Nevin Manimala

BMC Health Serv Res. 2026 Jul 15. doi: 10.1186/s12913-026-15126-5. Online ahead of print.

ABSTRACT

BACKGROUND: Workplace violence has emerged as a global problem that affects all nations, workplaces, and occupational categories. The health sector accounts for more than one-third of all workplace violence worldwide. There is very little information available in Ethiopia about workplace violence affecting healthcare professionals. This study aims to identify key associated factors of workplace violence to inform future evidence-based interventions and policy development. Therefore, the objective of this study was to assess the prevalence of workplace violence and associated factors among healthcare professionals working in selected public hospitals in Addis Ababa, Ethiopia.

METHODS: An analytic cross-sectional study was conducted from May 1 to June 30, 2023, among 599 randomly selected healthcare professionals working at four referral hospitals in Addis Ababa, Ethiopia via a multistage sampling technique. Data was collected via a pretested, structured, self-administered questionnaire adapted from a standard questionnaire. The data were coded and entered into EPI Information version 7 and exported to SPSS V.20.0 software for analysis. A frequency table was used to summarize the data. To identify factors associated with workplace violence, a binary logistic regression model in which the degree of association for variables was assessed via adjusted odds ratios (AORs) with 95% CIs and p values ≤ 0.05 was used.

RESULT: The prevalence of experiencing at least one type of workplace violence (physical, verbal, bullying, or sexual) in the previous year was 59.4% (95% CI = 55.6-63.1). The study revealed a statistically significant relationship between workplace violence and female sex (AOR = 1.56, 95% CI = 1.04-2.34, p = 0.033), pharmacist profession (AOR = 2.9, 95% CI = 1.15-7.33, p = 0.025), routine direct physical contact with patients (AOR = 2.19, 95% CI = 1.12-4.29, p = 0.022), emergency work starting (AOR = 2.50, 95% CI = 1.02-6.15, p = 0.045), and witnessing incidents of physical violence (AOR = 10.1, 95% CI = 5.75-17.59, p < 0.0001).

CONCLUSION: This study revealed a high prevalence of workplace violence among health care professionals working in government hospitals in Addis Ababa, Ethiopia. Healthcare facilities should prioritize the establishment of comprehensive health and safety programs focused on the prevention and management of workplace violence, with particular attention given to the most vulnerable groups.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42458501 | DOI:10.1186/s12913-026-15126-5

Cost Eff Resour Alloc. 2026 Jul 15. doi: 10.1186/s12962-026-00798-x. Online ahead of print.

ABSTRACT

OBJECTIVES: Bacterial vaginosis (BV) is associated with reduced fecundability in women. To address the limited accessibility and diagnostic sensitivity of current preconception BV screening in China, this study evaluated the cost-effectiveness of BV Blue, an accessible, self-administered rapid test.

METHODS: A decision tree model was constructed from a societal perspective to compare five screening strategies: No screening, Amsel criteria, BV Blue testing alone, sequential BV Blue-Nugent testing, and Nugent scoring alone. Effectiveness was defined as the number of pregnancies per 100,000 women over one year. Cost-effectiveness was evaluated using incremental cost-effectiveness ratios (ICERs), referenced against a willingness-to-pay (WTP) threshold based on China’s per capita GDP. Sensitivity analyses were conducted to assess model robustness.

RESULTS: In a simulated cohort of 100,000 women, BV Blue testing yielded 842 additional pregnancies compared with no screening (ICER: CNY 2,827 per pregnancy), well below the WTP threshold of CNY 99,665. The sequential and Amsel strategies were absolutely dominated by BV Blue testing. Compared with BV Blue testing, Nugent strategy yielded 171 additional pregnancies (ICER: CNY 198,051 per pregnancy), remaining below the three-fold per capita GDP threshold (CNY 298,995). However, sensitivity analyses indicated that the cost-effectiveness of Nugent strategy was not robust, being highly sensitive to BV Blue testing’s diagnostic sensitivity and pregnancy rates. On the cost-effectiveness acceptability curve, BV Blue testing consistently demonstrated the highest probability of being the optimal strategy.

