Introduction Postoperative atrial fibrillation (POAF) remains one of the most common complications following coronary artery bypass grafting (CABG), including minimally invasive cardiac surgery-CABG (MICS-CABG). The ligament of Marshall (LOM), containing myocardial fibres and rich autonomic innervation, has been implicated in atrial arrhythmogenesis. Despite evidence that catheter ablation targeting the LOM or surgical interruption during conventional CABG can be effective, prophylactic surgical excision of the LOM during MICS-CABG has not been evaluated in randomised controlled trials (RCTs)…
Introduction Growing evidence suggests that a part of the burden of Parkinson’s disease (PD) can be explained by exposure to environmental factors, including pesticides, heavy metals, solvents, and air pollution. However, several questions remain unanswered, pertaining to the associations with PD of environmental factors that are still in use today; the added risks of co-exposure to multiple environmental factors and gene–environment interactions. Additional questions remain on the relevant time window, duration, and level of environmental exposures in relation to PD risk. Furthermore, it is…
Introduction Outdoor active play is essential for children’s health, well-being and holistic development. However, there is a lack of high-quality evidence on effective sustainable and scalable interventions that leverage outdoor play and environmental affordances to promote physical literacy, including motor competence, physical activity, engagement and motivation for movement in early childhood. In particular, limited research has examined how outdoor kindergarten environments can be intentionally used and optimised to support diverse forms of active play through social and other potential…
Introduction Narcolepsy type 1 (NT1) is a chronic neurological disorder characterised by excessive daytime sleepiness, cataplexy and disturbed nocturnal sleep. Current pharmacological treatments often have limited efficacy, significant side effects or potential for abuse. Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulation technique that has shown promise in regulating sleep–wake cycles and neural network activity. Preliminary evidence from our prior study on Transcutaneous Auricular Vagus Nerve Stimulation in patients with NT1 (TARGET-NT1 study) suggests…
Objectives Same-day emergency care (SDEC) has been rolled out as a model of care in England with a limited evidence base. This study examined conversion to inpatient admission, 30-day reattendance and 30-day mortality, among adults managed through SDEC compared with those admitted for ≤48 hours, as a proxy for low acuity, over a 4-year period, to assess safety and effectiveness in a real-world operational setting across two acute hospital sites. Design Retrospective cohort study. Setting Two acute hospital sites within one National Health Service (NHS) trust in England, UK. Participants…
This randomized clinical trial investigates the effect of cognitive rehabilitation on goal attainment, cognitive, and clinical outcomes in individuals with long COVID–related cognitive impairment.
This cohort study compares the outcomes associated with first-line enfortumab vedotin plus pembrolizumab and gemcitabine plus cisplatin among patients with metastatic urothelial carcinoma.
This cohort study combines data from 4 US epidemiological studies to examine contributions of clinical, lifestyle, and sociodemographic factors to mortality differences among females identifying as Asian ethnicities compared with non-Latina White females and whether associations vary by nativity.
This cohort study uses electronic medical record data to compare short- and long-term health care utilization costs among patients with obesity and diabetes treated with glucagon-like peptide-1 receptor agonists (GLP-1RAs) vs those who underwent bariatric metabolic surgery.
This cross-sectional study evaluates the association between food insecurity and guideline-concordant colorectal, breast, and cervical cancer screening and assesses whether Supplemental Nutrition Assistance Program (SNAP) participation was associated with attenuation of screening disparities among food-insecure US adults.
AC01, a novel oral calcium-sensitizing isotope and ghrelin receptor agonist designed to increase myocardial contractility, appeared safe and well-tolerated over a 28-day treatment period in patients with heart failure with reduced ejection fraction (HFrEF), according to results from a phase 1b/2a randomized trial published June 24 in The Lancet.
by Seena Fazel Despite public health strategies focusing on men’s mental health and suicide risk, rates of suicide among men remain concerningly high. Targeted, specialized approaches for high-risk individuals should be prioritized alongside broader population-level strategies. Despite public health strategies focusing on men’s mental health and suicide risk, rates of suicide among men remain concerningly high. In this Editorial, Seena Fazel outlines why targeted, specialized approaches for high-risk individuals should be prioritized alongside broader population-level strategies.
