Categories
Nevin Manimala Statistics

An epidemiological model of monkeypox: model prediction and control application

BMC Infect Dis. 2025 Apr 9;25(1):485. doi: 10.1186/s12879-025-10873-y.

ABSTRACT

BACKGROUND: Monkeypox (Mpox) is an emerging infectious disease caused by the Mpox virus (MPX Virus). The outbreak of Mpox epidemic has caused global panic and is now a public health incident. Various approaches have been proposed in the recent literature to study and analyze the epidemiological dynamics of this infection and effective prevention and control measures. Using mathematical model to understand the transmission dynamics and control strategy is a useful way to understand the prevention of Mpox.

METHODS: A new compartment model is established to examine the effectiveness of vaccine on Mpox based on previous studies. Nonlinear least squares fitting is used for model’s parameter estimation. The impact of a series of preventive and control measures on the epidemic control is explored with optimal control theory in conjunction with the official data released by the authorities.

RESULTS: Firstly, a stability analysis of the developed model was carried out to show that, under certain circumstances, its equilibrium is both locally and globally stable. Secondly, based on the reported cases of Mpox infection in the United States between 2022 and 2023, the model’s optimal parameter values were obtained. A sensitivity analysis of the model parameters was then conducted to identify the key parameters that affect the development of Mpox epidemics in the United States. Lastly, the comparison of control effects under various control strategies showed that implementing the all suggested four control measures at the same time was the most effective way to curb the development of monkeypox epidemic in the United States.

CONCLUSIONS: This study has theoretical significance for understanding and controlling Mpox virus transmission.

PMID:40205551 | DOI:10.1186/s12879-025-10873-y

Categories
Nevin Manimala Statistics

Community pharmacists’ support for nursing mothers in Serbia: potential cost savings due to breastfeeding continuation

BMC Health Serv Res. 2025 Apr 9;25(1):523. doi: 10.1186/s12913-025-12523-0.

ABSTRACT

BACKGROUND: Despite many health benefits to infants, the overall breastfeeding rate remains low among Serbian women. The community pharmacists’ efforts aimed at supporting nursing mothers are important. The aim of the study was an evaluation of the pharmacists’ training for breastfeeding support and their perception about its usefulness. The second aim was an evaluation of the provided structured pharmaceutical care service (SPS) over four months, through a calculation of theoretical cost savings for counseled families in case of the risk for introduction of commercial milk formula (CMF).

METHODS: The continuation of breastfeeding instead of starting with CMF was theoretically monetized through cost savings analysis, which is based on energy equivalent human milk and CMF, regardless of the differences in health, social and ecology outcomes of breastfeeding. Cost savings for the counseled families were calculated as financial differences between continuing breastfeeding and switching to CMF.

RESULTS: The 256 pharmacists showed high satisfaction rates with the quality and the usefulness of the training (mean scores: content value 4.89 ± 0.51, technical value 4.91 ± 0.41, program value 4.96 ± 0.20, and usefulness value 4.94 ± 0.25, respectively), as well as a statistically significant higher level of knowledge (p < 0.001 for each of the 10 questions). The prospective observational study enrolled 256 community pharmacists who voluntarily underwent training aimed to breastfeeding support. Of all the trained pharmacists, 151 (59%) actively provided 1,243 SPS focused on breastfeeding support. Of all, 599 mothers of children under 6 months of age received SPS, while 590 provided full data In 275 cases (22.1%), a risk for early breastfeeding cessation was identified. The average age of children whose mothers had undergone SPS was 2.83 months, and the total average potential cost savings until 6 months of children age was 35,884.80 RSD (approximately 306 EUR) for average of 3.17 months.

CONCLUSIONS: The training of pharmacists adds significant value to their knowledge and skills for breastfeeding support, which may lead to potential cost savings for families.

PMID:40205538 | DOI:10.1186/s12913-025-12523-0

Categories
Nevin Manimala Statistics

Nutritional status of third-gender population of Dhaka City, Bangladesh

J Health Popul Nutr. 2025 Apr 9;44(1):113. doi: 10.1186/s41043-025-00736-2.

ABSTRACT

BACKGROUND: While existing studies conducted in South Asian countries have provided valuable insights into the nutritional status of the marginalized third-gender population and highlighted suboptimal nutritional conditions, regrettably such data is lacking in Bangladesh. Addressing this data gap is crucial to understanding and improving the nutritional condition of the third-gender community. Therefore, this study was conducted to estimate their nutritional status, dietary protein intake, lifestyle, social behavior, nutritional knowledge, and prevalence of diseases.

