Rare diseases (RDs) affect millions of people worldwide and present major challenges for research due to small patient populations, limited longitudinal data and the difficulty of capturing real-world disease manifestations. Digital technologies provide new opportunities to collect multimodal data directly from patients and their environments. In particular, video recordings, wearable-based physical activity monitoring and digital questionnaires can generate detailed, longitudinal information on symptoms, functional abilities and daily-life impact. The digital tools for rare disorders (DT4RD) protocol aims to develop and evaluate a digital framework that integrates these technologies to support data collection and analysis in RD research.

DT4RD will implement a technology-driven platform designed to collect and analyse multimodal patient-generated data. The protocol includes three main components: (1) structured video capture to document clinical signs and functional performance, enabling remote assessment and computational analysis; (2) continuous physical activity monitoring using wearable sensors to quantify mobility and daily activity patterns and (3) digital questionnaires to capture patient-reported outcomes and contextual information. These data streams will be integrated within a dedicated digital infrastructure supporting secure data collection, storage and analysis. This pilot study will be conducted with participants affected by rare neuromuscular diseases to evaluate the feasibility, usability and analytical potential of the platform as well as its ability to generate clinically relevant insights from multimodal digital data anchored to regular hospital visits.

The study was approved in France by the Comité de Protection des Personnes Sud-Est III on 21 February 2023 (National Number ID-RCB 2022-A02749-34). UK approval was granted by the Health Research Authority and Health and Care Research Wales on 4 March 2024 (IRAS project ID 331474). The protocol has been registered on ClinicalTrials.gov under the number NCT05798325. All participants will be provided with verbal and written information about the study and its procedures before providing written informed consent. Data will be anonymised and handled in accordance with GDPR, French CNIL regulations (MR-001) and applicable national data-protection requirements. Results will be communicated through peer-reviewed publications, conference presentations and lay reports.

NCT05798325.

A growing body of evidence supports prehabilitation in cancer patients, but the findings have been inconsistent. This overview aimed to identify, evaluate and summarise the effect of prehabilitation on the clinical outcomes of cancer patients.

Overview of systematic reviews.

PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library and the JBI Evidence Synthesis database (Joanna Briggs Institute, University of Adelaide, Australia; hosted on Ovid) were searched from inception to January 2025. The search was updated in May 2026, and no new articles were included.

We included systematic reviews of randomised controlled trials (RCTs) involving adult cancer patients with a clinically established diagnosis who received prehabilitation interventions prior to surgical treatment. We excluded abstract-only citations, narrative reviews and scoping reviews. Reviews were excluded if ≥50% of the included studies were postoperative interventions, or if preoperative subgroup data could not be extracted.

Two reviewers independently extracted data on participants’ characteristics, types of interventions, outcomes, synthesising methods and pooled anticipated absolute/relative effects for outcomes meta-analysed. Two reviewers assessed methodological quality using the A MeaSurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) tool and assessed the certainty of evidence for prehabilitation using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Overlap among included systematic reviews was quantified using the corrected covered area (CCA).

Twenty systematic reviews (137 RCTs and 18 941 participants) were included. Low- to moderate-certainty evidence indicated that prehabilitation may improve preoperative physical fitness (eg, 6-minute walk test, preoperative cardiopulmonary function, preoperative lung function), reduce surgical complications and shorten the length of hospital stay. None of the included systematic reviews demonstrated a statistically significant effect on preoperative handgrip strength, 30-day readmission, mortality, anxiety or depression. Findings regarding physical activity and quality of life remained inconsistent. Overlap among included reviews was slight (CCA=4.15%).

Low- to moderate-certainty evidence suggests that prehabilitation may improve preoperative physical fitness, reduce surgical complications and shorten the length of hospital stay in adult cancer patients undergoing surgery, whereas current evidence does not support a beneficial effect on 30-day readmission, mortality, quality of life or psychological status. Given the predominantly low-to-moderate certainty of the evidence and the methodological heterogeneity across the included systematic reviews, these findings should be interpreted with caution. Methodologically robust and transparently reported RCTs and systematic reviews are needed to strengthen the certainty of evidence and to inform clinical implementation of prehabilitation.

CRD 42024533214.

Respiratory syncytial virus (RSV) is an important viral pathogen in children, older adults and adults with certain high-risk conditions. In our prospective community-based cohort study of adults 50 years and older before the COVID-19 pandemic, the incidence of RSV acute respiratory infection (ARI) was 48.6 cases/1000 person-years (PY), which decreased to near zero during the COVID-19 pandemic. Our objective was to determine the incidence of RSV-ARI during the 2 years following the initial phase of the pandemic (2021–2022 and 2022–2023).

This is a community-based prospective cohort study.

Adults living in southeast Minnesota from October 2021 to September 2022 (year 3) and October 2022 to September 2023 (year 4).

Adults≥50 years (n=2500).

We calculated incidence and attack rates for RSV-ARI as primary outcome and reported hospitalisations, pneumonia and death following ARI as secondary outcome.

There were 2500 participants in the study with a mean age of 68.2 years (SD 9.3) at the start of year 3. Participants were predominantly female (60%), non-Hispanic white (96%) and residing in urban areas (76%). The incidence rate of RSV-ARI was 6.12/1000 PY (95% CI 3.42 to 10.09) in 2021–2022 and 16.40/1000 PY (95% CI 11.66 to 22.42) in 2022–2023. We noted higher attack rates of RSV-ARI during the winter months. There were no hospitalisations, pneumonia or deaths within 30 days of RSV-ARI.

Compared with the period before the COVID-19 pandemic, RSV-ARI incidence was lower in both 2021–2022 and 2022–2023 periods. In 2022–2023, the incidence increased 2.7-fold compared with the 2021–2022 period. The observed incidence rates, particularly the significant increase in the most recent season, underscore the continued public health relevance of RSV-ARI and support the rationale for ongoing RSV vaccination efforts to mitigate its overall burden in the population.

Gynaecological cancers increasingly affect women of reproductive age, necessitating fertility-sparing treatments that balance oncological safety with reproductive potential. However, the long-term impact of these treatments on survivorship—specifically regarding sexual function, quality of life (QoL) and reproductive outcomes—remains understudied. LIFE-Repro is a prospective multicentre cohort study designed to evaluate these impacts in young female cancer survivors.

Between 2023 and 2027, eleven tertiary referral hospitals in Korea will recruit 200 patients aged ≤45 years with gynaecological cancers who have undergone fertility-sparing treatment. Participants will undergo baseline assessments followed by prospective follow-ups every 6 months. At each visit, patient-reported outcomes assessing sexual function, QoL and health status will be collected using a mobile application developed by the research team. The primary endpoint is the incidence of post-treatment sexual dysfunction measured by the Female Sexual Function Index–Korean version. Secondary endpoints include longitudinal changes in QoL, cancer recurrence, survival, pregnancy rates, live birth rates and premature menopause.

The study protocol was approved by the Institutional Review Board of Korea University Guro Hospital (2024GR0484). Results will be disseminated through peer-reviewed journals and conference presentations.

KCT0009578.