Nevin Manimala

JMIR Res Protoc. 2025 Aug 13;14:e74068. doi: 10.2196/74068.

ABSTRACT

BACKGROUND: Marked by high mortality rates on a global scale, with disease mortality being notably focused among older adults, the COVID-19 pandemic has become a significant health crisis. Despite the numerous publications on COVID-19 mortality among older adults, there is still a gap in knowledge when considering centenarians, as there is no systematic review and meta-analysis that summarizes COVID-19 mortality in centenarians globally.

OBJECTIVE: This study aims to systematically review and synthesize global evidence on COVID-19 mortality rates among centenarians and the population of older adults worldwide, whether residing in long-term health facilities, hospitals, or their homes.

METHODS: An automated search was conducted on the following databases: PubMed, Scopus, and Web of Science. Observational studies, both cohort and case-control, were selected. Quality assessment of the selected studies was based on the Joanna Briggs Institute critical appraisal tool for observational cohort and case-control studies. Three independent authors conducted the searches, and any possible disagreements were resolved by consensus. A meta-analysis of mortality proportions will be conducted to calculate the raw, logit, and arcsine proportions for all studies included in our meta-analyses. Heterogeneity between studies with a significance of P=.05 will be assessed by calculating the I² value using the DerSimonian and Laird method for random effects. Odds ratios and 95% CIs for dichotomous data and weighted mean risk differences and 95% CIs for continuous variables will be calculated. Further subgroup analyses will be attempted to explore heterogeneity among over 6.7 million older adults. Leave-one-out sensitivity tests will be conducted to assess the robustness of our results. The meta-analysis will be conducted using R software version 4.4.2 (R Foundation for Statistical Computing).

RESULTS: A total of 4 studies were included in our systematic review and meta-analysis. Of the included studies, 3 are retrospective cohort studies and 1 is an observational, retrospective case-control study. As for study group size, 1 cohort study was conducted on a population of less than 1000 participants, 2 studies (1 cohort and 1 case-control) involved more than 10,000 participants, and 1 cohort study included more than 6 million participants.

CONCLUSIONS: This study has significant potential. Given the consensus that older adults, let alone centenarians, are the most vulnerable demographic to serious outcomes and deaths during pandemics. Addressing these gaps is crucial for the informed development of public policies, enabling countries to minimize the impacts on this population, particularly during health crises such as the COVID-19 pandemic.

TRIAL REGISTRATION: PROSPERO CRD42025645150; https://www.crd.york.ac.uk/PROSPERO/view/CRD42025645150.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/74068.

PMID:40802974 | DOI:10.2196/74068

JMIR Form Res. 2025 Aug 13;9:e73642. doi: 10.2196/73642.

ABSTRACT

BACKGROUND: Chemical ocular injuries are a major public health issue. They cause eye damage from harmful chemicals and can lead to severe vision loss or blindness if not treated promptly and effectively. Although medical knowledge has advanced, accessing reliable and understandable information on these injuries remains a challenge. This is due to unverified web-based content and complex terminology. Artificial intelligence tools like ChatGPT provide a promising solution by simplifying medical information and making it more accessible to the general public.

OBJECTIVE: This study aims to assess the use of ChatGPT in providing reliable, accurate, and accessible medical information on chemical ocular injuries. It evaluates the correctness, thematic accuracy, and coherence of ChatGPT’s responses compared with established medical guidelines and explores its potential for patient education.

METHODS: A total of 9 questions were entered into ChatGPT regarding various aspects of chemical ocular injuries. These included the definition, prevalence, etiology, prevention, symptoms, diagnosis, treatment, follow-up, and complications. The responses provided by ChatGPT were compared with the International Classification of Diseases-9 and International Classification of Diseases-10 guidelines for chemical (alkali and acid) injuries of the conjunctiva and cornea. The evaluation focused on criteria such as correctness, thematic accuracy, and coherence to assess the accuracy of ChatGPT’s responses. The inputs were categorized into 3 distinct groups, and statistical analyses, including Flesch-Kincaid readability tests, ANOVA, and trend analysis, were conducted to assess their readability, complexity, and trends.

