Nevin Manimala

BMC Psychiatry. 2025 Aug 28;25(1):831. doi: 10.1186/s12888-025-07282-5.

ABSTRACT

BACKGROUND: The first aim of the study was to assess the validity of non-affective psychosis diagnoses, including schizophrenia, for migrants and Swedish-born to determine if the registered diagnoses were of sufficient quality for epidemiological research. If the validity was insufficient, the second aim was to find out what the non-valid cases have in common to see if there was a feasible way to handle these cases in future studies.

STUDY DESIGN: We validated the register-diagnoses of 179 randomly selected patients aged 18-48 living in municipalities with a high proportion of migrants, diagnosed with non-affective psychotic disorder (F20-F29 according to ICD-10), drawn from the Region of Stockholm’s medical records database by comparing them to their case notes to see if they fulfilled the DSM-5 criteria.

RESULTS: We found acceptable validity for non-affective psychotic disorder for migrant men (70.5%), low for Swedish-born men (60.0%), and even lower for women (50.0% for Swedish-born and 40.0% for migrants). There was no statistically significant difference between Swedish-born and migrants. The case notes revealed that by excluding cases with an additional diagnosis equivalent of psychotic disorder due to psychoactive substance (ICD10: F11X.5 and F11X.7) the validity was good for both Swedish-born and migrant men.

CONCLUSIONS: This study supports continued use of the register-diagnoses but only after taking appropriate measures to avoid that patients with additional psychotic disorder due to psychoactive substance are not violating the validity. It also suggests caution when studying non-affective psychosis diagnoses among migrant women as the validity is low, possibly due to difficulties in separating non-affective psychosis from symptoms of other disorders with psychotic features.

PMID:40877884 | DOI:10.1186/s12888-025-07282-5

Genome Med. 2025 Aug 28;17(1):97. doi: 10.1186/s13073-025-01524-7.

ABSTRACT

BACKGROUND: The Women Informed to Screen Depending On Measures of risk (WISDOM) Study is the first prospective, population-wide application of personalized breast cancer screening. We aim to demonstrate the feasibility of the study’s novel use of polygenic risk scores (PRSs) to tailor screening, evaluate our strategy for adapting PRSs to diverse populations, and quantify the impact of incorporating PRS on the study’s screening recommendations.

METHODS: WISDOM is a randomized, preference-tolerant screening trial in the USA testing the safety and morbidity of risk-based versus annual screening in women aged 40-74 without a prior history of breast cancer. This early report includes participants in the risk-based arm only and compares screening recommendations generated by the Breast Cancer Surveillance Consortium (BCSC) clinical risk model alone versus the BCSC model modified by a PRS (BCSC-PRS). The main outcome of interest is the proportion of participants with a change in screening recommendation after integrating PRS for risk stratification.

RESULTS: In the risk-based arm, 21,631 participants received a PRS. Small but statistically significant differences in the PRS were seen between major racial and ethnic groups (p < 0.001), and higher PRS was associated with greater extent of family history (p < 0.001) and denser breasts (p < 0.001). BCSC-PRS risk estimates changed the screening recommendations for 14% of women aged 40-49 compared to BCSC alone and for 10% of women aged 50-74. Projected net screening encounters at the population level were similar for both age groups.

CONCLUSIONS: In a first-in-kind application of PRS to inform breast cancer screening approaches, we demonstrate feasibility for scaled implementation, moderate changes to individual screening recommendations, and minimal projected downstream burden on the healthcare system.

TRIAL REGISTRATION: Prospectively registered on ClinicalTrials.gov as NCT02620852 on 12/2/2015.

PMID:40877879 | DOI:10.1186/s13073-025-01524-7

J Cardiothorac Surg. 2025 Aug 28;20(1):346. doi: 10.1186/s13019-025-03564-x.

ABSTRACT

BACKGROUND AND AIM: Regarding the impact of the coronavirus disease 2019 (COVID-19) and the significance of controlling its spread and also due to the knowledge of the type of demographic characteristics during the Covid outbreak, investigating the cases affected by this condition in the course of its outbreak helps handle multiple critical situations.

