Nevin Manimala

Acta Parasitol. 2025 Jul 21;70(4):163. doi: 10.1007/s11686-025-01099-8.

ABSTRACT

BACKGROUND: Cyclospora cayetanensis is a coccidian protozoan parasite belonging to the phylum Apicomplexa. This systematic review and meta-analysis aimed to assess the prevalence and risk factors of C. cayetanensis in patients with Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS).

METHODS: A literature search was performed in international databases for studies published until October 18, 2024, focusing on cross-sectional and case-control studies. Data from eligible studies were analyzed using Comprehensive Meta-Analysis (CMA) software, employing random-effects models for pooled estimates and weighted odds ratios (ORs), along with heterogeneity assessment via I² statistic.

RESULTS: This systematic review analyzed 73 studies, including 48 cross-sectional and 25 case-control involving 13,986 HIV/AIDS patients and 3,559 non-HIV/AIDS controls across 22 countries, mainly in Asia and Africa. The global prevalence of C. cayetanensis infection was 4% in HIV/AIDS patients (95% CI: 2.9-5.4%) versus 1.8% in controls (95% CI: 1.1-3.2%), resulting in an OR of 3.5 (95% CI: 2.04-6.06), indicating HIV/AIDS patients were significantly more likely to be infected. Sensitivity analysis indicated that none of the studies significantly affected the pooled estimates and weighted ORs. The prevalence of infection showed no significant association with quantitative variables such as publication year, sample size, and Human Development Index (HDI). Moreover, the pooled prevalence of C. cayetanensis infection was estimated across various subgroups, including publication year, World Health Organization (WHO) region, country, continent, country income level, HDI value, and sample size.

CONCLUSION: The findings confirm the opportunistic nature of C. cayetanensis infection and highlight the need for increased awareness and diagnosis of this infection in HIV/AIDS patients. Monitoring this opportunistic infection is vital for patient management, particularly in resource-limited areas.

PMID:40690092 | DOI:10.1007/s11686-025-01099-8

Eat Weight Disord. 2025 Jul 21;30(1):56. doi: 10.1007/s40519-025-01767-8.

ABSTRACT

PURPOSE: The present study reports on the psychometric properties of the Dutch translation of the clinical impairment assessment (CIA) questionnaire in female patients with eating disorders. The aim of this study was to determine the factor structure of the CIA as there are conflicting studies supporting a three-factor, bifactor, and single-factor model with a general factor and three specific factors.

METHODS: The CIA was translated and administered to 321 female patients with various eating disorders receiving treatment in a specialized eating disorder center. Its factor structure, internal consistency, convergent validity, and sensitivity to change were investigated.

RESULTS: Confirmatory factor analyses showed the best fit was a bifactor model with one strong general factor and three less strong specific factors for personal, social, and cognitive impairment. Furthermore, good internal consistency (Cronbach’s α = 0.91), good convergent validity between CIA global score and eating disorder examination questionnaire global score (r = 0.58; p < 0.001) and good sensitivity to change (t (115) = 13.76, p < 0.001) were found.

CONCLUSIONS: The Dutch CIA is a reliable and valid instrument to measure impairment secondary to eating disorder symptoms, but interpretations made from subscales scores should be used with caution.

LEVEL OF EVIDENCE: Level III, validation study.

PMID:40690077 | DOI:10.1007/s40519-025-01767-8

Arch Orthop Trauma Surg. 2025 Jul 21;145(1):382. doi: 10.1007/s00402-025-05993-8.

ABSTRACT

BACKGROUND: Hip fractures have a significant impact on morbidity and mortality in older adults, often leading to loss of function and an increased healthcare burden. The role of geriatric co-management in improving postoperative outcomes remains controversial. This meta-analysis evaluates the impact of geriatric care on functional recovery, complications, length of hospital stay, and one-year mortality in older patients with hip fractures.

METHODS: A meta-analysis was conducted according to PRISMA guidelines. Randomized controlled trials (RCTs) and prospective cohort studies comparing standard orthopedic care with geriatric co-management were included. The primary outcomes examined were one-year mortality, functional independence (Barthel ADL scores, independent walking), length of hospital stay and postoperative complications (delirium, infections, falls).

RESULTS: Six RCTs with 1,780 patients (894 geriatric care, 886 standard care) were analyzed. Geriatric care was associated with improved ADL scores (Cohen’s d = 0.066, 95% CI 0.027-0.105) and a 19% higher rate of independent walking (RR = 1.19, 95% CI 1.092-1.288). The length of hospital stay was reduced by 1.39 days (95% CI – 1.98 to – 0.80). Complication rates decreased slightly (- 3.60%), but no significant reduction in one-year mortality was observed (- 2.26%). Heterogeneity was high for functional outcomes (I² = 99.91%) and LOS (I² = 99.99%).

