Conectar
To estimate tuberculosis (TB) incidence trends in the high-altitude Xizang, China, and to explore the key intervention strategies on achieving the WHO 2030 TB control target.
We developed a susceptible–exposed–infectious–recovered transmission model using routinely reported TB surveillance data from 2004 to 2022. Scenario-based simulations were conducted to project future TB incidence under alternative intervention strategies. Model assumptions are as follows: (1) a stable population, (2) lifelong vaccine-induced immunity, (3) infectiousness of active TB cases, (4) relapse risk after recovery and (5) homogeneous mixing within the population.
Seven prefectures of Xizang Autonomous Region on the Tibetan Plateau, China.
An estimated population of approximately 3 million individuals residing in Xizang.
We assessed the epidemiological impact of four interventions implemented independently: increasing vaccine efficacy rate, reducing transmission rates of susceptible individuals, decreasing progression rate from latent TB infection to active disease and reducing relapse rate among successfully treated patients, compared with continuation of current control measures.
The estimated basic reproduction number (R0 ) for TB in Xizang was 0.39 (95% CI 0.21 to 0.71) in the absence of additional interventions, which was the highest among all regions of China. Model simulations indicated that all four evaluated interventions were each likely to reduce TB incidence, but only reducing the latent-to-active TB progression had a substantial effect. A 50% reduction in the progression rate was predicted to lower TB incidence from 66.56 (62.00–70.11) to 40.54 (37.15–43.77) cases per 100 000 population, meeting the WHO 2030 TB control target.
Targeted management of individuals with latent TB infection should be strengthened to substantially reduce TB transmission in high-altitude areas.
The standard treatment for high-grade squamous intraepithelial lesions is excisional involving the uterine cervix, while surveillance is an acceptable approach for low-grade squamous intraepithelial lesions. There is controversy about excisional treatment on pregnancy outcomes. The objective of this study was to determine pregnancy outcomes in women living with and without HIV who underwent excisional treatment for high-grade cervical intraepithelial lesions.
This retrospective cohort study compared the pregnancy outcomes of women with and without HIV who were or were not treated for cervical intraepithelial lesions. A cohort of 488 women with and without HIV infection who did or did not receive excisional treatment for cervical intraepithelial lesions between 2009 and 2022 was enrolled. Adverse pregnancy outcomes (preterm delivery and pregnancy loss) in women with and without HIV, untreated or treated for cervical dysplasia, were recorded and analysed. The significance of the obtained results was judged at the 5% level.
The study was conducted at all Academic Model Providing Access to Healthcare-Kenya satellite sites, which offer cervical cancer screening and treatment for cervical dysplasia in western Kenya. The Moi Teaching and Referral Hospital was also included.
A cohort of 488 women aged between 20 years and 49 years, with and without HIV, diagnosed and treated for high-grade cervical intraepithelial neoplasia, and those followed up for low-grade cervical intraepithelial neoplasia between 2009 and 2022, were included.
The study was interested in adverse pregnancy outcomes, particularly pregnancy loss and preterm delivery following cervical excision treatment for high-grade cervical intraepithelial lesions.
After adjustment for confounding factors, excisional treatment involving the uterine cervix—particularly cold knife conisation—was associated with higher odds of adverse pregnancy outcomes (OR 13.1; 95% CI 1.1 to 137.1; p=0.032). A prior history of adverse pregnancy outcomes was also strongly associated with subsequent adverse outcomes after treatment (OR 37.7; 95% CI 13.8 to 102.7; p
Adverse pregnancy outcomes after excisional treatment of the uterine cervix for high-grade squamous intraepithelial lesions are multifactorial and were associated with cold knife conisation and prior adverse pregnancy outcomes, while maternal HIV infection was not independently associated with adverse outcomes.
To investigate the trajectories of swallowing function recovery and associated influencing factors in adult patients following orotracheal extubation in the intensive care unit (ICU).
Prospective cohort study.
