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Person-centred care (PCC) has been increasingly promoted in wound management, yet its theoretical foundations and practical application remain unclear. This scoping review aimed to map and synthesise how PCC frameworks, concepts and outcome measures have been used in wound care. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a systematic search was conducted across major databases for studies published between 2020 and 2025. Eligible sources included empirical research, reviews and conceptual papers addressing PCC in adults with chronic wounds. Data were extracted and analysed descriptively across conceptual and evaluative domains. Fourteen publications met inclusion criteria. Only one explicit framework of person-centred wound care was identified. Most studies referred to patient-centred rather than person-centred approaches and applied principles such as empowerment, shared decision-making and communication without consistent theoretical grounding. Outcome assessment focuses mainly on clinical or functional indicators, with limited attention to relational or experience-based dimensions of care. Some studies used the term person-centred as an unreflected keyword. Person-centred wound management remains conceptually fragmented, methodologically heterogeneous and sometimes unreflected. Greater theoretical precision, consensus on terminology and development of validated frameworks and measurement tools are required to translate person-centred principles into consistent, evidence-based clinical practice.

Multiple sclerosis (MS) onset occurs at diverse ages. Age of onset impact on clinical, brain MRI, and cognitive profiles remains unclear. We investigated the substrates of Symbol Digit Modalities Test (SDMT) impairment in patients with late-onset MS (LOMS) (⩾45 years) compared to adult-onset MS (AOMS) (<45 years). 294 AOMS and 80 LOMS patients with disease duration of maximum 6 years from symptom onset and 519 healthy controls were retrospectively included from a multicenter MAGNIMS data set. We assessed between-group differences and correlates of SDMT impairment measuring lesion volume (LV), atrophy, global, intra- and inter-hemispheric structural connectivity and disconnection indices. 38% LOMS were impaired on SDMT compared to 39% AOMS (p = 0.751). LOMS showed higher LV (FDR-p = 0.018), gray matter (GM) atrophy (FDR-p = 0.050), intra- and inter-hemispheric disconnection compared to AOMS (all FDR-p < 0.028). Furthermore, LOMS showed higher modularity (FDR-p = 0.018) and decreased density (FDR-p < 0.001). Substrates of SDMT impairment were intra-hemispheric disconnection, LV, clustering coefficient, mean strength and efficiency (AUC = 0.730) in AOMS and commissural ratio and GM atrophy (AUC = 0.760) in LOMS. Substrates contributing to SDMT impairment differ between these two distinct cohorts, being primarily driven by network dysfunction in AOMS and neurodegenerative processes in LOMS.

Autonomic nervous system (ANS) imbalance may contribute to functional pelvic disorders such as overactive bladder (OAB). Transcutaneous tibial nerve stimulation (TTNS) is a non-invasive therapy for OAB; however, its autonomic modulation mechanisms remain unclear. This exploratory study evaluated the acute effects of TTNS on ANS activity in healthy volunteers using heart rate variability (HRV) to model neuroautonomic pathways relevant to OAB. In this open-label, prospective, exploratory, single-arm study, 20 healthy volunteers (11 women; median age 31 years) underwent three 10-min phases: baseline rest, continuous submotor TTNS via surface electrodes on the left tibial nerve, and post-stimulation recovery. HRV was recorded using a Polar H10 sensor and analyzed with Kubios software. Time-domain (SDNN, RMSSD, pNN50), frequency-domain (LF, HF, LF/HF), and additional indices (PNS, SNS, Stress indices) were assessed in standardized 5-min windows. Friedman and Wilcoxon tests with Bonferroni correction were applied. A vagal-oriented composite response score (z-delta mean) was correlated with age and BMI (Spearman, permutation-based p values). Significant phase effects were observed for PNS index, SNS index, Stress index, SDNN, and RMSSD (p < 0.05). Post-hoc analyses confirmed increases in PNS index, SDNN, and RMSSD, and decreases in SNS and Stress indices during stimulation compared with baseline. Partial post-stimulation persistence was noted for SDNN and Stress index, although these changes did not remain significant after Bonferroni correction. The composite response score correlated negatively with age (ρ = -0.52; p = 0.019; permutation p = 0.016) and showed a non-significant positive trend with BMI (ρ = 0.38; p = 0.10). Acute TTNS enhances parasympathetic and suppresses sympathetic activity, with partially sustained effects after stimulation. Younger age predicts stronger vagal responsiveness, suggesting age-dependent neuromodulatory efficacy. Validation in OAB populations is warranted.

