Visual impairment is reported to affect 40%–50% of children with cerebral palsy (CP). Vision difficulties in the context of rehabilitation are often under-recognised, under-treated and therefore under-studied, pointing to an urgent need for the development of evidence-based vision interventions for infants and toddlers with cerebral vision impairment (CVI). We present the protocol of a multisite pragmatic pilot randomised controlled trial (RCT) of feasibility, acceptability and preliminary efficacy of an early vision-awareness and parent-directed environmental enrichment programme for infants with or at risk of CP under 7 months corrected age (CA) with vision impairment.

The main objective is to determine the feasibility and acceptability of the Vision Intervention for Seeing Impaired Babies: Learning through Enrichment (VISIBLE) intervention. We will estimate the preliminary effects of the programme on infants’ visual functions and early development, as compared with standard community-based care (SCC).

A two-group RCT will be conducted. Infants at 3–6 months at entry, with severe visual impairment and at high risk of CP, will be enrolled and randomised (n=16 per group) to receive the VISIBLE intervention compared to SCC. Randomisation will be completed through an independent automated process (Research Electronic Data Capture). VISIBLE intervention will be delivered by a therapist through home visits (90–120 min) once every 2 weeks. Completion of 10 visits (80% of the intervention target dose) within 6 months is required for adherence to the VISIBLE trial. Outcome will be assessed at 12 months CA. Visual function will be evaluated with the Infant Battery for Vision, motor outcomes with the Peabody Developmental Motor Scales, Second Edition. Developmental quotients, infant quality of life, parent well-being and parent-infant relationship will be also monitored through standardised tools.

The enrolling sites have historically demonstrated rapid and effective translation of successful evidence-based interventions into routine clinical practice, as well as the dissemination of the findings through local, national and international scientific meetings.

ACTRN12618000932268.

To describe the normal heart rate (HR) of healthy newborns ≥35+0 weeks’ gestation in the first 10 min after caesarean delivery (CD) with extrauterine placental transfusion, using dry-electrode ECG (NeoBeat).

Single-centre, prospective observational study.

Norwegian County Hospital.

Newborns ≥35+0 weeks’ gestation delivered by CD under regional anaesthesia were eligible for inclusion. Newborns delivered by CD under general anaesthesia, or who needed medical intervention, were excluded.

NeoBeat was attached to the newborn’s chest immediately following delivery. The placenta was delivered without cord clamping after 60–90 s and transferred with the newborn to a resuscitation table. Modified physiology-based cord clamping (PBCC) was performed.

HR was recorded every second for 10 min. HR quartiles were calculated. Events possibly influencing HR were annotated using Liveborn Observation App.

89 newborns with a mean (SD) gestational age of 39+3 weeks (10 days) and birth weight of 3649 (536) g were included. Median (IQR) HR was 164 (117–176) and 169 (145–186) beats per minute at 20 s and 30 s, respectively, peaking at 169 (152–183) beats per minute at 4 min and then slowly decreasing to 157 (146–167) beats per minute at 10 min. HR was not significantly affected by intact-cord blood sampling (mean difference=5.4 (95% CI –1.4 to 12.1)), placental delivery (mean difference=0.7 (95% CI –3.5 to 4.9)) or cord clamping (mean difference =–0.6 (95% CI –2.1 to 0.9)).

This report describes, for the first time, HR quartiles for healthy newborns ≥35⁰ weeks’ gestation from 15 s to 20 s and up to 10 min after CD with extrauterine placental transfusion and PBCC.

Early-stage mycosis fungoides (MF) is diagnostically challenging due to overlap with inflammatory dermatoses. Age-related immunological and cutaneous changes may modify histopathological presentation. We aimed to compare clinical, histopathological and immunophenotypic features of early-stage MF between geriatric and non-geriatric patients.

Multicentre retrospective cross-sectional study.

Dermatology departments of tertiary centres in Türkiye.

A total of 541 patients diagnosed with early-stage MF were included and stratified into geriatric (≥65 years) and non-geriatric (18–64 years) groups.

