Nevin Manimala

West Afr J Med. 2025 Jun 30;42(6):452-456.

ABSTRACT

BACKGROUND: Stroke remains one of the leading causes of disability worldwide. Arm function recovery is essential for stroke survivors’ ability to perform activities associated with daily living. Consequently, impairment in arm function is a significant target for stroke survivors’ physical or robotic rehabilitation. This study aims to explore the barriers and facilitators to the implementation of a robotic rehabilitation programme for stroke survivors in a resource-poor setting.

METHODS: A cross-sectional design with a qualitative approach was chosen. A semi-structured, interview-based questionnaire was administered and data were collected from stroke survivors presenting at the adult neurology clinic of two tertiary institutions in Nigeria. Data from the interview-based questionnaire were analyzed using descriptive statistics.

RESULTS: A total of 52 stroke survivors participated and were interviewed. More than half (55.8%) of the respondents were elderly, with a male-to-female ratio of 1.6:1. Majority of respondents (58%) had no idea about the use of robotics for stroke rehabilitation. About 44% of the respondents believe that the major determinant of interest in robotics will be favourable outcome after trials on other participants. Lack of financial support and transportation aid constitute barriers, while creation of awareness and the availability of transportation aid from home to hospital were the major facilitators to participation.

CONCLUSION: These findings highlight the fact that most stroke survivors in the resource-poor setting were not aware of the usefulness of robotics in stroke rehabilitation. Hence, increasing knowledge and creating awareness about robotic rehabilitation will make it more readily acceptable for stroke survivors. KEYWORDS: Barrier, Facilitator, Robotic rehabilitation, Stroke survivors, Implementation.

PMID:41252638

AIDS Educ Prev. 2025 Jul;6(1):1-11. doi: 10.1521/aeap.1994.6.1.1.

ABSTRACT

Heterosexual transmission of the human immunodeficiency virus (HIV) has become a significant health issue for women. The present study describes the extent to which a sample of women from an urban area report making efforts to protect themselves from becoming infected with HIV through several protective sexual behaviors. Secondly, we assess the extent to which adoption of these protective behaviors can be explained by health beliefs and previous HIV testing. Forty-nine percent of the sample reported having used a condom in the past year because of fear of AIDS and 48% reported having carried condoms. Women in this sample perceived themselves to be moderately susceptible to AIDS and they were well aware of the severity of the disease. Women tended to think that protecting themselves from AIDS would not be overly burdensome and that the recommended sexual protective behaviors were highly effective for preventing AIDS. Messages about the severity of AIDS and the effectiveness of protective sexual behaviors seem to be reaching women. Beliefs about personal susceptibility were consistently associated with the adoption of multiple protective behaviors, suggesting that messages emphasizing the ubiquity of risk, especially in demographically high-risk populations, may be particularly appropriate and effective.

PMID:41252637 | DOI:10.1521/aeap.1994.6.1.1

AIDS Educ Prev. 2025 Jul;6(1):12-26. doi: 10.1521/aeap.1994.6.1.12.

ABSTRACT

We examined correlates of condom use among heterosexual whites, blacks, and Hispanics (ages 20-45 years) with an human immunodeficiency virus (HIV) risk factor in a community-based longitudinal sample (San Francisco; n = 716). Lag models were used to examine hypothesized antecedents of condom use at wave 2. High levels of condom use were associated with labeling one’s sexual behavior as risky for HIV infection, high levels of condom enjoyment and commitment to use condoms, good sexual communication practices, gender (trend), and marital status. The results support the need for wide-ranging intervention programs that stimulate people to make personal risk assessments, teach basic sexual skills, and direct those in need of intensive help to appropriate agencies.

PMID:41252630 | DOI:10.1521/aeap.1994.6.1.12

J Med Internet Res. 2025 Nov 18;27:e80497. doi: 10.2196/80497.

