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Nutritional, functional, and microbial qualities of legume-based flour blends processed by SMEs in Zambia and Malawi compared to standard Corn-Soy Blend Plus (CSB +): a cross-sectional study

BMC Nutr. 2025 Mar 6;11(1):49. doi: 10.1186/s40795-025-01034-0.

ABSTRACT

BACKGROUND: Legumes enhance food security in developing countries, necessitating an understanding of their properties. This study examined the nutritional, functional, and microbial qualities of legume-based flour blends from Small and Medium Enterprises (SMEs) in Malawi and Zambia. SMEs were chosen for their key role in local food production, distribution, and complementary food supply.

METHOD: A total of 36 legume-based flour blend samples were collected using snowball sampling, consisting of 21 samples (7 sets of 3 similar samples) from SMEs in Zambia and 15 samples (5 sets of 3 similar samples) from SMEs in Malawi. Samples were analyzed for proximate composition, energy, iron, and zinc content. The nutritional contributions to the Recommended Dietary Allowances (RDA) for children aged 1-3 years were assessed. Additionally, functional properties such as water-holding and oil-holding capacities were measured. Microbial analysis was performed, and the data were statistically analyzed to determine significance (p ≤ 0.05).

RESULTS: Our findings revealed substantial variability in the nutritional content of these flour blends. Protein content ranged from 9.4% to 41.5%, carbohydrates from 8.1% to 71.3%, crude fat from 2.3% to 26.8%, and crude fiber from 6.2% to 35.2%. Iron and zinc levels also varied significantly, from 2.9 to 21.9 mg/100 g and 2.2 to 5.2 mg/100 g, respectively. These inconsistencies highlight a lack of standardization in nutrient content for blends intended for infant feeding. When prepared as 96 g porridge servings for children aged 1-3 years, the blends provided notable contributions to the Recommended Dietary Allowance (RDA). However, their nutrient levels were generally lower compared to the standard Corn-Soy Blend Plus (CSB +). The flour blends also showed variations in physico-functional properties, and some had microbial loads exceeding 250 cfu/g, reflecting inadequate hygiene practices during processing.

CONCLUSION: To enhance their products, SMEs should ensure that their flour blends meet both nutritional and safety standards while striving to match or surpass the nutrient content of CSB + to remain competitive in the market.

PMID:40050953 | DOI:10.1186/s40795-025-01034-0

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Efficacy of two doses of intra-articular ozone therapy for pain and functional mobility in knee osteoarthritis: a double-blind randomized trial

Adv Rheumatol. 2025 Mar 6;65(1):11. doi: 10.1186/s42358-025-00443-w.

ABSTRACT

AIM: This double-blind, trial sought to assess the effectiveness of intra-articular ozone therapy at concentrations of 20 µg/mL and 40 µg/mL in managing pain and enhancing functional mobility in patients with knee osteoarthritis (KOA).

METHOD: This parallel, three-arm randomized controlled trial, conducted between 2022 and 2023, included 59 knee osteoarthritis (KOA) patients randomly allocated to one of three groups: the first group received 40 µg/mL ozone therapy, the second group received 20 µg/mL ozone therapy, and the control group received oxygen. Functional mobility was assessed through the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee flexion range of motion (FROM), the Timed Up and Go (TUG) test, and the six-minute walk test (6MWT). Pain intensity was measured using the Visual Analog Scale (VAS) and the pain subscale of the WOMAC. Intra-articular injections were administered weekly for four consecutive weeks, with assessments conducted pre-treatment, and at two weeks, one month, and two months post-intervention. One-way ANOVA was employed for normally distributed quantitative data, while the Kruskal-Wallis test was utilized for non-normally distributed data. Qualitative variables were analyzed using the Chi-squared or Fisher’s exact test, as appropriate.

RESULTS: The groups receiving intra-articular ozone therapy exhibited notable reductions in mean VAS scores and improvement in functional mobility variables when compared to the control group (p < 0.05). However, post-hoc analysis indicated no statistically significant differences between the 40 µg/mL and 20 µg/mL ozone therapy groups regarding these parameters (VAS, FROM, TUG, 6MWT, or WOMAC scores) (p > 0.05).

