Category: Nevin Manimala

J Neurosci Nurs. 2025 Mar 6. doi: 10.1097/JNN.0000000000000826. Online ahead of print.

ABSTRACT

BACKGROUND: Thrombolytic therapy is an effective intervention for acute ischemic stroke. However, the timely administration of this treatment can be hindered by delayed decision-making on the part of family members. Little is known about the reasons for their delay in making decisions. METHODS: This qualitative interview study used face-to-face, individual, semistructured interviews with 16 participants from 2 tertiary hospital neurology wards in Guangdong, China. The interviews were analyzed using inductive content analysis, and descriptive statistics were used to summarize participants’ characteristics. RESULTS: Three main themes emerged: a large family communication network, struggling with bleeding risk, and seeking distance treatment advice. CONCLUSION: In China, family members make decisions on behalf of patients and are affected by various factors in the decision-making process, resulting in delayed decision-making. They may experience psychological conflicts when deciding whether to permit thrombolysis, and they tend to seek information from external sources without understanding thrombolysis. Healthcare professionals caring for stroke patients eligible for thrombolytic therapy should provide decision-making support programs tailored to the specific needs of these family members to reduce delayed decision-making.

PMID:40048642 | DOI:10.1097/JNN.0000000000000826

JMIR Hum Factors. 2025 Mar 6;12:e65785. doi: 10.2196/65785.

ABSTRACT

BACKGROUND: Artificial intelligence (AI) chatbots have been customized to deliver on-demand support for people with mental health problems. However, the effectiveness of AI chatbots in tackling mental health problems among the general public in Hong Kong remains unclear.

OBJECTIVE: This study aimed to develop a local AI chatbot and compare the effectiveness of the AI chatbot with a conventional nurse hotline in reducing the level of anxiety and depression among individuals in Hong Kong.

METHODS: This study was a pilot randomized controlled trial conducted from October 2022 to March 2023, involving 124 participants allocated randomly (1:1 ratio) into the AI chatbot and nurse hotline groups. Among these, 62 participants in the AI chatbot group and 41 in the nurse hotline group completed both the pre- and postquestionnaires, including the GAD-7 (Generalized Anxiety Disorder Scale-7), PHQ-9 (Patient Health Questionnaire-9), and satisfaction questionnaire. Comparisons were conducted using independent and paired sample t tests (2-tailed) and the χ2 test to analyze changes in anxiety and depression levels.

RESULTS: Compared to the mean baseline score of 5.13 (SD 4.623), the mean postdepression score in the chatbot group was 3.68 (SD 4.397), which was significantly lower (P=.008). Similarly, a reduced anxiety score was also observed after the chatbot test (pre vs post: mean 4.74, SD 4.742 vs mean 3.4, SD 3.748; P=.005), respectively. No significant differences were found in the pre-post scores for either depression (P=.38) or anxiety (P=.19). No statistically significant difference was observed in service satisfaction between the two platforms (P=.32).

CONCLUSIONS: The AI chatbot was comparable to the traditional nurse hotline in alleviating participants’ anxiety and depression after responding to inquiries. Moreover, the AI chatbot has shown potential in alleviating short-term anxiety and depression compared to the nurse hotline. While the AI chatbot presents a promising solution for offering accessible strategies to the public, more extensive randomized controlled studies are necessary to further validate its effectiveness.

PMID:40048637 | DOI:10.2196/65785

J Magn Reson Imaging. 2025 Mar 6. doi: 10.1002/jmri.29749. Online ahead of print.

ABSTRACT

BACKGROUND: MR-generated acoustic noise may be particularly concerning at 7-Tesla (T) systems. Noise levels can be reduced by altering gradient output using software optimization. However, such alterations might influence image quality or prolong scan times, and these optimizations have not been well characterized.

PURPOSE: To evaluate image quality, sound pressure levels (SPLs), and perceived noise levels when using the acoustic noise reduction technique SofTone for T₂-weighted fast spin echo (T₂W FSE) and three-dimensional T₁-weighted turbo field echo (3D T₁W TFE), and to compare with conventional imaging during 7-T brain MRI.

STUDY TYPE: Prospective.

SUBJECTS: Twenty-eight volunteers underwent brain MRI, with n = 26 for image quality evaluations.

FIELD STRENGTH/SEQUENCE: Conventional and SofTone versions of T₂W FSE and 3D T₁W TFE at 7 T.

ASSESSMENT: Peak SPLs (A-weighted decibels, dBA), participant-perceived noise levels (Borg CR10-scale), qualitative image assessments by three neuroradiologists (four-graded ordinal scales), interrater reliability, and percentage agreement.

STATISTICAL TEST: Paired t-test, Wilcoxon’s Signed-Rank Test, and Krippendorff’s alpha; p < 0.05 were considered statistically significant.

