International migrants comprise 3.6% of the global population and face systemic barriers to accessing sexual and reproductive health (SRH) services, such as contraception, safe abortion care and sexual function support. In high-income countries, policy frameworks vary widely, with migration status significantly influencing entitlement and access to host countries. This protocol outlines a planned study to systematically analyse SRH policies in high-income countries with strong migrant integration frameworks, aiming to identify policy gaps, assess inclusivity and inform recommendations to strengthen Australia’s SRH policy landscape.

This study employs a systematic policy analysis using the Joanna Briggs Institute scoping review methodology. Countries with ≥10% migrant populations and a Migrant Integration Policy Index health score ≥70 will be included. 13 countries meet these criteria, including Australia, Canada and Sweden. A comprehensive search of academic databases (PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature and ProQuest Public Health) and grey literature from governmental and non-governmental sources will be conducted. Data extraction will follow Bacchi’s ‘What’s the Problem Represented to Be?’ approach. Thematic analysis will combine deductive and inductive methods to examine the extent to which SRH policies address migrant and refugee needs, including sexual function, safe abortion care and fertility care. A comparative policy matrix will identify strengths, limitations and best practices.

As this study analyses publicly available policy documents, ethics approval is not required. Findings will be disseminated through peer-reviewed publications and policy briefs targeting stakeholders involved in SRH policy and migrant health.

This protocol is registered with the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/AYZ6P

Dexamethasone is commonly used to prevent postoperative nausea and vomiting (PONV). However, PONV is an unresolved complex problem; even with preoperative dexamethasone administration, 14.0%–26.3% of patients undergoing minimally invasive endoscopic procedures still experience PONV within 24 hours postoperatively. Compared with dexamethasone, dexamethasone palmitate has a long-lasting anti-inflammatory effect, two to five times that of traditional water-soluble dexamethasone, with fewer adverse events. This trial aims to assess the efficacy and safety of preoperative dexamethasone palmitate administration on postoperative PONV.

The INDEX trial is a multicentre, open-label, randomised, positive-controlled trial. A total of 588 patients will be recruited from three centres in China. Eligible patients are adults (aged 18–65 years) who undergo elective minimally invasive endoscopic surgery (laparoscopic or thoracoscopic surgery) under general anaesthesia. Eligible patients will be randomly assigned (1:1) to the dexamethasone palmitate or dexamethasone group. Patients in the dexamethasone palmitate group will receive intravenous injection of 8 mg of dexamethasone palmitate (containing 5 mg of dexamethasone), and those in the dexamethasone group will receive 5 mg of dexamethasone after anaesthesia induction and before surgical incision. The primary endpoint will be the incidence of PONV within the first 24 hours postoperatively. Secondary outcomes will include the incidence of PONV, postoperative nausea, postoperative vomiting, number of vomiting or retching episodes, severity of PONV, participant satisfaction, use of rescue antiemetic drugs and quality of postoperative recovery. The safety of participants will be monitored. A primary analysis will be conducted to evaluate between-group differences in the incidence of PONV in the intention-to-treat population and within the first 24 hours postoperatively. We will also perform a sensitivity analysis to evaluate the effect of missing values in the outcome parameters on the results. There is no plan to conduct an interim analysis.

Ethical approval was obtained from the Institutional Review Board of Beijing Tiantan Hospital Affiliated to Capital Medical University (KY 2025-041-02-01). The results will be disseminated in open-access publications and plain-language summaries.

NCT06981754

Secondary prevention strategies for coronary heart disease (CHD) can play a crucial role in averting acute coronary events and enhancing the overall well-being of CHD patients. This study aimed to investigate the knowledge, attitude and practice (KAP) of CHD patients in Shandong Province, China, toward secondary prevention medication regimens for CHD.

A multi-centre cross-sectional study.

Using a self-administered questionnaire.

This survey was conducted between October 2023 and February 2024 across four tertiary hospitals in Shandong Province, including the Provincial Hospital Affiliated with Shandong First Medical University, Qilu Hospital of Shandong University, Jinan Central Hospital and Jinan Fourth People’s Hospital.

