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To compare the effectiveness of multifactorial and exercise programs in preventing falls among older adults, with a specific focus on evaluating the individual and combined contributions of their key intervention components.
This study was a systematic review and component network meta-analysis. PubMed, Embase, and Web of Science were searched from inception to February 2025 for randomized controlled trials, focusing on four primary outcomes: fallers, recurrent fallers, injurious fallers, and fractured fallers. Risk of bias was evaluated using the Cochrane tool, and additive component network meta-analysis compared intervention group and component efficacy.
69 randomized controlled studies were included. In multifactorial interventions, traditional health education could increase fall risk (iRR: 1.10, 95% CI [1.03; 1.67]) and recurrent fall risk (iRR: 1.25, 95% CI [1.06; 1.48]). Medication management can increase recurrent fall risk (iRR: 1.35, 95% CI [1.09; 1.67]) and fracture risk (iRR: 2.11, 95% CI [1.48; 3.00]). Exercise (iRR: 1.24, 95% CI [1.01; 1.53]) increased fracture risk, and environment modification (iRR: 0.56, 95% CI [0.61; 0.79]) reduced it. The additive effect of risk assessment and advice, exercise, and environment modification reduced fall risk. In exercise programs, gait and balance (iRR: 0.58, 95% CI [0.36; 0.93]) can reduce recurrent fall risk. An intervention containing two components (gait and balance + strength and resistance) reduced the risk of falls and fall-related injuries.
Environment modification reduced fracture risk, emphasizing the value of creating safe living spaces. The combination of risk assessment, advice, exercise, and environment modification reduced fall risk, suggesting a holistic approach may be effective in preventing falls. Traditional methods of health education and medication management are in urgent need of updating to synergize with other exercise components and enhance the effectiveness of fall prevention. Prospective clinical trials are needed to optimize combinations of exercise components, particularly integrating gait and balance training with strength and resistance exercises.
The review was registered online in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number (CRD42025643530)
Oncology nurses are frequently subjected to significant psychological stress due to the demanding nature of cancer care, which negatively impacts their mental and physical health as well as the quality of patient care. Although Mindfulness-Based Stress Reduction has been demonstrated to be effective in alleviating stress, practitioners often encounter barriers such as limited engagement and difficulty maintaining regular practice.
To enhance engagement and adherence, we integrated art elements into the Mindfulness-Based Stress Reduction framework, creating the Mindfulness-Based art therapy program, and evaluated its effectiveness among oncology nurses.
A three-arm randomized controlled trial.
90 oncology nurses participated (Mindfulness-Based Art Therapy group = 30, Mindfulness-Based Stress Reduction group = 30, waitlist controls group = 30) in an 8-week program. Stress, anxiety, depression, fatigue, and mindfulness levels were assessed at baseline, immediately after the fourth week of intervention, and immediately after the intervention concluded. Compliance and satisfaction were evaluated using attendance rates and satisfaction questionnaires. Descriptive statistics were used to analyze general data; intervention effects were compared using one-way ANOVA and generalized estimating equations, and compliance and satisfaction were compared using independent samples t-test.
Both Mindfulness-Based Art Therapy and Mindfulness-Based Stress Reduction significantly improved stress, physiological markers, and mindfulness vs. controls. Mindfulness-Based Stress Reduction better reduced depression (β = −2.980, 95% CI: −5.427, −0.533, p = 0.017), while Mindfulness-Based Art Therapy was superior for fatigue (β = −11.582, 95% CI: −20.615, −2.550, p = 0.012). Mindfulness-Based Art Therapy had higher adherence (93.3% vs. 73.3%, p < 0.05) and satisfaction (3.27 ± 0.45 vs. 2.40 ± 0.52, p = 0.01).
For oncology nurses, Mindfulness-Based Art Therapy is as effective as Mindfulness-Based Stress Reduction for improving stress and mindfulness, while providing greater adherence, satisfaction, and more consistent fatigue reduction.
