Nevin Manimala

JMIR Cancer. 2025 Mar 14;11:e57414. doi: 10.2196/57414.

ABSTRACT

BACKGROUND: Cancers of the bladder, kidney, and prostate are the 3 major genitourinary cancers that significantly contribute to the global burden of disease (GBD) and continue to show increasing rates of morbidity and mortality worldwide. In mainland China, understanding the cancer burden on patients and their families is crucial; however, public awareness and concerns about these cancers, particularly from the patient’s perspective, remain predominantly focused on financial costs. A more comprehensive exploration of their needs and concerns has yet to be fully addressed.

OBJECTIVE: This study aims to analyze trends in online searches and user information-seeking behaviors related to bladder, kidney, and prostate cancers-encompassing descriptive terms (eg, “bladder cancer,” “kidney cancer,” “prostate cancer”) as well as related synonyms and variations-on both national and regional scales. This study leverages data from mainland China’s leading search engine to explore the implications of these search patterns for addressing user needs and improving health management.

METHODS: The study analyzed Baidu Index search trends for bladder, kidney, and prostate cancers (from January 2011 to August 2023) at national and provincial levels. Search volume data were analyzed using the joinpoint regression model to calculate annual percentage changes (APCs) and average APCs (AAPCs), identifying shifts in public interest. User demand was assessed by categorizing the top 10 related terms weekly into 13 predefined topics, including diagnosis, treatment, and traditional Chinese medicine. Data visualization and statistical analyses were performed using Prism 9. Results revealed keyword trends, demographic distributions, and public information needs, offering insights into health communication and management strategies based on online information-seeking behavior.

RESULTS: Three cancer topics were analyzed using 39 search keywords, yielding a total Baidu Search Index (BSI) of 43,643,453. From 2011 to 2015, the overall APC was 15.2% (P<.05), followed by -2.8% from 2015 to 2021, and 8.9% from 2021 to 2023, with an AAPC of 4.9%. Bladder, kidney, and prostate cancers exhibited AAPCs of 2.8%, 3.9%, and 6.8%, respectively (P<.05). The age distribution of individuals searching for these cancer topics varied across the topics. Geographically, searches for cancer were predominantly conducted by people from East China, who accounted for approximately 30% of each cancer search query. Regarding user demand, the total BSI for relevant user demand terms from August 2022 to August 2023 was 676,526,998 out of 2,570,697,380 (15.74%), representing only a limited total cancer-related search volume.

CONCLUSIONS: Online searches and inquiries related to genitourinary cancers are on the rise. The depth of users’ information demands appears to be influenced by regional economic levels. Cancer treatment decision-making may often involve a family-centered approach. Insights from internet search data can help medical professionals better understand public interests and concerns, enabling them to provide more targeted and reliable health care services.

PMID:40085845 | DOI:10.2196/57414

J Med Internet Res. 2025 Mar 14;27:e66683. doi: 10.2196/66683.

ABSTRACT

BACKGROUND: Seeking online health information can empower individuals to better understand their health concerns, facilitating their ability to manage their health conditions more effectively. It has the potential to change the likelihood and frequency of health service usage. Although existing literature has demonstrated the prevalence of seeking online health information among different populations, the factors affecting online health information perception and discussions on the associations between seeking online health information and health service utilization are limited.

OBJECTIVE: We analyzed the associations between online health information seeking behavior and health service utilization, as well as the online health information perception delivery mechanism.

METHODS: We analyzed data from the Chinese General Social Survey, the first national representative survey conducted in mainland China. The independent variable was the online health information seeking behavior. The outcome variable was health service utilization by the respondents, and online health information perception was selected as the mediating variable in this analysis. Factor analysis was conducted to obtain online health information perception. Multiple regressions were performed to investigate the effect of online health information seeking behavior on physician visits. Bootstrap methods were conducted to test the mediation effects of online health information perception.

