Tag: nevin manimala

Medicine (Baltimore). 2025 Nov 7;104(45):e45468. doi: 10.1097/MD.0000000000045468.

ABSTRACT

Diet is an important factor influencing chronic constipation and diarrhea. This investigation proposes to examine the correlation between the Planetary Health Diet Index (PHDI), a new dietary scoring system, and the risk of chronic constipation and diarrhea in the general population. Data on 13,669 adults (≥20 years) were extracted from the 2005 to 2010 National Health and Nutrition Examination Survey. The PHDI was calculated by two 24-hour dietary recall interviews and consisted of scores from 15 food groups with a total score range of 0 to 140. Multivariable logistical regression analyses were employed to examine the correlation between PHDI and chronic constipation/diarrhea, and presented as odds (OR) and 95% confidence interval. Subgroup evaluations were carried out according to population and disease characteristics. The weighted quantile sum analysis was applied to evaluate the effect of total PHDI and its components on chronic constipation. Among these 13,669 participants, 1027 reported chronic constipation, 1061 had chronic diarrhea, and 11,581 maintained normal bowels. The second (63.69-66.67) (OR = 0.73 [0.57-0.92]) and third (>66.67) tertiles (OR = 0.68 [0.54-0.85]) of PHDI were connected to lower odds of chronic constipation versus the first tertile of PHDI (<63.69). No significant correlation was identified between PHDI and chronic diarrhea (P > .05). There was a nonlinear link of PHDI with chronic constipation (Poverall < .001, Pnonlinear < .001), and the risk of chronic constipation in individuals decreased with the increase in PHDI. Subgroup analysis indicated that the connection between PHDI and chronic constipation risk was more obvious in populations aged <65 years, those without diabetes, and those with dyslipidemia (P < .05). The weighted quantile sum analysis demonstrated that the overall mixed exposure effect of PHDI on the risk of chronic constipation was 0.96 (95% confidence interval: 0.94-0.97) (P < .001). Among the contributions of each component to PHDI, “added sugar and fruit juices” contributed the most to the effect of PHDI, followed by “saturated oils and transfat,” while “legumes” and “nuts and seeds” contributed the least. A high PHDI is correlated with a lower risk of chronic constipation in the general population, which may suggest the potential benefits of dietary modification.

PMID:41204594 | DOI:10.1097/MD.0000000000045468

Medicine (Baltimore). 2025 Nov 7;104(45):e45711. doi: 10.1097/MD.0000000000045711.

ABSTRACT

Maternal smoking around birth (MSAB) has been associated with various adverse health outcomes in offspring, including an increased risk of kidney diseases. This study aims to investigate the potential causal relationship between MSAB and the risk of kidney diseases in descendants using Mendelian randomization (MR) methods, providing insights into the epidemiological background of kidney diseases and the application of MR in this context. We conducted a 2-sample MR analysis utilizing publicly available data from large-scale genome-wide association studies on MSAB (n = 397,732), breastfeeding (n = 352,094), and various kidney diseases, including acute kidney injury (AKI) (n = 482,266), chronic kidney injury (n = 482,858), glomerulonephritis (n = 500,348), renal malignancies (n = 463,010), and chronic kidney disease (n = 493,235). We employed multiple MR methods, including inverse variance weighted (IVW), weighted median, weighted mode, and MR Egger regression, to assess the causal effects. We used the odds ratio (OR) as our measure and conducted multivariable MR analysis to account for the confounding effect of breastfeeding. To ensure the reliability and stability of our results, we conducted sensitivity analyses, which included Cochran Q test, MR Egger, and leave-one-out analysis. The MR-IVW results indicated a strong positive causal association between MSAB and the risk of AKI (OR = 11.47, 95% confidence interval [CI]: 2.58-51.02, P-fdr = .008) and renal malignancies (OR = 1.02, 95% CI: 1.01-1.04, P-fdr = .01) in offspring. A potential causal relationship with glomerulonephritis was also observed (OR = 8.63, 95% CI: 1.13-65.88, P-fdr = .08). After adjusting for breastfeeding using multivariable MR, the associations between MSAB and AKI (OR: 13.43, 95% CI: 2.72-66.25, PIVW = .001) as well as renal malignancies (OR: 1.02, 95% CI: 1.01-1.04, PIVW = .005) remained statistically significant. This suggests that maternal smoking during pregnancy significantly increases the risk of AKI and renal malignancies in their children. Our study provides compelling evidence for a causal link between maternal smoking and an increased risk of kidney diseases in offspring, emphasizing the importance of addressing maternal smoking as a modifiable risk factor. Future research should focus on elucidating the underlying biological mechanisms and exploring interventions to mitigate the impact of maternal smoking on offspring health.