METHODS: This retrospective study with a cross-sectional analytical research design was conducted on the statistical population of all admitted patients during the study period with the primary diagnosis of IHD, admitted to Dr. Heshmat Teaching Hospital in Rasht, Gilan Province, Iran, from early February to late April 2020. The samples were selected using the convenience sampling technique through a census, the medical records, and the information completed according to the data collection form. The data analysis was performed using the SPSS Statistics (ver.16.0) software. All the statistical tests were also two-tailed, considering the significance level 0.05.

RESULTS: In the COVID-19 period group, there were more females (45.4% vs. 40.2%, P = 0.019) as well as older patients (62 [IQR 53-71] vs. 61 [IQR 53-70], P = 0.048) compared to the pre-COVID-19 period group. In general, the proportion of patients with current smoking (13.0% vs. 24.4%, P < 0.000), opium consumption (7.2% vs. 14.7%, P < 0.000), and alcohol consumption (0.8% vs. 2.7%, P < 0.001) was lower in the COVID-19 period group compared to the pre-COVID-19 period group.The study findings revealed that the frequency of daily admissions after the COVID-19 peak outbreaks had been significantly higher as compared to those before the pandemic (17.5 [IQR 13.25-22] vs. 12 [IQR 8-19.75], p < 0.001). As well, the in-hospital mortality rates during COVID-19 had been significantly higher than those in 2019, before this condition (4.8% vs. 2.4%, p = 0.004).

CONCLUSION: Given the increasing number of patients admitted during the COVID-19 period, clinical care of patients with IHD, as well as its management and outcomes, becomes more important. It was suggested that these patients be educated about telephone and online services.

PMID:40877865 | DOI:10.1186/s13019-025-03564-x

Popul Health Metr. 2025 Aug 28;23(1):51. doi: 10.1186/s12963-025-00413-w.

ABSTRACT

BACKGROUND: High rates of child morbidity and developmental challenges among children under five remain critical challenges in sub-Saharan Africa. Despite Zambia’s progress in reducing under-five morbidity, the rates remain high, with provincial-level disparities. These disparities are likely to be more pronounced at finer geographic levels, such as districts. However, demographic health surveys, designed for national and provincial estimates, lack sufficient data to produce reliable district-level morbidity statistics.

OBJECTIVE: This study investigates the geospatial distribution of child morbidity prevalence across disaggregated administrative units using small area estimation (SAE) methods.

DATA AND METHODS: Data from the 2018 Zambia Demographic and Health Survey and the 2010 Zambian Census were used to derive direct estimates of child morbidity for small domains cross-classified by district and age group. A hierarchical Bayesian SAE model was developed to account for spatial and unobserved heterogeneity at provincial and district levels, including cross-classifications by age group.

RESULTS: Model-based estimates show lower standard errors compared to the direct estimates and significant differences in morbidity levels within and between districts and provinces. Under-five morbidity prevalence remains high at 25%, with the highest rates in Luapula (approximately 40%) and Western provinces (around 35%) and among children aged 11-23 months (nearly 40%). SAE estimates at the district and district-by-age levels were numerically consistent when aggregated to higher levels, such as province or child age group.

CONCLUSION: These data-driven detailed level estimates provide critical insights into the spatial distribution of child morbidity, supporting targeted interventions and informed policymaking at disaggregated levels.

PMID:40877857 | DOI:10.1186/s12963-025-00413-w

BMC Health Serv Res. 2025 Aug 28;25(1):1144. doi: 10.1186/s12913-025-13335-y.

ABSTRACT

BACKGROUND: Monitoring of healthcare quality is typically focused on differences between group averages in relation to a desirable benchmark. However, we need to consider (i) the existence of interconnected socioeconomic axes of inequality like age, sex, income, and country of birth and (ii) individual heterogeneity around group averages. Additionally, (iii) we need clear criteria to quantify group differences. By applying the framework analysis of individual heterogeneity and discriminatory accuracy (AIHDA) on an established quality indicator (potentially inappropriate medication (PIM)), we illustrate how to achieve these improvements and how to avoid both unnecessary group stigmatization and false expectations.

