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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…

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…

MHRA (UK) · Jul 29, 2026

Guidance: Ambient voice technology-enabled products

Device qualification and classification of ambient voice technology-enabled products that are medical devices intended to be placed on the market, or put into service, in Great Britain.

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.

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