Nevin Manimala

BMC Pregnancy Childbirth. 2025 Aug 21;25(1):870. doi: 10.1186/s12884-025-08009-w.

ABSTRACT

BACKGROUND: The association between unplanned pregnancy and perinatal depression is understudied in racially and ethnically diverse and low-income populations. The present study was compromised of a secondary analysis of data from a low-income and 70% racially and ethnically minoritized sample to examine associations between unplanned pregnancy and perinatal depressive symptoms and to explore potential moderation by social factors.

METHODS: Pregnant individuals (n = 808) were enrolled in a larger study evaluating the effectiveness of a preventative intervention for postpartum depression, and self-reported depressive symptoms were collected prenatally and at 12 weeks postpartum using the 16-item Quick Inventory of Depressive Symptomatology. Multiple linear regression examined the relationship between unplanned pregnancy and maternal depressive symptoms, and the potential interactions between unplanned pregnancy and (1) race/ethnicity (2), education level (3), first-time parent status, and (4) a prenatal mental healthcare utilization. Analyses were conducted both within the sample as a whole and within racial/ethnic subgroups.

RESULTS: While bivariate regression revealed a significant association between unplanned pregnancy and prenatal depressive symptoms (β = 0.88, 95% CI [0.27, 1.49], p = 0.005), unplanned pregnancy was not significantly associated with prenatal or postpartum depression in adjusted models in the full sample. Analyses suggested different trends in racial/ethnic subgroups. Specifically, endorsing prenatal mental healthcare utilization and unplanned pregnancy was associated with higher prenatal depressive symptoms in the Latine subgroup compared to those whose pregnancies were planned (β = 4.59, 95% CI [0.60, 8.59], p = 0.025). Additionally, unplanned pregnancy was associated with higher depressive symptoms at 12 weeks postpartum compared to those with planned pregnancy also in the Latine sample (β = 1.06; 95% CI [0.10, 2.03], p = 0.031). Unplanned pregnancy was not found to be associated with prenatal depressive symptoms in the adjusted models of any other racial/ethnic subgroups.

CONCLUSIONS: These secondary analyses from a larger study suggest potentially important differences in the association between unplanned pregnancy and perinatal depressive symptoms by racial/ethnic subgroups. Future research should acknowledge the myriad stressors and protective factors experienced by low-income and racially and ethnically diverse perinatal populations when evaluating differences in outcomes among racial/ethnic subgroups.

PMID:40842004 | DOI:10.1186/s12884-025-08009-w

Glob Health Res Policy. 2025 Aug 21;10(1):36. doi: 10.1186/s41256-025-00439-5.

ABSTRACT

BACKGROUND: Optimizing the cultural accessibility of digital healthcare tools requires understanding user perspectives on usability features and cultural appropriateness.

METHODS: A cross-sectional survey of 3,030 caregivers (mean age 44.0, 52.9% female) and 2,108 inpatients (mean age 49.7, 54.0% female) at a Guangxi medical center (July-October 2024) assessed experiences with digital tools, support needs, and preferences for culturally adaptive features.

RESULTS: Caregivers reported a higher adoption of digital tools than patients (caregivers: 87.1% vs. patients: 62.0%, P-value < .001), yet 81.1% of caregivers reported unmet needs. Both groups (caregivers: 67.0%; patients: 64.0%) prioritized integrating traditional medicine over other cultural factors (language diversity, traditional medicine, folk customs, and medical resource availability). Caregivers valued interactive health management tools (73.3% vs. 66.7% among patients, P-value < .001) and user feedback mechanisms (61.2% vs. 55.0% among patients, P-value < .001) more than patients.

CONCLUSIONS: Despite high adoption, caregivers report significant gaps in culturally relevant support. Digital health interventions should prioritize user-centered designs, incorporating traditional medicine and addressing the divergent preferences of caregivers and patients.

PMID:40841989 | DOI:10.1186/s41256-025-00439-5

BMC Sports Sci Med Rehabil. 2025 Aug 21;17(1):244. doi: 10.1186/s13102-025-01299-9.

ABSTRACT

BACKGROUND: The lunge is a critical movement in badminton, facilitating rapid and efficient court coverage and enabling players to promptly reach the hitting position. While previous studies have examined the influence of lunge direction on lower limb biomechanics, the effects of gender have yet to be explored. Therefore, the purpose of this study was to investigate the combined effects of direction and gender on lower limb biomechanics during forehand and backhand forward lunges in amateur badminton players.

