Nevin Manimala

BMC Res Notes. 2025 Apr 1;18(1):137. doi: 10.1186/s13104-025-07193-4.

ABSTRACT

BACKGROUND: Childbearing is a major concern for women living with HIV especially in low-middle income countries. There are fears about access to care, risk of vertical transmission, health challenges, maternal and child morbidity/mortality. Investigation of childbearing progression and its associated factors among these women will be useful for design of reproductive healthcare services of these women and ultimately address their multifaceted concerns. This study examined childbearing progression and its correlates another among women living with HIV in Ibadan.

METHOD: The study used a dataset from a cross-sectional study on childbearing progression among 933 respondents aged (18-49) receiving HIV care at the University College Hospital, Ibadan. Synthetic Relational Gompertz method was used to estimate fertility rate in the study population while a multistate model was developed to identify the factors associated with progression from one birth to the next.

RESULTS: The average age of participants was 38 years, with majority being Yoruba tribe (80.5%). Nearly all had at least basic education (93%), and about half had 1-2 children at the time of their HIV diagnosis (47.6%). The likelihood of progressing from the first to a second birth was 77%, though no specific factors were statistically significant. However, progression to a third birth was significantly less likely (86% lower), and associated with factors such as: Having 1-2 children at HIV diagnosis (59% less likely to progress). Having more than 2 children at HIV diagnosis (94% more likely to progress), marital status (widowed women were 36% more likely to progress), partner’s education (secondary education increased the likelihood by 23%), partner’s employment status (unemployed partners increased the likelihood by 40%), desire for more children, partner’s HIV-negative status. Progression to fourth and subsequent births showed a continued decline, with the likelihood of a fourth birth being 82% lower and a fifth or sixth birth 85% lower. Women with secondary education were significantly less likely to progress to fifth births.

CONCLUSION: Overall, the corrected total fertility rate is 3.54, it’s below the national estimates and Southwest region which implies fertility is declining among women living with HIV in Ibadan. The findings revealed the relevance of socio-economic and demographic factors in childbearing progression among women living with HIV. Focused interventions should aim to provide better family planning support and integrate reproductive health counseling into HIV care programs.

PMID:40170188 | DOI:10.1186/s13104-025-07193-4

Parasit Vectors. 2025 Apr 1;18(1):124. doi: 10.1186/s13071-025-06772-5.

ABSTRACT

BACKGROUND: Thioester-containing proteins (TEPs) serve as crucial effectors and regulatory components within the innate immune system of mosquitoes. Despite their significance, the mechanisms by which TEPs exert negative regulation on the immune response in mosquitoes remain inadequately understood. This study aims to elucidate the role of TEPs in the negative regulation of melanization, thereby advancing our comprehension of their regulatory function in the immune response.

METHODS: We infected female Anopheles stephensi mosquitoes with Plasmodium yoelii by allowing them to feed on pre-infected female Kunming mice. Western blot, quantitative polymerase chain reaction, differential gene expression analyses, and gene silencing were then conducted. Student’s t-test was used to analyze continuous variables, with statistical significance defined as p < 0.05.

RESULTS: A. stephensi TEP15 (AsTEP15) negatively regulated mosquitos’ innate immunity and promoted Plasmodium development. AsTEP15 knockdown induced mosquito resistance to malaria parasite melanization during the oocyst stage and significantly reduced sporozoite numbers. Further analysis showed that AsTEP15 mainly negatively affects the TEP1 and immune deficiency (IMD) pathway, thereby inhibiting melanization.

CONCLUSIONS: We describe a mosquito TEP that negatively regulates immunity, further enriching the functional diversity of TEP family members. In addition, our results suggest that oocysts may exploit TEPs to escape or inhibit mosquito immunity, highlighting potential targets for blocking malaria transmission.

PMID:40170182 | DOI:10.1186/s13071-025-06772-5

Syst Rev. 2025 Apr 1;14(1):75. doi: 10.1186/s13643-025-02823-1.

ABSTRACT

BACKGROUND: Prior studies have 3suggested that theta burst stimulation (TBS) may be a promising intervention for the rehabilitation of aphasia after stroke. However, the results of these investigations have been inconsistent, with no definitive consensus on its efficacy and safety. Given the inconclusive nature of the existing evidence, this study aims to conduct a comprehensive and systematic review to evaluate the therapeutic effects of TBS on aphasia in stroke patients.

