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.
Results
- Showing results for:
- Reset all filters
Search results
-
Journal articleLi Z, Zhou Z, Lou H, et al., 2026,
A novel pouch-based tension sensor array for soft Cable-Driven Parallel Surgical Robot
, Measurement Journal of the International Measurement Confederation, Vol: 288, ISSN: 0263-2241Endoscopic Submucosal Dissection (ESD) is an advanced, minimally invasive procedure for the removal of tumors or lesions from the gastrointestinal tract. While robot-assisted surgery has enhanced the safety and efficacy of ESD, a significant limitation of current robot systems is the lack of force feedback capabilities. This deficiency increases the risk of excessive force being exerted on tissue. To address this challenge, this study proposes a soft Cable-Driven Parallel Robot (CDPR) integrated with a novel pouch-based sensor array that is disposable and has simple structure. This system utilizes hydraulic pressure sensors and pouch structures to estimate both cable tension and the three-dimensional forces at the end-effector, thereby providing the surgeon with crucial force feedback. During an ex vivo experiment, the mean absolute errors between the estimated forces and the ground truth values were 0.0267 N, 0.0659 N, and 0.0509 N for the x, y, and z axes, respectively. These results demonstrate the potential of the proposed CDPR for future clinical applications.
-
Journal articleSchmidt J, Carter AW, McGuire A, et al., 2026,
A systematic review of economic evidence of artificial intelligence in healthcare.
, Health Policy, Vol: 172BACKGROUND: Ambitious claims suggest AI could save $200-360 billion annually in US healthcare and €212 billion in Europe, though the empirical evidence base supporting these projections remains unclear. OBJECTIVE: This systematic review seeks to synthesise the available economic evidence of AI technologies in healthcare and contextualise the available economic evidence against the broader policy expectations surrounding the economic impact of AI in healthcare. METHODS: We searched MEDLINE, Embase, Global Health, PsycINFO, and Cochrane Central for scientific sources. The JBI dominance ranking matrix was used to compare and interpret the results of the included economic evaluations. Methodological quality was assessed using the JBI Critical Appraisal tool of Economic Evaluations and the CHEERS-AI reporting checklist. RESULTS: We identified 16,430 academic records and 1,593 grey literature records, of which 91 records met the inclusion criteria, representing 98 unique evaluations. Of these, 36% demonstrate a clear health economic preference for the AI technology, which increased to 44% when only considering the 51 high-quality studies. AI interventions were mainly designed for healthcare providers, with ophthalmology and oncology being the most common. CONCLUSIONS: The high-quality studies show definite potential for positive cost-effectiveness and economic impact of AI technologies, though we cannot yet support the ambitious claims that AI technologies can translate to hundreds of billions in cost-savings. When combining our findings with those of randomised controlled trials evaluating AI technologies in clinical practice, it becomes evident that AI technologies frequently yield improvements in terms of clinical and economic outcomes or match the current standard of care.
-
Journal articleLau SSS, Fong JWL, Lawrance EL, et al., 2026,
Extreme weather salience as a climate crisis signal: Examining the role of extreme weather fear in adaptive and maladaptive responses to eco-anxiety
, Global Environmental Change, Vol: 99, ISSN: 0959-3780Personal salience regarding extreme weather events may be crucial for recognising the profound effects of anthropogenic climate change. However, efforts to understand how individuals attribute extreme weather events to anthropogenic climate change, and their implications for eco-anxiety, have not effectively integrated psychological perspectives. Following Hong Kong’s wettest storm on record in 2023, we recruited a cross-sectional sample of adults (n = 376, ages 18–83) immediately after typhoon season onset (from 3 June to 11 September) in 2024. We aimed to examine (1) how extreme weather experiences and socio-demographic factors influence individuals’ subjective attribution of extreme weather to anthropogenic climate change, and (2) how extreme weather fear (i.e. storm fear), weather salience, uncertainty intolerance, anxiety control, nature connectedness, and future risk awareness of local climate disasters are associated with two distinct subdimensions of eco-anxiety, conceptualised as ‘habitual ecological worry’ and ‘negative consequences of eco-anxiety’, which may be associated respectively with adaptive and maladaptive responses to eco-anxiety. Our results suggest that only the personal salience of day-to-day local weather patterns significantly affected respondents’ subjective attribution of local weather patterns to anthropogenic climate impacts, rather than their extreme weather event experiences. Future risk awareness and nature connectedness were mainly associated with adaptive responses to eco-anxiety, while only storm fear was strongly associated with both adaptive and maladaptive responses. This finding underscores the dual effects of extreme weather fear, namely motivating action-oriented aspects of eco-anxiety and exacerbating functionally impairment of eco-anxiety. Promoting future risk awareness and increasing nature connectedness – independent of fear – could improve urbanised populations
-
Journal articleAggarwal A, Erridge S, Varadpande M, et al., 2026,
UK Medical Cannabis Registry: A Clinical Outcomes Analysis for Autism Spectrum Disorder.
