The Clinical Times
The Front Page of Medicine

Clinical & Research · page 24

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

BMJ Open · Jul 16, 2026

Real-world impact of SGLT2 inhibitors on the risk of symptomatic urinary tract infections in patients with cardiometabolic and kidney diseases: a prospective, multicentre, observational cohort study protocol

Introduction Sodium-glucose cotransporter-2 (SGLT2) inhibitors were originally introduced for glycaemic management of type 2 diabetes mellitus and now provide substantial cardiovascular and kidney benefits. Although their association with genital mycotic infections is well established, whether SGLT2 inhibitor initiation increases the risk of symptomatic urinary tract infections (UTIs) remains uncertain, particularly within the cardiovascular-kidney-metabolic syndrome framework. This protocol describes a prospective multicentre observational study designed to address this clinically important…

JAMA Network Open · Jul 16, 2026

Error in Figure

In the Original Investigation titled “Hurdles for the Delivery of Multinational Randomized Clinical Trials,” published July 2, 2025, there was an error in Figure 1. Panel C (protocol approval to first patient in) originally listed the comparison as the pre–COVID-19 pandemic period vs the COVID-19 period. The comparison was between UK and non-UK countries during the COVID-19 pandemic period only. This article has been corrected.

JAMA Network Open · Jul 16, 2026

Water-Energy-Food Security and Health in South Africa

This scoping review examines associations between water, energy, and food insecurities and health outcomes in South Africa and explores intermediate factors that may shape pathways between insecurities and health.

BMJ Open · Jul 15, 2026

Effects of targeted interventions on HIV testing, knowledge and sexual risk behaviours among long-distance truck drivers: a systematic review and meta-analysis

Objectives We aimed to systematically summarise and quantify the empirical evidence on targeted interventions and their effects on various HIV prevention outcomes for long-distance truck drivers (LDTDs) globally. Design A systematic review and meta-analysis. Data sources We searched PubMed, PubMed Central (PMC), Cumulated Index to Nursing and Allied Health Literature (CINAHL), ProQuest Central, EBSCOhost, ScienceDirect, World Health Organisation (Global Index Medicus), Cochrane Library, Scientific Electronic Library Online (SCiELO), Japan Science and Technology Information Aggregator…

BMJ Open · Jul 15, 2026

Effects of Chinas National Volume-Based Procurement policy on utilisation and affordability of statins in children: an interrupted time series analysis

Background Statins are effective in lowering lipids and reducing cardiovascular risk. In recent decades, rising paediatric lipid levels, especially in low- and middle-income countries (LMICs), have led to growing demand for lipid-lowering drugs. However, access remains limited in LMICs due to financial constraints. To address this, China launched its National Volume-Based Procurement (NVBP) policy in 2019, significantly improving the price and affordability of statins. This study evaluates the policy’s impact on statin use and expenditures in children. Methods The study used interrupted time…

BMJ Open · Jul 15, 2026

The neglected second wound: a qualitative study of patients experiences of lower limb vascular harvesting for coronary artery bypass grafting

Objective This study aimed to understand the experiences and feelings of patients undergoing lower limb vein harvesting for coronary artery bypass grafting (CABG). Design Qualitative, phenomenological research methodology with purposive sampling. Semistructured interview data were analysed using Colaizzi’s seven-step method with the NVivo 12 Plus software. Setting A single-centre study in a Grade A hospital in Nanjing, China. Participants A total of 23 patients who underwent CABG with saphenous vein harvesting between October 2024 and March 2025. Results The participants’ experiences were…

BMJ Open · Jul 15, 2026

Existing interventions for the management of different types of dysgraphia or specific learning disorder in written expression: a scoping review

Background Dysgraphia is a specific learning disorder characterised by difficulties in written expression. Identifying and finding remedies for children with this disorder is challenging due to the diverse interventions used in different contexts. Different interventions are used to rehabilitate children with this disorder. Objective This scoping review aims to map the existing interventions for dysgraphia across different contexts, that is, schools, rehabilitation centres, home-based services and clinics. Design Scoping review. Eligibility criteria This review included studies that used…

BMJ Open · Jul 15, 2026

Individually designed fall prevention strategies compared to generic strategies for mastering complex fall risk situations in people with multiple sclerosis: study protocol of a randomised controlled trial

Introduction Of individuals with mild-to-moderate multiple sclerosis (MS), 56% report falling at least once during a 3-month period. Several fall risk factors have been identified, but the issue is complex, with interactions between triggering factors and preceding activities and events. There is a lack of studies explicitly evaluating fall prevention strategies given as counselling over time. Methods and analysis The project includes (1) a two-armed randomised controlled internal pilot study with a nested qualitative study on participants’ experiences and (2) a randomised controlled trial…

BMJ Open · Jul 15, 2026

Do all individuals with type 2 diabetes mellitus prefer decentralisation in clinical trials? Findings from a discrete choice experiment

