Nevin Manimala

Afr J Reprod Health. 2024 Dec 31;28(12):61-72. doi: 10.29063/ajrh2024/v28i12.7.

ABSTRACT

This was a randomised controlled study to investigate the effect of web-based breastfeeding education given to primiparous pregnant women on postpartum breastfeeding. The study included a total of 120 primiparous pregnant women, including control group (n:60) and experimental group (n:60). The study was conducted in a district in northern Turkey. Only the pregnant women in the experimental group received web-based breastfeeding education. Descriptive statistics and independent two-sample t-test analysis were used to analyse the data and to compare the demographic characteristics and scale scores according to the groups. ‘IOWA Infant Feeding Scale’, “Edinburgh Depression Scale”, “IMDAT”, “Breastfeeding Self-Efficacy Scale”, “Perception of Insufficient Milk Scale” and “Breastfeeding Motivation Scale” were administered to the experimental and control groups on the 7th day, 3rd month and 6th month after birth. Several factors, including breastfeeding motivation, breastfeeding self-efficacy, and the perception of milk sufficiency for the baby, were significantly different between the groups (p<0.001). A significant difference was found between the two groups in terms of mothers breastfeeding their babies within the first half hour after birth. All of the mothers in the experimental group breastfed their babies within the first half hour. Breastfeeding self-efficacy and motivation levels in the experimental group showed a statistically significant increase when compared to both pre-training levels and the control group. (Clinical Trials Number: NCT06443801).

PMID:39764800 | DOI:10.29063/ajrh2024/v28i12.7

East Mediterr Health J. 2024 Dec 18;30(12):837-846. doi: 10.26719/2024.30.12.837.

ABSTRACT

BACKGROUND: Lebanon’s economic and financial crises have affected the quality-of-life, including food safety and food security.

AIM: To assess food safety knowledge and practices among a sample Lebanese population and the association with the sociodemographic and economic characteristics of participants.

METHODS: This cross-sectional study collected data online from 412 Lebanese adults aged ≥ 18 years [mostly female (77.7%)] between October and December 2021. The data included their sociodemographic characteristics, food safety knowledge and practices, experience of food insecurity, and financial wellbeing. We conducted logistic regression analyses to explore the associations between food safety knowledge and practices, sociodemographic variables, and food security status of participants.

RESULTS: A significantly higher proportion of married (vs single) participants said they reheated refrigerated meat or chicken before consumption (74.3% vs 63.1%, P = 0.017). A significantly higher proportion of participants in the higher income category and those with university education (versus lower level of education) knew the characteristics of a contaminated food (34.2% vs 15.0%, P = 0.008). Older participants were significantly more knowledgeable about the management of leftover food (mean 34.54 years vs 31.25 years; P = 0.014). Household food security status did not show any statistically significant association with any of the 5 food safety measures examined.

CONCLUSION: This study confirms the existence of suboptimal food safety knowledge and practices by almost half of the sample. There is therefore a need for evidence-based public health interventions to increase knowledge, and promote better practices, of safe food handling, thereby reducing the risk of foodborne diseases in Lebanon.

PMID:39764755 | DOI:10.26719/2024.30.12.837

East Mediterr Health J. 2024 Dec 18;30(12):821-828. doi: 10.26719/2024.30.12.821.

ABSTRACT

BACKGROUND: Child maltreatment is a global issue that significantly impacts children’s lives. In 2018, 32% of 15-year-olds in Albania reported experiencing physical abuse.

AIM: To assess the prevalence and sociodemographic correlates of child abuse and neglect in Albania.

METHODS: This was the 2022 Health Behaviour in School-aged Children nationwide survey in Albania conducted among 1877 schoolchildren (55% girls) aged 15 years. We collected data on sociodemographic characteristics, physical abuse, emotional abuse, sexual abuse, emotional neglect, and exposure to domestic violence. We analysed the data using SPSS version 19.0 and used binary logistic regression to assess associations between child abuse, neglect and sociodemographic characteristics.

