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Nevin Manimala Statistics

Neonatal resuscitation skills acquisition among healthcare providers after Helping Babies Breathe simulation training using improved tools across two regions in Tanzania

Adv Simul (Lond). 2025 Mar 1;10(1):6. doi: 10.1186/s41077-025-00338-2.

ABSTRACT

INTRODUCTION: Neonatal mortality is high in middle- and low-income countries, including Tanzania. Most of these deaths are preventable and linked to suboptimal quality of care. In this study, we assessed neonatal resuscitation skills acquisition after a 1-day Helping Babies Breathe (HBB) simulation training using improved tools and associated factors among healthcare providers in 12 facilities in Tanzania.

METHODS: A cross-sectional study was conducted among healthcare providers working in the labor wards in selected health facilities. The training was conducted in situ using the HBB second edition curriculum with improved simulation tools (Neonatalie Live simulator, NeoBeat heart rate meter, and Upright resuscitator). After training, skills acquisition was evaluated using Objectively Structured Clinical Evaluation. Participants who scored an average of 75% or above were considered passing. Descriptive statistics were used to determine the proportion of staff who passed the evaluation by different demographic categories. One-way analysis of variance was used to compare mean scores among demographic categories. Factors associated with neonatal resuscitation skills acquisition were analyzed using modified Poisson regression.

RESULTS: A total of 481 participants were enrolled in the study. Among these, 420 (87.3%) passed the skills evaluation on the first attempt. The overall mean skills score was 92.4%. In bivariable analysis, health facility level, region, age, and experience working in the labor ward were associated with passing skills evaluation on the first attempt. However, after controlling other variables in a multivariable model, none of the factors showed a statistically significant association.

CONCLUSION: In-situ, HBB simulation training using improved training tools effectively imparts neonatal resuscitation skills among healthcare providers. Participants learned skills similarly regardless of their different demographic characteristics, including level of education and working experience. Due to its potential to impart skills, frequent simulation training using improved tools may be considered for scaling up in other health facilities.

PMID:40025598 | DOI:10.1186/s41077-025-00338-2

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Effect of herpes zoster vaccine on patients after hematopoietic stem cell transplantation: a systematic review and meta-analysis

Virol J. 2025 Mar 2;22(1):54. doi: 10.1186/s12985-025-02670-5.

ABSTRACT

BACKGROUND: Herpes zoster(HZ), a severe complication following hematopoietic stem cell transplantation (HSCT), is associated with significant morbidity. The effect of herpes zoster vaccine(HZV) for preventing HZ on patients after HSCT is unclear. We conducted a systematic review and meta-analysis investigating the efficacy and safety of HZV in HSCT recipients.

METHODS: The databases Pubmed, Embase, and Cochrane Library were searched to identify relevant studies. Random-effects models were used to calculate risk ratios (RRs) and 95% confidence intervals (CIs) for HZ infection and related events.

RESULTS: A total of 3048 individuals from five studies (four randomized controlled trials and one retrospective cohort study) were included. The overall incidence of HZ in the HZV group and control group was 6.4% and 18.3% respectively, resulting in a pooled RR of 0.36 (95%CI, 0.29-0.45; P < 0.001), indicating no heterogeneity (P = 0.88,I2 = 0). HZV demonstrated a reduction in the risk of PHN (RR, 0.40; 95% CI, 0.15-1.11), although statistical significance was not reached (P = 0.08). Furthermore, through two independent RCTs, HZV showed a decrease in the incidence of HZ-related complications compared to placebo administration. The overall incidence of adverse events in the HZV group and control group was found to be 63.6% and 60.2% respectively, with a pooled RR of 1.02 (95% CI, 0.97-1.06, P = 0.51), indicating no heterogeneity (P = 0.66, I2 = 0).

CONCLUSION: The HZV group demonstrated a significant reduction in the risk of HZ among HSCT recipients, without an increase in adverse events. This highlights the positive impact of HZV on decreasing the incidence of PHN and complications associated with HZ. Furthermore, our findings support the effectiveness and tolerability of HZV as a preventive measure against HZ for HSCT recipients.

