Category: Nevin Manimala

PLoS One. 2025 Aug 5;20(8):e0326745. doi: 10.1371/journal.pone.0326745. eCollection 2025.

ABSTRACT

INTRODUCTION: The integrated care model considers sequences of kidney replacement therapies rather than individual modalities. Data from conventional registries describing trajectories are partial. The aim was to provide a complete description of the peritoneal dialysis pathway.

METHODS: Patients undergoing peritoneal dialysis in France between January 1, 2009, and December 31, 2019, were included. Data from the national REIN (Renal Epidemiology and Information Network) registry and the SNDS (Administrative Database of Outpatient and Inpatient Care Consumption) database were used. Patient trajectories and status (peritoneal dialysis, hemodialysis, mixed and hybrid dialysis, kidney transplantation, and death) were reconstructed. Each dialysis session, even a single day, was recorded. The trajectory was described using a Sankey diagram.

RESULTS: A total of 5,053 patients in the REIN registry and the SNDS database underwent peritoneal dialysis at some point. The Sankey diagram showed the great diversity and complexity of care pathways. Only 1,652 (33%) of patients underwent peritoneal dialysis only. A total of 1,807 (36%) patients changed kidney replacement therapy 2 times or more. There was high permeability between peritoneal dialysis and hemodialysis: 1,358 (27%) patients transferred from hemodialysis to peritoneal dialysis and 2,018 (40%) transferred from peritoneal dialysis to hemodialysis. A total of 251 (5%) patients underwent hybrid dialysis. A total of 498 (10%) patients experienced an unstable period of mixed dialysis and managed to return to peritoneal dialysis for a significant time (median of 339 days). The causes of transfers were not available.

CONCLUSION: Our results describe a more precise view of the trajectories of peritoneal dialysis patients compared to data from conventional registries. Peritoneal dialysis is a component of a multimodal pathway, as two thirds are likely to receive another kidney replacement therapies. Ongoing information about other kidney replacement therapies regimens seems necessary for peritoneal dialysis patients. The organization of each dialysis center must integrate and facilitate these transfers.

PMID:40763188 | DOI:10.1371/journal.pone.0326745

PLoS One. 2025 Aug 5;20(8):e0329761. doi: 10.1371/journal.pone.0329761. eCollection 2025.

ABSTRACT

In recent years, public perceptions of patient safety have evolved significantly, driven by media coverage, healthcare reforms, and greater awareness during the coronavirus disease 2019 (COVID-19) pandemic. The present study aimed to examine trends in public perceptions of patient safety, knowledge and self-efficacy in Germany during this pandemic between 2019 and 2023. A repeated cross-sectional study was conducted, using data from TK Monitor of Patient Safety. TK Monitor of Patient Safety in a nationwide survey assessing public perceptions of safety in medical treatment and diagnosis. Self-reported data were collected annually from a randomly selected sample of 1,000 different adults aged 18 and older residing in Germany. Statistical analyses included descriptive statistics, chi-square tests, and linear regressions for trend analyses. Our results revealed high perceived patient safety risk during the years of the study. Up to one third of respondents considered it very likely or somewhat likely that patients would be harmed when receiving medical treatment in hospital or ambulatory care, with lower perceived levels of risk before the COVID-19 pandemic. Regarding perceived prevalence of preventable adverse events, over half of respondents considered it very likely or somewhat likely that an illness of theirs would be diagnosed incorrectly, or that they would contract a nosocomial infection, at some stage in their lives. The majority of respondents considered themselves overall well informed about patient safety and reported higher levels of self-efficacy with regard to error prevention before and after the pandemic than during it. Given the facts that patient safety remains an important issue and that the German public perceives the level of patient safety risk but also of patient safety knowledge, and self-efficacy as high, actively involving patients in safety initiatives is essential for shaping positive public perception.

PMID:40763169 | DOI:10.1371/journal.pone.0329761

PLoS One. 2025 Aug 5;20(8):e0329151. doi: 10.1371/journal.pone.0329151. eCollection 2025.