by Margaret M. Byrne, Jill M. Kolesar Precision oncology is revolutionizing cancer care, but isn’t reaching enough patients. Molecular tumor boards (MTBs) translate complex genomic data to more effectively inform personalized care, and a new meta-analysis shows they boost clinical outcomes. But how can we feasibly and equitably expand the use of MTBs? Molecular tumor boards translate complex genomic data to more effectively inform personalized care, and a new meta-analysis shows they boost clinical outcomes. In this Perspective, Margaret Byrne and Jill Kolesar discuss how we may feasibly and…
Introduction Each year, approximately 17 000 children will have a mother who is imprisoned in England and Wales. The impact of maternal vs paternal imprisonment is very different; the negative health consequences on children are likely to be much greater if a mother is imprisoned. The number of children affected by non-custodial justice involvement is likely to be far greater given the higher number of women under probation supervision. However, no official statistics or estimates are collected for this population. The purpose of the CHAMPION (children whose mothers are involved in the…
Background Citizens depend on high-quality healthcare; however, significant disparities in quality persist among healthcare organisations. Healthcare services are complex organisations, making it essential to employ knowledge management as a strategic resource. This develops competent professionals capable of performing tasks effectively, thereby directly impacting the quality of care. Within this framework, organisational learning (OL) emerges as a key concept, referring to an institution’s ability to continuously reshape its knowledge over time without losing its organisational memory, thus…
Objectives To evaluate knowledge, attitudes and practices towards routine vaccination in the Lebanese population in the post-COVID-19 period, and to examine differences between COVID-19 vaccinated and non-vaccinated individuals. The study also aimed to identify sociodemographic and behavioural factors associated with vaccination status, and to explore changes in vaccination practices before and after the pandemic. Design Unmatched case-control study. Setting Community-based survey conducted across all regions of Lebanon between July and October 2023. Participants A total of 730 adults were…
Introduction In 2021, globally, cardiometabolic diseases (CMDs) accounted for 35% of the 1.73 billion disability-adjusted life years (DALYs) attributed to non-communicable diseases. The Healthy Life Trajectories Initiative (HeLTI), a four-country randomised controlled trial based on the developmental origins of health and disease(DOHaD) concept, evaluates whether integrated longitudinal public health interventions started prepregnancy reduce the risk of childhood adiposity and, consequently, the development of CMDs in the offspring. This paper presents the protocol for the economic evaluation…
Objectives To co-design a digital intervention (eTAPER) to support safe and timely opioid tapering after surgery in primary care, integrating behavioural theory and stakeholder perspectives. Design Qualitative co-design study using two online co-design workshops and one in-person stakeholder engagement event guided by the Experience-Based Co-Design (EBCD) methodology and mapped to the Theoretical Domains Framework. Qualitative data were collected during the two online co-design workshops, while the in-person stakeholder engagement event was used to sense-check and validate the findings from…
Objectives To characterise post-marketing adverse event (AE) reporting patterns associated with CD3 x CD20 bispecific antibodies (BsAbs) using multi-method disproportionality analysis and to identify potential safety signals warranting further investigation. Design Retrospective pharmacovigilance study using disproportionality analysis with multiple complementary methods. Setting Food and Drug Administration Adverse Event Reporting System database. Participants A total of 2237 AE reports associated with CD3 x CD20 BsAbs (1135 for epcoritamab, 673 for glofitamab and 429 for mosunetuzumab) were…
Introduction The rapid integration of artificial intelligence (AI) technologies in healthcare, ranging from diagnostic tools to clinical decision support systems, is transforming medical practice and education. However, without deliberate integration of ethics, there is a risk that medical education will reproduce a technosolutionist orientation by privileging efficiency and data-driven outputs over patient autonomy, justice and professional integrity. While AI-related courses are increasingly being introduced into medical curricula, ethical considerations often remain peripheral, with most…
Background Dengue continues to be a global public health challenge despite sustained control efforts. Dengue control strategies rely primarily on effective Aedes mosquito control. Sustaining community participation in mosquito control requires innovative efforts, especially in achieving consistent behavioural change. Schools offer a strategic entry point, with children being both learners and influencers. This leads to a ripple effect of intervention impacting beyond the classroom. While behaviour change strategies for dengue prevention exist, there is sparsity of studies addressing the…
Objective This study aims to explore the perceptions of intimate partner violence (IPV) and its potential consequences among adults (both married and unmarried) and adolescents in peri-urban India. Design A qualitative study design using thematic analysis was applied to 7 focus group discussions (FGDs) (n=56) and 33 in-depth interviews (IDIs) among adults (aged 19–48 years) and adolescents (aged 15–18 years). Interview guides for the FGDs and IDIs explored the perceptions of gender-based violence with a focus on IPV, risk factors and circumstances that justify IPV, triggers and consequences of…