Conectar
To assess the supply, demand, and utilisation of master's degree nurses in China's top-tier hospitals and identify recruitment and retention challenges.
A convergent parallel mixed-methods design.
From January and September 2022, eight top-tier hospitals in mainland China were selected using convenience sampling. The proportion of master's degree nurses, turnover rates, and recruitment outcomes were investigated and analysed using descriptive statistics. Concurrently, seven nursing administrators from these eight hospitals were interviewed using semi-structured interviews, and transcribed data were thematically analysed through inductive content analysis.
Among the eight hospitals surveyed, the average proportion of master's degree nurses was 3.58% (range: 0.58%–9.43%). The average ratio of planned to actual recruitment was 3.28, with four hospitals showing near parity (approximately 1:1) and three institutions failing to recruit any master's degree nurses. The annual turnover rate of master's degree nurses was 1.18%. Three themes emerged from the qualitative analysis: (1) shortages coexisting with oversupply; (2) nursing leaders' retention efforts versus limited institutional policy support; and (3) prioritisation of research and management over advanced clinical roles.
In China, even among top-tier hospitals, the proportion of master's degree nurses remains relatively low. There is an overall shortage of these nurses, juxtaposed with localised oversupply in specific institutions. Promotion to nursing supervisor or administrative roles is the only developmental pathway, while structured career progression pathways for advanced nursing practice remain conspicuously absent.
The study highlights the need to develop targeted policies that support the career advancement of master's degree nurses, particularly by expanding career options in Advanced Practice Nurses (APNs) rather than limiting roles to nursing management or education. This shift would better leverage their clinical expertise and strengthen healthcare systems through specialised practice and innovation.
What problem did the study address?: This study maps the supply–demand dynamics of master's degree nurses in leading hospitals and identifies retention, utilisation, and motivation policies and strategies from the perspective of nursing administrators. What were the main findings?: The proportion of master's degree nurses is low in China's top hospitals. There is both an oversupply and a shortage of master's degree nurses. Neither the government nor hospitals have policies in place to encourage the clinical involvement of master's degree nurses, and their career progression is limited to managerial roles. Where and on whom will the research have an impact?: Nursing administrators and other health policy makers in China and comparable global health systems will be affected. It will also influence nursing associations, nursing educators, and general nurses.
This study adhered to the Mixed Methods Article Reporting Standards.
No contributions from patients or the public were involved in this study.
To systematically identify and appraise existing risk prediction models for EN aspiration in adult inpatients.
A systematic search was conducted across PubMed, Web of Science Core Collection, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Biomedical Literature Database (CBM) and VIP Database from inception to 1 March 2025.
Systematic review of observational studies.
Two researchers independently performed literature screening and data extraction using the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS). The Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed to evaluate both the risk of bias and the clinical applicability of the included models.
A total of 17 articles, encompassing 29 prediction models, were included. The incidence of aspiration was 9.45%–57.00%. Meta-analysis of high-frequency predictors identified the following significant predictors of aspiration: history of aspiration, depth of endotracheal intubation, impaired consciousness, sedation use, nutritional risk, mechanical ventilation and gastric residual volume (GRV). The area under the curve (AUC) was 0.771–0.992. Internal validation was performed in 12 studies, while both internal and external validation were conducted in 5 studies. All studies demonstrated a high risk of bias, primarily attributed to retrospective design, geographic bias (all from different parts of China), inadequate data analysis, insufficient validation strategies and lack of transparency in the research process.
Current risk prediction models for enteral nutrition-associated aspiration show moderate to high discriminative accuracy but suffer from critical methodological limitations, including retrospective design, geographic bias (all models derived from Chinese cohorts, limiting global generalisability) and inconsistent outcome definitions.
Recognising the high bias of existing models, prospective multicentre data and standardised diagnostics are needed to develop more accurate and clinically applicable predictive models for enteral nutrition malabsorption.
Not applicable.
PROSPERO: CRD420251016435
Mediastinal and/or hilar lymphadenopathy (MHL) is increasingly identified owing to various underlying conditions. Minimally invasive biopsy techniques, including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), transbronchial mediastinal cryobiopsy (TBMC) and transbronchial forceps biopsy (TBFB), are common diagnosis tools. However, their safety and diagnostic efficiency remain unclear. This trial aims to compare the diagnostic yield and safety of these three techniques.
