Tag: nevin manimala

BMC Public Health. 2025 Aug 21;25(1):2868. doi: 10.1186/s12889-025-24220-y.

ABSTRACT

OBJECTIVE: To create and verify a machine learning model that integrates social determinants of health (SDoH) for assessing post-stroke depression (PSD) and examining the association between SDoH and disease outcomes.

METHODS: Data were acquired from the National Health and Nutrition Examination Survey. Logistic regression was employed to analyse the association between SDoH and PSD, whereas Cox regression was utilized to assess the correlation between SDoH and all-cause mortality in PSD. The Boruta algorithm was employed for feature selection, and four machine learning models were constructed (CatBoost, Logistic, Multilayer Perceptron, and Random Forest) to evaluate the predictive effectiveness, calibration, and clinical applicability of these ML models. SHAP values were computed to ascertain the predictive significance of each feature in the model that exhibited the highest predictive performance.

RESULTS: Logistic regression analysis revealed a significant positive correlation between SDoH and PSD prevalence(p for trend < 0.0001). Compared to the other three models, CatBoost (AUC = 0.966) demonstrated the best overall predictive performance. Moreover, the decision curve analysis (DCA) and calibration curve findings demonstrated that the CatBoost model possessed considerable clinical utility and consistent predictive efficacy. The ten-fold cross-validation method further confirmed the model’s robustness and generalization ability.

CONCLUSIONS: A linear relationship exists between SDoH and PSD, with CatBoost demonstrating the best performance in predicting PSD. SHAP values emphasize the importance of SDoH.

PMID:40841950 | DOI:10.1186/s12889-025-24220-y

BMC Public Health. 2025 Aug 21;25(1):2878. doi: 10.1186/s12889-025-24252-4.

ABSTRACT

OBJECTIVE: This study aimed to investigate the impact of physical activity (PA) on emotional management ability (EMA) in college students and to analyze the chain mediating roles of psychological resilience (PR) and health literacy (HL) in the relationship between PA and EMA.

METHODS: Demographic information was collected using a stratified, cluster, and multi-stage sampling method. Data on PA, PR, HL, and EMA among college students were collected using an online questionnaire. A total of 13,590 valid questionnaires were obtained.

RESULTS: A significant positive correlation was found between PA and EMA in college students (r = 0.177, P < 0.01). PR and HL played significant mediating roles in the relationship between PA and EMA. The mediation effect consisted of independent mediation by PR and HL and a chain mediation effect between the two. The values of the independent mediation effects and the chain mediation effect were 0.011, 0.010, and 0.004, respectively. The chain mediation effect was lower than each of the individual mediation effects and showed a statistically significant difference compared to the mediation effect of HL (P < 0.05).

CONCLUSION: PA significantly enhances college students’ EMA through direct effects and a chain mediation pathway involving PR and HL. Coordinated interventions, including regular exercise, PR training, and health education, are recommended to optimize college students’ psychological health.

PMID:40841939 | DOI:10.1186/s12889-025-24252-4

BMC Gastroenterol. 2025 Aug 21;25(1):608. doi: 10.1186/s12876-025-04177-3.

ABSTRACT

BACKGROUND: Advanced gastric cancer frequently leads to severe complications, such as bleeding, which severely impacts patients’ quality of life and prognosis. Traditional approaches for hemostasis include endoscopic treatments and surgery, but their invasive nature and potential for significant morbidity have made less invasive options like radiation therapy (RT) and transarterial embolization (TAE) appealing. Nonetheless, studies comparing the therapeutic effects and prognosis of RT and TAE are limited, underscoring a significant gap in research and clinical practice.

METHODS: This retrospective study analyzed patients with advanced gastric cancer who experienced uncontrollable bleeding and were treated with RT or TAE. The efficacy of these treatments was assessed based on the achievement of hemostasis, defined as the absence of the need for blood transfusion within 14 days post-treatment and no requirement for additional intervention for bleeding. Furthermore, the study evaluated the post-treatment course, including survival outcomes and re-bleeding rates, to compare the prognostic implications of treatment success or failure.

RESULTS: This study encompassed 28 patients, of whom 19 underwent RT and 9 received TAE. RT was associated with a superior rate of immediate hemostasis (94.7% versus 66.7%, p = 0.047). Nonetheless, the incidence of re-bleeding in the RT cohort was 15.8%, compared to 44.4% in the TAE group, a difference that did not reach statistical significance (p = 0.11). Furthermore, the occurrence of adverse events was comparable between the two treatment modalities (21.1% for RT versus 33.3% for TAE, p = 0.48). An examination of long-term outcomes underscored the initial treatment’s effectiveness and the potential transition to additional therapies as critical determinants of the re-bleeding risk. Groups achieving favorable initial outcomes (p < 0.001) and those for whom subsequent interventions were viable (p = 0.014) demonstrated a significant enhancement in re-bleeding-free survival. Despite the discrepancy in rates of immediate hemostasis, the comparison between the RT and TAE groups revealed no statistically significant difference in re-bleeding-free survival (p = 0.55).

