Conectar
by Kexin Wang, Chao Ban, Liming Zhao, Haiyan Ruan, Ziqiong Wang, Yi Zheng, Sen He
BackgroundThe study aimed to investigate the associations between cooking oils and survival outcomes in a nationwide, community-based, prospective cohort study of older adults in China.
MethodsA total of 5372 older participants (median age: 85.0, inter-quartile range [IQR] age: 77.0–93.0; male: 46.1%) from the 2014 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2014 were included, with follow-up until 2018. The exposure was cooking oils, including vegetable oils and lard, and outcomes were overall survival (OS) and disease-specific survival (i.e., cardiovascular disease [CVD]-specific survival and non-CVD-specific survival). Accelerated failure time (AFT) models were used to analyze the associations between cooking oils and study outcomes.
ResultsDuring a median follow-up of 3.5 years (IQR: 2.4–4.2 years), 2064 (38.4%) deaths were recorded, including 433 CVD deaths, 1229 non-CVD deaths, and 402 deaths with unknown causes. Kaplan-Meier analysis revealed cooking with lard was associated a higher CVD-specific survival probability than vegetable oils (93.9% vs. 88.2%, log-rank p Conclusions
Cooking with lard was associated with significantly longer CVD- specific survival compared to vegetable oils among older adults in China.
by Xiangxiang Kong, Lujie Karen Chen, Sancharee Hom Chowdhurry, Ryan B. Felix, Shiming Yang, Peter Hu, Neeraj Badjatia, Jamie Erin Podell
Paroxysmal sympathetic hyperactivity (PSH) is a syndrome that occurs in a large subset of critically ill traumatic brain injury (TBI) patients and is associated with complications and poor recovery. PSH is defined by recurrent episodic vital sign elevations in the appropriate clinical context. However, standard diagnostic criteria rely heavily on subjective judgment, leading to challenges and delays in recognition, monitoring, and management. The objective of this study was to develop automated PSH detection and quantification tools that exclusively utilize objective bedside continuous vital sign data. Using a cohort of 221 critically ill acute TBI patients with at least 14 days of continuous physiologic data (of which 107 were clinically diagnosed with PSH) we developed a high-resolution clinical feature scale based on established PSH-Assessment Measure criteria and two artificial intelligence-based episode detection models including an expert system approach and a machine learning model approach, using a clinician-annotated case example as ground truth. For the episode detection methods, PSH was quantified as the number, duration, and overall temporal burden of detected episodes. To evaluate performance, we compared quantifications across PSH cases and controls and explored precision and recall. All three methods demonstrated initial face validity to delineate PSH cases from non-PSH TBI controls. Future optimization and implementation of the described computational frameworks with real-time patient data could improve the standard monitoring and management of this challenging clinical syndrome.Despite the minimally invasive nature of video-assisted thoracoscopic surgery (VATS), moderate-to-severe postoperative pain remains frequent and impairs recovery. Intravenous lidocaine possesses multimodal analgesic, antihyperalgesic and anti-inflammatory properties that may improve pain control and functional outcomes, but robust evidence in thoracic surgery is lacking. Moreover, its potential to attenuate neuropathic pain, a key component of chronic post-thoracic pain syndromes, has not been adequately investigated. This trial will determine whether continuous perioperative intravenous lidocaine infusion improves recovery, reduces acute pain intensity and prevents the development of neuropathic pain after VATS.
This single-centre, randomised, double-blind, placebo-controlled trial will enrol 84 adult patients undergoing elective VATS. Participants will be randomised (1:1) to receive either intravenous lidocaine (bolus 1 mg/kg at induction followed by continuous infusion at 1.5 mg/kg/hour intraoperatively and postoperatively for 24 hours) or matched normal saline postoperatively, with identical intraoperative management in both groups. The primary outcome is the incidence of moderate-to-severe movement-evoked pain at 24 hours postoperatively. Secondary outcomes include pain at 48 and 72 hours, opioid consumption, pulmonary complications, sleep quality, quality of recovery, neurocognitive outcomes and chronic neuropathic pain at 3 months. Analyses will follow the intention-to-treat principle.
The study protocol was approved by the Institutional Review Board of Tongji Hospital (Reference No. TJ-IRB202509102) and registered in the Chinese Clinical Trial Registry (ChiCTR2500111163). Written informed consent will be obtained from all participants. Results will be submitted to peer-reviewed journals and academic conferences.
