Tag: nevin manimala

Am J Reprod Immunol. 2025 Dec;94(6):e70189. doi: 10.1111/aji.70189.

ABSTRACT

PURPOSE: Several studies have evaluated a wide range of immunomodulatory therapies for treatment of unexplained recurrent pregnancy loss (RPL) and granulocyte colony stimulating factor (G-CSF) is a new addition. We aimed to perform a cumulative meta-analysis to update and reevaluate the efficacy of the use of G-CSF to reduce the risk of first trimester miscarriages in women with a history of RPL.

METHODS: We searched electronic databases until September 26, 2024. We screened 309 citations and included six randomized control trials (RCTs) and four observational cohort studies. A total of 800 women were included in the analysis for the primary outcome; 426 (53%) women had treatment with G-CSF and 374 (47%) women had placebo or no treatment.

RESULTS: Women who were administered GCSF in early pregnancy had a statistically significant reduction in miscarriage compared to those who had placebo or no treatment, odds ratio [95% CI] = 0.4 [0.3; 0.7]. A subsequent significant increase in live birth was also found in women who had GCSF, odds ratio [95% CI] = 2.3 [1.4; 3.6].

CONCLUSION: Among women with a history of recurrent pregnancy loss, administration of granulocyte colony stimulating factor resulted in statistically significant reduction in first trimester miscarriage and subsequent improvement in live birth.

PMID:41316709 | DOI:10.1111/aji.70189

Hematol Transfus Cell Ther. 2025 Nov 27;48(1):106222. doi: 10.1016/j.htct.2025.106222. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to compare the outcomes of bone marrow (BM) to peripheral blood stem cells (PBSC) grafts in haploidentical hematopoietic cell transplantation using post-transplant cyclophosphamide-based graft-versus-host disease (GvHD) prophylaxis.

METHODS: A single-center retrospective analysis of all adult patients who underwent haploidentical transplants with at least one year of follow-up was conducted. Bivariate analyses were performed using chi-square tests and t-tests. Data were analyzed using SPSS with statistical significance being defined at p-value <0.05.

RESULTS: The study included 176 transplant recipients: 65 % received PBSC and 35 % received BM grafts. After a median follow-up of 21 months (range: 0-73 months), neither median overall survival nor disease-free survival had been reached. One-year overall survival (BM 75 % versus PBSC 74 %; p-value = 0.898) and one-year disease-free survival (63 % both groups; p-value = 0.994) were similar between groups. PBSC recipients exhibited earlier neutrophil engraftment (17 days versus 18 days; p-value = 0.022). The incidence of cytokine release syndrome was higher in PBSC (90 % versus 37 %) grafts (p-value <0.001). The incidences of Grade II-IV acute GvHD, relapse, non-relapse mortality, platelet engraftment, one-year chronic GvHD, and GvHD-free relapse-free survival were similar across both groups.

CONCLUSIONS: Haploidentical HSCT recipients observed similar outcomes regardless of graft source. Marginally faster neutrophil engraftment was observed in PBSC recipients. These findings suggest flexibility in using graft source for haploidentical transplants, though prospective studies are needed to confirm these results.

PMID:41313884 | DOI:10.1016/j.htct.2025.106222

Phytomedicine. 2025 Nov 17;149:157571. doi: 10.1016/j.phymed.2025.157571. Online ahead of print.

ABSTRACT

BACKGROUND: Recurrent acute exacerbations of chronic obstructive pulmonary disease (AECOPD) impose disease deterioration and economic burden. Tan Yin Wan (TYW), a traditional Chinese medicine (TCM) formulation, has shown promise in COPD management, but robust clinical evidence is lacking.

OBJECTIVE: We aimed to evaluate the efficacy and safety of TYW in delaying AECOPD onset, with subgroup analyses exploring the TCM principle of “Treating Winter Disease in Summer” (Dongbing Xiazhi, ), which advocates reinforcing physiological resilience in low-risk seasons to mitigate exacerbation and severity of disease in high-risk seasons.

METHODS: In this multicenter, randomized, double-blind, placebo-controlled, phase Ⅳ clinical trial, participants with moderate-to-severe COPD and high exacerbation risk received TYW or an identical placebo, in addition to standard therapy for 52 weeks. The primary outcome was time to the first AECOPD. Secondary outcomes included the severity of the first AECOPD, annualized exacerbation rate, proportion of AECOPD cases, symptom scales (Breathlessness, Cough, and Sputum Scale (BCSS), COPD Assessment Test (CAT), and modified Medical Research Council Dyspnea Scale (mMRC)), 6-Minute Walk Distance (6MWD), pulmonary function and safety.

