Nevin Manimala

BMC Public Health. 2025 Jan 4;25(1):32. doi: 10.1186/s12889-024-21224-y.

ABSTRACT

CONTEXT: Anemia is a medical condition resulting from a reduction in the number of red blood cells below the reference range. It is a major public health problem, particularly among adolescents, as it can have negative effects on cognitive performance, growth and reproduction. This study aims to assess the determinants of anemia among adolescents in schools in the city of Douala.

METHODS: A cross-sectional study was carried out among 511 adolescents aged 10-15 years, selected by random sampling from four secondary schools in Douala. Data were collected using a structured questionnaire, including anthropometric measurements and hemoglobin tests to assess anemia. Anemia was defined according to specific thresholds (e.g. hemoglobin < 12 g/dL for girls and < 13 g/dL for boys). Severity was classified as mild, moderate and severe. Multiple logistic regression analysis was performed to identify determinants of anemia, controlling for confounding variables, and associations were established by calculating Odds ratios, Odds ratio adjusts, confidence intervals and P-value. Statistical significance was declared at P < 0.05.

RESULTS: The mean age of participants was 11.9 ± 1.30 years, with a slight predominance of girls (50.7%) over boys (49.3%). The prevalence of anemia was 40.3% (95% CI: 35.0-45.6%), including 15.7% mild anemia (95% CI: 12.0-19.4%), 23.9% moderate anemia (95% CI: 19.7-28.1%) and 0.7% severe anemia (95% CI: 0.1-2.7%). Independent determinants of anemia included rural residence [AOR = 8.39 (95% CI: 5.26-13.65); p < 0.001], status of parents divorced [OR = 2.60 (95% CI: 1.57- 4.34); p = 0.0001] or deceased [AOR = 7.73 (95% CI: 1.65- 41.90); p = 0.011], onset of first menstrual period [AOR = 6.59 (95% CI: 2.28-72.19); p = 0.001], the absence of iron supplementation [AOR = 1.68 (95% CI: 1.04-2.74; p = 0.034] and the occurrence of an illness in the previous three months (malaria, sickle cell disease, viral hepatitis, amoebiasis, typhoid fever, etc.) [AOR = 3.24 (95% CI: 1.14-22.37); p = 0.012].

CONCLUSIONS: This study highlights a worrying prevalence of anemia among adolescents in Douala, with clearly identified determinants. The results underline the importance of factors such as rural residence, parental status and menarche, which can inform public health policies. It is essential to integrate these elements into targeted intervention programs, particularly in nutrition and iron supplementation, especially in rural areas. Finally, longitudinal studies and intervention-based research are needed to better understand the causal mechanisms of adolescent anemia in this context.

PMID:39754141 | DOI:10.1186/s12889-024-21224-y

Int J Behav Nutr Phys Act. 2025 Jan 3;22(1):2. doi: 10.1186/s12966-024-01699-z.

ABSTRACT

BACKGROUND: Effective evidence-based physical activity and nutrition interventions to prevent overweight and obesity and support healthy child development need to be sustained within Early Childhood Education and Care (ECEC) services. Despite this, little is known about factors that influence sustainability of these programs in ECEC settings. Therefore, the aim of this study was to describe the factors related to sustainability of physical activity and nutrition interventions in ECEC settings and examine their association with ECEC service characteristics.

METHODS: A cross-sectional study was undertaken with a nationally representative sample of 473 Australian ECEC services. Factors related to the sustainability of ECEC-based physical activity and nutrition interventions were assessed using the validated Integrated Measure of PRogram Element SuStainability in Childcare Settings (IMPRESS-C), measuring Outer Contextual Factors, Inner Contextual Factors, Processes and Characteristics of the Intervention domains for interventions that supervisors reported as currently implementing. Participants responded using a 5-point Likert scale, with responses ranging from 1 (completely disagree) to 5 (completely agree). Domain scores were calculated for each service by averaging item responses. Linear regression models between ECEC service characteristics and the IMPRESS-C domains were undertaken.