RESULTS: SofTone significantly reduced peak SPLs: from 116.3 to 97.0 dBA on T₂W FSE, and from 123.7 to 101.5 dBA on 3D T₁W TFE. SofTone was perceived as significantly quieter than conventional scanning. T₂W FSE showed no significant differences in image quality assessments (p = 0.21-1.00), except one radiologist noting significantly less artifact interference with SofTone. General image quality remained acceptable for 3D T₁W TFE, though one radiologist scored it significantly lower with SofTone (mean scores: 3.08 vs. 3.65), and two radiologists observed significantly worse white and gray matter differentiation with SofTone (mean scores: 3.19 vs. 3.54; 2.27 vs. 2.81).

DATA CONCLUSION: SofTone can significantly reduce sound intensity and perceived noise levels while maintaining acceptable image quality with T₂W FSE and 3D T₁W TFE in brain MRI. It appears to be an effective tool for providing a safer, quieter 7-T scan environment.

EVIDENCE LEVEL: 4 Technical Efficacy: Stage 5.

PMID:40048635 | DOI:10.1002/jmri.29749

Transplantation. 2025 Mar 6. doi: 10.1097/TP.0000000000005355. Online ahead of print.

ABSTRACT

BACKGROUND: Deciphering the impact of invasive percutaneous core needle biopsy of the kidney allograft on diagnostic biomarkers may help guide their clinical usage.

METHODS: We prospectively enrolled 39 adult kidney allograft recipients (patients) who underwent 41 clinically indicated, ultrasound-guided, percutaneous core needle biopsies. Pre- and post-biopsy urines were analyzed for urinary cell 3-gene signature score (UroMap), and the bloods for peripheral blood gene expression score (AlloMap Kidney) and plasma donor-derived cell-free DNA percentage (dd-cfDNA). We performed statistical analyses to compare pre- and post-biopsy values.

RESULTS: Median A260/A280 ratios of RNA from pre- and post-biopsy urines were 1.99 and 2.01, respectively; RNA yield, 0.78 versus 0.76 micrograms; and transcript copies of 18S rRNA, TGFβ1, CD3ε, CXCL10, and UroMap score were similar (all P > 0.05, Wilcoxon matched-pairs signed-rank test). The pre- and post-scores were very strongly correlated (Spearman’s correlation coefficient [rs]: 0.83, P < 0.0001). AlloMap Kidney scores in pre- and post-biopsy peripheral blood were similar (P > 0.05) and strongly correlated (rs = 0.70, P < 0.0001). dd-cfDNA in post-biopsy plasma was higher than in pre-biopsy plasma (0.61% versus 0.26%, P = 0.004). The higher post-biopsy percentage was replicated in an independent cohort of 119 post-biopsy plasma collected from 105 patients with no rejection biopsies. To normalize the biopsy-associated increase, a correction factor of -0.36% was derived by subtracting the pre-biopsy dd-cfDNA percent from the post-biopsy percent.

CONCLUSIONS: UroMap and AlloMap Kidney scores are not affected by the biopsy procedure. However, dd-cfDNA increases following the biopsy procedure and could be normalized using the correction factor identified in this study.

PMID:40048628 | DOI:10.1097/TP.0000000000005355

J Nurs Educ. 2025 Mar;64(3):156-161. doi: 10.3928/01484834-20241030-02. Epub 2025 Mar 1.

ABSTRACT

BACKGROUND: This study aimed to analyze the health status of northeastern U.S. baccalaureate nursing students.

METHOD: The sample for this cross-sectional analysis included 292 nursing students. Matriculated full- and part-time nursing students were invited to participate. Most of the sample represented individuals identifying as White, heterosexual women younger than age 25 years who lived off campus. Students across all 4 years of school were at high risk for burnout and experienced high rates of perceived stress but were satisfied with their lives.

RESULTS: Significant differences were found between housing status, physical activity, and burnout (t = -3.7926, df = 154.87, p = 2.13 × 10 – 5). On-campus students (n = 67) were significantly more active (t [65.8] = 1.69, p = .095) and less burned out than off-campus students (n = 189, t [154.8] = -3.79, p < .001).

CONCLUSION: Future research is needed to examine academia’s role in the workforce’s burnout crisis, especially concerning students younger than age 25 years. [J Nurs Educ. 2025;64(3):156-161.].

PMID:40048607 | DOI:10.3928/01484834-20241030-02

J Nurs Educ. 2025 Mar;64(3):170-176. doi: 10.3928/01484834-20241120-04. Epub 2025 Mar 1.

ABSTRACT

BACKGROUND: The drastic evolution in digital technologies has significantly transformed educational and learning processes, necessitating faculty members to incorporate these advancements into their teaching strategies. A research gap exists in investigating the use and acceptance of these technologies in nursing education. Thus, this research aims to assess how education delivered through WhatsApp (Meta) impacts undergraduate nursing students’ performance level and satisfaction.

METHOD: This interventional pretest-posttest study involved a sample of 65 undergraduate nursing students, who were categorized into intervention and control groups. The intervention group received weekly WhatsApp education.

RESULTS: The analysis showed no significant statistical difference in the course final grade between the intervention and control groups. However, there was a significant improvement in the student satisfaction scores following the educational intervention.

CONCLUSION: WhatsApp-delivered education can improve nursing education by fostering positive student perceptions and promoting engagement. This study offers valuable insights for educators and institutions aiming to optimize nursing education. [J Nurs Educ. 2025;64(3):170-176.].

