Conectar
by Yishu Wang, Ling Zhu, Shuna Jin, Yuhan Wang, Zhaoxiang Zeng, Yunzhou Zuo, Xingliang Xiang, Xugui Li, Rongzeng Huang, Chengwu Song
BackgroundSex hormones play critical roles in the pathogenesis and progression of osteoarthritis (OA), yet the hormone-related molecular networks remain poorly defined. This study aimed to identify candidate sex hormone-associated genes in OA and to explore their potential functional enrichment and immune-related characteristics using bioinformatics analysis.
MethodsOA gene expression data were obtained from the GEO database and integrated with candidate sex hormone-associated genes retrieved from GeneCards. The R package “limma” was then used to identify differentially expressed genes (DEGs) and sex hormone-associated DEGs (SADEGs). OA-associated SADEGs, termed OA-SADEGs, were selected using weighted gene co-expression network analysis (WGCNA), and their potential biological functions and pathways were explored by GO and KEGG enrichment analyses. Hub genes were identified using three machine learning models. xCell analysis was used to estimate immune infiltration and its associations with hub genes, and hub gene expression was further evaluated in external datasets and peripheral blood samples.
ResultsWe identified 32 sex hormone-associated genes in OA, enriched in extracellular matrix remodeling, receptor signaling, and antigen presentation pathways. Three candidate hub genes (LOXL1, HLA-DRA, and CYBB) were consistently upregulated in OA and showed significant correlations with immune infiltration scores. xCell analysis identified 13 differentially enriched immune cell types, of which three were associated with hub genes. External dataset analysis and peripheral blood qRT-PCR showed upregulation of LOXL1, HLA-DRA, and CYBB in OA samples.
ConclusionThis study integrated bioinformatics and immune analyses to identify candidate sex hormone-associated genes in OA. These findings provide associative bioinformatics evidence for sex hormone-associated molecular features in OA.
by Qingyuan Li, Yousong Yue
ObjectiveTo assess long-term trends in height, weight and body mass index (BMI) among children and adolescents from 2005 to 2020 in Macao Special Administrative Region (SAR), China.
MethodsHeight, weight and BMI data for Macao children and adolescents aged 6–18 years were obtained from the Physical Fitness Reports of Macao SAR Residents in 2005, 2010, 2015, and 2020. Sex-specific two-way analysis of variance was used to estimate the differences in means. The Bonferroni post hoc test was used for multiple comparisons.
ResultsDuring the entire period, the average height, weight and BMI increased by 2.1 cm (95% confidence interval (CI): 1.6 to 2.6 cm), 4.0 kg (95% CI: 3.2 to 4.8 kg), and 1.1 kg/m2 (95% CI: 0.8 to 1.3 kg/m2) for boys and 2.4 cm (95% CI: 1.9 to 2.9 cm), 2.6 kg (95% CI: 1.9 to 3.3 kg), and 0.5 kg/m2 (95% CI: 0.3 to 0.8 kg/m2) for girls, respectively (p Conclusion
There were positive long-term trends in growth among Macao children and adolescents since 2005. Sex differences in changes of weight and BMI over the past five years may be related to the pandemic, and efforts are needed by governments and public health departments.
To identify distinct dyadic coping patterns among prostate cancer patients undergoing androgen deprivation therapy and their spouses using a person-centred approach, and to explore factors associated with these patterns to inform the development of personalised interventions.
A cross-sectional, observational study design.
A total of 223 patient-spouse dyads were recruited from two tertiary urology departments in Guangdong Province, China, between October 2024 and August 2025. All participants completed a general information questionnaire and the Dyadic Coping Inventory. Latent profile analysis was used to identify distinct coping profiles. Univariate analysis and multivariate logistic regression were performed to examine factors associated with profile membership.
Among 223 patient-spouse dyads, four distinct dyadic coping profiles were identified: Efficient Coping (12.0%), Ambivalent Coping (30.0%), Stable Coping (53.8%), and Coping Distress (4.0%). The small Coping Distress subgroup (n = 9) was excluded from further analysis. Higher dyadic coping levels were associated with patient education of high school or above, absence of tumour recurrence, sufficient patient-perceived family support, low-to-moderate spouse-perceived medical burden, frequent dyadic communication, and sufficient spouse-perceived friend/colleague support. Spouse-perceived insufficient family support was unexpectedly associated with better dyadic coping.
Dyadic coping patterns among prostate cancer patients undergoing androgen deprivation therapy and their spouses are heterogeneous. Healthcare professionals should identify distinct dyadic coping characteristics and provide personalised nursing interventions based on the key influencing factors identified in this study.
