Tag: nevin manimala

JMIR Form Res. 2025 Oct 31;9:e78657. doi: 10.2196/78657.

ABSTRACT

BACKGROUND: Experiences of unfair treatment on college campuses are linked to adverse mental and physical health outcomes, highlighting the need for interventions. However, detecting such experiences relies mainly on self-reports. No prior research has examined the feasibility of using mobile sensing via smartphones and wearables for the passive detection of these experiences.

OBJECTIVE: This pilot study explores the potential of using passive sensing to detect daily experiences of perceived unfair treatment (PUT) after they occur. It aims to develop and evaluate machine learning models against naive baselines and establish a benchmark for future research.

METHODS: We analyzed data from 201 undergraduate students collected over two 10-week academic terms in 2018. PUT was self-reported at the daily level via ecological momentary assessment (EMA) surveys, with 413 of 9629 (4.3%) total responses indicating unfair treatment. We implemented two modeling approaches with distinct training schemes: (1) supervised classification models trained in a user-independent manner using data from different individuals, and (2) anomaly detection models trained in a user-dependent manner using historical data from the same individuals. Classification performance was assessed using stratified group 5-fold cross-validation for user-independent models and a chronological train-test split for user-dependent models.

RESULTS: Of the 201 study participants, 110 reported experiencing unfair treatment at least once. On average, participants reported unfair treatment in 4.66% of their EMA responses (95% CI 3.13% to 6.19%). User-independent classification models showed mixed performance (AUC-ROC [area under the receiver operating characteristic curve]: 0.546-0.640, AUC-PR [area under the precision-recall curve]: 0.047-0.093, F₁-score: 0.070-0.121). Tree-based models, particularly light gradient boosting machine (LightGBM) and Random Forest, outperformed all 3 baselines in AUC-ROC and AUC-PR; LightGBM also improved the F₁-score. In comparison, user-dependent anomaly detection models performed better, with the multiday long short-term memory-AE model (50 features, 7-day window) achieving the highest recall (0.830, +73.3%, P<.001) and F₁-score (0.391, +24.9%, P<.001) without reducing precision (0.256), and improving AUC-PR by 45.9% and AUC-ROC by 21.6% relative to naive baselines (P<.001). Feature importance analysis identified key behavioral patterns for population-level detection, including increased time spent off campus, elevated evening and nighttime activity, reduced indoor mobility on campus, prolonged screen use, delayed sleep onset, and shorter sleep duration.

CONCLUSIONS: Mobile sensing shows promise for detecting daily experiences of PUT in college students and identifying associated behavioral patterns. Our findings highlight opportunities for timely interventions through mobile technology to mitigate the impact of these experiences on students’ mental health and well-being.

PMID:41172295 | DOI:10.2196/78657

J Med Internet Res. 2025 Oct 31;27:e63909. doi: 10.2196/63909.

ABSTRACT

BACKGROUND: Societies worldwide have witnessed growing rifts separating advocates and opponents of vaccinations and other COVID-19 countermeasures. With the rollout of vaccination campaigns, the European German-speaking region (Germany, Austria, and Switzerland) initially exhibited a noticeably low vaccination uptake compared to other European regions. Later, uptake increased. It remains unclear which factors contributed to these changes.

OBJECTIVE: This study aimed to shed light on the intricacies of vaccine hesitancy among the German-speaking population and the possible dynamics between policy changes and public concerns using web discourse data. These insights are valuable for policymakers tasked with making far-reaching decisions-policies need to effectively curb the spread of the virus and at the same time respect fundamental civil liberties and minimize undesired consequences.

METHODS: This study drew on data from Twitter (subsequently rebranded X). We used a hybrid pipeline to detect and analyze 191,750 German-language vaccination-related tweets using a semiautomatic seed list generation approach, topic modeling, sentiment analysis, and a minimum of social scientific domain knowledge to evaluate the discourse about vaccinations in light of the COVID-19 pandemic. We further analyzed the evolution of public attention during different phases of the pandemic and in relation to policy changes to identify potential drivers of shifts in public attention.

