Nevin Manimala

Front Psychol. 2025 Dec 19;16:1606131. doi: 10.3389/fpsyg.2025.1606131. eCollection 2025.

ABSTRACT

INTRODUCTION: Since independence, African states have faced armed conflicts and economic crises, disrupting traditional cultures and causing trauma. In Sub-Saharan Africa, psycho trauma is seen as a shared expression of distress rather than a medical condition. Understanding these cultural manifestations is crucial for evaluating Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Posttraumatic stress disorder (PTSD) criteria. This review explores how PTSD symptoms manifest differently in these communities, aiming to enhance cultural understanding and improve patient care.

METHODS: We conducted a double bind scoping review following the PRISMA guidelines. A systematic search was performed across multiple databases, including ScienceDirect, Cairn.info, SAGE Journals, Google Scholar, APA PsycInfo, Springer Link, PubMed, and ProQuest, for publications from 2016 to 2024 using the keywords PTSD, Sub-Saharan Africa, war trauma, sexual violence, culture, and expression of trauma.

RESULTS: The search returned 268 records. We identified 15 studies, written in English and French, that met the inclusion criteria. The studies were conducted in 8 countries Burkina Faso (n = 1) Cameroon (n = 2), Democratic Republic of the Congo (n = 4), Ivory coast (2), Kenya (1), Republic of Congo n = 1), South Africa (3) and Togo (n = 1). Nine studies (60%) highlight the symptoms related to PTSD showing that the DSM-5 emphasis psychological dimensions, whereas in sub-Sahara PTSD is primarily attributed to spiritual causes. Six studies (40%) highlight the meaning of symptoms in African anthropological structures, and the challenges faced by clinical psychologists in the context where mental health is not integrated in the cultural model of healing which involves spiritual rituals, traditional healers, and religious interventions.

CONCLUSION: This scoping review underscores the necessity of a comprehensive understanding of PTSD in Sub-Saharan Africa, where trauma is predominantly expressed through somatic and spiritual frameworks. Recognizing these cultural expressions is essential for developing contextually relevant diagnostic approaches and improving culturally adapted patient care.

PMID:41488943 | PMC:PMC12757261 | DOI:10.3389/fpsyg.2025.1606131

Front Psychol. 2025 Dec 19;16:1636209. doi: 10.3389/fpsyg.2025.1636209. eCollection 2025.

ABSTRACT

BACKGROUND: College students’ academic success and future growth are greatly impacted by achievement motivation, an innate desire for excellence. Higher education is an important time for students to socialize, and achievement motivation has a big impact on personal values, which is important for producing top-notch workers.

OBJECTIVE: The purpose of this study was to examine the current state of college students’ achievement motivation and the elements that influence it.

METHODS: 2,849 students from a university in Shandong Province participated in a cross-sectional survey. The Achievement Motivation Scale was used to measure the motivation to strive for achievement vs. the motivation to avoid failure. SPSS version 27.0 was utilized for conducting descriptive statistics, single-factor analysis, and performing multiple linear regression analysis.

RESULTS: College students’ average achievement motivation score was 4.38 ± 12.99, with a noticeably unequal distribution across motivation levels. Gender, parental literacy level, personal and parental health condition, family annual income, future goals, and short-term plans all showed statistically significant variations in achievement motivation, according to a single-factor analysis (p < 0.05). However, multiple linear regression analysis showed that the direct effects of variables like family annual income and parental literacy level were no longer significant after adjusting for inter-variable interactions.

CONCLUSION: This study confirms that gender, personal health condition, and short-term plans are important influencing factors and demonstrates considerable individual differences in university students’ achievement motivation with an uneven overall distribution. It offers both practical advice and theoretical foundations for applying differentiated instruction in higher education settings.

PMID:41488939 | PMC:PMC12757273 | DOI:10.3389/fpsyg.2025.1636209

Front Physiol. 2025 Dec 18;16:1726454. doi: 10.3389/fphys.2025.1726454. eCollection 2025.

ABSTRACT

BACKGROUND: This study evaluated three-dimensional changes in incisive canal (IC) morphology, root-IC proximity, and apical root resorption following fixed orthodontic retraction, comparing extraction and non-extraction protocols.

