Tag: nevin manimala

J Orthop Surg Res. 2025 Jan 30;20(1):118. doi: 10.1186/s13018-024-05430-3.

ABSTRACT

OBJECTIVE: This study examines whether cross-education training of the healthy limb promotes cross-transfer through central nervous system stimulation, enhancing the function, kinematic parameters, dynamic balance, and plantar pressure of the affected knee joint in patients recovering from postoperative anterior cruciate ligament reconstruction (ACLR).

METHODS: Forty anterior cruciate ligament reconstruction (ACLR) patients, 5-6 weeks postoperatively, were included and randomly assigned to either an experimental group (n = 20) or a control group (n = 20). The experimental group participated in six weeks of cross-education (CE) training in addition to conventional rehabilitation, while the control group received only conventional rehabilitation. Assessment outcomes included knee function (Lysholm score, joint mobility, and surface electromyographic characteristics of the rectus femoris muscle), kinematic parameters (stride length, stride speed, and stride width), dynamic balance (gait line length, single-support line length, and medial-lateral displacements), and plantar pressure (forefoot, midfoot, and hindfoot pressures). The effect of CE training on postoperative ACLR rehabilitation was comprehensively assessed by comparing the pre- and post-intervention changes within each group and the differences between the groups.

RESULTS: Before the intervention, no statistically significant differences were observed between the two groups across all measured parameters (P > 0.05). Following the intervention, significant improvements in knee function, kinematic parameters, balance function, and plantar pressure were observed in both groups, with the experimental group showing significantly more significant improvements (P < 0.05). The Lysholm score, range of motion (ROM), and surface electromyographic activity of the rectus femoris muscle were significantly higher in the experimental group compared to the control group (P < 0.01). Among kinematic parameters, the experimental group demonstrated a significant increase in stride length and reduced stride width, whereas differences in stride speed were not statistically significant (P > 0.05). Regarding balance function, the experimental group exhibited significantly longer gait and single-support line lengths, significantly reducing medial-lateral displacement (P < 0.05). Analysis of plantar pressure revealed significant improvements in forefoot and hindfoot pressures in the experimental group, with a particularly notable increase in hindfoot pressure (P < 0.05). However, changes in midfoot pressure were not statistically significant (P > 0.05).

CONCLUSION: CE training markedly enhanced knee function, kinematic metrics, dynamic stability, and plantar pressure in postoperative ACLR patients providing initial evidence for the prospective utilization of CE theory in rehabilitation. Nonetheless, the fundamental mechanics of its effects remain ambiguous, and variables such as individual differences and neuromuscular adaptation processes may affect training results. Future studies should examine its long-term impacts and uncover potential neuromuscular pathways to establish a solid scientific basis for improving postoperative rehabilitation procedures.

PMID:39885535 | DOI:10.1186/s13018-024-05430-3

Gut Pathog. 2025 Jan 30;17(1):7. doi: 10.1186/s13099-025-00682-8.

ABSTRACT

BACKGROUND: Helicobacter pylori (H. pylori) eradication regimens may have different effects on the gut microbiota. Few studies have analyzed the safety of high-dose dual therapy (HDDT) from a micro-ecological perspective. This study aimed to compare the impact of H. pylori eradication with HDDT and bismuth quadruple therapy (BQT) on gut microbiota.

PATIENTS AND METHODS: H. Pylori-infected treatment-naive patients were recruited and screened from September 2023 to April 2024 and randomly assigned to the HDDT group (esomeprazole 20 mg, amoxicillin 750 mg, qid, 14 days) or BQT group (esomeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 600 mg, bid, 14 days). Fresh stool specimens were collected and stored before treatment and at week 2 and week 8 after treatment. The diversity and composition of the gut microbiota were compared and analyzed in both groups using 16 S rRNA gene sequencing.

RESULTS: Forty-nine H. pylori positive patients were enrolled and randomly assigned to either the HDDT (n = 24) or the BQT group (n = 25) group. Compared with baseline, alpha and beta diversities significantly changed at week 2 after receiving BQT and did not recover fully at week 8. However, in the HDDT group, the diversities at week 2 changed mildly without statistical significance, compared to baseline. Additionally, a greater number of species had alterations in their abundances in the BQT group compared to the HDDT group at week 2. However, the abundances of these species were restored to their previous levels at week 8 in both the HDDT and BQT groups.