RESULTS: The discourse concerning vaccinations was associated with more negative sentiments than the general discourse on German-speaking Twitter (47,159/191,750, 24.59% vs 1,758,776/12,297,163, 14.3% predominantly negative tweets, respectively). The relative frequencies of the discussed themes fluctuated heavily (eg, safety and side effects was the most dominant theme in wave 3 [1,611/9,179, 17.55%] but ranked 6th in wave 5 [428/4,865, 8.8%], and effectiveness of vaccinations ranked 7th in wave 3 [711/9,179, 7.75%] and 2nd in wave 5 [831/4,865, 17.08%]). In wave 3, vaccines were authorized, and vaccinations were suspended and resumed due to safety concerns. Later, policies were implemented that restricted the freedom of unvaccinated citizens. Change points in attention aligned better with policy actions than with pandemic phases. During the later phases, vaccination uptake increased (wave 2: 5.6%, wave 3: 47%, and wave 5: 74% compared to 30%, 62%, and 78%, respectively, in the United Kingdom), and so did the attention to freedom and civil liberties (wave 2: 1,139/6,595, 17.27%; wave 5: 1,403/4,865, 28.84%). Substantially increasing negative and stronger sentiments were expressed.

CONCLUSIONS: Our analyses suggest potential interactions among policies, public attention to different topics, and associated sentiments. While vaccination uptake increased, our findings indicate that citizens’ doubts and concerns did not decrease and that, rather than being fully persuaded, they remained skeptical. This study showcases that monitoring web discourse can provide valuable insights for data-driven policymaking in highly dynamic contexts such as the COVID-19 pandemic.

PMID:41172291 | DOI:10.2196/63909

BJS Open. 2025 Oct 30;9(6):zraf099. doi: 10.1093/bjsopen/zraf099.

ABSTRACT

BACKGROUND: This study aimed to compare preperitoneal ventral mesh patch with barbed suture in ventral hernia repair, evaluating recurrence rates and complications, and to assess the safety of preperitoneal patch placement.

METHODS: In this randomized clinical trial, adult patients undergoing ventral hernia repair at Karlskoga Hospital between 2020 and 2023 were randomized 1 : 1 to either a ventral mesh patch repair group or a non-absorbable barbed suture repair group, blinded to patients and outcome assessors. The primary outcome was recurrence detected at clinical examination and CT verification 1 year after surgery. Pain (measured on a visual analogue scale and using the Ventral Hernia Pain Questionnaire), nausea, and surgical site events (including wound infection, haematoma and seroma) were assessed 4 h, 1 week, 1 month, and 4 years after operation.

RESULTS: Of 256 eligible patients, 209 were screened, and 205 were randomized to ventral mesh patch repair (103) or barbed suture repair (102). The hernia recurrence rate at 1 year was lower in the ventral patch repair group (1.9 versus 5.9%), although this was not statistically significant (P = 0.14). The surgical site infection rate at 1 month was significantly lower in the ventral patch group (0.9 versus 6.9%; P = 0.02). At 1 month, the ventral patch repair group had higher ‘pain right now’ scores on the Ventral Hernia Pain Questionnaire (P = 0.02), although this difference had disappeared by 1 year.

CONCLUSION: Preperitoneal ventral hernia patch repair is a safe and effective technique with a recurrence rate not statistically significant from that after barbed suture repair. Although postoperative pain scores at 1 month were higher after ventral patch repair, this difference had disappeared by 1 year.

PMID:41172283 | DOI:10.1093/bjsopen/zraf099

JMIR Nurs. 2025 Oct 31;8:e68048. doi: 10.2196/68048.

ABSTRACT

BACKGROUND: Mobile health (mHealth) apps enhance clinical nursing by improving access to resources and patient care. Further benefits include reduced errors, time savings, better communication, cost reduction, and training. Understanding factors driving nurses’ continued mHealth adoption is key to its sustained success.

