Tag: nevin manimala

BMC Public Health. 2025 Feb 2;25(1):419. doi: 10.1186/s12889-025-21559-0.

ABSTRACT

BACKGROUND: Despite the relatively high prevalence of Sickle cell trait (SCT) in Nigeria, there has been little research into the correlates of having children with SCT among Nigerian mothers, particularly in terms of socio-demographic differentials. This study aims to investigate the maternal socio-demographic correlates of having under-five children with SCT in Nigeria.

METHOD: Data from the 2018 Nigeria Demographic and Health Survey (Household Person Recode and Children Recode) were merged. Mothers with at least one under-five child whose genotype was known (n = 7,493) served as the unit of analysis. Three forms of outcome variable were explored. First was the number of children with SCT by each mother. Second, the number of children with SCT was categorized as zero, one, two or more. Lastly, each mother was categorized as either having no child(ren) with SCT or having at least one child with SCT. Subsequently, we assessed multilevel Poisson, ordinal and binary logit models to identify the best fitting model using Akaike and Bayesian Information Criterion. Multilevel binary logistic regression model was identified as best fit used to identify factors associated with having children with SCT. Adjusted Odds Ratio with 95% Confidence Interval (CI) were reported as measures of association.

RESULT: Nearly 62% of the mothers lived in rural areas, 38.2% had no formal education and 37.4% had ever given birth to at least five children. About 26.1% (95% CI = 25.2-26.9) of the mothers had children with SCT. By geographical variation, the Northwest region had the highest proportion of mothers of under-five children with SCT. Results from the multilevel binary logistic regression revealed that women who were traditionalists (AOR = 1.77; 95% CI = 1.04-3.02) were more likely of having children with SCT.

CONCLUSION: Though SCT is a genetic outcome, findings from this study suggest that important socio-demographic factors such as religion, and region of residence are significantly associated with having children with SCT in Nigeria. Sustained efforts on awareness campaigns on SCT are recommended.

PMID:39894815 | DOI:10.1186/s12889-025-21559-0

Light Sci Appl. 2025 Feb 2;14(1):66. doi: 10.1038/s41377-024-01736-3.

ABSTRACT

Harmonic mode-locking, realized actively or passively, is an effective technique for increasing the repetition rate of ultrafast lasers. It is critically important to understand how a harmonically mode-locked pulse train responds to external perturbations and noise, so as to make sure that it is stable and resistant to noise. Here, in a series of carefully designed experiments, we elucidate the retiming dynamics of laser pulses generated in a soliton fiber laser harmonically mode-locked at GHz frequencies to the acoustic resonance in a photonic crystal fiber (PCF) core. We characterize the self-driven optomechanical lattice, which is distributed along the PCF and provides the structure that supports harmonic mode-locking, using a homodyne setup. We reveal that, after an abrupt perturbation, each soliton in the lattice undergoes damped oscillatory retiming within its trapping potential, while the retiming is strongly coupled to soliton dissipation. In addition, we show, through statistical analysis of the intra-cavity pulse spacing, how the trapping potentials are effective for suppressing timing jitter. The measurements and the theory developed in this work lay the groundwork for studies of the general stability and noise performance of harmonically mode-locked lasers as well as providing valuable insight into generic multi-pulse phenomena in mode-locked lasers.

PMID:39894811 | DOI:10.1038/s41377-024-01736-3

BMC Public Health. 2025 Feb 2;25(1):420. doi: 10.1186/s12889-025-21479-z.

ABSTRACT

BACKGROUND: Existing studies have indicated the potential role of non-invasive physical health indicators as an early detector of mild cognitive impairment (MCI) in older adults. However, evidence is lacking in determining the appropriate physical health indicators for early screening of cognitive decline in each domain. Therefore, the current study aimed to establish a comprehensive physical health indicators profile in association with cognitive performance.

METHODS: The present study utilized a three-year longitudinal cohort design, with data from the China Health and Retirement Longitudinal Study (CHARLS). 4,869 participants aged 60-97 years from CHARLS wave 2015 and 2018 who were cognitively and physically healthy were included in analysis. Physical functions (BMI, grip strength, blood pressure, balance tests, course walking time, repeated chair stands, and pulmonary function) were objectively measured by physical tasks. Cognitive performance domains (general cognition, episodic memory, executive function, verbal fluency, orientation, and language-and-praxis) were measured through standardised interviews and cognitive tasks. Multiple linear regression models were conducted to explore the association between physical health indicators and cognitive performance. Subgroup analysis was conducted to identify sex-specific factors.

RESULTS: Pulmonary function was identified as associated with all domains of cognitive performance in older adults (β ranged between 0.05 and 0.08). Right grip strength was also identified as an important factor associated with all cognitive domains except general cognition (β ranged between 0.04 and 0.12). Subgroup analysis revealed that the association between physical health indicators and cognitive performance is more pronounced in males than in females.

