Nevin Manimala

PeerJ. 2025 Nov 20;13:e20146. doi: 10.7717/peerj.20146. eCollection 2025.

ABSTRACT

OBJECTIVE: This meta-analysis aimed to explore the effects of multi-component exercise interventions on glycemic and lipid metabolism, physical fitness, and cognitive function in individuals with type 2 diabetes mellitus (T2DM).

METHODS: From inception to December 28, 2024, PubMed, Web of Science, Cochrane, and Elsevier databases were systematically searched for randomized controlled trials (RCTs) investigating multi-component exercise interventions for T2DM. A total of 37 articles, comprising 3,201 participants, were included. Primary and secondary outcome measures were categorized, summarized, and analyzed using RevMan 5.4 software.

RESULTS: Compared to control groups, multi-component exercise interventions produced statistically significant improvements across all measured outcomes in individuals with T2DM: (1) Glycemic control: HbA1c (standard mean difference (SMD) = -0.52, 95% confidence interval (CI) [-0.76 to -0.28]); fasting blood glucose (SMD = -0.53, 95% CI [-0.93 to -0.12]). (2) Lipid metabolism: high density lipoprotein (HDL) (SMD = 0.32, 95% CI [0.21-0.44]); low density lipoprotein (LDL) (SMD = -0.21, 95% CI [-0.33 to -0.09]); triglycerides (SMD = -0.18, 95% CI [-0.30 to -0.06]). (3) Physical fitness: upper limb strength (SMD = 0.67, 95% CI [0.51-0.83]); lower limb strength (SMD = 0.56, 95% CI [0.10-1.02]); peak oxygen consumption (SMD = 0.62, 95% CI [0.31-0.93]); body mass index (BMI) (SMD = -0.38, 95% CI [-0.67 to -0.09]). (4) Cognitive function: overall cognitive performance (SMD = 0.34, 95% CI [0.18-0.50]). (5) Quality of life: vitality (SMD = 0.37, 95% CI [0.09-0.64]); physical functioning (SMD = 0.48, 95% CI [0.20-0.75]); mental health (SMD = 0.35, 95% CI [0.07-0.63]); general health (SMD = 0.34, 95% CI [0.06-0.61]). Quality assessment indicated that the included studies were of high overall quality. Egger’s regression analysis did not reveal significant publication bias.

CONCLUSIONS: Multi-component exercise interventions significantly improved glycemic and lipid metabolism, physical fitness, and cognitive function in individuals with T2DM. These findings support the clinical value of incorporating multi-component exercise programs-particularly those performed at least three times per week and lasting 6 months or longer-into diabetes management strategies.

PMID:41287857 | PMC:PMC12640639 | DOI:10.7717/peerj.20146

PeerJ. 2025 Nov 20;13:e20414. doi: 10.7717/peerj.20414. eCollection 2025.

ABSTRACT

BACKGROUND: Virtual care can increase access to healthcare and improve provider efficiency; however, many healthcare providers lack formal education in virtual care delivery, including skills in virtual communication, physical examination adaptations, confidentiality, and billing procedures. This training gap can result in reduced confidence and suboptimal patient care. To address this, an asynchronous continuing professional development (CPD) module was developed. The objective of this study was to evaluate the module’s efficacy regarding satisfaction and changes in knowledge and confidence.

METHODS: The module covered key topics such as virtual visit etiquette, technology troubleshooting, adapted physical examinations, documentation, and remuneration processes. Interactive features included embedded videos, knowledge-check quizzes, and reflective questions. A single-group pre-post quasi-experimental design was used to evaluate its impact. Data were collected via electronic surveys administered at three time points (before, during, and post-module). Surveys included multiple choice questions assessing objective knowledge, and Likert-scale questions assessing confidence levels in virtual care delivery. Open-ended short answer questions captured qualitative feedback. Quantitative data were analyzed using descriptive statistics and paired t-tests or Wilcoxon signed-rank tests where appropriate. Qualitative data were analyzed thematically to identify learner-reported strengths and areas for improvement.

