Conectar
To explore whether vaccine confidence and vaccine delay intention mediated the effect of the pay-it-forward intervention on human papillomavirus (HPV) vaccine uptake.
This secondary mediation analysis of a two-arm randomised controlled trial was conducted among female adolescents aged 15–18 years in Chengdu, China, from July 2022 to June 2023.
This study was conducted in four residential areas representing diverse economic backgrounds in Chengdu.
A total of 321 parents of girls aged 15–18 years who had not received the HPV vaccine participated in the study.
Participants were randomly allocated into two arms. Pay-it-forward participants received a community-contributed subsidy (47.7 USD) to support the HPV vaccination, along with educational postcards and an opportunity to donate to support others. In the standard-of-care arm, participants paid for their vaccination.
Primary outcome was the receipt of the first HPV vaccine dose within a 3-month period following an intervention. Based on previous literature, we hypothesised that vaccine confidence and vaccine delay intention were potential mediators. Vaccine confidence was measured using the vaccine confidence index. Vaccine delay intention refers to the caregiver’s preference to postpone HPV vaccination for their daughter until the preferred vaccine type becomes available, rather than accepting the immediately accessible HPV vaccine. Data on these mediators were collected via a self-administered online questionnaire conducted after the intervention but before vaccination.
Among urban participants, when compared with the standard-of-care arm, about 39% of the effect of the pay-it-forward intervention on vaccine uptake was mediated by a reduction in vaccine delay intention. Notably, vaccine confidence did not appear to mediate the effect of the intervention on vaccine uptake. Among suburban participants, no mediation effects were observed. In the suburban setting, caregivers who vaccinated their daughters showed poorer prior awareness of the HPV vaccine before participating in the trial compared with those who did not vaccinate their daughters (41.5% vs 21.1%; p=0.011).
Our findings indicate that among urban participants, the pay-it-forward may have effectively reduced vaccine delay intention, which was associated with an increased uptake of the HPV vaccine. However, in suburban areas, enhanced awareness might be a potential contributing factor to improved vaccine uptake, but further research is necessary to affirm this.
Chinese Clinical Trial Registry: ChiCTR2200055542.
This study aimed to validate the mediating role of nurses' AI trust in the relationship between AI uncertainties and AI competence.
A cross-sectional study.
A purposive sample of 550 registered nurses with at least 1 year of clinical experience from three tertiary and two secondary hospitals in Jinan and Hangzhou, China, was used. Data were collected using structured questionnaires assessing AI uncertainty, trust and competence. Demographic data included gender, age, education level, years of clinical experience, professional title and hospital level. Mediation analysis.
Most nurses were from tertiary hospitals (88.9%), held a bachelor's degree (87.6%), and had over 6 years of experience. The mediating role of AI trust between AI uncertainties and AI competence is validated. AI uncertainties affected AI trust (B = 0.39, p < 0.0001), explaining 10% of the variance. AI uncertainties and AI trust affected AI competence (B = 0.25 and 0.67, p < 0.0001), explaining 63% of the variation. AI trust's total effect was 0.51, comprising direct and indirect effects of 0.25 and 0.26, respectively.
Hospitals can reduce uncertainty through an AI-transparent decision-making process, providing clinical examples of AI and training nurses to use AI, thereby increasing trust. Second, AI systems should be designed to consider nurses' psychological safety needs. Hospital administrators utilise optimised AI technology training and promotional techniques to mitigate nurses' resistance to AI and enhance their positive perceptions of AI competence through trust-building mechanisms.
Impact: Enhancing nurses' AI trust can reduce uncertainty and improve their competence in clinical use. Strategies such as transparency, explainability and training programmes are crucial for improving AI implementation in healthcare.
This study focused solely on clinical nurses and did not include patients or the public.
The study adhered to STROBE guidelines.