CONCLUSIONS: Geriatric care improves short-term functional outcomes, reduces complications and shortens hospital stay in elderly patients with hip fractures. However, its impact on one-year mortality is limited. Standardized geriatric care models and further research on long-term recovery strategies are needed to optimize outcomes.

PMID:40690069 | DOI:10.1007/s00402-025-05993-8

Int Ophthalmol. 2025 Jul 21;45(1):301. doi: 10.1007/s10792-025-03669-1.

ABSTRACT

PURPOSE: To investigate the effect of posterior corneal surface abnormalities following deep anterior lamellar keratoplasty (DALK) on visual outcomes and high order aberrations (HOA).

METHODS: A retrospective cohort study was conducted on DALK cases. Patients were divided into two groups: Group A with posterior corneal surface abnormalities (interface haze, pre-Descemet’s scarring, central Descemet’s membrane (DM) perforation, and central DM folds) and Group B (control group) with regular posterior surface. Visual acuity, refractive outcomes, contrast sensitivity, and HOA were assessed in both groups.

RESULTS: This study included 84 eyes of 78 patients. Group A included 42 eyes of 38 patients and an equal number of control eyes were randomly included in group B. Group A exhibited significantly lower corrected distance visual acuity (CDVA) compared to Group B (Mean LogMAR 0.45 ± 0.25 in group A vs 0.31 ± 0.21 in group B, P = 0.012). Subgroup analysis revealed the lowest visual acuity in eyes with multiple posterior surface abnormalities, although the difference was not statistically significant. The mean topographic astigmatism was significantly higher in group A than in group B (4.47 ± 2.36 diopters vs 3.11 ± 2.16 diopters, respectively, P = 0.001). No significant differences were found between the 2 groups regarding total eye or corneal HOA. Contrast sensitivity was significantly lower in Group A at lower spatial frequencies (P = 0.013 and P = 0.004 at 3 and 6 cycles per degree, respectively), particularly in eyes with large DM perforations.

CONCLUSION: Posterior corneal surface abnormalities after DALK can negatively impact visual outcomes, especially contrast sensitivity.

PMID:40690055 | DOI:10.1007/s10792-025-03669-1

Support Care Cancer. 2025 Jul 21;33(8):708. doi: 10.1007/s00520-025-09717-x.

ABSTRACT

OBJECTIVE: To explore the determinants of loneliness among patients undergoing peripheral blood stem cell transplantation (PBSCT) and to identify factors that influence their loneliness levels, with the aim of developing targeted nursing strategies and interventions.

METHODS: A total of 300 PBSCT patients were recruited through convenience sampling. Data were collected using a general information questionnaire, the UCLA Loneliness Scale (UCLA), the Functional Assessment of Cancer Therapy-General (FACT-G), and the Perceived Social Support Scale (PSSS). Statistical analyses were performed to assess loneliness levels and identify associated factors.

RESULTS: The average UCLA loneliness score among patients was 52.97 ± 12.35, indicating moderate to high levels of loneliness. Pearson correlation analysis revealed a significant negative relationship between loneliness and perceived social support as well as other measured dimensions (all P < 0.01). Multiple linear regression analysis identified marital status, employment status, presence of comorbidities, and perceived social support as significant predictors of loneliness (R² = 0.300, adjusted R² = 0.238, F = 17.874, P < 0.001), with social support and health status being the strongest contributors.

CONCLUSION: Loneliness in PBSCT patients is influenced by various factors, with social support and health status playing critical roles. To mitigate loneliness and enhance patients’ quality of life, healthcare teams should prioritize strengthening social support networks and addressing health-related challenges. Regular psychological assessments and timely interventions are essential for reducing loneliness and facilitating recovery in transplant patients.

PMID:40690046 | DOI:10.1007/s00520-025-09717-x

Cancer Med. 2025 Jul;14(14):e71053. doi: 10.1002/cam4.71053.

ABSTRACT

INTRODUCTION: Objective was to describe the association between baseline characteristics and the number of Symptom Screening in Pediatrics Tool (SSPedi) assessments completed over an 8-week period.

METHODS: This was a sub-analysis of a cluster randomized controlled trial among 10 sites that were randomized to the intervention group. Participants were English- or Spanish-speaking pediatric patients 8-18 years of age newly diagnosed with cancer. Participants were prompted to complete SSPedi three times weekly for 8 weeks. The outcome was the number of SSPedi assessments completed during the 8-week period. Factors associated with the number of assessments were determined using mixed effects Poisson regression.