This study is a three-arm, parallel-design, randomised controlled trial involving 972 adult patients with MHL recruited from multiple medical centres. Participants will be randomly assigned to the EBUS-TBNA, TBMC via a tunnel or TBFB via a tunnel group. The primary outcome is diagnostic yield, and the secondary outcomes include diagnostic sensitivity, sample quality and procedure-related complications. Statistical analyses will be conducted using the appropriate methods. An independent sample ² test will be used to test the differences in the diagnostic yield and incidence of procedure-related complications.
Ethics approval was obtained from the China-Japan Friendship Hospital Ethics Committee (2022-KY-194).
Written informed consent will be obtained from all patients or their guardians before their enrolment in the study. This study will be conducted per the principles established in the Declaration of Helsinki and the International Council for Harmonisation Guidelines for Good Clinical Practice.
To translate the Supportive and Palliative Care Indicators Tool (SPICT) into Chinese and conduct preliminarily tests of its performance in hospitalized patients with cancer.
A cross-sectional validation study conducted from January to March 2024.
SPICT 2022 was translated in both directions, following the Brislin translation model, and the Chinese version culturally debugged through expert consultation and pre-testing. Content validity was evaluated by expert scoring. Tool internal consistency was evaluated using KR-20 coefficient, and retest reliability was evaluated using kappa coefficient. The screening performance was evaluated by sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).
Of 388 hospitalized cancer patients included, approximately one-quarter had potential palliative care needs. Content validity of the Chinese version of SPICT was good, as were internal consistency and test–retest reliability. Accuracy (0.905), sensitivity (0.806), specificity (0.943), PPV (0.845), and NPV (0.926) for the Chinese version of SPICT indicated that it is an acceptable instrument.
The Chinese version of SPICT can be applied for screening of palliative care needs in hospitalized patients with cancer in China.
The Chinese version of SPICT had been adapted to assist clinicians or nurses in quickly identifying hospitalized patients with cancer who may have palliative care needs. This is conducive to help clinical team to start palliative care consultation, care goal discussion and (or) referral for patients in clinical practice. And it probably helps to advance integration between palliative care assessment and routine oncology care assessment.
This study provided a screening tool for palliative care, with good validity and reliability, as well as excellent screening performance to facilitate palliative care need screening in clinical practice, promote palliative care referrals and improve patient quality of life.
This study was reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
No patient or public contribution.
Frailty is a global health issue, particularly among older adults, and is strongly associated with adverse health outcomes. The intermediate stage of pre-frailty, which represents a transition from robust health to frailty, has garnered growing concern due to its potential reversibility. This systematic review and meta-analysis will aim to identify predictors associated with the progression from pre-frailty to frailty in older adults.
A comprehensive literature search will be conducted in PubMed, Web of Science, Embase, Cochrane Library, CINAHL, PsycINFO, CNKI, Wanfang Database, China Science and Technology Journal Database, and China Biomedical Literature Database from inception to the most recent search date. Eligible studies will report predictors of frailty progression among older adults with pre-frailty at baseline. Two reviewers will independently screen the studies, extract relevant data and assess methodological quality using the Newcastle Ottawa Scale. Meta-analysis and meta-regression will be performed to estimate pooled effect sizes and explore potential predictors. Subgroup analyses will be conducted to investigate possible sources of heterogeneity.
Ethical approval will not be required, as this study will not involve primary data collection. The findings will be submitted for publication in a peer-reviewed scientific journal.
CRD42024594175.
To refine fall risk assessment scale among older adults with cognitive impairment in nursing homes.
A cross-sectional survey.
Mokken analysis was conducted to refine the assessment scale based on unidimensionality, local independence, monotonicity, dimensionality, and reliability. Data were gathered from cognitively impaired older adults in a nursing home from January to February 2023. Trained nursing assistants conducted face-to-face assessments and reviewed medical records to administer the scale.