PMID:40048605 | DOI:10.3928/01484834-20241120-04

J Nurs Educ. 2025 Mar;64(3):185-191. doi: 10.3928/01484834-20250108-01. Epub 2025 Mar 1.

ABSTRACT

BACKGROUND: Cultural competence is an integral component of undergraduate nursing education. However, there is a lack of consensus on the best way to develop students’ cultural competence. Although evidence supports short-term study abroad, few studies have used a mixed-methods theory-driven design.

METHOD: This convergent mixed-methods study measured the change in cultural competence among baccalaureate nursing (BSN) degree students enrolled in an immersive study abroad program. Quantitative data from the instrument were analyzed to compare pre- and postexperience cultural competence scores. Reflective journal transcriptions were analyzed using deductive content analysis.

RESULTS: Results showed a statistically significant improvement in postexperience scores compared with preexperience scores. Major themes included embracing diversity, transformative journeys, emotional engagement, cross-cultural experiences, and joyful appreciation.

CONCLUSION: This study emphasizes the effectiveness of theory-designed study abroad in enhancing BSN students’ cultural competence and analyzes the effects on the individual theoretical constructs of cultural competence. [J Nurs Educ. 2025;64(3):185-191.].

PMID:40048603 | DOI:10.3928/01484834-20250108-01

Traffic Inj Prev. 2025 Mar 6:1-11. doi: 10.1080/15389588.2025.2469112. Online ahead of print.

ABSTRACT

OBJECTIVES: Different from research that statistically models discrete conflicts in space and time, this study focuses more on the dynamic process of conflicts and proposes a continuous multi-scale method for analyzing the risk characteristics.

METHODS: Firstly, using conflicts as a reference point, three scales of traffic entities-vehicle pair, vehicle cluster, and vehicle group-are defined based on the interaction range. Corresponding risk expression models are constructed for each scale. Subsequently, considering the temporal process of conflict formation, maintenance, and dissipation, the dynamic sequential structure is established. Next, for risk level at different scales, Spearman correlation analysis and Friedman test are employed to investigate the traffic features and their stage differences. Finally, road segment risk level is differentiated into four temporal patterns, and an unordered multinomial Logistic regression analysis is adopted to explore the occurrence conditions for each pattern.

RESULTS: The findings indicate that: (1) Risk levels do not strictly follow a monotonic increase or decrease, instead showing dynamic variations; (2) Traffic entities at different spatial scales (such as vehicle pairs, vehicle clusters, and vehicle groups) exhibit significant differences in risk-related characteristics during the stages of conflict formation, maintenance, and dissipation; (3) Unimodal low-risk patterns and unimodal high-risk patterns are the dominant risk evolution modes, with mean speed identified as the most critical precursor variable influencing these patterns.

CONCLUSIONS: This study provides an analysis of the conflict development process across multiple spatial scales and temporal stages. It reveals notable differences in risk characteristics and their spatiotemporal evolution among different traffic entities. This multi-dimensional approach offers a perspective for more thoroughly describing and analyzing the evolution of traffic risk and holds implications for improving road traffic safety management.

PMID:40048591 | DOI:10.1080/15389588.2025.2469112

Science. 2025 Mar 7;387(6738):1019. doi: 10.1126/science.adx1128. Epub 2025 Mar 6.

ABSTRACT

Is the air we breathe safe? This seemingly straightforward question is often unanswerable because regulations, monitoring approaches, and reporting structures cannot keep up with the rapid human-induced shifts to the planet and atmosphere. The air is becoming more burdened by pollutants from new sources such as intense fires at the wildland-urban interface, an ever-expanding area where human development meets natural habitats. Air pollution is the second leading cause of human death worldwide, a statistic that excludes numerous indoor and acute outdoor exposures. To protect public health everywhere, air quality standards must be modernized, advanced instrumentation mobilized, and collaborative networks established to move air quality assessment into the 21st century.

PMID:40048510 | DOI:10.1126/science.adx1128

NCHS Data Brief. 2024 Jul;(504). doi: 10.15620/cdc/158783.

ABSTRACT

INTRODUCTION: This report uses data from the 2022 National Health Interview Survey to describe the percentage of adults who walked for leisure and transportation in the past 7 days by selected sociodemographic characteristics.

METHODS: Point estimates and corresponding confidence intervals for this analysis were calculated using SAS-callable SUDAAN software to account for the complex sample design of the National Health Interview Survey. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. Linear and quadratic trends by age group, family income, and education were evaluated using orthogonal polynomials.

KEY FINDINGS: In 2022, 58.7% of adults walked for leisure in the past 7 days, with a higher prevalence among Asian non-Hispanic adults than Black non-Hispanic, other and multiple-race non-Hispanic, and Hispanic adults. Walking for leisure increased with increasing family income and education level. In 2022, 16.2% of adults walked for transportation; men (17.3%) were more likely than women (15.0%) to walk for transportation.

PMID:40048487 | DOI:10.15620/cdc/158783