Nevin Manimala

Colorectal Dis. 2025 May;27(5):e70114. doi: 10.1111/codi.70114.

ABSTRACT

AIM: Rectopexy with concomitant sacrocolpopexy (sacrocolporectopexy) is the favoured technique for treating combined pelvic organ prolapse and internal or external rectal prolapse, despite limited functional improvement. Previous studies have assessed anatomical change after standalone rectopexy or sacrocolpopexy, based on supine MRI defaecography. Since a supine position can underestimate the extent of pelvic organ prolapse, it might also incorrectly assess the anatomical effect of sacrocolporectopexy. The aim of this study was to assess the effect of sacrocolporectopexy on the pelvic anatomy in an upright position.

METHOD: Twenty one female patients undergoing sacrocolporectopexy from December 2022 to June 2024 were included. All patients underwent physical examination and MRI defaecography preoperatively and postoperatively. The descent of the bladder, vaginal vault and anorectal junction and the size of the rectocele and enterocele were assessed on the MRI defaecography images during maximum straining. Significance was tested using a paired t-test and an improvement of ≥10 mm was considered clinically relevant. The results were compared with previous studies, which used supine assessment.

RESULTS: Postoperative improvement was found for the bladder, vaginal vault, anorectal junction, rectocele and enterocele with 14, 44, 5, 16 and 54 mm respectively. The bladder, vaginal vault, rectocele and enterocele showed clinically relevant improvement. Compared with supine results, upright assessments revealed a larger organ lift for the vaginal vault as well as a higher, overall, position of the anorectal junction.

CONCLUSION: Upright assessment of sacrocolporectopexy differs from supine assessment, with statistical and clinically relevant lift for the pelvic organs.

PMID:40331245 | DOI:10.1111/codi.70114

Brain Spine. 2025 Apr 21;5:104259. doi: 10.1016/j.bas.2025.104259. eCollection 2025.

ABSTRACT

INTRODUCTION: Quality education is key in addressing the skilled neurological workforce gap in Africa. However, many medics are scared of the neurological sciences because of the challenges faced in medical schools in studying the neurosciences. Understanding its state and educational challenges is crucial for fostering interest in neurosurgery and related specialities on the continent.

RESEARCH QUESTION: What are the current state, challenges, and solutions to improve neuroanatomy education in Cameroon, Africa in miniature?

MATERIALS AND METHODS: A cross-sectional study using an 11-item electronic survey was conducted among medical students from all nine medical schools in Cameroon. Data were analysed using descriptive statistics and independent t-tests, with significance set at p < 0.05.

RESULTS: Among 220 respondents, 40.1 % and 35.0 % respectively, reported cranial nerves/brainstem and neurovascular anatomy to be the most challenging, with a mean comprehension score of 5.83/10. Faculty predominantly relied on PowerPoint lectures (83.2 %), while most students supplemented learning with YouTube videos (77.7 %). 63.9 % of the respondents perceived classroom teaching alone to limit their understanding of neuroanatomy, and 85.8 % of students reported the time allocated for neuroanatomy teaching to be inadequate. The usage of cadaver dissection (69.5 %), and neurosimulation practicals (66.4 %) were the most recommended tools by students to improve neuroanatomy teaching.

DISCUSSION AND CONCLUSION: Challenges in neuroanatomy education in Cameroon are perceived to arise from insufficient hands-on learning, time constraints, and limited access to specialised faculty. These suggest interactive teaching, increased curriculum time, and diverse resources as potential improvements, though further research is needed to assess their effectiveness and ultimately improve understanding, fostering a stronger neurological workforce.

PMID:40331209 | PMC:PMC12051654 | DOI:10.1016/j.bas.2025.104259

Dela J Public Health. 2025 Apr 30;11(1):10-18. doi: 10.32481/djph.2025.04.04. eCollection 2025 Apr.

ABSTRACT

BACKGROUND: The “Food is Medicine” (FIM) model bridges healthcare and food access to mitigate chronic health conditions and address social determinants of health.

