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To evaluate whether simulation-based I-PASS handoff training improves ICU nurses' knowledge, perceptions of handoff communication and safety attitudes.
Effective handoff communication is crucial for ensuring patient safety and reducing errors. However, simulation-based training (SBT) with structured protocols, such as I-PASS, is rarely used in Egyptian nursing education, highlighting a gap.
A quasi-experimental design was employed.
A convenience sample of 57 ICU nurses was studied from June to December 2023. Data were collected using the I-PASS Handoff Knowledge Questionnaire, Perception of Handoff Communication Tool and Patient Safety Questionnaire. Nurses completed baseline assessments, participated in two simulation-based I-PASS scenarios and repeated assessments post-intervention. Statistical analyses examined the training's impact and its relationships with participants' socio-demographic characteristics.
Significant improvements were observed in I-PASS knowledge, perceptions of handoff communication and safety attitudes (all p < 0.001). Nursing qualifications and place of residence have shown a significant correlation with perceptions of handoff communication and safety attitudes (p < 0.05).
Simulation-based I-PASS handoff training significantly enhances ICU nurses' knowledge, perceptions of handoff communication and safety attitudes. Targeted, context-sensitive educational interventions are necessary to strengthen handoff practices and improve patient safety within the Egyptian healthcare system.
Structured simulation-based training, such as I-PASS, can be effectively integrated into nursing education to standardise handoff communication and improve patient safety outcomes in intensive care settings.
No patient or public contribution.
by Md. Naziur Rahman, Abu Yousuf Hossin, Shahriar Mannan Imon Talukder, Mt. Sumaiya Siddika, Md. Harun-Ur-Rashid, Shahanaz Parveen, Md. Ridwanul Islam, Md. Yeamin Hossain, Mahfuj Ahmed, Brototi Chakraborty Dyuti, Zarin Tabassum, Ajoy Kumer
Non-small-cell lung cancer (NSCLC) remains the leading cause of lung cancer–related mortality, largely driven by aberrant activation of the epidermal growth factor receptor (EGFR). Despite the clinical success of EGFR tyrosine kinase inhibitors (TKIs), intrinsic and acquired resistance, coupled with safety concerns, highlight the need for novel, safer inhibitors. Natural products represent an underexplored source of structurally diverse bioactive compounds with favorable biocompatibility. In this study, a comprehensive in silico approach is used to evaluate phytochemicals from Adenium obesum as potential candidate EGFR-targeting compound. Initially, sixteen phytochemicals were first assessed for predicted antineoplastic activity using PASS. High-scoring molecules were docked against the EGFR kinase domain (PDB ID: 1M17), besides performed detailed protein–ligand interaction analysis, drug-likeness and ADMET profiling, toxicity prediction and 100-ns molecular dynamics (MD) simulations. PASS-based bioactivity prediction revealed strong anticancer potential among the sixteen screened compounds, with consistently high antineoplastic and antiproliferative activity probabilities (Pa > 0.79) and low inactivity scores, supporting their selection for subsequent docking, ADMET, and molecular dynamics analyses. Next, several phytochemicals exhibited strong docking affinities, with Cardenolide achieving the highest binding score (–9.9 kcal/mol) and forming stable interactions with key catalytic residues. A 100-ns MD simulation confirmed the structural stability, persistent binding, and dynamic integrity of the EGFR–Cardenolide complex under physiological conditions. Importantly, interaction mapping revealed that Cardenolide engages conserved and functionally critical regions of the EGFR kinase domain associated with catalytic activity and structural stability, supporting its mechanistic relevance as an ATP-competitive scaffold. Additionally, predicted pharmacokinetic and toxicity profiles further supported Cardenolide’s suitability as a drug-like candidate. Collectively, these results identify Cardenolide as a computationally prioritized candidate with favorable predicted EGFR-binding characteristics, structural stability, and physicochemical and toxicity profiles. However, as the present study is based entirely on computational analyses, these findings should be considered hypothesis-generating and do not establish EGFR inhibitory activity or therapeutic efficacy. Experimental validation, including biochemical kinase inhibition and cellular assays, is therefore required to determine the actual EGFR inhibitory potential and anticancer activity of Cardenolide. Nevertheless, the findings provide a rational basis for prioritizing Cardenolide for further experimental investigation and illustrate the potential of Adenium obesum phytochemicals as a source of candidate EGFR-targeting compounds for future NSCLC drug discovery.by Md Ahosanul Haque Shahid, Ajran Kabir, Shanta Das, Md. Tanvir Rahman, K. H. M. Nazmul Hussain Nazir
