Psychometric and clinical validation of the fear of childbirth questionnaire in a UK population

Abstract Introduction Severe fear of childbirth (FOC) during pregnancy holds significant implications for maternal mental health, decisions about mode of birth, and potentially infant development. Until recently, there were no tools available to measure FOC within a UK population that assessed the full construct using acceptable phraseology. A new tool, the Fear of Childbirth Questionnaire, has been developed but requires full psychometric evaluation. This study aimed to assess the validity and reliability of the Fear of Childbirth Questionnaire and examine possible threshold scores indicating clinical severity. Material and Methods Pregnant women ( N  = 540) completed the Fear of Childbirth Questionnaire online alongside additional measures for current/previous obstetric history, anxiety, and depression to test dimensions of validity (ISRCTN62032021). Most women ( N  = 360) then completed the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders 5th Edition (Research Version) Module F (phobia) with trained interviewers over the telephone. Sensitivity and specificity were calculated. A subsample ( N  = 61) repeated Fear of Childbirth Questionnaire completion 2 weeks later to inform test–retest reliability. Internal consistency, validity (convergent, discriminant, and criterion‐related), unidimensionality, and factor structure were examined. Results Internal consistency was excellent ( α  = 0.89; ω  = 0.89) and test–retest reliability was good ( r  = 0.87). Strong association with the Fear of Birth Scale ( r  = 0.69) indicated convergent validity. Discriminant validity was indicated via moderate correlations with general measures for anxiety ( r  =  0.40–0.53 ), and less so with those of depression (r  = 0.35). Scores were higher for those with current/previous mental health difficulties, previous birth trauma, those preferring an epidural, and those preferring a planned cesarean section, indicative of criterion‐related validity. An optimal cut‐off value of ≥33 total score and ≥4 current impact score is recommended to initiate further exploration of support/intervention needs (ROC Area under the curve = 0.80, 95% CI 0.75:0.85; sensitivity 71.9, specificity 85.4, positive predictive value 39.0, negative predictive value 95.9). Conclusions The Fear of Childbirth Questionnaire is psychometrically robust and can identify FOC at levels commensurate with a clinical phobia. It is the only tool purposefully developed and clinically validated to identify FOC in a UK population.

Nuclear‐Powered Artificial Organs: A Reconsideration, Ten Years Later

Pravastatin Corrects Endothelial Dysfunction in Ex Vivo Uterine Radial Arteries in Preeclampsia

ABSTRACT Aim Endothelium‐dependent relaxation in isolated uterine radial arteries from normotensive (NT) and preeclamptic (PE) pregnancies, and the acute effects of pravastatin in the latter vessels were assessed. Pravastatin is hypothesized to alleviate endothelial dysfunction in PE via modulating aspects of NO and endothelium‐derived hyperpolarization‐mediated relaxation. Methods Radial arteries isolated from the uterus of NT and PE pregnant patients were incubated with pravastatin (2 mM/6 h), methyl‐β‐cyclodextrin (10 mM/1 h) in vitro, or vehicle. Vessel function was determined with pressure myography, while related morphology and protein/mRNA expression were characterized using immunohistochemistry, electron microscopy, and qPCR. Results Endothelium‐dependent, bradykinin‐induced NO‐mediated relaxation was impaired in radial arteries from PE compared to NT pregnancy, with a reduced intermediate‐ and large‐conductance Ca 2+ ‐activated K + ‐channel contribution. Endothelial small‐conductance Ca 2+ ‐activated K + ‐channel function and expression were increased in arteries from PE, compared to NT patients. Pravastatin restored NO and endothelium‐derived hyperpolarization‐mediated relaxation in arteries from PE women; potentially overcompensating overall endothelium‐dependent relaxation. Myoendothelial gap junction and endothelial caveolae density, and caveolin‐1 and endothelial‐NOS expression were decreased in arteries from PE relative to NT pregnancies and increased following pravastatin incubation. Caveolae density in NT patient arteries was reduced by methyl‐β‐cyclodextrin, while endothelial caveolae were increased in vessels from PE patients. Pravastatin incubation restored endothelial function via improved NO and endothelium‐derived hyperpolarization‐type mechanisms. Conclusions Pravastatin restored endothelium‐dependent relaxation in uterine radial arteries from PE pregnancies. Data support the therapeutic potential for pravastatin in treating PE, with ongoing trials determining the validity of its use in the clinical setting. Trial Registration ClinicalTrials.gov identifier: NCT01717586

Systematic Review: Efficacy, Safety and Metabolic Outcomes of GLP‐1 Receptor Agonists in Inflammatory Bowel Disease

ABSTRACT Background Obesity and metabolic disease are increasingly prevalent in patients with inflammatory bowel disease (IBD) and can influence disease activity and treatment outcomes. Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) are effective for weight loss and metabolic control, yet their safety and effects in IBD remain uncertain as patients with IBD have been excluded from pivotal trials. Aims To systematically evaluate the weight‐related, metabolic, IBD‐specific, and safety outcomes of GLP‐1 receptor agonists in adults with IBD. Methods We conducted a systematic review according to PRISMA guidelines (PROSPERO CRD42025628850). We searched MEDLINE, Embase, Cochrane Library and ClinicalTrials.gov to 9 September 2025 for studies evaluating GLP‐1 RAs in adults with IBD. Primary outcomes were weight‐related measures. Secondary outcomes included metabolic parameters, IBD activity, and safety. Risk of bias was assessed using Joanna Briggs Institute (JBI) checklists. Results We included 14 studies of which 13 were retrospective cohort studies. Ten reported significant reductions in body weight, BMI, or percent weight loss. Four demonstrated improvements in metabolic markers, including decreased haemoglobin A1c and favourable lipid changes. Across multiple datasets, GLP‐1 RA use was not associated with increased IBD exacerbations. Several large registries reported reduced risks of corticosteroid use, hospitalisation and surgery among GLP‐1 RA users. Adverse events were primarily gastrointestinal, consistent with non‐IBD populations. Conclusion GLP‐1 RAs appear to be well tolerated in patients with IBD, with observational evidence suggesting potential associations with improved weight, metabolic, and disease‐related outcomes. Prospective, IBD‐specific studies are required to confirm safety, clarify mechanisms, and define optimal patient selection.

