Nevin Manimala

BMC Public Health. 2025 Aug 16;25(1):2812. doi: 10.1186/s12889-025-23721-0.

ABSTRACT

This research investigates how loneliness influences alexithymia among Chinese adolescents, drawing on Internet Compensation Theory and the Social Compensation Hypothesis. The study highlights the mediating role of problematic smartphone use (PSU) and the moderating effect of fear of negative evaluation (FNE). Using a cross-sectional design, data were collected from 688 secondary school students via the online Questionnaire Star platform. The results indicate that loneliness is positively associated with both PSU and alexithymia. PSU partially mediates the relationship between loneliness and alexithymia (based on statistical models). Additionally, FNE plays a moderating role in the relationship between loneliness and PSU or alexithymia. Subgroup analysis revealed that male students reported significantly higher levels of alexithymia than females. Among individuals with higher levels of FNE, the positive correlation between loneliness and alexithymia was significantly stronger. This study proposes a mechanism involving internal emotion (loneliness), external behavior (PSU), and cognitive evaluation (FNE), offering a systematic theoretical basis for adolescent mental health interventions.

PMID:40819026 | DOI:10.1186/s12889-025-23721-0

NPJ Digit Med. 2025 Aug 16;8(1):526. doi: 10.1038/s41746-025-01935-1.

ABSTRACT

The sensitive nature of electronic health records (EHR) and wearable data presents challenges in sharing biomedical resources while minimizing re-identification risks. This article introduces an end-to-end, titratable pipeline that generates privacy-preserving “digital twin” datasets from complex EHR and wearable-device records (Apple Watch data from 3029 participants) using DataSifter and Synthetic Data Vault (SDV) methods. Various obfuscation levels were applied (DataSifter: small, medium, large; SDV: CTGAN, Gaussian Copula) and benchmarked using utility (statistical fidelity, machine learning performance) and privacy (re-identification risk, detection likelihood) metrics. The highest-obfuscation DataSifter twin delivered the strongest privacy protection (0.83) while preserving key statistical and predictive signals (83.1% confidence interval overlap in regression models), outperforming SDV, particularly for longitudinal data. Despite declining performance in machine learning tasks with higher obfuscation, utility was generally preserved. The study underscores the importance of digital twin datasets and highlights DataSifter’s adaptability in privacy-utility trade-offs, advocating its utility for secure data sharing.

PMID:40818998 | DOI:10.1038/s41746-025-01935-1

BMC Public Health. 2025 Aug 16;25(1):2798. doi: 10.1186/s12889-025-24164-3.

ABSTRACT

OBJECTIVE: To understand the implementation of leprosy symptom surveillance in Guangdong Province, explore its role in early detection of leprosy, and provide a theoretical basis for leprosy prevention and control.

METHODS: Data from the National Leprosy Prevention and Management Information System (LEPMIS) and Guangdong Suspected Leprosy Symptom Surveillance System were collected, including symptom surveillance data (2018-2023) and newly diagnosed leprosy case records (2012-2023). The newly diagnosed leprosy case records were divided into pre-implementation (2012-2017) and post-implementation (2018-2023) of symptom surveillance. The effectiveness of the symptom surveillance program was evaluated by assessing the surveillance coverage and clinical outcomes, including but not limited to coverage rate, delayed discovery time, and early diagnosis. Database was established and checked for logical errors, followed by descriptive statistical analysis, chi-square test using SPSS 24.0.

RESULTS: By the end of 2023, the number of participating medical institutions was 2,891, increased by 92.3% compared to 2018 when the symptom surveillance was first initiated, and the county-level coverage rate increased from 11.3 to 97.6%. After implementation of symptom surveillance, the proportions of resident patients, Han ethnicity, and farmers or herders decreased significantly (p < 0.05). The delayed discovery time decreased from (36.2 ± 2.0) months to (31.8 ± 3.1) months, and the patients delayed discovery time decreased from (27.7 ± 1.8) months to (20.8 ± 2.5) months, both showing a statistically significant difference (p < 0.05).

