Nevin Manimala

Biometrics. 2025 Apr 2;81(2):ujaf034. doi: 10.1093/biomtc/ujaf034.

ABSTRACT

Testing differences in mean vectors is a fundamental task in the analysis of high-dimensional microbiome compositional data. Existing methods may suffer from low power if the underlying signal pattern is in a situation that does not favor the deployed test. In this work, we develop 2-sample power-enhanced mean tests for high-dimensional compositional data based on the combination of $P$-values, which integrates strengths from 2 popular types of tests: the maximum-type test and the quadratic-type test. We provide rigorous theoretical guarantees on the proposed tests, showing accurate Type-I error rate control and enhanced testing power. Our method boosts the testing power toward a broader alternative space, which yields robust performance across a wide range of signal pattern settings. Our methodology and theory also contribute to the literature on power enhancement and Gaussian approximation for high-dimensional hypothesis testing. We demonstrate the performance of our method on both simulated data and real-world microbiome data, showing that our proposed approach improves the testing power substantially compared to existing methods.

PMID:40171801 | DOI:10.1093/biomtc/ujaf034

Acta Odontol Scand. 2025 Apr 2;84:155-164. doi: 10.2340/aos.v84.42959.

ABSTRACT

BACKGROUND: Bruxism, defined by the involuntary grinding or clenching of teeth, and epilepsy, a neurological ailment marked by recurring seizures, are both common conditions that can significantly affect persons’ quality of life. Although numerous studies have investigated the relationship between bruxism and epilepsy, the current evidence is ambiguous. This systematic review seeks to consolidate existing information to elucidate the association between bruxism and epilepsy.

METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, a systematic search was performed across electronic databases, including PubMed, Lilacs, and Web of Science. The search encompassed all pertinent publications published until September 2021. The inclusion criteria were established to encompass observational studies (cohort, case-control, cross-sectional) that investigated the relationship between bruxism and epilepsy in human populations.

RESULTS: The preliminary search produced a total of 142 articles. After a rigorous screening process, 3 studies were declared appropriate for inclusion in the systematic review. The research varied in design, sample size, and methodology, with some studying the prevalence of bruxism in epileptic patients, while others studied the prevalence of epilepsy in individuals with bruxism. Heterogeneity among the research was handled using proper statistical analyses.

CONCLUSION: The findings from the included studies suggested a probable link between bruxism and epilepsy. However, the evidence was uneven and equivocal, with some research indicating a favourable correlation, while others showed no meaningful relationship. Methodological restrictions, such as changes in diagnostic criteria and data collection procedures, could contribute to the observed inconsistencies. In addition, the possible influence of confounding factors, such as medication use and comorbidities, should be addressed in interpreting the data.

PMID:40171773 | DOI:10.2340/aos.v84.42959

J Plast Surg Hand Surg. 2025 Apr 2;60:78-83. doi: 10.2340/jphs.v60.43198.

ABSTRACT

Longitudinal trends in breast reconstruction after modified radical mastectomy remain under described. This study aims to assess procedural trends in autologous reconstruction (AR) and implant-based reconstruction (IBR), to analyse demographic shifts in these patients, and to examine differences in oncologic management. This retrospective study utilizes the Surveillance, Epidemiology, and End Results (SEER) database to investigate trends in immediate breast reconstruction from 2000 to 2020 following unilateral modified radical and radical mastectomy. Demographic and oncologic variables were collected, and reconstruction types were categorised as IBR, AR, or a combination. Subgroup analyses compared IBR and AR patients, and demographic changes between the 2000-2010 and 2010-2020 cohorts were examined. Chi-square tests in R studio were used for statistical analysis. Of the 25,649 patients, 51.8% underwent IBR and 48.2% AR. AR patients were typically younger, more frequently Black, had higher incomes, and were less likely to live in rural areas compared to IBR patients. A shift from AR to IBR was observed, with AR decreasing from 41.8% in 2000 to 24.5% in 2020. Significant demographic changes in AR patients included increased age, higher proportions of Black and Asian patients, reduced income, and increased non-marital status. Oncologic management differed, as AR patients were less likely to have received chemotherapy and radiation prior to their reconstruction, and experienced longer reconstruction times compared to IBR patients. This study highlights a decline in AR and rising IBR popularity, and reveals evolving patient characteristics. Understanding these trends is crucial for equitable access and informed decision-making in breast cancer reconstructive care.

