Nevin Manimala

BMC Med Ethics. 2025 Jan 29;26(1):15. doi: 10.1186/s12910-025-01164-x.

ABSTRACT

INTRODUCTION: Despite the existing reports on mistreatment and disrespectful maternal care, few studies have investigated interventions to mitigate this issue. The present study aims to assess the impact of consulting midwives on maternal rights charter on perception of respectful maternity care and postpartum blues among postpartum women in two hospitals in southern Iran.

METHODOLOGY: This quasi-experimental study was conducted on 437 postpartum women (217 mothers before the intervention and 220 mothers after the intervention) and 44 midwives working in the maternity ward of two hospitals affiliated to Bushehr University of Medical Sciences in 2023-2024. The hospitals were randomly divided into control and intervention groups. The mothers and midwives were selected using convenience and census sampling methods, respectively. Initially, the first sampling phase of postpartum women was conducted. Then, midwives in the intervention group received consultation on patient rights charter in groups of 3-4 individuals over three sessions. After the intervention, the second phase of sampling of postpartum women was conducted. Data collection tools included questionnaires assessing women’s perception of respectful maternity care and postpartum blues. The data were analyzed using descriptive and analytical statistical tests in SPSS 20.0.

RESULTS: After performing the intervention on midwives, the mean score of postpartum respectful maternity care from the perspectives of the mothers in the intervention and control hospitals were 91.08 ± 5.51 and 68.34 ± 10.81 respectively (P < 0.001). Also, the mean scores of postpartum blues in the intervention and control hospitals were 12.88 ± 4.66 and 14.85 ± 5.94 respectively (P = 0.007). Multivariable linear regression analysis revealed that consulting with midwives regarding the Maternal Rights Charter, led to an increase in respectful maternity care (β coefficient = 0.780, 95% C.I. = 19.796). ~ 24.541) and decreased postpartum blues (β coefficient = -0.172, 95% C.I. = -3.318 ~ -0.390) from the perspectives of the mothers.

CONCLUSION: Consulting midwives on patient rights charter was positively correlated with mothers’ perception of respectful maternity care and negatively correlated with postpartum blues, indicating the positive effect of intervention on increasing women’s satisfaction and reducing postpartum blues. It is recommended that this consultation be included in midwives’ continuing education programs.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:39881329 | DOI:10.1186/s12910-025-01164-x

BMC Oral Health. 2025 Jan 29;25(1):156. doi: 10.1186/s12903-025-05545-x.

ABSTRACT

BACKGROUND: To compare the effects of first premolar extraction, molar distalization, and non-extraction treatments on the angulation and vertical positions of maxillary second molars (MxM2s) and maxillary third molars (MxM3s). To our knowledge, this is the first study to compare the effects of three different treatment types on MxM3 simultaneously.

METHODS: Initial (T0) and final (T1) panoramic radiographs of three different patient groups were analyzed: first premolar extraction group (n = 26 patients, 52 MxM2, 52 MxM3), molar distalization group (n = 20 patients, 40 MxM2, 40 MxM3), and non-extraction group (n = 31 patients, 62 MxM2, 62 MxM3). Descriptive data, including growth pattern, crowding, overjet, overbite, and maxillary incisor inclination, were recorded. Angular changes of maxillary third molars (MxM3) relative to the Interorbital Plane (IOP) and Palatal Plane (PP), as well as changes in inclination and vertical position according to Archer’s classification, were also documented. Differences between T0 and T1 within the same group were assessed using the paired sample t-test and Wilcoxon signed-rank test. Comparisons between groups were evaluated with one-way analysis of variance (ANOVA) and Kruskal-Wallis H test. The threshold for statistical significance was set at p < .05.

RESULTS: IOP and PP values of MxM2 and MxM3 showed significant improvement in the extraction group (EG)(p < .001). The improvement in MxM3 IOP and PP values was not significant in the distalization group (DG)(p = .196 and p = .544, respectively). According to Archer’s classification, within-group comparisons revealed that the inclination and vertical position of MxM3 showed significant improvement in the EG, DG, and non-extraction groups (NEG)(inclination: p < .001 in EG, p = .032 in DG, p = .024 in NEG; vertical position: p < .001 in EG, p = .048 in DG, p < .001 in NEG). In between-group comparisons, the most significant improvement was observed in the EG. The number of MxM3 with vertical positions in Stages 1 and 2 at T1 were 19 in EG, 3 in DG, and 10 in NEG.