Fowl cholera (FC), caused by Pasteurella multocida type A, represents a major threat to poultry production worldwide. Detailed characterization of the genotypic, phenotypic, and antimicrobial resistance profiles is essential for advancing epidemiological surveillance and guiding effective intervention strategies. A total of 80 suspected FC field samples were collected from which P. multocida was isolated and identified through conventional culture techniques, Gram staining, and PCR. Antimicrobial susceptibility testing was performed using the disc diffusion method with 16 antimicrobial drugs. Whole-genome sequencing of a representative isolate was conducted using the Illumina MiSeq platform, and genomic analysis was carried out with multiple bioinformatics tools. P. multocida type A was confirmed in 12 isolates (15%). RAST annotation revealed a genome size of 2,346,689 bp with 2,205 predicted coding sequences, 59 RNA genes, and a GC content of 40.2%. Phenotypic analyses showed resistance to cefixime, ceftriaxone, ertapenem, and meropenem, while the highest sensitivity was observed for ciprofloxacin, doxycycline, tetracycline, and levofloxacin. PathogenFinder predicted the isolate as a potential human pathogen with a probability score of 0.891. Virulence-associated genes identified included wecA, galU, manB, rfaD, rfaE, rfaF, lpxB, lpxC, and msbA, supporting the pathogenic potential of the isolates and suggesting a possible role in host immune evasion. Phylogenetic analysis using MEGA X with the maximum likelihood method revealed that the isolate was clustered within the monophyletic clade and that it showed closest genetic relatedness to strains from Australia, China, and Malaysia. These findings highlight the genomic basis of virulence and antimicrobial resistance in P. multocida type A from Bangladeshi layer for the first time. The isolate characterized in this study provides valuable genomic insights and the selection of targeted antimicrobials to improve fowl cholera control strategies.by Abdul Mannan, Jamshaid Ul Rahman, Ebraheem Alzahrani, Osman Abubakar Fiidow
The hepatitis C virus is a significant global health concern and a major cause of chronic liver disease. Therefore, developing a mathematical model is essential for understanding, controlling and managing its transmission dynamics. In this paper, we developed a mathematical model and simulated the dynamics of transmission of the hepatitis C virus, considering alcohol use, a key factor contributing to increased damage to the liver of infected individuals. Computational investigation of nonlinear biological models by traditional numerical solvers is challenging due to their nonlinearity and inherent complexity. Furthermore, we proposed a deep learning-based technique to solve the nonlinear differential equations governing the model for transmission of the hepatitis C virus in six compartments. The proposed deep learning-based model is compared with other established methods like the Runge-Kutta method and Livermore solver for ordinary differential equations algorithm to validate its efficacy and accuracy in predicting hepatitis C dynamics. The basic reproduction number, R0, is calculated and stability is analyzed at both the disease-free and endemic equilibrium points. Sensitivity analysis is performed to determine key parameters that contribute to hepatitis C transmission. The results indicate that the proposed approach is an efficient and robust solution with better convergence and stability than existing methods. This study highlights the potential of deep learning methods in epidemiology as a promising tool for predicting and controlling infectious diseases such as hepatitis C, particularly in the presence of behavioral risk factors such as alcohol consumption.Moral injuries (MIs) may result from individuals being exposed to potentially morally injurious events (PMIEs). PMIEs have been a feature of work within much of the National Health Service (NHS) for many years, and the understanding of MI is now more commonplace, having been highlighted during the COVID-19 pandemic; however, understanding of how such events affect workers over the long term is lacking.
To understand the development of healthcare workers’ (HCWs) experiences of PMIEs over a period of 3 years.
We carried out follow-up semistructured qualitative interviews with 15 NHS staff who were previously interviewed on the same topic in 2021. All interviews were recorded, transcribed and analysed using reflexive thematic analysis following an inductive approach.
Three main themes and six subthemes were identified: (1) internal context and subjective experiences, (1.i) control in a rigid system, (1.ii) psychosocial dynamics, (2) external context and the moral cost of culture, (2.i) organisational culture, (2.ii) sources of MI, (3) responses to PMIEs, (3.i) maladaptive responses, (3.ii) adaptive responses. Key issues identified included perceptions of insufficient control over their work and work environment, low psychological safety and perceived misunderstanding of the value of their work from patients and colleagues, leading to a challenging organisational culture. We found that in the 3 years between the interviews many staff reported developing ‘secondary’ feelings of betrayal as a result of perceived ongoing governmental neglect of recognition for HCWs’ sacrifices during the pandemic and a lack of acknowledgement of governmental mistakes made in the acute period.
Findings show an interplay between individual and organisational factors that HCWs faced while working in the NHS, underlining the need for wide-ranging intervention strategies. Since the HCWs’ original interviews in 2021, a secondary betrayal has developed, emphasising the need for interventions that can restore trust in the system.
