Nevin Manimala

BMC Public Health. 2025 Mar 29;25(1):1196. doi: 10.1186/s12889-025-22371-6.

ABSTRACT

OBJECTIVES: To identify key demographic, socio-economic, and cultural determinants influencing the continuation of FGM/C and to evaluate its prevalence and associated factors utilizing the 2020 Somali Demographic and Health Survey (SDHS).

METHODOLOGY: A secondary analysis of the Somali Demographic Health Survey (SDHS) in 2020 was conducted, utilizing responses from 6,580 mothers of female children aged 0-14 years. Descriptive statistics, chi-square tests, and multi-nominal logistic regression were employed to analyze the prevalence and associated factors of FGM/C. The analysis incorporated sampling weights to ensure accurate population representation.

RESULTS: The prevalence of FGM/C among respondents was 99.6% (n = 6,553), with Pharaonic circumcision being the most prevalent type (76.7%), followed by Sunni (14.1%) and intermediate forms (8.8%). Demographically, 83.9% of respondents had no formal education, while only 0.99% attained higher education, and the majority resided in nomadic (37.7%) and rural (33.6%) areas. Regional variations were observed, with the highest support for FGM/C continuation in Sanaag (77.2%) and the lowest in Maroodi-jeeh (42.2%). Chi-square analysis revealed significant associations between attitudes toward FGM/C and age (X² = 57.12, p < 0.001), place of residence (X² = 299.45, p < 0.001), education (X² = 140.09, p < 0.001), and wealth (X² = 67.48, p < 0.001). Women in nomadic areas (76.1%) and those with no education (67.6%) were more likely to support continuation, compared to urban residents (53.5%) and those with higher education (24.6%). Multinomial logistic regression indicated that urban residents were 44.7% less likely to support continuation than nomadic residents (Exp(B) = 0.553, p < 0.001), and women with no formal education were 2.3 times more likely to support continuation than those with higher education (Exp(B) = 2.307, p = 0.025). Religious beliefs strongly influenced attitudes, with those considering FGM/C a religious requirement overwhelmingly supporting its continuation (Exp(B) ≈ 0, p < 0.001).

CONCLUSION: Notwithstanding the near-universal prevalence of FGM/C in Somaliland, attitudes toward its perpetuation are influenced by educational attainment, socioeconomic status, geographical location, and religious convictions. Targeted educational initiatives and culturally appropriate interventions are imperative for altering perceptions and mitigating the practice.

PMID:40158153 | DOI:10.1186/s12889-025-22371-6

World J Surg Oncol. 2025 Mar 29;23(1):111. doi: 10.1186/s12957-025-03762-w.

ABSTRACT

BACKGROUND: In primary cutaneous melanoma (CM) with metastatic sentinel lymph node(s) (SLNB), treatment strategies may include completing a regional lymph node dissection (CLND). The prognostic benefit of this therapeutic approach remains a topic of debate. This retrospective, population-based cohort study explores the prognostic impact of CLND in a real-world clinical setting.

METHODS: This study analysed 280 incident cases of AJCC stage III CM with metastatic SLNB, as recorded by the Veneto population-based Regional Cancer Registry in 2015, 2017, and 2019. The overall survival and CM-specific survival rates were compared between patients who underwent CLND and those who did not. Kaplan-Meier analysis, Cox regression, and Fine-Gray models for competing risks tested the relationship between lymphadenectomy and overall and CM-specific survival.

RESULTS: Among CM patients with metastatic SLNB, 199/280 (71.1%) proceeded with CLND. When compared to those who did not receive treatment, CLND did not demonstrate significant advantages in terms of overall survival and CM-specific survival rates. The cost analysis found no significant differences in treatment choice (estimated costs: €23,695.71 for the treated group and €25,003.55 for the untreated group [p = 0.69]).

CONCLUSIONS: The present real-world data support omitting CLND in stage III CM with histologically documented sentinel nodal metastasis.

PMID:40158137 | DOI:10.1186/s12957-025-03762-w

BMC Public Health. 2025 Mar 29;25(1):1201. doi: 10.1186/s12889-025-22317-y.

ABSTRACT

BACKGROUND: Although household disinfectant cleaners are used at home frequently, less research has focused on standardized assessment tools to measure public awareness and precautions in practice, especially during health crises. The COVID-19 pandemic highlighted the important role of household disinfectants-cleaners in preventing infections. However, poor public awareness and unsafe practices can undermine their effectiveness. This study indirectly addresses this lack by developing and validating the Household Disinfectants-Cleaners Questionnaire (HDCQ), to make available an evidence-based comprehensive tool to support future assessments, public health research, and policy development.

OBJECTIVE: To assess the validity and reliability of a questionnaire designed to measure public awareness and performance regarding the safe use of household disinfectants-cleaners in Abu Dhabi.

