Vision screening in educational settings holds significant importance for early detection of visual impairment. A key challenge is the low uptake of referral services which significantly limits the effectiveness of screening. Mobile health (mHealth) is one intervention that is rapidly being adopted in Pakistan with more than 100 million smartphones users. However, evidence of its effectiveness on referral uptake outcomes is still limited. A concurrent, parallel-group, single-blinded randomised controlled trial will be conducted in government schools of Rawalpindi district, Pakistan. Participants will first be screened for visual impairment using the mHealth visual acuity application. After screening, schools will be randomly allocated (1:1) to intervention and control groups. Eligible participants will include children aged 5-15 years whose parents own a smartphone and who are diagnosed with visual impairment during screening. The intervention group will receive a multicomponent SMS reminder in addition to a printed referral form. The SMS will include a health promotion message, visual depiction of the vision of the child and a customised action plan. Reminders will be delivered automatically through the visual acuity application. All referred children will be followed for 8 weeks by telephone. Data will be analysed according to the intention-to-treat principle. A Cox regression model will be used to assess the effect of SMS reminders on referral uptake. Ethical approval was obtained from the Ethical Review Committee of Army Medical College, Rawalpindi, Pakistan (ERC/ID/415, dated 5 September 2024). Permission to conduct screening was granted by the Federal Government Education Institutions Directorate, Rawalpindi (0409/F-28/2024 FGEI, CPD-Trg), dated 20 October 2024. All children participating in the trial will be required to provide written informed consent from parents or guardians, along with assent from the child. Findings will be disseminated through methodology papers, conference presentations and peer-reviewed publications. Results will be reported according to the Consolidated Standards of Reporting Trials guidelines. Participation in national and international academic conferences will provide further opportunities for dissemination. NCT06616051 (dated 26 September 2024).

There is a lack of evidence on the efficacy of extracorporeal blood purification (EBP) to reduce the mortality rate in septic shock. We have designed the EABPSS (Efficacy of Adaptive Blood Purification for Septic Shock) study to confirm whether adaptive blood purification (ABP) intervention could confer a clinical benefit. In this multicentre, open-label, randomised controlled trial, we are recruiting a total of 276 patients with septic shock. Eligible patients who provide informed consent will be randomly assigned in a 1:1 ratio to either the control group or the intervention group. Patients in the control group will receive standard care according to the Surviving Sepsis Guidelines. Patients in the intervention group will receive two 6-hour sessions of ABP treatment within 24 hours of enrolment, based on standard care. ABP is a novel, adaptive EBP strategy proposed by our research team. Specifically, for patients with septic shock who do not require renal replacement therapy (RRT), plasmafiltration-adsorption (PFAD) will be used alone, and for patients with septic shock and acute kidney injury meeting RRT indications, a combination of PFAD-RRT will be employed. The primary endpoint of this study is all-cause mortality at 90 days after enrolment. Secondary endpoints of the study include the declining proportion of serum cytokines such as tumour necrosis factor-α (TNF-α), IL-4, IL-6, IL-8, IL-10 and high-mobility group box 1 within 24 hours after enrolment. Additionally, the study will evaluate the improvement of the Sequential Organ Failure Assessment score on day 7 postenrolment, as well as the 30-day mortality rate. The study was approved by the respective ethical committees of the participant centres, including: Ethics Committee of Beijing Chaoyang Hospital, Capital Medical University (2024-KE-348); Ethics Committee of PLA General Hospital (S2024-716-01); Ethics Committee of China-Japan Friendship Hospital (2024-KY181); Clinical Research Ethics Committee of Peking University First Hospital (2024YAN258-001); Ethics Committee of Beijing Hospital (2024BJYYEC-KY106-02); Ethics Committee of Air Force Medical Center, PLA (KONGTE2024-29-PJ01); Ethics Committee of Beijing Jishuitan Hospital, Capital Medical University (JILUN(K2023)(370)-00). The findings of the study will be disseminated in peer-reviewed journals and presented at national and international conference presentations. NCT06692036.

