Frontiers in Medicine最新文献

{"title":"Sijunzi decoction granules for the treatment of advanced refractory colorectal cancer: study protocol for a multicenter, randomized, double-blind, placebo-controlled trial.","authors":"Shuchang Nie, Yingyu Su, Lu Lu, Yanhua Jing, Zenghua Jiang, Yangxian Xu, Tingting Wu, Yi Zhong, Hao Wu, Junming Chen, Ming Ruan, Lan Zheng, Liyu Wang, Yabin Gong, Guang Ji, Hanchen Xu","doi":"10.3389/fmed.2025.1523913","DOIUrl":"10.3389/fmed.2025.1523913","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) ranks among the most common gastrointestinal cancers globally, with both its incidence and mortality rates showing an upward trend. In particular, the 5-year survival rate for stage IV CRC patients is only 14%. Conventional treatments such as chemotherapy and immunotherapy can lead to drug resistance, exacerbate gastrointestinal function damage, and induce immunosuppression. Sijunzi decoction (SJZD), as a fundamental formula of Traditional Chinese medicine (TCM), has been demonstrated to confer distinct advantages in treatment of CRC. Therefore, we designed this trial to explore the efficacy of SJZD for the treatment of advanced refractory CRC.</p><p><strong>Methods: </strong>A multicenter, randomized, double-blind, placebo-controlled trial is being conducted to assess the effectiveness of SJZD combined with standard therapy for treating advanced refractory CRC. Patients with advanced CRC will be recruited and randomly allocated to either the SJZD treatment group or the placebo group in a 1:1 ratio. Both groups will receive standard treatment. The intervention period will last for 6 months, with follow-up assessments every 8 to 10 weeks. Progression-free survival (PFS) is the main outcome measure. And the secondary outcomes contain duration of disease control (DDC), overall survival (OS), completion rate of chemotherapy, incidence of treatment-related adverse events, quality of survival scale score for tumor patients and changes in spleen deficiency patient-reported outcome (PRO) scores following the intervention.</p><p><strong>Expected outcomes: </strong>To the best of our knowledge, this trial marks the first clinical investigation into the therapeutic potential of SJZD for managing advanced refractory CRC. The primary aim of this study is to provide robust clinical evidence to support the integration of TCM with Western medicine in the treatment of advanced refractory CRC.</p><p><strong>Trial registration: </strong>The trial was registered at Chinese Clinical Trial Registry, http://www.chictr.org.cn (Registration No: ChiCTR2200065434); Date: 2022-11-04.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1523913"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between interleukin gene polymorphisms and the risk of pneumoconiosis: a systematic review and meta-analysis.","authors":"Lu Liu, Xiaowei Tian, Yilin Guo, Yanyan Yu, Yamei Wang, Wenjing Wang, Jun Meng, Guifang Li, Xiaojuan Sun","doi":"10.3389/fmed.2025.1479730","DOIUrl":"10.3389/fmed.2025.1479730","url":null,"abstract":"<p><p>Numerous studies have demonstrated that interleukin (IL) plays an essential role in the development of chronic inflammatory diseases, especially in pneumoconiosis. The association between various IL gene polymorphisms and pneumoconiosis susceptibility has been investigated extensively, but the results remain controversial. A literature search was conducted using PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang database to obtain relevant studies before 22 January 2025. Subsequently, odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the strength of correlations. A sensitivity analysis was performed to evaluate the robustness and reliability of the included studies. Overall, there was a significant association between IL-1RA +2018 and IL-6 -634 with the risk of pneumoconiosis. The IL-1RA +2018 variant was positively associated with an increased risk of pneumoconiosis among both Asians and Caucasians. In contrast, the IL-6 -634 genotype was associated with a lower risk of pneumoconiosis among Asians. Additionally, the IL-1RA +2018 genotype was significantly linked to a predisposition to coal workers' pneumoconiosis (CWP) and silicosis. The IL-6 -634 mutant significantly decreased silicosis and CWP risk. Additional large-scale replication