Tag: nevin manimala

Malar J. 2025 Dec 19. doi: 10.1186/s12936-025-05716-9. Online ahead of print.

ABSTRACT

BACKGROUND: Vector control is the most important malaria prevention strategy in Zambia. Attractive Targeted Sugar Baits (ATSB) are a potential new tool for vector control in this setting, which, if efficacious, would be intended to supplement insecticide-treated bed nets (ITNs) and indoor residual spraying (IRS). ATSBs target and kill sugar feeding mosquitoes, potentially limiting the spread of malaria. No information on the cost or cost-effectiveness of deployment of ATSB stations is currently available.

METHODS: A cluster randomized control trial (cRCT) was carried out in Western Province, Zambia to assess the efficacy of Sarabi v.1.2 ATSB stations in a highly malarious setting. Costs associated with the procurement, distribution, maintenance, and disposal of the ATSB stations were collected over a two-year period. These costs were assessed alongside the main trial efficacy outcomes to determine cost-effectiveness and potential budget impact on the deployment of ATSB stations in this setting. Total costs, incremental costs, incremental cost-effectiveness ratios (ICER) and budget impact were estimated using trial data. One-way, scenario and probabilistic sensitivity analysis were performed to further determine the impact of assumptions and uncertainty on cost-effectiveness estimates, and the potential cost implications of alternative deployment scenarios. Sub-group analysis was performed to determine the impact of deployment in settings with the most favorable effect scenarios.

RESULTS: The total cost of the intervention in the context of the cRCT was USD 1,261,515. ATSB cost accounted for 46% of the total cost followed by personnel (25%), supplies and transport (13% each), equipment (2%) and storage (1%). Over the two year (14-month intervention) this resulted in an estimated ICER of USD 79 per malaria incident case averted or USD 919 per disability-adjusted life year (DALY) averted and USD 10.08 per person-year protected. In a subset of high-density ATSB clusters ICER was USD 42 per incident case averted and USD 493 per DALY averted and USD 4.35 per person-year protected. Probabilistic sensitivity analysis indicated that deployment in areas with higher structure density may be more cost-effective, especially if potential cost-savings are considered. However, effect estimates in this subgroup were highly uncertain and not statistically significant. While the scenario appeared more cost-effective than the base case on the cost-effectiveness acceptability curve (CEAC), the probability of cost-effectiveness reached only around 70%, falling short of the commonly used 80% threshold and remaining relatively weak.

CONCLUSIONS: ATSB Sarabi v.1.2 as deployed in western Zambia were not likely to be cost -effective. ATSB would need to demonstrate higher or more certain efficacy along with affordable alternative distribution strategies prior to any deployment at scale. Trial registration The trial is registered on clinicaltrials.gov under registration number: NCT04800055.

PMID:41420162 | DOI:10.1186/s12936-025-05716-9

Acad Psychiatry. 2025 Dec 19. doi: 10.1007/s40596-025-02297-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to develop and assess the effectiveness of an online independent learning module for educating preclinical medical students about eating disorders.

METHODS: The curriculum was designed using Kern’s six-step framework. The 60-min eating disorders module incorporated case-based learning, narrative medicine, and real-time feedback to enhance engagement and critical thinking. Surveys were used to assess medical student attitudes, knowledge, and comfort with eating disorder diagnosis and treatment at pre-training and post-training. Paired t-tests and descriptive statistics were used for analysis.

RESULTS: Among 130 preclinical medical students, significant improvements were observed from pre to post-training in diagnostic knowledge (p < 0.05). Students also reported significantly improved comfort with eating disorder screening and differential diagnosis (p < 0.001), as well as significantly improved attitudes about the importance of medical and psychological support for people with eating disorders (p = .008).

CONCLUSIONS: Findings provide preliminary evidence of the effectiveness of a brief self-paced independent learning module in improving medical students’ knowledge, comfort, and attitudes in the initial identification and management of eating disorders. Future research can build on these initial findings to examine longer-term knowledge sustainment and additional interventions that may influence the application of knowledge or skills in real-world practice.

PMID:41420141 | DOI:10.1007/s40596-025-02297-2

Odontology. 2025 Dec 19. doi: 10.1007/s10266-025-01277-0. Online ahead of print.

