Conectar
To examine the relationship between job stress and job burnout among healthcare professionals (HPs) in a tertiary hospital in East China following the adjusted COVID-19 prevention policies and to explore the effects of demographic and work environment factors on burnout and its subtypes (emotional exhaustion (EE), depersonalisation (DP), personal accomplishment (PA)).
Cross-sectional, using a questionnaire-based survey method.
A tertiary hospital located in Qingdao, East China.
A total of 434 HPs were included, with 138 men (31.8%) and 296 women (68.2%); the mean age was 35.05±7.96 years. Participants included physicians (37.1%), clinical nurses (49.5%), clinical pharmacists (3.9%), medical technicians (5.1%) and administrative staff (4.4%). Demographic factors (age, sex, marital status, education level, professional title, length of employment, income) and work-related factors (weekly working hours, sleep duration) were collected.
No specific interventions were implemented; this was an observational study focusing on the burnout assessment and associated factors.
Primary outcomes: burnout levels assessed via the Chinese version of the Maslach Burnout Inventory—Human Services Survey (MBI-HSS), including three subscales: EE (9 items), DP (5 items) and PA (8 items). Severe burnout was defined as meeting ‘high-level’ criteria for all three subscales (EE ≥27, DP ≥10, PA ≤33).
Secondary outcomes: demographic (sex, professional role, length of employment) and work-related (weekly working hours, daily sleep duration) factors associated with burnout.
Among 434 HPs, 74 (17.1%) experienced severe burnout. The median scores of MBI-HSS subscales were 17 (IQR: 9–27) for EE, 3 (IQR: 0–7) for DP and 37 (IQR: 27.75–43) for PA. Multivariate logistic regression showed that: nurses had a higher risk of high EE than physicians (OR=2.86, 95% CI: 1.32 to 6.21, p40 hours (OR=2.30, 95% CI: 1.32 to 3.99, p
A high prevalence of severe burnout (17.1%) was observed among HPs after COVID-19 policy adjustment. Key risk factors include being a nurse, long working hours (>40 hours/week), short sleep duration (
Patients’ sense of gain experience (PSGE) is the comprehensive feeling throughout the treatment process, which is a critical benchmark for evaluating comprehensive medical and health system reform in China. This study aims to assess the current status of PSGE in public hospitals and identify important associated factors, providing evidence-based recommendations for improving healthcare services.
This was a cross-sectional study conducted from October to November 2023.
A total of 14 public hospitals in Foshan, Guangdong Province, China.
There were 3223 responses, including 1592 from outpatients and 1631 from inpatients.
PSGE was assessed across five domains: time accessibility, service accessibility, cost affordability, patient participation and efficacy predictability. Participants were also asked to provide an overall rating of the PSGE.
The overall score for PSGE was 4.47±0.53 (mean±SD), with service accessibility receiving the highest score (4.68±0.50) and affordability the lowest (4.17±0.86). Secondary hospitals scored an overall PSGE of 4.55±0.50, while tertiary hospitals scored 4.42±0.54. Key factors associated with PSGE were overall satisfaction (β=0.164, p
This study found that patients reported a positive PSGE with service accessibility but reported a less positive PSGE with cost affordability. A tier-based disparity was evident, with secondary hospitals outperforming tertiary hospitals in overall PSGE outcome. Stronger PSGE was positively associated with higher scores in overall satisfaction, treatment satisfaction, satisfaction with medical reforms, patient loyalty and hospital reputation. Demographic and institutional factors, such as hospital level, patient type and household registration, were associated with the PSGE. Efforts can be focused on enhancing clinicians’ willingness and competence in discussing treatment costs during clinical encounters. It is essential for policymakers to address disparities in healthcare experiences among patient groups across hospital tiers to advance equitable, patient-centred systems.
Cancer remains a major public health concern worldwide. Patient navigation, developed in the 1990s to address disparities in cancer outcomes, aims to guide patients through the complex healthcare system and improve access to timely, quality care. Despite its proven benefits, little is known about the implementation or impact of patient navigation programmes in African settings.