CONCLUSIONS: A profile of non-invasive physical health indicators associated with cognitive performance was established, which warrants future incorporation of non-invasive physical health indicators in early risk screening systems for MCI, enabling timely intervention and prevention in older adults. Future studies can delve deeper into the mechanisms underlying this full-dimensional relationship between physical and cognitive domains.

PMID:39894807 | DOI:10.1186/s12889-025-21479-z

Isr J Health Policy Res. 2025 Feb 3;14(1):7. doi: 10.1186/s13584-024-00663-3.

ABSTRACT

BACKGROUND: Israel is a multiethnic society with a population of 9.8 million at the end of 2023. Israeli Arabs (i.e., Arab Palestinian citizens of Israel) account for 21% of the Israel’s overall population, 22% of its working age population and 16% of the employed population. This study has several objectives: (1) To provide an overview of the current representation of Israeli Arabs in four key health care professions (medicine, nursing, dentistry, and pharmacy) in terms of employment, licensure, and professional studies; (2) To document changes in those parameters over the past decade, subject to limitations of data availability; (3) To provide a broader context on the employment of Israeli Arabs; (4) To explore the policy implications of the key findings.

METHODS: Estimates of employment levels are based on the Labor Force Survey (LFS) of the Central Bureau of Statistics (CBS). Data on licensure (i.e., professional qualification) and place of professional studies were extracted from the Ministry of Health report series entitled “The Health Care Professions”. Data on enrollment in degree programs in Israel was provided by the Council of Higher Education. Important background information was elicited from relevant policy documents and policy experts.

RESULTS: In 2023, among employed Israelis up to age 67, Arabs constituted approximately one-quarter of Israel’s physicians (25%), nurses (27%), and dentists (27%), and half of Israel’s pharmacists (49%). These percentages are substantially higher than they were in 2010, with the increase being particularly marked in the case of physicians (25% versus 8%). The number of new licenses granted annually increased significantly between 2010 and 2022 for both Arabs and Jews in each of the professions covered. The percentage of newly licensed professionals who are Arab increased substantially among physicians and nurses, while remaining stable among dentists and pharmacists. In medicine, dentistry, and pharmacy, many of the licensed Arab health professionals had studied outside of Israel; this phenomenon also exists for nursing but is less widespread there. In the 2022/3 academic year, the percentage of first-degree students in Israeli colleges and universities who were Arab was 70% in pharmacy, 33% in nursing, 23% in dentistry, and 9% in medicine. Between 2012/3 and 2022/3 the percentage of first-degree students who are Arab increased substantially for pharmacy, declined slightly for nursing, and declined substantially for medicine and dentistry.

CONCLUSIONS: Arab professionals play a substantial and recently increased role in the provision of health care services in Israel. It is important to recognize, appreciate, and maintain this substantial role. Moreover, its potential as a model for sectors other than health care should be explored. To build on achievements to date, and to promote continued progress, policymakers should expand access to health professional education within Israel, upgrade the skills of graduates of non-Israeli universities, promote diversity in leadership positions and key specialties, and expand specialty care services in Arab localities.

PMID:39894798 | DOI:10.1186/s13584-024-00663-3

Eur J Med Res. 2025 Feb 3;30(1):65. doi: 10.1186/s40001-025-02300-4.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is defined by a sharp decrease in the estimated glomerular filtration rate (eGFR). However, the impact of medication history on the survival of AKI patients has received little attention. Hence, it is necessary to investigate the potential of medication history as a predictor of survival outcomes among AKI patients in the intensive care unit (ICU).

METHODS: Critically ill AKI patients were sourced from the MIMIC-IV database. To ascertain significant, drug-related, independent predictors of survival, univariate Cox analysis and stepwise Cox regression were performed. Based on the identified predictor, a nomogram was developed to estimate the individualized survival probability for AKI patients. Additionally, to address potential confounders among patients with medications referenced in the nomogram, a propensity score matching procedure was applied. Ultimately, a comparative analysis was performed to elucidate the prognostic disparities among these patient subgroups.

RESULTS: This study enrolled 1,208 patients and developed a nomogram incorporating oxygen flow rate, respiratory frequency, continuous venovenous hemodiafiltration status, age, and medication use (including ibuprofen, epinephrine, cefazolin, warfarin, and vasopressin). The predictive model demonstrated diagnostic accuracy, with AUC values for 1-year, 3-year, and 5-year survival among AKI patients of 0.827, 0.799, and 0.777 in the training dataset, and 0.760, 0.743, and 0.740 in the internal validation dataset, respectively. Kaplan-Meier survival analyses revealed significant differences in survival outcomes among AKI patients based on their exposure to different medications.

CONCLUSIONS: In summary, the developed prediction model demonstrated accuracy for AKI patients in the ICU and helped clinical decision-making. However, future studies will require external validation to confirm these findings.

