Conectar
by Meirong Shan, Qian Guo, Ruofei Li, Ni Li, Yanhua Fu, Huanyu Qi, Ge Zhang, Qian Wang, Xingli Xu, Jinchuan Lai
Hypertension is one of the main causes of cardiovascular diseases worldwide, affecting over one billion people. Although aliskiren offers a valuable option for inhibiting the renin-angiotensin system, its safety profile in the real world remains insufficiently explored, especially for rare or under-recognized adverse events (AEs), which have not been fully clarified. Therefore, leveraging large-scale post-marketing surveillance data is crucial for identifying rare AEs and guiding safer clinical practice. This study aims to elucidate pharmacovigilance signals associated with aliskiren (an antihypertensive drug) by systematically analyzing the characteristics of adverse events (AEs) from the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database and WHO-VigiAccess database, which provides a reliable scientific basis for clinical practice and regulatory decision-making. We conducted a retrospective quantitative analysis of aliskiren-related AE reports from the aforementioned two databases, employing the Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS) algorithms for signal detection. The results indicate that there were 5,596 and 5,549 aliskiren-related reports in the FAERS and WHO-VigiAccess databases, respectively. The median duration of these AEs during the observation period was 62 days, with an interquartile range (IQR) of 7–282 days. In both databases, signals for aliskiren were distributed across 28 System Organ Classes (SOCs), among which investigations, cardiac disorders, renal and urinary disorders, vascular disorders, and metabolism and nutrition disorders exhibited significant signals based on specific criteria applied across the four algorithms. A total of 607 preferred terms (PTs) with significant disproportionality signals were detected using the four algorithms, including potential AEs not previously well-documented, such as palpitations, myalgia, proteinuria, muscular weakness, pulmonary edema, and pollakiuria. This study not only confirms the known adverse reactions of aliskiren but also uncovers new potential risks, highlighting the importance of strengthening drug safety monitoring to enhance therapeutic efficacy and reduce the risk of adverse reactions. It provides valuable safety insights for physicians considering the use of aliskiren in the management of primary hypertension.Early screening of non-alcoholic fatty liver disease (NAFLD) is critical for early diagnosis and management. The disease was renamed and its diagnostic criteria revised as metabolic-associated FLD (MAFLD) in 2020 and further updated to metabolic dysfunction-associated steatotic liver disease (MASLD) in 2023. This study evaluated the predictive performance and clinical feasibility of non-invasive diagnostic indicators across the NAFLD, MAFLD and MASLD diagnostic criteria.
Cross-sectional study.
Health Management Centre in China.
A total of 5810 participants aged ≥18 years were enrolled. Individuals with missing laboratory data, imaging results or self-reported information were excluded.
Disease-specific indicators included Fatty Liver Index (FLI), Hepatic Steatosis Index and Zhejiang University index (ZJU). Non-disease-specific indicators included lipid accumulation product (LAP), Visceral Adiposity Index and the Triglyceride and Glucose Index. Subgroup analysis was performed by gender and Body Mass Index (BMI).
The area under the receiver operating characteristic curve (AUROC) for all six non-invasive indicators exceeded 0.7. FLI showed the optimal predictive performance across the three criteria (NAFLD-AUROC: 0.802, MAFLD-AUROC: 0.847 and MASLD-AUROC: 0.811), with comparable performance observed for ZJU (0.797, 0.838 and 0.809, respectively). Pairwise z-tests demonstrated a significant difference between FLI and ZJU for MAFLD (p0.05). Subgroup analyses revealed that ZJU performed better in males (NAFLD-AUROC: 0.790, MAFLD-AUROC: 0.839 and MASLD-AUROC: 0.803), while FLI was superior in females (NAFLD-AUROC: 0.832, MAFLD-AUROC: 0.838 and MASLD-AUROC: 0.838) and in participants who were overweight (NAFLD-AUROC: 0.709, MAFLD-AUROC: 0.765 and MASLD-AUROC: 0.709). LAP exhibited the highest predictive efficacy in the normal BMI subgroup (NAFLD-AUROC: 0.758, MAFLD-AUROC: 0.804 and MASLD-AUROC: 0.796).
