Tag: nevin manimala

BMC Psychol. 2026 Jun 5. doi: 10.1186/s40359-026-04936-1. Online ahead of print.

ABSTRACT

BACKGROUND: Existing literature indicates that bullying victimization elevates the risk of depression among adolescents; however, longitudinal evidence on the associations between specific types of victimization (physical, verbal, relational, and cyberbullying) and depression remains limited, particularly with regard to gender differences. This study examined the predictive effects of these four forms of victimization on depression at a six-month follow-up and further explored the moderating role of gender.

METHODS: We collected two-wave longitudinal data from 457 Grade 10 students (230 boys, 227 girls; Mage = 15.93, SD = 1.94) at a high school in Gansu Province, China, in June 2024 (T1) and December 2024 (T2). Participants completed a series of self-report questionnaires, including measures of demographic characteristics, the Revised Bullying Victimization Questionnaire (BVQ-R), and the depression subscale of the Depression Anxiety Stress Scales (DASS-21). Hierarchical multiple regression analyses were conducted to examine both main and interaction effects, and simple slope analyses were performed to probe significant interactions.

RESULTS: After adjusting for demographic covariates, all four forms of T1 bullying victimization significantly predicted higher levels of depressive symptoms at T2 in the main-effects models. In the interaction models, none of the victimization × gender interaction terms reached statistical significance.

CONCLUSION: These findings suggest that multiple forms of bullying victimization are prospectively associated with subsequent depressive symptoms and that these associations do not appear to vary by gender in this sample.

PMID:42249517 | DOI:10.1186/s40359-026-04936-1

BMC Pharmacol Toxicol. 2026 Jun 5. doi: 10.1186/s40360-026-01158-4. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer remains one of the leading causes of cancer-related mortality among women worldwide. Although methyltestosterone (MT) has demonstrated therapeutic potential in hormone-responsive breast cancer, its clinical application may be limited by poor aqueous solubility and non-specific distribution. Albumin-based nanocarriers may enhance drug stability and intracellular availability. This study aimed to develop genipin-crosslinked human serum albumin (HSA) nanoparticles loaded with MT and to evaluate their physicochemical properties, release behavior, and in-vitro pharmacological and cytotoxic effects in MCF-7 breast cancer cells.

METHODS: MT-loaded HSA nanoparticles were prepared using the desolvation method followed by genipin crosslinking. Particle size, polydispersity index (PDI), and zeta potential were determined by dynamic light scattering (DLS), while morphology and crystallinity were evaluated using SEM and XRD analysis. Drug loading (DL) and encapsulation efficiency (EE) were quantified spectrophotometrically. In-vitro release was assessed under different pH conditions (5.5, 6.8, and 7.4). Cytotoxicity and pharmacological activity were evaluated in MCF-7 cells using MTT, LDH, and TUNEL assays. Statistical analysis was performed using one-way ANOVA (p < 0.05).

RESULTS: The formulated MT-HSA nanoparticles exhibited a mean diameter of 83 nm (PDI 0.25) and a zeta potential of – 16.3 mV, indicating uniform nanoscale distribution and moderate colloidal stability. Encapsulation efficiency and drug loading were 77% and 11%, respectively. Sustained and pH-dependent drug release was observed over 100 h, with higher release under acidic conditions (83% at pH 5.5). MT-HSA nanoparticles significantly reduced MCF-7 cell viability compared with free MT (p < 0.05), accompanied by increased LDH release and higher apoptotic index in TUNEL assays. Unloaded HSA nanoparticles showed negligible cytotoxicity. The formulation remained physically stable for two months at 4 °C.

CONCLUSIONS: Genipin-crosslinked MT-HSA nanoparticles demonstrated improved in-vitro pharmacological efficacy, enhanced cytotoxic and pro-apoptotic activity compared with free methyltestosterone, and favorable carrier biocompatibility. These findings support albumin-based nanoencapsulation as a promising strategy for optimizing steroid-based therapy in hormone-responsive breast cancer, although further in-vivo studies are required to confirm translational potential.

PMID:42249506 | DOI:10.1186/s40360-026-01158-4

BMC Nutr. 2026 Jun 5. doi: 10.1186/s40795-026-01360-x. Online ahead of print.

