Nevin Manimala

BMC Ophthalmol. 2025 Jan 15;25(1):20. doi: 10.1186/s12886-025-03864-9.

ABSTRACT

BACKGROUND: The quality of life for low vision patients is a comprehensive concept that involves multiple aspects, including physical, psychological, and social aspects. Visual impairment is an important factor in the decline of patients’ quality of life. The purpose of this study is to investigate the impact and feasibility of carrying out low vision rehabilitation nursing on the quality of life and nursing burden of low vision patients.

METHODS: Select 18 low vision patients who received treatment at a tertiary ophthalmic hospital in Shantou City and randomly divide them into an experimental group and a control group. The control group received routine low vision health education, while the experimental group received intervention measures based on low vision rehabilitation nursing plans. A questionnaire survey was conducted on two groups of study subjects and their caregivers using the Low Vision Quality of Life Questionnaire, General Self-Efficacy Scale, and Zarit Burden Interview before intervention, at week 4 after intervention, and at week 8 after intervention. The scores of each scale in the experimental group and the control group were statistically analyzed.

RESULT: The quality of life and self-efficacy scores of the experimental group patients were higher than those of the control group in the 4th and 8th week after intervention; The caregiver burden of the experimental group patients was lower than that of the control group caregivers in the 4th and 8th weeks after intervention.

CONCLUSION: Implement a low vision rehabilitation nursing plan, provide rehabilitation intervention and support to low vision patients, help patients find new ways to adapt to low vision conditions, and improve their quality of life. Low vision rehabilitation nursing interventions not only enable patients to regain the ability to independently complete daily activities, but also improve their self-efficacy, help rebuild confidence, and reduce the caregiving burden on their caregivers.

PMID:39815249 | DOI:10.1186/s12886-025-03864-9

BMC Infect Dis. 2025 Jan 11;25(1):56. doi: 10.1186/s12879-025-10486-5.

ABSTRACT

INTRODUCTION: Dengue viruses cause either symptomatic infections or asymptomatic seroconversion. Symptomatic dengue has a wide clinical spectrum ranging from self-limiting infection to severe manifestations, mostly characterized by plasma leakage with or without hemorrhage. World Health Organization classification in 2009 classified dengue into dengue without warning signs, dengue with warning signs, and severe dengue. This study aimed to determine patient characteristics and hematological parameters (leukopenia, and thrombocytopenia) in patients with dengue infection in the emergency department of a tertiary center.

METHODS: A cross-sectional study was conducted among 252 patients with dengue confirmed by serological testing against dengue-specific nonstructural protein 1 (NS1) antigen and immunoglobulin M (IgM) by enzyme-linked immunosorbent assay from September to November 2022 who presented in the emergency department of a tertiary hospital in Nepal after ethical approval was obtained. Dengue was categorized according to the World Health Organization 2009 classification. Hematological parameters were recorded by reviewing patients’ laboratory records. Data analysis was done using descriptive statistical parameters and a chi-square test.

RESULTS: Dengue without warning signs was present in 166 (65.87%) patients, while dengue with warning signs and severe dengue was present in 68 (26.89%) and 18 (7.14%) patients, respectively. Leukopenia (< 4000 cells/mm³⁾ was present among 163 (64.68%) patients. The lowest recorded leukocyte count was 1440. Similarly, thrombocytopenia (< 150000 cells/mm³) was present among 102 patients (40.48%). The lowest recorded platelet count was 26,000 cells/mm³. A significant association was found between the severity of dengue infection and leukopenia (χ² 13.268, p-value 0.001) and thrombocytopenia (χ² 43.924, p value < 0.001).

CONCLUSIONS: Monitoring of warning signs and clinical parameters is important for identifying the progression of dengue infection to the critical phase. Leukopenia and thrombocytopenia are present among many dengue-infected patients presenting in the emergency department. The severity of the disease will usually only be apparent around defervescence, which often coincides with the onset of the critical phase. Leukopenia and thrombocytopenia could indicate progression to severe disease during emergency department admission.

PMID:39815245 | DOI:10.1186/s12879-025-10486-5

Child Abuse Negl. 2025 Jan 14;161:107246. doi: 10.1016/j.chiabu.2025.107246. Online ahead of print.

