Nevin Manimala

Int Orthop. 2025 Aug 18. doi: 10.1007/s00264-025-06622-0. Online ahead of print.

ABSTRACT

PURPOSE: Humeral head osteonecrosis (HHN) is a joint-destructive condition, for which cementless humeral head resurfacing (CHHR) offers a bone-preserving treatment option. The aim of this study was to report long-term outcomes and implant survival of CHHR in patients with HHN.

METHODS: Patients with humeral head osteonecrosis treated with cementless humeral head resurfacing (CHHR) between 2004 and 2007 were included. Implant survival was assessed according to Kaplan-Meier analysis. Clinical evaluation included Constant-Murley-Score (CMS), Simple Shoulder Test (SST), Subjective Shoulder Value (SSV) and patient centered outcomes regarding satisfaction and quality of life. Radiographs were evaluated for glenoid erosion, Walch glenoid types as well as signs of implant loosening. Statistical comparison was performed using students t-tests with a significance level set to p < 0.05.

RESULTS: Seventeen shoulders were retrospectively included in the implant survival analysis. Two patients underwent revision surgery. five patients died with the implant and were therefore censored. Cumulative survival rate was 100% after ten years and 93.3% after 15 years. Seven shoulders were available for clinical and radiological evaluation at a mean follow-up of 19 years (range 17-22 years). Age- and sex-adjusted CMS improved from preoperative to the latest follow-up (44.4% vs. 82.9%; p < 0.01). No glenoid erosion of higher degree (Sperling grade > 2) and no signs of implant loosening were observed. All patients had Walch type A glenoids preoperatively.

CONCLUSION: In this small cohort with long-term follow-up of 17-22 years, CHHR showed promising durability and functional outcomes in carefully selected patients.

LEVEL OF EVIDENCE: Level IV Case series with no comparison group.

PMID:40820162 | DOI:10.1007/s00264-025-06622-0

Sci Rep. 2025 Aug 17;15(1):30047. doi: 10.1038/s41598-025-15472-0.

ABSTRACT

Group B Streptococcus (GBS) is a normal constituent of the female genital and gastrointestinal flora but remains a leading cause of perinatal bacterial infections, including endometritis, bacteremia, chorioamnionitis, and urinary tract infections in pregnant women. In Ethiopia, reported GBS colonization rates among pregnant women range from 7.2 to 25.5%. This study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of GBS colonization among pregnant women attending antenatal care (ANC) at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia. An institutional-based cross-sectional study was conducted from March 1 to May 30, 2021. After obtaining written consent, sociodemographic data were collected using a structured questionnaire, conveniently. A total of 210 recto-vaginal swabs were collected, inoculated into Todd-Hewitt broth, and sub-cultured on 5% blood agar. Antimicrobial susceptibility testing was performed using the disk diffusion method following Clinical and Laboratory Standards Institute 2020 guidelines. Data were entered and cleaned in Epi Data version 3.1 and analyzed using SPSS version 20. Binary logistic regression identified associations between variables, with a P value ≤ 0.05 considered statistically significant. The overall GBS colonization was 13.3% (28/210). Married women had significantly higher odds of colonization (AOR 5.774; 95% CI 1.074-31.03; P = 0.041), while those with a history of abortion had lower odds (AOR 0.294; 95% CI 0.102-0.850; P = 0.024). Most isolates were susceptible to chloramphenicol (96.4%). Resistance rates were highest for erythromycin (71.4%) and penicillin (67.9%), followed by ampicillin (64.3%), azithromycin (46.4%), vancomycin (46.4%), and ceftriaxone (32.1%). Half of the isolates were multidrug-resistant. GBS colonization among pregnant women in the study area warrants clinical attention due to its associated high antibiotic resistance. Being married and abortion had statistically significant associations with colonization. Therefore, clinicians could implement routine GBS screening for all pregnant women attending ANC to reduce GBS colonization. Routine GBS screening may help reduce neonatal sepsis, pneumonia, and meningitis by guiding timely intrapartum antibiotic prophylaxis.

