BMC Medicine最新文献

{"title":"Specific mode acupoint electrical stimulation combined with NGF for neurological recovery in ischemic stroke convalescence: A randomized controlled study.","authors":"Mengyuan Dai, Zhaoxing Jia, Ziqi Xuan, Junhong Liu, Xuewen Wu, Yiqing Zhang, Shuijin Zhang, Lixiu Wu, Jianxun Liu, Yibin Zhao, Huimei Zhu, Caijun Ma, Weiwei Han, Mengming Shao, Shiting Xu, Nuo Xu, Congcong Ma, Xianming Lin","doi":"10.1186/s12916-026-05073-7","DOIUrl":"10.1186/s12916-026-05073-7","url":null,"abstract":"<p><strong>Background: </strong>Nerve growth factor (NGF) has neurorestorative potential after ischemic stroke, but its efficacy may be limited by the blood-brain barrier (BBB). Preclinical studies suggested that specific mode acupoint electrical stimulation (SMES) may transiently increase BBB permeability and facilitate neurotrophic factor delivery. This study evaluated the efficacy and safety of SMES combined with NGF in ischemic stroke and explored treatment-associated functional brain changes.</p><p><strong>Methods: </strong>In this multicentre, randomized, placebo-controlled trial, adults aged 30-80 years with first-ever ischemic stroke, 14 days to 6 months after onset, modified Rankin Scale (mRS) score 3-4, and MMSE score < 27 were randomly assigned (1:1:1:1) to acupuncture + placebo, acupuncture + NGF, SMES + placebo, or SMES + NGF. NGF or placebo was administered by daily intramuscular injection for 28 days, followed by acupuncture or SMES at GV20 and GV26. The primary efficacy outcome was longitudinal change in mRS score. Secondary outcomes included the Modified Barthel Index, Fugl-Meyer Assessment, Tinetti Performance-Oriented Mobility Assessment, Montreal Cognitive Assessment, and Loewenstein Occupational Therapy Cognitive Assessment. Outcomes were assessed at baseline, week 2, and week 4, with mRS and MoCA further assessed during follow-up. Exploratory rs-fMRI and fNIRS assessments were performed at baseline and week 4.</p><p><strong>Results: </strong>Among 324 randomized participants, 296 completed treatment and follow-up. Repeated-measures ANOVA showed significant time and group-by-time effects for mRS, indicating different recovery trajectories among groups. In factorial analysis, NGF had a significant main effect on mRS improvement (P = 0.001), whereas the SMES main effect and SMES-by-NGF interaction were not significant. Cognitive outcomes showed a clearer combined-treatment pattern: the SMES + NGF group had the greatest improvements in MoCA and LOTCA at week 4, and the SMES-by-NGF interaction for MoCA was significant at week 4 (P = 0.019) and during follow-up (P < 0.001). Exploratory neuroimaging analyses suggested treatment-associated functional brain changes. Six adverse events occurred, with no serious treatment-related adverse events.</p><p><strong>Conclusions: </strong>NGF-containing interventions were associated with improved neurological disability after ischemic stroke, while SMES combined with NGF showed additional benefits for cognitive recovery. SMES combined with NGF may represent a promising adjunctive strategy for post-stroke rehabilitation.</p><p><strong>Trial registration: </strong>The protocol was registered in the Clinical Trials repository under NCT05231694.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, risk factors and tumor spectrum of second primary cancers after gastric cancer: a multicenter cohort study with long-term follow-up.","authors":"Xianchun Gao, Weili Han, Linbin Lu, Hongqing Xi, Jun Yu, Ying Liang, Lulu Zhao, Zhijun Tan, Xinrui Li, Zhongyang Zhang, Wen Fei, Rong Zheng, Dai Zhang, Shibo Wang, Chao Yue, Liang Chen, Hao Fan, Haiya Zhang, Fenglin Zhang, Junguo Hu, Linzhi Lu, Peng Nie, Qingchuan Zhao, Hong Liu, Kaichun Wu, Yingtai Chen, Gang Li, Lei Shang, Yongzhan Nie","doi":"10.1186/s12916-026-05018-0","DOIUrl":"10.1186/s12916-026-05018-0","url":null,"abstract":"<p><strong>Background: </strong>The development of second primary cancers (SPCs) has become an important late effect in gastric cancer (GC) survivors, yet its incidence, risk factors, and clinical implications remain poorly defined. This study aimed to evaluate the long-term risk of SPCs, identify clinical factors associated with SPC occurrence, and describe detection patterns and stage distribution of SPCs during long-term follow-up.</p><p><strong>Methods: </strong>Patients with GC who underwent curative-intent radical gastrectomy between 2007 and 2021 were identified from the Multidisciplinary Alliance of Gastric Integrative Studies (MAGIS) cohort. Clinical factors associated with SPC occurrence were selected using LASSO-penalized Cox regression, and exploratory risk-based stratification was performed. Stage distribution was descriptively compared between SPCs detected during asymptomatic surveillance and those diagnosed after symptom onset.