Emotion and State Dimension did not meet unidimensionality criteria (H = 0.14), particularly item Q9, which also violated local independence. Monotonicity analysis showed all items exhibited monotonic increases. After refinement at c = 0.3, the scale consists of nine items. With increasing c-values, the first seven items were ultimately retained to form the final version of the scale. Both optimised scales (9-item and 7-item) satisfied reliability requirements, with all coefficients (Cronbach's α, Guttman's lambda-2, Molenaar-Sijtsma, Latent Class Reliability Coefficient) ≥ 0.74.
The scale is suitable for assessing fall risk among older adults with cognitive impairment, with a unidimensional scale of the first seven items recommended for practical use. Future efforts should refine the scale by exploring additional risk factors, especially emotion-related ones.
The refined 7-item scale provides nursing home staff with a practical, reliable tool for assessing fall risk in cognitively impaired older adults, enabling targeted prevention strategies to enhance safety and reduce injuries.
The refined 7-item scale provides nursing home staff with a reliable, practical, and scientifically validated tool specifically designed for assessing fall risk in older adults with cognitive impairment. Its simplicity enables efficient integration into routine clinical workflows, empowering caregivers to proactively identify risk factors and implement timely, targeted interventions. This approach directly enhances resident safety by translating assessment results into actionable prevention strategies within daily care practices.
This study was reported in accordance with the STROBE guidelines.
No Patient or Public Contribution.
Tubal ectopic pregnancy (TEP) frequently presents as a gynaecological emergency, often necessitating prompt medical intervention. Although methotrexate therapy offers the advantage of being non-invasive, it still poses the risk of tubal rupture and consequent haemorrhage, which may require emergency surgery. The major challenges encountered in practice are the lack of reliable methods to anticipate the likelihood of failure of single-dose methotrexate therapy and identify associated risk factors and thereby preclude unnecessary medical procedures. Effective counselling, therefore, remains a pivotal step in clinical management. This study is aimed at developing a predictive model to assess response to single-dose methotrexate therapy in cases of TEP by employing a dynamic prediction model approach based on the clinical data of a large cohort.
This multicentre study will encompass 100 and 900 participants for the prospective and retrospective cohorts with TEP, respectively. Between 2010 and 2024, eligible patients who are diagnosed with TEP and opt for single-dose methotrexate therapy will be recruited as part of a retrospective cohort, from three participating hospitals in Zhejiang province, China. The comprehensive medical and obstetric histories of the patients will be collected, along with their clinical data, including the results of serological tests following the initial consultation. The control group will comprise patients who achieve uneventful, complete resolution of TEP, as evidenced by serum human chorionic gonadotropin level of
Ethical approval for data collection has been obtained from the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (No. 2024-KLS-346–02), Hangzhou First People’s Hospital (No. ZN-20240627-0219-01), Anji Hospital of Chinese Medicine (No. 2025年第5号), Qingyuan Hospital of Chinese Medicine (No. (2024)伦审第(9)号) and Beilun Hospital of Chinese Medicine (No. 2024年伦审第12号). Additionally, written informed consent will be obtained from all participants and they will retain the right to withdraw from the study at any stage. The findings of this study will be disseminated through publication in a peer-reviewed journal.
ChiCTR2400085829.
To understand current practices and identify barriers and facilitators to implementing guideline-recommended core osteoarthritis (OA) treatments in China.
An exploratory mixed-methods design
Public and private clinical institutions across mainland China.
A total of 498 healthcare professionals participated. The qualitative phase included semistructured interviews (n=15) and a qualitative survey (n=181). The quantitative phase consisted of a survey with 302 respondents across 19 provinces, representing seven health professions.
Five themes identified as barriers during the qualitative phase: misconceptions about OA; limitations in current medical insurance policies; insufficient multidisciplinary collaboration; lack of workplace support and low patient adherence to self-management. Three themes identified as facilitators: telehealth and community-based delivery pathways; professional training and patient education resources; and personalised services with positive feedback. Quantitative findings showed that physical agent therapy (56%) and traditional Chinese medicine (22%) were the most frequently used OA treatments, while exercise therapy was implemented in only 9% of cases. The average OA knowledge score was 31.2 (±8.9) out of 55, with the lowest self-rated confidence in interdisciplinary collaboration (3.4±0.1, ‘somewhat confident’). The most applicable factors impacting the implementation of core OA treatments included patient comorbidities, knowledge of pain science and exercise therapy, and financial support (all 2.8±0.8, ‘applicable’).