PMID:40820154 | DOI:10.1038/s41598-025-15472-0

BMC Psychol. 2025 Aug 17;13(1):924. doi: 10.1186/s40359-025-03295-7.

ABSTRACT

AIM: To investigate the relationship between professional identity and turnover intention for new nurses in China, and explore the mediating role of psychological capital and achievement motivation in these two variables.

BACKGROUND: As the main backup force in nursing career development, new nurses face challenges due to the conflict between theory and practice, a lack of skills, and the heavy demands of nursing work. As a result, the majority of new nurses have higher turnover intention. Reducing the turnover intention of new nurses is very important to reduce the shortage of nurses, stabilize the hospital talent team, and improve the nursing quality.

METHODS: A Cross-sectional survey was used to investigate 562 nurses in 6 hospitals in Henan Province from February to March 2024. Pearson correlation analysis, descriptive statistics and structural equation model were used to analyze the existing data.

RESULTS: There was a significant relationship between the professional identity, psychological capital, achievement motivation, and turnover intention of new nurses. Psychological capital and achievement motivation played a chain mediating role in the effect of professional identity on the turnover intention of new nurses.

CONCLUSION: The results can be used as a reference for formulating relevant hospital management policies and reducing the turnover intention of new nurses, which is of great significance for reducing the shortage of nurses and stabilizing the talent team of hospitals.

PMID:40820146 | DOI:10.1186/s40359-025-03295-7

Int J Behav Nutr Phys Act. 2025 Aug 18;22(1):111. doi: 10.1186/s12966-025-01810-y.

ABSTRACT

BACKGROUND: Contextual influences on program implementation exist across micro (individual), meso (organization), and macro (government/environment) system levels, yet macro factors are less frequently explored in implementation research. This retrospective study explored differences in adoption across meso- and macro-system levels using data from the 2018-2022 state-wide hybrid effectiveness-implementation trial of TransformUs Primary, a whole-school physical activity intervention. Aims were to: (1) assess differences in contextual characteristics between adopting and non-adopting schools and implications for equity, and (2) assess associations between macro-level events and dissemination events with program adoption over time.

METHODS: Descriptive statistics (number and %) and chi-squared tests were used to assess differences in contextual characteristics between adopting and non-adopting schools (Aim 1). A time-series analysis of daily data was used to explore associations between the number of dissemination events promoting program awareness (e.g., media, newsletters), macro-level policy events (e.g., education department policies), COVID-19-related remote/on-site learning periods, school term dates (i.e., during/outside of school term) and program adoption (i.e., the number of TransformUs Primary registrations per day) (Aim 2).

RESULTS: No differences in either school type (i.e., primary, combined, or special) or community level socio-educational advantage between adopting (n = 519) and non-adopting schools (n = 1,423) were identified. A higher proportion of adopting schools were located in major cities (71.7% vs. 54.5%; chi-square p < 0.001) and were government (public sector) schools (80.0% vs. 63.1%; chi-square p < 0.001). Time-series analysis results indicated that the likelihood of adopting TransformUs Primary decreased from the date of program launch to the end of the scale-up period (IRR 0.999, 95% CI 0.999-1.000; p < 0.005). Both school term date (IRR 5.95, 95% CI 4.78-7.41; p < 0.001) and dissemination events (IRR 3.30, 95% CI 2.67-4.06; p < 0.001) increased the likelihood of adopting TransformUs Primary. Results provided little evidence of an association between the number of policy events or COVID-19-related remote and on-site learning periods and adoption.

CONCLUSIONS: Select meso- and macro-level factors had an impact on TransformUs Primary adoption. Findings inform the need to work with stakeholders in scale-up to prioritize dissemination strategies that have a discernible impact on adoption above others and consider targeted efforts to reach regional/rural and non-government schools.

PMID:40820140 | DOI:10.1186/s12966-025-01810-y

Sci Rep. 2025 Aug 17;15(1):30084. doi: 10.1038/s41598-025-98410-4.

