Category: Nevin Manimala

BMC Med Educ. 2025 Jan 29;25(1):148. doi: 10.1186/s12909-025-06755-1.

ABSTRACT

BACKGROUND: Research shows that trauma team formation could potentially improve effectiveness of injury care in rural settings. The aim of this study was to determine the feasibility of rural trauma team training amongst medical trainees and traffic law enforcement professionals in Uganda.

METHODS: Prospective multi-centre interrupted time series analysis of an interventional training based on the 4th edition of rural trauma team development course of the American College of Surgeons. Trauma related multiple choice questions (MCQs), and trauma non-technical skills were assessed pre-and post-training between September 2019- August 2023. Acceptability of the training for promulgation to other rural regions and its relevance to participants’ work needs were evaluated on 5- and 3-point Likert scales respectively. The median MCQ scores (IQR) were compared before and after training at 95% CI, regarding p < 0.05 as statistically significant. Triangulation with open-ended questions was obtained. Time series regression models were applied to test for autocorrelation in performance using Stata 15.0. Ethical approval was obtained from Uganda National Council for Science and Technology (Ref: SS 5082).

RESULTS: A total of 500 participants including: 66 (13.2%) traffic police officers, 30 (6.0%) intern doctors, 140 (28.0%) fifth year and 264 (52.8%) third-year medical students were trained. Among the 434 medical trainees who completed the trauma-based MCQ assessment, the median pre- and post-test scores were 60%, IQR (50-65) and 80%, IQR (70-85) respectively. Overall, the mean difference between pre- and post-test scores was statistically significant (z = 16.7%, P|z|=<0.0001). Most participants strongly agreed to promulgate 389 (77.8%), relevance to their educational 405 (81.0%), and work needs 399 (79.8%). Each of the course components was rated above 76.0% as being very relevant. There was an overall increment in median (IQR) trauma-nontechnical skills team performance scores from 12 (9-14) to 17 (15-20) after the training (p < 0.001), with police teams advancing from 9.5 (6.0-12.5) to 19.5 (17.0-21.5) (p < 0.001).

CONCLUSION: This study demonstrates that rural trauma team development training had a positive effect on the test scores of course participants. The training is feasible, highly acceptable and regarded as relevant amongst medical trainees and traffic law enforcement professionals who provide first-aid to trauma patients in resource-limited settings. The findings could inform the design of future trauma teams in rural communities.

TRIAL REGISTRATION: Retrospective registration (UIN: researchregistry9450).

PMID:39881413 | DOI:10.1186/s12909-025-06755-1

BMC Psychol. 2025 Jan 29;13(1):84. doi: 10.1186/s40359-025-02413-9.

ABSTRACT

BACKGROUND: This study aimed to adapt the Psychological Food Involvement Scale (PFIS) to Turkish culture and test its validity and reliability. The PFIS measures individuals’ psychological, emotional, and social relationships with food, which significantly impact eating behaviors and health.

METHODS: The study was conducted with 478 participants aged 18-65. The PFIS underwent a six-stage translation and cultural adaptation process. Data collection was carried out via Google Forms, with participants completing a general information form, PFIS, and the Addiction-like Eating Behavior Scale (ALEBS). Reliability was assessed using the test-retest method. SPSS 24 was used for statistical evaluation, including internal consistency coefficient calculations, factor analysis, and correlation tests.

RESULTS: The Kaiser-Meyer-Olkin value was 0.94, indicating an adequate sample size, and Bartlett’s test of sphericity was significant (p < 0.05). Exploratory factor analysis revealed a four-factor structure explaining 79% of the variance, with factor loadings > 0.40 and eigenvalues > 1. Confirmatory factor analysis showed good fit indices: χ2 /sd = 2.28, GFI = 0.95, AGFI = 0.93 CFI = 0.98, NFI = 0.94, RMSEA = 0.05, SRMR = 0.04). Internal consistency analysis showed high reliability, with Cronbach’s Alpha coefficients ranging from 0.86 to 0.94 across subscales.

CONCLUSION: The Turkish version of the PFIS was found to be a valid and reliable tool for assessing psychological food involvement in the studied sample of the Turkish adult population.

PMID:39881412 | DOI:10.1186/s40359-025-02413-9

J Health Popul Nutr. 2025 Jan 29;44(1):22. doi: 10.1186/s41043-025-00752-2.

ABSTRACT

BACKGROUND: No study has assessed the impact of flavor capsule cigarettes (FCCs) on smoking cessation. Thus, the purpose of this exploratory study was to assess (1) the sociodemographic and smoking-related characteristics associated with using FCCs, and (2) the preliminary impact of FCCs on smoking cessation.