METHODS: We will perform an extensive search of eight online databases from their inception to August 1, 2024, to identify relevant randomized controlled trials (RCTs) that examine the impact of TBS on aphasia in stroke patients. The primary outcome will be the severity of aphasia, assessed using a suite of standardized evaluation tools. Secondary outcomes will include measures of naming, repetition, comprehension, spontaneous speech, aphasia quotient, quality of life, and documentation of adverse events. The review process will involve rigorous study selection, data extraction, risk of bias assessment, and evaluation of the certainty of evidence by two independent reviewers. Data synthesis and statistical analysis will be conducted using Review Manager (RevMan) software, version 5.3. If significant heterogeneity is not detected among the studies, a meta-analysis will be performed. Otherwise, a narrative qualitative summary will be provided. The quality of evidence will be assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system.

DISCUSSION: This study will be the first systematic review to comprehensively synthesize the existing evidence regarding the application of TBS in the treatment of aphasia in stroke patients. The findings are expected to provide valuable insights for clinicians and policymakers, facilitating the development of more equitable and high-quality healthcare services for this patient population.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024521347.

PMID:40170172 | DOI:10.1186/s13643-025-02823-1

BMC Oral Health. 2025 Apr 1;25(1):464. doi: 10.1186/s12903-025-05809-6.

ABSTRACT

PURPOSE: We conducted a systematic review and meta-analysis to assess and compare the diagnostic performance of elastosonography and 18 F-FDG PET/CT in differentiating between benign and malignant salivary gland tumors.

METHODS: Using PICOS criteria, experimental and observational research evaluating elastosonography or 18 F-FDG PET/CT for differentiating benign and malignant salivary gland tumors were included. A systematic search was conducted across PubMed, Embase, Web of Science, Scopus, Cochrane Library, and CINAHL, initially in July 2024 and updated in February 2025. A manual search for relevant gray literature was also performed. Data extraction and risk of bias assessment using QUADAS-2 were conducted independently by reviewers.

RESULTS: A total of 26 studies with 1609 patients were included in the analysis. The pooled sensitivity of elastosonography and 18 F-FDG PET/CT in the differential diagnosis of benign and malignant salivary gland tumors were 0.75 (95% CI 0.65-0.84) and 0.84 (95% CI 0.78-0.90), specificity was 0.79 (95% CI 0.69-0.87) and 0.85 (95% CI 0.69-0.96), respectively. The area under the curve (AUC) for elastosonography and 18 F-FDG PET/CT were 0.83 and 0.92 and there is a statistical difference between the two imaging modalities (Z = 2.77, P < 0.01). Fagan nomogram indicated that when the pre-test probability was set at 20%, the post-test probability for elastosonography and 18 F-FDG PET/CT could increase to 50% and 65%.

CONCLUSION: In differentiating between benign and malignant salivary gland tumors, 18 F-FDG PET/CT exhibits a superior AUC compared to elastosonography, suggesting that, despite its current limited use in the initial workup of salivary gland tumors, there may be a strong argument for its increased adoption in clinical practice. Nevertheless, it is crucial to note that the findings of this meta-analysis rely on studies with limited sample sizes. More extensive prospective studies are warranted to validate these results further.

PMID:40170169 | DOI:10.1186/s12903-025-05809-6

BMC Med Educ. 2025 Apr 1;25(1):471. doi: 10.1186/s12909-025-07045-6.

ABSTRACT

BACKGROUND: The ageing global population necessitates specialised geriatric/gerontological physiotherapy services (GPTS) to address age-related conditions. We explored the current state of geriatric/gerontological physiotherapy (GPT) academic programmes and clinical practice among World Physiotherapy member nations (WPMNs) and identified factors, including socioeconomic indicators, that predicted the GPTS globally.

METHODS: We conducted an online cross-sectional survey between April 1 and September 19, 2024, inviting official representatives of the 128 WPMNs to answer questions relating to GPT academic programmes and clinical services and practices. We also extracted the Human Development Index (HDI), life expectancy, and Gross National Income (GNI) per capita for each WPMN from the United Nations Development and World Bank databases. Data was analysed using descriptive statistics, a map, bubble charts, and logistic regression models.

