Tag: nevin manimala

N Z Med J. 2025 Jun 6;138(1616):69-98. doi: 10.26635/6965.6936.

ABSTRACT

AIM: To identify and synthesise the literature on mental health and wellbeing of Asian and MELAA (Middle Eastern, Latin American and African) women and girls in Aotearoa New Zealand (New Zealand).

METHODS: We searched American Psychological Association (APA) PsycInfo, CINAHL, Embase (Ovid) and MEDLINE (Ovid) for studies published in English up to July 2023 investigating the mental health and wellbeing of Asian and MELAA women and girls living in New Zealand. Studies including other participants were eligible if they provided disaggregated data for Asian and MELAA women/girls in New Zealand. We extracted data on study characteristics and all relevant findings related to their mental wellbeing.

RESULTS: Twenty-four studies provided data on approximately 15,000 Asian and MELAA women and girls aged over 12 years. The studies had heterogeneous population groups and outcomes. Three exclusively focussed on Asian women. Most studies (n=17) did not provide disaggregated data for Asian and MELAA women and girls in relation to all relevant outcomes reported. Investigated outcomes included prevalence data and symptoms of mental health conditions and mental wellbeing (n=18) and associations of socio-demographic factors with mental health (n=9).

CONCLUSION: The limited peer-reviewed data underpin the lack of evidence-based policy planning. Future research focussed on Asian and MELAA women and girls is needed to enhance their wellbeing and achieve equitable health outcomes.

PMID:40472364 | DOI:10.26635/6965.6936

N Z Med J. 2025 Jun 6;138(1616):28-42. doi: 10.26635/6965.6857.

ABSTRACT

AIM: Amid growing concerns surrounding the radiology workforce in New Zealand, our primary aim was to capture the retention rate of recent graduates of the Auckland Regional Training Scheme.

METHODS: In September 2023 we sent a standardised survey to all Royal Australian and New Zealand College of Radiologists (RANZCR) fellows who commenced their radiology training in Auckland in the year 2000 or later. Additional questions were asked regarding prior subspecialty training, public versus private work mix, future career plans, the key factors influencing our radiologists’ workplace selection and more.

RESULTS: With a response rate of 71.7% (99/138 survey recipients), we found that 75.8% (75/99) of our responders currently work in New Zealand, a greater proportion than perhaps anticipated. A little over half (58.2%) work in a mixture of both public and private settings, and 56.2% are considering, on some level, significantly reducing their hours in the next 1 to 5 years.

CONCLUSION: We hope the insights gained through this survey encourage further efforts to retain our growing number of trainees, while helping to paint the current landscape of our specialty at the consultant level.

PMID:40472360 | DOI:10.26635/6965.6857

Neurology. 2025 Jul;105(1):e213769. doi: 10.1212/WNL.0000000000213769. Epub 2025 Jun 5.

ABSTRACT

BACKGROUND AND OBJECTIVES: Phosphorylated tau at threonine 217 (p-tau217) is a highly sensitive blood-based biomarker for Alzheimer disease (AD) pathology, showing high diagnostic accuracy. However, its prognostic value across different clinical stages of AD remains unclear. The aim of this study was to assess the prognostic utility of plasma p-tau217, measured using a commercially available immunoassay, regarding clinical and functional decline across the clinical stages of AD in a cohort with up to 10 years of follow-up.

METHODS: We conducted a retrospective longitudinal cohort study using data from the Sant Pau Initiative on Neurodegeneration, a research project performed at the Sant Pau Memory Unit between 2011 and 2022. Participants were classified into clinical stages 1-6 based on AD pathology status in CSF, determined by the p-tau181/Aβ1-42 ratio. The primary outcomes were cognitive decline, measured by changes in the Mini-Mental State Examination (MMSE), and progression to dementia. Plasma p-tau217 and CSF p-tau181 levels were assessed, and statistical analysis was performed using linear mixed-effects models for longitudinal changes in MMSE scores and Cox proportional hazard regression was used to examine progression to dementia.

