Nevin Manimala

J Hum Nutr Diet. 2025 Dec;38(6):e70169. doi: 10.1111/jhn.70169.

ABSTRACT

INTRODUCTION: Promoting healthy aging is a public health goal, especially in regions with a high proportion of older adults, such as Greece. This cross-sectional study investigated the association of fish n-3 PUFA intake with indicators of healthy aging among older Greek Peloponnesian adults.

METHODS: In total, 449 individuals > 60 years of age were enroled. Sociodemographic, anthropometrical, medical, mobility, balance, lifestyle, dietary, cognitive and mental characteristics were assessed through validated questionnaires and procedures.

RESULTS: Analyses revealed that n-3 PUFA intake was associated with fewer depression symptoms (p < 0.001), higher cognition levels (p = 0.012) and levels of healthy aging (p < 0.001), derived from Successful Aging Index (SAI). In parallel, n-3 PUFA intake was associated with higher adherence to the Mediterranean diet (p < 0.001). Additionally, n-3 PUFA intake was inversely correlated with the presence of long COVID-19 symptomatology (p = 0.036). No association of n-3 PUFA intake with mobility or physical performance and balance (all ps> 0.05) was detected.

CONCLUSION: The results underscore the significance of nutrition in older adults, highlighting the possible protective impact of n-3 PUFAs on maintaining functionality. Future prospective studies may validate these associations and contribute to the development of targeted nutritional strategies for older adults.

PMID:41277355 | DOI:10.1111/jhn.70169

J Hum Nutr Diet. 2025 Dec;38(6):e70171. doi: 10.1111/jhn.70171.

ABSTRACT

BACKGROUND: Dietetic education should reflect evidence on current practice and demands of the profession yet information regarding the employment profile of dietitians in Ireland is limited. The study aimed to establish the employment profile of graduate dietitians in Ireland and assess their perceived preparedness for employment.

METHODS: A mixed methods design was used. Individuals who graduated from dietetic degrees in Ireland between 2020 and 2024 were invited to participate. An online survey was used to collect information on employment profile and perceived preparedness for employment. Semi-structured interviews explored graduate experiences during their dietetic education and employment in more depth. Interview data were analysed to construct thematic domains.

RESULTS: The online survey had a 49% response rate (132/271). The majority of graduates were employed in hospital dietetics for their first role postgraduation (67%, n = 90) and for their current employment (58%, n = 76). Nondietetic related roles (19%, n = 25) was the second most common current employment followed by community dietetics (12%, n = 16). At the time of survey completion, 29% (n = 37) were living outside Ireland. Most graduates felt slightly (40%, n = 51) or very prepared (46%, n = 59) for their first employment. Four themes were identified from the 13 semi-structured interviews: (1) the value of placement, (2) narrow career preparedness, (3) struggling with the transition to employment and (4) workplace support.

CONCLUSION: This is the first study to establish the employment profile and perceived preparedness of Irish dietetic graduates. Continued graduate tracking and research on solutions to the challenges highlighted in this study could provide evidence to support curricula alignment with workforce demands.

PMID:41277351 | DOI:10.1111/jhn.70171

Biol Sex Differ. 2025 Nov 23. doi: 10.1186/s13293-025-00793-6. Online ahead of print.

ABSTRACT

Many systematic reviews have summarized evidence on the association between behavioural factors and incident cancers. To date, there has been little synthesis of heterogeneity by sex/gender of this evidence.An umbrella review was conducted of systematic reviews with quantitative synthesis (meta-analysis, meta-regression) examining the exposures of body size; physical activity; wholegrains, vegetables, fruit and beans; “fast foods”; red and processed meat; sugar sweetened drinks; dietary supplements; alcohol; tobacco; and sun exposure with incident non-sex-specific cancers. A search of Ovid MEDLINE, Ovid Embase, and Cochrane library from database inception to May 2023 was conducted. We calculated the proportion of systematic reviews that provided quantitative sex/gender findings (e.g., subgroup analyses) and summarized findings narratively. Methodological quality was appraised with the AMSTAR-2 tool.From 13,227 records, 705 full-text systematic reviews were identified as meeting inclusion criteria. Of these, 361 (51.2%) reported quantitative sex/gender findings. The terms “sex” and “gender” were used interchangeably by 36.3% of the 361 systematic reviews and none reported findings for transgender, gender-diverse, or non-binary individuals. Overall, 98.6% (356/361) of systematic reviews were rated “critically low” with the AMSTAR-2 tool. Most of the 361 systematic reviews with quantitative sex/gender findings reported no statistically significant differences by sex/gender.This umbrella review found conflation of sex and gender in systematic reviews of behavioural factors and non-sex-specific cancers and a lack of research among non-cisgender individuals. The existing evidence base is of critically low quality and our findings of no sex/gender-specific trends must be interpreted with caution.