IntroductionOral health research provides evidence for policy and practice, yet no study has comprehensively mapped the scope of oral health research in Malaysia. The COVID-19 pandemic has also created a great impact on oral healthcare in Malaysia, including the dental care delivery. Additionally, there is a notable lack of research focusing on oral health during and after the COVID-19 pandemic. Therefore, this scoping review will aim to map the landscape of oral health research conducted in Malaysia and identify key topics, study designs, populations studied and gaps in the literature, in order to inform future research priorities and policy, particularly in the post-COVID-19 era.Methods and analysisThe methodology draws on Arksey and O’Malleys’ seminal framework for the scoping review and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines. We will search five major electronic databases—PubMed, Scopus, ProQuest, Cochrane and Web of Science—as well as selected grey literature sources (eg, theses, dissertations and conference proceedings) for studies published in English from January 2014 to December 2024. Studies of any design related to oral health in Malaysia will be included. Two reviewers will be performing title and abstract screening, in which they will be working independently. The included publication will undergo a full-text review, and references cited in these studies will be examined following the inclusion criteria. The PRISMA-ScR flow diagram will be used as a guide throughout the process. Data will be extracted, analysed and charted according to key categories identified in the included publications. A narrative synthesis and descriptive statistics will be presented.Ethics and disseminationThe results of this scoping review will illustrate an overview and provide a better understanding regarding the oral health research in the Malaysian context; whether research has already been conducted, is currently ongoing and is still needed; and which areas should be prioritised for future investigation. As this review will use publicly available literature, formal ethics approval will not be required. The findings will be submitted for publication in an open-access peer-reviewed journal, presented at national and regional conferences and shared with Malaysian dental professional bodies and relevant stakeholders.Trial registration numberThe protocol of this scoping review is registered with the Open Science Framework and is available at osf.io/hjq6m.

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The article examines the system of professional choreographic education at the State Academy of Choreography of Uzbekistan. In the process of optimizing the educational program, the need to synchronize theoretical and practical related disciplines has been identified. Such coordination contributes to more effective knowledge acquisition as well as the rational use of academic hours. One of the important directions of work is the “Ustoz-shogird” (“Teacher–Student”) principle, which enables students to gain experience directly from masters of the arts. In the educational process, it is essential to actively apply modern information technologies, innovative teaching methods, and the achievements of world choreography. The active involvement of students in national and international scientific and practical conferences fosters the development of the scientific potential of creative youth. Participation in academic mobility programs provides opportunities to acquire international experience. Cooperation with leading choreographic universities is one of the key areas in the development of the educational system at the State Academy of Choreography of Uzbekistan.

The 1997 National Conference of Nahdlatul Ulama (NU) Scholars in Lombok issued a groundbreaking fatwā permitting women to hold the position of vice president—a progressive step in advanc­ing gender justice within Islamic discourse. However, at the grassroots level, gender segregation remains deeply entrenched, particularly in Sumenep Regency. This study explores how NU feminists in Su­menep negotiate their struggle for gender equality and how local kiai and religious scholars respond to these efforts. Employing a qualita­tive approach with data collected through literature review, observa­tion, interviews, and documentation, this research is framed by Is­lamic feminist theory. The findings reveal that gender discourse in NU Sumenep remains weak when confronted with the religious authority of kiai and traditional scholars. Their ambivalent and skeptical re­sponses toward gender equality activism indicate that the discourse promoted by the NU Central Board (PBNU) has not been effectively internalized at the local level. Furthermore, the absence of pesantren-based initiatives on gender awareness perpetuates gender segregation, resulting in unequal competencies and opportunities between male and female students. This study highlights the gap between NU’s pro­gressive theological discourse and its limited cultural translation among rural communities.