CONCLUSIONS: Compared to BQT, HDDT exerted less impact on the diversity and composition of the gut microbiota.

CLINICAL TRIAL REGISTRATION: ChiCTR2100053268.

PMID:39885529 | DOI:10.1186/s13099-025-00682-8

BMC Health Serv Res. 2025 Jan 30;25(1):179. doi: 10.1186/s12913-025-12294-8.

ABSTRACT

INTRODUCTION: Healthcare provider burnout is highly prevalent and has negative consequences. However, many healthcare workers in LMICs, including Nepal, rarely recognize or ameliorate it. This problem is worse in rural settings. Competency-focused interventions that are developed using theoretical frameworks can address this gap.

METHODS: We used Kern’s framework of curriculum development to create, refine, and assess a theory-driven intervention tailored to the needs and constraints of rural healthcare workers in Nepal. During the first phase, we conducted a targeted needs assessment using an online survey among nine rural primary care physicians working in Charikot Hospital. We then developed learning objectives for knowledge, attitude, and skills domains based on the World Health Organization (WHO) definition of burnout. Then, we created animated educational videos designed to meet the learning objectives. We then implemented the educational intervention with rural physicians and assessed their knowledge, attitudes, and feedback. During the second phase, we further developed the intervention based on findings from the first phase and assessed acceptability, feasibility, and preliminary impact using pre- and post-intervention questionnaires and key informant interviews.

RESULTS: In the first phase, nine physicians participated in the targeted needs assessment, and eight responded to the post-intervention assessment. In the second phase, 18 attendees completed the pre-intervention burnout assessment, and 16 completed both the pre-test and post-test questionnaires. On the pre-test, correct answers across questions ranged from 31-88%, while on the post-test, participants responded correctly 88-100% of the time. Related-samples Wilcoxon signed-rank test showed a statistically significant difference (P = 0.007) in the post-test scores on the knowledge domain. Qualitative results showed burnout as an unrecognized and unreported issue, and its drivers included stigma and feelings of helplessness. Participants praised the interventions and reported that they translated learned skills into practice.

CONCLUSION: In this proof-of-concept study, we found that educational interventions developed using a theory-driven framework to meet the unique needs of rural healthcare workers are acceptable and feasible. Future studies can test the intervention impact in well-powered trials to support scale-up efforts to identify and address burnout.

PMID:39885518 | DOI:10.1186/s12913-025-12294-8

BMC Public Health. 2025 Jan 30;25(1):396. doi: 10.1186/s12889-025-21453-9.

ABSTRACT

BACKGROUND: Low back pain (LBP) is a leading cause of years lived with disability. However, the association of non-chronic LBP with levels of daily physical activity (PA) remains poorly explored. This study investigated the association between previous and current non-chronic LBP with daily PA and compliance with PA recommendations in middle and older-aged adults.

METHODS: This is a cross-sectional analysis including volunteers from the Baltimore Longitudinal Study of Aging who answered questions about LBP and wore an Actiheart accelerometer for 7days. Generalized linear models and logistic models were used and adjusted for potential confounders.

RESULTS: 662 volunteers were included (50.8% women, 68.1% white), aged 68.0 (± 11.4) years. Previous non-chronic LBP was reported by 240 (36.3%) participants with mean pain intensity of 3.5 ± 2.0 (ranging from 0 to 10). Current non-chronic LBP was reported by 5.7% (n = 38) with mean pain intensity of 4.1 ± 2.3. Participants reporting current non-chronic LBP had lower levels of total (β -0.18, 95% CI -0.34 to -0.02) and vigorous (β -0.29, 95% CI -0.56 to -0.007) daily PA and lower odds of meeting PA recommendations (OR 0.20, 95% CI 0.05 to 0.92) compared to those reporting no LBP. No association was observed for LBP intensity. Conversely, previous non-chronic LBP showed no statistically significant association with daily PA levels.

CONCLUSION: The presence of current non-chronic LBP seems to be negatively associated with PA levels driven mainly by lower engagement in vigorous PA. No association was observed for pain intensity.

PMID:39885512 | DOI:10.1186/s12889-025-21453-9

BMC Nurs. 2025 Jan 30;24(1):113. doi: 10.1186/s12912-025-02756-z.

ABSTRACT

BACKGROUND: Nursing prescribing rights have been proposed in many countries, with physicians’ attitudes playing an important role. This study aimed to investigate the attitudes of physicians toward nurse prescribing rights.