RESULTS: A total of nine to 22 learners responded at each time point. Respondents were heterogeneous, with most identifying as male (66.7%), general practitioners (55.6%), practicing in hospital settings (55.6%), and in communities of 2,000 to 10,000 people (55.6%). Learners reported high satisfaction with the module’s content relevance, navigation, and interactive components, but requested more interactive components (e.g., case-based learning). Statistically significant improvements were observed in confidence levels (n = 20-21; p < 0.001 to 0.009) and objective knowledge scores (n = 20-22; p = 0.046).

CONCLUSION: This evaluation study demonstrated that the asynchronous virtual care module had a statistically significant impact on objective knowledge and confidence, in addition to having positive satisfaction ratings. Limitations include the small sample size and lack of long-term follow-up to assess sustained practice change. However, these findings support the incorporation of asynchronous, virtual modules into CPD curricula to enhance provider competencies in virtual care delivery. Future directions include integrating additional case-based and specialty-specific content, as well as exploring the module’s scalability for other health professions to promote interprofessional virtual care training.

PMID:41287853 | PMC:PMC12640642 | DOI:10.7717/peerj.20414

PeerJ. 2025 Nov 20;13:e20088. doi: 10.7717/peerj.20088. eCollection 2025.

ABSTRACT

BACKGROUND: The 2023-24 El Niño event caused extreme marine heat stress and widespread coral bleaching. Coral reefs at the Reserva Biológica Isla del Caño and the northern coast of the Osa Peninsula, Costa Rica, underpin critical ecosystem services, including biodiversity conservation and marine tourism, and have previously withstood similar events with minimal coral loss. Evaluating the ecological impacts of the 2023-24 El Niño is essential to assess coral reef resilience and guide future management.

METHODS: Coral Reef Watch sea surface temperature (SST) data (1985-2025; CoralTemp V3.1) were used to calculate long-term SST trends and degree heating weeks (DHW). Reef surveys were conducted at nine sites between 2019 and 2025, with primary benthic composition and coral health data collected in 2024-25. Benthic cover was assessed using point-intercept, line-intercept, and quadrat methods, while coral diversity, abundance, and health were measured via belt transects. Beta regression was used to assess the effect of temperature on coral cover, and multivariate analyses, including principal component analysis (PCA) and similarity percentage analysis (SIMPER), evaluated benthic community changes and bleaching patterns. An Ecological Recovery Feasibility Index (ERFI) was developed using PCA loadings and benthic indicators to rank sites by recovery potential.

RESULTS: SST increased significantly over the past 40 years (∼0.23 °C/decade), with the 2023-24 El Niño recording peak SST (31.2 °C). Bleaching threshold exceedance days increased, while cool days declined. Twelve coral taxa were recorded; Pocillopora spp. and Porites lobata were present at all sites. Coral diversity varied, with Cueva and Ancla highest, and San Josecito lowest. Estimated baseline bleaching prevalence was ∼23%, highest in Pocillopora spp. (33.9%). SIMPER and PCA revealed a shift from coral to algal dominance: turf algae increased by 70.62%, dead coral declined 80.71%, and coral cover fell 40.44%. Major coral declines were statistically significant at Ancla, Esquina, and Tina. Bayesian regression confirmed coral decline at Chorro, Cueva, Tina, and Ancla, alongside turf algae increases. Coral cover was higher at warmer sites, though non-temperature site-specific factors were also influential. Chorro and Esquina had the highest recovery potential; Ancla, San Josecito, and Barco Profundo the lowest.

CONCLUSION: There is an urgent need to develop and implement a coral reef restoration strategy for Isla del Caño that addresses site-specific conditions, integrates tourism management, and promotes long-term resilience. Under continued climate change, localized, targeted restoration will be essential to maintain the ecological function of these historically resilient but increasingly vulnerable reefs in Costa Rica’s Eastern Tropical Pacific.

PMID:41287849 | PMC:PMC12640635 | DOI:10.7717/peerj.20088

PeerJ. 2025 Nov 20;13:e20361. doi: 10.7717/peerj.20361. eCollection 2025.