FLI exhibited the highest predictive efficacy across all diagnostic criteria, and ZJU showed comparable performance. Considering diagnostic accuracy and clinical practicality, ZJU is recommended as a favourable, non-invasive tool for population-based screening in the Chinese population.
Pressure injury (PI) is common in the ICU and not well captured by single-risk tools such as the Braden scale. We aimed to develop and internally validate a machine-learning model to predict new-onset PI using routinely collected ICU data. This retrospective single-centre cohort included adult ICU patients with length of stay ≥ 48 h (2018–2023). The primary outcome was new-onset PI during ICU stay. Candidate predictors were pre-specified: minimum albumin, maximum lactate, SOFA, APACHE II, first recorded Braden score, age, BMI, a nutrition score and treatment indicators. Missing values were imputed (median/mode). A gradient boosting model (GBM) was evaluated with stratified 3-fold cross-validation; a random forest (RF) served as a benchmark (stratified 70/30 train–test split). Discrimination (AUC) was primary; calibration, Brier score, decision-curve analysis (DCA) and feature importance were secondary. Logistic regression quantified independent associations. Among included ICU stays, 14.6% developed PI. On multivariable analysis, higher lactate, lower albumin, lower Braden scores, older age, CRRT, prone positioning, enteral nutrition and analgesic exposure were associated with increased PI risk, whereas sedatives showed an inverse association. The GBM achieved AUC≈0.69 with acceptable calibration and net clinical benefit across thresholds commonly used in preventive workflows (≈0.10–0.50). Single markers or simple combinations displayed only modest discrimination. A GBM built from routine ICU data provided moderate, well-calibrated discrimination for predicting new-onset PI and demonstrated decision-relevant net benefit. The model can complement Braden-based screening by refining risk stratification and prioritising intensified prevention for patients most likely to benefit. External validation and prospective evaluation are warranted.
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.by Siyu Xie, Qiang Gu, Guiyin Zhuang, Xiaojing Guo, Bo Sun
ObjectivesTo explore the pharmacotherapeutic efficacy of heparin in the management of meconium-induced acute lung injury (ALI) in near-term newborn rabbits subjected to mechanical ventilation (MV) and ancillary respiratory medications.
MethodsNewborn rabbits at 30-day gestation (term 31 days) were anesthetized, intratracheally intubated and received human meconium-saline suspension, followed by parallel MV with individually adjusted tidal volume in a multi-plethysmograph-ventilator system. When ALI was induced after initial 3-h MV, therapeutic effects of single or combined subcutaneous heparin (100 U/kg), surfactant (200 mg/kg), and inhaled nitric oxide (iNO, 10 ppm), were compared for lung protective ventilation and survival as outcome, analyzed with linear regression models.
ResultsSignificantly reduced respiratory compliance by meconium was reinstalled during ensuing 7-h MV, with improved survival, among the treatment groups. The impact was verified by lung injury severity, surfactant phospholipid pools, and multiple mRNA expressions of surfactant proteins, lung fluid clearance-related factors, inflammatory mediators, growth factors, endothelial cell injury and coagulation-related factors as subphenotyping biomarkers. The overall benefits of heparin alone, or exerted with the dual and triple regimens, were discernible by both generalized linear model and Cox proportional hazard ratio regression for survival and other major variables as outcome. Its adverse effects were intangible.
ConclusionThe comparable efficacy of heparin, alongside the PS and NO, was corroborated in attenuating meconium-mediated, ventilator-induced ALI, which should warrant clinical investigation to validate.
Robust assessment of health-related quality of life (HRQoL) is essential for evaluating the disease burden in patients with haematologic malignancies. This study examined the performance of the EuroQol-5 Dimensions-5 Levels (EQ-5D) instrument in patients with multiple myeloma (MM), acute leukaemia (AL) and lymphoma using time trade-off (TTO)-elicited utility scores as the reference, and explored factors contributing to discrepancies between EQ-5D and TTO utilities.
