Nevin Manimala

Disaster Med Public Health Prep. 2025 Jul 7;19:e178. doi: 10.1017/dmp.2025.10117.

ABSTRACT

OBJECTIVE: We aimed to explore concerns and feeling of safety among quarantined and non-hospitalized COVID-19 patients.

METHODS: We conducted a qualitative study of free text answers from participants of an online survey. The survey was conducted between March 2020 and June 2021. COVID-19 positive adults in home isolation and adults in quarantine were eligible for participation. 698 participants answered one or more of three open-ended questions about concerns and safety. We analyzed free-text answers using thematic analysis according to Braun and Clarke with an inductive approach.

RESULTS: Analysis of the free-text answers from all participants identified three main themes: (1) Fear of the unknown, (2) Views on personal care and public health measures, and (3) Concern for the future of a country in crisis. Participants’ feelings revolved around health-related concerns and societal related concerns. They were concerned about their own and other’s health, and possible long-term consequences of COVID-19 infection. Some participants were satisfied with the health care system, others thought follow-ups, testing, vaccination, and information would increase their feeling of safety.

CONCLUSIONS: People quarantined and isolated due to the COVID-19 pandemic had concerns regarding personal health and societal consequences of infection control measures. Health care follow-ups and individualized information would increase participants’ feeling of safety.

PMID:40621640 | DOI:10.1017/dmp.2025.10117

Disaster Med Public Health Prep. 2025 Jul 7;19:e175. doi: 10.1017/dmp.2025.10097.

ABSTRACT

BACKGROUND: The COVID-19 pandemic, which has killed millions of people worldwide, continues to be marked by waves of reinfections. We aimed to assess the incidence and clinical characteristics of reinfection in COVID- 19 cohort.

MATERIAL AND METHODS: A single-center descriptive study was conducted. Data were collected from all patients who tested positive for SARS-CoV-2 via PCR from March 18, 2020, the onset of the first major COVID-19 wave, until the end of 2020. All PCR-positive patients were followed-up, and those who had SARS-CoV-2 PCR positivity again at least 90 days after the initial onset were contacted via telemedicine.

RESULTS: 5814 patients diagnosed with COVID-19 with PCR positive in the first wave were included. The incidence of reinfection among the cohort of patients infected with SARS-CoV-2 during the initial wave of COVID-19 was 0.73%. Among healthcare workers, the 1-year reinfection rate was 2.14%, 3.9 times higher than non-healthcare workers. We observed that the clinical course was milder and less complicated in patients who had reinfection. In cases of reinfection among fully vaccinated individuals, statistically significantly fewer symptoms were observed.

CONCLUSIONS: We observed that healthcare workers are at approximately four times greater risk of reinfection. Reinfections generally presented with a milder clinical course.

PMID:40621638 | DOI:10.1017/dmp.2025.10097

Mult Scler. 2025 Jul 7:13524585251353079. doi: 10.1177/13524585251353079. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between attendance at specialized multiple sclerosis (MS) clinics and mortality has not been fully evaluated.

OBJECTIVE: We investigated the association between visits to specialized care in Danish MS clinics and mortality.

METHODS: We collected data from Danish national registers to assess survival among people with MS according to the number of visits in MS clinics. We employed the Kaplan-Meier method and extended Cox regression modelling.

RESULTS: In total, 9929 patients with MS were included in the study, contributing 105 115 person-years at risk. A total of 316 patients with MS died during a median follow-up of 10.3 years. Cumulative visits were not statistically associated with mortality (hazard ratio (HR), 95% confidence interval (CI) = 1.00, 0.99-1.02). Female sex (0.68, 0.53-0.87), being divorced (0.56, 0.37-0.86), being married or in a partnership (0.60, 0.45-0.79) and higher education (0.64, 0.45-0.91) were independently associated with reduced mortality. Expanded Disability Status Scale (EDSS) ⩾ 3 (2.38, 1.60-3.54), ischaemic cerebrovascular disease (1.97, 1.42-2.75) and pneumonia (7.03, 5.48-9.02) were associated with an increased mortality.

