Outcome measuresThe Research Articles

The efficacy and safety of thymosin α1 for sepsis (TESTS): multicentre, double blinded, randomised, placebo controlled, phase 3 trial

ObjectiveTo evaluate whether the immunomodulatory drug thymosin α1 reduces mortality in adults with sepsis.DesignMulticentre, double blinded, placebo controlled phase 3 trial.Setting22 centres in China, September 2016 to December 2020.Participants1106 adults...

Intra-arterial tenecteplase after successful endovascular recanalisation in patients with acute posterior circulation arterial occlusion (ATTENTION-IA): multicentre randomised controlled trial

ObjectiveTo assess whether intra-arterial tenecteplase administered after successful endovascular recanalisation improves outcomes in patients with acute arterial occlusion of the posterior circulation.DesignMulticentre randomised controlled trial.Setting31 hospitals in China, 24 January...

Opioid agonist therapy discontinuation in British Columbia: a cross-sectional study of people who access harm reduction services

ObjectivesThis study evaluates the prevalence and correlates of opioid agonist therapy (OAT) discontinuation across British Columbia (BC), using a sample of individuals who used substances and accessed harm reduction sites.DesignThis...

Missed opportunity for nasal continuous positive airway pressure in preterm neonates admitted at a tertiary-level hospital newborn unit in Kenya: a mixed method study

BackgroundRespiratory Distress Syndrome (RDS) is the most common complication of preterm neonates. It remains one of the major public health concerns that contribute to neonatal mortality and morbidity, especially in...

Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilities

ObjectivesThe objective of this study is to explore the relationship between loneliness and socioeconomic status and social networks in older adults with activity of daily living (ADL) disabilities in China...

Adaptive coping mechanisms use and associated factors among adult glaucoma patients attending the University of Gondar Comprehensive Specialized Hospital, Tertiary Eye Care and Training Center, Northwest Ethiopia: an institution-based cross-sectional study

ObjectiveAdaptive coping mechanisms (ACMs) are effective ways to cope with stress and anxiety in patients with chronic illnesses, such as glaucoma. This study aimed to assess the proportion of ACM...

Cost-utility analysis of combination medical therapies in chronic coronary syndrome: a comparative study using real-world and patient-level data from Iran

ObjectivesThe main objective was to evaluate the cost-effectiveness of various medical therapy combinations in managing chronic coronary syndrome (CCS) in Iran, based on real-world and patient-level data.DesignA cost-utility analysis employing...

Does candidate race influence simulated patient ratings in standardised assessments of clinical practice? A single-blinded randomised study in UK medical schools

ObjectivesStandardisation of medical examinations involves minimising assessor stereotyping and bias for a fair process. This study aimed to determine whether being a non-white candidate affected scoring by simulated patients, compared...

Subnational trends and inequalities of under-immunisation and zero-dose among children aged 12–23 months in Uganda: a national population-based cross-sectional study

ObjectiveDespite the Global Vaccine Action Plan’s goal of at least 90% vaccine coverage for all children, Uganda has made limited progress in vaccination over the past decade. The objective of...

Treating shock with norepinephrine administered in midline catheters in an intermediary care unit: a retrospective cohort study

ObjectivesA rising incidence of septic shock as well as recommendations for early vasopressor initiation has increased the number of patients eligible for norepinephrine (NE). Traditionally, NE has been administered through...