PMID:40025586 | DOI:10.1186/s12985-025-02670-5

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Gender disparities in the association between atherogenic index of plasma and chronic kidney disease

BMC Public Health. 2025 Mar 1;25(1):825. doi: 10.1186/s12889-025-22087-7.

ABSTRACT

OBJECTIVE: This study investigates the relationship between the atherogenic index of plasma (AIP) and chronic kidney disease (CKD) occurrence in the general population, with a focus on potential gender disparities.

METHODS: The study included 22,952 adults from the National Health and Nutrition Examination Survey (NHANES). Various statistical models were employed to evaluate the association between AIP and CKD occurrence and explore gender-specific differences.

RESULTS: Adjusted for confounding factors, higher AIP levels showed a mild association with increased CKD risk in the general population. Specifically, individuals in the highest AIP quartile had a slightly elevated odds ratio (OR) for CKD compared to the lowest quartile (OR: 1.24, 95% CI: 1.02-1.52, P for trend = 0.023). Gender-stratified analysis revealed significant differences. Among males, higher AIP levels were significantly associated with CKD risk (OR: 1.49, 95% CI: 1.15-1.94, P for trend < 0.001), whereas in females, the association was weaker and statistically non-significant (P for trend = 0.055). U-shaped relationships between AIP and CKD were observed. Mediation analysis provided insights into potential pathways underlying this association. Among males, changes in uric acid accounted for 44.50% of CKD prevalence related to AIP, while glomerular filtration rate (eGFR), BMI, and bicarbonate levels contributed 44.09%, 17.55%, and 15.36%, respectively. Among females, uric acid changes accounted for 45.53%, while eGFR, bicarbonate, C-reactive protein (CRP), sodium, and potassium levels contributed 37.96%, 12.43%, 6.37%, 5.58%, and 3.14%, respectively.

CONCLUSION: Our findings suggest that elevated AIP levels may increase CKD risk, particularly among males in the general U.S.

PMID:40025582 | DOI:10.1186/s12889-025-22087-7

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A study on the relationship between high school students’ sleep quality, physical exercise, academic stress, and subjective well-being

BMC Psychol. 2025 Mar 1;13(1):180. doi: 10.1186/s40359-025-02497-3.

ABSTRACT

OBJECTIVE: This Research explores the intermediary function of academic stress and sleep quality in the connection between physical exercise and subjective well-being among high school students.

METHODS: This Research conducted an online survey through random sampling with a sample of 540 (males = 310, females = 217; grade 10 = 159, grade 11 = 190, grade 12 = 178) high school students to explore the intermediary function of academic stress and sleep quality between physical exercise and subjective well-being. The participants were surveyed using PSQI, the Subjective Well-Being Scale, the ESSA, and PSQI. SPSS Statistics 26 was used to conduct reliability and validity tests, descriptive statistics, and correlation analysis. Mediation analysis was conducted utilizing Model 6 from the PROCESS 4.0 plugin.

RESULTS: (1) Physical exercise shows a significant positive correlation with subjective well-being, and the direct impact of physical exercise on subjective well-being is also significant. (2) Physical exercise adversely affects academic stress and positively influences sleep quality. Academic stress negatively impacts sleep quality and subjective well-being, while sleep quality positively influences subjective well-being. (3) Academic stress and sleep quality serve as significant mediators between physical exercise and subjective well-being. The mediation effect encompasses two indirect paths: In one aspect, physical exercise has an indirect impact on subjective well-being through its influence on academic stress; in another aspect, physical exercise indirectly affects subjective well-being via the chain mediation effects of academic stress and sleep quality.

CONCLUSION: Physical exercise can directly influence the subjective well-being of high school students. Additionally, physical exercise can indirectly impact their subjective well-being through academic stress, and it can also indirectly influence their subjective well-being through the chain mediation effect of academic stress and sleep quality. Based on these findings, it is recommended that schools provide more opportunities for physical exercise, integrated with psychological counseling and sleep management, to help students effectively alleviate academic stress, thereby enhancing their overall well-being.