The KAP of CHD patients toward secondary prevention medication regimens.

A total of 495 participants were finally enrolled, 347 (70.1%) were male and 248 (50.1%) were aged greater than or equal to 65 years. The mean score of KAP was 6.73 (5.19) (range: 0–20), 29.15 (3.81) (range: 7–35) and 28.61 (3.90) (range: 7–35), respectively. The structural equation model demonstrated that knowledge had a direct effect on attitude (β=0.427, p

CHD patients demonstrated insufficient knowledge, positive attitude and proactive practice toward secondary prevention medication regimens for CHD. It is recommended that healthcare providers implement targeted educational interventions to enhance patients’ knowledge levels regarding secondary prevention medication regimens for CHD.

Talaromycosis is a severe fungal infection caused by Talaromyces marneffei that predominantly affects people living with HIV (PLWH), particularly in southern China where it contributes substantially to AIDS-related mortality. While liposomal amphotericin B (L-AMB) is preferred for induction therapy due to its superior safety profile over conventional amphotericin B deoxycholate (AmBD), the efficacy of a single high-dose L-AMB regimen in talaromycosis remains unestablished. Furthermore, current guidelines recommend initiating antiretroviral therapy (ART) within 1 week of antifungal treatment, though real-world evidence in Chinese populations is limited. This study aims to evaluate the efficacy and safety of single high-dose L-AMB for AIDS-associated talaromycosis and provide clinical evidence on early initiation of bictegravir/emtricitabine/tenofovir alafenamide fumarate (B/F/TAF) in this population.

This multicentre, randomised controlled phase II clinical trial compares the efficacy and safety of single high-dose L-AMB (10 mg/kg), followed by itraconazole capsule 200 mg every 12 hours for the remaining 13 days of induction therapy, versus AmBD (0.5 mg/kg/day for 14 days) as induction therapy for AIDS-associated talaromycosis in PLWH adults with microbiologically confirmed diagnosis. Eligible participants (n=116) will be randomly assigned (1:1) at four Chinese centres to receive either treatment, followed by 10 weeks of itraconazole capsule consolidation therapy and secondary prophylaxis until CD4+ T-lymphocyte counts exceed 100 cells/mm³ for ≥6 months, with ART initiated within 7 days of antifungal treatment according to current ART guidelines. The primary endpoint is clinical resolution rate after induction, while secondary endpoints include overall survival, organ function recovery and adverse event incidence.

This study was approved by the Institutional Review Board of Shanghai Public Health Clinical Centre (Approval No. 2025-S039-01) and the ethics committees of all participating study centres: Guiyang Public Health Treatment Centre, Mengchao Hepatobiliary Hospital of Fujian Medical University and Chest Hospital of Guangxi Zhuang Autonomous Region. All procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki and national regulations. Written informed consent was obtained from all participants prior to enrolment. The findings of this study will be disseminated through publications in international peer-reviewed journals and presentations at scientific conferences. Participants who express interest in the study results will be provided with a summary report following the release of the primary findings.

ClinicalTrials. gov NCT06926569.

This study aims to assess the burden and predictors of age-related macular degeneration (AMD) among older age patients with diabetes attending comprehensive specialised hospitals in Northwest Ethiopia.

A multicentre cross-sectional study was conducted among older patients with diabetes using a systematic random sampling technique.

The study was conducted at five comprehensive specialised hospitals in Northwest Ethiopia from 8 May to 8 June 2023.

The study included 832 diabetic individuals aged 40 years and above.

Data were collected using a pretested structured questionnaire and physical examinations.

In this study, a total of 832 participants were involved, with a response rate of 96.85%. The burden of AMD was 15.4% (95% CI 13.0% to 18.0%). Male sex (adjusted OR (AOR) 2.04, 95% CI 1.17 to 3.56), older age (AOR 6.91, 95% CI 3.17 to 15.08), diabetes duration of 10 and more years (AOR 3.00, 95% CI 1.91 to 4.69), higher body mass index (AOR 2.56, 95% CI 1.15 to 5.71), presence of hypertension (AOR 2.45, 95% CI 1.56 to 3.85) and family history of diabetes mellitus (DM) (AOR 2.29, 95% CI 1.40 to 3.76) were positively associated with AMD.

