Nevin Manimala

BMC Psychol. 2025 Apr 24;13(1):432. doi: 10.1186/s40359-025-02749-2.

ABSTRACT

BACKGROUND: The perceived social stigma of caregivers of children with autism spectrum disorder (ASD) may negatively affect caregivers’ mental health and, consequently, the quality of care for these children. Religious and spiritual well-being may serve as protective factors against such stigma. This study aimed to examine the relationship between spirituality, religiosity, and perceived social stigma among caregivers of children with ASD.

METHOD: This cross-sectional study was conducted from September 2022 to June 2023 in Qom, Iran. A total of 102 caregivers were recruited from specialized rehabilitation centers through convenience sampling. Participants completed the Multidimensional Inventory for Religious-Spiritual Well-being (MI-RSB 48) and the Stigma Scale for Chronic Illnesses (SSCI-8), along with a demographic questionnaire. Data were analyzed using descriptive statistics and multiple regression analysis.

RESULTS: The mean perceived social stigma score was 16.85 ± 6.76, with 45.5% of participants reporting higher-than-average social stigma. All dimensions of spiritual-religious well-being, except belief in the afterlife and the experience of meaning, showed a significant negative correlation with perceived social stigma (P < 0.05). Multiple regression analysis revealed that the child’s age (β = 0.401, P = 0.018) and hope transcendent (β = 0.418, P = 0.012) were significant negative predictors of perceived stigma, explaining 59% of the variance.

CONCLUSION: The findings suggest that fostering transcendent hope and spiritual connectedness may mitigate the perceived stigma among caregivers of children with ASD, highlighting the potential of spirituality-based interventions in rehabilitation programs.

PMID:40275426 | DOI:10.1186/s40359-025-02749-2

Perioper Med (Lond). 2025 Apr 24;14(1):48. doi: 10.1186/s13741-025-00520-0.

ABSTRACT

PURPOSE: Extubation refers to removing the breathing tube from the patient’s airway after surgery under general anesthesia with tracheal intubation. Extubation procedures typically take less than 15 min, and if they take more, they are prolonged. Whether or not to extubate a patient depends on several factors, including the patient’s preoperative status, the type of surgery, anesthetic methods, and expected recovery after the procedure. Thus, the study’s objective was to determine the incidence of prolonged extubation and its associated factors among adult patients undergoing surgery at Jimma Medical Center.

METHODS: A prospective observational study through a consecutive sampling technique was conducted. Ethical clearance and approval were obtained from the institutional review board of Jimma University. Data on the extubation time and possible associated factors for a prolonged extubation time were collected using a data collection checklist. After being entered into EpiData 4.6 and exported into SPSS 25, descriptive analyses and logistic regression were carried out. In multivariate variables, p ≤ 0.05 was declared as statistical significance.

RESULT: Three-hundred eight adult patients were enrolled in the current study. Of these, the incidence of prolonged extubation was 24.7% (95% CI [20.0-29.9]). The identified associated factors were age ≥ 55 years (AOR = 5.7, 95% CI [2.62, 12.69], p ≤ 001); ASAPS > II (AOR = 4.27, 95% CI [1.59, 11.45], p = 004); BMI ≥ 30 kg/m² (AOR = 6.6, 95% CI [2.37, 18.36], p ≤ 001); the use of benzodiazepine (AOR = 3.43, 95% CI [1.42, 8.25], p = 0.006); using of isoflurane (AOR = 0.35, 95% CI [0.15, 0.78], p = 0.011); prone position (AOR = 4.68, 95% CI [1.56, 14.07], p = 0.006); extubation in afternoon (AOR = 2.69, 95% CI [1.26, 5.74]; p = 0.011); and duration of surgery ≥ 210 min (AOR = 5.2, 95% CI [2.32, 11.72], p ≤ 0.001).

CONCLUSIONS: The study found that prolonged time to extubation occurred in one-fourth of the patients. The independent factors statistically associated with prolonged extubation were older ages, higher ASA class, obesity (≥ 30 kg/m²), the use of benzodiazepine, halothane for maintenance, prone position, extubation in the afternoon, and longer procedures (≥ 210 min).

