Nevin Manimala

Adv Rheumatol. 2025 Mar 6;65(1):11. doi: 10.1186/s42358-025-00443-w.

ABSTRACT

AIM: This double-blind, trial sought to assess the effectiveness of intra-articular ozone therapy at concentrations of 20 µg/mL and 40 µg/mL in managing pain and enhancing functional mobility in patients with knee osteoarthritis (KOA).

METHOD: This parallel, three-arm randomized controlled trial, conducted between 2022 and 2023, included 59 knee osteoarthritis (KOA) patients randomly allocated to one of three groups: the first group received 40 µg/mL ozone therapy, the second group received 20 µg/mL ozone therapy, and the control group received oxygen. Functional mobility was assessed through the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee flexion range of motion (FROM), the Timed Up and Go (TUG) test, and the six-minute walk test (6MWT). Pain intensity was measured using the Visual Analog Scale (VAS) and the pain subscale of the WOMAC. Intra-articular injections were administered weekly for four consecutive weeks, with assessments conducted pre-treatment, and at two weeks, one month, and two months post-intervention. One-way ANOVA was employed for normally distributed quantitative data, while the Kruskal-Wallis test was utilized for non-normally distributed data. Qualitative variables were analyzed using the Chi-squared or Fisher’s exact test, as appropriate.

RESULTS: The groups receiving intra-articular ozone therapy exhibited notable reductions in mean VAS scores and improvement in functional mobility variables when compared to the control group (p < 0.05). However, post-hoc analysis indicated no statistically significant differences between the 40 µg/mL and 20 µg/mL ozone therapy groups regarding these parameters (VAS, FROM, TUG, 6MWT, or WOMAC scores) (p > 0.05).

CONCLUSION: Both 20 µg/mL and 40 µg/mL doses of intra-articular ozone therapy prove to be effective in reducing pain and enhancing functional mobility in patients with knee osteoarthritis (KOA). Nevertheless, there was no significant difference in the efficacy between the two ozone concentrations.

TRIAL REGISTRATION: The trial is registered on us ClinicalTrials.gov in 2024-05-01 with the following ID code NCT06088706.

PMID:40050950 | DOI:10.1186/s42358-025-00443-w

Respir Res. 2025 Mar 6;26(1):89. doi: 10.1186/s12931-025-03158-0.

ABSTRACT

BACKGROUND: There is increasing evidence that screening provides a catalyst for behavioural change. Low physical activity (PA) levels are a potentially modifiable risk factor for developing lung cancer. This study aims to assess the feasibility and safety of a semi-supervised 8-week multi-modal exercise program to improve health-related quality of life and PA levels of participants of lung cancer screening.

METHODS: Participants without lung cancer from a single Australian International Lung Screen Trial (ILST; NCT02871856) site were invited to this feasibility randomised controlled trial. Enrolled participants were randomised to usual care, written material, or a home-based exercise program (in addition to written material). Assessments occurred at baseline, 9 weeks, and 6 months.

RESULTS: 75 participants were enrolled over a 3-month period in 2022 (consent rate of 67%). 43% of participants were female, median age 66 years old (IQR 62, 73). Of the 25 participants randomised to the home-based exercise program, 22 participants (88%) attended > 70% of weekly sessions. 99% (74/75) of study participants attended their 9-week and 6-month follow-up assessments.

CONCLUSIONS: This study confirms the feasibility and high compliance of delivering a semi-supervised 8-week multi-modal exercise program to participants of a lung cancer screening program. It was safe, with no adverse events.

CLINICAL TRIAL REGISTRATION: Australian Clinical Trials Register https://www.australianclinicaltrials.gov.au ACTRN12622001001785.

PMID:40050941 | DOI:10.1186/s12931-025-03158-0

J Orthop Surg Res. 2025 Mar 6;20(1):243. doi: 10.1186/s13018-025-05664-9.

ABSTRACT

BACKGROUND: Whether patients with chronic ankle instability (CAI) can benefit from weight loss yielded by using glucagon-like peptide-1 receptor agonists (GLP1-RAs) has remained unclear.

