Hypertrophic cardiomyopathy (HCM) is a genetic cardiovascular disorder affecting approximately 1 in 200 to 1 in 500 adults, with nearly 70% exhibiting the obstructive phenotype Hypertrophic Obstructive Cardiomyopathy (HOCM). Randomised trials have demonstrated the efficacy of mavacamten, a first-in-class cardiac myosin inhibitor which significantly reduced outflow tract gradients and improved symptoms, exercise capacity and quality of life in the HOCM cases. Despite these findings, prospective real-world data on its safety and effectiveness remain limited, particularly in non-Western populations and further evidence from routine clinical practice is needed.

PERSIA-HOCM is a prospective, multicentre, observational study to be conducted at 19 cardiovascular referral centres in Iran. Adults aged 18 years or older with symptomatic obstructive HCM, defined as New York Heart Association (NYHA) class II to IV and a left ventricular outflow tract (LVOT) gradient of at least 50 mm Hg at rest or with provocation, who are prescribed mavacamten, will be enrolled. Key exclusions include left ventricular ejection fraction below 55%, non-obstructive phenotype and lack of consent. Participants will be followed for 1 year at 4-week intervals. Data collection will include symptoms, NYHA class, vital signs, echocardiographic parameters (including outflow gradients and ejection fraction), mavacamten dosing and adjustments and concomitant therapies. Echocardiography will be performed at weeks 4, 8, 12 and 24. Safety will be assessed using a predefined adverse event framework that includes mortality, hospitalisations and major clinical events. At weeks 12 and 48, cardiac troponin, N-terminal pro B-type natriuretic peptide and quality of life will be assessed. Primary endpoints will be safety, change in the NYHA class, resting and provoked LVOT gradient, quality of life, cardiac biomarkers and left ventricular ejection fraction. Secondary endpoints will include cardiac magnetic resonance imaging parameters for cardiac fibrosis, peak oxygen intake and genotype-based outcome. Analyses will be performed using R V.4.5.1, employing descriptive statistics, paired sample t tests and McNemar’s test.

Ethical approval was obtained from the Research Ethics Committee of Rajaie Cardiovascular, Medical and Research Institute/Iran National Committee for Ethics in Biomedical Research (Code: IR.RHC.REC.1404.210). Written informed consent will be required and filled by the patients. Considering full data confidentiality, analysis reports will be public every 6 months. Findings will be disseminated through peer-reviewed publications and scientific conferences.

Stroke is a leading cause of long-term disability, yet recovery trajectories are highly heterogeneous and difficult to predict at the individual level. Standardised clinical assessments primarily capture task accomplishment under controlled conditions but may overlook changes in movement quality, including the distinction between compensatory strategies and behavioural restitution. Additionally, they provide limited insight into the postural control processes that underlie functional task performance. Recent consensus initiatives emphasised the need for sensitive, functionally relevant measures of balance and mobility after stroke. Integrating routine clinical assessments with a sensor-based approach during functional tasks offers new opportunities to characterise recovery more precisely and to map longitudinal trajectories of poststroke change. Within the European Union-funded TARGET project, the FOSTER study aims to generate multimodal data to support data-driven, individualised prognostic models, so-called virtual twins, for personalised rehabilitation.

FOSTER is a prospective, single-centre observational cohort study at Rehabilitation Hospital Inkendaal (Belgium). We aim to include 100 adults within 8 weeks poststroke, assessed at three to five time points, including an entry assessment after admission and follow-up assessments within predefined windows at approximately 5, 8, 12 and 24 weeks poststroke. The protocol combines synchronised sensor-based measurements during functional tasks (seated reaching, standing reaching and gait initiation) obtained during an exergame, with standardised clinical tests and patient-reported outcome measures (PROMs). Sensors include surface electromyography, inertial measurement units, force plates and markerless motion capture. Sensor-based measurements target movement quality, and anticipatory and reactive postural control during self-initiated functional tasks. Derived outcomes will capture kinetic, kinematic and neuromuscular features of movement strategies, including temporal and asymmetry characteristics. In addition, in-task performance metrics, real-world activity monitoring through accelerometry, standardised clinical assessments and PROMs will be collected to provide a comprehensive, multimodal characterisation of recovery. Linear mixed-effects models will characterise longitudinal trajectories and relationships between clinical and sensor-derived measures.

The FOSTER study was approved by the Ethics Committee of Rehabilitation Hospital Inkendaal (B.U.N. 2024-TEE-002). Participants will be included after providing informed consent. Data are pseudonymised and stored on a General Data Protection Regulation-compliant platform. Findings will be disseminated through peer-reviewed publications, conferences and within the TARGET consortium.

NCT06806761.

Retention in HIV care is associated with higher rates of antiretroviral treatment adherence and viral suppression, as well as lower risk of AIDS-related morbidity and mortality. However, the multidimensional nature of retention complicates measurement standardisation, limiting comparability and global evaluation.

