Category: Nevin Manimala

Vet Surg. 2025 Feb 6. doi: 10.1111/vsu.14222. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the occurrence, degree, and risk factors associated with arthroscopic stifle joint synovitis in dogs with cranial cruciate ligament (CCL) disease.

STUDY DESIGN: Retrospective, observational study.

SAMPLE POPULATION: Canine CCL disease (n = 163) from 149 dogs and their arthroscopic video recordings.

METHODS: Arthroscopic video recordings were reviewed. A synovitis severity (0-5) and a modified Outerbridge cartilage classification system score were assigned, along with recording the presence or absence of a medial meniscal bucket handle tear. Medical records were reviewed for age, sex, limb, and duration of clinical signs. Univariate analyses were performed via a Fisher’s exact test for categorical independent variables, and ordered logistic regression was used for continuous variables. Multivariable ordered logistic regression considered independent variables with a p-value <.2 on univariate analyses. p-value <.05 was considered statistically significant.

RESULTS: Synovitis was identified in 100% of the stifles examined. The most frequent synovitis severity score was 3/5. Univariate analysis showed a significant association between synovitis severity score and bodyweight (p = .005), median cartilage score (p = .002), and being female (p = .032). On multivariable analysis, the synovitis severity score was significantly associated with median cartilage score (p = .042) and duration of clinical signs (p < .001).

CONCLUSION: Synovitis was arthroscopically always identified in stifles with CCL disease. The severity of synovitis was associated with more progressive damage to the articular cartilage and a longer duration of clinical signs.

CLINICAL SIGNIFICANCE: Earlier intervention in dogs with CCL disease may be warranted to decrease synovitis and progression of osteoarthritis.

PMID:39915894 | DOI:10.1111/vsu.14222

J Health Popul Nutr. 2025 Feb 6;44(1):26. doi: 10.1186/s41043-024-00723-z.

ABSTRACT

BACKGROUND: Caffeine is one of the world’s most frequently consumed central nervous system stimulants. Moderate caffeine intake has beneficial health effects, while increased caffeine intake may have harmful effects in the human body. Existing literature indicated that undergraduates consume caffeine excessively. Till this date, little is known about the consumption pattern of caffeine among Palestinian undergraduates. Therefore, the current study aimed to estimate the percentage of caffeine consumption among Palestinian undergraduates, to assess their caffeine daily intake, and to identify factors associated with unsafe caffeine consumption.

METHODS: A cross-sectional study was conducted in Palestine between March and May 2022. Undergraduates were recruited by random sampling after a personal invitation. Undergraduates aged between 18 and 25 were included in the study, while those who were taking medications, had medical conditions affecting the data collection process, and had incomplete responses were excluded from the study. Caffeine consumption was assessed using a semi-quantitative food frequency questionnaire (FFQ) developed by the research team. The content validity of the FFQ was done by three reviewers. Also, a questionnaire was used to collect data related to sociodemographic characteristics, medical history, lifestyle habits, sleeping quality, physical activity, and psychological status. Data were analyzed through the descriptive statistics and inferential statistics (Chi-square test, Mann-Whitney test, and Kruskal-Wallis H test).

RESULTS: The final analysis included 486 undergraduates with a mean age of 20.1 ± 1.48 years. The majority of the undergraduates were female (65.0%) and single (89.5%). The sample was distributed almost equally between the first (26.3%), second (23.0%), third (22.8%), and fourth (18.7%) academic years, and only 44 undergraduates (9.1%) were in their fifth year. The vast majority of university students (96.5%) consumed caffeinated products, with coffee ranking first place. Nearly half of the participants (32.7%) exceeded the safe levels of caffeine consumption. Males, smokers, poor physical activity, higher Sleep Hygiene Index (SHI) scores, and greater anxiety, stress, and depression scores had significantly higher rates of unsafe caffeine intake than their peers (p < 0.05). The total caffeine consumption was significantly associated with gender, low household income, smoking status, physical activity level, SHI score, as well as anxiety (p < 0.05).

CONCLUSION: Caffeine consumption in the studied sample was significantly high and exceeded the safe levels. The current study revealed that unsafe caffeine consumption was more common among males, smokers, and physically active individuals. Caffeine intake was also linked to poor-quality sleep and higher psychological concerns. Therefore, educational programs are recommended to increase awareness of the adverse effects of high caffeine intake.

