METHODS: A working group (n = 43 members) conducted a literature search spanning 2019-2024 using the keywords "Global Leadership Initiative on Malnutrition or GLIM." Prior GLIM guidance activities for using the criteria on muscle mass and inflammation were reviewed. Successive rounds of revision and review were used to achieve consensus.
RESULTS: More than 400 scientific reports were published in peer-reviewed journals, forming the basis of 10 systematic reviews, some including meta-analyses of GLIM validity that indicate strong construct and predictive validity. Limitations and future priorities are discussed. Working group findings suggest that assessment of low muscle mass should be guided by experience and available technological resources. Clinical judgment may suffice to evaluate the inflammation/disease burden etiologic criterion. No revisions of the weight loss, low BMI, or reduced food intake/assimilation criteria are suggested. After two rounds of review and revision, the working group secured 100% agreement with the conclusions reported in the 5-year update.
CONCLUSION: Ongoing initiatives target priorities that include malnutrition risk screening procedures, GLIM adaptation to the intensive care setting, assessment in support of the reduced food intake/assimilation criterion, and determination of malnutrition in obesity.
CASE PRESENTATION: We present the case of an 18-year-old Muslim female with no prior significant medical history who arrived at the emergency department unconscious and in impending respiratory arrest. The clinical team recommended intubation to prevent critical deterioration. However, the patient's sole legal guardian-her mother-adamantly refused consent for endotracheal intubation and other potentially life-saving measures, including CPR, citing personal mistrust and past negative healthcare experiences. In response, the team adopted a less effective non-invasive ventilation strategy and pursued repeated discussions to understand the mother's rationale. Despite these efforts, the patient's trajectory only improved gradually without the recommended definitive intervention. The patient, once conscious, deferred decision-making entirely to her mother. Subsequent readmissions repeated this pattern of refusal and partial treatment acceptance. Ultimately, the patient recovered sufficiently for discharge, though underlying risk factors remained poorly addressed as she defaulted on her subsequent follow-up appointment.
CONCLUSIONS: This case underscores the tension between guardian decisions, patient welfare, and religious-ethical principles. Our analysis reveals a principled basis for prioritising patient well-being over third-party refusal by examining Islamic jurisprudential rulings on consent. The insights from this case could inform more religio-culturally sensitive policies and strengthen clinical decision-making frameworks in contexts where religious norms significantly shape healthcare choices.
METHODS: Following the Systemic Rapid Assessment (SYSRA) framework, this ecological study examines the relationship between STH infections and anemia in children under five and reproductive-age women. Factors considered include Universal Health Coverage (UHC) Index, Water and Sanitation Indicators (SDG 6.1 and 6.2), Government Effectiveness, and Human Development Index (HDI). Paired t-tests assess annual changes in STH infection and anemia prevalence, while Chi-Square and logistic regression tests identify factors associated with anemia prevalence.
RESULTS: From 2015 to 2019, STH infection prevalence decreased significantly, while anemia prevalence fluctuated. STH infections were significantly associated with anemia in children under 5. However, STH infections did not significantly impact anemia prevalence in children under 5 or reproductive-age women. HDI influenced anemia prevalence in children under 5 (OR = 14.17, p
METHODS: This study scanned residual limbs of 2 transtibial amputees weighing 53 kg (P4) and 125 kg (P6) to create 3D-printed prosthetic sockets using FDM. Ten sockets of a P4 amputee were printed at various orientations from 0° to 90° for a structural static test. In addition, 6 sockets of the P6 amputee were printed at 90° for static and cyclic tests according to ISO 10328.
RESULTS: Based on the results, sockets printed at 0° and 90° for the P4 amputee exceeded static ultimate force under condition I according to ISO 10328 standards with 4880 N and 4430 N, respectively. Sockets at 30°, 45°, and 60° failed before the minimum force requirement was reached. Further validation of the 90° printed socket passed the static test in conditions I and II, and the cyclic test in condition II, enduring 3 million cycles without failure.
CONCLUSION: The 0° and 90° printing orientations are recommended for their superior mechanical properties, whereas other orientations may pose safety risks because of insufficient structural strength. These findings could contribute to developing more reliable and durable prosthetic sockets that meet ISO 10328 standards to enhance the quality of life for amputees.
METHODS: As part of the multi-country observational Every Woman StudyTM (EWS), semi-structured interviews were conducted with clinicians between June 2022 and June 2023. The interview guide was developed by the EWS LMIC Oversight Committee, including patients, clinicians and data specialists. Relational content and inductive thematic analyses were employed and categories synthesized using the World Health Organization's six building blocks of the Health Systems Framework.
RESULTS: 24 clinicians (54% female; 79% gynaecologic oncologists, 8% gynaecologists, 8% clinical oncologists not specializing in gynaecological cancers, and 4% clinical oncologists specializing in gynaecological cancers; 42% from Africa, 29% from Asia, 29% from Latin America) participated. Six dominant themes were identified: "Poor Ovarian Cancer Data'', "Inequity in Access to Treatment", "In-Country Inequities in Access to Care", "Role of Cultural Norms on Women's Health", "Increased Engagement of Men in Ovarian Cancer Control", and "Advocacy and Education for Empowering Women". Content analysis revealed system-level challenges such as delayed drug payments, lack of population-based cancer data, and limited imaging facilities. Patient-level challenges included disparities in access to specialists, limited medication affordability, poor symptom recognition, and reliance on alternative treatments.
