Common mental health outcomes among children in conflict with the law in correctional facilities in Africa are an under-researched area with significant public health implications. This review will synthesise available and accessible evidence on the prevalence and associated factors of common mental health outcomes among children in conflict with the law in Africa.

Comprehensive electronic searches will date from 01 January 2015 to 31 December 2025 and will be conducted in PubMed, Sabinet, Scopus, EBSCOhost, Web of Science and PsycINFO. Articles will be screened using defined inclusion and exclusion criteria and assessed for eligibility by three independent reviewers. Discrepancies will be reviewed by a ninth reviewer. The selection process of included articles will be reported by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used. The Mixed Methods Appraisal Tool will assess study quality, and data will be synthesised using meta-analysis or a narrative synthesis approach, depending on heterogeneity levels.

This study will not require ethical approval from an institutional review board, as it does not entail the direct collection of data from children in conflict with the law, nor does it pose any risk to their privacy. Once finalised, the full review report will be submitted for publication in a peer-reviewed journal. The key findings will also be shared at both local and international conferences, highlighting common mental health outcomes among children in conflict with the law.

CRD420251011484.

Intraventricular haemorrhage (IVH) remains a major contributor to mortality and long-term neurodevelopmental impairment among preterm infants, particularly those born extremely preterm or extremely low birth weight. Although extensive research has investigated various facets of IVH, including prevention, therapeutic interventions, underlying pathophysiology and long-term outcomes, the heterogeneity in selection, measurement and reporting across studies significantly impairs data synthesis through meta-analysis and limits the translation of evidence into clinical practice. To address this issue, we propose the development of a Core Outcome Set (COS) for IVH research in preterm infants.

This study will follow established guidance from the Core Outcome Measures in Effectiveness Trials Initiative and COS-Standards for Development. The sequential phases include: (1) a systematic review to comprehensively identify outcomes previously reported in IVH research involving preterm infants; (2) qualitative interviews with diverse stakeholders (clinicians, researchers and caregivers) to explore perspectives and identify additional relevant outcomes; (3) a multiround Delphi survey to achieve consensus on core outcomes; and (4) a consensus meeting to finalise the COS.

The entire project has been approved by the Ethics Committee of West China Second University Hospital (No. 2022-069). Written informed consent will be obtained from all participants prior to participation. Study findings will be disseminated through conferences and publications in peer-reviewed journals.

This study aimed to explore the experience of decision conflict among surrogate decision-makers for patients with critical illness undergoing neurosurgery.

A qualitative descriptive research design was used. Participants were selected using a purposive sampling method, and semi-structured interviews were conducted to collect data, which were then analysed using Colaizzi’s seven-step analysis method.

The study was conducted in a tertiary hospital in China.

This study included 15 surrogate decision-makers for patients with critical illness undergoing neurosurgery as interview participants.

In this interview study, two main themes and nine subthemes were identified：(a) core conflict in the decision-making process: conflicts between the quality of life and the length of life, conflict between patient and surrogate preferences and conflict between the expected and realistic treatment outcomes; and (b) complex causes of decisional conflict: the burden of decision-making in critical care, inadequate decision-making information, erosion of patient-physician trust, socio-cultural pressures, overwhelming financial burden and negative emotional distress.

Surrogate decision-makers for patients with neurological critical illness often experience complex decision conflicts during the clinical decision-making process. This underscores the need for healthcare providers to identify high-risk individuals for decision conflicts early on and provide personalised decision support strategies to mitigate such conflicts and enhance decision quality.

Transcranial magnetic stimulation (TMS) and upper extremity manipulation training have demonstrated clinical effectiveness in stroke rehabilitation. Post-stroke, the affected cerebral cortex often shows reduced excitability, which can limit the optimal outcomes of conventional manual training. To address this, we developed a new upper limb training method integrating TMS with active sensory training (AST) to enhance the fine motor ability in the upper limbs following stroke, potentially improving overall rehabilitation efficacy. However, the clinical effectiveness of this approach remains unclear. Importantly, we demonstrated the efficacy of the new rehabilitation strategy by using TMS in conjunction with AST in patients experiencing upper limb motor dysfunction after stroke.