This study found that the prevalence of AMD among patients with diabetes was 15.4%. Older age, male sex, longer DM duration, higher body mass index, presence of hypertension and family history of DM were significantly associated with AMD. Targeted screening of at-risk individuals for AMD, public health awareness campaigns focusing on these factors and further research to understand the burden and underlying mechanisms of these associations with AMD are recommended.

Mistreatment and obstetric violence constitute significant human rights violations with profound implications for maternal mental health. These detrimental practices persist globally, particularly in contexts where underfunded health systems, workforce shortages and entrenched gender inequalities intersect, depriving women of adequate psychosocial support and culturally sensitive mental healthcare. Although awareness of the immediate harms of mistreatment is increasing, its cumulative effects throughout the maternal care continuum remain insufficiently understood. This review will synthesise evidence on the impact of mistreatment on perinatal mental health, identify critical gaps and advocate for systemic change.

This systematic review and meta-analysis protocol complies with the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. A thorough literature search will be executed across multiple electronic databases, including CINAHL—Cumulative Index to Nursing and Allied Health Literature, Embase via Ovid, MEDLINE, PsycInfo, PubMed, Scopus, as well as other significant or specialised databases and grey literature. The review will incorporate only non-randomised study types and observational studies (cohort, cross-sectional, case-control), along with mixed-method and qualitative studies. Abstract and full-text screening will be performed by two reviewers using Covidence. The methodological quality of the included studies will be assessed using the Newcastle-Ottawa Scale for observational studies, the Risk of Bias in Non-Randomised Studies of Interventions, the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Statistical heterogeneity will be evaluated using the Higgins test. Meta-analysis will be conducted using R statistical software V.4.4.4, employing random effects models to determine the weights. The study results will be reported sequentially, beginning with primary outcomes, followed by secondary outcomes and significant subgroup outcome analyses.

Ethical approval is not required as no original data will be collected. The findings of this review will be disseminated through publication and conference presentations.

CRD420251044379.

To investigate the occurrence of unintentional injuries among children aged 3 to 12 in China over the past 5 years, and to provide a scientific basis for the prevention and control of such injuries.

A systematic review and meta-analysis. A random-effects model was specified a priori to synthesise study estimates given anticipated clinical and methodological heterogeneity across studies.

We searched CNKI, WanFang and PubMed for studies published between 1 January 2018 and 30 June 2024.

We included observational studies conducted in China with children aged 3–12 years, reporting incidence or person-time incidence of unintentional injuries and using clear injury definition criteria. Exclusion criteria included reviews, studies on special populations, duplicated datasets or incomplete data.

Two independent reviewers screened studies, extracted data and assessed study quality using Loney’s criteria. Heterogeneity was quantified with the I² statistic and Q test. Publication bias was assessed with funnel plots, Egger’s regression and fail-safe N. Certainty of evidence for primary outcomes was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

A total of 16 studies involving 37 877 participants were included. The results indicated that the combined effect size of the incidence of unintentional injuries among children aged 3 to 12 in China was 14.0% (95% CI 9.5% to 20.3%), and the person-time incidence was 15.3% (95% CI 8.6% to 25.8%), with falls demonstrating the highest combined effect size. Further subgroup analysis revealed several trends: the incidence of unintentional injuries was higher in boys (16.1%) than in girls (11.2%), among children aged 3–6 years (15.2%) compared with those aged 6–12 years (12.4%), in the western region (14.3%) versus the eastern region (13.1%) and when applying the 1996 injury criteria (17.7%) compared with the 2004 criteria (15.6%). All differences were statistically significant (p

The incidence of unintentional injuries among Chinese children aged 3–12 remains high, especially from falls. Injury rates differ significantly by gender, age, region and other factors. Future efforts should prioritise the safety of kindergarten children in western China, with a strong emphasis on preventing falls, which are a common type of injuries among children.

CRD42024604890.

