Nevin Manimala

PeerJ. 2025 Aug 29;13:e19970. doi: 10.7717/peerj.19970. eCollection 2025.

ABSTRACT

BACKGROUND: Stroke is a leading cause of death and disability worldwide, and there is still a lack of specific and sensitive biomarkers for its diagnosis.

OBJECTIVE: This study aimed to investigate the diagnostic value of FOXO4 and Ep300 proteins in acute ischemic stroke patients who visited the emergency department.

METHODS: Patients were consecutively included in the study. The amount of Ep300 and FOXO4 proteins was determined using an enzyme-linked immunosorbent assay (ELISA). Receiver operator characteristic (ROC) analyses of FOXO4 and Ep300 proteins were performed.

RESULTS: The study was conducted on a total of 39 acute ischemic stroke patients, 17 females and 22 males, with a mean age of 66.9 ± 11 years. Seventeen females and 23 male control were also included. The discriminative ability of Ep300 protein was not statistically significant (p value = 0.380). FOXO4 protein had moderate discriminative ability (AUC value = 0.705 and p value = 0.002). When the cut-off value for FOXO4 protein was accepted as > 1.15, the sensitivity was 74.29%, the specificity was 64.52%, the positive predictive value was 70.3%, the negative predictive value was 69%, the positive likelihood ratio was 2.09, and the negative likelihood ratio was 0.4.

CONCLUSIONS: The study’s findings suggest that FOXO4 protein could potentially serve as a valuable biomarker in the diagnosis of stroke in acute ischemic stroke patients.

PMID:40900757 | PMC:PMC12401024 | DOI:10.7717/peerj.19970

Front Public Health. 2025 Aug 14;13:1574623. doi: 10.3389/fpubh.2025.1574623. eCollection 2025.

ABSTRACT

BACKGROUND: Electronic cigarette (e-cigarette) use has become increasingly popular worldwide, including in Saudi Arabia, especially among younger individuals. This study investigates the patterns, motivations, and perceptions of e-cigarette use to inform public health interventions and policy.

METHODS: This descriptive cross-sectional study surveyed traditional cigarette smokers and ex-smokers above 18 in Saudi Arabia using an online questionnaire distributed via social media with convenience and snowball sampling. The tool, adapted from validated sources and refined through expert review and pilot testing, captured demographic data, smoking behaviors, perceptions, motivations, and patterns of e-cigarette use. Closed-ended questions ensured consistency in responses. A power analysis was conducted to determine the required sample size. Descriptive statistics, chi-square tests, one-way ANOVA, correlation analyses, and multinomial logistic regression were applied (p ≤ 0.05).

RESULTS: Findings revealed that e-cigarette use was significantly higher among younger males (p = 0.028), with 86% of participants being male and 63% aged 18-28. Socioeconomic factors such as lower income and education levels were associated with higher usage rates (p = 0.001 and p = 0.030, respectively). Dual users of e-cigarettes and traditional cigarettes made up 47% of participants, while 31% were ex-smokers, and 22% were exclusive e-cigarette users. A preference for high nicotine content (≥16 mg) was noted among 26% of participants, and 44% reported adverse effects like shortness of breath and chest pain. Key motivations included smoking cessation (45%), flavor variety (35%), and perceived safety (29%). Retailers (43%) and online stores (27%) were the primary sources. Notably, 61% of participants supported government regulation of e-cigarettes. Gender, region, marital status, and education were significant predictors of usage patterns (p < 0.05).

CONCLUSIONS: E-cigarette use is widespread among younger males in Saudi Arabia, driven by socioeconomic factors and perceptions of safety. Despite these perceptions, adverse effects like shortness of breath and chest pain were frequently reported. Comprehensive public health measures, including nicotine regulation, sales restrictions, taxation, and education, are urgently needed. Collaboration between the health and education sectors, along with continuous monitoring and research, is crucial for guiding effective national strategies.

