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Cardiac prehabilitation, rehabilitation and education in first-time atrial fibrillation (AF) ablation (CREED AF): Study protocol for a randomised controlled trial.Atrial fibrillation (AF) is a common arrhythmia [1–3] and is independently associated with increased morbidity and all-cause mortality [3–8]. Two-thirds of people with AF have at least intermittent symptoms which can be disabling and can markedly impair health-related quality of life (HRQoL) [9, 10]. Furthermore, AF is a growing epidemic due to the ageing population, chronic cardiovascular diseases, and the accumulation of AF related risk factors, such as diabetes, obesity, hypertension, alcohol, and smoking [6, 11, 12]. Current AF management is largely focused on stroke prevention via anticoagulation, and heart failure prevention with ventricular rate or rhythm control strategies (anti-arrhythmic drugs and catheter or surgical ablation) [3, 13] and is a top priority in the UK National Health Service (NHS) long-term plan [14]. Although current strategies can be effective in the short term, long-term success is limited and there is a failure to address key patient outcomes including exercise capacity and HRQoL.
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Common Clinical Trial Amendments, why they are submitted and how they can be avoided: a mixed methods study on NHS UK Sponsored Research (Amendments Assemble)Amendments are changes made to a clinical trial after it has received regulatory approval. An amendment can take a significant amount of time and resources to develop, review and implement at participating sites. This can affect the efficient delivery of clinical trials and potentially contribute to research waste. This study aimed to establish what the most common amendments are, why they are submitted, and what, if anything, can be done to avoid them.
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Psychometric sensitivity analyses can identify bias related to measurement properties in trials that use patient-reported outcome measures : a secondary analysis of a clinical trial using the disabilities of the arm, shoulder and hand (DASH) questionnaireObjectives: Demonstrate psychometric sensitivity analyses for testing the stability of study findings to assumptions made about patient-reported outcome measures (PROMs).
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Evaluation of tumour infiltrating lymphocytes in luminal breast cancer using artificial intelligence.Background: Tumour infiltrating lymphocytes (TILs) are a prognostic parameter in triple-negative and human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC). However, their role in luminal (oestrogen receptor positive and HER2 negative (ER + /HER2-)) BC remains unclear. In this study, we used artificial intelligence (AI) to assess the prognostic significance of TILs in a large well-characterised cohort of luminal BC.
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The roles of DGAT1 and DGAT2 in human myotubes are dependent on donor patho-physiological backgroundThe roles of DGAT1 and DGAT2 in lipid metabolism and insulin responsiveness of human skeletal muscle were studied using cryosections and myotubes prepared from muscle biopsies from control, athlete, and impaired glucose regulation (IGR) cohorts of men. The previously observed increases in intramuscular triacylglycerol (IMTG) in athletes and IGR were shown to be related to an increase in lipid droplet (LD) area in type I fibers in athletes but, conversely, in type II fibers in IGR subjects.
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Variation in Experiences and Attainment in Surgery Between Ethnicities of UK Medical Students and Doctors (ATTAIN): Protocol for a Cross-Sectional Study.Background: The unequal distribution of academic and professional outcomes between different minority groups is a pervasive issue in many fields, including surgery. The implications of differential attainment remain significant, not only for the individuals affected but also for the wider health care system. An inclusive health care system is crucial in meeting the needs of an increasingly diverse patient population, thereby leading to better outcomes. One barrier to diversifying the workforce is the differential attainment in educational outcomes between Black and Minority Ethnic (BME) and White medical students and doctors in the United Kingdom. BME trainees are known to have lower performance rates in medical examinations, including undergraduate and postgraduate exams, Annual Review of Competence Progression, as well as training and consultant job applications. Studies have shown that BME candidates have a higher likelihood of failing both parts of the Membership of the Royal Colleges of Surgeons exams and are 10% less likely to be considered suitable for core surgical training. Several contributing factors have been identified; however, there has been limited evidence investigating surgical training experiences and their relationship to differential attainment. To understand the nature of differential attainment in surgery and to develop effective strategies to address it, it is essential to examine the underlying causes and contributing factors. The Variation in Experiences and Attainment in Surgery Between Ethnicities of UK Medical Students and Doctors (ATTAIN) study aims to describe and compare the factors and outcomes of attainment between different ethnicities of doctors and medical students.