RESULTS: Data from 473 Australian childcare services nationally found that the domains: Processes ( $\overline{x}$ =3.78, SD = 0.64), consisting of partnership/engagement and training/support/supervision; and Outer Contextual Factors ( $\overline{x}$ =3.93, SD = 0.63), including policy and legislation, and socio-political context had the lowest mean scores indicating they may likely be barriers to sustainability. Linear regression analyses revealed no statistically significant associations between examined factors and ECEC service characteristics. There was a statistically significant association between the number of years services delivered their interventions and the Characteristics of the Intervention domain (p = 0.035) suggesting that this domain may influence sustainability of programs.

CONCLUSIONS: This study suggests that factors related to the Processes and Outer Contextual Factors domains had the lowest scores and as such, strategies to support the sustainability of physical activity and nutrition interventions implemented in ECEC settings may need to consider how to best address these factors.

PMID:39754137 | DOI:10.1186/s12966-024-01699-z

J Cardiothorac Surg. 2025 Jan 3;20(1):3. doi: 10.1186/s13019-024-03218-4.

ABSTRACT

BACKGROUND: Despite the promising results of both MitraClip and PASCAL systems for the treatment of mitral regurgitation (MR), there is limited data on the comparison of both systems regarding their safety and efficacy. We aim to compare both systems for MR.

MATERIALS AND METHODS: Five databases were searched until October 2024. Original studies were only included and critically appraised using an adapted version of the Newcastle-Ottawa scale for observational cohort studies and the Cochrane risk of bias tool for randomized controlled trials. The risk ratio (RR) and mean difference (MD) with their corresponding 95% confidence interval (95% CI).

RESULTS: From the database search, we identified 197 studies, of which eight studies comprising 1,612 patients who underwent transcatheter edge-to-edge repair with either MitraClip or PASCAL were included in this meta-analysis. The statistical analysis revealed no significant difference between the two devices in achieving a two-grade reduction in MR severity (RR = 0.95; 95% CI: [0.86, 1.04]; p = 0.28), one-grade reduction (RR = 1.17; 95% CI: [0.92, 1.49]; p = 0.19), or in cases with no improvement (RR = 1.23; 95% CI: [0.79, 1.90]; p = 0.36). Additionally, there were no significant differences between PASCAL and MitraClip regarding procedure time, procedural success, reinterventions, or all-cause mortality. However, PASCAL trended towards better residual MR reduction, although this was accompanied by moderate heterogeneity. Both devices demonstrated comparable safety profiles and were effective in reducing MR and improving cardiac function.

CONCLUSION: MitraClip and PASCAL devices showed comparable safety profiles and procedural success rates. However, the analysis did not reveal a statistically significant difference between the two devices in reducing the severity of MR.

PMID:39754135 | DOI:10.1186/s13019-024-03218-4

Arch Immunol Ther Exp (Warsz). 2025 Jan 3;73(1). doi: 10.2478/aite-2025-0002. eCollection 2025 Jan 1.

ABSTRACT

Systemic lupus erythematosus (SLE) is an autoimmune disease whose pathogenesis is not fully understood to date. One of the suggested mechanisms for its development is NETosis, which involves the release of a specific network consisting of chromatin, proteins, and enzymes from neutrophils, stimulating the immune system. One of its markers is citrullinated histone H3 (H3Cit). This study aimed to evaluate the correlation of H3Cit levels with the clinical characteristics of 80 SLE patients. Levels of H3Cit in the subjects’ serum were quantified spectrophotometrically. Statistical analysis was performed using MedCalc 15.8 and Statistica 13.3. Significantly higher H3Cit levels were found in patients with arthralgia (medians [interquartile range] [IQR]: 1.67 [1.67-1.69] vs. 1.67 [1.62-1.68], p = 0.0150, respectively) and reduced complement component C4 levels compared to patients without these conditions (medians [IQR]: 1.68 [1.67-1.70] vs. 1.68 [1.67-1.69], p = 0.0297, respectively). A significant weak negative correlation was observed between H3Cit levels and leukocytosis (rho = -0.2602, p = 0.0309) and reduced complement component C3 levels (rho = -0.2442, p = 0.0447) and a weak positive correlation with anti-double stranded DNA (anti-dsDNA) antibody levels (rho = 0.3794, p = 0.0036). Moreover, the clinical utility of the H3Cit assay in differentiating patients with arthralgia (area under the curve [AUC] = 0.709, p = 0.0115), seizures (AUC = 0.813, p = 0.0005), hepatomegaly (AUC = 0.746, p = 0.0111), and reduced levels of complement component C4 (AUC = 0.662, p = 0.0224) and without the above conditions was noted.

