by Eric Jauniaux, Helena C. Bartels, Yalda Afshar Placenta accreta spectrum (PAS) is a serious pregnancy complication caused by abnormal placental attachment to the uterus. In this Perspective, Eric Jauniaux and colleagues discuss emerging evidence that challenges our long-held pathophysiological understanding of PAS, and argue that a critical reassessment of definition, diagnosis, and management is overdue. In this Perspective, Jonathan Evans and colleagues discuss why restricting access to joint replacement surgery based on BMI alone is not supported by evidence, and highlight how such rest…
by Gabriella C. Silva, Aurore Fayosse, Louis Jacob, Séverine Sabia, Archana Singh-Manoux, Benjamin Landré Background Multimorbidity, the presence of several chronic conditions, is linked to higher mortality and healthcare use and thus poses a major challenge for aging populations. While most studies rely on simple counts of conditions, clustering approaches have been proposed to describe patterns of co-occurring diseases. We aimed to evaluate the extent to which these methodological choices influence prevalence and association with health profiles and mortality. Methods and findings Using UK…
Objectives To assess the relationship between the structural position of individuals within their village network and symptoms of depression and postpartum depression, among men and women. Design Community-based, observational, cross-sectional study. Setting 176 villages in the Copan region of Honduras. Participants Village residents, comprising 25 605 adults surveyed in a census-based study; using data collected between October 2015 and December 2019. Outcomes Symptoms of depression and postpartum depression, among men and women. Results Across all participants, 34.99% reported depression…
Introduction In patients with a hip fracture, anaemia has been associated with increased transfusion requirements, poor functional outcomes, prolonged hospital stays and increased mortality. While anaemia in elderly patients with hip fractures has traditionally been attributed to bleeding during or after surgery, many of these patients are anaemic on hospital admission. Thus, detecting and managing anaemia in the perioperative, postoperative and, most significantly, the preoperative period is important to avoid the need for blood transfusions and to improve patient outcomes. The protocol for…
Introduction Sexually transmitted infections (STIs) have emerged as significant public health concerns, imposing a substantial burden on both individuals and the healthcare system of the country. Additionally, STIs may also result in major extensive psychological consequences that profoundly affect individuals with STIs. Despite the government’s implementation of different initiatives aimed at addressing STI-related challenges, these conditions are associated with shame and stigma which act as barriers to the effective utilisation of healthcare services. The purpose of the present study is to…
Objective Total knee arthroplasty (TKA) is a common and effective procedure for end-stage knee osteoarthritis, yet patients frequently encounter a complex and dynamic symptom experience during the initial period that can significantly impact their rehabilitation and quality of life. This study aimed to explore the symptom experience of patients within 6 weeks after TKA. Design A longitudinal qualitative study using semi-structured interviews. Setting This study was conducted in an orthopaedics department of a tertiary general hospital in China. Participants Interviews were conducted with 16…
Introduction Emerging evidence supports a role for interleukin 6 (IL-6), a pro-inflammatory cytokine, in the pathogenesis of treatment-resistant major depressive disorder (TRD). However, interventional studies targeting IL-6 in this population remain scarce. Tocilizumab is a humanised monoclonal antibody that inhibits IL-6 signalling and is approved for the treatment of autoimmune conditions such as rheumatoid arthritis. The primary objective of this study is to examine whether IL-6 inhibition via tocilizumab can impact depressive symptoms, inflammation-related biomarkers and cognition in…
Introduction Despite implementation of the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), screening coverage for oral, breast and cervical cancers remains below 2%. Screening quality is inadequately addressed and delays in diagnosis and treatment initiation continue to persist. This multisite implementation research aims to improve district-level coverage and quality of screening, early diagnosis and timeliness of treatment initiation through a model co-developed within the NP-NCD context. Methods and analysis The study will be conducted in three phases…
Introduction Scaling and root planing (SRP) combined with adjunctive antibiotic therapy is widely adopted in the management of periodontitis in patients with type 2 diabetes mellitus (T2DM), with the aims of ameliorating glycaemic control, alleviating local inflammation and facilitating periodontal tissue regeneration. As a topically administered adjunctive antibiotic for periodontal treatment, minocycline hydrochloride (MH) ointment has shown favourable clinical efficacy in systemically healthy patients with periodontitis. However, robust evidence supporting its clinical efficacy and…