OBJECTIVES: This study assesses the impact of the Feeding Families (FF) program, a FIM initiative by Westside Family Healthcare in Delaware, which was conducted between February 2023 and February 2024 and designed to support individuals with diabetes, hypertension, and obesity.

METHODS: We employed a quasi-experimental design to evaluate the implementation and effectiveness of the program over 12 months. The FF program provided participants with nutrient-dense food, bi-weekly nutrition counseling, and behavioral support. Data on body mass index (BMI), glycated hemoglobin (A1C), and fruit and vegetable intake were collected from 43 participants at baseline, midpoint, and endpoint. Participant knowledge, dietary behaviors and food insecurity, changes in goal setting, consumption of sodium, sugar, and fats were also assessed.

RESULTS: Participants demonstrated significant reductions in BMI and improved dietary behaviors, including decreased consumption of sodium, sugar, and fats. While changes in A1C levels were not statistically significant, the overall trend indicated improvement. The program also led to modest enhancements in food security.

CONCLUSION: The Feeding Families program contributes to improving health outcomes among populations with chronic diseases, particularly in reducing BMI and promoting healthier dietary behaviors around sodium, sugar, and fat consumption.

POLICY IMPLICATIONS: The Feeding Families program demonstrates the potential of integrating tailored nutrition, behavioral support, and healthcare services to manage chronic conditions through ‘Food Is Medicine’ best practices, and its impact on BMI, salt, sugar and fat reduction among other benefits. Delaware should prioritize FIM, including establishing Medicaid waivers for funding.

PMID:40331171 | PMC:PMC12051899 | DOI:10.32481/djph.2025.04.04

J Mass Spectrom Adv Clin Lab. 2025 Apr 17;36:52-62. doi: 10.1016/j.jmsacl.2025.04.004. eCollection 2025 Apr.

ABSTRACT

BACKGROUND: Psoriasis is a chronic inflammatory disease with an unclear etiology that affects skin, nails, and joints and often accompanies comorbidities. Recent studies indicate that alterations in metabolites within psoriatic lesions might be linked to inflammation. Studying bioactive lipid mediators or metabolites in skin inflammation and immunity might provide new potential biomarkers and therapeutic prediction factors.

METHODS: Lipids and peptides in the scale extracts from psoriasis patients and healthy controls were characterized by thermal desorption-electrospray ionizationmass spectrometry and matrix-assisted laser desorption/ionization time-of-flightmass spectrometry, respectively. Principal component analysis (PCA) was then applied to these data to identify potential differences between psoriasis patients and healthy controls.

RESULTS: Psoriatic plaques show reduced wax esters and triglycerides and a predominant increase in human neutrophil defensins (HNPs), compared to non-lesional sites of psoriatic patients and healthy control. Additionally, when medical treatments were administered to psoriasis patients, levels of HNPs were significantly reduced, suggesting that they may serve as potential biomarkers to evaluate therapeutic efficacy for psoriasis.

CONCLUSION: Two mass spectrometric techniques were used to rapidly and non-invasively identify and monitor potential biomarkers between psoriasis patients and healthy controls. However, PCA results only showed slight differences, and we intend to broaden the sample base in the future to increase the statistical power of the investigation.

PMID:40331168 | PMC:PMC12051561 | DOI:10.1016/j.jmsacl.2025.04.004

J Diabetes Metab Disord. 2025 May 3;24(1):112. doi: 10.1007/s40200-025-01627-3. eCollection 2025 Jun.

ABSTRACT

BACKGROUND AND PURPOSE: Undesirable adherence to treatment is one of most important challenges in the control and treatment of type 2 diabetes. Therefore, the present study was conducted with the aim of determining the level of adherence to treatment and factors affecting it among patients with type 2 diabetes in Tehran.