OBJECTIVE: This study extends the expectation-confirmation model (ECM) to explore the determinants of Iranian nurses’ continuance intention to use mHealth apps in their daily clinical routines.

METHODS: A cross-sectional, descriptive-analytical study was conducted among 315 nurses from hospitals affiliated with Kashan University of Medical Sciences. The Nurses’ Mobile Health Device Acceptance Scale (NMHDA-Scale) was developed by the authors in 2022. The Intention to Continue Using Mobile Health Applications for Nurses questionnaire assesses nurses’ future willingness to use mHealth apps in their practice. This questionnaire was designed based on the ECM and the approach by Waltz et al. Its primary aim is to identify the factors that influence mHealth device acceptance, specifically among clinical nurses, as previous studies have not focused on this group and have shown inconsistent relationships between various factors. Participants completed structured questionnaires measuring perceived usefulness, perceived ease of use, social influence, habits, and technology anxiety. Data were analyzed using structural equation modeling in AMOS (version 26). The model tested relationships among confirmation, perceived usefulness, social influence, technology anxiety, and mHealth continuance behavior.

RESULTS: The analyzed sample (n=315) consisted primarily of female (252/315, 80%) and married (243/315, 77.1%) nurses, with a mean age of 35.67 (SD 1.24) years. The analysis revealed that perceived usefulness was significantly influenced by both confirmation (P<.001) and social influence (P<.001). Perceived ease of use was negatively impacted by new technology anxiety (P<.001), indicating that higher anxiety levels reduced perceived ease of use. Additionally, mHealth continuance behavior was positively associated with habits (P=.002), social influence (P<.001), and perceived security risks (P=.008). Contrary to expectations, perceived usefulness did not directly influence mHealth continuance (P=.15), suggesting that other factors, such as habits and social influence, play a more significant role in long-term use.

CONCLUSIONS: Sustained mHealth app use by nurses hinges more on social influence and confirmed expectations than perceived usefulness. Although new technology anxiety remains a barrier, habits and social influence are key to long-term adoption. Hospital leaders should prioritize strategies that foster positive social reinforcement, minimize security concerns, and reduce anxiety through training and support when integrating mHealth into nursing workflows. These findings offer critical insights for improving digital health implementation, ultimately enhancing patient care and clinical efficiency.

PMID:41172281 | DOI:10.2196/68048

Interdiscip Cardiovasc Thorac Surg. 2025 Oct 31:ivaf264. doi: 10.1093/icvts/ivaf264. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare the extent of pleural inflammation and fibrosis induced by autologous blood versus talc pleurodesis in an exploratory experimental model and evaluate effects of postoperative non-steroidal anti-inflammatory analgesics on pleurodesis formation.

METHODS: Twenty-eight Sprague Dawley rats underwent intrapleural instillation of autologous blood on one side and talc on the contralateral side. They were sacrificed at 2, 4, 6, 15, or 30 days for macroscopic and histopathological analysis. Eight animals in the late euthanasia groups received oral Ibuprofen postoperatively. A pathologist, who was blinded to the interventions assessed all animals for macroscopic adhesions in the chest as well as microscopic evaluation for inflammation and fibrosis.

RESULTS: We found no significant differences between autologous blood and talc regarding macroscopic adhesion scores, or grading of inflammation and fibrosis. The inflammatory response peaked earlier after autologous blood compared with talc. Fibrosis progressively increased after both interventions. Ibuprofen reduced inflammation and fibrosis in both types of pleurodesis. Statistically significant reductions in fibrosis were seen after 15 days in the talc group (p = 0.008) and after 30 days in the autologous blood group (p = 0.024).

CONCLUSIONS: Autologous blood and talc pleurodesis induce comparable inflammatory responses and fibrosis in this experimental model suggesting that the mechanism of autologous blood patch for prolonged air leakage is not just a mechanical plug effect. Ibuprofen reduced all inflammatory responses after both interventions suggesting that non-steroidal anti-inflammatory drugs may impair pleurodesis formation.

