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A comparison of the impact of nurse-led education and telehealth interventions on mental health outcomes for ambulatory patients in Saudi Arabia

BMC Nurs. 2025 Sep 2;24(1):1155. doi: 10.1186/s12912-025-03789-0.

ABSTRACT

BACKGROUND: Mental health disorders, including depression, anxiety, and pain, are prevalent among ambulatory patients. Nurse-Led Education and Telehealth interventions have emerged as promising approaches to improving mental health outcomes. However, their comparative effectiveness remains unclear, particularly in Saudi Arabia.

AIM: This study compares the impact of Nurse-Led Education and Telehealth interventions on mental health outcomes (depression, anxiety, and pain) for ambulatory patients in Saudi Arabia.

METHODS: A quasi-expremintal study with pre and post tests were conducted with 400 participants, who were recruited through purposive sampling and assigned to receive either Nurse-Led Education or Telehealth interventions over eight weeks. Depression, anxiety, and pain were measured using the PHQ-9, STAI, and VAS tools, respectively. Data were analyzed using descriptive statistics, independent t-tests, logistic regression, and Structural Equation Modeling (SEM), with anxiety examined as a potential mediator.

RESULTS: Both the Nurse-Led Education and Telehealth Intervention groups showed significant improvements in mental health outcomes, including reductions in depression (PHQ-9), anxiety (STAI), and pain (VAS). The Nurse-Led Education group improved from 20.3 to 12.4 in PHQ-9, while the Telehealth group decreased from 21.8 to 15.2, both with p < 0.001. Pain scores also decreased significantly in both groups, with the Nurse-Led group improving from 18.9 to 9.3 and the Telehealth group from 31.3 to 18.5 (p < 0.001). Anxiety levels decreased in both groups (p < 0.001). Regression analysis indicated that Telehealth had a stronger association with improvements across all outcomes, with anxiety playing a significant mediating role in the Telehealth group. Structural Equation Modeling (SEM) further demonstrated that Telehealth had a more pronounced effect on pain management and mental health outcomes, highlighting its potential for more robust results compared to Nurse-Led Education, though both interventions proved beneficial.

CONCLUSION: Telehealth interventions showed superior efficacy in managing depression and pain, potentially due to individualized care. Nurse-Led Education excelled in fostering peer support, which equally benefited anxiety management. These findings highlight the importance of tailored approaches in mental health care.

CLINICAL TRIAL: No clinical trial.

PMID:40898304 | DOI:10.1186/s12912-025-03789-0

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Late request for safe abortion and its determinants among reproductive age women in Ethiopia: systematic review and meta-analysis

Int J Equity Health. 2025 Sep 2;24(1):230. doi: 10.1186/s12939-025-02559-3.

ABSTRACT

INTRODUCTION: Late requests for safe abortion during the second trimester are strongly associated with severe maternal complications, including infertility, preterm birth, low birth weight, and maternal mortality, especially in developing countries. These delays also contribute to adverse pregnancy outcomes beyond direct maternal deaths. Despite these serious concerns, data on the prevalence and contributing factors of late abortion requests in Ethiopia remain limited.

OBJECTIVE: To estimate the pooled prevalence of late requests for safe abortion and identify the determinants among Ethiopian women of reproductive age.

METHODS: This systematic review and meta-analysis was conducted following the PRISMA 2020 guidelines. A comprehensive search was performed across major international databases, including PubMed, Cochrane Library, Google Scholar, Hinari, Scopus, Web of Science, and African Journals Online, using the CoCoPop strategy. Study quality was assessed using the Joanna Briggs Institute (JBI) tool. Heterogeneity among studies was evaluated with the I2 statistic, and publication bias was assessed using funnel plots and Egger’s test. A random-effects model was employed to estimate the pooled prevalence and adjusted odds ratios (AOR) with 95% confidence intervals (CI).

