Tag: nevin manimala

PLoS One. 2025 Mar 20;20(3):e0320074. doi: 10.1371/journal.pone.0320074. eCollection 2025.

ABSTRACT

INTRODUCTION: Clinical microbiology laboratories are essential for diagnosing and monitoring antimicrobial resistance (AMR). Here, we assessed the systems involved in generating, managing and analyzing blood culture data in these laboratories in an upper-middle-income country.

METHODS: From October 2023 to February 2024, we conducted a survey on the utilization of automated systems and laboratory information management systems (LIMS) for blood culture specimens in 2022 across 127 clinical microbiology laboratories (one each from 127 public referral hospitals) in Thailand. We categorized automated systems for blood culture processing into three steps: incubation, bacterial identification, and antimicrobial susceptibility testing (AST).

RESULTS: Of the 81 laboratories that completed the questionnaires, the median hospital bed count was 450 (range, 150-1,387), and the median number of blood culture bottles processed was 17,351 (range, 2,900-80,330). All laboratories (100%) had an automated blood culture incubation system. Three-quarters of the laboratories (75%, n = 61) had at least one automated system for both bacterial identification and AST, about a quarter (22%, n = 18) had no automated systems for either step, and two laboratories (3%) outsourced both steps. The systems varied and were associated with the hospital level. Many laboratories utilized both automated systems and conventional methods for bacterial identification (n = 54) and AST (n = 61). For daily data management, 71 laboratories (88%) used commercial microbiology LIMS, three (4%) WHONET, three (4%) an in-house database software and four (5%) did not use any software. Many laboratories manually entered data of incubation (73%, n = 59), bacterial identification (27%, n = 22) and AST results (25%, n = 20) from their automated systems into their commercial microbiology LIMS. The most common barrier to data analysis was ‘lack of time’, followed by ‘lack of staff with statistical skills’ and ‘difficulty in using analytical software’.

CONCLUSION: In Thailand, various automated systems for blood culture and LIMS are utilized. However, barriers to data management and analysis are common. These challenges are likely present in other upper-middle-income countries. We propose that guidance and technical support for automated systems, LIMS and data analysis are needed.

PMID:40112277 | DOI:10.1371/journal.pone.0320074

Neurology. 2025 Apr 22;104(8):e213486. doi: 10.1212/WNL.0000000000213486. Epub 2025 Mar 19.

ABSTRACT

BACKGROUND AND OBJECTIVES: Stroke is a leading cause of death and disability in the United States and may result in cognitive impairment and the inability to participate in treatment decisions, attesting to the importance of advance care planning (ACP). Although racial and ethnic differences have been shown for ACP in the general population, little is known about these differences specific to patients with stroke. The aim of this study was to examine the presence of ACP and receipt of life-prolonging care by race and ethnicity among decedents who had suffered a stroke.

METHODS: We used the Health and Retirement Study, a nationally representative longitudinal survey. We conducted a cohort study of decedents who died between 2000 and 2018 using multivariable logistic regression models to explore the association between self-reported ethnicity and race and completion of ACP (including a living will [LW] and durable power of attorney for healthcare [DPOAH]) and receipt of life-prolonging care at end of life, controlling for covariates. Stratified models for each race and ethnicity also were conducted.

RESULTS: This study included 3,491 decedents with a reported history of stroke; 57.4% were women, and the mean age was 81.5 years (SD = 10.2). Decedents who identified as non-Hispanic White had the highest end-of-life planning rates (LW: 57%, DPOAH: 72%, and ACP conversation: 63%) compared with those identifying as non-Hispanic Black (LW: 20%, DPOAH 40%, and ACP conversation: 41%) and Hispanic (LW: 20%, DPOAH: 36%, and ACP conversation: 42%; p < 0.001). The presence of ACP discussions, LW, and DPOAH was associated with lower odds of receiving life-prolonging care at end-of-life among non-Hispanic White decedents (OR = .64, CI = .447-0.904; OR = .30, CI = .206-0.445; OR = .61, CI = .386-0.948) but not among those who identified as Hispanic or non-Hispanic Black.

