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Author(s): C J Bennett [sup.1] , H Truby [sup.1] , Z Zia [sup.2] , S W Cain [sup.3] , M L Blumfield [sup.1] Author Affiliations: (1) Department of Nutrition and [...], Background/Objective: Reduced sleep is a strong and independent risk factor for weight gain and obesity. Maternal obesity preconception and throughout gestation can increase the risk of adverse pregnancy outcomes and impact on offspring health in later life. This study investigated the relationship between sleeping behaviour and macronutrient intake in childbearing aged women. Subjects/Methods: We used cross-sectional data from the Australian Longitudinal Study on Women's Health 1973-78 cohort, aged 31-36 years in 2009 (n=8200). Subjective sleeping behaviour was reported and macronutrient intake was measured using a validated food frequency questionnaire. Latent class analysis (LCA) was used to derive sleeping patterns. Multivariate regression analysis was used to investigate the relationships between sleep and macronutrient intake. Results: LCA identified three sleep patterns: (LC1) average sleep (~8 h) with no adverse sleep-related symptoms (n=3570); (LC2) average sleep (~8 h) with sleeping difficulties and severe tiredness (n=2109); and (LC3) short sleep (~6 h) with sleeping difficulties and severe tiredness (n=915). In fully adjusted models, LC2 was inversely associated with percentage energy as protein (b=-0.24; P=0.01) and the protein-to-carbohydrate ratio (b=-0.01; P Conclusions: Sleeping behaviour patterns were associated with macronutrient intake in childbearing aged women. Improved sleep patterns, together with diet and physical activity strategies, may make it easier for women to achieve a balanced diet and optimise their weight status in preparation for pregnancy.

In this work, a broadband dual-channel differential phase shifter is developed with a small phase deviation across a wide frequency range. The design consists of two main lines for 45° and 90° phase shifts, along with a reference line. A prototype is fabricated and measured to validate the performance of the design. Phase shifts of 45° ± 5° and 90° ± 5° over a frequency range of 1.26 GHz - 4 GHz (bandwidth of 104%) are achieved from the channels. The transmission losses of the three lines are less than 0.35 dB and the isolation between the adjacent ports is better than 20 dB. The area of this dual-channel differential phase shifter is 2.22λg² (14.7 mm x 66.15 mm), where λg is the guided wavelength at the center frequency. [ABSTRACT FROM AUTHOR]

Combining ability and heterosis for within-boll yield components and fibre quality traits were carried out using line × tester mating system in upland cotton at the University of Agriculture, Faisalabad, Pakistan.Variance due to specific combining ability was greater than general combining ability for all the traits depicting the importance of non-additive genetic effects.The line BH-89 was found to be good general combiner for lint mass per boll, seed volume per 100 seeds, surface area per seed and lint percentage. NIAB-999 was good general combiner for fibre fineness. The third line which was actually the F1 of the first two lines performed better regardingseed number per boll, seed mass per bolland fibre strength.Among testers, NIAB-78 exhibited higher GCA effects for seed number per boll, lint mass per boll and fibre fineness while CIM-1100 proved to be good general combiner for seed volume per 100-seeds, surface area per seed and lint percentage. NIAB-999 × VH-144 exhibited the highest SCA effects regarding seeds per boll and seed mass per boll while the cross NIAB-999 × CIM-70 was considered desirable for seed volume per 100-seeds and surface area per seed. Maximum heterosis over better parent for lint mass per boll and lint percentage was observed for the cross BH-89 × NIAB-78 while for seed volume per 100-seeds and surface area per seed, NIAB-999 × CIM-240 was the best. [ABSTRACT FROM AUTHOR]

While asthma is a known risk factor for Acute Chest Syndrome (ACS) and may increase overall mortality in SCD patients, this study specifically focuses on the rate of inpatient mortality, hospital stay, and costs in SCD patients who develop ACS. Our study was conducted using a retrospective cohort from the National Inpatient Sample (NIS), spanning 5 years from 2016 to 2020. Patients were carefully divided into two cohorts for comparison: those admitted with ACS and a history of asthma and those with ACS without a history of asthma. The primary endpoint was all-cause inpatient mortality, and we built a robust multivariate regression model adjusting for confounders. We also thoroughly examined secondary endpoints, including a comparison of length of stay (LOS), hospital, transfusion rates, mechanical ventilation (MV) rates, Continuous Renal Replacement Therapy (CRRT), and rates of hemodialysis (HD) for acute kidney injury (AKI). Our analysis of LOS and total cost was conducted using a multivariate