ABSTRACT

BACKGROUND: This study evaluated the effectiveness of a brief, Theory of Planned Behavior-based educational program on weight management and related health outcomes among university employees.

METHODS: In this quasi-experimental study conducted at two major universities in Erbil, Iraq, 200 employees with a body mass index (BMI) ≥ 25 kg/m² self-selected into an intervention (n = 100) or control (n = 100) group. The intervention consisted of five individual 35-40-minute sessions delivered over 12 weeks and covered obesity awareness, culturally adapted nutrition education, physical activity, and behavior-change strategies. The control group received only standard written materials. Primary outcomes were changes in body weight, BMI, and waist circumference. Secondary outcomes included lipid profile, fasting glucose, quality of life (Impact of Weight on Quality of Life-Lite [IWQOL-Lite]), dietary quality, and physical activity. All assessments were performed at baseline and 12 weeks.

RESULTS: The intervention was associated with a mean weight loss of 7.46 kg (95% CI 6.44-8.48) compared with a gain of 0.58 kg in the control group (adjusted difference – 8.04 kg; p < 0.001; Cohen’s d = 2.40). 79% of intervention participants lost ≥ 5% of their initial body weight (versus 0% in controls), and 41% lost ≥ 10%. Significant improvements were also observed in BMI, waist circumference, lipid profile, quality of life, and dietary quality (all p < 0.001; d > 1.8). Mediation analysis indicated that improvement in dietary quality accounted for 82% of the observed association between group assignment and change in BMI.

CONCLUSIONS: A brief, low-cost, culturally adapted educational intervention delivered in the workplace was associated with exceptionally large weight loss, cardiometabolic benefits, and psychosocial gains, with perfect retention. These findings suggest that this model may offer a promising approach for obesity management in Middle Eastern settings. However, confirmation in randomized controlled trials with longer follow-up is required before firm conclusions regarding scalability and effectiveness can be drawn.

CLINICAL TRIAL REGISTRATION: The study was not prospectively registered in a clinical trial registry because it employed a quasi-experimental design with participant self-selection rather than random allocation. However, the full study protocol including all primary and secondary outcomes, eligibility criteria, intervention details, and the statistical analysis plan was finalized, approved by the Hawler Medical University Ethics Committee (reference HMU-REC-2024-18, 15 September 2024), and locked prior to the start of participant recruitment and data collection. No outcomes were added, removed, or modified after data inspection, and no post-hoc analyses were conducted beyond those pre-specified in the protocol. The manuscript adheres fully to the TREND reporting standards for non-randomized evaluations.

PMID:42249502 | DOI:10.1186/s40795-026-01360-x

BMC Psychol. 2026 Jun 5. doi: 10.1186/s40359-026-04405-9. Online ahead of print.

ABSTRACT

BACKGROUND: Anxiety reduction is an objective that should be part of each patient’s care plan. The aim of this study was to develop, implement, and evaluate an anxiety management program for women under gynecological surgery with spinal anesthesia based on the participatory action research using PARIHS framework.

METHODS: This participatory action research was conducted from 2020 to 2023 in a referral gynecological surgery center in northeastern Iran and followed four phases: (1) problem identification using interviews, observations, literature review, and Numeric Visual Analog Anxiety Scale (NVASA); (2) planning through 16 expert panel and stakeholder sessions to design feasible evidence-based actions; (3) action, implemented in three cycles targeting healthcare providers, the environment, and patients; and (4) evaluation, was conducted by using NVASA measurements across cycles and assessments of communication skills and stress among healthcare providers. Data were analyzed using conventional content analysis for qualitative findings and paired statistical tests for quantitative outcomes.

RESULTS: Data analysis from interviews and observations in the first phase of the research process, led to the emergence of 20 subcategories and 6 main categories. A comprehensive literature review further delineated three intervention categories: healthcare provider, patient, and environmental interventions, along with 13 subcategories. In the main evaluation of the effectiveness of the cycles of action phase, mean anxiety score of patients before the interventions were 6.1 ± 1.9, and after the interventions of the health care providers, environment, and patient was 4.66 ± 2.17, 2.86 ± 1.79, and 2.64 ± 1.2, respectively, which had a statistically significant difference (p < 0.001).

CONCLUSIONS: Anxiety management program based on action research steps has reduced anxiety in patients of study, the application of the anxiety management program with the participation of patients and healthcare providers in the context with a combination of extracted evidence led to the change in the attitude of the stakeholders.

