This study aimed to identify and validate risk factors for suicidal ideation (SI) and non-suicidal self-injury (NSSI) among nursing staff through the development and application of a risk model and nomogram.

A cross-sectional online survey was conducted in Dehong District to collect relevant data.

A total of 1774 Chinese nursing staff members were enrolled in this study.

Multiple factors were independently associated with SI among nursing staff. These included divorce or other non-marital status (OR=2.42, 95% CI 1.07 to 5.44), drinking frequency (OR=1.34, 95% CI 1.001 to 1.79), loneliness (OR=1.26, 95% CI 1.11 to 1.44), depressive symptoms (OR=1.13, 95% CI 1.09 to 1.18), childhood trauma (OR=1.03, 95% CI 1.02 to 1.05) and life quality satisfaction (OR=0.63, 95% CI 0.49 to 0.80). Similarly, for NSSI among nursing staff, independent risk factors were identified, such as smoking frequency (OR=1.37, 95% CI 1.01 to 1.85), drinking frequency (OR=1.42, 95% CI 1.05 to 1.91), loneliness (OR=1.21, 95% CI 1.05 to 1.39), depressive symptoms (OR=1.13, 95% CI 1.09 to 1.18) and childhood trauma (OR=1.03, 95% CI 1.01 to 1.05). A nomogram for assessing SI/NSSI was established and demonstrated good calibration, with a Concordance Index of 0.82 (95% CI 0.79 to 0.86) for SI and 0.81 (95% CI 0.78 to 0.85) for NSSI.

The findings of this study can be used to identify nursing staff at risk of developing SI/NSSI. By using the developed nomograms for self-assessment, individuals might gain a better understanding of their occupational stress levels while performing routine work tasks. However, it should be noted that the study lacks external validation, which limits the generalisability of the findings at this stage.

First-degree relatives of colorectal cancer (CRC) patients have a twofold to fourfold increased risk of CRC. Tailored communication interventions have shown efficacy in improving their risk awareness and screening participation. While computer-based tailoring systems offer convenience, they often overlook the integration of healthcare professionals’ verbal input, potentially limiting effectiveness and long-term impact. To address this gap, we developed ScreenTalk, an intelligent voice-interactive tailored communication system that employs intelligent speech interaction to automate the tailoring process, enhance message credibility and improve scalability within CRC screening workflows.

This study is a two-arm, cluster-randomised controlled trial with a hybrid type I design involving 314 participants across three tertiary general hospitals in Guangzhou, China. Participants in both groups will receive usual care. Additionally, the intervention group will receive a 1-month tailored intelligent voice-interactive intervention, whereas the control group will receive unrelated health education to control for attention. Screening uptake (primary outcomes) and health beliefs (secondary outcomes) are measured at baseline and at 3 months, 6 months, 9 months and 12 month post the intervention. Implementation outcomes including reach, implementation, adoption and maintenance will be assessed through questionnaire, qualitative interviews and tailored system record.

The trial has been approved by the Ethics Committee of the Sun Yat-sen University (IRB No. L2024SYSU-HL-054). Information on the purpose and process of this study will be provided to the participants before recruitment, and written signatures will be collected from all participants to ensure their voluntary participation and protection of their rights and privacy.

NCT06710860 on ClinicalTrials.gov. Registered 26 November 2024. Date and version: 3.0, 14 July 2025.

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

The development of myopia is subject to individual genetic predisposition and environmental risk exposures. This study aims to investigate the trajectories and predictors of spherical equivalent (SE) among multiethnic school-aged children in Southwest China.

The school-based cohort study was conducted from October 2020 to March 2023 in Yunnan province, Southwest China. Ocular examinations and questionnaire surveys were administered at each visit. A total of 679 students with complete records from all three visits were included in the final analyses. Group-based trajectory modelling was used to identify SE trajectories. Associations between the trajectory groups and baseline predictors were assessed using multinomial logistic regression.

We identified two distinct trajectory groups of SE in grades 2–3: slow progressive (84.4% of students) and rapid progressive (15.6%). Multivariate analysis indicated that children with myopic parents and those who often stayed in the classrooms during recess were more likely to belong to the rapid progressive group. By contrast, three trajectory groups of SE were identified in grade 7: slow progressive (52.3% of students), moderate initial and rapid progressive (33%) and low initial and rapid progressive (14.7%). In multivariate models, being a girl, having myopic parents, using mobile screens for more than 0.5 hours per day and often staying in the classrooms during recess were predictors of the progressive groups. Moreover, there were no significant differences in SE trajectories between Han and ethnic groups.

