by Ziyi Zhou, Stewart G. Trost, Gemma C. Ryde, Solange Parra-Soto, Zhe Fang, Chao Xu, Yujia Lu, Kai Wang, Mengxi Du, Zhi Li, Yuebin Lv, Jason M.R. Gill, Stuart R. Gray, Carlos Celis-Morales, Marc J. Gunter, Edward Giovannucci, Jill P. Pell, Mingyang Song, Frederick K. Ho Background Current sedentary behavior (SB) guidelines primarily emphasize total time spent sedentary. We explored differences between interrupted and prolonged SB in relation to a range of cancer outcomes. Methods and findings This study included 91,292 UK Biobank participants with valid accelerometer data. Participants were…
In a major international effort to evaluate potential treatments for Ebola disease due to Bundibugyo virus (BVD), the PARTNERS clinical trial has opened enrolment today for patients in the Democratic Republic of the Congo.
Objective This study aims to explore disparities in eHealth literacy and perspectives on digital health among parents of preschool children from different cities and examine how these characteristics influence their willingness to participate in digital paediatric clinical research. Design Cross-sectional online survey. Setting Conducted between November and December 2023 among parents of preschool children in Yongchuan District (Chongqing) and Shunyi District (Beijing), China. Participants Parents of preschool children (aged 3–6 years). Among 1340 unique survey visits, 1274 started the…
Introduction HIV cure remains one of the major unsolved global health challenges. The persistence of the HIV reservoir is the key barrier to achieving viral eradication. The acute HIV infection (AHI) is crucial for reservoir establishment, making early intervention essential for long-term viral remission. Pegylated interferon-α (Peg-IFN-α) exhibits potent antiviral and immunomodulatory properties that may enhance reservoir clearance when combined with antiretroviral therapy (ART). This study aims to evaluate the efficacy and safety of Peg-IFN-α combined with ART in promoting…
Introduction The soluble FMS-like tyrosine kinase-1 and placental growth factor (sFlt-1/PlGF) ratio has demonstrated impressive predictive test characteristics in women with suspected pre-eclampsia. However, it remains a matter of debate whether the introduction of this novel test can indeed translate to a reduction in pre-eclampsia-related hospital admissions, outpatient visits and can consequently lower overall healthcare costs. The PREPARE II study aims to investigate whether the sFlt-1/PlGF ratio, along with digital self-monitoring, can reduce pre-eclampsia-related healthcare utilisation…
Background Menstrual health (MH) is vital to women’s overall health and well-being. Yet many women, especially in resource-limited settings, face challenges due to insufficient resources and support. Most MH research has focused on school-going adolescents while limited research has investigated MH experiences across the lifecourse. This study aims to understand menstrual experiences across women’s lifecourse in Zimbabwe, including MH-related pain and discomfort and women’s MH-related healthcare seeking behaviours. Methods From February to April 2024, we conducted eight participatory workshops…
Objectives To quantify out-of-pocket (OOP) costs and catastrophic health expenditure (CHE) among patients hospitalised with heart failure (HF) and to identify factors associated with CHE during a single index admission in northern Tanzania. Design Prospective cross-sectional study. Setting Medical ward of Kilimanjaro Christian Medical Centre, a tertiary referral hospital in northern Tanzania, from 1 May to 31 October 2024. Participants Consecutive patients aged 14 years or older admitted with acute decompensated HF diagnosed using Framingham criteria. Of 309 eligible patients, 290 completed…
Introduction Stroke, one of the leading causes of death worldwide, leads to disability in most patients, posing a burden on society and families. Intensive rehabilitation in the early stages is the most effective method of minimising these disabilities. Home-based rehabilitation strategies have emerged as a promising alternative to conventional approaches, as highlighted during the coronavirus disease pandemic. Currently, no systematic reviews are available on the effects of home-based lower extremity rehabilitation systems in patients with stroke, or on the design specifications for their…