This scoping review aims to map the current evidence on components, procedures, outcomes and impact, as well as barriers and challenges to implementation of patient navigation programmes in cancer care across Africa.
This scoping review will follow Arksey and O’Malley’s scoping review framework, as further developed by Levac et al. A systematic search will be conducted across PubMed, African Journals Online and Google Scholar to identify relevant studies published from database inception to the date of the final search, using a combination of relevant keywords and MeSH terms. Eligible studies must be reported in English, have been carried out in Africa, involved patients diagnosed with cancer or navigating the cancer care continuum, and report on the description, implementation or evaluation of patient navigation programmes. Screening will be managed with Rayyan and carried out through a two-stage process: screening by titles and abstracts, then by full-text screening based on the prespecified inclusion and exclusion criteria. Data will be extracted into a structured Excel spreadsheet and synthesised using qualitative content analysis to identify programme characteristics, outcomes, barriers and implementation challenges.
This scoping review does not require ethical approval. Our findings will be published in a peer-reviewed, open-access journal on completion.
Multiple sclerosis (MS) is a common autoimmune illness that causes inflammation, demyelination and neurological damage. Symptom relief and immunotherapy are part of the treatment, but several healthcare barriers significantly influence outcomes and quality of life.
This study aimed to assess different aspects among patients with MS, such as their knowledge of the disease, access to care, medications’ beliefs and depression, and to evaluate any correlations between these variables and their impact on the presence of depression.
A cross-sectional study was conducted from May 2024 to October 2024 at Al-Basheer Hospital, King Abdullah University Hospital (KAUH), Princess Basma Teaching Hospital and the Multiple Sclerosis Society of Amman. 200 participants were recruited after confirming consent. Data were collected through face-to-face interviews using validated instruments, covering sociodemographics, beliefs about medicines, knowledge about MS, access to care and levels of depression.
This study involved 200 patients with MS with a median age of 36 years, mostly women (70.5%), non-smokers (65%) and insured (77.5%). The majority had high education (58%) but low income (67%), with a mean duration of MS disease of 7.8 years after diagnosis. The majority (79.5%) were unaware of their MS type. Beliefs about medications varied, with 22% accepting, 48.5% ambivalent, 14.5% sceptical and 15% indifferent. Disease knowledge was high, with patients recognising MS as an immune, non-contagious and non-curable disease that affects women more than men. Despite good access to care, a percentage of patients needed to travel long distances for care. Depression affected 58% of participants, and it was influenced by access to care, concerning beliefs, income and education. Other variables such as gender, health insurance, the duration of the disease and the necessity of medications had no significant influence.
In conclusion, patients with MS deal with various challenges, such as difficulties in accessing care, associated with psychological factors such as depression. Addressing these barriers by optimising patients' beliefs about medications, enhancing access to care and focusing on the level of knowledge of the disease is crucial for ensuring better and optimal treatment outcomes, as well as decreasing the risk of depression development.
Video-assisted thoracoscopic surgery (VATS) has become the predominant method for lung cancer diagnosis and resection, with over 80% adoption in relevant surgeries. With technological advancements, uniportal VATS is now widely employed. However, it still poses a significant risk of moderate to severe acute postoperative pain, potentially leading to chronic post-thoracotomy pain syndrome (PTPS). Therefore, effective postoperative analgesia is crucial. Regional block techniques have gradually gained wide attention. Specifically, paravertebral block (PVB) has been considered the ‘gold standard’ for thoracic analgesia, but its application involves risks due to the challenging anatomy. The erector spinae plane block (ESPB) and intertransverse process block (ITPB) have emerged as alternatives. ESPB showed non-inferiority to PVB in pain management and recovery quality. However, the mechanism of ESPB and its consistency in providing analgesia are not fully understood. ITPB, targeting the ‘posterior space of the superior costotransverse ligament’, offers theoretical advantages in drug diffusion due to its closer proximity to the paravertebral space than ESPB. Despite these advancements, there is a lack of randomised controlled trials (RCTs) assessing the comparative efficacy of continuous ESPB and ITPB. This study aims to address these gaps by comparing the analgesic effects and recovery quality of continuous ESPB and ITPB in patients undergoing single-port VATS.