This single-centre, single-blind, sham stimulation, randomised controlled clinical trial investigated the efficacy of AST combined with TMS in patients with stroke and upper limb motor dysfunction post-stroke (1–24 months post-onset) at Brunnstrom stages III–V. Upper limb motor function was evaluated before and 2 weeks after the intervention. The primary outcome was the Action Research Arm Test result, and the secondary indicators included results on the Fugl–Meyer Assessment Upper Extremity Scale, Modified Barthel Index, Semmes–Weinstein Monofilament, Erasmus MC revised Nottingham Sensory Assessment Scale, Embodied Sense of Self Scale (stroke version), functional near-infrared spectroscopy and neuroelectrophysiology. Between-group differences were analysed using independent t-tests, and within-group differences were examined with paired t-tests, with statistical significance set at p

This study was approved by the Ethics Committee of the Second Rehabilitation Hospital of Shanghai for ethical application (Approval number: 2024-34-01). Written informed consent will be obtained from all participants. Study results will be disseminated through peer-reviewed journals and presentations at local and international conferences.

ChiCTR2500097067.

Tobacco use causes approximately 8 million deaths worldwide each year. Against the backdrop of a rapidly expanding game market, there is growing potential to develop tailored gaming interventions for smoking cessation. This study protocol describes the development of a personalised Serious Game Applet based on an integrated TTM–PMT–HAPA framework (Transtheoretical Model, Protection Motivation Theory, Health Action Process Approach) and evaluates its effectiveness compared with conventionalShort Messaging Service (SMS) -based smoking cessation interventions.

Design: The study comprises two phases. The first involves developing the Serious Game Applet using the TTM–PMT–HAPA theoretical framework. The second phase consists of a multicentre, two-arm, single-blind cluster randomised controlled trial, which will enrol 1320 eligible smokers from various enterprises. Enterprises will be randomised to either the Serious Game Applet group or the SMS push control group. Eligible participants include daily smokers aged 18–45 years, working in non-tobacco-related enterprises, with exhaled carbon monoxide levels ≥6 ppm.

Outcomes: Primary outcomes are smoking abstinence rates at 3 and 6 months. Secondary outcomes include abstinence rates at 1, 2 and 9 months; point-prevalence cessation rates at 1, 2, 3, 6 and 9 months; changes in cigarette consumption; stage transitions in smoking cessation; nicotine dependence scores and withdrawal symptoms. The trial will be conducted as a field study targeting smartphone users across three cities in Fujian Province, China.

This study has been approved by the Biomedical Research Ethics Committee of Fujian Medical University (Approval No. 127, 2024). Results will be disseminated through peer-reviewed journals and academic conferences.

ChiCTR2400088105.

Current prediction models for disease progression to AIDS in people living with HIV primarily rely on traditional statistical methods. This study aimed to develop and compare four machine learning models and to create a clinically applicable nomogram for identifying risk factors associated with AIDS progression.

A retrospective cohort study conducted from January 2013 to December 2022.

Yining City, Xinjiang, China.

Newly diagnosed HIV-infected patients (aged 18–60 years) who received antiretroviral therapy and had not progressed to AIDS at baseline.

Progression from HIV infection to AIDS, as defined by the Chinese Center for Disease Control and Prevention criteria.

Among the 2305 patients included, 652 progressed to AIDS. The cohort was predominantly male, with a mean baseline CD4 cell count of 384 cells/μL. Four machine learning models—Support Vector Machine, Random Forest, Logistic Regression and Extreme Gradient Boosting (XGBoost)—were developed. The XGBoost model demonstrated the best predictive performance (area under the curve, AUC: 0.877). Univariate and multivariate analyses identified WHO clinical stages, CD4 cell count, HIV transmission route, platelet count and haemoglobin level as significant predictors. The developed nomogram achieved an AUC of 0.840. Its calibration curve, after bias correction, showed good agreement with the ideal curve, and decision curve analysis indicated potential clinical utility.

In this cohort, the XGBoost model showed superior performance for predicting AIDS progression. The proposed nomogram may serve as a practical tool to facilitate rapid risk assessment in similar clinical settings. These findings suggest that enhanced monitoring and regular follow-up might be beneficial for patients with low CD4 counts for timely intervention and to improve outcomes.

This study aimed to investigate the trajectory patterns and influencing factors of sleep quality and verify the bidirectional association between physical activity and sleep quality during pregnancy.