Emergency ICU of a tertiary hospital in Shenyang, China.
A total of 182 adult patients who underwent orotracheal intubation were enrolled between December 2023 and December 2024 using convenience sampling. Among them, 168 patients completed all follow-up assessments, with a loss-to-follow-up rate of 10.1%.
Swallowing function was assessed using the Standardised Swallowing Assessment (SSA) at 2, 4, 6, 8, 24 and 48 hours after extubation. Latent class growth modelling (LCGM) was used to identify distinct swallowing function trajectories. Unordered multinomial logistic regression was performed to examine factors associated with different trajectory classes.
Among the 168 patients who completed all six assessments, no significant differences in baseline characteristics were observed between patients who completed follow-up and those lost to follow-up (all p>0.05). LCGM identified three distinct swallowing function trajectories: a low-risk group (46.1%), characterised by consistently low SSA scores below the dysfunction threshold (26 points); a rapid recovery group (24.6%), in which SSA scores declined to below 26 points within 24 hours after extubation and a high-risk group (29.3%), characterised by persistently elevated SSA scores above 26 points. Multinomial logistic regression analysis showed that age ≤50 years, absence of spinal cord injury or rib fractures, APACHE II score
Distinct trajectories of swallowing function recovery were observed in adult ICU patients after orotracheal extubation. Several clinical factors were associated with more favourable recovery patterns. These findings may help improve the understanding of heterogeneity in postextubation swallowing function and inform future risk stratification and individualised management strategies.
Ethics approval and consent to participate in the trial were approved by the Institutional Research Ethics Committee of General Hospital of Northern Theatre, Shenyang, Liaoning province, PR China (Project Number: Y (2023)232). Written informed consent was obtained from all participants. All procedures were conducted in accordance with relevant guidelines and regulations and the Declaration of Helsinki.
Symptom networks offer a new approach to explore the relationships among various symptoms and provide information for optimising precise symptom management strategies. However, no previous studies have identified the central symptoms of multidimensional frailty.
A cross-sectional study was conducted from December 2023 to March 2024 in China.
A total of 933 community-dwelling older adults (aged 60 years or older) in China were recruited via convenience sampling.
Sociodemographic variables, clinical variables and scores on the Tilburg Frailty Indicator were assessed in all participants. The qgraph package and IsingFit package of R software were applied to construct the symptom network. Three node centrality indices (strength, betweenness and closeness) and the expected influence were calculated to identify the central symptoms of the multidimensional frailty network. All statistical analyses were performed in R.
A total of 933 individuals were surveyed in this study, including 472 (50.6%) females. The median age of all participants was 71.0 years. A total of 408 subjects were assessed as multidimensional frailty. The prevalence of multidimensional frailty was 43.7%. The centrality indices revealed that ‘difficulty in walking’, ‘difficulty in maintaining balance’, and ‘feeling down’ were the symptoms with the largest strength and expected influence values.
This study primarily utilised network analysis to construct a symptom network of multidimensional frailty among community-dwelling older adults. The findings revealed that difficulty in walking, difficulty in maintaining balance, and feeling down were the most central symptoms.
This study identified the central symptoms of multidimensional frailty in older adults, which may serve as primary intervention targets. Nursing staff could incorporate targeted physical and psychological interventions into person-centred care plans.
This study was reported in accordance with the STROBE guidelines.
No patient or public contribution was involved in this study.
Skin temperature, including absolute temperature (at bony prominence areas under long-term compression) and relative temperature (the difference between bony prominence and adjacent control area), may serve as early warning indicators for PI. However, the optimal indicator remains unclear. This meta-analysis therefore synthesises evidence on their association with PI risk to identify the best indicator and evaluate its early-warning accuracy.
Systematic review and meta-analysis.
We included prospective cohort studies of adult patients investigating longitudinal associations between skin temperature and subsequent PI development. We pooled standardised mean difference (SMD) and odds ratios, complemented by summary receiver operating characteristic (SROC) curve analysis. The overall quality of evidence was evaluated using the GRADE method.
