Nevin Manimala

BMC Health Serv Res. 2025 Feb 10;25(1):223. doi: 10.1186/s12913-024-12162-x.

ABSTRACT

BACKGROUND: According to the WHO, assistive technology (AT) is defined as the superset of technologies that improve or maintain the functioning of different senses, mobility, self-care, well-being, and inclusion of patients. ATs also include technologies for healthcare workers (HCWs) to reduce workloads and improve efficiency and patient care outcomes. Software ATs for HCWs include communication software, artificial intelligence (AI), text editors, planning tools, decision support systems, and health records. Hardware ATs for HCWs can range from communication devices, sensors, and specialized medical equipment to robots.

AIMS: With this indicative study, we explore HCW utilization, perceptions, and adoption barriers of ATs. We emphasize ATs role in enhancing HCWs’ efficiency and effectiveness in healthcare delivery.

METHODS: A cross-sectional online survey was conducted through August 2024 with HCWs in Bavaria via a network recruiting approach. We used convenience sampling but ensured that only HCWs were part of our study population. Our survey included (i) usage, (ii) usefulness, and (iii) perceptions regarding ATs. The survey comprised 11 close-ended and three open-ended questions, including story stems evaluated by a deductive qualitative template analysis. Our mixed-method evaluation also employed descriptive and bivariate statistics.

RESULTS: Three hundred seventy-one HCWs (♂63.9 %, ♀36.1 %) participated in our survey, primarily 133 administrators, 116 nurses, and 34 doctors. More than half of the study participants (58.6 %) reported having advanced technical skills. Regarding usage, communication platforms (82.2 %) and communication devices (86 %) were the most commonly used ATs. Advanced ATs such as body-worn sensors, medical devices with interfaces, identification devices, and robots were underutilized in our sample. ATs were reported to be helpful in all job roles but need improvements in capacity and integration. Key barriers to adoption included outdated infrastructure, interoperability, and a lack of training.

CONCLUSION: Our study suggests that HCWs may want to incorporate ATs into their workflows as they see how, in theory, these technologies would improve HCW’s efficiency, resulting in better patient care. However, to realize this potential, efforts in ATs integration and accessibility are essential. Given this study’s modest sample size and generalizability limitations, further research is needed to explore the adoption, implementation, and impact of ATs in healthcare.

PMID:39930473 | DOI:10.1186/s12913-024-12162-x

J Ovarian Res. 2025 Feb 10;18(1):25. doi: 10.1186/s13048-025-01608-3.

ABSTRACT

BACKGROUND: Exosomes, extracellular vesicles with an average diameter of 30 ~ 150 nm, are pivotal in mediating the cellular microenvironment (CM) through their cargo-carrying capability. Despite extensive studies, the dynamic and regulatory mechanisms of exosomal cargoes, including lipids, proteins, nucleic acids, and metabolites, remain poorly understood.

METHODS: In this study, we collected culture medium of ovarian cancer cells at four different time points (12, 24, 36, 48 h). Exosomes were isolated using ultracentrifugation, and miRNA sequencing was performed for exosomes from each group (T12, T24, T36, and T48).

RESULTS: A total of 131 miRNAs were identified in all groups. Specifically, 41, 115, 63, and 24 miRNAs were detected in the T12, T24, T36, and T48 groups, respectively. Among these, 15 miRNAs were common to the all groups, while 3, 57, 10, and 3 miRNAs were unique to the T12, T24, T36, and T48 groups, respectively. Functional analyses of the target genes for both common and specific miRNAs indicated that numerous target genes were involved in signaling pathways and cancer-related processes.

CONCLUSION: It suggested that exosomal miRNAs might be critical in intercellular communication and in dynamically remodeling the tumor microenvironment. These insights could enhance our understanding of the role of exosomal miRNAs in cancer biology and inform the development of novel therapeutic strategies.

PMID:39930447 | DOI:10.1186/s13048-025-01608-3

BMC Public Health. 2025 Feb 10;25(1):532. doi: 10.1186/s12889-024-21007-5.

ABSTRACT

BACKGROUND: Malaria is a significant health challenge in Sierra Leone, particularly affecting pregnant women and children under five years of age. Despite efforts to reduce malaria cases, its prevalence remains high. The Sierra Leone National Malaria Elimination Strategic Plan (NMESP) 2021-2025 aims to reduce the malaria burden significantly through universal access to Insecticide Treated Nets (ITNs).

