Nevin Manimala

Psychiatr Serv. 2025 Nov 1;76(11):1027-1030. doi: 10.1176/appi.ps.20240487.

ABSTRACT

OBJECTIVE: Youths within the child welfare system have high rates of mental health needs and chronic barriers to service access. The cascade-of-care approach was used to explore this population’s use of mental health services.

METHODS: The mental health cascade was used with electronic medical record data to characterize service access among 97 youths served in a child welfare clinic.

RESULTS: Of the total sample, 82% of youths met criteria to identify those needing mental health services, 56% were referred for assessment and services, 33% completed an assessment, 24% had a treatment plan signed, and 17% received services. Time between steps averaged 64.52 days from screening to referral, 65.94 days from referral to assessment, 7.05 days from assessment to signed treatment plan, and 19.84 days from treatment plan to service initiation.

CONCLUSIONS: Significant gaps in the care cascade occurred, especially at earlier stages. Multilayered efforts to reduce service gaps in this population are needed.

PMID:41174942 | DOI:10.1176/appi.ps.20240487

Int J Gynaecol Obstet. 2025 Nov 1. doi: 10.1002/ijgo.70633. Online ahead of print.

ABSTRACT

OBJECTIVE: Our study aimed to evaluate the combined risk of macrosomia and nulliparity. We investigated whether macrosomia is independently associated with an increased rate of intrapartum cesarean delivery (CD) and adverse maternal and neonatal outcomes among nulliparous women delivering at term.

METHODS: We conducted a retrospective cohort study including nulliparous women with singleton, term (37-42 weeks) deliveries between 2005 and 2024 at two university-affiliated medical centers in Jerusalem, Israel. Women who delivered macrosomic neonates (birth weight ≥4000 g) were compared with those delivering neonates weighing 3000-3500 g. Exclusions included multifetal gestations, preterm deliveries, elective cesareans, fetal anomalies, and antepartum demise. The primary outcome was intrapartum cesarean delivery. Secondary outcomes included a range of maternal and neonatal complications. Multivariable logistic regression was used to adjust for potential confounders including maternal obesity, pre-gestational diabetes, labor induction, and gestational age at delivery.

RESULTS: Among 86 801 eligible nulliparous women, 2762 (3.2%) delivered macrosomic neonates and 40 963 (47.2%) served as the control group. The rate of intrapartum CD was significantly higher among macrosomic deliveries compared to controls (18.6% vs. 7.8%, P < 0.01), though this association was not statistically significant after adjustment (adjusted odds ratio [aOR] 1.81, 95% confidence interval [CI]: 0.91-3.58). Macrosomia was independently associated with increased odds of shoulder dystocia (aOR 33.42, 95% CI: 11.32-98.68), postpartum hemorrhage (aOR 2.13, 95% CI: 1.79-2.54), blood transfusion (aOR 2.45, 95% CI: 1.51-3.98), chorioamnionitis (aOR 2.03, 95% CI: 1.57-2.61), neonatal intensive care unit admission (aOR 1.62, 95% CI: 1.15-2.29), neonatal hypoglycemia (aOR 2.23, 95% CI: 1.32-3.77), and Erb’s palsy or clavicular fracture (aOR 9.43, 95% CI: 4.01-22.21). Stratification by birth weight categories revealed a dose-response relationship, with the highest complication rates among neonates >4500 g.

CONCLUSION: In nulliparous women delivering at term, macrosomia is independently associated with a higher risk of multiple adverse maternal and neonatal outcomes. These findings underscore the compounded risk faced by nulliparous women with macrosomic fetuses and highlight the need for enhanced prenatal surveillance and individualized delivery planning in this population.

PMID:41174933 | DOI:10.1002/ijgo.70633

J Diabetes Sci Technol. 2025 Nov;19(6):1457-1463. doi: 10.1177/19322968251371046. Epub 2025 Oct 14.

ABSTRACT

BACKGROUND: Type 1 diabetes is treated with exogenous insulin using multiple daily injections or insulin pumps. However, both strategies require carbohydrate counting for prandial insulin dosing, which is both burdensome and error prone.

METHODS: We conducted a pilot, randomized, controlled study to eliminate carbohydrate counting in adults (n = 12, 7 females, age 39.5 [15.1], HbA1c 7.4% [0.6]) using an automated insulin and pramlintide fully closed-loop system. The interventions included five arms during which participants underwent 14 hours of outpatient, free-living, supervised experiments of (1) faster aspart with carbohydrate counting (control), faster aspart and pramlintide without carbohydrate counting at (2) 8 µg/U and (3) 10 µg/U ratios, and aspart and pramlintide without carbohydrate counting at (4) 8 µg/U and (5) 10 µg/U ratios.