linear regression model adjusted for confounders, ensuring the thoroughness and validity of our results. Additionally, genotypes, demographics, and common comorbidities were described. Categorical variables required Chi-square (X2), and continuous variables required a Student t-test for hypothesis testing. A two-tailed P-value of < 0.05 was considered statistically significant. We utilized the National Inpatient Database (NIS). A total of 26,280 hospitalizations met the inclusion criteria:5,685 had ACS with a history of asthma, and 20,622 without ACS. Patients with ACS and Asthma were younger (mean age, 28 years vs. 32 years; p < 0.001), and females represented a higher proportion (53.03% vs. 47.56%; p = 0.940). Patients admitted with ACS and Asthma did not have higher odds of dying than those admitted with ACS without asthma (p = 0.176). The Charlson Comorbidity Index (CCI) was the only predictor of mortality. (aOR 1.52; p < 0.001). ACS with Asthma was a predictive factor for LOS (coefficient -0.65; p = 0.009). Conversely, female patients had a higher likelihood of experiencing a more extended hospital stay (coefficient, 0.61; p = 0.001). Additionally, ACS with Asthma significantly affected the total cost (coefficient: -15,201; p < 0.001), resulting in a lower cost than ACS patients without asthma. Finally, patients with ACS with Asthma did not have higher rates of transfusions, MV, CRRT, or HD due to AKI than those without asthma. Asthma did not increase the risk of in-hospital mortality in this large retrospective cohort study of patients admitted for Acute Chest Syndrome (ACS). While patients with ACS and a history of asthma were younger and had a lower total cost of care, their length of stay was shorter, and they did not experience higher rates of transfusion, mechanical ventilation, or acute kidney injury requiring dialysis. The primary predictor of mortality was the Charlson Comorbidity Index (CCI), highlighting the importance of overall comorbidity burden. These findings suggest that although asthma is a known risk factor for ACS, it does not independently worsen patient outcomes or survival, underscoring the need for a broader focus on managing comorbid conditions in these patients., Competing Interests: Declarations. • This study utilized the National Inpatient Sample (NIS) database, the largest publicly available inpatient care database in the United States. Access to the data requires purchasing the database. • Participants had no direct contact with the patients included in the data sample and did not participate in the consent process to participants. • The research leading to these results was conducted without any external funding. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background/objectives: Patients who use a language other than English (LOE) for health care communication are at increased risk of experiencing adverse events and worse outcomes. The objectives of this research are (1) to understand the lived experience of families who speak LOEs around the hospitalization of their child and (2) to understand the perspectives of patients and families who speak LOEs on opportunities to improve their experiences during hospitalization., Methods: This study is grounded in patient- and family-informed research. We designed a qualitative study involving children hospitalized in the general pediatric inpatient unit at a Canadian children's hospital. We conducted semistructured individual interviews with children and families with a medical interpreter. We used thematic analysis, and all interviews were coded by 2 reviewers., Results: A total 20 families of 16 different languages participated in the interviews. Themes important to understanding their lived experience were the following: (1) communication uncertainty-families experienced inconsistent interpreter use and availability, which affected in-the-moment communication and families' ability to understand the overall clinical context, leading to increased uncertainty; (2) lack of belonging-despite communicating that they had positive experiences in the hospital, families described a lack of belonging and felt that they were "other" during hospitalization; (3) altered trust-in addition to language, each patient/family's unique and complex social contexts contribute to developing an altered trust relationship with the health system that impacts their engagement in care processes. Families described opportunities for improvement such as supporting patient-initiated interpretation, increasing workforce diversity, and tailoring concepts such as shared decision making to their realities., Conclusions: Patients and families also revealed that they experience communication uncertainty, altered trust, and a lack of belonging within the hospital setting. Our research builds on the current literature and serves to advance our efforts to address health inequities experienced by this population., (Copyright © 2025 by the American Academy of Pediatrics.)

