Tag: nevin manimala

Acad Emerg Med. 2025 Feb 3. doi: 10.1111/acem.15112. Online ahead of print.

NO ABSTRACT

PMID:39901308 | DOI:10.1111/acem.15112

Stem Cell Res Ther. 2025 Feb 4;16(1):45. doi: 10.1186/s13287-025-04174-z.

ABSTRACT

BACKGROUND: Despite the existence of promising outcomes from standard 2D culture systems, these data are not completely akin to in vivo tumor parenchyma. Therefore, the development and fabrication of various 3D culture systems can in part mimic intricate cell-to-cell interaction within the real tumor mass. Here, we aimed to evaluate the tumoricidal impacts of metformin (MTF) on colorectal cancer (CRC) tumoroids in an in vitro system via the modulation of autophagy.

METHODS: CRC tumoroids were developed using human umbilical vein endothelial cells (HUVECs), adenocarcinoma HT29 cells, and fibroblasts (HFFF2) in a ratio of 1: 2: 1 and 2.5% methylcellulose. Tumoroids were exposed to different concentrations of MTF, ranging from 20 to 1000 mM, for 72 h. The survival rate was detected using an LDH release assay. The expression and protein levels of autophagy-related factors were measured using PCR array and western blotting, respectively. Using H & E, and immunofluorescence staining (Ki-67), the integrity and proliferation rate of CRC tumoroids were examined.

RESULTS: The current protocol yielded typical compact tumoroids with a dark central region. Despite slight changes in released LDH contents, no statistically significant differences were achieved in terms of cell toxicity in MTF-exposed groups compared to the control tumoroids, indicating the insufficiency of MTF in the induction of tumor cell death (p > 0.05). Western blotting indicated that the LC3II/I ratio was reduced in tumoroids exposed to 120 mM MTF (p < 0.05). These data coincided with the reduction of intracellular p62 content in MTF 120 mM-treated tumoroids compared to MTF 40 mM and control groups (p < 0.05). PCR array analysis confirmed the up-regulation, and down-regulation of several genes related to various signaling transduction pathways associated with autophagy machinery and shared effectors between autophagy and apoptosis in 40 and 120 mM MTF groups compared to the non-treated control group (p < 0.05). These changes were more prominent in tumoroids incubated with 120 mM MTF. Histological examination confirmed the loosening integrity of tumoroids in MTF-treated groups, especially 120 mM MTF, with the increase in cell death via the induction of apoptosis (chromatin marginalization) and necrotic (pyknotic nuclei) changes. In the 120 mM MTF group, spindle-shaped cells with the remnants of a fibrillar matrix were detected. Data indicated the reduction of proliferating Ki-67⁺ cells within the tumoroids by increasing the MTF concentration from 40 to 120 mM.

CONCLUSIONS: Different shared autophagy/apoptosis genes were modulated in CRC tumoroids after MTF treatment coinciding with both typical necrotic and apoptotic cells within the tumoroid structure. MTF can inhibit the integrity and proliferation of CRC tumoroids in dose-dependent manner.

PMID:39901295 | DOI:10.1186/s13287-025-04174-z

Ital J Pediatr. 2025 Feb 3;51(1):24. doi: 10.1186/s13052-025-01873-4.

ABSTRACT

BACKGROUND: Multiple studies have reported that infectious pneumonia can induce the production of plastic casts, which threatens children’s health. We explored the characteristics of plastic bronchitis (PB) in clinical practice by analysing clinical medical records.

METHODS: A retrospective study was conducted. Children with pneumonia and large chest shadows were included in this study. The differences in characteristics between patients with plastic bronchitis and those without plastic bronchitis were analysed. The distribution of pathogens was statistically analysed. Grouping analysis based on PB and pathogen conditions was also conducted.

