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Nevin Manimala Statistics

Knowledge, attitudes and practices of veterinarians and para-veterinarians towards antimicrobial stewardship in Malawi: underutilized strength in the fight against antimicrobial resistance

BMC Vet Res. 2025 May 30;21(1):390. doi: 10.1186/s12917-025-04837-2.

ABSTRACT

Antimicrobial resistance (AMR) is a global public health concern, and the inappropriate use of antibiotics in animals and humans is considered a significant contributing factor. Para-veterinarians and veterinarians are vital in the fight against AMR. The study aimed to evaluate the knowledge, attitudes and practices of the para-veterinarians and veterinarians towards antimicrobial stewardship in Malawi. A cross-sectional questionnaire survey among the para-veterinarians and veterinarians was conducted from October 2024 to January 2025. A total of 69 participants, comprised of 42 para-veterinarians and 27 veterinarians, participated in this study, and the response rate for the survey was 44% (n = 158). The study used a predetermined cutoff of ≥ 55% to classify scores as having good knowledge, good practice, and a positive attitude. The study found that 85.5% of the respondents had good knowledge and 98.6% had good practices towards antimicrobial stewardship and prevention of AMR, while 92.8% had favorable attitude towards AMR and antimicrobial stewardship. The maximum obtainable scores for each construct were 11, 13 and 13 for knowledge, practice, and attitude, respectively. The overall mean scores for knowledge, practice and attitude were 11.25 ± 2.83, 8.71 ± 1.34 and 9.04 ± 1.64, respectively. These findings indicated that the respondents had good knowledge, good practices and favorable positive attitude towards AMR and antimicrobial stewardship. The study concludes that there is good level of knowledge, practice and favorable attitude among para-veterinarians and veterinarians towards antimicrobial stewardship which can be capitalized in the fight against AMR in Malawi. The veterinary professionals can be entrusted to comply with responsible antimicrobial prescriptions and use.

PMID:40442733 | DOI:10.1186/s12917-025-04837-2

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The modified retroperitoneal laparoscopic adrenalectomy overcomes adhesive periadrenal fat and achieves superior outcomes than classical approach: a retrospective study

BMC Urol. 2025 May 29;25(1):143. doi: 10.1186/s12894-025-01809-4.

ABSTRACT

OBJECTIVES: Mayo adhesive probability (MAP) score affects the outcomes of adrenaletomy. Aimed to determine whether the modified retroperitoneal laparoscopic adrenalectomy (MRLA) overcomes periadrenal fat adhesion compared to Classical retroperitoneal laparoscopic adrenalectomy (CRLA) to achieve better surgical outcomes.

PATIENTS AND METHODS: Patients admitted from January 2016 to December 2022 were retrospectively analyzed and systematically categorized into two distinct cohorts: the MRLA group and the CRLA group, based on specific criteria.The main surgical techniques modified of MRLA is third separation level: between the edge of adrenal gland and the peripheral renal fat. The baseline characteristics and perioperative data, e.g., age, gender, BMI, tumor position, tumor size (cm), MAP score, P distance (cm), perinephric stranding, and periadrenal stranding, estimated blood loss, Operating time, were analyzed, with statistical significance defined as p < 0.05. We analyzed the differences between groups using the t test. For measurement data that didn’t follow normal distribution, we described the concentration and dispersion trended using M (Q25, Q75) and analyzed the differences between groups using the M-U test. For data that met certain conditions like being linear, normal and independent, we used linear regression analysis. For binary classification of dependent variables, we used binary logistic regression analysis.

RESULTS: A total of 731 patients underwent adrenaletomy, and 651 patients had adequate data, were available for MAP score assessment. Of these patients, 247 were in the MRLA group, whereas 404 were in the CRLA group, baseline characteristics weren’t found to be different between the two groups (p > 0.05). The MRLA group exhibited superior outcomes in terms of operating time, duration, postoperative hospital stay, estimated blood loss, and complications, in comparison to the CRLA group. Further analysis revealed that periadrenal stranding could be the underlying cause for this discrepancy.

CONCLUSIONS: The MRLA effectively overcame the impact of adhesive periadrenal fat (APAF) compared to CRLA. We recommend to employ the MRLA for patients with preoperative CT images indicating periadrenal fat adhesion.

PMID:40442731 | DOI:10.1186/s12894-025-01809-4

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Ligula intestinalis in Labeobarbus fish species at Lake Tana, Ethiopia: prevalence, histopathological investigation, and associated risk factors

BMC Vet Res. 2025 May 30;21(1):392. doi: 10.1186/s12917-025-04799-5.

