Objectives (1) To compare the effectiveness of guided group reflection (GGR) versus SNAPPS (Summarise history and physical examination, Narrow differentials, Analyse the differentials, Probe the preceptor, Plan of patient management, Self-directed learning), as a teaching intervention in improving clinical reasoning (CR) skills of final-year MBBS (Bachelor of Medicine, Bachelor of Surgery) students. (2) To determine which teaching intervention is more effective in improving specific components of CR (data acquisition, problem presentation, hypothesis generation, illness script comparison and…
Objectives An evidence synthesis informed the 2023 WHO infection prevention and control (IPC) guideline for Ebola disease (EBOD) and Marburg disease (MARD). Design A series of rapid reviews addressed 14 key questions (KQs) related to IPC measures for EBOD and MARD across three themes: (1) transmission/exposure, (2) personal protective equipment (PPE) and (3) decontamination/disinfection. Data sources Databases (Embase, Cochrane Database of Systematic Reviews, CENTRAL, Global Index Medicus) were searched from inception to May 2024, in addition to searches in MEDLINE and bio/medRxiv servers…
Objectives To analyse changes in the prevalence of suspected scoliosis among children and adolescents in Heqing County, South-West China, over different periods and to identify risk factors for its progression. Design A mixed-methods study, including a cross-sectional survey and longitudinal follow-up. Setting Single-centre study. An angle of torso rotation (ATR) ≥5° was defined as a positive screening result and progression was defined as an increase in ATR ≥2°. Participants In November 2021, 22 740 students aged 6–18 years were screened; in May 2023, 28 009 students aged 6–18 years…
Objectives To explore healthcare professionals’ (HCPs’) understanding and current practice in the screening and diagnosis of sarcopenia to help with the development of a standardised sarcopenia screening tool that can be implemented within the National Health Service (NHS) of the UK. Design A qualitative study using semistructured interviews that were analysed using Braun and Clarke’s reflexive thematic analysis steps. Setting The interviews were conducted online. Participants Ten HCPs (consultants, physiotherapists, community matrons, dieticians and community falls specialists) within acute…
Introduction Drug-resistant mesial temporal lobe epilepsy (mTLE) is a common and disabling focal epilepsy syndrome for which surgery offers the best chance of seizure freedom. Traditional open surgery (eg, anterior temporal lobectomy or selective amygdalohippocampectomy) is effective but may be associated with perioperative morbidity and neurocognitive sequelae. Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive alternative with encouraging observational outcomes but high-quality comparative evidence versus open surgery remains limited. The MINE…
Introduction Advances in surgical techniques and neoadjuvant care for rectal cancer have increased sphincter preservation, allowing restoration of bowel continuity through low anterior resection (LAR). However, up to 75% of patients experience low anterior resection syndrome (LARS), which is bowel dysfunction characterised by faecal incontinence, frequency, urgency and clustering of bowel movements, significantly impairing quality of life (QoL). Current management is largely empirical, using lifestyle or pharmacological strategies with variable success. Transanal irrigation (TAI) is a…
Introduction Africa faces a substantial health burden characterised by a dual burden of communicable and non-communicable diseases compounded by persistent health system and infrastructure constraints. Digital health interventions offer scalable opportunities to strengthen healthcare delivery. Interactive voice response (IVR), an automated telephone-based technology, shows promise across African health settings; however, existing evidence is dispersed across isolated studies and demonstrates variability in outcomes and implementation approaches. This scoping review maps existing evidence on…
Introduction Shared decision making (SDM) in healthcare is an ethical imperative and essential to patient-centred care. SDM is particularly useful when several preference-sensitive treatment options exist and in the setting of chronic conditions or longitudinal management. Chronic pain management embodies these characteristics, yet SDM often remains insufficient in this population. Decision aids are designed to facilitate SDM by helping patients and clinicians understand treatment options, clarify patient values, and guide collaborative decision processes. Despite their importance, the use of…
Introduction Reports on the epidemiology and outcomes of acute kidney injury in the critically ill provide variable estimates based on differences in populations and underlying exposures. Current and generalisable incidence data are needed along with information on long-term patient and kidney outcomes. The acute kidney injury-epidemiology in intensive care unit patients 2 (AKI-EPI 2) study aims to describe the occurrence and associated outcomes of AKI in critically ill patients worldwide. In addition, in selected centres, it aims to further describe the influence of AKI on long-term kidney…
Introduction Large language models (LLMs) are rapidly normalising in nursing education. However, evidence regarding their impact on critical thinking—a cornerstone of safe clinical practice—remains inconsistent. Current syntheses have largely focused on student satisfaction and general utility, leaving the specific instructional mechanisms that cultivate this competency unexplored. This mixed-methods systematic review aims to identify effective pedagogical strategies for fostering critical thinking, providing evidence-based guidance to safeguard clinical competency in an artificial…
GSK has walked away from a $2.2 billion biobucks neurodegenerative disease pact with Alector that has seen both “next generation” drugs involved flunk clinical trials.