Introduction Historically, patients diagnosed with recurrent head and neck cancer (rHNC) had a poor prognosis with the majority receiving best supportive care. Significant treatment advances over the past decade have changed the landscape for curative and non-curative management of rHNC with more treatment options for patients. This requires providing large amounts of information about treatment options and patients may experience different short-, medium- and long-term toxicities. To address complex discussions on treatment decisions and to identify potential unmet needs and provide timely…
Background Policies promote patient-centred tuberculosis (TB) care in Kenya, a high-burden TB country, but implementation remains limited. This study sought to understand the experiences of TB healthcare workers in implementing patient-centred TB services in primary health facilities in Nairobi and explore how the challenges they face can be addressed. Methods Using collaborative research design, we recruited healthcare workers (n=29) from primary health facilities across three densely populated subcounties in Nairobi and TB stakeholders (n=24) including policymakers and managers. From March…
Introduction Postoperative sore throat (POST), a common complication following tonsillectomy, significantly impairs patient recovery through persistent pain and dysphagia. The internal branch of superior laryngeal nerve block (iSLNB) can effectively alleviate POST. Specifically, the ultrasound (US)-guided modified anterior approach for iSLNB offers anatomical precision and reduced invasiveness compared with traditional approaches. This study aims to determine whether the US-guided modified anterior approach for iSLNB can relieve POST in adults after tonsillectomy. Methods and analysis A total…
Introduction Preterm birth (PTB) is a major adverse outcome in developing countries, including India, with serious adverse consequences. Although the pathophysiology is not fully understood, maternal biomarkers influencing placental function may contribute to premature rupture of membranes and PTB. Vitamin D₃ supplementation during pregnancy may lower the risk of PTB, particularly in populations with a high prevalence of vitamin D deficiency (~90% in India). However, available biomarkers for PTB prediction are non-confirmatory, costly and not part of routine care. The aim of the study is to…
Objectives The present study was designed to identify patterns of unfinished care among nursing assistants in Chinese long-term care homes and to examine how these patterns are associated with sociodemographic and work-related characteristics. Design A cross-sectional study. Setting The survey was conducted in 11 long-term care homes in China. Participants Between September 2024 and May 2025, 251 nursing assistants completed the survey. Outcome measures Unfinished care was assessed using the Chinese version of the Basel Extent of Rationing of Nursing Care for Nursing Homes instrument. Latent…
Objective This study aimed to explore emergency medical dispatchers’ (EMDs’) experiences of prioritising patients and stewarding ambulance resources when system capacity was constrained. Design Qualitative interview study using inductive qualitative content analysis. Setting Emergency medical communication centres (EMCCs) in Sweden, operated by the national emergency call provider and responsible for receiving 112 calls and dispatching ambulances. Participants 13 purposively sampled EMDs with at least 1 year of professional experience. Data analysis Interviews were analysed inductively using…
Introduction Bladder catheterisation is one of the most commonly performed medical procedures worldwide in hospitals. Although traditionally performed as a sterile procedure to prevent infections, it incurs a considerable carbon footprint and substantial healthcare costs. This study aimed to assess whether adopting clean bladder catheterisation as standard hospital practice is non-inferior to sterile catheterisation regarding the occurrence of catheter-associated urinary tract infections (CAUTIs), and to evaluate the carbon footprint of catheterisation sets. Methods This retrospective…
Introduction Contraceptive counselling is a key preventive intervention for reducing unintended pregnancies and unsafe abortions. In a setting such as Vietnam, where contraceptive use is prevalent, the quality and consistency of counselling provided by future physicians are critical. Although this is a core competency in medical education, evidence suggests that medical students demonstrate deficits in applied knowledge, skills and confidence regarding counselling. Evidence regarding medical students’ intentions to provide contraceptive counselling in Vietnam remains limited and has not been…
