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Background: The need for assessment of technical skills is well recognized and objective methods of assessment are currently under investigation in the UK. The applicability of these assessment tools to trainees with a different training background in another country was examined. Methods: Six bench-top models for basic surgical trainees (BSTs) and eight for higher surgical trainees (HSTs) (five in common) were assessed for construct validity in 70 subjects. Objective assessment methods included motion analysis using the Imperial College Surgical Assessment Device, Objective Structured Assessment of Technical Skills and Minimally Invasive Surgical Trainer in Virtual Reality. Results: All models shared between BSTs and HSTs exhibited construct validity (range P = 0.050 to P < 0.001). Of the three modules for HSTs alone, only one gave significant results (small bowel anastomosis; P = 0.005). Reasons for this were sought. Conclusion: The methods of objective technical skills assessment of trainees in the UK are applicable to those in Hong Kong. Their use should be promoted and the tracking of skills development encouraged. [ABSTRACT FROM AUTHOR]

Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: EM – has received grant funding from BGCS, Orion Corporation, Leicester, Leicestershire and Rutland Integrated Care Board, East Genomic Medicine Service Alliance, North East London Cancer Alliance, Intuitive Surgical Ltd, East Midlands Clinical Research Network and Medical Research Council (MRC). AT − Has received financial support to attend meetings from Merck & Co., Inc (MSD). AA − None to declare. CA − None to declare. RA − None to declare. SB – Has received grants to her institution from Astrazeneca and Glaxo Smith Kline (GSK), and consulting fees from Astrazeneca, Epsilogen, GSK, Immunogen MSD, Mersana, Myriad, Novartis, Oncxerna, Seagen, Shattuck Labs, Regeneron and Verastem. She has received honoraria payments for lectures from Abbive, Astrazeneca, GSK, Immunogen, MSD, Mersnae, Pfizer, Roche, Takeda and Novacure, and financial support for attending meetings from Astrazeneca, GSK and Verastem. She is on the Ovacome advisory board (unpaid). RB – Has received honoraria for lecturers and presentations from GSK, Astra Zeneca and EISAI; support to attend meetings from GSK and PharmaAnd. She is an advisory board member for MSD, Clovis, Astra Zeneca, and GSK.She has unpaid board roles for NCRI Gynae Deputy Lead (GTGUK), UKGOM (co-chair) and is the BGCS Medical Oncology Representative. LB – is a director of Buckley Consultants Ltd. NB – Has received financial support from RanD for travel to meetings. SC – None to declare. RE – Has received consulting fees from GSK; honoraria for lecturers from GSK and Astra Zeneca and sits on the for Advisory Board for International Rainbo Study. ME-B – None to declare. CF –Has received payments for participation on a Data Safety Monitoring Board or Advisory Board for GSK, Roche, Ethicon, Astra Zeneca, MSD. JF – Has received consulting fees from ASTELLAS ASP5354 Advisory Board and is a BGCS Council member (unpaid). RG – Has received honoraria payments for lectures from Astra Zeneca, on topics unrelated to this document. AG – has received honoraria for lectrures/presentation from GSK. LH – Has received royalties from Cambridge University Press, support from Mims and Roche and Tata Medical Center to attend meetings, and is an unpaid board member to the Royal College of Radiologists. BK – Has received funding from NIHR Imperial BRC. RM – has received research grant funding from Rosetrees Trust, Barts Charity, NHS England, NHS Innovational Accelerator, Yorkshire Cancer Research and GSK. He has received honoraria from GSK and Astrazeneca for lectures and presentations. He is Chair Trial of the Steering Committee BRCA DIRECT trial, a member NICE National Standards Quality Assurance Board for Ovarian Cancer and Topic Advisor NICE Guideline – [NG241] −- Ovarian cancer: identifying and managing familial and genetic risk. He is a scientific advisor to GO Girls, BRCA Umbrella and acted on an Expert Advisory Group NHS Jewish BRCA Programme. HM – In a trustee of GO Girsls Gynaecological Cancer Charity. AM – has received National Institute for Cancer Research (NCRI) and MERCK received research funding from MDS. She has received payment from EUSA Pharma and Clovis Oncology for advisory board roles and consulting. She has recived payment from GSK for invited lectures and manuscript writing. She has received educational support and support for meeting attendance from MSD and IPSEN. TM – Project lead for NHS transformation project to embed mainstream BRCA testing into practice for breast, ovarian cancers. Nurse advisor to The EVE APPEAL gynae cancer charity. CN – None to declare. SN – has received research grants from GSK, AstraZenenca, North Central London Cancer Alliance and BGCS via her