CONCLUSIONS: Hispanic or non-Hispanic Black decedents with stroke had significantly lower rates of ACP discussions, LWs, and naming a DPOAH compared with those who identified as non-Hispanic White. In addition, ACP activities were inversely associated with receipt of life-prolonging care among non-Hispanic White decedents, but not among those who identified as non-Hispanic Black and Hispanic. Small ethnic/racial subgroup sizes limit the generalizability of this study.

PMID:40112272 | DOI:10.1212/WNL.0000000000213486

JCO Glob Oncol. 2025 Mar;11:e2400604. doi: 10.1200/GO-24-00604. Epub 2025 Mar 20.

ABSTRACT

PURPOSE: This study aimed to examine trends in the incidence and mortality rates of endometrial cancer (EC) across ethnic groups in Brazil and to analyze the demographic and clinicopathological characteristics associated with these trends.

METHODS: The incidence of EC was analyzed from 2010 to 2015 using data from Brazilian Population-Based Cancer Registries (PBCRs), including crude rates and annual percentage changes (APCs). Clinical and sociodemographic information from 2000 to 2019 was gathered from Hospital-Based Cancer Registries. Mortality data between 2000 and 2021 were obtained from the National Mortality Information System, allowing for comparisons between White women and Black women.

RESULTS: From 2010 to 2015, a total of 32,831 new cases of EC were reported across 13 PBCRs, with Black patients accounting for 35.7% of these cases. The median age at diagnosis was 63 years, with Black women diagnosed at a younger age than White women. Black patients experienced a significant increase in incidence rate (APC +6.7% v +3.0%). A greater proportion of Black patients lived without partners (54.0%), had higher rates of alcohol consumption (15%) and smoking (25.8%), and resided in less developed regions (54.6%) with lower education levels (77.5%). From 2000 to 2021, Brazil recorded 72,189 EC-related deaths, showing higher mortality rates among White women (3.8 per 100,000) than Black women (2.4 per 100,000), although the downward trend was steeper among White women (-1.2%) than Black women (-0.6%).

CONCLUSION: Racial disparities in EC incidence and mortality in Brazil may be closely linked to unfavorable sociodemographic factors faced by Black women. Targeted public health initiatives are critical for improving early detection and access to equitable care for Black women.

PMID:40112259 | DOI:10.1200/GO-24-00604

JCO Glob Oncol. 2025 Mar;11:e2400513. doi: 10.1200/GO-24-00513. Epub 2025 Mar 20.

ABSTRACT

PURPOSE: Although international medical graduates (IMGs) and Puerto Rican Medical Graduates (PRMGs) comprise an integral part of the health care workforce, these individuals, particularly women, frequently face numerous types of discrimination throughout medical training and independent practice. To our knowledge, we conducted the first cross-sectional study to understand the journeys and consequences of migration faced by IMGs and PRMGs in the US oncology workforce.

METHODS: We developed a cross-sectional, online survey consisting of 51 multiple choice and open-ended questions that captured demographic information, professional status, period of migration to the United States, location within the United States that participants migrated to, reasons for migration, cultural adaptation, experiences of discrimination during training, and overall professional experiences in the United States.

RESULTS: The majority of participants cited better education, professional gains, and a lack of opportunities in participants’ home country as primary reasons for migration to the United States. However, most participants, particularly women, experienced staunch assimilation to fit the mold of professional American standards; women were also particularly likely to report experiences of racial/ethnic, language, and gender discrimination during oncology training in the United States, which only marginally improved during independent practice. Despite such discrimination, most participants reported excellent professional satisfaction during training and independent practice, although only moderate personal satisfaction. Most participants decided to stay in the United States, citing reasons pertaining to enhanced professional opportunities, whereas those that returned home valued reasons relating to family and quality of life.

