Latest research.
A closer look at everyday life.

Authors: Dikshya Adhikari, Hari Prasad Kaphle, Ramesh Ojha, Chiranjivi Adhikari

Background Health workers’ burnout compromises patient safety and satisfaction, in addition to their own health. Over the last three decades or more, burnout syndrome has been getting more attention. High levels of burnout have been reported by health workers globally, and Nepal is no exception, including those mainly in hospital settings. Despite this, burnout issues have not been given enough attention in the literature. Hence, this study aims to assess the prevalence of burnout among health workers in hospital settings in Pokhara and to assess its’ associated factors (personal, job-related, and work-life balance). Materials and methods A hospital-based cross-sectional observational study was carried out among 242 health workers from selected hospitals of Pokhara, Kaski, over a period of one month from Sep to Oct, 2024. Data were collected using a self-administered questionnaire to assess the prevalence of burnout and its’ associated factors. The Oldenburg Burnout Inventory scale was used for assessing the prevalence of burnout. Frequency, percentage, and median were calculated to describe the sample characteristics, whereas, chi-square tests and logistic regression were used to determine the factors associated with burnout. Results The prevalence of burnout was 61.6%. When subscales were evaluated separately, slightly more than and nearly three-fourths were found to have both high disengagement (76.4%) and high exhaustion (71.9%). Multivariate logistic regression showed that the insufficient sleeping hours at night (aOR: 2.292, 95% CI: 1.193–4.404), poor job satisfaction (aOR: 3.391, 95% CI: 1.286–8.943), and poor work-life balance (aOR: 5.187, 95% CI: 2.600–10.350) were associated with burnout status. Conclusions Nearly two-thirds of the hospital health workers experienced burnout in Pokhara. Insufficient sleeping duration at night, poor job satisfaction, and poor work-life balance determined the burnout status of health workers. Hospital administrators, policymakers, and health system leaders should prioritize interventions targeting burnout among health workers, which protect work-life balance and improve job satisfaction.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360067. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Zacharie Tsala Dimbuene, Hugues Sampasa-Kanyinga

Background Child stunting remains a major public health challenge in the Democratic Republic of the Congo (DRC), reflecting persistent inequalities in child nutrition and health outcomes. This study examines the distribution and spatial variation of height-for-age z-scores (HAZ) among children under five, while also assessing the influence of selected demographic and socioeconomic factors. Methods Data were obtained from the 2023–2024 Demographic and Health Survey (DHS-8). A structured additive regression model was then applied to assess the effects of child age and maternal education, allowing for nonlinear relationships through smooth functions. To capture geographic heterogeneity, spatial effects were decomposed into structured (spatially correlated) and unstructured (area-specific random) components, enabling the identification of regional clustering and residual province-level variation in stunting. Results Geographic analysis reveals substantial regional disparities in stunting prevalence across the 26 provinces of the DRC. The province of Kwilu emerges as a major hotspot with very high levels of stunting, while several provinces fall within medium to high prevalence categories, indicating that stunting is a widespread issue across the country. Model results highlight important nonlinear relationships for certain predictors. Child’s age shows a strong negative trend with stunting risk: younger children have higher log-odds of stunting, and the risk decreases sharply with age. Maternal education displays a weaker and nonlinear association, with generally small effects across most education levels and greater uncertainty at higher levels of schooling. Spatial modeling further demonstrates that geographic factors significantly contribute to variation in stunting outcomes. Both structured spatial effects, indicating regional clustering, and unstructured spatial effects, reflecting province-specific deviations, contribute to the observed patterns. The combined spatial effect suggests persistent geographic disparities even after adjusting for covariates, although uncertainty varies across regions. Conclusions The findings underscore the importance of geographic context and early childhood factors in shaping stunting outcomes in the DRC, highlighting the need for targeted, context-specific interventions to address persistent nutritional inequalities.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360056. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Ting Zhang, Sheng Ye, Liang Ye, Zekai Qian