There is heterogeneity in the developmental trajectories of SE, for both primary and secondary school students. Tailored intervention strategies based on the predictors of the SE trajectories should be under special consideration.

Herpes zoster (HZ) vaccinations effectively prevent HZ and may decrease dementia, but HZ vaccine uptake remains poor in China. Rapid verbal persuasion is an innovative intervention, in which physicians offered brief advice to encourage individuals to accept vaccination. This study aims to tailor this intervention to promote HZ vaccination among older adults.

The proposed study will be a two-arm randomised controlled trial and conducted across four community health centres in Shenzhen, China. A total of 388 participants aged 50 and above will be recruited and assigned to either the intervention arm or the standard-care arm. The primary outcome will be first-dose uptake, recorded within 3 weeks after intervention. The primary outcome will be calculated for each arm and compared using ² test.

This trial has been approved by the Ethics Committee of Southern Medical University (Ethical Approval (2024) No. 90). Our findings will be disseminated to patients, healthcare providers and stakeholders through outreach activities and published in peer-reviewed journals, as well as presented in scientific conferences to inform future research or evidence-based practices for public health promotion.

Chinese Clinical Trial Registry (No. ChiCTR2500100798). Registered on 15 April 2025.

The decline in intrinsic capacity (IC) among older adults poses significant challenges to healthy ageing. Despite the importance of self-management in enhancing IC, research on self-management patterns and their predictors among older adults with declined IC remains limited.

This study aimed to explore clusters of self-management behaviours and their predictors among older adults with declined IC using an integrated theoretical framework combining the Theory of Planned Behaviour (TPB) and the Health Action Process Approach (HAPA).

This cross-sectional study was conducted in two community health centres in China from December 2022 to June 2023. A convenience sample of 308 older adults with declined intrinsic capacity was recruited based on WHO-recommended criteria. Self-management behaviours were assessed using the Chronic Disease Self-Management Behaviour Scale. HAPA constructs (self-efficacy, outcome expectancy, risk perception, planning) and TPB constructs (subjective norms, behavioural attitudes, perceived behavioural control, behavioural intention) were measured via validated questionnaires refined through expert consultation. Unsupervised k-means clustering was applied to identify behavioural subgroups, validated by principal component analysis. Inter-subgroup differences were examined using Analysis of Variance (ANOVA) or rank-sum tests for continuous variables and chi-square tests for categorical variables.

Three distinct self-management behaviour subgroups were identified among older adults with declined intrinsic capacity: Hesitant to Act (n=196), Norm-Dependent (n=42) and Assertive Decisiveness (n=70). Significant differences were observed across subgroups in demographic characteristics, including gender (p=0.017) and education (p=0.005), as well as in HAPA/TPB construct scores, including perceived behavioural control and planning (all p

This study identifies three distinct patterns of self-management behaviours among older adults with declined IC. The findings highlight the need for tailored interventions targeting the specific challenges faced by each subgroup. Future research should validate these findings in larger samples and explore causal relationships between variables.

This study aimed to investigate the knowledge, attitude and practice (KAP) of patients living with functional gastrointestinal disorders (FGIDs) toward their diseases.

A web-based cross-sectional study was conducted.

The gastroenterology outpatient department of Zhejiang Hospital of Traditional Chinese Medicine, Zhejiang, China.

The study enrolled 503 patients with FGIDs from the Gastroenterology Outpatient Department of our hospital between September and October 2023.

Not applicable for cross-sectional study.

Participants completed a self-designed questionnaire that collected sociodemographic information and assessed KAP scores. The primary outcome measures were KAP scores.

The mean KAP scores were 6.57±2.76 (possible range: 0–10) for knowledge, 30.00±4.08 (possible range: 7–35) for attitude and 30.16±4.92 (possible range: 8–40) for practice. Pearson’s correlation analysis indicated a positive and moderate correlation between knowledge and attitude (r=0.330, p

Patients with FGIDs demonstrated moderate knowledge, positive attitudes and moderate practices regarding their disease. Drinking habits and household income reportedly influenced their KAP outcomes. Targeted educational interventions are warranted to enhance practice behaviours among patients with FGIDs.