The uptake of core OA treatments in China remains suboptimal, constrained by limitations in insurance coverage, workforce capacity and interdisciplinary integration. Enhancing telehealth accessibility, strengthening professional training and refining policy incentives may help bridge this evidence-practice gap and improve OA management in China.
Acute unstable syndesmosis injuries require accurate reduction and stable fixation to improve short-term and long-term outcomes. Several different fixation methods have been established for acute syndesmosis injuries, each with pros and cons. Although some meta-analyses have reported better outcomes with suture-buttons than screws, the optimal fixation method remains uncertain because of heterogeneous study results and limited comparisons of emerging techniques. This network meta-analysis combining randomised and observational studies aims to determine the optimal fixation method for acute syndesmosis injuries.
Five electronic databases (PubMed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data and Embase) will be comprehensively searched from their inception through 1 June 2025 for randomised and observational studies, published in English or Chinese, that compared two or more fixation methods for acute syndesmosis injuries. Inclusion and exclusion criteria will be used for selection based on patient, intervention, comparison, outcome and study standards. Risk of bias will be evaluated by the Cochrane risk-of-bias tool 2 and the Newcastle–Ottawa scale, respectively. Conventional pairwise meta-analyses with the DerSimonian–Laird random effects model will be conducted first, followed by network meta-analyses with a three-level Bayesian hierarchical model. The outcome measures include functional outcomes, radiological indicators and postoperative complications. Data analysis will be conducted using Review Manager 5.3 and R 4.1.2. Heterogeneity, transitivity and inconsistency tests, subgroup and sensitivity analyses and publication bias will also be assessed.
No ethical approval is required because all the data will be collected from published research. The results of this study will be published in a peer-reviewed journal.
INPLASY202480027.
This study aims to develop a deep learning algorithm (DLA) using the InceptionV3 architecture for effective diabetic peripheral neuropathy (DPN) screening via corneal confocal microscopy (CCM) images.
Retrospective study.
Ophthalmology Centre of General Hospital.
127 participants enrolled: 33 healthy participants, 57 diabetic patients with DPN (DPN+) and 37 diabetic patients without DPN (DPN–).
Not applicable.
The CCM image dataset, which was collected from participants (with five images per eye), was randomly divided into training, validation and test subsets in a 7:1:2 ratio. The images were preprocessed, augmented and used to train the InceptionV3 model. We compared its performance against the ResNet, DenseNet and Swin Transformer models. Performance was evaluated using accuracy, recall, F1 score and area under the curve (AUC) metrics.
For single-participant predictions, the InceptionV3 model achieved the highest accuracy (0.9231), recall (0.8846), F1 score (0.9020) and AUC (0.9534) compared with the other models. For single-image predictions in the three-class classification task of CCM images, the InceptionV3 model achieved a precision of 0.8385, a recall of 0.9083, an F1 score of 0.8720 and an AUC of 0.8769 for predicting DPN+.
The InceptionV3-based DLA model achieved superior performance compared with traditional convolutional neural network architectures like ResNet and DenseNet, and the Swin transformer model, highlighting its potential for effective DPN screening.
Although multicomponent exercise is a popular nonpharmacological treatment, its effects on cognition vary across studies because of the diversities in exercise combinations. Identifying the most effective combination is of great importance to the prevention and treatment of cognitive impairment.
To compare and rank the efficacy of various multicomponent exercise interventions on cognition in people with cognitive impairment.
We searched PubMed, Web of Science, Embase, Cochrane, SPORTDiscus and PsycInfo databases up to April 2025 for eligible randomised controlled trials about multicomponent exercise interventions in people with cognitive impairment. Primary outcome was global cognition, with secondary outcomes being executive function and memory. Pairwise and network meta-analyses were performed using random-effects models.
