Browse through all publications from the Institute of Global Health Innovation, which our Patient Safety Research Collaboration is part of. This feed includes reports and research papers from our Centre.
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Journal articleReka H, van Kessel R, Mossialos E, et al., 2026,
Private health insurance in Gulf Cooperation Council countries: A scoping review
, Health Policy Open, Vol: 10Private Health Insurance (PHI) in Gulf Cooperation Council (GCC) countries has experienced rapid growth over the past two decades, driven by demographic and economic changes. Although various analyses at the country level have been reported, no study has reviewed PHI systems in the GCC through a methodological approach. We provide a conceptual framework to review, describe and document the development of PHI in the GCC, based on literature from the scoping review. As of December 2023, all GCC countries have laws in place or have promulgated laws establishing mandatory PHI schemes. Most of these schemes are designed for expatriate populations residing in these countries, but there is a trend to extend them to nationals working in the private sector. The health system context plays a role in how PHI emerged and is designed in terms of role, eligibility, and coverage. PHI markets in the region are concentrated and dominated by local companies with performance levels that could be further improved. These markets are maturing and subject to more robust technical and prudential regulations as governments seek to enhance competition. Governments in the region must ensure the sustainable growth of these schemes and a more strategic alignment with health system objectives. Lessons learned from more mature markets are critical for future developments.
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Journal articleKoutsoftidis S, Petkos K, Zafeiropoulos G, et al., 2026,
A compact stimulator and recorder for atrial fibrillation ablation surgery: Realization and clinical evaluation
, MEASUREMENT, Vol: 257, ISSN: 0263-2241 -
Conference paperRoddan A, Czempiel T, Xu C, et al., 2026,
SAMSA: Segment anything model enhanced with spectral angles for hyperspectral interactive medical image segmentation
, MICCAI 2025, Publisher: Springer, Pages: 478-488, ISSN: 0302-9743Hyperspectral imaging (HSI) provides rich spectral information for medical imaging, yet encounters significant challenges due to data limitations and hardware variations. We introduce SAMSA, a novel interactive segmentation framework that combines an RGB foundation model with spectral analysis. SAMSA efficiently utilizes user clicks to guide both RGB segmentation and spectral similarity computations. The method addresses key limitations in HSI segmentation through a unique spectral feature fusion strategy that operates independently of spectral band count and resolution. Performance evaluation on publicly available datasets has shown 81.0% 1-click and 93.4% 5-click DICE on a neurosurgical and 81.1% 1-click and 89.2% 5-click DICE on an intraoperative porcine hyperspectral dataset. Experimental results demonstrate SAMSA’s effectiveness in few-shot and zero-shot learning scenarios and using minimal training examples. Our approach enables seamless integration of datasets with different spectral characteristics, providing a flexible framework for hyperspectral medical image analysis.
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Conference paperDaly C, Marconi E, Riva M, et al., 2026,
Towards markerless intraoperative tracking of deformable spine tissue
, MICCAI 2025, Publisher: Springer, Pages: 627-637, ISSN: 0302-9743Consumer-grade RGB-D imaging for intraoperative orthopedic tissue tracking is a promising method with high translational potential. Unlike bone-mounted tracking devices, markerless tracking can reduce operating time and complexity. However, its use has been limited to cadaveric studies. This paper introduces the first real-world clinical RGB-D dataset for spine surgery and develops SpineAlign, a system for capturing deformation between preoperative and intraoperative spine states. We also present an intraoperative segmentation network trained on this data and introduce CorrespondNet, a multi-task framework for predicting key regions for registration in both intraoperative and preoperative scenes.
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Journal articleByrne JP, Hinton EC, Humayun AM, et al., 2026,
A Randomized, Double-Blind, Placebo-Controlled Pilot Trial With Open-Label Extension of Sirona, a Hydrogel for Weight Loss.
, Obesity (Silver Spring), Vol: 34, Pages: 88-100OBJECTIVE: This study investigated the safety, tolerability, and preliminary efficacy of Sirona, a novel gastro-retentive, dual-network polymer for weight management. METHODS: This pilot trial comprised a randomized, parallel-group, double-blind, placebo-controlled (3:1 ratio), 12-week period, with a 12-week open-label extension (OLE), in participants with BMI of 30-40 kg/m2. Primary endpoints were feasibility, tolerability, and safety; secondary endpoints included weight loss and dietary intake, tested using Hedge's g [95% CI] as a measure of effect size. RESULTS: Participants received Sirona (n = 29/38) or Placebo (n = 9/38) (mean [SD] age = 40.9 [8.4]; weight = 101.7 [12.9] kg; BMI = 35.6 [3.0]; 29/38 female and 23/38 White British). Dosing was well tolerated (RCT Sirona: 95.2 [11.0]%; RCT Placebo: 97.8 [3.5]%; RCT + OLE Sirona: 93.1 [13.0]%). No serious adverse events occurred. Of the adverse events, nausea was most prominent (74.8%), mostly graded mild (79.3%) and requiring no intervention (84.4%). Percentage total body weight loss was greater for Sirona compared to Placebo after 12 weeks (3.9 [3.0]% versus 1.0 [2.1]%, g = 0.96 [-1.81, -0.10]). Weight loss continued in the OLE (change from baseline = 4.4 [3.8]%). Dietary intake reduced from baseline after 12 weeks of treatment (-382.5 [519.3] kcal; Placebo = 93.5 [670.3] kcal, g = -0.8 [-1.7, 0.0]) and after 24 weeks (-338.2 [486.7] kcal, g = 0.7 [0.2, 1.1]). CONCLUSIONS: Sirona was well tolerated, with mild, primarily gastrointestinal side effects. Reduced weight and dietary intake suggest Sirona is suitable as a nonpharmacological treatment for weight management. TRIAL REGISTRATION: ISRCTN14083641 (https://doi.org/10.1186/ISRCTN14083641).