RESULTS: A total of 185 patients were included in this study. The patients were divided into two groups: the PB group (n = 48) and the non-PB group (n = 137). The duration of illness before hospitalization in the PB group was mostly longer than that in the non-PB group. The frequency distribution of the inspiratory three concave signs in the PB group was significantly greater than that in the non-PB group. Compared with those in the non-PB group, the number of patients with abnormally elevated of D-D dimer, LDH, ALT, and AST in the PB group was significantly greater. Mycoplasma pneumoniae (MP) was the main pathogen observed in both the PB and non-PB groups. In cases of MP infection without plastic bronchitis, treatment with macrolide antibiotics occurred significantly earlier. Most cases of pleural effusion in the PB-MP group were discovered more than 7 days after onset. However, in the PB-nonMP group, most cases of pleural effusion were detected within 7 days of onset. There was a difference observed in the distribution of pulmonary necrosis between the PB group and the non-PB group.

CONCLUSIONS: MP is a common pathogen observed in PB cases caused by single-pathogen infections and multiple-pathogen infections. PB may be a potential cause of pulmonary necrosis. Furthermore, PB exhibits diverse clinical manifestations due to host and pathogen factors.

PMID:39901284 | DOI:10.1186/s13052-025-01873-4

Ital J Pediatr. 2025 Feb 4;51(1):25. doi: 10.1186/s13052-025-01863-6.

ABSTRACT

BACKGROUND: Pediatric septic shock is a critical condition associated with high mortality rates, largely due to sepsis-induced immunosuppression. Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been explored as a therapeutic intervention to counteract this immunosuppression. Despite its potential, the efficacy of GM-CSF in pediatric septic shock has not been clearly established. This study aims to investigate the impact of GM-CSF administration on survival rates and to identify key predictors of treatment outcomes in pediatric septic shock patients.

METHODS: We conducted a retrospective cohort study at the Pediatric Intensive Care Unit (PICU) of Children’s Hospital of Fudan University, Shanghai, from January 1, 2019, to December 31, 2023. The study included pediatric patients diagnosed with septic shock, analyzing their demographic data, GM-CSF and adjunctive therapies, laboratory results, and clinical outcomes. We employed univariate and multivariate logistic regression models to assess the influence of GM-CSF on 28-day mortality and identify significant predictors of treatment outcomes.

RESULTS: The study included 200 pediatric patients, with 66 receiving GM-CSF treatment and 134 not treated with GM-CSF. The initial comparison showed a higher 28-day mortality in the GM-CSF group (59.1%) compared to the non-GM-CSF group (35.1%, P = 0.001). Notably, after adjustment for confounding factors, multivariate analysis revealed that the effect of GM-CSF treatment on 28-day mortality among pediatric septic shock patients did not reach statistical significance, with an odds ratio (OR) of 0.472 and a 95% confidence interval (CI) ranging from 0.153 to 1.457 (P = 0.192). However, the analysis indicated a potential trend suggesting that GM-CSF treatment may contribute to a reduction in 28-day mortality. In addition, significant predictors of treatment outcomes included hematopoietic stem cell transplantation (HSCT), lactic acid (LAC) levels, hospital-acquired septic shock (HASS), red blood cell (RBC) count, and platelet (PLT) count.

CONCLUSIONS: GM-CSF treatment may benefit pediatric septic shock patients, especially those with higher lactic acid, and lower RBC and platelet counts. These factors, which are significant predictors of outcomes, should be monitored during therapy.

PMID:39901277 | DOI:10.1186/s13052-025-01863-6

Diabetol Metab Syndr. 2025 Feb 3;17(1):44. doi: 10.1186/s13098-025-01610-1.

ABSTRACT

BACKGROUND: To date, there is a lack of information on the use of flash glucose monitoring system (fCGM) in low-middle income countries, such as Brazil, as well as on digital health platforms most used to calculate the bolus insulin dose. In this study, we aimed to describe the population characteristics, prescription patterns and glycemic control of fCGM users compared to blood glucose monitoring (BGM) system in those who use Glic™, a digital health platform in Brazil, and to assess factors associated with better glycemic control in this population.

METHODS: This study is a cross-sectional retrospective study using anonymized aggregated data manually inputted by Glic™ users who self-reported a diagnosis of type 1 diabetes (T1DM), type 2 diabetes (T2DM), gestational diabetes (GDM) and latent autoimmune diabetes in adults (LADA).