METHODS: This study is a secondary data analysis of a single-arm study with 100 individuals living in Mexico who smoked and received a smoking cessation mHealth intervention and pharmacotherapy support. The primary outcomes were self-reported and biochemically verified 7-day smoking abstinence at Month 3.

RESULTS: Just over one-third of participants (36%) used FCCs, with a preference for one capsule and menthol/mint flavor. Compared to participants who smoked non-FCCs, participants who smoked FCCs were (1) younger, (2) more likely to be women, and (3) more likely to smoke less than 10 cigarettes per day (CPD; all p’s < 0.05). After controlling for all significant associations, age younger than 50 years old (AOR = 3.26, 95% CI 1.25-8.51) and being a woman (AOR = 3.62, 95% CI 1.41-9.35) were positively and independently associated with smoking FCCs. Treating those lost to follow-up as participants who continued smoking, 41.7% (15/36) of participants who smoked FCCs self-reported smoking abstinence at month 3 compared to 42.2% (27/64) of participants who smoked non-FCCs (p = 0.96). Furthermore, 33.3% (12/36) of participants who smoked FCCs were biochemically verified abstinent at Month 3 compared to 18.8% (12/64) of participants who smoked non-FCCs (p = 0.10).

CONCLUSIONS: Younger age and being a woman were associated with using FCCs. Self-reported smoking abstinence at Month 3 was comparable between participants who smoke FCCs and non-FCCs. However, biochemically verified abstinent at Month 3 was higher among participants who smoke FCCs compared to participants who smoke non-FCCs, although the difference was not statistically significant. Prospective and adequately powered comparisons must be made between individuals who smoke FCCs and non-FCCs to effectively assess differences in smoking abstinence, and the reasons for these differences.

PMID:39881408 | DOI:10.1186/s41043-025-00752-2

Eur J Med Res. 2025 Jan 29;30(1):58. doi: 10.1186/s40001-025-02304-0.

ABSTRACT

BACKGROUND: The systemic immune-inflammation index (SII) is an emerging marker of inflammation, and the onset of psoriasis is associated with inflammation. The aim of our study was to investigate the potential impact of SII on the incidence rate of adult psoriasis.

METHODS: We conducted a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) 2011-2014 data sets. Multiple logistic regression analyses with appropriate covariates adjustment were the major methods in this study. Subgroup analyses were conducted by age, gender, race, smoking status, alcohol consumption, history of heart attack, stroke, coronary heart disease and diabetes. Interactions among these variables were also detected. We further utilized smooth curve fitting to explore potential nonlinear associations between SII and psoriasis across different subgroups. The receiver operating characteristic curve analysis was used to assess the diagnostic value of SII for psoriasis in the general population and diabetic individuals. Multiple imputation was adopted as sensitivity analysis to address potential bias due to missing data.

RESULTS: 9314 participants (≥ 20 years) were included. A significant positive association was observed between SII and psoriasis (OR = 1.56; P = 0.0069). Subgroup analysis revealed significant positive association in males (OR = 1.52; P = 0.0288), females (OR = 1.61; P = 0.0322), Non-Hispanic Whites (OR = 1.55; P = 0.0190), people aged 40-59 years (OR = 1.98; P = 0.0386), diabetics (OR = 3.40; P = 0.0088), and overweight participants (OR = 1.80; P = 0.0034). SII had a higher predictive value for psoriasis in diabetic patients (AUC = 0.62; 95% CI [0.55, 0.70]). In stroke patients, SII was negatively correlated with the occurrence of psoriasis, and interaction test suggested the effect of SII on psoriasis was significantly modified by stroke (P = 0.0003). Nonlinear relationships between SII and psoriasis were observed in participants aged 20 to 39, former smokers, current drinkers, individuals with or without heart attack, those without coronary heart disease, and overweight participants.

CONCLUSIONS: SII was positively associated with psoriasis. Testing for SII levels may help to identify the onset of psoriasis early.

PMID:39881406 | DOI:10.1186/s40001-025-02304-0

Stem Cell Res Ther. 2025 Jan 29;16(1):31. doi: 10.1186/s13287-024-04116-1.

ABSTRACT

BACKGROUND: Closed head injury (CHI) provokes a prominent neuroinflammation that may lead to long-term health consequences. Microglia plays pivotal and complex roles in neuroinflammation-mediated neuronal insult and repair following CHI. We previously reported that induced neural stem cells (iNSCs) can block the effects of CXCL12/CXCR4 signaling on NF-κB activation in activated microglia by CXCR4 overexpression. Here we aim to uncover the mechanism of CXCR4 upregulation in iNSCs.