studies are needed to elucidate the precise role of various IL SNPs in the etiology of pneumoconiosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1479730"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of obstructive sleep apnea on inpatient outcomes of COVID-19: a propensity-score matching analysis of the US Nationwide Inpatient Sample 2020.","authors":"Wei Du, Hong Xu, Yunqi Chang, Biying Feng, Qiong Wang, Weifeng Li","doi":"10.3389/fmed.2025.1472176","DOIUrl":"10.3389/fmed.2025.1472176","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is associated with health complications, but its impact on COVID-19 outcomes is not known. This study investigated the association between OSA and outcomes of hospitalized COVID-19 patients.</p><p><strong>Methods: </strong>The Nationwide Inpatient Sample 2020 was searched for adults hospitalized for COVID-19. The outcomes of interest were in-hospital mortality, non-routine discharge, prolonged length of stay (LOS), and complications. Patients with OSA were matched to those without OSA in a 1:4 ratio using propensity score matching (PSM) according to age, sex, and major comorbidities.</p><p><strong>Results: </strong>After PSM, there were 54,900 adult COVID-19 patients consisting of 10,980 with OSA and 43,920 without OSA. The mean age was 63.2 years and 62.8% were male. Patients with OSA had higher odds of respiratory failure (adjusted OR [aOR] = 1.20, 95% confidence interval [CI]: 1.14-1.25), heart failure (aOR = 1.71, 95% CI: 1.60-1.82), and arrhythmias (aOR = 1.18, 95% CI: 1.08-1.30). Conversely, OSA was associated with lower odds of cerebrovascular accidents (CVAs) (aOR = 0.71, 95% CI: 0.62-0.81, <i>p</i> < 0.001), and a reduced likelihood of in-hospital mortality among patients ≥70 years old (aOR = 0.82, 95% CI: 0.75-0.89, <i>p</i> < 0.001) and males (aOR = 0.79, 95% CI: 0.72-0.88, <i>p</i> < 0.001), but not females.</p><p><strong>Conclusion: </strong>OSA is associated with higher risks of respiratory failure, heart failure, and arrhythmias in patients hospitalized for COVID-19. However, patients with OSA who are ≥70 years old and those who are male are less likely to have CVAs and in-hospital mortality. These findings underscore the complex relationship between OSA and COVID-19. As the study focused on hospitalized patients, the findings may not apply to mild or asymptomatic COVID-19 cases. Future research should include community-based cohorts and prospective studies to better understand this association.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1472176"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of brain death and consecutive donor management under combined circulatory support with ECMELLA therapy.","authors":"Florian J Raimann, Laurent M Willems","doi":"10.3389/fmed.2025.1569951","DOIUrl":"10.3389/fmed.2025.1569951","url":null,"abstract":"<p><strong>Background: </strong>Managing brain death determination (BDD) in potential organ donors is a challenging aspect of modern intensive care medicine. In critically ill patients with implanted circulatory or left ventricular support devices, standard recommendations for BDD are often no longer applicable.</p><p><strong>Methods/results: </strong>The available recommendations and evidence for BDD and organ procuring under ECMELLA therapy-a combined circulatory support using a veno-arterial extracorporeal membrane oxygenation (vaECMO) and an invasive left ventricular support device (Impella^® CP)-are discussed based on a clinical case. To the authors' knowledge, this is the first report of BDD under ECMELLA therapy.</p><p><strong>Conclusion: </strong>Although BDD in patients with multimodal invasive circulatory support, such as ECMELLA therapy, is demanding and time-intensive, it can still be performed safely and based on evidence. Given the continuing low numbers of organ donors, these insights may help to facilitate organ donation in patients with combined invasive mechanical circulatory support.