ABSTRACT

BACKGROUND: Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycaemia, affecting various metabolic processes and leading to multiple complications, particularly in wound healing. This study aims to evaluate the impact of diabetes on the healing of extraction sockets in non-diabetic, prediabetic, and type 2 diabetic patients in Saudi Arabia.

METHODOLOGY: A prospective observational study was conducted with 72 participants who were divided equally (n = 24 for each group) into three groups, viz. non-diabetic, prediabetic, and diabetic groups based on glycated hemoglobin (HbA1c) and random blood glucose levels. Tooth extractions were performed by an experienced maxillofacial surgeon. Healing outcomes were assessed by measuring extraction socket size, post-operative pain, discharge, swelling, infection, erythema, dry socket occurrence, and analgesic consumption over one week. Initially descriptive statistics were calculated and one way Analysis of Variance (ANOVA) test was done to compare the reduction in socket size between groups. The level of statistical significance was set at P ≤ 0.05.

RESULTS: Out of 275 screened participants, 104 provided informed consent, and 72 completed the study. Significant differences were found in socket size reduction, with non-diabetic patients showing a 62.5% reduction, prediabetic 56.4%, and diabetic 48.6% (p < 0.001). Diabetic patients experienced more post-operative pain (p = 0.039) and a higher incidence of complications such as swelling, infection, and discharge, although not statistically significant (p = 0.141).

CONCLUSION: Diabetes significantly affects post-operative healing in dental extractions, leading to less socket size reduction, higher pain levels, and increased complications. These findings underscore the necessity for specialized post-operative care for diabetic patients, including stringent infection control and pain management strategies. Further research with larger sample sizes and extended follow-up periods is recommended to better understand the long-term impacts of diabetes on oral health.

PMID:41287847 | PMC:PMC12640633 | DOI:10.7717/peerj.20361

F1000Res. 2025 Sep 9;14:805. doi: 10.12688/f1000research.167786.2. eCollection 2025.

ABSTRACT

BACKGROUND: Effective performance monitoring is essential for improving academic productivity, especially in private higher education institutions. This study aimed to establish the perception of academic staff toward performance monitoring and how these perceptions influence academic staff performance in private chartered universities in Western Uganda. Guided by Expectancy Theory and Self-Determination Theory, the study explored how monitoring practices affect motivation and performance outcomes.

METHODS: A convergent parallel mixed-methods design was employed. The quantitative strand involved 386 academic staff selected from five private chartered universities using stratified random sampling. Data were collected using structured questionnaires. In the qualitative strand, semi-structured interviews were conducted with 10 purposively selected Deans of Faculties. Quantitative data were analyzed using descriptive statistics, Pearson correlation, and regression analysis, while qualitative data were analyzed thematically.

RESULTS: Findings revealed that 58.2% of academic staff had a moderately positive perception of existing performance monitoring practices. Pearson correlation analysis showed a moderate positive relationship between perception of performance monitoring and academic staff performance (r = .476, p < 0.01). Regression analysis further indicated that perception of performance monitoring significantly predicted academic staff performance (β = 0.394, p = 0.000), explaining 18.7% of the variance (R ² = 0.187). Qualitative data revealed challenges such as irregular feedback, lack of transparency, and limited involvement of academic staff in developing performance indicators.

CONCLUSIONS: The study concludes that academic staff performance can be enhanced when performance monitoring systems are perceived as fair, transparent, and participatory. It recommends the standardization of performance evaluation procedures, improved feedback mechanisms, and the active involvement of academic staff in setting performance targets. Strengthening these areas could improve motivation, engagement, and overall academic performance in private universities across the region.

PMID:41287836 | PMC:PMC12640481 | DOI:10.12688/f1000research.167786.2

F1000Res. 2025 Sep 10;14:902. doi: 10.12688/f1000research.169601.1. eCollection 2025.