PMID:40275413 | DOI:10.1186/s13741-025-00520-0

Pneumonia (Nathan). 2025 Apr 25;17(1):9. doi: 10.1186/s41479-025-00164-0.

ABSTRACT

BACKGROUND: The incidence of pneumococcal pneumonia in the context of the Coronavirus Disease 2019 (COVID-19) pandemic, along with the real-world data on the ratio of non-invasive to invasive pneumococcal pneumonia, is an area that has not been thoroughly studied. The outcomes associated with coinfection of influenza and COVID-19 remain unknown. This study examined the incidence, demographics, coinfection with influenza and/or COVID-19, and clinical outcomes of pneumococcal hospitalizations in Hong Kong during the baseline, pandemic, and post-pandemic periods.

METHODS: Hospitalization records of individuals aged 18 years and above with pneumococcal disease from January 2015 to August 2024 were extracted from the territory-wide electronic medical record database. Pneumococcal disease was categorized into invasive pneumococcal pneumonia (IPP), invasive pneumococcal disease without pneumonia (IPDWP), and non-invasive pneumococcal pneumonia (NIPP), followed by univariate and multivariate analyses. Effects of coinfection with influenza and COVID-19 were analyzed.

RESULTS: The incidence of pneumococcal disease decreased during the COVID-19 pandemic but rebounded in the post-pandemic period. There were no significant changes in the distribution of pneumococcal serotypes across the three periods. The study revealed a strong positive correlation between monthly pneumococcal hospitalizations and the indicator of influenza activity, while the correlation with the COVID-19 indicator was weak. Additionally, strong positive correlations were observed between the indicator of influenza activity and influenza coinfections, as well as between the indicator of COVID-19 activity and COVID-19 coinfections. Multivariate analyses identified male gender, a higher comorbidity index, older age, invasive pneumococcal disease (IPP and IPDWP), coinfection with influenza and COVID-19, and hospitalization during the pandemic period as factors associated with adverse outcomes.

CONCLUSIONS: The study showcases changes in the epidemiology of pneumococcal disease during and after the COVID-19 pandemic. It highlights the adverse effects of influenza and COVID-19 coinfections on the outcomes of patients with pneumococcal disease and emphasizes the need to vaccinate vulnerable populations against these infections.

PMID:40275411 | DOI:10.1186/s41479-025-00164-0

Confl Health. 2025 Apr 24;19(1):26. doi: 10.1186/s13031-025-00666-0.

ABSTRACT

BACKGROUND: Severe acute malnutrition (SAM) remains a critical public health challenge in conflict-affected settings, where children face heightened vulnerability. Dual deficiencies in weight-for-height z-score (WHZ < -3) and mid-upper arm circumference (MUAC < 11.5 cm) indicate a more severe form of SAM, yet current admission protocols prioritize WHZ-based criteria for inpatient therapeutic feeding centers (TFCs). This approach may exclude children with MUAC deficiencies from optimal inpatient care, potentially impacting recovery outcomes in outpatient therapeutic programs (OTPs). In Yemen, prolonged conflict has exacerbated SAM burdens, leading to an expansion of TFC and OTP services since 2015. The aim is to determine whether existing WHO recovery criteria adequately support comprehensive recovery and prevent premature discharge.

METHOD: A retrospective analysis was conducted using data from a prospective longitudinal study of children admitted with complicated SAM to TFCs in Sana’a City from September 2023 to November 2024. Children were categorized based on SAM diagnostic criteria (WHZ < -3, MUAC < 11.5 cm, or both) and analyzed under four discharge scenarios: (1) WHZ recovery, (2) MUAC recovery, (3) recovery by either WHZ or MUAC, and (4) recovery of both indicators. Chi-square and Kruskal-Wallis tests were used to assess differences between groups, and P < 0.05 was used to determine statistical significance.