METHODS: A cross-sectional study of 112 Chinese physicians was conducted from January to March 2024. This study utilized a demographic information form, nurses’ prescription right knowledge questions, and a scale to measure nurse-physician collaboration. The data was analyzed with IBM SPSS-21 software using descriptive and inferential statistics. We used the mean±standard deviation, frequencies and percentages to describe the demographic information, T-test, Chi-square test or Fisher’ s exact test, and binary logistic regression analysis to analyze the correlated factors of the attitudes of physicians toward nurse prescribing rights.

RESULTS: Of 112 physicians, 60 supported nurse prescribing rights, accounting for 53.57% of the total. The results of the single-factor analysis indicated significant differences in the aspects of sex. The binary logistic regression revealed that being female (OR = 0.195, 95%CI = 0.072 ∼ 0.529), having knowledge of nurse prescribing rights (OR = 1.513, 95%CI = 1.051 ∼ 2.176), and promoting nurse-physician collaboration (OR = 1.058, 95%CI = 1.032 ∼ 1.084) were the factors that correlated with physicians’ attitudes toward nurse prescribing rights.

CONCLUSIONS: Most physicians expressed a favorable attitude toward nurse prescribing rights. The results of this study will help advance the development of nurse prescribing rights and ultimately improve the quality of patient care.

PMID:39885498 | DOI:10.1186/s12912-025-02756-z

BMC Health Serv Res. 2025 Jan 31;25(1):180. doi: 10.1186/s12913-025-12332-5.

ABSTRACT

BACKGROUND: Antenatal care is an essential component of maternal healthcare that plays a crucial role in promoting the health and well-being of both mother and baby. While previous studies have examined factors influencing antenatal care visits in other parts of Ethiopia, there is a lack of research specifically focusing on the Afar region. This study aimed to assess determinants of antenatal care visits among pregnant women in Afar region, Ethiopia.

METHODS: The data is 2019 Ethiopian Mini Demographic and Health Survey. In this study 641 weighted sample womens were included. Negative binomial regression model is applied.

RESULTS: About 27.77% achieve optimal ANC visits. Living rural (IRR = 0.575, 95%CI: 0.467, 0.708). Reading whole sentences (IRR = 1.683, 95%CI: 1.212, 2.339). Under five children in house 1-2 (IRR = 0.789, 95%CI: 0.632, 0.984), 3-4 (IRR = 0.692, 95%CI: 0.509, 0.941), > = 5 (IRR = 0.075, 95%CI: 0.021, 0.268). Married (IRR = 1.550 95%CI: 1.172, 2.051), Widowed (IRR = 2.043, 95%CI: 1.238, 3.372). Age first birth 16-20 (IRR = 0.805, 95%CI: 0.652, 0.992).

CONCLUSION: The study examined the utilization of antenatal care services among women in Afar regional state, North Eastern Ethiopia. The findings reveal that a significant proportion of women did not receive the recommended number of antenatal care visits during their pregnancy. Factors such as residence, mother’s literacy rate, age at first birth, number of living children, number of under five children in the house and marital status were major determinants of ANC (Antenatal Care) visit in Afar region. Increase access to antenatal care services by improving the availability and quality of health facilities in the region. Maternal health-care program should be expanded and mainly in rural areas of the region. Moreover, the necessary assessment and follow-up of ANC health care services should be encouraged in Afar region to decrease maternal mortality.

PMID:39885497 | DOI:10.1186/s12913-025-12332-5

JMIR Res Protoc. 2025 Jan 30;14:e64745. doi: 10.2196/64745.

ABSTRACT

BACKGROUND: Transitional-aged youth have a high burden of mental health difficulties in Canada, with Indigenous youth, in particular, experiencing additional circumstances that challenge their well-being. Mobile health (mHealth) approaches hold promise for supporting individuals in areas with less access to services such as Northern Ontario.

OBJECTIVE: The primary objective of this study is to evaluate the effectiveness of the JoyPop app in increasing emotion regulation skills for Indigenous transitional-aged youth (aged 18-25 years) on a waitlist for mental health services when compared with usual practice (UP). The secondary objectives are to (1) evaluate the impact of the app on general mental health symptoms and treatment readiness and (2) evaluate whether using the app is associated with a reduction in the use (and therefore cost) of other services while one is waiting for mental health services.

