Category: Nevin Manimala

Work. 2025 Jun;81(2):2670-2677. doi: 10.1177/10519815251319231. Epub 2025 Feb 26.

ABSTRACT

BACKGROUND: People who are unable to work because of a disability are at risk of social exclusion, so a special programme was introduced in Slovenia – the Social Inclusion Programme (SIP) – to support, maintain and develop the work skills, social skills and social integration of unemployable people with disabilities.

OBJECTIVE: To assess to what extent inclusion in the SIP benefits the programme’s users.

METHODS: In the period between 2020 and 2023, 752 users were enrolled in the SIP at 22 programme providers with units in 45 locations throughout Slovenia, who were assessed by vocational rehabilitation professionals on a 6-month basis. The professionals used a questionnaire that comprised demographic data, health status, frequency of participation in the SIP programme, and ratings of three domains (work adaptability, personality adaptability and interpersonal relationships).

RESULTS: Because of the large sample size, the worsening of the mean ratings of personality adaptability and interpersonal relationships was statistically significant, but it was negligible from the practical viewpoint. There was no statistically significant change regarding work adaptability. In all three domains, young people showed a slight improvement on average, whereas older people showed more deterioration on average than the middle-age group.

CONCLUSION: Overall, the work-related and social skills of the programme users remained practically unchanged over a period of approximately two to three years. This can probably be considered a success, because substantial deterioration would likely have occurred without the programme.

PMID:40421561 | DOI:10.1177/10519815251319231

Clin J Pain. 2025 May 27. doi: 10.1097/AJP.0000000000001302. Online ahead of print.

ABSTRACT

OBJECTIVES: Attrition from pediatric chronic pain clinics limits patients from receiving maximum benefit from evidence-based interventions, with likely persistence of chronic pain, functional and psychosocial impairments. We aimed to determine attrition prevalence from interdisciplinary pediatric outpatient chronic pain clinics and identify any associated patient and caregiver factors.

METHODS: A retrospective analysis was performed of longitudinal data from patients and caregivers attending 10 interdisciplinary pediatric outpatient chronic pain clinics in Australia or New Zealand contributing to the Paediatric electronic Persistent Pain Outcomes Collaboration (PaedePPOC) database. Data was retrieved for patient attrition, patient and caregiver factors at treatment commencement and subsequent documentation of the episode end for treatment completers and non-completers. Statistical associations with patient attrition were assessed using logistic regression analyses.

RESULTS: The prevalence of patient attrition was 19.3% in the PaedePPOC cohort (N=1051), occurring steadily over 11 months. Patients ending their treatment prematurely presented with longer pain duration (>12 mos) (χ2(1, n=879)=8.23, P=0.004) than treatment completers. In the regression model, only older patient age (P=0.010) and higher caregiver psychosocial burden (P=0.025) at treatment commencement were associated with attrition. While pain intensity, patient physical and psychosocial functioning scores and caregiver partner status were not.

DISCUSSION: One in five patients commencing an interdisciplinary pediatric outpatient chronic pain clinic intervention did not complete it. Identifying patients at pre-intervention screening with longer pain duration, older in age and from families with greater reported caregiver burden and providing tailored supports may minimize attrition, therefore optimizing efficiency of service provision.

PMID:40421547 | DOI:10.1097/AJP.0000000000001302

Hypertension. 2025 May 27. doi: 10.1161/HYPERTENSIONAHA.125.24980. Online ahead of print.

ABSTRACT

BACKGROUND: The field of renal denervation remains challenged by the inability to confirm successful ablation of the targeted renal sympathetic nerves. The availability of technology to measure regional blood flow in real-time makes sympathetic control of the renal vasculature a logical end point to assess effective renal denervation, but autoregulatory mechanisms mask effects on mean renal blood flow. We hypothesized that renal sympathetic vasomotion, a novel marker of rhythmic sympathetic control, reflects successive rounds of catheter-based radiofrequency renal denervation.

