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Background: Despite significant changes in healthcare, work practices, and leisure activity, the proposed precipitating factors for abdominal wall hernias have remained largely unchanged for almost two centuries. We aimed to investigate if there have been shifts in these factors over time by examining patients' perception of precipitating factors for abdominal wall hernia development. This study was conducted in the Royal College of Surgeons In Ireland Department of Surgery, Connolly Hospital, Blanchardstown, Dublin, where patients with abdominal wall hernias completed a questionnaire. Results: A total of 277 patients (mean age 55.7; 85.6% male) with abdominal wall hernia completed the questionnaire (66.1% inguinal; 10.8% umbilical; 6.9% paraumbilical; 10.5% epigastric; 3.2% incisional; 1.4% femoral, and 1.1% port-site). One hundred and twenty patients (43.3%) believed their hernia was due to lifting, 71 (25.6%) cited gym activity and 17 (6.1%) cited other sporting activities as the precipitating factor. Traditional factors – chronic cough and constipation - were cumulatively cited only by 11 patients (4.0%), while prostatic obstruction was not cited by any. Conclusion: This study suggests that fitness pursuits may be an increasing contributor to the development of abdominal wall hernia. Greater attention should be paid to the proper use of gym equipment to minimise the risk of hernia development. Key findings: Almost one quarter of patients attributed their hernia to gym activity which should be further explored in prospective studies. This potentially reflects changes in work practice and lifestyle. Traditional causes like chronic cough and constipation were rarely cited, probably reflecting improved healthcare and lifestyle practices. [ABSTRACT FROM AUTHOR]

Background and aims: Second‐generation direct‐acting antivirals (2G DAA) to cure HCV have led to dramatic clinical improvements. HCV‐associated hepatocellular carcinoma (HCC), however, remains common. Impaired immune tumor surveillance may play a role in HCC development. Our cohort evaluated the effects of innate immune types and clinical variables on outcomes including HCC. Methods: Participants underwent full HLA class I/KIR typing and long‐term HCV follow‐up. Results: A total of 353 HCV+ participants were followed for a mean of 7 years. Cirrhosis: 25% at baseline, developed in 12% during follow‐up. 158 participants received 2G DAA therapy. HCC developed without HCV therapy in 20 subjects, 24 HCC after HCV therapy, and 10 of these after 2G DAA. Two predictors of HCC among 2G DAA‐treated patients: cirrhosis (OR, 10.0, p = 0.002) and HLA/KIR profiles predicting weak natural killer (NK) cell‐mediated immunity (NK cell complementation groups 6, 9, 11, 12, OR of 5.1, p = 0.02). Without 2G DAA therapy: cirrhosis was the main clinical predictor of HCC (OR, 30.8, p < 0.0001), and weak NK‐cell‐mediated immunity did not predict HCC. Conclusion: Cirrhosis is the main risk state predisposing to HCC, but weak NK‐cell‐mediated immunity may predispose to post‐2G DAA HCC more than intermediate or strong NK‐cell‐mediated immunity. [ABSTRACT FROM AUTHOR]

In recent years, there has been increasing interest in developing detectors which are sensitive to sub-GeV dark matter and low-energy events from coherent neutrino scattering. Due to carbon's light atomic weight and its tendency to form crystals with high-energy, long-lived phonon modes, carbon-based crystals (including diamond and silicon carbide (SiC)) present themselves as natural target materials for scattering-based searches in this regime. We present our preliminary results in adapting our TES-based detectors to these substrates, specifically 4-H SiC and polycrystalline diamond. We focus on our fabrication efforts, specifically tuning the transition temperature ( T C ) of tungsten films sputtered on these materials, as well as our advancement toward fabricating and testing devices on these substrates. [ABSTRACT FROM AUTHOR]

This article reviews Éilís Ní Dhuibhne's career as a teacher of creative writing at University College Dublin and demonstrates her formidable contribution to the theory and practice of creative writing teaching. It draws from the 2011 symposium which she organised on the teaching and learning of creative writing in Ireland, and the subsequent publication Imagination in the Classroom, which she co-edited. Together the symposium and publication can be seen as the context in which the teaching of creative writing in Irish higher-level institutions assumed the mantle of an autonomous, professional discipline. [ABSTRACT FROM AUTHOR]

Objectives: Stakeholder involvement has long been considered a success factor for a joint European health technology assessment (HTA) process, and its relevance is now anchored in the EU HTA Regulation's (EU HTAR) legislative wording. Therefore, we aimed to explore the roles, challenges, and most important activities to increase the level of involvement per stakeholder group. Methods: At the 2022 Fall Convention of the European Access Academy (EAA), working groups addressed the involvement of patients, clinicians, regulators, health technology developers (HTD), and national HTA bodies and payers within the EU HTA process. Each working group revisited the pre-convention survey results, determined key role characteristics for each stakeholder, and agreed on the most important activities to fulfill the role profile. Finally, the activities suggested per group were prioritized by plenary group. Results: The prioritized actions for patients included training and capacity building, the establishment of a patient involvement committee, and the establishment of a patient unit at the EC secretariat. For clinicians, it included alignment on evidence assessment from a clinical vs. HTA point of view, capacity building, and standardization of processes. The most important actions for regulators are to develop joint regulatory-HTA guidance documents, align processes and interfaces under the regulation, and share discussions on post-licensing evidence generation. HTDs prioritized scientific advice capacity and the review of the scoping process, and further development of the scope of the assessment report fact checks. The top three actions for national HTA bodies and payers included clarification on the early HTD dialogue process, political support and commitment, and clarification on financial support. Conclusions: Addressing the activities identified as the most important for stakeholders/collaborators in the EU HTA process (e.g., in the implementation of the EU HTA Stakeholder Network and of the guidance documents developed by the EUnetHTA 21 consortium) will be key to starting an "inclusive civil society dialogue", as suggested by the European Commission's Pharmaceutical Strategy. [ABSTRACT FROM AUTHOR]

