PRISMA 2020 statement: What's new and the importance of reporting guidelines.

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, first published in 2009 [1], was developed in an attempt to increase the clarity, transparency, quality and value of these reports [2]. The 27-item checklist and four-phase flow diagram have become the hallmark of academic rigour in the publication of systematic reviews and meta-analyses, having been cited by over 60,000 papers [3]. These are frequently endorsed by journals in their 'Instructions to Authors' [4]. Developments in the methodology and terminology used when conducting systematic reviews [5], alongside the identification of limitations responsible for poor adherence, such as the use of ambiguous wording [6], have warranted an update to the PRISMA statement. The PRISMA 2020 statement, therefore, is intended to reflect this recent evolution in the identification, selection, appraisal and synthesis of research [7]. Here, we present an interpretive analysis of the updated statement, with a view towards encouraging its adoption by both journals and authors in the pursuit of advancing evidence-based medicine.

Impact of the coronavirus (COVID-19) pandemic on scientific research and implications for clinical academic training - A review.

A pneumonia outbreak of unknown aetiology emerged in Wuhan, China in December 2019. The causative organism was identified on 7th January 2020 as a novel coronavirus (nCoV or 2019-nCoV), later renamed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The resulting coronavirus disease (COVID-19) has infected over 88 million individuals, resulted in over 1.9 million deaths, and has led to an unprecedented impact on research activities worldwide. Extraordinary challenges have also been imposed on medical and surgical trainees following redeployment to full-time clinical duties. Moreover, the introduction of travel restrictions and strict lockdown measures have forced the closure of many institutions and laboratories working on research unrelated to the pandemic. The lockdown has similarly stifled supply chains and slowed research and development endeavours, whilst research charities have endured significant financial strains that have since reshaped the allocation and availability of funds. However, worldwide scientific adaptation to the COVID-19 pandemic has been observed through unprecedented levels of international collaboration alongside the uprise of remote telecommunication platforms. Although the long-term consequence of the COVID-19 pandemic on research and academic training is difficult to ascertain, the current crises will inevitably shape working and teaching patterns for years to come. To this end, we provide a comprehensive and critical evaluation of the impact of COVID-19 on scientific research and funding, as well as academic medical and surgical training.

Health policy and leadership models during the COVID-19 pandemic: A review.

On March 11, 2020, the spread of the SARS-CoV-2 virus was declared a pandemic by the World Health Organization (WHO). Approximately 19.3 million people have now been infected and over 700,000 have died. This global public health crisis has since cascaded into a series of challenges for leaders around the world, threatening both the health and economy of populations. This paper attempts to compartmentalise leadership aspects, allowing a closer examination of published reports and the analysis of current outcomes, thus enabling the authors to formulate a number of evidence-based recommendations on the de-escalation of restrictions.

Evidence based management guideline for the COVID-19 pandemic - Review article.

COVID-19 has now been declared a pandemic. To date, COVID-19 has affected over 2.5 million people worldwide, resulting in over 170,000 reported deaths. Numerous preventative strategies and non-pharmaceutical interventions have been employed to mitigate the spread of disease including careful infection control, the isolation of patients, and social distancing. Management is predominantly focused on the provision of supportive care, with oxygen therapy representing the major treatment intervention. Medical therapy involving corticosteroids and antivirals have also been encouraged as part of critical management schemes. However, there is at present no specific antiviral recommended for the treatment of COVID-19, and no vaccine is currently available. Despite the strategic implementation of these measures, the number of new reported cases continues to rise at a profoundly alarming rate. As new findings emerge, there is an urgent need for up-to-date management guidelines. In response to this call, we review what is currently known regarding the management of COVID-19, and offer an evidence-based review of current practice.

The socio-economic implications of the coronavirus pandemic (COVID-19): A review.

The COVID-19 pandemic has resulted in over 4.3 million confirmed cases and over 290,000 deaths globally. It has also sparked fears of an impending economic crisis and recession. Social distancing, self-isolation and travel restrictions have lead to a reduced workforce across all economic sectors and caused many jobs to be lost. Schools have closed down, and the need for commodities and manufactured products has decreased. In contrast, the need for medical supplies has significantly increased. The food sector is also facing increased demand due to panic-buying and stockpiling of food products. In response to this global outbreak, we summarise the socio-economic effects of COVID-19 on individual aspects of the world economy.

The rising prevalence of obesity: part A: impact on public health.

Excessive fat accumulation in the body may impair health leading to a significant long-term health consequences including the development of diabetes, coronary heart disease, and osteoarthritis as well as increasing the risk of developing certain cancers and influencing their outcomes. England has some of the worst figures and trends in obesity compared with the rest of the Europe. In the majority of European countries the trend has increased from 10% to 40% in the last 10 years, whereas in England prevalence has more than doubled. This article outlines the public health impact of rising obesity levels.

The rising prevalence of obesity: part B-public health policy solutions.

Obesity is likely to supersede tobacco as the biggest cause of premature death. England has some of the worst figures and trends in obesity compared with the rest of the Europe. Rising obesity prevalence is an international crisis that has the potential to overwhelm health care resources as well as creating enormous human suffering and social cost. This article outlines potential public health policy solutions to this crisis.