PMID:40900714 | PMC:PMC12401102 | DOI:10.3389/fpubh.2025.1574623

Front Public Health. 2025 Aug 18;13:1651676. doi: 10.3389/fpubh.2025.1651676. eCollection 2025.

ABSTRACT

BACKGROUND: Although radiation workers’ exposure levels consistently remained below established safety thresholds, accumulating evidence demonstrates that chronic low-dose ionizing radiation exposure may still pose significant health risks to humans. We aimed to explore the relationship between the years of low-dose radiation work and dyslipidemia.

METHODS: We collected occupational and physical examination data of 10,338 radiation workers from 1,200 workplaces during 2019-2020 in Guangdong Province, China. After controlling for social demographic and health behavior confounders, we used a mixed-effects model to assess the association of ionizing radiation exposure duration with blood lipid biomarkers as well as the prevalence of dyslipidemia. We further comprehensively evaluated the modifying effects of various demographic characteristics, health behavior factors, and air pollutant concentrations.

RESULTS: We found that participants with prolonged ionizing radiation exposure tended to have 8-40% higher levels of total cholesterol (TC) compared to those with < 10 years of exposure. The estimates were 9-23% for triglycerides (TG) and 5-26% for low-density lipoprotein cholesterol (LDL-C). Similar disparities were observed for the prevalence of overall dyslipidemia, abnormal TC or TG, hypercholesterolemia, hypertriglyceridemia, and high β-lipoproteinemia, with odds being 1.51-2.45 times higher in the group with > 30 years of ionizing radiation exposure compared to others. Our estimates further indicated greater effect estimates for prolonged ionizing radiation exposure and the prevalence of lipid abnormalities (p < 0.05) among the females, unmarried ones, and the workers with normal BMI.

CONCLUSION: These findings suggest a deleterious effect of prolonged ionizing radiation exposure on lipid metabolism, with certain groups of workers being particularly vulnerable.

PMID:40900712 | PMC:PMC12401101 | DOI:10.3389/fpubh.2025.1651676

Front Public Health. 2025 Aug 18;13:1632960. doi: 10.3389/fpubh.2025.1632960. eCollection 2025.

ABSTRACT

BACKGROUND: Sarcopenia and osteoporosis increase the likelihood of disability and caregiving burden. While progressive resistance training (PRT) is effective in mitigating these outcomes, patients often struggle to find suitable, long-term training facilities, making it difficult to adhere to exercise prescriptions.

OBJECTIVES: This feasibility study aimed to familiarize patients with PRT through educational training by a geriatrician, enabling them to identify a suitable long-term community-based training program.

PARTICIPANTS AND METHODS: Forty-one patients diagnosed with osteoporosis or sarcopenia at a medical center in Taiwan were enrolled via the researchers’ LINE app platform. Finally, 11 participants with osteoporosis were recruited. Among them, four had vertebral compression fractures and two also met the diagnostic criteria for sarcopenia. The median age was 68 (range 63-69) years, DXA femoral neck T-score was -3.3 (-3.5–2.2), and grip strength was 22.4 (20.3-26.7) kg. After cardiopulmonary exercise testing (CPET), participants received up to 10 PRT sessions, with vital signs monitored. In each session, researchers focused on six key learning points of free-weight PRT, addressed difficulties hindering progress, encouraged participants to find community-based training courses, and provided training summaries to external trainers. Descriptive statistics summarized patient data and referral rates. The primary outcome was the success of referrals to community-based training. Secondary outcomes, to be reported later, included changes in grip strength, DXA bone mineral density, DXA muscle mass, CPET results after 6 months, and sustainability of long-term resistance training (RT) in older people with osteoporosis or sarcopenia.

RESULTS: The recruitment success rate was 26.8%. Baseline characteristics did not correlate to successful referrals. A total of 67 physician-guided PRT sessions were conducted for the 11 participants. On average, after 4.5 in-hospital sessions, five participants secured self-paid one-on-one RT in the community, and one joined group training, resulting in a referral success rate of 54.5%.

