The goal of this observational study is to demonstrate that nutritional status and body composition have an impact on clinical outcomes in inflammatory bowel disease (IBD).
The main objectives are:
1. To compare the detection rates of undernutrition between a range of nutritional screening tools, physiological measures and assessment tools amongst patients with different IBD phenotypes
2. To correlate nutritional status, nutritional biomarkers and body composition with clinical outcomes in patients with IBD treated with advanced medical therapy or surgery
3. To determine a potential relationship between radiological muscle mass measurements and clinical outcomes in patients with IBD treated with advanced medical therapy or surgery
Participants will undergo an assessment at pre-treatment baseline and then again at their scheduled follow-up. This is a non-interventional study and participants will not be required to have any invasive tests or hospital visits beyond that of standard clinical care.

开始日期2025-09-01

申办/合作机构

Barts & The London NHS Trust

[+1]

ISRCTN13985150 / RecruitingN/A

In UK military veterans (P) the remotely delivered Fast Imagery Reversal Script for Trauma release Protocol (I), compared to waiting list control (C) is clinically and statistically effective in reducing post-traumatic stress disorder symptoms by the minimal clinically important difference (O) at 20 weeks (T)

开始日期2025-03-01

申办/合作机构

King's College London

NCT06678815 / Not yet recruitingN/A

How Can Volunteers in the NHS Be Best Supported?

This study aims to investigate the impact of volunteers in the English National Health Service (NHS) and increase the evidence base for supporting and developing volunteering to best help patients and services. The research will focus on one relatively established role: Community First Responders (CFR) supporting the ambulance service in English NHS Ambulance Trusts. We will take a mixed methods approach, combining qualitative and quantitative methods to learn more about the effectiveness and wider perceived value of the CFR role from the perspectives of CFRs themselves, other NHS staff and NHS patients who may interact with them.
Our primary Research Question is: How can we maximise the impact of the Community First Responder role? Secondary Research Questions focus on what we can learn from the Community First Responders to support volunteer roles more widely. In particular: How can policy makers improve the deployment of volunteers? How do staff perceive the support they receive from volunteers (including impact on their workload and morale)? How do patients perceive the support they receive from volunteers? How are volunteers impacting services? What opportunities are there for further developing the volunteer role? We will work with (up to five) Ambulance Trusts already involved in the National Ambulance Volunteering Dashboard to extract quantitative data from existing management systems. These data will focus on (1) number and demographic characteristics of CFRs; (2) aggregate CFR activity (incidents attended, first on scene, responses times, response outcomes) and (3) CFR incident data (including location, time, category and CFR attendance). From these Trusts we will select 2 for qualitative data collection consisting of documentary analysis and semi-structured interviews with CFRs, NHS staff and patients. This research aims to generate evidence to inform decisions on where policymakers can most efficiently focus future volunteer interventions and how the NHS can best support volunteers in the system.

开始日期2025-01-01

申办/合作机构

King's College London

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76,920

项与 King's College London 相关的文献（医药）

2025-03-01·Physiotherapy

A core capability framework for physiotherapists to deliver quality care when working with people living with dementia and their families/caregivers: an international modified e-Delphi study

Article

作者: Callisaya, Michele L ; Tangen, Gro Gujord ; Hobbelen, Hans ; Dal Bello-Haas, Vanina ; Taylor, Morag E ; Lawler, Katherine ; Hunter, Susan W ; Hall, Abi ; Goodwin, Victoria A ; Whitney, Julie ; Telenius, Elisabeth ; Bello-Haas, Vanina Dal ; Callisaya, Michele ; Rosendahl, Erik ; Toots, Annika ; Sverdrup, Karen ; Ries, Julie ; Hill, Keith

OBJECTIVE:

What are the core capabilities physiotherapists need to deliver quality care when working with people with dementia and their families/caregivers?

DESIGN:

A three-round modified e-Delphi study.

PARTICIPANTS:

Panel members were physiotherapists experienced in working with people with dementia and/or educating and/or researching in the dementia field.

METHODS:

A steering group (16 international physiotherapists and a consumer) developed a draft framework including 129 core capabilities across 5 domains for panel members to rate their appropriateness for inclusion as a core capability to provide high quality care to people with dementia and their caregivers/families. The RAND/UCLA method was used to assess consensus.