METHODS: The study is a pragmatic, parallel-arm randomized controlled superiority trial design spanning a 4-week period. All participants will receive UP, which involves waitlist monitoring practices at the study site, which includes regular check-in phone calls to obtain any updates regarding functioning. Participants will be allocated to the intervention (JoyPop+UP) or control (UP) condition in a 1:1 ratio using stratified block randomization. Participants will complete self-report measures of emotion regulation (primary outcome), mental health, treatment readiness, and service use during 3 assessments (baseline, second [after 2 weeks], and third [after 4 weeks]). Descriptive statistics pertaining to baseline variables and app usage will be reported. Linear mixed modeling will be used to analyze change in outcomes over time as a function of condition assignment, while a cost-consequence analysis will be used to evaluate the association between app use and service use.

RESULTS: Recruitment began September 1, 2023, and is ongoing. In total, 2 participants have completed the study.

CONCLUSIONS: This study will assess whether the JoyPop app is effective for Indigenous transitional-aged youth on a waitlist for mental health services. Positive findings may support the integration of the app into mental health services as a waitlist management tool.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05991154; https://clinicaltrials.gov/study/NCT05991154.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/64745.

PMID:39883939 | DOI:10.2196/64745

J Med Internet Res. 2025 Jan 30;27:e64749. doi: 10.2196/64749.

ABSTRACT

BACKGROUND: Few studies have explored the relationship between macronutrient intake and sleep outcomes using daily data from mobile apps.

OBJECTIVE: This cross-sectional study aimed to examine the associations between macronutrients, dietary components, and sleep parameters, considering their interdependencies.

METHODS: We analyzed data from 4825 users of the Pokémon Sleep and Asken smartphone apps, each used for at least 7 days to record objective sleep parameters and dietary components, respectively. Multivariable regression explored the associations between quartiles of macronutrients (protein; carbohydrate; and total fat, including saturated, monounsaturated, and polyunsaturated fats), dietary components (sodium, potassium, dietary fiber, and sodium-to-potassium ratio), and sleep variables (total sleep time [TST], sleep latency [SL], and percentage of wakefulness after sleep onset [%WASO]). The lowest intake group was the reference. Compositional data analysis accounted for macronutrient interdependencies. Models were adjusted for age, sex, and BMI.

RESULTS: Greater protein intake was associated with longer TST in the third (+0.17, 95% CI 0.09-0.26 h) and fourth (+0.18, 95% CI 0.09-0.27 h) quartiles. In contrast, greater fat intake was linked to shorter TST in the third (-0.11, 95% CI -0.20 to -0.27 h) and fourth (-0.16, 95% CI -0.25 to -0.07 h) quartiles. Greater carbohydrate intake was associated with shorter %WASO in the third (-0.82%, 95% CI -1.37% to -0.26%) and fourth (-0.57%, 95% CI -1.13% to -0.01%) quartiles, while greater fat intake was linked to longer %WASO in the fourth quartile (+0.62%, 95% CI 0.06%-1.18%). Dietary fiber intake correlated with longer TST and shorter SL. A greater sodium-to-potassium ratio was associated with shorter TST in the third (-0.11, 95% CI -0.20 to -0.02 h) and fourth (-0.19, 95% CI -0.28 to -0.10 h) quartiles; longer SL in the second (+1.03, 95% CI 0.08-1.98 min) and fourth (+1.50, 95% CI 0.53-2.47 min) quartiles; and longer %WASO in the fourth quartile (0.71%, 95% CI 0.15%-1.28%). Compositional data analysis, involving 6% changes in macronutrient proportions, showed that greater protein intake was associated with an elevated TST (+0.27, 95% CI 0.18-0.35 h), while greater monounsaturated fat intake was associated with a longer SL (+4.6, 95% CI 1.93-7.34 min) and a larger %WASO (+2.2%, 95% CI 0.63%-3.78%). In contrast, greater polyunsaturated fat intake was associated with a reduced TST (-0.22, 95% CI -0.39 to -0.05 h), a shorter SL (-4.7, 95% CI to 6.58 to -2.86 min), and a shorter %WASO (+2.0%, 95% CI -3.08% to -0.92%).

CONCLUSIONS: Greater protein and fiber intake were associated with longer TST, while greater fat intake and sodium-to-potassium ratios were linked to shorter TST and longer WASO. Increasing protein intake in place of other nutrients was associated with longer TST, while higher polyunsaturated fat intake improved SL and reduced WASO.

