A scoping review of formal leadership training in maxillofacial surgery. Are we nurturing or neglecting tomorrow's leaders?

Leadership is increasingly recognised as an essential non-technical skill for effective surgical practice, particularly in oral and maxillofacial surgery (OMFS) due to its multidisciplinary nature and clinical scope. The aim of this review is to identify current leadership development opportunities available to UK OMFS specialty trainees, evaluate their sufficiency, and propose areas for improvement. A comprehensive search of published and grey literature was conducted, screening 2796 articles, with 18 meeting the inclusion criteria.

Metabolic cost of external work: a novel CPET parameter optimises characterisation of exercise performance in obese individuals.

Purpose: Both obesity and cardiorespiratory fitness are crucial determinants of symptoms and prognosis. However, interpreting the gold-standard cardiopulmonary exercise test (CPET) is complicated by increasing body size and varying body composition. We hypothesised that the 'metabolic cost of external work' (or oxygen uptake (ml/min)/workload (Watts); V̇O/W), a body weight-independent determinant of endurance capacity, would reflect metabolic health more accurately than V̇O alone.

Exploring the Association Between COVID-19 and Avascular Necrosis: A Systematic Review.

Avascular necrosis (AVN) has emerged as an extrapulmonary complication associated with COVID-19 and corticosteroids. This review aims to evaluate the association between COVID-19 infection, corticosteroid use, and the development of AVN. We conducted a systematic review following the PRISMA guidelines, searching five databases until May 30, 2024.

Rationale and design of European microCirculatory Resistance and Absolute Flow Team: The Euro-CRAFT Registry.

Introduction: Coronary microvascular dysfunction (CMD) is increasingly recognized as an important cause of anginal symptoms and poor outcomes. Angina with non-obstructive coronary arteries (ANOCA) is often related to CMD. While physiological assessment of microcirculatory function by coronary bolus thermodilution is widely practiced, more precise and reproducible methodology as well as systematic assessment are necessary.

Second cancers in 475 000 women with early invasive breast cancer diagnosed in England during 1993-2016: population based observational cohort study.

Objective: To describe long term risks of second non-breast primary cancers and contralateral breast cancers among women with early invasive breast cancer after primary surgery.

Design: Population based observational cohort study.

Setting: Routinely collected data from the National Cancer Registration and Analysis Service for England.

Safety and immunogenicity of the ChAdOx1 nCoV-19 (AZD1222) vaccine in children aged 6-17 years: Final results of a phase 2, single-blind, randomised controlled trial (COV006).

Background: Paediatric COVID-19 vaccination programmes were initiated in response to the coronavirus pandemic declared by the World Health Organisation (WHO) in 2020. Ten COVID-19 vaccines received WHO Emergency Use Listing, however, only five were approved for use in children. ChAdOx1 nCoV-19 (AZD1222) was approved in adults in a two-dose regimen.

Development and evaluation of the first fertility preservation patient decision aid to support boys and young men with cancer: The Cancer, Fertility and Me for Boys and Young Men research protocol.

Introduction: Many cancer treatments can result in reduced fertility, impacting survivors' opportunities for biological parenthood. Fertility preservation (FP) methods for boys and young men, such as cryopreservation of testicular tissue or sperm, offer hope but are currently underused among young male patients with cancer. Despite guidelines recommending early discussion of fertility implications, many newly diagnosed males do not receive FP counselling or referral to fertility services.

Safety and efficacy of preoperative embolization in the treatment of brain arteriovenous malformations with perinidal aneurysms and single draining vein: a multicenter study with propensity score-weighting.

Background And Objectives: Arteriovenous malformations (AVMs) with perinidal aneurysms and single draining vein are associated with an elevated risk of rupture and increased procedural complexity. The role of preoperative embolization in this high-risk anatomical subset remains unclear. This study aimed to evaluate the safety and efficacy of microsurgery with preoperative embolization, compared with microsurgery alone in patients with such AVMs.

Evidence-Generated Sockets for Transtibial Prosthetic Limbs Compared With Conventional Computer-Aided Designs: A Multiple-Methods Study From the Patient's Perspective.

Background: Personalized prosthetic socket design depends upon highly skilled prosthetists. They aim to balance functional human-prosthesis coupling with safe, comfortable load transmission from the prosthesis to the skeleton, through vulnerable skin and soft tissues. Both traditional plaster and computer-aided design and manufacturing (CAD/CAM) methods are iterative, and sharing knowledge is difficult.

Hybrid closed-loop systems in UK type 1 diabetes care: National survey of healthcare professional awareness, confidence, and training needs.

Aims: Hybrid closed-loop (HCL) systems significantly improve glycaemia and have become the standard of care for type 1 diabetes (T1D), leading to the recent widescale implementation programme in England and Wales. Limited data exist regarding UK healthcare professionals' (HCPs) confidence and experience with commercially available HCL systems. This survey aimed to evaluate UK HCPs' awareness, confidence, and training needs concerning commercial HCL systems.

EMQN best practice guidelines for analysis and reporting of microsatellite instability in solid tumours.