The low uptake of cervical cancer screening (CCS) in rural areas is mainly related to the lack of awareness regarding cervical cancer. Using educational interventions has been shown to substantially improve knowledge and attitude towards cervical cancer, which are important determinants of undergoing CCS. The aim of this study was to analyse the impact of different educational intervention methods on knowledge, attitudes and willingness to undergo CCS among women in rural Indonesia.
A quasi-experimental study with a non-equivalent control group design.
The study was conducted in North Tobelo, a rural district in North Halmahera Regency.
Sample size was calculated using Power and Sample Size Calculations software (V.3.1.2). 150 women were recruited via convenience sampling from 12 Integrated Health Service Posts, cluster-randomised into three arms: control (n=50), flipchart (n=50) and video (n=50). A per-protocol approach was applied; all participants completed pre-intervention and post-intervention assessments within a single visit with no loss to follow-up. Continuous outcomes were analysed using the Kruskal-Wallis and Wilcoxon tests; categorical outcomes using ² or Fisher’s exact tests with Bonferroni correction. Non-parametric analysis of covariance (Quade’s method) controlled for baseline scores, age at first sexual intercourse and household income, with partial eta-squared reported as the effect size.
All study arms received identical educational content presented in simple Indonesian language and avoiding the use of medical terminology. The educational content included cervical cancer epidemiology, aetiology, risk factors, clinical symptoms, prevention methods, various CCS methods, visual inspection with acetic acid screening procedures, benefits and side effects of getting human papillomavirus vaccination and CCS, as well as a brief explanation regarding cervical cancer treatment. Knowledge, attitude and willingness were assessed using a structured pre-intervention and post-intervention questionnaire comprising both dichotomous items and Likert-scale questions.
Although knowledge improved significantly in all intervention groups (p
In conclusion, the video-based educational intervention demonstrated the greatest improvements in knowledge, attitude, and willngness to undergo CCS compared to other methods.
Guillain-Barré syndrome (GBS) is an autoimmune polyneuropathy manifested by progressive limb weakness. Anxiety and depression are significant yet under-recognised complications of GBS, particularly in low- and middle-income countries (LMICs). This study examined the proportion and progression of anxiety and depression in Bangladeshi GBS patients and their associations with clinical features, outcomes and quality of life (QoL).
A prospective cohort study.
National Institute of Neurosciences and Hospital, Dhaka, Bangladesh.
A total of 148 GBS patients aged ≥18 years diagnosed by National Institute of Neurological Disorders and Stroke criteria for GBS, were recruited within 2 weeks of symptom onset.
Anxiety and depression were evaluated as the primary outcome using the Hospital Anxiety and Depression Scale (HADS) at week 13 and week 26 post-GBS. Secondary outcomes included Medical Research Council sum score, GBS Disability Score, fatigue severity, pain intensity and EuroQol 5-Dimension 5-Level. Statistical analyses involved descriptive summaries, group comparisons, correlation tests and longitudinal assessments by analysis of variance.
A total of 111 patients with complete HADS data were analysed (median age 36 years; 71% male). At week 13, 45% had anxiety reducing to 36% at week 26. Depression was 53% at week 13 and 41% at week 26. Baseline bulbar involvement was significantly associated with week 13 depression and week 26 anxiety. Between week 13 and week 26, 27%–30% of patients had persistent symptoms and 13%–16% experienced worsening. Anxiety and depression mostly followed concordant patterns, though 28 patients showed discordant patterns. Elevated mood symptoms were associated with greater fatigue, pain and reduced QoL.
Anxiety and depression are common and persistent in GBS adversely affecting recovery and QoL. Mental health monitoring and targeted support should be integrated into GBS management, especially in LMIC settings.
by Heba Mohammed Arafat, Akbar Ali, Tengku Ahmad Damitri Al Astani Tengku Din, Ohood Mohammed Shamallakh, Rashid Jusoh, Maya Mazuwin Yahya, Wan Zainira Wan Zain, Wan Faiziah Wan Abdul Rahman
BackgroundBreast cancer outcomes improve substantially with earlier detection, yet mammography performance can be limited in dense breasts and may lead to false-positive investigations. Circulating microRNAs (miRNAs) and lipidomic/metabolomic signatures have emerged as promising minimally invasive biomarkers that could complement imaging for early-stage detection. The aim of this systematic review and meta-analysis is to evaluate the diagnostic accuracy of circulating microRNAs and lipidomic/metabolomic biomarkers for early breast cancer detection and to explore between-study heterogeneity.