PMID:41172267 | DOI:10.1093/icvts/ivaf264

Interdiscip Cardiovasc Thorac Surg. 2025 Oct 31:ivaf175. doi: 10.1093/icvts/ivaf175. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate whether digital drainage systems reduce chest tube duration and hospital stay following anatomical lung resection in a resource-limited healthcare setting.

METHODS: This retrospective study, approved by the institutional ethics committee (Approval No. 30491514.3.0000.0065), compared digital and conventional water seal drainage systems in a public hospital in Brazil. Outcomes included chest tube duration and hospital stay. Propensity score matching (PSM) was applied to control for confounding variables.

RESULTS: A total of 388 patients were included (67.8% smokers, mean age 63.8 years). After PSM, 85 matched pairs, no significant differences were observed in most demographic and clinical variables. Lobectomies were more frequent in the conventional group (100% vs 85.9%, p < 0.001). After paired statistical analysis using the Wilcoxon signed-rank test showed no significant differences in chest tube drainage time (4.2 vs 4.4 days, p = 0.397) or hospital stay duration (4.9 vs 5.2 days, p = 0.745).

CONCLUSIONS: In a resource-constrained setting, digital drainage systems are feasible and may support clinical decision-making through precise air leak quantification. However, no significant differences were observed in key outcomes when compared to conventional drainage, warranting further investigation into cost-effectiveness and broader implementation strategies.

PMID:41172262 | DOI:10.1093/icvts/ivaf175

J Gerontol A Biol Sci Med Sci. 2025 Oct 31:glaf242. doi: 10.1093/gerona/glaf242. Online ahead of print.

ABSTRACT

BACKGROUND: Falls are a leading cause of morbidity in older adults, with emerging evidence suggesting that systemic inflammation may contribute to this risk. C-reactive protein (CRP), a biomarker of inflammation, has been linked to various health issues, including declines in physical function. However, its direct influence on balance and fall risk remains uncertain. This study investigates the association between CRP levels and balance using observational data and Mendelian Randomization (MR) to explore its causal role in fall risk.

METHODS: We analyzed data from the 2021-2023 National Health and Nutrition Examination Survey (NHANES), including 1,215 participants aged 60 and older. CRP levels were measured using immunoturbidimetric assays, and balance was assessed via the Modified Romberg Test. We used multivariable ordinal logistic regression models to evaluate the relationship between CRP and balance, adjusting for demographic, health, and lifestyle factors. Genetic instruments for CRP were derived from genome-wide association studies (GWAS), and MR analysis was performed using fall risk summary statistics (2,215 cases, 6,289 controls).

RESULTS: In the NHANES cohort, higher CRP levels were associated with poorer balance (β = -0.201, p = 0.007). This association was stronger in males but not in females. MR analysis confirmed a causal link between elevated CRP and increased fall risk (OR = 1.13, p = 8.96 × 10-8), with no evidence of pleiotropy or heterogeneity.

CONCLUSIONS: our findings highlight CRP as a key factor influencing balance and a causal contributor to fall risk in older adults, suggesting that anti-inflammatory interventions may help reduce fall risk.

PMID:41172260 | DOI:10.1093/gerona/glaf242

Braz J Psychiatry. 2025 Oct 31. doi: 10.47626/1516-4446-2025-4514. Online ahead of print.

ABSTRACT

BACKGROUND: tDCS effects over the prefrontal cortex on reactive aggressive behavior are unclear. We aimed to perform an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing anodal tDCS versus sham stimulation on reactive aggressive behavior in healthy volunteers experimentally induced to aggressive behavior.

METHODS: We systematically searched PubMed, Cochrane, Embase, and PsychInfo databases for RCTs that compared tDCS to sham stimulation over the prefrontal cortex on reactive aggressive behavior. We computed standardized mean difference (SMD) with 95% confidence intervals (CIs) for all statistical models. Heterogeneity was assessed using I² statistics. Statistical analyses were performed using R softwere, version 4.5.1.