This study provides a person-centred classification framework for dyadic coping in couples undergoing androgen deprivation therapy, enabling nurses and other healthcare professionals to deliver targeted, stratified psychosocial care. Early identification of vulnerable couples, particularly those in the ambivalent coping subgroup, helps prevent maladaptive coping and alleviate psychological distress. By addressing modifiable factors including communication, family support, and caregiver burden, clinical practice can more effectively improve the psychosocial well-being and quality of life of both patients and their spouses throughout androgen deprivation therapy.
This study adheres to the relevant EQUATOR guidelines (STROBE) for cross-sectional studies.
Patients and their spouses were involved in the design of the study by providing feedback on the clarity and relevance of the questionnaire items during a pilot phase. They also participated in data collection by completing the self-report measures, and their input informed the interpretation of the findings related to dyadic coping experiences.
To explore how family resilience emerges and unfolds in dementia.
Qualitative meta-synthesis using thematic synthesis.
PubMed, CINAHL, Web of Science, PsycINFO were searched from inception through August 26, 2025.
Studies examining family-level resilience, adaptation or coping in home-based dementia care using qualitative methods were included. Two researchers independently screened and assessed quality. Thematic synthesis was applied to 18 studies selected through systematic prioritization until theoretical sufficiency.
Of 2437 records, 18 studies were analysed yielding 68 codes and 28 descriptive themes. Thematic synthesis revealed family resilience manifests three characteristics: ecological multidimensionality, iterative and cyclical progression and integrative manifestation. An ecological-processual interpretive framework was developed showing family resilience unfolds along two intersecting axes (ecological: intrapersonal, interpersonal, societal; processual: five iterative stages). Six analytical themes emerged integratively: multilevel adaptive resources and motivation; individual active adaptation; redefining dyadic relationships through dementia-personhood separation; family collaboration and structural reconstruction; social support construction and transcendent meaning expansion.
Family resilience unfolds as a dynamic process continuously reconstructed across ecological levels rather than a static outcome. Iterative and cyclical understanding is essential.
Practice requires longitudinal, process-oriented support for entire families including persons with dementia. Policy should establish family-unit assessment systems identifying changing patterns and respecting autonomy.
This study addressed how family resilience dynamically unfolds in dementia, which remained unclear despite research shifting from burden to resilience focus. An ecological-processual interpretive framework was developed integrating six themes across multiple ecological levels. Mental health nurses, dementia care practitioners, and policymakers will benefit from this framework when developing family-centered dementia care systems.
This review adhered to ENTREQ guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
Protocol registration PROSPERO: CRD42023485589
To systematically review the evidence on diagnostic prediction models for depression in patients with breast cancer.
Systematic review.
Ten databases were searched from inception to 22 August 2025, with an updated search on 17 December 2025, to identify original studies developing and/or validating diagnostic prediction models for depression in patients with breast cancer.
Data were extracted using the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) framework. Two reviewers independently assessed risk of bias and applicability of included studies using the Prediction Model Risk of Bias Assessment Tool (PROBAST).
Eleven studies were included. Reported area under the curve (AUC) values ranged from 0.784 to 0.890. All included studies were judged to be at high risk of bias, and seven raised high concerns regarding applicability. There was substantial heterogeneity in predictor selection across studies, with age, income level and family support being the most frequently reported predictors.
Although preliminary research on diagnostic prediction models for depression in patients with breast cancer has been undertaken, their methodological quality remains weak. Reporting of external validation and calibration assessment was limited. Current evidence is therefore insufficient to support their routine use in nursing practice. Future research should standardise model development and validation and strengthen the evaluation of model performance.
This review suggests that existing diagnostic prediction models for depression in patients with breast cancer are not yet sufficiently robust for routine nursing use, but may provide a reference for future nursing screening research and the optimisation of related tools.
This review synthesises the available evidence on diagnostic prediction models for depression in patients with breast cancer and provides a basis for future model development, validation and optimisation.
This review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis: Systematic Reviews and Meta-Analyses (TRIPOD-SRMA) checklist.
No patient or public contribution.
Postoperative nausea and vomiting (PONV) is a common and distressing complication following surgery, persisting despite advances in prophylactic regimens. Growth differentiation factor-15 (GDF-15) has been identified as a biomarker inversely associated with PONV risk and severity. As metformin is known to elevate circulating GDF-15 levels, we hypothesise that preoperative metformin use may be associated with a lower incidence of PONV. This study aims to evaluate the association between a history of preoperative metformin administration and the occurrence of PONV in adults undergoing general anaesthesia.