PMID:41204590 | DOI:10.1097/MD.0000000000045711

BMC Public Health. 2025 Nov 7;25(1):3834. doi: 10.1186/s12889-025-25111-y.

ABSTRACT

BACKGROUND: Reproductive tract infections (RTIs) remain a major public health concern among women of reproductive age, but limited evidence exists on their association with knowledge, attitudes, and practices (KAP) in university settings. This study examined the prevalence of RTIs and their relationship with KAP and sociodemographic factors among university-affiliated women.

METHODS: A cross-sectional survey was conducted from October 2023 to March 2024 among 457 women aged 18-48 years at a large comprehensive university in Tianjin, China, including students, faculty, administrative staff, and contracted workers. Participants were recruited through stratified convenience sampling and completed a validated 23-item KAP questionnaire, followed by standardized clinical examination and standardized clinical assessment with targeted laboratory testing. Associations between KAP, sociodemographic characteristics, and RTI prevalence were assessed using descriptive statistics and chi-square tests.

RESULTS: The mean KAP score was 50 (SD 14); 34.5% of participants were categorized as low, 46.3% as medium, and 19.0% as high. Overall RTI prevalence was 37.6%, with endometritis (17.7%) and salpingitis (17.2%) most common. Higher KAP levels were inversely associated with RTI prevalence (p < 0.001). Marked gradients were observed by education and expenditure: prevalence was 24.5% among women with a master’s degree or above versus 50.8% among college students, and 70.7% among those with monthly expenditure < 2,000 RMB.

CONCLUSIONS: Institutional affiliation alone did not confer adequate sexual health; persistent occupational and socioeconomic gradients indicate that structural socioeconomic and cultural barriers-rather than educational access per se-drive disparities. Equity-oriented, culturally appropriate, KAP-based interventions and longitudinal evaluation are warranted.

PMID:41204406 | DOI:10.1186/s12889-025-25111-y

BMC Cancer. 2025 Nov 7;25(1):1728. doi: 10.1186/s12885-025-15109-5.

ABSTRACT

BACKGROUND: While most studies on hematopoietic stem cell transplantation (HSCT) have focused on its negative impact, recent research has highlighted the concept of post-traumatic growth (PTG), where individuals experience positive psychological changes after a traumatic event. However, research on PTG in HSCT recipients remains limited. This study aimed to examine PTG as the primary outcome among HSCT recipients and identify key psychosocial and clinical predictors.

METHODS: Adult HSCT recipients within 1 year of transplantation at a university hospital in Seoul were enrolled from March 2018 to March 2022. Participants completed structured questionnaires, and treatment-related data were extracted from electronic medical records. Data were analyzed using descriptive statistics, t-tests, analysis of variance, Pearson’s correlation, and multiple regression analysis.

RESULTS: Overall, 106 patients were enrolled. The average PTG score was 73.75, with higher scores observed in autologous transplant recipients compared to those who received transplants from sibling and unrelated donor transplants. Significant factors influencing PTG included marital status (β=-2.91, p < .001), positive changes after transplantation (β=-0.196, p < .009), rumination (β = 0.298, p < .001), transplant type (β = 0.268, p < .001), and social support (β = 0.191, p < .006), with the regression model explaining 53% of the variance (F = 20.773, p < .001).

CONCLUSIONS: Our findings underscore the need for tailored interventions that address key factors influencing PTG in HSCT recipients. They also highlight the essential role of oncology nurses in assessing psychosocial needs and implementing individualized, evidence-based care strategies to support psychological recovery and promote PTG.

PMID:41204401 | DOI:10.1186/s12885-025-15109-5

BMC Cardiovasc Disord. 2025 Nov 7;25(1):792. doi: 10.1186/s12872-025-05248-9.