The role of executive functions in young children's static and sustained inattentional blindness

Abstract Inattentional blindness (IB), which refers to a failure to detect unexpected stimuli in the visual field, is associated with increased risk from undetected threats. While IB has been attributed to several individual factors, the role of cognitive control capacities, such as executive functions, remains unclear. To investigate this relationship, 154 Chinese children aged 3–6 (52.6% male) completed two IB tasks (static and sustained) and three executive function tasks. Findings show that the executive function tasks were predictive of IB, and this prediction varied by IB type: working memory predicted static IB, while cognitive flexibility predicted sustained IB. This underscores the necessity of specifying IB type and the importance of alignment to the cognitive predictors when studying individual differences in IB. When this alignment is achieved, findings suggest that executive function abilities may be differentially implicated in different IB phenomena.

Repurposing pacritinib to target MYD88 ‐mutated Waldenström macroglobulinaemia

Humoral and functional SARS ‐ CoV ‐2‐specific T‐cell responses elicited in chronic lymphocytic leukaemia patients with GEO ‐ CM04S1 a synthetic MVA ‐vectored COVID ‐19 vaccine

Real‐world experience with CPX ‐351 for secondary acute myeloid leukaemia: Comparison with FLAG ‐ IDA in a propensity score matching analysis

Prophylactic urethrectomy at the time of radical cystectomy for bladder cancer: does it really have an effect on oncological outcomes?

Objective To assess the oncological impact of prophylactic urethrectomy (PU) on recurrence, metastasis, and survival outcomes, as PU was historically performed alongside radical cystectomy (RC) in men but has become rare with the increasing use of orthotopic neobladder substitution and uncertain survival benefits. Patients and Methods A total of 1028 patients underwent RC at a single tertiary referral center between 1996 and 2022. Among them, 581 males who received either incontinent urinary diversion or continent cutaneous diversion were identified. A propensity score matching was performed to minimise selection bias, yielding a cohort of 332 patients, of whom 166 underwent PU and 166 did not. Kaplan–Meier survival analysis was conducted to evaluate recurrence‐free survival (RFS), urethral recurrence‐free survival (URFS), cancer‐specific survival (CSS), and overall survival (OS) at multiple time points postoperatively. Differences in survival outcomes between the two groups were assessed using the log‐rank test. Results A trend toward improved CSS was observed in the PU group; however, the difference was not significant, and no notable variation was found in RFS. At 10 years, URFS was higher in the PU group (97.9% vs 90.9%, P  = 0.05), but after matching, this difference (98.2% vs 95.9%) was no longer significant. A significant improvement in OS was observed among patients who underwent PU, with a 10‐year survival rate of 47.3% compared to 27.5% in those who did not receive the procedure ( P  = 0.002). Independent predictors of OS included age ≥80 years ( P  = 0.013), Charlson Comorbidity Index score ≥3 ( P  = 0.002), pathological N‐stage ≥N1 ( P  < 0.001), positive surgical margins ( P  < 0.001), and performing PU ( P  = 0.015). Conclusions Patients undergoing PU had significantly improved OS at 2‐, 5‐, and 10‐year follow‐up compared to those who did not. No significant differences were found in CSS and RFS. While PU was associated with a reduced risk of urethral recurrence at 10 years, this advantage was no longer significant after adjusting for confounders. The procedure may be most beneficial for select patients, particularly those with prostatic urethral involvement.

Patients With Pituitary Neuroendocrine Tumours Requiring Neurosurgery –Who Is Referring Them?

ABSTRACT Objective Patients living with pituitary neuroendocrine tumours (PitNETs) present with a spectrum of clinical manifestations and often follow a circuitous route to diagnosis, resulting in diagnostic delays. The objective of this study is to identify and report the various sources of referrals for patients who underwent pituitary resection for PitNETs in a tertiary referral centre for pituitary disease. Design Retrospective population‐based cohort study. Patients Patients undergoing a first surgery for management of PitNET in Northern Ireland between 01/01/2000‐19/07/2019. Measurements Demographics, referral sources, incidentaloma rates, apoplexy rates, symptoms, age at diagnosis and diagnostic delay according to referral source. Results Data were retrospectively analysed for 520 patients in whom the referral source leading to diagnosis was known. Fifty‐seven percent of patients were male. Median age at diagnosis was 54 years (range 18–85). Patients were referred from 29 different sources. The majority of referrals came from general practice (23%), ophthalmology (14%), emergency medicine (9%), optician/optometry (9%) and internists (8%). Twenty‐nine patients were referred following radiological discovery of an incidentaloma. Twenty‐seven patients were referred with an initial presentation of pituitary apoplexy, with emergency medicine accounting for 70% of these referrals. Visual disturbance and headache were the most frequently documented symptoms. Median diagnostic delay was 2 years (range 0–25 years). Conclusions Patients with PitNETs encounter a range of clinical services in their journey to pituitary surgery. Raising awareness of these tumours and educating healthcare professionals across all disciplines could reduce diagnostic delays, thereby minimising the adverse sequelae of delayed diagnosis.