</p><p><strong>Results: </strong>Among 11,027 GC survivors (8,519 men and 2,508 women), 241 (2.19%) developed SPCs during a follow-up of up to 16 years. The cumulative incidence of SPCs was 1.25% (95% CI, 1.03%-1.46%) at 5 years, 2.97% (95% CI, 2.55%-3.39%) at 10 years, and 4.15% (95% CI, 3.40%-4.91%) at 15 years after gastrectomy. The most frequent SPCs were lung (23.2%), colorectal (21.6%), and esophageal (12.9%) cancers, showing marked sex-specific differences: lung cancer predominated in males, whereas cervical cancer was most common in females. Factors associated with SPC occurrence included older age at time of gastrectomy (HR 1.04, 95% CI 1.02-1.05; p < 0.001), chronic HBV/HCV infection (HR 2.15, 95% CI 1.29-3.58; p = 0.003), family history of cancer (HR 1.57, 95% CI 1.16-2.12; p = 0.003), and elevated preoperative systemic inflammation (Log-SIRI; HR 1.86, 95% CI 1.31-2.65; p < 0.001). The derived model stratified patients into low-, intermediate-, and high-risk groups with corresponding 10-year SPC risks of 2.07%, 3.61%, and 4.33%. SPCs detected during asymptomatic surveillance were more frequently diagnosed at stage I than those identified after symptom onset (47.4% vs 17.6%; p < 0.001).</p><p><strong>Conclusions: </strong>SPCs represent an important long-term health burden among GC survivors, with distinct sex-specific disease patterns. The exploratory risk-scoring model showed preliminary risk stratification, and SPCs detected during asymptomatic surveillance were more often diagnosed at an earlier stage. These findings support further evaluation of risk-adapted, organ- and sex-specific surveillance strategies in methodologically rigorous studies.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of albendazole versus praziquantel in the treatment of Clonorchis sinensis infection: an infection intensity-stratified, open-label, phase 2, randomized controlled trial.","authors":"Men-Bao Qian, Jia-Guang Zhao, Xiao-Ping Han, Liu Liu, Chang-Hai Zhou, Ji-Lei Huang, Yu-Ying Zhu, Xiao-Qin Gan, Jun Meng, Shi-Zhu Li","doi":"10.1186/s12916-026-05071-9","DOIUrl":"10.1186/s12916-026-05071-9","url":null,"abstract":"<p><strong>Background: </strong>Praziquantel is the only drug recommended against Clonorchis sinensis, while adverse events are usually high. Albendazole is documented in treatment of clonorchiasis, but the evidence is low due to lack of high-quality randomized controlled trials.</p><p><strong>Methods: </strong>We did an exploratory randomized controlled trial in Binyang county, Guangxi, China. Eligible participants were adults aged 18-70 years with C. sinensis infection. Patients with light intensity (eggs per gram of feces (EPG): 1-999) and moderate plus heavy intensity (EPG: ≥ 1000) were randomly assigned to treatment groups respectively, with block sizes of two, four, and six, to receive praziquantel (25 mg/kg three times a day for 1 day) or albendazole (400 mg twice a day for 4 days) in a 1:1 ratio. Laboratory diagnosis technicians were blinded to group assignment. We assessed efficacy as cure rate and egg reduction rate in available-case analysis, while adverse events were also analyzed.</p><p><strong>Results: </strong>Fifty-two patients with light intensity and 50 with moderate plus heavy intensity were assigned, when three were lost to follow-up. The cure rate was 84.0% (21/25, 95% confidential intervals: 63.9%-95.5%) using praziquantel and 30.8% (8/26, 14.3%-51.8%) using albendazole in light intensity stratum (χ²=14.7, p < 0.001). It was 60.9% (14/23, 38.5%-80.3%) using praziquantel and 8.0% (2/25, 1.0%-26.0%) using albendazole in moderate plus heavy intensity stratum (χ²=15.1, p < 0.001). The corresponding egg reduction rate using geometric mean of EPG was 99.9% (99.7%-100.0%), 97.1% (94.1%-98.8%), 100.0% (99.9%-100.0%), and 98.9% (97.8%-99.5%), respectively. The overall cure rate was 72.9% (35/48, 58.2%-84.7%) in praziquantel groups and 19.6% (10/51, 9.8%-33.1%) in albendazole groups (χ²=28.3, p < 0.001), while the corresponding egg reduction rate was 99.9% (99.8%-100.0%) and 98.3% (97.1%-99.1%). The proportion of adverse events was higher in praziquantel than albendazole in light intensity stratum (46.2% vs. 15.4%), while there was no difference in moderate plus heavy intensity stratum (20% vs. 20%). The overall proportion was 33.3% in praziquantel groups and 17.6% in albendazole groups.