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.
by Min Wang, Yushun Yan, Wanqiu Yang, Ruini He, Lingdan Zhao, Yikai Dou, Yuanmei Tao, Xiao Yang, Qingqing Xiang, Xiaohong Ma
Psychiatric nurses represent a high-stress occupational group that experiences elevated levels of suicidal ideation (SI), emphasizing the need for focused mental health interventions. The main purpose of this study was to examine the prevalence of SI among psychiatric nurses and to identify the psychological and occupational factors associated with SI. A total of 1,835 psychiatric nurses completed questionnaires on depressive symptoms (PHQ-9), SI, quality of work-related life (QWL), and burnout. Multivariate logistic regression and phenotypic network analyses were conducted to identify factors associated with SI and the potential pathways linking depressive symptoms, burnout, and QWL to SI. The results indicated that 11.33% of the participants had SI in the past two weeks. Multivariate logistic regression revealed that emotional exhaustion, depersonalization, personal accomplishment, stress at work, general well-being, and the home-work interface were significant predictors of SI. Network analysis further revealed that psychomotor changes, guilt, sad mood, low energy, and appetite changes were the symptoms most directly associated with SI. In addition, sad mood, general well-being, and work-home interface were linked to job and career satisfaction, whereas sad mood and low energy were associated with emotional exhaustion and SI. These findings contribute valuable large-scale evidence on the mental health challenges faced by psychiatric nurses and highlight the importance of addressing mood disturbances, energy loss, and work-related stress in SI prevention efforts for this vulnerable group.by Mengzhen Qin, Mengyuan Qiao, Yuying Dong, Haiyan Wang
ObjectiveCompared with those without such impairment, middle-aged and older adults with sensory impairment (SI) demonstrate a greater prevalence and severity of depressive symptoms, significantly affecting their mental health. We aimed to develop and validate a depression risk prediction model for middle-aged and elderly individuals with SI.
MethodsData from the 2018 China Health and Retirement Longitudinal Study were randomly partitioned into training and validation sets at a 7:3 ratio. Within the training set, least absolute shrinkage and selection operator (LASSO) regression analysis and binary logistic regression were used to identify predictor variables, and a risk prediction column‒line graph was subsequently developed, with depression status among middle-aged and elderly individuals with SI as the dependent variable. Predictive performance of the training and validation sets was assessed via receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis.
ResultsIn total, 5308 middle-aged and older adults with SI were included, with 50.1% (n = 2657) developing depression. Multifactorial logistic regression analysis identified several depression predictors, including sex, education level, place of residence, marital status, self-rated health, life satisfaction, pension insurance status, nighttime sleep duration, functional impairment status, and pain (all P CI = 0.783–0.811) and 0.778 (95% CI = 0.755–0.800), respectively. The Hosmer–Lemeshow values were P = 0.176 and P = 0.606 (P > 0.05), and the calibration curves revealed significant agreement between the model and actual observations. ROC and DCA curves indicated good predictive performance for the column‒line graph.
ConclusionThis study presents a reliable, validated, and acceptable predictive model for depression risk in middle-aged and elderly individuals with SI, and the identified predictors have potential applications in public health policy and clinical practice.
by Ruilan Lin, Ru Qin, Yunlong Zhang, Yao Guan, Boheng Wu, Shangyang Li, Shenhong Qu, Yulin Yuan
BackgroundThis study aims to assess the diagnostic value of the Epstein-Barr virus (EBV) BNLF2b antibody(P85-Ab), alone or in combination with VCA-IgA, Rta-IgG, and Zta-IgA antibodies, in the context of nasopharyngeal carcinoma (NPC).
MethodsThe study included 100 NPC patients and 100 healthy controls. Chemiluminescent microparticle immunoassay was utilized to measure P85-Ab levels in the serum samples of both NPC patients and healthy controls. Additionally, the ELISA method was employed to detect serum levels of VCA-IgA, Rta-IgG, and Zta-IgA antibodies. The study analyzed the roles of serum P85-Ab in conjunction with VCA-IgA, Rta-IgG, and Zta-IgA antibodies in the diagnosis of NPC.
ResultsSerum levels of P85-Ab, VCA-IgA, Rta-IgG, and Zta-IgA antibodies in NPC patients were significantly higher than those in the normal control group (P Conclusion
The combined detection of P85-Ab with VCA-IgA, Rta-IgG, and Zta-IgA antibodies demonstrates high diagnostic value for nasopharyngeal carcinoma. Serum P85-Ab may serve as a potential marker for the diagnosis of NPC.
Preventing skin tears (STs) in older adults is an urgent public health concern, especially in long-term care (LTC) facilities. However, limited research on ST prevention among care workers exists due to a lack of suitable assessment tools. This study aims to develop and psychometrically evaluate the Knowledge, Attitude and Practice instrument for care workers in preventing Skin Tears (KAP-ST) in older adults.
