Conectar
by Qian Yue Tan, Kinda Ibrahim, Helen C. Roberts, Khaled Amar, Simon D.S. Fraser
BackgroundPeople with Parkinson’s (PwP) and their caregivers have to manage multiple daily healthcare tasks (treatment burden). This can be challenging and may lead to poor health outcomes.
ObjectiveTo assess the extent of treatment burden in Parkinson’s disease(PD), identify key modifiable factors, and develop recommendations to improve treatment burden.
MethodsA mixed-methods study was conducted consisting of: 1) a UK-wide cross-sectional survey for PwP and caregivers using the Multimorbidity Treatment Burden Questionnaire (MTBQ) to measure treatment burden levels and associated factors and 2) focus groups with key stakeholders to discuss survey findings and develop recommendations.
Results160 PwP (mean age = 68 years) and 30 caregivers (mean age = 69 years) completed the surveys. High treatment burden was reported by 21% (N = 34) of PwP and 50% (N = 15) of caregivers using the MTBQ. Amongst PwP, higher treatment burden was significantly associated with advancing PD severity, frailty, a higher number of non-motor symptoms, and more frequent medication timings (>3 times/day). Caregivers reporting higher treatment burden were more likely to care for someone with memory issues, had lower mental well-being scores and higher caregiver burden. Three online focus groups involved 11 participants (3 PwP, 1 caregiver and 7 healthcare professionals) recruited from the South of England. Recommendations to reduce treatment burden that were discussed in the focus groups include improving communication. clear expectation setting, and better signposting from healthcare professionals, increasing education and awareness of PD complexity, flexibility of appointment structures, increasing access to healthcare professionals, and embracing the supportive role of technology.
ConclusionsTreatment burden is common amongst PwP and caregivers and could be identified in clinical practice using the MTBQ. There is a need for change at individual provider and system levels to recognise and minimise treatment burden to improve health outcomes in PD.
by Zhongqun Guo, Qiangqiang Liu, Feiyue Luo, Shaojun Xie, Tianhua Zhou
The acidic leachate injected during the mining process of ion-type rare earth ores can damage the environmental characteristics of the soil, thereby triggering the activation and release of associated heavy metals. Severe Zn contamination has been found in the environment of ion-type rare earth mining areas, but the activation and release of Zn in the soil during the leaching process have not been fully understood. This study investigated the activation and release patterns and mechanisms of Zn in soil under different leaching agents ((NH4)2SO4, MgSO4, Al2(SO4)3) and varying concentrations of Al2(SO4)3 (1%, 3%, 5%, 7%) using a simulated leaching experimental system. The results show that the activation and release patterns of Zn in the soil vary significantly under the influence of the three leaching agents. During the entire leaching cycle, the peak Zn concentration in the leachate was highest under MgSO4 leaching, while the residual Zn content in the soil under Al2(SO4)3 leaching approached the high-risk environmental threshold. The high-concentration systems (5%, 7%) of Al2(SO4)3 significantly enhanced the activation and release efficiency of Zn in the soil compared to the low-concentration systems (1%, 3%) of Al2(SO4)3. (NH4)2SO4 mainly promotes the activation and release of Zn through ion exchange between NH4+ and Zn2+ and the acidification effect; Al2(SO4)3, on the other hand, dominates the activation and release of Zn by providing a strongly acidic environment and dissolving and damaging the mineral lattice; while MgSO4 not only exchanges ions between Mg2+ and Zn2+, but also alters the soil colloidal structure, facilitating Zn activation and release. The promoting effects of the three leaching agents on the transformation of Zn in soil follow the order of Al2(SO4)3> (NH4)2SO4 > MgSO4, with the environmental risk assessment index (RAC) being highest after Al2(SO4)3 leaching, indicating the greatest potential environmental risk. Compared to the other three concentrations (1%, 5%, 7%) of Al₂(SO4)3, the 3% concentration of Al2(SO4)3 had the most significant promoting effect on the transformation of Zn in soil. This study provides a theoretical basis for optimizing the green mining process of ion-type rare earth ores and preventing heavy metal pollution, and offers scientific support for revealing pollution mechanisms and formulating remediation and risk assessment strategies.Bedaquiline (BDQ), delamanid (DLM) and pretomanid (Pa) were widely used in recent years. This study aimed to analyse adverse drug event (ADE) reports associated with them based on the Food and Drug Administration Adverse Event Reporting System (FAERS) database, to explore the signals of ADEs and provide reference for clinical use.
