Nevin Manimala

BMC Public Health. 2025 Jul 7;25(1):2401. doi: 10.1186/s12889-025-23608-0.

ABSTRACT

BACKGROUND: The prevalence of eating disorders among youth has increased in recent decades, with significant health consequences. Depression, loneliness and social anxiety are associated with eating disorders. However, the underlying mechanisms of these associations remain insufficiently explored. Considering the possibility that mental disorders increase the risk of smartphone addiction and that smartphone addiction is associated with eating disorder in adolescents, this study aims to investigate whether smartphone addiction mediates the association between mental disorders and eating disorders.

METHODS: Between October and November 2023, we conducted an online survey among youth across 31 provincial-level administrative divisions (PLADs) in China. To align our sample composition with official statistics for each PLAD in terms of gender and school type, we applied sample weights to each respondent. Structural equation modeling (SEM) was used to examine the mediating effects. To assess the consistency of these results, we also performed analyses for each gender and age group.

RESULTS: Among 10,000 weighted participants, 51.7% are male, with a median age of 16 years (IQR: 14-19). About 40% of youth experienced eating disorders. Smartphone addiction partially mediated the association between depression, loneliness, social anxiety, and eating disorders, contributing 24.69% (95% confidence interval: 20.60%-28.79%), 32.33% (95% CI: 27.53%-37.12%), and 37.35% (95% CI: 31.79%-42.91%) of the total effects, respectively. No heterogeneity was observed when analyses were stratified by gender and age group.

CONCLUSION: Smartphone addiction must be taken into account when designing strategies to prevent eating disorders in adolescents, which requires the cooperation of schools, parents and the government.

PMID:40624640 | DOI:10.1186/s12889-025-23608-0

BMC Med Educ. 2025 Jul 7;25(1):1019. doi: 10.1186/s12909-025-07610-z.

ABSTRACT

BACKGROUND: Medical simulation is a global trend that improves disease interpretation, diagnostic skills, and clinical abilities, transforming them into skills for the practitioner. Simulator classes should be part of continuing medical education, generating advances that make it necessary for technical development and specialization in complex, complicated, or difficult-to-reproduce scenarios that students may face, based on clinical problems with negative feedback, allowing for learning from mistakes. The objective of the review is to identify the usefulness of simulation in teaching the new medicine.

METHODS: Using the PRISMA 2020 declaration, articles published in the last 5 years on simulation teaching in neurology were reviewed. These articles were sourced from databases such as PubMed, Mendeley, Wiley, Web of Science, Cochrane, Latindex, and Google Scholar. In the summary of results, only those studies that met the inclusion criteria were selected for analysis.

RESULTS: Twenty-six randomized clinical trials on medical education and training were selected. The analysis showed that simulation improved skill scores to support simulation-based medical diagnosis and treatment.

CONCLUSION: Simulation-based education has demonstrated statistical benefits in learning, skill acquisition, feedback, and stress reduction, particularly in the specialties of ophthalmology, emergency medicine, neurology, neurosurgery, neuroanatomy, and neuropathology, providing great relevance to the present review. No study reported beneficial effects or effects on mortality: despite improved surgical skill times among participants, no statistically significant data were found on a reduction in operative complications. Simulation technologies such as artificial intelligence, mixed reality, and robotics are under development, the impact of which on improving the quality of care is still unknown.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40624635 | DOI:10.1186/s12909-025-07610-z

BMC Nurs. 2025 Jul 7;24(1):865. doi: 10.1186/s12912-025-03505-y.

ABSTRACT

BACKGROUND: Due to high intensity, workloads and shift work, nurses have become a high prevalence group of pain. If not promptly intervened, pain may become chronic pain through the mechanisms of peripheral sensitization and central sensitization, which in turn induces psychological symptoms such as anxiety and depression, forming a vicious circle of “pain-mental health comorbidity”. In addition, long-term pain may accelerate the transition from acute pain to chronic pain, which will cause more serious damage to nurses’ health. However, few studies have deeply explored the association between chronic pain and multidimensional mental health outcomes (anxiety, depression, fatigue, burnout, loneliness, and well-being) among nurse populations.

METHODS: This study surveyed 147,832 nurses from 67 tertiary hospitals in China between December 2023 and January 2024, using cluster sampling and online questionnaires. Statistical analyses included descriptive analyses, correlation analysis, multivariable logistic regression, and binary logistic regression. This study followed the STROBE guidelines.