To identify novel, data-driven phenotypic clusters of metabolic dysfunction-associated fatty liver disease (MAFLD) and investigate their associations with cardiac remodelling.

Cross-sectional study.

Secondary care; a single-centre study in China.

A total of 3233 participants diagnosed with MAFLD were included in the study. The diagnosis was conducted in accordance with the established criteria for MAFLD. The exclusion criteria encompassed a history of significant cardiovascular or hepatic diseases, as well as excessive alcohol consumption.

Echocardiographic parameters of cardiac structure and function.

Four distinct clusters were identified. Cluster 1 (n=1381) comprised men with a normal metabolic state and low Fibrosis-4 Index (FIB-4) levels. Cluster 2 (n=453) included men with the highest body mass index (BMI) and uric acid levels. Cluster 3 (n=474) consisted of men with the most severe glucose and lipid metabolic disturbances. Cluster 4 (n=925) comprised women with the highest FIB-4 levels. Compared with Cluster 1, participants in Clusters 2 and 3 exhibited worse cardiac structure and function, including enlargement of the left atrium (LA), right atrium, left ventricular internal end-diastolic dimension, interventricular septum (IVS), left ventricular posterior wall (LVPW) thickness, right ventricular and reduced left ventricular ejection fraction. Conversely, participants in Cluster 4 had better cardiac structure and function compared with those in Cluster 1. After adjusting for confounders, Cluster 2 showed positive associations with the LA, IVS, LVPW, right atrium and right ventricular (all p

The heterogeneity of MAFLD reveals sex-specific patterns of cardiac remodelling: male phenotypes with high BMI and uric acid levels are associated with worse remodelling, whereas a female phenotype characterised by high FIB-4 levels correlates with preserved cardiac function.

To explore the suffering experiences of patients with nasopharyngeal carcinoma (NPC) in China.

This qualitative study employed a descriptive phenomenological approach. Data were collected through semistructured interviews and analysed using Colaizzi’s seven-step method. The study was conducted at a university-affiliated cancer centre in Southwest China. A total of 20 patients diagnosed with NPC were recruited through purposive sampling between January and April 2024.

‘Disruption to reinvention’ emerged as a unifying thread that integrated three main themes (and nine subthemes): (1) beginning of suffering: plunged into a world of illness (denial and fear, significant concern and life in chaos); (2) struggle for adjustment: a rollercoaster experience (suffering trajectory, aggravating factors and alleviating factors) and (3) beyond suffering: living with illness (perceived benefits, new normal in life and personal growth).

The suffering experiences of patients with NPC represent a complex and dynamic process. People with NPC frequently experience multiple sufferings, disrupting their lives. Notably, most patients progressed from disruption to reinvention, reflecting the possibility that suffering can be transcended. The findings of this study can assist healthcare professionals in better identifying the suffering of patients and its influencing factors, allowing for the tailoring of interventions to alleviate their suffering.

Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterised by varying degrees of inflammation and fibrosis. Among these, fibrotic interstitial lung disease (FILD) is receiving increasing attention. Many questions remain about FILD, such as identifying which ILDs are likely to progress to FILD, the timing of such progression, early recognition methods and biomarkers for FILD recognition and progression, highlighting the urgent need for a large multicentre FILD cohort to advance relevant studies.

The Fibrotic Interstitial Lung Disease Early Recognition and Strategic Therapy Study in China (FIRST) study is a prospective, multicentre cohort study of FILD conducted across 40 hospitals/centres in China, aiming to reveal clinical phenotype and further integrate multidimensional data to develop prediction models for fibrosis progression. The study will enrol more than 10 000 patients, using existing national ILD cohorts, and will collect comprehensive clinical, imaging, histological and biological data to support histopathological, imaging and biomarker-related studies. The primary outcome is fibrosis progression within 12 months, with secondary outcomes including the natural history, mortality, comorbidities and treatment conditions of FILD, using a standardised data collection and follow-up approach supported by an Electronic Data Capture system.

The study’s protocol has undergone a thorough review and received approval from the Ethics Committee of China-Japan Friendship Hospital and the other participating sites currently enrolling patients. The findings of the study will be shared with the broader scientific community through publication in peer-reviewed journals.

NCT06655090; Pre-results