METHODS: 16 male and 16 female amateur players were recruited. Kinematic and kinetic data were measured synchronously using a Vicon motion capture system and a Kistler force plate. A two-way mixed-design ANOVA was used to explore the effects of different lunge directions, gender, and the interaction between the two factors on each parameter. Joint angles during the stance phase were analyzed using the statistical nonparametric mapping method.

RESULTS: Interaction effects between gender and direction were observed for the second impact of vertical ground reaction force (VGRF), knee peak external rotation moment, ankle sagittal angles and knee frontal and transverse moments during the stance phase. Compared with the females, the males showed significantly greater loading rate and impulse of VGRF, peak flexion, sagittal range of motion (ROM) and abduction moment of knee joint. The sagittal ROM of hip and knee joint and the knee flexion moment around 84% of the stance phase during backhand lunge was significantly greater than during forehand lunge. In contrast, the sagittal ROM of ankle joint and peak abduction moment of knee joint was significantly lower during backhand lunge.

CONCLUSIONS: Gender-specific biomechanical strategies influence knee loading patterns during badminton lunges, contributing to direction-dependent variations in injury risk. These findings underscore the importance of incorporating directional biomechanical demands and sex-specific neuromuscular adaptations into training and injury prevention programs to mitigate injury risks.

PMID:40841982 | DOI:10.1186/s13102-025-01299-9

BMC Public Health. 2025 Aug 21;25(1):2868. doi: 10.1186/s12889-025-24220-y.

ABSTRACT

OBJECTIVE: To create and verify a machine learning model that integrates social determinants of health (SDoH) for assessing post-stroke depression (PSD) and examining the association between SDoH and disease outcomes.

METHODS: Data were acquired from the National Health and Nutrition Examination Survey. Logistic regression was employed to analyse the association between SDoH and PSD, whereas Cox regression was utilized to assess the correlation between SDoH and all-cause mortality in PSD. The Boruta algorithm was employed for feature selection, and four machine learning models were constructed (CatBoost, Logistic, Multilayer Perceptron, and Random Forest) to evaluate the predictive effectiveness, calibration, and clinical applicability of these ML models. SHAP values were computed to ascertain the predictive significance of each feature in the model that exhibited the highest predictive performance.

RESULTS: Logistic regression analysis revealed a significant positive correlation between SDoH and PSD prevalence(p for trend < 0.0001). Compared to the other three models, CatBoost (AUC = 0.966) demonstrated the best overall predictive performance. Moreover, the decision curve analysis (DCA) and calibration curve findings demonstrated that the CatBoost model possessed considerable clinical utility and consistent predictive efficacy. The ten-fold cross-validation method further confirmed the model’s robustness and generalization ability.

CONCLUSIONS: A linear relationship exists between SDoH and PSD, with CatBoost demonstrating the best performance in predicting PSD. SHAP values emphasize the importance of SDoH.

PMID:40841950 | DOI:10.1186/s12889-025-24220-y

BMC Public Health. 2025 Aug 21;25(1):2878. doi: 10.1186/s12889-025-24252-4.

ABSTRACT

OBJECTIVE: This study aimed to investigate the impact of physical activity (PA) on emotional management ability (EMA) in college students and to analyze the chain mediating roles of psychological resilience (PR) and health literacy (HL) in the relationship between PA and EMA.

METHODS: Demographic information was collected using a stratified, cluster, and multi-stage sampling method. Data on PA, PR, HL, and EMA among college students were collected using an online questionnaire. A total of 13,590 valid questionnaires were obtained.

RESULTS: A significant positive correlation was found between PA and EMA in college students (r = 0.177, P < 0.01). PR and HL played significant mediating roles in the relationship between PA and EMA. The mediation effect consisted of independent mediation by PR and HL and a chain mediation effect between the two. The values of the independent mediation effects and the chain mediation effect were 0.011, 0.010, and 0.004, respectively. The chain mediation effect was lower than each of the individual mediation effects and showed a statistically significant difference compared to the mediation effect of HL (P < 0.05).

CONCLUSION: PA significantly enhances college students’ EMA through direct effects and a chain mediation pathway involving PR and HL. Coordinated interventions, including regular exercise, PR training, and health education, are recommended to optimize college students’ psychological health.

PMID:40841939 | DOI:10.1186/s12889-025-24252-4

BMC Gastroenterol. 2025 Aug 21;25(1):608. doi: 10.1186/s12876-025-04177-3.