, Neuropsychopharmacol Rep, Vol: 46INTRODUCTION: Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with distressed behaviors and psychological challenges. This study aims to evaluate the change in health-related quality of life (HRQoL), anxiety, and sleep quality in autistic individuals prescribed cannabis-based medicinal products (CBMPs). METHOD: This observational case series analyzed data from the UK Medical Cannabis Registry on autistic adults treated with CBMPs. Demographic and clinical data were collected at baseline, with patient-reported outcome measures assessed up to 18 months. Primary outcomes included changes in anxiety (GAD-7), sleep quality (SQS), and HRQoL (EQ-5D-5L). Secondary outcomes included the incidence of adverse events. Statistical significance was indicated by p < 0.050. RESULTS: One-hundred and thirty individuals met the inclusion criteria. GAD-7 (p < 0.001) and SQS (p < 0.001) scores improved from baseline to 18 months. EQ-5D-5L index values showed improvement from baseline (0.43 ± 0.30) to 18 months (0.51 ± 0.32, p < 0.001), and PGIC scores increased from 1 month (5.43 ± 1.49) to 18 months (5.65 ± 1.32, p = 0.013). Twenty-five participants (19.23%) reported a total of 232 (178.46%) adverse events, with most being mild (n = 88; 67.69%) or moderate (n = 99; 76.15%). CONCLUSION: Treatment with CBMPs was associated with improvements in HRQoL, anxiety, and sleep outcomes in autistic patients over an 18-month period. Given the absence of a control group, these findings represent associations rather than proven treatment effects. Further high-quality randomized controlled trials are needed to confirm the long-term efficacy and safety of CBMPs in ASD.
-
Journal articleZhang Y, Giannarou S, Elson DS, 2026,
Self-supervised monocular depth estimation for colonoscopy using normal-guided cross-attention.
, Int J Comput Assist Radiol SurgPURPOSE: Reliable 3D reconstruction of colonoscopic scenes can facilitate navigation and enhance lesion assessment by indicating the regions that have been inspected and revealing the geometric structure of polyps. However, accurate depth estimation in colonoscopy remains highly challenging due to specular highlights and low-texture areas. This study aims to improve monocular depth estimation in colonoscopy by incorporating surface normal information. METHODS: We propose a self-supervised deep learning method for relative depth estimation that integrates surface normal information through a cross-attention mechanism. Surface normals are first predicted by an existing normal estimation model and then used as auxiliary geometric priors. The depth estimation network employs cross-attention to adaptively fuse normal features with image features, enabling spatially selective geometric refinement. RESULTS: Quantitative and qualitative comparisons show that the proposed method outperforms state-of-the-art self-supervised methods on SimCol3D, C3VD, and real colonoscopy data. The proposed method generates more realistic depth maps, preserving mucosal folds and lumen geometry. Ablation studies verify that the cross-attention module is crucial for effectively exploiting normal information for accurate depth estimation. CONCLUSION: By leveraging cross-attention to fuse predicted surface normals with image features, the proposed method enhances monocular depth estimation accuracy and robustness in colonoscopy. This approach provides a general and lightweight strategy for incorporating geometric priors into self-supervised frameworks, offering potential benefits for downstream tasks such as 3D reconstruction and endoscopic navigation.
-
Journal articleRahman RMT, Alyacoubi S, Leff DR, et al., 2026,
Objective Measurement of the Learning Curve in Live Laparoscopic Surgery: A Scoping Review of Methods.
