Category: Nevin Manimala

JMIR Form Res. 2025 Apr 10;9:e63928. doi: 10.2196/63928.

ABSTRACT

BACKGROUND: Gait speed indicates the onset or decline of physical performance in sarcopenia. However, real-time measurements of other gait parameters, such as step length, stride length, step width, and support time, are limited. The advent of wearable technology has facilitated the measurement of these parameters, necessitating further investigation into their potential applications.

OBJECTIVE: This study aimed to investigate the relationship between gait parameters measured using wearable sensors and muscle mass, strength, and physical performance in community-dwelling older adults.

METHODS: In a cross-sectional study of 91 participants aged ≥65 years, gait parameters, such as step count, step length, cadence, single and double support times, vertical oscillation, and instantaneous vertical loading rate (IVLR), measured using a wireless earbud device, were analyzed on the basis of the appendicular skeletal muscle mass index (SMI), calf circumference, handgrip strength, 5-time chair stand test, short physical performance battery (SPPB), and the SARC-F (strength, assistance with walking, rise from a chair, climb stairs and fall frequency) questionnaire. This study was conducted from July 10 to November 1, 2023, at an outpatient clinic of a university hospital in Seoul, Korea. Multiple regression analysis was performed to investigate independent associations after adjusting for age, sex, BMI, and comorbidities.

RESULTS: Among 91 participants (45 men and 46 women; mean age 74.1 years for men and 73.6 years for women), gait speed and vertical oscillation showed negative associations with their performance in the 5-time chair stand test (P<.001) and SARC-F and positive associations with their performance in the SPPB (P<.001). Vertical oscillations were also associated with grip strength (P=.003). Single and double support times were associated with performance in the 5-time chair stand test and SPPB (P<.001). In addition, double support time was associated with SARC-F scores (P<.001). Gait speed, support time, vertical oscillation, and IVLR showed independent associations with performance in the 5-time chair stand test and SPPB (P<.001), both related to muscle strength or physical performance. Gait speed, double support time, and vertical oscillation all had significant associations with SARC-F scores.

CONCLUSIONS: This study demonstrated a significant association between gait monitoring using wearable sensors and quantitative assessments of muscle strength and physical performance in older people. Furthermore, this study substantiated the extensive applicability of diverse gait parameters in predicting sarcopenia.

PMID:40209209 | DOI:10.2196/63928

JMIR Hum Factors. 2025 Apr 10;12:e69873. doi: 10.2196/69873.

ABSTRACT

BACKGROUND: Binge drinking, which is linked to various immediate and long-term negative outcomes, is highly prevalent among US college students. Behavioral interventions delivered via mobile phones have a strong potential to help decrease the hazardous effects of binge drinking by promoting safer drinking behaviors.

OBJECTIVE: This study aims to evaluate the preliminary efficacy of bhoos, a novel smartphone app designed to promote safer drinking behaviors among US college students. The app offers on-demand educational content about safer alcohol use, provides dynamic feedback as users log their alcohol consumption, and includes an interactive drink tracker that estimates blood alcohol content in real time.

METHODS: The bhoos app was tested in 2 independent pre-post studies each lasting 4 weeks, among US college students aged 18-35 years. The primary outcome in both trials was students’ self-reported confidence in using protective behavioral strategies related to drinking, with self-reported frequency of alcohol consumption over the past month examined as a secondary outcome.

RESULTS: In study 1, bhoos was associated with increased confidence in using protective behavioral strategies. Students also endorsed the high usability of the app and reported acceptable levels of engagement. Study 2 replicated findings of increased confidence in using protective behavioral strategies, and demonstrated a reduction in the self-reported frequency of alcohol consumption.

CONCLUSIONS: Bhoos is a personalized, accessible, and highly scalable digital intervention with a strong potential to effectively address alcohol-related behaviors on college campuses.

PMID:40209208 | DOI:10.2196/69873

JMIR Med Educ. 2025 Apr 10;11:e67244. doi: 10.2196/67244.

ABSTRACT

BACKGROUND: Recent advancements in artificial intelligence (AI), particularly in large language models (LLMs), have started a new era of innovation across various fields, with medicine at the forefront of this technological revolution. Many studies indicated that at the current level of development, LLMs can pass different board exams. However, the ability to answer specific subject-related questions requires validation.

OBJECTIVE: The objective of this study was to conduct a comprehensive analysis comparing the performance of advanced LLM chatbots-Claude (Anthropic), GPT-4 (OpenAI), Gemini (Google), and Copilot (Microsoft)-against the academic results of medical students in the medical biochemistry course.