RESULTS: Ten studies involving a total of 5,559 women were included. The pooled prevalence of late requests for safe abortion was 35.20% (95% CI: 26.21, 44.19). Significant determinants identified were delayed pregnancy diagnosis (AOR: 3.23; 95% CI: 2.52, 4.13), irregular menstrual cycles (AOR: 2.36; 95% CI: 1.86, 3.00), rural residence (AOR: 2.89; 95% CI: 2.34, 3.58), unmarried status (AOR: 2.86; 95% CI: 2.13, 3.86), and age under 19 years (AOR: 4.01; 95% CI: 2.41, 6.67).

CONCLUSION: Late requests for safe abortion are common in Ethiopia and are influenced by factors such as rural residence, young age, delayed recognition of pregnancy, and irregular menstrual cycles. Enhancing access to reproductive health services especially for rural and adolescent populations is essential to reduce maternal complications and promote timely care.

PROSPERO REGISTRATION NUMBER: CRD42024603467.

PMID:40898297 | DOI:10.1186/s12939-025-02559-3

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Endovascular embolization for ruptured intracranial aneurysms: efficacy and effects on oxidative stress levels

Perioper Med (Lond). 2025 Sep 2;14(1):93. doi: 10.1186/s13741-025-00577-x.

ABSTRACT

OBJECTIVE: This study aimed to investigate the efficacy of endovascular embolization in treating ruptured intracranial aneurysms (RIAs).

METHODS: RIA patients (n = 89) were grouped according to different surgical methods. The control group (n = 42) received aneurysm clipping surgery, whereas the observation group (n = 47) received endovascular embolization. The National Institutes of Health Stroke Scale (NIHSS) was used to assess neurological function pre-treatment and at 7 days post-treatment. Oxidative stress status, including superoxide dismutase (SOD) levels and serum malondialdehyde (MDA) levels, was compared between the two groups pre-treatment and at 7 days post-treatment. Intraoperative bleeding, operative time, and hospitalization time were compared between the two groups. Vascular endothelial function, including von Willebrand factor (vWF), endothelin-1 (ET-1), and nitric oxide (NO), was evaluated pre-treatment and 3 months post-treatment. Postoperative complications and surgical outcomes were observed.

RESULTS: After treatment, compared to the control group, the observation group had lower NIHSS scores, higher SOD levels, and lower MDA levels, with statistically significant differences (all P < 0.001); the observation group also had less intraoperative bleeding, shorter operation times, and shorter hospital stays, along with lower vWF and ET-1 levels, higher NO levels, and statistically significant differences (all P < 0.001). The incidence of postoperative complications was lower in the observation group, with a statistically significant difference (P = 0.048). The therapeutic effect was better in the observation group, with a statistically significant difference (P = 0.041).

CONCLUSION: Compared with microscopic aneurysm clipping, endovascular embolization offers better efficacy for patients with RIA and causes less vascular endothelial damage.

PMID:40898296 | DOI:10.1186/s13741-025-00577-x

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Outbreak dates of virus could be predicted by their protein sequence

J Transl Med. 2025 Sep 2;23(1):980. doi: 10.1186/s12967-025-07051-8.

ABSTRACT

INTRODUCTION: Since 1970, monkey-pox, the last outbreak of smallpox, coronavirus was outbreak in the world for more than 50 years. To find if the outbreak dates could be predicted by their one-dimension protein sequence, the mathematical model was needed to establish between them.

METHODS: (A) collecting the outbreak dates of monkey-pox, smallpox, and coronavirus, determine the outbreak time interval between the pathogen strain and the reference strain SARS-CoV-2 D614, z. (B) detecting the one-dimension antigenic amino acid sequence of the pathogen strain to determine the super-antigens. (C) calculating the super-antigen precision, determining the increase amount in antigen precision between the pathogen strain and the reference strain, x; y represents the number of tryptophan (W) in the super-antigen. (D) Determine the correlation among the outbreak time interval z, the increase amount in antigen precision, x, and the number of W the super-antigen contains, y.

RESULTS: The regression equation is z = 13.762x2 – 109.376x- 63.290y + 221.197, with a correlation coefficient of R = 1.0000000. After statistical testing, the probability of class I errors occurring is P = 0.008.

