Objective To evaluate the cognitive abilities of the leading large language models and identify their susceptibility to cognitive impairment, using the Montreal Cognitive Assessment (MoCA) and additional tests. Design Cross sectional analysis. Setting Online interaction with large language models via text based prompts. Participants Publicly available large language models, or “chatbots”: ChatGPT versions

Objectives To compare the manual dexterity and composure under pressure of people in different hospital staff roles using a buzz wire game. Design Prospective, observational, comparative study (Tremor study). Setting Leeds Teaching Hospitals NHS Trust, Leeds, UK, during a three week period in 2024. Participants 254 hospital staff members comprising of 60 physicians, 64 surgeons, 69 nurses, and 61 non-clinical

Objective To assess whether training provided to an inexperienced clinician just before performing a high stakes procedure can improve procedural care quality, measuring the first attempt success rate of trainees performing infant orotracheal intubation. Design Randomized clinical trial. Setting Single center, quaternary children’s hospital in Boston, MA, USA. Participants A non-crossover, prospective

Objective To analyze mortality attributed to Alzheimer’s disease among taxi drivers and ambulance drivers, occupations that demand frequent spatial and navigational processing, compared with other occupations. Design Population based cross-sectional study. Setting Use of death certificates from the National Vital Statistics System in the United States, which were linked to occupation, 1 January 2020-31

Objective To assess the effect of electrically heated mittens on physical hand function in people with osteoarthritis of the hands compared with control mittens. Design Randomised controlled trial. Setting Osteoarthritis outpatient clinic, Copenhagen, Denmark. Participants 200 people with hand osteoarthritis aged 42-90 years. 100 participants were assigned to the intervention group and 100 to the control

Objective To quantify changes in inequalities in uptake of childhood vaccination during a period of steadily declining overall childhood vaccination rates in England. Design Longitudinal study. Setting General practice data for five vaccines administered to children (first and second doses of the measles, mumps, and rubella vaccine (MMR1 and MMR2, respectively), rotavirus vaccine, pneumococcal conjugate

Objectives To test whether haemochromatosis HFE C282Y homozygotes have increased risk of diabetes, liver disease, and heart disease even when they have normal plasma iron, transferrin saturation, or ferritin concentrations and to test whether C282Y homozygotes with diabetes, liver disease, or heart disease have increased mortality compared with non-carriers with these diseases. Design Prospective cohort

Objective To prospectively investigate the associations between dark, milk, and total chocolate consumption and risk of type 2 diabetes (T2D) in three US cohorts. Design Prospective cohort studies. Setting Nurses’ Health Study (NHS; 1986-2018), Nurses’ Health Study II (NHSII; 1991-2021), and Health Professionals Follow-Up Study (HPFS; 1986-2020). Participants At study baseline for total chocolate analyses

Objectives To evaluate the clinical effectiveness and safety of a perioperative algorithm for cardiac output-guided haemodynamic therapy in patients undergoing major gastrointestinal surgery. Design Multicentre randomised controlled trial. Setting Surgical services of 55 hospitals worldwide. Participants 2498 adults aged ≥65 years with an American Society of Anesthesiologists physical status classification

Objective To assess the effect of contemporary menopausal hormone therapy on the risk of cardiovascular disease according to the route of administration and combination of hormones. Design Nationwide register based emulated target trial. Setting Swedish national registries. Participants 919 614 women aged 50-58 between 2007 and 2020 without hormone therapy use in the previous two years, identified

Objective To compare the effectiveness of interventions for the management of long covid (post-covid condition). Design Living systematic review. Data sources Medline, Embase, CINAHL, PsycInfo, Allied and Complementary Medicine Database, and Cochrane Central Register of Controlled Trials from inception to December 2023. Eligibility criteria Trials that randomised adults (≥18 years) with long covid

Objective To investigate the association between monthly turnover rates of hospital nurses and senior doctors and patient health outcomes (mortality and unplanned hospital readmissions). Design Retrospective longitudinal study. Setting All 148 NHS acute trusts in England (1 April 2010 to 30 March 2019), excluding specialist and community NHS hospital trusts. Participants Yearly records on 236 000 nurses

