The Role of Transport in Supporting a Healthy Future for Young People

The Health Foundation commissioned Sustrans and the University of the West of England to ‘assess the role of transport in supporting young people to develop and transition to an independent healthy future’. This report focuses on the transport available to young people and how it’s functioning can shape the long-term health of young people today.The report makes seven policy and research recommendations based on the review of existing literature and analysis of how transport can affect young people’s development and future prospects

Three-year cost utility analysis of mini versus standard slings : A trial based economic evaluation

Funding Information: This work was funded by the National Institute of Health Research, Health Technology Assessment programme: project number HTA‐12/127/157. Funding information Dr. Dwayne Boyers reports grants from UK NIHR during the conduct of the study. Ms. Mary Kilonzo reports grants from UK NIHR during the conduct of the study. Kiron Bhal: I have been a speaker and trainer for the following companies in the past Astellas, Pfizer, AMS, Contura, Allergan and others, where I have received honorariums and sponsorship towards attending scientific conferences. Professor James N'Dow reports HTA General Committee 2016–2018. Professor Graeme MacLennan reports grants from UK NIHR during the conduct of the study. Professor John Norrie reports grants from the University of Edinburgh, outside the submitted work; and past and present member of the following: HTA Commissioning Sub‐Board (EOI), NIHR CTU Standing Advisory Committee, NIHR HTA & EME Editorial Board, Pre‐Exposure Prophylaxis Impact Review Panel, EME Strategy Advisory Committee, EME—Funding Committee Members, EME Funding Committee Sub‐Group Remit & Comp Check, HTA General Committee, HTA Funding Committee Policy Group (formerly CSG) and HTA Commissioning Committee. HTA post‐funding committee teleconference 2016–2019; COVID‐19 reviewing 2020. Professor Mohamed Abdel‐Fattah: None in the last 5 years. Before 2015, I have been a speaker, consultant and/or surgical trainer for a number of industrial companies (Astellas, Ethicon, Bard, Pfizer, AMS, Coloplast and others): I have been reimbursed my travel expenses; and on occasions received personal honorariums; proctorship fees and sponsorship towards attending scientific conferences. Research grant from Coloplast managed by the University of Aberdeen. A limited number of my trainees attended pharmaceutical‐sponsored educational/leadership workshops and/or received assistance in presenting their research work at scientific conferences. Was Chairman of the Scottish Pelvic Floor Network (SPFN), which at the time received financial sponsorship from various industrial companies (including all those mentioned above) and non‐profit organisations for its annual meetings and surgical workshops. The SPFN provided an educational grant funding the PI at the highest recruiting site to attend the International Continence Society annual scientific conference in Brazil in 2014. Ongoing: I receive travel sponsorship and occasionally speaker‘s fees from numerous national and international conferences and non‐profit organisations when invited as a guest speaker and/or expert surgeon. In 2019, and at request from NHS Grampian, I attended 2 educational meetings for setting up sacral nerve stimulation service partially funded by Medtronic. I am the Chief Investigator for four NIHR—HTA‐funded studies. I do not hold (and never held) any shares (or similar) in any of the industrial companies (medical or non‐medical). To the best of my knowledge, none of the above have influenced my research or clinical practice. Publisher Copyright: © 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.Peer reviewedPublisher PD

Three-year cost utility analysis of mini versus standard slings:A trial based economic evaluation

OBJECTIVE: To report on the cost-effectiveness of adjustable anchored single-incision mini-slings (mini-slings) compared with tension-free standard mid-urethral slings (standard slings) in the surgical management of female stress urinary incontinence (SUI).PATIENTS AND METHODS: Data on resource use and quality were collected from women aged ≥18 years with predominant SUI undergoing mid-urethral sling procedures in 21 UK hospitals. Resource use and quality of life (QoL) data were prospectively collected alongside the Single-Incision Mini-Slings versus standard synthetic mid-urethral slings Randomised Control Trial (SIMS RCT), for surgical treatment of SUI in women. A health service provider's (National Health Service [NHS]) perspective with 3-year follow-up was adopted to estimate the costs of the intervention and all subsequent resource use. A generic instrument, EuroQol EQ-5D-3L, was used to estimate the QoL. Results are reported as incremental costs, quality adjusted life years (QALYs) and incremental cost per QALY.RESULTS: Base case analysis results show that although mini-slings cost less, there was no significant difference in costs: mini-slings versus standard slings: £-6 [95% CI -228-208] or in QALYs: 0.005 [95% CI -0.068-0.073] over the 3-year follow-up. There is substantial uncertainty, with a 56% and 44% probability that mini-slings and standard slings are the most cost-effective treatment, respectively, at a £20 000 willingness-to-pay threshold value for a QALY.CONCLUSIONS: At 3 years, there is no significant difference between mini-slings and standard slings in costs and QALYs. There is still some uncertainty over the long-term complications and failure rates of the devices used in the treatment of SUI; therefore, it is important to establish the long-term clinical and cost-effectiveness of these procedures.</p

Patient preferences for stress urinary incontinence treatments : a discrete choice experiment