In the Original Investigation titled “Early Neurodevelopmental Outcomes in Children With Congenital Heart Disease,” published June 1, 2026, there was an error in the Article Information section. The Funding/Support section should have read: “This project was supported by the Cardiac Neurodevelopmental Outcome Collaborative (CNOC), the Pediatric Cardiac Critical Care Consortium (PC4), and the Children’s Heart Foundation through their support for integrated registry initiatives as a part of Cardiac Networks United.” This article has been corrected.
In the Original Investigation titled “Life-Sustaining Treatment Decisions and Parent Caregiving Experiences for Children With Medical Complexity,” published June 11, 2026, there were errors in Table 3. For the subtheme titled, “Emotional-rational entanglement,” the second quote should have been attributed to a “39-year-old father of 7-year-old child with Goldenhar syndrome,” and the third quote should have been attributed to a “37-year-old mother of 4-year-old twins born prematurely.” In the abbreviations footnote, CMC should have been spelled out as “children with medical complexity.” This…
This cross-sectional study investigates trends in Escherichia coli and Klebsiella pneumoniae antimicrobial resistance in urinary samples from 6 African countries, 2010 to 2022.
This cohort study examines the association of P2Y purinergic receptor 12 (P2Y12) inhibitor antiplatelet use with stroke severity and in-hospital outcomes among patients with spontaneous intracerebral hemorrhage who used the antiplatelet therapy 7 days before hospitalization.
This cross-sectional study uses urine drug testing specimens to examine spatiotemporal trends in xylazine detection and relative concentration among samples positive for fentanyl from 2023 to 2025.
This diagnostic study investigates the ability of a previously trained artificial intelligence (AI) system to interpret blind sweep ultrasonography scans for gestational age estimation to generalize to new clinical environments.
This cohort study examines the association of the sustained availability of a dedicated high school health course with the prevalence of student-reported past 30-day substance use.
This cohort study compares sex-related differences in long-term all-cause and cause-specific mortality between male and female patients with cirrhosis.
Runners participating in Japanese marathon races largely held in autumn and winter had a greater risk of sudden cardiac arrest (SCA) when the ambient temperature was lower at race start, while no significant relationship between ambient air pollutants and SCA risk was identified, according to a study published June 30 in JACC: Advances.
Background Hospital-based physiotherapy can play an important role in the multidisciplinary treatment of hospitalised patients by optimising their functional mobility as part of the patient’s overall functional health condition. Considering that hospital-based physiotherapy services are structured differently among countries, providing hospital-based physiotherapy services may also face different barriers and facilitators. Objective This study aimed to explore the potential barriers and facilitators in providing hospital-based physiotherapy services in Iran. Design Based on the Theoretical…
Objectives Antimicrobial resistance (AMR) poses a serious threat across human, animal and environmental health. The One Health approach emphasises multisectoral collaboration and is critical in addressing AMR. While One Health governance has gained recognition from international organisations, there remains limited understanding of how it can be effectively implemented across institutional, social, economic and political contexts. This scoping review aims to explore the design and implementation of One Health governance across contexts. Design Scoping review Data sources We searched PubMed…