Mediastinal and/or hilar lymphadenopathy (MHL) is increasingly identified owing to various underlying conditions. Minimally invasive biopsy techniques, including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), transbronchial mediastinal cryobiopsy (TBMC) and transbronchial forceps biopsy (TBFB), are common diagnosis tools. However, their safety and diagnostic efficiency remain unclear. This trial aims to compare the diagnostic yield and safety of these three techniques.

This study is a three-arm, parallel-design, randomised controlled trial involving 972 adult patients with MHL recruited from multiple medical centres. Participants will be randomly assigned to the EBUS-TBNA, TBMC via a tunnel or TBFB via a tunnel group. The primary outcome is diagnostic yield, and the secondary outcomes include diagnostic sensitivity, sample quality and procedure-related complications. Statistical analyses will be conducted using the appropriate methods. An independent sample ² test will be used to test the differences in the diagnostic yield and incidence of procedure-related complications.

Ethics approval was obtained from the China-Japan Friendship Hospital Ethics Committee (2022-KY-194).

Written informed consent will be obtained from all patients or their guardians before their enrolment in the study. This study will be conducted per the principles established in the Declaration of Helsinki and the International Council for Harmonisation Guidelines for Good Clinical Practice.

www.clinicaltrials.gov (NCT06262620).

To compare the presenting demographic and clinical characteristics of rhegmatogenous retinal detachment (RRD) with other RD types, investigate risk factors of blinding RD and the outcome of surgical intervention.

Prospective, cross-sectional and multicentre.

Four ophthalmic centres in three geographic locations of Nigeria.

264 eyes from 237 patients diagnosed with RRD, tractional retinal detachment (TRD) and exudative retinal detachment (ERD) seen between April 2019 and March 2020.

264 eyes of 237 patients were diagnosed out of 35 641 patients screened. RRD was the most common RD (n=167 (70.5%), TRD 61 (25.7%) and ERD 9 (3.8%) patients). The hospital-based prevalence of all RD is 6.6 per 1000 patients (0.66%), and for RRD alone, 4.7 per 1000 patients (0.47%). The most common symptom was a sudden decline in vision, 100 patients (42.2%); floaters and flashes were uncommon, 5 (2.1%). RRD presented earliest, with a median symptom duration of 2 months, and TRD and ERD at 7.5 months each.

The 46–65-year age group had the highest representation, RRD (n=70, 41.9%), TRD (n=41, 67.3%), ERD (n=4, 44.4%). The mean age was highest in TRD (52.3±12.7 years) and lowest in RRD (44.0±17.5 years) and ERD (45.2±20.4 years). Males dominated (RRD 70.1%, TRD 62.3%, and ERD 66.7%). Ocular trauma was highest in RRD 29.3%, TRD 7.5% and ERD 10%; fellow eye RD was highest in TRD 47.5%, ERD 20%, RRD 8% and myopia was highest in RRD 27.6%.

Two-thirds of eyes were blind (Snellen best-corrected visual acuity

Shorter symptom duration is associated with better preoperative and postoperative vision. In contrast, longer durations are connected to poorer outcomes. Eyes with symptoms lasting less than a week had a 17% rate of postoperative blindness, compared with 30% in cases lasting 1–3 months, and 51% in cases exceeding 6 months.

Delays in diagnosing and treating RD result in high rates of preoperative blindness, which can be reversed with surgery even after several weeks of symptoms. Understanding the associations between RD and the risk of blinding RD in developing countries will benefit early diagnosis, treatment and improve treatment outcomes.

As the field of radiation oncology continues to evolve with rapidly advancing technologies, the need for innovative educational methods is critical. Extended reality (XR) technologies—including virtual reality, augmented reality and mixed reality—have emerged as transformative tools in medical education. While the potential of XR in healthcare education is recognised, there is a lack of comprehensive exploration specifically in the context of radiation oncology education. This scoping review aims to map the existing literature on XR technologies in radiation oncology training and education, identify barriers to their adoption and highlight opportunities for broader integration into curricula.

This scoping review will follow the Arksey and O'Malley framework with enhancements by Levac et al and will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search will be conducted across databases, including MEDLINE, Scopus and Web of Science, to identify relevant studies on the use of XR technologies in radiation oncology education. Studies will be selected based on predetermined inclusion criteria using the population, concept, context framework. Data extraction will focus on the types of XR technologies used, educational settings, learning outcomes, barriers to adoption and methodologies for evaluating XR effectiveness. The results will be synthesised through descriptive statistics and qualitative thematic analysis. A consultation phase will engage experts to refine findings and ensure the practical relevance of the review.

This protocol does not require ethics approval at the current stage as it involves a scoping review of publicly available literature. Ethics approval will be obtained prior to initiating the consultation phase involving experts. Written informed consent will be obtained from all individual participants included in the study. The study will be conducted in accordance with relevant guidelines and regulations and was approved by the Chang Gung Medical Foundation Institutional Review Board on 13 May 2025 (ref.: 202500731B0). The findings of this review will be disseminated through peer-reviewed publications, conference presentations and tailored executive summaries aimed at educators, policymakers and stakeholders in radiation oncology education.