Funding: The study was funded by the National Institute for Health Research (NIHR) Health Technology Assessment Programme (project number: 12/127/157). The full project report is available from the funder’s website: https://www.journalslibrary.nihr.ac.uk/hta/BTSA6148%23/abstract. The full citation for the funder report is: Abdel-Fattah M, Cooper D, Davidson T, Kilonzo M, Boyers D, Bhal K, et al. Single-incision mini-slings versus standard synthetic mid-urethral slings for surgical treatment of stress urinary incontinence in women: The SIMS RCT. Health Technol Assess 2022;26(47). The Health Economics Research Unit and Health Services Research Unit are both funded by the Chief Scientist’s Office (CSO) of the Scottish government health directorates. The SIMS trial was registered as: ISRCTN93264234.Peer reviewedPublisher PD

Single-Incision Mini-Slings for Stress Urinary Incontinence in Women

Supported by the NIHR (NIHR Evaluation, Health Technology Assessment Programme; funder number, 12/127/157). We thank all the SIMS trial patients without whom this trial would not have been possible; the members of the independent trial steering committee (Chris Mayne [chair], Isobel Montgomery, Dudley Robinson, Lynda Harper, Eleanor Mitchell, and Khaled Ismail) for their supervision of the trial and their guidance and support; the members of the independent data monitoring committee (Peter Brocklehurst [chair], Lee Middleton, Christian Phillips, and Doug Tincello) for their work in assessing all serious adverse events reported to the trial office in real time; Phil Assassa for his substantive role in the trial, including the obtaining of funding, the design of the protocol, and the recruitment of patients; Athele Khunda for his role in patient recruitment and for his contribution to the trial; and Ahmed Mansor and Katie Gillespie for their contribution with the systematic review.Peer reviewedPostprin

Single-incision mini-slings versus standard synthetic mid-urethral slings for surgical treatment of stress urinary incontinence in women:The SIMS RCT

BACKGROUND: Stress urinary incontinence is the most common type of urinary incontinence in premenopausal women. Until recently, synthetic mid-urethral slings (mesh/tape) were the standard surgical treatment, if conservative management failed. Adjustable anchored single-incision mini-slings are newer, use less mesh and may reduce perioperative morbidity, but it is unclear how their success rates and safety compare with those of standard tension-free mid-urethral slings. OBJECTIVE: The objective was to compare tension-free standard mid-urethral slings with adjustable anchored single-incision mini-slings among women with stress urinary incontinence requiring surgical intervention, in terms of patient-reported effectiveness, health-related quality of life, safety and cost-effectiveness. DESIGN: This was a pragmatic non-inferiority randomised controlled trial. Allocation was by remote web-based randomisation (1 : 1 ratio). SETTING: The trial was set in 21 UK hospitals. PARTICIPANTS: Participants were women aged ≥ 18 years with predominant stress urinary incontinence, undergoing a mid-urethral sling procedure. INTERVENTIONS: Single-incision mini-slings, compared with standard mid-urethral slings. MAIN OUTCOME MEASURES: The primary outcome was patient-reported success rates on the Patient Global Impression of Improvement scale at 15 months post randomisation (≈ 1 year post surgery), with success defined as outcomes of 'very much improved' or 'much improved'. The primary economic outcome was incremental cost per quality-adjusted life-year gained. Secondary outcomes were adverse events, impact on other urinary symptoms, quality of life and sexual function. RESULTS: A total of 600 participants were randomised. At 15 months post randomisation, adjustable anchored single-incision mini-slings were non-inferior to tension-free standard mid-urethral slings at the 10% margin for the primary outcome [single-incision mini-sling 79% (212/268) vs. standard mid-urethral sling 76% (189/250), risk difference 4.6, 95% confidence interval -2.7 to 11.8; pnon-inferiority < 0.001]. Similarly, at 3 years' follow-up, patient-reported success rates in the single-incision mini-sling group were non-inferior to those of the standard mid-urethral sling group at the 10% margin [single-incision mini-sling 72% (177/246) vs. standard mid-urethral sling 67% (157/235), risk difference 5.7, 95% confidence interval -1.3 to 12.8; pnon-inferiority < 0.001]. Tape/mesh exposure rates were higher for single-incision mini-sling participants, with 3.3% (9/276) [compared with 1.9% (5/261) in the standard mid-urethral sling group] reporting tape exposure over the 3 years of follow-up. The rate of groin/thigh pain was slightly higher in the single-incision mini-sling group at 15 months [single-incision mini-sling 15% (41/276) vs. standard mid-urethral sling 12% (31/261), risk difference 3.0%, 95% confidence interval -1.1% to 7.1%]; however, by 3 years, the rate of pain was slightly higher among the standard mid-urethral sling participants [single-incision mini-sling 14% (39/276) vs. standard mid-urethral sling 15% (39/261), risk difference -0.8, 95% confidence interval -4.1 to 2.5]. At the 3-year follow-up, quality of life and sexual function outcomes were similar in both groups: for the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life, the mean difference in scores was -1.1 (95% confidence interval -3.1 to 0.8; p = 0.24), and for the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, International Urogynecological Association-Revised, it was 0 (95% confidence interval -0.1, 0.1; p = 0.92). However, more women in the single-incision mini-sling group reported dyspareunia [12% (17/145), compared with 4.8% (7/145) in the standard mid-urethral sling group, risk difference 7.0%, 95% confidence interval 1.9% to 12.1%]. The base-case economics results showed no difference in costs (-£6, 95% confidence interval -£228 to £208) or quality-adjusted life-years (0.005, 95% confidence interval -0.068 to 0.073) between the groups. There is a 56% probability that single-incision mini-slings will be considered cost-effective at the £20,000 willingness-to-pay threshold value for a quality-adjusted life-year. LIMITATIONS: Follow-up data beyond 3 years post randomisation are not available to inform longer-term safety and cost-effectiveness. CONCLUSIONS: Single-incision mini-slings were non-inferior to standard mid-urethral slings in patient-reported success rates at up to 3 years' follow-up. FUTURE WORK: Success rates, adverse events, retreatment rates, symptoms, and quality-of-life scores at 10 years' follow-up will help inform long-term effectiveness. TRIAL REGISTRATION: This trial was registered as ISRCTN93264234. FUNDING: This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 47. See the NIHR Journals Library website for further project information

