Tag: nevin manimala

Acta Ophthalmol. 2025 Sep 22. doi: 10.1111/aos.70008. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluates whether mesopic microperimetry (MMP) provides a more robust measure of retinal function compared to visual acuity (VA) in age-related macular degeneration (AMD) clinical trials, with a focus on optimal analysis strategies.

METHOD: Fellow-eyes of unilateral neovascular AMD were prospectively studied. Presenting VA was measured. The Macular Integrity Assessment Microperimeter (MAIA) was used with a 4 to 2 staircase strategy with a 10° diameter grid containing 37 loci. Three analysis strategies were calculated: the mean of 37 sensitivity thresholds (MS), the per cent reduced threshold (PRT), and the log-transformed candela mean (MS cd log). Sample size requirements were calculated for 12- and 24-month follow-ups using a paired one-sided T-test (α = 0.05, power = 0.80).

RESULTS: N = 123 were analysed (82 (65.5%) females; mean age 74.2 (7.8) years). Ranked high to low, the required sample size at 12 months was: MS (n = 51), MS cd log (n = 52), PRT (n = 139), and VA (n = 203). Similar trends were seen at 24 months, with MS requiring the smallest sample size (n = 85) and VA the largest (n = 1673).

CONCLUSION: All MMP analysis strategies outperformed VA, and MS required the least number of patients to show significant changes. This trend was consistent for both 12 and 24 months. These findings provide strong statistical arguments for the use of MMP in longitudinal within-subjects clinical trials and suggest that averaging decibels is optimal.

PMID:40977307 | DOI:10.1111/aos.70008

J Health Organ Manag. 2025 Sep 23:1-23. doi: 10.1108/JHOM-12-2024-0493. Online ahead of print.

ABSTRACT

PURPOSE: This study refines equity theory by explaining the mediating roles of job frustration and job dissatisfaction, as well as the moderating role of personal income in the relationship between discriminatory workplace favoritism and hospital employees’ intent to quit.

DESIGN/METHODOLOGY/APPROACH: The study consists of two samples. In the first sample, survey questionnaires were administered to 267 public hospital employees in Turkey. In the second sample, 1,426 university healthcare students in Turkey answered four different scenarios that narrated school favoritism as well as students’ frustration, dissatisfaction and intent to quit. Structural equation modeling and ANOVA statistical analyses were conducted.

FINDINGS: Workplace favoritism positively affected employees’ intent to quit through the mediation of job frustration and job dissatisfaction. The mediating role of job frustration between workplace favoritism and intent to quit was stronger for high-income than for low-income employees and students.

PRACTICAL IMPLICATIONS: Favoring one employee may result in voluntary organizational exit by other employees, which is costly for the organization. Favoritism may encourage employees who were not previously prone to favoritism to seek favoritism. This may create a cycle that spreads favoritism further within the organization.

ORIGINALITY/VALUE: This is the first study to investigate the role of income in the relationship between workplace favoritism and employees’ intent to quit.

PMID:40977299 | DOI:10.1108/JHOM-12-2024-0493

Breastfeed Med. 2025 Sep 22. doi: 10.1177/15568253251381804. Online ahead of print.