METHODS: To test this, 10 pigs underwent unilateral surgical renal denervation, recovered for at least 7 days, and then underwent 4 successive rounds of catheter-based radiofrequency denervation of the contralateral kidney. Bilateral renal blood flow velocity and abdominal aortic pressure were measured before and after ablations to calculate renal vasomotion.

RESULTS: Before catheter-based denervation, the renal vasomotion profiles of the innervated and surgically denervated kidneys differed significantly (P<0.005). Ablation of the largest renal branch artery reduced renal sympathetic vasomotion by 52%. Ablation of the remaining renal branch arteries reduced sympathetic vasomotion by 95% from baseline and eliminated the statistical differences between surgically and catheter-denervated kidneys. Two additional rounds of catheter denervation of the main renal artery did not consistently decrease the renal sympathetic vasomotion magnitude any further.

CONCLUSIONS: These results indicate that renal sympathetic vasomotion could provide intraprocedural feedback for interventionalists performing catheter-based renal denervation and thereby improve the efficacy, safety, and consistency of this antihypertensive intervention.

PMID:40421540 | DOI:10.1161/HYPERTENSIONAHA.125.24980

Birth. 2025 May 27. doi: 10.1111/birt.12920. Online ahead of print.

ABSTRACT

BACKGROUND: Community births (those in homes or freestanding birth centers) are increasing in the US, although they still represent a small percentage of total births. Research shows that community births can offer positive outcomes for low-risk individuals, such as fewer interventions and greater satisfaction. However, when perinatal complications arise, transfer to hospital can result in negative care outcomes and experiences. Effective integration of care and respectful communication between community and hospital providers during transfers are crucial for improving quality care measures. This study aimed to investigate the experiences and outcomes of individuals transferring from community settings to an urban US hospital with established transfer guidelines.

METHODS: This multi-method study, utilizing descriptive statistics and a grounded theory approach, explores the outcomes and experiences of individuals transferring from planned home or birth center births to hospital care for intrapartum management from August 2019 to August 2020. We included participants who were 18 or older, English-speaking, and had experienced a live birth following transfer from home or birth center to hospital. Quantitative outcomes were obtained through chart review. Qualitative interviews were conducted within 6 weeks post-birth, recorded, transcribed, and analyzed using constant comparative analysis.

RESULTS: A total of 82 individuals transferred during the study period, with 23 participating in qualitative interviews, we identified 5 major themes: seamless transfer, teamwork, respectful care, changing expectations, and a complex relationship with autonomy and decision-making. Participants valued smooth communication, midwife-to-midwife transfer of care, and the balance between autonomy and reliance on provider recommendations during transfers.

DISCUSSION: Understanding the experiences of those who transfer from community settings to hospitals is crucial for improving perinatal care. With established guidelines for transfer in place to facilitate collaboration across care providers and birth settings, transfers can be managed effectively, resulting in respectful experiences of care with positive health outcomes.

PMID:40421515 | DOI:10.1111/birt.12920

Int J Biostat. 2025 May 23. doi: 10.1515/ijb-2024-0021. Online ahead of print.

ABSTRACT

With the increasing complexity of data, researchers in various fields have become increasingly interested in estimating the causal effect of a matrix exposure, which involves complex multivariate treatments, on an outcome. Balancing covariates for the matrix exposure is essential to achieve this goal. While exact balancing and approximate balancing methods have been proposed for multiple balancing constraints, dealing with a matrix treatment introduces a large number of constraints, making it challenging to achieve exact balance or select suitable threshold parameters for approximate balancing methods. To address this challenge, the weighted Euclidean balancing method is proposed, which offers an approximate balance of covariates from an overall perspective. In this study, both parametric and nonparametric methods for estimating the causal effect of a matrix treatment is proposed, along with providing theoretical properties of the two estimations. To validate the effectiveness of our approach, extensive simulation results demonstrate that the proposed method outperforms alternative approaches across various scenarios. Finally, we apply the method to analyze the causal impact of the omics variables on the drug sensitivity of Vandetanib. The results indicate that EGFR CNV has a significant positive causal effect on Vandetanib efficacy, whereas EGFR methylation exerts a significant negative causal effect.

