Tag: nevin manimala

BMC Pregnancy Childbirth. 2025 Feb 19;25(1):185. doi: 10.1186/s12884-024-07026-5.

ABSTRACT

INTRODUCTION: Short inter-birth intervals negatively impact maternal and child health; however, data on their prevalence and associated factors in Tanzania are limited. This study investigates the prevalence of short inter-birth intervals and the associated factors among women of reproductive age in Tanzania.

METHODS: This was a cross-sectional study utilizing the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey dataset. The study population included women aged 15-49 years with at least two births within five years preceding the survey. A short inter-birth interval was defined as a birth occurring < 33 months after the preceding birth. A generalized linear model with Poisson as a link and robust standard errors was used to examine factors associated with short inter-birth intervals. A p-value < 0.05 was considered statistically significant.

RESULTS: A total of 8,350 births from 6,034 women were included in this analysis. The mean (± SD) age of the women was 31.6 ± 6.8 years. The overall prevalence of short inter-birth intervals was 42.6%. Younger age (aPR 3.12, 95% CI 2.88-3.52 for age 15-24 years, and aPR 1.74, 95% CI 1.62-1.1.86 for age 25-34 years), being married (aPR 1.27, 95% CI 1.03-1.57), late age at first childbirth (aPR 1.24, 95% CI 1.17-1.32) for a 20-24 years and aPR 1.55, 95% CI 1.39-1.73 for ≥ 25 years), and higher birth order (aPR 1.02, 95% CI 1.03-1.19; aPR 1.24, 95% CI 1.14-1.34; aPR 1.72, 95% CI 1.58-1.86 for 3rd, 4th, and 5th or more birth orders, respectively, compared to 2nd birth order) were independently associated with short inter-birth intervals. Additionally, there was significant variation in the prevalence of short inter-birth intervals across different zones and levels of household wealth. Women from richer (aPR 0.87, 95% CI: 0.80-0.95) and richest (aPR 0.84, 95% CI: 0.74-0.94) households exhibited a lower prevalence of short inter-birth intervals.

CONCLUSION: This study highlights the significant prevalence of short inter-birth intervals among women of reproductive age in Tanzania. The associated factors include younger age, marital status, delayed first childbirth, higher birth order, geographical disparities, and lower household wealth. These findings highlight the need for targeted interventions to promote birth spacing and improve maternal and child health outcomes.

PMID:39972442 | DOI:10.1186/s12884-024-07026-5

BMC Ophthalmol. 2025 Feb 19;25(1):81. doi: 10.1186/s12886-025-03919-x.

ABSTRACT

BACKGROUND: Digital eyestrain (DES) is a collection of ocular and vision symptoms caused by prolonged use of digital devices that can greatly impact schoolchildren’s daily activities and learning. The main purpose of this study is to assess the prevalence of DES among schoolchildren and the associated risk factors in Palestine.

METHODS: From the 1st of April 2024 to the 30th of May 2024, a total of 492 school children who met the criteria for DES screening in the selected schools were included in the study. A quantitative, cross-sectional design was utilized with a self-structured questionnaire. The sample consisted of schoolchildren aged 11 to 18 years. The questionnaire is structured into three sections: (1) Sociodemographic information, (2) Information regarding the digital device used, and (3) DES assessment by using the Computer Vision Syndrome Questionnaire, and the visual acuity was measured using the Snellen chart. The data was analyzed using SPSS version 25 with a 95% CI.

RESULTS: The study analysis showed that 44.1% of school children experience DES. Snellen chart test analysis showed that 28.25% of students had results exceeding a score of six for either the right or left eye. For both eyes combined, (14.63%) of students had examination results greater than six. After conducting univariate analysis, statistically significant risk factors (p-value less than 0.05) affecting the development of DES in our study were posture, smartphone use at bedtime, and duration of device use, watching movies, social networking, and screen brightness. Moreover, females, older students, and those using devices closer than 30 cm or owning multiple devices reported higher eyestrain scores.

CONCLUSIONS: The current research found that Palestinian school children significantly experience eyestrain, indicating the influence of digital devices on eye health. The study results emphasize the need for early detection to prevent future eye health complications.

