Nevin Manimala

BMC Psychiatry. 2025 Jan 3;25(1):8. doi: 10.1186/s12888-024-06399-3.

ABSTRACT

BACKGROUNDS: Dissociative experiences are described as crucial psychological mechanisms involving the organism’s responses to severe psychological traumas and unpleasant past experiences. This research was conducted to examine the psychometric properties of the Dissociative Experiences Measure, Oxford (DEMO) in the Iranian general population.

METHODS: This study used cross-sectional correlation, and the statistical population consisted of Iranians over 15 years old. Among them, 712 subjects were chosen as the study sample using the convenience sampling technique. Data were acquired between February and April 2022 using DEMO, Dissociative Experiences Scale II (DES-II), and Depression Anxiety and Stress Scale (DASS-21). In order to determine DEMO’s psychometric properties, Confirmatory Factor Analysis (CFA) was used to investigate the factorial structure, Cronbach’s alpha analyses to examine the internal consistency reliability, and Pearson correlation analyses to examine the relationships between DEMO’s subscales and the subscales of DES-II and DASS-21, indicating convergent validity. In order to analyze the data, LISREL 8.0 and SPSS-26 were used.

RESULTS: Based on the results of the CFA, the proposed five-factor structure of DEMO showed an acceptable fit to the data (χ² = 1939.81, SRMR = 0.078, CFI = 0.96, RMSEA = 0.074). The internal reliability was satisfactory for the total scale (Cronbach’s alpha = 0.93) and the five subscales (Cronbach’s alpha = 0.89 for unreality, 0.87 for numb and disconnected, 0.80 for memory blanks, 0.85 for zoned out, and 0.79 for vivid internal world). The CFA results indicated that the five factors explained 60.69% of the variance. Significant correlations were observed between the DEMO subscales and the respective subscales of DES-II and DASS-21, confirming the measure’s convergent validity.

CONCLUSION: It can be concluded from the results of this study that the DEMO has high reliability and validity among the Iranian general population.

PMID:39754178 | DOI:10.1186/s12888-024-06399-3

Biol Sex Differ. 2025 Jan 3;16(1):1. doi: 10.1186/s13293-024-00683-3.

ABSTRACT

BACKGROUND: X chromosome inactivation (XCI) is a female-specific process in which one X chromosome is silenced to balance X-linked gene expression between the sexes. XCI is initiated in early development by upregulation of the lncRNA Xist on the future inactive X (Xi). A subset of X-linked genes escape silencing and thus have higher expression in females, suggesting female-specific functions. One of these genes is the highly conserved gene Kdm6a, which encodes a histone demethylase that removes methyl groups at H3K27 to facilitate gene expression. KDM6A mutations have been implicated in congenital disorders such as Kabuki Syndrome, as well as in sex differences in development and cancer.

METHODS: Kdm6a was knocked out (KO) using CRISPR/Cas9 gene editing in hybrid female mouse embryonic stem (ES) cells derived either from a 129 × Mus castaneus (cast) cross or a BL6 x cast cross. In one of the lines a transcriptional stop signal inserted in Tsix results in completely skewed X silencing upon differentiation. The effects of both homozygous and heterozygous Kdm6a KO on Xist expression during the onset of XCI were measured by RT-PCR and RNA-FISH. Changes in gene expression and in H3K27me3 enrichment were investigated using allele-specific RNA-seq and Cut&Run, respectively. KDM6A binding to the Xist gene was characterized by Cut&Run.

RESULTS: We observed impaired upregulation of Xist and reduced coating of the Xi during early stages of differentiation in Kdm6a KO cells, both homozygous and heterozygous, suggesting a threshold effect of KDM6A. This was associated with aberrant overexpression of genes from the Xi after differentiation, indicating loss of X inactivation potency. Consistent with KDM6A having a direct role in Xist regulation, we found that the histone demethylase binds to the Xist promoter and KO cells show an increase in H3K27me3 at Xist, consistent with reduced expression.

CONCLUSIONS: These results reveal a novel female-specific role for the X-linked histone demethylase, KDM6A in the initiation of XCI through histone demethylase-dependent activation of Xist during early differentiation. X chromosome inactivation is a female-specific mechanism that evolved to balance sex-linked gene dosage between females (XX) and males (XY) by silencing one X chromosome in females. X inactivation begins with the upregulation of the long noncoding RNA Xist on the future inactive X chromosome. While most genes become silenced on the inactive X chromosome some genes escape inactivation and thus have higher expression in females compared to males, suggesting that escape genes may have female-specific functions. One such gene encodes the histone demethylase KDM6A which function is to turn on gene expression by removing repressive histone modifications. In this study, we investigated the role of KDM6A in the regulation of Xist expression during the onset of X inactivation. We found that KDM6A binds to the Xist gene to remove repressive histone marks and facilitate its expression in early development. Indeed, depletion of KDM6A prevents upregulation of Xist due to abnormal persistence of repressive histone modifications. In turn, this results in aberrant overexpression of genes from the inactive X chromosome. Our findings point to a novel mechanism of Xist regulation during the initiation of X inactivation, which may lead to new avenues of treatment to alleviate congenital disorders such as Kabuki syndrome and sex-biased immune disorders where X-linked gene dosage is perturbed.