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Journal articleAshrafian H, Harling L, 2025,
Earliest depiction of port wine stains, eye signs and ear deformity in the portrait of Edward Grimston (c. 1399-1478) by Petrus Christus.
, J Neurol, Vol: 273 -
Conference paperChen Q, Mandal N, Ramkumar P, et al., 2025,
Transcutaneous Fluorescence Spectroscopy for Non-invasive Assessment of Small Bowel Permeability in Patients with Irritable Bowel Syndrome Undergoing Low FODMAP Diet
, ISSN: 1605-7422Transcutaneous fluorescence spectroscopy was used to assess intestinal barrier function non-invasively in irritable bowel syndrome (IBS), demonstrating effective discrimination between IBS patients and healthy volunteers and showing changes in IBS on low FODMAP diet.
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Journal articleLeón-Herrera S, Anjos de Almeida V, Neves AL, et al., 2025,
Postgraduate digital health training programs for primary care physicians: a scoping review protocol
, BMJ Open, ISSN: 2044-6055IntroductionThe digital transformation of healthcare has created an urgent need for primary care physicians (PCPs) to acquire competencies in digital health. However, the structure and scope of postgraduate training programs remain poorly defined and unevenly implemented worldwide, and no scoping review has yet synthesized the evidence. This review aims to map existing postgraduate digital health training programs for PCPs, including their content, structure, and delivery approaches.Methods and analysis:This scoping review will follow the Joanna Briggs Institute (JBI) methodology and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. A systematic search will be conducted across five databases (PubMed, Scopus, Cochrane Library, ScienceDirect, and Web of Science) and relevant grey literature, covering publications from January 2019 to June 2025. Studies describing postgraduate digital health training programs for PCPs will be eligible for inclusion. Data will be extracted and synthesized descriptively and thematically using an inductive approach.Ethics and dissemination:As this study is based on a review of publicly available literature, ethical approval is not required. The findings will be disseminated through a peer-reviewed publication and conference presentations and will inform future curriculum development and policy in digital health education for PCPs. The results may also inform national curriculum reforms and accreditation standards, supporting more consistent and competency-based digital health education globally.Registration details:This scoping review protocol has been registered with the Open Science Framework (OSF), and it is available under the DOI: 10.17605/OSF.IO/HDC3P [1].
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Journal articleBatcup C, Almukhtar A, Menon A, et al., 2025,
Barriers and enablers to sustainable anaesthetic practice: a mixed-methods study
, British Journal of Anaesthesia, ISSN: 0007-0912Background: Anaesthetic practices contribute significantly to the environmental impact of healthcare. Using local or regional anaesthesia instead of general anaesthesia, and TIVA instead ofinhalational anaesthesia, can reduce this impact. This study investigated why general anaesthesia is sometimes used over local and regional anaesthesia, and why inhalational agents are often chosen over TIVA.Methods: We conducted a mixed-methods study in the UK (June 2023–April 2024), underpinned by the Theoretical Domains Framework. Semi-structured interviews (n=19) with anaesthetists, surgeons and nurses of differing seniority were analysed using Framework Analysis. A national survey (n=347), distributed via posters and professional networks, was developed from early interview findings. Quantitative data were analysed descriptively and open-text responses were coded using the qualitative framework.Results: Four key themes were identified: (1) contextual factors affecting anaesthesia decision making; (2) patient differences and preferences; (3) influence of key decision makers on anaesthesia choice; and (4) default practices and lack of confidence in alternatives. These encompassed 17subthemes and mapped to 9 of 14 Theoretical Domains Framework domains.Conclusions: This study provides new insights into behavioural influences underlying anaesthetic practice, which can inform the design of interventions to improve the sustainability of anaesthesia, without compromising patient safety and comfort. Addressing systemic and behavioural barriers through dedicated local anaesthesia operating lists, improved patient communication, targeted training and supportive technologies may enhance efficiency while promoting safe, sustainable, patient-centred practice. Future interventions should be co-designed with surgeons, anaesthetists and patients to ensure clinical acceptability, feasibility, and sustainability
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Journal articleSingh Gill S, Jones GG, Cobb J, et al., 2025,
The link between depression, analgesia usage and function in osteoarthritis: a propensity score-matched analysis from the osteoarthritis initiative cohort
, Bioengineering, ISSN: 2306-5354Knee osteoarthritis (OA) affects around 37% of U.S. adults over 60, with over 25% expe-rience depressive symptoms (DSs), linked to worse pain and outcomes. Yet their impact on analgesic use and recovery remains unclear. This study aimed to assess if DSs influ-ence analgesic use and functional outcomes in knee OA. Using data from the Osteoar-thritis Initiative (n = 3680), we used a Machine Learning (ML)- based Gradient Boosting Machine (GBM) model to perform propensity score matching, matching pa-tients with knee OA and DSs (n = 487) to those without DSs (n = 487). Outcomes at baseline, 1 and 2 years included analgesic use, function (WOMAC), quality of life (KOOS-QoL), and physical health (SF-12 PCS). Regression and timepoint models com-pared follow-up with baseline. DSs alone were not associated with greater opioid use up to Year 2 (OR = 0.89, 95% CI: 0.45–1.73; p = 0.73). Among patients with DSs, SF-12 PCS improvement was less likely at Year 1, while decline was more likely up to Year 2. DSs in OA were linked to poorer physical health, but often greater functional gains than those in OA without DSs, and with no difference in opioid use. These findings highlight the need for multidisciplinary strategies, addressing both pain and psychosocial well-being.
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