RESULTS: Significant and robust associations were found between chronic pain and mental health among nurses’ occupational group. The correlation coefficients between chronic pain and six mental health symptoms ranged from 0.106 to 0.179, with the three largest correlation coefficients for depression (r = 0.179, P < 0.001), anxiety (r = 0.168, P < 0.001) and fatigue (r = 0.159, P < 0.001). Of all pain sites, head pain had the greatest correlation with depression (r = 0.167, P < 0.001) and low back pain had the greatest correlation with fatigue (r = 0.144, P < 0.001). Moreover, subgroup analyses by sex showed that among nurses with chronic pain, males are more likely to be fatigued. For multisite pain, the strength of the association with mental health increased significantly as the number of pain sites increased.

CONCLUSION: In this study, both chronic pain and number of pain sites were significantly associated with nurses’ mental health and showed site variability. After progressively controlling for variables such as sociodemographic, lifestyle, and work-related factors, this association remained robust and showed consistency across sex and age groups.

CLINICAL TRIAL REGISTRATION NUMBER: Not applicable. This study was not a clinical trial.

PMID:40624631 | DOI:10.1186/s12912-025-03505-y

BMC Gastroenterol. 2025 Jul 7;25(1):505. doi: 10.1186/s12876-025-04081-w.

ABSTRACT

OBJECTIVE: This meta-analysis aims to evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for hepatocellular carcinoma (HCC) located at specific anatomical sites of the liver compared with non-specific sites.

METHODS: A systematic search was conducted across five databases, covering literature from database inception to September 30, 2024. Eligible studies included prospective and retrospective cohorts involving ultrasound-guided percutaneous MWA for HCC. Data extraction and analysis were performed using Stata 15.1. The primary outcomes were 1-year, 3-year, and 5-year overall survival (OS) rates, complete ablation rates, and incidence of major complications. Pooled results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Nine studies involving 2,381 patients were included. Among them, 1,047 patients had HCC located at specific anatomical sites, and 1,334 at non-specific sites. The pooled ORs (95% CI) for OS at 1, 3, and 5 years were 0.89 (0.59-1.35), 0.83 (0.66-1.05), and 1.12 (0.91-1.38), respectively. The OR for complete ablation was 0.97 (0.61-1.53), and for major complications, 1.44 (0.59-3.51).

CONCLUSION: Ultrasound-guided percutaneous MWA demonstrates comparable efficacy and safety for treating HCC at specific anatomical sites of the liver relative to non-specific sites, with no statistically significant differences in survival outcomes, ablation success, or complication rates.

PMID:40624629 | DOI:10.1186/s12876-025-04081-w

BMC Ophthalmol. 2025 Jul 7;25(1):393. doi: 10.1186/s12886-025-04227-0.

ABSTRACT

BACKGROUND: To analyze the poor mental status of patients with primary closed-angle glaucoma(PACG), and to explore the correlation between mental status and ocular and systemic indices in patients with PACG.

METHODS: We collected patients’ axial length (AL), anterior chamber depth (ACD), nerve fiber layer thickness (RNFL), cup-to-disc ratio (C/D), antinuclear antibody (ANA), toxoplasmosis antibody (anti-Toxoplasma gondii IgM), and anxiety and depression scores (HAMA and HAMD scales). Statistical analysis was utilized to analyze the data for each of the patients in the PACG and cataract patient groups.

RESULTS: The results showed that there was a statistically significant difference between the glaucoma group and the cataract group in terms of anxiety and depression scores, AL, ACD, RNFL, C/D, ANA, and Anti-Toxo IgM (P < 0.05). Anxiety scores of glaucoma patients were positively correlated with AL and C/D (P < 0.05), negatively correlated with RNFL (P < 0.05), and correlation existed with ANA and Anti-Toxo IgM (Eta² > 0.16). Depression scores in glaucoma patients were positively correlated with C/D (P < 0.05), negatively correlated with AL and RNFL (P < 0.05), and correlated with ANA and Anti-Toxo IgM (Eta² > 0.16). In addition,RNFL and C/D can be considered significant predictors of anxiety status. AL and C/D can be considered significant predictors of depression status.

CONCLUSION: Patients with primary angle-closure glaucoma have higher anxiety and depression scores than the general population, and clinically we can predict the patient’s mental status by their ocular and systemic indicators so that appropriate treatment can be taken in time.