PMID:39754175 | DOI:10.1186/s13293-024-00683-3

BMC Nurs. 2025 Jan 3;24(1):1. doi: 10.1186/s12912-024-02478-8.

ABSTRACT

BACKGROUND: Disaster nursing involves systematic and professional care provided to communities affected by natural or man-made disasters. With limited resources in global disaster settings, nurses play a crucial role in disaster management. The aim of this study is to investigate the impact of integrating ‘Disaster Nursing’ into nursing curricula on nursing students’ perceptions of disaster literacy and preparedness.

METHODS: This quasi-experimental one-group pretest-posttest study was conducted at a public university in Izmir, Turkey. The pre-test took place on September 27, 2021, and the post-test on January 7, 2022. The study population comprised 66 nursing students enrolled in the elective “Disaster Nursing” course, with 62 volunteering for participation. Data collection tools included an individual introduction form, the Disaster Literacy Scale, and the Perception of Disaster Preparedness in Nurses Scale. The 14-week “Disaster Nursing” course served as the intervention. Data were collected online and analyzed using descriptive statistics, paired sample t-tests, and Pearson correlation.

RESULTS: Of the students, 51.6% were aged 22-23, and 62.9% were female. Additionally, 54.8% reported previous disaster experience. The mean pre-test score on the Disaster Literacy Scale was 32.97 ± 6.47, which increased significantly to 40.58 ± 5.95 post-test (p < 0.05). The mean pre-test score on the Perception of Disaster Preparedness in Nurses Scale was 81.66 ± 4.61, rising significantly to 90.64 ± 6.25 post-test (p < 0.05). A statistically significant positive correlation was found between the total scores of the Disaster Literacy and Disaster Preparedness in Nurses scales (r = 0.79).

CONCLUSIONS: The integration of “Disaster Nursing” into nursing curricula positively enhanced the disaster literacy and preparedness perceptions of nursing students. The results demonstrated that higher levels of disaster literacy were associated with increased disaster preparedness among nurses. These findings can inform the development of educational policies for disaster nursing education in Turkey.

PMID:39754162 | DOI:10.1186/s12912-024-02478-8

Nutr J. 2025 Jan 4;24(1):2. doi: 10.1186/s12937-024-01069-2.

ABSTRACT

BACKGROUND: mHealth, i.e. mobile-health, strategies may be used as a complement to regular care to support healthy dietary habits in primary care patients. We evaluated the effect of a 12-week smartphone-based dietary education on overall diet quality (primary outcome), and dietary intake and cardiometabolic risk markers (secondary outcomes) in people with type 2 diabetes.

METHODS: In this two-armed randomized clinical trial, people with type 2 diabetes were recruited within a primary care setting and randomized 1:1 to a smartphone-delivered dietary education for 12 weeks or a control group receiving regular care only. Dietary intake and cardiometabolic risk markers were measured at baseline and after 3 months. Diet was assessed using a 4-day dietary record and a food frequency questionnaire (FFQ). Overall diet quality was estimated with a Nordic Nutrition Recommendation (NNR) score and specific dietary intake was estimated for 13 food groups/nutrients. We used linear regression models to examine differences in change from baseline to the 3-month follow-up between the intervention and control group, adjusted for baseline values of each outcome variable.

RESULTS: The study included 129 participants (67 in the intervention group and 62 controls), of whom 61% were men. At baseline, mean age was 63.0 years and mean body mass index was 29.8 kg/m². When analyzing dietary record data, we found no effect of the intervention on diet quality or intake, however, the control group had increased their score by 1.6 points (95%CI: -2.9, -0.26) compared to the intervention group. In the analyses of FFQ data, the intervention group had lowered their daily intake in grams of saturated (β = -4.1, 95%CI: -7.9, -0.2) and unsaturated (mono- and polyunsaturated) (β = -6.9, 95%CI: -13.5, -0.4) fat more than the control group. The intervention group also presented lower serum triglycerides levels than the controls (β = -0.33, 95%CI: -0.60, -0.05). No statistical differences were found in any other dietary variables or cardiometabolic risk markers.

CONCLUSION: While we found no effect on overall diet quality, our findings suggest that a smartphone-based dietary education might impact dietary fat intake and corresponding cardiometabolic risk markers in people with type 2 diabetes. Our results should be considered hypothesis-generating and need to be confirmed in future studies.

TRIAL REGISTRATION: Registered at ClinicalTrials.gov ( NCT03784612 ). Registered 24 December 2018.

PMID:39754157 | DOI:10.1186/s12937-024-01069-2

BMC Public Health. 2025 Jan 3;25(1):23. doi: 10.1186/s12889-024-21176-3.