According to the United Nations Conference on Trade and Development, the world is going through a ‘fifth technological revolution’. Digitalization, artificial intelligence, cognitive research, neurotechnology and cryptocurrencies have radically changed the very nature of international relations and world politics. In these conditions, the countries of the World Majority are faced with the questions of how to ensure economic and technological sovereignty and formulate a development policy in the context of global high-tech inequality. This issue is particularly clearly visible in the agenda of BRICS+, a global association whose values, include inclusiveness and advancement based on scientific achievements, equality, progress and sustainable development. The Russian Federation, as one of the member countries of the association, is among the international actors advocating for technological sovereignty and its protection, as well as equal access to modern technologies. BRICS+ has the potential to become a leading platform for sharing innovations, especially in science and education. Russia is capable of making a significant contribution in these areas since it is known worldwide for its fundamental science, traditions of preparing highly qualified personnel and educational system. Moreover, in recent years the country has acquired unique experience and its own domestic producers interested in distributing their products and services. Russia is able to offer BRICS+ members a transfer of a number of high-tech and promising initiatives in the field of science and education, which are designed to strengthen the positions of states in the international arena and prepare them for all sorts of risks and threats.

Continuing professional development (CPD) involves ongoing learning to maintain and enhance professional competence. CPD for health information managers (HIMs) is embodied in the Health Information Management Association of Australia's (HIMAA) Professional Competency Standards. The CPD engagement of Australia's HIMs has not been explored. To examine HIMs' engagement with professional body-initiated CPD, and the associated enablers and barriers. A cross-sectional survey was administered to 72 Victorian graduate HIMs from four cohorts: 1985, 1995, 2005 and 2015. It elicited their perceptions of CPD and engagement with HIMAA events and activities. When asked if engaging in CPD was important: 70.8% agreed; 9.7% disagreed; 19.4% were unsure. Motivations for engagement were networking, continuous learning and skill development and gaining insights from the work of others. Barriers to participation included movement outside of HIM roles, lack of time or interest and perceived irrelevance. The most common activities were special interest/working group(s) (27.8%) and other (sub)committees (18.1%). Seventy-two percent had attended an (inter)national conference or seminar/webinar. Notably, 57% had not participated in any HIMAA-related activities. HIMs must continually build their knowledgebase and skills to align with the evolving health information ecosystem. A large proportion of participants acknowledged the importance of CPD; however, of concern, are the 29.1% who disagreed or were unsure, and the 57% who did not participate in any professional body-initiated CPD activities. There is room to strengthen HIMs' engagement with CPD to ensure their commitment to career-centred lifelong learning, maintain professional competence by meeting a core competency outlined in the Professional Competency Standards and contribute to the continuing development of the profession.Implications for health information management practice:HIMAA should continue to diversify CPD content and formats to sustain and further enhance engagement, to ensure HIMs remain competent, and responsive to the changing health information environment.

Before Anne Robson (née Taggart) became the second Lady Kerr upon marrying governor‐general John Kerr in 1975, she had an international career of some 30 years working as a French to English interpreter and consultant at over 30 national and international conferences and became the first Australian elected to the International Association of Conference Interpreters (AIIC) in 1966. She resigned from the profession and divorced her first husband in 1975 to marry John Kerr and within the year became entangled in the political and national crisis of the Whitlam dismissal, brought on by her new husband, and in which some contemporaries suspected she played a part. Eclipsed by the crisis and largely ignored by historians since, her life and career merit closer scrutiny. They speak to the professionalisation of interpreting services in the post‐Second World War era and to Australia's early endeavours in regional diplomacy. They underscore the critical role of language in facilitating and hindering international relations as well as of the invisibility of the interpreter in diplomatic history. Finally, her story merits closer examination for what it reveals about John Kerr, their relationship, his tenure as governor‐general and particularly his decision to dismiss Whitlam.

