Sherwood Forest Hospitals NHS Foundation Trust was formed in 2001 and gained Foundation Trust status in 2007. It runs three hospitals in Nottinghamshire - King's Mill Hospital, Newark Hospital and Mansfield Community Hospital. It also operates services from Ashfield Health Village.
Ultrasound-guided regional anesthesia (UGRA) has changed how we manage pain by allowing doctors to visualize nerves and other structures in real time, making the process more accurate, effective, and safe while also reducing risk. This narrative review examines the latest advancements in UGRA techniques, evaluating their efficacy and safety, particularly for peripheral nerve and truncal plane blocks, their potential to diminish opioid consumption, and their clinical applications in perioperative care. This review followed the Scale for the Assessment of Narrative Review Articles (SANRA) quality assessment guidelines and searched six databases for studies published from January 2015 to October 2025, including trials, meta-analyses, cohort studies, reviews, and technical reports. This review aims to give doctors, anesthesia experts, and researchers the newest information and methods about UGRA, focusing on better ways to see needles and use additives like dexamethasone and dexmedetomidine to make regional anesthesia more effective and last longer, which can help lower opioid use and speed up recovery after surgery, while ultrasound guidance makes these techniques safer and more accurate. Another important finding is that real-time imaging and protocols help reduce safety concerns like toxicity, nerve damage, and infection. Artificial intelligence (AI) and robotics in UGRA enhance precision, safety, and recovery, paving the way for further standardization and accessibility.
Atezolizumab-bevacizumab and durvalumab-tremelimumab have established immunotherapy as a first-line standard of care in advanced hepatocellular carcinoma (HCC). Yet, objective response rates (ORRs) remain confined to approximately 15-20%, and no validated predictive biomarker exists for patient selection. Unlike melanoma and lung cancer, conventional markers, including programmed death-ligand 1, microsatellite instability-high status, and tumor mutational burden, have not demonstrated reliable predictive value in HCC. Prior narrative reviews comprehensively catalogued the biomarker landscape through 2022 but predate a wave of clinically significant publications. This narrative review synthesizes evidence published between 2020 and 2026, with particular emphasis on 2023–2026 data, within a unified clinical framework not provided by prior reviews. We critically evaluate tissue-based biomarkers, including the AI-derived Atezolizumab-Bevacizumab Response Signature-Pathology model, spatial multiplex immunohistochemistry, and β-catenin mutational profiling; blood-based biomarkers encompassing circulating tumor DNA for minimal residual disease detection and peripheral immune phenotyping; and serum indices including the CRAFITY score and neutrophil-to-lymphocyte ratio. Hepatitis B virus etiology and non-alcoholic steatohepatitis are discussed as biological modifiers of biomarker performance. We propose an original biomarker-guided clinical algorithm, a comparative clinical readiness table, and a disease-continuum biomarker timeline as practical tools for clinicians and trialists. Prospective biomarker-enrichment trials represent the most critical next step toward clinical translation.
BACKGROUND:People seeking asylum and with refugee status (ASR) often face worse health outcomes compared with host populations. Despite this, ASR are underserved in health care and research, resulting in a knowledge gap about what promotes their health and resilience. AIM:The aim of this review was to define what ASR communities express makes them well. METHOD:This was a scoping review of peer-reviewed papers and grey literature documenting patient-centred holistic health, wellbeing, and social outcomes in community-based research with ASR. RESULTS:In total, 24 papers met the inclusion criteria. Findings were underpinned by the theory of salutogenesis, or asset-based approaches (what makes people well) and categorised into: on 'head' (for example, skills and knowledge), 'hands' (for example, meaningful activities), and 'heart' (for example, cultural and spiritual connections). Wellbeing was primarily defined by safety, empowerment, and a sense of purpose. CONCLUSION:The study demonstrates that wellbeing for ASR is multifaceted, encompassing psychological, social, and cultural dimensions. The salutogenesis framework provides a holistic approach to understanding these factors and this study shows that, to align with of 'no decision about me, without me' in health care, individual measures of health and wellbeing measures must encompass these factors.