RESULTS: At the 10 intervention sites, 216 patients were included in the analysis. Among these participants, 129 (59.7%) were male, 112 (51.9%) were white, and 83 (38.4%) were Hispanic. The number of SSPedi assessments was significantly higher for participants 11-14 years (rate ratio (RR) 1.13, 95% confidence interval (CI) 1.02-1.25) and 15-18 years (RR 1.15, 95% CI 1.04-1.27) compared to 8-10 years. Participants completed more SSPedi assessments if they were Asian compared to white (RR 1.27, 95% CI 1.10-1.46), non-Hispanic compared to Hispanic (RR 1.15, 95% CI 1.04-1.28) and from families with a household income ≥$60,000 (RR 1.12, 95% CI 1.03-1.21). Participants completed fewer SSPedi assessments if they had solid tumors compared to leukemia (RR 0.91, 95% CI 0.84-0.99).

CONCLUSION: Adherence to three-times weekly SSPedi varied by age, race, ethnicity, cancer diagnosis, and family income. This information may facilitate interventions to support routine symptom screening in clinical practice.

TRIAL REGISTRATION: NCT04614662.

PMID:40686265 | DOI:10.1002/cam4.71053

Cancer Med. 2025 Jul;14(14):e71052. doi: 10.1002/cam4.71052.

ABSTRACT

PURPOSE: We aimed to analyse trends in incidence, mortality and 5-year relative survival of malignant and benign/borderline brain and central nervous system (CNS) tumours between 1980 and 2021 in the Canton of Zurich, Switzerland, stratified by sex, age group, behaviour and histological subtypes.

METHODS: We used incidence data from the Cancer Registry of Zurich, Zug, Schaffhausen and Schwyz, including primary benign/borderline and malignant tumours diagnosed between 1980 and 2021 in the Canton of Zurich in patients aged ≥ 15 years (N = 10,226). Mortality data were provided by the Swiss Federal Statistical Office (N = 3514). We calculated age-standardised incidence and mortality rates per 100,000 person-years and used Joinpoint to analyse trends.

RESULTS: The age-standardised incidence rate of malignant tumours was stable over time (around 7.7-8.2 per 100,000 person-years in men and 4.6-5.2 in women), while the rate of benign/borderline tumours increased from 3.8 in 1980-1990 to 10.8 in 2011-2021 in men and from 5.7 to 19.1 in women. The age-standardised mortality rate remained stable over time for malignant tumours (around 5.5-6.1 in men and 3.5-4.0 in women) but significantly decreased for benign/borderline tumours (from 1.0 to 0.5 in men and from 1.2 to 0.5 in women). Age-standardised 5-year relative survival increased from around 80% in 1980-1989 up to > 90% in 2011-2017 for benign/borderline tumours and from < 20% to around 30% for malignant tumours. There was a small survival advantage in women compared to men.

CONCLUSIONS: We observed an increase in incidence and a decrease in mortality rates for benign/borderline tumours, while both rates remained stable for malignant tumours. Five-year relative survival improved over time. The increasing incidence rates in benign/borderline tumours may be due to improved diagnostic techniques and an increasing use of CT scans, as reported in other countries. The increase in relative survival may reflect earlier detection and better treatment options.

PMID:40686230 | DOI:10.1002/cam4.71052

J Alzheimers Dis. 2025 Jul 21:13872877251360241. doi: 10.1177/13872877251360241. Online ahead of print.

ABSTRACT

BackgroundRecent meta-analyses indicate that the relationship between grip strength (GS) and cognition is more complex than that was previously assumed. Multiple studies have established a significant correlation between body composition and GS.ObjectiveTo assess longitudinal relationships between absolute and relative GS trajectories and cognitive function.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) data with 2549 participants were analyzed using the Group-Based Trajectory Model (GBTM) to ascertain GS trajectories over time. Absolute GS was defined as the raw force, while relative GS was defined as grip strength adjusted by body weight. Directed Acyclic Graphs (DAGs) were used to identify confounding variables, which were subsequently adjusted for in generalized estimating equation (GEE) models that assessed associations between these trajectories and changes in cognitive function over time.ResultsWe observed that relative GS exhibited three distinct trajectories: The three relative GS trajectories were labeled as Low-decline (n = 823, 32.29%), Medium-decline (n = 1292, 50.69%), and High-decline (n = 434, 17.03%). Absolute GS showed similar downward trends. GEE revealed a uniform five-year decline in cognitive function across all GS trajectory groups (all p_time < 0.001). The overall interaction between the timing and patterns of changes in both absolute and relative GS and cognitive function was statistically significant (p < 0.001).ConclusionsIn middle-aged and older adults, lower grip strength trajectories align with accelerated cognitive decline, while higher grip strength is associated with slower cognitive deterioration. Monitoring grip strength may serve as a practical marker for cognitive health in aging populations.