It is an understatement to say that I have attended a few wound, ostomy and continence conferences. How much is there left to say about different etiologies, products, or new technologies? Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC®) demonstrated that the conversations and learnings must continue. This 44th annual conference in Montréal, QC, Canada was enlightening. The conference theme, IDEAs [Inclusivity, Diversity, Equity, Accessibility, shared — Inclusivite, Diversite, Equite, Accessibilite, solidaire] flowed seamlessly through a myriad of sessions. They are core beliefs of NSWOCC. There are signs of a seismic shift in Canada as NSWOCs with light skin tones are now advocating for health inequity in skin assessment to rectify years of white supremacy. Rebecca Dyck highlighted how many assessment tools reference skin colour. “They always note it may appear differently in darker skin ... let’s change the may. It does appear differently in dark skin, and then we need to go beyond. How does it look different? We need to be specific,” says Dyck. Presenters are describing tools as biased, including pulse oximetry and the Apgar score. The familiar body mass index was designed on studies in a now obsolete racial classification. Such surrogate health markers fail to represent the diversity of global population. We need to recognize bias and stigma. We agree that the skin is the largest organ in the body. Dr. Ray Samuriwo took us on a fascinating exploration of why the structure of the skin and its microbiome vary by different skin tones. Skin tone varies within cultures and even within families. “In terms of being honest about where we are and acknowledging the limitations of the system, we know that people with dark skin tones like mine often receive suboptimal care, and this is often because they are underrepresented in skin ... and wound healing research for variety of different reasons,” said Dr. Samuriwo. We wonder what future implications this could have for products or technologies in the fields of wound, ostomy and continence. Moderator Josh Moralejo thanked Lili Berescu and Priyanka Jani for their session — Canadian Best Practice Recommendations: Wound Care for People Who Use Drugs — A Harm Reduction Approach, concluding that we must “listen, acknowledge and respect the lived experiences of persons who use drugs, because as health care professionals here today, how can we provide individualized, holistic and sensitive care if we’re not going to be listening to our clients?” Of course, there were awards recognizing the deserving leaders whose tireless work inspires the next generation. We applaud these role models. Listening to the spouse of the late Dr. Laura Teague accept the Canadian Journal of Wound, Ostomy and Continence (CJWOCTM) manuscript award was a poignant moment. The manuscript was completed posthumously by Dr. Karen Campbell and acknowledged eight co-authors. Why do I pick out this individual award? Laura’s achievements and her husband’s vote of thanks epitomize the close-knit community and solidarity among the Canadian clinical community and, indeed, how united the industry is within it. Again, as one who has attended many NSWOCC conferences, seeing the number of Nurses Specialized in Wound, Ostomy and Continence (NSWOC®) and Skin Wellness Associate Nurse (SWANTM) graduates and the stage packed with members contributing to NSWOCC Board roles and initiatives is a testament to the exceptional growth. It signifies how that deep sense of community inspires emerging leaders in wound, ostomy and continence. A rightful acknowledgment is extended to the National Conference Planning Core Program committee for exemplary leadership and for creating a culture of open discussion at the conference and beyond. This all bodes well for a first-class WCET®/NSWOCC® 2026 Joint Congress in Vancouver, Canada in April 2026. Well done, NSWOCC, on bringing an informative conference with the IDEAs theme that took us away from our com-fort zone talking about etiologies, products and technologies and instead challenged our white supremacy, unconscious biases, pushed us to consider race, gender-affirming surgery, stigma, and harm reduction. It was refreshing and anything but the same old.

Evidence suggests a 38% risk reduction in breast and bowel cancer-specific mortality with higher levels of exercise, however, most of this evidence is observational. More clinical trials are needed to build strong evidence for exercise's impact on recurrence and survival. This study aims to assess the feasibility, acceptability and potential efficacy of a remote, tailored exercise programme on disease-free survival in patients recently completing curative treatment for early-stage, high-risk lung, breast or bowel cancer. This UK-based, multicentre randomised controlled basket feasibility trial compares a personalised, remote-delivered exercise programme supported by exercise professionals against usual care. Potential participants are approached if they are: aged 18 or over, diagnosed with high-risk, early-stage breast, bowel or lung cancer, and within 24 weeks of completing primary curative treatments. Participants complete objective measures of physical function (submaximal cardiovascular fitness, endurance, muscle strength and balance), body composition (bioelectrical impedance) and self-reported outcomes (total physical activity, sleep quality, general quality of life (QoL), cancer-related QoL and exercise confidence/motivation). Clinical case note review provides disease-free survival outcomes at 6, 12 and 24 months. The 12-week programme is delivered remotely (via phone, email and/or video conference) with trainer contact tapering off over the subsequent 12 weeks (24 weeks total). Recruitment is ongoing with a 660-participant goal. Descriptive measures (quantitative and qualitative) will be reported for feasibility outcomes: recruitment, adherence, retention rates, data collection quality, adverse events, intervention acceptability and fidelity. A process evaluation is being conducted concurrently and is reported separately. Kaplan-Meier curves will be plotted and median disease-free survival calculated for each arm. To determine intervention impact, a log-rank test (unadjusted) will compare 2-year disease-free survival between groups within and among cancer types. Secondary outcomes (physical function status, general/cancer-specific QoL and determinants of meeting activity guidelines) will be reported at each time point. Ethical approvals were obtained through Hull York Medical School (ID: 23/SS/0060) and UK NHS Health Research Authority (ID: 327663). Findings will be submitted for publication in high-impact journals, presentation at national and international conferences, press releases where appropriate, and dissemination activities to be decided on with the Patient Advisory Group. ISRCTN97662203.

