Nevin Manimala

Front Health Serv. 2025 Apr 10;5:1383292. doi: 10.3389/frhs.2025.1383292. eCollection 2025.

ABSTRACT

INTRODUCTION: The health and wellbeing of small and sick newborns and their families can be enhanced through family systems care (FSC) along the care continuum. FSC encompasses a broader approach than family-centered care. FSC identifies individual and family strengths while acknowledging illness-related suffering and providing expertise to help soften it through relational family systemic interventions. Contextual factors of the targeted healthcare setting need to be understood to implement FSC. This study aims to assess healthcare professionals’ perceptions of health system features that may influence the successful context-adapted implementation of FSC into the care continuum for small and sick newborns and their families in the Ghanaian healthcare setting.

METHODS: Cross-sectional data were collected from 143 healthcare professionals, comprising nurses, midwives, and physicians who provide maternal and newborn care at a secondary facility and 13 primary health facilities in the Hohoe Municipality, Ghana. The Context Assessment for Community Health (COACH) instrument, employing Likert scales ranging from 1 to 5 and including questions on training history, was used to collect data on FSC through self-administered interviews. Data were analyzed using descriptive statistics with STATA.

RESULTS: While 48.9% of healthcare professionals reported never receiving any didactic or school-based training, the majority (96.5%) indicated a need for in-service training in FSC. From the highest score of 5, the COACH dimension for organizational resources had the lowest score (2.8). Community engagement, commitment to work, monitoring services for action, and informal payment reported scores between 3.7 and 3.9. The highest scores were reported for the leadership and work culture dimensions, at 4.1 and 4.2, respectively. Among the different units of the care continuum, the largest variations were observed in the subdimensions of organizational resources (2.5-3.4) and informal payment (3.6-4.4).

CONCLUSION: The COACH tool provided contextual guidance for developing training strategies to implement a contextually appropriate FSC program in Ghana, which is likely to be adaptable and relevant in other low- and middle-income countries. Healthcare professionals perceive themselves as committed, with a favorable work culture and a positive perception toward their leaders, but they report limited resources and challenges in accessing knowledge sources. These findings indicate a readiness for FSC training along the continuum of care in the perinatal period.

PMID:40276641 | PMC:PMC12018503 | DOI:10.3389/frhs.2025.1383292

J Obstet Gynaecol Res. 2025 May;51(5):e16298. doi: 10.1111/jog.16298.

ABSTRACT

AIM: To compare the outcomes of intracytoplasmic sperm injection (ICSI) of fresh and cryopreserved sperm obtained via microdissection testicular sperm extraction (micro-TESE) in cases of non-obstructive azoospermia (NOA).

METHODS: A total of 147 patients with NOA who underwent micro-TESE and obtained viable sperm via micro-TESE at Istanbul Medipol In Vitro Fertilization unit were recruited retrospectively. The cases were divided into two groups depending on the sperm used (fresh or frozen-thawed) for ICSI: The micro-TESE group (n = 93) underwent ICSI cycles with fresh spermatozoa and the micro-TESE-Thaw group (n = 54) underwent ICSI cycles with cryopreserved spermatozoa. Patient demographics, embryo development, and pregnancy outcomes were compared between the two groups.

RESULTS: No statistical difference was observed between the two groups in terms of demographic features (age, body mass index, etc.) and cycle characteristics (induction protocol, gonadotropin dose, etc.). Fertilization rates and embryo quality were also similar between the groups. Higher clinical pregnancy and live birth rates were observed in the micro-TESE group than in the micro-TESE-Thaw group (p <0.04 and p <0.003, respectively). The miscarriage rate was higher in the micro-TESE-Thaw group, although the difference did not reach statistical significance.

CONCLUSION(S): In cases where frozen sperm obtained by micro-TESE are used, even if viable and motile sperm are found after thawing, there may be a negative impact on the ICSI result. Fresh testicular spermatozoa appear to result in better clinical pregnancy and live birth rates than cryopreserved testicular spermatozoa in males with NOA.

