Validating treat-to-target endpoints in childhood lupus: data-driven sensitivity analyses from the UK JSLE cohort study.

Objectives: To conduct data-driven sensitivity analyses to evaluate whether refined definitions of childhood-onset systemic lupus erythematosus (cSLE) treat-to-target goals provide better protection against moderate-severe flares and new damage, compared with original consensus-derived targets. Methods: The UK JSLE Cohort Study was utilised. Childhood-SLE target attainment was determined at each visit. Removal or transformation of cSLE target criteria ("variations") were investigated, for Childhood Lupus Low Disease Activity State (cLLDAS), cSLE Clinical Remission on Steroids (cCR) and cSLE Clinical Remission off Steroids (cCR-0). The impact of such variations on the hazards of subsequent moderate-severe flare and new damage was assessed, using Prentice-Williams-Peterson (PWP) models. Two-sided t-tests compared the hazard ratios (HRs) obtained from the PWP gap-time models for the original and varied cSLE target definitions. Results: Two variations of cLLDAS demonstrated significantly better protection against moderate-severe flare, including transformation of SLEDAI-2K cut-off to ≤ 3 (HR 0.13 [0.09, 0.19], p 0.05). A modified version of cLLDAS, combining these two transformations was also assessed, demonstrating further improvement in protection against moderate-severe flare (HR 0.12 [0.08, 0.17], p < 0.001). Conclusions: Refining the cLLDAS definition by lowering the SLEDAI-2K cut-off to ≤ 3 and PGA to ≤ 0.25 may enhance protection against moderate-severe flare, but not new damage. No variations of cCR or cCR-0 showed significant improvement

Factors that influence suicide behaviours and tendencies amongst university undergraduates in Nigeria: a systematic review and meta-analysis.

Background: Suicide is a major pressing public health concern, especially among young people in low-medium income countries like Nigeria and a major common cause of deaths among people aged 15-29 across the world. Aim: This study aims to identify the factors that influence suicide behaviours and tendencies amongst university undergraduates in Nigeria. Method: A systematic review of peer-reviewed primary studies followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered with PROSPERO. Eight databases (African Journal Online, African Index Medicus, CINAHL Complete, MEDLINE Complete, PsycINFO, APA PsycArticles and Psychology, Embase and Google Scholar) were searched for studies published between 2019 and 2025. A total of 31 studies were included after rigorous screening. Results: Thematic analysis identified three major themes and eleven sub-themes. These are academic factors (academic demands, academic stress, academic performance and academic environments), socioeconomic factors (family issues, parental problems, financial problems, media and internet) and psychological factors (mental illness, emotional intelligence, helplessness and hopelessness). Conclusion: Suicidal behaviours among Nigerian undergraduates arise from the combined effects of academic, socioeconomic and psychological stressors and vulnerabilities. Recommendations: A coordinated response, including university counselling and stress-management programmes, financial aid, family/community support, are needed to reduce student suicidality

PNA role in primary care (evidence summary)

This is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created

Psychopharmacotherapy of Alzheimer's Disease-What Do We Have at Hand?

~ Alzheimer's disease (AD) is a devastating relentlessly progressive illness for which currently there is no definitive curative treatment. The mainstay of treatment remains symptomatic, though. Psychopharmacotherapy is only part of a multi-pronged package of care involving caregivers. Herein, authors would shed light on the main pharmacological options at hand

Nasogastric tube insertion using lidocaine spray in adult stroke patients (evidence summary)

This is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created

Nintedanib as switch maintenance treatment in malignant pleural mesothelioma (NEMO): A double-blind randomized phase II trial (EORTC-08112-LCG).

© 2026 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Introduction: Pleural mesothelioma (PM) is a lethal malignancy in which angiogenesis and progressive fibrosis drives disease. We evaluated angiogenesis inhibition using nintedanib monotherapy as switch maintenance in patients with PM that completed 4-6 cycles of prior platinum-pemetrexed chemotherapy. The trial was performed in parallel to the LUME-Meso trial in an era prior to routine immune checkpoint inhibitor use, when platinum-pemetrexed was standard of care. Methods: This is a triple-blind, placebo-controlled, multicentric, randomized, phase II study. Patients with inoperable PM (all histologies) that completed 4-6 cycles of platinum-pemetrexed chemotherapy were randomized to nintedanib or placebo. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS) and safety. Results: The trial was prematurely closed due to poor accrual after LUME-meso reported. 37 patients were randomized (18 to nintedanib, 19 to placebo). All analyses performed were descriptive. The median PFS was 3.4 months (95% CI: 2.83-5.82) and 4.6 months (95% CI: 3.65-13.17) for nintedanib and placebo arms, respectively (HR = 2.25, 95% CI: 1.07-4.73) with corresponding median OS of 13.1 months (95% CI: 10.22-26.02) and 38.9 months (95% CI: 18.66-NE) for nintedanib and placebo arms, respectively (HR = 2.38, 95% CI: 1.05-5.43). Two patients (11.1%) in the nintedanib arm experienced ≥ grade 3 treatment-related adverse events. Post progression treatment was balanced between arms but more patients in the placebo arm received immunotherapy (87% vs 54%). Conclusions: Descriptive analyses suggest switch maintenance nintedanib does not improve PFS nor OS compared to placebo. Efficacy of the placebo arm may be related to imbalanced immunotherapy usage

Efficacy and Safety of Selexipag in Pulmonary Hypertension: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Selexipag, a selective prostacyclin receptor agonist, has been evaluated in randomized controlled trials (RCTs) for the treatment of pulmonary hypertension (PH), but results remain inconsistent. We performed an updated meta-analysis to assess its efficacy and safety. PubMed, Embase, and Cochrane databases were searched systematically from September 2025. Eligible studies were RCTs comparing selexipag with placebo in adults with PH. The primary outcome was the change in pulmonary vascular resistance (PVR). Secondary outcomes included 6-minute walk distance (6MWD), all-cause mortality, hospitalization for worsening PH, N-terminal pro-brain natriuretic peptide (NT-proBNP), serious adverse events (SAEs), and treatment-related adverse events (AEs). A random-effects meta-analysis was conducted using RevMan. Six RCTs enrolling 1686 patients were included. Selexipag therapy was associated with a statistically significant reduction in NT-proBNP (WMD = -150.19 pg/mL; 95% confidence interval [CI] -185.88 to -114.51), hospitalization for worsening PH (odds ratio [OR] = 0.63; 95% CI, 0.48-0.84), and SAEs (OR = 0.47; 95% CI, 0.38-0.59). Selexipag did not significantly reduce PVR (WMD = - 68.0 dyn·s·cm-5; 95% CI, -145.9 to 9.9) or improve 6MWD (WMD = -1.05 m; 95% CI, - 4.6 to 2.5), or mortality (OR = 0.80; 95% CI, 0.44-1.45) as compared with placebo. Selexipag reduces hospitalizations, SAEs, and NT-proBNP levels but shows no clear benefit on PVR or 6MWD. Future trials are needed to confirm these findings

Fatigue, patient safety and wellbeing in the clinical workforce (evidence summary)

This is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created

SFT KLS Newsletter - March 2026

The March edition of the Knowledge and Library Service newsletter from Somerset NHS Foundation Trust