Twenty-five trials involving 2298 participants were included. Pairwise meta-analyses showed multicomponent exercise interventions were effective on global cognition (standardised mean difference (SMD) = 0.59; 95% confidence interval (CI): 0.30, 0.89; p < 0.001) and executive function (SMD = 0.28; 95% CI: 0.12, 0.45; p < 0.001). Network meta-analyses revealed that aerobic exercise (AE) + balance & flexibility (BF) training had the highest probability (70.8%) of being the optimal exercise combination for global cognition (SMD = 1.07; 95% CI: 0.23, 1.90; p = 0.016), and AE + resistance exercise (RE) had the highest probability (43.1%) of being the optimal exercise combination for executive function (SMD = 0.56; 95% CI: 0.03, 0.10; p = 0.042). We did not observe significant effects of multicomponent exercise on memory.
AE + BF training is likely the most effective multicomponent exercise combination for global cognition, while AE + RE showed the optimal effect on executive function in people with cognitive impairment.
Our study contributes to guiding clinical professionals to design and conduct targeted multicomponent exercise interventions as per individual cognitive impairment characteristics to protect individual cognition.
No patient or public contribution applies to this work.
The study protocol was registered with PROSPERO (CRD42023489517).
The suicide rate of individuals with schizophrenia is higher than the general population. In clinical practice, it is essential to identify patients with schizophrenia who are at an elevated risk of suicide. However, previous studies may not fully account for potential factors that could influence the suicide risk among schizophrenia patients. Our study leverages machine learning to identify predictive variables from a broad range of indicators.
Cross-sectional.
A total of 131 patients with schizophrenia were recruited at the Mental Health Center of West China Hospital from August 2021 to July 2022. We collected complete blood analysis, thyroid function, inflammatory factors, childhood trauma experiences, psychological impact related to the Coronavirus Disease 2019 epidemic, sleep quality, psychological distress, income level and other demographic data. We utilised machine learning algorithms to predict the suicide risk of patients with the above features. The Shapley values were used to illustrate important predictive variables of suicide risk.
We gathered important variables for predicting suicide risk of patients with schizophrenia, such as the Nurses' Observation Scale for Inpatient Evaluation factor, neutrophil count, psychological impact during Coronavirus Disease 2019 epidemic, prolactin level and plasma thromboplastin component level.
The features identified in this study are anticipated to aid in the clinical identification of suicide risk in individuals with schizophrenia in the future. This study also promoted improvements in the suicide prediction model among patients with schizophrenia.
This study identified key predictive variables for suicide risk in schizophrenia patients using machine learning. Our findings will enhance clinical tools for assessing suicide risk in schizophrenia, potentially leading to more effective prevention strategies. This advancement holds promise for improving suicide prevention efforts and tailoring interventions to individuals' specific risk profiles.
STROBE Statement (for cross-sectional studies).
None.
by John Bosco Asiimwe, Hellen Namawejje, Faith Rachel Mirembe, Annet Adong, Jolly Achola, Herbert Nabaasa, Jebena Mulusew, Jonathan Izudi, Damazo T. Kadengye
A substantial proportion (7%) of people in Uganda practice open defecation. A Community-Led Total Sanitation (CLTS) project was started in 2011 to reduce indiscriminate disposal of excreta but the effect has not been rigorously evaluated. We, therefore, evaluated the effect of CLTS on reducing open defecation in the program intervention districts in Uganda. We used the 2016 Uganda Demographic and Health Survey (UDHS) data to conduct a quasi-experimental study using a propensity score matching (PSM) approach. The intervention group consisted of districts that implemented the CLTS and the comparison group were districts that did not implement the CLTS. We matched the intervention and comparison groups on several covariates in a 1:1 ratio within a caliper of 20% of the standard deviation of the propensity score. We confirmed balance in covariates using standardized mean difference (SMD) beingby Yi Chi, Xueqin Yang, Donglin Deng, Peimao Li, Yingbiao Zhang