We performed a cross-sectional observational study using EQ-5D and TTO to assess HRQoL.
A leading tertiary care hospital in China.
158 patients consecutively admitted to hospital for MM (n=50), AL (n=63) and lymphoma (n=45) between January and August 2024.
The primary outcome was the EQ-5D performance in terms of internal consistency (Cronbach’s α), criterion validity (Spearman’s correlation with TTO), and structural validity (exploratory factor analysis). The secondary outcome was the patient characteristics associated with discrepancies between EQ-5D and TTO utilities.
TTO utility scores were highest in AL (0.798), followed by lymphoma (0.755) and MM (0.693). EQ-5D utility values were consistently higher than TTO across all groups. Among the three groups, EQ-5D demonstrated the best psychometric performance in patients with MM, with excellent internal consistency (Cronbach’s α=0.899), strongest correlation with TTO (r=0.538, p
EQ-5D performed well in patients with MM, supporting its use in this population. In patients with AL, adjustments for clinical characteristics such as chronic kidney failure may improve the accuracy of EQ-5D utility values. The poor psychometric performance of EQ-5D in patients with lymphoma raises concerns about its appropriateness as a standalone instrument for HRQoL.
Adverse neurological complications, including postoperative delirium (POD) and stroke, remain one of the major risks after cardiac surgery. A lack of comprehensive knowledge about their causes and neuroprotective strategies has hindered the development of effective interventions to reduce these events. Personalised cerebral autoregulation (CA)-oriented blood pressure monitoring aims to identify blood pressure targets tailored to each individual patient, thereby reducing brain injury. The PRECISION study aims to assess whether perioperative duration and magnitude of mean arterial pressure (MAP) deviation from an individual’s CA limits are associated with adverse neurological complications.
This international, multicentre, prospective cohort study is conducted at two Swiss and one British hospital. Patients aged 65 years or older undergoing elective primary or re-operative coronary artery bypass graft and/or valvular and/or ascending aorta surgery requiring cardiopulmonary bypass are included. Preoperatively, the patient’s baseline of physical, cognitive and mental status is established. Intraoperatively, near-infrared spectroscopy (NIRS) and transcranial Doppler (TCD) are recorded in real-time to generate NIRS-derived and TCD-derived CA indices. The primary endpoint is POD, assessed daily on postoperative days 0 to 7 or up to discharge, whichever occurs earlier with the 3D-Confusion Assessment Method (3D-CAM) or CAM-Intensive Care Unit. Secondary endpoints include a composite neurological outcome of POD and overt stroke, postoperative neurocognitive disorders, major morbidity and mortality. Associations between neurologic outcomes, neurobiomarkers and genetic variation will be explored.
A total of 500 participants is required to achieve 90% power to find a statistically significant effect of the area under the curve MAP
Ethical approval has been obtained from all responsible ethics committees (Swiss lead ethics committee EKNZ 2022-01457 and Health Research Authority and Health and Care Research Wales, UK, REC 23/SW/0076). Results will be disseminated at national and international conferences and published in peer-reviewed journals.
To explore the complex relationships among non-suicidal self-injury, depression and anxiety symptoms in adolescents, identify key symptoms and provide a theoretical foundation for targeted interventions.
A cross-sectional study.
In total, 1126 adolescents from a tertiary hospital in Shandong Province were assessed using the Adolescent Self-Injury Questionnaire, Patient Health Questionnaire and Generalised Anxiety Disorder Scale. Network analysis was employed to construct symptom networks and identify central and bridging symptoms.
The network analysis revealed that nodes GAD5 (Restlessness), GAD2 (Uncontrollable worry), and GAD4 (Trouble relaxing) exhibited the highest centrality indices, establishing them as core symptoms within the overall symptom network. The highest bridge intensity nodes were GAD1 (Nervousness), GAD5 (Restlessness) and non-suicidal self-injury.