This special issue examines the impact of the fragmentation of multilateralism on Informal International Governmental Organisations (IIGOs) and Formal International Governmental Organisations (FIGOs) through the lens of Global North–Global South relations. In the first part, a short literature review on multilateralism and its crisis is presented. In the second part of our cluster, focusing on ‘Multilateralism and International Institutions’, the authors explore how China and India contest the current form and meaning of multilateralism, and how US policies towards institutions like the United Nations (UN) shift with presidential politics, as well as the roles of United Nations Conference on Trade and Developmen (UNCTAD) and The United Nations Commission on International Trade Law (UNCITRAL). The third part, on ‘Multilateralism, Informality and IOs’, addresses the intersection of informal governance, multilateralism and the Global South. It includes studies on the European Union’s (EU’s) informal engagement with IIGOs, states’ use of ad hoc coalitions, hybrid practices in The Association of Southeast Asian Nations (ASEAN), the Quad, and the China–Japan–Korea Trilateral Summit. The fourth and final part, on ‘Geopolitics, Multilateralism and International organisations (IOs)’, explores the interplay among geopolitics, multilateralism and IOs and engages with key themes such as the EU’s challenges in FIGOs led by authoritarian regimes favouring instrumental over normative cooperation, and the early emergence of Latin American IIGOs in the nineteenth century, predating formal IOs.

Fractures over venous sinuses (FOVSs) are associated with difficulties in diagnosis and treatment resulting in a high level of morbidity and mortality. Despite its importance, there are limited aggregate data to guide the management of these fractures ultimately inflicting a major callenge to neurosurgeons. This protocol describes the methodology of a scoping review that aims to synthesise contemporary evidence on the management and outcomes of FOVSs. The proposed study will be conducted in accordance with the Arksey and O'Malley's framework for scoping reviews. The research question, eligibility criteria and search strategy were developed based on the population, intervention, comparator and outcome strategy. The following electronic bibliographic databases will be searched without restrictions on language and date of publication: PubMed, WHO Global Index Medicus, African Journals Online, SCOPUS, Embase, Cochrane and ProQuest Central. All peer-reviewed studies of primary data reporting on the management and outcomes of FOVSs will be included. The data extracted from included articles will be presented through descriptive statistics, pooled statistics and a narrative description. Because this study did not directly involve human individuals, ethical approval was not necessary. Dissemination strategies will include publication in a peer-reviewed journal, oral and poster presentations at local, regional, national and international conferences and promotion over social media.

The Swedish national guidelines on penile cancer were first published in 2013. The objective of the present study is to present the 2023 update of these guidelines and highlight the differences to the European Association of Urology (EAU) / American Association of Clinical Oncology (ASCO) guidelines on penile cancer. A review of the literature and a comparison to the EAU / ASCO guideline on penile cancer was performed. Differences between the EAU / ASCO guidelines and the Swedish national guidelines are highlighted. Results: The Swedish national guidelines on penile cancer emphasized the consultation of a national multidisciplinary treatment conference for all patients diagnosed with both primary and recurrent penile cancer or penile intraepithelial neoplasia (PeIN). Clinically lymph node negative patients diagnosed with >pT1G1 are offered dynamic sentinel node biopsy (DSNB). In the EAU / ASCO guidelines the DSNB is optional for T1aG2 patients. Penile cancer surgery is centralized to two hospitals. Perioperative chemotherapy is offered to patients with ≥N2. In the EAU / ASCO guidelines the use of perioperative chemotherapy for N2 patients is optional. A structured follow-up program is advocated to find recurrences at an early stage. The Swedish national guidelines on penile cancer have been updated and compared to the EAU / ASCO guidelines. The national multidisciplinary treatment conference, centralization of surgery, the use of perioperative chemotherapy and a structured follow-up are the cornerstones of the Swedish national guidelines on penile cancer.