ABSTRACT

Objectives: Mothers of preterm infants who experience mother-infant separation frequently face increased challenges with lactation. This study aims to analyze the critical window for coming to volume (CTV) and its associated risk factors in pump-dependent mothers and to investigate the predictive value of postpartum expressed milk volume for the feeding method at discharge in preterm infants. Study Design: A prospective observational study was conducted between July 2020 and February 2021. Lactation diaries kept by mothers of preterm infants admitted to a neonatal intensive care unit in Guangzhou, China, were collected during this period. Binary multivariable Logistic regression, time-series analysis, Spearman correlation analysis, and K-Prototype cluster analysis were employed to investigate the critical window for CTV and its risk factors. The area under the receiver operating characteristic curves were used to evaluate the ability of expressed milk volume during postpartum days 8-14 to predict the feeding method at discharge for preterm infants. Results: Data from 1,232 diary days completed by 88 mothers were analyzed. 51.14% of mothers of preterm infants failed to CTV. Unscheduled pumping, a lower average pumping frequency on postpartum day 1-7, a lower average expressed breast milk volume on postpartum day 1-7, and a small intra-session bilateral volume discrepancy were identified as independent risk factors for no-CTV. During postpartum days 3-7, both pumping frequency and milk volume increased progressively. The frequency and volume of pumping between postpartum days 3 and 7 positively correlated with the milk volume on postpartum day 14. Clustering analysis based on early postpartum pumping behaviors identified two groups: High-Frequency Timed Group (HFTG) and Low-Frequency Untimed Group. The HFTG exhibited higher pumping frequency and milk volume, indicating a greater likelihood of achieving CTV. The expressed breast milk volume on postpartum day 8 significantly predicted the feeding method at discharge (Area Under the ROC Curve [AUC] [95% confidence interval]: 0.831 [0.746-0.916]), with no statistically significant difference in predictive performance compared to volumes on days 9-14 (p > 0.05). Conclusion: Postpartum days 3-7 represent the critical window for CTV among mothers of preterm infants, during which pumping behavior directly influences CTV. Postpartum day 8, as the first day following the critical window, provides an early and effective prediction of feeding outcomes at discharge.

PMID:40977274 | DOI:10.1177/15568253251381804

Isr J Health Policy Res. 2025 Sep 22;14(1):58. doi: 10.1186/s13584-025-00721-4.

ABSTRACT

BACKGROUND: Over the past two decades, the increasing frequency of disasters highlights the urgent need for nurses willing to respond to these crises. Although disaster care is part of their professional role, willingness to provide care in such situations is not always guaranteed and may be influenced by various factors. Understanding what shapes their intention to provide care is critical for effective disaster planning. This study investigates the role of empathy in shaping nurses’ intention to participate in disaster care, drawing on the Empathy-Altruism Hypothesis. To further contextualize this relationship, elements of the Theory of Planned Behavior-attitude toward the behavior, subjective norms, and perceived behavioral control-were also examined as potential predictors of behavioral intention.

METHODS: A cross-sectional and correlational study was carried out among nurses in Greece using a convenience sampling method. Data collection took place from December 2023 to April 2024. Participants completed a questionnaire covering demographics, academic background, experiences with disasters, empathy (assessed using the Jefferson Scale of Empathy), and behavioral intentions related to disaster care. The Behavioral Intention Scale was used to assess the behavioral intention, attitude toward the behavior, subjective norms and perceived behavioral control.

RESULTS: The final sample included 252 nurses. Findings revealed a strong intention to participate in disaster victim care. Empathy levels were moderate to high, with a mean score of 103.56 on a 20-140 scale. Multiple linear regression, using behavioral intention as the dependent variable, revealed a significant positive association between subjective norms and behavioral intention. In contrast, empathy, attitude, and perceived behavioral control were not significantly associated with behavioral intention.

CONCLUSIONS: This study provides insights into the factors that influence nurses’ intention to provide disaster care, with subjective norms emerging as the strongest predictor. These findings partially support the Theory of Planned Behavior and suggest that social expectations and perceived peer support may be critical in shaping willingness to respond. Although nurses exhibited strong empathy and a high intention to participate in disaster care, empathy did not significantly influence behavioral intention. Further research is needed to explore empathy’s potential contribution to motivating nurses to engage in disaster response.

PMID:40976832 | DOI:10.1186/s13584-025-00721-4

Neurol Ther. 2025 Sep 21. doi: 10.1007/s40120-025-00830-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Guillain-Barré syndrome (GBS) is an acute immune-mediated disorder of the peripheral nervous system, marked by rapid onset of neurological symptoms. Despite progress in understanding the etiology and improving clinical management, no validated biomarkers are currently available to predict disease severity or treatment response during the acute phase. This meta-analysis aims to evaluate the role of serum neurofilament light chain (NfL) as a biomarker of acute disease activity and prognostic outcomes in GBS.

