Postoperative depressive symptoms are common after breast cancer surgery and can adversely affect recovery and quality of life. This multicentre trial aims to determine whether a single intraoperative subanaesthetic dose of esketamine, as an adjunct to antidepressant therapy, improves postoperative depressive outcomes at postoperative day (POD) 30.

This multicentre, prospective, randomised, triple-blind, placebo-controlled trial will enrol 824 women aged 18–80 years with stage I–III breast cancer (American Society of Anesthesiologists physical status I–III) who are scheduled to undergo surgery. Participants will be randomised 1:1 to receive 0.2 mg/kg esketamine or an equivalent volume of normal saline after anaesthesia induction and before surgical incision. The primary outcome is the incidence of depressive symptoms at POD 30, assessed using the Hospital Anxiety and Depression Scale Depression (score ≥8). Secondary outcomes include acute and chronic pain, and anxious symptoms, etc. Primary analysis will use a generalised linear mixed model with a logit link on an intention-to-treat basis.

The study protocol has been formally approved by the institutional ethics committee of the National Cancer Center (Approval No.25/483-5429). Written informed consent will be obtained from all participants prior to enrolment. Results will be disseminated through peer-reviewed journals and international scientific conferences.

ChiCTR2600117573.

To examine the associations between social isolation (SI) and mental health, health behaviours and diabetes management among older adults with diabetes in South Korea, focusing on gender-specific syndemic patterns.

Cross-sectional secondary analysis.

2023 Korea Community Health Survey, a nationwide community-based survey.

18 924 adults aged ≥65 years with physician-diagnosed diabetes.

Mental health (depressive symptoms, perceived stress), health behaviours (smoking, high-risk drinking, physical activity) and diabetes management (medication use, complication screening, diabetes education) were assessed. Multivariable logistic regression was used to estimate the adjusted associations between SI and study outcomes.

SI was more prevalent among women (33.6%) than among men (14.1%). In men, SI was associated with depressive symptoms (aOR=1.60, 95% CI 1.18 to 2.18, p=0.003), smoking (aOR=1.51, 95% CI 1.25 to 1.82, p

SI was associated with poorer mental health and unhealthy behaviours among older adults with diabetes, with distinct gender-specific patterns. The SI also showed non-uniform associations with diabetes management, indicating that its impact may differ across management domains. Addressing SI may support improvements in selected aspects of diabetes care. Further research should clarify the mechanisms linking SI and disease management.

To investigate whether pneumoconiosis increases the risk of cataract.

Nationwide population-based retrospective cohort study.

Taiwan’s National Health Insurance database, which covers >99% of the population.

The study included 19 841 adults newly diagnosed with pneumoconiosis between 2001 and 2020 and 79 364 age-matched and sex-matched individuals without pneumoconiosis. Participants with a prior history of cataract were excluded.

The primary outcome was incident cataract identified through International Classification of Diseases diagnostic codes. Subgroup analyses were performed to evaluate cataract risk across different strata of age, sex and comorbidity. In addition, among patients with pneumoconiosis, we conducted a secondary analysis evaluating the association between systemic corticosteroid use and cataract development.

During follow-up, the incidence of cataract was significantly higher in the pneumoconiosis cohort (38.9 vs 35.3 per 1000 person-years). Patients with pneumoconiosis had an increased risk of cataract after adjustment for age, sex and comorbidities (adjusted HR (aHR)=1.22, 95% CI 1.18 to 1.26). Elevated risks were observed in both men (aHR=1.22, 95% CI 1.18 to 1.26) and women (aHR=1.20, 95% CI 1.13 to 1.29). All age groups showed increased risks, with the highest estimate observed among patients aged ≥75 years (aHR=1.24, 95% CI 1.19 to 1.30). Subgroup analyses showed an increased risk in patients with pneumoconiosis who had no comorbidities (aHR=1.12, 95% CI 1.07 to 1.18). In a secondary analysis, systemic corticosteroid exposure was not significantly associated with cataract development (adjusted OR=0.65, 95% CI 0.39 to 1.09).

Pneumoconiosis is associated with an increased risk of cataract. Routine ophthalmologic surveillance should be considered in pneumoconiosis management.

Programmes based on early childhood development (ECD) services play a vital role in improving child health and developmental outcomes. Across many countries, these programmes target children under 5 years of age—including those who are healthy, at risk or with developmental disorders—and are implemented in governmental and non-governmental organisations in both the health and non-health sectors globally. This protocol outlines a scoping review designed to systematically map and synthesise existing evidence on the components, implementation strategies and delivery mechanisms of ECD services worldwide. The review aims to inform the development of optimised and comprehensive interventions that support holistic child development.

This review will be conducted by Arksey and O’Malley’s framework and its recent advances. Several databases, including PubMed/MEDLINE, Scopus, Science Direct and Web of Science, Scientific Information Database, Magiran, IranMedex and Barakat knowledge network system, will be initially searched for studies up to December 2024. All searches will be done for published or unpublished articles/reports without time and language restrictions. Two researchers will independently carry out screening of the included studies and extraction of data. Any discrepancies will be resolved by consensus. In case no initial consensus is reached, a third researcher will be consulted to make a decision. The findings will be synthesised through the content-analysis method.

The findings of this review may offer a novel perspective for developing a comprehensive package of ECD services within the Iranian health system. Furthermore, it provides a detailed roadmap for researchers and stakeholders aiming to enhance child health and prevent developmental disorders. This study received ethical approval from Tabriz University of Medical Sciences (ID: IR.TBZMED.REC.1404.139), with no ethical concerns as it involves no patient participation or interventions.

Transporting critically ill patients between medical facilities can be hazardous and costly. Whether by road, fixed-wing aircraft or helicopter, many professional associations have proposed strategies to efficiently and safely transport patients at high risk of instability. Although these strategies have been assessed in some studies, no comprehensive synthesis of their benefits has been conducted to date. The aim of this study is to assess the effect of strategies to improve the safety and costs of interhospital transports for critically ill patients.

We will conduct a systematic review according to the Cochrane guidelines. The review will include randomised controlled trials (RCTs), cohort studies and case-control studies assessing the effect of interventions to improve interhospital transports of critically ill patients on safety and costs. We will search multiple electronic databases (PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library) from inception to 6 months prior to the submission of the final manuscript. Screening by title and abstract, full-text screening, data extraction and quality assessment will be performed by two independent reviewers. We will assess the risk of bias with the Cochrane revised tool for RCTs and with the risk of bias in non-randomised studies of interventions tool. If possible, we will calculate pooled effect estimates and 95% CIs to assess the effect of the interventions. We will also assess heterogeneity using the I² index and rate the certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation tool and trial sequential analysis.

Ethics approval is not required for this review. The results of this systematic review will be shared through publication in a peer-reviewed journal, conference presentations and our network of knowledge user collaborators.

International Prospective Register of Systematic Reviews (CRD42024595080).