Research is scarce about the lexical processes undertaken by thousands of L2 learners worldwide who already command one or more languages. Some aspects involved in lexical organisation and production, such as clustering and switching, have been traditionally approached through manual methods, which depend on subjective judgments of semantic relatedness between words. The present study seeks to provide a more objective exploration of EFL lexical production and organisation strategies of two rather similar groups of 12th grade learners of EFL as L2 and L3 via a distributional semantic analysis of semantic fluency. In addition to common measures of vocabulary performance, such as number of words produced, a series of lexical organisation and production strategies along with global and local semantic relatedness metrics will be examined. No differences were found about word frequency. While the L3 group used more word classes and cognates, and produced more idiosyncratic responses, the L2 group excelled in most semantic relatedness variables. These results might be due to the presence of the third language in the L3 group, which might be partly interacting with the other background languages. Evidence on these aspects may inform the development of precise language learning strategies adapted to the learner's linguistic profile. [ABSTRACT FROM AUTHOR]

Habitat fragmentation can increase the chance of population bottlenecks and inbreeding, and may ultimately lead to reduced fitness and local extinction. Notelaea lloydii is a native olive species endemic to Australia and listed as vulnerable due to its restricted distribution. A recent molecular systematics study has revealed there might be some geographic structuring among N. lloydii populations. Therefore, we undertook a genome‐wide single nucleotide polymorphism (SNP) analysis to determine levels and patterns of genetic diversity, inbreeding and gene flow within and among N. lloydii populations in south‐eastern Queensland. Furthermore, as the reproductive phase of a plant's life history has a profound influence on genetic diversity, life history reproductive traits were also studied. Our SNP analysis revealed low genetic diversity, inbreeding and significant genetic structuring even among proximate populations. Results of a flower and fruit bagging experiment in two consecutive seasons revealed that N. lloydii produced many flowers but only a few fruits survived to maturity. There were no differences in bagged and un‐bagged flowering and fruiting rates, and therefore, we conclude that the high fruit abortion rate was probably due to inbreeding depression and/or suboptimal conditions, rather than pollinator availability and insect attack. Overall, results of this study indicate that the populations of N. lloydii are small, inbred and genetically isolated and represent unique management units that require local conservation management due to ongoing threats associated with urbanisation. [ABSTRACT FROM AUTHOR]

Purpose: Prostate biopsy is central to the accurate histological diagnosis of prostate cancer. In current practice, the biopsy procedure can be performed using a transrectal or transperineal route with different technologies available for targeting of lesions within the prostate. Historically, the biopsy procedure was performed solely by urologists, but with the advent of image-guided techniques, the involvement of radiologists in prostate biopsy has become more common. Herein, we discuss the pros, cons and future considerations regarding their ongoing role. Methods: A narrative review regarding the current evidence was completed. PubMed and Cochrane central register of controlled trials were search until January 2024. All study types were of consideration if published after 2000 and an English language translation was available. Results: There are no published studies that directly compare outcomes of prostate biopsy when performed by a urologist or radiologist. In all published studies regarding the learning curve for prostate biopsy, the procedure was performed by urologists. These studies suggest that the learning curve for prostate biopsy is between 10 and 50 cases to reach proficiency in terms of prostate cancer detection and complications. It is recognised that many urologists are poorly able to accurately interpret multi parametric (mp)-MRI of the prostate. Collaboration between the specialities is of importance with urology offering the advantage of being involved in prior and future care of the patient while radiology has the advantage of being able to expertly interpret preprocedure MRI. Conclusion: There is no evidence to suggest that prostate biopsy should be solely performed by a specific specialty. The most important factor remains knowledge of the relevant anatomy and sufficient volume of cases to develop and maintain skills. [ABSTRACT FROM AUTHOR]

People with diabetes feature a life-risking susceptibility to respiratory viral infection, including influenza and SARS-CoV-2 (ref. 1), whose mechanism remains unknown. In acquired and genetic mouse models of diabetes, induced with an acute pulmonary viral infection, we demonstrate that hyperglycaemia leads to impaired costimulatory molecule expression, antigen transport and T cell priming in distinct lung dendritic cell (DC) subsets, driving a defective antiviral adaptive immune response, delayed viral clearance and enhanced mortality. Mechanistically, hyperglycaemia induces an altered metabolic DC circuitry characterized by increased glucose-to-acetyl-CoA shunting and downstream histone acetylation, leading to global chromatin alterations. These, in turn, drive impaired expression of key DC effectors including central antigen presentation-related genes. Either glucose-lowering treatment or pharmacological modulation of histone acetylation rescues DC function and antiviral immunity. Collectively, we highlight a hyperglycaemia-driven metabolic-immune axis orchestrating DC dysfunction during pulmonary viral infection and identify metabolic checkpoints that may be therapeutically exploited in mitigating exacerbated disease in infected diabetics.Hyperglycaemia leads to impaired costimulatory molecule expression, antigen transport and T cell priming in distinct lung dendritic cell subsets, driving a defective antiviral adaptive immune response, delayed viral clearance and enhanced mortality. [ABSTRACT FROM AUTHOR]

Involvement of all relevant stakeholders will be of utmost importance for the success of the developing EU HTA harmonization process. A multi-step procedure was applied to develop a survey across stakeholders/collaborators within the EU HTA framework to assess their current level of involvement, determine their suggested future role, identify challenges to contribution, and highlight efficient ways to fulfilling their role. The 'key' stakeholder groups identified and covered by this research included: patients', clinicians', regulatory, and Health Technology Developer representatives. The survey was circulated to a wide expert audience including all relevant stakeholder groups in order to determine self-perception by the 'key' stakeholders regarding involvement in the HTA process (self-rating), and in a second, slightly modified version of the questionnaire, to determine the perception of 'key' stakeholder involvement by HTA bodies, payers, and policymakers (external rating). Predefined analyses were conducted on the submitted responses. Fifty-four responses were received (patients9; clinicians: 8; regulators: 4; HTDs 14; HTA bodies: 7; Payers: 5; policymakers 3; others 4). The mean self-perceived involvement score was consistently lower for each of the 'key' stakeholder groups than the respective external ratings. Based on the qualitative insights generated in the survey, a RACI Chart (Responsible/Accountable/Consulted/Informed) was developed for each of the stakeholder groups to determine their roles and involvement in the current EU HTA process. Our findings suggest extensive effort and a distinct research agenda are required to ensure adequate involvement of the key stakeholder groups in the evolving EU HTA process. [ABSTRACT FROM AUTHOR]