ChiCTR2500111163.
There is a significant need for trials that evaluate the treatment of University of Texas (UT) grade 2 and 3 diabetic foot ulcers (bone, joint, or tendon exposed wounds). We undertook a trial looking at the effect of intact fish skin graft (IFSG) on these deep and difficult-to-heal ulcers. 262 patients Intent to Treat (ITT) patients with UT grade 2 and 3 DFUs were randomised to receive intact fish skin graft (IFSG) or a standardised treatment (SOC) that adhered to the International Working Group on the Diabetic Foot (IWGDF) guidelines. The secondary endpoints that were measured included wound area reduction (WAR), healing rates at 20 and 24 weeks; closure rates by UT grade, perfusion, quality of life, pain reduction and IFSG safety. We report ITT (all randomised) (mITT previosly reported) The (WAR) at 12 weeks was 65.53% for IFSG versus 30.82% for SOC (p = 0.007). UT 2 wounds (60% of total) exhibited a closure rate of 47% versus 23% at 16 weeks for IFSG versus SOC (p = 0.0033). Target wound infections were comparable (39 vs. 37) and major outcomes were comparable during the 24 week period (target-limb amputations 8% vs. 7%). Time-to-heal favoured IFSG (restricted mean to 24 weeks 17.31 vs. 19.37 weeks; KM/log-rank significant; Cox HR 1.59). The in the treatment of deep complex diabetic foot wounds the addition of IFSG significantly improved the number of patients with total wound closure as well as the time to wound closure without increased risk of complications. This improvement in total wound closure and time to wound closure was noted across prior amputation status, quality of perfusion, and UT grade.
To classify Italian home care models based on structural characteristics, process factors and stakeholder perceptions.
This is a secondary analysis of the AIDOMUS-IT multicentre cross-sectional study, conducted in Italy between July 2022 and December 2023.
Data were collected via online surveys completed by 33 Local Health Authority Nursing Directors, home care nurses and patients. Hierarchical cluster analysis was used to classify different organisational models based on structural and process-related factors. Nurses' and patients' perceptions of care were described for each identified cluster.
The analysis identified three distinct organisational home care models: The ‘multidisciplinary model’, in which nurses reported high dissatisfaction due to organisational complexity and excessive workloads. In the ‘nurse-centred model’, characterised by publicly employed nurses, strong leadership, and a supportive work environment, patients reported high levels of satisfaction. The ‘performance-based model’, which operated with a lower nurse-to-patient ratio, reduced service hours, and greater reliance on external professionals. Nurses in this model reported high job satisfaction but also a greater intention to leave, while patient satisfaction was lower.
This study underscores the importance of leadership, resource management, and a supportive work environment in influencing both job satisfaction and patient outcomes in home care settings.
Policymakers could use these findings to refine care models and improve service delivery.
Limited research has examined the organisational structures of home care services, which are important for professionals' organisational well-being, patient safety, and quality of care. This study identified three distinct organisational home care models that could be used to refine care approaches and improve service delivery.
This study respects the EQUATOR guideline for observational studies (STROBE).
This study did not include patient or public involvement in its design, conduct, or reporting.
The financial burden of diabetes-related foot disease (DFD) in Australia remains inadequately understood. This study aimed to explore the direct costs and resource utilisation associated with DFD management, incorporating insights from healthcare professionals actively involved in the treatment of individuals with DFD. A three-step approach informed the economic evaluation. First, a systematic review identified existing Australian cost data. Second, semi-structured interviews with healthcare professionals generated estimates of resource utilisation and addressed data source gaps. Third, a Markov model evaluated the costs of DFD management at both the individual and health system levels. The model included direct costs related to hospital admissions, outpatient/community visits, medications, diagnostics, wound care, offloading devices and amputation-related expenses. The average annual cost per patient for DFD management was AUD $44 691. The primary cost drivers were hospital admissions ($21 566), outpatient/community visits ($14 212) and wound debridement ($5918). The total cost to the Australian healthcare system in 2026 is estimated at AUD $3.08 billion, with projections reaching AUD $3.81 billion by 2030. This study provides essential cost estimates for DFD management at both the individual and health system levels, offering critical insights for policymakers seeking to optimise service delivery and improve patient outcomes in Australia.
