Nevin Manimala

BMC Public Health. 2024 Dec 25;24(1):3584. doi: 10.1186/s12889-024-21154-9.

ABSTRACT

BACKGROUND: Women’s decision-making power on contraceptive use is crucial for increasing modern contraceptive uptake. However, evidence in Ethiopia regarding this topic is limited and inconclusive.

OBJECTIVE: To assess the prevalence and factors associated with women’s decision-making power on modern contraceptive use in Girawa district, Eastern Ethiopia, January 1-30, 2024.

METHOD: A community-based cross-sectional study was conducted among 510 married contraceptive users in Girawa district selected through multistage sampling. Descriptive statistics and logistic regression analyses were employed. The questionnaire was developed reviewing different literature, and pretested before actual data collection. Trained data collectors were collected the data. Face-to-face interview was conducted to collect data from study participants. Data cleaned and entered to Epidata, transferred to SPSS version 20 for analysis. Descriptive statistics were computed for all variables and the results were presented using frequency, tables and percentages. Using binary logistic regression, bivariate analysis was conducted to recruit variables for multivariable analysis at p-value of less than 0.25. Then multivariable analysis was conducted to control confounding variables. The strength of associations of variables was reported using odds ratio, with its 95% confidence interval, and p-value less than 0.05 used to declare significant association of explanatory with outcome variable.

RESULTS: The prevalence of women’s decision-making power on modern contraceptive use was 78% (95%CI: 74.4, 81.6). Factors significantly associated with increased decision-making power included: women’s education (primary: AOR = 10.51[5.37, 20.56]; secondary and above: AOR = 2.58[1.35, 4.93]), husband’s education (primary: AOR = 2.53[1.33, 4.81]; secondary and above: AOR = 2.25[1.08, 4.68]), government employment (AOR = 5.29[1.44, 19.57]), ANC visits (1-3: AOR = 2.16[1.18, 3.95]; ≥4: AOR = 1.86[1.85, 4.05]), positive attitude (AOR = 2.83[1.28, 6.25]), and good knowledge about modern contraceptives (AOR = 3.67[1.78, 7.56]).

CONCLUSION: Three in four married women in Girawa district have decision-making power on modern contraceptive use. Education, employment, Antenatal care (ANC) utilization, positive attitudes, and good knowledge about contraceptives were associated with increased decision-making power. Interventions targeting these factors could further empower women in contraceptive decision-making.

PMID:39722021 | DOI:10.1186/s12889-024-21154-9

BMC Public Health. 2024 Dec 26;24(1):3587. doi: 10.1186/s12889-024-20926-7.

ABSTRACT

BACKGROUND: Terpenes have been shown to have an effect on metabolic status. However, it is unclear how they are associated with the metabolic syndrome (MetS) and whether insulin resistance (IR) mechanisms are involved.

METHODS: This cross-sectional study included data from the National Health and Nutrition Examination Survey (2013-2014). Serum terpenes (α- pinene, β- pinene, and limonene) were quantified by gas chromatography-tandem mass spectrometry. MetS was diagnosed by lipid, glucose, blood pressure, and waist circumference criteria. IR status was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR) model and triglyceride-glucose index. Regression analysis models, mixed-effects models (weighted quantile sum regression models, quantile g-computation and Bayesian Kernel machine regression models), and mediation analysis were used for analysis.

RESULTS: Among 1563 U.S. general population (mean age 39.0 years), 447 (28.6%) had a diagnosis of MetS, and the median concentration was 0.08 ng/mL for α- pinene, 0.08 ng/mL for β- pinene, and 1.18 ng/mL for limonene. The terpene mixture showed positive joint association with MetS (OR = 1.454, 95%CI = 1.153, 1.833) and HOMA-IR (β = 0.569, 95%CI = 0.196, 0.942), with limonene contributing relatively large weights in both MetS (41.1%) and HOMA-IR (68.9%). Furthermore, HOMA-IR was positively associated with MetS (OR = 2.299, 95%CI = 1.888, 2.817) and its diagnostic components. When identified as a mediator, HOMA-IR accounted for approximately 15.8%, 20.0%, and 14.3% of the indirect effects between terpenes (α- pinene, β- pinene, and limonene) and MetS, respectively. The results were consistent when the IR biomarker was replaced by triglyceride-glucose index.

CONCLUSION: Serum terpenes were positively associated with MetS, which might be partially mediated by the mechanism of IR.

PMID:39722019 | DOI:10.1186/s12889-024-20926-7

Crit Care. 2024 Dec 25;28(1):432. doi: 10.1186/s13054-024-05220-7.

