The Clinical Times
The Front Page of Medicine

Clinical & Research · page 8

New research and findings from open-access journals and the U.S. research agencies.

BMJ Open · Jul 29, 2026

Inconsistent reporting of adolescent and young adult (AYA) status in non-interventional cancer research: a critical barrier to evidence usability

Inconsistent reporting of age at cancer diagnosis limits the utility of non-interventional studies focused on adolescents and young adults (AYAs), defined by the National Cancer Institute as individuals diagnosed between ages 15 and 39. Standardised reporting is essential to synthesise evidence and develop targeted interventions to address this population’s unique needs. While initiatives have emphasised reporting age at study enrolment in reporting results, there is a lack of guidance on specifying age at diagnosis—an essential detail for accurately identifying AYA status. To estimate the…

BMJ Open · Jul 29, 2026

Reaching young and low-income people for sexual healthcare in Zurich, Switzerland: perspectives from healthcare workers - a qualitative study

Background Free voluntary counselling and testing (VCT) interventions improve access to HIV and sexually transmitted infections prevention, particularly for underserved populations. Financial barriers are widely recognised as a key deterrent to testing uptake in vulnerable populations. In 2023, Zurich (Switzerland) introduced a pilot programme offering free VCT for young people and low-income residents. Objectives This study explores healthcare professionals’ (HCPs) experiences with implementing the programme, with a focus on perceived benefits, barriers and opportunities for improvement…

BMJ Open · Jul 29, 2026

Gestational weight gain and child nutritional outcomes in East Coast Peninsular Malaysia: protocol for the 10-year prospective GROW-MY cohort study

Introduction Childhood overweight and obesity are growing public health concerns in Malaysia. Increasing evidence suggests that early-life factors, including maternal gestational weight gain (GWG) and nutritional status, contribute to long-term child health outcomes. The Gestational Weight Gain and Child Nutritional Outcomes in East Coast Malaysia study is a 10-year prospective cohort established to investigate the intergenerational effects of maternal GWG on the nutritional and metabolic health of their respective offspring living in the East Coast of Peninsular Malaysia. Method and analysis…

BMJ Open · Jul 29, 2026

Effect of transcutaneous electrical acupoint stimulation on postoperative gastrointestinal dysfunction following laparoscopic urological surgery: a protocol for a randomised, controlled trial

Introduction The incidence of urinary tract tumours is increasing annually, and laparoscopic surgery is currently the predominant surgical method employed in clinical practice. Postoperative gastrointestinal dysfunction (POGD) is one of the most prevalent adverse events associated with patients who receive laparoscopic surgery. Transcutaneous electrical acupoint stimulation (TEAS) may be an effective treatment for POGD. This study intends to evaluate the efficacy and safety of TEAS for POGD following urological laparoscopic surgery. Methods This is a prospective, single-centre, randomised…

BMJ Open · Jul 29, 2026

Parent-delivered Hand-arm Bimanual Intensive Training Including Lower Extremity for young children with bilateral cerebral palsy in Vietnam: protocol for a randomised controlled trial

Introduction Cerebral palsy (CP) is a leading cause of long-term disability for children in Vietnam and across the world, affecting both gross and fine motor skills as well as daily independence. Intensive therapy has been shown to significantly improve motor outcomes. Moreover, parental involvement in therapy contributes positively to child development. Hand–Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) is a structured intervention that targets motor function of the upper and lower extremities through intensive, goal-directed practice. This study aims to evaluate the…

BMJ Open · Jul 29, 2026

Learning from real-world conditions to advance green care for mental health equity in the Global North: protocol for a transdisciplinary multi-scalar project

Introduction There is increasing evidence that green care (from nature-in-everyday life and nature-based health promotion to nature-based therapy) can promote mental health and well-being. However, there is contradictory evidence and few large-scale international studies focused on health inequities. The GreenME project aims to identify ways in which effective green care can be scaled-up to improve adult mental health and well-being equity while contributing to multiple socio-ecological co-benefits across the Global North. Methods and analysis GreenME’s approach is threefold: (i) to diagnose…

BMJ Open · Jul 29, 2026

Comparison of heparin assay monitoring protocols (CHAMP): study protocol for a pragmatic randomised trial

Introduction Due to widespread availability and familiarity, unfractionated heparin (UFH) is the most used intravenous anticoagulant for many indications in hospitalised patients. UFH, however, is a high-risk medication with complex pharmacokinetics and pharmacodynamics that are highly variable between different patients and within the same patients over time. The traditional titration and monitoring approach uses a clot-based assay, the activated partial thromboplastin time (aPTT), titrated to one and a half to two and a half times the upper limit of the normal range. Alternate assays…