Objectives Digital health interventions (DHIs) show considerable promise in supporting hypertension self-management by promoting preventative care and self-monitoring. While their efficacy is increasingly evident, the long-term uptake, acceptance and sustained engagement with these tools are frequently challenged by issues such as usability, trust and varying user experiences. This review aims to synthesise qualitative evidence to identify barriers and facilitators and the key factors that impact the adoption, acceptance and engagement with DHIs for hypertension self-management. Design…
Introduction The DREAMSPHEN study (Dose REduction of Antipsychotics vs. Maintenance treatment in schizophrenia after Stratification based on psychotic PHENotype) aims to compare the benefits and risks of a hyperbolic tapering method for antipsychotics to the maintenance of antipsychotics in a sample of clinically stabilised patients with schizophrenia spectrum disorder. Methods and analysis A sample of 288 patients will be recruited from 12 centres in France. Inclusion criteria are: diagnosis of schizophrenia spectrum disorder (according to the 5th version of the Diagnostic and Statistical…
Objective This study aimed to determine the associations between adherence to the 24-hour movement guidelines and symptoms of anxiety and depression among Colombian university students. Study design Cross-sectional study. Participants 1125 individuals (mean age 20.2±2.5 years; 56.7% female). Setting Students sampled from a single public university. Primary and secondary outcome measures Participants completed validated self-report instruments: the International Physical Activity Questionnaire-Short Form to assess physical activity (PA), sedentary behaviour (SB) and the Pittsburgh Sleep…
Introduction An affordable heart-healthy dietary approach is essential for the management of familial hypercholesterolaemia (FH); however, the optimal dietary pattern and the role of adjunctive nutrient supplementation remain uncertain. This study aims to evaluate the effects of the Brazilian Cardioprotective Diet (DICA Br), adapted from the Portfolio Diet, with or without phytosterol and/or krill oil supplementation in individuals with probable or definite FH according to the Dutch Lipid Clinic Network (Dutch MEDPED) criteria. Methods and analysis The DICA-FH study is a national, multicentre…
Objectives To synthesise evidence from systematic reviews on difficult intravenous access (DIVA) in adults, focusing on definitions, diagnostic criteria, risk factors and clinical interventions to guide clinical practice and health policy. Design Umbrella review of systematic reviews and meta-analyses. Setting Any clinical setting involving adult patients requiring peripheral venous access (including hospital, emergency and outpatient care). Data sources A systematic search was performed in PubMed, CINAHL, Cochrane, Scopus and Web of Science in July 2025. Eligibility criteria Systematic…
Introduction Ophthalmic complaints account for a substantial proportion of presentations to emergency and acute eye care services, yet initial assessment or referral is frequently performed by non-ophthalmologist healthcare professionals. Previous single-centre studies suggest that one-third of referrals are incorrectly diagnosed, potentially delaying appropriate management of vision-threatening conditions. However, the overall magnitude of diagnostic error and patterns of misdiagnosis across healthcare settings remain unclear. This study aims to systematically review and synthesise the…
This quality improvement study examines the outcomes associated with a pilot telemedicine program for incarcerated individuals with diabetes in Illinois.
This cross-sectional study estimates the prevalence of visual impairment in US Hispanic and Latino adults with diverse backgrounds and explores whether it is associated with risk factors for cardiovascular disease.
This cross-sectional study estimates the association between implementation of point-of-sale comprehensive background check policies in 6 states—Colorado, Delaware, New Mexico, Oregon, Vermont, and Washington—and county-level firearm homicide rates.
This cross-sectional study of survey data from adults living in communities impacted by mass violence examines whether greater mass violence incident–related media consumption is associated with worry and avoidance behaviors associated with concerns about future violence.
This cohort study evaluates whether administration of 30 mL/kg or more of fluid within 6 hours of hospital arrival is associated with reduced 30-day mortality in adults with community-onset sepsis.
This Special Communication assesses National Institutes of Health–supported research projects focusing on ultraprocessed foods (UPF) for fiscal years 2016 to 2025 to identify critical gaps in UPF research and explore opportunities for advancements in the field.
Background A good limb position (GLP) plays an important role in the rehabilitation process of patients who have had a stroke with hemiplegia. However, there remains a lack of effective assessment tools for clinical nurses to evaluate their GLP management practices. Objective This study aimed to develop and test the psychometric properties of the Good Limb Position Management Scale for Stroke Patients with Hemiplegia by Nurses (GLPMSSPHN). Design A quantitative and cross-sectional design. Setting 89 hospitals in 16 cities of China. Participants A total of 516 participants completed the…