A retrospective pharmacovigilance study.
The FAERS database was extracted from 2015 to 2023, and the ADE reports about BDQ, DLM, and Pa were collected.
Data mining was carried out on relevant reports of BDQ, DLM, and Pa using the reporting odds ratio (ROR), proportional reporting ratio (PRR), medicines and healthcare products regulatory agency (MHRA) and the information component (IC).
A total of 4010 ADE reports were included: 2477 for BDQ, 1360 for DLM and 173 for Pa. Combined with disproportionality analysis in different backgrounds, the salient risks of three target drugs varied. In the entire dataset, prolonged ECG QT (BDQ: ROR=42.57; DLM: ROR=28.00; Pa: ROR=20.45), hepatitis toxic (BDQ: ROR=28.65; DLM: ROR=21.42; Pa: ROR=90.67), bilirubin conjugated increased (BDQ: ROR=14.40; DLM: ROR=14.56; Pa: ROR=53.95), increased aspartate aminotransferase (BDQ: ROR=9.10; DLM: ROR=8.83; Pa: ROR=7.77), increased alanine aminotransferase (BDQ: ROR=5.68; DLM: ROR=5.54; Pa: ROR=8.92), drug-induced liver injury (BDQ: ROR=6.51; DLM: ROR=6.24; Pa: ROR=3.61) and anaemia (BDQ: ROR=6.54; DLM: ROR=5.75; Pa: ROR=4.83) remained common risks for them. However, in the other two contexts, only decreased haemoglobin (tuberculosis dataset: ROR=2.15; target dataset: ROR=1.03), which was more pronounced associated with DLM and prolonged ECG QT (tuberculosis dataset: ROR=2.46; target dataset: ROR=1.23), hepatotoxicity (tuberculosis dataset: ROR=1.74; target dataset: ROR=4.03) was more pronounced associated with BDQ, while other ADEs, like pancreatitis (tuberculosis dataset: ROR=4.54; target dataset: ROR=7.36), death (tuberculosis dataset: ROR=5.71; target dataset: ROR=2.47) and multiple organ dysfunction syndrome (tuberculosis dataset: ROR=1.46; target dataset: ROR=2.76), were worthy of attention associated with Pa apart from the common ADEs. The combination of linezolid (LZD) with the target drugs elevated risk signals for hepatotoxicity, haematologic toxicity and neurotoxicity. Subgroup analyses revealed that
Our study highlights the differences in common ADEs of BDQ, DLM and Pa, as well as the differences in these ADEs among genders and age groups, providing valuable insights for clinical application.
Gastric cancer (GC) remains a leading cause of cancer-related mortality worldwide, with most Chinese patients diagnosed at a locally advanced stage. Neoadjuvant chemotherapy (NAC) is increasingly used to improve resectability and survival. Laparoscopy-assisted distal gastrectomy (LADG) provides short-term recovery benefits compared with open distal gastrectomy (ODG), but its safety and oncologic efficacy following NAC remain uncertain. This trial aims to determine whether LADG is non-inferior to ODG in terms of long-term survival outcomes in patients with locally advanced distal gastric cancer (LAGC) after NAC.
This is a multicentre, randomised, controlled, non-inferiority trial conducted at high-volume GC centres in China. Eligible patients (aged 18–75 years; cT3–4a, N0/+, M0) with histologically confirmed distal gastric adenocarcinoma who have completed standard NAC will be randomised 1:1 to LADG or ODG with D2 lymphadenectomy. Surgical quality will be standardised through operative manuals, intraoperative video recording and central auditing. The primary endpoint is 3-year disease-free survival. Secondary endpoints are 3- and 5-year overall survival. A total of 998 patients (499 per arm) will be enrolled, providing 80% power to test non-inferiority with an absolute 8% margin, accounting for 15% attrition. Analyses will follow the intention-to-treat principle, with Cox models used for survival comparisons and subgroup analyses according to nodal status, tumour size and pathological response.
