Category: Nevin Manimala

J Gastroenterol Hepatol. 2026 May 29. doi: 10.1111/jgh.70459. Online ahead of print.

NO ABSTRACT

PMID:42216230 | DOI:10.1111/jgh.70459

Chiropr Man Therap. 2026 May 29. doi: 10.1186/s12998-026-00652-0. Online ahead of print.

ABSTRACT

BACKGROUND: Headache disorders are among the leading causes of disability globally. In primary care, including chiropractic practice, clinicians often serve as the first point of contact for patients seeking evaluation and management of headache. Despite this, limited evidence exists regarding how Danish chiropractors assess, diagnose, and manage headache in routine practice. This study aimed to examine how Danish chiropractors adopt a profession-specific clinical care standard, conduct clinical assessments, apply the ICHD-3 diagnostic criteria, and manage patients presenting with headache.

METHODS: A cross-sectional, questionnaire-based study was conducted between May 2022 and August 2022 among Danish chiropractors. The Danish Headache Questionnaire was used covering aspects such as diagnostic knowledge, clinical assessments and management. Descriptive statistics were used to characterise respondents and their clinical practices. A predefined threshold of ≥ 70% was applied to indicate acceptable adherence to the clinical care standard and sufficient familiarity with the ICHD-3 criteria.

RESULTS: A total of 100 chiropractors completed the questionnaire, corresponding to a response rate of 14.4%. Self-reported data indicated that a larger percentage of Danish chiropractors demonstrate adequate knowledge of and adhere well to the clinical care standard. However, a proportion of respondents reported modest familiarity with specific elements of the standard and knowledge of red flags was limited. Overall familiarity with, and use of, the ICHD-3 diagnostic criteria was high. Management approaches largely aligned with guideline-supported strategies, with most chiropractors reporting the use of manual therapy, exercise, and patient education. In contrast, structured monitoring tools – such as headache diaries – were seldom used.

CONCLUSION: Respondents generally appear to follow the profession-specific clinical care standard, demonstrate good familiarity with ICHD-3 criteria, and deliver guideline-aligned management for patients with headache. These findings suggest that chiropractors may play a meaningful role in primary-care headache management and potentially help reduce the burden on other health-care providers, although the low response rate warrants caution in generalising these findings. Identified gaps in knowledge and practice indicate a need for targeted postgraduate education, enhanced implementation strategies to support consistent use of clinical care standards and guidelines, and policy initiatives that facilitate the integration of chiropractors into interdisciplinary headache care pathways.

PMID:42216224 | DOI:10.1186/s12998-026-00652-0

Mol Neurodegener. 2026 May 29. doi: 10.1186/s13024-026-00952-2. Online ahead of print.

ABSTRACT

BACKGROUND: In the adult mammalian central nervous system (CNS), failure of axon regeneration limits recovery after traumatic injury or in neurodegenerative disease. Local protein translation has been implicated in the regulation of axon growth in highly compartmentalized neurons. 3′ untranslated regions (3’UTRs) of mRNAs play critical roles in RNA localization and modification. Here we studied the regulation of 3’UTRs in growth cone and axon regeneration.

METHODS: Using fluorescence recovery after photobleaching (FRAP), we examined dynamic changes of mRNA 3’UTRs-related local translation in distal growth cones of primary neurons, initially comparing 3’UTRs from Gap43, normally localized to axons, and gamma-actin (Actg1), normally distributed to soma and axon. Local translation patterns in response to trophic factors and depolarization stimuli were analyzed, with or without translation inhibitor anisomycin. Adeno-associated viral vectors were used to express constitutively active Src with specific 3’UTRs after optic nerve injury in vivo. Axon growth and Src signaling were detected to identify function of 3’UTRs in axon regeneration. Statistical analysis was performed using one-way ANOVA or Kruskal-Wallis test, two-tailed unpaired t-test or Mann-Whitney test for data sets with different distributions.

RESULTS: We discovered different 3’UTRs led to differences in local translational regulation in growth cones in vitro, including in response to relevant signals such as brain-derived neurotrophic factor (BDNF), forskolin, ciliary neurotrophic factor (CNTF), depolarization and repolarization. In vivo, we found that addition of 3’UTRs from Gap43 or Actg1 to a construct expressing constitutively active Src, which normally regulates growth cone and axon elongation, increased Src mRNA and protein localization, and Src activity measured by phospho-FAK in the optic nerve and optic tract, and the 3’UTR of Gap43 promoted more long-distance axon regeneration after optic nerve injury.

CONCLUSIONS: Together these data enhance our understanding of the complexity of 3’UTR-mediated regulation of local axon translation, and point to potential therapeutic avenues for growth cone-related protein expression and local translation via 3’UTR manipulation.