We researched PubMed, Embase, CINAHL, Cochrane Library (CENTRAL), Wanfang and CNKI databases from inception to September 25, 2024.
After screening 1354 titles and abstracts, ten studies comprising 1742 participants were included in the final synthesis. No significant difference in absolute temperature (combined SMD) was found between the PI and non-PI groups (seven studies included). In addition, decreased relative temperature (< −0.1°C) was associated with a 16-fold increased likelihood of PI (95% CI 6.38–40.19, I 2 = 79.4%) (three studies included), with the SROC curve analysis showing an AUC of 0.776. According to GRADE, the evidentiary certainty was very low for AT and low for RT.
Relative temperature is significantly related to the risk of PI, supporting its role as a promising early warning indicator. Future studies should establish a standardised measurement protocol to facilitate its clinical application.
Monitoring skin temperature changes holds promise as a non-invasive tool for early warning of PI risk. However, the amount and quality of available evidence limit our confidence in these findings, underscoring the need for further research before a definitive conclusion can be drawn.
This study followed PRISMA guidelines.
No patient or public contribution.
PROSPERO CRD42024550099
Skin tone can affect clinical signs and device accuracy in paediatric anaemia and deterioration detection, creating risks of inequity.
Studies show disparities in diagnostic accuracy across different skin tones, supported by community-based evidence.
(1) Build multicenter networks with standardised skin-tone data. (2) Validate devices across varied skin tones. (3) Train clinicians in dark-skin sign recognition. (4) Include equity metrics in paediatric quality indicators.
Reducing skin-tone bias is essential for equitable paediatric care. Collaborative research across diverse regions is needed.
by Chao Feng, Guodong Chen, Yan Shu, Jing Chen, Wenxin Ye, Ligang Ren
IntroductionGiven the high recurrence rate of bladder cancer (BCa) and the significant adverse effects associated with conventional treatments, it is urgent to search for new clinical therapeutic targets and safer natural-derived compounds. Resveratrol (Res) has been demonstrated to exhibit cytotoxicity against various tumors. However, the signaling pathways and targets involved in inhibition of BCa cells still need further exploration. This study aims to investigate the mechanism of Res in Bca via suppression of the AURKA/STAT3 axis, providing important theoretical basis for subsequent further researches on Res for treating BCa.
MethodsDifferentially expressed genes were identified through bioinformatics methods and the binding sites of resveratrol were also identified. The cell survival rate was detected by the CCK8 method to calculate the concentrations of Res for 30% inhibition and for 50% inhibition. Then, flow cytometry was used to detect the cell cycle and apoptosis after treatment with different concentrations of Res. Immunofluorescence staining was used to detect the effects of Res and MLN8237 on the expression of STAT3. Western blot and qPCR analyses were used to verify the reliability of the effects of Res and MLN8237 on target proteins.
ResultsAURKA was identified as the potential target of Res by computational analysis. Further validation through CCK8 assays and flow cytometry demonstrated that Res could inhibit BCa cells and their cell cycle in a time- and dose-dependent manner. Immunofluorescence staining revealed both Res and MLN8237 suppressed STAT3 expression in BCa cells. Additionally, western blot and qPCR analysis confirmed that Res and MLN8237 inhibited the expression of AURKA and known target genes (VEGF, Bcl-2, and Cyclin D1).