PMID:42249493 | DOI:10.1186/s40359-026-04405-9

BMC Health Serv Res. 2026 Jun 5. doi: 10.1186/s12913-026-14843-1. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence based medicine is a critical cornerstone in contemporary medicine, yet uptake and adoption of evidence remain suboptimal. This is prominent in many fields of healthcare, including musculoskeletal health and surgery. Understanding the drivers of this translational lag is critical to ensure high-quality care and improved patient outcomes.

METHODS: A survey questionnaire, informed by the Theoretical Domains Framework was distributed to musculoskeletal clinicians and healthcare professionals, including surgeons, physiotherapists and nurses, around Australia. We assessed the barriers and enablers to translating evidence into practice, preferred sources of evidence for clinical decision-making, and the main drivers of change and improving implementation. Quantitative data were analysed using descriptive statistics and qualitative data were assessed using inductive thematic analysis.

RESULTS: 771 clinicians were invited to participate, of whom 82 completed the survey. Participants were from Australia and covered a range of disciplines, including surgeons, nurses and physiotherapists. In general, participants were supportive of evidence-based medicine and more than 90% agreed that engagement with literature was essential for determining the best treatment options. All respondents also considered delivery of evidence-based care to be a professional responsibility. Nonetheless, multiple barriers to translating evidence into practice were identified: poor support from leadership and professional culture (n=33, >40%), policy reform (n=18, >20%), improving access to research and the prioritisation of clinically relevant and practical evidence (n=25, >30%).

CONCLUSION: This survey study highlights the barriers surrounding the translation of research evidence into musculoskeletal care. Improving implementation will require multifaceted strategies including building stronger clinical and executive leadership, fostering supportive professional cultures and updating policy frameworks. Future research should evaluate these approaches to determine the most effective method for embedding evidence-based medicine into routine musculoskeletal care.

PMID:42249490 | DOI:10.1186/s12913-026-14843-1

J Cardiothorac Surg. 2026 Jun 5. doi: 10.1186/s13019-026-04288-2. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to investigate the temporal biological distribution characteristics of acute aortic dissection (AAD) onset in East China, analyze differences in onset patterns between patients with different types (Stanford Type A and Type B) and genders, and provide regional epidemiological evidence to inform our understanding of the temporal distribution of AAD in East China.

METHOD: Clinical data were retrospectively collected from 1,038 patients with confirmed AAD diagnosed between January 2009 and September 2025. SPSS 27.0 software was employed to analyze temporal distribution patterns of onset, including seasonal, monthly, weekly, and daily rhythmic characteristics, whilst investigating the influence of gender and disease subtype on temporal biological features.

RESULT: A total of 1,038 patients with AAD were included, comprising 571 cases (55.0%) of Stanford Type A AAD and 467 cases (45.0%) of Stanford Type B AAD; 767 were male (73.9%), with a mean age of 55.7 ± 13.5 years. Circadian patterns showed that 17:00-20:00 was the peak period for onset (21.4%), whilst 01:00-04:00 was the trough (12.5%); females exhibited more pronounced fluctuations across certain time scales. Regarding weekly distribution, Stanford Type B cases had the lowest proportion on Saturdays (11.8%); the weekly distribution of female patients showed a certain degree of variation. At the monthly and seasonal levels, cases were concentrated in January, February, March, November and December; the incidence was highest in winter (32.6%), followed by autumn (25.4%), spring (24.6%) and summer (17.4%). Seasonal differences were statistically significant (P < 0.0001), and the seasonal fluctuations in Stanford Type A AAD were greater than those in Stanford Type B AAD. Furthermore, significant differences were observed between patients of different subtypes in terms of gender distribution, history of smoking and alcohol consumption, and the prevalence of comorbidities (P < 0.05).

CONCLUSION: The incidence of AAD in East China exhibits distinct circadian patterns, with potential variations across different subtypes and gender groups at certain temporal scales. These findings provide an epidemiological basis for understanding the temporal distribution of AAD incidence in East China and for the preparation of clinical resources.