ABSTRACT

Optimal postoperative analgesia remains pivotal in endodontic success, particularly under acute inflammatory conditions. Although glucocorticoids such as dexamethasone exhibit potent anti-inflammatory efficacy, their prophylactic application in endodontics has not been extensively validated. This study assessed whether preoperative dexamethasone offers superior analgesia to postoperative ibuprofen in endodontic pain control. A randomized, controlled Phase IV clinical trial was undertaken at the Faculty of Dentistry, University of Salamanca, involving 82 ASA I patients undergoing single-visit root canal treatment. Subjects were equally randomized into two arms: the experimental group received 4 mg oral dexamethasone one hour preoperatively, while the control group was administered 400 mg ibuprofen at four-hour intervals post-treatment. Postoperative pain was evaluated using the Visual Analog Scale (VAS) at 4, 6, 8, 12, and 24 h. Intergroup differences were analyzed using the Mann-Whitney U test. The dexamethasone cohort demonstrated statistically significant reductions in VAS scores between 6- and 24-h post-intervention (p < 0.001), with no adverse events or need for rescue analgesia observed. Gender-based variation in pain perception was not significant. A single 4 mg preoperative oral dose of dexamethasone markedly enhances early postoperative analgesia in root canal treatment relative to standard ibuprofen regimens. These results support its integration into preemptive root canal protocols, contingent upon further multicenter validation. Approved by the Bioethics Committee (Ref. 2025_01/345; March 10, 2025). Clinical trial registration: NCT069063150 (April 1, 2025).The study adhered to the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

PMID:41420134 | DOI:10.1007/s10266-025-01277-0

Psychon Bull Rev. 2025 Dec 19;33(1):20. doi: 10.3758/s13423-025-02818-y.

ABSTRACT

Written words presented within a sequence of words are identified more accurately when this sequence forms a correct sentence or phrase compared with an ungrammatical re-ordering of the same words. Here we examined if this sentence superiority effect (SSE) is modulated by the predictability of the target word given the sentence context. Target words were at positions 2 and 5 in five-word sequences, and either had high or low cloze probabilities (measured by an independent cloze test and further checked using the word-in-context probabilities obtained with a Large Language Model (LLM)). Given that predictability only made sense when considering grammatically correct sequences, we performed two separate analyses. We found: (1) an effect of grammaticality (i.e., we replicated the SSE), (2) a small effect of predictability on responses to grammatically correct sequences, and (3) no interaction between predictability and grammaticality. The impact of predictability on the SSE was then evaluated by comparing the magnitude of the SSE obtained with more predictable words versus less predictable words, with the SSE in each of these conditions being measured using identification accuracy for the same word at the same position in grammatical and ungrammatical sequences. Results revealed no significant modulation of the SSE by word predictability. We conclude that syntactic and semantic constraints, and not predictability per se (as measured by a cloze test or LLM statistics), contribute to the sentence superiority effect. Crucially, this provides evidence against guessing accounts of the SSE according to which predictability should play a key role.

PMID:41420133 | DOI:10.3758/s13423-025-02818-y

Perfusion. 2025 Dec 19:2676591251409379. doi: 10.1177/02676591251409379. Online ahead of print.

ABSTRACT

IntroductionVacuum-assisted venous drainage (VAVD) has been proposed as a better alternative option than conventional gravitational venous drainage (GVD) in cardiac surgery. However, the literature reports conflicting results between both methods in terms of post-cardiac surgery complications. Therefore, we aimed to perform a meta-analysis to compare clinical outcomes between VAVD and GVD in patients undergoing cardiac surgery.MethodsPubMed, Scopus, and Web of Science databases were searched for any randomized control trials or cohort studies that compared clinical outcomes between VAVD and GVD in patients undergoing cardiac surgery.ResultsSixteen studies with 8426 patients were included in our study. The pooled effect estimate of the postoperative results showed a statistically significant association between VAVD and decreased blood loss/chest tube drainage (MD = -88.7, 95% CI = -154.71 to -22.69, p-value = 0.008), amount of packed red blood cells (pRBC) transfusion (MD = -0.25, 95% CI = -0.27 to -0.22, p < 0.00,001), re-exploration (RR = 0.6, 95% CI = 0.35 to 1, p = 0.05), and re-operation (RR = 0.47, 95% CI = 0.23 to 0.99, p-value = 0.05). However, our study revealed no significant difference between both groups in terms of postoperative mortality, hospital/ICU stay, other blood product transfusions, change of free hemoglobin at 24 h, and other clinical outcomes.ConclusionOur study revealed that VAVD is at least equivalent and may provide some benefits compared to GVD in patients undergoing cardiac surgery. While, VAVD requires specific expertise and training in order to optimize its outcomes, its ability to reduce blood loss and blood transfusion, support its use as a valuable alternative for GVD in high-risk groups.