CONCLUSION: We found no association between visits to specialized care and mortality. Our findings suggest that improving survival in patients with MS may require a focus on quality and content of care and proactive management of comorbidities.

PMID:40621617 | DOI:10.1177/13524585251353079

Proc Inst Mech Eng H. 2025 Jul 7:9544119251348490. doi: 10.1177/09544119251348490. Online ahead of print.

ABSTRACT

Lower limb fragility fractures included a break in bone from the pelvis to the foot. Weight-bearing and walking stability stand as key performance indicators to quantify fracture restoration. Normally, progress in fracture rehabilitation is observed through clinical assessments and patients’ responses, and modern research also presents instrumented gait analysis. There exists a gap to statistically compute the regaining in patients’ weight-bearing ability and walking stability following fractures. This study introduces methods to advance the analysis of instrumented signals and evaluate walking stability in fracture-healing patients. The centre of pressure (CoP) signals were captured for four conditions: tibia/fibula/talus fracture near the ankle (AF), lower-leg shaft fracture (LF), calcaneus fractures (CF), and normal ankle (NA). The time derivative for CoP signals showed impulsive responses during the loading and unloading transitions which were then modelled and transformed to the frequency domain. The developed models were further analysed by applying Nyquist and Bode methods and margins of stability were calculated for the fractured and healthy subjects. Results showed a substantial decline (Kruskal-Wallis’s test, p < 0.001) in the intralimb stability of all three fractures. Also, there was a strong interlimb dependency (p < 0.001) observed between fractured and intact limbs applying Spearman’s correlation during double limb support periods. Overall, the calcaneus fracture (CF) exhibited minimum intralimb stability and increased interlimb dependency. These methods stand clinically important in monitoring patients’ rehabilitation and in decision-making about alternative treatment plans.

PMID:40621615 | DOI:10.1177/09544119251348490

Int J Gen Med. 2025 Jun 30;18:3569-3578. doi: 10.2147/IJGM.S526759. eCollection 2025.

ABSTRACT

AIM: To investigate the clinicopathological features and prognostic factors of intrahepatic and extrahepatic cholangiocarcinoma.

METHODS: Clinicopathological and follow-up data of 328 cholangiocarcinoma patients treated at Shanxi Cancer Hospital from November 7, 2016, to August 11, 2021, were retrospectively reviewed. All samples were tested for Fibroblast growth factor receptor 2 (FGFR2) fusion by FISH. The expression of the proliferative marker Ki67 in patients with intrahepatic cholangiocarcinomas (iCCA) was evaluated by immunohistochemistry. All patients were followed up from the date of surgery to the time of death or August 31, 2023. Pathological specimens from patients with recurrence were collected and FGFR2 was tested again.

RESULTS: The positivity rates for FGFR2 fusion in intrahepatic, perihilar, and distal cholangiocarcinomas were 15%, 2.73%, and 1.69%, respectively. The chi-square test showed that tumor diameter, perineural invasion, complications, and FGFR2 fusion were statistically significant. Immunohistochemistry showed that patients with low expression of Ki67 accounted for 30% of iCCA, low expression of Ki67 and FGFR2 fusion was statistically significant. Relapse specimens were collected from 13 patients, and FISH showed that the expression of FGFR2 was consistent with that of the primary lesion. Multivariate analysis showed that lymph node metastasis was an independent factor for the prognosis of cholangiocarcinoma (P<0.05).

CONCLUSION: CCA is an aggressive tumor with high mortality and low survival rates, especially for perihilar cholangiocarcinoma (pCCA). Therefore, it is necessary to understand the clinicopathological features and prognostic factors of iCCA, pCCA and distal cholangiocarcinoma (dCCA). In addition, lymph node status is likely to be an independent and important prognostic factor.

PMID:40621597 | PMC:PMC12227518 | DOI:10.2147/IJGM.S526759

J Oral Biol Craniofac Res. 2025 Sep-Oct;15(5):925-931. doi: 10.1016/j.jobcr.2025.06.010. Epub 2025 Jun 22.

