Tag: nevin manimala

Alzheimers Res Ther. 2025 Jun 10;17(1):130. doi: 10.1186/s13195-025-01764-0.

ABSTRACT

BACKGROUND: The growing prevalence of dementia emphasizes the need for effective prevention strategies. Although the partial efficacy of multidomain interventions for dementia prevention has been demonstrated, understanding the characteristics of individuals who benefit most from these interventions is crucial for optimizing resource allocation. This study investigated the association between participants’ genetic backgrounds and the effectiveness of multidomain interventions for preventing dementia.

METHODS: This study utilized data from the Japan-Multimodal Intervention Trial for the Prevention of Dementia (J-MINT), where older adults with mild cognitive impairment underwent 18 months of multidomain intervention. The intervention included exercise, nutrition, cognitive stimulation, social participation, and vascular risk management. Participants who completed the J-MINT intervention and had genetic data, including whole-genome sequencing (WGS), were analyzed. Using Japanese polygenic risk scores (PRSs) for Alzheimer’s disease, participants were stratified into high- and low-genetic-risk groups. Cognitive composite score (CPS) improvement rates at 6-, 12-, and 18-months were compared between intervention and control groups, with subgroup analyses performed by age (< 75 and $\ge$ 75 years). Additionally, a comprehensive variant analysis using WGS was conducted to identify genetic signals potentially associated with the intervention’s effectiveness.

RESULTS: Among 289 participants analyzed (168 aged < 75 years; 121 aged ≥ 75 years), 99 were classified into the high-risk PRS group (56 intervention, 43 control) and 190 into the low-risk PRS group (92 intervention, 98 control). For participants aged ≥ 75 years, no statistically significant differences in CPS improvement rates were observed between the intervention and control groups, regardless of PRS classification. However, in participants aged < 75, those in the high-risk PRS group showed significant CPS improvement at the 6-month follow-up. Additionally, analysis of 9,978,605 genetic variants identified two loci, ID3 and LMO1 (rs2067053 and rs201082658), with suggestive associations (P < 1 × 10⁻⁴) to reduced intervention effectiveness.

CONCLUSIONS: This study highlighted the utility of PRS in predicting cognitive improvement following multidomain interventions and identified genetic variants that may influence the intervention’s effectiveness. The findings provide a valuable foundation for personalized dementia prevention strategies.

PMID:40490801 | DOI:10.1186/s13195-025-01764-0

Harm Reduct J. 2025 Jun 9;22(1):102. doi: 10.1186/s12954-025-01250-8.

ABSTRACT

BACKGROUND: The United States is experiencing an intersecting crisis of structural inequities, record levels of homelessness, and a surging fourth wave of the opioid epidemic. People experiencing unsheltered homelessness (PEUH) are at particularly high risk of opioid-related death. Although naloxone is a key tool for preventing overdose fatalities, PEUH face significant barriers to accessing and retaining it. This study examined the acceptability of a novel overdose education and naloxone distribution (OEND) intervention implemented during Kern County’s 2024 Point-in-Time (PIT) unsheltered count. As part of the initiative, volunteers were offered optional OEND training prior to distributing naloxone to PEUH during the annual PIT Count.

METHODS: Naloxone distribution was tracked, and PIT Count volunteers were recruited via convenience sampling to complete a post-intervention electronic survey. The survey assessed acceptability using domains from the Theoretical Framework of Acceptability. Descriptive statistics and thematic analysis were used to evaluate responses related to OEND training and naloxone distribution.