A double-blind RCT will be conducted, enrolling 96 patients electively undergoing single-port thoracoscopic surgery, randomly assigned to either the experimental group (ITPB group) or the control group (ESPB group). After routine surgery, block intervention and continuous pump catheterisation will be performed. The primary assessment will be the numeric rating scale (NRS) scores at 24 hours. Secondary outcomes include NRS at other time points, block effectiveness, Quality of Recovery-15 scores and chronic pain-related scores. Evaluations will be conducted at 0, 2, 6, 12, 24 and 48 hours. Additional assessment indicators include time to first self-administration of pulse analgesia pump, number of self-administrations within 48 hours, use of non-steroidal anti-inflammatory drugs and opioids postoperatively, Comprehensive Complication Index (CCI) score, length of hospital stay, incidence of adverse events and complications, patient satisfaction score and assessment of PTPS incidence at 3 months postoperatively using the Brief Pain Inventory short form and the Short-Form McGill Pain Questionnaire.
The study was reviewed and approved by the Medical Ethics Committee of the Fifth Affiliated Hospital of Sun Yat-sen University (No. K44-1, 2024). The results of the study will be submitted for publication in a peer-reviewed journal with online accessibility.
ChiCTR2400082856.
This study analysed the clinical outcomes and healthcare costs associated with diabetic foot ulcer (DFU) within a tertiary healthcare centre in Singapore.
This is a retrospective, single-centre study. Patient data were extracted from the hospital’s electronic health system, including demographic, clinical and hospitalisation information. Hospitalisation costs were categorised into DFU-related and other hospitalisation costs. A one-way sensitivity analysis was performed to estimate the total healthcare costs associated with DFU.
Tertiary centre within a population suffering from a diabetic epidemic.
All patients aged 18 years or older who received DFU treatment between January 2019 and December 2023 at the Singapore General Hospital were included.
A total of 2857 DFU patients were included in the study. In-hospital mortality remained stable at 5%–6% annually. Among the cohort, 39.1% underwent minor amputations, 19.6% had major amputations and 9.0% experienced both minor and major amputations. The median length of stay for surgical patients ranged from 10 (IQR 4–24) to 13 days (IQR 6–31), compared with 4 (IQR 2–8) to 5 (IQR 3–9.5) days for non-surgical patients. Total costs per admission for patients with DFU-related surgery ranged from US$28 588.96 to US$34 204.77, while for those without surgery, costs ranged from US$6637.59 to US$7955.23. Total hospitalisation costs for DFU during the study period ranged from US$65.87 million to US$72.16 million. All figures were inflation adjusted to 2023 US dollars.
DFU poses a significant clinical and economic burden in Singapore. Understanding the costs associated with DFU is essential for resource allocation and planning in DFU management.
We will recruit 478 paediatric patients with newly diagnosed IgAV across multiple centres. Participants will undergo prospective longitudinal assessment at disease onset and at 1, 3, 6 and 12 months postdiagnosis. Standardised evaluations will include clinical manifestations, physical examinations, laboratory parameters and patient-reported outcomes. The data will be analysed statistically with SPSS software (V.27.0), adopting a significance threshold of p
This study has been approved by the Medical Ethics Committee of the First Affiliated Hospital of Guangxi Medical University (2024-K0480), the Ethics Committee of the First People’s Hospital of Yulin (YLSY-IRB-SR-2025060), the Medical Research Ethics Committee of the Liuzhou Workers’ Hospital (KY2024356) and the Ethics Committee of the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region (No. (2025–1)003) and written informed consent was obtained from all the parents or guardians of the patients involved. It will be disseminated by publication of peer-reviewed manuscripts and presentation in abstract form at national and international scientific meetings.
ChiCTR2500099716.