METHODS: This cross-sectional descriptive study was conducted in 2023 on 117 patients with diabetes referred to Imam Khomeini Hospital in Tehran. The data collection tool was the Hill-Bone Medication Adherence Scale (HB-MAS), which was completed by the participants. Version 16 SPSS and descriptive analysis at the statistical level of 0.05 were used to analyze the data.

RESULTS: The mean age of the participants in this research was 45.06 ± 8.48 years. The results showed that 41.03% of the participants had the desirable treatment adherence and 58.97% had the undesirable treatment adherence. A significant relationship was observed between the compliance of patients with the variables of gender, level of education and job status (P < 0.05); But the variables of age, duration of illness and type of treatment had no significant relationship with treatment adherence.

CONCLUSION: The findings showed that the level of adherence to treatment in patients with type 2 diabetes in Tehran is not undesirable. It is better for the treatment team to take more effective measures to improve the awareness of patients in adherence to treatment. Planners and policy makers should also take more effective measures to empower patients to access health services.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-025-01627-3.

PMID:40331156 | PMC:PMC12049342 | DOI:10.1007/s40200-025-01627-3

Front Endocrinol (Lausanne). 2025 Apr 22;16:1544823. doi: 10.3389/fendo.2025.1544823. eCollection 2025.

ABSTRACT

BACKGROUND: Metabolic syndrome (MetS) and elevated high-sensitivity C-reactive protein (hs-CRP) have been identified as risk factors for heart failure (HF) in some studies. However, little was known about the co-exposure of MetS and inflammation to HF. We aimed to investigate the combined effect of MetS and high hs-CRP levels on the risk of incident HF.

METHODS: The study included 94,841 participants without HF selected from the Kailuan cohort in 2006 (the baseline) and then followed up until 31 December 2020. Participants were divided into four groups based on the presence of MetS and high hs-CRP levels (>3mg/L) at baseline: MetS-CRP- (n=53,937), MetS-CRP+ (n=10,338), MetS+CRP- (n=23,521), MetS+CRP+ (n=7,045). Cox regression models were used to analyze the association of MetS and inflammation with the risk of HF. Statistical significance was defined as a two-tailed P value < 0.05.

RESULTS: The mean age of the participants was 51.5 ± 12.5 years, and 75,976 (80.0%) were male. During 13.1 years of follow-up, 3,058 participants were diagnosed with HF. The HF incidence rate of four groups were 1.69/1000pys, 2.95/1000pys, 3.27/1000pys, 5.33/1000pys. The HR for MetS-CRP+, MetS+CRP-, and MetS+CRP+ were 1.29 (95% CI, 1.15-1.45), 1.40 (95% CI, 1.29-1.53), and 1.85 (95% CI, 1.65-2.06), respectively, compared with MetS-CRP-. After stratification by age (p for interaction < 0.01), compared with the MetS-CRP- group, the HR of the MetS+CRP+ group was 2.17 (95% CI, 1.83-2.57) in participants with < 60 years and 1.53 (95% CI, 1.32-1.78) in participants with ≥ 60 years. There was an interaction between groups and ues of antihypertension medication (p for interaction <0.01). Compared with MetS-CRP-, the risk of HF in the MetS+CRP+ group was increased 1.38-fold (95% CI, 1.12-1.70) in participants with antihypertension medication use and 2.00-fold (95% CI, 1.75-2.27) in participants without antihypertension medication use.

CONCLUSIONS: The combination of MetS and elevated hs-CRP was associated with increased risk of HF in the Chinese population.

CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn, identifier ChiCTR-TNRC-11001489.

PMID:40331143 | PMC:PMC12053502 | DOI:10.3389/fendo.2025.1544823

Clin Transl Radiat Oncol. 2025 Apr 19;53:100965. doi: 10.1016/j.ctro.2025.100965. eCollection 2025 Jul.

