Laryngeal reinnervation vs type I thyroplasty in unilateral vocal fold paralysis (VOCALIST) : a randomized feasibility study

Objectives. We wished to determine the feasibility of performing a multi-centre phase III randomized controlled trial that compares laryngeal reinnervation to type I thyroplasty for adults with unilateral vocal fold paralysis (UVFP) in the UK. Methods. A feasibility study was designed; 27 participants were recruited at three UK sites. Trial procedures mirrored those intended for a full-scale trial. We assessed recruitment rates, acceptability of randomization, and dropout rates and conducted a qualitative study to understand the recruitment processes. Participants were followed up for up to 12 months to assess optimal outcome measures for the definitive trial covering voice, swallowing, and overall quality of life. A qualitative study was run in parallel with the quantitative clinical trial. Results. Recruitment was successful with 23 patients with UVFP randomized to reinnervation (n = 12) and thyroplasty (n = 11). 96% (n = 22) of participants accepted the treatment to which they were allocated, of which 17 received their intervention before the study end date. The qualitative study identified minor recruitment challenges that could be addressed through in-trial training. The set of subjective and objective voice, swallowing, and quality of life outcome measures used demonstrated a responsiveness to change following interventions. Conclusion. The results from this study have provided us with the assurance that conducting an adequately powered randomized controlled clinical trial of laryngeal reinnervation versus type I thyroplasty for adults with UVFP in the UK is feasible in terms of conduct, recruitment, outcome measurement, and completion. Level of Evidence: 2. Trial Registration: ISRCTN9020173

Neural correlates of lexical, sublexical and motor processes in word handwriting

Writing recruits a vast neural network underpinning both linguistic and motor processes. Previous studies have tried to identify which brain areas underpin both the linguistic and motor aspects of writing. However, little is known about the neural substrate of the lexical and sublexical “routes” for spelling. In this fMRI study, participants (n = 25) copied or saw/read symbols or words. Words varied in lexical frequency and phonology-to-orthography (P-O) consistency. Anterior parts of the inferior frontal gyrus were selectively recruited when copying P-O inconsistent words, while the right Heschl's gyrus was recruited only when copying consistent words. Non-specific motor and linguistic areas were also identified. Our results contribute to our knowledge of the neural substrate of the lexical and sublexical spelling routes and suggest that different brain areas might be involved in the lexical processing of input (reading) and output (writing) orthography

Professional identity in nursing : a narrative review of the ISPIN definition and domains usage

Introduction. Established in 2020, the International Society for Professional Identity in Nursing (ISPIN) developed a definition of professional identity in nursing (PIN). This definition encompasses four domains: values and ethics, knowledge, nurse as leader, and professional comportment. Objective. This narrative review aimed to summarize and synthesize identified published evidence, the extent of discussion of PIN domains, and literature gaps for the ISPIN definition of PIN. Methods. Sources included peer-reviewed literature published between 2018 to 2025 from CINAHL and PubMed. Gray literature through Google Scholar and ISPIN archived publications were also searched. These were identified by two researchers and a PRISMA flow diagram was developed. No registered protocol was utilized. Search and MeSH terms included “professional identity,” “nurs*,” and “ISPIN.” Findings. Thirty-seven articles met inclusion criteria and were extracted from 16,295 initially identified articles, with the majority with authors from the United States. There were very few research papers and a noticeable dearth using quantitative methodologies. Twenty-eight of the retrieved articles were considered expert accounts, conceptual discussion or opinions, common for a relatively new concept. Discussion. Nurse as leader was discussed in 34 of 37 articles. Professional comportment was discussed in 31 articles. Both knowledge and value and ethics were discussed in 28 articles. Conclusion. This narrative review highlights the nature and prevalence of the ISPIN definitions and its four domains in current literature and can be visualized through diagramming. Minimal quantitative studies and a higher volume of discussion articles present limitations to its strength and applicability. Results suggests the need for further research in all domains, particularly in knowledge and values and ethics, and its implications in strengthening nursing practice and education

The Role of CEP164B in Trypanosoma brucei: Implications for Flagellum Biogenesis and Cell Cycle Regulation