METHODS: We performed bioinformatic analysis to detect the differentially expressed genes in iNSCs after co-cultured with LPS-activated microglia. Subsequently, we predicted the target genes and performed gain- and loss-of-functional studies, dualluciferase reporter, RNA immunoprecipitation, biotin-coupled miRNA pulldown, fluorescence in situ hybridization and cell transplantation assays to further elucidate the mechanism underlying the immunoregulatory effects of iNSCs. Student’s t-test and one-way analysis of variance (ANOVA) with Tukey’s post hoc test were used to determine statistical significance.

RESULTS: Our results indicated that Malat1 could act as a sponge of miR-139-5p to modulate the expression of CXCR4 that exerted significant influence on the immunoregulatory effects of iNSCs on the secretion of CXCL12, TNF-α and IGF-1 by activated microglia. Furthermore, Malat1 inhibition blocked the immunoregulatory effects of iNSC grafts on microglial activation as well as neuroinflammation in the injured cortices of CHI mice. Interestingly, NF-κB activation in iNSCs augmented the immunoregulatory effects of iNSCs on microglial activation by activating the axis of Malat1/miR-139-5p/Cxcr4. Notably, we found that TNF-α secreted by activated microglia could bind to TNFR1 at the surface of iNSCs to trigger NF-κB activation in iNSCs.

CONCLUSIONS: In short, our findings reveal a novel role of Malat1 in the immunomodulatory effects of iNSCs on microglial activation, suggesting that transplanted iNSCs may self-perceive the changes of the activated state of microglia and thus make prudential regulation of the neuroinflammation following CHI.

PMID:39881403 | DOI:10.1186/s13287-024-04116-1

Trials. 2025 Jan 29;26(1):30. doi: 10.1186/s13063-024-08666-w.

ABSTRACT

BACKGROUND: /aims. Pseudoxanthoma Elasticum (PXE, OMIM 264800) is an autosomal, recessive, metabolic disorder characterized by progressive ectopic calcification in the skin, the vasculature and Bruch’s membrane. Variants in the ABCC6 gene are associated with low plasma pyrophosphate (PPi) concentration. There is currently no reference treatment for this chronic debilitating disease.

METHODS: PROPHECI (PyROphosPHate supplementation to fight ECtopIc calcification in PseudoXanthoma Elasticum) is the first phase II, randomized, double-blind, placebo-controlled clinical trial (NTC 04868578) to evaluate the efficacy and safety of a daily oral PPi salt supplementation to attenuate and/or stabilize the progression of ectopic calcification in PXE patients. The primary endpoint is the change in arterial calcification volume quantified by non-contrast CT scan between baseline and 12 months of treatment. Secondary endpoints include the safety and efficacy of daily oral PPi administration on ocular and skin lesions and the evaluation of patients’ quality of life.

DISCUSSION: The PROPHECI trial aims to provide safety and efficacy data on the use of daily oral PPi to reduce or stabilize ectopic calcification in PXE. It also aims to validate the best markers to include in the design of future trials for the treatment of PXE and other parent diseases.

TRIAL REGISTRATION: Trial registration number: NCT04868578. References can be found on the ClinicalTrials.gov website: https://clinicaltrials.gov/study/NCT04868578?cond=Pseudoxanthoma%20Elasticum&intr=pyrophosphate&rank=2.

PMID:39881395 | DOI:10.1186/s13063-024-08666-w

Clin Epigenetics. 2025 Jan 29;17(1):16. doi: 10.1186/s13148-025-01822-2.

ABSTRACT

BACKGROUND: Glioblastoma is the commonest malignant brain tumor and has a very poor prognosis. Reduced expression of the MGMT gene (10q26.3), influenced primarily by the methylation of two differentially methylated regions (DMR1 and DMR2), is associated with a good response to temozolomide treatment. However, suitable methods for detecting the methylation of the MGMT gene promoter and setting appropriate cutoff values are debated.

RESULTS: A cohort of 108 patients with histologically and genetically defined glioblastoma was retrospectively examined with methylation-specific Sanger sequencing (sSeq) and methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) methods. The DMR2 region was methylated in 29% of samples, whereas DMR1 was methylated in 12% of samples. Methylation detected with the MS-MLPA method using probes MGMT_215, MGMT_190, and MGMT_124 from the ME012-A1 kit (located in DMR1 and DMR2) correlated with the methylation of the corresponding CpG dinucleotides detected with sSeq (p = 0.005 for probe MGMT_215; p < 0.001 for probe MGMT_190; p = 0.016 for probe MGMT_124). The threshold for methylation detection with the MS-MLPA method was calculated with a ROC curve analysis and principal components analysis of the data obtained with the MS-MLPA and sSeq methods, yielding a weighted value of 0.362. Thus, methylation of the MGMT gene promoter was confirmed in 36% of samples. These patients had statistically significantly better overall survival (p = 0.003).