PMID:42249482 | DOI:10.1186/s13019-026-04288-2

J Cardiothorac Surg. 2026 Jun 5. doi: 10.1186/s13019-026-04397-y. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to investigate the impacts of various body mass index (BMI) classifications on perioperative parameters and short-term outcomes in patients undergoing Da Vinci robot-assisted atrial septal defect (ASD) repair providing evidence for personalized perioperative management.

METHODS: A retrospective analysis was conducted on 100 patients who underwent Da Vinci robot-assisted ASD repair at Qingdao University Affiliated Hospital between November 2014 and December 2025. Based on the Chinese adult BMI classification criteria, the patients were categorized into four groups: underweight group (BMI < 18.5 kg/m², n = 9), normal weight group (18.5 ≤ BMI < 24.9 kg/m², n = 52), overweight group (25.0 ≤ BMI < 29.9 kg/m², n = 26), and obese group (BMI ≥ 30.0 kg/m², n = 13). This study compared baseline characteristics, intraoperative indicators, postoperative recovery, and short-term prognosis across these groups. Furthermore, multivariate logistic regression analyzed the independent associations of BMI classification and age with postoperative surgical site infection and hospital readmission.

RESULTS: No significant differences were observed among the four groups concerning baseline echocardiographic parameters, key intraoperative metrics (e.g., operation duration, cardiopulmonary bypass time), or most postoperative recovery measures (e.g., mechanical ventilation duration, length of intensive care unit stay), with all P > 0.05. No sternotomy conversion or early mortality occurred. Univariate analysis showed the obese group had significantly higher rates of surgical site infection (15.4%) and readmission (23.1%) (all P < 0.05), but multivariate regression did not identify BMI classification or age as independent predictors (all P > 0.05).

CONCLUSION: Da Vinci robot-assisted ASD repair is safe and effective across different BMI levels, with its minimally invasive nature appearing to mitigate weight-related surgical challenges within this cohort. Although obese patients face higher risks of postoperative infection and readmission, BMI was not found to be an independent influencing factor in this exploratory analysis; however, small subgroup sizes and sparse data limit the statistical reliability of this finding. Individualized enhanced perioperative management for obese populations is recommended, and weight status should not be a contraindication for this procedure.

PMID:42249473 | DOI:10.1186/s13019-026-04397-y

J Cardiothorac Surg. 2026 Jun 5. doi: 10.1186/s13019-026-04345-w. Online ahead of print.

ABSTRACT

BACKGROUND: Allogeneic blood is a limited and globally scarce resource. Protocols based on the Patient Blood Management (PBM) program, incorporating therapeutic alternatives to reduce the use of red blood cells (RBCs), fresh frozen plasma (FFP), and platelet concentrates (PCs), have become urgently needed. The aims of this study were: as a primary objective, to evaluate whether the implementation of a Patient Blood Management (PBM) protocol reduces allogeneic transfusion in patients undergoing coronary artery bypass grafting (CABG); and as a secondary objective, to assess the impact of transfusion on clinical outcomes and mortality following CABG surgery.

METHODS: The study analyzed patients ≥ 18 years undergoing isolated and elective on-pump coronary artery bypass grafting (CABG), including both arterial and venous grafts. Data were retrospectively collected for two distinct periods, forming two groups: Pre-PBM (2010) and Post-PBM (2012), based on the implementation of a multidisciplinary PBM protocol aimed at optimizing erythropoiesis, hemostasis, and physiological tolerance to anemia. Statistical analyses included between-group comparisons, correlation analyses, and multiple regression to identify independent predictors of increased mortality. Statistical significance was defined as a p-value < 0.05.

RESULTS: A total of 3,564 patients undergoing CABG were stratified into the Pre-PBM (n = 2,150) and Post-PBM (n = 1,414) groups. Implementation of a PBM protocol was associated with a significantly reduced allogeneic transfusions-RBC (62.7% to 48.4%), FFP (13.1% to 6.7%), and PC (5.4% to 3.0%) (p < 0.001). Mortality decreased from 4.5% to 3.1% (p = 0.042), with lower deep sternal wound infection rates (p < 0.001). Transfusion was an independent risk factor for increased mortality, with RBC (OR 3.63, 95% CI 2.20-5.99, p < 0.001), FFP (OR 5.69, 95% CI 3.91-8.27, p < 0.001), and PC (OR 6.45, 95% CI 4.07-10.24, p < 0.001) therapy demonstrating a dose-dependent association. Even in low-risk patients (EuroSCORE ≤ 2), allogeneic transfusion was associated with a significantly higher mortality (p < 0.001).