PMID:40171755 | DOI:10.2340/jphs.v60.43198

Nanomedicine (Lond). 2025 Apr 2:1-17. doi: 10.1080/17435889.2025.2481823. Online ahead of print.

ABSTRACT

AIM: The purpose of this study was to investigate comparatively the anticancer potential of Terbinafine loaded Dextran Sulphate coated Zein nanospheres against human prostate cancer PC3 cells to enhance the repurposing profile of terbinafine utilizing optimized nano-sized delivery systems.

MATERIALS & METHODS: The formula was fabricated using the thin film hydration technique. Particle size analysis, drug diffusion, and encapsulation efficiency were considered when evaluating the fabricated formula, which were developed using a Box-Behnken statistical design.

RESULTS: Due to the formula optimization, the mean particle size was 273.2 ± 1.98 nm, the zeta potential was -38.4 ± 2.77 mV, and the amount released after 36 h was 97.4 ± 5.7%. The formula exhibited significantly reduced IC₅₀ in PC3 cells by around 14-fold. A higher cellular uptake was observed. The cell cycle assay results obtained suppression of the proliferation, especially in the G₀/G₁ and S phases. This pro-apoptotic pattern of the optimized formula was confirmed by the increased mRNA expression of CASP3 and P53 and reduced expression of CDK1, CDK7, and CDK9. Furthermore, a higher production of reactive oxygen species was achieved.

CONCLUSION: The optimized formula revealed enhanced pro-apoptosis in PC3 cells which support the repurposing profile of terbinafine toward prostate cancer.

PMID:40171736 | DOI:10.1080/17435889.2025.2481823

Pediatr Int. 2025 Jan-Dec;67(1):e70010. doi: 10.1111/ped.70010.

ABSTRACT

BACKGROUND: The Lich-Gregoir procedure for bilateral vesicoureteral reflux (VUR) is limited by the risk of urinary retention. Here, we investigated the efficacy of the Lich-Gregoir procedure compared to that of the Cohen procedure for bilateral VUR in children.

METHODS: We retrospectively evaluated children who underwent open ureteral re-implantation for bilateral VUR between 2010 and 2022. The patients’ clinical characteristics and perioperative outcomes were compared after 1:1 propensity score matching (PSM).

RESULTS: A total of 137 patients were enrolled in this study, with 122 undergoing the Cohen procedure and 15 undergoing the Lich-Gregoir procedure. After PSM, there were 14 patients in each group. The operative time was shorter in the Lich-Gregoir group (121.0 vs. 157.0 min; p = 0.018), while the urethral Foley stay was longer in the Cohen group (6.0 vs. 4.0 days; p < 0.001). Only the Cohen group required ureteral catheter insertion (4.5 days) and had a higher rate of bladder spasms (85.7% vs. 0%; p < 0.001). The Cohen group experienced two postoperative complications, while the Lich-Gregoir group had one patient with temporary urinary retention. The hospitalization period was longer in the Cohen group (8.0 vs. 7.0 days; p < 0.001). There were no significant differences in postoperative hydronephrosis, postoperative urinary tract infection, and persistent VUR between the two groups.

CONCLUSIONS: The Lich-Gregoir procedure for bilateral VUR was safely and effectively performed in patients who met several criteria (e.g., toilet-trained patients, mild-to-moderate reflux, and normal bladder volume and function).

PMID:40171727 | DOI:10.1111/ped.70010

S Afr Fam Pract (2004). 2025 Mar 26;67(1):e1-e8. doi: 10.4102/safp.v67i1.6062.

ABSTRACT

BACKGROUND: Voluntary medical male circumcision (VMMC) is a significant biomedical and cost-effective intervention in preventing human immunodeficiency virus (HIV) transmission. This study aimed to compare VMMC before and during coronavirus disease 2019 (COVID-19) in Gauteng, one of the most affected provinces in South Africa by HIV and/or acquired immunity deficiency syndrome (AIDS) and COVID-19, to inform VMMC delivery and uptake during future pandemics.