The KAP-ST was developed and validated in four phases during May–October 2024. First, an item pool was generated through a comprehensive literature review. Second, a preliminary instrument was developed through a Delphi expert consultation and pilot testing. Third, the items and the final instrument were optimised through a cross-sectional survey involving 317 care workers from 29 LTC facilities in China. Finally, a psychometric evaluation was conducted in another cross-sectional survey involving 373 care workers from 18 LTC facilities.
The final KAP-ST contains 35 items across knowledge, attitude and practice dimensions. Exploratory factor analysis (EFA) revealed a nine-factor structure (factor loadings ranging from 0.451 to 0.799, accounting for 61.35% of total variance). The Item-Level Content Validity Index (I-CVI) values ranged from 0.926 to 1.000, and the Scale-Level Content Validity Index (S-CVI/Ave) was 0.991. The instrument's Cronbach's α, split-half, and test–retest reliability coefficients were 0.887, 0.744, and 0.934, respectively. The CFA analysis revealed an ideal absolute fit validity (RMSEA = 0.068; RMR = 0.029) and parsimony fit validity (PGFI = 0.684).
The KAP-ST demonstrates strong reliability, structural validity and content validity. It is well-suited for assessing care workers' knowledge, attitudes and practices in preventing STs among older adults. Further research is required to enhance and confirm its validity.
STs in the spotlight recently necessitate the use of appropriate investigative tools to facilitate in-depth research, especially for care workers, who should prioritise access to specialised knowledge. Introducing professional guidance in LTC facilities is recommended to enhance the knowledge, attitude and practice of care workers.
Standardised Guidelines for Scale Construction and COSMIN checklist.
No patient or public contributions.
In the era of ‘Undetectable = Untransmittable’ (U=U), reductions in condom use and increases in casual partnerships may contribute to elevated risks of coinfection with other sexually transmitted infections (STIs) and HIV super-infections among men living with HIV. These trends may reflect a shift in personal attitudes towards sexual behaviour and HIV risk, yet their influence on actual behaviours remains unclear.
To investigate how changes in personal attitudes and safe sex self-efficacy influence sexual decision-making.
Two-wave longitudinal study design.
We conducted a 3-month longitudinal study from March to December 2023 among HIV-positive men (≥ 18 years) initiating ART in Changsha, China. Cross-lagged panel analysis and half-longitudinal mediation analysis were used to examine how changes in personal attitudes influenced sexual behaviours.
427 men living with HIV were included at baseline, and 301 completed the follow-up survey. Sexual behaviours were associated with personal attitudes, namely safe sex fatigue, viral load/transmission beliefs, and sexual sensation seeking. More positive personal attitudes in these domains at baseline predicted lower safe sex self-efficacy over 3 months, while reduced baseline self-efficacy increased the likelihood of engaging in condomless sex and/or multiple sexual partners. All three personal attitude domains had significant indirect effects on sexual behaviours via safe sex self-efficacy.
In the era of U=U, the changed personal attitudes among men living with HIV may lead to the increased likelihood of engaging in condomless sex and/or having multiple sexual partners, and safe sex self-efficacy serves as a mediator in this relationship.
This study highlights the potential influence of attitudinal changes on sexual behaviours among men living with HIV in the ‘U=U’ era. Findings provide valuable evidence for developing more targeted interventions that address not only behavioural outcomes but also underlying personal attitudes.
No patient or public contribution.
Intracranial atherosclerosis is the main cause of stroke globally, with acute large vessel occlusive (LVO) stroke being a predominant contributor to stroke-related mortality. In recent years, aspiration thrombectomy (AT) has emerged as a novel therapeutic method for treating acute LVO stroke. The purpose of this study aims to investigate the safety and efficacy of AT alone or combined with stent retriever thrombectomy (SRT) in the treatment of acute LVO stroke
This is a multicentre and observational real-world study involving patients diagnosed with acute LVO stroke. Participants will be treated with AT alone or combined with SRT. According to the actual annual number of embolectomy in the sub-centre and the research years, the sample size of this study is estimated to be 400 patients, of which 300 patients of anterior circulation lesions and 100 patients of posterior circulation lesions are planned to be recruited, being considered that the incidence of posterior circulation is about 20–25%. Clinical data, including baseline characteristics, intraoperative details, postoperative outcomes and follow-up results, will be systematically collected using an Electronic Data Capture system over a follow-up period of 3 months. The primary efficacy endpoint is the rate of excellent functional outcome (modified Rankin Scale score range 0–3) after 90 days, and the successful recanalisation confirmed by digital subtraction angiography. The primary safety outcome is symptomatic intracranial haemorrhage within 48 hours (National Institutes of Health Stroke Scale score increase ≥4). This study will provide us with powerful guidance for the treatment of acute LVO stroke with different aetiologies.