Keloids are chronic fibroproliferative skin disorders with high recurrence rates and limited treatment options, yet reliable diagnostic biomarkers are lacking. Current classification systems rely heavily on clinical observation, underscoring the need for objective, noninvasive tools. In this exploratory study, serum-based 1H nuclear magnetic resonance (NMR) measurement combined with short-time Fourier transform (STFT) for time-frequency analysis was performed, followed by principal component analysis (PCA), to investigate potential patient subgroups. Serum samples from 29 patients were analysed and PC1 scores suggested two potential patient subgroups. Retrospective analysis showed that these subgroups differed primarily in keloid aetiology: one group predominantly included cases arising from unclear or minimal causes (e.g., acne, folliculitis), whereas the other comprised cases following clear traumatic events (e.g., surgery). Although most clinical variables showed no significant differences, significant differences in aetiology and Japan Scar Workshop Scar Scale (JSS) scores support the biological relevance of this separation of subgroups. These findings suggest that the time-frequency features of NMR signals from serum samples capture systemic characteristics associated with keloid pathophysiology. If validated in larger cohorts, this approach may serve as a noninvasive adjunct to clinical assessment and lay the foundation for objective patient stratification and precision-guided treatment strategies.
Thromboangiitis obliterans (TAO) is a rare, tobacco-associated vasculitis that primarily affects the distal extremities of young males. In advanced stages, it often leads to chronic limb ischemia with ischemic ulceration, culminating in amputation. Data on risk factors for reamputation in this population remain limited. This study aimed to identify clinical, radiological and microbiological predictors of reamputation in patients with TAO-related foot ulcers undergoing amputation. A retrospective cohort study was conducted on 25 patients (31 limbs) with Fontaine stage IV TAO ulcers who underwent lower extremity amputation between January 2021 and December 2024. Patients were stratified into two groups based on whether they underwent repeat amputation (Group 1) or a single procedure (Group 2). Preoperative magnetic resonance imaging, intraoperative tissue cultures and laboratory data were evaluated. Smoking status, hospitalisation metrics and adjunctive therapies were recorded. Statistical analysis included Mann–Whitney U, Fisher's exact test, ROC curve analysis and multivariate logistic regression. Seventeen limbs required reamputation. Persistent smoking was observed in 100% of Group 1 compared with 58.4% of Group 2 (p = 0.015). Positive intraoperative cultures were significantly more frequent in Group 1 (64.7% vs. 21.4%; p = 0.029), with all multidrug-resistant organisms confined to this group. Length of hospital stay was significantly longer in Group 1 (25.2 ± 6.4 vs. 15.8 ± 5.3 days; p = 0.001). ROC analysis identified > 19 days of hospitalisation as a threshold for reamputation risk (AUC = 0.781; p = 0.018). Multivariate analysis identified three independent predictors of reamputation: persistent smoking (OR: 5.2, 95% CI: 1.2–22.8; p = 0.015), positive intraoperative culture (OR: 4.7, 95% CI: 1.1–20.1; p = 0.041), and hospitalisation longer than 19 days (OR: 6.5, 95% CI: 1.4–29.4; p = 0.018). Reamputation in advanced-stage TAO is strongly associated with modifiable factors, particularly ongoing tobacco use, Gram-negative infection and prolonged hospital stay. Early identification and targeted intervention addressing these variables may improve limb preservation outcomes in this high-risk population.
Rising patient numbers and limited resources are creating a challenging environment for healthcare providers recently. Anaesthesiologists are also increasingly faced with complex situations, requiring high adaptability in the operating room. To enhance team adaptability during emergencies, effective communication methods are essential. This study aimed to compare the impact of mobile phones and intercoms on the response time and effectiveness of anaesthesiologist teams in emergency situations.
Prospective, observational and simulation study.
Anaesthesiology and Critical Care, Yokohama City University Medical Center, Yokohama, Japan.
This study, conducted at Yokohama City University Medical Center (Yokohama, Japan), evaluated how communication methods (intercoms vs mobile phones) impact the efficiency of anaesthesiologists in the simulation setting. Two scenarios were tested: (1) retrieving a video laryngoscope during a difficult intubation and (2) gathering support during cardiac arrest.
Outcomes measured included time to secure equipment, time for assistance to arrive and staff numbers gathered. The Wilcoxon signed-rank test was used to compare the outcomes between the intercom and mobile phone groups.