RESULTS:

Thirty-five physiotherapists from 11 countries participated in Round 1, 31 (89%) in Round 2 and 28 (80% of Round 1) in Round 3. All core capabilities were rated appropriate for inclusion in each round. Panel members recommended wording refinements across the rounds and suggested 51 core capabilities for consideration. Three rounds were needed to reach consensus, resulting in 137 core capabilities rated appropriate for inclusion across 5 domains: 1) Knowledge and understanding, n = 36; 2) Assessment, n = 39; 3) Management, interventions and prevention n = 40; 4) Communication, therapeutic relationship and person-centred care, n = 17; and 5) Physiotherapists self-management and improvement, n = 5.

CONCLUSIONS:

This e-Delphi study outlines the core capabilities physiotherapists need to provide high quality care to people with dementia and their families/caregivers. These core capabilities can be used by physiotherapists to help identify knowledge/skill gaps, as well as by educators to improve their training of undergraduate and postgraduate students, and clinicians. CONTRIBUTION OF PAPER.

2025-01-01·ADDICTIVE BEHAVIORS

Does Self-Reported smoking cessation fatigue predict making quit attempts and sustained abstinence among adults who smoke Regularly?

Article

作者: Cummings, K. Michael ; Nottage, Matilda K. ; Sheffer, Christine E ; Cea, Claudia M ; Cummings, K Michael ; Sheffer, Christine E. ; Borland, Ron ; Yong, Hua-Hie ; Nottage, Matilda K ; Cea, Claudia M. ; Michael Cummings, K.

BACKGROUND:

Quitting smoking is difficult and many people who smoke experience cessation fatigue (CF) as a result of multiple failed attempts. This study examined the association of CF with making and sustaining a smoking quit attempt.

METHODS:

Data analysed were 4,139 adults (aged 18 years or older) who smoked daily or weekly and participated in the 2018 and 2020 International Tobacco Control Four Country Smoking and Vaping Surveys (ITC 4CV) conducted in Australia, Canada, England, and the US. CF was assessed at baseline using a single question: "To what extent are you tired of trying to quit smoking?" with response options: "Not at all tired"; "Slightly tired"; "Moderately tired"; "Very tired"; or "Extremely tired". We used binary logistic regression models to test the hypothesis that baseline CF would predict lower odds of both making a quit attempt and sustaining abstinence for a month or longer at follow-up adjusted for socio-demographic and smoking/vaping-related covariates.

RESULTS:

Persons who currently smoked and reported at least some CF were more likely to make a quit attempt, but less likely to sustain abstinence for at least one month, than those who reported no CF. These associations were independent of socio-demographic variables, and they did not differ by country.

CONCLUSION:

Contrary to expectation, CF was positively associated with making a quit attempt and non-linearly associated with lower rates of sustained abstinence at follow-up. While these findings should be replicated, they suggest that people with CF may benefit from targeted support to remain abstinent after a quit attempt.

2025-01-01·MEDICAL IMAGE ANALYSIS

Enhancing global sensitivity and uncertainty quantification in medical image reconstruction with Monte Carlo arbitrary-masked mamba

Article

作者: Schönlieb, Carola-Bibiane ; Shi, Kuangyu ; Huang, Jiahao ; Nan, Yang ; Wu, Weiwen ; Yang, Liutao ; Wu, Yinzhe ; Aviles-Rivero, Angelica I ; Zhang, Daoqiang ; Yang, Guang ; Aviles-Rivero, Angelica I. ; Wang, Chengyan ; Wang, Fanwen

Deep learning has been extensively applied in medical image reconstruction, where Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs) represent the predominant paradigms, each possessing distinct advantages and inherent limitations: CNNs exhibit linear complexity with local sensitivity, whereas ViTs demonstrate quadratic complexity with global sensitivity. The emerging Mamba has shown superiority in learning visual representation, which combines the advantages of linear scalability and global sensitivity. In this study, we introduce MambaMIR, an Arbitrary-Masked Mamba-based model with wavelet decomposition for joint medical image reconstruction and uncertainty estimation. A novel Arbitrary Scan Masking (ASM) mechanism "masks out" redundant information to introduce randomness for further uncertainty estimation. Compared to the commonly used Monte Carlo (MC) dropout, our proposed MC-ASM provides an uncertainty map without the need for hyperparameter tuning and mitigates the performance drop typically observed when applying dropout to low-level tasks. For further texture preservation and better perceptual quality, we employ the wavelet transformation into MambaMIR and explore its variant based on the Generative Adversarial Network, namely MambaMIR-GAN. Comprehensive experiments have been conducted for multiple representative medical image reconstruction tasks, demonstrating that the proposed MambaMIR and MambaMIR-GAN outperform other baseline and state-of-the-art methods in different reconstruction tasks, where MambaMIR achieves the best reconstruction fidelity and MambaMIR-GAN has the best perceptual quality. In addition, our MC-ASM provides uncertainty maps as an additional tool for clinicians, while mitigating the typical performance drop caused by the commonly used dropout.

