Tag: nevin manimala

Eur J Med Res. 2025 May 31;30(1):431. doi: 10.1186/s40001-025-02707-z.

ABSTRACT

BACKGROUND: The ratio between erythrocyte distribution width and serum albumin (RAR) has gained recognition as a novel composite biomarker for inflammatory processes, though its clinical significance in Parkinson’s disease (PD) pathology requires further exploration. The purpose of this cross-sectional study was to investigate the relationship between RAR and PD.

METHODS: This epidemiologic investigation utilized data from participants enrolled in the National Health and Nutrition Examination Survey (NHANES) spanning 2003-2018. Study cohorts comprised PD-diagnosed individuals and matched controls. To elucidate the RAR-PD connection, we implemented three analytical strategies: multivariable-adjusted logistic regression models incorporating sample weights, restricted cubic spline (RCS) modeling for nonlinear relationships, and stratified analyses across demographic subgroups. Comparative assessment of inflammatory biomarkers’ discriminative performance was performed through ROC curve analysis, contrasting RAR against platelet-albumin ratio (PAR) and neutrophil-albumin ratio (NAR).

RESULTS: The analysis encompassed 31,848 adults (297 PD cases; 31,551 controls) from the NHANES database. Quantitative analysis revealed elevated RAR measurements in PD subjects compared to controls [3.28 (0.04) vs. 3.09 (0.01), P < 0.001]. Following covariate adjustment in weighted regression models, multivariable-adjusted analyses identified RAR as an independent predictor (adjusted OR = 1.40, 95% CI 1.06-1.85, P = 0.018). RCS modeling revealed nonlinear RAR-PD associations, peaking at 3.48 (inverted U-shape). Comparative ROC analysis confirmed RAR’s discriminative superiority over PAR and NAR in PD detection (P < 0.05).

CONCLUSIONS: As demonstrated by the research findings, RAR is strongly and independently associated with PD. RAR may serve as an indicator or screening tool for an increased risk of PD.

PMID:40448230 | DOI:10.1186/s40001-025-02707-z

Scand J Trauma Resusc Emerg Med. 2025 May 30;33(1):98. doi: 10.1186/s13049-025-01412-4.

ABSTRACT

BACKGROUND: Prehospital anaesthesia is a challenging procedure, and the outcome depends on the quality of the process. Hospital-acquired anaesthesia experience does not necessarily translate to high performance in the prehospital setting. We aimed to assess the quality and practice patterns in prehospital anaesthesia related to cumulative experience amongst new prehospital critical care physicians. In this study, we aimed to evaluate whether quality indicators for prehospital anaesthesia and related mortality improve as new prehospital critical care physicians become more experienced with this intervention.

METHODS: We conducted a registry-based observational study including all patients who underwent anaesthesia and airway management by physicians who started working in the national HEMS between January 2013 and August 2019. Patients were grouped and compared based on the provider’s cumulative case volume at the time of the mission: 1-10, 11-20, 21-40, 41-80 and > 80 cases. The association between cumulative experience and 30-day mortality was assessed using multivariate logistic regression analysis. Secondary outcomes included first-pass intubation success, post-intubation hypoxia and hypotension, the combined use of a neuromuscular blocking agent and anaesthetic, on-scene time, mechanical ventilation usage, and rates of normocapnia, hypoxia, and hypotension at handover.

RESULTS: 1,638 patients (median age 59, 64% male) were treated by 32 physicians. Median on-scene time decreased with increasing experience from 33 (interquartile range [IQR] 23-44) to 28 (IQR 19-38) minutes, P = 0.03. Higher experience was associated with increased use of mechanical ventilation (P < 0.001) and a combination of neuromuscular blocking agents and anaesthetics (P = 0.03). Other secondary outcomes did not show a statistically significant difference between the groups. Crude mortality decreased from 38 to 26% in the lowest to highest experience groups. In the multivariate logistic regression analysis, the same trend was still seen with the odds ratio of the highest experience group for 30-day mortality 0.59 (95% CI 0.38-0.94, lowest experience group as a reference).

CONCLUSIONS: In a prehospital critical care service, outcomes improve after a high number of prehospital cases, even when physicians with a solid foundation in in-hospital anaesthesia are employed. Limiting physician turnover may improve the quality of care.

PMID:40448224 | DOI:10.1186/s13049-025-01412-4

BMC Psychol. 2025 May 30;13(1):582. doi: 10.1186/s40359-025-02738-5.