ConclusionOur findings suggest that Res may regulate BCa cell expression through the AURKA/STAT3 axis, providing a theoretical foundation for the structural optimization of Res and the development of multi-target drugs for clinical application.
by Li Dong, Changkun Ma, Wanghai Tao, Quanjiu Wang
The flow characteristics of water and gas are closely linked to pore structure of porous media, which is of critical importance across various scientific and industrial fields. In this study, synthetic porous media with varying grain sizes and porosity were generated, and their corresponding pore structures were characterized using pore network modeling. Furthermore, the intrinsic permeability, water retention curve, water-gas relative permeability and relative gas diffusivity of the synthetic porous media were simulated via pore network modeling. The results demonstrate that the pore networks extracted from images can effectively distinguish pore structural characteristics. Specifically, the mean pore diameter, throat diameter, and throat length were larger in coarse-grained media compared to fine-grained media of the same porosity. In contrast, fine-grained media exhibited higher values for pore number, throat number, and coordination number. Additionally, the distributions of pore diameter, throat diameter, throat length and coordination were found to follow a lognormal distribution. Porous media with coarse grains and larger porosity exhibit greater intrinsic permeability and relative gas diffusivity compared to media composed of finer grains or lower porosity. The water-retention curves were fitting by van Genuchten model, revealing an exponential relationship between parameter α and throat diameter (or pore diameter). But the parameter n did not show a clear trend across various synthetic porous media, which is attributed to the relatively narrow range of pore size distribution. Similarly, for water-gas relative permeability, the critical water saturation did not vary significantly across different porous media. A strong correlation was observed among the pore structural parameters, irrespective of grain shape and size. Both intrinsic permeability and relative gas diffusivity exhibited a power-law relation with the porosity as well as with pore or throat radius. Moreover, the relationship between intrinsic permeability and relative gas diffusivity can be expressed as k = 166.51(Dp/D0)0.98, which provides a direct means of estimating relative gas diffusion from intrinsic permeability directly.The functional resonance analysis method (FRAM) is increasingly used to analyse healthcare processes. FRAM uses four steps to analyse a process and its potential variability. We systematically reviewed studies using FRAM in healthcare on how the four steps in FRAM are reported, defined and supported by data.
Systematic review following the preferred reporting items for systematic reviews and meta-analyses 2020 guidelines.
Web of Science, PubMed, Embase, Scopus, PsycINFO, Dimensions and Lens were searched up to December 2025.
All peer-reviewed studies using FRAM in a healthcare context that presented a FRAM visualisation were included. The papers had to be written in English.
Two independent reviewers screened titles and abstracts, and subsequently the full text of selected papers. Data was extracted reporting on the steps of FRAM, how functions were supported by data, and the functions and couplings of the visualisations.
Sixty-eight papers were included, of which 20 (29%) reported at least one aspect of all four steps in FRAM. While most studies (85%) described how functions were supported by data, the methods used varied widely. Terminology was interpreted differently concerning variability, the output of variability and the effect of combined variability.
Most FRAM studies in healthcare do not report all steps of FRAM, and interpretations of key terms differ. FRAM studies should more clearly describe which steps of the method are conducted, and how data is collected and analysed. Refinement of FRAM guidelines, particularly on data use and terminology, would enhance consistency and comparability across studies.
CRD42024592858.
Glaucoma is an optic neuropathy caused by the gradual degeneration of retinal ganglion cells. This study aimed to investigate the knowledge, attitude and practice (KAP) towards glaucoma among ophthalmic inpatients.
A web-based questionnaire.
Local hospital.
Ophthalmic inpatients (n=1238).
The primary outcome was the patients’ KAP.
Multivariable logistic regression analysis showed that rural residence (OR=0.488, 95% CI 0.313 to 0.762, p=0.002), college education or above (OR=4.996, 95% CI 2.942 to 8.483, p
Ophthalmic inpatients might have moderate knowledge and attitude, but a proactive practice towards glaucoma. A history of glaucoma, previous glaucoma surgery, education level, residency and alcohol consumption were potentially associated with knowledge and attitudes towards glaucoma among ophthalmic inpatients.
Outcome reporting in studies on sacrococcygeal teratoma (SCT) is highly heterogeneous, which limits comparability across studies and thus hampers the development of international treatment guidelines.