METHODS: We used 200 USMLE (United States Medical Licensing Examination)-style multiple-choice questions (MCQs) selected from the course exam database. They encompassed various complexity levels and were distributed across 23 distinctive topics. The questions with tables and images were not included in the study. The results of 5 successive attempts by Claude 3.5 Sonnet, GPT-4-1106, Gemini 1.5 Flash, and Copilot to answer this questionnaire set were evaluated based on accuracy in August 2024. Statistica 13.5.0.17 (TIBCO Software Inc) was used to analyze the data’s basic statistics. Considering the binary nature of the data, the chi-square test was used to compare results among the different chatbots, with a statistical significance level of P<.05.

RESULTS: On average, the selected chatbots correctly answered 81.1% (SD 12.8%) of the questions, surpassing the students’ performance by 8.3% (P=.02). In this study, Claude showed the best performance in biochemistry MCQs, correctly answering 92.5% (185/200) of questions, followed by GPT-4 (170/200, 85%), Gemini (157/200, 78.5%), and Copilot (128/200, 64%). The chatbots demonstrated the best results in the following 4 topics: eicosanoids (mean 100%, SD 0%), bioenergetics and electron transport chain (mean 96.4%, SD 7.2%), hexose monophosphate pathway (mean 91.7%, SD 16.7%), and ketone bodies (mean 93.8%, SD 12.5%). The Pearson chi-square test indicated a statistically significant association between the answers of all 4 chatbots (P<.001 to P<.04).

CONCLUSIONS: Our study suggests that different AI models may have unique strengths in specific medical fields, which could be leveraged for targeted support in biochemistry courses. This performance highlights the potential of AI in medical education and assessment.

PMID:40209205 | DOI:10.2196/67244

JMIR Public Health Surveill. 2025 Apr 10;11:e68724. doi: 10.2196/68724.

ABSTRACT

BACKGROUND: Effective dissemination of federal risk communication by news media during multijurisdictional enteric illness outbreaks can increase message reach to rapidly contain outbreaks, limit adverse outcomes, and promote informed decision-making by the public. However, dissemination of risk communication from the federal government by mass media has not been evaluated.

OBJECTIVE: This study aimed to describe and assess the dissemination of federal risk communication by news media outlets during multijurisdictional enteric illness outbreaks in Canada.

METHODS: A comprehensive systematic search of 2 databases, Canadian Newsstream and Canadian Business & Current Affairs, was run using search terms related to the source of enteric illnesses, general outbreak characteristics, and relevant enteric pathogen names to retrieve news media articles issued between 2014 and 2023, corresponding to 46 public health notices (PHNs) communicating information about multijurisdictional enteric illness outbreaks during the same period. A codebook comprised of 3 sections-general characteristics of the article, consistency and accuracy of information presented between PHNs and news media articles, and presence of health belief model constructs-was developed and applied to the dataset. Data were tabulated and visualized using RStudio (Posit).

RESULTS: News media communicated about almost all PHNs (44/46, 96%). News media commonly developed their own articles (320/528, 60.6%) to notify the public about an outbreak and its associated product recall (121/320, 37.8%), but rarely communicated about the conclusion of an outbreak (12/320, 3.8%). News media communicated most outbreak characteristics, such as the number of cases (237/319, 74.3%), but the number of deaths was communicated less than half the time (114/260, 43.8%). Benefit and barrier constructs of the health belief model were infrequently present (50/243, 20.6% and 15/243, 6.2%, respectively).

CONCLUSIONS: Canadian news media disseminated information about most multijurisdictional enteric illness outbreaks. However, differences in coverage of multijurisdictional enteric illness outbreaks by news media were evident. Federal organizations can improve future risk communication of multijurisdictional enteric illness outbreaks by news media by maintaining and strengthening interorganizational connections and ensuring the information quality of PHNs as a key information source for news media.

PMID:40209203 | DOI:10.2196/68724

N Z Med J. 2025 Apr 11;138(1613):87-95. doi: 10.26635/6965.6842.

ABSTRACT

AIM: To update prescribers about the revised Land Transport (Drug Driving) Amendment Act 2022 (LTAA) and implications for prescribing.

METHODS: We reviewed the legislation of the LTAA and the specific drugs identified in it, mainly benzodiazepines and opioids. We also briefly reviewed published evidence on the impact of benzodiazepines and opioids on driving.