ABSTRACT

Food security and employment prospects are significantly influenced by the fish industry. A cross-sectional study was conducted from February 2023 to March 2024 to determine the pathological lesions, prevalence, and associated risk factors of L. intestinalis infection in Labeobarbus fish species in Lake Tana, Ethiopia. A total of 384 Labeobarbus fish were randomly selected from local fishermen and their associations. Pathological lesions were examined using proper evisceration and post-mortem techniques. Various visceral organs including the gonads, liver, and spleen were collected from infected fish for histopathological examination. Gross pathological findings revealed abdominal distension, anal hemorrhage, and gonadal atrophy, displacement of internal organs, body emaciation, and visceral fibrosis accompanied by discoloration. Histopathological alterations were observed in multiple organs. In the ovaries, the main changes included fibrosis, infiltration of inflammatory cells, destruction, and atrophy of oocytes. Testicular tissues exhibited hyperemia, necrosis, fibrosis, and degeneration. The liver showed vacuolar degeneration, biliary duct hyperplasia, infiltration of inflammatory cells, fibrosis, and necrosis. In the spleen, exudation, hemorrhage, congestion, and fibrosis were the primary pathological findings. Out of the 384 Labeobarbus fish examined, 62 tested positive for L. intestinalis, indicating an overall prevalence of 16.2% in Lake Tana. Statistical analysis revealed that fish standard length (χ² = 76.919, P = 0.001), fish weight (χ² = 50.087, P = 0.001), sampling points (χ² = 16.947, P = 0.009), and fish species (χ² = 27.73, P = 0.034) were significantly associated with L. intestinalis infection. The pathological effects of L. intestinalis on vital organs, combined with its high prevalence, suggest a significant negative impact on fish production and reproductive performance in Lake Tana. Therefore, regular monitoring and surveillance, public awareness campaigns, ecological studies, and appropriate policy interventions should be implemented to protect livelihoods and mitigate the effects of this parasite.

PMID:40442723 | DOI:10.1186/s12917-025-04799-5

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Supporting authors of Ugandan young people living with HIV during the COVID-19 pandemic: A descriptive study

J Pediatr Nurs. 2025 May 28;84:114-123. doi: 10.1016/j.pedn.2025.05.017. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic introduced significant challenges for healthcare systems, particularly affecting young people living with HIV (YPLHIV). This study examines the experiences of YPLHIV in Kampala, Uganda, during the pandemic.

METHODS: This cross-sectional study involving 154 YPLHIV aged 15-20. Participants completed surveys during their HIV health appointments. Descriptive statistics and Chi-Square tests assessed differences by sex and age (15-17 vs. 18-20 years old) regarding perceived risks, emotional impacts, and coping strategies.

RESULTS: The sample was 52 % female, with a mean age of 17.9. Almost all (90 %) of the sample acquired HIV perinatally. Medication adherence was varied, with half missing doses in the past thirty days. Older participants experienced more anxiety about COVID-19 and greater concern for loved ones compared to younger participants. Despite challenges, a majority of participants leveraged their experience of coping with HIV to manage the stresses of the COVID-19 pandemic. Participants expressed increased gratitude for family and life.

CONCLUSIONS: The study highlights age-related differences and psychosocial challenges for YPLHIV during the pandemic, emphasizing the need for targeted research and supportive interventions. Findings may guide future nursing, midwifery, and healthcare interventions to enhance strategies that clinically bolster coping factors to support YPLHIV during routine and unexpected healthcare changes. Addressing these needs requires a targeted focus that consider this population’s unique challenges.

PMID:40441122 | DOI:10.1016/j.pedn.2025.05.017

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Association of urinary arsenic concentrations with inflammation: overall and by folate intake, body mass index, and gender

Int J Hyg Environ Health. 2025 May 28;267:114585. doi: 10.1016/j.ijheh.2025.114585. Online ahead of print.

ABSTRACT

BACKGROUND: Inorganic arsenic (iA) exposure is associated with increased risk of lung, bladder, and skin cancer, as well as cardiovascular disease and diabetes. C-reactive protein (CRP), a measurement of inflammation, has been associated with these conditions. As the relationship between urinary arsenic and CRP remains unclear, we aim to determine if there is an association and to examine effect modification by dietary and lifestyle factors.

