SAGE Open Medicine最新文献

{"title":"Pediatric BurnNet: Robust multi-class segmentation and severity recognition under real-world imaging conditions.","authors":"Xiang Li, Zhen Liu, Lei Liu","doi":"10.1177/20503121251360090","DOIUrl":"10.1177/20503121251360090","url":null,"abstract":"<p><strong>Objective: </strong>To establish and validate a deep learning model that simultaneously segments pediatric burn wounds and grades burn depth under complex, real-world imaging conditions.</p><p><strong>Methods: </strong>We retrospectively collected 4785 smartphone or camera photographs from hospitalized children over 5 years and annotated 14,355 burn regions as superficial second-degree, deep second-degree, or third-degree. Images were resized to 256 × 256 pixels and augmented by flipping and random rotation. A DeepLabv3 network with a ResNet101 backbone was enhanced with channel- and spatial attention modules, dropout-reinforced Atrous Spatial Pyramid Pooling, and a weighted cross-entropy loss to counter class imbalance. Ten-fold cross-validation (60 epochs, batch size 8) was performed using the Adam optimizer (learning rate 1 × 10⁻⁴).</p><p><strong>Results: </strong>The proposed Deep Fusion Network (attention-enhanced DeepLabv3-ResNet101, Dfusion) model achieved a mean segmentation Dice coefficient of 0.8766 ± 0.012 and an intersection-over-union of 0.8052 ± 0.015. Classification results demonstrated an accuracy of 97.65%, precision of 88.26%, recall of 86.76%, and an F1-score of 85.33%. Receiver operating characteristic curve analysis yielded area under the curve values of 0.82 for superficial second-degree, 0.76 for deep second-degree, and 0.78 for third-degree burns. Compared with baseline DeepLabv3, FCN-ResNet101, U-Net-ResNet101, and MobileNet models, Dfusion improved Dice by 15.2%-19.7% and intersection-over-union by 14.9%-23.5% (all <i>p</i> < 0.01). Inference speed was 0.38 ± 0.03 s per image on an NVIDIA GTX 1060 GPU, highlighting the modest computational demands suitable for mobile deployment.</p><p><strong>Conclusion: </strong>Dfusion provides accurate, end-to-end segmentation and depth grading of pediatric burn wounds captured in uncontrolled environments. Its robust performance and modest computational demand support deployment on mobile devices, offering rapid, objective assistance for clinicians in resource-limited settings and enabling more precise triage and treatment planning for pediatric burn care.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251360090"},"PeriodicalIF":2.1,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Beyond Treatment': Clinical and psychosocial predictors of health-related quality of life of patients with prostate cancer.","authors":"Michael Effah Ntiamoah, Vivian Efua Senoo-Dogbey","doi":"10.1177/20503121251360120","DOIUrl":"10.1177/20503121251360120","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study sought to assess the health-related quality of life and its predictors among patients diagnosed with prostate cancer in two municipalities in the Volta Region of Ghana and to compare the scores between patients receiving treatment and those not receiving treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional hospital-based analytical study was conducted among 205 prostate cancer patients attending 2 hospitals in the Volta Region. Health-related quality of life was measured using the functional assessment of cancer therapy-prostate instrument, comprising subscales for physical, emotional, social and functional well-being. Group differences were assessed using Kruskal-Wallis &lt;i&gt;H&lt;/i&gt; tests, and multiple linear regression was used to identify predictors of overall health-related quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The performance under the individual domains or subscales was 14.8 ± 8.7, 14.1 ± 5.6, 13.7 ± 6.6, 9.6 ± 7.7, and 20.1 ± 9.9 for the physical well-being, social/family well-being, emotional well-being, functional well-being and PC subscales, respectively. The functional assessment of cancer therapy-trial outcome index was 44.6 (standard deviation ±16.2). The Functional Assessment of Cancer Therapy-General (FACT-G) total score among the study participants was 52.2 (standard deviation ±15.5). The participants in this study had an overall functional assessment of cancer therapy-prostate total score of 72 (standard deviation ±22), an indication of a lower health-related quality of life performance. Contrary to expectations, untreated patients reported slightly better scores in physical and emotional well-being and higher overall health-related quality of life scores compared to those who received treatment. Emotional well-being was significantly lower among treated patients (mean = 12.6) compared to untreated patients (mean = 16.9). Treated patients showed marginally better social and functional well-being. While differences in total scores between the groups were not statistically significant (&lt;i&gt;p&lt;/i&gt; = 0.27), clinical variables such as urinary incontinence, pain, anxiety, erectile dysfunction and bowel problems were significantly associated with lower quality of life (all &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Regression analysis identified older age (β = -0.12, &lt;i&gt;p&lt;/i&gt; = 0.03), erectile dysfunction (β = -0.47, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), bowel problems (β = -0.19, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and anxiety (β = -0.18, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) as independent predictors of poorer scores, whereas being married was associated with higher performance on the scale (β = 0.13, &lt;i&gt;p&lt;/i&gt; = 0.01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The functional assessment of cancer therapy-prostate scale revealed notably low health-related quality of life scores among men with prostate cancer in the two municipalities of Ghana's Volta Region. Untreated patients reported better emotional and physical well-being, while treated patients had slightly better","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251360120"},"PeriodicalIF":2.1,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interplay of rheumatoid arthritis and cardiovascular disease: Insights and prospects.","authors":"Anastasia V Poznyak, Nikolay A Orekhov, Alexey V Churov, Irina Alexandrovna Starodubtseva, Dmitry Felixovich Beloyartsev, Tatiana Ivanovna Kovyanova, Vasily N Sukhorukov, Alexander N Orekhov","doi":"10.1177/20503121251330171","DOIUrl":"10.1177/20503121251330171","url":null,"abstract":"<p><p>Rheumatoid arthritis significantly increases the risk of cardiovascular disease due to chronic inflammation. This review's purpose is to critically analyze the intricate relationship between rheumatoid arthritis and cardiovascular disease, highlighting the mechanisms by which systemic inflammation contributes to cardiovascular risk and the effectiveness of current treatment strategies. We systematically evaluate existing literature on conventional cardiovascular risk factors in rheumatoid arthritis patients, as well as inflammation-specific markers that influence cardiovascular outcomes. Our conclusions indicate that while several treatment modalities, including methotrexate and other disease-modifying agents, may mitigate cardiovascular risk, there is a prevalent underestimation of true risk by standard cardiovascular disease assessment protocols. This review provides unique contributions by emphasizing the importance of integrating novel risk factors into assessment protocols and advocating for personalized management strategies that cater to the specific needs of rheumatoid arthritis patients. By synthesizing these elements, we aim to enhance understanding and guide clinicians in improving outcomes for rheumatoid arthritis patients at heightened risk of cardiovascular complications.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251330171"},"PeriodicalIF":2.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of intravenous medication diluent fluid composition on the development of dyschloremia in intensive care unit patients: A retrospective chart review.","authors":"Mahsa Movahedan, Glen Brown","doi":"10.1177/20503121251356069","DOIUrl":"10.1177/20503121251356069","url":null,"abstract":"<p><strong>Objective: </strong>Intravenous solutions such as dextrose 5% in water and 0.9% sodium chloride (normal saline) differ in electrolyte composition from human plasma and may contribute to serum chloride derangements (dyschloremia). This retrospective study aimed to explore the relationship between fluid composition, particularly medication diluents, and dyschloremia development in the intensive care unit.