institution. She has received consulting fees from GSK, AstraZeneca and Biontech, and honoraria payments from lectures from GSK and AstraZenca. She has received financial support for attending meetings from MSD. She is an data safety monitoring/advisory board member to AstraZeneca, GSK and Biontech. She has stock options with GSK and AstraZeneca, and she is chair of the GynaeOncology Trials Group UK (previously NCRI) (unpaid). NR – None to declare. NRy – has received grants from the Chief Scientist Office Scotland (NES/CSO Postdoctoral Clinical Lectureship Scheme) and Academy of Medical Sciences to his institution. He has received honorariao payments from GSK for lectures. He is an European Hereditary Tumour Group (EHTG) Board member (unpaid). SS – has received a research grant to University of Birmingham from AoA diagnostics. She has received consultancy fees from GSK and Immunogen, and honoraria for lecturers from Astra Zeneca, Merck and GSK. She is Surgery Lead for the National Ovarian Cancer Audit, England and Wales and Co-Chair Scientific Program, International Gynaecological Cancer Society conference 2024. KV – Councillor for British Association of Gynaecological Pathology (unpaid). AW – has received honoraria for lecturers and presentaions from GSK, Astra Zeneca and Clovis. JW – is President, British Association of Gynaecological Pathologists (unpaid). JM – has received grants to her institution from the National Institute for Health and Care Research (NIHR) and MRC. She is BGCS guidelines subgroup co-chair (unpaid), sitting on BGCS Council in this role, and a NHS Cervical Screening Research Innovation and Development Advisory Committee Member (unpaid). She was an unpaid council member to Cochrane Collaboration (2019–2023) and received financial support to attend a meeting from Cochrane.

The two most prevalent childhood vascular abnormalities are infantile hemangioma (IH) and port-wine stain (PWS). They become apparent shortly after birth but have distinct pathophysiology and clinical manifestations. The goal of this study was to determine if mother's history of angioma or PWS is associated with these vascular abnormalities. We evaluated an UK anonymized electronic medical records database with medical records that were linked between children and their mothers. Cox proportional hazards models were used to evaluate the association between maternal factors and the time of onset of either IH or PWS in children. Between 2004 and 2021, 639,085 children were linked to their mom's medical data with a total of 4,270,773 person-years of follow up. Children born to mothers with an angioma as compared to a mother without an angioma were more than 60% more likely to have an IH (HR: 1.64 [1.07, 2.52]). Children born to mothers with a PWS as compared to children born to mothers without a PWS were nearly 20 times more likely to have a PWS (18.95 [4.71,76.26]). Mothers with angiomas were not more likely to have children with PWS and mothers with PWS were not more likely to have children with IH. The effect estimates were minimally changed after adjustment. We demonstrated that children born to mothers with angiomas or PWS were at increased risk of IH or PWS, respectively., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Limited robust evidence exists comparing outcomes following completely minimally invasive oesophagectomy (CMIO) to hybrid oesophagectomy (HO) in the treatment of resectable oesophageal and gastro-oesophageal junctional (GOJ) cancer. This multi-centre study aims to assess postoperative morbidity between HO and CMIO according to the full Esophagectomy Complications Consensus Group (ECCG) complication platform., Methods: All consecutive patients undergoing an Ivor-Lewis HO or Ivor-Lewis CMIO for cancer between 2016 and 2018 in three UK tertiary centres were included. The primary study outcome was 30-day overall complications, evaluated by the ECCG complication subgroups. Secondary outcomes included survival outcomes and perioperative parameters between the two approaches., Results: Of the 382 patients included, 228 (59.7%) patients had HOs and 154 (40.3%) patients had CMIOs with no inter-group baseline differences. Patients undergoing CMIO experienced less 30-day postoperative complications compared to those under undergoing HO (43.5% vs 57.0%, p = 0.010). ECCG defined pulmonary and infective complications were less frequent in the CMIO group. Anastomotic leak rates and oncological outcomes were similar between the two groups. Independent predictors of 30-day postoperative complications include surgical approach with HO and high ASA grade on multivariable analysis., Conclusions: Ivor-Lewis CMIO demonstrates superior short-term surgical outcomes when compared to Ivor-Lewis HO with no compromise in oncological feasibility. Anastomotic leak rates were equivalent between both groups. A robust randomised controlled trial is required to validate