CONCLUSION: Premolar extraction has a positive effect on the angular and positional changes of MxM2 and MxM3. The changes in the inclination and vertical position of MxM3 between NEG and DG were not statistically significant.

PMID:39881326 | DOI:10.1186/s12903-025-05545-x

Nutr J. 2025 Jan 29;24(1):19. doi: 10.1186/s12937-024-01063-8.

ABSTRACT

BACKGROUND: A better understanding of correlates of sugary drink consumption is essential to inform public health interventions. This study examined differences in perceived healthiness of sugary drinks and related social norms between countries, over time, and sociodemographic groups and associations with sugary drink intake.

METHODS: This study used annual cross-sectional data from the International Food Policy Study from 2018 to 2021 in Australia, Canada, the United Kingdom, the United States, and Mexico. Analyses examined perceived healthiness of eight beverage types and two types of perceived social norms (descriptive, injunctive) that discourage sugary drink consumption. The 24-item Beverage Frequency Questionnaire was used to estimate beverage intake in the past 7 days. Logistic regression models examined trends over time in odds of perceiving each beverage type as unhealthy and agreeing with social norms discouraging sugary drink consumption, across countries and sociodemographic characteristics. Negative binomial regressions examined associations between perceived healthiness, social norms and consumption.

RESULTS: Energy drinks, regular soft drinks, and diet soft drinks were most frequently perceived as unhealthy in all countries, while water and 100% juice were least frequently perceived as unhealthy. Participants in Mexico had higher odds of perceiving 100% juice, chocolate milk, and iced tea as unhealthy in 2021 compared to 2018 (AOR = 1.71 99%CI 1.10-2.64; AOR = 2.69, 99%CI 1.70-4.26; AOR = 1.79, 99%CI 1.15-2.76; respectively), with little change in other countries. Agreement with social norms discouraging consumption of sugary drinks was higher in Mexico than in other countries. Trends in social norms over time were mostly stable, except in Mexico where participants had higher odds of agreeing with both norms in 2020 compared to 2018 (AOR = 1.27, 99%CI 1.09-1.48 for a descriptive norm and AOR = 1.27 99%CI 1.09-1.49 for an injunctive norm). In most countries, perceiving a beverage as unhealthy and agreeing with social norms discouraging consumption of sugary drink were associated with lower sugary drink consumption, with varying strength of associations across countries and beverage types.

CONCLUSIONS: Shifts over time in social norms and perceived healthiness observed in Mexico and associations with intake of sugary drinks in most countries suggest that targeted interventions to change norms and perceptions could help reduce sugary drink consumption.

PMID:39881318 | DOI:10.1186/s12937-024-01063-8

BMC Nurs. 2025 Jan 29;24(1):109. doi: 10.1186/s12912-025-02687-9.

ABSTRACT

BACKGROUND: Organizational well-being is a critical issue that should be addressed within nursing organizations as it boosts the morale and work motivation of its members by enhancing their satisfaction and happiness.

AIM: This study aimed to evaluate the levels of positive psychological capital, shared leadership, and organizational well-being among nurses, and examine the impact of positive psychological capital and shared leadership on organizational well-being.

METHODS: A descriptive survey research design was used, involving 177 nurses with at least one year of work experience at highly specialized hospitals in Korea treating patients with severe conditions. Data were collected via an online survey from July 1 to August 31, 2023, using a questionnaire that included items on general characteristics, job-related characteristics, positive psychological capital, shared leadership, and organizational well-being. The collected data were analyzed using the SPSS 29.0 software, employing statistical measures such as frequency, percentage, mean, standard deviation, t-test, ANOVA, Pearson correlation coefficient, and hierarchical regression analysis.