ABSTRACT

BACKGROUND: Neonatal abstinence syndrome (NAS), or withdrawal from prenatal opioid exposure at birth, can trigger a referral to child protective services (CPS). However, there is some evidence of selection into NAS diagnosis because NAS screening is not universal. Such referrals may protect the infant, help connect the mother to services, or cause harm.

OBJECTIVE: To study the relation between prenatal opioid exposure, NAS diagnosis, and CPS involvement during the (early) neonatal period.

PARTICIPANTS AND SETTING: We analyzed data (N = 236,868 Medicaid-covered live births) from the Wisconsin Administrative Data Core using linked birth records, Medicaid claims, CPS records, and benefit/earnings data from 2010 to 2018.

METHODS: We identified opioid exposure using Medicaid claims and CPS investigations within 7 and 28 days of life. We estimate linear probability models with and without the inclusion of NAS diagnosis and interactions of prenatal opioid exposure and NAS diagnosis.

RESULTS: Prenatal opioid exposure is positively associated with CPS involvement, but after controlling for NAS diagnosis, exposure to opioid medications used to treat pain (non-MOUD) or opioid use disorder (MOUD) are not statistically significantly associated with CPS investigations, whereas illicit opioid exposure is associated with increased CPS investigations. Fully interacted models suggest that, for infants diagnosed with NAS, non-MOUD and MOUD exposure are protective and reduce the likelihood of CPS involvement.

CONCLUSIONS: Understanding the type of opioid exposure during pregnancy, NAS diagnosis, and access to treatment OUD is important for referrals to child welfare agencies.

PMID:39813738 | DOI:10.1016/j.chiabu.2025.107246

J Med Internet Res. 2025 Jan 15;27:e59598. doi: 10.2196/59598.

ABSTRACT

BACKGROUND: Some scholars who are skeptical about open-access mega journals (OAMJs) have argued that low-quality papers are often difficult to publish in more prestigious and authoritative journals, and OAMJs may be their main destination.

OBJECTIVE: This study aims to evaluate the academic quality of OAMJs and highlight their important role in clinical medicine. To achieve this aim, authoritative journals and representative OAMJs in this field were selected as research objects. The differences between the two were compared and analyzed in terms of their level of disruptive innovation. Additionally, this paper explored the countries and research directions for which OAMJs serve as publication channels for disruptive innovations.

METHODS: In this study, the journal information, literature data, and open citation relationship data were sourced from Journal Citation Reports (JCR), Web of Science (WoS), InCites, and the OpenCitations Index of PubMed Open PMID-to-PMID citations (POCI). Then, we calculated the disruptive innovation level of the focus paper based on the local POCI database.

RESULTS: The mean Journal Disruption Index (JDI) values for the selected authoritative journals and OAMJs were 0.5866 (SD 0.26933) and 0.0255 (SD 0.01689), respectively, showing a significant difference. Only 1.48% (861/58,181) of the OAMJ papers reached the median level of disruptive innovation of authoritative journal papers (MD_AJ). However, the absolute number was roughly equal to that of authoritative journals. OAMJs surpassed authoritative journals in publishing innovative papers in 24 research directions (eg, Allergy), accounting for 40.68% of all research directions in clinical medicine. Among research topics with at least 10 authoritative papers, OAMJs matched or exceeded MD_AJ in 35.71% of cases. The number of papers published in authoritative journals and the average level of disruptive innovation in each country showed a linear relationship after logarithmic treatment, with a correlation coefficient of -0.891 (P<.001). However, the number of papers published in OAMJs in each country and the average level of disruptive innovation did not show a linear relationship after logarithmic treatment.

CONCLUSIONS: While the average disruptive innovation level of papers published by OAMJs is significantly lower than that of authoritative journals, OAMJs have become an important publication channel for innovative research in various research directions. They also provide fairer opportunities for the publication of innovative results from limited-income countries. Therefore, the academic community should recognize the contribution and value of OAMJs to advancing scientific research.

PMID:39813675 | DOI:10.2196/59598

J Med Internet Res. 2025 Jan 15;27:e65122. doi: 10.2196/65122.

ABSTRACT

BACKGROUND: A greater understanding of the effectiveness of digital self-management programs and their ability to support longer-term weight loss is needed.

OBJECTIVE: This study aimed to explore the total weight loss and patterns of weight loss of CSIRO (Commonwealth Scientific and Industrial Research Organisation) Total Wellbeing Diet Online members during their first 12 months of membership and examine the patterns of platform use associated with greater weight loss.