PMID:41276857 | DOI:10.1186/s13293-025-00793-6

Arch Public Health. 2025 Nov 24. doi: 10.1186/s13690-025-01796-w. Online ahead of print.

ABSTRACT

BACKGROUND: Exclusive breastfeeding (EBF) promotes optimal growth and health in infants. Despite national and global initiatives, EBF rates in Malaysia remain below the 70% target set for 2030. This study evaluated the impact of structured breastfeeding education supplemented with WhatsApp follow-up on infant feeding practices, growth, and health outcomes.

METHODS: A quasi-experimental study was conducted at six public health clinics in Gombak District, Selangor. Mothers of healthy-term infants were assigned to either an intervention group (structured education with WhatsApp follow-up) or a comparison group (routine care). A total of 500 mother-infant pairs were enrolled. Data on feeding practices, anthropometric indicators, length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length z-scores (WLZ) and common illnesses, including upper respiratory tract infection (URTI), gastroenteritis (GE), contact dermatitis (CD), bowel disorders (BD), and other illnesses (OI), were collected at Months 1, 3, and 6. Analyses included descriptive statistics, linear mixed-effects models, and generalised logistic mixed models.

RESULTS: Of the 602 mothers screened, 500 were enrolled across six purposively selected clinics, and 460 (220 in the comparison group and 240 in the intervention group) were included in the final analysis. Baseline maternal and infant characteristics were comparable between groups. EBF prevalence was initially higher in the comparison group but increased more significantly in the intervention group by Month 6. Although some baseline z-scores were negative, descriptive trends showed modest, non-significant improvements in LAZ, WAZ, and WLZ over time, indicating overall upward growth trajectories. Linear mixed-effects models confirmed significant time effects, but no group-by-time interactions were observed. Illness prevalence decreased with age, with significant reductions observed for GE and OI and a borderline improvement for URTI in the intervention group. Overall, the intervention improved EBF practices and selected morbidity outcomes but did not significantly alter growth trajectories.

CONCLUSIONS: Structured breastfeeding education, combined with WhatsApp follow-up, effectively enhanced exclusive breastfeeding practices and reduced certain infant illnesses, but showed no significant short-term effects on growth. Longer-term follow-up is warranted to assess the sustained effects on growth and health.

PMID:41276849 | DOI:10.1186/s13690-025-01796-w

Chin Med. 2025 Nov 24;20(1):199. doi: 10.1186/s13020-025-01258-z.

ABSTRACT

BACKGROUND: Chlorhexidine is widely used as a chemical antibacterial mouthwash, but its potential side effects have spurred interest in safer natural alternatives.

PURPOSE: This study aimed to evaluate the anticariogenic efficacy and inhibitory effects of a functional mouthwash containing Clematis chinensis Osbeck (C. chinensis Osbeck) extract in a randomized controlled clinical trial.

STUDY DESIGN AND METHODS: In this randomized, double-blind, controlled clinical trial conducted at Busan M Dental Clinic, 69 participants were randomly assigned to three groups: saline gargle (n = 23), chlorhexidine gargle (n = 23), and C. chinensis Osbeck extract gargle (n = 23). Participants used 15 mL of the assigned mouthwash four times daily for 2 weeks. The oral environment was standardized with professional scaling and a 1-week recovery period before the intervention. Clinical outcomes were evaluated using the O’Leary index and the Cariview™ test kit (AIOBIO Co. Ltd., Seoul, South Korea) at baseline, 1 week, and 2 weeks, respectively, to evaluate dental plaque acidogenicity and user satisfaction. Saliva tests (including cariogenic bacterial counts, acidogenicity, and buffering capacity) were performed using the SillHa Oral Wellness System (ARKRAY Inc., Kyoto, Japan). Subgingival plaque samples were analyzed by quantitative real-time polymerase chain reaction (PCR) analysis to detect cariogenic bacteria (Streptococcus mutans [S. mutans] and Gram-positive cariogenic bacteria [GS group], comprising S. mitis, S. sobrinus, and Lactobacillus casei). Statistical analyses were performed using analysis of variance (ANOVA) and Duncan’s post hoc test, with significance set at P < 0.05.

RESULTS: The C. chinensis Osbeck extract gargle group showed reductions in the O’Leary index score and cariogenic activity, alongside a progressive increase in user satisfaction. Saliva analysis revealed significant decreases in caries-causing bacterial numbers and acid production and improved buffering capacity, enhancing salivary defense. Only the C. chinensis Osbeck extract gargle group showed a significant reduction in S. mutans and the GS group. Compared with the saline and chlorhexidine groups, this group demonstrated a continuous decrease in caries risk over the 2 weeks.