METHODS: A systematic review and meta-analysis was conducted using PubMed, Scopus, and Cochrane Library databases to identify studies assessing NfL levels in patients with GBS. In addition, we included data from our own cohort of patients with GBS-whose NfL levels were measured at disease onset-and from healthy controls. The primary outcome was the difference in NfL levels-both in serum and cerebrospinal fluid (CSF)-between patients with GBS and controls. Secondary outcomes included the correlations between acute-phase NfL levels, clinical severity at admission as measured by the Guillain-Barré Disability Scale (GBDS) or the Hughes Functional Scale (HFS), and long-term outcomes such as the inability to walk or run 1 year after disease onset.

RESULTS: In this meta-analysis of nine studies, which also included data from our cohort, serum NfL levels were significantly higher in patients with GBS compared with controls (mean difference 143.17 pg/mL, 95% CI 67.7-218.6; p < 0.01; I² = 83%). In contrast, the difference in CSF NfL levels only approached statistical significance (mean difference 2091.1 pg/mL, 95% CI 171.2-4353.4; p = 0.07, I² = 92.1%). These findings were corroborated in our cohort, where median serum NfL concentrations were markedly higher in patients with GBS compared to controls (97 pg/mL, IQR 79-194 vs. 15 pg/mL, IQR 13-20; p < 0.05, Wilcoxon rank-sum test). Serum NfL levels were higher in patients with the acute motor axonal neuropathy (AMAN) compared to those with acute inflammatory demyelinating polyneuropathy (AIDP) (MD 531.9 pg/mL, 95% CI 32.8-1031.01; I² = 81.1%; p = 0.04). Moreover, NfL levels positively correlated with disease severity at admission (r = 0.38; p < 0.001) and poor long-term outcomes (OR 3.74, 95% CI 1.05-13.37; p < 0.001).

CONCLUSION: Serum NfL is a promising biomarker for early diagnosis and prognosis in GBS and may support risk stratification at hospital admission.

PMID:40976818 | DOI:10.1007/s40120-025-00830-x

Lifetime Data Anal. 2025 Sep 22. doi: 10.1007/s10985-025-09670-1. Online ahead of print.

ABSTRACT

Bayesian inference for survival regression modeling offers numerous advantages, especially for decision-making and external data borrowing, but demands the specification of the baseline hazard function, which may be a challenging task. We propose an alternative approach that does not need the specification of this function. Our approach combines pseudo-observations to convert censored data into longitudinal data with the generalized method of moments (GMM) to estimate the parameters of interest from the survival function directly. GMM may be viewed as an extension of the generalized estimating equations (GEE) currently used for frequentist pseudo-observations analysis and can be extended to the Bayesian framework using a pseudo-likelihood function. We assessed the behavior of the frequentist and Bayesian GMM in the new context of analyzing pseudo-observations. We compared their performances to the Cox, GEE, and Bayesian piecewise exponential models through a simulation study of two-arm randomized clinical trials. Frequentist and Bayesian GMMs gave valid inferences with similar performances compared to the three benchmark methods, except for small sample sizes and high censoring rates. For illustration, three post-hoc efficacy analyses were performed on randomized clinical trials involving patients with Ewing Sarcoma, producing results similar to those of the benchmark methods. Through a simple application of estimating hazard ratios, these findings confirm the effectiveness of this new Bayesian approach based on pseudo-observations and the generalized method of moments. This offers new insights on using pseudo-observations for Bayesian survival analysis.

PMID:40976813 | DOI:10.1007/s10985-025-09670-1

Eur J Appl Physiol. 2025 Sep 22. doi: 10.1007/s00421-025-05993-x. Online ahead of print.