This study aimed to explore the relationship between circadian rhythm gene polymorphisms, specifically MTNR1A rs2119882 and CLOCK rs1801260, and the risk of acne in an occupational population. MTNR1A encodes a melatonin receptor involved in circadian rhythm regulation, while CLOCK is a core transcription factor in the molecular circadian clock. Both genes are essential in maintaining hormonal balance, sleep-wake cycles, and inflammatory responses—factors closely associated with acne pathogenesis. A case-control study was conducted among 90 participants, comprising acne-affected workers (AAG), acne-free workers (AFG), and healthy control group (HCG). Peripheral blood samples were collected, and DNA was extracted for genotyping of MTNR1A rs2119882 and CLOCK rs1801260 polymorphisms. Sociodemographic, lifestyle, and occupational data were obtained via structured interviews. Logistic regression models were used to assess the association between gene polymorphisms and acne risk, adjusting for relevant covariates. Sensitivity analyses were performed to evaluate the robustness of the findings. In the overall population, no significant association was found between MTNR1A rs2119882 polymorphisms and acne risk. However, CLOCK rs1801260 polymorphisms showed a strong association with acne susceptibility. Under the dominant model, participants carrying the AG/GG genotypes exhibited a significantly higher risk of developing acne compared to those with the AA genotype (unadjusted odds ratios (OR) = 3.79, 95% CI: 1.27–11.31; adjusted OR = 5.08, 95% CI: 1.41–18.33). In the additive model, the risk of acne increased with additional G alleles (unadjusted OR = 2.95, 95% CI: 1.22–7.13; adjusted OR = 3.51, 95% CI: 1.25–9.81). Subgroup analysis among night shift workers revealed a significant association between MTNR1A rs2119882 and acne risk, such that carriers of the CC genotype exhibited increased susceptibility (adjusted OR = 3.97, p = 0.049). Moreover, individuals with AG/GG genotypes at CLOCK rs1801260 showed an even higher risk (OR = 4.96, 95% CI: 1.22–20.14). This study suggests that circadian rhythm gene polymorphisms, particularly CLOCK rs1801260, are associated with acne risk, especially in individuals working rotating night shifts.Pregnancy can cause stress for couples, potentially leading to anxiety. However, most studies on antepartum anxiety focus on expectant mothers, ignoring the expectant fathers and the stress transmission between couples. We aim to examine the mediation of dyadic coping between antepartum anxiety and stress in expectant mothers and fathers.
We implemented a cross-sectional study in Guangzhou, China, from October 2023 to January 2024.
Three-hundred and twenty-nine Chinese pregnant couples completed the Perceived Stress Scale, the Dyadic Coping Inventory, and the State–Trait Anxiety Inventory. The actor-partner interdependence mediation model was used for data analysis.
Expectant mothers experienced antepartum anxiety symptoms at a rate of 42.6%, while the rate for expectant fathers was 32.5%. Regarding the actor effects, stress was positively associated with antepartum anxiety in expectant mothers (β = 0.66, 95% confidence interval CI [0.56, 0.74]) and fathers (β = 0.58, 95% CI [0.42, 0.70]), with dyadic coping acting as a mediator (expectant mothers: β = 0.08, 95% CI [0.03, 0.14]; fathers: β = 0.11, 95% CI [0.04, 0.19]). Regarding the partner effects, maternal dyadic coping was positively associated with paternal stress (β = 0.10, 95% CI [0.01, 0.19]).
The study highlights the interplay of stress, dyadic coping, and antepartum anxiety in expectant mothers and fathers, emphasizing the need to assess their antepartum anxiety and implement couple-centered interventions to enhance their psychological well-being during the first trimester of pregnancy.
This study highlights the importance of assessing antepartum anxiety in both expectant mothers and fathers, emphasizing the mediation of dyadic coping in reducing stress and anxiety. The findings support the integration of couple-centered mental health interventions into routine antepartum care to enhance psychological well-being during pregnancy.