In scenario 1, the time to secure the video laryngoscope was significantly shorter with intercom use compared with mobile phones (intercom vs mobile phone, median (IQR): 29 (25–33) s vs 50 (39–62) s; p=0.013, effect size 20 (95% CI 7 to 31)). In scenario 2, the time from the request for assistance until the first supporting staff member reached the operating room was significantly shorter in using the intercoms (intercom vs mobile phone, median (IQR): 16 (14–18) s vs 35 (31–38) s; p=0.04, effect size 17 (95% CI 6 to 24)), and more personnel were available in the intercom group (intercom vs mobile phone, median (IQR): 3 (3–3.5) persons vs 2 (1–2) persons; p=0.04, effect size 1.5 (95% CI 1 to 3)).
Real-time information sharing through intercoms improved the ability of the anaesthesiologist team to respond more rapidly and effectively in emergency situations, enhancing overall team adaptability. This approach may improve patients’ outcomes by shortening response times and increasing team coordination.
To explore the lived experiences and daily interactions of older couples living with multimorbidity.
A descriptive-interpretive qualitative study based on a generic interpretive description framework.
A total of 20 dyads were recruited using a purposive sampling strategy, and 24 semi-structured in-depth interviews were conducted between May 2023 and January 2025. Reflexive thematic analysis was used to analyse data.
Four overarching themes were generated: (1) dynamic relationship structures; (2) diverse interaction patterns; (3) double burdens; and (4) double resilience. Dynamic relationship structures occurred in dyadic and triadic forms. Diverse interaction patterns involved independence, interdependence and dependence. Double burdens manifested as physical toll, financial hardship, emotional contagion and perceptual misalignment, whereas double resilience was reflected in the nudge effect, emotional resonance and promotion of family ownership of health.
This study adopted a dyadic perspective to explore the experiences and interactions of older couples living with multimorbidity. The caring dynamics and blurred roles of patient and care partner deviate from the traditional unidirectional, linear model of ‘one person caring for the other’. Formal or informal caregiving support from third parties, as well as the nudge effect and emotional resonance between spouses, may help orient older couples as they navigate the challenges associated with multimorbidity.
Our findings indicate that community nurses can play a proactive role in identifying older couples living with multimorbidity through routine care attendance and assessments, enabling early recognition of health management needs. Geriatric nurses can leverage insights into couples' interaction patterns to tailor more effective care plans at different stages of illness, monitor emerging risks and identify optimal timing for third-party support. By facilitating a responsive triadic network, nurses can help ensure continuous and sustainable health care.
Adhered to SRQR guidelines for qualitative research.
This study did not include patient or public involvement in its design, conduct, or reporting.
This study aims to explore the views and experiences of people with dementia, informal caregivers and professionals regarding eating and drinking difficulties.
A qualitative systematic review was conducted.
The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used to conduct this systematic review. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the data were thematically synthesised using Thomas and Harden's three-stage method.
Six electronic databases (PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL and PsycINFO) were searched from their respective inception dates to August 2025 to identify relevant studies.
Thematic analysis of the 16 included studies identified four key themes: (1) Physiological and psychological changes in people with dementia and caregivers; (2) factors influencing eating and drinking in people with dementia; (3) needs and recommendations for people with dementia, informal caregivers and professionals; (4) selection of eating methods for end-stage people with dementia.
Eating and drinking difficulties affect the well-being of both patients and caregivers. A good dining environment improves mealtime pleasure but demands caregivers' time and energy. All parties emphasised the importance of effective communication. In end-stage dementia, professional assistance is crucial for enteral nutrition decisions.
Collaboration among patients, caregivers and professionals is vital for creating tailored nutritional plans and improving mealtime environments, thereby enhancing nutritional intake. In advanced dementia, providers must provide balanced information on comfort feeding versus enteral nutrition to aid decision-making.