Halide‐perovskite‐based solar cells (HPSCs) have established themselves as a promising photovoltaic (PV) technology in a remarkably short time. The rapid improvement in HPSCs can be attributed to the unique material and optoelectronic properties of metal halide perovskite semiconductors coupled with a very knowledgeable and experienced PV community. This review briefly summarizes the chemistry of halide perovskites, delving into the fundamental aspects of crystal structure and optical bandgap, followed by a more in‐depth report on the advancements in HPSCs efficiencies, thanks to structural regulation, interfacial modulation, and thin‐film engineering. It is mainly focused on three metal halide perovskites topics: 1) high‐performance Pb‐based perovskites, 2) Sn‐based perovskites and their associated challenges, and 3) emerging work on mixed composition Pb–Sn perovskites. For each of these domains, the effects stemming from the tuning of the monovalent A‐site and the halide site are examined. Additionally, various approaches aimed at passivating defects in the bulk film and at the interface, along with carrier transport engineering, are discussed. The discussions also encompass the broader implications for device performance, stability, and material toxicity. Finally, perspectives on the future directions and the commercial feasibility of perovskite photovoltaic technologies are provided. [ABSTRACT FROM AUTHOR]

Feral pigs (Sus scrofa) are a destructive and widespread invasive pest in Australia. An understanding of feral pig movement is required to develop management strategies to control feral pigs in Australia. Because landscape structure can have a strong influence on animal movement, it is important to determine how landscape features facilitate or impede the movement of feral pigs. Consequently, we conducted a landscape genetic analysis of feral pig populations in the Herbert region of far north Queensland, Australia, to determine management units and provide recommendations to better inform feral pig population control strategies. Using microsatellite data obtained from 256 feral pig samples from 44 sites, we examined feral pig population structure at multiple spatial scales for univariate and multivariate landscape resistance surfaces to determine the optimal spatial scale and to identify which of the nine landscape features tested impede or facilitate feral pig gene flow. Only weak genetic structure was found among the 44 sampling sites, but major waterways were identified as a minor barrier to gene flow, and an isolation by distance model was supported. We also found that highways facilitated gene flow across the study area, and this suggests that they may act as movement corridors or indicate translocation of feral pigs. Additionally, incorporating a second spatial scale enhanced the ability of our landscape genetics analysis to detect the influence of landscape structure on gene flow. We identified three management units based on natural barriers to gene flow and future targeted control should be undertaken in these management units to deliver sustained reduction of feral pig populations in the Herbert region. This study demonstrates how a landscape genetic approach can be used to gain insight into the ecology of an invasive pest species and be used to develop population control strategies which utilise natural barriers to movement. [ABSTRACT FROM AUTHOR]

With the advent of automated speaker verification (ASV) systems comes an equal and opposite development: malicious actors may seek to use voice spoofing attacks to fool those same systems. Various counter measures have been proposed to detect these spoofing attacks, but current offerings in this arena fall short of a unified and generalized approach applicable in real-world scenarios. For this reason, defensive measures for ASV systems produced in the last 6-7 years need to be classified, and qualitative and quantitative comparisons of state-of-the-art (SOTA) counter measures should be performed to assess the effectiveness of these systems against real-world attacks. Hence, in this work, we conduct a review of the literature on spoofing detection using hand-crafted features, deep learning, and end-to-end spoofing countermeasure solutions to detect logical access attacks, such as speech synthesis and voice conversion, and physical access attacks, i.e., replay attacks. Additionally, we review integrated and unified solutions to voice spoofing evaluation and speaker verification, and adversarial and anti-forensic attacks on both voice counter measures and ASV systems. In an extensive experimental analysis, the limitations and challenges of existing spoofing counter measures are presented, the performance of these counter measures on several datasets is reported, and cross-corpus evaluations are performed, something that is nearly absent in the existing literature, in order to assess the generalizability of existing solutions. For the experiments, we employ the ASVspoof2019, ASVspoof2021, and VSDC datasets along with GMM, SVM, CNN, and CNN-GRU classifiers. For reproducibility of the results, the code of the testbed can be found at our GitHub Repository (https://github.com/smileslab/Comparative-Analysis-Voice-Spoofing). [ABSTRACT FROM AUTHOR]

This study seeks to delve into the potential role of divergent thinking, a component of creativity, in second language learning. Specifically, we compare the use of lexical organization and production strategies of two groups of more and less creative EFL learners in year 12 through an automatic vectorial semantic analysis of their retrieval in three second language semantic fluency tasks. Consistent with previous research in the field of creativity, our findings indicate that the creative group retrieved more second language words than the less creative group. These words were less related to each other and to the stimulus categories than the words generated by the less creative group. While the creative participants’ retrieval was based on an extensive use of switching, a slight but non-significant trend was found in the production of longer clusters by the less creative participants. These results yield interesting insights into the potential role of creativity in second language learning. [ABSTRACT FROM AUTHOR]

Ocean warming is increasingly affecting marine ecosystems across the globe. Reef‐building corals are particularly affected by warming, with mass bleaching events increasing in frequency and leading to widespread coral mortality. Yet, some corals can resist or recover from bleaching better than others. Such variability in thermal resilience could be critical to reef persistence; however, the scientific community lacks standardized diagnostic approaches to rapidly and comparatively assess coral thermal vulnerability prior to bleaching events. We present the Coral Bleaching Automated Stress System (CBASS) as a low‐cost, open‐source, field‐portable experimental system for rapid empirical assessment of coral thermal thresholds using standardized temperature stress profiles and diagnostics. The CBASS consists of four or eight flow‐through experimental aquaria with independent water masses, lighting, and individual automated temperature controls capable of delivering custom modulating thermal profiles. The CBASS is used to conduct daily thermal stress exposures that typically include 3‐h temperature ramps to multiple target temperatures, a 3‐h hold period at the target temperatures, and a 1‐h ramp back down to ambient temperature, followed by an overnight recovery period. This mimics shallow water temperature profiles observed in coral reefs and prompts a rapid acute heat stress response that can serve as a diagnostic tool to identify putative thermotolerant corals for in‐depth assessments of adaptation mechanisms, targeted conservation, and possible use in restoration efforts. The CBASS is deployable within hours and can assay up to 40 coral fragments/aquaria/day, enabling high‐throughput, rapid determination of thermal thresholds for individual genotypes, populations, species, and sites using a standardized experimental framework. [ABSTRACT FROM AUTHOR]