The primary outcomes were age-related differences in histopathological and immunohistochemical features. Secondary outcomes included clinical characteristics and quality of life measures. Primary endpoints were prespecified a priori (epidermotropism, basilar lymphocytes, epidermal atrophy, dermal lymphocytic infiltration, papillary dermal fibrosis and CD4-dominant versus CD8(+)/CD4(–) phenotypes); all other comparisons were considered exploratory.

The geriatric group had a higher proportion of males (59.5% vs 47.1%; p=0.004), while lesion type, duration, surface involvement and Dermatology Life Quality Index scores did not differ between groups. Histopathologically, epidermotropism (81.3% vs 63.3%), basilar lymphocytes (57.1% vs 45.7%), epidermal atrophy (26.6% vs 13.8%), dermal lymphocytic infiltration (75.8% vs 58.5%) and papillary dermal fibrosis (55.2% vs 38.4%) were more frequent in geriatric patients (all p

Although clinical characteristics were comparable across age groups, geriatric patients showed differences in reported histopathological and immunophenotypic features; these observations may facilitate clinicopathological recognition of early-stage MF in older individuals. However, some features (particularly epidermal atrophy and superficial/papillary fibrosis) are not MF-specific and may partly reflect background age- and site-related changes.

To examine Australian General Practitioners’ (GPs) confidence in initiating oral anticoagulants (OACs) for patients with atrial fibrillation (AF), and their practices for monitoring treatment adherence.

Cross-sectional online survey.

GPs practising in metropolitan, regional and rural/remote locations in Australia.

1765 Australian GPs recruited through professional GP networks.

GPs’ self-reported confidence initiating OACs; practices monitoring patient adherence and persistence; and perceived barriers to adherence. Demographic data including clinical experience and geographic location were collected. ² analyses were used to examine associations between the key outcome variables and GP location and clinical experience.

Of 1765 respondents, 83.1% had practised for >10 years and 27.6% worked in regional or rural/remote areas. Overall, only 50.2% reported high confidence initiating OACs in patients with CHA₂DS₂-VA score ≥2 (a cumulative stroke risk score with a score of 1 for: congestive heart failure, hypertension, diabetes, vascular disease and age 65-74 years and 2 for: stroke/transient ischaemic attack, age ≥ 75 years). Unsurprisingly, confidence was higher among GPs with >10 years experience (51.5%) compared with 5–10 years (44.9%) and

Only half of GPs reported high confidence initiating OAC treatment, and approximately a quarter do not routinely monitor medication adherence or persistence. Targeted strategies to improve confidence and align practices with guideline recommendations are required. Appropriate education should be developed targeting the specific issues underlying lack of confidence in initiating OAC and the practice of referring newly diagnosed patients to cardiology. Further research into implementing systems for monitoring and improving adherence and persistence would be worthwhile in the context of these findings.

To document the first application of the WHO New Vaccine Introduction Prioritization and Sequencing Toolkit (NVI-PST) in the WHO Eastern Mediterranean Region and to describe how Iran’s National Immunization Technical Advisory Group (NITAG) adapted and implemented the framework to develop a prioritised roadmap for vaccine introduction during 2025–2030.

Policy implementation case study applying a structured multicriteria decision analysis-informed prioritisation framework through a three-phase process including framework adaptation, evidence synthesis, ordinal ranking of candidate vaccines, weighted aggregation and development of sequencing scenarios.

National immunisation governance process in Iran, coordinated by the Ministry of Health and Medical Education and Iran’s NITAG, with technical support from the WHO Country Office.

Core and non-core members of Iran’s NITAG and key immunisation stakeholders involved in the deliberative prioritisation process.

Human papillomavirus (HPV) vaccine ranked highest in both importance and feasibility, followed by pneumococcal conjugate vaccine (PCV) for high-risk adults and seasonal influenza vaccine for high-risk groups. Two sequencing scenarios were proposed: both placed HPV first, with either PCV or influenza third after the already-approved hexavalent vaccine. Respiratory syncytial virus (RSV) and varicella vaccines were classified as low priority for the 5-year horizon. The toolkit enabled structured multistakeholder deliberation, improved the transparency and reproducibility of prioritisation, and supported systematic integration of epidemiological, economic and programme evidence. The main implementation challenges arose from national evidence constraints, particularly gaps in adult RSV and pneumococcal disease burden, limited locally generated cost-effectiveness analyses and uncertainty in long-term budget impact estimation under macroeconomic instability, rather than from limitations of the toolkit itself.

