Nevin Manimala

BMC Public Health. 2025 Feb 12;25(1):578. doi: 10.1186/s12889-025-21512-1.

ABSTRACT

BACKGROUND: Breast cancer is the most common type of cancer and the leading cause of cancer death among women worldwide. In 2020, approximately 2.3 million women were newly diagnosed with breast cancer, resulting in around 685,000 deaths globally. The high incidence and prevalence of breast cancer have made it a major public health problem in both developed and developing nations, leading to overburdened health systems and increased direct medical expenditure. This research was conducted to assess the impact of breast cancer awareness programs on breast screening utilization among women in the United Arab Emirates.

METHODS: A cross-sectional study using a content-validated interviewer-administered questionnaire was conducted among 959 women aged ≥ 20 years from 31st May 2023 to 31st October 2024, in the United Arab Emirates. Data on sociodemographics, awareness program participation, screening utilization, and barriers were analyzed using descriptive statistics and chi-square tests.

RESULTS: Among the study participants,304 (31.7%) had attended awareness programs. Attendance was associated with younger age, higher education, and being single (p < 0.001). Among those who have ever attended any breast cancer awareness programs who had utilized the screening were 38.5% compared to 13.3% non-attendees (p < 0.001). The study concluded that age, education level, and marital status were significantly associated with participation in breast cancer awareness programs (p-value < 0.05). Key barriers included a lack of physician recommendations (24.3%), knowledge gaps (23%), and cost concerns (22.6%).

CONCLUSIONS: The study shows that participation in the awareness programs varied based on age, education and marital status, additionally, those with lower educational levels had a higher attendance at the awareness programs, emphasizing the significance of educational initiatives. The study showed a link between attending breast cancer awareness programs and the use of screening services, furthermore, notable gap in screening utilization such as emotional and perceived barriers were noted. Thus, its necessary to overcome these challenges for enchaning early detection and treatment outcomes. Interventions such as targeted educational campaigns, improved screening facility and better communication between physicians and patients can aid in addressing these challenges.

PMID:39939986 | DOI:10.1186/s12889-025-21512-1

Diabetol Metab Syndr. 2025 Feb 12;17(1):55. doi: 10.1186/s13098-025-01618-7.

ABSTRACT

BACKGROUND: Although many previous trials have formalized the blood glucose-lowering effect of the DASH diet, relevant reports in China remain limited. This study aimed to explore the anti-hyperglycaemic effect of the Chinese Modified Dietary Approaches to Stop Hypertension diet combined with 23% low-sodium salt and meal packs in patients with hypertension and type 2 diabetes.

METHODS: We conducted a randomized controlled single-blinded trial with a semi-open design; 100 participants were randomly assigned to Group A (control), Group B (23% low-sodium salt), and Group C (meal packs) for 8 weeks of dietary intervention. All participants were followed up weekly to collect glycaemia data (standardized meal tolerance test), salt use, and adverse events.

RESULTS: Generalized estimating equation analysis indicated that fasting blood glucose decreased in all three groups following the intervention when compared to baseline. Group A decreased by 0.72 mmol/L (P = 0.008), while Groups B and C decreased by 2.02 mmol/L and 2.06 mmol/L, respectively (both P < 0.001). Although the latter two groups experienced greater reductions than Group A, the differences among the groups were not statistically significant (P = 0.450). For postprandial blood glucose, Group C showed the most pronounced decrease. The three groups recorded reductions of 2.43 mmol/L, 2.52 mmol/L, and 4.29 mmol/L, respectively (all P < 0.001), with again no significant difference observed between the groups (P = 0.088). The most notable enhancement in postprandial glucose was observed in Group C, which demonstrated a 51.5% improvement in its control rate. However, there was no statistically significant difference between the groups. No serious adverse events occurred during the trial.

CONCLUSION: The CM-DASH diet combined with 23% low-sodium salt and meal packs demonstrates potentially beneficial effects on glycemic control in patients with hypertension and type 2 diabetes. This intervention reduces salt intake and fosters the development of healthy eating habits, thereby contributing to the improvement of patients’ blood glucose. However, larger studies are necessary to confirm these findings. Trial registration ChiCTR2000029017. Registered January 11, 2020-Prospective registration, http://www.chictr.org.cn/.

PMID:39939983 | DOI:10.1186/s13098-025-01618-7

BMC Nurs. 2025 Feb 13;24(1):165. doi: 10.1186/s12912-024-02518-3.