This is a single-centre, prospective, observational cohort study. We plan to enrol 909 adult patients scheduled for surgery under general anaesthesia with endotracheal intubation from December 2025 to December 2028. Participants will be divided into two groups based on their preoperative metformin exposure: an exposed group (n=303) with a documented history of metformin use and a non-exposed group (n=606) without such history, using a 1:2 ratio. The metformin regimen (choice of agent and daily dosage) will be determined by the attending physician as part of routine clinical care, independent of this study. The primary outcome is the incidence of PONV, defined as the occurrence of any nausea, retching or vomiting, within 120 hours post-surgery. Secondary outcomes include the incidence of PONV in the early (0–24 hours) and late (24–120 hours) postoperative phases; the severity of PONV symptoms and the requirement for rescue antiemetic medication during these intervals; the quality of recovery (assessed at 0–24, 24–48, 48–72, 72–96 and 96–120 hours); potential PONV risk factors in blood or urine and long-term survival rates at 1, 3 and 5 years.
This study protocol (version 04, dated 23 November 2025) was approved by the Ethics Committee of the Sixth Affiliated Hospital of Sun Yat-sen University (Approval No. 2025ZSLYEC-689) prior to the initiation of participant recruitment. The first participant was enrolled under protocol version 04. A subsequent protocol amendment (version 05, dated 25 December 2025) was approved by the same Ethics Committee. This amendment added a quality of recovery assessment using the 15-item quality of recovery scoring system questionnaire at 30 days postoperatively. This amendment did not alter the primary or secondary outcomes, the sample size calculation, or any other key elements of the study design. The results of this study will be disseminated at scientific conferences and published in international peer-reviewed journals.
As populations age and climate variability intensifies, seasonal migration has emerged as a strategy among older adults to reduce exposure to climatic extremes and optimise living conditions. In China, millions of older adults migrate annually between cold northern and tropical southern regions, providing a natural setting to examine the health effects of seasonal migration. The Frigid-Tropical Migratory Population Health (ftMPH) cohort was established to assess the short- and long-term health effects of this migration and the underlying biological, behavioural and social pathways.
The ftMPH cohort is a prospective, dynamic cohort jointly conducted in Heilongjiang (a cold region) and Hainan (a tropical region) in China, with a planned sample size of approximately 26 000 participants. Adults aged ≥60 years are recruited and classified into four subcohorts: cold-origin seasonal migrants, cold-region residents, tropical-origin seasonal migrants and tropical-region residents. Baseline assessments include questionnaires, clinical examinations, biospecimen collection and environmental exposure measurements. Each migration cycle is assessed at predefined time points spanning the departure and return phases. Migration exposure will be updated longitudinally at each follow-up interval.
The primary outcome is the incidence of major cardiovascular disease events, including non-fatal myocardial infarction, coronary revascularisation, stroke and cardiovascular mortality. Secondary outcomes include non-cardiovascular mortality, chronic disease events, healthcare utilisation and ageing-related measures. Time-to-event analyses will be performed using Cox proportional hazards models. Inverse probability of treatment weighting (IPTW) will be used to control for baseline confounding, with stabilised weights and covariate balance assessed using standardised mean differences. Longitudinal changes in repeated measures will be analysed using mixed-effects models.
Ethical approval was obtained from the Ethics Review Committee of Harbin Medical University (approval No HMUIRB2024029PRE) and the Ethics Review Committee of Hainan Medical University (approval No HYMLL-2025-102). Findings will be disseminated through peer-reviewed publications, conference presentations and policy or technical reports.
The ftMPH cohort is registered with the Chinese Clinical Trial Registry (ChiCTR2500102337; registered on 13 May 2025).
The predominant concern during pregnancy is musculoskeletal pain, often accompanied by additional discomforts such as anxiety and insomnia. Pilates, as a low-impact mind-body exercise, may be beneficial in managing musculoskeletal pain and associated symptoms in adults. This systematic review and meta-analysis aimed to synthesise the evidence on the effectiveness of Pilates for alleviating musculoskeletal pain and other discomforts during pregnancy.
Systematic review and meta-analysis.
PubMed, Scopus, TRIP Medical Database, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to 14 January 2026.
Randomised controlled trials and prospective non-randomised controlled studies that compared Pilates with other prenatal care modalities for improving musculoskeletal pain and discomfort were eligible.
