This study aimed to identify potential categories of rotation stress among nurses undergoing standardised training and to explore the relevant factors associated with each profile.

Cross-sectional study.

Data were collected in November 2024 from three hospitals in Zunyi City, Guizhou Province, China.

Nurses undergoing standardised training were recruited for this study.

Convenience sampling method was used to recruit standardised training nurses in November 2024 from three hospitals in Zunyi City, Guizhou Province. The survey instruments used included demographic characteristics questionnaire, the Nursing Job Rotation Stress Scale and the Maslach Burnout Inventory. Latent profile analysis method was used to analyse rotation stress characteristics of nurses during standardised training. Additionally, logistic regression was performed to identify the factors influencing different characteristics.

A total of 493 nurses completed the questionnaires, of which 453 were valid, resulting in a validity rate of 91.88%. Rotation stress was classified into two profiles: ‘Low Emotional Response–Stress Adaptation Group’ (21.5%) and ‘High Emotional Response–Stress Distress Group’ (78.5%). Univariate analysis showed that highest degree (²=11.389, p=0.001), monthly night shifts (²=33.913, p2=20.858, p2=12.319, p2=35.754, p2=15.357, p=0.002) significantly influenced the two subgroups. Multivariable regression analysis revealed significant associations of monthly night shifts, pretraining work experience, training duration and burnout level (p

Nurses undergoing standardised training exhibit two distinct rotation stress profiles. Monthly night shifts, pretraining work experience, training duration and burnout are significant factors. Nursing managers should implement targeted interventions such as mindfulness, laughter therapy and emotional freedom techniques to mitigate stress and thereby enhance the quality of standardised training.

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.

Coronary artery involvement remains the primary focus in the long-term management of Kawasaki disease (KD). However, previous studies suggest that myocardial abnormalities frequently persist beyond coronary artery involvement in KD patients. Yet, their temporal evolution and clinical implications remain poorly characterised. To address this gap, we established the Kawasaki disease cardiac imaging (KDCI) cohort, integrating cardiac magnetic resonance (CMR) with echocardiography, coronary CT angiography (CCTA) and invasive angiography. These multimodal imaging approaches enable comprehensive assessment of cardiac abnormalities and elucidate the role of cardiac imaging in optimising long-term KD management.

The KDCI cohort is a prospective study aiming to enrol 400–500 KD patients diagnosed at West China Second University Hospital from September 2018 to September 2035. To date, 207 participants have been recruited. Participants will perform the multimodal cardiac imaging including echocardiography, CMR, CCTA, invasive angiography and comprehensive laboratory testing under a scheduled protocol in the follow-up.

The KDCI cohort has established baseline characteristics for 207 KD patients. Of those included to date, 72.0% (149/207) received intravenous immunoglobulin (IVIG) treatment, with 26.1% (54/207) demonstrating IVIG resistance, and 37.7% (78/207) exhibiting coronary artery dilatation. Longitudinal follow-up data are available for 80.7% (167/207) of participants, with a median follow-up duration of 2.7 years and a follow-up patient-years of 594 patient-years. Of the 207 patients, 16.9% (35/207) patients experienced endpoint events, encompassing coronary artery thrombosis (8.2%, 17/207), coronary stenosis/obstruction (5.3% 11/207) and clinical myocardial infarction (1.9%, 4/207). Based on the data collected, we have demonstrated the cardiac abnormalities beyond coronary artery involvement in KD by CMR and CCTA.

The KDCI cohort will maintain ongoing recruitment and longitudinal follow-up, with a projected enrolment exceeding 400 participants by 2035. This expansion will yield a median follow-up duration of 10 years, providing robust long-term outcome data. We have implemented standardised protocols for scheduled follow-up assessments and data collection in newly enrolled patients. Furthermore, planned genomic analyses will be incorporated to investigate the molecular pathogenesis and prognostic determinants of KD.