METHODS: We analyzed 731,339 individuals, ≥ 75-year-old belonging to 36 socioeconomic strata defined by the intersection of age, sex, income, and country of birth, who were alive and residing in the 21 regions Swedish during 2011. We calculated PIM prevalences and evaluate the discriminatory accuracy (DA) of the socioeconomic and geographical group differences using the area under the ROC curve (AUC). The benchmark value was defined as a prevalence of 19%.

RESULTS: In Sweden, the prevalence of PIM was 24% among ≥ 75-year-olds and regionally it ranged between 21% and 27%. Immigrant 80-84-year-old women with low income had the highest prevalence (29%). All strata including women had higher prevalence than those including men. However, the regional (AUC = 0.520) and socioeconomic (AUC = 0.544) differences were very small. For instance, in the five socioeconomic strata with the lowest prevalence there were about 8,000 more cases of PIM than in the five strata with the highest prevalence of PIM.

CONCLUSION: The prevalence of PIM was higher than the desired benchmark value. There were disparities between group averages, but overall, the regional and socioeconomic differences were very small as informed by their low AUC values. Therefore, interventions to reduce PIM in Sweden should be universal rather than only targeted at the regions and socioeconomic strata with the highest PIM prevalence.

PMID:40877856 | DOI:10.1186/s12913-025-13335-y

BMC Med Educ. 2025 Aug 28;25(1):1214. doi: 10.1186/s12909-025-07753-z.

ABSTRACT

BACKGROUND: The integration of gamification in educational settings has emerged as an innovative strategy to enhance student engagement and knowledge retention, particularly in complex fields like dentistry. This descriptive, survey-based study investigates the impact of gamified lectures on the learning experiences of undergraduate dental students in endodontic instrument education.

METHODS: By incorporating interactive elements such as real-time quizzes, live polls, and immediate feedback, the research explores how gamification can transform traditional passive learning environments. The study involved undergraduate dental students and employed a structured survey questionnaire to assess engagement, knowledge retention, and student perceptions.

RESULTS: Quantitative analysis using SPSS revealed significant findings: 56.6% of students rated the lectures as “very engaging” or “extremely engaging”, and 66% reported that gamification significantly contributed to their understanding of the subject matter. Correlation analyses demonstrated positive relationships between engagement, retention, and satisfaction, with correlation coefficients ranging from 0.535 (p = 0.003) to 0.621 (p < 0.01). The results underscore the potential of gamification in dental education, particularly in enhancing student engagement and perceived understanding. However, the findings reflect short-term, self-reported outcomes and do not yet confirm long-term knowledge retention, which warrants further investigation.

CONCLUSION: The results underscore the potential of gamification in dental education, highlighting its effectiveness in motivating active participation and improving learning outcomes. By providing empirical evidence of gamification’s benefits, this study contributes valuable insights for curriculum development and innovative pedagogical approaches in health professions education.

PMID:40877855 | DOI:10.1186/s12909-025-07753-z

BMC Pulm Med. 2025 Aug 28;25(1):410. doi: 10.1186/s12890-025-03819-2.

ABSTRACT

BACKGROUND: Its objective was to use meta-analysis (MA) to methodically assess the impact of perioperative breathing exercises on the postoperative rehabilitation of patients with lung cancer (LC) having radical resection. METHODS: PubMed, and other databases were searched for randomized controlled trials on radical resection of LC combined with perioperative respiratory training from January 1995 to January 2024. After quality assessment, MA was performed using Review Manager 5.3 software.