ABSTRACT

INTRODUCTION: Hypertension is among the most significant non-communicable public health issues worldwide. High blood pressure, or hypertension, has been associated with severe health consequences, including death, aneurysms, stroke, chronic renal disease, eye damage, heart attack, heart failure, peripheral artery disease, and vascular dementia. Consequently, this study aimed to investigate the predictors linked to survival time and the progression of blood pressure measurements in hypertensive patients.

METHODS: This study on retrospective cohort analysis was conducted among hypertensive patients receiving follow-up treatment. A total of 200 hypertensive patients were screened during their follow-up at Sawula General Hospital. Multivariate joint models typically combine a multivariate linear mixed-effects model for repeated measurements with a Cox model for time-to-event outcomes.

RESULT: The baseline characteristics of patients indicated that, out of 200 hypertensive patients, the majority were male, totaling 116 (58%). Regarding alcohol consumption, 72 (36%) of the hypertensive patients reported using alcohol, while 128 (64%) did not. The multivariate joint model emerged as the most effective model in this study. The analysis revealed that observation time, economic status, sex, place of residence, baseline FBS, and age significantly influenced log FBS, while visiting time, age, sex, pulse rate, place of residence, and baseline DBP were identified as significant factors for log diastolic blood pressure.

CONCLUSION: The multivariate joint model exhibited superior performance. Hypertension continues to be a non-communicable disease and a public health issue in Sawula and Ethiopia, deserving greater attention.

PMID:39754151 | DOI:10.1186/s12889-024-21176-3

J Orthop Surg Res. 2025 Jan 3;20(1):3. doi: 10.1186/s13018-024-05432-1.

ABSTRACT

BACKGROUND: Wrist synovitis often leads to persistent pain, swelling, and limited mobility, causing significant functional impairment and psychological distress, including anxiety. Although arthroscopic synovectomy can alleviate physical symptoms, whether it also improves anxiety and the causal relationship between synovitis and anxiety remains unclear.

METHODS: A prospective study was conducted on 44 patients diagnosed with wrist synovitis who underwent arthroscopic synovectomy. Patients were assessed preoperatively and at 2 and 4 weeks postoperatively using the Visual Analog Scale (VAS), Mayo Wrist Score, and Self-Rating Anxiety Scale (SAS). MR analysis was employed to investigate the causal relationship between wrist synovitis and anxiety using genome-wide association studies (GWAS) summary data.

RESULTS: Significant reductions in SAS and VAS scores were observed at 2 and 4 weeks postoperatively, along with improvements in wrist function as measured by the Mayo Wrist Score. MR analysis did not find statistically significant evidence of a direct causal relationship between wrist synovitis and anxiety, though a positive trend suggests that wrist synovitis may be a risk factor for anxiety.

CONCLUSIONS: Arthroscopic synovectomy may alleviate anxiety symptoms and may improve wrist function in patients with wrist synovitis. While a direct causal link between wrist synovitis and anxiety was not conclusively established, the observed associations highlight the need for integrated management of physical and psychological health in these patients. Trial registration This study was retrospectively registered with the WuXi 9th People’s Hospital (WuXi Orthopaedics Hospital) Medical Ethical Committee on August 6, 2023, with reference number KS2023081.

PMID:39754149 | DOI:10.1186/s13018-024-05432-1

BMC Psychiatry. 2025 Jan 3;25(1):14. doi: 10.1186/s12888-024-06440-5.

ABSTRACT

BACKGROUND: The association between physical fitness and autistic traits in adolescents remains under explored, especially in adolescents. Understanding this relationship can provide strategies to improve the quality of life of these people.

OBJECTIVE: To identify the association between cluster characteristics derived from levels of self-perceived physical fitness and the occurrences of individual levels of autistic traits in Brazilian adolescents.

METHOD: This descriptive study employed an analytical, quantitative approach involving 515 adolescents aged 11 to 18 (245 boys and 270 girls). Autistic traits were assessed using the Autism Quotient (AQ50), while physical fitness was measured with the Self-Reported Physical Fitness Questionnaire (QAPA). Cluster analysis using descriptive statistics with bootstrapping and generalized estimating equations was performed.

RESULTS: Boys reported higher physical fitness levels than girls, with significant differences in General Power Strength (QAPA 4) and Physical Fitness in Sports (QAPA 7). Girls scored slightly higher on social skills. AQ50 scores indicated that girls had higher aggregated difficulties in imagination, attention, communication, and social skills compared to boys. Higher self-perceived physical fitness was associated with lower levels of autistic traits in both genders. Girls with higher QAPA scores showed significant decreases in autistic traits related to social skills and overall AQ50 scores. Boys with higher physical fitness demonstrated reduced autistic traits in the domains of imagination and communication. Age-adjusted analyses confirmed these findings.

CONCLUSION: There is a significant association between self-perceived physical fitness and autistic traits in adolescents. Higher physical fitness levels are linked to fewer autistic traits, highlighting the importance of promoting physical fitness to mitigate challenges associated with autistic traits and improve adolescents’ well-being.

PMID:39754148 | DOI:10.1186/s12888-024-06440-5

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