ABSTRACT

BACKGROUND: Health disparities are closely associated with socioeconomic inequalities. Although this relationship is well recognized in the context of traditional health care access, its influence on online health-seeking behaviors such as posting questions on patient forums and seeking peer responses remains poorly understood, particularly in the context of resource-limited regions. Furthermore, it is unclear what types of questions are most frequently asked online and to what extent these questions receive helpful responses.

OBJECTIVE: This study aims to examine how socioeconomic status influences online health-seeking behavior by analyzing regional disparities in forum participation and their correlation with economic development. In addition, it aims to identify unmet informational needs among patients with lymphoma through large language model (LLM)-based forum thread classification and expert evaluation of forum responses by using data from the largest online blood cancer forum in China.

METHODS: We analyzed over 110,000 patient-initiated forum threads posted between 2012 and 2023, covering all the provinces of mainland China. Regional trends in forum participation rates were examined and correlated with economic development, as measured by gross regional product per capita. Second, an LLM was used to classify the threads into 6 predefined topics based on their semantic content, thereby providing an overview of the topics that users cared about. Additionally, an expert manual review was conducted based on relevance, accuracy, and comprehensiveness to assess whether users’ questions were adequately addressed within the forum discussions.

RESULTS: Regional forum participation rates were significantly associated with levels of regional economic development (Wilcoxon rank-sum test; P<.001), with the highest participation rates in the East Coast regions. Participation rates in less-developed regions steadily increased, reflecting the growing public demand for accessible health information. LLM-based analysis revealed that most discussions centered on medical concerns such as interpreting reports and selecting treatment plans across all regions. However, only 37% (117/316) of the user questions received useful responses, underscoring persistent gaps in access to reliable information.

CONCLUSIONS: To our knowledge, this study represents the most comprehensive real-world investigation to date of spontaneous online forum participation and information needs among patients with cancer. Our findings highlight the necessity for government and health care providers to implement initiatives such as artificial intelligence-driven information platforms and region-specific health education campaigns to bridge information gaps, reduce regional disparities, and improve patient outcomes across China.

PMID:41252192 | DOI:10.2196/80497

Mil Med. 2025 Nov 18:usaf571. doi: 10.1093/milmed/usaf571. Online ahead of print.

ABSTRACT

INTRODUCTION: Military medical students train in austere, high-stress environments that simulate prolonged casualty care and the cognitive and emotional demands of combat medicine. These scenarios can heighten stress and cognitive load, yet few curricula explicitly equip learners with structured strategies for psychological self-regulation. Mindfulness training has shown promise in clinical and operational contexts, but its educational role in military medical training is underexplored.

MATERIALS AND METHODS: We developed the Mental Strength and Resilience Training (MSRT), a brief, theory-informed mindfulness curriculum incorporating three 1-hour sessions and asynchronous video materials. Mental Strength and Resilience Training emphasized 5 mindfulness strategies-breathing, mantra, movement, stretching, and body scan-framed for transfer to prehospital operational environments. Ninety-seven third- and fourth-year medical students at the Uniformed Services University participated across 2 high-fidelity military medical field exercises: Operation Gunpowder (36 hours) and Operation Bushmaster (5 days). Outcomes were assessed with the Mindful Attention Awareness Scale (MAAS), Brief Resilience Scale (BRS), and Perceived Stress Scale (PSS) at 4 time points. These 4 time point measures were then analyzed using a repeated measures Analysis of Variance (ANOVA) model, and the relationships between each scale score were analyzed using correlations. Faculty observers also evaluated clinical performance at Operations Gunpowder and Bushmaster for all students. Performance comparisons between students involved in the study and students not involved were compared via independent samples t-testing. The relationships between study participants’ performance and their mindfulness, resilience, and stress were analyzed via correlations, with any significant correlations being entered into a regression model for further examination. This study was approved and deemed exempt by the Uniformed Services University Institutional Review Board (IRB) committee.

RESULTS: Learners demonstrated significant increases in mindfulness (η2p = 0.32, P < .001) and resilience (η2p = 0.06, P = .002), alongside reductions in perceived stress (η2p = 0.28, P < .001). Correlation analyses showed stress was consistently negatively associated with mindfulness and resilience. Faculty-rated performance scores did not differ significantly between the students involved in the study and non-participating students regularly enrolled at Operations Gunpowder and Bushmaster. However, pre-Bushmaster resilience predicted performance outcomes (P = .02) in the participating student sample.