The NVI-PST proved feasible under national leadership and generated credible, consensus-based recommendations aligned with Iran’s public health priorities and programme constraints. Minor refinements (streamlined evidence compendium, simpler weighting, stronger secretariat support) would make the toolkit lighter and more sustainable, especially for resource-constrained settings. This Iranian experience provides a replicable model for structured multi-vaccine prioritisation in the Eastern Mediterranean Region and beyond.

Insomnia disorder imposes a significant burden on children and adolescents; however, treatment options are limited. This paper describes the first controlled study to investigate the efficacy and safety of daridorexant, a dual orexin receptor antagonist, in children and adolescents with or without comorbid neurodevelopmental disorders, allowing its evaluation in a broad paediatric population.

This multicentre, double-blind, randomised, placebo-controlled, parallel-group, dose-finding Phase 2 trial includes male and female participants aged ≥10 to

This study has been approved by the respective health authorities and institutional review boards/independent ethics committees for each participating site and country and is conducted in accordance with the Declaration of Helsinki. Ethics approval has been obtained for each participating country/site. Regardless of the outcomes, the results will be published in an international peer-reviewed scientific journal.

NCT05423717.

Socioeconomic inequalities in neonatal mortality are observed globally but gaps remain in the evidence from current reviews, specifically: a wider range of socioeconomic indicators at the individual, household and area level than previous reviews, and alternative time frames to define neonatal mortality. Thus, a comprehensive updated review of the literature is required, focusing on multiple measures of socioeconomic status and alternative time frames, to assess the relationship between maternal socioeconomic status and neonatal mortality in high-income countries.

Three different search approaches will be used: electronic searching of three databases, grey literature searching and reference list checking. First, the three databases Medline, Scopus and Web of Science will be searched using relevant synonyms and adapted terms from medical subject heading terms (MeSH) in Medline for maternal socioeconomic status and neonatal mortality identified from previous systematic reviews on inequalities in adverse pregnancy outcomes. Second, grey literature will be searched by entering the relevant terms into Google. Title, abstract and full text screening will be conducted by the review team against the inclusion and exclusion criteria, with at least 10% checked by a second reviewer to assess for any bias and errors. We will also conduct the kappa statistic for inter-rater reliability. Third, the reference lists of included studies will be reviewed for any additional studies that meet the criteria. Data will be extracted using a data extraction form and extracted studies will be assessed using the Liverpool Quality Assessment Tool. A narrative synthesis will be conducted and, where appropriate, meta-analysis will be performed. If the data allow, subgroup analysis by neonatal care population and specific gestational ages will be performed.

Ethical approval is not required as all studies in this systematic review will be publicly available. The findings of this review will be presented at conferences and disseminated in peer-reviewed publications.

CRD42022315407.

Outcomes for degenerative cervical myelopathy (DCM) patients are limited by delayed and missed diagnoses, driven in part by poor professional awareness. Despite DCM being the most common cause of adult spinal cord injury, it remains under-recognised and undertaught in clinical education. Lessons from other common pathology like stroke and acute myocardial infarction highlight the potential of education to improve early diagnosis. This study will develop a professional education strategy to improve early DCM diagnosis. It will define key audiences and identify an effective delivery method, laying the groundwork for a sustained, targeted intervention.

The study aims to define who needs to know about DCM, what they need to know and how they can learn it. This will be carried out in three phases: phase 1—who and what: to establish the target population and to define core competencies for the educational intervention; phase 2—how: to create and review the educational intervention; phase 3—evaluation: to test whether the framework is an improvement to existing strategies.

Ethical approval is in place from the University of Cambridge (HBREC.2024.24). Results from the study will be disseminated through scientific publication, conference presentation, blog posts and podcasts.

CRD42023461838

Hypertension is a major modifiable risk factor for cardiovascular disease, and timely detection enables interventions that can substantially reduce this risk. General practice, with continuity of care (COC) as one of its core values, plays a pivotal role in hypertension detection. This study aimed to investigate the association between COC and the detection of hypertension in general practice.

