Pediatric hospital medicine (PHM) is a growing field with a unique scholarly perspective and evolving role in academic leadership. Since the last systematic assessment of PHM research in 2009, predating subspecialty certification in 2016 and fellowship accreditation in 2020, the research infrastructure within PHM has not been reevaluated. We sought to assess the current state of PHM research by assessing the number, scope, and scholarly domains of research faculty, as well as research funding and support. Using the Pediatrics Research in Inpatient Settings Network, we distributed a cross-sectional survey to PHM group leaders across the United States and Canada. The 16-item instrument, adapted from prior PHM and adult hospital medicine surveys, assessed program demographics, faculty effort allocation, research support, funding, and scholarly domains. Surveys were distributed via REDCap with follow-up reminders. Descriptive statistics were used. 49 programs responded (51% response rate), representing 1702 faculty (∼40% of US pediatric hospitalists). Fewer than half of programs (n = 21, 43%) reported faculty with more than 50% research effort. One-hundred and ninety faculty members (11%) had dedicated research time, and 72% of those conducting quality improvement research did so without any protected effort. Most PHM programs (n = 27, 55%) received less than $100 000 in total annual research funding. Despite recent PHM subspecialty designation and pediatric hospitalist desire to conduct research, dedicated time and associated supports are uncommon in PHM groups. Improvements in the PHM research pipeline will require understanding institutional financial constraints and diversifying and strengthening research funding.

Health policy and political decision-making increasingly shape reimbursement, technology access, workforce capacity, and research funding in urology. Despite these growing influences, many urologists receive little formal training in advocacy. This review is timely given ongoing reimbursement reform, regulatory shifts, cancer policy initiatives, and cross-border health legislation in both the United States and the European Union (EU). Recent literature highlights declining procedural reimbursement, workforce shortages, and regulatory barriers to innovation in the United States, alongside expanding EU-level influence in public health, data governance, research funding, and cancer screening policy. Case studies, including reform of vaginal estrogen labeling, Veterans' prostate cancer legislation, and EU prostate cancer screening recommendations, demonstrate how coordinated clinician advocacy can directly shape policy outcomes. Professional societies and policy offices increasingly serve as structured channels for specialty engagement. Advocacy is emerging as a core professional competency for urologists. Structured engagement at institutional, national, and supranational levels enables clinicians to align policy with clinical realities, promote equitable access, and safeguard innovation. Integrating policy literacy into urologic training may strengthen the specialty's ability to influence sustainable, evidence-based health systems.

Results of the American Venous Forum research retreat on C2 disease confirms that the biology of varicose veins including etiology, progression, and novel therapeutics, as well as disparities, are top research priorities.

Diversity analysis of indoor and outdoor fungal bioaerosols in UK households: a prospective, observational, longitudinal study.

Thriving at work experiences among newly registered masters prepared nurses: A qualitative study.

Internal mammary chain and medial supraclavicular lymph node irradiation in stage I-III breast cancer (EORTC trial 22922/10925): an unplanned subset analysis of 20-year outcomes in patients with node-negative breast cancer.