CONCLUSION: Both 20 µg/mL and 40 µg/mL doses of intra-articular ozone therapy prove to be effective in reducing pain and enhancing functional mobility in patients with knee osteoarthritis (KOA). Nevertheless, there was no significant difference in the efficacy between the two ozone concentrations.

TRIAL REGISTRATION: The trial is registered on us ClinicalTrials.gov in 2024-05-01 with the following ID code NCT06088706.

PMID:40050950 | DOI:10.1186/s42358-025-00443-w

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Physical activity and lung cancer screening (PALS): feasibility randomised controlled trial of exercise and physical activity in lung cancer screening

Respir Res. 2025 Mar 6;26(1):89. doi: 10.1186/s12931-025-03158-0.

ABSTRACT

BACKGROUND: There is increasing evidence that screening provides a catalyst for behavioural change. Low physical activity (PA) levels are a potentially modifiable risk factor for developing lung cancer. This study aims to assess the feasibility and safety of a semi-supervised 8-week multi-modal exercise program to improve health-related quality of life and PA levels of participants of lung cancer screening.

METHODS: Participants without lung cancer from a single Australian International Lung Screen Trial (ILST; NCT02871856) site were invited to this feasibility randomised controlled trial. Enrolled participants were randomised to usual care, written material, or a home-based exercise program (in addition to written material). Assessments occurred at baseline, 9 weeks, and 6 months.

RESULTS: 75 participants were enrolled over a 3-month period in 2022 (consent rate of 67%). 43% of participants were female, median age 66 years old (IQR 62, 73). Of the 25 participants randomised to the home-based exercise program, 22 participants (88%) attended > 70% of weekly sessions. 99% (74/75) of study participants attended their 9-week and 6-month follow-up assessments.

CONCLUSIONS: This study confirms the feasibility and high compliance of delivering a semi-supervised 8-week multi-modal exercise program to participants of a lung cancer screening program. It was safe, with no adverse events.

CLINICAL TRIAL REGISTRATION: Australian Clinical Trials Register https://www.australianclinicaltrials.gov.au ACTRN12622001001785.

PMID:40050941 | DOI:10.1186/s12931-025-03158-0

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Effects of semaglutide in patients with chronic ankle instability: evidence from a prospective cohort

J Orthop Surg Res. 2025 Mar 6;20(1):243. doi: 10.1186/s13018-025-05664-9.

ABSTRACT

BACKGROUND: Whether patients with chronic ankle instability (CAI) can benefit from weight loss yielded by using glucagon-like peptide-1 receptor agonists (GLP1-RAs) has remained unclear.

METHODS: In this observational study, we recruited more than 2000 adults with CAI according to the selection criteria proposed by International Ankle Consortium with at least two-year follow up from three medical centers. The primary endpoint was the change from baseline of the Foot and Ankle Ability Measure (FAAM) sports subscale at the last follow up. Secondary endpoints included the change from baseline of Foot and Ankle Outcome Score (FAOS)/ Cumberland Ankle Instability Tool (CAIT)/ FAAM activities of daily living (ADL) subscale, number of ankle sprains during study period, incident ankle surgery in treatment of CAI.

RESULTS: In this study, 71 out of 2018 patients who received semaglutide in purpose of treating type 2 diabetes (T2DM) and/or weight loss during the study period. After controlling baseline characteristics, the adjusted mean difference in change from baseline was 16.3 for FAAM sports subscale and 9.3 for FAAM ADL subscale. Likewise, the adjusted analysis of five subscales of FAOS showed similar results, all consistently favoring semaglutide group. For CAIT, patients in the semaglutide group had achieved statistically significant improvement compared with control group. The association of semaglutide exposure with improvement in FAAM sports and ADL subscales was mediated by the weight loss measured by BMI (mediation proportion: FAAM sports subscale, 31.2% [22.2-41.2%]; FHSQ ADL subscale, 34.1% [24.4-44.8%]). We also observed statistically significant decreases in number of recurrent ankle sprains during study period. For incident ankle surgery, 1 out of 71 patients (1.4%) and 151 out of 1947 patients (7.8%) received ankle surgeries in semaglutide and control groups, respectively (P = 0.047).