RESULTS: The participants’ scores were 3.32 ± 0.51 out of 5 for organizational well-being, 4.12 ± 0.58 out of 6 for positive psychological capital, and 3.64 ± 0.59 out of 5 for shared leadership. Factors identified that influenced organizational well-being included positive psychological capital (β = 0.462, p < .001) and shared leadership (β = 0.442, p < .001), which explained 58% of the total variance in the model (F = 48.74, p < .001).

CONCLUSIONS: To improve the organizational well-being of nurses, it is essential to develop capacity-building and intervention programs that boost positive psychological capital and shared leadership. Achieving this goal necessitates not only the individual efforts of organizational members but also robust organizational support, engagement, and proactive management.

PMID:39881317 | DOI:10.1186/s12912-025-02687-9

Disabil Rehabil. 2025 Jan 29:1-10. doi: 10.1080/09638288.2025.2458191. Online ahead of print.

ABSTRACT

PURPOSE: Adherence to home rehabilitation following total knee arthroplasty (TKA) is essential to reach optimal functional outcomes, especially in fast-track procedures. The aim of this study is to identify which sociodemographic and health factors significantly affect adherence in this context.

METHODS: This is a secondary analysis of a randomized controlled trial with 52 patients. Adherence was measured as the percentage of completed exercises. Two statistical analyses were performed, one on the entire population and another on the telerehabilitation group only, to study which factors significantly affects adherence.

RESULTS: The analysis included the 42 patients with adherence data (23 TRH, 19 control). In Analysis I (n = 42), six variables were statistically significant: history of depression (p = 0.00026), educational level (p = 0.00151), social support (p = 0.00157), treatment group (p = 0.0081), history of diabetes (p = 0.01153), and ASA score (p = 0.02752). In Analysis II (TRH, n = 23), three variables were significant: history of depression (p = 0.003), educational level (p = 0.006), and history of hypertension (p = 0.047).

CONCLUSION: There are sociodemographic and health factors affecting adherence to home rehabilitation post-TKA. Depression stands out as a negative factor, while high educational level and social support improve adherence. Telerehabilitation has positive effects and reduces the influence of social and economic factors.

PMID:39879639 | DOI:10.1080/09638288.2025.2458191

Appl Neuropsychol Adult. 2025 Jan 29:1-10. doi: 10.1080/23279095.2025.2457999. Online ahead of print.

ABSTRACT

In the fields of engineering, science, technology, and medicine, artificial intelligence (AI) has made significant advancements. In particular, the application of AI techniques in medicine, such as machine learning (ML) and deep learning (DL), is rapidly growing and offers great potential for aiding physicians in the early diagnosis of illnesses. Depression, one of the most prevalent and debilitating mental illnesses, is projected to become the leading cause of disability worldwide by 2040. For early diagnosis, a patient-friendly, cost-effective approach based on readily observable and objective indicators is essential. The objective of this research is to develop machine learning and deep learning techniques that utilize electroencephalogram (EEG) signals to diagnose depression. Different statistical features were extracted from the EEG signals and fed into the models. Three classifiers were constructed: 1D Convolutional Neural Network (1DCNN), Support Vector Machine (SVM), and Logistic Regression (LR). The methods were tested on a dataset comprising EEG signals from 34 patients with Major Depressive Disorder (MDD) and 30 healthy subjects. The signals were collected under three distinct conditions: TASK, when the subject was performing a task; Eye Close (EC), when the subject’s eyes were closed; and Eye Open (EO), when the subject’s eyes were open. All three classifiers were applied to each of the three types of signals, resulting in nine (3 × 3) experiments. The results showed that TASK signals yielded the highest accuracies of 88.4%, 89.3%, and 90.21% for LR, SVM, and 1DCNN, respectively, compared to EC and EO signals. Additionally, the proposed methods outperformed some state-of-the-art approaches. These findings highlight the potential of EEG-based approaches for the clinical diagnosis of depression and provide promising avenues for further research. Additionally, the proposed methodology demonstrated statistically significant improvements in classification accuracy, with p-values < 0.05, ensuring robustness and reliability.