RESULTS: Both opioids and benzodiazepines are associated with increased accidents in observational (non-controlled) studies, though the odds ratios are small (at most 1.65 for benzodiazepines and around 2.0 for opioids), and accident events are rare. Prescribers are not advised to do blood levels or bedside testing to assess driving fitness. They should consult a peer group or mental health pharmacist when advising patients taking multiple psychoactive medications if they are safe to drive.

CONCLUSION: There are no current jurisprudence or guidelines for prescribers on how to interact with the LTAA. Nor is it clear if or how investigations or complaints relating to the LTAA would be handled by the Health and Disability Commissioner (HDC), the Medical Council of New Zealand and/or the Coroner. Until more detailed instructions are published, this article should provide some guidance for professionals who prescribe benzodiazepines or opioids.

PMID:40209198 | DOI:10.26635/6965.6842

N Z Med J. 2025 Apr 11;138(1613):79-86. doi: 10.26635/6965.6809.

ABSTRACT

BACKGROUND: Delayed ovarian torsion management can lead to unnecessary oophorectomy and halving of a woman’s fertility potential.

AIMS: To improve recognition and efficiency of ovarian torsion management at Waitematā by examining common presenting symptoms/signs and identifying areas of treatment delay.

METHODS: An audit of all ovarian torsion cases at Waitematā over 24 months (01/05/2022-30/04/2024).

RESULTS: Forty-five women had ovarian torsion, and 42 were premenopausal. Common presenting features included abdominal pain (100%), ovarian cysts (97.8%), nausea (82%) and vomiting (51%). Peritonism was rare (13.3%). Oophorectomy was performed in 26 cases (57.8%). Rates of oophorectomy increased with increasing time from symptom onset until presentation. The time from presentation until surgery (average of 28 hours) was longer than other tertiary centres, with delays largely arising from triage to ultrasound, and then while awaiting access to theatre.

CONCLUSIONS: Improving torsion recognition and expediting both imaging and surgery should reduce oophorectomy rates. Women presenting with symptomatic ovarian cysts without torsion should be adequately counselled on the risk of future torsion events and encouraged to seek acute medical attention for changes in symptoms. Additionally, more study is needed to determine if relying on computed tomography (CT) findings alone (e.g., presence of ovarian cysts more than 5cm) in the presence of symptoms suggestive of ovarian torsion can reduce time to diagnosis and improve surgical outcomes, compared to the commonly used CT followed by ultrasound.

PMID:40209197 | DOI:10.26635/6965.6809

N Z Med J. 2025 Apr 11;138(1613):50-66. doi: 10.26635/6965.6806.

ABSTRACT

AIM: The New Zealand population defined as “Pacific” is ethnically diverse, but this diversity is seldom examined in health research. This paper applies novel methods for describing health outcomes for specific Pacific populations in New Zealand using all-cancer and gastric cancer incidence and mortality as examples. Effects of loss to follow-up from leaving the country are also assessed.

METHOD: The New Zealand Cancer Registry was linked to administrative datasets and analysed within Stats NZ’s Integrated Data Infrastructure (IDI). All-cancer and gastric cancer incidence was examined over the 1995-2022 period, as well as 1-5-year mortality among 1998-2017 diagnoses.

RESULTS: There was variability in age-standardised all-cancer incidence and gastric cancer incidence for different Pacific groups. Less variation in mortality was identified between groups, and these rates increased only modestly when adjusting for those who left the country. Lower all-cancer mortality was observed in 2008-2017 compared with 1998-2007.

CONCLUSION: Variation in health outcomes among specific Pacific ethnicities is masked when examining Pacific peoples as an aggregated ethnic group. However, small counts among small ethnicities create challenges for producing detailed, reliable data when using the IDI.

PMID:40209195 | DOI:10.26635/6965.6806

Eur J Gen Pract. 2025 Dec;31(1):2485073. doi: 10.1080/13814788.2025.2485073. Epub 2025 Apr 10.

ABSTRACT

BACKGROUND: COVID-19 pandemic caused a significant impact on healthcare workers’ mental health and burnout, which continues after the pandemic.

OBJECTIVES: To assess the levels of burnout in general practitioners (GP) in Catalonia at three different times.

METHODS: Cross-sectional study involving members of the GPs’ Catalan Society (n = 4700). A self-administered survey was sent via institutional email in June-July 2021 (T1), in March-April 2022 (T2), and in May-June 2023 (T3). Probable burnout was assessed through Maslach Burnout Inventory (MBI) test, with three independent dimensions: emotional exhaustion, depersonalisation, and personal achievement. A descriptive analysis was performed, as well as a comparison between T1, T2, and T3 results.