PMID:39894797 | DOI:10.1186/s40001-025-02300-4

Am Surg. 2025 Feb 2:31348251318392. doi: 10.1177/00031348251318392. Online ahead of print.

ABSTRACT

While there is agreement on the indications for intracranial pressure monitoring (ICPm) in patients with sTBI, there continues to be controversy concerning the ideal timing of its implementation. It is within this context that we decided to investigate whether a protocolization approach could optimize the timeliness of ICPm implementation. Neurosurgical and SICU providers agreed to a 3-tier protocol to identify patients with sTBI who could benefit from timelier ICPm implementation. The monthly compliance was monitored for a 9-month period. The study included a pre-protocolization group of 11 patients (2022) and a post-protocolization group of 9 patients (2023-2024). There was a trend toward earlier use of ICPm but the difference did not achieve statistical significance; there was no difference in the mortality rates between groups. A protocolization approach to the treatment of patients with sTBI developed with a consensus strategy may lead to earlier implementation of ICPm and possibly improved functional outcome.

PMID:39894784 | DOI:10.1177/00031348251318392

Expert Opin Drug Saf. 2025 Feb 2. doi: 10.1080/14740338.2025.2461197. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to describe the pulmonary toxicity of cyclin-dependent kinase 4/6 inhibitors (CDK 4/6 inhibitors) (palbociclib, ribociclib, and abemaciclib) in patients being treated for breast cancer using the Food and Drug Administration Adverse Event Reporting System (FAERS) database.

RESEARCH DESIGN AND METHODS: Disproportionality analysis was performed to assess pulmonary toxicity associated with CDK 4/6 inhibitors. Clinical characteristics, onset time, sensitivity analysis, subgroup analyses, drug combinations, comorbidities, and co-reported events were performed.

RESULTS: Out of 83,505 CDK 4/6 inhibitor-related adverse events (AEs) documented in the FAERS database during the study period, 437 cases of pneumonitis, 555 cases of pulmonary edema, and 181 cases of pulmonary thrombosis related to CDK 4/6 inhibitors were analyzed. Pneumonitis and pulmonary thrombosis had the strongest signal strength in abemaciclib, pulmonary edema had the strongest signal strength in ribociclib. The median latency for pneumonitis, pulmonary edema, and pulmonary thrombosis was 66-173.5 days 27-131 days, and 68-279 days), respectively. Pulmonary toxicity is statistically significant disproportionality in females as well as in patients over 60 years old.

CONCLUSION: Abemaciclib was most strongly associated with pneumonitis and pulmonary thrombosis. Ribociclib was most strongly associated with pulmonary edema. The correlation with pulmonary toxicity was, in descending order, abemaciclib, ribociclib, and palbociclib.

PMID:39894782 | DOI:10.1080/14740338.2025.2461197

J Infect Public Health. 2025 Jan 21;18(4):102677. doi: 10.1016/j.jiph.2025.102677. Online ahead of print.

ABSTRACT

BACKGROUND: Care retention and medication adherence are crucial for individuals living with human immunodeficiency virus (HIV). Discrepancies exist between real-world evidence and randomized trials regarding early antiretroviral therapy (ART) initiation and care retention. We investigated the effects of same-day ART initiation on care and medication discontinuation in new patients with acquired immunodeficiency syndrome (AIDS) and those newly infected with HIV.

METHODS: The two groups commenced ART from January 2017 to December 2021 in Taiwan. Data were collected from the National Health Insurance claims database. We defined care discontinuation as having no clinical visits for over 90 days since the last clinical visit and medication discontinuation as failing to pick up medication 30 days after the expected medication pick-up date. We used a doubly robust weighted Cox regression model to estimate the average hazard ratio for same-day ART initiation compared to rapid ART initiation within 7 days over a 12-month care- and medication-discontinuation risk horizon.

RESULTS: Among the 1528 HIV- and 5373 AIDS-group individuals, 1329 and 4494 initiated same-day ART, respectively. Same-day ART initiation did not impact care or medication discontinuation among HIV-infected patients. However, it was associated with a significantly lower hazard of care discontinuation (adjusted average hazard ratio [aAHR] = 0.86, 95 % CI: 0.74-0.99) and a higher, though not significant, hazard of medication discontinuation (aAHR = 1.14, 95 % CI: 0.86-1.52) among patients with AIDS.

CONCLUSION: Same-day ART initiation demonstrates varying impacts on care and medication continuation. While it improves care retention, caution is advised regarding medication discontinuation among patients with AIDS.

PMID:39893713 | DOI:10.1016/j.jiph.2025.102677

Clin Nutr. 2025 Jan 28;46:117-118. doi: 10.1016/j.clnu.2025.01.027. Online ahead of print.

NO ABSTRACT

PMID:39893704 | DOI:10.1016/j.clnu.2025.01.027