Building Dynamic Service Analytics Capabilities for the Digital Marketplace

Service firms are now interacting with customers through a multitude of channels or touchpoints. This progression into the digital realm is leading to an explosion of data, and warranting advanced analytic methods to manage service systems. Known as big data analytics, these methods harness insights to deliver, serve, and enhance the customer experience in the digital marketplace. Although global economies are becoming service-oriented, little attention is paid to the role of analytics in service systems. As such, drawing on a systematic literature review and thematic analysis of 30 in-depth interviews, this study aims to understand the nature of service analytics to identify its capability dimensions. Integrating the diverse areas of research on service systems, big data and dynamic capability theories, we propose a dynamic service analytics capabilities (DSAC) framework consisting of management, technology, talent, data governance, model development, and service innovation capability. We also propose a future research agenda to advance DSAC research for the emerging service systems in the digital marketplace

Additive manufacturing of multielectrode arrays for biotechnological applications

Multielectrode arrays (MEAs) are electrical devices that transduce (record/deliver) cellular voltage signals. Commercially available MEAs are expensive and here we provide proof of concept for the application of an additive manufacturing approach to prepare inexpensive MEAs and demonstrate their ability to interact with brain tissue ex vivo

Long -term feeding with high plant protein based diets in gilthead seabream (Sparus aurata, L.) leads to changes in the inflammatory and immune related gene expression at intestinal level

[EN] Background: In order to ensure sustainability of aquaculture production of carnivourous fish species such as the gilthead seabream (Sparus aurata, L.), the impact of the inclusion of alternative protein sources to fishmeal, including plants, has been assessed. With the aim of evaluating long-term effects of vegetable diets on growth and intestinal status of the on-growing gilthead seabream (initial weight = 129 g), three experimental diets were tested: a strict plant protein-based diet (VM), a fishmeal based diet (FM) and a plant protein-based diet with 15% of marine ingredients (squid and krill meal) alternative to fishmeal (VM+). Intestines were sampled after 154 days. Besides studying growth parameters and survival, the gene expression related to inflammatory response, immune system, epithelia integrity and digestive process was analysed in the foregut and hindgut sections, as well as different histological parameters in the foregut. Results: There were no differences in growth performance (p = 0.2703) and feed utilization (p = 0.1536), although a greater fish mortality was recorded in the VM group (p = 0.0141). In addition, this group reported a lower expression in genes related to pro-inflammatory response, as Interleukine-1 beta (il1 beta, p = 0.0415), Interleukine-6 (il6, p = 0.0347) and cyclooxigenase-2 (cox2, p = 0.0014), immune-related genes as immunoglobulin M (igm, p = 0.0002) or bacterial defence genes as alkaline phosphatase (alp, p = 0.0069). In contrast, the VM+ group yielded similar survival rate to FM (p = 0.0141) and the gene expression patterns indicated a greater induction of the inflammatory and immune markers (il1 beta, cox2 and igm). However, major histological changes in gut were not detected. Conclusions: Using plants as the unique source of protein on a long term basis, replacing fishmeal in aqua feeds for gilthead seabream, may have been the reason of a decrease in the level of different pro-inflammatory mediators (il1 beta, il6 and cox2) and immune-related molecules (igm and alp), which reflects a possible lack of local immune response at the intestinal mucosa, explaining the higher mortality observed. Krill and squid meal inclusion in vegetable diets, even at low concentrations, provided an improvement in nutrition and survival parameters compared to strictly plant protein based diets as VM, maybe explained by the maintenance of an effective immune response throughout the assay.The research has been partially funded by Vicerrectorat d'Investigacio, Innovacio i Transferencia of the Universitat Politecnica de Valencia, which belongs to the project Aquaculture feed without fishmeal (SP20120603). 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