, J Surg Educ, Vol: 83OBJECTIVE: This scoping review aims to provide an overview of the methodology used when defining the learning curve (LC) in live laparoscopic surgery. DESIGN: This review was performed in line with the Preferred Reporting Items for Systematic Reviews and Meta Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. English-language articles were included systematically using Boolean operators for search string combinations. Selected studies were qualitatively analyzed for LC measurement methodology, including statistical approaches. Additional analysis was undertaken by grouping LC metrics into intrinsic, surrogate, and outcome-based. SETTING: Only original publications in the English language were included. No date restrictions were applied. Eligible studies were those that measured LC in laparoscopic cases (i.e., not simulation studies) regardless of their surgical specialty. Robotic-assisted laparoscopic operations were also included. Articles analyzing non-laparoscopic procedures were not included. RESULTS: A total of 87 articles were extracted for review. The majority (45/87) were conducted within general surgery alongside gynecology, vascular, pediatrics, and urology. A total of 50 studies analyzed the LC for a new technology or novel technique. Multiple metrics were used to quantify LC, with the most common being operative time (n = 75), followed by complications (n = 31). Only 3 studies exclusively used intrinsic performance measures for LC analysis. There was significant heterogeneity in the statistical analysis and description of LC. The majority of studies (51/87) grouped cases temporally. Nineteen studies used a Cumulative Sum (CUSUM) statistical analysis. CONCLUSIONS: Measurement of the LC in live laparoscopic surgery has significant potential for training and appraisal of new techniques. Currently, the time-intensive nature of LC measurement limits its widespread adoption. However, newer techniques used alongside real-time measurement of metrics
-
Journal articleAgarwal G, Kamal R, Saeed D, et al., 2026,
Should Interventional Radiologists Incorporate Intravascular Ultrasound (IVUS) Into Their Daily Practice? A Systematic Review and Meta-Analysis of IVUS in Peripheral Arterial Endovascular Interventions.
, Cardiovasc Intervent Radiol, Vol: 49, Pages: 1441-1451PURPOSE: To provide a systematic review and meta-analysis of studies comparing intravascular ultrasound (IVUS)-guided versus angiography-guided peripheral vascular interventions (PVI) for peripheral arterial disease (PAD). MATERIALS AND METHODS: We performed a systematic review and meta-analysis, following PRISMA guidelines, of studies comparing IVUS-guided versus angiography-guided PVI for peripheral arterial disease (PAD). The study was registered in PROSPERO (CRD42024564731). Relevant databases were searched until Dec 2025. Eligible studies reported at least one of the following outcomes: amputation, all-cause mortality, target lesion revascularisation (TLR), restenosis/occlusion, major adverse limb events (MALE), or technical success. Random-effects models with inverse-variance weighting were used to generate pooled effect estimates. RESULTS: Twenty-five studies (23 observational, 2 randomised) including 1,110,593 patients (93,977 IVUS; 1,016,616 angiography) met inclusion criteria. Compared with angiography, IVUS guidance was associated with reduced rates of amputation (RR = 0.75, 95% CI for RR 0.61-0.93), all-cause mortality (RR = 0.86, 95% CI for RR 0.79-0.93), TLR (RR = 0.66, 95% CI for RR 0.48-0.91) and restenosis (RR = 0.74, 95% CI for RR 0.60-0.90). A numerically lower rate of major adverse limb events (MALE) was observed with IVUS guidance, although confidence intervals crossed the null effect (RR 0.66, 95% CI for RR 0.40-1.10). Technical success rates were similar between groups (RR 1.01, 95% CI for RR 1.00-1.01). CONCLUSION: IVUS-guided PVI was associated with lower rates of amputation, TLR, restenosis, and all-cause mortality compared with angiography alone. However, the available evidence is predominantly observational with low-to-moderate certainty. These findings suggest potential benefit of IVUS-guided intervention in PAD, although further randomised controlled trials are needed.