RESULTS: Lifetime prevalence rates were 33.1% for physical abuse, 16.2% for emotional abuse, 3.7% for sexual abuse, 15.7% for emotional neglect, and 7.0% for witness to domestic violence. Children living in urban areas had higher odds of experiencing physical or emotional abuse (OR = 1.4 and 1.6, 95% CI = 1.1-1.7 and 1.2-2.2). Girls had higher odds of experiencing emotional abuse (OR = 1.8, 95% CI = 1.4-2.4) or emotional neglect (OR = 3.4, 95% CI = 2.5-4.6). Girls and children from less affluent families had lower odds of experiencing sexual abuse (OR = 0.6, 95% CI = 0.3-0.9; OR = 0.5, 95% CI = 0.3-0.8, respectively). Children whose fathers were unemployed had higher odds of witnessing domestic violence (OR = 1.9, 95% CI = 1.1-3.2).

CONCLUSION: Abuse and neglect are highly prevalent among Albanian children aged 15 years, raising concerns over their future wellbeing. Action is needed by professionals and caregivers and at policy level to mitigate the negative impact and promote children’s protection and well-being in the country.

PMID:39764753 | DOI:10.26719/2024.30.12.821

East Mediterr Health J. 2024 Dec 18;30(12):812-820. doi: 10.26719/2024.30.12.812.

ABSTRACT

BACKGROUND: Breast cancer is often thought to occur at a younger age among Arab women based on the mean or median age at diagnosis, or the proportion of women diagnosed with breast cancer at a young age.

OBJECTIVE: To compare age-specific breast cancer incidence rates among women from selected Arab countries with selected high- and middle-income countries.

METHODS: We examined population-based, age-specific, national or regional breast cancer incidence data for 2008-2012 and 2013-2017 from Australia, Brazil, Canada, Germany, Japan, United Kingdom, and United States of America, and compared them with data from Algeria, Bahrain, Jordan, Kuwait, Morocco, Qatar, and Saudi Arabia.

RESULTS: Breast cancer incidence among young women in the selected Arab countries was comparable to, or even lower than, the selected high- and middle-income countries. In contrast to the continued increase in rates observed in the high- and middle-income countries, the rates tended to plateau or decrease among older Arab women. Age-standardized incidence rates were lower than crude rates in the Arab countries.

CONCLUSION: We found no evidence that Arab women are at higher risk of developing breast cancer at a younger age. The high number of cases among them was probably due to the younger population structure. These findings are important for refining breast cancer screening policies in the region.

PMID:39764752 | DOI:10.26719/2024.30.12.812

Aliment Pharmacol Ther. 2025 Jan 7. doi: 10.1111/apt.18459. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in the United Kingdom and the second largest cause of cancer death.

AIM: To develop and validate a model using available information at the time of faecal immunochemical testing (FIT) in primary care to improve selection of symptomatic patients for CRC investigations.

METHODS: We included all adults (≥ 18 years) referred to Nottingham University Hospitals NHS Trust between 2018 and 2022 with symptoms of suspected CRC who had a FIT. Predicted 1-year CRC diagnosis were calculated, and externally validated, using Cox proportional hazards modelling with selected multiple fractional polynomial transformations for age, faecal haemoglobin concentration (f-Hb) value, mean corpuscular volume (MCV), platelet count and sex.

RESULTS: At a CRC risk threshold of 0.6% (equivalent to f-Hb = 10 μg Hb/g (μg/g)) overall performance of the validated model across age strata using Harrell’s C index was ≥ 0.91% (overall C-statistic 93%, 95% CI 92%-95%) with acceptable calibration. Using this model yields similar numbers of detected and missed cancers, but requires ~20% fewer investigations than a f-Hb ≥ 10 μg/g strategy. For approximately 100,000 people per year with symptoms of suspected CRC, we predict it might save > 4500 colonoscopies with no evidence that more cancers would be missed if we used our model compared to using FIT f-Hb ≥ 10 μg/g.