</p><p><strong>Conclusions: </strong>Albendazole (400 mg twice a day for 4 days) demonstrates high egg reduction rate and low adverse events, but low cure rate in C. sinensis infection. Its application in preventive chemotherapy for morbidity control deserves further exploration.</p><p><strong>Trial registration: </strong>Controlled-Trials.com, ISRCTN46268871.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Device-measured movement behaviours and cancer incidence in a population sample of UK adults: Dual 24-hour analyses of postural and intensity compositions.","authors":"John J Mitchell, Raaj Kishore Biswas, Nicholas A Koemel, Matthew N Ahmadi, Joanna M Blodgett, Karen Canfell, I-Min Lee, Christine M Friedenreich, Armando Teixeira-Pinto, Peter A Cistulli, Dorothea Dumuid, Anthony D Okely, Abigail Fisher, Mark Hamer, Emmanuel Stamatakis","doi":"10.1186/s12916-026-05069-3","DOIUrl":"10.1186/s12916-026-05069-3","url":null,"abstract":"<p><strong>Background: </strong>Insufficient physical activity (PA) and excessive sedentary behaviour is associated with several cancers. Personalised approaches to increasing healthy movement behaviours over unhealthy behaviours may be more effective than a one-size-fits-all approach. Exploring both postures, and intensities across the 24-hour day may reveal actionable behavioural alternatives from current guidance.</p><p><strong>Methods: </strong>Using a novel dual-compositional approach, we assessed how differences in participant's composition of 24-hour daily movement (postures and intensities) and sleep are differentially associated with PA-related cancer incidence (a composite of 13 sites linked with physical inactivity). This prospective analysis involved adults drawn from the UK Biobank accelerometry subsample each followed-up by health linkage. Participant's daily movement was classified into two 24-hour compositions. Composition 1 (posture-focused): sleep duration, sedentary behaviour (SB), standing, moving at any intensity. Composition 2 (intensity-focused): sleep duration, sedentary time (ST), light PA (LPA), moderate PA (MPA), and vigorous PA (VPA). Secondary analysis combined VPA and MPA as moderate-to-vigorous PA (MVPA). PA-related cancer diagnoses were captured from health registry data for up to 9.5 years (y). Cox-proportional hazards models were adjusted for age, sex, education, smoking, alcohol, diet, parental cancer history, cardiovascular disease and medication use.</p><p><strong>Results: </strong>Analyses included 59,218 (55% female) participants (mean [SD] age: 61.7 [7.8]y), with a median follow-up of 8.0y [IQR: 7.4-8.5y; 464,640 person years] with 2,385 (4%) incident cancer events. Among the average, active participant, greater moving in place of other behaviours was associated with lower cancer risk, e.g. theoretically replacing 15 min of sleep or SB with 15 min of moving was associated with hazard ratios (HR) of 0.98 (95% Confidence Interval (95%CI): 0.97-0.99) and 0.98 (95%CI: 0.97-0.99), respectively. Similar risk reduction was observed with 30 min additional standing in place of sleep or SB. Regarding intensity, greater MVPA, in place of any behaviour proved most robustly associated with lower risk, although notably, the VPA component within MVPA proved the critical intensity.</p><p><strong>Conclusions: </strong>Beyond MVPA, moving at any intensity, in place of other postures, was associated with reduced risk of cancer. However, greater standing may also provide a plausible behavioural adjunct or alternative, warranting further investigation.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting sleep duration and mental distress among US high school students: National YRBS, 2011-2023.","authors":"Jing Zhao, Fanfan Xu, Wenhu Zhao, Ming Bai, Zheng Zhang, Qiguo Lian","doi":"10.1186/s12916-026-05074-6","DOIUrl":"10.1186/s12916-026-05074-6","url":null,"abstract":"<p><strong>Background: </strong>Adolescent mental distress is a prevalent global public health concern. Aligning with the goals of Healthy People 2030, this study aimed to characterize the sleep duration associated with the lowest prevalence of mental distress among US high school students.</p><p><strong>Methods: </strong>This study pooled and examined cross-sectional data from 7 waves of the national Youth Risk Behavior Survey (YRBS) in 2011-2023. All data analyses were sex-stratified. We estimated the prevalence of mental symptoms and suicidal behaviors across sleep duration, and examined both linear and quadratic associations. We also calculated adjusted odds ratios (AORs) with 95% CIs and compared the prevalence of mental distress indicators among sleep duration categories.