Chinese Clinical Trial Registry, ChiCTR2300078124 (http://www.chictr.org.cn), 30/11/2023
by Hang Sun, Haozhi Xu, Junying Li, Xiaoman Xie, Junmei Zhang, Hongjie Dong, Huanhuan Xie, Qi Wang, Guihua Zhao, Kun Yin, Jingyu Yang, Jianwei Zhou, Ruili Wu, Chao Xu
Gastric cancer (GC) is one of the most common and lethal cancers globally. methyltransferase-like 3 (METTL3)-mediated N6-methyladenosine (m6A) RNA methylation plays a crucial role in tumor initiation and progression by regulating RNA function. STM2457, a highly efficient METTL3 inhibitor, can inhibit METTL3 activity and may serve as a potential therapeutic strategy in cancers. However, the role of STM2457 for GC cells is still unknown. In this study, we analyzed the expression profile data of GC in TCGA and GEO databases, and further explored the expression involvement of METTL3 in GC cell line, investigated the therapeutic effect of STM2457 targeted inhibition of METTL3 in GC both in vitro and in vivo experiments. The results indicated that STM2457 could suppress GC cell proliferation and migration by inhibiting METTL3, and also promoted cell apoptosis and arrest the cell cycle in S phase. In addition, STM2457 could inhibit tumor growth in subcutaneous xenotransplantation mouse model. Our findings suggested that STM2457 had great potential for the treatment of GC and could serve as a foundation for future clinical applications.Walking, as a simple, low-cost and easily implemented form of exercise, offers multiple health advantages. The WalkLung trial aims to evaluate the efficacy of a home-based walking exercise and education intervention in promoting early functional recovery after lung cancer surgery.
WalkLung is a multicentre, parallel-group, randomised controlled trial conducted at three hospitals in China, with stratification by study centre. A total of 116 patients with postoperative lung cancer will be randomised in a 1:1 ratio to either the intervention group (home-based walking exercise and education for 4 weeks) or the control group (usual care). The primary outcome is the longitudinal walking difficulty score during the 4-week postdischarge, measured by the validated perioperative symptom assessment for lung surgery scale (0–10 scale), assessed at discharge and weekly for 4 weeks. Secondary outcomes are the 6-min walk test, pulmonary function, complications, physical activity level, quality of life, social functioning, exercise adherence and adverse events. Long-term outcomes (up to 6 months) will be analysed and reported separately. All analyses will use an intention-to-treat approach, with outcome measures analysed as appropriate using generalised estimating equations for repeated measures, and t-tests or 2 tests.
Ethical approval was obtained from the Ethics Committee for Medical Research and New Medical Technology of Sichuan Cancer Hospital (No. SCCHEC-02-2025-091) and all participating subcentres. Written informed consent will be obtained from all participants. The manuscript is based on protocol V.1.0 (2 January 2025). The study findings will be disseminated through peer-reviewed journal publications and conference presentations.
ChiCTR2500103081.
Respiratory syncytial virus (RSV) is a leading cause of hospitalisation in infants worldwide. New immunoprophylactic products, including long-acting monoclonal antibodies and maternal vaccines, have demonstrated high efficacy in prelicensure clinical trials. Understanding how these interventions perform outside controlled trials, and how viral evolution or host factors influence protection, is essential for sustaining confidence in RSV prevention programmes.
We will conduct a 5-year, test-negative case–control study among infants ≤12 months of age who present with acute respiratory illness (ARI) within a large healthcare delivery network serving a demographically diverse population. Cases will be infants testing positive for RSV by PCR, and controls will be RSV-negative infants meeting the same ARI criteria. Data will be obtained from electronic health records, structured caregiver surveys and state immunization registries to ensure accurate classification of exposures and covariates. Vaccine effectiveness will be estimated using multivariable logistic regression controlling for potential confounding. RSV-positive specimens will undergo full-genome sequencing to identify variant lineages and potential immune-escape mutations. A subset of participants will provide acute and convalescent blood samples for single-cell immune profiling to define innate and adaptive responses associated with breakthrough infection.
The study protocol has been approved by the Yale Human Investigation Committee (HIC #2000036550). Written informed consent will be obtained from all parents or legal guardians prior to participation. Study findings will be disseminated through peer-reviewed publications, scientific meetings and public repositories, with fully de-identified participant data to protect privacy and confidentiality. Viral genomic data will be shared in accordance with the National Institutes of Health Genomic Data Sharing Policy, and analytical code will be made publicly available to ensure reproducibility.