CONCLUSIONS: Brief, theory-informed mindfulness training enhanced learners’ self-regulation and reduced stress during high-fidelity military medical exercises. Although performance gains were not statistically significant, the findings suggest mindfulness is a feasible and scalable approach to strengthen psychological readiness in military medical education, with potential applications across military and civilian health professions training.

PMID:41252179 | DOI:10.1093/milmed/usaf571

Environ Entomol. 2025 Nov 18:nvaf114. doi: 10.1093/ee/nvaf114. Online ahead of print.

ABSTRACT

One of the main challenges in improving agricultural productivity is the prevalence of pests and diseases, which are highly sensitive to extreme weather conditions. The interaction between weather patterns and pest infestations significantly affects crop yield. Traditional statistical methods often struggle to capture the complex temporal and geographical dynamics of these interactions. However, employing multivariate cointegration has proven valuable for estimating such interactions and quantifying the extent to which various environmental conditions influence pest populations. The study further investigated impulse response functions, which revealed substantial impacts of temperature and relative humidity on pest populations through unit standard deviation shocks to endogenous variables. Specifically, this research examined the dynamic causal relationships between major pest occurrences and environmental variables in 3 groundnut-growing states of India-Andhra Pradesh, Gujarat, and Tamil Nadu, using cointegration and Vector Error Correction Model techniques. The analysis incorporated key environmental variables, including temperature, relative humidity, and rainfall. Results from the Johansen test indicated a strong long-term equilibrium relationship between pest populations and climatic conditions, confirming the presence of at least one cointegrating vector at the 5% significance level. Granger causality tests further revealed that temperature and relative humidity had a unidirectional causal influence on the pest occurrence. Additionally, impulse response analysis further revealed that shocks to temperature and relative humidity produced significant and persistent effects on pest incidence over time.

PMID:41252177 | DOI:10.1093/ee/nvaf114

Proc Natl Acad Sci U S A. 2025 Nov 25;122(47):e2504913122. doi: 10.1073/pnas.2504913122. Epub 2025 Nov 18.

ABSTRACT

The architectures of biological neural networks result from developmental processes shaped by genetically encoded rules, biophysical constraints, stochasticity, and learning. Understanding these processes is crucial for comprehending neural circuits’ structure and function. The ability to reconstruct neural circuits, and even entire nervous systems, at the neuron and synapse level, facilitates the study of the design principles of neural systems and their developmental plan. Here, we investigate the developing connectome of Caenorhabditis elegans using statistical generative models based on simple biological features: neuronal cell type, neuron birth time, cell body distance, reciprocity, and synaptic pruning. Our models accurately predict synapse existence, degree profiles of individual neurons, and statistics of small network motifs. Importantly, these models require a surprisingly small number of neuronal cell types, which we infer and characterize. We further show that to replicate the experimentally observed developmental path, multiple developmental epochs are necessary. Our model’s predictions of the synaptic connections and their strength, using multiple reconstructions of adult worms, reflect that it identified much of the shared part of the connectivity graph. Thus, the accuracy of the generative statistical models we use here offers a general framework for studying how connectomes develop and the underlying principles of their design.

PMID:41252150 | DOI:10.1073/pnas.2504913122

Cancer J. 2025 Nov-Dec 01;31(6):e0797. doi: 10.1097/PPO.0000000000000797. Epub 2025 Nov 18.

