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Access versus utilization: determinants of insecticide-treated net non-use in Myanmar

Malar J. 2025 Aug 28;24(1):278. doi: 10.1186/s12936-025-05535-y.

ABSTRACT

BACKGROUND: Vector control has played a pivotal role in malaria control and elimination efforts, with insecticide-treated nets (ITNs) recognized as one of the most effective and widely accepted strategies. This study assessed ITN use and identified factors associated with non-use among individuals with access to ITNs in Myanmar.

METHODS: Data were drawn from the nationally representative 2015-2016 Myanmar Demographic and Health Survey. Access to ITNs was defined as having at least one ITN per two household members, and ITN use as having slept under an ITN the night before the survey. Descriptive statistics and multivariable logistic regression models were conducted using the “svyset” command in STATA to account for the two-stage stratified cluster sampling design.

RESULTS: Among 6,140 individuals with access to ITNs, approximately one-third (31.6%, 95% CI 28.3%-35.0%) reported not using them. Factors associated with higher odds of ITN non-use were age 15-34 years (adjusted odds ratio [aOR]: 1.31; 95% CI 1.07-1.61) and ≥ 50 years (aOR: 1.33; 95% CI 1.07-1.67), rural residence (aOR: 1.82; 95% CI 1.10-3.01), and belonging to the fourth wealth quintile, representing higher socioeconomic status (aOR: 1.74; 95% CI 1.06-2.85).

CONCLUSIONS: Despite having access to ITNs at that time, a substantial proportion of individuals in Myanmar did not use them. These historical findings highlight behavioural and contextual barriers that existed before recent health system disruptions due to political unrest and COVID-19. Although present-day challenges differ, understanding past determinants of ITN non-use remains valuable for designing behaviour change communication (BCC) strategies, especially in regions where ITN distribution remains feasible.

PMID:40877931 | DOI:10.1186/s12936-025-05535-y

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Prevalence and risk factors of burnout symptoms among nurses during the COVID-19 pandemic: an updated systematic review and meta-analysis

Hum Resour Health. 2025 Aug 28;23(1):48. doi: 10.1186/s12960-025-01012-4.

ABSTRACT

BACKGROUND: COVID-19 has been a substantial challenge for nurses globally, as they have gone through prolonged crisis times where they were continually under immense psychological pressure. Working in these conditions for months and years has resulted in an increase in the prevalence of job burnout among nurses. This systematic review was conducted to provide solid evidence on the prevalence of burnout and its related factors among nursing staff in different parts of the world after the occurrence of the COVID-19 pandemic.

METHODS: Several electronic databases were searched, between January 2020 and September 15, 2024, for relevant studies, namely MEDLINE, Web of Science, Embase, Scopus, ScienceDirect, ProQuest, APA PsycINFO, Google Scholar, and EBSCOhost Research Platform. Multiple search keywords were defined for the search process. The Newcastle-Ottawa Scale was used to evaluate the quality of each study included. Our main outcome was the prevalence of burnout in nurses during COVID-19. We subsequently analyzed our data by age (< 30 vs. ≥ 30 years), country income levels (defined based on the World Bank Classification for the 2023 fiscal year), and culture (Western vs. Non-Western). We used RevMan software, developed by Cochrane, to perform the statistical analysis. The outcomes were assessed using odds ratios (OR) with corresponding 95% confidence intervals (CI) to ensure accurate and reliable estimates.

RESULTS: Data from the 19 studies and 11 countries indicated an overall burnout prevalence rate of 59.5% in the nurse population during COVID-19. In addition, analyses of 37 studies and 15,015 nurses revealed a pooled prevalence rate for emotional exhaustion of 36.1%. Analyses of 36 studies involving 14,864 nurses showed a pooled prevalence rate for depersonalization of 32.4%. Finally, data from 36 studies and 14,864 participants found a pooled prevalence rate for reduced personal accomplishment of 33.3%. Regarding subgroup analysis of total burnout by nurses’ characteristics, our results demonstrated that nurses working in higher income countries reported significantly higher prevalence rates of burnout relative to those working in low- and lower-to-middle-income countries. Those working in a Western context exhibited significantly higher risk for overall burnout compared to those working in a non-Western context. Finally, comparisons across age groups noted significantly higher levels of burnout among nurses aged 30 years and above compared to those aged < 30 years.

CONCLUSION: This review urges nursing leaders’ intervention, hospital administrators, and policymakers to minimize and prevent burnout among nurses, especially during crises times such as the COVID-19 pandemic. This review also encourages further research into efficient evidence-based interventions to support nurses and combat burnout in the nursing profession.

PMID:40877925 | DOI:10.1186/s12960-025-01012-4

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Caring hands, heavy minds: prevalence and associated factors of depression, anxiety, and stress symptoms among nurses in Mogadishu, Somalia

BMC Nurs. 2025 Aug 28;24(1):1128. doi: 10.1186/s12912-025-03801-7.

ABSTRACT

BACKGROUND: Nurses are the foundation of healthcare systems, providing clinical care, emotional support, health education, and patient advocacy. Their frontline role and dedication significantly enhance patient outcomes and healthcare system efficiency. However, the high-pressure nature of nursing exposes them to increased risk of mental health disorders, particularly depression, anxiety, and stress, which can undermine both personal well-being and the quality of patient care. Despite global recognition of this issue, data from resource-limited and conflict-affected settings, such as Somalia, remain scarce. This study therefore aimed to assess the prevalence of depression, anxiety, and stress symptoms and to identify associated factors among nurses in Mogadishu, Somalia.