Materials and methodsA PRISMA 2020–compliant systematic review and meta-analysis were conducted. MEDLINE (PubMed), Web of Science, Scopus, Springer, ScienceDirect, and the Cochrane Library were searched for eligible diagnostic studies assessing circulating microRNAs and lipidomic/metabolomic biomarkers measured in serum or plasma. No language restrictions were applied. Non-English reports were screened and, when potentially eligible, translated for full-text assessment and data extraction. Studies using whole blood were excluded. Study quality was assessed using QUADAS-2. Random-effects models (DerSimonian–Laird) pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR), and summary ROC (SROC) area under the curve (AUC). Heterogeneity was evaluated using Q and I2 statistics, and small-study effects were assessed using Deeks’ test.
ResultsThirty-two studies (2015–2025) comprising 6,935 participants (3,697 breast cancer cases; 3,238 controls) were included. Pooled sensitivity was 0.87 (95% CI [0.83, 0.90]) and pooled specificity was 0.84 (95% CI [0.79, 0.88]), with pooled DOR 46.10 (95% CI [27.80, 76.70]), PLR 5.17 (95% CI [3.99, 6.68]), NLR 0.16 (95% CI [0.13, 0.21]), and SROC AUC 0.92 (95% CI [0.87, 0.94]). Heterogeneity was substantial (I2 = 88.29% for sensitivity; I2 = 90.20% for specificity). In subgroup analyses, serum-based studies showed higher pooled specificity than plasma-based studies. A formal threshold effect assessment did not reveal a statistically significant correlation between sensitivity and false-positive rate (Spearman ρ = −0.334, p = 0.062). Deeks’ test suggested potential small-study effects (p = 0.043).
ConclusionsCirculating microRNA and lipidomic/metabolomic biomarkers demonstrate strong overall diagnostic performance for breast cancer detection; however, substantial heterogeneity and potential small-study effects limit their immediate clinical translation. Given that most included studies used retrospective case-control designs rather than prospective screening cohorts, these biomarkers are best regarded as investigational, complementary tools rather than replacements for mammography at this stage. Future large, prospective, standardized studies with harmonized pre-analytics and prespecified thresholds are needed to support the implementation of screening or triage pathways.
To preserve the validity and reliability of health instruments like patient-reported outcome measures across linguistic and cultural contexts, translation, cross-cultural adaptation and psychometric validation must be conducted using standardised, rigorous methodologies. Although international standards proposed by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) are available, adherence to these guidelines in Bangla-language instrument studies has not been systematically evaluated. This systematic review aims to identify, synthesise and critically appraise Bangla-language translation, cross-cultural adaptation and psychometric validation studies of health instruments for adherence to recommended methodological approaches, translation and cross-cultural adaptation guidelines and psychometric properties.
In this study, we will search three databases, including Ovid MEDLINE, PubMed and EMBASE via Ovid, from 1 February 2026 to 1 March 2026 to retrieve published articles on translation, adaptation and psychometric validation of health-related instruments into Bangla. Two reviewers will independently conduct title and abstract screening, full-text eligibility assessment, data extraction, evaluation of translation and cross-cultural adaptation quality and assessment of psychometric properties. The certainty of evidence will be graded. Disagreements will be resolved by consensus, with the consultation of a third reviewer when necessary. Methodological quality and psychometric properties will be assessed based on the COSMIN Risk of Bias (RoB) checklist and COSMIN standards. Evaluation of translation and cross-cultural adaptation will be based on the extended ISPOR guideline. COSMIN-Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to rate the certainty of evidence.
This study is a systematic review protocol, exclusively on published literature and publicly available data, and does not involve direct interaction with human participants or the collection of individual participant-level data. Therefore, ethical approval is not applicable. We expect to share our findings through national and/or international platforms. Moreover, the results will be published in a peer-reviewed journal. We anticipate that the result of this study will contribute to recommending a standardised roadmap for researchers, especially for conducting translation, validation and cross-cultural adaptation studies of health-related instruments in Bangla.
CRD420251250949.
by Osama Abdelrahman, Chew XinYing, Esraa Faisal Malik, Khaw Khai Wah, Cheong Zhi Lin, Teoh Wei Lin
Mental workload classification is critical in safety-sensitive fields such as healthcare and aviation. However, electroencephalography-based approaches still face challenges with generalizability, noise robustness, and interpretability. In this study, we propose an integrated hybrid deep learning framework to address these limitations and enable robust, interpretable electroencephalography-based mental workload classification. The proposed approach uses a Variational Autoencoder to enhance noise reduction and feature extraction from band-wise topographical videos, a Convolutional Block Attention Module to adaptively focus on important spatial-channel Electroencephalogram features, and a Bidirectional Long Short-Term Memory network to capture complex temporal dependencies under leave-one-subject-out cross-validation. We conducted ablation studies to identify each architecture component’s contribution and sensitivity analyses to determine the optimal parameters. The model achieved the highest overall accuracy among the baselines and reached an average accuracy of 83.9% across subjects for classifying four mental workload levels. Ablation studies confirmed the added value of all three architecture components for improving performance. Sensitivity analyses identified optimal parameters, including a 10-second window length that balances temporal context and specificity. For better interpretability and neurophysiological insight, we used Gradient-weighted Class Activation Mapping to visualize key frontal-parietal brain regions and frequency bands associated with workload dynamics. Future research could explore adaptive windowing strategies, multimodal data integration, cross-dataset benchmarking, and evaluation against transformer-based and graph neural network architectures under consistent subject-independent evaluation settings to further enhance model generalizability.Commentary on: Milanović-Dobrota B, Jelić S, Buha N, et al. Employer perspectives on hiring individuals with intellectual disabilities: a case study from Serbia. J Appl Res Intellect Disabil 2025;38(2):e70045.