Access to hypertension care remains insufficient, particularly in remote rural areas in resource-limited settings. Community health workers (CHWs), lay providers living in the communities they serve, may help close this gap, but the effectiveness and safety of lay CHW-led hypertension care-including independent initiation and titration of medication-remain uncertain. We conducted a 1:1 cluster-randomized trial nested within the Community-Based Chronic Care Lesotho (ComBaCaL) cohort study in 103 rural villages in Lesotho. Following community-based hypertension screening, 547 nonpregnant adults with blood pressure (BP) ≥140/90 mm Hg were enrolled (274 control and 273 intervention). In intervention clusters, lay CHWs independently prescribed and titrated a fixed-dose combination of amlodipine and hydrochlorothiazide, guided by a mobile clinical decision support system. In control clusters, participants were referred to health facilities for standard care. The primary objective was to assess the effectiveness and safety of lay CHW-led care, with the primary outcome defined as BP <140/90 mm Hg at 12 months. In the intention-to-treat analysis (543 participants with 4 exclusions owing to intercurrent pregnancy), BP control was achieved by 156/271 (58%) versus 130/272 (48%) in intervention and control arms, respectively (adjusted odds ratio 1.52, 95% confidence interval 1.01 to 2.29, P = 0.046). A predefined complete case analysis yielded consistent results. No relevant differences in safety outcomes were observed. Among people with uncontrolled hypertension, lay CHW-led, CDSS-supported care was safe and more effective than referral to facility-based professional care. These findings support expanding first-line hypertension management by lay CHWs in remote, resource-limited settings. Clinicaltrials.gov registration: NCT05684055 .

Despite prior demonstration of a detrimental effect of post-mastectomy radiotherapy (PMRT) on patient reported outcomes (PROs) in patients with breast cancer (BC) undergoing breast reconstruction, the impact of PMRT on patients without reconstruction remains less clear. The objective of this study was to assess the association between PMRT and patient-reported outcomes (PROs). Patients with stage 0-III BC who underwent mastectomy (including total mastectomy, nipple-sparing mastectomy, and skin-sparing mastectomy) at a Swiss university hospital between 01/2013-12/2023, who completed at least one postoperative BREAST-Q questionnaire, were identified from a prospectively maintained institutional database. Outcomes included the identification of differences in PROs relative to receipt of PMRT. Of 243 eligible patients, 30.9% (75/243) underwent PMRT. The median time to last PRO assessment was 30.4 months, without differences between the groups (p=0.100). The frequency and type of breast reconstruction were comparable between the groups, with 41.2% of patients not undergoing breast reconstruction. Physical well-being and psychosocial well-being were reduced following PMRT. In the multivariate analysis, PMRT was identified as a predictor of worse short-term (0-2 years postoperatively) physical well-being (estimated difference [ED] -7.9, 95 %CI -15.4 to -0.4) and showed a trend towards worse psychosocial well-being (ED -9.1, 95 %CI -18.3 - 0.1) irrespective of breast reconstruction. In conclusion, PMRT negatively impacts short-term PROs, regardless of whether breast reconstruction is performed or not.

BackgroundCerebral venous sinus thrombosis (CVST) is an uncommon cerebrovascular condition, constituting less than 1% of all stroke cases, particularly affecting young adults. CVST typically presents with nonspecific symptoms, complicating timely diagnosis. Although anticoagulation remains the primary treatment, complicated cases may necessitate endovascular intervention. Reports of CVST presenting with multifaceted neurological and orthopedic complications in young patients without thrombophilic disorders are uncommon, underscoring the importance and educational value of documenting such cases.Case presentationWe report the case of an 18-year-old female without prior medical or migraine history who presented to the emergency department with a six-day history of persistent, progressive headache accompanied by nausea. Initial clinical evaluation revealed no neurological deficits, but symptoms and positional exacerbation warranted further investigation. Neuroimaging via contrast-enhanced CT demonstrated extensive thrombosis involving the superior sagittal sinus and bilateral cortical veins, accompanied by minimal parietal hemorrhage and edema. Endovascular thrombectomy was performed due to progressive neurological deterioration, achieving significant clot reduction and continuous venous recanalization. Despite treatment, the patient experienced persistent left-sided hemianopsia and subsequent focal seizures, managed effectively with anti-epileptic therapy. She also sustained an orthopedic injury; anteroinferior left shoulder dislocation, secondary to nocturnal seizure activity, requiring orthopedic intervention. Extensive thrombophilia screening was negative, with no identifiable hereditary factors. Follow-up imaging showed marked thrombus resolution, clinical symptoms improved significantly, and hemianopsia resolved completely after seven months.ConclusionsThis case illustrates the potential severity and complexity of CVST in healthy young patients. It underscores the importance of prompt diagnosis and multidisciplinary management, including consideration of endovascular thrombectomy in refractory or complicated cases. Further research is needed to elucidate the underlying mechanisms and optimize treatment strategies, particularly in young patients without identifiable thrombophilic disorders.