Objective To prospectively assess the effect of endometriosis and uterine fibroids on the long term risk of premature mortality (younger than 70 years). Design Prospective cohort study Setting The Nurses’ Health Study II, United States (1989-2019). Participants 110 091 women aged 25-42 years in 1989 without a history of hysterectomy before endometriosis or fibroids diagnosis, cardiovascular diseases

Publications of living systematic reviews (LSRs) are increasing rapidly. Guidance facilitating transparent, complete, and accurate reporting of LSRs is needed. This paper reports the development of an extension of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement for LSRs (PRISMA-LSR). The PRISMA-LSR extension includes the PRISMA-LSR checklist, the PRISMA-LSR

Objectives To assess the efficacy and safety of the non-hormonal, neurokinin 3 receptor antagonist, fezolinetant, to treat moderate-severe vasomotor symptoms associated with menopause in individuals unsuitable for hormone therapy. Design Phase 3b randomised controlled trial. Setting 16 countries. Participants 453 individuals aged 40-65 years with moderate-severe vasomotor symptoms associated with menopause

Objectives To estimate the frequency, severity, and preventability of adverse events associated with perioperative care, and to describe the setting and professions concerned. Design Multicenter retrospective cohort study. Setting 11 US hospitals. Participants 1009 patients from a randomly selected sample of 64 121 adults admitted for surgery during 2018. Main outcome measures Adverse events during

Objective To investigate the association between sodium-glucose cotransporter-2 (SGLT-2) inhibitor use and risk of all cause mortality among patients with heart failure with reduced ejection fraction. Design Linked database study. Setting National registers in Denmark, July 2020 to June 2023. Participants Patients with heart failure, aged ≥45 years, with left ventricular ejection fraction ≤40%. Main

Objective To emulate target trials comparing recurrence of nephrolithiasis among patients with pre-existing nephrolithiasis (overall and stratified by concomitant gout) initiating sodium-glucose cotransporter-2 (SGLT-2) inhibitors versus an active comparator. Design Target trial emulation studies. Setting Canadian population database, January 2014 to June 2022. Participants 20 146 patients with nephrolithiasis

Objectives To assess trends and differences in child malnutrition by population subgroups among infants aged 6-23 months in China’s poorest rural counties. Design Six consecutive cross sectional surveys were conducted annually. Setting The study was conducted in 116 counties in 19 provinces from 2016 to 2021, representing China’s 832 poorest counties. Participants A total of 210 088 participants were

Objective To evaluate the feasibility of using a multigene signature to tailor individualised adjuvant therapy for patients with operable triple negative breast cancer. Design Randomised, multicentre, open label, phase 3 trial. Setting 7 cancer centres in China between 3 January 2016 and 17 July 2023. Participants Female patients aged 18-70 years with early triple negative breast cancer after definitive

Objectives To assess the short term temporal variations in suicide risk related to the day of the week and national holidays in multiple countries. Design Multicountry, two stage, time series design. Setting Data from 740 locations in 26 countries and territories, with overlapping periods between 1971 and 2019, collected from the Multi-city Multi-country Collaborative Research Network database. Participants

Objective To assess whether use of glucagon-like peptide-1 (GLP-1) receptor agonists before upper gastrointestinal endoscopy is associated with increased risk of pulmonary aspiration or discontinuation of the procedure compared with sodium-glucose cotransporter-2 (SGLT-2) inhibitors. Design Cohort study. Setting Two deidentified US commercial healthcare databases. Participants 43 365 adults (≥18 years)

Objective To evaluate the association between paternal metformin use and risk of congenital malformations in offspring. Design Population based, cross national cohort study. Setting Norway and Taiwan. Participants 619 389 offspring with paternal data during the period of sperm development (three months before pregnancy) in the Norwegian cohort during 2010-21 and 2 563 812 in the Taiwanese cohort during