DISCUSSION: Our findings indicate that the leprosy symptom surveillance program in Guangdong Province has effectively reduced delayed discovery time, particularly patients delayed discovery time in seeking medical care, thereby facilitating early detection of leprosy cases.

PMID:40818964 | DOI:10.1186/s12889-025-24164-3

Injury. 2025 Jul 19;56(10):112620. doi: 10.1016/j.injury.2025.112620. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: The best treatment of comminuted, proximal humeral fractures in the elderly population is an unresolved clinical problem. This study aimed to compare the outcome of hemiarthroplasty (HA) and nonoperative treatment in the elderly population patients with a comminuted proximal humeral fracture.

METHOD: From October 6, 2009 to April 26, 2017, 57 elderly patients with a comminuted proximal humeral fracture were enrolled in the multicenter randomized controlled trial (RCT). Patients were randomized to HA or nonoperative treatment. Outcome measures were the Constant-Murley score (primary outcome), Disabilities of the Arm, Shoulder, and Hand, pain (Visual Analog Score), quality of life (Short Form-36 and EuroQoL-5D-3 L), complications, revision operation, health care consumption, and costs. Patients were followed for two years.

RESULT: Of the 57 patients included, 30 underwent treatment with HA and 27 were treated nonoperatively. Patients had a median age of 77 years, and 89 % was female. According to the Hertel classification, most fractures were type 7 (47 %) or type 12 (42 %). The median Constant-Murley score increased from 23 (95 % CI 17-29) at six weeks to 48 (95 % CI 41-53) at 24 months in the HA group, and from 24 (95 % CI 17-31) to 59 (95 % CI 52-65) in the nonoperative group. Throughout follow-up, scores were similar in both groups. The DASH score consistently decreased over time in both groups. At 24 months, median DASH scores were 24.0 (95 % CI 17.4-30.8) and 23.4 (95 % CI 16.5-30.4) in the HA and nonoperative group, respectively. Pain levels, SF-36, and EQ-5D were similar in both groups throughout follow-up. Eleven patients, of which seven in the HA group, developed one or more complications, of which six patients required surgical interventions. Total costs were higher for HA, although not statistically significant.

CONCLUSION: Based on results of this RCT, primary hemiarthroplasty cannot be considered superior to nonoperative treatment for comminuted proximal humeral fractures in the elderly population. A trend favoring nonoperative treatment is observed in outcomes and in costs.

PMID:40818163 | DOI:10.1016/j.injury.2025.112620

J Mother Child. 2025 Aug 16;29(1):71-78. doi: 10.34763/jmotherandchild.20252901.d-25-00013. eCollection 2025 Feb 1.

ABSTRACT

BACKGROUND: Breastfeeding is the ideal nutrition for the first half of an infant’s life. It contains the right nutrients for the physical and mental development of the infant. In general, however, fewer than 50% of infants under six months are exclusively breastfed globally. This study aims to determine if Greece’s exclusive breastfeeding rates comply with WHO and UNICEF recommendations and to explore the variables that affect the lengthening of exclusive breastfeeding.

MATERIAL AND METHODS: This cross-sectional study was conducted in four municipalities of South Athens, Greece from July 2018 to June 2019 in day care centers. The sample of study consisted of 674 mother-child couples. The study was approved by the Department of Nursing at the University of the Peloponnese, as well as the municipal day care centers. The mothers were informed about the purpose of the study.

RESULTS: 236 (35.01%) women in the sample breastfed exclusively for six months or more, of which 106 (44.91%) women continued breastfeeding for one year, and 22 (9.32%) women until two years. Exclusive breastfeeding, satisfaction with the process, gestational diabetes, excess and normal maternal weight at the time of the study are statistically significant factors for increasing the duration of exclusive breastfeeding.

CONCLUSIONS: Exclusive breastfeeding rates in Greece fall short of WHO and UNICEF targets, with only 35.01% of mothers breastfeeding exclusively for six months.