METHODS: Participants were Australian adults who joined the program between October 2014 and June 2022 and were classified as longer-term members, meaning they completed at least 12 weeks of the program, had baseline and 12-week weight data, and had a paid membership of ≥1 year (N=24,035). Weight loss and percentage of starting body weight loss were calculated at 3, 6, 9, and 12 months using 3 statistical approaches: (1) multiple imputations method, (2) all available data, and (3) complete data only. Among members with complete data (6602/24,035, 27.5%), patterns of weight loss and gain were examined, and how this related to total weight loss was explored.

RESULTS: Members were mostly female (19,972/24,035, 83.09%), aged 31 to 50 years (9986/24,035, 41.5%) or 51 to 70 years (12,033/24,035, 50.06%), and most members were classified as overweight or obese (23,050/24,035, 95.9%). Using multiple imputations, the average estimated weight loss was 5.9 (SE 0.0245) kg at 12 weeks, 6.7 (SE 0.0348) kg at 6 months, 6.2 (SE 0.0400) kg at 9 months, and 5.5 (SE 0.0421) kg at 12 months. At 12 months, more than half the members (12,573/24,035, 52.3%) were at least 5% below their starting body weight and 1 in 4 (5865/24,035, 24.4%) were at least 10% below their starting body weight. In the subsample with complete data, the average weight loss at 12 months was 7.8 kg. The most common (961/6602, 14.56% members) weight loss pattern over the first 12 months was 6 months of weight loss, followed by 6 months of weight maintenance. This group had an average weight loss of 10.6 kg at 12 months (11.9% of their starting body weight). In a subgroup of participants who consistently lost weight over the 12-month period (284/6602, 4.3% of the sample), weight loss reached up to 22.3 kg (21.7% of their starting body weight). Weekly platform use was positively associated with total weight loss (r=0.287; P<.001). Members who used the platform >30 times per week (approximately >4 times/d) were more likely to lose weight in the first 6 months of the program.

CONCLUSIONS: This commercial weight loss program was shown to be effective, with 1 in 2 members achieving clinically significant results after 1 year. Greater engagement with the platform was associated with consecutive periods of weight loss and greater weight loss success overall.

PMID:39813669 | DOI:10.2196/65122

J Med Internet Res. 2025 Jan 15;27:e62645. doi: 10.2196/62645.

ABSTRACT

BACKGROUND: Health inequalities among older adults become increasingly pronounced as aging progresses. In the digital era, some researchers argue that access to and use of digital technologies may contribute to or exacerbate these existing health inequalities. Conversely, other researchers believe that digital technologies can help mitigate these disparities.

OBJECTIVE: This study aimed to investigate the relationship between the digital divide and health inequality among older adults and to offer recommendations for promoting health equity.

METHODS: Data were obtained from the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) scale, the Instrumental Activities of Daily Living scale, the Mini-Mental State Examination scale, and a 5-point self-rated health scale, respectively. The chi-square and rank sum tests were used to explore whether internet use and access were associated with health inequality status. After controlling for confounders, multiple linear regression models were used to further determine this association. Sensitivity analysis was conducted using propensity score matching, and heterogeneity was analyzed for different influencing factors.

RESULTS: The 2018 analysis highlighted widening health disparities among older adults due to internet access and use, with statistically significant increases in inequalities in self-rated health (3.9%), ADL score (5.8%), and cognition (7.5%). Similarly, internet use widened gaps in self-rated health (7.5%) and cognition (7.6%). Conversely, the 2020 analysis demonstrated that internet access improved health disparities among older adults, reducing gaps in self-rated health (3.8%), ADL score (2.1%), instrumental ADL score (3.5%), and cognition (7.5%), with significant results, except for ADL. Internet use also narrowed disparities, with significant effects on self-rated health (4.8%) and cognition (12.8%). The robustness of the results was confirmed through propensity score-matching paired tests. In addition, the study found heterogeneity in the effects of internet access and use on health inequalities among older adults, depending on sex, age, education, and region.

CONCLUSIONS: The impact of internet access and use on health inequalities among older adults showed different trends in 2018 and 2020. These findings underscore the importance of addressing the challenges and barriers to internet use among older adults, particularly during the early stages of digital adoption. It is recommended to promote equitable access to the health benefits of the internet through policy interventions, social support, and technological advancements.