Objective To quantify the predictive value of unexpected weight loss for cancer according to patient’s age, sex, smoking status, and concurrent clinical features (symptoms, signs, and abnormal blood test results). Design Diagnostic accuracy study (update). Setting Data from Clinical Practice Research Datalink electronic health records linked to the National Cancer Registration and Analysis Service

Objective To evaluate whether the intense simplified strategy, which comprises short term intensive insulin therapy (SIIT) followed by subsequent oral antihyperglycaemic regimens, could improve long term glycaemic outcomes in patients with newly diagnosed type 2 diabetes mellitus and severe hyperglycaemia. Design Multicentre, open label, randomised trial. Setting 15 hospitals in China between December

Objective To assess changes in key measures of kidney care using data reported in 2019 and 2023. Design Cross sectional survey in 148 countries. Setting Surveys from International Society of Nephrology Global Kidney Health Atlas between 2019 and 2023 that included participants from countries in Africa (n=36), Eastern and Central Europe (n=16), Latin America (n=18), the Middle East (n=11), Newly Independent

Objective To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality. Design Two stage time series analysis. Setting 645 locations across 34 countries or regions. Population Daily mortality data, comprising a total of 109 954 744 all cause, 31 164 161 cardiovascular, and 11 817 278 respiratory deaths

Objective To review the international literature and assess the ways healthcare systems are mitigating and can mitigate their carbon footprint, which is currently estimated to be more than 4.4% of global emissions. Design Systematic review of empirical studies and grey literature to examine how healthcare services and institutions are limiting their greenhouse gas (GHG) emissions. Data sources Eight

Objective To evaluate whether an integrated mental health video consultation approach (PROVIDE model) can improve symptoms compared with usual care in adults with depression and anxiety disorders attending primary care. Design Assessor masked, multicentre, randomised controlled trial (PROVIDE-C). Setting In 29 primary care practices in Germany, working remotely online from one trial hub. Participants

Objectives To investigate whether health insurance generated improvements in cardiovascular risk factors (blood pressure and hemoglobin A1c (HbA1c) levels) for identifiable subpopulations, and using machine learning to identify characteristics of people predicted to benefit highly. Design Secondary analysis of randomized controlled trial. Setting Medicaid insurance coverage in 2008 for adults on low

Objective To compare all licensed drug interventions as oral monotherapy for the acute treatment of migraine episodes in adults. Design Systematic review and network meta-analysis. Data sources Cochrane Central Register of Controlled Trials, Medline, Embase, ClinicalTrials.gov, EU Clinical Trials Register, WHO International Clinical Trials Registry Platform, as well as websites of regulatory agencies

The timing of embryo transfer, which aligns with different stages of embryo development, is an important element of in vitro fertilisation (IVF). This article briefly describes the main phases of IVF treatment, embryo development and transfer policies, cumulative live birth rates, and the key findings of the authors’ research. In vitro fertilisation (IVF) is a well established treatment for infertility

Objectives To evaluate whether embryo transfers at blastocyst stage improve the cumulative live birth rate after oocyte retrieval, including both fresh and frozen-thawed transfers, and whether the risk of obstetric and perinatal complications is increased compared with cleavage stage embryo transfers during in vitro fertilisation (IVF) treatment. Design Multicentre randomised controlled trial. Setting

Objective To estimate the real world effectiveness of modified vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccine against mpox infection. Design Emulation of a target trial. Setting Linked databases in Ontario, Canada. Participants 9803 men aged ≥18 years with a history of being tested for syphilis and a laboratory confirmed bacterial sexually transmitted infection (STI) in the previous year, or who

Objective To assess efficacy and safety of laughter exercise in patients with symptomatic dry eye disease. Design Non-inferiority randomised controlled trial. Setting Recruitment was from clinics and community and the trial took place at Zhongshan Ophthalmic Center, Sun Yat-sen University, the largest ophthalmic centre in China, between 18 June 2020 to 8 January 2021. Participants People with symptomatic

Objective To provide a comprehensive assessment of various fractionation schemes in radiation therapy for breast cancer, with a focus on side effects, cosmesis, quality of life, risks of recurrence, and survival outcomes. Design Systematic review and meta-analysis. Data sources Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (from inception to 23 October 2023). Study selection