ABSTRACT

The increasing prevalence of vector-borne diseases like West Nile virus (WNV) highlights the critical need for predictive modeling tools that can guide public health decision-making, particularly given the absence of effective vaccines. We developed a modular computational framework that simulates and analyzes WNV transmission dynamics through compartmental models capturing the intricate ecological interactions among avian hosts, mosquito vectors, and human populations. Our system integrates epidemiological parameters with customizable intervention mechanisms, facilitating the assessment of scenario-specific mitigation approaches. Distinguishing itself from conventional static models, this framework enables users to model dynamic, time-sensitive interventions including targeted mosquito control and strategic bird population management-the two principal containment strategies currently employed against WNV. Using simulations that reflect realistic outbreak scenarios, we evaluated how varying intervention intensities and implementation timings affect epi- demic progression. Our findings reveal that early implemented, dual-target strategies addressing both vector populations and avian reservoirs can substantially reduce transmission dynamics and minimize human exposure risk. This framework serves as a comprehensive decision-support platform for policymakers and vector control agencies, delivering mechanistic insights into the effectiveness of non-pharmaceutical interventions against zoonotic pathogens within complex ecological systems. The tool’s modular design and scenario-testing capabilities make it particularly valuable for proactive outbreak preparedness and evidence-based intervention planning.

PMID:41287835 | PMC:PMC12640483 | DOI:10.12688/f1000research.169601.1

F1000Res. 2025 Nov 14;14:1040. doi: 10.12688/f1000research.166837.2. eCollection 2025.

ABSTRACT

BACKGROUND: In an increasingly competitive healthcare sector, delivering exceptional services is crucial for enhancing patient satisfaction and fostering long-term loyalty. However, the direct impact of leadership and governance on patient experience and retention remains underexplored. This study examines the relationships between corporate governance, service quality, patient satisfaction, and loyalty, with a particular focus on entrepreneurial leadership in healthcare organizations in Indonesia.

METHODS: A cross-sectional survey was conducted with 384 executive patients across hospitals in Indonesia. Data were analyzed using structural equation modeling (SEM), with p-values reported to indicate statistical significance.

RESULTS: The findings reveal that entrepreneurial leadership significantly enhances both corporate governance and service quality. Corporate governance positively influences patient satisfaction and loyalty. Service quality was found to moderately influence patient satisfaction, but had a stronger, direct effect on patient loyalty. Additionally, patient satisfaction emerged as a critical mediator in the development of patient loyalty.

CONCLUSIONS: This study provides valuable insights for healthcare managers and policymakers seeking to improve organizational performance and patient retention. Theoretically, it advances the understanding of how leadership and governance frameworks impact patient retention and service quality in the Indonesian context. Practically, the study offers actionable recommendations for hospital administrators to enhance patient satisfaction and loyalty by implementing entrepreneurial leadership, robust governance practices, and continuous service improvement.

PMID:41287832 | PMC:PMC12640491 | DOI:10.12688/f1000research.166837.2

Drug Healthc Patient Saf. 2025 Nov 19;17:253-264. doi: 10.2147/DHPS.S564658. eCollection 2025.

ABSTRACT

BACKGROUND: Globally, healthcare systems are currently facing a significant challenge in terms of antibiotic resistance. Healthcare professionals actively participate in the process of prescribing, dispensing and administering antibiotics.

OBJECTIVE: We examined the knowledge, attitudes and practices regarding antibiotic use and antibiotic resistance among healthcare professionals working in a tertiary hospital located in Monrovia, Liberia.

METHODS: A hospital-based cross-sectional survey was carried out from January to June, 2023 involving 61 healthcare workers at the ELWA Hospital, Liberia. A purposive sample of healthcare workers across diverse professional roles was surveyed using a structured questionnaire on antibiotic use and resistance. Data were analyzed in SPSS v25 using descriptive statistics to summarize participant characteristics and inferential tests to explore variable associations.