Background: Insomnia is a common symptom of major depressive disorder (MDD). Presence of insomnia symptoms in MDD (MDDIS) has been associated with worse depression severity and outcomes. This study assessed the economic and clinical burden of MDDIS in the United States., Methods: Commercially and Medicaid-insured adults from Merative® MarketScan® Databases (01/2016-06/2021) with ≥1 MDD diagnosis (index date) were included in the MDDIS cohort if they had ≥1 insomnia diagnosis within 12 month afterwards or in the other MDD cohort if they had no insomnia diagnoses/treatments; patients without MDD diagnoses/treatments (random index date) were included in the non-MDD cohort. Cohorts were propensity score-matched. Healthcare resource utilization (HRU), costs, and treatment patterns 12 months post-index were compared between MDDIS and each control cohort using linear and Poisson regressions., Results: In both commercially (N = 52,280; mean age: 44 years; 67 % female) and Medicaid-insured (N = 15,653; mean age: 41 years; 73 % female) populations, the MDDIS cohort had significantly higher HRU and cost than the other MDD and non-MDD cohorts. Mean total all-cause healthcare cost difference between the MDDIS and other MDD cohort was $5842 (commercial) and $5152 (Medicaid); between the MDDIS and non-MDD cohort, it was $14,266 (commercial) and $11,314 (Medicaid). MDDIS compared to other MDD was associated with higher use of antidepressants, particularly agents with sedative effect., Limitations: Data were subject to incompleteness that might lead to measurement biases., Conclusions: MDDIS compared to other MDD and non-MDD was associated with significantly higher economic and clinical burden, highlighting the need for effective treatments for this population., Competing Interests: Declaration of competing interest MZ, DP, PB, and AS are employees of Analysis Group, Inc., a consulting company that has provided paid consulting services to Janssen Scientific Affairs, LLC., a Johnson & Johnson company, which funded the development and conduct of this study and manuscript. HK, JS, TD, and ZC are employees of Janssen Scientific Affairs, LLC., a Johnson & Johnson company, and hold stocks in Johnson & Johnson. MKJ has received contract research grants from Acadia Pharmaceuticals, Neurocrine Bioscience, Navitor/Supernus and Janssen Research & Development; honorarium to serve as Section Editor of the Psychiatry & Behavioral Health Learning Network and as Guest Editor for Psychiatric Clinics of North America from Elsevier; consultant fees from Eleusis Therapeutics US, Inc., Janssen Global Services, Janssen Scientific Affairs, Boehringer Ingelheim, and Guidepoint Global; fees to serve on Data Safety and Monitoring Board for Worldwide Clinical Trials (Eliem and Inversargo), Vicore Pharma and IQVIA (Click); and honoraria for educational presentations from North American Center for Continuing Medical Education, Medscape/WebMD, Clinical Care Options, and Global Medical Education., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The case fatality ratio (CFR) is a vital metric for assessing the disease severity of novel pathogens. The widely used direct method of CFR estimation-the ratio of total confirmed deaths to total confirmed cases-is inherently simplistic, as it fails to account for the essential time lag between case confirmation to death, and reporting delays. These limitations often lead to biased CFR estimates, particularly in the early stages of outbreaks. This study introduces a novel approach-the distributed-delay method that, like the direct method, utilizes publicly available aggregate time-series data on cases and deaths. It estimates CFR by flexibly incorporating a case-to-death time distribution without requiring a priori assumptions on distribution parameters. Using a fitting approach to forecast case fatalities based on known or assumed case-to-death time distributions, the method consistently recovers true CFR much earlier than the direct method under various simulation settings. These settings reflect variability in disease severity, uncertainties in case-to-death time parameters, and limited knowledge of case-to-death time distributions. It outperforms other methods such as Baud's, which assumes a non-zero constant case-to-death time, and the Generalized Baud's method, which allows for a direct comparison with our new approach. While evaluations based on empirical data are challenging, our conclusions are supported by CFR estimates obtained using empirical COVID-19 data from 34 countries. As an added value, this analysis also demonstrates a significant negative association between eventual CFR and the expected case-to-death time within the context of COVID-19 data. Our study highlights the complexities of inferring real-time CFR from aggregate time-series case and death data, highlighting that refining this method can lead to accurate real-time CFR estimations for actual outbreaks., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The FEDECOM project (Federated-system approach for flexible and interoperable energy communities) is a European Union-funded project aimed at fostering the integration and flexibility of local energy systems by demonstrating the potential of cross-border energy exchange by energy sector coupling through a federation of energy communities. The project seeks to provide economic benefits, improve grid stability and reliability, and contribute to the decarbonisation of the energy system. FEDECOM combines direct and indirect electrification strategies to leverage synergies and offers a cloud-based platform for managing local energy systems, including power, gas, thermal energy, industry, and mobility sectors. This paper discusses FEDECOM's approach to energy management at multiple pilot sites, seeking to optimize resource use, enhance grid stability, and promote sustainable energy practices. It presents an overview of the FEDECOM project's goals, structure, pilot sites, and technical innovations, including peer-to-peer trading, semantic data modeling, and a novel platform architecture., Competing Interests: No competing interests were disclosed., (Copyright: © 2025 Lennard Z.)