Variation in treatment and access to facilities contributes to differences in outcome reporting between centres and countries. Establishing a Core Outcome Set (COS) can improve consistency in outcome reporting and facilitate global collaboration and data comparison. We therefore aim to develop a Core Outcome Set for SCT (COS-SCT) using the Delphi method to achieve consensus on key outcomes. This will enhance the standardisation of outcome reporting and improve the quality of research and clinical care for SCT patients globally.
The development of the COS-SCT will consist of three phases. First, a systematic review will be performed to identify outcomes reported in studies on the surgical treatment of SCT in children. Second, an international Delphi survey will be conducted among key stakeholders, including clinicians, researchers and patient representatives, to establish consensus on outcome prioritisation. Finally, a consensus meeting with representatives from all stakeholder groups will be held to ratify the final Core Outcome Set. The study will follow methodological guidance from the Core Outcome Measures in Effectiveness Trials (COMET) initiative and will be developed and reported in accordance with the Core Outcome Set Standards for Development (COS-STAD) and Core Outcome Set Standards for Reporting (COS-STAR).
The medical research ethics committee of the Amsterdam University Medical Centre (Amsterdam UMC) confirmed that the Dutch Medical Research Involving Human Subjects Act (WMO) does not apply to this study, and therefore a full review by the ethics committee is not required. This study is registered in the COMET initiative database. Results will be disseminated in peer-reviewed academic journals and conference presentations.
Trial registration number: COMET registration number 3485
The Chinese neuroimmunological disease database (NIDBase) cohort was established to explore genetic and environmental risk factors, clinical features, multi-omics data and prognostic biomarkers. The aim is to enhance our understanding of central nervous system (CNS) demyelinating diseases. Additionally, the establishment of this cohort will address the critical issue of the lack of comprehensive genetic data and biological samples for precision diagnosis and treatment research related to neuroimmunological diseases in China.
56 hospitals in various regions of China were selected to participate in this study. The patients diagnosed with CNS demyelinating diseases were recruited, including clinically isolated syndrome (CIS), multiple sclerosis (MS), neuromyelitis optica spectrum disease (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A).
At the time of patient enrolment, the clinical information is designated as baseline data. The collected baseline data include demographic information, disease history, clinical features of each demyelinating event, treatment records, standardised scales, questionnaire assessments and laboratory test results. Furthermore, biological samples, MRI and high-density electroencephalography (hd-EEG) data will be collected at baseline. All patients will be followed up at 3 months and 6 months and annually thereafter. As of December 2024, 3866 patients with CNS demyelinating diseases have been enrolled, including 84 CIS, 282 MOGAD, 1405 MS and 2095 NMOSD. Our findings indicate that CNS demyelinating diseases, particularly NMOSD, are more prevalent in women in China, with significant age differences observed among NMOSD patients compared with those with CIS, MS and MOGAD.
In future, all patients in our cohort will be followed up at 3 months and 6 months and then annually. By the end of December 2024, the database has been locked and is now being processed and analysed, while our data continue to be updated and expanded for further analysis. Both prospective and retrospective observations will be included in this study. Subsequent publications will emerge from this multicentre cohort, encompassing genomics, clinical cohort studies, hd-EEG biomarkers, imaging-based radiomics and electrical stimulation therapies.
To explore the relationships between the pulse/breathing rate ratio (PBR) and the risk of death and critical illness.
This was a retrospective observational study.
This was a single-centre study from a tertiary hospital in Tianjin, China.
The study population consisted of patients aged ≥16 years who underwent consultation and were monitored for medical purposes at the clinic.
Between April 2021 and December 2021. Before the patients received any medical intervention, vital signs were measured, and the PBR and the National Early Warning Score (NEWS) were calculated on the basis of the above measured indicators.
The associations of PBRs with death and critical illness were evaluated.