METHODS: CBCT scans of 86 patients (172 maxillary central incisors; mean age 22.3 ± 5.7 years) were analyzed before (T1) and immediately after treatment (T2). Participants were assigned to extraction (n = 42) or non-extraction (n = 44) groups. Linear measurements (IC width, cortical bone width, root-IC distance, U1 length/width, IC height) were recorded at three vertical levels (H1-H3). IC and U1 volumes and surface areas were quantified using standardized 3D segmentation. Continuous group comparisons were performed using patient-averaged data, whereas incisor-level categorical outcomes were analyzed using cluster-adjusted statistical models. Root-IC proximity patterns were evaluated using Generalized Estimating Equations (GEE), and apical root resorption and volumetric changes were assessed using Linear Mixed Models (LMM). Predictors of root-IC contact/invasion and predictors of root-IC distance reduction were examined using multivariable GEE and LMM, respectively. Multiplicity was controlled using Holm-Bonferroni correction.

RESULTS: IC width and cortical bone width decreased at several levels in both groups, more prominently in extraction cases (P < 0.05). Root-IC distance decreased in all patients, with an adjusted overall mean reduction of 1.33 mm (95% CI, 1.28-1.37). LMM showed no independent effect of extraction status on root-IC distance change (B = 0.08, P = 0.079). Each millimeter of U1 retraction produced an additional 0.40 mm reduction in root-IC distance (95% CI, 0.37-0.43; P < 0.001). GEE demonstrated that each millimeter of U1 movement increased the odds of root-IC contact or invasion by 1.76-fold (95% CI, 1.21-2.56; adjusted P = 0.030). Apical root resorption was significantly higher in teeth showing canal contact or invasion, with an average 0.38 mm greater shortening compared with separated roots (95% CI, 0.08-0.69).

CONCLUSION: Changes in root-IC proximity during orthodontic retraction are driven primarily by the magnitude of tooth movement, not extraction status. Greater retraction increases both canal approximation and the likelihood of contact/invasion, which in turn intensifies apical root resorption. Pre-treatment CBCT assessment of IC morphology and careful force and torque control are essential to minimize biomechanical overload and reduce iatrogenic risk during orthodontic retraction.

PMID:41488921 | PMC:PMC12756103 | DOI:10.3389/fphys.2025.1726454

Front Pediatr. 2025 Dec 18;13:1634178. doi: 10.3389/fped.2025.1634178. eCollection 2025.

ABSTRACT

BACKGROUND: Minimally invasive approaches are being increasingly employed in pediatric orthopedic trauma surgery. Clinical practice has seen applications of minimally invasive techniques for fractures such as intercondylar eminence avulsion fractures, femoral shaft fractures, and humeral shaft fractures. However, open reduction remains the primary surgical approach for pediatric humeral lateral condyle fractures. Open reduction disrupts peripheral blood circulation and increases the risk of epiphyseal injury. Damage to the epiphysis may affect a child’s growth and development; therefore, surgical approach selection requires careful consideration. Our institution has accumulated substantial experience in applying arthroscopic techniques to trauma management. Through clinical exploration, we have developed an approach for treating pediatric humeral lateral condyle fractures involving arthroscopic reduction under endoscopic guidance combined with Kirschner wire fixation, aiming to provide new insights for clinical treatment.

OBJECTIVE: To compare the efficacy of arthroscopic reduction vs. open reduction for Jacob type II pediatric humeral lateral condyle fractures.

METHODS: A retrospective study was conducted on 60 pediatric patients with Jacob type II humeral lateral condyle fractures treated at Liuyang Orthopedics Hospital between January 2021 and June 2022. The cases were divided into an Arthroscopic Group and an Open Reduction Group based on surgical approach. The Arthroscopic Group underwent arthroscopy-assisted reduction with Kirschner wire fixation, while the control group (Open Reduction Group) received open reduction with Kirschner wire fixation. Operative time, intraoperative blood loss volume, and incision length were compared between the two groups; Pre- and postoperative Visual Analog Scale (VAS) pain scores, C-reactive protein (CRP) levels, and erythrocyte sedimentation rate (ESR) were compared; To assess whether arthroscopic reduction offers advantages over open reduction for pediatric humeral lateral condyle fractures, outcomes including the Mayo Elbow Performance Score (MEPS) and Baumann angle were evaluated at 3 months postoperatively.