CONCLUSION: RT exhibited superior hemostasis in advanced gastric cancer bleeding compared to TAE, yet both treatments showed similar re-bleeding-free survival rates. The success of the initial treatment, along with potential for further interventions, critically influenced outcomes, emphasizing the importance of effective initial hemostasis.

PMID:40841936 | DOI:10.1186/s12876-025-04177-3

BMC Urol. 2025 Aug 21;25(1):208. doi: 10.1186/s12894-025-01879-4.

ABSTRACT

OBJECTIVES: We aimed to examine the association between patient age and procedural intervention, especially nephrectomy, in patients with renal trauma in the National Trauma Data Bank (NTDB).

MATERIALS AND METHODS: We queried the 2013-2020 NTDB for adult renal trauma patients with an American Association for the Surgery of Trauma (AAST) grade. Patients without AAST grade or with no sign of life were excluded. We constructed a multinomial logistic regression model to demonstrate the association between age and procedural interventions (renal angioembolization, renorrhaphy and nephrectomy). Models were adjusted for patient, hospital, and clinical factors.

RESULTS: Our cohort was comprised of 49,884 patients with renal trauma aged 18-89 years, of which 691 (1.4%), 995 (1.9%), and 3,366 (6.8%) underwent angioembolization, renorrhaphy, and nephrectomy, respectively. After adjusting for relevant variables, the risks of nephrectomy and angioembolization were positively associated with patient age, particularly in those 40 years of age and older. Adjusted risk of nephrectomy (OR 0.07 per 10 years of age, 95% CI 0.03-0.11, p < 0.001) and angioembolization (OR 0.19 per 10 years of age, 95% CI 0.14-0.24, p < 0.001) ranged between ≈ 0.6% and ≈ 1%, and between ≈ 0.3% and ≈ 1% across the patient age range, respectively. Plots depicting marginal effect of age is demonstrated that in patients above 35-40 years of age, a 1-year increase in age is associated with a progressively higher increase in risk of both nephrectomy and angioembolization. The adjusted risk of Renorrhaphy (OR -0.003 per 10 years of age, 95% CI -0.06-0.06, p = 0.92) did not vary substantially with age and the marginal effect of age was negligible across all ages.

CONCLUSIONS: Older patients with renal trauma are more likely to receive procedural intervention namely nephrectomy and renal angioembolization. These results suggest possible age-related cognitive bias in renal trauma management.

PMID:40841903 | DOI:10.1186/s12894-025-01879-4

BMC Nurs. 2025 Aug 21;24(1):1096. doi: 10.1186/s12912-025-03754-x.

ABSTRACT

BACKGROUND: Investigating the links between individual perceived stress, social connection, and work involvement plays a crucial role in enhancing the psychological health and overall well-being of clinical nurses, as well as elevating the quality of nursing care in clinical settings. This study incorporates the concepts of social connection and work engagement. By considering the potential heterogeneity of variables and applying a mediation model, we identified the influence pathways through which subgroups of perceived stress affect social connection and work engagement. This study offers a valuable reference for understanding the nurses’ perceived stress profiles and improving their mental health.

METHOD: The research employed a cross-sectional study methodology. To select 600 clinical nurses from 3 hospitals in Guangzhou, a convenience sampling technique was implemented. Participants’ general demographics, levels of work engagement, perceived stress, and social connections were gathered through questionnaires. Statistical analyses were performed utilizing latent profile examination, mediation analysis and generalized additive models.

RESULTS: (1) The analysis revealed heterogeneity in stress levels among nurses, resulting in the identification of three distinct groups: low stress-high self-demand group (23.4%), high tension-low out-of-control group (57.5%), and high stress-low efficiency group (18.2%). (2) Clinical registered nurses that obtained support from their families were more inclined to be placed in the Low stress-high self-demand group. (3) Social connection significantly mediated the relationship between nurses’ work engagement and perceived stress. (4) Work engagement demonstrated a non-linear relationship with both perceived stress and social connection.

CONCLUSION: The social connections and work engagement of clinical nurses were notably affected by the stress on an individual. Nursing leaders should promptly identify the stress patterns of nurses, implement appropriate stress management strategies, enhance group cohesion through social networks, and promote the nurses’ mental health and occupational well-being, which in turn can decrease nurse turnover rates and enhance the quality of clinical nursing care.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40841901 | DOI:10.1186/s12912-025-03754-x

BMC Public Health. 2025 Aug 21;25(1):2865. doi: 10.1186/s12889-025-23843-5.