To characterise the aetiological spectrum of thoracic granulomatous diseases and identify diagnostic features that facilitate differentiation among causes.

Retrospective multicentre observational study.

Two tertiary hospitals in south-central China. Patient data were consecutively enrolled from 1 June 2020 to 30 June 2023.

Of 2486 patients with pathologically confirmed thoracic granulomas initially identified, exclusions were applied for specimens outside the lung/pleura/mediastinum (579), incomplete demographic/imaging/pathology data (280) or lack of follow-up (231). A total of 1396 patients met all criteria (853 from hospital 1 and 543 from hospital 2) and were included in the final analysis.

We quantified the aetiologic distribution of thoracic granulomatous diseases and examined age-stratified/lesion-location differences in aetiologic patterns. We also evaluated associations between histopathological features and specific aetiologies and compared the diagnostic accuracy across sampling modalities.

Among the 1396 enrolled cases, a confident, probable and uncertain diagnosis was made in 1086 cases, 307 cases and 84 cases. Infectious granulomas predominated (89.4%; 1248/1396), with tuberculosis comprising 87.8% (1096/1248) of infectious cases. Among non-infectious granulomas, sarcoidosis was most common (65.8%; 50/76). Patients aged ≥60 years had a higher proportion of infectious granulomas than younger groups (≥60 years: 389/422; 40–60 years: 633/714;

Most thoracic granulomas arise from mycobacterial or fungal infection, while sarcoidosis is the leading non-infectious cause. Thoracoscopy and surgical biopsy show superior diagnostic yields, and special staining aids differentiation of fungal aetiologies. Findings support a multidisciplinary approach to improve diagnostic accuracy.

Post-stroke patients with sarcopenia commonly exhibit impaired postural control and balance, which elevates fall risk and diminishes quality of life. This study investigates if combining Tai Chi with Dynamic Neuromuscular Stabilization (DNS) has synergistic benefits for neuromuscular control, core stability and balance in post-stroke patients with sarcopenia. Tai Chi enhances dynamic balance and lower limb strength through controlled weight-shifting movements. In contrast, DNS aims to restore neuromuscular synergy and regulate intra-abdominal pressure. It applies principles from developmental kinesiology. This study seeks to determine whether the combined intervention demonstrates significantly greater improvements in postural stability relative to isolated interventions or conventional rehabilitation approaches.

A single-blind randomised controlled trial will recruit 60 post-stroke patients with sarcopenia, randomly allocated into four groups: Tai Chi, DNS, Tai Chi+DNS and a control group (receiving conventional rehabilitation). Interventions will be conducted over 5 weeks, with primary outcomes evaluated using the Berg Balance Scale and Trunk Impairment Scale. Secondary outcomes comprise metrics from the Balance Manager System, 30-second Chair Stand Test, Timed Up and Go Test, bioelectrical impedance-derived phase angle, Modified Falls Efficacy Scale and Geriatric Depression Scale-Short Form.

The Ethics Committee of the Second Rehabilitation Hospital of Shanghai has approved this study. The findings will be distributed by publication in indexed journals and presentation at global academic forums.

ChiCTR2500102577.

We aimed to examine the associations of handgrip strength and walking pace with the risk of incident diabetes mellitus (DM) among people with HIV (PWH).

A cohort study.

This study was conducted in Taizhou City Center for Disease Control and Prevention in Zhejiang Province, mainland China.

A total of 1916 participants (mean age 43.3±14.2 years, 77.7% male) without diagnosed or unknown DM at baseline from the Comparative HIV and Aging Research in Taizhou cohort were included.

The primary outcome was incident DM, defined by fasting glucose >7.0 mmol/L, HbA1c concentration >6.5% or diagnosed with DM by a doctor during the period of follow-up.

During a mean follow-up of 3.2 years, 184 incident DM cases were identified. Overall, there was a significant inverse association between both handgrip strength and walking pace with the risk of incident DM in PWH. Compared with participants with lower handgrip strength (

Higher handgrip strength or faster walking pace was significantly associated with a reduced risk of incident DM among PWH.