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1569951"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted therapy for idiopathic pulmonary fibrosis: a bibliometric analysis of 2004-2024.","authors":"Xinlei Zhang, Zengze Yuan, Xiawei Shi, Junchao Yang","doi":"10.3389/fmed.2025.1543571","DOIUrl":"10.3389/fmed.2025.1543571","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a progressive and irreversible interstitial lung disease characterized by high mortality rates. An expanding body of evidence highlights the critical role of targeted therapies in the management of IPF. Nevertheless, there is a paucity of bibliometric studies that have comprehensively assessed this domain. This study seeks to examine global literature production and research trends related to targeted therapies for IPF.</p><p><strong>Method: </strong>A literature search was conducted using the Web of Science Core Collection, encompassing publications from 2004 to 2024, focusing on targeted therapies for IPF. The bibliometric analysis utilized tools such as VOSviewer, CiteSpace, and the \"bibliometrix\" package in R.</p><p><strong>Results: </strong>A total of 2,779 papers were included in the analysis, demonstrating a general trend of continuous growth in the number of publications over time. The United States contributed the highest number of publications, totaling 1,052, while France achieved the highest average citation rate at 75.74. The University of Michigan Medical School was the leading institution in terms of publication output, with 88 papers. Principal Investigator Naftali Kaminski was identified as the most prolific researcher in the field. The American Journal of Respiratory Cell and Molecular Biology emerged as the journal with the highest number of publications, featuring 98 articles. In recent years, the research has emerged surrounding targeted therapies for IPF, particularly focusing on agents such as TGF-β, pathogenesis, and autotaxin inhibitor.</p><p><strong>Conclusion: </strong>In this bibliometric study, we systematically analyze research trends related to targeted therapies for IPF, elucidating recent research frontiers and emerging directions. The selected keywords-idiopathic pulmonary fibrosis, targeted therapy, bibliometric analysis, transforming growth factor β, and autotaxin inhibitor-capture the essential aspects of this research domain. This analysis serves as a reference point for future investigations into targeted therapies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1543571"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of clinical characteristics of elderly patients with blood culture-positive bacterial liver abscess.","authors":"Hui-Fang Zhang, Jia-Wen Chen, Shan-Shan Li, Shi-Wen Wu, Shu Li, Chen-Yi Liu, Chao Cai, Ming-Qin Lu","doi":"10.3389/fmed.2025.1555056","DOIUrl":"10.3389/fmed.2025.1555056","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical features of elderly patients with blood culture-positive bacterial liver abscess (BLA) and improve diagnostic and treatment strategies.</p><p><strong>Methods: </strong>Elderly BLA patients admitted to our hospital from December 2018 to December 2023 were included in the study. Diagnostic tests included routine blood analysis, biochemistry, C-reactive protein (CRP), procalcitonin (PCT), imaging, and cultures of blood or pus. Treatments involved anti-infective therapy, ultrasound-guided abscess drainage, and supportive care.</p><p><strong>Results: </strong>(1) Elderly patients with blood culture-positive BLA had higher rates of prolonged hospital stays (≥2 weeks), ICU admission, biliary system diseases, hepatitis B infection, maximum body temperature ≥ 39°C, and qSOFA scores ≥2 compared to controls (<i>p</i> < 0.05)0. (2) Laboratory findings showed higher levels of total bilirubin (≥34.2 μmol/L), ALT (≥50 U/L), serum creatinine (≥80 μmol/L), PCT (≥5 ng/mL), and lower platelet counts (≤100 × 10⁹/L) in the research group (<i>p</i> < 0.05). ESBL-positive cases and liver abscesses ≤5 cm were more common in the research group (<i>p</i> < 0.05). (3) Complications such as pleural effusion, ascites, pulmonary infections, and extrahepatic abscesses were significantly more frequent in the blood culture-positive group (<i>p</i> < 0.05). (4) Microbiological analysis indicated that <i>Klebsiella pneumoniae</i> was the leading pathogen (87.93%), followed by <i>Escherichia coli</i>. For ESBL-positive infections, <i>E. coli</i> was dominant (75.76%), especially in patients with biliary diseases (75.56%). (5) Logistic regression identified prolonged hospital stay, hepatitis B infection, biliary system diseases, temperature ≥ 39°C, PCT ≥5, and abscess size ≤5 cm as independent risk factors for blood culture-positive BLA. (6) The combined diagnostic indicator showed good predictive ability (AUC = 0.840, sensitivity 76.6%, specificity 72.2%).