CONCLUSIONS: Semaglutide may show potential benefits as a supplementary intervention in treatment of CAI by improving patient-reported outcomes and preventing recurrent ankle sprains. Further randomized trial is warranted by the current study to further confirm our findings.

TRIAL REGISTRATION: researchregistry10716.

PMID:40050929 | DOI:10.1186/s13018-025-05664-9

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Hesitancy towards COVID-19 booster vaccine among healthcare workers in Bangladesh

BMC Health Serv Res. 2025 Mar 6;25(1):346. doi: 10.1186/s12913-025-12482-6.

ABSTRACT

BACKGROUND: Despite completing the COVID-19 vaccination series, healthcare workers (HCWs) remain at an elevated risk of re-infection. Booster uptake, though essential for this group, remains poorly characterized among Bangladeshi HCWs. This study identified the prevalence and driving factors behind booster hesitancy among Bangladeshi HCWs, providing valuable insights for targeted interventions.

METHOD: From December 2022 to June 2023, we conducted a cross-sectional survey among 1772 HCWs enrolled from 20 healthcare facilities of all tiers purposively selected across four administrative divisions of Bangladesh. We collected information through face-to-face interviews regarding their sociodemographic, pre-existing, and currently existing medical conditions, COVID-19 vaccination status, and their intention, hesitancy, and willingness to receive future booster doses. We used a multivariable logistic regression model to analyze factors associated with booster hesitancy. Odd’s ratio with 95% confidence intervals (CIs) was calculated for each factor, with p < 0.05 considered statistically significant.

RESULT: Of the 1772 HCWs interviewed in our study, 49% (879) were nurses [median age 36 years (IQR: 30.0-46.0)]; 69% were female. Among the respondents, 94% (1667) were willing to take a booster, and 6% (105) showed hesitancy. Safety concerns, especially regarding potential side effects post-booster administration (86%), emerged as the leading cause of booster hesitancy among healthcare workers. Our multivariable logistic regression analysis revealed that support staff, compared to physicians, were the most hesitant to receive any additional booster dose (aOR 4.68, 95% CI: 1.56-9.03; p=0.006). Compared to rural residency, HCWs with an urban residency type were also more reluctant to receive booster doses (aOR 4.45, 95% CI: 2.03-9.73; p < 0.001).

CONCLUSION: Concerns about side effects following booster administration were the primary driver of hesitancy in our study. Targeted interventions focusing on education and addressing these anxieties-supported by evidence-based communication strategies-could play a crucial role in improving booster acceptance and safeguarding this vulnerable workforce.

PMID:40050921 | DOI:10.1186/s12913-025-12482-6

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Long-term effects of yoga-based practices on neural, cognitive, psychological, and physiological outcomes in adults: a scoping review and evidence map

BMC Complement Med Ther. 2025 Mar 6;25(1):92. doi: 10.1186/s12906-025-04825-x.

ABSTRACT

BACKGROUND: Compared with short-term practices, long-term yoga might promote differential qualitative and quantitative outcomes. Following JBI’s and PRISMA-ScR guidelines, this scoping review followed an apriori and systematic protocol to document the long-term effects of yoga on neural, cognitive, psychological, and physiological outcomes, provide evidence maps for each yoga component, and summarize results identifying knowledge gaps and promising directions.

METHODS: Four databases (PubMed, Cochrane, LILACS, and PubPsych) were last searched in March 2023. Studies were included if they evaluated adults with > 1 year of practice, specified yoga-based practice(s) of interest, measured neural, cognitive, psychological, and/or physiological outcomes, were written in English, Spanish, or Portuguese, presented original data, and mentioned search terms in the title/abstract. Evidence maps for each yoga component followed a 4-level structure of outcome category, method, study design and literature size. Qualitative summaries followed the same structure, to facilitate information retrieval.