Implications for practice and research Facilitate structured, positive contact between employers and individuals with intellectual disabilities through internships and workplace inclusion programmes. Investigate the effectiveness of targeted employer education and contact-based interventions on hiring behaviours across different sectors.
People with intellectual disabilities (ID)—defined as having significant limitations in intellectual functioning and adaptive behaviour originating before age 18
Gastrointestinal cancer surgery commonly leads to postoperative complications and other adverse outcomes. While prehabilitation shows promise in reducing adverse postoperative outcomes, most hospitals have resource limitations that preclude its use as standard of care. Additionally, the need to expedite surgery from diagnosis often creates a narrow window for prehabilitation initiatives. Online, self-reported screening tools may address these challenges by facilitating early identification of high-risk patients and enabling targeted preoperative interventions, thereby allowing equitable allocation of limited resources. Therefore, the primary aim of this study is to evaluate the predictive utility of a tri-modal (physical, nutritional, psychological) screening tool for patients undergoing gastrointestinal cancer surgery.
This prospective international cohort study will recruit 1214 adults undergoing elective gastrointestinal cancer surgery across 35 sites from 19 countries. Participants will complete an online screening tool developed through a comprehensive, multistep, predefined process. The screening tool comprises the Duke Activity Status Index, Patient-Generated Subjective Global Assessment Short Form and the Patient Health Questionnaire-4, in English, Spanish, French or Portuguese. These tools were selected based on a scoping review, followed by an international Delphi consensus process. The primary outcomes include rate of postoperative complications, major complications (Clavien-Dindo Classification grade III–V) and overall complication severity assessed by the Comprehensive Complications Index; all assessed 30 days postoperatively. Secondary outcomes include hospital length of stay, readmission rate within 30 days, discharge destination (home vs other), days at home and alive in 30 days postsurgery, 30-day all-cause mortality and 12-month survival. Primary analyses will establish optimal screening tool cut-points to stratify patients into clinically actionable risk categories for postoperative complications and examine the independent predictive value of these screening scores after adjusting for established clinical risk factors.
This study has received ethical approval from the Sydney Local Health District Human Research and Ethics Committee (X25-0333 and 2025/ETH02465) and has been registered on the Open Science Framework (10.17605/OSF.IO/HVCGD). The results of Preoperative Risk Evaluation for Cancer Treatment will be submitted to reputable journals and presented at national and international conferences.
Effective management of type 2 diabetes mellitus (T2DM) in older adults requires interventions that address both metabolic control and functional capacity. Exercise improves insulin sensitivity, glucose uptake and cardiometabolic health, while high-protein diets support muscle mass preservation, satiety and glycaemic regulation. Evidence suggests that integrating structured exercise with a high-protein diet may provide additive benefits; however, research evaluating this combined approach in older adults with T2DM, particularly in low-resource settings, is limited. This study aims to determine whether a 12-week multimodal exercise programme combined with a high-protein diet improves glycaemic control and broader health outcomes compared with exercise alone.
In this randomised controlled trial (RCT), 140 adults aged ≥60 years with T2DM will be allocated 1:1 to an experimental group (multimodal exercise with high-protein diet, n=70) or a control group (multimodal exercise alone, n=70). All participants will engage in three supervised exercise sessions per week for 12 weeks. Additionally, the experimental group will follow a high-protein diet that provides approximately 30% of total energy from protein, with a 500-kcal daily energy deficit. The primary outcome is glycaemic control, measured by Glycated haemoglobin (HbA1c). Secondary outcomes include anthropometric measures, fasting blood glucose, lipid profile, functional capacity (6-minute walk test) and health-related quality of life Short Form-36 Health Survey (SF-36). All outcomes will be assessed at baseline, postintervention (week 12) and follow-up (week 24). Participants, outcome assessors and statisticians will remain blinded. Intervention fidelity, adherence and safety will be systematically monitored, and final results will be analysed using SPSS (v.26.0). The study will follow ethical standards and comply with Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) and Consolidated Standards of Reporting Trials (CONSORT) guidelines.