This study explored how HIV stakeholders define and assess retention, aiming to develop a patient-centred and conceptually robust understanding to inform research and practice.

We conducted a qualitative study using interpretive description methodology, an applied qualitative approach designed to generate practice-relevant knowledge in health research. We purposively sampled 20 stakeholders representing diverse areas of expertise and geographic regions across World Bank country income classifications. We conducted and video-recorded in-depth semistructured interviews and subsequently transcribed them. Using constant comparative analysis, we identified recurring, convergent and contradictory patterns.

The analysis identified five overarching themes. The first two, exploratory themes, included Patient-Centred Understanding of Retention in HIV Care, which captured how stakeholders conceptualised retention in their respective contexts and Operationalisation of Retention Measures, which explored the key components used to measure retention. The next two explanatory themes, included Purpose-Driven Definitions of Retention, which described how retention measures were selected based on their intended use, and Building Capacity through Shared Understanding and Integrated Action, which emphasised retention as a cyclical, interconnected process dependent on collaboration between patients and health systems. The final, prescriptive theme, Advancements Shaping Retention, reflected stakeholders’ shared vision of improving retention through innovations in HIV treatment and technology.

The findings suggest that stakeholders operationalise retention measures in line with specific objectives and individual health goals, while remaining attentive to contextual realities. Retention measures should remain flexible and patient-centred, rather than relying on a single rigid standard.

The low uptake of cervical cancer screening (CCS) in rural areas is mainly related to the lack of awareness regarding cervical cancer. Using educational interventions has been shown to substantially improve knowledge and attitude towards cervical cancer, which are important determinants of undergoing CCS. The aim of this study was to analyse the impact of different educational intervention methods on knowledge, attitudes and willingness to undergo CCS among women in rural Indonesia.

A quasi-experimental study with a non-equivalent control group design.

The study was conducted in North Tobelo, a rural district in North Halmahera Regency.

Sample size was calculated using Power and Sample Size Calculations software (V.3.1.2). 150 women were recruited via convenience sampling from 12 Integrated Health Service Posts, cluster-randomised into three arms: control (n=50), flipchart (n=50) and video (n=50). A per-protocol approach was applied; all participants completed pre-intervention and post-intervention assessments within a single visit with no loss to follow-up. Continuous outcomes were analysed using the Kruskal-Wallis and Wilcoxon tests; categorical outcomes using ² or Fisher’s exact tests with Bonferroni correction. Non-parametric analysis of covariance (Quade’s method) controlled for baseline scores, age at first sexual intercourse and household income, with partial eta-squared reported as the effect size.

All study arms received identical educational content presented in simple Indonesian language and avoiding the use of medical terminology. The educational content included cervical cancer epidemiology, aetiology, risk factors, clinical symptoms, prevention methods, various CCS methods, visual inspection with acetic acid screening procedures, benefits and side effects of getting human papillomavirus vaccination and CCS, as well as a brief explanation regarding cervical cancer treatment. Knowledge, attitude and willingness were assessed using a structured pre-intervention and post-intervention questionnaire comprising both dichotomous items and Likert-scale questions.

Although knowledge improved significantly in all intervention groups (p

In conclusion, the video-based educational intervention demonstrated the greatest improvements in knowledge, attitude, and willngness to undergo CCS compared to other methods.

Inappropriate antibiotic prescribing in primary care remains a major driver of antimicrobial resistance, despite national guidelines and audit-and-feedback systems. Digital antimicrobial stewardship tools may support clinicians in making evidence-based prescribing decisions. The Prescription Search Support (PSS) tool translates guideline recommendations into an interactive decision tree integrated into electronic health records (EHR). This project aims to evaluate the impact of implementing the tool on antibiotic prescribing behaviour in Belgian general practice and to understand the contextual factors influencing its adoption.

This stepped-wedge cluster randomised trial includes four steps over 12 months. Belgian general practices were randomised in a 1:3:3:3 ratio using stratified block randomisation. All practices start in the control condition, where physicians are expected to provide usual care. At each step, one cluster transitions to the intervention, where PSS becomes accessible through the EHR. The primary objective is to assess whether the implementation of the tool reduces practice-level antibiotic prescribing rates. The primary analysis will use generalised linear mixed models with a logit link, accounting for clustering, time effects and relevant covariates. Secondary analyses include subgroup analyses by region, EHR vendor and intensity of tool use. A nested process evaluation, combining user log file analysis and semistructured interviews, will assess usability, acceptability, fidelity and mechanisms of impact. Sample size calculations indicate that at least 36–48 practices are required to detect a 5% absolute reduction in prescribing with 80% power. All quantitative analyses will be performed in R, and qualitative data will be analysed using reflexive thematic analysis.