ABSTRACT

BACKGROUND: Advanced gastric cancer frequently leads to severe complications, such as bleeding, which severely impacts patients’ quality of life and prognosis. Traditional approaches for hemostasis include endoscopic treatments and surgery, but their invasive nature and potential for significant morbidity have made less invasive options like radiation therapy (RT) and transarterial embolization (TAE) appealing. Nonetheless, studies comparing the therapeutic effects and prognosis of RT and TAE are limited, underscoring a significant gap in research and clinical practice.

METHODS: This retrospective study analyzed patients with advanced gastric cancer who experienced uncontrollable bleeding and were treated with RT or TAE. The efficacy of these treatments was assessed based on the achievement of hemostasis, defined as the absence of the need for blood transfusion within 14 days post-treatment and no requirement for additional intervention for bleeding. Furthermore, the study evaluated the post-treatment course, including survival outcomes and re-bleeding rates, to compare the prognostic implications of treatment success or failure.

RESULTS: This study encompassed 28 patients, of whom 19 underwent RT and 9 received TAE. RT was associated with a superior rate of immediate hemostasis (94.7% versus 66.7%, p = 0.047). Nonetheless, the incidence of re-bleeding in the RT cohort was 15.8%, compared to 44.4% in the TAE group, a difference that did not reach statistical significance (p = 0.11). Furthermore, the occurrence of adverse events was comparable between the two treatment modalities (21.1% for RT versus 33.3% for TAE, p = 0.48). An examination of long-term outcomes underscored the initial treatment’s effectiveness and the potential transition to additional therapies as critical determinants of the re-bleeding risk. Groups achieving favorable initial outcomes (p < 0.001) and those for whom subsequent interventions were viable (p = 0.014) demonstrated a significant enhancement in re-bleeding-free survival. Despite the discrepancy in rates of immediate hemostasis, the comparison between the RT and TAE groups revealed no statistically significant difference in re-bleeding-free survival (p = 0.55).

CONCLUSION: RT exhibited superior hemostasis in advanced gastric cancer bleeding compared to TAE, yet both treatments showed similar re-bleeding-free survival rates. The success of the initial treatment, along with potential for further interventions, critically influenced outcomes, emphasizing the importance of effective initial hemostasis.

PMID:40841936 | DOI:10.1186/s12876-025-04177-3

BMC Urol. 2025 Aug 21;25(1):208. doi: 10.1186/s12894-025-01879-4.

ABSTRACT

OBJECTIVES: We aimed to examine the association between patient age and procedural intervention, especially nephrectomy, in patients with renal trauma in the National Trauma Data Bank (NTDB).

MATERIALS AND METHODS: We queried the 2013-2020 NTDB for adult renal trauma patients with an American Association for the Surgery of Trauma (AAST) grade. Patients without AAST grade or with no sign of life were excluded. We constructed a multinomial logistic regression model to demonstrate the association between age and procedural interventions (renal angioembolization, renorrhaphy and nephrectomy). Models were adjusted for patient, hospital, and clinical factors.

RESULTS: Our cohort was comprised of 49,884 patients with renal trauma aged 18-89 years, of which 691 (1.4%), 995 (1.9%), and 3,366 (6.8%) underwent angioembolization, renorrhaphy, and nephrectomy, respectively. After adjusting for relevant variables, the risks of nephrectomy and angioembolization were positively associated with patient age, particularly in those 40 years of age and older. Adjusted risk of nephrectomy (OR 0.07 per 10 years of age, 95% CI 0.03-0.11, p < 0.001) and angioembolization (OR 0.19 per 10 years of age, 95% CI 0.14-0.24, p < 0.001) ranged between ≈ 0.6% and ≈ 1%, and between ≈ 0.3% and ≈ 1% across the patient age range, respectively. Plots depicting marginal effect of age is demonstrated that in patients above 35-40 years of age, a 1-year increase in age is associated with a progressively higher increase in risk of both nephrectomy and angioembolization. The adjusted risk of Renorrhaphy (OR -0.003 per 10 years of age, 95% CI -0.06-0.06, p = 0.92) did not vary substantially with age and the marginal effect of age was negligible across all ages.

CONCLUSIONS: Older patients with renal trauma are more likely to receive procedural intervention namely nephrectomy and renal angioembolization. These results suggest possible age-related cognitive bias in renal trauma management.

PMID:40841903 | DOI:10.1186/s12894-025-01879-4

BMC Nurs. 2025 Aug 21;24(1):1096. doi: 10.1186/s12912-025-03754-x.