RESULTS: Among 188 children admitted with complicated SAM, 56% (105) were female, 53% (100) were aged 6-<12 months, and 59% (111/188) presented with dual deficiencies. Admission based on WHZ criteria accounted for 82% (154/188) of admissions, of whom 72% also had MUAC < 11.5 cm. At OTP discharge, 96% met WHO recovery criteria, yet only 38% achieved full recovery (WHZ ≥ -2 and MUAC ≥ 12.5 cm). Full recovery was significantly lower among children with dual deficiencies at TFC admission than those with single deficiencies in MUAC or WHZ (31% vs. 47% and 51%, respectively, p = 0.032).

CONCLUSIONS: These findings underscore the need to integrate WHZ and MUAC into discharge criteria to prevent premature discharge and ensure comprehensive recovery. Revising WHO protocols and enhancing SAM management in conflict-affected settings are critical to improving treatment outcomes.

PMID:40275406 | DOI:10.1186/s13031-025-00666-0

J Ovarian Res. 2025 Apr 24;18(1):84. doi: 10.1186/s13048-025-01667-6.

ABSTRACT

The aim of this in vitro short report was to determine whether activation of platelet-rich plasma (PRP) results in differential effects on growth factor release and cell proliferation in reproductive medicine. This study involved PRP from five donors, activated with either CaCl₂ (exogenous activation) or type I collagen (mimicking endogenous activation). The release of growth factors (EGF and PDGF-AB) and the proliferative response of human ovarian fibroblasts were analysed. PRP activated with CaCl₂ formed stable clots and released statistically significant higher levels of EGF (871 ± 426 pg/mL) and PDGF-AB (26535 ± 6477 pg/mL) compared to collagen-activated PRP (EGF: 141 ± 66 pg/mL, PDGF-AB: 13060 ± 2301 pg/mL). Additionally, CaCl₂-activated PRP induced greater proliferation in ovarian fibroblasts (34.90 ± 17.82 ng/mL DNA) than collagen-activated PRP (30.75 ± 18.21 ng/mL DNA). In conclusion, the activation of PRP with CaCl₂ results in higher growth factor release and a stronger biological response compared to type I collagen-activation. These findings underscore the importance of standardized PRP activation protocols to enhance clinical outcomes in reproductive medicine.

PMID:40275404 | DOI:10.1186/s13048-025-01667-6

Genome Biol. 2025 Apr 24;26(1):105. doi: 10.1186/s13059-025-03554-1.

ABSTRACT

In spatial transcriptomics data, spatially correlated genes promise to reveal high-interest phenomena like cell-cell interactions and latent variables. But in practice, most spatial correlations arise from the spatial arrangement of cell types, obscuring the more interesting relationships we hope to discover. We introduce InSituCor, a toolkit for discovering modules of spatially correlated genes. InSituCor returns only correlations not explainable by already-known factors like the cell type landscape; this spares precious analyst effort. InSituCor supports both unbiased discovery of whole-dataset correlations and knowledge-driven exploration of genes of interest. As a special case, it evaluates ligand-receptor pairs for spatial co-regulation.

PMID:40275395 | DOI:10.1186/s13059-025-03554-1

Clin Epigenetics. 2025 Apr 25;17(1):62. doi: 10.1186/s13148-025-01863-7.

ABSTRACT

BACKGROUND: Biological age reflects inter-individual differences in biological function and capacity beyond chronological age. DNA methylation age (DNAmA) and its deviation from chronological age, DNAmA acceleration (DNAmAA), which was calculated as residuals of leukocyte cell count adjusted linear regression of DNAmA on chronological age, were used to estimate biological age in this study. Low levels of serum selenium, selenoprotein P (SELENOP), and the selenocysteine-containing glutathione peroxidase 3 (GPx3) are associated with adverse health outcomes and selenium supplementation is discussed as an anti-aging intervention.

METHODS: In this study, we cross-sectionally analyzed 1568 older participants from the observational Berlin Aging Study II (mean age ± SD: 68.8 ± 3.7 years, 51% women). Serum selenium was measured by total reflection X-ray fluorescence (TXRF) spectroscopy and SELENOP was determined by sandwich ELISA. GPx3 was assessed as part of a proteomics dataset using liquid chromatography-mass spectrometry (LC-MS). The relationship between selenium biomarkers and epigenetic clock measures was analyzed using linear regression analyses. P values and 95% confidence intervals (not adjusted for multiple testing) are stated for each analysis.

