The Clinical Times
The Front Page of Medicine

Clinical & Research · page 9

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

BMJ Open · Jul 29, 2026

Multimodal characterisation of skeletal muscle properties in children with and without cerebral palsy using a non-invasive approach: an observational study protocol

Introduction Children with spastic cerebral palsy (CP) often exhibit significant changes in their skeletal muscles due to altered neural control and atypical mechanical loading. While muscle morphology, in particular muscle size, has been extensively studied, other important properties, such as passive stiffness and muscle composition, remain poorly characterised. Previous studies have typically examined these features in isolation, leaving the interactions among morphology, composition and passive stiffness largely unexplored. This protocol addresses these gaps by providing a comprehensive…

BMJ Open · Jul 29, 2026

Peer support based on Mental Health First Aid for medical residents in Lyon, France: protocol for a non-randomised controlled mixed-methods study

Introduction Medical residents frequently experience anxiety, depression, burnout and suicidal ideation. Existing support strategies have shown limited benefit. The Impact de la Pair-Aidance étudiante sur la Santé Mentale des internes de Médecine de première année (PAESSM) study will evaluate whether embedding Mental Health First Aid (MHFA)-trained peer supporters within a first-year residency cohort is associated with improved mental well-being and reduced psychological distress over 12 months. Methods and analysis PAESSM is a non-randomised controlled mixed-methods quasi-experimental study…

BMJ Open · Jul 29, 2026

STABILITY 2: A protocol for a randomised trial in orthopaedic surgery to determine whether anterior cruciate ligament (ACL) reconstruction using a patellar or quadriceps tendon autograft with or without lateral extra-articular tenodesis is more effective at reducing the incidence of recurrent instability in young, active athletes

Introduction Anterior cruciate ligament reconstruction (ACLR) is complicated by high failure rates in young, active individuals, which is associated with worse outcomes and higher rates of osteoarthritis (OA). Failure of ACLR limits activity, reduces quality of life and substantially increases socio-economic costs. Thus, strategies to reduce ACLR failure are imperative. In the STABILITY 1 trial, we showed that adding a lateral extra-articular tenodesis (LET) to ACLR with a hamstring tendon (HT) graft provided greater stability than HT alone (Relative Risk Reduction (RRR)=0.38; 95% CI 0.21 to…

BMJ Open · Jul 29, 2026

Early assessment, diagnosis and treatment of Parkinsonism and Related Syndromes study (ExPRESS): a protocol for an observational study on incident parkinsonism

Introduction Existing evidence from cohort studies of atypical parkinsonism has demonstrated that median time from symptom onset to diagnosis is 3.4 years for progressive supranuclear palsy (PSP) and 3.1 years for multiple system atrophy (MSA). This compares to only 1.0–1.2 years in Parkinson’s disease (PD). Earlier diagnosis is essential to facilitate recruitment to disease-modifying treatment trials. In the Early Assessment, Diagnosis and Treatment of Parkinsonism and Related Syndromes study, we will prospectively assess patients across the UK with incident parkinsonism and determine the…

BMJ Open · Jul 29, 2026

Inhaled corticosteroids and risk of cardiovascular events in chronic obstructive pulmonary disease: a nationwide cohort study in Denmark

Rationale Cardiovascular disease is a major comorbidity in chronic obstructive pulmonary disease (COPD). Previous studies evaluating the association between inhaled corticosteroids (ICS) and cardiovascular events (CVEs) in COPD have yielded conflicting results and a potential dose–response relationship remains unclear. Objectives To determine the association between ICS exposure and risk of CVE in COPD patients. Methods In this nationwide, retrospective register-based cohort study, we included patients with a specialist-verified COPD diagnosis between January 2008 and January 2022. ICS…

BMJ Open · Jul 29, 2026

Regional differences and influencing factors of needlestick injury protection among clinical nurses in China: a national cross-sectional survey based on economic region

Objectives This study aimed to investigate regional differences in needlestick injury (NSI) protection among clinical nurses across China’s economic regions and to explore the influencing factors including hospital management, training and assessment mechanisms. Study design A national cross-sectional survey was conducted using a stratified sampling strategy combined with online questionnaire dissemination. Mediation analysis was applied to examine the indirect effects of economic regions on NSI protection. Setting The survey was conducted across tertiary hospitals in 28 provincial-level…

BMJ Open · Jul 29, 2026

Improving laboratory workforce efficiency using AI-assisted digital cytology within an HPV-based cervical screening programme: A model-based evaluation for the NHS Cervical Screening Programmes

Objectives We aimed to estimate the time required to review and report cervical cytology slides within a Human Papillomavirus (HPV)-primary cervical cancer screening programme, where cytology is used for triage following a positive HPV test, comparing Artificial Intelligence (AI)-assisted digital cytology (Genius) with manual microscopy. Design A decision-tree model of the flow of slides through the National Health Service (NHS) England cervical screening cytology laboratory workflow, parameterised using published evidence and expert input. Setting Cytology laboratories within the NHS Cervical…

JAMA Network Open · Jul 29, 2026

Error in Methods

In the Original Investigation titled “Limbic System Microstructure in Neonates With Antenatal Opioid Exposure,” published July 2, 2026, the statement of the derivation of adjusted diffusion metrics in Methods should have listed all of these metrics. The article has been corrected.

JAMA Network Open · Jul 29, 2026

Dense Breast Legislation and Supplemental Breast Imaging

This cohort study comprising 12.6 million women evaluates the differential association of dense breast notification and insurance coverage laws with supplemental imaging use and assesses how specific legislative features are associated with imaging use.

