The Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH) in Gobowen, near Oswestry, Shropshire, England is a specialist orthopaedic hospital which provides elective orthopaedic surgery. It is managed by the Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust.
Histopathological analysis is considered the gold standard for the diagnosis and prognostication of cancer. Recent advances in AI, driven by large-scale digitisation and pan-cancer foundation models, are opening new opportunities for clinical integration. However, it remains unclear how robust these foundation models are to real-world sources of variability, particularly in H&E staining and scanners produced by different manufacturers. In this study, we use soft tissue tumours, a rare and morphologically diverse tumour type, as a challenging test case to systematically investigate the colour-related robustness and generalisability of seven AI models. Controlled staining and scanning experiments were utilised to assess model performance across diverse real-world data sources. Foundation models, particularly UNI-v2, Virchow and TITAN, demonstrated encouraging robustness to staining and scanning variation, particularly when a small number of stain-varied slides were included in the training loop, highlighting their potential as adaptable and data-efficient tools for real-world digital pathology workflows.
Never-events represent serious and preventable patient safety incidents within surgical practice, despite increasing national and international efforts to reduce them. Persistent concerns regarding wrong site surgery, retained surgical items, and incorrect implants highlight the need to understand contributory human factors and system-level weaknesses. A systematic search of PubMed/Medline, Google Scholar, and the Cochrane Library was conducted. Evidence published between 2014 and 2024 was screened according to predefined eligibility criteria to identify contemporary data relating to surgical never-events. Studies were assessed using standardised selection methods and relevant findings were extracted and synthesised. Thirty-seven studies met inclusion criteria. Across international literature, recurring contributory factors included communication breakdowns, reduced situational awareness, fatigue, inadequate staffing, inconsistent team composition, and increasing surgical caseloads. Despite advances in safety practices, these factors continued to contribute to adverse surgical outcomes. Never-events remain a persistent challenge in surgical care. Strengthening safety management systems, improving awareness of human factors, and prioritising non-technical skills training may help reduce the risk of these events. Ongoing evaluation of interventions and further UK-based research are required to support improvement in patient safety outcomes.
Spine degeneration represents a continuum of biomechanically related alterations that evolve over time. Disc degeneration is partly attributable to physiologic aging or senescence and partly due to pathologic conditions and this distinction is sometimes not very clear. Standard MR imaging is the mainstay for evaluating spine degeneration and newer noninvasive quantitative MR imaging techniques are rapidly emerging to detect early biochemical changes before the onset of structural changes. Degenerative disc disease although being a common and remarkable health problem, is still not completely understood and contributes significantly to years of life disability.