CONCLUSIONS: Our results show that the threshold for methylation detection with the MS-MLPA method determined here is useful from a diagnostic perspective because it allows the stratification of patients who will benefit from specific treatment protocols, including temozolomide. Detailed analysis of the MGMT gene promoter enables the more-precise and personalized treatment of patients with glioblastoma.

PMID:39881389 | DOI:10.1186/s13148-025-01822-2

BMC Nurs. 2025 Jan 29;24(1):110. doi: 10.1186/s12912-024-02657-7.

ABSTRACT

BACKGROUND: One of the best ways to impart important skills to trainees is through simulation-based training, which is more reliable than the conventional clinical examination method. It is used in pediatric nursing training to allow nurses to practice and improve their clinical and conversational skills during an actual child encounter. A heel-prick is a complex psychomotor task that requires skill and knowledge from the pediatric nurse performing the procedure while applying for the National Newborn Screening Program.

AIM: This study aimed to assess the impact of simulation-based training on pediatric nurses’ knowledge and performance regarding the heel-prick technique used during newborn blood screening tests in select hospitals in Saudi Arabia and Egypt.

METHODS: This study utilized an experimental pre-test and post-test design. The G*Power Program^® Version 3.1.9.4 was employed to determine the sample size to fulfil the study’s objectives. The sample consisted of 50 nurses recruited from the Maternity & Children Hospital Bisha, Al-Namas General Hospital in the Kingdom of Saudi Arabia, and Pediatric Assiut University Hospital in Egypt; they were randomly divided into two groups of 25 nurses, intervention and control. The sample size was calculated assuming α level of 0.05, a β level of 0.20, and a desired power of 80%. The study was conducted from June 1st to August 30th, 2023. Two data collection instruments were used: a structured questionnaire and an observational checklist for the heel-prick technique in newborn bloodspot screening sample collection. Before the training intervention, a pre-test assessing knowledge and performance was administered. Intervention and control groups received two hours of instruction every 5 days. The researcher utilized PowerPoint presentations, videos, and interactive learning session intervention to deliver the instructional content to increase nurses’ knowledge and also employed mannequins for a newborn blood spot test simulator to train participants on performance. A post-test 1 was administered immediately after the training sessions. Additionally, post-test 2 was conducted 20 days after the study and followed up after 40 days of intervention (post-test 3).

RESULTS: The study participants ranged in age from 25 to 30 years, with the majority being female. A statistically significant difference was observed in the knowledge and performance of pediatric nurses following simulation-based training. The majority of nurses demonstrated correct responses after the simulation-based learning intervention. However, the nurses’ knowledge varied, as evidenced by the mean scores of their total knowledge regarding the heel-prick for the newborn bloodspot screening test. Immediately after the learning intervention session, the mean scores were 37.86 ± 1.28 and 34.84 ± 1.22 in the experimental and control groups, respectively. At 20 days post-training, the mean scores were 40.16 ± 1.11 and 33.55 ± 1.18 in the experimental and control groups, respectively, with a highly statistically significant difference (P-value = 0.0001). Moreover, at 40 days post-training, the mean scores were 39.54 ± 1.09 and 29.66 ± 1.32 in the experimental and control groups, respectively, and a statistically significant difference was found (P-value = 0.0001). Conversely, the level of nurses’ performance before training was below average, with 52% and 56% in the experimental and control groups, respectively. Immediately after the simulation-based learning, the majority of nurses in the experimental group demonstrated a good level of performance in post-test 1, post-test 2, and post-test 3, with a statistically significant difference compared to the nurses in the control group (P-value = 0.001).

CONCLUSION: The use of newborn blood spot test simulators is useful during simulation-based training in raising the overall level of the pediatric nurses’ knowledge and performance, especially through 1, 2, & 3 post-training tests. The findings have several practical implications, and one is that pediatric nurses’ performance and knowledge concerning newborn blood screening tests should be prioritized to guarantee patient safety and quality of care in pediatric patient scenarios. It is essential for nursing trainers to effectively train pediatric nurses’ by using simulators to improve their caring knowledge and performance in educational settings. By improving nurses’ knowledge and performance, we can reduce the dangers caused by their training on real neonates; also, it can be an attractive way to train nurses when trained by simulators and ultimately enhance the overall quality of nursing services in the hospital.

CLINICAL TRIAL NUMBER: This study was registered by Clinical Trials.gov Identifier: (NCT06685471|| https://www.