To analyse the current status of psychological resilience in Parkinson's disease (PD) patients and its correlation with social support and coping style.
A cross-sectional study.
PD patients hospitalized in a tertiary-level hospital in Shijiazhuang, Hebei Province, from March 2022 to March 2023 were selected for the study using the convenience sampling method. A general information questionnaire, psychological resilience scale, Medical Coping Modes Questionnaire and Perceived Social Support Scale were used to investigate 111 cases of PD. SPSS 25.0 software was used for statistical analysis. The data were analysed using independent samples t-test, one-way ANOVA, multiple linear regression analysis and the Pearson correlation coefficient.
Parkinson's disease patients have a moderate level of psychological resilience. The results of the Pearson correlation analyses showed that the level of psychological resilience was positively correlated with social support and confrontation and was negatively correlated with avoidance and acceptance-resignation. The results of multiple linear regression analysis showed that social support and acceptance-resignation were the influencing factors of psychological resilience in PD patients.
The psychological resilience of PD patients is at a moderate level. Social support and acceptance-resignation are the factors influencing the psychological resilience of PD patients.
This study analysed the level of psychological resilience in PD patients and its correlation with social support and coping style from the perspective of positive psychology to provide some reference for targeted clinical interventions. Our study found that social support and acceptance-resignation are influential factors in psychological resilience in PD patients. Medical staff should encourage patients to face the disease positively and their social support should be increased in order to improve their level of psychological resilience.
No patient or public contribution.
Death preparedness is an important prerequisite for improving the quality of life and the quality of death in advanced cancer patients. However, research on the level of death preparedness in patients is insufficient, and there is little understanding of the current status and influencing factors of death preparedness in advanced cancer patients.
This study aims to assess the current status of death preparedness and its influencing factors in advanced cancer patients.
Based on the PRECEDE-PROCEED model, a structured survey questionnaire was designed to collect data on personal factors (such as gender, age and residence area), interpersonal factors (such as social support, caregiver readiness and healthcare worker readiness) and social factors (such as care resources, policy support and information supply). Through multiple linear regression and BP neural network analysis, the study explores the impact and significance of these influencing factors on death preparedness in advanced cancer patients.
A total of 930 valid questionnaires were collected in this study. The death preparedness score in advanced cancer patients was 72.18 ± 22.82, indicating a moderate level, with the highest score being the ‘reflexive care’ dimension and the lowest score being the ‘hospice programme’ dimension. Multivariate analysis revealed that meaning in life and social support were the most significant predictors of death preparedness in advanced cancer patients. In addition, personal factors such as dignity, household income and coping style, also played an important role. Interpersonal factors like social support, as well as social factors such as care resources and policy support, also had an impact on patients' death preparedness to some extent.
Death preparedness in advanced cancer patients is generally at a moderate level, and death preparedness is influenced by a combination of personal factors, interpersonal factors and social factors.
This study is based on the PRECEDE-PROCEED model to comprehensively explore the influencing factors of death preparedness in advanced cancer patients. It provides theoretical support for improving life services for advanced cancer patients. It offers valuable practical experience and insights for societal attention and reform in end-of-life care.
No Patient or Public Contributions were included in this paper.
The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience.
To evaluate the resilience level of Chinese nursing interns and explore the effects of factors affecting resilience early in their careers, focusing on the mediating roles of career adaptability between clinical learning environment and resilience.
The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment Scale for Nurse and the Career Adapt-Abilities Scale. Structural equation modelling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped confidence intervals.
The nursing interns showed a moderately high level of resilience [M (SD) = 70.15 (19.90)]. Gender, scholastic attainment, scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns' resilience. Male interns with good academic performance showed higher levels of resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.62, 0.18, respectively, p < .01). Career adaptability was also positively affected by the clinical learning environment (β = 0.36, p < .01), and mediated the effect of clinical learning environment on resilience (β = 0.22, p < .01).