RESULTS: Of 111 survey initiators, 94 met eligibility criteria. Most respondents (71.3%) participated in the OEND training, and nearly two-thirds (64.9%) distributed naloxone. Among those with prior overdose experience (n = 26), 88.5% had taken bystander action, most often administering naloxone or calling 911. Training participants reported positive affective attitudes (mean = 1.57), high perceived effectiveness (mean = 1.58), low burden (mean = 1.89), and low opportunity cost (mean = 4.40 on a reverse scale), with slightly lower self-efficacy (mean = 2.23). Overall acceptability was high (mean = 1.45). Among naloxone distributors, responses indicated strong comfort (mean = 1.6), confidence (mean = 1.7), coherence (mean = 1.6), and acceptability (mean = 1.8), along with low burden (mean = 1.9) and opportunity cost (mean = 4.5). Over 87% expressed willingness to distribute naloxone in future PIT Counts. Non-distributors cited reasons such as lack of opportunity, participant refusal, and discomfort. Open-ended responses suggested improvements in training availability, logistics, and messaging for PEUH.

CONCLUSIONS: Naloxone training and distribution during the PIT Count was feasible and highly acceptable. These findings support broader implementation to improve naloxone access and reduce overdose deaths among PEUH, and they provide a foundation for future effectiveness studies.

PMID:40490800 | DOI:10.1186/s12954-025-01250-8

Ital J Pediatr. 2025 Jun 9;51(1):185. doi: 10.1186/s13052-025-02048-x.

NO ABSTRACT

PMID:40490792 | DOI:10.1186/s13052-025-02048-x

BMC Health Serv Res. 2025 Jun 9;25(1):818. doi: 10.1186/s12913-025-12815-5.

ABSTRACT

BACKGROUND/PURPOSE: To examine how the choice of rural measurements affects estimates of hospitalization rates for depression and substance use disorders (SUD).

METHODS: We conducted cross-sectional analyses using the 2018 State Inpatient Database (SID) for 5 states, including Arizona, Kentucky, Maryland, Washington, and Florida, to determine how (1) estimates of hospitalization rates for depression and SUDs; and (2) patient characteristics among those hospitalized differ. Five measurements of rurality including rural-urban commuting areas (RUCA) codes, core-based statistical areas (CBSA), urban-rural category four (URCategory4) and two definitions of rural urban continuum codes (RUCC) were used. For each measurement, we calculated frequencies and percentages for age, race, sex, and insurance type. We conducted Spearman’s rank correlations to compare associations and internal agreement. We created an UpSet chart to visualize the overlap in different measurements.

RESULTS: There were 152,771 hospitalizations for depression and 43,760 hospitalizations for SUDs. The percentage of hospitalizations for depression or SUD differed significantly (3.2-8.1% for depression and 5.0-11.6% for SUDs ) based on rurality measure. Race and insurance characteristics of those identified as rural varied by rural measurement for depression and SUD hospitalizations. Spearman’s correlations were higher for hospitalizations for SUD than for depression, ranging from r = 0.61 (RUCC and RUCA) to r = 0.99 (CBSA and URCategory4).

CONCLUSIONS: Different rurality measurements result in differing estimates of hospitalizations for SUD or depression. Stakeholders should be aware that the choice of rural measurements can impact policy decisions and resource allocation for programs intended to improve care in rural areas.

PMID:40490786 | DOI:10.1186/s12913-025-12815-5

J Orthop Surg Res. 2025 Jun 9;20(1):578. doi: 10.1186/s13018-025-05953-3.

ABSTRACT

OBJECTIVE: The optimal surgical approach for tibial avulsion fractures of the posterior cruciate ligament (PCL) remains controversial. This study aimed to compare the clinical outcomes of four techniques: arthroscopic suture fixation, arthroscopic loop plate fixation, open reduction with cannulated screw fixation, and open reduction with anchor suture bridge fixation.

METHODS: A retrospective review was conducted of 73 patients treated between January 2019 and December 2023 using one of four surgical techniques: arthroscopic suture fixation (Group A, n = 26), arthroscopic loop plate fixation (Group B, n = 14), open reduction with cannulated screw fixation (Group C, n = 16), and open reduction with anchor suture bridge fixation (Group D, n = 17). Demographic data, operative time, pre- and postoperative visual analog scale (VAS) pain scores, Lysholm scores, International Knee Documentation Committee (IKDC) scores, knee range of motion (ROM), and postoperative complications were analyzed.