194

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2024-11-04

·Business Wire

Ondine Biomedical's US $11M Fundraise Enables a Q4 2024 Start of Its Pivotal Phase 3 US Trial

VANCOUVER, British Columbia--( BUSINESS WIRE )--Canadian life sciences company Ondine Biomedical announces that it is accelerating its final preparations for a Q4 2024 start to its key pivotal US Phase 3 trial following its recent successful raise of Cdn $16 million (£9m, US $11m). Alongside strong support from existing institutional shareholders, Ondine added a number of significant new shareholders, including M&G Investment Management Limited, which corner-stoned the recent financing. Ondine is also in discussions with a major U.S. healthcare group regarding a further potential investment of up to Cdn $5.5 (US$4 m,£3.1 m). The Company is pioneering the development of cost-effective, light-activated antimicrobials that kill all types of pathogens – viruses, bacteria and fungi – in minutes without causing the development of resistant strains of microbes. The company is presently focused on nasal decolonization prior to surgery to reduce hospital-associated infections through its proven Steriwave® technology. Hospitals deploying the Company’s unique, painless, infection control therapy have seen significant reductions in surgical site infection rates, patient re-admission numbers, length of stay, and antibiotic usage. Ondine's Steriwave technology is now used in many hospitals across Canada and in several UK NHS hospital trusts, including Mid Yorks, Leeds Teaching Hospitals, and Kings College London. The Company plans to expand its product reach outside North America through its recently announced distribution partnership with Mölnlycke Health Care . Carolyn Cross, CEO of Ondine, commented: “With this key financing behind us, we are able to move forward with our plans for our key Phase 3 clinical trial in the USA in support of FDA approval and US market access. The capital raised enables us to advance our goal to have the first patient treated in December 2024. “The robust interest we have had in this fundraise is testament to the excitement around our groundbreaking light-activated antimicrobial technology, particularly in the context of the growing death toll caused by antimicrobial resistance (AMR).” Ondine's is conducting its Phase 3 trial in close collaboration with its US clinical trial partner HCA Healthcare, the largest healthcare provider in the United States. i The 5,000-patient group-randomised crossover study will be carried out at 14 HCA hospital sites. It will compare standard-of-care infection prevention practices with and without Ondine's nasal photodisinfection (branded as Steriwave® outside the US). Recruitment of the first patient is now due by the end of 2024, with the final patient expected in mid-2025, and an early data readout anticipated in Autumn 2025. About Ondine Biomedical Inc. Ondine Biomedical Inc. is a Canadian life sciences company and leader innovating light-activated antimicrobial therapies (also known as 'photodisinfection'). Ondine's nasal photodisinfection system has a CE mark in Europe and the UK and is approved in Canada and several other countries under the name Steriwave®. In the US, it is currently undergoing clinical trials for regulatory approval. i https://www.definitivehc.com/blog/top-10-largest-health-systems