METHODS: The study includes 5761 adults, ages 25+, over four survey cycles (2005-2006, 2007-2008, 2009-2010, and 2015-2016), surveyed as part of the National Health and Nutrition Examination Survey (NHANES) and included in the laboratory subsample. Survey-weighted multivariable linear regression was used to determine the association between log-transformed arsenic concentrations (∑As, monomethylarsonate [MMA], and dimethylarsinate [DMA], and primary and secondary methylation indices [PMI, SMI]) and log-transformed CRP. Models were stratified by gender, body mass index (BMI), folic acid supplement use, and dietary folate intake.

RESULTS: Three forms of urinary arsenic were associated with statistically significant lower levels of CRP (∑As: -3.06 %, MMA: -2.34 %, DMA: -2.10 %, per 25 % increase in arsenic concentration). The association between SMI and CRP varied by gender (p-interaction: <0.01) and dietary folate intake (p-interaction: 0.04).

CONCLUSIONS: The inverse association between urinary arsenic concentrations and CRP was unexpected, highlighting a need to better characterize effects of iAs at low levels of exposure. Effect modification by dietary folate intake suggests that folate may affect the secondary methylation pathway, however, more research is needed to understand the role that folic acid plays in arsenic methylation.

PMID:40441120 | DOI:10.1016/j.ijheh.2025.114585

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Unveiling sources of organophosphate esters in marine environments utilizing multi-factor multi-modal high-dimensional clustering algorithm

Water Res. 2025 May 22;283:123886. doi: 10.1016/j.watres.2025.123886. Online ahead of print.

ABSTRACT

In marine environments, the sources of organophosphate esters (OPEs), particularly emerging OPEs (eOPEs) remain primarily unclear and present significant challenges for accurate source tracing. Here, we developed an unsupervised machine learning framework termed a multi-factorial multimodal high-dimensional clustering (MFM-clustering) algorithm to efficiently attribute source tracing of these pollutants. Our approach integrates physicochemical properties auch as log Kow and log BCF, along with geographical data, to comprehensively represent the environmental behavior of these compounds beyond traditional concentration data. The robustness of the MFM-clustering algorithm was validated, offering enhanced pollutant classification accuracy compared to conventional statistical methods by focusing on pollutant-specific features. We used a systematic framework comprising field investigations, target screening, risk assessment, and MFM-clustering-based source analysis. The methodology was applied to the Bohai Sea, China, as a case study, where 29 OPEs, including 15 eOPEs, were quantified in sediment samples. This application refined the clustering analysis and enabled detailed ecological risk assessments. Industries associated with OPEs production, sewage treatment plants, industrial discharges, surface runoff from automotive activities, atmospheric transport of volatile OPEs, and petroleum-related operations for most eOPEs have been identified as key contributors to OPE pollution in various regions of the Bohai Sea. Our results highlight the necessity of tracing upstream production processes and identifying environmentally safer alternatives as effective strategies for mitigating OPE emissions.

PMID:40441093 | DOI:10.1016/j.watres.2025.123886

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Nevin Manimala Statistics

Corrigendum to “Underlying health biases in previously-infected SARS-CoV-2 vaccination recipients: A cohort study” [J Infect 90 (2025) 106497]

J Infect. 2025 May 28;91(1):106522. doi: 10.1016/j.jinf.2025.106522. Online ahead of print.

NO ABSTRACT

PMID:40441063 | DOI:10.1016/j.jinf.2025.106522

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Nevin Manimala Statistics

Maternal physiological parameters and routine laboratory tests to screen for maternal sepsis: an observational cohort study

Int J Obstet Anesth. 2025 May 10;63:104683. doi: 10.1016/j.ijoa.2025.104683. Online ahead of print.

ABSTRACT

BACKGROUND: Maternal sepsis can lead to poor outcomes for the mother and neonate, and early diagnosis and treatment of infection is important to prevent sepsis. Current guidance to recognise maternal sepsis includes assessment of physiological markers, however normal physiological changes of pregnancy can hinder the diagnosis of sepsis. This study investigated the utility of routine clinical variables, including laboratory tests, in screening for maternal sepsis.

METHODS: Patients considered at risk of obstetric sepsis were recruited into a single centre cohort study. Microbiological, histological and clinical data categorised patients into three diagnostic groups: ‘infection confirmed’, ‘infection unknown’ and ‘infection unlikely’. Differences in physiological and routine laboratory variables were investigated.