ABSTRACT

BACKGROUND: This research protocol for the study ATICC (Addiction, Trauma and Immigration, prevention and Cross-Cultural support for care with the Grand Est youth network) aims to model the complex interrelations between trauma, substance use behaviors, migration and representations of mental health among vulnerable youth residing in Transitional Housing for Young Adults. This study focuses on a specific and underexplored population, many of whom have experienced traumatic events and/or complex migratory trajectories. The ultimate objective of this research is to develop transferable models of understanding that can inform the design of prevention and support programs tailored to this demographic.

METHODS/DESIGN: We adopt a tripartite methodology approach: (1) a cross-sectional study using standardized questionnaires to identify factors associated with substance use, trauma, and barriers to healthcare access; (2) an in-depth qualitative study based on semi-structured individual interviews with substance users, exploring their subjective experiences and perceptions related to substance use and mental health care; and (3) a longitudinal interventional study involving various configurations of focus groups open to residents of transitional housing structures, aiming to assess the impact of these group sessions on participants’ psychological well-being and attitudes toward care. Quantitative analyses will include descriptive and multivariate statistical tests using R, while qualitative data will be analyzed through thematic analysis with NVivo. The effectiveness of the group intervention will be evaluated using pre/post-tests, mixed models, and appropriate statistical corrections.

DISCUSSION: Analyses are expected to identify key psychosocial factors influencing addictive behaviors and mental health, highlight cultural and structural barriers to care, and assess the psychological benefits of the group intervention. The ATICC study aims to contribute to the development of culturally adapted prevention and support models for young adults in precarious situations. The results should assist healthcare professionals and policymakers in designing evidence-based interventions that effectively address the specific needs of this population.

TRIAL REGISTRATION: This study is registered with the Biomedical Research Identification Number (n°ID-RCB) assigned in France by the National Agency for the Safety of Medicines and Health Products (ANSM): 2024-A01534-43, and have received the approval from the committee for the protection of persons (CPP) Ile-de-France on November 18, 2024. Cette étude a également été déposée sur clinicaltrials (NCT06922721, date assigned April 10, 2025).

PMID:40448223 | DOI:10.1186/s40359-025-02738-5

Eur J Med Res. 2025 May 30;30(1):430. doi: 10.1186/s40001-025-02693-2.

ABSTRACT

BACKGROUND: The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a recently developed lipid parameter, but there are insufficient studies exploring its relationship with early cognitive impairment in patients with acute mild stroke. This study aims to determine the potential association between NHHR and early cognitive impairment in patients with acute mild stroke. By collecting data from patients with acute minor ischemic stroke in hospital, we will analyze the relationship between NHHR and cognitive function in these patients.

METHODS: This study enrolled 817 acute ischemic stroke (AIS) patients (NIHSS ≤ 5), Cognitive function was assessed using Mini-Mental State Examination (MMSE) within 2 weeks, with cognitive impairment defined by education-stratified thresholds. Statistical analysis of the baseline was performed. Multivariate logistic regression was performed to analyze the association between NHHR and cognitive impairment, and Receiver Operating Characteristic Curve (ROC) analysis were performed to evaluate the predictive value.

RESULTS: Patients were classified into cognitive impairment group (n = 473) and normal cognition group (n = 344). NHHR in the cognitive impairment group was significantly higher than that in the normal group (3.24 ± 1.63 vs. 3.02 ± 1.43, P = 0.046). There were significant differences in age and education level. There was a dose-response relationship between NHHR quartiles and the incidence of cognitive impairment (trend test P = 0.021). Multivariate regression analysis showed that for each unit increase in NHHR, the risk of cognitive impairment increases by 13.2% (OR = 1.13, 95% confidence interval 1.02-1.25, P = 0.018). The predictive model constructed by combining age and education level has an area under the ROC curve(AUC) of 0.71 (95% confidence interval 0.67-0.74).

CONCLUSIONS: NHHR is an independent risk factor for early cognitive impairment in mild AIS patients. The NHHR-based model demonstrates moderate predictive accuracy, supporting its potential clinical utility.

PMID:40448222 | DOI:10.1186/s40001-025-02693-2

BMC Psychol. 2025 May 30;13(1):584. doi: 10.1186/s40359-025-02923-6.