Trypanosoma brucei is the causative agent of Human African Trypanosomiasis (HAT) or African Sleeping Sickness. The protozoan kinetoplast relies on precise cell cycle regulation and flagellum biogenesis for survival and pathogenicity. The transition fibre protein CEP164B has been implicated in flagellar assembly, yet its specific role in trypanosome cell division remains underexplored. This study investigates the impact of CEP164B depletion on cell morphology, flagellum formation and cell cycle progression in T.brucei using RNA interference (RNAi). Fluorescence microscopy and quantitative analysis revealed that CEP164B interference significantly reduced flagellum length, the emergence of abnormal cell populations, including 0K1N cells (no kinetoplast, one nucleus), and defects in kinetoplast segregation. Statistical analyses confirmed significant shifts in cell populations, with a decline in 1K1N cells and an increase in multinucleated and mutant forms. The observed phenotypes suggest that CEP164B plays a crucial role in maintaining transition fibre integrity, basal body positioning, and coordinated organelle division. These findings highlight CEP164B as a potential therapeutic target for disrupting trypanosome proliferation

Lifestyle behaviour change following breast cancer : a qualitative exploration of experiences and unmet support and information needs

Lifestyle modification can reduce breast cancer recurrence risk and improve quality of life. However, few studies have explored patients’ experiences of lifestyle behaviour changes following breast cancer, specifically the information and support received regarding lifestyle changes. To explore this topic, interviews were conducted (n=21 women) and analysed thematically based on the Framework Approach. Themes included: Impact of cancer and behaviour change complexities; Impact of lifestyle messaging from healthcare professionals; Desire for empowering lifestyle advice and Shaping future lifestyle interventions. Lifestyle advice was either not provided, or perceived as unhelpful, with some being discouraged from making changes during treatment. If advice was received, emphasis tended to be in relation to physical activity and diet, with little mention of alcohol consumption. Personalised and empowering interventions are needed for patients and healthcare professionals to increase awareness regarding benefits of lifestyle changes after breast cancer, particularly regarding alcohol reduction, and to promote behaviour change

Re-framing European Union (EU) - United Kingdom (UK) cooperation to address human trafficking and migrant smuggling

Since the UK’s departure from the EU, the two parties have established a Trade and Cooperation Agreement (TCA) to shape their post-Brexit trade relationship. However, no formal agreement has been reached to address people smuggling and human trafficking, despite the UK government's stated intention to collaborate with the EU in tackling these crimes. We argue that when such an agreement is negotiated, it should adopt a human rights-based approach, ensuring the effective identification and protection of actual and potential victims of human trafficking. Enhanced cooperation in integrated border management, such as the 2024 post-Brexit arrangement between the European Border and Coast Guard Agency (Frontex) and the UK, and bilateral agreements with France, has yet to sufficiently prioritise human rights. Like the EU’s other cooperation agreements with third states, any potential future bilateral agreement should also incorporate human rights clauses, in line with specific measures contained in the TCA. These legally binding clauses are designed to safeguard and strengthen the protection of fundamental rights. Addressing the complexity of human trafficking and migrant smuggling, along with the multifaceted governance systems they entail, requires balancing the UK’s national sovereignty with the EU’s legal personality and primacy over its Member States in the development of bilateral agreements rooted in human rights. This challenge requires cooperation and responsibility-sharing, rather than uncoordinated systems that states, and non-state actors can exploit

Breaking barriers : promoting parent-child engagement with co-produced activity packs for 1-to-3-year-olds

Parent-child activities support children’s socio-emotional and cognitive development, yet numerous barriers limit engagement, particularly among families experiencing socio-economic disadvantage. This study uniquely investigates and addresses these challenges by integrating insights from parents and early years practitioners. Through online workshops, 118 parents and 127 practitioners identified barriers relating to opportunity (e.g., time constraints, access to resources, and worries about mess and damage), capability (e.g., gaps in knowledge and expectations) and motivation (practitioners in particular emphasized the importance of parental confidence and positive experiences of play). To address these barriers, three co-designed activity packs were distributed to over 1000 families. The packs featured simple, clearly explained, play-based activities requiring minimal setup, along with resources and guidance tailored to diverse family needs. Emphasizing the process over outcomes, the packs aimed to boost parental confidence, bridge knowledge gaps, and support parent-child interactions. Feedback from 23 parents and interviews with 10 practitioners highlighted the packs’ positive impact on parental perceptions of play, their confidence in supporting child development, and their ability to overcome practical constraints. Practitioners played a pivotal mediating role, fostering trust, addressing concerns, and encouraging participation through personalized interactions. This study offers a scalable, cost-effective intervention model that directly addresses practical and psychological barriers to parent-child engagement. The findings have significant implications for policymakers, emphasizing the need for targeted, evidence-based solutions that combine resource provision with practitioner support. Such approaches are essential for fostering equity in early childhood development and improving outcomes for children across diverse populations