Nevin Manimala

BMC Public Health. 2025 Dec 1;25(1):4197. doi: 10.1186/s12889-025-23513-6.

ABSTRACT

BACKGROUND: Effective Birth preparedness remain one of the most important intervention to reduce the risk of complications such as postpartum hemorrhage, obstructed labor, fetal distress, uterine rupture, pre-eclampsia, eclampsia, infections, still birth and unsafe abortion. Despite the efforts to encourage women to give birth in healthcare facilities, improvement has remained stagnant, particularly in remote Indigenous Maasai population in northern Tanzania. This study utilizes the Social Ecological Model (SEM) as a guiding framework to assess the multilevel determinants influencing health facility birth preparedness practices among Indigenous Maasai women. The study explores how individual, interpersonal, community, and societal-level factors influence maternal health behaviors.

METHODOLOGY: The study employed a community-based analytical cross-sectional study design, which was conducted among 355 Indigenous Maasai women who had given birth within the last 24 months, from 11th April 2024 to 30th June 2024. The study employed a multistage sampling technique to select the study participants. A structured questionnaire adapted from previous studies was used to collect data. The univariate and multivariate binary logistic regression model was used to analyze determinants of birth preparedness practices, and the statistical significance was declared at 95% CI, and p < 0.05.

RESULTS: The mean age of study participants was 29.6 years ± 7.4 (SD), only 10.14% of the participants were prepared for health facility birth. The determinants influencing health facility birth preparedness practices included higher average monthly income (AOR = 11.702, 95% CI: 1.306, 104.835, p = 0.028), adequate knowledge of obstetric danger signs (AOR = 85.273, 95% CI: 2.282, 3186.398, p = 0.016), availability of drugs and supplies (AOR = 5.901, 95% CI: 1.013, 34.385, p = 0.048), accessible roads throughout the year (AOR = 8.602, 95% CI: 1.420, 52.107, p = 0.019), and perceived quality of services at health facility (AOR = 21.661, 95% CI: 2.212, 212.072, p = 0.008).

CONCLUSION: This study reveals low health facility birth preparedness among Indigenous Maasai women, influenced by socioeconomic challenges, limited knowledge, and poor infrastructure. To address this, multifaceted interventions are needed to improve financial access, education, and healthcare quality. A sustainable approach requires collaboration between the health sector, local government, and community leaders. Ensuring equity in maternal healthcare is crucial, particularly for marginalized indigenous populations. Addressing systemic barriers like poor road infrastructure is essential to improving access. These strategies are vital for better birth preparedness and maternal health outcomes in the region.

PMID:41327113 | DOI:10.1186/s12889-025-23513-6

BMC Oral Health. 2025 Dec 1;25(1):1862. doi: 10.1186/s12903-025-06963-7.

ABSTRACT

OBJECTIVES: The aim of this observational case‒control study was to compare the oral health (OH) status of Bone metastatic cancer (BMC) patients (case Group 1), head and neck cancer HNC patients (case Group 2) and systemically healthy patients (control group). The secondary objective was to identify any risk factors associated with poor OH status.

METHODS: This study was conducted from 2018-2024, and all patients were evaluated at the Oral Medicine, Head and Neck Department-Fondazione Policlinico Universitario A. Gemelli-IRCSS, Rome. The OH status was clinically and radiographically evaluated using the DMFT index, a full periodontal chart and a radiological examination (orthopantomography). The OH status was defined as “poor” in patients with stage III or IV periodontitis and/or a DMFT score ≥ 13. The study protocol was approved by the Ethics Committee of the Università Cattolica del Sacro Cuore (ID-5746). Univariate statistical analysis was performed to detect associations between different clinical variables and OH. The associated variables were subjected to multivariate logistic regression to retrieve the independent risk factors for poor OH.

RESULTS: A total of 510 (170 per group) patients were analyzed. Logistic regression analysis revealed that HNC patients showed significantly worse oral conditions when compared to BMC patients and controls. HNC patients showed an OR of 2.36 (95% CI: 1.35-4.13, p = 0.003) for poor OH when compared to control group. No differences were found between BMC patients and control group. Smoking habits (OR: 3.22, 95% CI: 1.93-5.35, p < 0.0001), and age > 70 years (OR: 17.44, 95% CI: 8.78-34.66, p < 0.0001) were other significant risk factors for poor OH. The risk decreased for younger patients: for patients aged 60-69 years, the OR was 5.17 (95% CI: 2.74-9.75, p < 0.0001); for patients aged 50-59 years, it was 4.22 (95% CI: 2.30-7.76, p < 0.0001).