This was a prospective longitudinal study.

The study was conducted at the obstetric clinic in a tertiary maternity hospital in Zhejiang Province, mainland China.

A total of 645 pregnant women were selected through simple random sampling and completed follow-up assessments during the first, second and third trimesters of pregnancy from January to December 2024.

The desired data were collected using the Pittsburgh Sleep Quality Index and the International Physical Activity Questionnaire Short Form. Latent class growth analysis was applied to identify sleep quality trajectories, multiple logistic regression was used to determine the influencing factors, and cross-lagged panel analysis was used to explore the bidirectional association between sleep quality and physical activity.

Three distinct sleep quality trajectories were identified: the constantly poor sleep quality group (21.40%), the constantly decreasing sleep quality group (50.70%) and the constantly good sleep quality group (27.90%). Multiple logistic regression analyses indicated that being underweight (OR=3.013, 95% CI: 1.308 to 6.942) and having insufficient physical activity levels during the first (OR=3.346, 95% CI: 2.009 to 5.573) and second phases (OR=37.515, 95% CI: 20.215 to 69.620) were associated with an increased risk of exhibiting a consistently declining pattern. Being underweight (OR=2.679, 95% CI: 1.041 to 6.893), passive smoking (OR=11.433, 95% CI: 2.220 to 58.883) and having insufficient physical activity levels during the first (OR=12.624, 95% CI: 6.285 to 25.356) and second phases (OR=23.773, 95% CI: 11.745 to 48.118) were associated with an increased risk of exhibiting a consistently poor pattern. Additionally, results from the cross-lagged panel analysis revealed a bidirectional association between sleep quality and physical activity.

This study demonstrates heterogeneity in changes in sleep quality among pregnant women. Interventions aimed at promoting maternal and infant health during pregnancy should consider both sleep quality and physical activity. Earlier interventions are associated with better outcomes.

ChiCTR2300078952.

Post-chronic pancreatitis (CP) diabetes mellitus (PPDM-C) is a distinct form of diabetes, in which complex pathogenesis hampers adequate glycaemic control. This study aimed to identify risk factors for poor glycaemic status in PPDM-C to guide clinical management.

Cross-sectional study.

Shanghai, China.

Between January 2018 and March 2023, 1677 patients with CP were enrolled in the CP database of the National Clinical Research Center. After application of strict exclusion criteria, 302 patients diagnosed with PPDM-C were included in the study.

The primary outcome was glycaemic control. The secondary outcomes were factors that affect glycaemic control among patients with PPDM-C.

This retrospective study was conducted in patients with PPDM-C. Poor glycaemic status was defined as a glycated haemoglobin A1c level of >7% at admission. Patients were stratified into those with and without diabetes treatment. Multivariate logistic regression was performed to identify risk factors. The area under the curve (AUC) analysis was used to evaluate the predictive efficacy of these risk factors.

A total of 302 patients with PPDM-C were analysed. Poor glycaemic status was observed in 72.6% (61/84) of patients without diabetes treatment and 52.8% (115/218) of those with diabetes treatment. For those without diabetes treatment, a history of acute pancreatitis (AP) attacks (OR: 4.838, p=0.014) and smoking (1–20 pack-years, OR: 4.418; >20 pack-years, OR: 9.989; p0.001). In patients with diabetes treatment, AP attack history (OR: 5.640, p20 pack-years, OR: 11.395; p

Patients with PPDM-C in China exhibited a high prevalence of poor glycaemic status. Smoking and a history of AP attacks were significantly associated with an increased risk of poor glycaemic control. The early identification of patients with PPDM-C at elevated risk of poor glycaemic control may facilitate timely and optimised management of glycaemia.

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are high-risk factors for dementia. We developed a cognitive measurement tool for screening SCD and MCI in community-dwelling elderly individuals.

This study investigated the feasibility of using the Brief Elderly Cognitive Screening Inventory (BECSI) as a screening measure for MCI and SCD in community elderly.

A cross-sectional validation study.

The study included 1642 community-dwelling older adults aged ≥60 years.