RESULTS: Incisions healed by first intention in both groups. No statistically significant difference was found in operative time between groups [(30.17 ± 8.342) min vs. (29.07 ± 9.340) min, P = 0.632]. Incision length was significantly shorter in the Arthroscopic Group [(2.07 ± 0.254) cm vs. (4.63 ± 0.809) cm, P = 0.000]. Intraoperative bleeding was significantly less in the Arthroscopic Group [(7.59 ± 1.167) mL vs. (11.83 ± 2.706) mL, P = 0.012]. Both groups showed reduced VAS scores postoperatively, with significantly better scores in the Arthroscopic Group (P = 0.000). Postoperative CRP and ESR levels increased in both groups compared to preoperative values, but the Open Reduction Group demonstrated significantly greater increases (P < 0.05). At 3 months postoperatively, the Arthroscopic Group showed superior Mayo Elbow Performance Scores (P = 0.013), while no significant difference was observed in Baumann angle measurements.

CONCLUSION: Arthroscopic reduction for pediatric humeral lateral condyle fractures offers smaller incisions, reduced bleeding, attenuated inflammatory response, and is more conducive to postoperative functional recovery.

PMID:41488908 | PMC:PMC12756486 | DOI:10.3389/fped.2025.1634178

Front Pediatr. 2025 Dec 18;13:1657654. doi: 10.3389/fped.2025.1657654. eCollection 2025.

ABSTRACT

OBJECTIVE: Breastfeeding is globally recognized as the cornerstone of infant nutrition, offering unparalleled benefits for maternal and child health. However, exclusive breastfeeding rates remain below international targets, influenced by sociocultural, economic, and individual factors. This study aims to investigate breastfeeding practices in Türkiye, identify influencing factors, and compare these findings with global trends to highlight both commonalities and country-specific dynamics.

METHODS: This cross-sectional study was conducted at Ankara Bilkent City Hospital between June and August 2024, with 392 mothers of children aged 2-5 years. Data were collected through structured surveys addressing demographics, breastfeeding practices, and formula use. Statistical analyses were performed using SPSS, with p < 0.05 considered significant.

RESULTS: Exclusive breastfeeding during the first six months was reported by 37.5% and was influenced by perceived milk insufficiency, socioeconomic factors, and extended family involvement. Cesarean delivery was associated with increased formula use, and lower-income families were less likely to sustain breastfeeding to 24 months. Contrary to global patterns where family support is beneficial, extended family involvement in Türkiye negatively affected exclusive breastfeeding. In multivariable models, maternal chronic illness and cesarean delivery increased the odds of formula use (OR = 1.6; 95% CI = 0.98-2.79; p = 0.04 and OR = 1.8; 95% CI = 1.21-2.81; p = 0.004). Not receiving support from extended family and normal spontaneous vaginal delivery increased the odds of exclusive breastfeeding in the first six months (OR = 1.9; 95% CI = 1.25-2.91; p = 0.003 and OR = 1.5; 95% CI = 1.02-2.47; p = 0.041). University-level education was associated with initiating complementary feeding after six months (OR = 2.1; 95% CI = 0.27-0.80; p = 0.006). No significant model was established for total breastfeeding duration.

CONCLUSIONS: Breastfeeding practices in Turkey reflect global challenges, including maternal perceptions of insufficient milk supply and economic barriers, while also highlighting unique cultural dynamics, particularly the influence of extended family. Addressing these issues requires a dual approach: implementing universal interventions, including healthcare professional guidance and breastfeeding education, and developing culturally specific strategies to mitigate the negative impact of traditional norms on exclusive breastfeeding rates. Policymakers should prioritize reducing cesarean delivery rates and strengthening support systems for low-income mothers. Comprehensive, multifaceted interventions are essential to improve breastfeeding outcomes and align national practices with international health goals.

PMID:41488898 | PMC:PMC12756464 | DOI:10.3389/fped.2025.1657654

Front Pediatr. 2025 Dec 19;13:1700323. doi: 10.3389/fped.2025.1700323. eCollection 2025.

ABSTRACT

BACKGROUND: Hirschsprung’s disease (HSCR) is the second most common congenital gastrointestinal malformation, posing a significant health concern in pediatrics. The laparoscopic modified Soave procedure, a minimally invasive technique, has gained popularity due to its potential advantages. This study aimed to evaluate its clinical efficacy in comparison with the traditional transanal Soave procedure.

METHODS: This comparative retrospective cohort study included children with HSCR treated at Qilu Hospital between January 2014 and January 2024. The patients were divided into the following two groups: the Laparoscopic group (those who underwent the laparoscopic modified Soave procedure) and the Transanal group (those who underwent the transanal Soave procedure). The assessed outcomes included postoperative recovery metrics, complication rates, and 1-year follow-up results.