RESULTS: This analysis included 1475 cases. Among the participants, 939 (63.66%) sought online health information in the last 12 months. The mean age of the respondents was 46.72 (SD 15.86) years, and 794 (53.83%) were females. After controlling for other variables, individuals with online health information seeking behaviors showed 0.289 times more outpatient visits (P=.003), 0.131 times more traditional Chinese medicine outpatient visits (P=.01), and 0.158 times more Western medicine outpatient visits (P=.007) over the past year compared to those who did not seek health information online. Additionally, multiple regression analyses revealed statistically significant effects of gender, age, and health status on physician visits. The total effect revealed that seeking online health information significantly influenced the total physician visits (β=0.290; P=.003), indicating a certain correlation between online health information seeking behavior and physician visits. Seeking online health information had a significant positive impact on the perception (β=0.265; P<.001). The mediation effects analysis identified that online health information perception led to a significant increase in physician visits with the increase in the online health information seeking behaviors (β=0.232; P=.02).

CONCLUSIONS: The online health information perception of an individual influences the effect online health information seeking has on the frequency of physician visits. The online health information seeking behavior impacts outpatient service utilization both directly and indirectly through online health information perception and significantly increases the frequency of clinic visits after controlling for other variables. Interventions can be explored to improve the health utilization of residents by increasing their online health information perception.

PMID:40085841 | DOI:10.2196/66683

JMIR Res Protoc. 2025 Mar 14;14:e65576. doi: 10.2196/65576.

ABSTRACT

BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) collects and calculates risk-outcome data for modifiable lifestyle exposures (eg, dietary intake) and physical health outcomes (eg, cancers). These estimates form a critical digital resource tool, the GBD VizHub data visualization tool, for governments and policy makers to guide local, regional, and global health decisions. Despite evidence showing the contributions of lifestyle exposures to common mental disorders (CMDs), such as depression and anxiety, GBD does not currently generate these lifestyle exposure-mental disorder outcome pairings. This gap is due to a lack of uniformly collected and analyzed data about these exposures as they relate to CMDs. Such data are required to quantify whether, and to what degree, the global burden of CMDs could be reduced by targeting lifestyle factors at regional and global levels. We have established the Global burden of disease Lifestyle And mental Disorder (GLAD) Taskforce to address this gap.

OBJECTIVE: This study aims to generate the necessary estimates to afford the inclusion of lifestyle exposures as risk factors for CMDs in the GBD study and the GBD digital visualization tools, initially focusing on the relationship between dietary intake and CMDs.

METHODS: The GLAD project is a multicenter, collaborative effort to integrate lifestyle exposures as risk factors for CMDs in the GBD study. To achieve this aim, global epidemiological studies will be recruited to conduct harmonized data analyses estimating the risk, odds, or hazards of lifestyle exposures with CMD outcomes. Initially, these models will focus on the relationship between dietary intake, as defined by the GBD, and anxiety and depression.

RESULTS: As of August 2024, 18 longitudinal cohort studies from 9 countries (Australia: n=4; Brazil: n=1; France: n=1; Italy: n=3; The Netherlands: n=3; New Zealand: n=1; South Africa: n=1; Spain: n=1; and United Kingdom: n=3) have agreed to participate in the GLAD project.

CONCLUSIONS: Our comprehensive, collaborative approach allows for the concurrent execution of a harmonized statistical analysis protocol across multiple, internationally renowned epidemiological cohorts. These results will be used to inform the GBD study and incorporate lifestyle risk factors for CMD in the GBD digital platform. Consequently, given the worldwide influence of the GBD study, findings from the GLAD project can offer valuable insights to policy makers worldwide around lifestyle-based mental health care.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/65576.

PMID:40085831 | DOI:10.2196/65576

Int J Risk Saf Med. 2025 Mar 14:9246479251327814. doi: 10.1177/09246479251327814. Online ahead of print.

ABSTRACT

BackgroundThe use of rational and safe antibiotic therapies for pregnant women remains an important issue within the medical community.ObjectiveTo analyze the preferences in the choice of antimicrobial drugs (AMD) among obstetricians-gynecologists of Central Russia in treatment of infectious diseases in pregnancy.MethodsThis is anonymous survey of obstetrician and gynecology specialists conducted in Central Russia between September 1st, and November 30th, 2017. Study included five healthcare facilities (ambulatory and in-patient), located in regional center, city Belgorod. Questionnaire contained six open-ended questions to evaluate AMD preferences in treatment of Chlamydia trachomatis, Mycoplasma hominis or genitalium, Ureaplasma species, acute cystitis, pyelonephritis, and other conditions, such as placental insufficiency, fetal growth restriction. Descriptive statistics was used including absolute and relative frequencies, minimum and maximum values, mean, frequency of prescribing AMD, and their proportion in the total number prescribed.ResultsA total of 52 responses were included in final analysis. There was significant rate of 15.4% of prescribing pregnancy unsafe (fluoroquinolones, tetracyclines) or non-rational AMD or deviation from existing clinical protocols and guidelines.ConclusionsThere were large variations in provider’s AMD preference between healthcare facilities.