This trial has been reviewed and approved by the Biomedical Ethics Committee of West China Hospital, Sichuan University (Approval No. 2025 (865), 16 July 2025). Written informed consent will be obtained from all participants. The results will be disseminated through peer-reviewed journals and international conferences, providing high-level evidence to guide the surgical management of LAGC after NAC.
Chinese Clinical Trial Registry, ChiCTR2500109677; registered on 23 September 2025. Protocol V.2.1, dated 29 June 2025.
To construct a nursing diagnosis index system for burn patients under prolonged field care (PFC).
A modified Delphi study.
13 class A tertiary hospitals and 2 universities.
Nine experts were selected for expert interview: (1) bachelor’s degree or higher; (2) ≥10 years’ experience in burn care, nursing quality management or health service management, including participation in ≥3 PFC operations; (3) intermediate or higher professional title; (4) willingness to participate. 22 experts were selected for expert consultation: (1) bachelor’s degree or higher; (2) ≥3 years’ nurse management experience with theoretical expertise in burn nursing diagnosis; participation in ≥3 major non-combat military operations; (3) intermediate or higher professional title; (4) commitment to complete consultations.
Including a two-stage process: (1) system construction: developed a preliminary index system using The North American Nursing Diagnosis Association international’s framework, guided by US military ‘10 PFC Core Competencies’ and UK military SHEEP VOMIT standards, via literature analysis and expert interviews. (2) Delphi refinement: conducted three Delphi rounds with 22 experts. Finalised indicators using Analytical Hierarchy Process to assign weights.
The burn PFC nursing diagnosis index system established in this study comprises 7 primary indicators, 18 secondary indicators and 44 tertiary indicators. The valid questionnaire response rate for the expert consultation reached 100%, with an expert authority coefficient of 0.85. After three rounds of the Delphi expert consultation, Kendall’s coefficient of concordance (Kendall’s W) for indicators at all levels ranged from 0.104 to 0.305 (p
This systematic, scientific and rational index system provides a foundation for standardising burn PFC nursing plans, potentially enhancing care quality and efficiency in PFC settings.
The high prevalence of developmental delays among young children poses significant barriers to long-term social mobility in low-income and middle-income countries. Digital interventions aimed at early childhood development (ECD) have shown promise in improving developmental outcomes, yet scalable and effective strategies remain under-explored. This study aims to evaluate the effectiveness of a digitally delivered parenting intervention to improve early child development in rural China.
We design a parallel cluster-randomised controlled trial to evaluate a 12-month digitally delivered ECD intervention in rural China. Key inclusion criteria are households with children aged 6–24 months and without relocation intentions. Key exclusion criteria are children with a severe disability. Participants are masked to treatment assignment. The project implements village-level interventions in three counties in central China, involving 70 villages (clusters). Implementation involves two phases: the preparatory phase and the online phase, in which ‘Parenting the Future’ curriculum will be delivered through a newly developed mobile application. During the preparatory phase, county-level parenting trainers will conduct weekly home visits to each sampled household. In the online phase, caregivers will primarily access weekly parenting training through prerecorded videos on a mobile application. Trainers will conduct short, fortnightly home visits to manage toys and picture books loaned through the same application in accordance with the training. The planned total treatment involves 48 sessions over 1 year. Assessments were conducted via home visits at baseline and endline. The primary outcomes include cognitive development measured with the Bayley Scales of Infant and Toddler Development, third edition and social-emotional development measured with the age and stage questionnaire: social emotional. Secondary outcomes include caregiver engagement and the home learning environment measured by family care indicators and responsive caregiving rating scale. The trial aims to test the effectiveness and scalability of a hybrid ECD intervention.
Ethical approval for this study has been obtained from the Institutional Review Board of Southwestern University of Finance and Economics. Informed consent will be obtained from all participants, with appropriate measures in place to ensure participant confidentiality. Results from the study will be shared through academic publications, policy briefs and presentations to government stakeholders and international organisations, contributing to policy discussions on the scalability of digital ECD interventions.
AEA RCT Registry (AEARCTR-0013908); ISRCTN Registry (ISRCTN15854033).
This study aimed to examine alcohol-screening rates during pregnancy and documentation of prenatal alcohol exposure in a public health district in Australia.
A descriptive study using a retrospective medical record audit.