RESULTS: Of the 12,727 individuals included in this study, 11,007 (86.5%) reported their glucose monitoring method to be BGM, while 1720 (13.5%) reported using fCGM. Most individuals (70.5%) had T1DM. Compared to BGM, fCGM users were significantly younger, had a higher proportion of males, resided more frequently in the Southeast region of Brazil, had a lower BMI, a longer time since diagnosis, and used Glic™ platform more frequently. fCGM users were prescribed significantly more ultra-long and ultra-rapid acting insulins as their basal and bolus insulin, respectively, and less oral anti-diabetics drugs compared to BGM users. Considering only the T1DM and LADA individuals and their manual glucose inputs, fCGM users had non-significant lower glucose levels than BGM. Use of Glic™ platform and a higher percentage of basal insulin dose were associated with a better glycemic control.

CONCLUSION: This is the first and largest real-world evidence study that describe and compare fCGM and BGM in users of a digital health patient support platform in Brazil. fCGM users were significantly different from those who perform BGM, in terms of population characteristics and treatment patterns. Glycemic control was better in fCGM users, although not statistically significant due to a restricted sample size. Importantly, a higher frequency of Glic™ use was associated with a higher glucose time in range.

PMID:39901274 | DOI:10.1186/s13098-025-01610-1

Reprod Health. 2025 Feb 3;22(1):17. doi: 10.1186/s12978-025-01956-9.

ABSTRACT

BACKGROUND: High-risk fertility behaviour (HRFB) remains a significant public health concern in Nigeria, contributing to increase in maternal and child morbidity and mortality. The existence of HRFB presents significant barrier to accomplishing the Sustainable Development Goals. The objective of this study was to examine the prevalence and contextual factors of HRFB among Nigerian women.

METHODS: In this study, cross-sectional data with national representativeness from the 2018 Nigeria demographic and health survey (NDHS) were used. The sample was made up of 21,792 women aged 15-49 years selected from 1389 enumeration areas. A multilevel multivariable binary logistic regression model was utilised to examine the factors associated with HRFB.

RESULTS: The weighted prevalence of HRFB was 64% (95% CI 62-65%). Women having at least a secondary education had 14% (aOR = 0.86; 95% CI 0.77-0.98) reduction in the odds of HRFB when compared with women with at most a primary education. Muslim women had 20% (aOR = 1.20; 95% CI 1.06-1.36) increase in the odds of HRFB, when compared with the Christian women. Those who had 3-4 living children had 3.97 times higher odds of HRFB, when compared with women with no child (aOR = 3.97; 95% CI 2.92-5.40). Women aged 25-34 and 35-49 years had higher odds of HRFB when compared with women aged 15-24 years respectively. Women exposed to media use had 12% (aOR = 0.88; 95% CI 0.80-0.97) reduction in the odds of HRFB when compared with women not exposed to media use. The non-poor women had 12% (aOR = 0.88; 95% CI 0.79-0.99) reduction in the odds of HRFB when compared with poor women. Respondents from female-headed households had 21% reduction in the odds of HRFB when compared with those from households with male head (aOR = 0.79; 95% CI 0.69-0.92). The geographical region was significantly associated with HRFB among women.

CONCLUSION: The high prevalence of HRFB among Nigerian women underscores the need for policies and programmes targeted to address the issue. Addressing socioeconomic factors, improving education and healthcare access, and promoting family planning could significantly reduce HRFB.

PMID:39901270 | DOI:10.1186/s12978-025-01956-9

Implement Sci. 2025 Feb 3;20(1):7. doi: 10.1186/s13012-025-01419-6.

ABSTRACT

BACKGROUND: For nearly two decades, it has been widely recognized that individuals in jail settings have a high prevalence of opioid use disorders (OUD) and are highly susceptible to fatal overdose upon their release. This setting provides a public health opportunity to address OUD with Medication for Opioid Use Disorders (MOUDs). Yet, 56% of jails do not provide MOUD, creating a pressing need for better implementation approaches in jail and the hand-off to the community. Two successful implementation strategies, NIATx external coaching and the Extension for Community Healthcare Outcomes (ECHO) case management telementoring model, were compared to address this persistent treatment gap.