This article discusses definitions of the effect of vaccines across outcomes of interest, from individual level to contacts of vaccinated people to population level. The focus is on the outcome evaluated in an observational study on the effectiveness of mpox vaccine in the context of potential outcomes that could have been measured. When evaluating how well a vaccine works, two categories of outcomes

Objective To provide a baseline comparative assessment of the main epidemiological features of prostate cancer in European populations as background for the proposed EU screening initiatives. Design Population based study. Setting 26 European countries, 19 in the EU, 1980-2017. National or subnational incidence data were extracted from population based cancer registries from the International Agency

Objective To investigate associations between long term residential exposure to road traffic noise and particulate matter with a diameter <2.5 µm (PM2.5) and infertility in men and women. Design Nationwide prospective cohort study. Setting Denmark. Participants 526 056 men and 377 850 women aged 30-45 years, with fewer than two children, cohabiting or married, and residing in Denmark between 2000 and

Predicting future outcomes of patients is essential to clinical practice, with many prediction models published each year. Empirical evidence suggests that published studies often have severe methodological limitations, which undermine their usefulness. This article presents a step-by-step guide to help researchers develop and evaluate a clinical prediction model. The guide covers best practices in

Objective To compare the risk of dementia associated with sodium-glucose cotransporter-2 (SGLT-2) inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors in adults aged 40-69 years with type 2 diabetes. Design Population based cohort study. Setting Korean National Health Insurance Service data, 2013-21. Participants 110 885 propensity score matched pairs of adults with type 2 diabetes aged 40-69

Objective To evaluate the comparative effectiveness and acceptability of oral monotherapy using psychedelics and escitalopram in patients with depressive symptoms, considering the potential for overestimated effectiveness due to unsuccessful blinding. Design Systematic review and Bayesian network meta-analysis. Data sources Medline, Cochrane Central Register of Controlled Trials, Embase, PsycINFO,

Objectives To estimate age standardised suicide rate ratios in male and female physicians compared with the general population, and to examine heterogeneity across study results. Design Systematic review and meta-analysis. Data sources Studies published between 1960 and 31 March 2024 were retrieved from Embase, Medline, and PsycINFO. There were no language restrictions. Forward and backwards reference

Objective To assess the clinical benefit and actionability of molecular targets for genome targeted cancer drugs recommended for clinical practice by the National Comprehensive Cancer Network (NCCN). Design Cross sectional study. Participants/setting Genome targeted cancer drugs recommended by NCCN guidelines in the advanced setting. Main outcome measures Molecular target actionability was assessed

Objective To quantify global intakes of sugar sweetened beverages (SSBs) and trends over time among children and adolescents. Design Population based study. Setting Global Dietary Database. Population Children and adolescents aged 3-19 years in 185 countries between 1990 and 2018, jointly stratified at subnational level by age, sex, parental education, and rural or urban residence. Results In 2018

Objective To assess whether decompression alone is non-inferior to decompression with instrumented fusion five years after primary surgery in patients with degenerative lumbar spondylolisthesis. Design Five year follow-up of a randomised, multicentre, non-inferiority trial (Nordsten-DS). Setting 16 public orthopaedic and neurosurgical clinics in Norway. Participants Patients aged 18-80 years with symptomatic

Objective To evaluate the personal protective effects of wearing versus not wearing surgical face masks in public spaces on self-reported respiratory symptoms over a 14 day period. Design Pragmatic randomised superiority trial. Setting Norway. Participants 4647 adults aged ≥18 years: 2371 were assigned to the intervention arm and 2276 to the control arm. Interventions Participants in the intervention

Objectives To quantify prevalence, harms, and NHS costs in England of problematic oral non-steroidal anti-inflammatory drug (NSAID) prescribing in high risk groups. Design Population based cohort and economic modelling study. Setting Economic models estimating patient harm associated with NSAID specific hazardous prescribing events, and cost to the English NHS, over a 10 year period, were combined

