Category: Nevin Manimala

Malar J. 2026 Mar 2. doi: 10.1186/s12936-026-05831-1. Online ahead of print.

ABSTRACT

BACKGROUND: Malaria continues to pose a serious public health challenge in Zamfara State, Nigeria, disproportionately affecting women and children due to socio-economic barriers. This study aimed to develop a Composite Gender-Sensitive Malaria Vulnerability Index (CGMVI) to identify areas of heightened malaria vulnerability and support informed targeted interventions.

METHODS: Malaria incidence and mortality data from the Malaria Atlas Project, and population data from WorldPop, were integrated with indicators of Insecticide-Treated Net (ITN) access and usage, maternal education, and household wealth. A Pentagonal Fuzzy Analytic Hierarchy Process was used to compute the CGMVI, while Getis-Ord Gi* hotspot analysis identified spatial patterns of vulnerability across Zamfara State.

RESULTS: The CGMVI revealed a west-to-east gradient of malaria vulnerability across Zamfara State, with hotspots in Gummi (3.86) and Bukkuyum (3.62), characterized by low ITN usage (82-85%), high maternal education deficits (89-91%), and household poverty (85-90%). Moderate vulnerability was observed in central Local Government Areas (LGAs) such as Anka and Bungudu, while northern and eastern LGAs, including Shinkafi, Zurmi, and Tsafe, exhibited low vulnerability with higher ITN coverage (≈92%) and better socio-economic profiles. Hotspot analysis using Getis-Ord Gi* confirmed statistically significant clustering in western LGAs (z-scores 2.11-4.89 at 99% confidence), while coldspots in the north and east had z-scores from – 1.69 to – 3.39. These patterns reflect intersections of socio-economic barriers, ITN access, and maternal education, highlighting areas where women and children face elevated malaria risk.

CONCLUSION: The study offers a spatial framework for understanding how epidemiological, socio-economic, and gender-related factors shape malaria vulnerability in Zamfara State. By identifying areas where women and children may face elevated risk, the findings can inform gender-sensitive ITN distribution, community malaria literacy initiatives, and socio-economic support strategies. The CGMVI provides a tool to guide evidence-informed planning and better integrate gender considerations into malaria control efforts in the state.

PMID:41772643 | DOI:10.1186/s12936-026-05831-1

J Neuroinflammation. 2026 Mar 2. doi: 10.1186/s12974-026-03713-6. Online ahead of print.

NO ABSTRACT

PMID:41772634 | DOI:10.1186/s12974-026-03713-6

Harm Reduct J. 2026 Mar 2. doi: 10.1186/s12954-026-01414-0. Online ahead of print.

NO ABSTRACT

PMID:41772631 | DOI:10.1186/s12954-026-01414-0

AIDS Res Ther. 2026 Mar 2. doi: 10.1186/s12981-026-00869-2. Online ahead of print.

ABSTRACT

BACKGROUND: As a chronic disease, effective HIV self-management is crucial for men who have sex with men (MSM) living with HIV. Psychosocial factors, including perceived stress and self-regulatory fatigue, have been shown to negatively impact self-management behaviors. However, research on the relationships among perceived stress, self-regulatory fatigue, and self-management behaviors remains limited. This study aimed to explore the mediating effect of self-regulatory fatigue in the relationship between perceived stress and self-management behaviors among MSM living with HIV in China.

METHODS: From December 2024 to March 2025, cross-sectional data were collected from 328 MSM living with HIV at an HIV-designated hospital in Jiangsu Province using convenience sampling. Data were collected using the Perceived Stress Scale, Self-Regulatory Fatigue Scale, and HIV Self-Management Scale. Descriptive statistics, univariate analysis, and Pearson correlation analysis were performed in this study. The mediating effect of self-regulatory fatigue in the relationship between perceived stress and self-management behaviors was assessed using Model 4 of the PROCESS macro for SPSS.

RESULTS: Among 328 MSM living with HIV, the average score of perceived stress was 30.67 ± 7.87, the average self-regulatory fatigue score was 43.99 ± 8.76, and the average HIV self-management score was 36.65 ± 7.88. Perceived stress was positively related to self-regulatory fatigue (r = 0.544, p<0.05), whereas self-management behaviors were proven to be negatively associated with perceived stress (r = -0.486, p<0.05) and self-regulatory fatigue (r = -0.504, p<0.05). Self-regulatory fatigue partially mediated the association between perceived stress and self-management behaviors, accounting for 34.39% of the total effect.