ABSTRACT

Consumer food waste remains a significant concern in the United States, where approximately 40% of food goes uneaten, leading to major economic and environmental consequences. Packaging plays a key role in food preservation and consumer decision-making, yet little research has examined how specific packaging features, such as transparency, influence consumer waste behaviors. To explore this, we conducted a three-week framed field experiment involving approximately 200 university students, focusing on deli meat-a perishable item commonly wasted in U.S. households. In this study, students were recruited to purchase pre-packaged deli meat from the research team. To simulate opaque packaging conditions, we applied white duct tape externally to otherwise transparent packages. Participants picked up their food on a self-selected date and consumed it over time. They were instructed to return any food scraps between one and three weeks later, based on when they personally deemed the food unappealing. Food scraps were measured to examine the link between packaging transparency and food waste. Observed patterns suggest that transparency may exert two contrasting influences on consumer behavior. On one hand, transparency may foster a greater sense of perceived control by providing visual cues that enhance consumers’ confidence in monitoring food quality and planning consumption, potentially leading to reduced waste. On the other hand, transparency may lead to overconfidence, reducing consumers’ vigilance in checking food quality. This illusion of ongoing freshness could decrease the frequency of quality checks and delay initial inspections, ultimately increasing the risk of spoilage and waste. While the results did not reach statistical significance, they consistently revealed directional trends, supporting an exploratory interpretation of the behavioral mechanisms involved. Although these findings are exploratory, they offer valuable insights into how packaging transparency may paradoxically shape consumer behaviors, emphasizing the importance of tailoring packaging strategies to mitigate food waste.

PMID:40763167 | DOI:10.1371/journal.pone.0329151

JMIR Res Protoc. 2025 Aug 5;14:e65829. doi: 10.2196/65829.

ABSTRACT

BACKGROUND: Poststroke spasticity (PSS) is a frequent sequela in patients who have experienced stroke. This form of paralysis is more prevalent compared to other poststroke sequelae and is among the most challenging and complex symptoms to manage. Surface electromyography (sEMG) can reflect the physiological information of muscles in real time and is highly beneficial in diagnosing neuromuscular diseases in clinical medicine.

OBJECTIVE: This study aimed to investigate the timing of poststroke limb spasms using a nested case-control study combined with sEMG and to identify and predict factors of PSS at an early stage.

METHODS: This was a nested case-control study. Participants were assessed within 24 hours of the onset of hospitalization using a standardized case report form to evaluate general patient information and clinical data related to cerebral infarction and imaging. Upon inclusion, patients were assessed after 1, 2, 4, 8, and 12 weeks, using the Modified Ashworth Scale (MAS) for spasticity severity, root mean square values from sEMG for limb spasm severity, and the simplified Fugl-Meyer (S-FM) Assessment for limb motor function. Patients who experienced spasticity within 12 weeks were assigned to the spasticity group, whereas those who did not experience spasticity were assigned to the control group. Unmatched case grouping was implemented. Data with normal distribution were analyzed using the t test, while data with nonnormal distribution were analyzed using the rank-sum test; categorical data were analyzed using the chi-square test, rank-sum test, or Fisher exact test. Logistic regression analysis was used to investigate factors affecting treatment outcomes. Data processing, analysis, and visualization were conducted using Statistical Package for the Social Sciences software (version 26.0; IBM Corp).

RESULTS: This study is funded by the Chinese Association of Ethnic Medicine and began participant recruitment and registration in November 2023. The study is currently ongoing, with 66 participants enrolled as of March 2025.

CONCLUSIONS: This study selected a diagnostic method combining sEMG and subjective scales to determine PSS, aiming to eliminate diagnostic errors caused by subjective assessments. This study adopted a nested case-control study method, which has minimal information bias, allowing for the inference of causal relationships between exposure and disease.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2300077121; https://www.chictr.org.cn/showproj.html?proj=205037.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/65829.

PMID:40762971 | DOI:10.2196/65829

Infect Dis Ther. 2025 Aug 5. doi: 10.1007/s40121-025-01201-7. Online ahead of print.