RESULTS: The results showed that ChatGPT provided accurate and coherent responses for most questions about chemical ocular injuries, demonstrating thematic relevance. However, the responses sometimes overlooked critical clinical details or guideline-specific elements, such as emphasizing the urgency of care, using precise classification systems, and addressing detailed diagnostic or management protocols. While the answers were generally valid, they occasionally included less relevant or overly generalized information. This reduced their consistency with established medical guidelines. The average Flesch Reading Ease Score was 33.84 (SD 2.97), indicating a fairly challenging reading level, while the Flesch-Kincaid Grade Level averaged 14.21 (SD 0.97), suitable for readers with college-level proficiency. The passive voice was used in 7.22% (SD 5.60%) of sentences, indicating moderate reliance. Statistical analysis showed no significant differences in the Flesch Reading Ease Score (P=.38), Flesch-Kincaid Grade Level (P=.55), or passive sentence use (P=.60) across categories, as determined by one-way ANOVA. Readability remained relatively constant across the 3 categories, as determined by trend analysis.

CONCLUSIONS: ChatGPT shows strong potential in providing accurate and relevant information about chemical ocular injuries. However, its language complexity may prevent accessibility for individuals with lower health literacy and sometimes miss critical aspects. Future improvements should focus on enhancing readability, increasing context-specific accuracy, and tailoring responses to a person’s needs and literacy levels.

PMID:40802972 | DOI:10.2196/73642

Prehosp Emerg Care. 2025 Aug 13:1-12. doi: 10.1080/10903127.2025.2547653. Online ahead of print.

ABSTRACT

OBJECTIVES: Prehospital antibiotic administration prior to emergency department (ED) admission could reduce the delay of effective antibiotic treatment and thus mortality of septic patients. Additionally, collecting blood cultures early could improve microbial identification. We assessed the effect of ceftriaxone administration before ED admission on mortality. As our secondary objective, we evaluated the positivity and contamination rate of prehospital blood cultures in a prehospital physician-staffed system.

METHODS: The computerized databases of a physician-staffed prehospital unit were screened for patients presenting with suspected sepsis and low systolic blood pressure (< 90 mmHg) between May 2013 and December 2018. The association between prehospital ceftriaxone administration and 28-day mortality, Intensive care unit (ICU) admission and length-of-stay (LOS) was analyzed. The yield of blood cultures and frequency of contamination were calculated.

RESULTS: A total of 165 septic patients matched the inclusion criteria. Prehospital antibiotics were administered in 60.6% (100/165) of cases. Twenty-eight-day mortality was similar between patients receiving and not receiving antibiotics (39.0% vs 38.5%, p = 1.000). Hazard ratio of 28-day mortality was 0.87 (95%IC 0.51-1.47). Likewise, no statistically significant impact on 7-day mortality, ICU admission or LOS was found. Blood cultures showed a high positivity rate (35.4%, 23/65) and a low contamination rate (3.1%, 2/65).

CONCLUSIONS: In a physician-staffed prehospital system, prehospital blood cultures among critically ill, septic patients showed high positivity and low contamination rates. However, early ceftriaxone administration showed no impact on 28-day mortality, 7-day mortality, ICU admission and ED and ICU LOS.

PMID:40802942 | DOI:10.1080/10903127.2025.2547653

JCO Clin Cancer Inform. 2025 Aug;9:e2500018. doi: 10.1200/CCI-25-00018. Epub 2025 Aug 13.

ABSTRACT

PURPOSE: Breast cancer (BC) is a leading cause of morbidity and mortality among women. Symptoms and treatment-related side effects often go undetected during routine follow-ups. Digital health interventions offer promising tools for real-time monitoring and personalized care. We aimed to implement and evaluate the feasibility of a mobile health electronic Patient-Reported Outcomes (ePRO)-based platform for telemonitoring patients with BC undergoing (neo)adjuvant chemotherapy.