The waist-hip ratio (WHR) and waist-height ratio (WHtR) are associated with arterial stiffness (AS), yet there is limited research on this topic in patients with type 2 diabetes mellitus (T2DM). This study aims to investigate the relationship between WHR, WHtR and AS in patients with T2DM.
This cross-sectional study used data from patients with T2DM enrolled in the Metabolic Disease Management Center (MMC) at Changde Hospital, Xiangya School of Medicine, Central South University between May 2020 and October 2023.
A total of 3201 patients were collected, and after applying the exclusion criteria, data from 3006 patients were finally analysed.
The primary outcome of AS was assessed using brachial-ankle pulse wave velocity (baPWV).
After adjusting for gender and age, there was an increasing trend in baPWV across the quartiles of WHR and WHtR. In the multivariate regression analysis adjusting for confounding factors, it was observed that for each one-unit increase in the WHR z-score, baPWV increased by 18.1 cm/s (95% CI: 7.8 to 28.4). Similarly, for each one-unit increase in the WHtR z-score, baPWV increased by 28.6 cm/s (95% CI: 16.6 to 40.6). In the multivariate logistic regression analysis, after fully adjusting for confounding factors, it was found that for every one-unit increase in the WHR z-score, the OR for elevated baPWV was 1.2 (95% CI: 1.1 to 1.4). Similarly, for every one-unit increase in the WHtR z-score, the OR for elevated baPWV was 1.3 (95% CI: 1.1 to 1.5). According to the generalised additive model, we found that WHR and WHtR were positively correlated with baPWV and elevated baPWV. Subgroup analysis revealed that elevated WHR and WHtR are significant predictors of AS, with this association being substantially amplified by poor glycaemic control (glycated haemoglobin ≥7%).
In Chinese patients with T2DM, both WHR and WHtR are positively and independently associated with baPWV and the presence of elevated baPWV.
The application of artificial intelligence (AI) technology in the screening of diabetic retinopathy (DR) has made significant strides. However, there remains a lack of comprehensive validation and evaluation of AI-derived quantitative indicators in DR screening.
This study aims to assess the diagnostic performance of retinal microvascular indicators in the early detection of DR in patients with type 2 diabetes and to identify potential novel indicators for early DR screening.
This cross-sectional study included 533 community-recruited patients with type 2 diabetes mellitus who underwent fundus imaging. Based on the results of the fundus examination, the eyes were categorised into non-DR, mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR and severe NPDR groups. AI systems were employed to quantify various retinal microvascular indicators, including microaneurysms (MAs), haemorrhage count (HC), haemorrhagic area (HA), the ratio of HA to retinal area (HA/RA), the ratio of HA to MA (HA/MA) and HC and/or MA (H/MA). Multivariable logistic regression was used to analyse the association between fundus indicators and DR severity, and receiver operating characteristic (ROC) curve analysis was performed to assess the predictive and screening value of these indicators, determining sensitivity, specificity, ROC area under the curve (AUC) and optimal cut-off values.
Among the 533 participants (mean age 64.03±9.71 years; 51.6% female), the DR prevalence was 10.0%. After adjusting for age, gender, body mass index, hypertension, diabetes duration, glycated haemoglobin levels, smoking and alcohol consumption, multivariable logistic regression indicated that HA/RA (OR 1.873, 95% CI 1.453 to 2.416) and HA/MA (OR 1.115, 95% CI 1.063 to 1.169) were associated with mild NPDR. Similarly, HA/RA (OR 1.928, 95% CI 1.509 to 2.464) and HA/MA (OR 1.165, 95% CI 1.112 to 1.220) were associated with moderate NPDR, and HA/RA (OR 2.435, 95% CI 1.921 to 3.086) and HA/MA (OR 1.171, 95% CI 1.117 to 1.226) were linked to severe NPDR. ROC curve analysis revealed that before adjustment, HA/RA demonstrated the highest screening value for DR, with an AUC of 0.917, sensitivity of 86.14%, specificity of 93.41%, Youden’s index of 0.796 and an optimal cut-off value of 0.063. After adjusting for confounding factors, the AUC for HA/RA in diagnosing DR was 0.900, with sensitivity of 83.17%, specificity of 86.28%, Youden’s index of 0.695 and an optimal cut-off value of 0.093.