Two researchers independently extracted data using standardised forms with subsequent cross-verification. Risk of bias was assessed using the Cochrane Risk of Bias V.2.0 tool. Meta-analyses were performed using random-effects models. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.
13 studies were included in the systematic review, of which 10 contributed data to the meta-analysis. Primary outcomes were pain intensity and disability level. Pain intensity was assessed using Visual Analogue Scale (range 0–10). Moderate-certainty evidence demonstrated that Pilates significantly reduced musculoskeletal pain during pregnancy (mean differences (MD)=–2.59, 95% CI –4.19 to –1.00; I²=91%, p=0.001). Low-certainty evidence suggested that Pilates reduced pregnancy-related disability (standardised mean differences (SMD)=–1.82, 95% CI –2.99 to –0.66; I² = 93%, p=0.002). Secondary outcomes comprised sleep quality and psychological status. Multivariate meta-analysis showed significant improvements in psychological status (SMD=–0.86, 95% CI –1.31 to –0.42; ²=0.4, I²=86%, p=0.0005) but did not yield statistically significant improvements in sleep quality (MD=–1.93, 95% CI –4.70 to 0.84; I²=93%, p=0.17). Both secondary outcomes were supported by very low-certainty evidence. Risk of bias assessment rated three studies as high risk, three as unclear risk and seven as low risk. Formal assessment of publication bias was not feasible owing to the limited number of studies (fewer than 10 per outcome).
This meta-analysis demonstrates that, compared with standard care, structured prenatal Pilates significantly alleviates musculoskeletal pain and disability while also enhancing psychological status.
CRD42024628027.
Cardiac rehabilitation (CR) is an effective intervention for improving outcomes in patients with coronary heart disease (CHD). However, the actual participation rate is unsatisfactory and exhibits significant gender disparities. This study aimed to investigate gender-specific determinants of the decision to participate in CR among patients with CHD, together with underlying causes.
Cross-sectional study.
A cross-sectional survey of 264 patients with CHD from 3 Chinese tertiary hospitals between February 2024 and February 2025. Data were collected using questionnaires based on the Information Need in Cardiac Rehabilitation scale, the Chinese version of Cardiac Rehabilitation Barriers Scale, the Family APGAR index questionnaire, and the International Physical Activity Questionnaire-Short Form.
There were 158 men aged 66 (SD = 13.3) and 106 women aged 66 (SD = 11.0). 55.1% of men CHD patients decided to participate in CR, significantly higher than in women patients (34.0%; χ 2 = 11.351, p = 0.001). Logistic regression analysis for men indicated that the facilitators of the decision to participate in CR were the level of family functioning and ≥ 2 comorbidities. The barriers included emergency/safety information needs and functional status. For women, the facilitators were retirement, family functioning level, being overweight/obesity, ≥ 2 comorbidities, and work/vocational/social factors. The barriers included medication information needs, logistical factors, and functional status. Fairlie decomposition revealed gender differences primarily driven by work/vocational/social factors (contribution: 71.19%), functional status (50.50%), and retirement (−39.16%) (all p < 0.05).
This study highlights the necessity of gender-specific interventions during the decision-making phase for CR. Healthcare professionals should tailor CR strategies to address women's social role barriers and men's emergency risk concerns, while enhancing family functioning and targeting support for functional status and work-related factors.
STROBE checklist, cross-sectional.
Three tertiary hospitals assisted in participant recruitment.
by Shuhong Zheng, Renxiu Bian, Haixin Song, Zhiping Liao, Ting Gao, Min Yan, Heqing Huang, Zuodong Lou, Fangchao Wu, Jianhua Li
BackgroundLow-intensity focused ultrasound (LIFU) is a non-invasive neuromodulation technique with high spatial precision and the ability to reach deeper brain regions, offering potential advantages for post-stroke rehabilitation. Repetitive transcranial magnetic stimulation (rTMS) is a widely adopted non-invasive brain stimulation technique that modulates cortical excitability to promote neuroplasticity. However, direct head-to-head comparisons between these two modalities for post-stroke motor recovery remain limited.
ObjectiveTo perform a secondary head-to-head comparison of LIFU and repetitive transcranial magnetic stimulation (rTMS) for motor recovery after stroke, based on a prospectively registered randomized controlled trial.
