Introduction Pregnancy and childbirth are transformative experiences that can provoke anxiety, potentially reducing women’s confidence and satisfaction with the process. Systemic counselling, which considers family and interpersonal dynamics, may alleviate anxiety, enhance self-efficacy and improve satisfaction with childbirth. Addressing these psychological and relational factors is crucial for maternal and neonatal well-being. Methods and analysis This parallel-group randomised controlled trial will involve 72 primiparous pregnant women in Babol, Iran. Eligible participants will be randomly…
Introduction Autistic children can experience elevated levels of emotional and behavioural problems, which adversely impact their psychosocial functioning. Positive parenting behaviours can significantly shape children’s emotional and behavioural developmental trajectories. However, for autistic children, these parenting behaviours may vary depending on their social, sensory and intellectual profiles. Literature on the association between parenting behaviours and autistic children’s internalising and externalising symptoms has been mixed. Thus, the main objective of this study will be to…
Introduction Cannabis use is common in the USA and is associated with adverse outcomes across many domains, including sleep difficulties. Targeting insomnia with an evidence-based treatment could improve sleep and reduce frequent cannabis use. This randomised controlled trial (RCT) will compare evidence-based telemedicine-delivered cognitive-behavioural therapy for insomnia for adults with frequent cannabis use (CBTi-CB) against an active comparator, sleep hygiene education (SHE), for improving insomnia/sleep, associated daytime symptoms and cannabis use. The study will also determine the…
Objectives Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome mainly affecting younger to middle-aged women. Physical activity has been discussed as a potential trigger for SCAD. This study aimed to explore the perceptions of physical activity among patients and their experiences of cardiac rehabilitation following the event. Design Qualitative descriptive study using digital focus groups and inductive qualitative content analysis. Setting Six digitally conducted focus groups (Zoom) in Sweden. Participants Twenty-six women and three men (median age 57…
Introduction Inappropriate mechanical ventilation plays a pivotal role in the development of ventilator-induced lung injury (VILI) and subsequent postoperative pulmonary complications (PPCs), thus individualised lung protective ventilation became a hot topic of research during the past decades. Despite promising results from early trials focusing on separated ventilatory parameters, the incidence of PPCs has not decreased significantly, hence a new conceptual direction emerged in the last few years by evaluating the potential role of mechanical power of ventilation (MP), since MP encompasses…
Introduction Impairment of the hypothalamic–pituitary–adrenal axis during critical illness, called Critical Illness-Related Corticosteroid Insufficiency (CIRCI), is frequent. There is no standard treatment for CIRCI. This trial aims to determine whether, through biomarker enrichment using CIRCI criteria, hydrocortisone and fludrocortisone, compared with placebo, improve organ dysfunction-free survival in critically ill patients. Methods and analysis French multicentre, placebo-controlled, double-blind superiority trial that will randomly assign adults with CIRCI to receive a 7-day course of…
This cohort study examines the probability of experiencing violent reinjury after injury from blunt assault, stabbing, or firearms among patients treated at 4 level I trauma centers in St Louis, Missouri.
This cohort study evaluates associations of gestational exposure to identified chemicals in 10 classes with birth weight and gestational age at birth in a large, diverse US cohort.
This case-control study evaluates the performance of African-ancestry polygenic risk scores for overall breast cancer and triple-negative breast cancer in an independent African American cohort at elevated familial risk.
by Saul Martin-Rodriguez, Rodrigo Fernandez-Gonzalo, David Moher Summary points Systematic reviews and meta-analyses underpin clinical guidelines and health policy, yet their validity may be compromised by limited access to underlying datasets and associated analytical code. Reliance on incomplete or inconsistently reported summary statistics forces researchers to use imputation and unverifiable assumptions, which can distort effect estimates and mislead clinical decision-making. The consequences extend beyond methodology: flawed evidence synthesis can influence treatment recommendations…
New FDA guidance on the use of Bayesian statistics signals a broader shift in accommodating more flexible clinical trial designs and the complexities of diseases such as certain cancers and rare disorders, which may lead to more efficient trials, lower development costs, and faster innovation. The post The FDA’s Bayesian Guidance Could Quietly Reshape Clinical Trial Design appeared first on MedCity News .