CONCLUSIONS: The method can predict the outbreak dates by one-dimension protein sequence, such as monkey-pox, smallpox, and coronavirus.

PMID:40898294 | DOI:10.1186/s12967-025-07051-8

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Prevalence and factors associated with acute malnutrition among children aged 6-59 months in West Wollega, Oromia, Ethiopia, 2024

J Health Popul Nutr. 2025 Sep 2;44(1):319. doi: 10.1186/s41043-025-00928-w.

ABSTRACT

BACKGROUND: This study investigates acute malnutrition among children aged 6-59 months in conflict-affected districts of western Ethiopia. It addresses the lack of localized data by examining the prevalence and key contributing factors, including maternal health, child feeding practices, and healthcare access. Findings aim to inform targeted, multisectoral interventions to improve child nutrition in similar crisis-affected settings.

METHOD: A community-based cross-sectional study was conducted from June 1 to July 1, 2024, involving 513 children aged 6-59 months. A proportionate sample was selected from each Woreda using systematic sampling, with one child randomly chosen from households with multiple eligible children. Trained enumerators collected data using a pre-tested questionnaire, and nutritional status was assessed using mid-upper arm circumference (MUAC) measurements. Data were entered into Epi-data version 3.1 and exported to SPSS version 25.0 for analysis. Descriptive statistics were performed, followed by bivariable and multivariable logistic regression to identify factors associated with acute malnutrition, with statistical significance declared at P-value < 0.05.

RESULTS: A total of 498 participants were included within the study with a response rate of 97%. The largest proportions (44.4%) were aged 24-59 months. Acute malnutrition prevalence was 20.7% [17.1% to 24.3%] with 6.2% having severe malnutrition and 14.5% moderate. Key risk factors for acute malnutrition included food insecurity with (AOR: 1.81, 95% CI: 1.03-3.17), pre-lacteal feeding (AOR: 2.01, 95% CI: 1.09-3.68), maternal malnutrition (AOR: 4.11, 95% CI: 2.40-7.05), less than four antenatal visits of current child pregancy (AOR: 3.94, 95% CI: 1.64-9.45), and bottle-feeding (OR: 2.79, 95% CI: 1.51-5.14).

CONCLUSION AND RECOMMENDATION: The severe burden of acute malnutrition demands immediate, comprehensive action. An integrated approach is essential, emphasizing improved access to nutritious food, strengthened maternal and child health services, and increased caregiver awareness. Key strategies include merging maternal and child health initiatives, encouraging exclusive breastfeeding, ensuring regular antenatal care, and promoting appropriate infant feeding. Together, these efforts can play a crucial role in lowering acute malnutrition rates and enhancing child health in the community.

PMID:40898265 | DOI:10.1186/s41043-025-00928-w

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Evaluation of predictors of chronic kidney disease in hyperthyroid cats following radioiodine treatment – a pilot study

Tierarztl Prax Ausg K Kleintiere Heimtiere. 2025 Aug;53(4):209-219. doi: 10.1055/a-2563-9702. Epub 2025 Sep 2.

ABSTRACT

Currently, no suitable parameter to predict the occurrence of azotaemic chronic kidney disease (CKD) after hyperthyroidism treatment in cats exists. The aim of this study was to evaluate various clinical and laboratory parameters as well as renal cortical thickness (assessed by ultrasound) as predictors of azotaemic CKD after radioiodine therapy (RAIT).Cats presented for RAIT (April 2021-April 2022) were prospectively enrolled. Cats with azotaemia (creatinine≥140 µmol/L) and cats with pathological renal morphology were excluded. After RAIT, cats were followed for 6-12 months (measurement of total thyroxine [TT4], thyroid-stimulating hormone and creatinine). Cats with persistent hyperthyroidism and cats with a follow-up<6 months were excluded from the statistical analysis, as their thyroid and kidney function could not be sufficiently evaluated. Following parameters obtained prior RAIT were compared between cats that developed azotaemic CKD following RAIT and those that did not: age, weight, duration since the diagnosis of hyperthyroidism and RAIT, blood pressure, haematocrit, concentration of creatinine, urea, potassium, phosphate, TT4 and symmetrical dimethylarginine, urine-specific gravity, urine protein/creatinine ratio and sonographically assessed renal cortical thickness.51 cats were enrolled; 29/51 were included in the statistical analysis (11/29 became euthyroid and 18/29 became hypothyroid post RAIT). There was no difference in the frequency of azotaemia between euthyroid and hypothyroid cats (5/11 vs. 6/18, p=0.7). None of the clinical, laboratory and morphological markers proved to be predictive of the development of azotaemic CKD following RAIT.None of the investigated parameters was predictive of the development of azotaemic CKD in hyperthyroid cats after RAIT. Due to the small study population, future larger studies should be undertaken, especially to assess morphological markers.