Dicliptera bupleuroides has been used traditionally for treating various ailments in many countries. Its detailed phytochemical profiling and pharmacological evaluation in treating cancer based on reactive oxygen species (ROS) and mitochondrial membrane potential (MMP) analysis along with caspase activation studies has not been done previously. This study was conducted for detailed phytochemical profiling of D. bupleuroides by using ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS) and to evaluate its antioxidant and anticancer potential against hepatocellular carcinoma (HepG2) cells. The extract was subjected to UHPLC-QTOF-MS analysis for metabolite profiling, and GNPS Molnet enhancer determined its major phytochemical classes. Phytochemical tests and multimode antioxidant assays were also executed. The extract was pharmacologically evaluated for its anticancer potential against HepG2 cells using CCK-8 assay. Intracellular ROS generation and loss in MMP were studied by fluorescence microscopy. Network pharmacology and molecular docking of selected compounds were executed. The extract contains total phenolic content as 58.37 ± 0.32 μg GAE/mg extract, and remarkable antioxidant potential was revealed in total antioxidant contents (TAC) and total reducing power (TRP) assays, i.e., 70.4 ± 0.4, 83.2 ± 1.9 μg ascorbic acid equilant (AAE) Borges/mg extract. The UHPLC-QTOF-MS analysis showed that the extract contains flavonoid glycosides, phenolic acids, flavans, O-methylated flavonoids, linoleic acids, terpene glycosides, triterpenoid saponins, and certain other phytoconstituents. Maximum inhibition of 77.13% ± 1.60% against HepG2 cells was observed at 24 h. Loss in MMP by JC-1 (5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimi- dazolylcarbocyanine iodide) staining and increased ROS generation, and caspase-3, caspase-8 activation by extract significantly illustrated the cancer cell death by apoptosis. D. bupleuroides could be a potential source of safe and therapeutically active compounds that can be purified to develop safer, selective, and efficacious anticancer agents with fewer side effects., (© 2025 Wiley Periodicals LLC.)