Alcohol screening data of 45,048 pregnancies recorded by four public antenatal clinics between 2010 and 2021 were obtained. A manual data extraction was conducted on 53 pregnancies of the women who attended the substance use in pregnancy and parenting service for their alcohol concerns during the same time period. From early 2017, a repeat alcohol screening was required at 27–29 and 35–37 weeks gestation and was examined for 30 of the 53 pregnancies.
Overall, 99.3% of the pregnancies were screened for alcohol consumption at antenatal care booking and the screening rate remained above 99.0% over the years. Screening results showed that 1.3% were at high risk, 1.9% at medium risk and 4.2% at low risk. Of the 53 pregnancies examined, 90.6% were screened at antenatal care booking. Of the 30 pregnancies requiring repeat screening, screening rates were 50.0% at 27–29 weeks and 43.3% at 35–37 weeks. Prenatal alcohol exposure was only documented in 35.8% of the postnatal care plan and 20.8% of the neonatal discharge summary.
Almost all pregnancies were screened at the antenatal care booking; however, the number of alcohol-exposed pregnancies might be underestimated due to current alcohol use being screened. Completion of repeat alcohol screenings and documentation of prenatal alcohol exposure were suboptimal.
Not applicable.
by Xinfeng Xu, Xinyao Jiang, Meng Zou, Jinyan Hui, Guang Huang, Qian Wu
Perfluorinated compounds (PFCs) are persistent environmental pollutants with near-universal human exposure, yet their respiratory health impacts during adolescence remain insufficiently explored. This investigation evaluated single and combined effects of serum PFCs on pulmonary function and respiratory morbidity in a nationally representative adolescent cohort (n = 976, ages 12–19 years) utilizing 2007–2012 NHANES data. Advanced analytical approaches including multivariable regression, mixture modeling (BKMR and WQS), and mediation analysis were employed to assess associations with spirometric parameters (FEV1, FVC, FEV1/FVC) and respiratory symptoms while examining inflammatory and oxidative stress pathways. Computational approaches integrating network toxicology and molecular docking identified key protein targets. Analytical results demonstrated significant associations between specific PFC congeners (PFOA, PFHS, PFOS) and pulmonary function measures, with age-stratified effects observed for wheezing symptoms. Mixture analyses revealed PFOA as the predominant contributor to observed respiratory effects, partially mediated through oxidative stress pathways (6.8–8.2% mediation). Molecular investigations identified critical signaling nodes (INS, AKT1, TP53, TNF, IL6, ALB and PPARγ) potentially linking PFC exposure to respiratory outcomes. These findings provide mechanistic insights into PFC-induced pulmonary effects during adolescence, highlighting the need for continued investigation of these environmentally persistent compounds’ impact on developing respiratory systems. The integrated epidemiological-computational approach demonstrates the utility of combining population-level data with mechanistic modeling to elucidate environmental health effects.by Wenlong Qian, Kou Xu, Shuo Li, Zhuo Zhang, Xiaoxiao Hou, Bingjie Min, Jia Ling, Xinyu Zhu, Hui Zhou, Wenjuan Xu, Wenming Yang, Shijian Cao, Yonghua Chen
BackgroundPenicillamine(D-Penicillamine) and trientine are first-line therapies for Wilson’s Disease (WD), yet real-world data on their adverse events (AEs) remain scarce. We analyzed the FDA Adverse Event Reporting System (FAERS) to comprehensively assess the safety of penicillamine and trientine in WD treatment.
MethodsAEs for penicillamine and trientine (2004Q1–2024Q4) were analyzed using Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), and Bayesian Confidence Propagation Neural Network (BCPNN).
ResultsWe found 1,452 and 760 AEs related to penicillamine and trientine, respectively. In all adverse event (AE) reports, the ratio of females to males was approximately 1.3, with the highest proportion of AE reports in the 21–30 age group, and the largest number of AE reports coming from the United States. Signal detection showed that the most commonly reported AEs for penicillamine and trientine were drug hypersensitivity and tremor, respectively, with the highest proportions in the SOC categories of immune system disorders and gastrointestinal disorders. The main AEs for both drugs involved condition aggravated, and identified potential safety signals requiring further validation for the two drugs, such as decreased bone density and brain atrophy for penicillamine, and memory impairment, oesophageal ulcer and starvation for trientine. In addition, we found that women were more likely to experience drug hypersensitivity in penicillamine adverse event reports, while men were more likely to experience cutis laxa.