PMID:40025577 | DOI:10.1186/s40359-025-02497-3

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Identification of blood-derived exosomal tumor RNA signatures as noninvasive diagnostic biomarkers for multi-cancer: a multi-phase, multi-center study

Mol Cancer. 2025 Mar 1;24(1):60. doi: 10.1186/s12943-025-02271-4.

ABSTRACT

BACKGROUND: Cancer remains a leading global cause of mortality, making early detection crucial for improving survival outcomes. The study aims to develop a machine learning-enabled blood-derived exosomal RNA profiling platform for multi-cancer detection and localization.

METHODS: In this multi-phase, multi-center study, we analyzed RNA from exosomes derived from peripheral blood plasma in 818 participants across eight cancer types during the discovery phase. Machine learning techniques were applied to identify potential pan-cancer biomarkers. During the screening and model validation phases, the sample size was progressively expanded to 1,385 participants in two steps, while the candidate biomarkers were refined into a set of 12 exosomal tumor RNA signatures (ETR.sig). In the subsequent model construction phase, diagnostic models were developed using the expanded cohort and ETR.sig. Statistical analyses included the calculation of receiver operating characteristic (ROC) curves and AUC values to assess the models’ ability to distinguish cancer cases from controls and determine tumor origins. To further validate and explore the biological relevance of the identified biomarkers, we integrated tissue RNA-seq, single-cell data, and clinical information.

RESULTS: Machine learning analysis initially identified 33 candidate biomarkers, which were narrowed down to 20 ETR.sig in the screening phase and 12 ETR.sig in the validation phase. In the model construction phase, a diagnostic model based on ETR.sig, built using the Random Forest (RF) algorithm, showed excellent performance with an AUC of 0.915 for distinguishing pan-cancer from controls. The multi-class classification model also demonstrated strong classification power, with macro-average and micro-average AUCs of 0.983 and 0.985, respectively, for differentiating between eight cancer types. Additionally, tumor origin classification using the RF-based diagnostic models achieved high AUC values: BRCA 0.976, COAD 0.98, KIRC 0.947, LIHC 0.967, LUAD 0.853, OV 0.972, PAAD 0.977, and PRAD 0.898. Integration of tissue RNA-seq, single-cell data, and clinical information revealed key associations between ETR.sig-related genes and tumor development.

CONCLUSIONS: The study demonstrates the robust potential of exosomal RNA as a minimally invasive biomarker resource for cancer detection. The developed ETR.sig platform offers a promising tool for precision oncology and broad-spectrum cancer screening, integrating advanced computational models with nanoscale vesicle biology for accurate and rapid diagnosis.

PMID:40025576 | DOI:10.1186/s12943-025-02271-4

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Kata selection trends in top-level para-karate competitions: a multi-championship study

BMC Sports Sci Med Rehabil. 2025 Mar 1;17(1):33. doi: 10.1186/s13102-025-01081-x.

ABSTRACT

PURPOSE: Para-karate has been gaining popularity rapidly; however, scientific research on the subject remains limited. This study aims to examine the kata preferences at top-level para-karate events and explore the relationship between sport class (type of impairment) and kata selection.

METHODS: Data was collected from nine events-four World Para-Karate Championships (2016, 2018, 2021, 2023) and five European Para-Karate Championships (2018, 2019, 2021, 2022, 2023). A total of 906 katas were performed: 567 by males and 339 by females. Descriptive statistics and chi-square tests were used for analysis.

RESULTS: Top-level para-karate athletes utilized 62 katas (61%) from the official WKF list (102 katas). The most popular katas were Gojushiho Sho (19.9%), Unsu (11.5%), Kanku Sho (9.5%), Suparinpei (6.7%), and Jion (6.2%). A significant relationship was found between sport class and kata selection (p ≤ 0.05). The most popular kata for K30 was Unsu (15%), while K10 and K21 + K22 classes predominantly chose Gojushiho Sho (16.6% and 30.3%, respectively).

CONCLUSIONS: Kata selection for para-karate athletes is influenced by the type of impairment. Intellectually impaired athletes and their coaches often select a single, challenging kata with a balanced fast-to-slow movement ratio, such as Gojushiho Sho, to optimize performance.