The protocol has been approved by the Institutional Review Board of the Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (Approval No.: PTR-JUST/IRB/2025/09/192404) and registered with the Clinical Trials Registry of India. Findings will be disseminated via peer-reviewed journals, conference presentations and structured knowledge-sharing sessions to inform clinical practice in diabetes management.
Trial registration number: CTRI/2025/08/092509
To examine how household members, community health research workers (CHRWs) and broader social networks influenced pregnant women’s capabilities, opportunities and motivations to consume a daily balanced-energy protein (BEP) supplement or a multiple micronutrient supplement (MMS) in the context of an effectiveness trial in rural Bangladesh.
In-depth interviews, group interviews, focus group discussions, thematic analysis using the Capability, Opportunity, Motivation-Behaviour (COM-B) framework.
Gaibandha, Bangladesh.
Women (n=32) who had completed participation in the TARGET-BEP randomised trial, their husbands (n=13) and mothers-in-law (n=13), who participated in 13 group interviews, and CHRWs (n=39) who participated in six focus group discussions.
Capability to adhere to BEP and MMS was strengthened when family members understood the value of supplements and actively supported supplementation. Children emerged as unexpected facilitators, reminding mothers to consume supplements and tracking intake. Opportunity to use supplements consistently was enhanced by women’s educational attainment and the availability of household resources. Finally, motivation to take the supplements was influenced by many actors including neighbours, who could offer support but also often transmitted rumours and taboos, and CHRWs, who adeptly adapted adherence messages to the local context and to women’s specific concerns.
To improve antenatal supplement adherence and maternal–infant health in Bangladesh and similar contexts, pregnancy nutrition programmes should move beyond the woman-as-sole-agent paradigm by: (1) co-designing messages for husbands, mothers-in-law, children and neighbours in conversation with effective community health workers, such as those working in the TARGET-BEP trial; (2) equipping community health workers with flexible, family-engaging counselling strategies; and (3) complementing women’s education gains with gender-transformative and family-inclusive interventions.
ClinicalTrials.gov NCT05576207
Adhesive capsulitis (frozen shoulder) is a common condition characterised by pain, stiffness and reduced function. While conventional physiotherapy (typically comprising joint mobilisation, stretching, strengthening and electrotherapy) is widely used, there is limited evidence for the effectiveness of advanced neuromuscular techniques such as the reciprocal inhibition technique (RIT). This study aims to evaluate the impact of incorporating RIT into standard physiotherapy compared with standard physiotherapy alone in individuals with adhesive capsulitis.
This is a double-blind, randomised controlled trial. 30 adults aged 30–70 years with clinically confirmed adhesive capsulitis will be recruited from a tertiary rehabilitation centre in Dhaka, Bangladesh. Participants will be randomly allocated to receive either RIT combined with conventional physiotherapy or conventional physiotherapy alone, with both groups undergoing 12 treatment sessions over 4 weeks. The primary outcome is pain intensity at 4 weeks post-randomisation, measured by the Numeric Pain Rating Scale. Secondary outcomes include shoulder range of motion (abduction, internal and external rotation, assessed with a universal goniometer), functional ability (Shoulder Pain and Disability Index) and muscle strength (abduction, internal and external rotation, measured by hand-held dynamometry). Blinded assessors will conduct evaluations at baseline and after the intervention. Data will be analysed using intention-to-treat principles. Between-group comparisons will be made using linear mixed models with fixed effects for group, time and group-by-time interaction, and a random intercept for participants to account for repeated measurements. Within-group changes will be estimated from the models.
This trial has received ethical clearance from the Institutional Review Board of the Institute of Physiotherapy, Rehabilitation & Research (approval number BPA-IPRR/IRB/18/02/2025/32). Results will be disseminated through peer-reviewed publications and international conferences in accordance with Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. By addressing a significant evidence gap, this study may establish RIT as an effective and affordable adjunct to standard physiotherapy for managing adhesive capsulitis.
CTRI/2025/06/089288 [Registered on: 23/06/2025]
by Omar Muhumed Maidhane, Omran Salih, Abdisalam Hassan Muse, Abdirahman Omer Osman, Muse H. Abdi, Mahdi Hashi Hassan, Nur Mohamud Ali, Shacban Abdilahi Elmi
BackgroundAccess to adequate sanitation remains a critical public health challenge in Somalia, where a large portion of the population relies on unimproved facilities due to persistent conflict, climate shocks, and political instability. This reliance contributes to a high burden of waterborne diseases. This study aimed to assess the spatial distribution of unimproved sanitation and identify its individual and community-level determinants using recent national data to inform targeted interventions.
