Nevin Manimala

Am J Clin Pathol. 2025 Aug 29:aqaf093. doi: 10.1093/ajcp/aqaf093. Online ahead of print.

ABSTRACT

OBJECTIVE: Prior studies have shown that pretransfusion medication is not effective in preventing allergic transfusion reactions (ATRs), but these studies did not consider the patient’s history of ATR. This study evaluated whether pretransfusion antiallergy medications decrease the chance of ATRs in patients with a history of severe ATR.

METHODS: This single-center, retrospective study investigated the effect of pretransfusion medications on preventing ATRs in patients with a history of at least 1 severe ATR between March 2018 and January 2024. Patient demographics as well as clinical and transfusion reaction data were collected from our electronic health record (EHR) system. Data were analyzed using SPSS (IBM Corp) and machine learning in Python, version 3.12.4.

RESULTS: In our cohort, 53 patients aged 5 weeks to 94 years with 2767 analyzable transfusion encounters had experienced 88 lifelong mild and severe ATRs. Premedication (P = .021), regular antiallergy medication (P < .001), and washing/volume reduction (P = .032) were associated with a statistically significantly lower chance of developing ATRs in our patient population.

CONCLUSIONS: Patients with at least 1 severe ATR benefit from pretransfusion administration of antiallergy medications.

PMID:40877907 | DOI:10.1093/ajcp/aqaf093

BMC Health Serv Res. 2025 Aug 28;25(1):1146. doi: 10.1186/s12913-025-13274-8.

ABSTRACT

BACKGROUND: Digital transformation is rapidly changing healthcare delivery, which is changing the functions and responsibilities of the health workforce. The specialist digital health workforce support the frontline clinical workforce through the management of health data and information systems. Gender disparity in this new configuration of the healthcare workforce can undermine organisational aims, workforce wellbeing, equitable care, population health, patient experience, and economic sustainability.

RESEARCH AIM: The aim of this paper was to identify the nature of existing gender disparities and potential strategies for fostering gender equity in Australia’s specialist digital health workforce.

METHODS: The 2023 Australian Specialist Digital Health Workforce Census incorporated gender survey questions from the Telstra Health Understanding Gender Diversity in Australia’s Digital Health Sector Special Report 2021-22 for the first time. These data were statistically analysed, examining if there was a difference between women and men in: (1) Education, (2) Professional development, (3) Occupation, and (4) Workforce intention.

RESULTS: There were 857 valid responses, of which 595 (69.43%) respondents identified as woman. Women were less likely than men to have a formal digital health qualification. They were less likely to occupy higher paid roles, where both had formal qualifications. Women have fewer opportunities for mentoring and leadership training than men. Men indicated more senior roles than women, and more men were healthcare practitioners than women. More men than women aimed for senior management roles. Both valued work-life balance in employment. Barriers to career progression included age, financial constraints, outside of work responsibilities.

DISCUSSION: Gender disparities are a workforce issue in the Australian digital health landscape. Women are underrepresented in digital health roles, particularly in technology-related roles and analytics. Women have fewer opportunities for leadership training, which is particularly notable as they occupy fewer leadership roles and fewer aspire to leadership roles. Equitable care should be considered one aspect of equity within the workforce. Policy interventions, mentorship and networking, educational reform, and changes in organisation culture are suggested strategies for balancing gender in the digital health specialist workforce.

PMID:40877902 | DOI:10.1186/s12913-025-13274-8

J Cheminform. 2025 Aug 28;17(1):128. doi: 10.1186/s13321-025-01071-8.

ABSTRACT

Quantitative structure-activity relationship (QSAR) modeling has become a critical tool in drug design. Recently proposed Topological Regression (TR), a computationally efficient and highly interpretable QSAR model that maps distances in the chemical domain to distances in the activity domain, has shown predictive performance comparable to state-of-the-art deep learning-based models. However, TR’s dependence on simple random sampling-based anchor selection and utilization of radial basis function for response reconstruction constrain its interpretability and predictive capacity. To address these limitations, we propose Adaptive Topological Regression (AdapToR) with adaptive anchor selection and optimization-based reconstruction. We evaluated AdapToR on the NCI60 GI50 dataset, which consists of over 50,000 drug responses across 60 human cancer cell lines, and compared its performance to Transformer CNN, Graph Transformer, TR, and other baseline models. The results demonstrate that AdapToR outperforms competing QSAR models for drug response prediction with significantly lower computational cost and greater interpretability as compared to deep learning-based models.

PMID:40877895 | DOI:10.1186/s13321-025-01071-8

BMC Pregnancy Childbirth. 2025 Aug 28;25(1):895. doi: 10.1186/s12884-025-08019-8.