The study will be conducted in compliance with the principles of the Declaration of Helsinki (current version) and the principles of Good Clinical Practice and in accordance with all applicable regulatory requirements. Ethics approval for this study was obtained on 10 October 2025 from the Ethical Committee Research UZ/KU Leuven under reference MP037810. We will ensure that the findings of the study will be disseminated to relevant stakeholders beyond the scientific world including the public, healthcare providers and policy makers. The process evaluation that is part of this trial will inform the further implementation strategy. It will be essential to educate physicians on using this new PSS tool in daily practice.

NCT07347015.

To evaluate the relative strength of clinical and sociodemographic predictors of health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA) under real-life conditions.

This cross-sectional, observational study included adult patients fulfilling the 2010 American College of Rheumatology-European Alliance of Associations for Rheumatology classification criteria for RA, recruited from 11 public tertiary rheumatology centres in Brazil. To reflect real-life clinical practice, no restrictions were applied regarding disease stage or treatment status. HRQoL was assessed using the 12-item Short Form Health Survey (SF-12). Physical disability was measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI). Clinical and epidemiological variables were evaluated as candidate predictors. Associations were explored using bivariate analyses and multiple linear regression models. Standardised beta coefficients (zβ) were used to estimate the relative strength of independent predictors.

1079 patients were included; 89.4% were women and 56.0% were white, with a mean (SD) age of 57.0 (11.4) years and a median (IQR) disease duration of 152 (84.0–242.0) months.

In multivariate analysis, the following remained independently associated with physical score: HAQ-DI score (β=–3.92, 95% CI (–4.56 to –3.28), zβ=–0.44, p

For mental score, remaining independent predictors were HAQ-DI (β=–5.00, 95% CI (–6.17 to –3.83), zβ=–0.31, p

Physical disability was the strongest determinant of impaired HRQoL in both physical and mental domains among participants with RA. Other relevant determinants of poorer physical HRQoL in descending order of relative strength were non-White race and absence of regular physical activity, while for poorer mental HRQoL, fibromyalgia, race, smoking status, female sex and disease activity. These findings reinforce functional preservation as a key therapeutic target in routine RA care.

The Developmental Origin of Health and Disease framework emphasises the intergenerational influence of both maternal and paternal factors on the perinatal and longer-term outcomes of offspring. Aboriginal and Torres Strait Islander communities have driven major advances in family and health research across Australia, including longitudinal studies grounded in community priorities. Despite this progress, few birth cohort studies have focused on Indigenous families and even fewer have examined the health and well-being of Indigenous fathers.

The Indigenous Queensland Family Cohort (I-QFC) study is a prospective, longitudinal birth cohort study that commenced in 2021, recruiting Aboriginal and/or Torres Strait Islander families from the Mater Mothers’ Hospital in Brisbane, Australia. This feasibility study forms part of the larger QFC study to understand the acceptability and practical considerations of including Indigenous families in a birth cohort study. Participants include pregnant individuals, their partners (where applicable), and their infants, followed from pregnancy to 6 weeks post partum. Data collection involved self-administered and researcher-facilitated surveys, alongside biological sample collection.

The study enrolled 103 pregnant participants and 64 partners and outlined the study design and baseline characteristics. Survey completion rates were high for antenatal and birth-related data collection when facilitated by Indigenous research staff (>94%). In contrast, completion declined substantially at later time points and among partners, with only 35 mothers completing the 6-week survey post partum and progressive participant attrition observed across the study period. Variation in biological sample provision and longitudinal follow-up provided important insights into cultural, logistical and relational factors influencing engagement in family-based cohort research. Biological sample collection was more limited, with few participants contributing across multiple time points. Participants were influenced by cultural considerations, including the spiritual significance of placental tissue, as well as perceptions among male partners’ belief that their involvement in perinatal research was unnecessary.

By adopting a family-centred approach, I-QFC provides insights into culturally grounded research with Indigenous families, with the potential to strengthen health and well-being across generations. As such, these findings are currently used to inform the development of a forthcoming co-design birth cohort study of Aboriginal and Torres Strait Islander families in Queensland, Australia.

The continuous cash benefit (Benefício de Prestacão Continuada, BPC) is Brazil’s main non-contributory social pension. It guarantees a monthly income equivalent to one minimum wage to individuals aged ≥65 years and to people with disabilities living in poverty, but evidence on its health effects remains limited. This protocol describes the design and methods for evaluating the effects of BPC on hospitalisations and mortality among older adults and their household members.

This natural experiment study uses linked administrative records from the 100 Million Brazilian Cohort (2001–2021), BPC payments (2016–2021), mortality (2001–2020) and hospitalisation data (2008–2018). Eligibility for elders is defined by age (≥65 years) and monthly family per capita income (

This study was approved by the Brazilian National Research Ethics Commission (CONEP) (approval number: 85981225.6.0000.0040), in accordance with the Brazilian National Health Council Resolution No. 466/2012. Findings will be disseminated through peer-reviewed publications, conference presentations, and policy briefs targeting stakeholders in social protection and health in Brazil. Results will also be shared with relevant governmental and non-governmental actors to support evidence-informed decision-making.