PMID:40421507 | DOI:10.1515/ijb-2024-0021

Nanoscale. 2025 May 27. doi: 10.1039/d5nr00016e. Online ahead of print.

ABSTRACT

Liposomal drug delivery systems have shown promising potential to improve drug delivery in several aspects. Precise in vitro characterization of formulated liposomes is vital to achieve proper in vivo function. In particular, in vitro release testing of liposomes offers crucial insights for predicting in vivo drug release behavior, guiding the development of more effective liposomal formulations. Herein, random forest (RF)- and XGboost-genetic algorithms were implemented to establish a model to predict release profiles of liposomes based on critical characteristics of carriers, cargoes, and release media. The models were trained with a dataset consisting of release parameters of 203 different liposomal formulations extracted from the literature, divided into three categories: all cargoes, therapeutics with log P < 1, and log P > 1. The SHapley additive exPlanations (SHAP) approach was used to determine how data contributes to the model prediction. A mean squared error of 1.648 highlighted the capability of the genetic algorithm to optimize the hyperparameters of the tree-based models. Furthermore, the developed models demonstrated high accuracy as evidenced by loss functions and statistical metrics such as root mean squared error, mean absolute error, and R-squared. Our results shed light on the distinct influence of phase transition temperature, drug concentration, log P, water solubility, molecular weight, vesicle size, cholesterol to phospholipid molar ratio, and surfactant concentration in the release medium on drug release at different phases of the release profiles. The predictive models developed in this study can facilitate the design of an ideal liposomal formulation for any desired release profile.

PMID:40421505 | DOI:10.1039/d5nr00016e

Minerva Cardiol Angiol. 2025 May 27. doi: 10.23736/S2724-5683.25.06719-5. Online ahead of print.

ABSTRACT

BACKGROUND: The aging population in the USA has led to a concomitant rise in the prevalence of vascular dementia (VaD), yet there remains a paucity of investigation into mortality trends associated with VaD among adults.

METHODS: This cross-sectional analysis utilized death certificate data from the Centers for Disease Control and Prevention’s WONDER database. VaD-associated mortality was identified using the International Statistical Classification of Diseases and Related Health Problems-10th revision (ICD-10) code F01. Crude, and age-adjusted VaD-associated mortality rates per 100,000 and their corresponding 95% confidence intervals (CI) were computed. Age-adjusted mortality rates (AAMRs) were standardized to the 2000 US census population.

RESULTS: From 2005 to 2020, there were 375,575 deaths attributed to VaD among older adults. We observed a gradual increase in AAMR (APC: 3.70, 95% CI [-4.14, 5.21]) from 2005 to 2015, succeeded by a pronounced escalation (APC: 9.07, 95% CI [6.09, 17.62]) until 2020. The highest AAMR was noted in the West (17.65, 95% CI [17.55, 17.76]), followed by the Midwest (AAMR: 12.66, 95% CI [12.58, 12.75]), the South (AAMR: 12.60, 95% CI [12.54, 12.67]), and the Northeast (AAMR: 8.60, 95% CI [8.53, 8.68]). Metropolitan areas exhibited higher AAMRs (10.9, 95% CI [10.8, 11.0]) compared to non-metropolitan areas (8.1, 95% CI [8.00, 8.3]). Among age groups, individuals aged 75-85 and older showed the highest overall AAMR (99.80, 95% CI [99.47, 100.14]). In addition, non-Hispanic Black or African-American subset of the population showed the highest overall AAMR (8.12, [95% CI: 8.03, 8.20]).