PMID:40085828 | DOI:10.1177/09246479251327814

Med Sci Sports Exerc. 2025 Mar 14. doi: 10.1249/MSS.0000000000003703. Online ahead of print.

ABSTRACT

PURPOSE: We sought to evaluate the effect of intensive physical training on left ventricular (LV) hemodynamic forces (HDF) in athletes.

METHODS: Forty professional endurance athletes were evaluated at the beginning of their training cycle (off-season) and after a period of aerobic isotonic dynamic exercise (peak training period) using cardiac magnetic resonance (CMR). Images were analyzed off-line using dedicated software. LV HDF for the whole cardiac cycle and the different cardiac phases were measured. Standard statistics were used to compare off-season and peak training period values.

RESULTS: The average sport experience was 11 ± 7 years. There were no differences in LV volumes, stroke volume, LVEF and LV mass between off-season and peak training CMR. Similarly, there were no changes induced by physical training in the strain parameters. Physical training induced a significant increase of the longitudinal HDF (18.7 vs 21.2, p = 0.023) and an increase of the transverse HDF (3.4 vs 4.0, p = 0.048) throughout the entire heartbeat. After physical training, the peak values and the hemodynamic work (expressed as AUC) of the first part of the systole were significantly higher compared to off-season values (63.9 vs 53.9, p = 0.034; 4.67 vs 3.79, p = 0.015, respectively). The difference in the elastic rebound between off-season and peak training (-0.22 vs -0.37) did not reach statistical significance (p = 0.056).

CONCLUSIONS: Intense physical training induces an increase in LV HDF of the first part of the systole and of the elastic rebound phase, independent from geometric cardiac remodeling.

PMID:40085803 | DOI:10.1249/MSS.0000000000003703

NCHS Data Brief. 2024 Oct;(511).

ABSTRACT

INTRODUCTION: This report presents the latest findings from the National Health and Nutrition Examination Survey on the prevalence, awareness, treatment, and control of hypertension among adults in the United States during August 2021-August 2023.

METHODS: Nationally weighted prevalence estimates of hypertension (systolic blood pressure of 130 mm Hg or above or diastolic blood pressure of 80 mm Hg or above, or self-report of current blood pressure medication use), self-reported awareness, self-reported treatment, and control (blood pressure less than 130/80 mm Hg) were obtained using National Health and Nutrition Examination Survey August 2021-August 2023 data. Variance estimates accounted for the complex survey design by using Taylor series linearization. Differences between estimates overall, among subgroups, and compared with 2017-March 2020 were tested using a t statistic at the p < 0.05 significance level.

KEY FINDINGS: During August 2021-August 2023, the prevalence of hypertension in adults was 47.7%, was higher in men (50.8%) than women (44.6%), and increased with age: 23.4% for ages 18-39, 52.5% for 40-59, and 71.6% for 60 and older. Among adults with hypertension, 59.2% were aware of their hypertension status, more than one-half were currently taking medication to lower blood pressure, and about one-fifth had their blood pressure controlled to less than 130/80 mm Hg. No significant change in awareness, treatment, or control of hypertension was seen among adults with hypertension between 2017-March 2020 and August 2021-August 2023.

PMID:40085792

Int J Surg. 2025 Mar 14. doi: 10.1097/JS9.0000000000002330. Online ahead of print.

ABSTRACT

BACKGROUND: Fluid resuscitation represents a pivotal early therapeutic intervention in the management of acute pancreatitis (AP), yet a consensus on the optimal fluid type remains elusive. The present study endeavors to elucidate the differential effects of lactated Ringer’s solution (LR) and normal saline (NS) in the initial treatment of AP.