ABSTRACT

BACKGROUND: Due to long working hours, shifts, poor working conditions, and high risk of exposure to traumatic incidents at work, healthcare workers (HCWs) are at high risk of developing mental health and wellbeing issues. Family members and close friends of HCWs are often the primary support source for the HCWs. However, while supporting the HCWs, family members’ and friends’ mental health and wellbeing may be impacted negatively. According to the findings of previous literature, family members of other high-risk workers may experience secondary traumatic stress. To date, there has been no research focusing on secondary traumatic stress in family members and friends of HCWs.

METHODS: In this cross-sectional, mixed-method study, we examined secondary traumatic stress and associated factors amongst 320 household members (family members and housemates) of HCWs in the UK using the Secondary Traumatic Stress Scale. We used multivariable linear regression to examine the predictors of secondary traumatic stress, specifically sex, age, job role of the HCW, and the relationship with the HCW. Then we used content analysis of responses to open-ended questions to explore the experiences of household members in-depth.

RESULTS: 33.8% of household members reported secondary traumatic stress within the severe range. Female spouses and partners of HCWs with clinical roles showed higher STS compared to male and other household members of HCWs with non-clinical roles. In our regression model, we found that being female, having a HCW household member with a clinical role, and being a spouse or a partner of a HCW were statistically significant predictors of high STS. Open-ended responses showed that household members reported that HCWs tended to be irritated, quieter/distant, anxious/stressed, in low moods, and exhausted after having a difficult day at work. These feelings and behaviours impacted the rest of the household members negatively.

CONCLUSION: This is the first study which has examined secondary traumatic stress amongst household members of HCWs. While trying to support the HCW, household members were at high risk of developing secondary traumatic stress. There are research implications to understand HCWs’ and their household members’ experiences better, including extending current research and conducting further research exploring secondary traumatic stress in HCWs’ household members, and factors associated with it, which go beyond the demographics examined here. There are also organisational and clinical implications to protect and support both HCWs and their household members, such as improved working conditions for HCWs and carefully planned psychological support for both HCWs and their household members.

PMID:40448215 | DOI:10.1186/s40359-025-02923-6

Reprod Health. 2025 May 31;22(Suppl 1):78. doi: 10.1186/s12978-025-01989-0.

ABSTRACT

BACKGROUND: Adolescent sexual and reproductive health (ASRH) is an integral part of the global health agenda. It is strongly featured in the universal health coverage (UHC) agenda of the sustainable development goals (SDGs). The need to expand ASRH services to accelerate progress on UHC is urgent in Africa, compared to other regions, given its youthful population and unmet ASRH needs. Limited access to ASRH services increases the risk and vulnerability of adolescents to poor health outcomes such as unintended pregnancies, high adolescent birth rate, poor birth outcomes, high maternal and neonatal mortalities and high exposure to sexually transmitted infections. The unavailability and inaccessibility of ASRH interventions to adolescents and young adults in most African countries, including Ghana, arise from several limitations, including inadequate funding of interventions, cultural barriers and norms, lack of education, and inadequate supplies of ASRH services and commodities, among others. However, gains from investments in ASRH interventions, especially following the implementation of the Millennium Development Goals, highlight the importance of identifying and prioritising adequate funding for effective ASRH interventions. This paper identifies priority ASRH interventions that can potentially advance the sexual and reproductive health (SRH) needs of adolescents in Ghana to accelerate progress towards UHC.

METHODS: Qualitative descriptive methods, combining literature review and stakeholder engagement, were used for this study. A literature review complemented by stakeholder engagement ensured the listing, ranking and validation of interventions.

RESULTS: Adapting an established framework designed by the West African Health Organization (WAHO) through stakeholders’ engagement process, the paper identifies four of seven priority interventions ranked and validated by stakeholders for addressing the SRH needs of adolescents in Ghana. Consistent with the literature, several interventions exist to address ASRH needs. The most effective priority or promising four interventions in Ghana, according to stakeholders, include adolescent health clubs programmes, girls’ empowerment programmes through comprehensive sexuality education, national capacity-building programmes to deliver high-quality integrated family planning and comprehensive maternal health services, and electronic health (eHealth)/digital health programmes.

CONCLUSION: Identifying effective priority interventions for addressing the SRH needs of adolescents is a consultative process facilitated by proven and valid frameworks adapted to align with specific country contexts.

PMID:40448192 | DOI:10.1186/s12978-025-01989-0

J Orthop Surg Res. 2025 May 30;20(1):552. doi: 10.1186/s13018-025-05837-6.