PMID:39879638 | DOI:10.1080/23279095.2025.2457999

Surg Innov. 2025 Jan 29:15533506251317288. doi: 10.1177/15533506251317288. Online ahead of print.

ABSTRACT

BACKGROUND: In difficult colorectal cases, surgeons may opt for a hand-assisted laparoscopic (HALS) colectomy or attempt a laparoscopic surgery that may require an unplanned conversion to open (LCOS). We aimed to compare the clinical outcomes of these 2 types of surgeries.

METHODS: Colectomies for acute diverticulitis with a HALS or LCOS surgery were selected from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) 2022 Targeted Colectomy Database. After confirming a difference in propensity scores between the cohorts, they were matched using propensity score matching (PSM) based on preoperative factors. RStudio was utilized for filtering and performing the PSM, while Minitab was used for statistical analysis.

RESULTS: We identified 804 HALS colectomies and 284 LCOS colectomies. After PSM, both cohorts contained 284 patients. Absolute standardized mean errors for all matched factors were less than 0.1, confirming well-balanced cohorts. Following PSM, preoperative and perioperative factors were similar between both colectomy groups. Postoperatively, HALS surgeries had a shorter average length of stay (7.67 ± 0.38 vs 10.57 ± 0.41, P < 0.001) as well as lower rates of ileus (13.73% vs 22.54%, P = 0.007) and superficial surgical site infection (2.11% vs 5.28%, P = 0.045).

CONCLUSION: To the best of our knowledge, this is the first national database study comparing HALS and LCOS colectomies. After accounting for confounding variables, our PSM analysis showed the benefits of HALS colectomies for acute diverticulitis. Future studies may use single-center data containing risk adjustment profiles to create an even more uniform comparison.

PMID:39879635 | DOI:10.1177/15533506251317288

Orthopedics. 2025 Jan 29:1-6. doi: 10.3928/01477447-20250123-03. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study was to evaluate the performance and evolution of Chat Generative Pre-Trained Transformer (ChatGPT; OpenAI) as a resource for shoulder and elbow surgery information by assessing its accuracy on the American Academy of Orthopaedic Surgeons shoulder-elbow self-assessment questions. We hypothesized that both ChatGPT models would demonstrate proficiency and that there would be significant improvement with progressive iterations.

MATERIALS AND METHODS: A total of 200 questions were selected from the 2019 and 2021 American Academy of Orthopaedic Surgeons shoulder-elbow self-assessment questions. ChatGPT 3.5 and 4 were used to evaluate all questions. Questions with non-text data were excluded (114 questions). Remaining questions were input into ChatGPT and categorized as follows: anatomy, arthroplasty, basic science, instability, miscellaneous, nonoperative, and trauma. ChatGPT’s performances were quantified and compared across categories with chi-square tests. The continuing medical education credit threshold of 50% was used to determine proficiency. Statistical significance was set at P<.05.

RESULTS: ChatGPT 3.5 and 4 answered 52.3% and 73.3% of the questions correctly, respectively (P=.003). ChatGPT 3.5 performed significantly better in the instability category (P=.037). ChatGPT 4’s performance did not significantly differ across categories (P=.841). ChatGPT 4 performed significantly better than ChatGPT 3.5 in all categories except instability and miscellaneous.

CONCLUSION: ChatGPT 3.5 and 4 exceeded the proficiency threshold. ChatGPT 4 performed better than ChatGPT 3.5, showing an increased capability to correctly answer shoulder and elbow-focused questions. Further refinement of ChatGPT’s training may improve its performance and utility as a resource. Currently, ChatGPT remains unable to answer questions at a high enough accuracy to replace clinical decision-making. [Orthopedics. 202x;4x(x):xx-xx.].

PMID:39879624 | DOI:10.3928/01477447-20250123-03

Am J Hosp Palliat Care. 2025 Jan 29:10499091251316570. doi: 10.1177/10499091251316570. Online ahead of print.