CONCLUSION: C. chinensis Osbeck extract significantly improved clinical parameters related to dental caries, suggesting its potential as a safe and effective natural alternative to chemical antibacterial agents for caries prevention and oral health maintenance.

TRIALS REGISTRATION: ClinicalTrials.gov, KCT0008539. Registered on June 21, 2023, https://cris.nih.go.kr/cris/search/detailSearch.do/23816 ).

PMID:41276841 | DOI:10.1186/s13020-025-01258-z

Gut Pathog. 2025 Nov 24;17(1):93. doi: 10.1186/s13099-025-00763-8.

ABSTRACT

BACKGROUND: The incidence of an infection with Helicobacter pylori, or H. pylori rises with age, mostly affecting children.The infection rate of Helicobacter pylori increases with age, primarily affecting children. The rate of cases of disease of the hands, feet, and mouth (HFMD), an infectious illness that mostly affects newborns and young children and is ubiquitous throughout the Asia-Pacific area, declines with age. Asthma, shigellosis, TB, anaphylactic disease, and other diarrheal illnesses are all prevented by H. pylori. It also has a strong correlation with infectious disorders brought on by infection with pathogens including Orientia tsutsugamushi, HIV, HCV, and Brucella abortus. Nonetheless, the status of infection with H. pylori in individuals already infected with HFMD and the clinical implications of CagA⁺ H. pylori strains remain unreported.

METHODS: From October 2020 to October 2023, 130 children clinically diagnosed with HFMD enrolled in the observation group at the Affiliated Hospital of Youjiang Medical University for Nationalities Affiliated Hospital of Youjiang Medical College of Nationalities and the People’s Hospital of Beihai. With respect to gender, age, and location of residence, 150 chronologically matched healthy children made up the control group. Serum H. pylori antibodies in patients were measured, and the strain was identified through the Western blot technique.

RESULTS: 1. The frequency of infections with H. pylori with the prevalence of CagA + strains were found to be 16.2% and 8.5%, respectively, in patients with HFMD. These figures are lower than the 29.3% and 18.0% that are seen in healthy children, respectively (P-value < 0.05 for both). 2. The infection rate of the bacteria H. pylori and CagA + strains was found to be 18.5% and 9.3% in HFMD patients over 5 years of age, which is lower than the 41.5% and 26.2% observed in healthy children over 5 years, respectively (P-value < 0.05). In contrast, the rate of H. pylori and CagA + strains in HFMD patients aged 5 years and below was comparable to that of healthy children in the same age group, with both results showing no statistically significant differences. 3. H. pylori and CagA + strain prevalence were similar in primary and subsequent HFMV infections, although neither was statistically significant. 4.The findings of the univariate and multivariate analyses indicated that vaccination against HFMD and infection with H. pylori CagA + were protective factors against HFMD (0.203; 0.069-0.593; 0.004).

CONCLUSION: When compared to children in good health, individuals with HFMD had much lower levels of Helicobacter pylori infection. Additionally, H. pylori that carries the CagA gene could be able to prevent the development of HFMD.

PMID:41276838 | DOI:10.1186/s13099-025-00763-8

BMC Prim Care. 2025 Nov 24. doi: 10.1186/s12875-025-03117-0. Online ahead of print.

ABSTRACT

AIMS: Chronic kidney disease (CKD) is a major global health concern, often underdiagnosed in primary care settings. This study aimed to assess CKD screening practices using estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) among individuals in a primary care population in Girona Sud, Catalonia.

METHODS: A cross-sectional analysis was conducted using anonymised electronic health records from Girona Sud primary care centres. We included active patients aged ≥ 15 years with a recorded medical history. Demographic, clinical, and laboratory data, including eGFR and UACR, were analysed. CKD was defined as eGFR < 60 ml/min/1.73 m² and/or UACR ≥ 30 mg/g. Descriptive and inferential statistical analyses were performed.

RESULTS: Among the studied population (N = 230,922), 37% had mildly decreased eGFR (60-89 ml/min/1.73 m²), while 3% had more advanced CKD (G3b-G5). Albuminuria was mostly A1 (89%), with moderate (9.4%) and severe (1.8%) cases observed. Screening was more frequent in patients with type 2 diabetes, hypertension, and dyslipidaemia. Renal protective drugs, such as ACE inhibitors, ARBs, and SGLT2 inhibitors, were mainly prescribed in early CKD stages.

CONCLUSIONS: Early-stage CKD is prevalent in our primary care population, particularly among those with cardiometabolic conditions. It is important to optimize the CKD detection and management in primary care. Despite the availability of renal protective treatments, their underutilization in advanced stages of CKD highlights missed opportunities for timely and optimal intervention.