CONCLUSIONS: Including age, sex, MCV, platelets and f-Hb in a survival analysis model to predict the risk of CRC yields greater diagnostic utility than a simple binary cut off f-Hb ≥ 10 μg/g.

PMID:39764729 | DOI:10.1111/apt.18459

J Osteopath Med. 2025 Jan 8. doi: 10.1515/jom-2024-0158. Online ahead of print.

ABSTRACT

CONTEXT: The injuries caused by falls-from-height (FFH) are a significant public health concern. FFH is one of the most common causes of polytrauma. The injuries persist to be significant adverse events and a challenge regarding injury severity assessment to identify patients at high risk upon admission. Understanding the incidence and the factors that predict injury severity can help in developing effective intervention strategies. Artificial intelligence (AI) predictive models are emerging to assist in clinical assessment with challenges.

OBJECTIVES: This retrospective study investigated the incidence of FFH injuries utilizing conventional statistics and a predictive AI model to understand the fall-related injury profile and predictive factors.

METHODS: A total of 124 patients who sustained injuries from FFHs were recruited for this retrospective study. These patients fell from a height of 15-30 feet and were admitted into a level II trauma center at the border of US-Mexica region. A chart review was performed to collect demographic information and other factors including Injury Severity Score (ISS), Glasgow Coma Scale (GCS), anatomic injury location, fall type (domestic falls vs. border wall falls), and comorbidities. Multiple variable statistical analyses were analyzed to determine the correlation between variables and injury severity. A machine learning (ML) method, the multilayer perceptron neuron network (MPNN), was utilized to determine the importance of predictive factors leading to in-hospital mortality. The chi-square test or Fisher’s exact test and Spearman correlate analysis were utilized for statistical analysis for categorical variables. A p value smaller than 0.05 was considered to be statistically different.

RESULTS: Sixty-four (64/124, 51.6 %) patients sustained injuries from FFHs from a border wall or fence, whereas 60 (48.4 %) sustained injuries from FFHs at a domestic region including falls from roofs or scaffolds. Patients suffering from domestic falls had a higher ISS than border fence falls. The height of the falls was not significantly associated with injury severity, but rather the anatomic locations of injuries were associated with severity. Compared with border falls, domestic falls had more injuries to the head and chest and longer intensive care unit (ICU) stay. The MPNN showed that the factors leading to in-hospital mortality were chest injury followed by head injury and low GCS on admission.

CONCLUSIONS: Domestic vs. border FFHs yielded different injury patterns and injury severity. Patients of border falls sustained a lower ISS and more lower-extremity injuries, while domestic falls caused more head or chest injuries and low GCS on admission. MPNN analysis demonstrated that chest and head injuries with low GCS indicated a high risk of mortality from an FFH.

PMID:39764726 | DOI:10.1515/jom-2024-0158

J Osteopath Med. 2025 Jan 8. doi: 10.1515/jom-2024-0046. Online ahead of print.

ABSTRACT

CONTEXT: Point-of-care ultrasound (POCUS) has diverse applications across various clinical specialties, serving as an adjunct to clinical findings and as a tool for increasing the quality of patient care. Owing to its multifunctionality, a growing number of medical schools are increasingly incorporating POCUS training into their curriculum, some offering hands-on training during the first 2 years of didactics and others utilizing a longitudinal exposure model integrated into all 4 years of medical school education. Midwestern University Arizona College of Osteopathic Medicine (MWU-AZCOM) adopted a 4-year longitudinal approach to include POCUS education in 2017. There is a small body of published research supporting this educational model, but there is not much data regarding how this approach with ultrasound curriculum translates to real-world changes in POCUS use by graduate student clinicians having received this model of education.