METHODS: A multicenter, cross-sectional study was conducted between November and December 2024 among 372 nurses across four hospitals in Mogadishu. Data were collected using self-administered online questionnaires comprising a demographic section, the 21-item Depression, Anxiety, and Stress Scale, the Pittsburgh Sleep Quality Index, and the Oslo Social Support Scale-3. Statistical analysis was performed using SPSS version 26, including descriptive statistics, bivariate analyses, and multivariable logistic regression. Statistical significance was set at p < 0.05.

RESULTS: The prevalence of depression, anxiety, and stress symptoms among participants was 29% (95% CI: 24.5-33.9%), 32.5% (95% CI: 27.8-37.5%), and 15.1% (95% CI: 11.6-19.1%), respectively. Female was significantly associated with depression (AOR = 1.72; 95% CI: 1.01-2.92; p = 0.045) and anxiety (AOR = 1.69; 95% CI: 1.03-2.80; p = 0.040), while being over 30 years old was linked to anxiety (AOR = 2.59; 95% CI: 1.34-5.01; p = 0.005) and stress (AOR = 2.34; 95% CI: 1.09-5.02; p = 0.029). Stress was further associated with physical inactivity (AOR = 2.00; 95% CI: 1.02-3.81; p = 0.044) and ICU work assignments (AOR = 3.39; 95% CI: 1.08-10.65; p = 0.036). Notably, poor sleep quality and limited social support consistently were strongly associated with all outcomes, with adjusted odds ratios ranging from 4.60 to 8.18 for sleep and 2.46 to 3.86 for social support.

CONCLUSIONS: The findings underscore a critical mental health burden among nurses in Mogadishu, driven by both occupational and personal factors. High-risk groups such as ICU staff and female nurses appear particularly vulnerable. Urgent institutional responses including regular mental health screenings, support programs (e.g., peer-support groups or employee assistance programs), workload management, and wellness promotion are essential to safeguard nurse well-being and ensure the delivery of high-quality patient care.

PMID:40877922 | DOI:10.1186/s12912-025-03801-7

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Cardiac arrest during peri-anesthetic systemic induction and maintenance in valvular heart disease: proceed or abandon? Clinical validation of a modified cardiopulmonary bypass strategy in 21 patients

Eur J Med Res. 2025 Aug 29;30(1):818. doi: 10.1186/s40001-025-03096-z.

ABSTRACT

BACKGROUND: Critical gaps persist in clinical guidelines and resuscitation strategies for induction and maintenance phase peri-anesthetic cardiac arrest (IM-PACA), urgently necessitating exploration of feasible solutions during anesthesia induction and maintenance periods. This study evaluates a modified cardiopulmonary bypass (CPB) strategy for managing IM-PACA in valvular heart disease (VHD) surgical patients.

METHODS: A retrospective analysis was performed on IM-PACA patients (n = 21) from 1,043 cardiac valve surgeries between March 2019 and January 2022 as the cardiac arrest-resuscitation group (CAR group). Patients who completed normal cardiac valve surgery (n = 84) were randomly selected from the medical record database as the Routine Surgery group (RS group), serving as a benchmark control for the standard efficacy of routine surgery. The CAR group completed surgery after modified cardiopulmonary bypass strategy; the RS group completed surgery as planned. This study reviewed the possible causes of cardiac arrest in the CAR group and performed statistical analysis on surgical time-related metrics (total surgical duration, cardiopulmonary bypass duration, etc.) and postoperative follow-up data (paravalvular leak, cardiac-related complications, etc.) using SPSS 26.0.

RESULTS: The short-term postoperative survival rate was 95.24% in the CAR group and 100% in the RS group. Baseline characteristics including gender, age, and smoking history showed no significant differences between the two groups (P > 0.05). The CAR group showed a significantly shorter pericardiotomy-to-CPB time (250.00 (205.00-269.50) vs. 512.50 (459.25-563.00) s; P < 0.001), but longer rewarming time (68.00 (63.50-74.50) vs. 48.00 (35.25-61.75) min; P < 0.001), ventilator duration (980.00 (619.00-1106.50) vs. 900.00 (630.00-1103.75) min; P = 0.002), and higher day 2 drainage (190 (157.50-215.00) vs. 105 (71.25-150.00) ml; P < 0.001) compared to the RS group. Other intraoperative and postoperative parameters revealed no statistically significant differences when compared with the RS group (P > 0.05).

CONCLUSIONS: For IM-PACA patients undergoing cardiac valve surgery, the modified cardiopulmonary bypass strategy is an effective rescue method, and the strategy of continuing surgery after resuscitation is completely feasible.

PMID:40877919 | DOI:10.1186/s40001-025-03096-z

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History matters: Preventing severe allergic transfusion reactions

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

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Gender disparities in Australia’s specialist digital health workforce: a cross-sectional study on education and occupation

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

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AdapTor: Adaptive Topological Regression for quantitative structure-activity relationship modeling

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

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Epidemiology of stillbirths in india: findings of a multisite hospital-based sentinel surveillance from 2016 to 2020 in North India

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

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Interlimb asymmetries of lower limb isometric strength for predicting plantar fasciitis in male amateur marathon runners: a prospective cohort study

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

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The validity of diagnoses of non-affective psychotic disorder including schizophrenia in Swedish registers revisited – are the diagnoses valid for migrants and Swedish-born?

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