MethodsThis secondary analysis included patients with subacute stroke who received two weeks of standard rehabilitation combined with either LIFU (n = 25) or rTMS (n = 25) targeting the ipsilesional primary motor cortex. LIFU parameters: 0.5 MHz, spatial-peak pulse-average intensity (ISPPA) 10.2 W/cm² (free-field), pulse duration 0.2 ms, duty cycle 20%, 20 minutes per session, five days per week for two weeks (10 sessions total). rTMS parameters: 10 Hz, 80% resting motor threshold, 1,000 pulses per session (20 trains of 5 seconds), 20 minutes per session, five days per week for two weeks (10 sessions total). Motor outcomes were assessed using the Fugl–Meyer Assessment (FMA; upper and lower extremities), Modified Barthel Index (MBI), and Brunnstrom stages. Resting-state functional near-infrared spectroscopy (fNIRS) was used to evaluate cortical activity and functional connectivity before and after the intervention. Primary analyses were conducted in the intention-to-treat (ITT) population (n = 50), with completer analyses (n = 43) performed as sensitivity analyses.
ResultsBoth groups showed significant within-group improvements in FMA and MBI after the intervention (all p 0.05), and completer analyses yielded consistent between-group conclusions. In contrast, change-from-baseline analyses demonstrated greater improvements in FMA scores in the LIFU group compared with the rTMS group (ΔFMA upper limb: median 7 [IQR 3–10.5] vs. 2 [1–3], p = 0.001; lower limb: 3 [1–4.5] vs. 1 [0–1.5], p Conclusion
LIFU and rTMS were associated with comparable short-term motor outcomes in subacute stroke. Differences observed in change-from-baseline motor improvements and exploratory neuroimaging measures suggest potential divergence in recovery dynamics and cortical modulation, warranting further investigation in larger, longitudinal studies.
Trial registrationThis study was derived from a prospectively registered, three-arm randomized controlled trial in the Chinese Clinical Trial Registry (ChiCTR2500114687). The present manuscript reports a secondary head-to-head comparison between the two neuromodulation intervention arms.
To examine the risk of severe cardiovascular (CV) events in patients with chronic obstructive pulmonary disease (COPD) across different time periods following COPD exacerbations and the incidence rate of cardiopulmonary events in a real-world setting in China.
Retrospective cohort study.
Regional electronic health records database from Yinzhou District of Ningbo City, China.
A total of 14 713 patients aged ≥40 years with a first COPD diagnosis between 1 January 2014 and 1 March 2022.
The risk of severe CV events (ie, hospitalisation and a primary or secondary discharge code for acute coronary syndrome, heart failure decompensation, cerebral ischaemia, arrhythmia and CV-related death) during different exposed time periods following a COPD exacerbation, the incidence rate of overall cardiopulmonary events (ie, severe exacerbation of COPD, all-cause mortality, inpatient CV events, inpatient ischaemic stroke and inpatient tachyarrhythmia/atrial fibrillation) and the incidence rate stratified by COPD exacerbation history.
We included a total of 14 713 patients. During a median (IQR) follow-up of 2.8 (4.0) years, 20.1% experienced severe CV events. Compared with the unexposed period, the risk of severe CV events was the highest in the first 10 days following a COPD exacerbation (adjusted HR 10.00, 95% CI 8.16 to 12.25). The risk of severe CV events decreased over time but remained significantly elevated up to 90 days post exacerbation. We found that 32.7% of COPD patients experienced cardiopulmonary events, with a crude incidence rate of 9.38 (95% CI 9.09 to 9.69) per 100 person-years.
This study is the largest retrospective cohort study investigating CV and cardiopulmonary events among patients with COPD in China. Our findings highlight an elevated risk of CV events closer to the time of COPD exacerbations and show that nearly one-third of COPD patients experience cardiopulmonary events.
Periodontitis and chronic kidney disease (CKD) are inter-related conditions that can significantly impact patient health. This study aims to evaluate the efficacy of active non-surgical periodontal therapy (NSPT) combined with supportive periodontal care (SPC) in reducing tooth loss and improving masticatory function in patients with CKD and stage III periodontitis.
This randomised controlled trial will recruit 86 patients diagnosed with both stage III periodontitis and CKD. Participants will be randomly assigned at a 1:1 ratio to either an experimental group receiving active NSPT supplemented with SPC or a control group receiving oral hygiene instruction with scheduled periodontal monitoring. The intervention will last for 24 months, with assessments conducted at baseline and 3, 6, 12, 18 and 24 months. The primary outcome is the incidence of tooth loss due to periodontitis over the 2-year follow-up period. Secondary outcomes include the number of lost teeth, masticatory function, clinical periodontal parameters and oral health-related quality of life.
The study protocol and informed consent form were approved by the Institutional Ethics Committee of Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SH9H-2022-T404-1). Findings will be disseminated to participants and published in peer-reviewed journals.