ABSTRACT

In higher education, resilience is vital for enabling students and academics to confront challenges and sustain well-being. The COVID-19 pandemic has amplified concerns about how individuals in higher education, including in pharmacy education, adapt to drastic shifts in societal, economic, and educational contexts. This study aimed to explore resilience in pharmacy higher education within the Eastern Mediterranean Region. This cross-sectional study was conducted from October 2020 to January 2021, involving pharmacy students and academics across the 22 EMR countries. Data collection utilised an online questionnaire, that included, along with demographic and environmental items, the CD-RISC-22 scale, a modified version of the Connor Davidson Resilience Scale (CD-RISC-25). CD-RISC-22 is a 22 items, a self-administered psychometric scale, tailored to assess resilience among pharmacy students and academics in EMR region. Data were analysed using descriptive and comparative statistical methods. Students exhibited a significantly lower resilience scores (mean ± SD: 58.81 ± 13.41) when compared with academic staff/faculty (66.74 ± 10.29) across all constructs of the CD-RISC-22 scale (p < 0.000), with the exception of the ‘connection/spirituality’ factor (p = 0.1). The availability of mental health support services in educational institutions was found to be limited, with only 13 (10.7%) academic respondents reporting access to a mental health advisory scheme and 88 (17.7%) of students reporting access to mental health and well-being support training. Academics and students felt more supported by their colleagues and peers than by their institutions. This research sheds light on the variations in resilience levels between pharmacy students and academics in the EMR, emphasising the need for targeted interventions to enhance undergraduate students’ resilience.

PMID:40820138 | DOI:10.1038/s41598-025-98410-4

Sci Rep. 2025 Aug 17;15(1):30102. doi: 10.1038/s41598-025-08224-7.

ABSTRACT

This study investigated the effectiveness of daily living skills intervention training for children with autism in a virtual campus setting. First, six children with autism (age M = 10.50, SD = 2.22) participated in a 4-week experiment totaling 8.4 h. The effectiveness of the virtual school environment and the daily living skills intervention were used as indicators during data collection and processing. In addition, a series of 3D environments based on daily life were constructed using SketchUp Pro 2021, which were converted to virtual environments using Unreal Engine 4. The HTC Vive external headset facilitated intervention training for children with autism. Most importantly, the results demonstrated the effectiveness of interactive domains such as grabbing bread in a cafeteria environment, making a phone call in front of a school, and switching lights and picking up a book in a library environment, where participants showed significantly higher levels of performance (p < 0.05). Scores on the Social Communication Questionnaire (SCQ) for children with autism (M = 19.33, SD = 4.18) were lower than baseline values (M = 22.83, SD = 4.79), while scores on the Social Skills Questionnaire (SSQ) (M = 26.17, SD = 3.97) were higher than baseline values (M = 20.00, SD = 2.28), suggesting that the overall social effectiveness of the participants following the intervention improved (p < 0.05). In conclusion, the statistical analysis showed that participants who received the intervention had significantly improved daily living skills such as grabbing bread, making phone calls, changing lights, and picking up books.

PMID:40820136 | DOI:10.1038/s41598-025-08224-7

BMC Microbiol. 2025 Aug 18;25(1):518. doi: 10.1186/s12866-025-04263-2.

ABSTRACT

BACKGROUND: Gallibacterium anatis (G. anatis), a microorganism of the Pasteurellaceae family, is an emerging avian pathogen associated with reproductive and respiratory diseases in poultry. However, its role in ornamental birds is still poorly understood. The aim of the present study was to conduct the first comprehensive survey of the prevalence of G. anatis in pet birds, to investigate its antimicrobial resistance (AMR) profile and to assess its ability to form biofilms using cultural, biochemical, molecular and histopathological methods.