Clinical learning environment can positively affect the resilience level of nursing interns. Career adaptability can affect resilience directly and also play a mediating role between clinical learning environment and resilience. Thus, promotion of career adaptability and clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for female nursing interns with low academic performance.
To explore key stakeholders' experiences and perceptions of end-of-life communication in acute care settings.
A qualitative descriptive study.
Data were collected from 4 May to 31 October 2023. Patients with terminal illness, family caregivers and healthcare providers were recruited from two Chinese hospitals via purposive sampling. Individual interviews were conducted with patients and family caregivers, whereas healthcare providers participated in focus group discussions. Thematic analysis was conducted.
Nineteen patients, 22 family caregivers and 25 healthcare providers participated. Five themes emerged: (1) protective end-of-life communication, characterised by dominant family involvement, truth concealment and restricted end-of-life topics; (2) open end-of-life communication, characterised by dominant patient involvement, truth disclosure and diverse end-of-life topics; (3) patient-related factors, including comfort level in talking about end-of-life, burden and treatment engagement; (4) family-related factors, including comfort, burden, expectations, values and trust in healthcare providers and (5) healthcare provider-related factors, including comfort, time availability and clinical priorities, end-of-life communication awareness and skills and end-of-life care knowledge.
End-of-life communication in Chinese acute care settings oscillates between protective and open approaches, influenced by several individual factors.
Healthcare providers must overcome stereotypes rooted in cultural values and adopt a proactive approach to end-of-life communication. Enhanced training and institutional procedures are needed to improve end-of-life communication in acute care settings.
The study provides nuanced insights into end-of-life communication dynamics in Chinese acute care settings, complementing global evidence. Coexisting protective and open communication approaches highlight the need for context-sensitive approaches to end-of-life communication. Multifocal interventions addressing patient-, family- and healthcare provider-related factors are warranted.
Standards for Reporting Qualitative Research.
No patient or public contribution was involved in the design or conduct of the study.
To explore how life course factors shape the exercise participation decisions of frail older adults living in nursing homes.
This qualitative study is from the approach of social constructivism.
Seventeen frail older adults were purposefully recruited from a nursing home in Beijing, China. Data were collected through face-to-face semi-structured interviews between October 2024 and December 2024. Interviews were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis. Data collection and analysis continued until thematic saturation was achieved.
Three overarching themes were identified: (1) cumulative effects of key elements in the life course; (2) deficiencies in existing support across various systemic levels; and (3) lack of individual subjective agency. These factors interact dynamically to inhibit participation in exercise interventions.
This study highlights the complex interplay between life course experiences, systemic barriers and individual-level limitations that collectively discourage exercise participation among frail older adults in nursing homes. Tailored and culturally sensitive strategies, strengthened institutional support, family engagement and improved policy communication are needed to address these barriers.
These findings offer practical insights for designing person-centred exercise interventions that align with frail older adults' lived experiences and promote active ageing in institutional settings.
No patient or public contribution.
COREQ (Consolidated criteria for Reporting Qualitative research).
To co-design a nurse-led family support intervention for patients with cancer and their family members.
An intervention co-design process.
The Experience-Based Co-Design method was conducted in a hospital in northern Spain from January 2024 to February 2025 with nurses, patients and family members, following The Point of Care Foundation's eight steps: observations, individual interviews, editing the trigger film, feedback events, co-design and validation events and celebration event.
Four themes emerged from the integrated dataset. (1) Cancer: a family affair, (2) Needs of patients with cancer and their families, (3) The importance of establishing a trust-based nurse-family relationship and (4) Barriers and facilitators for a family-oriented approach in care. These findings informed feedback events where stakeholders identified critical intervention areas, including family support, illness communication, emotional expression and the importance of trust. Based on these results, the Family CARE-ON intervention was structured around three core components: Engaging, Supporting and Empowering.
This study highlights the value of the Experience-Based Co-Design methodology, with active engagement from stakeholders, to develop a family support intervention in oncology care. Further research is needed to evaluate the feasibility and effectiveness, as well as to explore the implementation and scalability of the intervention in oncological settings.