RESULTS: A total of 14 studies involving 880 patients were included, of which 434 patients received perioperative breathing training (Intervention group, IG). The differences between the two groups in terms of MIP (MD = -13.31, 95% CI: [-24.43, -2.19]; Z = 2.35, P = 0.02), FVC (MD = -0.23, 95% CI = [-0.36, -0.11]; Z = 3.69, P = 0.0002), 6-minute walk test (6MWT) values (MD = 36.42, 95% CI: [4.37, 68.48]; Z = 2.23, P = 0.03), incidence of pneumonia (OR = 0.38, 95% CI = 0.20-0.72; Z = 2.95, P = 0.003), and complication rates (OR = 0.66, 95% CI = 0.46-0.94; Z = 2.29, P = 0.02) were statistically significant. However, there were no significant differences between the two groups in MEP (MD = -6.10, 95% CI: [-12.10, -0.11]; Z = 2.00, P = 0.05), FEV1 (MD = -0.25, 95% CI = [-0.58, 0.08]; Z = 1.47, P = 0.14), FEV1/FVC (MD = -3.78, 95% CI = [-7.65, 0.09]; Z = 1.91, P = 0.06), PEF (MD = -15.02, 95% CI = [-45.88, 15.83]; Z = 0.95, P = 0.34), atelectasis (OR = 0.52, 95% CI = 0.24-1.12; Z = 1.68, P = 0.09), pneumothorax (OR = 1.20, 95% CI = 0.63-2.29; Z = 0.57, P = 0.57), and mechanical ventilation incidence (OR = 0.99, 95% CI = 0.34-2.91; Z = 0.01, P = 0.99).

CONCLUSION: This MA demonstrates that perioperative respiratory training significantly improves MIP, FVC, and 6MWT in patients undergoing radical LC surgery, while effectively reducing the incidence of postoperative pneumonia and overall complications. However, its impact on MEP, certain pulmonary function parameters (FEV1, FEV1/FVC, PEF), and specific complications (atelectasis, pneumothorax, mechanical ventilation requirement) did not reach statistical significance. The findings support the inclusion of respiratory training in perioperative rehabilitation programs for LC patients to optimize postoperative recovery outcomes.

PMID:40877852 | DOI:10.1186/s12890-025-03819-2

Virol J. 2025 Aug 28;22(1):294. doi: 10.1186/s12985-025-02924-2.

ABSTRACT

BACKGROUND: Respiratory viral infections, including Human Metapneumovirus (HMPV), Influenza (Flu), and human Respiratory Syncytial Virus (hRSV), are major global health concerns. While their impact on vulnerable groups is known, their characteristics in healthy adults (18-65 years) are less clear. This study aimed to determine the incidence and clinical-laboratory features of RSV and HMPV in this population and compared them with those of Influenza A(H1N1) and influenza A(H3N2) for improved epidemiological and diagnostic understanding.

METHODOLOGY: A retrospective analysis was conducted on data from an Acute Febrile Illness surveillance (2016-2018) in Manipal, India. The study included 96 HMPV, 68 hRSV, 75 Influenza A(H1N1), and 76 Influenza A(H3N2) positive hospitalized adults with fever (≥ 38 °C) and respiratory illness confirmed by RT‒PCR. Clinical and laboratory data collected within the first 8 days of illness were statistically analyzed.

RESULTS: The annual incidence rates of hRSV (0.33%-1.59%) and HMPV (0.14%-1.79%) varied. Coryza was common, but cough was most frequent in HMPV (97.9%). HMPV also resulted in increased rates of shortness of breath and chest pain. Leucopenia was most common in Influenza A(H1N1) patients, and thrombocytopenia was most common in hRSV patients. Significantly elevated leukocyte and platelet counts were observed in HMPV patients. Liver enzyme abnormalities are relatively common in hRSV and Influenza A(H1N1) patients. Symptom progression and laboratory trends revealed distinct patterns across the viruses.

CONCLUSION: Despite overlapping initial symptoms, HMPV, hRSV, and influenza resulted in different clinical and laboratory profiles in adults. HMPV was associated with more prominent lower respiratory symptoms and a stronger inflammatory response. These distinctions can aid in the clinical differentiation and management of these common respiratory viruses in adults, highlighting the importance of timely diagnosis for improved patient care and public health strategies.