By accurately identifying core and bridging symptoms, a scientific foundation is provided for developing precise and effective symptom management plans.
The study identified the most influential nodes in anxiety and depression among adolescents with non-suicidal self-injury. The findings would help in carrying out personalised and precise interventions to reduce non-suicidal self-injury occurrence and alleviate anxiety and depression symptoms among adolescents.
This study adheres to the STROBE guideline of reporting.
This study did not include patient or public involvement in its design, conduct or reporting.
To examine nurses' perceptions of decent work (defined by the ILO as safe, fair and socially recognised employment) and its relationship with work-related flow and psychological capital.
A cross-sectional survey design.
In 2023, we used convenient sampling to select 1930 nurses from 20 high-grade A hospitals. A general data questionnaire, decent work perception scale (DWPS), work-related flow inventory (WOLF) and psychological capital scale (PCQ) were used for the survey.
The total score of the decent work perception scale of 1930 nurses was 49.10 ± 6.18, indicating a low perception of decent work. The total score of the work-related flow inventory was 108.68 ± 18.5, suggesting a moderate level of work-related flow, and the total score of the psychological capital scale was 84.64 ± 14.52, indicating a moderate level of psychological capital. Pearson correlation analysis revealed that nurses' perceptions of decent work were positively correlated with work-related flow (r = 0.429, p < 0.001) and psychological capital (r = 0.385, p < 0.001). The multilevel regression analysis showed age, education, workplace violence, income and regional economy significantly influenced decent work perception (p < 0.01). Work-related flow (β = 0.401) and psychological capital (β = 0.350) remained strong predictors after adjustments (p < 0.001). Institutional differences explained 18.8% of variance (ICC = 0.188).
Nurse's decent work perception was at a low level. Decent work perception positively correlated with work-related flow and psychological capital among nurses.
Hospitals should enhance organisational support, ensure fair compensation and improve working conditions through shared governance and well-being initiatives. Strengthening nurses' decision-making participation, professional pride and psychological resilience is crucial. While systemic challenges exist, incremental reforms like nurse-led task forces and pilot programmes can foster sustainable improvements.
A STROBE checklist.
No patient or public contribution.
Ethnic minoritized women face cultural and systemic barriers in accessing antepartum and intrapartum care. Healthcare providers play a pivotal role in addressing these challenges, but their perspectives and experiences in delivering culturally competent care remain underexplored.
To synthesise healthcare providers' experiences and perspectives on providing culturally competent antepartum and intrapartum care for ethnic minoritised women.
A qualitative meta-synthesis study design was employed. Six electronic databases were searched from their inception date till January 2025. The included studies were assessed using the method of the Critical Appraisal Skills Programme tool, and findings were meta-synthesised using Sandelowski and Barroso's six-step approach. This review was registered via the International Prospective Register of Systematic Reviews.
Overall, 38 studies were included, and three themes emerged. The first theme revealed how providers' biases and professional training distorted their ability to understand and respect cultural practices. The second theme underscored the impact of systemic barriers such as time constraints, resource scarcity and lack of representation among providers. The final theme highlighted healthcare providers' aspirations for improved communication, targeted training and guidance on building trust to enhance care delivery.
Healthcare providers encounter notable challenges in delivering culturally competent antepartum and intrapartum care, but remain hopeful about bridging gaps in communication and understanding. Practical recommendations include implementing mandatory cultural competency training at all levels of healthcare professional education, increasing resources for interpreters and cultural liaisons and fostering diversity within the healthcare workforce. Future research should explore patient-centred interventions and systemic reforms to improve care for ethnic minoritised women. These findings highlight the need for policies and practices that empower providers to deliver equitable, culturally respectful antepartum and intrapartum care.
No patient or public contribution.
This study investigates how observed workplace ostracism affects nurses' helping behaviour from a bystander's perspective, examining the mediating roles of moral courage and employee resilience to inform strategies for fostering workplace harmony in nursing settings.