This study protocol was approved by the Ethics Committee on Human Experimentation at Shandong Provincial Hospital Affiliated to Shandong First Medical University (approval number: SWYX:2022–1025). All the participating sites have received the ethics approval. The outcomes will be disseminated through national and international presentations and peer-reviewed publications.
ChiCTR2200065172.
by Miao Yu, Li Ma, Qingbian Ma
IntroductionTriage is an essential strategy to mitigate crowding and guarantee patients’ safety in emergency departments. To improve the quality of triage in emergency departments, Nurses should be equipped with the necessary competencies. Therefore, this review aims to synthesize available evidence on the competency elements required for triage nurses in emergency departments and to identify factors that influence their competency development.
Methods and analysisThis scoping review will be implemented following the five steps outlined by Arksey and O’Malley. We will use the PCC (population, concept, context) frameworks-Triage nurse (Population), Nursing competency (Concept), and EDs (Context)- to determine the research questions, and formulate the search terms. We will search six electronic databases including PubMed, Embase, CINAHL Plus, Web of Science, and two Chinese databases (China National Knowledge Infrastructure and Wangfang Data). Internet resources including WorldCat, and Google Books will be also searched to ensure comprehensive coverage. Studies will be selected by two independent authors based on defined eligibly criteria, and completed in August 2025. This will be followed by data extraction, and summarizing in October 2025. Then, evidence will be synthesized using descriptive statistics and thematic analysis. Five-domain Consolidated Framework for Implementation Research will be used to guide our thematic analysis of barriers and facilitators to development of competency. The results will be presented in December 2025. Findings from this scoping review will be beneficial to develop the training programs to facilitate the successful transition of nurses into effective triage nurse roles in the future.
RegistrationThe scoping review was registered in Open Science (https://osf.io/6fcr4).
Chronic heart failure (CHF) is a progressive life-limiting condition that necessitates early implementation of advance care planning (ACP). However, patients and caregivers encounter emotional, informational, and cultural barriers to effective ACP engagement. This meta-synthesis consolidates qualitative evidence to deepen our understanding of ACP practices in CHF care.
This study aimed to explore experiences of CHF patients and their caregivers in ACP, which is defined as a proactive decision-making process to establish future treatment plans based on patients' values. The study also aimed to identify barriers and facilitators influencing ACP decisions and assess the impact of flexible, personalized ACP approaches on care quality.
Using qualitative meta-synthesis, we analyzed 10 qualitative studies on CHF patients' and caregivers' ACP experiences. Data were thematically synthesized to identify emotional, relational, and practical factors that influence engagement in ACP.
Three themes emerged: (1) heart failure patients and caregivers face difficulties in ACP (difficulties from patients, difficulties from the family, and difficulties from the society), (2) multidimensional drivers and impacts of ACP (advance care planning drivers, acceptance and implementation of ACP, emotions and effects of ACP), (3) flexible, personalized ACP delivers tangible benefits (timing and effectiveness of ACP discussions, patients and caregivers have personalized needs for ACP, and patients and caregivers affirm ACP benefits).
ACP plays a critical role in improving end-of-life care quality and reducing emotional and decision-making burdens on caregivers. Flexible and personalized ACP strategies supported by trained healthcare professionals more effectively meet the unique needs of patients and families. To overcome persistent barriers and promote broader ACP adoption, healthcare systems should prioritize provider communication training, ACP education, and support systems tailored to diverse cultural contexts.
The health communication ability of nurses significantly impacts patients' health positively. A strong knowledge base is essential for nurses to deliver high-quality health communication.
This study aims to explore the mechanisms linking nurse health knowledge acquisition and health communication ability.
A cross-sectional study.
This cross-sectional study utilised convenience sampling of 667 nurses from nine county-level hospitals. Questionnaires were used to assess health knowledge acquisition, health literacy, health education competence and health literacy communication ability in nurses. Structural equation modelling was employed to investigate the mechanisms linking nurse health knowledge acquisition and health literacy communication ability.
The correlation analysis revealed significant positive relationships among nurses' health knowledge acquisition, health literacy, health education competence and health communication ability. The chain-mediating model indicated that health knowledge acquisition significantly influences health communication ability, with a total effect, comprising a direct effect and an indirect effect. The indirect effects were mediated either independently by health education competence or through a combination of health literacy and health education competence.