The right to health is defined as every individual's entitlement to enjoy the highest attainable standard of physical, mental, and psychological well-being. This right extends beyond the mere provision of healthcare services to encompass the broader concept of a healthy life, ensuring both preventive and curative measures. It includes the essential determinants of health, such as access to clean drinking water, adequate nutrition, housing, and healthy working and environmental conditions. This study addresses the nature of the right to health through a descriptive examination of its scope and an analytical review of the legal texts governing it within both national legislation and international instruments. The first section of this paper aims to define the right to health from linguistic and terminological perspectives, followed by a legal definition of the right. It then explores the regulatory foundations of the right to health at the national level, referencing the Basic Law of Governance and relevant regulations, and at the international level, through conventions and treaties. The second section discusses preventive oversight mechanisms for safeguarding the right to health, as well as judicial oversight. The study concludes that the right to health is a comprehensive entitlement for every individual to enjoy the highest attainable standard of physical, mental, and psychological health, encompassing both prevention and treatment. This right is firmly grounded in the Basic Law of Governance and in international conventions and agreements. The Saudi legal framework guarantees individuals the right to seek judicial remedy—both general and administrative—in cases of infringement upon their right to health. In its final recommendations, the paper calls for amending the Health Law to include explicit provisions defining the right to health, outlining mechanisms for its protection, and stipulating penalties for violations. It also emphasizes the importance of enhancing the educational and research role of the Human Rights Commission by organizing regular national and international conferences and workshops that highlight the Kingdom’s efforts in protecting this right and promote awareness of its safeguarding mechanisms.

Background The submission of a thesis or dissertation is a requirement stipulated by the National Board of Examinations in Medical Sciences (NBEMS) before a candidate can be awarded a postgraduate degree. Although the thesis is a requirement, its subsequent publication in a journal is not mandatory; if not published, a large amount of potentially valuable research data is lost. Our primary objective was to assess the conversion rate of postgraduate theses into publications in biomedical journals, and the secondary objective was to estimate the frequency of presentations of papers and posters at conferences by postgraduates during their tenure. Methods In this retrospective study, we collected data (between 1991 and 2019) from 434 theses written by the residents of 7 departments of Sir Ganga Ram hospital, New Delhi which were submitted to the NBEMS in partial fulfilment of their final degrees. The 'conversion' rate to publication was calculated using data from the websites PubMed, Google Scholar, and our hospital journal, Current Medicine Research and Practice. Results The conversion rate of the thesis into a publication was 33.2%. The frequency of oral or poster presentations at state, national, or international conferences during the residency period was 47.2%. Conclusion Less than one-third of thesis were published. Almost half were, however, presented at various conferences.

IntroductionThe ventilatory ratio (VR) is a simple and accessible index that reflects ventilatory efficiency in critically ill patients. Although several studies have examined its potential as a prognostic marker in acute respiratory distress syndrome (ARDS), the results remain inconsistent and inconclusive. This systematic review and Bayesian meta-analysis aimed to evaluate the association between VR and mortality in adult patients with ARDS.Methods and analysisTwo investigators will independently conduct systematic literature searches in the PubMed, Embase, Scopus, Cochrane Library and Latin American and Caribbean Health Sciences Literature / Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) databases, covering all publications from database inception to July 2025.This systematic review and meta-analysis will include prospective and retrospective cohort studies evaluating the association between the VR and mortality in adult patients with ARDS. Specifically, we aim to answer the following Patient, Population or Problem, Intervention, Comparison, and Outcome (PICO) question: In adult patients with ARDS (Population), is an elevated VR (Exposure), compared to lower or normal VR values (Comparison), associated with an increased risk of mortality (Outcome)?The primary outcome will be mortality, as defined in each included study. Outcomes will be analysed according to the characteristics and reporting of the original publications.The methodological quality of the included studies will be assessed using the Quality In Prognosis Studies tool, and the certainty of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A hierarchical Bayesian random-effects model will be used to synthesise the data, with effect sizes expressed as ORs and 95% credible intervals. Weakly informative priors will be applied to model parameters.Between-study heterogeneity will be assessed through the estimation of the between-study variance (τ²) and the I² statistic. Subgroup analyses will be conducted based on study design and ARDS aetiology, and a bivariate meta-regression will explore potential effect modifiers. A leave-one-out sensitivity analysis will also be performed to assess the robustness of the findings.Publication bias will be evaluated using a Bayesian funnel plot and an adapted version of Egger’s test.Ethics and disseminationThis systematic review does not require ethics approval. The results will be published in scientific journals, presented at national and international conferences and shared on social media in accessible language.PROSPERO registration numberCRD420251008773