OBJECTIVE: This study evaluates the knowledge and utilization of ITNs for malaria control in the Moyamba and Bo districts of Sierra Leone (at the Njala University’s Main Campus in Moyamba District and Towama Location on Bo Campus in Bo District). It assesses awareness levels, factors associated with ITN use, and the effectiveness of current campaign strategies.

METHODS: A cross-sectional survey was conducted from July to September 2023, involving 742 participants from the Moyamba and Bo districts. Data were collected using a pretested interview guide covering ITN ownership, usage, and challenges. Descriptive statistics and Pearson’s Chi-squared test were used for data analysis.

RESULTS: Of the respondents, 84.8% received training on ITN usage, primarily from health workers (46.1%). Most participants (94.7%) understood that ITNs provide protection against mosquitoes, and 84.5% believed in their effectiveness in preventing malaria. Sociodemographic factors like age, sex, education, marital status, and sources of information were significantly associated with ITN knowledge and utilization. Moreover, health workers’ campaigns and interpersonal networks (community leaders, plus family and friends) play crucial roles in promoting ITN utilization, while mass media campaigns alone may not suffice. However, 48.2% of the participants found current ITN campaign strategies effective.

CONCLUSION: While awareness and ownership of ITNs are high in the Moyamba and Bo districts, utilization is hindered by various factors, including availability and alternative uses. Enhanced campaign strategies and increased ITN distribution are necessary to improve usage and reduce malaria incidence.

PMID:39930445 | DOI:10.1186/s12889-024-21007-5

BMC Public Health. 2025 Feb 10;25(1):547. doi: 10.1186/s12889-025-21722-7.

ABSTRACT

BACKGROUND: Men can play a crucial role in the effective use of contraceptives, both by utilizing themselves and by supporting their partners in preventing unwanted pregnancies; and addressing reproductive health issues. This study aims to examine the association of men’s contraceptive knowledge, attitudes, and behaviors (KAB) with the use of modern contraceptives.

METHODS: This study utilized data from the Nepal Demographic and Health Survey 2022, which included a total weighted sample of 2,649 married men aged 15-49 years. The Demographic and Health Survey is a nationally representative cross-sectional study. A weighted analysis of the samples was carried out accounting for the complex survey design. Bivariable and multivariable logistic regression analyses were conducted and the odds ratio (OR) with 95% confidence intervals (CIs) were presented to determine the association between men’s KAB and the use of modern contraception in Nepal.

RESULTS: The findings revealed that half of the married men (51.2%; CI: 48.5, 53.9) or their spouses have used some form of modern contraceptives. Interestingly, all men (100%) knew at least one type of modern contraceptive, while only one-third (33.7%; CI 3.12, 3.64) were aware of the ovulatory cycle period. Men with no knowledge of the ovulatory cycle (aOR: 1.31; CI: 1.07, 1.60), men who disagreed that women using contraceptives may become promiscuous (aOR: 1.27; CI:1.01,1.61) and men who discussed family planning with health workers (aOR: 1.72; CI:1.30, 2.28) were more likely to use modern contraceptives. Additionally, the use of modern contraceptives was more likely among men aged 20 to 29 (aOR: 8.04; CI: 2.19, 22.18), 30 to 39 (aOR: 17.11; CI: 6.20, 47.20), and 40 to 49 years (aOR: 23.25; CI: 8.41, 64.30) than their counterparts less than 20 years, as well as among men living in rural areas (aOR: 1.33; CI: 1.05, 1.67). Conversely, modern contraceptive use was less likely among highly educated men (aOR: 0.57; CI: 0.33, 0.97) and men living in Gandaki province (aOR: 0.87; CI: 0.59, 1.29).

CONCLUSION: This study highlights significant role of men’s KAB in the utilization of modern contraception among married men in Nepal. Contraceptive use can be promoted by enhancing the knowledge of men, developing a positive attitude, and encouraging supportive behaviors regarding reproductive health. The appropriate use of contraceptives can improve the reproductive health outcomes of both men and women. Providing a conducive environment for men to learn more about reproductive health including contraception is a key to positive health outcomes in Nepal.