ABSTRACT

BACKGROUND: Healthcare organizations are distinguished by intricate systems that undergo continual modifications and unpredictability. This greatly hinders the ability to estimate the exact consequences of any changes accurately. Therefore, scholars prove that strategic foresight enables leaders to anticipate future challenges and possibilities. The utilization of artificial intelligence (AI) in management is on the rise, mostly because of its ability to provide intelligent services, reduce medical errors, and improve operational efficiency.

PURPOSE: To examine the impact of strategic foresight on the quality of healthcare services provided by Jordanian nurses in the context of AI solutions in governmental hospitals.

METHOD: A cross-sectional descriptive correlational analysis was conducted. A convenience sampling approach was used in the four selected Jordanian governmental hospitals. The study’s target population consisted of nurses. Over three weeks between January and February 2024, 240 self-reported questionnaires were received using a five-point Likert scale, with a response rate of 88.9%. The completed surveys were suitable for analysis using AMOS SPSS v. 26 and SPSS.

RESULTS: Simple linear regression and (Pearson’s r) test results showed that (R = .279, R square = 0.078) between strategic foresight and the quality of healthcare services. (R = .543, R square = 0.295) between strategic foresight and the adoption of AI-based solutions. And (R = .432, R square = 0.187) between adopting AI-based solutions and the quality of healthcare services. That reveals a statistically significant, positive correlation coefficient relationship between the variables. In the presence of the mediator, the direct relationship between strategic foresight and healthcare service quality was not statistically significant (b = 0.063, p = .398). The path analysis test indicates a linear relationship between the variables sequentially, and the AI-based solutions completely mediate the relationship between strategic foresight and the quality of healthcare services.

CONCLUSIONS: A positive and significant correlation between the variables suggests that a simulation-proposed model for a healthcare quality forecasting system, which the researcher built and included in the study recommendations, has to be designed. Therefore, AI-based forecasting systems should incorporate health service quality parameters to facilitate high efficiency and prompt patient demand fulfillment.

PMID:39939972 | DOI:10.1186/s12912-024-02518-3

BMC Public Health. 2025 Feb 12;25(1):582. doi: 10.1186/s12889-025-21860-y.

ABSTRACT

OBJECTIVE: This study was conducted to explore the human immunodeficiency virus (HIV) status of and compare HIV knowledge, HIV testing, and other healthy behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO), to provide a scientific basis for targeted HIV interventions for this population.

METHODS: A cross-sectional survey was conducted to collect demographic and behavioral information using questionnaires for statistical analysis.

RESULTS: Among 1,993 participants, 772 (38.7%) reported having sexual intercourse with women. The results of the multivariate logistic regression model analysis indicated that MSMW had a lower probability than MSMO of reporting HIV knowledge 1 (adjusted odds ratio [aOR]:0.556, 95% CI: 0.409-0.756), knowledge 2 (aOR:0.626; 95% CI, 0.515-0.761), knowledge 3 (aOR:0.569; 95% CI: 0.447-0.724), informing their HIV status to the last casual sex partners offline (aOR: 0.515, 95% CI: 0.358-0.743), HIV testing more than once in the past 6 months (aOR: 0.696, 95% CI: 0.521-0.931), and HIV testing in a hospital in the past 6 months (aOR: 0.696, 95% CI: 0.521-0.931). In contrast, MSMW had a higher probability of post-exposure prophylaxis (PEP) intake in the past 6 months (aOR: 2.252, 95% CI: 1.570-3.229), pre-exposure prophylaxis (PrEP) intake in the past 6 months (aOR: 1.630, 95% CI: 1.091-2.434), and cumulative HIV testing more than twice (aOR: 1.917, 95% CI: 1.434-2.563).

CONCLUSION: MSMW showed significant differences with MSMO in HIV knowledge and HIV related risky reduction behaviors. It is necessary to enhance awareness and skills on HIV self-testing, PEP, and PrEP among MSM. Encouraging HIV knowledge education and HIV testing service are important for MSMW. PEP and PrEP might be enhanced among MSMO for reducing the risk of HIV transmission.

PMID:39939969 | DOI:10.1186/s12889-025-21860-y

Malar J. 2025 Feb 12;24(1):41. doi: 10.1186/s12936-024-05210-8.

ABSTRACT

BACKGROUND: Asymptomatic malaria parasitemia patients constitute an effective transmission pool for malaria infection in the community. However, less attention has been given to malaria control and elimination strategies. Therefore, to achieve a malaria elimination strategy, investigating the magnitude of asymptomatic malaria in different settings in Ethiopia is crucial. However, there is not enough information on the prevalence of asymptomatic malaria infection and associated risk factors in the Bench Sheko Zone, southwest Ethiopia. This study, therefore, aimed to provide information and help achieve sustainable malaria elimination.