RESULTS: 500 GPs responded in T1, 454 in T2, and 386 in T3. Samples were similar in demographic variables. Regarding burnout dimensions, the level of emotional exhaustion was 67.5% in T1, with a statistically significant decrease in T2 and T3 (56.4 and 58.1%, respectively, p = 0.001); levels of depersonalisation were 42.7% in T1, 37.0% in T2 and 36.7% in T3 (p = 0.091); levels of personal achievement were 29.9% in T1, 30.4% in T2 and 24.2% in T3 (p = 0.086). Starting at high levels of emotional exhaustion and depersonalisation, the prevalence decreased significantly over time in two groups: women and GPs who worked <10 years at the same workplace.

CONCLUSION: Catalan GPs experienced significant burnout during the COVID-19 pandemic with emotional exhaustion being particularly high. Although the prevalence of burnout decreased slightly over time, over half of the participants consistently reported high levels of emotional exhaustion.

PMID:40208687 | DOI:10.1080/13814788.2025.2485073

J Med Microbiol. 2025 Apr;74(4). doi: 10.1099/jmm.0.002000.

ABSTRACT

Introduction. Previous studies have shown vast differences in the skin and oral microbiomes of newborns based on delivery method [Caesarean section (C-section) vs vaginal]. Exposure to or absence of certain bacteria during delivery can impact the neonate’s future susceptibility to infections, allergies or autoimmunity by altering immune functions. Few studies have focused on the impact of maternal obesity on the variations of newborn skin and oral microbiomes. Obese pregnant women typically have a higher vaginal microbiome diversity, and their pregnancies are at higher risk for adverse outcomes and complications.Hypothesis. We hypothesized that the skin and oral microbiomes of newborns born to obese mothers would include more diverse, potentially pathogenic bacteria and that the skin and oral microbiome in C-section delivered newborns would be less diverse than vaginally delivered newborns.Aim. We aim to begin to establish maternal obesity and mode of delivery as factors contributing to increased risk for negative newborn outcomes through impacts on newborn bacterial dysbiosis.Methodology. A skin swab was collected immediately following delivery of 39 newborns from 13 healthy weight body mass index (BMI 18.50-24.99), 11 overweight (BMI 25.0-29.99) and 15 obese (BMI ≥30.00) pregnant participants. An oral swab was collected immediately following delivery for 38 of these newborns from 13 healthy weight, 10 overweight and 15 obese pregnant participants. Bacterial genera were identified via 16S rRNA amplicon sequencing.Results. The newborn skin microbiome was comprised of typical skin bacteria (i.e. Corynebacterium). Newborns of obese participants had a higher relative abundance of Peptoniphilus in their skin microbiome compared to newborns of healthy weight participants (P=0.007). Neonates born via C-section had a higher relative abundance of Ureaplasma in their oral microbiome compared to neonates delivered vaginally (P=0.046).Conclusion. We identified differences in the newborn skin and oral microbiomes based on pre-pregnancy BMI and method of delivery. These differences could be linked to an increased risk of allergies, autoimmune disease and infections. Future longitudinal studies will be crucial in determining the long-term impact of these specific genera on newborn outcomes. Understanding these connections could lead to targeted interventions that reduce the risk of adverse outcomes and improve overall health trajectory.

PMID:40208663 | DOI:10.1099/jmm.0.002000

J Perinat Neonatal Nurs. 2025 Apr 8. doi: 10.1097/JPN.0000000000000925. Online ahead of print.

ABSTRACT

BACKGROUND: Conventional surfactant administration via tracheal tube involves short periods of positive pressure ventilation, which carries the risk of lung injury. The aim of this study was to investigate the feasibility and potential benefits of the less invasive surfactant administration (LISA) method in premature infants compared to the usual intubation-surfactant-extubation (INSURE).

METHODS: This randomized clinical trial was performed in Yazd between 2021 and 2023. One hundred twenty neonates with RDS were included in the study. The INSURE group (n = 60) was injected with surfactant in the usual way inside the tracheal tube, and the LISA group was injected using nasal continuous positive airway pressure (CPAP) with a thin surfactant catheter.

RESULTS: Duration of need for respiratory support by nasal CPAP (nCPAP) and high-flow nasal cannula was significantly more in the LISA group (P value = .00). Primary and secondary outcomes during surfactant injection in 2 groups were not statistically significant.

CONCLUSION: In our study, there was no significant difference between the primary and secondary outcomes between LISA and INSURE groups. Therefore, more studies are needed in this field.

PMID:40208657 | DOI:10.1097/JPN.0000000000000925