The HA/RA and HA/MA show robust screening performance for early DR. These indicators should be considered for inclusion in AI-based early DR screening systems in the future.
In Bangladesh, evidence on the long-term trajectory of adolescents' sexual and reproductive health (SRH) remains limited, largely due to the lack of longitudinal data to assess the changes over time. To address this gap, the Advancing Sexual and Reproductive Health and Rights (AdSEARCH) project of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) set up an adolescent cohort study aimed at documenting changes in SRH knowledge, attitudes and practices, and identifying the factors affecting these changes. This article presents the baseline sociodemographic and SRH characteristics of this cohort as a pathway for future analyses.
This cohort study included 2713 adolescents from the Baliakandi Health and Demographic Surveillance System run by icddr,b. The cohort covered three age groups from girls and boys, giving a total of five cohorts: girls aged 12, 14 and 16 years; and boys aged 14 and 16 years. A total of seven rounds of data had been collected at 4-month intervals over 2-years follow-up period.
The majority of adolescents were attending school (90%), and school dropouts were higher among boys. Around 17% of the respondents were involved in income-generating activities, which were mostly boys. Among girls, the mean age of menarche was 12.2 years. Overall, 6% of adolescents had major depressive disorder, with prevalence increasing with age. Gender differences were evident regarding knowledge about conception and contraception. Egalitarian attitudes towards social norms and gender roles were found higher among girls (52%) compared to boys (11%). The majority of adolescents reported experiencing social/verbal bullying (43%), followed by physical violence (38%) and cyberbullying (4%).
This article presents the baseline findings only. A series of papers is in the pipeline for submission to different peer-reviewed journals. The findings from this study will be used to support data-driven policy formulation for future adolescent health programmes.
Transvaginal and transabdominal cerclage procedures have become established interventions to prevent mid-trimester pregnancy loss and preterm birth. Transabdominal cerclage seems to be superior to transvaginal cerclage in women with a history of a failed transvaginal cerclage. However, with the availability of a less invasive laparoscopic procedure, there is limited evidence concerning which type of cerclage to recommend to many other risk groups. The objective of this trial is to compare laparoscopic abdominal cerclage and transvaginal cerclage in women at moderate to high risk of spontaneous preterm birth.
The trial is an open, multicentre, superiority, parallel arm randomised controlled investigator-initiated trial with an embedded internal pilot. Women in whom the clinician has clinical equipoise between laparoscopic and transvaginal cerclage are randomised to either laparoscopic abdominal or transvaginal cerclage in a ratio of 1:1. The trial extends from sites in Denmark, Finland and Norway. The primary outcome is birth
The Central Denmark Region Committee on Biomedical Research Ethics, Denmark, Helsinki University Hospital Ethics committee, Finland and the Regional Committees for Medical and Health Research Ethics, Norway approved the trial. This protocol is published prior to complete data collection and analysis. Important protocol changes will be made publicly available on ClinicalTrials.org, on the trial website and distributed electronically to all active sites. Positive, inconclusive as well as negative results from the trial will be published in peer-reviewed international scientific journals.
Hip fractures are a prevalent type of fracture and a leading cause of disability and mortality among older patients, imposing a substantial burden on both families and society. As surgical intervention is considered the primary means of improving patient outcomes, perioperative optimisation management is essential for enhancing prognosis. A key component of the Enhanced Recovery After Surgery (ERAS) protocol for hip surgery is the innovation of preoperative fasting concepts, which includes the recommendation of preoperative oral carbohydrates for surgical procedures, particularly hip surgery. While preoperative oral carbohydrates have been shown to alleviate hunger and thirst symptoms in patients and promote postoperative recovery, concerns regarding intraoperative aspiration and gastric content retention persist, rendering the safety and feasibility of this approach for surgery a topic of debate. This study aims to investigate and summarise the clinical outcomes of preoperative oral carbohydrates in patients undergoing hip surgery, providing a comprehensive evaluation of their impact on patient recovery and safety.