PMID:40686228 | DOI:10.1177/13872877251360241

Int J Inj Contr Saf Promot. 2025 Jul 21:1-8. doi: 10.1080/17457300.2025.2533198. Online ahead of print.

ABSTRACT

Falls are considered one of the important causes of injuries and fatalities among children and adolescents. Students are continuously exposed to the risks of falls, in the school environment. Therefore, a thorough examination of student behaviours and the environmental conditions of schools is of significant importance for preventing fall-related injuries in students. This study aims to investigate the influential factors for preventing fall-related injuries among primary school students using the PRECEDE model. This cross-sectional study has been done among 428 primary school students from grades one to six in schools of Hamadan city, located in western Iran. The students were selected randomly through a multi-stage cluster sampling method and data collection has been done between December 2023 and February 2024. The data collection tool was a researcher-made questionnaire based on the PRECEDE model. The questionnaire was included three sections including demographic questions, questions related to the constructs of the PRECEDE model (preventive behaviour constructs; predisposing factors including knowledge and attitude; reinforcing factors; enabling factors; and environmental factors), and questions concerning the history of fall-related injuries at school. The data collection has been done through interviews with the students. Data were analyzed using SPSS24 software after collection. The results of this study revealed that out of 428 students, 131(30.6%) experienced falls, with ages ranging from 7 to 12 years and an average age of 9.5 ± 1.70 years. Among these, 54 (41.2%) were females and 77 (58.7%) were males. The findings indicate that males experienced more falls than females, and females exhibited better preventive behaviours than males (p = 0.002). Most falls occurred in the schoolyard (37.4%) and during recess time (40.5%). The most common types of injuries were abrasions (28.2%) and head injuries (24.4%). Additionally, the findings showed that parents’ education level was significantly associated with preventive fall behaviours among students. Hence, the students with parents who had higher education levels (mothers’ education with (p = 0.02) and fathers’ education with (p = 0.03) demonstrated better preventive behaviours and were less at risk of falls. Among the constructs of the PRECEDE model, the predisposing factors of knowledge (p = 0.04) and attitude (p = 0.001), enabling factors (p = 0.02), and environmental factors (p = 0.03) had a significant relationship with fall-preventive behaviours. According to the statistical results, the attitude construct was the predictor of students’ fall- preventive behaviours. The study results indicated that fall-related injuries in the studied group are high. Additionally, the PRECEDE model can help identify factors associated with fall prevention among students. Given the significant role of behaviour and the school environment in fall prevention in this study, implementing appropriate interventions to enhance students’ attitudes and knowledge and creating a safe school environment can be very beneficial and effective in improving fall-preventive behaviours.

PMID:40686208 | DOI:10.1080/17457300.2025.2533198

Emerg Med Australas. 2025 Aug;37(4):e70100. doi: 10.1111/1742-6723.70100.

ABSTRACT

OBJECTIVE: The study aimed to evaluate the prevalence and impact of low-value diagnostic tests at a regional, major-referral, mixed Emergency Department (ED).

METHODS: A single-site, cross-sectional study was conducted at Townsville University Hospital in April 2022. Adult patients (aged 18 years and above) who underwent one of 10 specified diagnostic tests were included. The tests encompassed coagulation studies, urine cultures, blood cultures, cranial computed tomography (CT) in syncope, cranial CT in minor head injury, cervical spine CT in neck trauma, ankle X-ray in acute ankle trauma, duplex lower extremity ultrasound in suspected deep vein thrombosis, CT pulmonary angiography in suspected pulmonary embolism, and CT kidney ureter bladder in renal colic. Tests were classified as low-value based on Choosing Wisely recommendations, with their value determined by a research assistant using clinical documentation, prior to the availability of test results. Emergency clinicians were blinded to the study conduct.

RESULTS: Of all diagnostic tests performed, 48.2% (276/572) were deemed low-value, including 50.6% of laboratory tests (246/486) and 24.4% of imaging tests (21/86). The median ED length of stay was 6.1 h (IQR 3.9-8.5). Low-value imaging tests contributed to 152 lost bed-hours per 100 tests.

CONCLUSION: A substantial proportion of diagnostic tests were low-value, exacerbating access block and reducing the availability of ED beds, thereby delaying timely emergency care. The implementation of evidence-based, effective strategies is imperative to mitigate patient harm associated with low-value diagnostic tests.

PMID:40686189 | DOI:10.1111/1742-6723.70100