PMID:39813666 | DOI:10.2196/62645

Neurology. 2025 Feb 11;104(3):e210286. doi: 10.1212/WNL.0000000000210286. Epub 2025 Jan 15.

ABSTRACT

BACKGROUND AND OBJECTIVES: Previous studies have shown inconsistent associations between red meat intake and cognitive health. Our objective was to examine the association between red meat intake and multiple cognitive outcomes.

METHODS: In this prospective cohort study, we included participants free of dementia at baseline from 2 nationwide cohort studies in the United States: the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS). Diets were assessed using a validated semiquantitative food frequency questionnaire. We ascertained incident dementia cases from both NHS participants (1980-2023) and HPFS participants (1986-2023). Objective cognitive function was assessed using the Telephone Interview for Cognitive Status (1995-2008) among a subset of NHS participants. Subjective cognitive decline (SCD) was self-reported by NHS participants (2012, 2014) and HPFS participants (2012, 2016). Cox proportional hazards models, general linear regression, and Poisson regression models were applied to assess the associations between red meat intake and different cognitive outcomes.

RESULTS: The dementia analysis included 133,771 participants (65.4% female) with a mean baseline age of 48.9 years, the objective cognitive function analysis included 17,458 female participants with a mean baseline age of 74.3 years, and SCD analysis included 43,966 participants (77.1% female) with a mean baseline age of 77.9 years. Participants with processed red meat intake ≥0.25 serving per day, compared with <0.10 serving per day, had a 13% higher risk of dementia (hazard ratio [HR] 1.13; 95% CI 1.08-1.19; p_linearity < 0.001) and a 14% higher risk of SCD (relative risk [RR] 1.14; 95% CI 1.04-1.25; p_linearity = 0.004). Higher processed red meat intake was associated with accelerated aging in global cognition (1.61 years per 1 serving per day increment [95% CI 0.20-3.03]) and in verbal memory (1.69 years per 1 serving per day increment [95% CI 0.13-3.25], both p_linearity = 0.03). Unprocessed red meat intake of ≥1.00 serving per day, compared with <0.50 serving per day, was associated with a 16% higher risk of SCD (RR 1.16; 95% CI 1.03-1.30; p_linearity = 0.04). Replacing 1 serving per day of nuts and legumes for processed red meat was associated with a 19% lower risk of dementia (HR 0.81, 95% CI 0.75-0.86), 1.37 fewer years of cognitive aging (95% CI -2.49 to -0.25), and a 21% lower risk of SCD (RR 0.79, 95% CI 0.68-0.92).

DISCUSSION: Higher intake of red meat, particularly processed red meat, was associated with a higher risk of developing dementia and worse cognition. Reducing red meat consumption could be included in dietary guidelines to promote cognitive health. Further research is needed to assess the generalizability of these findings to populations with diverse ethnic backgrounds.

PMID:39813632 | DOI:10.1212/WNL.0000000000210286

Neurology. 2025 Feb 11;104(3):e213348. doi: 10.1212/WNL.0000000000213348. Epub 2025 Jan 15.

ABSTRACT

BACKGROUND AND OBJECTIVES: Although around one-third of survivors of aneurysmal subarachnoid hemorrhage (aSAH) suffer from anxiety and depression, studies focusing on suicide risk after aSAH are lacking. Thus, we aimed to investigate whether survivors of aSAH have an elevated risk of suicide death in comparison with the general population.

METHODS: Using 2 externally validated nationwide registers (Care Register for Health Care and Cause of Death Register), we identified all ≥15-year-old survivors of aSAH (alive 30 days after hospital admission) in Finland during 1998-2017 and followed these patients until death or the end of 2018. By calculating standardized mortality ratios (SMRs) with 95% CIs using the Mid-P exact test, we compared the observed suicide rates of survivors of aSAH with the expected rates based on the age-matched, sex-matched, and year-matched general Finnish population.