Objectives To explore the experience of participants using the Neurofenix (Naples, Florida, USA) platform for hospital and home-based upper limb rehabilitation in acute and subacute stroke, and to report acceptability of trial and data collection processes in a feasibility randomised controlled trial (Rehabilitation using virtual gaming for Hospital and hOMe-Based therapy for the Upper limb in acute and subacute Stroke (RHOMBUS II)). The trial investigated safety, feasibility and acceptability of the platform, a non-immersive virtual reality (VR) tool, to facilitate upper limb rehabilitation…
Introduction Osteopenia, defined as a bone mineral density (BMD) T-score between –1.0 and –2.5, is a precursor to osteoporosis and fragility fracture which results in substantial morbidity. Patients with gastrointestinal (GI) cancer are particularly vulnerable due to disease-specific mechanisms of bone loss and treatment-related toxicities, which compound the risk of osteoporotic fractures and adverse oncological outcomes. Despite this, the global prevalence of osteopenia and incidence of osteoporotic fracture in GI cancer populations remains poorly quantified, limiting opportunities for…
Introduction Cancer literacy (CL) is essential for enabling informed decision-making, prevention, early detection and adherence to treatment. However, disparities in CL across Europe, coupled with the spread of disinformation, limit equitable access to cancer care. This protocol describes a collection of scoping reviews to document the state of CL, misinformation narratives and education and training initiatives and identify barriers and facilitators. This work is embedded within the activities of the Beating Cancer Inequalities through Literacy in Europe project and encompasses nine…
Introduction Despite optimised antiseizure medication, pharmacoresistant epilepsy still affects a substantial proportion of adult patients, especially when epilepsy surgery is not possible or is rejected. Transcutaneous vagus nerve stimulation (t-VNS) is a non-invasive neuromodulatory approach for which the evidence from randomised studies to date does not allow for a reliable assessment of its benefits due to small case numbers and methodological limitations. Transcutaneous vagus nerve stimulation as add-on therapy versus pharmacotherapy alone (TRAVAST) is a prospective, multicentre…
Introduction Bloodstream infections (BSIs) are a major cause of morbidity and mortality worldwide. Although recent clinical trials have increasingly adopted patient-centred outcome measures, patient-informed selection of outcome measures remains limited in infectious disease research. Greater deliberate engagement and partnership with patients and families are required to ensure that outcomes reflect priorities that are meaningful to those with lived experience. Our study aims to incorporate patient-informed perspectives into outcome selection for BSI clinical trials. Methods and analysis We…
Introduction Stroke survivors experience profound skeletal muscle deterioration, typically losing 15%–20% of skeletal muscle mass in the affected limb within 4–6 months post-stroke. This deterioration accelerates functional decline, falls and secondary sarcopenia. While combined nutrition and exercise interventions have shown synergistic effects in other muscle-wasting conditions, the evidence for stroke remains fragmented. This systematic review and meta-analysis aims to evaluate the efficacy of combined nutrition and exercise interventions on muscle health and performance in patients after…
Objectives This study aims to analyse the quantity and content of publicly discoverable statements that US-based medical societies issued regarding the 2023 escalation of violence in Palestine and Israel. Design We conducted a mixed-methods study using an explanatory sequential design. Methods Inclusion criteria were defined as US-based medical societies from the American Medical Association House of Delegates, Council of Medical Specialty Societies (CMSS), or Association of American Medical Colleges (AAMC) Council for Academic Specialty Societies, yielding 186 US-based professional medical…
Introduction Catheter-related bladder discomfort (CRBD) is a common and distressing complication after transurethral prostate surgery (TUPS). Many patients experience moderate to severe symptoms, which may delay recovery and reduce patient satisfaction. Currently, there are no standardised expert consensus statements or international guidelines for CRBD management. The ultrasound-guided anterior approach of sacral plexus block (anterior SPB) is a novel regional anaesthesia technique that may reduce CRBD through effects on multiple neural pathways. This trial is designed to evaluate the…