METHODS: A cross-sectional Google survey, involving a sample of 750 Abu Dhabi residents, was analyzed using IBM-SPSS (Version 27.0) and RStudio (Version 1.1.456, Inc., 2009-2018). Validity tests included face, content, and construct evaluations by nine academic experts based on seven parameters. Reliability was assessed through Cronbach’s alpha and inter-item correlation. Principal Factor Analysis (PFA), including the Kaiser-Meyer-Olkin (KMO) measure and Bartlett’s test, was conducted for each section in SPSS. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) in RStudio identified the underlying factors explaining item covariation.

RESULTS: Cronbach’s alpha values for the awareness and performance domains were 0.854 and 0.883, indicating high internal consistency. Expert ratings indicated high face validity, with importance levels ranging from 0.89 to 1.00. The average Content Validity Ratio (CVR) for the questionnaire was 0.95, indicating strong content relevance. The PFA results demonstrated adequate sampling adequacy, with a KMO measure values of 0.879 and 0.891 and Bartlett’s test was statistically significant (χ2 = 2,368, P < 0.001) and (χ2 = 3,274, P < 0.001) for each section respectively, confirming factorability and suitability for factor analysis. Both EFA and CFA indicated a good model fit with RMSEA of 0.077 for Sect. 1 and 0.090 for Sect. 2, CFI of 0.990 for Sect. 1 and 0.975 for Sect. 2, and TLI of 0.986 for Sect. 1 and 0.967 for Sect. 2, confirming the robustness of the factor structure and the questionnaire’s validity.

CONCLUSIONS: The findings demonstrate that this questionnaire is a valid and reliable tool for assessing public awareness and performance regarding the safe use of household disinfectants-cleaners for future pandemics. Recognizing inherent limitations, detailed in the conclusion section, is essential for effective application in public health contexts.

PMID:40158130 | DOI:10.1186/s12889-025-22317-y

BMC Public Health. 2025 Mar 29;25(1):1193. doi: 10.1186/s12889-025-22469-x.

ABSTRACT

BACKGROUND: Although experiences of violence are detrimental and may occur throughout the lifespan, few studies have examined the long-term health correlates of violence in both childhood and adulthood.

OBJECTIVE: To examine the association of exposure to child maltreatment (CM) as well as severe violence in adulthood with mental and physical health problems and health-related risk behaviors in adulthood.

METHODS: The study was cross-sectional and applied a novel survey instrument among a random sample of 10 337 Swedish women and men aged 18-74. Logistic regression was applied to calculate odds ratios.

RESULTS: Exposure to 0, 1, 2 or 3 or more types of CM showed graded associations for depression, anxiety, self-harm and PTSD in adulthood. Irritable bowel syndrome, fibromyalgia and obesity showed modest correlations. No significant associations were found between CM and ischemic heart disease (IHD), type 2 diabetes or cancer, although the ORs were in line with several previous ACE studies. When exposure to severe violence in adulthood was added to CM, odds ratios increased dramatically for mental health problems and health-related risk behaviors, suggesting that revictimization may moderate or mediate this relationship.

CONCLUSIONS: The results underscore the importance of studying violence exposure in a life-course perspective and suggest that the relationship between childhood adversities and long-term physical health problems in adulthood may be affected by the traumatic effects of revictimization in adult life. This points to the importance of early identification of child maltreatment and provision of robust services to protect children, treat symtoms of trauma, and enhance resilience to decrease the risk of poor health outcomes.

PMID:40158129 | DOI:10.1186/s12889-025-22469-x

Reprod Biol Endocrinol. 2025 Mar 29;23(1):50. doi: 10.1186/s12958-025-01384-1.

ABSTRACT

BACKGROUNDS: The study was designed to analyze early pregnancy loss rates in first-time fresh embryo transfer cycles in low prognosis patients according to the POSEIDON criteria.

METHODS: This was a retrospective cohort study, including patients with positive human chorionic gonadotropin after first fresh cycles in the Reproductive Center of Henan Province People’s Hospital from June 2018 to February 2023. A total of 2392 cycles were included in this study, which were divided into 4 groups according to the POSEIDON criteria. The general condition, laboratory indexes, and early pregnancy loss rates of patients were compared in each group and the prediction model was constructed in POSEIDON group 4.

RESULTS: The early pregnancy loss rate ranked from high to low in order of Group D (32.82%), Group B (23.31%), Group C (15.34%), and Group A (13.68%). After adjusting confounding factors, multivariate logistic regression analysis revealed that the early pregnancy loss rate was significantly higher in groups B and D than in groups A and C (all P < 0.05). The comparison between Group A and Group C, as well as between Group B and Group D, showed no statistical differences (both P > 0.05). Group D was randomly divided into training and validation cohorts according to 7:3. The prediction model was constructed based on risk factors. The AUC of the training cohort was 0.761(95% CI: 0.680-0.841), and the AUC of the validation cohort was 0.604(95% CI: 0.440-0.767).