ABSTRACT

BACKGROUND: Sepsis is the result of a dysregulated immune response to infection and is associated with acute organ dysfunction. The syndrome’s complexity is contingent upon the underlying pathology and individual patient characteristics, including their immune response. The involvement of multiple organs and physiological functions adds complexity, with “organ cross-talk” emerging as a pivotal pathophysiological and clinical aspect. This narrative review to evaluate the rationale and available clinical evidence supporting the use of extracorporeal blood purification therapies as adjunctive therapy in patients with sepsis and septic shock.

MAIN BODY: A search of the PubMed, Embase, Web of Science and Scopus databases for relevant literature from August 2002 to May 2024 has been conducted. The search was performed using the terms: 1) “blood purification” or “hemadsorption” or “plasma exchange” AND 2) “sepsis” or “septic shock”. Therefore the authors have focused our discussion on several key areas such as conducting well-designed trials, developing more personalized protocols, ensuring optimal management and monitoring.

CONCLUSIONS: Given the heterogeneity of patients with sepsis, conducting traditional randomized clinical trials in this domain can be a daunting task. However, statistical techniques such as Bayesian methods, propensity score analysis, and emulated clinical trials using clinical databases hold promise for enhancing comparability between the study groups. Indeed, to comprehend the clinical efficacy of extracorporeal blood purification techniques in patients with sepsis, it is imperative to assemble homogeneous groups of patients receiving uniform treatments. Clinical strategies should be individualized, signaling the end of the “one size fits all” approach in sepsis therapy and the need for personalized treatments.

PMID:39722012 | DOI:10.1186/s13054-024-05220-7

BMC Infect Dis. 2024 Dec 25;24(1):1462. doi: 10.1186/s12879-024-10352-w.

ABSTRACT

BACKGROUND: Long-acting injectable antiretrovirals (LAI-ARVs) for HIV prevention and treatment have been demonstrated in clinical trials to be non-inferior to daily oral medications, providing an additional option to help users overcome the challenges of daily adherence. Approval and implementation of these regimens in low- and middle-income settings have been limited.

METHOD: This study describes the anticipated barriers and facilitators to implementing LAI-ARVs in Vietnam to inform future roll-out. From July to August 2022, we conducted 27 in-depth interviews with healthcare workers and public health stakeholders involved in HIV programs at national, provincial, and clinic levels across four provinces in Vietnam. The interviews followed a semi-structured questionnaire and were audio recorded. Data were analyzed using a rapid thematic analysis approach to identify facilitators and barriers to the adoption of LAI-ARVs.

RESULTS: In total, 27 participants from 4 provinces were interviewed including 14 (52%) men and 13 (48%) women. Participants median age was 48 years and they had 11.5 years of experience with HIV services and programs. Perceived user-level facilitators included the greater convenience of injectables in comparison to oral regimens, while barriers included the increased frequency of visits, fear of pain and side effects, and cost. Clinic-level facilitators included existing technical capacity to administer injections and physical storage availability in district health centers, while barriers included lack of space and equipment for administering injections for HIV-related services, concerns about cold chain maintenance for LAI-ART, and workload for healthcare workers. Health system-level facilitators included existing mechanisms for medication distribution, while barriers included regulatory approval processes and concerns about supply chain continuity.

CONCLUSION: Overall, participants were optimistic about the potential impact of LAI-ARVs but highlighted important considerations at multiple levels needed to ensure successful implementation in Vietnam.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:39722011 | DOI:10.1186/s12879-024-10352-w

BMC Res Notes. 2024 Dec 25;17(1):385. doi: 10.1186/s13104-024-07068-0.

ABSTRACT

OBJECTIVE: Hypertension exerts a substantial financial burden on individuals, families, communities, and the health system of a country. The current study aimed to describe the association of hypertension with its main risk factors in the Afghan population living in Kandahar city.

RESULTS: The prevalence of tobacco smoking, naswar use, physical activity and a healthy diet was 22%, 55%, 63.9% and 33.6%, respectively, in men, while in women, the prevalence was 4.8%, 6.5%, 57.6% and 13.5%, respectively. The prevalence of hypertension was 28.2% and 23.9% in men and women, respectively. Hypertension was associated with age greater than 45 years [aOR (95% CI) = 2.13 (1.56-2.91)], widows [aOR (95% CI) = 1.91 (1.25-2.91)], medium and high monthly income [aOR (95% CI) = 3.45 (2.33-5.10) and aOR (95% CI) = 2.34 (1.50-3.64)], high physical activity [aOR (95% CI) = 1.72 (1.15-2.56)], obesity [aOR (95% CI) = 1.64 (1.16-2.34)] and family history of hypertension [aOR (95% CI) = 4.70 (2.44-9.04)]. Naswar use is more prevalent than tobacco smoking among urban residents from Kandahar province. Improved monitoring and control of risk factors for hypertension are required in all regions of Afghanistan.