PMID:39972437 | DOI:10.1186/s12886-025-03919-x

BMC Psychiatry. 2025 Feb 19;25(1):156. doi: 10.1186/s12888-025-06599-5.

ABSTRACT

INTRODUCTION: Depression and anxiety are prevalent psychological disorders that significantly affect physical, emotional, and social well-being, reducing quality of life and increasing medical costs. These issues are especially challenging for cancer survivors, complicating treatment management, affecting adherence, and potentially impacting survival rates. Thus, this umbrella review aimed to evaluate the global prevalence of pain, depression, and anxiety, as well as their determinants among cancer patients.

METHOD: An exhaustive umbrella review was conducted to systematically assess the prevalence and determinants of pain, depression, and anxiety among cancer survivors worldwide by analyzing systematic reviews and meta-analyses. The review involved a thorough search of multiple databases and included studies published in English up to July 2024 that reported on these symptoms. The process involved screening and selecting studies based on specific criteria, assessing the risk of bias using the AMSTAR tool, and analyzing data with statistical methods to determine overall prevalence and identify predictors. This comprehensive approach aimed to provide a detailed understanding of these psychological issues in cancer survivors and guide future research and interventions.

RESULT: The global summary prevalence of depression among cancer survivors was 33.16% (95% CI 27.59-38.74), while anxiety had a prevalence of 30.55% (95% CI 24.04-37.06). Pain prevalence after treatment was 39.77% (95% CI 31.84-47.70). Before treatment, 65.22% (95% CI 62.86-67.57) of cancer patients reported pain, which persisted in 51.34% (95% CI 40.01-62.67) during treatment. The analysis also found that during the COVID-19 pandemic, depression and anxiety rates among cancer patients were at their highest, with prevalences of 43.25% (95% CI 41.25-45.26) and 52.93% (95% CI 50.91-54.96), respectively.

CONCLUSION: The umbrella review found that depression and anxiety prevalence among cancer survivors was 33.16% and 30.55%, respectively, with significantly higher rates during COVID-19 at 43.25% and 52.93%. Key factors contributing to depression included poor social support, advanced cancer stage, and inadequate sleep, while anxiety was significantly linked to advanced cancer stage and poor sleep quality.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:39972435 | DOI:10.1186/s12888-025-06599-5

BMC Gastroenterol. 2025 Feb 19;25(1):93. doi: 10.1186/s12876-025-03684-7.

ABSTRACT

BACKGROUND: Gastrointestinal bleeding is a significant cause of morbidity and mortality among emergency unit patients. Several scoring systems are verified for predicting hospitalization and mortality such as Glasgow Blatchford Bleeding Score (GBS), AIMS65 score, Rockall score (RS), and International Bleeding Risk Score (INBS; ABC score). The aim of this study is to evaluate the efficacy and predictive value of these scoring systems.

METHODS: Adult emergency unit patients with gastrointestinal bleeding were retrospectively enrolled. The age, gender, complaints at admission, vitals and examination results, laboratory findings, outcomes, blood transfusion status, and endoscopic interventions were all reported, and GBS, AIMS65, RS, and INBS (ABC) scores were calculated individually for all enrollies.

RESULTS: A total of 311 patients were included. The median age of participants was 70 years (IQR (25-75%): 59-81), and 202 (65%) of them were male. The efficacy of all four scoring systems (GBS, AIMS65, RS, and INBS (ABC)) in predicting hospitalization, need of blood transfusion, determination of high- and low-risk patients, and mortality was found to be statistically significant (p < 0.05 for all). ROC-AUC analysis was revealed that while GBS is the most beneficial in predicting hospitalization, INBS (ABC) has the best predictive value on mortality. Besides, the only scoring model with predictive value in determining the need for endoscopic intervention was RS (p < 0.05).

CONCLUSION: The present study showed that, among adult emergency unit patients with gastrointestinal bleeding, GBS, AIMS65, RS, and INBS (ABC) scores could successfully predict hospitalization, need of blood transfusion, determination of high- and low-risk patients, and mortality. However, the only scoring system that could be used to determine the need of endoscopic intervention is RS. Finally, we believe further studies with prospective enrollment would be beneficial for more accurate conclusions.