PMID:41420131 | DOI:10.1177/02676591251409379

J Pharm Pract. 2025 Dec 19:8971900251408306. doi: 10.1177/08971900251408306. Online ahead of print.

ABSTRACT

Background: While traditional mail-order pharmacies have overcome some barriers to adherence, there is minimal evidence to indicate whether a novel prescription delivery program (PDP) can impact clinical endpoints in common disease states. The use of integrated pharmacy technicians, a local courier service, and hospital-owned pharmacies contributes to a comprehensive continuum of care. This study’s purpose was to assess the impact of a novel PDP on glycemic control in patients with diabetes mellitus (DM). Objectives: The primary objective of this study was to identify the change in glycated hemoglobin level (HbA1c) of DM patients at enrollment in the PDP to approximately one-year post-enrollment. Secondary objectives were to describe the percentage of patients achieving therapeutic goals, characterize enrolled population, and identify medication classes utilized in the PDP. Methods: This was a retrospective quasi-experimental study to evaluate whether implementation of an internally owned and operated PDP would improve HbA1c control for DM patients throughout primary care and specialty networks. Results: A total of 1223 patients were screened for inclusion. A convenience sample of 100 patients were evaluated. The outcome of change in HbA1c of patients with diabetes improved significantly from baseline at enrollment in a PDP to one-year post-enrollment (pre-PDP 8.2% vs post-PDP 7.4%, P < 0.001). Of the patients included in the study, 30% achieved goal HbA1c pre-enrollment in PDP. One-year post-PDP the percentage of patients who achieved goal HbA1c increased to 48% (P = 0.002), which was statistically significant. Conclusion: Among the studied population, enrollment in the PDP was associated with a significant reduction in HbA1c.

PMID:41420128 | DOI:10.1177/08971900251408306

NPJ Digit Med. 2025 Dec 19. doi: 10.1038/s41746-025-02223-8. Online ahead of print.

ABSTRACT

To clarify the real-world performance of regulator-approved deep-learning (DL) systems for autonomous diabetic retinopathy (DR) screening, we systematically searched PubMed, Embase, and ClinicalTrials.gov to 3 April 2025, identifying 82 studies (887,244 examinations) covering 25 devices in 28 countries. Hierarchical bivariate meta-analysis yielded pooled sensitivity/specificity of 0.93/0.90 on a per-patient basis and 0.92/0.93 per eye, closely paralleling expert grading. Meta-regression showed that DR severity threshold, national-income level, image gradability, pupil dilation, reference standard, and diagnostic criteria collectively explained most between-study heterogeneity; any-DR screening, low-income settings, or ungradable images increased false-positive rates, whereas dilated pupils, portable cameras, and adjudicated references improved specificity. Publication bias was minimal. Overall, regulator-approved DL algorithms provide accurate, scalable DR detection, but programs must tailor deployment and reimbursement to disease threshold, image quality, and local resources, and post-market audits with standardized gradability metrics are needed to ensure safe, equitable global adoption.

PMID:41420101 | DOI:10.1038/s41746-025-02223-8

Mol Neurobiol. 2025 Dec 20;63(1):314. doi: 10.1007/s12035-025-05507-y.