RESULTS: Between November 2020 and December 2022, 154 pregnant patients were recruited. Comparison between ‘infection confirmed’ (n=58) and ‘infection unlikely’ (n=17) showed statistical differences in temperature (P <0.001), neutrophil count (P =0.003) and leukocyte count (P =0.004) at the time of recruitment. Temperature was the best discriminator with an area under the receiver operating characteristic curve (AUC-ROC) of 0.82 (95% CI 0.70 to 0.94, P <0.0001) with an optimal threshold of ≥37.5°C.

CONCLUSION: This observational cohort study demonstrated that maternal temperature ≥37.5°C (rather than the threshold of 38°C found in most screening tools) may be important in screening patients at risk of developing maternal sepsis. When temperature ≥37.5°C persists, medical care should be expedited and maternal infection considered.

PMID:40441038 | DOI:10.1016/j.ijoa.2025.104683

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Socioeconomic gradients and inequalities in all-cause mortality and cardiovascular diseases: A retrospective cohort study using Korean NHANES-mortality linkage data

Public Health. 2025 May 28;244:105767. doi: 10.1016/j.puhe.2025.105767. Online ahead of print.

ABSTRACT

OBJECTIVES: Rapid economic growth in South Korea provides a valuable context for investigating how socioeconomic status (SES) impacts mortality and cardiovascular disease (CVD) risk in an emerging high-income Asian country. The objective of this study was to examine these associations in a general population and a subgroup with type 2 diabetes mellitus (T2DM).

STUDY DESIGN: Retrospective cohort study.

METHODS: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) linked to mortality records was used. A total of 48,190 participants including 6,382 patients with T2DM from the 2011-2020 KNHANES cohort were included and followed until death, a cardiovascular event (myocardial infarction or ischemic stroke), or the study endpoint.

RESULTS: Participants in the lowest income quintile had higher risks of mortality (Hazard ratio [HR]: 1.44, 95 % CI: 1.19-1.76) and CVD (HR: 1.35, 95 % CI: 1.05-1.74) compared to the highest quintile. Unemployed individuals had a higher mortality risk (HR: 1.34, 95 % CI: 1.19-1.51) than employed ones. Non-homeowners also had a higher mortality risk (HR: 1.46, 95 % CI: 1.20-1.77) than multi-homeowners. Participants with elementary school education or less had higher risks of mortality (HR: 1.59, 95 % CI: 1.32-1.93) and CVD (HR: 1.71, 95 % CI: 1.31-2.24) compared to college graduates. Among those with T2DM, unemployment (HR: 1.43, 95 % CI: 1.16-1.77) and low education (HR: 1.53, 95 % CI: 1.07-2.17) were associated with higher mortality.

CONCLUSIONS: This analysis revealed significant associations of low SES with increased risks of mortality and CVD. Similar associations were observed in T2DM population for mortality outcomes.

PMID:40441035 | DOI:10.1016/j.puhe.2025.105767

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Accuracy of ultrasound performed by medical residents in operating rooms in identifying parathyroid glands in patients with hyperparathyroidism

Braz J Otorhinolaryngol. 2025 May 28;91 Suppl 1:101607. doi: 10.1016/j.bjorl.2025.101607. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe the findings of US examinations performed by Head and Neck Surgery (HNS) resident physicians in patients in the preoperative period immediately before parathyroidectomy, and to compare these results with those of examinations performed preoperatively (ultrasonography and/ or scintigraphy) and with the findings of surgical procedures.

METHODS: Patients in the preoperative period of parathyroidectomy underwent US examinations performed by HNS resident physicians after induction of anesthesia. The findings were registered and later compared with those of preoperative and intraoperative examinations using descriptive statistical analysis and calculation of sensitivity, specificity, and accuracy.

RESULTS: At least one gland was identified in 81% of the patients, most commonly the left inferior parathyroid. There was 63% agreement between the examinations performed in the operating room and the preoperative examinations. Sensitivity of 76%, specificity of 100%, and accuracy of 81.25% were evidenced in identifying parathyroids > 5 mm in patients with hyperparathyroidism associated with Chronic Kidney Disease (CKD), and sensitivity of 33% was found in patients with primary hyperparathyroidism.

CONCLUSION: US examinations performed by HNS resident physicians in patients preoperatively to parathyroidectomy are accurate (81.25%) in identifying parathyroids compared with intraoperative findings in patients with hyperparathyroidism associated with CKD.

LEVEL OF EVIDENCE: Level III.

PMID:40441023 | DOI:10.1016/j.bjorl.2025.101607