</p><p><strong>Methods: </strong>This was a retrospective chart review of adult intensive care unit patients with normal serum chloride on admission who developed dyschloremia after 48 h of intensive care unit admission. Data were collected on fluid types and volumes administered in the intensive care unit in the 7 days prior to dyschloremia onset. Descriptive statistics and chi-square tests were used to compare characteristics between patients who developed hyperchloremia and hypochloremia.</p><p><strong>Results: </strong>Of 884 screened patients, 85 developed dyschloremia after 48 h (41 hypochloremia, 44 hyperchloremia). There was no significant association between the proportion of normal saline or dextrose 5% in water-containing fluids and the type of dyschloremia. However, dexmedetomidine, typically diluted in normal saline, was associated with hyperchloremia.</p><p><strong>Conclusion: </strong>While total fluid composition was not associated with dyschloremia type, high-volume use of specific diluent-medication combinations may contribute. Strategies to minimize diluent volume could help reduce dyschloremia risk.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251356069"},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of <i>Vibrio parahaemolyticus</i> isolated from stool specimens of diarrhea patients in Taizhou, China during 2020-2023.","authors":"Ding Ding, Yi Jiang, Yajing Lin, Ting Zhang, Jiejie Guo, Tian Jiang, Linyao Huang, Jianxin Yan, Long He","doi":"10.1177/20503121251355442","DOIUrl":"10.1177/20503121251355442","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the pathogenic characteristics of <i>Vibrio parahaemolyticus</i> in Taizhou City, China, to provide a scientific basis for the diagnosis and control of <i>Vibrio parahaemolyticus</i> in the region.</p><p><strong>Methods: </strong>Bacterial strains were isolated from stool specimens of diarrheal patients at the First People's Hospital of Wenling City. The virulence genes, serotypes, and antibiotic susceptibility of these strains were determined.</p><p><strong>Results: </strong>From June 1, 2020 to May 31, 2023, a total of 97 strains of <i>Vibrio parahaemolyticus</i> were isolated from stool specimens of diarrheal patients at the First People's Hospital of Wenling City. The results of virulence gene detection showed that 87.6% of the strains were thermostable direct hemolysin (TDH; <i>tdh</i>)⁺, thermolabile hemolysin (<i>tlh</i>)⁺, and <i>tdh</i>-related hemolysin (<i>trh</i>)^-, 11.3% were <i>tdh</i> ^- <i>tlh</i> ⁺ <i>trh</i> ^-, and 1.0% were <i>tdh</i> ⁺ <i>tlh</i> ⁺ <i>trh</i> ⁺. Six different serotypes were identified, with O3:K4 and O4:K4 being the most common, accounting for 42.3% and 32.0%, respectively. The other serotypes identified were O3:K6, O4:K8, and O1:KUT, accounting for 11.3%, 10.3%, and 3.1%, respectively. Furthermore, the results of antimicrobial susceptibility tests showed that most strains were sensitive to the tested drugs, while some strains exhibited resistance to cefuroxime (32.6%) and cefazolin (43.6%).</p><p><strong>Conclusion: </strong>The majority of the isolated <i>Vibrio parahaemolyticus</i> strains carried the <i>tdh</i> gene, and the O3:K4 serotype dominated in Taizhou City from 2020 to 2023, followed by the O4:K4 serotype. Furthermore, some strains exhibited resistance to cefuroxime and cefazolin.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251355442"},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family dynamics and diagnostic delay among pulmonary tuberculosis patients in Ile-Ife, South-Western Nigeria.","authors":"Ayanleye Ahmed Abdulakeem, Oloyede Oyegbade Olanrewaju, Olurotimi Ogundokun Akinjide, Fehintola Awopeju Olayemi, Sebutu Bello Ibrahim, Anu Olowookere Samuel, Oluwafemi Olajubu Temitope, Olalekan Ismail Waheed, Kolawole Adewumi Muideen, Omowonuola Sonibare Olubukola, Oladeji Gbadamosi Moroof, Oyemomi Ibrahim Azeez","doi":"10.1177/20503121251353436","DOIUrl":"10.1177/20503121251353436","url":null,"abstract":"<p><strong>Background: </strong>Despite the availability of directly observed treatment short-course, which provides free treatment to patients with tuberculosis, leading to some progress, Nigeria still faces a slow decline in tuberculosis incidence and low case detection. The delay in diagnosis of pulmonary tuberculosis, regarding access to healthcare, has made extensive efforts towards its control and elimination appear unrewarding. This study aimed to assess the relationship between family dynamics and diagnostic delay among patients with pulmonary tuberculosis receiving care in the directly observed treatment short-course centres in Ile-Ife, Nigeria.