ConclusionThis study reveals the characteristics of AEs and potential associated risks in the clinical application of penicillamine and trientine, emphasizing individualized medication and vigilant monitoring strategies to provide guidance for safe medication use.
To evaluate bioecology and environmental influences of patients presenting with alopecia regarding decisions made for hair camouflage.
A descriptive qualitative design was used.
Sixteen adult patients with alopecia were purposefully recruited from two specialised trichology clinics across the Jiangsu Province, China. Surveys and in-depth semi-structured interviews were conducted between October 2024 and December 2024. Practical thematic analysis of transcribed data was informed through Bronfenbrenner's ecological systems theory.
Five major facilitators (camouflaged demands drive, camouflaged psychological resilience, habituation and dependence, family resilience and cross-border support, social acceptance) and four major barriers (limited future orientation, perceived coordination barriers, marginalisation of camouflage-related information, runaway costs) to hair camouflage were identified. These themes align with different levels of the ecological systems theory.
This study captures the complex ecological and intersectional nature of choice, experience and decision-making in patients' views on hair camouflage amid alopecia. Nursing professionals must understand these complexities to provide informed support and evidence-based interventions throughout patients' experiences with alopecia.
This study uses patient voices to offer ecological insights for a holistic understanding of their experiences. It provides knowledge relevant to nursing practice and alopecia patient support. Understanding patient-identified barriers and facilitators in alopecia camouflage is essential to inform more patient-centred approaches to choice, decision-making and psychological adaptation. Nurses are pivotal in this process, making enhanced understanding crucial for improving patients' psychological wellbeing and quality of life.
Our research reveals factors that equip nurses and the broader healthcare team to develop targeted counselling strategies, educational programs and resources related to camouflage for patients with alopecia. The hair-camouflage industry can use these insights to create more personalised and accessible products, better addressing patients' concealment needs and preferences.
Standards for Reporting Qualitative Research.
No patient or public contribution.
by Qi Zhou, Lingling Qian, Luyu Wu, Haiqian Wu, Junwei Ye, Qinrou Yu, Xiangnan Gu, Yueli Zhu
PurposeExplore public perceptions and sentiments about cancer screening on social media. The dissemination of misinformation and negative attitudes continue to impede the access of many individuals with perceived risk to cancer screening services despite their awareness of the necessity and concept of early cancer screening.
MethodsThis study was divided into five steps: data collection, data cleaning, data standardization, sentiment analysis, and content analysis.
ResultsThis study analyzed 796 social media comments (53,151 words) from Weibo, Zhihu, and Xiaohongshu to explore public sentiments toward cancer screening. Seven emotion categories emerged: good, happy, surprise, anger, disgust, fear, and sadness. Positive emotions reflected trust in physicians, financial support, and perceived screening effectiveness, whereas negative emotions reflected fear of cancer, stigma, and procrastination.
ConclusionThe findings of this study include the development of health communication strategies, the promotion of public screening participation, and the improvement of nursing personalization and emotional sensitivity. These findings highlight barriers and facilitators for cancer screening promotion in China and inform targeted nursing communication strategies.
by Xu Jia, Jiaojiao Peng, Junhong Lv, Yuanting Li, Ziren Luo, Jing Xiang, Yaqin Hou, Qian Zheng, Bin Han
The presence of substantial quantities of antibiotics and their metabolites in hospital wastewater can lead to the accumulation of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs). Research on the influent and effluent sewage of hospitals is crucial for understanding the effectiveness of wastewater treatment systems in inactivating ARB and ARGs. Key features of microbial communities and ARGs in influent and effluent wastewater – including taxonomic diversity and relative abundance – were assessed via metagenomic sequencing. The treatment process resulted in a reduction of the overall bacterial count in hospital wastewater. However, a notable increase in relative abundance was observed for three phyla, 16 genera, and 21 species post-treatment. Bacteria harboring ARGs were predominantly identified as belonging to Pseudomonadota and Bacillota. A total of 354 ARGs were detected in the influent, while 331 were identified in the effluent samples, with a general decrease in absolute abundance. Nevertheless, the relative abundance of certain ARGs, such as mphG, fosA8, and soxR, was found to increase in the effluent across all samples. Seasonal fluctuations also played a role in the distribution of microbial communities and ARGs. These findings underscore the role of hospital wastewater treatment systems in reducing the discharge of ARB and ARGs into the environment, while also revealing potential shortcomings in the wastewater treatment process that necessitate further improvement for more effective removal of these ARGs.To investigate the mental health mechanisms linking chronic disease and mental health, specifically examining the mediating roles of self-efficacy and perceived social support in the associations with depressive and anxiety symptoms.
