Tag: nevin manimala

Nurs Res Pract. 2025 Apr 7;2025:5550685. doi: 10.1155/nrp/5550685. eCollection 2025.

ABSTRACT

Background: Migration of healthcare workers has become a foremost issue of health systems, generally from developing countries toward countries with higher income, producing destructive effects on health indicators. Aim: This study was proposed to investigate the intentions of migration among graduated and postgraduate Sudanese nursing students and the causes behind their intentions to migrate and determine the proportions and characteristics (e.g., per gender and profession) of Sudanese nursing students, both graduated and postgraduate, who intend to migrate. Materials and Methods: A descriptive cross-sectional survey was carried out in Khartoum State, Sudan, between January and April 2022. The study involved 321 Sudanese nurses, both graduate and postgraduate, who were selected through convenience sampling. Data collection was performed using a semistructured, self-administered questionnaire created by the researchers. The questionnaire, prepared in English, was distributed via Google Forms on social media platforms. The study received approval from the Research and Ethics Committee of Alzaiem Alazhari University. Informed consent was obtained from all participants prior to their involvement. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) software, Version 25. The results were presented in frequency tables and cross-tabulations. The Chi-square test was used to assess statistical significance, with a p value of < 0.05 considered significant. Results: The current study reflected that half of the nurses (49.5%) were willing to migrate after graduation if provided the opportunity. More than a third (36.8%) of them are interested in migrating to the Gulf countries, while that quarter (24.9%) of them said their main reason for migration is to save money quickly. There was a significant association between five sociodemographic variables (age, sex, education program, marital status, and place of residence) and the reason for migration with a p value of 0.05. Conclusion: The study concluded that there is high intention among graduated and postgraduate nursing students in Sudan to migrate and work outside Sudan.

PMID:40231226 | PMC:PMC11996273 | DOI:10.1155/nrp/5550685

Ann Afr Med. 2025 Apr 14. doi: 10.4103/aam.aam_230_24. Online ahead of print.

ABSTRACT

CONTEXT: The global spread of severe acute respiratory syndrome coronavirus 2 since its emergence in 2019 has led to widespread challenges in healthcare, prompting the World Health Organization to declare it a pandemic.

AIM: The aims of this study were to explore the prevalence of arterio-venous thrombosis (AVT) in COVID-19 patients, along with baseline characteristics and predictors of AVT.

SETTINGS AND DESIGN: This retrospective cohort study review of charts from adult patients presenting between March 1, 2020, and October 30, 2021, at King Fahd Hospital of the University.

SUBJECTS AND METHODS: Patients with both AVT and COVID-19 were included and categorized into groups: brain stroke, myocardial infarction (MI), pulmonary embolism (PE), and deep venous thrombosis (DVT). Demographic and clinical data were collected from electronic medical records, and patients were followed up 1 year after discharge.

STATISTICAL ANALYSIS USED: SPSS was used.

RESULTS: Five hundred nine adult patients were admitted with COVID-19, and 195 were diagnosed with AVT. Brain stroke, MI, PE, and DVT were observed in 48.7%, 25.6%, 10.8%, and 14.9% of cases, respectively. Risk factors such as hypertension, diabetes, dyslipidemia, and smoking were more prevalent among stroke patients. Follow-up revealed varying mortality rates and recurrent AVT cases among different AVT syndromes.

CONCLUSIONS: The study highlights a higher incidence of AVT, particularly brain stroke, in COVID-19-positive patients, with overlapping AVT syndromes observed. The findings emphasize the intricate relationship between COVID-19 and AVT, necessitating further research and targeted interventions to address this critical aspect of the disease.

PMID:40229925 | DOI:10.4103/aam.aam_230_24

Ann Afr Med. 2025 Apr 14. doi: 10.4103/aam.aam_212_24. Online ahead of print.

ABSTRACT

CONTEXT: Tuberculosis (TB) is a well-known global health problem with one-fifth of the global burden in India. Although there are diagnostic and prognostic markers for TB, there is lack of specificity and sensitivity of diagnostic methods.

AIMS: The goal of this study was to assess the diagnostic value of blood lymphocyte adenosine deaminase (ADA) levels in pulmonary TB patients.

SUBJECTS AND METHODS: This was a prospective observational case-control study. A total of 80 subjects were included in this study and were divided into two groups: 40 people who were healthy in every respect and 40 patients with pulmonary TB. ADA activity was measured in each group by the Giusti and Galanti method using a commercial kit.