RESULTS: A total of 731 participants (mean age 71.5 ± 10.1 years; 60% female) were included. Plasma p-tau217 levels showed a significant increase across advancing AD stages, with all between-group comparisons remaining significant after false discovery rate adjustment (p < 0.05). Longitudinal analysis showed a significant increase in plasma p-tau217 (β = 7.7, 95% CI 3.0-12.5, p = 0.002) and CSF p-tau181 (β = 3.2, 95% CI 1.4-5.0, p = 0.001). Baseline plasma p-tau217 levels were associated with faster MMSE decline (β = -0.08, 95% CI -0.11 to -0.05, p < 0.001) and progression to dementia (hazard ratio 1.03, 95% CI 1.01-1.05, p < 0.001), independent of clinical stage.

DISCUSSION: Plasma p-tau217 was significantly associated with cognitive and functional decline in AD. These findings support the potential use of plasma p-tau217 as a prognostic marker for monitoring AD progression in clinical practice. Future studies should validate these results across diverse cohorts and explore their utility in early-stage detection and monitoring.

PMID:40472304 | DOI:10.1212/WNL.0000000000213769

JCO Oncol Pract. 2025 Jun 5:OP2400936. doi: 10.1200/OP-24-00936. Online ahead of print.

ABSTRACT

PURPOSE: Newer targeted therapy (NTT), addressing alterations in BRAF, MET, NTRK, ROS1, and RET has become a common therapeutic option for non-small cell lung cancer (NSCLC). To date, only RET inhibitor has been shown in a phase III study to confer a survival advantage when used in the frontline setting. This study investigates timing of NTT and its impact on survival using a large, population-base data set.

METHODS: We searched a nationwide, electronic health record-derived, deidentified database for patients with advanced NSCLC treated with NTT between May 2014 and March 2023. Time to treatment initiation (TTI) was calculated from the diagnosis of advanced NSCLC. Landmark analytic technique was used to address immortal time bias.

RESULTS: Among 857 patients analyzed, the median TTI was 3.8 months. By month 2 or month 3 after diagnosis, patients who already initiated NTT had significantly better survival than those who had not initiated NTT at those time points: Hazard ratio (HR), 0.65 (95% CI, 0.53 to 0.81; P < .001) and HR, 0.69 (95% CI, 0.55 to 0.85; P = .001), respectively. A multivariate analysis indicated that delayed TTI was an independent prognostic factor of decreased survival, along with impaired performance status and squamous cell carcinoma histology. Subgroup analyses excluding RET inhibitor still demonstrated a statistically significant survival advantage in favor of earlier NTT initiation.

CONCLUSION: Among advanced NSCLC patients undergoing NTT, survival was significantly better among those who began treatment within 2 or 3 months after diagnosis than those whose treatment was delayed.

PMID:40472300 | DOI:10.1200/OP-24-00936

Am J Public Health. 2025 Jun 5:e1-e11. doi: 10.2105/AJPH.2025.308101. Online ahead of print.

ABSTRACT

Objectives. To evaluate trends in AIDS Drug Assistance Program (ADAP) utilization among demographic subpopulations. Methods. For 2008 to 2021, we collected US state-level data regarding ADAP client utilization and estimated HIV prevalence data. We used descriptive statistics to describe state ADAP utilization by geography, demographics (age, sex, race), and programmatic characteristics. Results. ADAP utilization proportion increased from 14.0% of all people with HIV (PWH) in 2008 to 22.3% in 2021. The proportion of female PWH supported by ADAP was lower in both 2008 (12.2%) and 2021 (18.3%) compared with the proportion of male PWH supported (2008: 14.5%; 2021: 22.9%). In 2008, the utilization proportion was lower for Black PWH at 11.7% compared with 16.0% for White PWH. In 2021, the utilization proportion for Black PWH was 25.2% compared with 28.4% for White PWH. Conclusions. ADAP enrollment and utilization have increased substantially. Despite equity gains, Black PWH and women were served at lower proportions by ADAP. Public Health Implications. National and state partners of ADAPs should examine ways to ensure that ADAP utilization is equitable in terms of age, sex, race/ethnicity, and other sociodemographic factors. (Am J Public Health. Published online ahead of print June 5, 2025:e1-e11. https://doi.org/10.2105/AJPH.2025.308101).