What problems were addressed in this study? This study addressed the lack of a consolidated, tri-perspective understanding of eating and drinking difficulties in dementia care settings. What are the main findings? Four key themes were identified: physiological and psychological changes, influencing factors, stakeholder needs and end-of-life decision-making. Where and on whom will the research have an impact? This will impact care practices for people with dementia and inform the training and support of informal caregivers and healthcare professionals.
by Peiling Zuo, Huanhuan Zhu, Chunying Sun, Xiaohan Ma, Sheng Chen, Rong Tang, Tong Wu, Ding Zhang, Xiao Tang, Wenquan Lv, Wenzhong Chen, Xiawei Wei, Encun Hou, Minsheng Wu, Minghe Jiang
BackgroundEvidence indicates that the Endothelial Activation and Stress Index (EASIX) is a predictor of mortality in endothelium-related conditions; however, its association with mortality risk in atrial fibrillation (AF) remains uncertain. Accordingly, this study examines the relationship between EASIX and mortality risk among patients with AF.
MethodsThis retrospective analysis utilized data from the Medical Information Marketplace in Intensive Care IV (MIMIC-IV) database, which includes critically ill patients diagnosed with AF. To examine the association between EASIX scores and mortality, Kaplan–Meier survival analysis, Cox proportional hazards models, and restricted cubic spline regression were applied to evaluate the relationship between EASIX and all-cause mortality. Subgroup analyses were conducted to explore potential interactions with key patient characteristics, and sensitivity analyses were performed to further confirm the robustness of the results.
ResultsA total of 3,193 patients were included in the analysis. KM survival analysis showed that elevated EASIX levels were associated with a higher risk of both in-hospital and ICU mortality. After adjusting for potential confounders, increased EASIX levels remained significantly associated with in-hospital mortality [HR, 1.09 (95% CI 1.03, 1.15), P = 0.0002] and ICU mortality [HR, 1.10 (95% CI 1.04, 1.17), P = 0.0002]. Stratified analyses revealed a significant interaction between sepsis, respiratory failure, and EASIX in relation to both in-hospital and ICU mortality. To evaluate the robustness of the findings, a sensitivity analysis was performed. After additionally adjusting for metoprolol and heparin as covariates, patients in the highest EASIX group continued to demonstrate the greatest mortality risk: the HR for in-hospital death was 2.08 (95% CI: 1.51–2.85), and the HR for ICU death was 1.83 (95% CI: 1.21–2.65).
ConclusionElevated EASIX levels correlate with higher mortality rates, underscoring its potential as an accessible tool for identifying high-risk patients and informing clinical decisions. However, further studies are needed to explore the underlying mechanisms and validate its applicability across diverse patient populations.
by Mireille Jasmin, Geneviève Piché, Aude Villatte, Andrea Reupert, Marie-Ève Clément, Anne Dorothee Müller, Marianne Fournier-Marceau, Darryl Maybery, Marie-Hélène Morin, Stéphane Richard-Devantoy
BackgroundParenting responsibilities can be particularly challenging for patients receiving mental health services, often resulting in a range of negative impacts on children. Incorporating a family-focused approach into the usual care of parents with mental illness has been recommended to promote patient recovery while supporting the well-being of children and the entire family unit. This study aimed to document the family-focused practices undertaken by psychiatrists working with parents who have a mental illness and to explore potential facilitators and barriers to these practices.
MethodsA sequential explanatory mixed-method design was used, combining an online survey and individual interviews. Family-focused practices were reported by 27 psychiatrists through the French version of the Family-Focused Mental Health Practice Questionnaire. Follow-up qualitative individual interviews were conducted with 5 psychiatrists. Item-by-item analysis of the quantitative data was performed, followed by a thematic analysis of the qualitative data, integrating findings from both sources.
ResultsAlthough psychiatrists acknowledge their patients’ parenting role, most are reluctant to provide further support. Key barriers to family-focused practice include the predominantly individual-focused nature of psychiatric care, stigma, consent issues, and limited collaboration between adult and child services. Facilitators include psychiatrists’ professional autonomy, personal experience, and confidence in conducting family meetings.
ConclusionPsychiatrists can play a pivotal role in identifying, acknowledging, and providing appropriate support to parents with mental illness and their families, including children. Developing comprehensive guidelines and targeted training is essential to equip psychiatrists with effective strategies for addressing parenting challenges in patients with complex mental health issues. Additionally, psychoeducational resources for children should be incorporated. Implementing these initiatives may lead to more compassionate, targeted care and improved outcomes for parents and their families.
To explore the relationship between sleep and cognitive frailty in older adults.
A systematic review and meta-analysis.
The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.
Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.
This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.
This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.
The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.
No patient or public contribution.
To explore how critical care nurses access, negotiate and apply knowledge in high-pressure clinical environments, focusing on organisational, cultural and leadership factors influencing evidence-based practice implementation in acute hospital settings.