A cross-sectional study design was adopted.
A survey of 346 nurses from two Grade III, Level A hospitals in Henan, China, utilised scales measuring workplace ostracism, moral courage, helping behaviour and employee resilience. SPSS Statistics 26.0, Mplus 8.3 and the SPSS macro program Process 4.1 plugin were used to test the associations among variables.
Observed workplace ostracism positively correlated with nurses' helping behaviour, with moral courage partially mediating this relationship. Employee resilience moderated both the link between observed workplace ostracism and moral courage, and the indirect effect of observed workplace ostracism on helping behaviour through moral courage.
Nurses with high levels of resilience demonstrate moral courage when observing workplace ostracism and engage in helping behaviours towards those ostracised.
This study examines how workplace ostracism undermines nursing team cohesion and individual well-being. It highlights that bolstering nurses' resilience and moral courage can alleviate these adverse effects, thereby improving patient care quality. Nursing managers are advised to adopt targeted strategies, such as resilience training, to mitigate workplace ostracism.
This study employs a questionnaire to explore nurses' views of workplace ostracism and helping behaviours, aiming to inform strategies for fostering nursing team harmony and improving care quality.
This study strictly follows the STROBE reporting guidelines to ensure the clarity and credibility of the research findings.
Data were collected from hospital nurses through electronic questionnaires.
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.
Lower extremity lymphedema (LEL) is a debilitating complication for patients with gynecologic cancer. A series of strategies have been recommended to mitigate the risk of LEL and improve patient outcomes; however, investigation into LEL risk management behaviours in this population is limited, and the absence of reliable and valid tools is an important reason.
To develop and evaluate the psychometric properties of the lower extremity lymphedema risk management behaviours questionnaire (LELRMBQ) for Chinese patients with gynaecologic cancer.
This was a methodological study.
Initial items were generated using a literature review. The initial LELRMBQ was refined, and its content validity was evaluated by conducting two rounds of expert consultation and a pilot study. Psychometric testing of 389 participants recruited by convenience sampling was conducted from December 2022 to June 2023. Exploratory factor analysis (EFA; subsample 1, N = 158) and confirmatory factor analysis (CFA; subsample 2, N = 231) were performed separately to determine the multi-dimensional structure of the questionnaire. Known-group validity, internal consistency reliability, and test–retest reliability were also evaluated.
A total of 25 items with satisfactory content validity were included in psychometric testing. The EFA identified a four-factor structure, comprising 18 items, which explained 74.49% of the total variance. The CFA supported this structure with acceptable fit indices. Known-group validity was partially supported by significant differences in total LELRMBQ scores among groups with different education levels, residence, cancer type, and LEL awareness. Internal consistency and temporal stability were acceptable.
The 18-item LELRMBQ demonstrated sufficient reliability and validity as a tool for measuring LEL risk management behaviours in patients with gynaecologic cancer.
The LELRMBQ has potential applicability in assessing LEL risk management behaviours, identifying gaps in educational practices, tailoring effective interventions, and evaluating intervention effectiveness.
This manuscript followed the STROBE guidelines.
Patients with gynecologic cancer participated in this study and provided the data through the survey.
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.
In December 2022, a large population infected with COVID-19 emerged in China, including frontline nurses. To maintain the medical system's function, many infected nurses returned to work before full recovery. This study aims to examine the characteristics of work resumption behaviour among the infected nurses and its influencing factors.
A nationwide cross-sectional study utilising questionnaire data.
An indicator was developed to assess the work resumption behaviour: work resumption type (autonomous work resumption, constrained work resumption). As the possible influencing factors of work resumption type, professional commitment, organisational commitment and psychological capital were included and measured by the Professional Commitment Scale (PCS), Organizational Commitment Questionnaire (OCQ), and Psychological Capital Questionnaire (PCQ). The logistic regression models were applied to estimate the association between the score of the PCS, OCQ, PCQ, and work resumption type.