Background: Patient evaluations of their physician have been utilized to evaluate physician performance and calculate hospital reimbursement. Despite the routine use of these evaluations, little research has been done to evaluate the accuracy of these evaluations. We assessed patient's ability to correctly identify the hospitalist providing their care and whether identification of the hospitalist affected the cumulative satisfaction scores. Methods: This prospective observational study was conducted at a suburban voluntary hospital. Hospitalists were evaluated anonymously by their patients over a 4-month period on a questionnaire designed to assess patient satisfaction. Results: One hundred fifty-eight patients evaluated 16 hospitalists yielding an average of 9.9 evaluations per hospitalist. Forty Nine (31%) patients were able to identify their hospitalist. The top score (3) accounted for 76% of patient responses across all questions. Significant differences (p =.0007) existed in the distribution of these scores when patients who could identify their hospitalist was compared with those who couldn't. The variables for effective communication and hospitalist introduction were scored significantly higher by patients who could identify their hospitalist (2.77 vs 2.55; p =.027 and 2.90 vs 2.67; p =.005). Patients of younger age and female gender were more likely identify their hospitalist. Conclusions: Less than one-third of patients were able to correctly identify their hospitalist. The variables for effective communication and hospitalist introduction to the patient were scored significantly higher by patients who could identify their hospitalist. The elimination of scores by patients who could not correctly identify their provider resulted in marked changes in the percentile ranking of these providers. [ABSTRACT FROM AUTHOR]

The Mid North Sea High (MNSH) region represents one of the least explored areas for the Late Permian Zechstein Hauptdolomit play in the Southern Permian Basin although some of the first offshore wells drilled in the UK were located here. In other parts of the basin such as onshore Poland, the Hauptdolomit Formation ("Hauptdolomit") is an active and attractive exploration target, with oil and gas production from commercial‐sized fields. In the UK, the play has been overshadowed by drilling campaigns in areas to the south of the MNSH which tested plays in the underlying Rotliegend and Carboniferous successions. However, with these areas now in decline, there is increased exploration interest in the Hauptdolomit in the MNSH region, particularly since 2019 when 3D seismic data were acquired and the first hydrocarbon discovery was made at Ossian (well 42/04‐01/1Z). Geochemical data from the latter discovery have pointed to the presence of a prolific petroleum system with the potential for Hauptdolomit reservoirs to be charged both by Zechstein‐generated oils and Carboniferous condensate/gas. With regard to hydrocarbon migration and preservation in the southern MNSH, a detailed evaluation of the effects of the Mid Miocene Unconformity has allowed for a greater understanding of the main factors controlling hydrocarbon preservation and remigration. Reservoir characterization of the Hauptdolomit play has been achieved by integrating petrographic microfacies analyses, core data and petrophysical interpretations. The most important factors controlling reservoir quality are the presence and extent of anhydrite cementation and the presence of high energy shoal facies. Thicker and coarser grained shoal facies are expected to occur along the yet‐to‐be explored Orchard platform margin where numerous prospects have been mapped and refined using recently acquired 3D seismic data. [ABSTRACT FROM AUTHOR]

Over the past 4 years, the authors have participated as members of the Mobilizing Computable Biomedical Knowledge Technical Infrastructure working group and focused on conceptualizing the infrastructure required to use computable biomedical knowledge. Here, we summarize our thoughts and lay the foundation for future work in the development of CBK infrastructure, including: explaining the difference between computable knowledge and data, and contextualizing the conversation with the Learning Health Systems and the FAIR principles. Specifically, we provide three guiding principles to advance the development of CBK infrastructure: (a) Promote interoperable systems for data and knowledge to be findable, accessible, interoperable, and reusable. (b) Enable stable, trustworthy knowledge representations that are human and machine readable. (c) Computable knowledge resources should, when possible, be open. Standards supporting computable knowledge infrastructures must be open. [ABSTRACT FROM AUTHOR]

Projecting the effects of climate change on net reef calcium carbonate production is critical to understanding the future impacts on ecosystem function, but prior estimates have not included corals' natural adaptive capacity to such change. Here we estimate how the ability of symbionts to evolve tolerance to heat stress, or for coral hosts to shuffle to favourable symbionts, and their combination, may influence responses to the combined impacts of ocean warming and acidification under three representative concentration pathway (RCP) emissions scenarios (RCP2.6, RCP4.5 and RCP8.5). We show that symbiont evolution and shuffling, both individually and when combined, favours persistent positive net reef calcium carbonate production. However, our projections of future net calcium carbonate production (NCCP) under climate change vary both spatially and by RCP. For example, 19%–35% of modelled coral reefs are still projected to have net positive NCCP by 2050 if symbionts can evolve increased thermal tolerance, depending on the RCP. Without symbiont adaptive capacity, the number of coral reefs with positive NCCP drops to 9%–13% by 2050. Accounting for both symbiont evolution and shuffling, we project median positive NCPP of coral reefs will still occur under low greenhouse emissions (RCP2.6) in the Indian Ocean, and even under moderate emissions (RCP4.5) in the Pacific Ocean. However, adaptive capacity will be insufficient to halt the transition of coral reefs globally into erosion by 2050 under severe emissions scenarios (RCP8.5). [ABSTRACT FROM AUTHOR]

Purpose: The current paper explores the use of equity theory in understanding the challenges of workforce localization of healthcare professionals in an international context. Design/methodology/approach: Utilizing the Delphi method with a team of senior healthcare professionals, equity theory framed the discussions and aided in understanding the managerial challenges of recruiting and retaining Saudi nurses. Findings: The article highlights how careful contextual considerations should be made when making referent choices to ensure the most effective and useful application of equity theory. Practical implications: A series of managerial implications are outlined for improving the localization of the nursing workforce of Saudi Arabia and beyond. Originality/value: Equity theory assists in addressing the decades old problem of localizing the Saudi nursing workforce, by proposing a hitherto unconsidered referent of public sector employees, rather than the conventional referent of expatriate nurses. [ABSTRACT FROM AUTHOR]