PMID:39915865 | DOI:10.1186/s41043-024-00723-z

Alzheimers Res Ther. 2025 Feb 6;17(1):38. doi: 10.1186/s13195-025-01689-8.

ABSTRACT

BACKGROUND: The clinical presentations of early-onset Alzheimer’s disease (EOAD) and late-onset Alzheimer’s disease are distinct, with EOAD having a more aggressive disease course with greater heterogeneity. Recent publications from the Longitudinal Early-Onset Alzheimer’s Disease Study (LEADS) described EOAD as predominantly amnestic, though this phenotypic description was based solely on clinical judgment. To better understand the phenotypic range of EOAD presentation, we applied a neuropsychological data-driven method to subtype the LEADS cohort.

METHODS: Neuropsychological test performance from 169 amyloid-positive EOAD participants were analyzed. Education-corrected normative comparisons were made using a sample of 98 cognitively normal participants. Comparing the relative levels of impairment between each cognitive domain, we applied a cut-off of 1 SD below all other domain scores to indicate a phenotype of “predominant” impairment in a given cognitive domain. Individuals were otherwise considered to have multidomain impairment. Whole-cortex general linear modeling of cortical atrophy was applied as an MRI-based validation of these distinct clinical phenotypes.

RESULTS: We identified 6 phenotypic subtypes of EOAD: Dysexecutive Predominant (22% of sample), Amnestic Predominant (11%), Language Predominant (11%), Visuospatial Predominant (15%), Mixed Amnestic/Dysexecutive Predominant (11%), and Multidomain (30%). These phenotypes did not differ by age, sex, or years of education. The APOE ɛ4 genotype was enriched in the Amnestic Predominant group, who were also rated as least impaired. Cortical thickness analysis validated these clinical phenotypes with dissociations in atrophy patterns observed between the Dysexecutive and Amnestic Predominant groups. In contrast to the heterogeneity observed from our neuropsychological data-driven approach, diagnostic classifications for this same sample based solely on clinical judgment indicated that 82% of individuals were amnestic-predominant, 9% were non-amnestic, 4% met criteria for Posterior Cortical Atrophy, and 5% met criteria for Primary Progressive Aphasia.

CONCLUSION: A neuropsychological data-driven method to phenotype EOAD individuals uncovered a more detailed understanding of the presenting heterogeneity in this atypical AD sample compared to clinical judgment alone. Clinicians and patients may over-report memory dysfunction at the expense of non-memory symptoms. These findings have important implications for diagnostic accuracy and treatment considerations.

PMID:39915859 | DOI:10.1186/s13195-025-01689-8

J Ovarian Res. 2025 Feb 6;18(1):24. doi: 10.1186/s13048-025-01602-9.

ABSTRACT

PURPOSE: To assess whether maternal age influences the pregnancy outcomes after single frozen euploid embryo transfer.

METHODS: This retrospective analysis was conducted on 1037 cycles of single euploid embryo transfer performed at Nanjing Women and Children’s Healthcare Hospital between January 2016 and April 2023. Patients with severe uterine pathologies, immune disorders, or endocrine diseases were excluded. The cycles were categorized into three age groups: <35 years, 35-37 years, and ≥ 38 years. Primary outcomes included live birth rate, clinical pregnancy rate, early pregnancy loss, and miscarriage rate. Data were analyzed using multivariable logistic regression with generalized estimating equations (GEE) to account for confounding factors and restricted cubic splines to visualize the relationship between maternal age and pregnancy outcomes.

RESULTS: Women aged ≥ 38 years demonstrated a significantly diminished live birth rate (41.7%) ,which was lower than that observed in women aged < 35 years (54.5%) and 35-37 years (54.0%), with statistical significance (P < 0.05). Multivariable regression analysis revealed that compared with women aged ≥ 38 years, younger women had reduced risk of miscarriage (aOR = 0.371, 95% CI: 0.139-0.988 for the < 35 years group; aOR = 0.317, 95% CI: 0.106-0.954 for the 35-37 years group) and increased likelihood of live birth (aOR = 2.188, 95% CI: 1.154-4.147 for the < 35 years group; aOR = 2.239, 95% CI: 1.0103-4.548 for the 35-37 years group) after adjusting for relevant confounders. Additionally, the analysis showed that embryos biopsied on day 5 were linked to higher clinical pregnancy rates than those biopsied on day 6, and high-grade blastocysts were associated with superior pregnancy outcomes.