B cell maturation antigen (BCMA) is a key therapeutic target in multiple myeloma (MM), yet its whole-body in vivo distribution and role in disease assessment remain incompletely defined. We aimed to evaluate the safety, diagnostic performance, and clinical utility of a novel BCMA-targeted PET tracer, 68Ga-PFBC01, in patients with plasma cell disorders. We conducted a single-center, prospective, single-arm phase I trial (ClinicalTrials.gov NCT06717113). Fifty patients underwent 68Ga-PFBC01 PET/CT, including 40 with paired 18F-FDG PET/CT for head-to-head comparison. Primary outcomes included diagnostic performance (sensitivity, specificity, PPV, NPV, and inter-reader agreement). Secondary outcomes included correlations with clinical biomarkers, treatment response assessment, impact on clinical decision-making, and safety. 68Ga-PFBC01 PET/CT demonstrated superior diagnostic performance compared with 18F-FDG PET/CT (sensitivity 96.9% vs 84.6%; specificity 71.4% vs 60.0%). Quantitative PET-derived tumor burden correlated with M protein (R = 0.325, P = 0.026), free light chains (R = 0.340-0.437, P ≤ 0.015), soluble BCMA (R = 0.433, P = 0.050), and bone marrow plasma cells (R = 0.682, P < 0.001). Imaging findings altered clinical management in multiple cases, enabling both therapy escalation and de-escalation. Blood-pool uptake strongly correlated with soluble BCMA (R = 0.899, P < 0.001) and overall disease burden (R = 0.736, P < 0.001). No serious tracer-related adverse events were observed; two patients (4%) experienced mild events. 68Ga-PFBC01 PET/CT provides biologically specific, whole-body assessment of MM, outperforming 18F-FDG and enabling integrated evaluation of tumor burden and systemic disease activity, with direct implications for clinical decision-making. gov NCT06717113. National Natural Science Foundation of China (82472018, 82402320) to Prof. Lei Kang, 82402320 to Dr. Tianyao Wang); Beijing Nova Program (20240484725) to Prof. Lei Kang; National High Level Hospital Clinical Research Funding (Interdisciplinary Research Project of Peking University First Hospital, 2024IR07, Scientific and Technological Achievements Transformation Incubation Guidance Fund Project of Peking University First Hospital, 2025CX38, 2024CX18) to Prof. Lei Kang.

Efficacy, safety, and immunogenicity of an Escherichia coli-produced nine-valent human papillomavirus vaccine: a multicentre, double-blind, randomised, controlled, phase 3 trial.

ABSTRACT Background The proposal to involve patients and the public (Patient and Public Involvement; PPI) in research is increasingly recognised as important in research concerning speech, language, and hearing and communication difficulties. Whilst there is extensive guidance about PPI involvement by national agencies such as the National Institute of Health Research in the UK, little information is currently available concerning whether these expectations are met in any area of healthcare provision. Aims This systematic review aimed to identify, describe and evaluate how PPI has been implemented and reported in research concerning childhood speech, language, hearing and communication difficulties. Methods Six electronic databases were systematically searched for eligible studies reporting PPI in these fields. Records were screened against predefined eligibility criteria. Data were extracted on study characteristics, PPI contributors, stages and methods of involvement, reported impacts, and quality of PPI reporting. The methodological and PPI quality were assessed using MMAT and GRIPP2 Short Form, and findings were synthesised narratively. Results Twenty‐one studies were included. PPI was reported variously across speech, language, hearing and communication topics, the implementations varied considerably. Parents, carers and professionals were more commonly involved than children and young people themselves. Most studies used consultation‐based approaches, often during early stages (e.g., study design or material development), while fewer reported involvement in later stages (e.g., dissemination, implementation or evaluation). Reporting was inconsistent, particularly regarding contributor characteristics, accessibility adaptations, decision‐making influence, and the impact of PPI. Conclusions The systematic review showed that PPI in childhood speech, language, and hearing difficulties has advanced significantly, with the growing interest and number of publications, particularly in the past five years. The review also highlighted challenges such as confusion and heterogeneity of PPI concepts, representativeness issues, tokenistic practices, lack of support given to lay contributors, and limited impact evaluation. Future research should distinguish PPI from research participation, involve children and young people more directly where appropriate, report contributors’ roles and influence more transparently, and consider accessibility and communication support throughout the involvement process. WHAT THIS PAPER ADDS What is already known on the subject Health service providers and research funders now require attention to Patients and Public Involvement (PPI) in healthcare research. PPI highlights the need to work jointly with stakeholders at all steps involved in research to allow them to take governance over their health conditions. Whilst emphasis on PPI applies to health issues in general, there is no specific review of PPI considerations in research on health factors that affect hearing and communication difficulties. This omission is particularly noteworthy when considering issues that arise in early development. What this study adds to existing knowledge A systematic review was conducted to assess current progress with respect to PPI for hearing and communication research in childhood and adolescence. The review identified research involving PPI that met quality requirements. Challenges related to PPI were highlighted in further analyses that revealed confusion and heterogeneity in PPI concepts, representativeness issues, tokenistic practices, a lack of support given to lay contributors, and a limited evaluation of the impacts of PPI. What are the clinical implications of this work? PPI involvement in clinical research for communication and hearing difficulties should have a positive impact on the well‐being of children and adolescents. Four challenges were highlighted when considering the current state of research on PPI in this domain: shallow involvement of the public and patients, conflicting expectations between groups participating in research, lack of clarity of research outcomes as they relate to PPI and variable standards of reporting PPI findings across studies. Tentative recommendations concerning how each of these matters could be addressed are offered.