RESULTS: The median time in target range (3.9-10.0 mmol/L) with the control arm was 78.6 [65.3-92.9], compared with 76.2 [64.6-86.9] and 78.8 [68.8-86.0] with the fully closed-loop faster aspart and pramlintide systems at 8 and 10 µg/U ratios, respectively, and compared with 65.9 [59.9-83.6] and 77.4 [72.1-82.7] with the fully closed-loop aspart and pramlintide systems at 8 and 10 µg/U ratios, respectively. Times spent below 3.9 and 3.0 mmol/L were numerically higher with the fully closed-loop aspart and pramlintide systems than the control arm. None of the differences were statistically significant.

CONCLUSIONS: This study suggests that automated insulin and pramlintide systems have the potential to alleviate carbohydrate counting without degrading time in range. A longer and larger study is underway.

PMID:41174925 | DOI:10.1177/19322968251371046

Int J Phytoremediation. 2025 Oct 31:1-12. doi: 10.1080/15226514.2025.2579150. Online ahead of print.

ABSTRACT

The application of engineered humic Fe/Zn complexes in remediating lead (Pb) biotoxicity, as well as their impact on CO₂ efflux, soil carbon distribution, and spinach growth, remains unexplored. This study revealed the impact of engineered Fe- and Zn-enriched humate complexes on Pb immobilization, geochemical fractionation, and translocation in a spinach crop, and the effects on soil biochemical health and CO₂-C efflux from tillage and no-tillage Pb-contaminated soils in closed chambers. Advanced statistical models like PLS-PM were employed to determine the direct and total effects of the applied amendments under different tillage regimes. Results demonstrated that Zn- and Fe-humate applications decreased Pb contents by 48% and 72% in tillage soil, while under no-tillage soil Pb concentration was reduced by 35%; 8.7 mg kg^-1 (Zn-humate) vs 33%; 5.9 mg kg^-1 (Fe-humate) compared to respective controls. Soil C distribution showed dramatically varying trends in tilled and no-tilled soils. Soil extracellular enzyme activity was enhanced under both tillage and no-tillage operations with Zn- and Fe-humate complexes. Human-associated health risk was reduced by 3-fold by the application of Fe-humate, and it was 2-fold with Zn-humate. Overall, findings revealed that the tillage-driven application of Fe/Zn humate complexes significantly enhanced spinach growth, reducing Pb bioavailability, highlighting their potential for sustainable soil management in contaminated farmlands.

PMID:41174889 | DOI:10.1080/15226514.2025.2579150

Am J Biol Anthropol. 2025 Nov;188(3):e70146. doi: 10.1002/ajpa.70146.

ABSTRACT

OBJECTIVES: During the Paleolithic-Neolithic transition, modern human femoral diaphyses underwent significant structural changes, primarily driven by shifts in subsistence patterns including decreased mobility and increased sedentism. However, femoral remains from East Asia during this period are inadequately reported and studied. This study investigates the femoral diaphyseal structures across East Asia during this transition, exploring their variation, evolutionary processes, and links to subsistence patterns reflected in the archeological record.

MATERIALS AND METHODS: Human femora from Qihe Cave, Donghulin, and Taipinghu, representing South, North, and Northeast China during the transition, were analyzed. Midshaft cross-sectional shapes were compared with Early Upper Paleolithic (EUP), Late Upper Paleolithic (LUP), and recent sedentary agricultural (RSA) samples. Morphometric maps illustrating cortical bone thickness, external radius, and bending rigidity along the entire diaphysis were compared with Late Pleistocene early modern humans from South and North China and RSA specimens.

RESULTS: Analysis of midshaft cross-sectional shapes revealed that DHL 4 and Qihe M2 align with the LUP group, whereas DHL M1 and TPH 45 show close affinities with the RSA group. Statistical analyses based on morphometric maps further reveal that DHL 4 and Qihe M2 share key features with Late Pleistocene early modern humans, whereas DHL M1 and TPH 45 fall within the RSA variation range.

DISCUSSION: Two distinct femoral diaphyseal patterns are identified among East Asian modern humans during the transition, reflecting regional variations and intrapopulation divisions of labor, primarily associated with hunting and gathering strategies shaped by local environmental conditions and corresponding archeological cultures.

PMID:41174884 | DOI:10.1002/ajpa.70146

Head Neck. 2025 Oct 31. doi: 10.1002/hed.70050. Online ahead of print.

ABSTRACT

OBJECTIVE: High-frequency ultrasound was used to observe and measure the width of the normal adult glottal-level paraglottic space (PGS).