This cross-sectional study with chain mediation analysis was performed using regression-based methods with bootstrapping. Data were collected from a national survey conducted in China between July and September 2021.
Data were obtained from 23 provinces, 5 autonomous regions and four municipalities across China, covering both urban and rural areas. A total of 3365 participants were included in the study.
The study involved 3365 participants (51.9% male, 48.1% female) aged ≥46 years. Participants were selected from diverse demographic backgrounds to ensure national representativeness.
Primary outcomes were symptoms of depression (Patient Health Questionnaire-9) and anxiety (Generalised Anxiety Disorder-7). Secondary measures included self-efficacy (New General Self-Efficacy Scale) and perceived social support (Perceived Social Support Scale).
Chronic disease was statistically significantly associated with increased severity of symptoms of depression (β=1.050, p0.001) and anxiety (β=0.758, p0.001). Self-efficacy was negatively associated with symptoms of both depression (β=–0.034, p>0.05) and anxiety (β=–0.036, p=0.050), whereas perceived social support was statistically significant negatively associated with symptoms of both depression (β=–0.077, p0.001) and anxiety (β=–0.061, p0.001). Chain mediation analysis indicated that self-efficacy and perceived social support partially mediated the effects of chronic disease on symptoms of both depression (indirect effect=0.064, p0.001) and anxiety (indirect effect=0.051,p=0.002).
This study demonstrates that chronic diseases exacerbate symptoms of depression and anxiety through the dual mediating pathways of self-efficacy and perceived social support. Enhancing self-efficacy and perceived social support may be crucial in developing effective mental health interventions for patients with chronic disease, particularly for those at risk of social isolation, such as older adults. Future interventions should focus on improving self-efficacy and expanding social support networks.
To identify barriers and facilitators to nurse prescribing implementation through a synthesis of qualitative studies.
The roles of healthcare professionals are expanding in response to the growing demand for access to high-quality healthcare services. Advanced practice nurses are a global trend, and nurse prescribing is a crucial feature of advanced practice nurses that can meet the needs of growing healthcare services. The development and promotion of nurse prescribing varies significantly across countries, and it is essential to identify the factors influencing the implementation of nurse prescribing.
A systematic search of PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wan Fang and Weipu database was conducted to retrieve literature on barriers and facilitators related to the implementation of nurse prescribing. We searched records from inception to 29 March 2025. Two researchers independently performed literature screening, literature evaluation, data extraction and synthesis. Literature screening and data extraction adhered to the predefined inclusion and exclusion criteria. Literature quality was evaluated using the JBI Checklist for Qualitative Research. The results were synthesised using the thematic synthesis approach. Information was extracted using the Consolidated Framework for Implementation Research (CFIR) in a deductive way, and barriers and facilitators to the implementation were categorised based on the CFIR. Report rigour assessed via ENTREQ.
The synthesis of 14 included papers identified 18 thematic categories, yielding two key findings. The main barriers identified included failure to anticipate the cost of nurse prescribing, legal constraints, social pressures, poor organisational structure, insufficient prescribing education, lack of competence of nurses leading to psychological changes, opposition and lack of cooperation of team members, and insufficient planning of nurse prescribing. Facilitating factors included prescribing experience, resource and labor conservation, cost reduction, resources, nurses' prescribing training, leadership support, patients' needs, nursing professional development, nurses' competence, and team cooperation and support.
Identifying barriers and facilitators to nurse prescribing is critical for informing policy-making and clinical prescribing practices. The results offers practical guidance to develop strategic plans that enhance implementation and adoption of nurse prescribing.