ChiCTR2300068923.
Advance care planning for people with dementia is an important process to ensure that patient preferences are respected throughout disease progression. However, the complexity of advance care planning and the challenges in effective communication hinder its implementation. The lack of clear procedural guidance for health care teams and the limited research on practical issues such as building trust and resolving conflicts further complicate this process.
To explore the key components of and processes for advance care planning for people with dementia.
The authors conducted a comprehensive search of databases, including PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, NICE, Open Grey, CNKI, and Wanfang. The inclusion criteria focused on studies reporting advance care planning practices and stakeholder perspectives related to dementia.
The review included 45 studies and identified key components and processes for successfully implementing advance care planning in dementia care. These components include enhancing readiness, capturing patient wishes, and executing those wishes. The implementation processes cover assessing participation capacity, selecting surrogate decision-makers, and identifying healthcare providers who implement advance care planning. As the condition of people with dementia progresses, the role of healthcare providers who implement advance care planning becomes increasingly important in advance care planning practices.
The success of advance care planning depends on the interconnection of multiple components, and the findings offer practical insights for improving the advance care planning process to ensure that the care preferences of people with dementia are respected throughout the progression of the disease.
PRISMA-ScR.
This is a review without patient and public contribution.
This study aims to determine the relationship between successful aging and happiness levels in the elderly and to explore the mediating role of general self-efficacy in this relationship.
This is a quantitative research study designed using a correlational research model between March and May 2022.
The Mini-Mental State Examination, the Descriptive Information Form, the Successful Aging Scale, the Oxford Happiness Questionnaire Short Form and the General Self-Efficacy Scale were filled out by 144 elderly individuals living in a nursing home.
It was determined that the participants had high levels of successful aging behaviours/attitudes and good levels of happiness. It was determined that general self-efficacy had a ‘partial mediating role’ in the relationship between successful aging and happiness.
Due to the ‘partial mediating role’ of general self-efficacy related to happiness and successful aging, increasing self-efficacy may positively impact happiness and successful aging.
Healthcare professionals should prioritise practices and training that support the self-efficacy of the elderly for their successful ageing and happiness. Within this scope, interventions can be made to increase the elderly's participation in self-care, active engagement and intrinsic motivation.
This study determined whether general self-efficacy has an effect on successful aging and happiness in the elderly. It was determined that general self-efficacy has a ‘partial mediating role’ in the relationship between successful aging and happiness. The general self-efficacy of elderly individuals is an important issue to focus on. Successful aging includes functional ability, independence and quality of life aimed at maintaining health and well-being in old age. Self-efficacy, which is thought to have an effect on successful aging, is an important determinant in initiating and maintaining behaviours that improve the health of the elderly.
This study was reported adhering to the Strengthening the Reporting of Observational Studies in Epidemiology checklist.
The elderly individuals residing in a nursing home were included in the study. All participants were selected from a single nursing home. This nursing home accommodates both outpatient and bedridden elderly individuals. One section is reserved for individuals diagnosed with dementia.
by Deye Ge, Liyan Wu, Jingrong Yang, Jingxian Sun, Jinying Wang, Jingxin Wang, Huihui Song, Ran Wei, Zecheng Xu, Binbin Zhao, Rongfei Sun, Yifei Wang
The U.S. Food and Drug Administration (FDA) approved intravenous edaravone for the treatment of amyotrophic lateral sclerosis (ALS) in 2017, followed by the approval of the oral formulation in 2022. This study aims to utilize the FDA#39;s Adverse Event Reporting System (FAERS) to investigate the spectrum and timing of adverse events (AEs) associated with edaravone administration, employing repeatability analysis, the Reporting Odds Ratio (ROR) approach, Weibull distribution, and stratification methods. The investigation focuses on data collected from the first quarter of 2017 through the fourth quarter of 2024, aiming to identify adverse event signals and their temporal patterns related to both intravenous and oral edaravone administration. In total, 3,262 records of edaravone-related adverse reactions were identified; among these, 1,534 incidents were associated with intravenous administration, while 453 incidents pertained to oral administration. The analysis revealed distinct adverse reaction profiles for the two routes of administration. Notably, the spectrum of adverse reactions resulting from oral administration predominantly involved the respiratory system, digestive system, and skin damage. In contrast, intravenous administration was more frequently linked to complications associated with invasive procedures and local tissue damage. Furthermore, the timing of adverse reactions exhibited significant variability between the two routes. Weibull distribution analysis indicated that the median onset time for adverse reactions following intravenous administration was 35 days, whereas for oral administration, it was 27 days. Both analytical approaches identified early failure signals, suggesting that the risk of adverse events diminishes over time.To evaluate the impact of a 5-min delay in needle removal after haemodialysis on complications and patient satisfaction in newly created arteriovenous fistulas.