PMID:40472297 | DOI:10.2105/AJPH.2025.308101

Singapore Med J. 2025 Jun 6. doi: 10.4103/singaporemedj.SMJ-2024-076. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the exponential increase in microbiome research, knowledge and beliefs about the gut microbiome and faecal microbiota transplantation (FMT) remain unclear. The aim of this study was to identify the extent of knowledge, awareness and perception among the general public regarding the gut microbiome and FMT.

METHODS: An online questionnaire on knowledge and beliefs about the gut microbiome and FMT was administered to 1831 participants. Data analysis software was used to generate descriptive statistics and explore associations between knowledge and sociodemographic variables.

RESULTS: Even though only 33% of participants had heard of the gut microbiome, more than 92% had consumed probiotic drinks or supplements. While 85% had not heard of the FMT procedure, 72% of respondents would consider having FMT to treat Clostridioides difficile infection (CDI). Willingness to receive FMT depended mainly on recommendation from healthcare providers (77%). Knowledge and awareness regarding the gut microbiome and FMT were relatively low, despite most participants having prior gut health-related behaviours.

CONCLUSION: This study identified the public’s perceptions of FMT and the potential barriers to its uptake. Insights from the study highlight the need for health education to enhance acceptance of FMT and the importance of using information supported by medical professionals to immunise the public against poorly validated science.

PMID:40472289 | DOI:10.4103/singaporemedj.SMJ-2024-076

Blood Adv. 2025 Jun 5:bloodadvances.2025016107. doi: 10.1182/bloodadvances.2025016107. Online ahead of print.

ABSTRACT

Venous thromboembolism is frequent in ovarian cancer especially after surgery. Elaboration of tissue factor bearing extracellular vesicles (TF+EV) has been linked to thrombosis in cancer and hypercoagulability of surgery. Rosuvastatin can reduce the generation of EV and decrease VTE risk in non-cancer populations. The use of rosuvastatin to mitigate post-surgical thrombosis by lowering TF+EV following ovarian cancer surgery has not been investigated. In a pilot phase 2 trial in women undergoing ovarian cancer, women were randomized to enoxaparin 40 mg daily for 30 days with or without rosuvastatin 40 mg daily (administered from days 15- 60). Women who elected to forgo randomization received enoxaparin 40 mg daily for 30 days per standard of care. Total EV and TF+EV were assessed at baseline, day 30, and day 60. Bilateral lower extremity ultrasound was performed on day 30 and 60. A total of 24 women enrolled in the trial, 15 underwent randomization and 7 women were randomized to enoxaparin with rosuvastatin (17 received enoxaparin alone). There were no statistical differences observed in circulating TF+EV with the addition of rosuvastatin to enoxaparin at day 30 or day 60. Similarly, there were no differences in C-reactive protein or D-dimer between groups. There were no lower extremity deep vein thrombosis identified on screening ultrasounds, although portal vein thrombosis was diagnosed in enoxaparin-only arm. No major hemorrhages were observed. The addition of rosuvastatin to enoxaparin following ovarian cancer surgery does not appear to impact number of circulating TF+EV nor alter markers of thromboinflammation.

PMID:40472284 | DOI:10.1182/bloodadvances.2025016107

Epidemiology. 2025 Jun 5. doi: 10.1097/EDE.0000000000001882. Online ahead of print.

ABSTRACT

BACKGROUND: For infectious diseases, characterizing symptom duration is of clinical and public health importance. Symptom duration may be assessed by surveying infected individuals and querying symptom status at the time of survey response. For example, in a severe acute respiratory syndrome coronavirus 2 testing program at the University of Washington, participants were surveyed at least 28 days after testing positive and asked to report current symptom status. This study design yielded current status data: outcome measurements for each respondent consisted only of the time of survey response and a binary indicator of whether symptoms had resolved by that time. Such study design benefits from limited risk of recall bias, but analyzing the resulting data necessitates tailored statistical tools.

METHODS: We review methods for current status data and describe a novel application of modern nonparametric techniques to this setting. The proposed approach is valid under weaker assumptions compared with existing methods, allows the use of flexible machine learning tools, and handles potential survey nonresponse. Our method relies on the assumption that the survey response time is conditionally independent of symptom resolution time within strata of measured covariates, and we propose an approach to assess the sensitivity of results to deviations from conditional independence.