METHODS: A comprehensive literature search was conducted through the PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, spanning from inception until July 2024. The primary outcome of interest was the likelihood of developing moderate-to-severe AP.

RESULTS: This meta-analysis synthesized evidence from six randomized controlled trials (RCTs) and four observational studies, involving a total of 1500 AP patients. Patients were stratified into two groups based on the administered fluid: LR (n = 689) and NS (n = 811). Our findings revealed that, compared to the NS group, patients in the LR group demonstrated a significantly lower risk of moderate-to-severe acute pancreatitis (OR 0.48; 95%Cl 0.34 to 0.67; P < 0.001; I2 = 0%), a shorter hospital stay (MD = – 0.74, 95% CI -1.20 to -0.28, P = 0.001; I2 = 0%), and a reduced ICU admission rate (RR = 0.42, 95% CI 0.20-0.89, P = 0.02; I2 = 0%). Moreover, the LR group also showed a lower incidence of local complications (RR = 0.58, 95% CI 0.34-0.98, P = 0.04). Conversely, no statistically significant differences were observed between the two groups in terms of mortality, organ failure rates, Fluid administered 24 h, systemic inflammatory response syndrome (SIRS).

CONCLUSIONS: Our analysis underscores the superior efficacy of Lactated Ringer’s (LR) solution in comparison to Normal Saline (NS). It provides compelling evidence of LR’s ability to significantly mitigate the onset of moderate to severe pancreatitis. Additionally, our findings reveal that LR is associated with a reduced need for Intensive Care Unit (ICU) admissions, a lower incidence of local complications, and a shorter overall hospital stay, thereby offering a more favorable clinical outcome. However, no notable differences were discerned in other complications. Subgroup analyses further suggest LR’s potential to curb pancreatic necrosis and other indices, albeit these findings necessitate corroboration through extensive experimentation.

PMID:40085761 | DOI:10.1097/JS9.0000000000002330

JMIR Res Protoc. 2025 Mar 14;14:e63636. doi: 10.2196/63636.

ABSTRACT

BACKGROUND: Global concern for the mental well-being of university students is on the rise. Recent studies estimate that around 30% of students experience mental health disorders, and nearly 80% of these individuals do not receive adequate treatment. Brazil, home to around eight million university students, lacks sufficient research addressing their mental health. To address this gap, we aim to conduct a longitudinal mental health survey at 2 Brazilian universities.

OBJECTIVE: This paper outlines the research protocol for a web-based mental health survey designed to assess the well-being of Brazilian university students.

METHODS: The survey targets undergraduate students (N=8028) from 2 institutions: UniFAJ (Centro Universitário de Jaguariúna) and UniMAX (Centro Universitário Max Planck). Students will be invited to respond to self-reported questionnaires, including theSMILE-U (lifestyle and quality of life), the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) self-rated level 1 cross-cutting symptom measure, and a brief version of the Adult Self-Report Scale for attention-deficit/hyperactivity disorder. Students who exceed thresholds for conditions such as depression, anxiety, and attention-deficit/hyperactivity disorder will receive additional diagnostic instruments. The survey will be conducted annually, tracking individual and group trajectories and enrolling new cohorts each year. Data will be analyzed using cross-sectional and longitudinal methods, focusing on descriptive, associative, and trajectory analyses.

RESULTS: The first wave of data collection began in February 2024 and is expected to conclude in December 2024. As of October 2024, a total of 2034 of 7455 (27.2 in 100) eligible students had completed the questionnaire. Cross-sectional statistical analysis is planned to commence immediately after data collection and is expected to be completed by June 2025.

CONCLUSIONS: This survey uses a scalable, cost-effective design to evaluate mental health conditions among Brazilian university students. The longitudinal framework facilitates the monitoring of mental health trends, supports the development of targeted interventions, and informs policy initiatives in higher education.

TRIAL REGISTRATION: OSF Registries OSF.IO/AM5WS; https://doi.org/10.17605/OSF.IO/AM5WS.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63636.

PMID:40085140 | DOI:10.2196/63636

J Nurs Res. 2025 Mar 17. doi: 10.1097/jnr.0000000000000665. Online ahead of print.