RESULTS: Sixty-seven countries (67/128, 52.3% response rate) completed the survey. Among them, 34 (50.7%) and 19 (28.4%) reported having geriatric/gerontology modules in their entry-level and graduate-level physiotherapy programmes, respectively. Additionally, 20 (29.9%) and 13 (19.4%) reported having entry-level geriatric/gerontology clinical placement and graduate-level clinical training, respectively. Physiotherapists were members of interdisciplinary geriatric/gerontological teams in Africa (9/11, 81.8%), Asia Western Pacific (10/16, 62.5%), Europe (15/27, 55.6%), North America Caribbean (4/7, 57.1%), and South America (5/6, 83.3%), but they can only lead the teams in few countries: Africa (1/11, 9.1%), Asia Western Pacific (4/16, 25.0%), Europe (5/27, 18.5%), North America Caribbean (2/7, 28.6%), and South America (2/6, 33.3%). GPTS were more common in countries with graduate-level geriatric physiotherapy academic programmes (OR = 33.47, 95% CI: 1.36, 822.39, p = 0.032) GPT Availability in Practice Act (OR = 41.93, 95% CI: 1.66, 1059.78, p = 0.023), and higher HDI (OR = 5.32e + 07, 95% CI: 49.78, 5.67e + 12, p = 0.003). Europe and North America Caribbean regions had lower older-adult-to-physiotherapist ratios and a higher life expectancy, HDI, and GPTS availability than other World Physiotherapy regions.

CONCLUSION: Geriatric/gerontological PT education and clinical practice are evolving, especially at the entry-level training across WPMNs; however, extra effort is required to enhance graduate specialization to cater to the emerging ageing population.

PMID:40170161 | DOI:10.1186/s12909-025-07045-6

BMC Nurs. 2025 Apr 1;24(1):355. doi: 10.1186/s12912-025-03009-9.

ABSTRACT

BACKGROUND: Patient safety is a global concern, with high rates of medical errors reported annually. Understanding the relationship between nurses’ job stress and patient safety culture (PSC) is crucial. Despite their pivotal role in healthcare, nurses face stress due to demanding job roles and the challenging healthcare system in Palestine. This study aims to explore the relationship between nurses’ job stress and PSC in Palestinian hospitals, identifying predictors that impact PSC to enhance healthcare outcomes and support healthcare professionals.

METHODS: This study employed a quantitative cross-sectional approach. Data collection took place from June to September 2023. The study utilized self-report surveys, including the Hospital Survey of Patient Safety Culture (HSOPSC) and the Nursing Stress Scale (NSS), administered to 355 nurses working in 16 North West Bank hospitals in Palestine. The data collected were analyzed via descriptive and inferential analysis.

RESULTS: Overall, 47% of the nurses reported having positive PSC. The areas with the most positive perception were “teamwork” and “organizational learning-continuous improvement”, with mean percentages of positive responses of 63.1% and 55.8%, respectively. Conversely, the composites with the lowest positive response scores included “Response to Error” and “Staffing and Work Pace”, with mean percentages of positive responses of 30.9% and 34.8%, respectively. Furthermore, the most common sources of job stress perceived by nurses were “workload” and “death and dying”, with mean scores of 1.42 and 1.20, respectively. However, the lowest-scoring sources of stress were in the subscales “Uncertainty concerning treatment” and “Inadequate preparation”, with mean scores of 1.02 and 1.06, respectively. Statistical tests revealed that six factors were significantly associated with the perception of PSC. Among these factors, income, hospital type, activities to improve PSC, patient safety ratings of work areas, and weekly night shifts emerged as predictors of PSC. Additional tests revealed nine factors significantly associated with job stress. Among these factors, gender, educational level, engagement in stress relief activities, participation in PSC improvement activities, and patient safety ratings emerged as predictors of job stress. Moreover, the study revealed negative correlations between job stress and PSC.

CONCLUSION: This study identified the need for tailored policies and interventions that address nurses’ specific stressors to enhance PSC within hospital settings. Moreover, the study shed light on the unique challenges faced by nurses in Palestine, such as limited resources, unemployment concerns, staffing, and transportation issues, which further exacerbated job stress levels and potentially compromised patient safety. Understanding these contextual factors is crucial for developing targeted interventions and support systems that prioritize the holistic well-being of nurses and the quality of patient care delivery.