PMID:39930441 | DOI:10.1186/s12889-025-21722-7

BMC Nurs. 2025 Feb 10;24(1):152. doi: 10.1186/s12912-024-02569-6.

ABSTRACT

BACKGROUND: Shared decision-making (SDM) is a collaborative patient-centred process for arriving at informed healthcare decisions. Decision coaching can help support SDM when combined with patient decision aids. As part of a meta-curriculum “Ready for SDM” for training different healthcare professionals in SDM, we developed and pilot-tested a new module designed to train nurses as decision coaches. The study assessed nurses’ perceptions of a decision coach training module, focusing on its feasibility, acceptability and its role in developing decision coaching capabilities.

METHODS: We used a two-phase approach guided by the Knowledge-to-Action Framework. In the first phase, we developed a decision coach training module. The second phase involved preliminary testing, using a descriptive design with qualitative and quantitative methods. We recruited a convenience sample of participants from two hospitals. Participants completed questionnaires at the end of Part A (classroom training). The assessment was informed by Kirkpatrick’s first three levels of educational outcomes: reaction (acceptability), learning (self-reported attitudes, intentions and confidence) and behaviour (practical application of decision coaching). A post-hoc inquiry investigated low participation in Part B of the coach training. Qualitative data underwent content analysis and quantitative data were analysed using descriptive statistics.

RESULTS: The development resulted in a decision coach training comprising a Part A (6 h) on SDM and decision coaching fundamentals and a Part B (1 h) which involved practical application of decision coaching in the participants’ own practice (audio recorded) with self-appraisal and individualised feedback. In preliminary testing with 19 nurses from seven clinical departments, 90% of participants rated Part A as acceptable and relevant to practice. Only one nurse completed Part B due to reluctance to audio record coaching sessions. The most reported perceived barrier was time constraints. Key perceived facilitators identified were interprofessional collaboration, management support and additional practical training.

CONCLUSION: Decision coach training was feasible to deliver in the classroom. Participants reported Part A as acceptable and relevant to their practice. The second part, including an audio recording component, proved unfeasible. Further research should explore alternative methods for skill assessment and feedback in clinical practice. The results from this study will inform further refinement of the Norwegian Ready for SDM meta-curriculum and implementation strategies, particularly regarding the practical training components.

TRIAL REGISTRATION: Retrospectively registered (14.02.2023) at ISRCTN (ISRCTN44143097).

PMID:39930431 | DOI:10.1186/s12912-024-02569-6

BMC Musculoskelet Disord. 2025 Feb 10;26(1):135. doi: 10.1186/s12891-025-08403-7.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the clinical efficacy of percutaneous vertebroplasty (PVP) performed with a two-step fluoroscopy technique for treating thoracic osteoporotic vertebral compression fractures (OVCFs) in older patients.

METHODS: A retrospective analysis was conducted on clinical and imaging data from 48 patients diagnosed with thoracic OVCFs, who underwent treatment with percutaneous vertebroplasty(PVP) utilizing a two-step fluoroscopy technique at Yangquan First People’s Hospital between January 2019 and January 2022. The study assessed the clinical efficacy of this procedure by analyzing Visual Analog Scale(VAS) scores, Cobb angle values, and vertebral height measurements before surgery and at 2 days, 3 months, 6 months, and 12 months postoperatively.

RESULTS: Before treatment, the mean VAS score of patients was 7.5 ± 0.6. Subsequently, at 2 days, 3 months, 6 months, and 12 months after the procedure, these mean scores decreased to 2.3 ± 0.6, 2.2 ± 0.5, 2.2 ± 0.4, and 2.0 ± 0.3, respectively. This decline was statistically significant (P < 0.05) compared to the preoperative VAS score. The preoperative Cobb angle was 12.1° ± 0.9°, and the Cobb angle values at the corresponding time points were 12.2° ± 0.8°, 12.3° ± 1.1°, 12.3° ± 1.0°, and 12.2° ± 0.9°. Initially, the mean height of the vertebral body in these patients was 17.38 ± 1.56 mm. Postoperatively, at 2 days, 3 months, 6 months, and 12 months, these values were 19.30 ± 1.81 mm, 19. 12 ± 1.60 mm, 19.00 ± 1.45 mm, and 19.00 ± 1.20 mm, respectively. No significant difference was observed between postoperative and preoperative Cobb angle and vertebral height (P > 0.05).