ABSTRACT Doctoral education in Sub-Saharan Africa has expanded rapidly, yet evidence on post-PhD career trajectories remains limited. This study examines employment outcomes, career pathways, and structural constraints shaping doctoral graduates’ experiences in Kenya, Ethiopia, and Rwanda. Using a mixed-methods design, the study integrates survey data (n = 154), key informant interviews (n = 27), and multi-stakeholder policy dialogues under the Regional Scholarship and Innovation Fund. Guided by identity–trajectory theory and academic precarity, the analysis explores how individual aspirations intersect with institutional conditions and broader structural dynamics. Findings show that while career advancement and research engagement motivate doctoral training, graduates navigate fragmented and uncertain career pathways. Academic employment is often characterized by low remuneration, limited research funding, and weak institutional support, prompting engagement in consultancy and externally funded projects. Policy dialogues highlight systemic gaps, including weak research ecosystems, limited industry linkages, and the absence of structured postdoctoral pathways. Alignment between doctoral training and employment is stronger in Kenya and Rwanda than in Ethiopia. The study demonstrates that doctoral career trajectories are shaped by interactions across micro, meso, and macro levels, providing comparative evidence and policy-relevant insights for strengthening doctoral training, research systems, and sustainable academic careers in Sub-Saharan Africa.

The assessment of vestibular schwannomas (VS) requires a standardized approach as growth is a key element in defining treatment strategy. Volumetric measurements offer higher sensitivity and precision, but existing methods of image segmentation, are labour-intensive and prone to variability. Artificial intelligence (AI) frameworks to segment VS using magnetic resonance imaging (MRI) achieving state-of-the-art capability can fully automate the detection and segmentation of VS. These tools can be used for automating the extraction process of various linear and volumetric measurements. A consistent approach to recording data, facilitated by AI, will allow the accumulation and comparison of evidence to identify the most effective treatments for patients with VS. This protocol aims to develop a Delphi consensus for the assessment of VS and deployment of AI-based image analysis as a tool for use in VS management. A three-phase consensus study will be undertaken; Phase 1: systematic review (PROSPERO registration number CRD42024604452) of trials and observational studies reporting the measurement of VS to identify a list of candidate indicators; Phase 2: refinement of this list and development of a set of questionnaire questions performed by our local steering committee; and Phase 3: a two-round Delphi questionnaire and consensus meeting with expert stakeholders from the British Skull Base Society (BSBS), European Skull Base Society (ESBS) and European Society of Head and Neck Radiology (ESHNR). Participants will be recruited through professional bodies. The core reporting set will be disseminated through peer-reviewed publication, co-production with journal editors, research funders and professional bodies, and presentation at national conferences. Not applicable.

Efficacy and safety of tirofiban after successful endovascular reperfusion in acute ischaemic stroke (ATTRACTION) in China: a multicentre, double-blind, randomised controlled trial.

The current debate in science funding of early-career researchers is shifting from exploring its effects on future outcomes to understanding who is more likely to benefit from it. In this paper, we explore the effect of research funding among male and female applicants. Using propensity score weighting on data from the Medical Research Council in the United Kingdom, we examine the effect on research income, scientific productivity (publications), as well as scientific influence (citations, relative citation ratio, field citation ratio and Altmetrics score). Successful applicants in both groups secure more future research funding than unsuccessful ones. In addition, successful female applicants receive more citations and are better cited in their field than female applicants who did not receive funding. There is no statistically significant difference in scientific productivity or influence between successful and unsuccessful male applicants.