RESULTS: Participants with deficient serum selenium levels (< 90 μg/L) had a higher rate of biological aging (DunedinPACE, β = – 0.02, SE = 0.01, 95% CI – 0.033 to – 0.004, p = 0.010, n = 865). This association remained statistically significant after adjustment for age, sex, BMI, smoking, and first four genetic principal components (β = – 0.02, SE = 0.01, 95% CI – 0.034 to – 0.004, p = 0.012, n = 757). Compared to the highest quartile, participants in the lowest quartile of SELENOP levels showed an accelerated biological aging rate (DunedinPACE, β = – 0.03, SE = 0.01, 95% CI – 0.051 to – 0.008, p = 0.007, n = 740, fully adjusted model). Similarly, after adjustment for confounders, accelerated biological age was found in participants within the lowest GPx3 quartile compared to participants in the fourth quartile (DunedinPACE, β = – 0.04, SE = 0.01, 95% CI – 0.06 to – 0.02, p = 0.001, n = 674 and GrimAge, β = – 0.98, SE = 0.32, 95% CI – 1.6 to – 0.4, p = 0.002, n = 608). Only the association with GPx3 remained statistically significant after multiple testing correction.

CONCLUSION: Our study suggests that low levels of selenium biomarkers are associated with accelerated biological aging measured through epigenetic clocks. This effect was not substantially changed after adjustment for known confounders.

PMID:40275394 | DOI:10.1186/s13148-025-01863-7

Lipids Health Dis. 2025 Apr 24;24(1):155. doi: 10.1186/s12944-025-02580-z.

ABSTRACT

BACKGROUND: The remnant cholesterol inflammatory index (RCII) is a novel metric that combines remnant cholesterol and high-sensitivity C-reactive protein, reflecting the metabolic and inflammatory risk. This study investigates the association between RCII and long-term risks of all-cause and cause-specific mortality in middle-aged and elderly populations in the US and China.

METHOD: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS), including 7,565 and 12,932 participants aged 45 years and older, respectively. The participants were categorized into quartiles based on natural log-transformed RCII (lnRCII) values. Kaplan-Meier survival analysis, Cox proportional hazards models, restricted cubic splines (RCS) and mediation analysis were used to examine the relationship between lnRCII and mortality outcomes, adjusting for potential covariates.

RESULT: The mean age of the participants was 59.90 ± 10.44 years (NHANES) and 58.64 ± 9.78 years (CHARLS), with 53.28% and 52.50% female, respectively. Kaplan-Meier survival analysis showed that higher lnRCII quartiles (≥ 0.79 in NHANES, ≥ -0.13 in CHARLS) were significantly associated with increased all-cause mortality risk (p < 0.001). Each standard deviation (SD) increase in lnRCII corresponded to a higher risk of all-cause mortality, and the hazard ratios (HRs) and 95% confidence interval (CI) were 1.29 (95% CI: 1.21-1.36) in NHANES and 1.26 (95% CI: 1.15-1.38) in CHARLS. In NHANES, lnRCII was also associated with elevated risks of cardiovascular mortality (HR = 1.21, 95% CI: 1.08-1.35) and cancer mortality (HR = 1.30, 95% CI: 1.09-1.55). RCS analysis indicated a J-shaped relationship between lnRCII and both all-cause and cardiovascular mortality, and a linear association with cancer mortality. Mediation analysis showed that systolic blood pressure and fasting plasma glucose partially mediated these associations. Subgroup analyses suggested a stronger association between lnRCII and all-cause mortality in middle-aged US participants (p for interaction = 0.010).

CONCLUSIONS: Elevated RCII levels are significantly associated with increased all-cause mortality risk middle-aged and elderly populations in both the US and China. In the US population, RCII is also associated with increased risks of cardiovascular and cancer mortality. By integrating metabolic and inflammatory risk factors, RCII may serve as a valuable tool for mortality risk stratification and clinical decision-making.