CONCLUSION: Advanced maternal age is associated with a higher miscarriage rate and lower live birth rate following euploid embryo transfer. Despite the exclusion of aneuploidy, age-related factors beyond chromosomal abnormalities appear to impact reproductive outcomes.

PMID:39915851 | DOI:10.1186/s13048-025-01602-9

AIDS Res Ther. 2025 Feb 6;22(1):14. doi: 10.1186/s12981-025-00710-2.

ABSTRACT

AIM: HIV remains one of the major epidemics and public health concerns within low and middle-income countries such as Tanzania. This study aimed to assess the prevalence and the factors associated with HIV testing-seeking behaviors among women of childbearing age in Tanzania.

METHODS: This study used the 2022 Tanzania Demographic and Health Survey dataset. The study utilized individual recodes (IR) files where data was collected using the Women’s Questionnaire to analyze factors influencing HIV testing behavior among women, Descriptive analysis, and bivariate and multivariate logistic regressions were performed and all the data were processed and analyzed using STATA version 17 at 95% CI and significance level P < 0.05.

RESULTS: This study included 2531 women with 90.0% having ever tested for HIV while 7.0% had never tested for HIV. Not employed [AOR:0.35, CI (0.20-0.61)] has lower odds of HIV testing than All-year employed status. Rural residents have reduced odds of HIV testing [AOR:0.43, CI (0.21-0.88)] compared to women living in urban areas. Those able to ask their partner to use a condom are more likely to have been tested with increased odds [AOR: 3.52, CI (2.31-5.37)]. Participants with a history of genital discharge [AOR:4.30, CI (1.28-14.46)] and those who don’t know their genital discharge history have [AOR: 0.20, CI (0.07-0.55)] are significant for HIV testing. Women who have heard about PrEP but are not uncertain about its approval [AOR: 36.07, CI (3.33-390.25)], respondents who have tested before with HIV testing kits [AOR:35.99, CI (4.00-324.13)] and women who are aware of HIV testing kids but never tested with them before [AOR: 2.80, CI (1.19-6.58)] are predictors of HIV testing seeking behaviors.

CONCLUSION: The government and other concerned agencies should introduce mobile or community-based testing units and subsidize testing costs to reach economically disadvantaged or rural populations. Promote Open Communication on Sexual Health: Public health campaigns should encourage open discussions about sexual health within relationships, emphasizing condom negotiation and mutual health checks as preventive measures. Raise Awareness and Accessibility of HIV Prevention Tools: Expand education on PrEP and HIV self-test kits to improve familiarity and acceptance, which may empower individuals to proactively seek testing. Integrate Sexual Health Screening into Routine Healthcare: Health facilities should incorporate HIV testing when individuals present with symptoms like genital discharge to improve early detection and intervention.

PMID:39915844 | DOI:10.1186/s12981-025-00710-2

Trials. 2025 Feb 6;26(1):42. doi: 10.1186/s13063-025-08759-0.

ABSTRACT

BACKGROUND: The TARGET Protein trial will evaluate the effect of greater enteral protein delivery (augmented protein) on clinical outcomes of critically ill adult patients when compared to usual care.

OBJECTIVE: To describe the statistical analysis plan for the TARGET Protein trial.

METHODS: TARGET Protein is a cluster randomized, cross-sectional, double cross-over, open-label, registry-embedded, pragmatic clinical trial conducted across Australia and New Zealand. The trial randomized eight intensive care units (ICU) to receive enteral formula containing either higher dose enteral protein (augmented protein) or usual dose protein in a 1:1 ratio. Each ICU received one trial formula for a 3-month period and then switched to the alternate formulae. This sequence was repeated, for a total trial length of 12 months. The primary outcome is the number of days free of the index hospital and alive at day 90. Secondary outcomes include proportion of patients alive at day 90, survivor-only analysis of days free of the index hospital at day 90, duration of invasive ventilation, ICU and hospital length of stay, incidence of tracheostomy insertion, renal replacement therapy, and discharge destination. The statistical methods and models which will be used to estimate the effects for the primary and secondary outcomes are described. All statistical models will account for the cluster-randomized cross-over design to ensure correct estimation of the 95% confidence intervals. Trial enrolment is complete with 3412 patients enrolled. Data linkage is ongoing.