CONCLUSION: This feasibility study aimed at achieving successful referral for long-term community-based RT. It provides valuable insights for future research on RT for patients with osteoporosis or sarcopenia, making exercise a sustainable and quantifiable intervention.

PMID:40900708 | PMC:PMC12401064 | DOI:10.3389/fpubh.2025.1632960

Front Public Health. 2025 Aug 18;13:1608109. doi: 10.3389/fpubh.2025.1608109. eCollection 2025.

ABSTRACT

BACKGROUND: Pneumoconiosis remains one of the most critical occupational health hazards globally. Utilizing data from the Global Burden of Disease (GBD) 2021, we have updated the epidemiological trends of pneumoconiosis.

METHODS: We conducted and analyzed pneumoconiosis-related data from the GBD 2021 study for individuals aged ≥20 years. Our analysis described the incident cases and age-standardized incidence rates (ASIRs) across various global regions and age groups. Temporal trends were evaluated using Estimated Annual Percentage Change (EAPC) for ASIRs between 1990 and 2021.

RESULTS: The ASIR of pneumoconiosis among individuals aged ≥20 years declined globally at an annual average of 0.48% between 1990 and 2021. Except for high socio-demographic index (SDI) regions, the ASIR of pneumoconiosis declined across all other SDI categories. Males had significantly higher incidence rates than females, especially in older adults. Silicosis emerged as the predominant type of pneumoconiosis, constituting ~56.7% of cases. While the ASIRs for silicosis, coal workers’ pneumoconiosis, and other pneumoconiosis decreased, the ASIRs for asbestosis exhibited a notable upward trend, with an EAPC of 1.21%. A strong negative correlation was observed between the EAPC of pneumoconiosis incidence and the 1990 ASIRs values. Notably, the EAPC showed a statistically significant but very weak positive correlation with the 2021 Human Development Index (HDI) values.

CONCLUSION: Despite a gradual global decline in the ASIR of pneumoconiosis, the disease burden remains substantial in certain regions. Our findings could inform governments and policymakers in developing targeted prevention strategies to mitigate this burden. Future strategies should integrate technological innovation with regulatory frameworks, prioritizing male-dominated high-risk sectors through strengthened global asbestos bans and lifetime health surveillance for workers in pneumoconiosis-prone occupations worldwide.

PMID:40900707 | PMC:PMC12400962 | DOI:10.3389/fpubh.2025.1608109

Front Public Health. 2025 Aug 18;13:1605296. doi: 10.3389/fpubh.2025.1605296. eCollection 2025.

ABSTRACT

OBJECTIVE: To assess the current status and identify factors influencing the medication literacy level of community residents, providing a scientific basis to enhance medication literacy and effectively promote the safe use of medications.

METHODS: A questionnaire survey was conducted among 2,008 community residents in Shenzhen, employing economic stratification and proportionate sampling methods. The analysis utilized various statistical methodologies, including T-tests, F-tests, multiple linear stepwise regression, and structural equation modeling to assess the current medication literacy status and the factors influencing it.

RESULTS: The levels of medication literacy among community residents typically exhibit a normal distribution. Specifically, 10.16% of residents achieved the excellent level, 40.49% reached the good level, 37.40% were classified as passing, and 11.95% were deemed to have failed. The analysis of factors influencing medication literacy revealed that demographic characteristics, such as age and educational level, as well as various elements of medication knowledge, attitude, behaviors, and skills, significantly impact medication literacy. Notably, medication knowledge emerged as the most critical factor. Structural equation modeling demonstrated that medication knowledge, attitude, behaviors, and skills mediate medication literacy, which can indirectly affect medication literacy and be utilized in multiple ways to improve it and ensure the safety of medication use effectively.