METHODS: The cross-sectional study was conducted in Dhaka City, Bangladesh. Fifty participants from the third-gender community were selected. Study subjects were individually interviewed through a structured questionnaire to gather specific data. SPSS was used for statistical analysis. Logistic Regression, Shapiro-Wilk Test, Kruskal-Wallis Test, and Chi-square tests were carried out to measure the associations among the variables.

RESULTS: The average age of the participants was 32.74 ± 9.30 years, with 26% lacking formal education and 72% engaged in money collection as a primary occupation. 36% earned less than BDT 5,000 monthly, with only 2% exceeding BDT 20,000. The mean height and mean body weights were 163 ± 5.21 cm and 60.64 ± 13.61 kg (mean ± SD) respectively. Mean Body Mass Index (BMI) was 23.02 ± 5.04 kg/m2, among whom 14% were underweight, 56% were normal, 20% were overweight, and 10% were obese. 48% of the participants had poor nutritional knowledge, and 46% had average. 50% of the participants had smoking habits and 34% of the participants consumed alcohol. Nutritional intake was skewed towards plant proteins (72%), with inadequate access to healthcare reported by 56% of subjects. Two-thirds (66%) of the respondents had no illness, and non-communicable diseases (NCDs) affected 34% of participants, with diabetes (12%) and low pressure (8%) prevalent. Smoking significantly correlated with lower normal BMI (AOR = 0.26, 95% CI: 0.07-0.84, p < 0.05). Unhealthy food intake was significantly associated with underweight risks (AOR = 0.17, 95% CI: 0.03-0.92, p < 0.05). When compared with male and female Bangladeshi populations, third-gender individuals had higher overweight prevalence, moderate normal BMI rates, and lower malnutrition than males.

CONCLUSION: The research identified suboptimal nutritional status among the third-gender population in Bangladesh, highlighting higher rates of both obesity and underweight, as well as a prevalence of non-communicable diseases, particularly diabetes.

PMID:40205527 | DOI:10.1186/s41043-025-00736-2

Categories
Nevin Manimala Statistics

The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study

BMC Res Notes. 2025 Apr 9;18(1):152. doi: 10.1186/s13104-025-07237-9.

ABSTRACT

OBJECTIVE: Cerebral edema is a severe and potentially fatal complication of diabetic ketoacidosis (DKA), particularly in pediatric patients. Despite its clinical significance, limited data exist on its incidence and associated risk factors in resource-limited settings. This study aimed to determine the incidence of cerebral edema in pediatric patients with DKA and investigate potential contributing factors. This retrospective study analyzed data from 270 pediatric DKA patients admitted to the Children’s Medical Center Hospital, Tehran, between March 2018 and March 2020. Patients aged 1 day to 18 years were included based on standard DKA diagnostic criteria (blood glucose > 250 mg/dL, pH < 7.3, bicarbonate < 18 mEq/L, and ketonemia/ketonuria). Patients with incomplete records or pre-existing neurological conditions were excluded. The statistical analyses included independent t-tests and Fisher’s exact tests.

RESULTS: The incidence of cerebral edema was 6.67%. Elevated blood glucose levels at admission were significantly associated with cerebral edema (P = 0.01), suggesting a potential role in its pathophysiology. Additionally, a strong correlation was observed between cerebral edema and ICU admission (P < 0.001), indicating a more severe disease course. The results suggest that early glucose control and neurological monitoring are critical for preventing adverse outcomes such as cerebral edema in pediatric DKA patients.

PMID:40205526 | DOI:10.1186/s13104-025-07237-9

Categories
Nevin Manimala Statistics

Patterns of opioid toxicity deaths after the implementation of COVID-19 emergency measures in Ontario, Canada: a weekly interrupted time series

Int J Drug Policy. 2025 Apr 8;139:104797. doi: 10.1016/j.drugpo.2025.104797. Online ahead of print.

ABSTRACT

BACKGROUND: In March 2020, Ontario, Canada, implemented COVID-19 public health measures, including school and non-essential business closures, physical distancing, border restrictions, and modified health services. We examined their association with changes in opioid toxicity mortality and assessed variations across age, sex, health region, and drug type.

METHODS: We conducted an interrupted time series using opioid toxicity death records (March 2019 to February 2021) from the Office of the Chief Coroner for Ontario. Using a generalized linear model (Poisson or negative binomial), we estimated changes in weekly death counts following the first (March 17th to May 19th, 2020) and second (November 23rd, 2020, to February 14th, 2021) lockdowns, as well as the entire post-COVID-19 period, modelling interventions as level shifts in opioid toxicity deaths.

RESULTS: Of 3844 individuals who died within the study period, 74.4 % were male, and the median age was 40 (interquartile range: 31 to 51). Weekly deaths ranged from 9 to 72. Following the province-wide state of emergency and first lockdown, there was a step increase in the number of deaths, with an estimated Rate Ratio (RR) of 1.21 (95 % CI 1.02 to 1.52). Over the duration of the post-COVID-19 period, an overall sustained increase in the number of opioid toxicity deaths (RR 1.11 [95 % CI 1.02 to 1.41]) was observed across the province.