PMID:41276836 | DOI:10.1186/s12875-025-03117-0

J Orthop Surg Res. 2025 Nov 24. doi: 10.1186/s13018-025-06531-3. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to compare radiological and clinical outcomes between midline lumbar fusion (MIDLF) and minimally invasive transforaminal lumbar interbody fusion (MITLIF) in patients with L4/5 lumbar spinal stenosis and concomitant osteoporosis.

METHODS: A retrospective cohort study was performed involving patients with osteoporosis who underwent either MIDLF or MITLIF. Participants were stratified into two groups based on the surgical technique. Primary outcome measures included operative duration, intraoperative blood loss, postoperative hemoglobin reduction, time to extubation, length of hospital stay, postoperative complication rate, fusion rate, and radiographic parameters: lumbar lordosis (LL), intervertebral disc height (HOD), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Clinical outcomes were assessed using the Visual Analogue Scale (VAS) for back and leg pain, Japanese Orthopaedic Association (JOA) scores, and the Oswestry Disability Index (ODI).

RESULTS: The MIDLF group comprised 22 patients with a mean follow-up duration of 32.48 months, while the MITLIF group included 21 patients with a mean follow-up of 35.32 months. Both groups demonstrated statistically significant postoperative improvements in VAS, JOA, and ODI scores relative to baseline. The MIDLF group exhibited significantly higher JOA scores at 3 and 12 months postoperatively. Intraoperative blood loss was significantly lower in the MITLIF group (p < 0.021), and time to extubation was also significantly shorter (p < 0.001). Although not statistically significant, the MIDLF group exhibited reduced surgical and hospitalization durations. No significant differences were observed between groups in terms of complication or fusion rates. Radiological evaluation indicated significant postoperative improvements in LL, HOD, and SS, along with reductions in PT and PI-LL mismatch; however, no statistically significant differences were observed between the surgical techniques.

CONCLUSION: Both MIDLF and MITLIF are effective in improving sagittal alignment and alleviating symptoms in patients with L4/5 lumbar spinal stenosis and osteoporosis. MITLIF may offer perioperative advantages, including reduced intraoperative blood loss and a shorter extubation times.

PMID:41276834 | DOI:10.1186/s13018-025-06531-3

Cogn Neurosci. 2025 Nov 23:1-4. doi: 10.1080/17588928.2025.2591254. Online ahead of print.

ABSTRACT

Ritchie and colleagues propose that the functional organization of higher visual cortex is best understood through the lens of behavioral relevance, advocating for a shift away from theories that center around category selectivity. Building on this, I suggest the statistical structure of visual inputs acts as an additional critical constraint on visual cortex, and that a complete understanding of visual system organization must account for input statistics and how they interact with behavioral relevance. I discuss this using cortical food selectivity as a case study, and additionally describe how deep neural networks can provide new avenues for testing these theories.

PMID:41276824 | DOI:10.1080/17588928.2025.2591254

BMC Med Educ. 2025 Nov 24. doi: 10.1186/s12909-025-08324-y. Online ahead of print.

ABSTRACT

BACKGROUND: Generative artificial intelligence chatbots have become increasingly popular in the nursing education. Numerous academics have integrated them into their courses to assess the effects of artificial intelligence-supported teaching method. However, few researches have examined the impact of generative artificial intelligence chatbots in nursing education in conjunction with a particular teaching methodology. This study introduced a novel teaching method called “generative artificial intelligence chatbots + project task driven teaching” and investigated the potential effects of the teaching method on nursing undergraduates’ nursing research ability and nursing research self-efficacy.

METHODS: The study was conducted among 108 nursing undergraduates at Ningxia Medical University who participated in the “generative artificial intelligence chatbots + project task driven teaching” in the Nursing Research Course from September to November 2023. Sociodemographic characteristics questionnaire, Nursing research capacity of self-evaluation questionnaire, Nursing research self-efficacy questionnaire, and Curriculum effectiveness evaluation form were used to collect data. The analysis included the descriptive statistics and the paired t-test. The demographic data was summarized using descriptive statistics, and the change in nursing research capacity and nursing research self-efficacy of nursing undergraduates before and after the Nursing Research Course was compared using the paired t-test. The significance level was set at P < 0.05.

RESULTS: Following the training, students’ nursing research capacity and nursing research self-efficacy significantly improved (P < 0.05), with the exception of data processing capacity (P = 0.165). The curriculum effectiveness evaluation form showed that only a few students believed that the teaching mode was ineffective, which indicated that most students still had a favorable opinion of it.

CONCLUSIONS: Nursing undergraduates can better adapt to the “generative artificial intelligence chatbots + project task driven teaching”, and the teaching mode had also achieved positive results in nursing research courses, which has improved students’ nursing research ability and nursing research self-efficacy. This also provides a credible reference for using generative artificial intelligence chatbots in subsequent nursing education reform.

PMID:41276820 | DOI:10.1186/s12909-025-08324-y