</p><p><strong>Methods: </strong>A descriptive cross-sectional study of 282 patients on treatment for pulmonary tuberculosis in the directly observed treatment short-course centres in Ile-Ife was conducted. The respondents were recruited using a multistage sampling technique. Data were collected using an interviewer-administered World Health Organization-validated questionnaire on case-finding in tuberculosis patients, the Perceived Social Support Family Scale, and the family adaptability, partnership, growth, affection, and resolve (APGAR) score. Multiple logistic regression was done to determine the family dynamics variables that independently predict diagnostic delay. A <i>p</i> < 0.05 was taken as statistically significant.</p><p><strong>Results: </strong>The family dynamics of the respondents showed that 68.1% of them had strong family support, with about two-thirds (69.1%) having functional families. The median diagnostic delay before diagnosis was 45 days (range 9-217 days). Having a dysfunctional family (Adjusted Odd Ratio (AOR), 3.87; 95% confidence interval, 1.704-8.777, <i>p</i> = 0.001), monthly family income <₦30,000 (US$56.07; AOR, 2.96; 95% confidence interval, 1.358-6.453, <i>p</i> = 0.006), and family size larger than 6 (AOR, 2.223; 95% confidence interval, 1.212-4.076, <i>p</i> = 0.010) were significant predictors of prolonged diagnostic delay.</p><p><strong>Conclusion: </strong>Family factors predicting diagnostic delay were large family size, low family income, and family dysfunction. There is a need to increase tuberculosis diagnostic access to families with these characteristics.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251353436"},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival differences according to baseline characteristics of patient with advanced heart failure treated with levosimendan.","authors":"Angel-Alberto Garcia-Peña, Alejandro Mariño, Oscar-Mauricio Muñoz-Velandia, Daniela Saa-González","doi":"10.1177/20503121251357357","DOIUrl":"10.1177/20503121251357357","url":null,"abstract":"<p><strong>Aims: </strong>To assess whether baseline characteristics (age, New York Heart Association functional class, left ventricular ejection fraction, glomerular filtration rate, systolic blood pressure, and N-terminal pro-brain natriuretic peptide) predicted different survival functions in patients with advanced heart failure, treated with intermittent inotropics.</p><p><strong>Methods: </strong>Survival analysis based on a retrospective cohort of patients with advanced heart failure, treated with intermittent infusion of levosimendan and managed at heart failure clinic of the Hospital Universitario San Ignacio, in Bogotá (Colombia). We evaluated which baseline characteristics were associated with worse survival outcomes, using Kaplan-Meier curves and log rank test.</p><p><strong>Results: </strong>Forty-two patients with advanced heart failure were included (mean age: 69.5 ± 13.2 years, 97.6% New York Heart Association III-IV, 54.7% of the population had quadruple therapy). A total of 39.5% died during 1-year follow-up. Survival functions were worse in patients with N-terminal pro-brain natriuretic peptide levels >6000 pg/mL (HR: 2.72; 95% CI: 1.01-8.01, <i>p</i> = 0.0493). In contrast, no significant difference in mortality was found for those with basal GFR <60 versus ⩾60 ml/min (<i>p</i> = 0.1030), left ventricular ejection fraction ⩽20% versus >20% (<i>p</i> = 0.1040), systolic blood pressure <90 mmHg versus ⩾90 mmHg (<i>p</i> = 0.2463), according to functional class (<i>p</i> = 0.840) or age > 65 years (<i>p</i> = 0.169). A significant increase of left ventricular ejection fraction measurements was observed in 26 surviving patients at 12 months of follow-up (20% vs 34%, <i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Our preliminary data suggest that the only characteristic that could predict worse survival in patients with advanced heart failure treated with levosimendan is N-terminal pro-brain natriuretic peptide levels greater than 6000 pg/ml. Future research is needed to confirm our findings.