ABSTRACT

INTRODUCTION: Chemsex, the intentional use of drugs to enhance sexual experiences among gay, bisexual, and other men who have sex with men (gbMSM), is linked to high-risk sexual behaviours and increased sexually transmitted infections (STIs). Data on its long-term evolution after implementing specific strategies in HIV settings are limited. We evaluated the incidence of drug use, sexual behaviour, STIs, and vulnerabilities over 3 years following a specific approach at the HIV Unit of Hospital Clinic in Barcelona, Spain.

METHODS: We included 209 gbMSM living with HIV who engaged in chemsex in a prospective cohort (2018-2022). Quarterly visits assessed sexual behaviours, drug use, and STIs screening. Data were collected via self-administered questionnaires, medical records, and microbiological tests. Statistical analyses included descriptive statistics and Poisson regression models.

RESULTS: Chemsex incidence decreased significantly (IRR 0.88, 95% CI 0.83-0.92, p < 0.001). People engaging in intravenous drug use (slamming) decreased in year 2 (IRR 0.71, 95% CI 0.52-0.98, p = 0.037) but rose non-significantly in year 3 (IRR 0.86, 95% CI 0.60-1.25, p = 0.434). High-risk sexual behaviours persisted, specifically unprotected anal sex (IRR 1.02, 95% CI 0.96-1.08, p = 0.481) and unprotected fisting (IRR 1.20, 95% CI 1.05-1.39, p = 0.010). Syphilis cases declined (IRR 0.40, 95% CI 0.26-0.60, p < 0.001). At baseline, 29% had HCV antibodies, with five new acute HCV cases. Concerns about chemsex decreased (IRR 0.52, 95% CI 0.43-0.63, p < 0.001), whereas the demand for sexuality-related assistance increased (IRR 1.53, 95% CI 1.20-1.94, p = 0.004). Loss to follow-up (21%) was greater among younger individuals, people engaging in intravenous drug use (slamming) (IRR 2.43 95% CI 1.33-4.42, p = 0.004), detectable HIV viral load (IRR 3.01, 95% CI 1.57-5.76, p = 0.001), and greater need for help (IRR 1.35, 95% CI 1.03-1.78, p = 0.03). Migrants and sex workers had higher rates of syphilis, lower education levels, and increased prevalence of STIs.

CONCLUSION: Chemsex incidence and syphilis rates declined, but persistent high-risk behaviours, subgroup vulnerabilities, and increasing demand for sexuality-related assistance require targeted interventions and comprehensive support.

PMID:40762951 | DOI:10.1007/s40121-025-01201-7

Ir J Med Sci. 2025 Aug 5. doi: 10.1007/s11845-025-04028-w. Online ahead of print.

ABSTRACT

AIM: The aim of the study is to evaluate the effects of a nursing intervention program on appropriate internet use, loneliness, and family harmony in adolescents who are problematic internet users.

METHODS: The first phase of this study, which was conducted with a sample of 490 people in a population of 1010 people, was a descriptive study, and the second phase was a randomized controlled experimental study. The second phase of the study was conducted with 74 adolescents who were divided into control and intervention groups among 93 adolescents identified as problematic internet addicts.

RESULTS: The rate of adolescents with problematic internet use was determined to be 18.98%. When the mean scores obtained from the scales applied in the study were compared, it was determined that the difference between the pre-test and post-test mean scores of the adolescents in the intervention group was statistically significant.

CONCLUSION: In the light of these results, it was shown that the nursing intervention program applied in the study positively affected family harmony and reduced internet addiction and loneliness in adolescents with problematic internet use.

PMID:40762937 | DOI:10.1007/s11845-025-04028-w

Ir J Med Sci. 2025 Aug 5. doi: 10.1007/s11845-025-04045-9. Online ahead of print.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by peripheral insulin resistance and impaired insulin secretion. It is prevalent worldwide including in Turkey and is a major contributor to metabolic and inflammatory complications. Macrophage Scavenger Receptor 1 (MSR1), a class A scavenger receptor (SR-A1), is primarily expressed in macrophages and plays a significant role in the immune response. MSR1 has been implicated in the pathogenesis of metabolic diseases, yet its precise role in glucose metabolism remains unclear, despite reports suggesting a correlation between its transcript levels and insulin sensitivity.