PMID:42216210 | DOI:10.1186/s13024-026-00952-2

Health Qual Life Outcomes. 2026 May 29. doi: 10.1186/s12955-026-02556-2. Online ahead of print.

ABSTRACT

BACKGROUND: Health-related quality of life (HRQoL) is a widely used indicator for assessing individuals’ subjective perception of life quality and population health status. It evaluates the multiple dimensions related to health, including physical, psychological, and social aspects, and may be associated with self-management behaviors and treatment adherence in patients with chronic diseases. This study examines the association between HRQoL and medication discrepancies (MDs) among older adults with type 2 diabetes mellitus (T2DM) during the transition from hospital to home care.

METHODS: The cross-sectional survey was conducted in Baoding City, Hebei Province, China. Data from patients (N = 552) were collected using a questionnaire that included the Chinese version of the MOS 36-Item Short Form Health Survey, a sinicized and modified version of the Medication Discrepancy Tool, and a general information form. Descriptive statistics, logistic regression models, and generalized additive models were employed to examine the associations between the variables.

RESULTS: The prevalence of MD in the study population was 55.8%. After adjustment for sociodemographic, clinical, and medication-related characteristics, both the Physical Component Summary and Mental Component Summary scores were significantly associated with MD. In the adjusted analyses, the medium-score group showed the highest odds of MD, followed by the high-score group, whereas the low-score group showed the lowest odds.

CONCLUSIONS: HRQoL is associated with MD among older adults with T2DM during the post-discharge care transition, with a non-monotonic pattern in which MD prevalence peaks in the moderate HRQoL range. Solely disease severity-based models may overlook the relevance of subjective health perceptions in relation to medication behaviors. These findings suggest that HRQoL warrants consideration in understanding medication safety during care transitions, though the conclusions await confirmation in prospective studies.

PMID:42216205 | DOI:10.1186/s12955-026-02556-2

Nutr Metab (Lond). 2026 May 29. doi: 10.1186/s12986-026-01143-y. Online ahead of print.

ABSTRACT

BACKGROUND: We investigated the serial mediating roles of insulin re-sistance (IR) and abdominal obesity in the association between the Dietary Inflamma-tory Index (DII) and hyperuricemia (HUA), and whether abdominal obesity moder-ated this pathway.

METHODS: We analyzed data from 8,232 adults in the National Health and Nutrition Examination Survey (2007-2016). The triglyceride-glucose (TyG) index served as a surrogate for IR. We employed serial mediation and moderated me-diation models.

RESULTS: Higher DII was associated with increased HUA risk. This re-lationship was serially mediated through the pathway: DII → TyG index → abdominal obesity → HUA. This indirect pathway accounted for 52.3% of the total effect, with abdominal obesity being the most potent mediator (contribution: 31.0%). Importantly, the mediating effect of the TyG index was significant only in individuals with a normal waist circumference (β = 0.0016, 95% CI: 0.0006, 0.0026) but was attenuated to non-significance in those with abdominal obesity.

CONCLUSION: Our findings suggest that IR and abdominal obesity may serially mediate the link between a pro-inflammatory diet and HUA. The me-diating role of IR appears to be prominent in individuals without abdominal obesity, whereas in those with obesity, obesity itself becomes the dominant factor. However, given the cross-sectional design, causal inferences cannot be drawn. These findings support developing stage-specific HUA prevention strategies, targeting insulin sensitivity or weight control based on an individual’s obesity status.

PMID:42216202 | DOI:10.1186/s12986-026-01143-y

Implement Sci Commun. 2026 May 29. doi: 10.1186/s43058-026-00967-2. Online ahead of print.

ABSTRACT

BACKGROUND: Rigorous development and evaluation of implementation outcome measures is needed to advance the field of implementation science. The Acceptability of Intervention Measure (AIM), Feasibility of Intervention Measure (FIM), and the Intervention Appropriateness Measure (IAM) are commonly used, psychometrically validated measures. The objective of the current analysis was to analyze use of the AIM, FIM, and IAM in a single-center pediatric intensive care (PICU) unit study.

METHODS: This was a secondary analysis of a mixed-methods interventional study. The initial project studied development of a novel cardiac arrest ventilation rate metronome to improve adherence to guideline-recommended ventilation rates during CPR; study components included contextual inquiry, participatory intervention design, and simulation usability testing. Using a purposive sampling strategy for pre-implementation contextual inquiry, eligible participants included multidisciplinary PICU clinicians. The pre-implementation questionnaire asked about current cardiac arrest ventilation practices and perceived acceptability, appropriateness, and feasibility of our proposed intervention (AIM, FIM, and IAM). Five-point scale Likert data were summarized using descriptive statistics (medians and interquartile ranges). A score of > 3 was considered favorable.