PMID:40897180 | DOI:10.1055/a-2563-9702

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Non-invasive monitoring of ovarian function in llamas and alpacas – Evaluation of the suitability of sex steroid measurement in milk and vaginal cytology

Tierarztl Prax Ausg G Grosstiere Nutztiere. 2025 Aug;53(4):231-244. doi: 10.1055/a-2625-9116. Epub 2025 Sep 2.

ABSTRACT

In South American Camelids (SAC), determining a suitable time point for mating poses challenges as females ready for conception do not show estrus signs or behavioral changes. Therefore, the applicability of measuring sex steroids in milk and vaginal cytology as non-invasive methods for monitoring ovarian activity was investigated.Samples were collected from a total of 10 alpacas (A) and 9 llamas (L) over a period of 4 weeks following parturition. The concentrations of progesterone (P4), estradiol-17β (E2) and total estrogens (GOE) in blood and milk were measured using radioimmunoassays after sample extraction. Vaginal swabs were prepared and evaluated according to the procedure routinely used in dogs.In A and L, the estrogen concentrations in milk were significantly lower than those in blood (E2 in blood: A: 11.1±2.9 pg/ml, L: 14.6±5.0 pg/ml; E2 in milk: A: 6.2±3.1 pg/ml, L: 7.9±5.8 pg/ml; GOE in blood: A: 120. 2±26.9 pg/ml, L: 143.7±45 pg/ml; GOE in milk: A: 57.1±16.1, L: 75.9±34.6 pg/ml), while the differences between the two species were not significant. The correlations between steroid concentrations in blood and milk were statistically significant in L, but not in A. While in L, correlations between estrogen concentrations and vaginal cytological parameters showed several statistical significances with p-values partly <0.01, in A only GOE in the blood was negatively correlated with the proportion of basal-/parabasal cells.P4 measurement in milk allows the detection of luteal phases in SAC with high reliability. Despite statistical significance, the correlations between estrogen concentrations in blood and milk were also too weak in L to estimate blood concentrations with acceptable accuracy based on estrogen concentrations in milk at the level of the individual animal. Vaginal cytology could in principle be suitable for the identification of the maturation phase of follicular waves in L. However, improvements of the methodology and further validation are warranted before its routine use.

PMID:40897165 | DOI:10.1055/a-2625-9116

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Genetic evidence for a causal relationship between oral bacterial taxa and asthma in east Asian population

Cytokine. 2025 Sep 1;195:157021. doi: 10.1016/j.cyto.2025.157021. Online ahead of print.

ABSTRACT

BACKGROUND: Emerging evidence highlights the significant role of microbiota (lung and gut) in the development of asthma. However, the potential effect between oral microbiota and asthma remains poorly understood.

METHODS: This study performed a bidirectional Mendelian randomization (MR) study using summary statistics from the genome-wide association studies of oral microbiota, immune cell traits and asthma. Various MR analysis methods were employed, including inverse variance weighted (IVW), constrained maximum likelihood model averaging-based method (cML-MA-BIC), maximum likelihood (ML), weighted mode, weighted median, and MR-robust adjusted profile score (MR-RAPS). Additionally, mediation analyses were performed to identify the immune cell traits that mediate these effects.

