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☐ ☆ ✇ PLOS ONE Medicine&Health

Assessment of allergy knowledge among the Palestinian community: A cross-sectional study

Por: Maha Rabayaa · Mustafa Ghanim · Malik Alqub · Mohammad Abuawad · Majdi Dwikat · Samar Alkhaldi · Haneen Badawi · Johnny Amer — Diciembre 17th 2025 at 15:00

by Maha Rabayaa, Mustafa Ghanim, Malik Alqub, Mohammad Abuawad, Majdi Dwikat, Samar Alkhaldi, Haneen Badawi, Johnny Amer

Introduction

Allergy is a form of chronic illness with an increasing prevalence globally. Adequate knowledge among the community about the causes, symptoms, and treatment of allergy is crucial in preventing the associated life-threatening complications. Limited research has been conducted in Palestine regarding this health priority. The current study aimed to assess the Palestinian community’s level of knowledge regarding allergy.

Methods

An observational cross-sectional study was conducted using an online questionnaire targeting Palestinians aged 18 years and older between 1 June 2024 and 26 January 2025. The questionnaire gathered demographic information about the participants and assessed their knowledge level concerning allergy.

Results

A total of 1002 participants were included in the study. The mean age of the participants was 30.33 years. 66.1% of the participants were females, 60.2% were unmarried, 60.1% had possessed a bachelor’s degree, 63.1% had a personal history of allergy, and 82% reported knowing of someone with allergies. The mean knowledge score about allergies was 5.4 out of 10, with over half of the participants having an average level of knowledge (4–6). The knowledge score about allergies was significantly different based on the participants’ sex, marital status, place of residence, educational level, and occupation (p-value Conclusion

The Palestinians’ knowledge of allergy is considered good regarding its common causes and symptoms. However, there is still inadequate knowledge about the treatment of allergy and its less common causes. The community awareness of allergy should be improved through targeted campaigns and brochures aimed at achieving earlier diagnosis and proper management to prevent the development of life-threatening complications.

☐ ☆ ✇ Journal of Nursing Scholarship

Examining Stroke Symptom Messages Implemented Globally: A Need for Contextually Relevant Stroke Symptom Messaging

Por: Hardeep Singh · Sarah Belson · Jennifer E. S. Beauchamp · Michelle L. A. Nelson — Diciembre 17th 2025 at 11:14

ABSTRACT

Background

Stroke is a global health concern. A timely response to a stroke can help reduce morbidity and mortality. However, barriers to timely response include poor recognition of stroke symptoms. Stroke symptom messages are designed to increase stroke recognition and encourage individuals to seek urgent medical assistance. The Face, Arm, Speech, Time (FAST) and Balance, Eyes, Face, Arm, Speech, Time (BE FAST) are commonly used stroke symptom messages shown to improve stroke symptom recognition and response. However, cultural factors and language differences may limit the effectiveness of stroke symptom messages and their acceptability in different countries and contexts. There has not been a comprehensive examination of the stroke symptom messages used worldwide and how these messages have been adapted in various settings.

Aims

We explored what stroke response messages are being used globally, and the contextual factors that influence the adoption of a stroke response mnemonic in different settings.

Methods

A 14-item survey was disseminated by the World Stroke Organization to its networks. The survey contained open- and closed-ended questions and allowed uploading relevant stroke symptom campaign materials. The survey was analyzed using descriptive statistics and a content analysis.

Results

All except one survey respondent used a stroke symptom message. Fifteen respondents (27%) reported they did not translate their stroke awareness messaging. Of these 15 respondents, they used the English versions of FAST (n = 8), BE FAST (n = 4), and both FAST and BE FAST (n = 3). Forty respondents (71%) reported that they/their organization used an acronym to raise public awareness of the signs/symptoms of stroke that was different from FAST or BE FAST (English), many of which were direct or indirect translations or influenced by FAST and BE FAST. Survey responses shared insights and recommendations related to the content, tailoring and dissemination of stroke symptom messages.

Conclusions

Study findings highlight the global use of stroke symptom messages and their contextual adaptations to fit diverse settings and contexts. The challenges in applying universal or commonly used stroke symptom messages to different contexts were highlighted.

Clinical Relevance

Nurses could have a key role in raising awareness of stroke symptoms and the development of locally adapted stroke symptom messages.

☐ ☆ ✇ Evidence-Based Nursing

Positive benefits of being a caregiver for a person living with advanced cancer

Por: Dunham · M. — Diciembre 15th 2025 at 09:45

Commentary on: Song Y, Wang M, Zhu M, Wang N, He T, Wu X, Shi Z, Chen M, Ji T, Shen Y. Benefit finding among family caregivers of patients with advanced cancer in a palliative treatment: a qualitative study. BMC Nursing. 2024;23(1):397.

