Information anxiety (IA) describes the distress caused by the gap between the information individuals have and what they feel they should possess. In the current digital environment—marked by volatility, uncertainty, complexity and ambiguity—IA has expanded beyond traditional academic and workplace contexts to become a pervasive concern across populations. Mapping the empirical evidence on IA is critical to understanding its prevalence, determinants, impacts and coping strategies.

This protocol outlines a scoping review guided by the Joanna Briggs Institute methodology and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We will systematically search EBSCOhost, Scopus and Web of Science for peer-reviewed empirical studies published from 1 January 2000 to the planned end date of 5 November 2025. Two reviewers will independently screen records, with a third resolving discrepancies. Data extraction will be conducted using a customised tool, and results will be synthesised narratively and visually, structured around bibliometric characteristics, the Population, Concept, Context framework and a Stimulus-Organism-Response model. Subgroup analyses will be conducted across populations, disciplines and regions.

As this study is based on secondary analysis of published data, ethical approval is not required. Findings will be disseminated through peer-reviewed journals and academic conferences.

Treatment options remain limited for patients with advanced hepatocellular carcinoma (HCC) who experience oligoprogression during first-line systemic therapy (FLST), especially given the modest efficacy and restricted availability of second-line systemic therapy (SLST). This trial aims to evaluate whether continuing FLST combined with radiotherapy (RT) to oligoprogressive lesions can improve progression-free survival (PFS) compared with an early switch to SLST in patients with oligoprogressive HCC while maintaining an acceptable safety profile.

The continuation of first-line therapy with radiotherapy for oligoprogression versus early switch to second-line therapy in oligoprogressive hepatocellular carcinoma trial is a prospective, multicentre, randomised phase III study that will enrol 132 patients with advanced HCC who experience their first oligoprogression during FLST. Oligoprogression is defined as one to five progressive lesions involving no more than one to three organs. Participants will be randomised (1:1) to either continuation of FLST combined with RT to all oligoprogressive lesions or discontinuation of FLST followed by initiation of SLST. RT will be delivered with a biologically effective dose (linear–quadratic model, α/β=10) of at least 60 Gy whenever feasible. The primary endpoint is PFS. Secondary endpoints include overall survival, objective response rate, disease control rate, duration of response and quality of life. Predefined exploratory analyses include circulating tumour DNA profiling, optional paired tumour biopsies, functional imaging with fibroblast activation protein inhibitor positron emission tomography-CT and longitudinal immune profiling.

This study has been approved by the Ethics Committee of the Affiliated Cancer Hospital of Shandong First Medical University (number: SDZLEC2025-025-02) and has been registered in ClinicalTrials. gov (NCT06841172). Final study results will be disseminated through peer-reviewed journals.

NCT06841172.

Pain experienced during functional activities, referred to as movement-evoked pain (MEP), is a common and disabling symptom in individuals with knee osteoarthritis (KOA). Unlike pain at rest, MEP may better reflect the real-life burden of KOA and is increasingly recognised as a core outcome in musculoskeletal pain trials. However, its clinical utility remains limited by a lack of evidence on its measurement properties. This study aims to evaluate the test-retest reliability and validity of MEP assessments during functional tasks in individuals with KOA.

This study includes two components: (1) a test-retest reliability assessment conducted over two sessions separated by approximately 7 days and (2) a cross-sectional analysis of convergent validity. We will recruit 62 participants with symptomatic KOA from the local communities. MEP will be assessed using an 11-point Numeric Rating Scale during five standardised functional tasks: 30-Second Chair Stand Test, One-Step Stair Climb Test, 40m Fast-Paced Walk Test, Timed Up and Go Test and Six-Minute Walk Test. Test-retest reliability will be evaluated using intraclass correlation coefficients (ICC_3,1). Convergent validity will be assessed separately for each functional task by calculating correlation coefficients between MEP ratings and the pain subscale of the Knee injury and Osteoarthritis Outcome Score.

This study was approved by the Ethics Committee from Shanghai University of Sport (Ref: 102772025RT193). The study protocol was registered on the Open Science Framework (10.17605/OSF.IO/B9N7G). The findings will be disseminated through presentations at national and international scientific conferences and submitted for publication in a peer-reviewed journal.

Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, may benefit from immunomodulatory drugs. Nevertheless, numerous clinical trials of these drugs have failed to demonstrate efficacy, partly due to substantial heterogeneous treatment responses. Subgroup analyses from these trials are frequently employed to investigate different treatment effects across subgroups. However, which drugs might have different effects across subgroups and how credible these findings are have not been well summarised and evaluated. Additionally, the differences in the characteristics and results of subgroup analyses based on whether the primary trial’s main effect is statistically significant remain unclear. We will conduct a systematic review to comprehensively address these questions.

