The Clinical Times
The Front Page of Medicine

Clinical & Research · page 18

New research and findings from open-access journals and the U.S. research agencies.

BMJ Open · Jul 21, 2026

Understanding the implementation of kidney supportive care interventions to improve palliative care outcomes for adults receiving haemodialysis: protocol for a rapid realist review

Introduction Chronic kidney disease (CKD) is a significant global health concern, contributing substantially to mortality; in advanced stages, adults often require kidney supportive care (KSC), a model of care/intervention that addresses complex palliative and supportive needs. These needs often remain insufficiently addressed, particularly among adults receiving haemodialysis, due to the interplay of multiple contextual factors and inconsistent reported outcomes. Consequently, it remains unclear how, for whom and under what circumstances KSC works (or does not work). Therefore, this rapid…

BMJ Open · Jul 21, 2026

Rationale and design of a prospective cohort study and biobank of the offspring born to mothers with a solid organ transplant: protocol for the TransplantLines Next Generation study

Introduction Successful pregnancies with healthy newborns have been reported after all types of solid organ transplantation (SOT). Limited data in young children suggest similar development and health compared with the general population. However, fetal development may be influenced by factors such as immunosuppressive medication and the increased incidence of pregnancy complications, and forthcoming health problems may only become apparent later in the life of the offspring. To allow for better investigation of the long-term health of offspring born after SOT, we designed the Transplantlines…

BMJ Open · Jul 21, 2026

Cluster randomised feasibility trial of PRISM: the PRimary Care Individual Social Norms MSK Data Dashboard to support first contact physiotherapy management of musculoskeletal patients in primary care

Introduction Musculoskeletal (MSK) conditions affect over 20 million people in the UK and account for one in seven General Practitioner (GP) consultations. To address capacity challenges, First Contact Physiotherapists (FCPs) now manage MSK patients in primary care. However, FCPs working in isolation from physiotherapy teams exhibit broad variation in decision-making that could pose risks to care quality. PRimary Care Individual Social Norms MSK Data Dashboard (PRISM) is a clinician-facing behaviour change digital dashboard that provides individualised social norms feedback such as, ‘you are…

BMJ Open · Jul 21, 2026

Temporal trends in epidemiology and patient characteristics of 36 cancers: a protocol for a multinational population-based cohort study using OMOP-standardised databases to investigate CANcer (OMOPCAN)

Introduction Cancer registries remain the gold standard for global cancer monitoring, yet complementing them with electronic health records and claims can significantly enhance the understanding of the cancer burden by providing a more complete picture of the patient journey. The main aim of this project is to serve as a proof of concept for using real-world data mapped to the Observational Medical Outcomes Partnership (OMOP) common data model (CDM) to monitor cancer epidemiology over time and characterise patients’ clinical history and outcomes. Methods and analysis This study will be…

BMJ Open · Jul 21, 2026

Comparison of a four-nerve block protocol versus adductor canal block plus local infiltration analgesia for primary total knee arthroplasty in two French private hospitals: protocol for the multicentre randomised INCA trial

Background INCA is a multicentre, prospective, randomised, two-arm superiority trial. 100 adult patients scheduled for primary total knee arthroplasty (TKA) will be randomised 1:1 to one of two locoregional analgesia strategies: group 1 (standard strategy), single-shot adductor canal block (ACB) combined with active surgeon-administered peri-articular infiltration with ropivacaine and participant-facing sham peripheral nerve blocks; group 2 (four-nerve block strategy), single-shot ACB combined with three additional ultrasound-guided nerve blocks (lateral femoral cutaneous, obturator and…

BMJ Open · Jul 21, 2026

Efficacy of high-flow nasal cannula versus conventional face mask oxygen therapy on ipsilateral cerebral haemodynamics during the immediate post-extubation phase following carotid endarterectomy: protocol for a randomised controlled trial

