Surgery has long been an important treatment for limiting optic nerve damage and minimising visual loss in patients with glaucoma. Numerous improvements, modifications, and innovations in glaucoma surgery over recent decades have improved surgical safety, and have led to earlier and more frequent surgical intervention in glaucoma patients at risk of vision loss. This review summarises the latest advancements in trabeculectomy surgery, glaucoma drainage device (GDD) implantation, and minimally invasive glaucoma surgery (MIGS). A comprehensive search of MEDLINE, EMBASE, and CENTRAL databases, alongside subsequent hand searches—limited to the past 10 years for trabeculectomy and GDDs, and the past 5 years for MIGS—yielded 2283 results, 58 of which were included in the final review (8 trabeculectomy, 27 GDD, and 23 MIGS). Advancements in trabeculectomy are described in terms of adjunctive incisions, Tenon’s layer management, and novel suturing techniques. Advancements in GDD implantation pertain to modifications of surgical techniques and devices, novel methods to deal with postoperative complications and surgical failure, and the invention of new GDDs. Finally, the popularity of MIGS has recently promoted modifications to current surgical techniques and the development of novel MIGS devices.

Background: Compared with patients who develop ST‐segment–elevation myocardial infarction (STEMI) outside the hospital and present at the emergency department (outpatient‐onset), patients with inpatient‐onset STEMI may paradoxically experience a poorer prognosis due to underlying disease, despite the apparent immediate access to acute health care services. Methods: Patients with first‐onset STEMI who underwent percutaneous coronary intervention ( PCI) in the Singapore Myocardial Infarction Registry (2007–2020) were included. For patients with inpatient‐onset STEMI , the recognition‐to‐balloon time was measured from symptom onset to PCI . For outpatient‐onset STEMI , the recognition‐to‐balloon time was defined as the sum of the symptom‐to‐door and door‐to‐balloon time. Logistic regression was used to identify factors associated with delayed PCI after inpatient‐onset STEMI . Cox regression was used to assess 30‐day, 1‐year, 5‐year, and 10‐year all‐cause and cardiovascular mortality. Results: A total of 19 149 patients, 17 659 (92.2%) outpatient‐onset and 1595 (7.8%) inpatient‐onset, were included. The median follow‐up duration was 6.91 years. Patients with inpatient‐onset STEMI were older, more frequently women, nonsmokers, more likely to have comorbidities, less likely to present with typical STEMI symptoms, and more likely to experience delays in PCI than patients with outpatient‐onset STEMI within the hospital setting. The independent predictors of delayed PCI for inpatient‐onset STEMI were age ≥65 years, diabetes, breathlessness at presentation, and Killip class III. After adjustment for differences in baseline and clinical characteristics, inpatient‐onset STEMI was associated with significantly greater 1‐year, 5‐year, and 10‐year all‐cause mortality (1‐year hazard ratio [HR], 1.27 [95% CI, 1.13–1.43]; 5‐year HR, 1.27 [95% CI, 1.13–1.43]). There was no difference in 30‐day all‐cause or short‐/long‐term cardiovascular mortality. Conclusions: Inpatient‐onset STEMI was linked to an increased long‐term risk of all‐cause mortality compared with outpatient‐onset STEMI despite a shorter recognition‐to‐balloon time.

Background/Objectives: Bereavement in childhood, adolescence, and young adulthood is associated with a range of grief responses, and a subset of bereaved individuals develop persistent or severe grief symptoms. Understanding the prevalence and risk factors of prolonged grief symptoms is important for guiding supportive care. Methods: We systematically searched PubMed, MedLine, Embase and PsycINFO for all studies comparing the prevalence and prognostic factors of prolonged grief-related symptoms among young individuals following parental or sibling death from cancer. Young individuals were defined as those not more than 25 years old before losing a parent or sibling to any cancer. Prolonged grief-related symptoms were defined as the presence of grief symptoms at least six months following the death of a parent or sibling of the bereaved person. Retrospective cross-sectional studies were included for evaluating prognostic factors affecting prolonged grief-related symptoms, but were not used for meta-analyses. Random-effects meta-analyses were conducted for the primary analysis. Results: From 1561 records identified, thirteen studies were included with five for quantitative pooling in meta-analysis. The pooled prevalence of self-reported prolonged grief-related symptoms was 48% (95% CI: 29–67%). Stratified analyses suggested a prevalence of 28% (95% CI: 7–65%) after parental death and 59% (95% CI: 45–72%) after sibling death. Factors associated with elevated prolonged grief-related symptoms included pre-existing depression, emotional difficulties, and insomnia. As no included studies conducted diagnostic clinical interviews, prolonged grief disorder according to the ICD-11 or DSM-5-TR criteria could not be assessed. Conclusions: Prolonged grief-related symptoms appear common among young individuals bereaved by loss of a parent or sibling to cancer, especially after sibling loss. However, interpretation remains limited by substantial heterogeneity, such as outcome measures, symptom thresholds, assessment time window, non-validated symptom measures, and predominance of cross-sectional studies. Future larger and methodologically rigorous studies using validated grief instruments across diverse settings are needed to clarify grief trajectories and guide developmentally appropriate intervention strategies.