CONCLUSION: In the preconception period, all screening strategies yielded more pregnancies than no screening. Both BV Blue testing and Nugent scoring were cost-effective, whereas the Amsel and sequential strategies were not. BV Blue testing is a promising screening tool for preconception BV management. These findings may inform the selection of diagnostic pathways in China’s national preconception screening program.

PMID:42458496 | DOI:10.1186/s12962-026-00798-x

Respir Res. 2026 Jul 15. doi: 10.1186/s12931-026-03809-w. Online ahead of print.

ABSTRACT

BACKGROUND: In a phase 2 trial (NCT04308681), treatment with admilparant (BMS-986278), an oral lysophosphatidic acid receptor 1 (LPA₁) antagonist, reduced lung function decline in patients with idiopathic pulmonary fibrosis (IPF) or progressive pulmonary fibrosis (PPF). In this exploratory analysis, we evaluated post-treatment changes in circulating biomarkers of lung fibrosis to elucidate mechanisms of admilparant action.

METHODS: Patients with IPF or PPF were randomized 1:1:1 to receive twice-daily admilparant (30 or 60 mg) or placebo for 26 weeks; background antifibrotics were allowed. The IPF and PPF cohorts were analyzed separately. Changes from baseline (CfB) in serum proteins associated with epithelial injury, inflammation, and fibrosis were measured by quantitative immunoassays at 4, 12, and 26 weeks, and compared between patients who received admilparant versus placebo. Pharmacodynamic biomarker changes were evaluated by clinical response status at week 26. Plasma samples from patients with IPF were assessed post hoc by SomaScan v4.1 proteomics assay. Statistical evaluations used linear mixed-effects models.

RESULTS: In the IPF cohort (n=276), nine serum proteins showed significant CfB (p<0.05) at week 26 in patients treated with 60-mg admilparant versus placebo, including increased adiponectin, MMIF, CD163, CEA, and ENRAGE, and decreased markers of epithelial injury and fibrosis (CA-125/MUC16, MMP-7, TN-C, PRO-FIB). In the PPF cohort (n=116), significant differences at week 26 (p<0.05) were observed for 11 serum proteins, including increased CEA and decreased periostin, IL6Rβ, CD163, KIM-1, multiple inflammatory markers (YKL-40, VCAM-1, PECAM-1, ferritin), and collagen degradation markers (C3M and C4M). Two serum proteins, CA-125 and TN-C, showed significantly greater CfB (p<0.05) in responders compared with non-responders in the IPF cohort. Plasma proteomic analysis identified differential expression (adjusted p<0.1) of adiponectin, CKMT1A, ANGPTL3, PDCD1LG2, and IGFBP6 at week 26 in patients with IPF treated with 60-mg admilparant versus placebo.

CONCLUSIONS: Treatment with 60-mg admilparant improved circulating biomarkers associated with epithelial injury and fibrosis in IPF, and with inflammation, fibrosis, and collagen degradation in PPF. Proteomic analysis identified additional biomarkers associated with mitochondrial and metabolic pathways in IPF. These findings expand our understanding of potential mechanisms of LPA₁ antagonism with admilparant and identify biomarkers that may help evaluate treatment response and disease activity.

PMID:42458495 | DOI:10.1186/s12931-026-03809-w

Harm Reduct J. 2026 Jul 15. doi: 10.1186/s12954-026-01425-x. Online ahead of print.