Recurrence of hypertriglyceridaemia-associated acute pancreatitis (HTG-AP) is common. Uncontrolled HTG after hospital discharge is an important risk factor for recurrence. However, the optimal triglyceride (TG) goal of lipid-lowering therapy for outpatients remains unclear. The efficacy and safety of intensive TG-lowering therapy on reducing recurrence of HTG-AP trial aims to determine whether intensive TG-lowering therapy (with a TG goal of
This is an investigator-initiated, multicentre, open-label, parallel, superiority, randomised, controlled trial. Adult patients who have been successfully treated and discharged from their index episode of HTG-AP will be screened for eligibility after a 4-week to 3-month run-in period in the outpatient setting, and then patients with the fasting serum TG levels ≥150 mg/dL at baseline are eligible. During the study period, a total of 256 study participants will be randomised to receive either intensive TG-lowering therapy or usual care. In the intensive TG-lowering therapy group, the goal of TG levels is lower than 150 mg/dL, which will be monitored at 1 month, 3 months, 6 months, 12 months and 18 months after randomisation. In the usual care group, the goal of TG levels is lower than 500 mg/dL according to the current guidelines. Lifestyle suggestions and TG-lowering agents are the main strategies to manage the lipid level. The primary endpoint is the incidence of recurrent episodes of HTG-AP at 18 months after randomisation.
This study has been approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University (No. 2023101–3). Ethics approval of each participating centre is required before initiation of enrolment. The results of this study will be published in peer-reviewed journals and reported at international conferences.
ChiCTR2300073483 (Chinese Clinical Trial Registry)
V.4.0 (2024).
To develop and validate a risk prediction model for oral frailty in elderly patients with ischaemic stroke.
A cross-sectional study.
A temporal cohort of 633 elderly isachemic stroke patients from May 2024 to February 2025 was chronologically divided into a training set (n = 443) and validation set (n = 190). Participants were classified into oral frailty and non-oral frailty groups based on the Oral Frailty Index-8. In the training set, feature selection combined least absolute shrinkage and selection operator regression and random forest recursive feature elimination, followed by Nomogram Construction via Binary Logistic Regression. The model underwent internal validation using bootstrap resampling, and its generalizability was assessed with the validation set. The model was comprehensively evaluated using Receiver Operating Characteristic (ROC) curves, the Hosmer-Lemeshow Test, Calibration Plots, and Decision Curve Analysis (DCA).
In both the training and validation sets, the prevalence of oral frailty among elderly ischaemic stroke patients was 63.2% and 62.1%, respectively. Wearing dentures, tooth brushing frequency, dry mouth symptoms, chewing difficulty, swallowing function, oral health literacy, and oral health status were identified as significant predictors of oral frailty. ROC analysis demonstrated strong discriminative ability of the nomogram. The Hosmer-Lemeshow Test confirmed model consistency, and the calibration curve indicated excellent and stable calibration performance. DCA revealed that the model provided significant net clinical benefit in clinical practice. This free, interactive dynamic nomogram is accessible at: https://xiaowen.shinyapps.io/dynnomapp/.
This study presents a reliable, accessible model to assess oral frailty risk in elderly ischaemic stroke patients, facilitating clinical identification of high-risk individuals and providing a scientific foundation for oral health interventions.
The nomogram helps healthcare professionals identify high-risk patients, understand risk factors, and improve oral health management.
TRIPOD-AI checklist.
No patient or public contribution.
To consolidate the best evidence on digital therapeutic interventions for self-management in patients with hip fragility fractures, providing a foundational guide for clinicians in developing digital therapy-based self-management plans.
Integrative review.
A comprehensive electronic search was conducted across multiple databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute, Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Chinese databases like China National Knowledge Infrastructure and SinoMed. This study retrieved papers published from the establishment of the database to September 2023.
Studies were selected based on inclusion criteria, such as relevance to hip fragility fractures and self-management through digital therapies. Quality assessments were conducted independently by two reviewers using established tools for each type of study, ensuring the inclusion of high-quality evidence.
Fifteen studies were included: 4 guidelines, 5 expert consensus documents, 5 systematic reviews and 1 evidence summary. From these, 26 best practices were identified across 4 domains: digital design, self-management influencing factors, intervention plans and intervention content.
This integrative review provides a comprehensive, evidence-based summary of digital therapeutic interventions for self-management in patients with hip fragility fractures. The findings offer healthcare professionals a scientific basis for integrating digital therapy into clinical practice, highlighting its potential to enhance patient self-management.
This review underscores the value of digital therapies in empowering patients to take an active role in their rehabilitation, potentially improving adherence to self-management strategies and long-term outcomes.
No patient or public contribution was used for this study.
FreshRSS 