CONCLUSION: The level of medication literacy among community residents was commendable. However, the proportion of individuals with high medication literacy levels remained insufficient. Key influencing factors, such as medication knowledge, attitude, behaviors, and skills, are explored, offering insights for the government to implement initiatives that publicize medication knowledge, monitor and improve public medication behaviors, promote health education, and enhance community medication literacy and health development.

PMID:40900696 | PMC:PMC12399700 | DOI:10.3389/fpubh.2025.1605296

Front Public Health. 2025 Aug 18;13:1546867. doi: 10.3389/fpubh.2025.1546867. eCollection 2025.

ABSTRACT

OBJECTIVE: We aimed to assess the recent levels of knowledge and attitudes toward tobacco smoking among adolescents aged 12-16 years in 2010-2019, and to examine trends from 1999 to 2019.

METHODS: We used the most recent data from 145 countries/territories (hereafter “countries”) that conducted at least one Global Youth Tobacco Survey (GYTS) between 2010 and 2019 to assess the current levels of knowledge and attitudes toward tobacco smoking among adolescents aged 12-16 years. And 112 countries that conducted at least three GYTS surveys from 1999 to 2019 were used to assess the trends among adolescents aged 12-16 years over time.

RESULTS: Among 570,492 adolescents from 145 countries, 13.9% (95% CI, 11.9%-15.8%) incorrectly believed that tobacco smoking was not harmful, and 16.1% (95% CI, 15.2%-16.9%) believed that exposure to secondhand smoke was not harmful. A substantial proportion believed that quitting smoking was easy (42.5%; 95% CI, 36.9%-48.0%) or that short-term smoking was safe if followed by quitting (40.2%; 95% CI, 39.1%-41.3%). Additionally, 25.8% (95% CI, 24.8%-26.8%) believed that tobacco smoking helps young people feel more comfortable, 26.4% (95% CI, 24.8%-28.0%) believed that it helps them make more friends, and 15.8% (95% CI, 14.6%-17.0%) believed that it makes them appear more attractive. Among 1,734,258 adolescents from 112 countries, 67.9% of countries showed increasing or stable trends in the belief that smoking is not harmful, 75.9% for the belief that secondhand smoke exposure is not harmful, 38.4% for short-term smoking being safe, 32.1% for quitting being easy, and 69.6, 43.8, and 44.6% for the beliefs that smoking helps with comfort, making friends, and appearing attractive, respectively, from 1999 to 2019.

CONCLUSIONS: Incorrect beliefs and positive attitudes toward tobacco smoking were prevalent among adolescents worldwide. Moreover, these beliefs and attitudes toward tobacco smoking have either persisted or increased in most included countries over time. Targeted interventions and policies are needed to reduce these and promote accurate knowledge about tobacco use and its harmful effects.

PMID:40900693 | PMC:PMC12399639 | DOI:10.3389/fpubh.2025.1546867

Front Public Health. 2025 Aug 18;13:1627464. doi: 10.3389/fpubh.2025.1627464. eCollection 2025.

ABSTRACT

INTRODUCTION: Structured, well-being interventions are under-researched in non-Western workplaces. This study evaluates The Good Life training program-a participatory, multi-component training intervention-on employee well-being, engagement and stress in South Africa.

METHODS: Employing an exploratory, quasi-experimental, explanatory sequential mixed-methods design, we collected quantitative data from 50 South African respondents across three delivery formats (four half-days online, two full-days in classroom, and four half-days in classroom) at pre-training and 3 months post-training using five validated scales (PSS-4, UWES-3, SWLS, FS, WEMWBS-14). No concurrent control group was retained due to attrition and contamination; thus, causal inferences are cautious. Qualitative data were gathered via semi-structured interviews with a purposive subsample of 15 participants to elucidate mechanisms of change.