Implications for practice and research

  • Caregivers of family members with advanced cancer need to be empowered, supported psychologically and socially, to be resilient and function effectively as carers.

  • Future research on this topic should consider more diverse populations to explore the holistic experiences of individuals and adopt a culturally sensitive approach to the topic.

  • Context

    The global incidence of cancer is significant, estimated at 53.5 million in 2022 with over 35 million new cases predicted in 2050.1 Family members and informal carers engage with many responsibilities, providing physical and emotional support to the person living with cancer.2 These family...

    ☐ ☆ ✇ Evidence-Based Nursing

    Older people: strategies for maintaining independence

    Por: Dunham · M. — Diciembre 15th 2025 at 09:45

    Commentary on: Crocker TF, Ensor J, Lam N, et al. Community based complex interventions to sustain independence in older people: systematic review and network meta-analysis. BMJ 2024 Mar 21;384.

    Implications for practice and research

  • Individualised care planning and effective and regular medication review are fundamental to ensuring the independence of older people living in the community.

  • More research is needed to identify the particular health and social care interventions which are most beneficial to the ageing population.

  • Context

    Globally, by 2025, the proportion of older people ≥60 years will double to one-fifth of the total world population.1 The importance of identifying evidence-based methods to support the independence of our ageing populations is evident to support the growing care needs of the aged and frail.1 In industrialised nations, the numbers of people living well beyond local retirement ages are proportionately increasing,...

    ☐ ☆ ✇ PLOS ONE Medicine&Health

    <i>Mycobacterium tuberculosis</i> complex lineages and drug resistance patterns among tuberculosis patients with or without diabetes mellitus in southern Ghana

    by Emelia Konadu Danso, Prince Asare, Amanda Yaa Tetteh, Phillip Tetteh, Augustine Asare Boadu, Ivy Naa Koshie Lamptey, Augustina Angelina Sylverken, Kwasi Obiri-Danso, Jane Sandra Afriyie-Mensah, Abraham Adjei, Dorothy Yeboah-Manu

    Drug-resistant (DR) tuberculosis (TB) and diabetes mellitus (DM) are intersecting epidemics that complicate management of both diseases and worsen patient outcomes. We conducted a prospective cohort study of 758 GeneXpert-confirmed pulmonary TB patients, of whom 75 had DM. Demographic, clinical, radiographic, and anthropometric data were collected at baseline. Sputum samples were cultured for mycobacterial isolation, and the obtained isolates were characterized for Mycobacterium tuberculosis complex (MTBC) lineage and drug-susceptibility testing using spoligotyping and microplate alamar blue assay. The TB-diabetes (TB-DM) comorbid cohort was older [TB-DM: 53/75 (70.7%) vs. 241/683 (35.3%) aged 41–60 years) (p 
    ☐ ☆ ✇ BMJ Open

    Association between the continuum of maternal healthcare services and child immunisation in East Africa: a propensity score matching analysis

    Por: Gebrehana · A. K. · Abrham Asnake · A. · Seifu · B. L. · Fente · B. M. · Bezie · M. M. · Asmare · Z. A. · Tsega · S. S. · Negussie · Y. M. · Asebe · H. A. · Melkam · M. — Diciembre 15th 2025 at 06:41
    Objective

    To assess the association between the maternal continuum of healthcare and child immunisation in East Africa using propensity score matching (PSM).

    Design

    Cross-sectional study using Demographic and Health Survey data.

    Setting

    This study was conducted in East African countries.

    Participants

    This study included a weighted sample of 13 488 women with children aged 12–23 months.

    Outcome measure

    Child immunisation was the outcome variable of this study.

    Results

    The PSM estimates indicate that the average treatment effect on the treated for complete child immunisation was 0.0583, meaning that children of mothers who received a complete maternal continuum of care had a 5.83% higher probability of being fully immunised compared with children of mothers with incomplete care. Expressed relative to the treated group’s mean, this corresponds to a 7.48% increase. Additionally, our results indicated that the population average treatment effect was 0.0629. This means that, on average, a complete continuum of maternal healthcare increases the probability of full child immunisation by approximately 6.29% across the entire population.

    Conclusion

    The study highlights that children whose mothers receive comprehensive maternal healthcare are more likely to complete their childhood immunisations. This finding underscores the need to integrate immunisation services into maternal healthcare programmes to enhance vaccination coverage and promote better child health. To maximise this connection, improving access to maternal healthcare, especially in underserved regions, is crucial, along with ensuring that immunisation is a regular part of maternal care.