Retrospective cohort study.
This study analysed 109 patients with new arteriovenous fistulas undergoing initial cannulation 8–12 weeks post-surgery. Participants were divided into two cohorts: a conventional group (n = 42) receiving immediate needle removal after pump cessation, and a delayed group (n = 67) retaining needles for 5 min post-pump cessation before removal. Outcomes included haemostasis time, hematoma incidence, 3-month reintervention rates, and patient satisfaction measured by a 5-point scale.
Delaying needle removal by 5 min reduced mean haemostasis time by 32% compared to immediate removal (16.4 min vs. 24.1 min). Hematoma incidence decreased substantially by 76% in the delayed group (3.3% vs. 13.1%). At 3-month follow-up, reintervention rates were 66% lower with delayed removal (9.0% vs. 26.2%). Patients also reported 50% less procedure-related pain and significantly higher satisfaction scores (median 4.5 vs. 2).
A brief 5-min delay in needle removal significantly reduces complications and enhances patient-centered outcomes during early arteriovenous fistula use.
This protocol establishes an evidence-based standard for post-dialysis needle management, directly reducing compression-induced pain and reintervention needs while requiring no additional nursing resources. Implementation can immediately improve vascular access safety in haemodialysis units.
The study addresses high complication rates (26.2%) from immediate needle removal in immature fistulas. Key findings demonstrate 76% fewer hematomas and 66% lower reinterventions with 5-min delayed removal. This evidence may transform global haemodialysis nursing protocols, benefiting a substantial population of patients receiving new fistulas annually.
This study follows the STROBE checklist.
Patients and the public were not involved in the design, conduct, or reporting of this retrospective medical record analysis.
Pressure injury (PI) is common in the ICU and not well captured by single-risk tools such as the Braden scale. We aimed to develop and internally validate a machine-learning model to predict new-onset PI using routinely collected ICU data. This retrospective single-centre cohort included adult ICU patients with length of stay ≥ 48 h (2018–2023). The primary outcome was new-onset PI during ICU stay. Candidate predictors were pre-specified: minimum albumin, maximum lactate, SOFA, APACHE II, first recorded Braden score, age, BMI, a nutrition score and treatment indicators. Missing values were imputed (median/mode). A gradient boosting model (GBM) was evaluated with stratified 3-fold cross-validation; a random forest (RF) served as a benchmark (stratified 70/30 train–test split). Discrimination (AUC) was primary; calibration, Brier score, decision-curve analysis (DCA) and feature importance were secondary. Logistic regression quantified independent associations. Among included ICU stays, 14.6% developed PI. On multivariable analysis, higher lactate, lower albumin, lower Braden scores, older age, CRRT, prone positioning, enteral nutrition and analgesic exposure were associated with increased PI risk, whereas sedatives showed an inverse association. The GBM achieved AUC≈0.69 with acceptable calibration and net clinical benefit across thresholds commonly used in preventive workflows (≈0.10–0.50). Single markers or simple combinations displayed only modest discrimination. A GBM built from routine ICU data provided moderate, well-calibrated discrimination for predicting new-onset PI and demonstrated decision-relevant net benefit. The model can complement Braden-based screening by refining risk stratification and prioritising intensified prevention for patients most likely to benefit. External validation and prospective evaluation are warranted.
by Vu Nhi Ha, Le Chi Cao, Tran Hai Dang, Dao Thi Huyen, Nguyen Tien Dung, Le Huu Song, Nguyen Linh Toan, Truong Nhat My, Thirumalaisamy P. Velavan
BackgroundHepatitis E virus (HEV) causes sporadic outbreaks worldwide, with zoonotic and waterborne genotypes contributing to infections. In Vietnam, HEV genotypes 3 and 4 circulate among humans and swine, but data from remote, ethnic minority populations remain limited.
MethodsA cross-sectional study was conducted among 272 ethnic minority students at Thai Nguyen University of Medicine and Pharmacy (TUMP) to determine HEV infection markers and associated risk factors. Anti-HEV IgM and IgG were tested in serum samples using Wantai ELISA kits, and HEV RNA was detected by nested PCR targeting the ORF1 region. Demographic and exposure data were collected via structured questionnaires. Statistical analyses were performed using binary logistic regression.
