Oran Knowlson, a British teenager with a severe type of epilepsy called Lennox-Gastaut syndrome, became the first person in the world to trial a new brain implant last October, with phenomenal results – his daytime seizures were reduced by 80%. "It's had a huge impact on his life and has prevented him from having the falls and injuring himself that he was having before," says Martin Tisdall, a consultant paediatric neurosurgeon at Great Ormond Street Hospital (Gosh) in London, who implanted the device. "His mother was talking about how he's had such a improvement in his quality of life, but also in his cognition: he's more alert and more engaged." Oran's neurostimulator sits under the skull and sends constant electrical signals deep into his brain with the aim of blocking abnormal impulses that trigger seizures. The implant, called a Picostim and about the size of a mobile phone battery, is recharged via headphones and operates differently between day and night. "The device has the ability to record from the brain, to measure brain activity, and that allows us to think about ways in which we could use that information to improve the efficacy of the stimulation that the kids are getting," says Tisdall. "What we really want to do is to deliver this treatment on the NHS."

Fecal incontinence, arising from a myriad of pathogenic mechanisms, has attracted considerable global attention. Despite its significance, the replication of the defecatory system for studying fecal incontinence mechanisms remains limited largely due to social stigma and taboos. Inspired by the rectum's functionalities, we have developed a soft robotic system, encompassing a power supply, pressure sensing, data acquisition systems, a flushing mechanism, a stage, and a rectal module. The innovative soft rectal module includes actuators inspired by sphincter muscles, both soft and rigid covers, and soft rectum mold. The rectal mold, fabricated from materials that closely mimic human rectal tissue, is produced using the mold replication fabrication method. Both the soft and rigid components of the mold are realized through the application of 3D-printing technology. The sphincter muscles-inspired actuators featuring double-layer pouch structures are modeled and optimized based on multilayer perceptron methods aiming to obtain high contractions ratios (100 %), high generated pressure (9.8 kPa), and small recovery time (3 s). Upon assembly, this defecation robot is capable of smoothly expelling liquid faeces, performing controlled solid fecal cutting, and defecating extremely solid long faeces, thus closely replicating the human rectum and anal canal's functions. This defecation robot has the potential to assist humans in understanding the complex defecation system and contribute to the development of well-being devices related to defecation.

Background: Postpartum urinary incontinence (PUI) is a common issue among postnatal women. Previous studies identified potential related variables, but lacked analysis on certain intrinsic and extrinsic patient variables during pregnancy. Objective: The study aims to evaluate the most influential variables in PUI using machine learning, focusing on intrinsic, extrinsic, and combined variable groups. Methods: Data from 93 pregnant women were analyzed using machine learning and oversampling techniques. Four key variables were predicted: occurrence, frequency, intensity of urinary incontinence, and stress urinary incontinence. Results: Models using extrinsic variables were most accurate, with 70% accuracy for urinary incontinence, 77% for frequency, 71% for intensity, and 93% for stress urinary incontinence. Conclusions: The study highlights extrinsic variables as significant predictors of PUI issues. This suggests that PUI prevention might be achievable through healthy habits during pregnancy, although further research is needed for confirmation.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

Millions of women over the last two decades have undergone vaginal mesh surgery, but it has recently become clear just how many have experienced severe complications. In our main interview this week, we hear from Sohier Elneil, one of the few surgeons in the UK qualified to remove mesh. Here, Kath Sansom shares her story of what it's like to undergo the treatment and the impact it had on her life. She had a mesh sling implanted in March 2015 to treat mild stress urinary incontinence. It was removed seven months later.