JAMA Network Open · Jul 29, 2026

Social Vulnerability, Wildfire Exposure, and Mental Health

This survey study of Los Angeles County residents, conducted before and after the January 2025 wildfires, estimates the association between wildfire exposure and psychological distress and assesses the social factors that modify this association.

JAMA Network Open · Jul 29, 2026

Genomic Testing Uptake Among Medicare Beneficiaries With Cancer

This cohort study examines trends and variation in uptake of next-generation sequencing (NGS) and non-NGS genomic testing among Medicare beneficiaries with common cancers using the Chronic Conditions Data Warehouse.

JAMA Network Open · Jul 29, 2026

Research Priorities in Pediatric Migrant Health

This survey study uses a participatory priority-setting process to identify the most important unanswered research questions in pediatric migrant health among migrant and clinician stakeholders in Europe.

JAMA Network Open · Jul 29, 2026

Design, Conduct, and Analysis of RCTs of Chinese Herbal Medicine

This cross-sectional study investigates the design, conduct, and analysis of Chinese herbal medicine randomized clinical trials (RCTs) and examines whether there are differences between RCTs published in English and Chinese.

MedCity News · Jul 28, 2026

Altimmune’s GLP-1 Drug Reduces Heavy Drinking in Alcohol Use Disorder Trial

Altimmune’s pemvidutide achieved a statistically significant reduction in heavy drinking days compared to a placebo in a Phase 2 trial. This peptide drug, which is designed to activate the GLP-1 and glucagon receptors, is also on track to begin a pivotal test in the fatty liver disease MASH. The post Altimmune’s GLP-1 Drug Reduces Heavy Drinking in Alcohol Use Disorder Trial appeared first on MedCity News .

ACC (Cardiology) · Jul 28, 2026

OPTIMA-AF: 1-Month vs. 12-Month Dual Antithrombotic Therapy Post PCI

Only one month of dual antithrombotic therapy followed by direct oral anticoagulant (DOAC) monotherapy proved to be noninferior in terms of efficacy and superior in terms of bleeding outcomes to the standard 12-month dual antithrombotic therapy post PCI among patients with atrial fibrillation (AFib), according to results of the OPTIMA-AF trial published July 15 in The Lancet.

PLOS Medicine · Jul 28, 2026

Maternal congenital heart disease: Implications for the next generation

by Elisabeth Leirgul, Gottfried Greve Advances in medical and surgical treatment of congenital heart disease (CHD) now allows most affected individuals to reach adulthood and parenthood. While maternal CHD is associated with pregnancy complications, emerging evidence suggests a possible increased risk of developmental challenges in offspring, particularly among children of mothers with severe CHD. In this Perspective, Elisabeth Leirgul and Gottfried Greve discuss emerging evidence that as well as maternal congenital heart disease (CHD) being associated with pregnancy complications, there is…

BMJ Open · Jul 28, 2026

Does the exercise environment matter? Indoor versus outdoor aerobic exercise for adolescents with subthreshold depression: a randomised controlled trial protocol

Introduction Aerobic exercise, defined as rhythmic and continuous physical activity performed at moderate intensity to improve cardiorespiratory fitness, is widely recognised as an effective non-pharmacological intervention for improving the mental health of adolescents with subthreshold depression. However, whether the environment in which exercise is performed—such as indoor versus outdoor settings—modulates its psychological benefits remains insufficiently understood, as empirical evidence is still scarce. This study aims to compare the psychological effects of aerobic exercise conducted in…

BMJ Open · Jul 28, 2026

Knowledge, attitude and practices on antimicrobial resistance among medical students in Africa: a systematic review protocol

Background Antimicrobial resistance (AMR) remains a global public health threat contributing to over 1.27 million deaths in 2019. The knowledge, attitude and practices (KAP) on AMR among medical students have a direct impact on the future of combating this global problem. Despite the presence of country-specific data on KAP among medical students, there still lacks a consolidated study synthesising this information in Africa. This study aims to assess the KAP on AMR among medical students in Africa. Methods This will be a systematic review of studies assessing the KAP on AMR among medical…

BMJ Open · Jul 28, 2026

PregInPoxVac maternal protocol: a phase 3 trial evaluating maternal immunogenicity and safety of the MVA-BN vaccine in the Democratic Republic of the Congo

Introduction Mpox remains endemic in the Democratic Republic of the Congo (DRC), with pregnant women at increased risk of severe disease and adverse outcomes. The WHO has called for data on mpox vaccination in high-risk groups, but no clinical trial has assessed the safety or immunogenicity of mpox vaccines in this population. The modified vaccinia Ankara–Bavarian Nordic (MVA-BN) vaccine, a third-generation, highly attenuated, non-replicating, live virus vaccine, has shown an excellent safety profile in adolescents and adults, including immunocompromised individuals, and is expected to be safe…

BMJ Open · Jul 28, 2026

Treatment outcomes and factors associated with recovery among children aged 6-59 months with severe acute malnutrition admitted to therapeutic feeding units in Central Tanzania: a longitudinal descriptive study

Objective The objective of this study was to investigate treatment outcomes and identify factors associated with recovery among children aged 6–59 months with severe acute malnutrition who were admitted to therapeutic feeding units in Tanzania’s central zone. Design Hospital-based longitudinal descriptive study. Setting The study was conducted in the therapeutic feeding units of Dodoma Regional Referral Hospital and Singida Regional Referral Hospital, Tanzania, between 1 April and 30 June 2024. Participants A total of 166 children aged 6–59 months admitted with severe acute malnutrition were…

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