METHODS: This prospective observational study enrolled patients with BC (TNM stages I to III) initiating chemotherapy at Barretos Cancer Hospital in Brazil. Participants were telemonitored using the ThummiOnco platform for 4-6 months, following a standardized protocol. Feasibility was assessed through platform usage, resolution of patient-reported symptoms (according to Common Terminology Criteria for Adverse Events) within 48-72 hours, and health care outcomes, including additional consultations, dose reductions, treatment interruptions/discontinuations, hospitalizations, and mortality. Statistical analysis was performed using descriptive statistics.

RESULTS: Between October 2022 and June 2023, 67 eligible patients (median age 51 years) were included, with 62% receiving neoadjuvant chemotherapy. The median number of app accesses per patient was 38, with 6.65 daily symptom reports and 94% adherence. At 48 hours, 67% of patient-reported symptoms were fully resolved, whereas at 72 hours the resolution rate was 75.4%. Regarding resolution by grade, 83% of grade 1, 69.5% of grade 2, and 54.8% of grade 3 symptoms were fully resolved. Complementary consultations were needed for 34 patients. Dose reductions occurred in 10 (14.9%), treatment interruptions/discontinuations in 35 (52.2%), and hospitalizations in seven (10.4%). One patient died from progressive disease.

CONCLUSION: Telemonitoring facilitated early symptom identification and management. Most reports were resolved through the platform, with minimal additional demands on the health care team. Future studies should assess cost-effectiveness and scalability across diverse populations.

PMID:40802911 | DOI:10.1200/CCI-25-00018

Eur J Public Health. 2025 Aug 13:ckaf140. doi: 10.1093/eurpub/ckaf140. Online ahead of print.

ABSTRACT

Some veterans face unique physical, mental, and social challenges, leading them to seek assistance from military charities. This case-control study uses data from the MONARCH Study and the tri-service food insecurity study, with the aim to identify key risk factors associated with charity usage among UK veterans. Cases (veterans who accessed charities in 2022) were compared to controls (veterans who did not access charities). Logistic regression and a random forest algorithm were used to identify risk factors for charity use. Several risk factors for charity use were identified: younger age, living alone, being a non-officer, and living in rented accommodation. Having dependents was found to be protective but emerged as a risk factor for veterans living alone and protective for veterans living with others. The use of a random forest algorithm confirmed the statistical importance of these variables, offering deeper insights into complex interactions. These results improve our understanding of the risk factors for charity usage by veterans and provide a predictive model that could be implemented in planning service provision in public health. Additionally, it could be used as the basis for the implementation of targeted preventive interventions, allowing for proactive measures to be taken to support veterans before they reach a point of needing charity services in a period of crisis. These predictive models could enable more efficient resource allocation and the development of tailored strategies to address the specific needs of at-risk veteran subgroups.

PMID:40802894 | DOI:10.1093/eurpub/ckaf140

J Biomater Appl. 2025 Aug 13:8853282251369228. doi: 10.1177/08853282251369228. Online ahead of print.

ABSTRACT

Although autografts and allografts remain common for bone defect repair, they entail donor-site morbidity, limited availability, and potential immune rejection. The development of tissue engineering has provided a potential solution to overcome these and facilitate effective bone regeneration. Extensive research has confirmed the osteogenic potential of bioactive molecules like Atorvastatin (ATV) and Icariin (ICA). But despite the increasing body of evidence supporting their individual merits, few studies have investigated the synergistic integration of these materials in Nanocomposite scaffolds. A novel three-dimensional scaffold composed of polycaprolactone (PCL), carboxymethyl chitosan (CMCs), and nano-hydroxyapatite (nHA), co-loaded with Icariin and Atorvastatin, and fabricated using the freeze-casting technique, is described. This study aimed to evaluate the scaffold’s effectiveness in promoting calvarial bone regeneration in Wistar rats, contributing to the advancement of biomaterials in bone tissue engineering. Scaffolds containing PCL/CMCs/nHA with 0.1% ICA and 0.1% ATV were fabricated using the freeze-casting method. In vitro assessments were conducted to evaluate the biomechanical and physiological properties of the scaffolds. In vivo experiments involved implanting the scaffolds into calvarial bone defects in six groups of Wistar rats. After 12 weeks, histological analysis was performed to assess bone regeneration, including fibrous tissue formation, bone formation, osteon development, and osteoblast cell numbers and fibroblast cell numbers. After 72 h of incubation, the PCL/CMCs/nHA/ATO/ICA scaffold significantly enhanced cell viability compared to other groups, however, the differences observed between the other groups were not statistically significant. In vivo, results showed significantly greater bone formation, osteon development, and osteoblast numbers in the PCL/CMCs/nHA/ATO/ICA group than in the negative and other groups. The PCL/CMCs/nHA/ATO/ICA scaffold demonstrated superior bone regeneration outcomes, showing comparable performance to autografts in terms of new bone tissue formation, osteon structure, and 72-h cell viability, suggesting its potential as a viable alternative in bone tissue engineering.