PMID:40877849 | DOI:10.1186/s12985-025-02924-2

BMC Med Educ. 2025 Aug 28;25(1):1218. doi: 10.1186/s12909-025-07593-x.

ABSTRACT

BACKGROUND: Taking notes during lectures plays a vital role in enhancing learning outcomes. With technological advancements, digital note-taking has gained popularity among university students in recent years due to its convenience, ease of storage, sharing, and searching. Different versions of digital note-taking have been introduced, including the use of styluses on tablets, which offer a blend of traditional handwriting and digital advantages. However, the use of digital devices may introduce distractions, such as access to social media, potentially disrupting focus and impacting learning effectiveness. Therefore, their impact on learning and cognition remains a topic of ongoing exploration. This study aimed to investigate the differences in cognitive functions between university students practicing either longhand or styluses digital note-taking methods in the United Arab Emirates.

METHODS: One hundred students participated in this cross-sectional study. Sociodemographic information, including age, sex, nationality, and study year were obtained. Participants reported the note-taking method they use (longhand vs. digital note-taking with styluses). A battery of cognitive tests was used in this study to assess different cognitive functions, including the Montreal Cognitive Assessment (MoCA), the Symbol Digit Modalities Test (SDMT), the Brief Visuospatial Memory Test-Revised (BVMT-R), and the Stroop Color and word test. The Mann-Whitney U tests were used to assess differences in different cognitive domains between participants following longhand and styluses digital note-taking.

RESULTS: Students that used longhand note-taking demonstrated significantly higher overall cognitive scores (MoCA, p = 0.005), along with superior information processing speed, working memory (SDMT, p = 0.045), and better visual memory (BVMT-R, p = 0.01), compared to those who used styluses digital note-taking. However, students using styluses digital note-taking exhibited better inhibitory cognitive control (Stroop test, p = 0.020).

CONCLUSIONS: Although using styluses offers a hybrid experience by combining the tactile benefits of handwriting with the digital advantages of electronic devices, students who employed longhand note-taking demonstrated significantly higher cognitive scores across several domains compared to their peers using stylus-based digital methods. However, while these differences were statistically significant, the effect size was small. Longitudinal cohort studies are needed to further examine the predictive, mediating, and confounding factors related to note-taking methods and cognitive abilities in students.

PMID:40877847 | DOI:10.1186/s12909-025-07593-x

J Eval Clin Pract. 2025 Sep;31(6):e70258. doi: 10.1111/jep.70258.

ABSTRACT

AIM AND OBJECTIVE: The Morning Report (MR) has been considered an essential phase of clinical educational. Yet evidence points to the MR format varying in terms of content, presentation, goals, and organization in different academic departments. Therefore, we hypothesized that a standard-based tool for assessing MR followed by interactive meetings and workshops as empowerment programs results in bridging the gap between standards and the current state.

METHODS: This quasi-experimental study was conducted during three stages in eight departments of academic hospitals of the Qazvin University of Medical Sciences (QUMS) in Iran. In the first stage, a possible gap of running MR were identified during an on-site assessment using a developed tool based on national standards. The tool focused on three areas running MR preparation, scheduling, and implementation. In the second stage, involved clinical educators were empowered to use the correct way of holding MR sessions. Finally, a reassessment was conducted 6 weeks afterward using the same tool, and the extent of changes in complying with the educational standards was measured. The data was analyzed using SPSS.

RESULTS: After the intervention, a significant change was observed in the preparation and implementation dimension of MR in different departments (p < 0.05). However, there was no statistically significant difference in the dimension of scheduling of quality of MR after intervention (p > 0.05).

CONCLUSION: Conducting an initial assessment during actual workplace practices using a standard-based tool following interventions can promote translating new knowledge into real practice, bridge the educational gap, and achieve the desired practice.

PMID:40874806 | DOI:10.1111/jep.70258