</p><p><strong>Conclusion: </strong>Elderly patients with biliary diseases, hepatitis B, high PCT levels (≥5 ng/mL), small abscesses (≤5 cm), and fever (≥39°C) are at higher risk for blood culture-positive BLA. <i>Klebsiella pneumoniae</i> remains the predominant pathogen (87.93%), highlighting the need for prompt empirical antibiotic therapy. The combined diagnostic model offers reliable predictive value for this condition. We developed a predictive model aimed at assisting clinicians in identifying high-risk patients prone to bloodstream infections secondary to BLA. This model provides valuable guidance for clinicians in formulating more rational and individualized treatment strategies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1555056"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putting the substance in substantial evidence: an evidence-based approach to flexible drug regulation.","authors":"Emanuel Krebs, Tania Bubela, Melanie McPhail, Christopher McCabe, Dean A Regier","doi":"10.3389/fmed.2025.1337890","DOIUrl":"10.3389/fmed.2025.1337890","url":null,"abstract":"<p><p>For new drugs or indications, substantial evidence of clinical effectiveness is required for market authorization. In most jurisdictions, substantial evidence is not explicitly defined. Health regulators exercise discretion and are increasingly tolerant of earlier or less mature evidence. To align with flexible evidentiary standards, we argue for the adoption of a principle and, context-based approach to the evidence threshold. Our approach aims to balance the potential benefits and harms of accelerated authorization, low therapeutic value, and safety, based on a value of information (VoI) framework. In our VoI framework, substantial evidence exists when the expected net health value of further research is less than or equal to zero. We operationalize this approach through two case examples that mirror real-time decision factors such as uncertainty, risk preferences and time inputs. As the evidentiary assessment landscape shifts towards flexibility, iterative and clearly defined approaches to risk assessment are warranted. Clarity will stimulate transparency and accountability for both stakeholders and regulators.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1337890"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction of kidney function in long-term kidney transplant recipients.","authors":"Krzysztof Batko, Anna Sączek, Małgorzata Banaszkiewicz, Jolanta Małyszko, Ewa Koc-Żórawska, Marcin Żórawski, Karolina Niezabitowska, Katarzyna Siek, Alina Bętkowska-Prokop, Andrzej Kraśniak, Marcin Krzanowski, Katarzyna Krzanowska","doi":"10.3389/fmed.2025.1469363","DOIUrl":"10.3389/fmed.2025.1469363","url":null,"abstract":"<p><strong>Background: </strong>Limited tools exist for predicting kidney function in long-term kidney transplant recipients (KTRs). Elabela (ELA), apelin (APLN), and the APJ receptor constitute an axis that regulates vascular and cardiac physiology in opposition to the renin-angiotensin-aldosterone system.</p><p><strong>Methods: </strong>Longitudinal, observational cohort of 102 KTRs who maintained graft function for at least 24 months, with no acute rejection history or active infection upon presentation. Serum APLN, ELA, fibroblast growth factor 23 (FGF-23) and α Klotho were tested using enzyme-linked immunoassay and compared with a control group of 32 healthy controls (HCs).</p><p><strong>Results: </strong>When comparing with HCs, higher serum FGF-23, ELA and APLN, but lower ɑ Klotho concentrations were observed in long-term KTRs. Most KTRs had stable trajectories of renal function. Mean estimated glomerular filtration (eGFR) over 2-year follow-up was associated with significantly lower odds of graft loss (OR 0.04, 95% CI 0.01-0.15; <i>p</i> < 0.001). Baseline renal function was significantly correlated with mineral-bone markers (log[FGF-23]: <i>r</i> = -0.24, <i>p</i> = 0.02; log[α-Klotho]: <i>r</i> = 0.34, <i>p</i> < 0.001) but showed no significant association with aplnergic peptides (APLN: <i>r</i> = -0.07, <i>p</i> = 0.51; ELA: <i>r</i> = 0.17, <i>p</i> = 0.10). Univariable random forest regression indicated that baseline eGFR alone explained 87% of the variance in future 2-year eGFR, suggesting its overarching importance in late-term predictions. Incorporating both simple clinical characteristics and candidate serum biomarkers into a model predicting last available eGFR allowed for moderate predictive performance. In univariable Cox Proportion Hazard models, lower log(α-Klotho) (HR 0.26, 95% CI 0.12-0.58; <i>p</i> = 0.001) and higher log(FGF-23) (HR 2.14, 95% CI 1.49-3.09; <i>p</i> < 0.001) were significant predictors of death-censored allograft loss.