METHODS: One thousand healthy Han Chinese adults (694 women; 18-79 years) were enrolled between October 2023 and April 2024. PGS ultrasound characteristics were observed, and the width was measured at the midpoint of the anterior, middle, and posterior 1/3 points. The data were stratified by age group and sex. Spearman correlation analysis was used to analyze the correlations between PGS width and sex, age, height, weight, BMI, and BSA.

RESULTS: The glottic-level PGS is a triangular hyperechoic structure that is narrow in the front and wide in the back of the parathyroid cartilage section. The PGS width reference ranges (5th and 95th percentiles) were as follows: Male: W₁ (0.45-1.16) mm, W₂ (0.55-1.71) mm, W₃ (1.30-2.35) mm; Female: W₁ (0.55-0.95) mm, W₂ (0.90-1.35) mm, W₃ (1.55-2.00) mm. There were no statistically significant differences in W₁, W₂, and W₃ between males and females or between different age groups (all p > 0.05).

CONCLUSIONS: This study summarized normal adult PGS ultrasound characteristics at the glottal level and established references for PGS width, which can provide reference values for clinical practice.

PMID:41174874 | DOI:10.1002/hed.70050

Health Informatics J. 2025 Oct-Dec;31(4):14604582251383804. doi: 10.1177/14604582251383804. Epub 2025 Oct 31.

ABSTRACT

Objectives: Digital patient-reported outcome (PRO) tools, though beneficial for managing inflammatory bowel disease (IBD), remain underutilized in Australia. This study aimed to investigate a group of Australian patients’ readiness to engage with digital PRO tools and identify potential barriers to their implementation. Methods: We assessed 58 patients from a tertiary IBD clinic in Melbourne, Australia, using the Readiness and Enablement Index for Health Technology (ReadHy) tool, and compared the results to those from a Danish study. Results: Compared to the Danish cohort, our patients were younger with more frequent users of electronic devices, showed higher readiness across most ReadHy dimensions, except in the “heiQ8 Emotional Distress” dimension. Conclusion: These findings suggest a generally favourable environment for implementing digital PRO tools at an Australian tertiary IBD clinic, though attention should be paid to emotional well-being to improve adoption. This study also provides a framework for other centres to evaluate their patients’ readiness for digital PRO engagement.

PMID:41174870 | DOI:10.1177/14604582251383804

Worldviews Evid Based Nurs. 2025 Dec;22(6):e70077. doi: 10.1111/wvn.70077.

ABSTRACT

BACKGROUND: Sleep disturbances and delirium are prevalent problems in the intensive care unit. Evidence suggests that these conditions negatively impact patient outcomes by increasing the length of hospital stays, delaying recovery, and raising healthcare costs.

AIM: This study aimed to investigate the effect of implementing a sleep care bundle on sleep quality and delirium among critically ill patients.

METHODS: A quasi-experimental research design was used. A purposive sample of 66 patients was divided equally into two groups: a bundle group that received a sleep care bundle and a control group that received routine unit care in the chest intensive care units at Mansoura University in Egypt. Data were collected using the critically ill patients’ outcome evaluation tool based on the Richards-Campbell Sleep Questionnaire Scale and the Intensive Care Delirium Screening Checklist.

RESULTS: Compared to the control group, the bundle group demonstrated statistically significant improvements across all sleep quality domains measured by the Richards-Campbell Sleep Questionnaire by Day 3. Specifically, sleep depth improved from 1.24 ± 0.44 to 1.82 ± 0.39 (effect size = 0.600), ability to fall asleep from 1.21 ± 0.42 to 1.91 ± 0.29 (effect size = 0.703), number of awakenings from 1.27 ± 0.45 to 1.79 ± 0.42 (effect size = 0.483), sleep efficiency from 1.24 ± 0.44 to 1.76 ± 0.44 (effect size = 0.600), and overall sleep quality from 1.24 ± 0.44 to 1.85 ± 0.36 (effect size = 0.600). In addition, the occurrence of delirium on Day 3 was significantly lower in the bundle group (0.0%) compared with the control group (15.2%) (χ² = 7.471, p = 0.023). Subsyndromal delirium was observed in 6.1% of the bundle group and 15.2% of the control group. The overall percentage of patients without delirium was significantly higher in the bundle group (93.9%) compared to the control group (69.7%).

LINKING EVIDENCE TO ACTION: Implementing a sleep care bundle enhances sleep quality and reduces the occurrence of delirium in critically ill patients. Therefore, it can be integrated as an adjunctive intervention alongside routine care for these patients. To strengthen future applications, incorporating fidelity monitoring is recommended to ensure consistent implementation of the sleep care bundle and to optimize its effectiveness in clinical practice.