METHODS: This 2 × 2 design compared high (n = 12) and low (n = 4) dose coaching with and without ECHO in a 12-month intervention and 12 M sustainability period. The national trial included 25 jails and 13 community-based partners. MOUD trends for buprenorphine, methadone, injectable naltrexone, and combined MOUD between the study arms were assessed.

RESULTS: Jail sizes ranged from 24% with < 100 and 24% with > 500 daily population, and community-based treatment providers ranged from 63% with < 50 and 7% with > 500 average monthly OUD intakes. New patient counts were found to significantly increase across the intervention phase for buprenorphine (p < .01) and combined MOUD (p < .01). Injectable naltrexone and methadone showed no consistent, significant gains. For sites with low coaching without ECHO, new patient counts for combined MOUD were predicted to increase by 47.44% during the intervention phase and 7.30% during the sustainability phase. ECHO demonstrated that MOUD use did not significantly increase compared to coaching across MOUDs in the intervention phase (p = .517). High- and low-dose coaching showed no significant differences in MOUD use during the intervention phase (p = .124).

CONCLUSIONS: Coaching emerged as a more effective implementation strategy than ECHO for increasing buprenorphine use in jail settings. In practice, ECHO sessions offered considerable overlap with coaching strategies. While high-dose coaching had greater gains for MOUDs overall than low-dose coaching, those gains were statistically insignificant, suggesting low-dose coaching to be more economical. To increase MOUD use in jail settings, jurisdictions should focus on new MOUDs so all three MOUDs are available and enhance the post-incarceration continuum of care.

TRIAL REGISTRATION: Name of registry: ClinicalTrials.gov.

TRIAL REGISTRATION NUMBER: NCT04363320. Date of registration: 2020-07-30. URL of trial registry record: https://clinicaltrials.gov/study/NCT04363320?term=molfenter&rank=7 .

PMID:39901259 | DOI:10.1186/s13012-025-01419-6

BMC Nurs. 2025 Feb 3;24(1):117. doi: 10.1186/s12912-024-02600-w.

ABSTRACT

BACKGROUND: Nurses’ work engagement is critical for improving quality care, facilitating positive patient outcomes, and solving considering the nursing shortage. This study aimed to identify the mediating effect of job crafting on the relationship between positive psychological capital and work engagement in registered nurses.

METHODS: A total of 132 hospital nurses with clinical experience of more than one year, excluding nurse administrators, participated. The participants were recruited from three hospitals in South Korea from August to September 2021. The SPSS 27.0 and PROCESS macro were used for data analysis.

RESULTS: Positive psychological capital had a significant association with job crafting (β = 0.74, 95% CI = 0.71 to 0.95), and job crafting had a positive association with work engagement (β = 0.51, 95% CI = 0.29 to 0.56). In the mediating effect analysis, the mediating role of job crafting on the relationships between positive psychological capital and work engagement was statistically significant (β = 0.35, 95% CI = 0.24 to 0.48).

CONCLUSIONS: Based on our findings that positive psychological capital and job crafting could improve the work engagement of registered nurses, strengths coaching-based programs for increasing positive psychological capital and job crafting exercises for helping nurses make their job more engaging need to be developed.

PMID:39901251 | DOI:10.1186/s12912-024-02600-w

BMC Nurs. 2025 Feb 3;24(1):119. doi: 10.1186/s12912-025-02769-8.

ABSTRACT

BACKGROUND: Prostate cancer is a worldwide health issue, and current prostate cancer care extends to the patient‒caregiver dyadic setting, where individuals are interdependent and interact with each other as well as possible negative psychological and behavioural outcomes. However, the impact of dyadic care interventions on health outcome indicators for prostate cancer patients and their informal caregivers has yet to be examined.

AIM: To describe the characteristics of dyadic interventions involving patients with prostate cancer and their informal caregivers and investigate their effects on psychosocial health, sexual health, and dyadic relationships.