</p><p><strong>Conclusion: </strong>Both aplnergic and mineral-bone peptides appear as relevant candidate markers for future studies investigating their predictive performance regarding renal allograft outcomes.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1469363"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interpretation of code status concept among pediatric health care workers, a multicenter cross sectional study across Lebanon.","authors":"Raymonda Chahrour, Amani Bannout, Marianne Majdalani, Rana Yamout, Ali Ismail, Elma Abou Raffoul, Jihane Moukhaiber","doi":"10.3389/fmed.2025.1532724","DOIUrl":"10.3389/fmed.2025.1532724","url":null,"abstract":"<p><strong>Background: </strong>Cardiopulmonary resuscitation (CPR) use with no considerations given to patient selection or therapeutic aim resulted in extension of the agony, pain and dying process for terminally ill patients. Four Resuscitation-limiting Codes other than Full Code exist. In a conservative country like Lebanon, several factors can influence such decisions, namely the ethical, legal, religious perspectives, pediatric population, and more importantly the lack of protocol, healthcare workers (HCWs) knowledge, understanding and readiness to discuss terminal care with the parents. The objectives of the study are to evaluate the knowledge, behavior and comfort level of Lebanese pediatric HCWs in code status discussions, and to determine major obstacles encountered.</p><p><strong>Methods: </strong>This is a cross-sectional observational study. An anonymous questionnaire has been sent electronically for 400 pediatric HCWs from different hospitals across Lebanon, over a period of 3 months.</p><p><strong>Results: </strong>Of the 400 pediatric HCWs recruited, 235 completed the survey. 39.9% of medical doctors (MDs), and 62% of registered nurses (RNs) did not know about code status subtypes. Most of the MDs are using the paternalistic approach. There were significant differences between MDs and RNs regarding their point of view toward code status, but both thought that it was not defined in the Lebanese law (86.7% of MDs vs. 87% of RNs), and are not comfortable in such discussions (79% for MDs vs. 84.8% for RNs). The decisions taken by MDs regarding life-sustaining treatments (LSTs) in different resuscitation-limiting codes showed clearly the knowledge gap. Moreover, attendings and trainees differed significantly in their decisions, where the latter seemed more conservative. Pediatric HCWs in Lebanon are facing major obstacles when it comes to code status decisions.</p><p><strong>Conclusion: </strong>Code status in Lebanon is an immature concept, and pediatric HCWs are challenged with conflicting decisions and obligations when it comes to code status discussions and LSTs. A multidisciplinary approach, with good communication between different members of the medical team would be the best. Addressing the obstacles encountered, and set a clear protocol will not only unify and solidify the HCWs decisions, but will have positive impact and repercussions on the patient care as well.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1532724"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Association of <i>Helicobacter pylori</i> related chronic atrophic gastritis and gastric cancer risk: a literature review.","authors":"Zefeng Zhang, Sitong Chen, Shudan Li, Yadan Zheng, Lifei Mai, Xiaoguang Zhang","doi":"10.3389/fmed.2025.1586952","DOIUrl":"https://doi.org/10.3389/fmed.2025.1586952","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fmed.2025.1504749.].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1586952"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}