PMID:40170149 | DOI:10.1186/s12912-025-03009-9

BMC Pregnancy Childbirth. 2025 Apr 1;25(1):379. doi: 10.1186/s12884-025-07534-y.

ABSTRACT

BACKGROUND: Preeclampsia (PE) is a heterogeneous, multi-organ pregnancy disorder that poses a significant health burden globally, with its pathogenesis remaining unclear. This study aimed to identify novel susceptibility genes for PE through a cross-ancestry genome-wide association study (GWAS).

METHODS: We performed meta-analysis to summarize the PE GWAS data from the United Kingdom, Finland, and Japan. Subsequently, the multi-ancestry sum of the single-effects model was used to perform cross-ancestry fine-mapping. The functional mapping and annotation (FUMA)-expression quantitative trait loci (eQTL) mapping method, transcriptome-wide association study (TWAS)- functional summary-based imputation (FUSION) method, genome-wide complex trait analysis (GCTA)-multivariate set-based association test (mBAT)-combo method, and polygenic priority score (PoPS) method were employed to screen for candidate genes. We utilized biomarker expression level imputation using summary-level statistics (BLISS), based on summary-level protein quantitative trait loci (pQTL) data, to conduct a multi-ancestry proteome-wide association study (PWAS) analysis, followed by candidate drug prediction.

RESULTS: Six novel susceptibility genes associated with PE risk were identified: NPPA, SWAP70, NPR3, FGF5, REPIN1, and ACAA1. High expression of the NPPA and SWAP70 and low expression of the remaining genes were associated with a reduced risk of PE. Furthermore, we identified drugs that target NPPA, NPR3, and REPIN1.

CONCLUSIONS: Our study identified NPPA, SWAP70, NPR3, FGF5, REPIN1, and ACAA1 as novel genes whose predicted expression was linked to the risk of PE, offering new insights into the genetic framework of this condition.

PMID:40170147 | DOI:10.1186/s12884-025-07534-y

BMC Surg. 2025 Apr 2;25(1):127. doi: 10.1186/s12893-025-02846-4.

ABSTRACT

BACKGROUND/OBJECTIVE: Surgical site infection (SSI) is the third common complication in spinal surgery and often results in poor clinical outcomes, prolonged hospital stays, and additional costs. This study estimated the incidence of SSI and identified risk factors in spine surgeries done within 10 years.

METHODOLOGY: This was a retrospective cohort review of all patients who had spine surgery between January 2014 and December 2023. Patients’ hospital records were retrieved, and relevant biodata and clinical information were obtained and entered into the Statistical Product and Service Solutions version 25. The incidence of SSI was computed and presented as a percentage, and a multivariable analysis to assess risk factors for SSI was done using the chi-square test and Fisher’s exact test. The level of significance was set at a p-value < 0.05 and a 95% Confidence Interval.

RESULTS: The incidence of SSI was 11.7%; (24/206), predominantly caused by Staphylococcus Aureus (37.5%,P = 0.01) and largely (70%) occurred among patients admitted ≤ 48 h before surgery. The majority were superficial incisional SSIs (19/24,79.2%). They occurred commonly among patients operated for spondylotic disease (13/67,19.4%) and bacterial spondylitis (one out of the two patients) compared to the other spinal pathologies (p = 0.042). Similarly, infection rates were significantly higher in surgeries performed at the lumbar (14/63,22.2%) and thoracolumbar junction (4/31, 12.9%) compared to the cervical and thoracic spine (p = 0.009). This was found to increase the odds of developing SSI by 2.2 times (odds ratio: 2.20;CI:1.38-3.47, P = 0.001), The median duration of hospital stay was 36.5 days for patients with SSIs versus 23 days for patients without SSI (p = 0.008).

CONCLUSION: This study found a relatively high incidence of SSI, which was predominantly superficial incisional SSI, caused by Staphylococcus Aureus, particularly among patients admitted within 48 h before surgery. Significant risk factors for these infections are patients operated on for spondylotic disease and those who had lumbar or thoracolumbar spine surgeries.

PMID:40170142 | DOI:10.1186/s12893-025-02846-4

BMC Pediatr. 2025 Apr 2;25(1):265. doi: 10.1186/s12887-025-05601-z.

ABSTRACT

BACKGROUND: The Centers for Disease Control and Prevention (CDC) reports that water fluoridation is among the ten greatest public health achievements of the 20^th Century. Tooth decay (TD) prevention and neurodevelopmental disorder (ND) risk were assessed in relation to childhood water fluoridation exposure.