METHODS: In this observational study, we recruited more than 2000 adults with CAI according to the selection criteria proposed by International Ankle Consortium with at least two-year follow up from three medical centers. The primary endpoint was the change from baseline of the Foot and Ankle Ability Measure (FAAM) sports subscale at the last follow up. Secondary endpoints included the change from baseline of Foot and Ankle Outcome Score (FAOS)/ Cumberland Ankle Instability Tool (CAIT)/ FAAM activities of daily living (ADL) subscale, number of ankle sprains during study period, incident ankle surgery in treatment of CAI.

RESULTS: In this study, 71 out of 2018 patients who received semaglutide in purpose of treating type 2 diabetes (T2DM) and/or weight loss during the study period. After controlling baseline characteristics, the adjusted mean difference in change from baseline was 16.3 for FAAM sports subscale and 9.3 for FAAM ADL subscale. Likewise, the adjusted analysis of five subscales of FAOS showed similar results, all consistently favoring semaglutide group. For CAIT, patients in the semaglutide group had achieved statistically significant improvement compared with control group. The association of semaglutide exposure with improvement in FAAM sports and ADL subscales was mediated by the weight loss measured by BMI (mediation proportion: FAAM sports subscale, 31.2% [22.2-41.2%]; FHSQ ADL subscale, 34.1% [24.4-44.8%]). We also observed statistically significant decreases in number of recurrent ankle sprains during study period. For incident ankle surgery, 1 out of 71 patients (1.4%) and 151 out of 1947 patients (7.8%) received ankle surgeries in semaglutide and control groups, respectively (P = 0.047).

CONCLUSIONS: Semaglutide may show potential benefits as a supplementary intervention in treatment of CAI by improving patient-reported outcomes and preventing recurrent ankle sprains. Further randomized trial is warranted by the current study to further confirm our findings.

TRIAL REGISTRATION: researchregistry10716.

PMID:40050929 | DOI:10.1186/s13018-025-05664-9

BMC Health Serv Res. 2025 Mar 6;25(1):346. doi: 10.1186/s12913-025-12482-6.

ABSTRACT

BACKGROUND: Despite completing the COVID-19 vaccination series, healthcare workers (HCWs) remain at an elevated risk of re-infection. Booster uptake, though essential for this group, remains poorly characterized among Bangladeshi HCWs. This study identified the prevalence and driving factors behind booster hesitancy among Bangladeshi HCWs, providing valuable insights for targeted interventions.

METHOD: From December 2022 to June 2023, we conducted a cross-sectional survey among 1772 HCWs enrolled from 20 healthcare facilities of all tiers purposively selected across four administrative divisions of Bangladesh. We collected information through face-to-face interviews regarding their sociodemographic, pre-existing, and currently existing medical conditions, COVID-19 vaccination status, and their intention, hesitancy, and willingness to receive future booster doses. We used a multivariable logistic regression model to analyze factors associated with booster hesitancy. Odd’s ratio with 95% confidence intervals (CIs) was calculated for each factor, with p < 0.05 considered statistically significant.

RESULT: Of the 1772 HCWs interviewed in our study, 49% (879) were nurses [median age 36 years (IQR: 30.0-46.0)]; 69% were female. Among the respondents, 94% (1667) were willing to take a booster, and 6% (105) showed hesitancy. Safety concerns, especially regarding potential side effects post-booster administration (86%), emerged as the leading cause of booster hesitancy among healthcare workers. Our multivariable logistic regression analysis revealed that support staff, compared to physicians, were the most hesitant to receive any additional booster dose (aOR 4.68, 95% CI: 1.56-9.03; p=0.006). Compared to rural residency, HCWs with an urban residency type were also more reluctant to receive booster doses (aOR 4.45, 95% CI: 2.03-9.73; p < 0.001).

CONCLUSION: Concerns about side effects following booster administration were the primary driver of hesitancy in our study. Targeted interventions focusing on education and addressing these anxieties-supported by evidence-based communication strategies-could play a crucial role in improving booster acceptance and safeguarding this vulnerable workforce.

PMID:40050921 | DOI:10.1186/s12913-025-12482-6

BMC Complement Med Ther. 2025 Mar 6;25(1):92. doi: 10.1186/s12906-025-04825-x.