PMID:41174866 | DOI:10.1111/wvn.70077

Worldviews Evid Based Nurs. 2025 Dec;22(6):e70074. doi: 10.1111/wvn.70074.

ABSTRACT

BACKGROUND: Hemodialysis can lead to complications that negatively impact patients’ quality of life. Managing hemodialysis effectively requires patient adherence to complex regimens.

AIM: This randomized controlled experimental study aimed to assess the impact of nurse-led telephone-based patient education and counseling on disease management, quality of life, and self-care behaviors in hemodialysis patients.

METHODS: Conducted between September 2022 and June 2023 at State Hospital’s Hemodialysis Unit, the study included an intervention and a control group. Data were collected using tools such as the Scale for Dietary Knowledge in Hemodialysis Patients (SDKHP), Attitude Scale for the Dietary Therapy of Hemodialysis Patients (ASDTHP), Dialysis Symptom Index (DSI), Fluid Control in Hemodialysis Patients Scale (FCHPS), the Scale for the Assessment of Self-Care Behaviors with Arteriovenous Fistula (AVF), and the Kidney Disease Quality of Life-36 (KDQOL-36).

RESULTS: Pre- and posttest comparisons showed significant improvements in the intervention group’s mean scores for SDKHP, ASDTHP, and FCHPS, with the control group experiencing declines. DSI scores indicated reduced symptoms in the intervention group and an increase in the control group. The AVF Self-Care Scale results demonstrated increased self-care behaviors in the intervention group, while a decrease was observed in the control group. KDQOL-36 subscales, including physical and mental functioning, disease burden, and symptom management, also improved in the intervention group, while scores declined in the control group. These findings confirm the effectiveness of telephone-based patient education and counseling on multiple outcome measures.

LINKING EVIDENCE TO ACTION: Nurse-led, telephone-based patient education and counseling improved dietary adherence and disease management. Telephone-based patient interventions enhanced patients’ self-care skills regarding AVF maintenance. Quality of life improved across multiple dimensions in the intervention group. Telephone counseling ensured continued monitoring and individual support, even after discharge. Nurses should integrate telephone-based counseling into routine care, especially for chronic disease management.

PMID:41174863 | DOI:10.1111/wvn.70074

Worldviews Evid Based Nurs. 2025 Dec;22(6):e70079. doi: 10.1111/wvn.70079.

ABSTRACT

BACKGROUND: Nurse-led telephone-based follow-up interventions play a role in patient follow-up, but at present, no meta-analysis has been found to assess the effectiveness of nurse-led, telephone follow-up interventions for patients with acute coronary syndrome.

OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the effectiveness of nurse-led telephone-based follow-up interventions on health outcomes in people with acute coronary syndromes.

DESIGN: Systematic review and meta-analysis of randomized controlled trials.

METHODS: A comprehensive search of six databases: PubMed, Web of Science, Embase, Cochrane Library, CINAHL and Scopus was conducted from the inception of the databases to 30 September 2023. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the included randomized controlled studies. Review Manager 5.4 and Stata 16.0 were used to conduct statistical analysis.

RESULTS: A total of 12 studies were included. Nurse-led telephone-based follow-up interventions may reduce systolic and diastolic blood pressure (MD = -2.55, 95% CI [-4.16, -0.94]) (MD = -2.15, 95% CI [-3.18, -1.12]) and low-density lipoprotein (MD = -9.06, 95% CI [-14.33, -3.79]) in patients with acute coronary syndrome. However, its effectiveness in controlling high-density lipoprotein (MD = 1.65, 95% CI [-4.30, 7.61]) and reducing total cholesterol (MD = -2.72, 95% CI [-7.57, 2.13]) was uncertain. In addition, the results showed that the nurse-led follow-up intervention did not play a role in improving anxiety (SMD = -0.20, 95% CI [-0.44, 0.04]) and depression (SMD = -0.07, 95% CI [-0.21, 0.06]) in patients with acute coronary syndrome, but it probably improved drug adherence (RR = 1.30, 95% CI [1.05, 1.60]) and smoking cessation (RR = 1.31, 95% CI [1.08, 1.60]).

LINKING EVIDENCE TO ACTION: The findings of this review suggest that nurse-led telephone-based follow-up interventions had a potentially positive effect on controlling blood pressure and low-density lipoprotein levels, as well as improving medication adherence and smoking cessation among patients with acute coronary syndrome, compared to usual care. However, the intervention did not appear to significantly impact high-density lipoprotein, total cholesterol, anxiety, and depression, indicating that further research in these areas will be necessary in the future.

TRIAL REGISTRATION: PROSPERO (International Prospective Register of Systematic Reviews): CRD42023465894.

PMID:41174862 | DOI:10.1111/wvn.70079