ABSTRACT

BACKGROUND: Attendance in substance-use-disorder group-treatment is challenging with only 32% of patients attending at least one session (Substance Abuse and Mental Health Services Administration and Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2023 admissions to and discharges from substance use treatment services reported by single state agencies, Bethesda, 2025). The present study tested a set of strategies to increase group session attendance in Community Wise, an innovative evidence-based group-intervention delivered in harm-reduction-community-based agencies and designed to reduce alcohol and substance use among people with substance-use-disorders living in predominantly Black and disinvested communities. We examined: (1) if strategies to increase attendance stratified by surveillance status (participation in mandatory programs that use urine screens regularly) would result in a clinically and statistically significant increase in intervention session attendance, with a goal of at least 50% of participants attending at least half of sessions; (2) the effects of group session attendance and strategies to increase attendance on alcohol and substance use frequency in the past 30 days at three-months-follow-up.

METHODS: We conducted a 2² stratified full factorial experiment with 164 adults with substance-use-disorder in East St. Louis, IL. Participants were randomized to combinations of two strategies to increase attendance: Financial incentives (receiving $20 to attend group sessions) and group type (open versus closed groups). Surveillance status was treated as a fixed factor in the analytical model. Logistic and multiple regression models, using effect coding, tested main and interaction effects on number of sessions attended and alcohol and substance use. Analyses followed an intent-to-treat approach, adjusting for demographic covariates, using SAS 9.4.

RESULTS: Of 164 participants, 29% attended ≥ 50% of Community Wise sessions. Paying participants increased odds of attending at least 50% of sessions (OR = 1.97, p = 0.004), while being under surveillance reduced odds by 39% (OR = 0.61, p = 0.036). No main effects were found for group type. Yet, a significant interaction showed financial incentives were more effective in closed versus open groups (OR = 0.58, p = 0.021). Higher attendance predicted reduced percent alcohol and substance use at follow-up (p = 0.011).

CONCLUSIONS: Financial incentives effectively improved intervention attendance, while being under surveillance reduced participation. Higher attendance was associated with decreased alcohol and substance use. The Community Wise intervention should be further tested for effectiveness in harm reduction community-based-organizations among people who are disengaged from treatment and experiencing vulnerabilities such as poverty and houselessness.

TRIAL REGISTRATION: Clinical Trials: NCT05934591.

PMID:42458493 | DOI:10.1186/s12954-026-01425-x

Diagn Pathol. 2026 Jul 16. doi: 10.1186/s13000-026-01804-9. Online ahead of print.

ABSTRACT

BACKGROUND: Prostate cancer is a common malignancy. Intraductal carcinoma of the prostate (IDCP) is associated with poor prognosis, but is underreported in certain geographic regions. The presence of IDCP is recently recognized as an independent prognosticatior of poor prognosis. We aim to identify factors associated with IDCP on radical prostatectomy specimens to aid in more accurate diagnosis of IDCP.

METHODS: A retrospective study was conducted on specimens from Showa Medical University Hospital (Japan) and Queen’s Medical Center (Hawaii) from April 2020 to March 2024. Clinical data included age, PSA, and race; pathological data included GS, GG, and factors indicated the extent of cancer (EPE, RM, LVI, PNI, SVI). IDCP was diagnosed morphologically; equivocal lesions underwent basal cell IHC. Statistical analyses identified factors associated with IDCP.

RESULTS: Among 279 cases, IDCP was found in 70 (25.1%). The IDCP-positive group had higher PSA levels (14.2 vs. 10.7 ng/ml, p = 0.048). Univariate and Multivariate analyses identified GS (OR: 16.41, p < 0.001), EPE (OR: 2.36, p = 0.02), and PNI(OR: 2.57, p = 0.02) remained independently associated.

CONCLUSION: High grade (GS ≥ 8), EPE, and PNI serve as practical pathological triggers to scrutinize ducts and apply basal-cell IHC, which may reduce under-recognition of IDCP in RP specimens.

PMID:42458491 | DOI:10.1186/s13000-026-01804-9

Radiat Oncol. 2026 Jul 15. doi: 10.1186/s13014-026-02886-x. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: The optimal postoperative adjuvant treatment for pathological T3N0M0 (pT3N0M0) thoracic esophageal squamous cell carcinoma (TESCC) remains unclear. This study evaluated whether adding radiotherapy to postoperative chemotherapy provides an additional survival benefit in these patients.