ABSTRACT

BACKGROUND AND AIMS: Stillbirth rate is an indicator reflecting quality of maternal healthcare services available to a pregnant woman in a country. At the community and individual level, it continues to be a public health tragedy. This paper presents the stillbirth rate, its causes and characteristics of women who experienced stillbirth from five years data of hospital-based stillbirth surveillance system. We also attempted to study the association between number of antenatal check-ups and causes of stillbirths, period of gestation and maternal parameters like presence of anaemia at the time of delivery.

METHODOLOGY: A multisite hospital-based sentinel surveillance system for estimating the stillbirth rate and its causes was established across seven tertiary care government hospitals of Delhi, India in 2015. A standardized stillbirth form was used to record information, and data was collected using an online portal from all hospitals. The data from 2016 to 2020 was analysed for calculating the stillbirth rate, its causes and maternal characteristics using STATA version 17.

RESULTS: Of the 12,569 stillbirths recorded among 416,677 deliveries, the still birth rate over the time period 2016-2020 was 29.3 per 1000 births. Nearly 50% women who experienced stillbirths did not receive any antenatal care. Antepartum stillbirths were more common (75.7%), the remaining were the intrapartum stillbirths (24.3%). Among antepartum causes, the most prevalent maternal cause was preterm labour (25.7%) followed by placental abruption/placenta previa/hemorrhage in 15.2%. Among foetal causes, majority of the still births were due to fetal growth restriction (31.2%) followed by congenital malformations (7%). Uterine rupture and eclampsia were reported as major intrapartum causes leading to still births in 11% and 8.3% cases, respectively.

CONCLUSIONS: The stillbirth rate of 29.3 per 1,000 births from hospital data underscores the need for community-based surveillance. Nearly half of pregnant women lacked antenatal care, and 75% of stillbirths were antepartum, stressing the need to strengthen antenatal care- both coverage and quality. Routine symphysio-fundal height measurements, mandatory third-trimester ultrasounds, and partograph use may help reduce intrapartum stillbirths.

PMID:40877890 | DOI:10.1186/s12884-025-08019-8

BMC Sports Sci Med Rehabil. 2025 Aug 28;17(1):255. doi: 10.1186/s13102-025-01295-z.

ABSTRACT

BACKGROUND: Plantar fasciitis (PF) is the third most common type of running-related injuries. However, there are few studies on the association between interlimb asymmetry of lower limb isometric strength and PF among marathon runners. The present study aims to investigate whether the interlimb asymmetry of lower limb isometric strength could predict PF in male amateur marathon runners.

METHODS: 172 male amateur marathon runners were tested for lower limb isometric strength using the MicroFet 3 muscle testing dynamometer and inclinometer. The interlimb asymmetry of the lower limb isometric strength were calculated. Subsequently, the subjects were followed up for 3-month to record the incidence of PF. Statistical analysis was performed using independent-sample t test, logistic regression analysis and receiver operating characteristic (ROC) curve analysis.

RESULTS: During the 3-month follow-up, a total of 12 runners experienced PF. The results of logistic regression analysis showed that the interlimb asymmetry of hip abduction isometric strength was significantly correlated with PF development (OR = 3.646; 95%CI:1.193-11.148; P = 0.023). The ROC curve analysis revealed that the area under the ROC curve was 0.717 (95% CI: 0.544-0.889, P = 0.012), and the sensitivity and specificity of the interlimb asymmetry of the hip abduction isometric strength for diagnosing PF were 0.667 and 0.238, indicating good discrimination. In addition, the Hosmer-Lemeshow fitting test showed that the model has statistical significance (X² = 14.365, P = 0.001).

CONCLUSIONS: The interlimb asymmetry of hip abduction isometric strength was associated with a greater likelihood of developing PF, and interlimb asymmetry of hip abduction isometric strength greater than 32.5% was a significant risk factor for the development of PF in male amateur marathon runners. The risk of PF occurence increased by 3.646 times if the interlimb asymmetry of hip abduction isometric strength greater than 32.5%. For clinicians, it is suggested to pay attention to the balanced development of bilateral muscle strength in the process of PF rehabilitation treatment, and regard the improvement of the interlimb asymmetry of hip abduction isometric strength as one of the rehabilitation therapies. Moreover, for runners and coaches, it is suggested that they should appropriately add unilateral or bilateral strength training (such as side-lying hip abduction training, clamshell exercise, supine bridge, etc.) in the daily training to ensure the balanced development of hip abduction strength, so as to prevent the occurrence of PF.

PMID:40877885 | DOI:10.1186/s13102-025-01295-z

BMC Psychiatry. 2025 Aug 28;25(1):831. doi: 10.1186/s12888-025-07282-5.