We will include randomised controlled trials (RCTs) evaluating immunomodulatory drugs for adult sepsis and exclude quasi-randomised trials, single-arm studies, animal research, conference abstracts, study protocols and non-English publications. To comprehensively search for subgroup analyses, we will search both RCTs and their published secondary analyses across PubMed, Embase, Web of Science, ClinicalTrials.gov and the Cochrane Library from their inception. Four reviewers will independently screen eligible studies and only one subgroup analysis will be selected for data extraction using standardised forms. The credibility of subgroup effects will be assessed using the Instrument for assessing the Credibility of Effect Modification Analyses. We will analyse the proportion and characteristics of subgroup analyses reported in trials. We will qualitatively summarise the results of subgroup analyses, focusing on findings with a subgroup-specific p value2 test or Fisher’s exact test, as appropriate.

No ethical approval is required because the data we will use do not include individual patient data. Findings will be disseminated through publication in a peer-reviewed journal.

CRD420251089737.

Chronic obstructive pulmonary disease (COPD) has an unpredictable clinical course, causing difficulties in short-term mortality prediction, overtreatment and delayed palliative care. Existing prediction models are limited and lack applicability to Chinese elderly patients with advanced COPD. Given the heavy disease burden and limited palliative care in China, we designed this multicentre cohort study to develop a 6-month mortality prediction model for elderly patients with advanced COPD to aid risk stratification, timely palliative care and efficient healthcare resource allocation.

Patient recruitment has been ongoing since May 2024 and will be completed by December 2026, with a 12-month follow-up to be completed by December 2027. Eligible patients are being enrolled, and multidimensional baseline data including demographic characteristics, clinical indicators, laboratory results, comprehensive geriatric assessment and COPD-specific prognostic factors are being systematically collected. All participants will receive 12 months of standardised follow-up (monthly for the first 6 months and quarterly thereafter) to monitor 6-month all-cause mortality (primary outcome), as well as survival duration, end-of-life healthcare utilisation and do-not-resuscitate status (secondary outcomes). After completion of data collection, we will employ multiple machine learning algorithms to develop and internally validate a 6-month mortality prediction model with pre-specified centres reserved for external validation. Model performance will be evaluated by discrimination and calibration and head-to-head comparisons with the Body Mass Index, Airflow Obstruction, Dyspnoea and Exercise Capacity (BODE) and Age, Dyspnoea and Airflow Obstruction (ADO) indices will be conducted to verify its clinical value. The findings will provide a China-specific prediction tool for elderly patients with advanced COPD to guide clinical intervention, palliative care referral and healthcare resource allocation.

This study was approved by the Biomedical Ethics Review Committee of West China Hospital, Sichuan University (No. 2024-2662) and registered at ChiCTR2500100351. Informed consent is being obtained from all participants. Results will be published in peer-reviewed journals and presented at academic conferences.

ChiCTR2500100351.

The purpose of this study is to evaluate the relationship between psychosocial factors, muscle performance and treatment response in individuals undergoing an exercise-based physical therapy (EBPT) programme for chronic low back pain (CLBP).

A secondary analysis of a prospectively collected clinical registry involving participants with CLBP enrolled in an 8–10-week EBPT programme. Participants completed psychosocial questionnaires before starting EBPT for CLBP. Lumbar extensor muscle performance was assessed using an isokinetic dynamometer, which recorded absolute and age and sex adjusted torque. Differences in muscle performance (absolute and adjusted) were calculated and regressed against psychosocial factors and clinical outcomes.

Absolute and adjusted torque increased with treatment (33.33% and 82.84% respectively, p0.20).

Individuals with CLBP demonstrated improved muscle performance and clinical outcomes after EBPT, though these improvements were independent of each other. Better absolute lumbar extensor muscle performance correlated with higher pain self-efficacy, and greater treatment response corresponded with lower fear-avoidance. These data suggest that pain coping strategies and addressing fear avoidance through educational and exposure-based interventions may be a target for modifying muscle performance in CLBP.

Metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH), is the hepatic manifestation of the metabolic syndrome. When it co-occurs with type 2 diabetes (T2DM), it presents a significant therapeutic challenge due to a higher risk of fibrosis progression and adverse outcomes. While new treatments for MASH are emerging, their efficacy in the T2DM subpopulation remains an unmet need. Chiglitazar is a novel peroxisome proliferator-activated receptor pan-agonist that regulates key pathways in lipid metabolism, glucose homeostasis and inflammation. This trial aims to evaluate the efficacy and safety of chiglitazar as a combination therapy for patients with MASH and T2DM.