STATISTICAL ANALYSIS USED: Data were analyzed using t-test with receiver operating characteristic curve analysis done to identify the cutoff values for ADA that had maximum sensitivity and specificity.

RESULTS: The mean serum ADA level in the pulmonary TB group was significantly increased as compared to control group (P < 0.0001), whereas blood lymphocyte ADA levels as well as blood lymphocyte/serum ADA ratio in the pulmonary TB group were significantly decreased as compared control group (P < 0.0001). In regard to the cutoff value of <34.06 IU/mg protein in patients with pulmonary TB, sensitivity and specificity were 90.00% and 80.00%, respectively.

CONCLUSIONS: Blood lymphocyte ADA level may be used as a biomarker for the diagnosis of pulmonary TB.

PMID:40229921 | DOI:10.4103/aam.aam_212_24

Ann Afr Med. 2025 Apr 14. doi: 10.4103/aam.aam_306_24. Online ahead of print.

ABSTRACT

AIM: To assess the diagnostic accuracy of the free androgen index (FAI) in diagnosing polycystic ovary syndrome (PCOS).

METHODS: We systematically searched PubMed, Cochrane Library, and Google Scholar databases for relevant studies published up to June 2024. The inclusion criteria were studies that reported the sensitivity and specificity of FAI for PCOS diagnosis. We used a random-effects model to find the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic area under the curve (SROC AUC). We determined positive and negative likelihood ratios (NLRs) using the Fagan nomogram and assessed heterogeneity using I2 statistics. We performed meta-regression and subgroup analysis to explore sources of heterogeneity and used Deeks’ funnel plot to assess publication bias. This study is registered with PROSPERO (ID: CRD42024546829).

RESULTS: We included 14 studies with 2870 PCOS patients and 3985 non-PCOS controls. Pooled sensitivity and specificity were 0.81 (95% confidence interval [CI]; 0.73-0.86) and 0.82 (95% CI; 0.72-0.90), respectively. The positive and NLRs were 4.6 (95% CI; 2.8-7.6) and 0.23 (95% CI; 0.17-0.33), respectively. The DOR was 20 (95% CI: 10-39), and the SROC AUC was 0.88 (95% CI: 0.85-0.90). Variability in FAI cutoff values contributed significantly to heterogeneity across studies.

CONCLUSION: Serum FAI is a reliable biomarker for diagnosing PCOS, demonstrating sensitivity and specificity exceeding 80%. It is particularly valuable in primary care settings where ultrasound facility is unavailable. FAI assists in diagnosing biochemical hyperandrogenism, especially in cases where clinical criteria are inconclusive.

PMID:40229920 | DOI:10.4103/aam.aam_306_24

Clin Transl Allergy. 2025 Apr;15(4):e70054. doi: 10.1002/clt2.70054.

ABSTRACT

BACKGROUND: Monitoring adherence in chronic diseases remains a significant challenge. Allergic rhinitis (AR), one of the most common chronic conditions, serves as an excellent model for studying determinants of app use in monitoring adherence and health assessment during treatment. The Mask-air® app supports clinical decision-making by involving patients in symptom observation and promoting adherence to therapy. This study aimed to identify the defining characteristics of Mask-air® users, describe their disease phenotype and satisfaction with the app, and explore reasons for discontinuation.

MATERIALS AND METHODS: Adult patients 20-44 years old suffering from AR (n = 198) receiving care at an allergy outpatient clinic were invited to participate in a trial using the Mask-air® app. Investigators collected data on symptoms, administered treatments, and clinical evaluation results through questionnaires. At a follow-up visit (n = 163), these were compared, and patients were questioned about their satisfaction with the app. Patients presented their app records, and those who declined or stopped using the app were asked to provide reasons in a questionnaire.

RESULTS: No distinguishing characteristics of Mask-air® users (n = 131) were identified compared with those who declined the app (n = 67). App readiness was analyzed according to age, socioeconomic status, disease severity, comorbidities, and therapeutic modality. Respondents were categorized into: those who did not install the app (17.7%), those who installed but did not use it (16.2%), and those who installed and evaluated it (66.2%), with 15.6% failing to produce symptom monitoring records. Overall, satisfaction ratings were high though patients were critical of the app’s therapeutic aspect.

CONCLUSIONS: The study found no specific features distinguishing Mask-air® users, suggesting that it can be recommended to all patients regardless of gender, socioeconomic or educational status, or disease phenotype. However, with a dropout rate of nearly 50%, it is essential for clinicians to emphasize the app’s benefits to improve adherence and engagement.