RESULTS: From the university study, we estimate that 19% of participants experienced ongoing symptoms 30 days after testing positive, decreasing to 7% at 90 days. We found the estimates to be more sensitive to violations of the conditional independence assumption at 30 days compared with 90 days. Female sex, fatigue during acute infection, and higher viral load were associated with slower symptom resolution.

CONCLUSION: The proposed method and accompanying sensitivity analysis procedure provide tools for investigators faced with current status data.

PMID:40472281 | DOI:10.1097/EDE.0000000000001882

Int J Adolesc Med Health. 2025 Jun 6. doi: 10.1515/ijamh-2025-0012. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate adolescents’ knowledge, attitude, and risk perceptions regarding e-cigarette usage and examine the associations and differences across various socio-demographic characteristics.

METHODS: A cross-sectional study was conducted in two government secondary schools in Johor. A total of 391 respondents were enrolled conveniently using a pre-validated questionnaire. The data were analysed using SPSS descriptive and inferential statistics.

RESULTS: Most participants demonstrated a moderate level of knowledge regarding e-cigarettes (77.5 %), achieving an average score of 3.82 (±0.89). A significant portion of the respondents were female (56.3 %) and Chinese (57.5 %), predominantly aged between 16 and 17 years (53.7 %). Presently, 11.5 % of the participants reported using e-cigarettes, while 6.6 % reported using traditional tobacco cigarettes. Notably, 12.3 % of adolescents correctly identified nicotine as a common component in e-cigarettes, highlighting its addictive nature. Furthermore, significant association and differences were observed between e-cigarette usage and a positive attitude towards them (86.7 %, p<0.001), as well as the perception of reduced health risks associated with e-cigarette consumption (9.11 ± 2.68, p<0.001). Adolescents who were susceptible to e-cigarette use were more inclined to support their usage (63.1 %, p<0.001) and perceived fewer health consequences (6.91 + 3.12, p=0.019) in comparison to those who were not susceptible.

CONCLUSIONS: E-cigarette users exhibited a moderate level of understanding along with a positive stance towards e-cigarettes, viewing them as less risky compared to non-e-cigarette users. As a result, collaborative endeavours are essential to enhance adolescent knowledge about e-cigarettes via community outreach initiatives. Consequently, all governing bodies must explore effective strategies to tackle this issue by implementing strict legislation.

PMID:40472268 | DOI:10.1515/ijamh-2025-0012

J Particip Med. 2025 Jun 5;17:e69253. doi: 10.2196/69253.

ABSTRACT

BACKGROUND: Patient portals demonstrate significant potential for improving health care engagement but face critical adoption challenges. Disparities persist across different demographic groups, creating a digital divide in health care access. Targeted training strategies, particularly personalized and one-on-one approaches, show promise in increasing portal utilization. Innovative solutions, like community health workers specializing in digital navigation, offer a potential pathway to reduce enrollment barriers. The key challenge remains developing a scalable, cost-effective training model.

OBJECTIVE: Our quality improvement (QI) project aimed to assess the feasibility and effectiveness of a collaborative effort between a free community-based digital navigation program and an urgent care clinic in facilitating patient access to their portal.

METHODS: We created the Digital Health Equity Navigation Training (DHENT) program to improve patient portal access and usage. The program used a train-the-trainer model to scale up patient portal training across the community. DHENT trainers partnered with urgent care physicians to enroll patients in the portal. Physicians briefly explained portal benefits and referred interested patients for DHENT assistance. Trainers then contacted patients by phone to help with enrollment and navigation. We employed 3 Plan-Do-Study-Act cycles to understand the feasibility of the collaboration. We used descriptive statistics to describe participant characteristics and referral processes.

RESULTS: The collaboration was marginally successful, exceeding referral targets by 27.7% (115/90). Most patients were under 60 years old (94/115, 81.7%) and White (78/115, 67.8%). There was a significant delay in contact, averaging 37 days. While 4.8% (5/104) of patients accessed the portal with DHENT trainer assistance, 9.6% (10/104) had already signed up independently after their urgent care visit.

CONCLUSIONS: Overall, we found our partnership had a moderate impact, and only a low dose of intervention and resources were needed.

PMID:40472267 | DOI:10.2196/69253