PMID:40025570 | DOI:10.1186/s13102-025-01081-x

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Risk prediction model for surgical site infection in patients with gastrointestinal cancer: a systematic review and meta-analysis

World J Surg Oncol. 2025 Mar 1;23(1):72. doi: 10.1186/s12957-025-03726-0.

ABSTRACT

BACKGROUND: Currently, various risk prediction models for surgical site infection (SSI) in patients with gastrointestinal tumors have been developed, but comprehensive comparisons regarding the model construction process, performance, and data sample bias are lacking. This study conducts a systematic review of relevant research to evaluate the risk bias and clinical applicability of these models.

MATERIALS AND METHODS: The Web of Science, PubMed, Cochrane Library, Embase, CINAHL, CBM, CNKI, Wanfang, and VIP databases were searched for studies related to SSI prediction models in gastrointestinal cancer patients published up to August 19, 2024. Two researchers independently screened the literature, extracted the data, and evaluated the quality. A meta-analysis was conducted on the common predictive factors included in the model, using odds ratio (OR) values and 95% confidence interval (CI) as effect statistics. The Q test and heterogeneity index I2 were used to assess heterogeneity. All the statistical analyses were performed via Stata 16.0 software. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was submitted as a supplement.

RESULTS: A total of 28 articles were included, and 39 models were constructed. The area under the receiver operating characteristic curve (AUC) for the models ranged from 0.660 to 0.950, indicating good predictive performance. Eight studies conducted internal validation, eight studies conducted external validation, and two studies used a combination of internal and external validation for model evaluation. The overall risk of bias in the literature was high, but the applicability was good. The results of the meta-analysis revealed that factors such as underlying diseases, surgical factors, demographic factors, and laboratory-related indicators are the main predictors of surgical site infections in patients with gastrointestinal tumors.

CONCLUSIONS: Currently, risk prediction models for surgical site infections in patients with gastrointestinal cancer remain in the developmental phase, and there is a high risk of bias in the areas of study subjects, outcomes, and analysis. Researchers need to enhance research methodologies, conduct large-scale prospective studies, and refer to the reporting standards of the bias risk assessment tool for predictive models to construct predictive models with low bias risk and high applicability.

PMID:40025565 | DOI:10.1186/s12957-025-03726-0

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Influence of acidic solutions on surface roughness of polished and glazed CAD-CAM restorative materials

Head Face Med. 2025 Mar 1;21(1):16. doi: 10.1186/s13005-025-00486-w.

ABSTRACT

BACKGROUND: The purpose of this in vitro study was to compare the surface roughness (Ra) changes of different dental ceramic materials with different compositions, which were applied two different surface treatments after exposure to acidic pH. The purpose of this in vitro study was to compare the Ra changes of different CAD-CAM materials with different compositions, which were applied two different surface treatments, after exposure to acidic pH.

METHODS: A total of the 168 samples (12 × 14 × 2 mm) were obtained from ceramic blocks (IPS e.max CAD (LDS)), GC Cerasmart (RNC-C), Lava Ultimate (RNC-L), and Vita Enamic (PIC). Half of each group was subjected to mechanical polishing, and the other half was glazed. After the initial Ra evaluations were made, the samples classified with 7 in each subgroup were kept in three different solutions (citric acid, Coca-Cola, and artificial saliva-control group). After 168 h, surface roughness values of the specimens were measured again.

RESULTS: In the RNC-C samples, varying surface treatments and exposure to various solutions did not produce a statistically significant difference. Different acidic solutions did not affect the Ra values of LDS and RNC-C ceramics. The percentage change in Ra values in the glazed samples of PIC exposed to Coca-Cola and RNC-L exposed to artificial saliva were higher than those applied mechanical polishing.

CONCLUSION: The Ra values of RNC-C ceramics were not affected by both surface treatment and acid exposure. The percentage change in Ra values was highest in PIC ceramics. In general, glazed samples had larger Ra change values and higher percentage change in Ra values than manually polished ones.

PMID:40025563 | DOI:10.1186/s13005-025-00486-w

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Association between Capillaria hepatica infection-induced alterations in gut microbiota and estrogen expression in Brandt’s voles (Lasiopodomys brandtii)

BMC Vet Res. 2025 Mar 1;21(1):126. doi: 10.1186/s12917-025-04524-2.