METHOD: A comparative analysis. Routine VMMC data were obtained from all public and private hospitals in Gauteng province from the District Health Information System and medical schemes. The datasets were merged with the years 2019 and 2020 as before and during COVID-19 periods, respectively. Percentage change in VMMC was calculated to determine changes in VMMC before and during the COVID-19 pandemic.

RESULTS: Provincially, VMMC declined in 2020 by an overall 33.8% for ≥ 10 years, 32.4% for 10-14 years and 35.8% for ≥ 15 years. All five districts in Gauteng province were affected differently. Exceptionally, the Tshwane Metropolitan district recorded an increase of 21.8% in ≥ 10 years and 36.0% in 10-14 years, despite a decline of -18.2% in ≥ 15 years in VMMC. While the other four districts saw a significant percentage decline in the three age groups of VMMC, the highest disruption was experienced in the West Rand district, in all three age groups.

CONCLUSION: In 2020 during the COVID-19 pandemic, VMMC substantially declined in Gauteng province. However, Tshwane, one of the five districts in Gauteng experienced an increase in VMMC, highlighting a health system resilient lesson to be learned. The fight against HIV is crucial and warrants the continuum of VMMC during future crises.Contribution: The evidence may inform policies on VMMC delivery post-COVID-19 and particularly during future outbreaks as a strive to curb HIV transmission in South Africa.

PMID:40171715 | DOI:10.4102/safp.v67i1.6062

S Afr Fam Pract (2004). 2025 Mar 21;67(1):e1-e7. doi: 10.4102/safp.v67i1.6010.

ABSTRACT

BACKGROUND: Human immunodeficiency viruses (HIV) and/or acquired immunodeficiency syndrome remains a significant global health issue, affecting millions of individuals worldwide. Medical male circumcision (MMC) demonstrated effectiveness in decreasing the spread of HIV, more specifically through heterosexual contact with HIV-positive partners. Studies have shown a correlation between male circumcision and lower HIV prevalence, especially in regions where circumcision is a cultural practice. The purpose of the study was to determine the knowledge and attitudes of men utilising the MMC services regarding circumcision.

METHODS: A cross-sectional study was conducted at a community health centre involving 164 male participants aged 18 years and above using a self-administered questionnaire. Descriptive and inferential statistics were used to determine means, frequencies and associations between knowledge and attitudes of men regarding male medical circumcision.

RESULTS: The median age of men seeking MMC services was 30 years, with hygiene cited as the primary reason by 88.4% of them. In addition, a majority (92%) were mindful of the advantages of circumcision in terms of lowering the risk of sexually transmitted infections and penile cancer (90%).

CONCLUSION: Hygiene emerged as the primary reason for seeking MMC, contrasting with other studies where cultural and religious factors were more common. Despite significant knowledge levels regarding MMC’s health benefits, the overall attitudes towards the procedure were predominantly negative.Contribution: The study highlights a unique factor influencing the decision to undergo MMC in a community health setting and awareness of its health benefits.

PMID:40171714 | DOI:10.4102/safp.v67i1.6010

Curationis. 2025 Mar 25;48(1):e1-e9. doi: 10.4102/curationis.v48i1.2653.

ABSTRACT

BACKGROUND: The South African public is not satisfied with the level of healthcare rendered by South African health institutions, particularly in Gauteng province; this is evidenced by the concerns raised by the South African Health Ombudsman, who, as of 2021, received more than 2000 complaints from the public, of which 40% were from Gauteng province. This is supported by South African Nursing Council (SANC)’s unprofessional report, which reflected the increase in poor nursing care cases.

OBJECTIVES: The objectives of the study were to identify the factors contributing to the quality of nursing care at the provincial hospitals of Gauteng province and to make recommendations for improving the quality of nursing care in hospitals.