PMID:39722005 | DOI:10.1186/s13104-024-07068-0

Malar J. 2024 Dec 26;23(1):401. doi: 10.1186/s12936-024-05215-3.

ABSTRACT

BACKGROUND: The national malaria control programmes in Cambodia, Nepal, and Bhutan aim to achieve malaria elimination by 2025-2030. While the vivax malaria burden remains challenging, the consistent decline in falciparum malaria in these countries over the last five years suggests that the goal is achievable. However, unexpected cases in previously falciparum malaria-free districts continue to occur. A virtual meeting was convened in May 2024, followed by smaller meetings, to discuss and share experiences among regional partners, focusing on falciparum malaria elimination.

MAIN TEXT: The discussion among regional partners from these three countries was prompted by an isolated outbreak of falciparum malaria in April 2022 in a previously malaria-free district in Pursat province, Cambodia. The National Center for Parasitology, Entomology and Malaria Control (CNM) worked with stakeholders to contain the outbreak, which was likely to have originated in forest goers. Community-based village malaria workers (VMWs) were augmented with the additional resources required to test and treat malaria among forest goers under the supervision of health centres and district hospitals. This response rapidly reduced malaria cases in the subsequent months. Regional partners from Nepal and Bhutan, who are also engaged in the final phase of malaria elimination, reported that isolated malaria outbreaks in their countries were not unusual and were mostly imported from a neighbouring country, India. Importation of cases was facilitated by unsupervised transborder travel including the movement of migrant workers. The imported cases were only established during the case investigation such as when responding to the isolated outbreaks. In contrast, in Cambodia, spread of malaria was known to be facilitated by mobile and migrant workers, and forest goers within the country. The specific differences between Nepal and Bhutan (South Asia), and Cambodia (Greater Mekong Subregion) offered insights into strategies for malaria elimination. A relevant component for countries embarking on malaria elimination included strengthening of local malaria surveillance and response in collaboration with the community health workers, and community members targeting the ‘at risk’ population.

CONCLUSION: In countries approaching malaria elimination, resourcing community-based health workers could play a critical role in enhancing malaria surveillance, early case detection and treatment, including interventions targeting migrant populations such as forest goers and seasonal migrant workers.

PMID:39722002 | DOI:10.1186/s12936-024-05215-3

Vis Neurosci. 2024 Dec 26;41:E008. doi: 10.1017/S0952523824000051.

ABSTRACT

Sparse coding theories suggest that the visual brain is optimized to encode natural visual stimuli to minimize metabolic cost. It is thought that images that do not have the same statistical properties as natural images are unable to be coded efficiently and result in visual discomfort. Conversely, artworks are thought to be even more efficiently processed compared to natural images and so are esthetically pleasing. This project investigated visual discomfort in uncomfortable images, natural scenes, and artworks using a combination of low-level image statistical analysis, mathematical modeling, and EEG measures. Results showed that the model response predicted discomfort judgments. Moreover, low-level image statistics including edge predictability predict discomfort judgments, whereas contrast information predicts the steady-state visually evoked potential responses. In conclusion, this study demonstrates that discomfort judgments for a wide set of images can be influenced by contrast and edge information, and can be predicted by our models of low-level vision, whilst neural responses are more defined by contrast-based metrics, when contrast is allowed to vary.

PMID:39721939 | DOI:10.1017/S0952523824000051

Int Dent J. 2024 Dec 24:S0020-6539(24)01600-9. doi: 10.1016/j.identj.2024.11.013. Online ahead of print.

ABSTRACT

OBJECTIVES: Periodontal ligament stem cells (PDLSCs) are promising for regenerative therapies due to their self-renewal and multilineage differentiation, essential for periodontal tissue repair. Although magnesium plays a vital role in bone metabolism, its specific effects on PDLSCs and potential applications in regeneration are unclear. This study aimed to investigate the effects of magnesium chloride (MgCl₂) on the proliferation and osteogenic differentiation of human PDLSCs (hPDLSCs).

METHODS: hPDLSCs were isolated, characterised, and treated with 0.1-40 mM MgCl₂. Cell viability and proliferation were assessed using an MTT assay. Cell migration was measured by a scratch assay. Colony-forming unit formation and cell cycle analysis were examined using crystal violet and propidium iodide staining. Osteogenic differentiation was assessed through alkaline phosphatase activity, Alizarin Red S staining, and RT-qPCR for osteogenic-related gene expression. RNA sequencing was performed to evaluate differential gene expression patterns in hPDLSCs treated with 10 mM MgCl₂. All statistical analyses were evaluated at P < .05.

