Climate change has led to extreme heat events, disproportionately affecting vulnerable populations. Heat stress during pregnancy is linked to adverse health outcomes, yet the biological mechanisms remain poorly understood. This research study aims to investigate the effect of environmental heat on maternal, fetal and infant health and examine the biological pathways linking heat stress to adverse pregnancy outcomes.

This prospective cohort study will recruit 6000 pregnant women from three districts in Sindh, Pakistan. Eligible participants ≥18 years old, will have a minimum of five scheduled visits from

The study has received ethical approval from the Aga Khan University (AKU) (Ref: 26249) and the Pakistan National Bioethics Committee (Ref: 1065/23/1736). Written informed consent will be obtained from all participants before enrolment. Referral pathways to healthcare facilities will be established to ensure timely management of pregnancy complications. Findings will be disseminated through peer-reviewed publications, scientific conferences, and engagement with policymakers and public health stakeholders to inform climate-resilient maternal health strategies. Results will also be shared with participants and communities through meetings and informal sessions to raise awareness and support evidence-based heat adaptation.

NCT01234567.

Total alloplastic replacement of the temporomandibular joint (TMJ) is a viable treatment option for severe TMJ disorders (TMDs) unresponsive to conservative approaches, as well as for reconstruction of congenital or acquired TMJ defects. However, clinical data on indications, outcomes, complications and long-term effects remain limited, and no global registry currently exists. This study aims to address this gap by establishing an international registry to collect data from patients undergoing total alloplastic TMJ replacement systematically. The registry will document clinical indications and disease progression, explore relationships between treatments, outcomes and quality of life, identify predictors of favourable outcomes and inform future research.

This international, prospective, multicentre, observational registry will enrol approximately 200 patients with TMD requiring total alloplastic TMJ replacement, with follow-up lasting up to 5 years postoperatively. The data collected will include underlying disease, treatment details, functional outcomes, patient-reported outcomes and procedure-related adverse events. The registry will also monitor patients who decline surgery and record their reasons. All treatments will adhere to the standard of care at each participating centre.

Ethics approval was obtained from the responsible ethics committee (EC) at each participating site prior to TMJ surgery. All patients will be enrolled following an informed consent process approved by the relevant EC. Study results will be disseminated through peer-reviewed publications.

Approving ECs include: Krishnadevaraya College of Dental Sciences and Hospital EC, KCDS/Ethical Comm/54/2022–23; Ethikkommission Nordwest- und Zentralschweiz, 2019–02387; University of Belgrade School of Dental Medicine EC, 36/19; National Videnskabsetisk Komité, 2401881; University of KwaZulu-Natal Biomedical Research EC, BREC/00001592/2020; Etikprövningsmyndigheten, 2019–04477; Ethikkommission Medizinische Hochschule Hannover, 8660_BO_K_2019; Ethik-Kommission an der Medizinischen Fakultät der Universität Leipzig, 080/21-lk; Comité de Ética de la Investigación con Medicamentos Hospital Universitario 12 de Octubre, 19/392; Landesärztekammer Rheinland-Pfalz EC, 2025–18012-andere Forschung/nachberatend; Local Ethical Committee at National Medical and Surgical Centre named after NI Pirogoov, LEC meeting 5; Ethikkommission bei der LMU München, 19–589; Komisja Bioetyczna przy Warmiłsko-Mazurskiej Izbie Lekarskiej w Olsztynie, 12/2021; De Medisch Ethische Toetsings Commissie Erasmus MC, MEC-2019–0696 and Comissão Nacional de Ética em Pesquisa, 3.825.711.

NCT03991728.

This cross-sectional survey study evaluates the influence of international observerships organised by the coalition of healthcare professionals from academic institutions—the Ukrainian Alliance for Medical Exchange and Development (UA-MED)—on the professional development, knowledge transfer and clinical practice improvement of Ukrainian healthcare professionals during the war.

A total of 263 international observerships were facilitated for 204 Ukrainian medical professionals across the institutions in the USA, Canada, Europe and Australia during 2022–2024. To assess the impact of these observerships, a survey was administered focusing on overall satisfaction, procedural knowledge gained and challenges faced when implementing new techniques on return. The primary outcome was the success score, defined as a composite score of implementing new procedures, initiating quality improvement projects and knowledge dissemination efforts.

A total of 128 medical professionals from 45 Ukrainian institutions who completed 138 observerships in 27 institutions abroad participated in the survey (response rate of 62.7%). Observers varied by profession: surgeons (32.8%), radiation oncologists (14.8%), medical oncologists (11.7%), anaesthesiologists (11.7%) and others. Observerships lasted a median of 4 weeks; 74.1% included conference attendance. The average success and satisfaction scores were 6.5/10 and 9.3/10, respectively.

The majority (92.7%) reported a shift in perception of how to practise medicine and 75.5% implemented new procedures on returning to Ukraine. Encouraged to disseminate knowledge, participants provided informal training to colleagues (67.3%), prepared presentations for their institutions (65.5%) and national conferences (32.7%), incorporated learnt materials into educational lectures (39.1%) and engaged in all the activities above (15.5%).

The international observerships played an important role in enhancing the reported skills and knowledge of Ukrainian healthcare professionals during the war. Improvements were reported in clinical practice, medical education and the implementation of new procedures. The success of these observerships underscores the potential for similar programmes in other low-income and middle-income countries/upper-middle-income countries.

This study aimed to describe the experiences of chemotherapy-induced oral mucositis among patients with breast cancer. Its primary focus is on how chemotherapy-induced oral mucositis affects day-to-day functioning, psychological wellness and overall quality of life.

12 Jordanian women who had been diagnosed with breast cancer and had presented with chemotherapy-induced oral mucositis were the purposive sample for this qualitative study, which employed in-depth, semistructured interviews. The verbatim transcriptions of the interviews were subjected to thematic analysis.

The thematic analysis of the 12 participants’ reviews revealed five main themes: distressing physical manifestations, eating and nutritional struggles, mouth care difficulties, psychological strain, social and emotional consequences, and coping and adaptation strategies.

Breast cancer patients’ daily routines, mental health and quality of life are all significantly impacted by chemotherapy-induced oral mucositis. According to the study, individuals with breast cancer who experience chemotherapy-induced oral mucositis should get patient-centred care and address their emotional, psychological, social and physical discomfort to maximise their outcomes.