PMID:40624620 | DOI:10.1186/s12886-025-04227-0

BMC Cancer. 2025 Jul 8;25(1):1153. doi: 10.1186/s12885-025-14570-6.

ABSTRACT

BACKGROUND: Neoadjuvant chemotherapy (NAC) is gaining attention as a treatment for advanced colorectal cancer owing to its potential to improve surgical outcomes and prognosis. However, reliable biomarkers to predict the response to NAC are lacking. We aimed to investigate the predictive value of cell-free DNA (cfDNA) integrity index for NAC response, using machine learning to compensate for the small cohort size.

METHODS: This retrospective study included 31 locally advanced colorectal cancer patients who underwent NAC and surgery at the Nippon Medical School Hospital between 2016 and 2020. Blood samples were collected pre-post-NAC to assess cfDNA levels using quantitative polymerase chain reaction. The cfDNA integrity index was calculated based on the ratio of long to short fragments in the long-interspersed element-1 repeat sequence. Statistical analyses, including random forest modeling, were performed to evaluate the predictive value of the cfDNA integrity index for treatment response.

RESULTS: Of the 31 patients, 19 (61.3%) were classified as responders and 12 (38.7%) as non-responders. The post-NAC cfDNA integrity index was significantly different between the groups (P = 0.002, odds ratio = 16.0). Random forest analysis identified changes in the cfDNA integrity index as the most important predictor of NAC response (%IncMSE: 15.79; IncNodePurity: 2.21), while sex, age, tumor site, and pre-NAC cfDNA levels were not significant predictors.

CONCLUSIONS: Variability in the cfDNA integrity index shows promise as a biomarker for predicting NAC efficacy in colorectal cancer.

PMID:40624619 | DOI:10.1186/s12885-025-14570-6

Reprod Biomed Online. 2025 Apr 10;51(3):104995. doi: 10.1016/j.rbmo.2025.104995. Online ahead of print.

ABSTRACT

RESEARCH QUESTION: Is a history of pregnancy loss correlated with low age-adapted ovarian reserve in women aged 35 years or younger?

DESIGN: This was a retrospective cohort study.

RESULTS: A total of 931 women aged 35 years or less with anti-Müllerian-hormone (AMH) values measured at presentation to a fertility centre were included in the analysis. The pregnancy loss rate, modelled as pregnancy loss count per previous pregnancy, increased at both ends of the age-normalized AMH z-score, showing a statistically significant increase (odds ratio 0.49, 95% confidence interval 0.25-0.94; P = 0.032) at the lower end (z-score lower than -1.28, 10th percentile) of AMH values.

CONCLUSIONS: Women aged 35 years or less are assumed to have a low risk of aneuploidy as a cause of pregnancy loss. While the association between low ovarian reserve and pregnancy loss in this group is still debated, the findings presented describe a significant association between a history of pregnancy loss in women of 35 years or less and an age-adjusted low ovarian reserve. This calls for assessment of the ovarian reserve in women with pregnancy losses, as an early diagnosis of low ovarian reserve may have far-reaching implications for fertility counselling, especially in an era when women often postpone childbearing.

PMID:40623339 | DOI:10.1016/j.rbmo.2025.104995

Curr Pharm Teach Learn. 2025 Jul 6;17(10):102437. doi: 10.1016/j.cptl.2025.102437. Online ahead of print.

ABSTRACT

BACKGROUND: Traditional lectures may be less effective than active learning strategies in supporting student’s successful performance on assessments. Jigsaw method, an active learning strategy, fosters engaging classrooms, empowers students in collaborative learning, promotes peer teaching, and increases individual accountability. This study explores the impact of a modified jigsaw activity with educational YouTube reels on pharmacy students’ learning outcomes, students’ satisfaction, and willingness to recommend the strategy.

METHODS: A pilot modified jigsaw activity incorporating educational YouTube reel creation was implemented in a first-year pharmacy course. Pre- and post-surveys collected data using instruments designed to operationalize students’ academic self-confidence, exam expectations, understanding of class material, and knowledge. Instruments operationalizing satisfaction and likelihood of recommending the intervention were administered at the end of the study. Descriptive statistics summarized baseline student characteristics, satisfaction, and likelihood to recommend the strategy. Paired sample t-test and Wilcoxon signed-rank test compared pre- and post-survey scores for normally and non-normally distributed data, respectively.