PMID:39883933 | DOI:10.2196/64749

Am J Drug Alcohol Abuse. 2025 Jan 30:1-11. doi: 10.1080/00952990.2024.2417820. Online ahead of print.

ABSTRACT

Background: While social support benefits those in treatment for opioid use disorder, it is unclear how social support impacts patient outcomes.Objectives: This study examines how support person attitudes toward buprenorphine and their communication about substance use are associated with the well-being of patients receiving buprenorphine treatment.Methods: We analyzed cross-sectional baseline data from 219 buprenorphine patients (40% female) and their support persons (72% female). Patients were recruited from five community health centers and asked to nominate a support person. Patient outcomes included symptoms of depression, anxiety, impairment due to substance use, and perceived social support. Support persons predictors included their attitudes toward buprenorphine from four statements (e.g. “Buprenorphine is just replacing one drug for another”) and communication using two items (e.g. comfort and effectiveness discussing substance use).Results: More stigmatizing attitudes, such as believing patients should quit on their own without medication, were associated with increased patient substance use-related impairment (F = 4.53, p = .01). Effective communication was associated with lower patient depression (F = 10.15, p < .001), anxiety (F = 4.73, p = .001), lower impairment (F = 6.46, p < .001), and higher perceived social support (F = 3.68, p = .007).Conclusions: This study highlights how support person attitudes and communication dynamics significantly affect the mental health and impairment of individuals receiving buprenorphine treatment. Interventions that reduce stigma and promote effective communication between patients and their loved ones could enhance treatment outcomes and overall well-being among patients with OUD.

PMID:39883925 | DOI:10.1080/00952990.2024.2417820

J Med Internet Res. 2025 Jan 30;27:e58760. doi: 10.2196/58760.

ABSTRACT

BACKGROUND: Primary intracranial germ cell tumors (iGCTs) are highly malignant brain tumors that predominantly occur in children and adolescents, with an incidence rate ranking third among primary brain tumors in East Asia (8%-15%). Due to their insidious onset and impact on critical functional areas of the brain, these tumors often result in irreversible abnormalities in growth and development, as well as cognitive and motor impairments in affected children. Therefore, early diagnosis through advanced screening techniques is vital for improving patient outcomes and quality of life.

OBJECTIVE: This study aimed to investigate the application of facial recognition technology in the early detection of iGCTs in children and adolescents. Early diagnosis through advanced screening techniques is vital for improving patient outcomes and quality of life.

METHODS: A multicenter, phased approach was adopted for the development and validation of a deep learning model, GVisageNet, dedicated to the screening of midline brain tumors from normal controls (NCs) and iGCTs from other midline brain tumors. The study comprised the collection and division of datasets into training (n=847, iGCTs=358, NCs=300, other midline brain tumors=189) and testing (n=212, iGCTs=79, NCs=70, other midline brain tumors=63), with an additional independent validation dataset (n=336, iGCTs=130, NCs=100, other midline brain tumors=106) sourced from 4 medical institutions. A regression model using clinically relevant, statistically significant data was developed and combined with GVisageNet outputs to create a hybrid model. This integration sought to assess the incremental value of clinical data. The model’s predictive mechanisms were explored through correlation analyses with endocrine indicators and stratified evaluations based on the degree of hypothalamic-pituitary-target axis damage. Performance metrics included area under the curve (AUC), accuracy, sensitivity, and specificity.

RESULTS: On the independent validation dataset, GVisageNet achieved an AUC of 0.938 (P<.01) in distinguishing midline brain tumors from NCs. Further, GVisageNet demonstrated significant diagnostic capability in distinguishing iGCTs from the other midline brain tumors, achieving an AUC of 0.739, which is superior to the regression model alone (AUC=0.632, P<.001) but less than the hybrid model (AUC=0.789, P=.04). Significant correlations were found between the GVisageNet’s outputs and 7 endocrine indicators. Performance varied with hypothalamic-pituitary-target axis damage, indicating a further understanding of the working mechanism of GVisageNet.

CONCLUSIONS: GVisageNet, capable of high accuracy both independently and with clinical data, shows substantial potential for early iGCTs detection, highlighting the importance of combining deep learning with clinical insights for personalized health care.

PMID:39883924 | DOI:10.2196/58760