ABSTRACT

INTRODUCTION: Heavy metal pollution is a concerning cardiovascular risk factor and a major public health concern. While traditional cardiovascular disease (CVD) risk factors are well-established, environmental exposures are less recognized, despite their growing significance.

METHODS: Adhering to PROSPERO and PRISMA guidelines, a search was conducted across PubMed, Cochrane, and Embase until April 2025 for studies involving patients with heart disease or stroke who were exposed to heavy metals. Primary outcomes were the events of CVD, CHD, and stroke. Proportions of events within populations with 95% confidence intervals were pooled. R software was used for the analysis, with statistical significance set at p < 0.05.

RESULTS: We included 16 studies involving 324,331 participants. The cadmium subgroup showed a pooled proportion of 0.09 (95% CI: 0.01-0.17), with individual values ranging from 0.01 to 0.22; the arsenic subgroup showed a pooled proportion of 0.04 (95% CI: 0.04-0.04). The overall pooled proportion was 0.08 (95% CI: 0.01-0.15). Six studies found cases of CHD in groups exposed to cadmium and arsenic, with combined rates of 0.10 (95% CI: 0.00-0.22) for cadmium and 0.00 (95% CI: 0.00-0.00) for arsenic. The overall pooled proportion was 0.08 (95% CI: 0.00-0.18). Ten studies assessed CVD proportions by metal exposure. Arsenic showed a pooled proportion of 0.06 (95% CI: 0.00-0.18), cadmium 0.14 (95% CI: 0.00-0.31), lead 0.08 (95% CI: 0.01-0.14), and mercury 0.05 (95% CI: 0.04-0.06). The overall pooled proportion was 0.10 (95% CI: 0.03-0.17).

CONCLUSION: This study emphasizes the significance of the toxic environmental metals contributing to cardiovascular risk beyond behavioural risk factors.

PMID:41204397 | DOI:10.1186/s12872-025-05248-9

J Orthop Surg Res. 2025 Nov 7;20(1):967. doi: 10.1186/s13018-025-06446-z.

ABSTRACT

AIM: The demand for total hip arthroplasty and hemiarthroplasty is rising, increasing the incidence of periprosthetic femoral fractures. This study aimed to assess clinical outcomes, including mortality, length of stay, and the impact of periprosthetic femoral fractures on mobility and frailty at one-year follow-up.

METHODS: A retrospective analysis of prospectively collected data was conducted looking at periprosthetic femoral fractures at a tertiary referral center from 2018 to 2024. The data collected included comorbidities, fracture classification, treatment method, length of stay, and discharge destination. The mortality rates at 30 days and one year were calculated. Mobility and frailty were assessed via the New Mobility Score and Clinical Frailty Scale before fracture and at one year. Statistical analysis included chi-square and Wilcoxon signed rank tests.

RESULTS: A total of n = 79 patients met the inclusion criteria (mean age 79.6 ± 9.5 years). There was a preponderance of females (35:44, M: F, p = 0.311). Vancouver B2 was the most common fracture pattern (n = 38). Surgical fixation was performed in n = 58 patients. Mortality rate at 30-day and one-year were 7.5% (n = 6) and 16.4% (n = 12) respectively. The mean Charlson Comorbidity Index was 4.39, with a score greater than 5 associated with higher one-year mortality (p = 0.031). Nursing home residency increased by 16%. The median New Mobility Score decreased from 7 to 5 (p < 0.001). The median Clinical Frailty Scale score increased from 4 to 5 (p < 0.001).

CONCLUSION: Periprosthetic femoral fractures affect elderly, comorbid patients and are associated with high mortality. We observed measurable and significant decreases in mobility and frailty. Prompt treatment and early mobilization should be prioritized to improve outcomes.

PMID:41204374 | DOI:10.1186/s13018-025-06446-z

Pilot Feasibility Stud. 2025 Nov 7;11(1):137. doi: 10.1186/s40814-025-01721-6.

ABSTRACT

BACKGROUND: Systematic reviews have demonstrated the scarcity of well-designed evaluations investigating outdoor nature-based play and learning provision for children in the early childhood education and care (ECEC) sector. This study investigated the feasibility of evaluating outdoor nature-based play and learning provision across urban ECEC settings in Scotland.