ABSTRACT

BACKGROUND: Prolonged depressive symptoms in individuals with schizophrenia not only diminish their quality of life but also significantly increase their risk of suicide. This, in turn, may lead to a lower average life expectancy among people with schizophrenia compared to the general population.

PURPOSE: This study was designed to examine the effectiveness of rumination-focused cognitive behavior therapy (RFCBT) on depressive symptoms in individuals with schizophrenia.

METHODS: This study was conducted between July 2019 and March 2020. Seventy-seven participants, all of whom had been diagnosed with schizophrenia, were randomly divided into the experimental group (n = 38) and control group (n = 39). The experimental group underwent a 12-week, six-session RFCBT regimen, whereas the control group received six sessions of psychosocial education. Outcomes were measured using the Beck Depression Inventory-II and the revised short form of the Chinese Response Style Questionnaire at three time points: baseline, postintervention, and at the 3-month follow-up. Statistical analyses were conducted using chi-square tests, independent t tests, and generalized estimating equations, with the generalized estimating equations model assessing between-group differences over time after adjusting for 13 covariates.

RESULTS: No effect on depressive symptoms was observed immediately following RFCBT. However, at the 3-month follow-up, the mean Beck Depression Inventory-II score had reduced significantly in the experimental group (from 17.24 to 15.56) and increased in the control group (from 17.59 to 23.03; p = .016). Chinese Response Style Questionnaire-10 scores, which are used to represent ruminative responses, did not differ significantly between the groups at any of the three time points.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: These findings offer compelling preliminary evidence in support of RFCBT as a potentially effective treatment strategy for alleviating depressive symptoms in patients with schizophrenia. The efficacy of RFCBT was demonstrated in terms of preventing the exacerbation of depressive symptoms. The findings have notable implications for clinicians, researchers, and policymakers with regard to developing more effective treatment strategies and enhancing outcomes for individuals with schizophrenia.

PMID:40085129 | DOI:10.1097/jnr.0000000000000665

Ophthalmic Surg Lasers Imaging Retina. 2025 Mar 1:1-8. doi: 10.3928/23258160-20250127-02. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: While anti-vascular endothelial growth factor (anti-VEGF) therapy has revolutionized treatment for diabetic macular edema, many patients still manifest refractory disease. This study evaluated rates of diabetic macular edema (DME) refractory to intravitreal bevacizumab in a diverse real-world setting, with the aim of studying demographic and optical coherence tomography (OCT)-based morphological factors associated with refractory disease.

PATIENTS AND METHODS: This was a retrospective cohort study of patients receiving treatment. Refractory DME was defined as a gain in visual acuity of < 5 letters after three consecutive injections of bevacizumab or less than 20% reduction in central retinal thickness (CRT) after three consecutive injections of bevacizumab. OCT images from preand post-injection visits were reviewed by two independent image readers. Multivariate logistic regression analysis evaluated for statistical significance between responders and those refractory to bevacizumab, and between Hispanic and non-Hispanic groups.

RESULTS: Ninety-nine patients were included. Of the participants, 42% were Hispanic, 10% were reported as white, 11% were Asian, 11% were Black, and 26% were defined as “not reported.” Fifty-four (54.5%) patients were refractory to bevacizumab and 45 were responders. Between responders and refractory patients, race was statistically significant (P = 0.04) with more refractory subjects found to be Hispanic (28/54, 51.9%). OCT morphologic characteristics (CRT, number of hyperreflective foci, disorganization of inner retinal layers, ellipsoid zone discontinuity, and sub-retinal fluid) were not statistically significant between responders and refractory subjects. Multivariate logistic regression demonstrated an odds ratio of 5.7 for refractory disease for Hispanics (CI 1.687 to 19.445, P = 0.01). When comparing Hispanics to non-Hispanics, Hispanics had an average lower baseline visual acuity, lower CSTs, and higher HbA1C.

CONCLUSIONS: Our study showed that Hispanics have a nearly 6 times relatively higher likelihood of refractory disease. There is a notable under-representation of these patients in completed clinical trials for diabetic retinopathy and DME. [Ophthalmic Surg Lasers Imaging Retina 2025;56:XX-XX.].

PMID:40085095 | DOI:10.3928/23258160-20250127-02