PMID:40275434 | DOI:10.1111/jog.16298

BMC Psychol. 2025 Apr 24;13(1):429. doi: 10.1186/s40359-025-02747-4.

ABSTRACT

BACKGROUND: Parents of children with attention deficit hyperactivity disorder (ADHD) often experience high levels of parental stress. This has exacerbated during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to examine the effectiveness of mindfulness-based stress reduction (MBSR) programme in the Chinese population, which is feasible among Chinese parents during the COVID-19 pandemic period in reducing the parental stress of parents compared with the usual care group.

METHODS: This study was designed as a pilot randomized controlled trial with single-blind repeated measures. Parents of children aged 3-12 years with a diagnosis of ADHD were recruited from the parent resource center (PRC) of a local nongovernmental organization between June and August 2022. The participants were randomly assigned to the MBSR intervention group (n = 18) or usual care group (n = 18).

RESULTS: With respect to the feasibility of the study, all 36 participants who were randomized fully completed the MBSR programme and assessments, resulting in a 100% attendance rate. 66% of the participants in the intervention group reported satisfaction with the intervention, which was helpful in reducing stress. They were willing to stay on this mindfulness-based programme in the future. The results of the repeated-measures ANOVA revealed a significant difference in self-perceived stress reduction between the groups (p < 0.001, ES = 0.192). The of within-group results revealed that the mean score of the intervention group decreased from 29.44 before the intervention to 25.50 (p < 0.001) immediately after intervention, and further decreased to 24.72 (p < 0.05) at one month after the intervention. By using the parental stress scale, the interaction effects also revealed significant differences between groups (p < 0.001, ES = 0.599). The stress level of the intervention group decreased from 74.50 before intervention, to 68.94 (p < 0.001) immediately after intervention, and further decreased to 67.50 (p < 0.05) at one month after intervention. These reports revealed statistically significant improvements in stress reduction and parental stress reduction in the intervention group.

CONCLUSION: The pilot study revealed that MBSR is feasible and acceptable for parents of children with ADHD in Chinese culture. The findings also suggested that the MBSR programme was effective in reducing parental stress and enhancing mental well-being. This study was registered in the National Library of Medicine, National Center for Biotechnology Information Clinical Trials Registry as Version 1, and the trial registration data are available as NCT06210113, 28/2/2024.

PMID:40275428 | DOI:10.1186/s40359-025-02747-4

BMC Psychol. 2025 Apr 24;13(1):432. doi: 10.1186/s40359-025-02749-2.

ABSTRACT

BACKGROUND: The perceived social stigma of caregivers of children with autism spectrum disorder (ASD) may negatively affect caregivers’ mental health and, consequently, the quality of care for these children. Religious and spiritual well-being may serve as protective factors against such stigma. This study aimed to examine the relationship between spirituality, religiosity, and perceived social stigma among caregivers of children with ASD.

METHOD: This cross-sectional study was conducted from September 2022 to June 2023 in Qom, Iran. A total of 102 caregivers were recruited from specialized rehabilitation centers through convenience sampling. Participants completed the Multidimensional Inventory for Religious-Spiritual Well-being (MI-RSB 48) and the Stigma Scale for Chronic Illnesses (SSCI-8), along with a demographic questionnaire. Data were analyzed using descriptive statistics and multiple regression analysis.

RESULTS: The mean perceived social stigma score was 16.85 ± 6.76, with 45.5% of participants reporting higher-than-average social stigma. All dimensions of spiritual-religious well-being, except belief in the afterlife and the experience of meaning, showed a significant negative correlation with perceived social stigma (P < 0.05). Multiple regression analysis revealed that the child’s age (β = 0.401, P = 0.018) and hope transcendent (β = 0.418, P = 0.012) were significant negative predictors of perceived stigma, explaining 59% of the variance.

CONCLUSION: The findings suggest that fostering transcendent hope and spiritual connectedness may mitigate the perceived stigma among caregivers of children with ASD, highlighting the potential of spirituality-based interventions in rehabilitation programs.