CONCLUSIONS AND POLICY SUMMARY: This study reveals the complexity of ovarian cancer treatment and care in LMICs and the need to mitigate disparities in these regions, underscoring the need for patient-centred, context specific and intersectoral strategies to be considered in cancer planning to improve ovarian cancer care quality and equity in LMICs.
METHODS: This study uses a designed guide RNA targeting the TRIB2 gene assembled via In-vitro synthesis. The gRNA with Cas9 protein leads to the formation of CRISPR-RNP structures, which target and cleave the TRIB2 gene. The assembled CRISPR-RNP system is transfected into target AML cell and control cell lines (i.e. HEK cells), and the subsequent gene cleavage and resulting changes to the AML cells in terms of cellular safety/tolerability and gene knockdown efficacy were studied via RT-qPCR, flow cytometry, and cell viability analysis.
RESULTS: The outcome demonstrates the well-tolerated transfection of the in-vitro assembled CRISPR RNP system with no signs of cellular toxicity and disruptions towards the AML cell's metabolic activities, promoting the safety aspects of CRISPR RNP post-transfection to human cells. The study further highlights the in-vitro efficacy of the CRISPR RNP in targeting the TRIB2 oncogene, where a statistically significant gene knockdown of more than 80% was detected via qPCR analysis of TRIB2 gene expression with minimal to no background effects from individual RNP components, equating to their targeted gene cleavage effects. In addition, the CRISPR TRIB2 gene knockdown also indicated the possibilities of induced AML cell death measured via flow cytometry markers, translating to favourable outcomes in eliminating cancerous growths.
CONCLUSIONS: This study research contributes to the refinement of the CRISPR-RNP strategy and preliminary evaluation for future clinical uses.
METHODS: A retrospective case series of 20 eyes with MHRD that underwent vitrectomy with internal limiting membrane (ILM) peeling and inverted flap (16 eyes, 80%), ILM insertion (3 eyes, 15%), or ILM free flap (1 eye, 5%) assisted by the SPOT technique in a tertiary referral center. The main outcomes measures were best-corrected visual acuity (BCVA) and the final hole closure and reattachment of the macula accessed by spectral-domain optical coherence tomography.
RESULTS: The mean axial length of was 28.17 ± 3.0 mm (range, 20.61-33.10 mm) and the mean follow-up time was 382 ± 214 days. After vitrectomy with SPOT technique, primary hole closure was noted in all 20 eyes. In two eyes (10%) the hole reopened but the retina remained attached. In another two eyes, minimal subretinal fluid persisted despite hole closure. The final hole closure and retinal reattachment rates were both 90% (18 eyes). At the last visit, 14 eyes (70%) had improved BCVA and the logMAR BCVA improved from 1.44 ± 0.47 (Snellen 20/550) to 1.12 ± 0.59 (Snellen 20/260). No significant difference was observed in the functional and anatomical outcomes between MHRD within the arcades (9 eyes, 45%) and beyond the arcades (11 eyes, 55%).
CONCLUSIONS: For macular holes with retinal detachment, SPOT successfully assisted different internal limiting membrane flap techniques and achieved 90% macular hole closure and 90% retinal reattachment rates. In 90% of the eyes, the vision stabilized or improved. SPOT technique has a gentle learning curve and allows surgeons to manipulate the ILM flap with ease, which is beneficial in challenging surgeries such as macular holes accompanied with a detached retina.
TRIAL REGISTRATION: Retrospectively registered.
METHODS: This study employed a cross-cultural adaptation and psychometric testing design to translate and validate the Chinese version of the I-PRRS (I-PRRS-Ch). The translation process followed established guidelines, including forward and backward translation by bilingual experts, followed by an expert panel review to ensure content validity. A pilot study was conducted to assess face validity and identify any potential translation or cultural adaptation issues. The floor and ceiling effects, test-retest reliability, composite reliability, convergent validity, and concurrent validity were assessed to evaluate the translated questionnaire's reliability and validity. To evaluate the reliability of the I-PRRS-Ch, test-retest reliability was employed using the intraclass correlation coefficient (ICC 3,1). Composite reliability and convergent validity were assessed using partial least squares structural equation modeling (PLS-SEM). The Chinese version of the Tampa Scale of Kinesiophobia (SC-TSK) was used to measure the concurrent validity of the I-PRRS-Ch.
RESULTS: A total of 183 injured athletes (male: n = 148, female: n = 35; age: Mean = 20.04, SD = 3) from various sports, including track and field, football, basketball, martial arts, volleyball, and gymnastics, participated in this study. Preliminary analysis showed no floor or ceiling effects were detected for the I-PRRS-Ch. Test-retest reliability of the I-PRRS-Ch scale was excellent (ICC = 0.98). Internal consistency measures included a Cronbach's alpha value of 0.85 and a composite reliability of 0.89, indicating good reliability. Convergent validity was established with an average variance extracted of 0.57. Concurrent validity was supported by a moderate inverse correlation (r = -.42) between the I-PRRS-Ch scale and the SC-TSK, validating the psychological readiness measure concerning kinesiophobia.
CONCLUSIONS: The I-PRRS-Ch scale is a reliable and valid tool that provides a screening mechanism to identify psychological barriers in Chinese athletes before returning to sport.