CONCLUSIONS: HNC patients exhibit significantly poorer OH than BMC patients and healthy controls, highlighting the need for enhanced dental care in oncologic management. Nevertheless, smoking habits and age remain important risk factors.

PMID:41327109 | DOI:10.1186/s12903-025-06963-7

BMC Infect Dis. 2025 Dec 1. doi: 10.1186/s12879-025-12252-z. Online ahead of print.

ABSTRACT

BACKGROUND: Occult hepatitis B virus infection (OBI) poses a significant challenge to blood transfusion safety, as it occurs in HBsAg-negative blood donors who are anti-HBc positive and carry detectable hepatitis B virus (HBV) DNA. The lack of additional serological screening and accessible molecular testing in blood banks allows blood units with anti-HBc positivity and HBV DNA to be transfused. The aim of the study was to determine the residual transfusion risk and to identify OBI genotypes among blood donors at the Yaoundé Central Hospital.

METHODS: This cross-sectional, analytical, and descriptive study involved 269 blood donors between February and June 2025 at the Yaoundé Central Hospital blood bank and at the Centre Pasteur du Cameroun. Informed consent was obtained from all participants. HBsAg was screened through both Rapid Diagnostics Test (RDTs) and Enzyme Linked Immunosorbent Assay (ELISA). ELISA was used for the detection of Anti-HBc IgM and IgG antibodies. Testing for occult HBV infection in the HBsAg-negative, anti-HBc-positive subjects was performed using quantitative polymerase chain reaction (qPCR). HBV genotypes were determined by sequencing a fragment of the surface gene (PreS1) and then performing phylogenetic analysis of the nucleotide sequences. Statistical analysis was performed using R software 4.4.3.

RESULTS: Of the 269 donors, 168 (62.45%) were HBsAg-negative and anti-HBc-positive. HBV DNA was detected in 9 donors, confirming occult HBV infection with a residual transfusion risk of 3.34%. The number of prior donations was significantly factor negatively associated with HBV DNA presence (p = 0.021, OR [95% CI]: 0.13 [0.0-0.80]). Sequencing of the PreS1 gene fragment from 3 isolates revealed co-circulation of HBV genotypes A and E in the studied population.

CONCLUSION: This study highlights that only sensitive HBV DNA screening would improve blood safety since anti-HBc screening would exclude 60% of donors in a situation of blood shortage. However, the cost of such testing, even in the low yield pools of 6 as practice in some countries, is likely prohibitive in Cameroon. In present Cameroon situation, systematic, compulsory, vaccination would be the best affordable prevention of OBI transfusion transmission.

TRIAL REGISTRATION: The study protocol was reviewed and approved by the Regional Ethics Committee for Human Health Research of the Center (CRERSH/C) (Number 000734/ CRERSHC/2025) and adhered to the ethical guidelines outlined in the 1975 Declaration of Helsinki.

PMID:41327108 | DOI:10.1186/s12879-025-12252-z

BMC Public Health. 2025 Dec 2. doi: 10.1186/s12889-025-25651-3. Online ahead of print.

ABSTRACT

BACKGROUND: The rapid proliferation of social media has reshaped how young adults access and engage with health information. This study investigates the relationship between social media usage, sexual health literacy, and healthy lifestyle skills among university students. The aim is to explore whether social media serves as a facilitator or barrier to health-promoting behaviors in this population.

METHODS: A cross-sectional, descriptive design was employed. The study population included 4,500 students from faculties of health sciences and social sciences at a Turkish university. Using the known population sampling formula, the minimum sample was calculated as 350; however, 598 university students voluntarily participated. Data were collected via an online questionnaire comprising a socio-demographic form, the Social Media Usage Scale, the Sexual Health Literacy Scale, and the Healthy Lifestyle Skills Scale. Statistical analyses were conducted using SPSS 24.0. Normality was tested using the Kolmogorov-Smirnov test. Parametric tests (t-test, ANOVA) and Pearson correlation analysis were used. Reliability of instruments was assessed using Cronbach’s Alpha.