MethodsThis study is a secondary analysis of the 2022 Somalia Integrated Household Budget Survey (SIHBS), which included 7,212 households. The primary outcome was the use of unimproved sanitation facilities, categorized according to the WHO/UNICEF Joint Monitoring Programme (JMP) definitions. We employed a multilevel logistic regression model to identify individual and community-level determinants associated with unimproved sanitation. To analyze the spatial patterns of unimproved sanitation, we used Global Moran’s I for spatial autocorrelation and the Getis-Ord Gi* statistic for hotspot analysis.
ResultsOverall, 36.87% of Somali households use unimproved sanitation facilities. There are significant disparities across residence types, with the highest prevalence among nomadic populations (83.28%), followed by rural (51.10%) and urban (23.88%) residents. The multilevel analysis revealed that households in permanent/formal housing (AOR: 3.42) and those with IDP status (AOR: 3.18) had significantly higher odds of using unimproved sanitation. At the community level, urban residence was paradoxically associated with higher odds of unimproved sanitation (AOR: 7.99) compared to rural areas, while nomadic populations had significantly lower odds (AOR: 0.04), likely reflecting a high prevalence of open defecation not captured as a “facility.” Spatial analysis identified significant hotspots of unimproved sanitation in the Hiraan (90.65%) and Bay (80.39%) regions, and cold spots in Banadir (5.37%) and Lower Shabelle (3.70%).
ConclusionThe findings highlight deep inequalities in sanitation access across Somalia, driven by geographic location, socioeconomic status, and population group. The high prevalence of unimproved sanitation, especially among nomadic, rural, and displaced populations, calls for urgent, geographically-targeted interventions. A multi-pronged approach is necessary, focusing on the specific needs of different communities and addressing the underlying structural and individual-level drivers of poor sanitation to advance public health and sustainable development goals in the region.
by Quazi Maksudur Rahman, Md. Tajuddin Sikder
BackgroundMale partners’ adequate understanding and engagement in maternity care plays a crucial role in enhancing women’s reproductive health. However, male involvement in maternal and child health care is still significantly below expectations, even though they perform key roles. Low knowledge levels appear to be a significant barrier to effective involvement.
ObjectiveTo examine the urban married men’s understanding and involvement in maternity care, as well as the factors associated with it.
MethodsIn this quantitative study, 422 data were collected through a structured questionnaire via face-to-face interviews between July and September 2022 among urban married males living in Dhaka City. The socio-demographic characteristics, level of understanding, males’ attitude and involvement status regarding maternity care were measured. The descriptive statistics along with logistic regression analysis were performed using STATA version 14.1.
ResultsA total of 422 urban married male were considered for this study, and the mean age of the study participants was 37.21 (SD ± 8.79). About 55.92% of the male participants had good understanding and 54% had positive attitude towards maternity care. Around 47% had good involvement in maternity care. Male who had good involvement in maternity care were more likely to have good understanding (AOR: 1.73; CI: 1.13 to 2.64; p = 0.01). In addition, urban male who had government jobs (AOR: 6.48; CI: 1.54 to 27.22; p = 0.01), positive attitude (AOR: 1.79; CI: 1.16 to 2.76; p = 0.01) and good understanding (AOR: 1.74; CI: 1.14 to 2.66; p = 0.01) were more likely to get involved in maternity care.
ConclusionMaternity care was well-understood and positively viewed by the most urban married males, but their level of involvement was far below the expected level. However, to strengthen safe motherhood initiatives in Bangladesh, it is important to properly address the understanding and participation of urban males in maternity care and other related factors.
by Md. Masud Reza, Hasibul Hasan Shanto, Samira Dishti Irfan, A. K. M. Masud Rana, Mohammad Niaz Morshed Khan, Golam Sarwar, Mohammad Sha Al Imran, Mahbubur Rahman, Md. Safiullah Sarker, Muntasir Alam, Md. Abu Hena Chowdhury, Mustafizur Rahman, Sharful Islam Khan
BackgroundUnintended pregnancy among female sex workers (FSW) is a pressing reproductive health concern attributable to risky sexual behaviors, healthcare inequities and poor negotiation powers with male sex partners. However, evidence is scarce on the prevalence and determinants of unintended pregnancies among FSW, which is crucial for enhancing reproductive healthcare. This analysis aims to measure the prevalence of lifetime unintended pregnancies and their associated factors.
MethodsA cross-sectional study was conducted on 327 FSW in Jashore (a border belt district of Bangladesh) from September 2022 to March 2023. Participants were recruited through take-all sampling. Data were collected on the lifetime history of unintended pregnancies and other relevant variables through face-to-face interviews. Chi-square statistic was used to compare the characteristics of FSW reporting unintended pregnancies. To assess the net association of factors associated with unintended pregnancy, multiple logistic regression was applied.