METHOD: The study utilised an exploratory descriptive qualitative design. The data were analysed following Colaizzi’s steps of data analysis, during which 4 themes and 9 sub-themes emerged. The study population consisted of registered professional nurses working in the two hospitals. The sample consisted of 12 registered professional nurses.

RESULTS: The study identified three positive factors, namely, nursing as a calling, supervision rounds and staff appreciation. Six negative factors that contribute to the quality of nursing care were identified as the lack of human and material resources, administrative challenges, unsupportive management, nurse-related factors, attitudes of patients, and private versus public health institutions.

CONCLUSION: The study revealed the positive factors that promote the quality of nursing care. The negative factors affecting the quality of nursing care were found to be more than the positive factors.Contribution: The study presented factors affecting the quality of nursing care and makes recommendations that can be utilised as basis for improving the quality of nursing care. The study findings and recommendations can be used to develop programmes to support nurses to provide dignified and quality patient care in the hospital.

PMID:40171707 | DOI:10.4102/curationis.v48i1.2653

Acta Oncol. 2025 Apr 2;64:499-506. doi: 10.2340/1651-226X.2025.42557.

ABSTRACT

BACKGROUND AND PURPOSE: Health literacy is defined as the ability to find, understand and use health information for informed decision. The role of health literacy in treatment decisions and outcome remains largely unexplored. This study sought out to assess the effect of individual health literacy on overall survival (OS) in cancer patients in Ostrobothnia.

MATERIAL AND METHODS: The present study is a follow-up of a cross-sectional survey study performed during December 2021 and March 2022. The survey assessed socioeconomic factors, lifestyle factors and self-reported health literacy. The follow-up included data on recorded death, cause of death, performance status (PS), clinical frailty scale, Charlson comorbidity index and body mass index. The sample size for this study was 400 participants, and any participant with a malignancy was eligible for the study.

RESULTS: Low health literacy was associated with increased risk of death. The disparity remained after adjustments for age, sex, comorbidities, PS, stage and hazard ratios (HR) = 1.47 (1.01-2.14). After adjustments for lifestyle patterns, the disparity remained, HR = 1.49 (1.03-2.17). The difference diminished after adjustments for cancer types. The median OS was 3.6 months longer for those with medium-high health literacy than those with low health literacy.

INTERPRETATION: The results indicated health literacy having a direct, clinically significant, effect on OS, which is likely not explained by differences in cancer entity alone. Future studies should focus on assessing whether an intervention aiming to improve health literacy may improve overall cancer survival.

PMID:40171705 | DOI:10.2340/1651-226X.2025.42557

Afr J Prim Health Care Fam Med. 2025 Mar 12;17(1):e1-e12. doi: 10.4102/phcfm.v17i1.4718.

ABSTRACT

BACKGROUND: The continuum of care (CoC) in maternal and neonatal services among women in Ethiopia was low because of individual and cultural barriers.

AIM: This study aims to identify factors that hindered the utilisation of the CoC services.

SETTING: The study took place in the Assosa Zone of north-western Ethiopia.

METHODS: A qualitative study using audio-taped individual interviews was conducted. A total of 52 study participants were purposefully recruited from the Assosa Zone. Thematic analysis was employed to identify major themes and categories from the transcripts.

RESULTS: Findings revealed the economic situation of women as the underlying barrier to women accessing and utilising maternal and neonatal CoC services. Presumably, high transport and medical costs and the inability to pay the raised costs were drivers to discontinuity of the CoC of maternal and neonatal services. Other barriers to utilisation of CoC services were found to be workload in the households, secreting pregnancy, traditional beliefs, husbands’ attitude and religion, awareness gaps in pregnancy, and maternal and neonatal care. These factors are thus regarded as important barriers to the utilisation of continuity of care in maternal and neonatal services in Ethiopia.

CONCLUSION: Moreover, economic, cultural and religious factors, maternal awareness and husbands featured as significant barriers to the utilisation of maternal and neonatal CoC services in Ethiopia.Contribution: The findings revealed the economic situation of women as a barrier to the CoC in maternal and neonatal services utilisation, manifesting itself in unaffordable transport and medication user fees.

PMID:40171698 | DOI:10.4102/phcfm.v17i1.4718