AIMS: This study aimed to evaluate the association between serum MSR1 levels and insulin resistance in patients with T2DM and to investigate its potential as a therapeutic target.

METHODS: The study included 40 patients with T2DM and 40 healthy volunteers. Blood samples were collected and sera were separated by centrifugation and stored at -80 °C. MSR1 serum levels were measured using a commercial ELISA kit (NE010338901) and absorbance was read at 450 nm. Statistical analysis was performed using IBM SPSS Statistics 21.

RESULTS: MSR1 levels were higher in the diabetic group than in controls; however, the difference was not statistically significant (p = 0.897).

CONCLUSIONS: The findings suggest a potential association between MSR1 and T2DM. Although the difference was not statistically significant, the observed trend supports the need for further studies with larger sample sizes to clarify the potential role and clinical relevance of MSR1 as a biomarker or therapeutic target.

PMID:40762936 | DOI:10.1007/s11845-025-04045-9

J Gastrointest Cancer. 2025 Aug 5;56(1):168. doi: 10.1007/s12029-025-01295-9.

ABSTRACT

PURPOSE: Gastric malignancies remain a significant public health concern and a major contributor to cancer-related mortality worldwide. This study aimed to analyze trends and disparities in gastric malignancy mortality across socio-demographic and regional factors in the United States (US) from 1999 to 2020.

METHODS: A retrospective analysis was conducted using CDC WONDER data from 1999 to 2020 for adults aged ≥ 25 years. Data on demographics (age, sex, race/ethnicity), urban-rural classification, and regional trends were extracted. Age-adjusted mortality rates (AAMR) were calculated using the 2000 U.S. population as a reference, with trends analyzed using Joinpoint regression to determine annual percentage changes (APC) with statistical significance (P < 0.05).

RESULTS: Between 1999 and 2020, 276,023 deaths due to gastric malignancies were recorded, with 59.3% occurring among males. The AAMR declined from 7.94 in 1999 to 4.66 in 2020, with an overall AAMR of 5.82. The 65 + age group had the highest AAMR (20.83), while the 25-44 age group had the lowest (0.74). Males consistently reported higher AAMRs (7.60) than females (4.85). NH Black individuals had the highest overall AAMR (10.82), while NH White individuals had the lowest (4.62). Urban areas had higher AAMRs (5.95) than rural areas (5.07).

CONCLUSION: Mortality from gastric malignancies has declined in the U.S. from 1999 to 2020; however, higher mortality rates in NH Black individuals, males, and urban dwellers highlight the need for targeted interventions and equitable access to prevention and treatment resources. Future research should focus on identifying actionable solutions to mitigate these gaps.

PMID:40762926 | DOI:10.1007/s12029-025-01295-9

JAMA Netw Open. 2025 Aug 1;8(8):e2525165. doi: 10.1001/jamanetworkopen.2025.25165.

ABSTRACT

IMPORTANCE: Despite the rising prevalence of bulimia nervosa and the associated risks of chronicity and severe physical and psychological morbidity, access to effective treatment remains poor. The effectiveness and acceptability of internet-based cognitive behavior therapy (ICBT) for women with bulimia nervosa in clinical settings in East Asia remain unclear.

OBJECTIVE: To determine the effectiveness and acceptability of a guided ICBT program to treat women with bulimia nervosa in Japan.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted at 7 university hospitals in Japan between August 2022 and October 2024. This study enrolled female participants aged 13 to 65 years whose symptoms met the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for bulimia nervosa, had a body mass index (BMI) of 17.5 or greater, had internet access, and had no history of practicing CBT-related techniques within the past 2 years.

INTERVENTIONS: Both the control and intervention groups received usual care. The intervention consisted of ICBT with additional guidance from a therapist. The therapy program was tailored to Japanese culture and grounded in a specific cognitive behavior model, and it was performed over a 12-week period.