METHODS: We retrospectively reviewed 1,090 TESCC patients treated at Sichuan Cancer Hospital (2009-2020). After applying inclusion and exclusion criteria, 356 patients who received adjuvant therapy were analyzed: 274 underwent surgery plus postoperative chemotherapy (S+POCT) and 82 received surgery plus postoperative chemoradiotherapy (S+POCRT). Propensity score matching balanced baseline characteristics between groups. Overall survival (OS) and disease-free survival (DFS) were compared, and survival predictors were assessed using a Cox proportional hazards model.

RESULTS: Before matching, the S+POCRT group had more female patients, and patients with vascular or perineural invasion were more likely to receive chemoradiotherapy. After matching (82 patients per group), baseline characteristics were balanced. The 5-year OS was 70.9% for the entire cohort. In the matched cohort, 5-year OS rates were 65.3% (S+POCT) versus 71.4% (S+POCRT), and 5-year DFS rates were 63.3% versus 70.9%, respectively. No statistically significant differences in OS or DFS were observed between the two groups. Multivariate analysis indicated that neither postoperative chemotherapy nor chemoradiotherapy independently improved OS. In the subgroup analysis, patients with tumors located in the lower third of the esophagus were more likely to derive a significant DFS benefit from S+POCRT but no subgroup showed a statistically significant OS benefit from S+POCRT compared with S+POCT.

CONCLUSIONS: For pT3N0M0 TESCC patients undergoing R0 resection without neoadjuvant therapy, postoperative chemotherapy alone provides comparable survival to chemoradiotherapy in the overall retrospective cohort. These findings suggest that the routine addition of postoperative radiotherapy to chemotherapy may not provide a clear survival advantage in the overall pT3N0M0 TESCC population. Further prospective studies are needed to identify patients who may benefit from postoperative radiotherapy.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42458490 | DOI:10.1186/s13014-026-02886-x

J Orthop Surg Res. 2026 Jul 15. doi: 10.1186/s13018-026-07094-7. Online ahead of print.

ABSTRACT

OBJECTIVE: Previous meta-analyses often lacked explicit time and included heterogeneous case types and surgical strategies. This led to substantial heterogeneity and limited the clinical applicability of these meta-analyses. This study focuses on evidence from the past 15 years, systematically comparing percutaneous pedicle screw fixation (PPSF) with open pedicle screw fixation (OPSF) for unstable traumatic thoracolumbar fractures (TTF). We aim to evaluate perioperative outcomes and radiographic correction based on contemporary practice.

METHODS: Randomized controlled trials (RCTs) published in English between January 2011 and January 2026 were retrieved from PubMed, Embase, the Cochrane Library, and the Web of Science Core Collection. Studies were screened using predefined inclusion and exclusion criteria. Six RCTs involving 305 patients were included, with 151 patients in the experimental group and 154 in the control group. Meta-analysis was performed using Review Manager 5.4. Mean difference (MD) was used as the effect size. Heterogeneity was assessed with the I² statistic. Sensitivity analysis was used to identify the main source of heterogeneity. Publication bias was evaluated using Egger’s test.

RESULTS: The random-effects meta-analysis showed that the experimental group had significantly less intraoperative blood loss (MD = – 32.51 mL, 95% CI – 57.52 to – 7.51, P = 0.01), shorter postoperative hospital stay (MD = – 2.09 d, 95% CI – 3.89 to – 0.29, P = 0.02), and smaller postoperative Cobb angle (MD = – 1.06°, 95% CI – 1.67 to – 0.46, P < 0.001). There was no significant difference in operative time (MD = – 10.15 min, 95% CI – 28.75 to 8.46, P = 0.29) or postoperative vertebral wedging angle (MD = 0.25°, 95% CI – 1.73 to 2.24, P = 0.80) between groups. Sensitivity analyses identified the study by Yang et al. as the main source of heterogeneity for operative time. After excluding this study, the fixed-effects model showed a shorter operative time in the experimental group (MD = – 8.85 min, 95% CI – 12.74 to – 4.95, P < 0.001). Perioperative outcomes showed high heterogeneity, whereas radiographic outcomes showed low to moderate heterogeneity. Egger’s test indicated no significant publication bias. Risk-of-bias assessment classified four RCTs as having a low risk of bias and two as having some concerns; no study was judged to have a high risk of bias.