CONCLUSION: This study demonstrated that self-regulatory fatigue partially mediated the relationship between perceived stress and self-management behaviors and underscored the importance of designing targeted interventions aimed at reducing perceived stress and self-regulatory fatigue to improve self-management behaviors among MSM living with HIV in China. Multidimensional strategies, achieved through collaborative efforts among patients, healthcare providers, government, and community, should incorporate personalized mental care and stress management, available social support, trained peer navigation, and consistent health education.

PMID:41772624 | DOI:10.1186/s12981-026-00869-2

J Transl Med. 2026 Mar 2. doi: 10.1186/s12967-026-07925-5. Online ahead of print.

ABSTRACT

OBJECTIVE: In the present meta-analysis, we aimed to explore the efficacy and safety of immunosuppressants and immunomodulators for the treatment of juvenile myasthenia gravis (JMG).

METHODS: We conducted a systematic search for studies published between January 1st, 2000 and July 28th, 2025, in PubMed, Embase, Web of Science, and the Cochrane Library. Statistical analyses were performed using Stata (version 16.0). Cochran’s Q test and the I² statistic were used to assess the heterogeneity among the included studies. If significant heterogeneity existed (I² ≥50% or P < 0.05), the random effects model was used; otherwise, the fixed effects model was used to calculate the pooled results.

RESULTS: A total of 3029 articles were retrieved. This meta-analysis included 9 cohort and case-control studies, 11 case series, 3 single-arm studies, and 1 randomized controlled trial, focusing on tacrolimus, glucocorticoids, monoclonal antibodies, and intravenous immunoglobulin. Regarding tacrolimus, 9 studies involving 310 patients assessed the efficacy of tacrolimus for treating JMG. The results showed a significant reduction in both the Quantitative Myasthenia Gravis (QMG) and Myasthenia Gravis Activities of Daily Living (MG-ADL) scores. Moreover, tacrolimus treatment allowed for a reduction in steroid dosage, with a response rate of 0.862 (95% CI: 0.716-0.967). For monoclonal antibodies, 6 studies with 67 patients analyzed the efficacy for JMG. The response rate of monoclonal antibodies was 0.993 (95% CI: 0.935-1.000). Descriptive analyses were conducted for glucocorticoids and IVIG. Besides, 5 studies with 348 patients assessed the efficacy of glucocorticoids for JMG. Included studies showed that the efficacy rate of glucocorticoid monotherapy for isolated ocular myasthenia gravis (OMG) was higher than that for patients with both OMG and generalized myasthenia gravis (GMG). Finally, regarding the use of IVIG, 4 studies reported efficacy for JMG. These investigations reported a response rate ranging from 47.06% to 94.3% for IVIG therapy.

CONCLUSIONS: In summary, this was the first comprehensive meta-analysis of immunosuppressants and immunomodulators in JMG. However, most included studies were single-center retrospective observational studies. Future prospective multicenter studies are needed to further investigate the efficacy and safety of immunosuppressants and immunomodulators in JMG.

PMID:41772612 | DOI:10.1186/s12967-026-07925-5

Harm Reduct J. 2026 Mar 2. doi: 10.1186/s12954-026-01427-9. Online ahead of print.

ABSTRACT

BACKGROUND: Appropriate treatments for nonopioid substance use are currently unavailable. Venlafaxine may reduce withdrawal from nonopioid substances, but the effects have not been evaluated. We aimed to investigate the association between venlafaxine use and the risk of withdrawal from nonopioid substances.

METHODS: We linked Taiwan’s National Health Insurance Research Database and the Taiwan Illicit Drug Issue Database from January 2012 to December 2019. We used a case-case-time-control study involving a case-crossover analysis and a control-crossover analysis consisting of future cases. The outcomes were withdrawal from substances and all-cause mortality. For each individual, venlafaxine use during the hazard period (day – 8 to – 67 before the outcome) was compared with that during the 60-day reference period (between days – 248 and – 307). Conditional logistic regression was used to determine odds ratios with 95% confidence intervals to evaluate the associations between outcome events and the use of venlafaxine.

RESULTS: The participants’ average age on the index date was 39.5 years (standard deviation 8.7), with 84.1% men and 88.3% having low income. Venlafaxine was significantly associated with a lower risk of withdrawal from substances (odds ratio 0.35, 95% confidence interval 0.13 to 0.96). However, we found no association between the recent use of venlafaxine and all-cause mortality (1.08, 0.55 to 2.14). The point estimates were similar in a series of sensitivity analyses, though not all analyses statistical significance.

CONCLUSIONS: This study provides strong ground for clinicians to consider the use of venlafaxine to reduce patient experiencing withdrawal symptoms from substances.