ABSTRACT

BACKGROUND: Compared with short-term practices, long-term yoga might promote differential qualitative and quantitative outcomes. Following JBI’s and PRISMA-ScR guidelines, this scoping review followed an apriori and systematic protocol to document the long-term effects of yoga on neural, cognitive, psychological, and physiological outcomes, provide evidence maps for each yoga component, and summarize results identifying knowledge gaps and promising directions.

METHODS: Four databases (PubMed, Cochrane, LILACS, and PubPsych) were last searched in March 2023. Studies were included if they evaluated adults with > 1 year of practice, specified yoga-based practice(s) of interest, measured neural, cognitive, psychological, and/or physiological outcomes, were written in English, Spanish, or Portuguese, presented original data, and mentioned search terms in the title/abstract. Evidence maps for each yoga component followed a 4-level structure of outcome category, method, study design and literature size. Qualitative summaries followed the same structure, to facilitate information retrieval.

RESULTS: Out of 2270 screened studies, 65 were included (meditative studies = 36, predominantly postural studies = 25, breathing practice studies = 8). Physiologicaland neural outcomes were the most common, followed by psychological and cognitive outcomes. Although heterogeneous, neural results reveal structural and functional changes related to sensorimotor, interoceptive, emotion regulation, and executive functions. Physiologically, most studies have associated long-term practice with parasympathetic-driven autonomic, hormonal and immune responses, but some studies revealed sympathetic-driven or mixed responses, maybe due to the specific technique or individual differences. Psychological outcomes included lower levels of negative affect, psychopathological symptoms, and emotional reactivity. Cognitive measures have shown improved memory/cognition for older adults, but mixed or null effects for other constructs. Commonly, however, long-term practitioners demonstrated improved neural or physiological efficiency while performing cognitive tasks.

CONCLUSIONS: Future research should provide clear descriptions of the investigated yoga practice, employ more experimental paradigms, and refine statistical reports and models. We encourage researchers to work with specific overarching theoretical frameworks to refine research predictions, such as the neurovisceral integration model or predictive coding models; to consider motivational, cultural, and contextual factors that might influence long-term outcomes; and to develop systematic reviews and meta-analyses as next steps of evidence summary.

PMID:40050913 | DOI:10.1186/s12906-025-04825-x

J Transl Med. 2025 Mar 6;23(1):283. doi: 10.1186/s12967-024-05932-y.

ABSTRACT

BACKGROUND: Studies have indicated that COVID-19 infection may accelerate the aging process in organisms. However, it remains unknown whether contracting COVID-19 affects life expectancy. Furthermore, the underlying biological mechanisms behind these findings are still unclear.

METHODS: We conducted a prospective cohort study on 56,504 participants of European ancestry from the UK Biobank who reported the time and number of COVID-19 infection between January 2020 and September 2023. The parental average longevity was used as a proxy for their own longevity. Linear regression was used to assess the relationship between COVID-19 infection and longevity. Furthermore, we investigated the shared genetic basis between COVID-19 and longevity using large-scale genome-wide association studies (GWAS) for COVID-19 (122,616 cases and 2,475,240 controls) and longevity (3,484 cases and 25,483 controls). Mendelian randomization (MR) and mediation analysis were utilized to assess causal relationships and potential mediators between COVID-19 susceptibility and longevity. Shared genetic loci between the two phenotypes were identified using conjunctional false discovery rate (conjFDR) statistical frameworks.

RESULTS: After controlling for relevant covariates, COVID-19 infection might not be significantly correlated with longevity. In all MR methods, generalized summary-data-based Mendelian randomization (GSMR) analysis revealed a significant decrease in longevity due to severe COVID-19 infection (OR = 0.91, 95%CI: 0.84-0.98, P = 0.015). Mediation analysis identified stroke and myocardial infarction as potential mediators between COVID-19 susceptibility and reduced longevity. At conjFDR < 0.05, we identified rs62062323 (KANSL1) and rs9530111 (PIBF1) as shared loci between COVID-19 and longevity.

CONCLUSION: Together, our findings provided preliminary evidence for the shared genetic basics between COVID-19 and aging. This discovery may have implications for personalized medicine and preventive strategies, helping identify individuals who may be more vulnerable to severe outcomes from COVID-19 due to their genetic makeup.