PMID:39752730 | DOI:10.2478/aite-2025-0002

J Med Internet Res. 2025 Jan 3;27:e52083. doi: 10.2196/52083.

ABSTRACT

BACKGROUND: Suicide is a critical public health issue in adolescents worldwide. Internet addiction may play a role in the increased rate of suicide attempts in this population. However, few studies have explored the relationship between pathological internet use and suicide attempts among adolescents.

OBJECTIVE: This study aimed to conduct a prospective cohort study to examine whether higher severity of pathological internet use was associated with an increased risk of suicide attempts among Chinese adolescents.

METHODS: A total of 782 adolescents were recruited from a middle school from November 2020 to December 2020 and followed up for 6 months. An online self-reported questionnaire was used to collect the participants’ demographic data and assess their mental health. The Depression, Anxiety, and Stress Scale-21 items (DASS-21) was used to evaluate depression, anxiety, and stress. The Chen Internet Addiction Scale-Revised (CIAS-R) was used to assess the symptoms and severity of pathological internet use. χ² test and ANOVA were used for intergroup comparison, and logistic regression analysis was used to examine the relationship between the severity of pathological internet use and suicide attempts. We also used a restricted cubic splines model to investigate the pattern of the association.

RESULTS: The participants had an average age of 12.59 (SD 0.64) years, with the majority being of Han ethnicity (743/782, 95.01%) and more than half being male (426/782, 54.48%). Most participants had no previous history of depression (541/782, 69.18%), anxiety (415/782, 53.07%), or stress (618/782, 79.03%). The rate of newly reported suicide attempts was 4.6% (36/782). A significant positive association was observed between internet addiction and suicide attempts (odds ratio 3.88, 95% CI 1.70-8.82), which remained significant after adjusting for age, sex, ethnicity, anxiety, depression, and stress (odds ratio 2.65, 95% CI 1.07-6.55). In addition, this association exhibited a linear pattern in the restricted cubic spline regression model.

CONCLUSIONS: This study suggested that internet addiction, rather than internet overuse, was associated with a higher likelihood of suicide attempts, which highlighted the importance of addressing internet addiction symptoms among Chinese adolescents for suicide prevention.

PMID:39752720 | DOI:10.2196/52083

JMIR Res Protoc. 2025 Jan 3;14:e64871. doi: 10.2196/64871.

ABSTRACT

BACKGROUND: Cancer is a leading cause of global mortality, accounting for nearly 10 million deaths in 2020. This is projected to increase by more than 60% by 2040, particularly in low- and middle-income countries. Yet, palliative and psychosocial oncology care is very limited in these countries.

OBJECTIVE: This study describes a protocol for the development, implementation, and evaluation of a psychosocial oncology and palliative care course on Cameroonian practicing nurses’ knowledge, self-perceived competence, and confidence in palliative and psychosocial oncology care provision for patients with cancer.