Objective To compare the effectiveness of intraosseous versus intravenous vascular access in the treatment of adult patients with out-of-hospital cardiac arrest. Design Cluster randomised controlled trial. Setting The VICTOR (Venous Injection Compared To intraOsseous injection during resuscitation of patients with out-of-hospital cardiac arrest) trial involved emergency medical service agencies with

Objective To evaluate the effectiveness of a clinical decision support system (CDSS) in improving the use of guideline accordant antihypertensive treatment in primary care settings in China. Design Pragmatic, open label, cluster randomised trial. Setting 94 primary care practices in four urban regions of China between August 2019 and July 2022: Luoyang (central China), Jining (east China), and Shenzhen

Objectives To evaluate the risk of major congenital anomalies according to infection with or vaccination against covid-19 during the first trimester of pregnancy. Design Prospective Nordic registry based study. Setting Sweden, Denmark, and Norway. Participants 343 066 liveborn singleton infants in Sweden, Denmark, and Norway, with an estimated start of pregnancy between 1 March 2020 and 14 February

Objective To examine trends in long term (>6 months) vaping among adults in England. Design Population based study. Setting England. Participants 179 725 adults (≥18 years) surveyed between October 2013 and October 2023. Main outcome measures Time trends in prevalence of long term vaping using logistic regression, overall and by vaping frequency (daily or non-daily), and main type of device used (disposable

Objectives To assess the clinical effectiveness of two speech and language therapy approaches versus no speech and language therapy for dysarthria in people with Parkinson’s disease. Design Pragmatic, UK based, multicentre, three arm, parallel group, unblinded, randomised controlled trial. Setting The speech and language therapy interventions were delivered in outpatient or home settings between 26

Objective To evaluate the effectiveness of behavioural interventions that include motivational interviewing on physical activity outcomes in adults. Design Systematic review and meta-analysis. Study selection A search of seven databases for randomised controlled trials published from inception to 1 March 2023 comparing a behavioural intervention including motivational interviewing with a comparator

Objective To investigate the incidence of cardiovascular disease (CVD) overall and by age, sex, and socioeconomic status, and its variation over time, in the UK during 2000-19. Design Population based study. Setting UK. Participants 1 650 052 individuals registered with a general practice contributing to Clinical Practice Research Datalink and newly diagnosed with at least one CVD from 1 January 2000

Objectives To evaluate the comparative effectiveness of sodium-glucose cotransporter-2 (SGLT-2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and dipeptidyl peptidase-4 (DPP-4) inhibitors in preventing hyperkalemia in people with type 2 diabetes in routine clinical practice. Design Population based cohort study with active-comparator, new user design. Setting Claims data from Medicare

Objectives To assess the efficacy and safety of colchicine versus placebo on reducing the risk of subsequent stroke after high risk non-cardioembolic ischaemic stroke or transient ischaemic attack within the first three months of symptom onset (CHANCE-3). Design Multicentre, double blind, randomised, placebo controlled trial. Setting 244 hospitals in China between 11 August 2022 and 13 April 2023.

Objective To compare the effectiveness and safety of nab-paclitaxel, cisplatin, and capecitabine (nab-TPC) with gemcitabine and cisplatin as an alternative first line treatment option for recurrent or metastatic nasopharyngeal carcinoma. Design Phase 3, open label, multicentre, randomised trial. Setting Four hospitals located in China between September 2019 and August 2022. Participants Adults (≥18

Objective To assess the effect of lateral episiotomy, compared with no episiotomy, on obstetric anal sphincter injury in nulliparous women requiring vacuum extraction. Design A multicentre, open label, randomised controlled trial. Setting Eight hospitals in Sweden, 2017-23. Participants 717 nulliparous women with a single live fetus of 34 gestational weeks or more, requiring vacuum extraction were

Objectives To estimate the burden, trends, and inequalities of type 1 diabetes mellitus (T1DM) among older adults at global, regional, and national level from 1990 to 2019. Design Population based study. Population Adults aged ≥65 years from 21 regions and 204 countries and territories (Global Burden of Disease and Risk Factors Study 2019) from 1990 to 2019. Main outcome measures Primary outcomes were