RESULTS: A total of 342 patients were recruited from 18 centers between July 13, 2021, and June 5, 2023, with 308 patients in the full analysis set (FAS) and 297 in the per-protocol set (PPS). TYW significantly prolonged the time to the first AECOPD vs. placebo after adjustment for baseline confounding (adjusted HR = 0.55, 95% CI = 0.35 – 0.87, p = 0.01), and the restricted mean survival time difference (ΔRMST) was 30.45 days (95% CI = 4.68 – 56.23, p = 0.02). Improvements were demonstrated in BCSS, CAT, mMRC, and 6MWD at multiple timepoints (all p < 0.05), though lung function showed no significant differences. Exploratory subgroup analysis indicated a numerical trend toward a prolonged time to first exacerbation by 40.29 days in summer-enrolled participants (June – August) compared to non-summer-enrolled participants. This observation is tentatively consistent with the TCM principle of “Treating Winter Disease in Summer” as a proactive preventive strategy, though formal statistical significance was not achieved. Safety profiles were comparable between groups.

CONCLUSIONS: TYW adjunct therapy might delay AECOPD onset and improve symptom burden, representing a preventive intervention that embodies TCM’s “Treating Disease Before Onset” (Zhi Wei Bing, ) philosophy, potentially through “Treating Winter Disease in Summer”, as a proactive seasonal strategy in long-term COPD management.

TRIAL REGISTRATION: This trial was registered at the Chinese Clinical Trials Registry (ChiCTR2100048801).

PMID:41313848 | DOI:10.1016/j.phymed.2025.157571

Phys Life Rev. 2025 Nov 22;56:33-60. doi: 10.1016/j.plrev.2025.11.006. Online ahead of print.

ABSTRACT

Understanding and promoting cooperative behaviour among self-interested individuals is a critical concern in physical, biological, and social sciences. Numerous foundational mechanisms for the evolution of cooperation have been identified, and these mechanisms have served as the basis for developing tools and interventions designed to sustain and enhance cooperative behaviour. However, since both foundational mechanisms and the derived tools and interventions often involve costs affecting individuals or institutions, striving for maximum cooperation can sometimes harm social welfare, defined as the total population payoff. Herein, we review existing evolutionary mechanisms for the evolution of cooperation as well as tools and interventions based on these mechanisms, emphasising the often-overlooked hidden costs that may lead to a misalignment between cooperation and social welfare. By explicitly incorporating these hidden factors into the models, we analyse the conditions under which they reduce social welfare, across a broad range of social dilemma games and evolutionary forces. Additionally, we review experimental studies that support and inform mathematical models and agent-based simulations. We highlight when considering social welfare is crucial, as misalignment is most likely to occur. Ultimately, we argue that social welfare, not just cooperation, should be the primary optimisation objective when designing interventions for social good. We also suggest several key directions to further explore this often-overlooked issue in the literature. Overall, we reveal that hidden costs often influence the alignment between cooperation and social welfare, challenging the common prioritisation of cooperation alone.

PMID:41313836 | DOI:10.1016/j.plrev.2025.11.006

Phys Life Rev. 2025 Nov 20;56:29-32. doi: 10.1016/j.plrev.2025.11.005. Online ahead of print.

NO ABSTRACT

PMID:41313835 | DOI:10.1016/j.plrev.2025.11.005

Midwifery. 2025 Nov 24;153:104683. doi: 10.1016/j.midw.2025.104683. Online ahead of print.

ABSTRACT

BACKGROUND: Primary postpartum hemorrhage (PPH) remains a major contributor to maternal morbidity and mortality globally. Despite improvements in maternal healthcare across the Middle East, the burden of PPH persists, and regional data on its predictors remain limited. This study aimed to examine the maternal and health service-related predictors of primary PPH among Middle Eastern women with vaginal delivery in Oman.

METHODS: A retrospective matched case-control study was conducted among 483 postpartum women who delivered vaginally at three hospitals in Oman between May 2022 and May 2024. Cases (women with PPH, ≥500 mL blood loss) were matched 1:2 with controls based on maternal age, parity, and pregnancy type. Demographic, maternal, and health service-related factors were obtained from medical records and standardized forms in collaboration with unit head nurses.” Data were analyzed using descriptive statistics, univariate analyses, and logistic regression (p < 0.05).

RESULTS: The prevalence of primary PPH was 10.4 %. No significant sociodemographic differences were observed between cases and controls. Logistic regression identified six significant predictors, including retained placenta (OR = 6.484), cervical tears (OR = 48.058), perineal tears (OR = 1.473), episiotomy (OR = 2.056), anticoagulant use (OR = 2.193), and mode of delivery (OR = 1.412). The highest PPH incidence occurred at the AXXX Hospital (28.58 %), which may reflect differences in service capacity and staffing.