ABSTRACT

PURPOSE: The role of androgen levels in physiological characteristics of females is poorly understood, as previous research has mainly focused on testosterone and females not using hormonal contraceptives. Our aim was to investigate whether androgen levels are associated with body composition and physical performance in recreationally active and trained premenopausal females.

METHODS: The study examined two phases of the menstrual/combined oral contraceptive (COC) cycle of healthy eumenorrheic (EUM) and COC using females (age 19-35 years, n = 83). Total and free serum testosterone, dehydroepiandrosterone, androstenedione, dehydroepiandrosterone (DHEA), DHEA-sulfate, and sex hormone-binding globulin (SHBG) levels were analyzed. Linear mixed-effects models were used to examine the associations between androgen levels and fat-free mass (FFM), fat mass (FM), counter movement jump (CMJ), maximal isometric force production, and aerobic capacity ( $\dot{\text{V}}\text{O}$ _2peak).

RESULTS: None of the measured androgens were significantly associated with body composition or physical performance outcomes in the pooled sample. However, significant androgen-COC-use interactions indicated that the associations between DHEA and FFM (β = 0.23, p = 0.017), SHBG and FFM-FM-adjusted CMJ (β = 0.72, p = 0.041), and total testosterone and unadjusted $\dot{\text{V}}\text{O}$ _2peak (β = – 0.27, p = 0.016) differed according to COC-use. A significant association between SHBG and CMJ (β = – 0.66, p = 0.047) and total testosterone and $\dot{\text{V}}$ O_2peak (β = 0.15, p = 0.044) was found only in EUM; however, adjustment for FFM eliminated this statistical significance.

CONCLUSION: Serum androgen levels were not robustly associated with body composition or physical performance outcomes in healthy, recreationally active and trained premenopausal females. Hormonal contraceptive status may attenuate the associations between androgens and performance, driven potentially by FFM and individuals with high androgen levels.

PMID:40976810 | DOI:10.1007/s00421-025-05993-x

Updates Surg. 2025 Sep 21. doi: 10.1007/s13304-025-02402-y. Online ahead of print.

ABSTRACT

Flail chest is a severe thoracic injury associated with high morbidity, prolonged hospitalization, and an increased risk of chronic pain. Surgical stabilization of rib fractures (SSRF) has become an increasingly accepted treatment modality in selected patients. However, the optimal timing of intervention and the prognostic value of radiologic injury scoring systems remain areas of investigation. Our findings confirm prior evidence supporting the early use of SSRF in selected patients and further explore the predictive value of radiologic injury scores in postoperative outcomes. This retrospective study included 74 patients who underwent SSRF for flail chest between 2012 and 2023. Demographic data, radiologic injury scores (AIS Thorax, RibScore, BPC18), timing of surgery, and clinical outcomes were analyzed. Patients were grouped according to age (≤ 65 vs. > 65 years) and timing of surgery (≤ 2 days vs. ≥ 3 days post-admission). Primary endpoints included ICU and hospital length of stay, postoperative complications, mortality, return to normal activity, and incidence of chronic pain. The median number of fractured ribs was 7 (IQR: 3-10), with a median AIS Thorax score of 4.05, RibScore of 4.66, and BPC18 score of 2.66. Early surgery (≤ 48 h) was associated with a significantly shorter hospital stay (median 8 vs. 10 days, p = 0.037), although ICU stay, complication rates, and return to activity did not significantly differ between early and late surgery groups. No statistically significant differences in outcomes were observed between the age groups. AIS Thorax showed the strongest correlation with ICU stay (r = 0.513, p < 0.001), followed by BPC18 (r = 0.377, p = 0.001) and RibScore (r = 0.317, p = 0.003). All three scores were significantly correlated with total hospital stay duration as well. However, none were associated with chronic pain or time to return to normal activity. Chronic pain developed in 20.2% of the patients. Logistic regression analysis revealed no independent predictors of chronic pain, including age, sex, number of fractured ribs, injury severity scores, or surgical timing. SSRF is a safe and effective treatment for flail chest, including in elderly and severely injured patients. Early surgery supports faster recovery without added complications. While injury scores reflect acute outcomes, they do not predict chronic pain or long-term recovery.