Physical activity (PA) has considerable benefits for older adults, yet they often face various barriers that hinder participation. Peer-led or peer-supported PA interventions represent a promising strategy to address barriers, such as cost and lack of motivation. Although existing reviews suggest that these interventions improve PA adherence, combining randomised controlled trials (RCTs) with other study designs may weaken their validity. Furthermore, their effects on PA levels and physical function are inconsistent, and their impacts on cognitive abilities, psychosocial well-being and social support, as well as the influence of peer characteristics and programme design, remain unexamined. This review aims to synthesise evidence regarding the effectiveness of peer-led or peer-supported PA interventions across multiple health outcomes and identify possible influencing factors.

The search will encompass six English and three Chinese databases, namely, PubMed, Web of Science, Embase, Cumulative Index to Nursing and Allied Literature, PsycINFO, CENTRAL, China National Knowledge Infrastructure, Wanfang Data and the Chinese Biomedical Literature Database. It will cover literature from inception to December 2025. Trial registries will be searched, and a manual search of relevant studies will also be conducted. RCTs that focus on community-dwelling older adults participating in peer-led or peer-supported PA interventions will be included. Outcomes include PA levels, physical function, cognitive function, psychosocial well-being, self-efficacy, social support, health-related quality of life (HRQoL) and programme adherence. Two reviewers will independently screen the literature, extract data and evaluate the risk of bias by using the Cochrane Risk of Bias Tool 2.0. Meta-analyses will be conducted for outcomes reported in at least two studies, and narrative analyses will be performed for others. Subgroup analyses, metaregression, sensitivity analyses and assessments of publication bias will be conducted as appropriate. The Grading of Recommendations, Assessment, Development and Evaluations approach will be used to assess the certainty of evidence.

Ethical approval is not required because only published data will be used. Results will be disseminated through peer-reviewed publications and conference presentations.

CRD420251112127.

Post-induction hypotension (PIH) is a critical concern in elderly surgical patients and is associated with adverse postoperative outcomes. This trial aims to compare the effects of propofol, etomidate and remimazolam on the incidence of PIH in older adults undergoing non-cardiac surgery.

In this single-centre, triple-arm, randomised controlled trial, 210 patients aged ≥80 years with American Society of Anaesthesiologists physical status I–III undergoing elective non-cardiac surgery will be recruited. All patients will receive general anaesthesia with endotracheal intubation. Patients will be randomised (1:1:1) to receive propofol, remimazolam or etomidate for anaesthesia induction (n=70 per group). The primary outcome is the incidence of PIH (mean arterial pressure (MAP) 30% from baseline, vasopressor requirements, bradycardia, injection pain, myoclonus, postoperative delirium, and cardiac, cerebral and renal complications during hospitalisation.

This trial was approved by the Ethics Committee of the First Affiliated Hospital of Soochow University (Approval No. 2024-380). The results will be peer-reviewed for publication in a scientific journal.

ChiCTR2400090800.

This study aims to assess the self-efficacy of returning to work among middle-aged and young patients with aortic dissection. Additionally, it seeks to identify distinct characteristics of these patients using latent profile analysis based on their return-to-work self-efficacy (RTW-SE) levels and to explore factors influencing the identified latent subgroups.

A cross-sectional study.

Data were collected from a Class III Grade A hospital in Fujian Province, China.

A total of 204 patients were recruited for this study.

Data collection used a self-generated general information questionnaire, RTW-SE, Fear of Progression Questionnaire-Short Form and Social support rate scale.

A total of 204 young and middle-aged patients with aortic dissection were classified into three categories based on their RTW-SE: high work coping–high internal coping group (9.8%), moderate overall level group (38.2%) and low work coping–low internal coping group (52.0%). Multivariate logistic regression analysis identified personal annual income, type of employment, education level and fear of disease progression as significant factors influencing RTW-SE in these patients (p

A significant proportion of aortic dissection patients exhibit low self-efficacy in returning to work. These findings underscore the importance of emphasising vocational rehabilitation and integrating it into comprehensive cardiac rehabilitation programmes.