ABSTRACT

BACKGROUND: Capillaria hepatica, a zoonotic parasite, is present in the population of Brandt’s voles (Lasiopodomys brandtii) and has been a central issue in ecological studies regarding its impact on host populations. Brandt’s voles are known for their extremely high reproductive capacity, and the population explosion of Brandt’s voles have occurred multiple times in the grasslands of Inner Mongolia over the past few decades. However, the mechanisms underlying the population dynamics of Brandt’s voles, particularly in response to C. hepatica infection, remain poorly understood. Given the critical role of the gut microbiota in modulating hormones within the reproductive endocrine system, this study aims to explore how alterations in the gut microbiota influence the host’s population dynamics in response to C. hepatica infection.

METHODS: Female Brandt’s voles were inoculated with eggs of infected C. hepatica, and BALB/C mice were used as a control. At the end of the experimental period, cecal contents were collected for 16 S rRNA amplicon sequencing, and the expression levels of reproductive-related hormones were determined using enzyme-linked immunosorbent assay (ELISA).

RESULTS: C. hepatica infection leads to an increased diversity of gut microbiota in Brandt’s voles, with significant changes in microbial composition. The relative abundance of Muribaculaceae and Eubacteriaceae increased significantly, while that of Rikenellaceae and Lachnospiraceae decreased significantly. The expression level of estradiol in the serum of infected Brandt’s voles shows a slight decrease without statistical significance. However, the expression of equol is significantly higher in the infected group compared to the uninfected group, and the expression of enterolactone is significantly lower in the infected group than in the uninfected group.

CONCLUSIONS: This study demonstrates that infection with C. hepatica indirectly affect the abundance of specific gut microbiota in Brandt’s voles, which are associated with reproductive hormones. This indirect effect on hormone expression can subsequently impact the reproductive function of the host. By investigating the changes in specific gut microbiota, this study sheds light on the mechanisms through which parasites regulate population fluctuations in Brandt’s voles.

PMID:40025543 | DOI:10.1186/s12917-025-04524-2

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Haloperidol for the treatment of delirium in ICU patients: a systematic review and meta‑analysis

Eur J Med Res. 2025 Mar 1;30(1):147. doi: 10.1186/s40001-025-02409-6.

ABSTRACT

OBJECTIVES: Haloperidol is the most frequently prescribed medication for managing delirium in the intensive care unit (ICU). However, there is limited and inconclusive evidence regarding its efficacy. A meta-analysis was conducted by pooling data from recent clinical randomized controlled trials to assess the effectiveness of haloperidol in adult ICU patients with delirium.

METHODS: Studies were searched in PubMed, Embase and Cochrane Library databases on August 10, 2024. We performed a meta-analysis to estimate the efficacy of haloperidol for the treatment of ICU adult patients with delirium. This study is registered with INPLASY, number 202480104. The estimates are expressed as odds ratio (OR) or mean difference (MD) with a 95% confidence interval (CI).

RESULTS: A total of 2863 patients were included in the analyses. All the included studies were randomized controlled trials. The frequency of patients diagnosed with delirium used both confusion assessment method of intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) was 34% (n = 2863), and used CAM-ICU only was 66% (n = 2863). There was no difference in short-term (28-30 days) mortality between the two groups [OR = 0.89, 95% CI 0.60-1.32, P = 0.56] and long-term (90 days to 1 year) mortality [OR = 0.87, 95% CI 0.70-1.07, P = 0.19]. Furthermore, the haloperidol group demonstrated an advantage in reducing the length of ICU stay [MD = -1.13, 95% CI – 1.93– 0.32, P < 0.05] compared to the placebo group, with no statistically significant difference in length of hospital stay [MD = – 0.24, 95% CI -1.71-1.24, P = 0.75].

CONCLUSIONS: Haloperidol showed a significant trend in reducing the length of ICU stay. However, there was no statistical difference between the two groups in terms of delirium reduction.

PMID:40025536 | DOI:10.1186/s40001-025-02409-6