A systematic and comprehensive search will be conducted across multiple databases, including CINAHL, PubMed, CNKI, VIP database, Wanfang database, Embase, CBM, Web of Science, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov (
This study uses previously published data, and as such, does not require additional ethical approval. The findings will be disseminated through peer-reviewed journals.
CRD42024611468.
To investigate the causal relationship between serotonin levels, adenosine deaminase (ADA) activity and multiple sclerosis (MS) progression using an integrative multi-omics approach.
A two-sample Mendelian randomisation (MR) analysis was performed using inverse variance weighted (IVW) estimation to assess causality between serotonin, ADA and MS risk. Single-cell transcriptomic data from the Gene Expression Omnibus (GSE194078) were analysed to identify ADA-expressing immune cell subpopulations. Moreover, machine learning algorithms (Support Vector Machine-Recursive Feature Elimination, Least Absolute Shrinkage and Selection Operator and random forest) were applied to identify diagnostic biomarkers, following which a nomogram was constructed and validated.
MR analysis revealed that serotonin levels were positively correlated with MS progression (IVW β=0.350, p=3.63E-05), whereas genetically predicted ADA levels were inversely associated with MS risk (IVW β=–0.395, p=2.73E-04). Additionally, serotonin levels exhibited an inverse causal relationship with ADA activity (IVW β=–0.089, p=8.70E-03), with no evidence of reverse causation. Single-cell analysis identified 18 cellular subpopulations and six major immune cell types, with ADA highly expressed in T-NK cells and expressed at lower levels in platelets. Meanwhile, ADA expression was higher in the low immune receptor signalling group. Enrichment analysis indicated that differentially expressed genes were enriched in biological processes such as cytoplasmic translation and RNA splicing, as well as Kyoto Encyclopedia of Genes and Genome pathways such as Ribosome and Neurodegeneration-Multiple Diseases. Three key feature genes (IK, UBA52 and CCDC25) were identified, and the nomogram based on these genes demonstrated high diagnostic accuracy, with an AUC of 1.000 in the training dataset and 0.976 in the validation dataset.
Serotonin promotes MS progression by inhibiting ADA activity, positioning the serotonin-ADA axis as a potential therapeutic target. The identified biomarkers (IK, UBA52 and CCDC25) and the constructed nomogram may enhance diagnostic precision for MS, providing valuable insights for MS management and laying a theoretical reference for future studies.
To investigate the correlation between fat-to-muscle ratio (FMR) or other body composition and secondary osteoporosis (OP) in patients with rheumatoid arthritis (RA) and to develop a predictive model using FMR and related clinical factors.
Cross-sectional observational study with machine learning-based risk modelling.
Tertiary hospital in eastern China, secondary care level.
A total of 670 hospitalised RA patients (135 males and 535 females; aged 58.00 (50.00–67.00) years; disease duration 8.00 (2.00–16.00) years) and 126 healthy controls were recruited between October 2019 and October 2022. There were no differences in basic indicators such as gender, age distribution and body mass index between the two groups. RA diagnosis followed American College of Rheumatology (ACR) 1987 or ACR/European League Against Rheumatism 2010 criteria. Exclusion criteria included major organ dysfunction, endocrine disease, infection or long-term hormone or psychotropic drug use.
Primary outcomes included total skeletal muscle mass, fat mass, FMR measured by bioelectrical impedance analysis and bone mineral density measured by dual-energy X-ray absorptiometry. Secondary outcomes included RA disease activity scores (clinical disease activity index (CDAI), simplified disease activity index, disease activity score in 28 joints (DAS28)) and glucocorticoid use. Logistic regression and four additional machine learning algorithms were used to build predictive models for OP.