RESULTS: Participants reported good levels of sexual health literacy (mean score: 51.26 ± 9.03) and moderate levels of healthy lifestyle skills (63.13 ± 11.62). A significant positive correlation was found between sexual health literacy and both social media usage and healthy lifestyle skills (p < 0.01). Participants with prior education in sexual health or media literacy scored significantly higher in both outcome measures. Demographic factors such as gender, income, and urban residence were also associated with healthier lifestyle behaviors.

CONCLUSIONS: The findings indicate that responsible social media use may contribute positively to young adults’ sexual health literacy and health-promoting behaviors. These results highlight the importance of integrating media literacy and sexual health education into public health policies and university curricula. Developing targeted, evidence-based digital interventions could empower youth to navigate health information critically and foster long-term improvements in individual and public health outcomes.

TRIAL REGISTRATION: Not applicable.

PMID:41327098 | DOI:10.1186/s12889-025-25651-3

Cytokine. 2025 Nov 30;197:157076. doi: 10.1016/j.cyto.2025.157076. Online ahead of print.

ABSTRACT

Dynamic molecular changes in early life follow a robust ontogeny as the infant immune system adapts to the demands of its new environment. Studies of plasma immunomodulatory cytokines and chemokines have previously demonstrated ontogenetic patterns of immune development across the first week of life. However, how plasma cytokine and chemokines concentrations evolve over the first 4 months of life remains unknown. In this study, we examined plasma cytokine and chemokine concentrations in a longitudinal cohort of infants in Papua New Guinea (Oceania; n = 87) across the first four months of life. Using a multiplex assay, concentration of 41 cytokines and chemokines in peripheral blood plasma samples collected at Day of Life (DOL) 0 (i.e., birth), -7, -30, and – 128 were measured. Several cytokines and chemokines that shape cellular immunity demonstrated a statistically significant increase in concentration over the first four months of life, including CXCL10 (5.5-fold), IFNγ (8.8-fold), and IL-2 (1.7-fold). In contrast, other cytokines and chemokines significantly diminished with age, including CCL2 (0.12-fold), CXCL8 (0.35-fold), IL-6 (0.38-fold), and TGFα (0.43-fold). Plasma cytokine and chemokine concentrations appeared to be minimally affected by demographic factors such as birth season, gestational age, sex, or maternal age. The patterns and directionality of these observations largely mirrored those reported in previous cohorts, suggesting universal patterns of plasma cytokine and chemokine trajectories in early life. Overall, understanding early life trajectories of plasma cytokines and chemokines provides insight into human immune development and supports future studies analyzing cytokine trajectories in relation to health and disease.

PMID:41325679 | DOI:10.1016/j.cyto.2025.157076

Nurse Educ Today. 2025 Nov 13;158:106915. doi: 10.1016/j.nedt.2025.106915. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore effects of credit bank on clinical communication skills, critical thinking skills, self-directed learning ability, professional identity and public stigma associated with hepatitis B patients of nursing interns in the infectious diseases department.

METHODS: Employing a table of random numbers method, 140 nursing interns from the infectious diseases department of a grade-A tertiary hospital in Hunan Province were selected at random between an intervention group and a control group. The control group received routine clinical teaching in the infectious diseases department, while the intervention group implemented the credit bank practice plan in addition to the routine teaching practice. After 4 weeks of training, the disparities in clinical communication skills, critical thinking skills, professional identity, self-directed learning ability, and reduction of public stigma towards hepatitis B patients were examined between the two groups of nursing interns.

RESULTS: Statistics revealed that after 4 weeks of intervention, the scores of clinical communication skills, critical thinking skills, professional identity, and self-directed learning ability of the intervention group were significantly higher in the intervention group than in the control group, while the scores of public stigma against hepatitis B patients were significantly lower in the intervention group compared to the control group, and the differences were statistically significant (P < 0.05).

CONCLUSION: The results of this study show that credit bank teaching practice can reduce the public stigma of hepatitis B patients among nursing interns in the infectious diseases department and improve their clinical communication skills, critical thinking skills, professional identity and self-directed learning ability.

PMID:41325672 | DOI:10.1016/j.nedt.2025.106915

Clin Neurol Neurosurg. 2025 Nov 28;261:109277. doi: 10.1016/j.clineuro.2025.109277. Online ahead of print.