OBJECTIVES: The objectives of this study are to determine the frequency of POCUS use by MWU-AZCOM graduates and to assess how a 4-year longitudinal ultrasound curriculum may enhance the abilities of MWU-AZCOM graduates to perform and interpret ultrasound imaging in specific residency programs.

METHODS: The study was approved by the MWU Institutional Review Board (#IRBAZ-5169, approval date October 3, 2022). An anonymous novel 12-question survey was conducted utilizing Research Electronic Data Capture (REDCap), a secure online platform, and distributed to MWU-AZCOM 2021 and 2022 graduates via email. Survey questions were aimed at assessing frequency of use, utilization of different imaging modalities, reasons for utilizing POCUS, barriers/enablers to utilizing POCUS, ultrasound training, and confidence in performing scans and interpreting POCUS imaging. All of the 104 surveys returned were included in the study. Statistical software R version 4.3 was utilized to conduct statistical analyses.

RESULTS: Of the 484 surveys distributed, 104 were completed (21.5 % response rate). Responses came from residents working in 14 different specialties, 50 in primary care and 54 in nonprimary care. Of all respondents, 85.6 % currently utilize POCUS in their practice on at least a monthly basis and 77.0 % believe that their POCUS training in medical school enriches their current practice in residency. The top five modalities utilized by residents were procedures (89.9 %), cardiac (88.8 %), pulmonary (82.0 %), Focused Assessment with Sonography for Trauma (FAST, 73.0 %), and vascular (71.9 %). Respondents recognized POCUS as a beneficial diagnostic tool (97.8 %) and reported enhancements in physical examination skills (58.4 %) and professional growth (61.8 %). Facilitators for POCUS adoption included cost-effectiveness (82.0 %), diagnostic differentiation (78.7 %), and safety (79.8 %). Barriers included a lack of trained faculty (27.9 %), absence of necessary equipment (26.9 %), and cost of equipment (22.1 %). Participants demonstrated high confidence levels in performing (74.0 %) and interpreting (76.0 %) POCUS, with 43.3 % believing that their POCUS training enhanced their attractiveness as residency candidates.

CONCLUSIONS: This study supports the positive impact of a 4-year longitudinal POCUS curriculum on graduates’ practice. It emphasizes the link between MWU-AZCOM’s curriculum and real-world clinical needs. Addressing identified barriers and advancing hands-on training can further enhance POCUS understanding, ensuring that future physicians are well-prepared to leverage its diagnostic potential across medical specialties.

PMID:39764717 | DOI:10.1515/jom-2024-0046

Genet Epidemiol. 2025 Jan;49(1):e22607. doi: 10.1002/gepi.22607.

ABSTRACT

Large-scale gene-environment interaction (GxE) discovery efforts often involve analytical compromises for the sake of data harmonization and statistical power. Refinement of exposures, covariates, outcomes, and population subsets may be helpful to establish often-elusive replication and evaluate potential clinical utility. Here, we used additional datasets, an expanded set of statistical models, and interrogation of lipoprotein metabolism via nuclear magnetic resonance (NMR)-based lipoprotein subfractions to refine a previously discovered GxE modifying the relationship between physical activity (PA) and HDL-cholesterol (HDL-C). We explored this GxE in the Women’s Genome Health Study (WGHS; N = 23,294; the strongest cohort-specific signal in the original meta-analysis), the UK Biobank (UKB; N = 281,380), and the Multi-Ethnic Study of Atherosclerosis (MESA; N = 4587), using self-reported PA (MET-min/wk) and genotypes at rs295849 (nearest gene: LHX1). As originally reported, minor allele carriers of rs295849 in WGHS had a stronger positive association between PA and HDL-C (p_int = 0.002). When testing available NMR metabolites to refine the HDL-C outcome, we found a stronger interaction effect on medium-sized HDL particle concentrations (M-HDL-P; p_int = 1.0 × 10^-4) than HDL-C. Meta-regression revealed a systematically larger interaction effect in cohorts from the original meta-analysis with a greater fraction of women (p = 0.018). In the UKB, GxE effects were stronger in women and using M-HDL-P as the outcome. In MESA, the primary interaction for HDL-C showed nominal significance (p_int = 0.013), but without clear sex differences and with a greater magnitude for large HDL-P. Our work provides additional insights into a known gene-PA interaction while illustrating the importance of phenotype and model refinement toward understanding and replicating GxEs.