METHODS: Seventy-seven ECEC settings in Glasgow, Scotland, were contacted to participate in a mixed-methods feasibility and pilot quasi-experimental non-equivalent control study. The evaluation involved ECEC settings with three different models of outdoor nature-based provision. Children aged 3 and 4 years old at participating ECEC settings were eligible. The feasibility of recruitment/retention of ECEC settings and children, propensity score matching in place of participant randomisation, outcome measures, routine monitoring procedures, and study design acceptability were investigated. Outcome measures were completed at baseline and 7 weeks later: anthropometric measures, Strength and Difficulties Questionnaire (SDQ), Preschool Gross Motor Quality Scale, and wrist-worn accelerometer. Feasibility was investigated using descriptive statistics, outcome measure completion rates, and thematic analysis of semi-structured interviews with 15 ECEC educators.

RESULTS: Ten percent (8/77) of ECEC settings expressed a willingness to participate, and six were taken forward for recruitment of children: two traditional ECEC settings, two fully outdoor ECEC settings, and two satellite ECEC (where the outdoor space is not adjacent to the physical premises) settings. Twenty-three percent of children (53/228) provided consent to participate in the study. Data of 46 children were collected at baseline. The retention rate of children at follow-up was 69.8% (37/53). We found few participants were matched on their propensity score. Excluding SDQ assessments and wrist-worn accelerometer, all outcome measures met the green progression category (70% or more completed). Routine monitoring tools, ‘learning journals’, provided a cross-sectional description of how children progress against curriculum outcomes. Practitioners found the pilot study design acceptable in terms of the limited intrusiveness to their daily operations and the level of participation required; however, they suggested that the wrist-worn accelerometers should be reconsidered.

CONCLUSION: Overall, the study design was accepted by practitioners; however, before an effectiveness evaluation, it is recommended that the recruitment process be improved. The quasi-experimental approach to randomisation should be reviewed considering the outcomes an effectiveness study wishes to investigate (e.g. balance or prosocial behaviour), identification of appropriate covariates, and appropriate sample size. It is recommended that the ‘learning journals’ be used within a case study design monitoring children’s progress against curriculum outcomes. This feasibility study will inform an effectiveness evaluation and support policy making and service delivery in the Scottish ECEC sector.

PMID:41204361 | DOI:10.1186/s40814-025-01721-6

J Eat Disord. 2025 Nov 7;13(1):252. doi: 10.1186/s40337-025-01365-0.

ABSTRACT

BACKGROUND: The involvement of a caregiver is fundamental in the process of caring for a person with eating disorders (ED). The aim of this study is to evaluate the functioning of family unit and the emotional burden of caregivers of individuals with ED treated at an outpatient service.

MATERIALS AND METHODS: We contacted by telephone the caregivers of individuals in care at ED Centre of the AUSL-Modena and selected a sample of 50 caregivers of 42 individuals with ED, who provided their informed consent. The following scales were administered to caregivers: caregiver burden inventory (CBI), Beck’s depression inventory (BDI), family assessment device (FAD), depression, anxiety and stress-scale (DASS-21). The following scales were administered to the care recipients: global assessment of functioning and clinical global impression severity scale. Demographic variables relating to the individuals with ED and their caregivers were collected: sex, age, employment situation, marital status, number of family members, living condition, family role. Clinical variables of care recipients were collected: body mass index, ED diagnosis, duration of ED and treatment and care at ED centre, medical complications, psychiatric comorbidities, substance use. The data was statistically analyzed.

RESULTS: All caregivers were the parents of individuals with ED, in particular the mother (76%), and were employed. Caregivers reported a mild to moderate emotional burden in CBI and mild to severe depressive symptoms in BDI in 62% of cases. Family functioning reported by FAD scale was slightly altered in the areas of “communication”, “roles” and “affective involvement”. Most care recipients were females (98%), suffering from anorexia nervosa (85.6%) with an average age of 18.54 ± 4.74. At multiple linear regression, two statistically significant associations were underscored with CBI score (dependent variable): the age of individuals in a negative way and the psychiatric comorbidities of the individuals with ED in a positive way.