PMID:39972434 | DOI:10.1186/s12876-025-03684-7

BMC Public Health. 2025 Feb 19;25(1):679. doi: 10.1186/s12889-025-21850-0.

ABSTRACT

Acrylamide (AA) is a ubiquitous neurotoxic contaminant. Our objectives were to evaluate associations of internal AA exposure with sleep health outcomes. Data from 2753 adults aged 20-79 years in the National Health and Nutrition Examination Survey (NHANES) was utilized. Internal AA exposure was assessed using hemoglobin adducts and urinary biomarkers. Short sleep duration (SSD) and self-reported trouble sleeping were employed as indicators of sleep health. Markers of systemic inflammation were calculated. Each one-unit increase in ln-transformed hemoglobin adducts of acrylamide (HbAA), hemoglobin adducts of glycidamide (HbGA) and HbAA + HbGA and creatinine-adjusted urinary N-Acetyl-S-(2-carbamoylethyl)-L-cysteine concentration was statistically significantly associated with 1.37-fold (95% confidence interval [CI]: 1.16, 1.62; p = 0.002), 1.41-fold (95%CI: 1.19, 1.68; p = 0.002), 1.43-fold (95%CI: 1.19, 1.70; p = 0.001), and 1.24-fold (95%CI: 1.08, 1.42; p = 0.007) risk in SSD, respectively. The significant associations were strengthened in smokers after stratification by smoking status. Higher AA hemoglobin biomarkers predicted increases in markers of systemic inflammation. In conclusion, internal AA exposure was associated with an increased risk of SSD and elevated systemic inflammation among United States adults. The findings shed light on the potential effects of AA’s health threat and future research is warranted to develop intervention strategies.

PMID:39972427 | DOI:10.1186/s12889-025-21850-0

BMC Psychiatry. 2025 Feb 19;25(1):146. doi: 10.1186/s12888-025-06567-z.

ABSTRACT

BACKGROUND: Obsessive-compulsive symptoms are mental health conditions marked by the presence of obsessions and/or compulsions. Even though significant portion people with schizophrenia are reportedly affected by obsessive-compulsive symptoms, there is scarce of information related to this topic in Africa, and particularly in study area.

OBJECTIVE: This study aimed to assess the magnitude and associated factors of obsessive‒compulsive symptoms among people with schizophrenia attending services at referral hospitals in Eastern Ethiopia from February 15 to March 15, 2024.

METHODS: An institutional-based, cross-sectional study was conducted among adults with schizophrenia. Systematic sampling was used to select 422 study participants. The Yale-Brown Obsessive-Compulsive Scale was used to assess obsessive-compulsive symptoms. Data entry and analysis were performed by EpiData 4.6 and STATA 14, respectively. Bivariable and multivariable logistic regression were performed, and variables with p values < 0.05 were considered statistically significant.

RESULTS: The proportion with obsessive‒compulsive symptoms in this study was 44.07% (95% CI, 39.33%-48.92%). After adjusting for possible confounders, duration of schizophrenia from 3-4 years (AOR = 3.41; 95% CI, 1.28-9.05), duration of schizophrenia 5 years and above (AOR = 6.08; 95% CI, 2.26-16.31), current use of alcohol (AOR = 2.12; 95% CI, 1.09-4.12), current use of khat (AOR = 6.09; 95% CI, 3.15-11.74), being a probable case of anxiety (AOR = 3.57; 95% CI, 1.95-6.53), being a probable case of depression (AOR = 4.56; 95% CI, 2.39-8.66), being on Risperidone (AOR = 5.08; 95% CI, 2.52-10.23) and being on Olanzapine (AOR = 5.95; 95% CI, 2.72-13.04) were significantly associated with obsessive‒compulsive symptoms. CONCLUSIONS AND RECOMMENDATION: The prevalence of obsessive‒compulsive symptoms was relatively high. Timely detection and appropriate interventions are crucial and special consideration is better to be given for those with comorbid substance use, comorbid anxiety and depression, as well as those taking second-generation antipsychotics.