Chimeric antigen receptor (CAR) T-cell therapy has revolutionized treatment for relapsed/refractory multiple myeloma (RRMM). However, comparative effectiveness across CAR products, target antigens, and patient subgroups remains incompletely characterized. Particularly, with the emergence of GPRC5D-directed, bispecific, and dual-target strategies, efficacy in patients who have relapsed/refractory disease after anti-BCMA therapy has not been studied in detail. We systematically searched five electronic databases from 1^st January 2010 to 5 December 2025. Eligible studies reported clinical outcomes of CAR T-cell therapy in MM. Primary efficacy endpoints included overall response (ORR) and complete response (CR) rate. Safety endpoints included hematologic and immunologic toxicities. Random-effects meta-analyses were performed using R, with prespecified subgroup and meta-regression analyses according to demographic, disease and treatment-related factors such as antigen target, CAR construct, prior treatment burden, extramedullary disease and high-risk cytogenetics. Fifty-two reports of forty-four cohorts (two frontline and forty-two relapsed/refractory cohorts) including 1833 patients were analysed. Across all CAR T-cell platforms, the pooled ORR was 88% (95%CI: 83-91) and CR rate was 55% (95%CI: 47-62). For autologous BCMA-directed CAR T-cell therapy, ORR was 89% (95%CI: 82-93) and CR rate was 57% (95%CI: 47-66), whereas allogeneic BCMA CAR-T had a lower ORR of 58% (95%CI: 1-100) and CR rate of 21% (95%CI: 6-51). Bispecific and dual-target strategies demonstrated encouraging activity with BCMA/CD19-directed CAR T-cells achieving an ORR of 92% (95%CI: 89-95) and CR rate of 64% (95%CI: 16-94), while BCMA/CD38-directed CAR T-cells achieved an ORR of 88% (95%CI: 82-93) and CR rate of 61% (95%CI: 22-90). For GPRC5D-directed CAR T-cell therapy, ORR was 89% (95%CI: 84-92) and CR rate was 50% (95%CI: 32-69). Among BCMA-relapsed/refractory patients, subsequent GPRC5D-directed CAR T-cell therapy achieved an ORR of 82% (95%CI: 66-91) and CR rate of 35%. MRD negativity was observed in 78% (95%CI: 68-86) of evaluable patients overall. Subgroup analyses demonstrated significantly lower ORR and CR in cohorts with higher extramedullary disease. Grade ≥3 hematologic toxicities were frequent: neutropenia occurred in 83% (95%CI: 76-89), leukopenia in 73% (95%CI: 59-83), anemia in 46% (95%CI: 38-54), and thrombocytopenia in 48% (95%CI: 41-56). Grade ≥3 cytokine release syndrome occurred in 8% (95%CI: 6-11), while grade ≥3 immune effector cell-associated neurotoxicity syndrome occurred in 3% (95%CI: 2-5). CAR T-cell therapy produces high response rates, substantial depth of remission, and frequent MRD negativity in multiple myeloma, including heavily pretreated RRMM. Antigen switching strategies after anti-BCMA failure with GPRC5D-directed strategies appear promising. Bispecific and dual-target CAR T-cell strategies appear especially promising, with high response rates and deep remissions. Extramedullary disease and high prior treatment burden remain important poor prognostic factors. However, these findings remain largely derived from early-phase, single-arm studies, and prospective comparative trials are needed to further guide optimal choice of CAR-T and long-term efficacy.