ABSTRACT

OBJECTIVE: The COVID-19 vaccination is a key strategy to control the pandemic; however, complex factors, including health awareness and social cognition, influence public intention to vaccinate. The Health Belief Model (HBM) provides a theoretical framework for understanding vaccination behavior, but how Vaccination awareness (VA) dynamically moderates the relationship between HBM domains and vaccination intentions remains unclear. This study aims to compare the characteristics of different VA classifications and explore the key factors influencing their future COVID-19 vaccination intentions based on the HBM.

METHODS: Using three-wave longitudinal cohort data from 500 adults in mainland China, participants were divided into four groups based on VA states: persistent awareness (Group 1), early-only awareness (Group 2), late-emerging awareness (Group 3), and persistently unaware (Group 4). ANOVA, chi-square tests, and binary logistic regression were used to analyze the relationships between HBM constructs, social cues, and vaccination intentions.

RESULTS: Group 1 (31.40%) had the highest education level, the COVID-19 vaccination rate (48.35%), and future vaccination intention (36.98%), with significantly higher HBM scores (perceived severity, self-efficacy, benefits) than other groups (all p < 0.001). Group 4 (27.00%) had the highest proportion of unvaccinated individuals (40.31%) and the highest perceived barriers score (M = 2.39 ± 0.73). Logistic regression showed that Group 1’s future COVID-19 vaccination intention was driven by medical expert advice (OR = 3.08, 95% CI: 1.47-6.45) and self-efficacy (OR = 3.68, 95% CI: 1.53-8.87), while Group 4 relied on government advice (OR = 1.56, 95% CI: 1.02-2.40), perceived severity (OR = 1.97, 95% CI: 1.12-3.46), and self-efficacy (OR = 3.68, 95% CI: 1.77-5.84). Trust in social media significantly reduced Group 3’s vaccination intention (OR = 0.08, 95% CI: 0.02-0.35).

CONCLUSIONS: Vaccination awareness states influence vaccination decisions by moderating HBM domains and social cues. Targeted interventions should address group-specific differences, such as enhancing self-efficacy (for Group 1, Group 2, and Group 4), correcting social media misinformation ( for Group 3), and strengthening government communication (for Group 4).

PMID:40841900 | DOI:10.1186/s12889-025-23843-5

BMC Oral Health. 2025 Aug 21;25(1):1346. doi: 10.1186/s12903-025-06695-8.

NO ABSTRACT

PMID:40841897 | DOI:10.1186/s12903-025-06695-8

BMC Public Health. 2025 Aug 21;25(1):2875. doi: 10.1186/s12889-025-24196-9.

ABSTRACT

BACKGROUND: Health literacy has recently been proposed as a resource to deal with health-related information during the COVID-19 pandemic. Especially the education sector was affected by the consequences of the pandemic, e.g. through school closures and reopenings by following strict hygiene regulations. During challenging times like these, school principals are the key actors in the school environment. They are not only responsible for school functioning, but school principals’ behavior and attitudes are also associated with health promoting school activities. The present study aimed to assess COVID-19 health literacy levels of German school principals, and to investigate the associations of COVID-19 health literacy with the implementation of health promotion in schools during the pandemic.

METHODS: As part of the joined studies coordinated by the COVID-HL Network, the COVID-19 Health Literacy School Principal Survey was conducted in Germany from March to April 2021. 2187 school principals and school management team members from four German federal states participated in the online survey. The HLS-COVID-Q22 was used to assess self-reported COVID-19 health literacy. The COVID-19 related HPS implementation scale was used to measure a holistic approach to school health promotion, consisting of 3 subscales: COVID-19 related support for students, staff and school. COVID-19 health literacy levels were computed using Rasch analysis. Multiple linear regression analysis was conducted to examine the association of school principals’ self-reported COVID-19 health literacy and the implementation of COVID-19 related health promotion in schools.

RESULTS: School principals showed good self-reported COVID-19 health literacy. Multiple linear regression analysis revealed that self-reported COVID-19 health literacy positively predicted the implementation of COVID-19 related health promotion in schools for all three subscales during the pandemic. In some regression models, the sociodemographic factors age, sex, and school type were also significant factors.

CONCLUSIONS: German school principals had high self-reported COVID-19 health literacy. School principals’ self-reported COVID-19 health literacy was a significant factor associated with the implementation of COVID-19 related health promotion in schools. The present findings underline the need to investigate the relationship of school principals’ health literacy and other potential influencing factors for the implementation of health promotion in schools.

PMID:40841892 | DOI:10.1186/s12889-025-24196-9

BMC Womens Health. 2025 Aug 21;25(1):403. doi: 10.1186/s12905-025-03947-1.