CONCLUSIONS: Patients in POSEIDON group 4 have the highest early pregnancy loss rate, followed by group 2, while patients in groups 3 and 1 have the lowest rate in first-time fresh cycles. The prediction model was successfully established which can predict the occurrence of early pregnancy loss in first-time fresh cycles in POSEIDON group 4.

PMID:40158126 | DOI:10.1186/s12958-025-01384-1

Dementia (London). 2025 Mar 29:14713012251330689. doi: 10.1177/14713012251330689. Online ahead of print.

ABSTRACT

Dementia is a progressive and neurodegenerative condition that leads to a gradual deterioration of the individual’s functional capacity and social relations. Engaging in meaningful activities is considered an effective approach to maintaining and increasing the well-being of people living with dementia. Digital media has the potential to improve the quality of life for people living with dementia, allowing them to engage in activities that are personally meaningful. This study sought to understand the needs and preferences people with early-stage dementia living in Portugal have for receiving information on meaningful activities. It also explored their relationship with technologies and digital media. Focus groups and interviews were carried out with people living with dementia (n = 21), informal carers (n = 9) and healthcare professionals (n = 8). Descriptive statistics were used for sample characterization and the verbatim transcriptions of interviews and focus groups were subjected to inductive thematic analysis. We developed three main themes: (i) engagement of people living with dementia in meaningful activities; (ii) experiences of people living with dementia with technology and digital resources; and (iii) the importance of a support network. This last theme is associated with the first two. The study identified several meaningful activities, such as household chores and intellectual hobbies, some of which were mediated by technology. People living with dementia reported to primarily use digital media, particularly computers and smartphones, for socialization and entertainment. The barriers identified for technology use and engagement in meaningful activities were both related to mobility problems and cognitive complaints. The support network emerged as essential for the use of digital technologies and engagement in meaningful activities. This study highlights a need to further research and design digital media that offer the opportunity for people living with dementia to be informed and engaged in meaningful activities.

PMID:40156603 | DOI:10.1177/14713012251330689

Cytotherapy. 2025 Mar 12:S1465-3249(25)00071-4. doi: 10.1016/j.jcyt.2025.03.002. Online ahead of print.

ABSTRACT

We evaluated the impact of center volume on outcomes in patients with B-cell acute lymphoblastic leukemia following their second allogeneic hematopoietic stem cell transplantation (allo-HSCT). Our cohort included 299 patients with relapse and 68 patients with graft failure after their first allo-HSCT between 2003 and 2017. Patients were stratified into low- and high-volume groups based on the number of allo-HSCT performed at each center. The primary endpoint was 5-year overall survival (OS) following the second allo-HSCT. In the relapse cohort, the high-volume group demonstrated significantly better 5-year OS (21.1% vs 13.6%, P = 0.0062) and progression-free survival (16.1% vs 10.6%, P = 0.010). Multivariate analysis showed that high-volume group was a favorable factor for OS (hazard ratio [HR]: 0.72, 95% confidence interval [CI]: 0.56-0.94, P = 0.016). This survival benefit was consistent in both Philadelphia chromosome-negative (HR: 0.71, 95% CI: 0.51-0.99, P = 0.042) and positive (HR: 0.61, 95% CI: 0.39-0.95, P = 0.030) subcohorts. In the graft failure cohort, the high-volume group showed a trend toward better 5-year OS (41.6% vs 24.4%, P = 0.098) and lower 5-year nonrelapse mortality (NRM) (55.9% vs 75.6%, P = 0.067). Multivariate analysis confirmed the protective effect of the high-volume group on NRM (HR: 0.55, 95% CI: 0.30-0.99, P = 0.044). Our findings demonstrate that center volume significantly impacts outcomes after the second allo-HSCT regardless of indication, highlighting the need for inter-center collaboration and standardized management strategies for this high-risk population.

PMID:40156598 | DOI:10.1016/j.jcyt.2025.03.002

J Nutr Educ Behav. 2025 Mar 28:S1499-4046(25)00052-1. doi: 10.1016/j.jneb.2025.02.011. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the feasibility and acceptability of a novel Digital Choice model at an urban food pantry from customer and staff perspectives.

DESIGN: Focus groups, cross-sectional survey, and in-depth interviews.

SETTING: New York City.

PARTICIPANTS: Thirty Digital Choice customers participated in 3 focus groups, 326 Digital Choice and non-Digital Choice customers completed the survey, and 8 program staff were interviewed.