PMID:40818148 | DOI:10.34763/jmotherandchild.20252901.d-25-00013

Med Oral Patol Oral Cir Bucal. 2025 Aug 16:27184. doi: 10.4317/medoral.27184. Online ahead of print.

ABSTRACT

BACKGROUND: The best technique to harvest gingival graft to treat gingival recessions (GR) remains a topic of ongoing debate. This systematic review aimed to evaluate the effect of de-epithelialized free gingival graft (DFGG) compared to subepithelial connective tissue graft (SCTG) in the treatment of GR Miller Class I and II or Cairo type I.

MATERIAL AND METHODS: Five databases were searched up to June 2024 to include randomized clinical trials (RCTs) comparing the clinical effects of DFGG with SCTG in the treatment of GR. The random effects model of mean differences was used to determine GR, and gain in keratinized tissue width (KTW), gingival thickness (GT) and clinical attachment level (CAL). The risk ratio was used to complete root coverage (CRC) at 6 and 12 months.

RESULTS: Five RCTs including 183 and 111 GR at 6 and 12 months were included in this systematic review. The meta-analysis showed no statistically significant difference in GR reduction, gain in KTW, GT, CRC or CAL between groups at 6 and 12 months.

CONCLUSIONS: At 12 months, the clinical results of DFGG were similar to those of SCTG in the treatment of GR.

PMID:40818139 | DOI:10.4317/medoral.27184

Med Oral Patol Oral Cir Bucal. 2025 Aug 16:27179. doi: 10.4317/medoral.27179. Online ahead of print.

ABSTRACT

BACKGROUND: Periodontitis triggers systemic inflammatory reactions that may be associated with different oncological diseases, such as prostate cancer (PC), although little information exists on the possibility of this association. To determine whether periodontitis is associated with PC and other non-metastatic urological cancers in patients over 50.

MATERIAL AND METHODS: This cross-sectional study was conducted between August and September 2024 at the outpatient clinic of the Belén de Trujillo Hospital (HBT) and the Regional Institute of Neoplastic Diseases “Dr. Luis Pinillos Ganoza” – IREN Norte (IREN), in Trujillo, Peru. In total, 192 patients were evaluated: 64 with PC, 64 with non-prostatic urological cancer (NPUC), and 64 with non-oncological urological disease (NOUD). Reliability was determined through inter- and intra-evaluator calibration to diagnose periodontitis, gingivitis inflammation, and plaque control. The corresponding specialist physician diagnosed PC, NPUC, and NOUD. Statistical analysis was performed using the Chi-square and Kruskal-Wallis tests, including nonparametric multiple comparison tests, with a significance level of p<0.05.

RESULTS: An association between periodontitis and PC was found in patients over 50. PC was also directly associated with moderate periodontitis (p=0.014) and generalized gingivitis inflammation (p=0.019). Concerning NPUC, an association was found with periodontal pockets of 3.5 – 5.5 mm (p=0.031) and last visit to the dentist more than one year ago (p=0.012).

CONCLUSIONS: There was an association between periodontitis and PC in patients over 50. Patients with moderate periodontitis and generalized GI were more likely to present PC compared with patients with NOUD. In addition, there was a greater probability of presenting PC versus NPUC in patients with periodontal pockets of 3.5-5.5 mm and in those whose last visit to the dentist was more than one year ago.

PMID:40818138 | DOI:10.4317/medoral.27179

Med Oral Patol Oral Cir Bucal. 2025 Aug 16:27059. doi: 10.4317/medoral.27059. Online ahead of print.

ABSTRACT

BACKGROUND: Oral Pathology (OP) is an important part of diagnosing and managing oral and maxillofacial diseases. Despite being recognized as a specialty in Brazil for over 50 years, significant gaps remain in the availability of specialists and training programs. Therefore, this study aims to map and analyze the training of specialists in OP in Brazil.

MATERIAL AND METHODS: A cross-sectional study was conducted using publicly available data from Brazilian governmental databases, including the Federal Council of Dentistry, the Brazilian Institute of Geography and Statistics, and the Ministry of Education. Variables analyzed included the number of OP specialists, their geographic distribution, training opportunities, and population coverage. Descriptive and comparative analyses were performed using Microsoft® Excel (version 2410) and Statistical Package for Social Sciences® (version 27.0).