RESULTS: Out of 2270 screened studies, 65 were included (meditative studies = 36, predominantly postural studies = 25, breathing practice studies = 8). Physiologicaland neural outcomes were the most common, followed by psychological and cognitive outcomes. Although heterogeneous, neural results reveal structural and functional changes related to sensorimotor, interoceptive, emotion regulation, and executive functions. Physiologically, most studies have associated long-term practice with parasympathetic-driven autonomic, hormonal and immune responses, but some studies revealed sympathetic-driven or mixed responses, maybe due to the specific technique or individual differences. Psychological outcomes included lower levels of negative affect, psychopathological symptoms, and emotional reactivity. Cognitive measures have shown improved memory/cognition for older adults, but mixed or null effects for other constructs. Commonly, however, long-term practitioners demonstrated improved neural or physiological efficiency while performing cognitive tasks.

CONCLUSIONS: Future research should provide clear descriptions of the investigated yoga practice, employ more experimental paradigms, and refine statistical reports and models. We encourage researchers to work with specific overarching theoretical frameworks to refine research predictions, such as the neurovisceral integration model or predictive coding models; to consider motivational, cultural, and contextual factors that might influence long-term outcomes; and to develop systematic reviews and meta-analyses as next steps of evidence summary.

PMID:40050913 | DOI:10.1186/s12906-025-04825-x

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COVID-19 infection and longevity: an observational and mendelian randomization study

J Transl Med. 2025 Mar 6;23(1):283. doi: 10.1186/s12967-024-05932-y.

ABSTRACT

BACKGROUND: Studies have indicated that COVID-19 infection may accelerate the aging process in organisms. However, it remains unknown whether contracting COVID-19 affects life expectancy. Furthermore, the underlying biological mechanisms behind these findings are still unclear.

METHODS: We conducted a prospective cohort study on 56,504 participants of European ancestry from the UK Biobank who reported the time and number of COVID-19 infection between January 2020 and September 2023. The parental average longevity was used as a proxy for their own longevity. Linear regression was used to assess the relationship between COVID-19 infection and longevity. Furthermore, we investigated the shared genetic basis between COVID-19 and longevity using large-scale genome-wide association studies (GWAS) for COVID-19 (122,616 cases and 2,475,240 controls) and longevity (3,484 cases and 25,483 controls). Mendelian randomization (MR) and mediation analysis were utilized to assess causal relationships and potential mediators between COVID-19 susceptibility and longevity. Shared genetic loci between the two phenotypes were identified using conjunctional false discovery rate (conjFDR) statistical frameworks.

RESULTS: After controlling for relevant covariates, COVID-19 infection might not be significantly correlated with longevity. In all MR methods, generalized summary-data-based Mendelian randomization (GSMR) analysis revealed a significant decrease in longevity due to severe COVID-19 infection (OR = 0.91, 95%CI: 0.84-0.98, P = 0.015). Mediation analysis identified stroke and myocardial infarction as potential mediators between COVID-19 susceptibility and reduced longevity. At conjFDR < 0.05, we identified rs62062323 (KANSL1) and rs9530111 (PIBF1) as shared loci between COVID-19 and longevity.

CONCLUSION: Together, our findings provided preliminary evidence for the shared genetic basics between COVID-19 and aging. This discovery may have implications for personalized medicine and preventive strategies, helping identify individuals who may be more vulnerable to severe outcomes from COVID-19 due to their genetic makeup.

PMID:40050903 | DOI:10.1186/s12967-024-05932-y

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The relationship between smartphone addiction and sleep quality in older adults: the mediating role of loneliness and depression

BMC Nurs. 2025 Mar 6;24(1):253. doi: 10.1186/s12912-025-02883-7.

ABSTRACT

BACKGROUND: This study explores the relationship between smartphone addiction and sleep quality, and to further assess the mediating role of loneliness and depression.

METHODS: A survey of 200 older adults individuals was conducted using the Smartphone Addiction Scale-Short Version (SAS-SV) for smartphone addiction, Pittsburgh Sleep Quality Index (PSQI) for sleep quality, Geriatric Depression Scale-15 (GDS-15) for depression, and DeJong Gierveld Loneliness Scale (DGLS) for loneliness. Linear regression and mediation analysis were performed for statistical analysis.