PMID:40050903 | DOI:10.1186/s12967-024-05932-y

BMC Nurs. 2025 Mar 6;24(1):253. doi: 10.1186/s12912-025-02883-7.

ABSTRACT

BACKGROUND: This study explores the relationship between smartphone addiction and sleep quality, and to further assess the mediating role of loneliness and depression.

METHODS: A survey of 200 older adults individuals was conducted using the Smartphone Addiction Scale-Short Version (SAS-SV) for smartphone addiction, Pittsburgh Sleep Quality Index (PSQI) for sleep quality, Geriatric Depression Scale-15 (GDS-15) for depression, and DeJong Gierveld Loneliness Scale (DGLS) for loneliness. Linear regression and mediation analysis were performed for statistical analysis.

RESULTS: A negative causal relationship was observed between smartphone addiction and sleep quality in the older adults (p < 0.05). Depression and loneliness in the older adults may potentially exacerbate the effect of smartphone addiction on sleep quality (p < 0.05).

CONCLUSION: Individuals with smartphone addiction appeared to have poorer sleep quality, psychological factors play a mediating role in the association between smartphone addiction and sleep quality in the older adults. This emphasizes the importance of care for the mental health of the older adults and recognizes the negative impact of smartphone addiction on their quality of life.

PMID:40050901 | DOI:10.1186/s12912-025-02883-7

Comput Inform Nurs. 2025 Mar 5. doi: 10.1097/CIN.0000000000001261. Online ahead of print.

ABSTRACT

Standardized nursing languages help nurses articulate issues with patients, forming the groundwork for the selection of nursing interventions aimed at achieving outcomes. However, the application of standardized nursing linkages on nursing processes and nursing home residents’ outcomes, as well as the identification of facility and resident factors, remains unexplored. The purpose of this study was to examine nursing home facility and resident factors on the use of NANDA, Nursing Interventions Classification, and Nursing Outcomes Classification (NNN) and frequently occurring NNN linkages surrounding nursing home residents in Korea. Data were collected from 53 nurses of 273 residents in 19 nursing homes in Korea using a newly developed smartphone application. Descriptive statistics, analysis of variance, and analysis of covariance were used for the data analysis. Nine NNN linkages were identified in this study, mostly centered on fall prevention. We also identified that residents’ factors (including acuity, age, and admission period) and organizational factors (including year of facility establishment and facility ownership status), were related to the use of NNN. Nursing home nurses’ clinical and critical judgment and the utilization of standardized nursing languages to select proper nursing interventions and outcomes should be based on both resident and organizational factors.

PMID:40048734 | DOI:10.1097/CIN.0000000000001261

J Am Acad Orthop Surg. 2025 Feb 26. doi: 10.5435/JAAOS-D-24-01234. Online ahead of print.

ABSTRACT

INTRODUCTION: Pickleball is one of the fastest growing sports in the United States. Despite its popularity, there is limited research on pickleball-related orthopaedic injuries, particularly in the spine. This study aims to provide a deeper understanding of spinal injuries in pickleball players and offers insights into injury patterns and risk factors.

METHODS: A retrospective review from our urban tertiary medical center’s electronic medical record from 2013 to 2023 was done using OpenAI’s Generative Pretrained Transformer-4 model to identify pickleball-related orthopaedic injuries. After artificial intelligence-driven identification, a manual review of medical records identified injuries related to the spine. The resulting medical records were manually reviewed for variables such as injury year, age, sex, spinal region affected, and treatment. Artificial intelligence did not generate any data, participate in writing, or assist with statistical analysis. Statistical analyses were done using Stata software, with significance set at P < 0.05.

RESULTS: Among 1,527 pickleball-related orthopaedic injuries, 135 (8.8%) involved the spine (77% women, median age: 62 ± 12.4 years). Pickleball-related spinal injuries increased 56-fold from 2013 to 2023. Most injuries involved the lumbar spine (84%), followed by the cervical spine (15%) and thoracic spine (1%). The most common complaint was lumbar radicular symptoms (63%). Forty-six percent of patients had a body mass index over 25, and this was associated with lumbar radiculopathy and acute disk herniation (P < 0.05). Most patients sought outpatient care (98%) and 10% required surgical intervention, primarily spinal decompression.