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251357357"},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenic bacteria in raw milk and milk products in Ethiopia: A decade review of prevalence, contributing factors, and antimicrobial resistance. A systematic review and meta-analysis.","authors":"Sifray Batire Belayneh, Chuol Kulang Luak, Samuel Alemu Bamboro","doi":"10.1177/20503121251353356","DOIUrl":"10.1177/20503121251353356","url":null,"abstract":"<p><strong>Background: </strong>Foodborne illnesses pose significant health challenges globally, affecting both developed and developing nations. Despite numerous review addressing pathogenic bacteria in various animal-origin foods in Ethiopia, there is a notable lack of research specifically focused on raw milk and milk products.</p><p><strong>Objective: </strong>This study aims to systematically review the prevalence of pathogenic bacteria in raw milk and milk products, identify associated risk factors and assess antimicrobial resistance in Ethiopia from 2014 to 2024.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, JANE, Scopus, and Google Scholar yielded 1596 articles, of which 18 full-text studies were included based on eligibility criteria, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted and analyzed to determine pooled prevalence rates, associated risk factors, and antimicrobial resistance across various Ethiopian regions.</p><p><strong>Results: </strong>The review identified a pooled prevalence of pathogenic bacteria at 18.7% (95% CI: 17.46%-19.94%) from January 2014 to February 2024. Major pathogens included <i>Escherichia coli</i> O157:H7 (5.2%), Staphylococcus <i>aureus</i> (18.27%), and <i>Listeria monocytogenes</i> (3.86%). The Oromia Region exhibited the highest prevalence (85.9%), while the lowest was recorded in Ambo, Holeta, and Bako towns (2.28%). Bacterial contamination of raw milk and milk product showed a statistically significant association with raw milk sample collectors (<i>p</i> < 0.028), livestock age (<i>p</i> < 0.001), inadequate hygiene (<i>p</i> < 0.0001), and illiteracy (<i>p</i> < 0.000), highlighting urgent educational needs. The overall antimicrobial resistance rate was alarming at 86.2%, with multidrug resistant isolates constituting 50.6%. Significant resistance was noted against commonly used antimicrobials such as nalidixic acid (100%), ampicillin (89.7%), amoxicillin (76.3%), penicillin (75%), oxacillin (73.6%), and streptomycin (61.5%).</p><p><strong>Conclusions: </strong>The findings indicate a critical need for enhanced surveillance and intervention strategies to address microbial contamination and antibiotic resistance in Ethiopia's dairy sector. Targeted educational initiatives and stricter regulations on antibiotic use in animal husbandry are essential to improve dairy safety and public health outcomes.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251353356"},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of immunization service delivery in primary healthcare centers in Akinyele and Lagelu local government areas, Oyo State, Nigeria.","authors":"Oladosu Timilehin Gbeminiyi, Ajayi IkeOluwapo Oyeneye","doi":"10.1177/20503121251352974","DOIUrl":"10.1177/20503121251352974","url":null,"abstract":"<p><strong>Introduction: </strong>Primary healthcare is the most accessible and affordable form of healthcare for Nigerians. It offers primary prevention strategies such as routine immunization. Routine immunization at government facilities, including primary healthcares, is provided free of charge under Nigeria's Expanded Program on Immunization. However, gaps such as a shortage of healthcare workers, inadequate infrastructure, and poor supply chain management can hinder the effective delivery of immunization services. This study assessed factors affecting the quality of immunization service delivery in Primary healthcares in Akinyele and Lagelu local government areas in Oyo State, Nigeria.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods cross-sectional design was adopted, combining quantitative data from 127 healthcare workers across 40 primary healthcares from the two local government areas with qualitative data from 10 in-depth interviews. Quantitative data were analyzed using descriptive statistics and Chi-square tests, while qualitative data were analyzed thematically.