RESULTS: In total, 96 patients were included in the study. Compared with the Transanal group, the Laparoscopic group demonstrated reduced surgical time, faster gastrointestinal recovery, and reduced hospital stay duration (P < 0.05). Intraoperative blood loss was greater in the Laparoscopic group (P < 0.05). Complication rates were lower in the Laparoscopic group (4.17%) than in the Transanal group (14.58%), although the difference was not statistically significant (P > 0.05). Notably, the incidence of postoperative abdominal distension was lower in the Laparoscopic group (P < 0.05), but no significant differences observed in multivariate analysis of postoperative outcomes (P < 0.05).

CONCLUSION: The laparoscopic modified Soave procedure demonstrated superior clinical efficacy compared to the transanal approach, offering faster recovery and a trend toward fewer complications. These findings support its wider adoption as a minimally invasive treatment option for HSCR.

PMID:41488890 | PMC:PMC12757382 | DOI:10.3389/fped.2025.1700323

Front Surg. 2025 Dec 18;12:1719911. doi: 10.3389/fsurg.2025.1719911. eCollection 2025.

ABSTRACT

OBJECTIVE: To compare the clinical efficacy between unilateral biportal endoscopic lumbar interbody fusion (ULIF) and traditional posterior lumbar interbody fusion (PLIF) in the treatment of L4/5 lumbar disc herniation (LDH).

METHODS: A total of eighty-five patients with L4/5 LDH were enrolled and assigned into two groups: the ULIF group (n = 37) and the PLIF group (n = 48). Data regarding surgical conditions, hospital stay, perioperative Visual Analogue Scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, and serum inflammatory factor levels were recorded.

RESULTS: No statistically significant differences were observed in preoperative clinical characteristics (including age, disease duration, BMI, gender distribution, preoperative VAS scores, JOA scores, and serum inflammatory factor levels) between the two groups (all P > 0.05), indicating good comparability. Compared with the PLIF group, the ULIF group was associated with significantly less intraoperative blood loss, reduced postoperative drainage volume, and a shorter postoperative hospital stay (all P < 0.05). Additionally, the ULIF group exhibited lower serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) at 24 h postoperatively, as well as significantly lower VAS scores and higher JOA scores at 7 and 30 days postoperatively (all P < 0.05). However, the ULIF group was associated with a longer operative time and a higher number of intraoperative C-arm fluoroscopies compared with the PLIF group (both P < 0.05).

CONCLUSION: ULIF exhibits significant advantages in minimally invasive. Although it requires longer operative time and more intraoperative fluoroscopies, it is associated with reduced blood loss, attenuated inflammatory responses, shorter hospital stay, and superior early postoperative pain and functional recovery, facilitating patient rehabilitation.

PMID:41488888 | PMC:PMC12756358 | DOI:10.3389/fsurg.2025.1719911

Diabetes Metab Syndr Obes. 2025 Dec 30;18:4831-4842. doi: 10.2147/DMSO.S543826. eCollection 2025.

ABSTRACT

PURPOSE: Dumping syndrome (DS) is a postsurgical complication of bariatric procedures. It is classified into early and late dumping based on occurrence within different postprandial timeframes. This study measures the prevalence of DS among adult patients and its association with social determinants and nutrition knowledge.

PATIENTS AND METHODS: This cross-sectional study used a convenience sampling method via distributing an online validated questionnaires to patients who underwent sleeve gastrectomy or gastric bypass surgery in ≥3 months.

RESULTS: Out of 352 participants, 237 (67.3%) had a modified Sigstad weighted DS score of ≥3.26, indicating the presence of DS; 182 (76.8%) had early DS (symptoms within 1 hour postprandially) and 55 (23.2%) had late DS (symptoms 1-3 hours postprandially). Only gender and monthly income showed statistically significant differences between early and late DS patients. No statistically significant associations were found between the DS subtypes and sociodemographic characteristics, although participants’ age approached significance (p = 0.052). Type 1 diabetes was significantly associated with DS and affected patients were 6.7 times more likely to experience symptoms. The mean nutrition knowledge score among all the participants was 60.88 (SD = 14.76) suggesting moderate nutrition knowledge.

CONCLUSION: There is a high prevalence of DS (67.3%) among post-bariatric surgery patients in Saudi Arabia, and early DS is more common than late DS. The findings suggest a strong correlation between type 1 diabetes and DS. Nutrition knowledge was moderate but insufficient in key areas that affect postoperative outcomes. The study is novel in reporting a high prevalence of DS among post-bariatric patients in Saudi Arabia and uniquely explores the association of DS with social determinants, nutrition knowledge, and type 1 diabetes-areas less examined in previous research. It emphasizes the imperative need for comprehensive patient education and continuous dietary counseling to improve long-term management and outcomes for bariatric surgery patients.