RESULTS: No significant differences were observed in baseline demographic data among the four groups (P >.05). Operative time was shortest in Group D (60.41 ± 12.39 min), significantly less than in the other groups (P =.0001). At 3 months postoperatively, all groups demonstrated significant improvements in VAS, Lysholm, and IKDC scores (P <.0001); however, intergroup differences were not statistically significant (P >.05). Group A demonstrated significantly less ROM recovery compared with the other groups (P =.0171). At final follow-up, further improvements in functional scores and ROM were observed in all groups, with no significant intergroup differences (P >.05). Complication rates differed significantly among the groups (P =.0361), with Group D reporting the lowest rate (0%) and Group A the highest (34.6%).

CONCLUSION: No significant differences were found in overall clinical outcomes among the four techniques. However, open reduction with anchor suture bridge fixation demonstrated favorable operative efficiency and complication profile, suggesting clinical advantages in selected patients.

TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2500100641. Registration Date: 2025-04-11, Retrospectively registered.

PMID:40490779 | DOI:10.1186/s13018-025-05953-3

Malar J. 2025 Jun 9;24(1):184. doi: 10.1186/s12936-025-05438-y.

ABSTRACT

BACKGROUND: The presence of a community effect in cluster randomized trials of malaria vector control interventions has led to the implementation of “buffer zones” around clusters to limit the potential for contamination between interventions. No consensus has been reached on how large these buffers need to be to encapsulate the effect.

METHODS: Nested within a phase-III cluster randomized malaria vector control trial in Northwest Tanzania, this study aims to determine the presence and spatial range of community effects from long-lasting insecticidal net (LLIN) and indoor residual spraying (IRS) interventions on household-level malaria infection in trial clusters four months post-intervention. Effective spatial range estimates of intervention community effects were compared to the 300m buffer distance implemented to limit intervention spillover between clusters in the trial. Geographically-weighted adjusted odds of malaria infection in children aged 0.5-14 years were determined four months post community-level intervention with a randomized allocation comprising one of two LLIN products (Olyset^TM LN: 1000mg/m² permethrin or Olyset^TM Plus LN: 400 + permethrin 800mg/m²) with either IRS (Actellic^®300CS: 1000mg/m² micro-encapsulated pirimiphos-methyl) or no IRS. Robust semivariances were calculated for each of 48 intervention clusters and fit to semivariogram models by Weighted Least Squares.

RESULTS: 6440 children from 2785 households were included in the geographically-weighted logistic regression. Prevalence of Plasmodium falciparum infection was 45.9% in the study population. Twenty (20) clusters had significant residual effect ranges, 13 of which were fit to Sine Hole Effect models, indicating periodicity in the study area. Effective range estimates for the study area had a median value of 1210 m (IQR: 958-1691). Clusters with IRS had a higher median range value: 1535 m (IQR: 976-3398) than those without IRS: 1168m (IQR: 829-1504).

CONCLUSIONS: Significant semivariogram model range estimates extended beyond the trial buffer sizes by a median average of 868 m in LLIN intervention clusters and 1235 m for IRS clusters. This presents a contamination, or spillover, potential for all trialed intervention types that may reduce the statistical power to detect difference between trial arms. Future studies should consider the ranges of intervention effects and contamination potential between trial arms when designing buffer areas.

PMID:40490768 | DOI:10.1186/s12936-025-05438-y

Confl Health. 2025 Jun 10;19(1):33. doi: 10.1186/s13031-025-00651-7.

ABSTRACT

BACKGROUND: People in war-affected and politically violent areas often experience traumatic events that can lead to long-lasting physical and mental health issues. This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD), identify associated risk factors, and examine its relationship with the quality of life.