PMID:40802859 | DOI:10.1177/08853282251369228

PLoS One. 2025 Aug 13;20(8):e0329390. doi: 10.1371/journal.pone.0329390. eCollection 2025.

ABSTRACT

Europe’s biodiversity faces increasing pressure from climate change, pollution, and habitat loss, while governments struggle to sustain the monitoring efforts required to respond effectively to these challenges. Addressing this gap calls for a coordinated and inclusive approach that brings together all relevant biodiversity stakeholders to co-design a robust European biodiversity monitoring system. To support this, the Europa Biodiversity Observation Network (EuropaBON) has established one of the most comprehensive biodiversity stakeholder networks in Europe. To analyse this community and support evidence-based improvements, we developed the EuropaBON Stakeholder Dashboard – a dynamic, interactive web application that maps and visualises the EuropaBON stakeholder network’s structure in real-time. Accessible at https://europabon.org/dashboard, the dashboard enables users to explore stakeholder connections across three key dimensions: occupational sector, realm (terrestrial, freshwater, marine), and geographic region. It displays detailed network graphs, an interactive map, and summary statistics that highlight institutional positions in biodiversity data flows (e.g., data users, data providers, or both), levels of participation in EuropaBON activities, and connections to key EU projects and infrastructures. Users can identify the most central and active institutions in the network, filter and download data, and assess coverage across different thematic areas and regions. This tool supports both researchers and policymakers by offering an up-to-date overview of who is involved in biodiversity monitoring across Europe, where collaborations exist, and where further engagement is needed. By combining technological integration with stakeholder participation, the EuropaBON Stakeholder Dashboard enhances transparency, promotes inclusivity, and contributes to a more coordinated and effective biodiversity monitoring landscape in Europe.

PMID:40802850 | DOI:10.1371/journal.pone.0329390

PLoS Negl Trop Dis. 2025 Aug 13;19(8):e0013375. doi: 10.1371/journal.pntd.0013375. Online ahead of print.

ABSTRACT

BACKGROUND: Rift Valley fever (RVF) virus and Coxiella burnetii infections are significant public health concerns in East Africa, causing recurring outbreaks. However, the prevalence of these pathogens among febrile patients in Ethiopia remains unknown. This study aimed to determine the prevalence and associated factors of these infections among febrile patients.

METHODS: A multisite cross-sectional study was conducted among 415 randomly selected adult febrile patients from health facilities in Shinile and Dire Dawa, Ethiopia, between March 01, 2023, and February 28, 2024. Serum samples were tested for the presence of antibodies against RVF virus and C. burnetii infections using various Enzyme Linked Immunosorbent Assays. Polymerase Chain Reaction (PCR) was used to detect RVF virus RNA and C. burnetii DNA in blood samples. A multivariable logistic regression model was used to identify predictive factors. A p value <0.05 was considered statistically significant.