ABSTRACT

PURPOSE: The use of neuronavigation with superimposed mapping tools has enabled visualization of key fiber tracts and improved peri-operative planning. However, a limitation of these approaches is their reliance on a static underlying brain atlas, particularly in neurosurgical patients with brain tumors. A tool that enables qualification and quantification of brain region connectivity could refine approaches to surgical resection.

METHODS: We utilized a machine learning imaging platform, Quicktome™, to generate individualized functional parcels and tracts that dynamically adapt to perioperative change. The connectome was derived from a combination of diffusion tensor imaging and resting-state function magnetic resonance imaging. Matrices were generated from the functional MRI of four patients with intracranial neoplasms and the pre- and post-operative parcellation values were compared. The individual correlation and strength of regions were quantified. Hypo- and hyper-connected regions were marked as anomalous.

RESULTS: We present a case series of four patients to illustrate the correlation of the anomaly matrices with post-operative neurological changes. These include: post-operative delirium originating associated with salience network hypoconnectivity; visual hemineglect linked to hypoconnectivity in the dorsal attention network; and quantifiable improvements in the language network following the resolution of expressive aphasia. All differences between pre-and post-operative paired correlation values were statistically significant.

CONCLUSION: We demonstrate a novel approach to quantifying the extent to which anomalies in the functional connectome correlate with post-operative neurological changes. This has relevance in post-operative prognostication, provision of specialist therapy services, and could serve as a useful tool in surgical education and pre-operative planning.

PMID:41325661 | DOI:10.1016/j.clineuro.2025.109277

Nanotechnology. 2025 Dec 1. doi: 10.1088/1361-6528/ae2626. Online ahead of print.

ABSTRACT

Memristors with multilevel storage capabilities have emerged as promising candidates for high-density memory and neuromorphic computing systems. In this study, a trilayer-structured memristor with an Al2O3/HfO2/Al2O3 (3/14/3 nm) dielectric stack was fabricated via atomic layer deposition (ALD), sandwiched between Ti and Pt electrodes. The analog switching characteristics of the memristor were systematically investigated through two strategies: adjusting the compliant current (Icc) during the SET process and controlling the RESET-stop voltage (VRESET-stop) in the RESET process. The experimental results indicate that Icc primarily modulates the values of low resistance states (LRSs), whereas VRESET-stop mainly influences the values of high resistance states (HRSs). To validate multilevel storage feasibility, Icc values of 0.5, 1, 2.5, and 5 mA and VRESET-stop voltages of 1.5, 1.7, 2, and 2.3 V were systematically applied. Statistical analysis demonstrated that VRESET-stop modulation yields more stable and repeatable resistance states compared to Icc tuning. Furthermore, the continuous resistance (or conductance) tuning capability of our fabricated memristor emulates neural network weight updates. This allows trained weights to be directly mapped to the memristor’s conductance states, achieving 91.6% accuracy in handwritten digit recognition. This work underscores the significant potential of the Al2O3/HfO2/Al2O3 trilayer-structured memristor for high-performance multilevel storage and neuromorphic computing applications.

PMID:41325628 | DOI:10.1088/1361-6528/ae2626

JMIR Public Health Surveill. 2025 Dec 1;11:e83450. doi: 10.2196/83450.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) face a disproportionately high risk of mpox infection, and China has recently experienced a rapid increase in the reported cases. This population also has a high prevalence of HIV, which has been identified as a critical factor in understanding the vulnerability to mpox. In addition, metabolic diseases frequently co-occur with HIV and share immunometabolic pathways, raising concerns that they may interact to confer additional risk of mpox infection.

OBJECTIVE: This study examines the potential interaction between HIV and metabolic comorbidity in relation to self-reported mpox among MSM in China.

METHODS: A cross-sectional study was conducted among MSM aged 18 to 76 years from October 2023 to March 2024 in 6 representative provincial regions of China. Participants completed an anonymous questionnaire on HIV infection, metabolic diseases (hypertension, diabetes mellitus, and hyperlipidemia), and mpox infection. Metabolic comorbidity was defined as the presence of more than one of these conditions. Logistic regression models were used to examine associations, and additive and multiplicative interactions between HIV and metabolic comorbidity were assessed.