CONCLUSION: This statistical analysis plan enables transparent reporting of the TARGET Protein trial. It will reduce the risk of potential selective reporting biases.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12621001484831). Registered on November 1, 2021.

PMID:39915843 | DOI:10.1186/s13063-025-08759-0

BMC Health Serv Res. 2025 Feb 6;25(1):214. doi: 10.1186/s12913-024-12164-9.

ABSTRACT

BACKGROUND: Individual psychosocial work characteristics have been associated with the health and well-being of registered nurses. However, it remains to be determined whether different types of psychosocial work characteristics form patterned profiles and whether the profiles are associated with registered nurses’ health and welfare at different stages of their careers. The purpose of this study was to identify latent psychosocial work characteristic profiles and examine whether the profiles are associated with a certain career stage and health outcomes.

METHODS: This cross-sectional study was conducted with 624 early-career registered nurses and 1,016 later-career registered nurses. Data were collected using an electronic survey with internationally validated measures including the Organizational Justice Scale, the Nurse Stress Index Scale, the Job Content Questionnaire, the Team Climate Inventory, the Psychological Distress Questionnaire, the Sleep Problems Questionnaire, and the Self-Rated Health Questionnaire. Latent profile analysis was conducted to identify subgroups with similar psychosocial work characteristic profiles. Multinomial and linear regression analyses were used to examine the association between latent work characteristics profiles, stage of career, and health outcomes.

RESULTS: We identified five profiles. The profiles were named based on class descriptions. The low strain/high support profile group and the moderate strain/high support profile group had statistically better self-rated health (p = < 0.001), less psychological distress (p = < 0.001) and less sleep problems (p = < 0.001) compared to the high strain/low support profile group.

CONCLUSIONS: Low to moderate strain, high interactional and procedural justice, and participative safety in teams form patterned profiles associated with better health in registered nurses. High strain, a lack of justice and a lack of participation safety form a risk combination pattern profile that may lead to health problems in registered nurses. Promoting procedural and interactional justice, and participation safety in teams seems efficient in enhancing the health and well-being of registered nurses. The findings indicate no significant correlation between career stages and work characteristic profiles. It is crucial to identify stressors specific for career stages and develop tailored interventions.

PMID:39915838 | DOI:10.1186/s12913-024-12164-9

Syst Rev. 2025 Feb 6;14(1):35. doi: 10.1186/s13643-025-02780-9.

NO ABSTRACT

PMID:39915835 | DOI:10.1186/s13643-025-02780-9

BMC Public Health. 2025 Feb 6;25(1):491. doi: 10.1186/s12889-024-21261-7.

ABSTRACT

BACKGROUND: Transgender, nonbinary, and gender diverse (TGD) people experience stigma in healthcare settings impacting healthcare utilization, including avoidance of care due to anticipated discrimination. Gender-affirming care refers to care for medical gender affirmation, such as gender-affirming hormones and surgery, as well as general care that affirms and respects TGD patients. This study sought to explore the experiences of TGD adults to inform gender-affirming care delivery and develop an actionable framework for practice.

METHODS: Between May-October 2021, one-time individual in-depth interviews were conducted with 27 TGD adults receiving any healthcare in the greater Boston Massachusetts area to gather data about gender-affirming care. Interviews were semi-structured, explored prior and current experiences in healthcare and ideal gender-affirming care models, and conducted virtually via a secure Zoom platform. Analyses were conducted using immersion crystallization and reflexive thematic analysis; interview transcripts were double coded by two coders.