A focused ethnographic collective case study was conducted across two contrasting critical care units in England.
Methods included non-participant observation (56 sessions), semi-structured interviews (36 participants) and document review. Spradley's Developmental Research Sequence guided data generation and analysis. Data were collected over an eight-month period (February to September 2022).
Five major themes were identified: sources of knowledge and acquisition strategies; institutional and hierarchical influences on knowledge use; role of experiential knowledge and clinical intuition; challenges to evidence-based practice implementation; and strategies for integrating knowledge into practice. Organisational structures, leadership engagement, mentorship and access to updated digital resources were key enablers of evidence-based practice. Barriers included workload pressures, inconsistent guideline dissemination and hierarchical cultures. Adaptive blending of formal evidence, clinical experience and intuition characterised effective knowledge negotiation at the bedside.
Knowledge use in critical care nursing is a dynamic, relational process shaped by leadership, organisational culture and systemic pressures. The availability of evidence alone is insufficient; visible leadership, peer learning, protected educational time and valuing of experiential knowledge are critical to embedding evidence-based practice into routine practice.
Strengthening organisational systems, investing in nurse manager development, expanding simulation-based learning and legitimising experiential knowledge are vital strategies to enhance evidence-based critical care.
This study provides actionable insights for healthcare leaders, educators and policymakers seeking to optimise evidence-based practice adoption in high-acuity clinical environments and improve patient outcomes.
The Consolidated Criteria for Reporting Qualitative Research checklist guided reporting.
Patients and the public were not involved in the design, conduct, reporting or dissemination of this research.
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.
The Infant Gut Bacterial Study in Nigeria (INBUGS-NG) investigates how delivery mode, antibiotic exposure, feeding practices and environmental factors shape gut microbiome development and acquisition of antibiotic resistance genes (ARGs) during the first year of life in northern Nigeria.
Between February and July 2024, 90 mother–infant dyads were enrolled at a tertiary hospital in Kano city, Nigeria. This was a prospective longitudinal cohort with follow-ups at 10 scheduled time points: days 0, 1, 3, 5, 7, 14, 28, 90, 180 and 365. We also intensified stool sampling after infant antibiotic administration, enabling dense early-life sampling. To date, the cohort has contributed 480 infant stool samples, 232 maternal rectal swabs, 254 breast milk samples and 806 environmental samples (total 1772). In parallel, socio-demographic, clinical and cultural data were collected using Research Electronic Data Capture (REDCap) and household visit diaries.
Baseline data show that 84/90 mothers (93.3%) received postpartum antibiotics, and 26/90 infants (28.9%) received antibiotics within the first 3 months of life. Only 8% of infants were exclusively breastfed, with early water supplementation common. Caesarean deliveries accounted for 25% of births, and the mean gestational age was 38.5 weeks. Across the cohort, high retention was achieved, and the study has generated a unique long-read metagenomic resource from an African infant population, with analyses ongoing.
Shotgun long-read metagenomic sequencing (Oxford Nanopore) will enable strain-level and plasmid-level profiling of microbial communities and ARGs. Planned analyses include associations between early-life exposures and resistome dynamics, as well as cross-cohort comparisons with a parallel study in Pakistan. Follow-up will continue through 12 months.
Palliative care supports the physical, emotional, social and spiritual needs of people with serious life-limiting illness. Future research must align with the priorities of people approaching the end of their lives, and those close to them.
To undertake a refresh of the James Lind Alliance Palliative and End of Life Care Priority Setting Partnership, to identify and prioritise areas for future research.
The James Lind Alliance process was applied, between May 2023 and February 2025. An initial online survey collected areas for future research from participants. These were synthesised into a long list of questions and shortlisted through a second online survey. Final ranking of priorities was achieved using an adapted Nominal Group Technique within a prioritisation workshop.
People living with serious life-limiting illnesses, carers, friends and family members supporting them, bereaved people, health and social care professionals, volunteers working in palliative and end-of-life care and members of the public.
1032 and 626 responses were received to survey 1 and 2, respectively. 20 people with lived and professional experience attended the prioritisation workshop. An updated list of 24 priorities for palliative and end-of-life care research was produced.
The priorities reflect the range of issues shaping end-of-life experiences and serve as a call to action for researchers and funders.
FreshRSS 