ABSTRACT

INTRODUCTION: Innovative approaches to curriculum design and implementation are critical in meeting the needs of today’s students. The present study was undertaken to determine the perspective of students on the introduced module of ‘Digital Dentistry’ along with knowing their self -directed learning abilities.

METHODS: The present study was conducted in the Medical University after ethical approval was obtained. Forty volunteers from 3rd and 4th year undergraduates of “Bachelor of Dental Surgery” course were selected and consent form was obtained. A pre-validated questionnaire on self-directed learning (SDLI) was administered to the volunteers to know their SDL abilities. A pre-post-session questionnaire containing feedback questionnaires was prepared, validated and administered before the session. A pre designed module was applied on the volunteers by using SDL session. 2 h duration of First contact session followed by 2 weeks of intersession period, where student went through the shared online/offline study material and visit to the lab under faculty supervision. Outcome assessment was done with 30 MCQ based on the 3 chapters taught in the session. In Second contact session, debriefing by faculty was done and post-module questionnaire was administered. The responses obtained from SDLI, assessment questionnaires and pre-post-module questionnaires were further analyzed statistically.

RESULTS: Student’s SDLI score with median value of 77.325 represented a good score, with learning motivation scored highest in SDLI. The total score significantly improved post-intervention, with the mean score increasing from 28.83 (5.43) pre-intervention to 35.35 (4.36) post-intervention.

CONCLUSION: Significant improvement in knowledge, awareness and perceptions of digital dentistry was seen after the conduct of the session.

PMID:40621583 | PMC:PMC12226062 | DOI:10.1016/j.jobcr.2025.06.010

Front Psychiatry. 2025 Jun 20;16:1556046. doi: 10.3389/fpsyt.2025.1556046. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aims to examine the effect of online verbal aggression on interpersonal trust and the chain-mediating role of core self-evaluation and emotional intelligence among college students.

METHOD: A questionnaire survey was conducted among 869 college students with experiences of online verbal aggression using the Cyber Verbal Bullying Scale, Interpersonal Trust Scale, Core Self-Evaluation Scale, and Emotional Intelligence Scale.

RESULTS: (1) After controlling other latent variables, it was found that online verbal aggression had a significant direct negative effect on college students’ interpersonal trust. (2) Core self-evaluation and emotional intelligence played significant mediating roles in the relationship between online verbal aggression and interpersonal trust, and their combined chain mediation effect was also statistically significant.

CONCLUSION: Victimization by online verbal aggression may lower core self-evaluation in college students, thereby impairing their emotional perception and regulation and ultimately reducing their interpersonal trust. Effective interventions should address self-evaluation, emotional intelligence, and interpersonal trust to mitigate the adverse effects of online verbal aggression on college students.

PMID:40621562 | PMC:PMC12226459 | DOI:10.3389/fpsyt.2025.1556046

Pak J Med Sci. 2025 Jun;41(6):1743-1748. doi: 10.12669/pjms.41.6.11856.

ABSTRACT

OBJECTIVE: To investigate clinical efficacy of novel biogenically fabricated titania nanoparticles enriched mouth wash in treating dentin sensitivity of patients.

METHODS: Tripple blinded randomized clinical trial was conducted at School of Dentistry Islamabad from 6^th June 2024 to 6^th December 2024 incorporating participants (n = 260) with Group-A (n = 130) and Group-B (n = 130). After attaining informed consent and randomization, Visual Analog Scoring system (VAS Value) was induced to check the Dentin hypersensitivity (DH) of the participants at baseline, after one month and three months follow up. Group-A was given Conventional Mouth wash and Group-B was given Novel-Nanoparticles (Nps) Mouth Wash for total three months to treat DH. The primary outcome was calculated as mean VAS Values for both Groups-A and B after one month and three months. Mann-Whitney-U Test was used for comparing DH between these two groups.

RESULTS: According to trial results, significant difference was obtained between Group -A that used Conventional Mouth wash and Group-B that used Novel- Nps Mouth wash after one month (p = 0.001) and three months (p = 0.002).