The RA group (age, 58.00; duration, 8.00; DAS28, 5.03; rheumatoid factor, 104.75; C-reactive protein, 25.65; erythrocyte sedimentation rate (ESR), 59.00) exhibited reduced total skeletal muscle mass (19.49 vs 25.38, p
FMR may serve as a useful clinical indicator of secondary OP in RA patients. A model based on FMR and associated risk factors can predict the possibility of secondary OP.
Stroke is a leading cause of death and disability worldwide, with spasticity affecting 4%–42.6% of stroke survivors. Prolonged spasticity can lead to pain, restricted joint mobility and muscle weakness. Current non-pharmacological treatments include physical therapy, orthoses and surgery. Muscle energy techniques (METs) and blood flow restriction training (BFRT) have shown promise in improving muscle function and reducing spasticity. This study aims to investigate the combined effect of MET and BFRT on upper limb motor function in patients with poststroke spasticity.
This study is a single-blind randomised controlled trial involving patients with poststroke spasticity. Participants will be randomly assigned to either the MET+BFRT group or the passive stretching group. Both groups will receive conventional rehabilitation therapy, with additional MET+BFRT or passive stretching interventions. The intervention will last for 6 weeks, with four sessions per week. Primary outcomes include the simplified Fugl-Meyer assessment (FMA) and surface electromyography, while secondary outcomes include the Modified Barthel Index and the Modified Ashworth Scale.
Based on literature data, patients who had a stroke have an average baseline upper limb FMA score of 40 points. Conventional rehabilitation typically improves FMA to 46 points (SD=8). This trial expects an additional 6-point improvement from the intervention. With α=0.05 (two-sided), 90% power (1–β=0.90) and 10% dropout rate, PASS V.11.0 calculation indicates a minimum requirement of 42 participants per group.
Statistical analysis will be conducted using IBM SPSS Statistics V.25. Intention-to-treat analysis will be used to analyse the result, which means the last observation will be used for interpolation when data are missing. Continuous variables will be summarised as mean±SD for normally distributed data or as median and IQRs for non-normally distributed data. Categorical variables will be presented as frequencies and percentages. For continuous variables that meet the criteria of normal distribution and homogeneity of variance, two-way analysis of variance with repeated measures will be applied; for those that do not meet these criteria, the Mann-Whitney U test will be used. Categorical variables will be analysed with the 2 test or Fisher’s exact test.
The study protocol has been approved by the ethics committee of Jiaxing Hospital of Traditional Chinese Medicine (2024-016). Participants will provide written informed consent before inclusion. The results will be disseminated through peer-reviewed journals and conference presentations.
ChiCTR2400085996.
To assess the knowledge, attitudes and practices (KAP) related to the management of gestational diabetes mellitus (GDM) among obstetric and gynaecological healthcare workers in Hubei Province, China, and to identify factors associated with these domains.
Cross-sectional study.
Online questionnaire administered in December 2023.
A total of 394 healthcare workers from 68 maternal and child health institutions across Hubei Province.
The questionnaire comprised 29 items covering four domains: demographic characteristics, knowledge, attitudes and practices.
None.
The overall awareness rate of GDM knowledge was 58.88%. The mean knowledge score was 5.60±2.23 (range: 0–12). The mean attitude score was 18.66±1.97 (range: 0–20), with 55.08% of participants reporting a positive attitude. The mean practice score was 19.26±2.40 (range: 0–21), with 58.63% reporting good practices. Knowledge scores were positively correlated with practice scores (rs=0.130, p=0.009), and a stronger correlation was observed between attitudes and practices (rs=0.393, p
Obstetric and gynaecological healthcare workers in Hubei Province exhibited limited knowledge but generally positive attitudes and good practices regarding GDM management. Targeted educational strategies are warranted to address knowledge gaps, particularly concerning the role of early pregnancy serum ferritin in GDM risk, and to strengthen support for younger and less experienced healthcare workers.
This study aimed to determine the association between diabetes mellitus (DM) medication use and glycaemic control.
This was a retrospective diabetes registry-based cohort study.
Singapore.
Patients aged 18 and above with incident DM in the SingHealth Diabetes Registry from 2013 to 2020 were included. The entire study period included a 1 year baseline period, a 1 year observation period and a 3 month outcome period.