Nurse prescribing improves patient access while mitigating healthcare strain. By streamlining medication delivery and optimising resource use in overburdened systems, this model strengthens patient-centered care while allowing physician specialisation in complex cases. This workforce innovation enhances team-based care and ensures continuity for vulnerable populations.
This paper identifies barriers and facilitators, offering policymakers, healthcare administrators, and educators actionable insights to enable nurse role expansion, reduce physician workload, and enhance outcomes through holistic care.
No patient or public contribution.
Recurrent in-stent restenosis (RISR) remains a major therapeutic challenge in patients undergoing percutaneous coronary intervention (PCI), with a high incidence of repeat revascularisation and increased mortality. Immune-mediated inflammation has been implicated in the pathogenesis of RISR. This trial aims to evaluate the clinical efficacy and safety of two anti-inflammatory strategies—low-dose colchicine and prednisone—on reducing ISR recurrence and cardiovascular events.
This is a multicentre, prospective, randomised, open-label controlled trial enrolling 252 patients with RISR. Following successful PCI, patients are randomly assigned (1:1:1) to receive: (1) standard medical therapy (control group); (2) colchicine 0.5 mg/day (colchicine group) or (3) prednisone 0.5 mg/kg/day, tapered monthly to 5–10 mg/day over 12 months (prednisone group). All groups receive background standard therapy per guidelines. The primary endpoint is angiographically confirmed ISR of the target lesion at 12 months post PCI. Secondary endpoints include the incidence of major adverse cardiovascular and cerebrovascular events (cardiovascular death, myocardial infarction, stroke and target vessel revascularisation), target lesion revascularisation and revascularisation of non-target coronary lesions within 12 months.
This trial has received ethical approval from the Ethics Committee of Fuwai Hospital (Chinese Academy of Medical Sciences and Peking Union Medical College), which acts as the central institutional review board. All participants will provide written informed consent. Study results will be disseminated via peer-reviewed journals and conference presentations.
ClinicalTrials.gov, NCT06090890. Registered 15 October 2023,
Patients with acute myocardial infarction (AMI) and multivessel disease are at elevated risk of recurrent events. Radial wall strain (RWS), a novel indicator derived from angiography, has emerged as a potentially useful adjunct to optical coherence tomography (OCT) for assessing plaque vulnerability. The NASCENT trial is a prospective, multicentre cohort study designed to assess the natural history of coronary plaque in this high-risk AMI population and investigate the predictive value of angiography-based RWS for lesion progression, compared with OCT-assessed vulnerable plaque.
Following successful culprit lesion revascularisation for AMI patients with multivessel disease, we assessed eligible non-culprit lesions (30%–80% diameter stenosis) in non-flow-limiting, non-infarct-related arteries (Murray law-based quantitative flow ratio >0.80) using OCT and offline RWS analysis. The primary endpoint is lesion progression at 1 year, defined as a ≥20% increase in diameter stenosis percentage measured by quantitative coronary angiography. Between April 2024 and April 2025, 131 patients were enrolled. The 1-year angiographic and OCT follow-ups will be completed by May 2026. Clinical follow-ups are planned at 1 month, 6 months, 1 year and annually up to 3 years. As the first prospective trial comparing angiography-based RWS with OCT for predicting lesion progression in the AMI population, this study may provide crucial evidence for RWS as a valuable tool for risk stratification and clinical decision-making.
The protocol has been approved by the Institutional Review Board and Ethics Committee (Fuwai Hospital Approval No. 2023-2039) and will be conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all participants. The study results will undergo peer-reviewed publication.
To assess the competence level and latent profiles of nursing interns regarding their management of workplace violence (WPV).
Workplace violence may have adverse effects on the physical and mental health, clinical practice behaviours and career plan of nursing interns. Besides, the competence of WPV management contributed to a sense of career security for nursing interns. However, few studies have focused on the current status of the competence of WPV management for nursing interns.
A cross-sectional self-report design that followed STROBE guidelines.
A total of 379 Chinese nursing interns were invited from three tertiary hospitals in Chengdu city by convenience sampling in this cross-sectional study. Data were collected using the Sociodemographic Characteristics Questionnaire, the Management of Workplace Violence Competence Scale (MWVCS) and the Chinese version of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Latent profile analysis and logistic regression were performed.