Longitudinal dynamic cohort study.

This study used routine care data from 48 Dutch general practices between 2013 and 2022.

106 755 adults without known cardiovascular diseases or risk factors at baseline.

The Herfindahl-Hirschman Index, an established measure for COC, was used to calculate both general practitioner (GP)- and team-COC. A multivariable Cox proportional hazard regression model was used to assess the association between COC level (low, intermediate, high) and the incidence of hypertension detection.

We included 106 755 patients (59.5% female, median age 35 years) in our analysis. The overall incidence rate was 9.42 hypertension diagnoses per 1000 person-years (95% CI 9.20 to 9.64). Compared with low COC, patients receiving intermediate or high GP-COC had a 1.9 (95% CI 1.7 to 2.1) to 4.9 (95% CI 4.4 to 5.4) higher HR of hypertension detection; patients receiving intermediate or high team-COC had a 2.3 (95% CI 2.2 to 2.5) to 7.3 (95% CI 6.8 to 7.8) higher HR of hypertension detection. High personal continuity was associated with up to 8.3 months (95% CI 8.6 to 7.9) earlier detection of hypertension. The association between COC and hypertension detection was dose-dependent.

This study shows that both GP-COC and team-COC are dose-dependently associated with increased HRs and earlier detection of hypertension in adults without preregistered cardiovascular conditions. Promoting COC contributes to cardiovascular preventive care.

This study aims to evaluate global trends in maternal and child health-related indicators in the Millennium Development Goals (MDG) and Sustainable Development Goal (SDG) eras, examine whether these associations differ across regions and income groups and assess their impact on life expectancy (LE) at birth.

We conducted a country-level panel analysis using data from 2000 to 2023 obtained from the Global Health Observatory and the World Development Indicator database. All WHO Member States with available data were included. Data on under-five mortality rate (U5MR), maternal mortality ratio (MMR), neonatal mortality rate (NMR), skilled birth attendance, ratio of nurses and midwives, total fertility rate (TFR), LE, prevalence of anaemia and hypertension in women aged 15–49 years, diphtheria tetanus toxoid and pertussis (DTP3) vaccine coverage, gross domestic product and government health expenditure as a percentage of GDP were collected, cleaned and prepared for analysis. Missing values (

Trends in LE and maternal and child health indicators and maternal and child-related factors associated with LE.

Maternal and child health improved substantially, with faster progress during the MDG era (2000–2015) compared with the SDG era (2015–2023). The MMR declined by 130.30 (100 in MDG vs 30.30 in SDG) deaths per 100 000 live births overall, from 327.60 (95% UI: 308.80–348.60) in 2000 to 197.30 (95% UI: 174.50–234.00) in 2023. Similarly, U5MR declined by 39.95 (28 in the MDG vs 11.95 in the SDG era) deaths, from 76.67 (95% UI: 75.70–77.86) to 36.72 (95% UI: 34.66–41.09) deaths per 1000 live births. The NMR decreased by 13.38 per 1000 live births, from 30.71 (95% UI: 29.91–31.58) to 17.33 (95% UI: 16.25–19.41) deaths, and LE increased by 6.6 years, from 66.77 (95% UI: 66.23–67.18) to 73.33 (95% UI: 72.73–73.93) globally. Fixed-effects regression results showed that higher U5MR (β=–0.0697, 95% CI –0.080 to –0.060, p

Despite progress in maternal and child health, gaps remain, particularly in low-income and lower-middle-income countries. Strengthening and retaining the health workforce, expanding access to immunisation and family planning services and improving early detection and management of hypertension and anaemia among women are critical to sustaining gains and accelerating improvements in LE.

Respiratory syncytial virus (RSV) is a leading cause of hospitalisation in infants worldwide. New immunoprophylactic products, including long-acting monoclonal antibodies and maternal vaccines, have demonstrated high efficacy in prelicensure clinical trials. Understanding how these interventions perform outside controlled trials, and how viral evolution or host factors influence protection, is essential for sustaining confidence in RSV prevention programmes.