METHODS: A community-based cross-sectional study was conducted from February to April 2019 in Mizan-Aman town, southwest Ethiopia. A semi-structured questionnaire was used to collect sociodemographic information. Plasmodium species were screened using microscopy and rapid diagnostic test (RDT). HemoCue was used to measure haemoglobin levels. Statistical Package for the Social Sciences (SPSS) version 20.0 was used for descriptive and logistic regression statistics to risk factors. A P-value of 0.05 was used as a cutoff-value for significance.

RESULTS: A total of 353 malaria-like symptom free participants were enrolled in this study. 17 seventeen (4.8%, 95% Confidence interval = 2.57, 7.03) asymptomatic malaria cases were revealed; among these, 12 (70.58%) (95% CI = 65.75, 75.25) were due to Plasmodium vivax and 5 (29.41%) (95% CI = 24.74, 34.25) were due to Plasmodium falciparum. Asymptomatic malaria was significantly associated with the presence of mosquito breeding sites [Adjusted odd ratio (AOR) = 6.06 (1.76-20.82)], insecticide-treated nets (ITN) use [AOR = 3.51 (0.97-12.68)], and indoor residual spraying (IRS) [AOR = 3.95 (1.26-12.37)]. Mild anaemia was found in 20% (3/15) of the asymptomatic malaria patients. Additionally, there was a significant association between malaria and anaemia [OR = 5.786 (1.46-22.85)] in this study.

CONCLUSIONS: The population of the current study area will be at risk because asymptomatic malaria is present. Low coverage of the IRS, ITN, and proximity of stagnant water in residences had an impact on asymptomatic malaria. Further studies are needed on the burden of asymptomatic malaria via molecular methods, and the Bench Sheko regional health office is better able to scale-up malaria prevention and control tools.

PMID:39939966 | DOI:10.1186/s12936-024-05210-8

BMC Public Health. 2025 Feb 13;25(1):591. doi: 10.1186/s12889-025-21626-6.

ABSTRACT

BACKGROUND: Homelessness is a growing concern in the United States, especially among people who use drugs (PWUD). The degree of material hardship among this population may be linked to worse health outcomes. PWUD experiencing homelessness in urban areas are increasingly subjected to policies and social treatment, such as forced displacement, which may worsen material hardship. It is critical to describe hardship among PWUD and examine if it is linked to health outcomes.

METHODS: Data were collected as part of a prospective cohort study of PWUD in Los Angeles, California and Denver, Colorado (n = 476). Analysis sample size was smaller (N = 395) after selecting for people experiencing homelessness and for whom data were complete. Five indicators assessing hardship (difficulty finding food, clothing, restrooms, places to wash/shower, and shelter) in the past three months were obtained from participants at baseline and were used in latent class analysis (LCA). We chose a base latent class model after examination of global fit statistics. We then built three auxiliary models using the three-step Bolck-Croon-Hagenaars (BCH) method to test the relationship of latent class membership to several hypothesized social and health variables in this same three month time period.

RESULTS: Fit statistics, minimum classification probabilities, and ease of interpretation indicated a three-class solution for level of material difficulty. We termed these classes “High Difficulty” (n = 82), “Mixed Difficulty” (n = 215), and “Low Difficulty” (n = 98). Average classification probabilities indicated good class separability. “High Difficulty” participants had high probabilities of usually having difficulty accessing all five resources. “Mixed Difficulty” participants indicated a range of difficulty accessing all resources, with restrooms and bathing facilities being the most difficult. “Low Difficulty” participants were defined by high probabilities of never having access difficulty. In auxiliary analyses, there were significant (p < 0.05) differences in experiences of displacement, opioid withdrawal symptoms, nonfatal overdose, and violent victimization between classes.

CONCLUSIONS: This LCA indicates that among PWUD experiencing homelessness there exist distinct differences in resource access and material hardship, and that these differences are linked with political, social, substance use, and other health outcomes. We add to the literature on the relationship between poverty and health among PWUD. Policies which increase difficulty accessing necessary material resources may negatively impact health in this population.

PMID:39939965 | DOI:10.1186/s12889-025-21626-6

BMC Complement Med Ther. 2025 Feb 13;25(1):51. doi: 10.1186/s12906-025-04783-4.

ABSTRACT

BACKGROUND: The human microbiome plays a vital role in human health, mediated by the gut-brain axis, with a large diversity of functions and physiological benefits. The dynamics and mechanisms of meditations on oral and gut microbiome modulations are not well understood. This study investigates the short-term modulations of the gut and oral microbiome during an Arhatic Yoga meditation retreat as well as on the role of microbiome in improving well-being through a possible gut-brain axis.