ResultThe lifetime prevalence of unintended pregnancies was reported at 75.8% (95%CI: 71.0–80.1). Among those who reported unintended pregnancies, 37.1% (95%CI: 30.8–43.8) had no education, 39.9% (95%CI: 32.8–47.5) were 25–34 years old, 49.6% (95%CI: 39.3–59.9) were currently married and 62.9% (95%CI: 49.7–74.4) earned ≤10,000 BDT per month compared to those who did not report lifetime unintended pregnancies. The likelihood of unintended pregnancies was significantly higher among those who reported having sex with non-transactional male sex partners (AOR: 2.4, 95%CI: 1.1–5.3, p = 0.036) than those who never had sex with any non-transactional male sex partner. The likelihood was also higher among those who reported rape in their lifetime (AOR: 2.0, 95%CI: 1.0–3.8, p = 0.037) and who self-reported mental health problems (AOR: 2.1, 95%CI: 1.0–4.2, p = 0.045) within the past year, compared to their counterparts.
ConclusionThis study highlights the considerable prevalence and associated determinants of unintended pregnancies among FSW in Jashore. These determinants need to be considered to strengthen reproductive healthcare interventions and policies for FSW. Reproductive health of FSW cannot be improved unless these factors are addressed in the ongoing interventions.
by Sangram Biswas, Lutfor Rahman, Md. Taofiqur Rahman, Susmita Chowdhury, Fahmida Khatun, Azimun Nahar, Sabina Yasmin
Probiotics are live, non-pathogenic microorganisms that help to improve the host’s gut health when administrated in sufficient proportions and are now serving as effective alternatives to antibiotics for managing animal infections and enhancing production. The objective of this study was to isolate, identify and characterize lactic acid bacteria (LAB) strains with excellent probiotic properties from the gastrointestinal tract (GIT) of retail broiler chickens. Samples were enriched in MRS broth at 37°C and plated on MRS agar to isolate distinct colonies of potential probiotic candidates. The isolates underwent a series of standard morphological and biochemical analysis to fulfill the criteria for presumptive identification of LAB and probiotic characteristics. These analyses included Gram staining, catalase testing, hemolytic activity assays, tolerance assays to NaCl, simulated gastric juice and bile salts, antagonistic activity assays, antibiotic susceptibility testing, cell adhesion assay and genotypic identification through 16S rRNA gene sequencing. A total of 40 microbial strains were isolated from the GIT of 20 retail broiler chickens. Among these, 4 LAB strains showed the best probiotic results and were genotypically identified as Enterococcus faecium MCI7, Pedicoccus pentosaceus MCI10, Pediococcus pentosaceus MCC6 and Pediococcus pentosaceus MCC12. The selected strains exhibited non-hemolytic activity and were able to survive in simulated gastric juice at pH 3. Furthermore, the strains displayed bile salt tolerance in the presence of 0.3% bile salt for 4 hours, ranging from 21.91 to 32.77% and a wide range of antimicrobial activities against various pathogenic bacterial strains with inhibition zones ranging from 10 to 16.5 mm. Moreover, three P. pentosaceus strains (MCI10, MCC6, MCC12) were sensitive to most of the tested antibiotics and demonstrated good adherence abilities. Our study identified four LAB strains as promising probiotic candidates for poultry feed additives to effectively establish intestinal microflora, enhance meat quality and growth, and control pathogens.Burn injuries are a significant cause of morbidity and mortality globally; however, limited data are available from low- and middle-income countries such as Jordan. This study aimed to describe burn patient presentation, initial management and factors associated with in-hospital mortality. A retrospective descriptive study was conducted using records of 493 patients admitted to a national referral centre in Jordan between 2018 and 2022. The sample was predominantly male (61.5%) with a mean age of 19.6 years (SD = 21); children under 18 years comprised 58.4%. The mean total body surface area (TBSA) burned was 18%. Flame (50.1%) and scald (44.6%) injuries were most common. Inhalation injury occurred in 25.8% and 21.3% required mechanical ventilation. The hospital mortality rate was 15.6%, significantly associated with TBSA, age, inhalation injury and low serum total protein. Baux and revised Baux scores showed high predictive accuracy (AUC = 0.902 and 0.918). Logistic regression identified TBSA, age, inhalation injury and total protein level as independent predictors of mortality. Burn injuries in Jordan disproportionately affect children and are associated with substantial mortality. Early identification of high-risk patients using validated scores and prompt nutritional and respiratory interventions are essential. Multicentre studies and a national burn registry are recommended to guide future policy and care improvements.
FreshRSS 