This study investigates the efficacy and safety of steam cleaning technology for the removal of surface contaminants from stone cultural relics at the Tomb of Yue Fei, a nationally protected heritage site in China. The research focuses on common pollutants including dust accumulation, surface encrustation, hydro erosion, bioerosion, and anthropogenic graffiti. An evaluation method based on infrared thermography is proposed to assess cleaning effectiveness by analyzing temperature variation (T) before and after treatment. Field experiments were conducted using a steam cleaner with controlled parameters (pressure, temperature, angle, distance, and duration), and cleaning outcomes were evaluated through visual inspection, chromatic aberration measurement, and microscopic imaging. Results demonstrate that steam cleaning effectively removes most contaminants without causing significant damage to the stone substrate. The study also provides a set of recommended steam cleaning parameters for different pollutant types on limestone surfaces. The findings validate the feasibility of using infrared thermography as a non-destructive evaluation tool for cleaning efficacy, contributing to the development of standardized protocols for the conservation of stone heritage.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0359835. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Jiayi Peng, Ji Liu, Yufeng Shen, Miao Yin, Changzheng Liu, Jie Zhou, Jia Liu, Ronghua Zhang, Qi Hong

Background Dental panoramic radiographs play an important role in oral disease screening, computer-aided diagnosis, and clinical treatment planning. However, accurate multi-class detection remains challenging due to small lesion sizes, ambiguous anatomical boundaries, insufficient multi-scale feature representation, and missed detections of complex dental structures. Objective This study aims to develop an accurate and efficient multi-class object detection framework for dental panoramic radiographs to improve the detection performance of small lesions, weak-boundary structures, and complex anatomical targets. Methods A novel re-parameterized cross-scale attention-enhanced framework, named RCTE, was proposed based on the YOLOv8n detector. The proposed framework integrates three complementary components: a Cross-Scale Channel Transformer (CSCT) module for cross-scale contextual interaction among P3, P4, and P5 features, a RepNCSPELAN4-based Re-parameterized Feature Pyramid Fusion (RPF) structure for enhancing multi-scale feature aggregation, and a Multi-Scale EMA (MS-EMA) mechanism for feature recalibration before the detection head. Experiments were conducted on a publicly available dental panoramic radiograph dataset containing 11 categories of dental structures and lesions. Model performance was evaluated using Precision, Recall, F1-score, mAP50, mAP75, and mAP50–95. Results Compared with the original YOLOv8n baseline, RCTE improved mAP50, mAP75, mAP50–95, and Recall by 2.55, 3.88, 2.40, and 5.10 percentage points, respectively. The proposed framework achieved better detection completeness and localization accuracy compared with other YOLO-based detectors. Furthermore, RCTE maintained real-time inference capability, demonstrating a favorable balance between detection accuracy and computational efficiency. Conclusion The proposed RCTE framework effectively improves multi-class object detection performance in dental panoramic radiographs by enhancing cross-scale feature interaction, multi-scale feature fusion, and detection feature recalibration. This method provides a potential solution for computer-aided dental image analysis.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0359630. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Shashika Bandara, Muriel Mac Seing, Charity Oga-Omenka, Michelle Amri, Zahid A. Butt, Amelia Dinh, Karina Dubois-Nguyen, Marie Dorey, Joelle Ducharme, Saad El-Din Hassan, Janet Hatcher-Roberts, Justus Holben, Tina Lines, Nihad Mahmalat, Margaret Mutumba-Nakalembe, Hannah Neufeld, Nitika Pant Pai, Sanskruti Patel, Claudia Ximena Robayo-Gonzalez, Bukola Salami, Lauren Smith, Sarah Stecko, Eric Tchouaket Nguemeleu, Kathryn E. Tiedje, Bilkis Vissandjée

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007441. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Alexandre Dukundane, Rachel Murekatete, Jimmy Opiyo, Laura Keyser, Jessica McKinney, Rashidah Nambaziira, Robert Ojiambo