RESULTS: Of 133 started instances of the pre-implementation survey, 107 were completed (80.5%). The response rate was 30.6% (107/350). Respondents included 34 nurses (31.8%), 18 respiratory therapists (16.8%), and 55 ordering providers (physicians and nurse practitioners; 51.4%). Most respondents (79/107; 73.8%) had previously participated in > 10 PICU cardiac arrests. Appropriateness, acceptability, and feasibility of the ventilation metronome were favorable (appropriateness median: 4 [IQR 4,5]; acceptability median: 4 [IQR 3,5]; feasibility median: 4 [IQR 4,4.5]). For each AIM, IAM, and FIM statement, ≥24.3% of all responses were the highest value on the 5-point scale. Of the 19.5% of survey instances with only partial responses, all but one (26/27; 96.3%) were stopped at the AIM, IAM, FIM matrix of statements.

CONCLUSIONS: In this single-center PICU study utilizing the previously validated Acceptability of Intervention Measure, Feasibility of Intervention Measure, and Intervention Appropriateness Measure, there were several challenges associated with the use of these scales, including (1) survey responses that were terminated at the portion of the questionnaire presenting the AIM, IAM, and FIM and (2) ceiling effect.

PMID:42216201 | DOI:10.1186/s43058-026-00967-2

Reprod Health. 2026 May 29. doi: 10.1186/s12978-026-02367-0. Online ahead of print.

ABSTRACT

BACKGROUND: Short birth interval (SBI) is a major public health concern, associated with adverse outcomes such as preterm birth, low birth weight, and maternal depletion. Identifying its influential predictors is essential for improving family planning and maternal health interventions. The study aimed to predict SBI and identify its influential predictors using stacked machine learning and SHAP explainability.

METHODS: This study used data, obtained from the Bangladesh Demographic and Health Survey (BDHS), 2022. The dataset comprised 11,872 respondents, of whom 2,137 experienced SBI (18.0%). Class imbalance problem was addressed by applying class weighting during model training. Boruta and least absolute shrinkage and selection operator-based methods were applied to identify the most important predictors of SBI. Subsequently, multiple machine learning models (including logistic regression, random forest, extreme gradient boosting, categorical boosting, artificial neural network, and stacking ensemble) were used to predict SBI and evaluated their model performances using accuracy, precision, sensitivity, F1-score, and the area under the curve (AUC). Finally, SHAP explainability were employed to identify the most influential predictors of SBI.

RESULTS: The stacking ensemble model achieved the highest predictive performance compared to the individual models, with an accuracy of 65.8%, precision of 42.6%, sensitivity of 72.3%, F1-score of 53.6%, and modest AUC of approximately 0.667. The SHAP analysis showed that no educated respondents, higher parity, and do not intend to use contraceptive method were the most influential predictors of SBI.

CONCLUSION: Interventions could therefore focus on improving female education, expanding access to contraceptives, and promoting awareness of optimal birth spacing. Policymakers may incorporate SHAP explainability to support data-driven reproductive health strategies to reduce SBI in Bangladesh.

PMID:42216193 | DOI:10.1186/s12978-026-02367-0

BMC Public Health. 2026 May 29. doi: 10.1186/s12889-026-27966-1. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic HBV infection remains a global health priority, contributing to over 800,000 annual deaths. In sub-Saharan Africa, high endemicity persists despite the availability of preventive vaccines. This study assessed the HBsAg seroprevalence and identified independent socio-demographic and clinical correlates among pregnant women in the Jirapa Municipality, providing the evidence base required for targeted maternal-child health interventions in the UWR of Ghana.

METHODS: A facility-based cross-sectional study was conducted among 235 pregnant women in the Jirapa Municipality using a mixed purposive-consecutive sampling approach. HBV infection status was determined via prospective data abstraction of laboratory-confirmed HBsAg rapid diagnostic test results. Firth’s penalized logistic regression was employed to minimize small-sample bias and ensure parameter stability. Model performance was validated through sensitivity analyses comparing penalized likelihood with complementary log-log regression. Final model selection was guided by Akaike (AIC) and Bayesian (BIC) Information Criteria, with specification verified via the link test. All analyses were performed in Stata 16.0, with significance set at p < 0.05.

RESULTS: The clinical prevalence of HBsAg seropositivity among the sampled population was 10.6% (95% CI: 7.0-15.3%), categorizing the Jirapa Municipality as a region of high HBV endemicity per WHO criteria. Bivariate analysis identified maternal age, marital status, number of co-wives, parity, religion, prior blood transfusion, hospital admission, gestational age, and ANC visit frequency as significant correlates (p < 0.05). However, in model 2, only the number of co-wives remained a persistent independent correlate. Specifically, having exactly one co-wife was associated with significantly lower odds of HBV infection compared to other marital structures (AOR = 0.05; 95% CI: 0.00-0.72; p = 0.027). Other socio-demographic and clinical factors did not retain statistical significance after adjustment for confounding variables.

