The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (WHO). Climate change, biodiversity loss, and pollution negatively impact all life on earth. All populations are impacted but not equally; the most vulnerable are at highest risk, an inequity further exacerbated by differences in access to healthcare globally. The delivery of healthcare exacerbates the planetary health crisis through greenhouse gas emissions, largely due to combustion of fossil fuels for medical equipment production and operation, creation of medical and non-medical waste, and contamination of water supplies. As representatives of radiology societies from across the globe who work closely with industry, and both governmental and non-governmental leaders in multiple capacities, we advocate together for urgent, impactful, and measurable changes to the way we deliver care by further engaging our members, policymakers, industry partners, and our patients. Simultaneous challenges including global health disparities, resource allocation, and access to care must inform these efforts. Climate literacy should be increasingly added to radiology training programmes. More research is required to understand and measure the environmental impact of radiological services and inform mitigation, adaptation and monitoring efforts. Deeper collaboration with industry partners is necessary to support innovations in the supply chain, energy utilization, and circular economy. Many solutions have been proposed and are already available, but we must understand and address barriers to implementation of current and future sustainable innovations.

Background/Aims: With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the USA. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery. Methods: Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related and non-liver-related mortality were analyzed. Results: Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; p<0.0001), liver-related (3.3% vs. 14%; p<0.0001), and non-liver-related mortality (22.3% vs. 26.9%; p=0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR]=0.63; p<0.0001), liver-related (aHR=0.24; p<0.0001), and non-liverrelated (aHR=0.81; p=0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR=0.39; p<0.0001) whereas open surgeries were associated with higher overall mortality (aHR=1.24; p=0.022). Conclusions Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.

Background: Laryngotracheal invasion occurs in a subset of patients with well-differentiated thyroid cancer (WDTC) and is associated with a poor prognosis. We aimed to analyze patterns and predictors/outcomes related to this high-risk manifestation. Methods: This population-based analysis utilized the Surveillance, Epidemiology, and End Results (SEER) registry (2000 to 2015) to identify WDTC patients. Temporal trends and geographic variation in invasion rates were assessed. Logistic regression and propensity score matching were employed to identify predictors of secondary malignancy, mortality, and treatment impact on overall and thyroid cancer (TC)-specific survival. Results: Of 131,721 WDTC patients, 1,662 (1.3%) had tracheal invasion and 976 (0.7%) had laryngeal invasion at diagnosis. Tracheal and laryngeal invasion rates declined from 3.7%–0.7% and 1.5%–0.6%, respectively, from 2000 to 2015. Compared to 98,835 noninvasive cases, patients with laryngotracheal invasion were older and more often male, Asian, and Hispanic (all P<0.001). This group had larger tumors with higher rates of nodal (N1: 61.8% vs. 15.1%) and distant metastases (M1: 9.3% vs. 0.4%). Age ≥55 years (hazard ratio [HR], 1.19; P=0.004) and metastases (HR, 1.75; P<0.001) increased TC-specific mortality, whereas the converse pattern was found for Asian race (HR, 0.63; P=0.002) and surgery (HR, 0.35; P<0.001). In rigorously matched groups to control confounding, adding radioactive iodine to surgery reduced mortality by 30% (P<0.001). However, external beam radiation and systemic therapy did not improve survival over surgery alone. Conclusion Laryngotracheal invasion is present in 0.7% to 1.3% of cases, conferring over double the mortality risk. Radioactive iodine with surgery improves outcomes in this aggressive WDTC subset.

Purpose: For end stage arthritis of the hip joint, total hip arthroplasty (THA) is the treatment of choice. Dual mobility (DM) liner is an implant designed to provide enhanced stability. Long-term effects and implant survivability remain areas of active research despite modern advancements in increased jump distance and dislocation reductions. The aim of this study is to understand the current research landscape and emerging trends through a bibliometric analysis of DM THA. Materials and Methods: An analysis of THA DM publications from between 1982-2022 was conducted through an extensive review of Web of Science Core Collection literature. To identify key trends, contributions, and thematic areas of focus, data on publications, authors, institutions, and countries were extracted and analyzed. Results: The bibliographic search identified 314 articles, with a notable increase in publications over the period of study. Globally, the leading contributors were France and the USA. The analysis highlighted the Journal of Arthroplasty as the most relevant journal. Research themes included mechanical complications, comparative outcomes, metallosis, and corrosion concerns. Conclusion This study provides a comprehensive DM THA research landscape overview highlighting postoperative outcome value. In an effort to guide future research, contributors, sources, and thematic trends were analyzed.