RESULTS: A negative causal relationship was observed between smartphone addiction and sleep quality in the older adults (p < 0.05). Depression and loneliness in the older adults may potentially exacerbate the effect of smartphone addiction on sleep quality (p < 0.05).

CONCLUSION: Individuals with smartphone addiction appeared to have poorer sleep quality, psychological factors play a mediating role in the association between smartphone addiction and sleep quality in the older adults. This emphasizes the importance of care for the mental health of the older adults and recognizes the negative impact of smartphone addiction on their quality of life.

PMID:40050901 | DOI:10.1186/s12912-025-02883-7

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Revisiting NANDA International-Nursing Interventions Classification-Nursing Outcomes Classifications Linkages of Nursing Home Residents in Korea

Comput Inform Nurs. 2025 Mar 5. doi: 10.1097/CIN.0000000000001261. Online ahead of print.

ABSTRACT

Standardized nursing languages help nurses articulate issues with patients, forming the groundwork for the selection of nursing interventions aimed at achieving outcomes. However, the application of standardized nursing linkages on nursing processes and nursing home residents’ outcomes, as well as the identification of facility and resident factors, remains unexplored. The purpose of this study was to examine nursing home facility and resident factors on the use of NANDA, Nursing Interventions Classification, and Nursing Outcomes Classification (NNN) and frequently occurring NNN linkages surrounding nursing home residents in Korea. Data were collected from 53 nurses of 273 residents in 19 nursing homes in Korea using a newly developed smartphone application. Descriptive statistics, analysis of variance, and analysis of covariance were used for the data analysis. Nine NNN linkages were identified in this study, mostly centered on fall prevention. We also identified that residents’ factors (including acuity, age, and admission period) and organizational factors (including year of facility establishment and facility ownership status), were related to the use of NNN. Nursing home nurses’ clinical and critical judgment and the utilization of standardized nursing languages to select proper nursing interventions and outcomes should be based on both resident and organizational factors.

PMID:40048734 | DOI:10.1097/CIN.0000000000001261

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Introduction to Spine Injuries in the Pickleball Athlete

J Am Acad Orthop Surg. 2025 Feb 26. doi: 10.5435/JAAOS-D-24-01234. Online ahead of print.

ABSTRACT

INTRODUCTION: Pickleball is one of the fastest growing sports in the United States. Despite its popularity, there is limited research on pickleball-related orthopaedic injuries, particularly in the spine. This study aims to provide a deeper understanding of spinal injuries in pickleball players and offers insights into injury patterns and risk factors.

METHODS: A retrospective review from our urban tertiary medical center’s electronic medical record from 2013 to 2023 was done using OpenAI’s Generative Pretrained Transformer-4 model to identify pickleball-related orthopaedic injuries. After artificial intelligence-driven identification, a manual review of medical records identified injuries related to the spine. The resulting medical records were manually reviewed for variables such as injury year, age, sex, spinal region affected, and treatment. Artificial intelligence did not generate any data, participate in writing, or assist with statistical analysis. Statistical analyses were done using Stata software, with significance set at P < 0.05.

RESULTS: Among 1,527 pickleball-related orthopaedic injuries, 135 (8.8%) involved the spine (77% women, median age: 62 ± 12.4 years). Pickleball-related spinal injuries increased 56-fold from 2013 to 2023. Most injuries involved the lumbar spine (84%), followed by the cervical spine (15%) and thoracic spine (1%). The most common complaint was lumbar radicular symptoms (63%). Forty-six percent of patients had a body mass index over 25, and this was associated with lumbar radiculopathy and acute disk herniation (P < 0.05). Most patients sought outpatient care (98%) and 10% required surgical intervention, primarily spinal decompression.

CONCLUSION: Pickleball-related spine injuries are relatively uncommon but increasing as the sport grows in popularity, with the lumbar spine being the most frequently affected region. Elevated body mass index emerged as an important modifiable potential risk factor, and the study found a relatively high rate of surgical intervention at 10%. These findings can help guide counseling and treatment for pickleball athletes, although further research is needed to better understand risk factors, treatment options, prognosis, and return-to-play guidelines.

PMID:40048727 | DOI:10.5435/JAAOS-D-24-01234