Objectives To explore differences in preferences for participation in trials with varying degrees of decentralisation among individuals with type 2 diabetes mellitus (T2DM) and to show how personal, disease specific, digital and trial experience factors influence these preferences as well as impact potential trial participation rates. Design A discrete choice experiment was conducted, including 16 choice tasks, with each two trial options and an opt-out. Setting Preference data was collected in the Netherlands between July 2023 and July 2024. Participants A total of 276 individuals with T2DM…

BMJ Open · Jul 15, 2026

Cross-sectional study of gender differences in the perception of body image during cancer-induced weight loss: study protocol for the GRACE study (Global Research on Appearance in Cancer)

Background Unintentional weight loss is prevalent in advanced cancer and maintaining weight is critical to improve clinical outcomes. Body image plays a significant role in how weight loss is perceived. A previous Swedish study showed that men with advanced cancer had a negative perception of cancer-induced weight loss whereas women perceived the weight loss more positively. Objectives The aim of the GRACE study (Global Research on Appearance in Cancer) is to study gender differences in the perception of body image during cancer-induced weight loss. Second, we aim to explore cross-country…

BMJ Open · Jul 15, 2026

Architecture, implementation and acceptance of performance-based resource allocation for medical education: an interview study protocol addressing medical schools in Germany and Switzerland

Introduction Performance-based resource allocation (PBRA) programmes have been increasingly adopted by medical schools as a strategic mechanism to optimise funding distribution, align resources with institutional priorities—particularly the delivery of high-quality education—and improve educational outcomes. In an era of budgetary constraints and growing demands for transparency and accountability in higher education, PBRA programmes offer means to enhance efficiency, incentivise quality and strengthen educational performance. Despite their widespread implementation, significant knowledge gaps…

BMJ Open · Jul 15, 2026

What is the impact of modest increases in physical activity on the future burden of diabetes in Brazil? A modelling study and projection analysis from 2026 to 2050

Background Diabetes is a major global public health challenge, with rapidly rising incidence, particularly in low- and middle-income countries. Physical activity is a well-established protective factor against type 2 diabetes (T2DM); however, the population-level impact of realistic modest increases in physical activity remains unclear. Objectives To estimate the burden of T2DM attributable to physical inactivity in Brazil and project the impact of modest increases in physical activity. Research design and methods We calculated the population attributable fractions (PAFs) and economic costs of…

BMJ Open · Jul 15, 2026

Reproductive healthcare use before and after infertility diagnosis: a population-based study in South Korea

Objectives This study examines heterogeneity in women’s use of reproductive healthcare services before and after receiving an infertility diagnosis and its association with pregnancy identified without recorded loss within one year following the first infertility diagnosis. Reproductive healthcare use was operationalised as care-seeking history, utilisation intensity and subsequent engagement with assisted reproductive technology (ART) and financial support. Design Population-based retrospective cohort study. Multivariate logistic regression analyses were performed. Setting Korean National…

BMJ Open · Jul 15, 2026

Relationship between perceived social support and domestic violence with maternal postpartum stress in Iranian women: a cross-sectional study

Objectives This study aimed to investigate the relationship between perceived social support and domestic violence with maternal postpartum stress in an Iranian context. Design This cross-sectional study was conducted in 2023 in Tabriz, Iran. Setting and participants A total of 349 mothers, 2–6 months post partum, who were living with a spouse and had no history of mental health disorders, were selected from municipal health centres using a cluster sampling method. Primary and secondary outcome measures Data were collected using the Maternal Postpartum Stress Scale, the Perceived Social…

BMJ Open · Jul 15, 2026

Short-term oral antibiotic discontinuation and its predictors among outpatients of public hospitals in Eastern Ethiopia: a prospective follow-up study

Objective To assess the prevalence of discontinuation of short-term oral antibiotic therapy and to identify its predictors among patients attending outpatient department pharmacy units of public hospitals in Harar, Eastern Ethiopia. Design Facility-based prospective follow-up study. Setting All public hospitals in Harar, Eastern Ethiopia. Participants A total of 422 patients who received short-term oral antibiotics from Hiwot Fana Comprehensive Specialized Hospital (HFCSH) and Jugal General Hospital (JGH) from 20 January to 20 April 2024 were recruited using a systematic random sampling…

BMJ Open · Jul 15, 2026

What is the impact of salutogenic design elements on human well-being in microhousing? A systematic review protocol

Introduction Rapid urbanisation, increasing housing density and rising costs have intensified pressure on urban housing systems, limiting access to health-promoting residential environments. Microhousing (compact units typically ranging from 15 to 40 m²) has emerged as a strategy to address these challenges. While microhousing improves affordability and spatial efficiency, it may also pose psychological and well-being challenges for residents. Salutogenic design, grounded in the sense of coherence framework, emphasises environmental resources that promote mental health and resilience…

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