CLINICALTRIALS: gov/ ) with the clinical Trail registry (12-11-2024).

PMID:39881378 | DOI:10.1186/s12912-024-02657-7

J Orthop Surg Res. 2025 Jan 30;20(1):111. doi: 10.1186/s13018-025-05475-y.

ABSTRACT

BACKGROUND: The use of intravenous tranexamic acid (TXA), an antifibrinolytic agent, has been shown to effectively reduce total blood loss and transfusion rates in total knee arthroplasty (TKA). The aim of this paper is to evaluate the implementation lag and clinical uptake of the use of TXA for primary TKA after publication of two landmark studies. Additionally, it assessed the efficacy of TXA use in TKA in reducing post-operative blood transfusions and hospital length of stay (LOS).

METHODS: A total of 763 patients aged over 18 years of age underwent primary TKA at a level 4 metropolitan hospital in Australia between January 2011 and December 2017. Primary outcome measure was use of TXA at operative induction. Secondary outcome measures were post-operative blood transfusion, haemoglobin levels and in-hospital length of stay.

RESULTS: The rate of TXA uptake was ≥ 50% by April-June 2013, 1.5 years following landmark paper publication. TXA use was ≥ 90% by April-June 2015, equating to 3.5 years after landmark publication. For each additional year since publication, the odds that TXA was used in a TKA surgery increased by 254.3%, 95% CI (confidence interval) [195.2%, 334.1%]. There was a negative association between TXA use and blood transfusion rate (p < 0.001), while controlling for other variables. TXA use reduced the odds of blood transfusions occurring by 73.5%, 95% CI [35.8% and 89.8%]. Analysis showed that reduced LOS was seen even after controlling for post-operative blood transfusion (p < 0.05).

CONCLUSION: The implementation lag from research to clinical practice, using ≥ 90% TXA use in TKA as a proxy, was 3.5 years. The use of TXA reduced LOS and blood transfusion rate in TKA patients.

PMID:39881376 | DOI:10.1186/s13018-025-05475-y

J Orthop Surg Res. 2025 Jan 29;20(1):108. doi: 10.1186/s13018-025-05541-5.

ABSTRACT

BACKGROUND: The endoplasmic reticulum stress (ER stress) has been involved in various musculoskeletal disorders including non-traumatic osteonecrosis of femoral head (NT-ONFH).

OBJECTIVE: The current study aimed to investigate the association of glucose-regulated protein 78 (GRP78) as well as CCAAT/enhancer-binding protein homologous protein (CHOP) expressions in serum and femoral head (FH) tissues with NT-ONFH’s severity.

METHODS: We enrolled NT-ONFH patients (n = 150) alongside healthy controls (HCs, n = 150). Meanwhile, 49 patients with femoral neck fracture (FNF) were also enrolled. Serum CHOP and GRP78 levels were determined through enzyme linked immunosorbent assay (ELISA). Local CHOP and GRP78 expressions were detected by immunohistochemistry, western blot, alongside real-time polymerase chain reaction (RT-PCR). Radiographic severity was assessed by FICAT grading system. The visual analogue scale (VAS) together with Harris hip score (HHS) were utilized to determine symptomatic severity.

RESULTS: Serum CHOP and GRP78 levels were markedly increased in NT-ONFH patients than HCs. NT-ONFH patients at FICAT stage 4 showed significant higher serum CHOP and GRP78 levels in contrast with those at stage 3. Furthermore, patients at stage 3 demonstrated higher serum CHOP and GRP78 levels than those at stage 2. There was a positive correlation observed between the serum CHOP and GRP78 levels and the severity of the FICAT stages. A total of 42 ONFH patients at FICAT stage 3, 40 patients at FICAT stage 4, and 49 FNF patients received total hip replacement (THR). The mRNA and protein levels of CHOP and GRP78 were elevated in necrotic area compared to the non-necrotic area of ONFH patients and the FH tissues of FNF patients with statistical significance. The expression levels of CHOP and GRP78 within the local tissues were significantly elevated in patients at FICAT stage 4 as opposed to those at stage 3. Besides, ROC curve analysis indicated that serum and local CHOP and GRP78 expressions may act as indicators of disease progression. The levels of CHOP and GRP78, both in serum and at the local site, were in a positive correlation with VAS scores but an inverse relationship with HHS.

CONCLUSIONS: Serum and local GRP78 as well as CHOP expressions were positively linked with disease progression in NT-ONFH patients. Potential therapeutics targeting ER stress related protein may serve as a method for alleviating NT-ONFH.

PMID:39881366 | DOI:10.1186/s13018-025-05541-5