PMID:39972414 | DOI:10.1186/s12888-025-06567-z

Clin Transl Sci. 2025 Feb;18(2):e70117. doi: 10.1111/cts.70117.

ABSTRACT

There has been a growing trend that activities relating to clinical trials take place at locations other than traditional trial sites (hence decentralized clinical trials or DCTs), some of which are at settings of real-world clinical practice. Although there are numerous benefits of DCTs, this also brings some implications on a number of issues relating to the design, conduct, and analysis of DCTs. The Real-World Evidence Scientific Working Group of the American Statistical Association Biopharmaceutical Section has been reviewing the field of DCTs and provides in this paper considerations for decentralized trials from a statistical perspective. This paper first discusses selected critical decentralized elements that may have statistical implications on the trial and then summarizes regulatory guidance, framework, and initiatives on DCTs. More discussions are presented by focusing on the design (including construction of estimand), implementation, statistical analysis plan (including missing data handling), and reporting of safety events. Some additional considerations (e.g., ethical considerations, technology infrastructure, study oversight, data security and privacy, and regulatory compliance) are also briefly discussed. This paper is intended to provide statistical considerations for decentralized trials of medical products to support regulatory decision-making.

PMID:39972404 | DOI:10.1111/cts.70117

Diabetes Obes Metab. 2025 Feb 19. doi: 10.1111/dom.16272. Online ahead of print.

ABSTRACT

AIMS: To determine the impact of body roundness index (BRI) on the 10-year risk of cardiovascular disease (CVD) and all-cause mortality in Chinese adults.

MATERIALS AND METHODS: We utilized data from a nationwide prospective cohort of 165 785 Chinese adults (aged ≥40 years, free of CVD and cancer at baseline), which was extracted from the China Cardiometabolic Disease and Cancer Cohort (4C). Cox regression and restricted cubic splines quantified BRI-outcome associations and identified optimal BRI cutoffs.

RESULTS: During a median follow-up of 10.1 years, we documented 10 538 CVD events and 8679 deaths. A monotonic increasing dose-response association was observed between BRI and CVD risk, while BRI and all-cause mortality exhibited a U-shaped relationship (p for non-linear <0.001), with the nadir at a BRI of 3.9. Gender differences indicated that increased CVD risk was associated with higher BRI in men. As age increases, the excess risk of CVD and mortality associated with BRI diminishes, with a significant harmful effect of low BRI observed on mortality in individuals aged ≥75 years. Moreover, the inclusion of BRI in the model significantly enhanced the C-statistic for CVD prediction by 0.00412 (p <0.001) and for mortality prediction by 0.00045 (p = 0.0097).

CONCLUSIONS: Our findings indicate a positive association between BRI and CVD and a U-shaped association between BRI and mortality. These findings underscore the importance of the BRI in assessing the risk of CVD and all-cause mortality, particularly when considering different genders and age groups.

PMID:39972403 | DOI:10.1111/dom.16272

Acta Neuropathol Commun. 2025 Feb 19;13(1):34. doi: 10.1186/s40478-025-01939-8.

ABSTRACT

BACKGROUND: Tumor-infiltrating lymphocytes (TILs) and tumor-associated macrophages (TAMs) have increasingly been reported to impact the brain metastatic process of solid tumors. However, data on intra-individual differences between primary tumor and brain metastasis (BM), as well as their correlation with clinical outcome parameters, is scarce.

METHODS: We retrospectively identified patients who received resection of the primary tumor and BM between 01/1990 and 10/2022. Density quantification of TAMs (CD68⁺, CD163⁺) and TILs (CD3⁺, CD8⁺, CD45RO⁺, FOXP3⁺) was performed by immunohistochemical staining of matched tumor tissue samples. Images were processed with QuPath software and heterogeneity of generated heatmaps was measured by Shannon Entropy. Time-to-BM (TTBM) was defined as the time from diagnosis of the primary tumor until the first diagnosis of BM.