Urinary incontinence (UI), an involuntary loss of urine, is a widespread pelvic floor disorder affecting 20–50% of women worldwide, with a 21% prevalence in Sub-Saharan Africa. Contributing factors include genetics, childbirth, and chronic conditions, leading to significant physical, social, and emotional challenges such as fear of leakage and isolation. Despite its impact, many affected women lack awareness of UI and available treatments, which include medication, surgery, and pelvic floor muscle training (PFMT). Knowledge gaps and misconceptions persist, hindering timely diagnosis and management. In response to these challenges, healthcare systems in Africa are adopting digital technologies (DTs), including WhatsApp and social media, to facilitate patient education and professional collaboration. Studies indicate that digital platforms can support women in managing UI, particularly through PFMT. However, little is known about women’s digital health education needs, barriers, and platform preferences. This study explored these aspects among women with UI in Kigali through a phenomenological qualitative approach across four hospitals: Masaka, Rwanda Military, Kibagabaga, and King Faisal. Using purposive sampling, 20 women aged 20–70 were selected. Data analysis was conducted through thematic analysis using deductive and inductive coding. The findings revealed four key themes. First, there are significant knowledge gaps about UI, necessitating multimodal education to address misinformation and misconceptions. Second, participants regularly use digital devices and the internet, recognizing their benefits and affordability for accessing health information. Third, barriers to digital health education included distrust in the accuracy of online information and financial constraints in maintaining digital devices and internet services. Lastly, participants expressed a strong interest in multimodal digital health education platforms to receive UI-related information. Many women misunderstood UI, often confusing it with aging or other conditions, leading to delayed diagnosis, emotional distress, social withdrawal, financial strain, and reduced quality of life. Although digitally literate, they rarely sought digital health information on UI due to knowledge gaps, financial limitations, and skepticism about online sources. The study underscores the urgent need for accessible and trustworthy digital health education to bridge knowledge gaps, provide support, and enhance UI management among affected women.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0006703. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: J. L. Wallace, M. K. Wright, M. A. Camargo-Valero, K. J. Charles, B. Engebretson, B. Gordon, F. Gore, G. Howard, R. Johnston, J. Kohlitz, F. Mills, K. Moon, A. Nijhawan, T. Slaymaker, M. Takane, J. Willetts, B. E. Evans

Despite sustained efforts over several decades, no region is projected to achieve universal sanitation access by 2030, according to international monitoring frameworks. Climate change is increasingly disrupting human and ecological systems, in turn deepening existing inequalities in access to essential services, including sanitation. Coupled with broader socio-economic and political dynamics, these pressures are expected to further widen the global sanitation service gap. Strengthening the resilience of sanitation systems to climate-related impacts represents a critical component of addressing this challenge. Building resilience requires an understanding of the attributes of sanitation systems and the adaptation actions across scales that contribute to their capacity to anticipate, withstand and recover from climate hazards. While existing scholarship has primarily examined the impacts of climate hazards on sanitation system performance, less attention has been given to resilience-building processes and practices. This systematic review is the first to synthesise the evidence on resilience in sanitation systems. The review identifies twenty-seven (n = 27) attributes and adaptation actions with potential to enhance resilience, none of which are currently considered in existing global monitoring processes. Only seventeen (n = 17) studies met the inclusion criteria, and empirical evidence remains scarce, highlighting substantial knowledge gaps. Findings also reveal a dominance of user-level, infrastructure focussed actions in low-income settings, with minimal evidence on operational or enabling environment strategies implemented by service providers or government actors. These findings highlight a substantial gap between identifying potential resilience-building measures and demonstrating how they contribute to resilience sanitation systems. Strengthening the evidence base requires greater emphasis on evaluating resilience outcomes, understanding interactions across the sanitation system, and examining how institutional and operational conditions shape adaptation over time. The findings provide a foundation for developing measurable indicators of climate resilience while highlighting the need for further empirical evidence to inform international monitoring frameworks and guide effective climate resilient sanitation planning.

Source: PLOS Water. DOI: 10.1371/journal.pwat.0000474. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Rusha Begna Wakweya

Ethiopia faces interconnected challenges of land degradation, climate change, and rural poverty. In response, the government launched the Green Legacy Initiative (GLI) in 2019, a nationwide afforestation and reforestation program aimed at planting billions of seedlings annually. Despite its ecological benefits, the initiative has generated substantial, yet often overlooked, socio-economic benefits that are critical to its long-term sustainability and contribution to the UN Sustainable Development Goals. This systematic review, therefore, aimed to identify the socio-economic benefits of the GLI and its role as a pathway to the UN Sustainable Development Goals (SDGs). Relevant literature was sourced from Scopus, Web of Science, and Directory of Open Access Journals (DOAJ), using the keywords “Green Legacy, Initiative, benefits, and Sustainable Development (SD).” The review included studies published between 2019 and 2025 that reported on the socio-economic outcomes of the GLI. The results indicated that livelihood diversification, community empowerment, and improved food security and human well-being were the major socio-economic associations reported. The initiative is associated with significant potential to advance sustainable development in Ethiopia by linking ecological restoration with socio-economic improvement. However, significant challenges remain: seedling survival (averaging 76.50% across districts), 65% of GLI employment being temporary, and socioeconomic data missing for 70% of Woredas. Realizing the full potential of this initiative requires integrated policies that strengthen rural markets, ensure inclusive participation, and establish long-term monitoring of both benefits and limitations.