Introduction: Imipenem/cilastatin/relebactam (IMI/REL), a combination β-lactam antibiotic (imipenem) with a novel β-lactamase inhibitor (relebactam), is an efficacious and well-tolerated option for the treatment of hospitalized patients with gram-negative (GN) bacterial infections caused by carbapenem-non-susceptible (CNS) pathogens. This study examines cost-effectiveness of IMI/REL vs. colistin plus imipenem (CMS + IMI) for the treatment of infection(s) caused by confirmed CNS pathogens. Methods: We developed an economic model comprised of a decision-tree depicting initial hospitalization, and a Markov model projecting long-term health and economic impacts following discharge. The decision tree, informed by clinical data from RESTORE-IMI 1 trial, modeled clinical outcomes (mortality, cure rate, and adverse events including nephrotoxicity) in the two comparison scenarios of IMI/REL versus CMS + IMI for patients with CNS GN infection. Subsequently, a Markov model translated these hospitalization stage outcomes (i.e., death or uncured infection) to long-term consequences such as quality-adjusted life years (QALYs). Sensitivity analyses were conducted to test the model robustness. Results: IMI/REL compared to CMS + IMI demonstrated a higher cure rate (79.0% vs. 52.0%), lower mortality (15.2% vs. 39.0%), and reduced nephrotoxicity (14.6% vs. 56.4%). On average a patient treated with IMI/REL vs. CMS + IMI gained additional 3.7 QALYs over a lifetime. Higher drug acquisition costs for IMI/REL were offset by shorter hospital length of stay and lower AE-related costs, which result in net savings of $11,015 per patient. Sensitivity analyses suggested that IMI/REL has a high likelihood (greater than 95%) of being cost-effective at a US willingness-to-pay threshold of $100,000–150,000 per QALY. Conclusions: For patients with confirmed CNS GN infection, IMI/REL could yield favorable clinical outcomes and may be cost-saving—as the higher IMI/REL drug acquisition cost is offset by reduced nephrotoxicity-related cost—for the US payer compared to CMS + IMI. [ABSTRACT FROM AUTHOR]

Purpose: Prolonged ureteroscopy (URS) is associated with complications including ureteral perforation, stricture, and urosepsis. As laser lithotripsy is one of the most common urologic procedures, small cost savings per case can have a large financial impact. This retrospective study was designed to determine if Thulium fiber laser (TFL) lithotripsy decreases operative time and costs compared to standard Holmium:YAG (Ho:YAG) lithotripsy without pulse modulation. Methods: A retrospective review of URS with laser lithotripsy was conducted for 152 cases performed from August 2020 to January 2021. Variables including cumulative stone size, location, chemical composition, prior ureteral stenting, and ureteral access sheath use were recorded for each case. A cost benefit analysis was performed to show projected cost savings due to potentially decreased operative times. Results: Compared to Ho:YAG, use of TFL resulted in an average decrease of 12.9 min per case (p =.021, 95% CI [2.03–23.85]). In subgroup analysis of cases with cumulative stone diameter less than 15 mm, the difference was 14.0 min (p =.007, CI [3.95–23.95]). For cases less than 10 mm, the mean difference was 17.3 min in favor of TFL (p =.002, 95% CI [6.89–27.62]). This ~ 13 min reduction in operative time resulted in saving $440/case in direct operating room costs giving our institution a range of $294,000 to $381,900 savings per year. Conclusions: TFL has a significantly shorter operative time and decreased cost when compared to the standard Ho:YAG for equivalent kidney stone and patient characteristics. Longer term follow up is needed to see if recurrence rates are affected. [ABSTRACT FROM AUTHOR]

Intestinal macrophages play a vital role in the maintenance of gut homeostasis through signals derived from the microbiota. We previously demonstrated that microbial‐derived metabolites can shape the metabolic functions of macrophages. Here, we show that antibiotic‐induced disruption of the intestinal microbiota dramatically alters both the local metabolite environment and the metabolic functions of macrophages in the colon. Broad‐spectrum antibiotic administration in mice increased the expression of the large neutral amino acid transporter LAT1 and accordingly, amino acid uptake. Subsequently, antibiotic administration enhanced the metabolic functions of colonic macrophages, increasing phosphorylation of components of mammalian/mechanistic target of rapamycin signalling pathways, with increased expression of genes involved in glycolysis and oxidative phosphorylation (OXPHOS), increased mitochondrial function, increased rate of extracellular acidification (ECAR; measure of glycolysis) and increased rate of oxygen consumption (OCR; measure of OXPHOS). Small bowel macrophages were less metabolically active than their colonic counterparts, with macrophage metabolism in the small intestine being independent of the microbiota. Finally, we reveal tissue‐resident Tim4+ CD4+ macrophages exhibit enhanced fatty acid uptake alongside reduced fatty acid synthesis compared to recruited macrophages. Thus, the microbiota shapes gut macrophage metabolism in a compartment‐specific manner, with important implications for monocyte recruitment and macrophage differentiation. [ABSTRACT FROM AUTHOR]