METHODS: A single group pre-posttest design, incorporating both quantitative and qualitative methods will be used. First, a psychosocial oncology and palliative care course for practicing nurses in Cameroon will be developed. This course will then be implemented with 50 practicing nurses purposefully selected from 2 oncology units in the Littoral region and 4 hospitals in the Southwest region of Cameroon. Finally, to assess the impact of the training program we will undertake a pre and posttest survey of nurses’ palliative and psychosocial oncology competences, a pre and post training audit of patients’ nursing records to examine nurses’ practice of palliative and psychosocial oncology care and undertake a critical-incident interview of nurses’ transfer of learning to practice. Descriptive and inferential statistics will be used to analysis quantitative data, while qualitative data will be analyzed using the framework approach.

RESULTS: This study was funded in September 2023. The training program development was initiated in March 2024 and completed in June 2024. Baseline data collection commenced in May 2024 and as of September 2024, we had collected data from 300 patient record. Training implementation is planned for October-December 2024, and post intervention data will be started in October 2024 and continue till April 2025. Data analysis will commence in October 2024 and we aim to publish study findings in peer review journals by November 2025.

CONCLUSIONS: This study will improve our understanding of Cameroonian nurses’ palliative and psychosocial oncology competency gaps. It will result in the development of a palliative care and psychosocial oncology course and in the training of 50 nurses in psychosocial oncology and palliative care in Cameroon. This study will inform strategies for future psychosocial oncology and palliative care training initiatives in Cameroon and other low- and middle-income countries.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/64871.

PMID:39752719 | DOI:10.2196/64871

J Neurosurg Pediatr. 2025 Jan 3:1-6. doi: 10.3171/2024.10.PEDS24228. Online ahead of print.

ABSTRACT

OBJECTIVE: Intraventricular baclofen (IVB) administration is used for the treatment of secondary dystonia associated with cerebral palsy (CP), but it has not been reported as a first-line infusion technique for spasticity. In this study, the authors report outcomes of patients with mixed or isolated spasticity treated with IVB administration.

METHODS: A retrospective analysis was performed of consecutive patients treated with IVB between 2019 and 2023. Demographics, baseline clinical variables, and complications data were collected. The primary outcome of the study was the change in spasticity and dystonia as measured by the modified Ashworth Scale (MAS) and Barry-Albright Dystonia Scale (BADS) scores, respectively. Wilcoxon rank-sum tests were performed to compare the change in the pre- and postoperative scores.

RESULTS: Fifteen patients were implanted with IVB pumps for spasticity related to CP between 2019 and 2023. The median change in the MAS score was 2 (interquartile range [IQR] = 1) and the median change in the BADS score was 1 (IQR = 2). The Wilcoxon rank-sum test revealed a statistically significant change in both scores following IVB pump placement (BADS z = 2.90, p = 0.003; MAS z = 3.2, p = 0.001). Three patients (20%) experienced minor perioperative complications, all of which were self-limiting and none required additional surgery.

CONCLUSIONS: This study reported on 15 cases of mixed or isolated spasticity and showed a relative improvement in the MAS and BADS scores after IVB pump placement. These results provide evidence that IVB can be a safe and effective treatment for spasticity-related CP in addition to dystonia. IVB may be advantageous when an intraventricular route of baclofen administration is preferred.

PMID:39752717 | DOI:10.3171/2024.10.PEDS24228

Phys Rev Lett. 2024 Dec 20;133(25):257401. doi: 10.1103/PhysRevLett.133.257401.

ABSTRACT

The random-energy model (REM), a solvable spin-glass model, has impacted an incredibly diverse set of problems, from protein folding to combinatorial optimization, to many-body localization. Here, we explore a new connection to secret sharing. We derive an analytic expression for the mutual information between any two disjoint thermodynamic subsystems of the REM. Our analyses reveal that the correlations in the REM exhibit extreme synergy, equivalent to that in a secure secret-sharing scheme. We formulate a secret-sharing scheme based on the REM and determine the ranges of temperatures and secret lengths over which the REM satisfies the requirement of secure secret sharing. We show further that a special point in the phase diagram exists at which the REM-based scheme is physically optimal in its information encoding. Our results for the thermodynamic limit are in good qualitative agreement with numerical simulations of finite systems, for which the strict security requirement is replaced by a tradeoff between secrecy and recoverability. Our work offers a new language to characterize synergistic correlations in many-body systems and a further example of information theory as a unifying concept, connecting problems in statistical physics to those in computation.