Following ASCO 2026, NCI Director Dr. Anthony Letai reflects on the pace of progress in cancer research, efforts to accelerate clinical trials, and NCI’s role in supporting the cancer research and care community. He highlights how decades of investment in science are driving progress for patients and creating new opportunities to improve outcomes.
Introduction This project will establish a nationally consistent and ethically defensible approach to embed genomic testing in Australian primary care. Many non-genetic health professionals (eg, general practitioners (GPs) and other specialists) have limited experience with such testing. Current tests—both subsidised and consumer-paid—target a range of genes and conditions, making appropriate selection challenging. A structured implementation approach is therefore crucial. We will develop, test, refine and evaluate internationally relevant tools to support GPs and consumers in using genomics…
Objectives To examine trends and factors associated with isoniazid preventive therapy (IPT) initiation among people living with HIV (PLHIV) aged ≥15 years who initiated antiretroviral therapy (ART) in mainland Tanzania between 2015 and 2020. Design A retrospective observational study using routinely collected data. Multilevel logistic regression analysis was used to identify factors associated with IPT initiation. Setting HIV care and treatment clinics across mainland Tanzania. Participants The study included PLHIV aged ≥15 years who initiated ART between 2015 and 2020. Primary and…
Introduction Sepsis is a life-threatening condition in intensive care units (ICUs), where any delay in diagnosis and treatment can lead to organ dysfunction, prolonged hospital stay and increased mortality. Early identification of sepsis prior to its clinical manifestation may enable timely intervention and improve outcomes. This review aims to identify, synthesise and categorise predictor variables assessed in adult ICU patients prior to sepsis diagnosis. Methods/design This protocol, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P)…
Objectives Following a Mediterranean-like diet has been associated with lower depression levels but there has been limited study of links with positive states of psychological well-being. We tested whether adherence to a Mediterranean diet was cross-sectionally associated with positive well-being among older adults in England in 2018/2019 and prospectively through the COVID-19 pandemic. Design Prospective observational cohort analysis. Setting Population study of older people ≥50 years in England. Participants 3296 participants (46% men) in the English Longitudinal Study of Ageing (ELSA)…
Introduction To date, there is no proven licensed systemic treatment for neurofibromatosis type 2 (NF2)-related schwannomatosis patients. There is a need for more effective, less toxic treatments and, as a rare disease, NF2 is often overlooked in targeted drug development. Subcutaneous schwannomas of the skin (CS) are common in the NF2 population. This trial involves the repurposing of medications already licensed for HIV—ritonavir and lopinavir (Kaletra and Norvir)—that have been shown to reduce tumour growth by reducing cell proliferation in human schwannoma and meningioma tumour cell…
Objective To evaluate the long-term efficacy and safety of paliperidone palmitate once-monthly (PP1M) and once-every-3-months (PP3M) PP long-acting injectable antipsychotics in young adults with schizophrenia treated in routine Rwandan healthcare settings. Design This was a single-arm, open-label, multicentre interventional study consisting of two consecutive phases: an observation/run-in (OR) phase (weeks 1–24), during which participants received standard-of-care oral antipsychotics, and a lead-in/maintenance (LM) phase (weeks 25–66), during which participants first received PP1M for ≥17…
Background Tobacco use remains a leading preventable risk factor for morbidity and mortality worldwide. Although global evidence indicates a general decline in tobacco use among women, it is unclear to what extent these trends and associated determinants apply to populations in East Africa. Therefore, this study aimed to examine the trends in tobacco use and its associated factors among women aged 15–49 across East African countries. Objective To examine trends in tobacco use and identify individual- and community-level factors associated with current tobacco use among women of reproductive…