PMID:40976804 | DOI:10.1007/s13304-025-02402-y

AIDS Behav. 2025 Sep 22. doi: 10.1007/s10461-025-04871-z. Online ahead of print.

ABSTRACT

This research evaluates the mediation and moderation of an efficacious physical activity (PA) intervention designed for African American men living with human immunodeficiency virus (HIV). Physical activity is a crucial element in managing the health of individuals with HIV, but African American men represent a population that is disproportionately affected by HIV and often faces barriers to engaging in regular PA. We analyzed data obtained from a randomized controlled trial (N = 302) that recruited African American men living with HIV who are 40 years or older and randomly assigned them to a PA intervention group or a health-awareness control group. We collected data at baseline, immediate post-intervention, and 3-, 6-, and 12-month post-intervention. We examined whether the intervention’s effect on adherence to PA guidelines was mediated through the Reasoned Action Approach and the Social Cognitive Theory constructs, including attitudes, social norms, self-efficacy, and intention. We explored whether individual characteristics, including Body Mass Index (BMI), Waist-Hip Ratio (WHR), age, education level, and marital status, influenced the intervention’s effect. We found that self-efficacy mediated the intervention’s effect (α × β × γ product = 0.125, 95% ACI [0.053, 0.229]) by influencing intentions. Statistical analyses did not identify significant moderations of the intervention effect by age, marital status, education level, BMI, or WHR. These findings suggest that interventions to enhance PA among African American men living with HIV should particularly focus on boosting self-efficacy to exercise. Future research should explore additional psychological mechanisms and potential moderators to further refine and tailor PA interventions for this population.

PMID:40976796 | DOI:10.1007/s10461-025-04871-z

Infect Dis Poverty. 2025 Sep 22;14(1):95. doi: 10.1186/s40249-025-01363-z.

ABSTRACT

BACKGROUND: Opisthorchiasis infected by Opisthorchis felineus has represented a significant but understudied public health issue for the population residing in Western Siberia and the Ural Region of the Russian Federation. This study aimed to produce high-resolution spatial-temporal disease risk maps for guiding prevention strategy in the above region.

METHODS: Data on prevalence and surveillance data reflecting reported annual incidence rate of O. felineus infection in the study region were collected through systematic review and the annual reports of the Ministry of Health of the Russian Federation. Environmental, socioeconomic and demographic data were downloaded from different open-access data sources. An advanced multivariate Bayesian geostatistical modeling approach was developed to estimate the O. felineus infection risk at high-resolution spatial-temporal by joint analysis of survey and surveillance data, incorporating potential influencing factors and spatial-temporal random effects. The annual spatial-temporal risk maps of O. felineus infection at a resolution of 5 × 5 km² were produced.

RESULTS: The final dataset included 76 locations of survey data and 303 locations of surveillance data on O. felineus infection. The infection risk was high (> 25%) in most part of central and eastern regions, and relatively low (< 25%) in most part of western region, while temporal variations were observed across the sub-regions in recent decades. Particularly, in the densely populated eastern region, there was an increased trend of infection risk from 30.46% (95% Bayesian credible intervals, BCI 10.78-53.45%) in 1980 to 53.39% (95% BCI 13.77-91.93%) in 2019 and gradually transformed into high-risk. In the study region (excluding the western region due to data sparsity), the population-adjusted estimated prevalence was 46.61% (95% BCI 15.09-76.50%) in 2019, corresponding to approximately 7.91 million (95% BCI 2.56-12.98 million) people infected.

CONCLUSIONS: The high-resolution risk maps of O. felineus in Western Siberia and the Ural Region of the Russian Federation have effectively captured the risk profiles, suggesting the infection risk remains high in recent years and providing substantial evidence for spatial-target control and preventive strategies.

PMID:40976794 | DOI:10.1186/s40249-025-01363-z