The use of face masks has increased dramatically since the COVID-19 pandemic started in order to to curb the spread of the disease. Additionally, breakthrough infections caused by the Delta and Omicron variants have further increased the importance of wearing a face mask, even for vaccinated individuals. However, the use of face masks also induces attenuation in speech signals, and this change may impact speech processing technologies, e.g., automated speaker verification (ASV) and speech to text conversion. In this paper we examine Automatic Speaker Verification (ASV) systems against the speech samples in the presence of three different types of face mask: surgical, cloth, and filtered N95, and analyze the impact on acoustics and other factors. In addition, we explore the effect of different microphones, and distance from the microphone, and the impact of face masks when speakers use ASV systems in real-world scenarios. Our analysis shows a significant deterioration in performance when an ASV system encounters different face masks, microphones, and variable distance between the subject and microphone. To address this problem, this paper proposes a novel framework to overcome performance degradation in these scenarios by realigning the ASV system. The novelty of the proposed ASV framework is as follows: first, we propose a fused feature descriptor by concatenating the novel Ternary Deviated overlapping Patterns (TDoP), Mel Frequency Cepstral Coefficients (MFCC), and Gammatone Cepstral Coefficients (GTCC), which are used by both the ensemble learning-based ASV and anomaly detection system in the proposed ASV architecture. Second, this paper proposes an anomaly detection model for identifying vocal samples produced in the presence of face masks. Next, it presents a Peak Norm (PN) filter to approximate the signal of the speaker without a face mask in order to boost the accuracy of ASV systems. Finally, the features of filtered samples utilizing the PN filter and samples without face masks are passed to the proposed ASV to test for improved accuracy. The proposed ASV system achieved an accuracy of 0.99 and 0.92, respectively, on samples recorded without a face mask and with different face masks. Although the use of face masks affects the ASV system, the PN filtering solution overcomes this deficiency up to 4%. Similarly, when exposed to different microphones and distances, the PN approach enhanced system accuracy by up to 7% and 9%, respectively. The results demonstrate the effectiveness of the presented framework against an in-house prepared, diverse Multi Speaker Face Masks (MSFM) dataset, (IRB No. FY2021-83), consisting of samples of subjects taken with a variety of face masks and microphones, and from different distances. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this prospective study was to determine platform and angle accuracy for dental implants using dynamic navigation, a form of computer-assisted surgery. Three hypotheses were considered: (1) the overall accuracy for implant placement relative to the virtual plan is similar to that of static tooth-borne computerized tomography (CT)–generated guides; (2) the dynamic system is more accurate than freehand methods; and (3) there is a learning curve associated with this method. Materials and Methods: This study involved three surgeons placing implants in the mandible and maxilla of patients using a dynamic navigation system (X-Guide, X-Nav Technologies). Virtual implants were placed into planned sites using the navigation system computer. Post–implant placement cone beam CT scans were taken on all patients. For each patient, this scan was mesh overlayed with the virtual plan and used to determine platform and angular deviations to the virtual plan. The primary outcome variables were platform and angular deviations comparing the actual placement to the virtual plan. Secondary analyses included determination of accuracy related to case experience and freehand placement of implants. Comparisons to published accuracy studies were made for implant placement using static guides. Results: Accuracy deviations from the virtual plan were similar to those reported for static tooth–based guides using literature references as the comparison. The accuracy of dynamic navigation was superior compared to freehand implant placement. The three surgeons had similar accuracies after their learning curve was achieved. Proficiency based on case series was achieved by the 20th surgical procedure. Conclusion: Dynamic navigation can achieve accuracy of implant placement similar to static guides and is an improvement over freehand implant placement. In addition, there was a learning curve to achieve proficiency. [ABSTRACT FROM AUTHOR]

Introduction: The 2019 novel coronavirus pandemic has caused significant disruptions in the clinical operations of hospitals as well as clinical education, training, and research at academic centers. New York State was among the first and largest epicenters of the pandemic, resulting in significant disruptions across its 29 emergency medicine (EM) residency programs. We conducted a cross-sectional observational study of EM residency programs in New York State to assess the impact of the pandemic on resident education and training programs. Methods: We surveyed a cross-sectional sample of residency programs throughout New York State in June 2020, in the timeframe immediately after the state's first "wave" of the pandemic. The survey was distributed to program leadership and elicited information on pandemic-prompted curricular modifications and other educational changes. The survey covered topics related to disruptions in medical education and sought details on solutions to educational issues encountered by programs. Results: Of the 29 accredited EM residency programs in New York State, leadership from 22 (76%) responded. Of these participating programs, 11 (50%) experienced high pandemic impact on clinical services, 21 (95%) canceled their own trainees' off-service rotations, 22 (100%) canceled or postponed visiting medical student rotations, 22 (100%) adopted virtual conference formats (most within the first week of the pandemic wave), and 11 (50%) stopped all prospective research (excluding COVID-19 research), while most programs continued retrospective research. Conclusion: This study highlights the profound educational impact of the pandemic on residency programs in one of the hardest- and earliest-hit regions in the United States. Specifically, it highlights the ubiquity of virtual conferencing, the significant impact on research, and the concerns about canceled rotations and missed training opportunities for residents, as well as prehospital and non-physician practitioner trainees. This data should be used to prompt discussion regarding the necessity of alternate educational modalities for pandemic times and the sequelae of implementing these plans. [ABSTRACT FROM AUTHOR]

Background and aims: The learning curve for robotic-assisted radical prostatectomy (RARP) is estimated to be about 50–200 cases. This study will evaluate the benefit of a mentorship programme after completing a mini-fellowship in RARP by an experienced surgeon who previously trained in open and laparoscopic surgery. Methods: Our study was a retrospective comparative analysis of RARP performed by a single consultant urologist. A retrospective chart review of the first 120 cases was performed. The 120 patients were divided into three groups of 40 cases. For the first 40 cases, an appropriately qualified mentor was present. The peri-operative and oncological outcomes were compared between the three groups. Results: Operative times significantly decreased with experience (250 min vs 234 min vs 225 min, p < 0.05). Complication rates, estimated blood loss, and length of stay were similar between all groups. There was a higher rate of positive margins in the final group (20% vs 17.5% vs 32.5%, p < 0.5). There was a greater number of pT3 tumours in group 3 (42%, n = 17) compared to groups 1 and 2 (20%, n = 8, and 22.5%, n = 9) which may account for the higher rate of positive margins in this group. Conclusion: In the transition of an experienced laparoscopic surgeon to robotic surgery, we showed that there is a benefit of a mentorship programme after a mini-fellowship in reducing the impact of the learning curve on patient outcomes. Ongoing mentorship may be of benefit in cases where a high volume of tumour is suspected and should be avoided in the early part of the learning curve to maximise oncological outcomes. [ABSTRACT FROM AUTHOR]