This is a prospective, multicentre, randomised, double-blind, placebo-controlled study. This trial will enrol 300 adult patients aged 18–75 years with biopsy-confirmed MASH and fibrosis stage F1 or higher. Participants will be randomised (1:1) to receive either chiglitazar 48 mg daily or a matching placebo. All participants will also receive background therapy consisting of vitamin E (100 mg three times a day) and polyene phosphatidyl choline (456 mg three times a day). The treatment duration is 78 weeks. The primary efficacy endpoint is resolution of steatohepatitis with no worsening of liver fibrosis. Key secondary endpoints include improvement in liver fibrosis by at least one stage and changes in metabolic and liver safety biomarkers.

Ethical approval has been obtained from the Shanghai Punan Hospital of Pudong New District Ethics Committee (Punan Branch of Renji Hospital Ethics Committee, Shanghai Jiaotong University School of Medicine). KY2025-066. The findings will be disseminated through publication in peer-reviewed journals and presentations at scientific conferences.

NCT07303803.

In the face of pandemics resulting from infectious disease, improving community resilience has become increasingly vital. China’s sudden exit from Zero-COVID policy in December 2022 triggered a surge in COVID-19 cases, compounded by medication shortages due to earlier restrictions, creating a public health crisis. This study assesses community resilience during the first post-Zero-COVID infection wave (8 December 2022 to 7 January 2023), focusing on adaptation mechanisms, resource mobilisation, protective behaviours and medicine access, using real-time social media data to capture these dynamics.

This cross-sectional study analysed all geotagged COVID-19-related posts on Sina Weibo—China’s largest public microblogging platform—collected from a megacity in eastern China with over 10 million residents, covering 8 December 2022 to 7 January 2023. Posts were obtained through a data purchase agreement with Sina Weibo and comprised publicly available content. Machine learning and natural language processing were applied to classify posts across four dimensions: content, responder, response type and time. Community resilience was assessed using the community-level response ratio, response speed and sentiment expressed in interactions related to medicine-seeking posts.

26 973 posts were analysed, of which 12 152 (45.05%) were help-seeking. Among these help-seeking posts, 11 236 (92.46%) specifically sought COVID-19 medicine, of which 8495 (75.61%) of these medicine-seeking posts received community support. Over 4 weeks, community responses comprised >70% of all replies (the rest were from market-based responders, government and NGOs). More than half of the community responses occurred within an hour, and the emotional state at the community level was the most stable and consistently positive, indicating a high level of prompt community engagement.

Communities in the sample area consistently exhibited prompt and proactive responses during the health crisis, with community responses accounting for the majority of interactions on medicine-seeking posts. The power of community mutual aid can significantly enhance responsiveness to public health emergencies. Such insights suggest that strengthening community resilience is crucial in designing more effective disaster response strategies.

Chronic obstructive pulmonary disease (COPD) is frequently accompanied by anxiety, depression and impaired health-related quality of life (HRQoL). Psychological comorbidities worsen symptom burden, daily functioning and self-management and are associated with more frequent exacerbations and higher mortality. Digital cognitive behavioural therapy (dCBT), in which core cognitive behavioural therapy (CBT) content is delivered predominantly via web-based or app-based platforms, offers a potentially scalable approach to addressing these needs. However, no systematic review and meta-analysis has yet synthesised randomised controlled trial (RCT) evidence on the effects of dCBT on patient-reported outcomes (PROs) in adults with COPD. This protocol describes the planned methods for such a review.

We will include RCTs enrolling adults (≥18 years) with COPD that compare dCBT with usual care, wait-list, attention control, non-CBT psychological or educational interventions, or other non-CBT digital interventions. For this review, dCBT will be defined as an intervention that explicitly states a CBT framework or CBT techniques, delivers most therapeutic content through digital platforms and uses digital CBT as the principal active component. Blended or multicomponent programmes will be eligible only when the dCBT component is clearly identifiable and central to the intervention. The primary outcomes will be PROs assessed by validated PRO measures, including disease-specific or generic HRQoL and psychological symptoms (anxiety and depression). Secondary outcomes will include other PROs such as disease-specific symptom burden, psychological distress or well-being, and self-efficacy where reported. We will search PubMed, Embase, the Cochrane Library, Web of Science, PsycINFO, CNKI, Wanfang Data and SinoMed from inception to 30 November 2025, without language restrictions. Two reviewers will independently screen studies, extract data and assess risk of bias using the Cochrane Risk-of-Bias 2 tool. Where appropriate, we will conduct random-effects meta-analyses, with subgroup, sensitivity and (if feasible) meta-regression analyses to explore heterogeneity. The certainty of evidence for key outcomes will be graded using the Grading of Recommendations Assessment, Development and Evaluation approach.

