Objectives Enteral nutrition (EN) constitutes a critical therapeutic intervention in the management of patients with sepsis; however, the optimal timing for its initiation remains uncertain. This study sought to evaluate the impact of early versus delayed EN on mortality rates and clinical outcomes among adult patients with sepsis in intensive care units (ICU). Design Retrospective cohort study using propensity score matching (PSM) methodology. Setting A tertiary hospital ICU in Hebei Province, China, from 2015 to 2024. Participants This retrospective analysis involved adult ICU patients with…
Introduction Falls are a major global public health challenge and a leading cause of severe consequences, such as fractures, traumatic brain injuries and even death among older adults. Older adults with knee osteoarthritis (KOA) are at a higher risk of falling and tend to experience more severe injuries due to impaired balance. Baduanjin, a mind-body exercise, has been shown to improve lower limb muscle strength and balance in older adults and to reduce fall risk in those with KOA; however, its specific mechanisms remain unclear. Therefore, this study aims to examine the effectiveness of…
Objectives Rising demand for emergency care in England is a continuing challenge driven by population ageing and increasing multimorbidity. Ambulatory emergency care (AEC) refers to the provision of same-day acute care for patients who might otherwise require admission. However, the contribution of AEC conditions to demand remains unclear. This study aimed to examine the proportion and nature of patients attending emergency departments (ED) with AEC-related conditions and to describe variation between hospitals in attendances and emergency admissions for AEC conditions. Design and setting A…
Introduction Common mental disorders (CMDs) are endemic globally. The availability of evidence-based mental health interventions has grown rapidly, with many services focused on psychotherapy. Most psychotherapies require multiple sessions, resulting in lengthy waiting times due to limited provider availability. These delays can lead to higher morbidity, poorer adherence and less favourable outcomes. Recent research indicates that single-session therapy (SST) can be as effective as multi-session approaches and offers cost savings. This pragmatic, prospective mixed-methods pilot cohort study…
Introduction Integrated care represents a transformative approach to delivering person-centred healthcare, aiming to reduce health inequalities, improve outcomes and boost system efficiency. The WHO advocates integrated care, which is also a central pillar of the UK government’s National Health Service (NHS) 10-year plan. However, there remains a significant evidence gap regarding optimal organisational strategies for designing and delivering integrated care services. Multiple long-term conditions (MLTCs) refer to the coexistence of two or more chronic physical and/or mental health conditions…
Introduction While evidence consistently demonstrates elevated COVID-19 risks among people with intellectual and physical disabilities, less is known about how household living arrangements shape these inequalities. Residential setting and household size influence exposure, capacity to isolate and reliance on care yet have rarely been examined jointly with disability status at a population scale. This study aims to estimate disability-related inequalities in COVID-19 infection, hospitalisation and mortality in Scotland and to assess whether residential setting and household size modify these…
Introduction Family members of survivors of critical illness are known to experience adverse outcomes in the months following the critical care admission, which can impact their physical, social and emotional health. This protocol describes the Family or Caregiver Outcomes after critical illness (FOCUS) study, which aims to develop a core outcome set (COS) for trials involving family members of critical care patients across the continuum of care. Methods and analysis A modified Delphi consensus process with researcher, clinician and patient/caregiver stakeholder groups and consensus meetings…
Introduction Peripheral neuropathic pain (PNP) is common, disabling and frequently refractory to pharmacotherapy. High-frequency repetitive transcranial magnetic stimulation (rTMS) can reduce neuropathic pain but response rates remain variable. Personalised target selection based on functional connectivity may improve analgesic efficacy and help elucidate neurobiological mechanisms. Methods and analysis This is a prospective, multicentre, randomised, double-blind, controlled superiority trial recruiting 152 adults with PNP (eg, trigeminal neuralgia, postherpetic neuralgia and diabetic…
Introduction Postoperative neuropsychological disorders including delirium, cognitive dysfunction and emotional distress are common after cardiac surgery and are linked to reduced quality of life, morbidity and mortality. Reliable preoperative risk factors remain difficult to identify. This study investigates stress-related parameters as predictors of postoperative neuropsychological disorders in patients undergoing cardiac surgery. Methods and analysis In this prospective study, 240 patients undergoing elective cardiac surgery (coronary artery bypass grafting: n=120, aortic valve replacement…
Introduction Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with reduced quality of life and increased healthcare utilisation. AF is increasingly recognised as a manifestation of an underlying cardiometabolic disease process, with obesity and related metabolic risk factors contributing to its development and progression. Consequently, upstream risk factor modification, including structured weight management, has emerged as a potential strategy to improve AF outcomes. While dietary and exercise interventions have been studied individually, the…
Introduction Depression is a major global health challenge, with onset commonly occurring in youth. There is an urgent need to better understand the epidemiology of depression to facilitate better interventions and preventions that are person-specific and time-specific. Long-term depression trajectories and ecological momentary assessment (EMA) can help address this need. Embedding EMA designs within established longitudinal cohorts offers a uniquely powerful approach to examine depression in both long- and short-term settings and to identify distal and proximal modifiable risk factors for…
These randomized clinical trials—a phase 1 crossover trail and a phase 2 placebo-controlled trial—examine the dissociative adverse effects of a prolonged-release oral ketamine tablet formulation and its outpatient efficacy at reducing symptoms of treatment-resistant depression.
This cohort study examines whether blood donor, red blood cell (RBC) modifications and storage, or transfusion thresholds or characteristics are associated with serious adverse outcomes in very-low-birth-weight infants receiving RBC transfusion.
This cross-sectional study examines whether a system-wide virtual care remuneration policy was associated with changes in 7-day postdischarge follow-up rates overall and by hospitalization type, patient rurality, and socioeconomic status.
This cohort study evaluates the association between prenatal exposure to acid-suppressive medications and the risk of inflammatory bowel disease using a nationwide birth cohort in South Korea.
This cross-sectional study assesses the association of trust in cancer information sources with awareness that human papillomavirus causes cervical cancer among US adults.
This cross-sectional study evaluates whether implementation of total abortion bans was associated with suicidal ideation and suicide attempts among female high school students participating in Youth Risk Behavior Surveys from 2017 to 2023.
This comparative effectiveness research study evaluates the long-term association between comprehensive smoke-free laws and county-level cardiovascular disease mortality and assesses whether these associations vary by age, sex, and race and ethnicity.
Among patients undergoing atrial fibrillation (AFib) ablation, single and double transeptal puncture (TSP) exhibited similar procedural safety and likelihood of discharge in sinus rhythm, according to a recent study published in the Journal of Interventional Cardiac Electrophysiology.