The mean score of nursing interns' management competence of WPV was 152.87 (SD = 25.67). The best latent profile model was identified as three profiles, namely the ‘low management competence of WPV subgroup’ (19.5%), ‘medium management competence of WPV subgroup’ (64.1%) and ‘high management competence of WPV subgroup’ (16.4%), respectively. Multiple logistic regression showed that attending the violence prevention training, interest in the nursing profession and resilience were protective factors of management competence of WPV for nursing interns.
The majority of nursing interns perform at a medium level with noted heterogeneous characteristics, which contribute to identifying different nursing interns' perceptions of competence to manage WPV. Therefore, nursing managers can provide targeted intervention strategies to further promote the competence of WPV management for nursing interns.
Nursing educators and managers could conduct systematic training on the competence of WPV management based on individual different characteristics, which can be used as pre-internship training programmes for nursing interns, and provide resilience support plans.
No patients or public contribution.
To investigate the prevalence of rapid response team delays, survival distribution of admission to rapid response team delay and its prognostic factors.
A retrospective single-centre study.
Data on rapid response team activations from 1 January 2018 to 31 December 2022 were retrieved from electronic medical records at a tertiary hospital in Hangzhou, China. All patients who met the eligibility criteria were included. Multivariable Cox regression analysis was conducted to analyse the data.
Out of 636 patients included, 18.4% (117) experienced a delay, with a median (interquartile range) of 8.5 (12) days from admission to rapid response team activation. Six significant prognostic factors were found to be associated with the higher hazard ratio of rapid response team delay, including call time (05:01 PM and 7:59 AM), emergency admission, a higher Modified Early Warning Score, an admission diagnosis of infection, a comorbidity of respiratory failure/Acute Respiratory Distress Syndrome and the absence of lung infection.
The prevalence of rapid response team delays was lower, and the days from admission to rapid response team delay was longer than in previous studies. Healthcare providers are suggested to prioritise the care of high-risk patient groups and provide proactive monitoring to ensure timely identification and management.
Implementing artificial intelligence in continuous monitoring systems for high-risk patients is recommended. The findings help nurses anticipate potential delays in rapid response team activation, enabling better preparedness.
The study highlights the prevalence of rapid response team delays, timing from admission to rapid response team activation and six prognostic factors influencing delays. It could shape patient care and inform future research. Hospital administrators should review staffing, especially during night shifts, to minimise delays. Further qualitative research is needed to explore why nurses may delay rapid response team activation.
The STROBE checklist was adhered to when reporting this study.
‘No patient or public contribution’.
Chronic pruritus has a significant global impact, which is common in the elderly population. Developing a standardised and validated assessment tool is the basis for managing chronic pruritus. However, there is little research on standardised assessment tools for self-management in older people with chronic pruritus.
To construct and test the Self-management Scale for Chronic Pruritus in older people and provide a scientific and reliable tool to measure the self-management level of older people with chronic pruritus.
A three-phased exploratory sequential mixed-method design was used. In phase I, the initial construction of scale dimensions and items was conducted through literature review, semi-structured interviews and the Delphi method. In phase II, the scale was optimised, and the test version of the scale was formed. In phase III, we used the scale for practical evaluation. This research was conducted according to the STROBE guidelines.
Based on literature reviews and examination by experts, a draft scale was formulated. From October 2023 to December 2023, a total of 180 older people were recruited for item analysis and 206 older people were recruited for practical evaluation.
A total of 20 items were finally retained by the item analysis from the initial pool. In the exploratory factor analysis, the five-factor model explained 75.491% of the total variation, and the data fit was good. Based on multiple linear regression, the self-management level of older people with chronic pruritus was significantly correlated with gender, occupation, income, pruritus-related diagnosis, awareness of pruritus predisposing factors and receipt of pruritus treatment.
Self-management Scale for Chronic Pruritus in older people has good reliability and validity, providing a reference basis for healthcare professionals to assess the self-management levels of older people with chronic pruritus.
Healthcare professionals can use this scale to evaluate the self-management level of chronic pruritus in older people and explore the influencing factors, which can help develop targeted health education programmes.
Experts provided suggestions for developing the scale. Older people with chronic pruritus participated in the scale revision process to improve wording.
FreshRSS 