The tectonic assembly of the Northern Cordillera is currently disputed and directly impacts Paleozoic‐to‐recent paleogeographic and plate tectonic reconstructions of North America. In this study, we present new U‐Pb zircon geochronology from the allochthonous Yukon‐Tanana terrane and the parautochthonous Cassiar terrane of the Northern Cordillera from south‐central Yukon, Canada. Our data provide new constraints for the assembly of the Northern Cordillera in this region. Metasedimentary samples from the Ingenika Group (Cassiar terrane) and the Snowcap and Finlayson assemblages (Yukon‐Tanana terrane) yielded detrital zircon age spectra that are comparable to known northwest Laurentia age spectra. One of our samples from the Snowcap assemblage yields a detrital zircon age spectrum that is anomalous for northwest Laurentia, but comparable to Early Paleozoic strata deposited in the Nevada‐Idaho‐Utah region. Zircon rim growth and Pb‐loss recorded by detrital zircon in the Snowcap assemblage and Ingenika Group samples record metamorphism at 370 ± 4 Ma and between 171 ± 5 and 135 ± 3 Ma. Late Devonian metamorphism and magmatism possibly corresponds to rifting of the Snowcap assemblage from the Laurentian margin. Middle Jurassic‐Early Cretaceous metamorphic zircon rim ages from the Cassiar terrane record metamorphism during collisions between the Intermontane superterrane (including the Yukon‐Tanana terrane) and Laurentia (Early to Middle Jurassic), and between the Insular superterrane and Laurentia (Middle to Late Jurassic). Our study suggests that collision between the Yukon‐Tanana terrane and the Laurentian margin began no earlier than ∼205 Ma. Plain Language Summary: The Northern Cordillera (northwestern North America) represents an amalgamation of continental, volcanic, and oceanic crustal blocks (terranes), which collided with North America (Laurentia) over the last 380 million years. Constraining the timing and sequence of these collisional events is crucial for our understanding of the tectonic and paleogeographic evolution of North America and the natural resources and hazards that it provides. In Yukon, Canada, the most widely accepted models propose that the earliest Cordilleran collisional event occurred between the Yukon‐Tanana terrane and Laurentia, ∼270 to 250 million years ago. However, in this study, we present new data which suggest that collision between the Yukon‐Tanana terrane and North America took place sometime between 205 and 170 million years ago. Our findings also suggest that the Yukon‐Tanana terrane represents a collage of smaller crustal blocks, one of which originated from western North America. Importantly, the present‐day structurally overlapping relationships of Cordilleran terranes means that our new interpretation of the Yukon‐Tanana‐Laurentia collision directly influences the interpretation of all younger and older collisional events in Northern Cordillera. Our study adds to a growing body of evidence that argues that the current and most widely accepted models and terrane definitions for the Northern Cordillera require revision. Key Points: Cassiar terrane in south‐central Yukon records Late Devonian and Middle Jurassic‐Early Cretaceous metamorphism of the Laurentian marginMiddle Jurassic‐Early Cretaceous metamorphism records collision between Yukon‐Tanana terrane and Laurentia, which began no earlier than ∼205 MaYukon‐Tanana terrane contains metasedimentary rocks sourced from Idaho‐Nevada‐Utah region [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the degree to which the editorial policies of business and management journals explicitly or implicitly discourage replication studies. Design/methodology/approach: The paper examines differences in editorial policy toward replication studies relative to journal quality, age and sub-discipline area. A total of 600 journals (listed as Q1 and Q2 in Scopus) were selected for the current study. Findings: The results reveal that out of 600 selected journals, only 28 (4.7%) were explicitly open to considering replication studies, while 331 (55.2%) were neutral, being neither explicitly nor implicitly dismissive of replication studies. A further 238 (39.7%) were implicitly dismissive of replication studies, and the remaining 3 (0.5%) journals were explicitly disinterested in considering replication studies for publication. CiteScore and Source Normalized Impact per Paper (SNIP) of neutral journals were significantly lower than those of journals, which were implicitly discouraging replication research. With regard to the journals implicitly discouraging replications (238), journals in the subcategory of business and international management (51) had the highest percentage (21.4%) followed by strategy and management 30 (12.6%) and Organizational Behavior (OB) and Human Resource (HR) 25 (10.5%). Originality/value: The available literature does not explore the degree to which the editorial policies of business and management journals explicitly or implicitly discourage replication studies. The current study attempts to address this gap in the literature. Given the lack of support for replications among business and management journals, the current paper sets forth the suggested steps which are deemed crucial for moving beyond the replication crisis in the business and management field. [ABSTRACT FROM AUTHOR]

The career of German writer Talvi (Thérèse Albertine Luise von Jacob Robinson [1797–1870]) illustrates her strong engagement with the intellectual and elite literary scenes of nineteenth-century Europe and America. This essay reviews her family background and early literary activities in Europe, while noting her extraordinary career as a language scholar, novelist, poet, translator, ethnologist and historian. Written during a period before the development of strong immigration laws in the United States, her complex novel Die Auswanderer (1852)– published in English translation as The Exiles (1853) – voices concerns relevant to both immigrants and American citizens alike, while providing strong views on issues such as slavery, immigration, cultural variation across American states and comparative national identities. The Exiles stands out as both an important early immigration novel and a notable example of German perspectives on the antebellum American social scene. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons. Design/methodology/approach: This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release. Findings: From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01). Research limitations/implications: A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention. Originality/value: This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to shed light on the use of bibliometric indicators as a people analytics tool for examining research performance outcome differences in faculty mobility and turnover. Design/methodology/approach: Employing bibliometric information from research databases, the publication, citations, h-index and newly developed individual annualized h-index (hIa-index) for a sample of university faculty is examined (N = 684). Information relating to turnover decisions from a human resource (HR) information system and bibliometric data from a research database are combined to explore research performance differences across cohorts of retained, resigned or terminated faculty over a five-year period in a single university. Findings: Analysis of variance (ANOVA) results indicate traditional bibliometric indicators of h-index, publication count and citation count which are limited in their ability to identify performance differences between employment status cohorts. Results do show some promise for the newly developed hIa-index, as it is found to be significantly lower for terminated faculty (p < 0.001), as compared to both retained and resigned faculty. Multinomial logistic regression analysis also confirms the hIa metric as a predictor of terminated employment status. Research limitations/implications: First, the results imply that the hIa-index, which controls for career length and elements of coauthorship is a superior bibliometric indicator for comparison of research performance. Practical implications: Results suggest that the hIa metric may serve as a useful tool for the examination of employment decisions for universities. It also highlights the potential usefulness of bibliometric indicators for people analytics and the examination of employment decisions, performance management and faculty turnover in research-intensive higher education contexts. Originality/value: This empirical paper is entirely unique. No research has previously examined the issue of turnover in a university setting using the bibliometric measures employed here. This is a first example of the potential use of hIa bibliometric index as an HR analytics tool for the examination of HR decisions such as employee turnover in the university context. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated costs and healthcare utilization associated with a culturally‐sensitive, medical and education program for pediatric Latino patients with type 1 diabetes. Research Design and Methods: Program participants included Latino children ages 1–20 years old diagnosed with type 1 diabetes (n = 57). Control subjects with type 1 diabetes were matched by age, sex, and zip code to intervention participants from the Colorado All Payer Claims Database. Data included emergency department (ED) visits, hospitalizations, demographic information, and health insurance claims data 180 days prior to program start/index date through 1 year after program start/index date. We tracked program staff time and estimated costs for healthcare utilization using data from the scientific literature. Generalized Estimating Equation (GEE) models with logit link were used to estimate group differences in probabilities of ED visits and hospitalizations over 6‐month periods pre/post‐study, accounting for correlation of within‐subject data across time points. Sensitivity analyses modeled longer‐term cost differences under different assumptions. Results: The intervention group had fewer hospitalizations, 2% versus 12% of controls (p = 0.047,OR = 0.13;95%CI: 0.02–0.97) for 6 months following start date. The intervention group had fewer ED visits, 19% versus 32% in controls (n.s.; p = 0.079,OR = 0.52;95%CI:0.25–1.08) and significantly fewer hospitalizations, 4% versus 15% of controls (p = 0.039,OR = 0.21;95%CI: 0.05–0.93) 6–12 months post‐start date. One‐year per‐patient program costs of $633 and healthcare cost savings of $2710 yielded total per‐patient savings of $2077, or a 5‐year cost savings of $14,106. Conclusion: This unique type 1 diabetes management program altered health service utilization of program participants, reducing major healthcare cost drivers, ED visits, and hospitalizations. [ABSTRACT FROM AUTHOR]