CONCLUSION: Percutaneous vertebroplasty using a two-step fluoroscopy method not only has the therapeutic effect of traditional surgical methods, reducing pain from thoracic vertebral compression fractures in the elderly and enhancing their quality of life and mobility, but also streamlines the intraoperative fluoroscopy procedure. This method stand as an effective approach for managing osteoporotic compression fractures of the thoracic vertebrae in elderly.

PMID:39930416 | DOI:10.1186/s12891-025-08403-7

BMC Public Health. 2025 Feb 10;25(1):550. doi: 10.1186/s12889-025-21693-9.

ABSTRACT

BACKGROUND: Approximately 11 million immigrants without legal status live in the United States and many of these individuals live in areas that are prone to natural hazards. While there is sufficient literature to suggest that these individuals are more vulnerable to the impacts of disasters and are less prepared for disasters, there is limited understanding of natural disaster risk perception, behavioral intentions, and trust in disaster assistance among individuals or their immediate family members lacking legal status (IFLLS) in the United States. To address this gap, this study sought to describe and compare risk perception, barriers to evacuation, and trust in disaster assistance between legal citizens and IFLLS.

METHODS: A cross-sectional, online survey was conducted from April 24 to June 3, 2024. Survey respondents were asked about their demographic and socioeconomic characteristics, their risk perceptions and attitudes regarding natural hazards, reasons for not complying with evacuation orders, and their trust in assistance offered by various entities during the response to natural hazards. Pearson chi-square tests and Cramér’s V were used to investigate the association between IFLLS and variables of interest.

RESULTS: 2,989 individuals completed the survey and 284 reported that they identified as IFLLS. Statistically significant relationships existed between IFLLS and residing in an area that experiences natural hazards, having been previously impacted by a disaster, anticipating being impacted by a natural hazard within the next 12 months, various reasons for noncompliance with evacuation orders, and trust in assistance offered during disaster response. There were not statistically significant relationships between IFLLS and the belief that preparedness for natural hazards is important or concern about natural hazards becoming more severe or frequent in the future.

CONCLUSIONS: These results provide the first nationally representative examination of disaster risk faced by IFLLS in the United States, as well as the barriers to evacuation. These findings highlight the importance of developing disaster preparedness and response plans that incorporate the needs of IFLLS, as these groups face higher risk. Preparedness and response policies must consider and address the unique barriers faced by IFLLS.

PMID:39930415 | DOI:10.1186/s12889-025-21693-9

BMC Oral Health. 2025 Feb 10;25(1):214. doi: 10.1186/s12903-025-05530-4.

ABSTRACT

BACKGROUND: One of the most frequent dental operations is the surgical extraction of an impacted third molar. The study aimed to evaluate the impact of the intra-socket application of 0.8% Hyaluronic Acid (HA) gel on hard & soft tissue healing after surgical removal of the impacted 3rd molar.

OBJECTIVE: MATERIALS AND METHODS: This randomized controlled clinical study included thirty patients aged from 21-36 years who were scheduled for surgical removal of impacted mandibular third molar. 0.8% hyaluronic acid gel (HA group) was applied immediately after surgery in the intra-socket of 15 patients, and nothing (No HA group) was applied to the socket of the other 15 patients. Soft tissue healing was assessed after extraction on the third, seventh, and fourteenth day. Bone healing was assessed 2 months post-extraction by measuring bone density and socket length from cone beam computerized tomography.

RESULTS: The soft tissue healing index was significantly better (very good or excellent) in the HA group compared with no HA group after fourteen days postoperative (p < .001). Also, the percentage increase of bone density in the HA group was statistically significantly higher after two months than in the no HA group ((p < .001).

CONCLUSION: Hyaluronic acid 0.8% gel application improves soft tissue healing and bone density healing following surgical extraction of the mandibular third molar. It could be considered a valuable material for improving bone healing and soft tissue.

TRIAL REGISTRATION: The trial is retrospectively registered at the Pan African Clinical Trial Registry with the identification number for the registry PACTR202407576478340 on 30/07/2024.