</p><p><strong>Results: </strong>Overall, 24.39% of adolescents reported 8-9 h of sleep (female: 22.51%; male: 26.21%). Compared with 8-9 h, insufficient sleep (< 8 h) was associated with significantly higher odds of all five mental distress indicators among female students: current bad mental health (AOR, 1.93; 95% CI, 1.61-2.30), feeling sad/hopeless (AOR, 1.59; 95% CI, 1.40-1.80), suicidal thoughts (AOR, 1.68; 95% CI, 1.49-1.91), suicide plan (AOR, 1.41; 95% CI, 1.25-1.59), and attempted suicide (AOR, 1.41; 95% CI, 1.20-1.66). Results were similar among male students. Across all five indicators in both sexes, the lowest prevalence was observed at 8-9 h; however, most comparisons at ≥ 10 h were not statistically significant.</p><p><strong>Conclusions: </strong>The lowest prevalence of mental distress across all indicators and both sexes was observed at 8-9 h of sleep; however, most ≥ 10-hour comparisons were not significant, likely reflecting the small proportion of adolescents in this category.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world serplulimab plus chemotherapy for extensive-stage small cell lung cancer in china: an external validation of ASTRUM-005 trial.","authors":"Lin Wu, Chengping Hu, Wenzhong Su, Hui Zhu, Wei Hong, Haichuan Su, Yan Yu, Tao Luo, Zhigang Liu, Zhentian Liu, Qing Pu, Caixia Wang, Xuhong Min, Hui Guo, Yifei Chen","doi":"10.1186/s12916-026-05055-9","DOIUrl":"10.1186/s12916-026-05055-9","url":null,"abstract":"<p><strong>Background: </strong>In the randomized phase 3 ASTRUM-005 trial, adding serplulimab to chemotherapy improved survival in extensive-stage small cell lung cancer (ES-SCLC), but whether these results generalize to routine practice remains uncertain. To evaluate the real-world effectiveness and safety of first-line serplulimab plus chemotherapy in China and to benchmark outcomes against the pivotal trial using a matching-adjusted indirect comparison (MAIC).</p><p><strong>Methods: </strong>This nationwide, observational study enrolled ES-SCLC patients treated with serplulimab and investigator-selected chemotherapy across 14 sites in China. For subsequent analyses, patients were grouped by alignment with the ASTRUM-005 trial regimen: an RCT-regimen cohort and a real-world regimen cohort. The primary endpoints were overall survival (OS) and real-world progression-free survival (rwPFS); secondary endpoints included objective response rate (ORR) and safety. The MAIC weighted eligible real-world patients to the aggregate baseline profile of the pivotal trial.</p><p><strong>Results: </strong>Among 635 patients, the median OS was 17.20 months (95% CI, 15.43-19.77) and the median rwPFS was 8.17 months (95% CI, 7.40-9.20). The ORR was 69.05%, with comparable efficacy observed between RCT-regimen and real-world cohorts. Poor performance status and liver metastases independently predicted higher mortality. In the MAIC, OS in the RCT-regimen cohort was comparable to the serplulimab arm of the pivotal ASTRUM-005 trial (weighted log-rank P = 0.784). Safety was manageable and consistent with known profiles.</p><p><strong>Conclusions: </strong>This large-scale real-world study confirms the efficacy of serplulimab plus chemotherapy and tolerability in diverse ES-SCLC population, supporting the external validity and generalizability of the pivotal ASTRUM-005 trial results.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov (NCT06748495).</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of timely community health services contact following hospital discharge on subsequent hospital use in England: retrospective observational study.","authors":"Beth Parkinson, Matt Sutton, Lachlan Cameron, Rachel Meacock","doi":"10.1186/s12916-026-05015-3","DOIUrl":"10.1186/s12916-026-05015-3","url":null,"abstract":"<p><strong>Background: </strong>Unplanned rehospitalisation is an undesirable outcome for patients and resource-constrained health systems. Community health services (CHS) support safe transitions home and recovery following hospital discharge, but evidence on their effectiveness in reducing rehospitalisation is limited. This study examined the impact of timely contact with CHS teams following hospital discharge on the odds of subsequent emergency hospital care.</p><p><strong>Methods: </strong>We used individual-level data from the Community Services Dataset on 63,019 individuals referred to 11 NHS Community Trust providers in England following hospital discharge between 1^st April and 31^st December 2019. Timeliness of CHS contact was defined as care being received within one day or between two and seven days post-discharge, compared to no contact within 30 days of discharge. Outcomes were emergency hospital readmission and emergency department (ED) attendance within 30 days of discharge. We used logistic regressions to estimate the association between timely CHS contact and hospital use, controlling for patient demographics, diagnosis and co-morbidities.