We will conduct a 5-year, test-negative case–control study among infants ≤12 months of age who present with acute respiratory illness (ARI) within a large healthcare delivery network serving a demographically diverse population. Cases will be infants testing positive for RSV by PCR, and controls will be RSV-negative infants meeting the same ARI criteria. Data will be obtained from electronic health records, structured caregiver surveys and state immunization registries to ensure accurate classification of exposures and covariates. Vaccine effectiveness will be estimated using multivariable logistic regression controlling for potential confounding. RSV-positive specimens will undergo full-genome sequencing to identify variant lineages and potential immune-escape mutations. A subset of participants will provide acute and convalescent blood samples for single-cell immune profiling to define innate and adaptive responses associated with breakthrough infection.

The study protocol has been approved by the Yale Human Investigation Committee (HIC #2000036550). Written informed consent will be obtained from all parents or legal guardians prior to participation. Study findings will be disseminated through peer-reviewed publications, scientific meetings and public repositories, with fully de-identified participant data to protect privacy and confidentiality. Viral genomic data will be shared in accordance with the National Institutes of Health Genomic Data Sharing Policy, and analytical code will be made publicly available to ensure reproducibility.

NCT06172660.

Antenatal care (ANC) plays a critical role in improving maternal and neonatal health outcomes. However, incomplete ANC attendance in Somaliland is associated with adverse maternal and birth outcomes. Barriers to ANC attendance may increase the risk of pregnancy-related complications, including maternal morbidity, mortality and poor neonatal health outcomes. Understanding the effect of ANC attendance on maternal and birth outcomes is crucial for informing policies and interventions aimed at reducing these risks. Hence, this study aimed to assess the effect of ANC attendance on maternal and birth outcomes in Somaliland.

A prospective cohort study was conducted among 1205 pregnant women enrolled by systematic sampling method.

The study was conducted in the Republic of Somaliland, which is situated in the Horn of Africa. Baseline data were collected at recruitment, and participants were followed up to delivery for the collection of outcome variables. The number of ANCs was considered to be a dichotomous independent variable; incomplete attendance (≤ 3 visits) and complete attendance (≥4 visits). The risk of pregnancy outcome among those with incomplete ANC was assessed using multi-variable logistic regression.

The outcome variables of the study were the maternal and birth outcomes. The independent variables included socio-demographic characteristics, such as age, residence, educational status, occupation, family size, wealth index and marital status, and reproductive factors, such as parity, gestational age at first ANC visit, current pregnancy desirability and previous pregnancy history.

Out of the total participants, 43.3% of women had complete attendance. The incidence of postpartum haemorrhage was 10.0% (95% CI 8.6 to 12.3); antepartum haemorrhage, 3.6% (95% CI 2.6 to 4.7); caesarean section, 14.8% (95% CI 12.9 to 16.8); preterm delivery, 13.7% (95% CI 11.7 to 15.4); low birth weight, 25.8% (95% CI 23.4 to 28.1); and stillbirth, 3.2% (95% CI 2.3 to 4.2). Complete attendance to ANC significantly reduced the risk of antepartum haemorrhage, caesarean section, preterm delivery and admission to the neonatal intensive care unit and stillbirth.

Nearly more than half of women in Somaliland had less than four ANC visits. The incidence of maternal and birth complications is higher among pregnant women who attended

To evaluate the effectiveness of early administration of excitatory amino acid (EAA) inhibitors on long-term neurological outcomes in adults with acute moderate to severe traumatic brain injury (TBI).

Systematic review and meta-analysis of randomised controlled trials (RCTs).

MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, WHO International Clinical Trials Registry Platform and ClinicalTrials.gov from inception to January 2026.

RCTs comparing EAA inhibitors with placebo, standard care or any other interventions were included. Trials enrolled adult patients (≥18 years) with moderate to severe TBI (Glasgow Coma Scale score ≤12) receiving the intervention within the acute phase of care (first week).

Pairs of reviewers independently screened trials, extracted data, assessed the risk of bias (RoB) with the Cochrane RoB tool 2 and graded the certainty of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach. Random effects models were used for all effect measures and trial sequential analyses (TSA) were performed for each outcome.