RESULTS: hPDLSCs exhibited mesenchymal stem cell characteristics. MgCl₂ concentrations higher than 10 mM were cytotoxic. Significant increases in cell proliferation, colony-forming unit percentages, and active cell cycle activity were observed when treated with 0.1, 0.5, and 1 mM MgCl₂. However, MgCl₂ had no effect on cell migration. Mineralised nodule formation was observed in hPDLSCs treated with 0.1 and 0.5 mM MgCl₂ in osteogenic induction media, mediated by TRPM7 cation channel, along with upregulated expression of osteogenic marker genes. Bioinformatic analysis indicated alterations in chemokine signalling and cellular calcium homeostasis pathways when treated with 10 mM MgCl₂.

CONCLUSIONS: MgCl₂ at a dose of 0.1 mM is the most effective concentration to promote cell proliferation and stimulate osteogenic differentiation of hPDLSCs in vitro. These findings indicate that MgCl₂ enhances both the proliferation and osteogenic differentiation of hPDLSCs, supporting its potential application in periodontal tissues and alveolar bone regeneration.

PMID:39721937 | DOI:10.1016/j.identj.2024.11.013

Prosthet Orthot Int. 2024 Dec 24. doi: 10.1097/PXR.0000000000000423. Online ahead of print.

ABSTRACT

BACKGROUND: Hallux valgus (HV) is a condition characterized by the lateral deviation of the first phalanx and medial deviation of the first metatarsal, leading to subluxation of the first metatarsophalangeal joint. Various orthotic applications are employed in the treatment of HV deformity. This study aimed to compare the effects of a toe separator (TS) and dynamic orthosis (DO) on hallux valgus angle (HVA), plantar pressure (PP), and quality of life (QoL).

METHODS: Thirty individuals aged between 18 and 65 years who had mild to moderate HV deformity were included in our study. Participants were randomized into TS and DO groups. Pretest and post-test evaluations at 4 weeks included goniometric measurement for HVA, PP measurement using the Sensor Medica device, QoL assessment using the American Orthopaedic Foot & Ankle Society-Hallux MTP-IP Scale and Manchester-Oxford Foot Questionnaire, and numerical evaluation scale for orthosis satisfaction.

RESULTS: No statistically significant changes were observed in HVA measurements (p > 0.05). In the DO group, significant differences were observed in PP assessment for right rearfoot loading (p = 0.048) and total average pressure measurement of the right foot (p = 0.025). QoL assessments were observed significant differences in the DO group compared with the TS group (p < 0.05).

CONCLUSIONS: After a 4-week period of wearing the TS and DO orthoses, no change in HVA was observed. In the DO group, a more balanced load distribution between the right and left foot (50.2% left, 49.8% right) and a more pronounced effect in reducing deformity-related pain and improving QoL by increasing functionality were noted.

PMID:39721066 | DOI:10.1097/PXR.0000000000000423

Oncologist. 2024 Dec 25:oyae333. doi: 10.1093/oncolo/oyae333. Online ahead of print.

ABSTRACT

BACKGROUND: Sarcomatoid carcinomas (SC) are rare tumors with both epithelial and mesenchymal characteristics, linked to aggressive behavior and poor prognosis. Sarcomatoid carcinoma of unknown primary (SCUP) is an exceedingly rare subset with limited literature and no standardized management guidelines. This study aims to characterize the clinical presentations, treatment patterns, and genomic landscape of SCUP.

PATIENTS AND METHODS: Data were retrospectively collected from the Mayo Clinic Rochester Cancer of Unknown Primary Registry. Patients included had biopsy-proven SC with no identifiable primary tumor despite comprehensive diagnostic evaluations. Baseline characteristics, immunohistochemistry (IHC) results, next-generation sequencing (NGS) data, and treatment outcomes were analyzed. Statistical analyses included descriptive statistics, Kaplan-Meier survival estimates, and Cox proportional hazards regression.

RESULTS: Fifty-two SCUP patients were identified, with a median age of 60 years. Most patients presented with widely metastatic disease, particularly lytic bone lesions. Elevated alkaline phosphatase (ALP) was noted in nearly half of the patients. IHC showed high positivity for AE1/AE3 and OSCAR antibodies. Tumor NGS revealed 247 alterations, with TP53 being the most common mutation. Patients receiving definitive therapy had a median overall survival (OS) of 72 months, significantly longer than those receiving systemic therapy (14 months). Immunotherapy was a significant prognostic factor, reducing the risk of death by 90%.

CONCLUSIONS: This study provides essential insights into the clinical and genomic characteristics of SCUP, advocating for the integration of definitive therapy and immunotherapy in treatment protocols. Further prospective studies are needed to validate these findings and improve patient outcomes.

PMID:39721045 | DOI:10.1093/oncolo/oyae333