CONCLUSION: DH declination was more prominent in patients that used Novel- Nps Mouth wash with nanoparticles in comparison to participants that used Conventional Mouth wash without any nanoparticles. This concludes that inclusion of biogenically fabricated titania nanoparticles in clinical dentistry could be beneficial in resolving Dentin Hypersensitivity.

PMID:40621550 | PMC:PMC12223751 | DOI:10.12669/pjms.41.6.11856

Pak J Med Sci. 2025 Jun;41(6):1734-1742. doi: 10.12669/pjms.41.6.12187.

ABSTRACT

BACKGROUND & OBJECTIVE: Recent studies have showed a correlation between hyperglycemia and insulin resistance with adverse outcomes in multiple critical diseases, including sepsis. The triglyceride-glucose index (TyGi) is now recognized as a proxy indicator of insulin therapy resistance. We aimed to ascertain the connection between TyGi and the sepsis prevalence and clinical outcomes in patient’s post-abdominal surgery.

METHOD: Data for this retrospective cohort study was acquired from the Medical Information Mart for Intensive Care IV database from 2008 to 2019. Patients (≥18 years) who had elective major abdominal surgery were included. The primary outcome was the occurrence of sepsis following abdominal surgery. The connection between TyGi and sepsis incidence was investigated with multivariable Cox regression analysis.

RESULTS: One thousand eight hundred eighty-four patients were included in this study. The cumulative incidence of sepsis during hospitalization was 12.3%. The adjusted Cox regression model showed that raised TyGi levels were linked to a greater probability of sepsis incidence (Hazard’s ratio, 1.907; 95% CI, 1.327-2.739; p<0.001). Restricted Cubic Spline analysis demonstrated that TyGi possessed a strong and almost linear connection with the likelihood of postoperative sepsis. Subgroup analysis showed interaction effects in the subgroup with low high-density lipoprotein cholesterol (p for interaction=0.018). Furthermore, the incorporation of TyGi into the existing prediction model shows an enhancement in outcome prediction. The C-statistic elevated from 0.696 to 0.722, p<0.007. The continuous net reclassification improvement (NRI) was 0.203, p=0.005, and the integrated discrimination improvement (IDI) was 0.007, p<0.001.

CONCLUSION: Patients at increased risk of developing sepsis following abdominal surgery may be identified in clinical practice with TyGi.

PMID:40621548 | PMC:PMC12223748 | DOI:10.12669/pjms.41.6.12187

Pharmacoepidemiol Drug Saf. 2025 Jul;34(7):e70177. doi: 10.1002/pds.70177.

ABSTRACT

Multi-database distributed data networks for post-marketing surveillance of drug safety and effectiveness use two main approaches: common data models (CDMs) and common protocols. Networks such as the U.S. Sentinel System, the Observational Health Data Sciences and Informatics (OHDSI) network, and the Data Analysis and Real-World Interrogation Network in Europe (DARWIN-EU) use a CDM approach in which participating databases are translated into a standardized structure so that a single, common analytic program can be used. On the other hand, the common protocol approach involves applying a single common protocol to site-specific data maintained in their native format, with analytic programs tailored to each data source. Some networks, such as the Canadian Network for Observational Drug Effect Studies (CNODES) and the Asian Pharmacoepidemiology Network (AsPEN), use a variety of approaches for multi-database studies. Regardless of the approach, distributed networks support comprehensive pharmacoepidemiologic studies by leveraging large-scale health data. For example, utilization studies can uncover prescribing trends in different jurisdictions and the impact of policy changes on drug use, while safety and effectiveness studies benefit from large, diverse patient populations, leading to increased precision, representativeness, and potential early detection of safety threats. Challenges include varying coding practices and data heterogeneity, which complicate the standardization of evidence and the comparability and generalizability of findings. In this Core Concepts paper, we review the purpose and different types of distributed data networks in pharmacoepidemiology, discuss their advantages and disadvantages, and describe commonly faced challenges and opportunities in conducting research using multi-database networks.

PMID:40619597 | DOI:10.1002/pds.70177