The primary outcome was long-term neurological function at 6 months (or the nearest earlier time point), assessed with the Glasgow Outcome Scale (GOS) or extended version (GOS-E), using the classical definitions of an unfavourable outcome (GOS 1–3 or GOS-E 1–4).

28 trials enrolling 4238 patients were included. Early administration of EAA inhibitors was not associated with reduced unfavourable neurological outcomes (relative risk 0.93 (95% CI (0.84 to 1.03); I²=40%; 15 trials, n=3613, moderate certainty). No statistically significant difference was observed based on EAA inhibitor type, timing or duration of administration, RoB or TBI severity. Mortality, intensive care unit lengths of stay and mean intracranial pressure were not statistically different between groups, but hospital length of stay was reduced in the EAA inhibitors group. The early use of EAA inhibitors was not associated with adverse events (low certainty). TSA showed insufficient power for the primary outcome.

In adults with moderate to severe TBI, the early administration of EAA inhibitors was not associated with a reduction of unfavourable neurological outcomes. Further high-quality and adequately powered RCTs are required to clarify their role in TBI management.

CRD42025635527.

Macrosomia is an emerging but neglected obstetric challenge in Africa, associated with potentially life-threatening complications to both the mother and the fetus, including maternal and neonatal morbidity and mortality. This study aimed to determine the pooled prevalence, associated risk factors, and neonatal and maternal outcomes of macrosomia by performing a systematic review and meta-analysis.

We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

We conducted a comprehensive search of PubMed, EMBASE and Web of Science to extract data from those that have investigated various aspects of the prevalence, risk factors and outcomes of macrosomia from the earliest records to 26 August 2025. Appropriate search terms were used for each database.

We included observational studies that examined the prevalence, risk factors and outcomes of macrosomia in Africa.

Two independent reviewers used standardised methods to search, screen and code included studies. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal tool and the Newcastle-Ottawa Quality Assessment Scale. Meta-analyses were performed using random-effects models to estimate the pooled prevalence of macrosomia. The I² statistic was used to examine statistical heterogeneity. Egger’s test and Funnel plot were used to evaluate publication bias. Grading of Recommendations Assessment, Development and Evaluation to assess the quality of the meta-analysis.

A total of 29 studies comprising 269 934 mother–infant pairs from 9 African countries were included. The pooled prevalence of macrosomia in Africa was 6.35% (95% CI 5.22% to 7.48%), with substantial heterogeneity (I²=94.9%). Sensitivity analysis excluding one outlier study reporting a prevalence of 35.89% produced a similar pooled estimate (6.02%, 95% CI 4.94% to 7.10%). Significant risk factors for macrosomia included male neonate (OR=1.58, 95% CI 1.05 to 2.11), gestational age ≥40 weeks (OR=1.54, 95% CI 1.11 to 1.97) and history of macrosomia (OR=5.44, 95% CI 1.82 to 9.06). With respect to outcomes, macrosomia was associated with an increased risk of shoulder dystocia (OR=2.07, 95% CI 1.12 to 3.03), and a reduced risk of postpartum haemorrhage (OR=0.86, 95% CI 0.82 to 0.91), while no significant associations were observed for gestational diabetes mellitus, caesarean delivery, neonatal mortality or maternal mortality.

Macrosomia remains a significant public health concern in Africa, with a pooled prevalence of 6.35%. There are multiple risk factors associated with macrosomia in Africa, including the male sex, prolonged gestation and a prior history of macrosomia. Also, macrosomia increases the likelihood of shoulder dystocia and other delivery complications. Preventive strategies and targeted interventions are needed to reduce the burden of macrosomia in Africa. At the same time, enhanced obstetric preparedness for macrosomic deliveries is essential to mitigate the associated adverse perinatal outcomes. However, our study is limited by high heterogeneity and publication and language biases, which should be addressed in future studies.

CRD42023485419.

Dance is an artistic and social form of exercise and has been shown to be effective across the lifespan. Intergenerational dance programmes can have beneficial effects in reducing discrimination and fostering communities. Previous intergenerational dance programmes included small sample sizes or were not designed to target physical outcomes. There is a need for well-designed community-based intergenerational dance programmes to target the needs of older adults (OAs) and adolescents addressing physical activity, ageism and loneliness.