The Cronbach’s α and split-half coefficients were calculated to test its reliability. The BECSI scores of the normal control group, SCD group and MCI group were compared. The internal consistency analysis, correlation analysis with the neuropsychiatric inventory (NPI) and core neuropsychological test (CNT) were conducted. The screening efficacy of BECSI was verified by receiver operating characteristic curve.

BECSI was a self-report questionnaire. Its Cronbach’s α coefficient and split-half coefficient were respectively 0.923 and 0.888. The correlation coefficients between the total score and individual items ranged from 0.185 to 0.813, and were also significantly correlated with NPI and CNT. Statistically significant differences were observed among the three groups in the total scores. The areas under the curves for distinguishing SCD from normal cognitive and MCI from SCD are 0.835 and 0.889, respectively, with the optimal cut-off points of 12.5 and 16.5.

BECSI is quick and easy to administer, and can be used as a feasible and useful measure for screening SCD and MCI in community-dwelling older adults.

This study aimed to assess the global, regional and national burden of non-rheumatic degenerative mitral valve disease (nrDMVD) from 1990 to 2021 using data from the global burden of disease (GBD) Study 2021, focusing on trends in incidence, prevalence, mortality and disability-adjusted life-years (DALYs). The analysis evaluated disparities by age, sex and sociodemographic index (SDI).

This was a systematic analysis leveraging GBD 2021 data and employing decomposition and frontier analyses to quantify the contributions of ageing, population growth and epidemiological transitions. Age-standardised rates (ASRs) and absolute case numbers were analysed across 204 countries and territories.

Global, regional and national data spanning 1990 to 2021, stratified by SDI quintiles (low to high), 21 GBD regions and age-sex groups.

Individuals diagnosed with nrDMVD, with data representing global populations categorised by age, sex and SDI.

Primary outcomes included incidence, prevalence, mortality and DALYs. Secondary outcomes encompassed age-standardised rates (ASR) (age-standardised incidence rate (ASIR), age-standardised prevalence rate (ASPR), age-standardised mortality rate (ASMR) and age-standardised DALYs rate (ASDR)) and temporal trends.

In 2021, there were 15.49 million prevalent cases (ASPR: 182.13 per 100 000 population) and 36 843 deaths (ASMR: 0.46 per 100 000 population) globally. From 1990 to 2021, ASRs for prevalence, mortality and DALYs declined significantly (estimated annual percentage change range: –0.17% to –0.31%), while absolute case numbers increased by 85% due to population ageing. High-SDI regions exhibited the highest ASIR (28.49 per 100 000) and ASPR (364.24 per 100 000), while low-SDI regions showed underdiagnosis. Sex disparities were pronounced, with higher ASIR (16.13 vs 11.38) and ASPR (385.09 vs 241.64) in females. Projections to 2050 indicated continued ASR declines, yet rising absolute cases. Frontier analysis identified Serbia, Georgia and high-SDI countries (eg, the Netherlands) as having the largest gaps between actual and achievable disease burden.

Despite declining ASRs, nrDMVD remains a critical global health challenge, driven by ageing populations and regional inequalities. Targeted interventions addressing gender disparities, ageing-related healthcare and resource allocation in low-SDI regions are urgently needed to mitigate future burdens.

The purpose of this study was to analyse the speech-language pathology (SLP) literature from 2012 to 2022 and evaluate authorship trends and factors associated with gender disparities.

Authorship across journals published by the American Speech-Language-Hearing Association (ASHA) was evaluated. Outcomes collected from each article included the gender of the first and senior authors, author department affiliations, study type, reported funding source and the country of origin. Three sets of linear regression models were explored to determine the probability of male first authorship, of male senior authorship, and of a study being funded.

A total of 2754 articles were identified for inclusion. The majority of the literature was authored by females, with 77% of first authors and 68% of senior authors being female. Studies with a male senior author were shown to be 4.05–4.67 times more likely to have a male first author than with a female senior author. Male senior authors were over-represented relative to their proportion of ASHA membership compared with female senior authors. Male authorship was associated with certain subtopics, including voice, stuttering and motor speech. Funding probability decreased for all authors regardless of gender between 2012 and 2022.

Implicit gender bias and societal gender stereotypes lead to a greater number of women in the field of SLP; the same biases and stereotypes often limit the research productivity and academic leadership potential of women in the field. Addressing these biases and stereotypes is vital to move towards gender equity in the field.