CONCLUSION AND CLINICAL RELEVANCE: This multi-center case-control study strengthens evidence on PPH predictors in this under-researched region. Both maternal and health service-related factors were associated with increased risk of primary PPH. Emphasis on targeted postpartum assessments, preventive measures such as selective episiotomy and perineal support during delivery, and improved clinical documentation is warranted. Policy-level actions, including investments in workforce capacity and service delivery, may further reduce PPH and improve maternal outcomes in Oman and comparable contexts.

PMID:41313817 | DOI:10.1016/j.midw.2025.104683

J Med Internet Res. 2025 Nov 28;27:e77087. doi: 10.2196/77087.

ABSTRACT

BACKGROUND: Caring for children with rare genetic disorders is challenging due to complex medical needs and limited information. Often, information is scarce due to geographical dispersion and lack of access to expertise. Social media groups are increasingly used in parenting and in healthcare as tools for data sharing and acquisition, and online peer support. Online groups relating to specific rare diseases are increasingly used by parents navigating the difficulties of understanding their child’s diagnosis and providing them with support. Parents expect professionals to interact with them about information reported from online groups, but little is known regarding the content within these groups and the impact on families.

OBJECTIVE: We aimed to synthesize current knowledge of social media use among parents and caregivers of children with a rare genetic syndrome to inform how these data might be used in parent-doctor interactions and in the research setting.

METHODS: We completed a comprehensive literature review across Web of Science, PubMed, and PsycINFO using a search strategy with themes of caregivers, rare genetic disease, and social media. Studies published in English from 2005 onwards, with parents and caregivers as a cohort and a focus on rare genetic diseases, were included. In total, 159 articles were identified, which underwent a title sift followed by an abstract sift based on inclusion and exclusion criteria. Reference lists of included articles were also reviewed. A total of 12 studies were included, and a critical synthesis methodology was used to extract relevant points.

RESULTS: Most parents and caregivers use social media platforms, especially Facebook (Meta Platforms, Inc), particularly the group function. They are using social media groups as a tool for finding information related to their child’s rare genetic disease. A majority also engaged in online groups by sharing information and contributions of their own. This review highlights that caregivers are seeking three main types of support from social media: (1) medical information around diagnosis and treatments, (2) practical tips on care needs and equipment, and (3) social support, involving connection with other families who shared similar experiences. The use of social media improved accessibility to information regardless of time or geography and reduced feelings of isolation. Caregivers felt empowered in decision-making, and their interactions with health care professionals improved. Challenges include misinformation, concerns around privacy, emotional impacts of comparison, and a lack of online spaces for the rarest conditions.

CONCLUSIONS: Social media is a key tool for caregivers of children with rare genetic diseases. Addressing the associated challenges and harnessing the potential of these platforms can positively impact these families. Health care providers should consider discussing social media engagement in conversations with caregivers, and future research should focus on larger, longitudinal studies to explore the impacts of social media engagement.

PMID:41313807 | DOI:10.2196/77087

JMIR Form Res. 2025 Nov 28;9:e79534. doi: 10.2196/79534.

ABSTRACT

BACKGROUND: Generative artificial intelligence (GenAI), exemplified by ChatGPT and DeepSeek, is rapidly advancing and reshaping human-computer interaction with its growing reasoning capabilities and broad applications across fields such as medicine and education.

OBJECTIVE: This study aimed to evaluate the performance of 2 GenAI models (ie, GPT-4-turbo and DeepSeek-R1) on a standardized audiologist qualification examination in Chinese and to explore their potential applicability in audiology education and clinical training.

METHODS: The 2024 Taiwan Audiologist Qualification Examination, comprising 300 multiple-choice questions across 6 subject areas (ie, basic hearing science, behavioral audiology, electrophysiological audiology, principles and practice of hearing devices, health and rehabilitation of the auditory and balance systems, and hearing and speech communication disorders [including professional ethics]), was used to assess the performance of the 2 GenAI models. The complete answering process and reasoning paths of the models were recorded, and performance was analyzed by overall accuracy, subject-specific scores, and question-type scores. Statistical comparisons were performed at the item level using the McNemar test.