CONCLUSION: PPSF may offer perioperative advantages over OPSF in selected unstable traumatic thoracolumbar fractures, mainly by reducing visible intraoperative blood loss and shortening postoperative hospital stay. PPSF was also associated with a modestly smaller postoperative segmental Cobb angle, although its clinical relevance and long-term durability remain uncertain. The operative-time finding should be interpreted cautiously because it became significant only in exploratory sensitivity analysis.

PMID:42458487 | DOI:10.1186/s13018-026-07094-7

BMC Med Educ. 2026 Jul 15. doi: 10.1186/s12909-026-09946-6. Online ahead of print.

ABSTRACT

BACKGROUND: The social model of disability acknowledges that the difficulties faced by persons who stutter (PWS) stem not only from speech dysfluency but also from societal barriers, misconceptions, and stigmatizing attitudes that limit participation and inclusion. As future healthcare professionals, health sciences students play an important role in promoting early detection, proper referral, and supportive care. However, there is limited research about their knowledge, beliefs, and attitudes around stuttering, particularly in Palestine and underserved areas.

METHODS: A cross-sectional study was carried out on 603 students enrolled in 14 health-related fields at An-Najah National University in Palestine. Participants completed an online questionnaire that assessed their knowledge and attitudes toward stuttering. SPSS version 25 was used to conduct descriptive statistics and chi-square tests to investigate the relationships between responses and gender, residence, and academic discipline.

RESULTS: Significant misconceptions persisted even though the majority of participants acknowledged the significance of early identification (87.9%) and disputed the idea that stutterers are less intelligent (83.3%). Less than half (38.1%) were aware of nearby treatment facilities, and only 22.9% recognized stuttering as a genetic problem. Many participants thought stutterers were quiet or shy (69.5%), more susceptible to mental health issues (73.6%), and socially ignored (46.1%). Gender, place of residence, and academic discipline all showed significant disparities. While students from a number of other disciplines showed more doubt and misconceptions, students in audiology and speech consistently showed the highest levels of knowledge and more evidence-informed attitudes.

CONCLUSION: This study reveals considerable knowledge gaps and persistent stigmatizing attitudes toward people who stutter among health sciences students, with marked disparities across disciplines. Targeted curricular interventions are warranted to address misconceptions about people who stutter.

PMID:42458485 | DOI:10.1186/s12909-026-09946-6

J Transl Med. 2026 Jul 15. doi: 10.1186/s12967-026-08654-5. Online ahead of print.

ABSTRACT

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in children, young people (CYP) lacks validated diagnostic biomarkers. Post-exertional malaise (PEM) is central to case definitions and is usually assessed by patient report. We evaluated the feasibility and clinical value of handgrip strength (HGS) testing in PEM-reporting CYP referred for suspected ME/CFS.

METHODS: In this prospective observational study at the Munich Chronic Fatigue Center for Young People (November 2022-November 2024), 147 patients (10-25 years) referred for the assessment of ME/CFS with positive DSQ-PEM screening and 83 healthy controls (HC) completed two HGS sessions (10 maximal grips/session; 3-s contraction/5-s rest; 60-minute inter-session break) using a digital dynamometer. We derived maximal force (Fmax), mean force (Fmean), fatigue ratio (FR = Fmax/Fmean), and recovery ratio (RR = Fmean session 2 / session 1). Analyses used repeated-measures ANCOVA, linear regression, partial Spearman correlations (adjusted for sex, age, and BMI), and proportional odds models for group membership (HC, noME/CFS, ME/CFS), reporting accuracy, and the C-statistic. Sensitivity analyses compared noME/CFS with confirmed CCC-ME/CFS.