PMID:40229918 | DOI:10.1002/clt2.70054

Ann Afr Med. 2025 Apr 14. doi: 10.4103/aam.aam_206_24. Online ahead of print.

ABSTRACT

BACKGROUND: Rheumatoid arthritis (RA), a chronic inflammatory disease, causes joint pain and impairment and affects sleep. Sleep disturbances in RA patients can exacerbate pain perception, disease activity, and functional impairment and reduce quality of life. Sleep problems in RA patients, especially in rural areas, have rarely been studied.

OBJECTIVE: The objective is to evaluate the prevalence of sleep disturbances in patients with RA and assess its correlation with disease activity, pain intensity, and functional disability.

METHODS: A total of 98 RA patients who met the ACR/EULAR 2010 classification criteria participated in this cross-sectional analytical study. Data were collected on demographic variables, disease duration, and medication history. Sleep quality was assessed using the Medical Outcome Study Sleep Scale, while disease activity was measured using the Clinical Disease Activity Index (CDAI). Pain intensity was assessed using the Visual Analog Scale (VAS), and functional disability was measured using the Health Assessment Questionnaire Disability Index (HAQ-DI). Statistical analysis was performed using SPSS V.21.0.

RESULTS: Sleep disturbance was found in 28.6% of patients with RA. Individuals with sleep problems had significantly increased CDAI scores (P < 0.001), longer disease duration (P = 0.014), increased pain VAS scores (P < 0.001), and greater functional impairment as assessed by the HAQ-DI. A significant association was found between sleep disturbance and increased physician and global VAS values (P < 0.001).

CONCLUSION: Sleep disturbances are common in RA patients and are significantly associated with higher disease activity, pain intensity, and functional disability. Addressing sleep issues in RA management may improve overall patient outcomes and quality of life.

PMID:40229915 | DOI:10.4103/aam.aam_206_24

Environ Evid. 2025 Apr 15;14(1):5. doi: 10.1186/s13750-025-00358-5.

ABSTRACT

Systematic reviews (SRs) in environmental science is challenging due to diverse methodologies, terminologies, and study designs across disciplines. A major limitation is that inconsistent application of eligibility criteria in evidence-screening affects the reproducibility and transparency of SRs. To explore the potential role of Artificial Intelligence (AI) in applying eligibility criteria, we developed and evaluated an AI-assisted evidence-screening framework using a case study SR on the relationship between stream fecal coliform concentrations and land use and land cover (LULC). The SR incorporates publications from hydrology, ecology, public health, landscape, and urban planning, reflecting the interdisciplinary nature of environmental research. We fine-tuned ChatGPT-3.5 Turbo model with expert-reviewed training data for title, abstract, and full-text screening of 120 articles. The AI model demonstrated substantial agreement at title/abstract review and moderate agreement at full-text review with expert reviewers and maintained internal consistency, suggesting its potential for structured screening assistance. The findings provide a structured framework for applying eligibility criteria consistently, improving evidence screening efficiency, reducing labor and costs, and informing large language models (LLMs) integration in environmental SRs. Combining AI with domain knowledge provides an exploratory step to evaluate feasibility of AI-assisted evidence screening, especially for diverse, large volume, and interdisciplinary studies. Additionally, AI-assisted screening has the potential to provide a structured approach for managing disagreement among researchers with diverse domain knowledge, though further validation is needed.

PMID:40229909 | DOI:10.1186/s13750-025-00358-5

BMC Psychol. 2025 Apr 14;13(1):382. doi: 10.1186/s40359-025-02670-8.

ABSTRACT

BACKGROUND: Athlete burnout, characterized by emotional and physical exhaustion, reduced accomplishment, and devaluation of sport, is a growing concern in sports psychology. Life stress has been identified as a significant factor associated with athlete burnout, yet the underlying mechanisms remain unclear. This study explores the relationship between life stress and athlete burnout, with a focus on the chain mediation roles of mindfulness and cognitive emotion regulation strategies.

METHODS: A total of 453 athletes from China were surveyed using convenience sampling. Participants completed four questionnaires: the College Student-Athletes’ Life Stress Scale, Five Facet Mindfulness Questionnaire, Cognitive Emotion Regulation Questionnaire, and Athlete Burnout Questionnaire. Data were analyzed using SPSS 22.0 for descriptive statistics and Amos 24.0 for structural equation modeling to explore mediating effects.

RESULTS: Life stress was positively correlated with athlete burnout. Cognitive emotion regulation strategies were a significant mediator in this relationship. A chain mediation effect was found, where mindfulness influenced cognitive emotion regulation, which in turn reduced athlete burnout.