PMID:41772603 | DOI:10.1186/s12954-026-01427-9

BMC Nurs. 2026 Mar 2. doi: 10.1186/s12912-026-04502-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Digitalization in healthcare has reshaped nursing practice but also introduced psychosocial challenges. While well-designed digital systems can enhance workflow efficiency and satisfaction, excessive digital demands may lead to technostress and digital fatigue, reducing nurses’ motivation. This study aimed to examine the mediating role of digital fatigue in the relationship between job satisfaction and motivation among nurses.

METHODS: This descriptive, cross-sectional study was conducted between July and October 2025 with 350 nurses working at a hospital in İzmir, Türkiye. Data were collected using the Participant Information Form, Job Satisfaction Scale, Nurse Work Motivation Scale, and Technostress Creators Scale for Health Professionals. Analyses were performed using SPSS 27.0 with descriptive statistics, t-tests, ANOVA, correlation, and mediation analysis.

RESULTS: Most participants were female (86.3%) and under 30 years old (68.6%). Over half (52%) reported experiencing technology-related fatigue or burnout. Job satisfaction was positively associated with both intrinsic and extrinsic motivation (p < .001) and negatively associated with technostress (p < .05). While job satisfaction significantly predicted both technostress (β = 0.083, p = .033) and motivation (β = -0.156, p = .000), technostress did not significantly predict motivation (β = 0.004, p = .882), indicating that digital fatigue did not fully mediate this relationship. Older and more experienced nurses reported higher job satisfaction and lower technostress levels.

CONCLUSION: Job satisfaction remains a primary driver of motivation among nurses. However, in digitally intensive clinical environments, digital fatigue poses a significant risk to sustaining motivation. Healthcare institutions should address both organizational and technological factors by improving digital system usability, offering training, and implementing strategies to mitigate digital fatigue to enhance nurses’ motivation and retention.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41772589 | DOI:10.1186/s12912-026-04502-5

Cardiovasc Diabetol. 2026 Mar 2. doi: 10.1186/s12933-026-03108-0. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with chronic kidney disease (CKD) and coronary artery diseases (CAD) have a poor long-term prognosis. Although insulin resistance (IR) and systemic inflammation are well-established drivers of cardiovascular risk, the prognostic value of their composite assessment across the glycemic spectrum in patients with CKD and CAD remains undetermined. This study aimed to evaluate the prognostic utility of composite IR-inflammation biomarkers for predicting mortality in patients with CKD and CAD stratified by glycemic status.

METHODS: 1353 patients with CKD and CAD were enrolled from National Health and Nutrition Examination Survey (NHANES) data (1999-2018). Composite biomarkers (TyG-hsCRP, TyG-CRP, and C-reactive Protein-Triglyceride Glucose Index [CTI]) were calculated. Patients were categorized by glycemic status (normoglycemia, prediabetes, diabetes) based on WHO/IEC criteria. The endpoint was all-cause and cardiovascular disease (CVD) death. Statistical analyses included Cox regression, Nelson-Aalen cumulative hazard plots with Log-rank test, restricted cubic splines, ROC curves, and reclassification metrics, adjusted for demographics, comorbidities, and treatments. Subgroup and sensitivity analyses ensured robustness.

RESULTS: Over a median follow-up of 63-months, 744 all-cause and 323 CVD deaths occurred. Adjusted models showed elevated composite indices linked to higher mortality (e.g., CTI HR 1.43 [95% CI 1.24-1.65] for all-cause; HR 1.32 [1.06-1.64] for CVD). CTI provided good discrimination (AUC 0.700) and reclassification (IDI 0.010; NRI 0.196 for all-cause). The predictive utility of all three composite biomarkers was most pronounced in patients with diabetes, whereas CTI retained the strong association with all-cause mortality in normoglycemic and prediabetic patients. Risk stratification using both CTI and glycemic status identified patients with diabetes and high CTI as having the highest all-cause (HR 1.63 [1.22-2.17]) and CVD (HR 1.37 [0.88-2.14]) death risk.

CONCLUSION: Composite biomarkers integrating IR and inflammation, particularly CTI, significantly enhance mortality prediction in patients with CKD and CAD. The predictive utility is modulated by underlying glycemic status, enabling refined risk stratification and potentially guiding tailored management strategies for this complex patient population.

PMID:41772566 | DOI:10.1186/s12933-026-03108-0

Cardiovasc Diabetol. 2026 Mar 2. doi: 10.1186/s12933-026-03119-x. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked to cardiometabolic disorders, and cardiovascular disease is the leading cause of death among affected individuals. Identifying simple biomarkers that capture metabolic-inflammatory burden and predict long-term mortality in MASLD remains a clinical priority. The C-reactive protein-triglyceride-glucose index (CTI) integrates inflammation, dyslipidaemia, and glycaemic status, but its relevance to MASLD and long-term mortality has not been fully elucidated.