Traditional data extraction strategies, such as human double extraction, are both time consuming and labour-intensive. Artificial intelligence (AI) has emerged as a promising tool for facilitating data extraction. However, it is not yet suitable as a standalone solution. We will conduct a randomised controlled trial (RCT) to compare the efficiency and accuracy of the AI-human data extraction strategy with human double extraction.

This study is designed as a randomised, controlled, parallel trial. Participants will be randomly assigned to either the AI group or the non-AI group at a 1:2 allocation ratio. The AI group will use a hybrid approach that combines AI extraction followed by human verification by the same participant, while the non-AI group will use human double extraction. Data will be collected for two tasks: event count and group size. Ten RCTs will be selected from an established database that analysed data extraction errors in systematic reviews of sleep medicine. The primary outcome measure will be the percentage of correct extractions by both groups for each data extraction task.

The trial is approved by the Ethics Council of Anhui Medical University (No. 81250507). We plan to publish the main results as an academic publication in an international peer-reviewed journal in 2026.

Chinese Clinical Trial Register (Identifier: ChiCTR2500100393).

Hepatic encephalopathy (HE), a severe complication of decompensated cirrhosis, is characterised as neurocognitive dysfunction. Emerging evidence suggests the potential role of human albumin infusion for the treatment of HE, but its optimal dosage remains undefined. Therefore, we planned a randomised controlled trial (RCT) to compare the efficacy of human albumin infusion at different dosages in patients with liver cirrhosis and overt HE.

This RCT will be conducted in the Departments of Gastroenterology or Hepatology of 16 tertiary hospitals in China. Overall, 174 patients with a diagnosis of liver cirrhosis, overt HE and a serum albumin level of 23–30 g/L will be enrolled. They will be stratified according to the severity of overt HE and randomly assigned at a ratio of 1:1 into the groups of human albumin infusion at a modified dosage and a routine dosage. The primary end point is the improvement of overt HE within 3–5 days after treatment. The secondary end points include recurrence of overt HE, survival and adverse events. We expect that this RCT will provide high-quality evidence on the optimal dosage of human albumin infused, which can achieve more clinical benefits to patients with liver cirrhosis and overt HE.

The study has been approved by the Medical Ethical Committee of the General Hospital of Northern Theater Command (ethical approval number Y2024-148). The study findings will be published in academic journals.

NCT06483737.

Atrial fibrillation (AF), the most common sustained arrhythmia globally, necessitates effective strategies for stroke prevention. Although current risk stratification tools, such as the CHA₂DS₂-VASc score, are widely used to guide anticoagulation therapy, their limited predictive accuracy underscores the urgent need for more precise and reliable models. This study aims to establish a nationwide AF registry incorporating multi-dimensional data to identify novel risk factors and develop a more accurate stroke prediction model to improve risk stratification and guide anticoagulation therapy in patients with AF.

The risk factors for stroke in patients with non-valvular AF in China (REFINE) registry is a nationwide, multicentre, observational registry integrating retrospective (n=20 000) and prospective (n=5000) cohorts. Demographics, lifestyle, medical history, physical examination, laboratory tests, ECG, echocardiography, contrast-enhanced CT scan and blood samples will be collected at baseline. Long-term follow-up will be performed to identify clinical events and treatment at the timepoint. We aim to use the multidimensional dataset to establish a more precise stroke risk predictive tool.

The study is approved by the Ethics Committee of Fuwai Hospital, CAMS&PUMC (No. 2022–1845; No. 2024–2489) and registered at ClinicalTrials.gov, identifier NCT05598632. The results of this study will be disseminated through publications in peer-­reviewed journals and conference presentations.

NCT05598632.

Disease activity assessment is important for Crohn’s disease (CD) management, since it involves the initial and subsequent therapeutic schedule. The purpose of this study is to identify a portable and reliable indicator for assessing and predicting activity and severity of CD.