CONCLUSION: Life stress is significantly associated with athlete burnout, and cognitive emotion regulation strategies play a crucial role in mitigating this effect. Interventions to reduce burnout should emphasize improving cognitive emotion regulation, potentially through mindfulness training.

PMID:40229894 | DOI:10.1186/s40359-025-02670-8

Diabetol Metab Syndr. 2025 Apr 15;17(1):127. doi: 10.1186/s13098-025-01696-7.

ABSTRACT

BACKGROUND: Circulating immune cells reportedly affect diabetic neuropathy (DN). Although associations have been previously established between numerous biomarkers and diseases, elucidating their causal relationships remains challenging. Mendelian Randomization (MR) could overcome this difficulty by applying genetic instruments to discern causal links. In this study, we conducted bidirectional two-sample MR to address this problem.

METHODS: We used freely available genome-wide association study summary statistics. We obtained immune cell phenotype-related summary data from a study cohort comprising 3,757 Sardinian individuals that reported data concerning 731 immune cell phenotypes. We obtained DN-related summary data from the FinnGen database and conducted sensitivity analyses. Furthermore, we assessed horizontal pleiotropy using combined MR-Egger and MR-Presso methods. We evaluated heterogeneity using Cochran’s Q test and applied False Discovery Rate correction to the findings.

RESULTS: Our MR analysis significantly associated 24 immune cell phenotypes with DN. Specifically, the presence of CD45 on CD66b + + myeloid cells, HLA DR on CD14 + CD16- monocytes, IgD- CD24- %B cells, and CD27 on IgD- CD38br lymphocytes significantly positively correlated with the risk of DN. In contrast, the presence of CD28- DN (CD4-CD8-) %T cells, FSC-A on HLA DR + T cells, and other four T cell types negatively correlated with DN. Finally, we further confirmed the relationship between different immune cell types and DN.

CONCLUSIONS: We demonstrated the immunological susceptibility of DN and clarified how immune responses influence the course of DN. These findings might help inform immunological therapy techniques as well as novel targets for DN diagnosis and treatment.

PMID:40229883 | DOI:10.1186/s13098-025-01696-7

J Orthop Surg Res. 2025 Apr 15;20(1):376. doi: 10.1186/s13018-025-05795-z.

ABSTRACT

BACKGROUND: Metacarpal neck fractures are common and there are numerous surgical methods available, but each has certain disadvantages and limitations. We modified the conventional Ilizarov external mini-fixator and this study is designed to compare the biomechanical stability of a modified Ilizarov external mini-fixator with conventional fixation methods for metacarpal neck fractures and to provide a basis for its clinical application.

METHODS: Forty fresh porcine metacarpal specimens were used to create metacarpal neck fracture models. The specimens were randomly assigned to four fixation groups (n = 10) as follows: (1) modified Ilizarov external mini-fixator (IEF), (2) retrograde crossed Kirschner wires (KW), (3) antegrade intramedullary Kirschner wires (IK), and (4) locking plate fixation (LP). In the IEF group, the modified design involved crossing two Kirschner wires (K-wires) through the fracture line, with their tails bent twice and connected to the external fixator frame. Biomechanical testing was performed using a modified three-point bending test. Maximum fracture force and bending stiffness were calculated from the force-displacement curves. Kruskal-Wallis test was used to compare statistical differences in maximum fracture force and stiffness among the groups, followed by post hoc pairwise comparisons adjusted with Bonferroni corrections.

RESULTS: The median maximum fracture force values (± interquartile range, IQR) for each group were as follows: IEF 160.3 ± 55.6 N, LP 173.5 ± 42.6 N, KW 91.1 ± 23.1 N, and IK 79.8 ± 37.8 N. The corresponding stiffness values were as follows: IEF 29.5 ± 10.4 N/mm, LP 32.9 ± 10.4 N/mm, KW 17.2 ± 11.3 N/mm, and IK 18.2 ± 13.7 N/mm. The IEF group demonstrated significantly higher maximum fracture force and stiffness than the KW and IK groups; however, no statistically significant differences were observed in the IEF group compared with the LP group.

CONCLUSION: The modified Ilizarov external mini-fixator provided significantly greater biomechanical stability for metacarpal neck fractures than retrograde crossed K-wires and antegrade intramedullary K-wires, achieving comparable performance to the locking plate system. This modified design combines the simplicity and minimally invasive advantages of K-wire fixation with enhanced stability, potentially facilitating early joint mobilization and minimizing the risk of complication.

PMID:40229877 | DOI:10.1186/s13018-025-05795-z