CONCLUSIONS: Implementing a PBM protocol was associated with significant reductions in blood transfusions, infection rates, and mortality following CABG. Allogeneic transfusion was a strong predictor of adverse outcomes, including higher mortality, supporting the routine use of PBM strategies in CABG.

PMID:42249468 | DOI:10.1186/s13019-026-04345-w

Trials. 2026 Jun 5. doi: 10.1186/s13063-026-09828-8. Online ahead of print.

ABSTRACT

BACKGROUND: Prior distributions must be specified for the parameters of interest in a Bayesian clinical trial. When existing evidence on the effects of the trial interventions is limited or inconclusive, prior distributions can be constructed with expert elicitation. However, conventional elicitation requires face-to-face interactions and intensive pre-elicitation training, which can be infeasible and costly. Our remote elicitation was based on an established expert elicitation methodology, and we incorporated bivariate prior distributions to introduce dependencies between the elicited probabilities. We aimed to elicit a prior distribution for the Croup Dosing Trial, which assesses the efficacy of two separate doses of dexamethasone on the number of return visits to the emergency department within 7 days in children with croup. This trial evaluates the non-inferiority of 0.15 mg/kg of dexamethasone, compared to the standard dose of 0.60 mg/kg to treat croup.

METHODS: We conducted three remote workshops to elicit expert beliefs on the efficacy of the two doses of dexamethasone. Each workshop consisted of two survey rounds, separated by a group discussion. Prior to the workshop, experts reviewed the same current literature that was provided on the effects of the two doses of dexamethasone. Beliefs were aggregated using expert-specific bivariate distributions with latent effects. The aggregated distribution, along with the surveyed non-inferiority margin, determined the sample size for the Bayesian non-inferiority trial design.

RESULTS: Twelve emergency medicine physicians participated in our remote elicitation exercise. The elicitation generated a prior distribution centered at 6% for the 0.60 mg/kg dose and 8% for the 0.15 mg/kg dose. The aggregated prior distribution produced a sample size of 1850, based on a non-inferiority margin of 4%.

CONCLUSIONS: We elicited a prior distribution that incorporated past evidence and expert opinion. The elicited prior is consistent with previous literature on the efficacy of the dexamethasone doses in treating croup. Our approach demonstrates the feasibility of remotely eliciting bivariate distributions to design clinical trials.

TRIAL REGISTRATION: NCT06272383 (Registered May 8, 2024).

PMID:42249465 | DOI:10.1186/s13063-026-09828-8

BMC Psychol. 2026 Jun 5. doi: 10.1186/s40359-026-04843-5. Online ahead of print.

ABSTRACT

PURPOSE: Emotional contagion, which is known as individuals unknowingly experiencing similar emotions, may cause fear of contagion and transmission in the presence of communicable diseases. This study aimed to evaluate the effect of emotional contagion on the fear of contracting or transmitting communicable diseases.

METHOD: This study employed a mixed-methods approach, conducted in December 2022. The quantitative dimension of the study was completed with 509 students, and the qualitative dimension with 49 university students. Data were collected with emotional contagion and fear of contagion/transmission scales. Pearson Correlation and linear regression were used to analyze quantitative data. Qualitative data were analyzed using descriptive analysis.

RESULTS: The mean score of the emotional contagion scale was 2.96 ± 0.49, and the mean score of the fear of contagion/transmission scale was 89.65 ± 16.58. A weak positive correlation was found between emotional contagion and fear of contamination. It was found that emotional contagion predicts fear of infection/transmission at a statistically significant level, though with a low effect size (r = 0.29). A total of 16 main themes were reached in the qualitative dimension of the study. The themes were as follows: fear, a compulsory process, taking precautions, danger to society, not finding it scary, disruption in social life, importance of hygiene, maintaining social distance, use of masks, strengthening immunity, negative psychological impact, negative social impact, negative physical impact, turning to positive thoughts, uneasiness, fear of the future and a normal process.

CONCLUSION: This study highlights the significance of emotional contagion in shaping the fear of contracting communicable diseases.

PMID:42249459 | DOI:10.1186/s40359-026-04843-5