临床3期

2024-10-23

·梅斯医学

轻轻一电，改善抑郁症？《自然-医学》：缓解率高出2倍之多

抑郁症是导致全球范围内残疾的主要原因之一，一线治疗策略是抗抑郁药联合心理治疗。临床上，超过1/3的抑郁症患者治疗后未能实现完全临床缓解。经颅直流电刺激（tDCS）是一种非侵入性脑刺激技术，通过置于头皮的两个或多个电极产生微弱直流电，来调节大脑皮质兴奋性。 ▲tDCS系统示意图（图片来源：参考文献[2]）既往研究发现，便携式的tDCS安全且耐受性良好，是抑郁症的潜在新一线治疗方案。但通常tDCS治疗需要连续治疗几周，且多数研究均在研究所开展，需要参与者每天接受访视，这在一定程度上限制了其临床应用前景。此外，既往已开展的研究纳入患者人数较少，且研究时间普遍限制在6周，仍需有大规模研究来佐证tDCS疗效。为此，来自伦敦国王学院、东伦敦大学、得克萨斯大学休斯顿健康科学中心等机构的研究团队共同开展了一项大型、双盲、随机优效性试验，结果显示，基于远程监督模式的为期10周家庭tDCS治疗抑郁症，显示出较好的疗效、可接受性和安全性，可有效缓解至少中度抑郁患者的症状。该研究发表于《自然-医学》（Nature Medicine）。研究共同作者，来自得克萨斯大学休斯顿健康科学中心的Machado-Vieira教授表示：“这项研究证实了基于家庭的tDCS在治疗抑郁症方面的安全性和积极有效性，有望帮助更多患者及时获得治疗”。截图来源：Nature Medicine 研究纳入174例抑郁症患者，其中69%为女性，至少为中度抑郁。所有患者既往未接受治疗、稳定服用抗抑郁药或接受心理治疗至少6周。基线时，汉密尔顿抑郁量表-17项（HDRS-17）评分（分数越高、病情越严重）平均分为19.07分。研究人员将患者随机纳入主动tDCS刺激组（87例）和假性tDCS刺激组（87例）。两组患者分别接受持续30分钟的2 mA直流电刺激，以及使用相同器械和应用程序进行假性刺激，假性tDCS刺激患者同样可感受到主动刺激的刺痛感，以充分模拟主动刺激。所有患者先接受为期10周的家庭环境tDCS治疗抑郁症，即每周5次，持续治疗3周，接着转为每周3次，持续治疗7周。10周家庭环境治疗结束后，进行为期10周的开放标签治疗，主动tDCS刺激组患者可继续接受每周3次的主动tDCS治疗，假性tDCS刺激组患者先接受每周5次，持续3周的主动tDCS刺激，再转为每周3次，治疗7周。整个研究过程中，研究人员均可进行远程监控，并根据机器传回的数据来判断患者操作的合规性。研究结果显示，基线至治疗第10周时，相比于假性tDCS刺激组，主动tDCS刺激组患者HDRS-17评分降低更多（9.41分 vs. 7.14分，P=0.012）。 ▲主动tDCS刺激组（蓝色圆点）和假性tDCS刺激组（黄色三角）的抑郁严重程度评分随时间的变化（图片来源：参考文献[1]）基于HDRS评分可知，主动tDCS刺激组患者临床应答率显著高于假性tDCS刺激组（58.3% vs. 37.8%，P=0.017）。主动tDCS刺激组患者缓解率高出假性tDCS刺激组2倍之多（44.9% vs. 21.8%，P=0.004）。此外，探索性分析还发现，两组患者的焦虑、轻躁狂症状均有所改善，且相比于假性tDCS刺激组，主动tDCS刺激组改善更明显。总之，这项研究表明基于家庭的tDCS可能是抑郁症的潜在一项治疗策略，其疗效高、患者可接受性强且安全性可靠。参考资料 [1] Woodham, R.D., Selvaraj, S., Lajmi, N. et al. Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial. Nat Med (2024). https://doi.org/10.1038/s41591-024-03305-y [2] 唐睿, 宋洪文, 孔卓, 等. 经颅直流电刺激治疗常见神经精神疾病的临床应用专家共识[J]. 中华精神科杂志, 2022, 55(5): 327-382. DOI: 10.3760/cma.j.cn113661-20220527-00131 撰文 | 医学新视点编辑 | 阿拉斯加宝 ●大无语！夜班收了3个患者，欠费逃单跑了俩，共欠1万多！当事医生后续会被扣钱、写情况报告！公立医院不再收押金，如何保证就医诚信？ ●震撼！坐车9小时去大三甲看病，医生下班了，睡在座椅下，副主任医师心疼加号！医生：不想被道德绑架，渴望有加号、退号和拒绝就诊的权力 ●荒唐！医学生发布大体老师头骨合影至短视频平台，自称“无所畏惧”！网友怒批：轻佻无知、毫无尊重，这样搞我们以后谁还敢去捐献遗体？版权说明：梅斯医学（MedSci）是国内领先的医学科研与学术服务平台，致力于医疗质量的改进，为临床实践提供智慧、精准的决策支持，让医生与患者受益。欢迎个人转发至朋友圈，谢绝媒体或机构未经授权以任何形式转载至其他平台。点击下方「阅读原文」立刻下载梅斯医学APP！

临床结果

2024-10-22

·GlobeNewswire-Health Care

Quell Therapeutics to Present Promising Data from Autologous and Allogenic CAR-Treg Programs at Upcoming International Congresses