Co-designing a family support intervention together with stakeholders ensures alignment with their needs and expectations, while also fostering the feasibility of the intervention in clinical practice.
The results show how stakeholders co-designed a family support intervention, drawing from their own experiences and perspectives on the impact of cancer on the family.
Guidance for reporting intervention development studies in health research (GUIDED) and Template for Intervention Description and Replication (TIDieR).
Nurses, patients and family members were involved in designing the family support intervention.
The feature cover image is based on the article Intent to treat analysis of the Primary and Secondary Outcomes for the XXX intact fish skin graft for deep diabetic foot wounds trial by John Lantis et al., https://doi.org/10.1111/iwj.70847.
The feature cover image is based on the article Intent to treat analysis of the Primary and Secondary Outcomes for the XXX intact fish skin graft for deep diabetic foot wounds trial by John Lantis et al., https://doi.org/10.1111/iwj.70847.
Turnover intention among nurses poses a significant threat to both workforce stability and the overall quality of healthcare delivery. However, few studies have comprehensively examined the associations between turnover intention and nurses' individual and team-level resources within a multilevel framework. Our study aims to provide an in-depth exploration of the relationship between turnover intention and nurses' individual and team-level resources.
The multicenter cross-sectional study adopted a stratified convenience sampling approach to enroll 773 clinical nurses from 62 teams across eight hospitals in Shandong Province, China.
We used the 10-item Connor-Davidson Resilience Scale for psychological resilience, the Perceived Social Support Scale for perceived social support, the 51-item Analyzing and Developing Adaptability and Performance in Teams to Enhance Resilience Scale for team resilience, and a single-item turnover intention measure. Multilevel logistic regression modeling was conducted to examine the simultaneous impacts of individual-level (psychological resilience and perceived social support) and team-level (team resilience) factors on turnover intention, while controlling for key demographic and organizational covariates.
The multilevel analysis revealed several key findings: (1) The prevalence of turnover intention reached 35.6%, indicating a substantial workforce stability challenge; (2) Multilevel modeling demonstrated significant between-team variance (ICC = 0.19), confirming the importance of examining nested data structures; (3) At the individual level, both psychological resilience (OR = 0.78, CI: 0.62–0.99) and perceived social support (OR = 0.75, CI: 0.60–0.94) showed significant negative associations with turnover intention; (4) At the team level, higher team resilience predicted lower turnover intention (OR = 0.73, CI: 0.56–0.94). These results were obtained after controlling for key demographic and organizational covariates, highlighting the robust protective effects of multilevel resources against nurses' turnover propensity.
The prevalence of turnover intention was relatively high in this study. Nurses with higher psychological resilience, perceived social support, and team resilience exhibited lower turnover intention. Healthcare administrators need to increase investments in nurses' multilevel resources to stabilize the nursing workforce and ensure the sustainability of the healthcare system.
Understanding the multi-level factors influencing nurses' turnover intention can help nursing managers develop targeted strategies from multiple perspectives in clinical settings, thereby reducing nurses' turnover intention.
Depression is a common complication of stroke that adversely affects functional recovery. Although a wide range of pharmacological and non-pharmacological interventions are used in clinical practice, evidence regarding their comparative efficacy and acceptability remains inconclusive. Therefore, we will conduct the first systematic review and network meta-analysis (NMA) to compare and rank available interventions for post-stroke depression (PSD).
The findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. In this systematic review and network meta-analysis, we will search PubMed, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform from database inception to 1 September 2025 to identify published and unpublished randomised controlled trials (RCTs). We will include studies comparing pharmacological and non-pharmacological treatments, or any control conditions as monotherapy for the treatment of patients with PSD. We will assess the certainty of evidence using the Confidence in Network Meta-Analysis framework. The primary outcomes will be the change score on depression scales from baseline to the end of treatment (efficacy) and all-cause discontinuation (acceptability). Secondary outcomes will include quality of life, cognitive and neurological function scores, anxiety and sleep quality. Two reviewers will independently screen and select eligible studies based on predefined inclusion and exclusion criteria. Risk of bias in all RCTs included in the NMA will be assessed using the revised Cochrane Risk of Bias tool (RoB 2). A frequentist NMA will be conducted in Stata and R. Meta-regression and sensitivity analyses will be performed to assess robustness.