PMID:41488871 | PMC:PMC12764344 | DOI:10.2147/DMSO.S543826

Diabetes Metab Syndr Obes. 2025 Dec 30;18:4803-4813. doi: 10.2147/DMSO.S555974. eCollection 2025.

ABSTRACT

OBJECTIVE: To identify risk factors for prognosis in diabetic foot patients undergoing digital subtraction angiography (DSA) intervention and analyze their correlation with ulcer severity.

METHODS: This retrospective study analyzed 135 diabetic foot patients who underwent DSA-guided intervention between August 2023 and January 2025. Patients were classified good and poor prognosis groups based on 6-month outcomes. We compared demographic data and clinical laboratory indexes between groups. Statistically significant variables were analyzed using Logistic regression to identify independent risk factors. The receiver operating characteristic (ROC) curves and Pearson correlation analysis were employed to assess the diagnostic value of these factors and correlation with ulcer severity.

RESULTS: The stratified diabetic foot ulcer risk score (SINBAD) was significantly higher in patients with poor prognosis (7.15±2.76) compared to those with good prognosis (3.24±1.81); Serum levels of procalcitonin (PCT), galactoagglutinin-3 protein (Gal-3), noncoding RNA molecule with circular structure (Hsa_circ_0057362), interleukin-6 (IL-6), and serum C-reactive protein (CRP) was significantly elevated in the poor prognosis group (P < 0.05). Pearson correlation analysis revealed positive corrections between these biomarkers and ulcer severity (r=0.283, 0.240,0.434, 0.370, 0.443, respectively; all P < 0.05); Logistic regression analysis identified PCT, Gal-3, Hsa_circ_0057362, IL-6, and CRP as independent influencing factors for poor prognosis in diabetic foot. Furthermore, ROC curve analysis demonstrated that each of these indicators possessed a certain degree of predictive value for poor prognosis following diabetic foot surgery.

CONCLUSION: A plethora of risk factors, including PCT, Gal-3, Hsa_circ_0057362, IL-6 and CRP, influence poor prognosis in diabetic foot patients undergoing DSA-guided intervention. These biomarkers demonstrate significant correlations with ulcer severity and hold substantial clinical utility in the predicting postoperative outcomes. Early identification of patients at risk for poor prognosis enables the implementation of targeted interventions, thereby effectively improving patient outcomes.

PMID:41488869 | PMC:PMC12764337 | DOI:10.2147/DMSO.S555974

Ann Gastroenterol Surg. 2025 Aug 31;10(1):241-250. doi: 10.1002/ags3.70087. eCollection 2026 Jan.

ABSTRACT

BACKGROUND: The survival benefit of adjuvant chemotherapy (AC) in intrahepatic cholangiocarcinoma (ICC) remains uncertain, particularly in advanced-stage disease.

METHODS: We retrospectively analyzed 480 patients who underwent curative-intent hepatic resection for ICC at eight institutions between 2006 and 2023. Patients were stratified by receipt of AC, and survival outcomes were compared across LCSGJ stages. Multivariable Cox regression was used to identify prognostic factors.

RESULTS: Among 480 patients, 206 received AC. While AC did not significantly improve survival in stage I-III disease, it was associated with significantly longer overall survival (median 25.5 vs. 17.1 months, p = 0.008) and recurrence-free survival (median 10.3 vs. 6.0 months, p = 0.010) in stage IV patients. Multivariable analysis in stage IV revealed that AC independently reduced the risk of death (HR 0.540, p = 0.020), while poor liver function, severe postoperative complications, tumor size, and lymph node metastasis were adverse prognostic factors. Among AC regimens, S-1 demonstrated significantly longer OS (69.3 vs. 17.1 months, p = 0.001) and RFS (9.6 vs. 6.0 months, p = 0.015) compared with no AC, whereas other regimens did not show statistically significant benefits.

CONCLUSIONS: Adjuvant chemotherapy was associated with improved survival in patients with resected stage IV ICC. Among available regimens, S-1 appeared to contribute to this benefit. These findings support the use of AC in advanced ICC and suggest that S-1 may play a potential role, warranting further prospective validation. Stage-specific treatment planning may be essential to optimize outcomes.

PMID:41488852 | PMC:PMC12757147 | DOI:10.1002/ags3.70087