PMID:40275426 | DOI:10.1186/s40359-025-02749-2

Perioper Med (Lond). 2025 Apr 24;14(1):48. doi: 10.1186/s13741-025-00520-0.

ABSTRACT

PURPOSE: Extubation refers to removing the breathing tube from the patient’s airway after surgery under general anesthesia with tracheal intubation. Extubation procedures typically take less than 15 min, and if they take more, they are prolonged. Whether or not to extubate a patient depends on several factors, including the patient’s preoperative status, the type of surgery, anesthetic methods, and expected recovery after the procedure. Thus, the study’s objective was to determine the incidence of prolonged extubation and its associated factors among adult patients undergoing surgery at Jimma Medical Center.

METHODS: A prospective observational study through a consecutive sampling technique was conducted. Ethical clearance and approval were obtained from the institutional review board of Jimma University. Data on the extubation time and possible associated factors for a prolonged extubation time were collected using a data collection checklist. After being entered into EpiData 4.6 and exported into SPSS 25, descriptive analyses and logistic regression were carried out. In multivariate variables, p ≤ 0.05 was declared as statistical significance.

RESULT: Three-hundred eight adult patients were enrolled in the current study. Of these, the incidence of prolonged extubation was 24.7% (95% CI [20.0-29.9]). The identified associated factors were age ≥ 55 years (AOR = 5.7, 95% CI [2.62, 12.69], p ≤ 001); ASAPS > II (AOR = 4.27, 95% CI [1.59, 11.45], p = 004); BMI ≥ 30 kg/m² (AOR = 6.6, 95% CI [2.37, 18.36], p ≤ 001); the use of benzodiazepine (AOR = 3.43, 95% CI [1.42, 8.25], p = 0.006); using of isoflurane (AOR = 0.35, 95% CI [0.15, 0.78], p = 0.011); prone position (AOR = 4.68, 95% CI [1.56, 14.07], p = 0.006); extubation in afternoon (AOR = 2.69, 95% CI [1.26, 5.74]; p = 0.011); and duration of surgery ≥ 210 min (AOR = 5.2, 95% CI [2.32, 11.72], p ≤ 0.001).

CONCLUSIONS: The study found that prolonged time to extubation occurred in one-fourth of the patients. The independent factors statistically associated with prolonged extubation were older ages, higher ASA class, obesity (≥ 30 kg/m²), the use of benzodiazepine, halothane for maintenance, prone position, extubation in the afternoon, and longer procedures (≥ 210 min).

PMID:40275413 | DOI:10.1186/s13741-025-00520-0

Pneumonia (Nathan). 2025 Apr 25;17(1):9. doi: 10.1186/s41479-025-00164-0.

ABSTRACT

BACKGROUND: The incidence of pneumococcal pneumonia in the context of the Coronavirus Disease 2019 (COVID-19) pandemic, along with the real-world data on the ratio of non-invasive to invasive pneumococcal pneumonia, is an area that has not been thoroughly studied. The outcomes associated with coinfection of influenza and COVID-19 remain unknown. This study examined the incidence, demographics, coinfection with influenza and/or COVID-19, and clinical outcomes of pneumococcal hospitalizations in Hong Kong during the baseline, pandemic, and post-pandemic periods.

METHODS: Hospitalization records of individuals aged 18 years and above with pneumococcal disease from January 2015 to August 2024 were extracted from the territory-wide electronic medical record database. Pneumococcal disease was categorized into invasive pneumococcal pneumonia (IPP), invasive pneumococcal disease without pneumonia (IPDWP), and non-invasive pneumococcal pneumonia (NIPP), followed by univariate and multivariate analyses. Effects of coinfection with influenza and COVID-19 were analyzed.

RESULTS: The incidence of pneumococcal disease decreased during the COVID-19 pandemic but rebounded in the post-pandemic period. There were no significant changes in the distribution of pneumococcal serotypes across the three periods. The study revealed a strong positive correlation between monthly pneumococcal hospitalizations and the indicator of influenza activity, while the correlation with the COVID-19 indicator was weak. Additionally, strong positive correlations were observed between the indicator of influenza activity and influenza coinfections, as well as between the indicator of COVID-19 activity and COVID-19 coinfections. Multivariate analyses identified male gender, a higher comorbidity index, older age, invasive pneumococcal disease (IPP and IPDWP), coinfection with influenza and COVID-19, and hospitalization during the pandemic period as factors associated with adverse outcomes.