This NMA does not need ethical approval, as the data used here are based on aggregated data in the public domain. Findings from the analysis will provide an overview and information on the relative efficacy and acceptability of non-pharmacological and pharmacological treatments in PSD. The results will be disseminated through peer-reviewed publication.
CRD420251136670
Hand osteoarthritis (OA) is a prevalent and debilitating joint disorder that impairs daily functioning and quality of life. Current treatments are often inadequate in managing the symptoms and progression of the disease. The cytokine interleukin (IL)-17 has been implicated in the inflammatory processes associated with OA, making it a potential target for therapeutic intervention. This trial aims to evaluate the efficacy of vunakizumab, an IL-17A inhibitor, in reducing pain and improving functional outcomes in patients with erosive hand OA.
This multicentre, randomised, placebo-controlled, double-blind trial will enrol 150 participants aged 30–80 years with symptomatic erosive hand OA. Participants will be randomised in a 1:1 ratio to receive either vunakizumab 120 mg or placebo subcutaneously every 4 weeks for 24 weeks, with a loading dose injection period during the first 4 weeks. The primary outcome is the change in hand pain assessed by the Visual Analogue Scale at 28 weeks. Secondary outcomes include changes in physical function measured by the Functional Index for Hand Osteoarthritis, the Quick Disabilities of the Arm, Shoulder and Hand questionnaire and the Health Assessment Questionnaire, as well as changes in grip strength and radiographic and MRI evaluations of the hands.
Written informed consent will be obtained from all participants. The study was approved by the Ethics Committee of Shanghai Sixth People’s Hospital (2024–217) and will adhere to the Declaration of Helsinki. Research results will be published in peer-reviewed journals.
ChiCTR2500101031; https://www.chictr.org.cn/showproj.html?proj=264789.
by Saad Al-Lahhaam, Raghad Dweikat, Tala Nazzal, Aman Maraqa, Joud Khalil, Tala Albadawi, Raghad Doufish, Wa'd Amer, Mustafa Ghanim, Mohammad Abuawad, Amer Ghrouz, Samar Alkhaldi, Laith El-lahham, Majdi Dwikat, Maha Rabayaa, Malik Alqub
BackgroundTinnitus is a prevalent condition worldwide, particularly among adolescents, that has a substantial impact on quality of life, yet it remains an understudied issue.
ObjectivesThis study aims to determine the prevalence of tinnitus and its associated risk factors among Palestinian adolescents aged 15–18.
MethodsA cross-sectional study was conducted from January to March 2025. A convenience sample of participants was recruited. The study utilized the European School for the Interdisciplinary Tinnitus Research Screening Questionnaire.
ResultsA total of 1,131 participants were enrolled in the study, with 64.5% being females. The prevalence of tinnitus among the study sample was 532, representing 47% of the population. Females had a higher prevalence of tinnitus, with 370 affected (50.7%) compared to males (40.4%). Significant associations were found between tinnitus and several factors: age, positive family history of tinnitus (threefold increased risk), sensitivity to external sounds (2.7 times higher likelihood), slight hearing difficulty in noisy environments (1.7 times higher risk), pain symptoms (double the risk), and difficulty falling asleep (1.8 times higher risk). Notably, the majority of affected participants (71.5%) had never sought professional care for their tinnitus.
ConclusionAlthough Tinnitus is common among Palestinian adolescents aged 15–18 years, the majority of affected participants did not seek professional care for tinnitus. These findings highlight the importance of conducting further research to shed insight into this prevalent and neglected health priority.
