eClinicalMedicine

BackgroundNeonatal jaundice management increasingly relies on transcutaneous bilirubinometry (TcB), yet discrepancies with serum bilirubin (TSB) have limited its clinical reliability. This study introduces Skin Residual Bilirubin Volume (SRBV) as a physiologically grounded framework to enhance TcB interpretation. ObjectiveTo evaluate SRBV as an explanation for TcB-TSB discordance and assess whether incorporating SRBV improves the interpretability and reliability of TcB measurements during diagn...

Background: Nursing interns are at high risk of psychological distress due to academic and clinical stressors. While poor sleep quality is linked to anxiety and depression, the buffering role of social support remains underexplored in this population. Aims: To explore the role of social support in regulating the relationship between sleep and mental health among nursing interns. Methods: A total of 396 nursing interns completed self-administered questionnaires including the Pittsburgh Sleep Qual...

ObjectivesVisit-to-visit blood pressure variability (VVV BPV) is an underutilised risk factor for cardiovascular disease (CVD). This study aims to determine the minimum number of BP measurements needed and to identify cut-off values for the standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) of systolic and diastolic VVV BPV to predict CVD risk in primary care. MethodsWe analysed data from the electronic practice-based research network (ePBRN) in Southwest...

BackgroundArtemisinin-based combination therapies (ACTs) are the most widely used treatment for Plasmodium falciparum malaria. Kelch 13 mutations associated with artemisinin partial resistance (ART-R) have emerged in Sub-Saharan Africa (SSA) and are now reported in an increasing number of countries. ACT treatment failure rates are at risk of unprecedented increase. To summarise existing surveillance data and guide future surveillance, we produce modelled estimates of the spatiotemporal distribut...

UK-based quantitative research on the health and education outcomes of Unaccompanied Asylum-Seeking Children (UASC) remains limited, especially at national level. Linked administrative data provide an unprecedented opportunity to study these outcomes among UASC. This paper lays a foundation for further research, particularly examining the influence of socio-demographic, legal and environmental factors on UASCs health and educational outcomes. We described the UASC population with a first record...

BackgroundMeasurement of human antibodies against Anopheles salivary proteins that are injected during mosquito bites may serve as biomarkers of mosquito biting exposure. These biomarkers have been suggested as surrogate outcomes in trials of vector control intervention effectiveness, however, studies to-date have been largely descriptive and do not directly quantify the instantaneous nor cumulative effects of the intervention on antibody outcomes. In this study, we sought to explore the use of ...

Sepsis caused by drug-resistant pathogens remains a major contributor to under-five mortality in low- and middle-income countries, threatening progress toward Sustainable Development Goal (SDG) 3.2. Blood culture, the gold standard for sepsis diagnosis and antimicrobial stewardship, remains underutilised in routine pediatric care. This study assessed the extent and determinants of blood culture utilisation among hospitalised children under five years with suspected sepsis at four antimicrobial r...

ObjectiveMyositis-associated interstitial lung disease (myositis-ILD) consists of two predominant radiologic patterns of lung injury--nonspecific interstitial pneumonia (NSIP) and organizing pneumonia (OP)--that oftentimes coexist. However, it remains unclear whether either is associated with clinical outcomes. We aimed to assess the therapeutic response in patients with NSIP-compared to those with OP-predominant myositis-ILD. MethodsThis retrospective, single-center cohort study recruited part...

Objective To test the effectiveness of a postpartum behavioural intervention delivered by automated text messaging in reducing weight. Design Two parallel group, multicentre, randomised controlled trial. Setting Recruitment from five areas across the United Kingdom (Belfast, Bradford, Stirling, London and Cardiff) through healthcare and community pathways, including social media. Participants A diverse sample of 892 women between 6 weeks and 24 months postpartum, aged 18 years or more and with a...

BackgroundUniversal Free School Meals (UFSM) were introduced by the Welsh Government in 2022 to provide every primary school child (aged 4-11) with a free meal at lunch time by 2024, aiming to improve nutrition and reduce inequality. While evidence suggests UFSM can support dietary quality and social inclusion; uptake remains inconsistent, and concerns have been raised regarding meal quality and portion sizes. Aims/ObjectivesThis study explored the perceptions of children and parents regarding ...