METHODS: In this study, 191 fecal and tissue samples were collected from various companion birds. Clinical samples were cultured on 5% sheep blood agar and MacConkey agar plates to isolate bacterial pathogens. After incubation, colonies were evaluated based on their macroscopic characteristics such as size, color, and hemolytic properties on blood agar-and a Gram stain was performed as an essential preliminary step for bacterial identification. The 16-23 S rRNA gene region of G. anatis was amplified by PCR method. The disc diffusion method was used to assess microbial susceptibility and resistance. Biofilm formation was analyzed using a microtiter plate assay. Tissue samples were routinely processed, embedded in paraffin, sectioned and stained with common haematoxylin-eosin (H&E).

RESULTS: In this study, 20 G. anatis strains were isolated from 191 clinical samples of pet birds, representing a prevalence of 10.5%. Isolates were identified by colony morphology, Gram staining, biochemical testing and PCR for the -intergenic spacer region of 16-23 S rRNA, which yielded diagnostic amplicons of 790 bp and 1080 bp. Antimicrobial susceptibility testing showed complete susceptibility to ciprofloxacin (100%) and remarkable resistance to erythromycin (80%). β-lactam resistance was prevalent, with 70% and 75% of isolates resistant to ampicillin and amoxicillin, respectively. Biofilm formation tests showed that 80% of isolates had moderate biofilm formation. Gross and histopathological examinations of infected birds revealed severe respiratory and systemic lesions, including tracheitis, bronchopneumonia with focal necrosis, multifocal hepatic necrosis, and vascular congestion in multiple organs.

CONCLUSIONS: These results support the idea that G. anatis is a potentially important pathogen, with a biofilm-forming ability that contributes to treatment failure and environmental persistence. The 45% prevalence of multidrug resistance (MDR) highlights the pressing need for antimicrobial stewardship in avian veterinary medicine. Given the zoonotic potential of G. anatis, our study underscores the importance of One Health surveillance efforts in mitigating risk to both poultry and humans.

PMID:40820131 | DOI:10.1186/s12866-025-04263-2

BMC Infect Dis. 2025 Aug 17;25(1):1028. doi: 10.1186/s12879-025-11410-7.

ABSTRACT

BACKGROUND: This study assessed the real-world effectiveness of the ChAdOx1 nCoV-19 vaccine in adults against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, symptomatic infection, and severe coronavirus disease 2019 (COVID-19) during periods of Beta and Delta variant dominance in Qatar.

METHODS: A national, matched, test-negative case-control study was conducted using 186,130 PCR-positive tests (cases) and 667,289 PCR-negative tests (controls) collected between January 1 and December 18, 2021. Subgroup analyses were performed to evaluate vaccine effectiveness across key strata.

RESULTS: The median time between the first and second doses was 61 days (interquartile range, 56-64 days). Two-dose primary-series effectiveness was 66.0% (95% CI, 55.1-74.3%) against any SARS-CoV-2 infection and 73.0% (95% CI, 44.1-87.0%) against symptomatic infection. Effectiveness was estimated at 100% (95% CI, 64.0-100%) against any Beta variant infection and 65.3% (95% CI, 54.2-73.8%) against any Delta infection. Protection against any infection of any variant peaked at 78.4% (95% CI, 50.7-90.5%) within the first month after the second dose, gradually declining to 45.6% (95% CI, 5.5-68.7%) after 150 days. Effectiveness against severe, critical, or fatal COVID-19, irrespective of variant, was 100% (95% CI, 49.3-100%), with no vaccinated individuals progressing to severe, critical, or fatal disease after infection. Effectiveness of a single dose was 59.9% (95% CI, 51.0-67.3%) against any infection-65.0% (95% CI, 49.7-75.6%) against Beta and 55.9% (95% CI, 43.8-65.5%) against Delta-78.4% (95% CI, 60.9-88.0%) against symptomatic infection, and 100% (95% CI, 88.9-100%) against severe, critical, or fatal COVID-19.

CONCLUSION: The ChAdOx1 nCoV-19 vaccine provided substantial protection against infection and strong protection against severe outcomes during periods dominated by the Beta and Delta variants, although protection against infection waned within the first few months following the primary series.