A multicentre, cross-sectional, diagnosis-based study. Data were obtained retrospectively from clinical records.

Patient data for the development cohort and internal validation cohort were collected from the Department of Gastroenterology, Xiangya Hospital, Central South University between January 2017 and June 2021. Patient data for the external validation cohort were collected from the Department of Gastroenterology, Xiangtan Central Hospital between January 2022 and April 2024.

Inpatients diagnosed with CD were potential participants, and those with CD who also had other autoimmune diseases, malignant tumours, pregnancy or lactation were excluded. We identified 224 patients in the development cohort, 96 patients in the internal validation cohort and 80 patients in the external validation cohort.

Demographic data and laboratory examination results were collected and seven integrated indices were established. Mann-Whitney U test, Kruskal-Wallis K test, ² test and multivariate logistic regression analysis were used to identify independent predictors. Receiver operating characteristics curve analysis was used to evaluate the performance of integrated indices in CD activity and severity staging, and Delong’s test was used for comparison.

In the development cohort, platelet-to-albumin ratio (PAR) had the largest area under the curve (AUC) in prediction of activity (AUC of 0.753 (0.687–0.819), sensitivity 73.0%, specificity 68.4%, cut-off value 8.02) and was the only possible alternative in prediction of severity (AUC of 0.770 (0.693–0.848), sensitivity 81.2%, specificity 68.4%, cut-off value 9.71). Moreover, PAR demonstrated coherence in the internal validation cohort, effectively predicting activity (AUC 0.737 (0.639–0.835), sensitivity 65.7%, specificity 79.3%, positive predictive value (PPV) 88.0%, negative predictive value (NPV) 50.0%) and severity (AUC 0.720 (0.591–0.848), sensitivity 88.5%, specificity 77.4%, PPV 76.7%, NPV 64.9%). Furthermore, it showed generalisability in the external validation cohort for predicting activity (AUC 0.661 (0.536–0.785), sensitivity 61.9%, specificity 70.6%, PPV 88.6%, NPV 33.3%) and severity (AUC 0.752 (0.619–0.884), sensitivity 73.1%, specificity 64.9%, PPV 59.4%, NPV 77.4%).

PAR could be a portable index to assess the activity and severity of CD. Several limitations of this study, such as the limited sample size and potential biases, should be overcome in the future via more extensive validation.

Intracranial atherosclerotic disease (ICAD), prevalent in over 65% of Asian populations, is a major cause of global cerebrovascular morbidity and mortality through cerebral hypoperfusion. Despite guideline-directed medical therapy, recurrent ischaemic events remain common due to inadequate collateral circulation. Previous randomised controlled trials (ie, International Extracranial-Intracranial Bypass Study, carotid occlusion surgery study, carotid and middle cerebral artery occlusion surgery study) demonstrated high perioperative risks of extracranial-to-intracranial bypass surgery, while recent single-arm studies suggest that indirect cerebral revascularisation may improve cerebral perfusion with enhanced safety.

This is a multicentre, randomised, open-label trial designed to enrol 378 participants (189 per group) with symptomatic ICAD (≥70% stenosis/occlusion, American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Score 0–2). Participants will be allocated using minimisation randomisation via an interactive web response system to receive multimodal indirect revascularisation plus intensive medical therapy or intensive medical therapy alone. The primary endpoints are the composite of stroke or death within 30 days and ipsilateral ischaemic stroke within 24 months. Secondary outcomes include transient ischaemic attack reduction, neurological function preservation (modified Rankin Scale), and cerebral perfusion improvements assessed by CT perfusion and MRI.

The study protocol has been approved by the Biomedical Research Ethics Committee of West China Hospital, Sichuan University (approval number: 2024 Review (2588)). Written informed consent will be obtained from all participants prior to enrolment. The study results will be disseminated through peer-reviewed publications and presentations at national and international conferences.

Chinese Clinical Trial Registry (ChiCTR2500099882).