Purpose: Total hip arthroplasty (THA), a commonly performed surgical procedure for management of end-stage osteoarthritis, is considered minimally invasive and the popularity of the direct anterior approach (DAA) is increasing. The objective of this study is to analyze the current literature on DAA THA through conduct of a comprehensive bibliometric analysis. Materials and Methods: A comprehensive search of the Web of Science Core Collection was conducted for identification of articles published between 1993 and 2022. Specific keywords associated with hip replacement and the anterior approach were used as an attempt to identify articles published in scientific journals. Results: As a result of the analysis, 743 articles were linked to DAA THA. The highest number of annual publications was reported for 2021, with 120 articles, followed by 2022 with 113 articles, 2020 with 104 articles, and 2018 with 69 articles. The United States led in contributions with 34.1% in production. The Medical University of Innsbruck contributed the highest number of studies with 263 articles, followed by the University of Ottawa with 229. The Journal of Arthroplasty emerged as the most influential journal with 903 articles and 4,571 citations. Keywords including “dislocation,” “posterior approach,” and “revision” were used frequently in 2015-2020, along with the increasing emphasis on perioperative complications and comparing different approaches. Conclusion The findings of this analysis provide helpful insights into the current attitude regarding DAA THA research, highlighting emerging trends and guiding the direction of future research. The increasing scientific production reflects growing interest in DAA THA.

Objective: On 2 September 2023, the Regional Epidemiology and Surveillance Unit of the Department of Health’s Center for Health Development in Calabarzon, Philippines, received a report of foodborne illness due to the ingestion of tuba-tuba (Jatropha curcas) seeds in Talao Talao Village, Lucena City. The objective of this study was to describe the public health event. Methods: A descriptive study was conducted. Cases were defined as previously well individuals who developed at least one of the following symptoms after eating tuba-tuba seeds: vomiting, abdominal pain, diarrhoea, headache or dizziness. Health records were reviewed, and key informant interviews and environmental surveys were conducted. Results: Ten cases were identified, ranging in age from 10 to 12 years. The onset of symptoms ranged from 1 to 4 hours after consumption. Six of the cases were taken to the hospital, although two went home before being admitted; all recovered after 3 days. The most common symptom was vomiting (100%); other symptoms included abdominal pain, diarrhoea, dizziness and headache. Discussion: This investigation confirmed that tuba-tuba seeds were the cause of symptoms among school-aged children in Lucena City. To prevent similar events in the future, we recommend intensifying educational campaigns at both the community and school levels, as tuba-tuba is common in the area.

The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (WHO). Climate change, biodiversity loss, and pollution negatively impact all life on earth. All populations are impacted but not equally; the most vulnerable are at highest risk, an inequity further exacerbated by differences in access to healthcare globally. The delivery of healthcare exacerbates the planetary health crisis through greenhouse gas emissions, largely due to combustion of fossil fuels for medical equipment production and operation, creation of medical and non-medical waste, and contamination of water supplies. As representatives of radiology societies from across the globe who work closely with industry, and both governmental and non-governmental leaders in multiple capacities, we advocate together for urgent, impactful, and measurable changes to the way we deliver care by further engaging our members, policymakers, industry partners, and our patients. Simultaneous challenges including global health disparities, resource allocation, and access to care must inform these efforts. Climate literacy should be increasingly added to radiology training programmes. More research is required to understand and measure the environmental impact of radiological services and inform mitigation, adaptation and monitoring efforts. Deeper collaboration with industry partners is necessary to support innovations in the supply chain, energy utilization, and circular economy. Many solutions have been proposed and are already available, but we must understand and address barriers to implementation of current and future sustainable innovations.