Introduction Cerebral hyperperfusion syndrome (CHS) is a severe complication following carotid endarterectomy (CEA). During emergence from general anaesthesia, residual anaesthetics induce mild respiratory depression and carbon dioxide accumulation, exacerbating hyperperfusion risks via hypercapnia-induced cerebral vasodilation. High-flow nasal cannula (HFNC) effectively reduces excessively elevated pressure of arterial carbon dioxide via multiple mechanisms including anatomical dead space washout. This trial aims to evaluate the effects of HFNC versus conventional mask oxygen therapy on…

BMJ Open · Jul 21, 2026

Associations between adverse working hours and nurses sickness absence: a longitudinal analysis of e-roster data from acute hospital wards

Objective To examine the associations between registered nurses’ shift work patterns and sickness absence in hospital inpatient wards. Design Retrospective longitudinal study using 1.4 million e-roster and sickness absence records analysed with logistic mixed-effects models. Setting All adult acute inpatient hospital wards in two large healthcare organisations (Trusts) in England. Participants Registered nurses (N=7515) working across 95 adult acute wards in 2015–2020. Primary outcome measure Nurses’ sickness absence in relation to the shift pattern configurations worked in the previous 7…

BMJ Open · Jul 21, 2026

Actionable health system and policy strategies for the prevention and mitigation of non-communicable diseases: a scoping review protocol

Introduction Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes, cancers and chronic respiratory diseases, account for a substantial proportion of global mortality and morbidity and represent a major challenge for the health system worldwide. Effective prevention and mitigation of NCDs requires coordinated strategies that combine health system interventions with population-level policies targeting key risk factors such as tobacco use, harmful alcohol consumption, unhealthy diets and physical inactivity. Evidence on actionable strategies implemented across diverse…

BMJ Open · Jul 21, 2026

Prophylactic antiseizure medication administration practices in neonates with hypoxic-ischaemic encephalopathy: a scoping review protocol

Introduction Hypoxic-ischaemic encephalopathy (HIE) is a leading cause of neonatal mortality and long-term neurodevelopmental impairment worldwide. Neonatal seizures are common in HIE and are associated with adverse outcomes. While antiseizure medications are routinely used for treatment, their prophylactic use in the absence of clinically evident seizures remains controversial, with limited consensus and variable clinical practices. Therefore, this review will map the existing evidence concerning the utilisation of antiseizure medication for prophylaxis among neonates with HIE. Methods and…

BMJ Open · Jul 21, 2026

Proof-of-concept randomised controlled trial of data-driven hearing rehabilitation versus standard care in older adults with hearing loss: the healthy hearing for healthy ageing protocol

Introduction Hearing aids (HAs) can alleviate hearing loss; however, HA rehabilitation is frequently hampered by delayed diagnosis, suboptimal fitting and lack of systematic follow-up. Although the association between hearing loss and cognitive decline has been identified, evidence from randomised controlled trials remains limited. Addressing these gaps is essential for reducing hearing loss-related experiences and evaluating whether effective HA use could reduce the risk of cognitive decline. Methods and analysis The healthy hearing for healthy ageing study is a proof-of-concept, single-site…

JAMA Network Open · Jul 21, 2026

Errors in Abstract, Results, and Table

In the Original Investigation titled “Epidemiology of Functional Seizures Among Adults Treated at a University Hospital,” published December 29, 2020, the odds ratios reported in the Abstract, Results, and Table 3 were incorrect. An error in the code used to generate the odds ratios resulted in a substantial underestimation of the point estimates. The authors have corrected the code and rerun the relevant analyses. The revised values do not change the direction of the associations or the overall conclusions. The article has been corrected, and the authors have explained how the error occurred…

JAMA Network Open · Jul 21, 2026

Effect Size Errors in Abstract and Main Article Results, Table 3, Table 4, and Supplement 2

In the Original Investigation titled “Cognitive Behavioral Therapy for Insomnia in Pain Management for Nonspecific Chronic Spinal Pain: A Randomized Clinical Trial,” published August 9, 2024, there were effect size errors in the Abstract and main article Results, Table 3, Table 4, and Supplement 2. The automation process of the effect size calculation caused the error. The effect sizes have been recalculated and updated. The authors have explained what happened in a Comment, and this article has been corrected.

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