IMPLICATIONS: The period after initial COVID-19 measures was associated with increases in opioid toxicity mortality. Future responses to public health emergencies must proactively mitigate the potential unintended consequence of toxic drug-related harms among substance-using populations.

PMID:40203470 | DOI:10.1016/j.drugpo.2025.104797

Categories
Nevin Manimala Statistics

Where Do Gender Disparities in Research Productivity Begin? A Study of Orthopedic Surgery Applicants and Residents

J Surg Educ. 2025 Apr 8;82(6):103509. doi: 10.1016/j.jsurg.2025.103509. Online ahead of print.

ABSTRACT

OBJECTIVE: The gender disparity in orthopedic surgery is multifactorial, driven by the lack of female mentorship, limited female leadership in academic roles, and challenges in pursuing academic positions. Research productivity and authorship are areas where these disparities manifest, with women being significantly underrepresented. The primary objective of this study is to evaluate whether gender disparities in orthopedic research productivity are apparent as early as medical school.

DESIGN, SETTING, AND PARTICIPANTS: A comprehensive analysis was conducted on orthopedic surgery residents from 208 ACGME-accredited programs across the United States. Data were collected between February and April 2024 from publicly accessible resources, covering 4320 residents (927 females, 3393 males). Pre-residency and residency publication data were gathered using Elsevier Scopus Application Programming Interface (APIs). The study compared total publications and first author publications between male and female residents, categorizing them as preresidency or residency publications. p-values were calculated using unpaired t-tests to evaluate gender differences.

RESULTS: Among the 2723 residents with preresidency publications, there was no statistically significant difference between male and female residents in the mean number of publications (p = 0.1267) or first authorship publications (p = 0.9389). During residency, however, male residents had a significantly higher mean number of publications than female residents (p = 0.0002), although no significant difference was observed in first authorships (p = 0.2538).

CONCLUSION: Our results suggest that while gender disparities in research productivity are not apparent preresidency, they emerge during residency, with male residents producing more publications. This difference is likely influenced by the lack of mentorship and female representation within the field of orthopedic surgery. Addressing these disparities requires targeted efforts to increase female mentorship and support within orthopedic residency programs.

PMID:40203465 | DOI:10.1016/j.jsurg.2025.103509

Categories
Nevin Manimala Statistics

Gender based disparities in research on injuries in NCAA athletes

Phys Sportsmed. 2025 Apr 9. doi: 10.1080/00913847.2025.2491111. Online ahead of print.

ABSTRACT

OBJECTIVES: Females participate in clinical research at a much lower rate than males, leading to clinical outcome disparities. The objective of this study was to determine whether gender-based disparities exist in orthopedic sports medicine injury research on NCAA college student-athletes.

METHODS: A PubMed search was conducted in September 2023 using the search terms ‘NCAA,’ ‘injury,’ and each of the 24 individual NCAA sports between 1980 and 2023. Statistical analysis was performed via determination of adjusted correlation coefficient R2 and multiple linear regression models. Gender was the independent variable, number of studies was the dependent variable.

RESULTS: Of 1,553 studies initially identified, 790 met inclusion criteria and underwent full text review. Of NCAA studies that assessed injury rates (injury rate studies) and those that evaluated other outcomes such as performance (non-injury rate studies), 468 of 790 (59%) discussed male collegiate athletes and 318 (40%) discussed females. For females, there was a negative association between athlete-exposure rate and injury rate studies (expected decrease of 0.31 studies per 100,000 athlete-exposures) and between athlete-exposure rate and non-injury rate studies (decrease of 0.007). For males, there was a positive association for each (increase of 1.15 and 1.96). Injury rates were positively associated with injury rate study numbers for both males and females (increase of 3.71). There was no significant relationship between injury rates and non-injury rate study numbers for either gender.

CONCLUSION: This study demonstrates gender disparities in orthopedic sports medicine injury research for collegiate athletes. There was a negative association between athlete-exposure rate and injury rate or non-injury rate studies for female NCAA athletes, but a positive association for males.

CLINICAL RELEVANCE: It is important to ensure that sports medicine research is focused on both male and female NCAA athletes to be able to evaluate injuries, outcomes, and opportunities for injury prevention.

PMID:40203455 | DOI:10.1080/00913847.2025.2491111

Categories
Nevin Manimala Statistics

Enhancing oral bioavailability of escitalopram by self-nanoemulsifying drug delivery systems (SNEDDS): An in-vivo, in-vitro and in-silico study

Pak J Pharm Sci. 2025 Jan-Feb;38(1):299-313.