PMID:39930405 | DOI:10.1186/s12903-025-05530-4

BMC Oral Health. 2025 Feb 10;25(1):215. doi: 10.1186/s12903-025-05497-2.

ABSTRACT

BACKGROUND: Sleep disorders (SDs), a public health concern, can lead to critical physiological conditions, and are associated with mental and behavior problems such as psychosocial stress, smoking, alcohol consumption, etc. This study aimed to investigate the cross-sectional associations between dentofacial deformities and sleep quality in young adults in China.

METHODS: Data were collected from 2,479 young adults (aged 17-25 years) enrolled at Fudan University across various regions of China. Participants completed a self-reported questionnaire that included general information and the Pittsburgh Sleep Quality Index (PSQI) under standardized guidance. Dentofacial characteristics were examined by experienced orthodontists. Data analysis employed one-way ANOVA, student’s t-test, chi-square tests, and multivariable logistic regression models.

RESULTS: The study revealed a median PSQI score of 5.92 ± 1.66, with 16.3% of participants classified as SDs. Higher PSQI scores were reported by females, underweight individuals, and participants from southern regions. Among the subjects, 44.36% exhibited protruding profiles, 6.86% had concave profiles, and various dentofacial abnormalities were prevalent. Logistic regression analysis identified protruding lateral profiles (OR 1.93, 95% CI 1.18-3.16, p = 0.008) and anterior crossbite (OR 1.44, 95% CI 1.01-2.04, p = 0.043) as significant risk factors for SDs. Additionally, reduced anterior overbite was associated with a higher prevalence of SDs, while deep overbite acted as a protective factor. Moderate overbite demonstrated statistical significance (OR 0.51, 95% CI 0.35-0.76, p = 0.001).

CONCLUSION: These findings suggest a significant association between dentofacial characteristics and sleep quality in young adults. Protruding facial profiles and anterior crossbites were identified as independent predictors for SDs. These findings underscore the importance of screening for SDs in individuals with dentofacial deformities and highlight the potential benefits of early correction of such dentofacial abnormalities to reduce the risk of SDs in adulthood.

PMID:39930404 | DOI:10.1186/s12903-025-05497-2

BMC Med Educ. 2025 Feb 10;25(1):214. doi: 10.1186/s12909-024-06389-9.

ABSTRACT

BACKGROUND: AI-powered chatbots have spread to various fields including dental education and clinical assistance to treatment planning. The aim of this study is to assess and compare leading AI-powered chatbot performances in dental specialization exam (DUS) administered in Turkey and compare it with the best performer of that year.

METHODS: DUS questions for 2020 and 2021 were directed to ChatGPT-4.0 and Gemini Advanced individually. DUS questions were manually entered into AI-powered chatbot in their original form, in Turkish. The results obtained were compared with each other and the year’s best performers. Candidates who score at least 45 points on this centralized exam are deemed to have passed and are eligible to select their preferred department and institution. The data was statistically analyzed using Pearson’s chi-squared test (p < 0.05).

RESULTS: ChatGPT-4.0 received 83.3% correct response rate on the 2020 exam, while Gemini Advanced received 65% correct response rate. On the 2021 exam, ChatGPT-4.0 received 80.5% correct response rate, whereas Gemini Advanced received 60.2% correct response rate. ChatGPT-4.0 outperformed Gemini Advanced in both exams (p < 0.05). AI-powered chatbots performed worse in overall score (for 2020: ChatGPT-4.0, 65,5 and Gemini Advanced, 50.1; for 2021: ChatGPT-4.0, 65,6 and Gemini Advanced, 48.6) when compared to overall scores of the best performer of that year (68.5 points for year 2020 and 72.3 points for year 2021). This poor performance also includes the basic sciences and clinical sciences sections (p < 0.001). Additionally, periodontology was the clinical specialty in which both AI-powered chatbots achieved the best results, the lowest performance was determined in the endodontics and orthodontics.

CONCLUSION: AI-powered chatbots, namely ChatGPT-4.0 and Gemini Advanced, passed the DUS by exceeding the threshold score of 45. However, they still lagged behind the top performers of that year, particularly in basic sciences, clinical sciences, and overall score. Additionally, they exhibited lower performance in some clinical specialties such as endodontics and orthodontics.

PMID:39930399 | DOI:10.1186/s12909-024-06389-9