the findings of this study., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Safety data for the multicomponent meningococcal group B vaccine (4CMenB) has so far been limited to experience from clinical trials and isolated local outbreaks. Since the UK is the first country to implement a nationwide routine immunisation programme with 4CMenB (at age 8 weeks, 16 weeks, and then 1 year), we aimed to assess the safety of 4CMenB in this setting., Methods: In this prospective surveillance study, we assessed suspected adverse reactions of 4CMenB in children up to age 18 months reported in the UK Yellow Card Scheme and primary care records extracted from the Clinical Practice Research Datalink (CPRD). We proactively assessed reports of fever, local reactions, Kawasaki disease, seizures, and sudden death, and compared the number of spontaneous reports with the expected number of events based on background incidence and the number of children vaccinated. We also identified any unexpected adverse reactions and estimated compliance with subsequent doses of routine vaccinations., Findings: From Sept 1, 2015, to May 31, 2017, approximately 1·29 million children aged 2-18 months received about a combined 3 million doses of 4CMenB. 902 reports of suspected adverse reactions were received through the UK Yellow Card Scheme, of which 366 (41%) were related to local reactions and 364 (40%) related to fever. The only unexpected finding was that 160 reports of local reactions described a persistent nodule at the site of injection, usually without other local symptoms. There were 55 (6%) reports of seizures, with an age-adjusted observed-to-expected ratio of 0·13 (95% CI 0·10-0·17). Ecological analyses found similar rates of seizures within 7 days of routine immunisation in the periods before and after 4CMenB introduction, with incidence rate ratios of 1·30 (95% CI 0·56-3·00) at age 2 months, 1·53 (0·49-4·74) at age 4 months, and 1·26 (0·69-2·32) at age 12 months. Of the 902 reports, three (<1%) were of Kawasaki disease (observed-to-expected ratio 1·40, 95% CI 0·29-4·08) and three (<1%) of sudden infant death syndrome within 3 days of vaccination in children aged 2-4 months (0·44, 0·12-1·14). Analysis of routine immunisations recorded in CPRD found that 11 602 (95·1%) of 12 199 children had received the second dose of 4CMenB by 26 weeks of age, 1793 (84·7%) of 2117 had received the third dose by 62 weeks of age, and 4CMenB introduction had not reduced compliance with doses of other routine vaccinations., Interpretation: We found no significant safety concerns after widespread use of 4CMenB in UK infants, and the vaccine appears to have been well accepted by parents. However, it is important to continue monitoring the safety and long-term effect of the immunisation programme in the UK to further characterise the reported suspected adverse reactions., Funding: None., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: The United Kingdom National External Quality Assessment Service (UK NEQAS) for Leucocyte Immunophenotyping Immune Monitoring Programme, provides external quality assessment (EQA) to non-U.S. laboratories affiliated with the NIH NIAID Division of AIDS (DAIDS) clinical trials networks. Selected laboratories are required to have oversight, performance monitoring, and remediation undertaken by Immunology Quality Assessment (IQA) staff under the DAIDS contract. We examined whether laboratory accuracy improves with longer EQA participation and whether IQA remediation is effective., Methods: Laboratory accuracy, defined by the measurement residuals from trial sample medians, was measured on four outcomes: both CD4+ absolute counts (cells/μL) and percentages; and CD8+ absolute counts (cells/μL) and percentages. Three laboratory categories were defined: IQA monitored (n = 116), United Kingdom/non-DAIDS (n = 137), and non-DAIDS/non-UK (n = 1034). For absolute count outcomes, the groups were subdivided into single platform and dual platform users., Results: Increasing EQA duration was found to be associated with increasing accuracy for all groups in all four lymphocyte subsets (P < 0.0001). In the percentage outcomes, the typical IQA group laboratory improved faster than laboratories from the other two groups (P < 0.005). No difference in the overall rate of improvement was found between groups for absolute count outcomes. However, in the DPT subgroup the IQA group ultimately showed greater homogeneity., Conclusions: EQA participation coupled with effective laboratory monitoring and remedial action is strongly associated with improved laboratory accuracy, both incrementally and in the proportion of laboratories meeting suggested standards. Improvement in accuracy provides more reliable laboratory information facilitating more appropriate patient treatment decisions. © 2017 International Clinical Cytometry Society., (© 2017 International Clinical Cytometry Society.)