</p><p><strong>Results: </strong>Across both local government areas, over 85% of healthcare workers received pre-service or onsite cold chain training and routinely provided immunization information. In Akinyele, onsite training was significantly associated with satisfactory cold chain management (χ² = 10.039, <i>p</i> = 0.002), while in Lagelu, healthcare workers' knowledge was associated with satisfactory cold chain practices (χ² = 7.004, <i>p</i> = 0.008). Qualitative interviews revealed that Lagelu's consistent Basic Healthcare Provision Fund funding facilitated regular outreaches, whereas Akinyele's dependence on out-of-pocket payments led to intermittent services. Both local government areas faced cold chain equipment shortages and reliance on temporary staff. Quantitative and qualitative study findings show that reliable funding and targeted training ensure consistent outreach and effective cold chain management.</p><p><strong>Conclusion: </strong>While previous studies have documented funding and cold chain gaps, this study uniquely demonstrates how localized Basic Healthcare Provision Fund access specifically stabilizes outreach but fails to address workforce and infrastructure deficits. Expansion of Basic Healthcare Provision Fund-like financing across primary healthcares, transition to permanent, competitively compensated immunization staff, investment in renewable-energy cold chain technologies, and integration of community-driven outreach into the existing healthcare framework will improve immunization service delivery.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251352974"},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the neural correlates of the left thalamus in women with fibromyalgia: A Granger causality and voxel-based morphometry approach.","authors":"Elijah Agoalikum, Hongzhou Wu, Benjamin Klugah-Brown, Michael Maes","doi":"10.1177/20503121251352360","DOIUrl":"10.1177/20503121251352360","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and psychological distress. Despite its high prevalence, the neurobiological mechanisms underlying fibromyalgia remain poorly understood. This study aims to investigate the structural and functional correlates of the left thalamus in fibromyalgia patients using a combined Granger causality and voxel-based morphometry approach.</p><p><strong>Methods: </strong>We analyzed functional and structural magnetic resonance imaging data from 20 female fibromyalgia patients and 20 female age-matched healthy controls. Voxel-based morphometry was employed to evaluate grey matter volume differences, while Granger causality analysis explored effective connectivity between the left thalamus and other brain regions. Psychological metrics, including pain intensity, pain self-perception, anxiety, depression, and pain catastrophizing, were assessed to determine correlations with neuroimaging findings.</p><p><strong>Results: </strong>Our analysis revealed significantly increased grey matter volume in the left thalamus among fibromyalgia patients compared to controls, alongside a decrease in the right amygdala. Correlation analyses indicated strong associations between increased thalamic volume and pain intensity, pain catastrophizing, and anxiety. Granger causality analysis demonstrated decreased outflow from the left thalamus to key regions involved in pain processing, including bilateral caudate, right fusiform, and right hippocampus, as well as increased inflow from areas associated with visual and cognitive processing, including right inferior occipital cortex, right middle frontal cortex, and right inferior parietal cortex, suggesting a complex interplay between structural changes and psychological factors in pain processing.</p><p><strong>Conclusions: </strong>This study provides novel insights into the neurobiological underpinnings of fibromyalgia, highlighting the role of the left thalamus in both pain perception and emotional regulation. Our findings underscore the necessity for a multi-faceted understanding of fibromyalgia that integrates neuroimaging, psychological assessments, and their implications for future therapeutic interventions. Further research is warranted to explore the longitudinal effects of treatment on structural and functional brain changes in fibromyalgia.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251352360"},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}