METHODS: A single-arm pilot clinical trial was conducted in a controlled environment during a 9-day intensive retreat of Arhatic Yoga meditation practices with vegetarian diet. Oral and fecal samples of 24 practitioners were collected at the start (Day0: T1), middle (Day3: T2), and end (Day9:T3) of the retreat. Targeted 16S rRNA gene amplicon sequencing was performed for both oral and gut samples. Functional pathway predictions was identified using phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt2). DESeq2 was used to identify the differential abundant taxa. Various statistical analyses were performed to assess the significant changes in the data.

RESULTS: Our findings revealed that Arhatic Yoga meditation together with a vegetarian diet led to changes in the oral and gut microbiome profiles within the 9-day retreat. Oral microbiome profile showed a significant (p < 0.05) difference in the species richness and evenness at the end of study, while non-metric multidimensional scaling (NMDS) confirmed the shift in the gut microbiome profile of the practitioners by T2 timepoint, which was further supported by PERMANOVA analysis (p < 0.05). Health-benefiting microbes known to improve the gastrointestinal and gut-barrier functions, immune modulation, and gut-brain axis were enriched. Gut microbiome of both beginner and advanced Arhatic Yoga practitioners showed similar trends of convergence by the end of study. This implies a strong selection pressure by Arhatic Yoga meditation together with a vegetarian diet on the beneficial gut microbiome.

CONCLUSION: This pilot study demonstrates that Arhatic Yoga meditation practices combined with a vegetarian diet during a short intensive retreat resulted in enrichment of known health-promoting microbes. Such microbial consortia may be developed for potential health benefits and used as probiotics to improve the gastrointestinal and immune systems, as well as functions mediated by the gut-brain axis.

TRIAL REGISTRATION: Study was submitted in https://clinicaltrials.gov/on28-02-2024 . Retrospective registered.

PMID:39939954 | DOI:10.1186/s12906-025-04783-4

BMC Complement Med Ther. 2025 Feb 12;25(1):49. doi: 10.1186/s12906-025-04780-7.

ABSTRACT

BACKGROUND: This study focuses on the investigation of the antioxidant and anti-inflammatory activities of alcohol extracts from Ribes nigrum leaves on murine BV-2 microglial Wt and Acyl-CoA oxidase 1 deficient (Acox1^-/-) cell line models, useful for the investigation of some neurodegenerative disorders.

METHODS: The extract chemical composition was analyzed via LC-Q-Orbitrap HRMS. Various assays, including DPPH, MTT, and H₂DCFDA, were used to assess the extract’s antioxidant capacity, cell viability, and reactive oxygen species (ROS) production. Immunoblotting and RT-qPCR techniques were employed to measure protein expression and gene transcription in treated cells. Statistical analysis was conducted using GraphPad Prism, with significance determined at p < 0.05.

RESULTS: Investigations showed the presence of phenolic compounds in this extract, among which flavan-3-ols, flavonols, furanocoumarins, hydroxycinnamates were major components, which are known for their biological activity in various test systems. The MTT test revealed a concentration of 0.125 mg/mL of R. nigrum extract as the highest non-toxic. The investigated extract showed high antioxidant activity in chemical-based tests. The antioxidant potential of the R. nigrum leaf extract was furtherly explored using the BV-2 microglial cell line models. Moreover, the extract was found to alter the activity of the main antioxidant enzyme, catalase and fatty acid oxidation enzyme, Acyl-CoA oxidase 1 (ACOX1) as well as the expression of appropriate genes in Wt and Acox1^-/- BV-2 microglial cells such as Cat, iNos, Il-1β, Tnf-α, and Abcd1. In Wt cells, after the 24-hour treatment with R. nigrum leaf extract, ACOX1 activity was downregulated, meanwhile the catalase activity remains unchanged. Further treatment led to the downregulation of catalase and the upregulation of ACOX1 activity. However, in Acox1^-/- cells, which represent a model of oxidative stress, an increase in catalase activity was observed only after 48 h of treatment. It was also observed the reduced ROS and NO formation in cells, showing the pronounced antioxidant capacity of R. nigrum extract in the investigated cell-models.

CONCLUSION: Our study demonstrated the protective effects of R. nigrum leaf extracts on BV-2 microglial cells by reducing oxidative and nitrosative stress, decreasing pro-inflammatory gene expression, and normalizing peroxisomal function, highlighting the potential of these extracts as therapeutic agents for managing oxidative stress and inflammation.

PMID:39939952 | DOI:10.1186/s12906-025-04780-7

Virol J. 2025 Feb 13;22(1):34. doi: 10.1186/s12985-025-02633-w.