METHOD: A community-based cross-sectional study was conducted Between April 1 and May 15, 2022, in 812 individuals living in war-affected districts of the North Shewa Zone, Amhara Region, Ethiopia. A multistage sampling technique was employed to select the study subjects. Sociodemographic and pre-existing illness data were collected through face-to-face interviews using a pre-tested instrument. The Post-Traumatic Stress Disorder Checklist (PCL-5) was used to measure the PTSD symptoms and cut-off above 33 was used to identify individuals with PTSD. Health-related quality of life was measured using the World Health Organization’s (WHO) Quality of Life-brief version (WHOQOL-BREF) questionnaire. Binary logistic regression analysis was used to identify PTSD associated factors, while the independent T-test was applied to compare the quality of life (QOL). The model’s fit was evaluated using the Hosmer-Lemeshow goodness-of-fit test and a p-value of 0.05 was considered statistically significant.

RESULT: The prevalence of PTSD was 42.4%. Khat use (AOR = 2.33, 95% CI: 1.33-4.07, p < 0.001), having friends or family who died from mental illness (AOR = 3.91, 95% CI: 1.66-9.20, p < 0.01), conflicts with family, friends or loved ones (AOR = 1.89, 95% CI: 1.18-3.01, p < 0.01), poor social support (AOR = 3.84, 95% CI: 2.53-5.81, p < 0.001), and being coerced into accepting ideas against their will (AOR = 2.04, 95% CI: 1.37-3.03, p < 0.001) were significant factors associated with PTSD. Further, quality of life (QOL) was significantly lower by 0.87 points among individuals with PTSD compared to those without PTSD (t-value = 12.279, p < 0.001).

CONCLUSION: About 4 in 10 individuals living in war-affected districts of the North Shewa Zone, Amhara Region experienced PTSD. Avoiding substance use (a negative coping style) and providing psychotherapy that can adequately addresses the community’s medical, social, and psychological needs is essential for improving QOL in war-related PTSD.

PMID:40490765 | DOI:10.1186/s13031-025-00651-7

BMC Health Serv Res. 2025 Jun 9;25(1):820. doi: 10.1186/s12913-025-12865-9.

ABSTRACT

BACKGROUND: This study evaluated the efficiency and effectiveness of Community-Based Voluntary Counseling and Testing (CBVCT) for HIV in Turin as part of the Fast-Track Cities initiative. It aimed to understand demographic characteristics and risk behaviors to identify factors associated with routine testing. The findings can help to better tailor interventions for reducing HIV transmission and improving public health outcomes.

METHODS: A cross-sectional design was employed, utilizing anonymous questionnaires administered throughout 2022. Participants were individuals attending rapid serological testing sessions for HIV organized by third-sector associations in Turin, Northern Italy. The sample comprised 795 participants who attended HIV testing sessions. Data were collected via paper-based questionnaires (n = 495), later digitized for analysis. Descriptive statistics, univariate, and logistic regression analyses were conducted to examine socio-demographic characteristics, risk behaviors, and testing outcomes. Cost-effectiveness was evaluated using a Markov model stratifying patients by CD4 + levels to assess QALYs and direct healthcare costs.

RESULTS: The study achieved a high HIV testing rate of 99.9%, with a positivity rate of 0.5%. All individuals with reactive tests were successfully linked to care. Syphilis testing had a lower uptake (76.7%) and identified a positivity rate of 0.7%. Significant demographic and behavioral differences were found: previously tested participants are more likely to be older (p < 0.001, OR = 1.15) than first-time testers, more likely to be MSM (Men who have Sex with Men) than MSF (Men who have Sex with Female) and FSM (Female who has Sex with Male) (p < 0.001, OR = 0.132; p < 0.001, OR = 0.183); and are more likely to have had a history of sexually transmitted infections (STIs)(p = 0.003, OR = 0.128). Immediate HIV diagnosis and access to antiviral therapy reduce healthcare costs by €3,841 per patient, with total savings of €23,808 due to lower treatment expenses before immunodeficiency onset.

CONCLUSIONS: CBVCT programs in Turin demonstrated high feasibility and effectiveness in engaging the target population and ensuring linkage to care. However, syphilis testing requires greater integration. The findings highlight the need for targeted interventions to address disparities in testing behaviors and reinforce the economic sustainability of early HIV diagnosis and treatment.