ABSTRACT

OBJECTIVE: To investigate the relationship between segmental motion and paraspinal muscle degeneration at the surgical level in patients with single-level lumbar degenerative disease (LDD) who have undergone either fusion or dynamic stabilization surgery.

METHODS: Patients treated with posterolateral intertransverse fusion (PITF group), Isobar TTL dynamic internal fixation (TTL group), or Isobar EVO dynamic internal fixation (EVO group) for single-level lumbar degenerative disease (LDD) between March 2012 and September 2020 were included in the study. Cases were selected with complete records and follow-up times ranging from 2 to 5 years, taking into account the effects of postoperative muscle edema and age-related muscle degeneration. The study compared operative time, intraoperative blood loss, preoperative and postoperative Oswestry Disability Index (ODI) scores, Lumbar Stiffness Disability Index (LSDI) scores, range of motion (ROM) at the surgical segment, cross-sectional area (CSA) of the paraspinal muscles, and functional cross-sectional area (FCSA) of the paraspinal muscles before and after surgery across all groups.

RESULTS: A total of 73 patients were included in this study: 23 in the PITF group, 26 in the TTL group, and 24 in the EVO group. There were no statistically significant differences among the three groups in terms of age, gender, follow-up duration, body mass index (BMI), preoperative lumbar VAS score, preoperative ODI score, and preoperative LSDI score (P > 0.05). Postoperative ODI scores were significantly higher in the PITF group compared to the TTL and EVO groups, with ODI scores demonstrating a moderate negative correlation with postoperative range of motion (ROM) of the surgical segment (Pearson’s r = -0.333, P < 0.004). A strong negative monotonic relationship was observed between ROM of the surgical segment and the rate of change in functional cross-sectional area (FCSA) of the paraspinal muscles across all groups, as evidenced by Spearman’s correlation coefficients (PITF: r = -0.766, P < 0.001; TTL: r = -0.818, P < 0.001; EVO: r = -0.865, P < 0.001) (Fig. 7). Multiple linear regression models confirmed that age, BMI, and gender had no significant effect on the rate of FCSA change. For the PITF, TTL, and EVO groups, the regression coefficients for ROM’s association with FCSA change were β = -0.653 (P < 0.005), β = -0.956 (P < 0.001), and β = -0.908 (P < 0.001), respectively. Similarly, postoperative LSDI scores were significantly elevated in the PITF group compared to the TTL and EVO groups, with LSDI scores exhibiting a strong negative correlation with postoperative ROM (r = -0.802, P < 0.001).

CONCLUSION: Compared to traditional decompression combined with rigid fusion surgery, decompression coupled with dynamic stabilization techniques can more effectively alleviate postoperative lumbar stiffness and functional impairment in patients. Moderately enhancing the range of motion at the surgical level facilitates the remodeling of paraspinal muscle tissue following surgery.

PMID:40448178 | DOI:10.1186/s13018-025-05837-6

Arthroplasty. 2025 May 30;7(1):31. doi: 10.1186/s42836-025-00308-z.

ABSTRACT

AIMS: This study aimed to assess whether the clinical outcomes of one-stage revision surgery for chronic knee periprosthetic joint infection (kPJI), guided by precision pathogen diagnosis strategies, are non-inferior to those of conventional two-stage revision surgery.

METHODS: A retrospective analysis was conducted on chronic kPJI patients who underwent precision pathogen detection and revision arthroplasty at the First Affiliated Hospital of Fujian Medical University between January 2016 and September 2022. Clinical characteristics, pathogen detection rates, targeted antibiotic therapy, reinfection rates, and functional outcomes were compared between patients who underwent one-stage and two-stage revision surgeries.

RESULTS: Thirty patients who underwent one-stage revision surgery with pathogen detection through precision pathogen diagnosis strategies were included in this study and were matched with 30 patients who received two-stage revision surgery via propensity score matching (PSM). The baseline clinical characteristics did not significantly differ between the two groups. Utilizing our optimized pathogen detection protocol, successful pathogen identification was achieved in all cases across both groups. The median duration of intravenous antibiotic administration in the one-stage revision cohort was 16.5 (8.5,23.0) days, followed by a 6-week course of sequential oral antibiotics. Both the one-stage and two-stage revision groups had 3 cases of reinfection each, with no statistically significant difference in success rates between the groups (P > 0.999). Furthermore, no significant differences were found in the range of motion (ROM) (P = 0.332) or Knee Society score (KSS) (P = 0.117) between the one-stage and two-stage revision groups at the 2-year postoperative follow-up. The Kaplan‒Meier survival curves for prosthesis infection-free survival nearly overlapped, with no statistically significant differences between the two groups (P = 0.675).