Drug use was measured using the proportion of days covered (PDC), and the changes in glycated haemoglobin (HbA1c) between the outcome and baseline periods were assessed. The associations between baseline HbA1c and PDC ≥0.80 and between PDC and change in HbA1c were analysed using logistic regression and the Kruskal–Wallis test, respectively.
Of 184 646 unique patients in the registry from 2013 to 2020, 36 314 met the inclusion and exclusion criteria and were included in the analysis. The median PDC for any DM drug, oral DM drugs and insulin during the observation period was 20.3%, 16.8% and 0%, respectively. Those who had good glycaemic control at baseline were less likely to receive DM drugs and those with poor baseline glycaemic control or missing baseline HbA1c were more likely to be consistent users (PDC >80%) (px 10-16).
The relationship between DM drug use and glycaemic control is complex and non-monotonic. Higher PDC for any DM drug and oral DM drugs during the observation period was significantly associated with clinically relevant HbA1c improvements.
The study aims to define the prevalence of Do-Not-Resuscitate (DNR) orders among patients with shock in the emergency department (ED) and explore their impact on clinical management and mortality outcomes.
A retrospective observational cohort study was conducted involving patients presenting to the ED with shock.
An ED in a tertiary hospital in western China.
2001 patients (aged ≥18 years) presenting to the ED with shock from 1 January 2022 to 31 December 2023.
The enrolled patients were divided into DNR (order issued within 24 hours of ED admission)/non-DNR groups. Demographics, vitals, comorbidities, laboratory values, medications and prognoses were obtained from electronic healthcare records. DNR prevalence and its associations with mortality, ICU admission, vasopressor administration and antibiotic administration were assessed via logistic regression.
Compared with patients without DNR orders, patients with DNR orders (n=399 (19.9%)) were older (p
Compared with patients with shock in the ED who did not have DNR status, those with DNR status (prevalence ~20%) had higher in-hospital and 30-day mortality (but most survived) and similar ICU admission and intervention treatments.
To assess the performance of a Vision Transformer (ViT)-based deep learning model in classifying oral mucosal diseases (OMD) and to explore the value of the integrated model for clinical support.
A pilot study that combines publicly available datasets with integrated modelling.
Developed an EfficientNet-B0 convolutional neural network and a ViT-B16 model, and tested three integration strategies: average method, weighted method and geometric average method. Evaluation metrics included accuracy, F1 score and inference speed. Diagnostic subject performance was compared between general dentists and oral specialists to validate model efficacy.
The integrated model outperformed individual models, with the geometric average integration method achieving an accuracy of 94.32%. When used by general dentists, the diagnostic time was reduced from 241 s to 112.4 s, with an accuracy rate of 93%.
The ViT-enhanced integrated system can improve the classification efficiency of OMD and provide support for non-specialist doctors. However, validation with larger datasets is needed in future research.
This study aims to investigate the association between dietary diversity (DD) and the periodontal health of older adults in China.
Design: A cross-sectional study.
The study was conducted at a health management centre of a large tertiary hospital in Hunan Province, China, which is also one of the largest health management centres in central and southern China.
A total of 26 595 older adults aged 60 years or older participated in the study from 2017–2024.
All participants completed a self-administered health assessment questionnaire before undergoing routine check-ups. DD among participants was evaluated using a dietary diversity score (DDS), which was subsequently classified into three levels: low-DDS, medium-DDS and high-DDS. Periodontal health examination results were recorded by professional physicians. Associations of DDS and food groups with periodontal health outcomes were assessed using multivariable logistic regression.
Up to 69.1% of participants had periodontal health problems, and only 18.2% of participants had a high-DDS. Among them, high-DDS (OR=0.69; 95% CI: 0.65 to 0.76; p
A higher DD was associated with lower odds of periodontal health problems among older adults in China. Specific dietary patterns, including the consumption of various food groups, were also found to be associated with periodontal health status and deserve further exploration through prospective studies.
FreshRSS 