A total of 1048 outpatients with fever were included. Restricted cubic spline (RCS) bars were used to explore potential nonlinear associations between PBR and mortality and critical illness. The abilities of the PBR and NEWS to predict the risk of death and critical illness were compared through decision curve analysis (DCA). The RCS showed a U-shaped nonlinear distribution of associations between PBRs and death and critical illness (nonlinear p values of p=0.036 and p=0.005, respectively). The risk of mortality was lowest between 4.6 and 6.2 for PBR, with the risk of mortality increasing progressively with decreasing PBR for PBR6.2. The risk of critical illness was lowest when the PBR was between 4.6 and 5.5, and the risk increased gradually with decreasing PBR for PBR5.5. The DCA results revealed that the value of the PBR in predicting death was similar to that of the NEWS. In the DCA, the net benefit achieved by the NEWS ranged from 3% to 10% threshold probability, and the net benefit achieved by the PBR ranged from 4% to 10% threshold probability, with similar net benefits for the NEWS and PBR and 1% for both the PBR and the NEWS when the threshold probability was 7% (equivalent to correctly identifying 10 mortalities per 100 patients).
The PBR helps to predict the risk of mortality and critical illness in acutely ill patients, and its value in predicting mortality is similar to that of the NEWS.
by Guoping Dong, Guifen Ma
With the deepening of carbon peak and carbon neutrality (“dual carbon”) initiatives, corporate responsibility for environmental information disclosure has become imperative. However, due to imperfect laws and regulations, companies may have incentives to over-disclose environmental information, which could trigger stock price crashes. This study investigates the behavior of excessive environmental information disclosure among A-share listed companies in China. Using a sample of A-share firms that published social responsibility reports from 2015 to 2023, we employ threshold effect and quantile regression models to verify the presence of “greenwashing” components in environmental textual disclosures. A panel fixed-effects model is further adopted to examine the potential impact of excessive environmental information disclosure on stock price crash risk. The findings reveal that corporate environmental disclosures contain non-substantive, embellished content-indicative of greenwashing-and that such behavior significantly exacerbates stock price crash risk, particularly in manufacturing industries. The mechanism lies in the fact that excessive textual disclosure reduces information quality and transparency, thereby amplifying irrational investment behaviors. Conversely, effective environmental disclosure practices are shown to mitigate crash risk. Further analysis demonstrates that reducing ownership concentration, increasing managerial shareholding, and enhancing the role of independent directors in corporate governance can improve the quality of environmental disclosure and curb over-disclosure. This study provides a novel analytical perspective on environmental textual disclosure and offers practical insights for guiding rational investor decision-making.To identify predictors of nurses' perceived care quality, explore their understanding of high-quality care and propose improvement strategies to inform clinical practice.
A mixed-methods design, integrating quantitative data analysis and qualitative in-depth individual interviews.
Quantitative analysis used cross-sectional data from the 2017 Chinese Nursing Work Environment Survey (C-NWES). Chi-square tests and logistic regression were used to examine how demographic characteristics, work environment and occupational burnout predicted perceptions of care quality at hospital and unit levels. Qualitatively, 42 frontline nurses were interviewed in 2024 to explore their perceptions of care quality, predicting factors and improvement strategies in a post-pandemic context. Thematic analysis was applied to code and synthesise the interview data.
Quantitative analysis revealed that gender, education, workload, experience, work environment and burnout had differing impacts on nurses' care quality perceptions at hospital and unit levels. In-depth individual interviews revealed that nurses perceive high-quality care as patient-centred, predicted by factors such as human resources, occupational burnout, patient and family cooperation at the unit level and environmental and policies factors at the hospital level. Unit-level strategies included improving communication, team collaboration and leadership support, while hospital-level recommendations focused on welfare benefits, continuing education, flexible scheduling and resource optimisation. Through the mutual validation of quantitative analysis and in-depth interviews, this study revealed the multidimensional understanding and key predictors of care quality among frontline clinical nurses in China.
Work environment, occupational burnout and demographic factors significantly impact nurses' perceived care quality, highlighting the need for targeted organisational improvements at both unit and hospital levels to enhance care quality.
The findings highlight the importance of organisational interventions. Nursing managers should promote a positive work environment and mitigate burnout. Future research should develop testing models to explore the relationship between work environment and perceived care quality and validate their effectiveness.