    ☐ ☆ ✇ BMJ Open

    Anatomic versus reverse total shoulder replacement for patients with osteoarthritis and intact rotator cuff: the RAPSODI-UK randomised controlled trial protocol

    Por: Rodrick · H. L. · Dias · J. · Watts · A. C. · Walton · M. J. · Brealey · S. · Page · R. · Foster · N. E. · Boland · K. · Cunningham · L. J. · Fairhurst · C. · Geoghegan · J. · Greenwood · W. · Hewitt · C. · Kirwan · C. · Leggett · H. · McDaid · C. · Parkes · M. · Parrott · S. · Powell · R. — Diciembre 12th 2025 at 18:11
    Introduction

    Shoulder osteoarthritis most commonly affects older adults, causing pain, reduced function and quality of life. Total shoulder replacements (TSRs) are indicated once other non-surgical options no longer provide adequate pain relief. Two main types of TSRs are widely used: anatomic TSR (aTSR) and reverse TSR (rTSR). It is not clear whether one TSR type provides better short- or long-term outcomes for patients, and which, if either, is more cost-effective for the National Health Service (NHS).

    Methods and analysis

    RAPSODI-UK is a multi-centre, pragmatic, two-parallel arm, superiority randomised controlled trial comparing the clinical- and cost-effectiveness of aTSR versus rTSR for adults aged 60+ with a primary diagnosis of osteoarthritis, an intact rotator cuff and bone stock suitable for TSR. Participants in both arms of the trial will receive usual post-operative rehabilitation. We aim to recruit 430 participants from approximately 28 NHS sites across the UK. The primary outcome is the Shoulder Pain and Disability Index (SPADI) at 2 years post-randomisation. Outcomes will be collected at 3, 6, 12, 18 and 24 months after randomisation. Secondary outcomes include the pain and function subscales of the SPADI, the Oxford Shoulder Score, health-related quality of life (EQ-5D-5L), complications, range of movement and strength, revisions and mortality. The between-group difference in the primary outcome will be derived from a constrained longitudinal data analysis model. We will also undertake a full health economic evaluation and conduct qualitative interviews to explore perceptions of acceptability of the two types of TSR and experiences of recovery with a sample of participants.

    Ethics and dissemination

    Ethics committee approval for this trial was obtained (London - Queen Square Research Ethics Committee, Rec Reference 22/LO/0617) on 4 October 2022. The results of the main trial will be submitted for publication in a peer-reviewed journal and using other professional and media outlets.

    Trial registration number

    ISRCTN12216466.

    ☐ ☆ ✇ BMJ Open

    Association of fine particulate matter exposure during pregnancy and stillbirth rates in Pakistan: a cross-sectional study

    Por: Hameed · W. · Usmani · B. A. · Rehman · S. U. · Ahmed · M. · Allana · A. · Minaz · A. · Ahmed · Z. · Fatmi · Z. — Diciembre 12th 2025 at 18:11
    Objectives

    This study assessed the association between fine particulate matter (PM2.5) exposure during pregnancy and stillbirth in Pakistan. We hypothesised that higher PM2.5 exposure is linked to increased stillbirth risk.

    Design

    A cross-sectional study using secondary data from the 2017 to 2018 Pakistan Demographic and Health Survey (PDHS), combined with satellite-derived PM2.5 exposure data.

    Setting

    The study covered urban and rural areas across Pakistan, including all four provinces (Punjab, Sindh, Khyber Pakhtunkhwa and Baluchistan) and administrative regions (Gilgit-Baltistan (GB), Islamabad, Federally Administered Tribal Areas and Azad Jammu Kashmir).

    Participants

    The study included 9172 married women aged 15–49 with at least one birth in the past 5 years. Women with incomplete pregnancy outcome data were excluded.

    Exposure assessment

    PM2.5 exposure was estimated using satellite data, matching PDHS clusters with the nearest air quality point via MATLAB. Monthly average exposure was categorised into quartiles.

    Primary outcome

    Stillbirth, defined as pregnancy loss at ≥28 weeks gestation.

    Results

    Multivariable logistic regression was used to assess the association between PM2.5 and stillbirth, adjusting for maternal age, gravidity, wealth index, birth interval, previous adverse pregnancy outcome and region of residence. The stillbirth rate in Pakistan for the most recent pregnancy was 17.0 (14.5–19.9) per 1000 births, with highest rates (28.9) in Baluchistan province. The mean level of PM2.5 exposure in Pakistan was 53.96 (SD 20.42; range 5.9–209.4) µg/m3. PM2.5 exposure was higher for urban (56.43) than rural (51.87) pregnancies, highest in Sindh (78.06) and lowest in GB (13.41) provinces. For every 1 µg/m3 average increase in PM2.5 during the pregnancy period, there was approximately 1% increase in stillbirth.

    Conclusions

    Increased PM2.5 exposure was strongly associated with stillbirth risk. This underscores the need for targeted public health interventions, such as government regulations, emission controls and clean energy initiatives to protect pregnant women in high-risk areas.