CONCLUSION: Our sobering findings underscore the need for institutional enforcement of an inclusive environment encompassing cultural humility, enactment of programs addressing barriers to socialization, immigration laws, and financial support, creation of IMG-specific support networks, and the sponsorship and promoting of minority women physicians.

PMID:40112258 | DOI:10.1200/GO-24-00513

J Natl Cancer Inst. 2025 Mar 20:djaf062. doi: 10.1093/jnci/djaf062. Online ahead of print.

ABSTRACT

BACKGROUND: Despite advances in breast cancer treatment, recurrence remains common and contributes to higher mortality risk. Among the potential mechanisms, inflammation plays a key role in recurrence by promoting tumor progression. Exercise provides a wide array of health benefits and may reduce inflammation, potentially reducing mortality risk. However, the effects of exercise, including mode (ie, resistance training [RT], aerobic training [AT], and combined RT and AT) and program duration, on inflammatory biomarkers in breast cancer survivors remain to be elucidated.

METHODS: A systematic search was undertaken in PubMed, CINAHL, Embase, SPORTDiscus and CENTRAL in August 2024. Randomized controlled trials examining the effects of exercise on IL-1β, IL-6, IL-8, IL-10, TNF-α, and CRP were included. A random-effects meta-analysis was undertaken to quantify the magnitude of change.

RESULTS: Twenty-two studies were included (n = 968). Exercise induced small to large significant reductions in IL-6 (SMD = -0.85; 95% CI = -1.68 to -0.02; p = .05) and TNF-α (SMD = -0.40; 95% CI = -0.81 to 0.01; p = .05) and a trend for a decrease in CRP. When stratifying by exercise mode, trends toward reduction in IL-6 and TNF-α were observed for combined exercise, whilst changes were not generally affected by exercise program duration.

CONCLUSION: Exercise, especially combined RT and AT, can reduce pro-inflammatory biomarkers, and may be a suitable strategy to reduce inflammation in breast cancer survivors. However, further research is needed to investigate the effects of exercise mode and program duration on markers of inflammation in this survivor group.

PMID:40112254 | DOI:10.1093/jnci/djaf062

PLoS One. 2025 Mar 20;20(3):e0319105. doi: 10.1371/journal.pone.0319105. eCollection 2025.

ABSTRACT

This study aimed to reveal urban-rural disparities in successful aging among Chinese older adults and the impact of gender and age on aging outcomes. We utilized the Successful Aging Index (SAI), a multidimensional measure encompassing social, economic, bio-clinical, psychological, and lifestyle factors. Scores on the SAI range from 0 to 10, with higher scores signifying better aging. Data was sourced from the 2018 Chinese Longitudinal Healthy Longevity Survey, comprising 7,315 participants. Urban older adults (OU) had significantly higher SAI scores than rural older adults (OR), with averages of 4.32 ± 1.44 and 3.85 ± 1.24, respectively (p < 0.001). Men showed more successful aging than women, regardless of their residence (p < 0.001). OU had better financial and educational status and higher social activity scores, except for friend interaction (p < 0.001). They were more physically active (p < 0.001), more adherent to the Mediterranean diet (p < 0.001), and less likely to smoke (p = 0.018). However, OU had a higher prevalence of cardiovascular disease risk factors compared to OR (p < 0.001). Notably, depression scores were similar between OU and OR (p = 0.129). In summary, significant urban-rural differences in successful aging are evident among Chinese older adults, with urban-dwelling older adults aging more successfully than their rural peers. Men, irrespective of their place of residence, experience more successful aging outcomes than women.

PMID:40112253 | DOI:10.1371/journal.pone.0319105

PLoS One. 2025 Mar 20;20(3):e0320065. doi: 10.1371/journal.pone.0320065. eCollection 2025.