No patient or public contribution.
To investigate, in a prospective cohort study, the association between cognitive impairment and cardiovascular disease (CVD), to quantify the extent to which uncontrolled risk factors mediate this association, and to explore whether the mediation effect varies across sex and age groups.
Prospective cohort study.
UK Biobank, a large population-based cohort study in the UK.
A total of 152 155 participants without prevalent CVD or dementia at baseline were included. The mean age was 56.3±8.2 years, and 44.0% were male.
Cardiovascular death and composite cardiovascular outcomes, assessed using Cox proportional-hazards models and mediation analyses.
During a median follow-up of 13.03–13.87 years, 1474 cardiovascular deaths and 21 518 composite cardiovascular outcomes were recorded. Participants with cognitive impairment (n=23 146; 15.2%) exhibited higher proportions of lifestyle, metabolic and psychological risks (p
Cognitive impairment is associated with increased risks of cardiovascular death and composite cardiovascular outcomes. Uncontrolled lifestyle, cardiometabolic and psychological risk factors partially mediate this association, highlighting the importance of comprehensive management to improve cardiovascular prognosis in this population.
To explore the perceived importance of essential Value-Based Healthcare (VBHC) and patient-centred care elements within operational military healthcare among wounded service members (WSM), military surgeons (MS) and medical commanders, and to identify preconditions that enable the delivery of patient-centred care and relevant medical outcomes during military operations.
A two-round Delphi study was conducted following the Accurate Consensus Reporting Document guideline. An initial list of 17 preconditions was developed through a narrative-style literature review and expert-panel discussion. Preconditions were rated on a four-point Likert scale (‘not important’ to ‘very important’) to reach consensus on ‘military-oriented’ preconditions for patient-centred trauma care.
An in-person expert-panel meeting and subsequent online Delphi surveys conducted between March 2020 and September 2022.
The expert panel consisted of Dutch military healthcare leaders and clinical specialists. A total of 30 participants completed both Delphi rounds, including 17 MS and commanding officers (Group 1) and 13 WSM (Group 2) with deployment experience in Uruzgan, Afghanistan, ensuring balanced representation of care providers, facilitators and recipients.
Primary outcome: identification of military-oriented preconditions essential for patient-centred and value-based trauma care. Secondary outcome: conceptual contribution to the future development of patient-centred outcome measures for military trauma populations.
Consensus was reached on 10 preconditions perceived as important or very important. While Group 1 prioritised operational readiness and procedural efficiency, Group 2 emphasised communication, shared decision-making and family involvement. Both groups rated informed consent, timely treatment registration and patient safety as the most critical elements, demonstrating convergence between logistic-oriented and patient-oriented perspectives.
Integrating VBHC principles into military medical doctrine can reconcile operational readiness with patient-centred care. The consensus-based preconditions identified in this study provide a foundation for developing measurable outcomes that reflect value for both patients and the military health system and can guide future VBHC implementation in trauma-related operational care.
To explore the levels of health-related functioning during pregnancy and postpartum and its association with non-severe maternal morbidities.
An observational longitudinal study.
A tertiary women’s hospital in urban China.
Pregnant women in late pregnancy were recruited via consecutive sampling. The Chinese version of the Women’s Outcome Instrument for maternal healthCarE instrument was applied to measure health-related functioning and maternal morbidities at 28–41.6 weeks of gestation and at 6 weeks postpartum. Main outcome measures included health-related functioning, physical symptoms, anxiety and depression.
Among the 624 participants, health-related functioning scores were significantly higher during late pregnancy than at 6 weeks postpartum (16.33±4.78 vs 14.40±3.65, p
Functional impairment is prevalent perinatally and associated interactively with maternal morbidities. Assessment of health-related functioning and the provision of targeted interventions are recommended to improve maternal health outcomes in the perinatal period and beyond.
FreshRSS 