CONCLUSION: Pickleball-related spine injuries are relatively uncommon but increasing as the sport grows in popularity, with the lumbar spine being the most frequently affected region. Elevated body mass index emerged as an important modifiable potential risk factor, and the study found a relatively high rate of surgical intervention at 10%. These findings can help guide counseling and treatment for pickleball athletes, although further research is needed to better understand risk factors, treatment options, prognosis, and return-to-play guidelines.

PMID:40048727 | DOI:10.5435/JAAOS-D-24-01234

JAMA Intern Med. 2025 Mar 6. doi: 10.1001/jamainternmed.2025.0205. Online ahead of print.

ABSTRACT

IMPORTANCE: The relationship between butter and plant-based oil intakes and mortality remains unclear, with conflicting results from previous studies. Long-term dietary assessments are needed to clarify these associations.

OBJECTIVE: To investigate associations of butter and plant-based oil intakes with risk of total and cause-specific mortality among US adults.

DESIGN, SETTING, AND PARTICIPANTS: This prospective population-based cohort study used data from 3 large cohorts: the Nurses’ Health Study (1990-2023), the Nurses’ Health Study II (1991-2023), and the Health Professionals Follow-up Study (1990-2023). Women and men who were free of cancer, cardiovascular disease (CVD), diabetes, or neurodegenerative disease at baseline were included.

EXPOSURES: Primary exposures included intakes of butter (butter added at the table and from cooking) and plant-based oil (safflower, soybean, corn, canola, and olive oil). Diet was assessed by validated semiquantitative food frequency questionnaires every 4 years.

MAIN OUTCOMES AND MEASURES: Total mortality was the primary outcome, and mortality due to cancer and CVD were secondary outcomes. Deaths were identified through the National Death Index and other sources. A physician classified the cause of death based on death certificates and medical records.

RESULTS: During up to 33 years of follow-up among 221 054 adults (mean [SD] age at baseline: 56.1 [7.1] years for Nurses’ Health Study, 36.1 [4.7] years for Nurses’ Health Study II, and 56.3 [9.3] years for Health Professionals Follow-up Study), 50 932 deaths were documented, with 12 241 due to cancer and 11 240 due to CVD. Participants were categorized into quartiles based on their butter or plant-based oil intake. After adjusting for potential confounders, the highest butter intake was associated with a 15% higher risk of total mortality compared to the lowest intake (hazard ratio [HR], 1.15; 95% CI, 1.08-1.22; P for trend < .001). In contrast, the highest intake of total plant-based oils compared to the lowest intake was associated with a 16% lower total mortality (HR, 0.84; 95% CI, 0.79-0.90; P for trend < .001). There was a statistically significant association between higher intakes of canola, soybean, and olive oils and lower total mortality, with HRs per 5-g/d increment of 0.85 (95% CI, 0.78-0.92), 0.94 (95% CI, 0.91-0.96), and 0.92 (95% CI, 0.91-0.94), respectively (all P for trend < .001). Every 10-g/d increment in plant-based oils intake was associated with an 11% lower risk of cancer mortality (HR, 0.89; 95% CI, 0.85-0.94; P for trend < .001) and a 6% lower risk of CVD mortality (HR, 0.94; 95% CI, 0.89-0.99; P for trend = .03), whereas a higher intake of butter was associated with higher cancer mortality (HR, 1.12; 95% CI, 1.04-1.20; P for trend < .001). Substituting 10-g/d intake of total butter with an equivalent amount of total plant-based oils was associated with an estimated 17% reduction in total mortality (HR, 0.83; 95% CI, 0.79-0.86; P < .001) and a 17% reduction in cancer mortality (HR, 0.83; 95% CI, 0.76-0.90; P < .001).

CONCLUSIONS AND RELEVANCE: In this cohort study, higher intake of butter was associated with increased mortality, while higher plant-based oils intake was associated with lower mortality. Substituting butter with plant-based oils may confer substantial benefits for preventing premature deaths.

PMID:40048719 | DOI:10.1001/jamainternmed.2025.0205