There is a significant need for trials that evaluate the treatment of University of Texas (UT) grade 2 and 3 diabetic foot ulcers (bone, joint, or tendon exposed wounds). We undertook a trial looking at the effect of intact fish skin graft (IFSG) on these deep and difficult-to-heal ulcers. 262 patients Intent to Treat (ITT) patients with UT grade 2 and 3 DFUs were randomised to receive intact fish skin graft (IFSG) or a standardised treatment (SOC) that adhered to the International Working Group on the Diabetic Foot (IWGDF) guidelines. The secondary endpoints that were measured included wound area reduction (WAR), healing rates at 20 and 24 weeks; closure rates by UT grade, perfusion, quality of life, pain reduction and IFSG safety. We report ITT (all randomised) (mITT previosly reported) The (WAR) at 12 weeks was 65.53% for IFSG versus 30.82% for SOC (p = 0.007). UT 2 wounds (60% of total) exhibited a closure rate of 47% versus 23% at 16 weeks for IFSG versus SOC (p = 0.0033). Target wound infections were comparable (39 vs. 37) and major outcomes were comparable during the 24 week period (target-limb amputations 8% vs. 7%). Time-to-heal favoured IFSG (restricted mean to 24 weeks 17.31 vs. 19.37 weeks; KM/log-rank significant; Cox HR 1.59). The in the treatment of deep complex diabetic foot wounds the addition of IFSG significantly improved the number of patients with total wound closure as well as the time to wound closure without increased risk of complications. This improvement in total wound closure and time to wound closure was noted across prior amputation status, quality of perfusion, and UT grade.
by Yanan Fu, YuXin Wei, ZiKun Pang, Jie Yang, XinGang Sun
PurposeThis study outlines the changes in the age- and sex-specific burden of motor neuron disease (MND) in China from 1990 to 2021, focusing on the prevalence, incidence, number of disability-adjusted life years and mortality. Additionally, these trends are evaluated in comparison to the Global Burden of Disease data.
MethodsPublic data from the Global Burden of Disease database covering the period from 1990 to 2021 were analyzed to explore the burden of motor neuron disease in China and worldwide. Trends in prevalence, incidence, disability-adjusted life years (DALYs) and mortality were examined in the analysis. The average annual percentage change was calculated using Joinpoint, and the relevant 95% confidence intervals (95% CIs) were examined to identify changes in the MND burden over time. Additionally, a thorough comparative analysis was performed to investigate the differences in the MND burden between China and other regions worldwide, considering factors such as age, sex, and time periods.
ResultsFrom 1990 to 2021, the age-standardized incidence rate (ASIR) of motor neuron disease (MND) in China declined from 0.65 per 100,000 to 0.46 per 100,000, whereas the global ASIR decreased slightly from 0.81 per 100,000 to 0.77 per 100,000. In contrast, the age-standardized prevalence rate (ASPR) in China increased from 2.131 per 100,000 to 2.298 per 100,000, whereas the global ASPR decreased slightly from 3.356 per 100,000 to 3.31 per 100,000. The age-standardized mortality rate (ASMR) in China increased from 0.151 per 100,000 to 0.181 per 100,000; the global ASMR also increased from 0.38 per 100,000 to 0.46 per 100,000 during this period. Moreover, the age-standardized disability-adjusted life year (ASDR) rate in China decreased slightly from 7.995 per 100,000 to 7.672 per 100,000, whereas the global ASDR increased from 11.221 per 100,000 to 12.167 per 100,000. The average annual percentage changes (AAPCs) for the ASPR, ASIR, ASDR, and ASMR in China were −1.10%, 0.25%, 0.57%, and −0.14%, respectively. In contrast, the global AAPCs were −0.16%, −0.04%, 0.58%, and 0.26%, respectively. Age and sex played distinct roles in shaping MND burden. The ASIR of MND decreased but then increased for both sexes, remaining higher for males. Its ASPR trends differed: a slight increase in males versus an increase then decrease in females. While the ASMR was consistently higher for males, the DALYs for males started to decrease but surpassed those for females. Global MND rates have remained stable.
ConclusionThe prevalence, incidence, DALYs and mortality of motor neuron disease in China decreased between 1990 and 2021, suggesting a relative decrease in the total burden of MND in the country. Age influences the burden of MND, with a higher occurrence incidence in children and middle-aged individuals; the prevalence of MND is highest in the younger population, whereas MND-related mortality is the highest within the middle-aged and senior populations. Compared with females, males are more likely to be affected by MND and have a greater likelihood of death. Given the rapid population aging in China, MND is expected to remain a significant public health issue.
FreshRSS 