-
Journal articleOlupot-Olupot P, Amorut D, Ongodia P, et al., 2026,
Hydroxyurea - Pragmatic Reduction In Mortality and Economic burden (H-PRIME): A 2x2x2 factorial randomised open-label trial investigating practical approaches to the treatment of sickle cell disease at four sites in Eastern Uganda
, Wellcome Open Research, Vol: 10, Pages: 244-244<ns5:p>Background Sickle cell disease is the most common and severe genetic disease in humans worldwide. The majority of those affected are born in sub-Saharan Africa, where resources to diagnose and manage them are often limited. Fresh approaches to the pragmatic management of children with sickle cell disease in Africa that improve both morbidity and mortality are urgently needed. Methods Hydroxyurea - Pragmatic Reduction In Mortality and Economic burden (H-PRIME) is a 2 × 2 × 2 factorial randomized open-label trial that is investigating three separate interventions. Eighteen hundred children aged 1–10 years attending sickle cell clinics at one of four sites in Eastern Uganda are being randomized to: (1) hydroxyurea administered at a low dose (10 mg/kg/day) versus high dose (25 mg/kg/day), prescribed pragmatically through a weight-band-based approach and with clinically, rather than laboratory-guided monitoring; (2) enhanced malaria prophylaxis with weekly doses of dihydroartemisinin-piperaquine versus monthly doses of sulfadoxine-pyrimethamine (standard of care); and (3) enhanced antibacterial prophylaxis with daily cotrimoxazole throughout life versus twice daily penicillin until the age of 5 years (standard of care). All children will be followed up for 48 months after the date on which the first child was randomized. The primary endpoint for the hydroxyurea randomization will be mortality, for the antimalarial randomization will be malaria-associated hospital admission, and for the antimicrobial randomization will be all-cause hospital admission. Secondary outcomes will include the incidence of sickle-specific complications, receipt of blood transfusions, hemoglobin and fetal hemoglobin concentrations, and economic costs and benefits of the three interventions. Conclusions The first participant was recruited for the trial on January 16, 2024. In total, 1487 of the 1800 target children were re
-
Journal articleDemircali AA, Yilmaz A, Keshavarz M, et al., 2026,
Autonomous Navigation of Pollen‐Inspired Magnetic Microrobots for Biomedical Applications
, Advanced Robotics Research, ISSN: 2943-9973<jats:p>Recent advances in microrobotics have expanded opportunities for biomedical delivery, but reliable navigation in complex microvascular environments remains challenging, particularly when continuous imaging is limited. Here we develop a sunflower pollen‐inspired magnetic microrobot for targeted delivery and tissue engineering applications. Fabricated by two‐photon polymerization and coated with nickel and titanium for magnetic actuation and biocompatibility, the 40 µm microrobot features an open, hydrodynamic geometry that facilitates cell adhesion through its surface topology. Finite‐element analysis supported this design rationale, showing 4.45‐fold lower translational drag and 4.1‐fold lower rotational hydrodynamic resistance than a solid spherical microrobot of the same outer diameter. We demonstrated stable rolling under physiologically relevant flow conditions, including upstream motion against opposing flow, and evaluated autonomous navigation in static and dynamic environments using a vision‐based closed‐loop controller combined with reinforcement learning. The system enabled trajectory tracking, shortest‐path selection, and multiturn maze navigation with microrobot‐scale error. By combining efficient rolling locomotion with navigation based on intermittent visual updates, this platform supports microrobot guidancein future minimally invasive interventions where continuous monitoring is restricted.</jats:p>
-
Journal articleSousi S, Glynou SP, Hyman S, et al., 2026,
Trends, disparities, and pregnancy outcomes of gestational diabetes mellitus in North West London: a nine-year population-based cohort study
, BMC Medicine, ISSN: 1741-7015Background: Gestational diabetes mellitus (GDM) affects approximately 1 in 20 pregnancies in England. North West London (NWL) serves a diverse population of 2.4 million with substantial ethnic and socioeconomic variation. However, population-level epidemiological evidence from NWL remains limited. This study aims to characterise GDM incidence, temporal trends, risk determinants, and associated pregnancy outcomes.Methods: A retrospective population-based cohort study using routinely collected data from the Whole Systems Integrated Care database included all birth episodes from 2017 to 2025, categorised as GDM or non-GDM. Incidence per 1,000 births was calculated and temporal trends were analysed. Multivariable generalised estimating equation (GEE) logistic regression models were used to examine maternal risk determinants for GDM and pregnancy outcomes associated with GDM, while controlling for confounders and accounting for within-woman clustering across pregnancies.Results: Among 172,332 births from 134,991 women, 18,892 (10.9%) were GDM-affected. Overall incidence was 109.6 per 1,000 births (95% CI: 108.2-111.1), rising from 80.5 per 1,00 births in 2017 to 138 per 1,000 births in 2025. Incidence increased with maternal age and deprivation (119 vs. 85.4 in most vs. least deprived quintiles). Asian women had the highest risk (aOR 2.27, 95% CI: 2.15-2.40) relative to White. GDM was associated with higher rates of labour induction (51% vs. 41%), caesarean delivery (47% vs. 36%), preterm birth (7.3% vs. 5.2%), greater maternity care costs (£4,674 vs. £3,971) and longer maternal length of stay (3 vs. 2 days).Conclusion: The incidence of GDM in NWL substantially exceeds national estimates and has nearly doubled over nine years, with pronounced ethnic and socioeconomic disparities. Targeted culturally appropriate prevention strategies and equity-focused service planning are needed in this population.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.