ABSTRACT

MATERIALS AND METHODS: The study included 100 patients with LACC who underwent definitive CCRT with IMRT/VMAT technique followed by 3D-IGABT. MRI-based contouring included T2WI and DWI images for primary tumor (GTVp) and lymph nodes (GTVn). The contours were imported to MIM software to extract first-order radiomic features. Radiomic values from pre-treatment (PreRx), pre-brachytherapy (PreBT), differences between PreRx and PreBT (Diff) radiomic and clinical factors were analyzed using univariate and multivariate Cox regression analysis. Predictive models of PFS, LRFS, DMFS, and OS were created along with the optimism index and calibration plot.

RESULTS: The median follow-up time was 24.5 months. The 2-year of PFS, LRFS, DMFS, and OS rates were 71, 88.6, 83.1, and 83.5 %, respectively. For all clinical outcomes, CF + RF combined from PreRx and PreBT resulted in the highest Harrell’s C-index compared with the CF or RF alone. Compare with Diff models, models from PreRx and PreBT resulted in higher Harrell’s C-index. The C-indexes from the CF + RF model from PreRx and PreBT for PFS, LRFS, DMFS, and OS were 0.739, 0.873, 0.830 and 0.967 with the optimism indexes of 0.312, 0.381, 0.316, and 0.242, respectively.

CONCLUSION: Radiomic features from the first-order statistics added values to clinical factors to predict the outcomes after CCRT. The highest prediction model performance was for the combined clinical and radiomics from PreRx and PreBT.

PMID:40331124 | PMC:PMC12051114 | DOI:10.1016/j.ctro.2025.100965

Front Public Health. 2025 Apr 22;13:1526309. doi: 10.3389/fpubh.2025.1526309. eCollection 2025.

ABSTRACT

INTRODUCTION: South Africa, like most developing countries, made some efforts to attain the Sustainable Development Goals by endeavoring to reduce individuals’ susceptibility to socio-economic hardships. However, the COVID-19 pandemic eroded most of those efforts. In this seemingly helpless situation, it is apparent that the coronavirus has compromised the commendable strides made toward achieving some of the efforts toward attaining some of these Sustainable Development Goals. This article, therefore, analyses the socioeconomic conditions exacerbated by COVID-19 on the East Coast of South Africa.

METHODOLOGY: The study adopted a quantitative research-method approach to quantify this socio-economic disparities and applied, descriptive statistics, chi-squared test of independence, and regression to analyse the data collected using a semi-structured questionnaire survey at a rural community in the Eastern Cape of South Africa. Simple random sampling was adopted for this study and Statistical Package for Social Scientists was used to analyse the data collected.

RESULTS: There was no significant relationship when the question of whether the municipality has adequately implemented measures to ensure the socio-economic protection of communities was regressed with other 3 Likert scale questions (χ² = 95.98; df = 77; P = 0.07; R ² = 38.0%). A series of Chi-square tests did not reveal any statistically significant difference in five demographic variables and the variables they were correlated with (P > 0.05). However, there was a statistically significant difference between most questions relating to the effectiveness of the COVID-19 response strategies the municipality employed and participants’ response to unmet community social needs (X² = 35.754; df = 14; P = 0.001).

DISCUSSIONS AND CONCLUSIONS: This study, therefore, revealed that social significance does not necessarily mean statistically significant following the results of the insignificant chi-squared test for the socio-economic and demographic variables. This study also sheds light on the profound impact of the COVID-19 pandemic on the socioeconomic landscape of the East Coast of South Africa. Despite commendable strides toward achieving Sustainable Development Goals aimed at reducing vulnerabilities to socio-economic hardships, the pandemic has presented daunting challenges, disrupting progress and exacerbating existing inequalities coupled with efforts of the study Municipalities strategies.

PMID:40331120 | PMC:PMC12053281 | DOI:10.3389/fpubh.2025.1526309

Front Public Health. 2025 Apr 22;13:1454037. doi: 10.3389/fpubh.2025.1454037. eCollection 2025.