A structural equation model was developed to provide a comprehensive framework for understanding the complex interplay among nurses' health knowledge acquisition, health literacy, health education competence and health communication ability. The model demonstrates that health knowledge acquisition has a significant overall effect and indirect effect on the improvement of health communication ability. Assisting nurses in translating health knowledge into health literacy may be a crucial step in enhancing their competence in health education.
These findings enhance our understanding of the predictive effects of health knowledge acquisition on health communication ability and offer practical implications for the promoting and intervening in the health communication ability of nurses.
STROBE statement.
No patient or public contribution.
by Ruibo Sha, Zhifeng Zhang, Xiao Cui, Qingzheng Mu
Sewer pipeline defect detection is a critical task for ensuring the normal operation of urban infrastructure. However, the sewer environment often presents challenges such as multi-scale defects, complex backgrounds, lighting changes, and diverse defect morphologies. To address these issues, this paper proposes a lightweight cross-scale feature fusion model based on YOLOv8. First, the C2f module in the backbone network is replaced with the C2f-FAM module to enhance multi-scale feature extraction capabilities. Second, the HS-BiFPN module is adopted to replace the original structure, leveraging cross-layer semantic fusion and feature re-weighting mechanisms to improve the model’s ability to distinguish complex backgrounds and diverse defect morphologies. Finally, DySample is introduced to replace traditional sampling operations, enhancing the model’s ability to capture details in complex environments. This study uses the Sewer-ML dataset to train and evaluate the model, selecting 1,158 images containing six types of typical defects (CK, PL, SG, SL, TL, ZW), and expanding the dataset to 1,952 images through data augmentation. Experimental results show that compared to the YOLOv8n model, the improved model achieves a 3.8% increase in mAP, while reducing the number of parameters by 35%, floating-point operations by 21%, and model size by 33%. By improving detection accuracy while achieving model lightweighting, the model demonstrates potential for application in pipeline defect detection.by Qinghua Wen, Xiaoyue Wang, Simin Li, Huanhuan Zhu, Fengyin Zhang, Chao Xue, Juan Li
BackgroundThe glucose disposal rate (eGDR) and a body shape index (ABSI) are predictors strongly associated with cardiovascular disease (CVD) and outcomes. However, whether they have additive effects on CVD risk is unknown. This study aimed to investigate whether combined assessment of eGDR and ABSI could improve prediction of CVD risk.
MethodsThe current study used data from NHANES from 1999 to 2018 and included 14,237 participants. Receiver operating characteristic (ROC) curve was used to evaluate the performance of each indicator in predicting CVD. Machine-learning algorithms were applied to screen variables to adjust the model. Finally, the ROC curve, net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration curve and decision curve analysis (DCA) were used to evaluate the predictive performance of the combination of eGDR and ABSI.
ResultsThe ROC curve showed that eGDR (C-statistics: 0.7255) and ABSI (0.7093) had the highest predictive performance. Among 14,237 participants, multivariate logistic regression showed that lower eGDR (≤6.448) and higher ABSI (≥0.086) significantly increased CVD risk (OR = 11.792, P Conclusion
The eGDR and ABSI have potential additive effects on predicting CVD risk, and have excellent predictive performance, which can evaluate cardiovascular risk more comprehensively.
This study aims to explore the trajectories and co-occurrence of perceived control and caregiver self-efficacy among patients with heart failure (HF) and their caregivers within 3 months post-discharge and identify associated risk factors.
A prospective cohort design.
A prospective cohort study was conducted from March to June 2024 in Tianjin, China. Information on perceived control and caregiver self-efficacy was collected 24 h before discharge, 2 weeks, 1 month, and 3 months after discharge. Group-Based Dual Trajectory Modelling (GBDTM) and logistic regression were used for analysis.
The study included 203 dyads of patients with HF and their caregivers (HF dyads). Perceived control identified three trajectories: low curve (15.3%), middle curve (57.1%) and high curve (27.6%). Caregiver self-efficacy demonstrated three trajectories: low curve (17.2%), middle curve (56.7%) and high stable (26.1%). GBDTM revealed nine co-occurrence patterns, with the highest proportion (36.7%) being ‘middle-curve group for perceived control and middle-curve group for caregiver self-efficacy’, and 16.7% being ‘high-curve group for perceived control and high-stable group for caregiver self-efficacy’. Age, gender, household income, NYHA class, symptom burden and psychological resilience were identified as risk factors for perceived control trajectories; marital status, regular exercise and psychological resilience were identified as risk factors for caregiver self-efficacy trajectories.