Background: Suicide helpline services (SHSs) are viewed as an essential part of suicide prevention. In the context of increased demand experienced by the services through the COVID-19 pandemic, as well as reduced funding, we aimed to evaluate such services to help assess their effectiveness and resilience., Methods: This multinational cross-sectional survey, conducted from Sept 1, 2022, to Feb 28, 2023, evaluated SHSs in 150 countries. Local collaborators created an SHS directory, and a 42-question questionnaire was distributed via Survey Monkey through Find A Helpline and local collaborators. A team of experts, including individuals with lived experience, helped shape the research questions and study design. We did descriptive statistical analysis of answers to the questions, and data were further analysed using the Bayesian Model Averaging method to predict managers' or supervisors' low overall satisfaction with the service (MS-LOSS)., Findings: The study involved 446 responses from 105 countries for descriptive statistics. 354 (79·4%) of 446 services had insufficient funding, 249 (55·8%) had post-COVID-19 budget reductions, and 278 (62·3%) observed a sharp rise in suicide help requests during the COVID-19 pandemic. 420 responses were used for finding the optimal logistic model, which had an area under the curve of 0·679, indicating that pre-service training for volunteers was significantly associated with a reduction in MS-LOSS (odds ratio 0·16 [95% CI 0·07-0·31]; p<0·001), as was having a quality assurance structure (0·15 [0·02-0·70]; p=0·030). Higher MS-LOSS was associated with staff training only every 2-3 years instead of one or more times per year (2·87 [1·23-6·85], p=0.016) and with dilemmas with providing services in severe cases (1·68 [1·06-2·68]; p=0·028)., Interpretation: Global SHS reports indicate that both pre-task and ongoing training for volunteers and staff, coupled with a quality assurance structure, could decrease MS-LOSS. Our findings emphasise the need for training for volunteers, continuous training programmes for staff, and on-site support for individuals at risk of suicide., Funding: RSTMH Small Grants Award 2021, UK NIHR, and MEXT., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

MXene has garnered growing interest in the field of electrochemistry, thanks to its unique electrical and surface characteristics. Nonetheless, significant challenges persist in realizing its full potential in chemoresistive sensing applications. In this study, a novel unidirectional freeze-casting approach for fabricating a Poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS)-facilitated vertically aligned MXene-based aerogel with enhanced chemoresistive sensing properties was introduced. Firstly, the persistent challenge of poor gelation in MXene was addressed by formulating a nanohybrid of MXene and PEDOT:PSS, which acted as flexible conductive nanobinder. Employing a unique freeze-casting method, MXene flakes interconnected by PEDOT:PSS, were stabilized into a flexible, vertically aligned structure, leading to maximum surface exposure and enhanced robustness. The resulting 3-dimentional (3-D) aerogel exhibited a fast, heightened chemoresistive response of 7 to 50 parts per million (ppm) acetone and expanded the working range to between 10 parts per billion (ppb)-8000 ppm. Interfacial heterostructures formed between MXene and PEDOT:PSS, provided active sites, reduced activation energy, and enhanced selectivity. Modulated MXene bandgap, and its electron mobility further facilitated electron transfer, and enhanced signal strength. The sensor showed excellent biocompatibility and was also successfully employed as a breathalyzing tool, for on-demand alcohol consumption monitoring., (© 2024 The Author(s). Advanced Materials published by Wiley‐VCH GmbH.)

Background: The diagnostic performance of the available risk assessment models for VTE in patients who are critically ill receiving pharmacologic thromboprophylaxis is unclear., Research Question: For patients who are critically ill receiving pharmacologic thromboprophylaxis, do risk assessment models predict who would develop VTE or who could benefit from adjunctive pneumatic compression for thromboprophylaxis?, Study Design and Methods: In this post hoc analysis of the Pneumatic Compression for Preventing VTE (PREVENT) trial, different risk assessment models for VTE (ICU-VTE, Kucher, Intermountain, Caprini, Padua, and International Medical Prevention Registry on VTE [IMPROVE] models) were evaluated. Receiver-operating characteristic curves were constructed, and the sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. In addition, subgroup analyses were performed evaluating the effect of adjunctive pneumatic compression vs none on the study primary outcome., Results: Among 2,003 patients receiving pharmacologic thromboprophylaxis, 198 (9.9%) developed VTE. With multivariable logistic regression analysis, the independent predictors of VTE were Acute Physiology and Chronic Health Evaluation II score, prior immobilization, femoral central venous catheter, and invasive mechanical ventilation. All risk assessment models had areas under the curve < 0.60 except for the Caprini model (0.64; 95% CI, 0.60-0.68). The Caprini, Padua, and Intermountain models had high sensitivities (> 85%) but low specificities (< 20%) for predicting VTE, whereas the ICU-VTE, Kucher, and IMPROVE models had low sensitivities (< 15%) but high specificities (> 85%). The positive predictive values were low (< 20%) for all studied cutoff scores, whereas the negative predictive values were mostly > 90%. Using the risk assessment models to stratify patients into high- vs low-risk subgroups, the effect of adjunctive pneumatic compression vs pharmacologic prophylaxis alone did not differ across the subgroups (P interaction > .05)., Interpretation: The risk assessment models for VTE performed poorly in patients who are critically ill receiving pharmacologic thromboprophylaxis. None of the models identified a subgroup of patients who might benefit from adjunctive pneumatic compression., Clinical Trial Registration: ClinicalTrials.gov, No.: NCT02040103, URL: www., Clinicaltrials: gov. ISRCTN44653506; International Standard Randomised Controlled Trial No.: ISRCTN44653506, URL: https://www.isrctn.com., Competing Interests: Financial/Nonfinancial Disclosures None declared., (Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Competing interests: The authors declare no competing interests.