CONCLUSIONS: Our findings underscore the imperative for targeted public health interventions aimed at addressing regional disparities and age-specific vulnerabilities to mitigate the mounting burden of VaD-related mortality.

PMID:40421495 | DOI:10.23736/S2724-5683.25.06719-5

Int J Nurs Educ Scholarsh. 2025 May 19;22(1). doi: 10.1515/ijnes-2024-0077. eCollection 2025 Jan 1.

ABSTRACT

OBJECTIVES: Nursing education commonly includes aspects of cognitive, psychomotor, and affective learning. Subsequently, the evaluation of student affective learning has been recognized as an important aspect within educational processes. Affective learning is crucial to professional nursing role development. However, a gap in the literature exists in measuring and evaluating affective learning in nursing students. Using the taxonomy developed by Krathwohl, Bloom, and Masia (1964. Taxonomy of educational objectives, handbook II: affective domain. Philadelphia: David McKay Company, Inc.), faculty developed a tool for students to rate their perceived level of affective learning.

METHODS: Faculty launched a quality improvement project to evaluate the accuracy of student self-assessments of affective learning at the end of their first nursing course.

RESULTS: Student and expert identification of the level of affective learning were not statistically different, which demonstrated that students accurately identified their affective level. The sample demonstrated competency through the first level of affective learning (i.e., receiving).

CONCLUSIONS: Cultivating professional values can significantly impact the lives of patients and communities. Use of the tool may lead to a deeper understanding of student nurse development of affective competencies.

PMID:40421479 | DOI:10.1515/ijnes-2024-0077

J Hand Surg Eur Vol. 2025 May 27:17531934251342419. doi: 10.1177/17531934251342419. Online ahead of print.

ABSTRACT

The purpose of this study was to investigate the epidemiology of flexor tendon injuries and operative complications post-repair on a national scale. Using Hospital Episode Statistics data we identified a total of 91,239 patients in England who underwent a flexor tendon repair in the 20-year period between 1 April 1998 and 31 March 2018. Individuals were more likely to be male (74.6%) and of lower socioeconomic status. Median age was 31 years and patients had few medical comorbidities. After primary repair, 3.1% of patients required a revision repair within 90 days and 2.8% tenolysis within two years. Complications other than rupture, adhesions and wound site infection were rare. This study has shown that flexor tendon repair is primarily a procedure of working-age men, with rupture and adhesions the most common complication. The complication rate is less than previously reported in the literature.Level of evidence: III.

PMID:40421478 | DOI:10.1177/17531934251342419

Neurodegener Dis Manag. 2025 May 27:1-8. doi: 10.1080/17582024.2025.2510145. Online ahead of print.

ABSTRACT

BACKGROUND: While neuropsychiatric symptoms are common in Huntington’s Disease (HD), there is a dearth of evidence about the effectiveness of psychotropic medication for treating behavioral and cognitive symptoms. This article systematically reviews and aggregates the evidence of the effects of antidepressants on individuals with early HD.

METHODS: A systematic review and random-effects meta-analysis of RCTs comparing antidepressants to placebo in individuals with HD was performed, with a focus on outcomes of executive functioning, functional capacity, mood, motor function, and adverse events.

RESULTS: A total of 4 studies with 123 of patients with early HD, of whom a total of 63 (51.2%) received an antidepressant, were identified in our search. In our pooled analysis, a modest but statistically significant improvement in mood resulted from antidepressant treatment in HD (OR -1.22; 95% CI -2.16,-0.27; p = 0.02). No significant differences in the other outcomes of interest were found following antidepressant exposure.

CONCLUSIONS: Our investigation suggests that antidepressant use may modestly improve mood, but not ameliorate functional, cognitive, or movement-related symptoms in mild HD. Further studies involving novel agents, larger samples, and longer follow-up times are needed to better characterize the effect of antidepressants on neuropsychiatric symptoms in HD.

PMID:40421472 | DOI:10.1080/17582024.2025.2510145