Background: Schistosoma mansoni is a leading cause of hepatosplenic disease in sub-Saharan Africa. Yet, associations with current Schistosoma mansoni infections and hepatosplenic organometry remain unclear in the context of widespread mass drug administration and co-endemic infections. Methods: From January to February 2024, we conducted a community-based, cross-sectional study nested within the SchistoTrack cohort in three districts of Uganda. Liver and spleen dimensions were assessed via point...

BackgroundThere is disparity between the incidence of malignant hyperthermia (MH) reactions and the prevalence of variants in the RYR1 gene associated with susceptibility to MH (where susceptibility is determined by in vitro contracture tests). Our aims were to use clinical and genetic data from the UK to explain this disparity and to examine if these data are consistent with the clinical risk of MH being inherited as an autosomal dominant trait. MethodsClinical MH and genotyping data were extr...

Background The microbial aetiology of early childhood caries (ECC) in sub-Saharan African populations remains poorly characterised, with most studies focusing on conventional cariogenic pathogens like Streptococcus mutans. This study aimed to characterise the salivary microbial profile of children with ECC in urban Kano, northern Nigeria. Methods In this cross-sectional study of 162 children aged 3-5 years in urban Kano, unstimulated saliva samples were collected and analysed using standard bact...

Background: Interstitial lung abnormalities (ILA) are radiologic findings of increased lung density or fibrosis in individuals without clinical interstitial lung disease (ILD) and are associated with increased mortality and progression to ILD. Understanding physiologic trajectories of lung function preceding ILA diagnosis may illuminate early mechanisms of lung injury. Methods: We recruited participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Study, a prospective ...

We developed and validated a self-administered clinical vignette platform powered by a large language model (LLM), deployed through a SurveyCTO web survey, to measure primary health care provider competencies in Vietnam. In a pilot focus group, nine physicians rated LLM-simulated patient interactions as realistic (mean 3.78/5) and user-friendly. In the validation phase, 22 providers completed 132 vignette interactions across ten clinical scenarios in Vietnamese. Essential diagnostic checklist sc...

Type 2 diabetes (T2D) affects 11.1% of the global population, underscoring the need for biomarkers that inform treatment response and glycemic outcomes. We evaluated the association between the FTO variant rs9939609-A and glycemic control in a Mexican population. A total of 174 individuals living with T2D from Merida and Sisal, Yucatan, were included, of whom 85% were receiving oral hypoglycemic agents as main treatment. Glycemic control was defined cross-sectionally as good ([≤]130 mg/dL, n=...

ObjectiveTo systematically identify and characterize methodological heterogeneity in sepsis case detection methods using the MIMIC-III database or the eICU-CRD, and to quantify the resulting variability in sepsis detection rates. Materials and MethodsWe conducted a PRISMA-guided systematic review of PubMed and Web of Science (2016-2024), and stratified studies by cohort definition to obtain comparable subsets. We extracted information on sepsis case detection methodology across six domains: par...

BackgroundTwo RSV immunisations products: a maternal vaccine, Abrysvo, and a long-acting monoclonal antibody, nirsevimab, both designed to prevent RSV illness in infants, have recently become available. Modelling evidence is required to inform how to optimally use these products in immunisation programs to reduce the burden of RSV in young children. MethodsWe extend a dynamic transmission model calibrated to RSV-hospitalisation data of children aged < 5 years in temperate Western Australia (WA)...

BackgroundColorectal carcinoma (CRC) remains a significant cause of cancer morbidity and mortality worldwide. Right- and left-sided tumours differ in clinical, morphological, and molecular features. Microsatellite instability-high (MSI-H) tumours, often right-sided, are associated with distinct histopathological characteristics and prognostic implications. In Sri Lanka, molecular MSI testing is currently unavailable, highlighting the need for alternative predictive approaches. ObjectivesGeneral...

BackgroundRespiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in children, often leading to hospitalisation in infants. In low-resource settings where routine RSV diagnostics are unavailable, clinical overlap with bacterial pneumonia frequently results in unnecessary antibiotic use, contributing to antimicrobial resistance. ObjectiveTo evaluate the frequency and clinical determinants of antibiotic use among RSV-positive children under two years at a tertiary...