Introduction: Burn-related fatalities pose a significant global public health challenge, with a substantial impact on the elderly population. This study examines two decades of burn-related mortality data in the United States, aiming to understand the trends, disparities, and contributing factors among adults aged 65 and older., Objectives: The primary objectives of this study are to (1) analyze the trends in burn-related mortality rates among older adults, (2) investigate disparities based on gender, race and geographic regions, and (3) identify comorbidities and complications associated with burn-related deaths in this demographic., Methods: Data were obtained from the Centers for Disease Control and Prevention (CDC) using the National Center for Health Statistics database. The study cohort consists of individuals aged 65 and older who experienced burn-related deaths between 1999 and 2020. Various demographic variables, including age, sex, race/ethnicity, and location of death, were considered. The study also examined urban-rural classifications and regional differences. Mortality rates were calculated and adjusted for age. Joinpoint regression analysis was employed to assess trends in age-adjusted mortality rates over time. Modes of death and common comorbidities and complications were analyzed., Results: Between 1999 and 2020, a total of 96,498 older adults succumbed to burn injuries in the United States. Analysis revealed a concerning increase in burn-related mortality rates from 2012 onwards. Demographic disparities were evident, with older men consistently exhibiting higher mortality rates compared to women. Racial disparities were observed, with Black individuals experiencing the highest mortality burden. Geographic analysis indicated elevated mortality rates in Western states and rural areas. Accidents emerged as the leading cause of death, with ischemic heart disease and hypertensive diseases being prevalent comorbidities. Complications, with septicemia being the most common, contribute significantly to mortality., Conclusion: Our analysis of 20 years of burn-related mortality data from the CDC reveals alarming trends in the United States. Unlike global trends, mortality rates have stagnated from 1999 to 2020, indicating a persistent public health challenge. Black individuals aged over 65 bear the brunt of burn-related mortality, facing the highest age-adjusted rates among all racial groups. Regional disparities are stark, with states in the top 90 % exhibiting significantly higher age-adjusted mortality rates compared to those in the bottom 10 %. Moreover, rural areas consistently report higher mortality rates than urban areas. Ischemic heart disease, hypertensive diseases, and other heart-related conditions emerge as prevalent comorbidities. To effectively reduce burn-related injuries and fatalities, targeted public health policies are imperative. These interventions must prioritize high-risk populations and adopt culturally sensitive approaches to promote safety. Additionally, enhancing access to healthcare and fire safety education is vital for mitigating the burden of burn-related mortality among the elderly population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Background: Training in complex high-risk indicated percutaneous coronary intervention (CHIP-PCI) has frequently been reserved for established operators (consultants/attending) with trainees (fellows-in-training or FIT) being often discouraged from carrying out such procedures as a primary operator due to their high-risk nature. Whether the outcomes of these cases differ if the primary operator is a supervised FIT compared with a consultant is unknown., Methods: Using multicentre PCI data from three cardiac centres in South Wales, UK (2018-2022), we identified 2295 CHIP-PCI cases with a UK-BCIS CHIP Score of 3 or more. These were then divided by primary operator status (supervised FIT vs consultant); the primary outcome was in-hospital major adverse cardiac events (IH-MACCE). Multivariate logistic models were developed to adjust for differences in baseline and procedural characteristics., Results: The primary operator in 838 (36%) of the PCIs was a supervised FIT. Baseline and procedural characteristics had lower complexity in CHIP-PCI cases carried out by supervised FIT vs consultant. In a multivariate-adjusted model, supervised FIT procedures were associated with lower odds of concurrent valve disease (OR 0.45, 95% CI: 0.29 to 0.69), dual access (OR 0.58, 95% CI: 