RESULTS: Of the 2403 MSM, 56 (2.33%) reported mpox, 199 (8.28%) reported HIV, and 325 (13.52%) reported at least one metabolic comorbidity (hypertension, diabetes, or hyperlipidemia). Both HIV (odds ratio [OR] 4.81, 95% CI 2.29-9.64) and metabolic comorbidity (OR 2.62, 95% CI 1.27-5.14) were associated with higher odds of mpox infection. A dose-response relationship was observed, with the odds of mpox increasing with the number of conditions (per-condition trend: OR 3.03, 95% CI 1.86-4.83). While multiplicative interaction was not statistically significant (interaction term=2.98, 95% CI 0.68-13.70; P=.15), additive interaction metrics suggested a possible excess association (relative excess risk due to interaction=10.80, 95% CI 1.21-37.52; attributable proportion due to interaction=0.74, 95% CI 0.07-0.87; synergy index=4.99, 95% CI 1.19-20.86). Compared to the participants without HIV or metabolic comorbidity, those with HIV and metabolic comorbidity had higher odds of mpox infection (OR 14.51, 95% CI 4.83-40.70).

CONCLUSIONS: This study suggests that HIV and metabolic comorbidity were each associated with higher odds of self-reported mpox, and exploratory analyses indicated a possible additive interaction. Given the reliance on self-reported diagnoses and the cross-sectional design, the findings should be interpreted with caution due to reporting bias and reverse causation. Further studies are needed to confirm these associations and better understand the comprehensive health needs of MSM with co-occurring conditions.

PMID:41325604 | DOI:10.2196/83450

JMIR Form Res. 2025 Dec 1;9:e81098. doi: 10.2196/81098.

ABSTRACT

BACKGROUND: In Argentina, diabetes is a growing public health concern, with a prevalence of 14% in 2024 and projections reaching 15.4% by 2050. In this context, a Diabetes Prevention and Care Program was implemented in low-income areas across 3 provinces. A key component of the program was a WhatsApp (WhatsApp LLC)-based intervention aimed at promoting self-care, encouraging healthy behaviors, and supporting follow-up among people with diabetes, those at risk, and pregnant women.

OBJECTIVE: This study aimed to describe the implementation and process evaluation of a WhatsApp-based intervention within Argentina’s public health system, using the Carroll Implementation Fidelity Framework, focusing on challenges encountered, implementation strategies used, and lessons learned across the 3 target populations.

METHODS: The intervention was implemented in 40 primary care centers. The population included adults residing in the catchment areas of the selected primary care centers. Participants included adults with type 2 diabetes, people at moderate or high risk based on the Finnish Diabetes Risk Score, and pregnant women. A set of 192 educational and reminder messages was developed and validated through expert input and community feedback. Messages were tailored to each target population and delivered through WhatsApp via Twilio (Twilio Inc) Business API (application programming interface). We assessed implementation fidelity focusing on adherence to the intervention, participant responsiveness, quality of delivery, and contextual barriers.

RESULTS: A total of 11,029 participants were enrolled in this study, of whom 9983 (90.5%) had a valid mobile phone number registered in the system. Among these, 32.8% (3276/9983) had a diagnosis of type 2 diabetes, 53.3% (5320/9983) were identified as being at moderate or high risk based on the Finnish Diabetes Risk Score questionnaire, and 13.9% (1387/9983) were pregnant women. Overall, 67.3% (n=5749) opted in to receive messages, with the highest acceptance among those with diabetes (n=2169, 74.3%) and the lowest among at-risk people (n=2935, 62.1%). Message adherence was high: 88.7% (n=5004) of participants received at least the minimum number of educational messages expected, and the mean proportion of messages read per participant was 82.2% (SD 29.8). The dropout rate was low (6.1%) but higher among pregnant participants (14.6%). Message delivery issues mostly included problems with WhatsApp on the mobile phones of participants. Technical challenges, including server overload, were addressed during implementation.

CONCLUSIONS: The WhatsApp-based intervention was feasible and well-received in public primary care settings in Argentina, particularly among people with diabetes. The experience illustrates how a WhatsApp-based intervention can be leveraged to strengthen service delivery in low-resource contexts, while also highlighting the need for further work on integration with electronic health records, tailoring of content to population needs, and strategies to enhance digital inclusion for underserved populations.

PMID:41325602 | DOI:10.2196/81098