the management patterns and educational needs of practicing allergists treating patients with food allergies.

Trees, terraces and llamas: Resilient watershed management and sustainable agriculture the Inca way.

The Inca and their immediate predecessors provide an exceptional model of how to create high-altitude functional environments that sustainably feed people with a diversity of crops, whilst mitigating erosion, protecting forestry and maintaining soil fertility without the need for large-scale burning. A comparison is provided here of landscape practices and impacts prior to and after the Inca, derived from a unique 4200-year sedimentary record recovered from Laguna Marcacocha, a small, environmentally sensitive lake located at the heart of the Inca Empire. By examining ten selected proxies of environmental change, a rare window is opened on the past, helping to reveal how resilient watershed management and sustainable, climate-smart agriculture were achieved.

Self-reports map the landscape of task states derived from brain imaging.

Psychological states influence our happiness and productivity; however, estimates of their impact have historically been assumed to be limited by the accuracy with which introspection can quantify them. Over the last two decades, studies have shown that introspective descriptions of psychological states correlate with objective indicators of cognition, including task performance and metrics of brain function, using techniques like functional magnetic resonance imaging (fMRI). Such evidence suggests it may be possible to quantify the mapping between self-reports of experience and objective representations of those states (e.

Regional and institutional trends in assessment for academic promotion.

The assessment of research performance is widely seen as a vital tool in upholding the highest standards of quality, with selection and competition believed to drive progress. Academic institutions need to take critical decisions on hiring and promotion, while facing external pressure by also being subject to research assessment. Here we present an outlook on research assessment for career progression with specific focus on promotion to full professorship, based on 314 policies from 190 academic institutions and 218 policies from 58 government agencies, covering 32 countries in the Global North and 89 countries in the Global South.

Adapting a consensus process for survivors of domestic abuse and child maltreatment: a brief report about adopting a trauma-informed approach in multistakeholder workshops.

Purpose: Among health researchers, there is a growing appreciation of the importance of the involvement of service users and members of the public. This recognition has not only resulted in involvement guidelines and improved research ethics but also an increasing use of consensus processes with service users and members of the public to determine research priorities and questions and to agree outcomes to be measured in intervention studies. There is, however, limited advice about how to safely involve survivors of violence and abuse in consensus-based studies.

Prognostic Value of the CURL Classification System for Proximal Ulna Fracture Dislocations of the Elbow.

Background: Proximal ulna fracture-dislocations comprise a wide spectrum of injury. The Coronoid, proximal Ulna, Radius and Ligaments (CURL) classification is a simple framework designed to aid surgical decision making by focusing attention on the key components of the injury and their relative severity. It has been demonstrated to have a high inter and intra-observer reliability.

Blood Flow Velocity Analysis in Cerebral Perforating Arteries on 7T 2D Phase Contrast MRI with an Open-Source Software Tool (SELMA).

Blood flow velocity in the cerebral perforating arteries can be quantified in a two-dimensional plane with phase contrast magnetic imaging (2D PC-MRI). The velocity pulsatility index (PI) can inform on the stiffness of these perforating arteries, which is related to several cerebrovascular diseases. Currently, there is no open-source analysis tool for 2D PC-MRI data from these small vessels, impeding the usage of these measurements.

A double dissociation between semantic and spatial cognition in visual to default network pathways.

Processing pathways between sensory and default mode network (DMN) regions support recognition, navigation, and memory but their organisation is not well understood. We show that functional subdivisions of visual cortex and DMN sit at opposing ends of parallel streams of information processing that support visually mediated semantic and spatial cognition, providing convergent evidence from univariate and multivariate task responses, intrinsic functional and structural connectivity. Participants learned virtual environments consisting of buildings populated with objects, drawn from either a single semantic category or multiple categories.

Lacrimal Sac CLL: A Review of Clinical Features, Investigations, and Management.

Purpose: This study reviews all reported cases of lacrimal gland chronic lymphocytic leukemia (CLL) to identify patterns in clinical presentation, diagnosis, and management to aid in early recognition and treatment of this uncommon occurrence.

Methods: A comprehensive search of medical literature databases was performed to identify studies reporting lacrimal sac involvement in CLL from 1970 to 2024. Data were extracted regarding demographics, symptoms, diagnostic methods, treatment, and outcomes.

Vitronectin regulates lung tissue remodeling and emphysema in chronic obstructive pulmonary disease.

Vitronectin (VTN) is an important extracellular matrix protein in tissue remodeling, but its role in COPD is unknown. We show that VTN regulates tissue remodeling through urokinase plasminogen activator (uPA) signaling pathway in COPD. In human COPD airways and bronchoepithelial cells and the airways of mice with cigarette smoke (CS)-induced experimental COPD, VTN protein was not changed, but downstream uPA signaling was altered (increased plasminogen activator inhibitor-1, uPAR) that induced collagen and airway remodeling.

What are the training and support needs for homelessness hostel staff supporting older residents with memory and cognitive problems? A qualitative study.

Background: An increasing number of older people are experiencing homelessness and memory problems, many of whom are supported in temporary hostel accommodation. This can be a challenge for hostel staff who may not have adequate training and support but who often support those with significant memory impairment in their day-to-day work. The study aimed to investigate the training and support that hostel staff require to meet the needs of older hostel residents experiencing memory and cognitive problems, and thus enhance hostel resident quality of life and well-being, considering what additional knowledge, skills, and support hostel staff need to achieve this.

Cultural assumptions and the good death: rethinking global frameworks.

The concept of a 'good death' remains debated, with research largely focused on the Global North, leaving gaps in understanding its relevance to the Global South. While the concept of a good death is not a strict binary, notable differences exist. In the Global North, emphasis often lies on individual autonomy and preferences, whereas in the Global South, the focus tends to include the perspectives and needs of family and social networks.

The adaptive value of recombination in resolving intralocus sexual conflict by gene duplication.

Recombination plays a key role in increasing the efficacy of selection. We investigate whether recombination can also play a role in resolving adaptive conflicts at loci coding for traits shared between the sexes. Errors during recombination events resulting in gene duplications may provide a long-term evolutionary advantage if those loci also experience sexually antagonistic (SA) selection since, after duplication, sex-specific expression profiles will be free to evolve, thereby reducing the load on population fitness and resolving the conflict.

Learning to play to learn in pediatric physical therapy.

Introduction: Play is a way for children to develop and learn about themselves in conjunction with the world. Using play as part of pediatric physical therapy is broadly recommended. This study investigates this integration of play and seeks to answer the research question: How do pediatric physical therapists (PPT) understand and manage embedding play in pediatric physical therapy with children aged 0-3?

Methods: This is a qualitative study in which we connect to an enactive theoretical framework.

Improving Communication and Teamwork Between Resident Doctor Teams Using a Group Messaging Application: A Quality Improvement Project.

Background Communication and teamwork are essential in medicine. Established standards emphasise the importance of collaboration and access to support. Some departments divide doctors into teams; however, inter-team communication is not always efficient.