ABSTRACT

This study aimed to develop SNEDDS to address the issue of low water solubility of escitalopram (ETP), which consequently leads to inadequate oral bioavailability. The formulation consisted of Tween 80, geranium oil, and polyethylene glycol 400. An evaluation was conducted to determine the surface charge and particle size of ETP-SNEDDS. The stability and compatibility of excipients were evaluated by TGA, DSC and FTIR. Studies were carried out to examine the dissolution, digestion, permeability, in in-vitro, in-vivo, and ex-vivo settings. ETP-SNEDDS bioavailability was assessed in a group of six albino rats under normal conditions. The synthesized SNEDDS exhibited thermodynamic stability, characterized by a 145nm droplet size with a polydispersity index of 0.120 and a minute emulsification duration. Developed SNEDDS containing ETP in FSSIF had a dissolution rate of 96%. Based on the permeation results, the SNEDDS demonstrated a 4.2-fold and 3.1-fold increase in drug penetration relative to standard powder-ETP drug and a reference tablet, correspondingly. Statistically significant improvements (p<0.05) were reported in in-vitro digestion, dissolution and ex-vivo permeability. SNEDDS exhibited a 5.34-fold increase in Cmax and a 4.71-fold rise in AUC compared to the reference. Based on findings, the formulated SNEDDS have a valuable method for enhancing ETP oral bioavailability.

PMID:40203451

Categories
Nevin Manimala Statistics

The influence of molecular framework of phytochemicals from five Asteraceae species’ extracts on their antibacterial and antioxidant activities

Pak J Pharm Sci. 2025 Jan-Feb;38(1):219-232.

ABSTRACT

The structure of active compounds determines their functions. This study investigates the phytochemical composition of five plant species, tests their capacity to obstruct the growth of four pathogenic bacteria (Bacillus subtilis, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli) and to scavenge free radicals and inspects the relationship between the biological activities and the phytochemical structural frameworks. GC-MS analysis was employed for specifying phytochemicals. The plant methanolic and ethanolic extracts and the antibiotic (AMC30), were evaluated for antibacterial capability utilizing the disc diffusion method. For assessing antioxidant activity, the DPPH method was used. Achillea fragrantissima exhibited the highest phytochemical diversity. Gram-negative bacteria were less sensitive to plant extracts. Pulicaria undulata and Pulicaria incisa demonstrated greater efficacy in suppressing bacterial proliferation. Artemisia judaica and P. undulata extracts showed higher free radicle scavenging relative to other species. The antioxidant action, antibacterial properties against B. subtilis, S. aureus and E. coli exhibited a statistically significant correlation with aromatic monocyclic compounds. A significant negative correlation was also observed between aliphatic polycyclic compound contents and E. coli growth inhibition, indicating that this compound category may have an E. coli growth stimulating capacity. This study proposes research into phytochemical frameworks and their target-specific properties.

PMID:40203443

Categories
Nevin Manimala Statistics

Characteristics and quality assessment of GRADE practice guidelines on maternal-fetal care

Medwave. 2025 Apr 9;25(3):e2937. doi: 10.5867/medwave.2025.03.2937.

ABSTRACT

The study aimed to assess the quality and applicability of current maternal-fetal health clinical practice guidelines that countries can adopt or adapt. A systematic search was conducted in the International Database of GRADE Guidelines (BIGG) for practice guidelines developed with the GRADE system (Grades of Recommendation, Assessment, Development, and Evaluation) and related to maternal-fetal care. The selected guidelines were evaluated with the AGREE-REX (Appraisal of Guidelines REsearch and Evaluation-Recommendations Excellence) tool to assess clinical applicability (domain-1), values and preferences (domain-2) and applicability (domain-3). The variables were presented descriptively, and a statistical analysis was performed on the domains according to institution and country of origin. Of 1,212 clinical practice guidelines, 72 met the inclusion criteria. According to the type of collaborating organization, the World Health Organization predominated with 58.3%, versus specialized medical societies. Domain 1, “Clinical applicability,” was the best rated by the reviewers (68.5%) compared to domain 2, “Values and preferences” (60%). According to the type of institution that developed the clinical practice guideline, a significant difference was demonstrated in domains 1 (p= 0.000), 2 (p= 0.006) and 3 (p= 0.000). Only domains 1 (p= 0.000) and 3 (p= 0.018) were statistically significant based on country of origin. This study emphasizes the importance of improving the quality of maternal-fetal clinical practice guidelines developed by organizations and governmental institutions and the need to strengthen the institutionalization of the use of evidence to develop, adapt and implement practice guidelines in countries such as the United Kingdom, Canada, Spain, Colombia, the United States, among others.

PMID:40203435 | DOI:10.5867/medwave.2025.03.2937