ABSTRACT

BACKGROUND: Sex workers of all genders have a high risk of HIV acquisition and are a priority population for HIV pre-exposure prophylaxis (PrEP). We aimed to assess current oral PrEP use and associated factors among cisgender female sex workers (FSW) in two Ugandan cities.

METHODS: We administered a survey questionnaire to 236 HIV-negative FSW in the cities of Mbale and Mbarara from January to March 2020. The survey was nested in a quasi-experimental study to assess the effect of peer education and text message reminders on the uptake of regular sexually transmitted infection (STI) and HIV testing. Using interviewer-administered questionnaires, we obtained data on current self-reported tenofovir-based oral PrEP use. We used modified Poisson regression with robust standard errors to evaluate the factors associated with current oral PrEP usage.

RESULTS: Nearly 70% of FSWs reported taking an HIV test during the past three months. Among the respondents, 33% (33/100) in Mbale and 67% (91/136) in Mbarara reported having ever heard of PrEP. However, only 9.7% (23/236) self-reported currently taking oral-PrEP. In Mbarara, FSWs were twice as likely to be aware of or use oral PrEP than those in Mbale (adjusted prevalence ratio [aPR] 2.33; 95% confidence interval (CI) 1.19-3.97; p = 0.01). Additionally, current use was positively associated with attainment of secondary (aPR 2.50; 95% CI: 1.14-5.45; p = 0.02) or tertiary education (aPR 3.12; 95% CI: 1.09-8.96; p = 0.03).

CONCLUSION: PrEP use in this cohort of FSWs was low and was associated with location and level of education. To increase PrEP uptake among FSWs, targeted educational campaigns and implementation studies are needed, particularly for those with lower levels of education.

PMID:40112250 | DOI:10.1371/journal.pone.0320065

Microsc Microanal. 2025 Mar 17;31(2):ozaf008. doi: 10.1093/mam/ozaf008.

ABSTRACT

Lead is a common heavy metal used in a variety of products. We investigated the effect of lead-oxide nanoparticles (PbO-NPs) on the histological structure of the rat olfactory bulb (OB) and the potential therapeutic effect of stem cell-derived exosomes (EXOs). Forty male rats were included: 8 for EXO isolation and 32 were distributed into 4 groups: control, PbO-NPs group [intranasal (IN) 50 µL PbO-NPs/rat for 3 weeks], recovery group (PbO-NPs for 3 weeks and left for another 4 weeks), and PbO-NP-EXO (PbO-NPs for 3 weeks then IN EXO for another 3 weeks). After 7 weeks, olfactory behavioral tests were done before scarification. OBs were stained with hematoxylin and eosin, toluidine blue, and immunohistochemistry for synaptophysin (SYP), and ionized calcium-binding adaptor molecule-1 (Iba-1) and glial fibrillary acidic protein (GFAP). The results were confirmed by histomorphometry and statistical analysis. PbO-NPs and recovery groups showed a significant olfactory dysfunction, significant decrease in the thickness of OB layers and diameter of glomeruli, Nissl’s granules of mitral cells and SYP immunostaining, and a significant increase in Iba-1 and GFAP expression compared with control rats. In PbO-NP-EXO, notable regaining of OB structure and function was obvious with reversal of most of the behavioral and morphometric findings compared with the untreated groups. IN EXO administration improved the structure and function of PbO-NP-induced OB neurotoxicity.

PMID:40112249 | DOI:10.1093/mam/ozaf008

PLoS One. 2025 Mar 20;20(3):e0317182. doi: 10.1371/journal.pone.0317182. eCollection 2025.