0.41 to 0.83), cutting/scoring balloons (OR 0.59, 95% CI: 0.44 to 0.79) and rotational atherectomy (OR 0.60, 95% CI: 0.42 to 0.87). After adjusting for all variables, however, there was no difference in the primary outcome (OR 0.72, 95% 0.34 to 1.51) or any secondary outcomes. Sensitivity analyses restricted to patients with higher CHIP Scores (4+ and 5+) showed comparable IH-MACCE., Conclusions: Training FIT as primary operators in CHIP-PCI appears to be feasible and safe and can be delivered within the standard training programme. The comparable outcomes are likely driven by the two-operator 'buddy' effect that a FIT supervised by a consultant benefits from., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)

Antibiotic-resistant bacteria often cause lethal infections in both the surficial and deep organs of humans. Failure of antibiotics in resistant infections leads to more effective alternative therapies, like spatiotemporally controllable piezodynamic therapy (PZDT) with deep penetration. Currently, PZDT demands further investigation for improved treatment outcomes and the corresponding therapeutic mechanisms. Herein, a nanocomposite cloaked is reported with a biomimetic coating of TLR-upregulated macrophage membrane for targeted PZDT against MRSA-induced skin wound infection and osteomyelitis, representing surficial and deep infection models, respectively. To boost the therapeutic efficacy, crystal defect engineering is applied by impregnating Fe 2+ into bismuth oxy-iodide nanosheets to increase the crystal defects. This results in a significantly higher piezoelectric coefficient than in previous reports, contributing to an amplified reactive oxygen species generation for bacterial killing. More importantly, the notable piezoelectric effect not only re-programs the macrophages into an anti-inflammatory M2 phenotype for accelerating bacterial wound healing but also stimulates the opening of the piezo-stimulated Ca 2+ channels and boosts the differentiation of mesenchymal stem cells into osteoblasts for expediting bone tissue repair in osteomyelitis model. Moreover, the Fe-doping supplements T2-magnetic resonance imaging for real-time visualization of nanocomposite distribution. This theranostic system opens a new avenue for future treatment of drug-resistant bacteria-caused diseases., (© 2025 Wiley‐VCH GmbH.)

Background: Pancreas Transplantation (PT) provides optimal treatment for patients with severe complicated Type 1 Diabetes Mellitus (T1DM). Restoration of beta-cell mass allows return to euglycaemia and insulin independence. We aimed to examine its impact on the secondary complications associated with severe T1DM including diabetic eye disease, neuropathy and cardiovascular disease., Methods: A database search using MedLINE to identify publications to April 2023 was conducted. Searches were performed using MeSH terms 'Pancreas Transplantation' AND 'Diabetes Mellitus, Type 1' 'Diabetic Retinopathy' OR 'Heart Disease' OR 'Cardiovascular Diseases' OR 'Peripheral Vascular Disease' OR "Amputation' OR 'Neuropathy.", Results: All articles were retrospective with 51.1 % (n = 23) case control studies and 48.9 % (n = 22) cohort studies. 82.2 % (n = 37) examined simultaneous pancreas and kidney (SPK) transplantation and 17.8 % (n = 8) analysed pancreas transplant alone (PTA). Heterogenous outcomes metrics were employed. 15 studies examined diabetic retinopathy (DR) with 53.3 % (n = 8) demonstrated improvements after PT, while the remainder (n = 7) exhibited stabilisation. 16 studies assessed neuropathy and 87.5 % (n = 14) demonstrated beneficial effects of PT on nerve conduction studies, vibration perception threshold or corneal confocal microscopy. There was a positive effect on cardiovascular disease by reduction in the incidence of cardiac events, improvement in metabolic profile and increased left ventricular ejection fraction. 14 studies examined cardiovascular disease (71.4 % (n = 10) improvement; 14.2 % (n = 2) stabilisation; 14.2 % (n = 2) progression)., Conclusion: SPK and PTA have beneficial effects in ameliorating or stabilising diabetes complications. Future work should seek to reduce heterogeneity of outcome metrics assessing T1DM complication profile to facilitate robust comparison of beta-cell replacement interventions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. DD is a UKRI Medical Research Council and Breakthrough T1D Clinical Research Training Fellow (MR/X00211X/1)., (Copyright © 2025. Published by Elsevier Inc.)