Source: PLOS Sustainability and Transformation. DOI: 10.1371/journal.pstr.0000299. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Zuzanna Gurzyńska, Karolina Kucka, Marcin Trzciński, Katarzyna Topolska, Katarzyna Nowicka-Sauer, Krzysztof Sobczak

The period of university studies is associated with numerous stressors that can negatively affect the psychological functioning of young adults. This study aimed to investigate the relationship between perceived stress levels, preferred coping strategies, and psychological resilience. The analysis focused on resilience as a potential moderator of the relationship between coping strategies and stress intensity. The study included 607 Polish students. A significant part of the group was medical students (61.72%). The study employed the Perceived Stress Scale (PSS-10), the Coping Inventory (Mini-COPE), the Resilience Scale (SPP-25), and used an author-developed questionnaire to collect sociodemographic information. The respondents exhibited moderate stress intensity (M = 22.54; SD = 7.04) and a moderately high level of general resilience (M = 59.39; SD = 15.37). Among coping strategies, acceptance (M = 1.94) and active coping (M = 1.85) were chosen most frequently, while turning to religion and helplessness were chosen least frequently. Analysis of personal resources showed the highest scores in openness to experience and sense of humor. Interaction effects rarely reached statistical significance. The study group showed a profile of students who were stressed but had functional coping resources. The moderation analysis results indicate the complex nature of the relationships among the variables studied—although psychological resilience is a key resource, its role as a moderator of the relationship between coping strategies and stress is not universal and emerges only in specific areas of functioning. The data obtained suggest that psychological interventions should focus on strengthening existing resources (such as active coping) and developing resilience, which may serve as a buffer against the negative effects of academic stress.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360002. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Solène Neyret, Julien Pellet, Julien Ryard, Mickaël Campo, Jean-Rémy Chardonnet

During a game, players experience substantial affective fluctuations, particularly through cognitive appraisal processes, which notably involves self-categorisation process. However, designing a mental training programme using the contextual elements of a game is still a challenge. Moreover, social contexts can be recreated in virtual reality and it has been demonstrated that people tend to have realistic affective and behavioural reactions to it. In this study, we recreated, in virtual reality, one of the key contexts that players can encounter during a rugby game, a try. After an embodiment phase, participants were standing on the field with other avatars representing the other players, surrounded by an audience of virtual supporters. We used different visual and auditory parameters creating two different kinds of social feedback. In the first condition the social feedback was aimed at inducing social identity, in the second condition the social feedback received in the virtual environment was aimed at inducing personal identity. We measured participants’ identity level before and after each condition, using interactive visual analogue scales inside the virtual environment. We also measured levels of presence and embodiment using the same method. Affective states were measured using an interactive adaptation of Russel’s affect grid, inside the virtual environment as well. Our experiment presents an innovative method aimed at inducing and measuring different identity levels in virtual reality.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0359964. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Christian Sommer, Jesper Borre Pedersen, Zara Kanaeva, Timo P. Streicher, Andrew W. Kandel, Nicholas J. Conard, Volker Hochschild

Macroscale and interdisciplinary approaches are emerging as central paradigms in the study of human evolution, as demonstrated by a growing body of large-scale, data-driven research. This development is paralleled by an expanding ecosystem of R packages that provide access to paleoenvironmental and paleoclimatic reconstructions, as well as advanced tools for spatial and temporal analysis and modeling. However, within this computational framework, direct programmatic access to comprehensive archaeological and anthropological data remains limited. We present roadDB, an R package that enables streamlined access to the ROCEEH Out of Africa Database (ROAD), a major repository of archaeological, paleoanthropological, paleoenvironmental, geographical and chronological data relevant to human evolution. roadDB bridges the gap between the existing R ecosystem and the ROAD archaeological dataset that covers most of the last 3 million years of human evolution across Africa and Eurasia and thereby represents the only openly available archaeological dataset with such an extensive temporal and geographic coverage. In short, roadDB offers the research community unrestricted, transparent access to a richly curated collection of site-level and assemblage-level information, opening new possibilities for large-scale quantitative research. The package strengthens the integration of archaeological and paleoenvironmental evidence in macroscale analyses and supports robust, transparent and interdisciplinary research on the spatio-temporal dynamics of human evolution.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0359952. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.