RESULTS: We identified 5,708 survivors of aSAH (59% female, median age 55 years) of whom 19 (5 female patients and 14 male patients) died by suicide during a total of 53,060 person-years (median 8.9 years) of follow-up. Of all deaths by suicide, 7 were caused by self-poisoning, 6 by hanging/strangulation, 3 by a firearm, 2 by jumping, and 1 by a sharp object. The observed rate of suicide was 35.8 per 100,000 person-years compared with the expected rate of 20.4 per 100,000 person-years resulting in an overall SMR of 1.75 (95% CI 1.09-2.69). The risk of suicide was especially high among 15-39-year-old female and male patients (72.5 per 100,000 person-years; SMR = 3.57 [1.31-7.92]) and during the first year after aSAH (81.2 per 100,000 person-years; SMR = 3.64 [1.16-8.77]), after which the risk attenuated.

DISCUSSION: Survivors of aSAH are at excessive risk of suicide death in comparison with the general population. Given that this risk seems to be the highest among young individuals and during the first year after aSAH, early assessment and management of psychological distress, especially in young survivors of aSAH may be warranted. Future studies should include detailed individual-level data on psychiatric comorbidities and aSAH-specific factors, as well as record both nonfatal and fatal suicide attempts.

PMID:39813630 | DOI:10.1212/WNL.0000000000213348

Hepatol Commun. 2025 Jan 16;9(2):e0620. doi: 10.1097/HC9.0000000000000620. eCollection 2025 Feb 1.

ABSTRACT

BACKGROUND: Refractory ascites (RA) remains a serious complication in patients with cirrhosis. Currently, the insertion of a TIPS is considered the standard of care in these patients. To achieve symptom control in those with TIPS contraindications, tunneled peritoneal catheters (PeCa) or ascites pumps were introduced. However, data comparing the available treatment options are scarce. This study aims to compare outcomes among patients with RA treated either with TIPS, PeCa, or ascites pump.

METHODS: All patients with RA and cirrhosis treated at Hannover Medical School between 2009 and 2023 were evaluated. Endpoints included mortality, acute kidney injury (AKI), hyponatremia, peritonitis, and rehospitalization rate. Propensity score matching was conducted to adjust for group differences.

RESULTS: First, 31 patients with ascites pump were compared to 62 patients with a PeCa after propensity score matching. There were no differences regarding mortality nor incidences of AKI, hyponatremia, or rehospitalization. However, incidences of peritonitis and explantation were lower in those with ascites pump (HR 0.32, 95% CI: 0.15-0.70, and HR 0.32, 95% CI: 0.14-0.71, respectively). Second, 35 ascites pump patients were matched with 70 individuals with TIPS. No differences regarding mortality or peritonitis incidence were observed. Ascites pump patients showed higher incidences of AKI (HR 4.55, 95% CI: 2.53-8.18) and hyponatremia (HR 4.13, 95% CI: 2.08-8.22). Last, 129 patients with TIPS were compared to 129 with PeCa. Mortality was comparable, while incidences of AKI (HR 5.01, 95% CI: 3.36-7.47), hyponatremia (HR 4.64, 95% CI: 3.03-7.12), and peritonitis (HR 2.19, 95% CI: 1.41-3.41) were higher in those with PeCa.

CONCLUSIONS: While ascites pump was associated with lower incidences of device infections and explantations, TIPS was associated with the lowest incidence of clinical complications in patients with RA.

PMID:39813591 | DOI:10.1097/HC9.0000000000000620

Epidemiol Serv Saude. 2025 Jan 13;33(spe1):e2024515. doi: 10.1590/S2237-96222024v33e2024515.especial.en. eCollection 2025.

ABSTRACT

OBJECTIVE: To describe the sociodemographic profile and access to social assistance and health services among trans people and travestis experiencing homelessness in Salvador, the capital city of Bahia state.

METHODS: This was a cross-sectional study involving 24 (4.5%) participants who identified as trans people or travestis out of a total of 529 people, aged 18 or older, living in public spaces or institutional shelters included in the survey. Data were collected between 2021 and 2022, using structured questionnaires.

RESULTS: The sample was predominantly comprised of trans women and travestis (n=18), young individuals (n=13), of Black race/skin color (n=22), single individuals (n=18) and those engaged in informal occupations (n=23), many of whom reported experiencing violence (n=17). Frequent barriers to accessing healthcare and social assistance services were found (n=15), including lack of documentation, delay in service provision and social/racial discrimination.

CONCLUSION: The findings highlight the heightened vulnerability of transgender people and travestis experiencing homelessness, who are subjected to multiple forms of discrimination and social exclusion.

PMID:39813583 | DOI:10.1590/S2237-96222024v33e2024515.especial.en