PMID:39752688 | DOI:10.1103/PhysRevLett.133.257401

Phys Rev Lett. 2024 Dec 20;133(25):251003. doi: 10.1103/PhysRevLett.133.251003.

ABSTRACT

We investigate the implications of the baryon acoustic oscillations measurement released by the Dark Energy Spectroscopic Instrument for interacting dark energy (IDE) models characterized by an energy-momentum flow from dark matter to dark energy. By combining Planck-2018 and Dark Energy Spectroscopic Instrument data, we observe a preference for interactions, leading to a nonvanishing interaction rate ξ=-0.32_{-0.14}^{+0.18}, which results in a present-day expansion rate H_{0}=70.8_{-1.7}^{+1.4} km/s/Mpc, reducing the tension with the value provided by the SH0ES Collaboration to less than ∼1.3σ. The preference for interactions remains robust when including measurements of the expansion rate H(z) obtained from the relative ages of massive, early-time, and passively evolving galaxies, as well as when considering distance moduli measurements from Type Ia supernovae sourced from the Pantheon-plus catalog using the SH0ES Cepheid host distances as calibrators. Overall, the IDE framework provides an equally good, or better, explanation of both high- and low-redshift background observations compared to the lambda cold dark matter model, while also yielding higher H_{0} values that align more closely with the local distance ladder estimates. However, a limitation of the IDE model is that it predicts lower Ω_{m} and higher σ_{8} values, which may not be fully consistent with large-scale structure data at the perturbation level.

PMID:39752687 | DOI:10.1103/PhysRevLett.133.251003

J Med Internet Res. 2025 Jan 3;27:e52786. doi: 10.2196/52786.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a common complication in hospitalized older patients, associated with increased morbidity, mortality, and health care costs. Major adverse kidney events within 30 days (MAKE30), a composite of death, new renal replacement therapy, or persistent renal dysfunction, has been recommended as a patient-centered endpoint for clinical trials involving AKI.

OBJECTIVE: This study aimed to develop and validate a machine learning-based model to predict MAKE30 in hospitalized older patients with AKI.

METHODS: A total of 4266 older patients (aged ≥ 65 years) with AKI admitted to the Second Xiangya Hospital of Central South University from January 1, 2015, to December 31, 2020, were included and randomly divided into a training set and an internal test set in a ratio of 7:3. An additional cohort of 11,864 eligible patients from the Medical Information Mart for Intensive Care Ⅳ database served as an external test set. The Boruta algorithm was used to select the most important predictor variables from 53 candidate variables. The eXtreme Gradient Boosting algorithm was applied to establish a prediction model for MAKE30. Model discrimination was evaluated by the area under the receiver operating characteristic curve (AUROC). The SHapley Additive exPlanations method was used to interpret model predictions.

RESULTS: The overall incidence of MAKE30 in the 2 study cohorts was 28.3% (95% CI 26.9%-29.7%) and 26.7% (95% CI 25.9%-27.5%), respectively. The prediction model for MAKE30 exhibited adequate predictive performance, with an AUROC of 0.868 (95% CI 0.852-0.881) in the training set and 0.823 (95% CI 0.798-0.846) in the internal test set. Its simplified version achieved an AUROC of 0.744 (95% CI 0.735-0.754) in the external test set. The SHapley Additive exPlanations method showed that the use of vasopressors, mechanical ventilation, blood urea nitrogen level, red blood cell distribution width-coefficient of variation, and serum albumin level were closely associated with MAKE30.

CONCLUSIONS: An interpretable eXtreme Gradient Boosting model was developed and validated to predict MAKE30, which provides opportunities for risk stratification, clinical decision-making, and the conduct of clinical trials involving AKI.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200061610; https://tinyurl.com/3smf9nuw.

PMID:39752664 | DOI:10.2196/52786