</p><p><strong>Results: </strong>Individuals in our sample were 72.5 years of age on average with 2.3 comorbidities, and 52% were female. 52% received care within one day of discharge, 20% within two to seven days, and 28% had no contact within 30 days. Having a CHS contact within one day of hospital discharge was associated with 33% lower odds of ED attendance (OR: 0.674, 95% CI: 0.640 to 0.709) and 38% lower odds of readmission within 30 days of discharge (OR: 0.615, 95% CI: 0.583 to 0.649), compared to individuals with no contact in the follow up period. Receiving a CHS contact between two to seven days of discharge was associated with 20% lower odds of ED attendance (OR: 0.804, 95% CI: 0.756 to 0.855) and 22% lower odds of readmission (OR: 0.775, 95% CI: 0.728 to 0.825) within 30 days of discharge.</p><p><strong>Conclusions: </strong>Timely contact with CHS teams following discharge was associated with substantially lower odds of subsequent emergency hospital use. Whilst contact within two to seven days was beneficial for many patients, contact within one day of discharge was consistently associated with the largest reductions in hospital use across all patient groups.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the 'Culturally Informed Ecological Model of Grief' - a national qualitative study of bereavement experiences among ethnically diverse communities.","authors":"Catriona R Mayland, Emily Fisher, Adejoke O Oluyase, Nikel-Shaniece Hector-Jack, Toslima Khatun, Rukia Saleem, Naureen Khan, Shirin Shahid, Riffat Mahmood, Gurpreet Grewal-Santini, Monika Afolabi, Candice Wang, Sarah Ng, Rashmi Kumar, Katherine Bristowe, Emily Harrop, Zoebia Islam, Jonathan Koffman, Gurch Randhawa, Lucy E Selman, Sabrina Bajwah","doi":"10.1186/s12916-026-05063-9","DOIUrl":"10.1186/s12916-026-05063-9","url":null,"abstract":"<p><strong>Background: </strong>Among people from ethnically diverse communities, evidence regarding bereavement experiences and support needs is limited; there are known inequities in access to formal bereavement support. Our study aimed to address this gap, provide new theoretical insights into grief, and inform more equitable bereavement support services.</p><p><strong>Methods: </strong>A national, qualitative study was conducted with bereaved participants purposively sampled by ethnicity, age, sex, relationship to the decedent, and nature of death. Community Researchers from ethnically diverse communities, trained in research methods, were integral to recruitment, data collection and analysis. Focus groups and interviews were conducted in participants' preferred language and analysed using framework analysis. A novel conceptual grief model was developed through inductive analysis.</p><p><strong>Results: </strong>One-hundred and twenty people (female = 88 (73.3%), aged 21-81 years) participated in nine focus groups (n = 67 participants) and 53 one-to-one interviews. Participants were of Bangladeshi, Indian, Chinese, Pakistani, Black African, Black Caribbean, Arab, White Irish or Polish ethnicity. They were bereaved due to adult or child deaths, sudden and anticipated deaths. Sixty-nine per cent were first-generation migrants, 55% had a first language other than English, and 38% did not have access to education beyond primary or secondary school.</p><p><strong>Conclusions: </strong>Racism was evident across multiple settings and closely intertwined with bereavement, compounding the emotional burden of grief. This study represents the largest qualitative investigation of bereavement among ethnically diverse communities in UK healthcare to date, providing a robust evidence base for improving equity in support. Bereavement services must prioritise cultural safety and actively address structural racism. The 'Culturally Informed Ecological Model of Grief' offers a new framework guiding more equitable bereavement support, relevant across national and international contexts.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inconsistent ethics reporting in individual participant data meta-analyses: a call for updating PRISMA and PRISMA-IPD.","authors":"Rafael Dal-Ré, Florence T Bourgeois, Lars G Hemkens, Soren Holm, David Moher, Florian Naudet","doi":"10.1186/s12916-026-05056-8","DOIUrl":"10.1186/s12916-026-05056-8","url":null,"abstract":"<p><strong>Background: </strong>Interest in performing individual participant (or patient) data meta-analysis (IPD-MA) from randomized controlled trials (RCTs) has increased in recent years. With our PubMed search approach which considered only the titles of the articles and was conducted in October 2025, the first IPD-MA was published in 1998, whereas 198 were published in the first 9 months of 2025. Researchers use PRISMA 2020 and, above all, PRISMA-IPD to report the results of these studies.