The aim of this study was to co-design and refine the content of an intergenerational dance programme with OAs and adolescents using the ‘six steps in quality intervention development framework’ (6SQuID). The objectives were to complete steps 1–4 of the 6SQuID framework and run a short pilot study with OAs.

A proof-of-concept pilot study.

The programme took place in a local community centre.

12 participants were recruited (n=5 adolescents; n=7 OAs). Adolescents were aged between 14 and 16 years. OAs were aged 60 years and older.

The intervention was led by a physiotherapist and dance teacher and comprised of intergenerational practice and social dance.

Outcome measures focused on physical activity, well-being, ageism and mobility. Accelerometers were used to establish programme intensity. Focus groups were conducted to explore the opinions of participants. Qualitative data were analysed using Thematic Analysis.

Six OAs and four adolescents completed the programme. The average age of OAs was 72.8±6.69 years and the adolescents were aged 14–16 years. The intensity of the classes was driven by participants, with some achieving vigorous intensity, and most achieving light-moderate intensity. This accounted for an average of 28.36 (±11.02) min of the class. The outcome measures were found to be meaningful for participants; however, more challenging balance measures were suggested by both cohorts. The social dance was enjoyable, especially when the music was tailored to participants’ preferences. Meeting with other age groups was valued, and it was suggested that more time should be given to icebreakers and socialising.

Intergenerational dance may be a promising way of improving well-being, intergenerational connections and achieving moderate-intensity activity. The process of designing an evidence-based intervention in this paper can be used to guide researchers and practitioners in designing an intergenerational arts-based programme.

The over 14 million African children who are HIV-exposed but uninfected (CHEU) are at risk for poor health outcomes, including neurodevelopmental conditions such as autism; however, no study to date has examined autism in CHEU in Africa, where the vast majority of these children live. Scalable diagnostic and neurobehavioural tools, including powerful, low-cost approaches such as eye-tracking, for detection and study of mechanistic neural processes are necessary to advance autism research in these settings. The objective of this study is to examine autism diagnostic outcomes and eye-tracking biomarkers in relation to CHEU while at the same time building capacity for neuro-health research in Kenya.

This study will leverage a longitudinally assessed cohort of CHEU and children who are HIV-unexposed and uninfected (CHUU) with well characterised HIV-related and contextual exposures. We will first determine and compare autism diagnostic outcomes between young CHEU and CHUU across a large cohort (n=850) of Kenyan children using research-grade autism assessment tools, and, second, determine whether neurobehavioural eye-tracking markers predict autism outcomes across this cohort.

Human subjects approvals have been obtained from Moi University Institutional Review and Ethics Committee (IREC; IREC/909/2024; Approval #0004835), Kenya’s National Commission for Science, Technology and Innovation (NACOSTI; Reference #NACOSTI/P/25/415028), the Institutional Review Board of the Indiana University School of Medicine (Protocol #23171), with reliance agreements executed with Purdue University and Boston University. Dissemination of findings will occur through multiple channels within the research and clinical community, including peer-reviewed journal publications and conference abstracts and presentations. As part of capacity building efforts, the research team will also communicate study results to policy makers, the lay public and other health systems involved in the care of young children with disabilities via study-hosted workshops and conferences.

All countries around the world have been encouraged to implement universal health coverage, emphasising its essential role in global health policy. Morocco has long been part of this international movement. Several health reforms have been implemented over the years, significantly improving the health status of the population and service coverage. However, several gaps continue to hinder the expected results. The current health financing model in Morocco is one of the main persistent challenges. It remains largely dependent on out-of-pocket expenditure, with no significant change since 1997/1998. This situation contributes to restricting access to care for low-income individuals, thereby exacerbating inequalities. In this context, the objective of this scoping review is to map the literature on health financing functions in the context of progress toward universal health coverage in Morocco.