RESULTS: We included nine trials with 547 participants, of whom 272 (49,7%) underwent anodal tDCS. There was not significant difference between anodal tDCS and Sham stimulation in reactive aggressive (SMD -0,24; 95% Cl [-0.54; 0.05]; p = 0.09; I² = 52,4%). However, subgroup analysis showed significant effects of online tDCS (SMD -0.41; 95% Cl [-0,61; -0.20]; I² = 0%), and unilateral tDCS (SMD -0.44; 95% Cl [-63; -0.25]; I² = 0%), when compared to sham stimulation.

CONCLUSION: While the overall analysis did not show a significant effect of anodal on reactive aggressive behavior in healthy volunteers, the results suggest that online tDCS and unilateral tDCS may have a potential impact. Given the heterogeneity of the studies and outcome measures, further research is needed to confirm these findings and better understand the role of tDCS in modulating reactive aggressive behavior.

PMID:41172252 | DOI:10.47626/1516-4446-2025-4514

Orthop Surg. 2025 Oct 31. doi: 10.1111/os.70205. Online ahead of print.

ABSTRACT

OBJECTIVES: Multiple imaging criteria are available for assessing fusion following anterior cervical discectomy and fusion (ACDF). In clinical trials, the 3-month postoperative follow-up serves as a critical timepoint for evaluating the efficacy of interventions on accelerating the fusion process. This study aims to determine how applying different fusion criteria influences the conclusions of a comparative analysis.

METHODS: Patients aged 18 or older who underwent ACDF with allograft or beta-tricalcium phosphate artificial bone between C3 and C7 were reviewed from 1 April 2023 to 30 September 2023. Fusion rates between the two grafts at three-month follow-up were compared under different criteria. Fusion status was judged by CT or dynamic radiographs, or their combinations. Cut-offs of dynamic indicators included angle changes of 4°, 3°, and 2°, and interspinous motion of 3, 2, and 1 mm. Criteria were applied singly, combined in pairs, or combined in groups of three, leading to a total of 31 criteria. Student’s t-test and Chi-squared test were employed, and Cohen’s kappa coefficient and phi coefficient were calculated.

RESULTS: Ninety-eight segments were included. Twenty-five criteria yielded higher fusion rates for artificial bone, with 7 out of 25 reaching statistical significance (p < 0.05). The remaining six criteria led to a reversed result, but none reached significance (p > 0.05). The agreement and correlation between CT and dynamic criteria were poor (kappa and phi < 0.200). In contrast, the agreement and correlation between two dynamic indicators were better, and even being close to moderate (kappa = 0.398, phi = 0.398) between 3° and 2 mm.

CONCLUSION: Changes in fusion criteria affected result significance but did not produce conflicting conclusions. There was a significant disagreement between the results under CT and dynamic radiographs criteria. Thresholds of 3° or 2 mm can be optimal choices for dynamic criteria.

PMID:41170599 | DOI:10.1111/os.70205

Inquiry. 2025 Jan-Dec;62:469580251382758. doi: 10.1177/00469580251382758. Epub 2025 Oct 31.

ABSTRACT

Older adults in rural areas often face barriers to accessing formal health services. Community-based programs serve as alternative models for delivering preventive care and psychosocial support. However, the effectiveness of specific program types on well-being outcomes remains underexplored. This cross-sectional study analyzed secondary data from 1033 older adults across 44 rural communities in Taiwan. Participants were involved in 5 types of community-based programs. Subjective well-being was assessed using the WHO-5 index. Associations between participation hours and well-being were examined using ANOVA, OLS regression, and linear mixed models, with community-level clustering and individual demographics controlled. Health promotion and recreational activities were positively associated with well-being, while horticultural therapy and social participation showed negative associations. Food and agricultural education was positively associated with well-being only after controlling for community context. Neither age nor gender significantly predicted outcomes. Community context moderated several program effects. Community-based programs impact rural older adults’ well-being in diverse ways depending on program type and local implementation. Tailored, context-sensitive interventions and ongoing program evaluation are essential for optimizing care outcomes in aging rural populations.

PMID:41170594 | DOI:10.1177/00469580251382758