ResultsOne participant (0.37%) tested positive for anti-HEV IgM, and 69 (25%) were positive for anti-HEV IgG, while HEV RNA was undetectable. HEV-IgG seroprevalence increased significantly with age (p = 0.004) but showed no sex-related differences. Consumption of tap or mixed water sources (p = 0.043) and raw or undercooked pork liver (p = 0.018) were significantly associated with HEV-IgG positivity. Multivariate analysis confirmed these factors as independent predictors of prior HEV exposure (adjusted OR = 1.6 and 4.8, respectively).
ConclusionsA moderate HEV seroprevalence among ethnic minorities indicates substantial prior exposure in northern Vietnam. Strengthening water sanitation, food safety awareness, and routine HEV surveillance is recommended to mitigate infection risk in vulnerable communities.
Healthcare quality improvement increasingly relies on patient experience data, yet traditional survey modes face declining response rates and rising costs. Mobile web surveys have emerged as a promising alternative for improving response rates. The primary aim of this study was to investigate the effectiveness of mobile web surveys in improving response rates in South Korea’s Patient Experience Assessment. We also aimed to assess the impact of a mixed-mode approach integrating mobile web and follow-up telephone surveys across different demographic groups.
A randomised experimental design was employed to compare response rates as well as contact and cooperation rates among survey modes. A total of 4800 patients from four general hospitals were randomly allocated to telephone, mobile web or mixed-mode survey, with 1600 patients per mode. Each mode allowed five contact attempts through calls or mobile survey links. The mixed-mode survey included follow-up calls for mobile non-respondents.
The survey was conducted between October and November 2022 among patients discharged from four general hospitals in South Korea.
A total of 4800 patients aged 19 years or older who were hospitalised for more than 1 day and discharged within 2–56 days from four general hospitals were included in this study. Exclusion criteria included patients in day clinics, palliative care, paediatrics and neuropsychiatry, as well as those without personal information consent forms during hospital admission.
The primary outcome measure was the response rate for each survey mode. Secondary outcome measures included the contact rate and the cooperation rate.
The mobile web survey yielded an overall higher response rate (32.5%) than the telephone survey (22.4%), with the mixed-mode survey achieving the highest response rate (39.3%). Decomposing response rates revealed that while contact rates were comparable for both telephone and mobile web surveys, the cooperation rate was considerably higher for the mobile web survey (73.2%) compared with the telephone survey (52.2%). Substantial gender-age subgroup differences were found.
Adopting mobile web surveys for patient experience assessments, which aligns with the public’s preference for information and communication technologies, could significantly improve response rates in patient experience surveys.
KCT0011374 (post-results).
To evaluate the effect of lobeglitazone on renal disease progression in patients with type 2 diabetes mellitus using longitudinal real-world data.
Retrospective cohort study.
Hospital-based Common Data Model database.
A total of 14 712 adults with type 2 diabetes mellitus who visited the Diabetes Center of Ewha Womans University Mokdong Hospital between 2013 and 2019 were identified. A 1:2 propensity score matching was performed to compare patients treated with lobeglitazone plus metformin with those receiving metformin monotherapy, sulfonylurea plus metformin, or a dipeptidyl peptidase-4 (DPP4) inhibitor plus metformin.
Treatment with lobeglitazone plus metformin compared with metformin monotherapy, sulfonylurea plus metformin or DPP4 inhibitor plus metformin.
Renal progression, defined as initiation of renal replacement therapy, a sustained ≥30% decline in estimated glomerular filtration rate (eGFR) from baseline, or doubling of serum creatinine with a concurrent eGFR ≤45 mL/min/1.73 m².
The HR of renal progression was 0.84 (95% CI 0.58 to 1.21) in the lobeglitazone plus metformin compared with metformin monotherapy, 1.00 (95% CI 0.79 to 1.27) compared with sulfonylurea plus metformin group, 1.10 (95% CI 0.84 to 1.44) compared with DPP4 inhibitor plus metformin group after adjusting for multiple variables. Subgroup analyses demonstrated significant interactions by sex in the comparison with metformin monotherapy (P for interaction=0.0179) and by glycaemic control in the comparisons with sulfonylurea plus metformin (P for interaction=0.0161) and DPP4 inhibitor plus metformin (P for interaction=0.0006), suggesting potential heterogeneity in treatment effects.
Lobeglitazone showed renal outcomes comparable to those of other antidiabetic medications, with a possible heterogeneity in treatment effects according to sex and glycaemic control.
FreshRSS 