RESULTS: Two full-day workshops led to significant improvements in overall well-being and work engagement, whereas the online format produced a significant boost in well-being only. The half-day format showed no statistically significant changes. Qualitative findings highlighted immersive peer interaction, structured reflection and managerial support as core drivers of impact.

DISCUSSION: Immersive, HR-facilitated training shows promise for enhancing well-being and engagement in South African workplaces. Future research should employ randomized controlled designs, larger samples and objective measures (e.g., absenteeism, physiological indicators) to substantiate and extend these preliminary findings.

PMID:40900692 | PMC:PMC12399526 | DOI:10.3389/fpubh.2025.1627464

Health Sci Rep. 2025 Sep 1;8(9):e71202. doi: 10.1002/hsr2.71202. eCollection 2025 Sep.

ABSTRACT

BACKGROUND AND AIMS: Frailty is one of the most common syndromes in old age. This syndrome, associated with adverse health outcomes and increased economic costs, can affect the quality of life of elderly people. This study investigates the prevalence and determinants of frailty in community-dwelling Iranian older adults.

METHODS: This analytical cross-sectional study was conducted over 5 months among the retired elderly people (> 60 years) in Isfahan. The tools used in this study included a demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), an assessment of polypharmacy, and the Edmonton Frail Scale. Data were analyzed using statistical tests in SPSS software.

RESULTS: The prevalence of frailty, based on the Edmonton Frail Scale, was 17.4%. No statistically significant difference in mean frailty scores was observed between men and women (p = 0.286). Logistic regression analysis showed that older age (B = 0.067, OR = 1.07, 95% CI: 1.01-1.15), lower education (B = -2.66, OR for MSc = 0.07, 95% CI: 0.00-0.74), polypharmacy (B = 1.82, OR = 6.16, 95% CI: 2.8-13.50), and poor sleep quality (B = 0.59, OR = 1.80, 95% CI: 0.88-3.78) were significantly associated with a higher likelihood of frailty (p < 0.05).

CONCLUSION: This study’s results indicated that age, education, polypharmacy, and poor sleep quality are associated with an increased risk of frailty in Iranian elderly people. Therefore, timely screening and intervention are recommended to identify these factors and prevent their irreversible physical, psychological, and financial consequences.

PMID:40900684 | PMC:PMC12399986 | DOI:10.1002/hsr2.71202

Adv Neonatal Care. 2025 Sep 2. doi: 10.1097/ANC.0000000000001289. Online ahead of print.

ABSTRACT

BACKGROUND: Feeding intolerance can hinder enteral nutrition in infants, often necessitating transpyloric tube feeding. However, the success of transpyloric tube placement varies.

PURPOSE: To compare the rate of correct transpyloric tube placement in infants with and without gastric air insufflation, and to assess complications associated with postpyloric feeding.

METHODS: A randomized controlled trial was conducted in a tertiary neonatal unit of a public teaching hospital. The estimated sample size included 11 participants in the intervention group (IG) and 11 in the control group (CG). In the IG, transpyloric tube insertion was aided by gastric air insufflation. Correct positioning was defined as the distal end of the tube reaching the third or fourth portion of the duodenum, as confirmed by radiography.

RESULTS: The success rate of correct tube placement was the same in both groups (45.4% vs 45.4%, P = 1.000). Two infants experienced complications (necrotizing enterocolitis and jejunal perforation), neither of which were related to the procedure.

IMPLICATIONS FOR PRACTICE AND RESEARCH: There were no significant differences between the IG and CG in terms of birth weight (1030 g vs 985 g, P = .895), gestational age (27 weeks vs 28 weeks, P = .973), or age at the time of the procedure (28 days vs 39 days, P = .224). The rate of jejunal tube placement was also statistically similar (27.7% vs 9.1%, P = .269). Gastric air insufflation did not increase the rate of successful transpyloric tube placement. Observed complications were not attributable to the procedure.

PMID:40900658 | DOI:10.1097/ANC.0000000000001289