MAIN OUTCOMES AND MEASURES: Severity of bulimia nervosa, measured by the weekly combined frequency of episodes involving binge eating and compensatory behaviors, was assessed by a blinded, independent rating team at baseline and at the 12-week intervention end point. Intention-to-treat analyses were conducted using a linear mixed model with effect sizes calculated using Cohen d.

RESULTS: A total of 61 women met the eligibility criteria and were randomized to the intervention group (n = 31) or the control group (n = 30). Participants were predominantly young (mean [SD] age, 27.8 [9.0] years), had normal weight (mean [SD] BMI, 21.1 [3.6]), and had a mean (SD) duration of illness of 9.3 (8.8) years; half (31 [50.8%]) were employed. Intent-to-treat analysis revealed that guided ICBT significantly reduced the weekly combined frequency of episodes involving binge eating and compensatory behaviors (by an adjusted mean difference of 9.84 episodes [95% CI, 2.49-17.18 episodes], P = .01; Cohen d = 0.73 [95% CI, 0.21-1.26]). Sensitivity analyses supported these findings.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, the intervention group experienced a significant decrease in bulimia symptoms compared with the control group, supporting the effectiveness and acceptability of the therapist-guided ICBT program. These findings suggest that integration of therapist-guided ICBT in usual care has the potential to improve accessibility to efficacious treatment options for women with bulimia nervosa.

TRIAL REGISTRATION: UMIN Clinical Trials Registry Identifier: UMIN00048732.

PMID:40762916 | DOI:10.1001/jamanetworkopen.2025.25165

JAMA Netw Open. 2025 Aug 1;8(8):e2525216. doi: 10.1001/jamanetworkopen.2025.25216.

ABSTRACT

IMPORTANCE: Women with dense breasts have elevated risk of false-negative mammograms and may benefit from supplemental screening.

OBJECTIVE: To assess potential outcomes of Pennsylvania’s law mandating insurance coverage for supplemental breast cancer screening among Black and White women.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included Black and White women, aged 40 to 74 years, without prior breast cancer or known BRCA1/2 variants who underwent mammography screening at a large urban academic health system from January 2015 to December 2021, with cancer outcomes ascertained through December 2022. Data analysis was conducted from June 2023 to April 2025.

EXPOSURES: Dense breasts; the law mandates insurance coverage for women with extremely dense breasts or those with heterogeneously dense breasts plus a greater than 20% lifetime breast cancer risk by risk models.

MAIN OUTCOMES AND MEASURES: The main outcomes were odds of eligibility for supplemental coverage and of a false-negative mammogram.

RESULTS: A total of 68 478 women (38 397 Black women [median (IQR) age, 57 (49-64) years] and 30 081 White women [median (IQR) age, 58 (49-65) years]) were used for the analysis. Fewer Black women had extremely dense breasts (561 [2.1%] vs 1464 [5.8%]; P = .02) and greater than 20% lifetime risk of breast cancer identified (257 [0.7%] vs 1905 [6.4%]; P = .04) compared with White women. Consequently, Black women were less likely to meet the eligibility criteria for supplemental screening (523 [1.6%] vs 2081 [8.4%]; P = .02). The criteria showed lower sensitivity but higher specificity for detecting false-negative mammograms in Black compared with White women in one round of screening. Using heterogeneously or extremely dense breasts alone would detect more false negatives but with significantly more women recommended for magnetic resonance imaging.

CONCLUSIONS AND RELEVANCE: In this study of 68 478 screening mammograms among Black and White women from 2015 to 2021, retrospectively applying criteria for supplemental screening based on heterogeneously or extremely dense breast density and lifetime risk had limited ability to identify women at risk for a false-negative mammogram. Given lower density and lifetime risk estimates, few Black women met criteria for insurance coverage in Pennsylvania, and the criteria had poor sensitivity for identifying Black women with false-negative mammograms. Additionally, using the current breast density criteria for magnetic resonance imaging may not accurately reflect breast cancer risk in Black women.

PMID:40762915 | DOI:10.1001/jamanetworkopen.2025.25216