ABSTRACT

BACKGROUND: In Ethiopia, hepatitis B virus infections are prevalent and highly endemic. Additionally, there has been a significant increase in hospital admissions, morbidity, and mortality associated with hepatitis B virus infections. This study aimed to assess the prevalence of hepatitis B virus infection and associated factors among adult intrafamilial household contacts of pregnant women index cases attending antenatal care clinics in the central Ethiopian region.

METHODS: A community-based cross-sectional study was conducted between October 1, 2023, and March 1, 2024. Three hundred eighty-five adult intrafamilial household contacts were randomly selected via lottery methods. A 3 ml venous blood sample was taken from adult intrafamilial household contacts and checked for hepatitis B virus infection through hepatitis B surface antigen. An interviewer-administered questionnaire was used to collect the data. A logistic regression model predicted the relationship between predictor and outcome variables. A p-value of < 0.05 indicated statistical significance.

RESULTS: The overall response rate was 96.1%. Two-thirds of the adults of intrafamilial household contacts (n = 229; 61.9%) were aged between 18 and 28 years, with a mean age of 28 years. The prevalence rate of hepatitis B virus infection among adults of intrafamilial household contacts with pregnant women as the index case was 11.6% (95% CI, 8.6 to 15.1). Being male (AOR: 0.09; 95% CI: 0.03, 0.37) and a duration of stay with the index case of less than six months (AOR: 0.30; 95% CI: 0.11, 0.81) were associated with a reduced risk of hepatitis B virus infection. Meanwhile, large family sizes (≥ 7) (AOR: 4.32; 95% CI: 1.34, 13.98), genital discharge (AOR: 3.14; 95% CI: 1.60, 6.15), engagement in unsafe sex (AOR: 2.37; 95% CI: 1.13, 4.97), and a history of mortality due to hepatitis in the family (AOR: 3.03; 95% CI: 1.09, 8.42) were associated with an increased risk of hepatitis B virus infection.

CONCLUSION: This study found that hepatitis B surface antigen seropositivity among adult intrafamilial household contacts with pregnant women index cases in the central Ethiopia region was high at 11.6%. These findings suggest that interventions to prevent HBV infection should prioritize educational campaigns targeting adult intrafamilial household contacts of HBV-positive index cases, focusing on risk factors associated with HBV transmission, prevention, counselling, testing, and vaccination.

PMID:39939946 | DOI:10.1186/s12985-025-02633-w

BMC Pediatr. 2025 Feb 12;25(1):111. doi: 10.1186/s12887-025-05467-1.

ABSTRACT

BACKGROUND: To validate the effectiveness of the application of a transition programme for adolescents with chronic kidney disease based on the Integrated Theory of Health Behavior Change.

METHODS: This study was a quasi-experiment study. We included 76 adolescents with chronic kidney disease, and based on their willingness to undergo transition intervention, participants were assigned to either the intervention group or the control group. The intervention group received the transition intervention guided by the Integrated Theory of Health Behavior Change, while the control group received standard care and education, remaining unaware of the intervention group’s existence. The data of the intervention group were collected before and after the intervention. Because the total intervention lasted approximately 4 weeks, the data of the control group were collected at baseline (T0) and 1 month (T1). We chose transition readiness as the primary outcome. The secondary outcomes included medication adherence and self-efficacy.

RESULTS: At the final assessment (T1), the scores related to transition readiness, medication adherence, self-care self-efficacy, and adolescent exercise and eating behavior self-efficacy in the intervention group were significantly higher than those in the control group (P < 0.05). Compared with those at T0, the scores of all the constructs in the intervention group increased at T1, and these differences were statistically significant. There was a weak positive correlation between participants’ transition readiness and their medication adherence (r = 0.389, P < 0.01), self-care self-efficacy (r = 0.501, P < 0.01), exercise behavior self-efficacy (r = 0.237, P < 0.05), and eating behavior self-efficacy (r = 0.481, P < 0.01).

CONCLUSIONS: Based on the Integrated Theory of Health Behavior Change, the transition program for adolescents with chronic kidney disease significantly improved participants’ transition readiness, self-care self-efficacy, and exercise and eating behavior self-efficacy. While the study’s design limits definitive conclusions on the program’s impact on medication adherence, the observed improvements suggest that potential benefits warrant further investigation.

TRIAL REGISTRATION: The study obtained approval from the local institutional review board and was registered on https://www.chictr.org.cn (Clinical Trial Number: ChiCTR2300077149) prior to the enrollment of the first subject on October 31, 2023.

PMID:39939945 | DOI:10.1186/s12887-025-05467-1