The Manchester Football Association (also known as the Manchester FA) is the governing body for association football in the centre of the city of Manchester, England. They are responsible for the governance and development of football at all levels in the area.
OBJECTIVE:The European Society for Vascular Surgery (ESVS) has developed clinical practice guidelines for the care of patients with descending thoracic and thoraco-abdominal aortic pathologies, in succession to the 2017 version, with the aim of assisting physicians and patients in selecting the best management strategy. METHODS:The guidelines are based on scientific evidence complemented with expert opinion on the matter. By summarising and evaluating the best available evidence, recommendations for the evaluation and treatment of patients have been formulated. The recommendations are graded according to the ESVS grading system, where the strength (class) of each recommendation is graded from I to III and the level of evidence from A to C. RESULTS:One hundred and twenty-nine recommendations have been issued across the following main topics: (1) acute thoracic aortic syndrome; (2) chronic type B aortic dissection; (3) descending thoracic and thoraco-abdominal aortic aneurysms; (4) ruptured descending thoracic and thoraco-abdominal aortic aneurysms; and (5) blunt thoracic aortic injury. Additional topics include genetic aortopathy, floating thrombus and shaggy aorta, inflammatory aortitis, mycotic aortic aneurysms, coarctation of the aorta, aberrant subclavian artery, and service standards such as surgical volume, imaging, risk assessment, and optimisation. Special considerations include pregnancy, left subclavian artery revascularisation, spinal cord ischaemia, stroke prevention, vascular access, and the patient's perspective. A final chapter addresses unresolved issues. CONCLUSION:These clinical practice guidelines provide comprehensive, up to date advice to clinicians and patients on the management of descending thoracic and thoraco-abdominal aortic pathologies.
OBJECTIVE:To systematically document the patterns of war related injuries in Gaza, Palestine. DESIGN:Survey study of international healthcare workers, August 2024 to February 2025. SETTING:Gaza, Palestine. PARTICIPANTS:78 international healthcare workers deployed to Gaza. MAIN OUTCOME MEASURES:The main outcome was the type of injuries observed by international healthcare workers during the conflict in Gaza. A Delphi informed survey was distributed through non-governmental organisation rosters and secure WhatsApp and email groups. Respondents completed the survey using contemporaneous logbooks and shift records. RESULTS:The survey collected data on 12 anatomical regions, mechanisms of trauma, and general medical conditions. 78 healthcare workers reported 23 726 trauma related injuries and 6960 injuries related to weapons. The most common traumatic injuries were burns (n=4348, 18.3%), lower limb injuries (n=4258, 17.9%), and upper limb injuries (n=3534, 14.9%). Explosive injuries accounted for most of the weapon related trauma (n=4635, 66.6%), predominantly affecting the head (n=1289, 27.8%), whereas firearm injuries disproportionately affected the lower limbs (n=526, 22.6%). Healthcare workers reported 4188 people with chronic disease across 11 domains requiring long term treatment. CONCLUSION:Healthcare workers deployed to Gaza reported an injury phenotype defined by extensive polytrauma (≥2 anatomical regions), complex blast injuries from high yield explosives, firearm related injuries to upper and lower limbs, and severe disruption to primary care and the treatment of chronic diseases. The results provide actionable insights to tailor humanitarian response and highlight the urgent need for structured, resilient clinical surveillance systems. EDITOR'S NOTE:This paper is based on research from an active war zone, where conventional research methods may be impossible to apply.
Direct reporting of child abuse by children themselves is rare. Children’s communication is increasingly managed through mobile phones and associated apps. Yet little is currently known about how statutory child protection services might be accessed through apps to support direct reports, or to find out about statutory child abuse responses. The objective of the present study was to identify the characteristics of apps that included reference to child abuse and to understand how a child might report if they had concerns. Searches of Google and Apple app stores were conducted at four intervals over a nine-year period from 2014 to 2023. Developer descriptions of apps containing terms relevant to child abuse were thematically analysed according to the app categorization in the store, target user, and child abuse report function. A total of 258 apps met the child abuse app inclusion criteria, <001 percent of all apps available. Just over a third were targeted at children, and a quarter at professionals. Seventeen applications enabled the reporting of child abuse concerns, of which six were aimed at children. Barriers to access included organizational membership and locality. Apps continue to rely on the NGO sector, schools, and health (i.e. adults) to report abuse.