This scoping review protocol was developed following the best practice guidelines for scoping study protocols from the Joanna Briggs Institute (JBI) Scoping Review Methodology Group. The final study will be reported in accordance with the JBI methodology for scoping studies. Relevant databases such as PubMed, SCOPUS, WOS and Google Scholar will be searched for articles published in English and French between 2005 and 31 January 2026. Additionally, government reports, technical reports and policy and institutional documents from grey literature will be included. We will include all interventions that address the implementation of health financing approaches aimed at achieving universal health coverage in Morocco. Article selection will be conducted by pairs of independent reviewers. Data extraction will also be performed by two independent reviewers. A narrative and thematic approach will be used to synthesise the findings.

It should be noted that formal ethical approval is not required, as no patients will be involved in the process. The results of this scoping review will be prepared and submitted for presentation as conference presentations and published in the form of a peer-reviewed article.

To translate and culturally adapt six self-report measures for depression, anxiety, post-traumatic stress disorder (PTSD) and somatic symptom disorder into Hindi and determine their diagnostic accuracy against a diagnostic clinical interview.

Cross-sectional validation study.

Rural Kangra, Himachal Pradesh, northern India.

480 perinatal (pregnant or within 12 months postpartum) and non-perinatal (not currently pregnant and not given birth within 12 months) women at one tertiary hospital and district-level Anganwadi (community health) centres.

Symptom endorsement; and discriminant validity, sensitivity, specificity, positive and negative predictive values and area under the receiver operating characteristic curve (AUROC) of the Kessler Scale of Psychological Distress (K10), Patient Health Questionnaire (PHQ9), Edinburgh Postnatal Depression Scale (EPDS), Generalised Anxiety Disorder Scale (GAD7), Perinatal Anxiety Screening Scale (PASS), PTSD Checklist (PCL-5) and Scale for the Assessment of Somatic Symptoms (SASS).

Complete data were available for 443 participants. Tiredness and body weakness were the most commonly endorsed symptoms among participants with common mental disorders. Among perinatal participants, the AUROC was highest for the GAD7 (0.88, 95% CI 0.79 to 0.96) and SASS (0.84, 95% CI 0.71 to 0.96). Among non-perinatal participants, the AUROC was highest for the SASS (0.92, 95% CI 0.88 to 0.97) and PHQ9 (0.91, 95% CI 0.86 to 0.96).

Measures which assess for fatigue, tiredness and somatic symptoms may help to identify women experiencing common mental disorders in this setting. Small numbers of participants with clinically diagnosed mental disorders in our sample mean results must be interpreted cautiously.

NCT05485701.

Each year, an estimated 1700 children should be diagnosed with cancer in western Kenya, with leukaemia making up nearly one-third of cases. However, far fewer are actually diagnosed, highlighting significant delays or errors in diagnosis. Flow cytometry, which the WHO considers essential for leukaemia diagnosis, remains underused across sub-Saharan Africa due to high costs, outdated equipment and a lack of trained personnel. In Kenya, decades-old cytometers have been adapted for leukaemia detection, but these systems are now outdated. Newer platforms, such as simplified single-tube multiparametric assays, provide a scalable and sustainable alternative. This study presents a protocol to evaluate the accuracy of diagnosis and the potential for implementing a streamlined flow cytometry assay using peripheral blood, supported by a regional educational initiative.

This prospective, mixed-methods implementation study has three aims: (1) to assess the concordance between the Beckman Coulter ClearLLab 10C gold standard 4-tube assay and the streamlined ClearLLab LS 1-tube assay using paired bone marrow and peripheral blood samples; (2) to evaluate the feasibility of peripheral facility referrals and transport logistics with couriered peripheral blood samples from referring sites across western Kenya; and (3) to measure training effectiveness and knowledge gain through a multimodal educational programme using the Project ECHO (Extension for Community Healthcare Outcomes) model. Up to 300 patients at Moi Teaching and Referral Hospital in Eldoret, Kenya, will be enrolled in Aim 1. A separate sample of 100 patients from peripheral facilities will be included in Aim 2. Surveys, knowledge assessments and structured interviews will be used to evaluate training impact under Aim 3. Diagnostic concordance, sensitivity, specificity and knowledge gain will be measured through appropriate quantitative and qualitative methods.

The protocol has received approval from institutional ethics committees at Moi University, MTRH and Indiana University. De-identified data will be analysed and shared through peer-reviewed publications, stakeholder presentations and educational platforms.