ABSTRACT

BACKGROUND: The first aim of the study was to assess the validity of non-affective psychosis diagnoses, including schizophrenia, for migrants and Swedish-born to determine if the registered diagnoses were of sufficient quality for epidemiological research. If the validity was insufficient, the second aim was to find out what the non-valid cases have in common to see if there was a feasible way to handle these cases in future studies.

STUDY DESIGN: We validated the register-diagnoses of 179 randomly selected patients aged 18-48 living in municipalities with a high proportion of migrants, diagnosed with non-affective psychotic disorder (F20-F29 according to ICD-10), drawn from the Region of Stockholm’s medical records database by comparing them to their case notes to see if they fulfilled the DSM-5 criteria.

RESULTS: We found acceptable validity for non-affective psychotic disorder for migrant men (70.5%), low for Swedish-born men (60.0%), and even lower for women (50.0% for Swedish-born and 40.0% for migrants). There was no statistically significant difference between Swedish-born and migrants. The case notes revealed that by excluding cases with an additional diagnosis equivalent of psychotic disorder due to psychoactive substance (ICD10: F11X.5 and F11X.7) the validity was good for both Swedish-born and migrant men.

CONCLUSIONS: This study supports continued use of the register-diagnoses but only after taking appropriate measures to avoid that patients with additional psychotic disorder due to psychoactive substance are not violating the validity. It also suggests caution when studying non-affective psychosis diagnoses among migrant women as the validity is low, possibly due to difficulties in separating non-affective psychosis from symptoms of other disorders with psychotic features.

PMID:40877884 | DOI:10.1186/s12888-025-07282-5

Genome Med. 2025 Aug 28;17(1):97. doi: 10.1186/s13073-025-01524-7.

ABSTRACT

BACKGROUND: The Women Informed to Screen Depending On Measures of risk (WISDOM) Study is the first prospective, population-wide application of personalized breast cancer screening. We aim to demonstrate the feasibility of the study’s novel use of polygenic risk scores (PRSs) to tailor screening, evaluate our strategy for adapting PRSs to diverse populations, and quantify the impact of incorporating PRS on the study’s screening recommendations.

METHODS: WISDOM is a randomized, preference-tolerant screening trial in the USA testing the safety and morbidity of risk-based versus annual screening in women aged 40-74 without a prior history of breast cancer. This early report includes participants in the risk-based arm only and compares screening recommendations generated by the Breast Cancer Surveillance Consortium (BCSC) clinical risk model alone versus the BCSC model modified by a PRS (BCSC-PRS). The main outcome of interest is the proportion of participants with a change in screening recommendation after integrating PRS for risk stratification.

RESULTS: In the risk-based arm, 21,631 participants received a PRS. Small but statistically significant differences in the PRS were seen between major racial and ethnic groups (p < 0.001), and higher PRS was associated with greater extent of family history (p < 0.001) and denser breasts (p < 0.001). BCSC-PRS risk estimates changed the screening recommendations for 14% of women aged 40-49 compared to BCSC alone and for 10% of women aged 50-74. Projected net screening encounters at the population level were similar for both age groups.

CONCLUSIONS: In a first-in-kind application of PRS to inform breast cancer screening approaches, we demonstrate feasibility for scaled implementation, moderate changes to individual screening recommendations, and minimal projected downstream burden on the healthcare system.

TRIAL REGISTRATION: Prospectively registered on ClinicalTrials.gov as NCT02620852 on 12/2/2015.

PMID:40877879 | DOI:10.1186/s13073-025-01524-7

J Cardiothorac Surg. 2025 Aug 28;20(1):346. doi: 10.1186/s13019-025-03564-x.

ABSTRACT

BACKGROUND AND AIM: Regarding the impact of the coronavirus disease 2019 (COVID-19) and the significance of controlling its spread and also due to the knowledge of the type of demographic characteristics during the Covid outbreak, investigating the cases affected by this condition in the course of its outbreak helps handle multiple critical situations.

METHODS: This retrospective study with a cross-sectional analytical research design was conducted on the statistical population of all admitted patients during the study period with the primary diagnosis of IHD, admitted to Dr. Heshmat Teaching Hospital in Rasht, Gilan Province, Iran, from early February to late April 2020. The samples were selected using the convenience sampling technique through a census, the medical records, and the information completed according to the data collection form. The data analysis was performed using the SPSS Statistics (ver.16.0) software. All the statistical tests were also two-tailed, considering the significance level 0.05.