Effects of mild cognitive impairment and sleep disorders on the minimum alveolar concentration value of sevoflurane

ObjectivesTo explore the effect of mild cognitive impairment (MCI) and MCI with sleep disorders on the potency of sevoflurane anesthesia in the elderly.DesignProspective study methods. Dixon up-and-down methods.SettingComprehensive public tertiary hospital, Cangzhou City, Hebei Province, China.Participants70 elderly patients scheduled for elective unilateral breast cancer surgery and finally analyzed 58 patients, including 30 patients with MCI (group M) and 28 patients with MCI with sleep disorders (group MS).Outcome measuresThe required minimum alveolar concentration (MAC) value of sevoflurane in the two groups was determined using the Dixon up-and-down method. The MAC value of sevoflurane and its 95% confidence interval (CI) were calculated using the logistic regression method. Serum melanin-concentrating hormone concentrations were determined by Elisa kits.ResultsThe MAC value of sevoflurane in group M was 1.43 (95% CI 1.05–1.61%), and the MAC value of sevoflurane in group MS was 1.93 (95% CI 1.78–2.08%), There were notable differences between the two groups (P < 0.0001). The level of melanin-concentrating hormone (MCH) in the MS group was significantly lower than that in the M group (21.52 ± 3.82 vs. 37.17 ± 3.66 pg/ml, P < 0.0001). There was a significant negative correlation between MCH levels and the probability of body movement during skin incision (OR = 0.844, 95% CI: 0.715–0.996, P = 0.045).ConclusionsPatients with MCI with sleep disorders required higher doses of sevoflurane than those with MCI alone. Changes in anesthetic requirements may be related to changes in MCH levels.

Trends in the survival of very preterm infants between 2011 and 2020 in France

ObjectiveThe objective is to evaluate changes in survival to discharge of liveborn infants less than 32 weeks’ gestational age (GA) in France, where the latest available data on very preterm...

Night shift work and prostate cancer: a large cohort study from UK Biobank and Mendelian randomisation study

ObjectiveThe global concern regarding the health implications of night shift work has escalated. Nevertheless, variations exist in the observed association between night shift work and prostate cancer (PCa). This study...

Cross-sectional evaluation of medical reversals among National Institute of Health guideline practices implemented during the COVID-19 pandemic: how often did experts err in a time of crisis?

ObjectiveThe COVID-19 pandemic required the rapid and often widespread implementation of medical practices without robust data. Many of these practices have since been tested in large, randomised trials and were...

Exploring the relationship between personal and cohabiting family members’ COVID-19 infection experiences and fear of COVID-19: a longitudinal study based on the Japan COVID-19 and Society Internet Survey (JACSIS)

ObjectivesThis study aims to explore the relationship between the combined experiences of COVID-19 infection in individuals and their family members and the resulting fear of COVID-19, with a focus on...

Efficacy of refrigerated gel packs for therapeutic hypothermia in neonatal retrieval: a retrospective cohort study

ObjectiveTo determine the efficacy of refrigerated gel packs in achieving and maintaining target temperature in neonates receiving therapeutic hypothermia (TH) for hypoxic ischaemic encephalopathy during neonatal retrieval.DesignRetrospective cohort study.SettingPaediatric Infant...

Effect of heated mittens on physical hand function in people with hand osteoarthritis: randomised controlled trial

ObjectiveTo assess the effect of electrically heated mittens on physical hand function in people with osteoarthritis of the hands compared with control mittens.DesignRandomised controlled trial.SettingOsteoarthritis outpatient clinic, Copenhagen, Denmark.Participants200 people...

Associations between maternal body mass index and childhood infections in UK primary care: findings from the Born in Bradford birth cohort study

ObjectiveTo explore associations between maternal body mass index (BMI) in early pregnancy and childhood infections.DesignBirth cohort study linked to primary care records.SettingBradford, UK.ParticipantsLive singleton births within the Born in Bradford...

Enhancing access to specialist appointments in tertiary healthcare in Shanghai, China: a structured reservation pathway using digital health technologies

ObjectiveThe aim of this study is to develop, implement the precise reservation path (PRP) and investigate its prediction function for scheduling shunting patients for specialist appointment registration in Shanghai, China.DesignThe...

Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort study

ObjectivesTo evaluate and compare medication adherence and persistence for patients newly initiating single-inhaler triple therapy (SITT) and multiple-inhaler triple therapy (MITT) for chronic obstructive pulmonary disease (COPD) in Japan.DesignRetrospective, new-user,...