RESULTS: After clinical work-up, 84/147 (57%) patients were classified as ME/CFS (confirmed or probable) and 63/147 (43%) as noME/CFS. HGS test completion rate was high (session 1: 146/147, 99.3%; session 2: 142/147, 96.6%). Compared with HC, patients had substantially lower HGS (mean difference -9.93 kg, 95% CI: -12.00 to -7.85), and HGS indices correlated modestly with physical functioning (SF-12 PCS), but not with PEM duration. Both noME/CFS and ME/CFS groups differed from HC in absolute strength indices (Fmean, Fmax) and FR. RR differed between ME/CFS and HC, whereas no HGS index significantly separated noME/CFS from ME/CFS. In proportional odds models, each HGS index improved fit (all p < 0.001), but discrimination across HC, noME/CFS, and ME/CFS patients was moderate (accuracy 49.2-57.3% vs no-information rate 36.5%, with best performance for Fmean in session 2). In the CCC-restricted sensitivity analysis, discrimination between confirmed CCC-ME/CFS and noME/CFS was moderate (accuracy 62.8-70.7%; C-statistic 0.63-0.73), with best performance for absolute strength indices and RR.

CONCLUSIONS: Standardized two-session repeated HGS testing is feasible in CYP with chronic fatigue and self-reported PEM and provides an objective marker of functional impairment that aligns with physical health status but not with PEM duration. However, HGS alone shows limited ability to discriminate ME/CFS from other fatiguing noME/CFS conditions. HGS may be useful for quantitative phenotyping, patient stratification, and longitudinal outcome assessment rather than as a standalone diagnostic biomarker.

TRIAL REGISTRATION: Not applicable.

PMID:42458481 | DOI:10.1186/s12967-026-08654-5

J Transl Med. 2026 Jul 15. doi: 10.1186/s12967-026-08625-w. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic lung diseases impose a massive global burden, yet translating genetic findings into biologically interpretable target hypotheses remains challenging. We aimed to prioritize genetically supported candidate gene-cell type-disease associations and characterize pharmacological annotations for asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and bronchiectasis (BE).

METHODS: We integrated immune-cell-specific single-cell cis-eQTL data (14 immune cell subsets) with two-sample cis-Mendelian randomization and Bayesian colocalization. Using FinnGen R12 and UK Biobank as independent outcome cohorts, we developed a cross-cohort tiered framework to rank candidate gene-cell type-disease associations based on MR evidence, colocalization support, and cross-cohort consistency.

RESULTS: Asthma yielded the most robust signals, highlighting 6 “Tier 1” candidates (e.g., CD247, FADS1) with replicated colocalization support across both cohorts. We mapped 17 prioritized druggable genes to existing drug-, compound-, or metabolite-related annotations via DrugBank, DGIdb, and HMDB. These annotations nominate CD247, FADS1, and other loci for mechanistic and pharmacological follow-up, but they should not be interpreted as direct evidence of clinical repurposing readiness. The limited peripheral immune signals observed in IPF and BE suggest that local tissue niches, together with limited power and phenotype heterogeneity, may influence signal detection.

CONCLUSIONS: By bridging single-cell genomics with pharmacological databases, our tiered prioritization framework provides a statistically grounded map of genetically supported candidate genes for chronic respiratory diseases. The results refine broad genetic loci into cell-contextualized candidate genes and pharmacological annotations that require independent, functional, and pharmacological validation before therapeutic inference. These findings should be interpreted as hypothesis-generating prioritization evidence rather than proof of therapeutic efficacy, clinical utility, or drug-repurposing readiness.

PMID:42458479 | DOI:10.1186/s12967-026-08625-w