PMID:39764704 | DOI:10.1002/gepi.22607

Eur J Orthod. 2024 Dec 4;47(1):cjae077. doi: 10.1093/ejo/cjae077.

ABSTRACT

BACKGROUND/OBJECTIVES: Evidence suggests nasal airflow resistance reduces after rapid maxillary expansion (RME). However, the medium-term effects of RME on upper airway (UA) airflow characteristics when normal craniofacial development is considered are still unclear. This retrospective cohort study used computer fluid dynamics (CFD) to evaluate the medium-term changes in the UA airflow (pressure and velocity) after RME in two distinct age-based cohorts.

MATERIALS/METHODS: The study included 48 subjects who underwent RME divided into two cohorts: a 6-9-year-old group (EEG group: early expansion group – 25 subjects) and an 11-14-year-old group (LEG group: late expansion group – 23 subjects). The nasal cavity and pharyngeal anatomy were segmented from Cone-beam computed tomography reconstructions taken before RME (T0) and 12 after RME (T1). The two UA airflow variables (pressure and velocity) were simulated using CFD. The maxillary expansion (PW) amount, two cross-sectional area measurements (CS1 = anterior cross-section and CS2 = posterior cross-section), and four UAs’ subregions (NC = nasal cavity, PAtotal = pharyngeal airway, NP = nasopharynx, VP = velopharynx, and OP = Oropharynx) were also considered. All data were statistically analyzed.

RESULTS: At the baseline, the airflow pressure, velocity, and noted obstructions were significantly higher in the EEG compared to LEG. At T1, there was a significant improvement in the median airway parameters in both groups, which was remarkably greater in the EEG. A significant negative correlation was found between pressure/velocity and both CS2 and NP. According to the CFD plots, the airflow pressure and velocity changes could be attributed to the reduction of the adenotonsillar tissues’ sizes, which were remarkably more marked in the EEG.

LIMITATIONS: The results of this study cannot be generalized since they referred to a retrospective orthodontic sample without obstructive adenotonsillar hypertrophy.

CONCLUSIONS/IMPLICATIONS: Twelve months after RME, normal craniofacial developmental changes and spontaneous adenotonsillar tissues volume regression could represent the most significant factors influencing UA airflow changes.

PMID:39764702 | DOI:10.1093/ejo/cjae077

Macromol Biosci. 2025 Jan 7:e2400429. doi: 10.1002/mabi.202400429. Online ahead of print.

ABSTRACT

Invasive fungal infections cause over 3.7 million deaths worldwide annually, underscoring the critical need for new antifungal agents. Developing selective antifungal agents is challenging due to the shared eukaryotic nature of both fungal and mammalian cells. Toward addressing this, synthetic polymers designed to mimic host defense peptides are promising new candidates for combating fungal infections. This study investigates well-defined multiblock terpolymers with specific arrangements of cationic, hydrophobic, and hydrophilic groups, as potential antifungal agents. The block sequence in these copolymers significantly impacts their minimum inhibition concentration (MIC) against Candida albicans and biocompatibility. Furthermore, compared to their statistical counterparts, these block polymers exhibit lower MIC values in certain instances. Notably, triblock terpolymers containing a central hydrophobic block present an enhanced antifungal efficacy and biocompatibility. These findings highlight the potential of block sequence-controlled polymers as a versatile platform for developing customized and targeted antifungal therapies.

PMID:39764700 | DOI:10.1002/mabi.202400429