Clinical trials have produced inconclusive results regarding the optimal glucose range for a patient with sepsis in the intensive care unit (ICU) receiving insulin treatment.

To investigate the optimal glucose range in patients with sepsis in the ICU independent of confounding covariates.

Targeted trial emulation of glucose ranges using causal inference targeted maximum likelihood estimation and longitudinal mixed-effects models combined with survival models.

Single-centre, academic referral hospital in Boston, Massachusetts, USA.

Adults fulfilling sepsis 3 criteria with at least three glucose readings and insulin treatment from the Medical Information Mart for Intensive Care (MIMIC)-IV database (2008–2019).

Five predefined glucose distributions with means at 100, 130, 160 (baseline), 190 and 220 mg/dL mimicking current guidelines’ recommendations (140–180 mg/dL).

The primary outcome was in-hospital mortality. Modified counterfactual treatment-policy risks across distinct time-weighted glucose ranges were estimated.

Of 73 181 eligible patients, 8002 patients with a median age of 66 years (41% women, 67% white ethnicity, 57% diabetes) were included. There was a U-shaped curve between glucose range and mortality in patients without diabetes, but overall, this association was not significant (mean glucose at 100 mg/dL with 21% mortality and mean glucose at 220 mg/dL with 26% mortality, p-for-trend 0.26). Mortality was lowest at 17%, with mean glucose between 130 and 160 mg/dL. Hypoglycaemic events (

Our data suggest a U-shaped association of glucose and mortality with an optimal average glucose between 160 and 190 mg/dL. These results confirm current guideline recommendations. Together with recent results from randomised controlled trials, intensivists should aim for a liberal glucose range in most patients.

Family caregivers of patients undergoing haemodialysis experience significant psychological, social and physical challenges that contribute to caregiver burden and reduced resilience. Strengths-based empowerment programmes, combined with the teach-back method, may help reduce burden and enhance resilience. This protocol describes a randomised controlled trial designed to evaluate the effect of such an intervention among family caregivers of haemodialysis patients.

This parallel-group randomised controlled trial will enrol 78 family caregivers of haemodialysis patients in Bojnurd, Iran, using a convenience sampling method. Participants will be randomised into intervention and control groups through block randomisation with a block size of four. The 10-week intervention will include 60 Short Message Service messages, five fortnightly teach-back phone calls and four structured inperson reinforcement sessions. The control group will receive the standard educational support provided by the dialysis unit. Outcomes will be measured at baseline, immediately post intervention and at the end of 8 weeks follow-up using the Caregiver Burden Questionnaire for Hemodialysis Caregivers and the Connor-Davidson Resilience Scale. A blinded statistician will perform repeated measures Analysis of Variance (ANOVA) for the analysis.

The participants will be assured that their data will remain confidential. Written informed consent will be obtained from the participants. The research proposal has been prospectively registered in the Iranian Clinical Trial Registration Centre (IRCT20250109064329N1; Date of full registration: 18 February 2025) and approved by the Ethics Committee of North Khorasan University of Medical Sciences (code: IR.NKUMS.REC.1403.128). All methods will be carried out in accordance with relevant guidelines and regulations. Findings will be disseminated to participants via a lay summary, to healthcare providers, policymakers and stakeholders through reports and presentations and submitted for publication in peer-reviewed journals. Deidentified participant data will be available from the corresponding author on reasonable request, in accordance with institutional policies and ethical approval.

IRCT20250109064329N1.

To evaluate the associations between anthropometric indices and components of metabolic syndrome (MetS), including blood pressure, fasting blood sugar (FBS), triglycerides, high-density lipoprotein cholesterol and waist circumference (WC) in Iranian adults.

Cross-sectional analysis of baseline data from a population-based cohort.

Fasa adults’ cohort study, a rural community-based cohort in Fars province, Iran.

A total of 1550 adults aged 35–70 years with MetS, identified from among 10 118 cohort participants using the National Cholesterol Education Programme Adult Treatment Programme III criteria.

The anthropometric indices include abdominal volume index (AVI), a body shape index (ABSI), atherogenic index of plasma (AIP), body roundness index (BRI), body adiposity index (BAI), conicity index, ponderal index and visceral adiposity index (VAI).

Participants (56.1% female) with a mean age of 49.8±9.5 years. AVI was significantly associated with systolic blood pressure (SBP) (β=0.010, p

Anthropometric indices, including VAI, AIP, BAI, BRI and AVI, exhibit significant associations with key components of MetS in Iranian adults, particularly blood pressure, glycaemic markers and central adiposity. Among these, BAI showed the strongest correlation with MetS parameters, while ABSI displayed the weakest.