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Post-induction hypotension (PIH) is a critical concern in elderly surgical patients and is associated with adverse postoperative outcomes. This trial aims to compare the effects of propofol, etomidate and remimazolam on the incidence of PIH in older adults undergoing non-cardiac surgery.
In this single-centre, triple-arm, randomised controlled trial, 210 patients aged ≥80 years with American Society of Anaesthesiologists physical status I–III undergoing elective non-cardiac surgery will be recruited. All patients will receive general anaesthesia with endotracheal intubation. Patients will be randomised (1:1:1) to receive propofol, remimazolam or etomidate for anaesthesia induction (n=70 per group). The primary outcome is the incidence of PIH (mean arterial pressure (MAP) 30% from baseline, vasopressor requirements, bradycardia, injection pain, myoclonus, postoperative delirium, and cardiac, cerebral and renal complications during hospitalisation.
This trial was approved by the Ethics Committee of the First Affiliated Hospital of Soochow University (Approval No. 2024-380). The results will be peer-reviewed for publication in a scientific journal.
ChiCTR2400090800.
The financial impact on trauma patients can be devastating. Although Taiwan has universal health insurance coverage, medical bill reimbursement cannot compensate for the damage to a person’s ability to work. The aim of this study was to investigate personal financial outcomes after major trauma.
A retrospective cohort study.
Nationwide data from Taiwan’s National Health Insurance Research Database.
This study included all patients with major trauma (injury severity score ≥16) in Taiwan from 2003 to 2007, and a 10-year follow-up was conducted. Patients aged 18–70 were enrolled. Patients who returned to work after trauma (RTW) and those who did not return to work (non-RTW) were compared. Basic demographics and short-term outcomes were analysed, and the 10-year trend of income variation was calculated.
The primary outcomes are the ratio of non-RTW after major trauma, and the independent risk factors for non-RTW. The secondary outcome is the 10-year trend of income variation of major trauma patients.
5965 patients were included, with 4741 (79.5%) in the RTW group and 1224 (20.5%) in the non-RTW group. Hospital-acquired pneumonia, urinary tract infection, prolonged intensive care unit length of stay (LOS) and prolonged hospital LOS were identified as independent risk factors for future non-RTW. The mean monthly income of all patients declined in the three consecutive years postinjury and slowly returned to the preinjury level 9 years after the injury.
Loss of working ability was noted in 20.5% of major trauma patients, and the income level for all patients did not recover to the preinjury level until 9 years after the injury. Further welfare planning beyond the extent of the National Health Insurance programme should be made to protect the financial shortcomings experienced by these patients.
Until now, there has still been a lack of sufficient evidence on patient-reported outcomes (PROs) measured by the EuroQol-5 Dimension (EQ-5D) in patients with systemic lupus erythematosus (SLE) in China. This study aims to comprehensively assess EQ-5D outcomes and influencing factors in Chinese patients with SLE.
A multicentre, cross-sectional study based on the Chinese Systemic Lupus Erythematosus Treatment and Research Group registry.
101 hospitals across 27 provinces of China.
1336 patients with SLE.
The information on EQ-5D was collected via an online questionnaire. Medical records were obtained from the Chinese Rheumatology Data Centre (CRDC). Clinical influencing factors related to the reported health problems were identified using multivariate logistic regression. Then, each health state was converted into a health utility score based on the Chinese 2014 tariff. Given the ceiling effects, Tobit regression models were used to analyse the factors influencing health utility scores.
A total of 1336 patients with SLE were included. Of them, 626 patients (46.9%) reported health problems using EQ-5D. The proportions of patients reporting problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression were 12.80%, 5.24%, 14.90%, 27.47% and 30.46%, respectively. The mean utility score was 0.89 (SD: 0.15), and the mean Visual Analogue Scale (VAS
EQ-5D may be a useful, preference-based PRO measure for SLE and could potentially be integrated into routine clinical monitoring of patients with SLE and applied in economic evaluations in the future.
We aimed to understand the factors affecting psychological well-being of patients undergoing haemodialysis (HD). First, we explored how physical symptom severity, emotional distress and social support influence psychological well-being. Second, we examined the impact of different types of social support. Third, we investigated whether any variables mediate the relationship with psychological well-being.
A cross-sectional study, a type of observational design, was conducted on patients at a medical centre in Taiwan in 2020.
A total of 117 outpatients who had undergone regular HD for at least 3 months were enrolled.
The psychological well-being was assessed through self-report questionnaires.