We identified distinct trajectories, co-occurrence patterns and risk factors of perceived control and caregiver self-efficacy among HF dyads. These findings help clinical nurses to better design and implement interventions, strengthening the comprehensive management and care outcomes for HF dyads.
These findings highlighted the interactive relationship between perceived control and caregiver self-efficacy trajectories, suggesting that interventions should boost both to improve personalised treatment plans and outcomes for HF dyads.
This study adhered to the STROBE checklist.
Patients and their caregivers contributed by participating in the study and completing the questionnaire.
Palmoplantar pustulosis (PPP) is a rare, debilitating inflammatory skin disease involving painful pustules on the palms and soles. Janus kinase (JAK) inhibitors target pathways relevant to PPP disease biology but also confer a risk of major adverse cardiovascular events and malignancy in certain ‘at risk’ individuals; this includes those with PPP given prevalent smoking and cardiovascular risk factors in the PPP population. The feasibility of JAK inhibitor therapy for PPP requires assessment prior to a randomised controlled trial evaluation of drug efficacy and safety for this indication.
The ‘Janus kinase inhibitors in palmoplantar pustulosis: a mixed-methods feasibility’ trial is an open-label, single-centre, single-arm, mixed-methods feasibility trial of JAK inhibition in PPP (REC reference: 24/NE/0147; ISRCTN61751241). Participants (n=20) will receive 8 weeks of treatment with the JAK inhibitor upadacitinib (‘Rinvoq’, 30 mg, once daily). Qualitative semistructured interviews (up to n=40) will be undertaken with trial participants, trial decliners and healthcare professionals. The primary outcome will be a composite assessment of feasibility across three domains: recruitment, adherence and acceptability, using a mixed-methods analysis approach. Secondary objectives include the identification of trial recruitment optimisation strategies, using the ‘Quintet Recruitment Intervention’, and the generation of an indication of effect size on disease severity (measured using the Palmoplantar Pustulosis Psoriasis Area and Severity Index) to inform future sample size calculations. Historic placebo control data from the Anakinra for Pustular Psoriasis: Response in a Controlled Trial (National Institute of Health and Social Care reference: 13/50/17; Research Ethics Commitee reference: 16/LO/0436) will be used as the effect size comparator. Study recruitment will be undertaken over a 24-month period, commencing in November 2024.
This study has been approved by the Newcastle North Tyneside 2 Research Ethics Committee, 24/NE/0132. Our findings will inform the feasibility of a future adequately powered RCT evaluating the efficacy of JAK inhibitor therapy in PPP.
To explore the network characteristics of symptom clusters in people with type 2 diabetes mellitus through network analysis, identify the core and bridging symptoms within the symptom network, and provide a foundation for targeted interventions and symptom management in people with T2DM.
A cross-sectional survey.
A total of 360 people with T2DM who were hospitalised in the endocrinology departments of two hospitals with Grade A in Daqing City between August 2024 and February 2025 were selected using a convenience sampling method. The symptoms of people with T2DM were measured using the Chinese version of the Diabetes Symptom Checklist-Revised (DSC-R). Symptom clusters were identified through factor analysis, and network analysis was used to identify core and bridging symptoms. This research adhered to the STROBE guidelines.
Six symptom clusters were obtained from factor analysis, which were psychological-behavioural symptom cluster, ophthalmological-neuropathy symptom cluster, cardiovascular symptom cluster, metabolic symptom cluster, body symptom cluster and nephrotic symptom cluster. Symptom network analysis revealed that ‘Deteriorating vision’ exhibited the highest strength centrality and expected influence. The top three symptoms with the highest bridge strength and bridge expected influence were ‘Aching calves when walking’, ‘Queer feeling in the legs or feet’ and ‘Sleepiness or drowsiness’.
People with T2DM commonly exhibit a range of symptoms. ‘Deteriorating vision’ is the most core symptom in people with T2DM. ‘Aching calves when walking’, ‘Queer feeling in the legs or feet’ and ‘Sleepiness or drowsiness’ are identified as the bridging symptoms in the network analysis. Healthcare professionals can design targeted interventions based on symptom clusters, core symptoms and bridging symptoms, thereby improving the efficiency of symptom management and optimising outcomes for people with T2DM.
No patient or public contribution.
FreshRSS 