To estimate the population-level incidence of emergency department (ED) visits for violent behaviour, identify associated factors and quantify the contribution of people presenting to ED for violent behaviour on the total number of ED visits for mental health problems.

Retrospective cohort study.

Regional healthcare authority serving a population of 1.2 million in Romagna, Italy, January 2022 to December 2023.

871 119 residents (70% of the regional population; 55.6% female) alive on 1 January 2022 with data on comorbidities. Participants were followed until 31 December 2023 with censoring at death.

Primary outcome: incidence of ED visits for violent/homicidal. Factors associated with violent ED visits were examined. Secondary outcome: quantification of the contribution of people presenting to ED for violent behaviour on the total number of ED visits for any mental health problem.

286 individuals (76.9% male) had 573 ED visits for violent behaviour, representing 4.2% of all psychiatric ED visits with an annual incidence rate of 3.48 per 10 000 person-years (95% CI 3.21 to 3.78). Male sex was associated with violent behaviour (OR 3.85, 95% CI 2.60 to 5.70; OR 4.64, 95% CI 3.12 to 6.92 among mental health service users). High comorbidity and prior mental health service use increased the risk. Having an ED visit for violent behaviour was associated with higher odds (OR 10.9, 95% CI 8.02 to 14.96) and higher incidence rate (incidence rate ratio 1.51, 95% CI 1.35 to 1.69) of psychiatric ED visits for other mental health problems.

ED visits for violent behaviour occur at relatively low population rates but predominantly affect high-risk groups: males with prior mental health service contact and either minimal or very high comorbidity. These findings supported the need for tailored interventions that address both the immediate risk of violence and underlying mental health issues, especially for high-risk groups.

Kerato-lenticule extraction (KLEx) is a refractive surgery technique that, in contrast with femtosecond laser-assisted in situ keratomileusis (FS-LASIK), does not require the creation of a flap to correct refractive defects. The potential advantages of this technique are related to the absence of a flap and its complications. On the other hand, FS-LASIK is the most widely practised refractive surgery worldwide, as it offers excellent visual outcomes and is currently the gold standard of refractive surgery. The objective of this study is to compare the effectiveness and safety of KLEx versus FS-LASIK as a treatment option in patients with myopia or myopic astigmatism.

This double-masked, parallel-group, single-centre randomised clinical trial will enrol 80 eyes from adults with myopia or compound myopic astigmatism within the ranges sphere –0.50 to –12.00 D and cylinder –0.50 to –6.00 D, recruited at the Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico. Participants will be allocated to KLEx or FS-LASIK and assessed at baseline and 1 day, 1 week, 1, 3, 6 and 12 months postoperatively. The primary outcome is uncorrected visual acuity at all postoperative visits. Secondary outcomes include postoperative spherical equivalent, best-corrected visual acuity (BCVA), loss of ≥2 BCVA lines, the proportion of eyes within ±0.50 D of the refractive target, corneal aberrations over a 5 mm pupil, epithelial changes and adverse events. Participants and outcome assessors will be masked to the assigned surgical technique.

Participant confidentiality will be maintained with the publication of results. This study was approved by the research and ethics committee of the Instituto de Oftalmología Fundación de Asistencia Privada Conde Valenciana (CI-017-2024). The study results will be disseminated in scientific articles published in peer-reviewed journals and presented through research posters at national and international conferences.

ClinicalTrials.gov registry (NCT06477081).

Despite low sensitivity and implementation challenges, the tuberculin skin test (TST) remains the standard-of-care tuberculosis (TB) infection test in Mexico. Interferon gamma release assays (IGRA) may overcome TST-related challenges. Within the confines of the local programmatic setting, this cross-sectional study evaluated the prevalence of TB infection (TBI) and concordance of TST and IGRA in three high-risk populations in Mexicali, Baja California, Mexico.

Household contacts (HHC) of individuals with TB, people who use drugs (PWUD), people deprived of liberty (PDL) and prison employees underwent evaluation for TBI using TST and QIAreach, a novel IGRA. Prevalence of infection, concordance of test results and reactivity trends of time-to-results (TTR) by TST-induration size were assessed.

In total, 214 of 411 (52.07%) people who had TST and 269 of 460 (58.48%) people who had IGRA tested positive for TBI. Frequency of infection varied across risk groups (HHC 29 (29.6%); PWUD 67 (70.53%); PDL 111 (56.06%) and prison employees 7 (35.0%), p20 mm, p=0.05).

All risk groups had a high frequency of TBI, necessitating locally tailored guidelines for screening, treatment and management of TBI to optimise care for vulnerable populations.