    ☐ ☆ ✇ BMJ Open

    Associations of functional foods consumption with gastrointestinal and musculoskeletal conditions: a cross-sectional study among Bangladeshi adults

    Por: Mazumdar · S. · Shuvo · S. D. · Khuku · T. K. · Adnan · M. M. · Hossain · M. S. · Kamal · M. M. · Fardaus · F. · Zohra · F.-T. · Ahammed · T. — Diciembre 11th 2025 at 11:26
    Objectives

    Functional foods have demonstrated potential in preventing gastrointestinal and musculoskeletal (osteo-related) disorders; however, evidence from cross-sectional studies in adults remains limited. This study aimed to examine the relationship between the frequency of functional food consumption and the prevalence of gastrointestinal and osteo-related conditions among adults in Bangladesh.

    Design

    Cross-sectional study.

    Setting

    A face-to-face interview was conducted in Southern Bangladesh.

    Participants

    A total of 959 adults participated. Socio-demographic characteristics, lifestyle factors, health status and patterns of functional food consumption were collected using a structured questionnaire.

    Main outcome measures

    The prevalence of gastrointestinal and musculoskeletal (osteo-related) diseases, as well as their associations with the frequency of functional food consumption, were assessed using binary logistic regression.

    Results

    Gastrointestinal and musculoskeletal (osteo-related) diseases were reported by 55.4% and 44.1% of participants, respectively. Multivariate logistic regression showed that several functional foods were associated with lower odds of gastrointestinal conditions, including regular seed intake (OR=0.35, p=0.034), weekly fibre-rich foods (OR=0.48, p=0.021), weekly probiotics (OR=0.26, p=0.012), monthly probiotics (OR=0.33, p

    Conclusions

    The consumption of functional foods, particularly seeds, probiotics, fibre-rich foods, nuts, tea/coffee and natural products were associated with a lower risk of gastrointestinal and musculoskeletal diseases in adults. These findings provide robust evidence to inform future prospective studies and support public health strategies in Bangladesh aimed at promoting the consumption of functional foods to prevent diet-related health conditions.

    ☐ ☆ ✇ Journal of Clinical Nursing

    What Can We Learn From Nurses' Experiences of Digital Technology Implementation During the COVID‐19 Pandemic? A Qualitative Study

    Por: Dawn Dowding · Louise Newbould · Nicholas R. Hardiker · Rebecca Randell · Manoj Mistry · Muhammad Faisal · Sarah Skyrme — Diciembre 10th 2025 at 12:49

    ABSTRACT

    Aim

    To explore nurses' experiences of the adoption, implementation, and use of digital technologies during the Covid-19 pandemic in the UK.

    Design

    A qualitative descriptive study.

    Methods

    A qualitative study using two data sources: qualitative responses from 55 respondents to an online survey, and data from in-depth interviews with 21 individuals. The NASSS framework was used to guide data collection and analysis. Data were analysed using framework analysis.

    Results

    Respondents reported using a variety of technologies including video conferencing applications, telemonitoring, systems to support care management and telecommunication systems. The analysis identified a range of reasons why technology had been introduced into services, and a recognition of its value in a situation where otherwise care may not have been able to continue. During the pandemic nurses were expected to change their work practices very rapidly, and we identified situations where organisational infrastructure either supported this effectively or created additional burdens for the nurses' work.

    Conclusion

    Nurses had to adapt to new ways of working rapidly, with digital technology being one of the primary means through which communication and care were delivered. The Covid-19 pandemic provided a unique set of circumstances where layers of governance and many of the existing barriers to technology introduction were reduced.

    Implications for the Profession

    It is important to learn from these experiences, to understand how to sustain innovations that have proved to be successful, as well as the factors that enable nurses to work effectively in this new environment.

    Reporting Method

    This study adheres to the guidance for publishing qualitative research in informatics.

    Patient or Public Contribution

    A public contributor was involved from the beginning of the study conceptualization. They had input into the study approach, were part of the team that acquired the funding for the study and gave input at various stages into the processes for data collection, analysis and writing up the findings. The public contributor is a co-author on this paper and has been involved in the writing and editing of this report.

    ☐ ☆ ✇ BMJ Open

    Positive health programme for British South Asian women with postnatal depression: a multiperspective qualitative study

    Por: Miah · J. · Bee · P. E. · Lunat · F. · McPhillips · R. · Taylor · A. K. · Aseem · S. · Sharma · D. · Husain · N. · Chew-Graham · C. — Diciembre 8th 2025 at 06:09
    Objectives

    To explore the views and perspectives of British South Asian (BSA) women and Positive Health Programme (PHP) facilitators on the usefulness and experiences of the PHP intervention for managing postnatal depression (PND) in primary care settings.