A total of 30,062 nurses were included. The mean time of nurses returning to work after infection was 1.8 days, with 88.6% exhibiting autonomous work resumption behaviour. One standard deviation increment in the score of the PCS, OCQ, and PCQ was associated with a 41% (OR = 1.41), 29% (OR = 1.29) and 42% (OR = 1.42) average increase in the odds of having an autonomous work resumption, respectively.
The majority of nurses returned to work before full recovery during the pandemic. Elevated professional commitment, organisational commitment and psychological capital were associated with autonomous work resumption behaviour.
The large-scale work resumption in this emerging infectious disease outbreak demonstrated that the healthcare system should reevaluate nursing workforce growth targets for pandemics. It is still warranted for future research to explore the long-term effects of work resumption on individual and organisational levels.
Chinese clinical trial registry: ChiCTR2300067706 (January 8, 2023)
This study aims to explore the mediating role of resilience and perceived social support in the relationship between gratitude and the work reintegration adaptability of cancer patients in China.
A cross-sectional and correlational study.
A total of 402 participants were collected from July to December 2023 from a tertiary hospital in Jiangsu Province, China, using a convenience sampling method. The survey utilised the General Information Questionnaire, the Gratitude Questionnaire-6 (C-GQ-6), the Cancer Patient Return-to-Work Adaptation Scale, the resilience Scale (CD-RISD), and the Perceived Social Support Scale (PSSS) to collect data. The theoretical hypothesis was tested using structural equation modelling (SEM) analysis, with model fit corrections performed to examine the internal relationships and pathways among gratitude, resilience, perceived social support and return-to-work adaptability.
Gratitude, resilience, and perceived social support were significantly correlated with work reintegration adaptability. Resilience and perceived social support independently mediate the relationship between gratitude and work reintegration adaptability, with mediation effects of 56.63% and 7.77%, respectively. Additionally, resilience and perceived social support fully mediate the relationship between gratitude and work reintegration adaptability, with a chain mediation effect of 35.60%.
Gratitude can affect cancer patients' return to work adaptation through resilience and perceived social support.
Healthcare professionals should focus on the impact of gratitude on cancer patients' adaptability to work reintegration. Interventions targeting resilience and perceived social support should be developed to enhance patients' work reintegration and promote their overall recovery and social reintegration.
STROBE checklist.
No patient or public contribution.
To synthesise qualitative evidence on how patients, caregivers and healthcare professionals perceive and respond to cancer-related anorexia (CRA), and to develop a multi-level framework for improving CRA care.
A qualitative meta-synthesis using the Joanna Briggs Institute (JBI) methodology, informed by the Social Ecological Model (SEM).
Seven databases were searched for qualitative studies from inception to April 2025. Studies were assessed using the JBI Critical Appraisal Checklist. Meta-aggregation was used to synthesise findings, and the ConQual method assessed confidence levels.
PubMed, Embase, CINAHL, PsycINFO, Cochrane Library, CNKI and WanFang.
Seventeen studies from 10 countries were included, reflecting the perspectives of patients, caregivers and healthcare professionals. Four synthesised findings were identified. At the individual level, CRA was linked to physical decline, emotional distress and changes in identity. The interpersonal level involved feeding-related tensions and caregiver burden. Organisational barriers included delayed care and poor cultural responsiveness. Policy-level factors such as limited insurance coverage and rural access further impeded care. Overall confidence in these synthesised findings was low to moderate.
CRA is not solely a biological condition but a multidimensional experience. Addressing CRA requires integrated and context-sensitive strategies across personal, relational, organisational and policy domains.
Nurses and clinicians should address not only physical symptoms but also the emotional and social dimensions of eating. Structured support for caregivers and improved service access, particularly in underserved settings, are needed.
This study provides a multi-level understanding of CRA. The findings support better patient care, caregiver support and more equitable healthcare policy design.
JBI methodology and ENTREQ guideline.
No Patient or Public Contribution.
PROSPERO Database: CRD420251041265
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.
FreshRSS 