RESULTS: Participants ages ranged from 20 to 60 years (mean = 40.7 ± 5) and nurses constituted the majority professional group (59%). Most respondents (68.9%) disagreed that antibiotics are effective against viral infections (OR = 0.45; p = 0.020). However, 36.1% believed antibiotics could be stopped when symptoms resolve and 24.6% believed leftover antibiotics could be reused (OR = 0.33; p = 0.002). Majority, 72.1% and 70.5%, reported never using antibiotics for body pain or headaches, respectively (OR = 3.67; p = 0.001 and OR = 4.78; p < 0.001). Despite this, 39.3% admitted to sometimes or always storing leftover antibiotics and 39.3% agreed or strongly agreed that stopping antibiotics early is safe (OR = 0.36; p = 0.016).

CONCLUSION: The study identified persistent gaps in healthcare workers’ knowledge, attitudes, and practices regarding antibiotic use and resistance, despite encouraging awareness in some areas. Misconceptions such as premature discontinuation and reuse of leftover antibiotics were common. Findings underscore the need for targeted education and strengthened stewardship programs in Liberia’s healthcare settings.

PMID:41287831 | PMC:PMC12640598 | DOI:10.2147/DHPS.S564658

Sci Rep. 2025 Nov 24;15(1):41522. doi: 10.1038/s41598-025-25311-x.

ABSTRACT

In recent years, the widespread dissemination of fake news on social media has raised concerns about its impact on public opinion, trust, and decision-making. Addressing the limitations of traditional detection methods, this study introduces a hybrid deep learning approach that enhances the identification of fake news. The objective is to improve detection accuracy and model robustness by combining a Long Short-Term Memory (LSTM) network for contextual feature extraction with a Convolutional Gaussian Perceptron Neural Network (CGPNN) for classification. To further optimize performance, we integrated a metaheuristic Moth-Flame Whale Optimization (MFWO) algorithm for hyperparameter tuning. Experimental evaluation was conducted on four benchmark datasets ISOT, Fakeddit, BuzzFeedNews, and FakeNewsNet using standardized preprocessing techniques and TF-IDF-based text representation. Results show that the proposed model outperforms existing methods, achieving up to 98% accuracy, 95% F1-score, and statistically significant improvements (p < 0.05) over transformer-based and graph neural network models. These findings suggest that the hybrid framework effectively captures linguistic patterns and textual irregularities in deceptive content. The proposed method offers a scalable and efficient solution for fake news detection with practical applications in social media monitoring, digital journalism, and public awareness campaigns. Overall, the framework delivers 3-8% higher accuracy and F1-score compared to state-of-the-art approaches, demonstrating both robustness and practical applicability for large-scale fake news detection.

PMID:41285851 | DOI:10.1038/s41598-025-25311-x

Nat Commun. 2025 Nov 24;16(1):10376. doi: 10.1038/s41467-025-65316-8.

ABSTRACT

The chaotic dynamics of small-scale vorticity plays a key role in understanding and controlling turbulence, with direct implications for energy transfer, mixing, and coherent structure evolution. However, measuring or controlling its dynamics remains a major conceptual and experimental challenge due to its transient and chaotic nature. Here we use a combination of experiments, theory, and simulations to show that small magnetic particles of different densities, exploring flow regions of distinct vorticity statistics, can act as effective probes for measuring and forcing turbulence at its smallest scale. The interplay between the magnetic torque, from an externally controllable magnetic field, and hydrodynamic stresses, from small-scale turbulent vorticity, uncovers an extremely rich phenomenology. Notably, we present the first experimental and numerical observation of stochastic resonance for particles in turbulence, where turbulent fluctuations, remarkably acting as an effective noise, enhance the particle rotational response to external forcing. We identify a pronounced resonant peak in the particle rotational phase lag when the applied rotating magnetic field matches the characteristic intensity of small-scale turbulent vortices. Furthermore, we reveal a novel symmetry-breaking mechanism: an oscillating magnetic field with zero mean angular velocity can counterintuitively induce net particle rotation in zero-mean vorticity turbulence. Our findings pave the way to developing flexible techniques for manipulating particle dynamics in complex flows. The discovered mechanism enables a novel magnetic resonance-based approach to be developed for measuring turbulent vorticity. In this approach, particles act as probes, emitting a detectable magnetic field that can characterize turbulence even under conditions that are optically inaccessible.

PMID:41285830 | DOI:10.1038/s41467-025-65316-8