PMID:40820125 | DOI:10.1186/s12879-025-11410-7

Sci Rep. 2025 Aug 17;15(1):30097. doi: 10.1038/s41598-025-14574-z.

ABSTRACT

Family medicine was established in Sudan in 2006 after the first family medicine master’s degree program was established. The objective of this study was to evaluate the effectiveness of the family medicine curriculum in the Sudan Medical Specialization Board (SMSB) and provide baseline and updated data on the strengths and weaknesses of the family medicine training program. A cross-sectional quantitative and qualitative descriptive survey was conducted from February to October 2024. Data was collected through a pretested, pre-coded online questionnaire. Semi-structured in-depth interviews were conducted with the family medicine specialists and trainers in the SMSB. All data were summarized numerically (mean, standard deviation, median) and graphically (frequency tables). The Chi square test was used to determine association among categorized variables. P value < 0.05 is considered statistically significant. Qualitative data was recorded, transcribed, coded, and analyzed using a content analysis approach. A total of 100 family medicine doctors participated in the study. Most of the participants (82%) were females. Regarding the job title (76%) of the participants were residents and the rest (24%) were specialists. More than half of the participants (66%) were from Khartoum state. Most of the participants (87%) reported satisfaction with the family medicine training curriculum in the SMSB and its effectiveness in improving knowledge and practices. Furthermore, (81%) of the participants reported that the lectures and workshops arranged for the residents were sufficient to improve their knowledge. Some of the residents interviewed (30%) complained of dissatisfaction with the research methodology course, and about half of them reported that the course was ineffective and did not improve their knowledge and skills in research. Furthermore, residents reported the family medicine research committee in the SMSB had unclear requirements which was reflected in a high rejection rate of the research proposals submitted by residents. The SMSB Family Medicine curriculum is a well-structured, training-focused program designed to enhance residents’ satisfaction, knowledge, and clinical competencies. Significant concerns arise regarding the need for standardized curriculum details, trainer availability, and research support, all of which are crucial for the ongoing development and effectiveness of the program.

PMID:40820123 | DOI:10.1038/s41598-025-14574-z

Eur Spine J. 2025 Aug 18. doi: 10.1007/s00586-025-09256-3. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: The environmental footprint of healthcare has become a growing concern, but the specific resource consumption associated with spine surgery remains largely unexplored. Despite the widespread use of continuous saline irrigation in endoscopic spine surgery, no study has previously compared the volume of saline consumption across different surgical techniques.

PURPOSE: This study aims to compare saline consumption across three surgical techniques for lumbar disc herniation: classical microdiscectomy (MD), uniportal endoscopy (FE), and biportal endoscopy (UBE).

STUDY DESIGN/SETTING: multicenter, international, retrospective observational study.

PATIENT SAMPLE: This study included 722 patients who underwent lumbar disc herniation surgery between March 2023 and September 2024. Patients were grouped based on the surgical technique used: MD (n = 127), FE (n = 253), and UBE (n = 342).

OUTCOME MEASURES: The primary outcome was total saline consumption (Liters). Data collected included also demographic information and surgical duration.

METHODS: Statistical analyses included Kruskal-Wallis tests, pairwise comparisons with Bonferroni correction, ROC curve analysis, and a fixed-effects model to assess factors influencing saline consumption.

RESULTS: Saline consumption varied significantly across techniques, with a median (IQR) of 0.08 L (0.02-0.15) for MD, 4.00 L (3.00-6.00) for FE, and 9.00 L (6.00-13.00) for UBE (p < 0.0001) FE technique consumes approximately 50 times more saline than MD, and UBE consume more than 112 times more saline than MD. No significant correlation was found between saline consumption and patient age or BMI.

CONCLUSION: Endoscopic techniques for lumbar disc herniation require substantially more saline than classical MD. This highlights the need for strategies promoting responsible resource stewardship in spine surgery. Future innovations, such as closed-loop fluid management systems, may help optimize both environmental sustainability and economic efficiency.

PMID:40820108 | DOI:10.1007/s00586-025-09256-3