We found that emotional distress (β=–0.25, p=0.033) had a significant negative impact on psychological well-being. However, the presence of appraisal support mitigated this effect. Specifically, appraisal support fully mediated the adverse impact of emotional distress on psychological well-being. In addition, the severity of physical symptoms was generally mild and did not influence psychological well-being.
Receiving appraisal support from family, friends and healthcare professionals not only alleviates emotional distress but also enhances psychological well-being both directly and indirectly among patients undergoing HD. Healthcare professionals should address issues of personal importance while serving as consultants, educators and evaluators to support patients in managing their chronic condition.
A spinal cord injury (SCI) disrupts synaptic connections between the corticospinal tract and motor neurons, impairing muscle control below the injury site. Many individuals with an SCI have impaired trunk control, affecting the performance of activities of daily living and quality of life. Work has shown improvements in trunk control after home-based, unsupervised arm-crank exercise training (ACET) in people with chronic motor-incomplete SCI. However, no studies have examined ACET’s impact on trunk control in individuals with subacute SCI. This study aims to investigate ACET’s effects on trunk control in adults with subacute incomplete SCI, and its mechanisms, and its long-term benefits on neuropathic pain, psychological well-being, physical activity levels and health-related quality of life.
This multicentre, parallel-group, randomised controlled trial will evaluate self-directed ACET in 60 individuals with subacute SCI (
This study was approved by The Health Research Authority and Health and Care Research Wales (22/NS/0054). Results will be published in peer-reviewed journals. Findings will be presented at National and International conferences for researchers and clinicians. Finally, results will be disseminated to the SCI community.
Human papillomavirus (HPV) is a major global health concern linked to cancers. Although a safe and effective vaccine exists, HPV vaccination rates are still low among Asian American and Pacific Islander (AAPI) populations. Barriers such as limited awareness, cultural stigma and systemic inequities contribute to this gap. This systematic review and meta-analysis aims to compile current evidence on HPV vaccination behaviours and related factors among AAPIs to help develop culturally tailored interventions and public health strategies.
This review will include descriptive and correlational studies (quantitative, qualitative and mixed methods), examining HPV vaccination intention or uptake among AAPI populations in the USA from inception to December 2024. Randomised controlled trials and intervention studies will be excluded. Databases to be searched include PubMed, CINAHL, PsycINFO and Cochrane. Study screening, data extraction and quality assessment will be conducted independently by three reviewers using standardised tools. Risk of bias in non-randomised studies will be assessed using Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I), and the Critical Appraisal Skills Programme (CASP) checklist will be used for qualitative studies. Quantitative findings will be synthesised narratively and, where appropriate, through meta-analysis using random-effects models. Qualitative themes will be synthesised to contextualise quantitative results.
Ethics approval is not required for this protocol as it does not involve primary data collection. Findings will be disseminated via peer-reviewed publications and conference presentations. Findings of this systematic review and meta-analysis will provide critical insights for promoting HPV vaccination and reducing HPV-related cancer disparities among AAPIs.
CRD420251008431.
Mild cognitive impairment (MCI) presents a significant risk, with a 75–80% likelihood of progressing to dementia. Despite this high risk, there is currently no straightforward and effective treatment strategy to halt or reverse this progression. Olfactory dysfunction, in conjunction with subjective cognitive decline, offers a crucial opportunity for early intervention in older adults at risk of MCI. Conventional olfactory training (COT) has demonstrated potential in enhancing neuroplasticity, which is vital for cognitive health. Initial studies indicate that modified olfactory training (MOT) may yield superior outcomes compared to COT. Thus, this study aims to evaluate the efficacy of MOT in delaying and preventing the progression of MCI in high-risk individuals.
This randomised, controlled, multicentre, prospective and open-label trial will be conducted at Peking University Third Hospital and enrol 114 participants, who will be randomised 1:1:1 into three groups: MOT, COT and a control group. Standardised assessments will be conducted at baseline, 3 months, 6 months, 12 months and 24 months to measure cognitive and olfactory outcomes. The primary outcomes will be the change in Montreal Cognitive Assessment score, neuroimaging assessments and the Sniffin’ Sticks test score. The secondary outcomes will include olfactory bulb volume and several neuroimaging tests.
This study protocol has been registered with ClinicalTrials.gov and has received approval from the Peking University Third Hospital Medical Science Research Ethics Committee (2023-347-01). The results will be disseminated through publication in scientific peer-reviewed journals.
FreshRSS 