    Design

    Qualitative study with semi-structured interviews to explore perceptions of acceptability and implementation. A patient and public involvement group provided their insights and feedback on study topic guides, analysis and outcomes.

    Setting and participants

    We sampled trial participants from the PHP intervention database to ensure variation in geographic setting, age, socioeconomic status and ethnicity. PHP facilitators involved in the trial were also invited to participate in an interview.

    Interviews with study participants were conducted at participants’ homes, and community centres, or via phone. Interviews with PHP facilitators were conducted via phone or online. Interview recordings were transcribed verbatim and analysed using thematic analysis and subsequently the Theoretical Framework of Acceptability (TFA) was applied. Recruitment took place between February 2017 and March 2020.

    Results

    Thirty interviews were conducted—19 trial participants and 11 PHP facilitators. The PHP intervention was viewed positively, with appreciation of its therapeutic content and components such as childcare and refreshments that facilitated engagement. Participants reported improved confidence and well-being and supported their needs. Participants understood the intervention’s purpose. Both intervention participants and facilitators noted strengthened self-efficacy.

    Some participants experienced difficulties balancing childcare and attendance, implying a need for logistical assistance. Stigma about mental health in the BSA community was viewed as persistent, recommending future programmes efforts on strategies to reduce stigma and develop supportive environment.

    Conclusion

    This study demonstrates the possibility of PHP intervention being integrated into routine care by providing culturally tailored support for BSA women with PND, primarily through family engagement and facilitator support. Future research on scalability, alongside community engagement efforts, will strengthen its acceptability and broader applicability.

    Trial registration number

    ISRCTN10697380.

    ☐ ☆ ✇ BMJ Open

    Economic evaluation of a hospital-initiated tobacco dependence treatment service

    Por: Robins · J. · Alltimes · G. · Patel · I. · McNeill · A. · Moxham · J. · Duckworth Porras · S. · Stock · A. · Woodhouse · A. · Robson · D. — Diciembre 5th 2025 at 09:25
    Objectives

    The treatment of tobacco dependence in patients admitted to hospital is a priority for the National Health Service in England. We aimed to conduct an economic analysis of a pilot ‘opt-out’ tobacco dependence treatment intervention adapted from the Ottawa Model of Smoking Cessation.

    Design

    Observational cost analysis of an inpatient tobacco dependence treatment intervention, and matched cohort study comparing readmission costs between patients who received the intervention and benchmarked equivalents who did not.

    Setting

    11 acute inpatient wards in a major teaching hospital in London, England.

    Participants

    673 patients who smoked, admitted between 1 July 2020 and 30 June 2021.

    Interventions

    The intervention consisted of the systematic identification of smoking status, automatic referral to tobacco dependence advisors, provision of pharmacotherapy and behavioural support throughout the hospital stay and telephone support for 6 months after discharge.

    Primary and secondary outcome measures

    The primary outcomes were cost-per-patient, cost-per-quit and incremental cost effectiveness ratio among patients who received the intervention. The secondary outcomes were patient-level readmission costs and bed-days from 6 months after discharge, compared between the intervention group and a group of matched benchmark patients who smoked but did not receive the intervention.

    Results

    The total cost of the intervention was £178 105. On the basis of 104 patients who reported not smoking at 6 months, the cost-per-quit was £1712.55, equating to an estimated age-adjusted incremental cost per life year gained of £3325. Among 611 patients who were successfully matched to a benchmark cohort, readmissions for patients in the intervention group cost £492 k less than their benchmark equivalents over 21 months from 1 January 2021 to 30 September 2022 (£266 k vs £758 k), incurred 414 fewer bed days (303 vs 717) and readmitted at a lower rate (5% vs 11%). There were reduced readmission rates and costs among all patients who received the intervention compared with their benchmarked equivalents, regardless of smoking status at 6 months, except among those who opted out.

    Conclusions

    A pilot ‘opt-out’ tobacco dependence treatment intervention implemented in an acute hospital setting in London demonstrated value for money through reduced readmission rates and costs among all patients who received it.

    ☐ ☆ ✇ BMJ Open

    Transforming first response through non-police, community safety response programmes: a peer-reviewed and grey literature scoping review protocol

    Por: Todd · T. L. · Lappen · H. · Neath · S. · Markham · M. J. · Purtle · J. · Allen · B. · Rouhani · S. · Friedman · B. — Diciembre 5th 2025 at 09:25
    Introduction

    Police are frequently dispatched to a wide range of 911 calls, including mental and behavioural health crises, despite lacking the training, resources and time to respond effectively. In particular, people with serious mental illness are at elevated risk of experiencing excessive use of force, arrest and continued criminal legal involvement following police contact. Following the murder of George Floyd and other highly publicised police killings, Community Safety Response (CSR) programmes, staffed by unarmed peers, mental health professionals and other trained responders, have proliferated to provide non-police responses to mental and behavioural health and other quality-of-life concerns. CSR programmes have expanded rapidly, yet the evidence base remains fragmented and largely outside the peer-reviewed literature.