CONCLUSIONS: The parents of sons with ED represented their caregivers, who suffered from a mild emotional burden and depressive symptoms and lived in altered family functioning, especially in communications. Ensuring psychological support for the caregiver may be useful for improving both caring and family relationships.

PMID:41204327 | DOI:10.1186/s40337-025-01365-0

J Eat Disord. 2025 Nov 7;13(1):253. doi: 10.1186/s40337-025-01428-2.

ABSTRACT

OBJECTIVE: This study aimed to elucidate how psychological distress, self-control, and sustainable healthy eating behaviors interact to shape food addiction, by simultaneously modeling their direct and indirect effects in adult population.

METHODS: A cross-sectional survey was conducted with 985 adults (mean age: 28.8 ± 10.9) from community health centers in Elazığ, Turkey. Standardized instruments measured depression, anxiety, stress (DASS-21), self-control, sustainable healthy eating, and food addiction (YFAS). Statistical analyses included logistic regression and structural equation modeling (SEM).

RESULTS: Food addiction prevalence was 34.9%. Individuals with food addiction had significantly higher mean depression, anxiety, and stress scores, and lower self-control (37.1 ± 4.3 vs. 40.2 ± 4.3, p < 0.001) and sustainable healthy eating scores (15.0 ± 3.9 vs. 17.6 ± 4.7, p < 0.001) compared to those without addiction. Logistic regression indicated that anxiety (OR[95% CI] = 1.27 [1.20-1.34]) was the strongest predictor, while higher self-control (OR = 0.92[0.88-0.95]) and sustainable eating (OR = 0.94[0.90-0.97]) reduced risk. The final model explained 44% of the variance. SEM showed that self-control and sustainable eating behaviors significantly mediated the relationship between stress and food addiction.

DISCUSSION: Anxiety exerts the strongest direct influence on food addiction, while self-control and sustainable dietary habits serve as key mediators, particularly in the stress-food addiction pathway. These findings underscore the need for multidimensional interventions that integrate psychological and behavioral strategies to effectively prevent and manage food addiction.

PMID:41204319 | DOI:10.1186/s40337-025-01428-2

Virol J. 2025 Nov 7;22(1):366. doi: 10.1186/s12985-025-02985-3.

ABSTRACT

BACKGROUND: Although the annual number of newly reported human immunodeficiency virus (HIV) infections in Beijing has shown a continuous decline since 2016, the population of people living with HIV (PLWH) has maintained a persistent upward trend. This retrospective study aimed to analyse data from newly diagnosed PLWH from 2015 to 2023 in Beijing to develop precision interventions.

METHODS: All newly diagnosed PLWH were subjected to sequence splicing, quality control, information matching, and analysis for pretreatment drug resistance (PDR) and molecular transmission network. The Stanford Drug Resistance Database was used to analyse drug resistance, and Hyphy and Cytoscape software were used to construct a molecular transmission network with the gene distance threshold of 0.015.

RESULTS: A total of 3,569 newly diagnosed PLWH were included in this study. A total of 42 HIV-1 subtypes were identified, with CRF01_AE being the most common subtype, followed by the CRF07_BC and B subtypes. However, for the first time, the dominant strain shifted from CRF01_AE to CRF07_BC in 2023. A total of 340 drug-resistant sequences were obtained, and the overall prevalence of PDR was 9.53% from 2015 to 2023. The most common mutations were distributed among V179, K103, M184, S68 and M46, which presented diverse distributions and combined mutation features. A total of 64 transmission clusters were identified in the network, among which CRF07_BC was dominated by large spreading clusters, whereas CRF01_AE was dominated by small- and medium-sized spreading clusters. The largest cluster for CRF07_BC expanded rapidly from 8 cases in 2015 to 161 cases in 2023.

CONCLUSIONS: This study revealed the prevalence of HIV-1 drug resistance and molecular transmission network in Beijing. The change in the dominant HIV strain of participants should be emphasized. Subtype CRF07_BC is prone to forming fast-spreading clusters, and targeted interventions should be designed to prevent high-risk transmission sources and reduce new HIV infections.

PMID:41204314 | DOI:10.1186/s12985-025-02985-3