ABSTRACT

OBJECTIVE: With accelerated population aging in China, older adult services and long-term care for people with disabilities are becoming serious problems. Currently, mobilizing and allocating social resources, establishing reasonable financing mechanisms to address the growing demand for long-term care for those with disabilities, and ensuring the sustainable operation of long-term care insurance financing mechanism are vital.

METHODS: Taking Nanning, China, as an example, based on the Nanning Statistical Yearbook and relevant policy documents of government departments such as the medical care and security department, we use the PADIS-INT model and the International Labour Organization financing model(ILO Model) to estimate the contribution levels of Nanning’s residents’ long-term care insurance for the years of 2025, 2030, and 2035, and analyze the feasibility of the government’s and rural and urban residents’ individual contribution burden.

RESULTS: The average annual contribution amount of long-term care insurance for urban and rural residents will increase from 108.80 yuan in 2025 to 202.71 yuan in 2035. According to the sharing method, in which the government and individuals each bear 50% of the financing responsibility for long-term care insurance, the proportion of the government’s financial responsibility for the cost of long-term care insurance for urban and rural residents to the current year”s financial income will be 0.34, 0.42, and 0.50% in 2025, 2030, and 2035, respectively, and the amount of money that can be used by individual urban and rural residents to pay premiums from 2025 to 2035 will range from 10.7 to 16 thousand yuan.

CONCLUSION: The finding shows that both the government and urban and rural residents can afford to pay future long-term care insurance costs; however, the long-term care insurance contributions of individual urban and rural residents in Nanning remain high. Hence, the Nanning municipal government should improve the awareness and participation rate of urban and rural residents in long-term care insurance; scientifically measure the financing level of long-term care insurance; establish a multichannel, scientifically reasonable, and dynamically adjusted long-term care insurance financing mechanism; and maintain the sustainable operation of the financing mechanism of long-term care insurance in Nanning.

PMID:40331119 | PMC:PMC12052943 | DOI:10.3389/fpubh.2025.1454037

Front Public Health. 2025 Apr 22;13:1568486. doi: 10.3389/fpubh.2025.1568486. eCollection 2025.

ABSTRACT

INTRODUCTION: Healthcare professionals play a critical role in providing affirmative care to gay and lesbian patients. However, their attitudes and practices can vary significantly depending on cultural and educational contexts. This study aimed to evaluate differences in affirmative practices among healthcare professionals in Poland and Spain, focusing on their approach to these patient groups, utilizing the Gay Affirmative Practice (GAP) Scale, as well as identifying key factors influencing these practices.

METHODS: A cross-sectional study was conducted among healthcare professionals in Poland and Spain using the GAP Scale, which assesses beliefs and behaviors toward gay and lesbian patients. Data collection included 495 participants, with 205 from Spain and 290 from Poland. Descriptive statistics, Mann-Whitney tests, and multivariate regression analyses were used to identify factors associated with affirmative practices.

RESULTS: Spanish participants scored significantly higher on both the beliefs and behaviors scales compared to Polish participants (p < 0.001 and p = 0.009, respectively). Gender of healthcare providers was a significant factor in both groups, with women demonstrating more affirmative beliefs than men. In the Polish group, being male was associated with a decrease in the belief scale score by an average of 6.572 points (regression coefficient = -6.572, p < 0.001), while attending LGBT-related training 1-2 times was associated with an increase of 5.356 points on the belief scale (regression coefficient = 5.356, p = 0.039). No significant independent predictors were identified for behaviors in the Polish group, as all p-values exceeded 0.05.

CONCLUSION: Spanish healthcare professionals showed more affirmative practices toward gay and lesbian patients than their Polish counterparts. Sex and gay and lesbian related training influenced beliefs, with male sex linked to lower affirmative practice in Poland. These findings highlight the need for systematic integration of gay and lesbian specific training into healthcare education programs to foster cultural competence and reduce disparities in patient care.

PMID:40331116 | PMC:PMC12053289 | DOI:10.3389/fpubh.2025.1568486