RESULTS: ChatGPT and DeepSeek achieved overall accuracies of 80.3% (241/300) and 79.3% (238/300), respectively, which are higher than the passing criterion of the Taiwan Audiologist Qualification Examination (ie, 60% correct answers). The accuracies for the 6 subject areas were 88% (44/50), 70% (35/50), 86% (43/50), 76% (38/50), 82% (41/50), and 80% (40/50) for ChatGPT and 82% (41/50), 72% (36/50), 78% (39/50), 80% (40/50), 80% (40/50), and 84% (41/50) for DeepSeek. No significant differences were found between the two models at the item level (overall P=.79), with a small effect size (accuracy difference=+1%, Cohen h=0.02, odds ratio 0.90, 95% CI 0.53-1.52) and substantial agreement (κ=0.71). ChatGPT scored highest in basic hearing science (88%), whereas DeepSeek performed the best in hearing and speech communication disorders (84%). Both models scored lowest in behavioral audiology (ChatGPT: 70% and DeepSeek: 72%). Question-type analysis revealed that both models performed well on reverse logic questions (ChatGPT: 79/95, 83%; DeepSeek: 80/95, 84%) but performed moderately on complex multiple-choice questions (ChatGPT: 9/17, 53%; DeepSeek: 11/17, 65%). However, both models performed poorly on graph-based questions (ChatGPT: 2/11, 18%; DeepSeek: 4/11, 36%).

CONCLUSIONS: Both GenAI models demonstrated strong professional knowledge and stable reasoning ability, meeting the basic requirements of clinical audiologists and suggesting their potential as supportive tools in audiology education. However, the presence of errors underscores the need for cautious use under educator supervision. Future research should explore their performance in open-ended, real-world clinical scenarios to assess practical applicability and limitations.

PMID:41313805 | DOI:10.2196/79534

JMIR Form Res. 2025 Nov 28;9:e63453. doi: 10.2196/63453.

ABSTRACT

BACKGROUND: The outbreak of the COVID-19 pandemic created significant challenges but also a unique opportunity, accelerating the evolution of higher education, including dental education. This encouraged dental education to adopt more flexible modes like blended learning.

OBJECTIVE: This study aimed to explore senior undergraduate dental students’ views on blended learning during and after the COVID-19 pandemic and to identify modifiable factors influencing their engagement.

METHODS: A survey was conducted among final-year undergraduate students at a top-ranking dental school in mainland China during the fall semesters of 2020-2021 and 2023-2024. The survey assessed satisfaction with blended learning, preferences for engagement, strengths compared to purely online or offline teaching, and factors influencing engagement during and after the pandemic.

RESULTS: Response rates were 75% (85/114) in 2020 and 73% (47/64) in 2023. Blended learning was used in 53% (26/49) of evaluated courses. High satisfaction was reported by 82% (93/114) in 2020 and 59% (38/64) in 2023, with significant differences between high- and low-satisfaction groups (P<.001). Satisfaction with specific course types and learning activities was analyzed. Factors associated with higher satisfaction were evaluated using Pearson correlation. Students acknowledged the strengths of blended learning over online- or offline-only formats. In total, 70% (80/114) in 2020 and 61% (39/64) in 2023 expressed a desire to participate in blended dental education. Factors decreasing engagement included unstable technical support (68/114, 60% in 2020 vs 26/64, 41% in 2023), poor online-offline integration (58/114, 51% vs 34/64, 53%), lack of motivation (51/114, 45% vs 24/64, 38%), and insufficient teacher-student interaction (44/114, 39% vs 20/64, 31%). Factors increasing engagement included high-quality learning materials (76/114, 67% vs 43/64, 67%) and improved technical environments (62/114, 54% vs 35/64, 55%).

CONCLUSIONS: Final-year dental students were generally satisfied with blended learning and recognized its strengths compared to purely online or offline formats, both during and after the pandemic. More efforts are required to enhance students’ potential engagement in blended learning for the future.

PMID:41313803 | DOI:10.2196/63453

Nurs Inq. 2026 Jan;33(1):e70071. doi: 10.1111/nin.70071.

ABSTRACT

Through an in-depth examination of how male nurses experience and overcome gender-based challenges in Turkey, where traditional gender norms and patriarchal values influence social perceptions and professional roles, this study aimed to advance larger conversations on workplace equality. In this respect, a qualitative descriptive design was used to conduct semi-structured interviews with 10 male nurses. The findings showed that most participants selected nursing for job security and financial stability over a career in caregiving. Some nurses advanced faster due to their perceived male authority, even though they often face social skepticism, gender-based discrimination, and isolation at work. The conflict between social acceptance and professional advancement is brought on by these dynamics. To eliminate preconceptions and attain gender equality in nursing, this study highlights the need for inclusive policies and cultural change by examining the experiences of male nurses in a conservative setting where women predominate.

PMID:41313800 | DOI:10.1111/nin.70071