PMID:40490747 | DOI:10.1186/s12913-025-12865-9

BMC Geriatr. 2025 Jun 9;25(1):420. doi: 10.1186/s12877-025-06094-2.

ABSTRACT

BACKGROUND: Frailty is associated with adverse outcomes in older adults across healthcare settings. Frailty screening tools can serve to identify older adults living with frailty and direct resources to high-risk older adults. This systematic review and meta-analysis examined the diagnostic and predictive accuracy of the Program of Research to Integrate the Services for the Maintenance of Autonomy 7 (PRISMA-7) frailty screening tool.

METHODS: A systematic literature search was conducted in PubMed, EMBASE, CINAHL, EBSCO and the Cochrane Library. Prospective or retrospective cohort and cross-sectional studies that explored the diagnostic and/or predictive accuracy of the PRISMA-7 tool in older adults were included across all healthcare settings. Study quality was assessed using the QUADAS-2 tool. Statistical analysis was completed using Stata version 12 (StataCorp, TX, USA). A bivariate random effects model was used to generate pooled estimates of sensitivity and specificity. RevMan5 was used to pool data comparing older adults living with frailty versus those without frailty.

RESULTS: Thirty-six studies were included in the review. The overall quality of the studies included was moderate. Meta-analysis of diagnostic accuracy (regardless of reference standard used) showed a pooled sensitivity and specificity of 72% (95% CI 54-84%) and 87% (95% CI 76-93%), respectively. Sub-analysis of the six studies that used Frailty Phenotype as a reference standard demonstrated pooled sensitivity and specificity of 82% (95% CI 73.8-88.2) and 79% (95% CI 72-85.6%), respectively. Meta-analysis of the predictive accuracy of the PRISMA-7 showed that older adults living with frailty spent significantly more time in the emergency department (FEM MD 2.66 h, 95% CI 2.15-3.16 h, I² = 25%) and stayed longer in hospital, (REM MD 1.89 days, 95% CI 0.18-3.6 days, I² = 86%), respectively.

CONCLUSION: The PRISMA-7 has a moderate sensitivity and high specificity for frailty identification. It has good predictive accuracy for multiple adverse outcomes among older adults, supporting its potential utilization across healthcare settings.

PMID:40490744 | DOI:10.1186/s12877-025-06094-2

BMC Pulm Med. 2025 Jun 9;25(1):286. doi: 10.1186/s12890-025-03750-6.

ABSTRACT

BACKGROUND: Stroke-associated pneumonia (SAP) is a common and severe complication following stroke, significantly impacting recovery and outcomes. Early identification of biomarkers and development of predictive models are essential for SAP diagnosis and prevention. This study systematically evaluated the diagnostic value of procalcitonin (PCT) and other biomarkers for SAP and explored their integration into predictive models.

METHODS: A systematic review and meta-analysis were conducted by searching PubMed, Web of Science, and CNKI databases for studies published up to March 2023. Inclusion criteria focused on studies reporting biomarkers for SAP diagnosis and predictive models. Statistical analyses included pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) using RevMan 5.4 and R software.

RESULTS: This meta-analysis included 11 studies with 1,478 patients and found that PCT levels were significantly elevated in SAP patients, particularly those with ischemic stroke (standardized mean difference [SMD] = 2.89, 95% confidence interval [CI] = 1.74-4.04). PCT demonstrated high diagnostic accuracy, with a pooled sensitivity of 0.84, specificity of 0.89, DOR of 48.78, and AUC of 0.91, outperforming other biomarkers like CRP and IL-6. Predictive models incorporating biomarkers improved risk stratification, though heterogeneity among studies underscores the need for standardization.

CONCLUSIONS: PCT is a reliable biomarker for SAP diagnosis, offering high sensitivity and specificity. Combining PCT with predictive models can enhance risk assessment and early detection of SAP. Further research is necessary to refine prediction models and validate the clinical application of biomarkers across diverse populations. This study underscores the importance of biomarkers in guiding SAP prevention and management strategies.

PMID:40490740 | DOI:10.1186/s12890-025-03750-6