    Methods and analysis

    This scoping review will synthesise peer-reviewed and grey literature from 2020 to present on CSR programmes operating in North America. Guided by Joanna Briggs Institute methodology and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) standards, we will search multiple databases (Medline, PsycINFO, Embase, SocIndex, Web of Science, Policy Commons) and employ complementary grey literature search strategies, including targeted website searches, reference tracking and review of internal and external reports and evaluations. Inclusion criteria require that programmes provide non-police first response to calls traditionally served by law enforcement and include information on programme operations or outcomes. Two reviewers will independently screen and extract data on process metrics including operational characteristics, dispatch, funding, services provided and outcomes such as populations served, diversion from police, service linkage and use of force.

    Ethics and dissemination

    No ethical review for this study is required as it will not include human subjects or any identifiable information. Findings will provide the first national synthesis of CSR programme models, operations and outcomes. Results will inform policy-makers, practitioners, researchers and community members. Findings will be disseminated through peer-reviewed publications and public-facing products to support implementation, scale-up and sustainability of CSR programmes.

    ☐ ☆ ✇ PLOS ONE Medicine&Health

    A Late Pleistocene archaic human tooth from Gua Dagang (Trader’s Cave), Niah national park, Sarawak (Malaysia)

    Por: Darren Curnoe · Mohammed S. Sauffi · Hsiao Mei Goh · Xue-feng Sun · Roshan Peiris — Diciembre 10th 2025 at 15:00

    by Darren Curnoe, Mohammed S. Sauffi, Hsiao Mei Goh, Xue-feng Sun, Roshan Peiris

    The rarity of Late Pleistocene hominin remains from Insular Southeast Asia (ISEA) has hampered our ability to understand a crucial episode of human evolutionary history, namely, the global dispersal of Homo sapiens from Africa. Moreover, recent discoveries indicate a surprising level of taxic diversity during this time with at least two species—H. floresiensis and H. luzonensis—endemic to the region when H. sapiens first arrived. A third hominin dubbed the ‘Denisovans’ is shown from DNA evidence to have interbred with the ancestors of contemporary Indigenous populations across ISEA, New Guinea and Australia. Yet, the Denisovans have not been identified from the fossil record of the area despite recent breakthroughs in this regard on mainland East Asia. New excavations by our team at the Trader’s Cave in the Niah National Park (‘Niah Caves’), northern Borneo, have yielded an isolated hominin upper central permanent incisor dated with Optically Stimulated Luminescence dating of sediments to about 52 − 55 thousand years ago. Specimen SMD-TC-AA210 has a massive crown absolutely and relative to its root size, the crown is wide (mesiodistally) and relatively short (labiolingually). Morphologically, it exhibits a very strong degree of labial convexity, pronounced shovelling, and the bulging basal eminence exhibits several upward finger-like projections. Labial enamel wrinking on the enamel-dentine junction is expressed as two large ridges exhibiting numerous spine-like projections, and the lingual extensions on the enamel surface of the basal eminence are expressed as six extensions. This combination of crown size and morphological traits is not normally found in H. sapiens and instead characterises archaic members of Homo such as H. erectus, H. neanderthalensis and Middle Pleistocene hominins sharing a clade with H. heidelbergensis. The Trader’s Cave tooth suggests that an archaic hominin population inhabited northern Borneo just prior to or coincident with the arrival of H. sapiens as documented at the nearby West Mouth of the Niah Great Cave.
    ☐ ☆ ✇ PLOS ONE Medicine&Health

    Spatial clustering of zero dose children aged 12 to 59 months across 33 countries in sub-Saharan Africa: A multiscale geographically weighted regression analysis

    Por: Chamberline E. Ozigbu · Zhenlong Li · Bankole Olatosi · James W. Hardin · Nicole L. Hair — Diciembre 10th 2025 at 15:00

    by Chamberline E. Ozigbu, Zhenlong Li, Bankole Olatosi, James W. Hardin, Nicole L. Hair