ABSTRACT

Neuronal and glial biomarkers like glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), tau protein, and neurofilament light chain (NfL) in serum are reported to be beneficial in detecting sports-related concussions (SRC) or intracranial trauma sequelae. However, routine blood measurements are invasive, and a non-invasive approach using urine could be advantageous. This prospective study analyzed urine samples from athletes with varying head trauma risks: high-risk (boxing), moderate-risk (American football, soccer), and low-risk (endurance sports). Samples were collected before (pre) and 48-72 h after (post) competition. Consecutive matches per athlete were sampled. Biomarker concentrations were adjusted for urine dilution using the creatinine ratio (CR). Statistical differences between groups were assessed using the Kruskal-Wallis test. A total of 48 athletes (boxing 11, American football 18, soccer 10, endurance 9) provided 112 samples. Ten SRC were recorded (boxing 9, soccer 1). Boxing athletes had the highest biomarker-CR, with significant differences in tau-CR and UCH-L1-CR compared to American football and endurance athletes (p = 0.005 and p = 0.001, respectively). No significant differences were found for NfL-CR or GFAP-CR. No significant changes were observed for biomarker-CRs 48-72 h after SRC. However, in a pooled analysis of all subsequent samples after a SRC, irrespective of the latency of sampling, there were significantly higher values for tau-CR and UCH-L1-CR (p = 0.02). Significantly higher levels of tau-CR and UCH-L1 were found in high-risk sports, potentially reflecting increased head impacts. However, an early increase of biomarker-CR within 72 h after SRC was not observed.

PMID:41420097 | DOI:10.1007/s12035-025-05507-y

Sci Rep. 2025 Dec 19. doi: 10.1038/s41598-025-31406-2. Online ahead of print.

ABSTRACT

The aim of this study was to investigate influence of curing mode of universal adhesives and dentin sealing approach on microtensile bond strength (MTBS) of CAD/CAM composite to dentin. Occlusal surfaces of 36 human molars were ground to expose flat dentin and randomly assigned to 6 groups according to: (1) Adhesive curing mode [light-cured/LC (One coat 7 Universal, COLTENE); dual-cure/DC (One coat 7 Universal/Dual-cure Activator, COLTENE); and self-cure/SC (Palfique Universal Bond, Tokuyama); and (2) Dentin sealing approach (delayed sealing/DDS and immediate sealing/IDS). Following 1-week provisionalization, CAD/CAM composite blocks (Brilliant Crios, COLTENE), 4 mm², were cemented over conditioned dentin surfaces. After 24 h, bonded assemblies were thermo-cycled for 5000 cycles. Specimens were tested for MTBS. Failure mode was analyzed under stereomicroscope. Data were statistically analyzed using ANOVA. DDS showed significantly higher MTBS values than IDS when using LC and DC adhesives. While, IDS produced significantly higher MTBS values than DDS when using SC adhesive. Predominant failure mode was adhesive in all groups, except for SC adhesive in IDS group, mixed failure was the predominant mode. Light- and dual-cured universal adhesives improved bond strength in delayed dentin sealing approach. Self-cure universal adhesive produced better bond strength when applied to immediately sealed dentin.

PMID:41420076 | DOI:10.1038/s41598-025-31406-2

Sci Rep. 2025 Dec 19. doi: 10.1038/s41598-025-33035-1. Online ahead of print.

ABSTRACT

Pteridium aquilinum is a medicinally important fern with a limited range in northern Iran, increasingly threatened by climate change. Using morphological, genetic, and environmental data, we assessed differentiation, adaptive capacity, and vulnerability across 11 populations. Factor analysis of mixed data (FAMD) identified stipe indument, pinnule shape, and pinnae number as key traits distinguishing populations. Redundancy and association analyses (RDA/CCA) revealed strong links between both morphological and genetic variation and climatic gradients, particularly temperature and humidity, indicating local adaptation. Several SCoT loci were detected as adaptive outliers. Spatial PCA showed that variation is shaped by both global and local spatial factors, forming clines and local variants. Populations varied in sensitivity and adaptive capacity; populations 2, 3, 7, and 8 exhibited the lowest adaptive indices and highest vulnerability. Connectivity modeling suggested that while some populations (e.g., 2, 4, and 6) may maintain or slightly improve connectivity, others risk isolation under future climates. Structural equation modeling (SEM) indicated a positive genetic contribution to adaptation, while differential equation modeling (DEM) predicted logistic growth with temporary instability and genetic decline in vulnerable groups. Overall, findings highlight spatially uneven adaptive responses and recommend targeted conservation through connectivity enhancement, assisted gene flow, and ex-situ preservation of adaptive genotypes.

PMID:41420001 | DOI:10.1038/s41598-025-33035-1