ABSTRACT

Pediatric neuro-oncology patients have one of the highest mortality rates among all children with cancer. Our study examines the potential relationship between palliative care consultation and intensity of in-hospital care and determines if racial and ethnic differences are associated with palliative care consultations during their terminal admission. Retrospective observational study using the Pediatric Health Information System (PHIS) database with data from U.S. children’s hospitals. PHIS was queried for patients under 18 years of age who received a diagnosis of brain tumor and had their terminal admission between January 1, 2017 and December 31, 2021. Of the 567 patients who fit the inclusion criteria, 359 (63%) patients had an inpatient palliative care consultation during their terminal hospital stay. There were no statistically significant differences seen when comparing palliative care consultation rates among racial groups. When comparing the ethnicity variables, patients in the Hispanic group had approximately a 10% higher rate of palliative care consultations than their non-Hispanic counterpart. Patients with palliative care consultations had a lower percentage of PICU admission (64.9 vs 83.2), mechanical ventilation (51.0 vs 76.0), and TPN use (18.1 vs 25.5) despite having similar lengths of stay. Pediatric neuro-oncology patients who received a palliative care consultation during their terminal hospital stay had lower intensity care (lower rates PICU admission, mechanical ventilation use, and TPN use) despite having similar lengths of stay. This may reflect the enhanced decision-making support for the patients and their families so that they may consider all options. Children facing a terminal illness and their families deserve access to optimal supportive services. This study highlights the importance of integrating palliative care in hospital admissions of terminally ill children with neuro-oncological diagnoses.

PMID:39879622 | DOI:10.1177/10499091251316570

JMIR Res Protoc. 2025 Jan 29;14:e63597. doi: 10.2196/63597.

ABSTRACT

BACKGROUND: TheKeep.Ca was built to facilitate engagement with those experiencing cancer in Manitoba, Canada. Constructed between 2020 and 2024 with a group of patient advisors, the website includes information on engagement activities including research participation, the patient advisor role, and how those experiencing cancer can access these Manitoba activities. A link allows visitors to register to be contacted about activities that match their demographics, cancer history, and activity preferences. After TheKeep.Ca was constructed, this protocol was developed to establish TheKeep.Ca as a platform for scientific research focused on optimally engaging those experiencing cancer.

OBJECTIVE: We asked the following questions: (1) What was the patient advisors’ experience who participated in developing TheKeep.Ca? (2) What are the baseline characteristics of website traffic and registrants at TheKeep.Ca? (3) How does registering with TheKeep.Ca impact the cancer experience?

METHODS: The planned launch date for the website and initiation of research activities is January 2025. For objective 1, the active patient advisors (N=6) participating in the website project will be invited to participate in project activities including with responses to a question prompt sheet, semistructured audio-recorded interviews, or both. Responses and interviews will be analyzed using reflexive thematic analysis to understand and inform practices for patient engagement on projects. At the website launch, TheKeep.Ca will become publicly accessible and indexable on internet search engines, but no additional promotional interventions will take place in the initial 6 months resulting in visitors primarily from web search traffic. For objective 2, Google Analytics and website registrant data collected during the first six months will be analyzed to obtain baseline characteristics of website visitors. For objective 3, an online survey will be emailed to registrants six months after the website launch characterizing their website experience, the activities they participated in, and collecting feedback on the website. For objectives 2 and 3, quantitative data will be analyzed using both descriptive and inferential statistics, and qualitative data from open-ended questions will be analyzed using thematic analysis guided by an inductive descriptive semantic approach.

RESULTS: This study was approved by the University of Manitoba Health Research Ethics Board on December 12, 2024 (HS26614-H2024L263). Institutional approval from CancerCare Manitoba is pending as of December 23, 2024. Findings from objective 1 are expected to be finalized within the first six months after the website launch. Those from objectives 2 and 3 are expected by the 12-month mark. Reporting will include peer-reviewed journals, conferences, and a lay-language summary on TheKeep.Ca.

CONCLUSIONS: The research outlined in this protocol will facilitate understanding patient advisors’ experience in developing TheKeep.Ca. It will also characterize the website’ effectiveness and its impact on the cancer experience, providing a baseline and direction for future research and development.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/63597.

PMID:39879620 | DOI:10.2196/63597