CONCLUSIONS: The study showcases changes in the epidemiology of pneumococcal disease during and after the COVID-19 pandemic. It highlights the adverse effects of influenza and COVID-19 coinfections on the outcomes of patients with pneumococcal disease and emphasizes the need to vaccinate vulnerable populations against these infections.

PMID:40275411 | DOI:10.1186/s41479-025-00164-0

Confl Health. 2025 Apr 24;19(1):26. doi: 10.1186/s13031-025-00666-0.

ABSTRACT

BACKGROUND: Severe acute malnutrition (SAM) remains a critical public health challenge in conflict-affected settings, where children face heightened vulnerability. Dual deficiencies in weight-for-height z-score (WHZ < -3) and mid-upper arm circumference (MUAC < 11.5 cm) indicate a more severe form of SAM, yet current admission protocols prioritize WHZ-based criteria for inpatient therapeutic feeding centers (TFCs). This approach may exclude children with MUAC deficiencies from optimal inpatient care, potentially impacting recovery outcomes in outpatient therapeutic programs (OTPs). In Yemen, prolonged conflict has exacerbated SAM burdens, leading to an expansion of TFC and OTP services since 2015. The aim is to determine whether existing WHO recovery criteria adequately support comprehensive recovery and prevent premature discharge.

METHOD: A retrospective analysis was conducted using data from a prospective longitudinal study of children admitted with complicated SAM to TFCs in Sana’a City from September 2023 to November 2024. Children were categorized based on SAM diagnostic criteria (WHZ < -3, MUAC < 11.5 cm, or both) and analyzed under four discharge scenarios: (1) WHZ recovery, (2) MUAC recovery, (3) recovery by either WHZ or MUAC, and (4) recovery of both indicators. Chi-square and Kruskal-Wallis tests were used to assess differences between groups, and P < 0.05 was used to determine statistical significance.

RESULTS: Among 188 children admitted with complicated SAM, 56% (105) were female, 53% (100) were aged 6-<12 months, and 59% (111/188) presented with dual deficiencies. Admission based on WHZ criteria accounted for 82% (154/188) of admissions, of whom 72% also had MUAC < 11.5 cm. At OTP discharge, 96% met WHO recovery criteria, yet only 38% achieved full recovery (WHZ ≥ -2 and MUAC ≥ 12.5 cm). Full recovery was significantly lower among children with dual deficiencies at TFC admission than those with single deficiencies in MUAC or WHZ (31% vs. 47% and 51%, respectively, p = 0.032).

CONCLUSIONS: These findings underscore the need to integrate WHZ and MUAC into discharge criteria to prevent premature discharge and ensure comprehensive recovery. Revising WHO protocols and enhancing SAM management in conflict-affected settings are critical to improving treatment outcomes.

PMID:40275406 | DOI:10.1186/s13031-025-00666-0

J Ovarian Res. 2025 Apr 24;18(1):84. doi: 10.1186/s13048-025-01667-6.

ABSTRACT

The aim of this in vitro short report was to determine whether activation of platelet-rich plasma (PRP) results in differential effects on growth factor release and cell proliferation in reproductive medicine. This study involved PRP from five donors, activated with either CaCl₂ (exogenous activation) or type I collagen (mimicking endogenous activation). The release of growth factors (EGF and PDGF-AB) and the proliferative response of human ovarian fibroblasts were analysed. PRP activated with CaCl₂ formed stable clots and released statistically significant higher levels of EGF (871 ± 426 pg/mL) and PDGF-AB (26535 ± 6477 pg/mL) compared to collagen-activated PRP (EGF: 141 ± 66 pg/mL, PDGF-AB: 13060 ± 2301 pg/mL). Additionally, CaCl₂-activated PRP induced greater proliferation in ovarian fibroblasts (34.90 ± 17.82 ng/mL DNA) than collagen-activated PRP (30.75 ± 18.21 ng/mL DNA). In conclusion, the activation of PRP with CaCl₂ results in higher growth factor release and a stronger biological response compared to type I collagen-activation. These findings underscore the importance of standardized PRP activation protocols to enhance clinical outcomes in reproductive medicine.