RESULTS: In total, 104 patients (46.2% female; median age 57.3 years at BM diagnosis) were included: 78/104 (75%) non-small cell lung cancer, 18/104 (17%) breast cancer, 8/104 (8%) renal cell carcinomas. Densities of CD3⁺ (p < 0.001) and CD8⁺-TILs (p < 0.001) were higher in primary tumor samples, while CD68⁺ (p = 0.035) and CD163⁺-TAM densities (p < 0.001) were higher in the matched BM. Higher CD3⁺, CD8⁺-TILs and CD163⁺-TAMs densities in primary tumors were associated with shorter TTBM (p = 0.005, p = 0.015 and p = 0.006, respectively). Higher entropies of CD3⁺ (p < 0.001) and FOXP3⁺ (p = 0.011) TILs were observed in primary tumors compared to BM. Longer TTBM was associated with higher entropy of FOXP3⁺ TILs (p = 0.024) and lower entropy in CD163⁺ TAMs (p = 0.039). No significant associations of immune cell densities or entropies with OS after BM diagnosis were found.

DISCUSSION: By utilizing a unique cohort of matched primary tumor and BM tissue samples, we could demonstrate higher TIL densities in primary tumors and higher TAM densities in BM, respectively. Higher cell densities of CD3⁺, CD8⁺-TILs and CD163⁺-TAMs in primary tumors were associated with shorter TTBM, while a larger difference between CD3⁺ and CD8⁺ densities between primary tumor and BM was associated with longer TTBM. These findings highlight the potential of targeting TAMs as a therapeutic strategy to mitigate the development of brain metastases.

PMID:39972401 | DOI:10.1186/s40478-025-01939-8

BMC Psychol. 2025 Feb 19;13(1):140. doi: 10.1186/s40359-025-02423-7.

ABSTRACT

BACKGROUND: Facial attractiveness, influenced by dental esthetics, impacts self-perception and social interactions. The rise of social media has further fueled the demand for cosmetic dental treatments. This study aimed to examine the influence of self-esteem on the inclination of dentists, dental students, and laypeople toward esthetic dental treatments.

METHODS: This cross-sectional study involved 410 participants, including dentists, dental students, and laypeople, selected through convenience sampling. Data were collected using a questionnaire that captured sociodemographic characteristics, oral hygiene status, previous experience with esthetic treatments, inclinations toward esthetic dental treatments, and self-esteem levels using the Rosenberg Self-Esteem Scale (RSES). The questionnaire, created on the Porsline© website, was distributed via social media platforms. Data were analyzed using SPSS version 21, employing the Chi-square test and logistic regression, with a p-value of less than 0.05 considered statistically significant.

RESULTS: The RSES showed that 16.3% of participants had low self-esteem, while 83.7% had high self-esteem. Among participants with previous cosmetic procedures, 84.3% expressed interest in pursuing additional treatments compared to 47.7% of those without such experience (P < 0.01). Among dental professionals, 38.3% of high and 37.5% of low self-esteem individuals expressed interest in cosmetic treatments (P = 0.42), while among laypeople, 66.6% of high and 82.2% of low self-esteem individuals indicated interest (P = 0.04). Regardless of profession, 66.7% of individuals with low self-esteem and 55.4% of those with high self-esteem expressed interest in esthetic treatments (P = 0.08). RSES scores varied significantly across age groups, with participants aged > 45 years showing the highest scores (P = 0.03). Regression analysis indicated that laypeople were more likely to seek esthetic dental treatments than dentists or dental students (OR = 3.02, 95% CI = 1.88-4.83). Participants with a history of esthetic dental treatments were also more likely to pursue further procedures (OR = 5.39, 95% CI = 2.97-9.77).

CONCLUSIONS: Self-esteem significantly correlates with laypeople’s inclination toward cosmetic dental treatments. Dentists and dental students tend to express less interest in such procedures, likely due to their understanding of potential long-term complications. Additionally, individuals with prior experience in esthetic dental treatments showed greater interest in pursuing further treatments.

PMID:39972400 | DOI:10.1186/s40359-025-02423-7