CONCLUSION: The 10.6% HBsAg prevalence documented in the study classifies Jirapa Municipality as a high-endemicity cluster. The independent association between HBV infection and spousal marital structure suggests antenatal care should serve as a gateway for family-centered interventions. The study recommends adopting a “Triple-Linkage” model integrating universal screening, reflex HBeAg risk stratification, and partner-inclusive counseling. Transitioning to this proactive care continuum is essential to strengthen the clinical infrastructure required to mitigate the regional burden of chronic hepatitis B.

PMID:42216187 | DOI:10.1186/s12889-026-27966-1

BMC Health Serv Res. 2026 May 29;26(1):771. doi: 10.1186/s12913-026-14795-6.

ABSTRACT

BACKGROUND: Patient satisfaction is an important indicator of healthcare quality. However, time constraints in primary care limit effective communication and history-taking. Digital medical history systems have the potential to improve the quality of medical consultations by enabling patient preparation and providing physicians with comprehensive pre-consultation information. This study aimed to evaluate the impact of a novel medical history-taking app (DASI app) on patient satisfaction in out-of-hours practices (OOHP) in Germany.

METHODS: We conducted a two-center, cluster-randomized trial over 12 months. Within each practice, weeks were randomized to either an intervention or control group, resulting in a cluster-randomized trial (CRT) with clustering in weeks within the same practice. Patients either used the DASI app before consultations (intervention group) or received standard care (control group). The DASI app is a patient-facing tool that guides patients through a dynamic questionnaire adapted to the selected complaints and previous answers. Patient satisfaction was measured using 17 items from the EUROPEP instrument covering relation and communication, medical care, and information and support. Additionally, we collected sociodemographic data. Statistical analyses included Mann-Whitney U tests for individual items and t-tests for domain scores. Analyses were performed with R, version 4.5.2.

RESULTS: Among 1,460 approached patients, 1,040 (71%) were enrolled and 1,034 included in analyses. Patient median age was 31 years, with 60% female participants. Patients in the intervention group (n = 496) showed significantly better ratings in 12 of 17 EUROPEP items compared to controls (n = 538) and demonstrated significantly higher satisfaction across all three EUROPEP domains. Between 78 and 96% of patients rated care as excellent or very good, with intervention group patients more likely to select top-level evaluations in 9 of 17 items.

CONCLUSIONS: Digital medical history taking significantly enhanced patient satisfaction in urgent care settings. The app likely improved satisfaction through multiple pathways including increased patient empowerment, better consultation preparation, and more efficient physician-patient interactions. These findings demonstrate that user-friendly digital tools can meaningfully enhance patient experience without disrupting existing workflows, supporting healthcare digitalization efforts while maintaining high-quality patient-centered care.

TRAIL REGISTRATION: German register for clinical trials (DRKS00026659; date of registration: 2021-11-03).

PMID:42216184 | DOI:10.1186/s12913-026-14795-6

BMC Med Inform Decis Mak. 2026 May 29. doi: 10.1186/s12911-026-03597-9. Online ahead of print.

ABSTRACT

The aim of this study was to assess the level of user satisfaction with an electronic medical record system (OpenClinic) among healthcare service providers in a hospital setting and its implication on their performance. The study was conducted at the “Centre Hospitalier Universtaire de Kigali”, which has been implementing OpenClinic as an Electronic Medical Record system since 2007. The study was a cross-sectional mixed research using explanatory embedded design. The data was collected on a convenient sample of 217 OpenClinic users through the questionnaires including closed and open ended questions in order to capture both quantitative and qualitative data. The study used the descriptive and inferential statistical tests for analysis for quantitative data, and content analysis for qualitative data. The OpenClinic user satisfaction was found to be high (91%) as well as the proportion of users who perceived it as having positive impact on their performance (94%). The relationship between user satisfaction and perceived impact was statistically significant (p < 0.001), and satisfied users were 20 times more likely to perceive it having positive impact than non-satisfied users (Fisher’s odds ratio = 20.5 [CI: 5.3, 85.1], Wald’s odds ratio = 21.2 [CI: 6.3, 71.1]. Important concerns were expressed by users and the main ones are the poor functionality of the system due to unstable internet, the limited capacity of use and the scarcity of computers. Therefore, the Electronic Medical Record system implementation at the hospital has been successful and its user satisfaction led to perceived positive impact, but it needs further improvements for optimal success.

PMID:42216182 | DOI:10.1186/s12911-026-03597-9