BMJ Open · Jul 29, 2026

Randomised superiority trial evaluating an online transdiagnostic emotion regulation treatment for adolescents with mental health conditions: study protocol

Introduction Mental health conditions are prevalent during adolescence, but access to early evidence-based treatments remains limited. Scalable, online, theory-based transdiagnostic interventions delivered in primary care have the potential to reduce this treatment gap, but the effectiveness remains unknown. The objective is to investigate whether an online transdiagnostic emotion regulation treatment for adolescents with mental health conditions is superior to an active control treatment. Methods and analysis This single-blind, randomised clinical superiority trial will evaluate the…

BMJ Open · Jul 29, 2026

HYPOChLorous Acid TEsting Studies in percutaneous DRAINAGE (HYPOCLATES:DRAINAGE): protocol for a single-centre, controlled, ambispective cohort study comparing hypochlorous acid versus saline irrigation in percutaneous drainage of intra-abdominal abscesses

Introduction Percutaneous drainage is the standard of care for intra-abdominal abscesses. Additional saline irrigation provides mechanical cleansing but lacks antimicrobial activity. Hypochlorous acid (HOCl), an endogenous antiseptic with broad-spectrum microbicidal activity and high tissue compatibility, is a promising alternative for intracavitary infection control. This study evaluates whether HOCl irrigation shortens the indwelling time of percutaneous irrigation drains and systemic antibiotic duration compared with saline irrigation in patients with intra-abdominal abscesses. Methods and…

BMJ Open · Jul 29, 2026

Use of heart rate variability in prediction of clinical deterioration in critically ill hospitalised adults: a systematic review protocol

Introduction Heart rate variability (HRV) is a measurement derived from the beat-to-beat variation in heart rate and reflects the complex interaction of physiological systems, including autonomic, endocrine, immune and cardiorespiratory. Reduced HRV has been shown to be associated with adverse outcomes in several disease states. In critical illness, commonly used prognostic tools such as the Acute Physiology and Chronic Health Evaluation II score rely on intermittently collected or rapidly obsolete data and may fail to detect acute deterioration. Continuous, non-invasive HRV monitoring may be…

BMJ Open · Jul 29, 2026

Identifying pharmacy medicine-dispensing patterns associated with high risk of asthma and COPD exacerbation: an Australian retrospective cohort study

Objectives To determine whether patterns of asthma and/or chronic obstructive pulmonary disease (COPD) medicine dispensed in pharmacy dispense records (PDRs) associated with high risk of asthma and COPD exacerbation can be identified in long-term PDRs. Design Retrospective cohort study. Setting NostraData between 2011 and 2019. Participants Deidentified PDRs containing respiratory medicines, with a minimum of three dispensing events across at least 5 years. Main outcome measures The primary outcome measures were to describe the frequency, duration and dosage of medicines such as short-acting…

BMJ Open · Jul 29, 2026

Teleconsultation and joint consultation across primary-secondary care in a Dutch urbanised area: an exploratory qualitative study of healthcare professionals experiences of implementation barriers and facilitators

Objectives This study explored healthcare professionals’ experiences with (asynchronous) teleconsultations and (synchronous) joint consultations in primary and secondary care as well as perceived implementation barriers and facilitators to their use in clinical practice. Design An implementation-focused qualitative study employing semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR). A systematic examination of implementation barriers and facilitators using deductive and inductive approaches, followed by thematic analysis that identified patterns…

BMJ Open · Jul 29, 2026

Development of an externally controlled trial from a single-arm study to assess first-line immunochemotherapy in advanced large cell neuroendocrine lung carcinomas: a study protocol from the FIRST-NEC GFPC 01-2022 trial

Background Large-cell neuroendocrine carcinomas (LCNECs) of the lung are rare tumours with poor prognosis. A platinum-based regimen is currently the recommended first-line treatment for advanced LCNECs. Retrospective studies suggest potential benefit from immune checkpoint inhibitors (ICIs) but prospective data is lacking. Methods and analysis The ongoing phase II FIRST-NEC (First-line treatment for NeuroEndocrine Carcinoma) externally-controlled trial evaluates the efficacy and safety of durvalumab combined with platinum-etoposide as first-line treatment in locally advanced, ineligible for…

BMJ Open · Jul 29, 2026

Characteristics and outcomes of paediatric intensive care unit admissions across Kuwait: multicentre national-level cohort study

Background National paediatric intensive care registries are essential for benchmarking care, understanding population-level disease burden and identifying inter-site variation. However, such national-level data from the Middle East remains limited. This study aims to describe national patterns of paediatric intensive care unit (PICU) admissions, case mix, interventions, seasonality and outcomes across Kuwait. Methods This retrospective multicentre cohort study included all PICU admissions across the governmental hospitals in Kuwait between 1 January 2023, and 30 June 2025. Demographic…

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