Introduction: The clinical efficacy and safety of ceftolozane/tazobactam for the treatment of ventilated hospital-acquired bacterial pneumonia (vHABP) and ventilator-associated bacterial pneumonia (VABP) has been demonstrated in the phase III randomised controlled trial ASPECT-NP. However, there are no published data on the cost-effectiveness of ceftolozane/tazobactam for vHABP/VABP. These nosocomial infections are associated with high rates of morbidity and mortality, and are increasingly complicated by growing rates of resistance and the inappropriate use of antimicrobials. This study is to assess the cost-effectiveness of ceftolozane/tazobactam compared with meropenem for the treatment of vHABP/VABP in a US hospital setting. Methods: A short-term decision tree followed by a long-term Markov model was developed to estimate lifetime costs and quality-adjusted life-years associated with ceftolozane/tazobactam and meropenem in the treatment of patients with vHABP/VABP. Pathogen susceptibility and clinical efficacy were informed by the Program to Assess Ceftolozane/Tazobactam Susceptibility (PACTS) database and ASPECT-NP, respectively. A US healthcare sector perspective was adopted, capturing direct costs borne by third-party payers or integrated health systems, and direct health effects for patients. Results: In the confirmed treatment setting (post-susceptibility results), the incremental cost-effectiveness ratio for ceftolozane/tazobactam compared to meropenem was US$12,126 per quality-adjusted life-year (QALY); this reduced when used in the early treatment setting (before susceptibility results) at $4775/QALY. Conclusion: Ceftolozane/tazobactam represents a highly cost-effective treatment option for patients with vHABP/VABP versus meropenem when used in either the confirmed or early treatment setting; with increased cost-effectiveness shown in the early setting. [ABSTRACT FROM AUTHOR]

A 58-year-old woman with a prior radical cystectomy and ileal conduit underwent a living-related donor renal transplant for end-stage renal disease secondary to autoimmune glomerulonephritis. She subsequently developed an ischaemic stricture of the transplant ureter. A successful ureteropyelostomy was performed with the native right ureter anastomosed to the pelvis of the renal transplant. She presented to the emergency department 18 months later feeling unwell and with raised inflammatory markers. Imaging demonstrated a large soft tissue mass over the right psoas muscle and hydronephrosis of the native right kidney. A nephrostomy and nephrostogram of the native right kidney diagnosed a urine leak from the native right kidney and she underwent an open right native nephrectomy. She recovered well postoperatively and continues to have excellent graft function. Renal transplantation in an abnormal urinary tract carries a high risk of complications. A multidisciplinary team approach is essential in offering the most appropriate treatment and ensuring good graft function is preserved. [ABSTRACT FROM AUTHOR]

A 29-year-old male patient presented to the emergency department with haematuria and flank pain. Ten months agopreviously, he had undergone orchidectomy and adjuvant chemotherapy for a testicular mixed germ cell tumour. Cystoscopy revealed a large bladder wall mass. The final diagnosis of yolk sac tumour was established after transurethral resection of the lesion. The patient was treated with salvage chemotherapy and placed on short- interval biochemical and radiological surveillance to assess treatment response. [ABSTRACT FROM AUTHOR]

Objective: To establish the incidence and define the nature of complications occurring following image-guided musculoskeletal injections at our institution. Materials and methods: All patients undergoing image-guided musculoskeletal injection during the study period (16/3/2016 to 24/01/2020) were included. Departmental records were reviewed to identify all patients describing possible complications following injection, what therapy was required (if any) and what the outcome was. No patients were excluded. Complications were classified as minor or major. Injections were categorised as follows: cervical spine, lumbar facet joint, lumbar nerve root, caudal epidural and 'other'. The complication rate for each individual category of procedure was compared with the combined complication rate for all other categories by constructing contingency tables and using Fisher's exact test. Results: A total of 8226 patients underwent image-guided musculoskeletal injections within the study period. Exactly 100 patients were identified as having reported a complication, producing an overall complication rate of 1.2%. One complication was categorised as 'major', with the patient requiring expedited surgery. The remainder (99 patients) were categorised as having experienced minor complications. The incidence of complications after 'other' injections was significantly greater than for other categories of injection (1.86%, p = 0.028). There was no significant difference in the complication rate for cervical spine (0.93%, p = 0.257), lumbar nerve root (0.85%, p = 0.401), lumbar facet joint (0.67%, p = 0.326) or caudal epidural (1.29%, p = 0.687) injections. 'Other' injections were subsequently further sub-categorised by anatomical site and imaging modality used. Glenohumeral (2.97%, p = 0.0361) and sacro-iliac (3.51%, p = 0.0498) joint injections were associated with a significantly increased risk of complications. There was no difference in the incidence of complications with fluoroscopic or ultrasound guidance. Conclusion: In conclusion, image-guided musculoskeletal injections are safe and well-tolerated procedures. Complications are rare, occurring in just 1.2% of patients. 99% of complications are minor, either not requiring intervention or resolving with simple supportive treatment. [ABSTRACT FROM AUTHOR]