    While prior studies have identified sociodemographic correlates of zero-dose status within populations in sub-Saharan Africa (SSA), few have applied spatial regression techniques to explore geographic variability in these relationships. We aimed to address this gap using data from Demographic and Health Surveys conducted in SSA between 2010 and 2020. Our sample comprised children aged 12–59 months in 33 countries and 329 survey regions. Data were aggregated to the first-level administrative unit prior to analysis. First, using ordinary least squares regression, we documented global relationships between theoretically important sociodemographic characteristics and zero-dose prevalence. Next, we identified patterns, i.e., geographic clustering, of zero-dose prevalence. Finally, using multiscale geographically weighted regression, we described spatial variability in relationships between sociodemographic characteristics and zero-dose prevalence. We detected 27 regions with higher than expected concentrations of zero-dose children. All but one of these hot spots were observed in 7 Western and Central African countries; only 1 was located in an Eastern African country. Regions with higher proportions of mothers with no antenatal care visits were consistently found to have higher rates of zero-dose children. In contrast, relationships between zero-dose prevalence and indicators of religious affiliation, delivery site, maternal age, maternal education, and maternal employment were found to vary locally in terms of their strength and/or direction. Study findings underscore spatial disparities in zero-dose prevalence within SSA and, further, highlight the importance of geographically informed strategies to effectively address immunization gaps. Implementing targeted interventions based on regional sociodemographic dynamics is crucial for achieving comprehensive vaccination coverage in SSA.
    ☐ ☆ ✇ PLOS ONE Medicine&Health

    Metabolic dysfunction-associated steatohepatitis is the leading indication for adult liver transplantation in Saudi Arabia

    by Saleh A. Alqahtani, Shadan AlMuhaidib, Dimitri A. Raptis, Waleed K. Al-Hamoudi, K. Rajender Reddy, Dieter C. Broering, Saad A. Alghamdi, The OTCE Collaborative

    Background

    Liver transplantation (LT) represents the life-saving treatment for advanced liver disease. We aim to investigate LT indication trends and outcomes in Saudi Arabia, following the evolution of effective therapies for hepatitis C virus (HCV) and the rising fatty liver disease prevalence.

    Methods

    We retrospectively analyzed data from adult patients who underwent LT from 2011 to 2023 at a tertiary referral center in Saudi Arabia. We assessed demographics, LT indication trends, Model for End-stage Liver Disease (MELD) scores, donor type, and survival outcomes.

    Results

    A total of 1,419 patients were included. The median age was 56.9 years, with 37.4% female. Living donor LT (LDLT) represented 79.8% of all transplants, and 22.0% of recipients had hepatocellular carcinoma (HCC). Metabolic dysfunction-associated steatohepatitis (MASH) was the predominant indication for LT (33.2%), followed by HCV (18.0%) and hepatitis B virus (HBV) (17.1%). Overall survival rates at 1-, 2-, 3-, 5-, and 10-years post-transplantation were 87.9%, 85.0%, 82.4%, 77.7%, and 71.3%, respectively. Hazard ratios (HR) for mortality were lower in patients with HBV compared to MASH (HR: 0.44, 95% CI: 0.28–0.69, p  Conclusions

    MASH represents the leading indication for LT in this large cohort, necessitating preventive strategies and early detection efforts.

    ☐ ☆ ✇ PLOS ONE Medicine&Health

    Caste- and age-specific venom composition of biogenic amines and the influence of diet in honey bees

    Por: Motoharu Hamano · Kazuya Niki · Keiki Imamura · Ken Sasaki — Diciembre 10th 2025 at 15:00

    by Motoharu Hamano, Kazuya Niki, Keiki Imamura, Ken Sasaki

    The chemical composition of the venom in social Hymenoptera differs between castes and ages. Biogenic amines are contained in the venom of honey bees and may be physiologically effective to vertebrate predators and insects. This study quantified the concentrations of biogenic amines in venom and compared them between different castes and ages of honey bees. The concentrations of dopamine and N-acetyldopamine in venom were significantly higher in virgin queens than workers of the same age. The concentrations of dopamine, norepinephrine, tyramine and serotonin increased with age in virgin queens and workers. There was a significant positive correlation between venom dopamine concentrations and ovarian development in queenless workers, suggesting that the concentration of dopamine in the venom transformed from normal workers to reproductive females as that in virgin queens. We also tested the possibility of dietary effects on the concentration of dopamine in venom. Workers fed tyrosine or royal jelly showed significantly higher concentrations of dopamine precursors, tyrosine, 3,4-dihydroxyphenylalanine (DOPA) and dopamine in the hemolymph, as well as higher concentrations of dopamine in venom than in controlled workers. These results suggest that compositions of biogenic amines in venom are influenced by nutrition and change based on their social roles in honey bee society.
    ☐ ☆ ✇ PLOS ONE Medicine&Health

    Prevalence and determinants of precancerous cervical lesions among women screened for cervical cancer in Africa: A systematic review and meta-analysis

    by Berihun Agegn Mengistie, Getie Mihret Aragaw, Tazeb Alemu Anteneh, Kindu Yinges Wondie, Alemneh Tadesse Kassie, Alemken Eyayu Abuhay, Wondimnew Mersha Biset, Gebrye Gizaw Mulatu, Nuhamin Tesfa Tsega

    Background

    Precancerous cervical lesions, or cervical intraepithelial neoplasia (CIN), represent a significant precursor to cervical cancer, posing a considerable threat to women’s health globally, particularly in developing countries. In Africa, the burden of premalignant cervical lesions is not well studied. Therefore, the main purpose of this systematic review and meta-analysis was to determine the overall prevalence of precancerous cervical lesions and identifying determinants among women who underwent cervical cancer screening in Africa.