</p><p><strong>Main text: </strong>There are five ethics items─which are not included in either PRISMA 2020 or PRISMA-IPD─that are inconsistently included in the IPD-MA published in prominent medical journals, as shown in a sample of 19 IPD-MAs published in top general/internal medicine journals between January and September 2025. Two items refer to the RCTs included in the meta-analysis, i.e., whether approval from a research ethics committee (REC) was obtained, and whether participants of those trials provided informed consent. The other three items refer to the IPD-MA itself, i.e., whether it was approved by an REC, what the de-identification status was for the data (i.e. pseudonymized vs. anonymized), and whether the participants in all the trials included in the meta-analysis had given their consent or had not objected to the secondary use and sharing of their data with third parties.</p><p><strong>Conclusions: </strong>Due to their relevance, readers should be informed about these five items in the text of the IPD-MA or, as an alternative in certain cases, in the disclosure section of the IPD-MA published report. Specifically, the two items of information concerning the trials included in the IPD-MA should be included in an updated PRISMA 2020. All five items should be included in the next update of the PRISMA-IPD.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease burden attributable to heat waves amid climate change and related hospital accessibility: a health impact assessment study based on two nationally representative surveys in China.","authors":"Wanzhou Wang, Fulin Wang, Xiao Zhang, Ze Liang, Shaoqing Wei, Yingying Qin, Jinwei Wang, Feifei Zhang, Pengfei Li, Ying Zhou, Limin Wang, Chao Yang, Luxia Zhang","doi":"10.1186/s12916-026-05067-5","DOIUrl":"10.1186/s12916-026-05067-5","url":null,"abstract":"<p><strong>Background: </strong>Heat waves are increasingly recognized as an environmental determinant of chronic kidney disease (CKD). However, the CKD burden attributable to heat waves and associated healthcare inequalities, particularly under future climate change, remains insufficiently characterized.</p><p><strong>Methods: </strong>Based on two nationally representative cross-sectional surveys in China, we established climate region-specific exposure-response functions between heat waves and CKD. Then, we conducted 1-km grid-level health impact assessments integrating the most up-to-date nationally representative CKD prevalence data, temperature projections, population estimates, and socioeconomic indicators. The analyses focused on stages 4-5 CKD (advanced CKD), given its progressive nature and requirements for continuous medical treatment. Heat wave-attributable CKD burden was quantified as attributable cases (ACs), attributable fractions (AFs), and population attributable fractions (PAFs). Projections for 2030-2090 were generated under multiple Shared Socioeconomic Pathways (SSPs). Hospital accessibility was evaluated using AC-weighted driving times and accessibility scores, with inequality assessed via Gini indices and Lorenz curves.</p><p><strong>Results: </strong>In 2020, an estimated 491,362 (227,772-694,191) stages 4-5 CKD cases (about 30.06% of all cases and 45.31 per 100,000 adults) were attributable to heat waves, disproportionately affecting rural areas (PAF: 47.08 per 100,000) and subtropical and tropical regions (PAF: 52.43 per 100,000) compared to their counterparts. Projections indicated increasing trends in PAFs under high-emission scenarios (e.g., SSP5-8.5 showing > 2-fold increase in 2090). The average driving time to the nearest hospital for ACs was 15.8 (7.6-22.3) minutes, with rural areas showing significantly longer times (20.4 min) and lower accessibility. The national Gini index for hospital accessibility was 0.45, indicating high inequality, and the inequality might persist across all future climate scenarios.</p><p><strong>Conclusions: </strong>Heat waves are associated with a substantial and spatially uneven burden of advanced CKD in China, compounded by significant inequalities in hospital accessibility. These inequalities may persist under future climate change given current hospital accessibility settings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}