Health equity depends on data equity: the representation of communities in the data used to identify disparities, target interventions, and hold systems accountable. Recent shifts in federal health data infrastructure, including changes to datasets and reductions in agency capacity, have introduced uncertainty for state officials who bear primary responsibility for population health outcomes. Even apart from these shifts, robust state capacity matters in its own right, making investment in resilient data infrastructure a timely priority. We examine how changes in federal health data infrastructure affect states' capacity to advance data equity and how policymakers can respond. We review across state data disaggregation legislation, draw on the California Health Interview Survey (CHIS) as a model case, and synthesize evidence on data interoperability, governance, and dissemination. Some states are already moving beyond federal minimums on race and ethnicity data collection. For example, Connecticut, Oregon, and Massachusetts have enacted expansive laws collecting detailed subgroups; Illinois, New York, and New Jersey have added Middle Eastern and North African and other categories across all state agencies. Colorado and Oregon extend collection to sexual orientation, gender identity, and disability status. We offer examples from California's recent legislation and show how CHIS operationalizes such mandates. We also identify persistent constraints, including incomplete demographic fields in administrative data, workforce and interoperability gaps, and the need for governance frameworks and data firewalls that safeguard privacy. State-led data infrastructure will help build effective public health practice. The aim is not 50 incompatible systems but an ecosystem of comprehensive and inclusive systems that are more granular, responsive, and community-accountable. For such an ecosystem to function, the systems must still communicate, which depends on shared standards and definitions that keep data comparable across states and over time. Realizing this vision requires diversified funding, cross-agency coordination, strong governance, and active roles for researchers, philanthropy, and communities, so that progress in measuring disparities endures across changing policy environments.

Government health research funders are frequently criticized on the grounds that their distribution of resources fails to reflect a population's disease burden. These critiques do not take into account what other research funders are doing. In this paper, I argue that this is a mistake. Both governmental and non-profit research funders ought to be aiming for a just distribution of overall research resources. Individual funders faced with the non-compliance of other funders therefore have two ethical obligations. First, an obligation to coordinate: each ought to share information about its funding allocations, to actively coordinate its activities with other funders, and to encourage other funders to do as they should. Second, an obligation to counterbalance: where an individual funder expects continuing non-compliance by other funders, it should skew its own funding so as to compensate for the shortfall as far as it can.

Protocol for a SPIRIT extension for reporting Pragmatic and Explanatory trial protocols designed using the PRECIS tool. (SPIRIT-PRECIS).

NIH Funding for Artificial Intelligence in Surgical Specialties: Allocation and Alignment with US Disease Burden.

Efficacy and effectiveness of long-acting monoclonal antibodies and vaccines against RSV: a systematic review and meta-analysis of studies from 2018 to 2025

Older adults often have impaired physiologic reserve and are at higher risk for postoperative complications after spinal fusion surgery. To evaluate the efficacy of multimodal prehabilitation plus Enhanced Recovery After Surgery (PREERAS) versus ERAS alone on 90-day postoperative complications in older adults undergoing elective spinal fusion. Multicenter, open-label, assessor-blinded, 1:1 parallel-group randomized controlled trial. (ClinicalTrials.gov: NCT06140797). 3 tertiary hospitals in China. Adults aged 75 years or older undergoing elective spinal fusion surgery between May 2024 and May 2025. Participants were randomly assigned to receive either preoperative Vivifrail-based, multimodal PREERAS (PREERAS group) or ERAS alone (ERAS group). The 4-week prehabilitation program integrated supervised group sessions, Vivifrail multicomponent exercise, nutritional optimization, and psychological interventions. The primary outcome was the occurrence of any postoperative complication within 90 days of surgery, recorded and graded per the Clavien-Dindo classification system. A total of 312 patients were assessed for eligibility, with 164 randomly assigned. Of the 159 patients included in the final analysis (mean age, 78.7 years; 59% women), 59 patients (74.7%) in the PREERAS group and 73 patients (91.2%) in the ERAS group experienced at least 1 complication (risk ratio, 0.80 [95% CI, 0.67 to 0.95]; risk difference, -18.0% [CI, -27.0% to -9.0%]). Unblinded participants and clinicians. Generalizability may be limited with longer hospital stays in the Chinese health care system. The implementation of multimodal prehabilitation in 3 tertiary hospitals in China reduced 90-day postoperative complications in older adults undergoing enhanced recovery after spinal fusion surgery. However, individual sites will need to consider applicability of findings and resource requirements of prehabilitation before implementation. Capital's Funds for Health Improvement and Research.

Self-administered acupressure training for depression in community-dwelling individuals: a randomized controlled trial and cost-effectiveness analysis