Interventions to reduce and prevent obesity in pre-conceptual and pregnant women: a systematic review and meta-analysis.

BACKGROUND: The increasing prevalence of obesity in pregnant women is associated with adverse maternal and neonatal outcomes, and increased costs to healthcare, the economy and broader society. OBJECTIVES: To assess the efficacy of behavioural interventions for managing gestational weight gain (GWG) in the pre-conceptual and pregnancy period in overweight, obese and morbidly obese women. SEARCH METHODS: A search was performed for published studies in the English language, from date? 2000-31 December 2012 in five electronic databases; PubMed, Scopus, Cochrane Library, CINAHL and PsycINFO. SELECTION CRITERIA: Studies were included if they compared the efficacy or effectiveness of a particular behavioural intervention in pregnant or pre-conceptual women with standard maternity care. Studies that included women with co-morbid conditions such as diabetes mellitus and polycystic ovarian syndrome were excluded to help isolate the effect of the intervention. RESULTS: Fifteen studies involving 3,426 participants were included. One study (n = 692) focused on the pre-conceptual period and the remaining 14 (n = 2,734) in the pregnancy period. Pooled mean difference for GWG indicated a lower GWG in the intervention groups when compared to standard maternity care groups (n = 1771, mean difference (MD) -1.66 kg, 95% CI -3.12 to -0.21 kg). With respect to the types of participants, considerable heterogeneity between studies was shown in the obese subgroup [Tau(2) = 15.61; Chi(2) = 40.80, df = 3 (P<0.00001); I(2) = 93%]. CONCLUSIONS: Behavioural interventions in pregnancy may be effective in reducing GWG in obese women without comorbid conditions, but not overweight or morbidly obese women. Behavioural interventions had no effect on postpartum weight loss or retention, gestation week of delivery and infant birth weight in overweight, obese and morbidly obese women.

Epidemiology and Pathogenesis of C. difficile and MRSA in the Light of Current NHS Control Policies: A Policy review.

Healthcare associated infections (HCAIs) cause significant morbidity and mortality, and are estimated to cost the United Kingdom National Health Service £1 billion annually. The current health care infection rates suggest that the level of performance to avoid HCAIs is not maintained consistently. Increasing screening, improving local accountability and performance management, careful use of antibiotics in the management of emergency patients, health economy wide approaches, and improved hand washing will be effective in lowering the rate of HCAIs. This paper reviews current NHS Control Policies in place for Methicillin Resistant Staphylococcus Aureus (MRSA) and C. difficile.

Skin Stretching for Burn Scar Excision - A Critically Appraised Topic.

Adults with burn scars are a clinical challenge, and the long term sequelae of burns can have a significant impact on the patient. Scar excision is thought to be the best treatment at present, as it results in a smaller scar. Scar stretching has shown promise in a previous study, as it may allow the surgeon to excise more burn scar. The goal of this study was to determine if good evidence exists for the use of burn scar stretching, in routine clinical practice, through the format of a critically appraised topic. A question was formulated using the Patient Intervention Comparator Outcome (PICO) method:-Patient - Adult burn victims-Intervention - Scar excision + skin stretching-Comparator - Scar excision-Outcome - Total remaining scar The PICO question was used to develop a search query: "stretch* burn scar" (where '*' represents a wildcard function). A search was then conducted using PubMed, SCOPUS, the Cochrane Library, and Trip Database. One paper was selected for critical appraisal following identification, screening, and eligibility evaluation. The paper was critically appraised using accepted methodology outlined by Straus et al. and reporting quality was assessed using the CONSORT statement for non-pharmacological trials. Areas of methodological or reporting weakness were highlighted. Burn scar stretching, using the device or technique in question, requires much further research before widespread usage in burns patients.

Reducing the need for surgeons by reducing pollution-derived workload: is there a role for surgeons?

The need for additional surgical workforce personnel is likely to increase dramatically at a rate beyond our capacity to train them. As surgical training programmes cannot be rapidly expanded, this paper explores an alternative solution to the quandary, a reduction of the disease burden by a war on pollution. Highlighting the role of pollutants in increasing the surgical workload, it identifies potential roles for surgeons in the battle against pollution and draws attention to the need to research out agents which could protect humans against their carcinogenic effects.

A history of Guy's, King's and St. Thomas' hospitals from 1649 to 2009: 360 years of innovation in science and surgery.

Much has been achieved in the scientific and surgical fields over the last 360 years. Some institutions have contributed disproportionately to these advances. The medical schools and hospitals of Guy's (est. 1721), King's (est. 1840) and St. Thomas' (est. 1173) seem to provide a focus and a catalyst for much innovation and creativity dating back to 1608. This review sets to provide an overview of the major contributors to surgical advances at these institutions over the last 360 years and what factors affected unique to these institutions contributed to the climate of discovery. It is based on a lecture given to the Osler Club of London (est. 1928) at the Royal College of Physicians in London on 4 November 2010. It is the author's premise that the people and the discoveries they made within these institutions within three square miles of London changed the practice and understanding of science and healthcare as we know it today.