RESULTS: In the COVID-19 period group, there were more females (45.4% vs. 40.2%, P = 0.019) as well as older patients (62 [IQR 53-71] vs. 61 [IQR 53-70], P = 0.048) compared to the pre-COVID-19 period group. In general, the proportion of patients with current smoking (13.0% vs. 24.4%, P < 0.000), opium consumption (7.2% vs. 14.7%, P < 0.000), and alcohol consumption (0.8% vs. 2.7%, P < 0.001) was lower in the COVID-19 period group compared to the pre-COVID-19 period group.The study findings revealed that the frequency of daily admissions after the COVID-19 peak outbreaks had been significantly higher as compared to those before the pandemic (17.5 [IQR 13.25-22] vs. 12 [IQR 8-19.75], p < 0.001). As well, the in-hospital mortality rates during COVID-19 had been significantly higher than those in 2019, before this condition (4.8% vs. 2.4%, p = 0.004).

CONCLUSION: Given the increasing number of patients admitted during the COVID-19 period, clinical care of patients with IHD, as well as its management and outcomes, becomes more important. It was suggested that these patients be educated about telephone and online services.

PMID:40877865 | DOI:10.1186/s13019-025-03564-x

Popul Health Metr. 2025 Aug 28;23(1):51. doi: 10.1186/s12963-025-00413-w.

ABSTRACT

BACKGROUND: High rates of child morbidity and developmental challenges among children under five remain critical challenges in sub-Saharan Africa. Despite Zambia’s progress in reducing under-five morbidity, the rates remain high, with provincial-level disparities. These disparities are likely to be more pronounced at finer geographic levels, such as districts. However, demographic health surveys, designed for national and provincial estimates, lack sufficient data to produce reliable district-level morbidity statistics.

OBJECTIVE: This study investigates the geospatial distribution of child morbidity prevalence across disaggregated administrative units using small area estimation (SAE) methods.

DATA AND METHODS: Data from the 2018 Zambia Demographic and Health Survey and the 2010 Zambian Census were used to derive direct estimates of child morbidity for small domains cross-classified by district and age group. A hierarchical Bayesian SAE model was developed to account for spatial and unobserved heterogeneity at provincial and district levels, including cross-classifications by age group.

RESULTS: Model-based estimates show lower standard errors compared to the direct estimates and significant differences in morbidity levels within and between districts and provinces. Under-five morbidity prevalence remains high at 25%, with the highest rates in Luapula (approximately 40%) and Western provinces (around 35%) and among children aged 11-23 months (nearly 40%). SAE estimates at the district and district-by-age levels were numerically consistent when aggregated to higher levels, such as province or child age group.

CONCLUSION: These data-driven detailed level estimates provide critical insights into the spatial distribution of child morbidity, supporting targeted interventions and informed policymaking at disaggregated levels.

PMID:40877857 | DOI:10.1186/s12963-025-00413-w

BMC Health Serv Res. 2025 Aug 28;25(1):1144. doi: 10.1186/s12913-025-13335-y.

ABSTRACT

BACKGROUND: Monitoring of healthcare quality is typically focused on differences between group averages in relation to a desirable benchmark. However, we need to consider (i) the existence of interconnected socioeconomic axes of inequality like age, sex, income, and country of birth and (ii) individual heterogeneity around group averages. Additionally, (iii) we need clear criteria to quantify group differences. By applying the framework analysis of individual heterogeneity and discriminatory accuracy (AIHDA) on an established quality indicator (potentially inappropriate medication (PIM)), we illustrate how to achieve these improvements and how to avoid both unnecessary group stigmatization and false expectations.

METHODS: We analyzed 731,339 individuals, ≥ 75-year-old belonging to 36 socioeconomic strata defined by the intersection of age, sex, income, and country of birth, who were alive and residing in the 21 regions Swedish during 2011. We calculated PIM prevalences and evaluate the discriminatory accuracy (DA) of the socioeconomic and geographical group differences using the area under the ROC curve (AUC). The benchmark value was defined as a prevalence of 19%.

RESULTS: In Sweden, the prevalence of PIM was 24% among ≥ 75-year-olds and regionally it ranged between 21% and 27%. Immigrant 80-84-year-old women with low income had the highest prevalence (29%). All strata including women had higher prevalence than those including men. However, the regional (AUC = 0.520) and socioeconomic (AUC = 0.544) differences were very small. For instance, in the five socioeconomic strata with the lowest prevalence there were about 8,000 more cases of PIM than in the five strata with the highest prevalence of PIM.

CONCLUSION: The prevalence of PIM was higher than the desired benchmark value. There were disparities between group averages, but overall, the regional and socioeconomic differences were very small as informed by their low AUC values. Therefore, interventions to reduce PIM in Sweden should be universal rather than only targeted at the regions and socioeconomic strata with the highest PIM prevalence.

PMID:40877856 | DOI:10.1186/s12913-025-13335-y