ABSTRACT

BACKGROUND: Investigating the links between individual perceived stress, social connection, and work involvement plays a crucial role in enhancing the psychological health and overall well-being of clinical nurses, as well as elevating the quality of nursing care in clinical settings. This study incorporates the concepts of social connection and work engagement. By considering the potential heterogeneity of variables and applying a mediation model, we identified the influence pathways through which subgroups of perceived stress affect social connection and work engagement. This study offers a valuable reference for understanding the nurses’ perceived stress profiles and improving their mental health.

METHOD: The research employed a cross-sectional study methodology. To select 600 clinical nurses from 3 hospitals in Guangzhou, a convenience sampling technique was implemented. Participants’ general demographics, levels of work engagement, perceived stress, and social connections were gathered through questionnaires. Statistical analyses were performed utilizing latent profile examination, mediation analysis and generalized additive models.

RESULTS: (1) The analysis revealed heterogeneity in stress levels among nurses, resulting in the identification of three distinct groups: low stress-high self-demand group (23.4%), high tension-low out-of-control group (57.5%), and high stress-low efficiency group (18.2%). (2) Clinical registered nurses that obtained support from their families were more inclined to be placed in the Low stress-high self-demand group. (3) Social connection significantly mediated the relationship between nurses’ work engagement and perceived stress. (4) Work engagement demonstrated a non-linear relationship with both perceived stress and social connection.

CONCLUSION: The social connections and work engagement of clinical nurses were notably affected by the stress on an individual. Nursing leaders should promptly identify the stress patterns of nurses, implement appropriate stress management strategies, enhance group cohesion through social networks, and promote the nurses’ mental health and occupational well-being, which in turn can decrease nurse turnover rates and enhance the quality of clinical nursing care.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40841901 | DOI:10.1186/s12912-025-03754-x

BMC Public Health. 2025 Aug 21;25(1):2865. doi: 10.1186/s12889-025-23843-5.

ABSTRACT

OBJECTIVE: The COVID-19 vaccination is a key strategy to control the pandemic; however, complex factors, including health awareness and social cognition, influence public intention to vaccinate. The Health Belief Model (HBM) provides a theoretical framework for understanding vaccination behavior, but how Vaccination awareness (VA) dynamically moderates the relationship between HBM domains and vaccination intentions remains unclear. This study aims to compare the characteristics of different VA classifications and explore the key factors influencing their future COVID-19 vaccination intentions based on the HBM.

METHODS: Using three-wave longitudinal cohort data from 500 adults in mainland China, participants were divided into four groups based on VA states: persistent awareness (Group 1), early-only awareness (Group 2), late-emerging awareness (Group 3), and persistently unaware (Group 4). ANOVA, chi-square tests, and binary logistic regression were used to analyze the relationships between HBM constructs, social cues, and vaccination intentions.

RESULTS: Group 1 (31.40%) had the highest education level, the COVID-19 vaccination rate (48.35%), and future vaccination intention (36.98%), with significantly higher HBM scores (perceived severity, self-efficacy, benefits) than other groups (all p < 0.001). Group 4 (27.00%) had the highest proportion of unvaccinated individuals (40.31%) and the highest perceived barriers score (M = 2.39 ± 0.73). Logistic regression showed that Group 1’s future COVID-19 vaccination intention was driven by medical expert advice (OR = 3.08, 95% CI: 1.47-6.45) and self-efficacy (OR = 3.68, 95% CI: 1.53-8.87), while Group 4 relied on government advice (OR = 1.56, 95% CI: 1.02-2.40), perceived severity (OR = 1.97, 95% CI: 1.12-3.46), and self-efficacy (OR = 3.68, 95% CI: 1.77-5.84). Trust in social media significantly reduced Group 3’s vaccination intention (OR = 0.08, 95% CI: 0.02-0.35).

CONCLUSIONS: Vaccination awareness states influence vaccination decisions by moderating HBM domains and social cues. Targeted interventions should address group-specific differences, such as enhancing self-efficacy (for Group 1, Group 2, and Group 4), correcting social media misinformation ( for Group 3), and strengthening government communication (for Group 4).

PMID:40841900 | DOI:10.1186/s12889-025-23843-5

BMC Oral Health. 2025 Aug 21;25(1):1346. doi: 10.1186/s12903-025-06695-8.

NO ABSTRACT

PMID:40841897 | DOI:10.1186/s12903-025-06695-8