ABSTRACT

Addressing the under-researched issue of weapon tolerance, the paper examines factors behind male knife and gun tolerance across four different cultures, seeking to rank them in terms of predictive power and shed light on relations between them. To this end, four regression and structural equation modelling analyses were conducted using samples from the US (n = 189), India (n = 196), England (n = 107) and Poland (n = 375). Each sample of male participants indicated their standing on several dimensions (i.e., predictors) derived from theory and related research (i.e., Psychoticism, Need for Respect, Aggressive Masculinity, Belief in Social Mobility and Doubt in Authority). All four regression models were statistically significant. The knife tolerance predictors were: Aggressive Masculinity (positive) in the US, Poland and England, Belief in Social Mobility (negative) in the US and England, Need for Respect (positive) in India and Psychoticism (positive) in Poland. The gun tolerance predictors were: Psychoticism (positive) in the US, India and Poland, Aggressive Masculinity (positive) in the US, England and Poland, and Belief in in Social Mobility (negative) in the US, Belief in Social Mobility (positive) and Doubt in Authority (negative) in Poland. The Structural Equation Weapon Tolerance Model (WTM) suggested an indirect effect for the latent factor Perceived Social Ecological Constraints via its positive relation with the latent factor Saving Face, both knife and gun tolerance were predicted by Psychoticism.

PMID:40112246 | DOI:10.1371/journal.pone.0317182

Neurology. 2025 Apr;104(7):e213442. doi: 10.1212/WNL.0000000000213442. Epub 2025 Mar 20.

ABSTRACT

BACKGROUND AND OBJECTIVES: There is uncertainty about whether patients with an anterior circulation large vessel occlusion (LVO) and a low NIH Stroke Scale (NIHSS) score (≤5) benefit from endovascular therapy (EVT) in the late time window (6-24 hours). We compared the clinical outcomes of these patients receiving EVT with those receiving medical management (MM).

METHODS: The CT for Late Endovascular Reperfusion multinational cohort study was conducted at 66 sites across 10 countries from January 2014 to May 2022. This subanalysis included consecutive patients with late-window stroke due to an anterior circulation LVO, defined as occlusion of the internal carotid artery or proximal middle cerebral artery (M1/M2 segments), and a baseline NIHSS score ≤5 who received EVT or MM alone. The primary end point was a 90-day ordinal shift in the modified Rankin Scale (mRS) score. Secondary outcomes were 90-day excellent outcome (defined as mRS scores 0-1 or return to baseline mRS score in patients with a prestroke mRS score >1) and favorable outcome (defined as mRS scores 0-2 or return to baseline mRS score in patients with prestroke mRS score >2). Safety outcomes were symptomatic intracranial hemorrhage and 90-day mortality. We used ordinal and binary logistic regression models to test for outcome differences.

RESULTS: Among 5,098 patients, 318 patients were included (median [interquartile range] age 67 [56-76] years; 149 [46.9%] were female; baseline NIHSS score was 4 [2-5]). A total of 202 patients (63.5%) received EVT and 116 MM (36.5%). There was no difference in favorable 90-day ordinal mRS score shift (adjusted common odds ratio [OR] 0.77, 95% CI 0.45-1.32), excellent outcome (adjusted OR 0.86, 95% CI 0.49-1.50), or favorable outcome (adjusted OR 0.72, 95% CI 0.35-1.50) in the EVT group compared with MM. Symptomatic intracranial hemorrhage risk (adjusted OR 3.40, 95% CI 0.84-13.73) and mortality at 90 days (adjusted OR 2.44, 95% CI 0.60-10.02) were not statistically different between treatment groups.

DISCUSSION: In patients with an anterior LVO and low NIHSS score in the 6-24-hour time window, there was no statistical difference in disability outcomes or intracranial bleeding risk between patients treated with EVT compared with MM. The retrospective and observational design limits our findings. Ongoing randomized controlled trials will provide further insight.

CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that in adult patients with anterior circulation LVO and low NIHSS score (≤5) presenting in the late time window (6-24 hours), EVT does not improve clinical outcome vs MM.

TRIAL REGISTRATION: This study was registered at clinicaltrials.gov under NCT04096248.

PMID:40112237 | DOI:10.1212/WNL.0000000000213442