This systematic review and meta-analysis will use data extracted exclusively from published randomised controlled trials and other publicly available sources. No new data will be collected directly from individual participants, and no identifiable personal information will be obtained; therefore, formal approval from a research ethics committee and informed consent are not required. The review will be carried out in accordance with established methodological guidance for systematic reviews and meta-analyses. The findings will be disseminated through peer-reviewed publication and conference presentations, and review-related data will be curated and made available as appropriate in the final report.

CRD420251246582.

Mechanical ventilation during patient transport is a high-risk clinical practice. While the novel Mindray TV80, a high-performance emergency transport ventilator, offers potential advantages for use across complex transport settings, rigorous clinical data comparing its oxygenation performance in critically ill, mechanically ventilated patients during transport are lacking. This study aims to address this gap by evaluating the non-inferiority of TV80 to Hamilton T1 in maintaining oxygenation stability.

This is a prospective, single-blind, single-centre, parallel-group, non-inferiority randomised controlled trial. Mechanically ventilated patients (18–80 years) requiring intrahospital or interhospital transport will be recruited. Eligible patients will be randomised at a 1:1 ratio to the TV80 group (intervention) or Hamilton T1 group (control) using a permuted block design stratified by transport type (intrahospital vs interhospital) via the electronic data capture system. The intervention involves using the assigned ventilator during transport, with parameters replicated from the patient’s pre-transport ventilator. The primary outcome is the difference in oxygenation index (P/F) before (within 1 hour) and after (within 1 hour) transport as measured by blood gas analyser. Continuous SpO₂ monitoring will be performed throughout the transport period to capture real-time oxygenation changes. Secondary outcomes include transport preparation time, changes in PaCO₂ and pH, variability of ventilator parameters (tidal volume, FiO₂) and vital signs (heart rate, SpO₂, mean arterial pressure) and incidence of adverse events (AEs)/serious AEs. Sample size is 98 (49 per group) to achieve 80% power with a non-inferiority margin of –30 mm Hg. Pre-specified subgroup analyses by transport type will be performed.

This study has been approved by the Human Research Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (approval number: LSY-2025-0903). Written informed consent will be obtained from participants’ legal representatives. All results will be submitted to a peer-reviewed journal for publication.

NCT07198269 (ClinicalTrials.gov).

(1) To compare the ability of body mass index (BMI), waist-to-height ratio and visceral fat, as measured by bioelectrical impedance analysis (BIA), to predict hypertension and diabetes in men and women and (2) to determine whether the correlation between BMI and visceral fat varies by height quantile.

We conducted a cross-sectional analysis of a representative survey that included data on anthropometrics, body composition, glycosylated haemoglobin and blood pressure. We used receiver operating characteristic analysis and DeLong CIs to compare the ability of each adiposity measure to predict diabetes and hypertension in each gender.

Tecpán and San Antonio Suchitepéquez, Guatemala.

806 non-pregnant adults from 347 households, primarily of Indigenous ethnicity.

Diabetes, defined as a haemoglobin A1c of greater than 6.5% or self-reported history and hypertension, defined as a systolic blood pressure over 140 or a diastolic blood pressure over 90.

Among the three adiposity measures, visceral fat was the best predictor of diabetes (area under the curve; AUC 0.73 (95% CI 0.66 to 0.81) (men); AUC 0.75 (95% CI 0.7 to 0.8) (women)) and hypertension (AUC 0.7 (95% CI 0.61 to 0.79) (men); AUC 0.76 (95% CI 0.7 to 0.82) (women)), followed by waist-to-height ratio followed by BMI. All three measures better predicted hypertension in women than in men. In sensitivity analysis, visceral fat and waist-to-height ratio better predicted hypertension and diabetes when BMI was below 30 kg/m². The correlation between BMI and visceral fat did not vary appreciably by height.

Of the three adiposity measures studied, BIA-derived visceral fat best predicted cardiometabolic disease in the population. In clinical practice, alternative techniques beyond BMI need to be considered when assessing adiposity, screening for cardiometabolic disease and diagnosing clinical obesity.