METHODS: We conducted a multi-stage investigation using two nationally representative cohorts from the United States and China. Cross-sectional associations between CTI and MASLD were assessed in the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS). Prospective associations of CTI with cardiovascular and all-cause mortality among participants with MASLD were examined utilising multivariable Cox proportional hazards models, restricted cubic splines, threshold analyses, and competing risk models. Causal mediation analyses were performed to measure the mediating functions of diabetes, hypertension, and body mass index. Extensive sensitivity analyses using alternative MASLD definitions and analytic strategies were conducted to assess robustness. Results from NHANES were externally validated in CHARLS.

RESULTS: Higher CTI levels were strongly and nonlinearly associated with the presence of MASLD in both cohorts. Among individuals with MASLD, elevated CTI was associated with significantly increased risks of all-cause and cardiovascular mortality. Each unit increase in CTI in NHANES was linked to a 57% increased risk of cardiovascular death (HR 1.57, 95% CI 1.24-1.99) and a 47% increased risk of all-cause death (hazard ratio [HR] 1.47, 95% confidence interval [CI] 1.28-1.69) in fully adjusted models. A pronounced threshold effect was observed, with mortality risk rising sharply once CTI exceeded approximately 5.6. Consistent associations with all-cause mortality were observed in CHARLS. Mediation analyses indicated that diabetes accounted for a substantial proportion of the association between CTI and mortality, whereas body mass index played a minimal mediating role.

CONCLUSIONS: CTI is a robust metabolic-inflammatory marker associated with MASLD and long-term all-cause and cardiovascular mortality across diverse populations. The strong mediating role of diabetes underscores the central importance of glycaemic dysfunction in cardiometabolic risk. As a readily obtainable index, CTI may aid in cardiometabolic risk stratification among individuals with MASLD.

PMID:41772559 | DOI:10.1186/s12933-026-03119-x

BMC Med Educ. 2026 Mar 2. doi: 10.1186/s12909-026-08892-7. Online ahead of print.

ABSTRACT

BACKGROUND: Reliable assessment and meaningful feedback are essential to effective learning in medical education. However, conventional unstructured evaluation of essay-type responses is highly vulnerable to rater bias, inter-rater variability, and nonspecific feedback. To address these limitations, we developed an Assessment-cum-Feedback Checklist to provide a structured, criterion-based approach to scoring and feedback. In this study, we evaluated the checklist’s effectiveness in enhancing the reliability, consistency, and clarity of assessment while exploring student and faculty perceptions of its educational value.

METHODS: We used a mixed-methods design. Sixty-two first-year MBBS students and four faculty members (two junior < 5 years’ experience; two senior > 10 years’ experience) participated. Two essay-type questions were assessed independently by all four teachers using both the conventional unstructured method and the checklist-based method. Quantitative analyses included descriptive statistics, Wilcoxon signed-rank tests, Levene’s test for equality of variance, intraclass correlation coefficients (ICC), and Bland-Altman analysis to compare variability and agreement across methods. Data were analysed using JASP (version 0.18.3.0) at a 5% significance level. Student perceptions were gathered using a structured questionnaire, and faculty perceptions were explored through in-depth interviews. Qualitative data were analysed using QCAmap (2020). Institutional Ethics Committee approval was obtained.

RESULTS: Checklist-based scoring demonstrated lower standard errors, standard deviations, and coefficients of variation, indicating improved precision and reduced subjective variability compared with the conventional method. Mean scores were lower with the checklist, and Bland-Altman analysis showed a negative bias, reflecting greater scoring stringency due to explicit criteria. ICC values increased notably with the checklist-particularly among senior teachers-demonstrating improved inter-rater reliability and tighter limits of agreement. Teachers reported that the checklist enhanced objectivity, reduced bias, clarified performance expectations, and standardized assessment practices. Students expressed strong support, citing improved clarity, transparency, and usefulness of feedback.

CONCLUSIONS: The Assessment-cum-Feedback Checklist was associated with measurable improvements in the reliability and consistency of essay-type assessment. Both faculty and students perceived the checklist-based approach to enhance clarity, transparency, and the usefulness of feedback by making assessment criteria explicit. With appropriate faculty orientation and iterative refinement, the checklist represents a promising and potentially adaptable tool for strengthening assessment and feedback practices in constructed-response formats in medical education.

PMID:41772543 | DOI:10.1186/s12909-026-08892-7