RESULTS: All thirty-three students enrolled in the course completed the baseline survey. Nineteen students completed both pre- and post-surveys. Students were mostly white with an average age of 23 years. Improvements were seen in confidence level (p = 0.011), understanding (p < 0.001), and knowledge of course materials (p = 0.043). There were no changes in exam expectations (p = 0.712) About 58.3 % of the students were satisfied and 60 % were willing to recommend the strategy.

CONCLUSION: Findings from this exploratory pilot study suggest that using a modified jigsaw activity incorporating YouTube reel creation may improve learning outcomes, including confidence, perceived understanding, and knowledge. Future confirmatory research is warranted.

PMID:40623334 | DOI:10.1016/j.cptl.2025.102437

Alcohol Alcohol. 2025 May 14;60(4):agaf041. doi: 10.1093/alcalc/agaf041.

ABSTRACT

In this retrospective study of 251 300 patient encounters at Veterans Administration Emergency Departments associated with alcohol intoxication per blood testing or ICD 9/10 coding, we found that 79% of these patients had positive Alcohol Use Disorders Identification Test-Consumption screens within 6 months of their visit. Therefore, we propose that presentation to an emergency department with any detectable ethanol concentration should prompt intervention accordingly.

PMID:40623318 | DOI:10.1093/alcalc/agaf041

Ann Intern Med. 2025 Jul 8. doi: 10.7326/ANNALS-24-00713. Online ahead of print.

ABSTRACT

BACKGROUND: A 2020 consensus statement proposed body mass index (BMI)-specific waist circumference (WC) thresholds to improve patient care.

OBJECTIVE: To determine whether stratifying BMI categories by BMI-specific WC thresholds improves mortality risk prediction.

DESIGN: Prospective cohort study.

SETTING: Women’s Health Initiative multicenter, population-based U.S. study, with enrollment from 1993 to 1998 and follow-up through 2021.

PARTICIPANTS: 139 213 postmenopausal women aged 50 to 79 years were included in a development cohort (n = 67 774) and 2 external validation cohorts. Validation Cohort 1 had high prevalence of overweight or obesity (n = 48 335), and Validation Cohort 2 included diverse, geographically separate centers (n = 23 104).

MEASUREMENTS: Height, weight, and WC measured at enrollment. BMI categories were normal weight (18.5 to <25 kg/m²), overweight (25 to <30 kg/m²), obesity-1 (30 to <35 kg/m²), obesity-2 (35 to <40 kg/m²), and obesity-3 (≥40 kg/m²), with further stratification by prespecified WC thresholds (≥80, ≥90, ≥105, ≥115, and ≥115 cm, respectively). Mortality was ascertained annually and was supplemented with serial National Death Index queries. Ten- and 20-year mortality prediction models that included BMI categories were compared to models with BMI categories stratified by WC thresholds using c-statistics and continuous net reclassification improvement (NRI).

RESULTS: Over a median of 24 years of follow-up, 69 297 participants died. Multivariable-adjusted mortality risk was consistently greater for BMI categories with large WC than those with normal WC. Compared with women with normal weight and normal WC, women with normal or overweight BMI but large WC (hazard ratios [HRs], 1.17 [95% CI, 1.12 to 1.21] and 1.19 [CI, 1.15 to 1.24], respectively) had risk similar to those with obesity-1 but normal WC (HR, 1.12 [CI, 1.08 to 1.16]). Mortality associated with obesity-1 and large WC (HR, 1.45 [CI, 1.35 to 1.55]) was similar to that with obesity-3 and normal WC (HR, 1.40 [CI, 1.28 to 1.54]). Models with BMI-specific WC thresholds improved discrimination and risk stratification at 10 years for Validation Cohort 1; c-statistics improved by 0.7% (CI, 0.3% to 1.0%) to 61.3% (CI, 60.2% to 62.5%), and continuous NRI was 20.4% (CI, 17.3% to 23.6%). Results were mixed for Validation Cohort 2; risk stratification improved (continuous NRI, 12.3% [CI, 8.5% to 16.0%]), but not discrimination. Results were similar at 20 years.

LIMITATION: The study did not include men or younger women.

CONCLUSION: Further stratifying BMI categories by WC thresholds modestly improved mortality risk stratification, with larger WC predicting greater mortality, although the degree of improvement varied by cohort. Discrimination did not improve consistently.

PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute of the National Institutes of Health.

PMID:40623313 | DOI:10.7326/ANNALS-24-00713