METHODS: This longitudinal cohort study examined the Independent Healthcare Research Database (IHRD) composed of prospectively collected healthcare data from the Florida Medicaid system for the period 1990-2012, using logistic and frequency statistical modeling (with adjustment for covariates). A cohort of 73,254 children continuously enrolled for their first 10 years of life was examined. The yearly percentage of persons in Florida receiving fluoridated water exposure from community water systems was examined by county. The number of children diagnosed with TD, autism spectrum disorder (ASD), attention deficit-hyperactivity disorder (ADHD), intellectual disability (ID), and specific delays in development (SDD) was evaluated.

RESULTS: Fluoride exposure in the year of birth, statistically significantly and dose-dependently, slightly reduced the risk of TD, and, separately, slightly increased the risk of ASD, ADHD, ID, and SDD. During the first 10 years of life, children who were fluoride-exposed as compared to unexposed were at significantly lower risk for TD, and, separately, at significantly greater risk for ASD, ID, and SDD.

CONCLUSIONS: Findings from the present study, coupled with previous studies, suggest new risk/benefit analyses of water fluoridation should be undertaken.

PMID:40170137 | DOI:10.1186/s12887-025-05601-z

BMC Cancer. 2025 Apr 1;25(1):595. doi: 10.1186/s12885-025-13975-7.

ABSTRACT

BACKGROUND: Healthcare-associated infections (HAI) lead to poor patient outcomes, including morbidity, mortality, length of hospital stay (LOS) and costs. However, limited data exists on the impact of HAI on LOS, cost at different quantiles and the survival of patients with cancer.

OBJECTIVE: To assess the impact of HAIs on LOS, costs, and survival of cancer patients.

METHODS: This retrospective cohort study used data from January 2017 to December 2018 from a tertiary cancer hospital in Henan. Patient demographic data were sourced from the hospital’s electronic medical records. Inclusion criteria were primary cancer diagnoses (ICD codes C00-C97). We balanced the distribution of baseline characteristics between patients with HAI and without using propensity score matching. Quantile regression can estimate how independent variables affect dependent variables at different quantiles. We conducted a quantile regression that assessing the impact of HAI on LOS and costs for patients with cancer and using Kaplan-Meier survival curves to compare the survival.

RESULTS: Our study included 291,535 patients with cancer, among of whom 4,784(1.6%) were diagnosed with HAI and 286,748 were not. Patients with HAI exhibited significantly longer hospital stays, with a mean duration of 26.1 days (range: 17.0 to 40.6 days), compared to their counterparts without HAIs, who had an average stay of 7.2 days (range: 4.0 to 14.0 days) (p < 0.01). Economically, the average hospitalization cost for patients without HAI was $1575.8 (range: 865.6 to 3106.3), substantially lower than the $8710.8 (range: $4073.8 to 13434.0) observed for patients with HAI (p < 0.01). After adjusting for confounders in quantile regression models, HAI was associated with a median increase in LOS of 11.4 (95% confidence interval (CI): 10.9-12.0) days and with excess costs of USD 3449.3 (95% CI: 3281.9-3616.7). The hazard ratio (HR) of death for patients with an HAI was significantly higher than for patients without an HAI (HR: 1.62, 95% CI: 1.50-1.74).

CONCLUSION: HAI prolongs the LOS, increases hospital costs, and worsens the survival of patients with cancer compared with other diseases. Our quantile regression results indicate that the impact of HAI on hospitalization costs and LOS is more pronounced among patients with higher baseline costs and longer LOS (e.g., at the 95th percentile). This suggests that patients with more severe conditions or advanced disease stages are more vulnerable to the adverse effects of HAI.

RELEVANCE TO CLINICAL PRACTICE: Targeted surveillance and preventive interventions, such as early infection screening and strict adherence to infection control protocols, should focus on high-risk patients with prolonged LOS and high costs. By preventing infections in these patients, we can more effectively reduce the additional burden of HAI on costs and LOS. This study informs clinical practice and decision-making for nurses and nursing educators who manage HAI.

PATIENT OR PUBLIC CONTRIBUTION: Patients and healthcare professionals helped in data collection at the Hospital.

PMID:40170132 | DOI:10.1186/s12885-025-13975-7