PMID:40275392 | DOI:10.1186/s12944-025-02580-z

J Health Popul Nutr. 2025 Apr 24;44(1):135. doi: 10.1186/s41043-025-00866-7.

ABSTRACT

BACKGROUND: Diabetes is a common metabolic disease worldwide, is also a global major public health problem. We carried out this meta-analysis to evaluate the effects of olive oil(OO) consumption on diabetes.

METHODS: PubMed, Embase, Scopus, Web of Science and Cochrane Library databases were systematically searched until October 2024. Heterogeneity among studies was examined using Q and I² statistics. Combined risk ratio (RR) with their 95% confidence interval (CI) were calculated by using a random effects model. Also dose-response analysis and subgroup analysis were performed.

RESULTS: 10 studies (4 cohorts and 6 RCT) involved more than 50,0000 subjects and 2,0000 individuals with diabetes were included in the meta-analysis. A 13% (RR = 0.87, 95%CI = 0.83 – 0.92, P < 0.01) decreased risk of diabetes was shown in Cohort study and 22% (RR = 0.78, 95%CI = 0.70 – 0.88, P < 0.01) decreased risk in RCT study for the highest vs. lowest olive oil consumption. Subgroup analysis results showed that there was a better effect on reducing diabetes risk in age > 50 years(RR = 0.77, 95%CI = 0.70 – 0.89, P < 0.01), Europe(RR = 0.81, 95%CI = 0.72 – 0.86, P < 0.01) and extra virgin olive oil ( RR = 0.75, 95%CI = 0.65-0.87, P < 0.01). Dose-response analysis showed a significant nonlinear association of diabetes risk with OO intake(Pnon-linearity < 0.05) and when 10-20 g of olive oil is consumed daily, the effect amount is statistically significant, while more than 20 g there was not statistically significant. Begg’s and Egger’s regression test results indicated that there was no publication bias and the results were reliable.

CONCLUSIONS: Evidence from this meta-analysis suggested that OO consumption is associated with a decreased risk of diabetes, especially, 10-20 g OO daily may be beneficial for prevention and management of diabetes.

PMID:40275388 | DOI:10.1186/s41043-025-00866-7

Int J Behav Nutr Phys Act. 2025 Apr 24;22(1):50. doi: 10.1186/s12966-025-01741-8.

ABSTRACT

BACKGROUND: Food consumption patterns have changed tremendously since the mid-twentieth century, with a rapid global nutritional shift raising concerns, particularly in disadvantaged regions such as the Eastern Mediterranean region (EMR). Given that food intake is very context-specific, this research examines food consumption patterns in Jordan, Lebanon, Palestine, and Syria, representing the contemporary Levant region.

METHODS: A systematic review was conducted by searching PubMed, EMBASE, Web of Science, and CINAHL. The eligibility criteria were to include only original peer-reviewed observational studies reporting individual-level food consumption among local Jordanians, Lebanese, Palestinians, and Syrians. Extracted data were synthesized through descriptive statistics and presented in tables and charts. The risk of bias was assessed using the tool developed by Hoy et al. for prevalence studies.

RESULTS: A total of 43 articles that measured and reported food consumption at the individual level for the populations in these countries were included. Findings reveal that in the 1960s, diets in the region were primarily local, seasonal, and plant-based, with moderate to low animal product intake. By the 1990s, a noticeable shift occurred, marked by increased consumption of processed foods, refined carbohydrates, and animal products, with minimal increase in fruit and vegetable intake. Most studies were conducted in Lebanon, limiting the generalizability of findings across the Levant countries.

CONCLUSION: This review presents an understanding of food consumption changes on the level of food items, food groups, and dietary patterns specific to the Levant. Future studies on food consumption patterns should prioritize national surveys using valid, reliable, and cultural-specific measurement tools and provide detailed, age-disaggregated dietary data. Public health interventions are needed to address the ongoing dietary shift, which is unfolding amid political instability, economic crises, and food insecurity.

PMID:40275353 | DOI:10.1186/s12966-025-01741-8