INTERVENTIONS: The Digital Choice model used text messaging/online forms to allow customers to preorder 1 of 4 pantry boxes for pickup at 1 of 3 community sites.

PHENOMENA OF INTEREST: Feasibility, acceptability.

ANALYSIS: Themes were identified in interviews and focus groups using inductive and deductive approaches, and descriptive statistics were produced from survey and order data.

RESULTS: Digital Choice customers indicated high overall satisfaction with the program (96% rated the experience positively), and staff found the program feasible to implement at the current scale. However, among the broader population of Digital Choice and non-Digital Choice customers, 40% indicated challenges with technology.

CONCLUSIONS AND IMPLICATIONS: This evaluation suggests that incorporating digital technology to facilitate customer choice and partnering with community sites in the food pantry process is feasible and acceptable for many, but not all, customers.

PMID:40156591 | DOI:10.1016/j.jneb.2025.02.011

Circ Cardiovasc Qual Outcomes. 2025 Mar 29:e011991. doi: 10.1161/CIRCOUTCOMES.125.011991. Online ahead of print.

ABSTRACT

BACKGROUND: Although Medicare Advantage (MA) plans provide coverage to >50% of Medicare beneficiaries, it is unclear whether MA claims can be used similarly to Medicare Fee-For-Service (FFS) claims for clinical outcomes assessment. In this study, we evaluate the accuracy of claims algorithms previously validated in FFS to assess comorbidities and outcomes in MA patients after aortic valve replacement.

METHODS: We compared the concordance of 11 claims-based covariates (diabetes, hypertension, atrial flutter/fibrillation, myocardial infarction) and outcomes (stroke, disabling stroke, transient ischemic attack, major vascular complication, bleeding, permanent pacemaker implantation, death) among FFS and MA patients with the covariates and adjudicated outcomes in the multinational Evolut Low-Risk Trial (2016-2018). We used claims algorithms for 1-year outcomes and calculated sensitivity, specificity, positive predictive value, negative predictive value, and kappa, using adjudicated outcomes as the reference. We compared the kappa for MA versus FFS using the 2-sample z-test with a significance level of P<0.05.

RESULTS: Among 1139 US patients aged 65+ years old in the Evolut Low-Risk Trial, 782 patients (175 MA and 607 FFS) were linked to claims data and had complete comorbidity data. Among all covariates, claims algorithms for covariates had sensitivities ≥85% for identifying diabetes, atrial flutter/fibrillation, and hypertension in MA and FFS. For the outcomes, sensitivities were ≥85% for bleeding (comprehensive), permanent pacemaker implantation, and death. The kappa was higher in MA versus FFS for diabetes (P=0.03) and hypertension (P=0.025) but was lower in myocardial infarction (P<0.0001). There was no statistically significant difference in the kappa agreement between MA versus FFS for any of the selected outcomes.

CONCLUSIONS: Medicare claims have a similar level of kappa agreement in MA versus FFS for most covariates and outcomes. As patients shift to MA, ascertainment of outcomes using Medicare claims in postapproval studies remains valid for select outcomes.

PMID:40156581 | DOI:10.1161/CIRCOUTCOMES.125.011991

Vasc Endovascular Surg. 2025 Mar 29:15385744251330930. doi: 10.1177/15385744251330930. Online ahead of print.

ABSTRACT

Background and AimThe aim of this study is to estimate the incidence of periprocedural outcomes after carotid revascularization with special emphasis on myocardial infarction and assess the safety of carotid artery stenting (CAS) and carotid endarterectomy (CEA) through systematic review and meta-analysis.MethodsA multiple electronic search was performed in Medline (database provider PubMed), Web of Science Core Collection, EMBASE (database provider Ovid) and Cochrane Central Register of Controlled Trials databases for articles from 2000 up to 2023 reporting outcomes after carotid revascularization. Randomized control trials comparing the perioperative events (30-day results) after CAS and CEA stating the perioperative risk of myocardial infarction were included in the present meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsA total of twelve randomized control trials (RCTs) with 11 153 patients were identified and considered eligible. The pooled risk of periprocedural stroke was found to be reduced after CEA compared to CAS [OR: 1.6, CI 95%:1.3-2.1, P < 0.05], while PMI was found to be more frequent after CEA, favoring CAS [OR: 0.4, CI 95%: 0.2-0.7, P < 0.05]. Periprocedural mortality was lower but not reaching statistical significance in the CEA compared to CAS [OR: 1.1, CI 95%: 0.6-2.1, P = 0.68]. The pooled OR for composite endpoint of stroke, MI or death was in favor of CEA as safer treatment [OR: 1.3, CI 95%: 1-1.5, P < 0.05].ConclusionsPMI risk was lower after CAS, although the currently available data do not demonstrate any increase in mortality rates.

PMID:40156572 | DOI:10.1177/15385744251330930