ABSTRACT

Generative artificial intelligence (Gen-AI) powered technologies are increasingly integrated across virtually all fields, including oncology, poised to fundamentally transform human-machine interaction (HMI). In biomedicine and oncology, Gen-AI tools are forming the foundation for intuitive patient-facing and clinician-facing interfaces that increase accessibility and efficiency of health care applications, enhance patient experience, and improve clinical workflows, ultimately optimizing patient outcomes. Despite Gen-AI’s great potential in health care, limitations related to data quality and learning algorithms can create persistent challenges to patient safety, warranting a thorough HMI evaluation by end-users and experts that goes beyond traditional statistical validation. In parallel, a legal framework for assigning liability among developers, deployers, maintainers, and end-users is essential to ensure fairness and promote safe and beneficial application of clinical AI.

PMID:41252128 | DOI:10.1097/PPO.0000000000000797

Anat Sci Int. 2025 Nov 18. doi: 10.1007/s12565-025-00909-3. Online ahead of print.

ABSTRACT

This study aims to elucidate the morphometric and morphological details of teeth in the Syrian hamster (Mesocricetus auratus, Waterhouse, 1839) and guinea pig (Cavia porcellus, Linnaeus, 1758) using µ-CT and stereology (n = 5). Notably, the hamsters exhibited distinctive roots in their cheek teeth, in contrast to the guinea pigs, where the tooth body extended as a dental root into the alveolar socket, making anatomical diagnosis challenging. The first and second cheek teeth of the hamster had four roots, but the last one had three roots. The hamster incisor teeth had a more voluminous pulp cavity compared to those of guinea pigs. While the ratio differences of arch parameters and enamel thickness were not statistically significant (P ≥ 0.05). The enamel layer in guinea pig incisor teeth were significantly thicker than that in the hamster teeth (P ≤ 0.05). Regarding the dentine-tooth width, the difference between the upper incisor teeth of the hamster and guinea pig was significant (P ≤ 0.05). The ratio of pulp-tooth volume in all incisor teeth of the hamster was significantly higher than that in the guinea pig’s teeth (P ≤ 0.05) indicating hamsters might have better regenerative dental health despite dietary variances. These insights contribute to deeper understanding of the evolutionary adaptations in rodent dentition and suggest improved information and methodologies for translational dental studies and selecting more appropriate animal models in dental research.

PMID:41252122 | DOI:10.1007/s12565-025-00909-3

J Racial Ethn Health Disparities. 2025 Nov 18. doi: 10.1007/s40615-025-02734-w. Online ahead of print.

ABSTRACT

INTRODUCTION: COVID-19 disproportionately affected Black Americans, and social determinants of health (SDOH) likely contributed to this disparity, yet their impact remains unclear. This study investigated the association between race and COVID-19-related hospitalization, assessing the added explanatory value of SDOH and clinical factors.

METHODS: In this observational study, we invited 22,895 adult (≥ 18 years) Kaiser Permanente Georgia (KPGA) members with a COVID-19 diagnosis between Jan. 2020 and Jun. 2021 to take a survey of which 482 participated (response rate = 2.1%). We included non-Hispanic Black or non-Hispanic White KPGA members with complete data (n = 306). Surveys were linked to KPGA’s electronic medical records. Multivariable logistic regression assessed the relationship between race (non-Hispanic Black compared with White) and likelihood of 30-day hospitalization post-COVID-19 diagnosis adjusting for clinical factors (demographics, comorbidities) and SDOH (neighborhood SDOH, pre-COVID-19 health behaviors, and COVID-19 social impacts). Max-scaled R-squares and likelihood ratio tests assessed model variation and covariate significance.

RESULTS: Our study population was 39.2% Black, 32.4% male, and mean age was 52.3 ± 13.3 years. Overall, 20.0% of Black and 12.4% of White members were hospitalized within 30 days of COVID-19 diagnosis. While not statistically significant, Black (compared with White) members were 72% (aOR: 1.72 [95% CI: 0.75 3.91]) more likely to be hospitalized. Race, clinical factors, and SDOH explained 1.8%, 18.6%, and 14.4% of the variation in hospitalization risk, respectively, and cumulatively explained 34.8%.

CONCLUSION: No significant racial differences in 30-day hospitalization were observed; however, we found that clinical factors and SDOH explained similar variation in hospitalization risk.

PMID:41252118 | DOI:10.1007/s40615-025-02734-w