    Methods

    This study followed the Preferred Reporting Item Review and Meta-analysis (PRISMA) guidelines. The protocol for this systematic review and meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42025645427). We carried out a systematic and comprehensive search on electronic databases such as PubMed and Hinari. In addition, Google Scholar and ScienceDirect were utilized to find relevant studies related to precancerous cervical lesions. Data from the included studies were extracted using an Excel spreadsheet and analyzed using STATA version 17. The methodological quality of the eligible studies was examined using the Joanna Briggs Institute (JBI) assessment tool. Publication bias was checked by using the funnel plot and Egger’s tests. A random-effects model using the Der Simonian Laird method was used to estimate the pooled prevalence of pre-cancerous cervical lesions in Africa. The I-squared and Cochrane Q statistics were used to assess the level of statistical heterogeneity among the included studies.

    Results

    A total of 112 eligible articles conducted in Africa, encompassing 212,984 study participants, were included in the quantitative meta-analysis. Thus, the pooled prevalence of pre-cancerous cervical lesions in Africa was 17.06% (95% confidence interval: 15.47%−18.68%). In this review, having no formal education (AOR = 4.07, 95% CI: 1.74, 9.53), being rural dweller(AOR = 2.38, 95% CI: 1.64, 3.46), history of STIs (AOR = 3.94, 95% CI: 2.97, 5.23), history of having multiple partners (AOR = 2.73, 95% CI: 2.28, 3.28), early initiation of coitus (AOR = 2.77, 95% CI: 2.11, 3.62), being HIV-seropositive women (AOR = 3.33, 95% CI: 2.32, 4.78), a CD4 count Conclusions

    In Africa, the overall prevalence of pre-cancerous cervical lesions is high (17%). The findings of this review highlight that health professionals, health administrators, and all other concerned bodies need to work in collaboration to expand comprehensive cervical cancer screening methods in healthcare facilities for early detection and treatment of cervical lesions. In addition, increasing community awareness and health education, expanding visual inspection of the cervix with acetic acid in rural areas, offering special attention to high-risk groups (HIV-positive women), encouraging adherence to antiretroviral therapy for HIV-positive women, overcoming risky sexual behaviors and practices, and advocating early detection and treatment of precancerous cervical lesions.

    ☐ ☆ ✇ Journal of Clinical Nursing

    Immersed in Fear and Doubt: Mothers' Experiences of Caring Transition for Children With Cancer—A Qualitative Study

    Por: Nasrin Ghanbari · Eesa Mohammadi · Mitra Khoobi — Diciembre 9th 2025 at 12:52

    ABSTRACT

    Aim

    This study aimed to explore and describe the experiences and perceptions of mothers of children with leukaemia regarding the transition of care from hospital to home.

    Design

    A qualitative content analysis with a conventional approach was employed, and this report follows the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

    Methods

    Thirteen mothers of children with leukaemia were recruited using purposive sampling from two Iranian paediatric hospitals. Data were collected through in-depth, semi-structured interviews conducted between 2023 and 2024 and analysed using conventional qualitative content analysis.

    Results

    Drowning in the Vortex of Fear and Doubt emerged as the central theme, encapsulating the shared experiences of mothers of children with leukaemia. This overarching theme comprised five categories: (1) Fear of Unpredictable and Life-Threatening Complications, (2) Paradoxical Concerns About Discharge, (3) Doubts and Hopelessness About Treatment Effectiveness, (4) Stress Regarding the Child's Future Life Trajectory and (5) Sense of Helplessness in Alleviating the Child's Suffering.

    Conclusion

    The findings underscore the need to provide comprehensive supportive services for parents of children with leukaemia. Policymakers and healthcare teams should prioritise initiatives that enhance parental awareness, deliver psychosocial support and empower families to navigate the arduous path of care and treatment with greater trust and confidence.

    Implications for the Profession and Patient Care

    Ensuring the well-being and comfort of both the child with cancer and the parents throughout the treatment process is essential for improving care outcomes.

    Reporting Method

    The study is reported according to the COREQ.

    Public Contribution

    Mothers of children with leukaemia participated as interviewees and contributed to ensuring the rigour of the study through data validation.

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