PMID:40275404 | DOI:10.1186/s13048-025-01667-6

Genome Biol. 2025 Apr 24;26(1):105. doi: 10.1186/s13059-025-03554-1.

ABSTRACT

In spatial transcriptomics data, spatially correlated genes promise to reveal high-interest phenomena like cell-cell interactions and latent variables. But in practice, most spatial correlations arise from the spatial arrangement of cell types, obscuring the more interesting relationships we hope to discover. We introduce InSituCor, a toolkit for discovering modules of spatially correlated genes. InSituCor returns only correlations not explainable by already-known factors like the cell type landscape; this spares precious analyst effort. InSituCor supports both unbiased discovery of whole-dataset correlations and knowledge-driven exploration of genes of interest. As a special case, it evaluates ligand-receptor pairs for spatial co-regulation.

PMID:40275395 | DOI:10.1186/s13059-025-03554-1

Clin Epigenetics. 2025 Apr 25;17(1):62. doi: 10.1186/s13148-025-01863-7.

ABSTRACT

BACKGROUND: Biological age reflects inter-individual differences in biological function and capacity beyond chronological age. DNA methylation age (DNAmA) and its deviation from chronological age, DNAmA acceleration (DNAmAA), which was calculated as residuals of leukocyte cell count adjusted linear regression of DNAmA on chronological age, were used to estimate biological age in this study. Low levels of serum selenium, selenoprotein P (SELENOP), and the selenocysteine-containing glutathione peroxidase 3 (GPx3) are associated with adverse health outcomes and selenium supplementation is discussed as an anti-aging intervention.

METHODS: In this study, we cross-sectionally analyzed 1568 older participants from the observational Berlin Aging Study II (mean age ± SD: 68.8 ± 3.7 years, 51% women). Serum selenium was measured by total reflection X-ray fluorescence (TXRF) spectroscopy and SELENOP was determined by sandwich ELISA. GPx3 was assessed as part of a proteomics dataset using liquid chromatography-mass spectrometry (LC-MS). The relationship between selenium biomarkers and epigenetic clock measures was analyzed using linear regression analyses. P values and 95% confidence intervals (not adjusted for multiple testing) are stated for each analysis.

RESULTS: Participants with deficient serum selenium levels (< 90 μg/L) had a higher rate of biological aging (DunedinPACE, β = – 0.02, SE = 0.01, 95% CI – 0.033 to – 0.004, p = 0.010, n = 865). This association remained statistically significant after adjustment for age, sex, BMI, smoking, and first four genetic principal components (β = – 0.02, SE = 0.01, 95% CI – 0.034 to – 0.004, p = 0.012, n = 757). Compared to the highest quartile, participants in the lowest quartile of SELENOP levels showed an accelerated biological aging rate (DunedinPACE, β = – 0.03, SE = 0.01, 95% CI – 0.051 to – 0.008, p = 0.007, n = 740, fully adjusted model). Similarly, after adjustment for confounders, accelerated biological age was found in participants within the lowest GPx3 quartile compared to participants in the fourth quartile (DunedinPACE, β = – 0.04, SE = 0.01, 95% CI – 0.06 to – 0.02, p = 0.001, n = 674 and GrimAge, β = – 0.98, SE = 0.32, 95% CI – 1.6 to – 0.4, p = 0.002, n = 608). Only the association with GPx3 remained statistically significant after multiple testing correction.

CONCLUSION: Our study suggests that low levels of selenium biomarkers are associated with accelerated biological aging measured through epigenetic clocks. This effect was not substantially changed after adjustment for known confounders.

PMID:40275394 | DOI:10.1186/s13148-025-01863-7