IntroductionAtrial fibrillation (AF) is the most common sustained arrhythmia worldwide, associated with significant morbidity, mortality and healthcare utilisation. AF rhythm control strategies demonstrate attrition with time. A number of modifiable AF risk factors contribute to an atrial cardiomyopathy culminating in incident AF but importantly also recurrence. We propose that a novel multidisciplinary lifestyle intervention (Super Rehab, SR) may improve symptoms and AF burden.Methods and analysisThis is a single-centre, randomised controlled study. Patients aged ≥18 years with a body mass index ≥27 kg/m2 with paroxysmal or persistent AF will be randomised 1:1 to National Health Service (NHS) usual care (UC) or to SR (together with NHS UC). SR incorporates high-intensity exercise, personalised dietary advice and AF risk factor modification. SR will be undertaken over 12 months. In addition to baseline assessments, follow-up assessments will occur at the 6, 12 and 15-month time points. The primary outcome will be the difference in AF symptom burden at 12 months between groups. Secondary outcomes include AF burden (assessed by an implantable cardiac monitor), changes to cardiac structure and function and computed tomography-based assessment of epicardial adipose tissue.Ethics and disseminationEthics approval was granted by London-Chelsea Research Ethics Committee (reference: 22/LO/0479 22/08/2022). All participants will provide written informed consent prior to enrolment. Study findings will be disseminated via presentations to relevant stakeholders, national and international conferences and open-access peer-reviewed research publications. A summary will also be communicated to the participants.Trial registration numberClinicalTrials.gov ID NCT05596175.

IntroductionAlthough emerging evidence supports the short-term efficacy of transcranial magnetic stimulation (TMS), including repetitive TMS (rTMS) and theta-burst transcranial magnetic stimulation (TBS-TMS), and transcranial direct current stimulation (tDCS) for managing patients with chronic musculoskeletal pain (CMP), their clinical utility in managing CMP remains inconclusive. This uncertainty may arise from methodological limitations, including heterogeneity in treatment parameters such as stimulation targets and dosages. Additionally, safety profiles for these non-invasive brain stimulation interventions in patients with CMP remain insufficiently reported, with limited data on adverse events, cumulative risks and long-term safety outcomes. Hence, in this scoping review protocol, we aim to systematically (1) identify and map the stimulation targets and dosages of TMS and tDCS used in previous studies to treat patients with CMP; (2) summarise the rationale for using the stimulation targets and dosages of TMS and tDCS; and (3) summarise the reports on the safety of TMS and tDCS in managing patients with CMP, including whether safety was reported and how it was described.Methods and analysisWe will adopt Arksey and O’Malley’s methodological framework and report findings according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Two authors will independently screen articles and extract data from PubMed, Scopus, Web of Science and Embase, including publications from inception to 1 August 2025. Discrepancies regarding study inclusion will be resolved through consultation with a third author. We will synthesise results using descriptive statistical methods.Ethics and disseminationThis scoping review does not require ethical approval. The findings will be disseminated through presentation at national or international conferences and peer-reviewed publication.Trial registration detailsOpen Science Framework (Registration DOI: https://doi.org/10.17605/OSF.IO/8HFBZ).