CONCLUSION: When pathogen identification is achieved through precision diagnostic strategies, the efficacy of one-stage revision surgery combined with targeted antibiotic therapy is comparable to that of two-stage revision surgery.

PMID:40448177 | DOI:10.1186/s42836-025-00308-z

J Orthop Surg Res. 2025 May 30;20(1):549. doi: 10.1186/s13018-025-05963-1.

ABSTRACT

BACKGROUND: Schoolbag weight in schoolchildren is a recurrent and contentious issue in education and health. Excessive schoolbag weight can lead to back pain in children, which increases the risk of chronic back pain in adulthood. This study aims to explore the pain experienced by primary school children and identify the risk factors for back pain among them.

MATERIALS AND METHODS: This observational, descriptive, cross-sectional study was conducted among Omdurman locality in Sudan primary school students from November 1, 2020, to May 31, 2021. A multistage random sampling technique was used to select the sample. Four schools were chosen. A total of 384 students were enrolled. The data were collected using a questionnaire administered by the researcher and analyzed by SPSS version 26.

RESULTS: A total of 384 students were included in this study. A total of 192 (50%) were female, and 192 (50%) were male. The ages of the respondents ranged from 7 to 13 years, and the mean age was 11.5 ± 2. 09) SD. More than half of the studied students reported back pain 200 (52.1%); 40 (20%) were females, and 160 (80%) were males. Regarding the Visual Analogue Scale (VAS) score, 129 (64.5%) students rated their pain mild. Most 170 (85%) took medication without medical consultation. More than half of 200 (52.3%) students carried a weight greater than 15% of their body weight, and no one carried a bag with a weight less than 10%. Most students reach school by walking, which takes 10-20 min. There was a significant statistical association between the presence of back pain and older student age, male sex, carrying a bag more than 15% of one’s body weight, carrying a bag by one shoulder or side handbag, holding a bag through a morning venue and reaching school by walking for 10-20 min. P value (0.000).

CONCLUSION: More than half of our students reported back pain 200 (52.1%); 40 (20%) were females, and 160 (80%) were males. This study highlights a strong link between the prevalence of low back pain and the lifting of heavy school bags in primary school students in the Omdurman locality. The weights of the students’ schoolbags were higher than the internationally accepted standards. Through this study we are aiming to raise awareness about the negative effects and consequences of carrying heavy schoolbags, and recommending proper scheduling of classes and providing lockers as well as transportations to decrease this phenomenon.

PMID:40448158 | DOI:10.1186/s13018-025-05963-1

Virol J. 2025 May 30;22(1):171. doi: 10.1186/s12985-025-02809-4.

ABSTRACT

BACKGROUND: Accumulating evidence has hinted at a correlation between immune cells and post-viral fatigue syndrome (PVFS). However, it is still ambiguous whether these associations indicate a causal connection.

OBJECTIVE: To elucidate the potential causal link between immune cells and PVFS, we performed a two-sample Mendelian randomization (MR) study.

METHODS: We obtained summary data on PVFS cases (Ncase = 195) and controls (Ncontrol = 382,198) from the FinnGen consortium. Additionally, we retrieved comprehensive statistical information on 731 immune cell features. Our analysis encompassed both forward and reverse MR approaches. To ensure the reliability and validity of our findings, we conducted rigorous sensitivity analyses, addressing issues of robustness and heterogeneity.

RESULT: Our study presents compelling evidence of a probable causal link between immune cells and PVFS. Notably, we have pinpointed 28 distinct types of immune cell traits that potentially exhibit a causal association with PVFS. Among a pool of 7 31 immune cell traits, we identified 28 immune cell types that exhibited a potential causal association with PVFS. These included 9 B cells, 1 conventional dendritic cell (cDC), 1 maturation stage of T cell, 3 myeloid cells, 9 T, B, NK, and monocyte cells (TBNK), and 5 regulatory T cells (Treg).

CONCLUSION: Through genetic analyses, our study has unveiled profound causal connections between specific types of immune cells and PVFS, offering valuable guidance for forthcoming clinical investigations.

PMID:40448142 | DOI:10.1186/s12985-025-02809-4