London, UK – October 22, 2024 – Quell Therapeutics Ltd (“Quell”), a leader in developing engineered T-regulatory (Treg) cell therapies for serious medical conditions driven by the immune system, announces upcoming oral and poster presentations at the 2024 European Society of Gene and Cell Therapy (ESGCT) 31st Annual Congress, held in Rome, Italy (October 22-25, 2024) and at the American Association for the Study of Liver Diseases (AASLD) The Liver Meeting, held in San Diego, CA (November 15-19). An oral presentation at ESGCT and a poster presentation at The Liver Meeting will highlight progress of the LIBERATE study of its lead CAR-Treg candidate QEL-001 to safely induce donor-specific tolerance in liver transplant patients thereby overcoming limitations encountered with previous clinical approaches. The clinical data being presented from the safety cohort demonstrate that QEL-001 is well-tolerated, has shown cell persistence post infusion up to six months and has a stable phenotype over time via FOXP3 and HELIOS expression. In addition, analysis of liver biopsies has confirmed the trafficking, engraftment, and phenotypic stability of the QEL-001 product in the transplanted livers. Having successfully completed the safety cohort, Quell is advancing QEL-001 in the efficacy cohort of the Phase 1/2 LIBERATE clinical trial in liver transplant patients. A poster presentation at ESGCT will describe progress in developing a differentiation process to generate Treg cells from iPSC stem cells, which will enable the future development of allogenic cell therapies for autoimmune and inflammatory diseases. The in vitro characterization data demonstrates the identity, stability and functionality of the iPSC-derived Tregs, which exhibit potent suppressive activity. Quell is advancing further development of the iPSC-Treg platform in collaboration with Cellistic, a specialist in process development and manufacture of immune cell therapies based on human iPSC technology. Details of the presentations can be found below: At ESGCT (October 22-25 – abstracts available to registered attendees by clicking here) Oral presentation: Abstract Title: CAR-Treg cell therapy to induce tolerance in liver transplantation – LIBERATE clinical trialAbstract Number: OR084Date & Time: Thursday, October 24, 2024; 3:30 p.m. - 5:30 p.m. (CET)Session: 9c – Immunotherapy and CAR-T Cells IIRoom: Meeting Room 2Presenter: Rupert Kenefek, PhD, Senior Director Translational Sciences at Quell Therapeutics Poster presentation: Abstract Title: Development and characterization of iPSC-derived regulatory T cells – Towards an allogenic cell therapy for the treatment of autoimmunity and inflammatory conditionsAbstract Number: PO368Date & Time: Wednesday, October 23, 2024; 1:30 p.m. - 3:00 p.m. (CET)Session: Poster Session IIPresenter: Sophie Howson, Scientist at Quell Therapeutics At The Liver Meeting (November 15-19 – abstract available by clicking here) Poster Presentation Abstract Title: The Safety and Tolerability of QEL-001, an Autologous Chimeric Antigen Receptor (CAR) T Regulatory (Treg) Cell Therapy, in Liver Transplantation – A Safety Cohort in the LIBERATE StudyAbstract Number: 1386Date & Time: Saturday, November 16, 2024; 1:00 p.m. - 2:00 p.m. (PST)Session: Poster Session IIPresenter: Alberto Sanchez-Fueyo, Professor of Hepatology and Academic Head of the Institute of Liver Studies at King’s College London, and Honorary Transplant Hepatology Consultant at King’s College Hospital, and Co-Founder of Quell Therapeutics ### About Quell TherapeuticsQuell Therapeutics is the world leader in developing engineered T-regulatory (Treg) cell therapies that aims to harness, direct and optimize their immune suppressive properties to address serious medical conditions driven by the immune system. The Company is leveraging its pioneering Foxp3 Phenotype Lock™ technology, unique multi-modular platform and integrated manufacturing capabilities to design and develop a pipeline of highly engineered Treg cell therapies with greater potential for persistence, potency and stability than earlier generations of Treg cell therapy approaches. Quell’s lead candidate QEL-001 is advancing in the Phase 1/2 LIBERATE clinical trial designed to investigate its ability to induce operational tolerance following liver transplantation, with the potential to protect the post-transplant liver without the need for chronic immunosuppressive medications. Quell is also advancing additional programs in neuroinflammatory and autoimmune diseases internally and in partnership with AstraZeneca. www.quell-tx.com. Contacts Media: Mark Swallow, PhD, Sandi Greenwood MEDiSTRAVA Quell-Tx@Medistrava.comInvestors: Corey Davis, PhD LifeSci Advisors cdavis@lifesciadvisors.com

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