METHODS: Ten electronic databases (Web of Science, Cochrane Library, PsycINFO, PubMed, Embase, CINAHL, CNKI, Wanfang, VIP, and SinoMed) were thoroughly searched for related publications published between the database’s founding and April 2024. The risk of bias for the included studies was evaluated using the Cochrane risk-of-bias tool, and a meta-analysis was performed using RevMan 5.4.

RESULTS: This study identified and evaluated 19 RCTs reporting 22 different interventions, as well as outcome indicators for the three aspects of psychosocial health, sexual health, and dyadic relationships in prostate cancer patients and informal caregivers. A meta-analysis of pooled data revealed that for prostate cancer patients, the intervention improved dyadic coping (SMD95% CI [95% CI] = 0.22 [0.01;0.42], p = 0.04), and for informal caregivers the dyadic care intervention reduced anxiety (SMD95% CI [95% CI] = -0.35 [-0.65;-0.06], p = 0.02), enhanced self-efficacy (SMD [95% CI] = 0.22 [0.01;0.43], p = 0.04), and improved sexual functioning (SMD [95% CI] = 0.29 [0.05;0.54], p = 0.02). No statistically significant overall effects were observed for the other outcome indicators.

CONCLUSION: The results of this review indicate that dyadic care interventions benefit prostate cancer patients and informal caregivers. However, given features such as research quality and sample size, further randomized controlled trials with excellent study designs are needed in the future to evaluate and validate the efficacy of dyadic care treatments for patients with prostate cancer.

TRIAL REGISTRATION: The protocol for this study is registered in PROSPERO with registration number (CRD42024567542).

PMID:39901243 | DOI:10.1186/s12912-025-02769-8

BMC Nurs. 2025 Feb 3;24(1):118. doi: 10.1186/s12912-025-02775-w.

ABSTRACT

INTRODUCTION: The persistent attrition of nurses from the profession is a significant challenge for both healthcare policymakers and administrative bodies within numerous low-income countries. In Ethiopia, various cross-sectional studies have been conducted regarding nurses’ intention to stay in the nursing profession; however, the results have demonstrated inconsistency. Hence, this study aims to pool the level of nurses’ intention to persist in the nursing profession.

METHODS: In our systematic review and meta-analysis, targeted findings were searched from a variety of electronic databases; including Pub Med, Google Scholar, African Journal Online, the Cochran Library, and Science Direct. To determine the pooled prevalence and associated factors of intent to stay in nursing profession among nurse in Ethiopia, all the necessary data was extracted by using a standardized data extraction format. We analyzed the data by using Stata 17 statistical software. Heterogeneity between the primary studies was assessed by I-square tests. A random-effect model was applied to estimate the pooled intention of nurses to continue within the nursing profession.

RESULT: We included a total of 12 full-text studies in our analysis. The findings of this meta-analysis revealed that the pooled prevalence of nurses’ intention to stay in nursing profession among Ethiopian nurses was 45.57% (95% CI; 38.43, 52.72). The subgroup analysis data revealed that the highest pooled prevalence of intention to stay was reported in the Tigray region which is 56.1% (95% CI 52.24, 59.96). In contrast the lowest prevalence was documented in Addis Ababa city administration which was 19.4% (95% CI 15.56, 23.24). Factors such as job satisfaction (OR = 2.69, 95% CI = 1.11 – 6.53), professional development (OR = 2.49, 95%CI = 1.27- 4.9), level of education (OR = 2.7, 95% CI = 1.92-3.8), payment and benefit (OR = 1.9, 95%CI = 1.15- 3.19) all were the significant determinants of nurses’ intention to continue in the nursing profession.

CONCLUSION: The results of our investigation suggested that the degree of intention to continue in the nursing profession among Ethiopian nurses was inadequate. The nurses’ intention to depart from the nursing profession is an alarming. Therefore, it’s imperative for healthcare policymakers and stakeholders to prioritize on retention strategies encompassing job satisfaction, recognition, incentives, career opportunities, professional support, and autonomy were necessary.

PMID:39901229 | DOI:10.1186/s12912-025-02775-w