RESULTS: In 2024, 424 active OP specialists were registered in Brazil, composed of 240 women and 184 men, representing only 0.3% of all dental specialists. The ratio of OP specialists to inhabitants was 1:478,964, with marked regional disparities. The Southeast had the highest density, while the North had the lowest, with some states lacking any OP specialists. Additionally, 12 active OP training programs were identified, primarily concentrated in the Southeast. Most programs were distance learning, limiting opportunities for practical training. Temporal analysis revealed a decline in OP specialist registrations over the past two decades, despite population growth.

CONCLUSIONS: Brazil faces challenges in OP training, including insufficient specialists, uneven regional distribution and limited hands-on training opportunities. The expansion of hybrid training models and the promotion of the OP specialty among dental students are vital to address these issues. Collaborative efforts between educational institutions, professional organizations, and the government are essential to strengthen the specialty and improve early diagnosis rates of oral cancer.

PMID:40818134 | DOI:10.4317/medoral.27059

Med Oral Patol Oral Cir Bucal. 2025 Aug 16:27222. doi: 10.4317/medoral.27222. Online ahead of print.

ABSTRACT

BACKGROUND: The study aimed to investigate the risk factors that could affect intraoperative blood loss in patients who underwent orthognathic surgery.

MATERIAL AND METHODS: The study included a retrospective analysis of 400 patients who underwent bimaxillary orthognathic surgery. Data on demographic, surgical, and hematological parameters affecting intraoperative blood loss were statistically analyzed.

RESULTS: The mean intraoperative blood loss of male patients was statistically higher than that of female patients (p ≤ 0.001). The mean blood loss was higher in patients aged 25 years and older than in patients aged 17-24 (p=0.004). Patient weight and duration of surgery were positively correlated with the amount of intraoperative bleeding (r = 0.280 and r = 0.371). Platelet (PLT) count negatively correlated with blood loss (r=-0.213). The MPV/PLT ratio and hemoglobin (HGB) levels were positively correlated with bleeding (r=0.208 and r=0.110).

CONCLUSIONS: In orthognathic surgeries, factors such as age, gender, body mass, and duration of surgery were found to be associated with intraoperative blood loss. Males, patients over 24, overweight patients, and prolonged surgical procedures are all significant risk factors for bleeding. In addition, high HGB levels, low platelet count, and low MPV/PLT ratios are also associated with an increased risk of blood loss.

PMID:40818130 | DOI:10.4317/medoral.27222

Med Oral Patol Oral Cir Bucal. 2025 Aug 16:27213. doi: 10.4317/medoral.27213. Online ahead of print.

ABSTRACT

BACKGROUND: After lower third molar surgery, suppurative infections can occur. They can spread into adjacent tissues, toward superficial mucosal or skin planes or toward deep facial and neck fascial spaces.

MATERIAL AND METHODS: The 2020 PRISMA guidelines for systematic reviews were followed. A literature search was conducted, without initial time limit, in the Medline database, via Pubmed (MEDLINE), and SCOPUS. For the analysis of statistical significance, the hypothesis test on the difference between means with unknown variances was used.

RESULTS: Eleven articles met the inclusion criteria. The total number of extractions taken from the articles included in the review is 7363, with a 5.35% total incidence of purulent infections. The incidence of purulent infections was found significantly higher in cases in which antibiotic prophylaxis was not performed.

CONCLUSIONS: Although lower third molar extraction is the most frequently performed oral surgical procedure, little has been written about post-operative purulent infections, in relation to risk factors, involved spaces, and performed therapies, so to be able to identify preventive and therapeutic behaviors based on scientific evidence. Antibiotic prophylaxis is the only variable which resulted in determining a significative statistical reduction in the incidence of purulent infection after lower third molar surgery.

PMID:40818128 | DOI:10.4317/medoral.27213