RESULTS: This study identified 12 oral bacterial taxa and 36 inflammatory cytokines associated with asthma. After identifying the oral microbiota and immune cell characteristics associated with asthma, we applied a mediation MR framework to investigate whether immune cell traits mediate the effect of microbiota on asthma. Finally, we identified eight immune cell traits that mediate asthma caused by bacteria.

CONCLUSIONS: Our results highlight the causal associations between oral bacterial taxa, immune cell traits, and asthma, providing evidence that various immune cell traits serve as critical mediators between the oral microbiota and asthma. The link between the oral microbiome and asthma has important implications for clinical practice.

PMID:40897151 | DOI:10.1016/j.cyto.2025.157021

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A correlational study of anxiety and motivation on learning Chinese as a foreign language

Acta Psychol (Amst). 2025 Sep 1;260:105483. doi: 10.1016/j.actpsy.2025.105483. Online ahead of print.

ABSTRACT

Compared to existing research on foreign language anxiety (FLA) and motivation, which focus on learning English as a foreign language (EFL), research on anxiety and motivation in learning Chinese as second or foreign language remains limited. Therefore, this study aims to examine the impact of anxiety and motivation on learning Chinese as a foreign language (CFL), as well as investigate the relationship between anxiety and motivation among CFL learners, with the primary factors that could contribute to increasing anxiety and motivation levels. Employing a correlational design, 66 first-year intermediate school CFL learners participated in this study. Data were collected using two questionnaires: the Foreign Language Classroom Anxiety Scale (FLCAS) by Sung and Li (2019) and a motivation scale adapted by Wen (1997). To analyze the data using the Statistical Package for the Social Sciences (SPSS), the present study employed a quantitative approach and a descriptive-analytical method. The findings revealed a high impact of anxiety on CFL learning, particularly concerning the mastery of language skills and writing Chinese characters. Learners expressed high levels of Chinese class performance anxiety, while levels of confidence in their overall ability to learn the language were significantly lower. Additionally, learners exhibited high motivation to learn Chinese. No significant relationship was observed between anxiety and motivation. This study highlights significant insights for Chinese language instructors, emphasizing the need to improve teaching approaches to minimize anxiety while improving motivation.

PMID:40897141 | DOI:10.1016/j.actpsy.2025.105483

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Acceptance and perceptions on the 2025 update of the ILAE classification of epileptic seizures: A survey of neurologists and neurology residents

Epilepsy Behav. 2025 Sep 1;172:110696. doi: 10.1016/j.yebeh.2025.110696. Online ahead of print.

ABSTRACT

PURPOSE: The International League Against Epilepsy (ILAE) has recently updated the classification of epileptic seizures. This study aims to explore the perspectives of a broad group of neurologists and neurology residents regarding the new classification.

METHODS: A structured, anonymous online survey was distributed among adult general neurologists, epileptologists, and neurology residents across 10 Spanish-speaking countries. A 23-item questionnaire covered demographic data and opinions on the ILAE seizure classifications. Descriptive and bivariate statistical analyses were performed.

RESULTS: A total of 124 participants completed the survey. While 56.5 % supported updating the 2017 classification, 53.3 % felt the revision came too soon. The 2017 version remained the preferred seizure classification (48.8 %), followed by the 2025 update (30.1 %) and earlier versions. Although 44.7 % of respondents expressed a favourable opinion of the 2025 classification, most participants feel it does not address the limitations of the previous version. Epileptologists were significantly more favourable toward the update (61.9 %) and rated it higher. Neurology residents were the most critical subgroup. Nearly half (49.6 %) of participants expect to adopt the new classification in their clinical practice, while 26.0 % are undecided, and 24.4 % believe they will not.

CONCLUSION: The 2025 ILAE seizure classification received mixed feedback from a considerable group of neurologists and neurology residents. While epileptologists were more receptive, many non-epileptologist neurologists and residents questioned its timing and practical benefit. The 2017 version remains the most accepted version of all ILAE classifications. Nevertheless, the new classification is expected to be widely adopted in clinical practice.

PMID:40897133 | DOI:10.1016/j.yebeh.2025.110696