RESULTS: Participants had a mean age of 28.5, ranging 18-45 years, and were: 7 transgender men, 6 transgender women, 8 nonbinary, 3 genderqueer, 1 agender, and 2 gender not specified. Themes about gender-affirming care coalesced into the acronym AFFIRM: (1) Affirms in individual interactions: Participants called for affirmation of TGD identity, lived expertise, and competent TGD providers and staff. (2) Flexible and accessible: Participants expressed the need for gender-affirming care to be available beyond urban population-specific clinics, in a timely fashion without long wait lists, and in a community-centered manner such as offering non-traditional times and settings. (3) Fights systemic oppression: Participants emphasized the need for providers and health systems to eliminate gatekeeping practices for gender-affirming care and create care models that resist intersecting oppressive systems such as racism and cisgenderism. (4) Interacts with community: Patients desired intentional interaction with TGD community to holistically address health and unmet gender affirmation needs. (5) Retains patients in care: Patients shared the need to collaboratively identify and problem-solve obstacles to gender-affirming care with providers and healthcare systems to optimize TGD-specific retention strategies. (6) Multidisciplinary: Patients called for interdisciplinary teams with co-located services such as primary care and mental healthcare with letter-writing for surgical care, and incorporation of peer navigators to meet the broader social, health, and well-being needs of TGD people.

CONCLUSIONS: Findings from this study and the AFFIRM Framework which emerged from TGD patient narratives can be applied to improve current care and set benchmarks for high-quality gender-affirming care delivery and practice.

PMID:39915834 | DOI:10.1186/s12889-024-21261-7

Cardiovasc Diabetol. 2025 Feb 6;24(1):55. doi: 10.1186/s12933-025-02610-1.

ABSTRACT

The stress hyperglycemia ratio (SHR) is an emerging biomarker used to assess blood glucose levels under acute stress conditions and has been linked to the incidence of adverse clinical outcomes. However, the precise role of SHR in patients with diabetic kidney disease (DKD) and chronic kidney disease (CKD), particularly in relation to mortality, remains poorly understood. This study seeks to investigate the clinical value of SHR as a predictive tool for all-cause and cardiovascular mortality in these patient groups. This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018, encompassing 3,507 individuals diagnosed with diabetic kidney disease (DKD) or chronic kidney disease (CKD). The primary endpoints included all-cause mortality and cardiovascular mortality, with mortality data obtained from the National Death Index (NDI) through December 31, 2019. Participants were categorized into quartiles based on the stress hyperglycemia ratio (SHR), and Cox proportional hazards regression models were employed to examine the association between SHR and mortality. Model 1 did not account for any covariates, Model 2 adjusted for age, sex, and race, while Model 3 additionally incorporated adjustments for educational attainment, marital status, body mass index, smoking behavior, hypertension, hyperlipidemia, and cardiovascular disease. The study comprised 3,507 patients with a mean age of 60.7 years, of whom 56% were female. The overall incidence of all-cause mortality was 38,000 per 100,000 person-years, while cardiovascular mortality was 11,405 per 100,000 person-years. Kaplan-Meier survival analysis revealed that the second quartile of the stress hyperglycemia ratio (SHR) (Q2) exhibited the lowest all-cause mortality (log-rank P = 0.003). Cox regression analysis indicated that the hazard ratio (HR) for all-cause mortality in Q2 was 0.76 (95% CI: 0.63, 0.92), whereas the HR for Q4 was 1.26 (95% CI: 1.04, 1.52). Restricted cubic spline (RCS) analysis revealed a J-shaped association between SHR and all-cause mortality, as well as a U-shaped association with cardiovascular mortality. The minimum risk values for SHR were 0.923 for all-cause mortality and 1.026 for cardiovascular mortality. In patients with diabetic kidney disease (DKD) and chronic kidney disease (CKD), SHR demonstrated a J-shaped relationship with all-cause mortality and a U-shaped relationship with cardiovascular mortality. Subgroup analyses indicated that the effect of spontaneous hypertension on mortality was consistent across all subgroups. This study highlights a significant association between the stress hyperglycemia ratio (SHR) and both all-cause and cardiovascular mortality in patients with diabetic kidney disease (DKD) or chronic kidney disease (CKD). SHR may serve as a critical biomarker for prognostic assessment in these populations, enabling clinicians to identify high-risk patients and tailor personalized treatment strategies that enhance patient quality of life and mitigate mortality risk.

PMID:39915833 | DOI:10.1186/s12933-025-02610-1