Microsatellite instability (MSI) is the accumulation of insertion and deletion variants (instability) in short tandem repeat DNA sequences (microsatellites). High levels of MSI occur following loss of function of the DNA mismatch repair system (MMR). MMR deficiency is an increasingly important cancer biomarker that is associated with chemotherapy resistance and response to immune checkpoint blockade, as well as one of the commonest hereditary cancer syndromes, Lynch syndrome.

Academic Department of Military Surgery and Trauma (ADMST): preparedness for the next conflict through collaboration in research and innovation.

The UK Strategic Defence Review 2025 provides a compelling examination of the threats faced by the UK. The UK as a whole, and the Ministry of Defence in particular, must become ready for large-scale conflict operations (LSCO) and learn the lessons from Ukraine. A successful academic military surgical department should regularly re-evaluate its mission, its surgical priorities and its outputs.

Improving Compliance With the British Orthopaedic Association Standards for Trauma and Orthopaedics (BOAST) Guidelines for Early Weight Bearing Following Ankle Fracture Fixation: A Closed-Loop Audit From a UK District General Hospital.

Background Ankle fractures are common injuries, and in many cases, operative treatment is required. While the indications for surgical fixation are well established, the optimal timing for weight bearing after open reduction and internal fixation (ORIF) remains controversial. Some surgeons continue to favour a conservative approach involving delayed weight bearing, whereas others encourage early mobilisation.

Best Oculomotor Endpoints for Clinical Trials in Hereditary Ataxias: A Systematic Review and Consensus by the Ataxia Global Initiative Working Group on Digital‑Motor Biomarkers.

Oculomotor deficits are common in hereditary cerebellar ataxias (HCAs) and their quantitative assessment offers a sensitive and reliable manner to capture disease-severity and progression. As a group of experts of the Ataxia Global Initiative to support trial readiness, we previously established harmonized methodology for quantitative oculomotor assessments in HCAs. Here, we aimed to identify to most promising oculomotor/vestibular outcomes as endpoints for future trials.

Red Cell Transfusion During Pediatric Intensive Care: A 28-Day Point Prevalence Study in Three European Countries in 2023.

Objectives: To describe the prevalence of RBC transfusion in children admitted to PICUs in three European countries and to determine hemoglobin threshold, triggers, and outcomes for transfusions.

Design: International 4-week point prevalence study in 2023.

Setting: Forty-four PICUs across Spain, the United Kingdom, and Italy.

Nivolumab and Ipilimumab for Metastatic Castration-Resistant Prostate Cancer With an Immunogenic Signature: The Multicenter, Two-Cohort, Phase II NEPTUNES Study.

Purpose: Efficacy of immune checkpoint inhibitors in unselected patients with metastatic castration-resistant prostate cancer (mCRPC) is limited. The NEPTUNES study evaluated combination nivolumab and ipilimumab in patients with immunogenic signature-positive (ImS+) mCRPC.

Materials And Methods: This open-label, 2-cohort, phase II trial enrolled patients with ImS+ mCRPC progressing on ≥1 previous line of treatment.

Pain after subcutaneous implantable cardioverter-defibrillator implantation: A secondary analysis of the PRAETORIAN-DFT trial.

Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) overcomes transvenous lead-related complications. Its extrathoracic design results in a generator twice the size of transvenous ICDs.

Objective: We investigated pain after S-ICD implantation and explore predictors for severe pain.

Quality of life (QoL) following transoral robotic surgery (TORS) resection of parapharyngeal space tumours.

Introduction: Parapharyngeal space tumours (PSTs) can be challenging to manage in view of their distinct location and proximity to vital neurovascular structures. Numerous surgical approaches have been described including minimally invasive techniques utilising transoral robotic surgery (TORS). This study aims to evaluate the role of TORS in the management of PSTs with a special focus on quality of life (QoL) outcomes.

Is age associated with different vital signs in adults presenting to hospital with bacterial infection? A systematic review and meta-analysis.

Background: It has long been suspected that the vital sign abnormalities that accompany bacterial infection are subtle or absent in older adults. This review summarises the evidence for whether older adults present with different vital sign abnormalities to younger adults when hospitalised with bacterial infection.

Methods: MEDLINE, EMBASE and CINAHL EBSCO were searched from inception to 19 December 2024 for English-language research articles of patients hospitalised with bacterial infection reporting age and admission vital signs.

Management of paediatric ulcerative colitis, part 1: Ambulatory care-An updated evidence-based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organisation.

Objectives: Despite advances in the management of ambulatory paediatric ulcerative colitis (UC), challenges remain as many patients are refractory to therapy and some require colectomy. The aim of these guidelines is to provide an update on optimal care for UC through detailed recommendations and practice points.

Methods: These guidelines are an update to those published in 2018 and are a joint effort of the Paediatric IBD Porto group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organisation.

Innovations and strategies for effective implementation of post pregnancy contraception services: Learnings from the FIGO PPIUD initiative.

The global unmet need for contraception continues to be unacceptably high at 218 million. The vast majority of these are women living in low and middle income countries, with a particularly high unmet need in the postpartum period. The FIGO PPIUD initiative demonstrated that it is feasible to embed counselling on contraception and insertion of PPIUD in maternity services.