ABSTRACT

BACKGROUND: Women’s smoking is a serious and growing problem worldwide. Determining the variables related to smoking to stop this increase is important for the protection of women in special groups with psychological and social risks such as dependent relatives. It was aimed to determine the smoking use of women with dependent spouses and its relationship with marital adjustment and perception of social support.

METHODS: The research is a cross-sectional study. Population of the study consists of 1.500 women who are the spouses of men with the diagnosis of alcohol/substance use disorder and alcohol withdrawal syndrome. The population was calculated with a 20% prevalence 4% margin of error and a 95% confidence interval, and the sample size was 306. The research was carried out between November 2019 and July 2021. Statistical significance level was accepted as P < 0.05. Chi-square Test was used in the analysis of categorical data. Logistic Regression Analysis was used in multivariate analysis.

RESULTS: The spouses of 250 people experiencing alcohol or substance use disorder were included in the study. The coverage of the research is 81.7%. Smoking frequency of women is 65.2%. In bivariate analysis, women’s smoking was found to be statistically significant with the variables of spouse’s addiction type, age, longest place of residence, educational status, history of chronic disease, need for mental support, and presence of hobbies(p < 0.05). In multivariate analysis, it was observed that each unit increase in age, social support score and marital adjustment score was associated with 1.08 (95% CI: 1.01-1.15), 1.35 (95% CI: 1.18-1.55) and 1.12 (95% CI: 1.00-1.12) times increase in smoking risk, respectively.

CONCLUSIONS: In this study, two out of three women with spouses experiencing alcohol/substance use disorder were found to smoke. It has been determined that the risk of smoking is high in women whose spouses have substance use disorder, have a high education level, have a chronic illness, need mental support, do not have a hobby, have a low perception of social support, and have an incompatible marriage. High rate of smoking in this population indicates need for preventive studies with people experiencing alcohol/substance use disorder and their relatives. In addition, it would be beneficial to develop smoking cessation programs with cognitive-behavioral interventions and that strengthen psycho-social support systems in addition to pharmacological treatments.

PMID:40841890 | DOI:10.1186/s12905-025-03947-1

Sci Rep. 2025 Aug 22;15(1):30831. doi: 10.1038/s41598-025-99971-0.

ABSTRACT

Advancing the mechanical properties of naturally weak clayey soils is crucial in geotechnical engineering and is often achieved through targeted stabilization techniques. This research focuses on reinforcing clayey soil by integrating inert material, specifically aeolian sand collected from roadside deposits, in varying proportions from 2.5 to 30%. An experimental approach is adopted to analyze the improvement in geotechnical properties resulting from the addition of aeolian sand to clay through a series of geotechnical tests. These tests include the methylene blue test (MBV), the determination of Atterberg limits (LL, PL, PI), compaction characteristics (MDD and OMC), direct shear testing (C and ϕ), and oedometer tests (Cc and Cs). Furthermore, an optimization approach based on response surface methodology (RSM) and a central composite design (CCD) is implemented to determine the optimal mixture composition and accurately predict the evolution of the geotechnical properties of the soil. The experimental findings demonstrate significant improvements in the mechanical characteristics of the soil following the incorporation of aeolian sand, with the best performance achieved at a 30% sand content. The MBV decreased by 34.98%, the LL decreased by 39.62%, the PL decreased by 37.50%, and the PI decreased by 45.45%. In contrast, the MDD increased by 12.25%, enhancing the compaction and load-bearing capacity of the soil. A reduction of approximately 7.59% in the OMC was observed, lowering the water demand. The internal friction angle (ϕ) increased significantly by up to 233.33%, improving the shear strength, whereas the cohesion decreased by 49.78%. Additionally, the Cc and Cs decreased by 16.15 and 54.45%, respectively, which reduced the sensitivity of the soil to volume changes. Mathematical models are developed and statistically validated using the clay and aeolian sand contents as predictive variables, while key parameters such as the maximum dry density (MDD), cohesion (C), internal friction angle (ϕ), compressibility coefficient (Cc), and swelling coefficient (Cs) serve as response metrics. By applying analysis of variance (ANOVA) and refining the quadratic model via RSM, the study demonstrated significant results, with a coefficient of determination (R²) exceeding 0.97 for all the responses. The alignment between R² and adjusted R², along with the observed P values for critical parameters, highlights the robustness of the model. These findings pave the way for practical applications in foundation and road infrastructure projects, particularly in arid regions where water management and soil stability are critical concerns. The integration of 30% sand proves to be an effective and sustainable solution for enhancing the strength and stability of clayey soils in moisture-sensitive environments.

PMID:40841757 | DOI:10.1038/s41598-025-99971-0