RESULTS: Of the 402 serum samples analyzed, 21 (5.2%) tested positive for immunoglobulin G (IgG) antibodies against RVF virus, and 86 (21.4%) tested positive for C. burnetii Phase I and Phase II antibodies. No RVF virus IgM was detected. Among the C. burnetii antibodies positive sera, 6 (7.0%) were positive for Phase II IgG antibodies. No blood samples tested positive for RVF virus RNA or C. burnetii DNA. Febrile patients aged ≥35 years had significantly higher odds of RVF virus exposure (AOR: 3.1, 95% CI: 1.3-7.8). Females (AOR: 1.7, 95% CI: 1.1-2.9), rural residents (AOR: 2.4, 95% CI: 1.3-4.5), and febrile patients who disposed of dead animals (AOR: 2.6, 95% CI: 1.2-5.6) exhibited significantly higher odds of C. burnetii infection.

CONCLUSIONS: This study reveals significant but underrecognized exposure to RVF virus (5.2%) and C. burnetii (21.4%) infections among febrile patients. Risk factors for RVF included older age, whereas C. burnetii infection was associated with females, rural residents, and exposure to dead animals. Health authorities are advised to consider these infections in the differential diagnosis of fever, implement active surveillance, and target public health interventions.

PMID:40802844 | DOI:10.1371/journal.pntd.0013375

J Clin Psychol. 2025 Aug 13. doi: 10.1002/jclp.70034. Online ahead of print.

ABSTRACT

OBJECTIVE: Students enrolled in health sciences programs, similar to practicing healthcare professionals, are at high risk for burnout. Despite the numerous challenges these students face, it is crucial to support their well-being. This study examined the impact of a brief online intervention that combined mindfulness and stretching exercises on mindfulness, self-compassion, and mental well-being among health sciences students.

METHOD: The study employed a randomized control group design with pre-test, post-test, and follow-up assessments. The study group consisted of 38 undergraduate students in the health sciences. The participants in the experimental group attended a six-session online program that integrated mindfulness and stretching exercises. In contrast, the participants in the control group did not receive any treatment. Data were collected using the Five Facet Mindfulness Questionnaire-Short Form, Self-Compassion Scale-Short Form, and Warwick-Edinburgh Mental Well-Being Scale.

RESULTS: The findings revealed that following a six-session online program combining mindfulness and stretching exercises, there were significant differences in mindfulness, self-compassion, and mental well-being scores between experimental and control groups over time. The experimental group showed statistically significant improvements in mindfulness, self-compassion, and mental well-being compared with the control group.

CONCLUSIONS: These results indicate that a brief mindfulness-based stretching exercises program delivered online can effectively enhance mindfulness, self-compassion, and mental well-being among undergraduate students pursuing health sciences. The results support the potential of such interventions to promote psychological well-being among health sciences students.

CLINICAL TRIAL REGISTRATION: This study was not pre-registered.

PMID:40802831 | DOI:10.1002/jclp.70034

PLoS One. 2025 Aug 13;20(8):e0327727. doi: 10.1371/journal.pone.0327727. eCollection 2025.

ABSTRACT

A random sample of 847 households (HHs) in southern Ethiopia was used to assess the impact of HH characteristics, land and livestock ownership, seasonal variations, and agricultural challenges on cereals and legumes, crucial to community livelihoods. A structured survey was integrated into the ODK data collection tool, validated, and used with trained agricultural agents, and analyzed using an R statistical package. Farm productivity was significantly influenced by gender, since male headed HHs produced 25.5% more yield than female headed HHs. Livestock ownership, land cultivation, farm productivity and product utilizations were also varied among the HHs. Furthermore, agricultural practices like labor utilization, fertilizer and composite application, and use of improved seed varieties significantly affected the farm productivity. Besides, maize was identified as the principal and top-priority crop, while common bean (legume) was the second-priority crop for local people. This shows that legumes were important in the region’s agricultural systems, but some farmers experienced reduced productivity due to poor agronomic practices. Consequently, a substantial proportion of farmers (>50%) faced food shortages from February to June, representing the peak of the dry season and the beginning of the rainy season (April to May). Integrating early-maturing legumes in the farming system would help to escape the food shortage periods. Many farmers disclosed that the cost of chemical fertilizers’ was unaffordable, indicating a need for options like use of rhizobia inoculants and showed interest to use on their farms for improved productivities.

PMID:40802795 | DOI:10.1371/journal.pone.0327727